Protocolos de indicação de soluções anestésicas para uso na clínica endodôntica / Anesthetic solution indication protocols for use in the endodontic clinic

A indicação das soluções anestésicas nos tratamentos endodônticos de rotina deve estar fundamentada nos conhecimentos dos possíveis efeitos que essas substâncias podem desencadear no paciente sistemicamente comprometido. Objetivo: O objetivo do presente estudo foi priorizar a indicação e discutir os possíveis efeitos secundários ou adversos passíveis de ocorrência com as substâncias que compõem as soluções anestésicas durante a rotina de tratamento dos canais radiculares (AU).

The indication of anesthetic solutions in routine endodontic treatments must be based on knowledge of the possible effects that these substances can trigger in systemically compromised patients. Aim: The aim of the present study was to prioritize the indication and discuss the possible secondary or adverse effects likely to occur with the use of substances of which anesthetic solutions are composed, during the routine treatment of root canals (AU).

Efeitos laxativos do polietilenoglicol 3350 e de soluções eletrolíticas em equinos / Laxative effects of polyethylene glycol 3350 and electrolyte solutions in equines

Compararam-se a motilidade intestinal, a frequência de defecação, a umidade e o aspecto das fezes, o tempo médio de retenção (TMR) e a taxa de passagem (TxP) da ingesta no intestino grosso (ig), em cinco éguas hígidas tratadas com: polietilenoglicol 3350, na dose única de 1,5g kg-1, em bolus, por via enteral (PEG); ou por polietilenoglicol 3350, na dose única de 1,5g kg-1, em bolus, por via enteral, associado ao Ringer lactato, 15mL kg-1 h-1 por fluxo contínuo de 12h, via intravenosa (PEG+RL); ou por solução isotônica poliônica enteral, 15mL kg-1 h-1 em fluxo contínuo de 12h (SIPE); ou por solução isotônica poliônica enteral, 7,5mL kg-1 h-1 por fluxo contínuo de 12h, via enteral, associada ao Ringer lactato, 7,5mL kg-1 h-1 por fluxo contínuo de 12h, via intravenosa (SIPE+RL); ou por cloreto de sódio 0,9%, 15mL kg-1 h-1 por fluxo contínuo de 12h, via intravenosa (NaCl 0,9%). O PEG apenas amoleceu discretamente as fezes. O PEG+RL, o SIPE+RL e o NaCl 0,9% foram mais eficazes em amolecer as fezes e aumentar a frequência de defecação do que o PEG. O SIPE foi o único tratamento que aumentou a motilidade intestinal, e foi o melhor em aumentar a frequência de defecações, amolecer as fezes e diminuir o TMRig, aumentando a TxPig. Conclui-se que os cinco tratamentos demonstraram efeito laxativo, sendo o SIPE o mais eficaz.

The intestinal motility, frequency of defecation, moisture and appearance of feces, mean retention time (MRT) and passage rate (RP) of ingesta in the large intestine (li) were compared in five healthy mares treated with: polyethylene glycol 3350 in a single dose of 1.5g kg-1, in bolus, administered enterally (PEG); or for polyethylene glycol 3350 in a single dose of 1.5g kg-1, in bolus, enterally, associated to the Ringer lactate, 15ml kg-1 h-1 by continuous flow of 12 hours, intravenously (PEG+RL); or for enteral isotonic polionic solution, 15ml kg-1 h-1 by continuous flow of 12 hours, enterally (SIPE); or for enteral isotonic polionic solution, 7,5ml kg-1 h-1 by continuous flow of 12 hours, enterally, associated to the Ringer lactate, 7.5mL kg-1 h-1 by continuous flow of 12 hours, intravenously (SIPE+RL); or sodium chloride 0.9 %, 15ml kg-1 h-1 by continuous flow of 12 hours, intravenously (NaCl 0.9%). PEG treatment only slightly softened feces. PEG+RL, SIPE+RL and NaCl 0.9% were more effective in softening the feces and increasing the frequency of defecation than PEG. SIPE was the best to increase the frequency of defecation, to soften the feces, and reduce the TMRli, increasing RPli. It is concluded that the five treatments demonstrated a laxative effect, but SIPE was the most effective.

Efeitos laxativos do polietilenoglicol 3350 e de soluções eletrolíticas em equinos / Laxative effects of polyethylene glycol 3350 and electrolyte solutions in equines

Compararam-se a motilidade intestinal, a frequência de defecação, a umidade e o aspecto das fezes, o tempo médio de retenção (TMR) e a taxa de passagem (TxP) da ingesta no intestino grosso (ig), em cinco éguas hígidas tratadas com: polietilenoglicol 3350, na dose única de 1,5g kg-1, em bolus, por via enteral (PEG); ou por polietilenoglicol 3350, na dose única de 1,5g kg-1, em bolus, por via enteral, associado ao Ringer lactato, 15mL kg-1 h-1 por fluxo contínuo de 12h, via intravenosa (PEG+RL); ou por solução isotônica poliônica enteral, 15mL kg-1 h-1 em fluxo contínuo de 12h (SIPE); ou por solução isotônica poliônica enteral, 7,5mL kg-1 h-1 por fluxo contínuo de 12h, via enteral, associada ao Ringer lactato, 7,5mL kg-1 h-1 por fluxo contínuo de 12h, via intravenosa (SIPE+RL); ou por cloreto de sódio 0,9%, 15mL kg-1 h-1 por fluxo contínuo de 12h, via intravenosa (NaCl 0,9%). O PEG apenas amoleceu discretamente as fezes. O PEG+RL, o SIPE+RL e o NaCl 0,9% foram mais eficazes em amolecer as fezes e aumentar a frequência de defecação do que o PEG. O SIPE foi o único tratamento que aumentou a motilidade intestinal, e foi o melhor em aumentar a frequência de defecações, amolecer as fezes e diminuir o TMRig, aumentando a TxPig. Conclui-se que os cinco tratamentos demonstraram efeito laxativo, sendo o SIPE o mais eficaz.(AU)

The intestinal motility, frequency of defecation, moisture and appearance of feces, mean retention time (MRT) and passage rate (RP) of ingesta in the large intestine (li) were compared in five healthy mares treated with: polyethylene glycol 3350 in a single dose of 1.5g kg-1, in bolus, administered enterally (PEG); or for polyethylene glycol 3350 in a single dose of 1.5g kg-1, in bolus, enterally, associated to the Ringer lactate, 15ml kg-1 h-1 by continuous flow of 12 hours, intravenously (PEG+RL); or for enteral isotonic polionic solution, 15ml kg-1 h-1 by continuous flow of 12 hours, enterally (SIPE); or for enteral isotonic polionic solution, 7,5ml kg-1 h-1 by continuous flow of 12 hours, enterally, associated to the Ringer lactate, 7.5mL kg-1 h-1 by continuous flow of 12 hours, intravenously (SIPE+RL); or sodium chloride 0.9 %, 15ml kg-1 h-1 by continuous flow of 12 hours, intravenously (NaCl 0.9%). PEG treatment only slightly softened feces. PEG+RL, SIPE+RL and NaCl 0.9% were more effective in softening the feces and increasing the frequency of defecation than PEG. SIPE was the best to increase the frequency of defecation, to soften the feces, and reduce the TMRli, increasing RPli. It is concluded that the five treatments demonstrated a laxative effect, but SIPE was the most effective.(AU)

[Soft-tissue infections due to non-tuberculous mycobacteria following mesotherapy. What is the price of beauty]. / Infecciones en tejidos blandos por micobacterias no tuberculosas secundarias a mesoterapia. 'Cuánto vale la belleza?

INTRODUCTION: Mesotherapy is widely used In Latin America for cosmetic purposes, particularly in obese individuals. We describe the clinical and epidemiological characteristics, microbiological diagnosis, treatment and follow-up of patients from Caracas (Venezuela) with soft tissue infection caused by non-tuberculous mycobacteria following mesotherapy. METHODS: Between March 2002 and December 2003, we evaluated 49 cases of skin and soft tissue infection following mesotherapy. Specimens obtained from the lesions and 15 products used in the mesotherapy procedure were cultured for the presence of non-tuberculous mycobacteria. Isolated mycobacteria were identified by PCR restriction fragment length polymorphism analysis of the hsp65 gene. RESULTS: Infection by non-tuberculous mycobacteria was confirmed in 81.6% of the 49 cases. Mycobacterium abscessus and M. fortuitum were the most common species, but M. chelonae, M. peregrinum, M. simiae and a new species that was designated "M. cosmeticum" were also isolated. Patients were treated with species-specific antibiotic agents for 3 to 18 months. Investigation into the source of the infection revealed that 21 patients were clustered within 3 different outbreaks and two products were found to be contaminated with M. fortuitum and M. abscessus, respectively. CONCLUSIONS: Physicians should be alerted to the possibility of infection by non-tuberculous mycobacteria in patients with a history of mesotherapy who develop late-onset skin and soft tissue infection, particularly if they do not respond to conventional antibiotic treatment.

Arsenic release from glass containers by action of intravenous nutrition formulation constituents.

Pharmacopoeias prescribe tests to determine the levels of arsenic in raw materials and glass containers. In this study, glass ampoules for injectables containing individually the main components of intravenous nutrition formulations were submitted to the hydrolytic resistance test by heating at 121 degrees C for 30 min. As(V) and As(III) levels in these solutions after heating were determined by hydride generation atomic absorption spectrometry. The arsenic content of substances used in these formulations was previously determined, as well as the arsenic content of the glass containers. The results showed that raw substances as well as glass containers contain arsenic. Moreover, arsenic is released during the heating (hydrolytic resistance test). However, the amount released and the arsenic species present in solution depend on the solution composition. While As(V) was the predominant specie in glass, solutions containing reducing substances such as glucose and vitamins had As(III) in higher concentration. Therefore, arsenic is released from glass containers during the heating for sterilization, and reacts with formulation constituents depending on their reducing properties.

Análise da superfície de materiais restauradores estéticos após utilizaçäo de soluçöes fluoretadas / Analysis of the aesthetic surface restauration materials after using fluoride mouthrinses

O propósito deste trabalho foi verificar, in vitro se há efeito danoso provocado pela utilizaçäo prolongada das soluçöes fluoretadas para bochecho disponíveis no mercado sobre a superfície de materiais restauradores estéticos utilizados comumente na clínica de Odontopediatria, através do microscópio eletrônico de varredura (MEV). Foram utilizadas soluçöes fluoretadas com pH neutro, pH ácido e associados à clorexidina. Quinze cavidades preparadas em blocos de acrílico foram obturadas com compósito (TPH©) e outras quinze foram preenchidas com cimento de ionômero de vidro (Vitremer©). Foram constituídos oito grupos: 1) TPH©, com três amostras para controle; 2) TPH©, com quatro amostras tratadas com soluçäo com pH neutro; 3) TPH©, com quatro amostras tratadas com soluçäo com pH ácido; 4) TPH©, com quatro amostras tratadas com soluçäo fluoretada associada à clorexidina; 5) Vitremer©, com três amostras para controle; 6) Vitremer©, com quatro amostras tratadas com soluçäo com pH neutro; 7) Vitremer©, com quatro amostras tratadas com soluçäo de pH ácido; 8) Vitremer©, com quatro amostras tratadas com soluçäo fluoretada associada à clorexidina. Após o polimento metalográfico, as amostras ficaram imersas nas soluçöes fluoretadas durante o período de 30 a 60 minutos. Foi possível constatar, em todos os casos, que houve alteraçäo superficial dos materiais testados em maior e menor grau, com dois tempos de tratamento. As soluçöes aciduladas e associadas à clorexidina provocaram maior efeito deletério, portanto, as soluçöes com pH neutro säo menos danosas

[Control of pediatric nosocomial bacteremia by a program based on culturing of parenteral solutions in use]. / Control de bacteriemia nosocomial pediátrica mediante un programa de cultivo de soluciones parenterales en uso.

OBJECTIVE: As Klebsiella, Enterobacter and Serratia are capable of growth in i.v. fluids and these bacteria are commonly implicated in nosocomial bacteremia, a control strategy through microbiological surveillance of in-use parenteral solutions is proposed. MATERIAL AND METHODS: A second level general teaching hospital, serving low-income patients. Through four consecutive strategies, a continuous surveillance program of i.v. fluids sterility in pediatric wards was stablished in 1992. During the first stage all of the in-use solutions were cultured. During the second stage randomly selected samples were studied. Third stage was designed as a case-control study. The last stage included samples drawn in convenience. Positive cultures point out eventual infusion mishandling, as well as high-risk areas and patients. RESULTS: After culturing 1940 parenteral solutions, infusion contamination rates decreased from 29.6% in 1992 to 12.9% in 1997 (p < 0.001). The proportion of Gram-negative rods isolated from blood cultures went from 72.7% to 40.85% (p < 0.0001), and the nosocomial bacteremia rate dropped from 3.12 to 1.54 per 100 discharges. CONCLUSIONS: The program has enabled us to: 1) Detect and control eventual bacteremia outbreaks; 2) Assess the endemic infusion contamination rate; 3) Arouse healthcare workers awareness about infusion line precautions; 4) Have a suitable surveillance strategy according to our laboratory's workload.