Prescribed footwear and orthoses are not prophylactic in preventing lower extremity injuries in military tactical athletes: a systematic review with meta-analysis.

INTRODUCTION: Military members are exposed to high cumulative physical loads that frequently lead to injury. Prescribed footwear and orthoses have been used to prevent injury. The purpose of this systematic review with meta-analysis was to assess if prescribed prophylactic footwear or foot orthoses reduced the risk of lower extremity injury in military tactical athletes. METHODS: MEDLINE, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature, SportDiscus, and Defense Technical Information Center databases were searched for randomised controlled trials published at any time that compared foot orthoses or prescribed footwear (to include shock-absorbing insoles and socks) with a placebo intervention or a no-treatment control. Methodological quality was assessed and the number of injuries, population at risk and duration of the study epoch were extracted and relative risk (RR) calculated. An omnibus meta-analysis was performed assessing all prescribed footwear and orthoses intervention studies, with subgroup analyses conducted on studies with similar interventions (ie, basketball athletic shoes, athletic shoes (prescribed by foot type), foot orthoses, shock-absorbing insoles, socks, tropical combat boots). RESULTS: Of 1673 studies identified, 22 were included. Three of eight studies that employed orthoses demonstrated significantly reduced overuse injuries compared with no-treatment controls (RR range: 0.34-0.68); one study showed neoprene insoles significantly decreased overuse injuries (RR: 0.75). There were no other significant effects in the individual studies and no protective effects observed in the omnibus meta-analysis or in the component subanalyses. CONCLUSIONS: Prescribed footwear and orthoses do not appear to have a prophylactic effect on lower quarter musculoskeletal injuries in military members and cannot be recommended at this time.

First case of synophthalmia and albinism in the Pacific angel shark Squatina californica.

The first record in Mexican waters of albinism and synophthalmia (partial cyclopia) in the Pacific angel shark, Squatina californica is presented. Albinism is not lethal, but synophthalmia may cause the death of the individual immediately after birth.

Preparation and evaluation of an experimental luting glass ionomer cement to be used in dentistry.

The aim of this paper is to compare the fluoride-releasing and mechanical properties of an experimental luting glass ionomer cement, which has a modified composition and a commercial luting cement. The experimental powder was obtained by sol-gel process and then, it was used to prepare the experimental cements. The properties of cement pastes, such as setting time and working time, microhardness and diametral tensile strength were determined. Fluoride release from GICs was evaluated at time intervals of 1, 7, 14, 21 and 28 days in deionized water. Atomic force microscopy (AFM) analyses showed that the surface of the experimental cements is more homogeneous than commercial GICs. The mechanical properties and the measure of liberation of fluoride of the two cements were influenced by ratio powder:liquid and chemical composition of the precursor powders. Experimental cements released less fluoride than commercial cements. However, this liberation was more constant during the analyzed period. Thus, the results obtained in this study indicated that the composition of the experimental powder modified by the niobium can lead the formation of the polysalt matrix with good mechanical properties. In other words, we can say that experimental powder offered considerable promise for exploitation in dental field.

[Descriptors of breathlessness in Mexican Spanish]. / El lenguaje de la disnea. Una visión desde el español de México.

OBJECTIVE: Breathlessness is the most common symptom of cardiovascular or pulmonary disease. The term encompasses a wide range of descriptors used by patients, however. Identifying those descriptors can be useful for analyzing symptoms and understanding how they arise. The aim of this study was to characterize the descriptors of breathlessness used in Mexican Spanish and to consider their association with various states of respiratory distress and cardiovascular or pulmonary disease. MATERIAL AND METHODS: A questionnaire was based on 21 descriptors of breathlessness, some of which had no equivalents in English. The subjects included 15 healthy individuals during a cardiopulmonary stress test, 13 healthy subjects after a carbon dioxide rebreathing procedure, and 10 healthy women during pregnancy. We also included 16 patients with confirmed heart disease in stable condition, 15 patients during exacerbation of asthma, 20 with stable chronic obstructive pulmonary disease, and 15 with diffuse interstitial lung disease also in stable condition. Descriptors of breathlessness were then grouped based on the results of cluster analysis. RESULTS: Seven clusters of phrasal descriptors were identified as possibly representative of types of dyspnea. These clusters of descriptors were categorized as follows: agitation, suffocation, smothering, inhalation, exhalation, panting, and rapidity. Associations between types of dyspnea and the groups of participants were identified based on how frequently they used the terms. CONCLUSIONS: At least 7 clusters or groups of descriptors of breathlessness were identified as equivalent to 7 types of dyspnea; some items have no equivalent in English. Healthy subjects with respiratory distress or certain groups of patients with cardiovascular or pulmonary disease are associated with certain types of dyspnea.

[Determination of colonic transit time in healthy subjects in Mexico City. Prospective study]. / Determinación del tiempo de tránsito colónico en personas sanas de la Ciudad de México. Estudio prospectivo.

UNLABELLED: Colonic transit time (CTT) is determined by multiple factors; currently, normal values for the Mexican population are not available. In order to get an estimate one must look at the values reported in the international literature, but cultural, ethnical, nutritional and economic differences may lead to different values. OBJECTIVE: To determine the normal values of colonic transit time in healthy people in Mexico City by the use of radiopaque markers. PATIENTS AND METHODS: Prospective, longitudinal and observational study, which included healthy patients ranging from 18 to 60 years old; excluding pregnant women. The whole group of patients was given before breakfast a gelatin capsule which had 20 radiopaque markers inside -the markers were each 2mm long, and were made by the researcher-. After that, they were taken a simple abdominal X-ray film every 24 hours until they totally eliminated the markers. Their eating and defecation habits were evaluated and also the total amount of liquid they consumed. Inferential statistics were used; data was validated with both parametric and non-parametric tests, considering a significance of p < 0.05. RESULTS: A hundred patients were included in the sample in which 48% were female and 52% male, they were divided in three groups: group A (31%)from 18 to 25 years, group B (37%)from 26 to 40 and group C (32%)from 41 to 60 years; there were no important differences in their water consumption, which was in average of 1.87 lts. in 24 hours; also, there were no considerable differences regarding to their meat, vegetables and fruits' consumption, which was in average of 4.4 times a week; the whole group eliminated the markers according to X-rays which was in 54% after 72 hrs, 45% after 48 hrs and 1% after 24 hrs. We can observe an increase of the CTT related to age: in group C 94% eliminated the markers after 72 hrs and there was no significant difference (statistically) with regards to the other groups. A tendency of an increase of CTT with regards to age was observed: in group A, 80% eliminated the markers after 48 hrs, in group B 49% eliminated them after 48 hrs and 51% after 72 hrs and, in group C, 94% eliminated them after 72 hrs without any statistically significant differences among the study groups. CONCLUSION: The CTT in healthy patients is in a 100% of the cases studied lower or equal to 72 hrs with a tendency to increase in relation to age.

Comparison of the tensile bond strengths of cast metal crowns luted with resin cements.

The limitation of photoactivation of dual-polymerized resin cements along the margins of metal restorations may adversely affect the mechanical properties of these cements, thus impairing the retention of restorations. The aim of this study was to assess the bond strength of cast metal crowns cemented with three dual-polymerized resin cements, using a chemically-activated resin cement and zinc phosphate as controls. Fifty nickel-chromium alloy crowns were cast and randomly assigned to five groups of equal size. Castings were cemented on their corresponding metal dies with one of the tested luting agents: Scotchbond Resin Cement, Enforce and Panavia F (dual-polymerized resin cements), Cement-It (chemically-activated resin cement) and Zinc Phosphate Cement (zinc phosphate cement). Specimens were stored in distilled water at 37 degrees C for 24 h and then loaded in tension until failure. Panavia F and Zinc Phosphate Cement provided the highest and lowest bond strength means, respectively. Scotchbond Resin Cement, Enforce and Cement-It cements exhibited similar intermediate values, but with statistically significant difference compared to the other materials (P < 0.05). Even with the restriction or absence of light activation, all tested dual-polymerized resin cements produced significantly higher bond strength than did the zinc phosphate cement and yielded similar or better results than the chemically activated cement. It should be pointed out that the findings of this study relate to a test scenario which does not mimic clinical circumstances and that further work is required to identify the clinical significance of the reported tensile bond strength differences between the different luting materials.

Hardness and compressive strength of indirect composite resins: effects of immersion in distilled water.

The aim of this study was to evaluate the effect of ageing in distilled water on the hardness and compressive strength of a direct composite resin Z100, a feldspatic porcelain (Noritake) and three indirect composites (Artglass, Solidex and Targis). For the Vickers hardness tests, five disk-shaped specimens (2 x 4 mm) of each material were prepared according to the manufacturers' instructions. The hardness tests were conducted using a Vickers diamond indentor. Compressive strength measurements were recorded on cylindrical specimens with a diameter of 6 mm and a length of 12 mm. The compression tests were carried out with a constant cross-head speed of 0.5 mm min(-1) on a mechanical test machine. For each material, 10 specimens were tested after 7 days of dry storage at 37 +/- 1 degrees C and 10 specimens were tested after water storage at 37 +/- 1 degrees C for 180 days. Noritake porcelain specimens showed higher hardness values than the composites. Among the composite materials, Z100 promoted the highest VHN values, regardless of the ageing periods. The results showed that Solidex and Z100 had the highest compressive strength values. Ageing in water reduced the hardness for all composites, but had no long-term effect on the compressive strength.

Effect of disinfectant agents on dimensional stability of elastomeric impression materials.

STATEMENT OF PROBLEM: Difficulties in sterilizing impressions by traditional methods have led to chemical disinfection as an alternative, and some studies have shown that disinfectants may adversely affect impressions. PURPOSE: This study investigated the effect of disinfection methods on the dimensional stability of 6 elastomeric materials. MATERIAL AND METHODS: Impression materials were submitted to the following treatments: immersion in 5.25% sodium hypochlorite solution for 10 minutes, immersion in 2% glutaraldehyde solution for 30 minutes, and no immersion (control). After treatments, impressions were poured, and respective stone casts were measured with a Nikon Profile projector and compared with the master model. RESULTS: The elastomeric materials had different reproduction capacities, and the disinfecting treatments did not differ from the control.

Metabolic alterations of skeletal muscle during ischaemia and reperfusion.

Recent studies have demonstrated that skeletal muscle cells are resistant to prolonged periods of ischaemia, but damage is observed after reperfusion. Periods of time longer than three hours of normothermal ischaemia in skeletal muscle lead to irreversible lesions. In the present study muscle metabolism during ischaemia and reperfusion was studied. After three hours of ischaemia two experimental groups were produced depending on whether or not they were to be followed by two hours of reperfusion. Adult mongrel dogs were submitted to ischaemia of the gracilis muscle. In this tissue, energetic metabolism was evaluated by its mitochondrial function and by glycogen level measurement. In a second experimental group the same ischaemic period was followed by two hours of reperfusion. The contralateral muscle of the same animal was used as a control. No changes in mitochondrial function, analysed by respiratory control ratio (RCR) or in any of its components, basal (state IV respiration) or ADP-activated (state III respiration) was observed. Glycogen levels also remained unaffected during the three hour ischaemic period and after two hours of reperfusion. We conclude that in the present dog model of gracilis preparation the skeletal muscle displays great resistance to ischaemia and reperfusion.

Equivalent outcomes during postoperative patient-controlled intravenous analgesia with lidocaine plus morphine versus morphine alone.

To evaluate a possible opioid-sparing effect of intravenous lidocaine we conducted a randomized, double-blind clinical trial. Patients undergoing intraabdominal surgery under general anesthesia were treated with patient-controlled analgesia (PCA) in three groups: Group 1 (n = 100; morphine 1 mg/mL), Group 2 (n = 44; morphine 1 mg/mL plus lidocaine 10 mg/mL), and Group 3 (n = 51; morphine 1 mg/mL plus lidocaine 20 mg/mL). Pain was evaluated using a 0-10 visual analog scale in the postanesthesia care unit (PACU) during deep inhalation at 15 and 30 min, and at 1, 2, and 4 h after arrival in the PACU, and continued after PACU discharge every 4 h for 36 h. Patients whose pain was more than 4/10 in the PACU received 2.5 mliters of the respective solutions every 7 min until pain was less than 4/10; then PCA was started. The number of bolus and cumulative drug doses during the study were recorded. Along with pain intensity, we assessed vital signs and side effects. Time to acceptance of oral liquids was also determined. Adding lidocaine 10 or 20 mg/mL to PCA morphine 1 mg/mL for acute pain treatment after abdominal surgery yielded no differences in opioid use, pain levels, or side effects.

[Electromyographic response to precurarization with vecuronium bromide]. / Respuesta electromiográfica de la precurarización con bromuro de vecuronio.

OBJECTIVE: To analyze electromyographic response and clinical effects after precurarization with vecuronium bromide (0.01 mg/Kg), also noting intubation conditions and the presence or not of fasciculations after administration of succinylcholine (1.5 mg/Kg). PATIENTS AND METHODS: A single precurarization dose of vecuronium was administered to 20 patients 5 minutes before anesthetic induction for general surgery. During this period we monitored neuromuscular transmission of the cubital nerve in the wrist by electromyography with a series of 4 stimuli, expressing each as the percentage of the first response and of the ratio T4/T1. We also recorded clinical repercussions. General anesthesia was then induced; after administration of succinylcholine, the presence or not of fasciculations was noted and intubation conditions were evaluated. RESULTS: The electromyographic response after precurarization was highly variable, as 4 different responses were recorded. We found potentiation phenomena in 20% of our patients, diminished response in 60%, fatigue phenomena in 15% and no change in 5%. Clinical signs noted were blurred vision and heavy eyelids. Fasciculations disappeared in 95% of the patients and intubation conditions were excellent. CONCLUSIONS: Vecuronium at a precurarization dose produces highly varied but well-tolerated electromyographic responses. The drug is effective in eliminating fasciculations produced by succinylcholine and does not affect intubation conditions.

[Influence of static flow (CREEP) on amalgam hardness. Effect of alloys and measured areas]. / Influência do escoamento estático (CREEP) na dureza do amálgama. Efeito de ligas e regióes de medida.

The authors studied the CREEP of 5 amalgam alloys (1 conventional and 4 with high cooper) by the application os static load of 36 MPa in 478 mm specimens, 7 days old. After CREEP test, the samples were included in acrylic resin and Vickers hardness determined by three penetrations for each portion (cervical, medium and occlusal). Samples not submitted to the creep test was used with control. They concluded that no statistic difference was found in creep test but in Vickers test all the studied materials showed different hardness averages. The load application to samples increased the hardness of all the studied materials.

[Influence of different bonding agents on traction resistance of metal alloys to dentin]. / Influência de diferentes agentes de fixação na resistência de união, por tração, de ligas metálicas fixadas à dentina.

They were casted pieces using three kinds of alloy (Ni-Cr, Ag-Sn and Cu-Al) with circular and smooth surface. They were cemented to human teeth, on occlusal surface, grounded at dentin level, through three different materials kind (zinc polycarboxylate cement, glassionomer cement and composite). After 24 hours storing, the samples were subjected to the tensile test. The results showed that the samples cemented with composite and the casts made with Ag-Sn alloy had higher bond strength.

[Penetration of calcium hydroxide based cements by dental enamel conditioning acids]. / Estudo da penetração de agentes ácidos para o condicionamento do esmalte dental em cimentos à base de hidróxido de cálcio.

It was verified the penetration of phosphoric acid into 3 commercial calcium hydroxide-based cements (Life, Renew and Prisma VLC Dycal). The colorimetric method employed permitted the identidication of phosphorus amount in representative samples of 6 successive layers 0.1 mm thick of each material. The acid etching used were the commercial products Scotchbond Etching Gel--3M at 36.114% by weight and Solução Condicionadora--Johnson & Johnson at 36.054% by weight. The contact time was 60 seconds. The result showed that layers 0.1 mm tick for Life and Prisma VLC Dycal and 0.2 mm thick for Renew were able to block the penetration of phosphoric acid solution whereas layers 0.1 mm thick for the 3 cements were able to block the penetration of phosphoric acid gel.

Endoperoxidation, hyperprostaglandinemia, and hyperlipidemia in a case of erythrophagocytic lymphohistiocytosis. Reversal with VP-16 and indomethacin.

Clinicopathologic and histopathologic evidence of both endoperoxidation with hyperprostaglandinemia and hyperlipidemia in a 5-week-old infant with a hemophagocytic syndrome is reported. Institution of histiocytolytic (VP-16) and cyclo-oxygenase inhibitor (indomethacin) therapies returned the prostaglandin levels and lipid profile to a nearly normal state coincidental with clinical recovery. It appears that by reducing the cell mass of histiocytes and controlling the over-production of prostaglandins, some types of hemophagocytic syndrome can be reversed.