RESUMO
OBJECTIVE: Color Adjustment Potential evaluates the color blending of dental Composite Resins. While Color Adjustment Potential is simple, its clinical relevance is unclear. This research aims to understand it better and to create an index for Composite Resins with meaningful clinical interpretation. MATERIALS AND METHODS: Single and double shade composite disks of various diameters and opacities were created to test the indices. Color measurements used a dental colorimeter, avoiding subjective assessments. Color Adjustment Potential analysis of each material revealed insights, leading to the creation of a new Color Blending Threshold, providing a clinically relevant numerical value for Composite Resins. RESULTS: Color Adjustment Potential's numerical significance was clarified and introduced a new index for clinical applications. Color adaptation of each test shade to all Vita shades was also calculated, useful for single-shade restorations in open and closed cavity types. CONCLUSIONS: The proposed Color Blending Threshold defines the open/closed cavity dimension that can be adequately restored with a single shade of resin composite. CLINICAL SIGNIFICANCE: Understanding how dental materials adapt to surrounding tooth colors enhances esthetic restorations, simplifies shade matching, and optimizes resin composite production. The proposed Color Blending Threshold is a parameter that directly relates to the clinical significance of a material's true color blending ability. It defines the cavity dimension that can be adequately restored with a single shade of resin composite while ensuring that the resulting color difference falls below a predetermined threshold, meeting the clinical requirements for an esthetic restoration.
Assuntos
Cor , Resinas Compostas , Resinas Compostas/química , Teste de Materiais , HumanosRESUMO
Desde la publicación de las guías de dispepsia 2007 de la Asociación Mexicana de Gastroenterología ha habido avances significativos en el conocimiento de esta enfermedad. Se realizó una revisión sistemática de la literatura en PubMed (01/2007 a 06/2016) con el fin de revisar y actualizar las guías 2007 y proporcionar nuevas recomendaciones basadas en evidencia. Se incluyeron todas las publicaciones en español e inglés, de alta calidad. Se redactaron enunciados que fueron votados utilizando el método Delphi. Se estableció la calidad de la evidencia y la fuerza de las recomendaciones según el sistema GRADE para cada enunciado. Treinta y un enunciados fueron redactados, votados y calificados. Se informan nuevos datos sobre definición, clasificación, epidemiología y fisiopatología. La endoscopia debe realizarse en dispepsia no investigada cuando hay datos de alarma o falla al tratamiento. Las biopsias gástricas y duodenales permiten confirmar infección por Helicobacter pylori y excluir enfermedad celiaca, respectivamente. Establecer una fuerte relación médico-paciente, cambios en la dieta y en el estilo de vida son útiles como medidas iniciales. Los bloqueadores H2, inhibidores de la bomba de protones, procinéticos y fármacos antidepresivos son efectivos. La erradicación de H. pylori puede ser eficaz en algunos pacientes. Con excepción de Iberogast y rikkunshito, las terapias complementarias y alternativas carecen de beneficio. No existe evidencia con respecto a la utilidad de prebióticos, probióticos o terapias psicológicas. Los nuevos enunciados proporcionan directrices basadas en la evidencia actualizada. Se presenta la discusión, el grado y la fuerza de la recomendación de cada uno de ellos.
Abstract Since the publication of the 2007 dyspepsia guidelines of the Asociación Mexicana de Gastroenterología, there have been significant advances in the knowledge of this disease. A systematic search of the literature in PubMed (01/2007 to 06/2016) was carried out to review and update the 2007 guidelines and to provide new evidence-based recommendations. All high-quality articles in Spanish and English were included. Statements were formulated and voted upon using the Delphi method. The level of evidence and strength of recommendation of each statement were established according to the GRADE system. Thirty-one statements were formulated, voted upon, and graded. New definition, classification, epidemiology, and pathophysiology data were provided and include the following information: Endoscopy should be carried out in cases of uninvestigated dyspepsia when there are alarm symptoms or no response to treatment. Gastric and duodenal biopsies can confirm Helicobacter pylori infection and rule out celiac disease, respectively. Establishing a strong doctor-patient relationship, as well as dietary and lifestyle changes, are useful initial measures. H2-blockers, proton-pump inhibitors, prokinetics, and antidepressants are effective pharmacologic therapies. H. pylori eradication may be effective in a subgroup of patients. There is no evidence that complementary and alternative therapies are beneficial, with the exception of Iberogast and rikkunshito, nor is there evidence on the usefulness of prebiotics, probiotics, or psychologic therapies. The new consensus statements on dyspepsia provide guidelines based on up-to-date evidence. A discussion, level of evidence, and strength of recommendation are presented for each statement. © 2017 Asociacion Mexicana de Gastroenterologiia.
Assuntos
Humanos , Adulto , Dispepsia/diagnóstico , Dispepsia/terapia , Endoscopia Gastrointestinal , Helicobacter pylori/efeitos dos fármacos , Infecções por Helicobacter , Infecções por Helicobacter/diagnóstico , Infecções por Helicobacter/terapia , Dispepsia , Dispepsia/tratamento farmacológico , Dispepsia/epidemiologiaRESUMO
Since the publication of the 2007 dyspepsia guidelines of the Asociación Mexicana de Gastroenterología, there have been significant advances in the knowledge of this disease. A systematic search of the literature in PubMed (01/2007 to 06/2016) was carried out to review and update the 2007 guidelines and to provide new evidence-based recommendations. All high-quality articles in Spanish and English were included. Statements were formulated and voted upon using the Delphi method. The level of evidence and strength of recommendation of each statement were established according to the GRADE system. Thirty-one statements were formulated, voted upon, and graded. New definition, classification, epidemiology, and pathophysiology data were provided and include the following information: Endoscopy should be carried out in cases of uninvestigated dyspepsia when there are alarm symptoms or no response to treatment. Gastric and duodenal biopsies can confirm Helicobacter pylori infection and rule out celiac disease, respectively. Establishing a strong doctor-patient relationship, as well as dietary and lifestyle changes, are useful initial measures. H2-blockers, proton-pump inhibitors, prokinetics, and antidepressants are effective pharmacologic therapies. H.pylori eradication may be effective in a subgroup of patients. There is no evidence that complementary and alternative therapies are beneficial, with the exception of Iberogast and rikkunshito, nor is there evidence on the usefulness of prebiotics, probiotics, or psychologic therapies. The new consensus statements on dyspepsia provide guidelines based on up-to-date evidence. A discussion, level of evidence, and strength of recommendation are presented for each statement.
Assuntos
Dispepsia/diagnóstico , Dispepsia/terapia , Dispepsia/epidemiologia , Dispepsia/etiologia , Endoscopia Gastrointestinal , Infecções por Helicobacter/complicações , Infecções por Helicobacter/diagnóstico , Infecções por Helicobacter/terapia , Helicobacter pylori , Humanos , México/epidemiologiaRESUMO
The biggest challenge while restoring anterior teeth is shade matching. Hue, chroma, value, opacity, translucency, intensity and anatomy must be seen to be reproduced. To see we need light, knowing that there is a strong relation between the nature of light and the components of natural teeth. This article enlightens the way to do the shade matching and the stratification of anterior teeth by choosing the relevant materials to mimic the nature. The physical properties of natural and polarized light will be studied to understand their correlation with dental materials and natural teeth to use them in the best combination.
Assuntos
Resinas Compostas/química , Materiais Dentários/química , Restauração Dentária Permanente , Luz , Pigmentação em Prótese , Estética Dentária , Humanos , IncisivoRESUMO
With time, natural and polarized light proved their importance and utility in dental photography. After studying the physical properties of natural and polarized light, in the first part of this article, to understand their correlation with dental materials and natural teeth and how to use them in the best combination, this second part will illustrate the importance of a polarized image in color matching, how to manipulate it and how to apply it in clinical cases.
Assuntos
Resinas Compostas/química , Materiais Dentários/química , Restauração Dentária Permanente , Luz , Pigmentação em Prótese , Planejamento de Prótese Dentária , Estética Dentária , Humanos , Fotografia DentáriaRESUMO
Restoring an anterior tooth has always been a challenge, regarding the shade matching, the choice of colors, opacities, translucencies of our composites and the final anatomical outcome. This article proposes a new method for color matching and a clinical stratification using a simple and reproducible procedure for anterior restorations. The physical and optical characteristics of enamel and dentine will be studied and applied to our dental materials that we are using to restore anterior teeth.
Assuntos
Resinas Compostas/química , Esmalte Dentário/anatomia & histologia , Materiais Dentários/química , Planejamento de Prótese Dentária , Dentina/anatomia & histologia , Pigmentação em Prótese/métodos , Cor , Dente Canino/anatomia & histologia , Restauração Dentária Permanente/métodos , Módulo de Elasticidade , Elasticidade , Fluorescência , Dureza , Humanos , Incisivo/anatomia & histologia , Luz , Refratometria , Propriedades de SuperfícieRESUMO
While restoring an anterior tooth, shade matching is one of the crucial points that we can face to have an esthetic final outcome. After studying the physical and optical characteristics of enamel and dentine in the first part of this article, the second part will propose a new method for color matching and a clinical stratification using a simple and reproducible procedure for anterior restorations with only one dentine and one enamel shade.
Assuntos
Esmalte Dentário/anatomia & histologia , Planejamento de Prótese Dentária , Restauração Dentária Permanente , Dentina/anatomia & histologia , Pigmentação em Prótese , Cor , Resinas Compostas/química , Materiais Dentários/química , Restauração Dentária Permanente/métodos , Humanos , Luz , Pigmentação em Prótese/instrumentação , Propriedades de SuperfícieRESUMO
INTRODUCTION: The goal of a comprehensive treatment in irritable bowel syndrome (IBS) patients should be the improvement of symptoms and improve the quality of life. AIM: To review the drugs recommended in IBS, their mechanisms of action, side effects, risks and benefits, contraindications, availability in our country and the evidence supporting their use. MATERIAL AND METHODS: A technical and narrative review which evaluated the articles published in national and world literature regarding the pharmacological treatment of IBS was performed. PubMed and IMBIOMED electronic databases were searched (until September 2009) using all descriptors regarding IBS and drug therapy. RESULTS: There is enough clinical evidence to recommend the use of antispasmodics (alone orin combination) and tricyclic antidepressants for pain treatment in IBS. Laxatives are useful in the management of chronic constipation, but there is little evidence in the management of IBS. Although, antiflatulents and antidiarrheals are widely used there is little information supporting its use. The use of a nonabsorbable antibiotic (rifaximin) is effective in a subgroup of IBS patients. Serotoninergics drugs have proven effective in relieving symptoms of IBS; however, these drugs require caution in their use. There are studies have shown that probiotics improve some symptoms of IBS. CONCLUSIONS: There are many effective treatment options in the symptomatic management of IBS. The choice of treatment should be based on the predominant symptoms of each patient.
Assuntos
Síndrome do Intestino Irritável/tratamento farmacológico , Alprostadil/análogos & derivados , Alprostadil/uso terapêutico , Antibacterianos/uso terapêutico , Antidiarreicos/uso terapêutico , Antiespumantes/uso terapêutico , Humanos , Laxantes/uso terapêutico , Lubiprostona , Parassimpatolíticos/uso terapêutico , Probióticos/uso terapêutico , Psicotrópicos/uso terapêutico , Serotoninérgicos/uso terapêuticoRESUMO
BACKGROUND: Extraintestinal symptoms and signs may be the only manifestations of celiac sprue. METHODS: We report a case of a patient with hypochromic microcytic anemia as the only expression of the disease. RESULTS: Was asymptomatic the patient with pallor at physical examination. The laboratory showed only hypochromic microcytic anemia due to iron deficiency. She was previously was treated twice with oral iron without achieving good results. The upper gastrointestinal endoscopy, the colonoscopy, and the small bowel barium contrast study were normal. The small bowel biopsy showed villous atrophy and a chronic inflammatory infiltrate of the lamina propria. The antiendomysial and antireticulin antibodies were negative. The IgA antigliadin antibody was positive (1:120). The patient was initiated on a gluten free diet and oral iron. After four months of treatment, hemoglobin and the iron serum levels were normal and at 6 months, the small bowel biopsy showed striking improvement. CONCLUSIONS: Familiarity with the diverse extraintestinal features of celiac sprue and a high index of suspicion are essential for accurate diagnosis in patients with subtle presentations.
Assuntos
Anemia Hipocrômica/etiologia , Doença Celíaca/complicações , Adulto , Feminino , HumanosRESUMO
Estudiamos manométricamente a 65 pacientes con sintomatología de esofagitis por reflujo gastroesofágico (ERGE), de ellos 36 tuvieron evidencia de reflujo endoscópicamente (21 masculinos y 15 femeninos). Las alteraciones encontradas en el cuerpo fueron ausencia de peristalsis efectiva en 20 por ciento y ondas no transmitidas en 75 por ciento con hipotomía y sin relajación apropiada 16 por ciento. Concluimos que no puede aseverarse si el reflujo es debido a las alteraciones o estas lo producen
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Endoscopia Gastrointestinal/estatística & dados numéricos , Manometria/estatística & dados numéricos , Refluxo Gastroesofágico/etiologia , Refluxo Gastroesofágico/fisiopatologia , Transtornos da Motilidade Esofágica/fisiopatologia , Junção Esofagogástrica/fisiopatologiaRESUMO
BACKGROUND: Laparoscopic cholecystectomy is the treatment of choice for patients with symptomatic gallstones. The management of choledocholithiasis in these patients remains controversial. Endoscopic retrograde cholangiopancreatography (ERCP) with ductal stone clearance prior to laparoscopic cholecystectomy is one of the options. OBJECTIVE: To evaluate the results of ERCP prior to laparoscopic cholecystectomy in patients with suspected ductal stones. METHODS: We performed a retrospective study from patients who underwent ERCP prior to laparoscopic cholecystectomy in a four years period. RESULTS: ERCP was successful in 86 out of 88 patients (97.7%). Common bile duct (CBD) stones were found in 34 patients (39.5%). Sixty two of 86 patients had symptomatic gallstones with abnormal liver function test and/or ultrasound. CBD stones were found in 25 of the 62 symptomatic patients (40.3%). Twenty four patients had acute biliary pancreatitis. CBD stones were found in nine of these patients (37.5%). All patients with CBD stones underwent stone extraction after endoscopic sphincterotomy (ES). Sixteen other patients underwent ES for suspected obstruction at the ampulla. Stone extraction was successful in 100% of patients. There were six patients with complications (6.9%). Four patients had pancreatitis (4.6%), one patient hemorrhage (1.1%) and one patient cholangitis (1.1%). Analysis using logistic regression model showed that CBD stones on ultrasonography was the only variable significantly associated with choledocholithiasis (P < 0.001). CONCLUSIONS: Preoperative ERCP is useful in the management of CBD stones prior to laparoscopic cholecystectomy.
Assuntos
Colangiopancreatografia Retrógrada Endoscópica , Colecistectomia Laparoscópica , Cálculos Biliares/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Diagnóstico Diferencial , Feminino , Cálculos Biliares/diagnóstico por imagem , Cálculos Biliares/cirurgia , Humanos , Testes de Função Hepática , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Esfinterotomia EndoscópicaRESUMO
BACKGROUND: Clostridium difficile is the cause of 25-30% of cases of antibiotic-induced diarrhea. Pseudomembranous colitis is the most dramatic manifestation of C. difficile infection. METHODS: We report four cases of pseudomembranous colitis and review the literature. RESULTS: Three of the four patients, were over 80 years old and had other underlying illnesses. Before they developed colitis, all had received cephalosporins (cefuroxime, ceftriaxone, cefalexine) and one of them also clindamycin. All the patients had severe watery bowel movements, with mucus (one patient had also bloody stools), abdominal pain, nausea, vomit and fever. Blood tests disclosed leucocytosis with neutrophilia and increased band neutrophils in all patients. One patient had anasarca and hypo-albuminemia, suggestive of protein losing enteropathy. Sigmoidoscopy showed raised, yellow plaques covering the rectum, sigmoid and descendent colon mucosa. The response to oral metronidazole or vancomycin was good. The response to intravenous metronidazole was good in one patient and poor in another one. Two of our patients had relapses. The response of the relapses to oral metronidazole was good. One patient had two relapses eventually responding to oral metronidazole and Saccharomyces boulardii. CONCLUSIONS: Pseudomem-branous colitis has high morbility in debilitated elderly patients. Relapses are frequent in these patients. If other studies should confirm it, Saccharomyces boulardii could be useful in the prevention and treatment of relapses of this colitis.
Assuntos
Enterocolite Pseudomembranosa , Adulto , Idoso , Idoso de 80 Anos ou mais , Enterocolite Pseudomembranosa/diagnóstico , Enterocolite Pseudomembranosa/tratamento farmacológico , Feminino , Humanos , MasculinoRESUMO
La epilepsia abdominal es una causa rara de dolor abdominal. Reportamos un paciente adulto con dolor abdominal epigástrico, intermitente, paroxístico, acompañado de náuseas, vomítos inquietud y angustia. A la exploración física sin alteraciones. En el laboratorio sólo leucocitosis con neurotrofilia. Estudios radiológicos, ultrasonido y tomografía abdominales, arteriografía mesentérica y laparotomía exploradora sin anormalidades. El electroencefalograma (EEG) mostró actividad lenta theta bilateral durante la hiperventilación. Se inició tratamiento con carbamazepina, permaneciendo asintomático durante nueve meses. Posteriormente tuvo una recaída por tomar irregularmente el medicamento. En ese momento los niveles séricos de carbamazapina eran bajos. En el EEG se encontraron brotes de ondas agudas difusas paroxísticas. Al llevar nuevamente los niveles séricos de carbamazepina dentro de rangos terapéuticos desapareció el dolor. Ha permanecido asintomático durante los siguientes doce meses, tomando regularmente su tratamiento
Assuntos
Adulto , Humanos , Masculino , Dor Abdominal/etiologia , Anticonvulsivantes/uso terapêutico , Carbamazepina/uso terapêutico , Epilepsia do Lobo Temporal/fisiopatologiaRESUMO
Abdominal epilepsy is a rare cause of abdominal pain. We report an adult patient with intermittent, paroxysmal epigastric abdominal pain, accompanied by nausea, vomiting, restlessness and anxiety. Physical examination was normal. Blood analysis disclosed only leucocytosis with neutrophilia. X ray examinations, ultrasound and CT abdominal scan, mesenteric arteriography and exploratory laparotomy did not show evidence of pathology. The electroencephalogram (EEG) showed bilateral theta slow activity during hyperventilation. We started treatment with carbamazepine and the patient remained asymptomatic for nine months. However he had a relapse because he did'nt take his medication regularly. At that time the serum levels of carbamazepine were low. The EEG showed bursts of diffuse paroxysmal acute waves. Once therapeutic serum levels of carbamazepine were achieved the pain disappeared. He has remained asymptomatic during the last twelve months, while taking his treatment regularly.