Local administration of Tiludronic Acid downregulates important mediators involved in periodontal tissue destruction in experimental periodontitis in rats.

OBJECTIVE: The purpose of this study was to evaluate whether local administration of TIL could influence the expression of the inflammatory mediators IL-1ß, TNF-α, MMP-8 and COX-2 in rats with experimental periodontitis (EP). METHODS: Twenty-four adult male rats (Rattus norvegicus, albinus, Wistar) were assigned to groups C, EP, EP-TIL (CControl group, EP-Periodontitis groups). On EP groups, a ligature was placed around maxillary 2nd molars on day 1. On group EP-TIL, 20 µL of TIL solution (1 mg/kg body weight) was injected into the subperiosteal palatal area adjacent to the maxillary 2nd molar every other day until euthanasia (day 11). Alveolar bone loss was morphometrically analyzed. mRNA expressions of IL-1ß, TNF-α, MMP-8 and COX-2 were assessed by qPCR. IL-1ß, TNF-α, MMP-8 and COX-2 were immunohistochemically analyzed. Data were analyzed statistically. RESULTS: Group EP-TIL presented reduced alveolar bone loss when compared with group EP (p < 0.05). Group EP-TIL presented decreased mRNA expressions of IL-1ß, TNF-α, MMP-8 and COX-2 and reduced immunolabeling of IL-1ß, TNF-α and MMP-8 when compared with group EP (p < 0.05). No differences regarding the immunolabeling of COX-2 were found when group EP-TIL was compared with the other groups (p > 0.05). CONCLUSION: Within the limits of this study, it can be concluded that local administration of TIL downregulates important mediators involved in periodontal tissue destruction in ligature-induced periodontitis in rats.

Hip and Knee Strengthening Is More Effective Than Knee Strengthening Alone for Reducing Pain and Improving Activity in Individuals With Patellofemoral Pain: A Systematic Review With Meta-analysis.

Study Design Systematic review with meta-analysis. Background The addition of hip strengthening to knee strengthening for persons with patellofemoral pain has the potential to optimize treatment effects. There is a need to systematically review and pool the current evidence in this area. Objective To examine the efficacy of hip strengthening, associated or not with knee strengthening, to increase strength, reduce pain, and improve activity in individuals with patellofemoral pain. Methods A systematic review of randomized and/or controlled trials was performed. Participants in the reviewed studies were individuals with patellofemoral pain, and the experimental intervention was hip and knee strengthening. Outcome data related to muscle strength, pain, and activity were extracted from the eligible trials and combined in a meta-analysis. Results The review included 14 trials involving 673 participants. Random-effects meta-analyses revealed that hip and knee strengthening decreased pain (mean difference, -3.3; 95% confidence interval [CI]: -5.6, -1.1) and improved activity (standardized mean difference, 1.4; 95% CI: 0.03, 2.8) compared to no training/placebo. In addition, hip and knee strengthening was superior to knee strengthening alone for decreasing pain (mean difference, -1.5; 95% CI: -2.3, -0.8) and improving activity (standardized mean difference, 0.7; 95% CI: 0.2, 1.3). Results were maintained beyond the intervention period. Meta-analyses showed no significant changes in strength for any of the interventions. Conclusion Hip and knee strengthening is effective and superior to knee strengthening alone for decreasing pain and improving activity in persons with patellofemoral pain; however, these outcomes were achieved without a concurrent change in strength. Level of Evidence Therapy, level 1a-. J Orthop Sports Phys Ther 2018;48(1):19-31. Epub 15 Oct 2017. doi:10.2519/jospt.2018.7365.

Cirurgia cardíaca em índios brasileiros / Heart Surgery in Brazilian Indians

PURPOSE: Our experience with surgical treatment of heart diseases in Indians living in the Amazon rain forest in primitive stages was reviewed. METHODS: From 1988 to 1995, 18 patients underwent cardiovascular surgical procedures at the São Paulo Hospital of the Escola Paulista de Medicina. Seven patients had valvar disease, nine congenital heart defects, one submitral aneurysm and one arrhythmia. Thirteen Indians came from tribes of the Amazon rain forest area: three from the Xavante, two from Waiapi, two from Tucano, two from Macuxi, two from Mayoruna, and one of each tribe of Xikrin, Guajajara, Terena, Surui, Galibi, Cinta-Larga and Pataxó. RESULTS: We performed 22 operations, with two hospital deaths. Follow-up was possible in 87.5 of cases, with one late death. The majority of cases were due to congenital heart defects and in this series it was noted the absence of operations to treat coronary artery disease. The incidence of valve disease was higher in accultured or semi-accultured Indians. CONCLUSION: The surgical treatment of cardiovascular disease has made possible to the surviving indians to return to and be accepted by their fellow tribesmen.