Post-cure Heat Treatments Influence the Mechanical and Optical Properties of Acrylic and Bis-acryl Composite Resins.

OBJECTIVE: To evaluate the influence of post-cure heat treatments (PCHT) on Knoop microhardness (KHN) and color change of bis-acryl composite resin (Protemp 4 - 3M ESPE, USA and PrimmaArt - FGM, Brazil) and chemically activated acrylic resins (Dencôr - Clássico, Brazil, and Duralay - Cotia, Brazil). METHODS AND MATERIALS: Specimens (12×1 mm) were prepared for each material (n=10/group). Thirty minutes after curing, the specimens were subjected to PCHT for 10 minutes at 70°, 100°, or 130°C. The control group was kept at room temperature (24°C) for the same amount of time. KHN was analyzed 24 hours after PCHT (n=10). Following Commission Internationale de l'Éclairage (CIE) Delta E 2000 (CIEDE2000 [ΔE00]), color measurements were obtained at three time points: 1. after polymerization; 2. after PCHT; and 3. after 30 days of storage in water, coffee, or red wine. Data for each material were analyzed by one-way analysis of variance (ANOVA) (p<0.05). RESULTS: The PCHT at 130°C produced the highest KHN values. Except for the 70°C groups from Dencôr and Protemp, all PCHTs increased the initial color values (p>0.05). In general, chemically activated acrylic resins showed an increase in color stability when subjected to PCHT (p>0.05). For bis-acryl composite resin, PCHT did not influence color stability (p<0.05). CONCLUSION: Overall, the results showed that PCHT increased the tested materials' color changes and Knoop microhardness. However, except for PCHT at 130°C in Duralay, the color changes remained within acceptable values. The PCHT treatment resulted in better color stability for most of the composite resins studied.

Endoscopic submucosal dissection for superficial gastric neoplasias in two referral hospitals in Brazil: Can the Japanese and South Korean results be equaled?

INTRODUCTION AND AIMS: Endoscopic submucosal dissection (ESD) in the treatment of superficial neoplasias of the gastrointestinal tract is currently one of the greatest advances in therapeutic endoscopy. Due to its high technical complexity, it is not yet a routine procedure in Latin America. The aim of the present study was to present the experience in Brazil with ESD in superficial gastric neoplasias, based on training received from Japanese experts. MATERIALS AND METHODS: A retrospective study was conducted, in which information was prospectively collected from a database that included all patients that underwent ESD due to superficial gastric neoplasias at two endoscopy referral centers in Brazil, within the time frame of June 2008 to June 2019. En bloc, complete, and curative resection rates were calculated, along with the local recurrence rate and adverse events. RESULTS: A total of 103 ESDs for superficial gastric neoplasias were performed during the study period. Eighty of those patients (77.6%) presented with early malignant gastric neoplasias or premalignant lesions (adenocarcinoma: 52.5%, high-grade dysplasia: 27.5%, low-grade dysplasia: 16.3%, and neuroendocrine tumors: 3.8%). Overall en bloc and complete resection rates for the superficial gastric neoplasias were 96.3% and 92.5%, respectively, whereas the curative resection rate based on expanded criteria was 76%. CONCLUSIONS: ESD for the treatment of superficial gastric neoplasias is a safe and effective therapeutic modality in Latin America, with results similar to those shown in the most representative Japanese studies.

Oral manifestations related to dengue fever: a systematic review of the literature.

The focus on oral manifestations of dengue fever (DF) is not common in the scientific literature and the patient affected can present signs and symptoms that may not be noticed by dental professionals. This systematic review article was conducted to identify and discuss the oral manifestations related to DF. The electronic databases PubMed, Latin American and Caribbean Literature in Sciences (LILACS), Web of Science and Scopus were searched from November to December 2016 by two authors, simultaneously, using the search terms 'dengue and oral manifestation' combined. We included complete original articles, clinical trials and clinical case reports published in Portuguese, Spanish and English. No limits were applied to the year of publication. Review articles and those with no health outcomes were removed. A limited number of studies aimed to investigate the oral manifestations of DF (N = 25). However, several manifestations were identified in the oral cavity of patients diagnosed with DF such as acute gingival and palate bleeding, dryness of the mouth, taste changes, and erythematous plaque and vesicles on the tongue and palate. Osteonecrosis of jaw associated with DF was also reported. In conclusion, oral manifestations may represent a relevant contributory factor to identify DF disease among patients undergoing dental procedures in general practise.

Sentinel node biopsy using blue dye and technetium99 in advanced gastric cancer: anatomical drainage and clinical application.

Lymph node metastases are an independent prognosis factor in gastric carcinoma (GC) patients. Radical lymphadenectomy can improve survival but it can also increase surgical morbidity. As a principle, sentinel node (SN) navigation surgery can avoid unnecessary lymphadenectomy without compromising prognosis. In this pilot study, 24 patients with untreated GC were initially screened for SN navigation surgery, of which 12 were eligible. Five patients had T2 tumors, 5 had T3 tumors and 2 had T1 tumors. In 33% of cases, tumor diameter was greater than 5.0 cm. Three hundred and eighty-seven lymph nodes were excised with a median of 32.3 per patient. The SN navigation surgery was feasible in all patients, with a median of 4.5 SNs per patient. The detection success rate was 100%. All the SNs were located in N1 and N2 nodal level. In 70.9% of cases, the SNs were located at lymphatic chains 6 and 7. The SN sensitivity for nodal staging was 91.6%, with 8.3% of false negative. In 4 patients who were initially staged as N0, the SNs were submitted to multisection analyses and immunohistochemistry, confirming the N0 stage, without micrometastases. In one case initially staged as negative for nodal metastases based on SN analyses, metastases in lymph nodes other than SN were found, resulting in a 20% skip metastases incidence. This surgery is a reproducible procedure with 100% detection rate of SN. Tumor size, GC location and obesity were factors that imposed some limitations regarding SN identification. Results from nodal multisection histology and immunohistochemistry analysis did not change initial nodal staging.

Sentinel node biopsy using blue dye and technetium99 in advanced gastric cancer: anatomical drainage and clinical application

Lymph node metastases are an independent prognosis factor in gastric carcinoma (GC) patients. Radical lymphadenectomy can improve survival but it can also increase surgical morbidity. As a principle, sentinel node (SN) navigation surgery can avoid unnecessary lymphadenectomy without compromising prognosis. In this pilot study, 24 patients with untreated GC were initially screened for SN navigation surgery, of which 12 were eligible. Five patients had T2 tumors, 5 had T3 tumors and 2 had T1 tumors. In 33% of cases, tumor diameter was greater than 5.0 cm. Three hundred and eighty-seven lymph nodes were excised with a median of 32.3 per patient. The SN navigation surgery was feasible in all patients, with a median of 4.5 SNs per patient. The detection success rate was 100%. All the SNs were located in N1 and N2 nodal level. In 70.9% of cases, the SNs were located at lymphatic chains 6 and 7. The SN sensitivity for nodal staging was 91.6%, with 8.3% of false negative. In 4 patients who were initially staged as N0, the SNs were submitted to multisection analyses and immunohistochemistry, confirming the N0 stage, without micrometastases. In one case initially staged as negative for nodal metastases based on SN analyses, metastases in lymph nodes other than SN were found, resulting in a 20% skip metastases incidence. This surgery is a reproducible procedure with 100% detection rate of SN. Tumor size, GC location and obesity were factors that imposed some limitations regarding SN identification. Results from nodal multisection histology and immunohistochemistry analysis did not change initial nodal staging.

Association between CD31 expression and histopathologic features in stage IB squamous cell carcinoma of the cervix.

This study was undertaken to evaluate the association between the expression of CD31 in the tumor and the histopathologic findings in patients with carcinoma of the cervix. This study included prospectively 30 women, aged 46.6 +/- 10.7 years, with stage IB squamous cell carcinoma of the cervix submitted to radical hysterectomy from November 2001 to September 2002. Samples from the tumor were taken and immunohistochemically evaluated by a monoclonal antibody for CD31. Clinicopathologic characteristics such as stage, tumor size, grade of differentiation, lymphatic vascular space invasion (LVSI), parametrial involvement, and status of pelvic lymph nodes were also recorded. The clinical stage (FIGO) was IB1 in 22 patients (73.3%) and IB2 in 8 patients (26.7%). The expression of CD31 was significantly associated with tumor size and the presence of LVSI, but not with grade of differentiation and vaginal or parametrial involvement (P= 0.03, P= 0.032, P= 0.352, P= 0.208, and P= 0.242, respectively). On univariate analysis, the presence of pelvic lymph node metastasis was influenced by LVSI (P= 0.003) and CD31 expression (P= 0.032). However, on multivariate analysis, the presence of LVSI (P= 0.007) was the only independent predictor of pelvic lymph node metastasis. The CD31 expression in tumor is significantly associated with LVSI and tumor size in patients with early-stage squamous cell carcinoma of the cervix.