Position Statement on the Use of Myocardial Strain in Cardiology Routines by the Brazilian Society of Cardiology's Department Of Cardiovascular Imaging - 2023. / Posicionamento do Departamento de Imagem Cardiovascular da Sociedade Brasileira de Cardiologia sobre o Uso do Strain Miocárdico na Rotina do Cardiologista ­ 2023.

Central Illustration : Position Statement on the Use of Myocardial Strain in Cardiology Routines by the Brazilian Society of Cardiology's Department Of Cardiovascular Imaging - 2023 Proposal for including strain in the integrated diastolic function assessment algorithm, adapted from Nagueh et al.67 Am: mitral A-wave duration; Ap: reverse pulmonary A-wave duration; DD: diastolic dysfunction; LA: left atrium; LASr: LA strain reserve; LVGLS: left ventricular global longitudinal strain; TI: tricuspid insufficiency. Confirm concentric remodeling with LVGLS. In LVEF, mitral E wave deceleration time < 160 ms and pulmonary S-wave < D-wave are also parameters of increased filling pressure. This algorithm does not apply to patients with atrial fibrillation (AF), mitral annulus calcification, > mild mitral valve disease, left bundle branch block, paced rhythm, prosthetic valves, or severe primary pulmonary hypertension.

Figura Central : Posicionamento do Departamento de Imagem Cardiovascular da Sociedade Brasileira de Cardiologia sobre o Uso do Strain Miocárdico na Rotina do Cardiologista ­ 2023 Proposta de inclusão do strain no algoritmo integrado de avaliação da função diastólica, adaptado e traduzido de Nagueh et al. 67 AE: átrio esquerdo; Ap: duração da onda A reversa pulmonar; Am: duração da onda A mitral; DD: disfunção diastólica; FEVEr: fração de ejeção do ventrículo esquerdo reduzida; IT: insuficiência tricúspide; SAEr: strain do AE de reservatório; SLGVE: strain longitudinal global do ventrículo esquerdo. Se remodelamento concêntrico, confirmar com SLGVE. Na presença de FEVEr, tempo de desaceleração da onda E mitral (TDE) < 160 ms e onda S < D pulmonar também são parâmetros de pressão de enchimento aumentada. Esse algoritmo não se aplica a pacientes com fibrilação atrial (FA), calcificação do anel mitral ou valvopatia mitral maior que discreta, bloqueio de ramo esquerdo (BRE), ritmo de marca-passo, próteses valvares ou hipertensão pulmonar (HP) primária grave.

Novel Pullulan/Gellan Gum Bilayer Film as a Vehicle for Silibinin-Loaded Nanocapsules in the Topical Treatment of Atopic Dermatitis.

In this study a novel gellan gum/pullulan bilayer film containing silibinin-loaded nanocapsules was developed for topical treatment of atopic dermatitis (AD). The bilayer films were produced by applying a pullulan layer on a gellan gum layer incorporated with silibinin nanocapsules by two-step solvent casting method. The bilayer formation was confirmed by microscopic analysis. In vitro studies showed that pullulan imparts bioadhesitvity for the films and the presence of nanocapsules increased their occlusion factor almost 2-fold. Besides, the nano-based film presented a slow silibinin release and high affinity for cutaneous tissue. Moreover, this film presented high scavenger capacity and non-hemolytic property. In the in vivo study, interestingly, the treatments with vehicle film attenuated the scratching behavior and the ear edema in mice induced by 2,4-dinitrochlorobenzene (DNCB). However, the nano-based film containing silibinin modulated the inflammatory and oxidative parameters in a similar or more pronounced way than silibinin solution and vehicle film, as well as than hydrocortisone, a classical treatment of AD. In conclusion, these data suggest that itself gellan gum/pullulan bilayer film might attenuate the effects induced by DNCB, acting together with silibinin-loaded nanocapsules, which protected the skin from oxidative damage, improving the therapeutic effect in this AD-model.

Pullulan film incorporated with nanocapsules improves pomegranate seed oil anti-inflammatory and antioxidant effects in the treatment of atopic dermatitis in mice.

This study aimed to prepare pullulan films containing pomegranate seeds oil (PSO) based nanocapsules, and evaluate the formulation efficacy in the treatment of atopic dermatitis (AD)-like lesions induced by 2,4-dinitrochlorobenzene (DNCB). The Eudragit RS 100® nanocapsules (PSONC) were prepared by the interfacial precipitation of preformed polymer, whereas the films were produced by the solvent casting method. Pomegranate seed oil nanoemulsions (PSONE) were prepared by the spontaneous emulsification method for comparative reasons. Both nanosystems presented adequate mean diameter (248 ± 16 nm for PSONE and 181 ± 6 nm for PSONC), polydispersity index (below 0.2), zeta potential (-25.63 ± 1.1 mV for PSONE and + 43.13 ± 0.7 mV for PSONC) and pH in the acid range (6.77 ± 0.27 and 5.31 ± 0.17, PSONE and PSONC). By a pre-formulation study, sorbitol (6.5%) and PEG 400 (1.5%) were considered the most suitable plasticizers for developing pullulan films (6%) intending topical application. In general, pullulan films were classified as flexible and hydrophilic, with high occlusive properties, 57.6 ± 0.8%, 64.6 ± 0.8% for vehicle, PSONCF (pullulan film containing PSONC), respectively. All formulations (films and nanocarriers) presented no irritant potential in the chorioallantoic membrane test. In the in vivo model, the treatments with free PSO and PSONCF attenuated the skin injury as well as the mechanical hypernociceptive behavioral induced by DNCB exposure to mice. Importantly, the biochemical analyses provided evidence that only the treatment with PSONCF modulated the inflammatory and the oxidative stress parameters evaluated in this study. In conclusion, these data lead us to believe that PSONC incorporation into a pullulan film matrix improved the biological properties of the PSO in this AD-model.

Clinical behavior of universal adhesives in non-carious cervical lesions: A randomized clinical trial.

OBJECTIVES: This randomized, double-blind clinical trial, , evaluated the behavior of two universal adhesives used in etch-and-rinse (ER) or self-etch (SE) approach in non-carious cervical lesions (NCCLs). METHODS: Two hundred and eleven NCCLs were selected in 54 participants and randomly allocated into four experimental groups: Scotchbond Universal Adhesive - SBU (3M Oral Care) and Prime & Bond Elect - PB (Dentsply Sirona) used in ER and SE modes. Two trained operators placed all resin composite restorations (Filtek Z250, 3M Oral Care). Restorations were evaluated at baseline and after 6 months using both FDI and USPHS modified criteria by a blinded calibrated examiner. Kruskal-Wallis and Mann-Whitney U non-parametric tests were used to compare the restoration failures among experimental groups. RESULTS: Statistically significant differences were found among groups regarding failures (p=0.000 for both FDI and USPHS criteria). PB-SE presented more failures (p<0.05) than other experimental groups. No significant difference was found between any other pair of groups (p>0.05). CONCLUSIONS: The etch and rinse approach affected the clinical performance of Prime and Bond Elect. For this material, the self-etch approach generated lower criteria scores after a six-month follow-up. The bonding strategy did not influence Scotchbond Universal Adhesive clinical performance. (RBR-2GQMVF) CLINICAL SIGNIFICANCE: The clinical behavior of mild universal adhesive Prime & Bond Elect depends on the bonding strategy. The etch-and-rinse approach is recommended for this adhesive system. Scotchbond Universal Adhesive can be used in both bonding strategies without impairing clinical performance.

Self-etch Approach of Universal Adhesives as an Alternative to Minimize Bond Degradation on Sound Dentin vs Caries-affected Dentin over Time.

PURPOSE: To investigate the influence of the etching strategy of universal adhesives on bond degradation to sound and artificially-induced caries-affected dentin. MATERIALS AND METHODS: The universal adhesives (Scotchbond Universal Adhesive; All-Bond Universal; Prime&Bond Elect) and adhesives used as controls (Adper Single Bond 2 and Clearfil SE Bond) were applied to sound and artificially-induced caries-affected bovine dentin. Microtensile bond strength was evaluated immediately (24 h) and after one year of water storage (1 year). Representative specimens were also prepared to assess nanoleakage. Bond strength data (MPa) were analyzed using three-way ANOVA and post-hoc Tukey's test (α = 0.05), considering each substrate separately. RESULTS: Bonding degradation was observed for all universal adhesives on caries-affected dentin, irrespective of the etching strategy. On sound dentin, bonding degradation was observed when adhesives were used on the etch-and-rinse strategy. CONCLUSION: The universal adhesives were not capable of maintaining bond stability over time on caries-affected dentin. The self-etch strategy seems better able to maintain the durability of adhesive interfaces created on sound dentin.

Evaluation of the Use of Potassium Iodide Application on Stained Demineralized Dentin Under Resin Composite Following Silver Diamine Fluoride Application.

Purpose: The purpose of this study was to assess the effect of potassium iodide (KI) after applying silver diamine fluoride (SDF) on the staining of demineralized dentin covered or not by a composite resin layer. Methods: Dentin blocks from 30 bovine incisors were demineralized and randomly allocated in three groups (N equals 10): (1) control (no treatment); (2) treated with SDF; and (3) treated with SDF and KI. Half of the specimens of each group received a composite resin restoration immediately after treatment. A colorimetric evaluation, according to the CIE L*a*b* system, was performed at baseline and after seven, 14, 30, and 60 days. The ΔE data were analyzed using the generalized linear model (Δ equals 0.05). Results: The use of KI immediately after applying SDF decreased the dentin staining at all assessment times. SDF treatment only stained the dentin under composite resin after 60 days. The application of KI reduced the dentin under composite resin staining as ΔE values were similar to the control group even after 60 days. Conclusions: The use of potassium iodide minimizes the darkening of dentin and prevents the staining of the dentin under composite resin restorations in the long-term.

Incorporation of nanocapsules into gellan gum films: A strategy to improve the stability and prolong the cutaneous release of silibinin.

This study aimed to develop gellan gum films containing silibinin-loaded nanocapsules as a novel approach for cutaneous administration of this flavonoid. The nanocapsule suspensions were prepared and presented mean size around 140 nm with homogenous distribution, negative zeta potential and silibinin encapsulation efficiency close to 100%. Then, these suspensions were converted into gellan gum films by solvent casting method. The films were transparent, flexible and maintained the gellan gum hydrophilicity. Nanocapsules provided the silibinin homogenous distribution in the films and prolonged its release, as well as improved the gellan gum occlusion potential. Besides, the nanosuspensions conversion into films improved the silibinin stability. Additionally, the nano-based films presented a swelling index 1.5 times higher than films containing non-nanoencapsulated silibinin. Microscopic analysis evidenced the homogeneous surface of the nano-based films, while films containing non-nanoencapsulated silibinin presented small cracks. The in vitro skin permeation profile confirmed the silibinin gradual release from the nano-based films and its greater retention in the dermis when the skin is damaged. Finally, the formulations presented no irritant effect in the HET-CAM assay. Therefore, the conversion of silibinin-loaded nanocapsule suspensions into films might be considered a promising platform for skin delivery of this flavonoid.

Evaluation of the Southwick Angle in Two Hundred Hips of Asymptomatic Children and Adolescents.

Objectives To measure the mean value of the Southwick angle using two different methods, the manual (1) and digital (2) methods, and to establish a normality value. Methods A primarily descriptive study with 100 children and adolescents. Individuals with orthopedic complaints regarding the hips and/or knees or gait alterations were excluded. For each patient, an X-ray was performed on the lateral incidence of Lowenstein, totaling 100 radiographs and 200 hips. The Southwick angle was measured in two different ways by the same researcher: the conventional method (1), tracing the lines with pencils and measuring the angle with the use of a goniometer and negatoscope, and through the GNU Image Manipulation Program (GIMP) image editor (open source), version 2.7.0 (2), in which the lines were plotted and the angles of both hips were gauged on each radiograph. Later, we sought to evaluate the correlation between the two methods and to verify the mean Southwick angle by categorically correlating it by gender, age group and body mass index (BMI) in asymptomatic children and adolescents. All radiographs were authorized by the children and adolescents' parents/legal guardians. The study was approved by the ethics committee of the institutions in which the research was conducted. Results The mean of the Southwick angles obtained by the conventional method was of 8.7° (±2.0°), and, by the digital method, it was of 9.9° (±1.8°). The angle obtained by the two methods was statistically significant ( p < 0.001). The majority of the studied population (95%) had a body mass index (BMI) > 18.5, and the mean of the angles was within the previously established value (∼ 10°). Conclusion For the first time, using a substantial sample size, a normal value for the Southwick angle measured in asymptomatic individuals was demonstrated. In addition, the image editor proved to be a reliable method to measuring the Southwick angle.

Evaluation of the Southwick Angle in Two Hundred Hips of Asymptomatic Children and Adolescents / Avaliação do ângulo de Southwick em duzentos quadris de crianças e adolescentes assintomáticos

Abstract Objectives To measure the mean value of the Southwick angle using two different methods, the manual (1) and digital (2) methods, and to establish a normality value. Methods A primarily descriptive study with 100 children and adolescents. Individuals with orthopedic complaints regarding the hips and/or knees or gait alterations were excluded. For each patient, an X-ray was performed on the lateral incidence of Lowenstein, totaling 100 radiographs and 200 hips. The Southwick angle was measured in two different ways by the same researcher: the conventional method (1), tracing the lines with pencils and measuring the angle with the use of a goniometer and negatoscope, and through the GNU Image Manipulation Program (GIMP) image editor (open source), version 2.7.0 (2), in which the lines were plotted and the angles of both hips were gauged on each radiograph. Later, we sought to evaluate the correlation between the two methods and to verify the mean Southwick angle by categorically correlating it by gender, age group and body mass index (BMI) in asymptomatic children and adolescents. All radiographs were authorized by the children and adolescents' parents/legal guardians. The study was approved by the ethics committee of the institutions in which the research was conducted. Results The mean of the Southwick angles obtained by the conventional method was of 8.7º (±2.0º), and, by the digital method, it was of 9.9º (±1.8º). The angle obtained by the two methods was statistically significant (p < 0.001). The majority of the studied population (95%) had a body mass index (BMI) > 18.5, and the mean of the angles was within the previously established value (∼ 10º). Conclusion For the first time, using a substantial sample size, a normal value for the Southwick angle measured in asymptomatic individuals was demonstrated. In addition, the image editor proved to be a reliable method to measuring the Southwick angle.

Resumo Objetivos Medir o valor médio do ângulo de Southwick utilizando dois métodos diferentes, manual (1) e digital (2), e estabelecer um valor de normalidade. Métodos Estudo primariamente descritivo, realizado com 100 crianças e adolescentes. Foram excluídos indivíduos que apresentavam queixa ortopédica nos quadris e/ou joelhos, ou alterações de marcha. Para cada paciente, foi realizada uma radiografia na incidência lateral de Lowenstein, totalizando 100 radiografias e 200 quadris. O ângulo de Southwick foi medido de duas formas pelo mesmo pesquisador: pelo método convencional (1), traçando-se as retas com lápis e medindo o ângulo com o uso de goniômetro e negatoscópio, e por meio do editor de imagem GNU Image Manipulation Program (GIMP; código aberto), versão 2.7.0 (2), no qual foram traçadas as linhas e aferidos os ângulos de ambos os quadris em cada radiografia. Posteriormente, buscou-se avaliar a correlação entre os dois métodos e verificar o ângulo médio de Southwick correlacionando-o categoricamente por gênero, faixa etária e índice de massa corpórea (IMC) em adolescentes e crianças assintomáticos. Todas as radiografias foram autorizadas pelos responsáveis. O estudo foi aprovado pelo comitê de ética das instituições em que a pesquisa foi realizada. Resultados A média do ângulo de Southwick obtida pelo método convencional foi de 8,7º (±2,0º), e pelo método digital, foi de 9,9º (±1,8º). O ângulo obtido pelas duas formas teve significância estatística (p < 0,001). A maioria da população estudada (95%) tinha índice de massa corpórea (IMC) > 18,5, e a média dos ângulos esteve dentro do valor previamente estabelecido como normal (∼ 10º). Conclusão Demonstrou-se, pela primeira vez, utilizando uma amostra substanciosa, um valor normal do ângulo de Southwick medido em indivíduos assintomáticos. Além disso, o editor de imagem mostrou ser um método confiável para mensuração do ângulo de Southwick.

Tansanal total mesorectal excision (TaTME): systematization and mediated results in 10 patients / Excisão total do mesorreto por via transanal (TaTME): sistematização e resultados mediatos em dez pacientes

Abstract Background: Transanal total mesorectal excision is a surgical technique for minimally invasive resection of the rectum and perirectal tissues. It is indicated for patients with medial and distal rectum cancer confined to the mesorectal envelope. This study describes a series of patients undergoing transanal total mesorectal excision. Methods: Ten patients were selected to undergo transanal total mesorectal excision using the SILS-Port® platform. All patients included here had middle or low rectal cancer. Abdominal access for proximal colon mobilization was performed by laparoscopy in all cases. As a rule, in 9 of the 10 cases, the surgical specimen was removed transanally. Result:s During a 41-month period, 10 patients underwent transanal total mesorectal excision based on curative intent. The first indication for transanal total mesorectum excision was medial and distal rectal cancer, locally invasive and confined to the mesortal envelope. The median age of patients with rectal cancer at the time of surgery was 61 years (mean 59.4 years, range 22-78 years), with 80% (8) female and 20% (2) male. The median surgical time was 305' (mean 314', range 260-420'). The median postoperative length of stay was five days (average of 7.3 days, interval of 3-23 days). There was no postoperative mortality. Surgical complications included postoperative ileus (n = 1), bladder paresis (n = 1), and ileostomy stenosis (n = 1). All patients had negative surgical margins for neoplasia and more than 12 resected lymph nodes. The tumors were between 1 and 9 cm from the anal margin. Conclusion: Total transanal mesorectal excision has been shown to be a viable method for oncologic resection of locally advanced rectal cancer with curative intent.

Resumo Contexto: A excisão total do mesorreto por via transanal é uma aborgadem crânio-caudal para a realização de ressecção minimamente invasiva do reto e tecidos perirretais em monobloco. É adequada para pacientes com câncer de reto médio e distal confinados ao envelope mesorretal. Aqui relatamos uma série de pacientes submetidos à excisão total do mesorreto por via transanal. Métodos: Dez pacientes foram selecionados para serem submetidos à excisão total do mesorreto por via transanal utilizando a plataforma SILS-Port®. Todos os pacientes eram portadores de câncer retal de localização extraperitoneal. O acesso abdominal para mobilização do cólon proximal, em todos os casos, foi realizado por laparoscopia. Como regra, a retirada do espécime cirúrgico, em nove casos, ocorreu por via transanal. Resultados: Durante um período de 41 meses, 10 pacientes foram submetidos à excisão total do mesorreto por via transanal com intenção curativa. A indicação primária para excisão total do mesorreto transanal foi o câncer de reto médio e distal, localmente invasor, mas confinado ao envelope mesorretal. A mediana de idade dos pacientes com câncer de reto no momento da cirurgia foi de 61 anos (média de 59,4 anos, faixa de 22-78 anos), sendo 80% (8) do sexo feminino e 20% (2) do sexo masculino. A mediana do tempo cirúrgico foi de 305' (média de 314', intervalo de 260-420'). A mediana do tempo de permanência pós-operatória foi de cinco dias (média de 7,3 dias, intervalo de 3-23 dias). Não houve mortalidade pós-operatória. As complicações cirúrgicas incluíram íleo paralítico (n = 1), paresia vesical (n = 1) e estenose de ileostomia (n = 1). Todos os pacientes tiveram margens cirúrgicas negativas para neoplasia e mais de 12 linfonodos ressecados. Os tumores distavam de 1 a 9 cm da margem anal. Conclusão: A excisão total do mesorreto transanal demonstrou-se um método viável para a ressecção oncológica de câncer de reto localmente avançado com intenção curativa.

1,3-Bis(2-oxoprop-yl)thymine.

In the title compound [systematic name: 5-methyl-1,3-bis-(2-oxoprop-yl)pyrimidine-2,4(1H,3H)-dione], C11H14N2O4, the two 2-oxopropyl groups are nearly perpendicular to the planar thymine unit. One methyl group of oxopropyl substituent is disordered. In the crystal, C-H⋯O inter-actions help to connect the mol-ecules into (001) layers.

Soft Sensors in the Primary Aluminum Production Process Based on Neural Networks Using Clustering Methods.

Primary aluminum production is an uninterrupted and complex process that must operate in a closed loop, hindering possibilities for experiments to improve production. In this sense, it is important to have ways to simulate this process computationally without acting directly on the plant, since such direct intervention could be dangerous, expensive, and time-consuming. This problem is addressed in this paper by combining real data, the artificial neural network technique, and clustering methods to create soft sensors to estimate the temperature, the aluminum fluoride percentage in the electrolytic bath, and the level of metal of aluminum reduction cells (pots). An innovative strategy is used to split the entire dataset by section and lifespan of pots with automatic clustering for soft sensors. The soft sensors created by this methodology have small estimation mean squared error with high generalization power. Results demonstrate the effectiveness and feasibility of the proposed approach to soft sensors in the aluminum industry that may improve process control and save resources.

Do bulk-fill resins decrease the restorative time in posterior teeth? A systematic review and meta-analysis of in vitro studies.

The aim of the present study was to compare the restorative time for filling cavities in posterior teeth using bulk-fill and conventional resin composites through a systematic review and meta-analysis. A search for clinical trials and laboratory studies was performed in PubMed/MEDLINE, Scopus, the Latin American and Caribbean Health Sciences Literature database, the Brazilian Library in Dentistry, Cochrane Library, Clinical Trials, and ReBEC (Registro Brasileiro de Ensaios Clínicos) databases without publication year or language restriction. Two reviewers identified eligible studies according to the inclusion criteria: bulk-fill compared to conventional resin in class I or II, and the restorative time as an outcome. A meta-analysis of the restorative time mean difference between composites was performed (inverse variance method, random effects model; Z-test, P ≤ .05). From the 662 eligible studies, 133 were selected for full-text analysis; three were included in the systematic review and in the meta-analysis. Overall, the restorative time was lower when bulk-fill was used (P = .0007, Z = 3.37), as the subgroup full-body bulk-fill (P < .00001, Z = 21.00). There was no difference in restorative time between flowable bulk-fill and conventional resins (P = .08, Z = 1.76). Moderate-to-substantial heterogeneity was detected. Full-body bulk-fill composites decrease the restorative time in posterior teeth compared to conventional resins. Full-body bulk-fill resins require a shorter restorative time to perform restorations in posterior teeth than conventional resins, but the same is not valid for flowable bulk-fill resin composites.

Short-term aging and the dentin bond strength of adhesive systems.

The aim of this study was to compare the effects of 2 aging methods on the dentin bond strength of different adhesive systems, including a universal adhesive. Seventy-two third molars were sectioned to create flat midcoronal dentin surfaces, which were randomly assigned to 12 groups (n = 6 each) according to the aging method (conventional aging, defined as 6 months of water storage; accelerated aging by means of a pH-cycling method; or negative control [immediate bond strength]) and adhesive system (Adper Single Bond 2, Clearfil SE Bond, Prime & Bond 2.1, or Scotchbond Universal). Composite resin blocks were constructed on the flattened dentin surfaces after application of the appropriate adhesive, and the specimens were stored in water for 24 hours. Specimens from the control group were immediately sectioned into resin-dentin sticks (0.8 mm2) and subjected to a microtensile bond strength test. Specimens from the experimental groups were sectioned and tested after undergoing the assigned aging method. Data were analyzed with 2-way analysis of variance and a Tukey test (α = 0.05). The study findings showed that neither aging method significantly affected the dentin bond strength (P = 0.917). Of the 4 adhesives, Adper Single Bond 2 had the highest bond strength value after aging (P < 0.001). Scotchbond Universal adhesive demonstrated statistically significantly higher bond strength values than Clearfil SE Bond and Prime & Bond 2.1, which had statistically similar values. Adhesive failures at the resin-dentin interface or adhesive failures mixed with cohesive failure of the adjacent substrate predominated in all groups. The 2 aging processes did not result in degradation of the adhesive interface or jeopardize the dentin bond strength of any of the adhesives tested.

Bonding of universal adhesive system to enamel surrounding real-life carious cavities.

This study aimed to evaluate the bond strength of a universal adhesive system to enamel surrounding real-life carious cavities. Twenty-eight permanent molars (n = 7) with carious lesions in dentin were subjected to selective carious tissue removal to firm dentin and had their crowns sectioned longitudinally. A universal adhesive system (Single Bond Universal [SBU] used in either etch-and-rinse and self-etch strategies) was compared with an etch-and-rinse Adper Single Bond 2 (ASB) and a self-etch Clearfil SE Bond (CSE) adhesive systems (control systems). Adhesives were applied on the enamel, assumed demineralized, surrounding the cavity margins and on sound enamel (control substrate). Composite cylinders were built (0.72 mm2) and microshear bond strength (µSBS) test was performed after 24 h of water storage. The µSBS values (MPa) were analyzed using two-way ANOVA and Tukey's post hoc tests (α = 0.05). Bond strength values obtained in demineralized enamel surrounding carious cavity margins were significantly lower than that obtained in sound enamel (distant from carious cavity margins) (p = 0.035). The bonding strategy of the SBU did not influenced the bond strength values, which were higher than that obtained with ASB. CSE showed similar µSBS values to ASB and SBU in the self-etch mode. In conclusion, the bond strength to enamel assumed demineralized is lower than to sound enamel. The enamel surrounding carious cavities jeopardize the bonding of universal adhesive system. The bond strength of universal adhesive is similar, regardless to bonding strategy.

A new defecographic parameter for assessing rectal emptying / Um novo parâmetro defecográfico para avaliar o esvaziamento retal

ABSTRACT Purpose: To validate a new defecographic parameter to assess rectal empyting correlating the percentage of weight reduction of barium paste and the variation in the percentage of area reduction of rectum compared before and after defecation during cinedefecography. Method: Thirty-two consecutive female patients with dyschezia who had clinical indication for cinedefecography were selected. Their median age was 58 years old (18-78 years, mean = 55 years). During cinedefecography, we calculated the cross-sectional sagittal area of the rectum before and after defecation and, thus, the percentage of area reduction of the rectum. The percentage of weight reduction of barium paste was calculated after weighing the contrast injected into the rectum and the amount of contrast evacuated, in grams, using a scale. Finally, both percentages were compared and checked for a correlation between them. Pearson's correlation (r) and Student's t test were used for statistical analysis. Results: A correlation between evacuated barium paste and cross-sectional sagittal area of the rectum at the end of defecation was demonstrated (r = 0.668 and p < 0.0001). Conclusion: It is possible to estimate how much barium paste is evacuated based on the variations in cross-sectional sagittal area of the rectum before and after defecation, in cinedefecography.

RESUMO Objetivo: Validar um novo parâmetro defecográfico para avaliar o esvaziamento retal correlacionando o percentual de redução de peso da pasta baritada e a variação da porcentagem da redução da área do reto antes e depois da evacuação durante o exame de cinedefecografia. Métodos: Foram selecionadas 32 pacientes consecutivas do sexo feminino, portadoras de disquezia, com indicação clínica de investigação por cinedefecografia. A mediana de idade da amostra foi 58 anos (18-78 anos, média de 55 anos). Durante o exame de cinedefecografia, calcularam-se as áreas retais pela secção sagital antes e após a defecação e, assim, o percentual de redução da área retal. O percentual de redução do peso do contraste baritado foi calculado após medidas de peso do contraste injetado no reto e da quantidade de contraste evacuado, em gramas, utilizando uma balança. Por fim, os percentuais foram comparados e verificou-se se havia correlação entre eles. Para análise estatística, foram utilizados correlação de Pearson (r)eT este t de Student. Resultados: Foi observada correlação entre o contraste baritado evacuado e a área retal pela secção sagital ao final da evacuação (r = 0.668; p < 0.0001). Conclusões: É possível estimar o percentual de contraste baritado evacuado através da análise da variação da área retal pela secção sagital antes e após a evacuação, utilizando a cinedefecografia.

Can Endodontic Irrigating Solutions Influence the Bond Strength of Adhesives to Coronal Dental Substrates? A Systematic Review and Meta-Analysis of In Vitro Studies.

PURPOSE: To systematically review the literature to analyze the influence of endodontic irrigating solutions on the bond strength of adhesives to coronal enamel or dentin. MATERIALS AND METHODS: The PubMed/MEDLINE, Web of Science and Scopus electronic databases were used to select laboratory studies related to the research question, without publication year or language limits. From 2461 potentially eligible studies, 2451 were selected for full-text analysis, and 97 were included in the systematic review. Two authors independently selected the studies, extracted the data, and assessed the risk of bias. Pooling bond strength data were calculated using RevMan5.1 with random effects model (α = 0.05), comparing control (no endodontic irrigating solution) and experimental groups (one or more endodontic solutions). RESULTS: No significant difference was found between the control and experimental groups (p = 0.12) in the overall meta-analysis and in the meta-analysis excluding chlorhexidine (p = 0.06). High heterogeneity was found in the meta-analyses. Most included studies in the systematic review were scored as having a high risk of bias. CONCLUSION: The different endodontic irrigating solutions evaluated showed no negative influence on the bond strength of dental adhesives to coronal dental substrates.

Masticatory satisfaction, ability, and performance in partially dentate patients after periodontal therapy / Satisfação, capacidade e performance mastigatória em pacientes parcialmente dentados após terapia periodontal

Introduction: Understanding the effects of periodontal therapy is essential in performance and satisfaction of partially dentate patients. Objective: To assess the effect of subgingival periodontal treatment in performance and masticatory satisfaction and ability as reported by partially dentate patients with untreated chronic periodontitis. Materials and method: Patients were given nonsurgical periodontal treatment and masticatory satisfaction, ability, and performance were evaluated before and after treatment. Performance was assessed based on sieving chewed standardized chewable material, while satisfaction and ability were analyzed using a questionnaire based on OHIP-EDENT. Result: Mean numbers of functional tooth units were 10.36 ± 1.43 anterior and 6.73 ± 0.79 posterior teeth. Masticatory performance did not vary significantly (p = 0.075), and mean particle sizes before and after treatment were 4.23 ± 1.84 mm and 3.90 ± 0.75 mm, respectively. Overall satisfaction and ability scores after treatment were higher (p > 0.05) compared with scores prior to the periodontal intervention. Conclusion: Periodontal treatment improves masticatory satisfaction and ability with no effect on performance.

Introdução: Entender os efeitos da terapia periodontal é fator essencial no desempenho e satisfação de pacientes parcialmente dentados. Objetivo: Avaliar o efeito do tratamento periodontal subgengival na performance ao mastigar e na satisfação e capacidade mastigatória auto-reportadas em pacientes parcialmente dentados. Material e método: Pacientes parcialmente dentados com periodontite crônica não tratada (n=11) receberam tratamento periodontal não-cirúrgico e tiveram a sua satisfação, capacidade e performance mastigatória aferidas antes e após o tratamento. A performance mastigatória foi aferida objetivamente pelo método da peneiragem de um alimento simulado após mastigação seguida da medição do tamanho das partículas. Resultado: A satisfação e a capacidade mastigatória foram mensuradas a partir de um questionário com base no OHIP-EDENT. O número médio de unidades funcionais anteriores foi de 10,36 ± 1,43 e posteriores de 6,73 ± 0,79, sem alterações após o tratamento. A performance mastigatória não apresentou diferença (p = 0,075) (tamanhos de partícula 4,23 ± 1,84 mm e 3,90 ± 0,75 mm antes e após o tratamento periodontal, respectivamente). A satisfação e a capacidade mastigatória apresentaram valores após o tratamento periodontal superiores (p > 0,05) em comparação aos valores prévios aos tratamentos. Conclusão: O tratamento periodontal, considerando a manutenção dos pares funcionais do início do tratamento, promove uma melhoria na satisfação e capacidade mastigatória auto-reportadas, sem afetar a performance mastigatória.

Performance of resin composite restorations in the primary dentition: a retrospective university-based study.

BACKGROUND: Limited data is available on variables influencing the survival of composite restorations in primary teeth. AIM: This retrospective university-based study assessed the survival and risk factors associated with failures of resin composite restorations performed in primary teeth. DESIGN: The sample was composed of 961 restorations from records of 337 patients (178 girls and 159 boys) attended in a university dental clinic. The restorations' longevity up to 48 months of follow-up was assessed using the Kaplan-Meier survival test. Multivariate Cox regression analysis with shared frailty was used to evaluate the factors associated with failures (P < 0.05). RESULTS: Mean survival time was 41.5 months (95% CI: 39.7-43.3), with 70.6% of the restorations surviving after 48 months of evaluation. The overall annual failure rate up to 48 months follow-up was 8.3%. Restorations placed in lower arch had lower survival rate than those in upper arch (HR: 1.82, 95% CI: 1.02-3.28). Restorations involving two or more surfaces had more risk of failure than restorations placed in cavities involving only one surface (HR: 2.55 95% CI: 1.34- 4.83). Girls had less risk of failure in their restorations (HR: 0.43, 95% CI: 0.19-0.96). CONCLUSION: Individual and dental variables such as gender, arch type and number of restored surfaces were associated with failure of composite restorations performed in children under daily life clinical environment.