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1.
Biology (Basel) ; 12(9)2023 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-37759659

RESUMO

BACKGROUND: In this study, wistar rats were used to examine the impact of diet consistency on maxillary and mandibular growth over three generations. METHODS: In this investigation, a breeding sample of 60 female and 8 male wistar rats was used. Measuring was only performed on female animals. The first generation's primary breeding sample consisted of 20 female wistar rats that were 30 days old and 4 male rats that were also 30 days old; two subsequent generations were created from these animals. At the age of 100 days, CBCTs were collected of all male rats. Twenty-eight craniofacial landmarks were selected for the linear measurements on stl format extracted from the DICOM files. A Bonferroni test was performed for the statistical analysis. RESULTS: Means of measurements of all soft diet groups compared to corresponding measurements of the hard diet groups were significantly different. According to linear measurements, there was statistical difference on the maxillary measurements between the soft diet groups of the first and third generation, while the rest did not appear to have any statistical difference. There was significant difference for the mandibular dimensions only when the first generation soft diet group was compared with the third generation soft diet group. CONCLUSIONS: Food consistency has a significant impact on the growth and development of the maxilla and mandible. Soft diet habits may result in retrognathic mandible, and narrower maxilla.

2.
Biomedicines ; 11(5)2023 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-37238945

RESUMO

BACKGROUND: There is a need for clinical markers to aid in the detection of individuals at risk of harboring an ascending thoracic aneurysm (ATAA) or developing one in the future. OBJECTIVES: To our knowledge, ATAA remains without a specific biomarker. This study aims to identify potential biomarkers for ATAA using targeted proteomic analysis. METHODS: In this study, 52 patients were divided into three groups depending on their ascending aorta diameter: 4.0-4.5 cm (N = 23), 4.6-5.0 cm (N = 20), and >5.0 cm (N = 9). A total of 30 controls were in-house populations ethnically matched to cases without known or visible ATAA-related symptoms and with no ATAA familial history. Before the debut of our study, all patients provided medical history and underwent physical examination. Diagnosis was confirmed by echocardiography and angio-computed tomography (CT) scans. Targeted-proteomic analysis was conducted to identify possible biomarkers for the diagnosis of ATAA. RESULTS: A Kruskal-Wallis test revealed that C-C motif chemokine ligand 5 (CCL5), defensin beta 1 (HBD1), intracellular adhesion molecule-1 (ICAM1), interleukin-8 (IL8), tumor necrosis factor alpha (TNFα) and transforming growth factor-beta 1 (TGFB1) expressions are significantly increased in ATAA patients in comparison to control subjects with physiological aorta diameter (p < 0.0001). The receiver-operating characteristic analysis showed that the area under the curve values for CCL5 (0.84), HBD1 (0.83) and ICAM1 (0.83) were superior to that of the other analyzed proteins. CONCLUSIONS: CCL5, HBD1 and ICAM1 are very promising biomarkers with satisfying sensitivity and specificity that could be helpful in stratifying risk for the development of ATAA. These biomarkers may assist in the diagnosis and follow-up of patients at risk of developing ATAA. This retrospective study is very encouraging; however, further in-depth studies may be worthwhile to investigate the role of these biomarkers in the pathogenesis of ATAA.

3.
Biology (Basel) ; 12(4)2023 Apr 07.
Artigo em Inglês | MEDLINE | ID: mdl-37106767

RESUMO

BACKGROUND: This study investigated the effect of diet consistency on mandibular growth of Wistar rats through three generations. METHODS: A total breeding sample of 60 female and 8 male Wistar rats were used in this study. Measurements took place only on female animals. Twenty female Wistar rats at 30 days old and four male rats at 30 days old comprised the primary breeding sample of the first generation, and from these animals two different generations were reproduced. Lateral cephalometric X-rays were taken from all female rats at the age of 100 days. A total of 7 craniofacial landmarks were selected for the linear measurements, and 12 curves and 90 landmarks were selected for geometric morphometric analysis of the lateral X-rays. Bonferroni test and a permutation test were performed for the statistical analysis. RESULTS: Means of measurements of all soft diet groups compared to hard diet groups were significantly smaller. According to linear measurements, there was a significant difference only between the first-generation soft diet with the third-generation soft diet group. According to geometric morphometric analysis, the statistical differences appeared on the condylar process and the angle of the mandible. CONCLUSIONS: The soft diet could be responsible for less mandibular growth, and this information might be passing through generations.

4.
Cureus ; 14(10): e30290, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36381820

RESUMO

INTRODUCTION: Peroxisome proliferator-activated receptors (PPARs) have been proposed as a medical treatment against endometriosis in preclinical and clinical studies. Their effect seems to be triggered through the suppression of angiogenesis. In the present study, we used a transgenic animal model with a loss of expression of PPAR-alpha receptors to examine their effect on the course of surgically induced endometriotic lesions. METHODS: Ten C57BL/6 mice that served as controls and 10 B6;129S4-PPARatm1Gonz/J t transgenic mice characterized by absolute loss of expression of PPAR-alpha receptors were used for induction of endometriosis with a previously described surgical technique. RESULTS: Five animals (50%) exhibited abundant endometriotic crypts in the control group whereas only one (10%) animal in the transgenic experimental group had a similar pathological image. Neo-vascularization significantly differed among the two groups (p=0.034) favoring the control group as it was extremely limited in half of the PPAR-alpha null animals. The median inflammation score was 2.5 (1-4) in the P B6;129S4-PPARatm1Gonz/J group, whereas it was minimal, 1 (0-2), in the C57BL/6 group. However, these differences were not statistically significant (p=0.101). The fibroblastic activity was also very limited in the PPAR-alpha-deficient model, whereas animals belonging to the control group exhibited an intermediate increase of this index (p=0.022). CONCLUSION: Surgically induced endometriotic implants in animals with loss of expression of PPAR-alpha receptors exhibit significant differences in their pathology compared to lesions induced in control animals. This information suggests that PPAR-alpha receptors have a significant impact on the course of the disease, indicating that they may serve as potential targets for future medical therapies.

5.
Biology (Basel) ; 11(6)2022 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-35741424

RESUMO

BACKGROUND: Our study intended to investigate the null hypothesis that there is no effect of diet consistency on rat mandibular growth. METHODS: A total sample of 24 female wistar rats, 30 days old, was used in this study. In the first group, the rats were fed soft diet and in the second group, they were fed hard diet for 60 days. On the 60th day, the rats were sedated and lateral cephalometric X-rays were taken. Lateral cephalometric X-rays were digitized with 7 craniofacial landmarks for the linear measurements, as well as with 12 curves and 90 landmarks, of which 74 were semilandmarks and 16 were fixed landmarks for morphometric analysis. These landmarks were exposed to Procrustes superimposition and Principal Component Analysis (PCA) to describe the shape variability of the mandible. RESULTS: Means measurements of the soft diet group compared to those of the hard diet group were significantly different in linear and morphometric analysis measurements. The soft diet group of wistar rats revealed significant changes on the condyle (smaller), the angle of the mandible, and on the body of the mandible. CONCLUSIONS: Diet consistency affects the craniofacial growth of rats. Soft diet could be responsible for less mandibular growth.

7.
Ann Vasc Surg ; 64: 355-360, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31626928

RESUMO

BACKGROUND: Paraoxonase-1 (PON-1) is a high-density lipoprotein (HDL)-associated hydrolase that appears to have a protective action against atherosclerosis. The aim of our study is to identify whether PON-1 levels may be associated with the manifestation of symptoms in patients with carotid artery stenosis. METHODS: We studied all patients who underwent carotid endarterectomy in the Vascular Surgery Department of Laikon Hospital, Athens, Greece, from July 2012 to July 2014. Medical history was recorded and PON-1 glucose, total cholesterol, HDL cholesterol, low-density lipoprotein cholesterol, and triglycerides levels were measured. Variables were compared between symptomatic and asymptomatic patients. A receiver operating characteristic (ROC) curve was constructed to evaluate the accuracy of PON-1 to predict symptoms. RESULTS: A total of 74 patients were included, 41 were asymptomatic and the mean age was 68.5 years. The 2 groups appear to differ significantly with regards to the PON-1 levels, with the symptomatic group showing lower levels (5.3 ± 1.19 vs. 4.6 ± 1.36 ng/mL; P = 0.025). ROC analysis demonstrated an area under the curve of 0.654 (P = 0.023). CONCLUSIONS: Reduced PON-1 levels showed a significant association with symptomatic status, which was independent of other traditional cardiovascular factors. Further studies are required to prospectively assess the role of PON-1 in predicting cerebrovascular events in patients with carotid artery disease.


Assuntos
Arildialquilfosfatase/sangue , Estenose das Carótidas/sangue , Idoso , Doenças Assintomáticas , Biomarcadores/sangue , Glicemia/análise , Estenose das Carótidas/complicações , Estenose das Carótidas/diagnóstico , Estenose das Carótidas/cirurgia , Estudos Transversais , Regulação para Baixo , Endarterectomia das Carótidas , Feminino , Humanos , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade
8.
Med Hypotheses ; 133: 109414, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31586810

RESUMO

Endometriosis is a common gynecological disorder that affects approximately 6-10% of the female population impairing the quality of life of patients. Several pathophysiologic pathways have been proposed as potential regulators of its severity; however, to date, the processes that trigger the onset and that influence the severity of the disease are not fully understood; hence, leading to disease recurrence in approximately 10-67% of cases. Cyclin-dependent kinase inhibitor 1 (p21/WAF1) is a protein that is a major target of p53 and is related to cell cycle arrest (it regulates transition from the G1 to the S phase) when DNA damage is detected. Its activity has been also linked to the angiogenic potential of tumors as it promotes the expression of various kinases that are responsible for endothelial development and function. Although several articles have underlined the importance of this protein in cancer cell development and tumor growth, there are no relevant data in the field of endometriosis. Indirect evidence suggests, however, that it may be involved in the pathogenesis of endometriosis as it inhibits the activity of various kinases which have been correlated with the course and severity of the disease. The present article investigates the background theory that implies the potential role of cyclin-dependent kinase inhibitor 1 (p21/WAF1) in the pathogenesis of endometriosis. Implications for future research are also provided given that indirect evidence seem to associate downregulation of p21 with decreased growth and invasiveness of human endometrial stromal cells.


Assuntos
Inibidor de Quinase Dependente de Ciclina p21/fisiologia , Endometriose/etiologia , Animais , Antineoplásicos/farmacologia , Antineoplásicos/uso terapêutico , Apoptose , Ciclo Celular , Inibidor de Quinase Dependente de Ciclina p21/antagonistas & inibidores , Inibidor de Quinase Dependente de Ciclina p21/deficiência , Modelos Animais de Doenças , Progressão da Doença , Desenho de Fármacos , Endometriose/metabolismo , Feminino , Previsões , Humanos , Camundongos , Camundongos Transgênicos , Proteínas de Neoplasias/fisiologia , Neoplasias/irrigação sanguínea , Neoplasias/tratamento farmacológico , Neovascularização Patológica/fisiopatologia
9.
Exp Ther Med ; 14(3): 2415-2423, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28962175

RESUMO

Autologous fat is considered the ideal material for soft-tissue augmentation in plastic and reconstructive surgery. The primary drawback of autologous fat grafting is the high resorption rate. The isolation of mesenchymal stem cells from adipose tissue inevitably led to research focusing on the study of combined transplantation of autologous fat and adipose derived stem cells (ADSCs) and introduced the theory of 'cell-assisted lipotransfer'. Transplantation of ADSCs is a promising strategy, due to the high proliferative capacity of stem cells, their potential to induce paracrine signalling and ability to differentiate into adipocytes and vascular cells. The current study examined the literature for clinical and experimental studies on cell-assisted lipotransfer to assess the efficacy of this novel technique when compared with traditional fat grafting. A total of 30 studies were included in the present review. The current study demonstrates that cell-assisted lipotransfer has improved efficacy compared with conventional fat grafting. Despite relatively positive outcomes, further investigation is required to establish a consensus in cell-assisted lipotransfer.

11.
Biomed Rep ; 6(5): 513-518, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28529733

RESUMO

Non-alcoholic fatty liver disease (NAFLD) is the result of the accumulation of adipose tissue deposits in the liver and it is associated with type 2 diabetes. Crocus sativus (saffron) is known for its antioxidant and its potential hypoglycemic effects. We investigated the role of saffron on NAFLD in diabetic rats. Thirty adult male rats were allocated into three groups; control (n=10), which received normal diet; streptozotocin (STZ) group (n=10), which received normal chow diet, 10% fructose in their drinking water and STZ (40 mg/kg body weight; STZ-saffron group (n=10), which followed the same dietary and pharmacological pattern as STZ group and were additionally supplemented with saffron (100 mg/kg/day). Metabolic profile was measured and histopathological examination of the liver was evaluated. STZ group exhibited the highest glucose levels at the end of the experiment (P<0.05), while there was no difference between control and STZ-saffron group (584 vs. 213 mg/dl vs. 209 mg/dl, respectively). STZ group revealed higher percentage of steatosis (5-33%) when compared to the other two groups (P<0.005). Saffron exhibits both hypoglycemic and hepatoprotective actions. Yet, further studies enlightening the exact mechanisms of saffron's mode of actions are required.

12.
Biomed Rep ; 5(4): 403-407, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27699005

RESUMO

Inflammatory bowel diseases (IBD) are chronic intestinal disorders caused by a number of factors, including external influences, intestinal microbiota and genetics. The two major clinically defined types of IBD are Crohn's disease and ulcerative colitis, each of which is characterized by relapses in the clinical course, thus patients must be under constant observation via regular endoscopies. As endoscopy, which has been used for direct evaluation and diagnosis of IBD, requires uncomfortable and expensive bowel preparation, a non-invasive test was required to reduce the number of patients undergoing unnecessary endoscopy. Calprotectin is a protein occurring in the cytosol of inflammatory cells and is released by the activation of leukocytes. As it is elevated and stable in the faeces of patients with IBD and can be reliably detected in faecal samples of <5 g, it may serve as an inexpensive, non-invasive diagnostic method for IBD. This is explored in the following review.

13.
Biomed Rep ; 5(6): 667-674, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28101339

RESUMO

The aim of the present study was to investigate the potential antiatherosclerotic activities of simvastatin in rabbits. Twenty-two, male, New Zealand rabbits were divided into the following groups: Control group (group C); cholesterol group (group A), in which the rabbits were fed a commercial rabbit chow supplemented with 0.5% w/w cholesterol for 8 weeks and then fed with normal chow for an additional 8 weeks; and a treatment group (group B), in which the rabbits initially received standard commercial rabbit chow along with being administered simvastatin for 8 weeks, following which they consumed a high-cholesterol diet for a further 8 weeks. The rabbits pre-treated with simvastatin presented significantly lower serum cholesterol and low-density lipoprotein cholesterol levels when compared with the non simvastatin-treated cholesterol-fed animals. Furthermore, none of the rabbits in the simvastatin group presented with atherosclerotic lesions in the aorta. Thus, simvastatin was demonstrated to exhibit preventive properties against the formation of atherosclerosis in the atherosclerosis model in the current study, predominantly via its hypolipidemic activity.

14.
Case Rep Vasc Med ; 2014: 780561, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25221686

RESUMO

Popliteal artery aneurysms (PAAs) are rare in general population but represent the second most common peripheral arterial aneurysms following those located in the aortoiliac segment. They usually affect men over 60 years old with established cardiovascular disease caused by atherosclerosis. Other more unusual conditions such as trauma, congenital popliteal aneurysm, mycotic aneurysm, inflammatory arteritis, or popliteal entrapment are responsible. The authors report the first ever case of a male diagnosed with chronic renal failure with giant popliteal artery aneurysm. We have successfully resected the aneurysm and revascularized with synthetic graft.

15.
In Vivo ; 26(2): 243-50, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22351665

RESUMO

BACKGROUND: Members of the immunoglobulin superfamily of endothelial adhesion molecules, vascular cell adhesion molecule (VCAM-1) and intercellular cell adhesion molecule (ICAM-1), participate in leukocyte adhesion to the endothelium and play an important role in all stages of atherosclerosis. The aim of the study was to examine the expression of VCAM-1 and ICAM-1 in the aorta of rats at the early stages of atherosclerosis and the correlation with their plasma concentrations. MATERIALS AND METHODS: Male rats (n=44), 10 weeks of age, were divided in 4 groups. Groups A and C (n=12) were fed with rich cholesterol diet for 12 and 16 weeks, respectively. Group B (regression group, n=12) was fed for the first 12 weeks with rich cholesterol diet and for another 4 weeks with normal diet. Group D (control group, n=8) was fed with normal diet for 12 weeks. We measured the serum lipid profile, the concentration of soluble ICAM-1 and the immunohistochemical expression of ICAM-1 and VCAM-1 in the endothelium, media and vasa vasorum of the aorta. RESULTS: There were significant differences (p<0.05) in the expression of ICAM-1 between group C (maximum time of rich cholesterol diet) and all other groups in the 3 groups of the aorta studied. There was regression of the expression of ICAM-1 in group B and significant differences (p<0.05) between group B and all the other groups, except group D in the expression of ICAM-1. There were no significant differences in the expression of VCAM-1 between any groups. The serum concentration of soluble ICAM-1 positively correlated with the expression of the molecule in the vasa vasorum (r=0.35, p<0.05) and fibroblasts/smooth muscular cells (r=0.34, p<0.05) of the aorta. CONCLUSION: A cholesterol diet plays a role in the expression of ICAM-1 but not in that of VCAM-1 in the rat aorta. The expression of ICAM-1 in the aorta regresses after the withdrawal of a cholesterol-rich diet. Soluble ICAM-1 is a reliable measure of ICAM-1 expression in the aorta, vasa vasorum and fibroblasts/smooth muscle cells.


Assuntos
Doenças da Aorta/metabolismo , Aterosclerose/metabolismo , Colesterol na Dieta/toxicidade , Dieta Hiperlipídica/efeitos adversos , Regulação da Expressão Gênica , Molécula 1 de Adesão Intercelular/biossíntese , Molécula 1 de Adesão de Célula Vascular/biossíntese , Animais , Doenças da Aorta/etiologia , Doenças da Aorta/patologia , Aterosclerose/dietoterapia , Aterosclerose/etiologia , Aterosclerose/patologia , Colesterol na Dieta/administração & dosagem , Dieta com Restrição de Gorduras , Endotélio Vascular/metabolismo , Fibroblastos/metabolismo , Molécula 1 de Adesão Intercelular/sangue , Molécula 1 de Adesão Intercelular/genética , Lipídeos/sangue , Masculino , Miócitos de Músculo Liso/metabolismo , Distribuição Aleatória , Ratos , Ratos Wistar , Solubilidade , Vasa Vasorum/metabolismo , Molécula 1 de Adesão de Célula Vascular/sangue , Molécula 1 de Adesão de Célula Vascular/genética
17.
Vascular ; 18(3): 162-5, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20470688

RESUMO

Persistent sciatic artery (PSA), a persistent embryologic continuation of the internal iliac artery, represents a rare yet clinically important vascular anomaly. PSA is prone to aneurysmal change, which can subsequently lead to distal embolization, sciatic neuropathy, or rupture. The conventional surgical treatment of PSA aneurysms is commonly complex and carries the risk for sciatic nerve damage. We report herein the successful endovascular management of a PSA aneurysm and postaneurysmal stenosis with the use of two overlapping self-expanding stent-grafts via a contralateral transfemoral approach. Additionally, a review of the literature regarding the treatment of these unusual peripheral aneurysms is provided.


Assuntos
Aneurisma/cirurgia , Artéria Ilíaca/cirurgia , Extremidade Inferior/irrigação sanguínea , Malformações Vasculares/complicações , Aneurisma/diagnóstico por imagem , Aneurisma/etiologia , Angioplastia , Arteriopatias Oclusivas/complicações , Arteriopatias Oclusivas/terapia , Prótese Vascular , Implante de Prótese Vascular/instrumentação , Constrição Patológica , Humanos , Artéria Ilíaca/anormalidades , Artéria Ilíaca/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Radiografia , Stents , Resultado do Tratamento , Malformações Vasculares/diagnóstico por imagem
18.
Cases J ; 2: 8525, 2009 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-19918379

RESUMO

INTRODUCTION: Cardiac amyloidosis is a manifestation of several systemic diseases known as amyloidoses. Arterial thromboembolic complications have not been reported to occur frequently, although the pathophysiology of cardiovascular amyloidosis would theoretically predispose to such manifestations. CASE PRESENTATION: We present the case of a 52-year-old woman, who suffered from cardiac amyloidosis and was admitted to our hospital for left acute limb ischemia. An urgent embolectomy was performed, improving her clinical condition and the pathologoanatomic examination of the embolus revealed deposition of amyloid. CONCLUSION: Peripheral arterial thromboembolic events in patients with amyloidosis are rare. An antiplatelet treatment is recommended in such patients with cardiac amyloidosis for the prevention of embolism.

19.
J Endovasc Ther ; 16(5): 567-76, 2009 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-19842737

RESUMO

PURPOSE: To present performance data on the use of the Aorfix stent-graft in patients with hostile infrarenal abdominal aortic aneurysm (AAA) anatomy. METHODS: A study protocol was designed to examine the safety and efficacy of the Aorfix endovascular stent-graft in AAA patients who had a proximal neck diameter between 18 and 30 mm, neck angulation between 60 degrees and 90 degrees , and/or severe iliac artery angulation/tortuosity. Between September 2005 and April 2009, 20 men (mean age 72.4+/-7.7 years, range 55-89) were enrolled in the study. The mean AAA diameter was 61.8+/-14.9 mm (range 45.5-102). The mean angulation of the proximal neck was 61.9 degrees +/-16.5 degrees (range 30 degrees -90 degrees ); in the iliac arteries, the angulation was 59.9 degrees +/-16.3 degrees (range 30 degrees -85 degrees ) for the left and 60.9 degrees +/-17.6 degrees (range 28 degrees -90 degrees ) on the right. Fourteen (70%) patients had >60 degrees proximal neck angulation. Outcome measures were analyzed using life-table analysis. RESULTS: The graft was successfully implanted in all but 1 patient (technical success 95%); failure to cannulate the contralateral iliac limb resulted in conversion to aortomonoiliac stent-graft placement. In 1 patient, bilateral renal artery stent rescue was performed due to severe procedure-related stenosis. Occlusion of an internal iliac artery was noted in 2 patients. Mean follow-up was 26.9 months (range 4.5-43.5). No aneurysm-related rupture or death occurred. Two endoleaks were observed: 1 type I without migration at 3 years and 1 type II at 13 months. Freedom from any type of endoleak was 91.6% at 1 year and 75.9% at 2 years. Freedom from any early or late intervention was 88.8% at 1 year and 76.0% at 2 years. Aneurysm sac shrinkage (>5 mm) was evident in 79% (11/14) of the cases reaching 12-month follow-up. CONCLUSION: The Aorfix device seems to be safe and reliable in purely complex infrarenal AAA anatomy, demonstrating good short and midterm clinical outcomes. Further larger or multicenter studies are needed to confirm the suitability of the Aorfix stent-graft in hostile infrarenal AAA anatomy.


Assuntos
Aneurisma da Aorta Abdominal/cirurgia , Aortografia/métodos , Implante de Prótese Vascular/instrumentação , Prótese Vascular , Artéria Ilíaca/diagnóstico por imagem , Stents , Tomografia Computadorizada por Raios X , Idoso , Idoso de 80 Anos ou mais , Aneurisma da Aorta Abdominal/diagnóstico por imagem , Implante de Prótese Vascular/efeitos adversos , Bases de Dados como Assunto , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estudos Prospectivos , Desenho de Prótese , Falha de Prótese , Reoperação , Medição de Risco , Fatores de Tempo , Resultado do Tratamento
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