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2.
J Prosthet Dent ; 2020 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-31987585

RESUMO

STATEMENT OF PROBLEM: There is a need to quantitatively differentiate between impaired and normal mastication by using straightforward and reliable methods because currently available methods are expensive, complex, and time-consuming. PURPOSE: The purpose of this clinical study was to assess the reliability, validity, and clinical utility of a new Web-based software program designed to calculate masticatory performance, the Chewing Performance Calculator (CPC) measuring masticatory performance (MP), by analyzing the area of mixed bicolored chewing gum. MATERIAL AND METHODS: One hundred and ten participants were consecutively recruited from the School of Dentistry of the University of Salamanca. MP was determined by using 2-colored chewing gum that was masticated for a total of 20 strokes. The masticated gum was then flattened between 2 transparent glass tiles, generating a 1-mm-thick specimen that was scanned to calculate the percentage of area where the 2 colors were mixed. The area was calculated by using a photo-editing software program as described by Schimmel et al (gold standard method). In addition, all the images were analyzed by using the CPC Web application, which took as input the image of the masticated bolus enclosed in a customized plastic platen that allowed 3 parts of the image to be selected interactively: the platen, the bolus background, and the mixed color fraction of the bolus. The application then computed MP as a percentage. Additionally, an oral examination was carried out to record the number of occlusal units. These data were used to assess the validity of CPC by using the Pearson correlation coefficient. Construct validity was assessed by using ANOVA by comparing the MP scores obtained for masticated gums, classified upon inspection as being poorly, moderately, or highly mixed. The time spent evaluating the specimens with GSM and CPC methods was also recorded and used to indicate the usefulness of the procedure. RESULTS: The MP was found to range between 5.2% and 100% (95% CI: 80.8-88.8) with the GSM and between 9.2% and 96.4% (95% CI: 60.0-67.6) with the CPC. The time needed to calculate MP by using the GSM was significantly higher (235.2 versus 260.5 seconds) than that with the CPC (42.3 to 48.6 seconds). Both methods were significantly intercorrelated (r=0.65; P<.001) and correlated with the number of occlusal units (r=0.54 for CPC and r=0.40 for GSM). The correlation coefficient of MP calculated by using CPC (r=0.54; P<.001) was greater than that calculated by using GSM (r=0.40; P<.001). Moreover, both methods showed adequate construct validity because the values calculated for MP significantly increased as the mixing of the masticated gums also increased, subjectively classified as poor, moderate, and high. CONCLUSIONS: The CPC software allowed MP to be determined in a valid and easy-to-use manner by using 2-colored chewing gum.

3.
Medicina (Kaunas) ; 56(2)2020 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-31972958

RESUMO

Background and Objectives: Maxillary bone defects related to post-extraction alveolar ridge resorption are usual. These defects may lead to failure in further surgical implant phases given the lack of bone volume to perform the dental implant. The objective of this clinical assay was to evaluate the safety and efficacy of an experimental synthetic bone substitute in the preservation of post-extraction maxillary alveoli. Materials and Methods: 33 voluntary patients who had at least one maxillary premolar tooth that was a candidate for exodontia (n = 39) and subsequent implant rehabilitation participated. The regenerated alveoli were monitored by means of periodic clinical examinations (days 9 ± 1, 21 ± 4, 42 ± 6, and 84 ± 6), measuring the height and width of the alveolar crest (days 0 and 180 ± 5), measurement of radiodensity using tomographic techniques (days 0-5 and 175 ± 5), and histological examination of biopsies collected at 180 ± 5 days. Results: No significant differences were observed during the entire follow-up period between the two groups with respect to the safety variables studied. A variation in width of -0.9 ± 1.3 mm and -0.6 ± 1.5 mm, and a variation in height of -0.1 ± 0.9 mm and -0.3 ± 0.7 mm was observed for experimental material Sil-Oss® and Bio-Oss®, respectively. The radiodensity of the alveoli regenerated with the experimental material was significantly lower than that corresponding to Bio-Oss®. However, the histological study showed greater osteoid matrix and replacement of the material with newformed bone in the implanted beds with the experimental material. Conclusions: Both materials can be used safely and proved equally effective in maintaining alveolar flange dimensions, they are also histologically biocompatible, bioactive and osteoconductive. The experimental material showed the advantage of being resorbable and replaced with newformed bone, in addition to promoting bone regeneration.

4.
Sci Rep ; 10(1): 1175, 2020 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-31980715

RESUMO

Thrombospondin-1 (TSP-1) is a multifunctional matrix protein with antitumor activities due in part to its ability to inhibit angiogenesis, which in turn contributes to determine the fate of many tumours. Previous studies have shown that TSP-1 expression supports normal kidney angiostasis, and decreased TSP-1 levels contribute to the angiogenic phenotype of renal cell carcinomas (RCC). The loss of the von Hippel-Lindau tumour suppressor gene (VHL) in these tumours favours stabilization of the Hypoxia Inducible Factors (HIF), which in turn contribute to adapt tumour cells to hostile environments promoting tumour progression. However, HIF-independent regulation of certain genes might also be involved. We have previously shown that TSP-1 is regulated in hypoxia in clear cell RCC (ccRCC) in a HIF-independent manner; however, the effect of VHL protein (pVHL) on TSP-1 expression has not been evaluated. Our results proved that pVHL loss or mutation in its alpha or beta domain significantly decreased TSP-1 levels in ccRCC in a HIF-independent manner. Furthermore, this regulation proved to be important for ccRCC cells behaviour showing that decreased TSP-1 levels rendered ccRCC cells more migratory. This data substantiates a unique regulation pattern for TSP-1 in a pVHL-dependent manner, which may be relevant in the aggressiveness of ccRCC.

5.
Materials (Basel) ; 12(21)2019 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-31690054

RESUMO

This study shows the effects of wear on welded joints of ASTM A355 Gr. P11 "Seamless Ferritic Alloy-Steel Pipe for High Temperature Service" steels subjected to the welding procedures established by codes B31.1 and ASME III. The standard welding procedure establishes the following steps: a preheating process, welding and post-weld heat treatment. This generates a wear behavior that depends on the thermal cycles to which the different areas of the joint are subjected. The objective of this article was the study of the behavior against the flow-accelerated corrosion of the welded joints of a low alloy steel. There is the possibility of establishing welding procedures other than those established, while maintaining the safety ranges, depending on the field of application for the steel.

6.
J Adv Prosthodont ; 11(5): 239-246, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31754413

RESUMO

PURPOSE: The purpose of this study was to propose and assess a shade guide for pink gingival aesthetics using a Spanish population sample. MATERIALS AND METHODS: The L*, C*, h, a* and b* coordinates of 259 participants were measured using a spectrophotometer in 3 standardized points along the attached gingiva of the maxillary central incisors. A hierarchical clustering analysis was applied to obtain separate solutions regarding the number of shade tabs. For each of the solutions obtained, color differences (ΔE*) were calculated using the CIELab and CIEDE2000 formulas, and the proposed shade guide was selected considering (1) the color differences between tabs and (2) the coverage error of each of the solutions. RESULTS: The proposed shade guide consisted of 8 gingival shade tabs and achieved CIELab and CIEDE2000 coverage errors of less than the respective 50:50% acceptability thresholds (ΔE*=4.6 units and ΔE00=4.1). The coordinates for the various gingival shade tabs were as follows: Tab 1: L*43.3, a*21.9, b*12.3 (1.6); Tab 2: L*42.9, a*34.1, b*19.1; Tab 3: L*46.5, a*25.8, b*10.9; Tab 4: L*46.5, a*27.3, b*15.1; Tab 5: L*49.6, a*23.5, b*16.8; Tab 6: L*51.5, a*19.7, b*13.6; Tab 7: L*55.9, a*22.0, b* 15.0; and Tab 8: L*56.0, a*19.9, b*18.8. CONCLUSION: The CIELab and CIEDE2000 coverage errors for the 8 shade tabs of the proposed gingival shade guide were significantly lower than those of other guides. Therefore, despite the limitations of this study, the proposed guide is more appropriate for matching gingival shade in the Spanish general population.

7.
J Prosthet Dent ; 2019 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-31383527

RESUMO

STATEMENT OF PROBLEM: Improvement in the masticatory function after replacing missing teeth is one of the main expected outcomes that need to be comprehensively measured with both clinical and patient-centered assessments. An evaluation of the responsiveness of these methods is lacking. PURPOSE: The purpose of this clinical study was to assess the responsiveness of both objective and subjective methods for measuring the impact of different conventional prostheses on masticatory function at prosthesis delivery and 2 months later. MATERIAL AND METHODS: Participants (N=118) requiring prosthetic rehabilitation were selected from patients attending the Faculty of Dentistry of the University of Salamanca. Masticatory function was assessed by means of subjective methods (self-rated ordinal scales, visual analog scale, and food intake ability questionnaire) at baseline and 2 months after treatment. The ability to mix 2-colored chewing gum after 5, 10, and 15 cycles was also evaluated objectively. The responsiveness of each method was categorized by the effect size (ES) as low (<0.5), moderate (0.5 to 0.8), or large (>0.8). RESULTS: The study revealed that in all subgroups, the masticatory function improved 2 months after the treatment. The most responsive method was the visual analog scale (ES: 1.2) and the number of pattern foods perceived to be easily masticated by participants (ES: 0.7 to 1.3). By contrast, the masticatory performance assessed by using the mixing ability test showed a smaller magnitude of change (ES: 0.3 to 0.7). Both the objective and subjective masticatory functions were coherently correlated with age and clinical variables (number of occlusal units or the Eichner index) in all subgroups. However, masticatory performance and masticatory ability were not significantly correlated (r=0.22; P=.12). CONCLUSIONS: Conventional prosthetic treatments significantly improve masticatory function 2 months after delivery, and the subjective methods were the most responsive in assessing changes in participants.

8.
Front Immunol ; 10: 1268, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31214201

RESUMO

Accumulating evidence on the role of Thrombospondin-1 (TSP-1) in the immune response has emerged during the last years. In spite of the importance of TSP-1 not only as anti-angiogenic factor but also as an immunomodulatory molecule, studies on the role of TSP-1 in psoriasis have been neglected. TSP-1 and CD47 expression were analyzed in skin samples from psoriasis patients and control subjects using RT-PCR and immunofluorescence. Expression of these molecules was also evaluated in peripheral blood CD4+ T cells, moDCs, and circulating primary DCs. The functional role of TSP-1/CD47 signaling axis in psoriasis was assessed in Th17 and Treg differentiation assays. Additionally, small interfering RNA assays specific to TSP-1 were performed in CD4+ T cells and monocyte derived DC to specifically evaluate the function of this protein. Lesional skin of psoriasis patients expressed lower TSP-1 and CD47 mRNA levels compared to non-lesional skin or skin from controls. Immunofluorescence staining revealed decreased expression of CD47 in CD45+ dermal cells from psoriasis samples compared to control subjects. Peripheral CD4+ T cells and circulating primary DCs from psoriasis also expressed lower levels of CD47 compared to controls. Although no significant differences were detected in TSP-1 expression in CD4+ T cells and moDCs between patients and controls, TSP-1 expression in psoriasis patients inversely correlated with disease activity evaluated by the Psoriasis Area and Index Activity. Furthermore, exogenous TSP-1 inhibited Th17 differentiation and stimulated the differentiation of CD4+ T cells toward Treg cells. Furthermore, RNA interference specific for TSP-1 confirmed the role of this molecule as a negative regulator of T cell activation. Because of the impact of TSP-1/CD47 signaling axis in Th17 and Treg differentiation, a dysregulated expression of these molecules in the immune cells from psoriasis patients may favor the exacerbated inflammatory response in this disease.

9.
Odontology ; 107(3): 383-392, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30648197

RESUMO

This research aims to evaluate changes in Oral Health-related Quality of Life (OHQoL) by means of the Oral Impacts on Daily Performances (OIDP) of patients treated with three distinct implant strategies. This clinical trial consisted of an oral examination and a questionnaire-based interview carried out before and after the definitive prosthetic rehabilitation in a consecutive sample of patients requiring dental implants. According to the clinical diagnosis and patient preference, patients were assigned to the one of the following groups: the conventional group (CGCL; n = 40), where implants were inserted without guiding and conventionally loaded; to the guided surgery but conventional loading group (GSCL; n = 35); or to the guided surgery and immediate loading group (GSIL; n = 29). At baseline, the OHQoL was significantly greater among those assigned to CGCL (2.4 ± 1.3) than those assigned to GSCL (3.3 ± 1.3), which were both greater than those patients assigned to GSIL (4.6 ± 2.0). After implant therapy, the oral well-being was significantly better than at baseline, and patient satisfaction was greater when the implants were loaded immediately (8.7 ± 1.1) than if the prosthetic rehabilitation was delayed (8.3 ± 1.1). In the GSIL group, the effect size of the OIDP exceeded the threshold value of 0.8 for all of the OIDP domains and for the total OIDP score and patient satisfaction. A global improvement in the OHQoL scores and patient satisfaction was observed after implant therapy, but the change was markedly greater in the GSIL group.


Assuntos
Implantes Dentários , Carga Imediata em Implante Dentário , Implantação Dentária Endo-Óssea , Prótese Dentária Fixada por Implante , Seguimentos , Humanos , Saúde Bucal , Qualidade de Vida , Resultado do Tratamento
10.
J Prosthet Dent ; 121(5): 791-796, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30598312

RESUMO

STATEMENT OF PROBLEM: Clinicians are aware that the vertical dimension of occlusion and the interocclusal rest space (IRS) are 2 major factors that require consideration in the management of patients needing oral reconstructive procedures. However, how the dimensions vary with age and prosthetic status is unclear. PURPOSE: The purpose of this clinical study was to analyze the IRS in dentate, partially edentulous, and completely edentulous participants using both conventional and electromyographic (EMG)-based methods. The effect of age and prosthodontic status on the clinical and EMG assessment of the IRS was also explored. MATERIAL AND METHODS: The IRS was determined for a group of dentate (n=31) and partially edentate (n=31) participants, as well as a group of completely edentulous (n=31) participants who had worn dentures for at least 10 years before participating in the study. Clinical and EMG-based assessments (monitoring both elevator and depressor activity) were carried out using 5 different methods: rest, relaxing mask, phonetics, deglutition, and myobalance. Bivariate and multivariate analyses (forward stepwise linear regression models) were performed to compare the effect of age and prosthodontic status on the IRS (α=.05). RESULTS: The average IRS values obtained from clinical and EMG-based assessments were significantly greater among dentate participants (2.8 ±0.4 mm and 3.6 ±0.6 mm, respectively) than partially edentulous (1.9 ±0.5 mm and 2.6 ±0.5 mm) and completely edentulous participants (1.4 ±0.5 mm and 2.2 ±0.6 mm). The IRS values obtained using the 5 methods of clinical assessment were statistically smaller than those obtained by EMG. Correlation and regression analyses showed that age and extended edentulism significantly decreased the IRS. For the IRS determined clinically, a decrease was found of 0.01 to 0.02 mm/year, based on the age of the participant. However, this decrease became greater (0.05 to 0.6 mm) where the participant had changed from being dentate to partially edentulous and partially edentulous to completely edentulous. CONCLUSIONS: The IRS becomes significantly smaller in relation to age and denture extension. The rest position in the clinical examination was located cranial to the position used to make the EMG-based measurement. Small but significant differences were found between the IRS values obtained in the clinical and EMG-based methods of assessment in all the prosthetic groups.


Assuntos
Prótese Total , Boca Edêntula , Planejamento de Dentadura , Humanos , Prostodontia , Dimensão Vertical
11.
Med. oral patol. oral cir. bucal (Internet) ; 24(1): e20-e25, ene. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-180402

RESUMO

Background: To improve eradication strategies of health-compromising behaviors between oral cancer survivors, this study aimed to explore the extent of clustering of risk behaviors and to assess possible factors associated. Material and Methods: A cross-sectional study was carried out among oral cancer patients at least 6 months after treatment. They completed a questionnaire about smoking, alcohol consumption, oral hygiene habits and dental visits. Presence of clusters was evaluated through pairwise Pearson correlations and principal component analysis. Factors associated with each identified cluster were analyzed with multivariate models. Results: Among 142 patients, 14.8% smoked, 51.7% consumed alcohol, 52.1% performed oral hygiene less than twice a day, and 74.6% visited to dentist when there was a problem or never. There were two distinct clusters: smoking-alcohol consumption (general risk behaviors cluster) and oral hygiene-dental attendance (oral risk behaviors cluster). Multivariate analysis showed significant associations between males and both clustering patterns of health compromising behaviors, patients with clinical stage I or with longer follow-up and the presence of general risk behaviors cluster and worse social class and the presence of oral risk behaviors cluster. Conclusions: A high proportion of patients treated for oral cancer presented health-compromising behaviors occurring in clusters which reinforce the need for health promotion strategies to target multiple behaviors. Factors analyzed suggest that chances of having detrimental behavioral clustering are higher in male, patients with clinical stage I, with lower social class and those with longer follow-up after treatment


No disponible


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Neoplasias Bucais/terapia , Cooperação do Paciente/estatística & dados numéricos , Comportamentos Relacionados com a Saúde , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Neoplasias Bucais/epidemiologia , Pacientes Desistentes do Tratamento/estatística & dados numéricos , Adesão à Medicação/estatística & dados numéricos , Sobreviventes/estatística & dados numéricos
12.
Odontology ; 107(1): 80-89, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29845402

RESUMO

The aims of the study were: to describe the gingival color surrounding the upper incisors in three sites in the keratinized gingiva, analyzing the effect of possible factors which modulate (socio-demographic and behavioral) intersubject variability; to study whether the gingiva color is the same in all three locations and to describe intrasubject color differences in the keratinized gingiva band. Using the CIELAB color system, three reference areas (free gingival margin, keratinized gingival body, and birth or upper part of the keratinized gingiva) were studied in 259 individuals, as well as the related socio-demographic factors, oral habits and the chronic intake of medication. Shadepilot™ spectrophotometer was used. Descriptive and inferential statistical analysis was performed. There are statistically significant differences between males and females for coordinates L* and a* in the middle and free gingival margin. For the b* coordinate, there are differences between males and females in the three locations studied (p < 0.05). The minimum and maximum coordinates in which the CIELAB natural gingival space is delimited are L* minima 28.3, L* maximum 65.4, a* minimum 11.1, a* maximum 37.2, b* minimum 6.9, and b* maximum 25.2*. Age, smoking, and the chronic intake of medication had no significant effect on gum color. There are perceptible color differences within the keratinized gingiva band. These chromatic differences must be taken into account if the prosthetic characterization of gingival tissue is to be considered acceptable. There are significant differences between the color coordinates of the three sites studied in the keratinized gingiva of men and women.


Assuntos
Cor , Gengiva/anatomia & histologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Incisivo , Masculino , Maxila , Pessoa de Meia-Idade , Espectrofotometria
13.
Odontology ; 107(1): 72-79, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29687274

RESUMO

The objectives of this study were to determine the relationship between the results provided by the classical CIELab (ΔEab*) and the CIEDE2000 (ΔE00) formulas and the gingival color space using the Bland and Altman limits of agreement, to use this relationship to establish the equivalences between the gingival color thresholds of perceptibility of both formulas, and to evaluate whether the relationship between ΔEab* and ΔE00 is modified depending on the axis in which the changes occur. The means of the L*, a*, and b* coordinates of the 21 gingiva porcelain samples (Heraceram, Heraeus Kulzer Mitsui Chemical Groups) were used and the differences in color were calculated in 210 pairs of samples using the CIELab (ΔE*ab) and CIEDE2000 (ΔE00) color-difference formulas. The results obtained with these formulas were compared and the limits of agreement after a logarithmic transformation of the data were obtained. The relationship between both formulas was ln ΔE00 = - 0.22 + ln ΔEab*. The results obtained with the CIELab formula were between 1.01 (95% confidence interval 0.98-1.03) and 1.54 (95% confidence interval 1.52-1.59) times higher than those obtained with the CIEDE200 formula. In the gingiva color space, the scale factor between the CIEDE2000 and CIELab values changes from 0.63 to 1.02, such that providing an accurate scale factor between both values proves difficult. The pairs with the highest ratio were those where the difference in color was mainly due to changes in lightness, whereas the pairs with the smallest ratio were those where the difference in color was mainly due to changes in the blue-yellow or green-red axes.


Assuntos
Cor , Materiais Dentários/química , Porcelana Dentária/química , Gengiva/anatomia & histologia , Estética Dentária , Humanos , Teste de Materiais
14.
Lasers Med Sci ; 34(2): 297-304, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30019263

RESUMO

Bonding orthodontic brackets to ceramic materials is a challenging procedure; femtosecond (FS) laser conditioning could provide improved results, but the ideal settings for effective bracket-zirconia bonding have never been established. This study aimed to analyze the differences in surface roughness and shear bond strength (SBS) produced by different femtosecond laser settings and establish a protocol to prepare zirconia surfaces for optimal adhesion to metal orthodontic brackets. One hundred eighty zirconia samples were assigned to six groups according to surface treatment: (1) control; (2) air-particle abrasion (APA); (3) FS laser irradiation (300 mW output power, 60 µm inter-groove distance); (4) FS laser irradiation (200 mW, 100 µm); (5) FS laser irradiation (40 mW, 60 µm); and (6) FS laser irradiation (200 mW, 60 µm). Surface roughness was measured. Orthodontic brackets were bonded to the zirconia specimens, and SBS was measured. SBS in groups 3 and 6 was significantly higher than the other groups (5.92 ± 1.12 MPa and 5.68 ± 0.94 MPa). No significant differences were found between groups 1, 2, 4, and 5 (3.87 ± 0.77 MPa, 4.25 ± 0.51 MPa, 3.74 ± 0.10 MPa, and 3.91 ± 0.53 MPa). Surface roughness was significantly greater for FS laser than for control and APA groups (p = 1.28 × 10-8). FS laser at 200 mW, 60 µm can be recommended as the ideal settings for treating zirconia surfaces, producing good SBS and more economical energy use.


Assuntos
Braquetes Ortodônticos , Zircônio/química , Colagem Dentária , Teste de Materiais , Resistência ao Cisalhamento , Propriedades de Superfície , Fatores de Tempo
15.
Prog Retin Eye Res ; 69: 80-115, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30391362

RESUMO

Myopia is a highly frequent ocular disorder worldwide and pathologic myopia is the 4th most common cause of irreversible blindness in developed countries. Pathologic myopia is especially common in East Asian countries. Ocular alterations associated with pathologic myopia, especially those involving the macular area-defined as myopic maculopathy-are the leading causes of vision loss in patients with pathologic myopia. High myopia is defined as the presence of a highly negative refractive error (>-6 to -8 diopters) in the context of eye elongation (26-26.5 mm). Although the terms high myopia and pathologic myopia are often used interchangeably, they do not refer to the same eye disease. The two key factors driving the development of pathologic myopia are: 1) elongation of the axial length and 2) posterior staphyloma. The presence of posterior staphyloma, which is the most common finding in patients with pathologic myopia, is the key differentiating factor between high and pathologic myopia. The occurrence of staphyloma will, in most cases, eventually lead to other conditions such as atrophic, traction, or neovascular maculopathy. Posterior staphyloma is for instance, responsible for the differences between a myopic macular hole (MH)-with and without retinal detachment-and idiopathic MH. Posterior staphyloma typically induces retinal layer splitting, leading to foveoschisis in myopic MH, an important differentiating factor between myopic and emmetropic MH. Myopic maculopathy is a highly complex disease and current classification systems do not fully account for the numerous changes that occur in the macula of these patients. Therefore, a more comprehensive classification system is needed, for several important reasons. First, to more precisely define the disease stage to improve follow-up by enabling clinicians to more accurately monitor changes over time, which is essential given the progressive nature of this condition. Second, unification of the currently-available classification systems would establish standardized classification criteria that could be used to compare the findings from international multicentric studies. Finally, a more comprehensive classification system could help to improve our understanding of the genetic origins of this disease, which is clearly relevant given the interchangeable-but erroneous-use of the terms high and pathologic myopia in genetic research.


Assuntos
Miopia Degenerativa/classificação , Doenças Retinianas/classificação , Neovascularização de Coroide/patologia , Humanos , Miopia Degenerativa/diagnóstico por imagem , Miopia Degenerativa/patologia , Descolamento Retiniano/patologia , Doenças Retinianas/diagnóstico por imagem , Doenças Retinianas/patologia , Neovascularização Retiniana/patologia , Tomografia de Coerência Óptica
16.
Retin Cases Brief Rep ; 13(2): 162-166, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-28234781

RESUMO

PURPOSE: To report three cases of choroidal neovascularization after hormonal treatment for ovarian stimulation during a fertility therapy. METHODS: A comprehensive ophthalmic examination was performed in all cases including best-corrected visual acuity, color fundus examination, fluorescein angiography, and optical coherence tomography. RESULTS: Three females in their thirties developed unilateral acuity vision loss and metamorphopsia. They all were undergoing hormonal supplementation for ovarian stimulation with gonadotropins at the moment of presentation. Intravitreal therapy with ranibizumab was used; all cases showed a significant functional and anatomical improvement. DISCUSSION: Hormonal supplementation for fertility therapy is a common procedure that may be associated with the development of choroidal neovascularization in healthy young females. Further studies should be performed to evaluate this association, but both ophthalmologist and gynecologist should be aware of this potential complication.


Assuntos
Neovascularização de Coroide/induzido quimicamente , Gonadotropinas/efeitos adversos , Indução da Ovulação/efeitos adversos , Adulto , Inibidores da Angiogênese/uso terapêutico , Feminino , Humanos , Resultado do Tratamento , Transtornos da Visão/induzido quimicamente
17.
J Oral Facial Pain Headache ; 32(4): 349-357, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30365570

RESUMO

AIMS: To determine the prevalence of the signs and symptoms of temporomandibular disorders (TMD) and associated variables over the past two decades in samples of Spanish adults and seniors. METHODS: Data from Spanish national oral health surveys from the last two decades (1993, 2000, 2005, 2010, and 2015) were analyzed from a total of 2,602 adults (35-44 years of age) and 2,529 seniors (65-74 years of age). All surveys were carried out using similar methods (according to World Health Organization standards) for determining prosthetic, dental, and periodontal statuses. For TMD (assessed only among the adults and seniors), inspection/palpation of the temporomandibular joint and masticatory muscles was used to evaluate three different domains: joint sounds; pain-related conditions (joints/muscles); and range of jaw motion. Risk factors were identified using bivariate analysis and were confirmed after a multivariate logistic regression analysis for predicting the presence of TMD pain/dysfunction. RESULTS: Despite the clear improvement in oral health status observed over the entire study period (1993-2015), the prevalence of temporomandibular pain and dysfunction increased over time in both adults and seniors (the odds ratio [OR] 95% confidence interval [CI] for the entire study period increased, to 2.39 to 4.29). The odds of women and those living in rural areas developing TMD were higher than for men (OR = 1.85; 95% CI 1.52 to 2.25; P < .001) and for those living in urban areas (OR = 1.55; 95% CI 1.24 to 1.94; P < .001), respectively; however, the prevalence of joint sounds (with no pain or functional restrictions) appeared to be stable throughout the study period at around 14%. CONCLUSION: The prevalence of painful or dysfunctional TMD has significantly increased in the last 22 years in Spain. Besides the time factor, other major predictors of TMD were gender and place of residence.


Assuntos
Transtornos da Articulação Temporomandibular/epidemiologia , Adulto , Idoso , Feminino , Humanos , Modelos Logísticos , Masculino , Análise Multivariada , Razão de Chances , Prevalência , Fatores de Risco , População Rural , Fatores Sexuais , Espanha/epidemiologia , Inquéritos e Questionários
19.
Metas enferm ; 21(7): 12-16, sept. 2018. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-172701

RESUMO

Objetivo: determinar la incidencia de úlceras por presión (UPP) en las unidades de cuidados intermedios y críticos neonatales (UCI-N) de un hospital de tercer nivel, así como caracterizar las UPP neonatales en función de su localización, grado, duración y factores sociodemográficos y clínicos del neonato. Método: estudio descriptivo longitudinal prospectivo en la UCI-N y Unidad de Cuidados Intermedios del Hospital Universitario Vall d’Hebron (Barcelona). Los datos se recogieron de marzo a junio de 2016, siendo la ocupación de 243 pacientes. Se realizó una recogida diaria de la aparición de nuevos casos de UPP y su posterior seguimiento. Resultados: se detectaron un total de 49 UPP en 38 pacientes ingresados. Se estimó una tasa de incidencia acumulada del 15,6% y una tasa de incidencia de 1,3 úlceras por cada 100 días-neonato. El 65,3% de las UPP se detectó en estadio I y la duración media fue de 7,26 días. En un 85,7% de los casos la aparición de lesiones estaba asociada a la presencia de dispositivos (en el 57,1% de tipo respiratorio, especialmente CPAP (40,8%)); consecuentemente, la localización más habitual fue la zona nasal (53,1%). Conclusiones: aunque aún queda posibilidad de mejora, el bajo grado y la rápida resolución de las UPP demuestran una buena vigilancia de la piel y que, una vez detectada la lesión, las acciones encaminadas a su curación son efectivas. La alta incidencia de lesiones asociadas a dispositivos tipo CPAP, pone de manifiesto la importancia del trabajo multidisciplinar en el desarrollo de medidas preventivas y de tratamiento


Objectives: to determine the incidence of pressure ulcers (PUs) in the neonatal intermediate and critical care units (CCU) of a third level hospital, as well as to classify neonatal PUs according to their location, level, duration, and sociodemographical and clinical factors of the newborn. Method: a descriptive cross-sectional prospective study in the N-ICU and Intermediate Care Unit of the Hospital Universitario Valld’Hebron (Barcelona). Data were collected from March to June, 2016, from 243 hospitalized patients. There was a daily collection of any new cases of PUs and their subsequent follow-up. Results: in total, 49 PUs were detected in 38 hospitalized patients. A 15.6% cumulative incidence rate was estimated, and an incidence rate of 1.3 ulcers per each 100 days-newborn. Of these PUs, 65.3% were detected in Stage I, and their mean duration was 7.26 days. In 85.7% of cases, the development of lesions was associated with the presence of devices (respiratory in 57.1% of cases, particularly CPAP (40.8%)); therefore, the most frequent location was the nasal area (53.1%). Conclusions: even though there is still room for improvement, the low degree and fast resolution of PUs show that the skin is adequately monitored, and that once the lesion has been detected, those actions targeted to its cure are effective. The high incidence of lesions associated with CPAP-type devices show the importance of multidisciplinary work for the development of prevention and treatment measures


Assuntos
Humanos , Recém-Nascido , Terapia Intensiva Neonatal/estatística & dados numéricos , Lesão por Pressão/epidemiologia , Equipe de Assistência ao Paciente/organização & administração , Unidades de Terapia Intensiva Neonatal/estatística & dados numéricos , Estudos Prospectivos , Doenças do Recém-Nascido/epidemiologia , Doenças do Prematuro/epidemiologia , Indicadores de Qualidade em Assistência à Saúde/estatística & dados numéricos
20.
Int J Oral Maxillofac Implants ; 33(16): 838-846, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30025000

RESUMO

PURPOSE: To quantify the rate of maintenance interventions of mandibular prostheses: complete dentures and overdentures retained by two implants, with either internal hex or external hex connections. MATERIALS AND METHODS: This study analyzed patients with edentulous mandibles treated with distinct treatment protocols: a control group received complete dentures; a second group received Locator-retained overdentures supported by two external hex connection implants; and a third group received overdentures supported by internal hex connection implants. All of the maintenance interventions associated with the prosthetic treatment after delivery were recorded (starting from 2000 until the final assessment in 2012). Moreover, patient satisfaction was assessed using a 0 to 10 visual analog scale. RESULTS: The final sample was composed of 136 patients: 56 in the control group, 31 in the hex implant overdenture group, and 49 in the internal connection overdenture group followed over a period of 60 months (ranging from 3 to 144 months). Prosthetic adjustment was the most frequent intervention carried out, particularly within the control group (a mean rate of 1.1 ± 1.9 times/subject/year) in comparison with the internal connection (0.6 ± 0.8 times/subject/year) and hex implant overdenture groups (0.3 ± 0.2 times/subject/year). Relining was also frequently required, occurring on average every 4 years in the control group and every 7 years in the overdenture groups. Abutment loosening was more frequent in the hex implant overdenture group than in the internal connection overdenture group (8/31 versus 8/49), as well as abutment wear (5/31 versus 5/49). Gingival inflammation was significantly more common in the hex implant overdenture group (19/31 patients), as compared with the controls (16/56 subjects), and satisfaction was higher in patients in the two overdenture groups (mean Oral Satisfaction Scale [OSS] score of 8.1 ± 1.9 for external and 8.4 ± 1.6 for internal connections) than in the control group (5.3 ± 3.3). CONCLUSION: Locator-retained overdentures needed less than half the number of maintenance interventions when compared with the control group, and maintenance was required every 2 to 4 years.


Assuntos
Prótese Dentária Fixada por Implante , Retenção de Dentadura/métodos , Revestimento de Dentadura , Arcada Edêntula/cirurgia , Mandíbula/cirurgia , Idoso , Estudos de Casos e Controles , Implantes Dentários , Prótese Total Inferior , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Estudos Retrospectivos , Escala Visual Analógica
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