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1.
J Prosthet Dent ; 124(3): 274-349, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32811666

RESUMO

This comprehensive review of the 2019 restorative dental literature is offered to inform busy dentists regarding remarkable publications and noteworthy progress made in the profession. Developed by the Scientific Investigation Committee of the American Academy of Restorative Dentistry, each author brings discipline-specific expertise to 1 of 8 sections of the report: (1) prosthodontics; (2) periodontics, alveolar bone, and peri-implant tissues; (3) implant dentistry; (4) dental materials and therapeutics; (5) occlusion and temporomandibular disorders; (6) sleep-related breathing disorders; (7) oral medicine and oral and maxillofacial surgery; and (8) dental caries and cariology. The report targets important information likely to influence day-to-day dental treatment decisions. Each review is not intended to stand alone but to update interested readers so that they may visit source material when greater detail is desired. As the profession moves toward evidence-based clinical decision-making, an incredible volume of potentially valuable dental literature continues to increase. It is the intention of this review and its authors to provide assistance in negotiating the extensive dental literature published in 2019. It is our hope that readers find this work useful in the clinical management of dental patients.


Assuntos
Cárie Dentária , Materiais Dentários , Oclusão Dentária , Humanos , Periodontia , Prostodontia , Estados Unidos
2.
Nat Metab ; 2020 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-32694821

RESUMO

A key metabolic activity of the gut microbiota is the fermentation of non-digestible carbohydrate, which generates short-chain fatty acids (SCFAs) as the principal end products. SCFAs are absorbed from the gut lumen and modulate host metabolic responses at different organ sites. Evidence suggests that these organ sites include skeletal muscle, the largest organ in humans, which plays a pivotal role in whole-body energy metabolism. In this Review, we evaluate the evidence indicating that SCFAs mediate metabolic cross-talk between the gut microbiota and skeletal muscle. We discuss the effects of three primary SCFAs (acetate, propionate and butyrate) on lipid, carbohydrate and protein metabolism in skeletal muscle, and we consider the potential mechanisms involved. Furthermore, we highlight the emerging roles of these gut-derived metabolites in skeletal muscle function and exercise capacity, present limitations in current knowledge and provide suggestions for future work.

3.
J Esthet Restor Dent ; 32(6): 545-553, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32613725

RESUMO

OBJECTIVE: The aim of this report is to present an interdisciplinary treatment involving periodontics, orthodontics, dental implant placement, and prosthodontics with a fully digital dentistry approach. CLINICAL CONSIDERATIONS: The patient presented with an edentulous ridge on the area of the lower left lateral incisor as well as gingival recession on the adjacent teeth. After performing a digital orthodontic setup and indirect bonding bracket placement, a dental implant placement was carried out before orthodontic treatment in combination with guided bone regeneration (GBR), connective tissue graft (CTG) and periodontal accelerated osteogenic orthodontics (PAOO). In a 6-month period, orthodontic treatment was fully completed and the dental implant was restored at 8 months. Following one-and-a-half years, significant gingival recession reduction was accomplished and soft tissue augmentation around the dental implant appeared stable with a good functional and esthetic result. CONCLUSION: The use of the digital POIP concept with a proper diagnosis and careful planning is crucial for reducing treatment time and enhancing precision.


Assuntos
Aumento do Rebordo Alveolar , Implantes Dentários para Um Único Dente , Implantes Dentários , Retração Gengival , Implantação Dentária Endo-Óssea , Estética Dentária , Humanos , Maxila/cirurgia
4.
Sci Rep ; 10(1): 1703, 2020 02 03.
Artigo em Inglês | MEDLINE | ID: mdl-32015477

RESUMO

The nuclear hormone receptor Dax1 functions during development as a testes-determining gene. However, the phenotype of male mice lacking Dax1 is strain-dependent due to the background-specific abundance of male-determining Sry gene-transcripts. We hypothesised that inter-individual variation in Sry mRNA-abundance would result in a spectrum of phenotypes even within-strain. We found that while all XY C57BL/6J mice lacking Dax1 presented as phenotypic females, there was a marked inter-individual variability in measures of fertility. Indeed, we report rare occasions where sex-reversed mice had measures of fertility comparable to those in control females. On two occasions, these sex-reversed XY mice were able to give birth to live offspring following mating to stud-males. As such, this work documents within-strain variability in phenotypes of XY mice lacking Dax1, and reports for the first time a complete sex-reversal capable of achieving live birth in these mice.

5.
PLoS Biol ; 17(12): e3000482, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31805040

RESUMO

Better understanding of feeding behaviour will be vital in reducing obesity and metabolic syndrome, but we lack a standard model that captures the complexity of feeding behaviour. We construct an accurate stochastic model of rodent feeding at the bout level in order to perform quantitative behavioural analysis. Analysing the different effects on feeding behaviour of peptide YY3-36 (PYY3-36), lithium chloride, glucagon-like peptide 1 (GLP-1), and leptin shows the precise behavioural changes caused by each anorectic agent. Our analysis demonstrates that the changes in feeding behaviour evoked by the anorectic agents investigated do not mimic the behaviour of well-fed animals and that the intermeal interval is influenced by fullness. We show how robust homeostatic control of feeding thwarts attempts to reduce food intake and how this might be overcome. In silico experiments suggest that introducing a minimum intermeal interval or modulating upper gut emptying can be as effective as anorectic drug administration.


Assuntos
Ingestão de Alimentos/efeitos dos fármacos , Comportamento Alimentar/efeitos dos fármacos , Comportamento Alimentar/fisiologia , Animais , Depressores do Apetite/farmacologia , Ingestão de Alimentos/fisiologia , Peptídeo 1 Semelhante ao Glucagon/farmacologia , Homeostase/efeitos dos fármacos , Leptina/farmacologia , Masculino , Camundongos , Obesidade , Fragmentos de Peptídeos/farmacologia , Peptídeo YY/farmacologia , Ratos
6.
J Anal Toxicol ; 43(7): 564-570, 2019 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-31062862

RESUMO

Due to the rise in their misuse and associated mortality, the UK government is reclassifying gabapentin (GBP) and pregabalin (PGL) to Class C controlled drugs from April 2019. However, it is impossible to gauge the extent of their use with current post-mortem toxicological screening, where GBP and PGL are only screened for if they are mentioned in the case documents. This study determines the prevalence of GBP and PGL, the potential extent of their under-reporting and poly-drug use in a post-mortem population. Between 1 January 2016 and 31 December 2017, 3,750 deceased from Coroners' cases in London and South East England underwent a routine drugs screen and a specific screen for GBP and PGL. The prevalence of both drugs was determined in the cohort and the subcategories of heroin users and non-heroin-users. The prevalence of both drugs was compared to tramadol (Class C drug). Case documents were reviewed to investigate the under-reporting of GBP and PGL and poly-drug use. Of 3,750 samples analyzed, 118 (3.1%) were positive for GBP, 229 (6.1%) for PGL and 120 (3.2%) were positive for tramadol. If routine analysis without additional screening of GBP and PGL had been performed in this cohort, GBP would have been under-reported by 57.6% (P < 0.0001) and PGL by 53.7% (P < 0.0001) in deaths. The most common drug group observed with GBP and PGL was non-heroin-related opioids at 60.2% and 64.6%, respectively. In total 354 deceased (9.4%) were heroin users. GBP was positive in 23 (6.5%) of these cases and PGL was positive in 69 (19.5%). The prevalence of PGL in heroin users (19.5%) was 4.1 times greater than in non-heroin users (4.7%) (P < 0.0001). GBP and PGL are being significantly under reported in fatalities. Both drugs are extensively used with opioids. The prevalence of PGL in heroin users is highly significant.


Assuntos
Toxicologia Forense/métodos , Gabapentina/análise , Pregabalina/análise , Transtornos Relacionados ao Uso de Substâncias , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Inglaterra/epidemiologia , Feminino , Dependência de Heroína/diagnóstico , Dependência de Heroína/mortalidade , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Prevalência , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/mortalidade
7.
Gut ; 68(8): 1430-1438, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30971437

RESUMO

OBJECTIVE: To investigate the underlying mechanisms behind changes in glucose homeostasis with delivery of propionate to the human colon by comprehensive and coordinated analysis of gut bacterial composition, plasma metabolome and immune responses. DESIGN: Twelve non-diabetic adults with overweight and obesity received 20 g/day of inulin-propionate ester (IPE), designed to selectively deliver propionate to the colon, a high-fermentable fibre control (inulin) and a low-fermentable fibre control (cellulose) in a randomised, double-blind, placebo-controlled, cross-over design. Outcome measurements of metabolic responses, inflammatory markers and gut bacterial composition were analysed at the end of each 42-day supplementation period. RESULTS: Both IPE and inulin supplementation improved insulin resistance compared with cellulose supplementation, measured by homeostatic model assessment 2 (mean±SEM 1.23±0.17 IPE vs 1.59±0.17 cellulose, p=0.001; 1.17±0.15 inulin vs 1.59±0.17 cellulose, p=0.009), with no differences between IPE and inulin (p=0.272). Fasting insulin was only associated positively with plasma tyrosine and negatively with plasma glycine following inulin supplementation. IPE supplementation decreased proinflammatory interleukin-8 levels compared with cellulose, while inulin had no impact on the systemic inflammatory markers studied. Inulin promoted changes in gut bacterial populations at the class level (increased Actinobacteria and decreased Clostridia) and order level (decreased Clostridiales) compared with cellulose, with small differences at the species level observed between IPE and cellulose. CONCLUSION: These data demonstrate a distinctive physiological impact of raising colonic propionate delivery in humans, as improvements in insulin sensitivity promoted by IPE and inulin were accompanied with different effects on the plasma metabolome, gut bacterial populations and markers of systemic inflammation.


Assuntos
Microbioma Gastrointestinal/fisiologia , Insulina/metabolismo , Inulina , Metaboloma/fisiologia , Obesidade , Sobrepeso , Adulto , Índice de Massa Corporal , Estudos Cross-Over , Suplementos Nutricionais , Método Duplo-Cego , Fezes/microbiologia , Feminino , Humanos , Inflamação/metabolismo , Resistência à Insulina/fisiologia , Inulina/administração & dosagem , Inulina/metabolismo , Masculino , Pessoa de Meia-Idade , Obesidade/diagnóstico , Obesidade/dietoterapia , Obesidade/metabolismo , Sobrepeso/diagnóstico , Sobrepeso/dietoterapia , Sobrepeso/metabolismo , Propionatos/administração & dosagem , Propionatos/metabolismo , Resultado do Tratamento
8.
Obesity (Silver Spring) ; 26(11): 1721-1726, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30358156

RESUMO

OBJECTIVE: The satiating effect of protein compared with other nutrients has been well described and is thought to be mediated, in part, by gut hormone release. Previously, it has been shown that oral L-arginine acts as a GLP-1 secretagogue both in vitro and in vivo in rodents. Here, the effect of L-arginine on gut hormone release in humans was investigated. METHODS: The hypothesis was tested in two separate studies. The first study assessed the tolerability of oral L-arginine in healthy human subjects. The second study assessed the effect of oral L-arginine on gut hormone release following an ad libitum meal. Subjects were given L-arginine, glycine (control amino acid), or vehicle control in a randomized double-blind fashion. RESULTS: At a dose of 17.1 mmol, L-arginine was well tolerated and stimulated the release of plasma GLP-1 (P < 0.05) and PYY (P < 0.001) following an ad libitum meal. Food diaries showed a trend toward lower energy intake and particularly fat intake following L-arginine treatment. CONCLUSIONS: L-arginine can significantly elevate GLP-1 and PYY in healthy human volunteers in combination with a meal. Further work is required to investigate whether L-arginine may have utility in the suppression of appetite and food intake.


Assuntos
Depressores do Apetite/uso terapêutico , Arginina/uso terapêutico , Ingestão de Alimentos/efeitos dos fármacos , Peptídeo 1 Semelhante ao Glucagon/efeitos dos fármacos , Peptídeo YY/efeitos dos fármacos , Período Pós-Prandial/efeitos dos fármacos , Adulto , Depressores do Apetite/farmacologia , Arginina/farmacologia , Método Duplo-Cego , Feminino , Peptídeo 1 Semelhante ao Glucagon/sangue , Humanos , Masculino , Peptídeo YY/sangue
9.
J R Soc Interface ; 15(138)2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-29367240

RESUMO

Obesity is a major global public health problem. Understanding how energy homeostasis is regulated, and can become dysregulated, is crucial for developing new treatments for obesity. Detailed recording of individual behaviour and new imaging modalities offer the prospect of medically relevant models of energy homeostasis that are both understandable and individually predictive. The profusion of data from these sources has led to an interest in applying machine learning techniques to gain insight from these large, relatively unstructured datasets. We review both physiological models and machine learning results across a diverse range of applications in energy homeostasis, and highlight how modelling and machine learning can work together to improve predictive ability. We collect quantitative details in a comprehensive mathematical supplement. We also discuss the prospects of forecasting homeostatic behaviour and stress the importance of characterizing stochasticity within and between individuals in order to provide practical, tailored forecasts and guidance to combat the spread of obesity.


Assuntos
Metabolismo Energético , Glucose/metabolismo , Homeostase , Aprendizado de Máquina , Modelos Biológicos , Obesidade/metabolismo , Bases de Dados Factuais , Humanos
10.
PLoS One ; 13(1): e0192014, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29370263

RESUMO

[This corrects the article DOI: 10.1371/journal.pone.0176821.].

11.
Mol Metab ; 7: 71-79, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-29122559

RESUMO

OBJECTIVE: Brain insulin-induced improvement in glucose homeostasis has been proposed to be mediated by the parasympathetic nervous system. Non-invasive transcutaneous auricular vagus nerve stimulation (taVNS) activating afferent branches of the vagus nerve may prevent hyperglycemia in diabetes models. We examined the effects of 14-min taVNS vs sham stimulation by Cerbomed Nemos® on glucose metabolism, lipids, and hepatic energy homeostasis in fasted healthy humans (n = 10, age 51 ± 6 yrs, BMI 25.5 ± 2.7 kg/m2). METHODS: Heart rate variability (HRV), reflecting sympathetic and parasympathetic nerve activity, was measured before, during and after taVNS or sham stimulation. Endogenous glucose production was determined using [6,6-2H2]glucose, and hepatic concentrations of triglycerides (HCL), adenosine triphosphate (ATP), and inorganic phosphate (Pi) were quantified from 1H/31P magnetic resonance spectroscopy at baseline and for 180 min following stimulation. RESULTS: taVNS did not affect circulating glucose, free fatty acids, insulin, glucagon, or pancreatic polypeptide. Rates of endogenous glucose production (P = 0.79), hepatic HCL, ATP, and Pi were also not different (P = 0.91, P = 0.48 and P = 0.24) between taVNS or sham stimulation. Hepatic HCL, ATP, and Pi remained constant during prolonged fasting for 3 h. No changes in heart rate or shift in cardiac autonomic function from HRV towards sympathetic or parasympathetic predominance were detected. CONCLUSION: Non-invasive vagus stimulation by Cerbomed Nemos® does not acutely modulate the autonomic tone to the visceral organs and thereby does not affect hepatic glucose and energy metabolism. This technique is therefore unable to mimic brain insulin-mediated effects on peripheral homeostasis in humans.


Assuntos
Trifosfato de Adenosina/metabolismo , Metabolismo Energético , Jejum/metabolismo , Fígado/metabolismo , Sistema Nervoso Parassimpático/fisiologia , Estimulação do Nervo Vago , Adulto , Jejum/fisiologia , Feminino , Glucose/metabolismo , Frequência Cardíaca , Humanos , Masculino , Pessoa de Meia-Idade , Triglicerídeos/metabolismo
13.
Curr Opin Pharmacol ; 37: 16-23, 2017 12.
Artigo em Inglês | MEDLINE | ID: mdl-28802874

RESUMO

Gut hormones have important roles in the regulation of appetite and glucose homeostasis. Understanding how macronutrient sensing in the gastrointestinal tract modulates gut hormone release may reveal novel pharmacological or dietary approaches to metabolic disease. In this short review we discuss the mechanisms by which the gut senses macronutrients and the products of macronutrient digestion, and their putative utility in treating obesity and related conditions.


Assuntos
Trato Gastrointestinal/metabolismo , Obesidade/tratamento farmacológico , Animais , Metabolismo dos Carboidratos , Humanos , Metabolismo dos Lipídeos , Obesidade/metabolismo , Proteínas/metabolismo
14.
PLoS One ; 12(8): e0182659, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28796827

RESUMO

BACKGROUND: Patients with multiple injuries or sepsis requiring intensive care treatment invariably develop a catabolic state with resultant loss of lean body mass, for which there are currently no effective treatments. Recovery can take months and mortality is high. We hypothesise that treatment with the orexigenic and anti-inflammatory gastric hormone, ghrelin may attenuate the loss of body mass following critical illness and improve recovery. METHODS: Male Wistar rats received an intraperitoneal injection of the fungal cell wall derivative zymosan to induce a prolonged peritonitis and consequent critical illness. Commencing at 48h after zymosan, animals were randomised to receive a continuous infusion of ghrelin or vehicle control using a pre-implanted subcutaneous osmotic mini-pump, and continued for 10 days. RESULTS: Zymosan peritonitis induced significant weight loss and reduced food intake with a nadir at Day 2 and gradual recovery thereafter. Supra-physiologic plasma ghrelin levels were achieved in the treated animals. Ghrelin-treated rats ate more food and gained more body mass than controls. Ghrelin increased adiposity and promoted carbohydrate over fat metabolism, but did not alter total body protein, muscle strength nor muscle morphology. Muscle mass and strength remained significantly reduced in all zymosan-treated animals, even at ten days post-insult. CONCLUSIONS: Continuous infusion of ghrelin increased body mass and food intake, but did not increase muscle mass nor improve muscle function, in a long-term critical illness recovery model. Further studies with pulsatile ghrelin delivery or additional anabolic stimuli may further clarify the utility of ghrelin in survivors of critical illness.


Assuntos
Composição Corporal/efeitos dos fármacos , Caquexia/tratamento farmacológico , Grelina/farmacologia , Músculo Esquelético/fisiopatologia , Peritonite/metabolismo , Animais , Peso Corporal , Caquexia/etiologia , Caquexia/metabolismo , Avaliação Pré-Clínica de Medicamentos , Ingestão de Energia , Humanos , Masculino , Contração Muscular , Força Muscular , Peritonite/complicações , Peritonite/fisiopatologia , Ratos Wistar
15.
PLoS One ; 12(5): e0176821, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28464043

RESUMO

Kisspeptins regulate the mammalian reproductive axis by stimulating release of gonadotrophin releasing hormone (GnRH). Different length kisspeptins (KP) are found of 54, 14, 13 or 10 amino-acids which share a common C-terminal 10-amino acid sequence. KP-54 and KP-10 have been widely used to stimulate the reproductive axis but data suggest that KP-54 and KP-10 are not equally effective at eliciting reproductive hormone secretion after peripheral delivery. To confirm this, we analysed the effect of systemic administration of KP-54 or KP-10 on luteinizing hormone (LH) secretion into the bloodstream of male mice. Plasma LH measurements 10 min or 2 hours after kisspeptin injection showed that KP-54 can sustain LH release far longer than KP-10, suggesting a differential mode of action of the two peptides. To investigate the mechanism for this, we evaluated the pharmacokinetics of the two peptides in vivo and their potential to cross the blood brain barrier (BBB). We found that KP-54 has a half-life of ~32 min in the bloodstream, while KP-10 has a half-life of ~4 min. To compensate for this difference in half-life, we repeated injections of KP-10 every 10 min over 1 hr but failed to reproduce the sustained rise in LH observed after a single KP-54 injection, suggesting that the failure of KP-10 to sustain LH release may not just be related to peptide clearance. We tested the ability of peripherally administered KP-54 and KP-10 to activate c-FOS in GnRH neurons behind the blood brain barrier (BBB) and found that only KP-54 could do this. These data are consistent with KP-54 being able to cross the BBB and suggest that KP10 may be less able to do so.


Assuntos
Fármacos do Sistema Nervoso Central/farmacologia , Kisspeptinas/farmacologia , Análise de Variância , Animais , Barreira Hematoencefálica/efeitos dos fármacos , Barreira Hematoencefálica/metabolismo , Permeabilidade Capilar/efeitos dos fármacos , Permeabilidade Capilar/fisiologia , Fármacos do Sistema Nervoso Central/farmacocinética , Relação Dose-Resposta a Droga , Ensaio de Imunoadsorção Enzimática , Humanos , Hipotálamo/citologia , Hipotálamo/efeitos dos fármacos , Hipotálamo/metabolismo , Imuno-Histoquímica , Kisspeptinas/farmacocinética , Hormônio Luteinizante/sangue , Hormônio Luteinizante/metabolismo , Masculino , Camundongos da Linhagem 129 , Neurônios/citologia , Neurônios/efeitos dos fármacos , Neurônios/metabolismo , Proteínas Proto-Oncogênicas c-fos/metabolismo
16.
Forensic Sci Int ; 270: 93-97, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27936427

RESUMO

BACKGROUND: Gamma-hydroxybutyrate (GHB) is the drug most linked to acute harm out of those used in chemsex, the incidence of which is reported to be increasing. However, there have been few systematic studies of the harms associated with GHB use. We investigated GHB-associated deaths from London coroners' jurisdictions between 2011 and 2015. METHODS: Blood and urine samples were collected by pathologists and submitted for toxicological analysis at the request of coroners. Data from the Toxicology Unit, Imperial College London was retrospectively analysed. This comprised of 6633 cases from seven out of eight coroners' jurisdictions in London that underwent toxicological analysis between January 2011 and December 2015. RESULTS: A total of 61 GHB-associated deaths (0.92% of total cases), 184 cocaine-associated deaths (2.8% of total cases) and 83 MDMA-associated deaths (1.3% of total cases) were identified. There was a 119% increase in the proportion of GHB-associated deaths detected in 2015 compared to 2014. Over the same time period there was a 25% increase in cocaine-associated deaths and a 10% decrease in MDMA-associated deaths. CONCLUSIONS: Our data suggest that GHB-associated deaths are increasing in London, and that this is likely at least in part due to increasing use of GHB for chemsex. Further studies on the use of GHB are urgently required to understand the extent of its use, whether this is as prevalent in other major urban areas in the UK, and the full extent of the harms it causes.


Assuntos
Drogas Ilícitas/envenenamento , Comportamento Sexual , Oxibato de Sódio/envenenamento , Transtornos Relacionados ao Uso de Substâncias/mortalidade , Adulto , Idoso , Feminino , Toxicologia Forense , Cromatografia Gasosa-Espectrometria de Massas , Infecções por HIV/epidemiologia , Homossexualidade Masculina , Humanos , Drogas Ilícitas/análise , Londres/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Oxibato de Sódio/análise , Corpo Vítreo/química , Adulto Jovem
17.
Obesity (Silver Spring) ; 24(8): 1723-30, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-27460713

RESUMO

OBJECTIVE: To assess appetite and gut hormone levels in patients following partial (PR) or total resection (TR) of the large bowel. METHODS: A comparative cross sectional study was carried out with healthy controls (n = 99) and patients who had undergone PR (n = 64) or TR (n = 12) of the large bowel. Participants consumed a standard (720 kcal) breakfast meal at 0830 (t = 0) h followed by lactulose (15 g) and a buffet lunch (t = 210 min). Participants rated the subjective feelings of hunger at t = -30, 0, 30, 60, 120, and 180 min. Breath hydrogen (BH) concentrations were also evaluated. In a matched subset (11 controls, 11 PR and 9 TR patients) PYY and GLP-1 concentrations were measured following breakfast. The primary outcome measure was appetite, as measured using visual analogue scales and the buffet lunch. The secondary outcome was BH concentrations following a test meal. RESULTS: PR and TR participants had lower hunger and energy intake at the buffet lunch meal compared to controls. PR subjects had higher BH concentrations compared to controls and TR subjects. BH levels correlated with circulating GLP-1 levels at specific time points. CONCLUSIONS: PR or TR of the large bowel reduced feelings of hunger and energy intake, and PR increased gastrointestinal fermentation.


Assuntos
Apetite , Ingestão de Alimentos , Hormônios Gastrointestinais/metabolismo , Fome , Intestino Delgado/metabolismo , Intestino Delgado/cirurgia , Adulto , Desjejum , Estudos Transversais , Ingestão de Energia , Feminino , Gastrectomia , Polipeptídeo Inibidor Gástrico/metabolismo , Humanos , Almoço , Masculino , Obesidade/cirurgia
19.
Compend Contin Educ Dent ; 37(2): S1-12, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26905092

RESUMO

While, overall, dental implants are highly efficacious, consistently achieving predictable esthetic results can pose color-driven challenges at the implant/soft-tissue interface, particularly in the esthetic zone. An ongoing, 5-year, multicenter (eight sites) prospective study is following a total of 168 implants placed in 120 patients using a novel biomimetic (osteoconductive) implant system with pink collars and abutments that afford better gingival color matching, enhanced design variability, and streamlined fabrication and customization of the abutment/implant-tissue interface. The full results of this study will be published at the 3-year and 5-year timepoints; however, clinical analyses of the 18-month interim survival rates, marginal bone and soft-tissue level changes, and esthetics have been completed, showing an overall success rate among all of the implanted sites of 95.8%. For the three representative cases described in this article (two anterior, one posterior), all of the implant site probing depths were ≤ 3 mm at the final crown placement as well as at 6, 12, and 18 months after implant placement. Facial soft-tissue heights were stable or increased by ≥ 0.86 mm; lingual soft-tissue heights were reduced by ≤ 1.11 mm. Facial and lingual attached-gingiva widths were reduced by ≤ 1.20 mm and ≤ 0.63 mm, respectively. Interproximal marginal alveolar bone levels were stable (gain/loss range: +0.40 to -1.1 mm) from the start of the study through 18 months. Gingival inflammation, bleeding on probing, and plaque were infrequently observed, and esthetic results were uniformly excellent at the 18-month follow-up visit.


Assuntos
Biomimética/instrumentação , Cor , Desenho Assistido por Computador , Implantes Dentários , Gengiva/anatomia & histologia , Projeto do Implante Dentário-Pivô , Implantação Dentária Endo-Óssea , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Software , Resultado do Tratamento
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