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1.
Eur Heart J ; 43(14): 1416-1424, 2022 04 06.
Artigo em Inglês | MEDLINE | ID: mdl-34910136

RESUMO

AIMS: REVEAL was the first randomized controlled trial to demonstrate that adding cholesteryl ester transfer protein inhibitor therapy to intensive statin therapy reduced the risk of major coronary events. We now report results from extended follow-up beyond the scheduled study treatment period. METHODS AND RESULTS: A total of 30 449 adults with prior atherosclerotic vascular disease were randomly allocated to anacetrapib 100 mg daily or matching placebo, in addition to open-label atorvastatin therapy. After stopping the randomly allocated treatment, 26 129 survivors entered a post-trial follow-up period, blind to their original treatment allocation. The primary outcome was first post-randomization major coronary event (i.e. coronary death, myocardial infarction, or coronary revascularization) during the in-trial and post-trial treatment periods, with analysis by intention-to-treat. Allocation to anacetrapib conferred a 9% [95% confidence interval (CI) 3-15%; P = 0.004] proportional reduction in the incidence of major coronary events during the study treatment period (median 4.1 years). During extended follow-up (median 2.2 years), there was a further 20% (95% CI 10-29%; P < 0.001) reduction. Overall, there was a 12% (95% CI 7-17%, P < 0.001) proportional reduction in major coronary events during the overall follow-up period (median 6.3 years), corresponding to a 1.8% (95% CI 1.0-2.6%) absolute reduction. There were no significant effects on non-vascular mortality, site-specific cancer, or other serious adverse events. Morbidity follow-up was obtained for 25 784 (99%) participants. CONCLUSION: The beneficial effects of anacetrapib on major coronary events increased with longer follow-up, and no adverse effects emerged on non-vascular mortality or morbidity. These findings illustrate the importance of sufficiently long treatment and follow-up duration in randomized trials of lipid-modifying agents to assess their full benefits and potential harms. TRIAL REGISTRATION: International Standard Randomized Controlled Trial Number (ISRCTN) 48678192; ClinicalTrials.gov No. NCT01252953; EudraCT No. 2010-023467-18.


Assuntos
Aterosclerose , Infarto do Miocárdio , Oxazolidinonas , Adulto , Aterosclerose/tratamento farmacológico , Atorvastatina/uso terapêutico , Método Duplo-Cego , Humanos , Infarto do Miocárdio/tratamento farmacológico , Oxazolidinonas/efeitos adversos , Resultado do Tratamento
2.
Entropy (Basel) ; 22(7)2020 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-33286502

RESUMO

One of the most important subduction zones in the world is located in the Mexican Pacific Coast, where the Cocos plate inserts beneath the North American plate. One part of it is located in the Mexican Pacific Coast, where the Cocos plate inserts beneath the North American plate with different dip angles, showing important seismicity. Under the central Mexican area, such a dip angle becomes practically horizontal and such an area is known as flat slab. An earthquake of magnitude M7.1 occurred on 19 September 2017, the epicenter of which was located in this flat slab. It caused important human and material losses of urban communities including a large area of Mexico City. The seismicity recorded in the flat slab region is analyzed here in natural time from 1995 until the occurrence of this M7.1 earthquake in 2017 by studying the entropy change under time reversal and the variability ß of the order parameter of seismicity as well as characterize the risk of an impending earthquake by applying the nowcasting method. The entropy change ΔS under time reversal minimizes on 21 June 2017 that is almost one week after the observation of such a minimum in the Chiapas region where a magnitude M8.2 earthquake took place on 7 September 2017 being Mexico's largest quake in more than a century. A minimum of ß was also observed during the period February-March 2017. Moreover, we show that, after the minimum of ΔS, the order parameter of seismicity starts diminishing, thus approaching gradually the critical value 0.070 around the end of August and the beginning of September 2017, which signals that a strong earthquake is anticipated shortly in the flat slab.

3.
Am Heart J ; 187: 182-190, 2017 05.
Artigo em Inglês | MEDLINE | ID: mdl-28454801

RESUMO

Patients with prior vascular disease remain at high risk for cardiovascular events despite intensive statin-based treatment. Inhibition of cholesteryl ester transfer protein by anacetrapib reduces low-density lipoprotein (LDL) cholesterol by around 25% to 40% and more than doubles high-density lipoprotein (HDL) cholesterol. However, it is not known if these apparently favorable lipid changes translate into reductions in cardiovascular events. METHODS: The REVEAL study is a randomized, double-blind, placebo-controlled clinical trial that is assessing the efficacy and safety of adding anacetrapib to effective LDL-lowering treatment with atorvastatin for an average of at least 4years among patients with preexisting atherosclerotic vascular disease. The primary assessment is an intention-to-treat comparison among all randomized participants of the effects of allocation to anacetrapib on major coronary events (defined as the occurrence of coronary death, myocardial infarction, or coronary revascularization). RESULTS: Between August 2011 and October 2013, 30,449 individuals in Europe, North America, and China were randomized to receive anacetrapib 100mg daily or matching placebo. Mean (SD) age was 67 (8) years, 84% were male, 88% had a history of coronary heart disease, 22% had cerebrovascular disease, and 37% had diabetes mellitus. At the randomization visit (after at least 8weeks on a protocol-defined atorvastatin regimen), mean plasma LDL cholesterol was 61 (15) mg/dL and HDL cholesterol was 40 (10) mg/dL. INTERPRETATION: The REVEAL trial will provide a robust evaluation of the clinical efficacy and safety of adding anacetrapib to an effective statin regimen. Results are anticipated in 2017.


Assuntos
Anticolesterolemiantes/uso terapêutico , Atorvastatina/uso terapêutico , Doença das Coronárias/prevenção & controle , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Oxazolidinonas/uso terapêutico , Idoso , Anticolesterolemiantes/efeitos adversos , HDL-Colesterol/sangue , HDL-Colesterol/efeitos dos fármacos , LDL-Colesterol/sangue , LDL-Colesterol/efeitos dos fármacos , Método Duplo-Cego , Quimioterapia Combinada , Feminino , Humanos , Análise de Intenção de Tratamento , Masculino , Pessoa de Meia-Idade , Oxazolidinonas/efeitos adversos , Projetos de Pesquisa
4.
J Fish Biol ; 89(1): 529-36, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27109861

RESUMO

This study reports for the first time the roles of genetic and body phenotypic variation in two Saccodon dariensis dental morphs. Results showed a lack of ancient mitochondrial differentiation between morphs and body variations concordant with genetic polymorphism or differential plastic responses to diet quality and foraging strategies of S. dariensis.


Assuntos
Caraciformes/genética , Acrilatos , Animais , Caraciformes/anatomia & histologia , Caraciformes/fisiologia , Colômbia , Comportamento Alimentar , Feminino , Boca/anatomia & histologia , Fenótipo , Éteres Fenílicos , Filogenia , Polimorfismo Genético , Análise de Sequência de DNA , Caracteres Sexuais , Dente/anatomia & histologia
5.
J Fish Biol ; 89(1): 522-8, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27117920

RESUMO

Landmark-based geometric morphometrics were used to evaluate the effect of flow and depth in the water column on the body size and shape of Brycon henni from river and stream populations. The dendrogram showed that stream populations clustered apart and showed significantly smaller centroid size and narrower bodies than river populations, indicating a role for flow and depth on whole body morphometric variation. The results are concordant with morphometric variation described in other fish species and provide the first insights into phenotypic variation in natural populations of B. henni.


Assuntos
Caraciformes/anatomia & histologia , Animais , Tamanho Corporal , Caraciformes/crescimento & desenvolvimento , Feminino , Masculino , Rios , Caracteres Sexuais , Movimentos da Água
6.
Sci Rep ; 12(1): 17149, 2022 10 13.
Artigo em Inglês | MEDLINE | ID: mdl-36229514

RESUMO

Rhabdomyosarcoma is a soft tissue cancer that arises in skeletal muscle due to mutations in myogenic progenitors that lead to ineffective differentiation and malignant transformation. The transcription factors Pax3 and Pax7 and their downstream target genes are tightly linked with the fusion positive alveolar subtype, whereas the RAS pathway is usually involved in the embryonal, fusion negative variant. Here, we analyse the role of Pax3 in a fusion negative context, by linking alterations in gene expression in pax3a/pax3b double mutant zebrafish with tumour progression in kRAS-induced rhabdomyosarcoma tumours. Several genes in the RAS/MAPK signalling pathway were significantly down-regulated in pax3a/pax3b double mutant zebrafish. Progression of rhabdomyosarcoma tumours was also delayed in the pax3a/pax3b double mutant zebrafish indicating that Pax3 transcription factors have an unappreciated role in mediating malignancy in fusion negative rhabdomyosarcoma.


Assuntos
Rabdomiossarcoma Embrionário , Rabdomiossarcoma , Animais , Proteína Forkhead Box O1/metabolismo , Fatores de Transcrição Forkhead/metabolismo , Proteínas de Fusão Oncogênica/genética , Fator de Transcrição PAX3/genética , Fator de Transcrição PAX3/metabolismo , Fator de Transcrição PAX7/genética , Fator de Transcrição PAX7/metabolismo , Fatores de Transcrição Box Pareados/genética , Fatores de Transcrição Box Pareados/metabolismo , Proteínas Proto-Oncogênicas p21(ras)/genética , Proteínas Proto-Oncogênicas p21(ras)/metabolismo , Rabdomiossarcoma/genética , Rabdomiossarcoma/patologia , Rabdomiossarcoma Embrionário/genética , Peixe-Zebra/genética , Peixe-Zebra/metabolismo , Proteínas de Peixe-Zebra/metabolismo
7.
Stat Med ; 30(13): 1528-40, 2011 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-21341301

RESUMO

In recent years adaptive seamless phase II/III designs (ASDs) allowing treatment or dose selection at an interim analysis have gained much attention because of their potential to save development costs and to shorten time-to-market of a new compound compared to conventional drug development programmes with separate trials for individual phases. In this paper, we describe an ASD with treatment selection based on early outcome data, specifically considering the situation where no final outcomes are observed at the time of the interim analysis. Bringing together combination tests for adaptive designs and the closure principle for multiple testing, control of the familywise type I error rate in the strong sense is achieved. Furthermore, a simulation model is proposed based on standardized test statistics that allows the generation of virtual trials for a variety of outcomes. We use this simulation model to investigate the actual type I error rate of the proposed testing procedure and find that the familywise type I error rate is controlled as expected. The method is often conservative, with the degree of conservatism depending on the correlation between early and late outcome, the true mean values of the early outcome in the different treatment groups and the selection rule. The investigations are motivated and illustrated by an application of the proposed design and simulation model to progressive multiple sclerosis.


Assuntos
Ensaios Clínicos Fase II como Assunto/métodos , Ensaios Clínicos Fase III como Assunto/métodos , Modelos Estatísticos , Esclerose Múltipla/tratamento farmacológico , Anti-Inflamatórios/uso terapêutico , Simulação por Computador , Humanos , Projetos de Pesquisa , Resultado do Tratamento
8.
Cutan Ocul Toxicol ; 30(1): 7-14, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21091383

RESUMO

Agonist and antagonist drugs acting on epidermal growth factor receptor (EGFR) signaling are emerging as a new possibility for pharmaceutical study and clinical manipulation of some skin and corneal disorders. EGFR activation appears to be effective in reducing the time of reepithelialization after corneal wound healing, with potential uses in penetrating keratoplasty, refractive surgery, alkali burns, diabetic keratopathy, keratopathy following chemotherapy, cornea transplantation, and dry eye. Most of the studies show therapeutic advantages of human recombinant epidermal growth factor (hrEGF) eye drops without showing adverse effects. In contrast, EGFR inhibition delays epithelial cell proliferation and stratification during corneal regeneration.The aim of this review is to summarize the most seminal discoveries and recent advances so as to clarify the role of the EGFR system in corneal physiology and pharmacology. Epidermal growth factor eye drops could be a first-choice treatment for promoting regeneration in numerous epithelial defects in the medium to long term.


Assuntos
Córnea/metabolismo , Lesões da Córnea , Fator de Crescimento Epidérmico , Receptores ErbB/metabolismo , Animais , Proliferação de Células/efeitos dos fármacos , Córnea/efeitos dos fármacos , Fator de Crescimento Epidérmico/agonistas , Fator de Crescimento Epidérmico/antagonistas & inibidores , Epitélio Corneano/efeitos dos fármacos , Receptores ErbB/farmacologia , Humanos , Proteínas Recombinantes , Regeneração/efeitos dos fármacos , Transdução de Sinais/efeitos dos fármacos , Cicatrização/efeitos dos fármacos , Cicatrização/fisiologia
9.
SAR QSAR Environ Res ; 32(1): 29-50, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33241943

RESUMO

Leishmaniasis affects mainly rural areas and the poorest people in the world. A computational study of the antileishmanial activity of organic selenium and tellurium compounds was performed. The 3D structures of the compounds were optimized at the wb97xd/lanl2dz level and used in the quantitative structure-activity relationship (QSAR) analysis. The antileishmanial activity was measured by L. donovani ß carbonic anhydrase inhibition (Ki) and the half-maximal inhibitory concentration (IC50) against L. infantum amastigotes. The dataset was divided into training (75%) and test sets (25%) by using a k-means clustering algorithm. For pKi prediction, model M3 with seven 3D topographic descriptors was characterized by the following statistical parameters: r 2 = 0.879, Q 2 LOO = 0.822, and Q 2 ext = 0.840. For pIC50 prediction, model M12 with six attributes was characterized by the following statistical parameters: r 2 = 0.907, Q 2 LOO = 0.824, and Q 2 ext = 0.795. Both models met all the requirements of Tropsha´s test, which implies predictions of pIC50 and pKi activities with high accuracy. Concomitantly, favourable interactions of the sulphonamide group with the Zn atom in the protein were revealed by the docking analysis.


Assuntos
Antiprotozoários/farmacologia , Leishmania donovani/efeitos dos fármacos , Leishmania infantum/efeitos dos fármacos , Simulação de Acoplamento Molecular , Relação Quantitativa Estrutura-Atividade , Compostos de Selênio/farmacologia , Telúrio/farmacologia
10.
Intern Med J ; 40(1): 76-9, 2010 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-20561369

RESUMO

The HICAP (Hypertension and Heart Failure in Primary Care) study is a cross-sectional, multicentre, epidemiological study conduced in primary care centres in Spain. The results indicate that among hypertensive patients without heart failure (HF), diagnosed renal dysfunction is associated with the risk for developing HF and that the renal function evaluation using the Modification of Diet in Renal Disease Study Group formula could be useful to detect hypertensive patients at high risk of developing HF.


Assuntos
Insuficiência Cardíaca/epidemiologia , Hipertensão/epidemiologia , Nefropatias/epidemiologia , Testes de Função Renal , Idoso , Estudos Transversais , Feminino , Insuficiência Cardíaca/complicações , Insuficiência Cardíaca/fisiopatologia , Humanos , Hipertensão/complicações , Hipertensão/fisiopatologia , Nefropatias/complicações , Nefropatias/fisiopatologia , Testes de Função Renal/métodos , Masculino , Pessoa de Meia-Idade , Atenção Primária à Saúde/métodos
11.
Chemotherapy ; 55(4): 228-33, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19451712

RESUMO

In the Americas, approximately 20 million people suffer from the chronic phases of Chagas' disease, of which chagasic cardiomyopathy is the most important clinical feature. The elimination of Trypanosoma cruzi is a pivotal step in arresting the evolution of the disease. Unfortunately, currently available chemotherapy is mostly ineffective due to its limited efficacy and toxic side effects. The following case highlights the efficacy of new diagnostic and follow-up methods in the evaluation of novel trypanocidal compounds such as amiodarone and itraconazole.


Assuntos
Amiodarona/uso terapêutico , Antiarrítmicos/uso terapêutico , Doença de Chagas/tratamento farmacológico , Itraconazol/uso terapêutico , Tripanossomicidas/uso terapêutico , Animais , Doença de Chagas/diagnóstico , Doença Crônica , Quimioterapia Combinada , Ensaio de Imunoadsorção Enzimática , Imunofluorescência , Humanos , Masculino , Pessoa de Meia-Idade , Trypanosoma cruzi
12.
Food Sci Biotechnol ; 28(2): 441-448, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30956856

RESUMO

This study examined the impact of emulsifier type on the physicochemical characteristics and antifungal capacity of oregano oil-in-water emulsions: Tween 80, hydroxylated soy lecithin, and gum arabic. GC/MS analysis showed that the major components of the Lippia graveolens essential oils were thymol (31.7%), p-cymene (18.7%), and carvacrol (14.6%). The oil-in-water emulsions were made using ultrasonic technology in which thymol and carvacrol quantities were 12.26-13.67 g/L and 5.6-6.2 g/L, respectively. The droplet size of the emulsions followed the next descendent order: gum arabic > lecithin > T80. The zeta potential of the emulsions favored the stability against coalescence. Finally, the antifungal activity of the emulsions was evaluated, in which, 30 µL/mL of gum arabic or hydroxylated soy lecithin emulsions inhibited the growth of Candida albicans. The result suggests that Mexican oregano essential oil emulsions can be used as an antifungal against of C. albicans.

13.
Nat Commun ; 10(1): 403, 2019 01 24.
Artigo em Inglês | MEDLINE | ID: mdl-30679422

RESUMO

Albuminuria affects millions of people, and is an independent risk factor for kidney failure, cardiovascular morbidity and death. The key cell that prevents albuminuria is the terminally differentiated glomerular podocyte. Here we report the evolutionary importance of the enzyme Glycogen Synthase Kinase 3 (GSK3) for maintaining podocyte function in mice and the equivalent nephrocyte cell in Drosophila. Developmental deletion of both GSK3 isoforms (α and ß) in murine podocytes causes late neonatal death associated with massive albuminuria and renal failure. Similarly, silencing GSK3 in nephrocytes is developmentally lethal for this cell. Mature genetic or pharmacological podocyte/nephrocyte GSK3 inhibition is also detrimental; producing albuminuric kidney disease in mice and nephrocyte depletion in Drosophila. Mechanistically, GSK3 loss causes differentiated podocytes to re-enter the cell cycle and undergo mitotic catastrophe, modulated via the Hippo pathway but independent of Wnt-ß-catenin. This work clearly identifies GSK3 as a critical regulator of podocyte and hence kidney function.


Assuntos
Albuminúria/metabolismo , Quinase 3 da Glicogênio Sintase/metabolismo , Nefropatias/metabolismo , Rim/fisiologia , Podócitos/metabolismo , Albuminúria/sangue , Albuminúria/patologia , Albuminúria/urina , Animais , Ciclo Celular , Linhagem Celular , Modelos Animais de Doenças , Drosophila , Deleção de Genes , Inativação Gênica , Quinase 3 da Glicogênio Sintase/genética , Glicogênio Sintase Quinase 3 beta/efeitos dos fármacos , Glicogênio Sintase Quinase 3 beta/genética , Glicogênio Sintase Quinase 3 beta/metabolismo , Via de Sinalização Hippo , Estimativa de Kaplan-Meier , Rim/patologia , Nefropatias/sangue , Nefropatias/patologia , Nefropatias/urina , Masculino , Camundongos , Podócitos/enzimologia , Podócitos/patologia , Isoformas de Proteínas/genética , Isoformas de Proteínas/metabolismo , Proteínas Serina-Treonina Quinases/genética , Proteínas Serina-Treonina Quinases/metabolismo , Proteômica , Ratos Wistar , Insuficiência Renal , Verteporfina/farmacologia , beta Catenina/metabolismo
14.
Neuroscience ; 155(3): 603-12, 2008 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-18616989

RESUMO

Stimulation of kappa-opioid receptors in the substantia nigra pars reticulata (SNPR) increases the locomotor activity of young rats: an effect blocked by systemic administration of a D2-like receptor agonist. Based on these initial findings, we proposed that: (a) D2-like receptors in the dorsal striatum are responsible for attenuating kappa-opioid-induced locomotor activity, and (b) the effects of D2-like receptor stimulation are mediated by the indirect pathway, which extends from the dorsal striatum to the SNPR via the globus pallidus (GP) and subthalamic nucleus (STN). To test the first hypothesis, young rats were given a systemic injection (i.p.) of saline or the kappa-opioid receptor agonist (+/-)-trans-U50,488 methanesulfonate salt (U50,488) on postnatal day (PD) 18. Later in the testing session, rats received bilateral infusions of vehicle or the D2-like receptor agonist R(-)-propylnorapomorphine (NPA) into the dorsal striatum, and the ability of NPA to block U50,488-induced locomotor activity was determined. To test the second hypothesis, rats were given sham or bilateral electrolytic lesions of the GP or STN on PD 16. Two days later, saline- and U50,488-induced locomotor activity was measured after systemic (i.p.) administration of vehicle or NPA. As predicted, dorsal striatal infusions of NPA attenuated the U50,488-induced locomotor activity of young rats. Contrary to our expectations, bilateral lesions of the GP or STN did not impair NPA's ability to block U50,488-induced locomotor activity. When considered together, these results suggest that: (a) stimulation of D2-like receptors in the dorsal striatum is sufficient to attenuate the kappa-opioid-mediated locomotor activity of young rats; and (b) the indirect pathway does not mediate the effects of D2-like receptor stimulation in this behavioral model.


Assuntos
Apomorfina/análogos & derivados , Corpo Estriado/efeitos dos fármacos , Agonistas de Dopamina/farmacologia , Atividade Motora/efeitos dos fármacos , Receptores Opioides kappa/fisiologia , (trans)-Isômero de 3,4-dicloro-N-metil-N-(2-(1-pirrolidinil)-ciclo-hexil)-benzenoacetamida/farmacologia , Analgésicos não Narcóticos/farmacologia , Análise de Variância , Animais , Animais Recém-Nascidos , Apomorfina/farmacologia , Comportamento Animal/efeitos dos fármacos , Corpo Estriado/fisiologia , Relação Dose-Resposta a Droga , Globo Pálido/lesões , Globo Pálido/fisiologia , Atividade Motora/fisiologia , Vias Neurais/efeitos dos fármacos , Vias Neurais/fisiologia , Ratos , Ratos Sprague-Dawley , Núcleo Subtalâmico/lesões , Núcleo Subtalâmico/fisiologia
15.
Arch Soc Esp Oftalmol ; 83(10): 579-88, 2008 Oct.
Artigo em Espanhol | MEDLINE | ID: mdl-18855277

RESUMO

PURPOSE: Systematic review on efficacy and safety of intravitreal bevacizumab (IVB) in the treatment of neovascular glaucoma (NVG). All original papers published in Medline (prior to August 2008) were included. METHODS: Search and selection of information on the internet and in Medline, validated by Kappa Index (K). Statistical and clinical study of the results in the selected articles on a one by one basis. RESULTS: 26 original papers analyzed the efficacy and safety of the procedure in case reports and short series of cases (127 eyes). The efficacy calculated in the sample was 68.7% and the recurrence rate was 18.6% in 4.2 months of follow-up. All studies were after 2006 and none of them was a clinical randomized controlled assay. Ophthalmic complications were under 0.78% and no systemic complications were found. CONCLUSIONS: The use of bevacizumab demonstrates that intravitreal injections may be effective and useful to manipulate growth factors in the anterior chamber. IVB could serve as a first line treatment for NVG. Clinical trials are needed to confirm these results before its use is authorized.


Assuntos
Inibidores da Angiogênese/administração & dosagem , Anticorpos Monoclonais/administração & dosagem , Glaucoma Neovascular/tratamento farmacológico , Corpo Vítreo , Anticorpos Monoclonais Humanizados , Bevacizumab , Humanos , Injeções
16.
Cir Pediatr ; 21(2): 73-8, 2008 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-18624273

RESUMO

In this paper we describe the surgical management and postoperative recurrence of preauricular fistula (PAF) since the surgical treatment is characterized by high recurrence rates. All clinical, operative and postoperative data were collected from a retrospective review of patients's charts who underwent primary surgical management between January 2001 and December 2006 at five Hospitals in Guadalajara, Jalisco. Thirty-eight patients (15 male, 23 female) with PAF underwent 44 surgical procedures. Recurrent acute infection and discharge were the most common symptoms. The surgical management included 25 standard techniques (sinectomy) and 19 supra-auricular approaches. The overall rate of recurrence was 59%, it differed widely between surgical techniques employed. The 52.2% recurrence rate of standard technique was significantly higher than the 6.8% recurrence rate of the supra-auricular approach (p = 0.01). Also, the patients in whom a portion of the cartilage of the helix was not excised from the base of the tract, 84.6% recurred vs. 15.3% when cartilage was excised (p = 0.01). Our experience has shown that independently of clinical presentation of PAF, the standard technique and not to remove a portion of the cartilage at the base of the helix contributed to recurrence. We advise the supra-auricular approach particularly when there are abscess prior to surgery.


Assuntos
Orelha Externa/anormalidades , Fístula/congênito , Fístula/cirurgia , Adolescente , Adulto , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Masculino , Recidiva , Estudos Retrospectivos
17.
Med Intensiva (Engl Ed) ; 42(8): 490-499, 2018 Nov.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-29486905

RESUMO

In nested case-control studies, sampling of controls is usually done by density of incidence and pairing. With regard to the classic control cases studies, nested ones are more efficient, allow the calculation of the incidence of the disease and they have more internal validity due to the lower presence of bias. Competitive risks techniques can be used if we study different types of events and focus on the time and type of the first event. Recursive partitioning is a type of multivariate analysis whose purpose is the construction of classification algorithms, and it is especially useful when there are a large number of predictive variables with complex relationships with the event.


Assuntos
Cuidados Críticos/estatística & dados numéricos , Estudos Epidemiológicos , Pesquisa/estatística & dados numéricos , Algoritmos , Estudos de Casos e Controles , Causalidade , Ensaios Clínicos como Assunto/ética , Ensaios Clínicos como Assunto/estatística & dados numéricos , Grupos Controle , Projetos de Pesquisa Epidemiológica , Ética em Pesquisa , Humanos , Incidência , Estudos Observacionais como Assunto/ética , Estudos Observacionais como Assunto/estatística & dados numéricos , Projetos de Pesquisa , Medição de Risco , Estatísticas não Paramétricas
18.
Av. odontoestomatol ; 39(4)2023. ilus, tab
Artigo em Espanhol | IBECS (Espanha) | ID: ibc-227562

RESUMO

Introducción: El objetivo del presente estudio era mostrar los resultados clínicos del tratamiento del maxilar superior posterior con implantes colocados mediante la técnica de elevación transalveolar del seno maxilar en pacientes geriátricos. Pacientes y Métodos: 24 pacientes geriátricos (15 hombres y 9 mujeres) con pérdidas dentales maxilares fueron tratados con 28 implantes diferentes colocados mediante la técnica de elevación sinusal transalveolar para su posterior rehabilitación prostodóncica. Los implantes fueron cargados después de un periodo de cicatrización de 6 meses. Resultados: Los hallazgos clínicos indican una supervivencia y éxito de los implantes del 96,4%. En un paciente de los 24 tratados (4,2%) se perdió un implante (3,6%). La altura ósea residual media fué de 6,38 ±1,10 mm (rango:5-10 mm). La ganancia media de hueso vertical fué de 4,40 ±1,15 mm (rango: 2-7 mm). 67,8% de los implantes se insertaron en localización molar y el 32,2% en la localización premolar. Se utilizaron biomateriales en el 97,8% de los implantes. Se realizaron coronas unitarias en 20 pacientes (83,3%), puentes fijos en 3 pacientes (12,5%) y una sobredentadura con bolas en un paciente (4,2%). El seguimiento medio de los pacientes estudiados ha sido de 64,2 ±8,6 meses con un rango entre 50 y 82 meses. Conclusiones: Este estudio indica que el tratamiento con implantes dentales mediante la elevación transalveolar del seno maxilar superior en pacientes geriátricos, constituye una terapéutica implantológica con una elevada tasa de éxito. (AU)


Introduction: The aim of this study was to report the clinical findings of treatment of posterior maxilla with dental implants inserted by transalveolar sinus elevation in geriatric patients. Patients and Methods: 24 geriatric patients (15 males and 9 females) with maxillary tooth loss were treated with 28 different implants placed by transalveolar sinus elevation for rehabilitation of posterior maxilla. Implants were loaded after a healing free-loading period of 6 months. Results: Clinical findings indicate a survival and success rate of implants of 96.4%. In one patient of 24 treated patients (4.2%), one implant was lost (3.6%). The mean residual height was 6.38 mm±1.10 mm (range: 5-10 mm). The mean elevation height was 4.40 mm±1.10 mm (range: 2-7 mm). 67.8% of implants were inserted in molar and 32.2% in premolar localization. Bone substitutes were used in 97.8% of implants. Twenty patients (83.3%) were restored with single crowns, 3 patients with fixed bridges (12.5%) and one patient (4.2%) with overdenture. The mean follow-up period of treated patients was 64.2 ±8.6 months (range: 50-82 months). Conclusions: This study indicates that treatment with dental implants placed by transalveolar sinus elevation in geriatric patients constitute an implant treatment with a high success rate. (AU)


Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Maxila/cirurgia , Implantes Dentários , Levantamento do Assoalho do Seio Maxilar , Espanha , Materiais Biocompatíveis , Envelhecimento
19.
Av. odontoestomatol ; 39(4)2023. ilus
Artigo em Espanhol | IBECS (Espanha) | ID: ibc-227563

RESUMO

Introducción: El objetivo del presente estudio era mostrar los resultados del tratamiento con implantes dentales insertados en área regeneradas con betafosfato tricálcico. Métodos: 48 pacientes con pérdidas dentales parciales fueron tratados con 97 implantes Galimplant ® en área regeneradas con betafofato tricálcico Osteoblast ®. Diversas técnicas fueron realizadas (implantes inmediata en alveolos postextracción; expansión ósea con expansores u osteotomos y elevación transalveolar / lateral del seno maxilar). Los implantes fueron cargados después de un periodo de cicatrización de 6 meses. Resultados: 48 pacientes fueron tratados con implantes, con una edad media de 37,4 años (rango: 22-63 años). En 16 pacientes (33,3%) se realizó la inserción de implantes de forma inmediata en alveolos postextracción. En 9 pacientes (18,7%) se realizó la técnica de expansión ósea con expansores u osteotomos. En 10 pacientes (20,8%) se realizó la elevación transalveolar del seno maxilar. En 13 pacientes (27,1%) la elevación sinusal fué lateral. En la investigación realizada se perdieron 4 implantes de los 97 insertados (4,1%). 2 implantes fueron fracasos inmediatos o precoces (2,06%) ya que se perdieron, durante la fase de cicatrización, al no conseguir la oseointegración. Los 2 fracasos tardíos fueron por periimplantitis (2,06%). La pérdida media de hueso marginal fué de 1,34 ±1,19 mm. Se realizaron un total de 78 prótesis (100%), 61 coronas unitarias (78,2%) y 17 puentes fijos (21,8%). El periodo de seguimiento clínico ha sido de 5 años. Conclusiones: Este estudio indica que los implantes dentales pueden ser insertados con éxito en las áreas regeneradas con betafosfato tricálcico. (AU)


Introduction: The aim of this study was to report the outcome of treatment with dental implants inserted in regenerated sites with beta-tricalcium phosphate. Methods: 48 patients with partial tooth loss were treated with 97 Galimplant ® implants in regenerated sites with beta-tricalcium phosphate Osteoblast ®. Patients were treated with several surgical tecniques (immediate implants in fresh sockets, alveolar ridge expansion, transalveolar /lateral sinus elevation). Implants were loaded after a healing free-loading period of 6 months. Results: 48 patients were treated, with a mean age of 37.4 years (range: 22-63 yr), with 97 implants. Sixteen patients (33.3%) were treated with immediate implants in fresh sockets; in 9 patients (18.7%), alveolar ridge expansion were used; and 10 patients (20.8%) were treated with transalveolar or lateral sinus elevation (13 patients; 27.1%). 2 implants (2,06%) were lost during the healing period and two implant (2,06%) was lost by peri-implantitis. Marginal bone loss was 1.34 ±1.19 mm. A total of 78 prostheses were realized, 61 single crowns (78.2%) and 17 fixed bridges (21.8%). The follow-up period was of 5 years. Conclusions: This study indicate that dental implants can be inserted with success in regenerated sites with beta-tricalcium phosphate. Conclusions: This study indicates that treatment with dental implants placed by transalveolar sinus elevation in geriatric patients constitute an implant treatment with a high success rate. (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Implantes Dentários , Transplante Ósseo , Regeneração Óssea , Resultado do Tratamento , Fosfatos de Cálcio , Implantação de Prótese
20.
Av. odontoestomatol ; 39(4)2023. ilus, tab
Artigo em Espanhol | IBECS (Espanha) | ID: ibc-227564

RESUMO

Introducción: El objetivo del presente estudio era mostrar los resultados de la pérdida ósea marginal en el tratamiento con rehabilitación fija mediante implantes dentales en pacientes edéntulos totales. Material y Métodos: 24 pacientes edéntulos fueron tratados con 210 implantes KTX ® con superficie arenada y grabada para la rehabilitación total fija. Los implantes fueron cargados inmediatamente en el mismo día de la cirugía. El seguimiento clínico medio fue de 37,1 ±14,6 meses. Resultados: Los hallazgos clínicos indican una supervivencia y éxito de los implantes del 99,5%. Los pacientes fueron rehabilitados con 33 prótesis totales fijas atornilladas. Complicaciones biológicas fueron observadas en el 50% de los pacientes y las complicaciones prostodóncicas en el 4,2% de los pacientes. La pérdida ósea marginal fue de 1,33± 0,77 mm. La pérdida ósea marginal no estuvo relacionada significativamente con la edad, sexo, hábito de fumar, antecedentes médicos, tipos de prótesis y seguimiento clínico. Conclusiones: Este estudio indica que la rehabilitación fija mediante implantes dentales en pacientes edéntulos totales constituye una terapéutica con éxito con una pérdida ósea marginal frecuente. (AU)


Introduction: The aim of this study was to report the outcome of marginal bone loss in the treatment of fully edentulous patients with fixed prostheses supported with dental implants. Material & Methods: 24 edentulous patients were treated with 210 KTX ® sandblasted and acid surface implants for fixed maxilla/mandible rehabilitation. Implants were immediately loaded in the same day of the surgery. The mean follow-up was 37.1 ±14.6 months. Results: Clinical results indicate a survival and success rate of implants of 99.5%. One implant was lost during the follow-up period. The patients were restored with 33 screw fixed rehabilitations. Biological complications were observed in 50% of patients and technical complications in 4.2% of patients. Mean marginal bone loss was 1.33 ± 0. 77 mm. Marginal bone loss are not significantly related with age, gender, smoking, medical background, types of prostheses, and clinical follow-up. Conclusions: This study indicates that fixed rehabilitations by dental implants in totally edentulous patients constitute a successful treatment with a frequent marginal bone loss. (AU)


Assuntos
Humanos , Reabsorção Óssea/reabilitação , Implantes Dentários , Arcada Edêntula/reabilitação , Arcada Edêntula/cirurgia , Implantação de Prótese , Carga Imediata em Implante Dentário
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