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INTRODUCTION: The prone transpsoas technique (PTP) is a modification of the traditional lateral lumbar interbody fusion approach, which was first published in the literature in 2020. The technique provides several advantages, such as lordosis correction and redistribution, single-position surgery framework, and ease of performing posterior techniques when needed. However, the prone position also leads to the movement of some retroperitoneal, vascular, and neurological structures, which could impact the complication profile. Therefore, this study aimed to investigate the occurrence of major complications in the practice of early adopters of the PTP approach. METHODS: A questionnaire containing 8 questions was sent to 50 participants and events involving early adopters of the prone transpsoas technique. Of the 50 surgeons, 32 completed the questionnaire, which totaled 1963 cases of PTP surgeries. RESULTS: Nine of the 32 surgeons experienced a major complication (28%), with persistent neurological deficit being the most frequent (7/9). Of the total number of cases, the occurrence of permanent neurological deficits was approximately 0,6%, and the rate of vascular and visceral injuries were both 0,05% (1/1963 for each case). CONCLUSION: Based on the analysis of the questionnaire responses, it can be concluded that PTP is a safe technique with a very low rate of serious complications. However, future studies with a more heterogeneous group of surgeons and a more rigorous linkage between answers and patient data are needed to support the findings of this study.
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Complicações Pós-Operatórias , Músculos Psoas , Fusão Vertebral , Humanos , Fusão Vertebral/métodos , Fusão Vertebral/efeitos adversos , Complicações Pós-Operatórias/epidemiologia , Decúbito Ventral , Inquéritos e Questionários , Vértebras Lombares/cirurgia , Masculino , FemininoRESUMO
Scoliosis is the most prevalent type of spinal deformity, with a 2-3% prevalence in the general population. Moreover, surgery for scoliotic deformity may result in severe blood loss and, consequently, the need for blood transfusions, thereby increasing surgical morbidity and the rate of complications. Several antifibrinolytic drugs, such as tranexamic acid, have been regarded as safe and effective options for reducing blood loss. Therefore, the present study aimed to analyse the effectiveness of this drug for controlling bleeding when used intraoperatively and in the first 48 h after surgery. A prospective randomized study of a cohort of patients included in a mass event for scoliosis treatment using PSF was performed. Twenty-eight patients were analysed and divided into two groups: 14 patients were selected for intraoperative and postoperative use of tranexamic acid (TXA), and the other 14 were selected only during the intraoperative period. The drainage bleeding rate, length of hospital stay, number of transfused blood units, and rate of adverse clinical effects were compared. All the patients involved had similar numbers of fusion levels addressed and similar scoliosis profiles. The postoperative bleeding rate through the drain did not significantly differ between the two groups (p > 0.05). There was no significant difference in the number of transfused blood units between the groups (p = 0.473); however, in absolute numbers, patients in the control group received more transfusions. The length of hospital stay was fairly similar between the groups, with no statistically significant difference. Furthermore, the groups had similar adverse effects (p = 0.440), with the exception of nausea and vomiting, which were twice as common in the TXA group postoperatively than in the control group. No significant differences were found in the use of TXA during the first 48 postoperative hours or in postoperative outcomes.
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Antifibrinolíticos , Perda Sanguínea Cirúrgica , Escoliose , Fusão Vertebral , Ácido Tranexâmico , Humanos , Ácido Tranexâmico/uso terapêutico , Escoliose/cirurgia , Feminino , Fusão Vertebral/métodos , Fusão Vertebral/efeitos adversos , Masculino , Antifibrinolíticos/uso terapêutico , Perda Sanguínea Cirúrgica/prevenção & controle , Adolescente , Estudos Prospectivos , Adulto , Transfusão de Sangue/estatística & dados numéricos , Resultado do Tratamento , Período Pós-Operatório , Tempo de Internação , Adulto Jovem , Hemorragia Pós-Operatória/epidemiologiaRESUMO
OBJECTIVES: This study aimed to describe the effects of two single-file systems on the diversity of the endodontic microbiome of teeth with primary asymptomatic apical periodontitis. MATERIALS AND METHODS: The root canals from single-rooted teeth with apical periodontitis were prepared using either the Reciproc Blue (RB) or the XP-endo Shaper (XPS) instrument system. The latter was followed by a supplementary step with the XP-endo Finisher (XPF) instrument. For irrigation, 5.25% sodium hypochlorite was used. Root canal samples were taken at the baseline (S1), after preparation (S2), and after the supplementary step (S3). DNA was extracted and subjected to high-throughput sequencing using the MiSeq Illumina platform. RESULTS: Samples from 10 teeth from the RB and 7 from the XPS group were subjected to DNA sequencing. Initial samples differed significantly from post-preparation samples in bacterial diversity, with no significant difference when comparing the two instrument systems. The most dominant phyla in S2 were Bacteroidetes, Proteobacteria, Firmicutes, Fusobacteria, and Actinobacteria. The same phyla were found to dominate baseline samples and samples taken after using XPF, but with differences in the ranking of the most dominant ones. At the genus level, the most dominant genera identified after RB instrumentation were Bacteroidaceae [G-1], Fusobacterium, and Staphylococcus, while the most dominant genera after XPS instrumentation were Fusobacterium and Porphyromonas. These genera were also dominant in the initial samples. CONCLUSIONS: Both treatment protocols had measurable effects on the root canal microbial diversity, with no significant differences between them. Most of the dominant taxa involved in the primary infection and probably in the aetiology of apical periodontitis were eliminated or substantially reduced. CLINICAL RELEVANCE: The most dominant taxa that persisted after instrumentation were Fusobacterium, Porphyromonas, Staphylococcus, and Bacteroidaceae [G-1].
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Periodontite Periapical , Preparo de Canal Radicular , Humanos , Cavidade Pulpar/microbiologia , Tratamento do Canal Radicular , Periodontite Periapical/microbiologia , BactériasRESUMO
OBJECTIVES: This prospective randomized multicenter clinical trial (PRMCT) investigated postoperative pain after single-visit root canal treatments in teeth affected by pulp necrosis (PN), and asymptomatic apical periodontitis (AAP) (with apical radiolucent areas) or normal periradicular tissues (without apical radiolucent areas) comparing different instruments' kinematics and apical instrumentation limits. METHODS: Before chemomechanical preparation, 240 patients/teeth were randomly distributed into four groups (n = 60) according to the instruments' kinematics (rotary or reciprocating) and apical instrumentation limits (with or without intentional foraminal enlargement [IFE]). After that, specimens were submitted to the same irrigation and obturation techniques, and the patients were referred to undergo the definitive restorations. No medication was prescribed, but the patients were instructed to take either paracetamol (750 mg every 6 h for three days) or ibuprofen (600 mg every 6 h for three days) in pain cases. Postoperative pain incidence and levels were assessed at 24-, 48-, and 72 h following treatment completion according to a verbal rating scale (VRS) following a score. The Kolmogorov-Smirnov test was applied to assess the normality of the data. Mann-Whitney U, Chi-square, Friedman's ANOVA, and Friedman's multiple 2 to 2 comparison tests were employed to identify potential significant statistical differences among the variables in the study groups (P < .05). RESULTS: Significant statistical differences were only observed among the groups considering tooth, periradicular status, and the occurrence of overfilling (sealer extrusion) (P < 0.00). Patients with teeth instrumented through rotary kinematics and without IFE experienced lower rates of postoperative pain; however, this difference was relevant only at 24 h (P < 0.05). CONCLUSIONS: Postoperative pain was lower after using a rotary file system (Profile 04) inserted up to the apical constriction (AC). However, this finding was just statistically meaningful at 24 h. TRIAL REGISTRATION: This PRMCT was approved by the Human Research Ethics Committee of the Paranaense University - UNIPAR, Francisco Beltrão, PR, Brazil (CAAE. 46,774,621.6.0000.0109) on 02/09/2021. It was registered at The Brazilian Registry of Clinical Trials - ReBEC (RBR-3r967t) on 01/06/2023, was performed according to the Principles of the Helsinki Declaration and is reported following the Consolidated Standards of Reporting Trials Statement.
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Cavidade Pulpar , Preparo de Canal Radicular , Humanos , Cavidade Pulpar/cirurgia , Estudos Prospectivos , Fenômenos Biomecânicos , Dor Pós-Operatória/etiologia , Dor Pós-Operatória/epidemiologiaRESUMO
AIM: To evaluate the efficacy of Odontopaste in reducing the microbial load in endodontics compared to other intracanal medicaments. MATERIALS AND METHODS: The literature was electronically searched on PubMed, Google Scholar, Scopus, Ovid Medline and Web of Science. In-vitro, ex-vivo and in-vivo studies that evaluated the antimicrobial efficacy of Odontopaste were included. The risk of bias was assessed using the Quality Assessment Tool for In Vitro Studies. RESULTS: A total of four in-vitro studies were included in the systematic review. One study showed that Odontopaste had significantly more microbial cell growth on roots in all dentine depths compared to other medicaments or test agents. Another study found that Odontopaste significantly decreased colony-forming units compared to propolis and chlorhexidine. Further results showed that Odontopaste did not significantly decrease microbial numbers when used in isolation. Additionally, combining Odontopaste and calcium hydroxide did not enhance the effectiveness of calcium hydroxide. The studies had a medium to high risk of bias. CONCLUSION: There is insufficient high-quality evidence to assess the antimicrobial efficacy of Odontopaste compared to other intracanal medicaments. Further research is required to determine Odontopaste's efficacy as an antimicrobial medicament in endodontics.
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Freshwater cetaceans play a significant role as sentinel animals, providing important data on animal species and aquatic ecosystem health. They also may serve as potential reservoirs of emerging pathogens and host virulence genes in their microbiota. In this study, we evaluated virulence factors produced by Gram-negative bacteria recovered from individuals belonging to two populations of free-ranging Amazon river dolphins (Inia geoffrensis). A total of 132 isolates recovered from the oral cavity, blowhole, genital opening and rectum of 21 river dolphins, 13 from Negro River and 8 from Tapajós River, Brazil, were evaluated for the production of virulence factors, such as biofilms and exoproducts (proteases, hemolysins and siderophores), in planktonic and biofilm forms. In planktonic form, 81.1% (107/132) of the tested bacteria of free-ranging Amazon river dolphins were able to produce virulence factors, with 44/132 (33.4%), 65/132 (49,2%) and 54/132 (40,9%) positive for protease, hemolysin and siderophore production, respectively. Overall, 57/132 (43.2%) of the isolates produced biofilms and, under this form of growth, 66/132 (50%), 88/132 (66.7%) and 80/132 (60.6%) of the isolates were positive for protease, hemolysin and siderophore production. In general, the isolates showed a higher release of exoproducts in biofilm than in planktonic form (P < 0.001). The present findings show that Amazon river dolphins harbor potentially pathogenic bacteria in their microbiota, highlighting the importance of monitoring the micro-organisms from wild animals, as they may emerge as pathogens for humans and other animals.
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Golfinhos , Humanos , Animais , Fatores de Virulência/genética , Ecossistema , Proteínas Hemolisinas , Sideróforos , Bactérias Gram-Negativas , Peptídeo HidrolasesRESUMO
Identifying the factors swaying physiological stress levels in wild animals can help depict how they cope with environmental and social stressors, shedding light on their feeding ecology, behavioral plasticity, and adaptability. Here, we used noninvasive methods to explore the link between glucocorticoid levels and behavior in an endangered neotropical primate facing habitat fragmentation pressure, the black lion tamarin (Leontopithecus chrysopygus). We investigated monthly and day-to-day glucocorticoid variations independently to attempt to disentangle the complex nature of the adrenocortical activity. Between May 2019 to March 2020, we followed two groups of black lion tamarins in two different areas, a continuous forest and a small fragment, and gathered behavioral data (over 95 days in total; 8.6 ± 3.9 days/month) and fecal samples (Nsamples = 468; 4.93 ± 3.5 samples/day) simultaneously. Preliminary analyses enabled us to identify circadian variations linked to the biological rhythm, which were taken into account in subsequent models. Monthly analyses revealed that black lion tamarin fecal glucocorticoid metabolite levels vary according to changes in activity budget associated with the fruit consumption, movement, and resting time of the groups. At a day-to-day level, while intergroup encounters led to increases in fecal glucocorticoid metabolite concentrations, we found that changes in food intake or activity level did not trigger physiological stress responses. These findings suggest that diet and ranging patterns, driven by food availability and distribution, influence physiological stress at a seasonal scale, while acute stressors such as interspecific competition trigger short-term stress responses. Exploring fecal glucocorticoid metabolite variations over different timescales can help uncover the predictive and reactive facets of physiological stress in wild species. Moreover, having a comprehensive understanding of the physiological state of species is a valuable conservation tool for evaluating how they cope in changing environments.
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Glucocorticoides , Leontopithecus , Animais , Glucocorticoides/análise , Primatas , Animais Selvagens , EcossistemaRESUMO
INTRODUCTION: The lateral lumbar interbody fusion arose as a revolutionary approach to treating several spinal pathologies because the techniques were able to promote indirect decompression and lordosis restoration through a minimally invasive approach allowing for reduced blood loss and early recovery for patients. However, it is still not clear how the technique compares to other established approaches for treating spinal degenerative diseases, such as TLIF, PLIF, and PLF. MATERIAL AND METHODS: This is a systematic review and meta-analysis of articles published in the last 10 years comparing lateral approaches to posterior techniques. The authors included articles that compared the LLIF technique to one or more posterior approaches, treating only degenerative pathologies, and containing at least one of the key outcomes of the study. Exclusion articles that were not original and the ones that the authors could not obtain the full text; also articles without the possibility to calculate the standard deviation or mean were excluded. For count variables, the odds ratio was used, and for continuous variables, the standard means difference (SMD) was used, and the choice between random or fixed-effects model was made depending on the presence or not of significant (p < 0.05) heterogeneity in the sample. RESULTS: Twenty-four articles were included in the quantitative review. As for the intra-/perioperative variables, the lateral approaches showed a significant reduction in blood loss (SMD-1.56, p < 0.001) and similar operative time (SMD = - 0.33, p = 0.24). Moreover, the use of the lateral approaches showed a tendency to lead to reduced hospitalization days (SMD = - 0.15, p = 0.09), with significantly reduced odds ratios of complications (0.53, p = 0.01). As for the clinical outcomes, both approaches showed similar improvement both at improvement as for the last follow-up value, either in ODI or in VAS-BP. Finally, when analyzing the changes in segmental lordosis and lumbar lordosis, the lateral technique promoted significantly higher correction in both outcomes (p < 0.05). CONCLUSION: Lateral approaches can promote significant radiological correction and similar clinical improvement while reducing surgical blood loss and postoperative complications.
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Lordose , Fusão Vertebral , Humanos , Lordose/cirurgia , Vértebras Lombares/cirurgia , Fusão Vertebral/métodos , Região Lombossacral/cirurgia , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Resultado do TratamentoRESUMO
OBJECTIVE: The aim of this paper was to evaluate the changes in radiographic spinopelvic parameters in a large cohort of patients undergoing the prone transpsoas approach to the lumbar spine. METHODS: A multicenter retrospective observational cohort study was performed for all patients who underwent lateral lumber interbody fusion via the single-position prone transpsoas (PTP) approach. Spinopelvic parameters from preoperative and first upright postoperative radiographs were collected, including lumbar lordosis (LL), pelvic incidence (PI), and pelvic tilt (PT). Functional indices (visual analog scale score), and patient-reported outcomes (Oswestry Disability Index) were also recorded from pre- and postoperative appointments. RESULTS: Of the 363 patients who successfully underwent the procedure, LL after fusion was 50.0° compared with 45.6° preoperatively (p < 0.001). The pelvic incidence-lumbar lordosis mismatch (PI-LL) was 10.5° preoperatively versus 2.9° postoperatively (p < 0.001). PT did not significantly change (0.2° ± 10.7°, p > 0.05). CONCLUSIONS: The PTP approach allows significant gain in lordotic augmentation, which was associated with good functional results at follow-up.
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Lordose , Fusão Vertebral , Humanos , Estudos Retrospectivos , Lordose/diagnóstico por imagem , Lordose/cirurgia , Complicações Pós-Operatórias/epidemiologia , Fusão Vertebral/métodos , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/cirurgia , Resultado do TratamentoRESUMO
INTRODUCTION: Lumbar interbody fusion is a standard method to treat certain degenerative conditions that are refractory to conservative treatments. LLIF reduces posterior muscle damage, can relieve neurological symptoms through indirect decompression, provides increased stability with its wider cages, and promotes more significant segmental lordosis than standard posterior techniques. However, the technique possesses its issues, such as unusual positioning, possible plexus-related symptoms, and median segmental lordosis correction. Trying to ease those issues, the idea of a prone transpsoas technique occurred. METHODS: Retrospective, single-centric, comparative, and non-randomized study. The authors paired patients receiving lateral lumbar interbody fusion (LLIF) or prone transpsoas (PTP) to evaluate the technique's impact on the segmental lordosis correction. A correlation test selected the covariates for the matching. p-Values inferior to 0.05 were deemed significant. RESULTS: Seventy-one patients were included in the analysis, 53 in the LLIF group and 18 in the PTP group. The significant covariates to the segmental lordosis correction were technique, preoperative segmental lordosis, cage position, and preoperative pelvic tilt. After the paring model, PTP showed significant segmental lordosis correction potential regarding the LLIF. CONCLUSION: The prone transpsoas approach can significantly enhance the correction of segmental lordosis proportionated to the traditional LLIF approach.
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Lordose , Fusão Vertebral , Humanos , Lordose/etiologia , Lordose/cirurgia , Estudos Retrospectivos , Vértebras Lombares/cirurgia , Postura , Fusão Vertebral/métodosRESUMO
A 57-year-old man was diagnosed with acute myocardial infarction and Stanford type A aortic dissection that had spread to the common iliac arteries. He underwent a Bentall procedure for vascular repair. Immediately after surgery, he developed numbness and severe weakness in his left leg. On examination, he had hypotonia, absent deep tendon reflexes, weakness in the left leg (Medical Research Council (MRC) scale for muscle strength - 0/5 distal, 3/5 proximal) and reduced sensation in the left leg. Electromyography confirmed subacute involvement of the left lumbar and lumbosacral plexus. MR scan of the lumbar plexus showed diffuse muscle oedema involving the left gluteus maximus. We diagnosed ischaemic lumbosacral plexopathy secondary to extensive aorta dissection and internal iliac artery occlusion. We discuss the clinical features of ischaemic plexopathy and the diagnostic approach and review the vascular anatomy of the lumbosacral plexus.
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Dissecção Aórtica , Isquemia , Masculino , Humanos , Pessoa de Meia-Idade , Isquemia/diagnóstico por imagem , Isquemia/etiologia , Isquemia/cirurgia , Artéria Ilíaca/cirurgia , Músculo Esquelético , Eletromiografia , Dissecção Aórtica/complicações , Dissecção Aórtica/diagnóstico por imagem , Dissecção Aórtica/cirurgiaRESUMO
BACKGROUND: Mechanical heart valves (MHV) and its fluid dynamics inside a pulsatile pediatric ventricular assist device (PVAD) can be associated with blood degradation. In this article, flow structures are analyzed and compared by an experimental investigation on the effect of bileaflet MHV positioned at varying angles in the inlet port orifice of a PVAD. METHODS: Time-resolved particle image velocimetry was applied to characterize the internal flow of the device. St Jude Medical bileaftlet valves were used on the inlet orifice and positioned at 0°, 15°, 30°, 45°, 60°, and 90° in relation to the centerline of the device. Three planes with bidimensional velocity magnitude fields were considered in the analysis with visualization of diastolic jets, device wall washing patterns and flow circulation during emptying or systole of the pump. Also, the washing vortex area, and vertical velocity probabilities of regurgitant flows in the inlet valve were evaluated. RESULTS: The results show that a variation in the angle of the MHV at the inlet port produced distinct velocities, fluid structures, and regurgitant flow probabilities within the device. MHV positioned at an angle of 0° generated the strongest inlet jet, larger vortex area during filling, more prominent outgoing flow, and less regurgitation compared to the angles studied. The presence of unfavorable fluid structures, such as small vortices, and/or sudden flow structure interruption, and/or regurgitation, were identified at 45° and 90° angles. CONCLUSIONS: The 0° inlet angle had better outcomes than other angles due to its consistency in the multiple parameters analyzed.
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Próteses Valvulares Cardíacas , Coração Auxiliar , Baías , Velocidade do Fluxo Sanguíneo , Criança , Humanos , Modelos Cardiovasculares , Desenho de Prótese , Fluxo PulsátilRESUMO
INTRODUCTION: With the increase in life expectancy and consequent aging of the population, degenerative lumbar spine diseases tend to increase its number exponentially. Several treatment options are available to treat degenerative spinal diseases, such as laminectomies, posterior fusions, and interbody fusions, depending on their locations, correction necessities, and surgeon philosophy. With the advance in technology and surgical knowledge, minimally invasive techniques (MIS) arose as a solution to reduce surgical morbidity, while maintaining the same benefits as the traditionally/open surgeries. Several studies investigated the possible advantages of MIS techniques against the traditional open procedures. However, those articles are usually focused only on one technique or on one pathology. METHODS: The electronic databases, including PubMed, Google Scholar, Ovid, and BVS, were systematically reviewed. Only original articles in English or Portuguese were added to the review, the revision was performed following the PRISMA guideline. RESULTS: Fifty-three studies were included in the meta-analysis. Of the studied outcomes the Length of Stay Odds of complications, Blood Loss, and Surgery costs presented significantly favored MIS approaches, while the Last FUP ODI score, and Surgery Time did not differ among the groups. CONCLUSION: Minimally invasive techniques are a remarkably interesting option to traditional open surgeries, as these procedures showed a significant reduction in blood loss, hospitalization time, complications, and surgical costs.
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Fusão Vertebral , Humanos , Vértebras Lombares/cirurgia , Região Lombossacral/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Estudos Retrospectivos , Fusão Vertebral/métodos , Resultado do TratamentoRESUMO
BACKGROUND AND PURPOSE: Anterior lumbar approaches are recommended for clinical conditions that require interbody stability, spinal deformity corrections or a large fusion area. Anterior lumbar interbody fusion in lateral decubitus position (LatALIF) has gained progressive interest in the last years. The study aims to describe the current habit, the perception of safety and the perceptions of need of vascular surgeons according to experienced spine surgeons by comparing LatALIF to the standard L5-S1 supine ALIF (SupALIF). METHODS: A two-round Delphi method study was conducted to assess the consensus, within expert spine surgeons, regarding the perception of safety, the preoperative planning, the complications management and the need for vascular surgeons by performing anterior approaches (SupALIF vs LatALIF). RESULTS: A total of 14 experts voluntary were involved in the survey. From 82 sentences voted in the first round, a consensus was reached for 38 items. This included the feasibility of safe LatALIF without systematic involvement of vascular surgeon for routine cases (while for revision cases the involvement of the vascular surgeon is an appropriate option) and the appropriateness of standard MRI to evaluate the accessibility of the vascular window. Thirteen sentences reached the final consensus in the second round, whereas no consensus was reached for the remaining 20 statements. CONCLUSIONS: The Delphi study collected the consensus on several points, such as the consolidated required experience on anterior approaches, the accurate study of vascular anatomy with MRI, the management of complications and the significant reduction of the surgical times of the LatALIF if compared to SupALIF in combined procedures. Furthermore, the study group agrees that LatALIF can be performed without the need for a vascular surgeon in routine cases.
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Fusão Vertebral , Cirurgiões , Técnica Delphi , Humanos , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/cirurgia , Fusão Vertebral/métodos , Resultado do TratamentoRESUMO
INTRODUCTION: The lateral lumbar interbody fusion (LLIF) is a safe and effective technique to treat a vast range of lumbar disorders. However, the technique is also burdened by some problems. A new approach to the lateral lumbar interbody fusion was devised to solve or reduce some of the problems regarding the lateral approach. Its principal difference from the standard LLIF relies on positioning the patient in a prone decubitus, which might lead to an increase in the intradiscal lordosis. METHODS: A retrospective, multicentric, non-randomized study to evaluate segmental and regional lordosis following prone transpsoas (PTP) approach to LLIF. All patients undergoing prone transpsoas surgery at the involved institutions were included. Patients with low-quality images not allowing the measurements of the required spinopelvic parameters were excluded. Measurements included pre- and postoperative index-level segmental lordosis, lumbar lordosis, pelvic incidence, and pelvic tilt. RESULTS: Thirty-two (32) patients were included in the study, in which 23 underwent single-level, six (6) underwent two-level, Two (2) underwent three-level, and one underwent four-level PTP. Mean index level segmental lordosis increased from 8.7° to 14.8°(p < 0.001); lumbar lordosis (L1-S1) increased from 42.1° to 45.8° (p = 0.11), although after excluding an outlier value L1-S1 lordosis results were 41.9° pre-op to 46.7° post-op (p = 0.003). Twenty-two (22) patients had a pre-op PI-LL mismatch of 10° or more, while at the postoperative visit, only 12 patients had a mismatch outside of 10° (p = 0.01). CONCLUSION: The prone transpsoas technique is feasible and is associated with a significant gain of segmental lordosis and correction of spinopelvic alignment parameters.
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Lordose , Fusão Vertebral , Humanos , Lordose/diagnóstico por imagem , Lordose/cirurgia , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/cirurgia , Região Lombossacral , Estudos RetrospectivosRESUMO
INTRODUCTION: This study aimed to determine the level of incorporation of current technologies for endodontic treatment in undergraduate dentistry courses in a south-eastern state of Brazil. METHODS: For data collection, a self-assessment-based online questionnaire was created using the "Google Forms" platform, consisting of 12 multiple-choice and a few open-ended questions. The questions were related to the use of current technologies for diagnosis, imaging, use of ultrasonics in endodontics, instrumentation, use of apex locator, microscopy, photodynamic therapy and thermoplastic techniques during endodontic treatment. The questionnaire was sent to 54 dental schools in Minas Gerais. RESULTS: The results show low technological incorporation during the various stages of endodontic treatment by undergraduate students in dentistry courses in Minas Gerais. CONCLUSION: Despite the availability of several technologies to help perform different stages of endodontic treatment, it was observed that most universities do not teach the use of these technologies. Additional studies are needed to correlate how the lack of incorporation of these technologies could impact on the quality of the endodontic learning for undergraduate students.
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Endodontia , Estudantes de Odontologia , Brasil , Educação em Odontologia , Humanos , Tratamento do Canal Radicular , TecnologiaRESUMO
Unfortunately, the third and fourth author names have been incorrectly published in the original publication. The complete correct names are given below.
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Cryptosporidium and Giardia are protozoans that can infect humans and wild and domestic animals. Due to the growing importance of diseases caused by protozoan parasites in aquatic species, we aimed to evaluate the frequency of infection by Cryptosporidium spp. and Giardia sp. in aquatic and marine mammals in the northern and northeastern regions of Brazil. We collected 553 fecal samples from 15 species of wild-ranging and captive aquatic mammals in northern and northeastern Brazil. All samples were analyzed by the Kinyoun technique for identification of Cryptosporidium spp. oocysts. Giardia sp. cysts were identified by means of the centrifugal-flotation technique in zinc sulfate solution. Subsequently, all samples were submitted for direct immunofluorescence testing. The overall frequency of infection was 15.55% (86/553) for Cryptosporidium spp. and 9.04% (50/553) for Giardia sp. The presence of Cryptosporidium spp. was detected in samples from 5 species: neotropical river otter Lontra longicaudis (15.28%), giant otter Pteronura brasiliensis (41.66%), Guiana dolphin Sotalia guianensis (9.67%), Amazonian manatee Trichechus inunguis (16.03%), and Antillean manatee T. manatus (13.79%). Giardia sp. was identified in L. longicaudis (9.23%), P. brasiliensis (29.16%), pygmy sperm whale Kogia breviceps (100%), dwarf sperm whale K. sima (25%), S. guianensis (9.67%), T. inunguis (3.81%), and T. manatus (10.34%). This is the first report of Cryptosporidium spp. in L. longicaudis, P. brasiliensis, and S. guianensis, while the occurrence of Giardia sp., in addition to the 2 otter species, was also identified in manatees, thus extending the number of hosts susceptible to these parasitic agents.
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Organismos Aquáticos , Criptosporidiose/parasitologia , Cryptosporidium/isolamento & purificação , Giardia/isolamento & purificação , Giardíase/veterinária , Mamíferos/parasitologia , Animais , Brasil/epidemiologia , Criptosporidiose/epidemiologia , Giardíase/epidemiologia , Giardíase/parasitologiaRESUMO
The study was to assess the effects of photodynamic therapy (PDT) on root canals contaminated by Enterococcus faecalis (E. faecalis). PDT was performed with 0.005% methylene blue dye and with a low-intensity red emission laser. Microbiological samples were collected before, immediately and 72 hours after instrumentation. Although PDT performed with the chosen light parameters promoted additional microbial reduction, this therapy did not achieve a statistically significant reduction of E. faecalis.
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Enterococcus faecalis/efeitos dos fármacos , Fotoquimioterapia , Cavidade Pulpar/microbiologia , Enterococcus faecalis/isolamento & purificação , Humanos , Testes de Sensibilidade MicrobianaRESUMO
The Amazonian manatee (Trichechus inunguis) is a threatened aquatic mammal endemic to the Amazon basin. The aim of this study was to evaluate the urinary and salivary reproductive hormone levels of captive Amazonian manatees collected during two seasons of the year. Salivary samples from four males and urinary and salivary samples from three females were collected during two seasons (March-June and September-November) over two consecutive years. Salivary testosterone in males was measured by radioimmunoassay and reproductive hormones in females (salivary progesterone and oestradiol and urinary progestogens, oestrogens and luteinising hormone) were measured by enzyme immunoassay. The data were analysed in a 2×2 factorial design, where the factors were year and season. There was no effect of year or season for salivary testosterone. All female hormones showed a seasonal effect (higher hormone levels during March-June than September-November) or an interaction between year and season (P<0.05). These results strongly indicate the existence of reproductive seasonality in Amazonian manatees; however, apparently only females exhibit reproductive quiescence during the non-breeding season. Further long-term studies are necessary to elucidate which environmental parameters are related to reproductive seasonality in T. inunguis and how this species responds physiologically to those stimuli.