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1.
Int J Mol Sci ; 25(2)2024 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-38256037

RESUMO

The activation of inflammasomes is thought to induce the inflammatory process around dental implants. No information is available on the correlation between microbiota and inflammasomes in clinical samples from patients suffering peri-implantitis. For this cross-sectional study, 30 biofilm samples were obtained from 19 patients undergoing surgical treatment for peri-implantitis because of the presence of bleeding on probing, probing depth higher than 6 mm, and radiographic bone loss higher than 3 mm. Then, soft tissue samples from around the implant were also collected. The relative abundance of bacteria and alpha-diversity indexes were calculated after analyzing the 16S rRNA gene using next-generation sequencing. The soft-tissue samples were processed for evaluation of the inflammasomes NLRP3 and AIM2 as well as caspase-1 and IL-1ß. The relative abundance (mean (SD)) of specific species indicated that the most abundant species were Porphyromonas gingivalis (10.95 (14.17)%), Fusobacterium vincentii (10.93 (13.18)%), Porphyromonas endodontalis (5.89 (7.23)%), Prevotella oris (3.88 (4.94)%), Treponema denticola (2.91 (3.19)%), and Tannerella forsythia (2.84 (4.15)%). Several correlations were found between the species and the immunohistochemical detection of the inflammasomes NLRP3 and AIM2 as well as caspase-1 and IL-1ß, both in the epithelium and the lamina propria. A network analysis found an important cluster of variables formed by NLRP3 in the lamina propria and AIM2, caspase-1, and IL-1ß in the lamina propria and the epithelium with Prevotella dentalis, Prevotella tannerae, Tannerella forsythia, or Selenomonas timonae. Thus, it could be concluded that inflammasomes NLRP3 and AIM2 and their downstream effectors caspase-1 and interleukin-1ß can be significantly associated with specific bacteria.


Assuntos
Microbiota , Peri-Implantite , Humanos , Inflamassomos , Proteína 3 que Contém Domínio de Pirina da Família NLR/genética , Estudos Transversais , RNA Ribossômico 16S , Caspase 1
2.
Int J Psychiatry Clin Pract ; : 1-10, 2024 Jun 22.
Artigo em Inglês | MEDLINE | ID: mdl-38909282

RESUMO

BACKGROUND: Anxiety is a common and disabling condition that significantly impacts quality of life. Subsyndromal anxiety (SSA) refers to anxiety symptoms that do not meet the full diagnostic criteria for an anxiety disorder but pose a risk for developing such disorders. We aimed to provide practical recommendations for the treatment of SSA in primary care settings. METHODS: A narrative review was conducted to identify strategies for recognizing and treating patients with SSA. RESULTS: The recommendations for treating SSA include lifestyle modifications such as exercise and stress reduction techniques, psychotherapy, and pharmacological treatments, including natural compounds like the lavender oil extract Silexan. Regular follow-up care is essential to monitor treatment response and address ongoing symptoms. Additionally, the use of the GAD-7 tool is recommended for accurately identifying patients with SSA. CONCLUSION: Implementing these recommendations in primary care can lead to effective treatment of SSA, preventing the development of more severe anxiety disorders. An integrative approach, combining lifestyle modifications, psychotherapy, and pharmacotherapy, including natural compounds, offers significant benefits for managing anxiety.


Anxiety is prevalent and disablingSubsyndromal anxiety is a risk factor for anxiety disordersSubsyndromal anxiety can be assessed with the GAD-7 (Generalised Anxiety Disorder-7 scale)Subsyndromal anxiety can be treated with life-style modification, psychotherapy and pharmacological treatment, including silexan, a natural compound.

3.
J Periodontal Res ; 57(3): 479-486, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35293616

RESUMO

AIM: To determine periodontitis prevalence in patients with systemic lupus erythematosus (SLE) and to assess whether periodontitis in SLE patients is associated with a greater subclinical atherosclerosis. METHODS: An observational case-control study was conducted in SLE (cases) and patients without any rheumatic diseases (controls), matched for sex. Sociodemographic and cardiometabolic variables were gathered, and SLE activity was assessed through several indexes. Periodontal examination registered probing pocket depth, clinical attachment level, bleeding on probing, plaque index, and tooth loss. Subclinical atherosclerosis was assessed by measuring the carotid-femoral pulse wave velocity (PWV) by Doppler velocimetry, homocysteine levels, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR). Bivariate analyses and logistic regression were used to assess the association of any of the studied variables with SLE. RESULTS: Seventy-one cases and 72 controls were included in the study. Thirty-nine SLE patients (54.9%) were diagnosed with periodontitis, compared with 16 controls (22.2%). High levels of PWV (≥7.7 m/s, 75th percentile) were shown by 44.3% of the cases vs. 22.4% of the controls (p = .011). Among SLE patients, those with periodontitis showed higher PWV values (8.1 ± 1.52 vs. 7.16 ± 1.11 m/s, p = .006) and higher homeostasis model assessment index (indicative of insulin resistance) (1.7 ± 0.73 vs. 2.92 ± 3.05, p = .028) compared to those with periodontal health. Logistic regression showed that waist circumference (OR 1.06, 95% CI 1.01-1.12, p = .015); ESR (OR 1.09, 95% CI 1.03-1.16, p = .003); and bleeding on probing (OR 1.1, 95% CI 1.01-1.19, p = .018) were associated with the risk of SLE. CONCLUSION: Systemic lupus erythematosus patients showed a higher periodontitis percentage than controls. Higher PWV values were found in SLE patients with periodontitis, indicating a higher prevalence of subclinical atherosclerosis. Patients with higher gingival bleeding showed a higher risk of SLE.


Assuntos
Aterosclerose , Lúpus Eritematoso Sistêmico , Periodontite , Aterosclerose/complicações , Estudos de Casos e Controles , Humanos , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/metabolismo , Periodontite/complicações , Análise de Onda de Pulso , Fatores de Risco
4.
Medicina (Kaunas) ; 58(5)2022 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-35630038

RESUMO

Periodontitis is a microbially driven host-mediated disease that leads to loss of periodontal attachment and bone. It is associated with elevation of systemic inflammatory markers and with the presence of systemic co-morbidities. Furthermore, periodontal treatment leads to a 24-48 h-long acute local and systemic inflammatory response. This systemic response might increase the burden of patients with compromised medical history and/or uncontrolled systemic diseases. The correlation between periodontitis and systemic diseases, the impact of periodontitis on the quality of life and public health, the effects of periodontal treatment on systemic health and disease, and the available methods to manage systemic inflammation after periodontal therapy are discussed. The main focus then shifts to a description of the existing evidence regarding the impact of periodontitis and periodontal treatment on systemic health and to the identification of approaches aiming to reduce the effect of periodontitis on systemic inflammation.


Assuntos
Periodontite , Qualidade de Vida , Humanos , Inflamação/complicações , Periodontite/complicações , Periodontite/terapia
5.
Medicina (Kaunas) ; 58(4)2022 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-35454384

RESUMO

There is very recent and strong evidence relating Fusobacterium nucleatum to colorectal cancer. In this narrative review, we update the knowledge about gingival dysbiosis and the characteristics of Fusobacterium nucleatum as one of the main bacteria related to periodontitis. We provide data on microbiome, epidemiology, risk factors, prognosis, and treatment of colorectal cancer, one of the most frequent tumours diagnosed and whose incidence increases every year. We describe, from its recent origin, the relationship between this bacterium and this type of cancer and the knowledge and emerging mechanisms that scientific evidence reveals in an updated way. A diagram provided synthesizes the pathogenic mechanisms of this relationship in a comprehensive manner. Finally, the main questions and further research perspectives are presented.


Assuntos
Neoplasias Colorretais , Periodontite , Bactérias , Neoplasias Colorretais/complicações , Neoplasias Colorretais/epidemiologia , Comorbidade , Disbiose/complicações , Disbiose/epidemiologia , Fusobacterium nucleatum , Humanos , Periodontite/complicações , Periodontite/epidemiologia
6.
Sensors (Basel) ; 21(18)2021 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-34577500

RESUMO

This work studies the propagation characteristics of a rectangular waveguide with aligned/misaligned double-sided dielectric-filled metallic corrugations. Two modes are found to propagate in the proposed double-sided configuration below the hollow-waveguide cutoff frequency: a quasi-resonant mode and a backward mode. This is in contrast to the single-sided configuration, which only allows for backward propagation. Moreover, the double-sided configuration can be of interest for waveguide miniaturization on account of the broader band of its backward mode. The width of the stopband between the quasi-resonant and backward modes can be controlled by the misalignment of the top and bottom corrugations, being null for the glide-symmetric case. The previous study is complemented with numerical results showing the impact of the height of the corrugations, as well as the filling dielectric permittivity, on the bandwidth and location of the appearing negative-effective-permeability band. The multi-modal transmission-matrix method has also been employed to estimate the rejection level and material losses in the structure and to determine which port modes are associated with the quasi-resonant and backward modes. Finally, it is shown that glide symmetry can advantageously be used to reduce the dispersion and broadens the operating band of the modes.

7.
Clin Oral Investig ; 24(4): 1369-1378, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32060656

RESUMO

OBJECTIVES: To analyse evidence regarding the efficacy of periodontal regenerative procedures in intrabony defects in patients treated for aggressive periodontitis (AgP). MATERIAL AND METHODS: A systematic search of the literature for randomised controlled clinical trials including patients treated for aggressive periodontitis that compared a group treated with regenerative therapy with another group treated with surgical debridement alone was conducted by two independent reviewers. RESULTS: Six studies were included in the meta-analysis of clinical and/or radiographic parameters at 6 and 12 months. Probing pocket depth was smaller at 6 months in patients treated with regenerative therapies compared with those treated with regular debridement (1.00 mm, p < 0.001, 95% CI (0.67, 1.34)). At 12 months this difference was more marked (0.41 mm, p = 0.12, 95% CI (- 0.10, 0.91)). The distance between the cemento-enamel junction and the alveolar crest at both 6 (1.36 mm, p < 0.001, 95% CI (1.03, 1.68)) and 12 months (0.90 mm, p = 0.01, 95% CI (0.24, 1.56)) was smaller in the group treated with regeneration. CONCLUSIONS: The use of biomaterials for regenerative therapy in AgP may be more effective than surgical debridement. Better outcomes were observed in terms of probing pocket depth and distance between the cemento-enamel junction and the alveolar crest at 6 months. Regeneration should be considered as a therapy to prevent tooth loss, although more studies with larger sample size and longer follow-up are needed. CLINICAL RELEVANCE: Periodontal regeneration is effective in the treatment of intrabony defects in patients with AgP, as it leads to better outcomes in clinical and radiographic parameters.


Assuntos
Periodontite Agressiva/terapia , Regeneração Tecidual Guiada Periodontal , Processo Alveolar , Humanos , Desbridamento Periodontal , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
8.
Clin Oral Investig ; 24(10): 3721-3722, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32880689

RESUMO

The authors are correcting this article because they accidentally included some wrong data in the analysis.

9.
J Periodontal Res ; 54(3): 218-224, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30298590

RESUMO

BACKGROUND AND OBJECTIVE: Neutrophil extracellular traps (NETs) are a recently discovered antimicrobial mechanism used by neutrophils that have been proposed as an intervention in the pathogenesis of periodontitis. The objective of our study was to characterize the expression of NETs in gingival tissues with periodontitis and controls and to compare the expression of these traps in gingival tissue samples of patients with gingivitis and periodontitis. MATERIAL AND METHODS: An observational cross-sectional study was conducted on patients with periodontitis, gingivitis, and controls that needed tooth extraction. Gingival tissue biopsies were gathered after clinical examination and tooth extraction. Electron microscopy and immunofluorescence were performed to characterize NETs, comparing periodontitis and control patients. Immunohistochemical analysis was performed to quantify neutrophil extracellular trap expression through extracellular citrullinated histone H3 and myeloperoxidase in biopsies from patients with gingivitis and periodontitis. RESULTS: Thirteen biopsies were gathered from 13 patients: five gingivitis, six periodontitis, and two controls. Electron microscopy and immunofluorescence imaging showed greater expression of neutrophils present in periodontal inflamed tissue compared with controls. Release of nuclear content to the extracellular space was observed, compatible with the formation of NETs. The expression of citrullinated histone H3 was higher in gingivitis samples than periodontitis samples (P = 0.0106). Myeloperoxidase expression was higher in periodontitis than gingivitis, but without achieving statistical significance. CONCLUSION: Neutrophil extracellular traps were found in tissue samples of periodontitis as extracellular components of chromatin, along with neutrophil enzymes, that were not present in healthy controls. The comparison of NETs expression in periodontitis and gingivitis showed higher expression in gingivitis, associating them to acute phases of the periodontal inflammatory process.


Assuntos
Armadilhas Extracelulares , Gengiva/patologia , Gengivite/patologia , Neutrófilos/citologia , Periodontite/patologia , Estudos de Casos e Controles , Cromatina , Estudos Transversais , Gengiva/metabolismo , Gengivite/metabolismo , Histonas/metabolismo , Humanos , Microscopia Eletrônica de Transmissão , Neutrófilos/ultraestrutura , Periodontite/metabolismo , Peroxidase/metabolismo , Projetos Piloto
10.
J Clin Periodontol ; 45(7): 791-798, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29723438

RESUMO

AIM: To determine the association between chronic periodontitis and erectile dysfunction adjusting for biochemical markers and other comorbidities. METHODS: A case-control study was conducted on 158 male patients; 80 cases with erectile dysfunction according to the International Index of Erectile Function and 78 controls. Sociodemographic data were gathered, and a periodontal examination was performed. Testosterone, lipid profile, C-reactive protein and glycaemic parameters were assessed. All variables were compared between groups, and multivariate logistic regression analyses were performed. RESULTS: 74% of the cases were diagnosed with chronic periodontitis. Number of sites with pocket probing depth 4-6 mm (p = 0.05) and number of sites with clinical attachment loss >3 mm (p < 0.01) were higher in the cases. Triglycerides (p < 0.01), C-reactive protein (p = 0.02) and glycosylated haemoglobin (p = 0.04) were also higher in the cases. Logistic regression showed that patients with chronic periodontitis were more likely to have erectile dysfunction (OR=2.17; 95% CI (1.06-4.43); p = 0.03) independently of other confounders. CONCLUSION: Patients with erectile dysfunction showed worse periodontal condition. Chronic periodontitis seems to play a key role as a risk factor in the pathogenesis of erectile dysfunction independently of other morbidities.


Assuntos
Periodontite Crônica , Disfunção Erétil , Proteína C-Reativa , Estudos de Casos e Controles , Humanos , Masculino , Perda da Inserção Periodontal , Triglicerídeos
12.
Neurocirugia (Astur) ; 28(2): 97-101, 2017.
Artigo em Espanhol | MEDLINE | ID: mdl-27810194

RESUMO

INTRODUCTION: Craniopharyngioma accounts for around 3% of all primary tumours of the central nervous system. It is usually located in the suprasellar region, although it may also have an ectopic location. CASE REPORT: The case is presented on 29 year-old male who underwent surgery for a jaw osteoma when he was 19 years old and was subsequently diagnosed with Gardner's syndrome. He was admitted in our Hospital with right facial paresis and diplopia of one day onset. The examination showed mild right VII and VI cranial nerves paresis. Magnetic resonance imaging of the brain demonstrated a rounded solid and cystic lesion with well-defined contours of about 2cm in diameter filling the fourth ventricle. The patient underwent a posterior fossa craniotomy using a telovelar approach with complete removal of the tumour implanted at roof level of the fourth ventricle. The final histology of the tumour was reported as adamantinomatous craniopharyngioma. CONCLUSION: Craniopharyngioma may appear in another location other than the suprasellar region. Its atypical location may be related to Gardner syndrome by still unknown pathogenic mechanisms.


Assuntos
Neoplasias do Ventrículo Cerebral/genética , Craniofaringioma/genética , Síndrome de Gardner/diagnóstico , Adulto , Neoplasias do Ventrículo Cerebral/complicações , Neoplasias do Ventrículo Cerebral/diagnóstico por imagem , Neoplasias do Ventrículo Cerebral/cirurgia , Craniofaringioma/complicações , Craniofaringioma/diagnóstico por imagem , Craniofaringioma/cirurgia , Craniotomia , Diplopia/etiologia , Paralisia Facial/etiologia , Quarto Ventrículo , Humanos , Imageamento por Ressonância Magnética , Masculino , Neoplasias Mandibulares/genética , Neuroimagem , Osteoma/genética
13.
Opt Express ; 24(10): 10265-74, 2016 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-27409851

RESUMO

Solid metal films are well known to be opaque to electromagnetic waves over a wide frequency range, from low frequency to optics. High values of the conductivity at relatively low frequencies or negative values of the permittivity at the optical regime provide the macroscopic explanation for such opacity. In the microwave range, even extremely thin metal layers (much smaller than the skin depth at the operation frequency) reflect most of the impinging electromagnetic energy, thus precluding significant transmission. However, a drastic resonant narrow-band enhancement of the transparency has recently been reported. The quasi-transparent window is opened by placing the metal film between two symmetrically arranged and closely spaced copper strip gratings. This letter proposes an analytical circuit model that yields a simple explanation to this unexpected phenomenon. The proposed approach avoids the use of lengthy numerical calculations and suggests how the transmissivity can be controlled and enhanced by manipulating the values of the electrical parameters of the associated circuit model.

14.
J Clin Periodontol ; 43(12): 1109-1115, 2016 12.
Artigo em Inglês | MEDLINE | ID: mdl-27396322

RESUMO

AIM: To determine the incidence of tooth loss in patients with generalized aggressive periodontitis (GAgP) during supportive periodontal therapy (SPT), identify tooth loss risk factors, and quantify alveolar crest height changes on periapical X-ray during follow-up. MATERIAL AND METHODS: This retrospective study included 25 GAgP patients with 656 teeth after periodontal treatment (baseline). Data were gathered on sociodemographic, periodontal, and radiological variables at baseline and at the end of follow-up. Linear regression models were used to assess the association of risk factors with tooth loss. RESULTS: Twenty-eight teeth were extracted during SPT. The mean tooth loss per patient was 1.12 ± 2.01 for all causes and 0.9 ± 2.0 for periodontal disease after a mean follow-up of 10.9 ± 2 years. Clinical variables were improved at the end of follow-up, with a mean reduction of -1 ± 0.8 mm in probing pocket depth (-0.7 to -1.3, 95% CI) and -0.6 ± 0.9 mm in clinical attachment loss (-0.9 to -0.2, 95% CI). Mean alveolar bone crest loss at the end of follow-up was 0.36 ± 0.56 mm (0.10-0.61, 95% CI). Smoking was associated with tooth loss (p = 0.052). CONCLUSIONS: Tooth loss rate was low in GAgP in a regular supportive care programme. Clinical variables improved, and bone loss was minimal over time. Smoking was associated with tooth loss.


Assuntos
Perda de Dente , Periodontite Agressiva , Perda do Osso Alveolar , Seguimentos , Humanos , Estudos Longitudinais , Bolsa Periodontal , Estudos Retrospectivos , Resultado do Tratamento
15.
Clin Oral Investig ; 20(4): 669-74, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26245274

RESUMO

OBJECTIVES: The aim was to determine whether clinical periodontal parameters are associated with plasma anti- and/or pro-inflammatory cytokines in pregnant woman with preterm birth (PB) or low birth weight (LBW) neonates. MATERIALS AND METHODS: An observational case-control study was performed in 131 puerperal women: mothers of PB/LBW neonates (cases, n = 67) and mothers of full-term normal-weight neonates (controls, n = 64). Sociodemographic and periodontal data was gathered from all participants, and interleukin (IL)-1ß, IL-6, IL-8, IL-10, IL-17, IL-23, and tumor necrosis factor alpha (TNF-α) were determined in plasma. RESULTS: In multiple linear regression models, clinical attachment loss was associated with TNF-α (0.28 ± 0.14; 95% confidence interval (CI) [0.006, 0.553]) and IL-1ß (0.43 ± 0.21; 95%CI [0.018, 0.842]), independent of group membership. IL-1ß (-1.67 ± 0.27, 95%CI [-2.199, -1.141]), IL-6 (-0.86 ± 0.27; 95%CI [-1.389, -0.331]), and IL-8 (-3.84 ± 0.50, 95%CI [-4.820, -2.860]) were lower, and IL-10 (0.86 ± 0.26; 95%CI [0.350, 1.370]) was higher in cases versus controls after adjusting for potential confounders. CONCLUSIONS: Clinical attachment loss was associated with plasma TNF-α and IL-1ß levels. No plasma cytokine profiles suggestive of systemic inflammatory response were observed in the pregnant women with PB/LBW neonates. CLINICAL RELEVANCE: Clinical attachment loss, as the main periodontal measure, is associated with TNF-α and IL-1ß plasma levels in pregnant women. No relationship was found between PB/LBW and the markers of systemic inflammatory response assessed in this study.


Assuntos
Citocinas/sangue , Recém-Nascido de Baixo Peso , Índice Periodontal , Nascimento Prematuro , Estudos de Casos e Controles , Feminino , Humanos , Recém-Nascido , Inflamação , Interleucina-10 , Gravidez , Fator de Necrose Tumoral alfa
16.
Actas Esp Psiquiatr ; 44(1): 20-9, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26905887

RESUMO

BACKGROUND: Metabolic syndrome (MS) and cardiovascular risk factors (CRF) have been associated with patients with schizophrenia. The main objective is to assess the evolution of CRF and prevalence of MS for 12 months in a cohort of overweight patients diagnosed with schizophrenia schizophreniform disorder or schizoaffective disorder in which the recommendations for the assessment and control of metabolic and cardiovascular risk were applied. METHODS: The Control of Metabolic and Cardiovascular Risk in Patients with Schizophrenia and Overweight (CRESSOB) study is a 12-month, observational, prospective, open-label, multicentre, naturalistic study including 109 community mental health clinics of Spain. The study included a total of 403 patients, of whom we could collect all variables related to CRF and MS in 366 patients. Of these 366 patients, 286 completed the follow-up, (baseline, months 3, 6 and 12) where they underwent a complete physical examination and a blood test (glucose, cholesterol and triglycerides), they were asked about their health-related habits (smoking, diet and exercise) and they were given a series of recommendations to prevent cardiovascular risk and MS. RESULTS: A total of 403 patients were included, 63% men, mean age (mean; (SD)) 40.5 (10.5) years. After 12 months, the study showed statistically significant decrease in weight (p<0.0001), waist circumference (p<0.0001), BMI (p<0.0001), blood glucose (p=0.0034), total cholesterol (p<0.0001), HDL cholesterol (p=0.02), LDL cholesterol (p=0.0023) and triglycerides (p=0.0005). There was a significant reduction in the percentage of smokers (p=0.0057) and in the risk of heart disease at 10 years (p=0.0353). CONCLUSION: Overweight patients with schizophrenia who receive appropriate medical care, including CRF monitoring and control of health-related habits experience improvements with regard to most CRFs.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Aconselhamento , Síndrome Metabólica/prevenção & controle , Obesidade/terapia , Sobrepeso/terapia , Esquizofrenia/terapia , Adulto , Feminino , Promoção da Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/fisiopatologia , Sobrepeso/fisiopatologia , Estudos Prospectivos , Fatores de Risco , Esquizofrenia/fisiopatologia , Espanha
17.
World J Surg ; 39(2): 536-42, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25326422

RESUMO

AIM: To evaluate if application of failure mode and effect analysis (FMEA) to laparoscopy training can help surgeons acquire laparoscopy skills. METHODS: After preparing a FMEA matrix of laparoscopic sigmoidectomy, we have introduced it during three laparoscopy courses. Forty-eight surgeons, divided into 24 teams of two surgeons, have participated in three courses. During each course, every team has performed three laparoscopic sigmoidectomies in three experimental animals (1 OR session every day). Risk priority number (RPN) has been calculated for every surgery, and the results have been discussed at the end of each training day with all participants. RESULTS: We have observed a decline in the median RPN from 1339 during the first OR session through 62 during second OR session to reach 0 in the third OR session. Only two teams out of 24 were not able to reach a RPN of less than 300 during third OR session. When the type of failures were analysed, we have observed a shift from procedure-type failures to technical failures that depended on each participant technical abilities. CONCLUSION: Application of FMEA principles to laparoscopy training can help acquire non-technical skills necessary for safe laparoscopic surgery.


Assuntos
Colo Sigmoide/cirurgia , Avaliação Educacional/métodos , Laparoscopia/educação , Ensino/métodos , Animais , Competência Clínica , Procedimentos Cirúrgicos do Sistema Digestório/educação , Retroalimentação , Humanos , Modelos Animais , Suínos
18.
Clin Oral Implants Res ; 25(9): 1034-40, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23750807

RESUMO

AIM: To investigate the relationship of tobacco consumption with alveolar crest height (ACH) loss and mandibular bone mass estimated by digital panoramic radiography and cone-beam computed tomography (CBCT). MATERIAL AND METHODS: We studied 315 patients (43.2% [n = 136] men and 56.8% [n = 179] women) with mean age of 36.6 ± 5.3 (range 21-30 years (16.2%), range 31-46 years (83.8%); 9% (n = 71) were smokers (>10 cig./day). A mean of 13.0 ± 2.0 mandibular teeth were present: 37.5% of patients had 6-12 teeth and 62.5% 13-16 teeth. We analyzed 315 digital panoramic radiographs (2D) and calculated the ACH, mandibular cortical width, and basal and alveolar bone gray level values. ACH and bone density were also measured on CBCT (3D) in the 110 patients scheduled for implantation. RESULTS: In the univariate analysis, ACH loss was greater in older patients (P = 0.012) and in those with fewer mandibular teeth (P < 0.001) and showed a relationship with tobacco consumption that was close to significant (P = 0.079). In the multivariate analysis, the number of mandibular teeth (P < 0.001) and tobacco consumption (P = 0.048) were significantly associated with ACH. Alveolar and basal bone densities were associated, respectively, with number of mandibular teeth (P = 0.012) and cortical width (P = 0.030). CONCLUSION: In a Caucasian population aged 21-46 years, tobacco consumption was significantly associated with ACH loss. However, ACH loss showed no significant relationship with mandibular bone mass estimated either as mandibular cortical width index or bone density on digital panoramic radiographs or as bone density on CBCT. ACH loss was a local event independent of mandibular bone mass status.


Assuntos
Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/etiologia , Densidade Óssea , Mandíbula/diagnóstico por imagem , Fumar/efeitos adversos , Adulto , Feminino , Humanos , Imageamento Tridimensional , Masculino , Pessoa de Meia-Idade , Radiografia Panorâmica , Estudos Retrospectivos , Fatores de Risco
19.
Clin Oral Implants Res ; 25(3): 366-371, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23356496

RESUMO

OBJECTIVES: Our objectives were to examine vascular and cellular colonization in anorganic bovine bone (ABB) after 6 months of healing in human maxillary sinus augmentation grafts. MATERIAL AND METHODS: Fifty unilateral maxillary sinus augmentation procedures were performed on 50 consecutive patients. Bone cores were obtained through the implant receptor sites 6 months later and evaluated with morphological image analysis and immunohistochemical techniques. RESULTS: Image analysis revealed a mean of 35.44 ± 16% vital bone, 31.66 ± 15% non-mineralized tissue, and 32.72 ± 25% remnant ABB particles. In our patients, neovascularization in 46.3% of cases was demonstrated within ABB particles 6 months after sinus floor augmentation surgery. Neovascularization of ABB particles was inversely related to age, directly to osteoclast number per mm², and not influenced by habits or disease. CD44-positive cells colonization was found in 74% of cases. An important correlation was found regarding CD44 expression and number of vessel in ABB particles (r = 0.624 P < 0.001, Pearson). Osteopontin expression was detected on the interstitial boundary of bone with ABB particles and within the osteocyte lacunae and bone canaliculi and was relationship with presence of CD44-positive cells inside ABB particles (r = 0.388, P = 0.046, Pearson). CONCLUSION: In conclusion, images compatible with osteone colonized by osteocytes CD44 positive and neovascularization in ABB particles were observed after 6 months of graft maturation. These biologic events have not previously been morphologically and immunohistochemically documented.


Assuntos
Receptores de Hialuronatos/metabolismo , Minerais/farmacologia , Osteócitos/metabolismo , Levantamento do Assoalho do Seio Maxilar/métodos , Adulto , Idoso , Animais , Biópsia , Bovinos , Feminino , Humanos , Técnicas Imunoenzimáticas , Masculino , Microscopia Eletrônica , Pessoa de Meia-Idade , Osteopontina/metabolismo
20.
Neurocirugia (Astur) ; 25(4): 183-8, 2014.
Artigo em Espanhol | MEDLINE | ID: mdl-24792915

RESUMO

Supratentorial liponeurocytoma is a rare tumor, predominantly appearing in young males. It most commonly affects the lateral ventricles, with involvement of the third ventricle being exceptional. It is defined as a low-grade neuroglial tumor, with areas of associated lipomatosis. The most common clinical manifestation is that resulting from the presence of secondary intracranial hypertension and hydrocephalus. We present the first case reported in Spain of this tumor type and one of the few appearing in the literature so far. We report the case of a 33-year-old male patient, suffering from crural sensitive symptoms and recent onset headache. The radiographic study revealed the presence of a large supratentorial tumor; intraventricular, multicystic, heterogeneous and with areas of associated lipomatosis. The patient underwent surgery and complete tumor resection was achieved. The definitive diagnosis was of supratentorial liponeurocytoma. The presence of a supratentorial intraventricular tumor with areas of fatty degeneration should lead us to consider this type of tumor in the differential diagnosis. Complete tumor resection is considered to be the treatment of choice.


Assuntos
Neoplasias Encefálicas/diagnóstico , Ventrículos Laterais , Lipoma/diagnóstico , Neoplasias Primárias Múltiplas/diagnóstico , Neurocitoma/diagnóstico , Adulto , Humanos , Masculino , Espanha
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