129 resultados para Withholding and withdrawing treatment


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A high prevalence of dental trauma exists and its effects on function and esthetics deserve the attention of general dentists. The aim of this study was to assess the level of general dental practitioners' (GDPs) knowledge about guidelines for dental avulsion and its prevention using a questionnaire. The 21-item questionnaire was distributed among 264 GDPs and the survey was realized between August-November 2006. The data obtained were statistically analyzed using descriptive analysis and Pearson's Chi-square test to determine associations between knowledge regarding emergency treatment and dentists from public or private dental schools and years of experience. The results showed that the participants exhibited appropriate knowledge concerning procedures in cases of tooth avulsion and its prevention. The number of correct answers was low in relation to recommended treatment at the site of injury. Storage medium, preparation of the alveolus and splint time for receiving the avulsed tooth received a high number of correct answers. One statistically significant association between years of experience and recommended treatment at the site of the injury in the case an avulsed tooth (KH2 = 9.384, P = 0.009). In conclusion, this survey showed appropriate knowledge of dental avulsion management and its prevention among the surveyed dentists. The findings also showed that communication between dentists and the population is deficient, especially concerning practitioners of high risk and contact sports.

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Photodegradation of the pharmaceuticals amoxicillin (AMX), bezafibrate (BZF) and paracetamol (PCT) in aqueous solutions via the photo-Fenton process was investigated under black-light and solar irradiation. The influences of iron source, initial H2O2 concentration and matrix (distilled water and sewage treatment plant effluent) on degradation efficiency were discussed in detail. The results showed that (i) the degradation of the drugs was favored in the presence of potassium ferrioxalate (FeOx) in comparison to Fe(NO3)(3): (ii) the increase of the H2O2 concentration improved the efficiency of AMX and BZF oxidation; however, the same was not observed for PCT: (iii) the influence of the matrix was observed for the degradation of BZF and PCT: (iv) under solar irradiation, the oxidation of the BZF and PCT is faster than under black-light irradiation. All these pharmaceuticals can be efficiently degraded employing the process evaluated. (C) 2008 Elsevier B.V. All rights reserved.

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Long-term treatment with clomipramine (CMI), a tricyclic antidepressant, induces food craving and body weight gain in patients. The present study investigated the effects of chronic treatment with CMI on total food intake, macronutrient selection, and body weight gain in rats. Male Wistar rats were maintained on a dietary self-selection regime with separate sources of protein, fat and carbohydrate. Animals received i.p. injections of CMI (0, 3, 10, 30 mg/kg) during 27 consecutive days. Food consumption and body weight were recorded daily and results were calculated as average of three consecutive days, namely during pre-treatment (3 d before pharmacological treatment), treatment (7th-9th; l6th-l8th and 25th-27th days), and post-treatment (28th-33rd days). Results showed that CMI (30 mg/kg) significantly decreased energy intake during all treatment period, an effect that was related to a decrease in both carbohydrate-rich diet intake and body weight gain. At dose of 3 mg/kg CMI increased the total energy intake in the 16th-18th days, suggesting an apparent biphasic effect of chronic treatment with CMI on caloric intake. Chronic administration with CMI (27 d) did not alter protein-rich or fat-rich diet consumption. The main result of this study indicated that chronic treatment with CMI decreases rather than increase food consumption and body weight gain in rats exposed to a macronutrient self-selection procedure.

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Follicle ablation has been recognized as an efficient method of follicular wave synchronization. Treatment with recombinant bovine somatotropin (BST) has been shown to enhance follicular development in <(Bos taurus)under bar>. This experiment assessed the effects of these treatments in Nelore (<(B. indicus)under bar>) heifers. Eight cycling Nelore heifers were randomly assigned to 3 different treatments. on Day 2 of a synchronized cycle (Day 0 = day of ovulation), heifers assigned to Treatments 1 and 2 received 2 mL of saline, whereas heifers assigned to Treatment 3 received 320 mg of BST. on Day 5, the first-wave dominant follicle was ablated by ultrasoundguided transvaginal aspiration in heifers in Treatments 2 and 3, and all heifers received an injection of prostaglandin on Day 11. Aspiration of the dominant follicle advanced and synchronized (P < 0.05) the day of second-wave emergence (6.9 +/- 0.1 vs. 8.4 +/- 0.4) and the day of the pre-wave FSH peak (6.0 +/- 0.0 vs. 6.9 +/- 0.4), and increased FSH peak concentrations (381 +/- 21 vs. 292 +/- 30; pg/mL; P < 0.01). Recombinant bovine somatotropin treatment caused a two-fold increase in plasma insulin-like growth factor-I (IGF-I) concentrations (P < 0.001) and resulted in a 36% increase in the number of small follicles (<5 mm; P < 0.001) compared with saline-treated heifers. In summary, in agreement with previous reports on <(B. taurus)under bar>, dominant follicle aspiration synchronized ovarian follicular development, and BST treatment increased peripheral concentrations of IGF-I in Nelore heifers. Recombinant bovine somatotropin also increased the number of small follicles, but this response appeared to be inferior to that reported for <(B. taurus)under bar>. (C) 2000 by Elsevier B.V.

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To assess the occurrence, extension, and severity of gingival margin alterations in a sample of youth after orthodontic treatment. Records from 209 Caucasian adolescents (118 female and 91 male) before and after orthodontic treatment were selected. Patients presented a mean age at the beginning of orthodontic treatment of 11.20 ± 1.86 years and a final mean age of 14.72 ± 1.83 years. Class I and II patients with mandibular incisors and canines that were completely erupted and with spacing or crowding not exceeding 4 mm were evaluated. The presence of gingival recession on the labial surface of the mandibular anterior teeth was evaluated in intraoral photographs and casts made before and after treatment. The proportion of patients with gingival recession after treatment was statistically higher than at the beginning (P<.001). After orthodontic treatment, gingival recession was not present in any of the teeth for 63.6% of the patients; in 29.2% of the patients, recession was present in at least 1 tooth. In terms of severity, the majority of affected teeth (47%) presented gingival recession less than 2 mm and in 2% more than 4 mm. It may be concluded that alterations in the gingival margin, especially gingival recession, occur in patients after orthodontic therapy, but the extent and severity of this finding are low. COPYRIGHT © 2007 BY QUINTESSENCE PUBLISHING CO, INC.

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The purpose of this work was to evaluate the Ti-35Nb-7Zr experimental alloy after surface treatment and soaking in solution body fluid (SBF) to form bonelike apatite. The Ti-35Nb-7Zr alloy was produced from commercially pure materials (Ti, Nb and Zr) by an arc melting furnace. All ingots were submitted to sequences of heat treatment (1100 °C/2 h and water quenching), cold working by swaging procedures and heat treatment (1100 °C/2 h and water quenching). Discs with 13 mm diameter and 3 mm in thickness were cut. The samples were immersed in NaOH aqueous solution with 5 M at 60 °C for 72 h, washed with distilled water and dried at 40 °C for 24 h. After the alkaline treatment, samples were heat treated in both conditions: at 450 and 600 °C for 1 h in an electrical furnace in air. Then, they were soaking in SBF for 24 h to form an apatite layer on the surface. The surfaces were investigated by using scanning electron microscope (SEM), energy dispersive X-ray spectroscopy (EDX), infrared spectroscopy (FTIR) and contact angle measurements. The results indicate that calcium phosphate could form on surface of Ti-35Nb-7Zr experimental alloy. © Springer-Verlag Berlin Heidelberg 2013.

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Background:Hepatitis C is a disease spread throughout the world. Hepatitis C virus (HCV), the etiological agent of this disease, is a single-stranded positive RNA virus. Its genome encodes a single precursor protein that yields ten proteins after processing. NS5A, one of the non-structural viral proteins, is most associated with interferon-based therapy response, the approved treatment for hepatitis C in Brazil. HCV has a high mutation rate and therefore high variability, which may be important for evading the immune system and response to therapy. The aim of this study was to analyze the evolution of NS5A quasispecies before, during, and after treatment in patients infected with HCV genotype 3a who presented different therapy responses.Methods:Viral RNA was extracted, cDNA was synthesized, the NS5A region was amplified and cloned, and 15 clones from each time-point were sequenced. The sequences were analyzed for evolutionary history, genetic diversity and selection.Results:This analysis shows that the viral population that persists after treatment for most non-responder patients is present in before-treatment samples, suggesting it is adapted to evade treatment. In contrast, the population found in before treatment samples from most end-of-treatment responder patients either are selected out or appears in low frequency after relapse, therefore changing the population structure. The exceptions illustrate the uniqueness of the evolutionary process, and therefore the treatment resistance process, in each patient.Conclusion:Although evolutionary behavior throughout treatment showed that each patient presented different population dynamics unrelated to therapy outcome, it seems that the viral population from non-responders that resists the treatment already had strains that could evade therapy before it started. © 2013 Bittar et al.

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In this study, in vitro cytocompatibility was investigated in the Ti-30Ta alloy after two kinds of surfaces treatments: alkaline and biomimetic treatment. Each condition was evaluated by scanning electron microscopy/energy-dispersive X-ray spectroscopy. Cellular adhesion, viability, protein expression, morphology, and differentiation were evaluated with Bone marrow stromal cells (MSCs) to investigate the short and long-term cellular response by fluorescence microscope imaging and colorimetric assays techniques. Two treatments exhibited similar results with respect to total protein content and enzyme activity as compared with alloy without treatment. However, it was observed improved of the biomineralization, bone matrix formation, enzyme activity, and MSCs functionality after biomimetic treatment. These results indicate that the biomimetic surface treatment has a high potential for enhanced osseointegration. © 2013 Wiley Periodicals, Inc.

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Breast cancer is a public health problem throughout the world. Moreover, breast cancer cells have a great affinity for hydroxyapatite, leading to a high occurrence of bone metastasis. In this work we developed a bio-nanocomposite (bio-NCP) in order to use such affinity in the diagnosis and treatment of breast cancer. The bio-NCP consists of magnetic nanoparticles of Mn and Zn ferrite inside a polymeric coating (chitosan) modified with nanocrystals of apatite. The materials were characterized with synchrotron X-ray Powder Diffraction (XPD), Time-of-Flight Neutron Powder Diffraction (NPD), Fourier Transformed Infra-red Spectroscopy (FTIR), Scanning Electron Microscopy (SEM) and magnetic measurement with a Physical Property Measurement System (PPMS). We obtained ferrite nanoparticles with a high inversion degree of the spinel structure regarding the Fe and Mn, but with all the Zn in the A site. The coating of such nanoparticles with chitosan had no notable effects to the ferrite microstructure. In addition, the polymeric surface can be easily modified with apatite nanocrystals since the hydration of the bio-NCP during synthesis can be controlled. The resulting bio-NCP presents a spherical shape with a narrow size distribution and high magnetic response at room temperature and is a very promising material for early diagnosis of breast cancer and its treatment. © 2013 Elsevier B.V.

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Spontaneous isolated dissection of iliac arteries is very rare, with few reports in the literature. Medical, surgical, and endovascular treatment modalities have all been used to manage iliac artery dissections. We report a case of symptomatic, isolated, spontaneous dissection of the common iliac and external iliac arteries. Both dissections were successfully treated by separate percutaneous stent-graft placement, preserving hypogastric artery flow. This technique is interesting because it provides adequate sealing of proximal and distal dissection sites while preserving hypogastric artery and pelvic flow.

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The aim of the present study was to evaluate the effect of bovine somatotropin (bST; 500 mg) administration on lactating buffalo donors submitted to two different ovum pick-up (OPU) and in vitro embryo production schemes with a 7 or 14 d intersession OPU interval. A total of 16 lactating buffalo cows were randomly assigned into one of four experimental groups according to the bST treatment (bST or No-bST) and the OPU intersession interval (7 or 14 d) in a 2 x 2 factorial design (16 weeks of OPU sessions). The females submitted to OPU every 14d had a larger (P < 0.001) number of ovarian follicles suitable for puncture (15.6 +/- 0.7 vs. 12.8 +/- 0.4) and an increased (P = 0.004) number of cumulus-oocyte complexes (COCs) recovered (10.0 +/- 0.5 vs. 8.5 +/- 0.3) compared to the 7 d interval group. However, a 7 or 14 d interval between OPU sessions had no effect (P = 0.34) on the number of blastocysts produced per OPU (1.0 +/- 0.1 vs. 13 +/- 0.2, respectively). In addition, bST treatment increased (P < 0.001) the number of ovarian follicles suitable for puncture (15.3 +/- 0.5 vs. 12.1 +/- 0.4) but reduced the percentage (18.9% vs. 10.9%; P = 0.009) and the number (1.4 +/- 0.2 vs. 0.8 +/- 0.1; P = 0.003) of blastocysts produced per OPU session compared with the non-bST-treated buffaloes. In conclusion, the 14d interval between OPU sessions and bST treatment efficiently increased the number of ovarian follicles suitable for puncture. However, the OPU session interval had no effect on embryo production, and bST treatment reduced the in vitro blastocyst outcomes in lactating buffalo donors.

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Introduction: The aim was to confirm that PSF (probability of stone formation) changed appropriately following medical therapy on recurrent stone formers.Materials and Methods: Data were collected on 26 Brazilian stone-formers. A baseline 24-hour urine collection was performed prior to treatment. Details of the medical treatment initiated for stone-disease were recorded. A PSF calculation was performed on the 24 hour urine sample using the 7 urinary parameters required: voided volume, oxalate, calcium, urate, pH, citrate and magnesium. A repeat 24-hour urine sample was performed for PSF calculation after treatment. Comparison was made between the PSF scores before and during treatment.Results: At baseline, 20 of the 26 patients (77%) had a high PSF score (> 0.5). Of the 26 patients, 17 (65%) showed an overall reduction in their PSF profiles with a medical treatment regimen. Eleven patients (42%) changed from a high risk (PSF > 0.5) to a low risk (PSF < 0.5) and 6 patients reduced their risk score but did not change risk category. Six (23%) patients remained in a high risk category (> 0.5) during both assessments.Conclusions: The PSF score reduced following medical treatment in the majority of patients in this cohort.

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