Assistência cirúrgico-odontológica a pacientes imunodeprimidos por uso crônico de corticoides

Objective: The objective of this work, and review concepts on the physiology of hormones Adrenals to enhance pre, trans and post-operative care to dentists facing surgical, dental care of immunosuppressed patients. Literature review: The corticosteroids are among the most used drugs in medicine in recent times due to its anti-inflammatory and immunosuppressive activities, especially in transplant patients and patients with chronic autoimmune diseases. However, the continuing use of these drugs leads to a decrease in endogenous production of cortisol by the adrenal. Besides depressing the patient’s immune system, it may generate many parallel undesirable effects like blocking the production of the natural hormone of adrenal cortex, or steroid called cortisol, which may be the cause of a malfunctioning of the adrenal gland, causing hypofunction or hyperfunction of the gland. Final considerations: This fact will lead to changes in the planning of dental surgery, where it will be necessary special actions towards the patients who have this condition.

Renal function after laparoscopic cholecystectomy and analgesia with tramadol and dipyrone or ketorolac

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

Microbiologic characterization of equine mastitis

Mastitis occurrence in mares is low if compared to other livestock species. The microorganisms often isolated and detected in milk and mammary gland secretions of mares are Streptococcus beta-haemolytica, Staphylococcus spp., Pseudomonas aeruginosa, Actinobacillus spp., and enterobacter. The present experiment was designed to evaluate the main microorganisms present in the milk of healthy mares and having a mammary infection. One hundred and ten mammary glands from 55 lactating mares were analyzed, ranging from 15 to 150 d post-partum. The mastitis diagnostic was performed through analysis of the milk via the screened test of the mug with dark background (Tamis), mammary gland inflammation and/or systemic signs. The subclinical mammary gland infection was characterized via the California Mastitis Test (CMT). From the 55 lactating mares, 2 (3.64%) had clinical mastitis. Following the CMT, the mares presented: 13 (23.60%), 7 (12.72%), and 12 (21.88%) scores from 1+, 2+, and 3+, respectively. From the 110 mamary glands were analysed, in 47 (85.45%) of these samples strains of microorganisms were isolated. In summary, results from our experiment suggest a low occurrence of clinical mastitis in lactating mares.

Glucose,cholesterol,total proteins and insulin-like growth factor typeI values in the follicular fluid of female river buffaloes (Bubalus bubalis)

Twenty six Murrah female river buffaloes, between 45 and 70 d post-partum, empty, multiparae, with an average live weight of 675 ± 56 kg, and average body condition of 3.5 points, in a 1 to 5 scale, were used to determine the concentrations of glucose, cholesterol, total protein and insulin-like growth factor type I(IGF-I) in the follicular fluid. The fluid was collected from dominant follicles, with diameters between 8 and 12 mm, by in vivo follicular aspiration. The oestrous cycle stage was not taken into account. The wave of follicular development was synchronized six days prior to the collection. Biochemical analyses of glucose and cholesterol were performed by the enzymatic colorimetric method with the utilization of commercial kits of Glicose (GOD-PAP) and Cholesterol (CHOD-PAP) (Kovalent), respectively. For the determination of total protein, the commercial kit total Protein (Kovalent), method Biuret, was employed. Readings were carried out through absorption spectrophotometry with visible light. Through the radioimmunoanalysis (RIA) technique the concentration of IGF-I was obtained using commercial kits of IRMA IGF-I (IMMUNOTECH). Descriptive statistics was used, by applying the PROC MEANS procedure of the SAS (2009) statistical package. Glucose concentrations (4.0 ± 0.75 mmol/L) and IGF-I (340 ± 129.83 ng/mL) showed higher values in female river buffaloes and dairy cows regarding those reported in other studies. However, cholesterol levels (0.51 ± 0.12 mmol/L) and total proteins (58.4 ± 4.43 g/L) were lower. Results indicate that there is a relationship between the concentration of biochemical indicators, the nutritional aspects, the diameter of the aspired follicles and the productive period.

Diâmetro folicular e taxa de prenhez em protocolo de sincronização com GnRH ou Benzoato de Estradiol no dia 0 em vacas de corte

This work aimed to evaluate the pregnancy rate and follicular diameter using EB or GnRH on the insertion of progesterone implant (D0) in lactating beef cows. Two groups were tested in two experiments. In Exp. 1 were used 61 Nelore cows divided into two groups: G-BE (n = 32) and G-GnRH (n = 29), on D0 was inserted P4 implant (CIDR ) and applied 2 mL of BE (G-BE) or 2.5 mL GnRH (G-GnRH). In D9 was performed ultrasonography (U.S.) to measure the diameter of the dominant follicle (DF) present in the ovary and the implant was removed, with concomitant administration of 2.5 mL of PGF2a and estradiol cypionate (ECP ) followed by calves removal. After 48 hours all the cows were inseminated and the calves returned. In Exp. 2 50 cows were used following the same protocol described above, but the pregnancy was assessed without performing ovarian US. There was no difference (p>0.05) in pregnancy rate between treatments, BE (55%) or GnRH (41%), but the follicular diameter was significantly higher (p<0.05) in pregnant cows treated with EB (10.7 mm vs. 8.5 mm) and in cows treated with GnRH there was no difference (p>0.05) between pregnant and no pregnant cows (11.6 mm vs. 10.2 mm). We concluded the use of GnRH on D0 did not improve the pregnancy rate in lactating beef cows and follicular diameter was greater (p <0.05) in pregnant cows compared to non-pregnant only in G-BE.

Utilização do sufentanil durante indução anestésica em anestesia venosa total com remifentanil em infusão contínua

Pós-graduação em Anestesiologia - FMB

Salivary alpha amylase and cortisol levels in children with global developmental delay and their relation with the expectation of dental care and behavior during the intervention

The purpose of this study was to analyze the alpha-amylase (sAA) and cortisol levels in children with Global developmental delay (GDD) before and after dental treatment and its association with the children's behavior during treatment. The morning salivary cortisol levels and activity of sAA of 33 children with GDD were evaluated before and after dental treatment and were compared to 19 healthy children. The behavior of children with GDD during dental care was assessed by the Frankl scale. Children with GDD showed lower levels of sAA activity than healthy children, but this result was not significant. The salivary cortisol levels were similar between GOD and healthy children. GDD children showed increased levels of sAA (but not cortisol) prior to the dental treatment as compared to the post-treatment phase. GOD children who showed less favorable behavior during dental care had higher levels of sAA and salivary cortisol than GOD children with more favorable behavior, but only the sAA results were significant. In conclusion, GOD children show hyperactivity of the SNS-axis in anticipation of dental treatment which indicates the need for strategies to reduce their anxiety levels before and during dental care. (C) 2011 Elsevier Ltd. All rights reserved.

The effect of adhesive systems on the pullout strength of a fiberglass-reinforced composite post system in bovine teeth

Purpose: To evaluate the pullout strength of a glass fiber-reinforced composite post (glass FRC) cemented with three different adhesive systems and one resin cement. The null hypothesis was that pullout strengths yielded by the adhesive systems are similar. Materials and Methods: Thirty bovine teeth were selected. The size of the specimens was standardized at 16 mm by sectioning off the coronal portion and part of the root. The specimens were divided into three groups, according to the adhesive system, which were applied following the manufacturers' instructions: G1, ScotchBond Multi-Purpose Plus; G2, Single Bond; G3, Tyrian SPE/One-Step Plus. The glass FRCs (Reforpost) were etched with 37% H3PO4 for 1 min and silanized (Porcelain Primer). Thereafter, they were cemented with the dual resin cement En-Force. The specimens were stored for 24 h, attached to an adapted device, and submitted to the pullout test in a universal testing machine (1 mm/min). The data were submitted to the one-way ANOVA and Tukey's test (α = 0.05). Results: G1 (30.2 ± 5.8 Kgf) displayed the highest pullout strength (p < 0.001) when compared to G2 (18.6 ± 5.8 Kgf) and G3 (14.3 ± 5.8 Kgf), which were statistically similar. Analysis of the specimens revealed that all failures occurred between the adhesive system and the root dentin (pullout of the post cement), regardless of group. Conclusion: The multiple-bottle, total-etch adhesive system provided higher pullout strength of the glass FRC when compared to the single-bottle, total-etch, and single-step self-etching adhesive systems. The null hypothesis was rejected (p < 0.001).

Microtensile bond strength between a quartz fiber post and a resin cement: Effect of post surface conditioning

Purpose: To test the bond strength between a quartz-fiber-reinforced composite post (FRC) and a resin cement. The null hypothesis was that the bond strength can be increased by using a chairside tribochemical silica-coating system. Materials and Methods: Thirty quartz-FRCs (Light-Post) were divided into 3 groups according to the post surface treatment: G1) Conditioning with 32% phosphoric acid (1 min), applying a silane coupling agent; G2) etching with 10% hydrofluoric acid (1 min), silane application; G3) chairside tribochemical silica coating method (CoJet System): air abrasion with 30-μ SiO x-modified Al2O3 particles, silane application. Thereafter, the posts were cemented into a cylinder (5 mm diameter, 15 mm height) with a resin cement (Duo-Link). After cementation, the specimens were stored in distilled water (37°C/24 h) and sectioned along the x and y axes with a diamond wheel under cooling (Lab-cut 1010) to create nontrimmed bar specimens. Each specimen was attached with cyanoacrylate to an apparatus adapted for the microtensile test. Microtensile testing was conducted on a universal testing machine (1 mm/min). The data obtained were submitted to the one-way ANOVA and Tukey test (α = 0.05). Results: A significant influence of the conditioning methods was observed (p < 0.0001). The bond strength of G3 (15.14 ± 3.3) was significantly higher than the bond strengths of G1 (6.9 ± 2.3) and G2 (12.60 ± 2.8) (p = 0.000106 and p = 0.002631, respectively). Notwithstanding the groups, all the tested specimens showed adhesive failure between the resin cement and FRC. Conclusion: The chairside tribochemical system yielded the highest bond strength between resin cement and quartz-fiber post. The null hypothesis was accepted (p < 0.0001).

Fatigue resistance of bovine teeth restored with resin-bonded fiber posts: Effect of post surface conditioning

This study evaluated the effect of post surface conditioning on the fatigue resistance of bovine teeth restored with resin-bonded fiber-reinforced composite (FRC). Root canals of 20 single-rooted bovine teeth (16 mm long) were prepared to 12 mm using a preparation drill of a double-tapered fiber post system. Using acrylic resin, each specimen was embedded (up to 3.0 mm from the cervical part of the specimen) in a PVC cylinder and allocated into one of two groups (n = 10) based on the post surface conditioning method: acid etching plus silanization or tribochemical silica coating (30 μm SiOx + silanization). The root canal dentin was etched (H2PO3 for 30 seconds), rinsed, and dried. A multi-step adhesive system was applied to the root dentin and the fiber posts were cemented with resin cement. The specimens were submitted to one million fatigue cycles. After fatigue testing, a score was given based on the number of fatigue cycles until fracture. All of the specimens were resistant to fatigue. No fracture of the root or the post and no loss of retention of the post were observed. The methodology and the results of this study indicate that tribochemical silica coating and acid etching performed equally well when dynamic mechanical loading was used.

Patient Education and Self-Care for the Management of Jaw Pain upon Awakening: A Randomized Controlled Clinical Trial Comparing the Effectiveness of Adding Pharmacologic Treatment with Cyclobenzaprine or Tizanidine

Aims: To compare the effectiveness of adding cyclobenzaprine, tizanidine, or placebo to patient education and a self-care management program for patients with myofascial pain and specifically presenting with jaw pain upon awakening. Methods: Forty-five patients with a diagnosis of myofascial pain based on the guidelines of the American Academy of Orofacial Pain participated in this 3-week study. The subjects were randomly assigned into one of three groups: placebo group, TZA group (tizanidine 4 mg), or CYC group (cyclobenzaprine 10 mg). Patients were evaluated for changes in pain intensity, frequency, and duration by using the modified Severity Symptoms Index and changes in sleep quality with the use of the Pittsburgh Sleep Quality Index. Data were analyzed by ANOVA and post-hoc or nonparametric statistical tests as appropriate. Results: All three groups had a reduction in pain symptoms and improvement of sleep quality based on a comparison of pretreatment and treatment scores. However, no significant differences among the groups were observed at the posttreatment evaluation. Conclusion: The use of tizanidine or cyclobenzaprine in addition to self-care management and patient education was not more effective than placebo for the management of patients with myofascial jaw pain upon awakening.