964 resultados para Clinical-applications


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

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Nowadays, articaine hydrochloride (ATC) is a local anesthetic widely used in dental procedures, but its side effects include paresthesia and nerve injury. Alginate/chitosan nanoparticles (AG/CSnano) can be used as carrier for drugs, overcoming the problems. The aim of this work was to evaluate the factors (Calcium/alginate [Ca2+:AG] and Chitosan/alginate [CS:AG] mass ratios) influence on the average size, polydispersity index, zeta potential and encapsulation efficiency of ATC. AG/CSnano containing ATC were prepared by ionic pregelation method. A three-level factorial design was carried out and the factors varied were Ca2+/AG mass ratio and CS/AG mass ratio. There were obtained nanoparticles with size range of 340–550 nm and polydispersity index between 0.2 and 0.5, zeta potential range –19 and –22 mV and encapsulation efficiency of ATC in AG/Csnano between 22 and 45%. According to the results, the average size, polydispersity index and encapsulation efficiency were significantly affected to the variation of Ca2+/AG and CS/AG mass ratio, but the zeta potential didn't change significantly with factor variations. The factorial design showed it was possible to identify formulations that presented better results for the parameters measured. The factor chosen for the suitable formulations was the encapsulation efficiency. Through this parameter, one formulation was chosen with highest encapsulation efficiency of ATC and presented good colloidal stability parameters aiming future clinical applications.

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Over the last few years, new technologies have been developed to making cavity preparations, among which the diamond burs CVDentus® (CVDentus, São José dos Campos, Brazil) are outstanding. These points are produced by chemical deposition from the vapor phase, forming a single diamond stone, with greater durability than the conventional diamond burs. Coupled to the ultrasound appliance, they have several clinical applications in Dentistry with advantages over conventional rotary instruments, such as lower pressure, noise, vibration and heat, as well as reducing the need to use local anesthesia, contributing to minimize patient’s fear and anxiety. The aim of this study was to present the complete restorative dental treatment performed with this system in a child patient with a prior history of non-cooperative behavior. The use of this new technology offered the patient greater comfort, making it possible recondition the patient’s attitude to dental treatment, in addition to favoring conservative cavity preparations to be made.

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Periodontal disease is an infectious disease characterized by the connective tissue destruction and consequent alveolar bone loss in response to plaque accumulation on the tooth surface. The clinical diagnosis of periodontal disease is based both on clinical examination involving the evaluation of probing depth and radiographic examination of alveolar bone loss but these examinations are not enough to determine the activity of the disease process. For that reason, it has been proposed to seek predictive disease markers in an attempt to assess the disease activity and so, evaluate the efficacy of the periodontal disease treatment. The aim of this review is to present recent advances in the development of proteomic, genomics and microbial biomarkers and potential clinical applications. It was concluded that periodontal treatment based on assessing the levels of salivary biomarkers emerges as a promising method in near future and will become an integral part of the evaluation of periodontal health.

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The ability to tridimensionally evaluate pathological and anatomical areas, in apical surgery planning, presents a number of advantages. Cone beam computed tomography (CBCT) was developed for dental applications. This paper aims to present a literature review on CBCT, highlighting its advantages over both conventional computed tomography (CT) and radiography. Moreover, its clinical applications in apical surgery are discussed. LITERATURE REVIEW AND CONCLUSION: Unlikely CT, CBCT captures a volume of data in a single 360º rotation, providing benefits such as higher accuracy, better resolution, reduced scanning time and reduced radiation dose. In the maxillofacial region, CBCT has been mainly used in the assessment of dento-alveolar pathology and oral traumatology. CBCT provides a better diagnosis and quantitative information on periodontal bone levels than conventional radiography. It has also been used for patients requiring surgical facial reconstruction, orthognathic surgery, dental implants, and more complex tooth extractions. Besides that, it seems to be a significant tool in modern endodontic practice, presenting useful applications in apical surgery.

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Hair ingested by licking during cat grooming can eventually coalesce into solid masses in cat gastrointestinal tract. It is believed that dietary fibre might reduce formation of these trichobezoars (hairballs). The effects of two insoluble fibre sources added to kibble diets were evaluated with respect to trichobezoar faecal excretion. Thirty-two cats and four diets were used in a randomised block design: a control diet without additional fibre, 10 % added sugarcane fibre, 20 % added sugarcane fibre or 10 % added cellulose. Animals were fed for 42 d and during three separate periods (days 15-17, 25-27 and 40-42), the cats were housed individually in metabolic cages and their faeces were totally collected. The faeces were evaluated and the trichobezoars were isolated and classified into small (<1 cm), medium (1·1-2 cm) or large (>2·1 cm). Means were evaluated by repeated measures ANOVA and contrasts (P < 0·05). Cats fed sugarcane fibre shown a linear reduction of small and medium trichobezoar excretion (number per cat per day; P = 0·004) as well as a reduction in trichobezoar mass excretion (mg per cat per day; P < 0·01). The control group showed increased faecal excretion of large trichobezoars (P = 0·003), which were not present in the high sugarcane fibre group (P < 0·006). No effect of cellulose was observed for any evaluated trait. Therefore, long fibres (sugarcane fibre) may cause greater peristaltic stimulation, increasing the propulsion of hair through the gut, but further research is needed to validate this mechanism. In conclusion, sugarcane fibre reduced faecal hairball elimination in cats, which may have clinical applications for the prevention of health problems related to trichobezoars.

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The neural control of the cardiovascular system is a complex process that involves many structures at different levels of nervous system. Several cortical areas are involved in the control of systemic blood pressure, such as the sensorimotor cortex, the medial prefrontal cortex and the insular cortex. Non-invasive brain stimulation techniques - repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) - induce sustained and prolonged functional changes of the human cerebral cortex. rTMS and tDCS has led to positive results in the treatment of some neurological and psychiatric disorders. Because experiments in animals show that cortical modulation can be an effective method to regulate the cardiovascular system, non-invasive brain stimulation might be a novel tool in the therapeutics of human arterial hypertension. We here review the experimental evidence that non-invasive brain stimulation can influence the autonomic nervous system and discuss the hypothesis that focal modulation of cortical excitability by rTMS or tDCS can influence sympathetic outflow and, eventually, blood pressure, thus providing a novel therapeutic tool for human arterial hypertension. (C) 2009 Published by Elsevier Ltd.

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In this work, we present a numerical study of the use of reconfigurable arrays (RCA) for vibro-acoustography (VA) beam formation. A parametric study of the aperture selection, number of channels, number of elements, focal distance, and steering parameters is presented to show the feasibility and evaluate the performance of VA imaging based on RCA. The transducer aperture was based on two concentric arrays driven by two continuous-wave or toneburst signals at slightly different frequencies. The mathematical model considers a homogeneous, isotropic, inviscid medium. The point-spread function of the system is calculated based on angular spectrum methods using the Fresnel approximation for rectangular sources. Simulations considering arrays with 50 x 50 to 200 x 200 elements with number of channels varying in the range of 32 to 128 are evaluated to identify the best configuration for VA. Advantages of two-dimensional and RCA arrays and aspects related to clinical importance of the RCA implementation in VA, such as spatial resolution, image frame rate, and commercial machine implementation, are discussed. It is concluded that RCA transducers can produce spatial resolution similar to confocal transducers and steering is possible in the elevational and azimuthal planes. Optimal settings for number of elements, number of channels, maximum steering, and focal distance are suggested for VA clinical applications. Furthermore, an optimization for beam steering based on the channel assignment is proposed for balancing the contribution of the two waves in the steered focus.

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Mesenchymal stem cells (MSCs) are characterized as multipotent stromal cells with the capacity for both self-renewal and differentiation into mesodermal cell lineages. MSCs also have a fibroblast-like phenotype and can be isolated from several tissues. In recent years, researchers have found that MSCs secrete several soluble factors that exert immunosuppressive effects by modulating both innate (macrophages, dendritic and NK cells) and adaptive (B cells and CD4+ and CD8+ T cells) immune responses. This review summarizes the principal trophic factors that are related to immune regulation and secreted by MSCs under both autoimmune and inflammatory conditions. The understanding of mechanisms that regulate immunity in MSCs field is important for their future use as a novel cellular-based immunotherapy with clinical applications in several diseases.

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Background: The high and increasing prevalence of Dilated Cardiomyopathy (DCM) represents a serious public health issue. Novel technologies have been used aiming to improve diagnosis and the therapeutic approach. In this context, speckle tracking echocardiography (STE) uses natural myocardial markers to analyze the systolic deformation of the left ventricle (LV). Objective: Measure the longitudinal transmural global strain (GS) of the LV through STE in patients with severe DCM, comparing the results with normal individuals and with echocardiographic parameters established for the analysis of LV systolic function, in order to validate the method in this population. Methods: Seventy-one patients with severe DCM (53 +/- 12 years, 72% men) and 20 controls (30 +/- 8 years, 45% men) were studied. The following variables were studied: LV volumes and ejection fraction calculated by two and three-dimensional echocardiography, Doppler parameters, Tissue Doppler Imaging systolic and diastolic LV velocities and GS obtained by STE. Results: Compared with controls, LV volumes were higher in the DCM group; however, LVEF and peak E-wave velocity were lower in the latter. The myocardial performance index was higher in the patient group. Tissue Doppler myocardial velocities (S', e', a') were significantly lower and E/e' ratio was higher in the DCM group. GS was decreased in the DCM group (-5.5% +/- 2.3%) when compared with controls (-14.0% +/- 1.8%). Conclusion: In this study, GS was significantly lower in patients with severe DCM, bringing new perspectives for therapeutic approaches in this specific population. (Arq Bras Cardiol 2012;99(3):834-842)

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A myriad of titanium (Ti) surface modifications has been proposed to hasten the osseointegration. In this context, the aim of this study was to perform histomorphometric, cellular, and molecular analyses of the bone tissue grown in close contact with Ti implants treated by anodic spark deposition (ASD-AK). Acid-etched (AE) Ti implants either untreated or submitted to ASD-AK were placed into dog mandibles and retrieved at 3 and 8 weeks. It was noticed that both implants, AE and ASD-AK, were osseointegrated at 3 and 8 weeks. Histomorphometric analysis showed differences between treatments only for bone-to-implant contact, being higher on AE implants. Although not backed by histomorphometric results, gene expression of key bone markers was higher for bone grown in close contact with ASD-AK and for cells harvested from these fragments and cultured until subconfluence. Cell proliferation at days 7 and 10 and alkaline phosphatase activity at day 10 was higher on AE surfaces. No statistical significant difference was noticed for extracellular matrix mineralization at 17 days. Our results have shown that the Ti fixtures treated by ASD-AK allowed in vivo osseointegration and induced higher expression of key markers of osteoblast phenotype, suggesting that this surface treatment could be considered to produce implants for clinical applications. (c) 2012 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 100A:30923098, 2012.

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The pathophysiology of neurodegenerative diseases (ND) such as Alzheimer's disease (AD) and Parkinson's disease (PD) has not yet been completely elucidated. However, in the past few years, there have been great knowledge advances about intra-and extracellular proteins that may display impaired function or expression in AD, PD and other ND, such as amyloid beta (AB), alpha-synuclein, tau protein and neuroinfiammatory markers. Recent developments in the imaging techniques of positron emission tomography (PET) and single photon emission computed tomography (SPECT) now allow the non-invasive tracking of such molecular targets of known relevance to ND in vivo. This article summarizes recent findings of PET and SPECT studies using these novel methods, and discusses their potential role in the field of drug development for ND as well as future clinical applications in regard to differential diagnosis of ND and monitoring of disease progression.

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Steatotic livers show increased hepatic damage and impaired regeneration after partial hepatectomy (PH) under ischemia/reperfusion (I/R), which is commonly applied in clinical practice to reduce bleeding. The known function of retinol-binding protein 4 (RBP4) is to transport retinol in the circulation. We examined whether modulating RBP4 and/or retinol could protect steatotic and nonsteatotic livers in the setting of PH under I/R. Steatotic and nonsteatotic livers from Zucker rats were subjected to PH (70%) with 60 minutes of ischemia. RBP4 and retinol levels were measured and altered pharmacologically, and their effects on hepatic damage and regeneration were studied after reperfusion. Decreased RBP4 levels were observed in both liver types, whereas retinol levels were reduced only in steatotic livers. RBP4 administration exacerbated the negative consequences of liver surgery with respect to damage and liver regeneration in both liver types. RBP4 affected the mobilization of retinol from steatotic livers, and this revealed actions of RBP4 independent of simple retinol transport. The injurious effects of RBP4 were not due to changes in retinol levels. Treatment with retinol was effective only for steatotic livers. Indeed, retinol increased hepatic injury and impaired liver regeneration in nonsteatotic livers. In steatotic livers, retinol reduced damage and improved regeneration after surgery. These benefits of retinol were associated with a reduced accumulation of hepatocellular fat. Thus, strategies based on modulating RBP4 could be ineffective and possibly even harmful in both liver types in the setting of PH under I/R. In terms of clinical applications, a retinol pretreatment might open new avenues for liver surgery that specifically benefit the steatotic liver. Liver Transpl 18:1198-1208, 2012. (c) 2012 AASLD.