Influence of Y-TZP ceramic treatment and different resin cements on bond strength to dentin

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

Treatment of pediatric myelodysplastic syndromes and juvenile myelomonocytic leukemia: the Brazilian experience in the past decade

Background: Therapy strategies for myelodysplastic syndromes (MDS) and juvenile myelomonocytic leukemia (JMML) vary considerably. Objective: To review the treatment of Brazilian children who were diagnosed with MDS or JMML in the past decade and reported to the Brazilian Cooperative Group on Pediatric Myelodysplastic syndromes (BCG-MDS-PED). Results: of 173 children reported to the BCG-MDS-PED from January 1997 to January 2003 with a suspected diagnosis of MDS or JMML, 91 had the diagnosis confirmed after central review of the bone marrow aspirate and biopsy. Information on previous treatments was available for 78 MDS/JMML patients. Treatment varied from different schedules of low-dose (14%) and standard-dose chemotherapy (50%), granulocyte-colony-stimulating factor (G-CSF 7%), interferon (5%), steroids (2%) and erythropoietin (2%) to allogeneic stem-cell transplantation (SCT) (14%). No survival advantage could be demonstrated based on Hasle's classification or based on treatment. Conclusion: This report reflects the current practice in treating Brazilian children with MDS/JMML without specific Cooperative Group guidelines. Treatment modalities were very heterogeneous. The strategies for implementing a national protocol should consider international guidelines and focus on local experience and available resources. (C) 2004 Elsevier Ltd. All rights reserved.

Treatment of traumatized primary teeth: A conservative approach

This retrospective study examined some different types of treatment to primary teeth. The aim of this study was to assess the treatment of traumatized primary teeth and the importance of a long-term follow up. Brazilian children in the age group of 1-4 years from a baby clinic took part in the study. Three hundred and fifteen patients suffered some type of traumatic injury, a total of 338 affected teeth. Data were registered in specific records and submitted to statistic analysis. The most prevalent type of treatment was monitor only (85%) followed by tooth extraction and endodontic procedure. Invasive treatments were performed in case of severe traumas, usually 6 months after the injury. We verified that a careful follow up might be the preferential choice to the treatment of traumatic primary teeth even in some severe cases.

A general treatment for the conductivity of electrolytes in the whole concentration range in aqueous and nonaqueous solutions

Despite the great importance of ion transport, most of the widely accepted models and theories are valid only in the not very practical limit of low concentrations. Aiming to extend the range of applicability to moderate concentrations, a number of modified models and equations (some approximate, some fundamented on different assumptions, and some just empirical) have been reported. In this work, a general treatment for the electrical conductivity of ionic solutions has been developed, considering the electrical conductivity as a transport phenomenon governed by dissipation and feedback. A general expression for the dependence of the specific conductivity on the solution viscosity (and indirectly on concentration), from which the whole conductivity curve can be obtained, has been derived. The validity of this general approach is demonstrated with experimental results taken from the literature for aqueous and nonaqueous solutions of electrolytes.

The use of glucan as immunostimulant in the treatment of paracoccidioidomycosis

A group of 10 patients, nine of them seriously infected with Paracoccidioides brasiliensis (G1), received glucan (beta-1,3 polyglucose) as an immunostimulant intravenously once a week for one month, followed by monthly doses (10 mg) over an ii-month period, together with a specific anti-fungal agent as an immunostimulant. A second group of eight moderately infected patients (G2) was treated with only the anti-fungal agent. Among the patients in G1, there was only one case of relapse compared with five in G2. Values for the erythrocyte sedimentation rate (ESR) showed a significant difference (P < 0.01) post-treatment in G1 patients, when compared with the pretreatment levels. There was also a significant reduction (P < 0.001) in the level of serum antibodies to P. brasiliensis in the G1 patients in post-treatment examinations. The phytohemagglutinin (PHA) skin test showed a positive reaction among the patients in G1 (P < 0.01) post-treatment and there was a tendency towards an increase in the number of CD4+ T lymphocytes in both groups after treatment. The serum level of tumor necrosis factor (TNF) proved to be significantly higher (P < 0.02) in the G1 patients during treatment. In the G1 patients, the correlation between ESR and TNF tended to be negative whereas that between ESR and serum antibodies was positive. The present results indicate that the patients who received glucan, in spite of being more seriously ill, had a stronger and more favorable response to therapy.

LIFE QUALITY of PEOPLE INFECTED BY HIV WITH OR WITHOUT ANTIRETROVIRAL TREATMENT

The "HIV/Aids-Quality of Life" (HAT-Qol) is a specific multifunctional instrument used to measure the life quality of HIV infected persons. It is divided into nine domains: general activity, sexual activity, secrecy about HIV seropositivity, concern about health, financial concern, awareness about HIV, satisfaction with life, issues about medications and belief in the doctor. The current study analyzed the life quality of HIV infected individuals-who attended the DST/Aids Program in Maringa city, Parana state-regarding the use or not of antiretroviral therapy (TARV) and their demographic, epidemiological and clinical characteristics. Data were collected by retrospective analysis from 1,200 medical charts of patients registered in the program. The HAT-Qol instrument was applied before routine medical consultation. One hundred and sixty-nine patients, who had HIV infection confirmed, were divided into two groups, G1 with 118 individuals receiving antiretroviral therapy and G2 with 51 individuals who were not under this therapy.Result analysis, regarding social and demographic characteristics, revealed no difference among responses related to gender, educational degree and sexual option. Age influenced satisfaction with sexual activity and marital status. Regarding HIV awareness, the lowest response index or worst quality of life came from, respectively, men between 50 and 69 years old and patients who did not have regular partners compared with the ones who did. Additionally, it was observed that the time of diagnosis influenced general activities, HIV awareness, concern about health and financial issues, satisfaction with life and topics about medications. The variables were compared in both groups. There was no influence on the use or not of antiretroviral therapy regarding age, sexual activity, HIV diagnosis time and the domains that evaluated general activities, financial concern, awareness of HIV and satisfaction with life. In relation to time of diagnosis, there was an influence only in persons who had been diagnosed two or three years before, in which a lower quality of life was observed among individuals who were not under antiretroviral therapy. It was not possible to compare variables about medication use, HIV plasmatic viral rate ant time of diagnosis, because G2 individuals were not receiving the antiretroviral therapy. Furthermore, no comparison was made regarding marital status and HIV awareness, because there were no married individuals in G2. Thus, the analysis of the results showed that the use of antiretroviral treatment did not influence the life quality of HIV patients studied by the HAT-Qol scale.

Ileal and caecal microbial populations in broilers given specific essential oil blends and probiotics in two consecutive grow-outs

Specific essential oil (EO) blends and probiotics used as feed additives have been shown to promote healthy digestive microbials resulting in improved poultry production. Two consecutive experiments were conducted with broilers fed corn-soybean meal diets to determine comparative effects of feed additives on ileal and caecal microbial populations (MP). Ross 708 broilers were placed in 84 pens with previously used litter and treatments maintained in the same pens for both experiments. Eight treatment groups were fed diets containing: Bacitracin methylene disalicylate (BMD) as positive control (PC); no additives as negative control (NC); three probiotics: BC-30; BioPlus 2B (B2B); and Calsporin; and the essential oil blends Crina Poultry Plus (CPP) at 300 or 150 ppm in the first experiment; and CPP at 300 ppm and Crina Poultry AF at 100 ppm in experiment 2. Starter and grower diets contained the ionophore (Coban). Ileal and caecal samples were collected at 43 days of age from male broilers. The DNA of microbial populations was isolated from digesta samples and analysed by denaturing gradient gel electrophoresis to generate percentage similarity coefficients (%SC) from band pattern dendrograms. Differences were observed in ileal and caecal populations depending on treatment, respectively, and especially between experiments. Broilers fed diets with probiotics had very similar MP. The EO CPP at 300 ppm resulted in ilea! MP similar to those observed in chickens fed probiotics. We concluded that antibiotic treatment affected ileal, but no caecal MP. More pronounced changes in ileal and caecal MP were seen in broilers at 43 days of age following probiotic and essential oil treatments.

Response to Treatment in a Prospective Cohort of Patients with Large Ulcerated Lesions Suspected to Be Buruli Ulcer (Mycobacterium ulcerans Disease)

Background: The World Health Organization (WHO) advises treatment of Mycobacterium ulcerans disease, also called Buruli ulcer'' (BU), with a combination of the antibiotics rifampicin and streptomycin (R+S), whether followed by surgery or not. In endemic areas, a clinical case definition is recommended. We evaluated the effectiveness of this strategy in a series of patients with large ulcers of >= 10 cm in longest diameter in a rural health zone of the Democratic Republic of Congo (DRC).Methods: A cohort of 92 patients with large ulcerated lesions suspected to be BU was enrolled between October 2006 and September 2007 and treated according to WHO recommendations. The following microbiologic data were obtained: Ziehl-Neelsen (ZN) stained smear, culture and PCR. Histopathology was performed on a sub-sample. Directly observed treatment with R+S was administered daily for 12 weeks and surgery was performed after 4 weeks. Patients were followed up for two years after treatment.Findings: Out of 92 treated patients, 61 tested positive for M. ulcerans by PCR. PCR negative patients had better clinical improvement than PCR positive patients after 4 weeks of antibiotics (54.8% versus 14.8%). For PCR positive patients, the outcome after 4 weeks of antibiotic treatment was related to the ZN positivity at the start. Deterioration of the ulcers was observed in 87.8% (36/41) of the ZN positive and in 12.2% (5/41) of the ZN negative patients. Deterioration due to paradoxical reaction seemed unlikely. After surgery and an additional 8 weeks of antibiotics, 98.4% of PCR positive patients and 83.3% of PCR negative patients were considered cured. The overall recurrence rate was very low (1.1%).Interpretation: Positive predictive value of the WHO clinical case definition was low. Low relapse rate confirms the efficacy of antibiotics. However, the need for and the best time for surgery for large Buruli ulcers requires clarification. We recommend confirmation by ZN stain at the rural health centers, since surgical intervention without delay may be necessary on the ZN positive cases to avoid progression of the disease. PCR negative patients were most likely not BU cases. Correct diagnosis and specific management of these non-BU ulcers cases are urgently needed.

Antibody response to the 43 kDa glycoprotein of Paracoccidioides brasiliensis as a marker for the evaluation of patients under treatment

Sera of patients with paracoccidioidomycosis contained IgG-, IgA-, and IgM-specific antibodies to a 43 kDa antigen contained in the filtrate of a culture of Paracoccidioides brasiliensis. IgG- and IgA-specific antibodies were present in all observed patients. The IgM response was more frequent in acute cases, and the mean titers of IgG- and IgM-specific antibodies were higher in the acute forms. By the fourth month of chemotherapy, there was a decay of IgG, IgA, and IgM antibody titers to this antigen in acute cases, correlating with clinical improvement. The detection of IgG and IgA antibodies and the sequential determination of antibodies to the 43 kDa glycoprotein may be useful tools for serodiagnosis and evaluation of therapeutic efficacy.

Specific components found in circulating immune complexes (CIC) in paracoccidioidomycosis

Circulating immune complexes (CIC) from 15 paracoccidioidomycosis (PCM) patient sera and from 20 healthy control sera were analysed. After CIC precipitation, solubilization and acid treatment, only a little reactivity to P. brasiliensis antigens was found in the free antibodies from PCM-CIC. This result has suggested that there were antibodies with a high affinity bound to fungus components. Dissociated CIC were fractionated in a column of Sephacryl S300 and the fractions that probably contained antigens were pooled and applied to an affinity column, prepared with mouse anti-gp43 monoclonal antibody. Using ECL-Western blotting assay two polypeptide with apparent mass of 43 and 62 kDa were found.

Detection of circulating Paracoccidioides brasiliensis antigen in urine of paracoccidioidomycosis patients before and during treatment

For the diagnosis and follow-up of paracoccidioidomycosis patients undergoing therapy, we evaluated two methods (immunoblotting and competition enzyme immunoassay) for the detection of circulating antigen in urine samples. A complex pattern of reactivity was observed in the immunoblot test. Bands of 70 and 43 kDa were detected more often in urine samples from patients before treatment. The immunoblot method detected gp43 and gp70 separately or concurrently in 11 (91.7%) of 12 patients, whereas the competition enzyme immunoassay detected antigenuria in 9 (75%) of 12 patients. Both tests appeared to be highly specific (100%), considering that neither fraction detectable by immunoblotting was present in urine samples from the control group. gp43 remained present in the urine samples collected during the treatment period, with a significant decrease in reactivity in samples collected during clinical recovery and increased reactivity in samples collected during relapses. Reactivity of some bands was also detected in urine specimens from patients with 'apparent cure.' The detection of Paracoccidioides brasiliensis antigens in urine appears to be a promising method for diagnosing infection, for evaluating the efficacy of treatment, and for detecting relapse.

IL-12 and neutralization of endogenous IL-10 revert the in vitro antigen-specific cellular immunosuppression of paracoccidioidomycosis patients

Treatment of patients with paracoccidioidomycosis is still a challenge. Patients present defective lymphoproliferation and IFN-γ responses to the main Paracoccidioides brasiliensis antigen (gp43), which correlates with disease severity. Here, we demonstrated that the patients show also a defective synthesis of interleukin (IL)-12. Therefore, we attempted to revert this immune disfunction by adding IL-12 and neutralizing anti-IL-10 antibody to gp-43-stimulated peripheral blood mononuclear cell cultures. Both treatments increased IFN-γ secretion to levels observed with healthy sensitized individuals, but affected proliferation only modestly. When combined, the treatments further increased IFN-γ synthesis and cell proliferation. The addition of suboptimal concentrations of IL-2 also further increased the IL-12-mediated secretion of IFN-γ. Interestingly, the immune modulation was mostly antigen-specific, since the responses to Candida albicans' antigen were not affected. These results suggest that appropriate immune intervention with cytokines and/or anti-cytokines may help in the treatment of PCM. © 2002 Elsevier Science Ltd. All rights reserved.

Specific depth cone resistivity measurements to determine soil engineering properties

The University of British Columbia (UBC) began performing piezocone penetration tests (CPTU) with electrical resistivity measurements (RCPTU) in 1989. Since then, RCPTU research at UBC has focused on obtaining geo-environmental parameters such as fluid resistivity and soil engineering properties such as porosity and degree of saturation from measurements of bulk soil electrical resistivity using the empirical relationship proposed by Archie (1942). Within this framework, the paper illustrates and discusses important design and calibration issues for resistivity modules such as the use of isolated circuitry to achieve linear calibrations over large ranges of resistivity. The suitability of RCPTU measurements for determination of geo-environmental and geotechnical parameters are assessed using typical ranges of soil and groundwater properties and methods of isolating individual factors for study are discussed. Illustrative examples of RCPTU research efforts including the environmental characterization of mine tailings, delineation of saline water intrusions in fresh water aquifers and the quality control of geotechnical ground densification are presented throughout the text. It is shown that groundwater temperature and hence ion mobility is not significantly altered by frictional heat generated during piezocone penetration and that ratio-based approaches to monitoring soil porosity can be used to eliminate the requirement for extensive groundwater sampling programs. Lastly, it is shown that RCPTU measurements above the water table can only be made using resistivity modules that are stable over a large range of resistivities and that such measurements are the most difficult to interpret because of grain surface conduction effects and generally unknown fluid resistivities.

Possible effects of sodium chloride treatment on quality of effluents from Alabama channel Catfish ponds

Channel catfish ponds are treated with salt (sodium chloride) to increase chloride concentration and prevent nitrite toxicity in fish. A survey indicated that most farmers try to maintain chloride concentration of 50 to 100 mg/L in ponds by annual salt applications. Averages and standard deviations for selected water quality variables in salt-treated ponds were as follows: chloride, 87.2 ± 37.5 mg/L; total dissolved solids (TDS), 336 ± 96 mg/L; specific conductance, 512 ± 164 μmhos/cm. Maximum values were 189 mg/L for chloride, 481 mg/L for TDS, and 825 μmhos/cm for specific conductance. Good correlations between specific conductance values and both chloride and TDS concentrations suggest that specific conductance can be a rapid method for estimating concentrations of these two variables in surface water. The maximum limit for chloride concentration in Alabama streams allowed by the Alabama Department of Environmental Management is 230 mg/L. The usual recommended upper limit of TDS for protection of aquatic life in freshwater streams is 1,000 mg/L. Based on the observed relationship between TDS concentration and specific conductance in Alabama catfish ponds, 1,000 mg/L TDS corresponds to 1,733 μmhos/cm specific conductance. It is unlikely that effluents from salt-treated catfish ponds would violate the in-stream chloride standard of 230 mg/L or harm aquatic life in streams. Nevertheless, chloride concentrations in ponds should be measured before salt application as a safe guard against excessive salt application and chloride concentrations above the in-stream chloride standard.

Treatment of atherosclerotic renovascular disease

Treatment of atherosclerotic renovascular disease is controversial and revascularization is not a beneficial approach to all patients. Conditions as progressive deterioration of renal function, refractory hypertension or accelerated cardiovascular disease, especially recurrent pulmonary edema, could profit from renal angioplasty with stent placement. Surgical revascularization is a good option for patients who will need concomitant surgical corrections of abdominal aortic lesions. Treatment of all other patients must be individualized. Medical therapy is indicated for all patients with atherosclerotic renovascular disease. Observational studies pointed out to the beneficial effect of controlling blood pressure (<130/80 mm Hg), glucose and lipids profile, lifestyle modifications, specific use of platelet antiaggregant therapy, Angiotensin Conversion Enzyme Inhibitors (ACEI) and statins. All others cardiovascular risk factors must be controlled. The evaluation and management of other systemic atherosclerotic vascular lesions is important, especially coronary, carotid and abdominal aortic. This paper presents a review of evidences to rationale the atherosclerotic renovascular disease treatment. © 2008 Bentham Science Publishers Ltd.