885 resultados para Clinical stages of infection
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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
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This randomized clinical trial sought to evaluate the performance of two packable composites over a period of 36 months. A total of 39 Class I and II restorations were placed in the permanent teeth of 20 patients. Using United States Public Health Services criteria, two investigators evaluated the restorations immediately after placement and again after 12 and 36 months, examining color match, marginal discoloration, marginal integrity, recurrent caries, proximal contact, anatomical shape, surface texture, and postoperative sensitivity. It was concluded that the packable composites evaluated showed satisfactory clinical performance after three years.
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We report on the results of a double-blind, randomized, controlled clinical trial comparing two preparations of ethinylestradiol and cyproterone acetate in the treatment of women of reproductive age presenting menstrual irregularities of hyper-androgenic origin. After obtaining informed consent, subjects were randomized to a 4-month treatment period consisting of one daily dose of 0.035mg ethinylestradiol + 2mg cyproterone acetate. The treatment regimen cycle consisted of one pill, once daily for 21 days, followed by a 7-day pill-free period. We compared the efficacy of two presentations of the drug combination after each treatment cycle (Visits 2, 3, 4, and 5) in establishment and maintenance of menstrual regulation, intensity of menstrual flow, and dysmenorrhea, as well as a comparison of the two presentations in terms of Global Satisfaction and Drug Satisfaction assessments performed by the patients and the investigating physician. At each study visit, drug compliance and use of concomitant medications, as well as incidence, severity and duration of adverse events were recorded. A total of 86 subjects were randomized to treatment, with 43 subjects in each treatment group. At Visit 2 and each subsequent visit, all patients in both treatment groups reported an episode of withdrawal bleeding during the 7-day hormone-free period. We observed a statistically significant (p<0.0001) decrease in the incidence of dysmenorrhea at each study visit in relation to the pretreatment assessment. There was a significant reduction (p<0.0001) in the number of subjects reporting intermenstrual bleeding at each study visit in both treatment groups. Global Satisfaction scores by the patient and physician increased significantly at each successive study visit in both treatment groups. There were no clinically significant changes in vital signs, weight, and body mass index throughout the study period in either group. The number of subjects reporting adverse events at each visit did not vary between treatment groups. The combined oral contraceptive pill containing ethinylestradiol and cyproterone acetate was found to be both effective and safe in the menstrual irregularities of hyper-androgenic origin (amenorrhea, dysmenorrhea, and intermenstrual bleeding) assessed in this study. © Copyright Moreira Jr. Editora. Todos os direitos reservados.
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The use of low-level laser (LLL) may be an useful tool to promote reduction of muscular pain caused by TMD. Aim: This study evaluated the immediate efficacy of low-level laser therapy on women reporting pain and diagnosed with temporomandibular dysfunction (TMD). Methods: Diode laser (GaAlAs) at 790 nm wavelength (infrared spectrum) was applied as experimental treatment. Irradiations of 1.5 J/cm2 were made at 4 points of the temporomandibular joint (TMJ) and of 3 J/cm2 at 3 points in the temporal muscle. An electromyographic (EMG) evaluation of the masseter and anterior temporal was done at the following intervals: before, immediately after, 5 min and 20 min after laser application. Results: Comparison of the electrical activity at the times of measurement revealed a statistically significant difference in masseter muscles before (P=0.025) and immediately after (P=0.013) LLLT. Conclusions: Both masseter and temporal muscles showed a reduction in the measured EMG activities at all times after LLLT, and the temporal muscle showed higher EMG activity than the masseter muscle at all the evaluation times. LLLT caused significant immediate relaxation of the masseter muscles.
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This study aimed to stablish the efficacy of a multivitamin and polyminerals supplemented with Panax ginseng extract (Natus Gerin ®) on patients subjected to common physical or mental stress. Patients were randomly divided in two groups and underwent a thorough clinical examination. Group A received Natus Gerin ® capsules and B placebo capsules. Two capsules were taken daily during meals during four weeks. Mood and physical activity were evaluated through a questionnaire assessing quality of life. From the 176 patients enrolled, 17 were excluded due to voluntary withdrawal, 81 completed the study in group A and 78 in group B. The treatment with Natus Gerin ® increased the quality of life when compared to placebo. After 15 and 30 days, group A showed a significant increase in average scoring score from 1.78 to 3.78, and finally 5.32 points. The study has shown that the daily use of Natus Gerin ® can be effective in improving quality of life in patients suffering from physical and mental stress.
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Ceramics have been widely used for esthetic and functional improvements. The resin cement is the material of choice for bonding ceramics to dental substrate and it can also dictate the final esthetic appearance and strength of the restoration. The correct use of the wide spectrum of resin luting agents available depends on the dental tooth substrate. This article presents three-year clinical results of a 41 years old female patient B.H.C complaining about her unattractive smile. Two all-ceramic crowns and two laminates veneers were placed in the maxillary incisors and cemented with a self-adhesive resin luting cement and conventional resin luting cement, respectively. After a three-year follow-up, the restorations and cement/teeth interface were clinically perfect with no chipping, fractures or discoloration. Proper use of different resin luting cements shows clinical appropriate behavior after a three-year follow-up. Self-adhesive resin luting cement may be used for cementing all-ceramic crowns with high predictability of success, mainly if there is a large dentin surface available for bonding and no enamel at the finish line. Otherwise, conventional resin luting agent should be used for achieving an adequate bonding strength to enamel.
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Objectives: The objective of this study was to evaluate the clinical performance of 124 non-carious cervical lesion restorations at 12 months. Materials And Methods: Three study groups were formed according to the material and technique used. All teeth received 37% phosphoric acid etching in enamel and dentin. The teeth of Group I received the conventional adhesive system Scotch Bond Multi Purpose, followed by resin composite Filtek Z350; teeth of Group II were restored with resin-modified glassionomer cement Fuji II LC; teeth of Group III were restored with the same resin-modified glass-ionomer cement-however, before it was inserted, 2 coats of primer of the Scotch Bond Multi Purpose adhesive system were applied to dentinal tissue. The teeth were evaluated by 2 examiners with regard to the factors of retention, marginal adaptation, marginal discoloration, color alteration, presence of marginal caries lesion, anatomic shape, and sensitivity. Results: Application of the Kruskal-Wallis test showed no statistically significant difference for anatomic shape, marginal discoloration, color alteration, caries lesion, marginal adaptation, and sensitivity among the three study groups, but the variable retention presented statistically significant difference at 12 months, with Group III presenting a behavior superior to that of Group II but similar to that of Group I. Conclusion: The analyzed restorations of non-carious cervical lesions presented a good clinical performance at 12 months. © 2012 Nova Science Publishers, Inc.
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This clinical study assessed the performance of posterior composite resins applied with the Adper™ Single Bond Plus (SB) and Adper ™ Scotchbond SE (SE) adhesive systems and Filtek ™ Supreme Plus composite resin, using modified US Public Health Service criteria. A total of 97 restorations were placed in posterior teeth by two calibrated operators. Application of the materials followed manufacturers' instructions. The restorations were evaluated by two examiners at baseline and after one year. Statistical analyses were conducted using the proportion test at a significance level of 5% (p<0.05). All the restorations evaluated (ie, 100%) received an alpha rating for the criteria of marginal discoloration and marginal integrity at baseline. At one year, for marginal discoloration, 64.6% of SB and 61.2% of SE received an alpha rating. For marginal integrity, 72.9% of SB and 77.6% of SE received an alpha rating. The other restorations received bravo ratings for both criteria. None of the teeth that received the restorative systems presented caries lesions around the restorations. A total of eight teeth presented postoperative sensitivity one week after baseline, five with SB and three with SE; the symptom had disappeared one year later. One year later, composite resin restorations using either adhesive system showed satisfactory clinical performance.
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The purpose of the present study was to evaluate in vivo the failure rate of metallic brackets bonded with two orthodontic composites. Nineteen patients with ages ranging from 10.5 to 38.7 years needing corrective orthodontic treatment were selected for study. The enamel surfaces from second premolars to second premolars were treated with Transbond Plus-Self Etching Primer (3M Unitek). Next, 380 orthodontic brackets were bonded on maxillary and mandibular teeth, as follows: 190 with Transbond XT composite (3M Unitek) (control) and 190 with Transbond Plus Color Change (3M Unitek) (experimental) in contralateral quadrants. The bonded brackets were light cured for 40 s, and initial alignment archwires were inserted. Bond failure rates were recorded over a six-month period. At the end of the evaluation, six bond failures occurred, three for each composite. Kaplan-Meyer method and log-rank test (Mantel-Cox) was used for statistical analysis, and no statistically significant difference was found between the materials (p=0.999). Both Transbond XT and Transbond Plus Color Change composites had low debonding rates over the study period.
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Includes bibliography
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Aim Primary implant stability can be compromised by overdrilling of the implant bed. Filling the gap between the implant and the bone with a highly viscous copolymer of polylactic and polyglycolic acid (PLA/PGA) might stabilize the implant and thus supply osseointegration. The aim of this study was to evaluate implants installed in overdrilled beds associated with PLA/PGA in rats tibia model by means of removal torque test and fluorochrome analysis. Materials and methods For this experiment two groups were selected: in the test group 0.4 mm overdrilled defects (2.0 in diameter and 3 mm long ) were produced in the right tibia of seven rats and implants were placed covered with PLA/PGA biomaterial to fill the gap; the control group was not overdrilled and the implants were placed without the biomaterial. Implants of 1.6 mm in diameter and 3 mm long where placed into all defects. Calcein, alizarin and oxytetracyclin were injected at 7, 15 and 21 postoperative days, respectively, and the animals were sacrificed at 35 postoperative day. Results The results showed that all the implants achieved osseointegration. There were no statistical significance differences in torque-reverse and fluorocrome analysis (P>0.05). Conclusion We can conclude that overdrilled defects filled with PLA/PGA did not disturb osseointegration in this experimental model. © ARIESDUE.
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Background: Acute kidney injury (AKI) requiring dialysis in critically ill patients is associated with an in-hospital mortality rate of 50-80 %. Extended daily hemodialysis (EHD) and high volume peritoneal dialysis (HVPD) have emerged as alternative modalities. Methods: A double-center, randomized, controlled trial was conducted comparing EHD versus HVPD for the treatment for AKI in the intensive care unit (ICU). Four hundred and seven patients were randomized and 143 patients were analyzed. Principal outcome measure was hospital mortality, and secondary end points were recovery of renal function and metabolic and fluid control. Results: There was no difference between the two groups in relation to median ICU stay [11 (5.7-20) vs. 9 (5.7-19)], recovery of kidney function (26.9 vs. 29.6 %, p = 0.11), need for chronic dialysis (9.7 vs. 6.5 %, p = 0.23), and hospital mortality (63.4 vs. 63.9 %, p = 0.94). The groups were different in metabolic and fluid control. Blood urea nitrogen (BUN), creatinine, and bicarbonate levels were stabilized faster in EHD group than in HVPD group. Delivered Kt/V and ultrafiltration were higher in EHD group. Despite randomization, there were significant differences between the groups in some covariates, including age, pre-dialysis BUN, and creatinine levels, biased in favor of the EHD. Using logistic regression to adjust for the imbalances in group assignment, the odds of death associated with HVPD was 1.4 (95 % CI 0.7-2.4, p = 0.19). A detailed investigation of the randomization process failed to explain the marked differences in patient assignment. Conclusions: Despite faster metabolic control and higher dialysis dose and ultrafiltration with EHD, this study provides no evidence of a survival benefit of EHD compared with HVPD. The limitations of this study were that the results were not presented according to the intention to treat and it did not control other supportive management strategies as nutrition support and timing of dialysis initiation that might influence outcomes in AKI. © 2012 Springer Science+Business Media Dordrecht.
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Meta-analysis of the heterogeneous symptoms of obsessive-compulsive disorder (OCD) has found a four-factor structure of symptom dimensions consisting of cleaning, forbidden thoughts, symmetry, and hoarding. Research into age of onset of symptom dimensions has yielded inconsistent results, and it is unknown whether symptoms along these dimensions differ in their clinical course. We assessed age of onset and clinical course of different OCD symptom dimensions in a large cohort of adult patients. Nine-hundred fifty-five subjects were assessed using the Dimensional Yale-Brown Obsessive-Compulsive Scale. For age of onset analysis, we tested across three methods of classification: (1) primary (more severe) symptom dimension (2) clinically significant symptoms within a dimension or (3) any symptoms within a dimension. Age of onset was defined as the earliest age of onset reported for any individual item within a symptom dimension. For analysis of different types of clinical course, we used chi-square tests to assess for differences between primary symptom dimensions. OCD symptoms in the symmetry dimension had an earlier age of onset than other OCD symptom dimensions. These findings remained significant across all three methods of classification and controlling for gender and comorbid tics. No significant differences were found between the other dimensions. Subjects with primary OCD symptoms in the forbidden thoughts dimension were more likely to report a waxing-and-waning course, whereas symmetry symptoms were less likely to be associated with a waxing-and-waning course. © 2013.
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Phylogeographic studies provide an important framework for investigating the mechanisms operating during the earliest stages of speciation, as reproductive barriers can be examined among divergent lineages in a geographic context. We investigated the evolution of early stages of intrinsic postmating isolation among different populations and lineages of Epidendrum denticulatum, a Neotropical orchid distributed across different biomes in South America. We estimated genetic diversity and structure for both nuclear and plastid markers, using a haplotype network, differentiation tests, Bayesian assignment analysis, and divergence time estimates of the main lineages. Reproductive barriers among divergent lineages were examined by analyzing seed viability following reciprocal crossing experiments. Strong plastid phylogeographic structure was found, indicating that E. denticulatum was restricted to multiple refuges during South American forest expansion events. In contrast, significant phylogeographic structure was not found for nuclear markers, suggesting higher gene flow by pollen than by seeds. Large asymmetries in seed set were observed among different plastid genetic groups, suggesting the presence of polymorphic genic incompatibilities associated with cytonuclear interactions. Our results confirm the importance of phylogeographic studies associated with reproductive isolation experiments and suggest an important role for outbreeding depression during the early stages of lineage diversification. © 2013 The Society for the Study of Evolution.
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This study evaluated the photodynamic inactivation (PDI) mediated by Photodithazine® (PDZ) against 15 clinical isolates of Candida albicans, Candida glabrata and Candida tropicalis. Each isolate, in planktonic and biofilm form, was exposed to PDI by assessing a range of PDZ concentrations and light emitting diode fluences. Cell survival of the planktonic suspensions was determined by colony forming units (CFU ml-1). The antifungal effects of PDI against biofilms were evaluated by CFU ml-1 and metabolic assay. Data were analyzed by non-parametric tests (α = 0.05). Regardless of the species, PDI promoted a significant viability reduction of planktonic yeasts. The highest reduction in cell viability of the biofilms was equivalent to 0.9 log10 (CFU ml-1) for C. albicans, while 1.4 and 1.5 log10 reductions were obtained for C. tropicalis and C. glabrata, respectively. PDI reduced the metabolic activity of biofilms by 62.1, 76.0, and 76.9% for C. albicans, C. tropicalis, and C. glabrata, respectively. PDZ-mediated PDI promoted significant reduction in the viability of Candida isolates. © 2013 Taylor & Francis.