High volume peritoneal dialysis vs daily hemodialysis: A randomized, controlled trial in patients with acute kidney injury

There is no consensus in the literature on the best renal replacement therapy (RRT) in acute kidney injury (AKI), with both hemodialysis (HD) and peritoneal dialysis (PD) being used as AKI therapy. However, there are concerns about the inadequacy of PD as well as about the intermittency of HD complicated by hemodynamic instability. Recently, continuous replacement renal therapy (CRRT) have become the most commonly used dialysis method for AKI around the world. A prospective randomized controlled trial was performed to compare the effect of high volume peritoneal dialysis (HVPD) with daily hemodialysis (DHD) on AKI patient survival. A total of 120 patients with acute tubular necrosis (ATN) were assigned to HVPD or DHD in a tertiary-care university hospital. The primary end points were hospital survival rate and renal function recovery, with metabolic control as the secondary end point. Sixty patients were treated with HVPD and 60 with DHD. The HVPD and DHD groups were similar for age ( 64.2 +/- 19.8 and 62.5 +/- 21.2 years), gender ( male: 72 and 66%), sepsis ( 42 and 47%), hemodynamic instability ( 61 and 63%), severity of AKI ( Acute Tubular Necrosis-Index Specific Score (ATN-ISS): 0.68 +/- 0.2 and 0.66 +/- 0.2), Acute Physiology, Age, and Chronic Health Evaluation Score (APACHE II) (26.9 +/- 8.9 and 24.1 +/- 8.2), pre-dialysis BUN (116.4 +/- 33.6 and 112.6 +/- 36.8mg per 100 ml), and creatinine ( 5.8 +/- 1.9 and 5.9 +/- 1.4 mg per 100 ml). Weekly delivered Kt/V was 3.6 +/- 0.6 in HVPD and 4.7 +/- 0.6 in DHD ( P<0.01). Metabolic control, mortality rate ( 58 and 53%), and renal function recovery ( 28 and 26%) were similar in both groups, whereas HVPD was associated with a significantly shorter time to the recovery of renal function. In conclusion, HVPD and DHD can be considered as alternative forms of RRT in AKI.

Cervical Lactobacillus and leukocyte infiltration in preterm premature rupture of membranes

Objectives: To evaluate the possible association between microorganisms present in the cervical secretions and amniotic fluid of pregnant women with preterm premature rupture of membranes (PPROM), and histologic chorioamnionitis. Methods: Thirty-seven pregnant women with PPROM and 21 healthy pregnant women were studied. Secretions from the cervical canal and amniotic fluid were collected to isolate microorganisms present in the genital tract. Cervical smears were Gram stained and evaluated microscopically. At delivery, chorioamniotic membranes were collected for histopathologic analysis. Results: Microscopic examination of the cervical secretion smears obtained from the PPROM group showed a low rate of Lactobacillus species, large numbers of leukocytes, and a wide diversity of microorganisms compared with the control group. The PPROM group presented an 80% rate of chorioamnionitis. Staphylococcus aureus isolation in cervical secretion was associated with intense inflammatory infiltrate in the membranes and might play a role in the pathogenesis of PPROM. Conclusions: the low colonization of cervical flora by Lactobacillus species associated with an intense leukocyte infiltrate detected in Gram-stained cervical smears can be considered a rapid method of detecting chorioamnionitis in pregnant women with PPROM. (C) 2003 International Federation of Gynecology and Obstetrics. Published by Elsevier B.V. Ireland Ltd. All rights reserved.

Inflammatory cytokine mRNA detection by real time PCR in chorioamniotic membranes from pregnant women with preterm premature rupture of membranes

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

The effect of 6% Hydroxyethyl starch vs. Ringer's lactate on acute kidney injury after renal ischemia in rats

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

Short-term vs long-term calcium hydroxide therapy after immediate tooth replantation: a histomorphometric study in monkey's teeth

Endodontic treatment is an important step of tooth replantation protocols, but the ideal moment for definitive obturation of replanted teeth has not yet been established. In this study, a histomorphometric analysis was undertaken to evaluate the repair process on immediate replantation of monkeys teeth after calcium hydroxide (CH) therapy for 1 and 6 months followed by root canal filling with a CH-based sealer (Sealapex (R)). The maxillary and mandibular lateral incisors of five female Cebus apella monkeys were extracted, kept in sterile saline for 15 min, replanted and splinted with stainless steel orthodontic wire and composite resin for 10 days. In Group I (control), definitive root canal filling was performed before tooth extraction. In Groups II and III, CH therapy started after removal of splint, and definitive root canal filling was performed 1 and 6 months later, respectively. The animals were euthanized 9 months after replantation, and specimens were processed for histomorphometric analysis. In all groups, epithelial attachment occurred at the cementoenamel junction or very close to this region; the areas of resorption on root surface had small extension and depth and were repaired by newly formed cementum; and the periodontal ligament was organized. Statistical analysis of the scores obtained for the histomorphometric parameters did not show any statistically significant difference (P = 0.1221) among the groups. The results suggests that when endodontic treatment is initiated 10 days after immediate replantation and an antibiotic regimen is associated, definitive root canal filling can be performed after a short-term CH therapy.

Effect of implant connection and restoration design (screwed vs. cemented) in reliability and failure modes of anterior crowns

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Comparison of space analysis performed on plaster vs. digital dental casts applying Tanaka and Johnston's equation

OBJETIVO: comparar medidas de tamanhos dentários, suas reprodutibilidades e a aplicação da equação de regressão de Tanaka e Johnston na predição do tamanho dos caninos e pré-molares em modelos de gesso e digital. MÉTODOS: trinta modelos de gesso foram escaneados para obtenção dos modelos digitais. As medidas do comprimento mesiodistal dos dentes foram obtidas com paquímetro digital nos modelos de gesso e nos modelos digitais utilizando o software O3d (Widialabs). A somatória do tamanho dos incisivos inferiores foi utilizada para obter os valores de predição do tamanho dos pré-molares e caninos utilizando equação de regressão, e esses valores foram comparados ao tamanho real dos dentes. Os dados foram analisados estatisticamente, aplicando-se aos resultados o teste de correlação de Pearson, a fórmula de Dahlberg, o teste t pareado e a análise de variância (p < 0,05). RESULTADOS: excelente concordância intraexaminador foi observada nas medidas realizadas em ambos os modelos. O erro aleatório não esteve presente nas medidas obtidas com paquímetro, e o erro sistemático foi mais frequente no modelo digital. A previsão de espaço obtida pela aplicação da equação de regressão foi maior que a somatória dos pré-molares e caninos presentes nos modelos de gesso e nos modelos digitais. CONCLUSÃO: apesar da boa reprodutibilidade das medidas realizadas em ambos os modelos, a maioria das medidas dos modelos digitais foram superiores às do modelos de gesso. O espaço previsto foi superestimado em ambos os modelos e significativamente maior nos modelos digitais.

In vitro comparison of 1.5 mm vs. 2.0 mm screws for fixation in the sagittal split osteotomy

Purpose: Numerous "in vitro" investigations have been conducted to evaluate the role of screw size and pattern in determining optimal resistance to deformation, often these have been controversial. The aim of this study was to evaluate the effect of screw size and insertion technique on the stability of sagittal split osteotomies.Materials and methods: This study used twenty polyurethane replicas of human hemimandibles with a prefabricated sagittal split ramus osteotomy (SSRO). The hemimandibles were stabilized with 1.5 mm and 2.0 mm titanium screws inserted in an inverted L configuration. All specimens were tested to determine the strength and stability of the fixation.Results: In all cases there was failure of the synthetic bone before there was any evidence of screw failure. There were no significant differences in the load necessary to make the construct fail between the 1.5 or 2.0 mm screw sizes.Conclusion: There was no statistically significant difference between the strengths achieved with screws of 1.5 and 2.0 mm diameters for fixation of SSRO performed in synthetic mandibles. There was no fracture of the 1.5 mm or 2.0 mm diameter screws in any of the tests. 1.5 mm diameter screws in an inverted L pattern have as much stability and mechanical resistance as a 2.0 mm screw, may be safely used for this procedure. (C) 2010 European Association for Cranio-Maxillo-Facial Surgery.

Ingestion of hypertonic NaCl vs. palatable drinks by sodium-depleted rats

This work investigated whether the preference for NaCl solution is shifted to more palatable solutions in the adult male sodium-depleted rat (n=6-10 per group). Animals had daily access to three bottles, one containing water, another 1.8% NaCl (300 mM), and a third containing 0.9% NaCl (150 mM), Gatorade (orange-OG or grape flavored-GG), orange juice (sweetened or unsweetened, from concentrate), or 10% sucrose (no sodium). Sodium content in Gatorade and orange juice ranged from 7 to 14 mEq/l. Daily intakes were recorded for at least 5 days prior to sodium depletion. Then, the animals were depleted of sodium (diuretic plus sodium-deficient diet and water for 24 h). Then, the other two bottles were returned to the animals and the intakes were recorded for 120 min (sodium preference test, SPT). Daily intake from the third bottle (except for unsweetened orange juice) at least doubled the daily 1.8% NaCl intake. The average 1.8% NaCl intake (13 +/- 2 ml) in the SPT was higher than the intake of 10% sucrose (6 +/- 1 ml) or of any other solution (less than 6 ml). The intakes of 1.8% NaCl and 0.9% NaCl (10 +/- 3 ml) were similar during the SPT. The animals also preferred 0.9% NaCl (27 +/- 1 ml) to OG (3 +/- 1 ml) in the absence of 1.8% NaCl in the SPT. Therefore, the preference for sodium in sodium-depleted rats also applies when palatable and nutritive solutions are simultaneously available. (C) 2002 Elsevier B.V. All rights reserved.

Durability of Microtensile Bond to Nonetched and Etched Feldspar Ceramic: Self-adhesive Resin Cements vs Conventional Resin

Purpose: The objective of this study was to evaluate the effect of thermocycling (TC), self-adhesive resin cements and surface conditioning on the microtensile bond strength (mu TBS) between feldspathic ceramic blocks and resin cements.Materials and Methods: Fifty-six feldspathic ceramic blocks (10 x 7 x 5 mm) (Vita Mark II) were divided into groups according to the factors "resin cement" (3 cements) and "surface conditioning" (no conditioning or conditioning [10% hydrofluoric acid etching for 5 min + silanization]) (n = 8): group 1: conditioning+Variolink II (control group); group 2: no conditioning+Biscem; group 3: no conditioning+RelyX U100; group 4: no conditioning+Maxcem Elite; group 5: conditioning+Biscem; group 6: conditioning+RelyX U100; group 7: conditioning+Maxcem Elite. The ceramic-cement blocks were sectioned to produce non-trimmed bar specimens (adhered cross-sectional area: 1 +/- 0.1 mm(2)), which were divided into two storage conditions: dry, mu TBS immediately after cutting; TC (12,000x, 5 degrees C/55 degrees C). Statistical significance was deterimined using two-way ANOVA (7 strategies and 2 storage conditions) and the post-hoc Tukey test (p<0.05).Results: Resin cement and thermocycling affected the mu TBS significantly (p = 0.001). In the dry condition, group 5 (18 +/- 6.5 MPa) presented the lowest values of mu TBS when compared to the other groups. TC decreased the mean mu TBS values significantly (p<0.05) for all resin cements tested (9.7 +/- 2.3 to 22.1 +/- 6.3 MPa), except for the resin cement RelyX U100 (22.1 +/- 6.3 MPa). In groups 3 and 4, it was not possible to measure mu TBS, since these groups had 100% pre-test failures during sectioning. Moreover, the same occurred in group 2 after TC, where 100% failure was observed during thermocycling (spontaneous failures).Conclusion: Hydrofluoric acid etching and silanization of the feldspathic ceramic surface are essential for bonding self-adhesive resin cement to a feldspathic ceramic, regardless of the resin cement used. Non-etched ceramic is not recommended.

Integrability vs supersymmetry: Poisson structures of the pohlmeyer reduction

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)