786 resultados para Endoscopic retrograde cholangiopancreatography (ERCP)


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Objective. The objective of this study was to evaluate periapical repair following retrograde filling using different root-end filling materials.Study design. After induction of periapical lesions, 48 root canals from do teeth were partially filled. Endodontic surgery was performed and 3 different materials were used for root-end filling: Sealer 26, Sealapex plus zinc oxide, or mineral trioxide aggregate (NITA). No additional procedures were performed in the control group after partial filling of the root canal. After 180 days, the animals were killed, the rnaxillas and mandibles were removed, and specimens were submitted for histologic processing.Results. Histopathologic analysis revealed similar periapical repair for the groups in which Sealer 26, Sealapex plus zinc oxide, and MTA were used (P >.05). The control group showed unsatisfactory periapical repair W <.05).Conclusion. There was no difference in periapical tissue healing alter retrograde filling with the tested materials, which indicates that these 3 root-end filling materials are equally useful.

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The Brazilian Consensus on Gastroesophageal Reflux Disease considers gastroesophageal reflux disease to be a chronic disorder related to the retrograde flow of gastroduodenal contents into the esophagus and/or adjacent organs, resulting in a variable spectrum of symptoms, with or without tissue damage. Considering the limitations of classifications currently in use, a new classification is proposed that combines three criteria - clinical, endoscopic, and pH-metric - providing a comprehensive and more complete characterization of the disease. The diagnosis begins with the presence of heartburn, acid regurgitation, and alarm manifestations (dysphagia, odynophagia, weight loss, GI bleeding, nausea and/or vomiting, and family history of cancer). Also, atypical esophageal, pulmonary, otorhinolaryngological, and oral symptoms may occur. Endoscopy is the first approach, particularly in patients over 40 yr of age and in those with alarm symptoms. Other exams are considered in particular cases, such as contrast radiological examination, scyntigraphy, manometry, and prolonged pH measurement. The clinical treatment encompasses behavioral modifications in lifestyle and pharmacological measures. Proton pump inhibitors in manufacturers' recommended doses are indicated, with doubling of the dose in more severe cases of esophagitis. The minimum time of administration is 6 wk. Patients who do not respond to medical treatment, including those with atypical manifestations, should be considered for surgical treatment. Of the complications of gastroesophageal reflux disease, Barrett's esophagus presents a potential development of adenocarcinoma; biopsies should be performed, independent of Barrett's esophagus extent or location. In this regard the designation short Barrett's is not important in terms of management and prognosis. © 2002 by Am. Coll. of Gastroenterology.

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Leiomyomas of the rectum are rare, with low reported incidence in literature. In most cases, patients are asymptomatic, and are often incidental endoscopic findings. The difficult distinction from leiomyosarcomas, associated with the possibility of recurrence, implies the absence of a standard treatment. Endoscopic resection, if well indicated, may be a therapeutic option. In this study, we report two cases of asymptomatic leiomyoma of the rectum in two patients, discovered incidentally during a routine colonoscopy, removed by conventional polypectomy and discuss its diagnostic and therapeutic aspects based on a literature review.

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Newly available materials for retrograde obturation should have their sealing properties evaluated. The goal of this study was to evaluate the sealing ability of Endo CPM sealer, an MTA-based endodontic cement. Single-rooted extracted human teeth were endodontically treated. After apical sectioning, retrograde cavities were prepared. Teeth were divided into five experimental groups (n=12), in which the following materials were used: Sealer 26 (S26), white Mineral Trioxide Aggregate (MTA), Endo CPM Sealer (CPM1), Endo CPM Sealer in thicker consistency (CPM 2), and zinc oxide and eugenol cement (ZOE), and two control groups (n=3). After retrograde obturation, the teeth were immersed in 0.2% rhodamine B dye for 48 hours in a vacuum chamber Marginal leakage data were subjected to ANOVA and Tukey tests at 5% significance level. S26 presented greater sealing ability (p<0.05) than ZOE, MTA, CPM1, and CPM2, all of which had similar results (p>0.05). We concluded that Sealer 26 has the greatest sealing ability. Endo CPM Sealer, with sealing ability similar to MTA, could be used as a retrograde obturation material.

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

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

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The authors investigate the complications of transnasal transsphenoidal endoscopic surgery in the treatment of 301 patients with pituitary adenomas. A retrospective analysis of complications in 301 patients submitted to transsphenoidal transnasal endoscopic surgery at the General Hospital of Fortaleza, Brazil between January 1998 and December 2009. The complications were divided in two groups: anatomical (oronasofacial, sphenoid sinus, intrasellar, suprasellar and parasellar) and endocrinological complications (anterior and posterior pituitary dysfunctions). We observed a total of 81 complications (26.9%) in our series. Anatomical complications occurred in 8.97% (27 cases): 8 CSF postoperative leaks (2.6%), 6 cases (1.9%) of delayed nasal bleeding, 5 cases (1.6%) of sphenoidal sinusitis, 3 cases (0.9%) of carotid artery lesion, 2 cases of meningitis (0.6%) and one case (0.3%) of each of the uncommon following complications: intrasella-suprasella hematoma, pontine hematoma and chiasmaplexy. Endocrinological complications occurred in 17.9% (54 cases): additional postoperative anterior lobe insufficiency in 35 cases (11.6%), and postoperative diabetes insipidus in 19 cases (6.3%). In our series, 3 cases of deaths (not directly related to the procedure) were also observed. Endoscopic transsphenoidal surgery represents an effective option for the treatment of patients with pituitary tumor. Complications still occur and must be reduced as much as possible. Successful endoscopic pituitary surgery requires extensive training in the use of an endoscope and careful planning of the surgery. Additional improvement can be expected with greater experience and new technical developments.

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

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The Mineral Trioxide Aggregate (MTA) has excellent biological property. However, its consistency makes it difficult to be inserted into retrograde cavities. Objective:To evaluate the ability of different methods to fill retrograde cavities with MTA. Material and methods: Root canals of thirty single-rooted resin teeth were prepared and filled. After the cut of 3 mm short of apical third, retrograde cavities with 3 mm deep were prepared using an ultrasound device and retrotips (CVD, São José dos Campos, SP, Brazil). The retrograde preparation was evaluate by using an operative microscope (D.F. Vasconcellos, São Paulo, SP, Brazil). The teeth were randomly divided into three groups (n = 10), according to the method: 1) condenser (Trinity, São Paulo, SP, Brazil); 2) MTA applicator (Angelus, Londrina, Brazil) + condenser; 3) condenser associated with ultrasound (CVD, São José dos Campos, SP, Brazil). After the filling of retrograde cavities with white MTA (Angelus, Londrina, Brazil), teeth were radiographed using a digital system (Kodak RVG 6000, Rochester, NY, USA). The images were analyzed by UTHSCSA Image Tool 3.0 software. The percentage of filling was calculated by the proportion between the total area of retrograde cavity and the filled area. The radiographic density mean of each third of retrograde cavity filled with MTA was measured by using the histogram tool of the software. The results were submitted to ANOVA and Tukey tests, with 5% of significance. Results: There was no difference in percentage of filling among the groups (p > 0.05) (approximately 85%). By comparing the thirds, the condenser and MTA applicator groups showed higher density for apical and middle third than cervical third (p < 0.05). The ultrasound group presented similar density among the thirds. Conclusion: The filling ability was similar for the studied methods. Ultrasound promoted better distribution of MTA in retrograde cavity, but did not increase the density of material.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)