Exposure to lipopolysaccharide and calcium silicate-based materials affects the behavior of dental pulp cells

Abstract This study assessed the cell viability, cytokine production, and mineralization potential of human dental pulp cells (hDPCs) after exposure to lipopolysaccharide (LPS) and application of calcium silicate-based materials (CSBM). Characterization of the CSBM was performed by infrared spectroscopy (n = 3). Extracts of Bio-C Repair, Biodentine, Cimmo HD, and MTA Repair HP were prepared and diluted (1:1, 1:4, and 1:16). Culture of hDPCs was established and treated or not with 1 µg/mL of LPS from Escherichia coli for 7 days. MTT assay was used to assess cell viability at 24, 48, and 72 h (n = 6). Alkaline phosphatase (ALP) activity was assayed on day 7 (n = 4). Il-10 and TNF-α were quantified by ELISA at 24 h (n = 6). Data were analyzed by ANOVA and Tukey's test (α = 0.05). Cell viability of LPS-activated hPDCs was higher than untreated control in 48 and 72 h (p < 0.05). Differences between non-treated and LPS-activated hPDCs were observed for Biodentine and Cimmo HP (p < 0.05). The CSBM influenced the cell viability (p < 0.05). ALP activity was higher in LPS-activated hDPCs (p < 0.05). No changes in the concentration of TNF-α were observed between groups (p > 0.05). The CSBM increased the Il-10 production (p < 0.05). LPS-activated hDPCs presented increased cell viability and ALP activity. The CSBM showed mild toxicity and was able to enhance the cell viability and mineralization potential of untreated and LPS-activated hDPCs. The CSBM also induced anti-inflammatory mechanisms without compromising pro-inflammatory ones.

Resumo Este estudo avaliou a viabilidade celular, produção de citocinas e potencial de mineralização de células da polpa dentária humana (hDPCs) após exposição a lipopolissacarídeo (LPS) e aplicação de materiais à base de silicato de cálcio (CSBM). A caracterização do CSBM foi realizada por espectroscopia (n = 3). Extratos de Bio-C Repair, Biodentine, Cimmo HD e MTA Repair HP foram preparados e diluídos (1: 1, 1: 4 e 1:16). A cultura de hDPCs foi estabelecida e tratada ou não com 1 µg / mL de LPS de Escherichia coli por 7 dias. O ensaio de MTT foi usado para avaliar a viabilidade celular em 24, 48 e 72 h (n = 6). A atividade da fosfatase alcalina (ALP) foi avaliada no dia 7 (n = 4). Il-10 e TNF-α foram quantificados por ELISA em 24 h (n = 6). Os dados foram analisados ​​por ANOVA e teste de Tukey (α = 0,05). A viabilidade celular das hPDCs ativados por LPS foi maior do que o controle não tratado em 48 e 72 h (p <0,05). Diferenças entre hPDCs não tratados e ativados por LPS foram observados para Biodentine e Cimmo HP (p < 0,05). Os CSBM influenciaram na viabilidade celular (p <0,05). A atividade de ALP foi maior em hDPCs ativadas por LPS (p <0,05). Não foram observadas alterações na concentração de TNF-α entre os grupos (p> 0,05). Os CSBM aumentaram a produção de Il-10 (p < 0,05). Os hDPCs ativados por LPS apresentaram um aumento na viabilidade celular e atividade ALP. Os CSBM apresentaram toxicidade moderada e foram capazes de aumentar a viabilidade celular e o potencial de mineralização de hDPCs não tratados e ativados por LPS. Os CSBM também induziram mecanismos anti-inflamatórios sem comprometer os pró-inflamatórios.

Response of periodontal ligament stem cells to lipopolysaccharide and calcium silicate-based materials

Abstract This study was conducted to assess the in vitro response of human periodontal ligament stem cells (hPDLSCs) to bacterial lipopolysaccharide (LPS) activation and application of three calcium silicate-based materials (CSBM): Bio-C Sealer, MTA Fillapex and Cimmo HP. Characterization of the CSBM was performed by FTIR (n = 3). Extracts of Bio-C Sealer, MTA Fillapex and Cimmo HP were prepared and diluted (1:1, 1:4 and 1:16). Culture of hPDLSCs was established and treated or not with LPS from Escherichia coli (1 µg/mL) for 7 days. MTT assay was used to assess cell viability at 24, 48 and 72 h (n = 9). Alkaline phosphatase (ALP) activity was indirectly assayed at day 7 (n = 5). TNF-α and Il -1 0 cytokines were quantified by ELISA at 24h-cell supernatants (n = 6). Data were analyzed by ANOVA and Tukey's test (α = 0.05). The cell viability of the LPS-activated hPDLSCs were higher than untreated control (p < 0.05). The application of CSBM affected the cell viability of untreated and LPS-activated cells (p < 0.05). ALP activity was higher for Bio-C Sealer and Cimmo HP in untreated and LPS-activated cells, respectively (p < 0.05). Application of CSBM normalized the TNF-α secretion in the LPS-activated cells (p < 0.05). Only MTA Fillapex in untreated hPDLSCs presented higher values of Il -1 0 (p < 0.05). Taken collectively, the results suggests that the simulation of the inflammatory process by LPS affect the in vitro response the hPDLSCs to the application of the CSBM.

Resumo Este estudo objetivou avaliar a resposta in vitro de células-tronco do ligamento periodontal humano (hPDLSCs) à ativação por lipopolissacarídeo bacteriano (LPS) e aplicação de três materiais à base de silicato de cálcio (CSBM): Bio-C Sealer, MTA Fillapex e Cimmo HP. A caracterização dos CSBM foi realizada por FTIR (n = 3). Extratos de Bio-C Sealer, MTA Fillapex e Cimmo HP foram preparados e diluídos (1:1, 1: 4 e 1:16). A cultura de hPDLSCs foi estabelecida e tratada ou não com 1 µg / mL de LPS de Escherichia coli por 7 dias. O ensaio de MTT foi usado para avaliar a viabilidade celular em 24, 48 e 72 h (n = 9). A atividade de ALP foi avaliada indiretamente no dia 7 (n = 5). As citocinas TNF-α e Il-10 foram quantificadas por ELISA em sobrenadantes de células em 24h (n = 6). Os dados foram analisados por ANOVA e teste de Tukey (α = 0,05). A viabilidade celular das hPDLSCs ativados por LPS foi maior do que o controle (p <0,05). A aplicação dos CSBM afetou a viabilidade celular de células ativadas ou não por LPS (p <0,05). A atividade de ALP foi maior para Bio-C Sealer e Cimmo HP em células não ativadas e ativadas por LPS, respectivamente (p <0,05). A aplicação dos CSBM normalizou a secreção de TNF-α nas células ativadas por LPS (p <0,05). Apenas o MTA Fillapex em hPDLSCs não ativadas apresentou valores mais elevados de Il-10 (p <0,05). Em conclusão, os resultados sugerem que a simulação do processo inflamatório por LPS afetou a resposta in vitro de células-tronco do ligamento periodontal e de materiais à base de silicato de cálcio.

Determining the Presence of 5-Fluorouracil in Hamster Saliva by HPLC / Determinação, por CLAE, da Presença do 5-Fluorouracil em Saliva de Hamsters

Abstract Introduction: Various methods of analysis for the assay of chemotherapeutic agent 5-Fluorouracil (5-FU) in human and animal biological fluids have previously been reported. However, there is no standardization for detecting 5-FU in the hamsters' saliva that received the chemotherapeutic agent. Objective: Considering that the administration of 5-FU in some way changes the morphology and function of the salivary glands, and that the presence of the chemotherapeutic agents in the oral mucosa may lead to some oral complications, the aim of this study was to determine the presence of 5-FU in the hamsters' saliva that received the chemotherapeutic agent, by means of the High Performance Liquid Chromatography technique (HPCL) since this animal model is used in studies of 5-FU induced oral mucositis and glandular hypofunction. Methods: Twelve animals were divided into 4 groups: CP and CPI, in which the animals received pilocarpine (CP) or pilocarpine + isoproterenol (CPI) and the chemotherapy vehicle intraperitoneally; and Groups QP and QPI, in which the animals received the same secretagogues listed above, and the chemotherapeutic agent 5-FU, respectively. After the secretagogue administration, saliva was collected from all the animals for a period of 60 mins. Subsequently, the saliva was frozen at -80 ˚C for later determination of the chemotherapeutic agent by HPLC. After the the chromatograms analysis, and based on the results obtained, it was possible to identify the presence of 5-FU in the saliva samples from hamsters that received the chemotherapeutic agent intraperitonally, by the HPLC technique. (AU)

Resumo Vários métodos de análise para o ensaio do quimioterápico 5-Fluorouracil (5-FU) em fluidos biológicos de humanos e animais, foram previamente relatados. No entanto, não há uma padronização para detecção de 5-FU na saliva de hamsters que receberam o quimioterápico. Considerando que a administração do 5-FU altera de alguma maneira a morfologia e função das glândulas salivares, e que a presença do quimioterápico na mucosa oral pode levar a algumas complicações orais, este trabalho teve como objetivo de determinar a presença de 5-FU na saliva de hamsters que receberam o quimioterápico pela técnica de Cromatografia Líquida de Alta Eficiência (CLAE), uma vez que este modelo animal é usado nos estudos com mucosite oral e hipofunção glandular, induzidas por 5-FU. Doze animais foram divididos em 4 grupos: CP e CPI, onde os animais receberam intraperitonealmente pilocarpina (CP) ou pilocarpina + isoproterenol (CPI) e o veículo do quimioterápico, e os grupos QP e QPI, onde os animais receberam, respectivamente, os mesmos secretagogos listados acima e o quimioterápico 5-FU. Após a administração do secretagogo, foi coletada a saliva de todos os animais, por um período de 60 min. Em seguida, a saliva foi congelada a -80 ˚C para posterior determinação do quimioterápico por CLAE. Após análise dos cromatogramas, e com base nos resultados obtidos, foi possível identificar a presença do 5-FU nas amostras de saliva de hamsters que receberam o quimioterápico via intraperitoneal pela técnica da CLAE. (AU)

Antioxidant effect of chamomile tea on the salivary glands of streptozotocin-induced diabetic rats

Abstract: This study aimed to analyze oxidative stress and the activity of antioxidant enzymes in the salivary glands of streptozotocin (STZ)-induced diabetic rats with ad libitum consumption of chamomile tea in substitution of water for 21 days. Rats were divided in two control groups (untreated control and treated control) and two diabetic groups (untreated diabetic and treated diabetic). Superoxide dismutase (SOD), glutathione peroxidase (GPx), catalase (CAT) activities, total antioxidant status (TAS), and malondialdehyde (MDA) concentrations were determined. The chemical composition of the chamomile essential oil revealed 39 compounds, accounting for 93.5% of the total oils. The polyphenolic profile of the tea showed the presence of apigenin, luteolin, umbelliferone, and esculetin. SOD, GPx, CAT, and TAS levels were lower in the parotid (PA) diabetic glands, but treatment increased their concentration in both the submandibular (SM) and PA diabetic salivary glands. Increased MDA levels were observed in the PA diabetic glands, which were decreased by the consumption of chamomile tea with a reduction in hyperglycemia compared to that in untreated diabetic rats. However, the SM diabetic glands showed no difference in the MDA content. The consumption of chamomile tea prevented oxidative stress in the PA glands of diabetic rats, exhibiting hypoglycemic and antioxidant effects. Thus, chamomile tea could be a potential candidate for preventing oral complications in diabetes mellitus.

Cytotoxicity of Reparative Endodontic Cements on Human Periodontal Ligament Stem Cells

ABSTRACT Objective To compare the cytotoxicity of commercial reparative endodontic cements on human periodontal ligament stem cells (hPDLSCs). Material and Methods The culture of hPDLSCs was established. Cell density was set at 2 × 104 cells/well in 96-well plates. Extracts of Biodentine, Bio-C Repair, Cimmo HD, MTA Repair HP and White MTA were prepared. Then, the extracts were diluted (pure, 1:4 and 1:16) and inserted into cell-seeded wells for 24, 48, and 72 h to assess cell viability through MTT assay. hPDLSCs incubated with culture medium alone served as a negative control group. Data were analyzed by Two-Way ANOVA and Tukey's test (α=0.05). Results At 24 h, pure extract of MTA Repair HP and Biodentine 1:16 presented higher cell viability compared to control. Lower cell viability was found for pure extract of Cimmo HD, MTA Repair HP 1:4 and 1:16, and White MTA 1:16. At 48 h, pure extract of Bio-C Repair and MTA Repair HP presented higher cell viability compared to control. At 72 h, only the pure extract of MTA Repair HP led to higher cell proliferation compared to control. Conclusion Biodentine, Bio-C Repair and MTA Repair HP were able to induce hPDLSCs proliferation. Cimmo HD and White MTA were found to be mostly cytotoxic in hPDLSCs.

Calcium silicate-based cements affect the cell viability and the release of TGF-β1 from apical papilla cells

Abstract This study investigated the cytotoxicity and release of Transforming Growth Factor Beta 1 (TGF-β1) from cultured human apical papilla cells (APCs) after application of four bioactive materials. Culture of APCs was established and used for cytotoxic and quantitative assays. Extracts of Biodentine, Bio-C Repair, MTA Repair and White MTA were prepared and diluted (1, 1:4 and 1:16) and used for MTT assays up to 72 h. Total TGF-β1 was quantified by ELISA. Data were analyzed by ANOVA and Tukey's test (α = 0.05). For Biodentine, at 24 h and 48 h, cell viability was lower than control (p < 0.05). At 72 h, only undiluted extract of Biodentine were cytotoxic (p < 0.05). At 24 h, a cytotoxic effect was found for undiluted and 1:4 dilution of Bio-C Repair (p < 0.05). At 48 h, however, Bio-C Repair at 1:4 and 1:8 dilution showed higher cell viability (p < 0.05). At 24 and 48 h, the cell viability for undiluted MTA Repair were higher than control (p < 0.05). For White MTA, at 24 and 48 h, all dilutions were cytotoxic (p < 0.05). All cements led to reduced release of total TGF-β1 from the APCs (p < 0.05). In conclusion, cell viability varied depending on the material and dilution. Only Bio-C repair and MTA repair led to higher cell viability of APCs. All materials induced a decrease in the release of total TGF-β1 from the APCs.

Resumo Este estudo investigou a citotoxicidade e liberação do Fator de Crescimento Transformador Beta 1 (TGF-β1) em células da papila apical humana (APCs) cultivadas após a aplicação de quatro materiais bioativos. A cultura de APCs foi estabelecida e usada para ensaios citotóxicos e quantitativos. Extratos de Biodentine, Bio-C Repair, MTA Repair e White MTA foram preparados e diluídos (1, 1: 4 e 1:16) e usados para ensaios de MTT por até 72 h. O TGF-β1 total foi quantificado por ELISA. Os dados foram analisados por ANOVA e teste de Tukey (α = 0,05). Para o Biodentine, em 24 h e 48 h, efeito citotóxico foi observado (p <0,05). Em 72 h, apenas o extrato não diluído de Biodentine teve efeito citotóxico (p <0,05). Em 24 h, valores mais baixos de viabilidade celular foram encontrados para o extrato não diluído e diluidi 1:4 de Bio-C Repair (p <0,05). Em 48 h, no entanto, Bio-C Repair na diluição 1:4 e 1:8 mostrou maior viabilidade celular (p <0,05). A viabilidade celular para MTA Repair não diluído em 24 e 48 h foi maior que o controle (p <0,05). Para White MTA, às 24 e 48 h, a viabilidade celular em todas as diluições foram citotóxicas (p <0,05). Todos os cimentos levaram à redução da liberação de TGF-β1 total das APCs (p <0,05). Em conclusão, a viabilidade celular variou dependendo do material e da diluição. Biodentine, Bio-C Repair e MTA Repair levaram a uma maior viabilidade celular de APCs. Todos os materiais induziram uma diminuição na liberação de TGF-β1 total das APCs.

Cytotoxicity and cytokine production by calcium silicate-based materials on periodontal ligament stem cells

Abstract This study investigated the effect of three commercial calcium silicate-based materials (CSBM) on cytotoxicity and pro-and anti-inflammatory cytokines production in cultured human periodontal ligament stem cells (hPDLSCs). Culture of hPDLSCs was established and characterized. Extracts of Bio-C Sealer (Angelus, Londrina, PR, Brazil), MTA Fillapex (Angelus, Londrina, PR, Brazil) and PBS Cimmo HP (Cimmo Soluções em Saúde, Pouso Alegre, MG, Brazil) were prepared by placing cement specimens (5 x 3 mm) in culture medium. Then, the extracts were serially two-fold diluted (1, 1:2, 1:4, 1:8, 1:16) and inserted into the cell-seeded wells for 24, 48 and 72 h for MTT assays. TNF-α and IL-10 cytokines were quantified by ELISA at 24h-cell supernatants. Data were analyzed by ANOVA and Tukey's test (α = 0.05). All CSBM exhibited some cytotoxicity that varied according to extract concentration and time of evaluation. MTA Fillapex presented the highest cytotoxic effects with significant reduction of metabolic activity/cell viability when compared to Bio-C Sealer and Cimmo HP®. TNF-α was significantly upregulated by the three tested cements (p < 0.05) while only MTA Fillapex significantly upregulated IL-10 in comparison to control. Taken collectively, the results showed that PBS Cimmo HP®, Bio-C Sealer and MTA Fillapex present mild and transient cytotoxicity and slightly induced TNF-α production. MTA Fillapex upregulated IL-10 release by hPDLSCs.

Resumo Este estudo investigou o efeito de três materiais comerciais à base de silicato de cálcio (CSBM) na citotoxicidade e na produção de citocinas pró e antiinflamatórias em células-tronco do ligamento periodontal humano (hPDLSCs). Cultura de hPDLSCs foi estabelecida e caracterizada. Extratos de Bio-C Sealer (Angelus, Londrina, PR, Brasil), MTA Fillapex (Angelus, Londrina, PR, Brasil) e PBS Cimmo HP® (Cimmo Soluções em Saúde, Pouso Alegre, MG, Brasil) foram preparados com a colocação de espécimes dos cimentos (5 x 3 mm) em meio de cultura. Em seguida, os extratos foram diluídos (1, 1: 2, 1: 4, 1: 8, 1:16) e inseridos nos poços semeados de células para ensaio de citotoxicidade por meio de MTT por 24, 48 e 72 h. As citocinas TNF-α e IL-10 foram quantificadas por ELISA em sobrenadantes de células de 24 h. Os dados foram analisados por ANOVA e teste de Tukey (α = 0,05). Todos os CSBM exibiram alguma citotoxicidade que variou de acordo com a concentração do extrato e o tempo de avaliação. O MTA Fillapex apresentou os maiores efeitos citotóxicos com redução significativa da atividade metabólica / viabilidade celular quando comparado ao Bio-C Sealer e Cimmo HP®. O TNF-α foi regulado positivamente pelos três cimentos testados (p <0,05), enquanto apenas o MTA Fillapex regulou positivamente a liberação de IL-10 em comparação com o controle. Tomados em conjunto, os resultados mostraram que PBS Cimmo HP®, Bio-C Sealer e MTA Fillapex apresentam citotoxicidade leve e transitória e induziram a produção de TNF-α. O MTA Fillapex regulou positivamente a liberação de IL-10 por hPDLSCs.

Assessment methods of vastus lateralis muscle architecture using panoramic ultrasound: a new approach, test-retest reliability and measurement error / Métodos de avaliação da arquitetura do músculo vasto lateral usando ultrassonografia panorâmica: nova abordagem, confiabilidade teste-reteste e erro da medida

Abstract Extended-field-of-view ultrasonography is a valid alternative to determine the dimensions of the skeletal striated muscle; however, some factors may influence the final measurement. The aim of this study was to determine the test-retest reliability and measurement error of vastus lateralis muscle architecture variables through internal anatomical landmarks and to compare three fixed determined points using extended-field-of-view ultrasonography. Twelve young (24 ± 6 years) adult university male students participated in the study. Images were obtained through extended-field-of-view ultrasonography of the vastus lateralis muscle. Measurements were made for muscle thickness (MT), fascicle length (FL), and fascicle pennation angle (FA) using a method that identifies internal anatomical landmarks. MT was also measured at predetermined distances of 2 cm proximal, 6 cm proximal, and 2 cm distal. One-way ANOVA with repeated measures did not identify any test-retest significant differences for all variables measured. Typical measurement error in centimeters (cm) or degrees (º), coefficient of variation in percentage (%) and intraclass correlation coefficient were MT = 0.07 cm, 2.93%, 0.964; FL = 0.31 cm, 2.89%, 0.947; FA = 0.92°, 4.08%, 0.942; MT 2 cm proximal = 0.10 cm, 3.77%, 0.910; MT 6 cm proximal = 0.27 cm, 9.66%, 0.576; MT 2 cm distal = 0.35 cm, 19.76%, 0.564. MT, FL and FA showed high reliability and low measurement error. Internal anatomical landmarks proved to be more reliable and presented smaller measurement errors when compared to the predetermined distances method.

Resumo A ultrassonografia panorâmica é uma alternativa válida para determinar as dimensões da musculatura estriada esquelética, entretanto alguns fatores podem influenciar a medida final. Objetivou-se determinar a confiabilidade e o erro da medida das variáveis da arquitetura do músculo vasto lateral através de marcações anatômicas internas, bem como comparar dois métodos de avaliação diferentes através da ultrassonografia panorâmica. Doze homens (idade: 24 ± 6 anos) participaram do estudo. As imagens foram obtidas através da ultrassonografia panorâmica do músculo vasto lateral. Foram realizadas as medidas da espessura muscular (EM), comprimento do fascículo (CF) e ângulo de penação do fascículo (AP) através do método que identifica marcações anatômicas internas. A EM também foi medida através de distâncias predeterminadas de 2 cm proximal, 6 cm proximal e 2 cm distal. A ANOVA de uma via com medidas repetidas não identificou diferença significativa para todas as variáveis mensuradas, o erro típico de medida em centímetros (cm) ou graus (º), o coeficiente de variação em percentual (%) e o coeficiente de correlação intraclasse foram respectivamente: EM = 0,07 cm, 2,93%, 0,964; CF = 0,31 cm, 2,89%, 0,947; AP = 0,92º; 4,08%; 0,942; EM 2 cm proximal = 0,10 cm, 3,77%, 0,910; EM 6 cm proximal = 0,27 cm, 9,66%, 0,576; EM 2 cm distal = 0,35 cm, 19,76%, 0,564. EM, CF e AP apresentaram alta confiabilidade e baixo erro de medida. As marcações anatômicas internas demonstraram ser mais confiáveis e apresentam menores erros de medida quando comparados ao método de distâncias predeterminadas.

Salivary Glands, Saliva and Oral Findings in COVID-19 Infection

Abstract The world is under the threat of the novel coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Despite several efforts to contain the disease spread, it still constitutes a public health emergency of international concern. Several published reports in the scientific literature called attention of the oral cavity as the potential route of infection, the implications for dental practice and the use of saliva in the diagnose of the COVID-19. The aim of this article is to provide an overview of the literature on the salivary glands and saliva in the context of SARS-CoV-2 infection. A brief discussion of taste disturbances and oral findings in COVID-19 patients is also presented. The literature shows that SARS-CoV-2 could infect the salivary glands. It is not possible, however, to make speculations regarding them as reservoirs for the SARS-CoV-2. In addition, patients with COVID-19 presented several oral repercussions, including hyposalivation and taste disturbances. A few reports showed oral ulcers and blisters associated with SARS-CoV-2 infection. However, it remains not fully understood and might lead to erroneous assumptions. Overall, further studies are necessary to understand the real role of salivary glands and saliva in the context of SARS-CoV-2 infection.

Assessment of oxidative stress in saliva of children with dental erosion / Avaliação do estresse oxidativo da saliva de crianças com erosão dentária

ABSTRACT Objective To evaluate oxidative stress in saliva of children with dental erosion as compared to children with no erosion. Methods One single examiner, trained and prepared to make diagnosis of dental erosion according to the Basic Erosive Wear Examination index, selected 40 children aged 4 to 6 years, who attended a pediatric dentistry prevention clinic. Two groups were formed - one comprising children with dental erosion (n=22), and another with no dental erosion (n=18). The quantity of dental biofilm was verified using the Simplified Index of Oral Hygiene, and unstimulated saliva was collected for biochemical analyses. The following were assessed in saliva: flow rate, buffering capacity, pH, and total protein concentration. Malondialdehyde levels were also verified to determine oxidative stress and total antioxidant status. Results The quantity of biofilm was smaller in children with mean dental erosion±standard deviation (0.76±0.25), as compared to those with no dental erosion (1.18±0.28). There was no statistical difference in saliva parameters of oxidative stress in children with dental erosion. Conclusion The activity of oxidative stress in saliva did not influence dental erosion process when in its early stages.

RESUMO Objetivo Avaliar o estresse oxidativo da saliva de crianças que possuíam erosão dentária, comparadas àquelas que não apresentavam esta situação. Métodos Um único examinador, treinado e calibrado para o diagnóstico de erosão dentária, segundo o índice de Basic Erosive Wear Examination, selecionou 40 crianças de 4 a 6 anos de idade que frequentavam uma clínica de prevenção de odontopediatria. Dois grupos foram formados - um com aquelas que apresentavam erosão (n=22) e outro sem erosão (n=18). A quantidade do biofilme dental foi obtida utilizando o Índice de Higiene Oral Simplificado, tendo sido feita a coleta de saliva não estimulada para as análises bioquímicas. O fluxo salivar, a capacidade tampão da saliva, o pH salivar e a proteína total da saliva foram avaliados. Também foi verificado o valor do malondialdeído para determinação do estresse oxidativo e o total antioxidante. Resultados A quantidade de biofilme foi menor nas crianças, com erosão dentária média±desvio padrão (0,76±0,25) comparadas àquelas sem erosão dentária (1,18±0,28). Não houve diferença estatística nos parâmetros salivares de estresse oxidativo em crianças com erosão dentária. Conclusão A ação do estresse oxidativo na saliva não influenciou na erosão dentária, quando ainda nos estágios iniciais.

Goal-directed therapy in patients with early acute kidney injury: a multicenter randomized controlled trial

OBJECTIVES: Acute kidney injury is associated with many conditions, and no interventions to improve the outcomes of established acute kidney injury have been developed. We performed this study to determine whether goal-directed therapy conducted during the early stages of acute kidney injury could change the course of the disease. METHODS: This was a multicenter prospective randomized controlled study. Patients with early acute kidney injury in the critical care unit were randomly allocated to a standard care (control) group or a goal-directed therapy group with 8h of intensive treatment to maximize oxygen delivery, and all patients were evaluated during a period of 72h. ClinicalTrials.gov: NCT02414906. RESULTS: A total of 143 patients were eligible for the study, and 99 patients were randomized. Central venous oxygen saturation was significantly increased and the serum lactate level significantly was decreased from baseline levels in the goal-directed therapy group (p=0.001) compared to the control group (p=0.572). No significant differences in the change in serum creatinine level (p=0.96), persistence of acute kidney injury beyond 72h (p=0.064) or the need for renal replacement therapy (p=0.82) were observed between the two groups. In-hospital mortality was significantly lower in the goal-directed therapy group than in the control group (33% vs. 51%; RR: 0.61, 95% CI: 0.37-1.00, p=0.048, number needed to treat=5). CONCLUSIONS: Goal-directed therapy for patients in the early stages of acute kidney injury did not change the disease course.

Development and validation of a stability indicating HPLC method to determine diltiazem hydrochloride in tablets and compounded capsules

ABSTRACT A stability indicating HPLC method to determine diltiazem hydrochloride (DTZ) in tablets and compounded capsules was developed and validated according to Brazilian and the International Conference on Harmonization (ICH) guidelines. The separation was carried out on a Purospher Star® C18 (150 x 4.6 mm i.d., 5 µm particle size, Merck Millipore) analytical column. The mobile phase consisted of a 0.05% (v/v) trifluoroacetic acid aqueous solution and a 0.05% trifluoroacetic acid methanolic solution (44:56, v/v). The flow rate was 1.0 mL.min-1 with a run time of 14 minutes. The detection of DTZ and degradation products (DP) was performed at 240 nm, using a diode array detector. The method proved to be linear, precise, accurate, selective, and robust, and was adequate for stability studies and routine quality control analyses of DTZ in tablets and compounded capsules.

Comparative study on optical performance and visual outcomes between two diffractive multifocal lenses: AMO Tecnis ® ZMB00 and AcrySof ® IQ ReSTOR ® Multifocal IOL SN6AD1 / Estudo comparativo de desempenho óptico e resultado visual entre duas lentes multifocais difrativas: Tecnis ZMB00 e AcrySof SN6AD1

ABSTRACT Purpose: To compare the optical performance and visual outcomes between two diffractive multifocal lenses: AMO Tecnis® ZMB00 and AcrySof® ReSTOR® SN6AD1. Methods: This prospective, non-randomized comparative study included the assessment of 74 eyes in 37 patients referred for cataract surgery and candidates for multifocal intraocular lens implants. Exclusion criteria included existence of any other eye disease, previous eye surgery, high axial myopia, preoperative corneal astigmatism of >1.00 cylindrical diopter (D), and intraoperative or postoperative complications. Ophthalmological evaluation included the measurement of uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), distance-corrected near visual acuity (DCNVA), and distance-corrected intermediate visual acuity (DCIVA), with analysis of contrast sensitivity (CS), wavefront, and visual defocus curve. Results: Postoperative UDVA was 0.09 and 0.08 logMAR in the SN6AD1 and ZMB00 groups, respectively (p=0.868); postoperative CDVA was 0.04 and 0.02 logMAR in the SN6AD1 and ZMB00 groups, respectively (p=0.68); DCIVA was 0.17 and 0.54 logMAR in the SN6AD1 and ZMB00 groups, respectively (p=0.000); and DCNVA was 0.04 and 0.09 logMAR in the SN6AD1 and ZMB00 groups, respectively (p=0.001). In both cases, there was an improvement in the spherical equivalent and UDVA (p<0.05). Under photopic conditions, the SN6AD1 group had better CS at low frequencies without glare (p=0.04); however, the ZMB00 group achieved better sensitivity at high frequencies with glare (p=0.003). The SN6AD1 and ZMB00 lenses exhibited similar behavior for intermediate vision, according to the defocus curve; however, the ZMB00 group showed a shorter reading distance than the SN6AD1 group. There were no significant differences regarding aberrometry between the two groups. Conclusion: Both lenses promoted better quality of vision for both long and short distances and exhibited a similar behavior for intermediate vision. The SN6AD1 and ZMB00 groups showed better results for CS under photopic conditions at low and high spatial frequencies, respectively.

RESUMO Objetivo: Comparar o desempenho óptico e resultado visual entre duas lentes multifocais difrativas: AMO Tecnis® ZMB00 e AcrySof® ReSTOR® SN6AD1. Métodos: O estudo prospectivo, comparativo não randomizado incluiu avaliação de 74 olhos em 37 pacientes com indicação de facectomia e candidatos a implante de lente multifocal. Critérios de exclusão foram: presença de outras doenças oculares; cirurgia ocular prévia; alta miopia axial; astigmatismo cornenano maior que 1,00 D cilíndrica; complicações intraoperatórias ou pós-operatórias. A avaliação oftalmológica contou com medida da acuidade visual para longe corrigida (CDVA) e não corrigida (UDVA), intermediária (DCIVA) e curta distância (DCNVA) com melhor correção óptica para longe; teste de sensibilidade ao contraste; análise de frente de onda e curva visual de Defocus. Resultados: A UDVA foi de 0,09 logMAR para o grupo SN6AD1 e 0,08 logMAR para o grupo ZMB00; com correção foi de 0,04 logMAR para SN6AD1 e 0,02 para o grupo ZMB00 (p>0,05). O grupo SN6AD1 obteve valor de 0,04 logMAR e o grupo ZMB00 de 0,09 logMAR para DCNVA (p<0,05) e DCIVA de 0,17 logMAR para SN6AD1 e 0,54 logMAR para ZMB00 (p=0,000). Houve melhora do equivalente esférico e da UDVA em ambos os grupos (p<0,05). Em condições fotópicas, o grupo SN6AD1 teve melhor sensibilidade ao contraste em baixas frequências sem ofuscamento (p<0,05), contudo grupo ZMB00 obteve melhor sensibilidade em altas frequências (p<0,05) com ofuscamento. As lentes SN6AD1 e ZMB00 obtiveram comportamento semelhantes para visão intermediária na curva de Defocus, porém, o grupo ZMB00 mostrou menor distância de leitura que o grupo SN6AD1. Não houve diferença com significância estatística relacionada à aberrometria na comparação dos dois grupos. Conclusão: As duas lentes promoveram melhor qualidade de visão para longe e perto e comportamento semelhante para visão intermediária. O grupo ZMB00 exibiu melhores resultados para sensibilidade ao contraste em condições fotópicas em alta frequência espacial e SN6AD1 em baixa frequência espacial.

Carcinoma Mucoepidermóide do Pulmão ­ estado da arte a propósito de um caso clínico / Mucoepidermoid carcinoma of the lung ­ state of art with regard to a case report

O Carcinoma Mucoepidermóide do Pulmão (CMP) é um tumor com baixo potencial de malignidade; acredita-se que é indolente, mas pouco se sabe sobre as suas características dada a sua baixa incidência (0,2% de todos os tumores pulmonares). Os autores apresentam um caso clínico de um Carcinoma Mucoepidermóide do Pulmão de alto grau, a que se associa, habitualmente, metastização à distância, recorrência do tumor e mau prognóstico. Destaca-se a exuberante metastização (pleural, pericárdica, ganglionar e cerebral), que contrasta com o curso da doença, relativamente indolente, volvidos 12 meses do diagnóstico. Dado não ter indicação cirúrgica, a doente foi tratada com radioterapia e quimioterapia, apesar de ainda não estar definido um tratamento standard para este tipo histológico. A raridade do diagnóstico e os escassos estudos da literatura condicionam a abordagem terapêutica sistémica destes doentes, constituindo um desafio para a comunidade médica. O possível papel da terapêutica dirigida, como os inibidores da tirosina cinase do receptor do fator de crescimento epidérmico (EGFR) ou a terapêutica contra o oncogene de fusão CRTC1-MAML2, tem sido investigado, em doentes com Carcinoma Mucoepidermóide do Pulmão de alto grau.

Mucoepidermoid Carcinoma of the Lung (MECL) is a tumor of low malignant potential; we believe it is indolent, but little is known about its clinical features because of the low incidence rate (incidence of 0.2% of all lung cancers). We present a clinical case of a high degree Mucoepidermoid carcinoma of the lung, which frequently have distant metastasis, tumor recurrence and a bad prognosis. It is highlighted in this case the exuberant metastases (pleural, pericardial, cerebral, lymph nodes), contrasting with the relatively indolent course of the disease since the diagnosis (10 months ago). Our patient was treated with radiotherapy and chemotherapy, although effective treatment measures for high-grade tumors have not been established. The rarity of the diagnosis and the rare studies in the literature affect the systemic approach to these patients, becoming a challenge for the scientific community. The role of targeted therapy directed against the epidermal growth factor receptor (EGFR) and the novel fusion oncogene CRTC1-MAML2, is being investigated in high-grade tumors.

Aspergilose pulmonar necrotizante e aspergiloma pulmonar / Necrotizing pulmonary aspergillosis and pulmonary aspergilloma

A aspergilose pulmonar necrotizante ou semi-invasiva é um processo infecioso indolente, com consequente destruição do parênquima pulmonar, causado pela inalação de Aspergillus, geralmente Aspergillus fumigatus. O aspergiloma é caracterizado pelo desenvolvimento de uma bola fúngica numa cavidade pulmonar preexistente e pode ser visto em cerca de 50% dos doentes com aspergilose pulmonar necrotizante. Os autores apresentam um caso clínico de aspergilose pulmonar necrotizante e aspergiloma que, por sua gravidade clínica e coexistência de patologia pulmonar prévia grave, sem imunossupressão conhecida, ilustra as particularidades destas patologias.

Necrotizing pulmonary aspergillosis also called semi-invasive aspergillosis is an indolent, infectious and destructive process of the lung due to invasion by Aspergillus species, usually Aspergillus fumigatus. Aspergilloma (fungus ball) usually develops in a preexisting cavity in the lung and may be seen in nearly 50% of patients with Necrotizing pulmonary aspergillosis. The authors present a case report of necrotizing pulmonary aspergillosis and an aspergilloma with underlying chronic lung disease but without any known immunodeficiency, that illustrates the particularities of these diseases.

Diabetes: noções gerais para o Cirurgião-Dentista / Diabetes: general characteristics for dentists

Diabetes mellitus é uma enfermidade crônica de origem endocrinológica e que afeta mais de 170 milhões de pessoas no mundo e possui como principal característica a hiperglicemia. Na Odontologia, alguns estudos mostram que os pacientes diabéticos descompensados reportam algumas alterações na cavidade oral, relacionadas com o estado hiperglicêmico, como por exemplo, xerostomia e hipossalivação, aumento nos índices de cárie e doença periodontal e alteração na reparação tecidual. Com isto, este trabalho tem o objetivo de levar aos cirurgiões dentistas conceitos, características da doença, complicações orais relacionadas com o Diabetes mellitus e algumas opções de terapias para estas complicações orais, como a laserterapia e a terapia fotodinâmica antimicrobiana.

Diabetes mellitus consists of a group of metabolic diseases characterized by hyperglycemia, resulting from disorders in insulin secretion, insulin action or both. A higher incidence of oral diseases, related to poorly controlled diabetes, can be observed in diabetic patients, such as xerostomia, hyposalivation, higher risk of infection, carious lesions, taste alterations, in addition to inadequate preparation of food for digestion. Thus, the aim of this study was to get some important information about this disease, for dentistis, as well as some therapeutic options for oral complications, suh as lasertherapy and antimicrobial photodynamic therapy.

Effect of mouthrinses with different active agents in the prevention of initial dental erosion.

Introduction: Hydrochloric acid (HCl) from the gastric juice is the only source of intrinsic acid, which can reach the oral cavity in cases of gastroesophageal reflux or chronic vomiting, enhancing the risk of dental erosion. Aim: Compare the effects of mouthrinses with different active agents in the prevention of initial dental erosion caused by HCl. Subjects and Methods: Casein (CAS at 0.2%), sodium hexametaphosphate (HMP at 0.02%), titanium tetrafluoride (TiF4 at 0.34%), and stannous fluoride (SnF2 at 0.87%) were individually added to an experimental mouthrinse. The mouthrinse without additives was used as the negative control (C) and a commercially available mouthrinse for erosion (ELM – Elmex®) as the reference product. Enamel specimens were exposed to human saliva and randomly assigned to 6 experimental groups (n = 8). Specimens were submitted to erosion in HCl for 10 s, followed by to the experimental mouthrinses for 30 s, and artificial saliva for 60 min. This cycle was repeated 3 times. The total amounts of calcium and phosphorus released by the specimens in the 2nd and 3rd erosive challenges were evaluated by atomic emission spectrometry. Statistical analysis used Shapiro–Wilks and Hartley tests, followed by one‑way ANOVA and Tukey tests. Results: When compared with C, ELM and HMP presented significantly less calcium in solution, with no difference between them. All the groups showed similar and significantly less phosphorus than C, except CAS. Conclusions: HMP was the only agent that could match the protection against initial erosion of the commercially available mouthrinse in both analyses.

Porosity, residual monomer and water sorption of conventional heat-cured, microwave-cured and cross-linked acrylic resins

This study compared the residual monomer release, water sorption and superfi cial porosity of different resins commonly employed in eye prostheses: heat-cured (HC); microwave-cured (MC) and self-curing cross-linked acrylic resins (SC). Four groups were established: G1, HC / water bath cycle; G2, MC / microwave cycle; G3, HC / microwave cycle; G4, SC. The amount of residual monomer was similar in G1 and G3, lower in G2 and higher in G4. Water sorption was similar in all groups. G2 showed more superfi cial porosity, and G1 and G3 were similar in this regard. Neither the conventional heat-curing cycle nor the microwave cycle affected the amount of residual monomer or porosity of the conventional heat-cured acrylic resin. Water sorption was not affected by the type of resin or polymerization cycle used. Residual monomer release and porosity were related to the type of resin employed rather than the polymerization cycle they were submitted to.

Predição da massa corporal magra de adultos brasileiros através da área muscular do braço / Prediction of lean body mass in Brazilian adults through arm muscle area / Predicción de la masa corporal magra de adultos brasileños a través del área muscular del brazo

INTRODUÇÃO: A área muscular do braço (Amb) é componente da massa corporal magra (MCM). OBJETIVO: Propor uma equação para estimativa da MCM através da Amb. MÉTODOS: Quarenta e cinco voluntários masculinos, aparentemente saudáveis, com idade média de 22 ± 3 anos e massa corporal 74,9 ± 8,43 kg, foram distribuídos randomicamente em grupos de validação interna (VI) e validação externa (VE). Tais sujeitos foram submetidos a medidas antropométricas e à hidrometria. Antes dos testes, os sujeitos receberam as seguintes orientações: a) evitar o consumo de cafeína e álcool nas 24 horas precedentes; b) não realizar atividade física extenuante (≥ 5 METs), pelo menos nas 12 horas prévias ao exame e; c) período pós-prandial de quatro horas. A área muscular do braço foi determinada através da equação: Ama= [C-(T . π)]²÷(4 . π). RESULTADOS: O modelo derivado para predição foi: MCM= 9,127 + (0,625 . MC) + (0,139 . Amb); r2= 0,91, EPE= 1,85 kg (2,5% da massa corporal ou MC). Para VE, não houve diferença significativa entre a MCM medida pela eletrobioimpedância e a prevista pela fórmula acima (p=0,350), r²= 0,94, CV%= 2,0%, CCI= 0,97 e EPE= 1,87 kg. CONCLUSÃO: A equação de regressão múltipla derivada permite estimar a MCM de jovens brasileiros do sexo masculino. .

INTRODUCTION: Arm muscle area (Ama) is a component of lean body mass (LBM). OBJECTIVE: The objective of this study was to develop an equation for estimating LBM through the Ama. METHODS: Forty-five apparently healthy young males, with an average age of 22 ± 3 years and body mass of 74.9 ± 8.43 kg, were randomly divided into two groups: internal validation (IV) and external validation (EV). The total sample was submitted to anthropometric and hydrometric measurements. Before the test, the subjects received the following instructions: a) to avoid caffeine and alcohol 24 hours before the test; b) not to do any strenuous physical activity (≥5 METs) for at least 12 hours prior to exam and; c) a postprandial period of 4 hours. Ama was obtained by the equation: Ama=[C- (T . π) ]² ÷ (4 . π). RESULTS: The prediction model obtained was: LBM= 9.127 + (0.625 . BW) + (0.139 . Ama); r2=0.91; SEE=1.85 kg (2.5% BW). For the EV, no significant difference was found between LBM measured by BIA and that provided by the formula (p=0.35); r²= 0.94; CV%= 2.0%; ICC= 0.97 and SEE= 1.87 kg. CONCLUSION: The multiple regression equation enables the LBM to be estimated for young Brazilian males. .

INTRODUCCIÓN: El área muscular del brazo (Amb) es componente de la masa corporal magra (MCM). OBJETIVO: Proponer una ecuación para estimativa de la MCM a través de Amb. MÉTODOS: Cuarenta y cinco voluntarios masculinos, aparentemente saludables, con edad promedio de 22 ± 3 años y masa corporal 74,9 ± 8,43 kg, fueron distribuidos aleatoriamente en grupos de validación interna (VI) y validación externa (VE). Tales sujetos fueron sometidos a medidas antropométricas y a hidrometría. Antes de los tests, los sujetos recibieron las siguientes orientaciones: a) evitar el consumo de cafeína y alcohol en las 24 horas precedentes; b) no realizar actividad física extenuante (≥ 5 METs), por lo menos en las 12 horas previas al examen y, c) período postprandial de cuatro horas. El área muscular del brazo fue determinada a través de la ecuación: Ama= [C-(T . π)]²÷(4 . π). RESULTADOS: El modelo derivado para predicción fue: MCM= 9,127 + (0,625 . MC) + (0,139 . Amb); r2= 0,91, EPE= 1,85 kg (2,5% de la masa corporal o MC). Para VE, no hubo diferencia significativa entre la MCM medida por la electrobioimpedancia y la prevista por la fórmula de arriba (p=0,350), r²= 0,94, CV%= 2,0%, CCI= 0,97 y EPE= 1,87 kg. CONCLUSIÓN: La ecuación de regresión múltiple derivada permite estimar la MCM de jóvenes brasileños del sexo masculino. .

Development and validation of an HPLC method for the simultaneous determination of artesunate and mefloquine hydrochloride in fixed-dose combination tablets

The present study developed and validated an HPLC method for the simultaneous determination of artesunate (AS) and mefloquine hydrochloride (MQ) in fixed-dose combination tablets, according to ICH guidelines. The chromatographic separation was carried out on an XBridge C18 (250 x 4.6 mm i.d., 5 µm particle size, Waters) analytical column. The mobile phase included a 0.05 M monobasic potassium phosphate buffer (pH adjusted to 3.0 with phosphoric acid) and acetonitrile (50 + 50, v/v). The flow rate was 1.0 mL/min, and the run time was 13 minutes. A dual-wavelength approach was employed: AS detection was performed at 210 nm and MQ was detected at 283 nm, using a diode array detector. Stability of sample solutions was evaluated for 8 hours after preparation, during which time the solutions remained stable. Youden's test was employed to evaluate robustness. The method proved to be linear (r²>0.99), precise (RSD<2.0%), accurate, selective, and robust, proving to be appropriate for routine drug quality control analysis.

Um método por cromatografia a líquido de alta eficiência para a determinação simultânea de artesunato (AS) e cloridrato de mefloquina (MQ) em comprimidos em dose fixa combinada foi desenvolvido e validado, de acordo com as normas do ICH. A separação cromatográfica foi realizada com uma coluna analítica XBridge C18 (250 x 4,6 mm d.i., partículas de 5 µm, Waters). A fase móvel foi constituída de tampão fosfato monobásico de potássio 0,05 M (pH ajustado para 3,0 com ácido fosfórico) e acetonitrila (50 + 50, v/v). O fluxo da fase móvel foi de 1,0 mL/min e o tempo de corrida foi de 13 minutos. Utilizaram-se dois comprimentos de onda: a detecção do AS foi realizada em 210 nm e a de MQ foi realizada em 283 nm, utilizando-se um detector de arranjo de diodos. A estabilidade das soluções padrão e amostra foi avaliada por 8 horas após sua preparação e as soluções permaneceram estáveis nesse período. O teste de Youden foi empregado para a avaliação da robustez do método. O método se mostrou linear (r²>0,99), preciso (DPR<2,0%), exato, seletivo e robusto, sendo adequado para análises rotineiras de controle de qualidade dos medicamentos.