ABSTRACT
Abstract Background: Arteriovenous fistula (AVF) maturation is one of the main concerns in patients with end-stage renal disease (ESRD) and finding a strategy for increasing success rate and accelerating fistula maturation is valuable. The aim of this study was to evaluate the effects of papaverine injection on AVF maturation and success rate. Method: This study was a randomized clinical trial that involved 110 patients with ESRD that were referred for AVF construction. Patients were allocated in papaverine group and control group with block randomization according to age and sex. In the case group, papaverine (0.1 or 0.2 cc) was injected locally within the subadventitia of artery and vein after proximal and distal control during AVF construction and in the control group, AVF construction was done routinely without papaverine injection. Results: Maturation time in case and control groups was 37.94 ± 11.49 and 44.23 ± 9.57 days, respectively (p=0.004). Hematoma was not seen in the case group but occurred in one patient in the control group. One patient of the case group developed venous hypertension. Four functional fistulas, 1 (1.8%) in the case group and 3 (5.5%) in the control group, failed to mature (p=0.618). Maturation rate did not differ between the two groups statistically (p=0.101). Conclusion: Local papaverine injection increased vessel diameter and blood flow, increasing shearing stress in both arterial and venous segment of recently created AVF. In this way, papaverine probably can decrease AVF maturation time without an increase in complications.
Resumo Introdução: A maturação da fístula arteriovenosa (FAV) é uma das principais preocupações em pacientes com doença renal terminal (DRT). Assim, é importante identificar estratégias para aumentar as taxas de sucesso e acelerar a maturação da fístula. O objetivo do presente estudo foi avaliar os efeitos da infiltração de papaverina sobre a maturação da FAV e suas taxas de sucesso. Método: O presente ensaio clínico randomizado incluiu 110 pacientes com DRT encaminhados para colocação de FAV. Os pacientes foram randomizados em bloco em função de idade e sexo e alocados nos grupos caso ou controle. Os indivíduos no grupo caso receberam infiltração local de papaverina (0,1 ou 0,2 ml) no plano da sub-adventícia da artéria e veia após o controle proximal e distal durante a construção da FAV. No grupo controle, a construção da FAV foi realizada rotineiramente sem infiltração de papaverina. Resultados: Os tempos de maturação dos grupos caso e controle foram 37,94 ± 11,49 e 44,23 ± 9,57 dias, respectivamente (p = 0,004). Foi observado hematoma em apenas um paciente do grupo controle. Um paciente do grupo caso desenvolveu hipertensão venosa. Quatro fístulas funcionais, uma (1,8%) no grupo caso e três (5,5%) no grupo controle, não amadureceram (p = 0,618). A taxa de maturação não diferiu estatisticamente entre os dois grupos (p = 0,101). Conclusão: A infiltração local de papaverina aumentou o diâmetro do vaso e o fluxo sanguíneo, elevando a tensão de cisalhamento nos segmentos arterial e venoso da FAV recentemente criada. Desta forma, a papaverina provavelmente consegue reduzir o tempo de maturação da FAV sem aumentar as complicações.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Papaverine/pharmacology , Vasodilator Agents/pharmacology , Arteriovenous Shunt, Surgical/methods , Kidney Failure, Chronic/surgery , Papaverine/administration & dosage , Thrombosis/etiology , Vasodilator Agents/administration & dosage , Venous Pressure , Arteriovenous Shunt, Surgical/adverse effects , Prospective Studies , Follow-Up Studies , Renal Dialysis , Treatment Outcome , Hematoma/etiologyABSTRACT
Background: Peripheral nerves may be damaged during an injury and its current standard treatment is using an autologous nerve
Objectives: The purpose of this experimental study is to evaluate and compare the histological results of nerve regeneration after using the eggshell membrane [ESM] guidance channel with autograft
Materials and Methods: Thirty adult male rats were divided into three experimental groups: ESM guidance channel, autograft, and sham surgery. The decalcifying membrane of egg rotated over the Teflon mandrel and dried at 37°C. A 10 mm nerve segment of left sciatic nerve was cut and removed. In ESM group, the ends of the sciatic nerve were telescoped into the nerve guides. In autograft group, the nerve segment was reversed and used as an autologous nerve graft. At 90 days after surgery, all animals were evaluated by histological and immunohistochemical assessment
Results: The diameters of regenerated myelinated fibers were 5.24 +/- 2.14 microm for the ESM group, and 5.89 +/- 2.99 microm for the autograft group. The number of myelinated axons regenerated in the ESM group [9824 +/- 218 nerve fibers] was significantly greater than autograft group [7865 +/- 314 nerve fibers] [p<0.05]
Conclusion: These findings demonstrate that ESM effectively enhances nerve regeneration in injured rat sciatic nerve
ABSTRACT
Aims: To examine simultaneous effects of Conjugated Linoleic Acid (CLA) and L-carnitine (LC) on weight gain in diet induced obese rats. Study Design: Experimental study. Place and Duration of Study: Department of Nutrition, Faculty of Para-Medical Sciences, Ahvaz Jundishapur University of Medical Sciences (January 2014 to January 2015). Methodology: Forty male Wistar rats were randomly divided into two groups: Normal fat diet (n=8), and High fat diet (HFD) (n=32). After eight weeks, the second group maintained HFD and was subdivided into 4 categories: Corn Oil group, 500 mg CLA, 200 mg LC, and 500 mg CLA+ 200 mg LC (all doses per kg body weight), which were administered by oral gavage for four weeks. Body weights were measured and recorded weekly by means of a digital scale. SPSS Version 16 was used for statistical analysis. Results: At the end of eighth week, a significant difference in weights was observed between HFD (295.43±5.36 gr) and NFD (246.38±6.48 gr) group. After four weeks, LC significantly reduced weight gain by 7.5% (P = .047). Trend of weight gain in CLA and LC + CLA groups were decelerated (24 and 25 gr respectively), but it was statistically insignificant (P = .08, .12 respectively). Conclusion: Findings of this experimental study showed that a high fat diet led to obesity and combined LC and CLA could decelerate weight gain to some extent. However, it needs further work to validate reliability in human.
ABSTRACT
Objective: Furcal perforation is an undesirable complication that may occur during root canal therapy and seriously compromises the prognosis of endodontic treatment. The prognosis of furcal perforation repair depends on the prevention of bacterial infection of the perforation site. Thus, use of a biocompatible material for complete sealing of the perforation site is critically important
This study aimed to compare the micro leakage of mineral trioxide aggregate [MTA] and octaca1cium phosphate [OCP] for furcal perforation repair
Methods: This experimental study was conducted on 70 human mandibular molars with divergent roots, intact furcation site and completely formed apices. The teeth were randomly divided into 4 groups of two experimental [n=30], one positive control and one negative control group [n=5]
The furcation floor was then perforated. In the first and second experimental groups, furcation perforations were repaired with OCP and MT A, respectively. In the positive control group, the perforation was left untreated and in the negative control group no furcal perforation was created. The access cavity in all groups was filled with Cavit. The teeth were stored in 100% humidity for 48h. Root apices were sealed with sticky wax and the entire external surface of teeth except for 0.5 mm around the perforation site was covered with two coats of nail polish. The specimens were immersed in India ink for 4 days and then sectioned in half buccolingually. The sections were separated and dye penetration was evaluated using a stereomicroscope at 25X magnification. Obtained data were Janalyzed using independent t-test
Results: No micro leakage was observed in the negative control group. In the positive control group, the dye had completely penetrated into the walls. The amount of dye penetration was 1.64 and 1.22mm in the OCP and MT A groups, respectively. Statistical analysis of data revealed that the sealability of MTA was significantly greater than that ofOCP [P<0.0001]
Conclusion: OCP cannot be an acceptable alternative to MT A in terms of sealability