Apical periodontitis in endodontically-treated teeth: association between missed canals and quality of endodontic treatment in a Colombian sub-population. A cross-sectional study / Periodontite apical em dentes tratados endodonticamente: associagao entre canais nao localizados e qualidade do tratamento endodontico em uma populagao colombiana: Um estudo transversal

ABSTRACT A high prevalence of post-treatment apical periodontitis associated to variables such as endodontic treatment quality and missed canals has been reported. Aim The aim of this study was to evaluate the quality of endodontic treatment and the frequency of missed canals associated with teeth with apical periodontitis (AP) through CBCT in a Colombian sub-population. Material and Method This was a crosssectional study assessing 318 cone beam computed tomography (CBCT) scans of endodontically treated teeth from Colombian individuals. The scans were taken using J Morita X550 (J Morita Corporation, Osaka, Japan), with voxel size 0.125 to 0.20 mm. All endodontically treated teeth were assessed for quality of treatment, presence of missed canals and AP. All samples were analyzed by two endodontics specialists and an radiology specialist. Chi-square or Fisher's test and odds ratio were calculated to identify the association and risk relationship between the presence of AP and the study variables. Results Missed canals were found in 18.61% (86/462), and 95.3% were associated with AP. The frequency of AP was 62.34% (288/462) for all the evaluated teeth. AP was found in 27.43 % (79/288) of the teeth with adequate endodontic treatment, in contrast to 72.57% (209/288) of the teeth with inadequate treatment (P<0.01). The frequency of missed canals was highest in maxillary molars, with 55.23% (58/105), with 96.55% presenting AP. The second mesiobuccal canal was the most frequently missed canal, 88.52% (54/61), with AP in 90.74% (49/54) of the cases. Conclusion There was a high frequency of teeth with missed canals and PA. More than half of the teeth with missed canals were maxillary molars, with MB2 being the most common canal, commonly presenting apical periodontitis.

RESUMO Uma alta prevalência de periodontite apical pós-tratamento associada a variáveis como qualidade do tratamento endodôntico e fracasso do tratamento é relatada na literatura. O objetivo deste estudo foi avaliar a qualidade do tratamento endodôntico e a frequência e fracasso do tratamento associados a dentes com periodontite apical (PA) por meio de tomografia computadorizada de feixe cônico (TCFC) em uma subpopulação colombiana. Material e Método Este foi um estudo transversal que avaliou 318 tomografias computadorizadas de dentes tratados endodonticamente de indivíduos colombianos. Os exames foram realizados utilizando o tomógrafo J Morita X550, com tamanho de voxel de 0,125 a 0,20 mm. Todos os dentes tratados endodonticamente foram avaliados quanto à qualidade do tratamento, presença de canais não localizados e AP. Todas as amostras foram avaliadas por dois especialistas em endodontia e um especialista em radiologia. Foram calculados o teste qui-quadrado ou de Fisher e a razão de chances para identificar associação e relação de risco entre a presença de PA e as variáveis do estudo. Resultados Foram encontrados canais não localizados em 18,61% (86/462) e 95,3% estavam associados à PA. A frequência de AP foi de 62,34% (288/462) para todos os dentes avaliados. AP foi encontrada em 27,43% (79/288) dos dentes com tratamento endodôntico adequado, em contraste com 72,57% (209/288) dos dentes com tratamento inadequado (P<0,01). A frequência de canais não localizados foi maior nos molares superiores, com 55,23% (58/105), sendo que 96,55% apresentavam PA. O canal mésio-palatino (MB2) apresentou maior frequência de canal não localizado (88,52% - 54/61), com PA em 90,74% (49/54) dos casos. Conclusão Houve alta frequência de dentes com canais não localizados e com PA. Mais da metade dos dentes com canais não localizados eram molares superiores, sendo o MB2 é o canal com a maior frequência, comumente apresentando periodontite apical.

Preparation and performance of gelatin modified by methacrylic anhydride/treated dentin matrix bioactive scaffolds / 中国组织工程研究

BACKGROUND:Pulp regeneration has been a hot and difficult research topic in recent years,and the construction of composite bio-scaffolding materials provides new ideas and methods for pulp regeneration. OBJECTIVE:To observe the effect of freeze-dried gelatin modified by methacrylic anhydride/treated dentin matrix bioactive scaffolds on proliferation,migration,and osteogenic differentiation of human dental pulp stem cells. METHODS:The mass ratios of gelatin modified by methacrylic anhydride and treated dentin matrix at 2:1,1:1 and 1:2 were obtained by dispersing different masses of treated dentin matrix into gelatin modified by methacrylic anhydride solution.The gelatin modified by methacrylic anhydride/treated dentin matrix bioactive scaffolds were prepared by vacuum freeze-drying.The microstructure,water absorption,and mechanical properties of the scaffolds were measured.Human dental pulp stem cells were cultured with different mass ratios of scaffold extract and DMEM(control group)to detect cell proliferation and migration.Human dental pulp stem cells were cultured with different mass ratios of scaffold extract + osteogenic induction solution and DMEM + osteogenic induction solution(control group),and their osteogenic ability was analyzed by alkaline phosphatase staining. RESULTS AND CONCLUSION:(1)Under scanning electron microscopy,the scaffolds of the three groups all had porous structures.The porosity of the scaffolds increased with the increase of treated dentin matrix quality,and there was significant difference between the two groups(P＜0.05).The water absorption of scaffolds increased with the increase of treated dentin matrix mass,and there was significant difference between groups(P＜0.05).The compressive strength and shear strength of the scaffold increased with the increase of the mass of treated dentin matrix.(2)CCK-8 assay showed that after 3,5,and 7 days of culture,the cell proliferation absorbance values in the 2:1,1:1,and 1:2 scaffold groups were higher than those in the control group(P＜0.05).The cell proliferation absorbance values increased with the increase of treated dentin matrix mass in the scaffold(P＜0.05).The cell scratch test showed that the cell migration rate in the 2:1,1:1,and 1:2 scaffold groups was higher than that in the control group(P＜0.05),and the cell migration rate increased with the increase of treated dentin matrix mass in the scaffold(P＜0.05).(3)Alkaline phosphatase staining showed that the osteogenic differentiation ability of cells in the 2:1,1:1,and 1:2 scaffold groups was stronger than that in the control group,and the osteogenic ability of cells was enhanced with the increase of treated dentin matrix mass in the scaffold.(4)The results showed that the scaffold with a mass ratio of 1:2 between gelatin modified by methacrylic anhydride and treated dentin matrix was the most suitable for the proliferation and differentiation of dental pulp stem cells.

Bioremediation of tannery wastewater using UV-treated bacteria in the free and immobilized form

Aims@#Heavy metals are significant environmental pollutants and toxic to life and chromium (Cr) (VI) is one of them being discharged in the environment due to many human activities. The leather industry uses Cr(VI) salt in the tanning process, which is discharged untreated and becomes a source of many diseases. The use of microbes to remove metals is a cost-effective and clean method. The present study aims to isolate local and native microbes for Cr(VI) removal from tannery wastewater and enhance their capacity to bioremediate the tannery wastewater. Further, efficiency in free and immobilized forms was also checked.@*Methodology and results@#Microbes were isolated from a local tannery wastewater outlet and after many rounds of minimum inhibitory concentration, and concentration of 500 µg/mL was found to be that concentration at which microbes could survive, above which they died. The sequencing of 16S rRNA and its analysis showed that it was closely related to Staphylococcus saprophyticus and in the given study, it was named B6. At 37 °C, pH 7.5 and 120 h of incubation, it removed 77% Cr(VI) from the reaction mixture. B6 was exposed to UV to obtain mutant. Exposure of 15 min to a UV lamp gave mutant MB6, which showed a removal capacity of 77% after 72 h only. Cr(VI) removal capacity of the mutant was then analyzed in the free and attached form where coal and sodium alginate were used as solid surfaces. Mutants immobilized on coal showed 91% Cr(VI) removal after 96 h, while sodium alginate showed 58% Cr(VI) removal in 120 h, thus showing coal as a more effective surface for adsorption.@*Conclusion, significance and impact of study@#Our present study shows the use of cheap and environmentally friendly methods to remediate tannery wastewater, which is a big problem in a country like Pakistan. Pakistan is the second largest producer of leather but lacks a wastewater treatment facility. So, this method offers in-situ wastewater treatment, which can be further enhanced in different ways.

Effects of three rehydration methods on prevention of on-site and delayed blood donation-related vasovagal responses: a cluster-randomized trial / 中国输血杂志

【Objective】 To compare the effects of 3 rehydration methods before blood donation on the prevention of on-site and delayed blood donation-related vasovagal response (VVR) . 【Methods】 From January to June 2021, 6 250 whole blood donors in 6 fixed blood donation sites signed informed consent and were divided into 198 clusters according to donor sites and dates, then they were randomly assigned to receive either oral rehydration salts (ORS), sugar water, or water group, and each drank 500 mL of ORS, sugar water or water within 20 minutes before blood donation. The researchers recorded the actual intervention accepted on site, and recorded the immediate VVR and related information. At rest after blood donation, donors submitted an electronic questionnaire containing socio-demographic information. At 48 hours after blood donation, the researchers called back every donor to record delayed VVR and related information. Logistic regression based on intention to treat (ITT) was used to analyze the difference of the incidence of VVR among the three groups, and the average treatment effect on treated (ATT) was calculated. PASS 2021was used to estimate the sample size and R (4.2.0) for statistical analysis. 【Results】 The cumulative incidence of blood donation-related VVR was 2.67% (2.29%-3.11%) among street whole blood donors under the 3 rehydration methods, in which, the incidence of immediate and delayed VVR was 1.02% (0.79%-1.31%) and 1.65% (1.36%-2.01%) respectively. ITT analysis found that ORS were more effective than water in reducing the incidence of delayed VVR【OR=0.59,95% CI[0.37,0.94]】.There was no significant difference in the incidence of immediate VVR between any two groups (P > 0.05), and there was no significant difference in the incidence of delayed VVR in the sugar water group compared with the water group (P > 0.05). There was a difference of -0.013 (【95% CI[-0.022, -0.004]】or -0.008【95% CI[-0.017, -0.000]】in the incidence of delayed VVR in the ORS group compared with water group or sugar water group, the difference was significant (P<0.05). The cumulative VVR of the three groups showed similar results to the delayed VVR. 【Conclusion】 Drinking ORS before blood donation is the most effective rehydration method to prevent delayed VVR. The next step is to establish the predictive model of delayed VVR to screen the susceptible population and provide them with ORS before blood donation, while other population can choose any liquid they like, thus achieving personalized blood donation-related VVR prevention and control.

The experience on the construction of the cluster prevention and control system for COVID-19 infection in designated hospitals during the period of "Category B infectious disease treated as Category A" / 中华危重病急救医学

The COVID-19 epidemic has spread to the whole world for three years and has had a serious impact on human life, health and economic activities. China's epidemic prevention and control has gone through the following stages: emergency unconventional stage, emergency normalization stage, and the transitional stage from the emergency normalization to the "Category B infectious disease treated as Category B" normalization, and achieved a major and decisive victory. The designated hospitals for prevention and control of COVID-19 epidemic in Tianjin has successfully completed its tasks in all stages of epidemic prevention and control, and has accumulated valuable experience. This article summarizes the experience of constructing a hospital infection prevention and control system during the "Category B infectious disease treated as Category A" period in designated hospital. The experience is summarized as the "Cluster" hospital infection prevention and control system, namely "three rings" outside, middle and inside, "three districts" of green, orange and red, "three things" before, during and after the event, "two-day pre-purification" and "two-director system", and "one zone" management. In emergency situations, we adopt a simplified version of the cluster hospital infection prevention and control system. In emergency situations, a simplified version of the "Cluster" hospital infection prevention and control system can be adopted. This system has the following characteristics: firstly, the system emphasizes the characteristics of "cluster" and the overall management of key measures to avoid any shortcomings. The second, it emphasizes the transformation of infection control concepts to maximize the safety of medical services through infection control. The third, it emphasizes the optimization of the process. The prevention and control measures should be comprehensive and focused, while also preventing excessive use. The measures emphasize the use of the least resources to achieve the best infection control effect. The fourth, it emphasizes the quality control work of infection control, pays attention to the importance of the process, and advocates the concept of "system slimming, process fattening". Fifthly, it emphasizes that the future development depends on artificial intelligence, in order to improve the quality and efficiency of prevention and control to the greatest extent. Sixth, hospitals need to strengthen continuous training and retraining. We utilize diverse training methods, including artificial intelligence, to ensure that infection control policies and procedures are simple. We have established an evaluation and feedback mechanism to ensure that medical personnel are in an emergency state at all times.

Biomechanical impact of labiolingual diameter on endodontically treated anterior teeth with crown restoration under occlusal loading

Abstract Objective To evaluate the effect of the labiolingual diameter and construction of an endodontically treated (ET) anterior tooth with crown restoration on stress distribution and biomechanical safety under occlusal loading. Methodology Three-dimensional finite element models were generated for maxillary central incisors with all-ceramic crown restorations. The labiolingual diameters of the tooth, defined as the horizontal distance between the protrusion of the labial and lingual surfaces, were changed as follows: (D1) 6.85 mm, (D2) 6.35 mm, and (D3) 5.85 mm. The model was constructed as follows: (S0) vital pulp tooth; (S1) ET tooth; (S2) ET tooth with a 2 mm ferrule, restored with a fiber post and composite resin core; (S3) ET tooth without a ferrule, restored with a fiber post and composite resin core. A total of 12 models were developed. In total, two force loads (100 N) were applied to the crown's incisal edge and palatal surface at a 45° oblique angle to the longitudinal axis of the teeth. The Von Mises stress distribution and maximum stress of the models were analyzed. Results Regardless of the loading location, stress concentration and maximum stress (34.07~66.78MPa) in all models occurred in the labial cervical 1/3 of each root. Both labiolingual diameter and construction influenced the maximum stress of the residual tooth tissue, with the impact of the labiolingual diameter being greater. A reduction in labiolingual diameter led to increased maximum stress throughout the tooth. The ferrule reduced the maximum stress of the core of S2 models (7.15~10.69 MPa), which is lower compared with that of S3 models (19.45~43.67 MPa). Conclusion The labiolingual diameter exerts a greater impact on the biomechanical characteristics of ET anterior teeth with crown restoration, surpassing the influence of the construction. The ferrule can reduce the maximum stress of the core and maintain the uniformity of stress distribution.

Clinical observation on moxibustion combined with Western medicine in improving rheumatoid arthritis due to damp heat affecting bones/joints / 针灸推拿医学（英文版）

Objective:To observe the efficacy of gentle moxibustion combined with Western medicine in treating rheumatoid arthritis(RA)due to damp heat affecting bones/joints to further certificate the scientific nature of the theory that"heat pattern can be treated by moxibustion therapy". Methods:A total of 78 patients with RA due to damp heat affecting bones/joints were divided into an observation group and a control group using the random number table method,with 39 cases in each group.The control group was treated with regular Western medicine,on the basic of which the observation group was treated with additional gentle moxibustion.Patients in the observation group received gentle moxibustion therapy once a day for 8 weeks with a one-day rest every 2 weeks.The wrist circumference,wrist pain degree,skin color and temperature of the wrist,and range of dorsiflexion motion of the wrist in the two groups of patients were compared before and after treatment under the condition of safety observed. Results:The total effective rate in the observation group was 94.9%,which was higher than the result of 79.5%in the control group(P<0.05).Among the quantitative indicators of syndrome differentiation,the wrist circumference,pain degree,skin temperature,and range of dorsiflexion motion in both groups were significantly improved(P<0.01),and the improvements were more significant in the observation group than in the control group(P<0.05).The skin color of the wrist joint was improved in both groups after treatment(P<0.05),and there was no statistical significance in comparing the improvement of skin color and the occurrence of adverse reactions between the two groups(P>0.05). Conclusion:Compared with Western medicine treatment alone,the combination of gentle moxibustion and Western medicine treatment has significantly better treatment efficacy and shares high safety,which helps to prove the scientific nature of the theory that"heat pattern can be treated by moxibustion therapy".

The Use of Fiber-Reinforced Composites for Restoration of Endodontically Treated Teeth: A Review

@#This review summarized the most recently published literature pertaining to the use of fiber-reinforced composite (FRC) to restore endodontically treated teeth (ETT) and its influence on the mechanical behavior of restored teeth. Indepth¬ literature review in Google Scholar, ScienceDirect and PubMed was performed for these keywords: “fiber-reinforced composite”; “fiber post”; “endodontically treated”; “short fiber-reinforced composite”— only published fulltext articles between 2009 and 2021 are included in this review. Fourteen articles were selected for this review. The studies concentrated on laboratory-based research conducted on human and bovine extracted teeth with different restorative techniques. Fatigue survival and load to failure tests with assessment of survival rate and fracture strength values respectively, as well as fracture pattern analysis were done. We concluded that FRC materials have improved fracture strength of restored teeth compared to conventional composites using different restorative techniques, however not to the attained level of an intact natural tooth. In addition, authors recommend a better simulation of oral environment, such as dynamic fatigue-testing.

Clinical characteristics of liver injury caused by anti-tuberculosis drugs in newly treated pulmonary tuberculosis patients co-infected with hepatitis B virus / 公共卫生与预防医学

Objective To investigate the clinical characteristics of drug-induced liver injury caused by anti-tuberculosis drugs in newly treated pulmonary tuberculosis patients with hepatitis B virus (HBV). Methods A total of 133 patients with pulmonary tuberculosis and HBV who were treated in Zhuzhou Central Hospital from January 2018 to early January 2022 were selected, and all were treated with conventional anti-tuberculosis 2HRZE/4HR regimen. According to the liver injury, the patients were divided into liver injury group and no liver injury group. Univariate analysis was used to analyze the related factors of liver injury caused by anti-tuberculosis drugs, and multivariate logistic regression analysis was used to analyze the independent risk factors of liver injury caused by anti-tuberculosis drugs. Results Among 133 cases of newly treated pulmonary tuberculosis patients with HBV, 24 cases had liver injury caused by anti-tuberculosis drugs, accounting for 18.05%; 109 patients had no liver injury caused by anti-tuberculosis drugs, accounting for 81.95%. Univariate analysis showed that there were significant differences in smoking history, drinking history, diabetes history, hypertension history, anti-tuberculosis treatment plan, malnutrition, and use of hepatoprotective drugs between the liver injury group and the no liver injury group (P<0.05). Multivariate logistic regression analysis showed that smoking history, drinking history, diabetes history, hypertension history, PZA-containing regimen, malnutrition, and no use of hepatoprotective drugs were independent risk factors for liver injury caused by anti-tuberculosis drugs. Conclusion Smoking history, drinking history, diabetes history, hypertension history, PZA-containing regimen, malnutrition, and no use of hepatoprotective drugs are the risk factors for drug-induced liver injury caused by anti-tuberculosis drugs in newly treated pulmonary tuberculosis patients with HBV.

Malaria and Its Prevention: Socio-acceptability in the Application of Insecticides-treated Bed Nets Among Household Heads in the Rural Village Community of Mazabuka, Zambia

@#Introduction: Malaria poses immerse public health challenges in the world as it is still causing significant morbidity and mortality especially in endemic regions such as Zambia. One of the effective tools in preventing malaria is the application of insecticide-treated bed nets (ITNs). This study aims to explored the socio-acceptability of malaria and ITNs among rural village community of Mazabuka, Zambia. Methods: A semi-structured questionnaire was administered to 177 respondents via two different approached methods; focus group discussions and one-to-one interviews to assess the level of KAP of the respondents about malaria and ITNs. Results: Most of the respondents (98.7%) possessed ITNs that were provided free of charge by the Ministry of Health Zambia. Overall, the knowledge and attitude of respondents on malaria and ITNs were at moderate levels of 68.1% and 71.8%, respectively. In contrast, the level of practice was poor with only 36.2% of positive response. Although 92.1% of the respondents answered correctly on the association between malaria and mosquito bites, myths and misconceptions were still common as some of them still attributed malaria to drinking dirty waters (32.8%), bad weather (15.8%), witchcraft (3.4%), and bathing dirty water (19.8%). The practice was significantly associated with knowledge (p=0.003), but not attitude (p=0.230). Logistic regression analysis revealed that respondents with high knowledge level and tertiary education were more likely to use ITNs correctly (OR=2.957; OR=21.739, respectively). Conclusion: The present study showed that the knowledge gaps were remained among the villagers as misconceptions and their believe of myths were still exist.

Malaria prevalence and associated additional risk factors among children under-five years who sleep under insecticide treated nets in Zambia

Background:Insecticide Treated Nets are one of the backbones of malaria prevention in Africa where the vector mosquitos bite at night and prefer humans for feeding. Children who sleep under Insecticide Treated Nets though protected still get malaria infections. This study aimed to assess the risk factors of malaria infection among under-five childrenwhosleepunderinsecticide-treatedTreated Nets. Methodology:This was a secondary analysis of a cross-sectional survey the Malaria Indicator survey of 2021 in Zambia. Data was extracted from the database at the Ministry of Health and analysed in STATAversion 14. Data was analysed in counts and frequencies,cross-tabulations andassociationsassessed using logistic regressing using complex data analysis.Results:Atotal of 1695 children aged below five years who had slept under an Insecticide Treated Net the night before the survey were included in the study, 50.9% were female while 49.1 were male. Over a third of them (23.9%) had a fever in the previous two weeks, over half 51.9% of them had anaemia and 28.8% of them had malaria infection tested using Rapid Diagnostic tests. There was a 3.46 (95%CI 2.67 ­ 4.49) increase in the odds of having malaria ifthe under-five child was anaemic (haemoglobin less than 11mg/dl). Other factors that are usually associated with malaria infection such as younger age group, low socio-economic status, residing in rural areas and having had a fever in the previous two weeks. Conclusion:In Zambia, about a third of under-five children who slept under insecticide-treated nets still had evidence of malaria infection. Asignificant risk factor for malaria infection among the under-five children who slept under ITNs was anaemia. Other known risk factors for malaria among under-five children such as age, rural residence, wealth status, province of residence and education of guardians were not statistically significant.

Survival of severely compromised endodontically treated teeth restored with or without a fiber glass post

Abstract Objective The use of a fiber glass post (FGP) type and choice of FGP diameter to restore endodontically treated incisors without ferrule is controversial. This study evaluated survival rate and failure mode of severely compromised central incisors without ferrule rehabilitated using resin-based composite (RBC) with or without FGP with different diameters. Methodology A total of 60 decoronated bovine incisors without a ferrule were endodontically treated and prepared for 1.4, 1.6, and 1.8 mm diameter FGPs (Whitepost System DC 0.5, Fit 0.4, and DCE 0.5; FGM). Half of the teeth received FGPs cemented using dual-cure resin cement (Allcem Core; FGM), the other half were filled using only bulk-fill RBC (OPUS Bulk Fill; FGM). The crowns were directly restored with RBC. The roots were embedded in polystyrene resin and the periodontal ligament was simulated with polyether impression material. Fatigue testing was conducted under 5 Hz cyclic loading at 30 degrees to the incisal edge, beginning at 50 N (5,000 cycles) as a warmup. After, the load was increased 100 N every 15,000 cycles until fracture occurred. All specimens were subjected to transillumination, micro-CT analysis, and digital radiography before and after fatigue testing. Fracture mode was classified according to severity and repair potential. Data were analyzed with Kaplan-Meier survival test and post hoc log-rank test (α=0.05) for pairwise comparisons. Results Using FGP significantly increased the number of cycles to failure, irrespective of FGP diameters (p=0.001). The FGP diameters had no statistically significant effect on cycles to failure or failure mode. Conclusion Using FGP without ferrule improved survival rate of structurally severely compromised central incisors compared with rehabilitation without FGP. The diameter of the FGPs had no effect on the survival rate and failure mode.

Fracture Resistance of Endodontically Restored Teeth with Two System Root Post

ABSTRACT: The objective of this study was to determinate the fracture resistance of endodontically treated teeth and restored with two root post systems: i) resin post, ii) fiber post. A total of 60 teeth were freshly extracted, endodontic ally treated and randomly divided in two groups (n= 30/each group) for standardized restoration; Group 1 (Group R): Resin post and resin restoration, Group 2 (Group FP): Fiberglass post and resin restoration. Both groups' samples were mounted in a metallic base at 135º to allow them to be stabilized and held in the universal testing machine by applying a vertical force at cross speed of 1mm/min. Data were recorded in Newtons (N) Previous to test the fracture resistance; all samples were stored in distilled water at 37 ºC for 24 hours. Data were subject to the Saphiro-Wilk test for normality distribution and Student's t test. Significance was considered at 0.05 values. The values of fiber post group showed normal distribution compared to the resin group, demonstrating less variability among the values. The group FP displayed higher fracture resistance (299.77±100 N) than group R (205.57±86.40 N), with significant differences (p= 0.00002). The greatest fracture resistance was recorded for the group having fiber post reinforced and composite cores. It is suggested that fiberglass post restoration is the first option when endodontic treatment requires core restoration.

RESUMEN: El objetivo del estudio fue determinar la resistencia a la fractura de dientes tratados endodónticamente y restaurados con dos sistemas de endopostes radiculares: I) poste de resina, II) poste de fibra. Un total de 60 dientes recién extraídos fueron tratados endodónticamente y divididos al azar en dos grupos (n= 30/ cada grupo) para la restauración estandarizada; Grupo 1 (Grupo R): Pilares de resina y restauración, Grupo 2 (Grupo FP): Pilares de fibra de vidrio y restauración de resina. Las muestras de ambos grupos se montaron en una base metálica a 135º para permitir su estabilización y sujeción en la máquina universal de ensayos aplicando una fuerza vertical a velocidad transversal de 1 mm/min. Los datos se registraron en Newtons (N), para probar la resistencia a la fractura; todas las muestras se almacenaron en agua destilada a 37 ºC durante 24 horas. Los datos se sometieron a la prueba de normalidad de Saphiro-Wilk y la pruebas t de Student. La significancia se consideró con un valor de 0,05. Los valores del grupo de postes de fibra mostraron una distribución normal en comparación con el grupo de resinas, demostrando menor variabilidad entre los valores. El grupo FP mostró mayor resistencia a la fractura (299,77±100 N) que el grupo R (205,57±86,40 N) que el grupo con diferencias significativas (p= 0,00002). La mayor resistencia a la fractura se registró para el grupo que tenía núcleos compuestos y reforzados con postes de fibra. Se sugiere que la restauración posterior de fibra de vidrio es la primera opción cuando el tratamiento de endodoncia requiere una restauración del núcleo.

Short- and long-term cardiovascular outcomes in insulin-treated versus non-insulin-treated diabetes mellitus patients after percutaneous coronary intervention: A systematic review and meta-analysis

Aims: This study aims to assess differences in severity of short-term (<1 year) and long-term (_x005F_x0001_1 year) adverse CV outcomes after PCI in insulin-treated vs. non-insulin-treated diabetes mellitus (DM) patients. Methods: A systematic search on Pubmed and Embase led to the incorporation of 29 studies that compared post-percutaneous coronary interventional outcomes in insulin-treated and non-insulintreated diabetes mellitus. Diabetes mellitus (type 2) was defined as fasting blood glucose (FBG) level of >7.0 mmol/L or with an oral glucose tolerance test (OGTT) level of >11.1 mmol/L at least on two separate occasions. Adverse CV outcomes were assessed in insulin-treated and non-insulin-treated DM after the PCI procedure considered for the analyses were mortality, MACE, TLR, TVR, MI, stent thrombosis, target lesion failure (TLF), and need for-post PCI CABG. Data were pooled and analyzed using Review Manager 5.3, and risk ratios (RR) with respective 95% confidence intervals (CI) were calculated.The statistical analyses were carried out by Review Manager v.5.3, and the data were pooled using a random-effects model. Risk ratios (RRs) with 95% confidence intervals (CI) were reported along with forest plots. The chi-square test was performed to assess for differences between the subgroups. Heterogeneity across studies was evaluated using Higgins I2 statistics. Visual inspection of the funnel plot and Begg's regression test were used to assess publication bias. Results: A total of 40,527 patients (11742 in the Insulin-treated diabetes mellitus group and 28785 in the non-insulin-treated DM group) who underwent PCI were included. The pooled analysis of short-term follow up outcomes preceding PCI demonstrated a significantly higher risk of mortality (RR ¼ 1.75 [1.24,2.47]; p ¼ 0.002), MI (RR ¼ 1.81[1.14,2.87]; p ¼ 0.01], stent thrombosis (RR ¼ 1.63[1.13, 2.35]; p ¼ 0.009) and target lesion revascularization (TLR) (RR ¼ 1.29[1.02,1.63]; p ¼ 0.03) in insulin-treated DM patients. Similarly, analysis of long-term follow-up studies depicted a significantly higher risk mortality (RR ¼ 1.55 [1.22, 1.97]; p ¼ 0.0003), MI (RR ¼ 1.63 [1.35, 1.97]; p¼<0.00001), MACE (R ¼ 1.47 [1.31, 1.65]; p¼<0.00001), stent thrombosis (RR ¼ 1.54 [1.19,1.99]; p ¼ 0.001), TLR (RR ¼ 1.40 [1.18, 1.66]; p ¼ 0.0001), target vessel revascularization (TVR) (RR ¼ 1.35 [1.11, 1.64]; p ¼ 0.003) in insulin-treated DM group after PCI versus non-insulin-treated DM patients. Conclusion: Despite a tremendous technical success rate of multi-vessel stenting, people living with diabetes who were being treated with insulin had higher long-term, and short-term mortality rates, MI, TLR, TVR, and stroke compared to people living with diabetes who were being treated with means other than insulin and are more prone to detrimental cardiovascular outcomes.

Impact of treated sewage on meiobenthic nematodes: a case study from the Tunisian Refining Industries Company / Impacto de esgoto tratado em nematoides meiobentônicos: um estudo de caso da Tunisian Refining Industries Company

The main objective of the current study was to assess the impact of the water taken from the 'Tunisian Refining Industries Company' on meiobenthic nematodes, before and after a series of treatments in decantation basins followed by its discharge in Bizerte bay, Tunisia. The comparison of environmental parameters of the two types of water was clearly indicative of an improvement in the quality of treated waters after a significant reduction in their loads in hydrocarbons. Overall, the water retained a good quality after being treated by 'Tunisian Refining Industries Company' before discharge in the sea. At the end of the experiment, differential responses were observed according to the richness of sediment in organic matter and hydrocarbons. Thus, it was apparent that the nematode assemblage exposed to the treated waters was closer to controls and associated to higher values of abundance, than that under untreated ones. It was also assumed that the species Microlaimus honestus De Man, 1922, Paramonohystera proteus Wieser, 1956 and Cyartonema germanicum Juario, 1972 are sensitive bioindicators of bad environmental statues and of hydrocarbon presence in the environment. On the other hand, Metoncholaimus pristiurus (Zur Strassen, 1894) Filipjev, 1918 would rather be classified as a positive bioindicative species of this type of pollutants.

O principal objetivo do presente estudo foi avaliar o impacto da água retirada da "Tunisian Refining Industries Company" sobre os nematoides meiobentônicos, antes e depois de uma série de tratamentos em bacias de decantação seguidos de seu descarte na baía de Bizerte, Tunísia. A comparação dos parâmetros ambientais dos dois tipos de água foi claramente indicativa de uma melhoria na qualidade das águas tratadas após uma redução significativa das suas cargas em hidrocarbonetos. No geral, a água reteve uma boa qualidade após ser tratada pela "Tunisian Refining Industries Company" antes da descarga no mar. Ao final do experimento, foram observadas respostas diferenciais de acordo com a riqueza de sedimentos em matéria orgânica e hidrocarbonetos. Assim, ficou claro que a assembleia de nematoides exposta às águas tratadas estava mais próxima dos controles e associada a maiores valores de abundância do que nas não tratadas. Também foi assumido que as espécies Microlaimus honestus De Man, 1922, Paramonohystera proteus Wieser, 1956 e Cyartonema germanicum Juario, 1972 são bioindicadores sensíveis de más estátuas ambientais e da presença de hidrocarbonetos no meio ambiente. Por outro lado, Metoncholaimus pristiurus (Zur Strassen, 1894) Filipjev, 1918 preferiria ser classificado como uma espécie bioindicativa positiva deste tipo de poluentes.

Impact of treated sewage on meiobenthic nematodes: a case study from the Tunisian Refining Industries Company

Abstract The main objective of the current study was to assess the impact of the water taken from the Tunisian Refining Industries Company on meiobenthic nematodes, before and after a series of treatments in decantation basins followed by its discharge in Bizerte bay, Tunisia. The comparison of environmental parameters of the two types of water was clearly indicative of an improvement in the quality of treated waters after a significant reduction in their loads in hydrocarbons. Overall, the water retained a good quality after being treated by Tunisian Refining Industries Company before discharge in the sea. At the end of the experiment, differential responses were observed according to the richness of sediment in organic matter and hydrocarbons. Thus, it was apparent that the nematode assemblage exposed to the treated waters was closer to controls and associated to higher values of abundance, than that under untreated ones. It was also assumed that the species Microlaimus honestus De Man, 1922, Paramonohystera proteus Wieser, 1956 and Cyartonema germanicum Juario, 1972 are sensitive bioindicators of bad environmental statues and of hydrocarbon presence in the environment. On the other hand, Metoncholaimus pristiurus (Zur Strassen, 1894) Filipjev, 1918 would rather be classified as a positive bioindicative species of this type of pollutants.

Resumo O principal objetivo do presente estudo foi avaliar o impacto da água retirada da Tunisian Refining Industries Company sobre os nematoides meiobentônicos, antes e depois de uma série de tratamentos em bacias de decantação seguidos de seu descarte na baía de Bizerte, Tunísia. A comparação dos parâmetros ambientais dos dois tipos de água foi claramente indicativa de uma melhoria na qualidade das águas tratadas após uma redução significativa das suas cargas em hidrocarbonetos. No geral, a água reteve uma boa qualidade após ser tratada pela Tunisian Refining Industries Company antes da descarga no mar. Ao final do experimento, foram observadas respostas diferenciais de acordo com a riqueza de sedimentos em matéria orgânica e hidrocarbonetos. Assim, ficou claro que a assembleia de nematoides exposta às águas tratadas estava mais próxima dos controles e associada a maiores valores de abundância do que nas não tratadas. Também foi assumido que as espécies Microlaimus honestus De Man, 1922, Paramonohystera proteus Wieser, 1956 e Cyartonema germanicum Juario, 1972 são bioindicadores sensíveis de más estátuas ambientais e da presença de hidrocarbonetos no meio ambiente. Por outro lado, Metoncholaimus pristiurus (Zur Strassen, 1894) Filipjev, 1918 preferiria ser classificado como uma espécie bioindicativa positiva deste tipo de poluentes.

Impact of treated sewage on meiobenthic nematodes: a case study from the Tunisian Refining Industries Company / Impacto de esgoto tratado em nematoides meiobentônicos: um estudo de caso da Tunisian Refining Industries Company

The organization of the roots, ganglia and the peripheral distribution of the cranial nerves of the fully formed embryos of Oreochromis niloticus are examined in the transverse serial sections. These nerves carry fibers, which were also analyzed. The results of this study demonstrated that the glossopharyngeal nerve originates by means of only one root, which leaves the cranium through the glossopharyngeal foramen. This nerve gives fibers (visceromotor) to the first internal and external levator arcus branchialis muscles. There is a single epibranchial (petrosal) ganglion located extracranially. Nervus glossopharyngeus has three rami; pharyngeus, pretramticus and posttrematicus. The ramus pharyngeus carries only viscerosensory fibers; general for the pharyngeal epithelium and special ones for the pseudobranch. General viscerosensory fibers are also carried by rami pretrematicus and posttrematicus for the pharyngeal epithelial lining. The special sensory fibers are carried by the ramus pretrematicus for the taste buds and by ramus posttrematicus for the gill filaments. The ramus pretrematicus also carries visceromotor fibers for the first adductor arcus branchialis and to the first obliquus ventralis muscles.

A organização das raízes, gânglios e a distribuição periférica dos nervos cranianos dos embriões totalmente formados de Oreochromis niloticus são examinados nas seções transversais seriais. Esses nervos carregam fibras, que também foram analisadas. Os resultados deste estudo demonstraram que o nervo glossofaríngeo se origina por meio de apenas uma raiz, que sai do crânio pelo forame glossofaríngeo. Este nervo fornece fibras (visceromotoras) para os primeiros músculos levantadores do arco branquial interno e externo. Existe um único gânglio epibranquial (petroso) localizado extracranialmente. Nervus glossopharyngeus tem três ramos; faríngeo, pretramticus e póstrematicus. O ramo faríngeo contém apenas fibras viscerossensoriais ­ gerais para o epitélio faríngeo e especiais para o pseudobrânquio. Fibras viscerossensoriais gerais também são transportadas por ramos pretrematicus e posttrematicus para o revestimento epitelial da faringe. As fibras sensoriais especiais são transportadas pelo ramus pretrematicus para as papilas gustativas e pelo ramus posttrematicus para os filamentos branquiais. O ramo pretrematicus também carrega fibras visceromotoras para o primeiro adutor arcus branchialis e para o primeiro músculo oblíquo ventral.

Caracterização atual da objeção de consciência: proposta crítica e renovada / Current characterization of conscientious objection: a critical and renewed proposal / Caracterización actual de la objeción de conciencia: propuesta crítica y renovada

Resumo O artigo caracteriza a "objeção de consciência" - cercada por controvérsias e marcada pela ausência de definição unificada - e os limites de seu exercício. O objetivo da pesquisa, baseada na abordagem de revisão crítica de literatura, é propor uma definição para o termo. Para isso, identificaram-se situações em que a objeção de consciência é erroneamente invocada ou serve de pretexto para comportamentos antiéticos, e se procurou estabelecer os elementos que verdadeiramente compõem tal objeção. O conceito proposto pretende contribuir para esclarecer o assunto e estabelecer limites justos ao exercício ético desse direito.

Abstract This article characterizes "conscientious objection" - surrounded by controversies and marked by the absence of a unified definition - and the limits of its exercise. From a critical literature review approach, the objective is to propose a definition for the term. For such, situations where conscientious objection is wrongly invoked or serves as a pretext for unethical behavior were identified, and an attempt to establish the elements that truly compose such objection was made. The proposed concept intends to contribute to clarifying the matter and establishing fair limits to the ethical exercise of this right.

Resumen El artículo caracteriza la "objeción de conciencia", rodeada de controversias y marcada por la ausencia de una definición unificada, y los límites de su ejercicio. El objetivo de la investigación, basada en el enfoque de la revisión crítica de la literatura, es proponer una definición para el término. Para ello, se identificaron situaciones en las que la objeción de conciencia se invoca erróneamente o sirve de pretexto para conductas poco éticas, y se intentó establecer los elementos que verdaderamente componen dicha objeción. El concepto propuesto pretende contribuir a clarificar el tema y establecer límites justos al ejercicio ético de este derecho.

Fenestration and dehiscence frequency in maxillary teeth with apical periodontitis: a CBCT study / Frecuencia de dehiscencias y fenestraciones en dientes maxilares con periodontitis apical: un estudio con TCHC

ABSTRACT Introduction: to determine the frequency of fenestration and dehiscence bone defects present in maxillary teeth with apical periodontitis, mainly in teeth with endodontic treatment, as they are frequently cause of nonspecific symptoms after treatment. Methods: 1201 Maxillary Cone Beam Computed Tomography (CBCT) exams were analyzed and 803 teeth with apical periodontitis were selected. Results: of the teeth with apical periodontitis, 142 had a fenestration defect (18%) of which 105 teeth (74%) were endodontically treated. The highest frequency was observed in premolars, with no statistical differences between groups. Dehiscence defect was found in 139 teeth (17%) out of which 90 (65%) were endodontically treated. The highest frequency was observed in molars, with statistical differences in relation to other tooth types (p< 0.001). Conclusion: an important number of teeth with apical periodontitis present dehiscence or fenestration bone defects, especially in teeth with root canal treatment.

Resumen Introducción: determinar la frecuencia de fenestraciones y dehiscencias presentes en dientes maxilares con periodontitis apical, principalmente en dientes con tratamiento de endodoncia, pues frecuentemente son causa de síntomas inespecíficos después del tratamiento. Métodos: se examinaron y analizaron 1201 tomografías computarizadas de haz cónico (TCHC), y se seleccionaron 803 dientes con periodontitis apical. Resultados: de los dientes con periodontitis apical, 142 presentaban fenestración (18%), de los cuales, 105 dientes (74%) estaban tratados endodónticamente. La mayor frecuencia fue observada en premolares, sin diferencias estadísticas entre los grupos. La dehiscencia fue encontrada en 139 dientes (17%), de los cuales 90 (65%) estaban tratados endodónticamente. La mayor frecuencia fue encontrada en molares con diferencia estadísticas en relación con los otros tipos de dientes (p<0,001). Conclusión: un importante número de dientes con periodontitis apical presentan fenestraciones y dehiscencias, especialmente en dientes con tratamiento de canales radiculares.

Estudio comparativo entre coronas, endocoronas y endocoronas con ausencia de una pared axial ante fuerzas de tracción / Comparative study between crown, endocrown and endocrown without one axial wall after tensile strength

Introducción: Las alternativas de tratamiento de órganos dentales con gran destrucción en su estructura varían, no sólo por el material de restauración, sino también por el valor económico y estético. Dentro de las alternativas existe: corona convencional, endocorona cuyo objetivo principal es la elaboración de una restauradora que evita la colocación de postes intraconducto y endocorona con ausencia de una pared axial (EPA) que se realiza cuando una pared, mesial, distal, vestibular o palatina está ausente. Objetivo: Verificar si la endocorona EPA se comporta de igual manera que las coronas convencionales y endocoronas al medir su resistencia ante fuerzas de tracción. Material y métodos: Treinta premolares fueron tratados endodóncicamente, 10 fueron preparados para recibir una corona convencional (grupo A), 10 para endocorona (grupo B) y 10 para endocorona EPA (grupo C). Se realizaron fuerzas de tracción para obtener el valor máximo en el cual las coronas fallaron. Se realizó una prueba ANOVA para comparar los resultados. Resultados: Al someter a los tres tipos de coronas a fuerzas de tracción los resultados obtenidos fueron: 3.04 ± 0.55 MPa para la corona, 7.08 ± 1.6 MPa para la endocorona y 6.17 ± 1.12 MPa para la endocorona EPA. Conclusiones: No existió diferencia significativa entre la endocorona (7.08 MPa) y la EPA (6.17 MPa), convirtiéndose en una alternativa de tratamiento con buen pronóstico en la práctica diaria (AU)

Introduction: The alternatives of treatment of tooth with excessive wear vary not only by the restoration material but also by the economic and aesthetic value. Among the alternatives there is: conventional crown, endocrown whose main objective is the elaboration of a restorative that avoids the placement of intraconducting posts and endocrown without one axial wall (EPA) that is done when a wall; mesial, distal, vestibular or palatal is absent. Objective: To verify if the (EPA) behaves in the same way as the conventional crown and endocrown when measuring its resistance to tensile strength. Material and methods: 30 premolars were treated endodontically, ten were prepared to receive a conventional crown, 10 for endocrown and 10 for EPA. Tensile strength were performed to obtain the maximum value at which the crowns failed, an ANOVA test was performed to compare the results. Results: When the three types of crowns were subjected to tensile strength, the results obtained were; 3.04 ± 0.55 MPa for the crown, 7.08 ± 1.6 MPa for the endocrown and 6.17 ± 1.12 MPa for the EPA endocrown. Conclusions: There was no significant difference between the endocrown (7.08 MPa) and EPA endocrown (6.17 MPa) becoming an alternative treatment with good prognosis in daily practice (AU)