99mTc-AgNPs-ICG: nanopartícula para imagen híbrida / 99mTc-AgNPs-ICG: nanoparticle for hybrid image / 99mTc-AgNPs-ICG: nanopartícula para imagem híbrida

Introducción: actualmente la nanotecnología ha cambiado radicalmente el diagnóstico de muchas patologías humanas. El objetivo de este trabajo es obtener nanopartículas de plata para imagen híbrida (99mTc-AgNPs-ICG) que tengan potenciales aplicaciones clínicas en imagen. Materiales y métodos: se mezclaron 2 ml de ácido ascórbico (1.7 x10-4 M), 5 mCi de 99mTcO4-, 2 ml de ácido cítrico (8.0 x 10-4 M) y 0.5 ml de nitrato de plata (2.5 x 10-3 M). El pH de la solución fue 5, y se agitó durante 20 minutos a 37º C. A continuación, se añadieron 2 µl de verde de indocianina (1.3 x 10-3 M) (99mTc-AgNPs-ICG). Las propiedades fisicoquímicas de la solución se caracterizaron mediante UV (λ1 = 420 nm, λ2 = 254 nm) y detector gamma. Se evaluaron la imagen de fluorescencia, el tamaño de las partículas y el espectro IR. Resultados: se obtuvieron nanopartículas de plata en solución acuosa a un pH de 5. Su pH, color y espectro fueron estables durante siete días. Además, el pico principal caracterizado por HPLC, UV y detector Gamma tenía tiempos de retención similares. Su espectro UV mostró una banda de absorción de 420 nm, que corresponde a la banda de absorción plasmónica de estas nanopartículas. El tamaño de las partículas era de 46 nm ± 1,5 nm. El espectro IR mostró bandas de absorción en 3193, 2624, 1596 y 1212 cm-1. Conclusiones: describimos por primera vez en la literatura la síntesis de nanopartículas de plata híbridas (radioactivas y fluorescentes). Se caracterizaron sus propiedades fisicoquímicas, siendo estables y su etiquetado fue reproducible teniendo potenciales aplicaciones biomédicas.

Introduction: Currently nanotechnology has radically changed the diagnosis of many human pathologies. The aim of this work is to obtain silver nanoparticles for hybrid imaging (99mTc-AgNPs-ICG) having potential clinical imaging applications. Materials and methods: We mixed 2 ml of ascorbic acid (1.7x10-4 M), 5 mCi of 99mTcO4-, 2 ml of citric acid (8.0 x 10-4 M) and 0.5 ml of silver nitrate (2.5 x 10-3 M). Solution pH was 5, and it was shaken for 20 minutes at 37º C. Afterwards, 2 µL of Indocyanine Green (1.3 x 10-3 M) was added (99mTc-AgNPs-ICG). Physiochemical properties of the solution were characterized by UV (λ1 = 420 nm, λ2 = 254 nm) and gamma detector. Fluorescence image, particle size and IR spectrum were evaluated. Results: Silver nanoparticles were obtained in aqueous solution a pH of 5. Their pH, color and spectrum were stable for seven days. Furthermore, the principal peak characterized by HPLC, UV and Gamma detector had similar retention times. Its UV spectrum showed an absorption band of 420 nm, which corresponds to the plasmon absorption band of these nanoparticles. The particle size was 46 nm ± 1.5 nm. The IR spectrum showed absorption bands in 3193, 2624, 1596 y 1212 cm-1. Conclusions: We describe for the first time in literature the synthesis of hybrid (radioactive and fluorescent) silver nanoparticles. Their physiochemical properties were characterized, being stable and their labelling was reproducible having potential biomedical applications.

Introdução: Atualmente, a nanotecnologia mudou radicalmente o diagnóstico de muitas patologias humanas. O objetivo deste trabalho é obter nanopartículas de prata para imagens híbridas (99mTc-AgNPs-ICG) com possíveis aplicações de imagens clínicas. Materiais e métodos: Misturamos 2 ml de ácido ascórbico (1.7 x 10-4 M), 5 mCi de 99mTcO4-, 2 ml de ácido cítrico (8.0 x 10-4 M) e 0.5 ml de nitrato de prata (2.5 x 10-3 M). O pH da solução era 5 e ela foi agitada por 20 minutos a 37º C. Em seguida, foram adicionados 2 µL de indocianina verde (1,3x10-3 M) (99mTc-AgNPs-ICG). As propriedades físico-químicas da solução foram caracterizadas por UV (λ1 = 420 nm, λ2 = 254 nm) e detector gama. A imagem de fluorescência, o tamanho das partículas e o espectro de infravermelho foram avaliados. Resultados: As nanopartículas de prata foram obtidas em solução aquosa com pH de 5. Seu pH, cor e espectro permaneceram estáveis por sete dias. Além disso, o pico principal caracterizado por HPLC, UV e detector gama teve tempos de retenção semelhantes. Seu espectro de UV mostrou uma banda de absorção de 420 nm, que corresponde à banda de absorção plasmônica dessas nanopartículas. O tamanho da partícula foi de 46 nm ± 1,5 nm. O espectro de IV mostrou bandas de absorção em 3193, 2624, 1596 e 1212 cm-1. Conclusões: Descrevemos pela primeira vez na literatura a síntese de nanopartículas de prata híbridas (radioativas e fluorescentes). Suas propriedades físico-químicas foram caracterizadas, sendo estáveis e sua rotulagem foi reprodutível, com possíveis aplicações biomédicas.

Identification and expression analysis of citrate synthase 3 gene family members in apple / 生物工程学报

As one of the key enzymes in cell metabolism, the activity of citrate synthase 3 (CS3) regulates the substance and energy metabolism of organisms. The protein members of CS3 family were identified from the whole genome of apple, and bioinformatics analysis was performed and expression patterns were analyzed to provide a theoretical basis for studying the potential function of CS3 gene in apple. BLASTp was used to identify members of the apple CS3 family based on the GDR database, and the basic information of CS3 protein sequence, subcellular localization, domain composition, phylogenetic relationship and chromosome localization were analyzed by Pfam, SMART, MEGA5.0, clustalx.exe, ExPASy Proteomics Server, MEGAX, SOPMA, MEME, WoLF PSORT and other software. The tissue expression and inducible expression characteristics of 6 CS3 genes in apple were determined by acid content and real-time fluorescence quantitative polymerase chain reaction (qRT-PCR). Apple CS3 gene family contains 6 members, and these CS3 proteins contain 473-608 amino acid residues, with isoelectric point distribution between 7.21 and 8.82. Subcellular localization results showed that CS3 protein was located in mitochondria and chloroplasts, respectively. Phylogenetic analysis divided them into 3 categories, and the number of genes in each subfamily was 2. Chromosome localization analysis showed that CS3 gene was distributed on different chromosomes of apple. The secondary structure of protein is mainly α-helix, followed by random curling, and the proportion of β-angle is the smallest. The 6 members were all expressed in different apple tissues. The overall expression trend from high to low was the highest relative expression content of MdCS3.4, followed by MdCS3.6, and the relative expression level of other members was in the order of MdCS3.3 > MdCS3.2 > MdCS3.1 > MdCS3.5. qRT-PCR results showed that MdCS3.1 and MdCS3.3 genes had the highest relative expression in the pulp of 'Chengji No. 1' with low acid content, and MdCS3.2 and MdCS3.3 genes in the pulp of 'Asda' with higher acid content had the highest relative expression. Therefore, in this study, the relative expression of CS3 gene in apple cultivars with different acid content in different apple varieties was detected, and its role in apple fruit acid synthesis was analyzed. The experimental results showed that the relative expression of CS3 gene in different apple varieties was different, which provided a reference for the subsequent study of the quality formation mechanism of apple.

Efeito protetor de enxaguatórios com diferentes fluoretos utilizados previamente aos desafios erosivos/abrasivos em esmalte e dentina / Protective effect of solutions with different fluorides used previously to erosive/abrasive challenges in enamel and dentin

Aim: To evaluate the protection offered by commercial mouthwashes containing sodium fluoride or stannous chloride associated with sodium fluoride to enamel and dentin, prior to erosive and abrasive cycling. Materials and Methods: Enamel and dentin samples were obtained from bovine incisors and subdivided into 3 groups (n=10), according to the fluoridated ingredient tested: FS (sodium fluoride - NaF (225 ppm)); FE (tin fluoride - NaF + SnCl2 (800 ppm Sn2+)); control (distilled water). The samples were submitted to an erosive/abrasive cycle with immersion in citric acid (lemon soda for 5 min, 4×/day, 5 days, with remineralization intervals in artificial saliva for 60 min). Abrasion was carried out with an electric brush (200 g/force) after the first and last cycles, 2x/day, and immediately afterward immersed in the tested solutions. Structure loss was obtained by optical profilometry. The data were subjected to analysis of variance and multiple comparison for each substrate separately. Results: For enamel there was a difference between the groups (p = 0.027), with the FS showing less loss of structure compared to the control 2.02 (±0.48). The FE group showed similar loss to the control and FS 2.32 (±0.58)ab. For dentin there was a difference between the groups (p = 0.011), with FE showing less loss of structure compared to the other groups, 0.82 (25% - 0.34; 75% - 0.95). Discussion: The protection of fluorides in erosive/abrasive challenges depends on the type and dental substrate. Conclusion: Mouthwash with sodium fluoride prior to erosive/abrasive challenges caused less loss of enamel surface, while for dentin, sodium fluoride associated with stannous chloride caused less loss of structure.

Objetivo: Avaliar a proteção oferecida por soluções para bochecho de fluoreto de sódio ou cloreto de estanho associado ao fluoreto de sódio ao esmalte e à dentina, previamente à ciclagem erosiva e abrasiva. Materiais e Métodos: Amostras de esmalte e dentina foram obtidas a partir de incisivos bovinos e subdivididas em 3 grupos (n=10), de acordo com o princípio ativo fluoretado testado: FS (fluoreto de sódio - NaF (225 ppm)); FE (fluoreto de estanho - NaF + SnCl2 (800 ppm Sn2+)); controle (água destilada). As amostras foram submetidas a um ciclo erosivo/abrasivo com imersão em ácido cítrico (refrigerante de limão por 5 min, 4×/dia, 5 dias, com intervalos de remineralização em saliva artificial por 60 min). A abrasão foi realizada com escova elétrica (200 g/força) após o primeiro e o último ciclos, 2×/dia, e logo em seguida imersos nas soluções testadas. A perda de estrutura foi obtida por perfilometria óptica. Os dados foram submetidos à análise de variância e comparação múltipla para cada substrato separadamente. Resultados: Para esmalte houve diferença entre os grupos (p = 0,027), tendo o FS apresentados menor perda de estrutura comparado ao controle 2,02 (±0,48). O grupo FE apresentou perda similar ao controle e ao FS 2,32 (±0,58)ab. Para dentina houve diferença entre os grupos (p = 0,011), sendo que o FE apresentou menor perda de estrutura comparado aos demais grupos 0,82 (25% - 0,34; 75% - 0,95). Discussão: A proteção dos fluoretos em desafios erosivos/abrasivos depende do tipo e do substrato dental. Conclusão: O bochecho com fluoreto de sódio previamente aos desafios erosivos/abrasivos apresentou menor perda de superfície em esmalte, enquanto para dentina o fluoreto de sódio associado ao cloreto de estanho apresentou menor perda de estrutura.

Efeito de diferentes irrigantes finais na resistência união de um cimento de silicato de cálcio: estudo in vitro / Effect of different final irrigants on the bond strength of a calcium silicate cement : in vitro study

Objetivo: Este estudo teve como objetivo avaliar a resistência de união do cimento Biodentine® à dentina radicular após a utilização de diferentes irrigantes finais. Método: Vinte dentes humanos extraídos tiveram seu terço médio radicular cortado em fatias que foram submersas em hipoclorito de sódio 2,5% e posteriormente divididas aleatoriamente em 4 grupos experimentais (n=15) conforme o irrigante final utilizado (1) água destilada (controle), (2) QMixTM, (3) ácido cítrico 10%, (4) EDTA 17%. Após a imersão na substância teste as amostras foram preenchidas com o cimento Biodentine e imersas em solução salina tamponada com fosfato (PBS) por um período de 7 dias. O teste de push out foi realizado e os valores de resistência de união em Mpa foram obtidos. Os dados foram analisados pelos testes de Kruskal Wallis e Studend- Newman-Keuls. Resultados: Os piores valores de união foram obtidos após a utilização do EDTA enquanto a água destilada, o QMix e o ácido cítrico apresentaram resultados estatisticamente semelhantes entre si. Conclusão: A remoção da smear layer não resultou em melhora nos resultados de união do cimento Biodentine.(AU)

Objective: This study aimed to evaluate the bond strength of Biodentine® cement to root dentin after the use of different final irrigants. Method: Twenty extracted human teeth had their middle root third cut into slices that were submerged in 2.5% sodium hypochlorite and then randomly divided into 4 experimental groups (n=15) according to the final irrigant used (1) distilled water (control), (2) QMixTM, (3) 10% citric acid, (4) 17% EDTA. After immersion in the test substance the samples were filled with Biodentine cement and immersed in phosphate buffered saline (PBS) for a period of 7 days. The push out test was performed and the bond strength values in MPa were obtained. The data were analyzed by Kruskal Wallis and Studend- Newman-Keuls tests. Results: The worst bond values were obtained after using EDTA while distilled water, QMix and citric acid showed statistically similar results to each other. Conclusion: Removal of the smear layer did not result in improved bonding results of Biodentine cement.(AU)

Citraturia en pacientes pediátricos con urolitiasis / Citraturia in pediatric patients with urolithiasis

La urolitiasis en niños y adolescentes es etiológicamente multifactorial, incluyendo bajo volumen urinario o desequilibrio entre factores promotores e inhibidores de la cristalización urinaria. La hipocitraturia es una alteración bioquímica relacionada con pH urinario acido y dietas ricas en proteínas o deficientes en frutas y hortalizas. Objetivos: determinar los valores urinarios de citrato y de algunos promotores de la cristalización (calcio, ácido úrico y fósforo) en pacientes menores de 18 años con urolitiasis. Métodos: se incluyeron 68 pacientes menores de 18 años con diagnóstico de urolitiasis en quienes se realizaron los siguientes estudios: examen general de orina (muestra aislada), calcio, fosforo, ácido úrico y citrato (recolección de 24 horas), gases venosos, electrolitos séricos y ecosonograma renovesical. En los pacientes hipocitratúricos también se determinó la citraturia después de seis meses de tratamiento con citrato de potasio. Los pacientes se dividieron en dos grupos: grupo A, pacientes normocitratúricos y grupo B, pacientes hipocitratúricos. Resultados: cuarenta y tres pacientes (63%) presentaron antecedentes familiares de litiasis. valores de citraturia (mgs/24hrs): grupo total: X:280±108,8; grupo A: 488,503±112,4; grupo B: X:169,5±95,2. Se evidenció hipocitraturia en 44 pacientes (64,71%). Alteraciones asociadas (n/%): acidosis metabólica (23/33%), de los cuales 20 pacientes (87%) tuvieron hipocitraturia; hiperuricosuria (16/23,52%); hipercalciuria (15/22,05%); hiperfosfaturia (09/13,23%); pH urinario ácido (35/51%) y alcalino o neutro (33/49%); pH urinario persistentemente acido (18/41%). en 28 pacientes (41,17%) se encontraron alteraciones metabólicas mixtas. Conclusiones: la hipocitraturia se encontró en más de la mitad de los pacientes estudiados y se asoció de manera significativa con otras alteraciones metabólicas litogénicas(AU)

Urolithiasis in children and adolescents is etiologically multifactorial, including low urinary volume or imbalance between urinary crystallization promoting and inhibiting factors. Hypocitraturia is a biochemical alteration related to urinary acid pH and diets high in protein or low in fruits and vegetables. Objectives: to determine urinary values of citrate and crystallization promoters (calcium, uric acid and phosphorus) in patients less than 18 years of age with urolithiasis. Methods: sixty-eight patients under 18 years of age with a diagnosis of urolithiasis were submitted to the following studies: urinalysis (isolated urine sample), calcium, phosphorus, uric acid and citrate (24-hour collection), venous gases, serum electrolytes and abdominal ultrasonogram. In hypocytraturic patients, citraturia was also determined after six months of treatment with potassium citrate. Patients were divided into two groups: group A, normocytraturic patients, and group B, hypocytraturic patients. Results:. Forty-three patients (63%) had a family history of urolithiasis. urinary citrate values (mgs/24hrs): total group: X:280±108.8; group A: 488,503±112.4; group B: X:169.5±95.2. hypocitraturia was observed in 44 patients (64.71%). Associated alterations (n/%): metabolic acidosis (23/33%), of which 20 patients (87%) had hypocitraturia; hyperuricosuria (16/23.52%); hypercalciuria 15/22.05%; hyperphosphaturia 9/13.23%; urinary acid pH (35/51%) and alkaline or neutral (33/49%); persistently urinary acid pH (18/41%). Mixed metabolic alterations were found in 28 patients (41.17%). Conclusions: hypocitraturia was found in more than half of the patients and was significantly associated with other lithogenic metabolic alterations(AU)

Use of phytase and citric acid supplementation on growth performance and nutrient digestibility of Cirrhinus mrigala fingerlings fed on canola meal based diet / Uso de suplementação de fitase e ácido cítrico no desempenho do crescimento e digestibilidade de nutrientes de dedos Cirrhinus mrigala alimentados em dieta à base de refeição de canola

Fishmeal; being a limited and costly feed ingredient is continuously been substituted with locally available plant proteins. However, the occurrence of anti-nutritional factors in plant meal suppresses its potential to be fully replaced. Therefore, in this study we aimed to study the synergistic effects of dietary additives like citric acid and phytase enzyme supplementation on growth performance and nutrient digestibility of Cirrhinus mrigala fingerlings. Canola meal (CM) was used as a test ingredient to replace fishmeal (FM) as; 0%, 25%, 50% and 75%. These four diets were further supplemented by varying levels of phytase (0 and 750 FTU kg-1) and citric acid (0% and 2.5%) to formulate total sixteen test diets as T1, T2, T3, T4, T5, T6, T7, T8, T9, T10, T11, T12, T13, T14, T15 and T16. Each treatment contained three replicates; applied to fish groups having 15 fingerlings each; following 3×3 factorial arrangement. 1% of chromic oxide was added as an inert marker. Maximum weight gain% (288%) and the lowest value of FCR (1.07) were recorded when fish was fed on diet T12 as compared to fish fed control diet (T1). Similarly, optimum nutrient digestibility values such as crude protein (77%), crude fat (84%) and gross energy (70%) were noted on same level. It was concluded that 50% canola meal can optimally replace fishmeal when supplemented with phytase and citric acid at the levels of 750 FTU kg-¹ and 2.5%, respectively.

A farinha de peixe, por ser um ingrediente alimentar limitado e caro, é continuamente substituída por proteínas vegetais disponíveis localmente. No entanto, a ocorrência de fatores antinutricionais na farinha de plantas suprime seu potencial de ser totalmente substituída. Portanto, neste estudo objetivamos estudar os efeitos sinérgicos de aditivos dietéticos como ácido cítrico e suplementação com enzima fitase sobre o desempenho de crescimento e digestibilidade de nutrientes de alevinos de Cirrhinus mrigala. A farinha de canola (CM) foi usada como ingrediente de teste para substituir a farinha de peixe (FM) como: 0%, 25%, 50% e 75%. Essas quatro dietas foram suplementadas por níveis variados de fitase (0 e 750 FTU kg-1) e ácido cítrico (0% e 2,5%) para formular um total de 16 dietas de teste como T1, T2, T3, T4, T5, T6, T7, T8, T9, T10, T11, T12, T13, T14, T15 e T16. Cada tratamento continha três repetições; aplicado a grupos de peixes com 15 alevinos cada; seguindo o arranjo fatorial 3 × 3. 1% de óxido crômico foi adicionado como um marcador inerte. % de ganho de peso máximo (288%) e o valor mais baixo de FCR (1,07) foram registrados quando os peixes foram alimentados com dieta T12 em comparação com peixes alimentados com dieta controle (T1). Da mesma forma, valores ótimos de digestibilidade de nutrientes, como proteína bruta (77%), gordura bruta (84%) e energia bruta (70%) foram anotados no mesmo nível. Concluiu-se que 50% da farinha de canola pode substituir de forma ideal a farinha de peixe quando suplementada com fitase e ácido cítrico nos níveis de 750 FTU kg-¹ e 2,5%, respectivamente.

Use of phytase and citric acid supplementation on growth performance and nutrient digestibility of Cirrhinus mrigala fingerlings fed on canola meal based diet / Uso de suplementação de fitase e ácido cítrico no desempenho do crescimento e digestibilidade de nutrientes de dedos Cirrhinus mrigala alimentados em dieta à base de refeição de canola

Abstract Fishmeal; being a limited and costly feed ingredient is continuously been substituted with locally available plant proteins. However, the occurrence of anti-nutritional factors in plant meal suppresses its potential to be fully replaced. Therefore, in this study we aimed to study the synergistic effects of dietary additives like citric acid and phytase enzyme supplementation on growth performance and nutrient digestibility of Cirrhinus mrigala fingerlings. Canola meal (CM) was used as a test ingredient to replace fishmeal (FM) as; 0%, 25%, 50% and 75%. These four diets were further supplemented by varying levels of phytase (0 and 750 FTU kg-1) and citric acid (0% and 2.5%) to formulate total sixteen test diets as T1, T2, T3, T4, T5, T6, T7, T8, T9, T10, T11, T12, T13, T14, T15 and T16. Each treatment contained three replicates; applied to fish groups having 15 fingerlings each; following 3×3 factorial arrangement. 1% of chromic oxide was added as an inert marker. Maximum weight gain% (288%) and the lowest value of FCR (1.07) were recorded when fish was fed on diet T12 as compared to fish fed control diet (T1). Similarly, optimum nutrient digestibility values such as crude protein (77%), crude fat (84%) and gross energy (70%) were noted on same level. It was concluded that 50% canola meal can optimally replace fishmeal when supplemented with phytase and citric acid at the levels of 750 FTU kg-1 and 2.5%, respectively.

Resumo A farinha de peixe, por ser um ingrediente alimentar limitado e caro, é continuamente substituída por proteínas vegetais disponíveis localmente. No entanto, a ocorrência de fatores antinutricionais na farinha de plantas suprime seu potencial de ser totalmente substituída. Portanto, neste estudo objetivamos estudar os efeitos sinérgicos de aditivos dietéticos como ácido cítrico e suplementação com enzima fitase sobre o desempenho de crescimento e digestibilidade de nutrientes de alevinos de Cirrhinus mrigala. A farinha de canola (CM) foi usada como ingrediente de teste para substituir a farinha de peixe (FM) como: 0%, 25%, 50% e 75%. Essas quatro dietas foram suplementadas por níveis variados de fitase (0 e 750 FTU kg-1) e ácido cítrico (0% e 2,5%) para formular um total de 16 dietas de teste como T1, T2, T3, T4, T5, T6, T7, T8, T9, T10, T11, T12, T13, T14, T15 e T16. Cada tratamento continha três repetições; aplicado a grupos de peixes com 15 alevinos cada; seguindo o arranjo fatorial 3 × 3. 1% de óxido crômico foi adicionado como um marcador inerte. % de ganho de peso máximo (288%) e o valor mais baixo de FCR (1,07) foram registrados quando os peixes foram alimentados com dieta T12 em comparação com peixes alimentados com dieta controle (T1). Da mesma forma, valores ótimos de digestibilidade de nutrientes, como proteína bruta (77%), gordura bruta (84%) e energia bruta (70%) foram anotados no mesmo nível. Concluiu-se que 50% da farinha de canola pode substituir de forma ideal a farinha de peixe quando suplementada com fitase e ácido cítrico nos níveis de 750 FTU kg-1 e 2,5%, respectivamente.

Efectividad de anticoagulación regional con citrato en terapia de reemplazo renal continua / Effectiveness of regional citrate anticoagulation in continuous renal replacement therapy

BACKGROUND: Anticoagulation in continuous renal replacement therapy (CRRT) is essential to counteract the coagulation cascade activation, induced by the dialysis circuit. Heparin is the most widely used anticoagulant, followed by regional citrate anticoagulation (RCA). AIM: To determine the effectiveness and safety of anticoagulant treatment with citrate in CRRT. Material and Methods: Retrospective study of adults in CRRT hospitalized between the years 2014 and 2020 in critical units, who required change to RCA according to established protocols. RESULTS: We studied 24 patients aged 63 ± 13 years (12 females). The reasons for admission were acute kidney injury (AKI) in 80% and stage 5 chronic kidney disease in 20%. The indication of RCA in 75% of patients was by coagulation of more than 3 circuits in 24 hours. The duration of the circuit in RCA was 18.5 ± 4.8 hours versus 11.9 ± 4.9 hours with heparin (p < 0.0001). There were 19 mild complications that did not affect the RCA. Conclusions: RCA is feasible to perform, it is a safe and efficient procedure if it is protocolized, allowing a longer duration of the dialysis circuit.

Application effects of bundle nursing of citric acid extracorporeal anticoagulation on continuous renal replacement therapy of severe burn patients / 中华烧伤杂志

Objective: To explore the application effects of bundle nursing of citric acid extracorporeal anticoagulation on continuous renal replacement therapy (CRRT) of severe burn patients. Methods: A non-randomized controlled study was conducted. Forty-six patients who met the inclusion criteria and received regular nursing of citric acid extracorporeal anticoagulation during CRRT in the First Affiliated Hospital of Army Medical University (the Third Military Medical University) from January to December 2017 were included in regular nursing group (30 males and 16 females, aged 42.0 (38.7,47.0) years, with 201 times of CRRT performed), and 48 patients who met the inclusion criteria and received bundle nursing of citric acid extracorporeal anticoagulation during CRRT in the same hospital from January to December 2018 were included in bundle nursing group (32 males and 16 females, aged 41.0 (36.0,46.0) years, with 164 times of CRRT performed). The clinical data of all the patients in the two groups were recorded, including the length of intensive care unit (ICU) stay, total cost of treatment in ICU, cost of CRRT, unplanned ending of treatment, ending of treatment due to operation (with the rates of unplanned ending of treatment and ending of treatment due to operation calculated), times of disposable hemodialysis filter and supporting pipeline filter (hereinafter referred to as filter) with use time>24 h, times of CRRT, and lifetime of filter. For the patients in both groups who continuously received CRRT for 3 days or more from the first treatment, the prothrombin time (PT), activated partial thromboplastin time (APTT), international normalized ratio (INR), total calcium, ionic calcium (with the difference of total calcium or ionic calcium between before and after treatment calculated), creatinine, urea, β2 microglobulin, cystatin C, platelet count, mean arterial pressure, pH value, oxygenation index, bicarbonate radical, and lactic acid levels before the first treatment (hereinafter referred to as before treatment) and 3 days after the first treatment (hereinafter referred to as after 3 days of treatment). The treatment-related complications of all patients in the two groups were recorded during hospitalization. Data were statistically analyzed with independent sample t test, Mann-Whitney U test, and chi-square test. Results: Compared with those in regular nursing group, the length of ICU stay was significantly shortened (Z=-4.71, P<0.01), the total cost of treatment in ICU was significantly reduced (t=-1.39, P<0.01), the cost of CRRT had no significant change (P>0.05), the rates of unplanned ending of treatment and ending of treatment due to operation were both significantly decreased (with χ2 values of 12.20 and 17.83, respectively, P<0.01), the times of filter service time>24 h was increased significantly (Z=-5.93, P<0.01), the times of CRRT were significantly reduced (Z=-4.75, P<0.01), and the filter service life was significantly prolonged (Z=-9.24, P<0.01) among patients in bundle nursing group. Thirty-one patients in bundle nursing group and 28 patients in regular nursing group continuously received CRRT for 3 days or more from the first treatment. Before treatment, PT, APTT, and INR of patients in bundle nursing group were 24.10 (16.08, 39.20) s, 38.81 (32.32, 45.50) s, and 1.17 (1.12, 1.19), respectively, similar to 31.75 (22.99, 40.96) s, 41.82 (35.05, 48.06) s, and 1.15 (1.11, 1.19) of patients in regular nursing group (P>0.05); the levels of total calcium and ionic calcium of patients in the two groups were similar (P>0.05). After 3 days of treatment, PT, APTT, and INR of patients in bundle nursing group and regular nursing group were 29.06 (20.11, 39.46) s, 35.25 (30.06, 40.28) s, 1.13 (1.09, 1.17) and 36.51 (26.64, 42.92) s, 39.89 (34.81, 46.62) s, 1.14 (1.10, 1.18), respectively, similar to those before treatment (P>0.05); the level of ionic calcium of patients in regular nursing group was significantly higher than that before treatment (Z=-2.08, P<0.05); the levels of total calcium and ionic calcium of patients in bundle nursing group were both significantly higher than those before treatment (with Z values of -3.55 and -3.69, respectively, P<0.01); compared with those in regular nursing group, APTT of patients was significantly shorter (Z=-2.29, P<0.05), while the total calcium level of patients was significantly higher in bundle nursing group (Z=-2.26, P<0.05). The difference of total calcium between before and after treatment of patients in bundle nursing group was significantly higher than that in regular nursing group (Z=-3.15, P<0.01). The differences of ionic calcium between before and after treatment of patients in the two groups were similar (P>0.05). Before treatment, the level of β2 microglobulin of patients in bundle nursing group was significantly higher than that in regular nursing group (Z=-2.84, P<0.01), the platelet count of patients in bundle nursing group was significantly lower than that in regular nursing group (Z=-2.44, P<0.05), while the levels of creatinine, urea, cystatin C, mean arterial pressure, pH value, oxygenation index, bicarbonate radical, and lactic acid of patients in the two groups were similar (P>0.05). After 3 days of treatment, the levels of creatinine, urea, β2 microglobulin, cystatin C, pH value, bicarbonate radical, and lactic acid of patients were all significantly lower than those before treatment (with Z values of -2.10, -2.90, -3.11, -2.02, -2.34, -2.63, and -2.84, respectively, P<0.05 or P<0.01), while the levels of platelet count, oxygenation index, and mean arterial pressure of patients were all significantly higher than those before treatment in bundle nursing group (with Z values of -6.65 and -2.40, respectively, t=-9.97, P<0.05 or P<0.01); the levels of creatinine, urea, β2 microglobulin, cystatin C, platelet count, pH value, bicarbonate radical, and lactic acid of patients were all significantly lower than those before treatment (with Z values of -5.32, -2.31, -2.41, -2.21, -3.68, -2.93, -2.20, and -2.31, respectively, P<0.05 or P<0.01), while the oxygenation index and mean arterial pressure of patients were both significantly higher than those before treatment in regular nursing group (Z=-5.59, t=-7.74, P<0.01). After 3 days of treatment, compared with those in regular nursing group, the levels of creatinine, cystatin C, platelet count, oxygenation index, bicarbonate radical, and mean arterial pressure of patients were all significantly higher (with Z values of -2.93, -1.99, -6.39, -2.09, and -2.52, respectively, t=-3.28, P<0.05 or P<0.01), while the levels of urea, β2 microglobulin, pH value, and lactic acid of patients were all significantly lower (with Z values of -3.87, -2.58, -4.24, and -2.75, respectively, P<0.05 or P<0.01) in bundle nursing group. During hospitalization, there were no treatment-related bleeding events or hypernatremia related to citric acid treatment of patients in the two groups. The ratio of total calcium to ionic calcium in one patient in bundle nursing group was >2.5, but there was no manifestation of citric acid accumulation poisoning; 1 patient had hypoionic calcemia, and 1 patient had severe metabolic alkalosis. Five patients had hypoionic calcemia and 2 patients had severe metabolic alkalosis in regular nursing group. Conclusions: The implementation of bundle nursing of citric acid extracorporeal anticoagulation during CRRT for severe burn patients shortens the length of ICU stay, reduces the total cost of treatment in ICU and the occurrence of treatment-related complications, relieves the economic burden of patients, and improves the continuity and quality of treatment.

Efeitos do citrato de clomifeno, letrozol e estradiol sobre apoptose em células do cumulus oophorus humano / Effects of clomiphene citrate, letrozole and estradiol on apoptosis in human cumulus oophorus cells

Citrato de clomifeno (CC) e letrozol (LE) são indutores de ovulação que, apesar das altas taxas de ovulação confirmada, atingem baixas taxas de gravidez. Este estudo teve como objetivo investigar os efeitos de CC e LE in vitro, isoladamente ou em combinação com estradiol (E), na apoptose de células do cumulus oophorus humano. Realizamos um estudo prospectivo controlado utilizando culturas primárias de células do cumulus de pacientes submetidas à fertilização in vitro (n=22). A coloração com Giemsa e a imunocitoquímica para alfa-inibina foram utilizadas para avaliar a pureza e a morfologia da cultura celular. A viabilidade celular foi avaliada pelo ensaio MTT, o ciclo celular por citometria de fluxo e a expressão gênica de Caspase-3, Bax e Superóxido dismutase 2 (SOD-2) e S26 por reação em cadeia de polimerase (PCR) em tempo real. As células foram tratadas por 24 horas em 5 grupos de tratamento: CC, CC + E, LE, LE + E e controle. Nenhum dos tratamentos afetou a viabilidade celular, mas o LE reduziu a porcentagem média de células na fase S em relação ao controle (24,79 versus 21,70, p=0,0014). O tratamento com CC aumentou a expressão gênica de Bax (4 vezes) e SOD-2 (2 vezes), que foi revertida quando adicionado E à cultura. A expressão de SOD-2 aumentou em células tratadas com LE quando comparado ao controle (4 vezes), que foi também revertida por adição de E. Estes achados sugerem que CC e LE não afetam significativamente a viabilidade das células do cumulus humana. Porém, houve modulação na expressão de genes envolvidos na apoptose por essas drogas isoladamente e em associação com E, sugerindo que CC e LE podem ter efeitos diretos nas células do cumulus além de seus mecanismos de ação conhecidos.

Clomiphene citrate (CC) and letrozole (LE) are ovulatory stimulants that, despite high ovulation rates, achieve low pregnancy rates. This study aimed to investigate the in vitro effects of CC and LE, alone or in combination with estradiol (E), on apoptosis in human cumulus cells. We performed a controlled prospective study using primary cumulus cell cultures from patients undergoing in vitro fertilization (n=22). Giemsa stain and alpha-inhibin immunocytochemistry was used to assess cell culture purity and morphology. Cell viability was evaluated by MTT assay, cell cycle status by flow cytometry, and Caspase-3, Bax and superoxide dismutase 2 (SOD-2), and S26 gene expression by real-time polymerase chain reaction (qPCR). Cells were treated for 24 hours in 5 conditioned media: CC, CC + E, LE, LE + E and control. None of the treatments affected cell viability, but LE reduced the mean percentage of cells in the S phase compared to control (24.79 versus 21.70, p=0.0014). CC treatment increased mRNA expression of Bax (4 fold) and SOD-2 (2 fold), which was reversed by co-treatment with E. SOD-2 expression increased in cells treated with LE compared to control (4 fold), which was also reversed by E. These findings suggest that CC and LE do not significantly affect the viability of human cumulus cells. Still, the expression of genes involved in apoptosis was modulated by these drugs alone and in association with E, suggesting that CC and LE may have direct effects on cumulus cells beyond their known mechanisms of action.

Enamel Deproteinization: Will It Save The Shear Bond Strength For The Sake Of Preventing White Spot Lesions? / Desproteinização do esmalte: salvará a resistência ao cisalhamento para prevenir lesões de manchas brancas?

Objective: This study attempted to investigate the effect of enamel deproteinization using citric acid, PEG 400 and NaOCL on the shear bond strength of orthodontic brackets to enamel using nano-silver modified resin for the prevention of white spot lesions. Material and Methods: 68 premolars were used in the study; nano-silver modified adhesive resin was used to bond orthodontic brackets to the enamel. Specimens were divided into 4 groups according to the applied surface treatment before bonding. Group I (control): acid etching with 37% phosphoric acid. Group II: deproteinization using 5.25% sodium hypochlorite (NaOCl) before acid etching. Group III:deproteinization using 10% citric acid before acid etching. Group IV:deproteinization using 5% polyethylene glycol (PEG 400) before acid etching. The specimens were then thermo- cycled for 6000 cycles. They were examined for surface roughness, shear bond strength and using electron microscope. Results: In both surface roughness and shear bond strength tests, Group III (citric acid) showed the highest values, followed by Group II (sodium hypochlorite); (p < 0.001). The least values were shown for Groups I (control) and IV (PEG 400), with no statistically significant difference between them (p = 0.948). SEM revealed etching pattern type 1 and 2 in the citric acid group while PEG 400 showed shallower micro- porosities. Conclusions: Deproteinization of enamel using either NaOCl or citric acid increased the bond strength of nano-sliver modified resin to enamel, with citric acid showing greater increase in bond strength. Deproteinization using PEG 400 did not increase the bond strength. (AU)

Objetivo: Este estudo buscou investigar o efeito da desproteinização do esmalte utilizando ácido cítrico, PEG 400 e NaOCl na resistência ao cisalhamento de braquetes ortodônticos ao esmalte usando resina modificada com nanoprata para a prevenção de lesões de manchas brancas. Material e Métodos: 68 pré-molares foram usados no estudo; resina adesiva modificada com nanoprata foi usada para colar os braquetes ortodônticos ao esmalte. Os corpos-de-prova foram divididos em 4 grupos de acordo com o tratamento de superfície aplicado antes da colagem. Grupo I (controle): condicionamento ácido com ácido fosfórico a 37%. Grupo II: desproteinização com hipoclorito de sódio a 5,25% (NaOCl) antes do condicionamento ácido. Grupo III: desproteinização com ácido cítrico a 10% antes do condicionamento ácido. Grupo IV: desproteinização com polietilenoglicol 5% (PEG 400) antes do condicionamento ácido. As amostras foram então termocicladas por 6.000 ciclos. Eles foram examinados quanto à rugosidade da superfície, resistência ao cisalhamento e usando microscópio eletrônico. Resultados: Nos testes de rugosidade superficial e resistência ao cisalhamento, o Grupo III (ácido cítrico) apresentou os maiores valores, seguido do Grupo II (hipoclorito de sódio); (p <0,001). Os menores valores foram apresentados para os Grupos I (controle) e IV (PEG 400), sem diferença estatisticamente significativa entre eles (p = 0,948). A microscopia eletrônica revelou padrão de ataque tipo 1 e 2 no grupo de ácido cítrico, enquanto PEG 400 mostrou microporosidades mais rasas. Conclusões: A desproteinização do esmalte com NaOCl ou ácido cítrico aumentou a força de união da resina modificada com nanoprata ao esmalte, com o ácido cítrico apresentando maior aumento na força de união. A desproteinização usando PEG 400 não aumentou a resistência de união. (AU)

Sodium fluoroacetate poisoning: A case report / Intoxicación por fluoroacetato de sodio, un reporte de caso

Abstract Introduction: Sodium fluoroacetate, known as compound 1080, was discovered in Germany during the Second World War. It is usually used as a rodenticide, it is an odorless and tasteless substance, with a lethal dose in humans of 2 mg / kg that is why it was withdrawn from the market in some countries, including Colombia; however, it is obtained illegally. This substance has biochemical and physiological effects at the cellular level that alter the transport of citrate at the mitochondrial level, generating accumulation of lactic acid and alteration of the glucose use. The clinical manifestations are nonspecific since there is no any cardinal symptom. Therefore, its diagnosis is made due to high clinical suspicion associated with establishment of exposure to the compound in view of the difficulty to obtain paraclinical confirmation in a timely manner. Methods: We present a case report of intentional ingestion of sodium fluoroacetate in an adolescent that is associated with an infection added to the bloodstream by methicillin- sensitive Staphylococcus aureus (MSSA). The patient developed multiple complications that lead to support in the Intensive Care Unit (ICU) with a satisfactory outcome. In view of the lack of a specific antidote, she was treated with ethanol in order to increase the level of acetate; thus, offering an alternative substrate to the Krebs cycle. It is suggested that the ethanol offers benefits in the acute treatment of these patients. Results: The patient with sodium fluoroacetate poisoning and kidney failure received renal replacement therapy with a favorable evolution and survival at discharge from the intensive care unit of a third-level hospital in the city of Pereira, Risaralda, Colombia. Conclusions: Sodium fluoroacetate poisoning is relatively rare and can cause acute kidney injury and multi-organ failure with a high rate of complications and death. A case of self-inflicted poisoning that received a timely manner continuous renal replacement therapy with a favorable outcome in terms of ICU survival was presented.

Resumen Introducción: El fluoroacetato de sodio ⎯conocido como compuesto 1080⎯, fue descubierto en Alemania durante la segunda guerra mundial, suele ser utilizado como raticida y se caracteriza por ser una sustancia inodora e insabora. En humanos, una dosis de 2 a mg/kg es letal; debido a su toxicidad fue retirado del mercado en algunos países, incluyendo Colombia, no obstante, se consigue de forma ilegal. Esta sustancia tiene efectos bioquímicos y fisiológicos a nivel celular que altera el transporte del citrato a nivel mitocondrial, generando acumulación de ácido láctico y alteración en la utilización de la glucosa. Las manifestaciones clínicas son inespecíficas y no existe un síntoma cardinal. Por ende, su diagnóstico se realiza por alta sospecha clínica, asociado al establecimiento de la exposición al compuesto, ya que la confirmación paraclínica es difícil de realizar oportunamente. Métodos: Se presenta un reporte de caso de ingestión intencional en un adolescente, asociado con infección agregada al torrente sanguíneo por Estafilococos Aureos Meticilino Sensible (EAMS). El paciente desarrolló múltiples complicaciones y requirió asistencia en Unidad de Cuidados Intensivos (UCI) con desenlace satisfactorio. Ya que no se cuenta con antídoto específico , se le dio tratamiento con etanol para aumentar el nivel de acetato, ofreciendo así un sustrato alterno al ciclo de Krebm. Se estima que el etanol puede ofrecer beneficios en el tratamiento agudo de estos pacientes. Resultados: Paciente con intoxicación por fluoroacetato de sodio e insuficiencia renal, recibe terapia de reemplazo renal con un evolución favorable y supervivencia al alta de la Unidad de Cuidados Intensivos de un hospital de tercer nivel en la ciudad de Pereira, Risaralda, Colombia. Conclusiones: La intoxicación por fluoroacetato de sodio es relativamente poco frecuente y puede causar injuria renal aguda y falla multiorgánica con alta tasa de complicaciones y muerte. Se presentó un caso de intoxicación autoinfligida que recibió terapia de reemplazo renal continua temprana con un desenlace favorable en términos de supervivencia en la UCI.

No inferioridad entre dos agentes de bajo volumen (picosulfato de sodio/citrato de magnesio frente al sulfato de sodio/potasio/magnesio) en la preparación del colon para procedimientos diagnósticos: estudio observacional / Non-inferiority between two low-volume agents (sodium picosulfate/magnesium citrate vs. sodium sulfate/potassium/magnesium) to prepare the bowel for diagnostic procedures: an observational study

Resumen Introducción: el cáncer colorrectal es un problema de salud pública; sin embargo, la detección temprana reduce su morbimortalidad. La colonoscopia es el procedimiento de elección para detectar lesiones premalignas y el éxito depende de una limpieza adecuada. El objetivo es evaluar el desempeño de dos preparaciones de bajo volumen empleados en un hospital de alto nivel. Materiales y métodos: estudio prospectivo en adultos que asistieran a colonoscopia en la Fundación Santa Fe de Bogotá, Colombia. Las preparaciones se evaluaron con la escala de Boston, con puntaje ≥ 6 puntos para una limpieza adecuada. Se realizó un análisis de regresión logística para establecer la efectividad de los medicamentos con un cálculo de no inferioridad del 3 %-5 %. Resultados: 598 pacientes fueron evaluados. El 49 % (293) fue expuesto al picosulfato de sodio/citrato de magnesio y el 51 % (305) fue expuesto al sulfato de sodio/potasio/magnesio. Con un promedio de Boston de 6,98 ± 1,86 (78 % con puntaje de Boston ≥ 6) y 7,39 ± 1,83 (83 %), respectivamente (p = 0,649). Según el análisis de la presencia y frecuencia de síntomas no deseados, el picosulfato fue mejor tolerado (p < 0,001). Conclusiones: los estudios de preparación intestinal en pacientes de un escenario real son muy escasos. Los medicamentos de bajo volumen obtuvieron una efectividad global y por segmento de colon similar, confirmando la no-inferioridad; el picosulfato de sodio/citrato de magnesio fue mejor tolerado. Un estudio de costo-efectividad podría definir esto según las necesidades de la población de estudio.

Abstract Introduction: Colorectal cancer is a public health problem; however, early detection reduces morbidity and mortality. Colonoscopy is the procedure of choice for detecting precancerous lesions, and success depends on proper bowel cleansing. Objective: To evaluate the performance of two low-volume agents used in a high-level hospital. Materials and methods: Prospective study in adults who underwent colonoscopy at the Fundación Santa Fe in Bogotá, Colombia. Preparations were evaluated using the Boston Bowel Preparation Scale. A score ≥6 points indicated adequate preparation. A logistic regression analysis was carried out to establish the effectiveness of the medicines with a non-inferiority ratio of 3-5%. Results: 598 patients were evaluated. 49% (293) received sodium picosulfate/magnesium citrate and 51% (305) received sodium sulfate/potassium/magnesium, with an average Boston score of 6.98±1.86 (78% Boston ≥6) and 7.39±1.83 (83%), respectively (p=0.649). According to the analysis of the presence and frequency of unwanted symptoms, picosulfate was better tolerated (p < 0.001). Conclusions: Bowel preparation studies in patients from a real-life scenario are scarce. Low-volume agents had similar overall and segmental effectiveness in the colon, confirming non-inferiority; sodium picosulfate/magnesium citrate was better tolerated. A cost-effectiveness study could establish the best option according to the needs of the study population.

The Effect of 17% Ethylenediaminetetraacetic Acid and 10% Citric Acid Solutions with Manual and Ultrasonic Agitation on Smear Layer Removal and Intraradicular Dentine Erosion: A Scanning Electron Microscope Evaluation

This study evaluated the ex vivo effectiveness of different final irrigation protocols in smear layer removal and intraradicular dentine erosion. Thirty five extracted human canines were instrumented and randomly divided, according to final rinse techniques used, into 7 groups: 1 (ED3M) and 3 (ED3US), 17% EDTA for 3 minutes with manual and ultrasonic agitation, respectively; 2 (CA30M) and 4 (CA30US), 10% citric acid for 30 seconds with manual and ultrasonic agitation, respectively; 5 (CA3M) and 6 (CA3US), 10% citric acid for 3 minutes with manual and ultrasonic agitation, respectively; and, 7 (Na3), 5.25% NaOCl for 3 minutes without agitation (control). All specimens then were irrigated with 5.25% NaOCl, split lengthwise, and examined under scanning electron microscopy (SEM) in apical, middle and coronal thirds. Data were analyzed with Kruskal-Wallis and Mann-Whitney tests. The effectiveness of 17% EDTA and 10% citric acid in removing smear layer was significantly greater than 5.25% NaOCl (control). There were no significant differences among final irrigation protocols in smear layer removal or erosive effects. However, when comparing the thirds in groups 1 (ED3M) and 2 (CA30M), the least smear layer removal and erosion was seen in the apical third, but the group 4 procedure (CA30US) was more effective than 1 (ED3M) (p=0.0004), 2 (CA30M) (p=0.0018) or 3 (ED3US) (p=0.0003) in smear layer removal for the apical third. It was concluded that protocols used in this study were similar in smear layer removal and erosive effects.

Seminal citrate is superior to PSA for detecting clinically significant prostate cancer

ABSTRACT Purpose: To establish whether the citrate concentration in the seminal fluid ([CITRATE]) measured by means of high-resolution nuclear magnetic resonance spectroscopy (1HNMRS) is superior to the serum prostate-specific antigen (PSA) concentration in detecting of clinically significant prostate cancer (csPCa) in men with persistently elevated PSA. Materials and Methods: The group of patients consisted of 31 consecutively seen men with histological diagnosis of clinically localized csPCa. The control group consisted of 28 men under long-term follow-up (mean of 8.7 ± 3.0 years) for benign prostate hyperplasia (BPH), with persistently elevated PSA (above 4 ng/mL) and several prostate biopsies negative for cancer (mean of 2.7 ± 1.3 biopsies per control). Samples of blood and seminal fluid (by masturbation) for measurement of PSA and citrate concentration, respectively, were collected from patients and controls. Citrate concentration in the seminal fluid ([CITRATE]) was determined by means of 1HNMRS. The capacities of PSA and [CITRATE] to predict csPCa were compared by means of univariate analysis and receiver operating characteristic (ROC) curves. Results: Median [CITRATE] was significantly lower among patients with csPCa compared to controls (3.93 mM/l vs. 15.53 mM/l). There was no significant difference in mean PSA between patients and controls (9.42 ng/mL vs. 8.57 ng/mL). The accuracy of [CITRATE] for detecting csPCa was significantly superior compared to PSA (74.8% vs. 54.8%). Conclusion: Measurement of [CITRATE] by means of 1HNMRS is superior to PSA for early detection of csPCa in men with elevated PSA.

Acondicionamiento radicular en el tratamiento periodontal no quirúrgico y quirúrgico / Root conditioning in non-surgical and surgical periodontal therapy

La instrumentación mecánica durante el tratamiento periodontal trae consigo la formación de escombros microcristalinos que inhiben la adhesión tisular a la superfi cie radicular y favorece la proliferación bacteriana, lo cual perjudica los resultados del tratamiento periodontal a corto y largo plazo. Hoy en día el acondicionamiento radicular con el uso de biomodifi cadores es una opción de tratamiento adicional en el tratamiento de la periodontitis y el tratamiento de cobertura radicular. El objetivo del presente estudio es realizar una revisión de la literatura acerca de las aplicaciones y del acondicionamiento radicular con ácido cítrico, tetraciclina, EDTA y láser en el tratamiento periodontal no quirúrgico y quirúrgico (AU)

Mechanical instrumentation during periodontal treatment brings the formation of microcrystalline debris that inhibits tissue adhesion to the root surface and favors bacterial proliferation, which harms the results of the short and long term periodontal treatment. Nowadays, root conditioning with the use of biomodifi cators is an additional treatment option in the treatment of periodontitis and root coverage therapy. The aim of the present study is to conduct a literature review about the applications and the root conditioning with citric acid, tetracycline, EDTA and laser in the non surgical and surgical periodontal treatment (AU)

Ácidos orgânicos, alfa-tocoferol em polpa de goiaba araçá / Organic acids, alpha-tocoferol in polpa of araçá guava

As frutas são constituídas por substâncias que exercem ação antioxidante, dentre tais substâncias estão incluídas as vitaminas. Os ácidos orgânicos mais comuns e presentes em frutas são: ácido ascórbico e ácido cítrico. Tais ácidos orgânicos bem como os tocoferóis ocorrem de forma natural nos alimentos e são potentes antioxidantes que possuem a capacidade de eliminar diversos radicais livres. O presente estudo teve como objetivo identificar e quantificar ácidos orgânicos (ascórbico e cítrico) e α-tocoferol presentes na polpa da goiaba araçá fazendo-se uso da Cromatografia Líquida de Alta Eficiência (CLAE). Os teores de ácido ascórbico e ácido cítrico encontrados no presente estudo foram de 2,501 mg.g-1 e 9,240 mg.g-1, respectivamente, enquanto que o teor α-tocoferol foi de 3,399 µg.g-1. Comparadas a outras frutas, os teores de ácidos orgânicos e α-tocoferol encontrados no presente estudo indicam que a goiaba araçá é rica em compostos antioxidantes.

Safety of blood mixture transfusion by rapid infusion device in liver transplantation recipients

BACKGROUND: Information on biochemical changes following rapid transfusion of blood mixtures in liver transplantation patients is limited. METHODS: A blood mixture composed of red blood cells, fresh frozen plasma, and 0.9% saline was prepared in a ratio of 1 unit:1 unit:250 ml. During massive hemorrhage, 300 ml of the blood mixture was repeatedly transfused. A blood mixture sample as well as pre- and post-transfusion arterial blood samples were collected at the first, third, fifth, and seventh bolus transfusions. Changes in pH, hematocrit, electrolytes, and glucose were measured with a point-of-care analyzer. The biochemical changes were described, and the factors driving the changes were sought through linear mixed effects analysis. RESULTS: A total of 120 blood samples from 10 recipients were examined. Potassium and sodium levels became normalized during preservation. Biochemical changes in the blood mixture were significantly related to the duration of blood bank storage and reservoir preservation (average R2 = 0.41). Acute acidosis and hypocalcemia requiring immediate correction occurred with each transfusion. Both the pre-transfusion value of the patient and the blood mixture value were significant predictors of post-transfusion changes in the body (average R2 = 0.87); however, the former was more crucial. CONCLUSIONS: Rapid infusion of blood mixture is relatively safe because favorable biochemical changes occur during storage in the reservoir, and the composition of the blood mixture has little effect on the body during rapid transfusion in liver recipients. However, acute hypocalcemia and acidosis requiring immediate correction occurred frequently due to limited citrate metabolism in the liver recipients.

Effect of Citric Acid on Accuracy of ¹³C-Urea Breath Test after Helicobacter pylori Eradication Therapy in a Region with a High Prevalence of Atrophic Gastritis

BACKGROUND/AIMS: The validity of ¹³C-urea breath test (¹³C-UBT) for Helicobacter pylori detection is influenced by atrophic gastritis. The aim of this study was to evaluate the effect of citric acid on the accuracy of ¹³C-Urea breath test after H. pylori eradication therapy in a region where atrophic gastritis is common. METHODS: In this prospective study, H. pylori-positive patients received ¹³C-UBT after H. pylori eradication regimen. They were classified into citric acid group and control group. To determine diagnostic accuracy of ¹³C-UBT, patients were offered invasive methods. RESULTS: A total of 1,207 who successfully took H. pylori-eradication regimen received UBT. They were assigned into the citric acid group (n=562) and the control group (n=645). The mean ¹³C-UBT value of the citric acid group was 10.3±26.4‰, which was significantly (p<0.001) higher than that of that control group (5.1‰±12.6‰). Of these patients 122 patients were evaluated by endoscopic biopsy methods. Based on invasive tests, the accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of ¹³C-UBT for the citric acid group were 83.3%, 91.7%, 81.3%, 55.0%, and 97.5%, respectively. Those of the control group were 87.7%, 90.9%, 88.2%, 62.5%, and 97.8%, respectively. They were not significantly different between the two groups. Although the presence of gastric atrophy and intestinal metaplasia (IM) decreased the accuracy, the decrease was not significant. CONCLUSIONS: In a country with high prevalence of atrophic gastritis or IM, false positivity remained common despite the use of citric acid in ¹³C-UBT.

Is a Citric Acid Meal Useful for Increasing Accuracy of the ¹³C-Urea Breath Test in Asian Populations?

No abstract available.