Effect of Triflusal on Primary Vascular Dysregulation Compared with Aspirin: A Double-Blind, Randomized, Crossover Trial

PURPOSE: Primary vascular dysregulation (PVD) is a condition in which the response to cold temperature or external stimuli is abnormal. We investigated whether triflusal use results in amelioration of PVD symptoms and improvement of several related parameters compared with aspirin. MATERIALS AND METHODS: Eighty-eight PVD patients (54% female, 56+/-8 years) were randomly selected to receive either triflusal (300 mg, b.i.d.) or aspirin (150 mg, b.i.d.) for a period of 6 weeks followed by crossover. PVD was defined as both red-blood-cell standstill in video-assisted microscopic capillaroscopy during cold stimulation using carbon dioxide gas and a score of more than 7 points in a validated questionnaire. Efficacy of treatment was assessed by 1) cold intolerance symptom severity (CISS) score, 2) finger Doppler indices, and 3) indocyanine green perfusion imaging. RESULTS: The use of triflusal resulted in a greater improvement in CISS score (44.5+/-18.4 vs. 51.9+/-16.2; p<0.001) and in mean radial peak systolic velocity (69.8+/-17.2 vs. 66.1+/-16.4; p=0.011) compared to aspirin. Furthermore, significant differences were also observed in perfusion rates on indocyanine green perfusion imaging between triflusal and aspirin (45.6+/-25.8 vs. 51.6+/-26.9; p=0.020). CONCLUSION: Triflusal was more effective and demonstrated a more consistent impact on the improvement of symptoms and blood flow in patients with PVD than aspirin.

Retocolite ulcerativa não complicada / Ulcerative colitis not complicated

Retocolite ulcerativa inespecífica (RCU) e doença de Crohn (DC) são consideradas as principais doenças inflamatórias intestinais idiopáticas (DIIs). De etiologia ainda desconhecida, evoluem, clinicamente, por surtos recorrentes, intercalando episódios de atividade inflamatória, acompanhados de manifestações digestivas e extradigestivas, com períodos de remissão, ambos imprevisíveis...

Nonspecific ulcerative recolitis (NUC) and Chron's Disease (CD) are considered the mainly idiopathic inflammatory bowel disease (IBD). Etiology unknown, the nonspecific ulcerative recolitis has a clinical proceed, by recurrent outbreaks, episodes of intercalated inflammatory activity, following by digestive and extra digestive symptoms, with period of remission, both of them are unpredictable...

Effect of MTA-based sealer on the healing of periapical lesions

Some manufacturers have recently added specific components to improve the ease of handling and insertion material properties of MTA in order to create MTA-based sealers. Objective The aim of this study was to evaluate the healing of periapical lesions in canine teeth after a single session of endodontic treatment with MTA Fillapex® compared with Sealapex® or Endo-CPM-Sealer®. Material and Methods Sixty-two root canals were performed on two 1-year-old male dogs. After coronal access and pulp extirpation, the canals were exposed to the oral cavity for 6 months in order to induce periapical lesions. The root canals were prepared, irrigated with a solution of 2.5% sodium hypochlorite and filled with gutta-percha and different sealers, according to the following groups: 1) Sealapex®; 2) Endo-CPM-Sealer®; and 3) MTA Fillapex®. Some teeth with periapical lesions were left untreated for use as positive controls. Healthy teeth were used as negative controls. After 6 months, the animals were sacrificed and serial sections from the roots were prepared for histomorphologic analysis and stained with hematoxylin and eosin and the Brown and Brenn technique. The lesions were scored according to pre-established histomorphologic parameters and the scores statistically analyzed using the Kruskal-Wallis test. Results All 3 materials produced similar patterns of healing (p>0.05); in particular, persistent inflammation and absence of complete periapical tissue healing were consistently noted. Conclusions Preparation of the infected root canals followed by filling with the materials studied was insufficient to provide complete healing of the periapical tissues. .

Sealing Ability of MTA Used as a Root End Filling Material: Effect of the Sonic and Ultrasonic Condensation

Despite the excellent properties of mineral trioxide aggregate (MTA), the condensation technique may have some influence in its sealing ability. The purpose of this study was to compare the sealing ability of sonic and ultrasonic setting of MTA. Thirty-four extracted human teeth had their canals prepared and filled with Sealapex sealer and gutta-percha using the active lateral condensation technique. The teeth were rendered waterproof and apicoectomy performed at 3 mm from the apex. Root-end cavities (3.0 mm deep and 1.4 mm diameter) were prepared with diamond ultrasonic tips. The root-end cavities were filled with Pro-Root MTA® with ultrasonic vibration, sonic vibration or no vibration. The positive control group did not receive any material while the negative control group was totally rendered waterproof. After material set, the specimens were immersed in Rodhamine B for 24 h, under vacuum in the first 15 min, then washed, dried and split longitudinally for evaluating the infiltration at the dentin/material interface. Data were analyzed using ANOVA and Tukey's tests at 5% significance level. Sonic vibration promoted the lowest infiltration values (p<0.05). It was concluded that sonic vibration could be considered an efficient aid to improve the sealing ability of MTA when used as root-end filling material.

Resumo O objetivo deste estudo foi avaliar in vitro, a influência da vibração sônica e ultrassônica no selamento marginal proporcionado pelo MTA. Trinta e quatro dentes humanos tiveram seus canais radiculares instrumentados e obturados com cimento Sealapex® pela técnica da condensação lateral ativa. Os dentes foram impermeabilizados e seccionados os 3 mm apicais. Retrocavidades (3 mm de profundidade e 1,4 mm de diâmetro) foram preparadas com pontas ultrassônicas diamantadas. As retrocavidades foram preenchidas com Pro-Root MTA® com auxílio da vibração ultrassônica, com auxílio da vibração sônica e sem vibração alguma. O grupo controle positivo não recebeu material retrobturador, enquanto que o negativo foi totalmente impermeabilizado. Após a presa do material, os espécimes foram mergulhados em Rodamina B por 15 min em vácuo, permanecendo nesta solução por mais 24 h. Em seguida, foram lavados, secados e clivados longitudinalmente para avaliação da infiltração do corante na interface dentina/material retrobturador. Os dados foram analisados utilizando a análise de variância e o teste de Tukey (p<0,05). Observou-se que apenas a vibração sônica foi diferente apresentando os menores índices de infiltração. Pode-se concluir que vibração sônica contribui com a melhora da capacidade de selamento marginal proporcionado pelo MTA quando empregado como material retrobturador. .

Effect of immediate and delayed post space preparation on the apical seal of root canals obturated with different sealers and techniques

During mechanical preparation of the post space, the root canal filling may be twisted or vibrated, depending on several factors associated with the preparation technique and quality of filling. OBJECTIVE: The purpose of this study was to investigate the effect of immediate and delayed post space preparation on the integrity of the apical seal. MATERIAL AND METHODS: Sixty-four extracted human incisors were biomechanically prepared using the step-back technique. Sixty roots were randomly assigned to 6 experimental groups of 10 teeth each and the remaining 4 roots served as positive and negative controls (n=2). The root canals in the different groups were obturated with cold lateral and warm vertical condensation of gutta-percha and one of two sealers (Sealapex and Diaket). Post space was prepared either individually or simultaneously. An insulated copper wire was cut into 10-cm-long pieces. In each canal, one piece was inserted to maintain contact with gutta-percha and extended to the outside as one of two working electrodes. A stainless steel wire with the same dimensions of those of the copper wire, used as the other working electrode, was immersed into the background electrolyte from the center of the bottle. The electrical current between standard and experimental electrodes in canals was measured over a period of 10 days applying a conductivity meter. The Kruskal-Wallis test (p=0.05) determined whether there was a significant difference in microleakage among the groups and the Mann-Whitney U test (p=0.01) was used for multiple comparison grouping variables. RESULTS: The results suggest that only the differences between the root canal filling techniques were statistically significant (p<0.01). There were no statistically significant difference in the sealers and the times of filling removal for post space preparation (p>0.01). CONCLUSION: The quality of the root canal filling is important for the integrity of the apical seal.

Helicobacter pylori infection and thrombocytopenia: A single-institution experience in Mexico / Infección por Helicobacter pylori y trombocitopenia: Experiencia en una sola institución mexicana

The association between gastrointestinal H. pylori infection and thrombocytopenia was studied in a single institution in Mexico, over a 5-year period. In 99 individuals with H. pylori infection, the prevalence of thrombocytopenia was 14%, whereas in 23 consecutive patients with chronic refractory thrombocytopenic purpura, the prevalence of H. pylori infection was 60%, this figure being similar to that informed in the general population of Mexico (66%); the association between thrombocytopenia and H. pylori infection was not significant. In 14 patients who were found to have both thrombocytopenia and H. pylori infection, eradication treatment was given and the platelet count recovered in three. It is not still clear if detection of H. pylori infection should be routinely included in the initial workup of chronic thrombocytopenia.

Se investigó la asociación entre infección del tubo digestivo por H. pylori y trombocitopenia en una sola institución en México, en un periodo de cinco años. En 99 individuos infectados por H. pylori, la prevalencia de trombocitopenia fue de 14%; por otro lado, en 23 pacientes consecutivos con púrpura trombocitopénica crónica refractaria, la prevalencia de infección por H. pylori fue de 60%, cifra similar a la descrita para la población general de nuestro país, de alrededor de 66%; en consecuencia, la asociación entre trombocitopenia e infección por H. pylori no fue significativa. En 14 pacientes en quienes coexistieron púrpura trombocitopénica e infección por H. pylori, se administró tratamiento de erradicación de la bacteria y la cuenta de plaquetas se normalizó en tres. Los datos apoyan otras publicaciones que muestran falta de asociación entre estas variables y son insuficientes para recomendar si es prudente o no investigar la infección por H. pylori en el estudio inicial de todos los pacientes con púrpura trombocitopénica.

Effect of smoking on failure of H. pylori therapy and gastric histology in a high gastric cancer risk area of Colombia / Efecto del tabaquismo en la falla al tratamiento anti-H. pylori y en la histología gástrica en una zona de alto riesgo de cáncer gástrico en Colombia

It has been proposed that eradication of Helicobacter pylori infection is a sound strategy for gastric cancer prevention. Several factors including smoking have been associated to treatment failure rates. This study aimed to evaluate the smoking effect on the efficacy of H. pylori therapy, as well as on the histological parameters in the gastric mucosa from subjects from a high gastric cancer risk area. Two-hundred-sixty-four Colombian subjects with gastric precancerous lesions who participated in a chemoprevention trial, received anti- H. pylori treatment at baseline and had data recorded on cigarette use, were included in this study. A detailed histopathological assessment of the gastric mucosa was performed in biopsies taken before any intervention. H. pylori eradication was assessed in gastric biopsies at 36 months post-treatment. The overall eradication rate was 52.3%; rates of 41.3% and 57.1% were observed for active-smokers and non-smokers, respectively. Multivariate logistic regression analysis showed that smokers had a 2-fold higher probability of failure in Helicobacter pylori eradication than non-smokers (OR: 2.0; 95% CI: 1.01-3.95). At baseline, activesmokers had a higher score of intestinal metaplasia compared to non-smokers. In the corpus mucosa, active-smokers showed lower scores of H. pylori density, total inflammation, neutrophil infiltration, and mucus depletion than non-smokers. In the antrum, no significant differences were observed between active-smokers and non-smokers. In summary, in patients who smoked, H. pylori treatment was less effective. Smoking cessation may benefit H. pylori eradication rates.

La erradicación del Helicobacter pylori ha sido propuesta como medida promisoria en la prevención del cáncer gástrico. Varios factores, incluyendo el tabaquismo, se asocian con la falla del tratamiento. El objetivo de este estudio fue evaluar el efecto del tabaquismo en la eficacia del tratamiento anti-H. pylori y en la histología gástrica en residentes de una zona de alto riesgo de cáncer gástrico. Este estudio incluyó 264 sujetos colombianos con lesiones gástricas preneoplásicas que participaron en un estudio de quimioprevención, recibieron tratamiento anti-H. pylori al ingreso, y proveyeron información sobre tabaquismo. Se realizó un detallado análisis histopatológico en las biopsias colectadas al ingreso. La erradicación de la infección fue evaluada en las biopsias gástricas a los 36 meses post-tratamiento. El porcentaje general de erradicación fue de 52.3%, con proporciones de 41.3% y 57.1% en fumadores activos y no fumadores, respectivamente. El análisis de regresión logística múltiple mostró que el riesgo de presentar falla al tratamiento fue doble en fumadores en comparación con los no fumadores (OR: 2.0; 95% CI: 1.01-3.95). Los fumadores presentaron un mayor índice de metaplasia intestinal comparado con los no fumadores. En la mucosa del cuerpo gástrico los fumadores mostraron menores índices de colonización por H. pylori, inflamación total, infiltración de neutrófilos y depleción de moco que los no fumadores. En el antro no se observaron diferencias significacomtivas entre ambos grupos. En conclusión, el tratamiento anti-H. pylori fue menos efectivo en sujetos fumadores. La cesación del consumo de tabaco puede beneficiar las tasas de erradicación del H. pylori.

Treatment of rheumatic carditis.

Rheumatic fever and rheumatic heart disease continue unabated in most of the developing nations, affecting young individuals. Focal outbreaks of smaller magnitude have also been reported since mid 1980s from industrialized western nations, where this disease had almost disappeared. Introduction of penicillin in mid 1940s had markedly changed the natural history of rheumatic fever, although the incidence of rheumatic fever declined in developed nations before that, due to better living conditions. Treatment of rheumatic fever chiefly involves use of antibiotics (penicillin) to eradicate streptococci, and anti-inflammatory drugs like salicylates or corticosteroids. Patients with severe carditis, congestive heart failure and/or pericarditis are best treated with corticosteroids as these are more potent anti-inflammatory agents than salicylates. Salicylates may be sufficient for cases with mild or no carditis. The treatment must be continued for 12 weeks. Several studies have shown that valvular regurgitation, and not myocarditis, is the cause of congestive heart failure in active rheumatic carditis. Therefore surgery with mitral valve replacement or repair is indicated in cases with intractable hemodynamics due to mitral regurgitation. Development of chronic valvular lesion after an episode of rheumatic fever is dependent upon presence or absence of carditis in the previous attack and compliance with secondary prophylaxis. Recurrences due to inadequate penicillin prophylaxis are responsible for hemodynamically significant chronic valvular lesions requiring surgery.

Modification of controlled hypotension induced by nicardipine or nitroprusside in cats pretreated with injectable acetyl salicylic acid

Controlled hypotension is a well established technique to decrease blood loss and improve surgical visibility. Several different pharmacologic agents have been used for controlled hypotension including direct acting vasodilators such as sodium nitroprusside and calcium channel blockers [Testa and Tobias, l995]. This study was designed to assess the effect of non-steroidal anti-inflammatory drug [NSAID] acetyl salicylic acid [ASA] therapy on the efficacy and safety of I.V. infusion of nicardipine compared with the more commonly used agent; sodium nitroprusside. The effect of each drug on blood pressure and ECG pattern of normal"control" cats and cats pretreated with [ASA] was investigated. A target mean arterial pressure [MAP] of 55-65 mmHg was to be achieved. It was found that both nicardipine and nitroprusside achieved a stable controlled hypotensive state in control groups. Comparison between the two drugs revealed a significant increase in [MAP] with nitroprusside after drug discontinuation. Pretreatment with [ASA], attenuated significantly the effect of nicardipine infusion on [MAP]. However, pretreatment with ASA produced insignificant effect on the decrease in MAP caused by nitroprusside except at 4 min. during infusion where ASA pretreatment attenuated its effect. Moreover [ASA] pretreatment decreased nitroprusside dose needed to reach the target blood pressure and increased time of blood pressure to returin to base line. Both nicardipine and nitroprusside infusion caused increase in mean heart rate [HR] without ECG changes in control and pretreated groups.There was a Statistically significant increase in [HR] in the [ASA] pretreated groups of both drugs when compared to that in the control groups. When the increase in [HR] induced by nitroprusside infusion was compared to that induced by nicardipine infusion, there was insignficiant difference in the control groups, while in [ASA] pretreatred groups the difference was significant

Kawasaki disease: presentation of a case / Enfermedad de kawasaki: a propósito de un caso

Se presenta una paciente de 2 meses de edad con los síntomas y signos de la enfermedad de Kawasaki. Se descartan mediante los exámenes complementarios otras enfermedades más comunes en la infancia. Se hace una revisión de la enfermedad y se señala la importancia del diagnóstico y tratamiento precoces. A pesar de la corta edad de la niña ésta no presentó afectación de las arterias coronarias. Su evolución fue favorable, y se observó mejoría (caída de la temperatura a menos de 38 C) a partir del 4to. día después de comenzar el tratamiento. Se utilizó el esquema de dosis única de gammaglobulina asociada con los salicilatos

Estudio comparativo de la eficacia de la bencidamina, mentol y salicilato de metilo vs el clorhidrato de bencidamina para el tratamiento de los traumatismos del sistema musculoesquelético / Benzydamine hidrochloride vs. methyl-salicylate in external trauma

En este trabajo se presentan los resultados de un estudio clínico fase III, prospectivo, longitudinal y experimental. Se comparó la eficacia y seguridad de dos medicamentos para el tratamiento de los síntomas y signos posteriores al traumatismo musculoesquelético. Dicho estudio se realizó en dos grupos paralelos de 25 deportistas escogidos al azar. Los resultados muestran que el medicamento combinado de bencidamina más mentol y salicilato de metilo, disminuyó significativamente la presencia e intensidad del dolor, calor, rubor y edema en el sitio del traumatismo y recuperación más rápida de la capacidad funcional en la región afectada por el traumatismo. Se observaron también menos efectos adversos con el uso del medicamento combinado en comparación con el medicamento constituido por bencidamina sola. De esta manera se puede concluir que la inclusión de mentol y salicilato de metilo en la crema para el tratamiento tópico de los traumatismos ofrece un tratamiento más eficiente y seguro que la bencidamina sola

Lupus eritematoso sistémico y embarazo (análisis de 84 casos) / Systemic lupus erytematosus and pregnancy (review of 84 cases)

Se presentan 84 embarazos (3 gemelares) en 80 mujeres con lupus eritematoso sistémico. A pesar de un control prenatal multidisciplinario, en 83 por ciento de los casos, se presentó una o más complicaciones durante el embarazo, predominó el nacimiento pretérmino, la ruptura prematura de membranas y la enfermedad hipertensiva aguda del embarazo. La enfermedad se exacerbó en 15/84 casos (17.85 por ciento). El deterioro de la función renal fue la manifestación más frecuente. Se presentaron nueve abortos, tres muertes fetales y una neonatal. Dos neonatos presentaron bloqueo cardiaco congénito. No se presentó ningún caso de muerte materna

Os principais medicamentos utilizados na terapêutica dos problemas diagnósticos no centro de saúde na atençäo primária, envolvendo a atividade docente-discente assistencial / The basic drugs in a Primary Care Setting involving teaching care integration

Os medicamentos utilizados para a abordagem de 85 por cento dos problemas diagnósticos que demandam ao Centro de Saúde (CS) säo: penicilina G, penicilina semi-sintética de uso oral, sulfametoxanol-trimetropim, ácido acetilsalicílico, tiazida, furosemida, beta-bloqueador, metronidazol, tinidazol, mebendazol, tiabendazol, hidróxido de alumínio, salbutamol, terbutalina, anticoncepcional oral. Estas drogas devem constituir o padräo básico de farmácia de um CS que atua em atençäo primária à saúde.

Avaliaçäo clínica de uma linha de produtos indicados para controle da acne em adolescentes / Clinical evaluation of a line of products indicated for juvenile acne control

A alta prevalência das formas iniciais da acne juvenil e a grave evoluçäo que delas pode ocorrer, impöem a necessidade de controlá-las, de forma prática e efetiva. OBJETIVO. Comprovar a efetividade de uma linha de produto de uso popular, à base de triclosan e ácido salicílico (Sistema Clean & Clear - Johnson & Johnson), no controle da acne juvenil. MÉTODO - Em um ensaio clínico randomizado, setenta voluntários, de idades entre 12 e 17 anos, portadores de formas iniciais de acne, foram aleatoriamente divididos em três grupos: dois de vinte e um de trinta indivíduos. A cada grupo foi entregue um kit, composto de um detergente facial (em espuma ou barra), uma loçäo tônica e uma loçäo hidratante; o grupo 3 utilizou, também, um gel secativo. O período de tratamento, em cada grupo, foi de trinta dias. Na primeira fase do estudo, os grupos 1 e 2 foram tratados por trinta dias, enquanto o 3 foi controle e iniciou o tratamento trinta dias após. As lesöes acneias foram quantificadas antes e após o tratamento, e as seborréia facial classificada em nula, moderada ou intensa. RESULTADOS - Foram considerados apenas os casos em que a aderência foi igual ou maior que 50 por cento. A seborréa facial foi abolida em 45,95 por cento dos casos e em 4 por cento dos controles. As lesöes näo-inflamatórias foram, significativamente, reduzidas (p<0,05) nos casos, em comparaçäo aos controles e pré e pós-tratamento. Quanto às les 8es inflamatórias, observou-se diminuiçäo na soma dos três grupo tratados, quando comparados ao estado basal, porém esse comportamento näo diferiu dos controles. CONCLUSAO - Tratando-se de um estudo de efetividade, conclui-se que essa linha de produtos mostrou-se efetiva para o controle da seborréia e das lesöes näo-inflamatórias da acne em adolescentes

Evaluation of psoralen with solar ultraviolet light (puvasol) and adjunctive topical tar therapy in psoriasis.

Fifty patients having psoriasis were studied with a view to assess the efficacy of 'puvasol' (Oral psoralen with sun-rays exposure) alone and in combination with topical tar therapy and were placed in 2 groups, each group being consisted of 25 patients. At the end of 8 weeks, out of 25 patients (Group 1) receiving 'Puvasol' in combination with topital tar therapy 15 patients (60%) showed complete clearance, marked improvement of lesions were seen in 4 cases (16%) and deterioration in one case (4%). Out of 25 patients (Group I) receiving 'Puvasol' alone 8 cases (32%) showed complete clearance of lesions and 11 patients (44%) showed marked im-provement of lesions. It is found that topical tar therapy when used as an adjunct to 'Puvasol' was more effective than 'Puvasol' alone.

Avaliaçåo clínica de um shampoo contendo enxofre e ácido salicílico no tratamento da dermatite seborréica do couro cabeludo / Clinical trial of an association of salicilic acid and suphur under form of shampoo to the seborreic dermatitis

Cem pacientes portadores de dermatite seborréica foram tratados com um shampoo contendo proteínas hidrolisadas mais ácido salicílico e enxofre, usado três vezes por semana. Os resultados demonstram a eficácia do produto no tratamento da dermatite seborréica

Avaliaçåo clínica de uma loçåo com enxofre e ácido salicílico no tratamento do acne vulgar / Clinical trial of an association of salicilic acid and sulphur in the treatment of acne vulgaris

Setenta e cinco pacientes portadores de acne vulgar foram tratados com uma loçåo contendo ácido salicílico e enxofre, usada diariamente. Os resultados demonstram a eficácia do produto no tratamento da acne vulgar