Association between cognitive function and parameters of echocardiography and coronary artery angiography / Associação entre a função cognitiva e parâmetros de ecocardiografia e angiografia da artéria coronária

ABSTRACT We aimed to determine whether there is an association between cognition and the results of echocardiography and angiography, based on neuropsychological assessments. Methods: We assessed the cognition of 85 patients who had recently undergone coronary artery angiography. We calculated the Gensini score for the coronary artery disease index. We also performed echocardiography to find indices of cardiac functioning. Results: The lower left ventricular ejection fraction correlated with lower scores on visuospatial, executive function, processing speed/attention and verbal memory capacities (p ≤ 0.05). A higher Gensini score and left atrial size correlated with lower executive function and processing speed/attention (p ≤ 0.05). In the group of patients with an impaired cognitive state, higher Gensini scores correlated with decreased processing speed/attention (p = 0.01) and the e' index was associated with lower capacity of executive function (p = 0.05). Conclusion: Decreased processing speed/attention and executive function may correlate with cardiac dysfunction and coronary artery disease. The Color Trail Test may be considered for simple screening for cognitive problems in elderly patients with coronary artery disease or diastolic dysfunction.

RESUMO O objetivo deste estudo é encontrar associação entre cognição e resultados de exames ecocardiográficos e angiográficos, com base em avaliações neuropsicológicas. Método: Foi avaliada a cognição de 85 pacientes que foram submetidos a angiografia coronária. O escore de Gensini foi calculado para o índice de doença arterial coronariana (DAC). Foi realizado também, o exame ecocardiográfico a fim de descobrir os índices de funcionamento cardíaco. Resultados: A fração de ejeção do ventrículo inferior esquerdo está correlacionada com a baixa pontuação na capacidade visual e espacial, função executiva, velocidade de processamento/atenção e memória verbal (p ≤ 0,05). Alto escore de Gensini e tamanho do átrio esquerdo correlacionados com baixa função executiva, velocidade de processamento/atenção (p ≤ 0,05). No grupo de pacientes com estado cognitivo prejudicado, alto escore de Gensini correlacionado com diminuição da velocidade de processamento/atenção (p = 0,01) e índice e' associado a baixa capacidade da função executiva (p = 0,05). Conclusão: Diminuição da velocidade de processamento/atenção e da função executiva pode estar correlacionado a disfunção cardíaca e DAC. O Color Trail Test pode ser considerado para uma triagem simples de problemas cognitivos em pacientes idosos com DAC ou disfunção diastólica.

Antibacterial effect of calcium hydroxide combined with chlorhexidine on Enterococcus faecalis: a systematic review and meta-analysis

Objective: Enterococcus faecalis (E. faecalis) is the most frequently isolated strain in failed endodontic therapy cases since it is resistant to calcium hydroxide (CH). Whether a combination of CH and chlorhexidine (CHX) is more effective than CH alone against E. faecalis is a matter of controversy. Thus, the aim of this study was to conduct a systematic review and meta-analysis of the literature. Material and Methods: A comprehensive search in PubMed, EMbase, EBSCOhost, The Cochrane Library, SciELO, and BBO databases, Clinical trials registers, Open Grey, and conference proceedings from the earliest available date to February 1, 2013 was carried out and the relevant articles were identified by two independent reviewers. Backward and forward search was performed and then inclusion and exclusion criteria were applied. The included studies were divided into "comparisons" according to the depth of sampling and dressing period of each medicament. Meta-analysis was performed using Stata software 10.0. The level of significance was set at 0.05. Results: Eighty-five studies were retrieved from databases and backward/forward searches. Fortyfive studies were considered as relevant (5 in vivo, 18 in vitro, 18 ex vivo, and 4 review articles). Nine studies were included for meta-analysis. Inter-observer agreement (Cohen kappa) was 0.93. The included studies were divided into 21 comparisons for meta-analysis. Chi-square test showed the comparisons were heterogeneous (p<0.001). Random effect model demonstrated no significant difference between CH/CHX mixture and CH alone in their effect on E. faecalis (p=0.115). Conclusions: According to the evidence available now, mixing CH with CHX does not significantly increase the antimicrobial activity of CH against E. faecalis. It appears that mixing CH with CHX does not improve its ex vivo antibacterial property as an intracanal medicament against E. faecalis. Further in vivo studies are necessary ...