Impact of calcium aluminate cement with additives on dental pulp-derived cells

Abstract Calcium aluminate cement (CAC) has been highlighted as a promising alternative for endodontic use aiming at periapical tissue repair. However, its effects on dental pulp cells have been poorly explored. Objective: This study assessed the impact of calcium chloride (CaCl2) and bismuth oxide (Bi2O3) or zinc oxide (ZnO) additives on odontoblast cell response to CAC. Methodology: MDPC-23 cells were exposed for up to 14 d: 1) CAC with 2.8% CaCl2 and 25% ZnO (CACz); 2) CAC with 2.8% CaCl2 and 25% Bi2O3 (CACb); 3) CAC with 10% CaCl2 and 25% Bi2O3 (CACb+); or 4) mineral trioxide aggregate (MTA), placed on inserts. Non-exposed cultures served as control. Cell morphology, cell viability, gene expression of alkaline phosphatase (ALP), bone sialoprotein (BSP), and dentin matrix protein 1 (DMP-1), ALP activity, and extracellular matrix mineralization were evaluated. Data were compared using ANOVA (α=5%). Results: Lower cell density was detected only for MTA and CACb+ compared with Control, with areas showing reduced cell spreading. Cell viability was similar among groups at days one and three (p>0.05). CACb+ and MTA showed the lowest cell viability values at day seven (p>0.05). CACb and CACb+ promoted higher ALP and BSP expression compared with CACz (p<0.05); despite that, all cements supported ALP activity. Matrix mineralization were enhanced in CACb+ and MTA. Conclusion: In conclusion, CAC with Bi2O3, but not with ZnO, supported the expression of odontoblastic phenotype, but only the composition with 10% CaCl2 promoted mineralized matrix formation, rendering it suitable for dentin-pulp complex repair.

Effect of addition of nano-hydroxyapatite on physico-chemical and antibiofilm properties of calcium silicate cements

ABSTRACT Objective Mineral Trioxide Aggregate (MTA) is a calcium silicate cement composed of Portland cement (PC) and bismuth oxide. Hydroxyapatite has been incorporated to enhance mechanical and biological properties of dental materials. This study evaluated physicochemical and mechanical properties and antibiofilm activity of MTA and PC associated with zirconium oxide (ZrO2) and hydroxyapatite nanoparticles (HAn). Material and Methods White MTA (Angelus, Brazil); PC (70%)+ZrO2 (30%); PC (60%)+ZrO2 (30%)+HAn (10%); PC (50%)+ZrO2 (30%)+HAn (20%) were evaluated. The pH was assessed by a digital pH-meter and solubility by mass loss. Setting time was evaluated by using Gilmore needles. Compressive strength was analyzed by mechanical test. Samples were radiographed alongside an aluminum step wedge to evaluate radiopacity. For the antibiofilm evaluation, materials were placed in direct contact with E. faecalis biofilm induced on dentine blocks. The number of colony-forming units (CFU mL-1) in the remaining biolfilm was evaluated. The results were submitted to ANOVA and the Tukey test, with 5% significance. Results There was no difference in pH levels of PC+ZrO2, PC+ZrO2+HAn (10%) and PC+ZrO2+HAn (20%) (p>0.05) and these cements presented higher pH levels than MTA (p<0.05). The highest solubility was observed in PC+ZrO2+HAn (10%) and PC+ZrO2+HAn (20%) (p<0.05). MTA had the shortest initial setting time (p<0.05). All the materials showed radiopacity higher than 3 mmAl. PC+ZrO2 and MTA had the highest compressive strength (p<0.05). Materials did not completely neutralize the bacterial biofilm, but the association with HAn provided greater bacterial reduction than MTA and PC+ZrO2 (p<0.05) after the post-manipulation period of 2 days. Conclusions The addition of HAn to PC associated with ZrO2 harmed the compressive strength and solubility. On the other hand, HAn did not change the pH and the initial setting time, but improved the radiopacity (HAn 10%), the final setting time and the E. faecalis antibiofilm activity of the cement.

Effects of the association of antifungal drugs on the antimicrobial action of endodontic sealers

This in vitro study aimed to determine the susceptibility of oral specimens and ATCC lineages of Candida albicans for five endodontic sealers, which were pure and associated with two antifungal drugs, and to analyze their effect on the physical properties. For this purpose, 30 lineages of C. albicans, collected from the oral cavity of patients assisted at the endodontics clinic of the Universidade Sagrado Coração, were analyzed. Yeasts susceptibility to the sealers was tested by diffusion on agar plates. Physical properties were evaluated according to the ADA specification no. 57. The pure versions of the Sealer 26, AH Plus, Endofill, Fillapex, and Sealapex demonstrated antifungal activity, with Endofill presenting the greatest inhibition zones. All cements, except for Endofill, had their antifungal actions enhanced by addition of ketoconazole and fluconazole (p < 0.05), and the AH Plus presented the best antifungal activity. The addition of antifungal drugs did not interfere with the setting time and flowability of the sealers. It was concluded that the addition of antifungals to endodontic sealers enhanced the antimicrobial action of most cements tested without altering their physical properties.

Influence of bismuth oxide concentration on the pH level and biocompatibility of white Portland cement

Objectives: To investigate if there is a relation between the increase of bismuth oxide and the decrease of pH levels and an intensification of toxicity in the Portland cement. Material and Methods: White Portland cement (WPC) was mixed with 0, 15, 20, 30 and 50% bismuth oxide, in weight. For the pH level test, polyethylene tubes were filled with the cements and immersed in Milli-Q water for 15, 30 and 60 days. After each period, the increase of the pH level was assessed. For the biocompatibility, two polyethylene tubes filled with the cements were implanted in ninety albino rats (n=6). The analysis of the intensity of the inflammatory infiltrate was performed after 15, 30 and 60 days. The statistical analysis was performed using the Kruskal-Wallis, Dunn and Friedman tests for the pH level and the Kruskal-Wallis and Dunn tests for the biological analysis (p<0.05). Results: The results showed an increase of the pH level after 15 days, followed by a slight increase after 30 days and a decrease after 60 days. There were no significant statistical differences among the groups (p>0.05). For the inflammatory infiltrates, no significant statistical differences were found among the groups in each period (p>0.05). The 15% WPC showed a significant decrease of the inflammatory infiltrate from 15 to 30 and 60 days (p<0.05). Conclusions: The addition of bismuth oxide into Portland cement did not affect the pH level and the biological response. The concentration of 15% of bismuth oxide resulted in significant reduction in inflammatory response in comparison with the other concentrations evaluated. .

New Guidelines for Helicobacter pylori Treatment: Comparisons between Korea and Japan / 대한소화기학회지

Korea and Japan show the highest incidence of gastric cancer and Helicobacter pylori infection. New 2013 guidelines on H. pylori infection differ between the two countries with regard to the indications for H. pylori eradication, diagnostic methods, and treatment regimens. Indications for eradication in Korean guideline focus on specific diseases such as peptic ulcer disease, low-grade gastric mucosa-associated lymphoid tissue lymphoma, and after resection of early gastric cancer, while Japanese guideline includes all H. pylori-associated gastritis for the prevention of dissemination. With regard to the diagnosis, either noninvasive or invasive method (except for bacterial culture) is recommended in Korea, while two noninvasive tests including serum anti-H. pylori IgG antibody level are preferred in Japan. As for the treatment regimens, second-line treatment (quadruple bismuth-containing regimen) is recommended without first-line triple therapy in areas of high clarithromycin resistance in Korea. However, there is no bismuth-based second-line treatment in Japan, and the Japanese regimen consists of a lower dose of antibiotics for a shorter duration (7 days). Such discrepancies between the two countries are based not only on the differences in the literature search and interpretation, but also on the different approvals granted by the national health insurance system, manufacturing process of the antibiotics, and diagnostic techniques in each country. Collaborations are required to minimize the discrepancies between the two countries based on cost-effectiveness.

Evaluation of pH, calcium ion release and antimicrobial activity of a new calcium aluminate cement

This study evaluated the pH, calcium ion release and antimicrobial activity of EndoBinder (EB), containing different radiopacifiers: bismuth oxide (Bi2O3), zinc oxide (ZnO) or zirconium oxide (ZrO2), in comparison to MTA. For pH and calcium ion release tests, 5 specimens per group (n = 5) were immersed into 10 mL of distilled and deionized water at 37°C. After 2, 4, 12, 24, 48 h; 7, 14 and 28 days, the pH was measured and calcium ion release quantified in an atomic absorption spectrophotometer. For antimicrobial activity, the cements were tested against S. aureus, E. coli, E. faecalis and C. albicans, in triplicate. MTA presented higher values for pH and calcium ion release than the other groups, however, with no statistically significant difference after 28 days (p > 0.05); and the largest inhibition halos for all strains, with no significant difference (E. coli and E. faecalis) for pure EB and EB + Bi2O3 (p > 0.05). EB presented similar performance to that of MTA as regards pH and calcium ion release; however, when ZnO and ZrO2 were used, EB did not present antimicrobial activity against some strains.

Influence of radiopacifying agents on the solubility, pH and antimicrobial activity of portland cement

The aim of this study was to evaluate the interference of the radiopacifiers bismuth oxide (BO), bismuth carbonate (BC), bismuth subnitrate (BS), and zirconiun oxide (ZO) on the solubility, alkalinity and antimicrobial properties of white Portland cement (WPC). The substances were incorporated to PC, at a ratio of 1:4 (v/v) and subjected to a solubility test. To evaluate the pH, the cements were inserted into retrograde cavities prepared in simulated acrylic teeth and immediately immersed in deionized water. The pH of the solution was measured at 3, 24, 72 and 168 h. The antimicrobial activity was evaluated by a radial diffusion method against the microorganisms S. aureus (ATCC 25923), P. aeruginosa (ATCC 27853), E. faecalis (ATCC 29212) and C. albicans (ATCC 10231). The zone of microbial growth inhibition was measured after 24 h. The addition of BS and BC increased the solubility of the cement. The pH values demonstrated that all materials produced alkaline levels. At 3 h, BS showed lower pH than WPC (p<0.05). At 168 h, all materials showed similar pHs (p>0.05). The materials did not present antimicrobial activity for S. aureus, P. aeruginosas and E. faecalis (p>0.05). With regards to C. albicans, all materials formed an inhibition zone, mainly the mixture of WPC with ZO (p<0.05). The type of radiopacifier incorporated into WPC interfered with its physical and antimicrobial properties. ZO was found to be a viable radiopacifier that can be used with WPC.

Biocompatibility of sealers used in apical surgery: a histological study in rat subcutaneous tissue

The aim of this study was to evaluate the biocompatibility of sealers used in apical surgery in rat subcutaneous tissue. Sterile polyethylene tubes were filled with the following sealers: Sealapex, Sealapex with addition of zinc oxide, Sealer 26, Sealer 26 with thicker consistency (greater powder-to-resin ratio) and White MTA. The tubes were implanted in the dorsum of male rats and after 7, 21 and 42 days, the animals were killed, obtaining 5 specimens for each sealer in each evaluation period. The lateral surface of the tube was used as negative control. The inflammatory reaction to contact with the sealers was classified as absent, mild, moderate and severe. At 7 days, all sealers caused similar inflammatory reactions in the connective tissue of the animals, with most specimens presenting a moderate to intense chronic inflammatory reaction, with presence of multinucleated giant cells. At 21 days, Sealer 26 and Sealer 26 with thicker consistency presented more intense inflammatory reaction (p=0.004), whereas after 42 days, the inflammatory reaction ranged from absent to mild with statistically similar results for both materials (p=0.08). Except for MTA, all sealers presented foreign-body granulomatous reaction at 42 days. All sealers but Sealapex presented a statistically significant decrease of the inflammatory reaction over time. In conclusion, all sealers caused moderate to severe inflammation in the earlier evaluation period. However, Sealer 26 and Sealer 26 with thicker consistency caused more intense inflammatory reactions after 21 days of contact with the tissues and no granulomatous reaction was observed for MTA at the final period of analysis.

O objetivo deste estudo foi avaliar a biocompatibilidade de cimentos utilizados em cirurgia apical, em tecidos subcutâneos de ratos. Tubos de polietileno esterilizados foram preenchidos com os seguintes cimentos: Sealapex, Sealapex acrescido de óxido de zinco, Sealer 26, Sealer 26 espessado (maior proporção pó:resina) e MTA branco. Os tubos foram implantados no dorso de ratos machos e após 7, 21 e 42 dias, os animais foram mortos, obtendo 5 amostras por cimento em cada período analisado. A superfície lateral do tubo foi utilizada como controle negativo. A reação inflamatória em contato com os cimentos foram classificadas como ausente, leve, moderada e severa. Aos 7 dias, todos os cimentos induziram reações inflamatórias similares no tecido conjuntivo dos animais, com a maioria dos espécimes apresentando reação inflamatória crônica de moderada a intensa, com presença de células gigantes multinucleadas. Aos 21 dias, Sealer 26 e Sealer 26 espessado apresentaram reação inflamatória mais intensa (p=0,004), enquanto após 42 dias, a reação inflamatória variou de ausente a leve, com resultados estatisticamente semelhantes para ambos materiais (p=0,08). Com exceção do grupo MTA, todos os cimentos apresentavam reação granulomatosa de corpo estranho após 42 dias. Todos os grupos, exceto o Sealapex, apresentaram redução estatisticamente significante dos índices inflamatórios ao longo do tempo. Conclui-se que todos os cimentos induziram reação inflamatória de moderada a intensa no período inicial de análise. Entretanto, Sealer 26 e Sealer 26 espessado apresentaram reação inflamatória mais intensa após 21 dias de contato com os tecidos e reação granulomatosa não foi observada no grupo MTA no período final de análise.

Sealing ability of MTA-Angelus with propyleneglycol in furcal perforations

This study evaluated the sealing ability of gray MTA-Angelus mixed with propyleneglycol in furcal perforations using a bacterial leakage test. Furcal perforations were created in 30 human mandibular molars using a size 3 round bur. The samples were divided randomly into 2 experimental groups (n=10) according to the mixing agent. In G1, the MTA powder was mixed with propyleneglycol, while distilled water was used in G2. A 3:1 powder-liquid ratio was used for both groups. The MTA was placed in the perforation with an MTA carrier and condensed with hand pluggers. Nonrepaired (n=5) and totally sealed (n=5) perforations served as positive and negative controls, respectively. Bacterial leakage was assessed daily for 30 days in a double-chamber apparatus with Enterococcus faecalis. Data were analyzed using Fisher exact test (p<0.05) for three leakage periods: 1st to 10th day (P1); 11th to 20th day (P2); and 21st to 30th day (P3). The positive control presented leakage in all specimens within the first 24 hours, while no leakage was observed in the negative control during the experimental period. Leakage was observed in five (50%) of the 10 samples of the propyleneglycol group (G1) and seven (70%) of the distilled water group (G2) by the 20th day, without significant difference between the groups in periods P1 and P2 (p=0.137). The leakage was significantly lower for G1 than G2 in period P3 (50% versus 100%, respectively, p=0.016). In this single aerobic bacterial leakage method, the use of propyleneglycol as a vehicle for gray MTAAngelus increased its sealing ability in furcal perforations at the end of the 30-day experimental period.

Este estudo avaliou a capacidade de selamento do MTA-Angelus cinza manipulado com propilenoglicol em perfuracoes de furca usando um teste de infiltracao bacteriana. Perfuracoes de furca foram criadas em 30 molares inferiores usando uma broca esferica numero 3. As amostras foram divididas aleatoriamente em dois grupos experimentais (n=10) de acordo com o agente de manipulacao. Em G1, o po do MTA foi manipulado com propilenoglicol enquanto que a agua destilado foi utilizada no G2. A proporcao po-liquido de 3:1 foi usada para ambos os grupos. O MTA foi colocado na perfuracao com uma porta- MTA e condensado com condensadores manuais. Perfuracoes nao-reparadas (n=5) e totalmente impermeabilizadas (n=5) serviram como controle positivo e negativo, respectivamente. A infiltracao bacteriana foi verificada diariamente durante 30 dias em um aparato de dupla camara com Enterococcus faecalis. Os dados foram analisados pelo teste exato de Fisher (p<0,05) para tres periodos: 1o ao 10o dia (P1), 11o ao 20o dia (P2) e do 21o ao 30o dia (P3). O controle positivo apresentou infiltracao em todas as amostras nas primeiras 24 horas, enquanto nenhuma infiltracao foi observada no controle positivo durante o periodo experimental. Infiltracao foi observada em 5 (50%) das 10 amostras do grupo do propilenoglicol (G1) e 7 (70%) do grupo da agua destilada no 20o dia, sem diferenca significativa entre o grupos nos periodos P1 e P2 (p=0,0137). A infiltracao foi significantemente menor para G1 que para G2 no periodo P3 (50% versus 100%, respectivamente, p=0,016). Neste metodo de infiltracao de apenas uma bacteria aerobica, o uso do propilenoglicol como veiculo para o MTA-Angelus cinza aumentou sua capacidade de selamento em perfuracoes de furca no final do periodo experimental de 30 dias.

Influence of apical patency and filling material on healing process of dogs' teeth with vital pulp after root canal therapy

Foi propósito deste trabalho observar o processo de reparo de dentes de cães após obturação dos canais com dois cimentos diferentes, fazendo ou não a patência apical. Após uma sobreinstrumentação, os canais receberam um curativo de uma solução de corticosteróide-antibiótico por 7 dias, com o objetivo de obter invaginação de tecido conjuntivo para dentro dos canais. Após esse período, esse tecido foi totalmente removido em metade dos casos (grupos com patência apical) e preservados no restante dos casos (grupos sem patência apical). Os canais foram obturados pela técnica da condensação lateral empregando um cimento a base de hidróxido de cálcio (Sealer Plus) ou um cimento de Grossman (Fill Canal). Os animais foram sacrificados por overdose anestésica 60 dias após o tratamento endodôntico e as peças anatômicas foram obtidas e preparadas para análise histológica. Os dados obtidos foram analisados com base em diversos parâmetros histomorfológicos. Os resultados foram melhores nos grupos sem patência apical (p=0,01) do que nos grupos com patência. Dentre os cimentos estudados, os melhores resultados foram observados com o cimento Sealer Plus (p=0,01). Em conclusão, tanto a patência apical (presença ou ausência) quanto o tipo de material obturador de canal influíram no processo de reparo apical de dentes de cães com polpas vitais após tratamento endodôntico. O emprego de um cimento a base de hidróxido de cálcio em dentes sem patência apical promoveu os melhores resultados, dentre as condições experimentais propostas.

Sealing ability of MTA, Super EBA, Vitremer and amalgam as root-end filling materials

Este estudo avaliou a capacidade de selamento do agregado trióxido mineral (MTA Angelus), de um cimento de óxido de zinco e eugenol reforçado (Super EBA), de um cimento de ionômero de vidro reforçado por resina (Vitremer) e de um amálgama sem zinco (GS-80) (controle). Os canais radiculares de oitenta molares inferiores humanos foram acessados, limpos, modelados e obturados. Os ápices foram seccionados, e as cavidades, preparadas. Os dentes foram divididos em 4 grupos de 40 cavidades, retrobturados com os materiais e imersos em azul de metileno por 72 h a 37ºC. As raízes foram então seccionadas transversalmente a cada milímetro e avaliadas sob aumento, observando-se a penetração de corante a cada corte. Os dados foram avaliados usando-se o teste de Kruskal-Wallis (5%), que mostrou diferenças entre todos os materiais (p < 0,001). A ordem crescente de infiltração marginal foi MTA < Vitremer < Super EBA < amálgama. Níveis mais altos de infiltração foram observados nos cortes de primeiro milímetro de amálgama, Vitremer e MTA, quando comparados com o terceiro milímetro (p < 0,05).

Susceptibilidad in vitro de cepas de helicobacter pylori: aislamiento de cepas resistentes a claritromicina / In vitro antimicrobial susceptibility of helicobacter pylori strains isolated in Chile

Background: Our laboratory has carried out an epidemiological surveillance of Helicobacter pylori antimicrobial susceptibility since 1997. Aim: To report the antimicrobial susceptibility of H pylori strains, isolated in Chile from August 1997 to August 2000. Material and methods: Ninety one H pylori strains, obtained from antral gastric biopsies during upper gastrointestinal endoscopies were studied. Susceptibility towards clarithromycin, amoxicillin, bismuth subcitrate and metronidazole was studied by an agar diffusion technique. Results: All strains were susceptible to amoxicillin and two strains were resistant to clarithromycin. Forty two percent of strains were resistant to metronidazole and 13 per cent were resistant to bismuth subcitrate. Conclusions: These results underscore the need to maintain an epidemiological surveillance of H pylori antimicrobial susceptibility, to modify its eradication therapy accordingly

Ulcera duodenal e helicobacter pilori: ensaio clínico randomizado, comparativo entre terapia tríplice e ranitidina / Duodenale ulcer abd helicobacter pylori: randomized clinical essay comparactive between triplice therapy and ranitidine

INTRODUÇÄO: O papel patogêno do Helicobacter pylori na doença ulcerosa péptica está estabelecido e sua erradicaçäo se reflete na queda dos índices de recidiva da úlcera duodenal. É importante a realizaçäo de estudos epidemiológicos e ensaios clínicos em nosso meio (Bahia) por se tratar de populaçäo de baixo nível sócio-econômico, fator considerado de risco na aquisiçäo da bactéria. OBJETIVOS: avaliar a cicatrizaçäo e a recidiva da úlcera duodenal, a erradicaçäo do H. pylori, o tipo e intensidade do infiltrado inflamatório da mucosa gástrica, no intervalo de 12 meses, comparando-se dois esquemas terapêuticos. MATERIAL E MÉTODOS: Foi realizado ensaio clínico prospectivo, randomizado, simples cego. Neste estudo, 60 pacientes H. pylori-positivos com úlcera em atividade foram submetidos a exame clínico, endoscópico e histológico a cada 4, 8 e 12 semanas, 6 e 12 meses. Os esquemas de tratamento foram: esquema 1: ranitidina 150mg 2x/dia durante quatro semanas; esquema 2 (terapia tríplice): subcitrato de bismuto coloidal 120mg 4x/dia durante 4 semanas + amoxicilina 500mg 3x/dia + tinidazol 500mg 2x/dia durante as duas últimas semanas. Os pacientes nos quais a úlcera näo cicatrizou com quatro semanas foram submetidos a mudança de tratamento, de um esquema para outro (cruzamento terapêutico). Foram excluídos os pacientes nos quais a úlcera näo cicatrizou após oito semanas e aqueles que näo compareceram às reavaliaçöes. RESULTADOS: Dos 21 pacientes do esquema 1 e dos 39 do esquema 2, a úlcera cicatrizou em 14 (66,7 porcento) e em 32 (82,1 porcento), respectivamente, após quatro semanas (p> 0,6). Os nove pacientes nos quais a úlcera näo cicatrizou foram submetidos ao cruzamento terapêutico e destes, três (33,3 porcento) continuaram sem que a úlcera cicatrizasse. A erradicaçäo do H. pylori foi observada em 19 (46,3 porcento) dos 41 pacientes que foram submetidos ao esquema 2. Após acompanhamento de 12 meses, foi observada recorrência da infecçäo pelo H. pylori em seis (31,6 porcento) pacientes. Desses, quatro (66,7 porcento), recidivaram a úlcera duodenal. Os 13 pacientes que se mantiveram erradicados até o final do estudo näo recidivaram a úlcera. Dos 43 pacientes positivos para o H. pylori, 21 (48,8 porcento) recidivaram a úlcera em até 12 meses. Ao final do estudo, a recidiva da úlcera foi observada em 11 (78,6 porcento) dos pacientes do esquema 1 e em 22 (68,7 porcento) do esquema 2 (p > 0,7). Houve melhora histológica nos pacientes que erradicaram o H...

Dispepsia no ulcerosa y Helicobacter Pylori: comparación del efecto de la asociación de Bismuto más Furazolidona Vs. Sucralfate

Se describen los resultados clínicos e histopatológicos de un grupo de pacientes con DNU, quienes consultaron únicamente por dolor de "tipo ulceroso" y fueron tratados con la asociación de subsalicilato de bismuto más furazolidona dirigido contra el Helicobacter Pylori (grupo I) o sucralfate, un conocido citoprotector de la mucosa gástrica (grupo II). Se encontró una mejoría significativa con los dos tipos de tratamiento, sinembargo, en el grupo que recibió el tratamiento dirigido a eliminar la colonización gástrica por Helicobacter Pylori, la mejoría histológica fue superior que la observada en el grupo tratado con sucralfate. La disminución de los cambios inflamatoria encontrada en el grupo de sucralfate podría estar relacionada con sus propiedades citoprotectoras y con la disminución de la adhesión del Helicobacter pylori a las células epiteliales del estómago. Los hallazgos sugieren que el Helicobacter pylori puede ser la causa de síntomas dispépticos y en un grupo adecuadamente seleccionado de pacientes con DNU, un tratamiento de erradicación mejora los síntomas

Bismuto más furazolidona Vs. Famotidina en el tratamiento de la gastritis erosiva crónica

Se estudiaron 42 pacientes con síntomas dispépticos con hallazgos endoscópicos sugestivos de gastritis erosiva crónica. La mitad fueron tratados con la asociación de bismuto más furazolidona y el resto con Famotidina. Se encontró mejoría endoscópica significativa con los dos tratamientos, pero la mejoría histológica fue mayor con el primer tratamiento, el cual se asoció a desaparición del Helicobacter pylori. Los resultados anteriores sugieren una etiología múltiple de los cambios observados en la mucosa gástrica en esta entidad

Eliminacion de Helicobater Pylory en pacientes con dolor abdominal recurrente con la administracion simultanea de ranitina, subsalicilato de bismuto y claritromicina / Elimination of Helicobacter pylori in patients with recurrent abdominal pain simultaneous administration of ranitidine, bismuth subsalicylate and claritromycin

Objetivo: Evaluar la eliminación de Helicobacter pylori, así como la mejoría clínica en niños con gastritis asociada; cuando se les administró en forma simult nea claritromicina, ranitidina y subsalicilato de bismuto. Antecedentes: Diversos esquemas de tratamiento se han utilizado para la eliminación de Helicobacter pylori en niños con gastritis, con diferentes resultados. Método: Se estudiaron 22 pacientes que acudieron al servicio de Gastroenterología, del Instituto Nacional de Pediatría, durante el período comprendido entre enero de 1992 y junio de 1993. Se incluyeron todos los niños con dolor abdominal recurrente en quienes se identificó Helicobacter pylori en las biopsias de antro g strico. El tratamiento consistió en la administración simult nea de claritromicina durante 15 días y ranitidina y subsalicilato de bismuto durante un mes. Resultados: en 14 de 22 niños se logró mejoría clínica, así como la eliminación de Helicobacter pylori. Conclusiones: La eliminación de Helicobacter pylori y la mejoría clínica se obtuvieron en el 63.7 por ciento de los niños, con buena tolerancia al tratamiento.

Efeito do Roter sobre as lesöes agudas da mucosa gástrica produzidas pelo uso do álcool / Effect of Roter on acute injuries of gastric mucosa produced by alcohol use

A úlcera péptica é uma das mais freqüentes doenças do aparelho digestivo. Por sua morbidade e pelos aspectos etiopatogênicos atuantes na sua formaçäo, tem se constituído em motivo de investigaçäo. O presente trabalho tem por objetivo avaliar o efeito do álcool sobre a mucosa gástrica, bem como a proteçäo produzida pelo Roter. Utilizou-se 133 ratos Wistar, pesando em média 200 g. Destes, 118 foram submetidos a administraçäo de 1,5 ml de álcool a 50% por sonda gástrica, enquanto 15 receberam soluçäo fisiológica, estando todos em jejum prévio de 24 horas. O tratamento preconizado foi a utilizaçäo de Roter (Nitrato Básico de Bismuto + Carbonato de Magnésio + Acido de Sódio + (Rhamnus purshiana) na dose de 120 mg/ rato/dia. O presente estudo constou de 8 grupos com diferentes tratamentos e concluíu-se que o tratamento efetuado foi significativo para o número de lesöes e mostrou-se ainda mais efetivo em relaçäo à gravidade das lesöes. As lesöes produzidas pelo álcool säo reversíveis após 48 horas e esta reversäo é potencializada pelo tratamento com Roter

Contaminación bacteriana gástrica por empleo de bloqueadores H2: efecto del bismuto coloidal como bactericida / Gastric bacterial contamination by the use of H2 blockers: effect of choloidal bismuth as bactericidal

Estudio abierto y prospectivo donde se evalúa el efecto bactericida del tripotásico-diccitrato bismutato, administrado en pacientes críticamente enfermos, con bloqueo H2 protector gástrico y en los que se demostró contaminación bacteriana gástrica. Los resultados muestran una efectividad del 100% sobre bacterais y aparente resistencia por parte de cándida albicans. La muestra es aún pequeña para una evaluación definitiva, más los resultados iniciales señalan una llamativa efectiviadad bactericida

Citoprotección de la mucosa gástrica inducida por T.D.B. ante la agresión del etanol: mecanismos sulfidrilo, dopaminérgico y prostaglandino endógeno dependientes / Cytoprotection of gastric mucosa induced by T.D.B. against the ethanol aggression: sulphydryl, dopaminergic and dependent endogenous prostaglandin mechanisms

En varios grupos de ratas blancas Wistar, se estudió el efecto citoprotector gástrico inducido por TDB ante la agresión del etanol absoluto; donde se halló protección macroscópica y citoprotección histológica del cuerpo gástrico y no en el antro gástrico. El mecanismo de citoprotección dado por TDB, fue estudiado por las pruebas indirectas de la Indometacina, CL2 Hg, Domperidona, Clorpromazina y Acetozolamida, dadas como pre tratamiento, protegiendo la mucosa gástrica con TDB y posterior agresión con etanol. Se concluyó que TDB dio citoprotección gástrica por el mecanismo de los sulfrilos no proteicos endógenos; así como por su acción dopaminérgica neuronal periférica, parcialmente por su acción prostaglandino endógena dependiente; muy escasamente por incremento del AMPc y no participa el bicarbonato de sodio