Oral and endotracheal tubes colonization by periodontal bacteria: a case-control ICU study.

Periodontal infection is a possible risk factor for respiratory disorders; however, no studies have assessed the colonization of periodontal pathogens in endotracheal tubes (ET). This case-control study analyzed whether periodontal pathogens are able to colonize ET of dentate and edentulous patients in intensive care units (ICU) and whether oral and ET periodontal pathogen profiles have any correlation between these patients. We selected 18 dentate and 18 edentulous patients from 78 eligible ICU patients. Oral clinical examination including probing depth, clinical attachment level, gingival index , and plaque index was performed by a single examiner, followed by oral and ET sampling and processing by quantitative polymerase chain reaction (total bacterial load, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and Tannerella forsythia). Data were statistically analyzed by Mann-Whitney U, two-way analysis of variance (p < 0.05). Among dentate, there was no correlation between clinical parameters and ET bacterial levels. Both dentate and edentulous patients showed similar ET bacterial levels. Dentate patients showed no correlation between oral and ET bacterial levels, while edentulous patients showed positive correlations between oral and ET levels of A. actinomycetemcomitans, P. gingivalis, and T. forsythia. Periodontal pathogens can colonize ET and the oral cavity of ICU patients. Periodontal pathogen profiles tend to be similar between dentate and edentulous ICU patients. In ICU patients, oral cavity represents a source of ET contamination. Although accompanied by higher oral bacterial levels, teeth do not seem to influence ET bacterial profiles.

Influence of endodontic sealers on the bond strength of carbon fiber posts.

OBJECTIVE: The aim of this study was to verify the influence of endodontic sealers on the bond strength of an adhesive system and a resin cement used for carbon posts cementation. METHODS: Thirty extracted human premolars were instrumented and randomly divided into three groups according to the tested sealer: EndoFill, Sealapex, or EndoREZ. Specimens were stored at 37 degrees C. After 48 h, half of specimens were prepared to receive the post and the others after 7 days. The posts were cemented with Adper Single Bond/Rely X ARC and stored in distilled water at 37 degrees C for 7 days. After this period, the specimens were sectioned in three slices (coronal, middle, and apical). The push-out test was performed in a universal machine and the debonded area was examined in a stereomicroscope. RESULTS: Data were submitted ANOVA and Tukey test (alpha = 0.05). The EndoFill showed lower bond strength than other sealers (p < 0.01). The EndoREZ sealer was statistically greater than other groups for coronal and middle portions and similar for apical portion (p > 0.05). Coronal and middle portions showed the best results for all groups, mainly when the canal preparation was performed after 48 h (p < 0.01). Mixed failure occurs with more frequency (55.6%) followed by failure in adhesive-dentin interface (34.4%) and adhesive-post interface (10.0%). CONCLUSION: The use of EndoREZ sealer promoted higher bond strength in root coronal and middle portions when carbon post was fixed with a resin cement.

Macrophage populations and cardiac sympathetic denervation during L-NAME-induced hypertension in rats.

The rat model of hypertension induced by prolonged treatment with Nomega-nitro-L-arginine methyl ester (L-NAME) has been extensively used. However, the effects on cardiac autonomic innervation are unknown. Here, the cardiac sympathetic innervation is analyzed in parallel with myocardial lesions and leukocyte infiltration during L-NAME (40 mg/Kg body weight/day, orally) treatment. The occurrence of cardiomyocyte hypertrophy, a controversial matter, is also addressed. Degenerating cardiomyocytes and focal inflammation occurred one day after treatment. Inflammatory lesions became gradually more frequent until day 7. At day 14 fibroblast-like cells were outstanding. Interstitial and perivascular connective tissue increased from day 28 on. In the left ventricle, cardiomyocyte hypertrophy occurred only around the damaged area during the first 14 days. After 28 days, it became more widespread. In the right ventricle, the hypertrophic cardiomyocytes were restricted to damaged areas. Significant reduction of the noradrenergic nerve terminals occurred from day 3 to 28. The area occupied by ED1+ (hematogenous) macrophages increased until day 7, and dropped to control levels by day 10. ED2+ (resident) macrophages increased from day 3 to 7 and remained higher than control values up to day 77. Animals receiving both L- NAME and aminoguanidine (AG), an inducible nitric oxide synthase (iNOS) inhibitor (65 mg/Kg body weight/day, orally), showed significant decrease in the nitrite serum levels, sympathetic denervation and macrophage infiltration at day 7. No denervation was detectable at day 14 of double treatment, using subcutaneous AG. Our findings favor a role for ED1+ macrophages and iNOS in the hypertension-induced denervation process.