High fructose intake and the route towards cardiometabolic diseases.

It is known that dietary habits have a strong influence on body metabolism. In the last decades, the dietary habits have changed worldwide, and the consumption of fructose, especially in sugar-sweetened beverages, increased significantly. In this perspective, the present review aimed to summarize the effects of fructose on different cardiometabolic conditions. Clinical, experimental, and epidemiological studies evidenced that fructose can exert several deleterious effects when its consumption is above the recommended amounts. The increased fructose consumption decreases satiety, favoring a positive energy balance, increases adipogenesis, leading to visceral fat accumulation, induces ectopic fat accumulation, especially in the skeletal muscle and liver, leading to insulin resistance, inflammation, and lipid metabolism impairment, increases arterial blood pressure and causes vascular damage. Therefore, increased fructose consumption is linked to the development of alarming cardiometabolic conditions, such as obesity, insulin resistance, type 2 diabetes, non-alcoholic fatty liver disease, and cardiovascular diseases, through several different mechanisms. Further clinical and experimental studies are still necessary to elucidate additional signaling pathways and mechanisms by which fructose is involved in all the mentioned cardiometabolic disorders. Also, the reported findings raise the need for the creation of public health policies aimed to prevent diet-associated cardiometabolic disorders, thus improving the population quality of life.

Effect of Syzygium cumini leaves on laying hens performance and egg quality.

The aim of this study was to evaluate the effect of Syzygium cumini leaves (SCL) in laying hens diets on productive performance, egg quality and lipid oxidation of yolk. A total of 108 Hysex White laying hens were distributed in a completely randomized design with three treatments and six replicates of six birds each. The treatments consisted of SCL inclusion at dietary levels of 0, 5 and 10 g/kg. There was no significant effect of SCL inclusion on feed intake, laying percentage, weight and egg mass, feed conversion ratio, Haugh units, specific gravity, percentage of yolk, albumen and egg shells and shell thickness. However, the inclusion of SCL significantly influenced the yolk color and yolk lipid oxidation measured by TBARS values. Yolk color increased and TBARS values ​​decreased with the inclusion of SCL. The inclusion of SCL in laying hens diets improves pigmentation and lipid stability of yolk.

Effect of Syzygium cumini leaves on laying hens performance and egg quality

ABSTRACT The aim of this study was to evaluate the effect of Syzygium cumini leaves (SCL) in laying hens diets on productive performance, egg quality and lipid oxidation of yolk. A total of 108 Hysex White laying hens were distributed in a completely randomized design with three treatments and six replicates of six birds each. The treatments consisted of SCL inclusion at dietary levels of 0, 5 and 10 g/kg. There was no significant effect of SCL inclusion on feed intake, laying percentage, weight and egg mass, feed conversion ratio, Haugh units, specific gravity, percentage of yolk, albumen and egg shells and shell thickness. However, the inclusion of SCL significantly influenced the yolk color and yolk lipid oxidation measured by TBARS values. Yolk color increased and TBARS values ​​decreased with the inclusion of SCL. The inclusion of SCL in laying hens diets improves pigmentation and lipid stability of yolk.

Blood Pressure Decreases Following Lead Treatment Cessation: Highest NO Bioavailability Involved.

Although lead is known to induce arterial hypertension and vascular damage, it is not clear if after cessation of lead treatment, the increase of blood pressure is sustained and the vascular function is different from untreated rats. Therefore, we aimed to evaluate the systolic blood pressure during and following lead-treatment discontinuance and the possible vascular alterations involved with it. Rats received lead acetate (100 mg/L) in the drinking water or distilled water for 14 days. After 14 days, lead acetate solution was substituted by water distilled for more 28 days, as control group. Systolic blood pressure (SBP) was measured weekly by tail plethysmography, and the vascular reactivity to phenylephrine in isolated aortic rings was evaluated at end of treatment time. The increase in SBP induced by lead was reversed after stopping exposure, and it was accompanied by a reduction on vasoconstrictor response to phenylephrine. L-NAME treatment increased the phenylephrine response in both groups, but its effect was greater in lead group. Our findings provide evidence that the increased modulation by NO on contractile response to phenylephrine could be a compensatory mechanism that might contribute to decrease blood pressure after lead treatment cessation.

Acute Cadmium Exposure Reduces the Local Angiotensin I Converting Enzyme Activity and Increases the Tissue Metal Content.

Cadmium exposure causes health problems that may result from increased oxidative stress and from changes in enzyme metalloproteases activities as angiotensin-converting enzyme (ACE). In fact, cadmium produces inhibition of serum ACE but is not known how cadmium acts on tissue ACE activity and whether following acute exposure tissue cadmium content is increased. In order to elucidate these issues, a cadmium bolus was injected intravenously in Wistar rats, and the cadmium content and the ACE activity were measured in the serum, lungs, aorta and kidneys. Moreover, in order to clarify if the cadmium affects directly tissue ACE activity, acute metal exposure in vitro was performed. Our results demonstrated that 120 min following cadmium administration, blood and organ cadmium content were both increased. Serum and lung ACE activity were reduced following acute cadmium exposure, but aortic and kidney ACE activities were not affected. The inhibitory effects induced by cadmium on ACE activity were also observed in the serum, as well as the lungs and the aorta, but not in the kidneys following in vitro exposure. Moreover, the inhibitory effects induced by cadmium on ACE activity were partially restored in vitro by zinc supplementation, suggesting a possible interaction or competition between cadmium and zinc by at the active site of ACE. Summarising, our results suggest that acute cadmium exposure promotes an increase in the tissue metal content that was accompanied by direct inhibition of serum, aorta and lung ACE activity, an effect that is cadmium concentration-dependent and is partially reversed by zinc.

Exposure to a Low Lead Concentration Impairs Contractile Machinery in Rat Cardiac Muscle.

Lead exposure has been considered to be a risk factor for hypertension and cardiovascular disease. Our purpose was to evaluate the effects of low plasma lead concentration on cardiac contractility in isolated papillary muscles. Wistar rats were divided in control group or group treated with 100 ppm of lead acetate in the drinking water for 15 days. Blood pressure (BP) was measured weekly. At the end of the treatment period, the animals were anesthetized and euthanized, and parameters related to isolated papillary muscle contractility were recorded. The lead concentrations in the blood reached 12.3 ± 2 µg/dL. The BP was increased in the group treated with 100 ppm of lead acetate. Lead treatment did not alter force and time derivatives of the force of left ventricular papillary muscles. In addition, the inotropic response induced by an increase in the extracellular Ca(2+) concentration was reduced in the Pb(2+) group. However, the uptake of Ca(2+) by the sarcoplasmic reticulum and the protein expression of SERCA and phospholamban remained unchanged. Postrest contraction was similar in the both groups, and tetanic peak and plateau tension were reduced in lead group. These results demonstrated that the reduction in the inotropic response to calcium does not appear to be caused by changes in the trans-sarcolemmal calcium flux but suggest that an impairment of the contractile machinery might be taking place. Our results demonstrate that even at a concentration below the limit considered to be safe, lead exerts deleterious effects on the cardiac contractile machinery.

Discovery of a rare pterosaur bone bed in a cretaceous desert with insights on ontogeny and behavior of flying reptiles.

A pterosaur bone bed with at least 47 individuals (wing spans: 0.65-2.35 m) of a new species is reported from southern Brazil from an interdunal lake deposit of a Cretaceous desert, shedding new light on several biological aspects of those flying reptiles. The material represents a new pterosaur, Caiuajara dobruskii gen. et sp. nov., that is the southermost occurrence of the edentulous clade Tapejaridae (Tapejarinae, Pterodactyloidea) recovered so far. Caiuajara dobruskii differs from all other members of this clade in several cranial features, including the presence of a ventral sagittal bony expansion projected inside the nasoantorbital fenestra, which is formed by the premaxillae; and features of the lower jaw, like a marked rounded depression in the occlusal concavity of the dentary. Ontogenetic variation of Caiuajara dobruskii is mainly reflected in the size and inclination of the premaxillary crest, changing from small and inclined (∼ 115°) in juveniles to large and steep (∼ 90°) in adults. No particular ontogenetic features are observed in postcranial elements. The available information suggests that this species was gregarious, living in colonies, and most likely precocial, being able to fly at a very young age, which might have been a general trend for at least derived pterosaurs.

A implementação do uso dos sistemas rotatórios em endodontia / The implementation of rotary systems in endodontics

A introdução da técnica de instrumentação rotatória com instrumentos de níquel-titânio (NiTi) diminuiu o número de erros operatórios e aumentou a qualidade dos tratamentos endodôntico. Contudo, poucos trabalhos, no Brasil e no mundo, mostram a difusão do uso de técnicas rotatórias entre os profissionais que realizam endodontia. O presente estudo tem como objetivo analisar o grau de implementação do preparo de canais radiculares com sistemas rotatórios de NiTi na endodontia no Brasil. Para a coleta de dados, foi desenvolvido um questionário on-line autoaplicável composto por 16 questões, enviado para 250 endereços eletrônicos. Das 108 respostas obtidas, os dados analisados nos permitiram observar que 71% eram especialistas em endodontia e 26% estavam cursando a pós-graduação; 88% utilizavam instrumentação mecanizada e, desses, 55% combinavam a rotação contínua com a alternada e, 41% faziam usoapenas da rotação contínua. O risco de fratura e custo operacionalforam os principais motivos abordados para a não implementação dos sistemas rotatórios de NiTi em endodontia.

The use of NiTi rotary instruments in Endodontics increased the quality of endodontic treatments and reduced the number of errors during root canal preparation. There are few papers in Brazil and around the world analyzing the diffusion of this new technology. The aim of this study involving Brazilian dentists was analyzed the accept of the new technologic in Endodontics. The increased purchasing of this new technology does not necessarily lead to correct use and incorporation into practice. A questionnaire survey comprising 16 questions was sent to 250 students and endodontics?s e-mails. The sampling frame was 108, comprising 71% specialists and 26% postgraduate students. Rotary instruments were used by 88%, 55% of them used rotary and alternatedrotation system and 41% only rotary instrumentation. Fracture and the high cost of the instruments were the main reasons for not using rotary NiTi in endodontics.

Efficacy of calcium hydroxide paste prepared with different vehicles against salivary microbial infiltration of root canals.

This in vitro study evaluated the efficacy of calcium hydroxide Ca(OH)2 pastes prepared with different vehicles in preventing bacterial infiltration in teeth exposed to human saliva. This study used 52 central incisors, of which 4 teeth were used as positive and negative controls (n = 2). The root canals were instrumented and filled with Ca(OH)2 paste prepared with different vehicles: saline solution (Group 1), polyethylene glycol (Group 2), or polyethylene glycol and camphorated paramonochlorophenol (Group 3). Only 6 teeth in Group 1 showed contamination. All teeth in Groups 2 and 3 were contaminated after 32 days of incubation. There were significant differences between Groups 1 and the other groups (P < 0.05) in terms of the mean time to contamination. By contrast, there was no such difference in terms of mean time to contamination between Groups 2 and 3 (P > 0.05). Based on the results, it was possible to conclude that calcium hydroxide paste prepared with saline solution was most effective for retarding microbial contamination.

Does Lip-Repositioning Surgery Improve Long-Term Smile Outcome and Dental Esthetics in Patients With Excessive Gingival Display? A Review of the Current Literature.

Focused Clinical Question: In patients with normal crown dimensions and excessive gingival display, does lip-repositioning surgery improve long-term smile outcome and dental esthetics? Clinical Scenario: A 27-year-old systemically healthy female presents with the chief complaint of "excessive gingival display when smiling" (Fig. 1). She reports that orthodontic treatment was performed and that she was referred for orthognathic surgery to correct the maxillary vertical excess and altered passive eruption. Clinically, the patient is periodontally healthy with favorable long-term periodontal prognosis. She is unsatisfied with her smile and states that it is "compromising her self-esteem." However, she refuses to accept the orthognathic surgery because of the extensiveness and morbidity of the procedure. She inquires about alternative solutions for her esthetic problem and whether it is possible to solve her gummy smile with a less invasive procedure. Lip-repositioning and anatomic crown-lengthening surgeries are presented as treatment options. The patient decides to pursue these treatment options. Lip-repositioning surgery is performed as described by Rosenblatt and Simon1 and Simon et al.,2 and healing is uneventful. Anatomic crown lengthening is performed 6 months after the previous surgery. The patient is pleased with the reduction of the excessive gingival display after these procedures (Fig. 2). However, there is lack of clinical evidence regarding the long-term stability of this surgical procedure.

Regeneração endodôntica: existe um protocolo? / Endodontic regeneration: is there a protocol?

O tratamento de dentes com rizogênese incompleta e necrose pulpar representa grande desafio para a terapia endodôntica. O panorama atual recai no conceito de regeneração do tecido pulpar. A endodontia regenerativa propõe o controle da infecção do sistema de canais radiculares, com o mínimo de ação dos instrumentos, farta irrigação. Vários protocolos têm sido propostos com variáveis pequenas, sem um consenso entre os autores. O presente artigo descreve e discute os três principais protocolos e suas variáveis, especificando os pontos mais obscuros de uma terapia que é o mais excitante novo campo da Endodontia e cujos avanços proporcionarão benefícios inestimáveis para toda a população. Importa considerar que o sucesso da regeneração deve atender três principais objetivos: primeiro aeliminação dos sintomas e a evidenciação de reparo dos tecidos periapicais; segundo promover espessamento das paredes do canal e/ou a continuidade da formação radicular (desejável, mas não essencial) e terceiro, obter resposta positiva aos testes de vitalidade, que, se alcançado certamente indicará a presença de um tecido pulpar mais organizado.

Treatment of immature permanent teeth with pulpal necrosis presents a unique challenge to the endodontists. The current panorama lies in the concept of pulpal tissue regeneration. Endodontic regeneration is based on the control of endodontic infection with minimal instrumentation and plentiful irrigation of the root canal system. Different protocols have been suggested with very little differences. The aim of this article is to present the main three basic protocols and their variables, specifying the darkest points of a therapy that is the most exciting new of Endodontics and advances will provide invaluable benefits to the entire population. It considers that the success of regeneration must meet three main goals: primary: the elimination of the symptoms and the evidence of bony healing; secondary: increased root wall thickness and/or increased root length (desirable but perhaps not essential); tertiary: positive response to vitality testing (wich, if achieved, could indicate a more organized vital pulp tissue).

Chronic cadmium treatment promotes oxidative stress and endothelial damage in isolated rat aorta.

Cadmium is a highly toxic metal that is present in phosphate fertilizers, and the incidence of cadmium poisoning in the general population has increased, mainly due to cigarette smoking. Once absorbed, cadmium accumulates in the tissues, causing harmful effects including high blood pressure, endothelial damage and oxidative stress. Oxidative stress is known to efficiently produce oxidized low-density lipoprotein and consequently atherosclerosis, mainly in the aorta. However, the mechanisms through which endothelial damage is induced by cadmium have not been elucidated. Thus, the aim of this study was to investigate the effects of this metal in the isolated aorta and the possible role of oxidative stress. Rats received 100 mg.L(-1) cadmium chloride (CdCl2) in the drinking water or distilled water alone for four weeks. The pressor effect of cadmium was followed throughout the exposure period by tail plethysmography. At the end of the fourth week, the blood cadmium content was established, and the vascular reactivity of the isolated aorta to phenylephrine, acetylcholine and sodium nitroprusside was analyzed in the context of endothelium denudation and incubation with L-NAME, apocynin, losartan, enalapril, superoxide dismutase (SOD) or catalase. We observed an increased response to phenylephrine in cadmium-treated rats. This increase was abolished by catalase and SOD incubation. Apocynin treatment reduced the phenylephrine response in both treatment groups, but its effect was greater in cadmium-treated rats, and NOX2 expression was greater in the cadmium group. These results suggested that cadmium in blood concentrations similar to those found in occupationally exposed populations is able to stimulate NOX2 expression, contributing to oxidative stress and reducing NO bioavailability, despite enhanced eNOS expression. These findings suggest that cadmium exposure promotes endothelial damage that might contribute to inflammation, vascular injury and the development of atherosclerosis.

[Pulmonary and renal involvement in a TNFα antagonist drug-induced sarcoidosis]. / Sarcoïdose pneumo-rénale apparue sous anti-TNFα.

Several cases of sarcoidosis with pulmonary, neurological or ophthalmological involvement occurring during a treatment by anti-TNFα have been reported in the literature. We report a 66-year-old man who presented with renal failure and hypercalcaemia, associated with fatigue, shortness of breath and dry cough. He was receiving infliximab since 2004 for psoriatic arthritis. The diagnosis of sarcoidosis was obtained with biopsy sampling of a mediastinal lymph node, and the lung involvement was documented with lung function tests, bronchoalveolar lavage and computed tomographic scan. Laboratory tests were suggestive of interstitial sarcoid nephritis. Disease course was favourable with corticosteroids and discontinuation of infliximab.

Método para o ensino de endodontia laboratorial: plataforma radiográfica para canais simulados / Method for teaching endodontic laboratory: the radiographic platform for simulated root canals

O preparo do canal radicular tem sido avaliado por diferentes métodos ao longo dos anos: a microscopia ótica, a microscopia eletrônica de varredura, o exame radiográfico, analises fotográficas, moldagem, os métodos computadorizados e recentemente a análise tomográfica. Até 1987, a grande dificuldade na avaliação estava na ausência de um controle negativo uma vez que o preparo só podia ser avaliado após a instrumentação. Neste ano, Bramante et al. desenvolveram um método que permitiu a análise antes e após o preparo, usando dentes incluídos em resina e em morsa adequada e seccionados transversalmente, o qual se tornou o mais importante método para análise da qualidade do preparo do canal radicular. Em 1991 Sydney et al.3, desenvolveram uma plataforma radiográfica com a finalidade de padronizar as tomadas radiográficas, obtendo numa mesma película as imagens dos instrumentos antes e depois da instrumentação, para em seguida analisar a manutenção do trajeto original do canal radicular ou não. Face às restrições no uso de dentes naturais e as dificuldades de sua obtenção, o ensino básico da endodontica viu-se obrigado a buscar alternativas. Dente estas, o uso de canais simulados tem se mostrado uma opção de grande valia o que gerou ao desenvolvimento de uma plataforma radiográfica específica para estes, tornando-se valioso auxiliar no ensino da Endodontia.

Root canal preparation has been evaluated by different methods along the years: common optical microscope, the scanning electron microscope, radiographic examination, photographic studies, root canal models, computer programs and recently the tomography. Until 1987 the difficulty on analyzing root canal preparation was the negative control. In this year, Bramante et al. introduced a method that allowed the analysis before, during and after instrumentation. In 1991 Sydney et al.3 developed the radiographic platform method that makes possible to get in the same film the position of the file at the beginning and at the end of instrumentation. Deviations and imperfection are directly observed. The importance of simulated root canals in teaching endodontics is significant as we have difficulties and restrictions on getting human tooth for the grad students. The development of a radiographic platform for simulated root canals is an important teaching aid in endodontics.

Recanalização tubária videolaparoscópica pós-laqueadura: resultados iniciais / Tubal reanastomosis by videolaparoscopy after surgical sterilization: initial results

Os autores descrevem sua experiência em recanalizaçao tubária videolaparoscópica pós laqueadura em 10 pacientes, tratados no período de junho de 1994 a fevereiro de 1996. A duraçao da 1ª cirurgia foi de 4 horas e 30 minutos e da última foi de 2 horas e 30 minutos. A metade das recanalizaçoes foi ístmo-ístmica. O tamanho mínimo das tubas restantes foi de 4 cm de cada lado e os fios utilizados para a sutura foram o 7-0 e 6-0 monofilamentares, derivados do ácido poliglicólico. A permeabilidade tubária foi verificada pela histerossalpingografia 3 meses após a cirurgia e, como resultado, 88,8 por cento das tubas operadas estavam permeáveis. Quatro das pacientes consideradas aptas para engravidar ficaram grávidas durante o período de seguimento. O tempo médio de permanência hospitalar foi de 24 horas. Nao houve complicaçoes cirúrgicas ou anestésicas.

Increased risk of Pneumocystis carinii pneumonia in patients with Wegener's granulomatosis.

Combining cyclophosphamide (Cy) and corticosteroids has dramatically improved the prognosis of Wegener's granulomatosis (WG). But this treatment carries the risks of severe infectious complications and drug toxicity. During a 10-month period, we observed 6 cases of Pneumocystis carinii pneumonia (PCP) in 23 patients with biopsy-proven WG and renal involvement. These 23 patients were enrolled in a multicenter controlled clinical trial designed to evaluate the efficacy and safety of either intermittent high-dose pulse Cy or daily oral low-dose Cy in combination with oral prednisone. Mean delay of onset of PCP was 2.5 months after the beginning of the immunosuppressive therapy. In all cases, the diagnosis of PCP was established by cytological examination of bronchoalveolar lavage fluid. None of the patients experienced severe leukopenia at the time of diagnosis, but the mean lymphocyte count decreased to 495/mm3 (range 100 to 830/mm3) and 2 patients had inverted CD4/CD8 T-cell ratios. Renal function was significantly impaired (creatininemia = 493.5 vs 195.4 micromol/l; p = 0.03) in the 6 patients presenting PCP vs those without. High-dose co-trimoxazole therapy was successful in 3 patients, but 3 others who required mechanical ventilation died. Treatment of WG with daily prednisone and either pulse or oral Cy may have contributed to higher rates of PCP in the past than previously thought and, therefore, patients currently receiving such a regimen may be at greater risk for PCP. For these patients, this opportunistic infection must remain highly suspect in order to reach a diagnosis earlier and rapidly initiate treatment. In addition, recommendations for prophylactic therapy are needed.