Impact of dengue fever on depression, anxiety, and stress symptoms in Esmeraldas Province, Ecuador: a prospective cohort study.

BACKGROUND: Physical symptoms of dengue have been documented extensively, but knowledge gaps on dengue-associated mental health hazards remain. We investigated the frequency of psychiatric symptoms (depression, anxiety, and stress) and neurocognitive performance during the first year after a dengue episode. METHODS: Using DASS-21 scores at 3, 6, and 12 months, we assessed depression, anxiety, and stress in anti-dengue IgM-positive adults and matched controls during the 2021 dengue season in Esmeraldas Province, Ecuador. Patients with DASS-21 scores ≤ 4 were considered normal; those with scores of 5-7, 8-10, and ≥ 11 indicated mild, moderate, and severe depression, respectively; cutoff scores for anxiety and stress were ≥ 5 and ≥ 9, respectively. We also assessed 'delayed matching to sample' (DMS) and 'spatial working memory' (SWM) using the Cambridge Neuropsychological Test Automated Battery. RESULTS: We enrolled 102 cases and 78 controls. At 3 months, 90 cases and 70 controls were available for follow-up, among these 40/90 (44.4%) cases and 12/70 (17.1%) controls had DASS-21 scores ≥ 5 (RR 2.7, 95% CI [1.5-4.7]). Dengue remained a predictor for depression after adjusting for age, sex, and COVID-19 status. We observed no difference in anxiety between the groups, but stress scores increased at month 3 (RR 1.87, 95% CI [1.01-3.4]). DASS-21 scores normalized during follow-up. DMS and SWM did not differ between groups at 3 and 6 months. At month 12, cases had lower SWM than controls did (p value < 0.001). CONCLUSIONS: Care providers should be aware of dengue-associated mood disorders and facilitate timely referral to mental health services. Future longitudinal studies are warranted to validate our observations regarding the impact of dengue on mental health and neurocognitive status in affected patients.

AMOC decline and recovery in a warmer climate.

This study presents novel insight into the mechanisms of Atlantic Meridional Overturning Circulation (AMOC) reduction and its recovery under a warmer climate scenario. An one-thousand-year-long numerical simulation of a global coupled ocean-ice-atmosphere climate model, subjected to a stationary atmospheric radiative forcing, depict a coherent picture of the Arctic sea ice melting as a trigger for the initial AMOC reduction, along with decreases in the northward fluxes of salt and heat. Further atmospheric-driven ocean processes contribute to an erosion of the stable stratification of the fresher, yet colder waters in the surface layers of the North Atlantic, contributing to the recovery of a permanently altered AMOC.

Exercise intolerance in post-coronavirus disease 2019 survivors after hospitalisation.

Rationale: Post-coronavirus disease 2019 (COVID-19) survivors frequently have dyspnoea that can lead to exercise intolerance and lower quality of life. Despite recent advances, the pathophysiological mechanisms of exercise intolerance in the post-COVID-19 patients remain incompletely characterised. The objectives of the present study were to clarify the mechanisms of exercise intolerance in post-COVID-19 survivors after hospitalisation. Methods: This prospective study evaluated consecutive patients previously hospitalised due to moderate-to-severe/critical COVID-19. Within mean±sd 90±10 days of onset of acute COVID-19 symptoms, patients underwent a comprehensive cardiopulmonary assessment, including cardiopulmonary exercise testing with earlobe arterialised capillary blood gas analysis. Measurements and main results: 87 patients were evaluated; mean±sd peak oxygen consumption was 19.5±5.0 mL·kg-1·min-1, and the tertiles were ≤17.0, 17.1-22.2 and ≥22.3 mL·kg-1·min-1. Hospitalisation severity was similar among the three groups; however, at the follow-up visit, patients with peak oxygen consumption ≤17.0 mL·kg-1·min-1 reported a greater sensation of dyspnoea, along with indices of impaired pulmonary function, and abnormal ventilatory, gas-exchange and metabolic responses during exercise compared to patients with peak oxygen consumption >17 mL·kg-1·min-1. By multivariate logistic regression analysis (receiver operating characteristic curve analysis) adjusted for age, sex and prior pulmonary embolism, a peak dead space fraction of tidal volume ≥29 and a resting forced vital capacity ≤80% predicted were independent predictors of reduced peak oxygen consumption. Conclusions: Exercise intolerance in the post-COVID-19 survivors was related to a high dead space fraction of tidal volume at peak exercise and a decreased resting forced vital capacity, suggesting that both pulmonary microcirculation injury and ventilatory impairment could influence aerobic capacity in this patient population.

Assessment of heart rate turbulence in dogs with myxomatous mitral valve disease.

BACKGROUND: Myxomatous mitral valve degeneration (MMVD) is the most common heart disease affecting small dogs, it reduces cardiac output resulting in compensatory adaptation of the autonomic nervous system. Chronically, it leads to reduced heart rate variability (HRV) which is an accurate marker for autonomic balance. More than two decades ago in human medicine an indicator of autonomic balance that happens after a premature ventricular beat, it was described as heart rate turbulence (HRT). In humans with ischemic heart disease, the absence of HRT has proven to be a more accurate and an independent indicator of mortality than known HRV parameters. Currently, there are very few studies of HRT in dogs and it is still not tested in small dogs within different stages of myxomatous mitral valve disease. AIM: The aim of this study was to assess the HRT indicators, onset and slope, in small dogs with myxomatous mitral valve disease and to statistically test it. METHODS: Dogs under 25 kg had electrocardiogram and echocardiography performed and, in some patients, holter monitoring was carried out. Data were divided into groups B1, B2, C, and D for mean comparison with analysis of variance and Tukey test. In addition, receiver operating characteristic (ROC) curve for differentiating among symptomatic and asymptomatic dogs and for differentiating between remodeled and non-remodeled hearts. The Pearson was executed after correlations of turbulence onset (TO) and turbulence slope (TS) with commonly used echocardiographic parameters. RESULTS: Variance analyses held significant differences in TO and TS between stages B1 from stages C and D, while B2 held similarity to the other groups. In the receiver operating curve was found a very good area under the curve for differentiating among symptomatic and asymptomatic dogs and remodeled and non-remodeled dogs. Few echocardiography parameters held weak correlation with TO while others held weak to moderate correlation with TS. CONCLUSION: In dogs with MMVD and without other diseases, HRT is a feasible indicator for autonomic balance. Our result suggests HRT changes as the MMVD progresses and congestive heart failure is present. More studies with HRT are needed. The number of ventricular premature contractions (VPCs) may be the strongest limitation for the technique.

Electrocardiographic markers of myocardial conduction and repolarization in Boxer dogs / Marcadores eletrocardiográficos de condução e repolarização miocárdica em cães da raça Boxer

Electrocardiographic markers have been used in people to classify arrhythmogenic risk. The aims of this study were to investigate electrocardiographic markers of conduction and repolarization in Boxers and non-Boxer dogs, and compare such findings between groups. Ten-lead standard electrocardiograms of Boxer dogs and non-Boxers recorded from 2015 to 2018 were retrospectively reviewed. Dogs >/ 4 years of age and weighing > 20kg were included. Animals with valvular insufficiencies, congenital cardiopathies, cardiac dilation, suspected systolic dysfunction, biphasic T-wave, bundle branch blocks, and those receiving antiarrhythmics were excluded. Electrocardiographic markers of conduction, QRS duration (QRSd) and dispersion (QRSD), and repolarization (corrected QT interval, Tpeak-Tend, JT and JTpeak), as well as derived indices, were measured. Two hundred dogs met the inclusion/exclusion requirements, including 97 Boxers (8.1±2.5 years old; 30±7kg) and 103 non-Boxer (8.8±2.5 years old, 30±8kg). QRSd and QRSD, and repolarization markers in lead II and left precordial lead V4 were considered similar between groups. Dispersion of late repolarization on lead rV2, Tpeak-Tend interval, was considered longer in Boxers (45±8ms vs 38±10ms, P=0.01). The Tpeak-Tend/JTpeak and the JTpeak/JT also differed between groups. Our results indicate that the dispersion of myocardial late repolarization in lead rV2 is slower in Boxers than other dog breeds.(AU)

Marcadores eletrocardiográficos têm sido estudados em seres humanos para estratificação do risco arritmogênico. Os objetivos deste estudo foram investigar os marcadores eletrocardiográficos de condução e repolarização miocárdica em Boxers e em cães de outras raças, e comparar tais resultados entre os grupos. Para tal, a eletrocardiografia convencional de 10 derivações registradas de 2015 a 2018 foram avaliadas de maneira retrospectiva. Cães com idade igual ou superior a 4 anos e pesando > 20kg foram incluídos. Animais com insuficiência valvar, cardiopatias congênitas, dilatação cardíaca, suspeita de disfunção sistólica, onda T bifásica, bloqueio(s) de ramo(s), ou aqueles que recebiam antiarrítmicos foram excluídos. Variáveis eletrocardiográficas de condução, como a duração e dispersão do complexo QRS (QRSd e QRSD, respectivamente), e repolarização (intervalo QT corrigido, Tpico-Tfinal, JT e JTpico), bem como índices derivados, foram mensurados. Duzentos cães que se adequaram aos critérios de inclusão/exclusão foram incluídos, 97 Boxers (8,1±2,5 anos; 30±7kg) e 103 não Boxers (8,8±2,5 anos; 30±8kg). O QRSd e o QRSD, e os marcadores de repolarização nas derivações II e V4 foram similares entre os grupos. O marcador de dispersão da repolarização tardia na derivação rV2, Tpico-Tfinal, foi considerado mais longo no Boxers (45±8ms vs 38±10ms, P=0.01). O Tpico-Tfinal/JTpico e o JTpico/JT também diferiram entre os grupos. Nossos resultados indicam que a dispersão da repolarização miocárdica tardia na derivação precordial direita, rV2, é mais lenta no Boxer do que nas outras raças.(AU)

Electrocardiographic markers of myocardial conduction and repolarization in Boxer dogs / Marcadores eletrocardiográficos de condução e repolarização miocárdica em cães da raça Boxer

ABSTRACT: Electrocardiographic markers have been used in people to classify arrhythmogenic risk. The aims of this study were to investigate electrocardiographic markers of conduction and repolarization in Boxers and non-Boxer dogs, and compare such findings between groups. Ten-lead standard electrocardiograms of Boxer dogs and non-Boxers recorded from 2015 to 2018 were retrospectively reviewed. Dogs >/ 4 years of age and weighing > 20kg were included. Animals with valvular insufficiencies, congenital cardiopathies, cardiac dilation, suspected systolic dysfunction, biphasic T-wave, bundle branch blocks, and those receiving antiarrhythmics were excluded. Electrocardiographic markers of conduction, QRS duration (QRSd) and dispersion (QRSD), and repolarization (corrected QT interval, Tpeak-Tend, JT and JTpeak), as well as derived indices, were measured. Two hundred dogs met the inclusion/exclusion requirements, including 97 Boxers (8.1±2.5 years old; 30±7kg) and 103 non-Boxer (8.8±2.5 years old, 30±8kg). QRSd and QRSD, and repolarization markers in lead II and left precordial lead V4 were considered similar between groups. Dispersion of late repolarization on lead rV2, Tpeak-Tend interval, was considered longer in Boxers (45±8ms vs 38±10ms, P=0.01). The Tpeak-Tend/JTpeak and the JTpeak/JT also differed between groups. Our results indicate that the dispersion of myocardial late repolarization in lead rV2 is slower in Boxers than other dog breeds.(AU)

Marcadores eletrocardiográficos têm sido estudados em seres humanos para estratificação do risco arritmogênico. Os objetivos deste estudo foram investigar os marcadores eletrocardiográficos de condução e repolarização miocárdica em Boxers e em cães de outras raças, e comparar tais resultados entre os grupos. Para tal, a eletrocardiografia convencional de 10 derivações registradas de 2015 a 2018 foram avaliadas de maneira retrospectiva. Cães com idade igual ou superior a 4 anos e pesando > 20kg foram incluídos. Animais com insuficiência valvar, cardiopatias congênitas, dilatação cardíaca, suspeita de disfunção sistólica, onda T bifásica, bloqueio(s) de ramo(s), ou aqueles que recebiam antiarrítmicos foram excluídos. Variáveis eletrocardiográficas de condução, como a duração e dispersão do complexo QRS (QRSd e QRSD, respectivamente), e repolarização (intervalo QT corrigido, Tpico-Tfinal, JT e JTpico), bem como índices derivados, foram mensurados. Duzentos cães que se adequaram aos critérios de inclusão/exclusão foram incluídos, 97 Boxers (8,1±2,5 anos; 30±7kg) e 103 não Boxers (8,8±2,5 anos; 30±8kg). O QRSd e o QRSD, e os marcadores de repolarização nas derivações II e V4 foram similares entre os grupos. O marcador de dispersão da repolarização tardia na derivação rV2, Tpico-Tfinal, foi considerado mais longo no Boxers (45±8ms vs 38±10ms, P=0.01). O Tpico-Tfinal/JTpico e o JTpico/JT também diferiram entre os grupos. Nossos resultados indicam que a dispersão da repolarização miocárdica tardia na derivação precordial direita, rV2, é mais lenta no Boxer do que nas outras raças.(AU)

The gill-associated microbiome is the main source of wood plant polysaccharide hydrolases and secondary metabolite gene clusters in the mangrove shipworm Neoteredo reynei.

Teredinidae are a family of highly adapted wood-feeding and wood-boring bivalves, commonly known as shipworms, whose evolution is linked to the acquisition of cellulolytic gammaproteobacterial symbionts harbored in bacteriocytes within the gills. In the present work we applied metagenomics to characterize microbiomes of the gills and digestive tract of Neoteredo reynei, a mangrove-adapted shipworm species found over a large range of the Brazilian coast. Comparative metagenomics grouped the gill symbiont community of different N. reynei specimens, indicating closely related bacterial types are shared. Similarly, the intestine and digestive gland communities were related, yet were more diverse than and showed no overlap with the gill community. Annotation of assembled metagenomic contigs revealed that the gill symbiotic community of N. reynei encodes a plethora of plant cell wall polysaccharides degrading glycoside hydrolase encoding genes, and Biosynthetic Gene Clusters (BGCs). In contrast, the digestive tract microbiomes seem to play little role in wood digestion and secondary metabolites biosynthesis. Metagenome binning recovered the nearly complete genome sequences of two symbiotic Teredinibacter strains from the gills, a representative of Teredinibacter turnerae "clade I" strain, and a yet to be cultivated Teredinibacter sp. type. These Teredinibacter genomes, as well as un-binned gill-derived gammaproteobacteria contigs, also include an endo-ß-1,4-xylanase/acetylxylan esterase multi-catalytic carbohydrate-active enzyme, and a trans-acyltransferase polyketide synthase (trans-AT PKS) gene cluster with the gene cassette for generating ß-branching on complex polyketides. Finally, we use multivariate analyses to show that the secondary metabolome from the genomes of Teredinibacter representatives, including genomes binned from N. reynei gills' metagenomes presented herein, stands out within the Cellvibrionaceae family by size, and enrichments for polyketide, nonribosomal peptide and hybrid BGCs. Results presented here add to the growing characterization of shipworm symbiotic microbiomes and indicate that the N. reynei gill gammaproteobacterial community is a prolific source of biotechnologically relevant enzymes for wood-digestion and bioactive compounds production.

A Simplified Approach to Select Exercise Endurance Intensity for Interventional Studies in COPD.

Time to exercise limitation (Tlim) in response to constant work rate (CWR) is sensitive to interventions in chronic obstructive pulmonary disease (COPD). This is particularly true when the pre-intervention test lasts between 3 and 8 min (Tlim3'-8'). There is, however, no simple method to select a work rate which is consistently associated with Tlim3'-8' across the spectrum of COPD severity. We assessed 59 GOLD stages II-IV patients who initially cycled to Tlim at 75% peak. In case of short (<3 min, low-endurance) or long (>8 min, high-endurance) tests, patients exercised after 60 min at 50% or 90%, respectively (CWR50%⇐75%⇒90%). Critical mechanical constraints and limiting dyspnea at 75% were reached within the desired timeframe in 27 "mid-endurance" patients (46%). Increasing work rate intensity to 90% hastened the mechanical-ventilatory responses leading to Tlim3'-8' in 23/26 (88%) "high-endurance" patients; conversely, decreasing exercise intensity to 50% slowed those responses leading to Tlim3'-8' in 5/6 (83%) "high-endurance" patients. Repeating the tests at higher (60%) or lower (80%) intensities fail to consistently produce Tlim3'-8' in "low-" and "high-endurance", respectively (p > 0.05). Compared to a fixed work rate at 75%, CWR50%⇐75%⇒90% significantly decreased Tlim's coefficient of variation; consequently, the required N to detect 100 s or 33% improvement in Tlim decreased from 82 to 26 and 41 to 14, respectively. This simplified approach to individualized work rate adjustment (CWR50%⇐75%⇒90%) might allow greater sensitivity in evaluating interventional efficacy in improving respiratory mechanics and exercise tolerance while simultaneously reducing sample size requirements in patients with COPD.

Clinical impact of the immunochemical fecal occult blood test for colorectal cancer screening in Brazil.

BACKGROUND: Colorectal cancer (CRC) screening programs based on the fecal occult blood test (FOBT) reduce CRC mortality. We carried out an observational prospective study to determine the accuracy of immunochemical FOBTs for the detection of CRC in individuals at average risk for the disease. METHODS: This population-based study was performed between April 2015 and January 2016 in two gastroenterology referral centers in Southern Brazil. It included 1039 average-risk volunteers aged 50-75 years who were symptom-free for colonic disease. Participants underwent OC-Light immunochemical fecal occult blood test (i-FOBT, EIKEN chemical Co., Tokyo, Japan) as well as screening colonoscopy. RESULTS: Nine hundred forty-eight (91.2%) of the 1039 participants completed and returned the i-FOBT (95% confidence interval [CI] 89.4-92.9). Among the 73 participants with a positive i-FOBT who underwent colonoscopy, advanced CRC was detected in 9 (12.3%). Two (2.7%) early CRCs, 7 (9.5%) high-grade dysplasia adenomas and 25 (34.2%) low-grade dysplasia adenomas were also diagnosed. Among the 243 negative i-FOBT cases who underwent colonoscopy, one (0.4%) advanced CRC and 91 (37.6%) low-grade dysplasia adenomas were detected. The detection rate of CRC considering the whole screened population (n=1039) was 1.05% (11/1039). CONCLUSIONS: The i-FOBT test in the CRC screening programs in Brazil showed a high compliance and high detection rates for cancers and high-risk adenomas. The i-FOBT test is feasible for CRC screening in an average-risk population.

[High sensitivity T troponin and CA-125 as prognostic biomarkers in patients with end stage renal disease in hemodialysis]. / Troponina T ultrasensible y CA125 como marcadores pronóstico en pacientes con enfermedd renal terminal en hemodialisis.

INTRODUCTION: The end stage renal disease confers a high morbidity and mortality risk, mainly due to cardiovascular disease. The cardiac T troponin and carbohydrate antigen-125 (CA-125) are useful biomarkers to determine cardiovascular prognosis in order to start preventive treatment in the high risk patients. METHODS: We included patients with end stage renal disease in hemodialysis treatment. Plasma high sensitivity cardiac T troponin (hs-TNT) and CA-125 were measured at the beginning of follow up. The patients with clinical evidence of an acute myocardial infarction were excluded. Twelve month after the measurement of the biomarkers the patients were called to assess the occurrence of major adverse cardiovascular events (MACE) and hospitalizations for any reason. RESULTS: Eighty seven patients were included. The mean age was 5815 years, and 76% were male. The hs-TNT was elevated in 95.4% of the patients and the median value was 49 ng/l (15.3 - 214.1). CA-125 median value was 13.7 U/ml (6.1 - 52.7). The patients that presented a MACE had higher CA-125 (p< 0.03) and hs-TNT (p <0.001); and all of them had a troponin value ≥ 69.37 ng/l. CONCLUSIONS: The prevalence of high hs-TNT was 95.4% and of CA-125 10%. MACE were significantly higher in patients with elevated biomarkers, conferring them prognostic utility in this group of patients.

Diagnóstico diferencial entre doença de crohn e hidradenite supurativa: relato de caso / Differential diagnosis between crohn's disease and hidradenitis supurativa: case report

A doença de Crohn é uma doença inflamatória intestinal crônica com inflamação transmural segmentar, que pode complicar com formação de fístulas e abscessos. A hidradenite supurativa (HS) é caracterizada por abscessos recorrentes e dolorosos, com predileção por áreas ricas em glândulas apócrinas como as regiões axilares, inguinais e perineal. O diagnóstico diferencial entre estas doenças é difícil e pode comprometer o tratamento. Relatamos o caso de C.R.M.A., 40 anos, feminina, branca, com doença de Crohn íleocolônica com fístula perianal e retovaginal há 12 anos, em terapia biológica desde maio 2010. Em setembro de 2010 apresentou abscesso em glúteo direito com saída de secreção purulenta refratária ao uso de ciprofloxacino e metronidazol. Ultrassonografia apresentando coleção de 30 cm3 em região glútea direita. A hipótese diagnóstica foi HS e a paciente foi submetida à ressecção cirúrgica em bloco (10 x 2 cm), com cicatrização por segunda intenção. Realizou enxerto de pele em dezembro de 2010 sem sucesso. Retornou em janeiro de 2011 com nova fístula no local da ressecção, compatível com doença de Crohn. Em fevereiro de 2011 foi submetida à drenagem dos abscessos e colocação de setons nas fístulas perianais. Atualmente em terapia biológica, com boa evolução das fístulas. A prevalência da HS varia de 0,3 a 4% da população em geral. A axila é a região mais afetada e as lesões perianais estão associadas com maior debilidade. Há relatos na literatura de associação entre a HS e a doença de Crohn de forma esporádica, e novos estudos são necessários para avaliar uma patogênese em comum. O diagnóstico diferencial deve ser realizado em todos os casos para tratamento imediato, evitando-se, assim, as complicações e a piora da qualidade de vida do doente.

Crohn?s disease is a chronic inflammatory bowel disease with segmental transmural inflammation, which complicate with formation of fistulas and abscesses. The hidradenitis suppurativa (HS) is characterized by recurrent abscesses, with a predilection for areas rich in apocrine glands such as the axillary, inguinal and perineal. The differential diagnosis between these diseases is difficult and may compromise treatment. Report case: C.R.M.A., 40 year-old, female, white, ileal and colonic Crohn?s disease complicated with perianal and rectovaginal fistula for 12 years, treated with biological therapy since May 2010. In Sep/2010 presented with an abscess in the buttock D with purulent discharge refractory to the use of ciprofloxacin and metronidazole. USG: collection of 30 cm3 in buttock D. The diagnosis was HS and the patient underwent extensive surgical removal of the affected areas (10 x 2 cm) with healing by secondary intention. Skin graft performed unsuccessfully in Dec/2010. The patient returned in jan/2011 with a new fistula at the site of resection, consistent with Crohn?s disease. In fev/2011 underwent drainage of abscesses and placement of setons in perianal fistulas. Currently in therapy with good biological evolution of fistulas. The prevalence of HS varies from 0.3 to 4% of the population in general. The axilla is the region most affected and perianal lesions are associated with greater weakness. There are published reports of association between HS and Crohn?s disease sporadically and further studies are needed to assess a common pathogenesis. The differential diagnosis should be performed in all cases planning immediate treatment, avoiding complications and worsening of the patient?s quality of life.

Influence of enamel sandblasting prior to etching on shear bond strength of indirectly bonded lingual appliances.

OBJECTIVE: To test the null hypothesis was that there is no difference in the mean shear bond strength of indirectly bonded lingual brackets prepared with or without sandblasting prior to acid etching. MATERIALS AND METHODS: Forty extracted human premolars were obtained and randomly divided into two groups of 20 each: group I (control), phosphoric acid and indirect bonding with Maximum Cure and Phase II (Reliance, Itasca, Ill); and group II, sandblasting with 50 µm aluminum oxide (Microetcher, Danville Engineering, Danville, Calif) prior to etching and indirect bonding. All products were used according to the manufacturer's instructions. Instron universal testing machine was used to apply an occlusogingival shear force directly onto the enamel-bracket interface at a speed of 0.5 mm/min. The groups were compared using unpaired Student's t-test. Kaplan-Meir survival plots and log-rank test were done to compare the survival distribution between the two groups. RESULTS: Mean (SD) shear bond strength for group I was 13.17 (4.33) MPa and for the group II was 16.42 (5.41) MPa. Significant difference was observed in the bond strengths of the two groups evaluated (P = .048). However, the log-rank test demonstrated that clinical performance of the groups evaluated was not significantly different (P = .091). The adhesive remnant index (ARI) was significantly higher when using sandblasting prior to acid etching than in the control group (P = .011). CONCLUSIONS: Intraoral sandblasting prior to enamel etching increased the bond strength of lingual brackets, but the clinical performance of the groups was not significantly different.

Primer on the base of polycarbonate brackets: should we apply it or not?

OBJECTIVE: The purpose of this study was to evaluate shear bond strength of polycarbonate brackets bonded with or without the previous application of primer on their bases. MATERIALS AND METHODS: Forty-six extracted bovine permanent mandibular incisors were obtained and randomly divided into two groups of 23 each: group 1 (control), 37% phosphoric acid and direct bonding with Orthoprimer (Morelli Orthodontic Products, São Paulo, Brazil) and Orthobond (Morelli Orthodontic Products); and group 2, Orthoprimer application on bracket base prior to conventional bonding. Polycarbonate maxillary central incisor brackets (Composite, Morelli Orthodontic Products) were used in this study. All products were used according to the manufacturer's instructions. An Universal Testing Machine was used to apply an occlusal shear force directly onto the enamel-bracket interface at a speed of 0.5mm/min. The groups were compared using Student's t-test. RESULTS: Mean results and standard deviation (in MPa) for the groups were: group 1 - 5,81 (1,90); and group 2 - 6,09 (1,28). Significant difference was not observed in the bond strengths of the two groups evaluated (p=0.5601). The adhesive remnant index (ARI) did not indicate significant difference (p=0.617) between the two groups. CONCLUSIONS: These results indicated that primer application on polycarbonate bracket base did not result in increased bond strength.

Angiographic and intravascular ultrasound findings following implantation of the Endeavor zotarolimus-eluting stents in patients from the real-world clinical practice.

AIMS: The aim of this study was to investigate the angiographic and intravascular ultrasound (IVUS) findings of the Endeavor zotarolimus-eluting stent (ZES) in patients from a "real-world" clinical practice. METHODS AND RESULTS: From January to March 2006, 100 patients undergoing routine or emergency percutaneous intervention were prospectively enrolled at one institution. Overall, 39% of the patients were diabetics and 80.8% of lesions were type B2/C. A total of 140 lesions were successfully treated with 174 ZES, and procedural success was 98%. Mean vessel diameter was 2.69 mm and mean lesion length was 16.0 mm; at 6-month angiographic follow-up (completed in 96%), in-stent late lumen loss was 0.66 mm, and in-segment restenosis was 8.2%. Angiographic restenosis was increased among diabetics (15.5 vs. 2.6%, p=0.009), and diabetes was the only significant predictor of angiographic restenosis (OR=15.27 [95%CI 2.45-95.04], p=0.003). By IVUS (performed in 88% at 6-month), % volume obstruction was 14.4+/-13.4%, and there was no late acquired incomplete stent apposition (ISA). At 1-year, overall MACE rate was 6%, including 5 TLRs (4% of patients), with no occurrence of stent thrombosis. CONCLUSIONS: In this prospective "real-world" experience, the ZES demonstrated favourable angiographic and IVUS results in complex patients, with overall in-stent late lumen loss of 0.66 mm, and absence of late acquired ISA. At 1-year, there were no safety concerns including absence of death and stent thrombosis.

Shear bond strength of brackets bonded with two light-curing orthodontic adhesives.

PURPOSE: To compare the shear bond strength of stainless steel brackets bonded with two orthodontic adhesive systems, Transbond XT (3M Unitek) and Orthobond (Morelli Dental Products). MATERIALS AND METHODS: Forty bovine teeth were randomly divided in two groups of 20 each: group 1 (control): Transbond XT primer + Transbond XT Adhesive paste (3M Unitek); group 2: Orthoprimer (Morelli Dental Products) + Orthobond. In each group all teeth were etched with 37% phosphoric acid, and all products were used according to manufacturers instructions. After 30 min, a universal testing machine was used to apply an occlusal shear force directly to the enamel/bracket interface at a speed of 0.5 mm/min. The groups were compared using Student's t-test. RESULTS: Mean results and standard deviations for the groups were: group 1= 11.22 Mpa (1.68), group 2= 4.88 Mpa (1.18). A significant difference was observed in the bond strengths of the two groups evaluated (p < 0.0001). CONCLUSION: Under the conditions of this study, Orthobond system presented lower shear bond strength when compared to Transbond XT.

Hiperplasia neo-intimal intra-stent e progressão de placa aterosclerótica no vaso-alvo em pacientes tratados com stents libertadores de zotarolimus / Intra-stent neointimal hyperplasia and plaque progression inthe target vessel in patients treated with zotarolimus eluting stents

Fundamentos: Após intervenções coronárias percutâneas, tem sido descrita uma reação inflamatória local que está diretamente relacionada à hiperplasia neo-intimal e à reestenose. O quanto esse processo inflamatório pode levar à progressão de placa aterosclerótica no vaso tratado ou nas outras artérias coronárias é ainda motivo de debate. Objetivo: Avaliar se há relação entre o grau de hiperplasia intimal intra-stent e a progressão de placa no vaso tratado. Método: Estudo retrospectivo com 36 pacientes com 40 lesões tratados com stents liberadores de zotarolimus, avaliados com ultra-sonografia intracoronária (USIC) após o procedimento e no reestudo protocolar tardio. Obtidos o porcentual do volume de obstrução intimal intra-stent (%VO) e a mudança de volume da placa aterosclerótica fora do segmento tratado (ΔVAT). Avaliamos a intensidade da relação entre as variáveis %VO e ΔVAT por meio do coeficiente de correlação de Spearman. Resultados: O %VO foi de 14,5% ± 14,9%. Observada progressão de placa nas porções proximais (20,04 mm³/mm ± 58,61 mm³/mm) e distais (7,37 mm³/mm ± 25,86 mm³/mm) ao segmento tratadocom stent. Não houve correlação entre o porcentual de hiperplasia neo-intimal e o grau de progressão de placa proximal (-0,015; p = 0,93), distal (-0,166; p = 0,36) ou em ambos os segmentos (-0,026; p = 0,89). Conclusão: Neste grupo de pacientes tratados com stents liberadores de zotarolimus, a ausência de correlação entre o volume de obstrução intimal intra-stent e a progressão de placa fora do segmento tratado sugere a existência de diferentes mecanismos inflamatórios por trás desses processos.

Background: A local inflammatory response has been described after percutaneous coronary intervention and has been associated with neointimal hyperplasia and restenosis. Whether this inflammatory process might cause atherosclerotic progression in the same coronary artery or in the other coronary arteries is a matter of debate. Objectives: To assess a possible relation between the degree of neointimal hyperplasia and the progression of atherosclerotic plaque in the nearby stented segments. Methods: Retrospective study in which 36 patients with 40 lesions treated with zotarolimus eluting stents were studied with intravascular ultrasound (IVUS) during the index and follow-up procedures. In-stent percent volume obstruction (%VO) and change in atheroma volume in the arterial subsegments outside the stented segment (ΔATV) were obtained. We assessed the strength of the relationship between %VO and ΔATV by the Spearman correlation coefficient. Results: %VO was 14.5% ± 14.9%. Plaque progression was observed in proximal (20.04 mm³/mm ± 58.61 mm³/mm) and distal (7.37 mm³/mm ± 25.86 mm³/mm) arterial subsegments nearby the stented segment. There was no correlation between the degree of neointimal hyperplasia and the degree of plaque progression either in the proximal (-0.015; p = 0.93), distal (-0.166; p = 0.36) or both segments (-0.026, p = 0.89). Conclusion: In this group of patients treated with zotarolimus eluting stents, the lack of correlation between the degree of neointimal hyperplasia and plaque progression suggests different inflammatory reactions behind those phenomena.

Efecto de la aplicación de la hormona de crecimiento recombinante (rbST) sobre la respuesta superovulatoria y la viabilidad embrionaria en ovejas de pelo / Effect of recombinant growth hormone (rsST) application on supervolatory response and embyro viability in hair ewes

Se estudió el efecto del uso de una proteína de alto valor nutricional y su interacción con la hormona de crecimiento recombinante (rbST) sobre la respuesta superovulatoria y la viabilidad embrionaria en ovejas de pelo. Se utilizaron doce ovejas adultas de raza Pelibuey, distribuidas completamente al azar en dos tratamientos. TA : Control. TB : 100 mg de Somatotropina Bovina recombinante (rbST). La sincronización del estro en ambos grupos duró 14 días, utilizando esponjas vaginales impregnadas con 40 mg de FGA, con cambio a los 7 días. La superovulación se realizó con FSH ovina (oFSH) a intervalos de 12 h en dosis decrecientes, iniciando 72 h antes de la retirada de las esponjas. En la primera aplicación se les administró adicionalmente 2 mL de prostaglandina PGF2a las ovejas. La inyección de rbST en el TB se hizo junto con la octava aplicación de oFSH. Todas las ovejas se inseminaron vía intrauterina a las 56 ±1 h de la retirada de las esponjas, con semen refrigerado (10 a la 8 espermatozoides/pajuela). Los embriones se colectaron 5 días después de la inseminación y la viabilidad embrionaria se midió utilizando criterios morfológicos. Se observó un incremento en todas las variables de respuesta evaluadas por efecto de la aplicación de rbST: cuerpos lúteos (89 vs 119), cuerpos lúteos considerados (77 vs 117), embriones recuperados (64 vs 78), embriones viables (35 vs 64) y embriones viables por oveja (5,8 vs 10,6) siendo significativa la tasa de ovulación (86,52 por ciento vs 96,64 por ciento) y la tasa de viabilidad embrionaria (54,69 por ciento vs 82,05 por ciento) (P<0,01), esto probablemente se atribuye a que la rbST altera los componentes del sistema de factores de crecimiento insulínico estimulando la esteroidogénesis folicular. La hormona de crecimiento aplicada antes de la ovulación estimula la maduración de mayor cantidad de folículos e incrementa la cantidad recuperada de embriones y la viabilidadembrionaria.

The objective of this study was measure the effect of using nutritional high quality protein and its interaction with recombinant growth hormone over the ovulatory response and embryo viability in hair ewes. Twelve adult multiparous Pelibuey ewes were used and randomly submitted to two different treatments. In treatment A (TA, Control group), the ewes received a superovulation treatment without the application of recombinant growth hormone (rbST) in treatment B (TB), the ewes received the same superovulation treatment with the addition of 100 mg of recombinant bovine somatotropin (rbST). The induction and synchronization of the estrous cycle was realized by the insertion of vaginal sponges impregnated with 40 mg of FGA during 14 days, with sponge change at the seventh day. To induce the superovulation follicle stimulating ovine hormone (oFSH) was used in decreasing doses levels (every 12 h) starting 72 h before the sponges withdrawal. In the first application 2 mL of prostaglandin PGF2a were additionally applied. The application of 100 mg of rbST was done during the eighth administration of oFSH. The ewes were inseminated 56 ± 1 h after the sponge withdrawal with refrigerated semen (108 sperm/ straw). The embryos were collected 5 days after the insemination and the embryo viability was measured by morphological evaluation. An increase was observed in all the variables evaluated in the rbST group: corporea lutea (89 vs 119), corporea lutea considered (77 vs 117), embryos recovered (64 vs 78), viable embryos (35 vs 64), and viable embryos by ewe (5.8 vs 10.6), with statistical significance, considered ovulation rate (86.52% vs 96.64%) and embryo viability rate (54.69% vs 82.05%) (P<0.01), this is probably due to the effect of rbST over the growing insuline factors that control the follicular esteroidogenesis. The rbST application before the ovulation influence the maturation of higher amount of follicles and increase the quantity and viability of the embryos obtained.

Influencia de la suplementación en la dieta con levaduras y minerales sobre la producción de ovocitos de ovejas púberes estimuladas ováricamente / The influence of diet supplementation with yeasts and organic minerals over oocyte production of ovarian stimulated ewes

Para producir ovocitos cultivados “in vivo” se estudió la respuesta superovulatoria de ovejas púberes suplementadas con un alimento proteico que contiene levaduras o minerales orgánicos. Dieciocho hembras (7 meses de edad) fueron distribuidas en 3 grupos: TA:1 kg alimento 15% PC+Yea Sacc®, (levadura Saccharomyces cerevisiae cepa 1026). Dosis: 5 gr/animal/día+heno ad libitum. TB:1 kg alimento 15% PC+Bioplex Plus®, (cultivo de levaduras vivas y minerales orgánicos). Dosis: 4 gr/animal/día+heno ad libitum. TT:Testigo. 1 kg alimento 15% de PC+heno ad libitum. El estro se sincronizó con esponjas vaginales (40 mg FGA) durante 12d. A los 10d de la inserción de las esponjas se aplicó 225 mg de prostaglandina/oveja. La superovulación se realizó 36h antes de la retirada de las esponjas mediante 100 mg-NIH FSHp y 500 UI eCG en una sola dosis/oveja. 24h de la retirada de las esponjas se aplicaron 100 µg GnRH/oveja. La tasa de ovulación se midió por endoscopia. Los ovocitos se recuperaron del oviducto 48h de la retirada de las esponjas. La TO resultó superior (P<0,05) en los TA y TB (16,6±6,84 y 15,5±4,18), respecto al TT (9,16±3,81). La tasa de recuperación (TR) muestra diferencias (P<0,05) entre el TA (93,9%) respecto a los TB (56,9%) y TT (61,8%). La proporción (P<0,05) de ovocitos de calidad 1 en el TA respecto a los TB y TT fue mayor. En conclusión, la adición de levaduras en la dieta favorece la respuesta a un tratamiento de estímulo superovulatorio en ovejas púberes incrementando la tasa de ovulación y calidad de los ovocitos.

The superovulatory response of pre-pubertal or pubertal ewes fed with protein suplement that contained yeast or organic minerals was evaluated in order to obtain “in vivo” maturated oocytes. Eighteen females (7 months of age) were allocated to one of the following treatment and fed as follow: Treatment A (TA): 1 kg food with 15% PC+Yea sacc® (yeast Saccharomyces cerevisiae stump 1026), dose: 5 gr/animal/day and hay ad libitum. Treatment B (TB): 1 kg food with 15% PC+Bioplex Plus® (Cultivation of live yeasts and organic minerals), dose: 4 gr/animal/day and hay ad libitum. Treatment C (TT: Control): 1 kg food with 15% PC and hay ad libitum. The estrous cycle was synchronized through the insertion of vaginal sponges with 40 mg of fluorogestone acetate (FGA) during 12 days. At day 10th of the sponges insertion 225 mg of prostaglandin F2á was administered per ewe. To induce supra-ovulation 100 mg-NIH FSHp and 500 UI eCG in a single dose were applied 36 h before the withdrawal of the sponges, and 24 h from the last application 100 µg of GnRH was also injected. The ovulation rate was measured by endoscopy and ovulated oocytes collected by flushing. The total of ovulation (TO) was greater in the TA and TB (16.6±6.84 and 15.5±4.18) treatment, than on the control TT (9.16±3.81) (P<0.05). The oocyte recovery (TR) after flashing was significantly higher in the TA (93.9%) treatment compared to TB (56.9%) and TT (61.8%). Finally, the proportion (P<0.05) of grade I oocytes in the diet supplementation in TA was in higher than the quality of oocytes in the TB and TT treatment. In conclusion, the addition of with yeasts, to supra-ovulated pre-pubertal ewes promotes ovulation rate and oocytes quality.

Effect of a self-etching primer on shear bond strength of adhesive precoated brackets in vivo.

The aim of this study was to evaluate the influence of a self-etching primer (SEP) (Transbond Plus SEP, 3M Unitek, Monrovia, Calif) on shear bond strength of adhesive uncoated and precoated Victory brackets (3M Unitek). The sample group consisted of 23 patients, with four premolars each, equally divided in four different groups. Brackets were bonded in vivo by the same operator using a split-mouth random technique: group 1, 37% phosphoric acid + primer + composite + conventional Victory bracket; group 2, 37% phosphoric acid + primer + precoated Victory bracket; group 3, SEP + composite + conventional bracket; group 4, SEP + precoated bracket. After 30 days, premolars were extracted for orthodontic reasons and a Universal Instron Machine was used to apply an occlusal shear force directly to the enamel-bracket interface at a speed of 0.5 mm/min. The groups were compared using two-way analysis of variance. Mean results and standard deviation for the groups were: group 1 = 11.60 +/- 2.65 Mpa, group 2 = 9.79 +/- 2.71 Mpa, group 3 = 10.75 +/- 2.67 Mpa, and group 4 = 10.31+/- 2.70 Mpa. No difference was observed between the conventional etching and primer or SEP (P = .948). However, significant differences in bond strength were present between the uncoated and precoated brackets (P = .032). Considering the values required to withstand normal orthodontic forces (8-9 Mpa), it could be concluded that the SEP combined with adhesive precoated brackets showed adequate shear bond strength and may be suitable for clinical use.