Preclinical in vivo animal models of intervertebral disc degeneration. Part 1: A systematic review.

Intervertebral disc degeneration (IVDD), a widely recognized cause of lower back pain, is the leading cause of disability worldwide. A myriad of preclinical in vivo animal models of IVDD have been described in the literature. There is a need for critical evaluation of these models to better inform researchers and clinicians to optimize study design and ultimately, enhance experimental outcomes. The purpose of this study was to conduct an extensive systematic literature review to report the variability of animal species, IVDD induction method, and experimental timepoints and endpoints used in in vivo IVDD preclinical research. A systematic literature review of peer-reviewed manuscripts featured on PubMed and EMBASE databases was conducted in accordance with PRISMA guidelines. Studies were included if they reported an in vivo animal model of IVDD and included details of the species used, how disc degeneration was induced, and the experimental endpoints used for analysis. Two-hundred and fifty-nine (259) studies were reviewed. The most common species, IVDD induction method and experimental endpoint used was rodents(140/259, 54.05%), surgery (168/259, 64.86%) and histology (217/259, 83.78%), respectively. Experimental timepoint varied greatly between studies, ranging from 1 week (dog and rodent models), to >104 weeks in dog, horse, monkey, rabbit, and sheep models. The two most common timepoints used across all species were 4 weeks (49 manuscripts) and 12 weeks (44 manuscripts). A comprehensive discussion of the species, methods of IVDD induction and experimental endpoints is presented. There was great variability across all categories: animal species, method of IVDD induction, timepoints and experimental endpoints. While no animal model can replicate the human scenario, the most appropriate model should be selected in line with the study objectives to optimize experimental design, outcomes and improve comparisons between studies.

Expansão unilateral da maxila com a utilização de aparelho expansor apoiado em mini-implantes (MARPE) / Unilateral maxillary expansion using an expander device supported in mini-implants (MARPE)

Resumo A Expansão Rápida da Maxila (ERM) vem sendo uma alternativa eficaz para correção das deformidades faciais com uso de aparelhos disjuntores. Na literatura atual são muitos os artigos relacionados à expansão maxilar apoiada em miniparafusos (MARPE) e a utilização desse sistema ajudando muito nas correções transversais superiores, principalmente, em indivíduos adultos sem a necessidade de cirurgias assistidas. Com a evolução da técnica, alguns autores sugeriram as corticoperfurações sobre a rafe palatina no intuito de fragilizar essa estrutura, favorecendo uma separação das hemimaxilas. Ainda mais recente foi complementada com perfurações também na região de crista infrazigomática, facilitando ainda mais o ganho transversal e em alguns casos, corrigindo a assimetria facial com uma expansão unilateral. Quando realizadas as perfurações unilaterais em uma das cristas infrazigomáticas, pode se observar o deslocamento lateral da maxila em maior quantidade no lado em que a crista foi fragilizada. A comprovação em radiografias e tomografias desse maior ganho unilateral abre um novo horizonte para as correções assimétricas da face. O objetivo deste trabalho é comprovar esse tipo de correção e o maior deslocamento unilateral da maxila após a utilização desse sistema. (AU)

Abstract Rapid Maxillary Expansion (RME) has been an effective alternative for correcting facial deformities with the use of circuit breakers. In the current literature there are many articles related to maxillary expansion supported by miniscrews (MARPE) and the use of this system helping in many upper transverse corrections, especially in adult individuals without the need for assisted surgery. With the evolution of the technique, some authors have suggested corticoperforations over the palatine raphe in order to weaken this structure, favoring hemimaxillas separation. More recently, it was complemented with perforations also in the infrazygomatic crest region, facilitating even more the transversal gain and in some cases correcting the facial asymmetry with a unilateral expansion. When performing unilateral perforations in one of the infrazygomatic ridges, we can observe a greater amount of lateral displacement of the maxilla on the side where the ridge was weakened. The confirmation in radiographs and tomographies of this greater unilateral gain opens a new horizon for face asymmetric corrections. The objective of this work is to substantiate this type of correction and the greater unilateral displacement of the maxilla after using this system. (AU)

Smear layer removal by different chemical solutions used with or without ultrasonic activation after post preparation.

OBJECTIVES: This study evaluated smear layer removal by different chemical solutions used with or without ultrasonic activation after post preparation. MATERIALS AND METHODS: Forty-five extracted uniradicular human mandibular premolars with single canals were treated endodontically. The cervical and middle thirds of the fillings were then removed, and the specimens were divided into 9 groups: G1, saline solution (NaCl); G2, 2.5% sodium hypochlorite (NaOCl); G3, 2% chlorhexidine (CHX); G4, 11.5% polyacrylic acid (PAA); G5, 17% ethylenediaminetetraacetic acid (EDTA). For the groups 6, 7, 8, and 9, the same solutions used in the groups 2, 3, 4, and 5 were used, respectively, but activated with ultrasonic activation. Afterwards, the roots were analyzed by a score considering the images obtained from a scanning electron microscope. RESULTS: EDTA achieved the best performance compared with the other solutions evaluated regardless of the irrigation method (p < 0.05). CONCLUSIONS: Ultrasonic activation did not significantly influence smear layer removal.

EUS-guided Gastrojejunostomy Versus Laparoscopic Gastrojejunostomy: An International Collaborative Study.

INTRODUCTION: Endoscopic ultrasound-guided gastrojejunostomy (EUS-GJ) with placement of a lumen-apposing metal stent is a minimally invasive and efficacious procedure for gastric outlet obstruction (GOO) patients not amenable to surgery. Laparoscopic gastrojejunostomy (Lap-GJ) has traditionally been the standard of care. No direct comparison between EUS-GJ and Lap-GJ has been described. Our aim was to compare the clinical outcomes, success rate, and adverse events (AE) of EUS-GJ with Lap-GJ. METHODS: Patients with GOO from 4 academic centers in 3 countries were included. Technical success was defined as successful creation of a gastrojejunostomy. Clinical success was defined as the ability to tolerate a diet postprocedure. RESULTS: Data were collected on 54 patients. A total of 25 patients underwent EUS-GJ (male n=11, mean age 63.9 y) and 29 patients underwent Lap-GJ (male n=22, mean age 75.8 y). Technical success was achieved in 29 (100%) Lap-GJ group patients and 23 (88%) in the EUS-GJ group (P=0.11). AEs occurred in 41% (n=12) of patients in the Lap-GJ group and 12% (n=3) in the EUS-GJ group (P=0.0386). According to the Clavien-Dindo Classification, the Lap-GJ group AEs were grade I (n=4), grade II (n=5), grade III (n=2), and grade V (n=1); the EUS-GJ AEs were grade II (n=2) and grade V (n=1). CONCLUSIONS: Although the EUS-GJ group contained more complex patients, efficacy was similar between the groups. AEs were significantly lower in the EUS-GJ group. EUS-GJ is a safe and efficacious, minimally invasive option for patients with GOO.