Effect of EDTA Activation on Blood Clot Structure in Regenerative Endodontics: A Scanning Electron Microscopy Study.

INTRODUCTION: EDTA plays a crucial role in regenerative endodontic therapy (RET) because of its significant biological effects. However, EDTA is also recognized as the preferred anticoagulant for hematologic tests. Thus, this study aimed to assess the influence of different EDTA activation techniques on the morphology of blood clots after conditioning the root canal dentin. METHODS: Forty extracted human teeth were prepared to simulate immature teeth and divided into the following 5 groups: (1) saline solution (negative control), (2) EDTA 17% + saline solution (CNI), (3) CNI + ultrasonic activation, (4) CNI + Easy clean activation, and (5) CNI + XP-endo Finisher activation. After irrigation, the roots were cleaved, and the root canals were filled with human blood to clot formation. The morphology and density of erythrocytes, platelets, and the fibrin network were observed using a scanning electron microscope. The fibrin network density was classified using a 4-point scale. Data were analyzed using the Friedman test and the Kruskal-Wallis test with Bonferroni adjustment (α = 5%). RESULTS: All groups exhibited consistent blood clot morphology characterized by a high density of erythrocytes, platelets, and white blood cells throughout the entire length of the root canal. The negative control group showed statistically significant high scores of fibrin density compared with the CNI group in all root thirds (P < .05). However, there was no statistical difference in the scores for the fibrin network density between the groups irrigated with EDTA with and without activation (P > .05). CONCLUSIONS: EDTA may impair the fibrin network formation compared with the saline group. However, EDTA activation did not significantly change the effects on the blood clot in contact with the conditioned intraradicular dentin.

Cochlear Implantation in Children with Auditory Neuropathy: Meta-Analysis.

BACKGROUND: Auditory neuropathy (AN) is a nosological entity of unknown etiology, which is associated with fluctuations in rates of speech discrimination. Its diagnosis is based on presence of otoacoustic emissions and lack of, or abnormal, brainstem auditory evoked potential. With respect to treatment, we have variable results in the literature about development of speech perception and skills, in children with AN and cochlear implant (CI) rehabilitation. OBJECTIVES: Comparatively assessing results recorded for the development of auditory and speech skills in children with auditory neuropathy spectrum disorder (ANSD), who were subjected to cochlear implantation, in comparison to results recorded for children with sensorineural hearing loss associated with other causes was the objective of this study. METHOD: A systematic literature review with meta-analysis was performed, with studies published from 1975 to 2023. RESULTS: Nineteen studies were included in the systematic review, and eight were selected for the meta-analysis, which showed there was no evidence allowing the conclusion that the two groups were different from each other about results in speech performance after 1 year of CI placement. CONCLUSION: Therefore, this study shows that CI provides the comparable benefit to children with ANSD in comparison to children with neurosensory hearing loss associated with other causes in their speech development.

In Vitro Dental Discoloration Provoked by Intracanal Calcium Silicate-based Dressing Used for Regenerative Endodontic Procedures: An One-year Spectrometric Analysis.

INTRODUCTION: Regenerative endodontic procedures provide conditions for the continuity of apical formation and increase of the dentin wall thickness, being a useful technique to resume root development of necrotic teeth with incomplete apex. This study aimed to evaluate the coronal discoloration promoted by a new intracanal calcium silicate-based dressing and compare it with other intracanal dressings used in regenerative endodontic procedures. METHODS: Sixty bovine incisors were prepared to simulate teeth with incomplete apexes and divided according to the intracanal dressing used: triple antibiotic paste-double antibiotic paste-DAP, calcium hydroxide associated with 2% chlorhexidine gel, calcium hydroxide associated with saline solution, and Bio-C Temp. As control, no dressing was performed. The intracanal dressings remained in the simulated root canal for 21 days. Luminosity (ΔL) and color difference (ΔEab and ΔE00) were evaluated using long-term (1 year) spectrophotometric analysis. The results were analyzed using the ANOVA test with Tukey post hoc with a significance of 5%. RESULTS: Triple antibiotic paste showed the highest values of ΔEab and ΔE00 and lowest values of ΔL (P < .05). Bio-C Temp showed higher ΔEab than the other groups from 6 months (P < .05), higher ΔE00 and lower ΔL after 1 year (P < .05). CONCLUSIONS: Bio-C Temp induced noticeable coronary discoloration after the 1-year analysis.

Surgical Treatment Applied to Bilateral Vocal Fold Paralysis in Adults: Systematic Review.

INTRODUCTION: Bilateral vocal fold paralysis is a condition accounting for great mortality and significant worsening in patients' quality of life. Treatment applied to these patients seek balance among breathing, airway protection and voice quality. AIM: Critically and systematically reviewing the current literature on the topic in order to set the best technique to restore breathing comfort, without the need of tracheostomy, in patients with bilateral vocal fold paralysis. Furthermore, it seeks the surgical type technique accounting for the best breathing rate and for the smallest changes in voice parameters. MATERIALS AND METHODS: Preferred Reporting Items for Systematic Reviews and Meta-Analyses method methodology and population, interventions, comparatives, outcomes and study design criteria were used as systematic search in the biggest databases and in the grey literature. The following meshes were used for the search: surgical interventions, surgical treatment, bilateral vocal cord paralysis, bilateral vocal fold paralysis, tracheostomy, decannulation, voice, and dysphonia. The selected studies should have followed the randomized clinical-trial type or be longitudinal observational controlled prospective studies (cohort studies). RESULTS: In total, 3,548 articles were found. After duplicate studies were removed from the selection, the inclusion and exclusion criteria were applied and 06 articles were selected for qualitative analysis. CONCLUSIONS: The assessed surgical procedures showed good cost-benefit to treat bilateral vocal fold paralysis, either because they improved the breathing function in most patients and allowed decannulation in patients with tracheostomy, or because they accounted for small changes to both voice parameters or deglutition. However, none of the described techniques has shown respiratory and functional outcomes better than those recorded for the other ones. The decision on what surgery to perform still must be made based on the judgement of an experienced surgeon.

Prevalence of dental trauma in Brazilian children and adolescents: a systematic review and meta-analysis.

This study aimed to investigate the prevalence of dental trauma in Brazilian children and adolescents. A systematic review was conducted considering eight databases: MEDLINE (via PubMed), LILACS, BBO, Scopus, Embase, Web of Science, Open Access Theses and Dissertations, and OpenThesis. Only prevalence studies that used a probabilistic sampling method were included, without restriction on year or language of publication. The JBI critical appraisal tools for prevalence studies were used to assess the individual risk of bias. The individual studies were combined in the meta-analysis using the random-effects model. The heterogeneity between the studies was analyzed by Cochran's Q and the I-square statistics. A meta-regression analysis was performed to evaluate the sources of heterogeneity. The GRADE approach assessed the certainty of evidence across included studies. The search resulted in 2,069 records, of which 36 were included in the study. The eligible studies were published from 2000 to 2021, with a total sample of 40,194 children and adolescents. Most studies (75%) had a low risk of bias. In permanent teeth, the prevalence of dental trauma was 21% (95%CI: 16.0; 26.0) and in deciduous teeth; 35% (95%CI: 26.0; 44.0). The prevalence of dental trauma among boys was higher than among girls for both dentitions. Based on a low certainty, the prevalence of traumatic dental injuries in Brazilian children and adolescents is higher than that found worldwide both in deciduous and permanent teeth. Also, the prevalence of dental trauma among boys is higher than among girls.

Cochlear implant and tinnitus-a meta-analysis.

INTRODUCTION: Tinnitus is a frequent symptom in cochlear implant patients, often reported as persistent and disabling in implant candidates. Tinnitus is rarely considered in the preoperative evaluation of patients who are eligible for cochlear implantation. Many studies have shown that a cochlear implant leads to a significant change in the perception of tinnitus. OBJECTIVE: To identify evidence in the scientific literature indicating that cochlear implant in eligible patients with tinnitus can improve tinnitus perception. METHODS: One hundred forty articles were found from nine databases, and 20 articles from the gray literature mentioned the relationship between cochlear implant and tinnitus perception in patients eligible for cochlear implant. The PICOS (population, intervention, comparison, and outcome) strategy, was used to define the eligibility criteria. The studies that met the inclusion criteria for this second step were included in a qualitative synthesis, and each type of study was analyzed using the Joanna Briggs Institute critical appraisal checklist for quasi-experimental studies and the Joanna Briggs Institute critical appraisal checklist for randomized clinical trials. RESULTS: The full texts of 11 articles were read, and 6 studies were selected for the meta-analysis. The total sample size in the evaluated articles was 136 patients with tinnitus who were eligible for cochlear implantation. CONCLUSIONS: Taken together, these findings support the feasibility of cochlear implantation to reduce the perception of tinnitus, thus providing a new perspective in the treatment of tinnitus in patients with hearing loss who are candidates for cochlear implantation.

Prevalence of dental trauma in Brazilian children and adolescents: a systematic review and meta-analysis / Prevalência de lesões dentárias traumáticas em crianças e adolescentes brasileiros: uma revisão sistemática e metanálise / Prevalencia de lesiones dentales traumáticas en niños brasileños y adolescentes: una revisión sistemática y metaanálisis

Abstract: This study aimed to investigate the prevalence of dental trauma in Brazilian children and adolescents. A systematic review was conducted considering eight databases: MEDLINE (via PubMed), LILACS, BBO, Scopus, Embase, Web of Science, Open Access Theses and Dissertations, and OpenThesis. Only prevalence studies that used a probabilistic sampling method were included, without restriction on year or language of publication. The JBI critical appraisal tools for prevalence studies were used to assess the individual risk of bias. The individual studies were combined in the meta-analysis using the random-effects model. The heterogeneity between the studies was analyzed by Cochran's Q and the I-square statistics. A meta-regression analysis was performed to evaluate the sources of heterogeneity. The GRADE approach assessed the certainty of evidence across included studies. The search resulted in 2,069 records, of which 36 were included in the study. The eligible studies were published from 2000 to 2021, with a total sample of 40,194 children and adolescents. Most studies (75%) had a low risk of bias. In permanent teeth, the prevalence of dental trauma was 21% (95%CI: 16.0; 26.0) and in deciduous teeth; 35% (95%CI: 26.0; 44.0). The prevalence of dental trauma among boys was higher than among girls for both dentitions. Based on a low certainty, the prevalence of traumatic dental injuries in Brazilian children and adolescents is higher than that found worldwide both in deciduous and permanent teeth. Also, the prevalence of dental trauma among boys is higher than among girls.

Resumo: O estudo buscou investigar a prevalência de trauma dentário em crianças e adolescentes brasileiros. Foi realizada uma revisão sistemática em oito bases de dados: MEDLINE (via PubMed), LILACS, BBO, Scopus, Embase, Web of Science, Open Access Theses and Dissertations e OpenThesis. Foram incluídos apenas estudos de prevalência que usavam métodos de amostragem probabilística, sem limitação de ano ou idioma de publicação. Para avaliar o risco individual de viés, foram utilizadas as ferramentas de avaliação crítica da JBI para estudos de prevalência. Os estudos individuais foram combinados na metanálise com o uso do modelo de efeitos aleatórios. A heterogeneidade entre os estudos foi analisada pelas estatísticas Q de Cochran e I-quadrado. A análise de metarregressão foi realizada para avaliar as fontes de heterogeneidade. A abordagem GRADE avaliou a certeza das evidências entre os estudos incluídos. A busca resultou em 2.069 registros, dos quais 36 foram incluídos no estudo. Os estudos elegíveis foram publicados entre 2000 e 2021, com uma amostra total de 40.194 crianças e adolescentes. A maioria dos estudos (75%) teve baixo risco de viés. Nos dentes permanentes, a prevalência de trauma dentário foi de 21% (IC95%: 16,0; 26,0) e nos dentes decíduos foi de 35% (IC95%: 26,0; 44,0). A prevalência de trauma dentário foi mais alta no sexo masculino que no feminino, para ambas as dentições. Com base na baixa certeza, a prevalência das lesões dentárias traumáticas em crianças e adolescentes brasileiros é mais alta que no resto do mundo, tanto nos dentes decíduos quanto nos permanentes. Além disso, a prevalência de trauma dentário é mais alta em meninos que em meninas.

Resumen: Este estudio tuvo como meta investigar la prevalencia de trauma dental en niños y adolescentes brasileños. Se realizó una revisión sistemática considerando ocho bases de datos: MEDLINE (via PubMed), LILACS, BBO, Scopus, Embase, Web of Science, Open Access Theses and Dissertations y OpenThesis. Solamente se incluyeron estudios de prevalencia que usaron un método de muestreo probabilístico, sin restricción sobre el año o lengua de publicación. Se usó las herramientas de evaluación crítica del JBI para estudios de prevalencia studies para evaluar el riesgo individual de sesgo. Los estudios individuales se combinaron en metaanálisis, usando un modelo de efectos aleatorios. La heterogeneidad entre los estudios se analizó mediante las estadísticas de Cochran Q e I-cuadrado. Se realizó un análisis de meta-regresión para evaluar las fuentes de heterogeneidad. El enfoque GRADE evaluó la certidumbre de evidencia a través de los estudios incluidos. La búsqueda resultó en 2.069 registros, de los cuales treinta y seis se incluyeron en el estudio. Los estudios elegibles se publicaron entre 2000 y 2021, con una muestra total de 40.194 niños y adolescentes. La mayoría de los estudios (75%) tenían un bajo riesgo de sesgo. En los dientes permanentes la prevalencia de trauma dental fue 21% (IC95%: 16,0; 26,0) y en los dientes deciduos la prevalencia de trauma dental fue 35% (IC95%: 26,0; 44,0). La prevalencia trauma dental entre niños fue más alta que entre niñas en ambas denticiones. Basado en una baja certidumbre, la prevalencia de lesiones traumáticas dentales en niños y adolescentes brasileños es más alta que la encontrada en el resto del mundo, tanto en dientes deciduos como en dientes permanentes. Asimismo, la prevalencia de trauma dental entre niños es más alta que entre niñas.

Provenance of heavy and clay minerals in bottom sediments of Green Lake, an Amazonian fluvial lake in Brazil

Studies on provenance of minerals in Amazonian rivers focus mostly on suspended sediments, while processes that control bottom-sediment production and distribution are still little known. We determined the provenance of the bottom sediments of Green Lake, a micro-basin draining into the Tapajós River, in the eastern Brazilian Amazon. We used X-ray powder diffraction (XRD), Fourier-transform infrared spectroscopy (FTIR), scanning electron microscope (SEM) and, cathodoluminescence techniques to analyze clay, light and heavy minerals of 22 samples. The lake is L-shaped, with 5.5 m maximum depth, and predominance of mud over sand in the center. Quartz and feldspar were dominant in the light fraction, while zircon, tourmaline, kyanite, rutile, and staurolite were dominant in the heavy fraction. The clay fraction was dominated by kaolinite, with morphology and degree of crystallinity indicative of a detrital origin related to weathering. The Alter do Chão Formation (ACF) is suggested as the main source of sand sediments and heavy minerals, due to their mineralogical and percentage similarity. The provenance of kaolinite was mainly the ACF, with a minor contribution of the Amazon and Tapajós rivers. The primary origin of the heavy minerals in the ACF indicates the basement of the Amazonas Basin as source rock and this formation as a source of sediments for Green Lake through weathering and erosion processes under current tropical conditions. The presence of Aulacoseira granulata and Aulacoseira ambigua indicates the importance of current erosive processes on sediment production. (AU)

Vaginose bacteriana: aspectos microbiológicos e terapêutica com imidazólicos / Bacterial Vaginosis: microbiological and therapeutics aspects with imidazoles

Os autores apresentm os aspectos microbiológicos conhecidos que envolvem a fisiopatologia e diagnóstico da vaginose bacteriana, uma afecção comum que acomete mulheres em idade reprodutiva e que se manifesta clinicamente com o corrimento vaginal de odor desagradável. Posteriormente apresentam e discutem a eficácia dos imidazólicos utilizados para o seu tratamento, ressaltando as controvérsias e os problemas decorrentes da utilização desses medicamentos na prática clínica.

Vaginites: recursos auxiliares para o diagnóstico correto / Vaginitis: complementary methods for the correct diagnosis

Os sintomas relacionados com os processos inflamatórios da vagina são freqüentemente encontrados em mulheres que procuram atendimento nos ambulatórios de ginecologia. Embora, essas mulheres mereçam atenção especial do médico, a multiplicidade de etiologias e diferentes manifestações clínicas limitam a eficácia do exame clínico para fins diagnósticos. Os métodos complementares são importantes para o diagnóstico de vaginite, pois o correto esclarecimento da etiologia assegura uma abordagem terapêutica adequada. Os autores apresentam uma revisão bibliográfica sobre a avaliação diagnóstica de vaginites, onde são descritos os vários recursos propedêuticos, enfatizando a importância da utilização adequada de cada um deles

Corrimento vaginal / Vaginal discharge

Os autores fazem uma revisão bibliográfica sobre corrimento vaginal, abrangendo os aspectos epidemiológicos, etiológicos e clínicos. São enfatizadas as múltiplas etiologias, onde se incluem desde modificações fisiológicas do meio vaginal até processos infecciosos, aléricos ou auto-imunes

Ação da solução do polivinilpirrolidona-iodo como agente descontaminante de enxertos osteotendinosos: análise in vivo em cobaias / Polyvinylpyrrolidone iodine solution as a decontamination agent for osteotendinous grafts: an in vivo analysis in rats

Os autores realizaram trabalho experimental, no qual estudaram a contaminação de um enxerto osteotendinoso de tendÒo aquileu e calcÔneo em trÛs grupos de ratos Roltsmann e a eficiencia do polivinilpirrolidona-iodo (PVPI) em solução aquosa como agente descontaminante, bem como sua interferencia no processo de consolidação/cicatrização. Após analise clinica, anatomopatológica e radiológica dos especimes, os autores encontraram um pequeno indice de infecção e complicações quanto Ó cicatrização/consolidação nos ratos nos quais o enxerto, após contaminação, foi submetido a imersão numa solução aquosa de PVPI a 10,0 por cento. Esse, portanto, mostrou-se um eficaz agente de descontaminação com influência deleteria, porem não significativa (p = 0,3042) no processo de consolidação do enxerto osteotendinoso

Una visión desde la UNESCO hacia la reducción de vulnerabilidad de la planta física educativa

El Programa de Arquitectura para la Educación, de la UNESCO, es coordinado por la Sección de Arquitectura para la Educación en la sede. Se lleva a cabo a través de las oficinas regionales de educación de la UNESCO (Dakar, Bangkok, Beirut y Santiago) donde trabajan de manera interdisciplinaria con planificadores de la educación y pedagogos. Las actividades del programa son: Cooperación técnica con los Estados Miembros; Formación y capacitación, desde el punto de vista de la reducción de la vulnerabilidad. Todas estas acciones están interrelacionadas e implican un seguimiento permanente en cada país para tener resultados a corto, mediano y largo plazo. Se presentan ejemplos de intervenciones de la UNESCO en materia de establecimientos educativos