InP Nanowire Biosensor with Tailored Biofunctionalization: Ultrasensitive and Highly Selective Disease Biomarker Detection.

Electrically active field-effect transistors (FET) based biosensors are of paramount importance in life science applications, as they offer direct, fast, and highly sensitive label-free detection capabilities of several biomolecules of specific interest. In this work, we report a detailed investigation on surface functionalization and covalent immobilization of biomarkers using biocompatible ethanolamine and poly(ethylene glycol) derivate coatings, as compared to the conventional approaches using silica monoliths, in order to substantially increase both the sensitivity and molecular selectivity of nanowire-based FET biosensor platforms. Quantitative fluorescence, atomic and Kelvin probe force microscopy allowed detailed investigation of the homogeneity and density of immobilized biomarkers on different biofunctionalized surfaces. Significantly enhanced binding specificity, biomarker density, and target biomolecule capture efficiency were thus achieved for DNA as well as for proteins from pathogens. This optimized functionalization methodology was applied to InP nanowires that due to their low surface recombination rates were used as new active transducers for biosensors. The developed devices provide ultrahigh label-free detection sensitivities ∼1 fM for specific DNA sequences, measured via the net change in device electrical resistance. Similar levels of ultrasensitive detection of ∼6 fM were achieved for a Chagas Disease protein marker (IBMP8-1). The developed InP nanowire biosensor provides thus a qualified tool for detection of the chronic infection stage of this disease, leading to improved diagnosis and control of spread. These methodological developments are expected to substantially enhance the chemical robustness, diagnostic reliability, detection sensitivity, and biomarker selectivity for current and future biosensing devices.

The vibrational properties of the bee-killer imidacloprid insecticide: A molecular description.

The chemical imidacloprid belongs to the neonicotinoids insecticide class, widely used for insect pest control mainly for crop protection. However, imidacloprid is a non-selective agrochemical to the insects and it is able to kill the most important pollinators, the bees. The high toxicity of imidacloprid requires controlled release and continuous monitoring. For this purpose, high performance liquid chromatography (HPLC) is usually employed; infrared and Raman spectroscopy, however, are simple and viable techniques that can be adapted to portable devices for field application. In this communication, state-of-the-art quantum level simulations were used to predict the infrared and Raman spectra of the most stable conformer of imidacloprid. Four molecular geometries were investigated in vacuum and solvated within the Density Functional Theory (DFT) approach employing the hybrid meta functional M06-2X and the hybrid functional B3LYP. The M062X/PCM model proved to be the best to predict structural features, while the values of harmonic vibrational frequencies were predicted more accurately using the B3LYP functional.

Spectral engineering with coupled microcavities: active control of resonant mode-splitting.

Optical mode-splitting is an efficient tool to shape and fine-tune the spectral response of resonant nanophotonic devices. The active control of mode-splitting, however, is either small or accompanied by undesired resonance-shifts, often much larger than the resonance splitting. We report a control mechanism that enables reconfigurable and widely tunable mode splitting while efficiently mitigating undesired resonance shifts. This is achieved by actively controlling the excitation of counter-traveling modes in coupled resonators. The transition from a large splitting (80 GHz) to a single-notch resonance is demonstrated using low-power microheaters (35 mW). We show that the spurious resonance shift in our device is only limited by thermal crosstalk, and resonance-shift-free splitting control may be achieved.

Comparison between Clinical Aspects and Salivary Microbial Profile of Children with and without Early Childhood Caries: A Preliminary Study.

PURPOSE: To compare the clinical aspects and microbial profile of children with and without early childhood caries (ECC). STUDY DESIGN: 14 patients (7 without caries and 7 with ECC) were submitted to anamnesis, clinical exam and saliva collection for microbiological analyses. Counts of Streptococcus mutans, Lactobacillus spp. Candida spp., and total microorganisms were performed by culture methods. Microbial diversity was characterized by PCR-DGGE. Demographic/clinical data and salivary microbial counts were compared between groups. RESULTS: Habits of hygiene and breastfeeding presented no association with ECC. Use of pacifiers was associated with absence of caries (p=0.035). Counts of total microorganisms and Candida spp. did not differ between the groups. The ECC group presented larger quantity of S. mutans (p=0.026) and Lactobacillus spp. (p=0.002). There was no correlation between microorganisms and breastfeeding and pacifier use. The dmf-t of ECC Group was 10.5 ± 1.9 and the modified dmf-t was 11.3 ± 3.6. The DGGE demonstrated difference in the pattern of bands between the groups. CONCLUSION: Pacifiers usage was associated with the absence of ECC and microorganism number was higher in the caries group. The PCR-DGGE revealed a characteristic microbial diversity in the ECC Group, being an excellent tool for observing the dynamics of the salivary microbial community in these patients.

Resultados angiográficos e do seguimento clínico de 5 Anos após implante de stents farmacológicos com revestimento biodegradável em pacientes com alto risco de reestenose: análise de subgrupo do estudo randomizado PAINT / Angiographic and 5-year clinical follow-up after implantation of drug-eluting stents with biodegradable coating in patients at high risk of restenosis: the PAINT randomized trial

Introdução: Polímeros biodegradáveis foram desenvolvidos para reduzir a reação de hipersensibilidade associada aos polímeros duráveis dos stents farmacológicos de primeira geração, mantendo sua eficácia antiproliferativa e aumentado sua segurança. Avaliamos os resultados angiográficos de 9 meses e os resultados clínicos de longo prazo dos stents farmacológicos com polímeros biodegradáveis em pacientes com alto risco de reestenose. Métodos: Pacientes com diâmetro de referência ≤ 2,5 mm, extensão da lesão ≥ 15 mm, diabetes, ou uma combinação dessas características foram selecionados da população do estudo PAINT. Esses pacientes foram previamente randomizados e alocados para intervenção coronária percutânea recebendo os stents farmacológicos com polímeros biodegradáveis com sirolimus ou com paclitaxel ou stents metálicos, na razão 2:2:1. Resultados: Cento e setenta e oito pacientes foram tratados com stents farmacológicos com polímeros biodegradáveis (n = 142) ou stents metálicos (n = 36). No acompanhamento angiográfico de 9 meses, os primeiros mostraram menor perda tardia (0,40 ± 0,42 mm vs. 0,90 ± 0,47 mm; p < 0,01) e reestenose binária (7,4% vs. 25%; p < 0,01). No acompanhamento clínico de 5 anos, o grupo com stents farmacológicos com polímeros biodegradáveis mostrou menores taxas do desfecho combinado de morte cardíaca, infarto do miocárdio e revascularização do vaso-alvo (16,2% vs. 38,0%; p = 0,03), principalmente devido à redução da revascularização do vaso-alvo (9,9% vs. 36,1%; p < 0,01). Morte total, morte cardíaca e infarto do miocárdio não foram diferentes entre os grupos. A trombose do stent, provável ou definitiva, ocorreu em 2,8% vs. 0% (p = 0,30). Conclusões: Os stents farmacológicos com polímeros biodegradáveis eluidores de paclitaxel ou sirolimus foram eficazes na redução de reestenose angiográfica aos 9 meses e na necessidade de reintervenção por reestenose clínica em 5 anos, sem aumentar o risco de...

Background: Biodegradable polymers were developed to reduce the hypersensitivity reaction associated to durable polymers found with the first generation drug-eluting stents, while maintaining antiproliferative efficacy and increasing safety. This study evaluated the 9-month angiographic follow-up and long-term clinical outcomes of biodegradable polymer-coated drug-eluting stents compared with identical platform metallic stents in patients with high-risk for restenosis. Methods: Patients with a reference diameter ≤ 2.5 mm, lesion length ≥ 15 mm, diabetes, or a combination of these characteristics were selected from the population of the PAINT trial. These patients were previously randomized and allocated for percutaneous coronary intervention with either a sirolimus-eluting biodegradable polymer-coated stent, a paclitaxel-eluting biodegradable polymer-coated stent, or an identical metallic platform stent, at a ratio of 2:2:1. Results: One hundred and seventy-eight patients were treated with biodegradable polymer-coated drug-eluting stents (n = 142) or bare metal stents (n = 36). At the 9-month angiographic follow-up, biodegradable polymercoated drug-eluting stents had lower rates of late loss (0.40 ± 0.42 mm vs. 0.90 ± 0.47 mm; p < 0.01) and binary restenosis (7.4% vs. 25%; p <0.01). In the 5-year clinical follow-up, the group with biodegradable polymer-coated drug-eluting stents had lower rates of the composite endpoint of cardiac death, myocardial infarction, and target vessel revascularization (16.2% vs. 38.0%; p = 0.03), especially due to the reduction of target vessel revascularization (9.9% vs. 36.1%; (p 0.01). Total death, cardiac death and myocardial infarction were not different among groups. 0% (p = 0.30). Conclusions: Paclitaxel or sirolimus-eluting biodegradable polymer-coated stents were effective in reducing angiographic restenosis at 9 months and the need of reintervention for clinical restenosis in 5...

Antibacterial effect of coffee: calcium concentration in a culture containing teeth/biofilm exposed to Coffea Canephora aqueous extract.

UNLABELLED: This study determined the changes of calcium concentration in a medium containing teeth/biofilm exposed to Coffea canephora extract (CCE). Enamel fragments were randomly fixed into two 24-well polystyrene plates containing BHI. Pooled human saliva was added to form biofilm on fragments. Specimens were divided into treatment groups (G, n = 8 per group) and treated with 50 µl daily for 1 min per week, as follows: G1, 20% CCE; G2, Milli-Q water (negative control); G3, antibiotic (positive control). Six fragments represented the blank control (G4). The calcium content was observed at baseline, 4 and 7 days of treatment by atomic-absorption spectrophotometry. Cross-sectional hardness of enamel was a demineralization indicator. Calcium increased in the medium after 4 and 7 days of treatment in G1 (3·80 ± 1·3 mg l(-1) and 4·93 ± 2·1 mg l(-1) , respectively) and G3 (4th day = 5·7 ± 1·8 mg l(-1) ; 7th day = 6·7 ± 3·5 mg l(-1) ) (P > 0·05). Calcium from G2 decreased after 7 days, which was different from G3 (P < 0·05). The lower calcium content, at the end of the experiment, was represented by G4, 2·16 ± 0·2 mg l(-1) . The increase in calcium after treatment with CCE is probably due to its antibacterial effect, which caused the bacterial lysis and consequent release of calcium in the medium. SIGNIFICANCE AND IMPACT OF THE STUDY: This study revealed an inhibitory action of Coffea canephora against dental biofilm. This coffee species caused bacterial lysis and consequent release of calcium into the medium. Furthermore, the advantage of coffee as an antibacterial beverage is that it is consumed in a concentrated form (6-10%) as opposed to various medicinal infusions that have shown such effect in vitro and are usually consumed at 1-2%. Therefore, a light roasted C. canephora aqueous extract can be considered as a potential anticariogenic substance.

Very late outcomes of drug-eluting stents coated with biodegradable polymers: insights from the 5-year follow-up of the randomized PAINT trial.

BACKGROUND: Few studies have examined the very long-term outcomes after implantation of drug-eluting stents (DES) coated with biodegradable polymers (BP). This report presents the 5-year clinical follow-up of patients treated with BP-DES in the randomized PAINT trial. METHODS: The PAINT study is a prospective, multicenter randomized controlled trial that allocated 274 patients for treatment with two BP-DES formulations [paclitaxel-eluting stents (PES) or sirolimus-eluting stents (SES)] or bare metal stents (BMS) in a 1:2:2 ratio, respectively. The primary end-point of this sub-study was defined as the composite of the major cardiac adverse events (MACE) cardiac death, myocardial infarction (MI) or ischemia-driven target vessel revascularization (TVR) at 5 years. RESULTS: The 5-year MACE rates were different among the groups: 35.3%, 22.5% and 16.9% for BMS, PES and SES, respectively (P<0.05 for both DES vs. bare stent comparisons). The primary end-point was mainly driven by TVR: 31.8%, 14.1% and 12.2% for bare stents, PES and SES, respectively (P<0.05 for both DES vs. bare stent comparisons). The incidence of stent thrombosis (ST) was null for BMS during the entire follow-up. There was no definite or probable ST in the SES group after the second year, while one patient (1.0%) presented with a definite ST episode in the PES group between 4 and 5 years. CONCLUSIONS: The tested biodegradable-polymer coated stents releasing either paclitaxel or sirolimus, compared with same bare metal platform, sustained their effectiveness in reducing combined major adverse cardiac events and re-intervention without an increase in ST during 5 years of follow-up.

Effect of minimally invasive restorations on microorganism count in the oral cavity of a patient with early childhood caries.

BACKGROUND: The effect of minimally invasive restorations on the microorganism count in the oral cavity of children with early childhood caries (ECC) has been only briefly discussed in the literature. CASE REPORT: This study presents the case of a child with ECC who was treated using a minimally invasive restorative approach and the patient's salivary levels of Streptococcus mutans, Lactobacillus spp. and Candida spp. were recorded throughout the treatment. In addition, a detailed discussion on the role of these microorganisms in the development of ECC is also presented. TREATMENT: Included minimally invasive techniques such as ART and removal of caries with ultrasound. The whole unstimulated saliva samples of the patient were inoculated in culture media for microbial count. FOLLOW-UP: A 6-monthly review was achieved for a period of 1 year. The microbiological data were statistically analysed and a significant reduction (ANOVA, p < 0.05) of all microorganisms studied were recorded at the end of the treatment. CONCLUSION: The therapy used in this case and the salivary microorganism levels reported at the end of the treatment showed that minimally invasive restorative techniques were effective in controlling oral microorganisms involved in ECC.

Cross-sectional microhardness of bovine enamel subjected to three paediatric liquid oral medicines: an in vitro study.

AIM: This study aimed to investigate the in vitro effects of three paediatric liquid oral medicines on bovine dental enamel subsurfaces under pH cycling conditions. METHODS: Bovine enamel blocks were evaluated for surface hardness at baseline for sample selection. 52 intact bovine enamel blocks (16mm(2)) were randomly divided into four groups (n=13) according to the immersion treatments: G1: antibiotic (Klaricid®), G2: antihistamine (Claritin®), G3: antihistamine (Dimetapp®) and G4: control (de-ionised water). The blocks were submitted to pH cycling treatments twice a day for 12 days. The medicines were evaluated for pH, viscosity, and concentration of calcium, phosphate and fluoride. After the treatment period, cross-sectional microhardness (CSMH) measurements of the enamel blocks were taken and the data, expressed in Knoop hardness number (kg/mm(2)) was used to calculate the ΔS. STATISTICS: ANOVA followed by the Tukey test were used for statistical analyses (p<0.05). RESULTS: The antibiotic Klaricid® showed the highest concentration of fluoride, calcium and phosphate. Considering pH and viscosity, the following pattern was observed according to the treatment group: G4>G1>G2>G3 and G1>G2>G3>G4 respectively. Regarding the demineralisation pattern, the following results were observed: G4>G3>G2>G1. Compared to the control, the antibiotic and both the antihistamines provoked less demineralisation of the enamel blocks (p<0.05). CONCLUSIONS: Antibiotic G1 (Klaricid®) presented an in vitro protective effect against acid attacks probably due to its mineral content and viscosity.

Late clinical outcomes after implantation of drug-eluting stents coated with biodegradable polymers: 3-year follow-up of the PAINT randomised trial.

AIMS: The long-term clinical performance of drug-eluting stents (DES) coated with biodegradable polymers is poorly known. METHODS AND RESULTS: A total of 274 coronary patients were randomly allocated to paclitaxel-eluting stents, sirolimus-eluting stents, or bare metal stents (2:2:1 ratio). The two DES used the same biodegradable polymers and were identical except for the drug. At three years, the pooled DES population had similar rates of cardiac death or myocardial infarction (9.0% vs. 7.1; p=0.6), but lower risk of repeat interventions (10.0% vs. 29.9%; p<0.01) than controls with bare stents. The cumulative 3-year incidence of definite or probable stent thrombosis in the pooled DES group was 2.3% (first year: 1.8%; second year: 0.4%; third year: zero). There were no significant differences in outcomes between paclitaxel- and sirolimus-eluting stents. CONCLUSIONS: The biodegradable-polymer coated DES releasing either paclitaxel or sirolimus were effective in reducing the 3-year rate of re-interventions.

Inhibitory properties of Coffea canephora extract against oral bacteria and its effect on demineralisation of deciduous teeth.

OBJECTIVES: The antibacterial activity of Coffea canephora extract was evaluated in vitro against Streptococcus mutans and Streptococcus sobrinus. The viability of planktonic cells was analysed by susceptibility tests (MIC and MBC) and time-kill assays. The effect of the extract on dental demineralisation was also investigated. METHODS: Primary 1st molar fragments (n=24) were inoculated with a saliva pool and sustained in a multiple plaque growth system for 10 days to form biofilm. The biofilm was treated with light roasted C. canephora extract at 20%, Milli-Q water (negative control) and chlorhexidine (positive control) once a day, during a week. Blank controls comprised fragments without treatment. Biofilm pH was monitored in the last day of treatment. Changes in tooth mineralisation were assessed by cross-sectional microhardness (CSMH) test. RESULTS: MIC and MBC for S. mutans were 7±2 mg/mL and 160±0 mg/mL, respectively, showing no activity for S. sobrinus. The extract produced a 4-log reduction in the number of colonies of S. mutans after 3-h treatment (p<0.05) with undiluted extract (20%) and MBC concentration (16%). There was no difference among negative/blank controls and coffee plaque pH. Differences between CSMH values of dental fragments subjected to the coffee extract and to chlorhexidine were not significant. At depths up to 30 µm from the enamel surface, coffee extract and chlorhexidine promoted higher CSMH values when compared to blank/negative controls (p<0.05). CONCLUSION: Our data suggest that light roasted C. canephora extract is beneficial as an anticariogenic substance.

Fundamento e desenho do teste randomizado PAINT / Rationale and design for the PAINT randomized trial / Fundamento y diseño del test randomizado PAINT

Fundamento: Descrevemos as bases teóricas e o formato do "Estudo PAINT - Intervenção percutânea com stents com eluição de paclitaxel ou sirolimus em polímero biodegradável comparados com stents sem recobrimento no tratamento de lesões coronárias de novo". Objetivo: Avaliar duas novas formulações de stents com eluição de paclitaxel ou sirolimus em comparação com um stent de estrutura metálica idêntica, porém sem recobrimento polimérico ou eluição de droga. Métodos: O PAINT é um estudo randomizado, multicêntrico, de 3 braços, conduzido em centros terciários brasileiros, que incluiu 275 pacientes alocados para tratamento com os stents InfinniumR (paclitaxel), the SupralimusR (sirolimus) ou Milennium MatrixR (sem recobrimento) na proporção 2:2:1 ratio. Os pacientes apresentavam lesões coronarianas de novo em vasos nativos com um diâmetro entre 2,5 e 3,5 mm, passíveis de tratamento com um único stent com comprimento de 29 mm ou menos. O objetivo primário era comparar a perda tardia aos nove meses de ambos stents com paclitaxel- ou sirolimus versus a perda luminal dos stents convencionais de controle. Objetivos secundários importantes incluíam a comparação angiográfica entre os dois tipos de stents farmacológicos, bem como a análise da ocorrência de eventos clínicos adversos. Resultados e conclusões: O estudo PAINT apresenta um formato peculiar e único que permitiu a avaliação da segurança e eficácia de duas novas formulações de stents farmacológicos, com carreador polimérico biodegradável, e liberação de paclitaxel ou sirolimus, os quais foram comparados contra um stent metálico convencional (objetivo primário). Uma vez que os stents farmacológicos diferiram entre sí somente pela droga, mas eram idênticos nas suas outras características, os estudo também permitiu a comparação do efeito anti-restenótico entre sirolimus e paclitaxel (objetivo secundário).

Background: We describe the rationale and design for the "PercutAneous Intervention with biodegradable-polymer based paclitaxel-eluting or sirolimus-eluting versus bare stents for de novo coronary lesions - PAINT trial". Objectives: To evaluate two novel formulations of paclitaxel-eluting stent and the sirolimus-eluting stent against a stent with the same metallic structure but without polymer coating or drug elution. Methods: The PAINT is a multicenter 3-arm randomized trial, conducted in Brazilian tertiary institutions, which included 275 patients allocated for the InfinniumR paclitaxel-eluting stent, the SupralimusR sirolimus-eluting stent or the Milennium MatrixR bare metal stent in a 2:2:1 ratio. Patients had de novo coronary lesions in native vessels with a diameter between 2.5 and 3.5 mm, amenable for treatment with a single stent of 29 mm or less in length. The primary objetive was to compare the in-stent late loss at 9 months of both paclitaxel- and sirolimus-eluting versus the late loss of control bare metal stents. Important secondary objectives included the comparison in outcomes between sirolimus and paclitaxel stents, as well as the analysis of the incidence of major adverse cardiac events. Results amd conclusions: The PAINT trial had a unique design that allowed for the evaluation of the safety and efficacy profiles of two novel drug-eluting stent formulations, with a biodegradable-polymer carrier and releasing paclitaxel or sirolimus, which were compared against a bare metal stent (primary objective). As the drug-eluting stents differed by the drug, but were identical otherwise, the trial also allowed the comparison of the anti-restenosis effects of sirolimus versus paclitaxel (secondary objective).

Fundamento: Describimos las bases teóricas y el formato del "Estudio PAINT - Intervención percutánea con stents recubiertos de paclitaxel o sirolimus en polímero biodegradable comparados con stents no recubiertos en el tratamiento de lesiones coronarias de novo". Objetivo: Evaluar dos nuevas formulaciones de stents con liberación de paclitaxel o sirolimus en comparación con un stent de estructura metálica idéntica, pero sin recubierto polimérico o liberación de droga. Métodos: El PAINT es un estudio randomizado, multicéntrico, de 3 brazos, llevado a cabo en centros terciaros brasileños, que incluyó a 275 pacientes destinados a tratamiento con los stents InfinniumR (paclitaxel), the SupralimusR (sirolimus) o Milennium MatrixR (no recubierto) en la proporción 2:2:1. Los pacientes presentaban lesiones coronarias de novo en vasos nativos con un diámetro entre 2,5 y 3,5 mm, pasibles de tratamiento con un único stent de hasta 29 mm de longitud. El objetivo primario era comparar la pérdida luminal tardía a los nueve meses de ambos stents con paclitaxel- o sirolimus versus la pérdida luminal de los stents convencionales de control. Los objetivos secundarios importantes incluían la comparación angiográfica entre los dos tipos de stents farmacológicos, así como el análisis de la ocurrencia de eventos clínicos adversos. Resultados y conclusiones: El estudio PAINT presenta un formato peculiar y único que permitió la evaluación de la seguridad y eficacia de dos nuevas formulaciones de stents farmacológicos, con transportador polimérico biodegradable, y liberación de paclitaxel o sirolimus, los que fueron comparados con un stent metálico convencional (objetivo primario). Dado que los stents farmacológicos diferían entre sí solamente por la droga, pero eran idénticos en sus otras características, el estudio también permitió la comparación del efecto antireestenótico entre sirolimus y paclitaxel (objetivo secundario).

Randomized evaluation of two drug-eluting stents with identical metallic platform and biodegradable polymer but different agents (paclitaxel or sirolimus) compared against bare stents: 1-year results of the PAINT trial.

OBJECTIVES: We tested two novel drug-eluting stents (DES), covered with a biodegradable-polymer carrier and releasing paclitaxel or sirolimus, which were compared against a bare metal stent (primary objective). The DES differed by the drug, but were identical otherwise, allowing to compare the anti-restenosis effects of sirolimus versus paclitaxel (secondary objective). BACKGROUND: The efficacy of novel DES with biodegradable polymers should be tested in the context of randomized trials, even when using drugs known to be effective, such as sirolimus and paclitaxel. METHODS: Overall, 274 patients with de novo coronary lesions in native vessels scheduled for stent implantation were randomly assigned (2:2:1 ratio) for the paclitaxel (n = 111), sirolimus (n = 106), or bare metal stent (n = 57) groups. Angiographic follow-up was obtained at 9 months and major cardiac adverse events up to 12 months. RESULTS: Both paclitaxel and sirolimus stents reduced the 9-month in-stent late loss (0.54-0.44 mm, 0.32-0.43 mm, vs. 0.90-0.45 mm respectively), and 1-year risk of target vessel revascularization and combined major adverse cardiac events (P < 0.05 for both, in all comparisons), compared with controls. Sirolimus stents had lower late loss than paclitaxel stents (P < 0.01), but similar 1-year clinical outcomes. There were no differences in the risk of death, infarction, or stent thrombosis among the study groups. CONCLUSION: Both novel DES were effective in reducing neointimal hyperplasia and 1-year re-intervention, compared to bare metal stents. Our findings also suggest that sirolimus is more effective than paclitaxel in reducing angiographic neointima, although this effect was not associated with better clinical outcomes.

Rationale and design for the PAINT randomized trial.

BACKGROUND: We describe the rationale and design for the 'PercutAneous INTervention with biodegradable-polymer based paclitaxel-eluting or sirolimus-eluting versus bare stents for de novo coronary lesions - PAINT trial'. OBJECTIVES: To evaluate two novel formulations of paclitaxel-eluting stent and the sirolimus-eluting stent against a stent with the same metallic structure but without polymer coating or drug elution. METHODS: The PAINT is a multicenter 3-arm randomized trial, conducted in Brazilian tertiary institutions, which included 275 patients allocated for the InfinniumR paclitaxel-eluting stent, the SupralimusR sirolimus-eluting stent or the Milennium MatrixR bare metal stent in a 2:2:1 ratio. Patients had de novo coronary lesions in native vessels with a diameter between 2.5 and 3.5 mm, amenable for treatment with a single stent of 29 mm or less in length. The primary objective was to compare the in-stent late loss at 9 months of both paclitaxel- and sirolimus-eluting versus the late loss of control bare metal stents. Important secondary objectives included the comparison in outcomes between sirolimus and paclitaxel stents, as well as the analysis of the incidence of major adverse cardiac events. RESULTS AND CONCLUSIONS: The PAINT trial had a unique design that allowed for the evaluation of the safety and efficacy profiles of two novel drug-eluting stent formulations, with a biodegradable-polymer carrier and releasing paclitaxel or sirolimus, which were compared against a bare metal stent (primary objective). As the drug-eluting stents differed by the drug, but were identical otherwise, the trial also allowed the comparison of the anti-restenosis effects of sirolimus versus paclitaxel (secondary objective).

Reliability assessment of a plaque scoring index using photographs.

OBJECTIVES: The need to evaluate the reliability of a clinical index before using it as a research tool is clearly recognized. Therefore the aim of this study was to evaluate whether a new calibration method by means of photographs would be useful for assessing the examiners' reliability in the interpretation of a plaque index. METHODS: Nine children were randomly recruited from a public school in Rio de Janeiro, Brazil. Two trained examiners evaluated these children for dental plaque, in a classroom environment, in order to record plaque scores. The children's teeth were dyed and colored photographs were taken of all tooth surfaces using a camera, mouth mirrors and lip retractors. The photographs were evaluated to select and identify the best visible tooth surfaces, and the final sample consisted of 343 tooth surfaces. One week after the clinical examination, both examiners scored the tooth surfaces from the photographs according to the index used. The intra and inter-examiner agreements were measured by intra-class correlation coefficient (ICC) for individual mean scores and for tooth surfaces scores. RESULTS: The data showed an excellent agreement (ICC >0.80) between clinical and photographic examinations, for both examiners, both for tooth surface and patient analysis. The statistics also demonstrated excellent (ICC >0.80) inter-examiner agreement on clinical and photographic examinations. CONCLUSION: The method seems to be an effective technique to evaluate the reliability of the plaque index, improving the reproducibility of epidemiological studies.

Long-term effect of an oral health promotion program for schoolchildren after the interruption of educational activities.

This study aimed to verify the long-term effects of an oral-health-promotion program for 203 schoolchildren 24 months after the interruption of educational activities. They were clinically examined to assess dental plaque and gingival bleeding at baseline, immediately after the educational phase (EP), and 12 and 24 months after withdrawal of the EP The mean plaque scores gradually increased after interruption of the EP, and in the last assessment they were higher than the baseline scores, but similar to the ones verified 12 months after withdrawal of the EP The mean gingival bleeding scores were maintained after interruption of the EP However it was verified that in the last assessment they were lower than the previous evaluations. And, in all analyses, it was far from the baseline mean scores (P < 0.05). Analysis indicated that the duration of the program favorably influenced its outcome.

Case report: ultrasonic cavity preparation -- an alternative approach for caries removal in paediatric dentistry.

BACKGROUND: Since the invention and application of rotating instruments, the operative treatment of carious lesions has often resulted in considerable removal of tooth structure. Moreover, conventional caries removal and cavity preparation by a combination of the use of a turbine and a handpiece with a bur presents disadvantages to very young patients, whose perception of drilling is unpleasant. This report concerns an alternative approach for caries removal in a child using ultrasound and discusses the advantages and disadvantages of this technique. CASE REPORT: A 2-year-old male child was brought by his mother to a private paediatric dental clinic in Rio de Janeiro, Brazil. The mother's main complaint was the presence of dental caries in her son's anterior teeth. Intraoral clinical examination revealed that the patient had two carious lesions in the maxillary central incisors on mesial surfaces. Cavity preparation was performed using ultrasound and restoration with a light-curing resin. FOLLOW-UP: One year and a half after the restorative procedure the patient presented with the restored teeth in perfect condition.