RESUMO
Periodontitis is an oral-cavity inflammatory disease and is the principal cause associated with tooth loss. Matrix metalloproteinases 2 and 9 (MMP-2 and MMP-9) are important proteases involved in periodontal tissue destruction. The omega-3 polyunsaturated fatty acids (ω-3 PUFA) have been demonstrated to possess immunoregulatory properties in periodontitis. The aim of the study was to investigate the effects of ω-3 PUFA on inflammation and on the expression of MMP-2 and -9 in a murine periodontitis model. Twenty-four male C57BL/6 mice were divided into control mice (Control), control mice treated with ω-3 PUFA (O3), mice with periodontitis (P), and mice with periodontitis treated with ω-3 PUFA (P + O3). ω-3 PUFA were administered orally once a day for 70 days. Periodontitis in mice was induced by Porphyromonas gingivalis-infected ligature placement around the second maxillary molar. The mice were sacrificed, and blood and maxillary samples were collected. Flow cytometry was used to quantify tumor necrosis factor-alpha (TNFα), interleukin (IL)-2, IL-4, IL-5, and interferon-gamma. Histologic analysis and immunohistochemistry for MMP-2 and -9 were performed. The data were statistically evaluated using analysis of variance (ANOVA) and the Tukey post hoc test. Histological analysis showed that ω-3 PUFA supplementation prevented inflammation and tissue destruction and revealed that bone destruction was more extensive in the P group than in the P + O3 group (p < 0.05). Also, it decreased the serum expressions of TNFα and IL-2 and the tissue expression of MMP-2 and -9 in the periodontitis-induced model (p < 0.05). ω-3 PUFA supplementation prevented alveolar bone loss and periodontal destruction, probably by decreasing the expression of MMP-2 and MMP-9 and its immunoregulatory properties.
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Ácidos Graxos Ômega-3 , Periodontite , Camundongos , Masculino , Animais , Metaloproteinase 2 da Matriz , Metaloproteinase 9 da Matriz , Ácidos Graxos Ômega-3/farmacologia , Modelos Animais de Doenças , Fator de Necrose Tumoral alfa , Camundongos Endogâmicos C57BL , Periodontite/tratamento farmacológico , Periodontite/prevenção & controle , Periodontite/metabolismo , Inflamação , Dieta , Porphyromonas gingivalisRESUMO
OBJECTIVE: This study aimed to evaluate whether ligature-induced periodontitis and rheumatoid arthritis (RA) potentiate the deleterious effects on functional capacity, periodontal and synovial tissues, leukocyte migration, and interleukin 17 (IL-17) levels, and to investigate the repercussions of single Freund's Complete Adjuvant (FCA) injection associated with periodontitis. MATERIALS AND METHODS: Fifty-one male Wistar rats were randomised into six groups: control (CG, n = 8), RA (RAG, n = 9), periodontitis (PG, n = 9), periodontitis and RA (PRAG, n = 9), periodontitis and intradermal injection (PIDG, n = 9), and periodontitis and intra-articular injection (PIAG, n = 7). The animals underwent ligature placement and one or two injections with FCA to induce RA. Motor disability, nociceptive threshold, joint edema, and muscle strength were assessed, and the animals were euthanized on day 30. Synovial fluid, hemimandibles, and knee joints were collected. RESULTS: PRAG showed no reduction of edema or improvement of muscle strength, whereas it showed most significant changes in leukocyte migration, morphological analyses of the synovial membrane (SM), and radiographic and histometric analyses of the jaw. The PIAG showed some alterations, though not permanent. CONCLUSION: Ligature-induced periodontitis and RA induced by two FCA injections accentuated the deleterious effects on functional capacity, leukocyte migration, synovial and periodontal tissues.
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Artrite Reumatoide , Periodontite , Animais , Masculino , Ratos , Artrite Reumatoide/complicações , Edema/induzido quimicamente , Leucócitos , Modelos Teóricos , Periodontite/complicações , Ratos Wistar , Movimento Celular , Interleucina-17RESUMO
OBJECTIVE: The objective of this study was to summarize and compare the local and systemic impact of different models of experimental periodontitis in mice. DESIGN: After defining the PICO strategy, was performed a search for articles in English following the PRISMA guidelines in PubMed, Embase, Scopus, Web of Science, Cochrane and LILACS databases. The search strategy provided 8815 articles from which were selected experimental studies comparing the local and/or systemic effects of two or more models for the induction of periodontitis in mice according to the inclusion and exclusion criteria. RESULTS: After selection, 7 articles that met the inclusion criteria for the review. Were analyzed differences between the following experimental models of periodontitis in mice: ligature, gavage, injection of bacteria, ligation embedded in bacteria and association between them. CONCLUSION: Although most experimental models of periodontitis are efficient in causing alveolar bone loss, there are differences in their characteristics. In ligature, an acute process is established and the host tends to repair itself, decreasing the significance of this loss over time. In models where bacterial challenge is added bone loss appears to be significant with longer induction time, indicating the presence of a chronic condition. Regarding systemic outcomes, gavage showed greater potential for modulating the host's response with systemic inflammatory changes, proving to be more promising between periodontitis and chronic systemic diseases.
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Perda do Osso Alveolar , Periodontite , Perda do Osso Alveolar/etiologia , Animais , Bactérias , Modelos Animais de Doenças , Ligadura/efeitos adversos , Camundongos , Periodontite/microbiologiaRESUMO
Periodontitis is a chronic inflammatory disease associated with the presence of dysbiotic microbial communities. Several studies interrogating periodontitis pathogenesis have utilized the murine ligature-induced periodontitis (LIP) model and have further examined the ligature-associated microbiome relying on 16S rRNA-based sequencing techniques. However, it is often very challenging to compare microbial profiles across studies due to important differences in bioinformatic processing and databases used for taxonomic assignment. Thus, our study aim was to reanalyze microbiome sequencing datasets from studies utilizing the LIP model through a standardized bioinformatic analysis pipeline, generating a comprehensive overview of microbial dysbiosis during experimental periodontitis.We conducted a reanalysis of 16S rDNA gene sequencing datasets from nine published studies utilizing the LIP model. Reads were grouped according to the hypervariable region of the 16S rDNA gene amplified (V1-V3 and V4), preprocessed, binned into operational taxonomic units and classified utilizing relevant databases. Alpha- and beta-diversity analyses were conducted, along with relative abundance profiling of microbial communities. Our findings revealed similar microbial richness and diversity across studies and determined shifts in microbial community structure determined by periodontitis induction and study of origin. Clear variations in the relative abundance of bacterial taxa were observed starting on day 5 after ligation and onward, consistent with a distinct microbial composition during health and experimental periodontitis. We also uncovered differentially represented bacterial taxa across studies, dominating periodontal health and LIP-associated communities. Collectively, this reanalysis provides a unified overview of microbial dysbiosis during the LIP model, providing new insights that aim to inform further studies dedicated to unraveling oral host-microbial interactions.
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Microbiota , Periodontite , Animais , Camundongos , Bactérias/genética , DNA Ribossômico , Disbiose/microbiologia , Microbiota/genética , Periodontite/microbiologia , RNA Ribossômico 16S/genéticaRESUMO
For decades, the link between poor oral hygiene and the increased prevalence of oral cancer has been suggested. Most recently, emerging evidence has suggested that chronic inflammatory diseases from the oral cavity (e.g., periodontal disease), to some extent, play a role in the development of oral squamous cell carcinoma (OSCC). The present study aimed to explore the direct impact of biofilminduced periodontitis in the carcinogenesis process using a tobacco surrogate animal model for oral cancer. A total of 42 Wistar rats were distributed into four experimental groups: Control group, periodontitis (Perio) group, 4nitroquinoline 1oxide (4NQO) group and 4NQO/Perio group. Periodontitis was stimulated by placing a ligature subgingivally, while oral carcinogenesis was induced by systemic administration of 4NQO in the drinking water for 20 weeks. It was observed that the Perio, 4NQO and 4NQO/Perio groups presented with significantly higher alveolar bone loss compared with that in the control group. Furthermore, all groups receiving 4NQO developed lesions on the dorsal surface of the tongue; however, the 4NQO/Perio group presented larger lesions compared with the 4NQO group. There was also a modest overall increase in the number of epithelial dysplasia and OSCC lesions in the 4NQO/Perio group. Notably, abnormal focal activation of cellular differentiation (cytokeratin 10positive cells) that extended near the basal cell layer of the mucosa was observed in rats receiving 4NQO alone, but was absent in rats receiving 4NQO and presenting with periodontal disease. Altogether, the presence of periodontitis combined with 4NQO administration augmented tumor size in the current rat model and tampered with the protective mechanisms of the cellular differentiation of epithelial cells.
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Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Neoplasias Bucais , Doenças Periodontais , Periodontite , 4-Nitroquinolina-1-Óxido/toxicidade , Animais , Carcinogênese , Carcinoma de Células Escamosas/induzido quimicamente , Carcinoma de Células Escamosas/patologia , Modelos Animais de Doenças , Humanos , Neoplasias Bucais/induzido quimicamente , Neoplasias Bucais/patologia , Ratos , Ratos Wistar , Carcinoma de Células Escamosas de Cabeça e Pescoço , Nicotiana/efeitos adversosRESUMO
OBJECTIVE: In laparoscopic appendectomy (LA), closure of the appendix stump is important. This method must be safe and easy-to-use as well as an economical one. We compared three methods of the appendix stump closure in terms of safety, easiness, and financial cost. MATERIALS AND METHODS: Three-hundred and ten LA patients operated between January 2011 and December 2019 and appendix stump was closed using one of the three methods, namely, non-absorbable polymeric clips (Group 1, n = 126), knot-tying group (Group 2, n = 101), and laparoscopic loop ligature group (Group 3, n = 83) were retrospectively analyzed in terms of stump leakage, infection, operation, and hospital stay duration. RESULTS: There were 148 female and 162 male patients. The mean age was 33.57 ± 12.60 years. There was not any appendiceal stump leakage nor intra-abdominal infection in none of the groups. Local trocar site infection in 11 patients was medically treated. Surgical site infection and hospital stay period did not show statistically important difference among the groups. The operation duration in Group 1 was found to be shorter compared to the other groups. CONCLUSIONS: All three techniques are safe in LA. Non-absorbable polymer clips provide a shorter operation time. Extracorporeal knot-tying with knot-pusher provides the cheapest closure of the stump.
OBJETIVO: En la apendicectomía laparoscópica (LA), el cierre del muñón del apéndice es importante. Comparamos tres métodos de cierre de tocones del apéndice en términos de seguridad, facilidad y costo financiero. MATERIALES Y MÉTODOS: Se incluyeron 310 pacientes de AL intervenidos entre 2011-2019 con cierre del muñón del apéndice mediante uno de los tres métodos: clips poliméricos no absorbibles (grupo 1), grupo de anudado (grupo 2) y grupo de ligadura de asa laparoscópica (grupo 3). Se analizaron las complicaciones, la operación y la duración de la estancia hospitalaria. RESULTADOS: Hubo 148 pacientes mujeres y 162 hombres. La edad media fue de 33.57 ± 12.60 años. No hubo ninguna fuga del muñón apendicular ni infección intraabdominal en ninguno de los grupos. La infección local del sitio del trocar en 11 pacientes fue tratada médicamente. La infección del sitio quirúrgico y el período de estancia hospitalaria no mostraron diferencias estadísticamente importantes entre los grupos. CONCLUSIONES: Las tres técnicas son seguras en LA. Los clips de polímero no absorbible brindan un tiempo de operación más corto. El atado de nudos extracorpóreo con empujador de nudos proporciona el cierre más económico del muñón.
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Apendicite , Laparoscopia , Adulto , Apendicectomia/métodos , Apendicite/cirurgia , Feminino , Humanos , Laparoscopia/métodos , Masculino , Pessoa de Meia-Idade , Polímeros , Estudos Retrospectivos , Instrumentos Cirúrgicos , Adulto JovemRESUMO
OBJECTIVES: The aim of this study was to measure the frictional resistance of different types of ligatures used on conventional and self-ligating brackets. MATERIALS AND METHODS: Monoblock (conventional) and Portia (self-ligating) brackets were used and the archwire used was nickel-titanium. On conventional brackets the ligatures tested were the Elastomeric type and steel 0.30 tie-wire. The groups were divided according to the ligature types (n=8): (1) conventional elastomeric ligature; (2) relaxed conventional elastomeric ligature; (3) elastomeric ligature in shape-8; (4) double vertical elastomeric ligatures; (5) double-crossed elastomeric ligatures; (6) crossed ligature; (7) steel wire ligature; and (8) self-ligating ligature (self-ligating bracket). A segment of five brackets, each ligature types, was mounted. The archwire, between the bracket and the ligature, was connected on Instron® Universal test machine to simulate the frictional resistance. The maximum frictional resistance was obtained, and the mean values were submitted to the analysis of variance (ANOVA) and the Tukey's post-hoc test (α=0.05). RESULTS: The elastomeric ligature in shape-8 showed the highest value compared with other groups (P<0.05). Although the crossed elastomeric ligature presented the lowest mean value and it was not statistically different regarding relaxed conventional elastomeric ligature, steel wire ligature and self-ligating (P≥0.05). CONCLUSIONS: The frictional resistance was influenced by ligature types. Elastomeric Ligature in shape-8 showed the highest frictional force. Crossed Elastomeric Ligature had the lowest frictional force value.
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Braquetes Ortodônticos , Fios Ortodônticos , Ligas Dentárias , Análise do Estresse Dentário , Fricção , Humanos , Teste de Materiais , Níquel , Desenho de Aparelho Ortodôntico , Aço Inoxidável , TitânioRESUMO
Introducción. La apendicectomía por laparoscopia se considera el patrón de oro en el tratamiento de la apendicitis aguda. Sin embargo, su disponibilidad es limitada en nuestro sistema de salud, principalmente por los costos asociados. El objetivo de este estudio fue evaluar la relación entre el uso de los diferentes tipos de energía y los métodos de ligadura de la base apendicular, con las complicaciones postoperatorias, al igual que describir los costos asociados. Métodos. Estudio observacional analítico de una cohorte retrospectiva de pacientes mayores de 15 años a quienes se les realizó apendicectomía por laparoscopia, en un hospital universitario entre los años 2014 y 2018. Se utilizaron modelos de regresión logística y lineal para evaluar la relación entre métodos de ligadura del meso y base apendicular, desenlaces operatorios y costos. Resultados. Se realizaron 2074 apendicectomías por laparoscopia, 58,2 % (n=1207) en mujeres, la edad mediana fue de 32 años. En el 71,5 % (n=1483) la apendicitis aguda no fue complicada. La energía monopolar para la liga-dura del meso apendicular fue la utilizada más frecuentemente en 57,2 % (n=1187) y el Hemolok® el más utilizado para la ligadura de la base apendicular en el 84,8 % (n=1759) de los pacientes. No se observaron diferencias estadísticamente significativas en la tasa de infección del sitio operatorio, reintervención o íleo. El uso de energía simple redujo los costos del procedimiento de manera significativa durante el período evaluado. Discusión. El uso de energía monopolar demostró ser una técnica segura, reproducible y de menor costo en comparación con el uso de energía bipolar, independientemente de la fase de la apendicitis aguda. Lo anterior ha permitido que se realicen más apendicectomías por laparoscopia y que los médicos residentes de cirugía general puedan realizar procedimientos laparoscópicos de forma más temprana
Introduction. Laparoscopic appendectomy is considered the gold standard in the treatment of acute appendicitis. However, its availability is limited in our health system mainly due to the associated costs. The objective of this study is to evaluate the relationship between the use of different types of energy and the methods of ligation of the appendicular base with postoperative complications, as well as to describe the associated costs. Methods. Retrospective observational study of a cohort of patients older than 15 years old who underwent laparoscopic appendectomy in a university hospital between 2014 and 2018. Logistic and linear regression models were used to evaluate the relationship between methods of ligation of the meso and appendicular base, operative outcomes and costs. Results: 2074 laparoscopic appendectomies were performed. Of those, 58.2% (n=1207) were women, median age was 32 years. In 71.5% (n=1483), acute appendicitis was uncomplicated. Monopolar energy for ligation was the most frequently used for ligation of the appendicular meso in 57.2% (n=1187) and Hem-o-lok® the most used for ligation of the appendicular base in 84.8% (n=1759) of the patients. There were no statistically significant differences in the rate of surgical site infection, reoperation, or ileus. The use of simple energy reduced the costs of the procedure significantly during the study period. Discussion. The use of monopolar energy proved to be a safe, reproducible and a lower cost technique compared to the use of bipolar energy, regardless of the phase of acute appendicitis. This has allowed more laparoscopic appendectomies to be performed and the general surgery residents to perform laparoscopic procedures earlier
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Humanos , Apendicite , Laparoscopia , Apendicectomia , Fontes de Energia Bioelétrica , Controle de Custos , LigaduraRESUMO
Chronic ethanol consumption and sepsis cause oxidative stress and renal dysfunction. This study aimed to examine whether chronic ethanol consumption sensitizes the mouse kidney to sub-lethal cecal ligation and puncture (SL-CLP) sepsis, leading to impairment of renal function by tissue oxidative and inflammatory damage. Male C57BL/6J mice were treated for 9 weeks with ethanol (20%, v/v) before SL-CLP was induced. Systolic blood pressure (SBP), survival rate, creatinine plasma, oxidative stress, and inflammatory parameters, inducible nitric oxide synthase (iNOS), cytokines, and metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) levels were evaluated. Chronic ethanol consumption increased SBP, plasma creatinine, O2.-, H2O2, lipid peroxidation, catalase activity, Nox4, IL-6, and TNF-α levels, and MMP-9/TIMP-1 ratio. SL-CLP decreased SBP, increased creatinine, lipid peroxidation, IL-6, TNF-α, nitrate/nitrite (NOx), and iNOS levels, and MMP-2/TIMP-2 ratio, and decreased catalase activity. SL-CLP mice previously treated with ethanol showed a similar decrease in SBP but higher mortality and creatinine levels than SL-CLP alone. These responses were mediated by increased O2-, lipid peroxidation, IL-6, TNF-α, NOx, iNOS, MMP-2, and MMP-9 levels, and MMP-9/TIMP-1 and MMP-2/TIMP-2 ratios. Our findings demonstrated that previous oxidative stress and inflammatory damage caused by ethanol consumption sensitizes the kidney to SL-CLP injury, resulting in impaired kidney function and sepsis prognosis.
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Sepse , Animais , Modelos Animais de Doenças , Peróxido de Hidrogênio , Masculino , Camundongos , Estresse OxidativoRESUMO
Introducción: Las varices esofágicas son canales vasculares que unen la circulación venosa portal y la sistémica. Se forman como consecuencia de la hipertensión portal, predominantemente en la submucosa del tercio inferior del esófago. Objetivo: Caracterizar a pacientes con rotura de varices esofágicas según principales variables clinicoepidemiológicas y terapéutico-endoscópicas. Métodos: Se realizó un estudio observacional, descriptivo y longitudinal de 20 pacientes con hemorragia digestiva alta por rotura de varices esofágicas, los cuales recibieron tratamiento endoscópico con bandas elásticas en el Servicio de Gastroenterología del Hospital General Docente Dr. Juan Bruno Zayas Alfonso de Santiago de Cuba, de noviembre de 2016 a febrero de 2018. En el análisis estadístico se utilizó el porcentaje como medida de resumen y se aplicó la prueba de independencia de la Χ2 para identificar alguna asociación significativa entre variables. Resultados: Existió un predominio del sexo masculino (80,0 %) y del grupo etario de 51 a 60 años (40,0 %). La mayoría de los afectados presentó cirrosis hepática (60,0 %) como causa de la hipertensión portal y hematemesis (50,0 %) como forma de hemorragia digestiva alta; asimismo, el gran tamaño de las varices fue el principal factor de riesgo asociado a la rotura (70,0 %) y, luego de practicado el tratamiento endoscópico, no se produjo resangrado en la casi totalidad de los pacientes (95,0 %). Conclusiones: La aplicación de este procedimiento terapéutico resultó ser satisfactoria y no provocó complicación alguna.
Introduction: The esophageal varicose veins are vascular channels that unite the portal venous and systemic circulation. They are formed as consequence of the portal hypertension, predominantly in the submucosa of the inferior section of the esophagus. Objective: To characterize patients with break of esophageal varicose veins according to main clinical epidemiological and therapeutic-endoscopic variables. Methods: An observational, descriptive and longitudinal study of 20 patients with upper digestive bleeding due to break of esophageal varicose veins was carried out, they received endoscopic treatment with banding in the Gastroenterology Service of Dr. Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba, from November, 2016 to February, 2018. In the statistical analysis the percentage was used as summary measure and the chi-square test was applied to identify the existence of some significant association among variables. Results: There was a prevalence of the male sex (80.0 %) and the 51 to 60 age group (40.0 %). Most of the patients presented liver cirrhosis (60.0 %) as cause of the portal hypertension and hematemesis (50.0 %) as form of upper digestive bleeding; also, the great size of the esophageal varicose veins was the main risk factor associated with the break (70.0 %) and, after the implementation of the endoscopic treatment, there was no second bleeding in almost all the patients (95.0 %). Conclusions: The application of this therapeutic procedure was satisfactory and it didn't cause any complication.
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Varizes Esofágicas e Gástricas , Ligadura , Hematemese , Gastroenterologia , Hipertensão Portal , Cirrose HepáticaRESUMO
Periodontal disease is one of the most common causes of tooth loss in the world. Ligature-induced is the most used method to study periodontitis. Here, we describe a alternative, easy and accessible experimental technique of ligation in mice. Twenty C57BL/6 female mice were divided in two groups, control and ligation. Ligature group (n = 10) was immobilized in a well described stabilization board and ligature was performed at the first molar using a new procedure here described in detail. Eight weeks later animals were euthanized, and periodontitis hallmarks were evaluated. Ligatures remained attached to the teeth in all animal during the hole experiment. The procedure induced a temporary loss of weight but no causalities or tooth loss. The animals affected by ligation in their molar teeth presented all periodontitis hallmarks, including alveolar bone loss, gingival retraction and inflammatory infiltrate in the studied region both macro and microscopically. The alternative method is low cost, easily reproducible, and induces all periodontitis hallmarks that are sustained until 8 weeks after placement. â¢Ligature-induced periodontitis in mouse is a powerful tool of research.â¢Methods describing the procedure in literature are difficult to reproduce.â¢A alternative stabilization and ligation procedure in mice is completely described here.
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Resumen Antecedentes Los casos de epistaxis posterior representan alrededor del 10 al 20% de las epistaxis. El tratamiento convencional para este tipo de padecimientos son los taponamientos nasales. El abordaje quirúrgico (cauterización y/o clipaje) está indicado cuando existe falla del tratamiento médico convencional; sin embargo, en la actualidad, se considera como primera opción. Material y métodos Se revisaron todos los casos de epistaxis posterior tratados en el Hospital Español de México de enero de 2007 a enero de 2017. Se realizó estadística descriptiva e inferencial para comparar al grupo conservador (taponamiento nasal) versus el grupo quirúrgico (clipaje). Resultados Se revisaron 242 expedientes; de ellos, se excluyeron 108. Se incluyeron 134 pacientes: 96 correspondieron al grupo quirúrgico y 38 al conservador. El 60.20% perteneció al género masculino y el 39.80% al femenino. La media para la edad fue de 60 años. El grupo quirúrgico (3.4 ± 1.9 días) requirió menos días de estancia hospitalaria en comparación con el conservador (4.8 ± 3.0 días), p < 0.01. Los pacientes con una epistaxis del lado derecho en el grupo quirúrgico tuvieron un mayor tiempo quirúrgico (p = 0.001) y más días de estancia hospitalaria (p = 0.006). Conclusiones La epistaxis sucede en la mayoría de los casos de forma idiopática; es frecuente en hombres mayores de 60 años con enfermedades cardiopulmonares, sin conocerse de forma precisa su fisiopatología. La epistaxis derecha tratada quirúrgicamente resulta tener más morbilidad. El abordaje quirúrgico es seguro, eficaz y acorta los días de estancia hospitalaria en comparación con el tratamiento conservador.
Abstract Background The cases of posterior epistaxis represent approximately 10 to 20% of all epistaxis. The conventional treatment for this type of ailment is nasal packing. A surgical approach (cauterization and/ or clipping) is indicated when there is a failure of the conventional medical treatment; however, it is currently considered as the first option. Material and methods All the epistaxis cases treated at the Hospital Español de México from January 2007 to January 2017 were reviewed. Descriptive and inferential statistics were used to compare the conservative group (nasal packing) versus the surgical one (clipping). Results 242 dossiers were reviewed, of which 108 were excluded. 134 patients were included: 96 belonged to the surgical group and 38 to the conservative one. 60.20% were male and 39.80% were female. The mean age was 60 years. The surgical group (3.4 ± 1.9 days) required fewer days of hospital stay compared to the conservative group (4.8 ± 3.0 days), p < 0.01. Patients with right-sided epistaxis in the surgical group had a longer surgical time (p = 0.001) and more days of hospital stay (p = 0.006). Conclusions Epistaxis occurs in most cases idiopathically, often in men over 60 years with cardiopulmonary diseases, without a precise knowledge of its physiopathology. Right epistaxis treated surgically results in more morbidity. The surgical approach is safe, effective and shortens the days of hospital stay compared to the conservative treatment.
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Resumen El hallazgo de un cadáver con signos de suspensión y en circunstancias dudosas plantea la posibilidad de que la muerte esté relacionada a la intervención de terceros. Presentamos el caso de un varón de 36 años que fue encontrado muerto, con una compresión cervical mecánica extrínseca, en una vía pública, sin testigos del hecho. Inicialmente, se investigó el caso como un homicidio, con diagnóstico diferencial de suicidio. El estudio exhaustivo del sitio de la muerte, más el examen post-mórtem completo, incluyendo: autopsia, histopatología y toxicología, permitió descartar la posibilidad de la acción de terceros y confirmar la hipótesis diagnóstica de una estrangulación autoinducida, de ubicación atípica, ejecutada con lazo.
Abstract Finding a suspended body in doubtful circumstances raises the possibility that the manner of death is homicide. We present the case of a 36 years-old male who was found dead, with extrinsic mechanical cervical compression, on a public place, there were no witnesses of the fact. Initially, the case was investigated as a homicide, with differential diagnosis of suicide. The comprehensive analysis of the scene and a complete post-mortem examination: including autopsy, histopathology and toxicology results, allowed us to rule out the possibility of the action of third parties and confirm the hypothesis of a self-induced atypical strangulation.
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Humanos , Masculino , Adulto , Autopsia , Suicídio , Causas de Morte , Médicos Legistas , Patologia Legal , Estenose Esofágica , Medicina LegalRESUMO
Background: Splenic hematoma is an encapsulated blood accumulation, which is macroscopically indistinguishable from malignant spleen. The treatment of choice and final diagnosis were by splenectomy and exploratory laparotomy followed by biopsy and histopathological examination, respectively. Nylon tie bands are devices made of polyamide 6.6, same material of surgical nylon wires, and has been used in different surgical procedures in animals. The present report case aimed to describe the use of nylon tie bands polyamide 6.6 in a 2.3-year-old Golden retriever dog diagnosed with splenic hematoma and lymphoid hyperplasia; and the clinical presentation, diagnostic evaluation, histological diagnosis of splenic hematoma and lymphoid hyperplasia. Case: A 2.3-year-old intact male Golden retriever dog was presented with history of anorexia, apathy, regurgitation and weight loss. During the physical examination was identified a mass in the left side of abdomen. The complete blood count (CBC), serum biochemistry, urinalysis, and thoracic radiographs were no alteration. Abdominal ultrasound revealed splenomegaly and heterogeneous hypoechoic structure. Splenectomy using an adjustable nylon ties polyamide 6.6 for hemostasis technique was performed during an exploratory laparotomy. The spleen presented hematoma and lymphoid hyperplasia at the histopathological examination, as well as the presence of siderocalcinotic plate in the trabecular spleen. The dog presented with no regurgitation, apathy or anorexia after 10 days of surgery. CBC, serum biochemistry analysis, thoracic radiographs and abdominal ultrasound revealed no abnormalities. Video laparoscopy did not showed any sign of adherence on the local where used the nylon tie bands. One year and three months after the surgery, the owner was contacted by telephone, since he had changed to other city, and he reported that the dog was healthy without any clinical signs...
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Masculino , Animais , Cães , Esplenopatias/veterinária , Estruturas Linfoides Terciárias , Hemostasia Cirúrgica/métodos , Hemostasia Cirúrgica/veterinária , Nylons , Esplenectomia/veterináriaRESUMO
Background: Splenic hematoma is an encapsulated blood accumulation, which is macroscopically indistinguishable from malignant spleen. The treatment of choice and final diagnosis were by splenectomy and exploratory laparotomy followed by biopsy and histopathological examination, respectively. Nylon tie bands are devices made of polyamide 6.6, same material of surgical nylon wires, and has been used in different surgical procedures in animals. The present report case aimed to describe the use of nylon tie bands polyamide 6.6 in a 2.3-year-old Golden retriever dog diagnosed with splenic hematoma and lymphoid hyperplasia; and the clinical presentation, diagnostic evaluation, histological diagnosis of splenic hematoma and lymphoid hyperplasia. Case: A 2.3-year-old intact male Golden retriever dog was presented with history of anorexia, apathy, regurgitation and weight loss. During the physical examination was identified a mass in the left side of abdomen. The complete blood count (CBC), serum biochemistry, urinalysis, and thoracic radiographs were no alteration. Abdominal ultrasound revealed splenomegaly and heterogeneous hypoechoic structure. Splenectomy using an adjustable nylon ties polyamide 6.6 for hemostasis technique was performed during an exploratory laparotomy. The spleen presented hematoma and lymphoid hyperplasia at the histopathological examination, as well as the presence of siderocalcinotic plate in the trabecular spleen. The dog presented with no regurgitation, apathy or anorexia after 10 days of surgery. CBC, serum biochemistry analysis, thoracic radiographs and abdominal ultrasound revealed no abnormalities. Video laparoscopy did not showed any sign of adherence on the local where used the nylon tie bands. One year and three months after the surgery, the owner was contacted by telephone, since he had changed to other city, and he reported that the dog was healthy without any clinical signs...(AU)
Assuntos
Animais , Masculino , Cães , Hemostasia Cirúrgica/métodos , Hemostasia Cirúrgica/veterinária , Esplenopatias/veterinária , Nylons , Estruturas Linfoides Terciárias , Esplenectomia/veterináriaRESUMO
We evaluated the effects of phenylephrine, norepinephrine, angiotensin II, and vasopressin in mesenteric, renal, carotid, and tail arteries, and in perfused mesenteric vascular bed from rats subjected to the cecal ligation and puncture (CLP) model of sepsis. Phenylephrine and angiotensin II were less efficacious in mesenteric arteries from the CLP 6 h and CLP 18 h groups than in preparations from non-septic animals, but no differences were found for norepinephrine and vasopressin between the preparations. In renal arteries, none of the vasoconstrictors had impaired activity in the CLP groups. Nonetheless, carotid arteries from the CLP 18 h group presented reduced reactivity to all vasoconstrictors tested, but only phenylephrine and norepinephrine had their effects reduced in carotid arteries from the CLP 6 h group. Despite the reduced responsiveness to phenylephrine, tail arteries from septic rats were hyperreactive to vasopressin and norepinephrine at 6 h and 18 h after the CLP surgery, respectively. The mesenteric vascular bed from CLP groups was hyporeactive to phenylephrine, norepinephrine, and angiotensin II, but not to vasopressin. The vascular contractility in sepsis varies from the well-described refractoriness, to unaltered or even hyperresponsiveness to vasoconstrictors, depending on the vessel, the vasoactive agent, and the time period evaluated.
RESUMO
Uno de los grandes problemas a tratar por el ortodoncista es la incompetencia labial. Ésta se presenta cuando el labio superior pierde tonicidad y se torna hipotónico mientras que el inferior se vuelve hipertónico. Esta es una característica de los pacientes clase II, cuya inclinación de incisivos superiores se encuentra aumentada y produce la falla en el selle de los labios. Gracias a la ortodoncia es posible corregir dicho defecto por medio de un diagnóstico y plan de tratamiento adecuado, que conlleva el estudio clínico y radiográfico del caso. Con esto el especialista podrá brindar la solución al problema inicial de la consulta. El objetivo del presente trabajo de investigación fue mejorar el perfil del paciente y corregir la incompetencia labial. Mediante la extracción dental de primeros premolares superiores y gracias a la aplicación de la técnica MBT mediante el uso de retro ligadura se pudo cumplir el objetivo inicial, mejorando la estética y la función de las estructuras dento faciales.
One of the major problems to be treated by the orthodontist is the labial incompetence. This occurs when the upper lip loses tonicity and becomes hypotonic while the lower becomes hypertonic. This is a characteristic of class II patients, whose inclininación of upper incisors is increased and causes the failure to seal the lips. Thanks to orthodontics can correct the defect by a diagnosis and appropriate treatment plan, involving the clinical and radiographic study of the case. With this, the specialist can provide the solution to the initial problem of the query. The objective of this research was to improve the patient's profile and correct lip incompetence. By tooth extraction of first premolars and thanks to the implementation of the MBT technique using retro ligature could meet the initial objective, improving the aesthetics and function of dento facial structures.
RESUMO
This article reports a case of suicidal strangulation by ligature of a 51-year-old woman with a psychiatric disorder. She had been suffering from depression with a history of previous suicidal attempt. The deceased accomplished self-strangulation using two ligatures, with one placed above the other and consisting of a satin fabric and a shoelace. The underlying shoelace ligature was fastened by a secure fixed square knot at the back of the neck. The overlying fabric piece was tied with a half-knot under the chin and was tightened around the neck manually. A detailed investigation and autopsy examination strongly suggests suicide. The case is of interest due to its rarity and uncommon method of execution.
Assuntos
Asfixia/patologia , Lesões do Pescoço/patologia , Suicídio , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
Este artigo apresenta e discute os resultados de um estudo sobre a orquiectomia eletiva realizada em campo pela técnica aberta, na Região Noroeste do Estado do Paraná, em 880 bovinos, utilizando abraçadeira de náilon 6.6 (poliamida) para ligaduras vasculares hemostáticas. Os animais responderam bem a cirurgia realizada sob contenção física em tronco de contenção, com anestesia local intratesticular, sem quaisquer problemas operatórios. A única complicação observada foi a ocorrência de miíases em 25 animais (3,09%). O método empregado teve fácil execução e baixo custo, sendo plenamente efetivo na substituição do fio de náilon cirúrgico para promover hemostasia preventiva, com redução do tempo cirúrgico. Os resultados permitem sugerir o uso de abraçadeiras de náilon 6.6 (poliamida) para as ligaduras vasculares emorquiectomias realizadas em campo nos bovinos, como método seguro e eficiente, capaz de reduzir o tempo de procedimento cirúrgico.(AU)
This paper reports the results of a study about elective field orchiectomy performed by open technique, in the northwestern region of Paraná State, Brazil, in 880 bulls, using 6.6 nylon (polyamide) cable ties for hemostatic vascular ligature. The cattle responded well to surgery performed under physical restraint and intra-testicular local anesthesia, without any surgical intercurrence. The only complication was the occurrence of myiases in 25 animals (3.09%). The method was inexpensive and easy to perform, being fully effective in replacing nylon sutures to promote preventive surgical hemostasis, and significantly reducing surgical time. These results indicate the use of 6.6 nylon (polyamide) cable ties for hemostatic vascular ligatures in field orchiectomyin bovine cattle, as a safe and efficient method, capable to reduce surgical time.(AU)
Este artículo presenta y discute los resultados de un estudio sobre la castración electiva realizada en campo por la técnica abierta, en la Región Noroeste del Estado de Paraná, en 880 bovinos, empleando abrazadera de nylon 6.6 (poliamida) para ligaduras vasculares . Los animales respondieron bien a la cirugía realizada bajo sujeción física y anestesia local intratesticular, sin cualquier problema quirúrgico. La única complicación observada fue la aparición de miíasis en 25 animales (3,09%). El método empleado ha sido de fácil ejecución y bajo costo, siendo plenamente eficaz en la sustitución del hilo de nylon quirúrgico para promover la hemostasia preventiva, con reducción del tiempo quirúrgico. Los resultados sugieren el empleo de abrazaderas de nylon 6.6 (poliamida) para ligaduras vasculares en castraciones de bovinos realizadas en campo, como método seguro y eficiente, capaz de reducir el tiempo del procedimiento quirúrgico.(AU)
Assuntos
Animais , Bovinos , Orquiectomia/veterinária , Ligadura/veterinária , Bovinos/cirurgia , NylonsRESUMO
Este artigo apresenta e discute os resultados de um estudo sobre a orquiectomia eletiva realizada em campo pela técnica aberta, na Região Noroeste do Estado do Paraná, em 880 bovinos, utilizando abraçadeira de náilon 6.6 (poliamida) para ligaduras vasculares hemostáticas. Os animais responderam bem a cirurgia realizada sob contenção física em tronco de contenção, com anestesia local intratesticular, sem quaisquer problemas operatórios. A única complicação observada foi a ocorrência de miíases em 25 animais (3,09%). O método empregado teve fácil execução e baixo custo, sendo plenamente efetivo na substituição do fio de náilon cirúrgico para promover hemostasia preventiva, com redução do tempo cirúrgico. Os resultados permitem sugerir o uso de abraçadeiras de náilon 6.6 (poliamida) para as ligaduras vasculares emorquiectomias realizadas em campo nos bovinos, como método seguro e eficiente, capaz de reduzir o tempo de procedimento cirúrgico.(AU)
This paper reports the results of a study about elective field orchiectomy performed by open technique, in the northwestern region of Paraná State, Brazil, in 880 bulls, using 6.6 nylon (polyamide) cable ties for hemostatic vascular ligature. The cattle responded well to surgery performed under physical restraint and intra-testicular local anesthesia, without any surgical intercurrence. The only complication was the occurrence of myiases in 25 animals (3.09%). The method was inexpensive and easy to perform, being fully effective in replacing nylon sutures to promote preventive surgical hemostasis, and significantly reducing surgical time. These results indicate the use of 6.6 nylon (polyamide) cable ties for hemostatic vascular ligatures in field orchiectomyin bovine cattle, as a safe and efficient method, capable to reduce surgical time.(AU)
Este artículo presenta y discute los resultados de un estudio sobre la castración electiva realizada en campo por la técnica abierta, en la Región Noroeste del Estado de Paraná, en 880 bovinos, empleando abrazadera de nylon 6.6 (poliamida) para ligaduras vasculares . Los animales respondieron bien a la cirugía realizada bajo sujeción física y anestesia local intratesticular, sin cualquier problema quirúrgico. La única complicación observada fue la aparición de miíasis en 25 animales (3,09%). El método empleado ha sido de fácil ejecución y bajo costo, siendo plenamente eficaz en la sustitución del hilo de nylon quirúrgico para promover la hemostasia preventiva, con reducción del tiempo quirúrgico. Los resultados sugieren el empleo de abrazaderas de nylon 6.6 (poliamida) para ligaduras vasculares en castraciones de bovinos realizadas en campo, como método seguro y eficiente, capaz de reducir el tiempo del procedimiento quirúrgico.(AU)