RESUMEN
AIM: The present retrospective cohort study aimed to evaluate luxated permanent teeth for pulp prognosis and risk factors. METHODOLOGY: Case records and radiographs of 224 patients, involving 427 luxated permanent teeth, referred for treatment at the Dental Trauma Center-School of Dentistry, Universidade Federal de Minas Gerais, (DTC-SD-UFMG) from 2014 to 2022, were assessed for pulp prognosis classified as vitality, necrosis and pulp canal obliteration (PCO). A competing risk survival analysis estimated the hazards of the three outcomes, and the effect of demographic, clinical and treatment variables was tested using a cause specific Cox regression model. RESULTS: Pulp vitality was found in163 teeth (38.2%), pulp necrosis in 120 teeth (28.1%) and 55 teeth (12.9%) developed PCO. Pulp vitality decreased in the presence of concomitant crown fractures (HR 0.38 95% CI [0.2-0.8] p = 0.006). The risk of pulp necrosis (HR 0.62 95% CI [0.4-0.96] p = 0.03) was lower in cases with open apices but increased with concomitant crown fractures (HR 4.0 95% CI [2.6-6.1] p = 0.001) and intrusions (HR 2.3 95% CI [1.2-4.1] p = 0.007). Lateral or extrusive luxations (HR 3.0 95% CI [1.3-6.9] p = 0.001) and open apices (HR 2.4 95% CI [1.2-4.7] p = 0.01) showed higher rates of PCO. CONCLUSION: Type of luxation, the diameter of the apical foramen, and the presence of concomitant crown fractures were main determinants of pulp prognosis after luxation injuries in permanent teeth. CLINICAL RELEVANCE: Pulp prognosis after tooth luxation is dependent on the presence and direction of tooth displacement together with infection control. CLINICAL TRIAL REGISTRATION: Not applicable.
Asunto(s)
Avulsión de Diente , Fracturas de los Dientes , Humanos , Necrosis de la Pulpa Dental/terapia , Estudios Retrospectivos , Pulpa Dental , Avulsión de Diente/complicaciones , Pronóstico , Medición de RiesgoRESUMEN
A síndrome de lise tumoral (SLT) é uma emergência onco-hematológica, associada à alta mortalidade e morbidade, que pode ocorrer espontaneamente ou em resposta à quimioterapia ou bioterapia anticâncer. A rasburicase é uma droga urato oxidase recombinante, a qual reduz o ácido úrico sanguíneo liberado, prevenindo e tratando a lesão renal aguda, que representa a principal complicação da SLT. O objetivo deste artigo foi avaliar a eficácia da rasburicase na prevenção e no tratamento da SLT, contribuindo para melhor compreensão do manejo dessa frequente síndrome em pacientes oncológicos. Foi realizada uma revisão de literatura sistematizada por meio de busca no banco de dados do PubMed e uptodate, de novembro de 2021 a janeiro de 2022, utilizando-se os descritores: prevention [title/abstract] AND prophylaxis [title/abstract] AND tumor lysis syndrome [title/abstract]. Dos 212 artigos encontrados, após exclusão por título, abstract e leitura completa, apenas nove foram selecionados. Os estudos mostraram, em sua maioria, uma redução do ácido úrico plasmático com o uso da rasburicase em pacientes com alto risco para SLT. A rasburicase foi eficaz para prevenção e tratamento da hiperuricemia em pacientes com risco de SLT. Apesar dos estudos analisados serem positivos para eficácia da rasburicase na prevenção e no tratamento da síndrome, nenhum deles trouxe como desfecho principal a redução de mortalidade. Torna-se relevante, portanto, a realização de mais estudos multicêntricos, prospectivos e com emprego de instrumentos validados sobre o tema desta revisão sistemática.
Tumor lysis syndrome (TLS) is an onco-hematological emergency associated with high mortality and morbidity, of spontaneous onset or in response to chemotherapy or anticancer biotherapy. Rasburicase is a recombinant urate oxidase drug that reduces blood uric acid released, preventing and treating acute kidney injury, considered the main TLS complication. This systematic literature review sought to evaluate the rasburicase effectiveness in preventing and treating tumor lysis syndrome, to better understand how to manage this frequent syndrome in cancer patients. Bibliographic search was conducted on the PubMed database from November 2021 to January 2022, using the following descriptors: prevention [title/abstract] AND prophylaxis [title/abstract] AND tumor lysis syndrome [title/abstract]. After exclusion by title, abstract and full reading, only nine papers were selected from the 212 found. Most studies showed reduced plasma uric acid by rasburicase use in high-risk patients for TLS. Rasburicase effectively prevented and treated hyperuricemia in patients at risk for tumor lysis syndrome. Despite these positive outcomes, none of the studies showed reduced mortality as the main outcome. Thus, further multicenter prospective studies using validated instruments are needed on the subject.
El síndrome de lisis tumoral (SLT) es una urgencia oncohematológica, asociada a una alta mortalidad y morbilidad, que puede presentarse de forma espontánea o en respuesta a quimioterapia o bioterapia anticancerígena. La rasburicasa es un fármaco de urato oxidasa recombinante, que reduce el ácido úrico sanguíneo liberado mediante la prevención y el tratamiento de la lesión renal aguda, que representa la principal complicación del SLT. El objetivo de este artículo fue evaluar la efectividad de la rasburicasa en la prevención y tratamiento del SLT, lo que contribuye a una mejor comprensión del manejo de este síndrome frecuente en pacientes oncológicos. Se hizo una revisión sistemática de la literatura mediante búsqueda en la base de datos PubMed y actualizada de noviembre de 2021 a enero de 2022, utilizando los descriptores de PubMed: prevention [title/abstract] AND prophylaxis [title/abstract] AND tumor lysis syndrome [title/abstract]. De los 212 artículos encontrados, después de la exclusión por título, resumen y lectura completa, solo 9 fueron seleccionados. La mayoría de los estudios mostraron una reducción del ácido úrico plasmático con el uso de rasburicasa en pacientes con alto riesgo de SLT. La rasburicasa fue eficaz para la prevención y el tratamiento de la hiperuricemia en pacientes con riesgo de síndrome de lisis tumoral. A pesar de que los estudios analizados fueron positivos para la eficacia de la rasburicasa en la prevención y tratamiento del síndrome, ninguno de ellos trajo como desenlace principal la reducción de la mortalidad. Por lo tanto, es relevante realizar más estudios prospectivos multicéntricos utilizando instrumentos validados sobre el tema de esta revisión sistemática.
Asunto(s)
Síndrome de Lisis Tumoral/mortalidadRESUMEN
The aim of the present study was investigate the binding affinity of 5-((4-methoxyphenyl)thio)benzo[c][1,2,5]thiadiazole (MTDZ) with acetylcholinesterase (AChE). We also evaluated the effect of MTDZ against scopolamine (SCO)-induced amnesia in mice and we looked at the toxicological potential of this compound in mice. The binding affinity of MTDZ with AChE was investigated by molecular docking analyses. For an experimental model, male Swiss mice were treated daily with MTDZ (10 mg/kg, intragastrically (i.g.)) or canola oil (10 ml/kg, i.g.), and induced, 30 min later, with injection of SCO (0.4 mg/kg, intraperitoneally (i.p.)) or saline (0.9%, 5 ml/kg, i.p.) daily. From day 1 to day 10, mice were submitted to the behavioral tasks (Barnes maze, open-field, object recognition and location, Y-maze and step-down inhibitory avoidance tasks), 30 min after induction with SCO. On the tenth day, the animals were euthanized and blood was collected for the analysis of biochemical markers (creatinine, aspartate (AST), and alanine (ALT) aminotransferase). MTDZ interacts with residues of the AChE active site. SCO caused amnesia in mice by changing behavioral tasks. MTDZ treatment attenuated the behavioral changes caused by SCO. In ex vivo assay, MTDZ also protected against the alteration of AChE activity, reactive species (RS) levels, thiobarbituric acid reative species (TBARS) levels, catalase (CAT) activity in tissues, as well as in transaminase activities of plasma caused by SCO in mice. In conclusion, MTDZ presented anti-amnesic action through modulation of the cholinergic system and provided protection from kidney and liver damage caused by SCO.
Asunto(s)
Acetilcolinesterasa/metabolismo , Amnesia/tratamiento farmacológico , Inhibidores de la Colinesterasa/uso terapéutico , Nootrópicos/uso terapéutico , Sulfuros/uso terapéutico , Tiadiazoles/uso terapéutico , Amnesia/inducido químicamente , Animales , Reacción de Prevención/efectos de los fármacos , Inhibidores de la Colinesterasa/metabolismo , Masculino , Aprendizaje por Laberinto/efectos de los fármacos , Ratones , Simulación del Acoplamiento Molecular , Nootrópicos/metabolismo , Unión Proteica , Escopolamina , Sulfuros/metabolismo , Tiadiazoles/metabolismoRESUMEN
A padronização dos Registros Eletrônicos em Saúde (RES) tem sido amplamente requerida desde de sua regulamentação pelo Ministério da Saúde. Neste contexto, o modelo de referência openEHR foi definido para a padronização dosRES. OBJETIVO: Avaliar a viabilidade de uma aplicação RESTful utilizando o openEHR (cwOpenEhr RestApi). MÉTODOS: O tempo de Requisição-Resposta (TRR) do cwOpenEhrRestApi foi comparado com uma aplicação que não utiliza REST e com um tempo máximo aceitável por um usuário (15 segundos). RESULTADOS: Há indicação de que o TRR do cwOpenEhrRestApifoi menor do que o tempo máximo aceitável. Além disso, o TRR foi diferente ao de uma aplicação que não utilizou RESTful. CONCLUSÃO: A utilização de RESTful com openEHR foi considerada viável, uma vez que, embora exista uma diferença estatisticamente significativa do TRR com relação à abordagem sem RESTful, o TRR do cwOpenEhrRestApi foi significativamente menor que o tempo máximo aceitável por um usuário.
Standardize Electronic Health Records (EHR) has been widely required since its regulation by the Brazilian Ministry of Health. In this context, openEHR's reference model has been defined to standardize the EHR. OBJECTIVE: Evaluate the feasibility of a RESTful openEHR solution (cwOpenEhrRestApi). METHODS: The Request-Response Time(RRT) of cwOpenEhrRestApi was compared to an application that does not use RESTful and to a maximum acceptable time for a user (15 seconds). RESULTS: There is an indication that the RRT of cwOpenEhrRestApi was lower than the maximum acceptable time. Furthermore, the time was different to a non-based RESTful application. CONCLUSION: The use ofRESTful with openEHR was considered feasible, since, despite the fact that there is a statistically significant differenceregarding the non-based RESTFul RRT, the RRT of cwOpenEhrRestApi was significantly lower than the maximum acceptabletime for a user.