RESUMEN
This systematic review aimed to evaluate the accuracy of customized titanium plates in orthognathic surgery compared to standard outcome in virtual surgical planning. PRISMA and JBI guidelines were followed. Research protocol was registered in PROSPERO. Six databases and two gray literature repositories were used as sources of research articles. Descriptive clinical studies, that performed orthognathic surgery using custom titanium plates, were included. Risk of bias was assessed by "The Joanna-Briggs Institute Critical Appraisal tools for use in Systematic Reviews Checklist for Case Series". Of the 11,916 studies initially identified, seven met the eligibility criteria and were included. The studies were published between 2015 and 2019. Most of the studies (57%) had a low risk of bias, while one had a high risk of bias. Total sample included 74 patients with 63 bimaxillary surgeries and 11 unimaxillary surgeries. All studies showed acceptable accuracy within previously established clinical parameters. Although the eligible articles assessed the accuracy of the orthognathic surgery with respect to virtual planning, the wide variability of evaluation methodologies made it impossible to calculate a combined accuracy measure. It was not possible to perform a meta-analysis, so a pragmatic recommendation on the use of these plates is not possible.
Asunto(s)
Cirugía Ortognática , Procedimientos Quirúrgicos Ortognáticos , Placas Óseas , Humanos , TitanioRESUMEN
Protocols that mimic resistance exercise training (RET) in rodents present several limitations, one of them being the electrical stimulus, which is beyond the physiological context observed in humans. Recently, our group developed a conditioning system device that does not use electric shock to stimulate rats, but includes fasting periods before each RET session. The current study was designed to test whether cumulative fasting periods have some influence on skeletal muscle mass and function. Three sets of male Wistar rats were used in the current study. The first set of rats was submitted to a RET protocol without food restriction. However, rats were not able to perform exercise properly. The second and third sets were then randomly assigned into three experimental groups: 1) untrained control rats, 2) untrained rats submitted to fasting periods, and 3) rats submitted to RET including fasting periods before each RET session. While the second set of rats performed a short RET protocol (i.e., an adaptation protocol for 3 weeks), the third set of rats performed a longer RET protocol including overload (i.e., 8 weeks). After the short-term protocol, cumulative fasting periods promoted loss of weight (P<0.001). After the longer RET protocol, no difference was observed for body mass, extensor digitorum longus (EDL) morphology or skeletal muscle function (P>0.05 for all). Despite no effects on EDL mass, soleus muscle displayed significant atrophy in the fasting experimental groups (P<0.01). Altogether, these data indicate that fasting is a major limitation for RET in rats.
Asunto(s)
Animales , Masculino , Condicionamiento Físico Animal/fisiología , Ayuno/fisiología , Músculo Esquelético/fisiología , Entrenamiento de Fuerza/métodos , Valores de Referencia , Factores de Tiempo , Peso Corporal/fisiología , Adaptación Fisiológica , Distribución Aleatoria , Ingestión de Alimentos/fisiologíaRESUMEN
Protocols that mimic resistance exercise training (RET) in rodents present several limitations, one of them being the electrical stimulus, which is beyond the physiological context observed in humans. Recently, our group developed a conditioning system device that does not use electric shock to stimulate rats, but includes fasting periods before each RET session. The current study was designed to test whether cumulative fasting periods have some influence on skeletal muscle mass and function. Three sets of male Wistar rats were used in the current study. The first set of rats was submitted to a RET protocol without food restriction. However, rats were not able to perform exercise properly. The second and third sets were then randomly assigned into three experimental groups: 1) untrained control rats, 2) untrained rats submitted to fasting periods, and 3) rats submitted to RET including fasting periods before each RET session. While the second set of rats performed a short RET protocol (i.e., an adaptation protocol for 3 weeks), the third set of rats performed a longer RET protocol including overload (i.e., 8 weeks). After the short-term protocol, cumulative fasting periods promoted loss of weight (P<0.001). After the longer RET protocol, no difference was observed for body mass, extensor digitorum longus (EDL) morphology or skeletal muscle function (P>0.05 for all). Despite no effects on EDL mass, soleus muscle displayed significant atrophy in the fasting experimental groups (P<0.01). Altogether, these data indicate that fasting is a major limitation for RET in rats.
Asunto(s)
Ayuno/fisiología , Músculo Esquelético/fisiología , Condicionamiento Físico Animal/fisiología , Entrenamiento de Fuerza/métodos , Adaptación Fisiológica , Animales , Peso Corporal/fisiología , Ingestión de Alimentos/fisiología , Masculino , Distribución Aleatoria , Ratas Wistar , Valores de Referencia , Factores de TiempoRESUMEN
We investigated the effects of supplement identification on exercise performance with caffeine supplementation. Forty-two trained cyclists (age 37 ± 8 years, body mass [BM] 74.3 ± 8.4 kg, height 1.76 ± 0.06 m, maximum oxygen uptake 50.0 ± 6.8 mL/kg/min) performed a ~30 min cycling time-trial 1 h following either 6 mg/kgBM caffeine (CAF) or placebo (PLA) supplementation and one control (CON) session without supplementation. Participants identified which supplement they believed they had ingested ("caffeine", "placebo", "don't know") pre- and post-exercise. Subsequently, participants were allocated to subgroups for analysis according to their identifications. Overall and subgroup analyses were performed using mixed-model and magnitude-based inference analyses. Caffeine improved performance vs PLA and CON (P ≤ 0.001). Correct pre- and post-exercise identification of caffeine in CAF improved exercise performance (+4.8 and +6.5%) vs CON, with slightly greater relative increases than the overall effect of caffeine (+4.1%). Performance was not different between PLA and CON within subgroups (all P > 0.05), although there was a tendency toward improved performance when participants believed they had ingested caffeine post-exercise (P = 0.06; 87% likely beneficial). Participants who correctly identified placebo in PLA showed possible harmful effects on performance compared to CON. Supplement identification appeared to influence exercise outcome and may be a source of bias in sports nutrition.
Asunto(s)
Ciclismo/fisiología , Cafeína/farmacología , Suplementos Dietéticos , Sustancias para Mejorar el Rendimiento/farmacología , Adulto , Rendimiento Atlético , Cafeína/administración & dosificación , Método Doble Ciego , Prueba de Esfuerzo , Humanos , Masculino , Consumo de Oxígeno , Sustancias para Mejorar el Rendimiento/administración & dosificación , Prueba de Estudio Conceptual , Fenómenos Fisiológicos en la Nutrición DeportivaRESUMEN
The autonomic nervous system maintains homeostasis, which is the state of balance in the body. That balance can be determined simply and noninvasively by evaluating heart rate variability (HRV). However, independently of autonomic control of the heart, HRV can be influenced by other factors, such as respiratory parameters. Little is known about the relationship between HRV and spirometric indices. In this study, our objective was to determine whether HRV correlates with spirometric indices in adults without cardiopulmonary disease, considering the main confounders (e.g., smoking and physical inactivity). In a sample of 119 asymptomatic adults (age 20-80 years), we evaluated forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1). We evaluated resting HRV indices within a 5-min window in the middle of a 10-min recording period, thereafter analyzing time and frequency domains. To evaluate daily physical activity, we instructed participants to use a triaxial accelerometer for 7 days. Physical inactivity was defined as <150 min/week of moderate to intense physical activity. We found that FVC and FEV1, respectively, correlated significantly with the following aspects of the RR interval: standard deviation of the RR intervals (r =0.31 and 0.35), low-frequency component (r =0.38 and 0.40), and Poincaré plot SD2 (r =0.34 and 0.36). Multivariate regression analysis, adjusted for age, sex, smoking, physical inactivity, and cardiovascular risk, identified the SD2 and dyslipidemia as independent predictors of FVC and FEV1 (R2=0.125 and 0.180, respectively, for both). We conclude that pulmonary function is influenced by autonomic control of cardiovascular function, independently of the main confounders.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Frecuencia Cardíaca/fisiología , Pulmón/fisiología , Fumar/fisiopatología , Sistema Nervioso Autónomo/fisiología , Estudios Transversales , Dislipidemias/fisiopatología , Volumen Espiratorio Forzado/fisiología , Conducta Sedentaria , Espirometría , Capacidad Vital/fisiologíaRESUMEN
The autonomic nervous system maintains homeostasis, which is the state of balance in the body. That balance can be determined simply and noninvasively by evaluating heart rate variability (HRV). However, independently of autonomic control of the heart, HRV can be influenced by other factors, such as respiratory parameters. Little is known about the relationship between HRV and spirometric indices. In this study, our objective was to determine whether HRV correlates with spirometric indices in adults without cardiopulmonary disease, considering the main confounders (e.g., smoking and physical inactivity). In a sample of 119 asymptomatic adults (age 20-80 years), we evaluated forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1). We evaluated resting HRV indices within a 5-min window in the middle of a 10-min recording period, thereafter analyzing time and frequency domains. To evaluate daily physical activity, we instructed participants to use a triaxial accelerometer for 7 days. Physical inactivity was defined as <150 min/week of moderate to intense physical activity. We found that FVC and FEV1, respectively, correlated significantly with the following aspects of the RR interval: standard deviation of the RR intervals (r =0.31 and 0.35), low-frequency component (r =0.38 and 0.40), and Poincaré plot SD2 (r =0.34 and 0.36). Multivariate regression analysis, adjusted for age, sex, smoking, physical inactivity, and cardiovascular risk, identified the SD2 and dyslipidemia as independent predictors of FVC and FEV1 (R2=0.125 and 0.180, respectively, for both). We conclude that pulmonary function is influenced by autonomic control of cardiovascular function, independently of the main confounders.
Asunto(s)
Frecuencia Cardíaca/fisiología , Pulmón/fisiología , Conducta Sedentaria , Fumar/fisiopatología , Adulto , Anciano , Anciano de 80 o más Años , Sistema Nervioso Autónomo/fisiología , Factores de Confusión Epidemiológicos , Estudios Transversales , Dislipidemias/fisiopatología , Femenino , Volumen Espiratorio Forzado/fisiología , Humanos , Masculino , Persona de Mediana Edad , Espirometría , Capacidad Vital/fisiologíaRESUMEN
OBJECTIVE: To evaluate the reproducibility of caries detection and treatment planning among public health dentists and estimate the possible impact of their decisions on financial costs. RESEARCH DESIGN AND SETTINGS: Thirty nine dentists working in the public health service of Piracicaba, São Paulo, Brazil made a combined visual-radiographic caries examination of 40 occlusal surfaces of extracted permanent teeth mounted on two dental mannequins and proposed treatment plans for each tooth. Histological validation then evaluated the diagnoses validity and the suitability of the treatment plans. OUTCOME MEASURES: Inter-examiner agreement was calculated by Cohen's Kappa statistics. The sensitivity and specificity of caries detection and treatment decision were calculated. The costs of dental treatment plans for public health system were calculated from a Brazilian public health service fee scale. RESULTS: Inter-examiner agreement for caries detection was moderate (kappa = 0.42) while for treatment decisions it was fair (kappa = 0.29). The sensitivity and specificity were 0.69 and 0.65 for caries detection and 0.56 and 0.65 for treatment decision respectively. Dentists overestimated the presence and depth of carious lesions and there was a tendency to treat enamel lesions using invasive therapeutic procedures. Mean treatment cost across the two cases was 32US$ (range 9-65) while the histologically validated cost was 23US$. CONCLUSION: The variability in caries detection and treatment decision negatively affected the cost of the dental treatment.
Asunto(s)
Atención Odontológica/economía , Caries Dental/diagnóstico , Planificación de Atención al Paciente , Diente Premolar/patología , Brasil , Resinas Compuestas/economía , Toma de Decisiones , Amalgama Dental/economía , Tratamiento Restaurativo Atraumático Dental/economía , Caries Dental/patología , Caries Dental/terapia , Esmalte Dental/patología , Materiales Dentales/economía , Restauración Dental Permanente/economía , Dentina/patología , Fluoruros Tópicos/economía , Fluoruros Tópicos/uso terapéutico , Cementos de Ionómero Vítreo/economía , Costos de la Atención en Salud , Humanos , Diente Molar/patología , Variaciones Dependientes del Observador , Planificación de Atención al Paciente/economía , Selladores de Fosas y Fisuras/economía , Selladores de Fosas y Fisuras/uso terapéutico , Odontología en Salud Pública/economía , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Espera Vigilante/economía , Adulto JovenRESUMEN
OBJECTIVE: Early dental caries diagnosis within the changing global pattern of dental caries development requires the use of auxiliary resources and adjuncts to diagnosis. The aim of this study was to introduce an alternative resource for drying teeth to enable early diagnosis of dental caries in epidemiological surveys. METHODS: Polyurethane tips and three-in-one syringes were fitted to nebulizers and non-professional portable compressors for dental surface drying. The output air pressure of these sets was compared with the output pressure from the three-in-one syringe in a dental office. RESULTS: Although the output pressure from the alternative resources was lower than the output pressure from the dental office equipment, the dental surfaces were dried satisfactorily, allowing the early diagnosis of the dental caries. CONCLUSION: When a dental setting is not available, these alternative resources for drying teeth can be used satisfactorily.
Asunto(s)
Caries Dental/diagnóstico , Desecación/métodos , Presión del Aire , Brasil/epidemiología , Niño , Preescolar , Aire Comprimido , Índice CPO , Caries Dental/epidemiología , Equipo Dental , Encuestas de Salud Bucal , Desecación/instrumentación , Métodos Epidemiológicos , Humanos , Nebulizadores y Vaporizadores , Factores SocioeconómicosRESUMEN
OBJECTIVES: Clonal kidney cells (Vero cells) are extensively utilized in the manufacture of biological preparations for disease diagnostics and therapeutics and also in preparation of vaccines. In all cells, regulation of volume is an essential function coupled to a variety of physiological processes and is a topic of interest. The objective here was to investigate involvement of ion channels in the process of volume regulation of Vero cells. METHODS: Involvement of ion channels in cell volume regulation was studied using video-microscopy and flow cytometry. Pharmacologically unaltered cells of different sizes, which are presumably at different phases of the cell cycle, were used. RESULTS: Ion transport inhibitors altered all phases of regulatory volume decrease (RVD) of Vero cells, rate of initial cell swelling, V(max) and volume recovery. Effects were dependent on type of inhibitor and on cell size (cell cycle phase). Participation of aquaporins in RVD was suggested. Inhibitors decelerated growth, arresting Vero cells at the G(0) /G(1) phase boundary. Electrophysiological study confirmed presence of volume-activated Cl(-) channels and K(+) channels in plasmatic membranes of the cells. CONCLUSION: Vero cells of all sizes maintained the ability to recover from osmotic swelling. Activity of ion channels was one of the key factors that controlled volume regulation and proliferation of the cells.
Asunto(s)
Tamaño de la Célula , Canales Iónicos/metabolismo , Riñón/citología , Riñón/metabolismo , Ácido 4,4'-Diisotiocianostilbeno-2,2'-Disulfónico/farmacología , Animales , Ciclo Celular/efectos de los fármacos , Proliferación Celular/efectos de los fármacos , Tamaño de la Célula/efectos de los fármacos , Células Cultivadas , Chlorocebus aethiops , Citometría de Flujo , Gliburida/farmacología , Canales Iónicos/antagonistas & inhibidores , Microscopía , Nitrobenzoatos/farmacología , Tetraetilamonio/farmacología , Células VeroRESUMEN
Leishmania metacyclogenesis is associated with changes in morphology, gene expression, and structural alterations of the lipophosphoglycan (LPG), the promastigote most abundant surface glycolipid. Purification of metacyclics is accomplished using lectins or monoclonal antibodies (MAbs) that exploit stage-specific differences in the LPG. Besides, LPG displays extensive interspecies polymorphisms and is synthesized by promastigotes of all species investigated to date. In this work we studied the species- and stage-specificity of two MAbs (3A1-La and LuCa-D5) used to purify metacyclics of Leishmania amazonensis. Their ability to recognize different members of the Trypanosomatidae family was tested by direct agglutination, indirect immunofluorescence, and dot-blot analysis of LPG. We found that both MAbs were highly selective for L. amazonensis: 3A1-La recognized only promastigotes and LuCa-D5 labeled amastigote and promastigote stages of this species. These MAbs might be useful for Leishmania typing.
Asunto(s)
Anticuerpos Monoclonales/inmunología , Anticuerpos Antiprotozoarios/inmunología , Especificidad de Anticuerpos , Leishmania/clasificación , Leishmania/crecimiento & desarrollo , Pruebas de Aglutinación , Animales , Anticuerpos Monoclonales/biosíntesis , Anticuerpos Antiprotozoarios/biosíntesis , Técnica del Anticuerpo Fluorescente , Glicoesfingolípidos/inmunología , Humanos , Immunoblotting , Leishmania/inmunología , Estadios del Ciclo de Vida , Ratones , Ratones Endogámicos BALB C , Especificidad de la Especie , Trypanosomatina/clasificación , Trypanosomatina/inmunologíaRESUMEN
PURPOSE: The evaluation of the clinical aspects of the dilated cardiomyopathy (DCM) in infants and children regarding, mainly, to the evolution and prognostic of this disease. PATIENTS AND METHODS: 38 patients divided in two groups: A) 22 infants till 22 (11.60 +/- 6.50) months of age, 15 female, and B) 15 children of 2 to 12 years of age (5.23 +/- 3.13) the majority males (10). A retrospective study was carried out based on the data from the patients's records. It was performed, in all the cases, a clinical, electrocardiographic, echocardiographic (M module and two dimensional echocardiography) and radiologic evaluation. RESULTS: The dyspnea on exercise (included sucking) was the predominant symptom in 15 (65.22%) patients of the A group and 10 (66.67%) of the B group followed by perilabial cyanosis in 7 (30.43%) and 6 (40%) patients, respectively. In the A group the clinical diagnostic hypothesis was inspecific myocarditis (IM) in 12 (52.17%), endocardial fibroelastosis (EFE), in 8 (34.79%), and "idiopathic" dilated cardiomyopathy (IDCM) in 3 (13.04%). In the B group to the diagnostic conclusion of myocarditis was made in 10 patients (66.67%)--5 of them IM--EFE in 3 (20%); and IDCM in 2 (13.33%). The average time of evolution was 5.48 months in the A group and 18.56 in the B group. In the A group the evolution was excellent in 3 (3.04%), good in 10 (43.46%), stable in 2 (8.70%) and bad in 1 (4.35%). In the B group, excellent in 8 (53.33%), good in 2 (20%) stable in 1 (6.67%). No bad evolution in this group. There was a decrease in the A group (4.34%); 6 patients in this group (26.09%) and 3 (20%) of the B group interrupt the follow-up. CONCLUSION: 1) The prognosis of infants with DCM including those with the diagnostic hypothesis of EFE seems to be less adverse than it could be supposed to be; 2) the prognostic in children with the diagnosis of DCM established above 2 years of age seems to be good; 3) the differential clinical diagnosis between EFE and IM is difficult and with no accuracy; 4) it is possible that the IM could be more prevalent in infants till 6 months of age than we suppose it was.