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Background: Pregnancy exacerbates the periodontal inflammation; however, the biological mediators involved are not well characterized. Neuropilins (NRPs) are transmembrane glycoproteins involved in physiological and pathogenic processes such as angiogenesis and immunity but its relationship with periodontal disease in pregnant women has not been studied. Objective: To explore the soluble Neuropilin-1 (sNRP-1) levels in gingival crevicular fluid (GCF) samples during early pregnancy and its association with the periodontitis severity and periodontal clinical parameters. Methods: 80 pregnant women were recruited, and GCF samples were collected. Clinical data and periodontal clinical parameters were recorded. sNRP-1 expression was determined by ELISA assay. The relationship between sNRP-1(+) pregnant women with the severity of periodontitis and periodontal clinical parameters was determined by Kruskal-Wallis and Mann-Whitney tests. Spearman's test estimated the correlation between sNRP-1 levels and periodontal clinical parameters. Results: Periodontitis was classified as mild in 27.5% (n = 22) women, moderate in 42.5% (n = 34), and severe in 30% (n = 24). sNRP-1 expression was higher in the GCF of pregnant with severe (41.67%) and moderate (41.17%) periodontitis compared than in those with mild periodontitis (18.8%). The sNRP-1(+) pregnant had a higher BOP (76.5% v/s 57%; p = 0.0071) and PISA (1199.5 mm2 v/s 880.2 mm2; p = 0.0282) compared with sNRP-1(-). A positive correlation between sNRP-1 levels in GCF and BOP (p = 0.0081) and PISA (p = 0.0398) was observed. Conclusions: The results suggest that sNRP-1 could be involved in periodontal inflammation during pregnancy.
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Rosacea is a chronic inflammatory skin disease whose prevalence rates remain unknown in Chile. Laboratory benchmark testing for this disease is not useful, therefore, we aimed to evaluate the gingival crevicular fluid (GCF) levels of extracellular metalloproteinases (MMP)-2 and MMP-9 as novel rosacea biomarkers. We designed a cross-sectional study with a control group. Participants were systemically healthy adults (n = 20) and persons with rosacea (n = 18). We performed a periodontal evaluation and collected gingival crevicular fluid to measure MMP-2 and MMP-9 levels. Analysis showed mean and standard deviation of MMP-9 concentrations in the GCF for patients with rosacea was 764.52 ± 569.83 pg/mL; for healthy patients, it was 260.69 ± 170.43 pg/mL (p < 0.05). The diagnosis of rosacea was responsible for the levels of MMP-9 in the GCF (p < 0.05), as opposed to periodontitis, smoking, and age (p > 0.05). The Area under ROC for MMP-9 was 0.869 (95%, C.I: 0.719−0.956), with a sensitivity of 72.22% and specificity of 81.58% for the diagnosis of rosacea. We conclude that the quantification of MMP-9 in the GCF could be used as a biomarker of rosacea. Also, rosacea was responsible for increasing the levels of MMP-9 in the GCF independent of periodontal status.
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Líquido do Sulco Gengival , Rosácea , Adulto , Biomarcadores/análise , Chile , Estudos Transversais , Humanos , Metaloproteinase 9 da Matriz , Rosácea/diagnósticoRESUMO
ABSTRACT: Objective: To explore patient experience for non-surgical periodontal therapy using phenomenography. Methods: This qualitative study was performed in a postgraduate specialist training program in periodontics. Patients reported their experiences through in-depth interviews in order to recognize the impact of non-surgical periodontal therapy on their quality of life and their satisfaction. A homogeneous sampling procedure was used, establishing redundancy after the fifteenth interview. Interviews were audio recorded, transcribed and analyzed by three researchers who codified the answers into categories to determine the emerging topics. Results: The core emerging themes were: (i) lack of information about periodontal disease; (ii) experience during treatment; (iii) treatment implications; and (iv) clinician-patient relationship. Conclusions: Patients seem to have limited knowledge about periodontal diseases. Reasons for attendance mainly include bleeding gums, tooth mobility, and aesthetic problems. Therapy can generate pain, fear, and is considered invasive, whereas dentine hypersensitivity may occur post-operatively. Despite this, patients would be willing to undergo treatment again and were generally satisfied with the level of care and treatment received.
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Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Pacientes/psicologia , Doenças Periodontais/psicologia , Doenças Periodontais/terapia , Periodontite/psicologia , Periodontite/terapia , Relações Médico-Paciente , Entrevistas como Assunto , Pesquisa QualitativaRESUMO
RESUMEN La microscopía virtual (MV) está siendo ampliamente implementada en educación y podría llevar a reemplazar a la microscopía óptica (MO). Objetivo: Proporcionar una revisión de la literatura a partir de las preguntas ¿Cuál es la percepción de académicos y estudiantes? y ¿Cuál es el desempeño de los estudiantes? respecto a la enseñanza de histología y/o histopatología con MV en odontología. Material y métodos: Se consultaron las bases de datos: Pubmed, Scielo, Science Direct y Scopus, y 10 artículos fueron seleccionados. Resultados: La totalidad de estudios que evaluaron percepción y desempeño académico obtuvieron resultados a favor de la MV. Conclusiones: La MV tiene un futuro prometedor, pero más estudios con metodologías similares y que consideren la percepción de los académicos son requeridos.
ABSTRACT Virtual microscopy (VM) is being widely implemented in education and could lead to the replacement of light microscopy (LM). Objective: To provide a review of the literature based on the questions: What is the perception of academics and students? and What is the performance of students? regarding the teaching of histology and/or histopathology with VM in dentistry. Material and methods: The following databases were consulted: Pubmed, Scielo, Science Direct and Scopus, and 10 articles were selected. Results: All the studies that evaluated perception and academic performance obtained results in favor of VM. Conclusions: VM has a promising future, but more studies with similar methodologies and that consider the perception of academics are required.
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BACKGROUND: Soluble Neuropilin-1 (sNRP-1) is a glycoprotein with angiogenic and immune regulatory functions, which correspond to processes deeply involved with periodontal diseases. This study's objective was to determine the concentration of sNRP-1 in gingival crevicular fluid (GCF) samples of severe periodontitis (stages III-IV) compared to mild-moderate (stages I-II) periodontitis patients. MATERIALS AND METHODS: An exploratory cross-sectional study was conducted, including 36 adults subjected to a complete periodontal exam, which recorded the following periodontal parameters: periodontal probing depth (PPD), clinical attachment loss (CAL), bleeding on probing (BOP), gingival index (GI) and periodontal inflamed surface area (PISA). Periodontitis was defined by two periodontists using the case definition proposed by the 2017 World Workshop for periodontal diseases. GCF samples were collected to determine the levels of sNRP-1 via ELISA. The results were analyzed using descriptive statistics, Mann-Whitney, Kruskal Wallis, and Spearman tests. RESULTS: The levels of sNRP-1 in patient's GCF with periodontitis in stages III-IV showed a median of 38.385 âng/mL (iqr 30.98), in comparison with 20.085 âng/mL (iqr 12.74) for stages I-II (p â= â0.202). Regardless of the periodontitis stage, we observed a positive correlation between the levels of sNRP-1 in BOP (Rho: 0.45; p â= â0.0048), PISA (Rho: 0.50; p â= â0.0019), PD (Rho: 0.3; p â= â0.015) and GI (Rho: 0.37; p â= â0.02). CONCLUSIONS: The GCF-sNRP-1 concentration was positively related to periodontal clinical inflammatory parameters and probably could be involved in pro-inflammatory and angiogenic mechanisms observed in periodontitis. Additional studies are necessary to confirm these preliminary results.
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INTRODUCTION: The quick spread of COVID-19 has caused part of the world's population to adopt quarantine protocols that have limited professional activities, including dental training programmes. This study aimed to explore the experiences of students and personnel at a Chilean dental school during the COVID-19 pandemic. MATERIALS AND METHODS: This phenomenological descriptive qualitative study reported staff and students' experiences during the pandemic through in-depth, semi-structured interviews. These were recorded on audio and video with a digital platform. Three researchers then transcribed and analyzed the recordings and codified the answers into categories to determine the emerging topics until a saturation point was reached. RESULTS: The core emerging themes among the staff group were (1) change in the personal/professional life balance, (2) online learning through digital platforms, (3) staff perceptions of students' learning experiences, and (4) concerns about the future. For students, the themes were (1) changes in the learning process, (2) online learning through digital platforms, (3) interpersonal relationships, and (4) concerns about the future. CONCLUSION: The COVID-19 pandemic has been a period of learning for our dental school staff and students. Even though online learning has been a useful tool for delivering didactic (theoretical) concepts, it has been unable to replace conventional education, including skills training. Students and teachers reported being overwhelmed at the beginning of the pandemic, but they have shown remarkable adaptability and resilience during this period.
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COVID-19 , Pandemias , Educação em Odontologia , Humanos , SARS-CoV-2 , Faculdades de Odontologia , Estudantes de OdontologiaRESUMO
Characterization and control of surfaces and interfaces are critical for photovoltaic and photocatalytic applications. In this work, we propose CH3NH3PbI3 (MAPI) perovskite slab models whose energy levels, free of quantum confinement, explicitly consider the spin-orbit coupling and thermal motion. We detail methodological tools based on the density functional theory that allow achieving these models at an affordable computational cost, and analytical corrections are proposed to correct these effects in other systems. The electronic state energies with respect to the vacuum of the static MAPI surface models, terminated in PbI2 and MAI atomic layers, are in agreement with the experimental data. The PbI2-terminated slab has in-gap surface states, which are independent of the thickness of the slab and also of the orientation of the cation on the surface. The surface states are not useful for alignments in photovoltaic devices, while they could be useful for photocatalytic reactions. The energy levels calculated for the MAI-terminated surface coincide with the widely used values to estimate the MAPI alignment with the charge transport materials, i.e., -5.4 and -3.9 eV for valence band maximum and conduction band minimum, respectively. Our study offers these slab models to provide guidelines for optimal interface engineering.
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OBJECTIVE: This study aimed to determine the effect of macro design in the primary stability of short and extra-short implants using resonance frequency analysis (RFA). MATERIAL AND METHODS: On an ex-vivo model using pig's ribs, we inserted 80 short and extra-short dental implants (20 implants per brand): Biohorizons®(B) 4.6 × 6mm; Intralock®(I) 4.75 × 6.5 mm; Straumann®(S) 4.1 × 4mm; and Tixos®(T) 5 × 5mm. Primary implant stability was measured using an RFA device. We compared mean ISQ values through ANOVA test. RESULTS: Mean ISQ values: B = 73.36 (±3.39); I = 75.13 (±3.88); S = 65.38 (±8.38); T = 72.13 (±11). B and I showed higher ISQ than S (p-value < 0.001). Short (I) showed higher ISQ than extra-short (B,S,T) implants (p-value = 0.001). Tapered (B,I) had higher ISQ than parallel (S,T) implants (p-value < 0.001). There was a moderate positive correlation between ISQ and length (r = 0.52), and a weak correlation with diameter (r = 0.33). DISCUSSION: The final result is a combination of implant design, length, and diameter. Tapered design (B and I) and larger implants (I) showed better primary stability in terms of ISQ values. This information could be beneficial at implant selection in a severely reabsorbed low-quality bone, privileging length (as long as it is safe), and conical walls design.
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OBJECTIVE: Quantify the effect of the osseodensification Densah® protocol on the insertion torque, ISQ, and the removal torque of conical BioHorizons® implants. MATERIALS AND METHODS: An ex vivo model over fresh pig tibia bone was used. Test group (TG) included 50 osteotomies using Densah® osseodensification protocol, and the control group (CG), 50 osteotomies using BioHorizons®'s recommended procedure. Conical BioHorizons® implants (3.8 × 10.5 mm) were implanted, verifying the insertion torque with a manual torque meter. ISQ values were registered with Ostell® device. Finally, implants were removed with manual reverse torque registering the values. Results were analyzed and compared with the Mann-Whitney test and t-test. RESULTS: Median and interquartile range per group were as follows: insertion torque, CG: 26 (12) Ncm; TG: 42 (26) Ncm, removal torque, CG: 25 (20) Ncm; TG: 40 (28) Ncm, ISQ value, CG: 69.25 (5.5); TG: 71.5 (4). All variables were significantly higher (p ≤ 0.05) in the osseodensification group. CONCLUSIONS: The Osseodensification technique may improve primary stability in the clinical scenario on tapered implants. Further human RCTs are necessary to validate this.
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PURPOSE: To describe the presence and anatomical characteristics of lingual foramina and canals using cone-beam computed tomography (CBCT) in a sample of Chilean dry mandibles. METHODS: Cone-beam computed tomography images of 68 adult mandibles of indeterminate sex and age were analyzed. The description of number and position of lingual foramina were tabulated using a position regarding the mental spines (superior, between, and inferior to the mental spines). Area and diameter of the foramina and length of the canals found were measured. RESULTS: All the mandibles had one or more lingual foramen. The median was 3 foramina with a minimum of 1 and a maximum of 4. The most frequent positions were superior and inferior with 88% and 85% of presence, respectively. The lingual canal diameter obtained for the superior position was 1.04 ± 0.38 mm, for the between position was 1.02 ± 0.5 mm, and finally 1 ± 0.3 mm for the inferior position. The lingual canal length for the superior position was 6.38 ± 2.4 mm, for the between position 6.77 ± 1.33, and 5.38 ± 0.25 mm for the inferior position. CONCLUSIONS: All the mandibles have one or more lingual foramina. The most frequent positions were superior and inferior. Many of the lingual foramina found were over 1 mm in diameter. The lingual canal length was over 5 mm for all the positions.
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Tomografia Computadorizada de Feixe Cônico/métodos , Mandíbula/anatomia & histologia , Mandíbula/diagnóstico por imagem , Adulto , Chile , Feminino , Humanos , Técnicas In Vitro , MasculinoRESUMO
RESUMEN: El objetivo de este estudio fue valuar la utilidad del uso de la tinción de Tricrómico de Masson (TM) en la cuantificación de la densidad media vascular (DMV) en Mucosa Oral Normal (MON), Displasia Epitelial Oral (DEO) y Carcinoma Oral de Células Escamosas (COCE). Estudio descriptivo de serie de casos. Se analizaron 17 muestras de MON, 15 muestras de DEO y 16 de COCE, teñidas con TM. Para determinar su utilidad, se compararon con las mismas muestras analizadas con técnica de inmunohistoquímica contra CD31. La cuantificación de la DMV se realizó en las 3 áreas de mayor vascularización de cada muestra. Se determinó la DMV según diagnóstico mediante la tinción TM e inmunohistoquímica contra CD31, y se calculó la correlación entre ambos. La DMV cuantificada con TM y contra CD31 difiere según el diagnóstico, observándose un aumento de la DMV al malignizarse el diagnóstico. No se encontraron diferencias al comparar la DMV cuantificada con TM y contra CD31. La correlación de la DMV analizado por TM y contra CD31 es significativa y moderada. La cuantificación de vasos sanguíneos es posible mediante la tinción de TM en muestras de MON, DEO y COCE, con una correlación moderada con la inmunohistoquímica contra CD31.
SUMMARY. The objective of this study was to evaluate the utility of Masson's Trichrome (TM) staining in the quantification of the mean vascular density (DMV) in samples of normal oral mucosa (MON), oral epithelial dysplasia (ODE) and oral squamous cell carcinoma (COCE). The design - a descriptive study of case series. We analyzed 17 samples of MON, 15 samples of DEO and 16 samples of COCE, stained with TM. To determine usefulness, we compared and analyzed the same samples, either stained with TM or with immunohistochemical technique against CD31. Quantification of the DMV was performed in the 3 areas of greatest vascularization in each sample. DMV was determined according to diagnosis by TM staining and immunohistochemistry against CD31, and the correlation between the two was then calculated. DMV quantified with TM and against CD31 differs according to the diagnosis, with an increase in DMV upon malignant diagnosis. No differences were found when comparing DMV quantified with TM and against CD31. The correlation of the DMV analyzed by TM and against CD31 is significant and moderate. Quantification of blood vessels is possible by TM staining in samples of MON, DEO and COCE. TM staining is moderately correlated with immunohistochemistry against CD31.
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Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Carcinoma de Células Escamosas/patologia , Neoplasias Bucais/patologia , Neovascularização Patológica/patologia , Coloração e Rotulagem/métodos , Células Epiteliais/patologia , Imuno-Histoquímica , Mucosa Bucal/patologia , Molécula-1 de Adesão Celular Endotelial a PlaquetasRESUMO
Se propone una estrategia, desde un enfoque desarrollador del proceso de enseñanza-aprendizaje, con vistas a contribuir a la superación profesional de los docentes de los institutos superiores tecnológicos en relación con el uso de los entornos virtuales, lo cual les permitirá responder al desafío transformador de este nivel educativo.
A strategy of the teaching-learning process is proposed from a developing approach, with the aim of contributing to the professional training of the teaching staff of the technological higher institutes in relation to the use of the virtual environments, which will allow them to respond to the transforming challenge of this educational level.
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Humanos , Masculino , Feminino , Ensino , Interface Usuário-Computador , Gestão da Informação , Pessoal Técnico de Saúde/educação , Estratégias de Saúde , Tecnologia Educacional , Educação a DistânciaRESUMO
Se han descrito forámenes ubicados en la cara interna del sector mandibular anterior, ya sea en hueso seco, radiografía convencional y en estudios mediante cone beam CT (CBCT). El objetivo de este estudio fue comparar la presencia, posición y las características anatómicas de los forámenes y canales linguales encontrados en CBCT de mandíbulas Chilenas secas, con los resultados de la misma muestra estudiada con visión directa en hueso seco. Se utilizaron 68 mandíbulas secas de la unidad de morfología de la Universidad de los Andes. Se evaluó número de dientes remanentes, número de forámenes relacionados con las espinas mentonianas, posición, área y longitud de cada canal en hueso seco y en CBCT de la misma muestra. Se encontró presencia del foramen lingual en 100 % de CBCT y 97 % de observación directa en hueso. Se observaron 150 forámenes en hueso seco y 170 forámenes en CBCT. La mayor cantidad se encontró por superior (hueso: 55; CBCT:61) e inferior (hueso:66 ; CBCT:92) a las espinas mentonianas. La confiablidad no fue la esperada, con un kappa para el número de forámenes superiores de 0,43, una correlación intraclase (rho) para el número de forámenes inferiores de 0,31. El área de forámenes superiores tuvo un rho de 0,059 e inferiores un rho de 0,144, mientras que, la longitud de los canales superiores, un rho de 0,5 e inferiores un rho de 0,246. Se observó una tendencia a mayores diámetros y longitudes de canales en las mediciones realizadas en CBCT comparadas con las mediciones en hueso seco. Teniendo en cuenta la alta prevalencia de estos forámenes, es recomendable previo a cualquier cirugía en el sector mandibular anterior, el estudio mediante CBCT. Además de mantener un margen de seguridad respecto a los forámenes linguales debido a una mínima distorsión esperable de estas estructuras.
On several studies, there has been described foramina located in the inner face of the anterior mandible, whether on dry bone, conventional radiography and cone beam CT (CBCT). The aim of this study was compare the presence, position and anatomical characteristics of foramina and lingual canals found in CBCT of Chilean mandibles, with the results of the same sample studied with direct vision in dry bone. We studied 68 mandibles from the morphology unit of Universidad de los Andes. The number of teeth, foramina related to mental spines, position, area and length of each canal were evaluated, in dry bone and CBCT from the same sample. Presence of lingual foramen was found in 100 % of CBCT and 97 % of direct observation in bone. There were 150 foramina in dry bone and 170 foramina in CBCT. The greatest amount was found superior (bone: 55; CBCT: 61) and inferior (bone: 66; CBCT: 92) to the mental spines. . The reliability was not as expected, with a kappa for the number of upper foramina of 0.43, an intraclass correlation for the number of lower foramen of 0.31. The upper foramen area had an intraclass correlation of 0,059 and an inferior correlation of 0.144 while, the length of the superior canals, had a 0.5 and inferior 0.246 of intraclass correlation. A trend was observed for higher diameters and canal lengths in the measurements performed with CBCT compared to the measurements in dry bone. Taking into account the high prevalence of these foramina, it is advisable prior to any surgery in the anterior mandible, the prior study using CBCT. In addition to maintaining a margin of safety with respect to lingual foramina.
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Humanos , Mandíbula/anatomia & histologia , Mandíbula/diagnóstico por imagem , Tomografia Computadorizada de Feixe CônicoRESUMO
The infratemporal spine, or sphenoidal tubercle, is a bony structure described in both classical anatomical literature and contemporary literature. However, the available literature does not mention the specific anatomical characteristics or the distribution of this bony element in the population. The aim of this study was to define this structure, identify its presence, and identify its morphology in a sample of Chilean human skulls. Fifty-seven dry skulls, obtained from the morphology unit at Universidad de los Andes, were used. The great wings of the sphenoid bone on both sides of the skull were evaluated in search of the infratemporal spine. These spines were classified according to their morphological characteristics of either laminar, pyramidal, or truncated pyramidal, as they related to the infratemporal crest and as they related to the pterygoid process. The presence of the infratemporal spine was found in 100 % of the studied skulls, unilaterally or bilaterally. The most common morphology was found to be laminar (40 %), followed by pyramidal (35 %), and, finally, truncated pyramidal (24 %). The majority (73 %) of these infratemporal spines was closely associated with the pterigoyd process with a complete or partial relation, with fewer (34 %) being associated with the infratemporal crest.
La espina infratemporal o tubérculo esfenoidal es un reparo óseo mencionado tanto en la literatura anatómica clásica como en los artículos más actuales. Las publicaciones disponibles no mencionan las características anatómicas ni la distribución en la población de este elemento óseo. El objetivo de este trabajo fue definir, identificar la presencia y describir la morfología de la espina infratemporal en una muestra de población chilena. Se utilizaron 57 cráneos secos de la unidad de anatomía de la Universidad de los Andes. Se evaluaron las alas mayores del hueso esfenoides tanto derechas como izquierdas en búsqueda de la espina infratemporal. Se clasificaron según sus características morfológicas, siendo piramidal, piramidal truncada o laminar, según su relación con la cresta infratemporal y según su relación con el proceso pterigoideo. Se encontró la presencia de la espina infratemporal en un 100 % de los cráneos estudiados, ya sea de manera uni o bilateral. La morfología más común correspondió a laminar con un 40 %, seguido de piramidal con un 35 % y finalmente un 24 % de morfología piramidal truncada. Se relacionaron más bien con el proceso pterigoideo ya sea de manera completa o media (73 %) y en menor medida con la cresta infratemporal (34 %).
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Humanos , Osso Esfenoide/anatomia & histologia , Osso Temporal/anatomia & histologia , Chile , Crânio/anatomia & histologiaRESUMO
UNLABELLED: Cardiac inflammation can be produced by pathogen-associated molecular patterns (PAMPs), from parasitic, bacterial or viral origin; or by danger-associated molecular patterns (DAMPs), released from dead cells after cardiac tissue damage, for example by cardiac infarction. Both, PAMPS and DAMPS activate TLR4 on resident immune cells and heart tissue cells, triggering an inflammatory process necessary to begin the wound healing process. Cardiac fibroblasts (CF) are the most abundant cells in the heart and are critical to wound healing, along with cardiac myofibroblasts (CMF), which are differentiated from CF through a TGF-ß1-mediated process. While TLR4 and the inflammasome complex are known to play important roles in CF function, the effects of TGF-ß1 on TLR4 and inflammasome expression and activity remain unknown. To elucidate this important point, we evaluated the effect of TGF-ß1 on TLR4, and the inflammasome protein expression and activity through activation by LPS, mimicking a myocarditis condition by bacterial origin. We found that TGF-ß1 increased TLR4 expression in CF and that the process was mediated by the TGFßRI and p38 signaling pathways. In both CF and CMF, LPS triggered ERK1/2, PI3K-Akt, and p65-NF-κB phosphorylation. All of these effects were blocked by TAK-242, a TLR4 signaling pathway inhibitor. LPS increased pro-IL-1ß levels, which were dependent on the ERK1/2, PI3K-Akt, and NF-κB signaling pathways, and levels were higher in CF than CMF. NLRP3 and ASC levels were similar in CF and CMF, while pro-caspase-1 levels and caspase-1 activity were higher in CMF. LPS+ATP treatment induced inflammasome complex assembly and activation, triggering the release of IL-1ß in both CMF and CF. Finally, the unsecreted pro-IL-1ß in the CF was degraded by autophagy. CONCLUSION: TGF-ß1 increases TLR4 expression in CF. Despite different pro-IL-1ß and caspase-1 activity levels in CF versus CMF, the two cell types secreted similar levels of IL-1ß after LPS+ATP treatment. These findings suggest that both cell types are active participants in inflammation.
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Fibroblastos/imunologia , Inflamassomos/imunologia , Interleucina-1beta/biossíntese , Miocárdio/imunologia , Miofibroblastos/imunologia , Receptor 4 Toll-Like/imunologia , Animais , Western Blotting , Ensaio de Imunoadsorção Enzimática , Imunofluorescência , Masculino , Miocárdio/citologia , Reação em Cadeia da Polimerase , Ratos , Ratos Sprague-DawleyRESUMO
Background: The dose of oral anticoagulants (OAC) shows great variability among patients. Pharmacogenetic studies have shown that common variants in genes CYP2C9 (*2 and *3) and VKORC1 (-1639G>A) are associated with lower requirements of OAC. Aim: To study the association between average maintenance doses of oral anticoagulant therapy required to maintain a stable INR and CYP2C9 and VKORC1 gene variants in Chilean adults. Material and Methods: Prospective study of patients on anticoagulant treatment and with a stable international normalized ratio (INR) for prothrombin time for at least three months. Patients were classified as having high or low acenocoumarol or warfarin requirements. Peripheral blood DNA genotyping was performed by polymerase chain reaction and restriction fragment polymorphism or sequencing and electrophoresis. Results: The study included 185 patients, 125 on acenocoumarol and 60 on warfarin. Patients with VKORC1-1639A allele were more likely to require lower doses of both drugs than patients with the G allele (Odds ratio [OR] for acenocoumarol 9.06, and OR for warfarin = 18.7). There was no association between CYP2C9*2 and*3 and acenocoumarol or warfarin requirements. Conclusions: There is an association between VKORC1-1639A variant and anticoagulant doses.
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Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Anticoagulantes/administração & dosagem , /genética , Polimorfismo Genético/genética , Vitamina K Epóxido Redutases/genética , Acenocumarol/administração & dosagem , Administração Oral , Chile , Relação Dose-Resposta a Droga , Frequência do Gene/genética , Variação Genética/genética , Genótipo , Coeficiente Internacional Normatizado , Estudos Prospectivos , Tempo de Protrombina , Varfarina/administração & dosagemRESUMO
The purpose of this study was to evaluate in dry skulls the length and angle between the greater palatine foramen and the foramen rotundum in both the frontal and sagittal planes. In 50 human skulls from the department of morphology, the distance and angulation required to reach the foramen rotundum through the greater palatine canal were measured in the frontal and sagittal planes. A stylet was introduced up to the foramen rotundum in each greater palatine canal and fixed. The skulls were then photographed from a front and lateral view (both right and left). Finally, the stylets were photographed on graph paper. These images were analyzed with Photoshop software. In the frontal plane, mean angulations of 5.32 degrees on the right side and 6.15 degrees on the left side were obtained. In the sagittal plane, mean angulations of 61.66 degrees on the right side and 61.81 degrees on the left side were obtained. Finally, the mean length required to reach the foramen rotundum was 31.95 âmm on the right side and 32.49 âmm on the left side. Some of these results differ from those stated in the foreign literature (10 degrees front, 70 degrees sagittal). These differences should be considered for both clinical practice and teaching in Chile.
Assuntos
Palato Duro/anatomia & histologia , Adulto , Processo Alveolar/anatomia & histologia , Cefalometria/métodos , Humanos , Processamento de Imagem Assistida por Computador/métodos , Palato/anatomia & histologia , Fotografação/métodos , Fossa Pterigopalatina/anatomia & histologia , Osso Esfenoide/anatomia & histologiaRESUMO
La diafanización dentaria consiste en lograr transparentar la estructura mineralizada, permitiendo observar la arquitectura interna del diente. Se realiza principalmente a partir de métodos por deshidratación de la muestra. Por otro lado existen técnicas utilizadas para el estudio de centros de osificación basadas en métodos por maceración utilizando hidróxido de potasio y glicerina, de las cuales no se tiene antecedentes de haber sido utilizada en diafanización dentaria. El objetivo de este trabajo fue describir una técnica de diafanizado por maceración de tejidos dentarios mediante hidróxido de potasio y mostrar el resultado obtenido con un seguimiento de 5 años. Se seleccionó una muestra de 40 dientes (10 incisivos, 6 caninos, 10 premolares y 14 molares). Se limpiaron los dientes (destartraje) y luego se descalcificaron parcialmente con ácido clorhídrico. El 25% de la muestra fue diafanizada con el método clásico de deshidratación. El 75% restante fue diafanizado con el método por maceración, que consistió básicamente en una maceración parcial del diente mediante baños en hidróxido de potasio de baja concentración, luego agregando glicerina en forma ascendente hasta terminar en glicerina pura por tiempo indefinido. La técnica por maceración logró diafanización adecuada de los tejidos con una óptima visualización del sistema de canales radiculares en las muestras diafanizadas. Con ambas técnicas se logró transparentar los dientes pero con diferencias evidentes. Con la primera los dientes lograron un tono amarillento, perdiéndose gran cantidad de tejido dentario en cambio las muestras diafanizadas por maceración conservaron mejor su estructura y obtuvieron un color más cercano al del diente original. Con el método por maceración se obtienen dientes diafanizados más similares a la realidad que lo logrado con el método por deshidratación.
Dental clearing objective is performed to obtain the translucency of the mineralized structure, allowing an appreciation of the inner architecture of the tooth. It is achieved mainly using the dehydration technique on the sample. On the other hand, there are other techniques used for the study of ossification centers based on the maceration methods using potassium hydroxide and glycerin, none of which have been reported for dental clearing. The purpose of this study was to describe the maceration technique of the dental tissue using potassium hydroxide with a five-year follow up. We selected 40 teeth to complete the sample (10 incisors, 6 cuspid, 10 bicuspids and 14 molars). The teeth were cleaned and then partially decalcified with hydrochloric acid. A quarter of the sample was cleared by classic dehydration method. The other three quarters were cleared with the maceration method, that consisted mainly in a partial maceration using potassium hydroxide baths at low concentrations, followed by the addition of glycerin at ascending concentrations and finally using pure glycerin for an undefined period of time. The maceration technique achieved an adequate clearing of the mineralized tissue with an optimal visualization of the root canal system in the cleared sample. With both techniques it was possibly to clear the teeth but with evident differences. With the first technique the teeth achieved a yellowish color, losing a great amount of dental tissue however the maceration technique sample allowed the preservation of more structure and obtained a coloration similar to the original tooth. With the maceration method the samples were more similar to the original ones than the cleared teeth obtained with dehydration.
Assuntos
Técnicas Histológicas/métodos , Dente/anatomia & histologiaRESUMO
BACKGROUND: The dose of oral anticoagulants (OAC) shows great variability among patients. Pharmacogenetic studies have shown that common variants in genes CYP2C9 (*2 and *3) and VKORC1 (-1639G>A) are associated with lower requirements of OAC. AIM: To study the association between average maintenance doses of oral anticoagulant therapy required to maintain a stable INR and CYP2C9 and VKORC1 gene variants in Chilean adults. MATERIAL AND METHODS: Prospective study of patients on anticoagulant treatment and with a stable international normalized ratio (INR) for prothrombin time for at least three months. Patients were classified as having high or low acenocoumarol or warfarin requirements. Peripheral blood DNA genotyping was performed by polymerase chain reaction and restriction fragment polymorphism or sequencing and electrophoresis. RESULTS: The study included 185 patients, 125 on acenocoumarol and 60 on warfarin. Patients with VKORC1-1639A allele were more likely to require lower doses of both drugs than patients with the G allele (Odds ratio [OR] for acenocoumarol 9.06, and OR for warfarin = 18.7). There was no association between CYP2C9*2 and*3 and acenocoumarol or warfarin requirements. CONCLUSIONS: There is an association between VKORC1-1639A variant and anticoagulant doses.
Assuntos
Anticoagulantes/administração & dosagem , Citocromo P-450 CYP2C9/genética , Polimorfismo Genético/genética , Vitamina K Epóxido Redutases/genética , Acenocumarol/administração & dosagem , Administração Oral , Adulto , Idoso , Idoso de 80 Anos ou mais , Chile , Relação Dose-Resposta a Droga , Feminino , Frequência do Gene/genética , Variação Genética/genética , Genótipo , Humanos , Coeficiente Internacional Normatizado , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Tempo de Protrombina , Varfarina/administração & dosagem , Adulto JovemRESUMO
The anesthetic technique through the greater palatine canal seeks to block the maxillary nerve in the pterygopalatine fossa and anesthetize a large area, including the pulp and periodontium of the arch in question. After applying this technique in a patient, it failed to obtain the expected result. The patient began to experience dizziness, nausea, vomiting and the sensation of fluid in the ear. She was evaluated in both the emergency room of the Hospital Parroquial de San Bernardo and at a private clinic without accurate diagnosis. Only symptomatic treatment was provided. The next day she was discharged with reduced symptoms, which disappeared completely during the day. We propose the hypothesis of a diffusion of the anesthetic solution into the middle and inner ear through the auditory tube. This diffusion would explain the vestibular symptoms and the absence of anesthesia in the expected areas. We carried out an anatomic correlation in cadavers, following the path of a needle from the palatal mucosa to the pharyngeal opening of auditory tube. We conclude that the vertiginous syndrome could be due to an incorrect application of the technique, with the needle entering the auditory tube and spreading the anesthetic solution into the middle ear.
La técnica anestésica vía canal palatino mayor tiene como objetivo abordar al nervio maxilar en la fosa pterigopalatina, anestesiando un gran territorio, incluyendo la pulpa y periodonto de la hemiarcada correspondiente. Después de haber aplicado esta técnica en una paciente y no obteniendo el resultado esperado, esta comenzó a experimentar vértigo, náuseas, sensación de líquido en el oído y vómitos. Fue evaluada en el servicio de urgencias del Hospital Parroquial de San Bernardo y en una Clínica Privada, sin lograr un diagnóstico preciso y realizando solo un tratamiento sintomático. Al día siguiente fue dada de alta con baja sintomatología, la cual desapareció totalmente durante el día. Se propone la hipótesis de una difusión del anestésico hacia el oído medio e interno mediante el tubo auditivo. Esto explicaría por un lado la sintomatología vestibular y por otro la ausencia de anestesia en los dientes y territorios esperados. Además se realizó una correlación anatómica en cadáveres, utilizando 8 hemicabezas conservadas y siguiendo el posible trayecto de la aguja desde la mucosa palatina hasta el orificio faríngeo de la tuba auditiva. Se concluyó que el síndrome vertiginoso experimentado por la paciente se pudo deber a una técnica fallida al nervio maxilar vía canal palatino mayor con ingreso de la aguja al tubo auditivo, difundiendo el anestésico hacia el oído medio.