In vitro evaluation of the susceptibility of endodontic pathogens to calcium hydroxide combined with different vehicles

The aim of this study was to investigate in vitro the antimicrobial activity of calcium hydroxide [Ca(OH)2] in combination with different vehicles against endodontic pathogens. For such purpose, a broth dilution test was performed. Pastes were prepared with Ca(OH)2 powder and the following vehicles: sterile water, glycerin, camphorated monochlorophenol (CMCP), CMCP + glycerin, polyethyleneglycol and CMCP + polyethyleneglycol. The time required for the pastes to produce negative cultures against the tested microorganisms was recorded and analyzed statistically using the Kruskal Wallis test at 5% significance level. Timing for pastes to eliminate the aerobic and facultative anaerobic microorganisms ranged from 6 to 24 h, while strict anaerobic microorganisms were inhibited within 30 s to 5 min. Microbial susceptibility, ranked from weakest to strongest, can be presented as follows: Enterococcus faecalis (the most resistant microorganism), Candida albicans, Staphylococcus aureus, Porphyromonas gingivalis, Porphyromonas endodontalis and Prevotella intermedia (the last two microorganisms required the same time to be eliminated). In conclusion, calcium hydroxide pastes needed more time to eliminate facultative than anaereobic microorganisms. These findings suggest that the antimicrobial property is related both to paste formulation and to microbial susceptibility.     

In vitro evaluation of the antimicrobial activity of chlorhexidine and sodium hypochlorite

The aim of this study was to investigate in vitro the antimicrobial activity of 0.2%, 1%, and 2% chlorhexidine gluconate (CHX gel and CHX liquid), against endodontic pathogens and compare the results with the ones achieved by 0.5%, 1%, 2.5%, 4%, and 5.25% sodium hypochlorite (NaOCl). A broth dilution test was performed, and the timing for irrigants to kill microbial cells was recorded and statistically analyzed. Both 2.0% gel and liquid formulations eliminated Staphylococcus aureus and Candida albicans in 15 seconds, whereas the gel formulation killed Enterococcus faecalis in 1 minute. All tested irrigants eliminated Porphyromonas endodontalis, Porphyromonas gingivalis, and Prevotella intermedia in 15 seconds. The timing required for 1.0% and 2.0% CHX liquid to eliminate all microorganisms was the same required for 5.25% NaOCl. The antimicrobial action is related to type, concentration, and presentation form of the irrigants as well as the microbial susceptibility.     

Image-guided study of swine anatomy as a tool for urologic surgery research and training

Purpose:To describe the anatomy of the swine urinary system using computed tomography and to discuss the role of this animal as an experimental model for urological procedures.Methods:Three male Landrace pigs underwent computed tomography and the anatomy of the urinary system and renal circulation was analyzed and described.Results:In all animals, 2 kidneys, 2 ureters and one bladder were identified. Each kidney presented a single renal artery vascularization, with a mean diameter on the right of 4.45 and 5.31 mm on the left (p < 0.0001) and single renal vein drainage, with a mean diameter on the right of 5.78 and 5.82 mm on the left (p = 0.0336). The average renal length was 9.85 cm on the right and 10.30 cm on the left (p < 0.0001). The average renal volume was 113.70 cm³ on the right and 109.70 cm³ on the left (p < 0.0001). The average length of the ureter was 19.78 cm on the right and 22.08 cm on the left (p < 0.0001). The average bladder volume was 423.70 cm³.Conclusions:The data obtained show similarities with human anatomy, suggesting the viability of the swine model for planning preclinical trials, basic research, refinement in experimental surgery and surgical training for urological procedures.Key words: Urologic Surgical Procedures, Tomography, X-Ray Computed, Anatomy, Swine     

Revision rhinoplasty: physician–patient aesthetic and functional evaluation

Introduction

Approximately 5–15% of patients submitted to rhinoplasty operations undergo revision surgery. Those patients have varied functional and aesthetic complaints that should receive a detailed assessment that includes all the expectations the patient had before the previous procedure.

Incidence and characteristics of methicillin-resistant coagulase-negative Staphylococcus aureus in peritoneal dialysis-associated peritonitis in a single center using molecular methods

International Urology and Nephrology - Peritonitis is a serious complication of peritoneal dialysis and coagulase-negative Staphylococcus (CNS) is the most frequent cause of peritoneal dialysis...     

Ayahuasca and Kambo intoxication after alternative natural therapy for depression,confirmed by mass spectrometry

Forensic Toxicology - We present a case report about an acute intoxication episode after an oral administration of Ayahuasca and dermal exposure of Kambo for treatment of depression. The clinical...     

Acute Coronary Syndrome Management in Cancer Patients

Purpose of Review

Coronary artery disease and cancer often co-exist. Patients with cancer have been excluded by most major cardiology trials and registries and their management remains largely empiric. Cancer patients experience an approximately 10-times increased mortality compared to the general population. Conservative therapy of ACS in cancer therapy results in 1-year mortality of 74%. This review article aims to describe the mechanisms of acute coronary syndromes in cancer patients, their clinical presentation, and their management.

Recent Findings

Newer studies have shed light on the mechanisms of ACS in cancer patients, which are different and related to the type of malignancy and its associated therapy. Medication-specific coronary effects (vasospasm, endothelial dysfunction, spontaneous thrombosis, accelerated atherosclerosis), radiation vasculitis, cancer cell coronary embolism, and coronary compression from thoracic malignancies are unique ACS mechanisms in cancer patients.

Summary

Close collaboration between oncologists and cardiologists for thoughtful patient selection and decision making strategies is necessary to provide optimal medical care.

     

Maternal Roux-en-Y gastric bypass impairs insulin action and endocrine pancreatic function in male F1 offspring

European Journal of Nutrition - Obesity is predominant in women of reproductive age. Roux-en-Y gastric bypass (RYGB) is the most common bariatric procedure that is performed in obese women for...     

Reducing Trocar Movement in Operative Laparoscopy through Use of a Fixator

Study ObjectiveTo evaluate trocar stability using a fixation device to control trocar insertion depth and in particular to provide greater stability during laparoscopic procedures, and to evaluate the effects of using a fixator to control mobility of trocars.DesignNon-blinded prospective study (Canadian Task Force classification II-2).SettingUniversity hospital department of gynecology, obstetrics, and gynecological oncology.PatientsForty-three patients scheduled to undergo gynecologic laparoscopic intervention with planned operative time >10 minutes.InterventionsIn all procedures, 5-mm working trocars bearing a plain (smooth) sleeve were used. The fixator device, consecutively either on the left or right side, was attached to 1 of 2 side trocars before insertion. In 18 patients, an unsutured fixator was used (FX-US subgroup). In the remaining 25 patients, the device was sutured to the skin via specially designed suturing ports (FX-S subgroup). The position of both trocars in the groups with a fixator (FX group) and without a fixator (NFX group) in the abdominal wall was evaluated at the start of the procedure and every 10 minutes intraoperatively.Measurements and Main ResultsIn the FX group, there was significantly decreased trocar movement compared with the NFX group (mean [SD] 0.02 [0.6] cm vs 0.84 [4.4] cm). In addition, in the NFX group, the trocar tended to slip into the abdomen during the operation, whereas in the FX group, trocars tended to slip out. Of 43 ports, 11 (25.6%) had to be either reinserted or readjusted at some point during the operation. In 2 procedures, reinsertion of the trocar at exactly the same location was impossible. In the FX-US subgroup, there was 1 incidence of trocar dislocation, whereas there were no dislocations in the FX-S subgroup. The difference in the effect between the 2 study arms, fixator unsutured and fixator sutured, was expected to produce only a small benefit in the sutured fixator arm; however, the benefit was greater than anticipated.ConclusionUse of a fixator significantly reduces plain (smooth) sleeve trocar movement and prohibits complete dislocation or slippage of the port, and suturing the device to the skin further minimizes trocar movement. Trocar stabilization via a fixation device may lead to shorter operative time and reduce problems associated with trocar slippage or dislocation.