Use of radiographs for periodontal diagnosis in private practice

The aim of the present study was to determine the percentage of dentists who use radiographic examination on the initial appointment, and establish the relation between the use of periodontal probe and graduation year. Dentists were interviewed in their private offices in three cities in Rio Grande do Sul. They were asked about the routine use of radiographic examination and, if applicable, what technique was applied and what clinical instrument was used at the first appointment. Opened and closed questions were included in the interview and for some of them more than one answer was possible. A significant number of dentists (62.9%) reported some kind of radiographic examination at the initial appointment. Among the radiographic techniques, the periapical was the most cited (74.3%), followed by the panoramic (36.2%) and bite-wing (32.9%) techniques. There was an association between the use of periodontal probe and the use of radiographic examination at the initial appointment. Dentists who used periodontal probe used radiographic examination more frequently (p=0.010). More recently graduated dentists (1991-2005) used radiographic examination more than the others (p=0.022). In conclusion, a large number of dentists reported the use of radiographic examination at the initial appointment. There was an association between the use of this examination technique and the use of the periodontal probe; recently graduated dentists used radiographic examinations more frequently than the others.     

Hydrolytic stability of composite repair bond

The hydrolytic stability of composite repairs is a desirable property. In the present study, the composite repair microtensile bond strength, failure mode distribution, and nanoleakage occurrence before and after thermocycling were evaluated. Standardized, 1-month-old composite substrates were roughened, cleaned, and randomly assigned to seven groups according to the intermediate agent applied. Resin-based, silane-based, and combined silane/adhesive coupling agents were investigated. The same resin composite as the substrate was used for repair. For each group, repaired samples were wet stored for 24 h (37 degrees C) or thermocycled (5,000 cycles, 5-55 degrees C). Failure mode and silver nitrate penetration were examined by stereomicroscopy. Intermediate agent, experimental condition, and their interaction were significant factors. Hydrophobic flowable composites resulted in statistically higher repair strengths, lower occurrence of adhesive failures, and good quality interfacial coupling without any silver uptake in both conditions. Light-curing, hydrophilic resin monomer-based intermediate agents, although not affected by thermocycling, showed a more pronounced silver penetration. The composite repair strength of a self-curing silane/adhesive agent was significantly affected by thermal stresses, despite the absence of silver uptake. A prehydrolized silane agent recorded the lowest repair strength, with minimal or no evidence of interfacial silver impregnation after thermocycling. In conclusion, flowability and hydrophobic nature can be considered important properties when selecting intermediate agents for composite repair.     

An anthropological study about headache and migraine in native cultures from Central and South America

OBJECTIVE: To describe the ritual and ethnobotanical treatments about migraine performed by shamans from several native cultures. METHODS: Anthropological field study conducted with Tzeltal Maya (Mexico), Kamayurá (Brazil), and Uru-Chipaya (Bolivia) American Indians. RESULTS: Migraine is called yaxti-wanjol chawaj by Tzeltal shamans. They wash the head of the patient with an herbal solution to treat headache. The boiled leaves of a shrub called payté wamal (Tagetes nelsonii) are used to relieve migraine. Migraine is called monkey's disease by Kamayurá natives. The disease is originated by the revenge of the killed monkey's spirit, striking to Kamayurá hunter on his head. It is treated with an herbal infusion applied in the eyes of the patient. Migraine is called eskeclamix by Chipaya people, and is treated by drinking the ca?ahua plant (Chenopodium palludicale) boiled with water. The patient's head may also be washed with shaman's fermented urine. CONCLUSIONS: Cultural equivalents of migraine exist in the healing system of isolated American cultures.     

Noradrenaline induces peripheral antinociception by endogenous opioid release

Background

The aim of this study was to investigate this involvement in not inflammatory model of pain and which opioid receptor subtype mediates noradrenaline-induced peripheral antinociception. Noradrenaline is involved in the intrinsic control of pain-inducing pro-nociceptive effects in the primary afferent nociceptors. However, inflammation can induce various plastic changes in the central and peripheral noradrenergic system that, upon interaction with the immune system, may contribute, in part, to peripheral antinociception.

Co-exposure to silver nanoparticles and cadmium induce metabolic adaptation in HepG2 cells

Although multiple studies have reported the toxicological effects and underlying mechanisms of toxicity of silver nanoparticles (AgNP) in a variety of organisms, the interactions of AgNP with environmental contaminants such as cadmium are poorly understood. We used biochemical assays and mass spectrometry-based proteomics to assess the cellular and molecular effects induced by a co-exposure of HepG2 cells to AgNP and cadmium. Cell viability and energy homeostasis were slightly affected after a 4-h exposure to AgNP, cadmium, or a combination of the two; these endpoints were substantially altered after a 24-h co-exposure to AgNP and cadmium, while exposure to one of the two contaminants led only to minor changes. Proteomics analysis followed the same trend: while a 4-h exposure induced minor protein deregulation, a 24-h exposure to a combination of AgNP and cadmium deregulated 43% of the proteome. The toxicity induced by a combined exposure to AgNP and cadmium involved (1) inactivation of Nrf2, resulting in downregulation of antioxidant defense and proteasome-related proteins, (2) metabolic adaptation and ADP/ATP imbalance, and (3) increased protein synthesis possibly to reestablish homeostasis. The adaptation strategy was not sufficient to restore ADP/ATP homeostasis and to avoid cell death.     

Cost evolution of biological agents for the treatment of spondyloarthritis in a tertiary hospital: influential factors in price

Background Spending on biological agents has risen dramatically due to the high cost of the drugs and the increased prevalence of spondyloarthritis. Objective To evaluate the annual cost per patient and cost for each biological drug for treating patients with spondyloarthritis from 2009 to 2016, and to calculate factors that affect treatment cost, such as optimizing therapies by monitoring drug serum levels, the use of biosimilar-TNF inhibitors, and official discounts or negotiated rebates in biologicals acquired by the pharmacy department. Method Retrospective, observational study in a Spanish tertiary hospital. Main outcome Annual cost per patient and per drug. Factors that influenced the costs and socio-demographic parameters and disease activity. Results A total of 129, 215, and 224 patients were treated in 2009, 2013, and 2016, respectively. The annual cost per patient decreased: EUR11,604 in 2009, EUR8513 in 2013, and EUR7464 in 2016. The introduction of new drugs drives economic competition, leading to total savings per drug, with discounts reaching 5.8, 12.4, 16.7, 17.7, 13.7, and 24.8% for original infliximab, etanercept, adalimumab, ertolizumab, golimumab, and secukinumab, respectively, while rebates for biosimilar infliximab reached 31.90% in 2016. The number of patients with optimized therapies reached 47.5% in 2016, which led to cost savings of EUR798,614, in addition to savings from official discounts and rebates of EUR252,706 and savings from optimized therapies of EUR545,908 in 2016. Conclusion The cost of biological treatments declined after official discounts, negotiated rebates, and optimized therapies, leading to a significant decrease in the annual cost per patient. The greatest contribution to economic savings in biological therapy according to our study was biological therapy optimization.