Eighteen‐month clinical and radiographic evaluation of two root canal‐filling materials in primary teeth with pulp necrosis secondary to trauma

Abstract – Aim: This study compared clinically and radiographically the use of zinc oxide and eugenol cement (ZOE) and a commercial calcium hydroxide and polyethylene glycol‐based paste (Calen^®) thickened with zinc oxide as root canal‐filling materials for primary teeth with pulp necrosis secondary to trauma within 18 months of follow up. Material and methods: Eligible patients of both genders aged 2 years and 6 months to 5 years and 10 months who had been referred for dental treatment at a pediatric dental trauma service and presented at least one anterior primary tooth (central and/or lateral incisor) with pulp necrosis secondary to traumatic injury were selected. Twenty‐six children (n = 31 teeth) with mean age of 3.4 years met the inclusion criteria and were enrolled after parental written consent. The root canals were instrumented and filled with either ZOE (group I; n = 15 teeth) or Calen^® paste [composition: 2.5 g calcium hydroxide, 0.5 g zinc oxide, 0.05 g colophony, and 1.75 ml polyethylene glycol 400 (vehicle)] thickened with zinc oxide (Calen^®/ZO; group II; n = 16 teeth). ZO was added to the Calen^® paste for slowing paste resorption, which should ideally occur simultaneously with the physiologic resorption of primary tooth roots. Clinical success after 18 months of follow up was considered as absence of pain, tooth mobility or fistula, and radiographic success as the partial or total remission of apical periodontitis, absence of pathological root resorption or presence of new bone formation. Results: Eighteen months after treatment, the teeth obturated with ZOE and Calen^®/ZO presented statistically similar (Fisher’s exact test; P > 0.05) success rates of 93.3% and 87.5%, respectively. Conclusion: Our results showed the clinical and radiographic outcomes for Calen^®/ZO to be equal to those for ZOE after 18 months, suggesting that both materials can be indicated for obturating primary teeth with pulp necrosis after trauma.     

Genotypic characteristics of HIV type 1 based on gp120 hypervariable region 3 of isolates from Southern Brazil

The aim of this study was to investigate HIV-1 molecular diversity and the epidemiological profile of HIV-1-infected patients from Ribeir?o Preto, Brazil. A nested PCR followed by sequencing of a 302-base pair fragment of the env gene (C2-V3 region) was performed in samples from HIV-1-positive patients. A total of 45 sequences were aligned with final manual adjustments. The phylogenetic analyses showed a higher prevalence of HIV-1 subtype B in the studied population (97.8%) with only one sample yielding an F1 subtype. The viral genotyping prediction showed that CCR5 tropism was the most prevalent in the studied cohort. Geno2pheno analysis showed that R5 and CXCR4 prediction were 69% and 31%, respectively. There was no statistical significance, either in viral load or in CD4(+) T cell count when R5 and X4 prediction groups were compared. Moreover, the GPGR tetramer was the most common V3 loop core motif identified in the HIV-1 strains studied (34.1%) followed by GWGR, identified in 18.1% of the samples. The high level of B subtype in this Brazilian population reinforces the nature of the HIV epidemic in Brazil, and corroborates previous data obtained in the Brazilian HIV-infected population.     

Is Visceral Leishmaniasis the same in HIV-coinfected adults?

Introduction

Visceral Leishmaniasis is the most severe form of disease caused by the Leishmania donovani complex, with significant morbidity and mortality in developing countries. Worse outcomes occur among HIV-positive individuals coinfected with Leishmania. It is unclear, however, if there are significant differences on presentation between Visceral Leishmaniasis patients with or without HIV coinfection.

Pulmonary Artery Pressure,Gender, Menopause,and Pregnancy in Schistosomiasis-Associated Pulmonary Hypertension

Background

Schistosomiasis-associated pulmonary arterial hypertension (SPAH) is a major concern worldwide. However, the role of gender specific contributing factors in SPAH is unknown.

Objective

We investigated how systolic pulmonary artery pressure (SPAP) values and the presence of severe SPAP relate to gender, menopausal status, and pregnancy history in SPAH patients.

Methods

Seventy-nine patients diagnosed with SPAH from 2000 to 2009 were assessed and 66 were enrolled in the study. Information about age, menopausal status, pregnancy, echocardiography-derived SPAP, and invasive mean pulmonary artery pressure (mPAP) was collected from medical records. The relation between values of SPAP and mPAP and their agreement for severe disease were assessed. Regression models assessed the association of gender, menopausal status, and pregnancy history with SPAP values and the presence of severe SPAP.

Results

Moderate correlation and good agreement for severe disease were found between mPAP and SPAP. Mean SPAP values were similar for men and women. A trend toward higher values of SPAP was found for non-menopausal women compared to men. Higher SPAP values were found for menopausal compared to non-menopausal women; the values were non-significant after adjustment for age. Pregnancy history had no association with SPAP. Menopause and positive pregnancy had no association with severe SPAP.

Conclusion

In SPAH patients, neither gender, nor menopausal status, nor pregnancy history showed independent correlation with SPAP values assessed by echocardiography.     

Longitudinal clinical and radiographic evaluation of severely intruded permanent incisors in a pediatric population

Abstract – Intrusion is defined as the axial dislodgment of the tooth into its socket and is considered one of the most severe types of dental trauma. This longitudinal outcome study was undertaken to evaluate clinically and radiographically severely intruded permanent incisors in a population of children and adolescents. All cases were treated between September 2003 and February 2008 in a dental trauma service. Clinical and radiographic data were collected from 12 patients (eight males and four females) that represented 15 permanent maxillary incisors. Mean age at the time of injury was 8 years and 9 months (range 7–14 years and 8 months). Mean time elapsed to follow‐up was 26.6 months (range 10–51 months). The analysis of data showed that tooth intrusion was twice as frequent in males. The maxillary central incisors were the most commonly intruded teeth (93.3%), and falling at home was the main etiologic factor (60%). More than half of the cases (53.3%) were multiple intrusions, 73.3% of the intruded teeth had incomplete root formation and 66.6% of the teeth suffered other injuries concomitant to intrusion. Immediate surgical repositioning was the treatment of choice in 66.7% of the cases, while watchful waiting for the tooth to return to its pre‐injury position was adopted in 33.3% of the cases. The teeth that suffered additional injuries to the intrusive luxation presented a fivefold increased relative risk of developing pulp necrosis. The immature teeth had six times more chances of presenting pulp canal obliteration that the mature teeth and a lower risk of developing root resorption. The most frequent post‐injury complications were pulp necrosis (73.3%), marginal bone loss (60%), inflammatory root resorption (40%), pulp canal obliteration (26.7%) and replacement root resorption (20%). From the results of this study, it was not possible to determine whether the type immediate treatment had any influence on the appearance of sequelae like pulp necrosis and root resorption after intrusive luxation, but the existence of additional injuries and the stage of root development influenced the clinical case outcome in a negative and positive manner, respectively.     

Nursing and sport practices: learning with ethical dilemas

This study aimed to identify the difficulties related to the first aids during one students competition and also it correlates the experience learned regarding technician aspects, cientifics and ethical approaches when the performance of the first-aid nurse. The report was taking into account the production basis regarding the performance of the first aids professionals and a workshop of consensus to solve ethical dilemmas. It was described the taking decision ethical, the material resources available and also the harms which might affected the physical integrity of the athletes and the interventions executed. It was concluded that the sports has a feature of preventive and curative medicine that demands the moral commitment of the organizers to provide the necessary material resources for occasion of some damage suffered for the athletes.