Análise in vivo do selamento do canal protéico com diferentes materais adesivos

This in vivo study analyzed the sealing ability of two adhesives in post spaces, cyanoacrylate (Super Bonder® - Henkel Loctite Adesivos Ltda., Itapevi, SP, Brazil) and ScotchbondTM Multi-Purpose (3M Dental Products, St. Paul, MN, USA), testing the hypothesis that their use would result in a decreased leakage through the remaining filling material. Forty extracted premolars (80 root canals) of dogs were used. The root canals were cleaned, shaped and filled by the lateral condensation technique using Sealer 26TM. The post space was created removing two thirds of the filling material within the root canal. The canals were randomly divided in three groups, which were treated as follows: Group A received the ScotchbondTM Multi-Purpose adhesive system; for Group B the cyanoacrylate adhesive, Super BonderTM, was employed; and no adhesive was applied into the post space for Group C (control group). A glass ionomer provisional restoration was placed allowing the sealer to set for 72 hours. Then the restoration was removed and the root canal was exposed to the oral environment for 45 days. The dogs were then killed and their jaws were removed. The post spaces were filled with India ink and the teeth were restored for 96 hours. Afterwards, the teeth were extracted and the roots were sectioned at the furcation for allocation to their specific groups. The teeth were turned transparent and the quantitative analysis of leakage was performed using light microscopy. The results showed no significant differences between groups, rejecting the initial hypothesis. Leakage occurred in a great extent in all specimens. Therefore, sealing post spaces with the adhesives used in this study was not an effective method to prevent microleakage.Esse estudo in vivo analisou a capacidade de selamento do canal protético com dois adesivos, o Super Bonder® (Henkel Loctite Adesivos Ltda., Itapevi, SP) e o Scotchbond® Multi-Purpose (3M Dental Products, St. Paul, MN, EUA), testando a hipótese de que a aplicação desses adesivos resulta em menor infiltração de corante no material obturador remanescente. Quarenta dentes pré-molares (80 canais) de cães foram obturados pela técnica da condensação lateral usando o cimento endodôntico Sealer 26®. O canal protético foi preparado removendo-se 2/3 da obturação do canal radicular. Os canais preparados foram distribuídos, aleatoriamente, em três grupos: no grupo A, foi realizado o selamento do canal protético com o adesivo dentinário; no grupo B, esta impermeabilização foi realizada com o Super Bonder®; e no grupo C, controle, não foi aplicado qualquer material às paredes do canal protético. Os dentes foram selados, provisoriamente, com cimento de ionômero de vidro por 72 horas, objetivando a presa do cimento endodôntico. Removido o selamento coronário, os canais ficaram expostos ao meio bucal por 45 dias, quando os cães foram mortos e os maxilares removidos. Tinta nanquim foi colocada no canal protético e os dentes foram selados por 96 horas. Depois de extraídos, os dentes foram seccionados na região da furca e cada raiz alocada em seu respectivo grupo. Feita a diafanização, foi realizada a análise quantitativa da infiltração do corante com lupa esteroscópica. Os resultados mostraram não haver diferenças entre os três grupos experimentais, negando a hipótese inicial. Houve infiltração do corante no remanescente obturador de todas as raízes analisadas

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Longitudinal urethral sling with prepubic and retropubic fixation for male urinary incontinence

OBJECTIVE: Description and early results of a new urethral sling technique for treatment of postprostatectomy urinary incontinence, which combines efficacy, low cost and technical simplicity. MATERIALS AND METHODS: From May 2003 to April 2004, 30 patients with moderate or total urinary incontinence, following radical prostatectomy or endoscopic resection of the prostate, underwent the new technique. The technique is based on the placement of a longitudinal-shaped sling in the bulbar urethra, measuring 4 cm in length by 1.8 cm in width, made of Dacron or polypropylene mesh, fixed by 4 sutures on each side, with 2 sutures passed with Stamey-Pereira needle by retropubic approach and 2 by prepubic approach, which are then tied over the pubis. Pressure control was determined by interrupting the loss of infused water through a suprapubic cystostomy 60 cm from the pubis level. RESULTS: Pre-operative assessment excluded vesical instability, urethral stenosis and urinary infection. Suprapubic cystostomy was removed when the patient was able to satisfactorily void with urinary residue lower than 100 mL, which occurred in 29 of the 30 cases. In 2 cases, there was infection of the prosthesis, requiring its removal. In 3 cases, there was the need to adjust the sling (increasing the tension), due to failure of the urinary continence. Overall, 20 of 30 (66.7%) operated patients became totally continent, and did not require any kind of pads. Four of 30 (13.3%) patients achieved partial improvement, requiring 1 to 2 pads daily and 6 of 30 (20%) patients had minimal or no improvement. There was no case of urethral erosion. CONCLUSION: This new sling technique has shown highly encouraging preliminary results. Its major advantage over other surgical techniques for treatment of moderate or severe stress urinary incontinence is the simplicity for its execution and low cost. A long-term assessment, addressing maintenance of continence, detrusor function and preservation of the upper urinary tract, is still needed

In vitro multiplication of 'Flordaguard' rootstock: cytokinin source and concentration effects, explants orientation and period of permanence in the culture medium

This work aimed at studying the effects of different sources and cytokinin concentrations, as well as explants orientation and time of their permanence in shoots induction medium to obtain high multiplication rate. Four experiments were carried out to evaluate the sprout percentage mean, shoots number per explant, elongated shoots percentage and shoots length. The treatments with 2iP and zeatin did not promote in vitro plant multiplication. When different BAP concentrations were tested, an increase in sprout percentage was obtained using BAP concentration up to 3.66 mg L-1 (80%), and for shoots number per explant a linear behavior was observed, showing a mean of four shoots per explant with 4.0 mg L-1 BAP. For the 'Flordaguard' rootstocks, the explants orientation did not alter the potential in vitro multiplication and the shoots growth. However, the explants permanence in the shoots induction medium for 40 days provided the best results for shoots growth