Efeito do numero de ciclos termicos sobre a deformação permanente de materiais reembasadores resilientes e sua resistencia a tração da união com a resina acrilica

Orientador: Marcelo Ferraz MesquitaTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: O objetivo deste estudo foi avaliar o efeito do número de ciclos térmicos sobre a deformação permanente e resistência à tração da união com resina acrílica, de reembasadores resilientes definitivos usados como forradores de bases de próteses: um à base de silicone (Softliner), e outro à base de resina acrílica (Eversoft). Para o ensaio de resistência à tração da união, estes materiais foram unidos a uma resina acrílica (QC-20), e para o de deformação, não. Para a confecção das amostras foram utilizadas matrizes metálicas (40 x 10 x 10 e 13 x 19 mm) incluídas em mufla, cujo molde impresso na silicone por condensação e no gesso foi preenchido com resina acrílica e/ou material resiliente. Foram confeccionadas 400 amostras, metade para o ensaio de resistência à tração da união e metade para o de deformação permanente, divididas em 10 grupos, com 10 amostras por material para o ensaio de tração, e 10 para o de deformação permanente: grupo I - não submetido à termociclagem (grupo controle); grupo II -200 ciclos; grupo III - 500 ciclos; grupo IV - 1000 ciclos; grupo V - 1500 ciclos; grupo VI - 2000 ciclos; grupo VII ¿2500 ciclos; grupo VIII - 3000 ciclos; grupo IX -3500 ciclos e grupo X - 4000 ciclos. O tratamento térmico foi realizado no aparelho termociclador MSCT-3 plus com ciclos de imersão de 1 minuto em água a 5°C (± l°C) e 1 minuto em água a 55°C (±1°C). Para o ensaio de resistência à tração da união, as amostras foram adaptadas às garras autotravantes de uma máquina de ensaios universal EMIC DL-500 MF, com velocidade de 5 mm/minuto. Para o ensaio de deformação permanente, foi utilizado um dispositivo mecânico descrito na especificação nº 18 da A.D.A. Os dados obtidos foram submetidos à análise de variância (ANOVA) e as médias comparadas pelo Teste de Tukey, em nível de 5% de probabilidade, e as amostras do ensaio de resistência à tração da união, observadas quanto ao tipo de falha ocorrida (adesiva, coesiva ou mista). O material Softliner submetido aos diferentes números de ciclos térmicos não apresentou diferença estatística nos valores de resistência à tração da união, entretanto, o material Eversoft, quando se comparou o grupo controle (0,47 MPa) e o de 500 ciclos (0,46 MPa) com o de 4000 ciclos térmicos (0,70 MPa), observou-se aumento dos valores de resistência à tração da união, com significância estatística. Quanto ao tipo de falha, observou-se que: Eversoft apresentou maior porcentagem de falha adesiva e mista. Já, a base resiliente Softliner, apresentou 100% de falha adesiva. Para o ensaio de deformação permanente, independente do tratamento recebido, o material Eversoft apresentou o valor mais elevado (2,27%) e diferiu estatisticamente do Softliner (0,38%). A termociclagem promoveu a elevação gradativa da porcentagem de deformação permanente apenas para o material à base de resina acrílica, diferindo estatisticamente a partir dos 1500 ciclos térmicos (1,88%) e respectivamente nos grupos dos 2000 (2,19%), 2500 (2,57%), 3000 (2,85%) e 3500 ciclos (3,24%). O grupo dos 4000 ciclos (3,45%) não apresentou diferença estatística significativa se comparado com o dos 3500 ciclosAbstract: The purpose of this study was to evaluate the effect of thermal cycling on the tensile bond strength and the permanent deformation of two soft denture liner materiaIs (one silicone - Softliner and one acrylic resin - Eversoft). In the first study (tensile bond strength), one acrylic resin (QC-20) for denture base was used. For each study was used 200 samples divided in 10 groups, with 10 samples for each material: group I - not thermocycled (control group); group II- 200 cycles; group III - 500 cycles; group IV - 1000 cycles; group V - 1500 cycles; group VI ¿ 2000 cycles; group VII - 2500 cycles; group VIII - 3000 cycles; group IX - 3500 cycles and group X - 4000 cycles. The thermal cycling was made in the machine MSCT-3 plus where cycles of 1 minute in water at 5°C (± l°C) and 1 minute of water at 55°C (± l°C) were made. For the making of the samples, metallic dies (40 x 10 x 10 and 13 x 19 mm) were used invested in flasks, whose model impressed in the silicone of the condensation and in the gypsum was filled up with acrylic resin and/or soft materiaIs. After each period, the samples of the first study were submitted to a tensile bond strength test in a universal testing machine (EMIC DL-500 MF) at the crosshead speed of 5 mm / minute. The samples of the second study were submitted to a permanent deformation test in a mechanic machine described in the A.D.A.' s specification nº 18. The obtained results were submitted to the variance analyses (ANOVA) and to the Tukey' s Test, at the leveI of 5% of probability and the tensile bond strength samples were analyzed according to the kind of failure occurred. Based in the results of the tensile bond strength study, the Softliner material submitted to the thermal treatments didn't presented values of the bond strength with statistical difference, however Eversoft presented a significant statistical difference in the control group (0.47 MPa) and the group of the 500 cycles (0.46 MPa) when compared with the group of the 4000 cycles (0.70 MPa). The Eversoft material presented adhesive and mixed failures. The Softliner material presented 100% of adhesive failures. Based in the results of the permanent deformation study, when we observe the averages of the values independent the treatment was used, the Eversoft material presented the highest values (2.27%) and the Softliner presented the lowest (0.38%). To the acrylic resin soft denture material the thermal cycling increased the values of permanent deformation, however were observed a significant statistical difference only after the group of 1500 cyclesDoutoradoProtese DentalDoutor em Clínica Odontológic

Cardiac Troponin Mutations and Restrictive Cardiomyopathy

Mutations in sarcomeric proteins have recently been established as heritable causes of Restrictive Cardiomyopathy (RCM). RCM is clinically characterized as a defect in cardiac diastolic function, such as, impaired ventricular relaxation, reduced diastolic volume and increased end-diastolic pressure. To date, mutations have been identified in the cardiac genes for desmin, α-actin, troponin I and troponin T. Functional studies in skinned muscle fibers reconstituted with troponin mutants have established phenotypes consistent with the clinical findings which include an increase in myofilament Ca2+ sensitivity and basal force. Moreover, when RCM mutants are incorporated into reconstituted myofilaments, the ability to inhibit the ATPase activity is reduced. A majority of the mutations cluster in specific regions of cardiac troponin and appear to be mutational “hot spots”. This paper highlights the functional and clinical characteristics of RCM linked mutations within the troponin complex

How to avoid the inappropriate use of antibiotics in upper respiratory tract infections? A position statement from an expert panel

Introduction: Bacterial resistance burden has increased in the past years, mainly due to inappropriate antibiotic use. Recently it has become an urgent public health concern due to its impact on the prolongation of hospitalization, an increase of total cost of treatment and mortality associated with infectious disease. Almost half of the antimicrobial prescriptions in outpatient care visits are prescribed for acute upper respiratory infections, especially rhinosinusitis, otitis media, and pharyngotonsillitis. In this context, otorhinolaryngologists play an important role in orienting patients and non-specialists in the utilization of antibiotics rationally and properly in these infections. Objectives: To review the most recent recommendations and guidelines for the use of antibiotics in acute otitis media, acute rhinosinusitis, and pharyngotonsillitis, adapted to our national reality. Methods: A literature review on PubMed database including the medical management in acute otitis media, acute rhinosinusitis, and pharyngotonsillitis, followed by a discussion with a panel of specialists. Results: Antibiotics must be judiciously prescribed in uncomplicated acute upper respiratory tract infections. The severity of clinical presentation and the potential risks for evolution to suppurative and non-suppurative complications must be taken into 'consideration'. Conclusions: Periodic revisions on guidelines and recommendations for treatment of the main acute infections are necessary to orient rationale and appropriate use of antibiotics. Continuous medical education and changes in physicians' and patients' behavior are required to modify the paradigm that all upper respiratory infection needs antibiotic therapy, minimizing the consequences of its inadequate and inappropriate use. (C) 2018 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial. Published by Elsevier Editora Ltda. This is an open access article under the CC BY license.Introdução: A resistência bacteriana a antibióticos nos processos infecciosos é um fato crescente nos últimos anos, especialmente devido ao seu uso inapropriado. Ao longo dos anos vem se tornando um grave problema de saúde pública devido ao prolongamento do tempo de internação, elevação dos custos de tratamento e aumento da mortalidade relacionada às doenças infecciosas. Quase a metade das prescrições de antibióticos em unidades de pronto atendimento é destinada ao tratamento de alguma infecção de vias aéreas superiores, especialmente rinossinusites, otite média aguda supurada e faringotonsilites agudas, sendo que uma significativa parcela dessas prescrições é inapropriada. Nesse contexto, os otorrinolaringologistas têm um papel fundamental na orientação de pacientes e colegas não especialistas, para o uso adequado e racional de antibióticos frente a essas situações clínicas. Objetivos: Realizar uma revisão das atuais recomendações de utilização de antibióticos nas otites médias, rinossinusites e faringotonsilites agudas adaptadas à realidade nacional. Método: Revisão na base PubMed das principais recomendações internacionais de tratamentos das infecções de vias aéreas superiores, seguido de discussão com um painel de especialistas. Resultados: Os antibióticos devem ser utilizados de maneira criteriosa nas infecções agudas de vias aéreas superiores não complicadas, a depender da gravidade da apresentação clínica e dos potenciais riscos associados de complicações supurativas e não supurativas. Conclusões: Constantes revisões a respeito do tratamento das principais infecções agudas são necessárias para que sejam tomadas medidas coletivas no uso racional e apropriado de antibióticos. Somente com orientação e transformações no comportamento de médicos e pacientes é que haverá mudanças do paradigma de que toda infecção de vias aéreas superiores deva ser tratada com antibióticos, minimizando por consequência os efeitos de seu uso inadequado.Univ Fed Rio Grande do Sul, Dept Oftalmol & Otorrinolaringol, Fac Med FAMED, Porto Alegre, RS, BrazilUniv Fed Sao Paulo UNIFESP, Dept Otorrinolaringol & Cirurgia Cabeca & Pescoco, EPM, Sao Paulo, SP, BrazilUniv Estadual Campinas, UNICAMP, Dept Otorrinolaringol & Oftalmol, Campinas, SP, BrazilUniv Sao Paulo, FM, Disciplina Otorrinolaringol, Sao Paulo, SP, BrazilUniv Sao Paulo, FM, Otorrinolaringol, Sao Paulo, SP, BrazilHosp Infantil Sabara, Otorrinolaringol, Sao Paulo, SP, BrazilHosp Paranaense Otorrinolaringol IPO, Inst Paranaense Otorrinolaringol, Curitiba, Parana, BrazilFac Ciencias Med Santa Casa de Sao Paulo, Sao Paulo, SP, BrazilUniv Fed Pernambuco UFPE, Dept Cirurgia, Div Otorrinolaringol, Recife, PE, BrazilUniv Luterana Brasil, Fac Med, Porto Alegre, RS, BrazilUniv Sao Paulo, FM, Sao Paulo, SP, BrazilHosp Albert Einstein, Sao Paulo, SP, BrazilUniv Sao Paulo, FMRP, Dept Oftalmol Otorrinolaringol & Cirurgia Cabeca, Ribeirao Preto, SP, BrazilUniv Fed Ciencias Saude Porto Alegre, Hosp Crianca St Antonio, Serv Otorrinolaringol Pediat, Porto Alegre, RS, BrazilUniv Estado Rio De Janeiro, Fac Ciencias Med, Disciplina Otorrinolaringol, Rio De Janeiro, RJ, BrazilUniv Fed Goias, Goiania, Go, BrazilPontificia Univ Catolica Goias PUC GO, Goiania, Go, BrazilCtr Univ Anapolis, Anapolis, Go, BrazilUniv Fed Sao Paulo UNIFESP, Dept Otorrinolaringol & Cirurgia Cabeca & Pescoco, EPM, Sao Paulo, SP, BrazilSciEL

Rehabilitative treatment of cleft lip and palate: experience of the Hospital for Rehabilitation of Craniofacial Anomalies/USP (HRAC/USP) - Part 5: Institutional outcomes assessment and the role of the Laboratory of Physiology

The Laboratory of Physiology provides support for the diagnosis of functional disorders associated with cleft lip and palate and also conducts studies to assess, objectively, the institutional outcomes, as recommended by the World Health Organization. The Laboratory is conceptually divided into three units, namely the Unit for Upper Airway Studies, Unit for Stomatognathic System Studies and the Unit for Sleep Studies, which aims at analyzing the impact of different surgical and dental procedures on the upper airways, stomatognathic system and the quality of sleep of individuals with cleft lip and palate. This paper describes the main goals of the Laboratory in the assessment of procedures which constitute the basis of the rehabilitation of cleft lip and palate, i.e., Plastic Surgery, Orthodontics and Maxillofacial Surgery and Speech Pathology

Nasal polyposis : more than a chronic inflammatory disorder : a disease of mechanical dysfunction : the São Paulo position

Introduction The importance of our study lies in the fact that we have demonstrated the occurrence of mechanical dysfunction within polypoid tissues, which promotes the development of polyps in the nasal cavity. Objective To change the paradigm of nasal polyposis (NP). In this new conception, the chronic nasal inflammatory process that occurs in response to allergies, to pollution, to changes in the epithelial barrier, or to other factors is merely the trigger of the development of the disease in individuals with a genetic predisposition to an abnormal tissue remodeling process, which leads to a derangement of the mechanical properties of the nasal mucosa and, consequently, allows it to grow unchecked. Data Synthesis We propose a fundamentally new approach to intervening in the pathological process of NP, addressing biomechanical properties, fluid dynamics, and the concept of surface tension. Conclusion The incorporation of biomechanical knowledge into our understanding of NP provides a new perspective to help elucidate the physiology and the pathology of nasal polyps, and new avenues for the treatment and cure of NP

High-resolution multibeam bathymetry of the northern Mid-Atlantic Ridge at 45–46° N: the Moytirra hydrothermal field

This work presents a new high-resolution multibeam bathymetric map of a segment of active deep sea-floor spreading in the Atlantic Ocean, the northern Mid-Atlantic Ridge (MAR) at 45–46º N. New high-resolution bathymetry data were acquired using an Atlas multibeam echosounder onboard the research vessel Sarmiento de Gamboa during the EXPLOSEA-2 survey in 2019. The final map of the MAR (50 m cell grid size) at the original scale of 1:200,000 shows a segment of 140 × 35 km of the MAR, at water depths from 715 to 3700 m. This new high-resolution bathymetric map allows to better defining the submarine morphology of the Moytirra hydrothermal active field, the only high-temperature field identified between the Azores Archipelago (Portugal) and Iceland. ROV submarine observations reaching the deepest part of the system for the first time show giant anhydrite-sulfide chimneys up to 20 m high, active strong black smokers and polymetallic massive sulfides

Multidisciplinary Scientific Cruise to the Northern Mid-Atlantic Ridge and Azores Archipelago

This work presents the preliminary result of the multidisciplinary cruise EXPLOSEA2 surveying the northern Mid-Atlantic Ridge and Azores Archipelago from 46 300 N to 38 300 N aboard the R/V Sarmiento de Gamboa and ROV Luso over 54 days (June 11 to July 27, 2019). In this cruise report, we detail the geophysical, hydrographic, geological, oceanographic, ecological, and microbiological data acquired and a brief of main findings. The cruise addressed the exploration and comprehensive characterization of venting sites, including the water column, the sediments and rocks that host the hydrothermal activity, and the associated mineralizations, biology, and microbiology. Deep hydrothermal chimneys and massive sulfide deposits (up 3,000 m in depth) within the Moytirra hydrothermal active field were identified on slopes that had not been explored previously. Another striking finding made during the EXPLOSEA2 cruise was the field of carbonate chimneys named the “Magallanes-Elcano” field, a potentially relict ultramafic-hosted hydrothermal site sourced by abiotic methane. This field is related to a serpentinite and gabbro rock outcropping on a dome-shaped massif named the “Iberian Massif.” An outstanding finding of the EXPLOSEA2 survey was the identification of the first garden of soft corals growing after active submarine eruptions were reported in the Azores Archipelago composed by a high density of soft corals the suborder Alcyoniina at the summit and flanks of a recent volcanic cone at 160 m water depth developed during the 1957–1958 eruption of Capelinhos. Several cold-water coral habitats formed by colonial scleractinians (e.g., Lophelia pertusa and Madrepora oculata), coral gardens composed of mixed assemblages of black corals (Leiopathes sp.), and octocorals and dense aggregations of the glass sponge Pheronema carpenteri that may be classified as vulnerable marine ecosystems (VMEs) have been discovered during the EXPLOSEA2 cruise along the northern Mid-Atlantic Ridge. This work reveals the importance of multidisciplinary surveys to the knowledge of deep-sea environments