O uso do endoguide no planejamento e tratamento de dentes permanentes calcificados / The use of endoguide in the planning and treatment of calcified permanent teeth

A localização e a manipulação dos canais calcificados são fatores que tornam o tratamento endodôntico bastante desafiador, capazes de comprometer o processo de desinfecção dos condutos radiculares. Atualmente vários recursos clínicos têm sido utilizados para auxiliar este tratamento, sendo o Endoguide uma nova abordagem terapêutica para a resolução desses casos complexos. Dessa forma ,este estudo tem como objetivo descrever a aplicação clínica do Endoguide em tratamento de canais calcificados incluindo a descrição da técnica, indicações, contraindicações, vantagens, desvantagens, e alguns relatos de casos clínicos encontrados na literatura. Foi empregado como método de pesquisa a análise crítica da revisão literária considerada concisa para elaboração deste estudo, na qual utilizou-se como fontes de informações artigos obtidos na base de dados: Bireme, Scielo, Lilacs, Medline e Google Acadêmico. O acesso endodôntico guiado pode ter melhores resultados através do planejamento com TCFC, scanner-intraoral e softwares especificos. Além disso,essa técnica mostrou-se bastante resolutiva, segura, previsivel e clínicamente viável.

Câncer de boca grau de conhecimento e perfil epidemiológico dos romeiros de Juazeiro Do Norte - CE / Boat screen degree of knowledge and epidemiological profile of the romeiros de Juazeiro Do Norte - CE

Este estudo propôs avaliar o grau de conhecimento sobre o câncer de boca dos romeiros de Juazeiro do Norte CE, uma população de mais de 130 cidades brasileiras, predominantemente da região Nordeste, reunida em evento religioso, buscando uma correlação com seus indicadores sociodemográficos, como o nível de escolaridade e renda. Através de aplicação de questionário, foram entrevistados 422 romeiros durante as peregrinações dos meses de setembro e novembro de 2016. De acordo com a qualidade das respostas, convencionou-se quatro classificações para o grau de conhecimento: pleno, aceitável, comprometido e insuficiente. Os resultados apontaram para uma população com níveis de renda e escolaridade baixos, e com o grau de conhecimento insuficiente para o câncer de boca, o mais inferior. As variáveis renda, escolaridade e risco ocupacional apresentaram relação estatística significante com o grau de conhecimento.

Antiemetic activity of trans-ferulic acid possibly through muscarinic receptors interaction pathway: In vivo and in silico study

Current study was conducted to assess the effectiveness of the polyphenol trans-ferulic acid (TFA) as an antiemetic agent using in vivo and in silico methods. To evaluate this, we induced emesis in 3-day-old chicks through the oral administration of copper sulfate (CuSO4·5H2O) at a dose of 50 mg/kg. To ascertain the potential antiemetic mechanism of TFA, we employed various reference drugs such as domperidone (6 mg/kg), ondansetron (5 mg/kg), and hyoscine (21 mg/kg) as positive control groups, while the vehicle acted as a negative control group. TFA was administered orally at the doses of 25, 50 and 100 mg/kg body weight. Both the TFA and reference drug provided alone or in combined groups to assess their synergistic or antagonistic activity on the chicks. Molecular docking of TFA and the selected reference drugs was conducted against 5HT3, D2, H1, NK1, and mAChRs (M1-M5) receptors for determining binding affinity to the receptors. Active binding sites and drug-receptor interactions were predicted with the aid of various computational tools. Various pharmacokinetic features and drug-likeness of all the selected ligands were determined through the SwissADME online server. The results suggest that TFA diminishes the mean number of retches and enhances latency in the chicks at lower doses. In the combined drug therapy, TFA exhibited better antiemetic effects with ondansetron and hyoscine. In silico ADME proposed that TFA retains preferable drug-likeness and better pharmacokinetic properties to be a reliable lead. Additionally, TFA revealed the elevated binding affinity against mAChRs and the ligand (TFA) expressed the highest binding affinity (−7 kcal/mol) with the M5 receptor (6OL9). In conclusion, TFA demonstrated mild antiemetic effects in chicks, possibly through the mAChRs interaction pathway

Pancreatic surgery outcomes: multicentre prospective snapshot study in 67 countries

Background: Pancreatic surgery remains associated with high morbidity rates. Although postoperative mortality appears to have improved with specialization, the outcomes reported in the literature reflect the activity of highly specialized centres. The aim of this study was to evaluate the outcomes following pancreatic surgery worldwide.Methods: This was an international, prospective, multicentre, cross-sectional snapshot study of consecutive patients undergoing pancreatic operations worldwide in a 3-month interval in 2021. The primary outcome was postoperative mortality within 90 days of surgery. Multivariable logistic regression was used to explore relationships with Human Development Index (HDI) and other parameters.Results: A total of 4223 patients from 67 countries were analysed. A complication of any severity was detected in 68.7 percent of patients (2901 of 4223). Major complication rates (Clavien-Dindo grade at least IIIa) were 24, 18, and 27 percent, and mortality rates were 10, 5, and 5 per cent in low-to-middle-, high-, and very high-HDI countries respectively. The 90-day postoperative mortality rate was 5.4 per cent (229 of 4223) overall, but was significantly higher in the low-to-middle-HDI group (adjusted OR 2.88, 95 per cent c.i. 1.80 to 4.48). The overall failure-to-rescue rate was 21 percent; however, it was 41 per cent in low-to-middle-compared with 19 per cent in very high-HDI countries.Conclusion: Excess mortality in low-to-middle-HDI countries could be attributable to failure to rescue of patients from severe complications. The authors call for a collaborative response from international and regional associations of pancreatic surgeons to address management related to death from postoperative complications to tackle the global disparities in the outcomes of pancreatic surgery (NCT04652271; ISRCTN95140761)