Conventional dual-cure versus self-adhesive resin cements in dentin bond integrity

During post preparation, the root canal is exposed to the oral cavity, and endodontic treatment may fail because of coronal leakage, bacterial infection and sealing inability of the luting cement. OBJECTIVE: this study quantified the interfacial continuity produced with conventional dual-cure and self-adhesive resin cements in the cervical (C), medium (M) and apical (A) thirds of the root. MATERIAL AND METHODS: Forty single-rooted human teeth were restored using Reforpost # 01 conical glass-fiber posts and different materials (N=10 per group): group AC=Adper™ ScotchBond™ Multi-purpose Plus + AllCem; group ARC=Adper™ ScotchBond™ Multi-purpose Plus + RelyX ARC; group U100=RelyX U100; and group MXC=Maxcem Elite. After being kept in 100% humidity at 37°C for 72 hours, the samples were sectioned parallel to their longitudinal axis and positive epoxy resin replicas were made. The scanning electron micrographs of each third section of the teeth were combined using Image Analyst software and measured with AutoCAD-2002. We obtained percentage values of the interfacial continuity. RESULTS: Interfacial continuity was similar in the apical, medium and cervical thirds of the roots within the groups (Friedman test, p>0.05). Comparison of the different cements in a same root third showed that interfacial continuity was lower in MXC (C=45.5%; M=48.5%; A=47.3%) than in AC (C=85.9%, M=81.8% and A=76.0%), ARC (C=83.8%, M=82.4% and A=75.0%) and U100 (C=84.1%, M=82.4% and A=77.3%) (Kruskal-Wallis test,

In-hospital and late outcomes of patients undergoing percutaneous mitral valvuloplasty in a center with intermediate volume of structural procedures

ABSTRACTBackgroundPercutaneous mitral valvuloplasty is the treatment of choice for rheumatic mitral stenosis with favorable anatomy, for its ability to prevent complications inherent to a surgical procedure, while maintaining effectiveness. It is necessary to promote comparisons between the results obtained by the procedure performed at referral centers with high patient inflow and at institutions with lower volume and fewer patients, which represents the main objective of this study.MethodsThirty-one consecutive patients undergoing percutaneous mitral valvuloplasty were analyzed from September 2006 to January 2015. Immediate procedural success and late event-free survival rates were evaluated, defined as cardiovascular death or need for a new mitral valve intervention.ResultsThe mean age was 40.9 ± 14.2 years, with a predominance of females (96.8%). The mean Wilkins and Block score was 8.1 ± 1.2. All procedures were performed using the Inoue technique, with an immediate success rate of 90.3%. At mean follow-up of 6.8 ± 2.5 years, seven events (22.6%) were observed: two cardiovascular deaths, four surgeries for mitral valve replacement, and one mitral commissurotomy.ConclusionsIn a hospital with intermediate procedure volume, the results of percutaneous mitral valvuloplasty in the treatment of rheumatic mitral stenosis with favorable anatomy were comparable to those achieved by high-volume centers

Perfil clínico e angiográfico de pacientes jovens submetidos à intervenção coronária percutânea primária

ResumoIntroduçãoO atual declínio observado na taxa de mortalidade entre pacientes com infarto do miocárdio com supradesnivelamento do segmento ST pode ser atribuído não apenas a maior utilização de estratégias de reperfusão, mas também a uma mudança no perfil demográfico dessa população, notadamente à redução em sua média de idade.MétodosForam analisados retrospectivamente todos os pacientes submetidos à intervenção coronária percutânea primária no período de abril de 2010 a dezembro de 2014. O objetivo primário foi a caracterização dos fatores de risco mais prevalentes, a natureza angiográfica das lesões, os aspectos técnicos do procedimento e a evolução clínica hospitalar de pacientes jovens, com idade ≤ 45 anos, comparando‐os àqueles com idade > 45 anos.ResultadosDentre 489 pacientes com diagnóstico de infarto agudo do miocárdio, 54 tinham idade ≤ 45 anos e 435, idade > 45 anos. Pacientes jovens exibiram maior prevalência de tabagismo e obesidade, enquanto pacientes > 45 anos eram mais propensos a apresentar hipertensão arterial sistêmica, diabetes melito, dislipidemia e infarto do miocárdio antigo. Intervenção coronária percutânea primária em jovens associou‐se ao uso de menor quantidade de cateteres‐guia, menor tempo de fluoroscopia e maior porcentual de implante direto de stent. Pacientes jovens exibiram boa evolução hospitalar, com reduzida taxa de eventos cardíacos adversos (3,7% vs. 9,2%; p = 0,30).ConclusõesPacientes com idade ≤ 45 anos representaram aproximadamente 10% dos casos de infarto do miocárdio com supradesnivelamento do segmento ST e exibiram elevada prevalência de fatores de risco modificáveis.AbstractBackgroundThe current decline observed in mortality rate among patients with ST‐segment elevation acute myocardial infarction can be attributed not only to the increased use of reperfusion strategies, but also to a change in the demographic profile of this population, notably the reduction in mean age.MethodsWe retrospectively reviewed all patients undergoing primary percutaneous coronary intervention in the period from April 2010 to December 2014. The primary objective was the characterization of the most prevalent risk factors, the angiographic nature of the lesions, the technical aspects of the procedure, and in‐hospital clinical outcomes in patients aged ≤ 45 years, comparing them to those aged > 45 years.ResultsAmong 489 patients with acute myocardial infarction, 54 were ≤ 45 years, and 435 were > 45 years. Young patients exhibited a higher prevalence of smoking and obesity, while patients > 45 years were more likely to have hypertension, diabetes mellitus, dyslipidemia, and previous myocardial infarction. Primary percutaneous coronary intervention in young patients was associated with the use of fewer guide catheters, shorter fluoroscopy time, and higher percentage of direct stent implantation. Young patients exhibited good in‐hospital outcomes, with lower rate of adverse cardiac events (3.7% vs. 9.2%; p = 0.30).ConclusionsPatients aged ≤ 45 years accounted for approximately 10% of cases of ST‐segment elevation acute myocardial infarction and exhibited high prevalence of modifiable risk factors

Taking the pulse of Earth's tropical forests using networks of highly distributed plots

Tropical forests are the most diverse and productive ecosystems on Earth. While better understanding of these forests is critical for our collective future, until quite recently efforts to measure and monitor them have been largely disconnected. Networking is essential to discover the answers to questions that transcend borders and the horizons of funding agencies. Here we show how a global community is responding to the challenges of tropical ecosystem research with diverse teams measuring forests tree-by-tree in thousands of long-term plots. We review the major scientific discoveries of this work and show how this process is changing tropical forest science. Our core approach involves linking long-term grassroots initiatives with standardized protocols and data management to generate robust scaled-up results. By connecting tropical researchers and elevating their status, our Social Research Network model recognises the key role of the data originator in scientific discovery. Conceived in 1999 with RAINFOR (South America), our permanent plot networks have been adapted to Africa (AfriTRON) and Southeast Asia (T-FORCES) and widely emulated worldwide. Now these multiple initiatives are integrated via ForestPlots.net cyber-infrastructure, linking colleagues from 54 countries across 24 plot networks. Collectively these are transforming understanding of tropical forests and their biospheric role. Together we have discovered how, where and why forest carbon and biodiversity are responding to climate change, and how they feedback on it. This long-term pan-tropical collaboration has revealed a large long-term carbon sink and its trends, as well as making clear which drivers are most important, which forest processes are affected, where they are changing, what the lags are, and the likely future responses of tropical forests as the climate continues to change. By leveraging a remarkably old technology, plot networks are sparking a very modern revolution in tropical forest science. In the future, humanity can benefit greatly by nurturing the grassroots communities now collectively capable of generating unique, long-term understanding of Earth's most precious forests. Resumen Los bosques tropicales son los ecosistemas más diversos y productivos del mundo y entender su funcionamiento es crítico para nuestro futuro colectivo. Sin embargo, hasta hace muy poco, los esfuerzos para medirlos y monitorearlos han estado muy desconectados. El trabajo en redes es esencial para descubrir las respuestas a preguntas que trascienden las fronteras y los plazos de las agencias de financiamiento. Aquí mostramos cómo una comunidad global está respondiendo a los desafíos de la investigación en ecosistemas tropicales a través de diversos equipos realizando mediciones árbol por árbol en miles de parcelas permanentes de largo plazo. Revisamos los descubrimientos más importantes de este trabajo y discutimos cómo este proceso está cambiando la ciencia relacionada a los bosques tropicales. El enfoque central de nuestro esfuerzo implica la conexión de iniciativas locales de largo plazo con protocolos estandarizados y manejo de datos para producir resultados que se puedan trasladar a múltiples escalas. Conectando investigadores tropicales, elevando su posición y estatus, nuestro modelo de Red Social de Investigación reconoce el rol fundamental que tienen, para el descubrimiento científico, quienes generan o producen los datos. Concebida en 1999 con RAINFOR (Suramérica), nuestras redes de parcelas permanentes han sido adaptadas en África (AfriTRON) y el sureste asiático (T-FORCES) y ampliamente replicadas en el mundo. Actualmente todas estas iniciativas están integradas a través de la ciber-infraestructura de ForestPlots.net, conectando colegas de 54 países en 24 redes diferentes de parcelas. Colectivamente, estas redes están transformando nuestro conocimiento sobre los bosques tropicales y el rol de éstos en la biósfera. Juntos hemos descubierto cómo, dónde y porqué el carbono y la biodiversidad de los bosques tropicales está respondiendo al cambio climático y cómo se retroalimentan. Esta colaboración pan-tropical de largo plazo ha expuesto un gran sumidero de carbono y sus tendencias, mostrando claramente cuáles son los factores más importantes, qué procesos se ven afectados, dónde ocurren los cambios, los tiempos de reacción y las probables respuestas futuras mientras el clima continúa cambiando. Apalancando lo que realmente es una tecnología antigua, las redes de parcelas están generando una verdadera y moderna revolución en la ciencia tropical. En el futuro, la humanidad puede beneficiarse enormemente si se nutren y cultivan comunidades de investigadores de base, actualmente con la capacidad de generar información única y de largo plazo para entender los que probablemente son los bosques más preciados de la tierra. Resumo Florestas tropicais são os ecossistemas mais diversos e produtivos da Terra. Embora uma boa compreensão destas florestas seja crucial para o nosso futuro coletivo, até muito recentemente os esforços de medições e monitoramento foram amplamente desconexos. É essencial formarmos redes para obtermos respostas que transcendem fronteiras e horizontes de agências financiadoras. Neste estudo nós mostramos como uma comunidade global está respondendo aos desafios da pesquisa de ecossistemas tropicais, com equipes diversas medindo florestas, árvore por árvore, em milhares de parcelas monitoradas à longo prazo. Nós revisamos as maiores descobertas científicas deste trabalho, e mostramos também como este processo está mudando a ciência de florestas tropicais. Nossa abordagem principal envolve unir iniciativas de base a protocolos padronizados e gerenciamento de dados a fim de gerar resultados robustos em escalas ampliadas. Ao conectar pesquisadores tropicais e elevar seus status, nosso modelo de Rede de Pesquisa Social reconhece o papel-chave do produtor dos dados na descoberta científica. Concebida em 1999 com o RAINFOR (América do Sul), nossa rede de parcelas permanentes foi adaptada para África (AfriTRON) e Sudeste asiático (T-FORCES), e tem sido extensamente reproduzida em todo o mundo. Agora estas múltiplas iniciativas estão integradas através de uma infraestrutura cibernética do ForestPlots.net, conectando colegas de 54 países de 24 redes de parcelas. Estas iniciativas estão transformando coletivamente o entendimento das florestas tropicais e seus papéis na biosfera. Juntos nós descobrimos como, onde e por que o carbono e a biodiversidade da floresta estão respondendo às mudanças climáticas, e seus efeitos de retroalimentação. Esta duradoura colaboração pantropical revelou um grande sumidouro de carbono persistente e suas tendências, assim como tem evidenciado quais direcionadores são mais importantes, quais processos florestais são mais afetados, onde eles estão mudando, seus atrasos no tempo de resposta, e as prováveis respostas das florestas tropicais conforme o clima continua a mudar. Dessa forma, aproveitando uma notável tecnologia antiga, redes de parcelas acendem faíscas de uma moderna revolução na ciência das florestas tropicais. No futuro a humanidade pode se beneficiar incentivando estas comunidades basais que agora são coletivamente capazes de gerar conhecimentos únicos e duradouros sobre as florestas mais preciosas da Terra. Résume Les forêts tropicales sont les écosystèmes les plus diversifiés et les plus productifs de la planète. Si une meilleure compréhension de ces forêts est essentielle pour notre avenir collectif, jusqu'à tout récemment, les efforts déployés pour les mesurer et les surveiller ont été largement déconnectés. La mise en réseau est essentielle pour découvrir les réponses à des questions qui dépassent les frontières et les horizons des organismes de financement. Nous montrons ici comment une communauté mondiale relève les défis de la recherche sur les écosystèmes tropicaux avec diverses équipes qui mesurent les forêts arbre après arbre dans de milliers de parcelles permanentes. Nous passons en revue les principales découvertes scientifiques de ces travaux et montrons comment ce processus modifie la science des forêts tropicales. Notre approche principale consiste à relier les initiatives de base à long terme à des protocoles standardisés et une gestion de données afin de générer des résultats solides à grande échelle. En reliant les chercheurs tropicaux et en élevant leur statut, notre modèle de réseau de recherche sociale reconnaît le rôle clé de l'auteur des données dans la découverte scientifique. Conçus en 1999 avec RAINFOR (Amérique du Sud), nos réseaux de parcelles permanentes ont été adaptés à l'Afrique (AfriTRON) et à l'Asie du Sud-Est (T-FORCES) et largement imités dans le monde entier. Ces multiples initiatives sont désormais intégrées via l'infrastructure ForestPlots.net, qui relie des collègues de 54 pays à travers 24 réseaux de parcelles. Ensemble, elles transforment la compréhension des forêts tropicales et de leur rôle biosphérique. Ensemble, nous avons découvert comment, où et pourquoi le carbone forestier et la biodiversité réagissent au changement climatique, et comment ils y réagissent. Cette collaboration pan-tropicale à long terme a révélé un important puits de carbone à long terme et ses tendances, tout en mettant en évidence les facteurs les plus importants, les processus forestiers qui sont affectés, les endroits où ils changent, les décalages et les réactions futures probables des forêts tropicales à mesure que le climat continue de changer. En tirant parti d'une technologie remarquablement ancienne, les réseaux de parcelles déclenchent une révolution très moderne dans la science des forêts tropicales. À l'avenir, l'humanité pourra grandement bénéficier du soutien des communautés de base qui sont maintenant collectivement capables de générer une compréhension unique et à long terme des forêts les plus précieuses de la Terre. Abstrak Hutan tropika adalah di antara ekosistem yang paling produktif dan mempunyai kepelbagaian biodiversiti yang tinggi di seluruh dunia. Walaupun pemahaman mengenai hutan tropika amat penting untuk masa depan kita, usaha-usaha untuk mengkaji dan mengawas hutah-hutan tersebut baru sekarang menjadi lebih diperhubungkan. Perangkaian adalah sangat penting untuk mencari jawapan kepada soalan-soalan yang menjangkaui sempadan dan batasan agensi pendanaan. Di sini kami menunjukkan bagaimana sebuah komuniti global bertindak balas terhadap cabaran penyelidikan ekosistem tropika melalui penglibatan pelbagai kumpulan yang mengukur hutan secara pokok demi pokok dalam beribu-ribu plot jangka panjang. Kami meninjau semula penemuan saintifik utama daripada kerja ini dan menunjukkan bagaimana proses ini sedang mengubah bidang sains hutan tropika. Teras pendekatan kami memberi tumpuan terhadap penghubungan inisiatif akar umbi jangka panjang dengan protokol standar serta pengurusan data untuk mendapatkan hasil skala besar yang kukuh. Dengan menghubungkan penyelidik-penyelidik tropika dan meningkatkan status mereka, model Rangkaian Penyelidikan Sosial kami mengiktiraf kepentingan peranan pengasas data dalam penemuan saintifik. Bermula dengan pengasasan RAINFOR (Amerika Selatan) pada tahun 1999, rangkaian-rangkaian plot kekal kami kemudian disesuaikan untuk Afrika (AfriTRON) dan Asia Tenggara (T-FORCES) dan selanjutnya telah banyak dicontohi di seluruh dunia. Kini, inisiatif-inisiatif tersebut disepadukan melalui infrastruktur siber ForestPlots.net yang menghubungkan rakan sekerja dari 54 negara di 24 buah rangkaian plot. Secara kolektif, rangkaian ini sedang mengubah pemahaman tentang hutan tropika dan peranannya dalam biosfera. Kami telah bekerjasama untuk menemukan bagaimana, di mana dan mengapa karbon serta biodiversiti hutan bertindak balas terhadap perubahan iklim dan juga bagaimana mereka saling bermaklum balas. Kolaborasi pan-tropika jangka panjang ini telah mendedahkan sebuah sinki karbon jangka panjang serta arah alirannya dan juga menjelaskan pemandu-pemandu perubahan yang terpenting, di mana dan bagaimana proses hutan terjejas, masa susul yang ada dan kemungkinan tindakbalas hutan tropika pada perubahan iklim secara berterusan di masa depan. Dengan memanfaatkan pendekatan lama, rangkaian plot sedang menyalakan revolusi yang amat moden dalam sains hutan tropika. Pada masa akan datang, manusia sejagat akan banyak mendapat manfaat jika memupuk komuniti-komuniti akar umbi yang kini berkemampuan secara kolektif menghasilkan pemahaman unik dan jangka panjang mengenai hutan-hutan yang paling berharga di dunia

Conventional dual-cure versus self-adhesive resin cements in dentin bond integrity

During post preparation, the root canal is exposed to the oral cavity, and endodontic treatment may fail because of coronal leakage, bacterial infection and sealing inability of the luting cement. OBJECTIVE: this study quantified the interfacial continuity produced with conventional dual-cure and self-adhesive resin cements in the cervical (C), medium (M) and apical (A) thirds of the root. MATERIAL AND METHODS: Forty single-rooted human teeth were restored using Reforpost # 01 conical glass-fiber posts and different materials (N=10 per group): group AC=Adper™ ScotchBond™ Multi-purpose Plus + AllCem; group ARC=Adper™ ScotchBond™ Multi-purpose Plus + RelyX ARC; group U100=RelyX U100; and group MXC=Maxcem Elite. After being kept in 100% humidity at 37°C for 72 hours, the samples were sectioned parallel to their longitudinal axis and positive epoxy resin replicas were made. The scanning electron micrographs of each third section of the teeth were combined using Image Analyst software and measured with AutoCAD-2002. We obtained percentage values of the interfacial continuity. RESULTS: Interfacial continuity was similar in the apical, medium and cervical thirds of the roots within the groups (Friedman test, p>0.05). Comparison of the different cements in a same root third showed that interfacial continuity was lower in MXC (C=45.5%; M=48.5%; A=47.3%) than in AC (C=85.9%, M=81.8% and A=76.0%), ARC (C=83.8%, M=82.4% and A=75.0%) and U100 (C=84.1%, M=82.4% and A=77.3%) (Kruskal-Wallis test, p<0.05). CONCLUSIONS: Allcem, Rely X ARC and U100 provide the best cementation; cementation was similar among root portions; in practical terms, U100 is the best resin because it combines good cementation and easy application and none of the cements provides complete interfacial continuity