Enamel And Dentin Bond Strength, Interfacial Ultramorphology And Fluoride Ion Release Of Self-etching Adhesives During A Ph-cycling Regime

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Purpose: This study evaluated the effects of pH cycling on fluoride release and bond strength of two self-etching adhesive systems to both enamel and dentin. The ultramorphology of the interfaces produced by the adhesive systems were also analyzed. Materials and Methods: The buccal surfaces of bovine incisors were flattened to expose enamel and dentin, which were bonded with either Clearfil Protect Bond (CPB) or One-Up Bond F Plus (OBP). The bonded samples were prepared for microtensile bond strength (mu TBS) testing, fluoride ion release, and transmission electron microscopy. pH cycling comprised demineralization (8 h/day) and remineralization (16 h/day) cycles for 8 days. The mu TBS data were analyzed by two-way ANOVA, while fluoride release was analyzed using the Friedman and Wilcoxon tests. Results: The adhesives presented similar bond strengths to enamel. However, the dentin bond strength of CPB was higher than that of OBP. pH cycling did not influence enamel or dentin mu TBS. The amount of fluoride released from the bonded enamel and dentin was low and varied among the groups. The morphological evaluation showed that the thickness of the dentin hybrid layers was similar for both adhesives. Conclusion: The pH-cycling regime did not affect enamel or dentin bond strengths. In enamel, both the self-etching adhesives tested presented similar bond strengths, but in dentin, Clearfil Protect Bond showed higher dentin bonding than One-Up Bond F Plus.1712734Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)FAPESP [06/53828-2]CNPq [303587/2007-5

Fab labs : a systematic review

O objetivo deste artigo é mapear quais temáticas vêm sendo abordadas em produções científicas acerca de laboratórios de fabricação, e quais tipos de metodologias são empregadas nestes estudos, a partir de uma revisão sistemática de artigos e dissertações que tenham esse tipo de espaço como tema central. A busca se deu em bases de dados como Web of Science, SciELO, Scopus e Google Acadêmico (utilizado pela escassez de trabalhos desenvolvidos no Brasil nas outras bases de dados), incluindo trabalhos publicados entre 2014 e 2018, em português, inglês e espanhol. Foram analisados 26 artigos que continham os termos “Fab Lab” ou “Textile Lab” no título, palavras-chave ou resumo. Os resultados mostram que todos os trabalhos empregam uma abordagem qualitativa para coleta e análise de dados; sete diferentes eixos temáticos foram encontrados e a maioria dos artigos traz estudos sobre as relações de aprendizado no contexto Fab Lab.The purpose of this article is to map which themes have been approached about manufacturing laboratories, and what types of methodologies are used in these studies. To do so, a systematic review of articles and dissertations were employed. The search was done in databases such as Web of Science, SciELO, Scopus and Google Scholar (used for the shortage of works developed in Brazil in other databases), including works published between 2014 and 2018 in portuguese, english and spanish. 26 articles that contained the terms "Fab Lab" or "Textile Lab" in the title, keyword or abstract were analyzed. The results show that all the studies use a qualitative approach for data collection and analysis; seven different thematic axes have been found and most of the articles present studies on learning relationships in the Fab Lab context

O diabético antes e após uma amputação – Conhecimento sobre pé diabético e consequências das amputações

Amputações de membros inferiores são uma grave complicação a que pacientes diabéticos estão expostos. Tais lesões além de mutilantes, determinam uma redução na capacidade em realizar as atividades diárias dos pacientes. O objetivo deste trabalho é investigar o conhecimento dos pacientes a respeito do pé diabético, o impacto das amputações sobre as atividades diárias e as percepções dos pacientes sobre estas limitações. O estudo foi feito de forma qualitativa, através da análise de conteúdo de entrevistas semiestruturadas. Foram entrevistados nove pacientes diabéticos, com história de ulceração seguida de amputação. Predomina a ignorância a respeito da natureza do diabetes e suas complicações. As amputações determinaram prejuízos nas atividades diárias dos pacientes e na sua interação social, gerando dependência e sentimentos negativos. O desconhecimento dos riscos relacionados ao pé diabético implicou na ausência de medidas profiláticas. Uma vez amputado o paciente não conseguiu recuperar o estilo de vida anterior.

TURNER SYNDROME – AN UNUSUAL CAUSE FOR AORTIC DISSECTION

Turner syndrome (TS) is a disorder of female development with cardinal features of short stature and congenital cardiovascular defects. Congenital or acquired cardiological problems occur commonly in TS, being potentially progressive and responsible for severe complications, such as aortic dissection in young women. Accordingly, we describe a case of type A aortic dissection occurring in a woman with TS, highlighting the need to prioritize investigation in those patients to avoid a catastrophic aortic scenario

EVAR POST-IMPLANTATION SYNDROME – CAN HEMATOLOGICAL VALUES HELP US?

Introduction: Post-implantation syndrome (PIS) is the clinical and biochemical expression of an inflammatory response following endovascular repair of an aortic aneurysm (EVAR). The reported incidence in literature varies from 14-60%. Recentently, a study has demonstrated that red blood cell distribution width (RDW) is an independent biomarker predictor of the PIS in patients submitted to EVAR in the early postoperative period. Methods: Retrospective institutional review of consecutive patients submitted to elective EVAR (January 2015- April 2020). The primary outcome was to evaluate the incidence of PIS, defined as fever (>38ºC) and leukocytosis (>12000/μL), excluding infection complication. The secondary outcomes were to identify the potential role of clinical and biomarker parameters to predict the risk of developing PIS after EVAR. Results and conclusion: According to the inclusion criteria, 107 patients were identified. The median age was 75 years old (93.5% men). Comorbidities presented: hypertension (75%), smoking (66%), hypercholesterolemia (59%), coronary artery disease (32%), chronic kidney disease (30%), and diabetes mellitus (DM) (18%). The incidence of PIS was 10,2%. Age, gender and cardiovascular risk factors were found to be similar in both groups (P>0.05). Regarding the procedure approach, the majority of patients were treated with percutaneous access (72%) (P=0,49). In both groups (PIS vs. no PIS), the hemoglobin values significantly decreased (P=0,04) after surgery by approximately 14%. The same trend was observed for mean corpuscular volume (MCV) (P=0.032), which reflected the increasing of the RDW although not reaching statistical significance. Although delta variation of hemoglobin and delta RDW did not reach statistical significance comparing both groups (P=0,53 and P= 0,07 respectively), delta MCV was found to be significantly lower in the group with PIS (P=0.012). The importance of having a biomarker which measurement allows the prediction of patients who have more risk to develop PIS, may help with the early management of this condition

TRAUMATIC POPLITEAL ARTERY INJURY – A RARE LESION THAT CAN'T BE MISSED

Introduction: Traumatic popliteal artery injury is a rare clinical entity, but it is the most common cause of amputation in injured extremities. The aim of this study was to report the incidence of popliteal artery injury after knee trauma and report therapeutic management and results. Methods and material: ICD-10/ ICD-9 codes (S85.0/904.41; S83.1/836.5; S83.4; S83.5; S72,4/821.2; S82,1/823.0) were used to identify patients admitted with popliteal artery injury and/or knee trauma at our tertiary center from 1/1/2010 to 31/5/2021. A statistical analysis was realized using the SPSS program version27. Results: At our center from 1/1/2010 to 31/5/2021 535 patients were admitted due to knee trauma (28 with knee dislocation and 507 with fracture close to the knee) and 9 patients with popliteal artery injury (seven males, median age 39.0 years) The mechanism of PAI was motorcycle (4) or bicycle (1) or work (1) accidents (4); one fall, one running over and one iatrogenic injury. The incidence of PAI after knee trauma was 1.5%, after knee dislocation 17.9% and 0.8% after fracture close to the knee. Regarding associated injuries, four patients had severe soft tissue damage, two had venous injuries and two had nerve disruptions. The median ischemic time was 6.0 hours and mean vascular surgical time was 2.4 hours. Regarding vascular treatment, eight patients were submitted to bypass surgery and one was treated conservatively. Therapeutic fasciotomies were performed in three patients. No primary amputations were performed. A secondary major amputation was performed in one patient. The mean hospital length of stay was 24.9 days and mortality was 0%. Three patients returned to their normal activity level and six were limited in their daily activity. Discussion/Conclusion: The risk of PAI after knee dislocation is higher than after knee fracture (17,9% vs 0.8% in our study, and 3,4-8,2% vs 0,2 % in Swedish registration), so orthopedic surgeons must be aware of that increased risk, to avoid missing this diagnosis. The amputation rate in our serie was lesser than the Swedish registration and the United States National Trauma Data Bank (11% vs 28% and 14,5%, respectively). However, it ́s still a high rate considering that it mostly affects a young and active population and only 33.3% patients return to a normal life. A multidisciplinary approach is essential to decrease ischemia time and to promote a holistic treatment

FIBROBLASTOMA DESMOPLÁSICO ENVOLVENDO A ARTÉRIA BRAQUIAL — UM CASO CLÍNICO ÚNICO

O fibroblastoma desmoplásico (FD), também conhecido como fibroma colagenoso, é uma neoplasia fibrosa benigna rara, de crescimento indolente, recentemente descrita. Ocorre predominantemente no tronco e membros superiores, podendo surgir em qualquer idade. Os autores descrevem um caso de uma doente do sexo feminino de 42 anos de idade com FD, com compromisso neurovascular do membro superior. Foi submetida a exérese em bloco da massa tumoral e artéria braquial, com reconstrução arterial (enxerto de interposição autólogo). A análise anatomopatológica foi consistente com FD e o diagnóstico foi validado por laboratório externo internacional1. Trata-se da primeira descrição na literatura de um FD envolvendo um segmento arterial

PRE-OPERATIVE ANEMIA AS A PREDICTIVE MORBIDITY OUTCOME — A RETROSPECTIVE ANALYSIS OF A VASCULAR SURGERY DEPARTMENT

Introduction: Anemia is associated with increased adverse outcomes during the early postoperative period because of high physiologic stress and increased cardiac demand. The aim of this study was to assess the relationship between pre-operative anemia and morbi-mortality outcomes in patients undergoing elective carotid endarterectomy (CEA), open aortic repair (OAR) or endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms (AAA) and infrainguinal bypass surgery in chronic limb-threatening ischemia.  Methods: Retrospective analysis of all elective patients between 2016-2018, who underwent: CEA, OAR, EVAR and infrainguinal bypass surgery in chronic limb-threatening ischemia. Emergency procedures and transfusion of more than 4 units of red blood cells (RBC) were excluded. Hemoglobin levels were categorized according to the WHO definition for anemia: severe (< 8 g/dL), moderate (8-10.9 g/dL), mild (11-11.9 g/dL in women and 11-12.9 g/dL in men) and no anemia (≥12 g/dL in women and ≥13 g/dL in men).  Results: Our study population comprised 257 patients, of which 74 (28%) underwent EVAR, 26 (10.1%) OAR, 67 (26.1%) CEA and 90 (35%) infrainguinal bypass. Pre-operative anemia was identified in 37.4% (n = 96) of the patients. Of those, 67.7% (n = 65) had mild anemia and 32.3% (n = 31) had moderate-severe anemia. Anemic patients have longer length of stay when compared with non-anemic patients (16.61±16.5; 7.68±4.92, respectively) (p = 0.022) and also longer stay in the post-operative care unite in comparison with patients with hemoglobin within the normal range (average 2.08 days ± 1.12; 1.77 days ± 1.01, respectively) (p<0.001). Pre-operative anemia was associated with the need of peri-operative transfusions (p < 0.001), as expected. In-hospital adverse events were influenced by the presence of anemia (p<0.001), namely surgical site infection (p = 0.002) and re-intervention (p<0.007). Patients who received blood transfusion peri-operatively were more prone to adverse outcomes (p<0.001), such as renal disfunction (p = 0.006), respiratory infections (p =0.015), surgical site infection (p = 0.001) and re-intervention (p = 0.001).  Conclusion: Pre-operative anemia evaluation should be incorporated into the preoperative risk assessment. Iron deficiency anemia is the most frequent type of anemia. In these cases, oral or IV iron supplementation pre-operatively is the preferential treatment, and might decrease the need of blood transfusions. Patients with iron deficiency without anemia also have indication to take oral iron supplementation. This situation urges the application of a well-structured protocol to optimize pre-operative hemoglobin, reduce intra-operative blood loss and improve anemic patients’ status in an effort to reach better outcomes.

RUPTURED POPLITEAL ARTERY ANEURYSM — AN UNCOMMON PRESENTATION

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