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Biomedical subjects

L A Silva

Publications and source records attributed to L A Silva.

At least 19 recordsLinked to original sources

Temporal associations among pulses of 13,14-dihydro-15-keto-PGF2alpha, luteal blood flow, and luteolysis in cattle.

Luteal blood flow was studied in heifers by transrectal color-Doppler ultrasound. Data were normalized to the decrease in plasma progesterone to <1 ng/ml (Day 0 or Hour 0). Blood flow in the corpus luteum (CL) was estimated by the percentage of CL area with color flow signals. Systemic prostaglandin F2alpha (PGF) treatment (25 mg; n=4) resulted in a transient increase in CL blood flow during the initial portion of the induced decrease in progesterone. Intrauterine treatment (1 or 2 mg) was done to preclude hypothetical secondary effects of systemic treatment. Heifers were grouped into responders (luteolysis; n=3) and nonresponders (n=5). Blood flow increased transiently in both groups; induction of increased blood flow did not assure the occurrence of luteolysis. A transient increase in CL blood flow was not detected in association with spontaneous luteolysis when examinations were done every 12 h (n=6) or 24 h (n=10). The role of PGF pulses was studied by examinations every hour during a 12-h window each day during expected spontaneous luteolysis. At least one pulse of 13,14-dihydro-15-keto-PGF2alpha (PGFM) was identified in each of six heifers during the luteolytic period (Hours -48 to -1). Blood flow increased (P<0.02) during the 3-h ascending portion of the PGFM pulse, remained elevated for 2 h after the PGFM peak, and then decreased (P<0.03) to baseline. Results supported the hypothesis that CL blood flow increased and decreased with individual PGFM pulses during spontaneous luteolysis.

Animals↗

Conversion from azathioprine to mycophenolate mofetil followed by calcineurin inhibitor minimization or elimination in patients with chronic allograft dysfunction.

UNLABELLED: The purpose of this study was to evaluate the effects of the conversion from azathioprine (AZA) to mycophenolate mofetil (MMF) followed by calcineurin inhibitor (CNI) elimination or minimization in patients with progressive chronic allograft dysfunction (CAD). METHODS: Between November 6, 1999 and February 12, 2003, 169 patients receiving CNI/AZA/prednisone (153 CsA; 14 tacrolimus) were included in this study. Demographics, immunosuppression, graft function, hematology, and biochemistry were obtained before (-6, -3, and -1 month) and 1, 3, 6, 9 and 12 months after and at last follow-up visit after conversion. RESULTS: Mean age was 34 +/- 12 years, 66% males, 51% Caucasian, and 72% living allograft recipients. Mean follow-up times before and after conversion were 32.4 and 19.4 months; 10 patients completed 3 years of follow-up. CNI elimination was performed in 39% and minimization in 61% of patients. Overall there was significantly improved graft function at 1 year after conversion (2.6 +/- 1.0 vs 2.1 +/- 0.6 mg/dL, P = .038). The slopes of the regression lines of 1/Cr vs time were significantly improved from preconversion to after conversion (-0.026 vs +0.007 mg(-1)/dL per day(-1), P = .001). There was a significant decrease in mean systolic (141 +/- 21 vs 135 +/- 22 mm Hg, P = .015) and diastolic (89 +/- 15 vs 84 +/- 14 mm Hg, P = .005) blood pressure values at 1 year. There were four episodes of acute rejection (Banff IA) treated with steroids. Three years after conversion, patient and graft survivals were 95% and 79%, respectively. One patient developed posttransplant lymphoproliferative disease. CONCLUSION: Among patients with CAD, conversion from AZA to MMF followed by CNI minimization or elimination was a safe and effective strategy to preserve or improve graft function.

Adult↗

Impact of initial exposure to calcineurin inhibitors on kidney graft function of patients at high risk to develop delayed graft function.

We conducted a retrospective analysis of the influence of full doses of calcineurin inhibitors [8-10 mg kg-1 day-1 cyclosporine (N = 80), or 0.2-0.3 mg kg-1 day-1 tacrolimus (N = 68)] administered from day 1 after transplantation on the transplant outcomes of a high-risk population. Induction therapy was used in 13% of the patients. Patients also received azathioprine (2 mg kg(-1) day(-1), N = 58) or mycophenolate mofetil (2 g/day, N = 90), and prednisone (0.5 mg kg(-1) day(-1), N = 148). Mean time on dialysis was 79 +/- 41 months, 12% of the cases were re-transplants, and 21% had panel reactive antibodies > 10%. In 43% of donors the cause of death was cerebrovascular disease and 27% showed creatinine above 1.5 mg/dL. The incidence of slow graft function (SGF) and delayed graft function (DGF) was 15 and 60%, respectively. Mean time to last dialysis and to nadir creatinine were 18 +/- 15 and 34 +/- 20 days, respectively. Mean creatinine at 1 year after transplantation was 1.48 +/- 0.50 mg/dL (DGF 1.68 +/- 0.65 vs SGF 1.67 +/- 0.66 vs immediate graft function (IGF) 1.41 +/- 0.40 mg/dL, P = 0.089). The incidence of biopsy-confirmed acute rejection was 22% (DGF 31%, SGF 10%, IGF 8%). One-year patient and graft survival was 92.6 and 78.4%, respectively. The incidence of cytomegalovirus disease, post-transplant diabetes mellitus and malignancies was 28, 8.1, and 0%, respectively. Compared to previous studies, the use of initial full doses of calcineurin inhibitors without antibody induction in patients with SGF or DGF had no negative impact on patient and graft survival.

Adult↗

An early endometrial vascular indicator of completed orientation of the embryo and the role of dorsal endometrial encroachment in mares.

The spherical equine embryonic vesicle is mobile throughout the uterine lumen for several days before becoming fixed in the caudal segment of a uterine horn on Day 16 (ovulation = Day 0). Orientation refers to the position of the embryo proper at the periphery of the vesicle relative to the position of the mesometrial attachment. In mares, the embryonic pole of the vesicle is antimesometrial after completion of orientation. Day of vesicle fixation, differential thickening of the endometrium near the mesometrial attachment, and orientation of the embryonic vesicle were studied in 30 ponies, using B-mode and color-Doppler transrectal ultrasonography. The thickness of the endometrium at the mesometrial aspect of the vesicle divided by the thickness at the antimesometrial aspect was termed the encroachment ratio. At the future site of fixation, the first increase (P < 0.05) in the encroachment ratio occurred between 4 and 1 days before fixation. An early vascular indicator of the future position of the embryo proper was discovered by color-Doppler imaging and consisted of a colored spot in the image of the endometrium close to the wall of the embryonic pole. The early indicator was detected in each mare 0.5 +/- 0.1 days after fixation and 2.5 +/- 0.2 days before first detection of the embryo proper. The position of the early indicator when first detected at the periphery of the embryonic vesicle was not significantly different from the position of the embryo proper when first detected. Results supported the hypothesis that differential thickening of the endometrium precedes orientation and indicated that orientation occurs immediately after fixation.

Animals↗

Changes in vascular perfusion of the endometrium in association with changes in location of the embryonic vesicle in mares.

The equine embryonic vesicle is mobile on Days 12-14 (Day 0 = ovulation), when it is approximately 9-15 mm in diameter. Movement from one uterine horn to another occurs, on average, approximately 0.5 times per hour. Mobility ceases (fixation) on Days 15-17. Transrectal color Doppler ultrasonography was used to study the relationship of embryo mobility (experiment 1) and fixation (experiment 2) to endometrial vascular perfusion. In experiment 1, mares were bred and examined daily from Day 1 to Day 16 and were assigned, retrospectively, to a group in which an embryo was detected (pregnant mares; n = 16) or not detected (n = 8) by Day 12. Endometrial vascularity (scored 1-4, for none to maximal, respectively) did not differ on Days 1-8 between groups or between the sides with and without the corpus luteum. Endometrial vascularity scores were higher (P < 0.05) on Days 12-16 in both horns of pregnant mares compared to mares with no embryo. In pregnant mares, the scores increased (P < 0.05) between Day 10 and Day 12 in the horn with the embryo and were higher (P < 0.05) than scores in the opposite horn on Days 12-15. In experiment 2, 14 pregnant mares were examined from Day 13 to 6 days after fixation. Endometrial vascularity scores and number of colored pixels per cross-section of endometrium were greater (P < 0.05) in the endometrium surrounding the fixed vesicle than in the middle portion of the horn of fixation. Results supported the hypothesis that transient changes in endometrial vascular perfusion accompany the embryonic vesicle as the vesicle changes location during embryo mobility.

Animals↗

Voltammetric determination of all DNA nucleotides.

The voltammetric oxidation of all deoxyribonucleic acid (DNA) monophosphate nucleotides is investigated for the first time over a wide pH range by differential pulse voltammetry with a glassy carbon electrode. Experimental conditions such as the electrode size, supporting electrolyte composition, and pH were optimized to obtain the best peak potential separation and higher currents. This enabled the simultaneous voltammetric determination of all four DNA bases in equimolar mixtures and detection limits in the nanomolar range at physiological pH. It was also possible to detect for the first time the oxidation of each of the purine and pyrimidine nucleotides free in solution or as monomers in single-stranded DNA.

DNA↗

Long-term kidney transplant outcomes in patients receiving oil-based or microemulsion formulations of cyclosporine.

UNLABELLED: In the last 20 years long-term experience with cyclosporine use in kidney transplantation has increased, allowing a more precise identification of its benefits. METHODS: We performed a retrospective analysis of 1619 kidney transplants that received cyclosporine-based immunosuppressive therapy. Patients were divided into three groups (1) oil-based cyclosporine (SIM) with trough monitoring (GI, n=617); (2) microemulsion formulation (NEO) with trough monitoring (GII, n=962); and (3) NEO with C2 monitoring (GIII, n=40). Information was obtained on transplant demography; adjunctive immunosuppressive agent; living (LD) versus cadaveric (CAD) recipients; delayed graft function; any treated acute rejection; graft function at 3, 6, and 12 months, patient and graft survival, as well as causes of graft loss and death. RESULTS: At 15 years follow-up, patient and graft survival were 67.5% and 41.6%, being superior, among LD versus CAD recipients (patient: 78.7% vs 57.7%, P<.001; graft: 56.4% vs 30.5%, P<.001). In LD (54% vs 32%, P<.001) and CAD (69% vs 55%, P<.001) NEO reduced the incidence of AR and improved 8-year patient (LD: 81.8% vs 94.7%; CAD: 66.4 vs 79.9%, P<.01) and graft survival (LD: 58.3 vs. 80%; CAD: 40.2% vs. 59.5%, P<.01), compared to SIM. Overall 8-year graft survival was inferior among patients with increased 1-year creatinine values (< or =1.5, 1.6-2.5 and >2.5 mg/dL) level (74% vs 63.9% vs 22.4%, P<.001) or change in Cr (< or =0.1, 0.2-0.4, >0.5 mg/dL) level (73.1% vs 61.9% vs 37.2%, P<.001). In patients at the same level of graft function, those receiving NEO showed superior 8-year patient and graft survival compared with SIM. CONCLUSION: Compared to SIM, NEO reduced the incidence of acute rejection and produced superior long-term patient and graft survival.

Adult↗

An impedance study of the adsorption of nucleic acid bases at glassy carbon electrodes.

Electrochemical impedance has been used to study the adsorption at glassy carbon electrodes of guanine, its corresponding nucleoside, guanosine, and adenine. Impedance studies at different concentrations and applied potentials show clearly that all three bases are adsorbed on the electrode, blocking the surface. Irradiating the electrode with low-frequency (20 kHz) ultrasound whilst recording the impedance spectra increased transport of molecules to the electrode surface with cavitation cleaning the surface and removing strongly adsorbed molecules of bases. In this way, sonoelectrochemical experiments enabled the electrode processes to be studied in the absence of adsorption.

Adsorption↗

Evaluation of apical sealing of three endodontic sealers.

AIM: The apical sealing ability of three different endodontic sealers was evaluated in extracted teeth using dye penetration. METHODOLOGY: The root canals of 99 extracted human maxillary central incisors were prepared sequentially 2 mm beyond the apical foramen with a size 55 Nitiflex file. The teeth were divided into three experimental groups and obturated by lateral condensation of cold gutta-percha and one of the following sealers: group 1, zinc oxide and eugenol sealer (Fill Canal); group 2, glass ionomer sealer (Ketac-Endo) and group 3, epoxy resin sealer (AH Plus). The teeth were covered with nail varnish to within 1 mm of the apical foramen and immersed in 2% methylene blue in a reduced pressure environment for 24 h. After this period, the teeth were washed and cut longitudinally for apical leakage analysis. The values were obtained from the maximum depth of leakage as well as the average between the maximum and minimum values observed for each group. RESULTS: Statistical evaluation of the results showed no significant difference in the leakage between Fill Canal and Ketac-Endo (P > 0.05). Leakage with AH Plus was significantly less (P < 0.01) than with the other sealers. CONCLUSIONS: All three sealers allowed some leakage to occur. Leakage with AH Plus was significantly different than with Fill Canal or Ketac-Endo.

Barium Sulfate↗

In vivo antimicrobial activity of 2% chlorhexidine used as a root canal irrigating solution.

The aim of the present study was to evaluate the in vivo antimicrobial activity of 2% chlorhexidine gluconate (FCFRP-USP) used as a root canal irrigating solution in teeth with pulp necrosis and radiographically visible chronic periapical reactions. Culture techniques and measurement of the inhibition zone were used. Twenty-two root canals of incisors and molars of 12 patients were used. After accessing the canal, the first root canal sample was collected with two sterile paper points that were transferred to a tube containing reduced transport fluid. The root canal was instrumented using chlorhexidine solution. A small sterile cotton pellet was placed at the root canal entrance, and the cavity was sealed with zinc oxide-eugenol cement. The canals were maintained empty for 48 h. Three sterile paper points were then introduced to absorb the root canal fluid (second sample). One paper point was placed on an agar plate inoculated with Micrococcus luteus ATCC 9341 and incubated for 24 h at 37 degrees C, and the other two were submitted to microbiological evaluation. Present in 10 cases at baseline, mutans streptococci was reduced by 100% at the second assessment. Treatment showed an efficiency of 77.78% for anaerobic microorganisms at the second assessment. These data suggest that chlorhexidine prevents microbial activity in vivo with residual effects in the root canal system up to 48 h.

Adolescent↗

Connective tissue responses to calcium hydroxide-based root canal medicaments.

AIM: The objective of the present study was to evaluate the tissue inflammatory response induced by calcium hydroxide pastes, with or without paramonochlorophenol and camphor. METHODOLOGY: Isogenic BALB/c mice were inoculated into the subcutaneous tissue with either 0.1 mL of a suspension of Calen, Calen with camphorated paramonochlorophenol, Calen with paramonochlorophenol, Calasept paste or phosphate-buffered saline (control). After 6, 12 and 24 h and 2, 3, 5, 7 and 15 days, three animals in each group were sacrificed and the excised lesions processed for histopathological evaluation of the inflammatory response. Events monitored and graded included the assessment of vascular congestion, oedema, haemorrhage, inflammatory infiltrate, necrosis and tissue repair. RESULTS: The pastes induced an inflammatory response at every observation period, although the intensity, duration and extension of inflammation varied. Calen paste always produced an initial short-term inflammatory response whilst the other pastes produced extended reactions. All pastes allowed repair to take place by the end of the experimental period, although the speed of this process varied between the materials. Calen presented the best biocompatibility; the phenolic compound caused greater tissue response, which was even more severe in the absence of camphor. Calasept paste was damaging and the repair process slower. CONCLUSIONS: All calcium hydroxide formulations caused an inflammatory response. The severity and longevity of the responses varied between pastes as a result of the various antiseptic agents. Although irritating, repair was apparent with all formulations.

Animals↗

[Infectious and parasitic diseases in Brazil: a decade of transition].

Brazil has been undergoing a period of epidemiological and demographic transition, which has included an improvement in the quality of death certificate registrations and major changes in the patterns of mortality from infectious and parasitic diseases. This article outlines the changes in the mortality patterns that were observed in the country and in its states during the decade of the 1980s. We used data from the Ministry of Health Mortality Information System, classified according to the International Classification of Diseases, 9th Revision. Our analysis showed important changes in mortality patterns in Brazil. Mortality from infectious diseases decreased by 41% among men and by 44% among women. While these types of changes were especially noticeable in the states of the North and Northeast, these states still have the highest mortality rates in the country. The changes particularly affected the extreme limits of the age continuum, most especially children under 1 year of age. Within the group of infectious and parasitic diseases, we also assessed the mortality due to intestinal infectious diseases, tuberculosis, and septicemia. We found that in the 1980s there was a major decrease in the rates of mortality due to intestinal infectious diseases and to tuberculosis. However, there was an increase in the risk of death from septicemia during the decade. In conclusion, we find that the rate of mortality caused by infectious and parasitic diseases remains high in Brazil. Therefore, Brazilian health authorities still need to give priority attention to this cause of death.

Brazil↗

Effect of different root canal sealers on periapical repair of teeth with chronic periradicular periodontitis.

Teeth with induced chronic periradicular periodontitis in dogs were root canal treated. After the biomechanical preparation, using K files and 5.25% sodium hypochlorite as the irrigant solution, all root canals were dressed with an antibacterial dressing based on calcium hydroxide, which was left in place for 7 days. After this time, the root canals were obturated with lateral condensation of cold gutta-percha with either a calcium hydroxide root canal filling material (Sealapex) or a zinc oxide-eugenol sealer (Fill Canal). After 270 days, histopathological analysis showed better apical and periapical repair in the teeth obturated with Sealapex (P < 0.05).

Animals↗

Inflammatory response to calcium hydroxide based root canal sealers.

This study evaluated the inflammatory response to Sealapex, CRCS, Apexit, and Sealer 26 in the subcutaneous tissue and in peritoneal cavity of Balb/c mice. The inflammatory response of subcutaneous tissue was analyzed after 2, 4, 8, and 16 days. Intense neutrophilia was seen in response to all sealers during the initial periods. Differences among them related to the presence of necrosis and the number of inflammatory cells. In the intermediate phase marked differentiation of cells of the mononucleate phagocytic system into macrophages, epithelioid cells and multinucleate giant cells were observed with Sealapex. This response was less intense with CRCS and Apexit. Tissue necrosis was observed only at tissue sealer interfaces and only during the initial period with Sealapex but was seen throughout the experiment with all other sealers. The animals were injected in the peritoneal cavity with solutions containing the sealers and five mice from each group were killed 6 and 24 h, and 5 and 15 days later. During the initial periods (6 and 24 h) there was an intense migration of polymorphonuclear leukocytes to the peritoneal cavity in response to all sealers compared to the control. This migration was more intense for Sealer 26 and Apexit. An increase in mononucleate cell number was observed after 6 and 24 h and 5 days for all sealers and no differences were observed in relation to the control after 15 days.

Animals↗

Calcium hydroxide root canal sealers--histopathologic evaluation of apical and periapical repair after endodontic treatment.

Eighty root canals of the premolars of 4 dogs, with vital pulp, were instrumented and filled during the same session with the Sealapex, CRCS, Sealer 26, and Apexit sealers. The animals were sacrificed 180 days after root canal filling and their maxillae and mandibles were removed and fixed in 10% formalin. After routine histologic processing, the sections were stained with hematoxylin-eosin and Mallory trichrome. Histopathologic analysis showed that Sealapex was the sealer that best permitted the deposition of mineralized tissue at the apical level and was the only sealer that provided complete sealing (37.5% of cases). With the use of Sealapex, no inflammatory infiltrate occurred and there was no reabsorption of mineralized tissues. In contrast, partial sealing and a moderate inflammatory infiltrate occurred with the use of CRCS. When Apexit and Sealer 26 were used the absence of sealing was frequent and active reabsorption of mineralized tissues occurred in most cases. The inflammatory infiltrate predominating with the use of Apexit was of the severe type, whereas with the use of Sealer 26 the inflammatory infiltrate was mild or absent.

Animals↗

Determination of the p-monochlorophenol residue in the calcium hydroxide + P-monochlorophenol combination used as an intracanal dressing in pulpless teeth of dogs with induced chronic periapical lesion.

To determine the presence of p-monochlorophenol in the calcium hydroxide (Calen) + p-monochlorophenol combination after its use as intracanal dressing, periapical lesions were induced in 60 root canals of upper and lower premolars of four dogs. After biomechanical preparation, the root canals received the intracanal medication, which was removed from the apical third after 2, 4, 7, and 14 days for chemical analysis by spectrophotometry. The results showed a p-monochlorophenol loss of approximately 50.0% in the dressing after 48 h, with no further significant loss after longer periods of times. p-Monochlorophenol was still present in the medication after 14 days.

Analysis of Variance↗

[Myocardial revascularization through small left anterior minithoracotomy].

PURPOSE: To analyze the results of myocardial revascularization through small left anterior thoracotomy utilizing the left thoracic internal artery (LTIA) to left anterior descending coronary artery (LAD) without cardiopulmonary bypass, in order to simplify the operative procedure. METHODS: From September/95 till August/96 we operated on 45 patients with lesions in LAD or LAD and diagonal arteries that were revascularized with an anastomoses of the LTIA to LAD or LAD and diagonal as composite grafts, through left anterior small thoracotomy. In the second postoperative day 43 out of 45 patients were restudied with arteriography and/or transthoracic echocardiography that showed excellent patency in 39 of them. RESULTS: Six patients with obstruction or stenoses were reoperated through median sternotomy without complications. We did not observe flow through intercostal arteries in these restudies except in cases of obstructed anastomosis, showing that it is not necessary to ligate these branches. We observed too, excellent correlation between angiographic patterns and diastolic flows detected in the thoracic internal artery with transthoracic echocardiography. CONCLUSION: These initial results suggest that this approach may be good to a subset of patients with lesions in LAD and/or diagonal arteries and if associated with complementary angioplasties of other coronary arteries may be the best choice of invasive treatment of coronary insufficiency in a near future.

Adult↗

[Diagnostic accuracy of dobutamine-atropine stress echocardiography].

PURPOSE: To analyze the diagnostic accuracy of dobutamine-atropine stress echocardiography. METHODS: We studied 304 consecutive patients using dobutamine-atropine stress echocardiography who underwent coronary angiography within a month of the exam. Patients received high dobutamine doses associated or not with atropine. RESULTS: The global sensitivity was 92%, specificity was 72% and diagnostic accuracy was 87%. Analyzing 120 patients with normal LV function, we found sensitivity of 85%, specificity of 79% and accuracy of 82%. CONCLUSION: Dobutamine-atropine stress echocardiography is an accurate method for the detection of coronary artery disease.

Atropine↗