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Costa RC, Takeda TTS, Dini C, Bertolini M, Ferreira RC, Pereira G, Sacramento CM, Ruiz KGS, Feres M, Shibli JA, Barāo VAR, Souza JGS. Efficacy of a novel three-step decontamination protocol for titanium-based dental implants: An in vitro and in vivo study. Clin Oral Implants Res 2024; 35:268-281. [PMID: 38131526 DOI: 10.1111/clr.14224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 11/05/2023] [Accepted: 11/28/2023] [Indexed: 12/23/2023]
Abstract
AIM The aim of the study was to evaluate several mechanical and chemical decontamination methods associated with a newly introduced biofilm matrix disruption strategy for biofilm cleaning and preservation of implant surface features. MATERIALS AND METHODS Titanium (Ti) discs were obtained by additive manufacturing. Polymicrobial biofilm-covered Ti disc surfaces were decontaminated with mechanical [Ti curette, Teflon curette, Ti brush, water-air jet device, and Er:YAG laser] or chemical [iodopovidone (PVPI) 0.2% to disrupt the extracellular matrix, along with amoxicillin; minocycline; tetracycline; H2 O2 3%; chlorhexidine 0.2%; NaOCl 0.95%; hydrocarbon-oxo-borate-based antiseptic] protocols. The optimal in vitro mechanical/chemical protocol was then tested in combination using an in vivo biofilm model with intra-oral devices. RESULTS Er:YAG laser treatment displayed optimum surface cleaning by biofilm removal with minimal deleterious damage to the surface, smaller Ti release, good corrosion stability, and improved fibroblast readhesion. NaOCl 0.95% was the most promising agent to reduce in vitro and in vivo biofilms and was even more effective when associated with PVPI 0.2% as a pre-treatment to disrupt the biofilm matrix. The combination of Er:YAG laser followed by PVPI 0.2% plus NaOCl 0.95% promoted efficient decontamination of rough Ti surfaces by disrupting the biofilm matrix and killing remnants of in vivo biofilms formed in the mouth (the only protocol to lead to ~99% biofilm eradication). CONCLUSION Er:YAG laser + PVPI 0.2% + NaOCl 0.95% can be a reliable decontamination protocol for Ti surfaces, eliminating microbial biofilms without damaging the implant surface.
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Affiliation(s)
- Raphael Cavalcante Costa
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Thais Terumi Sadamitsu Takeda
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Caroline Dini
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Martinna Bertolini
- Department of Periodontics and Preventive Dentistry, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Raquel Carla Ferreira
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil
| | - Gabriele Pereira
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil
| | - Catharina Marques Sacramento
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Karina Gonzales S Ruiz
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Magda Feres
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Jamil A Shibli
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil
| | - Valentim A R Barāo
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Joāo Gabriel S Souza
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil
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Borges GA, Costa RC, Nagay BE, Sacramento CM, Ruiz KGS, Solano de Almeida L, Rossino LS, Fortulan CA, Rangel EC, Barão VAR, Mesquita MF. Targeting Biomechanical Endurance of Dental-Implant Abutments Using a Diamond-Like Carbon Coating. ACS Appl Bio Mater 2023; 6:5630-5643. [PMID: 38052058 DOI: 10.1021/acsabm.3c00802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
Abutment components (i.e., fixtures associated with oral implants) are essentially made of titanium (Ti), which is continuously exposed to the hash oral environment, resulting in scratching. Thus, such components need to be protected, and surface treatments are viable methods for overcoming long-term damage. Diamond-like carbon (DLC), an excellent protective material, is an alternative surface-treatment material for Ti abutments. Here, we demonstrate that a silicon interlayer for DLC film growth and the pulsed-direct current plasma-enhanced chemical vapor deposition (DC-PECVD) method enables the deposition of an enhanced protective DLC film. As a result, the DLC film demonstrated a smooth topography with a compact surface. Furthermore, the DLC film enhanced the mechanical (load-displacement, hardness, and elastic modulus) and tribological properties of Ti as well as increased its corrosion resistance (16-fold), which surpassed that of a bare Ti substrate. The biofilm formed (Streptococcus sanguinis) after 24 h exhibited an equal bacterial load (∼7 Log colony-forming units) for both the groups (Ti and DLC). In addition, the DLC film exhibited good cytocompatibility, owing to its noncytotoxicity toward human gingival fibroblast cells. Therefore, DLC deposition via DC-PECVD can be considered to be a promising protective and cytocompatible alternative for developing implant abutments with enhanced mechanical, tribological, and electrochemical properties.
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Affiliation(s)
- Guilherme Almeida Borges
- University of Campinas (UNICAMP), Piracicaba Dental School, Department of Prosthodontics and Periodontics, Avenida Limeira, 901, Piracicaba, São Paulo 13414-903, Brazil
| | - Raphael Cavalcante Costa
- University of Campinas (UNICAMP), Piracicaba Dental School, Department of Prosthodontics and Periodontics, Avenida Limeira, 901, Piracicaba, São Paulo 13414-903, Brazil
| | - Bruna Egumi Nagay
- University of Campinas (UNICAMP), Piracicaba Dental School, Department of Prosthodontics and Periodontics, Avenida Limeira, 901, Piracicaba, São Paulo 13414-903, Brazil
| | - Catharina Marques Sacramento
- University of Campinas (UNICAMP), Piracicaba Dental School, Department of Prosthodontics and Periodontics, Avenida Limeira, 901, Piracicaba, São Paulo 13414-903, Brazil
| | - Karina Gonzales Silverio Ruiz
- University of Campinas (UNICAMP), Piracicaba Dental School, Department of Prosthodontics and Periodontics, Avenida Limeira, 901, Piracicaba, São Paulo 13414-903, Brazil
| | - Larissa Solano de Almeida
- Federal University of São Carlos (UFSCar) - Campus Sorocaba, Postgraduate Program in Materials Science, Rodovia João Leme dos Santos, Km 110, Sorocaba, São Paulo 18052-780, Brazil
| | - Luciana Sgarbi Rossino
- Federal University of São Carlos (UFSCar) - Campus Sorocaba, Postgraduate Program in Materials Science, Rodovia João Leme dos Santos, Km 110, Sorocaba, São Paulo 18052-780, Brazil
- State Center of Technological Education "Paula Souza" (CEETEPS), Sorocaba Technology College - Campus Sorocaba (Fatec Sorocaba), Avenida Engenheiro Carlos Reinaldo Mendes, 2015, Sorocaba, São Paulo 18013-280, Brazil
| | - Carlos Alberto Fortulan
- University of São Paulo (USP), Department of Mechanical Engineering, Trabalhador São Carlense 400, São Carlos, São Paulo 13566-590, Brazil
| | - Elidiane Cipriano Rangel
- São Paulo State University (UNESP), Institute of Science and Technology, Laboratory of Technological Plasmas, Avenida Três de Março, 51, Sorocaba, São Paulo 18087-180, Brazil
| | - Valentim A R Barão
- University of Campinas (UNICAMP), Piracicaba Dental School, Department of Prosthodontics and Periodontics, Avenida Limeira, 901, Piracicaba, São Paulo 13414-903, Brazil
| | - Marcelo Ferraz Mesquita
- University of Campinas (UNICAMP), Piracicaba Dental School, Department of Prosthodontics and Periodontics, Avenida Limeira, 901, Piracicaba, São Paulo 13414-903, Brazil
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Saha S, Costa RC, Silva MC, Fonseca-Santos JM, Chen L, Phakatkar AH, Bhatia H, Faverani LP, Barão VA, Shokuhfar T, Sukotjo C, Takoudis C. Collagen membrane functionalized with magnesium oxide via room-temperature atomic layer deposition promotes osteopromotive and antimicrobial properties. Bioact Mater 2023; 30:46-61. [PMID: 37521273 PMCID: PMC10382637 DOI: 10.1016/j.bioactmat.2023.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 07/02/2023] [Accepted: 07/17/2023] [Indexed: 08/01/2023] Open
Abstract
Artificial bone grafting materials such as collagen are gaining interest due to the ease of production and implantation. However, collagen must be supplemented with additional coating materials for improved osteointegration. Here, we report room-temperature atomic layer deposition (ALD) of MgO, a novel method to coat collagen membranes with MgO. Characterization techniques such as X-ray photoelectron spectroscopy, Raman spectroscopy, and electron beam dispersion mapping confirm the chemical nature of the film. Scanning electron and atomic force microscopies show the surface topography and morphology of the collagen fibers were not altered during the ALD of MgO. Slow release of magnesium ions promotes bone growth, and we show the deposited MgO film leaches trace amounts of Mg when incubated in phosphate-buffered saline at 37 °C. The coated collagen membrane had a superhydrophilic surface immediately after the deposition of MgO. The film was not toxic to human cells and demonstrated antibacterial properties against bacterial biofilms. Furthermore, in vivo studies performed on calvaria rats showed MgO-coated membranes (200 and 500 ALD) elicit a higher inflammatory response, leading to an increase in angiogenesis and a greater bone formation, mainly for Col-MgO500, compared to uncoated collagen. Based on the characterization of the MgO film and in vitro and in vivo data, the MgO-coated collagen membranes are excellent candidates for guided bone regeneration.
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Affiliation(s)
- Soumya Saha
- Department of Biomedical Engineering, University of Illinois Chicago, Chicago, USA
| | - Raphael Cavalcante Costa
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Mirela Caroline Silva
- Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery and Implantology, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - João Matheus Fonseca-Santos
- Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery and Implantology, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - Lin Chen
- Department of Periodontics, Center for Wound Healing and Tissue Regeneration, College of Dentistry, University of Illinois Chicago, Chicago, USA
| | - Abhijit H. Phakatkar
- Department of Biomedical Engineering, University of Illinois Chicago, Chicago, USA
| | - Harshdeep Bhatia
- Department of Chemical Engineering, University of Illinois Chicago, Chicago, USA
| | - Leonardo P. Faverani
- Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery and Implantology, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - Valentim A.R. Barão
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Tolou Shokuhfar
- Department of Biomedical Engineering, University of Illinois Chicago, Chicago, USA
| | - Cortino Sukotjo
- Department of Restorative Dentistry, University of Illinois Chicago College of Dentistry, Chicago, USA
| | - Christos Takoudis
- Department of Biomedical Engineering, University of Illinois Chicago, Chicago, USA
- Department of Chemical Engineering, University of Illinois Chicago, Chicago, USA
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Dini C, Costa RC, Bertolini M, Shibli JA, Feres M, Klein MI, de Avila ÉD, Souza JGS, Barão VAR. In-vitro polymicrobial oral biofilm model represents clinical microbial profile and disease progression during implant-related infections. J Appl Microbiol 2023; 134:lxad265. [PMID: 37951291 DOI: 10.1093/jambio/lxad265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 10/31/2023] [Accepted: 11/09/2023] [Indexed: 11/13/2023]
Abstract
AIM Clinically relevant in-vitro biofilm models are essential and valuable tools for mechanistically dissecting the etiopathogenesis of infectious diseases and test new antimicrobial therapies. Thus, the aim of this study was to develop and test a clinically relevant in-vitro oral polymicrobial biofilm model that mimics implant-related infections in terms of microbial profile. METHODS AND RESULTS For this purpose, 24-well plate system was used to model oral biofilms, using three different microbial inoculums to grow in-vitro biofilms: (1) human saliva from periodontally healthy patients; (2) saliva as in inoculum 1 + Porphyromonas gingivalis strain; and (3) supra and subgingival biofilm collected from peri-implant sites of patients diagnosed with peri-implantitis. Biofilms were grown to represent the dynamic transition from an aerobic to anaerobic community profile. Subsequently, biofilms were collected after each phase and evaluated for microbiological composition, microbial counts, biofilm biomass, structure, and susceptibility to chlorhexidine (CHX). Results showed higher live cell count (P < .05) for biofilms developed from patients' biofilm inoculum, but biomass volume, dry weight, and microbiological composition were similar among groups (P > .05). Interestingly, according to the checkerboard DNA-DNA hybridization results, the biofilm developed from stimulated human saliva exhibited a microbial composition more similar to the clinical subgingival biofilm of patients with peri-implantitis, with proportions of the main pathogens closer to those found in the disease. In addition, biofilm developed using saliva as inoculum was shown to be susceptible to CHX with significant reduction in bacteria compared with biofilms without exposure to CHX (P < .05). CONCLUSION The findings suggested that the in-vitro polymicrobial biofilm developed from human saliva as inoculum is a suitable model and clinically relevant tool for mimicking the microbial composition of implant-related infections.
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Affiliation(s)
- Caroline Dini
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, Universidade Estadual de Campinas (UNICAMP), Piracicaba, SP 13414-903, Brazil
| | - Raphael Cavalcante Costa
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, Universidade Estadual de Campinas (UNICAMP), Piracicaba, SP 13414-903, Brazil
| | - Martinna Bertolini
- Department of Periodontics and Preventive Dentistry, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA 15260, United States
| | - Jamil Awad Shibli
- Dental Research Division, Guarulhos University, Guarulhos, SP 07011-010, Brazil
| | - Magda Feres
- Dental Research Division, Guarulhos University, Guarulhos, SP 07011-010, Brazil
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA 02115, United States
| | - Marlise Inêz Klein
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas (UNICAMP), Piracicaba, SP 13414-903, Brazil
| | - Érica Dorigatti de Avila
- Department of Dental Materials and Prosthodontics, School of Dentistry at Araraquara, São Paulo State University (UNESP), Araraquara, SP 14801-385, Brazil
- Department of Dental Materials and Prosthodontics, School of Dentistry at Araçatuba, São Paulo State University (UNESP), Araçatuba, SP 16015-050, Brazil
| | | | - Valentim Adelino Ricardo Barão
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, Universidade Estadual de Campinas (UNICAMP), Piracicaba, SP 13414-903, Brazil
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Costa RC, Borges GA, Dini C, Bertolini M, Souza JGS, Mesquita MF, Barão VAR. Clinical efficacy of triclosan-containing toothpaste in peri-implant health: A systematic review and meta-analysis of randomized clinical trials. J Prosthet Dent 2023:S0022-3913(23)00508-5. [PMID: 37723004 DOI: 10.1016/j.prosdent.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 08/01/2023] [Accepted: 08/07/2023] [Indexed: 09/20/2023]
Abstract
STATEMENT OF PROBLEM Recent evidence suggests that toothpaste containing 0.3% triclosan (TCS) is more effective than regular toothpaste in improving clinical periodontal conditions. However, a consensus on whether TCS favors a healthy peri-implant environment is limited. PURPOSE The purpose of this systematic review and meta-analysis of randomized clinical trials was to determine the effects of TCS-containing toothpaste on dental implant health based on clinical, immunological, and microbiological parameters, as well as on reported adverse events. MATERIAL AND METHODS Clinical studies comparing peri-implant conditions in participants by using TCS toothpaste versus conventional fluoride toothpaste (control) were extracted from 9 databases. The studies were assessed with the Cochrane risk-of-bias tool for randomized clinical trials (RoB 2). Datasets for bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), gingival index (GI), plaque index (PI), osteo-immunoinflammatory mediators, and bacterial load were plotted, and the standard mean difference (SMD) quantitative analysis was applied by using the Rev Man 5.3 software program. Adverse effects reported by the studies were also tabulated. The certainty of evidence was assessed by using the grading of recommendations assessment, development, and evaluation approach. RESULTS Six studies were included in the meta-analyses. BOP was higher in the control group than in the TCS toothpaste group at 3 months (SMD -0.59 [-1.11, -.07] P=.002, I2=77%) and 6 months (SMD -0.59 [-0.83, -0.34] P=.009, I2=79%). PD (SMD -0.04 [-0.08, -0.00] P=.04, I2=0%) was also deeper in the control group versus TCS toothpaste at 6 months (SMD -0.41 [-0.73, -0.10] P=.04, I2=77%). CAL, GI, and PI did not differ between groups (P>.05). Among the osteo-immunoinflammatory mediators, IL-10 levels increased, and IL-1β and osteoprotegerin levels decreased in the TCS toothpaste group (P<.05). Microbiological findings found that TCS toothpaste prevented the growth of periodontal pathogens, specifically in up to approximately 20% of the Prevotella intermedia. Adverse effects were not reported after toothbrushing in either group. However, most studies had "some" or "high" risk of bias, and the certainty of the evidence was considered to be "very low." CONCLUSIONS Most studies were short-term (3 and 6 months) analyses, and the results found that, although TCS-containing toothpaste had positive osteo-immunoinflammatory and microbiologic results, clinical parameters, including CAL, GI, and PI, were not influenced.
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Affiliation(s)
- Raphael Cavalcante Costa
- PhD student, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Guilherme Almeida Borges
- PhD student, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Caroline Dini
- PhD student, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Martinna Bertolini
- Assistant Professor, Department of Periodontics and Preventive Dentistry, School of Dental Medicine, University of Pittsburgh, Pittsburgh, USA
| | - Joāo Gabriel S Souza
- Professor, Dental Research Division, Guarulhos University (UnG), Guarulhos, SP, Brazil
| | - Marcelo Ferraz Mesquita
- Full Professor, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Valentim Adelino Ricardo Barão
- Associate Professor, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil..
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Hung CCU, Costa RC, Pereira G, Abdo VL, Noronha MDS, Retamal-Valdes B, Bertolini M, Feres M, Shibli JA, Barão VAR, Souza JGS. Oral microbial colonization on titanium and polyetheretherketone dental implant healing abutments: An in vitro and in vivo study. J Prosthet Dent 2023:S0022-3913(23)00538-3. [PMID: 37716897 DOI: 10.1016/j.prosdent.2023.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 08/10/2023] [Accepted: 08/10/2023] [Indexed: 09/18/2023]
Abstract
STATEMENT OF PROBLEM Although polyetheretherketone (PEEK) implant healing abutments have become popular because of their esthetic, mechanical, and chemical properties, studies analyzing oral polymicrobial adhesion to PEEK abutments are lacking. PURPOSE The purpose of this in vitro and in vivo study was to evaluate oral microbial adhesion and colonization on titanium (Ti) and PEEK healing abutments. MATERIAL AND METHODS Ti (N=35) and PEEK substrates (N=35) were evaluated in vitro in terms of the initial adhesion (1 hour) or biofilm accumulation (48 hours) of Candida albicans and a polymicrobial inoculum using stimulated human saliva to mimic a diverse oral microbiome. Surface decontamination ability was evaluated after 24 hours of in vitro biofilm formation after exposure to an erbium-doped yttrium aluminum garnet (Er:YAG) laser. Conventional and flowable composite resin veneering on PEEK was also tested for microbial adhesion. In addition, an in vivo model with 3 healthy volunteers was conducted by using a palatal appliance containing the tested materials (3 or 4 specimens of each material per appliance) for 2 days to evaluate the effect of substrate on the microbial profile. Biofilms were evaluated by live cell counts and scanning electron microscopy images, and the microbial profile by Checkerboard deoxyribonucleic acid (DNA)-DNA hybridization. The t test and Mann-Whitney test were used to compare the groups (α=.05). RESULTS PEEK and Ti materials showed similar fungal adhesion (P>.05). Although the PEEK surface limited the initial in vitro polymicrobial adhesion (approximately 2 times less) compared with Ti (P=.040), after 48 hours of biofilm accumulation, the microbial load was statistically similar (P=.209). Er:YAG laser decontamination was more effective on PEEK than on Ti surfaces, reducing approximately 11 times more microbial accumulation (P=.019). Both composite resins tested showed similar microbial adhesion (1 hour). In vivo, the PEEK material showed reduced levels of 6 bacterial species (P<.05), including the putative pathogen Treponema denticola. CONCLUSIONS Although PEEK and Ti had similar bacterial and fungus biofilm attachment and accumulation, PEEK promoted a host-compatible microbial profile with a significantly reduced T. denticola load.
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Affiliation(s)
- Celeste Cecilia Urdaniga Hung
- PhD student, Department of Periodontology, Dental Research Division, Guarulhos University (UnG), Guarulhos, São Paulo, Brazil
| | - Raphael Cavalcante Costa
- PhD student, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Gabriele Pereira
- Graduate student, Guarulhos University (UnG), Guarulhos, São Paulo, Brazil
| | - Victória Lopes Abdo
- PhD student, Department of Periodontology, Dental Research Division, Guarulhos University (UnG), Guarulhos, São Paulo, Brazil
| | - Mayara do Santos Noronha
- Postdoctoral Fellow, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Belén Retamal-Valdes
- Professor, Department of Periodontology, Dental Research Division, Guarulhos University (UnG), Guarulhos, São Paulo, Brazil
| | - Martinna Bertolini
- Professor, Department of Periodontics and Preventive Dentistry, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pa
| | - Magda Feres
- Chair, Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Mass
| | - Jamil Awad Shibli
- Professor, Department of Periodontology, Dental Research Division, Guarulhos University (UnG), Guarulhos, São Paulo, Brazil
| | - Valentim A R Barão
- Associate Professor, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - João Gabriel Silva Souza
- Professor, Department of Periodontology, Dental Research Division, Guarulhos University (UnG), Guarulhos, São Paulo, Brazil; and Professor, Dental Science School (Faculdade de Ciências Odontológicas - FCO), Montes Claros, Minas Gerais, Brazil..
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7
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Bertolini M, Costa RC, Barão VAR, Cunha Villar C, Retamal-Valdes B, Feres M, Silva Souza JG. Oral Microorganisms and Biofilms: New Insights to Defeat the Main Etiologic Factor of Oral Diseases. Microorganisms 2022; 10:microorganisms10122413. [PMID: 36557666 PMCID: PMC9781395 DOI: 10.3390/microorganisms10122413] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 07/19/2022] [Indexed: 12/12/2022] Open
Abstract
The oral cavity presents a highly diverse community of microorganisms due to the unique environmental conditions for microbial adhesion and growth [...].
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Affiliation(s)
- Martinna Bertolini
- Department of Periodontics and Preventive Dentistry, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA 15106, USA
- Correspondence:
| | - Raphael Cavalcante Costa
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba 13083-970, SP, Brazil
| | - Valentim Adelino Ricardo Barão
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba 13083-970, SP, Brazil
| | - Cristina Cunha Villar
- Division of Periodontics, Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo 05508-010, SP, Brazil
| | | | - Magda Feres
- Dental Research Division, Guarulhos University, Guarulhos 05508-010, SP, Brazil
- Center for Clinical and Translational Research, Forsyth Institute, Boston, MA 02142, USA
| | - João Gabriel Silva Souza
- Dental Research Division, Guarulhos University, Guarulhos 05508-010, SP, Brazil
- Dental Science School (Faculdade de Ciências Odontológicas—FCO), Montes Claros 39401-303, MG, Brazil
- Oncovida Cancer Research Center, Montes Claros 39400-111, MG, Brazil
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Duarte KLS, Castellanos RM, Costa RC, Mahler CF, Bassin JP. Start-up of an aerobic granular sludge system from stored granules: Evaluating the impact of storage period on biomass activity and stability and the effect of temperature on nitrification and phosphorus removal rates. J Environ Manage 2021; 296:113200. [PMID: 34284343 DOI: 10.1016/j.jenvman.2021.113200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 06/24/2021] [Accepted: 06/29/2021] [Indexed: 06/13/2023]
Abstract
Aerobic granular sludge (AGS) has been considered a breakthrough within the wastewater treatment sector. However, the long reactor start-up for the formation of granules is challenging and may hinder the spread of this technology. To circumvent this obstacle, inoculation of the reactors with pre-formed granules from existing plants is an interesting approach. In this context, issues related to biomass storage becomes very relevant. In this study, reactivation of aerobic granular biomass after storage was evaluated in a sequencing batch reactor (SBR) designed for achieving simultaneous organic matter, nitrogen and phosphorus removal. Two different scenarios, short (40 days) and long (180 days) storage periods, were assessed, and their influence on the granules physical properties and bioactivity was addressed. The results revealed that the granules stored for a shorter period showed higher resistance to breakage and underwent smooth color changes. On the other hand, the biomass stored for a longer period acquired a dark color and was more susceptible to disruption during reactivation. The granules stored for 6 months become swollen and exhibited an irregular morphology and fluffy structure within the first days of reactivation. Consequently, their settling properties were adversely affected, and some parameters such as the food-to-microorganism ratio had to be adjusted to prevent granules disintegration. Regarding the bioactivity of important microbial functional groups, COD removal was rapidly restored within a few days of SBR operation with the biomass stored for a shorter period. However, it took longer for the biomass stored for 180 days to reach the same performance observed for the granules stored for 40 days. A similar trend is valid for nitrification. In the experiments with sludge stored for a longer time, it took almost twice as long to reach effluent ammonium concentrations lower than 1 mg NH4+-N L-1 compared to the test using biomass stored for 40 days. Phosphate removal was strongly affected by biomass storage, especially after 180 days of inactivity, a condition found to be detrimental for polyphosphate-accumulating organisms. Finally, cycle tests were also conducted to assess substrate conversion rates for comparison between different trials and evaluate the influence of temperature (10-35 °C) on nitrification and phosphate removal rates.
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Affiliation(s)
- K L S Duarte
- Civil Engineering Program, COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - R M Castellanos
- Chemical Engineering Program, COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - R C Costa
- Civil Engineering Program, COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - C F Mahler
- Civil Engineering Program, COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - J P Bassin
- Civil Engineering Program, COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Chemical Engineering Program, COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
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9
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Ribeiro ILA, de Castro RD, Costa RC, Damascena LCL, de Lucena NNN, Maracajá PMB, Dos Santos FG, de Medeiros Serpa EB, Sousa SA, Valença AMG. Integrated oral care contributes positively to the course of treatment of oncopediatric patients. Eur J Pediatr 2021; 180:2757-2764. [PMID: 33754206 DOI: 10.1007/s00431-021-04024-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 03/04/2021] [Accepted: 03/10/2021] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to implement a model of permanent oral health care for oncopediatric patients and to observe its effects on severe oral mucositis and subsequent treatment interruptions. We performed a quasi-experimental study in the Pediatric Department of Napoleão Laureano Hospital, in the city of João Pessoa, Brazil. A integrated oral care was implemented by a dentistry team for prevention of comorbidities, such as infections, oral pain, oral function maintenance, oral mucositis, and interventions for lesions due to severe oral mucositis. The oral comorbidities were compared before and after the implementation. The duration of severe oral mucositis (SOM) before and after the interventions and the interruptions in treatment due to SOM were the main outcome measures. Permanent oral health care reduced the duration of SOM and reduced pediatric chemotherapy interruptions due to SOM by 81.8%.Conclusion: The permanent oral health care to offer to oncopediatric patients increased surveillance regarding oral comorbidities and reduced chemotherapy interruptions due to severe oral mucositis. This care plan could be adopted anywhere around the world. What is Known: • Several studies on oral care for pediatric oncology patients, especially regarding both prevention of and treatment for oral mucositis during antineoplastic therapy, have been published. What is New: • This study describes the benefits of permanent oral care with daily oral surveillance for pediatric patients, which reduced the duration of severe oral mucositis, increased surveillance and the efficiency in diagnostic for signs of oral mucositis, enabling early intervention, and decreased chemotherapy interruptions, contributing positively to the course of treatment.
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Affiliation(s)
| | - Ricardo Dias de Castro
- Postgraduate Program in Dentistry, Federal University of Paraíba, Campus I, João Pessoa, PB, 58051900, Brazil
| | - Raphael Cavalcante Costa
- Postgraduate Program in Clinical Dentistry, State University of Campinas, Piracicaba, SP, Brazil
| | | | | | | | - Fabio Gomes Dos Santos
- Postgraduate Program in Dentistry, Federal University of Paraíba, Campus I, João Pessoa, PB, 58051900, Brazil
| | | | - Simone Alves Sousa
- Postgraduate Program in Dentistry, Federal University of Paraíba, Campus I, João Pessoa, PB, 58051900, Brazil
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10
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Dini C, Borges GA, Costa RC, Magno MB, Maia LC, Barão VAR. Peri-implant and esthetic outcomes of cemented and screw-retained crowns using zirconia abutments in single implant-supported restorations-A systematic review and meta-analysis. Clin Oral Implants Res 2021; 32:1143-1158. [PMID: 34352144 DOI: 10.1111/clr.13824] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 06/23/2021] [Accepted: 07/07/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To evaluate the peri-implant tissue changes and esthetic outcomes of cemented and screw-retained crowns of single-tooth implants in the esthetic zone using zirconia abutments. MATERIAL AND METHODS An electronic search was performed on nine databases. The risk-of-bias was assessed by the revised Cochrane risk-of-bias tool for randomized (RoB 2) and non-randomized (ROBINS-I) clinical trials. Marginal bone level change, soft tissue thickness, bleeding on probing, probing depth, survival rates of implants and crowns, complications, plaque and papilla indexes, and pink esthetic score data were extracted and analyzed. The certainty of evidence was accessed through the GRADE approach. RESULTS Nine records were included and 7 were used in the meta-analyses. Screw-retained crowns presented greater marginal bone level change (MD -0.04 [-0.08, -0.00] p = 0.04, I2 = 0%) compared to cemented crowns up to 1-year. At 3 and 4 years no significant differences (p > 0.05) were observed. Soft tissue thickness did not differ between groups (p > 0.05). The bleeding on probing was higher in cemented group than in screw-retained crowns at 1-year (MD 0.17 [0.08, 0.27] p = 0.0005, I2 = 0%), at medium-term periods (3 and 4 years) no statistically significant differences (p > 0.05) were observed for this outcome. Probing depth, survival rates of implants and crowns, complications, and plaque index, as well as esthetic analysis using the papilla index and pink esthetic score did not differ statistically (p > 0.05) between both retention systems at short and medium-term periods. CONCLUSION The connection system considering zirconia abutments presented no influence on peri-implant parameters and esthetics evaluation for medium-term periods (3 and 4 years).
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Affiliation(s)
- Caroline Dini
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP, Piracicaba, Brazil
| | - Guilherme Almeida Borges
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP, Piracicaba, Brazil
| | - Raphael Cavalcante Costa
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP, Piracicaba, Brazil
| | - Marcela Baraúna Magno
- Department of Pediatric Dentistry and Orthodontics, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Rua Rodolpho Paulo Rocco - Cidade Universitária, Rio de Janeiro, Brazil
| | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Rua Rodolpho Paulo Rocco - Cidade Universitária, Rio de Janeiro, Brazil
| | - Valentim Adelino Ricardo Barão
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP, Piracicaba, Brazil
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11
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de Araújo ECF, Costa RC, Ribeiro ILA, Almeida LDFDD, Serpa EBDM, Valença AMG. Unstimulated salivary flow and oral streptococci in pediatric patients with hematological tumors: A longitudinal study. Spec Care Dentist 2021; 42:49-59. [PMID: 34240441 DOI: 10.1111/scd.12628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 06/20/2021] [Indexed: 12/01/2022]
Abstract
AIMS To evaluate the unstimulated salivary flow (USF) and salivary colonization of total Streptococcus spp. (TS) and mutans-group (MS) in pediatric patients with hematological tumors. Correlations of salivary and microbiological changes with chemotherapy and patient-related factors were also verified. METHODS AND RESULTS Eligible children (n = 31) were evaluated before (control) and after (2, 5, and 10-weeks) the chemotherapy protocol was applied. Saliva samples were collected by the traditional spitting method to determine the USF (ml/min). Salivary TS and MS were determined by colony-forming units (CFU ) counts in a selective medium. The caries experience was evaluated by DMFT/dmft indexes. Data were submitted to Student's t-test, one-way ANOVA, and correlation tests (α = 0.05). The USF rate at baseline was 0.89 (±0.73) ml/min with up to 20% reduction during the follow-up and did not differ statistically during chemotherapy (p > .05). Chemotherapy did not modify the salivary TS load (p > .05), but induced a dysbiotic shift with higher MS counts (∼ 5 fold-increase) at 10-weeks (p < .05). There is a correlation of USF with age (r = .390) and SM load with caries experience (rs = -.540) at 5-weeks. CONCLUSION Chemotherapy may promote a specific increase of mutans-group streptococci without changing the Streptococcus spp. load and unstimulated saliva flow. Correlation reinforced the need for further enlightenment about the chemotherapy mechanisms in the salivary and microbiological parameters.
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Affiliation(s)
| | - Raphael Cavalcante Costa
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | | | | | | | - Ana Maria Gondim Valença
- Department of Clinical and Social Dentistry, University of Paraíba (UFPB), João Pessoa, PB, Brazil
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12
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Borges GA, Costa RC, Nagay BE, Magno MB, Maia LC, Barão VAR, Mesquita MF. Long-term outcomes of different loading protocols for implant-supported mandibular overdentures: A systematic review and meta-analysis. J Prosthet Dent 2021; 125:732-745. [DOI: 10.1016/j.prosdent.2020.04.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 04/14/2020] [Accepted: 04/14/2020] [Indexed: 12/17/2022]
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Abstract
Implant devices have = proven a successful treatment modality in reconstructive surgeries. However, increasing rates of peri-implant diseases demand further examination of their pathogenesis. Polymicrobial biofilm formation on titanium surfaces has been considered the main risk factor for inflammatory processes on tissues surrounding implant devices, which often lead to implant failure. To overcome microbial accumulation on titanium surfaces biofilm targeting strategies have been developed to modify the surface and incorporate antimicrobial coatings. Because antibiotics are widely used to treat polymicrobial infections, these agents have recently started to be incorporated on titanium surface. This review discusses the biofilm formation on titanium dental implants and key factors to be considered in therapeutic and preventative strategies. Moreover, a systematic review was conducted on coatings developed for titanium surfaces using different antibiotics. This review will also shed light on potential alternative strategies aiming to reduce microbial loads and control polymicrobial infection on implanted devices.
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Affiliation(s)
- João Gabriel Silva Souza
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo 13414-903, Brazil
- Dental Research Division, Guarulhos University, Guarulhos, SP 07023-070, Brazil
- Dentistry Science School (Faculdade de Ciências Odontológicas - FCO), Montes Claros, Minas Gerais, 39401-303, Brazil
| | - Martinna Mendonça Bertolini
- Department of Oral Health and Diagnostic Sciences, University of Connecticut Health Center, Farmington, CT 06030, USA
| | - Raphael Cavalcante Costa
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo 13414-903, Brazil
| | - Bruna Egumi Nagay
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo 13414-903, Brazil
| | - Anna Dongari-Bagtzoglou
- Department of Oral Health and Diagnostic Sciences, University of Connecticut Health Center, Farmington, CT 06030, USA
| | - Valentim Adelino Ricardo Barão
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo 13414-903, Brazil
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Costa RC, Souza JGS, Bertolini M, Retamal-Valdes B, Feres M, Barão VAR. Extracellular biofilm matrix leads to microbial dysbiosis and reduces biofilm susceptibility to antimicrobials on titanium biomaterial: An in vitro and in situ study. Clin Oral Implants Res 2020; 31:1173-1186. [PMID: 32894779 DOI: 10.1111/clr.13663] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 08/18/2020] [Accepted: 08/29/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To test the role of exopolysaccharide (EPS) polymers matrix to modulate the composition/virulence of biofilms growing on titanium (Ti) surfaces, the effect on antibiotic susceptibility, and whether a dual-targeting therapy approach for disrupted EPS matrix could improve the antimicrobial effect. MATERIALS AND METHODS A microcosm biofilm model using human saliva as inoculum was used, and the microbial composition was assessed by checkerboard DNA-DNA hybridization. EPS-enriched biofilms virulence was tested using fibroblast monolayer. Povidone-iodine (PI) was used as EPS-targeting agent followed by amoxicillin + metronidazole antibiotic to reduce bacterial biomass using an in situ model. RESULTS An EPS-enriched environment, obtained by sucrose exposure, promoted bacterial accumulation and led to a dysbiosis on biofilms, favoring the growth of Streptococcus, Fusobacterium, and Campylobacter species and even strict anaerobic species related to peri-implant infections, such as Porphyromonas gingivalis and Tannerella forsythia (~3-fold increase). EPS-enriched biofilm transitioned from a commensal aerobic to a pathogenic anaerobic profile. EPS increased biofilm virulence promoting higher host cell damage and reduced antimicrobial susceptibility, but the use of a dual-targeting approach with PI pre-treatment disrupted EPS matrix scaffold, increasing antibiotic effect on in situ biofilms. CONCLUSION Altogether, our data provide new insights of how EPS matrix creates an environment that favors putative pathogens growth and shed light to a promising approach that uses matrix disruption as initial step to potentially improve implant-related infections treatment.
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Affiliation(s)
- Raphael Cavalcante Costa
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - João Gabriel Silva Souza
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Martinna Bertolini
- School of Dental Medicine, University of Connecticut (UCONN), Farmington, CT, USA
| | - Belén Retamal-Valdes
- Department of Periodontology, Dental Research Division, Guarulhos University (UnG), Guarulhos, SP, Brazil
| | - Magda Feres
- Department of Periodontology, Dental Research Division, Guarulhos University (UnG), Guarulhos, SP, Brazil
| | - Valentim A R Barão
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil
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15
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Souza JGS, Bertolini M, Costa RC, Lima CV, Barão VAR. Proteomic profile of the saliva and plasma protein layer adsorbed on Ti-Zr alloy: the effect of sandblasted and acid-etched surface treatment. Biofouling 2020; 36:428-441. [PMID: 32456471 DOI: 10.1080/08927014.2020.1769613] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 05/02/2020] [Accepted: 05/11/2020] [Indexed: 06/11/2023]
Abstract
Titanium-zirconium (Ti-Zr) alloy has been widely used as a biomaterial for implant devices, and it is commonly treated by sandblasting followed by acid etching (SLA) to improve biological responses. Although protein adsorption is the first biological response, the effect of this SLA treatment on the proteomic profile of proteins adsorbed from saliva and blood plasma has not been tested. In this study, the proteomic profile was evaluated by liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS). Streptococcus sanguinis was used to test whether the protein layer affects bacterial adhesion. SLA treatment affected the proteomic profile, showing exclusive proteins adsorbed from saliva (14) and plasma (3). However, both groups exhibited close patterns of intensity for common proteins, molecular functions and biological processes mediated by proteins. Interestingly, Ti-ZrSLA showed higher bacterial adhesion (∼1.9 fold over) for the surface coated with plasma proteins. Therefore, SLA treatment of Ti-Zr alloy changed the proteomic profile, which may affect bacterial adhesion.
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Affiliation(s)
- João Gabriel Silva Souza
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Martinna Bertolini
- School of Dental Medicine, University of Connecticut (UCONN), Farmington, CT, USA
| | - Raphael Cavalcante Costa
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | | | - Valentim Adelino Ricardo Barão
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
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16
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Holanda AER, Souza BC, Carvalho ECD, Oliveira RS, Martins FR, Muniz CR, Costa RC, Soares AA. How do leaf wetting events affect gas exchange and leaf lifespan of plants from seasonally dry tropical vegetation? Plant Biol (Stuttg) 2019; 21:1097-1109. [PMID: 31251437 DOI: 10.1111/plb.13023] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 06/25/2019] [Indexed: 06/09/2023]
Abstract
Foliar uptake of dew is likely an important mechanism of water acquisition for plants from tropical dry environments. However, there is still limited experimental evidence describing the anatomical pathways involved in this process and the effects of this water subsidy on the maintenance of gas exchange and leaf lifespan of species from seasonally dry tropical vegetation such as the Brazilian caatinga. We performed scanning electron, bright-field and confocal microscopic analyses and used apoplastic tracers to examine the foliar water uptake (FWU) routes in four woody species with different foliar phenology and widely distributed in the caatinga. Leaves of plants subjected to water stress were exposed to dew simulation to evaluate the effects of the FWU on leaf water potentials, gas exchange and leaf lifespan. All species absorbed water through their leaf cuticles and/or peltate trichomes but FWU capacity differed among species. Leaf wetting by dew increased leaf lifespan duration up to 36 days compared to plants in the drought treatment. A positive effect on leaf gas exchange and new leaf production was only observed in the anisohydric and evergreen species. We showed that leaf wetting by dew is relevant for the physiology and leaf lifespan of plants from seasonally dry tropical vegetation, especially for evergreen species.
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Affiliation(s)
- A E R Holanda
- Graduate Program in Ecology and Natural Resources, Department of Biology, Federal University of Ceará, Fortaleza, Brazil
| | - B C Souza
- Graduate Program in Ecology and Natural Resources, Department of Biology, Federal University of Ceará, Fortaleza, Brazil
| | - E C D Carvalho
- Graduate Program in Ecology and Natural Resources, Department of Biology, Federal University of Ceará, Fortaleza, Brazil
| | - R S Oliveira
- Department of Plant Biology, Institute of Biology, University of Campinas - UNICAMP, Campinas, Brazil
| | - F R Martins
- Department of Plant Biology, Institute of Biology, University of Campinas - UNICAMP, Campinas, Brazil
| | - C R Muniz
- Embrapa Tropical Agroindustry, Fortaleza, Brazil
| | - R C Costa
- Department of Biology, Federal University of Ceará, Fortaleza, Brazil
| | - A A Soares
- Department of Biology, Federal University of Ceará, Fortaleza, Brazil
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17
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Bezerra PMM, Costa RC, Ribeiro ILA, Bonan PRF, Sousa SAD, Valença AMG. Salivary Flow in Pediatric Cancer Patients Compared to Healthy Children and Adolescents. Pesqui bras odontopediatria clín integr 2019. [DOI: 10.4034/pboci.2019.191.141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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18
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Rodrigues JE, Ferrer MM, Cunha TR, Costa RC, Sambrano JR, Rodrigues AD, Pizani PS. First-principles calculations and Raman scattering evidence for local symmetry lowering in rhombohedral ilmenite: temperature- and pressure-dependent studies. J Phys Condens Matter 2018; 30:485401. [PMID: 30403190 DOI: 10.1088/1361-648x/aae803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
ATiO3-type materials may exist in two different crystalline forms: the perovskite and ilmenite. While many papers have devoted their attention to evaluating the structural properties of the perovskite phase, the structural stability of the ilmenite one still remains unsolved. Here, we present our results based on the lattice dynamics and first-principles calculations (density functional theory) of the CdTiO3 ilmenite phase, which are confronted with experimental data obtained through micro Raman spectroscopy that is a very good tool to probe the local crystal structure. Additional Raman bands, which are not foreseen from group-theory for the ilmenite rhombohedral structure, appeared in both low temperature (under vacuum condition) and high-pressure (at room temperature) spectra. The behavior can be explained by considering the local loss of inversion symmetry operation which reduces the overall space group from [Formula: see text] ([Formula: see text]) to [Formula: see text] ([Formula: see text]). Our results can also be extended to other ilmenite-type compositions.
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Affiliation(s)
- J E Rodrigues
- Optical Spectroscopy and Raman Scattering Research Group, Federal University of São Carlos, São Carlos SP 13565-905, Brazil
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19
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Costa RC, Mesquita LP, Nunes MVL, Oliveira IM, Oliveira LFS, Souza AR, Maiorka PC, Varaschin MS. Neospora caninum bioassay in gerbils using placental tissues from naturally infected goats. Vet Parasitol 2017; 249:70-73. [PMID: 29279089 DOI: 10.1016/j.vetpar.2017.11.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 10/25/2017] [Accepted: 11/20/2017] [Indexed: 11/28/2022]
Abstract
Neospora caninum is one of the main agents that causes abortions in cattle worldwide. However, little is known about the pathogenesis of neosporosis in small ruminants, especially goats. Gerbils (Meriones unguiculatus) have been used as a model for neosporosis, and this species is highly susceptible to infection by bovine N. caninum strains. The present study aimed to evaluate the susceptibility of gerbils to a N. caninum isolate from goats. The placentas were obtained from naturally infected goats, that presented with mild to severe lymphoplasmacytic and histiocytic infiltrate, foci of necrosis, calcification and protozoan-like structures. Immunosuppressed gerbils bioassayed with N. caninum-infected placental tissues showed severe neurological signs. Microscopic lesions in these gerbils were characterized by encephalitis, myocarditis, myositis and pancreatitis. These lesions were often associated with a small to moderate number of N. caninum tachyzoites, confirmed by immunohistochemistry and PCR. This is the first report showing that goat N. caninum strains could infect immunocompetent gerbils and cause severe lesions and clinical signs in immunosuppressed gerbils.
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Affiliation(s)
- R C Costa
- Department of Pathology, University of Sao Paulo, Sao Paulo, Brazil; Department of Veterinary Medicine, Federal University of Lavras, Lavras, Brazil.
| | - L P Mesquita
- Department of Pathology, University of Sao Paulo, Sao Paulo, Brazil
| | - M V L Nunes
- Department of Veterinary Medicine, Federal University of Lavras, Lavras, Brazil
| | - I M Oliveira
- Department of Veterinary Medicine, Federal University of Lavras, Lavras, Brazil
| | - L F S Oliveira
- Department of Veterinary Medicine, Federal University of Lavras, Lavras, Brazil
| | - Alinne R Souza
- Department of Veterinary Medicine, Federal University of Lavras, Lavras, Brazil
| | - P C Maiorka
- Department of Pathology, University of Sao Paulo, Sao Paulo, Brazil
| | - M S Varaschin
- Department of Veterinary Medicine, Federal University of Lavras, Lavras, Brazil
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Silva ER, Sancinetti GS, Fransozo A, Azevedo A, Costa RC. Abundance and spatial-temporal distribution of the shrimp Xiphopenaeus kroyeri (Decapoda: Penaeidae): an exploited species in southeast Brazil. BRAZ J BIOL 2016; 76:764-73. [PMID: 27097079 DOI: 10.1590/1519-6984.01814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 06/10/2015] [Indexed: 11/21/2022] Open
Abstract
This study evaluated the abundance and spatial-temporal distribution of the shrimp Xiphopenaeus kroyeri in the coastal region of Macaé, state of Rio de Janeiro, southeastern Brazil. Monthly samples were obtained from March 2008 to February 2010 in six stations located in Inner (5, 10 and 15m depth) and Outer (25, 35 and 45m depth) areas. It was used a commercial fishery boat equipped with an otter-trawl net (3.5 m mouth width, mesh size 20mm and 15mm in the cod end). Water samples were taken for determination of temperature and salinity, and sediment samples for determination of texture and organic matter content. A total of 7146 shrimps were sampled. About 95% of all shrimps were caught in the shallow area, i.e., depths <20m. Greatest abundances were recorded in winter and spring. No significant correlation was observed between sediment (phi) and abundance. The distribution of X. kroyeri in the studied area was closely related to seasonal cold waterfront of the South Atlantic Central Water (SACW) and temperature was the main factor affecting the species abundance.
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Affiliation(s)
- E R Silva
- Núcleo em Ecologia e Desenvolvimento Sócio-Ambiental de Macaé, Universidade Federal do Rio de Janeiro, Universidade Federal do Rio de Janeiro, Macaé RJ , Brazil, Núcleo em Ecologia e Desenvolvimento Sócio-Ambiental de Macaé - NUPEM, Universidade Federal do Rio de Janeiro - UFRJ, Av. Professor Aloísio Teixeira, campus UFRJ-Macaé, CEP 27971-550, Macaé, RJ, Brazil
| | - G S Sancinetti
- Departamento de Zoologia, Instituto de Biociências, Universidade Estadual Paulista "Júlio de Mesquita Filho", Universidade Estadual Paulista, Botucatu SP , Brazil, Núcleo de Estudos em Biologia, Ecologia e Cultivo de Crustáceos - NEBECC, Departamento de Zoologia, Instituto de Biociências, Universidade Estadual Paulista "Júlio de Mesquita Filho" - UNESP, CEP 18618-000, Botucatu, SP, Brazil
| | - A Fransozo
- Departamento de Zoologia, Instituto de Biociências, Universidade Estadual Paulista "Júlio de Mesquita Filho", Universidade Estadual Paulista, Botucatu SP , Brazil, Núcleo de Estudos em Biologia, Ecologia e Cultivo de Crustáceos - NEBECC, Departamento de Zoologia, Instituto de Biociências, Universidade Estadual Paulista "Júlio de Mesquita Filho" - UNESP, CEP 18618-000, Botucatu, SP, Brazil
| | - A Azevedo
- Núcleo em Ecologia e Desenvolvimento Sócio-Ambiental de Macaé, Universidade Federal do Rio de Janeiro, Universidade Federal do Rio de Janeiro, Macaé RJ , Brazil, Núcleo em Ecologia e Desenvolvimento Sócio-Ambiental de Macaé - NUPEM, Universidade Federal do Rio de Janeiro - UFRJ, Av. Professor Aloísio Teixeira, campus UFRJ-Macaé, CEP 27971-550, Macaé, RJ, Brazil
| | - R C Costa
- Faculdade de Ciências, Universidade Estadual Paulista "Júlio de Mesquita Filho", Universidade Estadual Paulista, Bauru SP , Brazil, Laboratório de Biologia de Camarões Marinhos e de Água Doce - LABCAM, Departamento de Ciências Biológicas, Faculdade de Ciências, Universidade Estadual Paulista "Júlio de Mesquita Filho" - UNESP, CEP 17033-360, Bauru, SP, Brazil
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Costa RC, Nóbrega BM, Dantas ELA, Damascena LC, Protásio APL, Valença AMG. Profile of Hospitalizations and Deaths from Craniofacial Fractures in Brazilian Children and Adolescents: An Ecological Study. Pesqui bras odontopediatria clín integr 2016. [DOI: 10.4034/pboci.2016.161.11] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Costa RC, Nóbrega JBM, Dantas ELA, Ribeiro ILA, Lima LNC, Rabello PM, Valença AMG, Santiago BM. Use of the Chronological Dental Mineralization Table of Nicodemo, Moraes and MediciFilho (1974) to Estimate Age by Undergraduate Dentistry Students. Pesqui bras odontopediatria clín integr 2016. [DOI: 10.4034/pboci.2016.161.25] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Pantaleão JAF, Hirose GL, Costa RC. Ocurrence of male morphotypes of Macrobrachium amazonicum (Caridea, Palaemonidae) in a population with an entirely freshwater life cycle. BRAZ J BIOL 2015; 74:S223-32. [PMID: 25627389 DOI: 10.1590/1519-6984.03713] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Accepted: 06/05/2013] [Indexed: 11/22/2022] Open
Abstract
This study records, for the first time, the occurrence of all four male morphotypes in a population of Macrobrachium amazonicum from a continental environment, with an entirely freshwater life cycle. The specimens studied came from the Tietê River, state of São Paulo, Brazil, and were collected in a lotic environment downstream from Ibitinga Dam. This population was compared with other continental populations, including a population from the dam itself, collected in a previous study. Four samples of 30 minutes were taken monthly, using a trap, from January to April 2011. Each male specimen was measured with respect to seven body dimensions as follows: carapace length (CL), right cheliped length (RCL), dactyl length (DCL), propodus length (PPL), carpus length (CRL), merus length (ML) and ischium length (IL). The relative growth was analyzed based on the change in growth patterns of certain body parts in relation to the independent variable CL. The four male morphotypes proposed for the species were found using morphological and morphometric analyses. Different biological characteristics were found between the populations studied. The male population of the lake of Ibitinga and from Pantanal presented mean sizes and number of morphotypes lower than the population studied here. These differences seem to be closely related to ecological characteristics of the environments inhabited by these populations. Our results supported the hypothesis that coastal and continental populations of M. amazonicum belong to the same species.
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Affiliation(s)
- J A F Pantaleão
- Laboratório de Biologia de Camarões Marinhos e de Água Doce - LABCAM, Departamento de Ciências Biológicas, Faculdade de Ciências, Universidade Estadual Paulista "Júlio de Mesquita Filho" - UNESP, Bauru, SP, Brazil
| | - G L Hirose
- Laboratório de Carcinologia, Centro de Ciências Biológicas e da Saúde - CCBS, Universidade Federal de Sergipe - UFS, São Cristóvão, SE, Brazil
| | - R C Costa
- Laboratório de Biologia de Camarões Marinhos e de Água Doce - LABCAM, Departamento de Ciências Biológicas, Faculdade de Ciências, Universidade Estadual Paulista "Júlio de Mesquita Filho" - UNESP, Bauru, SP, Brazil
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Horta ML, Morejon LCL, da Cruz AW, Dos Santos GR, Welling LC, Terhorst L, Costa RC, Alam RUZ. Study of the prophylactic effect of droperidol, alizapride, propofol and promethazine on spinal morphine-induced pruritus. Br J Anaesth 2006; 96:796-800. [PMID: 16597655 DOI: 10.1093/bja/ael072] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND We have compared the use of alizapride, propofol, droperidol and promethazine for the prevention of spinal morphine-induced pruritus. METHODS Three hundred ASA I or II women undergoing Caesarean section under spinal anaesthesia, in which morphine 0.2 mg was added to a local anaesthetic, were assigned randomly to receive i.v., in the operating room, just after delivery of the baby, alizapride 100 mg, propofol 20 mg, droperidol 1.25 mg, promethazine 50 mg or saline 2 ml (control group). In the postoperative period, the women were assessed for pruritus (absent, mild, moderate or severe) or other untoward symptoms by blinded observers. We used 95% confidence limits (95% CI) for the cumulative incidence of moderate and severe pruritus to compare the groups, and the NNT and 95% CI to compare droperidol, propofol and alizapride as for their effectiveness in preventing pruritus. For other untoward effects, the chi(2)-test was used, results being considered significant when P<0.05. RESULTS The droperidol, propofol and alizapride groups had significantly lower incidences of pruritus compared with the control and promethazine groups, while the incidence of pruritus was similar among the patients assigned to the promethazine and control groups. As for the prevention of moderate and severe pruritus, droperidol had the lowest NNT (3.52; 95% CI: 3.37-3.67), followed by propofol (4.61; 95% CI: 4.45-4.77) and alizapride (5.43; 95% CI: 5.27-5.59). As for untoward effects, droperidol and promethazine increased the incidence of somnolence, which seemed more severe with promethazine. Otherwise, there were no differences between the groups. CONCLUSION Droperidol, propofol and alizapride, in a decreasing order of effectiveness in the doses used in this study, reduced the incidence of pruritus induced by the use of morphine 0.2 mg intrathecally. On the other hand, promethazine 50 mg was shown to be ineffective.
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Affiliation(s)
- M L Horta
- Department of Anaesthesiology, Hospital Universitário São Francisco de Paula da UCPEL, Pelotas, RS, Brazil.
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Gomes P, Costa J, Martins J, Gutierrez F, Mousalem L, Simões S, Pereira S, Mesquita A, Araújo L, Rosemblat M, Costa R. Crit Care 2005; 9:P102. [DOI: 10.1186/cc3646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Corrêa P, Felix R, Campos L, Costa R, Costa J, Esporcatte R, Guttfile B, Mesquita E, Volchan A, Mesquita C, Fonseca L. Crit Care 2003; 7:P38. [DOI: 10.1186/cc2234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Costa R, Fleury R, Favero A, Chacur F, Gomes P, Simões S, Martins J, Costa J. Crit Care 2001; 5:P94. [DOI: 10.1186/cc1427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Carazzato JG, Costa RC. [The ideal age for starting sportive practice]. Rev Hosp Clin Fac Med Sao Paulo 1991; 46:311-4. [PMID: 1843744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The authors analyse the benefits of physical activities for the different systems of the organism. They discuss four basic phases of the human being as to of his motor and physical development since his birth until the end of puberty. The physical activities that should be performed in each one of these phases are described.
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Affiliation(s)
- J G Carazzato
- Departamento de Ortopedia e Traumatologia, Faculdade de Medicina, Universidade de São Paulo
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Abstract
To gain insight into the activity of cytosolic proteases in tumors, the ATP-dependent proteolysis of cell sap and the ATP- and ubiquitin-dependent proteolysis of Fraction II (a cytosolic subfraction freed of endogenous ubiquitin) were measured in the anaplastic Yoshida ascites hepatoma AH 130. Hepatoma cell sap showed only low, although significant, ATP-stimulated proteolysis, as best seen by comparisons with rat liver made on the basis of wet weight. Much of the basal proteolytic activity of cell sap and of its subfraction enriched in high Mr complexes (Fraction X) peaked near 18S in sucrose gradients. In contrast with cell sap, Fraction II from hepatoma degraded [14C]methylcasein more efficiently than Fraction II from normal liver, but the activities for liver and tumor did not differ on a wet weight basis. Altered polypeptide patterns shown by SDS-PAGE in the Yoshida hepatoma suggested that some abundant hepatoma-specific cytosolic protein might interfere with degradation of the [14C]methylcasein by hepatoma.
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Affiliation(s)
- R C Costa
- Institute of General Pathology, University of Milano, Italy
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Cordeiro EN, Costa RC, Carazzato JG, Silva JDS. Periprosthetic fractures in patients with total knee arthroplasties. Clin Orthop Relat Res 1990:182-9. [PMID: 2302883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Ten patients with total knee arthroplasties sustained periprosthetic fractures. Nine of these were supracondylar fractures, and one occurred in the middle one-third of the tibia. These patients were treated with conservative methods in two cases and internal fixation with plate and screws in three cases. The remaining five patients were treated with intramedullary fixation using a specially designed revision prosthesis with long intramedullary stems. The best results wer achieved through the revision arthroplasty, based on walking ability, range of motion, and early rehabilitation.
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Affiliation(s)
- E N Cordeiro
- Department of Orthopaedics and Traumatology, University of São Paulo, Brazil
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Costa RC, Lacerda AA, Cordeiro JM, Esteves MS. [Semiologic x-ray computed tomography patterns of benign tumors of the liver]. ACTA MEDICA PORT 1989; 2:138-41. [PMID: 2696328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Specific benign lesions may be suggested when appropriate c.t. findings are detected in the liver. Characteristic c.t. patterns which may contribute to the study of hepatic masses are described and the importance of their recognition to the differential diagnosis is referred.
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Cordeiro EN, Costa RC, Carazzato JG, Suzuki I. [Total arthroplasty of the knee: study based on 180 cases]. Rev Hosp Clin Fac Med Sao Paulo 1986; 41:161-6. [PMID: 3602815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Carazzato JG, Hori AH, Ribak S, Napoli MM, Cordeiro EN, Costa RC. [Surgical treatment of varus deformity of the foot in cerebral palsy]. Rev Hosp Clin Fac Med Sao Paulo 1986; 41:181-6. [PMID: 3602818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Costa RC, Cordeiro EN, Carazzato JG, Basile R, Suzuki I. [Total arthroplasty of the hip in inveterate congenital dislocation]. Rev Hosp Clin Fac Med Sao Paulo 1986; 41:173-6. [PMID: 3602817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Costa RC. [Use of proteolytic enzymes, isolated or in combination with antibiotics, in orthopedics and in injuries]. Rev Bras Med 1969; 26:696-9. [PMID: 5396435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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