[Efficacy of hydrotherapy versus gym treatment in primary total knee prosthesis due to osteoarthritis: a randomized controlled trial]

BACKGROUND

Physiotherapy is postulated as an effective treatment after total knee arthroplasty (TKA). The objective of the study was to assess the efficacy of hydrotherapy versus gym kinesitherapy during the second phase of treatment in TKA patients, with regard to the improved gait test, pain, stiffness, joint balance, muscle strength and inflammation.

METHODS

A controlled and randomized trial was carried out. TKA patients received a first rehabilitative phase (15 60-minutes sessions) at the gym. In the second phase (15 40-minute sessions), one group performed physiotherapy in a gym and another in a swimming pool. Different variables were assessed (basal, after 15 and after 30 ses-sions): functional capacity, pain and stiffness with WOMAC index, joint balance with goniometer; muscle strength with Lovett scale, and result of 6-minute gait test.

RESULTS

A total of 115 patients participated, 59 (51.3%) in the gym group and 56 (48.7?%) in the pool group. After the second phase of re-habilitation, higher clinical improvements were observed in the pool group, with statistically significant differences in pain (p?=?0.005), stiffness (p?=?0.010), joint balance (p?=?0.027) and muscle strength (p?=?0.049) in the operated knee, and in the result of the 6-minute gait test (p?=?0.002).

CONCLUSIONS

In TKA patients, hydrotherapy during the second phase of rehabilitative treatment was more effective than gym physiother-apy in terms of improved pain, stiffness, joint balance, muscle strength and gait testing.

Molecular subtypes and clinicopathological features of breast cancer in Mexican women

BACKGROUND

Breast cancer is a multifactorial and heterogeneous disease with distinct molecular features and histopathologic subtypes involving different therapeutic responses and clinical outcomes. Classification of breast cancer in molecular subtypes has made possible an approach to develop therapeutic strategies in order to have a better understanding of the breast cancer development. Due to the heterogeneity of the disease, there are still features to be elucidated in the behavior, etiology and clinical outcomes of each molecular subtype in breast cancer.

METHODS

Variables measured in 1,695 cases of invasive breast carcinoma were age, histopathological diagnosis, histopathological grade, expression of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor-2 (HER2), cell proliferation marker (Ki67) and basal cytokeratins (CK 5/6). P values were obtained using Chi square test and hazard ratios were calculated with 95% confidence intervals.

RESULTS

An increase of aggressive molecular subtypes of breast cancer was observed. The mean age of incidence of breast cancer patients is decreasing, and breast cancer Patients younger than 40-years-old showed higher risk to exhibit Triple negative and Basal-like tumors.

CONCLUSIONS

The mean age for this pathology is decreasing in our population and there is predominance in the differential occurrence of etiologically distinct entities of breast cancer affecting to the young women.

Influence of Spectroscopic Techniques on the Estimation of the Degree of Conversion of Bulk-fill Composites

OBJECTIVES

To compare the degree of conversion (DC) of different flowable and sculptable bulk-fill composites (BFC), at 0- and 4-mm depths from the surface, by Fourier transform infrared (FTIR), attenuated total reflection FTIR (ATR-FTIR), and FT-Raman spectroscopic techniques.

METHODS AND MATERIALS

Six BFC were investigated, including three sculptable composites (Admira Fusion [Voco], Aura Bulk Fill [SDI], and X-tra Fill [Voco]) and three flowable composites (Venus Bulk Fill [Heraeus], Filtek [3M], and X-tra Base [Voco]). Three molds of each composite were light cured as specified by the manufacturer. For each mold, slices corresponding to 0-mm (surface) and 4-mm depth were analyzed by spectroscopic techniques: ATR-FTIR, FTIR, and FT-Raman. The spectra of uncured composite material were used as an analytical control for background subtraction of the treated composite. The area and amplitude of the reference peaks (1607 and 1637 cm^-1) were obtained to calculate the DC percentage at 0- and 4-mm depth. A Kruskal-Wallis nonparametric test was used for materials, and paired comparisons were made using Mann-Whitney nonparametric test. Wilcoxon's rank test was used for comparison between spectroscopic methods and between 0- and 4-mm depth in each composite. Significance was accepted at p<0.05.

RESULTS

FTIR showed significantly lower DC values, both in areas and amplitudes of the peaks, when compared with the results reported by different BFC. Differences between the surface and 4-mm depth were detected more precisely by FT-Raman. ATR-FTIR obtained DC values significantly higher than those obtained by FTIR.

CONCLUSIONS

The vibrational spectroscopy method significantly influenced DC measurements of the flowable and sculptable BFC explored.

[Frequency of cervical epithelial lesions reported in the Regional Laboratory of Exfoliative Cytology in Jalisco]

BACKGROUND

The Official Mexican Norm for the prevention, treatment and control of Cervical Cancer (CC) indicates that the Papanicolau (Pap) is the procedure for the detection of this neoplasia; therefore, it is of interest to know the prevalence of suspected cases by this technique in Mexican population. In this study, we show the diagnosed cases in the State of Jalisco, México.

METHODS

A retrospective study was made to the samples that arrived for their analysis to the Laboratorio Regional de Citología Exfoliativa (LARCE), of the Instituto Mexicano del Seguro Social (IMSS) in Guadalajara, Jalisco. We considered all cases from January 2010 to December 2012.

RESULTS

We analyzed 188 095 cases, from which 5.3 % had a diagnosis of low dysplasia, 0.18 % of moderated dysplasia and 0.05 % of high dysplasia. Microinvasive and invasive cancer showed a low frequency (0.03 %).

CONCLUSIONS

The frequency of abnormal findings identified by vaginal cervical cytology is relatively low. The number of inadequate and limited samples for cytological assessment is high; there is a high proportion of women attending for the first time in life to cytology evaluation in older age groups.

Effect of CHX on the Decalcifying Effect of 10% Citric Acid, 20% Citric Acid, or 17% EDTA

The objective of this study was to measure the demineralization capacity of 10% and 20% citric acid and 17% EDTA after three time periods and to determine whether it was modified by the addition of 1% of commercial chlorhexidine (CHX). Three slices of 2-mm thickness were cut from the cervical third of the root of ten bovine incisors and sectioned into two equal parts, obtaining six specimens per tooth. Specimens were assigned to one of six groups (n = 10) for immersion in 25 ml of the above mentioned solutions or 25 ml of these same solutions plus 1% CHX (Hibimax). At 3, 10, and 15 min of immersion, the concentration of Ca2+ was measured by atomic absorption spectrophometry. The demineralization effect of all solutions was time-dependent (F = 158,448; p < 0.001), without significant differences among them (p = 0.783). Addition of 1% CHX did not modify the demineralizing capacity of these solutions. In the first three minutes, significantly more [Ca2+] was obtained when 17% EDTA was used in comparison with the other solutions.

Individualized wedge

The preparation of an individualized wedge in the gingival embrasure before cavity preparation using photo-cured resin permits rehabilitation of the interproximal space and the original contact point position. Because the individualized wedge completely fills the embrasure, the adaptation to the gingival and proximal walls of the molar to be restored is perfect, avoiding any overextension of obturation material during insertion. Furthermore, the original position of the contact point is preserved.

Influence of different composite restoration techniques on cuspal deflection: an in vitro study

Cuspal deflection produced by polymerization shrinkage was measured after using different composite restoration techniques. This study included 30 healthy premolars embedded in acrylic resin connected to a system that simulated intrapulpal pressure. A small ball was attached to each cuspal vertex as a reference point for intercuspal distance measurements. A large mesio-occlusal cavity was cut in each premolar. All premolars were treated with the same adhesive (ScotchBond) and composite (Tetric Ceram). The teeth were randomly distributed among three study groups: Group 1, filled with two horizontal increments; Group 2, filled with two horizontal increments, the first up to half the cavity height and light cured using a transparent plastic cone (Cerana), and the second filling the remainder of the cavity and Group 3, filled in the same way as Group 2, except that the first increment only filled one-third of the cavity height. The intercuspal distance was measured before beginning the restoration and immediately after polymerization of the first and second increments. Under the experimental conditions used, none of the filling techniques utilized avoided the cuspal deflection phenomenon. Polymerization of the final increment, which binds occlusal enamel in the buccal-lingual plane, was the main cause of cuspal deflection and produced a statistically significant reduction in intercuspal distance vs the baseline measurement in the three study groups. The global deflection ranged from 4 microm to 6 microm, depending on the filling technique used, although the differences among techniques did not reach statistical significance (p<0.05).

Decalcification of root canal dentine by citric acid, EDTA and sodium citrate

AIM

To measure the demineralization capability of 1 and 10% citric acid, 10% sodium citrate and 17% EDTA during immersions of 5, 10 and 15 min on root canal dentine.

METHODOLOGY

Crowns were sectioned from eight maxillary canines. The cementum was removed from the cervical third of the roots to expose the dentine. Canals were prepared using a handpiece-mounted Largo Peeso reamer. A 3-mm thick cross-sectional slice was obtained from the cervical third of each root. Each slice was sectioned into four equal parts. These specimens were assigned to one of four groups (n = 8) for the application of 1% citric acid, 10% citric acid, 10% sodium citrate or 17% EDTA. Each specimen underwent three successive 5-min immersions in each solution at room temperature. The solutions were not renewed between immersions. Two millimetres of solution were collected from the extracts and lanthanum oxide was added for the calcium reading by spectrophotometry. To compare the amounts of calcium removed by each solution, the Friedman test was used for the global comparison and the Wilcoxon test for paired comparisons. Differences between groups were evaluated using the Kruskal-Wallis test for the global comparison and Mann-Whitney test for paired comparisons.

RESULTS

Overall, 1 and 10% citric acid were more effective than EDTA or sodium citrate at the three immersion times (P < 0.001); 10% citric acid was more effective than 1% citric acid (P < 0.001). EDTA and 1 and 10% citric acid showed decreasing effectiveness with time, and the decrease was significant for citric acid at both concentrations (P < 0.001). Although sodium citrate removed little calcium during the three time periods, the small increase recorded was significant (P < 0.01).

CONCLUSIONS

Citric acid at 10% was the most effective decalcifying agent, followed by 1% citric acid, 17% EDTA and 10% sodium citrate.

The effect of various surface treatments and bonding agents on the repaired strength of heat-treated composites

STATEMENT OF PROBLEM

Some clinical situations may require the repair of a secondary polymerized or aged composite. The higher indirect resin conversion rate may prove to be a disadvantage if a repair procedure based on covalent bonding from unreacted methacrylate groups is attempted.

PURPOSE

This study evaluated the effectiveness of different combinations of surface treatments and 2 bonding agents used to enhance heat-polymerized and aged composite repairs.

MATERIAL AND METHODS

Ninety Herculite XRV and 90 Heliomolar Radiopaque specimens were prepared and then postpolymerized and stored for 4 weeks. All composites were subjected to 1 of 9 treatment regimens that involved adding fresh composite onto a corresponding postpolymerized composite (Herculite/Herculite or Heliomolar/Heliomolar). The surfaces were treated with different combinations of air abrasion, phosphoric acid, hydrofluoric acid, acetone, Special Bond II, Heliobond, and Prime & Bond 2.0.

RESULTS

Surface treatment with air abrasion resulted in the strongest repairs; surface treatment with phosphoric acid resulted in the weakest repairs.

CONCLUSION

The use of air abrasion and Prime & Bond 2.0 adhesive consistently improved the shear bond strength for both composites tested.