This study aimed to assess the acute and delayed cytotoxicity of three, popular light-cured methacrylate-based restorative resins (MRs): Charisma (C), Estelite (E), and Filtek (F), to human gingival fibroblasts in culture. Cells were grown for up to 24 h with light-cured (or pre-cured) resins. We evaluated resin cytotoxicity, redox imbalance, necrosis/apoptosis, miR-9, and heat shock protein 70 (HSP70). The role of resin-induced oxidative stress (damage) in HSP70-response (repair) was assessed using binary fluorescence labeling. All MRs decreased viable cell numbers and cell proliferation and damaged cell membranes, and their 24 h-delayed toxicity was lower (C), higher (F), or similar (E) to that induced by freshly-cured resins. Cell membrane damage induced by C and E decreased with time, while F produced a linear increase. All resins generated intracellular oxidative stress with the predominant necrotic outcome, and produced heterogeneous responses in miR-9 and HSP70. The double fluorescence (damage/repair) experiments pointed to common features of E and F but not C. In the subset of cells, the binary response induced by E and F was different from C, similar to each other, and positively interrelated. Experimental data show that selective MR cytotoxicity should be taken into account when considering repetitive use or massive reconstruction.
Background:The perspective of palliative care has changed dynamically over the years, and palliative medicine, which was originally concerned with patients with advanced oncology diseases, has become an interdisciplinary area. Many societies have published guidelines for the use of palliative medicine in intensive care units. Methods: This article presents indications and methods for implementing the principles of palliative medicine in intensive care units. Particular attention is devoted to the consultations of palliative medicine for current medical trends -COVID-19 infection, oncological diseases, fragility syndrome, and end-stage circulatory failure. Conclusions: Elements of palliative medicine are necessary for everyday practices in the intensive care unit. The most important task in cooperation is to present classifications that can help in the objective identification of patients requiring palliative care. It seems that creating a checklist of the qualifications for a palliative medicine consultation can be the next step towards making decisions about this form of therapy.
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