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Non-Hodgkin's Lymphoma (NHL) is a malignancy of the lymphoid lineage of the hematopoietic system has worldwide, especially in developed countries. Better diagnostic and recording techniques, longer life expectancy, and greater exposure to risk factors are hypotheses for this growing incidence curve. Occupational exposures to chemical, biological, and physical agents have also been associated with NHL development, but the results are still controversial. We have investigated the occupational and lifestyle case-control study design with 214 adult patients and 452 population controls. Socio-demographic, clinical, and occupational exposure data were obtained through individual interviews with a standardized questionnaire. Clinical, laboratory, and histopathological data were obtained through medical records. Risk of NHL (any subtype), B-cell lymphoma, DLBCL, Follicular lymphoma and T-cell lymphoma was elevated among the those who had ever been exposed to any solvents, hydrocarbon solvents, pesticides, meat and meat products, and sunlight and tended to increase by years of exposure. A significant upward trend with years of exposure was detected for any solvents and hydrocarbon solvents (NHL (any subtype) p-value for trend<0.001), B-cell lymphoma (p-value for trend<0.001), and T-cell lymphoma (p-value for trend<0.023), pesticides (NHL (any subtype), p for trend<0.001) and T-cell lymphoma (p for trend<0.002), meat and meat products (NHL (any subtype) (p for trend<0.001) and DLBCL (p for trend<0.001), and sunlight (B-cell lymphoma (p for trend<0.001). The results of this study agree line with other international studies, can be extrapolated to other countries that have the same socio-demographic and occupational characteristics as Brazil and support strategies for surveillance and control of work-related cancer.
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Linfoma de Células B , Linfoma de Células T Periférico , Linfoma de Células T , Exposição Ocupacional , Praguicidas , Adulto , Humanos , Estudos de Casos e Controles , Exposição Ocupacional/efeitos adversos , Fatores de Risco , Solventes/efeitos adversos , HidrocarbonetosRESUMO
Leukocyte-platelet-rich fibrin (L-PRF) contains growth factors that stimulate bone regeneration. This study evaluated the bone repair in a tibia rat model around two implant surfaces in combination or not with L-PRF by assessing microtomographic and histomorphometric parameters. A total of 48 female rats were used in the study, in which 24 received implants with two types of surface treatments (dual acid etched-DAE or nanohydroxyapatite-nanoHA), and the other 24 received the same mini implants with L-PRF, which was collected by cardiac puncture, centrifugated, and inserted in the bone bed. The animals were euthanized 7 and 30 days after implant placement, and the retrieved samples were prepared for microtomographic and histomorphometric (bone-to-implant contact-BIC; and Bone Area Fraction Occupancy-BAFO) analyses. The adhesion of the nanoHA surface onto the implant surface was investigated by insertion and removal in simulated bone medium (Sawbones). The adhesion evaluation revealed that the loss of nanoHA after this procedure (as measured with SEM) from the implant surface was less than 1%. Overall, the nanoHA surface presented more bone in contact and in proximity to the implant, a higher bone surface/tissue volume fraction, a higher number of bone trabeculae, as well as trabecular separation relative to the DAE surface. Such results were more evident when the nanoHA surface was combined with L-PRF and after 30 days in vivo. The nanoHA surface presented higher BAFO when compared to DAE, with or without association with L-PRF. Therefore, implants with a nanoHA surface potentially benefit from the association to L-PRF.
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BACKGROUND: Gingival recession (GR) is described as an apical displacement of the gingival margin in relation to the cementoenamel junction, exposing the root surface to the oral cavity environment. This study aimed to evaluate the clinical results of a bilateral root coverage (RC) of GR associated with an autogenous connective tissue graft (aCTG) alone or combined with low-level laser therapy (aCTG + LLLT). METHODS: This cross-sectional, split-mouth, double-blind, clinical pilot study featured three individuals who attended a periodontics post-graduate program with the main complaint of GR and dental hypersensitivity (DHS). Of these, only one patient met the inclusion criteria and the parameters evaluated were: DHS, the keratinized tissue's thickness and width clinical attachment level (CAL), probing on depth (PD), and bilateral GR based on Cairo RT I. The patient was evaluated by a first clinical evaluator and the treatment was randomly divided into two groups, G1: aCTG only (control group, n = 3 teeth per side) and G2: aCTG + LLLT (test group, n = 3 teeth per side). LLLT used a diode laser (660 nm) with a dose of 3 J/cm2 per point and 4 s per point was applied in four different periods, preoperatively; transoperatively and immediately postoperatively, the application was performed in three points (eight applications) on alternate days for 7 days and a 90-day follow-up was performed for clinical evaluations of the periodontal parameters and the collected data were analyzed by Kruskal-Wallis and Dunn tests. RESULTS: the RC mean percentage was <95% in both groups after 90 days. Comparing treatment sides, G1 (n = 3/3, 100%) had a higher prevalence of RC than G2 had (n = 3/3, 95%). DHS significantly decreased after 90 days in both groups. Both groups showed an improvement in the other periodontal parameters evaluated during the short-term follow-up; mainly, PD had a statistically significant (p Ë 0.05) increase after 90 days and a CAL decrease during this period; KTW and KTT also had a significant increase in both groups (p Ë 0.05). CONCLUSIONS: the results indicated that aCTG + LLLT might have an additional benefit to GR root coverage within the evaluated time and this section also includes the within-study limitations.
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Background: Throughout recent years, periodontal disease (PD) has been linked to innumerable medical systemic conditions, such as cardiovascular disease (CVD). This association could negatively impact oral health, so the knowledge of dentists who have graduated must follow modern dentistry in order to promote oral health, mainly in systemically compromised patients. Therefore, the present study aimed to determine and evaluate the knowledge level of dentistry undergraduate students (DUS) regarding the correct periodontal treatment and management of cardiac patients with PD. Methods: This cross-sectional and populational-based study was conducted between March and June 2022 in northern Brazil. A total of 153 DUS received an anonymous digital form (Google Forms Platform) using a non-probabilistic "snowball" sampling technique. The digital form was composed of four blocks of dichotomous and multiple-choice questions. After signing the informed consent term, DUS were divided into three groups according to their period/semester in dentistry graduation during the study time (G1: 1st period/semester; G2: 5th period/semester and G3: 10th period/semester). A total of 25 questions referring to demographic, educational and knowledge data about the dental and periodontal care of cardiac patients with PD were asked, and all data were presented as descriptive percentages and then analyzed using the Kappa test. Results: From a total of 153 (100%) DUS, the sample was mostly composed of 104 (68%) female participants, with an average age of 21.1 years. Regarding basic knowledge, the majority of answers were no, with G1 being higher than G2 and G3. Regarding clinical questions, 1247 (58.3%) answers were no. Additionally, regarding fundamental clinical questions 1, 2, 3, 7, 9, 11, 13 and 14, the majority of G1, G2 and G3 answered no, demonstrating a major lack of knowledge. Conclusions: In our study, DUS demonstrated a low knowledge level of the dental and periodontal care of cardiac patients with PD and its bi-directional link. Thus, according to our results, an improvement in dentistry educational programs regarding periodontal medicine must be implemented.
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Doenças Cardiovasculares , Doenças Periodontais , Humanos , Feminino , Adulto Jovem , Adulto , Masculino , Doenças Cardiovasculares/complicações , Estudos Transversais , Doenças Periodontais/complicações , Doenças Periodontais/terapia , Estudantes , OdontologiaRESUMO
INTRODUCTION: Acute kidney injury (AKI) is one of the main complications of COVID-19 caused by SARS-CoV-2. This study aimed to evaluate the incidence of AKI in Brazilian hospitalized patients diagnosed with COVID-19 and identify the risk factors associated with its onset and those associated with its prognosis. METHODS: A prospective cohort study of hospitalized patients diagnosed with COVID-19 at a public and tertiary university hospital in São Paulo from March to December 2020. RESULTS: There were 347 patients hospitalized with COVID-19, 52.4% were admitted to the intensive care unit (ICU) and 47.6% were admitted to the wards. The overall incidence of AKI was 46.4%, more frequent in the ICU (68.1% vs 22.4, p < 0.01) and the overall mortality was 36.1%. Acute kidney replacement therapy was indicated in 46.6% of patients with AKI. In the general population, the factors associated with AKI were older age (OR 1.03, CI 1-1.05, p < 0.05), mechanical ventilation (OR 1.23, CI 1.06-1.83, p < 0.05), presence of proteinuria (OR 1.46, CI 1.22-1.93, p < 0.05), and use of vasoactive drugs (OR 1.26, CI 1.07-1.92, p < 0.05). Mortality was higher in the elderly (OR 1.08, CI 1.04-1.11, p < 0.05), in those with AKI (OR 1.12, CI 1.02-2.05, p < 0.05), particularly KDIGO stage 3 AKI (OR 1.10, CI 1.22-2.05, p < 0.05) and in need of mechanical ventilation (OR 1.13, CI 1.03-1.60, p < 0.05). CONCLUSION: AKI was frequent in hospitalized patients with COVID-19 and the factors associated with its development were older age, mechanical ventilation, use of vasoactive drugs, and presence of proteinuria, being a risk factor for death.
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Injúria Renal Aguda , COVID-19 , Doenças Transmissíveis , Humanos , Idoso , COVID-19/complicações , COVID-19/epidemiologia , SARS-CoV-2 , Brasil/epidemiologia , Estudos Prospectivos , Incidência , Estudos Retrospectivos , Prognóstico , Doenças Transmissíveis/complicações , Unidades de Terapia Intensiva , Injúria Renal Aguda/epidemiologia , Injúria Renal Aguda/etiologia , Injúria Renal Aguda/terapia , Fatores de Risco , Mortalidade Hospitalar , Proteinúria/complicaçõesRESUMO
Background: In the absence of direct therapy for COVID-19, extracorporeal blood treatment (EBT) could represent an option for cytokine removal. Objective: This study aimed to describe and compare cytokine removal during intermittent haemodialysis (IHD) and continuous renal replacement therapy (CRRT) in COVID-19 patients with Acute Kidney Injury (AKI). Methods: It was a cohort study that studied patients with COVID-19-related AKI according to KDIGO criteria and admitted at Intensive Care Unit (ICU). Blood samples were collected at the start and end of both IHD using high flux (HF) membranes (10 patients) and continuous venovenous haemodiafiltration (CVVHDF:10 patients) in two sessions for measuring 13 different plasma interleukins and calculating the cytokine removal rate. Results: There was no difference between the two groups regarding mechanical ventilation, vasoactive drug, age or prognostic scores. Patients treated by CRRT presented higher levels of IL-2 and IL-8 than patients treated by IHD at dialysis start. Cytokine removal ranged from 9% to 78%. Patients treated by CRRT presented higher cytokine removal for IL-2, IL-6 IL-8, IP-10 and TNF. The removal rates of IL-4, IL-10, IL-17A, IFN, MCP-1 and TGF-B1 were similar in two groups. After one session of CVVHDF (24 h), IL-2 and IL-1ß levels did not vary significantly, whereas IL-4, IL-6, IL-8, IL-10, IL-17A, TNF, IFN, IP-10, MCP-1, IL-12p70 and TGF-B1 decreased by 33.8-76%, and this decrease was maintained over the next 24 h. In IHD groups, IL-2, IL-6, TNF, IP-10 and IL-1ß levels did not decrease significantly whereas IL-4, IL-8, IL-10, IL-17A, IFN, MCP-1, IL-12p70 and TGF-B1 decreased by 21.8-72%; however, cytokine levels returned to their initial values after 24 h. Conclusion: Cytokine removal is lower in IHD using HF membranes than in CVVHDF, and in IHD the removal is transient and selective, which can be associated with mortality during cytokines storm-related COVID-19.
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Introduction: Elderly patients with COVID-19 are at a higher risk of severity and death as not only several comorbidities but also aging itself has been considered a relevant risk factor. Acute kidney injury (AKI), one of the worst complications of SARS-CoV-2 infection, is associated with worse outcomes. Studies on AKI with COVID-19 in Latin-American patients of older age remain scarce. Objectives: To determine AKI incidence and the risk factors associated with its development, as well as to compare outcome of elderly patients with or without AKI associated with SARS-CoV-2 infection. Methods: This retrospective cohort study evaluated patients with SARS-CoV2 infection admitted to a Public Tertiary Referral Hospital from 03/01/2020 to 12/31/2020, from admission to resolution (hospital discharge or death). Demographic, clinical, and laboratory data were collected from patients during hospitalization. Daily kidney function assessment was performed by measuring serum creatinine and urine output. AKI was diagnosed according to KDIGO 2012 criteria. Results: Of the 347 patients with COVID-19 admitted to our hospital during the study period, 52.16% were elderly, with a median age of 72 years (65- 80 years). In this age group, most patients were males (56.91%), hypertensive (73.48%), and required ICU care (55.25%). AKI overall incidence in the elderly was 56.9%, with higher frequency in ICU patients (p < 0.001). There was a predominance of KDIGO 3 (50.48%), and acute kidney replacement therapy (AKRT) was required by 47.57% of the patients. The risk factors associated with AKI development were higher baseline creatinine level (OR 10.54, CI 1.22 -90.61, p = 0.032) and need for mechanical ventilation (OR 9.26, CI 1.08-79.26, p = 0.042). Mortality was also more frequent among patients with AKI (46.41%vs24.7%, p < 0.0001), with death being associated with CPK level (OR 1.009, CI 1.001-1.017, p = 0.042), need for mechanical ventilation (OR 17.71, CI 1.13-277.62, p = 0.002) and KDIGO 3 (OR 2.017 CI 1.039 -3.917, p = 0.038). Conclusion: AKI was frequent among the elderly hospitalized with COVID-19 and its risk factors were higher baseline creatinine and need for mechanical ventilation. AKI was independently associated with a higher risk of death.
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Renal involvement is frequent in COVID-19 (4-37%). This study evaluated the incidence and risk factors of acute kidney injury (AKI) in hospitalized patients with COVID-19. Methodology: This study represents a prospective cohort in a public and tertiary university hospital in São Paulo, Brazil, during the first 90 days of the COVID-19 pandemic, with patients followed up until the clinical outcome (discharge or death). Results: There were 101 patients hospitalized with COVID-19, of which 51.9% were admitted to the intensive care unit (ICU). The overall AKI incidence was 50%; 36.8% had hematuria or proteinuria (66.6% of those with AKI), 10.2% had rhabdomyolysis, and mortality was 36.6%. Of the ICU patients, AKI occurred in 77.3% and the mortality was 65.4%. The mean time for the AKI diagnosis was 6 ± 2 days, and Kidney Disease Improving Global Outcomes (KDIGO) stage 3 AKI was the most frequent (58.9%). Acute renal replacement therapy was indicated in 61.5% of patients. The factors associated with AKI were obesity [odds ratio (OR) 1.98, 95% confidence interval (CI) 1.04-2.76, p < 0.05] and the APACHE II score (OR 1.97, 95% CI 1.08-2.64, p < 0.05). Mortality was higher in the elderly (OR 1.03, 95% CI 1.01-1.66, p < 0.05), in those with the highest APACHE II score (OR 1.08, 95% CI 1.02-1.98, p < 0.05), and in the presence of KDIGO stage 3 AKI (OR 1.11, 95% CI 1.05-2.57, p < 0.05). Conclusion: AKI associated with severe COVID-19 in this Brazilian cohort was more frequent than Chinese, European, and North American data, and the risk factors associated with its development were obesity and higher APACHE II scores. Mortality was high, mainly in elderly patients, in those with a more severe disease manifestation, and in those who developed KDIGO stage 3 AKI.
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This study evaluated the response of a nano-hydroxyapatite coating implant through gene expression analysis (runt-related transcription factor 2 (Runx2), alkaline phosphatase (Alp), osteopontin (Opn), osteocalcin (Oc), receptor activator of nuclear factor-kappa B (Rank), receptor activator of nuclear factor-kappa B ligand (Rank-L), and osteoprotegerin (Opg)). Three-dimensional evaluation (percent bone volume (BV/TV); percent intersection surface (BIC); bone surface/volume ratio (BS/BV); and total porosity (To.Po)) were also analyzed. Mini implants were surgically placed in tibias of both healthy and diabetic rats. The animals were euthanized at 7 and 30 days. Evaluating all factors the relative expression of Rank showed that NANO surface presented the best results at 7 days (diabetic rats). Furthermore the levels of Runx2, Alp, Oc, and Opn suggest an increase in osteoblasts proliferation, especially in early stages of osseointegration. %BIC in healthy and diabetic (7 days) depicted statistically significant differences for NANO group. BV/TV, BS/BV and To.Po demonstrated higher values for NANO group in all evaluated time point and irrespective of systemic condition, but BS/BV 30 days (healthy rat) and 7 and 30 days (diabetic rat). Microtomographic and gene expression analyses have shown the benefits of nano-hydroxyapatite coated implants in promoting new bone formation in diabetic rats.
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Regeneração Óssea/efeitos dos fármacos , Materiais Revestidos Biocompatíveis/farmacologia , Durapatita/farmacologia , Regulação da Expressão Gênica/efeitos dos fármacos , Implantes Experimentais , Nanopartículas , Osteogênese/efeitos dos fármacos , Microtomografia por Raio-X , Animais , Subunidade alfa 1 de Fator de Ligação ao Core/biossíntese , Subunidade alfa 1 de Fator de Ligação ao Core/genética , Diabetes Mellitus Experimental , Durapatita/uso terapêutico , Masculino , Microscopia Eletrônica de Varredura , Nanopartículas/uso terapêutico , Osseointegração , Osteocalcina/biossíntese , Osteocalcina/genética , Osteogênese/genética , Osteopontina/biossíntese , Osteopontina/genética , Osteoprotegerina/biossíntese , Osteoprotegerina/genética , Ligante RANK/biossíntese , Ligante RANK/genética , Ratos , Ratos Wistar , Tíbia/cirurgiaRESUMO
BACKGROUND: New bone formation and tissue remodeling are the major challenges in implantology today. Titanium meshes have demonstrated reconstructive potential for vertical bone gain. However, the soft tissue healing is technically sensitive to the surgical procedure. The combined usage of collagen membrane and specification of the meshes may ensure greater predictability. Therefore, this study aims to evaluate the influence of collagen membrane on the quality of the new bone formation in guided bone regeneration (GBR) procedures with different titanium meshes. METHODS: Twenty-eight Wistar rats were randomly allocated into four main experimental groups, according to mesh pore size in µm: Group P300 (titanium meshes, with 0.3-mm thickness and 3-mm pore size; n = 7); Group P175 (titanium meshes, with 0.3-mm thickness and 1.75-mm pore size; n = 7); Group P85: (titanium meshes, with 0.04-mm thickness and 0.85-mm pore size; n = 7); Group P15: (titanium meshes. with 0.04-mm thickness and 0.15-mm pore size; n = 7). The femurs of each animal were subdivided into test and control groups: Test: bovine bone graft associated with porcine collagen and collagen membrane was used; control: bovine bone graft associated with porcine collagen was used without association with collagen membrane. Bone quality evaluation by in vivo microtomography and histologic analysis were performed. RESULTS: Bone volume formation was similar between groups (P >0.05). However, the titanium meshes with pore size >1 mm demonstrated higher mineral bone density in comparison with meshes with pore size <1 mm (P <0.05), regardless of the combined usage of collagen membrane. All groups showed a spongy bone formation after 30 days. CONCLUSIONS: Combined usage of collagen membrane in GBR procedures with titanium mesh did not show improvements in new bone quality in rat femur model. However, titanium mesh pore size specifications may influence bone quality.
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Telas Cirúrgicas , Titânio , Animais , Regeneração Óssea , Bovinos , Colágeno , Membranas Artificiais , Ratos , Ratos WistarRESUMO
INTRODUÇÃO: Para manter as dimensões ósseas e gengivais do alvéolo até a instalação de implantes tardios o cirurgião dentista pode lançar mão de diversas técnicas de regeneração óssea guiada, dentre estas existentes a associação de um substituto ósseo com um selador do alvéolo vem apresentando resultados clínicos satisfatórios. OBJETIVO: O objetivo do presente trabalho é relatar um caso clínico onde a preservação alveolar em área estética maxilar foi realizada com materiais xenógenos. RELATO DE CASO: Paciente gênero feminino com 50 anos, melanoderma, não fumante e sem alterações sistêmicas apresentou-se a pós-graduação em periodontia da Faculdade de Odontologia de Ribeirão Preto devido a incômodo estético nos elementos 11 e 21. No exame clínico verificou comprometimento periodontal extenso nos dentes 11 e 21 sendo indicada a exodontia com reabilitação oral via implantes dentários. O tratamento proposto foram as exodontias seguidas de preservação alveolar com materiais xenógenos para posterior instalação de implantes na área enxertada. Porém a pedido da paciente e por conta das condições periodontais e estéticas as exodontia foram realizadas em momentos diferentes demonstrando um planejamento diferenciado e individualizado. CONCLUSÃO: Podemos concluir que a associação entre o substituto ósseo com a membrana substituta de tecido mucoso conseguiu obter resultados satisfatórios na preservação e manutenção das dimensões ósseas e teciduais no caso apresentado (AU)
INTRODUCTION: To maintain the bone and gingival dimensions of the ridge until the installation of implants the dental surgeon can use several techniques of guided bone regeneration, among these the association of a bone substitute with a ridge's sealant has shown satisfactory clinical results. OBJECTIVE: The objective of this study is to report a clinical case where ridge preservation in maxillary aesthetic area was performed with xenogenic materials. CASE REPORT: A 50-year-old female patient, melanoderma, non-smoker and no systemic conditions presented at post-graduation in periodontics from the Faculty of Dentistry of Ribeirão Preto due to aesthetic discomfort in elements 11 and 21. At the clinical examination it was verified that there was extensive periodontal impairment on teeth 11 and 21, that why it was indicated an oral rehabilitation with dental implants. The proposed treatment was the exodontia followed by ridge preservation with xenogenic materials for posterior implant installation in the grafted area. However, at the request of the patient and due to the periodontal and aesthetic conditions, the exodontia were performed at different times, demonstrating a different and individualized treatment planning. CONCLUSION: We can conclude that the association between the bone substitute and the mucosal tissue replacement membrane was able to obtain satisfactory results in the preservation and maintenance of the bone and tissue dimensions in the presented case.tissue (AU)
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Humanos , Feminino , Pessoa de Meia-Idade , Regeneração Óssea , Transplante Ósseo , Alvéolo Dental , XenoenxertosRESUMO
Introdução: a Terapia Fotodinâmica Antimicrobiana (TFDa) vem sendo considerada como coadjuvante para o tratamento da doença periodontal. Objetivo: Relatar um caso clínico onde a TFDa foi utilizada como tratamento adjuvante a Raspagem e Alisamento Radicular (RAR). Relato de caso: Paciente do gênero masculino, 56 anos de idade, melanoderma, diabetes tipo II, apresentou-se aÌ pós graduação em Periodontia da Faculdade de Odontologia de Ribeirão Preto com a queixa principal de sangramento espontâneo da gengiva e hipersensibilidade generalizada. Durante o exame clínico observou-se higienização deficiente, presença de biofilme bacteriano, cálculos subgengivais, inflamação crônica, bolsas periodontais com Profundidade de Sondagem (PS) ≥ 5 mm e mobilidade dentária, sendo indicado o tratamento periodontal não cirúrgico. O tratamento foi realizado por meio de RAR da boca toda utilizando instrumentos manuais e ultrassônicos e aplicações múltiplas da TFDa como adjuvante a esse tratamento (4 episódios: dias 0, 2, 7 e 14). A TFDa foi realizada com a aplicação do corante de cloridrato de fenotiazina a 10mg/ml na profundidade total bolsa periodontal e em seguida esta foi irradiada com um laser diodo num total de 1 minuto por elemento durante 14 dias. Conclusão: A terapia fotodinâmica antimicrobiana demonstrou que pode ser uma alternativa viável como coadjuvante no tratamento da Doença Periodontal, pois após aplicar o protocolo os parâmetros clínicos como ausência de sangramento gengival, redução na quantidade de biofilme dentário, da mobilidade e diminuição da PS com médias de 3mm puderam ser observados (AU)
Introduction: Antimicrobial Photodynamic Therapy (PDTa) has been considered as a coadjuvant alternative for the treatment of periodontal disease. Objective: To report a case report wherePDTawas performed as an adjuvant treatment to Root Scaling and Planing (RSP). Case report: A 56-year-old male patient, melanoderma, type II diabetes, presented to the post-graduation in Periodontics of the School of Dentistry of Ribeirão Preto with the main complaint of spontaneous bleeding of the gingiva and generalized hypersensitivity. During the clinical examination, deficient hygiene, presence of bacterial biofilm, subgingival calculations, chronic inflammation, periodontal pockets with Probing Depth (PD) ≥ 5 mm and dental mobility were observed, and non-surgical periodontal treatment was indicated. The treatment was carried out by RSP of the whole mouth using manual and ultrasonic instruments and multiple applications of PDTa as an adjuvant to this treatment (4 episodes: days 0, 2, 7 and 14). The PDTa was performed with the application of the 10 mg / ml phenothiazine hydrochloride dye to the total periodontal pocket depth and then it was irradiated with a diode laser in a total of 1 minute per elemento for 14 days. Conclusion: PDTa has shown that it may be a viable alternative as an adjuvant in the treatment of Periodontal Disease, since after applying the protocol clinical parameters such as absence of gingival bleeding, reduction in the amount of dental biofilm, mobility and decrease of PS with averages of 3mm could be observed. (AU)
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Humanos , Masculino , Pessoa de Meia-Idade , Doenças Periodontais , Fototerapia , Fotoquimioterapia , Terapia com Luz de Baixa Intensidade , Periodontite CrônicaRESUMO
Scaling and root planing (SRP) may not always be effective in preventing periodontal disease (PD) progression. The aim of this study was to evaluate the adjunctive effect of antimicrobial photodynamic therapy (aPDT) to SRP on induced PD in rats, analyzing histomorphometrical, immunohistochemical, and immunoenzymatic parameters. Ligatures were placed around the first mandibular molars and second maxillary molars of 60 rats to induce PD. After 14 days, they were removed and the animals were divided into six groups, with nine animals each: G1 = no treatment, G2 = SRP, G3 = light-emitting diode (LED), G4 = SRP + aPDT, G5 = aPDT, and G6 = erythrosine. The animals were euthanized after 3, 7, and 15 days. There were also two control groups (n = 3): without PD (WPD) induction and with maximum PD (PD+). In the histomorphometrical analysis of linear bone loss, G4 showed a statistically significant difference from the other experimental groups after 3 and 15 days. The tartrate-resistant acid phosphatase (TRAP)-positive cell counting was significantly lower in G4 when compared to G2 and PD+ after 3 days. Immunoenzymatic assay shows the values of the ratio (RANKL/OPG × 100). The lowest value is from the WPD group, and the group that received the SRP + aPDT treatment tended to approach this value over time. After 3 days, statistically significant differences were observed between G4 and all other experimental groups, as well as versus PD+ (one-way ANOVA + Tukey's post hoc test were performed, p < 0.05). It was concluded that the adjunctive use of aPDT in combination with SRP showed the best therapeutic results in the treatment of periodontal disease in rats.
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Anti-Infecciosos/uso terapêutico , Doenças Periodontais/tratamento farmacológico , Fotoquimioterapia/métodos , Animais , Citocinas/metabolismo , Raspagem Dentária/métodos , Eritrosina , Doenças Periodontais/patologia , Ligante RANK/metabolismo , Ratos , Aplainamento Radicular/métodos , Fosfatase Ácida Resistente a TartaratoRESUMO
O objetivo do estudo foi apresentar uma revisão da literatura relacionada à influência de fatores sistêmicos (diabetes, osteoporose e hábito de fumar) e possíveis protocolos de tratamento na terapia com implantes dentários nesses pacientes. A interrupção do tabagismo e o uso de antibióticos sistêmicos pré e pós-operatórios parecem otimizar o tratamento com implantes em fumantes ativos. Na presença de diabetes mellitus, apenas pacientes bem controlados podem ser candidatos a receber tratamento com implantes, não havendo evidências concretas de que pacientes diabéticos controlados apresentem risco aumentado na falha de implantes. O uso de antibióticos sistêmicos e bochechos com clorexidina 0,12% no pré e pós-operatório tem demonstrado aumento na sobrevivência de implantes em pacientes diabéticos. A osteoporose e o uso de bifosfonatos orais também não representam uma contraindicação absoluta para instalação de implantes dentários, sendo que o principal determinante para falhas no tratamento com implantes é a qualidade óssea local. A contraindicação absoluta está relacionada ao uso de bifosfonatos intravenosos. Sendo assim, concluiu-se que nenhum dos fatores sistêmicos analisados constitui uma contraindicação ao tratamento com implantes dentários, que o tratamento para pacientes com comprometimento sistêmico deve ser realizado mediante estabilização do quadro e avaliação óssea local, através de exames pré-operatórios, e que tratamentos complementares e técnicas menos traumáticas otimizam a terapia.
The aim of this study is to present a literature review on the influence of systemic factors (diabetes, osteoporosis, and smoking) and possible treatment protocols for dental implant therapy. Stop smoking and use of pre and postoperative systemic antibiotics seems to optimize implant treatment in active smokers. In the presence of diabetes mellitus, only well-controlled patients can be considered suitable for treatment with implants and there is no concrete evidence that controlled diabetic patients have an increased risk of implant failure. The use of systemic antibiotics and chlorhexidine mouthwashes before and after surgery has shown an increase in implant survival for diabetic patients. Osteoporosis and the use of oral bisphosphonates do not represent a contraindication for implant placement, being local bone quality the main determinant for implant failure. Absolute contraindications are related to the use of intravenous bisphosphonates. In conclusion, none of the analyzed systemic factors constitute a contraindication to implant placement; treatment for systemic patients should be achieved by stabilization of the systemic condition through preoperative tests, local bone assessment, and supplementary treatments with less traumatic techniques to optimize implant therapy.
Assuntos
Humanos , Implantes Dentários , Diabetes Mellitus , Osteoporose , Fatores de Risco , FumarRESUMO
O objetivo do tratamento periodontal é o restabelecimento da saúde do periodonto a partir da remoção dos redutos bacterianos presentes na superfície radicular. Seu sucesso depende da eliminação dos agentes que promovem a destruição dos tecidos periodontais. No entanto, a terapia mecânica é limitada em remover os patógenos periodontais devido à habilidade de alguns microrganismos em invadir o interior dos tecidos, tornando a bolsa inacessível aos instrumentos periodontais, além de servir como foco de reinfecção. Deste modo, a busca por métodos coadjuvantes ao tratamento periodontal tem aumentado nos últimos tempos. Constitui propósito do presente estudo apresentar uma revisão da literatura sobre o efeito da terapia fotodinâmica antimicrobiana (TFDa) nos patógenos periodontais. A análise da literatura demonstrou que a TFDa mostrou-se eficaz na redução bacteriana, inclusive das bactérias periodontopatogênicas, apresentando-se como um coadjuvante promissor à terapia periodontal básica. Embora existam evidências científicas desses achados, novos estudos devem ser realizados para se determinar parâmetros específicos do laser e do agente fotossensitizador, capazes de tornar a TFDa mais efetiva e previsível.
Assuntos
Biofilmes , Gengivite/terapia , Terapia a Laser , Periodontite , Fotoquimioterapia , Periodontite/terapiaRESUMO
Visceral leishmaniasis (VL) is a major public health challenge in Brazil, especially in states where it is endemic. The aim of this study was to investigate the relationship of sand fly population density with environmental variables (temperature, rainfall and relative humidity) in urban areas of the city of Mossoró, Rio Grande do Norte, Northeastern Brazil. Sand flies were captured with Center Disease Control (CDC) traps installed monthly in the intra and peridomicile of three houses. Data analysis was based on the chi-square test and linear regression. A total of 7,347 sand flies were captured, being 93.85% Lutzomyia longipalpis and 6.15% Lutzomyia evandroi. Sand flies were more commonly found in the peridomicile and there was no difference between the number of males and females. The variables rainy season as well as relative humidity and rainfall, alone or together, did not have an effect on sand fly population density. However, high temperatures had a negative effect. The study of the behavior of sand flies in specific units of endemic areas can provide input to public health authorities for planning appropriate VL vector control measures.
Assuntos
Leishmaniose Visceral/transmissão , Psychodidae , Animais , Brasil/epidemiologia , Meio Ambiente , Feminino , Humanos , Leishmaniose Visceral/epidemiologia , Masculino , Densidade Demográfica , Saúde da População UrbanaRESUMO
Visceral leishmaniasis (VL) is a major public health challenge in Brazil, especially in states where it is endemic. The aim of this study was to investigate the relationship of sand fly population density with environmental variables (temperature, rainfall and relative humidity) in urban areas of the city of Mossoró, Rio Grande do Norte, Northeastern Brazil. Sand flies were captured with Center Disease Control (CDC) traps installed monthly in the intra and peridomicile of three houses. Data analysis was based on the chi-square test and linear regression. A total of 7,347 sand flies were captured, being 93.85 percent Lutzomyia longipalpis and 6.15 percent Lutzomyia evandroi. Sand flies were more commonly found in the peridomicile and there was no difference between the number of males and females. The variables rainy season as well as relative humidity and rainfall, alone or together, did not have an effect on sand fly population density. However, high temperatures had a negative effect. The study of the behavior of sand flies in specific units of endemic areas can provide input to public health authorities for planning appropriate VL vector control measures.
A leishmaniose visceral (LV) é um grande desafio para a saúde pública no Brasil, particularmente nos estados onde é endêmica. O objetivo deste estudo foi verificar a relação da densidade populacional de flebotomíneos com as variáveis ambientais (temperatura, precipitação de chuva e umidade relativa do ar) em bairros urbanos de Mossoró, Rio Grande do Norte. Os flebotomíneos foram capturados com armadilhas CDC instaladas mensalmente no intra e peridomicílio de três casas. A análise dos dados foi baseada no teste Qui-quadrado e na regressão linear. Foram capturados 7.347 flebotomíneos, sendo 93,85 por cento Lutzomyia longipalpis e 6,15 por cento Lutzomyia evandroi. Os flebotomíneos foram encontrados mais comumente no peridomicílio e nenhuma diferença significativa entre o número de machos e fêmeas foi observada. As variáveis estação chuvosa, bem como a umidade relativa e precipitação de chuva, associadas ou isoladas, não influenciou a densidade populacional dos flebotomíneos. No entanto, a alta temperatura afetou essa densidade de forma negativa. Portanto, este estudo específico em áreas endêmicas é importante, porque as agências de Saúde Pública podem usar essas informações para um planejamento adequado das medidas de controle de vetores LV.
Assuntos
Animais , Feminino , Humanos , Masculino , Leishmaniose Visceral/transmissão , Psychodidae , Brasil/epidemiologia , Meio Ambiente , Leishmaniose Visceral/epidemiologia , Densidade Demográfica , Saúde da População UrbanaRESUMO
Urban increase of visceral leishmaniasis (VL) in Brazil is associated with the adaptation of its vector, Lutzomyia longipalpis, to environments modified by humans. The present study reports the results of an entomological monitoring of L. longipalpis and the effect of environmental variables on its population density. Sandflies were captured in the municipality of Mossoró, State of Rio Grande do Norte, Northeastern Brazil, from January 2005 to December 2006. Two CDC light traps were placed monthly for four consecutive nights in the peridomicile of selected households. Data analysis was based on the chi-square test and linear regression. A total of 2,087 sandflies were captured, 99.86% of which were L. longipalpis. A higher proportion of females were captured (p < 0.05). Monthly analysis of the variables temperature, relative humidity and rainfall did not show a significant influence on population density. However, there were seasonal differences: approximately 70% of sand flies were captured during the rainy season (p < 0.05). The predominant species, L. longipalpis, is present in substantial number, representing a public health risk. Therefore, because of higher prevalence during the rainy season, we recommend intensified VL control measures before and during this season to reduce the risk of disease transmission.
Assuntos
Leishmaniose Visceral/transmissão , Psychodidae , Animais , Brasil/epidemiologia , Feminino , Masculino , Vigilância da População , Estações do AnoRESUMO
Urban increase of visceral leishmaniasis (VL) in Brazil is associated with the adaptation of its vector, Lutzomyia longipalpis, to environments modified by humans. The present study reports the results of an entomological monitoring of L. longipalpis and the effect of environmental variables on its population density. Sandflies were captured in the municipality of Mossoró, State of Rio Grande do Norte, Northeastern Brazil, from January 2005 to December 2006. Two CDC light traps were placed monthly for four consecutive nights in the peridomicile of selected households. Data analysis was based on the chi-square test and linear regression. A total of 2,087 sandflies were captured, 99.86 percent of which were L. longipalpis. A higher proportion of females were captured (p < 0.05). Monthly analysis of the variables temperature, relative humidity and rainfall did not show a significant influence on population density. However, there were seasonal differences: approximately 70 percent of sand flies were captured during the rainy season (p < 0.05). The predominant species, L. longipalpis, is present in substantial number, representing a public health risk. Therefore, because of higher prevalence during the rainy season, we recommend intensified VL control measures before and during this season to reduce the risk of disease transmission.
No Brasil, o crescimento urbano da leishmaniose visceral (LV) está associado com a adaptação do seu vetor, Lutzomyia longipalpis, aos ambientes modificados pelo homem. Este estudo relata a vigilância entomológica de L. longipalpis e os efeitos das variáveis ambientais sobre a sua densidade populacional. Os flebotomíneos foram capturados no município de Mossoró, Rio Grande do Norte, no Nordeste do Brasil, a partir de janeiro de 2005 a dezembro de 2006. Duas armadilhas tipo CDC foram colocadas mensalmente durante quatro noites consecutivas no peridomicílio das casas escolhidas. A análise dos dados foi baseada no teste Qui-quadrado e regressão linear. Um total de 2.087 flebotomíneos foram capturados, dos quais 99,86 por cento foram L. longipalpis. Mais fêmeas do que machos foram capturados (p < 0,05). Na análise mensal das variáveis ambientais a temperatura, umidade relativa e a chuva não tiveram impacto significativo sobre a densidade populacional de L. longipalpis. No entanto, houve diferenças sazonais: aproximadamente 70 por cento dos flebotomíneos foram capturados durante a estação chuvosa (p < 0,05). Assim, L. longipalpis, a espécie predominante, representa um risco à saúde pública. Portanto, devido à maior prevalência no período chuvoso, recomendamos intensificar as medidas de controle da LV antes e durante este período para reduzir o risco de transmissão da doença.
Assuntos
Animais , Feminino , Masculino , Leishmaniose Visceral/transmissão , Psychodidae , Brasil/epidemiologia , Vigilância da População , Estações do AnoRESUMO
Urban increase of visceral leishmaniasis (VL) in Brazil is associated with the adaptation of its vector, Lutzomyia longipalpis, to environments modified by humans. The present study reports the results of an entomological monitoring of L. longipalpis and the effect of environmental variables on its population density. Sandflies were captured in the municipality of Mossoró, State of Rio Grande do Norte, Northeastern Brazil, from January 2005 to December 2006. Two CDC light traps were placed monthly for four consecutive nights in the peridomicile of selected households. Data analysis was based on the chi-square test and linear regression. A total of 2,087 sandflies were captured, 99.86% of which were L. longipalpis. A higher proportion of females were captured (p < 0.05). Monthly analysis of the variablestemperature, relative humidity and rainfall did not show a significant influence on population density. However, there were seasonal differences: approximately 70% of sand flies were captured during the rainy season (p < 0.05). The predominant species, L. longipalpis, is present in substantial number, representing a public health risk. Therefore, because of higher prevalence during the rainy season, we recommend intensified VL control measures before and during this season to reduce the risk of disease transmission.(AU)
No Brasil, o crescimento urbano da leishmaniose visceral (LV) esta associado com a adaptação do seu vetor, Lutzomyia longipalpis, aos ambientes modificados pelo homem. Este estudo relata a vigilancia entomologica de L. longipalpis e os efeitos das variáveis ambientais sobre a sua densidade populacional. Os flebotomíneos foram capturados no município de Mossoró, Rio Grande do Norte, no Nordeste do Brasil, a partir de janeiro de 2005 a dezembro de 2006. Duas armadilhas tipo CDC foram colocadas mensalmente durante quatro noites consecutivas no peridomicílio das casas escolhidas. A analise dos dados foi baseada no teste Qui-quadrado e regressao linear. Um total de 2.087 flebotomíneosforam capturados, dos quais 99,86% foram L. longipalpis. Mais fêmeas do que machos foram capturados (p < 0,05). Na análise mensal das variáveis ambientais a temperatura, umidade relativa e a chuva não tiveram impacto significativo sobre a densidade populacional de L. longipalpis. No entanto, houve diferenças sazonais: aproximadamente 70% dos flebotomíneos foram capturados durante a estação chuvosa (p < 0,05). Assim, L. longipalpis, a espécie predominante, representa um risco a saúde publica. Portanto, devido a maior prevalência no período chuvoso, recomendamos intensificar as medidas de controle da LV antes e durante este periodo para reduzir o risco de transmissão da doença.(AU)