Avaliação da presença de osteopatia decorremte do diabetes tipo 1 em criança e adolecentes do Rio Grande do Norte

Diabetes Mellitus (DM) and osteoposes are chronic diseases with great socioeconomic consequences, mainly due to the late complications and consequent disabilities. The potential effects of DM on bone metabolism remain a very conroversial issue, and disagreement exists with regard to the clinical implications of diabetic osteopenia and the mechanism of its ocurrence. The issue is further complicated by the contribuicion of the especific factors, such as duration of disease an dthe degree of metabolic control. The objective of this study is to identify the osteopathy in children and adolescents with DM 1 assisted in the hospital of pediatrics, UFRN, through biochemical markers of bone and mineral metabolism and the extent of bone mineral density. The study was composed by 74 diabetics type 1 patients (DM1) of both gender and aged 6 to 20 yars. Normoglicêmic group was composed by 97 healthy subjects of both genders, which showed the same age range of DM1, in addition to same socioeconomic class. These individuals qere students from the networks of public education in the city of Natal-RN, randomly invited to paticipate in our study. Both groups DM1 and NG were divided intofour subgroups, according to the classification of tanner , T1, T2, T3, T4 for achieving a benchmark. Diabetic individuals showed up with a poor glycemic control. the group DN1 T4 showed an incresead value for total protein, albumin, urea and microalbumiuria are predictors of grumelura injury in DM1 patients . The total alkaline phosphatase activitywas kept on high levels for both groups because they are in a stature development age. For osteocalcin there were decreased levels for groups Dm1 T1, T2, and T3 when compared to their NG (s), suggesting that this decrease could be associated with reduction in the number and/or differentiation os osteoblasts thereby contributing to reducing bone formation. There were no changes in the activity of TRAP. The serum concentrations of total and ionized calcium, phosphorus and magnesium were included within the RV. It was observed that the BMD (Z- SCORE ) has always been within the RV for both groups, despite to DM1 T4. Taking all together, our results support the hypothesis that children and adolescents with type 1 DM present the risk in the long run to suffer a reduction in the bone mass, associated to poor glicemic control and disease duration. It could limit the bone growth and increase the probality of development of osteopenia, as well as other complications surch as retinopathy and renal failure

Preparação e carcterização de complexos multicomponentes contendo ciclodextrinas e benznidazol

The benznidazole (BNZ) is the only alternative for Chagas disease treatment in Brazil. This drug has low solubility, which restricts its dissolution rate. Thus, the present work aimed to study the BNZ interactions in binary systems with beta cyclodextrin (β-CD) and hydroxypropyl-beta cyclodextrin (HP-β-CD), in order to increase the apparent aqueous solubility of drug. The influence of seven hydrophilic polymers, triethanolamine (TEA) and 1-methyl-2- pyrrolidone (NMP) in benznidazole apparent aqueous solubility, as well as the formation of inclusion complexes was also investigated. The interactions in solution were predicted and investigated using phase solubility diagram methodology, nuclear magnetic resonance of protons (RMN) and molecular modeling. Complexes were obtained in solid phase by spray drying and physicochemical characterization included the UV-Vis spectrophotometric spectroscopy in the infrared region, scanning electron microscopy, X-ray diffraction and dissolution drug test from the different systems. The increment on apparent aqueous solubility of drug was achieved with a linear type (AL) in presence of both cyclodextrins at different pH values. The hydrophilic polymers and 1-methyl-2-pyrrolidone contributes to the formation of inclusion complexes, while the triethanolamine decreased the complex stability constant (Kc). The log-linear model applied for solubility diagrams revealed that both triethanolamine and 1-methyl-2-pyrrolidone showed an action cosolvent (both solvents) and complexing (1-methyl-2-pyrrolidone). The best results were obtained with complexes involving 1-methyl-2-pyrrolidone and hydroxypropylbeta- cyclodextrin, with an increased of benznidazole solubility in 27.9 and 9.4 times, respectively. The complexes effectiveness was proven by dissolution tests, in which the ternary complexes and physical mixtures involving 1-methyl- 2-pyrrolidone and both cyclodextrins investigated showed better results, showing the potential use as novel pharmaceutical ingredient, that leads to increased benznidazole bioavailability

Avaliação do estado nutricional relativo ao selênio e da expressão gênica de selenoproteínas em pacientes com aterosclerose tratados com estatinas

The aim of this study was to determine the effects of the use of rosuvastatin in patients with atherosclerosis, in relation to blood parameters of selenium and selenoproteins, and also observe possible changes in gene expression of selenoproteins in these patients. The sample consisted of 27 adult and elderly patients with a clinical diagnosis of coronary artery disease undergoing angioplasty, treated at Natal Hospital Center hospital, Natal, RN. Patients were treated with rosuvastatin 10 mg/day during four months. Anthropometric variables such as body mass index (BMI) and Waist circumference (WC) were measured before and after treatment, as well as lipid profile, blood glucose and liver enzymes (AST and ALT). The diet of the patients was also analyzed using 24-hour diet recall. We analyzed the concentrations of selenium in plasma and erythrocytes, and also the activity of Glutathione Peroxidase and gene expression by Real Time PCR of selenoproteins GPx1, SelP1 and SelN1. Patients had mean age of 61.0 ± 9.4 years, 59.3% were men and 40.7% were women. After four months of treatment there was significant reduction of CA and, according to BMI, most were overweight. The intake of macronutrients, cholesterol, polyunsaturated fatty acids, monounsaturated and saturated was adequate, but the energy and fiber intake was below the recommendations. Regarding the selenium intake was observed a high prevalence of inadequacy. As expected, after treatment with rosuvastatin, a significant reduction in total cholesterol, LDL and glucose, which was not observed for HDL. Selenium concentrations in plasma and erythrocytes showed no changes, keeping within the established cutoffs. We observed a significant increase in GPx enzyme activity and mRNA expression of GPX1 and SEPN1, but not for gene SEPP1. Thus, it was found that treatment with rosuvastatin did not reduce the expression of selenoproteins. More studies are needed to clarify the effects of rosuvastatin on gene expression of selenoproteins in patients with atherosclerosis

Avaliação da atividade antimicrobiana de sistemas emulsionados contendo óleos naturais para o tratamento de infecções cutâneas

Natural oils have shown a scientific importance due to its pharmacological activity and renewable character. The copaiba (Copaifera langsdorffii) and Bullfrog (Rana catesbeiana Shaw) oils are used in folk medicine particularly because the anti-inflammatory and antimicrobial activities. Emulsion could be eligible systems to improve the palatability and fragrance, enhance the pharmacological activities and reduce the toxicological effects of these oils. The aim of this work was to investigate the antimicrobial activity of emulsions based on copaiba (resin-oil and essential-oil) and bullfrog oils against fungi and bacteria which cause skin diseases. Firstly, the essential oil was extracted from copaiba oil-resin and the oils were characterized by gas chromatography coupled to a mass spectrometry (GC-MS). Secondly, emulsion systems were produced. A microbiological screening test with all products was performed followed (the minimum inhibitory concentration, the bioautography method and the antibiofilm determination). Staphylococcus aureus, S. epidermidis, Pseudomonas aeruginosa, Candida albicans, C. parapsilosis, C. glabrata, C. krusei and C. tropicalis American Type Culture Collection (ATCC) and clinical samples were used. The emulsions based on copaiba oil-resin and essential oil improved the antimicrobial activity of the pure oils, especially against Staphylococcus e Candida resistant to azoles. The bullfrog oil emulsion and the pure bullfrog oil showed a lower effect on the microorganisms when compared to the copaiba samples. All the emulsions showed a significant antibiofilm activity by inhibiting the cell adhesion. Thus, it may be concluded that emulsions based on copaiba and bullfrog oils are promising candidates to treatment of fungal and bacterial skin infections

Preparação e caracterização de sistemas emulsionados contendo benznidazol

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Avaliação da argila atapulgita para potencial uso como excipiente farmacêutico em formas sólidas

Clays are natural materials that have great potential for use as excipients for solid dosage forms. Palygorskite is a type of clay that has hydrophilic properties as well as a large surface area, which could contribute to the dissolution of drugs. Thus, the present study aims to evaluate the use of palygorskite clay, from Piaui (Northeast region of Brazil), as a pharmaceutical excipient for solid dosage forms, using rifampicin and isoniazid as the model drugs. The former is a poorly soluble drug often associated with isoniazid for tuberculosis treatment. Palygorskite was characterized by X-ray diffraction (XRD), X-ray fluorescence (XRF), particle size, transmission electron microscopy (TEM), scanning electron microscopy (SEM) and specific surface area (BET). The rheological and technological properties of palygorskite were determined and compared to those of talc, magnesium stearate and Aersosil 200. Mixtures between drugs and palygorskite were analyzed by differential scanning calorimetry (DSC), thermogravimetric analysis (TG) combined with thermal analysis (DTA) and Fourier Transform Infrared Spectroscopy (FT-IR), where the results were compared with those of the individual compounds. In addition, dissolution studies of solid dispersions and capsules containing the drugs, mixed with either palygorskite or a mixture of talc and magnesium stearate, were performed. The results showed that palygorskite has small particles with a high surface area. Its rheological characteristics were better than those of others commonly used glidants and lubricants. There was no interaction between palygorskite and the drugs (rifampicin and isoniazid). Among the dispersions studied, the mixture with palygorskite (5%) showed the highest drug dissolution when compared to other excipients. The dissolution of the rifampicin capsules containing palygosrkite was faster in higher concentrations. However, these differences were statistically different only in the first minutes of the dissolution experiment. The dissolution profile of isoniazid was also statistically different on the initial part of the experiment. The formulations prepared with isoniazid and palygorskite showed higher drug dissolution, but it was in descending order of concentration. According to these results, the palygorskite clay used in this study has great potential for application as an excipient for solid dosage forms

Obtenção e caracterização de complexos de inclusão binários e ternários com praziquantel

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Estudo dos genes do complexo do antígeno leucocitário humano (hla) associados à susceptibilidade ao diabetes mellitus tipo 1

Of all of the genes associated with the development of Diabetes mellitus type 1 (T1D), the largest contribution comes from the genes in the Human Leukocyte Antigen (HLA) region, mostly the class II DR e DQ genes. Specific combinations of alleles DRB1, DQA1 and DQB1 constituting haplotypes, and further, a combination of more than one haplotype, providing multilocus genotypes are associated with susceptibility, protection and neutrality to DM1. Thus, the aim of present study was to verified the association of polymorphisms of HLA genes class II with susceptibility to type 1 diabetes mellitus (T1D). Ninety-two patients with T1D and 100 individuals normoglycemics (NG) aged between 6 and 20 years were studied. Genomic DNA was obtained from peripheral whole blood, collected in EDTA tube, using the extraction kit Illustra Triple Prep®, GE Healthcare. For HLA typing was used DNA LABType system by One Lambda kit applying Luminex® technology to the method of PCRSSO typing reverse. The alleles DRB1*03:01, *04:05, *04:01, *04:02, DQA1*03:01g, *05:01g, DQB1*02:01g, *03:02, the haplotypes DRB1*03:01-DQA1*05:01-DQB1*02:01, DRB1*04:05-DQA1*03:01g-DQB1*03:02, DRB1*04:02-DQA1*03:01g-DQB1*03:02, DRB1*04:01-DQA1*03:01g-DQB1*03:02 and DR3-DQ2/DR4-DQ8 genotype were significantly associated with the chance of developing T1D. The alleles DRB1*11:01, *15:03, *15:01, *13:01, DQA1*01:02, *04:01g, *01:03, DQB1*06:02, *03:01g, *06:03, *04:02, the haplotypes DRB1*11:01-DQA1*05:01-DQB1*03:01, DRB1*13:01-DQA1*01:03-DQB1*06:03 and DRX-DQX/DRX-DQX genotype, formed by other than the DR3-DQ2 or DR4-DQ8 haplotypes, were significantly associated with T1D protection Despite the major racial Brazilian, even at the regional level, these results are similar to the majority of alleles, genotypes and haplotypes of HLA class II-related susceptibility or resistance to T1D, extensively described in the literature for Caucasian population. Children with age at diagnosis less than 5 years of age had significantly higher frequency of the heterozygous genotype DR3-DQ2/DR4-DQ8 compared to children with age at diagnosis than 5 years old. These results also demonstrate strong association of the genetic profile of the class II HLA for this age group, possibly associated with the severity and rapid progression to the onset of T1D. The knowledge of HLA class II genes may be useful in genetic screens that allow the prediction of T1D

Eficácia do bochecho de quitosana a 0,4% sobre o biofilme e bactérias orais

The purpose of this study was evaluate the effectiveness of the chitosan at 0.4 with high molecular weight and high deacetylation degree mouthrinse over the total decrease of the streptococci, Streptococcus mutans, lactobaci/li and over the perceptible bacterial film and gingival bleeding indices. For that, a total of 68 healthy students between 11 and 13 years old, not allergic to crustacean and not users of antibiotics or antimicrobial agent for the last three months or during the treatment, was selected. From those, thirty two individuaIs used the mouthrinse test, and thirty six, the control one. The participants rinsed 10 mL of the solutions twice a day, one during the moming (which was supervised), and another one during the aftemoon (which was not supervised), for fifteen days. The saliva collect for the microbiological analysis, as well as the perceptible bacterial film and gingival bleeding indices check, were made before the use ofthe mouthrinses (base line), immediately after the last mouthrinse on the day (zero time) and fifteen days after (fifteen time). These data were collected at school and the saliva was carried inside the ice to the laboratory. The samples were diluted, and 0.1 mL ofthe 10 -1 dilution was seeded in Rogosa SL agar, for further analysis of the total of lactobaci/lus~ 0.1 mL of the 10-4 dilution in Mitis Salivarius with bacitracin, for S. mutans analysis; and 0.1 mL of the 10-6 dilution in Mitis Salivarius for the analysis ofthe total of streptococcus. The Rogosa SL agar plates were incubated in aerobic at 37°C for 72 hours and the MSB and the MS were incubated in anaerobic in Gaspak@ jars at 37°C for 48 hours for further count ofColonies Former Units (CFUs). The assay was made in duplicate for each bacterial group analyzed. The number of CFUs transformed in LOGlO was analyzed according to the following tests: ANOV A, t of Paired and Not Paired Student, Friedman, Man-Whitney and square-qui test. On the base line, alI the variables analyzed were similar on both tested groups. On both groups, for the total of streptococcus there was no significant difference along the time and for S. mutans there was a statistic significant increase of the CFUs from the base line to the zero time. For the total of lactobaccilus there was no significant difference on the test group along the time, and on the control there was a significant increase ofthe CFUs ITom the base line to the zero time. For both groups, there was significant decrease ofthe perceptible bacterial film index along the time, and that can be explained by the mechanic effect of the mouthrinse over the bacterial film and by the participation of the students on the research which could have motivated him to a better toothbrushing (Hawthome effect). The gingival bleeding index also showed a decrease along the time, even though it was not significant. Therefore, the conclusion of this study was that the chitosan at 0.4 % mouthrinse was not effective on the CFUs reduction of the three bacterial groups analyzed, as well as on the reduction of the perceptible bacterial film and gingival bleeding indices

Controle profissional de biofilme dentário como estratégia para manutenção da saúde periodontal de pacientes com aparelho ortodôntico fixo: análise comparativa entre diferentes períodos

The presence of fixed orthodontics appliances interfere on sanitation, allowing periodontal diseases to appear, despite the fact patients keep on visiting the dentist every month. This research aims to determine a protocol for the mechanical control of the dental biofilm performed by the professional. A protocol that was able to maintain the periodontal health of the patients under orthodontic treatment with fixed appliances, and in order to do so, it used a non-controlled, randomized and blind clinical essay. The sample involved 40 adolescents who were under the installation of fixed orthodontics appliances and it was divided in three groups, as follows: monthly controlled group (group 1) composed of 11 patients, the quarterly controlled group (group 2) with 16 patients and the semestrial controlled group (group 3) with 13 patients. For data collection, an interview and clinical exams with probing depth measurement, quantity of keratinized mucosa, Gingival Index and the Plaque Index were used. On the initial exam all patients received brushing guidelines as well as the professional control of dental biofilm, with periodontal scaler, Robinson s brush and prophylactic paste. However, Group 1 returned every month for control procedures; Group 2 every three months and Group 3 after six months. The intervention had a six-month duration (for all the three groups), when all the exams were repeated by another examiner who did not know which group each patient was inserted in. Finally, the research concluded that despite the fact there is no statistically significant difference among the three groups, clinically the patients from the monthly group presented a better response to professional control, with less accumulation of dental biofilm and less rate of gingival inflammation. Thus, the mechanical control of the dental biofilm performed by the professional could not avoid gingival increase, characterized by the raise of probing depth measurement, neither the quantity of keratinized mucosa

Avaliação da eficácia de selante ionomérico modificado por resina e escovação dentária na preservação de cárie oclusal

The purpose of this study was to evaluate the effectiveness during a twelve-month period, of resin-modified glass ionomer (Vitremer@) used as fissure sealants compared to supervised teeth brushing in the prevention of oclusal caries in permarient molars of pubIlc school children from 5 to 7 years of age. A total of 91 children participated in the study, being randomly divided up into three groups of investigation: group with sealant (n=31), group of supervised brushing (m=30), and control gorup (n=30). After 12 months, a total of 28.5% of tosses in the sample of 26 children was registered, and although there wasn t a significant diference between these losses and the groups studles (p = 0.6355), there was a considerable reduction in the sample. The results showed that none of the independentIy studied variables (present caries experience, biofilm, bleeding, sealant retention, position of the tooth in the arch, and sex) interfered in the final results, and that there was no significant difference between applying the sealant in question, perfornling supervised dental brushing, or not intervening at alI (p=0.542). These results could have been a consequence of the limitations found alI through the study, especially relating to the losses occurred because of school evasion, transfer, or because of the accident in the Marise Paiva Municipal School, Keeping students away for approximately one semester, so tht a new reseach had to be developed sos as to better clarify the effects among the treatments done there

Os Centros de Especialidades Odontológicas como suporte da atenção básica: uma avaliação na perspectiva da integralidade

The public dental services in Brazil were limited, practically, to the basic care, so that the specialized services acted, up to 2002, no more than 3,5% of the total of clinical procedures. That lower offer reveals the difficulty of continuity of the attention, that is, the comprehensiveness in the assistance, particulary, the reference and counter-reference system. Brasil Sorridente search to supply those needs when proposing Speciality Dental's Centers(CEOs Centros de Especialidades Odontológicas, Brazil) to compose the services of average complexity. In 2005, Ministry of Health enabled the three CEOs of Natal, located in the North II, East and West Sanitary Districts. This investigation evaluated the implantation of these CEOs, as support of the family health care teams, in the perspective of organization of the services in assistencial nets in Natal/RN. It was a study of evaluation, with qualitative approach and some quantitative data as contribution. Dentists, users and managers were interviewed to identify and to understand their perceptions, relationships and experiences in the daily of the services. The conceptual base that orientated the investigation was the principle of comprehensiveness, in its operational sense of the hierarchization in health attention levels. The collection of data was done with documental research, direct observation and semi-structured interview. The analysis was accomplished by triangulation of the extracted content from the used techniques and sources of interviewed groups depositions, looking for theoretical-conceptual support in specific bibliography. The results pointed aspects that go away from the comprehensiveness like: low resolution of problems in the basic net; little valorization of the space in the health units; traditional models of access to health services, insufficient offer for some specialties, compromising the reference and counter-reference system; practices centered in procedures in the CEO; bureaucratic directions from basic care to the specialized service; disintegrated and disjointed system among levels of attention; disrespect to the municipal protocol. On the other hand, there is an approach of compreensiveness in situations like: increase of the access and covering in the Family Health Strategy (ESF Estratégia Saúde da Família, Brazil); larger approach between professional and user; tendency to the quantitative and qualitative growth of specialized actions; punctual initiatives of relationships among levels; existence of protocol to guide professionals

O programa Saúde da Família pelo olhar do Cirurgião-Dentista

This study tried to know the social representation of dentists surgeons about the Family Health Program (FHP). Where used as methodological instruments a semi-structured interview and direct observation of work process in tive towns that are part of the metropolis region ofNatal city. During the interview some aspects where broached, such as the reasons of dentists surgeons join the FHP, what are the implications ofthe introduction of this program in the everyday practice, what kind of activities are they practicing and what are those professional missing the most in the FHP. In the direct observation where take in account some aspects related to the physic structure of health units, its service organization and demand, relationship amongst dentist and other member of the team, and about patient receptiveness, when they arrives at health unit. This study also identifY the researches subject showing their age, sex, for how they are graduates, what are them specialty and for how long they work for the FHP. The data had been analyzed through the analysis of content of Bardin5. The dentists depict the FHP for the change in assistance model through the preventive proposal of social work that makes possible to work with an ample concept of health. However what makes the FHP more attractive to dentists is the salary questiono The creation of bonds whit the community and the work whit groups and in team had been the main occurred changes in the daily one of the pratices ones of these professionals. The principal activities executed for these professionals inside of the new strategy of assistance in oral health are the carried trough preventive activities achieved in health units and social area. To them, the absence of institutional support and the employment of only one dentist for each team it is one the main point of strangling. There is no doubt that FHP is new strategy and that it is need a better integration amongst the professional, the institution

Fatores associados à condição de saúde bucal de pacientes internados em hospitais públicos do município de Natal-RN

The hospitalization is an event that can attack any person, independent of gender, race, social and economical condition. Last year, the prevalence of hospitalization was 8.1 for 100 inhabitants and the average time of hospitalization was 8.5 days for each patient one in Natal city. Therefore, an important point is whether the attention to the patients during the permanence in these health establishments incorporates the health integral model suggested by the principles proposed by the National Health System in Brazil (SUS), with actions of promotion and protection by different kinds of professionals, beside those called convalescence. Then, the aim of this study was to evaluate the patient s oral health conditions hosted in public hospitals of the Natal city, looking for to establish its relationship with several risk factors by two dimensions: the characteristics of the hospitalization and the patient s general and economical conditions. We accomplished a cross-sectional study with 205 patients distributed among the hospitals Onofre Lopes, Giselda Trigueiro and Monsenhor Walfredo Gurgel, looking for to know the socio-demographic characteristics, the food habits and of oral hygiene and the conditions of oral health, through the Visible Plaque Index and Gingival Bleeding Index. We observed that the conditions of the patient s oral health interned at public hospitals of reference of the municipal district of Natal is bad, existing accumulation of dental plaque and, consequently, a great number of patients with gingival bleeding. However, the time of hospitalization and its reason, the type of medicine used in this time and the toothbrush frequency were not configured as risk factors for this oral health condition

Avaliação clínica do efeito da irradiação pós-opratória do laser de baixa intensidade na cicatrização de gengivoplastias em humanos

Many studies have been made to understand the process of tissular cicatrization, as well as the possible effects of laser therapy in the wound healing. However, the influence of low frequency laser irradiation in the repairing process is not completely understood. Our study has the purpose to assess clinically the effect of postoperative irradiation of the low frequency laser in humans, and the gingival repairing process postgingivoplasty performed with the extern bevel technique. Twenty-four patients with inflammatory gingival hyperplasia were enrolled in this study, which did not reduce with basic periodontal procedures, and patients with melanin pigmentation, with esthetic indications. After surgery the test group, randomly selected by a drawing, received laser application with energy density of 4 J/cm2, immediately after surgery and each 48 hours, during a week, with a total of 4 sections. The control group did not receive irradiation. The visual clinical analyses were performed by a single blind examiner, in the 2nd, 4th, 6th, 8th, 15th and 21st days post surgery. For statistic analyses of the data was used a Q-square test. Concerning the color, the results showed a better wound healing during days 6 to 8. when assessed the degree of progress of surgical wound, the results showed that the test group had a better cicatrization compared with the control group in the 2nd, 6th, 8th and 15th days post surgery, and at the 21st day both groups had the same results. Our results confirm that the laser had clinical influence in the repairing process after gingivoplasty surgery during days 2 to 15 post surgery