Avaliação de polimorfismos genéticos na progressão da infecção de pacientes monoinfectados e coinfectados com os Vírus da Imunodeficiência Humana (HIV) e Vírus da Hepatite C (VHC)

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Emprego de redes complexas para modelar e analisar a disseminação de microrganismos da familia enterobacteriaceae em pacientes mantidos em unidades de terapia intensiva

Nowadays the studies of different methodologies to interfere in the growing and spread of serious infections and systemic status in institutionalized patients those kept on intensive therapy units are relevant to understanding these complex systems and bring benefits to several health areas, particularly public health. In this study, it was analyzed the clinical and microbiological data from patients hospitalized in intensive therapy units. The interaction between patients and caregivers was modeled and analyzed using dynamic system model and complex network theory, identifying outbreaks values of microorganisms of Enterobacteriaceae Family.

Perfil clínico de crianças com indicação da cirurgia das tonsilas em um hospital terciário universitário

The indications for adenotonsillectomy in pediatric patients have changed considerably during the 90th decade. Local or systemic complications of the adenoid or tonsil hypertrophy itself have now been substituted by signs of obstructive ventilatory disturbances, including obstructive sleep apnea as the major indications for surgery. Objective: This study analyses the clinical profile of children submitted to adenotonsilectomy in their pre and postoperative state, at Botucatu Medical School-State University São Paulo, UNESP. Methods: 332 children of both genders, aged 1 to 12 years, who underwent adenotonsillectomy between 1999 and 2004, were studied, focused on epidemiological profile, pre and postoperative (1 month) symptoms, obtained from medical records. Height and weight were compared to brazilian normal age related values. Results: We found a predominance of the male gender, except in he group aged from 10 to 12 years. Considering wheight and height, we found important failure to thrive, mostly for height deficit. Among clinical aspects, we found a significant reduction in obstructive symptoms like snoring or apneia (p<0001) in the postoperative period. Conclusion: Our results were similar to the literature findings of patients clinical profile. The major indication for adenotonsillectomy in our service was clinical diagnosis of obstructive sleep apnea.

Speech-language therapy for treatment of dysphagia and dysphonia in systemic granulomatous diseases: granulomatous diseases: dysphagia and dysphonia treatments

The granulomatous lesions are frequently founded in infectious diseases and can involve the larynx and pharynx and can cause varying degrees of dysphonia and dysphagia. There is still no systematic review that analyzes effectiveness of speech therapy in systemic granulomatous diseases. Research strategy: A systematic review was performed according to Cochrane guideline considering the inclusion of RCTs and quasi-RCTs about the effectiveness of speech-language therapy to treat dysphagia and dysphonia symptoms in systemic granulomatous diseases of the larynx and pharynx. Selection criteria: The outcome planned to be measured in this review were: swallowing impairment, frequency of chest infections and voice and swallowing symptoms. Data analysis: We identified 1,140 citations from all electronic databases. After an initial shift we only selected 9 titles to be retrieved in full-text. After full reading, there was no RCT found in this review and therefore, we only described the existing 2 case series studies. Results: There were no randomized controlled trials found in the literature. Therefore, two studies were selected to be included only for narratively analysis as they were case series. Conclusion: There is no evidence from high quality studies about the effectiveness of speech-language therapy in patients with granulomatous diseases of the larynx and pharynx. The investigators could rely in the outcomes suggested in this review to design their own clinical trials.

Avaliação do grau de conhecimento sobre Leishmaniose e Toxoplasmose em moradores do município de Araçatuba, SP

Considering the importance of zoonotic infections by Leishmania spp. and Toxoplasma gondii in Araçatuba region, São Paulo, this study determined the degree of knowledge of residents of Araçatuba about these two diseases. Questionnaires about these diseases were applied to 123 people. Regarding schooling, all the respondents were literate, and 69.9% (86/123) did not attend higher education and 30.8% (37/123) completed an undergraduate degree. Of these, 91.9% (34/37) knew the meaning of the term zoonosis, with significant difference compared to those who were not trained. This word was unknown by 57% (29/123) of total respondents. Most non-graduates, 59.3% (51/86) did not know what is toxoplasmosis and among graduates, 35.1% (13/37) ignored the subject.There were significant difference between these groups. Regarding the prevention of Leishmania infection, a greater proportion of the residents advocated environmental cleanup, the collar repellent and use of citronella. In relation to toxoplasmosis, 54.5% did not know the ways of transmission of this disease and among those with graduate degree, 13 ignoring any transmission medium. When it comes to prevention of this disease, 55.3% (68/123) did not know any prophylactic. In the group of higher education, 14 did not know how to prevent toxoplasmosis. The results of this study show that the majority of respondents are not aware about the mode of transmission of these diseases, especially in relation to toxoplasmosis.

Efeito do plasma rico em glicose na apoptose de neutrófilos de cães

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

O papel do epstein barr vírus na carcinogênese oral

Introduction: the squamous cell carcinoma (SCC) is the head and neck cancer of higher occurrence, representing about 90% of all these tumors. The SCC has several risk factors as smoking, alcohol and some oncogenic viruses, including the Epstein Barr virus (EBV). The EBV is a member of Herpesviridae family and has tropism for B lymphocytes and also for epithelial cells. Aim: the aim of this study was accomplish a review of the literature about the presence of the EBV in oral carcinomas. Conclusion: EBV is closely related to nasopharyngeal carcinoma, a SCC of high incidence in Southeast Asia, however its role in others oral SCC has not been proved.

Manutenção em próteses implantossuportadas: peri-implantite

The identification and treatment of peri-implant infections are an essential stage in the maintenance of dental implants, reflecting the longevity of rehabilitation. Therefore, the aim of the study was to conduct a literature review addressing peri-implantitis in dental implants in order to guide planning for the longevity of oral rehabilitation. It was conducted a detailed search strategy by the PubMed / Medline Dentistry and Oral Science, it was used as descriptors: “peri-implantitis” and “Dental Implant”, until July 2013. From 566 articles, after a review, according to the inclusion criteria, 34 articles were selected. The results were grouped together in topics (concept, etiology, diagnosis, surgical and nonsurgical, and aspects of oral rehabilitation) for further discussion and conclusions. Conclusions: The accumulation of plaque has been associated with a higher propensity to peri-implantitis. There is a higher incidence of the peri-implantitis disease among patients with previous history of periodontal disease. The local administration of antibiotics and association with mouthwashes / topical use are indicated as suitable for the treatment of moderate peri-implantitis.

Biofilmes orais como um possível fator de risco ao câncer bucal: revisão da literatura

Introduction: much studies regarding risk factors associated with oral cancer. Factors such as smoking and alcohol and solar radiation are well established, but others, such as bacterial influence in the development or progression of a tumor still remain unexplained. Interest in the possible relationship between bacteria and different stages of cancer development has increased since the classification of H. pylori by the WHO as a definite carcinogen. Subsequently, links between infection and the onset of cancer in various sites in the body were discovered. Review of literature: this literature review attempts to show the influence of poor oral hygiene, with consequent bacterial accumulation as a possible important risk factor for the initiation and development of mouth cancer, and correlate the possible mechanisms by which bacteria can initiate or promote carcinogenesis. Conclusion: there is much evidence that bacteria in the oral cavity and periodontopathic are present in tumor tissue, however, still can not affirm that these bacteria initiate or promote carcinogenesis.

Diabetes mellitus: avaliação do conhecimento de cirurgiões-dentistas em municípios de três estados brasileiros

Introduction: Pathological changes in the bucal cavity associated with Diabetes mellitus (DM) may include gingivitis, periodontal disease, salivary gland dysfunction and xerostomia (dry mouth), susceptibility to bucal infections, burning mouth syndrome, and altered taste. Objective: This study assessed the technical and scientific knowledge of dentists working in primary care in the National Health System (SUS) on the DM. Material and method: The study was conducted in the municipalities of Birigui-SP, Maringá-PR and TrêsLagoas-MS, with the participation of 76 dentists working in the SUS primary care system.These professionals agreed to answer to a questionnaire developed for this study and the results of the questions were submitted to a quantitative analysis. Result: Showed that 94.7% were in contact with diabetic patients; 97.4% know what is DM; about other types of DM, 77.6% said they know, the most mentioned (by 55.9%) was the gestational DM. The DM2 was indicated as the most prevalent by 59.2%; the normal range of fasting blood glucose level was quoted correctly by 2.6% of the participants; obesity was reported by 98.7% of participants as a risk factor for DM; 96.0% stated correctly what are the main signs and symptoms related to Diabetes; periodontal disease was reported by 92.1% as an bucal manifestation in diabetic patients. Conclusion: The dentist needs to develop specific knowledge about DM, being able to identify normal levels of blood glucose and ready to identify and meet the bearer of DM.

Terapia fotodinâmica na Endodontia: emprego de uma estratégia coadjuvante frente à infecção endodôntica

O tratamento endodôntico é de fundamental importância para abolir a infecção nos dentes com necrose pulpar. O sucesso desse tratamento depende: da eliminação eficiente da infecção no sistema de canais radiculares (SCR) e do correto selamento pela obturação dos canais radiculares. Devido à complexidade anatômica do SCR, certas áreas podem ser inacessíveis ao preparo biomecânico (PBM), portanto, o emprego de uma medicação intracanal potencializa a redução dos microrganismos (MO) e seus produtos tóxicos no SCR. Mesmo com o avanço técnico e científico da Endodontia, há MO que ainda sobrevivem ao PBM, sendo os principais responsáveis pela manutenção infecção endodôntica. Assim, novos tratamentos devem ser pesquisados. Com o advento dos aparelhos de laser e LED, surgiram alternativas de tratamentos na área da saúde, como a terapia fotodinâmica (TFD), que é um conjunto de procedimentos físicos, químicos e biológicos, que ocorrem após a administração de um agente fotossensibilizador (FS) ativado por meio de uma luz visível de comprimento de onda específico (laser ou LED) para destruir a célula-alvo, ou auxiliar no combate das infecções. Na Endodontia, foram demonstrados em estudos in vitro e in vivo que o emprego da TFD atua como um coadjuvante e potencializa a desinfecção do SCR, além de ser de fácil aplicação e não promover resistência microbiana. O objetivo da presente revisão é apresentar o estado atual da terapia fotodinâmica em Endodontia.

Influência da clareação sobre a polpa dentária

Tooth bleaching is the most common treatment and more conservative to get a smile with white teeth. However, the tooth sensitivity has been a major adverse effects caused by this treatment, which raises questions about the effect of bleaching the pulp. Therefore, we performed a literature review in order to study the relationship between bleaching agents and their possible effects on the dental pulp. We review various articles showing that the peroxide compound used to whiten teeth, penetrates through enamel and dentin until the pulp chamber causing changes of variable intensity or induce pulp necrosis. Moreover, we found that the higher the concentration of peroxide in the bleaching agent, and the greater the contact time with this dental structure, the greater the damage caused in the pulp. Although several studies show that the bleaching agent hydrogen peroxide-based pulp can make changes, there are still many gaps to be filled.

Susceptibility of microorganisms isolated from necrotic pulps to calcium hydroxide

Calcium hydroxide has been used as pulp-capping agent and canal dressing due to its antimicrobial and anti-inflammatory properties besides its ability to induce formation of mineralized tissues. The aim of this study was to evaluate the susceptibility to calcium hydroxide of 146 bacterial strains isolated from endodontic infections. MIC was determined by using an agar dilution method, while contact bactericide activity was performed through in broth. All the isolates were sensitive to calcium hydroxide in concentrations that varied from 0.5mg/ml to 128 mg/ml, and the genera Enterococcus, Pseudomonas, Staphylococcus and Actinomyces were the most resistant. Gramnegative anaerobes proved to be the most sensitive isolates. All the isolates were inhibited after 60 minutes of contact with the alkali in concentration of 100mg/ml

Atividade inibitória de extratos de plantas da savana brasileira sobre microrganismos superinfectantes e oportunistas

A utilização de compostos naturais na medicina de populações tradicionais é uma realidade em todo o mundo e o cerrado brasileiro apresenta grande diversidade de vegetais com uso potencial no tratamento de infecções por microrganismos oportunistas. Esse estudo avaliou a atividade antimicrobiana dos extratos vegetais do cerrado brasileiro sobre microrganismos oportunistas e superinfectantes. Nos testes foram preparados extratos hidroalcoólicos e aquosos de 22 espécies de plantas utilizadas nas regiões Norte, Nordeste e Centro-Oeste como parte da medicina popular. Esses extratos foram testados sobre Enterococcus faecalis ATCC 19433 e Pseudomonas aeruginosa ATCC 10145 e dez isolados clínicos de cada uma dessas espécies microbianas. Inicialmente foi realizada uma triagem para se determinar a atividade antimicrobiana dos extratos. Em seguida, foram realizados testes para avaliar a maior diluição inibitória dos extratos por meio do método de diluição em caldo e testes de atividade inibitória em biofilme. Os resultados demonstraram que embora aproximadamente 20% de todos os extratos mostraram atividade inibitória sobre algum dos microrganismos alvo, os mais ativos foram os extratos aquosos e hidroalcoólicos de araçá e aroeira, se mostrando ativos frente a todos os microrganismos.

Severidade da mucosite bucal em pacientes com câncer de cabeça e pescoço submetidos à raditoerapia

Radioterapia é uma das modalidades terapêuticas mais utilizadas no tratamento de neoplasias de cabeça e pescoço. Contudo apresenta severos efeitos colaterais, dentre os quais a mucosite é uma das mais prevalentes e sérias, ocasionando áreas ulceradas com extremo desconforto para alimentação e possibilidades de infecções secundárias, muitas delas por microrganismos oportunistas. Esse estudo objetivou investigar a ocorrência e grau de severidade da mucosite oral em pacientes com lesões malignas de cabeça e pescoço submetidos à radioterapia, bem como relacionar com a interrupção do tratamento. 50 pacientes foram avaliados clinicamente e por meio de questionário, durante e após o tratamento, no Centro de Radioterapia de Megavoltagem em São José do Rio Preto-SP utilizando-se os critérios de mucosite da OMS. Pode-se verificar que a maioria dos pacientes apresentou algum grau de mucosite durante o tratamento e persiste em alguns pacientes mesmo após a interrupção da radioterapia. A má higiene bucal e tratamentos odontológicos prévios são fatores associados aos graus mais severos das lesões.