Prevenção da reabsorção óssea alveolar após extração dentária

Introdução: O processo alveolar é o conjunto de osso que se encontra em redor da raiz do dente. Este osso é sensível a uma variedade de fatores ambientais e fisiológicos que influenciam a sua integridade e o seu funcionamento. Como tal, a sua formação assim como a sua preservação é dependente da presença contínua do dente. A reabsorção do processo alveolar após extração dentária é uma consequência natural e fisiológica indesejável, que pode dificultar a colocação de um implante dentário na posição desejada. Com o aumento cada vez mais das demandas estéticas em medicina dentária, torna-se, portanto, necessário prevenir que a reabsorção óssea provoque este defeito na arcada dentária. Objetivos: Realizar uma revisão bibliográfica sobre as várias técnicas e materiais para preservação do rebordo alveolar, a fim de prevenir ou minimizar a reabsorção alveolar após extração dentária. Material e Métodos: A pesquisa foi realizada nas bases de dados Pubmed, B-on e Scielo, não foi aplicado nenhum limite temporal, e os critérios de inclusão foram artigos em língua inglesa e portuguesa. Num total de 164 artigos, selecionaram-se 82 estritamente relacionados com o tema. Os artigos excluídos desviavam-se do objetivo do trabalho ou eram inconclusivos. Selecionaram-se, também, capítulos do livro Clinical Periodontology and Implant Dentistry Volume 1 e 2, dos autores Niklaus P.Lang e Jan Lindhe. Desenvolvimento: De modo a compreender como o processo alveolar reabsorve, deve-se ter em conta as várias técnicas que se podem realizar para permitir uma boa quantidade de osso remanescente na arcada adequada a cada caso para uma possível reabilitação. As técnicas de preservação do osso alveolar após extração passam pela realização de técnicas cirúrgicas minimamente invasivas, estabilização do coágulo pelo princípio da cicatrização por primeira intenção usando membranas ou retalhos, preenchimento do alvéolo dentário com materiais de enxerto ou substitutos ósseos, terapias combinadas com a colocação de implantes imediatos e o recurso a células e fatores de crescimento. Conclusão: A preservação alveolar tem grande importância para uma posterior reabilitação oral com implantes com maior quantidade de osso disponível do que quando não é feita qualquer tipo de preservação. A extração das peças dentárias deve ser feita com cuidado para preservar ao máximo ou não danificar as superfícies ósseas remanescentes. É aconselhado que o encerramento da ferida seja por primeira intenção e que proporcione estabilidade ao coágulo, podendo ser usado retalhos ou mesmo membranas. O uso de enxertos ósseos tem uma importante função de proporcionar uma matriz para o coágulo se formar e promover o processo de cicatrização. O método de implante imediato, para além de ser bastante usado, tem como finalidade o conforto para o paciente de não ser submetido a uma posterior cirurgia para colocação do mesmo e, simultaneamente, mantem a estabilidade dos tecidos moles. Ainda uma técnica menos usada é com células e fatores de crescimento que proporciona uma cicatrização mais rápida e um aumento do potencial regenerativo dos tecidos.

Gewebeansatz-Strukturen auf pyritisierten Steinkernen von Ammonoideen

3400 pyritized internal moulds of Upper Devonian, Triassic, Jurassic and Lower Cretaceous ammonoids show various soft tissue attachment structures. They are preserved as regularly distributed black patterns on the moulds. All structures can be interpreted as attachment areas of muscles, ligaments and intracameral membranes. Paired structures are developed along the umbilicus and on the flanks of the moulds, unpaired ones appear on the middle of their dorsal and ventral sides. Strong lateral muscles cause paired twin lines on the flanks of the phragmocone and of the body chamber. A ventral muscle is deduced from small rounded or crescent shaped spots in front of each septum on the ventral side. These spots are often connected, forming a band-like structure. Broad dark external bands on the ventral side of the phragmocone, ventral preseptal areas in the posterior part of the living chamber, small twin lines or oval shaped areas on the ventral side of the living chamber represent paired or unpaired attachment areas of the hyponome muscle. A middorsal muscle is documented by small roughened areas in front of each dorsal lobe. Dark spots along the umbilicus, often connected and thus forming a band-like structure (tracking band), are remains of a pair of small dorsolateral muscles at the posterior end of the soft body. Dark bands, lines and rows of small crescent shaped structures behind the tips of sutural lobes are due to spotlike fixation places of the posterior part of the mantle and their translocation before subsequent septal secretion. Devonian goniatites had a paired system of lateral and ventrolateral muscles preserved on the moulds as black or incised lines on the flanks of the living chamber and as dark preseptal areas, ventrally indented. These structures represent the attachment areas of paired lateral cephalic and paired ventral hyponome retractors. Fine black lines on the phragmocone situated parallel to the sutures (pseudosutures) represent a rhythmical secretion of camera! membranes during softbody translocation. Goniatites had a paired system of lateral and ventrolateral muscles, whilst Neoammonoids have a paired lateral and dorsolateral system, and, additionally, an unpaired system on the ventral and on the dorsal side. Mesoammonoids show only a paired lateral and an unpaired dorsal one. Fine black lines situated parallel to the saddles and behind the lobes of the suture line can be interpreted as structures left during softbody translocation and a temporary attachment of rhythmical secreted cameral membranes. Cameral membranes had supported the efficiency of the phragmocone. Only some of the observed structures are also present in recent Nautilus. Differences in the form and position of attachment sites between ammonoids and recent Nautilus indicate different soft body organizations between ammonoids and nautiloids. The attachment structures of goniatites especially of tornoceratids can be compared with those of Nautilus which indicates Richter - Gewebeansatz-Strukturen bei Ammonoideen 3 a comparable mode of life. Differences in the form and position of attachment structures between goniatites and ammonites may indicate an increasing differentiation of the muscular system in the phylogeny of this group. Different soft body organization may depend on shell morphology and on a different mode of life. On the modification or reduction of distinct muscle systems ammonoids can be assigned to different ecotypes. Based on shell morphology and the attachment areas of cephalic and hyponome retractor muscles two groups can be subdivided: - Depressed, evolute morphotypes with longidome body-chambers show only small ventral hyponome retractor muscles. Lateral cephalic retractors are not developed. These morphotypes are adapted to a demersal mode of life. Without strong cephalic retractor muscles no efficient jet propulsion can be produced. These groups represent vertical migrants with efficient phragmocone properties (multilobate sutures, cameral membranes, narrow septal spacing). - Compressed, involute moiphotypes with brevidome body-chambers show strong cephalic and hyponome retractor muscles and represent a group of active swimmers. These morphotypes were able to live at different depths, in the free water column or/and near the seafloor. They are not confined only to one habitat. Most of the examined genera and species belong to this group. Changes of the attachment structures in the course of ontogeny confirm that juveniles of Amaltheus and Quenstedtoceras lived as passive planche drifters in upper and intermediate parts of the free water column after hatching. At the end of the juvenile stage with a shell diameter of 0,3 - 0,5 cm cephalic retractor muscles developed. With the beginning of an active swimming mode of life (neanic stage) the subadult animals left the free water column and moved into shallow water habitats. Fuciniceras showed no marked changes in the attachment structures during ontogeny. This indicates that there occur no differences in the mode of life between juvenile and adult growth stages. Based on attachment structures and shell morphology of Devonian goniatites their relation to the systematic position permits statements about probable phylogenetic relationships between the Cheiloceratidae and Tornoceratidae. In some cases attachment structures of ammonites permit statements about phylogenetic relationships on family and genus level.

Mesenchymal chondrosarcoma: prognostic factors and outcome in 113 patients. A European Musculoskeletal Oncology Society study

BACKGROUND: Mesenchymal chondrosarcoma (MCS) is a distinct, very rare sarcoma with little evidence supporting treatment recommendations. PATIENTS AND METHODS: Specialist centres collaborated to report prognostic factors and outcome for 113 patients. RESULTS: Median age was 30 years (range: 11-80), male/female ratio 1.1. Primary sites were extremities (40%), trunk (47%) and head and neck (13%), 41 arising primarily in soft tissue. Seventeen patients had metastases at diagnosis. Mean follow-up was 14.9 years (range: 1-34), median overall survival (OS) 17 years (95% confidence interval (CI): 10.3-28.6). Ninety-five of 96 patients with localised disease underwent surgery, 54 additionally received combination chemotherapy. Sixty-five of 95 patients are alive and 45 progression-free (5 local recurrence, 34 distant metastases, 11 combined). Median progression-free survival (PFS) and OS were 7 (95% CI: 3.03-10.96) and 20 (95% CI: 12.63-27.36) years respectively. Chemotherapy administration in patients with localised disease was associated with reduced risk of recurrence (P=0.046; hazard ratio (HR)=0.482 95% CI: 0.213-0.996) and death (P=0.004; HR=0.445 95% CI: 0.256-0.774). Clear resection margins predicted less frequent local recurrence (2% versus 27%; P=0.002). Primary site and origin did not influence survival. The absence of metastases at diagnosis was associated with a significantly better outcome (P<0.0001). Data on radiotherapy indications, dose and fractionation were insufficiently complete, to allow comment of its impact on outcomes. Median OS for patients with metastases at presentation was 3 years (95% CI: 0-4.25). CONCLUSIONS: Prognosis in MCS varies considerably. Metastatic disease at diagnosis has the strongest impact on survival. Complete resection and adjuvant chemotherapy should be considered as standard of care for localised disease.

Validation of single photon absorptiometry for on-farm measurement of density and mineral content of tail bone in cattle

A validation study examined the accuracy of a purpose-built single photon absorptiometry (SPA) instrument for making on-farm in vivo measurements of bone mineral density (BMD) in tail bones of cattle. In vivo measurements were made at the proximal end of the ninth coccygeal vertebra (Cy9) in steers of two age groups (each n = 10) in adequate or low phosphorus status. The tails of the steers were then resected and the BMD of the Cy9 bone was measured in the laboratory with SPA on the resected tails and then with established laboratory procedures on defleshed bone. Specific gravity and ash density were measured on the isolated Cy9 vertebrae and on 5-mm2 dorso-ventral cores of bone cut from each defleshed Cy9. Calculated BMD determined by SPA required a measure of tail bone thickness and this was estimated as a fraction of total tail thickness. Actual tail bone thickness was also measured on the isolated Cy9 vertebrae. The accuracy of measurement of BMD by SPA was evaluated by comparison with the ash density of the bone cores measured in the laboratory. In vivo SPA measurements of BMD were closely correlated with laboratory measurements of core ash density (r = 0.92). Ash density and specific gravity of cores, and all SPA measures of BMD, were affected by phosphorus status of the steers, but the effect of steer age was only significant (P < 0.05) for steers in adequate phosphorus status. The accuracy of SPA to determine BMD of tail bone may be improved by reducing error associated with in vivo estimation of tail bone thickness, and also by adjusting for displacement of soft tissue by bone mineral. In conclusion a purpose-built SPA instrument could be used to make on-farm sequential non-invasive in vivo measurements of the BMD of tailbone in cattle with accuracy acceptable for many animal studies.

Assessment of seawater pollution by heavy metals (lead & cadmium) in the Qeshm rocky shore: use of the sea urchin, Echinometra mathaei, as a bioindicator

The general purpose of this study is to investigate the degree of heavy metal accumulation in hard and soft tissue of sea urchin, and determining these tissues as the most suitable bioindicator for lead and cadmium in the environment of the sampling stations. The way of doing this assessment was MOOPAM. Samples were prepared and classified according to sea urchin organ (soft tissue, hard tissue, Tube feet, Test, Lantern Structure and spines) and then lead and cadmium were measured in them. Result of this study shows that hard tissue is a better index of lead and cadmium than soft tissue. The result of bioaccumulation of lead in the related tissue was found to be in the following order: Soft tissue=21, hard tissue=28.1, Test=20.8, Lantern Structure=20.5 and spines=23.9. The result of bioaccumulation of cadmium in the related tissue was found to be in the following order: Soft tissue=9. 7, hard tissue=5.01, Test=4.2, Lantern Structure=4.06 and spines=5.53.

Malignant Otitis Externa and Stroke

Malignant otitis externa (MOE) is an aggressive but benign entity which evolves into skull base osteomyelitis. An 81-year-old female patient was admitted for left hemiparesis and homonymous hemianopia. She complained of headache radiating to the right cervical area. A recent history of recurrent otitis media was present. Head and neck imaging showed an ischemic infarction (right temporo-occipital) and a parapharyngeal soft tissue mass originating in an external and medial ear infection. Culture samples revealed Pseudomonas aeruginosa infection leading to the diagnosis of Malignant otitis externa (MOE). Parenteral antibacterial therapy and hyperbaric oxygen therapy resulted in improvement.

Seasonal variation of acetylcholinesterase, catalase, glutathione s transferase in different size of Pinctada radiata and metal pollution (Pb, Cd, Ni) in Persian Gulf

There are various tools for monitoring the concentration of pollutants on aquatic ecosystems. Today these studies are based on biological monitoring and biomarkers. The aim of this study was to measure the concentration of the acetylcholinesterase (AChE), glutathione S-transferase and catalase as biomarkers of heavy metal contamination in pearl oyster Pinctada radiata and their mechanism in aquatic ecosystems. Heavy metals lead, cadmium and nickel were measured in soft tissue and studied stations in four seasons. Samples were collected seasonally in Lavan stations, Hendurabi and Nakhilo (in the northern Persian Gulf) from spring 2013 to winter of that year by scuba diving. Pearl oysters are divided according to their shells size; shells separated from soft tissues and were transferred to the laboratory for analysis of heavy metals and enzymes. Moopam standard method for were used for measuring the concentration of heavy metals and for analyzing tissue concentrations of glutathione S-transferase in Clam the method recommended by Habig et al in 1974 were used. For measuring acetylcholinesterase Ellman method were used. Catalase contamination in pearl oyster in the supernatant obtained from the study based on the method homogeate soft tissue of mussels (Abei, 1974) was evaluated. The results showed that the concentration of lead has significant difference in sediments station, the concentration of lead in Lavan is significantly higher than the other two stations, This could be due to the movement of tanker, boats and floating refueling and with a considerable amount of wastewater containing oil and Petroleum into the water, and also due to precipitation and industrial discharges the lead in the region is increasing, land-disposed sewage sludge, has large concentrations of lead. Compare the results of this study with standards related and other similar studies at the regional and international level showed that pollutant concentration of heavy metals in all cases significantly less than all the standards and guide values associated. And also compared to other world research results have been far less than others, Being Less of the conclusion given in this research according that nickel is one of the indicators of oil pollution in the study area and emissions have been relatively low of oil. The concentration of acetylcholinesterase at several stations, in large and small sizes and in the seasons had no significant difference. Variations of catalase, and glutathione S-transferase were almost similar to each other and parameters, station and seasons were significantly different in the concentrations of these enzymes. The effects and interaction between various parameters indicate that following parameters has impact on the concentration of catalase and glutathione S-transferase. Stations; Seasonal changes in antioxidant enzymes related to (assuming a constant in salinity and oxygen) to age, reproductive cycle, availability of food and water temperature. With increasing temperature at warm season, antioxidant enzymes were increase, with increasing temperature and abundance of food in the environment the amount of antioxidant enzymes may increase. The presence of the enzyme concentration may indicate that the higher levels of the enzyme to eliminate ROS activities to be any healthier situation. At the time of gonads maturation and spawning season catalase activity increases. This study also indicates that catalase was significantly higher in the warm season. Due to low pollutants of heavy metals in the study area, a lower level of contaminants were observed in shellfish tissue incidents of international standards and strong correlation between the amount of heavy metal contamination in pearl oyster tissue and enzymes was not observed. Therefore, we can say that the pearl oyster remains in a healthy condition and the amount of enzyme is normal.

Deficiencias minerales en bovinos para carne: diagnóstico, caracterización y control

La demanda de una producción de alimentos cada vez mayor a nivel mundial sumado a la tecnificación y al ritmo acelerado del progreso de las explotaciones agropecuarias actuales hacen que el ganado deba soportar elevadas presiones de producción aumentando los requerimientos de nutrientes. Este es el caso de los minerales considerados actualmente elementos esenciales para los animales, aunque tradicionalmente fueron definidos como los nutrientes pobres de la nutrición y alimentación animal. Actualmente se ha demostrado con evidencia clínica y productiva, el importante rol metabólico de los minerales en el animal sano y productivo, como también se ha definido qué elemento mineral y porcentaje del mismo es requerido para el normal funcionamiento del organismo. Los macro-minerales (calcio, magnesio, fósforo, sodio, potasio, cloro y azufre) y los oligo-minerales (cobre, zinc, hierro, selenio, cobalto, iodo, manganeso, molibdeno y cromo) son elementos esenciales y necesarios para transformar la proteína y la energía de los alimentos en componentes del organismo o en productos animales como leche, carne, crías, piel, lana. Además, ayudan al organismo a combatir las enfermedades, manteniendo al animal en buen estado de salud. Se ha considerado a los minerales como el tercer grupo limitante en la nutrición animal, siendo a su vez, el que mayor potencial y menor costo tiene para incrementar la producción del ganado. Los minerales desempeñan funciones tan importantes como ser constituyentes de la estructura ósea y dental, de tejidos blandos y líquidos corporales. Están involucrados en el funcionamiento celular, siendo activadores de más de trescientas enzimas, constituyentes esenciales de vitaminas, hormonas y pigmentos respiratorios y facilitando la actividad de los microorganismos del rumen. Cuando el aporte de minerales en la ración no es el adecuado en calidad y/o cantidad se originan las deficiencias minerales, encuadradas dentro de las enfermedades metabólicas o enfermedades de la producción. Estas han sido informadas en casi todo el mundo y son responsables de importantes pérdidas económicas en los rodeos de bovinos para carne. Las deficiencias y/o desequilibrios minerales pueden causar los siguientes trastornos en los animales: bajo porcentaje de parición, mayor número de servicios por concepción, abortos, retenciones placentarias, incremento del intervalo entre partos, baja producción de leche, menor peso al nacimiento y al destete, menor porcentaje de destete, menor ganancia de peso, mayor incidencia de enfermedades infecciosas, fracturas espontáneas, diarrea, deformación de huesos y mortandad. Así cobra importancia el diagnóstico mediante el análisis de la sangre de los animales, del pasto y el agua que consumen y la caracterización de estas deficiencias en primarias o secundarias con el objetivo de poder realizar un control de las mismas mediante un adecuado plan de suplementación mineral acorde a las necesidades de los distintos establecimientos agropecuarios.

Développement de matériaux à base de protéines extraites du byssus de la moule bleue Mytilus edulis

Le byssus est un amas de fibres que les moules produisent afin de s’ancrer aux surfaces immergées sous l’eau. Ces fibres sont pourvues de propriétés mécaniques impressionnantes combinant rigidité, élasticité et ténacité élevées. De plus, elles possèdent un comportement d’auto-guérison de leurs propriétés mécaniques en fonction du temps lorsque la contrainte initialement appliquée est retirée. Les propriétés mécaniques de ces fibres sont le résultat de l’agencement hiérarchique de protéines de type copolymère blocs riches en collagène et de la présence de métaux formant des liens sacrificiels réversibles avec certains acides aminés comme les DOPA et les histidines. Bien que cette fibre soit très intéressante pour la production de matériaux grâce à son contenu élevé en collagène potentiellement biocompatible, cette ressource naturelle est traitée comme un déchet par les mytiliculteurs. L’objectif de cette thèse était de valoriser cette fibre en extrayant les protéines pour générer une nouvelle classe de matériaux biomimétiques. Un hydrolysat de protéines de byssus (BPH) riche en acides aminés chargés, i.e. ~30 % mol, et permettant de former des films a pu être généré. Lorsque solubilisé à pH 10.5, le BPH forme un hydrogel contenant des structures en triple hélice de collagène et des feuillets β anti-parallèles intra- et inter-moléculaires. Suite à l’évaporation de l’eau, le film de BPH résultant est insoluble en milieu aqueux à cause des structures secondaires très stables agissant comme points de réticulation effectifs. Les propriétés mécaniques des films de BPH sont modulables en fonction du pH. Au point isoélectrique (pI = 4.5), les interactions électrostatiques entre les charges opposées agissent comme points de réticulation et augmentent la rigidité des films et leur contrainte à la rupture sans affecter la déformation à la rupture. À pH plus élevé ou plus bas que le pI, les performances mécaniques des films sont plus faibles à cause de la répulsion entre les groupements fonctionnels de même charge qui interagissent plutôt avec les molécules d’eau et causent le gonflement de la matrice protéique des films. Le BPH contenant un nombre élevé d’acides aminés chargés et réactifs, nous avons pu réticuler les films de manière covalente à l’aide d’EDC ou de glutaraldéhyde. Les propriétés mécaniques des films sont modulables en fonction de la concentration d’EDC utilisée lors de la réticulation ou en employant du glutaraldéhyde comme agent réticulant. Les films sont à la fois plus rigides et plus forts avec un degré de réticulation élevé, mais perdent leur extensibilité à mesure que les segments libres de s’étirer lors d’une traction deviennent entravés par les points de réticulation. La réticulation augmente également la résistance à la dégradation enzymatique par la collagénase, les films les plus fortement réticulés lui étant pratiquement insensibles. La spectroscopie infrarouge montre enfin que la réticulation entraîne une transition de feuillets β anti-parallèles inter-moléculaires vers des structures de type hélices de collagène/PPII hydratées. Des liens sacrificiels ont été formés dans les films de BPH par traitement au pI et/ou avec différents métaux, i.e. Na+, Ca2+, Fe3+, afin de moduler les propriétés mécaniques statiques et d’évaluer le rôle de ces traitements sur le comportement d’auto-guérison lors de tests mécaniques cycliques avec différents temps de repos. Plus la valence des ions métalliques ajoutés augmente, plus les propriétés mécaniques statiques affichent un module, une contrainte à la rupture et une ténacité élevés sans toutefois affecter la déformation à la rupture, confirmant la formation de liens sacrificiels. Les tests mécaniques cycliques montrent que les traitements au pI ou avec Ca2+ créent des liens sacrificiels ioniques réversibles qui mènent à un processus d’auto-guérison des performances mécaniques dépendant du pH. L’ajout de Fe3+ à différentes concentrations module les performances mécaniques sur un plus large intervalle et la nature plus covalente de son interaction avec les acides aminés permet d’atteindre des valeurs nettement plus élevées que les autres traitements étudiés. Le Fe3+ permet aussi la formation de liens sacrificiels réversibles menant à l’auto-guérison des propriétés mécaniques. Les spectroscopies Raman et infrarouge confirment que le fer crée des liaisons avec plusieurs acides aminés, dont les histidines et les DOPA. Les résultats dans leur ensemble démontrent que les films de BPH sont des hydrogels biomimétiques du byssus qui peuvent être traités ou réticulés de différentes façons afin de moduler leurs performances mécaniques. Ils pourraient ainsi servir de matrices pour des applications potentielles dans le domaine pharmaceutique ou en ingénierie tissulaire.

Evaluation of the antioxidant activity and antitumor activity of marine invertebrates extracts

Dissertação de Mestrado, Biologia Marinha, Faculdade de Ciências e Tecnologias, Universidade do Algarve, 2014

Diabetes Mellitus tipo 1 em Odontopediatria

A Diabetes Mellitus é conhecida por uma doença metabólica caracterizada por um défice na ação ou secreção da insulina, na qual a consequência direta é o aparecimento de hiperglicemia, isto é, o nível de glicose apresentar valores elevados (Kidambi, 2008; Silva-Sousa, 2003). A DM1, especificamente, é apresentada como uma doença que é resultado da destruição das células beta do pâncreas, desenvolvendo assim, um défice na produção de insulina (Raymond et al., 2001). As complicações orais da DM1 incluem xerostomia, doença periodontal (gengivite e periodontite), abcessos dentários, perda de dentes, lesões de tecidos moles e síndrome de ardência oral. A complicação oral mais frequente da DM1 nas crianças é o aumento da sensibilidade à doença periodontal. A doença periodontal é caracterizada como uma reação inflamatória infecciosa dos tecidos gengivais (gengivite) ou do suporte dos dentes, ou seja, ligamento periodontal, cemento e osso alveolar (periodontite), podendo induzir um certo grau de resistência à insulina. Ambas as doenças resultam da interação entre microorganismos periodontais patogénicos. A avaliação e influência do controlo da doença é expressa pelos valores médios de hemoglobina glicosada (Hba1c) na saúde oral nas crianças e adolescentes com DM1. Vários estudos demonstraram que o controlo glicémico teve uma influencia sobre a saúde oral de crianças e adolescentes com DM1. Assim uma avaliação oral, deve fazer parte de procedimentos de rotina no atendimento de crianças e adolescentes com DM1. O dentista deve ser parte da equipa multidisciplinar que auxilia os indivíduos com DM1. O tratamento precoce numa população infantil com DM1, pode diminuir a severidade da doença periodontal. O presente trabalho tem por objectivo realizar uma revisão bibliográfica sobre a importância do estudo em crianças e adolescentes portadores de DM1 e doenças da cavidade oral, nomeadamente, a periodontite, e respetivas implicações.

Manifestações orais associadas ao consumo da droga de abuso MDMA

O uso para fins ou meios festivos de lazer da droga ilícita MDMA, também chamado de Ecstasy ou Moly, tem vindo a aumentar drasticamente em Portugal e no Mundo. Esta situação desafia os profissionais de saúde para vários parâmetros na saúde oral e geral. O objetivo desta dissertação visa avaliar e descrever as lesões e patologias na cavidade oral que estão relacionadas com o consumo da substância ilícita MDMA. As consequências para a cavidade oral podem ser a xerostomia, o bruxismo, as cáries rampantes, a doença periodontal, o desgaste e a erosão dentária, e as lesões dos tecidos moles. Os indivíduos consumidores podem apresentar carências nutricionais e um estímulo aumentado à dor. A gestão do prognóstico e o tratamento realizado aos consumidores de MDMA, pois afeta vários órgãos e sistemas no corpo humano, requer uma abordagem multidisciplinar que inclui educação, prevenção e tratamento integrados. Esta revisão bibliográfica teve com base artigos publicados em revistas científicos e monografias disponíveis em vários motores de busca. As palavras-chave usadas foram: “ecstasy”, “MDMA”, “oral manifestations”, “oral health”, “substance abuse”, ”overdose treatment”, “xerostomia” e “methamenfetamine” e a sua conjugação. As situações orais, perante as mais prevalentes comorbidades patogénicas relacionadas com o MDMA e outras dependências ilícitas, necessitam de mais atenção e reforço em relação à prática clínica e aos serviços de saúde. Uma das dificuldades para o tratamento correto destes indivíduos é a falta de informação sobre o assunto referente à prática na clínica dentária. A omissão sobre o consumo por parte do paciente bem como de uma recaída no uso, apresentam dúvidas sobre o fator em causa ou até mesmo no diagnóstico. São, muitas vezes, os Médicos Dentistas os primeiros a terem a oportunidade de diagnosticar o aparecimento de possíveis alterações surgidas em virtude do consumo de MDMA.

Caracterización de trastornos musculo esqueléticos en trabajadores de dos empresas de servicios en Bogotá D.C 2015

Objetivo: El objetivo de este estudio fue determinar la prevalencia de los trastornos músculoesqueléticos y la asociación con factores sociodemográficos y hábitos de vida en trabajadores de las áreas administrativa y operativa de dos empresas de servicio de la ciudad de Bogotá 2015. Materiales y Métodos: Se realizó un estudio de corte transversal, con información secundaria, procedente de bases de datos suministrada por las dos empresas con 696 registros de trabajadores de servicios generales, y 943 registros de trabajadores del área administrativa, para un total de 1639 registros, en los cuales se evaluó la presencia de síntomas osteomusculares clasificados por segmento. Adicionalmente se contaba con información de características sociodemográficas y estilos de vida de estos trabajadores. Se obtuvieron las distribuciones de frecuencias absolutas y relativas para las variables cualitativas, y las medidas de tendencia central y de dispersión para las variables cuantitativas. Para establecer la asociación entre factores sociodemográficos con las variables dependientes se utilizó la prueba chi2 de asociación. Resultados: La prevalencia de molestia o dolor en los diferentes segmentos corporales fue de 21.5 % (n = 203) en cuello para la población administrativa y de 17.5% (n = 148) en mano y muñeca derecha para la población de servicios generales. Vale la pena aclarar que el diagnóstico médico más frecuente referido por la población en estudio fue traumas en musculo, bursa tendón y/o ligamento con 10.5% en la población administrativa y con el 12.4% en la población de servicios generales. De las asociaciones significativas entre diagnósticos presentes y hábitos de vida y sueño se encontró que sueño no reparador se asoció significativamente con enfermedad general de músculos y huesos (p = 0.001), enfermedad o trauma activo de tejidos blandos (p = 0,000) y antecedente o enfermedad actual de columna vertebral (p = 0,000). De manera similar, el consumo de medicamentos para conciliar el sueño se asoció con enfermedad de tejidos blandos (p = 0,000) y enfermedad actual de columna vertebral (p = 0,000). El consumo de café (p = 0.001) y el sedentarismo (p = 0.031) están asociados con la enfermedad general de músculos y huesos. Conclusiones: Los TME son un factor de alta prevalencia en la población trabajadora de Colombia, y como se demostró en este estudio, afectan a la población de las empresas de servicio. Se evidencia cada vez más que los segmentos corporales más afectados en la población administrativa, son cabeza y cuello, debido a las posturas mantenidas por largos periodos de tiempo, y en la población de servicios se encontró molestia y dolor en muñecas y manos debido a los movimientos repetitivos que deben de realizar durante la jornada laboral. Se hace necesario profundizar más en la asociación significativa de los trastornos del sueño y la presencia de los TME, ya que se encontró una relación importante entre estos dos.

Spectral Region Optimization for Raman-Based Optical Biopsy of Inflammatory Lesions

Objective: The biochemical alterations between inflammatory fibrous hyperplasia (IFH) and normal tissues of buccal mucosa were probed by using the FT-Raman spectroscopy technique. The aim was to find the minimal set of Raman bands that would furnish the best discrimination. Background: Raman-based optical biopsy is a widely recognized potential technique for noninvasive real-time diagnosis. However, few studies had been devoted to the discrimination of very common subtle or early pathologic states as inflammatory processes that are always present on, for example, cancer lesion borders. Methods: Seventy spectra of IFH from 14 patients were compared with 30 spectra of normal tissues from six patients. The statistical analysis was performed with principal components analysis and soft independent modeling class analogy cross-validated, leave-one-out methods. Results: Bands close to 574, 1,100, 1,250 to 1,350, and 1,500 cm(-1) (mainly amino acids and collagen bands) showed the main intragroup variations that are due to the acanthosis process in the IFH epithelium. The 1,200 (C-C aromatic/DNA), 1,350 (CH(2) bending/collagen 1), and 1,730 cm(-1) (collagen III) regions presented the main intergroup variations. This finding was interpreted as originating in an extracellular matrix-degeneration process occurring in the inflammatory tissues. The statistical analysis results indicated that the best discrimination capability (sensitivity of 95% and specificity of 100%) was found by using the 530-580 cm(-1) spectral region. Conclusions: The existence of this narrow spectral window enabling normal and inflammatory diagnosis also had useful implications for an in vivo dispersive Raman setup for clinical applications.

Tissue and serum immune response in chronic hepatitis C with mild histological lesions

The immunopathogenesis of chronic hepatitis C virus (HCV) infection is a matter of great controversy and has been suggested to involve a complex balance between cytokines with pro and anti-inflammatory activity. We investigated the expression of inflammatory cells and cytokines in the liver and serum of 51 chronically HCV infected patients and compared them to data from two sets of normal controls: 51 healthy blood donors and 33 liver biopsies of healthy liver donors. We also assessed the relationship between selected cytokines and cell populations in hepatic compartments and the disease stage. Compared with controls, hepatitis C patients had a greater expression of portal TNF-α, TGF-β and CD4+ and acinar IFN-γ, TNF-α, IL-1β and IL-4, as well as a higher serum concentration of IL-2, IL-10 and TGF-β. Significant positive correlations were found between portal CD4+ and TNF-α, portal CD8+ and TGF-β, portal CD45+RO and TNF-α, acinar CD45+RO and IFN-γ and acinar CD57+ and TGF-β. In conclusion, we have shown that (i) in this sample of predominantly mild disease, the immune response was associated with a pro-inflammatory response pattern, (ii) CD4+ T-lymphocytes played a major role in orchestrating the immune response and (iii) these events primarily took place in the portal space.