Traumatismos dentários em desportos de contacto

Dissertação para obtenção do grau de Mestre no Instituto Superior de Ciências da Saúde Egas Moniz

Efeitos da suplementação oral com L-arginina e L-glutamina sobre a próstata ventral de ratos submetidos à irradiação

O objetivo deste trabalho foi verificar o possível efeito protetor da L-glutamina e da L-arginina sobre a próstata ventral de ratos quando administradas por gavagem. Procurou-se simular as condições clinicas de pacientes submetidos à radioterapia pélvica tendo como órgão alvo outro órgão pélvico que não a próstata. Foram analisados os efeitos desta irradiação sobre a próstata considerando este órgão como normal. Foram utilizados ratos Wistar divididos em quatro grupos: Controle, animais não submetidos à irradiação (n= 10); Irradiado, submetidos à irradiação abdominal e sem suplementação adicional de aminoácido por 21 dias (n= 10); Irradiado + Lglutamina, submetidos à irradiação abdominal e com suplementação adicional de L- glutamina por 21 dias (n= 10); e Irradiado + L-arginina, submetidos à irradiação abdominal e com suplementação adicional de L- arginina por 21 dias (n= 9). Os grupos foram mantidos em condições padrão de laboratório durante todas as etapas do experimento. Os animais submetidos à irradiação abdominal receberam uma dose única de 1000 cGy no dia 8 da experimentação. A Lglutamina e a L-arginina foram dissolvidas em água destilada e administrada por gavagem através da agulha IC-810. As próstatas foram removidas e processadas para inclusão em parafina. Foram estudados os seguintes parâmetros: estrutura acinar (área dos ácinos e altura do epitélio) e colágeno analisados por métodos morfométricos e peso corporal. O ganho de peso nos grupos suplementados foi significativamente maior se comparado ao grupo irradiado. Houve redução da altura do epitélio no grupo irradiado quando comparado ao controle. A altura do epitélio no grupo suplementado com L-arginina foi significativamente maior do que nos grupos irradiado e suplementado com L-glutamina. Houve diminuição, de aproximadamente 18%, da área dos ácinos no grupo suplementado com L-glutamina. Já no grupo suplementado com Larginina o valor foi similar ao do controle. O efeito da L-glutamina sobre o parênquima prostático foi o de manter proporcionalmente o colágeno, preservando a integridade da matriz extracelular. No grupo suplementado com L-arginina, apesar da discreta redução na distribuição proporcional de colágeno este também manteve índices semelhantes ao do controle. A radiação abdominal promoveu algumas modificações estruturais na próstata ventral de ratos. Essas modificações podem ser parcialmente prevenidas pela suplementação oral com L-glutamina e de L-arginina.

Avaliação clínica e microbiológica das condições de saúde oral dos receptores de transplante renal do Hospital Universitário Onofre Lopes, Natal RN

Introduction: The chronic immunosuppression promotes the development of changes in the oral cavity of the kidney transplant recipients (KTR), however with the exception of gingival overgrowth, little is known regarding the prevalence of oral lesions in this population. Objective: To evaluate the prevalence of clinical and microbiological conditions of the oral cavity of the recipients of kidney transplantation and the associated factors. Methods: This was a cross-sectional study which examined 96 clinical KTR and experimental where collected saliva stimulated them to identify Candida sp. Data collection consisted of evaluation stomatologic, socio-demographic, clinical aspects of transplantation, condition of oral hygiene and dental caries, yonder to questions about knowledge of oral alteration after transplantation. Results: Of the total, 66.7% of KTR had some type of oral manifestation. The most common was saburral tongue, followed by gingival overgrowth, with both oral manifestations related to gender and concomitant use of cyclosporine and nifedipine (p <0.05). Tacrolimus showed a protective effect for gingival overgrowth (OR = 0.13). The oral hygiene was associated with saburral tongue(p = 0.03) and severity of gingival overgrowth (p = 0.0001). Oral candidiasis was diagnosed in 17.7% of patients and Candida albicans was isolated most frequently in the saliva of RTR with a colonization of 58.3%. The average DMF-T increased with age. The method of oral hygiene was most used brush and toothpaste to 61.5%. Changes in the oral cavity was seen in 54.2% of KTR, citing as the main growth and gingival ulcers. Instructions for oral hygiene after transplantation were neglected for 61.5% of RTR. Dry mouth and halitosis were reported in 30.2% and 36.5% respectively. Conclusions: More the half of the KTR had at least one injury of the mouth, the immunosuppressive drugs and oral hygiene are associated with these alterations. Prospective cohort studies are needed to elucidate the relationship between oral manifestations and levels of drug and risk of oral manifestations occur over time. The kidney transplant recipients showed to be aware of oral alterations occurred after transplantation and uninformed about the oral hygiene instructions. With regard to hygiene, the incidence of caries was considered high, conditions of risk were identified and improvements in primary attention should be encouraged and reflected in the monitoring of renal transplant

Efeito protetor da vitima E(ɑ-TOCOFEROL) contra a atividade citotóxica do peróxido de hidrogenênio

Pós-graduação em Reabilitação Oral - FOAR

Avaliação do efeito protetor da prolactina em linfócitos expostos a ação do metilmercúrio

O mercúrio pode ser encontrado em diversas formas, sendo a orgânica como metilmercúrio (MeHg), considerada a mais tóxica. Facilmente absorvido por via oral, se acumula na cadeia trófica e se amplifica em carnívoros aquáticos, principalmente em peixes, daí o risco maior para as populações que deles se alimentam preferencialmente, como os ribeirinhos Amazônidas. O efeito neurotóxico dessa forma de mercúrio tem sido amplamente demonstrado através de estudos epidemiológicos e experimentais. Alguns desses estudos também mostraram que hormônios e substâncias antioxidantes podem agir protegendo o organismo contra a ação deletéria do mercúrio. A prolactina é um destes hormônios que apresenta ação protetora, mas age também como citocina pró-inflamatória. Desde que o MeHg pode também agir como uma substância imunotóxica, procuramos neste trabalho estudar a ação citoprotetora da PRL em cultivos contínuos de linhagem B95-A de linfócitos de primata afim de avaliar sua fragilidade ao MeHg e sua reatividade a ação da PRL. Com o objetivo de avaliar a integridade funcional dos linfócitos expostos ao MeHg utilizou-se teste de reação colorimétrica para 3-(4,5-dimetiltiazol-2-yl)-2,5-difenil tetrazólio bromide (MTT), o qual detecta atividade metabólica mitocondrial. Para avaliar a resposta imune do linfócito, medidas da concentração do fator de necrose tumoral alfa (TNF α) no sobrenadante do cultivo, foram realizadas por ELISA. É uma citocina pró-inflamatória liberada em resposta a agressão celular de diferentes causas, incluindo estresse oxidativo, um dos efeitos agudos mais evidentes do MeHg, além disso, esta citocina também poder responder a regulação prolactinérgica em linfócitos humanos. Após 18 horas de exposição do cultivo a crescentes concentrações do metal (0,1; 1, 5, 10 e 50 μM) verificou-se significativa diminuição do tipo dose-dependente da viabilidade celular a partir de 1 μM (35%) e progressivamente até 50 μM (80%), quando poucas células íntegras foram encontradas nos cultivos. Um efeito bifásico em forma de “sino” ocorreu na liberação de TNF α, onde concentrações mais baixas de MeHg inibiram (0,1 e 1 μM), a intermediária estimulou (5 μM) e as duas maiores (10 e 50 μM) voltaram a inibir. A prolactina também diminuiu a viabilidade celular, em cerca de 30%, somente na dose mais elevada (10 nM). Por outro lado, na dose de 1 nM a PRL preveniu a diminuição de 40% da viabilidade celular resultante a exposição ao MeHg a 5 μM. Esta dose de 1 nM de PRL foi a única a estimular a liberação de TNF α, mas curiosamente, reverteu a liberação desta citocina quando associada a 5 μM de MeHg, concentração que igualmente estimulou a secreção de TNF α. Os resultados confirmaram a toxidade do MeHg para linfócitos de primatas (linhagem B95-A) e sua reversão por uma possível ação protetora da PRL. Um efeito bifásico na secreção de TNF α resultou da exposição ao MeHg, sugerindo a presença de diferentes mecanismos citotóxicos resultantes a ação mercurial. Por outro lado, a PRL foi pouco efetiva em estimular a secreção daquela citocina, invertendo esta resposta quando associada ao MeHg. No entanto, estes resultados são preliminares e carecem de um estudo mais acurado para sua completa elucidação.

Estresse oxidativo, alterações metabólicas e renais decorrentes da elevada ingestão de sacarose: efeito protetor da N-acetilcisteína (NAC)

Oxidative stress is related with physiopathology of diabetes mellitus type II and with its secondary complications, such as diabetic nephropathy. Thus, the purpose of this study was to examine the effects of n-acetylcysteine NAC, an antioxidant from Allium cepa, on oxidative stress, morphometrical and nutritional parameters and basal metabolism and energetic substrate utilization, serum glucose and oral glucose tolerance test (OGTT), and renal function of high-sucrose intake rats. Animals were initially divided into three groups. Rats in the control group (C; n=10) were given free access to a standard chow and water; (S; n=10) group received standard chow and 30% sucrose in its drinking water; (SN; n=5) group received standard chow and 2g/L NAC and 30% sucrose in its drinking water. After 25 days of treatments, rats were submitted to indirect calorimetry in fasted and feed states. After 30 days of treatments, rats from C and S groups were divided into four groups of five rats each. The (CC) and (SS) groups were given an intra-gastric dose 0,6mL saline (0,9%NaCl) and the (CNAC) and (SNAC) groups were treated with a intra-gastric dose of 0,6mL NAC (160g/day), and then everybody received a intra-gastric dose of glucose solution (20%) for the OGTT. Animals of S and SN groups have higher liquid consumption and lower food consumption than C group. Calorimetric analyses confirm that despite of the final body weight had not statistical difference among groups, S group have lower resting metabolic rate when compared to C and SN animals. Besides, S group has higher respiratory quotient, higher carbohydrate oxidation and lower lipid oxidation, both in fasted and feed states, than C and SN groups, evidencing the beneficial effect of NAC. Fasting plasma glucose is increased in SS and SNAC animals when compared to CC and CNAC, however SN group has glicemic level at 30 min before OGTT decreased when ...(Complete abstract click electronic access below)

Comportamentos alimentares e saúde oral em voleibolistas

Introdução e objectivos: A saúde oral em atletas é parte essencial para a saúde geral, sendo um factor determinante para a qualidade de vida e desempenho desportivo. Logo, um bom estado de saúde só existirá se a cavidade oral se encontrar ausente de patologias. Os desequilíbrios nutricionais possuem efeitos sobre a cavidade oral, condicionando assim a qualidade de vida e desempenho do atleta. Desta forma, o excesso de ingestão de alguns alimentos podem ser factores de risco para a saúde, tendo conta em que, a etiologia da cárie dentária está relacionada com a ação de microorganismos orais que produzem ácidos orgânicos, a partir do metabolismo dos hidratos de carbono. O objectivo deste estudo foi avaliar a saúde oral bem como os hábitos alimentares e o uso de protetores bucais durante a prática desportiva. Participantes e Métodos: Foram observados 55 atletas de voleibol entre os 15 e 18 anos de ambos os géneros, do clube de voleibol Academia José Moreira e Leixões. Tratou-se de um estudo transversal, no qual foi realizado exame clínico intraoral (índice de cárie CPOd, indice de erosão dentária BEWE) e preenchimento de questinário, em que os indivíduos foram caracterizados em 5 componentes: dados sociodemográficos (idade, peso e estatura), dados sobre perceção de saúde, dados sobre comportamentos de saúde oral, dados sobre prática desportiva e dados sobre comportamentos alimentares (questionário semi-quantitativo de frequência alimentar). A análise estatística descritiva e inferencial dos dados recolhidos foi realizada com o auxílio do programa informático SPSS, versão 23.0. Resultados: Os hábitos de saúde oral não são os mais adequados e a percentagem de atletas que visita o médico dentista é elevada para “só quando tem dores” ou “ocasionalmente”. A média do CPOD geral foi de 4,22 ± 4,55. Não houve diferenças estatisticamente significativas (p>0,05) entre o CPOD geral e o IMC. Nenhum dos atletas usa protetor bucal durante a prática desportiva. Os alimentos mais consumidos foram a carne, fruta, leite, peixe e, biscoitos, bolos e bolachas; e os menos consumidos foram as bebidas alcoólicas, mel ou compotas e café. Conclusão: Os hábitos de higiene oral são um melhor indicador do que o IMC para a presença de cárie. Não há relação direta entre índice CPOD e IMC. Seria importante prestar mais informação sobre vantagens do uso de protetores bucais junto dos atletas e de treinadores bem como, esclarecer que a consistência e as propriedades sensoriais ligadas à textura e à consistência dos alimentos na superfície dentária interferem com a cárie.

Screening for drugs in oral fluid : illicit drug use and drug driving in a sample of urban and regional Queensland motorists

Police services in a number of Australian states and overseas jurisdictions have begun to implement or consider random road-side drug testing of drivers. This paper outlines research conducted to provide an estimate of the extent of drug driving in a sample of Queensland drivers in regional, rural and metropolitan areas. Oral fluid samples were collected from 2657 Queensland motorists and screened for illicit substances including cannabis (delta 9 tetrahydrocannibinol [THC]), amphetamines, ecstasy, and cocaine. Overall, 3.8% of the sample (n = 101) screened positive for at least one illicit substance, although multiple drugs were identified in a sample of 23 respondents. The most common drugs detected in oral fluid were ecstasy (n = 53), and cannabis (n = 46) followed by amphetamines (n = 23). A key finding was that cannabis was confirmed as the most common self-reported drug combined with driving and that individuals who tested positive to any drug through oral fluid analysis were also more likely to report the highest frequency of drug driving. Furthermore, a comparison between drug vs. drink driving detection rates for one region of the study, revealed a higher detection rate for drug driving (3.8%) vs. drink driving (0.8%). This research provides evidence that drug driving is relatively prevalent on Queensland roads, and may in fact be more common than drink driving. This paper will further outline the study findings’ and present possible directions for future drug driving research.

Orals ain't orals : how instruction and assessment practices affect delivery choices with prepared student oral presentations.

Despite an ostensibly technology-driven society, the ability to communicate orally is still seen as an essential ability for students at school and university, as it is for graduates in the workplace. The need to develop effective oral communication skills is often tied to future work-related tasks. One tangible way that educators have assessed proficiency in this area is through prepared oral presentations. While some use the terms oral communication and oral presentation interchangeably, other writers question the role more formal presentations play in the overall development of oral communication skills. Adding to the discussion, this paper is part of a larger study examining the knowledge and skills students bring into the academy from previous educational experiences. The study examines some of the teaching and assessment methods used in secondary schools to develop oral communication skills through the use of formal oral presentations. Specifically, it will look at assessment models and how these are used as a form of instruction as well as how they contribute to an accurate evaluation of student abilities. The purpose of this paper is to explore key terms and identify tensions between expectations and practice. Placing the emphasis on the ‘oral’ aspect of this form of communication this paper will particularly look at the ‘delivery’ element of the process.

Quality-based benefit design in health insurance : the impact of a product benefit design change on the utilisation of oral health services by members of a private health insurance fund in regional and rural New South Wales, Australia

Objective: To examine the impact on dental utilisation following the introduction of a participating provider scheme (Regional and Rural Oral Health Program {RROHP)). In this model dentists receive higher third party payments from a private health insurance fund for delivering an agreed range of preventive and diagnostic benefits at no out-ofpocket cost to insured patients. Data source/Study setting: Hospitals Contribution Fund of Australia (HCF) dental claims for all members resident in New South Wales over the six financial years from l99811999 to 200312004. Study design: This cohort study involves before and after analyses of dental claims experience over a six year period for approximately 81,000 individuals in the intervention group (HCF members resident in regional and rural New South Wales, Australia) and 267,000 in the control group (HCF members resident in the Sydney area). Only claims for individuals who were members of HCF at 31 December 1997 were included. The analysis groups claims into the three years prior to the establishment of the RROHP and the three years subsequent to implementation. Data collection/Extraction methods: The analysis is based on all claims submitted by users of services for visits between 1 July 1988 and 30 June 2004. In these data approximately 1,000,000 services were provided to the intervention group and approximately 4,900,000 in the control group. Principal findings: Using Statistical Process Control (SPC) charts, special cause variation was identified in total utilisation rate of private dental services in the intervention group post implementation. No such variation was present in the control group. On average in the three years after implementation of the program the utilisation rate of dental services by regional and rural residents of New South Wales who where members of HCF grew by 12.6%, over eight times the growth rate of 1.5% observed in the control group (HCF members who were Sydney residents). The differences were even more pronounced in the areas of service that were the focus of the program: diagnostic and preventive services. Conclusion: The implementation of a benefit design change, a participating provider scheme, that involved the removal of CO-payments on a defined range of preventive and diagnostic dental services combined with the establishment and promotion of a network of dentists, appears to have had a marked impact on HCF members' utilisation of dental services in regional and rural New South Wales, Australia.

A qualitative study of the experience of oral cancer among Taiwanese men

The incidence and mortality of oral cancer in Taiwanese men have increased over the past decade, primarily associated with a surge in the popularity of betel quid chewing. The aim of this study was to examine the experience of six Taiwanese men with oral cancer, who were aged between 40 and 60 years, using a qualitative approach. The three major themes emerging from the data include: (i) understanding the cancer diagnosis; (ii) the challenges of cancer treatment; and (iii) adapting to difference. Increasing nurses' understanding of the experiential aspects of oral cancer in this population is required if nurses are to develop successful health promotion programmes and nursing interventions to meet these patients' needs.

Telcagepant is a new oral treatment for migraine

Background : Migraine is a common cause of disability. Many subjects (30 – 40%) do not respond to the 5-HT 1B/1D agonists (the triptans) commonly used in the treatment of migraine attacks. Calcitonin gene-related protein (CGRP) receptor antagonism is a new approach to the treatment of migraine attacks. Objectives/methods : This evaluation is of a Phase III clinical trial comparing telcagepant, an orally active CGRP receptor antagonist, with zolmitriptan in subjects during an attack of migraine. Results : Telcagepant 300 mg has a similar efficacy to zolmitriptan in relieving pain, phonophobia, photophobia, and nausea. Telcagepant was better tolerated than zolmitriptan. Conclusions : The initial Phase III clinical trial results with telcagepant are promising but several further clinical trials are needed to determine the place of telcagepant in the treatment of migraine attacks

The oral health of critically ill children

Introduction. In adults, oral health has been shown to worsen during critical illness as well as influence systemic health. There is a paucity of paediatric critical care research in the area of oral health; hence the purpose of the Critically ill Children’s Oral Health (CCOH) study is to describe the status of oral health of critically ill children over time spent in the paediatric intensive care unit (PICU). The study will also examine the relationship between poor oral health and a variety of patient characteristics and PICU therapies and explore the relationship between dysfunctional oral health and PICU related Healthcare-Associated Infections (HAI). Method. An observational study was undertaken at a single tertiary-referral PICU. Oral health was measured using the Oral Assessment Scale (OAS) and culturing oropharyngeal flora. Information was also collected surrounding the use of supportive therapies, clinical characteristics of the children and the occurrence of PICU related HAI. Results. Forty-six participants were consecutively recruited to the CCOH study. Of the participants 63% (n=32) had oral dysfunction while 41% (n=19) demonstrated pathogenic oropharyngeal colonisation during their critical illness. The potential systemic pathogens isolated from the oropharynx and included Candida sp., Staphylococcus aureus, Haemophilus influenzae, Enterococcus sp. and Pseudomonas aeruginosa. The severity of critical illness had a significant positive relationship (p=0.046) with pathogenic and absent colonisation of the oropharynx. Sixty-three percent of PICU-related HAI involved the preceding or simultaneous colonisation of the oropharynx by the causative pathogen. Conclusion. Given the prevalence of poor oral health during childhood critical illness and the subsequent potential systemic consequences, evidence based oral hygiene practices should be developed and validated to guide clinicians when nursing critically ill children.