King George III of England and Queen Maria I of Portugal: bipolar disorder and prince regents as common features of their reigns

Abstract Humanity is sporadically subjected to leaders with deviant behavior, ego problems, or psychiatric disorders, potentially leading to social instability. Bipolar disorder is not common in all populations, but, coincidentally, studies suggest that it affected two sovereigns that were contemporaries, King George III of England, who died 201 years ago, and Queen Maria I of Portugal, who died 205 years ago. They lived during a time when Europe was in turmoil with the French Revolution and Napoleonic Wars, which also coincided with the rise of psychiatry. Both monarchs were forced to have prince regents rule in their place, due to their emotional decline, and they shared the same medical consultant, Francis Willis.

Antibiotic indication in endodontics by Colombian dentists with different levels of training: a survey / Indicação dos antibióticos em Endodontia por dentistas colombianos com diferentes níveis de formação: uma pesquisa por questionário

ABSTRACT Aim: This study investigated how Colombian dentists with different academic levels indicate antibiotics with therapeutic purposes in endodontics. Materials and method: A cross-sectional survey was conducted among 559 dentists in the form of an online questionnaire. Results: Three hundred and twenty questionnaires were answered (57.2%). There were significant differences among respondents. For irreversible pulpitis, 140 dentists (43.7%) said they prescribe antibiotics (57.5% of general practitioners, 20.1% of specialists and 38.9% of those with Master's and/or PhD degrees), while for symptomatic apical periodontitis, 183 (57.2%) did so (74.1% of general practitioners, 28.4% of specialists and 50.0% of those with Master's and/or PhD degrees) (p < 0.05). Amoxicillin was the most frequently prescribed antibiotic, and its association with clavulanic acid was the most often cited for acute periradicular abscess with systemic involvement. Conclusions: The greatest misunderstandings in prescribing antibiotics occurred among general practitioners. Considering all clinical conditions that do not require antibiotics, 60% of general practitioners and 34% of specialists, on average, indicated antibiotics.

RESUMO Objetivo: Este estudo investigou como dentistas colombianos com diferentes níveis acadêmicos indicaram antibióticos com fins terapêuticos em Endodontia. Materiais e método: Realizou-se um levantamento transversal com 559 dentistas. Foi enviado um questionário online. Resultados: Foram respondidos 320 questionários (57,2%). Houve diferenças significativas entre os profissionais com diferentes níveis de formação. Para pulpite irreversível, 140 (43,7%) dentistas afirmaram indicar antibióticos (57,5% clínicos gerais, 20,1% especialistas e 38,9% com mestrado e/ou doutorado), enquanto para periodontite apical sintomática, 183 (57,2%) prescrevem estes medicamentos (74,1% clínicos, 28,4% especialistas e 50,0% com mestrado e doutorado) (p < 0,05). A amoxicilina foi a mais indicada entre os profissionais, e sua associação com ácido clavulânico foi a mais referida para abscesso perirradicular agudo com acometimento sistêmico. Conclusões: Os maiores equívocos na prescrição de antibióticos ocorreram com os clínicos gerais. Considerando todas as condições clínicas que não requerem antibióticos, 60% dos clínicos gerais e 34% dos especialistas, em média, indicaram estes medicamentos.

Pro-and Anti-inflammatory Biomarkers as Potential Prognosis Markers in Oral Squamous Cell Carcinoma

ABSTRACT: The most widely used method to classify prognostic factors in cancers today is TNM. However, Oral Squamous Cell Carcinoma (OSCC) often demonstrates different behaviors in relation to aggressiveness and therapeutic response at the same TNM stage. So, in such cases biomarkers can be used to identify the biological diversity of these tumors more reliably, leading to better therapeutic strategies and disease management. The presence of inflammatory immune cells in the tumor microenvironment can have pro or antitumor effects and the investigation of the expression of inflammatory markers in OSSC can be usefulto design immunotherapeutic interventions. The Transforming Growth Factor alpha is a potent stimulator of cell migration that acts on cell proliferation, invasion and metastasis of cancer, as well as immune suppression and angiogenesis. Inflammatory cytokines, such as Interferon-gamma, mediate macrophage differentiation. Macrophages are an important component of the OSCC microenvironment. The greater amount of tumor-associated macrophages, especially the M2 phenotype, may be associated with a more aggressive biological behavior of the OSCC and, consequently, with reduced survival.

RESUMEN: El método más utilizado para clasificar los factores de pronóstico en los cánceres en la actualidad es TNM. Sin embargo, el carcinoma oral de células escamosas (COCE) a menudo muestra diferentes comportamientos en relación con la agresividad y la respuesta terapéutica en la misma etapa TNM. Entonces, en tales casos, los biomarcadores pueden usarse para identificar la diversidad biológica de estos tumores de manera más confiable, lo que lleva a mejores estrategias terapéuticas y manejo de la enfermedad. La presencia de células inmunes inflamatorias en el microambiente tumoral puede tener efectos pro o antitumorales y la investigación de la expresión de marcadores inflamatorios en COCE puede ser útil para diseñar intervenciones inmunoterapéuticas. El factor de crecimiento transformante α es un potente estimulador de la migración celular que actúa sobre la proliferación celular, la invasión y metástasis del cáncer, así como la inmunosupresión y la angiogénesis. Las citocinas inflamatorias, como el IFN-γ, median en la diferenciación de macrófagos. Los macrófagos son un componente importante del microambiente COCE. La mayor cantidad de macrófagos asociados a tumores, especialmente el fenotipo M2, puede estar asociada a un comportamiento biológico más agresivo del COCE y, en consecuencia, a una menor supervivencia.

Validation of an original Behavioral Changes Scale on the Use of Digital Technologies During Social Distancing

Abstract Introduction The social distancing (SD) adopted during the coronavirus disease 2019 (COVID-19) pandemic has transformed the internet from a convenience into a necessity. The behavioral changes caused by isolation range from adaptation of consumption, work, and teaching routines to altered leisure options to occupy idle time at home. Such transformations can be positive, expanding use of digital technologies (DT), but they can also have serious future physical and emotional consequences if there conscious use of technological devices is lacking. Objectives The study aimed to validate the Behavioral Changes Scale on the Use of Digital Technologies During Social Distancing (BCSDTSD), an instrument for assessing behavioral changes related to use of DT during SD. Method Validation of the BCSDTSD in five phases: 1. construction of an initial scale with 10 questions; 2. evaluation of the questions by a panel of experts; 3. application to 1,012 volunteers via the internet; 4. statistical analysis of the results; and 5. preparation of the validated final version of the BCSDTSD. Data were analyzed using the dplyr, psy , and paran packages and the REdaS statistical program. Three statistical criteria were used in the factor analysis (FA). Results FA confirmed that all 10 questions in the questionnaire should be maintained, confirming its robust construction, and Cronbach's alpha demonstrated its internal consistency with a value of 0.725, which is satisfactory for first-application questionnaires. Conclusion The BCSDTSD instrument was validated for assessment of behavioral changes related to the use of DT during SD.

Optimization Tifton-85 grass cutting for productivity and nutrient value

The objective of this work was to determine the impact of cutting Tifton-85 grass at 14, 28, 42, 46, 70, and 80 days of regrowth on its production and nutritional characteristics during the rainy season. The study area of 238 m2 was divided into four sub-area, with 6 plots of 2 × 2 m spaced 1 m between plots and 2 m between sub-area. Random block design was used. The statistical analyses were performed following a randomized block design. Results were obtained as means from evaluations conducted in two consecutive years. The neutral detergent fiber (NDF) and acid detergent fiber (ADF) increased as the cutting age increased. However, crude protein, NDF nitrogen, ADF nitrogen and leaves/stem relationship decreased as the cutting age increased. The production of digestible dry matter increased linearly as the cutting age increased. Similarly, grass height, green matter and dry matter production (DMP) increased as the cutting age increased. The different cutting age did not influence the nitrogen A, B1 + B2, and B3 fractions of the grass. However, the C fraction increased as the cutting age increased. Longer intervals between cuts increased the grass productivity per cut, but compromised its nutritional composition and leaves/stem relationship. For Tifton -85, the regrowth age of 28 days allows greater production of dry matter and greater accumulated production of crude protein and digestive dry matter in the rainy season or over time.

Disinfection and outcome of root canal treatment using single-file or multifile systems and Ca(OH)2 medication

Abstract This clinical study reports on the antibacterial effects and outcome of endodontic treatment using either a single-file or a multifile system, associated with calcium hydroxide interappointment medication. The root canals of single-rooted teeth with apical periodontitis were treated by using either Reciproc or BioRaCe instrument systems, 2.5% NaOCl irrigation, and calcium hydroxide medication. Bacteriological samples taken before preparation and immediately before obturation were evaluated for total bacterial counts by quantitative real-time polymerase chain reaction (qPCR). Patients were followed up and the treatment outcome was assessed by clinical and radiographic criteria. Decreasing lesions were classified as success in a lenient criterion or failure in a rigid one. Bacteria were detected in all initial samples (47 cases) and were significantly reduced after treatment in both groups (p<0.001). In the Reciproc and BioRaCe groups, 7/25 (28%) and 11/22 (50%) root canals yielded negative qPCR results before obturation, respectively (p>0.05). Quantitative bacterial reduction was similar between groups (p>0.05). The success rate in the BioRaCe group was 95.5% and 77% in the loose and rigid criterion, respectively. In the Reciproc group, corresponding figures were 88% and 76%. Differences in outcome were not significant (p>0.05). No diseased case showed negative qPCR results for bacteria. A difference of >1 Log10 counts was observed between healed and diseased cases. Root canal treatments of teeth with apical periodontitis using a single-file or a multifile system for preparation, associated with NaOCl irrigation and calcium hydroxide interappointment medication, showed similar antibacterial effectiveness and success rate.

Resumo Este estudo clínico relata os efeitos antibacterianos e o resultado de tratamentos endodônticos usando um sistema de instrumentação de instrumento único ou de múltiplos instrumentos, associado à medicação intracanal com hidróxido de cálcio. Os canais radiculares de 80 dentes unirradiculares com lesão perirradicular foram tratados com os sistemas Reciproc ou BioRaCe, irrigação com NaOCl a 2,5% e medicação com pasta de hidróxido de cálcio por 7 a 10 dias. Amostras bacteriológicas foram colhidas antes do preparo e imediatamente antes da obturação e examinadas quanto à contagem total de bactérias pela reação em cadeia da polimerase em tempo real quantitativa (qPCR). Os pacientes foram acompanhados e o resultado do tratamento foi avaliado por critérios clínicos e radiográficos (índice periapical). Os casos com lesões que diminuíram mas não desapareceram foram classificados como sucesso em um critério leniente ou fracasso em um critério rígido. Quarenta e sete pacientes estavam disponíveis para avaliação bacteriológica e de resultados. Bactérias foram detectadas em todas as amostras iniciais desses casos e foram significativamente reduzidas após o tratamento nos dois grupos (p<0,001). Nos grupos Reciproc e BioRaCe, os canais radiculares apresentaram resultados negativos na qPCR em 7/25 (28%) e 11/22 (50%) casos antes da obturação, respectivamente (p>0,05). A redução bacteriana foi semelhante entre os grupos (p>0,05). O período médio (mediana) de acompanhamento foi de 20,5 (18,5) meses para BioRaCe e 17,4 (18) meses para Reciproc (p>0,05). No grupo BioRaCe, a taxa de sucesso foi de 95,5% e 77% nos critérios leniente e rígido, respectivamente. No grupo Reciproc, os valores correspondentes foram 88% e 76%. As diferenças no resultado não foram estatisticamente significativas (p>0,05). Nenhum caso de doença pós-tratamento mostrou resultados negativos de qPCR para bactérias. Foi observada uma diferença >1 Log10 nas contagens bacterianas entre os casos curados e doentes. O tratamento do canal radicular de dentes com lesão perirradicular utilizando um sistema de instrumento único ou múltiplos no preparo, associado à irrigação com NaOCl e medicação entre consultas com hidróxido de cálcio, mostrou eficácia antibacteriana e taxa de sucesso semelhantes.

CONHECIMENTO SOBRE BEIJO NA BOCA DE ADOLESCENTES DE UM GRUPO DE ESCOLAS PRIVADAS DE NOVA IGUAÇU/RIO DE JANEIRO ­ ESTUDO PILOTO / KNOWLEDGE ABOUT KISSING IN THE MOUTH OF ADOLESCENTS FROM A GROUP OF PRIVATE SCHOOLS IN NOVA IGUAÇU / RIO DE JANEIRO - PILOT STUDY

Objetivo: Descrever os conhecimentos sobre o beijo na boca e sua possibilidade de transmissão de doenças infecciosas em um grupo de adolescentes de escolas privadas de Nova Iguaçu/Rio de Janeiro, através deste estudo piloto. Metodologia: Estudo seccional em que foi aplicado um roteiro de perguntas semi-estruturado autoaplicável em adolescentes (de 18 e 19 anos) de ambos os gêneros, pertencentes a três escolas da rede de ensino privado do município de Nova Iguaçu no Estado do Rio de Janeiro. Resultados: De um total de 100 adolescentes que participaram deste estudo, mais da metade eram solteiros e do gênero feminino (61%), apenas estudantes como ocupação (88% do total) e 96% já haviam beijado na boca. A amostra selecionada demonstrou características próprias, com a alta frequência do conhecimento da possibilidade de transmissão de doenças infecciosas pelo beijo na boca e saliva (71%), que possivelmente se confirmou pela baixa ocorrência de lesões após o ato do beijo e pela observação da boca do parceiro antes de beijar. Conclusão: A pratica do beijo na boca e o sexo oral devem ser temáticas consideradas na assistência fornecida a adolescentes. O uso de estratégias preventivas e o acesso às redes sociais podem contribuir para a redução de situações de risco advindos de situações de vulnerabilidade.

Aim: To describe the knowledge about the kiss on the mouth and its possibility of transmission of infectious diseases in a group of adolescents from private schools in Nova Iguaçu / Rio de Janeiro, through this pilot study. Methodology: Cross-sectional study in which a self-administered semi-structured question script was applied to adolescents (18 and 19 years) of both genders, belonging to three schools of the private school system of Nova Iguaçu, Rio de Janeiro State. Results: Of a total of 100 adolescents who participated in this study, more than half were single and female (61%), only students as occupation (88% of the total) and 96% had already kissed the mouth. The selected sample demonstrated its own characteristics, with the high frequency of the knowledge of the possibility of transmission of infectious diseases by kissing in the mouth and saliva (71%), which was possibly confirmed by the low occurrence of lesions after the kiss and the observation of the mouth. of the partner before kissing. Conclusion: The practice of kissing on the mouth and oral sex should be thematic considered in the care provided to adolescents. The use of preventive strategies and access to social networks can contribute to the reduction of risk situations arising from vulnerability situations. Keywords: mouth, infectious diseases, adolescent (s), health education, strategies and oral health

Análise de limas endodônticas submetidas a biocorrosão por bactérias redutoras de sulfato in vitro / Analysis of endodontic files submitted to biocorrosion by sulfate reducing bacteria in vitro

Objetivo: Avaliar as alterações químicas presentes na superfície metálica de limas endodônticas fraturadas em canais radiculares, in vitro, após a inoculação intrarradicular de culturas de BRS de três cepas microbianas, Desulfovibrio desulfuricans (uma cepa oral e outra ambiental) e Desulfovibrio fairfieldensis. Métodos: foram analisadas 5 limas kerr #90, sendo uma Lima Kerr nova, sem tratamento, e as outras 4 limas fraturadas dentro de canais radiculares in vitro, com posterior inoculação de Desulfovibrio desulfuricans, cepa oral e ambiental, e Desulfovibrio fairfieldensis e um grupo controle sem inoculação bacteriana, por 477 dias. Os grupos foram analisados no modo EDS (Espectrometria de Energia Dispersiva de Raios-x) do microscópio eletrônico de varredura (FEI-Inspect-S50). Resultados:A presença do S, Cl e O foram relacionados ao processo biocorrosivo, assim como a redução dos elementos de liga nesta área. Conclusão:As análises no modo EDS demonstraram biocorrosão ao longo da superfície metálica das limas quando empregado o biofármaco BACCOR, nas três diferentes cepas empregadas, indicada pela redução dos elementos formadores da liga metálica, Fe, Ni e Cr, com a associação da presença de elementos indicadores de biocorrosão como O, Cl e S. (AU)

Aim:To evaluate the chemical alterations present on the metallic surface of root canal fractured endodontic files in vitro after the intraradicular inoculation of BRS cultures of three microbial strains, Desulfovibrio desulfuricans (one oral and one environmental strain), and Desulfovibrio fairfieldensis. Methods: Five kerr #90 files were analyzed, one new untreated Kerr file and the other 4 files fractured within root canals in vitro, with a subsequent inoculation of Desulfovibrio desulfuricans (oral and environmental strains), and Desulfovibrio fairfieldensis, as well as a control group without bacterial inoculation for 477 days. The groups were analyzed using the scanning electron microscope (FEI-Inspect-S50) EDS (X-ray Dispersive Energy Spectrometry) mode. Results:The presence of S, Cl, and O were related to the biocorrosive process, as well as the reduction of alloying elements in this area. Conclusion: The EDS mode analysis showed biocorrosion along the metallic surface of the files when the BACCOR biopharmaceutical was used in the three different strains employed in this study, indicated by the reduction of the alloying elements ­ Fe, Ni, and Cr ­ with the association of the presence of indicator elements of biocorrosion, such as O, Cl, and S. (AU)

Validation of a scale to evaluate the abusive use of technologies (Computer, cell phone, tablet, among others)

BACKGROUND INFORMATION: Daily, prolonged interactivity of individuals with technologies (computer, cell phone, tablet, among others) impacts life and significantly changes habits, behaviors, personal and social relationships. Technologies lead to a multitude of advantages, but attention is required concerning possible damages. OBJECTIVE: Validation of a scale to evaluate the abuse use of technologies (TAUS). METHOD: TAUS validation was carried out in 5 phases: (1) initial scale construction with 20 questions, (2) expert evaluation, (3) application to 200 volunteers, (4) statistical analysis and results, (5) preparation of the final version of the validated TAUS. We used the R statistical program and the "dplyr" package version 3.4.2 to present descriptive statistics, to test hypotheses of means differences and for factorial analysis. Factor analysis was used for the orthogonal model. The method used was Principal Components based on Spearman's correlation matrix. RESULTS: The results provided a final, validated version of a TAUS suitable for clinical and research contexts. The last step of the study was to calculate Cronbach's alpha, in order to measure the internal consistency of the scale. The value found was 0.910, which is considered good. CONCLUSIONS: This Technology Abuse Scale may contribute to future studies, to the conscious use of technologies, to a reduction of physical and emotional damage and to an improvement of the subjects' quality of life.

Validation of a scale to evaluate Digital Dependence of Employees

BACKGROUND: The evolution of technologies and mobility, new digital resources have emerged transforming human behavior. These include the abusive use of digital devices, leading to various dependences regarding the way people use technology. Collective environments also begin to exhibit symptoms of such dependences. OBJECTIVE: Validate a Digital Dependence of Employees Scale (DDES), applied to personnel not holding leadership positions in organizations. METHOD: Data were collected via Internet. The sample totaled 301 volunteers from a state-owned company, of which 294 were statistically validated. Participants were asked to answer 20 questions prepared by experts. After the collection procedure, a database was created for statistical analysis. RESULTS: Statistical analysis procedure including factorial analysis was conducted, which confirmed data adequacy. Three statistical criteria were used: Bartlett Sphericity test, Kaiser-Meyer-Olkin Criterion and Factorial analysis, including Screeplot; the latter determined adequate commonalities, indicating the cancellation of only 1 out of the 20 original scale questions. The internal consistency of the scale measured through the Cronbach Alpha Coefficient showed a positive result of 0.764. Thus, scale validation objectives were achieved. CONCLUSION: The DDES scale was considered validated to be applied to employees in organizational environments. The limitations found to apply the scale did not compromise its results.

Validation of a scale to assess Facebook dependence

BACKGROUND INFORMATION: Facebook is a social network that has become part of the everyday life of contemporary humanity and is notably the most accessed digital tool, worldwide; through it, one can simultaneously relate to millions of people, as a source of information, communication or entertainment. OBJECTIVE: To produce and validate a scale to evaluate Facebook dependence (FDS). METHOD: Validation was performed in 5 phases: 1- initial scale construction with 20 questions, 2- expert evaluation, 3- application in 200 volunteers, 4- statistical analysis and results, and 5- elaboration of the final 18-question validated version of FDS. RESULTS: We obtained a descriptive statistical analysis, a clear-cut separation of dependents vs. non-dependents and a successful factorial analysis. These results provided a validated version of FDS. CONCLUSIONS: We were able to construct the validated final version of FDS with 18 questions appropriate to the clinical contexts and to be used in conducting research on Facebook dependence. This scale will contribute to future research related to this specific digital dependence, hopefully reducing harmful effects and improving quality of life.

Validation of the scale to evaluate physical damages related to the Abusive Use of Technology in daily life (PDAUTS)

BACKGROUND INFORMATION: New computer technologies, namely smart cellphones and tablets, among others, interacting along the daily life of individuals may contribute toward the rise of problems: depression, stress and physical damage (undue postures, upper and lower extremity disorders, vision problems, obesity), all of them related to excessive time spent on technological equipment; together with inadequate furniture, quality of life can be seriously affected. OBJECTIVE: To validate a scale to evaluate physical damage related to the Abusive Use of Technology (PDAUTS) in daily life. METHODS: Validation of the PDAUTS was performed through 5 phases: (1) initial scale construction with 20 questions; (2) expert evaluation of questions; (3) application to 200 volunteers; (4) statistical analysis of the results; (5) preparation of the final validated version, retaining the 20 questions. RESULTS: We used the R statistical program, version 3.4.2 and the "dplyr" package to present the descriptive statistics, the hypothesis tests of mean differences and the factor analysis. The results provided a validated final version for PDAUTS. The last step of the study was to calculate Cronbach's alpha parameter, in order to measure the internal consistency of the scale. The value found was 0.897, which in is considered very good. CONCLUSION: The validated PDAUTS allowed us to evaluate physical damage in each subject and design adequate training and treatment programs, reducing overall impairments and contributing to the improvement in quality of life.

Validation of the Cell Phone Dependence Scale

BACKGROUND INFORMATION: The boundary between cellphone use and abuse is quite tenuous. Research is required to evaluate the use of this device interacting in the everyday life of users, whether to speak or to perform tasks. OBJECTIVE: To construct a novel and specific scale to evaluate cellphone dependence checking its psychometric properties for clarity, accuracy and reliability. METHODS: Validation of a Cellphone Dependence Scale (CPDS) was performed in 5 phases: 1- initial scale construction with 20 questions, 2- expert evaluation, 3- application to 200 volunteers, 4- statistical analysis and results, and 5- elaboration of the final version of the CPDS. RESULTS: We used the R statistical program Version 3.4.2 and the "dplyr" package to present the descriptive statistics, the hypotheses tests of differences of means and the factorial analysis. The results provided a validated and accepted final version for CPDS. The last step of the study was to calculate Cronbach's alpha, in order to measure the internal consistency of the questionnaire. The value found was 0.897, which is considered very good. CONCLUSIONS: This project resulted in the construction of the final CPDS version suitable for the clinical context and to be used in the conduct of research on cellphone dependence. CPDS may contribute to future studies, conscious use of cellphones, harm reduction, and improved quality of life vis-à-vis the cellphone.

Validation of the scale for assessing depression and its relation to technology dependence

ABSTRACT BACKGROUND: The daily coexistence with the technologies (computer, mobile phone, tablet, among others), begins to produce significant changes in human behavior. We have observed that there is an association between dependence on technologies and major depressive disorder, as well as with other mental disorders. OBJECTIVE: To validate a scale for assessing depression and its relation to dependence on everyday technologies. METHODS: Validation of a Technology Dependent Depression Scale (TDDS) was performed in 5 phases: (1) initial scale construction with 20 questions; (2) expert evaluation; (3) application to 100 volunteers, (4) statistical analysis and results, (5) preparation of the final version of the validated TDDS. RESULTS: We used the R statistical program, version 3.4.2 and the "dplyr" package to present descriptive statistics, hypotheses tests of mean differences and factorial analysis. The results provided a validated and approved final version for TDDS. CONCLUSIONS: We constructed the final version of the validated TDDS, which is adequate for clinical contexts and to be used in future research. All the psychometric properties were checked for accuracy, reliability, presentation, clarity, pertinence and comprehension of the instrument conferring validity to the end-product.

Dental bleaching with and without LED/Laser association: a split-mouth controlled study

Objective: The aim of this study was to compare dental color changes after a one-session tooth bleaching procedure using 35% hydrogen peroxide with and without hybrid light (LED/diode laser) activation. Material and Methods: 20 volunteers were included in a split-mouth controlled clinical trial. A 35% hydrogen peroxide gel was applied directly on the buccal surface and adjacent areas of all upper anterior teeth. The six teeth were divided into two groups: the upper right incisors and canine were submitted to the tooth bleaching with the gel and the hybrid light (LED/diode laser) while the left incisors and canine were submitted to tooth bleaching with only the gel. Dental color was measured with a visual color scale and a spectrophotometer at five different moments: initial appointment, immediately after prophylaxis, and 14, 30 and 180 days after bleaching. Results: The comparison between the results of both treatments (with and without LED/laser) did not show any statistically significant differences (p > 0.05; Wilcoxon test) neither for objective (spectrophotometer) nor for subjective evaluations (visual color scale). Conclusion: The results of the present study showed that there are no differences in dental color changes between dental bleaching with gel and LED/Laser activation and dental bleaching with only gel.

Caracterização do atraso no diagnóstico do câncer de boca e orofaringe em dois centros de referência / Characterization of diagnostic delay in oral and oropharyngeal cancer at two referral centers

Resumo Objetivo Estimar se variáveis clínicas e epidemiológicas influenciam no atraso do diagnóstico em dois centros de referência. Métodos Foi realizado um estudo analítico longitudinal retrospectivo. Todos os prontuários de pacientes maiores de 18 anos diagnosticados no período de junho de 2005 a junho de 2013 foram analisados por meio do SPSS® 20. Para testar associações entre as variáveis epidemiológicas e clínicas com os atrasos do paciente e do profissional, foram utilizados os testes: ANOVA, t de Student e Kruskal-Wallis. Resultados Foram incluídos no estudo 121 prontuários. Prevaleceram pacientes do sexo masculino, com idade média de 64,3 anos (DP=12,94), pardos, procedentes do interior, analfabetos, tabagistas e etilistas. A grande maioria (85,1%) foi diagnosticada nos estádios avançados. O maior atraso estava relacionado ao paciente, com média de tempo de 197,8 dias (DP=323,9). O atraso no diagnóstico profissional foi de 20 dias (DP=25,9), e aquele relacionado ao sistema de saúde foi de 71,1 dias (DP=71,7). Não houve associação entre as variáveis clínicas/epidemiológicas e o atraso no diagnóstico (do paciente e do profissional). Conclusão De acordo com os resultados do presente estudo, as variáveis clínicas e epidemiológicas não influenciam no atraso do diagnóstico.

Abstract Objectives To analyze the chronology of diagnosis and determine whether clinical and epidemiological variables have an influence on diagnostic delay at two referral centers. Methods The medical records of all patients older than 18 years diagnosed with oral/oropharyngeal cancer from June 2005 to June 2013 were analyzed using SPSS® 20. The association between epidemiological and clinical variables with patient and professional delay was performed using ANOVA, Student’s t-test, and Kruskal-Wallis test. Results In total, 121 medical records were included in the study. Patients were predominantly brown, male, illiterate, living in country towns, smokers, and heavy drinkers (mean age 64.3 years, SD=12.94). The majority (85.1%) of patients were diagnosed at advanced stages of their disease. The greatest delay was patient-related, mean 197.8 days (SD=323.9). Delay in establishing the medical diagnosis averaged 20 days (SD=25.9), and health care system-related delay was 71.1 days (SD=71.7). There was no association of clinical and epidemiological variables with delayed diagnosis (patient and professional). Conclusion Data from the present study suggest that clinical and epidemiological variables do not influence diagnostic delay.

Drugs or disease: evaluating salivary function in RA patients

Abstract Oral complications of RA may include temporomandibular joint disorders, mucosa alterations and symptoms of dry mouth. The aim of this study was to evaluate the salivary gland function of subjects with rheumatoid arthritis (RA) comparing it to healthy controls. Subjects with other systemic conditions known to affect salivary functions were excluded. A questionnaire was applied for the evaluation of xerostomia. Resting and chewing-stimulated salivary flow rates (SFR) were obtained under standard conditions. There were 145 subjects included of the study (104 RA and 38 controls). About 66.7% of the RA subjects and 2.4% in control group presented xerostomia. The median resting SFR were 0.24 ml/min for RA subjects and 0.40 mL/min for controls (p = 0.04). The median stimulated SFR were 1.31 mL/min for RA subjects and 1.52 ml/min for controls (p = 0.33). No significant differences were found between resting and stimulated SFR of RA subjects not using xerogenic medications and controls. There was significantly higher number of subjects presenting hyposalivation in the RA group than among controls, even when subjects using xerogenic medications were eliminated from the analysis. In conclusion, hyposalivation and xerostomia were more frequent among RA subjects not using xerogenic medication than among controls, although there were no significant differences in the median SFR between groups.

Influência da periodontite apical nos níveis séricos de marcadores de Proteína C-reativa: revisão da literatura / Influence of apical periodontitis on serum levels of C-reactive protein: literature reviewd

A periodontite apical é uma doença de origem bacteriana que ativa a liberação local de mediadores pró-inflamatórios capazes de induzir a produção hepática de proteínas de fase aguda, como a proteína C-reativa (CRP). Mesmo pequenos aumentos nos níveis séricos de CRP já estão associados com o aumento do risco cardiovascular. Há na literatura vários estudos avaliando a correlação entre doença periodontal, marcadores inflamatórios (como CRP e IL6) e doenças cardiovasculares, entretanto poucos estudos têm estudado uma possível associação entre a periodontite apical crônica ou história de tratamento endodôntico e doença cardiovascular. O objetivo desta revisão foi investigar as evidências atuais em relação à possível associação entre periodontite apical crônica e o aumento dos níveis séricos de CRP.

Apical periodontitis is a bacteria-induced disease that activates the localized release of pro-inflammatory mediators capable of inducing the production of acute-phase proteins (like C-reactive protein) by the liver. Even mild elevations of serum levels of CRP are associated with higher cardiovascular risk. Literature shows many studies that evaluates the correlation between periodontal disease, inflammatory markers (like CRP and IL6) and cardiovascular diseases. However, few studies have assessed the possible association between chronic apical periodontitis or history of endodontic treatment and cardiovascular diseases. The aim of the present review was to assess the current evidence regarding the possible association between chronic apical periodontitis and elevation of serum CRP.

Respirometria e emissão de metano por ovinos alimentados com capim-elefante cortado com diferentes idades / Respirometry and methane emissions by sheep fed elephantgrass at different cutting ages

Objetivou-se com este trabalho mensurar a respirometria e a emissão de metano entérico por ovinos alimentados com o capim-elefante cortado aos 56, 84 e 112 dias de crescimento. Foram utilizados 18 carneiros adultos sem raça definida, com peso médio de 34,7 ± 6 kg alojados em gaiolas de estudo de metabolismo. A mensuração dos gases foi realizada através de uma câmara respirométrica de fluxo aberto. O delineamento experimental utilizado foi inteiramente casualizado, com seis repetições, e as médias foram comparadas pelo teste SNK (P<0,05). Os animais alimentados com o capim colhido após 56 dias de rebrotação consumiram mais oxigênio e produziram mais dióxido de carbono e metano. As produções de calor variaram 87,19 a 143,57 Kcal/kg 0,75/dia. O coeficiente respiratório foi semelhante entre os tratamentos, com valor médio de 0,98. A produção de metano variou entre 11,74 e 22,51 g/dia, havendo redução com o aumento da idade da planta forrageira. Quando expressa em g/kg0,75/dia, a produção deste gás foi superior para animais que receberam o capim-elefante-verde cortado aos 56 dias de idade (1,53 g/kg 0,75/dia). A emissão de metano (g) por quilo de matéria seca (MS) e de fibra insolúvel em detergente neutro (FDN) consumido para o capim colhido mais novo (56 dias) foi superior à do capim colhido no estádio mais avanço de maturação (112 dias). Porém, as emissões de metano em gramas por quilo de MS digestível (27,2 g/kg) e FDN digestível (44,4 g/kg) foram semelhantes para os capins colhidos nas diferentes idades de corte. A emissão diária de metano (g/kg 0,75/dia) foi maior em animais alimentados com a planta forrageira colhida mais nova, enquanto que se expressa em gramas por quilo de MS ou FDN digestível a emissão deste gás não sofreu influência do capim-elefante no momento do corte.

The aim of this work was to determinate the respirometry and enteric methane emission from sheep fed fresh elephant grass cut at 56, 84 and 112 days of regrowth. Eighteen crossbred sheep (34.7 ± 6 kg) individually housed in metabolic crates were used in this experiment. The gases measurements were accomplished with an open circuit respirometric chamber. The experimental design was completely randomized with three treatments (grass regowth age) and six repetitions (sheep). The data were subjected to ANOVA and means were compared by SNK test (P<0.05). The animals fed with elephant grass harvested at 56 days of regrowth had higher oxygen uptake and carbon dioxide and methane emissions. Heat production ranged from 87.19 to 143.57 Kcal/kg 0.75/day. The respiratory quotients were similar (P>0.05) among treatments, averaging 0.98. Methane emissions ranged from 11.74 to 22.51 g/day. When expressed in g/kg 0.75/day, methane emissions were higher for sheep fed fresh elephant grass with 56 days of regrowth (1.53 g/kg 0.75/day). Methane emissions expressed in g/kg of dry matter (DM) intake or neutral detergent fiber (NDF) intake were higher (P<0.05) for the grass harvested with 56 days of regrowth compared to the grass harvested in more advanced stage of maturity (112 days). However, methane emissions in g/kg of digestible DM (27.2 g/kg) and digestible NDF (44.4 g/kg) were similar among treatments. While daily methane emissions (g/kg 0.75/day) were higher in sheep fed fresh elephant grass harvested with 56 days of regrowth, it was not affected by regrowth age when expressed as g/kg of digestible DM or digestible NDF.

Avaliação de pacientes odontológicos para auxílio no diagnóstico precoce da osteoporose / Evaluation of dental patients to aid in early dignosis of osteoporosis

A osteoporose, doença osteometabólica mais frequente, é caracterizada pela diminuição da massa óssea e deterioração do tecido ósseo. O objetivo deste estudo foi verificar a relevância dos exames clínico e radiográfico no auxílio do diagnóstico precoce da osteoporose. Participaram do estudo 57 pacientes de ambos os gêneros, acima dos 30 anos atendidos na Clínica da FO-UNESA. Após anamnese, os pacientes foram submetidos aos exames radiográficos. As radiografias panorâmicas foram analisadas através dos índices radiomorfométricos quantitativos e qualitativos. Conclui-se que os índices radiomorfométricos, principalmente o IMC, apresentaram maior precisão na detecção da redução da densidade óssea quando associados aos fatores de risco para o desenvolvimento da osteoporose.

Osteoporosis, the most common osteometabolic disease, is characterized by decreased bone mass and deterioration of bone tissue. The aim of this study was to assess the relevance of clinical and radiographic examinations aid in early diagnosis of osteoporosis. The study included 57patients of both sexes over age 30 treated at the Clinic FO-UNESA. After interview, the patients underwent radiographic examinations. Panoramic radiographs were analyzed using quantitative and qualitative radiomorphometric indexes. We concluded that the radiomorphometric indexes, mainly IMC, were more accurate in the detection of low bone density when associated with risk factors for the development of osteoporosis.