A influência da doença periodontal e a manipulação dos tecidos periodontais na bacteremia sistêmica: uma revisão de literatura / The influence of periodontal disease and the manipulation of periodontal tissues on systemic bacteremia: a review of the literature

Periodontal disease is the most prevalent oral infection in patients admitted to intensive care units. The periodontium is surrounded by a multitude of lymphatic vessels. Through this path, the lymphatic fluid mixes with the venous blood, resulting in an invasion of bacteria in the circulatory system, even for a short period of time. Periodontal bacteria, in addition to entering the circulatory system, produce inflammatory mediators that are generally not limited to periodontal tissues. Through these and other processes, it is possible to observe the relationship between periodontal diseases and systemic diseases. The objective of this review was to observe the pathways between periodontal disease and systemic events, emphasizing the bacteremia caused by the manipulation of periodontal tissues in patients with periodontitis. A search was performed on the Pubmed, Lilacs and Scielo databases, using the English descriptors "periodontal diseases", "periodontitis", "bacteremia", "bacteraemia" and "periodontal therapy". Studies show that periodontal disease and manipulation of periodontal tissues are capable of promoting bacteremia and of influencing systemic diseases. It was also concluded that the studies present a heterogeneous methodology, which suggests the need for greater standardization to better compare the data (AU)

A doença periodontal é a infecção bucal de maior prevalência em pacientes internados em unidades de terapia intensiva. O periodonto é cercado por uma infinidade de vasos linfáticos. Por este trajeto, o fluido linfático se mistura ao sangue venoso, resultando numa invasão de bactérias no sistema circulatório, ainda que por curto período de tempo. As bactérias periodontais, além de adentrarem no sistema circulatório, produzem mediadores inflamatórios que, geralmente, não se limitam aos tecidos periodontais. Por meio desses e outros processos, é possível observar a relação das doenças periodontais com as doenças sistêmicas. O objetivo desta revisão foi observar as vias de ligação entre a doença periodontal e os eventos sistêmicos, salientando a bacteremia originada da manipulação dos tecidos periodontais em pacientes com periodontite. Foi realizada uma busca nas bases de dados Pubmed, Lilacs e Scielo, utilizando os descritores em inglês "periodontal diseases", "periodontitis", "bacteremia", "bacteraemia", "periodontal therapy". Estudos mostram que a doença periodontal e a manipulação dos tecidos periodontais são capazes de promover a bacteremia e de influenciar doenças sistêmicas. Concluiu-se ainda, que os estudos apresentam uma metodologia heterogênea, o que sugere a necessidade de maior padronização para melhor comparação dos dados (AU)

Eventos adversos de la vacuna cubana antimeningocóccica / Adverse events of antimeningococcal Cuban vaccine

Introducción: en nuestro país hay un sistema de vigilancia exhaustivo que brinda información estadística sobre los eventos adversos a vacunas graves, menos graves y leves. Esta vigilancia es llevada a cabo por el Equipo Básico de Salud; no obstante, en muchas ocasiones al presentar estos eventos una sintomatología poco definida y de poca gravedad, pueden quedar sin diagnóstico y sin investigación. Objetivo: caracterizar los eventos adversos a la vacuna antimeningocóccica VAMENGOC-BC® en los lactantes del municipio Caimito durante el año 2006. Métodos: con un diseño de estudio descriptivo retrospectivo, se analizaron los 381 lactantes de 3 y 5 meses de edad que recibieron de forma programada la vacuna VAMENGOC-BC® según esquema nacional en el año 2006. El instrumento que se empleó para la recogida de la información de las historias clínicas fue la Encuesta Epidemiológica de Eventos Adversos a la Vacunación, establecida por el Programa Nacional de Inmunización. Resultados: de los 381 lactantes que recibieron la vacuna en ese año, hubo 17 con eventos adversos. El mayor porcentaje fue después de administrar la primera dosis (3,01 por ciento). Las manifestaciones locales más frecuentes fueron dolor en el sitio de la inyección con un 50,00 por ciento después de la primera dosis y la induración (66,67 por ciento) después de la segunda. Los eventos adversos sistémicos más frecuentes en la primera dosis fueron la fiebre (54,55 por ciento) e irritabilidad (27,27 por ciento). La incidencia de lactantes con eventos adversos fue mayor en las primeras 72 horas (3,41 por ciento) y en la primera dosis (2,46 por ciento). Sin embargo, la mayoría de las manifestaciones desaparecieron en las primeras 72 horas (3,41 x cada 100 lactantes vacunados), es decir que la recuperación fue rápida. Conclusiones: los eventos adversos locales y sistémicos fueron discretos, con predominio de los segundos, para ambas dosis de la vacuna, y fue la fiebre el evento más frecuente después de aplicadas las dos dosis. No existieron eventos adversos graves que requirieran de hospitalización, ni hubo secuelas.

Introduction: in our country there is a surveillance exhaustive system offering statistical information on the severe, less severe and slight adverse events related to vaccines. This surveillance system is carried out by the Basic Health Staff; however, in many occasions, if these events have a poor defined and of less severity symptomatology they could remain without diagnosis and without research. Objective: using the design of retrospective and descriptive study, it was possible to analyze the 381 infants aged 3 and 5 months received the programmed VAMNGOC-BC® vaccine according the national scheme in 2006. The tool used for collection of information from medical records was the Epidemiological Survey of Adverse Events of Vaccination, established by the National Immunization Program. Results: from the 381 infants received vaccine that year, there were 17 with adverse events. The great percentage was after administration of the first dose (3,01 percent). The more frequent local manifestations was pain in the injection site with 50,00 percent after the first dose and induration (66,67 percent) after the second one. The more frequent systemic adverse effects in the first dose were fiver (54,55 percent) and irritability (27,27 percent). The incidence of infants with adverse events was higher at the first 72 h (3,41 percent) and in the first dose (2,46 percent). However, most of manifestation disappeared during the first 72 h (3,41 by each 100 vaccinated infants, that is, that recovery was fast. Conclusions: the local and systemic adverse events were discrete with predominance of the second ones for both doses of vaccine and the fever was the more frequent event after applied the two doses. There was neither severe adverse event requiring admission nor sequelae.