Absence of cytomegalovirus in gingivitis and chronic periodontitis in HIV-1 patients in Northern Brazil

Abstract INTRODUCTION The influence of cytomegalovirus (CMV) on the progression of chronic periodontitis in HIV patients is poorly investigated. METHODS ELISA was used for anti-CMV antibody IgG titer measurements and real-time polymerase chain reaction for qualitative and quantitative CMV detection. Data on the CD4 + T lymphocyte count and plasma HIV viral load were obtained from patient records. RESULTS CMV DNA was detected in samples of subgingival biofilm in only three individuals, two of them with chronic periodontitis (4%) and one with gingivitis (3.3%). CONCLUSIONS The prevalence of CMV is very low both in HIV-1 patients with gingivitis and chronic periodontitis.

Analysis of IL-10 in HIV-1 patients with chronic periodontitis in northern Brazil

The objective of this study was to investigate the levels of IL-10 in the gingival crevicular fluid in HIV-1 positive patients with chronic periodontitis and to compare with HIV-1 negative patients with chronic periodontitis, also to correlate clinical periodontal parameters, viral load and count of CD4 + and CD8 + lymphocytes (LTCD4 + and LTCD8 +). Methods: 33 patients were selected and splitted into two groups: 16 HIV-1 positive patients and 17 HIV-1 negative patients and all with chronic periodontitis. The clinical periodontal parameters recorded were: Probing Depth (PD) and Clinical Attachment Level (CAL); the sistemical parameters LTCD4 +, LTCD8 + and viral load were analized by the gingival crevicular fluid collected from all patients. Enzymelinked immunosorbent assay (ELISA) was used to determine the concentrations of Interleukin (IL)-10. For the statistical analysis the Student t, Mann-Whitney and Spearman tests were performed. IL-10 levels were significantly lower in both patients groups. Results: There was statistical difference betwen groups for probing depth (p=0.015) and clinical attachment level (p=0.011), no significant correlation was found among the analyzed variables. Conclusion: The IL-10 levels in HIV-1 positive patients had no influence in periodontal and medical parameters (AU)

Root and canal morphology of permanent mandibular incisors / Morfología de raíz y ranal de incisivos molares permanentes

There are no studies in the literature reporting the prevalence of root canal ramifications in samples of lower incisors in the population of northern Brazil. The knowledge of the usual endodontic morphology and its possible anatomical variations is important. The aim of this study was to evaluate the prevalence of canals in the lower incisors in the population of northern Brazil using the descaling and diaphanization method. In addition, external measurements were performed and the direction of the apical foramen was observed. One hundred teeth were used for this study, and 18 % of them had two canals, with type 3 being the most prevalent, and the lowest incidence was type 5. The average length of the teeth was 18.5 mm, with 76.31 % of the teeth having a foramen that coincided with the long axis of the tooth. Prior knowledge of such changes should be considered before endodontic therapy.

No hay estudios en la literatura que reporten la prevalencia de las ramificaciones del canal radicular en muestras de incisivos inferiores en la población del Norte de Brasil. El conocimiento de la morfología dentaria en endodoncia y sus posibles variaciones anatómicas es importante. El objetivo del estudio fue evaluar la prevalencia de canales en los incisivos inferiores en la población del Norte de Brasil utilizando el método de descalcificación y diafanización. Además, se realizaron mediciones externas y se observó la dirección del foramen apical. Cien dientes fueron utilizados en este estudio, 18 % tenían dos canales, siendo el tipo 3 el más prevalente, y solo un diente presentó el tipo 5. La longitud promedio de los dientes fue de 18,5 mm, de los cuales en el 76,31 % de éstos se observó un foramen que coincidió con el eje longitudinal del diente. El conocimiento previo de éstas variaciones debe ser considerado antes de la terapia endodóntica.

Knowledge and attitudes of pregnant women about oral health / Conocimientos y actitudes de las mujeres embarazadas sobre la salud oral

There are evidences that maternal profile, habits and health knowledge, influence in the oral health of children. The aim of this study was to assess pregnant women knowledge on oral hygiene practices and maintenance of Baby´s oral cavity. A descriptive epidemiological survey was conducted with 147 pregnant women. Sample was predominantly formed by young women and 33.33 % had incomplete primary education and most were housewives with family income between 1-2 minimum wages. Family was considered the primary means in the transfer of information about oral hygiene.

Hay evidencia de que los perfiles, hábitos y conocimientos de la salud influyen en la salud oral de los niños. El objetivo de este estudio fue evaluar el conocimiento de las mujeres embarazadas en las prácticas de higiene oral y el cuidado de la cavidad oral del bebé. Una encuesta epidemiológica se llevó a cabo en 147 mujeres embarazadas. La muestra estuvo compuesta predominantemente por mujeres jóvenes, de las cuales el 33,33 % no había completado la escuela primaria y la mayoría eran amas de casa con ingresos familiares entre 1-2 salarios mínimos. La familia fue considerado el principal medio de transmisión de información sobre la higiene oral.

Conditions for oral health in patients with autism / Condiciones de salud oral en pacientes con autismo

Autism is characterized as a behavioral disorder. The autistic patient has some difficulties with common life routines, such as oral hygiene and also improper diet. As a consequence the refusal of physical contact, the implementation of brushing and flossing by caregivers is difficult. The present study aimed to conduct an epidemiological study of autistic patients in treatment at the Rehabilitation Center and Neurological Organization in North of Brazil, adopting the CPO-D and ceo-d. The clinical examination has been performed with the patient sitting in chairs, at the Rehabilitation Centre itself, under artificial fluorescent light intended for room lighting. From 26 patients included in the study, 76.9 % of subjects were male with a mean age of 13 years. Fifty percent had caries, and 11.5% had lesions on the gums. The mean ceo-d of children 2­8 years was 0.67. In patients 10­15 years and 20­40 years, the mean CPO-D was 0.70, and 3.00, respectively. From the study, the most significant data, seen was that half of autistic patients had carious lesions. It is vital to improve oral health conditions in these patients and by using preventive dentistry, analyze their susceptibility to oral diseases.

El autismo se caracteriza como un trastorno conductual. El paciente autista tiene algunas dificultades en las rutinas ordinarias de la vida, tales como la higiene oral. Como consecuencia, la negativa al contacto físico, la implementación del cepillado y uso de hilo dental es difícil para los cuidadores. Este estudio tuvo como objetivo llevar a cabo un estudio epidemiológico de los pacientes autistas en el Centro de Rehabilitación y la organización neurológica en el norte de Brasil, adoptando el CPOD y ceod. El examen clínico se realizó con el paciente sentado en una silla en el propio Centro de Rehabilitación, bajo una luz fluorescente artificial para la iluminación de la habitación. Veintiseis pacientes fueron incluidos en el estudio, el 76,9 % de los sujetos eran varones con una edad media de 13 años con un 50 % de caries, y en un 11,5 % se observaron lesiones gingivales. La media ceod de los niños de 2 a 8 años fue de 0,67. En los pacientes de 10­15 años y 20­40 años, el promedio CPOD fue de 0,70 y 3,00, respectivamente. A partir del estudio se pudo determinar que la mitad de los pacientes autistas tienen caries. Es importante la educación de estos pacientes para mejorar la salud oral y la aplicación de la odontología preventiva.

Manifestaciones orales en pacientes reumatológicos: una revisión de los conocimientos / Oral manifestations of rheumatologic patients: a knowledge review

La cavidad oral a través de sus estructuras, dientes y mucosas, desempeñan diversas funciones orgánicas. Actúan en el proceso masticatorio, en la percepción de los sabores, además de servir de vía respiratoria. La relación entre alteraciones sistémicas y manifestaciones orales está bien relatada en la literatura. Observándose en numerosos estudios, palabras claves de morbilidades primariamente bucales, seguidas del diagnóstico de trastornos sistémicos. Las enfermedades reumáticas pueden manifestarse con alteraciones de la condición bucal, además de las presentaciones clínicas peculiares a cada morbilidad. Para la realización de este trabajo fueron investigados en la literatura estudios que evidencien la presencia de manifestaciones orales en enfermedades reumáticas a través de la búsqueda en las bases de datos Lilacs, PubMed y Bireme, incluidos en el año 2009-2015. Las evidencias existentes en la literatura nos revelan la importancia de la inclusión de la evaluación clínica de la boca y sus estructuras anexas, como elemento importante en el diagnóstico auxiliar y orientación para el manejo adecuado de las quejas de estos pacientes.

The oral cavity has several physiological functions through their structures. Such structures act in the chewing process, the perception of flavors, besides serving airway. The relationship between systemic diseases and oral manifestations is well reported in the literature. It is observed in numerous studies, morbidity descriptions primarily mouth followed by a diagnosis of systemic disorders. Rheumatic diseases exemplify that these can manifest with changes in oral health in addition to the peculiar clinical presentations to each morbidity. For this work we investigated in the literature studies that provided evidence of the presence of oral manifestations in rheumatic diseases by searching Lilacs, PubMed and Bireme databases, included in the year 2009­2015. The available evidence in the literature, reveal the importance of including clinical evaluation of the mouth and its associated structures as an important element for the diagnosis and guidance for the proper handling of complaints of these patients.

Genetic Autosomal Dominant Disorders: A Knowledge Review / Trastornos Autosómicos Dominantes: Una Revisión de los Conocimientos

Genetic disorders occur by excess or absence of chromosomal material, and the consequence of these changes is reflected in morphological and physiological changes. Autosomal disorders, which have dominant inheritance, as cleidocranial dysostosis, Craniofacial syndrome Apert, Treacher Collins and Achondroplasia have peculiar and similar characteristics. Because of their implications in the dental field, the aim of this review is to report on dysostoses, through exposure of general clinical factors and highlighting the signs in the oral cavity. Articles were selected from Lilacs, PubMed and Bireme databases, included in the year 2007­2014, and the keywords were: cleidocranial dysplasia, craniofacial dysostosis, mandibulofacial dysostosis, dysostosis and oral. Alterations of maxillofacial bones and craniofacial are well documented in the literature, but studies reporting an association between treatment odontologic and dysostoses are scarce. In conclusion, Oral pathological manifestations developed cause difficulty in speech, chewing, breathing, social involvement, and in a general perspective, psychological impairment and physical limitations.

Las enfermedades genéticas se producen debido a un exceso o ausencia de material cromosómico, y la consecuencia de estos cambios se refleja en los cambios morfológicos y fisiológicos. Trastornos autosómicos dominantes que tienen herencia dominante, como la disostosis cleidocraneal, el síndrome craneofacial de Apert, Treacher Collins y acondroplasia tiene características peculiares y similares. Debido a sus implicaciones en el campo de la odontología, el objetivo de esta revisión es hablar, a través de la exposición de los factores clínicos y generales, destacando los signos en la cavidad oral. Se seleccionaron los artículos de las bases de datos Lilacs, PubMed y BIREME, incluyendo los años 2007-2014, y las palabras clave fueron: displasia cleidocraneal, craneofacial mandibulofacial disostosis, disostosis y oral. Los cambios de huesos maxilofaciales y craneofaciales están bien documentados en la literatura, pero los estudios que informaron una asociación entre el tratamiento dental y disostosis son escasos. En conclusion, las manifestaciones orales son causas de dificultades del habla, masticación, respiración y la participación social.

Perfil dos pacientes com necessidades especiais de uma clínica de odontopediatria / Profile of special needs patients at a pediatric dentistry clinic

Objetivo: Avaliar o perfil dos Pacientes com Necessidades Especiais atendidos na Clínica de Odontopediatria da Faculdade de Odontologia da Universidade Federal do Pará. Métodos: Estudo observacional descritivo, realizado no período de março de 2007 a dezembro de 2009, analisando 137 prontuários, dos quais se extraíram os seguintes dados: gênero, idade, procedência, história médica atual e pregressa, tipo de necessidades especiais e principais doenças bucais. Aplicou-se a estatística descritiva, tabela unidimensional de frequência e elaboraram-se gráficos dos resultados. Resultados: Encontraram-se 77 (56,2%) pacientes do gênero masculino, com média de idade de 8,1 anos; 118 (86,2%) residentes na capital do Estado do Pará; 21 (15,3%) com problemas respiratórios; 37 (27,3%) com alguma alergia a medicamentos e 54 (39,4%) fazendo uso de medicamento controlado. Quanto ao tipo de necessidade especial, verificou-se que 29 (28,3%) apresentaram atraso no desenvolvimento neuropsicomotor, e a principal doença bucal encontrada foi a cárie, atingindo 84 (61,3%) indivíduos. Conclusão: O perfil avaliado dos pacientes com necessidades especiais caracteriza-se por pacientes residentes na capital do Estado do Pará, predominância de crianças do sexo masculino, portadores de atraso de desenvolvimento neuropsicomotor, com idade média de 8,1 anos, apresentando, principalmente, cárie.

Objective: To assess the characteristics of special needs patients assisted at the Clinic of Pediatric Dentistry, Faculty of Dentistry, Federal University of Pará. Methods: A descriptive observational study conducted from March 2007 to December 2009, assessing 137 records of which were extracted the following data: gender, age, origin, current and past medical history, type of special needs and major oral diseases. We applied descriptive statistics, one-dimensional frequency table and prepared graphs of the results. Results: We found 77 (56.2%) male patients, with mean age of 8.1 years; 118 (86.2%) living in the state capital of Para, 21 (15.3%) with respiratory problems, 37 (27.3%) with some allergy to medications and 54 (39.4%) making use of controlled drugs. Regarding the type of special need, we observed that 29 (28.3%) had neurologic and psychomotor delay and the primary oral disease found was dental caries, affecting 84 (61.3%) subjects. Conclusion: The assessed profile of patients with special needs is characterized by patients residing in the state capital of Para, with predominance of male children, with neurologic and psychomotor delay, with a mean age of 8.1 years, presenting mainly caries.

Perfl dos pacientes sob terapia intensiva com pneumonia nosocomial: principais agentes etiológicos / Patients profile under intensive care with nosocomial pneumonia: key etiological agents

O ambiente hospitalar é inevitavelmente um grande reservatório de patógenos virulentos e oportunistas, que podem ser transmitidos ao indivíduo por via endógena e, assim, desencadear infecções respiratórias, principalmente a pneumonia, que acomete comumente os pacientes submetidos à ventilação mecânica em Unidade de Terapia Intensiva (UTI). No período de janeiro de 2009 a janeiro de 2010, foram acompanhados 73 pacientes com pneumonia nosocomial internados nas UTIs - adulto, pediátrica e Centro de Queimados - do Hospital Metropolitano de Urgência e Emergência (HMUE), em Belém - PA, com o objetivo de avaliar o perfil desses pacientes e os principais agentes infecciosos envolvidos na infecção respiratória. Após o estudo, verificou-se uma idade média de 38,7 anos, sendo 87,7% do gênero masculino. A partir do lavado broncoalveolar, da hemocultura e da secreção traqueal, foram obtidas culturas positivas e 17 tipos de bactérias diferentes foram isolados, sendo Staphylococcus aureus o agente infeccioso mais frequente nas infecções nosocomiais (30,7%). Considerando que na microbiota normal, patógenos potencialmente respiratórios - como Staphylococcus aureus, Pseudomonas aeruginosa e alguns bacilos gram-negativos - podem colonizar o biofilme bucal, pode-se ressaltar que os cuidados odontológicos em pacientes sob terapia intensiva são essenciais como parte integrante da saúde geral, evitando agravos sistêmicos.

The hospital environment is inevitably a large reservoir of virulent and opportunistic pathogens, which can be transmitted via the individual endogenous. Which in turn can trigger respiratory infections, especially pneumonia, which commonly affects patients undergoing mechanical ventilation in the Intensive Care Unit (ICU). From January 2009 to January 2010 were followed 73 patients with nosocomial pneumonia hospitalized in ICU adult and pediatric burn center of the Metropolitan Hospital Emergency and Emergency-HMUE Belém - Pará in order to evaluate the profile of these patients and main infectious agents involved in respiratory infection. After the study it was found that the average age was 38.7 years and 87.7% were males. From broncoalveolar lavage, blood culture and tracheal aspirate positive culture was obtained and 17 kinds of different bacteria were isolated, Staphylococcus aureus the most frequent infectious agent in nosocomial infections (30.7%). Whereas the normal flora potential respiratory pathogens such as Staphylococcus aureus, Pseudomonas aeruginosa and some gram-negative bacilli can colonize the oral biofilm, may be noted that dental care for patients under intensive therapy is essential as part of general health, preventing systemic diseases.

Avaliação in vitro da atividade antifúngica de óleos essenciais e extratos de plantas da região amazônica sobre cepa de Candida albicans / In vitro evaluation of the anti-fungii activity of essential oils and plant extracts present in the amazon region about the strain of Candida albicans

A candidíase é uma doença fúngica oportunista causada pela proliferação de espécies de Candida, principalmente Candida albicans, sendo esta a espécie mais patogênica em humanos. Muitos antifúngicos existentes no mercado apresentam efeitos colaterais indesejáveis ou podem induzir a resistência fúngica, principalmente em indivíduos imunodeprimidos. Nessa perspectiva, o objetivo desta pesquisa foi avaliar in vitro a atividade antifúngica de óleos e extratos vegetais extraídos de plantas da região Amazônica e determinar a concentração inibitória mínima das espécies que apresentaram atividade antifúngica frente à cepa padrão de Candida albicans (ATCC 90028). A atividade antifúngica dos óleos essenciais Copaifera multijuga, Carapa guianenses, Piper aduncum e Piper hispidinervum foi avaliada pelo método de difusão em meio sólido em diluições de 32 a 2%, para determinação da concentração inibitória mínima. Os extratos de Annona glabra, Azadiractha indica, Bryophyllum calycinum, Eleutherine plicata, Mammea americana, Psidium guajava e Syzygium aromaticum foram testados nas concentrações de 500, 250, 125 e 62,5 mg.mL-1 e a atividade antifúngica foi verificada pelo método de difusão em meio sólido, utilizando-se discos de papel filtro. Os óleos testados não apresentaram efeito antifúngico sobre a cepa de Candida albicans e, dos extratos testados, somente os de Eleutherine plicata, Psidium guajava e Syzygium aromaticum apresentaram atividade antifúngica, com concentração inibitória mínima, respectivamente, de 250, 125 e 62,5 mg.mL-1. A partir dos resultados apresentados, verificou-se que os extratos de Eleutherine plicata, Psidium guajava e Syzygium aromaticum apresentam potencial efeito inibitório para crescimento de Candida albicans, servindo de guia para a seleção de plantas com atividades antifúngicas para futuros trabalhos de âmbito toxicológico e farmacológico.

Candidiasis is an opportunistic fungus disease caused by the proliferation of Candida species, mainly Candida albicans, what seems to be the most pathogenic one to humans. Several anti-fungii drugs available in the market present undesirable side effects or develop resistance, mainly in immune-depressed individuals. Hence, the aim of this paper was to evaluate in vitro the anti-fungii activity of vegetal oils and extracts present in the Amazon region and to determine the minimal inhibitory concentration of such species that have presented anti-fungii activity against the pattern strain of Candida albicans (ATCC 90028). The anti-fungii activity of the essential oils Copaifera multijuga, Carapa guianenses, Piper aduncum and Piper hispidinervum was determined through the method of difusion in a solid means and in dilutions of 32 to 2% in order to determine its minimal inhibitory concentration. The extracts Annona glabra, Azadiractha indica, Bryophyllum calycinum, Eleutherine plicata, Mammea americana, Psidium guajava and Syzygium aromaticum have been tested under the concentrations of 500, 250, 125 and 62,5 mg.mL-1 and the anti-fungii activity was determined through the method of difusion in a solid means using discs of flter paper. The tested oils did not present any anti-fungii effect on the strain of Candida albicans and, from the extracts tested, only Eleutherine plicata, Psidium guajava and Syzygium aromaticum have presented anti-fungii activity with minimal inhibitory concentrations, respectively, 250, 125 and 62,5 mg.mL-1. With the results presented, the extracts of Eleutherine plicata, Psidium guajava and Syzygium aromaticum present a potential inhibitory effect to the growth of Candida albicans, acting as a guide for the selection of plants with anti-fungii activities for further papers on a toxicologic and pharmacologic.

Deficiência da enzima G6PD em pacientes com paralisia cerebral / G6PD deficiency among patient with cerebral palsy

A icterícia neonatal severa é a principal causa da paralisia cerebral do tipo atetoide e pode ser decorrente da deficiência de uma enzima chamada Glicose-6-Fosfato-Desidrogenase (G6PD). Esta pesquisa tem como objetivo avaliar laboratorialmente a deficiência de G6PD em pacientes com paralisia cerebral e a história clínica de icterícia ou kernicterus, a fim de verificar uma possível relação entre a deficiência dessa enzima e a incidência de paralisia cerebral. Foram incluídos no estudo, pacientes com paralisia cerebral e história clínica de icterícia ou kernicterus. Após o aceite, os pacientes foram submetidos a exames de sangue para avaliar a deficiência de G6PD. A análise das amostras foi realizada pelo método enzimático, de acordo com o princípio colorimétrico, que consiste na mistura por inversão das amostras e reagentes (glicose 5%, nitritode sódio 1,25% e azul de metileno), ficando em banho-maria por três horas a 37 °C. Em seguida, retirou-se 0,1 mL do sedimento, acrescentaram-se 10 mL de água destilada e fez-se a leitura. Dos20 pacientes pré-selecionados, quatro (20%) não participaram, pois estavam doentes no momento da coleta. Dos 16 pacientes que foram submetidos ao exame de sangue, quatro (25%) tiveram resultadopositivo para deficiência de G6PD. Baseado nos resultados desta pesquisa, pode-se concluir que a deficiência de G6PD é um fator predisponente à paralisia cerebral e o cirurgião-dentista deve terprecaução, principalmente quanto à prescrição de medicamentos de risco para o desenvolvimento de anemia severa em pacientes com deficiência de G6PD.

Neo-birth severe jaundice is the main cause for cerebral palsy of the athetoid type and may be due to the deficiency of an enzyme called Glicosis-6-Phosphate-Dehydrogenase (G6PD). This paper aimed to evaluate, in laboratory, the deficiency of G6PD in patients with cerebral palsy in order to enable a better action by the surgeon-dentist, besides tutoring and furnishing to the patient?s companion a diagnosis of G6PD deficiency, a list of medicines which may be avoided due to anemia risk. It was included, in this paper with cerebral palsy and clinical record of jaundice or kernicterus. After agreement, patients underwent blood examination in order to evaluate G6PD deficiency. Sample analysis was performed by the enzymatic, according to the calorimetric principlewhich consists in the mixture by inversion of samples and reagents (glucose 5%, sodium nitrite 1.25%) e methylene blue in double boiling for three hours at 37 °C and, right after, it was taken 0.1 mL of the sediment, added 10 mL of distilled water and the records were measured. Fromthe 20 patients who have been pre-selected, 4 (25%) did not participate for they were sick at the moment of collection; and from the 16 patients who underwent blood examination, 4 (25%) were positive for G6PD deficiency. Based on results of this research it may be concluded that G6PD deficiency is a factor that prepares to cerebral palsy and the surgeon-dentist shall be precautious when prescribe medicines with risk to development anemia in patient with cerebral palsy.