Factors associated with the morphology of the mandibular symphysis and soft tissue chin

ABSTRACT Objectives: This study aimed to (I) assess the morphology of the symphysis and soft tissue chin associated with sex, age and sagittal/vertical skeletal patterns, and (II) identify the individual and combined contributions of these variables to different portions of the symphysis. Methods: This cross-sectional study included 195 lateral cephalometric radiographs from untreated adults. Alveolar, basal, and soft tissue of the symphysis were measured by an X/Y cranial base coordinate system, and divided in accordance to four predictor variables: sex, age, and sagittal/vertical skeletal patterns. Parametric tests were conducted for comparison and correlation purposes, while multiple regression analysis was performed to explore combined interactions. Results: Alveolar inclination is related to sagittal and vertical patterns, and both explained 71.4% of the variations. Alveolar thickness is weakly predicted and poorly influenced by age. Symphysis height was 10% higher in males, and associated with a vertical skeletal pattern and sex, and both explained 43.6% of variations. Basal symphyseal shows an individual thickness, is larger in males, and vertically short-positioned with age. Soft tissue chin is not necessarily related to the size of the underling skeletal pattern, and enlarges with age, even in adulthood. Conclusions: The symphysis and surrounding tissues are influenced by sex, age, and sagittal and vertical patterns, acting differently on the alveolar, basal and soft tissue portions. Sagittal and vertical skeletal patterns are the strongest association on alveolar symphysis inclination, whereas sex and age acts on the vertical symphysis position and soft tissues thickness.

RESUMO Introdução: O presente estudo objetivou: 1) avaliar a morfologia da sínfise mandibular e dos tecidos tegumentares do mento, associada ao sexo, idade, padrões sagital e vertical; e 2) identificar as contribuições dessas variáveis, individualmente ou combinadas, às diferentes regiões da sínfise. Métodos: Este estudo transversal incluiu 195 radiografias cefalométricas laterais de adultos não tratados ortodonticamente. Os tecidos alveolar, basal e mole da sínfise foram medidos por um sistema de coordenadas x, y e z da base do crânio e divididos de acordo com quatro variáveis preditoras: sexo, idade e padrões esqueléticos sagitais e verticais. Testes paramétricos foram conduzidos para fins de comparação e correlação, enquanto a análise de regressão múltipla foi realizada para explorar as interações combinadas. Resultados: A inclinação alveolar está relacionada aos padrões sagitais e verticais, e ambos explicaram 71,4% das variações. A espessura alveolar é fracamente prevista e pouco influenciada pela idade. A altura da sínfise foi 10% maior no sexo masculino e esteve associada ao padrão esquelético vertical e ao sexo, sendo que ambos explicaram 43,6% das variações. A sínfise basal mostra espessura individual, é maior no sexo masculino e verticalmente curta com a idade. O tecido mole do mento não está necessariamente relacionado ao tamanho do padrão esquelético subjacente e aumenta com a idade, mesmo na idade adulta. Conclusões: A sínfise e os tecidos circundantes são influenciados pelo sexo, idade e padrões sagitais e verticais, que atuam de forma diferenciada nas porções alveolar, basal e de tecidos tegumentares. Os padrões esqueléticos sagitais e verticais são a associação mais forte na inclinação da sínfise alveolar, enquanto o sexo e a idade atuam na posição vertical da sínfise e na espessura dos tecidos tegumentares.

Acuracy and concordance of anthropometric indicators and body composition in heart failure / Precisão e concordância de indicadores antropométricos e composição corporal na insuficiência cardíaca

Background: Anabolic/catabolic disorder in heart failure (HF) favors cardiac cachexia, implying a reduction in HF survival. Objectives: To assess the accuracy and concordance of the diagnosis of protein malnutrition and excess fat among the anthropometric and body composition methods in individuals with HF. Method: A study of accuracy that included 60 individuals with HF. Body mass index (BMI), arm circumference (AC), triceps skinfold thickness (TST), adductor pollicis muscle thickness (APMT), arm muscle circumference (AMC) and corrected arm muscle area (cAMA). Fat free mass index (FFMI) and body fat percentage (BF%), obtained by electrical bioimpedance (EBI), were used to compare the diagnosis of protein malnutrition and excess fat. Accuracy was assessed by calculating sensitivity, specificity, positive and negative predictive value. The concordance of the EBI diagnosis and other methods was performed by the chi-square test and kappa (k) statistic, where p<0.05 was considered significant.Results: Higher frequencies of protein malnutrition were identified by cAMA and AMC, and excess fat by BF%. BMI presented low sensitivity (43%) and accuracy (38.5%), with moderate concordance (0.50). AMC sensitivity was 86%, accuracy 66.4%, and acceptable concordance (0.36) compared to FFMI. Similar percentages of moderate sensitivity and low accuracy were observed for TST and BMI.Conclusion: AMC may be useful to identify protein malnutrition and TST has not been adequate to diagnose adiposity. BMI was not sensitive to assess muscle and adipose reserve. EBI was more accurate

Association between kidney function and Framingham risk score in an admixed population of Brazil

ABSTRACT Chronic kidney disease (CKD) increases cardiovascular disease (CVD) risk development. However, the mechanisms of reduced kidney function with CVD risk are unclear. This study aimed to investigate the association between kidney function and Framingham risk score (FRS) in participants with traditional cardiovascular risk factors and normal estimated glomerular filtration rate (eGFR) > 60 mL/min/1.73 m² in an admixed population of Brazil. The participants were divided into three groups according to FRS: low risk group with 0% to <10%, moderate risk group with ≥10% to 20% and high risk group with >20%. The eGFR was calculated using Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI). Data from participants were collected by questionnaire, and blood and urine samples were collected to analyze biochemical markers. A total of 214 subjects aged 53±10 years old was collected. There were 77 individuals in low risk group, 59 in moderate risk group and 78 in high-risk group. Mean eGFRCKD-EPI was 89.39±15.05 mL/min/1.73 m² and 90.74±16.17 mL/min/1.73 m2 when race adjustment. The results indicated that there is an increasing the cardiovascular risk with a decreased of eGFR, conforming to a significant inverse correlation observed between eGFR and FRS with Spearman correlation (R²=-0.256, p<0.001; R²=-0.224, p=0.001, when adjusted for race). There was a statistically significant difference in eGFRCKD-EPI (p<0.001) and eGFRCKD-EPI with race adjustment (p=0.002) among risk groups. The data suggests that the reduction eGFR is associated with elevated FRS among Brazilian adults without CKD. Furthermore, the results suggest that race adjustment it's not necessary in Brazilian population.

Variance sources and ratios to estimate energy and nutrient intakes in a sample of adolescents from public schools, Natal, Brazil / Fontes e razões de variância para estimar a ingestão de energia e nutrientes de uma amostra de adolescentes de escolas públicas

OBJECTIVE: The aim of this study was to describe the sources of dietary variance, and determine the variance ratios and the number of days needed for estimating the habitual diet of adolescents. METHODS: Two 24 hour food recalls were used for estimating the energy, macronutrient, fatty acid, fiber and cholesterol intakes of 366 adolescents attending Public Schools in Natal, Rio Grande do Norte, Brazil. The variance ratio between the intrapersonal and interpersonal variances, determined by Analysis of Variance, was calculated. The number of days needed for estimating the habitual intake of each nutrient was given by the hypothetical correlation (r)>0.9 between the actual and observed nutrient intakes. RESULTS: Sources of interpersonal variation were higher for all nutrients and in both genders. Variance ratios were <1 for all nutrients and higher in women. Two 24 hour dietary recalls were enough to assess energy, carbohydrate, fiber and saturated and monounsaturated fatty acid intakes accurately. However, the accurate assessment of protein, lipid, polyunsaturated fatty acid and cholesterol intakes required three 24 hour recalls. CONCLUSION: Interpersonal dietary variance in adolescents was greater than intrapersonal variance for all nutrients, resulting in a variance ratio of less than 1. Two to three 24 hour recalls, depending on gender and the study nutrient, are necessary for estimating the habitual diet of this population.

OBJETIVO: O objetivo deste estudo foi descrever as fontes de variância da dieta, determinar as razões de variâncias e o número de dias necessários para estimar a dieta habitual em adolescentes. MÉTODOS: A ingestão de energia, macronutrientes, ácidos graxos, fibra e colesterol foram estimadas por meio de dois recordatórios de 24 horas, aplicados em 366 adolescentes de escolas públicas de Natal, Rio Grande do Norte. A razão de variância foi calculada entre o componente da variância intrapessoal e interpessoal, determinada pela Análise de Variância. A definição do número de dias para a estimativa da ingestão habitual de cada nutriente foi obtida considerando a correlação hipotética de (r)>0,9, entre a verdadeira ingestão de nutrientes e a observada. RESULTADOS: As fontes de variância interpessoal foram maiores para todos os nutrientes e em ambos os sexos. As razões de variâncias foram <1 para todos os nutrientes, e mais elevadas no sexo feminino. Dois dias de recordatórios de 24 horas seriam suficientes para avaliar com precisão o consumo de energia, carboidratos, fibra, ácidos graxos saturados e monoinsaturados, exceto para proteínas, lipídeos, ácidos graxos poliinsaturados e o colesterol, que necessitariam de três dias. CONCLUSÃO: A variância interpessoal da dieta dos adolescentes foi maior do que a intrapessoal, para todos os nutrientes, repercutindo em uma razão de variância menor que 1. Para estimar a dieta habitual nesta população, uma variação de dois a três dias é necessária considerando o sexo e o nutriente avaliado.

Efeito da suplementação com minerais antioxidantes em pacientes com aterosclerose tratados com estatinas / Effect of supplementation with antioxidant minerals in patients with atherosclerosis treated with statins

O objetivo deste estudo clínico randomizado duplo-cego foi avaliar o efeito da suplementação oral de zinco e selênio concomitante ao tratamento com rosuvastatina sobre os marcadores de estresse oxidativo e inflamação, bem como o status de zinco e selênio, em pacientes com aterosclerose, apresentando angina estável. A amostragem foi composta por adultos e idosos, 47 homens e 29 mulheres, com diagnóstico de aterosclerose coronariana por angiografia, atendidos no Serviço de Hemodinâmica do Natal Hospital Center - Natal / RN. O projeto foi aprovado pelos Comitês de Ética em Pesquisa da UFRN e da FCF-USP. A coleta de dados foi realizada no primeiro momento e após 4 meses do tratamento com rosuvastatina 10 mg, concomitante à suplementação com zinco (30mg/d) e selênio (150µg/d), ou placebo, sendo avaliados os parâmetros antropométricos e dietéticos, zinco e selênio plasmáticos e eritrocitários, perfil lipídico, LDL minimamente oxidada, anticorpos anti-LDL(-), imunocomplexos Ac-LDL(-), GPx, SOD, IL-6 e PCR-as. Houve predominância do gênero masculino, idade média em torno de 60 anos, ex-fumantes, portadores de hipertensão arterial, alta freqüência do sobrepeso/obesidade e circunferência abdominal aumentada/muito aumentada. As dietas caracterizaram-se como hipocalórica, hiperprotéica, normoglicídica e hipolípídica, com baixo teor de fibra e altas prevalências de inadequação de ingestão de zinco e selênio. O status de zinco e selênio no plasma e eritrócitos não foi alterado significativamente nos grupos placebo e suplementado entre os dois momentos do estudo. A terapia com a rosuvastatina mostrou-se eficaz na redução das concentrações de colesterol total, LDL, colesterol não-HDL, triacilgliceróis e PCR-as, independente da suplementação com os minerais zinco e selênio. As concentrações de LDL(-), Ac anti-LDL(-), imunocomplexos, IL-6 e as atividades das enzimas SOD e GPx não foram modificadas em função das intervenções com rosuvastatina associadas ou não à suplementação. Conclui-se que o tratamento com rosuvastatina 10mg durante 4 meses não alterou o status de zinco e selênio considerando os biomarcadores avaliados. A suplementação de zinco e selênio não influenciou os biomarcadores de estresse oxidativo e inflamação. Estudos adicionais serão necessários para avaliação da necessidade de suplementação neste grupo de pacientes com aterosclerose, analisando-se outras doses, tempo de suplementação e biodisponibilidade da forma química dos minerais prescritos

The aim of this randomized double-blind study was to evaluate the effect of oral zinc and selenium supplementation, concomitant with rosuvastatin treatment, on markers of oxidative stress and inflammation, as well as the status of zinc and selenium in adult patients with atherosclerosis and stable angina. The study included 47 men and 29 women, average age around 60 years, with coronary atherosclerosis diagnosed by angiography at the Hemodynamic Service at Natal Hospital Center - Natal / RN. The project was approved by the Ethics Committee of UFRN and FCF-USP. Data from patients were obtained at beggining and after four months of treatment with 10 mg rosuvastatin, concomitantly with zinc (30mg/d) and selenium (150µg/d) supplementation or placebo. The anthropometric and dietary data, zinc and selenium concentrations in plasma and erythrocyte, lipid profile, electronegative LDL (LDL(-)), anti- electronegative LDL, Ac-LDL(-) immune complexes, GPx and SOD activities, IL-6 and hs-CRP were evaluated in all patients. Most patients were former smokers with arterial hypertension, high rate of overweight/obesity and increased waist circumference. The diets contained low-calorie, hyperproteic, normoglycidic, low-fat and fiber content and inadequate intake of zinc and selenium. The status of zinc and selenium in plasma and erythrocytes was not changed significantly in the supplemented and placebo groups between the two moments of the study. Rosuvastatin therapy was effective in reducing total cholesterol, LDL, non-HDL cholesterol, triglycerides and hs-CRP level, regardless of supplementation with the minerals zinc and selenium. The concentrations of LDL (-), anti- LDL (-), immune complexes, IL-6 and the activities of SOD and GPx were not modified by zinc and selenium supplementation associated with rosuvastatin. In conclusion, the treatment with 10 mg rosuvastatin for 4 months did not change either the status of zinc and selenium or the biomarkers evaluated in this study. Zinc and selenium supplementation did not affect oxidative stress and inflammation biomarkers. Additional studies are needed to evaluate the need for antioxidant minerals supplementation in patients with atherosclerosis, mainly to investigate other doses, duration of supplementation and bioavailability of the chemical form of the prescribed minerals.