Localized Necrotizing Periodontitis: A Possible Oral Manifestation of COVID-19

We investigated an unusual report of localized necrotizing periodontitis coinfection in patients with mild COVID-19. Male patient, 30 years old, with previous medical history of hypovitaminosis, immunized with two doses of the Pfizer® vacci ne, attended in a dental college in northern Brazil with an acute dental emergency reporting itching, halitosis, intense gingival p ain and spontaneous bleeding, mild fever of 37.8ºC, dry cough, muscle pain and nausea. Metronidazole and chlorhexidine were prescribed to improve the necrotizing condition, to treat periodontitis scaling and root planing (SRP) were performed associated with chlo rhexidine irrigation and oral hygiene instructions, which treated the patients conditions. COVID-19 coinfections are possible, specially, oral bacterial infections which is demonstrated in this report, so correct treatment is necessary for both infections. This letter d escribes the first known occurrence of severe localized necrotizing periodontitis in the urban area of Brazil's Amazon region.

Investigamos un reporte inusual de coinfección de periodontitis necrotizante localizada en pacientes con COVID-19 con síntomas leves: Paciente masculino, de 30 años, con antecedentes médicos de hipovitaminosis, inmunizado con dos dosis de la vacuna Pfizer®, atendido en una facultad de odontología en el norte Brasil, con urgencia dental aguda reportando prurito, halitosis, dolor gingival intenso y sangrado espontáneo, fiebre leve de 37,8 ºC, tos seca, mialgias y náuseas. Se prescribió metronidazol y clorhexidina para mejorar el cuadro necrosante, para tratar la periodontitis se realizó raspado y alisado radicular (SRP) asociado a irrigación con clorhexidina e instrucciones de higiene oral. Las coinfecciones por COVID- 19 son posibles, especialmente las infecciones bacterianas orales, lo cual se demuestra en este reporte, por lo que es necesario un correcto tratamiento de ambas infecciones. Esta carta describe la primera aparición conocida de periodontitis necrotizante severa de un paciente del área urbana de la región amazónica de Brasil.

Doença de Alzheimer como fator de risco à doença periodontal: uma revisão de literatura / Alzheimer's disease as a risk factor to periodontal disease: a literature review

Introdução: A medicina periodontal é a área da periodontia que investiga a interação fisiológica e patológica entre a saúde do periodonto e/ou a Doença Periodontal na saúde sistêmica do individuo. Atualmente estudos evidenciaram possíveis correlações entre a Doença Periodontal e o Alzheimer, nestes trabalhos os autores consideram que estas patologias dividem fatores de risco e/ou modificadores em comum podendo haver uma relação bidirecional entres estas. Objetivo: Realizar uma revisão da literatura para descrever uma correlação entre o Alzheimer e a doença periodontal através dos fatores pro-inflamatórios, imunológicos e periodontopatogênicos. Materiais e Métodos: Foi realizada uma busca na literatura nas bases de dados: Google Acadêmico, PubMed, EBSCO e Scielo, contendo artigos científicos de 2000 até 2019, nos idiomas inglês e português usando os termos de pesquisa e descritores: "Periodontite Crônica" E/OU "Doença de Alzheimer" E/OU "Microbiologia periodontal" E/OU "Citocinas", como critérios de inclusão tivemos estudos de caso-controle, case series e estudos clínicos com criteriosa metodologia, aspectos metodológicos bem organizados estruturalmente e protocolos de pesquisa bem delineados. Conclusão: Consideramos que periodontistas e cirurgiões-dentistas devem estar atentos as possíveis associações entre o Alzheimer e a doença periodontal e durante os atendimentos estar atento aos sinais e sintomas do Alzheimer e orientar a pacientes, familiares e cuidadores quanto a correta higienização bucal, prevenção e tratamento da doença periodontal. (AU)

Introduction: Periodontal medicine is the area of periodontics that investigates the physiological and pathological interaction between periodontal health and / or periodontal disease in the individual's systemic health. Currently, studies have shown possible correlations between Periodontal Disease and Alzheimer's, in these studies, the authors consider that these pathologies divide risk factors and / or modifiers in common, and there may be a bidirectional relationship between them. Objective: To perform a literature review to describe a correlation between Alzheimer's disease and periodontal disease through pro-inflammatory, immunological and periodontopathogenic factors. Materials and Methods: A literature search was performed in the databases: Google Scholar, PubMed, EBSCO and Scielo, containing scientific articles from 2000 to 2019, in the English and Portuguese languages using the search terms and descriptors: "Chronic Periodontitis" E / OR "Alzheimer's Disease" AND / or "Periodontal Microbiology" AND / or "Cytokines", as inclusion criteria we had case-control studies, case series and clinical studies with methodological criteria, well structured methodological aspects and research protocols well outlined. Conclusion: We believe that periodontists and dental surgeons should be aware of the possible associations between Alzheimer's disease and periodontal disease, and during the visits to be alert to the signs and symptoms of Alzheimer's disease and to guide patients, family members and caregivers about correct oral hygiene, prevention and treatment of periodontal disease (AU)

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.

JC virus/human immunodeficiency virus 1 co-infection in the Brazilian Amazonian region

Abstract JC virus (JCV) is a member of the Polyomaviridae family and is associated to a severe disease known as progressive multifocal leukoencephalopathy, PML, which is gradually increasing in incidence as an opportunistic infection among AIDS patients. The present study aimed to investigate the occurrence of JCV among HIV-1 carriers including their types and molecular subtypes and the possible association with disease. Urine samples from 66 HIV-1 infected subjects were investigated for the presence of the virus by amplifying VP1 (215 bp) and IG (610 bp) regions using the polymerase chain reaction. JCV was detected in 32% of the samples. The results confirmed the occurrence of type B (subtype Af2); in addition, another polyomavirus, BKV, was also detected in 1.5% of samples of the HIV-1 infected subjects. Apparently, there was no significant difference between mono- (HIV-1 only) and co-infected (HIV-1/JCV) subjects regarding their TCD4+/TCD8+ lymphocyte counts or HIV-1 plasma viral load. Self admitted seizures, hearing and visual loses were not significantly different between the two groups.

Toll-like receptor 3 gene polymorphisms are not associated with the risk of hepatitis B and hepatitis C virus infection

INTRODUCTION: The present study investigated the prevalence of two single-nucleotide polymorphisms (SNPs) in the Toll-like receptor 3 (TLR3) gene in patients infected with hepatitis B virus (HBV) and hepatitis C virus (HCV). METHODS: Samples collected from HCV (n = 74) and HBV (n = 35) carriers were subjected to quantitative real-time PCR (qPCR) to detect the presence of the SNPs rs5743305 and rs3775291 in TLR3 and to measure the following biomarkers: alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), and prothrombin time (PT). A healthy control group was investigated and consisted of 299 HCV- and HBV-seronegative individuals. RESULTS: No significant differences in allele, genotype and haplotype frequencies were observed between the investigated groups, and no association was observed between the polymorphisms and histopathological results. Nevertheless, genotypes TA/AA (rs5743305) and GG (rs3775291) appear to be associated with higher levels of ALT (p<0.01), AST (p<0.05) and PT (p<0.05). In addition, genotypes TT (rs5743305; p<0.05) and GG (rs3775291; p<0.05) were associated with higher GGT levels. CONCLUSIONS: This genetic analysis revealed the absence of an association between the polymorphisms investigated and susceptibility to HBV and HCV infection; however, these polymorphisms might be associated with a greater degree of biliary damage during the course of HCV infection. .

Investigação do vírus Epstein-Barr em pacientes com Periodontite Crônica / Investigation of the Epstein-Barr virus in patients with chronic periodontitis

Introdução: Nos últimos anos, um número crescente de estudos sugere a participação dos herpesvírus na doença periodontal. Objetivo: Este trabalho investiga a relação entre a presença do herpesvírus Epstein-Barr (EBV) e a infecção periodontal em pacientes com periodontite crônica. Metodologia: Foram coletadas amostras de biofilme subgengival de sítios com profundidades de sondagem de 4 a 6 mm e > 7 mm, de 28 pacientes com periodontite crônica. Como controles, foram incluídos 16 indivíduos, sistemicamente saudáveis e sem doença periodontal. Adicionalmente, parâmetros clínicos de profundidade de sondagem (PS), nível clínico de inserção (NCI) e índice de sangramento à sondagem (SS) foram registrados. Resultado: Os resultados demonstraram médias de 2,7 mm PS, 1,7 mm NCI e 0,3% dos sítios apresentaram SS. A investigação do EBV no biofilme subgengival dos grupos foi realizada por meio da reação em cadeia da polimerase com primer espécie-específico. Os resultados da análise viral indicaram ausência de EBV em todas as amostras subgengivais analisadas. Conclusão: A partir destes resultados, não foi encontrada relação entre a presença do herpesvírus Epstein-Barr e a periodontite crônica.

Introduction: In recent years, a growing number of studies have suggested the participation of the herpes virus in periodontal disease. Objective: this study investigates the relationship between the presence of the Epstein-Barr herpes virus and periodontal infection in patients with chronic periodontitis. Methodology: subgingival biofilm samples were collected of subgingival sites with probing depths of 4 mm to 6 mm, and > 7 of 28 patients with chronic periodontitis. The control group consisted of 16 healthy subjects without clinical evidence of chronic periodontitis. Additionally, clinical parameters of probing depth, attachment level and Bleeding index were recorded. Result: the results showed averages of 2 mm probing depth, 1, 7 mm attachment level and 0.3 % bleeding on probing. Investigation of the herpes virus in the subgingival biofilm of the groups was performed using polymerase chain reaction with species-specific primer. Results of viral analysis indicated the absence of EBV in all subgingival samples analyzed. Conclusion: these results found no relationship between the presence of the Epstein-Barr herpes virus and chronic periodontitis.

Characterization of mannose-binding lectin plasma levels and genetic polymorphisms in HIV-1-infected individuals / Caracterização dos polimorfismos genéticos e dos níveis plasmáticos da lectina ligante de manose em indivíduos infectados pelo HIV-1

INTRODUCTION: The present study investigated the association between mannose-binding lectin (MBL) gene polymorphism and serum levels with infection by HIV-1. METHODS: Blood samples (5mL) were collected from 97 HIV-1-infected individuals resident in Belém, State of Pará, Brazil, who attended the Special Outpatient Unit for Infections and Parasitic Diseases (URE-DIPE). CD4+ T-lymphocyte count and plasma viral load were quantified. A 349bp fragment of exon 1 of the MBL was amplified via PCR, using genomic DNA extracted from controls and HIV-1-infected individuals, following established protocols. MBL plasma levels of the patients were quantified using an enzyme immunoassay kit. RESULTS: Two alleles were observed: MBL*O, with a frequency of 26.3 percent in HIV-1-infected individuals; and the wild allele MBL*A (73.7 percent). Similar frequencies were observed in the control group (p > 0.05). Genotype frequencies were distributed according to the Hardy-Weinberg equilibrium in both groups. Mean MBL plasma levels varied by genotype, with statistically significant differences between the AA and AO (p < 0.0001), and AA and OO (p < 0.001) genotypes, but not AO and OO (p = 0.17). Additionally, CD4+ T-lymphocytes and plasma viral load levels did not differ significantly by genotype (p > 0.05). CONCLUSIONS: The results of this study do not support the hypothesis that MBL gene polymorphism or low plasma MBL concentrations might have a direct influence on HIV-1 infection, although a broader study involving a large number of patients is needed.

INTRODUÇÃO: O presente estudo investigou a associação entre o polimorfismo no gene da lectina ligante de manose (MBL) e os níveis séricos da proteína com a infecção pelo HIV-1. MÉTODOS: As amostras de sangue (5mL) foram coletadas de 97 indivíduos infectados pelo HIV-1 residentes em Belém, Estado do Pará, Brasil, que frequentavam a Unidade de Referência Especial para Doenças Infecciosas e Parasitárias Especiais (URE-DIPE). Os níveis de linfócitos T CD4+ e da carga viral plasmática foram quantificados. Um fragmento de 349pb do exon 1 da MBL foi amplificado via PCR, utilizando DNA genômico extraído das amostras controles e dos indivíduos portadores do HIV-1, seguindo protocolos previamente estabelecidos. O nível plasmático de MBL nos pacientes foi quantificado usando kit de ensaio imunoenzimático. RESULTADOS: Dois alelos foram observados - MBL*O, com uma frequência de 26,3 por cento em indivíduos infectados e o alelo selvagem MBL*A (73,7 por cento). Frequências similares foram observadas no grupo controle (p > 0,05). As frequências genotípicas estavam em equilíbrio de Hardy-Weinberg em ambos os grupos. A média dos níveis plasmáticos MBL variou por genótipo, com diferenças significativas entre os genótipos AA e AO (p < 0,0001), e AA e OO (p < 0,001), mas não entre AO e OO (p=0,17). Além disso, os linfócitos T CD4+ e os níveis plasmáticos de carga viral não diferiram significativamente de acordo com o genótipo (p>0,05). CONCLUSÕES: Os resultados deste estudo não apoiam a hipótese de que o polimorfismo no gene MBL ou baixa concentração plasmática de MBL poderia ter uma influência direta sobre a infecção pelo HIV-1, embora um estudo com número maior de pacientes seja necessário.

Caracterização molecular do HTLV-1/2 em doadores de sangue em Belém, Estado do Pará: primeira descrição do subtipo HTLV-2b na região Amazônica / Molecular characterization of HTLV-1/2 among blood donors in Belém, State of Pará: first description of HTLV-2b subtype in the Amazon region

Este trabalho objetivou a caracterização molecular do vírus linfotrópico de células T humanas infectando doadores de sangue atendidos na Fundação Centro de Hemoterapia e Hematologia do Pará. Amostras de DNA de 79 indivíduos soropositivos para o vírus linfotrópico de células T humanas foram analisadas por meio da reação em cadeia da polimerase para as regiões genômicas pX, env e 5'LTR, de polimorfismos de comprimento de fragmentos de restrição e do seqüenciamento da região 5LTR, com posterior análise filogenética, definindo o tipo e o subtipo do HTLV circulante na população estudada. Observou-se uma maior prevalência de HTLV-1 (71 por cento) em relação ao HTLV-2 (29 por cento). As amostras de HTLV-1 sequenciadas foram classificadas como pertencentes ao subtipo Cosmopolita, subgrupo Transcontinental, sendo as de HTLV-2 identificadas como HTLV-2c. A análise de polimorfismos de comprimento de fragmentos de restrição da região env e do sequenciamento da região 5'LTR, identificou, pela primeira vez na Amazônia Brasileira, uma amostra de HTLV-2b, enfatizando a necessidade de estudos moleculares contínuos na região para melhor entendimento da epidemiologia de transmissão do HTLV na população e permitir a vigilância epidemiológica da emergência de novos tipos e subtipos.

This study aimed to perform molecular characterization on the human T-cell lymphotropic virus (HTLV) infecting blood donors attended at the Hematology and Hemotherapy Center-Foundation of Pará. DNA samples from 79 HTLV-seropositive individuals were analyzed by means of the polymerase chain reaction on the pX, env and 5'LTR genomic regions; restriction fragment length polymorphism analysis; and sequencing of the 5'LTR region with subsequent phylogenetic analysis. From this, the HTLV types and subtypes circulating in the study population were defined. There was higher prevalence of HTLV-1 (71 percent) than of HTLV-2 (29 percent). HTLV-1 samples were classified as belonging to the Cosmopolitan subtype, Transcontinental subgroup; and the HTLV-2 samples as HTLV-2c. Analysis on the restriction fragment length polymorphisms of the env region and sequencing of the 5'LTR region identified a sample of HTLV-2b, for the first time in the Brazilian Amazon region. This emphasizes the need for ongoing molecular studies in this region, in order to have better understanding of the epidemiology of HTLV transmission in the population, and to enable epidemiological surveillance of the emergence of new types and subtypes.

Soroprevalência de infecções por vírus da hepatite B e vírus da hepatite C em indivíduos do Estado do Pará / Seroprevalence of hepatitis B virus and hepatitis C virus infections among individuals in the State of Pará

As hepatites B e C continuam sendo um importante problema de saúde pública no Brasil. Neste estudo, determinou-se a prevalência de marcadores sorológicos para as hepatites B e C em indivíduos do Estado do Pará, atendidos no Laboratório Central de Saúde Pública do Pará, no período de janeiro de 2002 a dezembro de 2005. Foram realizados 11.282 exames para a pesquisa do HBsAg, 2.342 para o anti-HBc e 5.542 para o anti-vírus da hepatite C. A prevalência de HBsAg foi de 3,6 por cento e predominou na faixa etária de 20 a 29 anos, enquanto que o anti-HBc foi observado em 37,7 por cento dos indivíduos. A prevalência do antivírus da hepatite C foi de 3,6 por cento e predominou entre indivíduos acima de 50 anos. Assim, as freqüências dos marcadores encontradas no Pará foram mais altas que em vários outros estados do país, sugerindo a necessidade de medidas de saúde publica mais eficazes no combate a estes agravos na região.

Hepatitis B and C continue to be important public health problems in Brazil. In this study, the prevalence of serological markers for hepatitis B and C in individuals from the State of Pará, attended at the Central Public Health Laboratory of Pará between January 2002 and December 2005, was determined. 11,282 tests to investigate HBsAg, 2,342 for anti-HBc and 5,542 for anti-HCV were performed. The prevalence of HBsAg was 3.6 percent and it was predominantly found in the age range of 20 to 29 years old, while anti-HBC was observed in 37.7 percent of the subjects. The prevalence of anti-hepatitis C virus was 3.6 percent and it was predominantly found in individuals over 50 years old. Thus, the frequencies of the markers found in Pará were higher than many other states in Brazil, hence suggesting that there is a need for public health measures of greater effectiveness for combating these illnesses in this region.