Aspectos relevantes da síndrome de Sjõgren para o cirurgião-dentista / Sjogren’s syndrome’s relevant aspects for the dental surgeon

A síndrome de Sjõgren (SS), conhecida como síndrome sicca, é uma doença autoimune caracterizada pela hipofunção das glândulas salivares e lacrimais, cuja prevalência na população mundial é de aproximadamente 0,5% a 1%. Por ser uma doença autoimune complexa e de difícil diagnóstico, é sub-diagnosticada e sub-tratada segundo o consenso realizado em 2012 pelo Colégio Americano de Reumatologia (ACR). O Cirurgião-Dentista pode desempenhar papel importante na detecção de possíveis alterações compatíveis com a síndrome, além de auxiliar no tratamento de diversas patologias orais decorrentes da síndrome. Este trabalho tem como objetivo explanar aspectos importantes referentes ao diagnóstico e tratamento da síndrome aqui discutida. A SS apesar de ser considerada uma doença de evolução lenta, em estágios avançados pode ser fatal, principalmente por aumentar as chances dos pacientes virem a desenvolver linfoma não Hodking. O tratamento odontológico dos pacientes com SS deve principalmente ser profilático, com a recomendação do uso de repositores de saliva e controle rígido da higiene bucal.

Sjogren’s syndrome (SS), known as the sicca syndrome, is an autoimmune disease characterized by salivary and lacrimal glands hypofunction which prevalence in the world population is approximatel y around 0,5% to 1%. For being a complex autoimmune disease and with difficult diagnosis, it is sub diagnosed and miss treated according to the consensus occurred in 2012 by the American College of Rheumatology (ACR). The surgeon-dentist (SD) may play a important role on the detection of possible changes compatible to the syndrome, besides can help in the treatment of many oral pathologies caused by the syndrome. This work has the main purpose to explain the important aspects regards to the correct diagnosis and treatment of this syndrome.The SS besides been considered a slow evolution disease, in advanced stages it can be fatal,mainly for increasing the patient’s chances of developing non-Hodking lymphoma. The dental treatment of patients with SS must be prophylactic, with the recomedations of the use of salivary replenishing and careful control of the oral hyigiene.

Conjunctival impression cytology in xerophthalmia among rural children.

The advent of Conjunctival Impression Cytology (CIC) has opened a new chapter in the detection of Vitamin A deficiency as it is a simplified field technique. The need for such a technique was of paramount importance in India where as estimated 5 to 7 percent children suffer from eye signs of Vitamin A deficiency. In the present study the results of clinical evaluation of apparently healthy children and those having clinical sings and symptoms of Vitamin A deficiency have been compared with CIC results. Serum Vitamin A levels have also been estimated wherever possible. The findings indicate that CIC results are superior to the clinical assessment and it is suggested that CIC can be used as screening tool for children of school going age (and earlier) for early detection and correction of Vitamin A deficiency.

A prevalence study of xerophthalmia in the Philippines: implications for supplementation strategies.

In three provinces of the Philippines (Quezon, Northern Samar and Zamboanga del Sur), 11,378 children between 6 and 83 months of age were examined for signs of xerophthalmia and weighed to determine weight-for-age status. Xerophthalmia prevalence ranged from 1.6% to 4.4% for nightblindness and 0.6% to 2.7% for Bilot's spots in the three provinces indicating a serious vitamin A deficiency problem. These levels contrast sharply with the recent national xerophthalmia prevalence (0.7% for night blindness and 0.2% for Bitot's spots). There was a preponderance of mild xerophthalmia among males, and among children 4-6 years of age. No consistent association between weight-for-age status and xerophthalmia was found. The study recommends the universal distribution of vitamin A to children in high-prevalence regions, rather than the current practice of providing vitamin A supplements to moderately and severely underweight children identified through the annual village-based child weighing sessions, to ensure reaching children most at risk for xerophthalmia. The study also suggests the need for regional vitamin A assessments to identify areas endemic for vitamin A deficiency because the aggregate national prevalence may mask a more serious localized problem.

Ulceracao corneana bilateral nao infecciosa associada a sindrome de Sjogren: relato de um caso / Noninfectious bilateral corneal ulceration associated with Sjögren's syndrome: report of a case

Os autores relatam um caso de ulceracao corneana bilateral nao infecciosa em uma paciente de 46 anos com sindrome de Sjögren. Discutem a evolucao clinica e apresentam uma revisao da terapeutica disponivel na presenca da associacao ulceracao corneana e sindrome de Sjögren.