Influence of Diabetes Mellitus and Smoking on Pro- and Anti-Inflammatory Cytokine Profiles in Gingival Crevicular Fluid.

Smoking and diabetes mellitus have been recognized as significant modifying factors of the evolution of periodontitis, being considered at the moment as descriptive factors in the periodontitis grading system. The purpose of this study was to assess the consequence of smoking, type 2 diabetes, and the combination of these two factors on clinical periodontal parameters, on the levels of gingival crevicular fluid (GCF), and also on ratios of pro-inflammatory and anti-inflammatory cytokines by using a commercially available kit-based multiplex fluorescent immunoassay. The study was carried out on 124 volunteers (control (C) group = 29, diabetes mellitus (DM) group = 32, smoking (S) group = 31, and S + DM group = 32). Total mean bleeding on probing was significantly lower in the S and S + DM groups, compared to that of the other groups (p < 0.05). Total amounts of TGF-ß, MIP-1α, IL-6, IL-2, and IL-17 were significantly increased in the periodontally healthy sites of diabetes patients (p < 0.05), compared to those of the controls. Systemically healthy smoking patients had higher values of GM-CSF, TGF-ß, IL-4, TNF-α, IL-5, and IL-7, while diabetic smoking patients showed higher values of IL-4, TGF-ß, and MIP-1α. In smoking and systemically healthy patients, IL-23, IL-7, and IL-12 showed increased concentrations, while concentrations of TGF-ß, MIP-1α, IL-2, IL-7, IL-12, IL-17, IL-21, and IL-23 were higher in smoking DM patients. In conclusion, in our study, diabetes mellitus induced a general pro-inflammatory state, while smoking mainly stimulated immunosuppression in the periodontal tissues of periodontitis subjects.

Study on the Effects of Melatonin on Glycemic Control and Periodontal Parameters in Patients with Type II Diabetes Mellitus and Periodontal Disease.

Background and Objectives: There is evidence that melatonin could improve the periodontal status and also glycemic control of patients with diabetes mellitus. Therefore, the aim of this study was to assess the effects of scaling and root planing plus adjunctive systemic treatment with melatonin on periodontal parameters and glycemic control in patients with type 2 diabetes and chronic periodontitis. Materials and Methods: The study was conducted on 54 subjects with periodontitis and diabetes mellitus randomly assigned to the study group (n = 27, subjects with scaling and root planing + melatonin) or control group (n = 27, subjects with scaling and root planing + placebo). Periodontal parameters (probing depth-PD; clinical attachment loss-CAL; bleeding on probing-BOP; and hygiene level) and glycated hemoglobin (HbA1c) were assessed at baseline and 8 weeks after. Results: At baseline, there were no significant differences between groups, but at the second evaluation 8 weeks later the association of melatonin with the non-surgical periodontal therapy exerted statistically significant improvements, both in periodontal parameters, with a significant decrease in periodontal disease severity, and glycated hemoglobin when compared to the control subjects. Conclusions: In our study, combined non-surgical periodontal treatment and systemic treatment with melatonin provided additional improvements to severe periodontal condition and the glycemic control of patients with diabetes type 2 when compared to non-surgical periodontal treatment alone.

Symptoms and reason for a medical visit in lung cancer patients.

BACKGROUND: Patients with lung cancer usually present with symptoms at the time of diagnosis, but it is common that neither the doctor nor the patient initially associate them with the possibility of a malignant tumour. OBJECTIVES: The aim of our study is to analyse the symptoms of patients with lung cancer and the relationship with the personal characteristics or the oncological disease. MATERIAL AND METHODS: A retrospective study was conducted on all patients diagnosed with lung cancer in the Pontevedra Health Area over a period of three years. The symptoms presented by the patient, the reason for the consultation and the agreement between both or any factors associated with either of the two are analysed. RESULTS: A total of 358 patients, with a mean age of 68.7 years, and of whom 87% males, were included in the study. The most common initial symptoms were, constitutional in 30.4% of the cases, cough in 20.9% of cases, and in third place was chest pain, which was referred to by 12% of the patients. The most frequent reason for the consultation was dyspnea in 22.1% of patients, an incidental finding in 15.4%, and haemoptysis in 12.8%. There was a moderate association (correlation coefficient = 0.495) between the initial symptoms and the consulting symptom. CONCLUSIONS: A high percentage of patients with lung cancer had symptoms associated with the tumour at the time of diagnosis, even in early stage disease.

Contexto: A Os doentes com o diagnóstico de cancro do pulmão estão habitualmente sintomáticos no momento do diagnóstico, sendo comum que o médico ou o doente não associem essa sintomatologia com a eventualidade de um tumor maligno. Objectivos: Este estudo teve como objectivo a análise dos sintomas de doentes com cancro do pulmão e sua relação com as características pessoais ou com a doença oncológica. Material e Métodos: Foi levado a cabo um estudo retrospectivo englobando todos os doentes com o diagnóstico de cancro do pulmão na Região de Saúde de Pontevedra (Espanha) ao longo de um período de três anos. São analisados os sintomas de apresentação do doente, o motivo de consulta e a concordância entre ambos ou com quaisquer factores correlacionados. Resultados: Foram incluídos no estudo 358 doentes, com uma média etária de 68,7 anos, sendo 87% dos doentes do sexo masculino. Os sintomas iniciais mais comuns foram sintomas constitucionais em 30,4% dos casos, tosse em 20,9% e dor torácica, descrita por 12% dos doentes. O motivo de consulta mais frequente foi dispneia em 22,1% dos doentes, um achado acidental em 15,4% dos doentes e hemoptise em 12,8%. Observou-se uma associação moderada (coeficiente de correlação = 0,495) entre os sintomas iniciais e o motivo de consulta. Conclusões: Uma elevada percentagem de doentes com um diagnóstico de cancro do pulmão apresentou sintomas associados com o tumor no momento do diagnóstico, mesmo num estadio inicial da doença.