Salivary Diagnosis of Dental Caries: A Systematic Review.

The activity of dental caries, combined with its multifactorial etiology, alters salivary molecule composition. The present systematic review was developed to answer the following question: "Are salivary biomarkers reliable for diagnosis of dental caries?". Following the "Preferred Reporting Item for Systematic Reviews and Meta-analysis" (PRISMA) guidelines, the review was conducted using multiple database research (Medline, Web of Science, and Scopus). Studies performed on healthy subjects with and without dental caries and providing detailed information concerning the clinical diagnosis of caries (Decayed, Missing, Filled Teeth-DMFT and International Caries Detection and Assessment System-ICDAS criteria) were included. The quality assessment was performed following a modified version of the Joanna Briggs Institute Prevalence Critical Appraisal Checklist. The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO, ID: CRD42022304505). Sixteen papers were included in the review. All studies reported statistically significant differences in the concentration of salivary molecules between subjects with and without caries (p < 0.05). Proteins were the most investigated molecules, in particular alpha-amylase and mucins. Some studies present a risk of bias, such as identifying confounding factors and clearly defining the source population. Nevertheless, the 16 papers were judged to be of moderate to high quality. There is evidence that some salivary compounds studied in this review could play an important diagnostic role for dental caries, such as salivary mucins, glycoproteins (sCD14), interleukins (IL-2RA, 4,-13), urease, carbonic anhydrase VI, and urea.

The Association between Salivary Metabolites and Gingival Bleeding Score in Healthy Subjects: A Pilot Study.

Periodontal diseases, including gingivitis and periodontitis, are among the most prevalent diseases in humans. Gingivitis is the mildest form of periodontal disease, characterized by inflammation of the gingiva caused by the accumulation of dental plaque. Salivary diagnostics are becoming increasingly popular due to the variation in saliva composition in response to pathological processes. We used a metabolomics approach to investigate whether a specific saliva metabolic composition could indicate preclinical stage of gingivitis. 1H-NMR spectroscopy was used to obtain the salivary metabolite profiles of 20 healthy subjects. Univariate/multivariate statistical analysis evaluated the whole saliva metabolite composition, and the Full-Mouth Bleeding Score (FMBS) was employed as a classification parameter. Identifying a signature of specific salivary metabolites could distinguish the subjects with high FMBS scores but still within the normal range. This set of metabolites may be due to the enzymatic activities of oral bacteria and be associated with the early stages of gingival inflammation. Although this analysis is to be considered exploratory, it seems feasible to establish an FMBS threshold that distinguishes between the absence and presence of early inflammatory alterations at the salivary level.

Human Serum and Salivary Metabolomes: Diversity and Closeness.

Saliva, which contains molecular information that may reflect an individual's health status, has become a valuable tool for discovering biomarkers of oral and general diseases. Due to the high vascularization of the salivary glands, there is a molecular exchange between blood and saliva. However, the composition of saliva is complex and influenced by multiple factors. This study aimed to investigate the possible relationships between the salivary and serum metabolomes to gain a comprehensive view of the metabolic phenotype under physiological conditions. Using 1H-NMR spectroscopy, we obtained the serum metabolite profiles of 20 healthy young individuals and compared them with the metabolomes of parotid, submandibular/sublingual, and whole-saliva samples collected concurrently from the same individuals using multivariate and univariate statistical analysis. Our results show that serum is more concentrated and less variable for most of the shared metabolites than the three saliva types. While we found moderate to strong correlations between serum and saliva concentrations of specific metabolites, saliva is not simply an ultrafiltrate of blood. The intense oral metabolism prevents very strong correlations between serum and salivary concentrations. This study contributes to a better understanding of salivary metabolic composition, which is crucial for utilizing saliva in laboratory diagnostics.

Metabolic Profiles of Whole, Parotid and Submandibular/Sublingual Saliva.

The detection of salivary molecules associated with pathological and physiological alterations has encouraged the search of novel and non-invasive diagnostic biomarkers for oral health evaluation. While genomic, transcriptomic, and proteomic profiles of human saliva have been reported, its metabolic composition is a topic of research: metabolites in submandibular/sublingual saliva have never been analyzed systematically. In this study, samples of whole, parotid, and submandibular/sublingual saliva from 20 healthy donors, without dental or periodontal diseases, were examined by nuclear magnetic resonance. We identified metabolites which are differently distributed within the three saliva subtypes (54 in whole, 49 in parotid, and 36 in submandibular/sublingual saliva). Principal component analysis revealed a distinct cluster for whole saliva and a partial overlap for parotid and submandibular/sublingual metabolites. We found exclusive metabolites for each subtype: 2-hydroxy-3-methylvalerate, 3-methyl-glutarate, 3-phenylpropionate, 4-hydroxyphenylacetate, 4-hydroxyphenyllactate, galactose, and isocaproate in whole saliva; caprylate and glycolate in submandibular/sublingual saliva; arginine in parotid saliva. Salivary metabolites were classified into standard and non-proteinogenic amino acids and amines; simple carbohydrates; organic acids; bacterial-derived metabolites. The identification of a salivary gland-specific metabolic composition in healthy people provides the basis to invigorate the search for salivary biomarkers associated with oral and systemic diseases.

Variabilidade espontânea da extra-sistolia ventricular na cardiopatia chagásica crônica / Spontaneous variabitity of ventricular extrasystole in chronic Chagas cardiopathy

Purpose - To study the spontaneous variability of single (VPCs) and coupled (CVPCs) in patients with chronic Chagas' disease (CCD). Patients and Methods - Twenty patients with CCD, 14 male, in class I and III NYHA, with frequent VPCs and VCPCs, free of drug therapy were studied.21 hour Holter monitoring was done for 4 subsequent days. The data analysis assessed the variation in the frequency of VPCs and CVPCs between patients, seven hour periods one hour periods in a hierarchical model by a Poisson process. Results - a) the frequency of VPCs follows a circadian rhythm, closely related to the hourly variations of the mean heart rate; b) disregarding the heart rate influence on the variability of the ventricular arrhythmia, its behavior was at random and unpredictable; c) the minimal percentual reduction in VPCs/h that discriminated between antiarrhythmic effect and spontaneous between antiarrhythmic effect and spontaneous variability was 121.86% for sevenhour, 58.42% for 21-hour and 38.45% for 42-hour electrocardiographic monitoring periods; d) the same approch for the VCPCs revealed values of 133,8%, 63.21% and 41.3% respectively

Hepatite crônica näo-A, näo-B: estudo clínico e morfológico / Chronic hepatitis non-A, non-B: clinical and morphologic study

Tendo em vista a grande freqüência mundial da hepatite crônica näo-A, näo-B (HCNANB) e a escassez de dados nacionais sobre a doença, realizamos estudo retrospectivo de 85 pacientes, atendidos até dezembro de1987. Foram divididos em quatro grupos: I: pós transfusional (PT), 35 pacientes (41,2%); II: de risco (GR), incluindo profissionais da saúde e toxicômanos, 11 (12,9%); III: esporádico com início bem definido (EBD), 19 (22,4%) e IV: esporádico com início näo definido (END), 20 (23,5%). A média de idade no grupo I foi significativamente maior que nos grupos II e III. O padräo polifásico das transaminases foi observado nos quatro grupos. Histologicamente, a freqüência das formas graves foi semelhante nos quatro grupos mas a HC lobular predominou no grupo III. Concluiu-se que a maneira como foi adquirida a infecçäo aguda näo tem implicaçöes prognósticas

Estudo clínico comparativo da remoçäo da placa bacteriana supragengival com taça de borracha versus Profident: avaliaçäo da eficiência e receptividade dos métodos / Comparative clinical study of subgengival dental plaque remotion with rubber cup versus Profident: evaluation of methods efficency and receptivity

Este estudo clínico comparou a eficiência da remoçäo de placa bacteriana supragengival com taça, cone de borracha e uma mistura cremosa de pedra-pomes e água em motor de baixa velocidade, versus o sistema Profident com jato de bicarbonato de sódio, água e ar. Foram selecionados 100 pacientes com gengiva clinicamente saudável ou com gengivite leve. Em cada paciente foram feitos dois quadrantes para cada método. A eficiência dos dois métodos foi semelhante e a preferência dos pacientes foi para o sistema taça de borracha. O sistema Profident provocou mais queixa de dor, ou desconforto e sangramento gengival, sendo o método mais rápido

Treatment of patients with Schistosomiasis mansoni: a double blind clinical trial comparing praziquantel with oxamniquine

Com objetivo de se compararem a tolerabilidade e eficácia do praziquantel e oxamniquine, procedeu-se a um estudo prospectivo duplo-cego envolvendo 120 pacientes com esquistossomose intestinal ou hepatintestinal. Os pacientes foram randomizados em dois grupos. Um foi tratado com praziquantel, na dose de 55 mg/kg de peso, o outro com oxamniquine, 15 mg/kg de peso, sempre administrados em dose única por via oral. O diagnóstico e seguimento parasitológicos basearam-se no exame de fezes pelo método de Kato-Katz. Em 73 de 77 casos negativos após tratamento, executaram-se biopsias retais. Efeitos colaterais, principalmente tontura, sonolência, dores abdominais, cefaléia, náuseas e diarréia foram observados em 87% dos casos. Sua incidência, intensidade e duraçäo foram semelhantes em ambos os grupos, mas a dor abdominal foi significativamente mais freqüente após praziquantel, havendo maior tendência para tontura intensa após oxamniquine. Observou-se aumento significante de alamina-aminotransferase e gama-glutamiltransferase após oxamniquine e de bilirrubina total após praziquantel. Um total de 48 pacientes tratados com praziquantel e 46 com oxamniquine completaram os exames de controle até o sexto mês. As percentages de cura foram de 79,2% e de 84,8% respectivamente, diferença näo significativa. Os pacientes näo curados mostraram reduçäo média do número de ovos de 93,5% e de 84,1%, diferença näo significativa. Cinco pacientes retratados com praziquantel curaram-se, mas somente um de três retratados com oxamniquine. Estes resultados mostram que ambas as drogas-apesar de diferentes propriedades farmacológicas - provocam reaçöes colaterais semelhantes e apresentam eficácia terapêutica comparável