Primary Dengue and Long-Term Health Status in Madeira Island, Portugal: A Retrospective Questionnaire-Based Study.

Dengue is among the most important mosquito-borne viral diseases worldwide. Although its acute manifestations are well known, little is known about the long-term impact of dengue on the population's health status. Madeira Island experienced a single outbreak of autochthonous dengue from September 2012 to March 2013. To extend our knowledge about the clinical impact of the outbreak on this naive population, we applied an online questionnaire to 168 adults diagnosed with dengue at the time to characterize retrospectively their symptoms during the infection and to identify long-term manifestations, possibly triggered by dengue. The most frequent symptoms during the clinical period, reported by more than three-quarters of our participants, were fever, myalgia, extreme tiredness, and headaches, whereas vomiting, pruritus, nausea, retro-orbital pain, and arthralgia occurred in 35% to 50% of participants. In the 8 years after dengue, 61.5% of participants reported at least one recurrent previously nonexistent symptom, the most frequent being headaches, abundant hair loss, extreme tiredness, arthralgia, and myalgia, experienced by 25% to 35% of participants. Nearly 20% of the participants with persistent symptoms reported the onset of chronic illness in the 4 years after dengue, most frequently ophthalmological and autoimmune diseases (5.6% each), versus only 2.2% of chronic disease onset in participants without persistent symptoms. Our results suggest that the occurrence of persistent symptoms after primary dengue might be more frequent than anticipated and may persist for several years, having an impact on the health status and well-being of a considerable proportion of the infected population.

Flying under the radar - impact and factors influencing asymptomatic DENV infections.

The clinical outcome of DENV and other Flaviviruses infections represents a spectrum of severity that ranges from mild manifestations to severe disease, which can ultimately lead to death. Nonetheless, most of these infections result in an asymptomatic outcome that may play an important role in the persistent circulation of these viruses. Also, although little is known about the mechanisms that lead to these asymptomatic infections, they are likely the result of a complex interplay between viral and host factors. Specific characteristics of the infecting viral strain, such as its replicating efficiency, coupled with host factors, like gene expression of key molecules involved in the immune response or in the protection against disease, are among crucial factors to study. This review revisits recent data on factors that may contribute to the asymptomatic outcome of the world's widespread DENV, highlighting the importance of silent infections in the transmission of this pathogen and the immune status of the host.

Selfie Dental Plaque Index: A New Tool for Dental Plaque Assessment.

Background: Plaque quantification indices are frequently used to evaluate personal oral hygiene. Education in self-care and self-diagnosis is effective in prevention and control of both dental and periodontal disease. Mobile technology has become a ubiquitous technology and can be particularly useful in the self-monitoring of health promotion. To evaluate the selfie dental plaque index compared with O´Leary index (DPI) and visible plaque index (VPI). The secondary outcome was to compare full-mouth and anterior teeth plaque index analysis. Material and Methods: A sample of 47 adults were evaluated using a four-stage protocol. All teeth (except third molars) were analyzed for VPI and DPI. A selfie Digital Camera captured the image of the patient's smile (without and with disclosing solution), which was analyzed using Image J software (ImageJ 1.52a, National Institutes of Health). Adobe Photoshop software (Copyright © 2020 Adobe) was used for individual segmentation. The calculation of the selfie index of visible plaque (SVPI) and disclosed (SDPI) was done through the area with plaque of each image in relation to the total teeth area. Results: Spearman's correlation test showed a moderate correlation between VPI and SVPI (rho = 0.6, p<0.001), whereas between DPI and SDPI the correlation was weak (rho = 0.2, p = 0.13). The correlation between the plaque index using all the teeth present, showed a strong correlation with the analysis only of the anterior teeth (rho = 0.8, p<0.001). Conclusions: Our results showed the potential of smiling images as a new tool for quantitative measurements and showed moderate correlation when compared with the visible plaque index. Anterior teeth provided reliable plaque indexes when compared with full mouth analysis. Key words:Dental Plaque Index, dental hygiene, mHealth, health Promotion, oral Health.

Insights into the influence of canine breed on proteomics of the spermatozoa and seminal plasma.

This study aimed to characterize the proteome of spermatozoa and seminal plasma of 4 purebred dogs (Golden Retriever, Great Dane, Bernese Mountain Dog, and Maremmano-Abruzzese Sheepdog). The ejaculate of 13 dogs was collected, and sperm characteristics were subjectively evaluated. Seminal plasma and sperm cells were separated and prepared individually for mass spectrometry. Data were evaluated by univariate and multivariate statistical analysis. A total of 162 proteins were identified, 47 in spermatozoa, 109 in seminal plasma, and 6 in both samples. Serum albumin in spermatozoa and tubulin alpha-3E chain, acrosin binding protein, and tubulin alpha-3 chain in plasma seminal were statistically relevant. Serum albumin and acrosin binding protein improve the sperm capacitation, acrosome reaction, and seminal quality. The tubulin family proteins are related to structural cell organization and flagella movement, and their presence in seminal plasma may be related to sample handling. According to cluster formation, a high association was observed among Bernese Mountain Dog and Great Dane, Golden Retriever, and Maremmano-Abruzzese Sheepdog for sperm proteins. For seminal plasma proteins, Bernese Mountain Dog, Great Dane, and Maremmano-Abruzzese Sheepdog were related. Further studies on breed-specific proteins in the semen of purebred dogs need to be performed to clarify its fertility roles. SIGNIFICANCE: For the first time spermatozoa proteins of dogs are described. The comparison of spermatozoa and seminal plasma proteins of four purebred dogs were performed. These results supporting that differences in semen protein profile of different canine breeds exist, which can improve the biotechnologies of reproduction in this species.

Seminal Plasma Does Not Influence Canine Semen Stored at 5°C for Long-Term Conservation.

Seminal plasma has several components that protect the sperm cells and assist in the fertilization process. In contrast, the exact role carried out by seminal plasma during the cooling of canine semen remains controversial. Moreover, concerning the long estrus period, the possibility to store chilled semen at 5°C for more than 72 hours and maintain good sperm quality for additional inseminations could increase fertilization rates. Thus, this study aimed to evaluate the seminal plasma influence on quality and oxidative stress of the extended canine semen stored at 5°C for 7 days. Three ejaculate pools from eight healthy dogs were collected by digital manipulation of the penis. The sperm kinetics, sperm vitality (eosin/nigrosin stain), integrity of plasma and acrosomal membranes, morphology, superoxide and hydrogen peroxide production, mitochondrial potential, lipid peroxidation, and oxygen reactive species production (induced and spontaneous thiobarbituric acid [thiobarbituric acid reactive substances, TBARS] assay) were evaluated every 48 hours (M0, M48, M96, and M168) until 7 days (168 hours) in cooled extended (TRIS egg yolk) semen of dogs at 5°C with (+SP) or without (-SP) autologous seminal plasma. No statistical difference was found for sperm kinetics in cooled samples with +SP and -SP during the experimental time period, except for the progressive motility of +SP samples that was higher at M48 than M96 (p = 0.023). The seminal plasma did not influence any other evaluated sperm characteristics. Finally, our results demonstrated that the presence or lack of seminal plasma during cooling the semen of dogs does not influence sperm quality at 5°C. Moreover, the components of the semen extender may contribute to maintaining good sperm quality and low reactive oxygen species production during the long period of the dog's semen cooling, even after semen centrifugation.

Proteomic data of seminal plasma and spermatozoa of four purebred dogs.

Semen contains several proteins that are important to fertilization and to identify reproductive failures. There are proteins that are specie-specific expressed, although differs among several breeds. This article provides experimental data describing the protein profile of seminal plasma and spermatozoa of four healthy purebred dogs: Golden Retriever (n=3), Bernese Mountain Dog (n=4), Great Dane (n=3), and Maremmano-Abruzzese Sheepdog (n=3), housed at São Paulo state, Brazil. Semen samples were collected by manual stimulation of the penis in a presence of a teaser bitch, when possible. The seminal plasma and sperm cells were separated by centrifugation and prepared for mass spectrometry. The gene ontology annotation of the proteins found is described. This is the first time that proteomic profile of the semen of purebred dogs is described. These data are a valuable resource to improve the biotechnologies of reproduction applied to canid species.

Surgical reconstruction of the interdental papilla: 2 case reports.

The loss of interdental papillae may create esthetic and phonetic problems and facilitates food impaction. Nonsurgical and surgical approaches can be developed to restore these areas, depending on the amount of tissue lost. Periodontal surgical techniques are difficult to perform in the interdental space because of the limited amount of tissue and poor blood supply. The aim of this article is to describe a periodontal plastic surgical technique in which subepithelial connective tissue grafts associated with composite restorations are used to reconstruct interdental papillae. This approach was followed in 2 patients whose grafts were obtained from different donor sites: the palate and the retromolar tuberosity. The 12-month recall examinations of both patients revealed satisfactory results, including stable gingival margins and complete, harmonious fill of the interdental papillary areas.

Chemical Restraint of Free-ranging South American Coatis ( Nasua nasua ) with a Combination of Tiletamine and Zolazepam.

We describe the use of a combination of tiletamine and zolazepam (Zoletil®) for chemical restraint of South American coatis ( Nasua nasua ) under field conditions. We immobilized 53 coatis from a free-ranging population at Iguaçu National Park, Brazil, with Zoletil. Males and females (1.0-8.7 kg) of different age groups participated in the study. Four dosage (milligram per kilogram body weight) groups were created based on quartiles as follows: 1) 4.76-6.68 mg/kg (n=13), 2) 6.83-7.71 mg/kg (n=13), 3) 7.72-8.68 mg/kg (n=18), and 4) 8.98-11.57 mg/kg (n=9). Variables analyzed were sex, age, body weight, dosage, induction time, handling time (HT: time elapsed between the onset of immobilization and first signs of recovery), time from injection to first stand-up posture after anesthesia, heart and respiratory rates, and body temperature. Mean (±SD) induction time was 2.9 (±1.4) min and was positively correlated with age. In dosage groups 1-4, mean HTs were 40.3 (±24.0), 64.5 (±19.1), 54.8 (±15.0), and 60.3 (±12.0), respectively. Handling time had a positive linear relationship with age and body weight, but the relationship between HT and dosage was nonlinear. Group 1 had a shorter HT compared to the other groups combined. Time from injection to first stand-up was 105.0 (±33.5) min. Zoletil was quick acting and safe for immobilization of coatis in the wild.

Coverage Root after Removing Peripheral Ossifying Fibroma: 5-Year Follow-Up Case Report.

When lesions in soft tissue reach the gingival margin, they can produce aesthetic defects during its permanence and after its removal. Periodontal plastic surgery allows the correction of the gingival contour using different techniques. This paper is a case report of a peripheral ossifying fibroma removal in the interproximal area of teeth 21 and 22 in addition to root coverage of the affected area through two surgical phases: keratinized gingival tissue augmentation surgery with free gingival graft concurrent with removal of the lesion and, in a second stage, root coverage by performing coronally advanced flap technique with a follow-up of five years. The initial results achieved, which were root coverage of 100% after 6 months, promoted an adequate gingival contour and prevented the development of a mucogingival defect or a root exposure with its functional and aesthetic consequences. After five years, the results showed long term success of the techniques, where the margin remained stable with complete root coverage and tissues were stable and harmonic in color.

Sleep disorder investigation might be considered to be mandatory in attention deficit/hyperactivity disorder guideline.

OBJECTIVE: To determine the prevalence of obstructive sleep apnea (OSA) in children with attention deficit/hyperactive disorder (ADHD) and compare amplitude and latency of the P300 potential among children with and without OSA. METHOD: Sixty-one children with ADHD underwent oddball auditory attention tests for detection of P300 (ERPs) followed by an all-night polysomnography. The children were divided in two groups, those with and without OSA. RESULTS: Significant decreased amplitude of the P300 potential was observed in children with OSA when compared with children without OSA. CONCLUSION: The study showed that sleep fragmentation as a result of OSA can exacerbate the attention disorder that characterizes ADHD, and highlights the importance of assessing the presence of OSA in the differential diagnosis of children with attention deficits.

Prevalence of peri-implant mucositis / Prevalência de mucosite peri-implantar

ABSTRACT Objective: The aim of this study was to evaluate the prevalence of peri-implant mucositis, as well as hygiene care around implants and the correlation between keratinized gingiva and probing depth around implants. Methods: The study consisted of 107 dental implants of 24 patients treated at Faculdade São Leopoldo Mandic who were evaluated for the presence of bleeding, presence of keratinized gingiva and implant placement time. Moreover, demographic data and oral hygiene methods used in the area of implants were obtained. Results: The prevalence of mucositis in this population was 81.31% of the implants. The average percentage of bleeding score was 29.91%. Of the 107 implants, 52.34% had keratinized tissue. Regarding the use of interproximal tooth cleaning, 43% of patients used dental floss, 26.71% used interdental brush and 20.56% used single brush. It was observed only a weak negative correlation between marginal bleeding and presence of keratinized tissue (p <0.001, r = -0.27). Conclusion: It can be observed a high prevalence of mucositis around the implants, which highlights the need for professionals' greater awareness about oral hygiene guidance and health promotion encouragement in patients receiving dental implant rehabilitation, as well as more studies to investigate the real role of keratinized tissue around implants.

RESUMO Objetivo: O objetivo desse estudo foi avaliar a prevalência de mucosite, bem como os cuidados de higiene bucal ao redor de implantes e a correlação entre a faixa de gengiva queratinizado e a profundidade de sondagem nos implantes. Métodos: Foram avaliados 107 implantes dentários de 24 pacientes em atendimento na Faculdade de Odontologia São Leopoldo Mandic. Os implantes foram avaliados em relação à presença de sangramento, tecido queratinizado e tempo de instalação dos implantes. Além disso, foram obtidos dos voluntários, os dados demográficos, bem como informações sobre os cuidados e métodos de higienização utilizados na região dos implantes. Resultados: A prevalência de mucosite foi de 81,31% dos implantes. A média de porcentagem de sangramento obtida foi de 29,91%. Dos 107 implantes, em 52,34% havia presença de tecido queratinizado. Quanto ao uso de métodos auxiliares para controle de biofilme, 43% dos pacientes utilizavam fio dental, 26,71% utilizavam escova interdental e 20,56% utilizavam escova unitufo. Foi observada apenas uma fraca correlação negativa entre sangramento marginal e presença de tecido queratinizado (p< 0,001, r= -0,27). Conclusão: Pode-se observar uma alta prevalência de mucosite ao redor dos implantes, o que evidencia a necessidade de uma maior conscientização dos profissionais quanto à orientação de higiene bucal e incentivo à promoção de saúde em pacientes que recebem reabilitação com implantes dentais, bem como mais estudos investigando o real papel do tecido queratinizado ao redor dos implantes.

Fibrina rica em plaquetas e a reconstrução tecidual periodontal / Platelet-rich fibrin and periodontal tissue regeneration ­ a literature review

As evidências na literatura dos efeitos benéficos dos concentrados de plaqueta, obtidos do sangue autólogo em procedimentos cirúrgicos periodontais, têm aumentado muito nos últimos anos. O uso da fibrina rica em plaquetas ainda se encontra na fase inicial, porém, o potencial clínico de suas aplicações é muito promissor. O objetivo desta revisão foi conceituar o uso da fibrina rica em plaquetas como um procedimento que visa à regeneração das estruturas periodontais perdidas. Pôde-se concluir que a fibrina rica em plaquetas tem grande potencial de aplicação nas cirurgias periodontais e peri-implantares, demonstrando ser eficaz no tratamento de defeitos infraósseos de três paredes e de furca II mandibulares, sendo um procedimento de baixa complexidade e morbidade, de fácil aplicação clínica e com baixo custo.

The evidence in the literature of the beneficial effects of platelet concentrates obtained from autologous blood in periodontal surgical procedures has increased significantly in recent years. The use of platelet-rich fibrin is still in its early days; however, their clinical application is very promising. The objective of this review was to conceptualize the use of platelet-rich fibrin as a procedure which aims to the regeneration of lost periodontal structures. It could be concluded that platelet-rich fibrin have great potential for application in periodontal and peri-implant surgeries and have shown to be effective in treating intra-bony 3 walls and mandibular furcation II defects, being a low complexity and morbidity procedure, easy for clinical applicability and of a low cost.

Câncer e doença periodontal / Cancer and periodontal disease

Atualmente, tem se discutido a influência e a repercussão da doença periodontal sobre o organismo humano. O termo “medicina periodontal” foi introduzido em 1996, focando na validação desta relação. As evidências já foram constatadas de que a saúde periodontal deficiente está associada à deficiência da saúde sistêmica. Seu envolvimento está cada vez mais comprovado nas doenças cardiovasculares, diabetes, complicações na gestação e parto, bebês de baixo peso, acidentes vasculares cerebrais, artrite reumatoide e vários tipos de câncer. Segundo a literatura existente nessa área, o fator causal está na inflamação crônica provocada pela doença periodontal e a resposta do hospedeiro frente à inflamação. Com base nessas informações, o objetivo deste trabalho foi buscar na literatura atual informações que sustentam e comprovam tais hipóteses. Como conclusão, temos a confirmação do envolvimento da saúde periodontal na saúde sistêmica e a comprovação de que esta associação está relacionada não somente ao papel das bactérias, mas principalmente à inflamação crônica provocada pelas mesmas. Concluiu-se também que, tanto a Medicina como a Odontologia, devem estar cada vez mais integradas, a fim de proporcionar aos pacientes melhores condições de saúde, destacando o papel do cirurgião-dentista na prevenção da doença periodontal, assegurando que a mesma não contribua com a doença sistêmica.

Avaliação da eficácia de um agente dessensibilizante a base de nitrato de potássio / Evaluation of the effectiveness of a desensitizing agent made of potassium nitrate

A hipersensibilidade dentinária (HSD) é uma condição dolorosa comumem muitos pacientes periodontais, sendo caracterizada por dor curta eforte em resposta a diferentes estímulos, sejam estes térmicos, evaporativos,táteis, osmóticos ou químicos. Seu tratamento pode consistir nainterrupção da resposta neural ou através da oclusão dos túbulos dentinários,por métodos profissionais (aplicação de agentes dessensibilizantes naforma de gel, aplicação de resinas, vernizes, agentes adesivos, realizaçãode tratamento endodôntico ou cirurgia) ou caseiros (enxaguatórios oudentifrícios). O objetivo deste estudo foi avaliar a eficácia de um agentedessensibilizante a base de nitrato de potássio (UltraEZ). Para a realizaçãodeste trabalho foram avaliados 20 dentes de dez pacientes da Faculdadede Odontologia São Leopoldo Mandic que apresentavam HSD. Os dentesforam submetidos a três tipos de testes: 1) estímulo mecânico com sondaexploradora; 2) jato de ar comprimido com seringa tríplice; 3) jato de águacom seringa tríplice. O grau de HSD foi avaliado com a utilização de umaescala de medida verbal (EMV). Cada dente foi submetido a três aplicaçõesdo agente dessensibilizante com intervalos regulares de sete dias. A cadaretorno foi executada nova avaliação do grau de HSD. Os resultados obtidosforam submetidos à análise estatística. Foram observadas diferençasestatisticamente significantes quando comparados os valores obtidos dehipersensibilidade dentinária nas segunda e terceira semanas em relaçãoà avaliação inicial e primeira semana (p < 0,05). Concluiu-se que o agentedessensibilizante foi eficaz no tratamento da HSD.

Association between tooth loss and bone mineral density in Brazilian postmenopausal women.

BACKGROUND: To evaluate oral health in postmenopausal women and verify whether there is a correlation between tooth loss according to index of decayed, missing, filled teeth (DMFT) and bone mineral density (BMD). METHODS: A cross-sectional study was conducted with 100 women. The DMFT and its associations with lumbar and femoral BMD (T-score and g/cm) were assessed. Analysis of covariance and multiple logistic regression were applied and the mean and standard deviation, absolute and relative frequencies (percentages) were obtained. RESULTS: The analysis of covariance (ANCOVA) revealed significant association between the DMFT index and bone mass (T-score), compared to the young adult in L2-L4 (P = 0.0252) and in bone mass in L2-L4 (below average) in g/cm(2) and in the DMFT index (P = 0.0332), and for women with bone mass below the average index DMFT was higher. Between L2-L4 below average (g/cm(2)) and extracted component (P = 0.0483) association was also significant because women with bone mass below the average had a greater extracted component. CONCLUSIONS: Postmenopausal women with poor oral health may present reduced bone mass. There was significant association between BMD and DMFT at the L2-L4 site. Women must be advised that their good oral health, amount and quality of bone mass should also be matters of concern.

Aumento da faixa de tecido ceratinizado ao redor de implante / Keratinized tissue width augmentation around implant

A necessidade de tecido ceratinizado ao redor de dentes foi questionada por muitos anos. Atualmente, há um consenso de que uma quantidade mínima é necessária. Em regiões submetidas a reabilitações implantossuportadas também se busca uma faixa desse tecido para obter melhor manutenção da saúde peri-implantar, conforto durante a higienização e facilitar os procedimentos técnicos de confecção da reabilitação. Constata-se que são escassos os estudos sobre o tema em humanos a longo prazo, e que esse tópico ainda é controverso. Com o caso clínico apresentado, buscou-se mostrar a importância do tecido ceratinizado marginal para manutenção da saúde peri-implantar, realizando um enxerto de tecido conjuntivo subepitelial removido de área doadora palatina para aumento da quantidade dessa gengiva.

The need for keratinized tissue around teeth for many years has been questioned, there is now a consensus that a minimum amount is required. In regions undergoing implant-supported rehabilitation an adequate width of this tissue is also important for maintenance of peri-implant health, facilitates technical procedures for preparation or rehabilitation and comfort in hygiene. It appears that studies on the subject in humans in the long term are scarce and that this topic is still controversial, and has not been established a minimum consensus. With this clinical case was sought to show the importance of marginal keratinized tissue for peri-implant health maintenance, performing a subepithelial connective tissue graft removed from palatal area to increase the amount of this tissue.

Recobrimento radicular com enxerto de tecido conjuntivo subepitelial em recessões classe III de Miller / Root coverage with subepithelial connective tissue graft in Miller class III recessions

Atualmente, a demanda por cirurgia plástica periodontal para tratamentos de recessões gengivais se tornou rotina, principalmente quando o paciente relata desconfortos como hipersensibilidade ou prejuízo de estética pela exposição radicular. A etiologia é considerada multifatorial, podendo estar presentes fatores predisponentes e/ou desencadeantes. Várias são as técnicas utilizadas para o recobrimento radicular, dentre elas o retalho posicionado coronalmente associado ao enxerto de tecido conjuntivo subepitelial. No caso clínico apresentado, as recessões gengivais foram classificadas como classe III de Miller e o tratamento clínico promoveu ganho de tecido ceratinizado, recobrimento radicular e a redução significativa da hipersensibilidade, que era a queixa principal da paciente, representando assim uma alternativa viável para o tratamento dessas recessões. Considerações sobre fatores biológicos e etiológicos podem influenciar na previsibilidade do recobrimento, sendo fundamental a escolha da melhor alternativa terapêutica, visando minimizar o trauma cirúrgico e favorecer melhores resultados, solucionando problemas estéticos e alterações funcionais.

Currently, the demand for periodontal plastic surgery for treatment of gingival recessions has become routine, especially when the patient reports discomforts as hypersensitivity or prejudice of aesthetics by root exposure. The etiology is considered multifactorial and may be present predisposing factors and trigger. There are several techniques used for root coverage, and among them, the coronally positioned flap associated with subepithelial connective tissue graft. In the clinical case presented, the gingival recessions were classified as class III of Miller and clinical treatment promoted gain of keratinized tissue, root coverage and the significant reduction of hypersensitivity, which was the main complaint of the patient, thus representing a feasible alternative for the treatment of gingival recessions. Considerations about biological and etiological factors may influence the predictability of the coverage, and is important to choose the best therapeutic option, seeking to minimize the surgical trauma and to promote better results, troubleshooting aesthetic and functional changes.

Treatment of gingival recession in two surgical stages: Free gingival graft and connective tissue grafting.

This report describes a clinical case of severe Miller Class II gingival recession treated by two stages of surgery that combined a free gingival graft and connective tissue grafting. First, a free gingival graft (FGG) was performed to obtain an adequate keratinized tissue level. Three months later, a connective tissue graft (CTG) was performed to obtain root coverage. The results indicated that the FGG allows for a gain in the keratinized tissue level and the CTG allows for root coverage with decreased recession level after 16 months. Therefore, for this type of specific gingival recession, the combination of FGG and CTG can be used.