Expression of microRNAs (133b and 138) and Correlation with Echocardiographic Parameters in Patients with Alcoholic Cardiomyopathy.

INTRODUCTION: Alcoholic Cardiomyopathy (ACM) is a disease with a difficult diagnosis. The real mechanisms related to its pathophysiology are not fully understood. OBJECTIVE: The aims of this study were to investigate whether miR-133b and miR-138 could be associated with ACM. METHODS: Forty-four patients were included comprising 24 with ACM and 20 with cardiomyopathies of different etiologies (control group). Real-time PCR was performed to verify the relative expression among the studied groups. In the statistical analysis, the quantitative variables t-student Mann- Whitney and correlation of Pearson tests were carried out, while the qualitative variable comprised the chi-square test, with p<0.05 being considered statistically significant. RESULTS: There was no association between clinical and sociodemographic characteristics of the groups. The patients with ACM presented downregulation of miR-133b in comparison with control patients (p=0.004). On the other hand, for the miR-138, there was no association when the ACM group was compared with the control group. The presence of miR-133b among cases and controls was not correlated with any of the echocardiographic parameters. However, the increase in the expression of miR-138 was correlated with an increase in the ejection fraction (r=0.28, p=0.01) and the diameter of the left atrium (r=0.23, p=0.04) in patients with ACM. CONCLUSION: The downregulation of miR-133b might be a marker for ACM and, in addition, miR- 138 could be used to correlate the increase in ejection fraction with and normalization of the diameter of the left atrium diameter in patients with this disease.

Polymorphisms of CYP2C9*2, CYP2C9*3 and VKORC1 genes related to time in therapeutic range in patients with atrial fibrillation using warfarin.

INTRODUCTION: Warfarin continues to be the most widely used anticoagulant in clinical practice around the world for the prevention of thromboembolic events in patients with atrial fibrillation (AF). The evaluation of the quality of anticoagulation control, estimated by time in therapeutic range (TTR), is accepted as a good method to evaluate the quality of anticoagulation. The variability of TTR can be explained by the presence of variants of the CYP2C9 and VKORC1 genes. METHODS: This study examined the association between polymorphisms of the CYP2C9 and VKORC1 genes and control of oral anticoagulation, through TTR, in patients with AF. A cross-sectional study was conducted within a cohort follow-up. The study comprised of 317 patients with AF, using warfarin, who were followed up for one year. The genotyping of genes CYP2C9 (rs1057910), (rs1799853) and VKORC1 (rs923231) was performed by PCR in real time, using TaqMan probes. RESULTS: Patients who had variant genotypes for the CYP2C9*3 gene (rs1057910) presented higher TTR (TTR 81-100%) when compared to when compared to the <45% and 46-60% TTR groups (p=0.005 and p=0.002, respectively). Regarding VKORC1 (rs923231), patients who had the variant genotype for the VKORC1 (rs923231) gene also presented a higher TTR (TTR 81-100%), when when compared to the <45% and 46-60% TTR groups (p=0.005 and p=0.004, respectively). In a multivariate model, VKORC1 (rs923231) remained associated for comparisons with the TTR groups (<45% vs 81-100% groups, p=0.01; and 46-60% vs 81-100% groups, p=0.01). CONCLUSION: The genotypes of the CYP2C9*3 (AA) and VKORC1 -1639 (GG) genes were associated with the worst quality of anticoagulation control (TTR) in patients with AF using warfarin in the northeast of Brazil.

Merenda escolar na promoção da saúde bucal: o potencial cariogênico dos alimentos / School meal in promotion of oral health: the cariogenic potential of food

Studies on school meals have increased in recent years in pursuit of strategies to offer food that serves not only to feed students, but also provide adequate physical and mental development, as well as promote general and oral health, emphasizing the prevention of caries. This article is a bibliographical review concerning works about foods and meals offered in schools, considering their cariogenic potential, as well as its role in the promotion of oral health. Carbohydrates, mainly the simple ones, are the nutrients of bigger impact on caries. However, an active bacterial flora is necessary to metabolize such nutrients in the mouth, which depends on the individual's oral hygiene. The variation in the cariogenic potential of different foods must also be considered, and this depends on the consistency, the way they are prepared and the period of time the food is adhered to the dental surface. Few studies on the cariogenic potential of meals served in schools were found in the literature. However, many foods offered present a great cariogenic potential. Some examples are cheese, bovine milk, rapadura (a Brazilian preparation of raw brown sugar in bars), some fruits, yoghurt and sugar. A lack of con cern about the damage of these foods to the dental health is observed. Some authors alert about the importance of making adjustments in school meals to preserve oral health and recognize that feeding programs must be joined to education about oral hygiene, control of the dental plaque, application of fluorides and permanent reinforcement of the educative task

Estudios sobre la merienda escolar han aumentado en los últimos años procurando estrategias para ofrecer una alimentación que sirva no apenas para saciar el apetito de los alumnos sino también para garantizar unadecuado desarrollo físico y mental, promoverla salud en general y en particular la prevención de la carie dentaria. Este trabajo es una revisión bibliográfica de los trabajos sobre alimentos y comidas ofrecidas en la merienda escolar em relación a su potencial cariogénico y su papelen la promoción de la salud bucal. Los carbohidratos, principalmente los de bajo peso molecular son los nutrientes de mayor impacto sobre la carie. Sin embargo, es necesario que haya una flora bacteriana activa para metabolizar tales nutrientes en la cavidad oral,lo cual está determinado por la higiene bucal.Es necesario considerar también la variación enel potencial cariogénico de los alimentos, que depende de la consistencia, modo de preparación y tiempo que el alimento permanece adherido ala superficie dental. La literatura presenta pocos estudios sobre la cariogenicidad de refeccionesservidas en la merienda escolar, pero muchos delos alimentos ofrecidos presentan gran potencial cariogénico: queso, leche bovino, algunas frutas, yogur y azúcar, sin observar alguna preocupación en relación a los daños de esta alimentación a la salud de los dientes. Algunos autores alertan para la importancia de realizar ajustes en la merienda escolar para contribuir apreservar la salud bucal, advirtiendo también que programas de alimentación deben estar unidos a la enseñaza de higiene bucal, control de la placa bacteriana, aplicación de fluoreto, con refuerzo permanente de la tarea educativa

Estudos sobre a merenda escolar vêm aumentando nos últimos anos com a busca de estratégias para oferecer uma alimentação que não sirva apenas para saciar a fome dos alunos, mas também para proporcionar um adequado desenvolvimento físico e mental, além de promovera saúde geral e bucal, com ênfase na prevenção da cárie. Este artigo refere-se a uma revisão bibliográfica realizada acerca de trabalhos referentes a alimentos e refeições oferecidos na merenda escolar quanto ao seu potencial cariogênico, bem como seu papel na promoção da saúde bucal. Os carboidratos, principalmente os simples, são os nutrientes de maior impacto sobre a cárie. No entanto, é necessário que haja uma flora bacteriana ativa para metabolizar tais nutrientes na cavidade oral, o que depende da higiene bucal do indivíduo. Deve-se considerar também a variação no potencial cariogênico dos alimentos, que depende da consistência, do modo de preparação e do tempo que o alimento fica aderido à superfície dentária. Foram encontrados na literatura poucos estudos sobre a cariogenicidade de refeições servidas na merenda escolar, porém, muitos alimentos oferecidos apresentam grande potencial cariogênico, a exemplo do queijo, leite bovino, rapadura, algumas frutas, iogurte e açúcar, e o que se observa é a inexistência de preocupação quanto aos prejuízos desta alimentação à saúde dos dentes. Alguns autores alertam para a importância de se realizarem ajustes na merenda escolar de forma a preservar a saúde bucal, e reconhecem que programas de alimentação devem estar unidos ao ensino de higiene bucal, controle da placa bacteriana, aplicação de fluoretos e reforço permanente da tarefa educativa