Effect of Water and Chlorhexidine with Different Pressures of Oral Irrigation Device on the Surface Roughness and Topography of Giomer

Abstract Objective: To evaluate the effect of different pressures of an oral irrigation device (OID) and the irrigation solution type on the surface roughness of the giomer restorative material. Material and Methods: In this in vitro study, disk-shaped giomer samples were fabricated and assigned to 5 groups (n=23): Group 1, storage in distilled water (control); Group 2, OID #7 pressure/ water; Group 3, OID #10 pressure/ water; Group 4, OID #7 pressure/ 0.05% CHX; Group 5, OID #10 pressure/ 0.05% CHX. The samples' treatment simulated a one-year application of OID. Surface roughness (Ra) and topography of the giomer were evaluated using profilometry and scanning electron microscopy. The data were analyzed with Paired t-test, Tukey, and ANOVA tests (α=0.05). Results: The Ra of the samples increased significantly after treatment with OID (p<0.001). The roughness increase in groups with a pressure of 10 was higher than those with a pressure of 7 (p<0.001). The effect of pressure on surface changes was significant (p<0.001). However, the solution type and the cumulative effect of these two factors were insignificant (p=0.08 and p=0.43, respectively). Conclusion: Oral irrigation device with both solutions significantly increased the surface roughness and topographic changes of the giomer. The severity of these changes was related to the device's pressure.

Polihexametilenobiguanida versus solução salina na carga microbiana em feridas: protocolo de revisão sistemática / Polyhexamethylene biguanide versus saline on microbial load in wounds: a systematic review protocol

OBJETIVO: Analisar a efetividade de Polihexametileno Biguanida (PHMB), comparado à solução salina na carga microbiana de pacientes com feridas. MÉTODO: Protocolo de revisão sistemática, construído segundo o Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA), de acordo com metodologia do Joanna Briggs Institute (JBI). Os estudos serão avaliados por dois pesquisadores independentes, nas bases de dados: Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Base de Dados de Enfermagem (BDENF), Sistema Online de Busca e Análise de Literatura Médica (MEDLINE)e Excerpta Medica Database (Embase). As pesquisas a serem incluídas serão aquelas publicadas em português, inglês ou espanhol e a busca não definirá recorte temporal. Serão desconsiderados estudos em animais ou in vitro, revisões, cartas ao editor ou estudos de casos. Após a seleção dos estudos, a extração de dados ocorrerá de maneira sistemática e os registros correspondentes serão feitos de forma narrativa e tabular.

OBJECTIVE: To analyze the effectiveness of polyhexamethylene biguanide (PHMB) compared to saline on the microbial load of wounds. METHOD: Systematic review protocol, built according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) and the Joanna Briggs Institute's (JBI) methodology. Studies will be evaluated by two independent researchers in the following databases: Latin America and the Caribbean Literature on Health Sciences (LILACS), Nursing Database (BDENF), Medical Literature Analysis and Retrieval System Online (MEDLINE), and Excerpta Medica Database (Embase). Studies published in Portuguese, English, or Spanish will be included, and the search will not be restricted by publication date. Animal or in vitro studies, reviews, letters to the editor, and case studies will be excluded. After selecting studies, data extraction will take place systematically, and the corresponding records will be presented in a narrative and tabular way.

Could polyhexanide and chlorine dioxide be used as an alternative to chlorhexidine? A systematic review

ABSTRACT BACKGROUND: Maintenance of oral microbiota balance is the simplest way to prevent infectious oral diseases, through controlling dental biofilm. Combined use of mouthwash and mechanical removal has been shown to be a very effective way for this. OBJECTIVES: To identify clinical studies comparing the antimicrobial effect and possible adverse effects and/or side effects of chlorhexidine-based mouthwashes with those of mouthwashes containing chlorine dioxide and/or polyhexanide, for controlling oral microbiota. DESIGN AND SETTING: Systematic review designed by the stomatology sector of postgraduation in applied dental sciences of Bauru Dentistry School, University of São Paulo, Brazil. METHODS: A systematic review was conducted using online databases (PubMed, Embase, Web of Science and Science Direct) up to April 8, 2020. The search was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS: The studies included comprised eight articles published between 2001 and 2017. A total of 295 young adults, adults and elderly people were evaluated (males 44.75% and females 55.25%). Three articles compared polyhexanide with chlorhexidine and five articles compared chlorine dioxide with chlorhexidine. No studies comparing all three mouthwashes were found. The concentrations of the study solutions were quite varied, and all rinses had an antimicrobial effect. In four studies, it was stated that no side effects or adverse effects had been found. Three studies did not address these results and only one study addressed side effects and/or adverse effects. CONCLUSION: Mouthwashes containing chlorine dioxide and polyhexanide are viable alternatives to chlorhexidine, since they reduce oral biofilm and have little or no reported side or adverse effects.

Metformina: uso clínico y actualización / Metformin: clinical use and update

La metformina (biguanida), grupo de medicamentos que proceden de la guanidina, se ha utilizado desde época medieval para tratamiento de la diabetes. Esta revisión bibliográfica narrativa tiene el propósito de contribuir a mejorar su uso clínico. Se realizó búsqueda de artículos originales, revisiones sistemáticas y artículos de revisión en internet, período 2012-2018, o anterior si fuera relevante. La metformina actúa como un hipoglucemiante, reduce la producción hepática de glucosa inhibiendo la gluconeogénesis y la glucogenólisis, aumenta captación de glucosa a nivel muscular y disminuye absorción de glucosa a nivel gastrointestinal. Una vez intracelular, aumenta la glucólisis anaerobia, uno de sus principales efectos adversos. La metformina es un fármaco que genera incremento de sensibilidad a insulina, mayor control de la glucemia, mejoría del perfil lipídico y de la función vascular, es de bajo costo y es en la actualidad la primera opción en el tratamiento de la diabetes mellitus tipo 2...(AU)

Polyhexanide 0 2% in treatment of trophic foot ulcers in leprosy - preliminary study

Abstract: Leprosy is a chronic infectious disease caused by Mycobacterium leprae, which affects peripheral nerves, skin and mucous membranes. The impairment of neural function as well as sensory or sensory-motor disabilities in leprosy continue to be a problem that requires careful attention in the management of patients with the aim to avoid or minimize their progression to prevent sequelae. One of the most common characteristics of these ulcers is the tendency to chronicity, with variable therapeutic response. In this article, we shall discuss the therapeutic management of thirteen trophic leprosy ulcers in eight patients using polyhexanide 0.2% products.

Effect of final irrigation protocols on microhardness reduction and erosion of root canal dentin

Abstract This study aimed to evaluate the effect of final irrigation protocols on microhardness reduction and erosion of root canal dentin. Sixty root canals from mandibular incisors were instrumented and randomly divided into six groups (n = 10) according to the irrigant used: QMiX, 17% EDTA, 10% citric acid (CA), 1% peracetic acid (PA), 2.5% NaOCl (solution control), and distilled water (negative control). The chelating solutions were used to irrigate the canal followed by 2.5% NaOCl as a final flush. After the irrigation protocols, all specimens were rinsed with 10 mL of distilled water to remove any residue of the chemical solutions. Before and after the final irrigation protocols, dentin microhardness was measured with a Knoop indenter. Three indentations were made at 100 µm and 500 µm from the root canal lumen. Afterwards, the specimens were prepared for scanning electron microscopic analysis and the amount of dentin erosion was examined. Wilcoxon and Kruskal-Wallis tests were used to analyze the results with a significance level set at 5%. At 100 µm, all protocols significantly reduced dentin microhardness (p < .05), while at 500 µm, this effect was detected only in the EDTA and QMiX groups (p < .05). CA was the irrigant that caused more extensive erosion in dentinal tubules, followed by PA and EDTA. QMiX opened dentinal tubules, but did not cause dentin erosion. Results suggest that QMiX and 17% EDTA reduced dentin microhardness at a greater depth. Additionally, QMiX did not cause dentin erosion.

Antimicrobial activity of different disinfectants against cariogenic microorganisms

Abstract The aim of this study was to assess the in vitro antimicrobial effects of chlorhexidine digluconate (CHX), polyhexamethylene biguanide (PHBM), and octenidine dihydrochloride (OCT) on cariogenic microorganisms by using their minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC). CHX, PHBM, and OCT were diluted in distilled water to the final test concentrations. Using the in-tube dilution method, Streptococcus mutans, Lactobacillus acidophilus, Lactobacillus rhamnosus, and Actinomyces viscosus were cultivated on blood agar and Mueller-Hinton broth (MHB) at 37°C for 48 h. They were read using a spectrophotometer to detect MIC. To determine MBC, samples in the range of the turbidity threshold after 24 h were transferred onto blood agar and evaluated for growth after 24 h. Different MICs and MBCs were observed in all disinfectants against each microorganism. The lowest MIC and MBC against S. mutans (60 mg/L) were obtained from PHBM. The lowest values against L. rhamnosus (15 mg/L, 30 mg/L), A. viscosus (30 mg/L), and L. acidophilus (15 mg/L, 30 mg/L) were determined by OCT. PHBM and OCT have the potential to be replaced with CHX because they were effective against cariogenic microorganisms.

QMix® irrigant reduces lipopolysacharide (LPS) levels in an in vitro model

AbstractThe presence of endotoxin inside the root canal has been associated with periapical inflammation, bone resorption and symptomatic conditions.Objectives To determine, in vitro, the effect of QMix® and other three root canal irrigants in reducing the endotoxin content in root canals.Material and Methods Root canals of single-rooted teeth were prepared. Samples were detoxified with Co-60 irradiation and inoculated with E. coli LPS (24 h, at 37°C). After that period, samples were divided into 4 groups, according to the irrigation solution tested: QMix®, 17% EDTA, 2% chlorhexidine solution (CHX), and 3% sodium hypochlorite (NaOCl). LPS quantification was determined by Limulus Amebocyte Lysate (LAL) assay. The initial counting of endotoxins for all samples, and the determination of LPS levels in non-contaminated teeth and in contaminated teeth exposed only to non-pyrogenic water, were used as controls.Results QMix® reduced LPS levels, with a median value of 1.11 endotoxins units (EU)/mL (p<0.001). NaOCl (25.50 EU/mL), chlorhexidine (44.10 EU/mL) and positive control group (26.80 EU/mL) samples had similar results. Higher levels were found with EDTA (176.00 EU/mL) when compared to positive control (p<0.001). There was no significant difference among EDTA, NaOCl and CHX groups. Negative control group (0.005 EU/mL) had statistically significant lower levels of endotoxins when compared to all test groups (p<0.001).Conclusion QMix® decreased LPS levels when compared to the other groups (p<0.001). 3% NaOCl, 2% CHX and 17% EDTA were not able to significantly reduce the root canal endotoxins load.

Diabetes Mellitus Tipo 2 no mundo: atualização do tratamento medicamentoso / Type 2 Diabetes Mellitus in the world: an update of drug treatment

O diabetes mellitus tipo 2 (DM2) está alcançando proporções epidêmicas, e embora as mudanças no estilo de vida possam manter o controle glicêmico, o curso da doença, em longo prazo, requer algum tipo de intervenção farmacológica. É bem conhecido que os indivíduos que se mantêm mal controlados apresentam mais complicações macro e microvasculares e a redução da hemoglobina glicada (HbA1c) diminui significativamente o risco de desenvolvimento de complicações microvasculares em pacientes com DM2. Atualmente há seis classes de antidiabéticos orais: sulfonilureias, meglitinidas, biguanidas, tiazolidinedionas (TZDs), inibidores da alfa-glicosidase e os incretinomiméticos. As sulfonilureias e as meglitinidas estimulam a secreção de insulina; a metformina age principalmente suprimindo a produção hepática de glicose; as tiazolidinedionas melhoram a resistência periférica à insulina e os inibidores da alfa-glicosidase retardam a degredação e a digestão dos carboidratos complexos no intestino. Uma nova opção terapêutica para o DM2 são as drogas incretinomiméticas. Dentre elas temos os análogos de GLP-1 (exenatida e liraglutida) e os inibidores da DPP-IV. Ambos estimulam a secreção de insulina, suprimem a secreção de glucagon e desaceleram o esvaziamento gástrico; a redução de peso é característica dos análogos. O bom controle glicêmico em longo prazo e a prevenção do DM2 requerem uma abordagem agressiva e abrangente. No entanto, uma vez instalada a doença, além das modificações do estilo de vida, o tratamento farmacológico deve ser iniciado e cuidadosamente monitorado, com o uso de drogas que agem nos diversos mecanismos fisiopatológicos conhecidos. Novos estudos serão sempre necessários para se obter mais informações a respeito do diabetes e, assim, aprimorar o desenvolvimento de novas drogas.

The type 2 diabetes has reached epidemic proportions in the worldwide and lifestyle modification provide insufficient glucose control over the long-term course of the disease, the vast majority of patients require some type of pharmacological intervention. Several studies have shown that individuals who remain poorly controlled have more macro and microvascular complications and the decrease in glycated hemoglobin (HbA1c) significantly reduces the risk of developing microvascular complications in type 2 diabetes. At the moment, there are six classes of oral antidiabetics drugs: sulfonylureas, meglitinides, biguanides (metformin), thiazolidinediones (pioglitazone), alpha-glucosidase inhibitors (acarbose) and incretin-mimetics drugs. The sulfonylureas and meglitinide acting insulin secretion; metformin acts primarily by suppressing hepatic glucose production; thiazolidinediones improve insulin resistance; and alpha-glucosidade inhibitors retard the degradation and digestion of complex carbohydrates in the intestine and incretin-mimetics drugs that stimulate insulin secretion, suppress glucagon secretion, slows gastric emptying and weight loss (it is characteristic of the GLP-1 analogues). The good longterm glycemic control and prevention of type 2 diabetes requires an aggressive and comprehensive approach. However, once installed the disease, in addition to lifestyle modifications, pharmacotherapy should be initiated and carefully monitored using drugs that act on different pathophysiologicals mechanisms. New studies are always necessary to obtain more information about diabetes and thus improve the development of new drugs.

Central 5-HT2A receptors modulate the vagal bradycardia in response to activation of the von Bezold-Jarisch reflex in anesthetized rats

Activation of 5-hydroxytryptamine (5-HT) 5-HT1A, 5-HT2C, 5-HT3, and 5-HT7 receptors modulates the excitability of cardiac vagal motoneurones, but the precise role of 5-HT2A/2B receptors in these phenomena is unclear. We report here the effects of intracisternal (ic) administration of selective 5-HT2A/2B antagonists on the vagal bradycardia elicited by activation of the von Bezold-Jarisch reflex with phenylbiguanide. The experiments were performed on urethane-anesthetized male Wistar rats (250-270 g, N = 7-9 per group). The animals were placed in a stereotaxic frame and their atlanto-occipital membrane was exposed to allow ic injections. The rats received atenolol (1 mg/kg, iv) to block the sympathetic component of the reflex bradycardia; 20-min later, the cardiopulmonary reflex was induced with phenylbiguanide (15 µg/kg, iv) injected at 15-min intervals until 3 similar bradycardias were obtained. Ten minutes after the last pre-drug bradycardia, R-96544 (a 5-HT2A antagonist; 0.1 µmol/kg), SB-204741 (a 5-HT2B antagonist; 0.1 µmol/kg) or vehicle was injected ic. The subsequent iv injections of phenylbiguanide were administered 5, 20, 35, and 50 min after the ic injection. The selective 5-HT2A receptor antagonism attenuated the vagal bradycardia and hypotension, with maximal effect at 35 min after the antagonist (pre-drug = -200 ± 11 bpm and -42 ± 3 mmHg; at 35 min = -84 ± 10 bpm and -33 ± 2 mmHg; P < 0.05). Neither the 5-HT2B receptor antagonists nor the vehicle changed the reflex. These data suggest that central 5-HT2A receptors modulate the central pathways of the parasympathetic component of the von Bezold-Jarisch reflex.

Diabetes Mellitus tipo 2 no mundo: novas abordagens terapêuticas / Type 2 diabetes in the world: new therapeutic approaches

A Federação Internacional de Diabetes (/DF) publicou novos dados indicando a enormidade da epidemia mundial da doença. Esses dados demonstram que o diabetes afeta atualmente 246 milhões de pessoas em todo o mundo, sendo que 46% destes com idades entre 40 e 59 anos. Dados atuais predizem que, se nada for feito, o número total de portadores de diabetes ultrapassará 380 milhões de pessoas em 20 anos. O estilo de vida moderno trouxe inúmeras mudanças de hábito e comportamento, como menor tempo dedicado à prática de atividades físicas regulares, um cotidiano mais estressante, além da maior oferta de alimentos industrializados, ricos em carboidratos simples e gorduras, pobres em fibras, minerais e vitaminas. Atualmente dedica-se mais tempo a atividades em frente às telas de computadores e a jogos de videogame e programas de televisão. Como consequência, tem-se observado maior incidência de doenças metabólicas, tais como obesidade, diabetes mellitus tipo 2 (DM 2), hipertensão arterial sistêmica (HAS), dislipidemia e, portanto, doenças cardiovasculares (DCVs), gerando a necessidade crescente de pesquisas em busca de novas opções terapêuticas para estas doenças. O presente trabalho visa fazer uma breve revisão sobre os avanços terapêuticos do diabetes mellitus tipo 2.

The International Diabetes Federation (/DF) has published new data indicating the enormity of the diabetes epidemic in the globe. That data show that the disease now affects a staggering 246 million people worldwide, with 46% of a11 those affected in the 40-59 age group. The new data predict that the total number of people living with diabetes will skyrocket to 380 million within twenty years if nothing is done. The modern life style has brought many changes such as more variety of food rich in sugar, fat and poor in fiber, vitamins and minerals, less time to practice a regular physical activity and a more stressful lifestyle. Nowadays, people spend more time in front of their computers, playing video games and watching programs of TV. As a consequence, many metabolic diseases have been increasing such as obesity, type I1 diabetes mellitus, high blood pressure, hyperlipidemia and cardiovascular diseases, leading the growing necessity of researches for new therapeutic options to these diseases. This article is a short review of type II diabetes mellitus's new treatment.

Avaliação da ação antimicrobiana de soluções multiuso para desinfecção de lentes de contato hidrofílicas, in vitro / Antimicrobial efficacy assessment of multi-use solution to disinfect hydrophilic contact lens, in vitro

OBJETIVO: Avaliar a influência da ação antimicrobiana das soluções multiuso para desinfecção de lentes de contato hidrofílicas. MÉTODOS: Duas soluções multiuso denominadas solução A (poliquaternário-1 a 0,001 por cento e miristamidopropil dimetilamina a 0,0005 por cento) e solução B (poliaminopropil biguanida a 0,0001 por cento) foram testadas em lentes de contato hidrofílicas contaminadas com Pseudomonas aeruginosa (ATCC27583), Staphylococcus epidermidis (ATCC1226), Klebsiella pneumoniae (ATCC13883), Staphylococcus aureus (ATCC25923) e Candida albicans (ATCC 10231) para verificar a quantidade de redução do crescimento dos microrganismos após o enxágue com as soluções. Foram seguidas as instruções preconizadas pelos fabricantes. RESULTADOS: Houve redução de 90 por cento do crescimento de Pseudomonas aeruginosa, Staphylococcus epidermidis, Staphylococcus aureus e Candida albicans. Não houve crescimento de Klebsiella pneumoniae. CONCLUSÃO: As soluções testadas neste trabalho mostraram redução do número de microrganismos testados.

PURPOSE: To evaluate the efficacy of disinfecting solutions in hydrophilic contact lenses (CL). METHODS: Two multi-use solutions denominated solution A (0.001 percent polyquaternium-1 and 0.0005 percent myristamidopropyl dimethylamine) and solution B (0.0001 percent polyaminopropyl biguanide) were used. The solutions were tested in hydrophilic contact lenses infected with Pseudomonas aeruginosa (ATCC27583), Staphylococcus epidermidis (ATCC1226), Klebsiella pneumoniae (ATCC13883), Staphylococcus aureus (ATCC25923) and Candida albicans (ATCC 10231) and the decrease in microorganisms growth after the hydrophilic contact lenses were cleaned with the respective solutions was verified. The manufacture's instructions were followed. RESULTS: A decrease of 90 percent of Pseudomonas aeruginosa, Staphylococcus epidermidis, Staphylococcus aureus, Candida albicans and a decrease 100 percent of Klebsiella pneumoniae was observed. CONCLUSION: The solutions decreased the amount of microorganisms tested.

Maximum inhibitory dilution of mouthwashes containing chlorhexidine and polyhexamethylene biguanide against salivary staphylococcus aureus

OBJECTIVE: The aim of the present study was to determine the in vitro maximum inhibitory dilution (MID) of two chlorhexidinebased oral mouthwashes (CHX): Noplak®, Periogard®, and one polyhexamethylene biguanide-based mouthwash (PHMB): Sanifill Premium® against 28 field Staphylococcus aureus strains using the agar dilution method. MATERIALS AND METHODS: For each product, decimal dilutions ranging from 1/10 to 1/655,360 were prepared in distilled water and added to Mueller Hinton Agar culture medium. After homogenization, the culture medium was poured onto Petri dishes. Strains were inoculated using a Steers multipoint inoculator and dishes were incubated at 37ºC for 24hours. For reading, MID was considered as the maximum dilution of the mouthwash still capable of inhibiting microbial growth. RESULTS: Sanifill Premium® inhibited the growth of all strains at 1/40 dilution and of 1 strain at 1/80 dilution. Noplak® inhibited the growth of 23 strains at 1/640 dilution and of all 28 strains at 1/320 dilution. Periogard® showed inhibited growth of 7 strains at 1/640 dilution and of all 28 strains at 1/320 dilution. Data were submitted to Kruskal-Wallis statistical test, showing significant differences between the mouthwashes evaluated (p<0.05). No significant difference was found between Noplak® and Periogard® (p>0.05). Sanifill Premium® was the least effective (p<0.05). CONCLUSION: It was concluded that CHX-based mouthwashes present better antimicrobial activity against S. Aureus than the PHMB-based mouthwash.

Eficacia de los hipoglicemiantes orales en el control metabólico de pacientes con diabetes mellitus gestacional / Effectiveness of oral hypoglycemic drugs in the metabolic control of patients with gestational diabetes

Gestational Diabetes is characterized by different degrees of glucose intolerance that produce a series of fetal and perinatal alterations. During many years, in those cases of gestational diabetes that did not respond to nutritional interventions, the use of insulin was a proven treatment to achieve metabolic control and thus a better perinatal outcome. At present, some new oral hypoglycemic drugs, from the family of sulfonylureas and biguanides, have been shown to be safe, of low cost, and apparently effective in the metabolic control of this disease. We review the publications that propose the use of oral hypoglycemic drugs for the metabolic control of gestational diabetes that does not respond to nutritional measures.

Agentes orales en el manejo de la diábetes mellitus tipo 2: biguanidas, tiazolidinedionas, inhibidores de la alfa-glucosidasa / Oral agents in the handling of the diabetes mellitus type 2: biguanides, thiazolinediones, alpha-glucosidase inhibitors

Actualmente se describen clases de antidiabéticos orales, los cuales se diferencian por su potencia, acción farmacológica, farmacéutica y metabolismo. De acuerdo a su mecanismo de acción se agrupan en: (1)Agentes que estimulan la secreción de insulina o secretagogos,que incluyen las Sulfonilureas y Meglitinidas; (2)Agentes que sensibilizan la acción de la insulina (insulinosensibilizadores), los cuales actúan en menor o mayor medida inhibiendo la producción de glucosa hepática e incrementando la utilización de la glucosa por los tejidos periféricos, entre los que se cuentan las Biguanidas (Metformin), Tiazolidinedionas (Rosigletazona, Pioglitazona); y (3) Agentes que disminuyen la absorción intestinal de glucosa, como son los inhibidores de las glucosidasa (Acarbosa, Miglitol). El primer grupo de agentes orales se consideran fármacos hipoglicemiantes, mientras que el segundo y el tercero antihiperglicemiantes. En una primera entrega de esta revisión se abordaran los agentes secretagogos, en el presente artículo se describen los restantes.

Diabetes "Mellitus" do tipo II nos dias atuais / Diabetes mellitus type II in nowadays

A modernidade trouxe inúmeras mudanças de hábito e comportamento como menor tempo para prática de atividade física regular, um estilo de vida mais estressado, além de maior oferta de alimentos industrializados, ricos em carboidratos simples e gorduras, pobres em fibras, minerais e vitaminas. Atualmente passa-se mais tempo em frente aos computadores e às televisões. Como conseqüência tem-se observado maior incidência de doenças metabólicas, tais como obesidade, diabetes mellitus tipo II (DM II), hipertensão arterial sistêmica (HAS), dislipidemia e, portanto, doenças cardiovasculares (DCVs). O presente trabalho visa fazer uma breve revisão sobre diabetes mellitus tipo II e suas conseqüências para a saúde.

The modern life style has brought many changes such as more variety of food rich in sugar, fat and poor in fiber, vitamins and minerals, less time to practice a regular physical activity and a more stressful lifestyle. Nowadays, people spend more time in front of their computers and TV. As a consequence, many metabolic diseases have been increasing such as obesity, type II diabetes mellitus, high blood pressure, hyperlipidemia and cardiovascular diseases. This article is a short review of type II diabetes mellitus and its consequences.

Farmacologia de la Insulinorresistencia: Situacion actual y perspectivas / Insulin Resistance Pharmacology: Current Situation and Perspectives

El proposito de este trabajo es revisar las estrategias farmacologicas especificamente destinadasa disminuir la insulinoresistencia. Se plantean cuatro objetivos, siendo el primero la inhibicion de la produccion hepatica de glucosa. Aqui se incluye a la metformina, biguanida que reduce la gluconeogenesis desde lactato y aumenta la actividad de la AMPK (enzima que estimula la oxidacion de acidos grasos no esterificados y disminuye la gluconeogenesis y sintesis de colesterol), Tambien se encuentran el BAY-27-9955 y NNC-25-2504L (antagonistas del glucagon) y los inhibidores de la glucogeno fosforilasa hepatoica, glucogenosintasa-kinasa-3, piruvato-deshidrogena-kinasa, fructosa-1,6-difosfatasa y glucosa-6-fosfatasa. Los insulinosensibilizadores, segundo objetivo, incluyen a tiazolidinodionas (agonistas PPARgamma) que aumentan la exposicion de GLUT 4, lipogenesis y disminuyen la glucogenesis. y a drogas en desarrollo: nuevos agonistas PPAR, activadores RxR, agosnistas Beta3 e inhibidores de la PTB-1B. El tercer objetivo son los modificadores del metabolismo lipidico, y contiene a los inhibidores de la 11Beta-HSD1. Los activadores del receptor insulinico, dependientes e independientes de insulina, constituyen el cuarto objetivo. La importancia del desarrollo de nuevos farmacos radica en que el control de la insulinorresistencia retrasaria la aparicion de diabetes 2 e implicaria un menor riesgo cardiovascular

Diabetes Mellitus / Diabetes Mellitus

Os criterios atuais de diagnostico e as várias drogas disponíveis para tratamento do diabetes tipo 1 e tipo 2 bem como os novos análogos da insulina são discutidos.