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1.
J Clin Densitom ; 27(2): 101467, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38306807

RESUMO

INTRODUCTION: Poor eating habits and a sedentary lifestyle can impair health. Regular physical activity improves the quality of life and is essential for bone health. Therefore, the present study aimed to evaluate the effects of the cafeteria diet on bone quality of sedentary and exercised rats. METHODS: Sixty young male Wistar rats were divided into six groups (n=10) according to diet composition and activity level, being: SD+CON, standard diet and control; SD+SED, standard diet and sedentary; SD+EX, standard diet and exercised; CD+CON, cafeteria diet and control; CD+SED, cafeteria diet and sedentary; CD+EX, cafeteria diet and exercised. The exercise protocol consisted of 10 ladder-climbing sessions/day, 5 days/week, and the sedentary rats were maintained in individual cages with limited mobility. Body mass and food intake were evaluated weekly. After 10 weeks, the animals were euthanized, and white adipose tissue was collected. The bone structure was evaluated by densitometry, mechanical tests, histomorphometric, and micro-computed tomography analyses. RESULTS: The cafeteria diet increased adipose tissue (p<0.001), decreased bone mineral density (p=0.004), and impaired biomechanical properties (p<0.05) and histomorphometry parameters (p=0.044). The sedentarism decreased bone mineral density (p<0.001) and biomechanical properties (p<0.05), and the exercise did not improve bone properties. CONCLUSION: In this experimental model, it was concluded that the cafeteria diet and a sedentary lifestyle negatively affect bone, and ladder-climbing exercise could not prevent the effects of the unhealthy diet.


Assuntos
Densidade Óssea , Condicionamento Físico Animal , Ratos Wistar , Comportamento Sedentário , Microtomografia por Raio-X , Animais , Masculino , Condicionamento Físico Animal/fisiologia , Ratos , Dieta , Osso e Ossos/diagnóstico por imagem , Osso e Ossos/metabolismo , Tecido Adiposo Branco/diagnóstico por imagem
2.
Int J Sports Med ; 2024 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-38729165

RESUMO

This study investigated the effects of different resistance training (RT) volumes quantified by weekly sets at high intensity (load and effort) on dynamic strength adaptations and psychophysiological responses in trained individuals. Twenty-four athletes were randomly allocated to three groups that performed three (3 S, n=8), six (6 S, n=8), and nine (9 S, n=8) weekly sets, respectively, three times a week on the barbell back squat and bench press during an 8-week period. While all groups showcased strength gains (p<0.05), post hoc comparisons revealed that 6 S and 9 S elicited greater strength adaptations than 3 S in barbell back squat (p=0.027 and p=0.004, respectively) and bench press (p=0.001 and p=0.044, respectively). There were no differences between 6 S and 9 S conditions for back squat (p=0.999) and bench press (p=0.378). Although a time effect was observed for Session-RPE (p=0.014) and Total Quality Recovery scale (p=0.020), psychophysiological responses were similar among groups. Our findings suggest that performing six and nine weekly sets at high intensities led to greater strength gains compared to three weekly sets in strength-trained individuals, despite similar psychophysiological responses.

3.
BMC Med Educ ; 24(1): 63, 2024 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-38229060

RESUMO

BACKGROUND: Adequacy of learning models and their ability to engage students and match session's objectives are critical factors in achieving the desired outcome. In this systematic review and meta-analysis, we assess the methodological approach, content, and effectiveness of training initiatives addressing medical students' knowledge, attitudes, confidence and discrimination perception towards LGBTQIA + people. METHOD: PubMed, Web of Science, Medline and Scopus were searched to identify published studies, from 2013 to 2023, on effectiveness of training initiatives addressing medical students' knowledge, attitudes, confidence and discrimination perception towards LGBTQIA + people. The risk of bias of the selected studies was assessed by the Medical Education Research Study Quality Instrument. Overall effect sizes were calculated using a Mantel-Haenszel method, fixed effect meta-analyses. RESULTS: A total of 22 studies were included, representing 2,164 medical students. The interventions were highly diverse and included seminars, lectures, videos, real-case discussions, roleplay, and group discussions with people from the LGBTQIA + community. After the interventions, there was a significant improvement in self-confidence and comfort interacting with patients and in the understanding of the unique and specific health concerns experienced by LGBTQIA + patients. CONCLUSION: Our findings indicated that the outcomes of interventions training actions for medical students that promote knowledge and equity regarding LGBTQIA + people, regardless of their scope, methodology and duration, result in a considerable increase in students' self-confidence and comfort interacting with LGBTQIA + patients, highlight the need for more actions and programs in this area promoting a more inclusive society and greater equity.


Assuntos
Educação Médica , Minorias Sexuais e de Gênero , Estudantes de Medicina , Humanos , Aprendizagem , Atitude
4.
Emerg Med J ; 41(3): 187-192, 2024 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-38253364

RESUMO

BACKGROUND: Right ventricular (RV) dysfunction is the main cause of death in patients with normotensive acute pulmonary embolism (PE). The optimal management for this subset of patients remains uncertain. This systematic review and meta-analysis focused on the comparison of diuretics and fluid expansion in patients with acute PE presenting with RV dysfunction and haemodynamic stability. METHODS: A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines considering only RTCs. The authors searched the traditional and grey literature through 1 November 2022. Meta-analysis used open source packages in R. Inverse variance fixed-effects models with OR as the effect measure were used for primary analyses. The main outcomes defined in this review protocol included pulmonary arterial systolic pressure (PASP), creatinine value changes and N-terminal pro-B-type natriuretic peptide during the first 24 hours. RESULTS: Four studies with a total of 452 patients met the inclusion criteria. The baseline characteristics of patients were similar across all studies. Overall, patients receiving diuretics had a significant 24 hours reduction in pro-B-type natriuretic peptide (standard mean difference of -41.97; 95% CI -65.79 to -18.15), and PASP (standard mean difference of -5.96; 95% CI -8.06 to -3.86). This group had significantly higher creatinine levels (standard mean difference of 7.74; 95% CI 5.04 to 10.45). The quality of the studies was heterogeneous; two had a low risk of bias, and the other two had a high risk of bias. CONCLUSIONS: Very few studies have compared the efficacy and safety of diuretics and fluid expansion in normotensive patients with acute PE with RV failure. Overall, furosemide appears to reduce RV dysfunction in this subset of patients compared with fluid expansion. Further research is required to confirm these findings.


Assuntos
Diuréticos , Embolia Pulmonar , Humanos , Diuréticos/uso terapêutico , Peptídeo Natriurético Encefálico , Pressão Sanguínea , Creatinina , Embolia Pulmonar/tratamento farmacológico , Doença Aguda
5.
Int J Sport Nutr Exerc Metab ; 34(3): 179-187, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38266627

RESUMO

Despite the abundance of research investigating the efficacy of caffeine supplementation on exercise performance, the physiological and biochemical responses to caffeine supplementation during intermittent activities are less evident. This study investigated the acute effects of caffeine supplementation on measures of exercise performance, ratings of perceived exertion, and biomarkers of oxidative stress induced by an acute bout of sprint interval training. In a randomized crossover design, 12 healthy males (age: 26 ± 4 years, height: 177.5 ± 6 cm, body mass: 80.7 ± 7.6 kg) ingested 6 mg/kg of caffeine or placebo 60 min prior to performing sprint interval training (12 × 6 s "all-out sprints" interspersed by 60 s of rest). Performance scores and ratings of perceived exertion were assessed after every sprint. Blood samples were collected before supplementation, prior to and following each sprint, and 5 and 60 min after the last sprint. Caffeine had no effect on any performance measures, ratings of perceived exertion, or biomarkers of oxidative stress (p > .05). In conclusion, caffeine supplementation does not improve performance or decrease oxidative stress after an acute bout of sprint interval training.


Assuntos
Desempenho Atlético , Treinamento Intervalado de Alta Intensidade , Corrida , Adulto , Humanos , Masculino , Adulto Jovem , Desempenho Atlético/fisiologia , Biomarcadores , Cafeína/farmacologia , Estudos Cross-Over , Método Duplo-Cego , Estresse Oxidativo , Corrida/fisiologia
6.
J Prosthodont ; 2024 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-38305664

RESUMO

PURPOSE: This study aimed to develop and evaluate a simple, non-destructive method for assessing the misfit and passivity of implant-retained prostheses frameworks. MATERIALS AND METHODS: To simulate the rehabilitation of a mandible posterior partially edentulous area using 3-unit screw-retained frameworks supported by two implants were fabricated and divided into the following five groups (n = 10 in each group): OP = one-piece framework cast in Co-Cr with the conventional method (control-group); Co-Cr frameworks sectioned and welded by laser (=LAS) or tungsten inert gas (=TIG); Co-Cr CAD-CAM = milled Co-Cr framework; Zir CAD-CAM = milled zirconia framework. The horizontal |X| and vertical |Y| misfits were measured using confocal laser scanning microscopy with one or both screws tightened. Data were analyzed by a two-way ANOVA with repeated measures and Bonferroni correction (α = 0.05). RESULTS: The greatest |X| misfit was observed in the OP group with both screws tightened (290 µm) and one screw tightened (388 and 340 µm). The conventional casting groups sectioned and welded by laser or TIG had lower mean values (235.35 µm, both screws tightened; and 275 µm, one screw tightened) than the OP framework. However, these values still exceeded those of the milled Co-Cr and zirconia frameworks (190 and 216 µm with both screws tightened). Across all reading conditions, every framework subjected to testing consistently maintained vertical |Y| misfit levels below the threshold of 53 µm; however, the milled frameworks exhibited higher vertical misfits than the frameworks obtained by the conventional cast method. CONCLUSIONS: The frameworks, whether cast and sectioned with laser welding or milled from Co-Cr, exhibit improved marginal misfit and enhanced passive fit when compared to other fabrication methods. Additionally, the use of confocal laser scanning microscopy is highly effective for passivity and misfit analysis.

7.
J Cell Biochem ; 124(4): 520-532, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-36791261

RESUMO

Gluten intolerance is associated with several disorders in the body. Although research has grown in recent years, the understanding of its impact on different tissues and the effects of physical exercise in mitigating health problems in the condition of gluten intolerance are still limited. Therefore, our objective was to test whether gliadin would affect metabolism and inflammation in liver tissue and whether aerobic physical exercise would mitigate the negative impacts of gliadin administration in rodents. Wistar rats were divided into exercised gliadin, gliadin, and control groups. Gliadin was administered by gavage from birth to 60 days of age. The rats in the exercised gliadin group performed an aerobic running exercise training protocol for 15 days. At the end of the experiments, physiological, histological, and molecular analyzes were performed in the study. Compared to the control group, the gliadin group had impaired weight gain and increased gluconeogenesis, lipogenesis, and inflammatory biomarkers in the liver. On the other hand, compared to the gliadin group, animals in the exercise-gliadin group had a recovery in body weight, improved insulin sensitivity, and a reduction in some gluconeogenesis, lipogenesis, and inflammatory biomarkers in the liver. In conclusion, our results revealed that the administration of gliadin from birth impaired weight gain and induced an increase in hepatic inflammatory cytokines, which was associated with an impairment of glycemic homeostasis in the liver, all of which were attenuated by adding aerobic exercise training in the gliadin group.


Assuntos
Doença Celíaca , Gliadina , Ratos , Animais , Ratos Wistar , Doença Celíaca/metabolismo , Aumento de Peso , Inflamação/induzido quimicamente , Inflamação/terapia , Biomarcadores
8.
Am J Physiol Endocrinol Metab ; 325(5): E513-E528, 2023 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-37755454

RESUMO

Nonalcoholic fatty liver disease (NAFLD), a condition characterized by the accumulation of fat in the liver, is estimated to be the most common liver disease worldwide. Obesity is a major risk factor and contributor, and, accordingly, weight loss can improve NAFLD. Previous studies in preclinical models of diet-induced obesity and fatty liver disease have shown the independent benefits of resistance exercise training (RT) and time-restricted feeding (TRF) in preventing weight gain and hepatic build-up of fat. Here, we tested the combined effect of TRF and RT on obesity and NAFLD in mice fed a high-fat diet. Our results showed that both TRF-8-h food access in the active phase-and RT-consisting of three weekly sessions of ladder climbing-attenuated body weight gain, improved glycemic homeostasis, and decreased the accumulation of lipids in the liver. TRF combined with RT improved the respiratory exchange rate, energy expenditure, and mitochondrial respiration in the liver. Furthermore, gene expression analysis in the liver revealed lower mRNA expression of lipogenesis and inflammation genes along with increased mRNA of fatty acid oxidation genes in the TRF + RT group. Importantly, combined TRF + RT was shown to be more efficient in preventing obesity and metabolic disorders. In conclusion, TRF and RT exert complementary actions compared with isolated interventions, with significant effects on metabolic disorders and NAFLD in mice.NEW & NOTEWORTHY Whether time-restricted feeding (TRF) combined with resistance exercise training (RT) may be more efficient compared with these interventions alone is still unclear. We show that when combined with RT, TRF provided additional benefits, being more effective in increasing energy expenditure, preventing weight gain, and regulating glycemic homeostasis than each intervention alone. Thus, our results demonstrate that TRF and RT have complementary actions on some synergistic pathways that prevented obesity and hepatic liver accumulation.


Assuntos
Doenças Metabólicas , Hepatopatia Gordurosa não Alcoólica , Treinamento Resistido , Camundongos , Animais , Humanos , Hepatopatia Gordurosa não Alcoólica/metabolismo , Metabolismo dos Lipídeos , Dieta Hiperlipídica/efeitos adversos , Obesidade/metabolismo , Fígado/metabolismo , Aumento de Peso , Doenças Metabólicas/metabolismo , RNA Mensageiro/metabolismo , Camundongos Endogâmicos C57BL
9.
Am J Dent ; 36(2): 75-80, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37076296

RESUMO

PURPOSE: To evaluate the effectiveness of five alkaline peroxide-based effervescent tablets in reducing both biofilms and the food layer adhered on the cobalt-chromium surface. METHODS: Cobalt-chromium metal alloy specimens were contaminated with Candida albicans, Candida glabrata, Streptococcus mutans and Staphylococcus aureus. After biofilm maturation, the specimens were immersed in Polident 3 Minute, Polident for Partials, Efferdent, Steradent, Corega Tabs or distilled water (control). Residual biofilm rates were determined by colony forming units counts and biofilm biomass. In parallel, to investigate the denture cleaning capability of effervescent tablets, artificially contaminated removable partial dentures were treated with each cleanser. Data were analyzed by Kruskal-Wallis followed by Dunn post hoc test or ANOVA followed by Tukey post hoc test (α= 0.05). RESULTS: None of the hygiene solutions reduced C. albicans biofilm. Efferdent and Corega Tabs promoted reduction of C. glabrata biofilm, while Steradent was favorable against S. aureus biofilm. For S. mutans, lower biofilm rates were observed after immersion in Polident for Partials and Steradent. The effervescent tablets showed good cleaning performance, removing an artificial layer with carbohydrates, proteins, and fats, however, they were not effective in removing aggregated mature biofilm. CLINICAL SIGNIFICANCE: The different effervescent tablets presented favorable antimicrobial activity against C. glabrata, S. mutans and S. aureus on cobalt-chromium surfaces and showed cleaning capability. However, for an appropriate biofilm control, a complementary method should be evaluated since none of the peroxide-based solutions reduced C. albicans biofilms or substantially removed aggregated biofilm.


Assuntos
Prótese Parcial Removível , Staphylococcus aureus , Candida albicans , Candida glabrata , Higiene , Higienizadores de Dentadura/farmacologia , Comprimidos/farmacologia , Peróxidos/farmacologia , Biofilmes
10.
J Prosthet Dent ; 129(1): 140-146, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36192195

RESUMO

STATEMENT OF PROBLEM: Denture-related stomatitis (DRS), an inflammation frequently present in human immunodeficiency virus-positive (HIV+) individuals, can be attributable to colonization by Candida spp., which is considered a main factor. The virulence factors of these species are often modulated by the systemic condition of their hosts. PURPOSE: The purpose of this clinical study was to evaluate the incidence, virulence, and morphology of Candida spp. isolated from biofilms of complete denture wearers with DRS, with and without an HIV diagnosis. In addition, the interaction of the systemic condition with the ability of Candida spp. to colonize was evaluated. MATERIAL AND METHODS: Fifty-five complete denture wearers diagnosed with DRS were divided into 2 groups: experimental (HIV+) and control (human immunodeficiency virus-noninfected participants [HIV-]). Biofilm was collected by a standardized method of ultrasonification of prostheses. The incidence was evaluated by a chromogenic method and polymerase chain reaction (PCR). The virulence factors were assessed by using the capacity for biofilm formation by counting colony-forming units (CFUs/mL), biofilm metabolism by tetrazolium salt metabolization, and proteinase and phospholipase production by using a fluorimetric kit. Morphology was verified by using the hyphae-inducing test, and participants' health data were collected with a form. Data were analyzed by using the Student t, Mann-Whitney U, Spearman, and Fisher tests (α=.05). RESULTS: The results of incidence were related to 55 participants (22 experimental and 33 control); in total, 63 Candida spp. samples were isolated, showing 28 Candida albicans and 36 nonalbicans strains. No significant difference was found between groups in baseline CFU/mL counts, biofilm formation capacity, cell metabolism, and phospholipase production. Proteinase production was higher for C. albicans in the control (P=.031) and for nonalbicans in the experimental (P=.016) groups. Relative to health data, the experimental group showed a moderate negative correlation between the CFU count/mL at baseline for nonalbicans and DRS classification (P=.020). CONCLUSIONS: C. albicans was the most prevalent species. No difference was found in the Candida spp. of complete denture wearers with DRS, with and without an HIV diagnosis, with regard to virulence factors (except for proteinase production) and morphology.


Assuntos
Implantes Dentários , Infecções por HIV , Estomatite sob Prótese , Humanos , Candida , Candida albicans , Prótese Total/efeitos adversos , Peptídeo Hidrolases/metabolismo , Fosfolipases/metabolismo , Infecções por HIV/complicações , Biofilmes
11.
Gerodontology ; 40(4): 472-483, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36629151

RESUMO

OBJECTIVE: To evaluate the anti-biofilm action of chitosan, nanoparticulate chitosan, and denture cleanser Nitradine™ against biofilms comprising Candida albicans, Candida glabrata, Staphylococcus aureus, and Streptococcus mutans. BACKGROUND: Biofilm removal from removable partial dentures (RPD) is important for success in prosthetic rehabilitation. MATERIALS AND METHODS: The anti-biofilm action of the experimental chitosan-based solutions and Nitradine™ was evaluated on acrylic resin and cobalt-chromium alloy through assessing cell viability, cell metabolism, residual aggregated biofilm, and extracellular polymeric substance and biofilm morphology. RESULTS: Only chitosan reduced the viability of C. albicans on cobalt-chromium alloy surface, by 98% (a 1.7 log10 reduction in cfu). Chitosan-based solutions neither promoted substantial alteration of the metabolic activity of the four-species biofilm nor reduced the amount of the aggregated biofilm. After immersion in chitosan and nanoparticulate chitosan, viable microorganisms and extracellular polymeric substances distributed over the entire specimens' surfaces were observed. Nitradine™ reduced the viability and metabolic activity of biofilm grown on both surfaces, but it did not remove all aggregated biofilm and extracellular polymeric substances. After immersion in Nitradine™, approximately 35% of the specimens' surfaces remained covered by aggregated biofilm, mainly composed of dead cells. CONCLUSION: Although chitosan and Nitradine™ promoted changes in the viability of microorganisms, neither solution completely removed the four-species biofilm from the Co-Cr and acrylic resin surfaces. Thus, isolated use of hygiene solutions is not indicated for biofilm control on RPDs; this requires complementary mechanical removal.


Assuntos
Resinas Acrílicas , Quitosana , Humanos , Resinas Acrílicas/farmacologia , Quitosana/farmacologia , Matriz Extracelular de Substâncias Poliméricas , Contagem de Colônia Microbiana , Propriedades de Superfície , Candida albicans , Biofilmes , Ligas de Cromo , Higienizadores de Dentadura
12.
J Cross Cult Gerontol ; 38(2): 155-171, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37243786

RESUMO

Caregiving by older adults is a common phenomenon, enhanced in the era of HIV infection. This longitudinal study was set up to examine the effect of caregiver age, relationship and mental wellbeing on child (4-13 years) outcomes (psychosocial and cognitive) in a sample of 808 caregiver- child dyads in South Africa and Malawi. Respondents were drawn from consecutive attenders at Community Based Organisations (CBOs) and interviewed with standardised inventories at baseline and followed up 12-15 months later. Analysis focused on three separate aspects of the caregiver; age, relationship to the child, and mental wellbeing, results are stratified with regard to these factors. Results showed that compared to younger caregivers, over 50 years were carrying a heavy load of childcare, but caregiver age for the most part was not associated with child outcomes. Being biologically related to the child (such as biological grandparenting) was also not a significant factor in child outcomes measured. However, irrespective of age and relationship, caregiver mental health was associated with differences in child outcome - those children of caregivers with a greater mental health burden were found to report experiencing more physical and psychologically violent discipline. Over time, the use of violent discipline was found to reduce. These data suggest that older caregivers and grandparents are providing comparable care to younger caregivers, for young children in the face of the HIV epidemic and that interventions should focus on mental health support for all caregivers, irrespective of age or relationship to the child.


Assuntos
Infecções por HIV , Poder Familiar , Humanos , Pré-Escolar , Idoso , Cuidadores/psicologia , Infecções por HIV/psicologia , Estudos Longitudinais , Saúde Mental
13.
Clin Exp Pharmacol Physiol ; 49(10): 1072-1081, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35690890

RESUMO

Obesity is associated with low-grade inflammation and disturbances in hepatic metabolism. This study aimed to investigate the effects of resistance exercise on inflammatory signalling related to IκB kinase (IKK) ɛ protein (IKKɛ) and on hepatic fat accumulation in obese mice. Male Swiss mice were distributed into three groups: control (CTL) fed with standard chow; obese (OB) mice induced by a high-fat diet (HFD); obese exercised (OB + RE) mice fed with HFD and submitted to a resistance exercise training. The resistance exercise training protocol consisted of 20 sets/3 ladder climbs for 8 weeks, three times/week on alternate days. The training overload was equivalent to 70% of the maximum load supported by the rodent. Assays were performed to evaluate weight gain, hepatic fat content, fasting glucose, insulin sensitivity, IKKɛ phosphorylation and proteins related to insulin signalling and lipogenesis in the liver. Mice that received the high-fat diet showed greater adiposity, impaired insulin sensitivity, increased fasting glucose and increased hepatic fat accumulation. These results were accompanied by an increase in IKKɛ phosphorylation and lipogenesis-related proteins such as cluster of differentiation 36 (CD36) and fatty acid synthase (FAS) in the liver of obese mice. In contrast, exercised mice showed lower body weight and adiposity evolution throughout the experiment. In addition, resistance exercise suppressed the effects of the high-fat diet by reducing IKKɛ phosphorylation and hepatic fat content. In conclusion, resistance exercise training improves hepatic fat metabolism and glycaemic homeostasis, which are, at least in part, linked to the anti-inflammatory effect of reduced IKKɛ phosphorylation in the liver of obese mice.


Assuntos
Adiposidade , Quinase I-kappa B , Fígado , Obesidade , Treinamento Resistido , Animais , Dieta Hiperlipídica/efeitos adversos , Glucose/metabolismo , Humanos , Quinase I-kappa B/metabolismo , Resistência à Insulina , Fígado/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Obesos , Obesidade/metabolismo , Fosforilação
14.
BMC Geriatr ; 22(1): 561, 2022 07 06.
Artigo em Inglês | MEDLINE | ID: mdl-35790949

RESUMO

BACKGROUND: Development has promoted longer and healthier lives, but the rise in the proportion of older adults poses new challenges to health systems. Susceptibilities of older persons resulting from lower knowledge about services availability, health illiteracy, lower income, higher mental decline, or physical limitations need to be identified and monitored to assure the equity and quality of health care. The aim of this study was to develop equity indicators for the Assessing Care of Vulnerable Elders (ACOVE)-3 checklist and perform the first cross-cultural adaptation and validation of this checklist into Portuguese. METHODS: A scoping literature review of determinants or indicators of health (in)equity in the care of older people was performed. A total of 5 language experts and 18 health professionals were involved in the development and validation of the equity and quality indicators through expert opinion and focus groups. Data collected from focus groups was analyzed through directed or conventional content analysis. The usefulness of the indicators was assessed by analyzing the clinical records of 30 patients. RESULTS: The literature review revealed that there was a worldwide gap concerning equity indicators for older people primary health care. A structured and complete checklist composed of equity and quality indicators was obtained, validated and assessed. A significant number of non-screened quality or equity related potential occurrences that could have been avoided if the proposed indicators were implemented were detected. The percentage of non-registered indicators was 76.6% for quality and 96.7% for equity. CONCLUSIONS: Applying the proposed checklist will contribute to improve the monitoring of the clinical situation of vulnerable older people and the planning of medical and social actions directed at this group.


Assuntos
Lista de Checagem , Idioma , Idoso , Idoso de 80 Anos ou mais , Etnicidade , Humanos , Portugal/epidemiologia , Indicadores de Qualidade em Assistência à Saúde
15.
Am J Dent ; 35(1): 15-19, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35316587

RESUMO

PURPOSE: To compare the stress distribution through photoelasticity, microhardness and roughness of intact crowns of primary molars (CC) and the preformed crowns of stainless steel (SSC) and zirconia (ZC) used in dental restorations in pediatric dentistry. METHODS: Six healthy primary molars were selected. For the photoelastic models, the teeth were fixed in photoelastic resin. A load of 100 N was applied, and the models were analyzed by transmission polariscope. The Tardy method was used to quantify the fringe order which calculates the maximum stress (T) value in each selected point. The teeth were prepared for cementation of the crowns. The photoelastic test was repeated for each experimental crown. Knoop microhardness was assessed on the buccal surfaces of the CCs, SSCs, and ZCs using a microhardness tester. Parameters were 50 gf for 5 seconds. Roughness was evaluated using a confocal 3-D laser scanning microscope/software at 216x magnification. Roughness average (Ra) values from each model (expressed in µm) were collected and group means were calculated. The stress distribution, microhardness, and roughness data were compared by using one-way ANOVA and the Tukey's test (α= 0.05). RESULTS: There was no difference in the stress distribution for the CCs, SSCs and ZCs. For the microhardness analysis, the ZCs obtained the highest values compared to the CCs and the SSCs (P< 0.001). The CCs were significantly higher than the SSCs (P= 0.027). There was no difference in roughness for the three models (P= 0.615). The SSCs and ZCs showed satisfactory mechanical behavior. CLINICAL SIGNIFICANCE: The use of preformed crowns, especially those made of esthetic materials, is currently increasing in the field of pediatric dentistry. The knowledge of mechanical properties of stainless steel- and zirconia-prefabricated crowns provides scientific foundation for safe clinical application, especially in primary teeth.


Assuntos
Aço Inoxidável , Zircônio , Criança , Coroas , Humanos , Dente Molar
16.
Nutr Health ; 28(3): 401-415, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35014893

RESUMO

Background: Green tea, obtained from the plant Camellis sinensis, is one of the oldest drinks in the world and contains numerous bioactive compounds. Studies have demonstrated the efficacy of green tea in preventing obesity and cardiovascular diseases that may be related to the reduction of lipid levels. Aim: This study aimed to evidence, through a systematic review, the therapeutic potential of green tea on the lipid profile in preclinical studies in obese animals and clinical studies in obese individuals. Methods: This systematic review follows the recommendations of the preferred report items for systematic reviews and meta-analyses. The electronic databases, PubMed (Medline), Science Direct, Scopus, and Web of Science were consulted. Articles from January 2009 to December 2019 were selected. Results: This search resulted in twenty-nine articles were included cirtically reviewed. In experimental studies, green tea administration has been shown to reduce total cholesterol, triglycerides and low-density lipoprotein cholesterol in animals exposed to obesity-inducing diet. In humans' studies green tea was not shown to be effective for obese lipid control. Because supplementation with green tea extract reduced total cholesterol, triglycerides, low-density lipoprotein for three months at a specific dose. Conclusion: Therefore, green tea appears to act as a protective agent for dyslipidemia in obesity-induced animals. In human studies, green tea has not been shown to be effective in controlling obese lipids.


Assuntos
Obesidade , Chá , Animais , Colesterol , Humanos , Lipoproteínas LDL/uso terapêutico , Obesidade/tratamento farmacológico , Extratos Vegetais/farmacologia , Extratos Vegetais/uso terapêutico , Triglicerídeos
17.
J Prosthet Dent ; 127(2): 319.e1-319.e8, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34857392

RESUMO

STATEMENT OF PROBLEM: Frequent maintenance because of the limited lifetime of overdenture attachments with O-rings has led to the development of materials that might improve their functionality and longevity. However, testing of newly developed attachment materials is lacking. PURPOSE: The purpose of this in vitro study was to evaluate a newly developed attachment made of polyetheretherketone (PEEK) for an implant-retained overdenture. MATERIAL AND METHODS: Specimens of PEEK, polyacetal, and Teflon O-ring materials were prepared for analysis of roughness, surface hardness, and compressive strength. For the fatigue resistance test, new specimens based on acrylic resin were subjected to 2880 insertion and removal cycles. Compression and roughness data were compared with the Kruskal-Wallis and Dunn post hoc test; hardness data with ANOVA and t test; and fatigue and stereomicroscopy with ANOVA with repeated measures, t test, and Bonferroni adjustment (α=.05). RESULTS: Polyacetal had the lowest surface roughness (P=.038). There was a significant difference in hardness among the materials (P<.05). PEEK presented the highest compressive strength among the materials (P<.001). For the fatigue resistance, only polyacetal showed a difference between the initial time-point (P<.05) and subsequent time-points. Polyacetal had a higher fatigue resistance than Teflon (P<.001) and PEEK (P<.05). Regarding the internal deformation of the attachments, a significant difference was observed among the materials (P<.05). CONCLUSIONS: PEEK showed promising results regarding the physicomechanical properties necessary for use as an overdenture attachment when compared with other evaluated materials. In addition, the PEEK attachment showed results comparable to those in the control group (O-rings) in terms of retention.


Assuntos
Implantes Dentários , Revestimento de Dentadura , Benzofenonas , Prótese Dentária Fixada por Implante/métodos , Análise do Estresse Dentário , Retenção de Dentadura/métodos , Teste de Materiais , Polímeros
18.
J Prosthet Dent ; 128(4): 664-673, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33736863

RESUMO

STATEMENT OF PROBLEM: Denture stomatitis affects complete denture wearers and is frequently treated with antifungals drugs, as well as treating the denture with sodium hypochlorite. Whether the limitations of these treatments can be overcome with local hygiene protocols that do not damage the denture materials or adversely affect the patient is unclear. PURPOSE: The purpose of this randomized controlled trial was to evaluate the effect of denture hygiene protocols on complete denture wearers with denture stomatitis. MATERIAL AND METHODS: For this randomized, double-blind controlled clinical trial, 108 participants were assigned to parallel groups: 0.25% sodium hypochlorite (positive control) 0.15% Triclosan, denture cleaning tablets, or denture cleaning tablets plus gingival cleaning tablets. The participants were instructed to brush the dentures and the palate and immerse the denture in the solutions. The outcomes of denture stomatitis remission, biofilm removal, decrease of microbial load (colony-forming units), and odor level of the mouth and denture were measured at baseline and after 10 days. Descriptive analyses were used for sociodemographic characterization of the participants; the Pearson chi-square test was used to compare participant frequency with different degrees of denture stomatitis. The data were not normally distributed (Shapiro-Wilks test) or homogeneous (Levene test). So, the Kruskal-Wallis and Dunn post hoc tests and Wilcoxon test were used to compare the effects of solutions and time on the variables (α=.05). RESULTS: The frequency of the highest to lowest denture stomatitis scores was significantly different for the 0.15% Triclosan and denture cleaning tablets groups. No significant difference was found among the groups in terms of denture stomatitis scores, biofilm, or colony-forming unit count of Candida spp. or C. albicans and S. mutans; a significant reduction was found in these parameters. The 0.25% sodium hypochlorite and 0.15% Triclosan treatments caused a significant reduction in Gram-negative microorganisms; these 2 protocols, and the denture cleaning tablets showed a significant reduction in Staphylococcus spp.; all protocols had similar effects. Only the S. mutans count of the palate decreased after 10 days. The odor level of the mouth and the denture was not significantly different (P=.778). CONCLUSIONS: The evaluated protocols can be recommended for the hygiene of complete dentures, since they were effective for all the variables studied.


Assuntos
Estomatite sob Prótese , Triclosan , Humanos , Higienizadores de Dentadura/uso terapêutico , Higienizadores de Dentadura/farmacologia , Estomatite sob Prótese/tratamento farmacológico , Hipoclorito de Sódio/uso terapêutico , Hipoclorito de Sódio/farmacologia , Odorantes , Triclosan/uso terapêutico , Triclosan/farmacologia , Biofilmes , Candida albicans , Higiene , Contagem de Colônia Microbiana , Ensaios Clínicos Controlados Aleatórios como Assunto
19.
J Oral Implantol ; 48(2): 79-83, 2022 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33690819

RESUMO

This study aimed to test and compare 2 novel dental mini-implant designs to support overdentures with a commercial model, regarding the stress distribution, by photoelastic analysis. Three different mini-implant designs (Ø 2.0 mm × 10 mm) were tested: G1-experimental threaded (design with threads and 3 longitudinal and equidistant self-cutting chamfers), G2-experimental helical (design with 2 long self-cutting chamfers in the helical arrangement), and G3-Intra-Lock System. After including the mini-implants in a photoelastic resin, they were subjected to a static load of 100 N under two situations: axial and inclined model (30°). The fringe orders (n), that represents the intensity of stresses were analyzed around the mini-implants body and quantified using Tardy's method that calculates the maximum shear stress (τ) value in each point selected. In axial models, less stress was observed in the cervical third mini-implants, mainly in G1 and G2. In inclined models (30°), higher stresses were generated on the opposite side of the load application, mainly in the cervical third of G2 and G3. All mini-implant models presented lower tensions in the cervical third compared with the middle and apical third. The new mini-implants tested (G1 and G2) showed lower stresses than the G3 in the cervical third under axial load, while loading in the inclined model generated greater stresses in the cervical of G2.


Assuntos
Implantes Dentários , Revestimento de Dentadura , Planejamento de Prótese Dentária , Prótese Dentária Fixada por Implante , Análise do Estresse Dentário/métodos , Estresse Mecânico
20.
J Prosthodont ; 31(5): e12-e19, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35150590

RESUMO

PURPOSE: This randomized controlled trial compared four denture hygiene protocols in terms of patient satisfaction, oral health-related quality of life (OHRQoL), and salivary parameters in complete denture wearers with denture stomatitis. MATERIAL AND METHODS: For this randomized, double-blind, controlled clinical trial, 108 participants were assigned to soak their dentures in one of the following solutions: (1) 0.25% sodium hypochlorite (positive control), (2) 0.15% Triclosan, (3) denture disinfecting tablets, or (4) denture disinfecting tablets plus palatine mucosa brushing solution. The outcomes of patient satisfaction, OHRQoL, and salivary parameters (salivary flow rate and pH) were measured at baseline and after 10 days. The Kruskal-Wallis and Dunn tests (between groups), and Wilcoxon test (between times) were used to compare the results. (α = 0.05). RESULTS: After the hygiene protocols, and when compared with baseline, the overall patient satisfaction, maxillary denture satisfaction, maxillary denture comfort, and maxillary denture retention were ameliorated. A significant improvement was noted in OHRQoL in 3 of 4 domains evaluated (orofacial pain and discomfort, masticatory discomfort and disability, and psychological disability and discomfort). The salivary flow rate (unstimulated and stimulated) and salivary pH were not significantly affected at the times evaluated. CONCLUSIONS: Complete denture wearers may feel more satisfied with their complete dentures when treated for denture stomatitis. The tested treatments lead to similar improvement in terms of patient satisfaction and OHRQoL.


Assuntos
Satisfação do Paciente , Estomatite sob Prótese , Retenção de Dentadura , Prótese Total/psicologia , Humanos , Higiene , Saúde Bucal , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Estomatite sob Prótese/terapia
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