In Hemodialysis Patients, Intradialytic Resistance Exercise Improves Osteoblast Function: A Pilot Study.

OBJECTIVE: Abnormalities in mineral and bone metabolism are frequent in chronic kidney disease patients. Physical exercise can improve many indicators of physical functioning, and recent studies showed beneficial effects on bone mineral density in the general population. The aim of this study was to evaluate the effects of resistance exercise training on bone markers and body composition in hemodialysis (HD) patients. DESIGN: This was a randomized controlled trial. SUBJECTS: The study included 13 HD patients (46.2% men). INTERVENTION: Patients were divided into a control group and an exercise group, which performed 8 weeks of intradialytic resistance exercise. Serum sclerostin, bone alkaline phosphatase (BAP), insulin, leptin, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, and body composition were measured before and after the exercise period. RESULTS: In the exercise group, BAP levels increased from 11.4 ± 6.5 to 14.6 ± 6.4 U/L (P < .05) and serum 1,25-dihydroxyvitamin D levels from 46.0 ± 23.5 to 87.2 ± 31.8 ng/mL (P < .05). After exercise, serum BAP levels were inversely correlated with serum sclerostin (r = -0.96, P < .05). There was no change in body composition in either group. CONCLUSION: Resistance exercise training appears to be an interesting approach for stimulating BAP production in HD patients and may prevent bone loss and stimulate bone formation.

Exercise Training Alters the Bone Mineral Density of Hemodialysis Patients.

Marinho, SM, Moraes, C, Barbosa, JEdSM, Eduardo, JCC, Fouqe, D, Pelletier, S, and Mafra, D. Exercise training alters the bone mineral density of hemodialysis patients. J Strength Cond Res 30(10): 2918-2923, 2016-Patients with chronic kidney disease undergoing hemodialysis (HD) frequently present low bone mineral density (BMD), and exercise may be useful for treating bone loss. This study aimed to assess the effects of an intradialytic resistance exercise training program (RETP) on BMD in HD patients. Twenty-one patients were enrolled into 2 groups; 10 patients performed exercise (80.0% men; 46.9 ± 12.1 years; 27.0 ± 3.4 kg·m) and 11 patients were in the control group (54.5% men; 50.5 ± 11.5 years; 24.1 ± 8.7 kg·m). Dual-energy x-ray absorptiometry was used to measure the BMD, lean mass, and body fat before and after the supervised RETP (performed with elastic bands and ankle cuffs in both lower limbs 3 times a week for 24 weeks-72 sessions). In the exercise group, 30.0% of patients presented with osteopenia and 20.0% osteoporosis and in the control group, 45.5% osteopenia and 36.4% osteoporosis. Only in the exercise group, the osteoporosis percentage was reduced to 10.0% and the femoral neck BMD and T-score improved from 0.89 ± 0.1 to 0.93 ± 0.1 g·cm and from -1.3 ± 0.8 to -1.0 ± 0.8 g·cm (p ≤ 0.05), respectively, after the intervention. In contrast, these parameters were reduced in the control group. The results suggest that resistance exercise may be useful for improving the BMD in HD patients. In summary, 24 weeks of the supervised RETP played a role in improving the BMD of HD patients.

Effects of resistance exercise training on acyl-ghrelin and obestatin levels in hemodialysis patients.

BACKGROUND: Patients undergoing hemodialysis (HD) present altered levels of appetite hormones such as acyl-ghrelin (orexigenic) and obestatin (anorexigenic), which may contribute to anorexia. Physical exercise may affect these hormones and improve appetite in these patients. OBJECTIVES: The objective of this study is to evaluate the effects of a resistance exercise program in appetite hormones, body composition, and nutritional status in HD patients. DESIGN: Intervention study with the control group. SUBJECTS: Fifty-two patients on regular HD program were enrolled into two groups: 37 patients performed exercises (56.7% male, 45 ± 12.8 years, 57 (9-192) months on HD) and 15 patients comprised the control group (66.7% men, 50 ± 10.6 years, 57 (11-153) months on HD). MEASUREMENTS: Exercise program (performed with elastic bands and ankle cuffs in both lower limbs) was supervised three times a week during 6 months (72 sessions). Patients had their blood drawn in a regular HD day after overnight fasting, before and after 6 months of exercise program. Obestatin, acyl-ghrelin, routine biochemical parameters, quality of life, and anthropometric data were collected and analyzed before and after 6 months. RESULTS: After 6 months of exercise, obestatin levels reduced [from 3.0 ng/mL (2.3-3.4) to 1.9 ng/mL (0.6-3.4)] and acyl-ghrelin levels increased [from 21.5 pg/mL (1.3-77.7) to 37.2 pg/mL (16.7-94.1)] and the control group presented no significant differences in both plasma levels of hormones. Body composition and physical functional assessed by SF-36 and albumin levels (3.7 ± 0.3 to 3.9 ± 0.2, p < 0.05) improved after exercises. CONCLUSION: Six months of resistance exercises contributed to changes in plasma appetite hormones, body composition, and nutritional status in hemodialysis patients.

Oral mucosal conditions in preschool children of low socioeconomic status: prevalence and determinant factors.

The aim of the present study was to determine the prevalence of oral mucosal conditions and associated factors among 541 preschoolers of low socioeconomic status. A cross-sectional study was carried out. Sociodemographic data and information on harmful oral habits were gathered with the use of a questionnaire. A clinical exam was performed for the determination of oral mucosal conditions, dental caries and level of oral hygiene. Data analysis involved statistical analysis, the Kruskal-Wallis test, Mann-Whitney test, chi-square test, Fisher's exact test and multivariate regression (p < 0.05, 95 % CI). The prevalence of oral mucosal conditions was 40.7 %. The most prevalent oral mucosal conditions were coated tongue (23.4 %), melanotic macules (14.4 %), oral ulcers (11.8 %), Fordyce's spots (8.1 %), angular cheilitis (3.0 %), geographic tongue (2.8 %), linea alba (1.5 %) and fistula (1.3 %). Children between 3 and 5 years of age had a greater chance of exhibiting coated tongue (OR, 2.55; 95 % CI, 1.6-4.1), melanotic macules (OR, 4.07; 95 % CI, 2.3-7.2) and Fordyce's spots (OR, 12.70; 95 % CI, 7.2-28.6). The female gender had a greater chance of exhibiting melanotic macules (OR, 2.23; 95 % CI, 1.3-1.8). Coated tongue was more prevalent among children from low-income families (OR, 2.35; 95 % CI, 1.3-4.3) and those with inadequate oral hygiene (OR, 4.65; 95 % CI, 2.9-7.4). Caries constituted a predictive factor for oral ulcers (OR, 2.15; 95 % CI, 1.2-3.9) and fistula (OR, 12.00; 95 % CI, 1.4-11.3). Bruxism (teeth clenching/grinding) was a predictive factor for angular cheilitis (OR, 5.55; 95 % CI, 1.9-16.3). The determinant factors for oral mucosal conditions were the female gender, age between 3 and 5 years, inadequate oral hygiene, low household income, residence in rural areas and presence of dental caries and bruxism.

Effect of propolis on mast cells in wound healing.

Wound healing is divided into three phases: inflammatory, proliferative and remodeling. Mast cells participate in all these phases. The aim of the present study was to determine the effects of propolis on the population of mast cells in oral surgical wounds in comparison to the results obtained with dexamethasone. This study was prospective, in vivo, randomized, semiexperimental, quantitative and comparative animal. A circular surgical wound was made on the dorsum of the tongue of 90 hamsters divided into three experimental groups: topical application of 30% propolis alcoholic extract (Group 1); 0.1% dexamethasone in orabase cream (Group 2); and orabase cream alone (Group 3). Applications were performed every 12 h throughout the experiment. The postoperative times for killing of the animals were 1, 3, 7, 14 and 28 days. The Student's t test for independent samples was employed in the statistical analysis. In the inflammatory phase of healing, propolis caused a greater reduction in the number of mast cells on the edge and in the central region of the surgical wound in comparison to dexamethasone. Moreover, the number of mast cells on day 1 was lower in the central region of the wounds treated with the orabase cream alone in comparison to dexamethasone. In conclusion, the anti-inflammatory action of propolis mediated by mast cells was more effective than dexamethasone in the inflammatory phase of healing.

Impact of vector control actions in the abundance of Lutzomyia longipalpis in Montes Claros, Brazil.

Visceral leishmaniasis (VL) is endemic to many states in Brazil. To prevent further expansion of the disease, the Brazilian Ministry of Health adopted integrated measures through the Program of Surveillance and Control of Visceral Leishmaniasis (PSCVL), whose actions include the diagnosis and euthanasia of seropositive dogs (the main domestic reservoirs), the use of residual insecticides, environmental management (EM) to control vector population (mainly Lutzomyia longipalpis phlebotomine), rigorous epidemiological surveillance, and health education. The present study was conducted in areas with recent moderate VL transmission to evaluate the efficacy of vector control activities. The systematic capture of phlebotomine was performed for three consecutive days per month, from August 2015 to July 2017. The number of specimens captured was taken as a representative of the monthly insect population. A total of 38,055 phlebotomine specimens were captured and identified at the species level. Lu. longipalpis was consistently found to be the predominant species (97.7%) each month. In the first year of the study, no intervention was performed. In the second year, two cycles of chemical spraying, EM, or a combination of both were performed before and after the rainy season. All interventions, either individually or in combination, reduced the abundance of Lu. longipalpis in the study area.

Occurrence and spatial distribution of triatomines (Hemiptera: Reduviidae) in the urban area of the municipality of Montes Claros, Northern Minas Gerais, Brazil.

The north of the Brazilian state of Minas Gerais is classified as an area of high risk of vectorial transmission of Chagas disease (CD) or of reestablishing transmission in the home, but the Chagas disease control programme is disjointed. The study evaluated the occurrence, natural infection and the spatial distribution of species of triatomines associated with climatic variations in the urban area of Montes Claros, a municipality endemic to CD in the north of Minas Gerais, Brazil. Triatomine data were obtained from passive entomological surveillance actions of the Chagas Disease Control Program (Programa de Controle de Doença de Chagas-PCDCh), registered by the Zoonosis Control Center (Centro de Controle de Zoonoses-CCZ) from 2009 to 2019. A total of 277 triatomines belonging to eight species were collected, and of these, 203 insects were examined. It was found that 46.2% of triatomines were captured inside the home and 8.3% around the home. The natural infection rate was 6.9%; 14 specimens showed natural infection by Trypanosoma cruzi (12 females and 2 males), and of these, 13 were found in the home and one in an uninformed location. The number of triatomine records collected was significantly higher in the month of September (p = .01), and there was an inverse correlation between the number of triatomines and the relative humidity of the air (p < .001). It was verified that the highest triatomine densities are located in transition areas between urban infrastructure (32.12%) and pasture (25.72%). The diversity of species of triatomines infected with T. cruzi in residential units in urban areas in the municipality of Montes Claros is worrying, as it suggests a potential risk of transmission of the parasite to domestic animals and humans.

Uremic toxins levels from the gut microbiota seem not to be altered by physical exercise in hemodialysis patients.

PURPOSE: Regular physical exercise may result in many benefits to patients with chronic kidney disease (CKD) on hemodialysis (HD), including gut microbiota modulation and solute removal. The study aimed to evaluate the effects of two programs of intradialytic exercises on uremic toxins plasma levels in HD patients. METHODS: In experiment 1, twenty HD patients [12 men, 44.1 ± 8.9 years, BMI of 23.4 ± 2.4 kg/m2] were randomized into two groups: Aerobic exercise group (AEG, n = 11) that performed aerobic exercise on an adapted exercise bike three times a week for three months (36 sessions) and Control group (CG, n = 9). In experiment 2, twenty-six HD patients [19 men, 47.6 ± 11.0 years, BMI of 25.9 ± 3.6 kg/m2] were randomized into Resistance exercise group (REG, n = 14) that performed a resistance exercise program (using elastic bands and ankle cuffs with both lower limbs) monitored three times a week, during six months (72 sessions) and CG (n = 12). P-cresyl sulfate (p-CS), indoxyl sulfate (IS), and indol-3-acetic acid (IAA) plasma levels were determined by high-performance liquid chromatography (HPLC) with fluorescent detection. RESULTS: The uremic toxins plasma levels did not reduce in both exercise programs, aerobic exercise (IS: 32.7 ± 14.0 vs 33.0 ± 15.4 mg/L, p = 0.86; p-CS: 59.9 ± 39.3 vs 60.0 ± 41.2 mg/L, p = 0.99; IAA: 2233 [1488-2848] vs 2227 [1275-2824] µg/L, p = 0.72) and resistance exercise (IS: 28.3 ± 11.3 vs 29.1 ± 9.7 mg/L, p = 0.77; p-CS: 31.4 ± 21.3 vs 34.2 ± 19.8 mg/L, p = 0.63; IAA: 1628 [1330-3530] vs 2000 [971-3085] µg/L, p = 0.35) in HD patients. CONCLUSION: According to our findings, physical exercise does not appear to alter the levels of uremic toxins produced by the gut microbiota in HD patients.

Identification of Candida spp. by phenotypic tests and PCR.

The correct identification of Candida species is of great importance, as it presents prognostic and therapeutical significance, allowing an early and appropriate antifungical therapy. The purpose of this study was to identify isolates of Candida spp. from oral mucosa of 38 patients with oral candidosis evaluated in 2004 by phenotypic methods and PCR, discriminating C. albicans from the other Candida species. The tests used for phenotypic analysis were germ-tube and chlamydoconidia production, culture in CHROMAgar™ Candida, carbohydrate assimilation test, growth at 45ºC and culture in Tween 80 agar. Genotypic confirmation was performed by PCR. Phenotypic tests showed that 63.2% strains formed germ-tubes, 73.7% produced chlamydoconidia, and 63.2% showed green colonies in chromogenic medium, presumptively indicating C. albicans or C. dubliniensis. The carbohydrate assimilation test confirmed these results. A total of 21% strains were identified as C. krusei and 13.2% were indicative of C. tropicalis. Of these later strains, three produced chlamydoconidia. The association of other phenotypic tests with culture in Tween 80 agar identified 95.8% of strains as C. albicans and 4.2% as C. dubliniensis. All 24 strains indicative of C. albicans and C. dubliniensis were confirmed by PCR as C. albicans.

[Pain, anxiety and quality of life related to the oral health of patients treated in a dental emergency clinic]. / Dor, ansiedade e qualidade de vida relacionada à saúde bucal de pacientes atendidos no serviço de urgência odontológica.

The scope of this study was to assess the association between preoperative pain, anxiety and the impact of the oral condition on the quality of life of patients treated at the Dental Emergency Service at the Federal University of the Jequitinhonha and Mucuri Valleys. A retrospective cross-sectional study was conducted evaluating data from 240 patient charts aged from 18 to 65 years. Pain was measured by the Heft-Parker Visual Analog Scale; dental anxiety by Corah's Dental Anxiety Scale; and oral health-related quality of life by the Oral Health Impact Profile (OHIP-14). Associations were analyzed using Pearson's Chi-square test (p < 0.05). A statistically significant association was observed between pain and poorer quality of life, with impacts on psychological discomfort (p < 0.001), physical incapacity (p < 0.001) and the psychological (p < 0.001) and social (p < 0.001) domains. Anxiety influenced poorer quality of life, with impacts on the psychological discomfort (p = 0.009), physical disability (p = 0.016), psychological disability (p = 0.011) and social disadvantage (p = 0.028) domains. This study is relevant for the planning of programs and actions aimed at the oral health of patients treated in dental emergency services, prioritizing those with the greatest psychosocial impact arising from oral problems.

O objetivo deste estudo foi avaliar associação entre dor pré-operatória, ansiedade e impacto da condição bucal na qualidade de vida dos pacientes atendidos no serviço de Urgência Odontológica da Universidade Federal dos Vales do Jequitinhonha e Mucuri. Estudo transversal retrospectivo foi conduzido avaliando dados clínicos de 240 prontuários de pacientes com idades entre 18 e 65 anos. A dor foi mensurada pela Heft-Parker Visual Analogue Scale; ansiedade, pela Corah's Detal Anxiety Scale e qualidade de vida, pelo Oral Health Impact Profile (OHIP-14). Associações foram analisadas pelo Teste qui-quadrado de Pearson (p < 0,05). Foi observada associação estatisticamente significante entre dor e pior qualidade de vida, com impacto nos domínios desconforto psicológico (p < 0,001), incapacidade física (p < 0,001), psicológica (p < 0,001) e social (p < 0,001). Ansiedade influenciou na pior qualidade de vida, com impacto nos domínios desconforto psicológico (p = 0,009), incapacidade fisica (p = 0,016), psicológica (p = 0,011) e desvantagem social (p = 0,028). Esse estudo é relevante para o planejamento de ações voltadas para a saúde bucal dos pacientes atendidos nos serviços de urgência odontológica, priorizando aqueles com maiores impactos psicossociais decorrentes dos problemas bucais.

Epidemiological profile of young patients with squamous cell carcinoma in northeast Brazil.

AIM: The aim of the present study was to delineate the epidemiological profile of young patients with squamous cell carcinoma (SCC) treated at a healthcare service in northeastern Brazil. METHODS: A cross-sectional study was performed involving the quantitative analysis of 51 medical records from patients diagnosed with SCC between 1998 and 2013. All patients aged ≤50 years were included in the study. Statistical analysis involved Pearson's χ2 -test, Fisher's exact test, and the Mann-Whitney U-test, with the level of significance set at 5% (P < .05). RESULTS: The mean age was 46 ± 7.94 years, and males accounted for 80.4% of the sample. The tongue was the most affected site (37.3%). Most tumors were classified as stage III (26.3%) or IV (42.1%). Surgery associated with chemotherapy was the most common therapeutic approach (39.3%). Female patients had a lower mean age (P = .013) and less advanced clinical staging (P = .022). Smoking was more associated with male sex (P = .043). CONCLUSION: SCC in young patients is more common in males aged 46 ± 7.94 years, with the tongue being the most affected anatomic site. Important differences were found in clinical-epidemiological features between young men and women.

Angioarchitecture of the ventral surface of the tongue from Wistar rats.

The goal of this study was to describe the angioarchitecture of the ventral surface of the tongue from Wistar rats using a vascular corrosion casting technique associated with scanning electron microscopy (SEM). Six Wistar rats were used for the vascular casting method with Mercox resin. Following the resin polymerization, the tongue of each animal was dissected and corroded in a 5% sodium hydroxide solution. Once the corrosion and drying of the specimens were completed, the specimens were mounted on aluminum stubs, coated with carbon and gold and analyzed under SEM. The results showed that the ventral surface of the tongue presents simple, even and abundant vasculature constituted by a vascular plexus consisting of a superficial vascular network and by the ranine veins. The superficial vascular network, made up of the ascending and descending branches, presents as a loose network, with little morphological variation between the capillary loops.

Extensive myiasis infestation over a squamous cell carcinoma in the face. Case report.

Human myiasis is a parasitosis found in tropical and underdeveloped countries. It usually affects the elderly, unhealthy and mentally disabled individuals. It is caused by dipterous that lay their eggs in necrotic or infected tissues, although areas of the body that are apparently healthy can also be affected. Frequently the fly deposits several eggs on the peripheral parts of scratches and wounds. The treatment of myiasis involves mechanical removal of the larvae with hemostatic pincers. Larvae rupture must be avoided. Application of topical ether or similar volatile substance is useful. Preventive approach measures, including basic health care, hygiene, access to primary health service, and safe water and drainage, are fundamental to prevent human myiasis. The authors present a case report of myiasis infestation over an extensive head and neck squamous cell carcinoma from a 72-year-old patient living in a rural area. Approximately 200 larvae were removed and the patient was taken to the hospital's head and neck surgery service.

Computer-assisted analysis of tongue thickness of golden hamster (Mesocricetus auratus) following topical chronic exposure to distilled alcoholic beverages.

The aim of this study was to measure changes in epithelial thickness in the lingual mucosa of golden hamsters submitted to the topical application of distilled alcoholic beverages. Forty golden hamsters were randomly divided into: Group 1-cachaça 48° GL and Group 2-whisky 40° GL. Alcohol was applied to the right side of the tongue, the left side served as control. Seventy microscopic fields were evaluated. The data were submitted to descriptive statistics, the Wilcoxon test and the Mann-Whitney U test (p < 0.05). In Group 1, there was a significant difference in mean total epithelial thickness between the test side and control side (p = 0.044), with significant reductions in the thickness of the epithelial and corneal layers (p < 0.001 and p = 0.021, respectively). At 13 weeks, statistically significant reductions were found in the thickness of both the corneal and epithelial layers (p = 0.032 and p < 001, respectively). At 20 weeks, a statistically significant reduction was found in only the epithelial layer (p = 0.002). In the whisky group, significant increases were found in the thickness of the corneal and epithelial layers (p = 0.015 and p = 0.012, respectively) at 13 weeks. Cachaça 48° GL promoted epithelial atrophy, whereas whisky 40° GL promoted epithelial hyperplasia. Based on the present findings, different types of distilled alcoholic beverages cause different morphometric and morphological changes in the lingual mucosa. Cachaça caused epithelial atrophy, which may facilitate the penetration of carcinogenic agents, whereas whisky caused epithelial hyperplasia, especially in the basal layer, which suggests the onset of the development of premalignant lesions.

Prospective evaluation of quality of life in patients with head and neck cancer.

OBJECTIVES: This study aimed to evaluate, prospectively, the quality of life of patients with head and neck cancer. STUDY DESIGN: A quantitative, longitudinal, and prospective study was conducted. The survey instrument was the University of Washington quality of life questionnaire. The sample consisted of 47 patients. For data analysis, paired t test, McNemar test, Student t test, and 1-way analysis of variance tests were used. The significance level was 5% (P < .05). RESULTS: Mood (68.89 ± 35.41) and anxiety (70.22 ± 32.99) domains were the most affected at the time of diagnosis. Chewing (71.11 ± 39.15) and speech (76.22 ± 33.72) domains were the most affected in the revaluation of the questionnaire, after 3 months. In the temporal assessment of the domains at diagnosis and after 3 months, it was observed that domains that improved quality of life were pain (P = .013) and mood (P = .039). Swallowing (P = .017), chewing (P = .024), speech (P = .048), and saliva (P = .004) domains produced a worse quality of life. CONCLUSIONS: The parameters that influence quality of life differ when the the University of Washington quality of life questionnaire is applied at the time of diagnosis and 3 months after diagnosis.

Cigarro Eletrônico: Mocinho ou vilão? / Cigarrillo Electrónico: ¿Bueno o malo? / Electronic Cigarette: Good guy or bad guy?

RESUMEN Objetivo: Discutir los efectos sobre la salud causados por el uso de cigarrillos electrónicos. Material y métodos: Para ello, se realizó una búsqueda en la base de datos PubMed/Medline de artículos completos publicados en los últimos 10 años. Se utilizaron un total de 21 artículos, según los criterios de inclusión establecidos, con mayor prevalencia de estudios transversales. Resultados: Se encontró que los cigarrillos electrónicos pueden incluso ayudar en el cese del tabaquismo convencional, sin embargo, sus usuarios no están exentos de sufrir complicaciones de salud sistémicas. Estos contienen sustancias tóxicas y no deben considerarse completamente seguros e inofensivos. Conclusiones: se necesitan más estudios para determinar las implicaciones para la salud a largo plazo del uso de este deben considerarse completamente seguros e inofensivos.

SUMMARY Objective: to discuss the health effects caused by the use of electronic cigarettes. Material and Methods : A search was performed in the PubMed/Medline database of complete articles published in the last 10 years. A total of 21 articles were used, according to the established inclusion criteria, with a higher prevalence of cross-sectional studies. Results: It was verified that electronic cigarettes may even help in the cessation of conventional smoking, however, their users are not exempt from suffering systemic health complications. They present toxic substances and should not be considered totally safe and harmless. Conclusions : Further studies are still needed to determine the implications of the use of this electronic device on the health of its users in the long term.

[Clinical-epidemiologic profile of paracoccidioidomycosis at the Stomatology Department of São Lucas Hospital, Pontificia Universidade Católica of Rio Grande do Sul]. / Perfil clínico-epidemiológico dos pacientes portadores de paracoccidioidomicose no Serviço de Estomatologia do Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul.

The aim of the article was to describe clinical and epidemiological features of 61 oral paracoccidioidomycosis cases from the Stomatology Department of São Lucas Hospital, analyzed from July 1976 to June 2004. The State of Rio Grande do Sul is an endemic region due to ecoepidemiologic conditions, that are favorable for the development of the yeast. Men are the most affected gender, with 58 (95%) affected compared to 3 (5%) women. Ii is most prevalent (70.5%) between 40 and 59 years of age. Agricultural labor was the most common occupation with 27/61 (44.3%) patients. Tobacco smoking was prevalent in 52 (85.3%) of the sample, and alcoholism was a frequent finding. All the patients showed stomatologic manifestations, with ulcers and mulberry-like stomatitis the most prevalent, these oral lesions were also observed in many anatomical sites. Alterations were present in 32 (65.3%) of the pulmonary radiographs.

Association Between Body Composition and Bone Mineral Density in Men on Hemodialysis.

Studies have revealed complex interactions between bone and fat, however there are few studies about this crosstalk in patients with chronic kidney disease. This study investigated possible relationship between bone mineral density (BMD) and body composition in patients who underwent hemodialysis. Twenty patients were enrolled in a cross-sectional study (47.0 [42.3-56.8] years, body mass index 26.0 ± 4.2 kg/m, dialysis vintage of 48.5 [26.7-95.7] months). Body composition and BMD were assessed by dual-energy X-ray absorptiometry. Leptin and parathormone levels were analyzed using Multiplex kits (R&D System Inc). Low bone mass in the femoral neck was reported in 54.8% of patients. Total BMD and total T-score were positively correlated with lean mass (r = 0.46, P = 0.04; r = 0.47, P = 0.04, respectively), but not with leptin or body fat mass. In conclusion, lean body mass is probably important to maintain bone health in male patients who underwent hemodialysis.

Diabetes na odontologia: manifestações bucais e condutas para atendimento / Diabetes in dentistry: Oral manifestations and conducts for care

Introdução: O Diabetes Mellitus inclui um grupo de doenças metabólicas caracterizadas por hiperglicemia, resultantes de defeitos na secreção da insulina e/ou em sua ação. É uma patologia de importância para a saúde sistêmica e geral dos portadores, devendo ser especialmente considerada no planejamento e tratamento odontológicos. Objetivos: Este estudo teve por objetivo abordar o DM, respaldando etiologia, patogenia e aspectos clínicos, bem como suas complicações, que possam ocorrer durante o tratamento odontológico. Métodos: Este estudo caracterizou-se por uma busca bibliográfica nas bases de dados eletrônicos PubMED/Medline, Lilacs, Scielo e Scopus, limitando-se ao período de 2005 a 2020. Os descritores utilizados foram: diabetes mellitus, atenção odontológica e manifestações bucais. Resultados obtidos: O DM consiste em um grupo de doenças metabólicas caracterizadas pelo aumento excessivo da glicemia sérica. Existem três tipos de diabetes: tipo 1 (aproximadamente 5% dos casos), tipo 2 (90-95% dos casos) e gestacional. O paciente diabético pode apresentar, com maior frequência, algumas manifestações bucais como as doenças periodontais, halitose, disfunções salivares, infecções fúngicas e infecções bacterianas. Além disso, durante atendimento odontológico, pode ser necessário realizar algumas adequações nos protocolos clínicos utilizados nesses pacientes. Conclusão: É importante incentivar os pacientes com DM a visitarem regularmente o cirurgião dentista (CD), para que sejam orientados e recebam instruções sobre saúde bucal e sua relação com doenças sistêmicas. Em alguns casos, o encaminhamento para atendimento médico pode ser necessário antes do início do tratamento, exceto em casos de urgência odontológica.

Introduction: Diabetes Mellitus includes a group of metabolic diseases characterized by hyperglycemia, resulting from defects in insulin secretion and/or its action. It is a pathology of importance for the systemic and general health of patients, and it should be especially considered in dental planning and treatment. Objectives: This study aimed to address DM, supporting etiology, pathogenesis, and clinical aspects, as well as its complications, which may occur during dental treatment. Methods: This study was characterized by a bibliographic search in the electronic databases PubMED / Medline, Lilacs, Scielo and Scopus, limited to the period from 2005 to 2020. The descriptors used were diabetes mellitus, dental care, and oral manifestations. Results obtained: DM consists of a group of metabolic diseases characterized by an excessive increase in serum glucose. There are three types of diabetes: type 1 (approximately 5% of cases), type 2 (90-95% of cases) and gestational. The diabetic patient may more frequently present some oral manifestations such as periodontal diseases, halitosis, salivary dysfunctions, fungal infections, and bacterial infections. In addition, during dental care it may be necessary to make some adjustments to the clinical protocols used in these patients. Conclusion: It is important to encourage patients with DM to regularly visit the dental surgeon (DS), so that they are guided and receive instructions on oral health and its relationship with systemic diseases. In some cases, referral to medical care may be necessary before treatment begins, except in cases of dental urgency.

Toxina botulínica como opção no tratamento da disfunção temporomandibular / Botulinic toxin as an option in treating Temporomandibular Dysfunction

Uma grande parcela de odontólogos está optando pelo uso de toxina botulínica (TxB) em seus pacientes. Sua aplicação é diversa, podendo tanto ser utilizada para fins estéticos, como terapêuticos. Em estudos preliminares, a TxB tem sido usada com sucesso para tratar várias síndromes de dor, incluindo o disfunção temporomandibular (DTM). O objetivo deste trabalho é discutir a aplicação da toxina botulínica como forma de tratamento das disfunções temporomandibulares, além de revisar alguns estudos e técnicas de aplicação. Trata-se de uma revisão de literatura, realizada no mês de janeiro de 2019, referente aos últimos cinco anos, por meio das bases de dados online PubMED/Medline, Lilacs e Scielo. Os descritores utilizados foram: treatment and Botulinum toxins and disorders and temporomandibular joint como mecanismo de busca, sendo selecionados apenas os disponíveis em sua versão completa (Full Text). Um total de 136 artigos foram levantados, sendo 118 no Pubmed, com 58 selecionados disponíveis em sua versão completa (Full Text), após uma cautelosa seleção sobre o assunto. No Lilacs, foram encontrados 12 artigos, dos quais apenas 6 condiziam com assunto, e no Scielo, foram encontrados 6 artigos, nos quais 5 eram duplicados e 1 não condizia com o assunto. Mesmo existindo outras soluções tradicionais disponíveis, a toxina botulíca pode ser um tratamento viável, seguro e eficaz para muitas disfunções da musculatura facial e oral, principalmente em casos refratários ao tratamento convencional.

The use of botulinum toxin by dentists, in their patients, increased in recent times.It's a diverse treatment, it can be used both in esthetic or therapeutic purpose. In previous studies, botulinum toxin has been used successfully in the treatment of several pathological pains, including temporomandibular joint (TMJ) dysfunction. To discuss botulinum toxin use as a treatment for temporomandibular joint (TMJ) dysfunction, also review some studies and application techniques. This paper is a review of a recent articlein temporomandibular joint (TMJ) dysfunction treatment using botulinum toxin. The bibliographic research was done in January, 2019, in the last five years, through the online data bases PubMED / Medline, Lilacs and Scielo. The key words used in the search were "treatment" and "Botulinum toxin" and "dysfunction" and "temporomandibular ". Overall of 136 items were found. In the PubMED/Medline was found 118 papers and of those were selected only the available in Full text. After a careful selection on the papers about the subject, and limiting the search between the period from 1976 to 2019, 58 papers were chosen. In the other hand, on Lilacs, 12 papers were found, of which only 6 corresponded to the subject, and on the Scielo were found 6 papers in which 5 were duplicated and 1 did not agree to the subject. Even if other traditional solutions exists, the research shows that botulinum toxin is a viable, safe and effective treatment for many facial and oral musculature dysfunctions, mainly in refractory cases to conventional treatment.