7.1',8.3'- and 7.3',8.5'-Connected Bicyclo[3.2.1]octanoids and Oxabicyclo[3.2.2]nonane-Type Neolignans from Ocotea aciphylla: Structures and Absolute Configurations.

The phytochemical investigation of the leaves and trunk bark of a specimen of Ocotea aciphylla collected in the southern portion of the Amazon forest led to the isolation of an oxabicyclo[3.2.2]nonane-type neolignan and 15 bicyclo[3.2.1]octanoid neolignans, 14 of which are unreported compounds (2-15), including one with an unusual oxidation pattern of the side chain at C-1' and two rare 7.1',8.3'-connected bicyclo[3.2.1]octanoid derivatives. Their structures and relative configurations were determined by extensive spectrometric analysis based on 1D- and 2D-NMR spectroscopy and HRESIMS data, while their absolute configurations were unambiguously assigned using electronic and vibrational circular dichroism data assisted by density functional theory calculations. Additionally, known sesquiterpenes, phenylpropanoids, and phytosterols were also isolated.

Combined application of DP4+ and ANN-PRA to determine the relative configuration of natural products: The alpha-bisabol case study.

The combination of computational methods and experimental data from Nuclear Magnetic Resonance (NMR) is a considerably valuable tool in the elucidation of new natural product structures and, also, in the structural revision of previously reported compounds. Until recently, only classical statistical parameters were used, for example, linear correlation coefficient (R2 ), mean absolute error (MAE), or root mean square deviation (RMSD), as a way to statistically "validate" the structure pointed out by experimental NMR spectra. Regarding the resolution of the relative configuration of organic molecules, novel tools were available in the last few years to assist in the NMR elucidation process. The most relevant are DP4+, which is based on a Bayesian probability, and ANN-PRA, which is based on artificial neural networks. The combined application of these tools has become the most accurate and important alternative to solve structural and stereochemical problems in natural product chemistry. Therefore, herein, in this case study, we intended to promote these novel tools, exploring the strengths and limitations of each approach in resolving the relative configuration of the sesquiterpene alpha-bisabol. We also highlighted the advantages of the complementary use of H- and C-DP4+ to obtain optimal results in the differentiation of the stereoisomers, validating the proposal with ANN-PRA method.

Revisiting the structure of Heliannuol L: A computational approach.

Recently, structural elucidation of natural products has undergone a revolution. The combined use of different modern spectroscopic methods has allowed obtaining a complete structural assignment of natural products using small amounts of sample. However, despite the extraordinary ongoing advances in spectroscopy, the mischaracterization of natural products has been and remains a recurrent problem, especially when the substance presents several stereogenic centers. The misinterpretation of nuclear magnetic resonance (NMR) data has resulted in frequent reports addressing structural reassignment. In this context, a great effort has been devoted to developing quantum chemical calculations that simulate NMR parameters accurately, allowing to achieve a more precise spectral interpretation. In this work, we employed a protocol for theoretical calculations of 1 H NMR chemical shifts and coupling constants using density functional theory (DFT), followed by the application of the DP4+ method to revisit the structure of Heliannuol L, a member of the Heliannuol class, isolated from Helianthus annuus. Our results indicate that the originally proposed structure of Heliannuol L needs a stereochemical reassignment, placing the hydroxyl bonded to C10 in the opposite side of the methyl and hydroxyl groups bonded to C7 and C8, respectively.

Determination of parabens in serum by liquid chromatography-tandem mass spectrometry: Correlation with lipstick use.

Parabens are the most widely used preservative and are considered to be relatively safe compounds. However, studies have demonstrated that they may have estrogenic activity, and there is ongoing debate regarding the safety and potential cancer risk of using products containing these compounds. In the present work, liquid chromatography-tandem mass spectrometry was applied to determine methylparaben and propylparaben concentrations in serum, and the results were correlated with lipstick application. Samples were analyzed using liquid-liquid extraction, followed by liquid chromatography-tandem mass spectrometry. The validation results demonstrated the linearity of the method over a range of 1-20 ng/mL, in addition to the method's precision and accuracy. A statistically significant difference was demonstrated between serum parabens in women who used lipstick containing these substances compared with those not using this cosmetic (p = 0.0005 and 0.0016, respectively), and a strong association was observed between serum parabens and lipstick use (Spearman correlation = 0.7202).

Absolute Configuration of (-)-Centratherin, a Sesquiterpenoid Lactone, Defined by Means of Chiroptical Spectroscopy.

(-)-Centratherin is a bioactive sesquiterpenoid lactone, whose absolute configuration (AC) was not established, but has been proposed based on those of germacrane precursors. To verify this proposal, the experimental electronic circular dichroism (ECD), electronic dissymmetry factor (EDF), optical rotatory dispersion (ORD), vibrational circular dichroism (VCD), and vibrational dissymmetry factor (VDF) spectra of (-)-centratherin have been analyzed with the corresponding density functional theoretical predictions. These analyses suggest the AC of naturally occurring (-)-centratherin to be (6R,7R,8S,10R,2'Z).

Oral health challenges in patients with chronic kidney disease: A comprehensive clinical assessment.

Loss of kidney function causes oral manifestations and multiple complications that have implications for dental treatment and patients' systemic conditions. We aimed to determine the clinical condition, epidemiological profile, and incidence of dental caries in patients with chronic kidney disease (CKD). This was an observational, cross-sectional, field study using a quantitative and epidemiological approach. The sample consisted of 45 randomly selected patients with CKD from a total of 114 patients. Data were collected through oral clinical examination, anamnesis, and medical records compiled in a clinical file specially developed for this research. Clinical evaluation was performed, including a Decayed, Missing, and Filled Teeth (DMFT) index examination. Data were analyzed using the Shapiro-Wilk test, Mann-Whitney test, and Spearman's rho coefficient. All analyses were performed using IBM SPSS Statistics software version 20.0, with a confidence interval of 95 % and significance level of 5 % (p < 0.05). The results indicated that CKD is more prevalent in the 5th decade of life, with a slight predilection for men. Oral cavity alterations were observed in 77.8 % of patients. The study population had a very high DMFT index, with a high number of missing teeth and a low number of decayed and filled teeth. Poor oral health in patients with CKD indicates a lack of care that supports the necessity of installing a preventive and therapeutic oral program and a regular follow-up aimed at this group of patients.

Renal health: Evaluation of the spontaneous use of a new m-health technology and validation of its content to support patients undergoing peritoneal dialysis.

INTRODUCTION: Chronic kidney disease is a worldwide public health problem, with a high prevalence of patients on dialysis. mHealth technologies can greatly support the treatment and monitoring of these patients. Thus, this study aimed to evaluate the spontaneous use of the application (app) Renal Health, a previously available technology, for patients on hemodialysis and validate content to support patients undergoing peritoneal dialysis. METHODS: The first stage consisted of evaluating the spontaneous use of the app, and the second stage consisted of methodological research for the development, evaluation, and improvement of a technological instrument for use in clinical practice as a support for patients undergoing peritoneal dialysis (PD). The association between categorical variables was performed using the chi-square test, adopting a significance level of 5%. RESULTS: The app was accessed by 753 users and of these, 34 % accessed the hemodialysis section. Most accesses were in the state of São Paulo/Brazil and performed by women. The records of biochemical tests did not vary according to gender and age group (p > 0.05). The developed and validated PD section enables section control, allowing the user to manage their sessions. The analysis of the technology by the specialists showed good results for the global content validity index (CVI) regarding objectives (CVI = 0.95), structure (CVI = 0.97), and relevance (CVI = 1.0). CONCLUSION: It is concluded that the hemodialysis section of the Renal Health app aroused the interest of the population and that the developed peritoneal dialysis section was validated by specialists.

Milligram scale enantioresolution of promethazine and its main metabolites, determination of their absolute configuration and assessment of enantioselective effects on human SY-SY5Y cells.

The misuse of pharmaceuticals has significantly increased in recent decades, becoming a major public health concern. The risks associated with medication misuse are particularly high in cases of overdose, especially when the active substances are chiral, as enantioselectivity plays an important role in toxicity. Promethazine (PMZ) is a chiral antihistamine marketed as a racemate and it is misused in "Purple Drank", a recreational drug beverage, that combines codeine and/or PMZ, with soda or alcohol leading to serious health consequences and fatalities in consumers around the world, particularly among teenagers. Information regarding the enantioselectivity in the toxicity of (R,S)-PMZ and its main metabolites, namely promethazine sulfoxide (PMZSO) and desmonomethyl promethazine (DMPMZ), is unknown. This work reported, for the first time, the enantioseparation, in milligram scale, of (R,S)-PMZ, (R,S)-DMPMZ, (R,S)- PMZSO and the determination of their absolute configurations by electronic circular dichroism (ECD). The enantioseparation of all the six enantiomers was accomplished in a homemade semi-preparative column with amylose tris-3,5-dimethylphenylcarbamate (AD) coated with aminopropyl Nucleosil silica. The enantiomeric purity was evaluated using the analytical Lux® 3 µm i-Amylose-3 column, yielding enantiomeric purity values ranging between 94.4% and 99.7%. The elution order of all the enantiomers was accomplished combining the ECD results with an optical rotation detector. The elution order of the enantiomers was influenced only by the chiral selector, rather than the mobile phase. The cytotoxicity of the racemates and the isolated enantiomers towards differentiated SH-SY5Y cells was evaluated. (R,S)-DMPMZ exhibited a significantly higher cytotoxicity than (R,S)-PMZ, suggesting the metabolic bioactivation of (R,S)-PMZ. Conversely, no significant cytotoxicity was found for (R,S)-PMZSO, underscoring a metabolic detoxification pathway. Remarkably, enantioselectivity was observed for the cytotoxicity of PMZ; (R)-PMZ was significantly more cytotoxic than (S)-PMZ. The results underscore the importance to isolate the enantiomers in their enantiomerically form and their correct identification for toxicity enantioselectivity studies, which are vital to understand the drug's behaviour and safety, especially in case of overdoses.

3-Ishwarone, a rare ishwarane sesquiterpene from Peperomia scandens Ruiz & Pavon: structural elucidation through a joint experimental and theoretical study.

3-Ishwarone, (1), a sesquiterpene with a rare ishwarane skeleton, was isolated from Peperomia scandens Ruiz & Pavon (Piperaceae). Its structure was unambiguously determined by 1D- and 2D-NMR and infrared analyses, as well as by comparative theoretical studies which involved calculations of 13C-NMR chemical shifts, using the Density Functional Theory (DFT) with the mPW1PW91 hybrid functional and Pople's 6-31G(d) basis set, and of vibrational frequencies, using the B3LYP hybrid functional and triple ζ Dunning's correlation consistent basis set (cc-pVTZ), of (1) and three of its possible diastereomers, compounds 2-4.

Population knowledge on chronic kidney disease, its risk factors and means of prevention: a population-based study in Fortaleza, Ceará, Brazil.

INTRODUCTION: Chronic kidney disease (CKD) has been increasing significantly. There is evidence that a large part of the population does not have enough knowledge on the subject. OBJECTIVE: To investigate the level of knowledge about CKD in the general population, its risk factors and means of prevention. METHODS: We ran a cross-sectional study in the population of Fortaleza, Ceará - Brazil, between 2017 and 2020, with the application of a questionnaire on CKD, risk factors and prevention. RESULTS: we interviewed 735 volunteers, with a mean age of 38 years, of which 55% were female. Only 17.2% correctly responded to the concept of CKD, and 5.8% knew the concept of creatinine. Low water intake was the most cited risk factor by respondents (79.3%). The main risk factors and direct causes of CKD (diabetes and hypertension) were mentioned less frequently (13.2% and 15.1%, respectively). Men were more correct regarding risk factors and ways to prevent CKD. Older respondents answered more correctly the questions about the definition of CKD (n = 22; 28.6%) and creatinine (n = 7; 9.0%). With regards to education there was a statistically significant correlation in all the questions (p < 0.05). CONCLUSION: There is little knowledge about CKD in the general population. Higher level of education is associated with better knowledge. More health education actions are needed so that the population becomes better acquainted with CKD and, consequently, can adopt more adequate prevention and control measures.

Theoretical study of keto-enol tautomerism in 7-epi-clusianone by quantum chemical calculations of NMR chemical shifts.

Plants from the Garcinia genus have been used worldwide due to their therapeutic properties. Among the various metabolites isolated from this genus, 7-epi-clusianone, a tetraprenylated benzophenone, stands out for its wide range of identified biological activities. This benzophenone can exist in five tautomeric forms, although the benzene-d6 and chloroform-d3 solution nuclear magnetic resonance (NMR) spectra revealed only two tautomeric forms (B and C) in equilibrium, with concentration ratio depending on the solvent in which the spectrum was obtained. Calculated energy values suggested that tautomeric forms B and E would be prevalent in benzene-d6 solution, in contrast to the experimental data. Considering this conflicting result, we employed the statistical DP4 + method based on 13C and 1H NMR chemical shift calculations, in the gas phase and in benzene-d6 solution, to confirm that the B and C tautomeric forms of 7-epi-clusianone are the most prevalent in the experimental conditions.

Renal Health: Providing Information and Technological Tools to Empower Patients to Live Better with Kidney Disease.

Chronic kidney disease (CKD) is a growing Public Health problem. Recent evidence points that low education and poor socio-economic conditions are associated with higher risk of developing CKD and progressing to dialysis or transplantation need. Hence patient empowerment through health education and qualification with technological tools that allows better treatment adherence may play an important role in the achievement of optimal clinical outcomes. The Renal Health is a multidisciplinary project created at the University of Fortaleza, northeast Brazil, in 2015, aiming to create novel educational material and technological tools for people with CKD, in different treatment modalities, including dialysis and transplant. The products developed so far in the project include an application for smartphones aiming to help patients in dialysis and transplant in their treatments, including schedule for medications, with alarms, water ingestion control, laboratory tests results, and medical appointments' agenda, besides all information regarding CKD. The other tools include a medication box, an insole for weight control (both are in the prototype phase), connection with smartbands (for vital signs monitoring) and multimedia educational tools, including a profile in the Instagram and a channel in YouTube. Since the first release of the application in the virtual stores, there were more than 1,000 downloads, predominantly in Brazil, although the app is also available in English and Spanish. All these tools represent innovative ways of patient empowerment and may be increasingly present in daily life. Further studies are required to assess the impact of these tools in patients' outcomes, including CKD progression and mortality.

Population knowledge on chronic kidney disease, its risk factors and means of prevention: a population-based study in Fortaleza, Ceará, Brazil / Conhecimento da população sobre a doença renal crônica, seus fatores de risco e meios de prevenção: um estudo de base populacional em Fortaleza, Ceará, Brasil

ABSTRACT Introduction: Chronic kidney disease (CKD) has been increasing significantly. There is evidence that a large part of the population does not have enough knowledge on the subject. Objective: To investigate the level of knowledge about CKD in the general population, its risk factors and means of prevention. Methods: We ran a cross-sectional study in the population of Fortaleza, Ceará - Brazil, between 2017 and 2020, with the application of a questionnaire on CKD, risk factors and prevention. Results: we interviewed 735 volunteers, with a mean age of 38 years, of which 55% were female. Only 17.2% correctly responded to the concept of CKD, and 5.8% knew the concept of creatinine. Low water intake was the most cited risk factor by respondents (79.3%). The main risk factors and direct causes of CKD (diabetes and hypertension) were mentioned less frequently (13.2% and 15.1%, respectively). Men were more correct regarding risk factors and ways to prevent CKD. Older respondents answered more correctly the questions about the definition of CKD (n = 22; 28.6%) and creatinine (n = 7; 9.0%). With regards to education there was a statistically significant correlation in all the questions (p < 0.05). Conclusion: There is little knowledge about CKD in the general population. Higher level of education is associated with better knowledge. More health education actions are needed so that the population becomes better acquainted with CKD and, consequently, can adopt more adequate prevention and control measures.

Resumo Introdução: A doença renal crônica (DRC) vem aumentando de forma significativa. Há evidências de que grande parte da população não tem conhecimento suficiente sobre o assunto. Objetivo: Investigar na população geral o nível de conhecimento sobre a DRC, seus fatores de risco e meios de prevenção. Métodos: Foi realizado estudo transversal na população de Fortaleza, Ceará, Brasil, entre 2017 e 2020, com aplicação de um questionário sobre DRC, fatores de risco e prevenção. Resultados: Foram entrevistados 735 voluntários, com média de idade de 38 anos, dos quais 55% eram do sexo feminino. Apenas 17,2% responderam corretamente ao conceito de DRC, e 5,8% sabiam o conceito de creatinina. A baixa ingestão hídrica foi o fator de risco mais citado pelos entrevistados (79,3%). Os principais fatores de risco e as causas diretas de DRC (diabetes e hipertensão) foram mencionados com menor frequência (13,2% e 15,1%, respectivamente). Os homens tiveram maior acerto com relação aos fatores de risco e às formas de prevenção da DRC. Os entrevistados com idade mais avançada responderam mais corretamente às perguntas sobre a definição de DRC (n = 22; 28,6%) e creatinina (n = 7; 9,0%). No que diz respeito à escolaridade, em todas as perguntas houve correlação estatisticamente significativa (p < 0,05). Conclusão: Há um baixo nível de conhecimento sobre a DRC na população geral. Maior nível de escolaridade associa-se a um melhor conhecimento. São necessárias mais ações de educação em saúde para que a população conheça melhor a DRC e consequentemente possa adotar medidas de prevenção e controle mais adequadas.

Structural determination of complex natural products by quantum mechanical calculations of (13)C NMR chemical shifts: development of a parameterized protocol for terpenes.

Nuclear magnetic resonance (NMR) spectroscopy is one of the most important tools for determining the structures of organic molecules. Despite the advances made in this technique, revisions of erroneously established structures for natural products are still commonly published in the literature. In this context, the prediction of chemical shifts through ab initio and density functional theory (DFT) calculations has become a very powerful tool for assisting with the structural determination of complex organic molecules. In this work, we present the development of a protocol for (13)C chemical shift calculations of terpenes, a class of natural products that are widely distributed among plant species and are very important due to their biological and pharmacological activities. This protocol consists of GIAO-DFT calculations of chemical shifts and the application of a parameterized scaling factor in order to ensure accurate structural determination of this class of natural products. The application of this protocol to a set of five terpenes yielded accurate calculated chemical shifts, showing that this is a very attractive tool for the calculation of complex organic structures such as terpenes.

Diazepam influences urinary bioindicator of occupational toluene exposure.

In the present study, we investigated the influence of diazepam (DZP) on the excretion of TOL by examining their urinary metabolites, hippuric acid (HA) and ortho-cresol (o-C). Male Wistar rats were exposed to TOL (20ppm) in a nose-only exposure chamber (6h/day, 5days/week for 6 weeks) with simultaneous administration of DZP (10mg/kg/day). Urinary o-C levels were determined by GC-MS, while HA, creatinine (CR), DZP and its metabolite, nordiazepam, were analysed by HPLC-DAD. The results of a Mann-Whitney U test showed that DZP influenced the urinary excretion of o-C (p<0.05). This pioneering study revealed that there was an interaction between DZP and TOL, probably by the inhibition of the CYP isoforms (CYP2B6, CYP2C8, CYP2E1, and CYP1A2) involved in the oxidative metabolism of the solvent. This is relevant information to be considered in the biomonitoring of occupational toluene exposure.

Amelogênese imperfeita do tipo hipoplásica: relato de dois casos familiares / Amelogénesis imperfecta del tipo hipoplásico: informe de dos casos familiares / Hypoplastic amelogenesis imperfecta: report of two family cases

RESUMO Introdução: Diariamente o cirurgião dentista se depara com diversos casos que exigem acurácia no diagnóstico inicial e atenção para o tratamento que irá ser proposto, uma dessas é a amelogênese imperfeita, que é uma rara alteração dentária de caráter hereditário. As características principais da amelogênese imperfeita são hipomineralização ou hipoplasia da matriz de esmalte, o que ocasiona descoloração, sensibilidade e fragilidade deste tecido, apresentando diferentes subtipos clínicos, sendo a variante hipoplásica a mais prevalente. Objetivo: Relatar dois casos de amelogênese imperfeita do tipo hipoplásica entre membros de uma mesma família, correlacionando-os. Apresentação do caso: O diagnóstico foi feito através dos exames clínico e radiográfico, além da correlação entre os achados clínicos encontrados em cada paciente e com outros familiares, sendo proposto um plano de tratamento multidisciplinar e consistente com a condição adequada. Conclusões: É importante para o cirurgião dentista estudar e conhecer essas alterações raras para poder estabelecer diagnóstico preciso. Além disso, deve-se ampliar a conduta clínica através de um planejamento individualizado e/ou familiar, tratando não apenas aspectos estéticos e funcionais, mas também psicológico e sociais(AU)

RESUMEN Introducción: Diariamente el cirujano dentista se enfrenta a varios casos que exigen precisión en el diagnóstico inicial y atención para el tratamiento que se propondrá, una de las cuales es la amelogénesis imperfecta, que es un rara alteración dental de carácter hereditario. Las características principales de la amelogénesis imperfecta son hipomeralización o hipoplasia de la matriz de esmalte, lo que ocasiona decoloración, sensibilidad y fragilidad de este tejido, con la presencia de diferentes subtipos clínicos, siendo la variante hipoplásica la más prevalente. Objetivo: Informar dos casos de amelogénesis imperfecta del tipo hipoplásica entre miembros de una misma familia, correlacionándolos. Presentación del caso: El diagnóstico se realizó a través de los exámenes clínicos y radiográficos, además de la correlación entre los hallazgos clínicos encontrados en cada paciente y con otros familiares, por lo que fue propuesto un plan de tratamiento multidisciplinario y consistente con la condición adecuada. Conclusiones: Es importante para el cirujano dentista que estudie y conozca estos cambios raros para poder establecer un diagnóstico preciso. Además, se debe ampliar la conducta clínica a través de una planificación individualizada y / o familiar, tratando no solo aspectos estéticos y funcionales, sino también psicológicos y sociales(AU)

ABSTRACT Introduction: Dental surgeons are confronted every day with several cases that require accuracy in the initial diagnosis and attention to the treatment that will be proposed. One of these is amelogenesis imperfecta, a rare hereditary tooth alteration. The main features of amelogenesis imperfecta are hypomineralization or hypoplasia of the enamel matrix resulting in discoloration, sensitivity and fragility of this tissue. Of the existing clinical subtypes, the hypoplastic variant is the most prevalent. Objective: Report and correlate two cases of hypoplastic amelogenesis imperfecta in members of the same family. Case presentation: The diagnosis was based on clinical and radiographic examination, as well as analysis of the correlation between the clinical findings obtained from each patient and other relatives. The treatment plan proposed was therefore multidisciplinary and appropriately consistent with the condition. Conclusions: It is important for dental surgeons to study and be aware of these rare changes to be able to establish an accurate diagnosis. On the other hand, clinical management should be broadened through individualized and/or family planning, paying attention not only to esthetic and functional aspects, but psychological and social as well(AU)

Psoríase com manifestação oral exclusiva / Psorías con manifestación bucal exclusiva / Exclusively oral psoriasis

RESUMO Introdução: a psoríase é uma doença inflamatória crônica e recorrente da pele que raramente ocorre apenas e primariamente na mucosa bucal. Objetivo: A descrever um caso de psoríase primária na mucosa bucal. Apresentação do caso: Um paciente de 16 anos de idade relatou uma "mancha que fez com que se sentisse desconfortável". O paciente apresentava uma placa leucoplásica, exofítica e uma úlcera. Na histopatologia e com as características clínicas, a suspeita de mucosite psoriasiforme foi confirmada. O tratamento escolhido para as lesões da psoríase foi a aplicação tópica de valerato de betametasona 1 mg/g por três semanas. Após duas semanas de tratamento, o paciente retornou para reavaliação clínica e foi observado sucesso na terapêutica. Conclusões: A presença de psoríase exclusiva na cavidade bucal é uma entidade rara. A apresentação clínica variada e a ausência de alterações locais ou sistêmicas associadas foram elementos-chave na suspeição diagnóstica. A abordagem por meio de cirurgia para remoção da lesão exofítica e o uso de betametasona tópica permitiram o controle locorregional(AU)

RESUMEN Introducción: La psoriasis es una enfermedad inflamatoria crónica y recurrente de la piel y que en rara ocasión ocurre única y por primaria vez en mucosa bucal. Objetivo: Describir un caso de psoriasis primaria en mucosa bucal. Presentación de caso: Paciente de 16 años de edad consultada que refirió una "mancha que incomodaba al comer". La paciente presentaba una placa leucoplásica, exofítica y una úlcera. En la histopatología y con las características clínicas, se confirmó la sospechosa de mucositis psoriasiforme. El tratamiento elegido para las lesiones de psoriasis fue la aplicación tópica de valerato de betametasona 1 mg/g durante tres semanas. Después de dos semanas de tratamiento la paciente retornó para reevaluación clínica y se constató éxito en la terapéutica escogida. Conclusiones: la presencia de psoriasis exclusiva en la cavidad bucal es una entidad poco frecuente. La presentación clínica variada y la ausencia de alteraciones locales o sistémicas asociadas fueron elementos clave en la sospecha diagnóstica. El abordaje por medio de cirugía para remoción de la lesión exofítica y utilización de betametasona tópica posibilitó el control locorregional(AU)

ABSTRACT Introduction: Psoriasis is a chronic inflammatory and recurrent skin disease that rarely occurs solely and primarily in the oral mucosa. Objective: Describe a case of primary psoriasis of the oral mucosa. Case presentation: A 16-year-old female patient attends consultation and reports "a spot that hurts when eating." Clinical observation revealed the presence of leukoplastic, exophytic plaque and an ulcer. Histopathological examination confirmed the suspicion of psoriasiform mucositis. The treatment chosen for the psoriatic lesions was topical application of betamethasone valerate 1 mg/g for three weeks. After two weeks of treatment, the patient returned for clinical reassessment and the treatment applied was found to have been successful. Conclusions: Exclusively oral psoriasis is an uncommon condition. Multi-faceted clinical presentation and the absence of local or systemic associated alterations were key elements in the diagnostic suspicion. Surgical removal of the exophytic lesion and application of topical betamethasone led to locoregional control(AU)

Perfil epidemiológico de casos de sífilis em gestantes em uma maternidade pública / Perfil epidemiológico de los casos de sífilis en embarazadas en una maternidad pública / Epidemiological profile of syphilis cases in pregnant in a public maternity

OBJETIVO: O objetivo do estudo foi analisar operfil epidemiológico dos casos de sífilisem gestante em uma maternidade deTeresina, Piauí, em 2016. MÉTODO: Pesquisa epidemiológica descritiva e documental, com abordagem quantitativa, realizado no Serviço de Vigilância Epidemiológica da referida maternidade, de novembro de 2016 a janeiro de 2017, a partir de dados do Sistema de informação de Agravos de Notificação (SINANNET). Os dados foram estratificados segundo: faixa etária, escolaridade, idade gestacional no diagnóstico, titulação do teste não treponêmico, a classificação da sífilis e adesão do parceiro. RESULTADO SE DISCUSSÃO: Em relação a prevalência, no ano de 2016 foram notificados setenta e cinco casos, que corresponde a 2,8%. A doença mostrou-se prevalente nas mulheres na faixa etária de 20 a 29 anos e que cursaram ensino fundamental incompleto. A maioria (77,33%) foi diagnosticada no terceiro trimestre, 22,7% das gestantes apresentaram VRDL de 1:16, a classificação clinica mais incidente foi a terciária e latente com 61,33% dos casos, com relação à adesão dos parceiros, somente 32% realizaram tratamento. CONCLUSÕES: É necessário um diagnóstico, tratamento e seguimento rigorosos na tentativa de reduzir os casos de sífilis em gestantes e sífilis congênita, assim como romper a cadeia de transmissão com estratégias e ações direcionadas no combate à doença

OBJETIVO: El objetivo del estudio fue analizar el perfil epidemiológico de casos de sífilis en gestantes en una maternidad de Teresina, Piauí, en 2016. MÉTODO: Investigación epidemiológica descriptiva y documental, con abordaje cuantitativo, realizada en el Servicio de Vigilancia Epidemiológica de la referida maternidad, desde noviembre de 2016 hasta enero de 2017, con datos del Sistema de Información de Agravios de Notificación (SINANNET). Los datos fueron estratificados según: grupo de edad, escolaridad, edad gestacional en el diagnóstico, titulación del test no treponémico, clasificación de sífilis y adhesión del socio. RESULTADOS Y DISCUSIÓN: En relación a la prevalencia, en el año 2016 se notificaron 75 casos, lo que corresponde al 2,8%. La enfermedad fue prevalente en mujeres de 20 a 29 años y que cursaron enseñanza fundamental incompleta. La mayoría (77,33%) fue diagnosticada en tercer trimestre, 22,7% de las gestantes presentaron VRDL de 1:16, la clasificación clínica más incidente fue la terciaria y latente con 61,33% de casos, con relación a la adhesión de los socios, sólo 32% realizaron tratamiento. CONCLUSIONES: Es necesario diagnóstico, tratamiento y seguimiento rigurosos con intento de reducir los casos de sífilis en gestantes y sífilis congénita, así como romper la cadena de transmisión con estrategias y acciones dirigidas a combatir la enfermedad

OBJECTIVE: The objective of the study was to analyze the epidemiological profile ofsyphilis cases in pregnant women in a maternity hospital from Teresina, Piauí, in 2016. METHOD: Descriptive and documental epidemiological research with quantitative approach, carried out at the Epidemiological Surveillance Service of the maternity, from November 2016 to January 2017, based on data from the Notification of Injury Information System (SINANNET). Data were stratified according to age group, education, gestational age in diagnosis, titration of the non-treponemic test, syphilis classification and partner adherence. RESULTS: and DISCUSSION: In relation to the prevalence, seventy-five cases were notified in 2016, corresponding to 2,8%. The disease was prevalent in women aged from 20 to 29 years old who had incomplete elementary school education. The majority (77,33%) were diagnosed in third trimester, 22,7% of the pregnant women presented VDRL of 1:16, the most frequent clinical classification was tertiary and latent with 61,33% of the cases, with regard to the partners' adherence, only 32% performed the treatment. CONCLUSIONS: It's necessary a rigorous diagnosis, treatment and follow-up in the attempt to reduce cases of syphilis in pregnant women and congenital syphilis, as well as to break the chain of transmission with directed strategies and actions in the fight against the disease

Análise radiográfica e tomográfica da íntima relação dos terceiros molares inferiores com o canal mandibular / Radiographic and tomographic analysis of the relationship between inferior third molars and the mandibular canal

Objetivo: Avaliar a íntima relação entre os terceiros molares inferiores impactados e o canal mandibular, em imagens panorâmicas e de tomografia computadorizada de feixe cônico. Métodos: O universo foi constituído por 432 tomografias computadorizadas de feixe cônico (TCFC) e 713 radiografias panorâmicas. Obteve-se uma amostra de 13 pares de exames (radiografia panorâmica e TCFC), totalizando 20 dentes de pacientes atendidos em um serviço de radiologia odontológica particular da cidade de Patos - PB. Foram realizadas análises dos exames por dois avaliadores em dois momentos. As radiografias panorâmicas foram analisadas segundo as classificações de Winter, Félez-Gutiérrez e Koong. A TCFC foi considerada padrão-ouro para a avaliação. Os dados foram analisados de forma descritiva, utilizando o programa Microsoft Excel 2013, por meio de gráficos, tabelas e porcentagens. Resultados: Segundo a classificação de Winter, o posicionamento mais frequente dos terceiros molares inferiores foi o mesioangulado, os sinais radiográficos mais prevalentes foram o estreitamento do canal e ápices em ilha na classificação de Félez-Gutiérrez, e na classificação de Koong os sinais de estreitamento do canal e ápices superpostos foram os mais frequentes. Nas tomografias, o relacionamento mais frequente foi o canal passando inferiormente aos terceiros molares. Na comparação dos sinais radiográficos com o padrão-ouro, houve 45% de falso-positivos, tanto na classificação de FélezGutiérrez como na de Koong. Conclusão: A TCFC é o exame de escolha para o planejamento cirúrgico, nos casos onde há íntimo contato entre os terceiros molares inferiores com o canal mandibular

Objetctive: This research aimed to evaluate the intimate relationship between impacted lower third molars and the mandibular canal in panoramic images and cone beam computed tomography (CBCT). Methods: The sample consisted of 432 CBCTs and 713 panoramic radiographs. A sample of 13 pairs of exams (panoramic radiography and CBTC) were obtained, totaling 20 teeth from patients who received dental care at a private radiology unit in the city of Patos, PB, Brazil. Two different examiners carried out the analysis in two distinct moments. The panoramic radiographs were analyzed according to Winter, Félez-Gutierrez, and Koong classifications. The CBTC was considered the gold standard for the evaluation. Data were analyzed descriptively by using the Microsoft Excel 2013 program, through graphs, charts, and percentages. Results: According to the Winter classification, the most frequent position of the lower third molars was Mesio Angular. The most prevalent radiographic signs were narrowed channel and islet-shaped apex in the Félez-Gutiérrez classification, while in the Koong classification, the signs of narrowed channel and superimposed apexes were the most frequent. In the CBCT scans, the most frequent relationship was the channel passing below the third molars. In the comparison of the radiographic signs with the gold standard, 45% of false positives were found in both the Félez-Gutiérrez and Koong classifications. Conclusion: The CBTC is the best choice for the surgical plan, especially in the cases in which there is intimate contact between the lower third molars and the mandibular canal

RELAÇÃO ENTRE DESORDENS TEMPOROMANDIBULARES (DTM) E PACIENTES PORTADORES DE PRÓTESES PARCIAIS REMOVÍVEIS / RELATIONSHIP BETWEEN TEMPOROMANDIBULAR DISORDERS (DTM) AND PATIENTS WITH PARTIAL REMOVABLE PROSTHESIS

Apesar de todos os avanços a dor ainda é um dos problemas que afetam a qualidade de vida das pessoas, podendo estar relacionada às Desordens Temporomandibulares (DTMs), que muitas vezes são diagnosticadas de forma errônea. Esses desdentados parciais podem optar pelo não uso das próteses parciais removíveis (PPRs) contribuindo para um colapso no sistema estomatognático assim como nas articulações temporomandibulares. Caso a opção seja a reposição dos dentes perdidos pela PPR, devemos estar atentos para a confecção deste tipo de prótese, seguindo critérios que devem ser obedecidos tanto na sua confecção como em função e o não respeito a esses parâmetros podem levar a danos ao sistema estomatognático. Por este motivo essa revisão de literatura busca evidenciar, se a PPR pode ser um dos fatores relacionados ao aparecimento da DTM e de que forma poderíamos fazer com que a PPR proteja também a articulação temporomandibular. A metodologia adotada consistiu em uma revisão bibliográfica, através de livros texto, monografias e artigos científicos coletados nas bases de dados: Medline/Pubmed; Scielo; Periódicos CAPES e Lilacs. Concluiu-se nesse estudo que o uso da PPR bem confeccionada, adaptada, respeitando os princípios básicos de execução e função, não leva ao aparecimento de DTMs por si só e que essa relação entre DTMs e PPR é possível quando se negligenciam esses princípios tanto por parte dos laboratórios de prótese, quanto por parte do Cirurgião-Dentista.

Despite all the advances, pain is still one of the problems that affect the quality of life, and may be related to temporomandibular disorders (TMD), which are often wrongly diagnosed. These partial edentulous may choose for not using of removable partial dentures (RPD), contributing to a collapse in the stomatognathic system and temporomandibular joint, if the option is the replacement of missing teeth by RPD, we should pay attention to the making of this type of prosthesis, following criteria that must be met, both in its production as a function, and failure to comply with these parameters can lead to damage to the stomatognathic system. For this reason, this literature review seeks to show if the RPD can be one of the factors related to the onset of TMD and which other way we could also make the RPD to protect the temporomandibular joint. The methodology consisted of a literature review, through textbooks, monographs and scientific articles collected in databases: Medline/Pubmed; SciELO, CAPES Periodicals and Lilacs. It was concluded in this study that the use of well prepared RPD, adapted, which respects the basic principles of implementation and function, does not lead to the onset of TMD itself and that this relationship between TMD and RPD is possible when neglect these principles both part of prosthetic laboratories, as by the Dental Surgeon.