Efficiency of mixed and rigid occlusal stabilization splints: Randomized clinical trial

Abstract Occlusal stabilization splints are the most common treatment for controlling the deleterious effects of sleep bruxism. This study aimed to evaluate the effectiveness of a low-cost, mixed occlusal splint (MOS) compared to that of a rigid splint. A randomized clinical trial was performed on 43 adults of both sexes with possible sleep bruxism and satisfactory dental conditions. They were divided into rigid occlusal splint (ROS) (n = 23) and MOS (n = 20) groups. Masticatory muscle and temporomandibular joint (TMJ) pain intensity (visual analog scale), quality of life (WHOQOL-BREF), indentations in the oral mucosa, anxiety, and depression (HADS), number of days of splint use, and splint wear were evaluated. All variables were evaluated at baseline (T0), 6 months (T6), and 12 months (T12) after splint installation (T0), and splint wear was evaluated at T6 and T12. Student's t-test, Mann-Whitney U test, non-parametric Friedman's analysis of variance for paired samples and pairwise multiple comparisons, Pearson's chi-square test, two-proportion z-test, non-parametric McNemar's and Cochran's Q, and Wilcoxon tests were used (p < 0.05). In both groups, there was a decrease in TMJ pain and pain intensity over time and improvements in the quality of life scores. At T6, there was a higher rate of splint wear in the MOS group than in the ROS group (p = 0.023). The MOS showed a higher rate of wear than the rigid splint but had similar results for the other variables. Therefore, the use of a mixed splint appears to be effective in controlling the signs and symptoms of sleep bruxism.

Factors associated with extreme weight loss behaviors among adolescents of Northeastern Brazil: a hierarchical approach / Comportamentos extremos para perda de peso e fatores associados em adolescentes do Nordeste brasileiro: uma abordagem hierárquica

Abstract The objective of this article is to identify the prevalence and evaluate the factors associated with extreme weight loss behaviors among adolescents of Northeastern Brazil. Cross-sectional study with 2,439 adolescents from Sample 2 (2015) of the National School-based Health Survey. Extreme weight loss behaviors, such as self-induced vomiting, laxative use and use of medicines or formulas (outcome) and independent variables were evaluated using a self-administered electronic questionnaire. The statistical analysis was performed following a hierarchical conceptual model. The prevalence of extreme weight loss behaviors in the sample was 12.1%. Among the factors that showed significant association with the outcome, we emphasize the administration model of the private school (PR = 0.62; CI = 0.46-0.84), bullying related to body appearance and for other reasons (PR = 1.62; CI = 1.19-2.20), forced sexual intercourse (PR = 2.65; CI = 1.90-3.69), insomnia (PR = 1.84; CI = 1.43-2.37), and be perceived as fat or very fat (PR = 1.90; CI = 1.50-2.42). Moderate prevalence of extreme weight loss behaviors was identified among adolescents. Socioeconomic factors, exposure to violence, mental health, and body image were associated with the adoption of these behaviors.

Resumo O objetivo deste artigo é identificar a prevalência e avaliar os fatores associados aos comportamentos extremos para perda de peso em adolescentes do Nordeste brasileiro. Estudo transversal com 2.439 adolescentes da Amostra 2 (2015) da Pesquisa Nacional de Saúde do Escolar. Os comportamentos extremos para perda de peso (desfecho) e as variáveis independentes foram avaliadas por meio de um questionário eletrônico autoaplicável. A análise estatística foi realizada seguindo um modelo conceitual hierárquico. A prevalência de comportamentos extremos para perda de peso na amostra foi de 12,1%. Entre os fatores que mostraram associação significativa com o desfecho, destacam-se a situação administrativa da escola privada (RP = 0,62; IC = 0,46-0,84), ser vítima bullying relacionado à aparência corporal e pelos demais motivos (RP = 1,62; IC = 1,19-2,20), ser forçado a ter relação sexual (RP = 2,65; IC = 1,90-3,69), ter insônia (RP = 1,84; IC = 1,43-2,37) e se autoperceber como gordo ou muito gordo (RP = 1,90; IC = 1,50-2,42). Prevalência moderada de comportamentos extremos para perda de peso foi identificada entre os adolescentes. Os fatores socioeconômicos, de exposição à violência, de saúde mental e da imagem corporal se associaram à adoção de tais comportamentos.

Chronic exposure to lipopolysaccharides as an in vitro model to simulate the impaired odontogenic potential of dental pulp cells under pulpitis conditions

Abstract Simulating a bacterial-induced pulpitis environment in vitro may contribute to exploring mechanisms and bioactive molecules to counteract these adverse effects. Objective To investigate the chronic exposure of human dental pulp cells (HDPCs) to lipopolysaccharides (LPS) aiming to establish a cell culture protocol to simulate the impaired odontogenic potential under pulpitis conditions. Methodology HDPCs were isolated from four healthy molars of different donors and seeded in culture plates in a growth medium. After 24 h, the medium was changed to an odontogenic differentiation medium (DM) supplemented or not with E. coli LPS (0 - control, 0.1, 1, or 10 µg/mL) (n=8). The medium was renewed every two days for up to seven days, then replaced with LPS-free DM for up to 21 days. The activation of NF-κB and F-actin expression were assessed (immunofluorescence) after one and seven days. On day 7, cells were evaluated for both the gene expression (RT-qPCR) of odontogenic markers (COL1A1, ALPL, DSPP, and DMP1) and cytokines (TNF, IL1B, IL8, and IL6) and the production of reactive nitrogen (Griess) and oxygen species (Carboxy-H2DCFDA). Cell viability (alamarBlue) was evaluated weekly, and mineralization was assessed (Alizarin Red) at 14 and 21 days. Data were analyzed with ANOVA and post-hoc tests (α=5%). Results After one and seven days of exposure to LPS, NF-κB was activated in a dose-dependent fashion. LPS at 1 and 10 µg/mL concentrations down-regulated the gene expression of odontogenic markers and up-regulated cytokines. LPS at 10 µg/mL increased both the production of reactive nitrogen and oxygen species. LPS decreased cell viability seven days after the end of exposure. LPS at 1 and 10 µg/mL decreased hDPCs mineralization in a dose-dependent fashion. Conclusion The exposure to 10 µg/mL LPS for seven days creates an inflammatory environment that is able to impair by more than half the odontogenic potential of HDPCs in vitro, simulating a pulpitis-like condition.

Assessment of the regenerative potential of macro-porous chitosan-calcium simvastatin scaffolds on bone cells

Abstract This study evaluated the bioactive potential of a macro-porous chitosan scaffold incorporated with calcium hydroxide (CH-Ca) and functionalized with bioactive doses of simvastatin (SV) for bone tissue regeneration. Initially, the bioactive dose of SV in osteoblastic cells (SAOS-2) was determined. For the direct contact experiment, SAOS-2 cells were plated on scaffolds to assess cell viability and osteogenic differentiation. The second assay was performed at a distance using extracts from scaffolds incubated in culture medium to assess the effect of conditioned medium on viability and osteogenic differentiation. The initial screening showed that 1 μM SV presented the best biostimulating effects, and this dose was selected for incorporation into the CH-Ca and pure chitosan (CH) scaffolds. The cells remained viable throughout the direct contact experiment, with the greatest cell density in the CH-Ca and CH-Ca-SV scaffolds because of their higher porosity. The CH-Ca-SV scaffold showed the most intense bio-stimulating effect in assays in the presence and absence of osteogenic medium, leading to an increased deposition of mineralized matrix. There was an increase in the viability of cells exposed to the extracts for CH-Ca, CH-SV, and CH-Ca-SV during the one-day period. There was an increase in ALP activity in the CH-Ca and CH-Ca-SV; however, the CH-Ca-SV scaffold resulted in an intense increase in the deposition of mineralized nodules, approximately 56.4% at 7 days and 117% at 14 days, compared with CH (control). In conclusion, functionalization of the CH-Ca scaffold with SV promoted an increase in bioactivity, presenting a promising option for bone tissue regeneration.

Pro-inflammatory mediators expression by pulp cells following tooth whitening on restored enamel surface

Abstract This paper aimed to assess the influence of adhesive restoration interface on the diffusion of hydrogen peroxide (H2O2), indirect toxicity, and pro-inflammatory mediators expression by odontoblast-like cells, after in-office tooth whitening. Dental cavities prepared in bovine enamel/dentin discs were adhesively restored and subjected or not to hydrolytic degradation (HD). A whitening gel with 35% H2O2 (WG) was applied for 45 min onto restored and non-restored specimens adapted to artificial pulp chambers giving rise to the groups: SD- intact discs (control); SD/HP- whitened intact discs; RT/HP- restored and whitened discs; and RT/HD/HP- restored and whitened discs subjected to HD. The extracts (culture medium + WG components diffused through enamel/dentin/restoration interface) were collected and applied to odontoblast-like MDPC-23 cells. The study evaluated the amount of H2O2 in the extracts, as well as the cell viability (CV), cell morphology (CM), and gene expression of inflammatory mediators (TNF-α and COX-2) by the pulp cells exposed to the extracts (ANOVA and Tukey tests; 5% significance). All whitened groups presented lower CV than SD (control; p<0.05). The highest CV reduction and gene expression of TNF-α and COX-2 was observed in the RT/HD/HP group in comparison with SD/HP and RT/HP (control; p<0.05). CM alterations occurred in all whitened groups. The intensity of these cell side effects was directly related with the amount of H2O2 in the extracts. We concluded that adhesive restoration of dental cavity increases the H2O2 diffusion after in-office whitening, enhancing the indirect toxicity of this therapy and trigger pro-inflammatory overexpression by MDPC-23 cells.

Resumo Este trabalho teve como objetivo avaliar a influência da interface de uma restauração adesiva na difusão do peróxido de hidrogênio (H2O2), toxicidade indireta e expressão de mediadores pró-inflamatórios por células odontoblastóides, após clareamento dental em consultório. Cavidades dentárias preparadas em discos de esmalte / dentina foram restauradas com adesivo e submetidas ou não à degradação hidrolítica (HD). Um gel clareador com 35% H2O2 (WG) foi aplicado por 45 min em discos restaurados e não restaurados adaptados às câmaras pulpares artificiais dando origem aos grupos: SD- discos intactos (controle); SD / HP - Discos intactos clareados; RT / HP - discos restaurados e clareados; e RT / HD / HP - discos restaurados, clareados e submetidos a HD. Os extratos (meio de cultura + componentes WG difundidos através da interface esmalte/dentina/restauração) foram coletados e aplicados em células odontoblastóides MDPC-23. Foi avaliada a quantidade de H2O2 nos extratos, bem como a viabilidade (CV), morfologia (CM) e expressão gênica de mediadores inflamatórios (TNF-α e COX-2) pelas células pulpares expostas aos extratos (ANOVA e testes de Tukey; 5% de significância). Todos os grupos clareados apresentaram menor CV do que SD (controle; p <0,05). A maior redução CV e expressão gênica de TNF-α e COX-2 foi observada no grupo RT / HD / HP em comparação com SD / HP e RT / HP (controle; p <0,05). Alterações na CM ocorreram em todos os grupos clareados. A intensidade desses efeitos celulares teve relação direta com a quantidade de H2O2 nos extratos. Concluímos que a presença de uma cavidade contendo restauração adesiva aumenta a difusão de H2O2 após o clareamento em consultório, o que, por sua vez, aumenta a toxicidade indireta dessa terapia e desencadeia a expressão de mediadores pró-inflamatórios pelas células pulpares MDPC-23.

O consumo de farinha de taro (Colocasia esculenta) favorece a integridade óssea em ratos machos / Taro (Colocasia esculenta) flour intake enable bone integrity in male rats

Objetivo: A proposta deste estudo foi investigar a composição óssea em ratos tratados com dieta suplementada com farinha de taro (Colocasia esculenta) até eles completarem 90 dias de idade. Métodos: No momento do desmame, os ratos foram divididos em grupo controle (C, n = 11) e experimental (T, n = 12) ­ composto por animais tratados com farinha de taro até os 90 dias de idade. Ingestão alimentar, massa e comprimento corporal foram avaliados semanalmente ao longo de todo o período experimental. Dimensões ósseas, bem como a densidade mineral óssea (DMO), conteúdo mineral ósseo (CMO), área óssea total e propriedades biomecânicas foram determinadas no final de 90 dias. Resultados: Grupo T apresentou elevados valores (P<0.05) para massa e comprimento corporal; DMO, CMO e área óssea da coluna vertebral; DMO na quarta vértebra lombar; massa femoral, distância entre as epífises, largura do ponto médio da diáfise, DMO, força máxima e concentrações séricas de osteocalcina, quando comparado ao grupo controle. Conclusões: A ingestão da farinha de taro apresentou efeito positivo na saúde óssea. (AU)

Objective: This study aimed to investigate bone composition in male rats treated with diet supplemented with taro (Colocasia esculenta) flour until their 90 days. Methods: Weanling male rats were divided into control (C, n=11) and experimental group (T, n=12); the latter comprised animals treated with taro flour until their 90 days. Food intake, body mass and length were evaluated on a weekly basis throughout the experimental period. Spine bone dimension, as well as bone mineral density (BMD), mineral content (BMC), total area and biomechanical properties were determined after 90 days. Results: T group recorded higher values for (P<0.05) body mass and length; BMD, BMC and total spinal area; BMD of the fourth lumbar vertebra; femoral mass, distance between epiphysis, medial point of diaphysis width, BMD, maximum strength and osteocalcin concentrations than the control. Conclusion: Taro flour intake had positive effect on bone health. (AU)

Proliferation rate and expression of stem cells markers during expansion in primary culture of pulp cells

Abstract: The aim of the present study was to evaluate the proliferation rate and the expression of stem cells markers during expansion in primary culture of dental pulp stem cells (DPSCs), comparing different techniques (explant and enzymatic digestion), subject ages (up to 40 and over 40) and cell passages (#2, #5 and #8). DPSCs were isolated using either the enzymatic digestion (ED) or explant (EX) technique. The number of days needed for the cells to reach confluence was determined. Immunophenotyping was performed by immunofluorescence and flow cytometry analysis using antibodies specific for nestin, vimentin, CD44, CD146, Oct3/4 and CD34. Data were subjected to three-way analysis of variance (n = 6/group). The ANOVA tests were complemented by Tukey's or t-tests (p < 0.05). The variables "donor age" and "technique" were analyzed to define the optimal desirability value using a response optimization. DPSCs presented a high proliferation rate from passages 2 to 5 while cells from passage 8 proliferated at a slower rate. For all markers, no significant difference was observed among passages, irrespective of the technique used or the donor's age. The mean fraction of specific antibodies was 73.7% (± 11.5), 49.0% (± 18.7), 80.1% (± 8.0), 45.2% (± 13.7), 64.7% (± 5.3) and 2.0% (± 1.5) for CD44, OCT, vimentin, nestin, CD146 and CD34, respectively. The highest optimal desirability value was obtained using the ED technique and cells from younger patients (d = 0.92). However, it was concluded that neither the isolation technique nor the donor age or cell passage significantly interfered with the stem cell phenotype and proliferation rate during cell expansion.

Proteolytic activity and degradation of bovine versus human dentin matrices

Abstract Non-human teeth have been commonly used in research as replacements for human teeth, and potential dissimilarities between the dental tissues should be considered when interpreting the outcomes. Objective: To compare the proteolytic activity and degradation rate of bovine and human dentin matrices. Methodology: Dentin beam specimens were obtained from human molars (n=30) and bovine incisors (n=30). The beams were weighed hydrated and after complete dehydration to obtain the mineralized wet and dry masses. Then, the beams were demineralized in 10 wt% phosphoric acid. Next, 15 beams from each substrate were randomly selected and again dehydrated and weighed to obtain the initial demineralized dry mass (DM). Then, the beams were stored in saliva-like buffer solution (SLBS) for 7, 14 and 21 days. SLBS was used to evaluate hydroxyproline (HYP) release after each storage period. The remaining beams of each substrate (n=15) were tested for initial MMP activity using a colorimetric assay and then also stored in SLBS. DM and MMP activity were reassessed after 7, 14 and 21 days of incubation. The data were subjected to two-way ANOVA tests with repeated measures complemented by Bonferroni's tests. Unpaired two-tailed t-tests were also used (p<0.05). Results: Similar water and inorganic fractions were found in human and bovine dentin, while human dentin had a higher protein content. The most intense proteolytic activity and matrix deterioration occurred short after dentin was demineralized. Both substrates exhibited a sharp reduction in MMP activity after seven days of incubation. Although human dentin had higher MMP activity levels, greater HYP release and DM loss after seven days than bovine dentin, after 14 and 21 days, the outcomes were not statistically different. Conclusion: Bovine dentin is a suitable substrate for long-term studies involving the degradation of dentin matrices.

Bioactivity effects of extracellular matrix proteins on apical papilla cells

Abstract Potent signaling agents stimulate and guide pulp tissue regeneration, especially in endodontic treatment of teeth with incomplete root formation. Objective This study evaluated the bioactive properties of low concentrations of extracellular matrix proteins on human apical papilla cells (hAPCs). Methodology Different concentrations (1, 5, and 10 µg/mL) of fibronectin (FN), laminin (LM), and type I collagen (COL) were applied to the bottom of non-treated wells of sterilized 96-well plates. Non-treated and pre-treated wells were used as negative (NC) and positive (PC) controls. After seeding the hAPCs (5×103 cells/well) on the different substrates, we assessed the following parameters: adhesion, proliferation, spreading, total collagen/type I collagen synthesis and gene expression (ITGA5, ITGAV, COL1A1, COL3A1) (ANOVA/Tukey; α=0.05). Results We observed greater attachment potential for cells on the FN substrate, with the effect depending on concentration. Concentrations of 5 and 10 µg/mL of FN yielded the highest cell proliferation, spreading and collagen synthesis values with 10 µg/mL concentration increasing the ITGA5, ITGAV, and COL1A1 expression compared with PC. LM (5 and 10 µg/mL) showed higher bioactivity values than NC, but those were lower than PC, and COL showed no bioactivity at all. Conclusion We conclude that FN at 10 µg/mL concentration exerted the most intense bioactive effects on hAPCs.

Influence of bisphosphonates on the behavior of osteoblasts seeded onto titanium discs

Abstract Among other factors, types of bisphosphonates and treatment regimens seem to be strongly associated with the success or failure of installation of osseointegrated implants. This study investigated the influence of two bisphosphonates, sodium alendronate (SA) and zoledronic acid (ZA), on the metabolism of osteoblasts. Human osteoblasts (Saos-2) were seeded onto machined or acid-treated titanium discs previously placed on 24-well plates in complete culture medium. After 24 h, cells were exposed to bisphosphonates at 0.5, 1 or 5 µM for 24 h, 48 h or 7 days. The effects of SA and ZA on osteoblasts were assessed based on the adhesion of these cells to the titanium surfaces by direct fluorescence, cell viability, total protein and collagen synthesis. Alkaline phosphatase activity and mineral nodule deposition by these cells were also evaluated. Data were evaluated by ANOVA and Tukey tests (α=0.05). Decreased adhesion of cells to the titanium discs was observed when exposed to both bisphosphonates; however, this lack of cell adhesion was more evident for ZA-treated cells. In addition, the exposure of osteoblasts to ZA decreased the viability, ALP activity and mineral nodule deposition, which may be related to poor osseointegration after implant installation.

Resumo Entre outros fatores, os tipos de bisfosfonatos bem como os regimes de tratamento parecem estar diretamente associados com o sucesso ou falhas na instalação de implantes osseointegrados. Este estudo avaliou a influência de dois bisfosfonatos, o alendronato de sódio (AS) e o ácido zoledrônico (AZ), no metabolismo de osteoblastos. Osteoblastos humanos (Saos-2) foram cultivados sobre discos de titânio polidos ou submetidos a tratamento ácido superficial, previamente alocados em placas de 24 compartimentos, utilizando meio de cultura completo. Após 24 horas, as células foram expostas aos bisfosfonatos, nas concentrações de 0,5, 1 ou 5 µM, por 24 h, 48 h, ou 7 dias. Os efeitos do AZ e AZ sobre os osteoblastos foram determinados considerando a adesão destas células às superfícies de titânio, por meio de fluorescência direta, a viabilidade celular, produção de proteína total e síntese de colágeno. A atividade de fosfatase alcalina e a deposição de nódulos mineralizados também foram avaliadas. Os dados foram analisados por meio do teste ANOVA complementado por Tukey (α = 0.05). Menor adesão dos osteoblastos foi observada quando estas células foram expostas a ambos os bisfosfonatos, porém, esta falha na adesão foi mais evidente para as células tratadas com AZ. Além disso, a exposição dos osteoblastos ao AZ também resultou em diminuição da viabilidade, atividade de ALP e deposição de nódulos mineralizados, o que pode estar relacionado a uma pobre osseointegração após a instalação do implante.

Racismo e necropolítica: um debate entre teoria social e psicanálise / Racism and necropolitics: a debate between social theory and psychoanalysis / Racismo y necropolítica: un debate entre teoría social y psicoanálisis

Ao tomar a pandemia de Covid-19 como contexto e analisador, este artigo discute os elos históricos entre o racismo e a gestão medicalizada do direito de vida e de morte no Brasil. Parte-se do entendimento de que a escuta e manejo clínicos das situações de sofrimento psíquico no contexto da medicalização da vida (na pandemia, e mesmo fora dela) implicam, necessariamente, fazer também crítica social. Para tal, propomos um debate que enoda teoria da clínica, as histórias da medicina social e da psicanálise no Brasil, e os conceitos de bio e necropolítica. Nossa hipótese é a de que se por um lado, em sua chegada ao Brasil, a psicanálise foi "cooptada" por uma tradição médica higienista (o que polarizou por anos a forma como ela foi vista em nosso país), por outro, por sua estrutura conceitual, pelo contraponto inicial com o modernismo brasileiro, e por seu atual debate sobre a segregação, essa práxis pode explicitar sua potência e vocação antirracista.

Taking Covid-19 Pandemic as a context and analyzer, this article discusses the historical links between racism and the medicalized management of the right to life and death in Brazil. It is based on the understanding that listening and clinical management of situations of psychological distress in the context of the medicalization of life (in Pandemic, and even outside it) necessarily imply making social criticism as well. To this end, we propose a debate that encapsulates clinical theory, the histories of social medicine and psychoanalysis in Brazil, and the concepts of bio and necropolitics. Our hypothesis is that if, on the one hand, on its arrival in Brazil, psychoanalysis was "co-opted" by a hygienist medical tradition (which for years polarized the way it was seen in our country), on the other, by its conceptual structure, by the initial counterpoint with Brazilian modernism, and by its current debate on segregation, this praxis can make explicit its anti-racist power and vocation.

Tomando como como contexto y analizador la Pandemia Covid-19, este artículo analiza los vínculos históricos entre el racismo y la gestión medicalizada del derecho a la vida y muerte en Brasil. Se basa en el entendimiento de que la escucha y el manejo clínico de situaciones de malestar psicológico en el contexto de la medicalización de la vida (en Pandemia, e incluso fuera de ella) implica necesariamente hacer también crítica social. Para ello, proponemos un debate que encapsula la teoría clínica, las historias de la medicina social y el psicoanálisis en Brasil, y los conceptos de biopoder y necropolítica. Nuestra hipótesis es que, si, por un lado, a su llegada a Brasil, el psicoanálisis fue "cooptado" por una tradición médica higienista (que durante años polarizó la forma en que se veía en nuestro país), por el otro, por su estructura conceptual, por el contrapunto inicial con el modernismo brasileño, y por su actual debate sobre la segregación, esta praxis puede hacer explícito su poder y vocación antirracista.

Morbidade hospitalar, associada ao aparelho circulatório em Santo Antônio de Jesus - Bahia / Hospital morbidity associated with the circulatory apparatus in Santo Antônio de Jesus, Brazil

Current analysis compared the number of deaths associated with diseases of the circulatory apparatus in Santo Antônio de Jesus (SAJ) and those of Salvador, the capital of the state of Bahia (SSA). Investigation was based on census data (2005 ­ 2014). Results: SAJ has 90,985 residents, with 42,965 (48%) males and 48,020 (52%) females. Further, 87.15% resided in the urban area, most within the 30-39 and 40-49 age bracket; 97.71% worked in the municipality. SAJ (vs. SSA) had the lowest number of deaths (p<0.05) with a greater percentage of hospital morbidity (p<0.05). Percentage of hospital morbidity associated with diseases of the circulatory apparatus were higher among males (p<0.05) and lower among females (p<0.05). Epidemiological studies and the development of strategies to cope with cardiologic issues, as an object of public health, are required in SAJ.

O objetivo do estudo foi comparar o número de óbitos, associados às doenças do aparelho circulatório, no município de Santo Antônio de Jesus (SAJ) em relação à capital do Estado da Bahia, Salvador (SSA). Estudo retrospectivo baseado nos dados do Censo (2005 ­ 2014). Resultados: SAJ: apresentou 90.985 residentes, sendo 42.965 (48%) do sexo masculino e 48.020 (52%) do sexo feminino. 87,15% das pessoas residem na zona urbana e maior parte destas está na faixa etária de 30-39 e 40-49 anos; 97,71% das pessoas trabalham no município. SAJ (vs. SSA) apresentou menor número de óbitos (p<0,05), no entanto, com maior percentual de morbidade hospitalar (p<0,05). Os percentuais de morbidade hospitalar associada às doenças do aparelho circulatório foram maiores entre os homens (p<0,05) e menores entre as mulheres (p<0,05). Estudos epidemiológicos e o desenvolvimento de estratégias de abordagem dos problemas cardiológicos, como objeto da saúde pública, são necessários no município de Santo Antônio de Jesus.

Comparação entre três softwares de cálculo de dietas: uma análise do valor energético de uma dieta enteral semiartesanal / Comparing three softwares for diet calculation: analysis of energetic value in a semi-amateur enteral diet

O objetivo do presente estudo foi recalcular as dietas enterais semiartesanais padrões apresentados em uma Cartilha de Terapia Nutricional Enteral Domiciliar. Foram selecionadas as dietas 1.500, 1.800 e 2.100 kcal. Utilizaram-se três softwares de cálculo de dietas, Programa A, B, C, e cálculo manual com o auxílio de três referências bibliográficas. A dieta de 1.500 kcal pelo Programa A apresentou percentual de inadequação de -22,62%, Programa B -13,9%, Programa C +15,73% e pelo cálculo manual -1,1%. A dieta de 1.800 kcal apresentou no Programa A -26,6%, Programa B -15,6%, Programa C +11,17% e no cálculo manual -1,8%. A dieta de 2.100 kcal pelo Programa A -25,5%, Programa B -15,8%, Programa C +7,2% e no cálculo manual -4,8%. No estudo foi inviável reproduzir as dietas com auxílio do Programa A, B e C. O cálculo manual foi o método que mais se aproximou dos valores de oferta calórica apresentados pela cartilha.

Current analysis recalculates standard semi-amateur enteral diets given in a handout for Home Enteral Nutrition Therapy. Diets with 1,500, 1,800 and 2,100 kcal were selected. Three softwares for diet calculation were employed, namely, Program A, B, C, and a manual calculation, with the help of three bibliographical references. Diet 1,500 kcal of Program A had a non-adequacy percentage of -22.62%; Program B featured -13.9%; Program C featured +15.73%; manual calculation featured -1.1%. Diet 1,800 kcal features -6.6% in Program A; -15.6% in Program B; +11.17% in Program C; and -1.8% in manual calculation. Diet 2,100 kcal of Program A featured -25.5%; Program B featured -15.8%; Program C featured +7.2%; manual calculation featured -4.8%. Analysis showed unfeasibility of diets with Programs A, B and C. Manual calculation was the method that was closest to values of calorie calculation presented in the guideline.

Antioxidant action of alpha lipoic acid on the testis and epididymis of diabetic rats: morphological, sperm and immunohistochemical evaluation

ABSTRACT Introduction Chronic hyperglycemia is caused by diabetes mellitus-committed genital morphophysiology, and oxidative stress is one of the main factors involved in this process. Alpha lipoic acid (ALA) can prevent metabolic and morphological changes in diabetic individuals. Objectives In present study, we evaluated the effects of regular ALA consumption on the spermatogenesis and histoarchitecture in the male genital system of diabetic rats. Materials and Methods Thirty-two Wistar rats were divided into groups: Control (CG); Diabetic Control (DCG), receiving commercial diet: ALA Group (ALAG) and Diabetic ALA Group (DALAG), fed diets with added ALA (300 mg/Kg bw). The diabetic groups received a single injection of streptozotocin (60 mg/kg). After sixty days of the diet, the animals were euthanized, and semen, testis and epididymis samples were collected. A histomorphometric analysis was performed to determine the epithelial height, tubular and luminal diameter, tubular and luminal area of seminiferous tubules and each epididymal region. Sertoli cells were evidenced using the antivimenti antibody and were quantified. The results were statistically analyzed by the ANOVA test. Results At the end of the experiment, the DALAG glycemia was significantly lower than DCG. The histomorphometric parameters of the seminiferous and epididymal tubules did not show improvement in the DALAG. However, there was an improvement in the DALAG in terms of the concentration, motility and percentage of spermatic pathologies, as well as in the number of Sertoli cells (p<0.001). Conclusions The results demonstrated that supplementation with the ALA antioxidant retards testicular lesions and preserve the process of spermatogenesis in diabetes.

Increased whitening efficacy and reduced cytotoxicity are achieved by the chemical activation of a highly concentrated hydrogen peroxide bleaching gel

Abstract Objective This study was designed for the chemical activation of a 35% hydrogen peroxide (H2O2) bleaching gel to increase its whitening effectiveness and reduce its toxicity. Methodology First, the bleaching gel - associated or not with ferrous sulfate (FS), manganese chloride (MC), peroxidase (PR), or catalase (CT) - was applied (3x 15 min) to enamel/dentin discs adapted to artificial pulp chambers. Then, odontoblast-like MDPC-23 cells were exposed for 1 h to the extracts (culture medium + components released from the product), for the assessment of viability (MTT assay) and oxidative stress (H2DCFDA). Residual H2O2 and bleaching effectiveness (DE) were also evaluated. Data were analyzed with one-way ANOVA complemented with Tukey's test (n=8. p<0.05). Results All chemically activated groups minimized MDPC-23 oxidative stress generation; however, significantly higher cell viability was detected for MC, PR, and CT than for plain 35% H2O2 gel. Nevertheless, FS, MC, PR, and CT reduced the amount of residual H2O2 and increased bleaching effectiveness. Conclusion Chemical activation of 35% H2O2 gel with MC, PR, and CT minimized residual H2O2 and pulp cell toxicity; but PR duplicated the whitening potential of the bleaching gel after a single 45-minute session.

Reflexões psicanalíticas sobre o amor a partir de Eros / Réflexions psychanalytiques sur l'amour d'Eros / Psychoanalytic reflections of love from Eros

"Eros" é uma das palavras utilizadas pelos gregos para definir o amor, de modo que abordá-la pode ser um caminho para trabalhar a temática amorosa. Isto se confirma ao adentrarmos o campo psicanalítico para pautarmos nossa investigação, pois neste se apresentam importantes referências e alusões a este termo. Por isso, este artigo objetiva apontar algumas articulações entre o amor e o conceito de Eros em meio às reflexões psicanalíticas, o que se justifica pelo paradoxal movimento em que ora Eros parece abarcar o amor, e, ora o amor parece caminhar entre as dimensões pulsionais Eros e Tânatos. Com este objetivo, empregaremos uma revisão bibliográfica de obras da psicanálise e algumas articulações destas à obra O Banquete de Platão. Veremos, então, que a pluralidade semântica, as relações entre amor e falta e a complexidade dos processos afetivos ligados à esfera erótica nos levam a estabelecer certo contraste entre as tradições mítico -filosóficas clássicas e o discurso psicanalítico, pois, se naquelas o direcionamento ao "Bem supremo" e a Unicidade se fazem horizonte e alvo, naquele vemos como que o Um que tensiona o amor não poderia existir se não fosse a falta, mãe de Eros e condição de existência do amor

"Eros" est l'un des mots utilisés par les Grecs pour définir l'amour, donc l'approcher peut être une façon de travailler sur le thème de l'amour. Ceci est confirmé en entrant dans le champ psychanalytique pour guider notre enquête, car il présente d'importantes références et allusions à ce terme. Cet article vise donc à mettre en évidence certaines articulations entre l'amour et le concept d'Eros au milieu de réflexions psychanalytiques, ce que justifie le mouvement paradoxal dans lequel parfois Eros semble embrasser l'amour, et parfois l'amour semble marcher entre des dimensions. Pulsions Eros et Thanatos. À cette fin, nous utiliserons une révision bibliographique d'œuvres de psychanalyse et quelques articulations de celles-ci avec l'œuvre Le Banquet Platon. Nous verrons donc que la pluralité sémantique, les relations entre amour et manque et la complexité des processus affectifs liés à la sphère érotique nous amènent à établir un certain contraste entre les traditions mytho-philosophiques classiques et le discours psychanalytique, puis que Le «Bien suprême¼ et l'Unité deviennent horizon et cible, en ce sens que Celui qui raffermit l'amour ne peut exister s'il n'est pas dépourvu de manque, mère d'Eros et condition d'existence de l'amour

"Eros" is one of the words used by the Greeks to define love, so approaching it can be a way of working on the love theme. This is confirmed by entering thepsychoanalytic field to guide our investigation, as it presents important references and allusions to this term. Therefore, this article aims to point out some articulations between love and the concept of Eros in the midst of psychoanalytic reflections, which is justified by the paradoxical movement in which sometimes Eros seems to embrace love, and sometimes love seems to walk between dimensions. Eros and Thanatos pulses. For this purpose, we will use a bibliographical revision of works of psychoanalysis and some articulations of these to the work The Plato Banquet. We will see, then, that semantic plurality, the relations between love and lack and the complexity of affective processes linked to the erotic sphere lead us to draw a certain contrast between the classic mythical-philosophical traditions and psychoanalytic discourse, since if in them the direction towards "Supreme Good" and Oneness become horizon and target, in that we see that the One who tenses love cannot exist if it were not lack, mother of Eros and condition of existence of love

A objetalização científica como "paradoxo na relação entre fala e linguagem" / Scientific objectification as "paradox in the relationship between speech and language" / La objetalización científica como "paradoja en la relación entre el habla y el lenguaje"

Este artigo resgata elementos do que Lacan chamou de "paradoxos na relação entre fala e linguagem". Visando o debate contemporâneo, este trabalho desenha para si um triplo fim. Primeiramente, identificar como na modernidade a linguagem, ao ser formalizada, permite identificar o efeito não substancial ou essencial que é o sujeito. Num segundo ponto, apreender como a formalização inerente ao projeto de civilização científica e capitalista pode segregar esse sujeito mediante a redução da linguagem ao paradigma informacional e pela alienação do sujeito à função de consumidor. Por fim, propor a fala em sua dimensão performativa e de enlace, reconhecimento e alteridade, de modo a pensar a clínica psicanalítica como forma de resistência a esses processos de segregação.

This article rescues elements of what Lacan called "paradoxes in the relationship between speech and language". Aiming at the contemporary debate, this work draws to itself a triple purpose. First, to identify how, in modern times, the formalization of language allows to identify the insubstantial and no essential effect that is the subject. In a second point, the work considers that the formalization inherent to the scientific and capitalist civilization project can segregate this subject by reducing language to the informational paradigm and by alienating this subject to the consumer function. Finally, the paper propose that speech, in its dimensions of performance, social, recognition and otherness, is one way to think of the psychoanalytical clinic as a form of resistance to these segregation processes.

En este artículo rescata elementos de lo que Lacan llamó "paradojas en la relación entre el habla y el lenguaje". Dirigido al debate contemporáneo, este trabajo atrae hacia sí una triple finalidad. En primer lugar, identificar la forma cómo el lenguaje moderno, al ser formalizado, identifica el efecto no sustancial o esencial que es el sujeto. En un segundo punto, aprender cómo la formalización inherente al proyecto de civilización científica y capitalista puede segregar ese sujeto por la reducción de lenguaje en el paradigma informacional y por la alienación del sujeto a la función de consumidor. Por último, proponer el habla en su dimensión performativa y de enlace, reconocimiento y alteridad, y así pensar la clínica psicoanalítica como una forma de resistencia a estos procesos de segregación.

Bond Strength and Cytotoxicity of a Universal Adhesive According to the Hybridization Strategies to Dentin

Abstract This study evaluated application protocol (etch-and-rinse/ER and self-etching/SE) and dentin wettability (wet and dry) on microtensile bond strength (μTBS) and transdentinal cytotoxicity of ScotchbondTM Universal (SU) adhesive system. The μTBS values and fracture mode were registered 24 h after adhesive system application and resin composite block build-up (n=5). For analysis of transdentinal cytotoxicity, odontoblast-like MDPC-23 cells were seeded on pulpal surface of dentin discs (0.4 mm thick) adapted to artificial pulp chambers (n=8). The adhesive system was applied to occlusal surface, followed by 24-h incubation time. Cell viability (Alamar Blue) and morphology (SEM) were assessed. Adper Single Bond 2 and Clearfil SE Bond were used as positive controls of the ER and SE application protocols, respectively. No treatment was performed on negative control (NC) group. Data were analyzed by ANOVA and Tukey's tests (α=5%). Higher μTBS values were found for ER mode in comparison with SE protocol (p<0.05). Dentin wettability had no effect on bond strength of SU in both the ER and SE techniques (p>0.05). Most fractures involved hybrid layer and/or adhesive layer. Neither variable prevented the intense toxic effects of adhesive systems on MDPC-23 cultured cells, since intense reduction in cell viability (±88%) and severe alterations in cell morphology were observed for all groups compared to NC, with no differences among them (p>0.05). Therefore, it was concluded that application of SU following the ER protocol had better adhesive performance. However, this adhesive system featured intense transdentinal cytotoxicity to pulp cells, regardless of application protocol and dentin wettability.

Resumo Este estudo avaliou o protocolo de aplicação (convencional/ER e autocondicionante/SE) e o grau de umidade da dentina (úmida e seca) sobre a resistência de união à microtração (μTBS) e a citotoxicidade transdentinária do sistema adesivo ScotchbondTM Universal (SU). Os valores de μTBS e o modo de fratura foram registrados 24 h após aplicação do sistema adesivo e restauração com resina composta pela técnica incremental. Para avaliação da citotoxicidade transdentinária, células odontoblastóides MDPC-23 foram semeadas na face pulpar de discos de dentina (0,4 mm de espessura) adaptados a câmaras pulpares artificiais (n = 8). O sistema adesivo foi aplicado na superfície oclusal, seguido de incubação por 24 h. A viabilidade e morfologia celular foram avaliadas pelo teste de Alamar Blue e MEV, respectivamente. Adper Single Bond 2 e Clearfil SE Bond foram utilizados como controle positivo do protocolo de aplicação ER e SE, respectivamente. Nenhum tratamento foi realizado no grupo controle negativo (NC). Os dados foram analisados pelos testes de ANOVA e Tukey (α = 5%). Maiores valores de μTBS foram encontrados para o modo ER em comparação com o protocolo SE (p < 0,05). O grau de umidade da dentina não apresentou efeito na resistência de união do SU em ambos os protocolos ER e SE (p > 0.05). A maioria das fraturas envolveu a camada híbrida e / ou camada adesiva. Ambas as variáveis não preveniram o intenso efeito citotóxico dos sistemas adesivos sobre as células MDPC-23 em cultura, uma vez que redução intensa na viabilidade celular (± 88%) e alterações severas na morfologia celular foram observadas para todos os grupos quando comparados ao NC, sem diferenças entre eles (p > 0.05). Desta forma, foi concluído que a aplicação do SU seguindo o protocolo ER apresentou melhor performance adesiva. No entanto, esse sistema adesivo promoveu intensa citotoxicidade transdentinária sobre células pulpares, independente do protocolo de aplicação e grau de umidade dentinária.

Análise da citotoxicidade de um gel clareador com 10% de peróxido de hidrogênio sobre células odontoblastóides de acordo com a espessura do substrato dental / Analysis of the cytotoxicity of a 10% hydrogen peroxide bleaching gel to odontoblast-like cells according to the thickness of dental substrate

Objetivo: Avaliar a citotoxicidade de um gel clareador contendo 10% de peróxido de hidrogênio (H2O2), aplicado sobre discos de esmalte/dentina simulando diferentes espessuras dentais. Material e método: Discos com 2,3; 3,5; e 4,0 mm de espessura foram obtidos para simular incisivos centrais inferiores, incisivos centrais superiores e segundos pré-molares superiores, respectivamente. Para cada espessura, o gel com 10% de H2O2 foi aplicado sobre o esmalte por 3x 15 min, 1x 15 min ou 1x 5 min. O protocolo 35% H2O2 3x 15 min foi empregado como controle positivo (CP), e nenhum tratamento foi realizado no controle negativo (CN). Células odontoblastóides MDPC-23 foram expostas por 1 h aos componentes da difusão trans-amelodentinária coletados imediatamente após o clareamento, sendo realizada análise da viabilidade celular, estresse oxidativo, deposição de nódulos de mineralização, bem como a quantificação da difusão de H2O2 pelos discos. Resultados: O gel com 10% de H2O2 não promoveu redução significativa da viabilidade celular em relação ao CN para todos os protocolos e espessuras testadas, resultando em valores de difusão de H2O2 significativamente inferiores ao CP. Apenas o protocolo 10% 3x 15 min aplicado sobre os discos simulando incisivos promoveu aumento no estresse oxidativo e reduziu a deposição de nódulos de mineralização em relação ao CN; porém, estes efeitos foram significativamente inferiores ao CP. Conclusão: De acordo com a metodologia usada neste estudo, foi possível concluir que, independente da espessura dental, a aplicação de um gel clareador com 10% de H2O2 por 5-45 min sobre o esmalte causa limitado efeito citotóxico sobre células pulpares.

Objective: To evaluate the cytotoxicity of a bleaching gel with 10% hydrogen peroxide (H2O2) applied onto enamel/dentin discs simulating different dental thicknesses. Material and methods: Discs with 2.3; 3.5; and 4.0 mm thickness were obtained to simulate low central incisors, upper central incisors and upper second pre-molars, respectively. For each thickness, the 10% H2O2 gel was applied for 3x 15 min, 1x 15 min or 1x 5 min. A gel with 35% H2O2 applied for 3x 15 min was used as positive control (PC) and no treatment was performed in negative control (NC). Odontoblast- like MDPC-23 cells were exposed for 1 h to the transenamel and trans-dentinal components collected immediately after bleaching. Cell viability, oxidative stress and mineralized nodule deposition were assessed as well as the quantification of H2O2 diffused through the discs. Results: The 10% H2O2 gel did not promote significant reduction on cell viability in comparison to NC for all tested protocols and thicknesses, resulting in H2O2 diffusion values significantly lower than PC. Only the protocol 10% H2O2 3x 15 min applied onto discs simulating incisors increased significantly the oxidative stress and reduced mineralized nodule deposition compared to NC; however, these effects were significantly lower than PC. Conclusion: According to the methodology employed in this laboratorial study, the application of a bleaching gel with 10% H2O2 for 5-45 min onto dental structure featured limited cytotoxicity to pulp cells, disregarding the enamel/dentin thicknesses.

Systemic effect of mineral aggregate-based cements: histopathological analysis in rats

Abstract Objective: Several studies reported the local tissue reaction caused by mineral aggregate-based cements. However, few studies have investigated the systemic effects promoted by these cements on liver and kidney when directly applied to connective tissue. The purpose of this in vivo study was to investigate the systemic effect of mineral aggregate-based cements on the livers and kidneys of rats. Material and Methods: Samples of Mineral Trioxide Aggregate (MTA) and a calcium aluminate-based cement (EndoBinder) containing different radiopacifiers were implanted into the dorsum of 40 rats. After 7 and 30 d, samples of subcutaneous, liver and kidney tissues were submitted to histopathological analysis. A score (0-3) was used to grade the inflammatory reaction. Blood samples were collected to evaluate changes in hepatic and renal functions of animals. Results: The moderate inflammatory reaction (2) observed for 7 d in the subcutaneous tissue decreased with time for all cements. The thickness of inflammatory capsules also presented a significant decrease with time (P<.05). Systemically, all cements caused adverse inflammatory reactions in the liver and kidney, being more evident for MTA, persisting until the end of the analysis. Liver functions increased significantly for MTA during 30 d (P<.05). Conclusion: The different cements induced to a locally limited inflammatory reaction. However, from the systemic point of view, the cements promoted significant inflammatory reactions in the liver and kidney. For MTA, the reactions were more accentuated.