Localized Necrotizing Periodontitis: A Possible Oral Manifestation of COVID-19

We investigated an unusual report of localized necrotizing periodontitis coinfection in patients with mild COVID-19. Male patient, 30 years old, with previous medical history of hypovitaminosis, immunized with two doses of the Pfizer® vacci ne, attended in a dental college in northern Brazil with an acute dental emergency reporting itching, halitosis, intense gingival p ain and spontaneous bleeding, mild fever of 37.8ºC, dry cough, muscle pain and nausea. Metronidazole and chlorhexidine were prescribed to improve the necrotizing condition, to treat periodontitis scaling and root planing (SRP) were performed associated with chlo rhexidine irrigation and oral hygiene instructions, which treated the patients conditions. COVID-19 coinfections are possible, specially, oral bacterial infections which is demonstrated in this report, so correct treatment is necessary for both infections. This letter d escribes the first known occurrence of severe localized necrotizing periodontitis in the urban area of Brazil's Amazon region.

Investigamos un reporte inusual de coinfección de periodontitis necrotizante localizada en pacientes con COVID-19 con síntomas leves: Paciente masculino, de 30 años, con antecedentes médicos de hipovitaminosis, inmunizado con dos dosis de la vacuna Pfizer®, atendido en una facultad de odontología en el norte Brasil, con urgencia dental aguda reportando prurito, halitosis, dolor gingival intenso y sangrado espontáneo, fiebre leve de 37,8 ºC, tos seca, mialgias y náuseas. Se prescribió metronidazol y clorhexidina para mejorar el cuadro necrosante, para tratar la periodontitis se realizó raspado y alisado radicular (SRP) asociado a irrigación con clorhexidina e instrucciones de higiene oral. Las coinfecciones por COVID- 19 son posibles, especialmente las infecciones bacterianas orales, lo cual se demuestra en este reporte, por lo que es necesario un correcto tratamiento de ambas infecciones. Esta carta describe la primera aparición conocida de periodontitis necrotizante severa de un paciente del área urbana de la región amazónica de Brasil.

Chemical composition, antimicrobial and antifungal activity of Lippia Thymoide essential oil in oral pathogens

Aim: This study evaluated the chemical composition of Lippia thymoides (Lt) essential oil and its antimicrobial activity against fungal strains of Candida albicans (Ca) and Gram-negative bacteria Prevotella intermedia (Pi) and Fusobacterium nucleatum (Fn). Methods: Lt essential oil was obtained by hydrodistillation apparatus with a modified Clevenger extension. The chemical analysis was analyzed by gas phase chromatography and mass spectrometry on Shimadzu QP 2010 plus. Sample sensitivity evaluation was performed by ABHb-inoculum and culture plates were developed with triphenyltetrazolium chloride, also Fn and Pi samples analysis were in anaerobic environment and Ca sample analysis was performed in aerobic environment. The minimum inhibitory concentration (CIM) was determinated by microdilution in eppendorfs tubes. Results: The chemical analysis showed that Thymol (59,91%) is the main compound found in Lt essential oil, also other antifungal and antimicrobial agents were present γ-terpinene (8.16%), p-cymene (7.29%) and ß-caryophyllene (4.49%), Thymol is a central ingredient of many medicinal plants and has a potent fungicidal, bactericidal and antioxidant activity, it has been previously shown to have anti-inflammatory activity against Periodontal Disease (PD) cause can reduces prostanoids, interleukins, leukotrienes levels in periodontium. CIM result Pi was 6.5 µg/mL, Fn was 1.5 µg/mL and Ca was 0.19 µg/mL. Conclusion: The antimicrobial activity of L. thymoides, through the compound Thymol, has been shown promising potential against gram-negative periodontopathogenic bacteria and fungi whose therapeutic arsenal is still very restricted

Adherence to antiretroviral therapy among women living with HIV/AIDS in the interior of the Brazilian state of Pará: cross-sectional study

ABSTRACT BACKGROUND: High prevalence of human immunodeficiency virus (HIV) infection and occurrence of drug-resistant strains have been recorded in northern Brazil. Abandonment of treatment and insufficient and inadequate adherence to antiretroviral therapy (ART) among people living with HIV/AIDS (PLWHA) have been recorded in the metropolitan area of Belém, the capital of the state of Pará. OBJECTIVES: To identify the sociodemographic profile and level of adherence to ART among women seen at a referral unit in the interior of Pará, northern Brazil. DESIGN AND SETTING: Cross-sectional study at a referral unit for care for PLWHA. METHODS: We included 86 women living with HIV/AIDS (WLWHA) in the Rio Caeté integrated region, northeastern Pará. Social, demographic and behavioral information, as well as the ART level, were obtained using forms that have been described in the scientific literature. Logistic regression models were used to assess associations of variables with ART. RESULTS: Most WLWHA were single (52.4%), young (47.7%) and heterosexual (97.7%), had low levels of education (63.0%), were unemployed (69.8%), had one sexual partner (75.7%), used condoms (46.7%) and were not using either licit drugs (68.7%) or illicit drugs (89.6%). Their adherence level was classified as insufficient , and only their viral load showed an association with ART. CONCLUSIONS: The participants' low level of education and poor socioeconomic conditions may have been interfering with their adherence to ART. Such influences can be minimized through multiprofessional interventions that take the individuality of women served by the healthcare service into consideration.

Syphilis in female sex workers: an epidemiological study of the highway system of the state of Pará, northern Brazil

Abstract INTRODUCTION: Female sex workers (FSWs) are considered a bridge for transmission of pathogens from high-risk to general populations. We assessed the epidemiological status of syphilis in FSWs along the Pará highway system. METHODS: Two hundred and twenty-two FSWs were interviewed and samples were analyzed using rapid qualitative tests and real-time polymerase chain reaction. RESULTS: The prevalence of syphilis was high (36.94%). The high rate of prostitution, use of illicit drugs, and search for financial resources increased Treponema pallidum transmission through unprotected sex. CONCLUSIONS: Several characteristics of FSWs were identified, which reinforce the need for measures guaranteeing their health and protection.

Hcv infection trrough perforating and cutting mterial among candidates for bloood donation in belém, Brazilian amazon / Infecção pelo HCV através de materiais cortantes e perfurantes entre candidatos à doação de sangue em Belém, Amazônia Brasileira

This study evaluated epidemiological factors for HCV infection associated with sharing perforating and cutting instruments among candidates for blood donation (CBD) in the city of Belém, Pará, Brazilian Amazon. Two definitions of HCV infection cases were used: anti-HCV positivity shown by EIA, and HCV-RNA detection by PCR. Infected and uninfected CBD completed a questionnaire about possible risk factors associated with sharing perforating and cutting instruments. The information was evaluated using simple and multiple logistic regressions. Between May and November 2010, 146 (1.1%) persons with anti-HCV antibodies and 106 (0.8%) with HCV-RNA were detected among 13,772 CBD in Belém. Risk factors associated with HCV infection based on the EIA (model 1) and PCR (model 2) results were: use of needles and syringes sterilized at home; shared use of razors at home, sharing of disposable razors in barbershops, beauty salons etc.; and sharing manicure and pedicure material. The models of HCV infection associated with sharing perforating and cutting instruments should be taken into account by local and regional health authorities and by those of other countries with similar cultural practices, in order to provide useful information to guide political and public strategies to control HCV transmission.

Este estudo avaliou fatores epidemiológicos para infecção pelo HCV associados ao compartilhamento de instrumentos cortantes e perfurantes em candidatos à doação de sangue (CDS) na cidade de Belém, Pará, Amazônia Brasileira. Duas definições de infecção pelo HCV foram utilizadas: positividade por anti-HCV detectada por EIA, e HCV-RNA detectado por PCR. CDS infectados e não-infectados preencheram questionário sobre possíveis fatores de risco associados com o compartilhamento de instrumentos cortantes e perfurantes. As informações foram avaliadas usando regressão logística simples e múltipla. Entre maio e novembro de 2010, 146 (1,1%) indivíduos com anticorpos anti-HCV e 106 (0,8%) com HCV-RNA foram detectadas entre 13.772 CDS em Belém. Os fatores de risco associados à infecção pelo HCV baseado em resultados de EIA (modelo 1) e PCR (modelo 2) foram: uso de agulhas e seringas esterilizadas em casa, uso compartilhado de lâminas em casa, compartilhamento de lâminas em barbearias, salões de beleza, etc., e compartilhamento de material de manicure e pedicure. Os modelos de infecção pelo HCV associados com o compartilhamento de instrumentos cortantes e perfurantes devem ser considerados pelas autoridades de saúde local e regional e de países com práticas culturais semelhantes, a fim de fornecer informações uteis para direcionar estratégias e políticas públicas de controle da transmissão do HCV.

Incidência dos genótipos 16 e 18 do HPV em mulheres de cidade da região amazônica. / Incidence of HPV genopypes 16 and 18 in women in city amazon region

OBJETIVO: estudar a incidência dos genótipos 16 e 18 do HPV em mulheres, com ou sem citologia associada a efeito citopático compatível com HPV, provenientes do município de Barcarena - Pará. MÉTODO: participaram deste estudo 50 voluntarias, através de coleta cérvico-vaginal para realização de PCR-RT para HPV 16 e 18, e citologia convencional. RESULTADOS: a citologia mostrou prevalência de 02/50 casos de LSIL/NICI, associadas ao efeito citopático compatível com HPV. O genótipo 16 do HPV ocorreu em 04/05 casos e os genótipos 16/18 ocorreram em 01/05 casos, principalmente em mulheres que apresentavam lesões do tipo ASC-US ou LSIL/NIC I. CONSIDERAÇÕES FINAIS: a presença de alterações citológicas do tipo ASC-US ou LSIL/NIC I (p=0,0166) representou um importante alerta para a possível infecção pelos tipos 16 e 18 do HPV.

OBJECTIVE: studying the incidence of HPV genotypes 16 and 18 in women, with or without cytology associated with HPV, living in the municipality of Barcarena, Pará. METHOD: fiftyvolunteers participated in the study through cervicovaginal sampling for PCR-RT to test for HPV 16 and 18 and for conventional cytology of smears. RESULTS: cytology showed an incidence of 02/50 cases of LSIL/CINI associated with a cytopathic effect compatible with HPV. Genotype 16 of HPV occurred in 04/05 cases and genotype 16/18 in 01/05 cases, mainly in women who showed lesions of the ASC-US or LSIL/CINI type. CONCLUSIONS: the presence of cytological changes of the ASC-US or LSIL/CINI type (p=0.0166) represents an important flag for possible infection by HPV types 16 and 18.

Distribution of hepatitis C virus genotypes among different exposure categories in the State of Pará, Brazilian Amazon / Distribuição dos genótipos do vírus da hepatite C em diferentes categorias de exposição no Estado do Pará, Amazônia Brasileira

INTRODUCTION: Epidemiological studies concerning HCV genotypic distribution in the Brazilian Amazon are scarce. Thus, this study determined the patterns of distribution of HCV genotypes among different exposure categories in the State of Pará, Brazilian Amazon. METHODS: A cross-sectional study was conducted on 312 HCV-infected individuals belonging to different categories of exposure, who were attended at the HEMOPA, CENPREN and a private hemodialysis clinic in Belém. They were tested for HCV antibodies using an immunoenzymatic test, RNA-HCV, using real-time PCR and HCV genotyping through phylogenetic analysis of the 5' UTR. The population groups were epidemiologically characterized according to data collected in a brief interview or medical consultation. RESULTS: Genotype 1 predominated in all the different categories of HCV exposure. HCV genotypic distribution among blood donors comprised genotypes 1 (94 percent) and 3 (6 percent). All patients with chronic hematologic diseases had HCV genotype 1. The genotypic distribution in illicit-drug users comprised genotypes 1 (59.6 percent) and 3 (40.4 percent). In patients under hemodialysis, genotypes 1 (90.1 percent), 2 (3.3 percent), and 3 (6.6 percent) were detected. Finally, the frequency of genotypes 1 and 3 was significantly different between the groups: BD and DU, PUH and DU, PUH and PCHD and PCHD and DU. CONCLUSIONS: The genotypic frequency and distribution of HCV in different categories of exposure in the State of Pará showed a predominance of genotype 1, regardless of the possible risk of infection.

INTRODUÇÃO: Estudos epidemiológicos sobre a distribuição genotípica do HCV na Amazônia Brasileira são escassos. Baseado nisto, determinamos o padrão de distribuição genotípica do HCV em diferentes categorias de exposição no Estado do Pará, Amazônia Brasileira. MÉTODOS: Estudo transversal foi realizado com 312 indivíduos infectados pelo HCV, pertencentes a diferentes categorias de exposição atendidas pelo HEMOPA, CENPREN e uma clínica privada de hemodiálise em Belém. Eles foram testados quanto à presença de anticorpos anti-HCV por teste imunoenzimático, RNA-HCV utilizando PCR em tempo real e genotipados através de análise filogenética da 5' UTR. Os grupos de populações foram caracterizados epidemiologicamente de acordo com dados coletados em breve entrevista ou consulta de prontuários médicos. RESULTADOS: Em todas as diferentes categorias de exposição ao HCV, foram encontrados predomínio do genótipo 1. A distribuição genotípica do HCV em doadores de sangue (BD) foi constituída pelos genótipos 1 (94 por cento) e 3 (6 por cento). Todos os pacientes com doenças hematológicas crônicas (PCHD) possuíam genótipo 1. A distribuição genotípica em usuários de drogas ilícitas (DU) foi constituída pelos genótipos 1 (59,6 por cento) e 3 (40,4 por cento). Em pacientes em hemodiálise (PUH) foram detectados os genótipos 1 (90,1 por cento), 2 (3,3 por cento) e 3 (6,6 por cento). Finalmente, a frequência entre os genótipos 1 e 3 foi significativamente diferente entre os grupos: BD e DU, PUH e DU, PUH e PCHD, e PCHD e DU. CONCLUSÕES: A frequência genotípica e distribuição de HCV em diferentes categorias de exposição no Estado do Pará mostraram predominância do genótipo 1, independentemente do possível risco de infecção.

Likely transmission of hepatitis C virus through sharing of cutting and perforating instruments in blood donors in the State of Pará, Northern Brazil / Possível transmissão do vírus da hepatite C por compartilhamento de materiais cortantes e perfurantes em doadores de sangue no Estado do Pará, Norte do Brasil

We determined the risk factors for HCV infection in blood donors in the State of Pará, Northern Brazil. We examined 256 blood donors seen at the Blood Bank of Pará State between 2004 and 2006. They were divided into two groups, depending on whether they were infected with HCV or not; 116 donors were infected with HCV, while the other 140 were free of infection. The HCV-RNA was detected by real-time PCR. All of the participants filled out a questionnaire about possible risk factors. The data were evaluated using simple and multiple logistic regressions. The main risk factors for HCV were found to be use of needles and syringes sterilized at home (OR = 4.55), invasive dental treatment (OR = 3.08), shared use of razors at home (OR = 1.99), sharing of disposable razors in barbershops, beauty salons, etc. (OR = 2.34), and sharing manicure and pedicure material (OR = 3.45). Local and regional health authorities should educate the public about sharing perforating and cutting materials at home, in barber/beauty shops, and in dental clinics as risk factors for HCV infection.

Nós determinamos os fatores de risco à infecção pelo HCV em doadores de sangue no Estado do Pará, Brasil. Foram analisados 256 doadores de sangue atendidos na Fundação HEMOPA de 2004 a 2006, sendo divididos em dois grupos: infectados e não-infectados. O diagnóstico foi realizado por PCR em tempo real. Todos os participantes responderam a questionário sobre possíveis fatores de risco, sendo a modelagem estatística feita por regressão logística simples e múltipla. Os fatores de risco à infecção foram: uso de agulhas e seringas de vidros esterilizadas em casa (OR = 4,55), realização de tratamento dentário invasivo (OR = 3,08), compartilhamento de lâminas em domicílio (OR = 1,99), compartilhamento de lâminas descartáveis em barbearias, salões de beleza (OR = 2,34), e compartilhamento de material de manicure e pedicure (OR = 3,45). As autoridades de saúde devem conscientizar a população sobre o compartilhamento de materiais perfuro-cortantes em domicílio, salões de beleza e consultórios dentários como fatores de risco à infecção.

Increased risk of venous thrombosis by AB alleles of the ABO blood group and Factor V Leiden in a Brazilian population

Most cases of a predisposition to venous thrombosis are caused by resistance to activated protein C, associated in 95 percent of cases with the Factor V Leiden allele (FVL or R506Q). Several recent studies report a further increased risk of thrombosis by an association between the AB alleles of the ABO blood group and Factor V Leiden. The present study investigated this association with deep vein thrombosis (DVT) in individuals treated at the Hemocentro de Pernambuco in northeastern Brazil. A case-control comparison showed a significant risk of thrombosis in the presence of Factor V Leiden (OR = 10.1), which was approximately doubled when the AB alleles of the ABO blood group were present as well (OR = 22.3). These results confirm that the increased risk of deep vein thrombosis in the combined presence of AB alleles and Factor V Leiden is also applicable to the Brazilian population suggesting that ABO blood group typing should be routinely added to FVL in studies involving thrombosis.