Relationship of levels of trace elements in saliva and dental caries in preschool children using total reflection X-ray fluorescence technique (TXRF)⋆.

BACKGROUND: Considering that studies on the relationship between dental caries and trace elements present contradictory and inconclusive results, the purpose of this study was to determine the levels of salivary trace elements in saliva samples of preschool children and investigate their relationship with dental caries. METHODS: In total, 120 samples of unstimulated saliva were collected from children aged 36-72 months, of both sexes, who participate in the preventative educational program in oral health at the State University of Londrina, Brazil. The children were divided into two groups, caries (n = 60) and non-caries (n = 60). Levels of Al, Cu, Fe, Mn, and Zn were analyzed by total reflection X-ray fluorescence (TXRF). Descriptive statistics, the Student's t-test, Mann-Whitney U test, and Pearson's Chi-squared test were performed (P < 0.05). RESULTS: The concentrations of Mn and Fe were significantly higher in the caries group (Mn =0.015 mg/L [0.007-0.020]; Fe =0.080 mg/L [0.031-0.239] than the non-caries group (Mn =0.010 mg/L [0.001 - 0.017]; Fe =0.044 mg/L [0.023 - 0.107]). CONCLUSION: The results suggest a relationship between trace elements and dental caries, indicating possible involvement of these elements in the metabolism of microorganisms involved in the carious process. In addition, the use of TXRF presented satisfactory results, with a simple and fast methodology for the detection of the studied elements.

Oral Hygiene of Patients with Cancer in the Intensive Care Unit / Higiene Bucal de Pacientes com Câncer em Unidade de Terapia Intensiva

Dental care in Intensive Care Units - ICU, plays an important role in maintaining the health and well-being of critically ill patients. Although infection is a frequent manifestation in Intensive Care Unit (ICU) patients, the risk of infection by the oral cavity should also be considered. The immune response of this patient may be compromised, and consequently latent infections may intensify. The mouth is considered an ideal microbial incubator because of its characteristic of pH, presence of nutrients and hard surfaces. The relationship between periodontal disease and systemic conditions, including lung infections, is being explored. This study had the purpose of evaluating the odontology conditions in hospitalized patients with cancer in an intensive care unit at the Cancer Hospital of Londrina - Paraná, Brasil, quantifying the oral microbiota and evaluating bacterial resistance. Inclusion criteria involved critical patients of both sexes, two male and two female, ranging from 40 to 80 years old, submitted to mechanical endotracheal breathing. The presence of visible biofilm and xerostomia were the most prevalent. The results obtained are three patients who presented Klebsiella pneumoniae producer of Carbapenemase, due to the oral hygiene deficiency in patients hospitalized in the ICU, which are responsible for major systemic complications, increasing hospitalization time.(AU).

O atendimento odontológico nas Unidades de Terapia Intensiva - UTI, tem papel importante na manutenção da saúde e bem-estar dos pacientes criticamente doentes. Embora a infecção seja uma manifestação frequente em pacientes de Unidade de Terapia Intensiva (UTI), o risco de infecção pela cavidade bucal também deve ser considerado. A resposta imune desse paciente pode ser comprometida e consequentemente infecções latentes podem intensificar. A boca é considerada uma incubadora microbiana ideal devido à sua característica de pH, presença de nutrientes e superfícies duras. A relação entre doença periodontal e condições sistêmicas, incluindo infecções pulmonares, está sendo explorada. Este estudo teve a finalidade de avaliar as condições odontológicas em pacientes com câncer internados em unidade de terapia intensiva do Hospital do Câncer de Londrina estado do Paraná, Brasil, quantificando a microbiota bucal e avaliando a resistência bacteriana. Os critérios de Inclusão envolveram pacientes críticos de ambos sexos, dois masculinos e dois femininos com idade variando dos 40 aos 80 anos, submetidos à respiração mecânica endotraqueal. A presença de biofilme visível e xerostomia foram a alteração mais prevalente. Nos resultados obtidos encontrou-se três pacientes que apresentaram Klebsiella pneumoniae produtoras de Carbapenemase, pela deficiência de higienização bucal nos pacientes internados na UTI, que são responsáveis por grandes complicações sistêmicas, aumentando o tempo de internamento.(AU).

Palmitate-induced Slc2a4/GLUT4 downregulation in L6 muscle cells: evidence of inflammatory and endoplasmic reticulum stress involvement.

BACKGROUND: Obesity is strongly associated to insulin resistance, inflammation, and elevated plasma free fatty acids, but the mechanisms behind this association are not fully comprehended. Evidences suggest that endoplasmic reticulum (ER) stress may play a role in this complex pathophysiology. The aim of the present study was to investigate the involvement of inflammation and ER stress in the modulation of glucose transporter GLUT4, encoded by Slc2a4 gene, in L6 skeletal muscle cells. METHODS: L6 cells were acutely (2 h) and chronically (6 and 12 h) exposed to palmitate, and the expression of several proteins involved in insulin resistance, ER stress and inflammation were analyzed. RESULTS: Chronic and acute palmitate exposure significantly reduced GLUT4 protein (~ 39%, P < 0.01) and its mRNA (18%, P < 0.01) expression. Only acute palmitate treatment increased GRP78 (28%, P < 0.05), PERK (98%, P < 0.01), eIF-2A (35%, P < 0.01), IRE1a (60%, P < 0.05) and TRAF2 (23%, P < 0.05) protein content, and PERK phosphorylation (106%, P < 0.001), but did not elicit eIF-2A, IKK phosphorylation or increased XBP1 nuclear content. Additionally, acute and chronic palmitate increased NFKB p65 nuclear content (~ 30%, P < 0.05) and NFKB binding activity to Slc2a4 gene promoter (~ 45%, P < 0.05). CONCLUSION: Different pathways are activated in acute and chronic palmitate induced-repression of Slc2a4/GLUT4 expression. This regulation involves activation of initial component of ER stress, such as the formation of a IRE1a-TRAF2-IKK complex, and converges to NFKB-induced repression of Slc2a4/GLUT4. These results link ER stress, inflammation and insulin resistance in L6 cells.

Smear layer removal by different chemical solutions used with or without ultrasonic activation after post preparation.

OBJECTIVES: This study evaluated smear layer removal by different chemical solutions used with or without ultrasonic activation after post preparation. MATERIALS AND METHODS: Forty-five extracted uniradicular human mandibular premolars with single canals were treated endodontically. The cervical and middle thirds of the fillings were then removed, and the specimens were divided into 9 groups: G1, saline solution (NaCl); G2, 2.5% sodium hypochlorite (NaOCl); G3, 2% chlorhexidine (CHX); G4, 11.5% polyacrylic acid (PAA); G5, 17% ethylenediaminetetraacetic acid (EDTA). For the groups 6, 7, 8, and 9, the same solutions used in the groups 2, 3, 4, and 5 were used, respectively, but activated with ultrasonic activation. Afterwards, the roots were analyzed by a score considering the images obtained from a scanning electron microscope. RESULTS: EDTA achieved the best performance compared with the other solutions evaluated regardless of the irrigation method (p < 0.05). CONCLUSIONS: Ultrasonic activation did not significantly influence smear layer removal.

Crepping attachment tardio ­ relato de caso com três anos de acompanhamento / Delayed creeping attachment occurence ­ a case report with 3 years of follow-up

O objetivo desse artigo foi apresentar, através de um caso clínico, o efeito do creeping attachment com acompanhamento constante até três anos após a cirurgia de recobrimento radicular. Paciente do sexo masculino relatava sensibilidade na região inferior do lado esquerdo e buscava resolução para sua queixa. Em exame físico, foram observadas recessões gengivais dos dentes 32 ao 35. Optou-se então pelo tratamento cirúrgico. Após incisão tipo sulcular e rebatimento do retalho de espessura parcial, realizou-se regularização das raízes dos dentes 33 ao 35. As papilas foram mantidas e em seguida foi realizado o enxerto de tecido conjuntivo heterógeno; o retalho foi posicionado coronariamente e suturado nas papilas remanescentes. Foi realizado o acompanhamento pós-cirúrgico nos períodos de sete, 30, 60 e 180 dias, dois e três anos. Com 180 dias já era possível notar a presença de tecido queratinizado bem definido e fixado na linha mucogengival. O fenômeno de creeping attachment foi observado dois anos e oito meses após a cirurgia. A partir do caso clínico, concluiu-se que, quando há pouca ou nenhuma perda de papila interproximal classificada em classe I e II de Miller, o creeping attachment certamente ocorrerá, desde que haja uma manutenção adequada da região.

The purpose of this article was to present, through a clinical case, the effect of creeping attachment with constant recalls up to three years after root coverage surgery. A male patient reported tenderness in the lower left mandibular side and sought resolution for his complaint. On physical examination, gingival recessions of the teeth 32 to 35 were observed. Then, the surgical treatment was proposed. After a sulcular type incision and partial-thickness flap elevation, the roots of the teeth 33 to 35 were regularized. The papillae were maintained and the heterogeneous connective tissue graft was performed. The flap was positioned coronally and sutured in the remaining papillae. Post-surgical follow-up was performed after 7, 30, 60 and 180 days, two and three years later. At 180 days it was already possible to notice the presence of a well-defi ned keratinized tissue attached to the mucogingival line. The creeping attachment phenomenon was observed after two years and eight months. From this clinical case, it was concluded that, when there is little or no loss of interproximal papilla (Miller's Class I and II), the creeping attachment will certainly occur, provided that there is adequate maintenance of the region.

Reduced Slc2a4/GLUT4 expression in subcutaneous adipose tissue of monosodium glutamate obese mice is recovered after atorvastatin treatment.

BACKGROUND: Decreased expression of glucose transporter protein GLUT4, encoded by the solute carrier 2A4 (Slc2a4) gene, is involved in obesity-induced insulin resistance. Local tissue inflammation, by nuclear factor-κB (NFκB)-mediated pathway, has been related to Slc2a4 repression; a mechanism that could be modulated by statins. Using a model of obesity with insulin resistance, this study investigated whether (1) inflammatory markers and Slc2a4 expression are altered; (2) atorvastatin has beneficial effects on inflammation and Slc2a4 expression; and (3) inhibitor of NFκB (IKK)/NFκB pathway is involved in subcutaneous adipose tissue (SAT). FINDINGS: Obese mice showed insulin resistance, decreased expression of Slc2a4 mRNA (66%, P < 0.01) and GLUT4 protein (30%, P < 0.05), and increased expression of interleukin 6 (Il6) mRNA (44%, P < 0.05) in SAT. Obese mice treated with atorvastatin had enhanced in vivo insulin sensitivity, besides increased Slc2a4/GLUT4 expression and reduced Il6 expression in SAT. No alterations of tumor necrosis factor-α, interleukin 1ß and adiponectin expression or IKKα/ß activity in SAT of obese mice or obese mice treated with atorvastatin were observed. CONCLUSIONS: Atorvastatin has beneficial effect upon glycemic homeostasis, which may be related to its positive impact on Il6 and Slc2a4/GLUT4 expression in SAT.

Oleic and linoleic fatty acids downregulate Slc2a4/GLUT4 expression via NFKB and SREBP1 in skeletal muscle cells.

Oleic (OA) and linoleic (LA) fatty acids may be important regulators of Slc2a4 gene (GLUT4 protein) in skeletal muscle, thus participating in insulin resistance. We investigated the effect of OA and LA on the Slc2a4/GLUT4 expression in L6 muscle cells; as well as potential transcriptional regulators. OA and LA (50-400 µM) decreased the Slc2a4/GLUT4 expression in a dose-dependent way (maximum of ~50%, P < 0.001). OA and LA did not alter the Slc2a4-binding activity of oxysterols-receptor-LXR-alpha and peroxisome-proliferator-activated-receptor-gamma; but decreased the Slc2a4-binding activity of the sterol-regulatory-element-binding-protein-1 (SREBP1) enhancer (50%, P < 0.001), and increased (~30%, P < 0.001) the nuclear proteins binding into the Slc2a4-nuclear-factor-NF-kappa-B-binding site (repressor), and the phosphorylation of the inhibitors of nuclear-factor-kappa-B-kinase alpha/beta (150-300%, P < 0.001). In sum, OA and LA are potent inhibitors of the Slc2a4/GLUT4 expression in muscle cells; an effect involving reduced SREBP1 and increased NFKB transcriptional activity. These regulations may participate in the fatty acid-related pathophysiology of insulin resistance.

Soybean and sunflower oil-induced insulin resistance correlates with impaired GLUT4 protein expression and translocation specifically in white adipose tissue.

Free fatty acids are known for playing a crucial role in the development of insulin resistance. High fat intake is known for impairing insulin sensitivity; however, the effect of vegetable-oil injections have never been investigated. The present study investigated the effects of daily subcutaneous injections (100 microL) of soybean (SB) and sunflower (SF) oils, during 7 days. Both treated groups developed insulin resistance as assessed by insulin tolerance test. The mechanism underlying the SB- and SF-induced insulin resistance was shown to involve GLUT4. In SB- and SF-treated animals, the GLUT4 protein expression was reduced approximately 20% and 10 min after an acute in vivo stimulus with insulin, the plasma membrane GLUT4 content was approximately 60% lower in white adipose tissue (WAT). No effects were observed in skeletal muscle. Additionally, both oil treatments increased mainly the content of palmitic acid ( approximately 150%) in WAT, which can contribute to explain the GLUT4 regulations. Altogether, the present study collects evidence that those oil treatments might generate insulin resistance by targeting GLUT4 expression and translocation specifically in WAT. These alterations are likely to be caused due to the specific local increase in saturated fatty acids that occurred as a consequence of oil daily injections.