Can NLR be a biomarker for mucositis and gvhd in patients undergoing allogeneic HSCT?

Allogeneic hematopoietic stem cell transplantation (HSCT) is a treatment for many diseases; however, it can induce complications such as Oral Mucositis (OM) and Graft-versus- Host Disease (GVHD). The neutrophil-lymphocyte ratio (NLR) is a peripheral biomarker of systemic inflammation and an independent prognostic factor for several inflammatory diseases. Aim: This study aimed to evaluate the association of NLR with OM and GVHD in patients undergoing allogeneic HSCT. Methods: Patients who underwent allogeneic HSCT at the Bone Marrow Transplant Service of the Hospital de Clínicas Complex of the Federal University of Paraná were included in the study. Socio-demographic data and blood counts were collected from patients' medical records. The NLR was calculated and associated with OM and GVHD. Results: 45 patients were included in the study. Although NLR was higher in patients with OM and oral GVHD, no statistical difference was observed, and no relationship between OM and GVHD with NLR could be stated. Conclusion: Although both OM and GVHD are associated with an inflammatory response as well as the immune system, it was not associated with NLR. Further investigation considering other variables related to HSCT might find possible associations, as it could favor patient management and prevention

Challenge of Brazilian health researchers in the COVID-19 pandemic scenario.

Advances in Brazilian science made the country reach the 13th position in the world scientific production, and, in 2020, o Brazil was responsible for 2.39% of the world scientific production, reaching the 11th position among the countries that most published about COVID-19. The aim of this study was to contribute to and reflect on the issue of health researchers and graduate students in the scenario of COVID-19 pandemic. This pandemic highlighted the importance of science in the outcome of public policies and the fragility of the research system in Brazil, where the workforce is mainly composed of graduate students, who often do not have ideal working conditions and are not included in the response plans to global public health emergencies. This text brings a reflection and a questioning on the role of health researchers and graduate students and reinforces the importance of discussing the work of researchers/scientists in a period of great uncertainty in society.

Os avanços na ciência brasileira alcançaram a 13ª posição na produção científica mundial, e, em 2020, o Brasil foi responsável por 2,39% da produção científica mundial, alcançando a 11a posição entre os países que mais publicaram sobre a COVID-19. O objetivo deste trabalho foi contribuir e refletir sobre o debate dos pesquisadores e pós-graduandos da área de saúde no cenário pandêmico da COVID-19. A pandemia da COVID-19 evidenciou a importância da ciência no desfecho de políticas públicas e a fragilidade do sistema de pesquisa no Brasil, em que a maior força de trabalho se concentra em pós-graduandos, que muitas vezes não possuem condições ideais de trabalho e não estão inseridos nos planos de resposta às emergências globais de saúde pública. Este texto traz uma reflexão e problematização sobre o papel dos pesquisadores e pós-graduandos em saúde e reforça a importância de discutir a atuação de pesquisadores/cientistas em um período de grandes incertezas na sociedade.

Mandibular-related bone metabolism in orchiectomized rats treated with sex hormones.

OBJECTIVE: This study aimed to compare the impact of testosterone and estrogen replacement therapy on mandibular bone density and bone-related markers. DESIGN: Forty male adult rats were randomly allocated to 4 experimental groups (n = 10/group): Sham (Control); Orchiectomy; Orchiectomy plus testosterone replacement; and orchiectomy plus estradiol replacement. Twenty-four days after orchiectomy, the hemi-mandibles were collected and processed for analysis of microhardness in cortical and trabecular bone, radiographic bone density and histomorphometric evaluation. Serum was collected for the analysis of calcium, phosphorus, alkaline phosphatase and magnesium. RESULTS: The orchiectomy group had the lowest mandibular bone density (p < 0.01) and also their serum levels of alkaline phosphatase were higher than all other experimental groups (p < 0.001). Estradiol replacement significantly reduced microhardness when compared to orchiectomy in cortical bone (p < 0.05). Both testosterone and estrogen replacement reverted orchiectomy impact on this parameter (p < 0.01); and decreased alkaline phosphatase to levels comparable to the Sham-Control group. The effect of estrogen was more pronounced than testosterone, and a statistically significant difference was observed between Sham-Control and testosterone replacement (p < 0.05) but not between Sham-Control and estradiol replacement groups. CONCLUSION: Our findings demonstrated that both estradiol and testosterone replacement therapies play a role in mandibular bone metabolism, but suggest different pathways.

Sex hormone replacement therapy in periodontology-A systematic review.

OBJECTIVE: To analyse whether sex hormone replacement therapy (HRT) improves periodontal parameters and dental implants osseointegration in humans. MATERIALS AND METHODS: Electronic databases and hand searches were performed from June to August 2018 in SciELO, LILACS and PubMed/MEDLINE. Human observational and interventional studies that evaluated the following parameters were included: clinical attachment loss (CAL), probing pocket depth (PPD), bleeding on probing (BOP), radiographic bone loss (RBL) or osseointegration. RESULTS: Initial search retrieved 1,282 non-duplicated articles. Fifteen studies were selected after inclusion criteria were applied. All studies were performed in postmenopausal women. Mean differences for PPD reduction ranged from 0.02 to 0.2 mm in HRT-positive patients; mean CAL gain -0.18 to 0.54 mm; mean RBL reduction -0.87 to 0.15 mm; and mean BOP reduction 9%-30.3%. Failure rate of dental implants increased -5.5% to 11.21% when HRT was used. CONCLUSIONS: Very low but consistent evidence suggests a reduction in BOP and no impact on RBL in postmenopausal women receiving HRT. There are inconsistent reports that suggest that HRT in postmenopausal women: (a) improves or does not impact PPD reduction and CAL gain; and (b) does not impact or increase implant loss. In summary, there is no evidence to support HRT prescription for either men or women for periodontal/implant placement purposes.

The role of androgens on periodontal repair in female rats.

BACKGROUND: Testosterone replacement enhances cognitive function and musculoskeletal health in postmenopausal women. However, the biological role of testosterone on inflammation and bone metabolism in females is not well understood. Our objective was to measure the impact of androgens and their receptors on periodontal tissues during periodontal repair in female rats. METHODS: Seventy female Holtzman rats were divided into seven groups (n = 10/group): negative control; repair control; androgen receptor antagonist (flutamide, 50 mg/kg, every other day); estrogen receptor antagonist (fulvestrant, 1.5 mg/kg/day); testosterone supplementation (durateston, 250 mg/kg, weekly); aromatase inhibitor (anastrozole, 0.2 mg /kg/day); testosterone plus anastrozole. Cotton ligatures were kept for 13 days, when pharmacological treatment was initiated. On day 14, the ligatures were removed. The rats were euthanized on the 17th or the 28th day (n = 5/group/period) for the evaluation of markers related to inflammation and bone. The tissue and serum samples were evaluated using a multiplexed immunoassay for the inflammatory targets. Radiographic and histologic analyses were performed to assess changes in tissues. RESULTS: Blockage of androgen receptors had little effect on inflammatory cell count, although it tended to increase interleukin (IL)-4, vascular endothelial growth factor (VEGF), and epidermal growth factor (EGF) as well as decrease IL-1ß, tumor necrosis factor (TNF)-α, and IL-6. Flutamide also significantly impaired bone repair (P < 0.05) and had greater osteoclast count, although this last difference was not statistically significant. Testosterone supplementation significantly increased the inflammatory cell count, decreased the levels of IL-4, IL-10, IL-1ß, IL-6, and TNF-α; and increased VEGF and EGF. CONCLUSION: The blockage of androgen receptors significantly impair bone repair in females through mechanisms that are different from those related to estrogen receptors.

Avaliação contínua da aprendizagem por meio da aplicação de quiz semanal no ensino da Periodontia / Continuous learning evaluation through the application of weekly quiz in Periodontics

A avaliação contínua e rotineira mantém o estudante sob constante estudo, leitura e aprendizado, além de suavizar o impacto das avaliações teóricas formais sobre os critérios tradicionais de aprovação. O objetivo deste estudo foi avaliar o impacto da aplicação de quiz semanal sobre a nota da avaliação teórica formal no componente curricular Periodontia I do Curso de Odontologia da Universidade Federal do Paraná. Para este estudo observacional retrospectivo, avaliaram-se os campos "nota quiz" e "nota avaliação" dos diários de classe das turmas do primeiro e segundo semestres de 2016, respectivamente "sem quiz" (n=53) e "com a realização de quiz semanal" (n=55). As avaliações teóricas formais foram idênticas para as duas turmas. Os dados referentes ao número de quizzes realizados e média das notas de quiz foram tabulados. As análises estatísticas utilizadas foram teste t de Student e coeficiente de correlação de Spearman. A aplicação de quiz semanal deslocou a curva referente às notas de avaliação teórica à direita, sendo que as notas foram significativamente maiores neste grupo (p<0.01). Além disso, houve correlação significativa entre a nota da avaliação teórica e o número de quizzes realizados por cada estudante (r=0,39; p<0,01), bem como com a média da nota do quiz (r=0,47; p<0,01). Concluiu-se que a utilização de quiz semanal como instrumento de avaliação da aprendizagem influi positivamente no grau de conhecimento adquirido, provavelmente devido a um maior estímulo à leitura e estudo constante (AU).

Continuous and routine evaluation keeps the student studying, reading and learning permanently, as well as lightens the impact of formal theoretical exams on the traditional criteria for passing a course. The aim of this study was to evaluate the impact of weekly quiz application on the formal theoretical exam score in the course of Periodontics I ­ a theoreticalpractical course ­ at the School of Dentistry at Federal University of Paraná, Brazil. For this retrospective observational study, the fields "quiz score" and "exam score" of the register book from students of the first and second term of 2016, "no quiz" (n=53) and "weekly quiz application" (n=55), respectively, were analyzed. Formal theoretical exams were identical for both students groups. Data related to the number of quizzes taken by each student and quiz scores were tabulated. Student's t-test and Spearman correlation coefficient test were used for statistical analyses. Weekly quiz application moved the theoretical exam scores curve to the right and scores were significantly greater in this group (p<0.01). Besides, there was a significant correlation between theoretical exam score and the number of quizzes taken by each student (r=0.39; p<0.01), as well as with mean quiz score (r=0.47; p<0.01). We concluded that weekly application of quiz as an evaluation instrument in Periodontics positively influences acquired knowledge, probably due to stimulating permanent studying (AU).