Educação física e Covid-19: o que dizem os protocolos de volta às aulas presenciais / Physical education and Covid-19: what do the protocols for going back to presential classes say / Educación física y Covid-19: qué dicen los protocolos para volver a las clases presenciales

Diante do cenário causado pela SARS-CoV-2, este estudo buscou identificar diretrizes das unidades da federação brasileira e refletir sobre os impactos na Educação Física no retorno presencial. Analisou-se quatorze documentos oficiais elaborados até setembro de 2020, utilizando-se de Análise de Conteúdo. Identificaram-se diretrizes gerais de higienização para prevenção do contágio no ambiente escolar e orientações específicas à Educação Física, como reorganização dos espaços, proibição de eventos e atividades coletivas, suspensão de atividades esportivas e adoção de aulas teóricas. Concluiu-se que os protocolos abordam nuances próprias da Educação Física, mas são notáveis os limites de infraestrutura, recursos humanos e materiais para viabilizar o retorno seguro e igualitário.

Given the scenario caused by SARS-CoV-2, this study aiming to identify the guidelines of Brazilian units federation and reflect about impacts of returning on Physical Education. Fourteen official documents prepared by September 2020 were analyzed, using Content Analysis technique. General hygiene guidelines for prevention of contagion in the school environment and specific guidelines for Physical Education were identified, such as reorganization of school spaces, prohibition of events and collective activities, suspension of sports activities and adoption of theorical classes. It was concluded that the protocols address specific nuances to Physical Education, but the limits of infrastructure and human and material resources are remarkable to enable safe return in an equal way.

Dado el escenario del SARS-CoV-2, este estudio identificó las pautas de las unidades de la federación brasileña y reflexionó sobre los impactos en la Educación Física en el retorno presencial. Se analizaron catorce documentos oficiales elaborados hasta septiembre de 2020, utilizando Análisis de Contenido. Se identificaron pautas generales de higiene para la prevención del contagio en el ambiente escolar y pautas específicas para la Educación Física, como reorganizar espacios, prohibir eventos y actividades colectivas, suspender actividades deportivas y adoptar clases teóricas. Se concluyó que los protocolos abordan matices de la EducaciónFísica, pero son notables los límites de infraestructura, recursos humanos y materiales para viabilizar el retorno seguro e igualitario.

Educação física e Covid-19: o que dizem os protocolos de volta às aulas presenciais / Physical education and Covid-19: what do the protocols for going back to presential classes say / Educación física y Covid-19: qué dicen los protocolos para volver a las clases presenciales

Diante do cenário causado pela SARS-CoV-2, este estudo buscou identificar diretrizes das unidades da federação brasileira e refletir sobre os impactos na Educação Física no retorno presencial. Analisou-se quatorze documentos oficiais elaborados até setembro de 2020, utilizando-se de Análise de Conteúdo. Identificaram-se diretrizes gerais de higienização para prevenção do contágio no ambiente escolar e orientações específicas à Educação Física, como reorganização dos espaços, proibição de eventos e atividades coletivas, suspensão de atividades esportivas e adoção de aulas teóricas. Concluiu-se que os protocolos abordam nuances próprias da Educação Física, mas são notáveis os limites de infraestrutura, recursos humanos e materiais para viabilizar o retorno seguro e igualitário (AU).

Given the scenario caused by SARS-CoV-2, this study aiming to identify the guidelines of Brazilian units federation and reflect about impacts of returning on Physical Education. Fourteen official documents prepared by September 2020 were analyzed, using Content Analysis technique. General hygiene guidelines for prevention of contagion in the school environment and specific guidelines for Physical Education were identified, such as reorganization of school spaces, prohibition of events and collective activities, suspension of sports activities and adoption of theorical classes. It was concluded that the protocols address specific nuances to Physical Education, but the limits of infrastructure and human and material resources are remarkable to enable safe return in an equal way (AU).

Dado el escenario del SARS-CoV-2, este estudio identificó las pautas de las unidades de la federación brasileña y reflexionó sobre los impactos en la Educación Física en el retorno presencial. Se analizaron catorce documentos oficiales elaborados hasta septiembre de 2020, utilizando Análisis de Contenido. Se identificaron pautas generales de higiene para la prevención del contagio en el ambiente escolar y pautas específicas para la Educación Física, como reorganizar espacios, prohibir eventos y actividades colectivas, suspender actividades deportivas y adoptar clases teóricas. Se concluyó que los protocolos abordan matices de la EducaciónFísica, pero son notables los límites de infraestructura, recursos humanos y materiales para viabilizar el retorno seguro e igualitario (AU).

Educação física, gênero e mercado de trabalho: percepções de mulheres sobre a futura área de atuação profissional / Physical education, gender and labor market: perceptions of women about the future area of professional activity / Educación física, género y mercado de trabajo: percepciones de las mujeres sobre el futuro ámbito de la actividad profesional

Resumo O estudo analisou a perspectiva de graduandas em Educação Física sobre o exercício de sua futura profissão, o mercado de trabalho e as questões de gênero. Desenvolveram-se quatro Grupos Focais, que foram apreciados sob a técnica de Análise de Conteúdo. Delinearam-se quatro categorias de análise: Condição da mulher, Enfrentamento dos estereótipos, Percepções sobre a Educação Física e O mercado da Educação Física para elas. Concluiu-se que as estudantes prospectam enfrentar um mercado de trabalho desvalorizado e marcado por desigualdades entre homens e mulheres.

Abstract This study analyzed the perspective of Physical Education undergraduates on the exercise of their future profession, the labor market and gender issues. Four Focus Groups were developed, which were analyzed using the Content Analysis technique. Four categories of analysis were outlined: Condition of women, Confronting stereotypes, Perceptions about Physical Education and The Physical Education market for them. It was concluded that the students' prospect is to face a devalued labor market and marked by inequalities between men and women.

Resumen El estudio analizó la perspectiva de las estudiantes del bachillerato de Educación Física sobre el ejercicio de su futura profesión, el mercado de trabajo y las cuestiones de género. Se desarrollaron cuatro Grupos Focales, los cuales fueron analizados bajo la técnica de Análisis de Contenido. Se delinearon cuatro categorías de análisis: Condición de la mujer, Enfrentamiento de los estereotipos, Percepciones sobre la Educación Física y El mercado de la Educación Física para ellas. Se concluyó que las estudiantes prospectan enfrentar un mercado laboral devaluado y marcado por desigualdades entre hombres y mujeres.

Carnaval de rua em Belo Horizonte: interstícios de insurgências sociais e de apropriações do mercado cultural (2010 a 2020) / Street carnival in Belo Horizonte: interstices of social insurgencies and cultural market appropriations (2010 a 2020)

A presente pesquisa tem como objetivo a analisar mudanças ocorridas no carnaval de rua de Belo Horizonte, entre os anos de 2010 e 2020, que o transformou no maior evento turístico-cultural da cidade. O estudo de natureza qualitativa e utilizou como procedimentos metodológicos a pesquisa bibliográfica e documental, a fala de atores que participam da organização da festa e entrevistas semiestruturadas com representantes de blocos de rua e gestores públicos. A perspectiva crítica da análise revela que desde os primórdios dessa festa, essa efervescência coletiva apresenta traços de insurgências sociais populares e de tentativas de organização da festa pelo poder público, processo semelhante ao que acontece atualmente com a festa na capital mineira. No entanto, a essa festa nacional sofre interferências diretas de um mercado econômico cultural que atua na e para a festa. O esforço foi de trazer à tona relações que se estabeleceram entre um carnaval como foco e engajamento com pautas políticassociais, alicerçado em um cenário mercadológico. Muitas dessas tensões surgiram no fazer e na apropriação do carnaval pela sociedade, nas lutas, nas reivindicações e nas irreverências dos atores sociais apontando o jogo de forças político-econômico-social entre os que fazem a festa (população), os gestores públicos e o mercado econômico.

This research aims to analyze changes that occurred in Belo Horizonte's street carnival, between 2010 and 2020, which turned it into the biggest tourist-cultural event in the city.The study was qualitative and used bibliographical and documentary research as methodological procedures, the speech of actors who participate in the organization of the party and semi-structured interviews with representatives of street blocks and public managers.The critical perspective of the analysis reveals that since the beginnings of this party, this collective effervescence presents traces of popular social insurgencies and attempts by the government to organize the party, a process similar to what currently happens with the party in the capital of Minas Gerais. However, this national festival is directly influenced by a cultural economic market that operates in and for the festival.The effort was to bring to light the relationships that were established between a carnival as a focus and engagement with political-social agendas, based on a market scenario.These tensions originated in the making and appropriation of carnival by society, in the struggles, claims and irreverence of social actors, pointing to the political-economic-social forces play between those who make the party (population), public administrators and theeconomic market.

Estratégia e táticas do projeto "Cine Luce" no contexto pandêmico da Covid -19: o lazer em foco / Strategy and tactics of the "Cine Luce" project in the pandemic context of Covid-19: leisure in focus

Este artigo consiste em um estudo bibliográfico que objetiva socializar a experiência da concepção e realização do projeto Cine Luce. Apresenta, por meio das concepções de De Certeau (2014), a estratégia e as táticas utilizadas para sua concretização como um projeto de extensão universitária e de enfrentamento ao discurso anti-ciência promovido no Brasil pelo atual governo federal. Para tanto, aproveitou a diversidade de formatos audiovisuais para fomentar diálogos em salas virtuais. As temáticas escolhidas para deflagrar as discussões sobre o lazer focalizaram implicações econômico-sociais, políticas, culturais e diversidades de etnias, gêneros e classes que marcam o Brasil. Sob os impactos decorrentes da pandemia Covid-19, tornou-se urgente e necessário fomentar reflexões sobre esses marcadores sociais e suas influências na fruição do lazer, em suas diversas expressões e territorialidades. A proposta buscou promover uma discussão horizontal e aberta ao público interessado em dialogar sobre a temática de cada bate-papo virtual, não sendo necessário ser um pesquisador ou estudioso ­embora este seja o perfil mais expressivo entre os participantes. Considera-se que a produção do conhecimento proposto pelo projeto foi ao encontro da ideia de pesquisar para transformar, intencionando cumprir seu papel acadêmico e social de disseminar os conhecimentos produzidos no campo acadêmico para além dos muros da universidade.

This article consists of a bibliographic study that aims to socialize the experience of conceiving and carrying out the Cine Luce project. It presents, through the concepts of De Certeau (2014), the strategy and tactics used for its implementation as a university extension project and to confront the anti-science discourse promoted in Brazil by the current federal government. To this end, it took advantage of the diversity of audiovisual formats to foster dialogues in virtual rooms. The themes chosen to trigger the discussions on leisure, focused on economic-social, political, cultural implications and diversity of ethnicities, genders and classes that mark Brazil. Under the impacts resulting from the Covid-19 pandemic, it became urgent and necessary to encourage reflections on these social markers and their influences on the enjoyment of leisure, in its various expressions and territorialities. The proposal sought to promote a horizontal and open discussion to the public interested in talking about the topicof each virtual chat, without having to be a researcher or scholar -although this is the most expressive profile among the participants. It is considered that the production of knowledge proposed by the project values the idea of researching to transform, intending to fulfill its academic and social role of disseminating the knowledge produced in the academic field beyond the walls of the university.

A Novel Analysis via Micro-CT Imaging Indicates That Chemically Modified Tetracycline-3 (CMT-3) Inhibits Tooth Relapse after Orthodontic Movement: A Pilot Experimental Study.

OBJECTIVE: To evaluate the effect of chemically modified tetracycline-3 (CMT-3) and simvastatin on tooth relapse after orthodontic movement in rats using a novel analysis method employing high-resolution micro-CT (Micro-CT) images. In addition, the correlation between bone density and orthodontic relapse was also evaluated for each experimental group. METHODS: Forty adult male Wistar rats had stainless steel springs installed on their left upper first molars in order to generate tooth movement for 18 days. After this initial period, the animals were divided into three groups: (1) 30 mg/kg of CMT-3; (2) 5 mg/kg of simvastatin; and (3) 0.5% carboxymethylcellulose, and each group was treated for 20 days. Micro-CT images were analyzed (conventional method and 3D reconstruction) on the 7th and 18th days following spring fixation and finally, 20 days after treatment either with CMT-3 or simvastatin (38th day). Bone mineral density (BMD) of the mesial and distal roots of the upper first molar was also analyzed. RESULTS: The difference was statistically significant between the groups as to recurrence (p=0.048), and the post hoc test identified the value of p=0.007 between the control group and the CMT-3 group. Simvastatin was not able to inhibit tooth relapse. The bone mineral densities of both the mesial and distal roots were different between the three groups, after the 20th day of drug use (p=0001 and p < 0001). CONCLUSION: Our findings support the initial evidence that CMT-3 is able to prevent relapse after tooth movement. Future trials in humans should evaluate such treatment as a promising approach to preventing this common phenomenon. CLINICAL RELEVANCE: Considering the results obtained, CMT-3 can be used to avoid relapse after tooth movement.

Ocupar o espaço público! Os músicos de rua e a luta pelo direito à cidade / To occupy the public space! The street musicians and the struggle by the right to the city

Encontrar músicos tocando nas ruas de cidades turísticas é cada vez mais corriqueiro. A condição básica para que essa prática social aconteça é a ocupação do espaço público. Os processos de turistificação dessas metrópoles, acarretam a privatização do espaço social transformando-o em espaço para consumo. Nesse ponto nevrálgico, essa investigação, fruto de uma pesquisa etnográfica, debruça-se na intenção de compreender as relações presentes na ocupação dos espaços públicos pelos músicos de rua em duas cidades cosmopolitas e turísticas: Rio de Janeiro e Barcelona. Recorte de uma tese doutoral, esse artigo, envolveu observação de campo e 23 entrevistas. As análises, seguindo os pressupostos etnográficos de reconhecimento de significados culturais e pessoais, evidenciaram tanto a luta dos músicos de rua pelo "direito à cidade", como suas "artes de fazer" em táticas cotidianas para resistir e não ser banido pela ordem social vigente na ocupação do espaço público.

It is more and more trivial to find musicians playing on the streets of tourist towns. The basic condition for this social practice to occur is the occupation of the public space. The process of touristification of the metropolis, cause the privatization of the social space transforming into space for consumption. In this crucial matter, that investigation, result of ethnographic research, intends to understand the present relations in the occupation of public spaces by street musicians in two cosmopolitan and tourist cities: Rio de Janeiro and Barcelona. Clipping a doctoral thesis, this article, involved field observation and 23 interviews. The analysis, following the ethnographic assumptions of cultural and personal recognition meanings, evidenced both the struggle of the street musicians for the "right to the city" and their "art of making" in everyday tactics to resist and not be banished by the current social order in the occupation of public space.

Oral lichen planus and malignant transformation: The role of p16, Ki-67, Bub-3 and SOX4 in assessing precancerous potential.

The association of oral lichen planus (OLP) lesions with malignant transformation risk has remained a controversial topic and is of clinical importance. Therefore, the present study evaluated the expression levels of p16, Ki-67, budding uninhibited by benzimidazoles 3 (Bub-3) and sex-determining region Y-related high mobility group box 4 (SOX4), and their roles as precancerous biomarkers in OLP. A retrospective study was performed, in which tissue blocks of OLP, oral dysplasia (OD), cutaneous lichen planus (CLP) and oral fibrous hyperplasia (OFH) were used (n=120). A positivity index (PI) for p16, BUB3, Ki-67 and SOX4 expression was calculated in each group. The PI for p16 was 20.65% for OLP, 7.85% for OD, 86.59% for CLP and 11.8% for OFH, and the difference between these groups was statistically significant (P<0.001). PIs of Ki-67 were indicated as 11.6% for OLP, 14.4% for OD, 8.24% for CLP and 5.5% for OFH, and a statistically significant difference was observed between the groups (P<0.001). Notably, the expression levels of BUB3 were not statistically different among groups. The highest expression levels of SOX4 were identified in CLP (P<0.001 vs. OLP/CLP; P=0,001 vs. CLP/OD). The determined expression levels of p16 and Ki-67 suggest that specific OLP lesions may have an intermediate malignant potential and should be carefully followed up. The intense SOX4 staining in CLP indicated a different proliferation pattern of epithelium compared with oral mucosa cells. These findings suggest that SOX4 expression may also be associated with the different clinical courses of OLP and CLP.

Assessment of the accuracy of portable monitors for halitosis evaluation in subjects without malodor complaint. Are they reliable for clinical practice?

Halitosis is defined as a foul odor emanated from the oral cavity, with great impact in quality of life and social restraints. Recently, the use of Breath Alert™ in research increased significantly. Halimeter™, another portable device, is often used in clinical practice. Nevertheless, not many studies have verified the accuracy and compared the results of both devices simultaneously. OBJECTIVE: To verify the accuracy of Breath Alert™ and Halimeter™ in patients without chief complaint of halitosis, using the organoleptic test (OT) as "gold standard." The second aim was to verify whether their concomitant use could enhance the diagnostic accuracy of halitosis. MATERIAL AND METHODS: A cross-sectional analytical study was performed. The quality of expired air of 34 subjects without chief complaint of halitosis was assessed. Two experienced examiners carried out the OT. Afterward, a third blinded examiner performed Halimeter™ (HT) and Breath Alert™ (BA) tests. RESULTS: The OT identified halitosis in 21 subjects (62%). The area under the ROC curve (95% confidence interval) was 0.67 (0.48-0.85) and 0.54 (0.34-0.75) for HT and BA, respectively. The accuracy for HT and BA was 59% and 47%, respectively. The combined usage of HT and BA provided 11 positive results, being 9 subjects (43%) out of the total of 21 positive cases. CONCLUSIONS: Halimeter™ and Breath Alert™ were not able to diagnose halitosis in non-complainer subjects at the same level as the organoleptic examination, since their accuracy were low. Our results suggest that such portable devices are not reliable tools to assess halitosis and may neglect or misdiagnose a considerable number of patients in clinical practice.

Assessment of the accuracy of portable monitors for halitosis evaluation in subjects without malodor complaint. Are they reliable for clinical practice?

Abstract Halitosis is defined as a foul odor emanated from the oral cavity, with great impact in quality of life and social restraints. Recently, the use of Breath Alert™ in research increased significantly. Halimeter™, another portable device, is often used in clinical practice. Nevertheless, not many studies have verified the accuracy and compared the results of both devices simultaneously. Objective: To verify the accuracy of Breath Alert™ and Halimeter™ in patients without chief complaint of halitosis, using the organoleptic test (OT) as "gold standard." The second aim was to verify whether their concomitant use could enhance the diagnostic accuracy of halitosis. Material and Methods: A cross-sectional analytical study was performed. The quality of expired air of 34 subjects without chief complaint of halitosis was assessed. Two experienced examiners carried out the OT. Afterward, a third blinded examiner performed Halimeter™ (HT) and Breath Alert™ (BA) tests. Results: The OT identified halitosis in 21 subjects (62%). The area under the ROC curve (95% confidence interval) was 0.67 (0.48-0.85) and 0.54 (0.34-0.75) for HT and BA, respectively. The accuracy for HT and BA was 59% and 47%, respectively. The combined usage of HT and BA provided 11 positive results, being 9 subjects (43%) out of the total of 21 positive cases. Conclusions: Halimeter™ and Breath Alert™ were not able to diagnose halitosis in non-complainer subjects at the same level as the organoleptic examination, since their accuracy were low. Our results suggest that such portable devices are not reliable tools to assess halitosis and may neglect or misdiagnose a considerable number of patients in clinical practice.

Hypnosis as a Valuable Tool for Surgical Procedures in the Oral and Maxillofacial Area.

Hypnosis is a valuable tool in the management of patients who undergo surgical procedures in the maxillofacial complex, particularly in reducing and eliminating pain during surgery and aiding patients who have dental fear and are allergic to anesthesia. This case report demonstrates the efficacy of hypnosis in mitigating anxiety, bleeding, and pain during dental surgery without anesthesia during implant placement of tooth 14, the upper left first molar.

Pesquisa qualitativa: conceitos importantes e breve revisão de sua aplicação à geriatria/gerontologia / Qualitative research: key concepts and a brief overview of its application in geriatrics/gerontology

Introdução: Este artigo faz parte de uma série especial destinada a contribuir para o desenvolvimento de projetos de pesquisa de profi ssionais de saúde. A proposta é rever a importância, a metodologia e a aplicabilidade da pesquisa qualitativa. Objetivo: Discutir a metodologia de pesquisa qualitativa, seus critérios de validade, seu rigor científi co e sua aplicabilidade na área de saúde, com enfoque na geriatria/gerontologia. Métodos: Foi realizada uma revisão não sistemática da literatura (PubMed.gov ­U.S. National Library of Medicine/National Institute of Health) no intuito de detectar artigos relevantes na temática proposta. Resultados: A pesquisa qualitativa tem crescido bastante na área de saúde devido à sua capacidade única de explorar de forma sistemática e completa questões a serem estudadas. Ela proporciona um conhecimento mais profundo para a interpretação de fenômenos, experiências e comportamentos e o signifi cado deles na vida das pessoas estudadas ­ elementos esses não explorados nos métodos quantitativos. Conclusão: A abordagem qualitativa possui rigor científi co similar à pesquisa quantitativa e consegue aprofundar o entendimento do comportamento do participante de forma mais holística ­ o que é extremamente relevante na área de geriatria/gerontologia.

Introduction: This paper is part of a special series designed to help health professionals to develop a research project. It reviews the importance, methodology, and applicability of qualitative research. Objective: To discuss the methodology of qualitative research presenting validity criteria and emphasizing the scientific rigor, with focus in healthcare area, especially in geriatrics/gerontology. Methods: The authors performed a non-systematic literature review (PubMed.gov ­ U.S. National Library of Medicine/National Institute of Health) and included articles that clarified the main themes. Results: Qualitative research has grown considerably in the area of healthcare due to its ability to broaden the knowledge and interpretation of phenomena, experiences, behaviors, and their meaning in the lives of the people studied ­ elements not explored in quantitative methods. Conclusion: Qualitative approach has scientific rigor similar to quantitative research and manages to broaden understanding of participant behavior in a more holistic approach ­ which is extremely relevant in the area of geriatrics/gerontology.

What rheumatologists should know about orofacial manifestations of autoimmune rheumatic diseases.

Orofacial manifestations occur frequently in rheumatic diseases and usually represent early signs of disease or of its activity that are still neglected in clinical practice. Among the autoimmune rheumatic diseases with potential for oral manifestations, rheumatoid arthritis (RA), inflammatory myopathies (IM), systemic sclerosis (SSc), systemic lupus erythematosus (SLE), relapsing polychondritis (RP) and Sjögren's syndrome (SS) can be cited. Signs and symptoms such as oral hyposalivation, xerostomia, temporomandibular joint disorders, lesions of the oral mucosa, periodontal disease, dysphagia, and dysphonia may be the first expression of these rheumatic diseases. This article reviews the main orofacial manifestations of rheumatic diseases that may be of interest to the rheumatologist for diagnosis and monitoring of autoimmune rheumatic diseases.

What rheumatologists should know about orofacial manifestations of autoimmune rheumatic diseases / O que o reumatologista deve saber sobre as manifestações orofaciais das doenças reumáticas autoimunes

ABSTRACT Orofacial manifestations occur frequently in rheumatic diseases and usually represent early signs of disease or of its activity that are still neglected in clinical practice. Among the autoimmune rheumatic diseases with potential for oral manifestations, rheumatoid arthritis (RA), inflammatory myopathies (IM), systemic sclerosis (SSc), systemic lupus erythematosus (SLE), relapsing polychondritis (RP) and Sjögren's syndrome (SS) can be cited. Signs and symptoms such as oral hyposalivation, xerostomia, temporomandibular joint disorders, lesions of the oral mucosa, periodontal disease, dysphagia, and dysphonia may be the first expression of these rheumatic diseases. This article reviews the main orofacial manifestations of rheumatic diseases that may be of interest to the rheumatologist for diagnosis and monitoring of autoimmune rheumatic diseases.

RESUMO Manifestações orofaciais ocorrem com frequência nas doenças reumáticas e, comumente, representam sinais iniciais ou de atividade da doença que ainda são negligenciados na prática clínica. Entre as doenças reumáticas autoimunes com possíveis manifestações orais, incluem-se a artrite reumatoide (AR), miopatias inflamatórias (MI), esclerose sistêmica (ES), lúpus eritematoso sistêmico (LES), policondrite recidivante (PR) e síndrome de Sjögren (SS). Sinais e sintomas orofaciais como hipossalivação, xerostomia, disfunções temporomandibulares, lesões na mucosa bucal, doença periodontal, disfagia e disfonia podem ser a primeira expressão dessas doenças reumáticas. Esse artigo revisa as principais manifestações orofaciais das doenças reumáticas que podem ser de interesse do reumatologista, para diagnóstico e acompanhamento das doenças reumáticas autoimunes.

What rheumatologists should know about orofacial manifestations of autoimmune rheumatic diseases. / O que o reumatologista deve saber sobre as manifestações orofaciais das doenças reumáticas autoimunes.

Orofacial manifestations occur frequently in rheumatic diseases and usually represent early signs of disease or of its activity that are still neglected in clinical practice. Among the autoimmune rheumatic diseases with potential for oral manifestations, rheumatoid arthritis (RA), inflammatory myopathies (IM), systemic sclerosis (SSc), systemic lupus erythematosus (SLE), relapsing polychondritis (RP) and Sjögren's syndrome (SS) can be cited. Signs and symptoms such as oral hyposalivation, xerostomia, temporomandibular joint disorders, lesions of the oral mucosa, periodontal disease, dysphagia, and dysphonia may be the first expression of these rheumatic diseases. This article reviews the main orofacial manifestations of rheumatic diseases that may be of interest to the rheumatologist for diagnosis and monitoring of autoimmune rheumatic diseases.

Salivary proteomics: A new adjuvant approach to the early diagnosis of familial juvenile systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) is a chronic multisystemic disease characterized by autoimmune inflammatory disturbance. Pleomorphic manifestations are present and a potentially progressive and debilitating course can be detected. SLE rarely manifests before age 5, and its onset peaks is around puberty. Although clinical manifestations, immunological alterations and treatment do not differ between juvenile and adult SLE, children tend to present with a more aggressive disease course than adults. Hence, autoimmune rheumatic diseases are the most common cause of morbidity and mortality in pediatric populations. Blood serum analysis plays an especially important role in the detection and monitoring of autoantibodies in SLE. However, since blood sampling is an uncomfortable procedure, especially in children, novel less invasive techniques and approaches are of utmost importance to evaluate pediatric subjects. In this regard, saliva samples have several advantages, such as: easy access, fast collection, painless and riskless procedure. Saliva has antimicrobial, immunomodulatory and anti-inflammatory properties, as well as several other relevant features. The whole saliva is a complex mixture of major and minor salivary gland secretion, gingival crevicular fluid, transudates plasma protein, keratinocyte products and oral microbiota. This biological fluid reflects the physiological state of the body, including the emotional condition, and endocrine, nutritional and metabolic changes. Therefore, salivary proteomics is becoming increasingly used for the early diagnosis of several diseases such as breast cancer, oral cancer, Sjögren's syndrome, diffuse systemic sclerosis, rheumatoid arthritis, among others. Considering the detection of some potential markers related to SLE in serum and urine, this study aims to conduct an initial evaluation of the possible presence of such biomarkers in saliva. Furthermore, it is expected to track down new salivary proteins that could be correlated with the disease. As such, it is important to evaluate whether the analysis of the salivary proteome of children whose mothers have SLE may help identify biomarkers for the early detection and monitoring of the condition.

Salivary function impairment in type 2 Diabetes patients associated with concentration and genetic polymorphisms of chromogranin A.

OBJECTIVES: The purpose of this study was to evaluate the effect of type 2 diabetes mellitus (T2DM) on salivary function impairments according to glycemic control status and subsequently compare the concentration of chromogranin A (CHGA) with its genetic profile. MATERIALS AND METHODS: Thirty-six patients with controlled T2DM, 36 with poorly controlled T2DM, and 38 nondiabetic subjects underwent salivary flow rate measurements by means of unstimulated labial (ULS), unstimulated whole (UWS), and stimulated whole saliva (SWS) collections. CHGA concentrations were determined in saliva and plasma with ELISA, and two CHGA polymorphisms (T-415C and Glu264Asp) were analyzed by polymerase chain reaction-restriction fragment length polymorphism. RESULTS: T2DM patients presented significantly lower ULS and UWS flow rates regardless of glycemic control status compared to controls (P = 0.002 and P = 0.027, respectively). The SWS flow rate in the poorly controlled T2DM was the lowest among the groups (P = 0.026). Significantly higher plasma and salivary CHGA levels were found in T2DM groups (P = 0.019 and P < 0.001, respectively). CHGA gene variants (T-415C and Glu264Asp) revealed significant differences between diabetics and control subjects when associated with lower salivary flow and higher salivary CHGA production (P < 0.05). CONCLUSIONS: T2DM causes abnormalities in the function of salivary glands. However, poorly controlled T2DM has the most influence on SWS flow rates. Our findings indicate an association between plasma and salivary CHGA levels and T2DM patients. Furthermore, the results suggest that CGHA polymorphisms might be associated with salivary gland hypofunction and higher salivary CHGA production in T2DM patients. Nevertheless, further epidemiological studies are required to elucidate this clinical implication. CLINICAL RELEVANCE: Salivary impairments and high levels of CHGA are associated with T2DM patients. In addition, CGHA polymorphisms might be associated with salivary gland hypofunction and higher salivary CHGA production in T2DM patients. This could be a significant insight to establish a role for salivary CHGA as a potential clinical biomarker to T2DM.

Impact of glycemic control on oral health status in type 2 diabetes individuals and its association with salivary and plasma levels of chromogranin A.

OBJECTIVE: To evaluate the effect of glycemic control status in type 2 diabetes mellitus (T2DM) individuals on clinical oral health indicators and to compare the concentrations of plasma and salivary chromogranin A (CHGA) among nondiabetic subjects and T2DM patients, exploring their associations. DESIGN: In this cross-sectional study, 32 patients with controlled T2DM, 31 with poorly controlled T2DM and 37 nondiabetic subjects underwent a clinical and periodontal examination. CHGA concentrations were determined in saliva and plasma with ELISA. RESULTS: Poorly controlled T2DM group exhibited significantly higher mean buffering capacity, plaque index and bleeding on probing than other groups (P<0.05). No difference was found to DMFT (decayed, missed and filled teeth) index between groups. Sites with clinical attachment loss (CAL) of 4 and 5-6mm were significantly higher in both diabetic groups compared to control group (P<0.05). Poorly controlled T2DM group had significantly higher sites with CAL ≥ 7 mm than other groups (P=0.001). Significantly higher plasma and salivary CHGA levels were found in T2DM groups (P<0.05). In both diabetic groups, probing depths 5-6mm and CAL 5-6mm were associated with higher salivary CHGA concentration (P<0.05). CONCLUSIONS: The findings revealed that T2DM patients were more prone to periodontal tissue damage than to caries risk. The results also provide some evidence that the degree of attachment loss deteriorates significantly with poor glycemic control in T2DM (CAL ≥ 7 mm). Moreover, the results suggest that high concentrations of salivary CHGA are associated with worse periodontal parameters and T2DM, and this could be related to the pathogenesis of both diseases.

Percepções de pacientes sobre a relação entre diabetes mellitus e saúde oral: um estudo transversal / Patients perceptions towards diabetes mellitus and oral health: a cross-sectional study

Purpose: To evaluate the knowledge of diabetic patients towards the connection between diabetes mellitus (DM) and oral diseases. Oral status was also assessed in order to evaluate the correlation among patients' perception and their oral health. Material and Methods: A sample of 132 diabetic subjects answered a questionnaire containing 12 questions addressing their knowledge, attitudes and practices related to oral health. Oral examination accessed the presence of cavity carious lesions, residual roots, dental biofilm, calculus, gingivitis, tooth mobility and gingival recession. Results: Fifty-four percent of the sample had never been instructed by their health professionals that DM could cause oral diseases. However, 66% presumed being more vulnerable to develop oral illnesses and 57.5% answered that they assumed having no oral disturbances at that moment. In contrast, intraoral clinical examination showed that 99% presented at least one oral injury such as caries lesions, plaque/calculus, gingival inflammation, tooth mobility, residual root and xerostomia. Conclusions: Health care professionals usually neglect oral status in diabetic patients. Above all, there is a huge gap between patients' perceptions towards oral health and their real oral status. This study highlights the need of developing new models of prevention that properly address the important clinical relation between oral diseases and DM.(AU)

Sialometry of upper labial minor glands: a clinical approach by the use of weighing method Schirmer's test strips paper.

OBJECTIVES: To establish referential values ranges of hyposalivation and normosalivation for the salivary flow rate (SFR) of upper labial (LS) and palatal (PS) mucosa using Schirmer's test strips paper and as a second goal to determine the values ranges of the SFR of palatal (PS) and upper labial (LS) mucosa in subjects with and without xerostomia. METHODS: A cross-sectional study was conducted among subjects distributed in three groups according to their unstimulated and stimulated whole saliva. RESULTS: 144 subjects were enrolled in groups as follows: severe hyposalivation (n = 24), mild hyposalivation (n = 78), and normosalivation (n = 42). The mean and the 95% confidence interval for the LS flow rate ( µ L/cm(2)/min) were 3.2 (2.46 to 3.94), 5.86 (4.96 to 6.75), and 9.08 (7.63 to 10.53) (P < 0.001) for each group, respectively. The PS results were 1.01 (0.68 to 1.34), 1.72 (1.31 to 2.13), and 2.44 (1.66 to 3.22) (P = 0.014). Xerostomia complainers presented lower rates of LS (5.17 (4.06 to 6.23)) than non-complainers (7.33 (6.4 to 8.27)) (P = 0.003). CONCLUSIONS: The test was reliable to provide referential values ranges for LS flow rate measurement and was shown to be valid to distinguish normosalivation from severe and mild hyposalivation and also to predict xerostomia.