Patients with type 2 diabetes and severe periodontitis harbor a less pathogenic subgingival biofilm than normoglycemic individuals with severe periodontitis.

BACKGROUND: Whether, and to what extent, diabetes mellitus (DM) can affect the subgingival biofilm composition remains controversial. Thus, the aim of this study was to compare the composition of the subgingival microbiota of non-diabetic and type 2 diabetic patients with periodontitis using 40 "biomarker bacterial species." METHODS: Biofilm samples of shallow (probing depth [PD] and clinical attachment level [CAL] ≤3 mm without bleeding) and deep sites (PD and CAL ≥5 mm with bleeding) of patients with or without type 2 DM were evaluated for levels/proportions of 40 bacterial species by checkerboard DNA-DNA hybridization. RESULTS: A total of 828 subgingival biofilm samples from 207 patients with periodontitis (118 normoglycemic and 89 with type 2 DM) were analyzed. The levels of most of the bacterial species evaluated were reduced in the diabetic compared with the normoglycemic group, both in shallow and in deep sites. The shallow and deep sites of patients with type 2 DM presented higher proportions of Actinomyces species, purple and green complexes, and lower proportions of red complex pathogens than those of normoglycemic patients (P < 0.05). CONCLUSIONS: Patients with type 2 DM have a less dysbiotic subgingival microbial profile than normoglycemic patients, including lower levels/proportions of pathogens and higher levels/proportions of host-compatible species. Thus, type 2 diabetic patients seem to require less remarkable changes in biofilm composition than non-diabetic patients to develop the same pattern of periodontitis.

Antibacterial and Antitubercular Activities of Cinnamylideneacetophenones.

Cinnamaldehyde is a natural product with broad spectrum of antibacterial activity. In this work, it was used as a template for design and synthesis of a series of 17 cinnamylideneacetophenones. Phenolic compounds 3 and 4 exhibited MIC (minimum inhibitory concentration) and MBC (minimum bactericidal concentration) values of 77.9 to 312 µM against Staphylococcus aureus, Streptococcus mutans, and Streptococcus sanguinis. Compounds 2, 7, 10, and 18 presented potent effects against Mycobacterium tuberculosis (57.2 µM ≤ MIC ≤ 70.9 µM). Hydrophilic effects caused by substituents on ring B increased antibacterial activity against Gram-positive species. Thus, log Po/w were calculated by using high-performance liquid chromatography-photodiode array detection (HPLC-PDA) analyses, and cinnamylideneacetophenones presented values ranging from 2.5 to 4.1. In addition, the effects of 3 and 4 were evaluated on pulmonary cells, indicating their moderate toxicity (46.3 µM ≤ IC50 ≤ 96.7 µM) when compared with doxorubicin. Bioactive compounds were subjected to in silico prediction of pharmacokinetic properties, and did not violate Lipinski's and Veber's rules, corroborating their potential bioavailability by an oral route.

Relationship between resting heart rate and anthropometric, metabolic and hemodynamic parameters in the elderly aged 80 years and over

This study examined the relationship between resting heart rate (RHRr) and anthropometric, metabolic and hemodynamic parameters in subjects aged 80 years and over. One hundred thirteen individuals were divided into two groups (RHR:<66 beats/min and ≥66 beats/min). Anthropometric parameters (weight, height, body mass index and waist circumference (WC) were measured. Hemodynamic parameters (systolic (SBP) and diastolic (DBP) pressure) were measured and pulse pressures (PP) were obtained. Metabolic parameters were fasting blood glucose, triglycerides and total cholesterol. In elderly aged 80 and over, RHR influenced the changes observed in DBP, PP and triglycerides. Additionally, subjects with RHR≥66 beats/min had higher DBP, glucose, total cholesterol and lower PP as compared with elderly with RHR<66 beats/min. Men demonstrated greater weight, height, and WC than women while women had higher percentage of body fat, trunk fat, and higher total cholesterol. Thus, subjects with 80 years old and over who present RHR≥66 have higher DBP and lower PP and heart rate variability compared with the elderly with RHR<66.

Cardiovascular risk factors and body fat distribution in brazilians aged 80 years or over / Fatores de risco cardiovascular e distribuição de gordura corporal em brasileiros com 80 anos ou mais

Study design: Cross-sectional study. Objective: To analyze the presence of cardiovascular risk factors (CRFs) according to the pattern of body fat distribution, in Brazilians aged 80 years or over. Methods: The sample consisted of 113 subjects, of 83.4 years, of both sexes. The percentages of total and abdominal body fat, hypertension and lipid profile were used for characterization of CRFs. The chisquare test was used to assess proportions of CRFs and the Mann-Whitney test was used to compare the results of adiposity. Results: Eutrophic subjects presented lower triglycerides (p=0.017), total cholesterol (p=0.001) and prevalence of both hypertension (p=0.003) and hypertriglyceridemia (p=0.007). Subjects with higher abdominal adiposity presented higher total cholesterol (p=0.026) and prevalence of hypertriglyceridemia (p=0.011) and hypercholesterolemia (p=0.026) than those with no excess abdominal adiposity. Those with excess fat (total, abdominal or both), with the exception of glucose(p=0.877), presented a high prevalence of CRFs. Those with both types of excess fat presented differences, with a higher prevalence level when compared to those with only one or neither of the excesses. Conclusion: Obesity, whether abdominal or total, is similarly associated with CRFs in subjects aged 80 years and over.

Modelo do estudo: Estudo transversal. Objetivo: Analisar a presença de fatores de risco cardiovascular (FRC) de acordo com o padrão de distribuição de gordura corporal em brasileiros com 80 anos ou mais. Materiais e Método: A amostra foi composta de 113 idosos, com média de idade de 83,4 anos, de ambos os sexos. O percentual de gordura corporal total e abdominal, hipertensão e perfil lipídico foram usados para caracterização dos FRC. O teste qui-quadrado foi utilizado para avaliação das proporções de FRC e o teste Mann-Whitney foi utilizado para comparar os resultados de adiposidade. Resultados: Idosos eutróficos apresentaram baixo triglicerídeos (p=0,017) e colesterol total (p=0,001) além de menores prevalências de hipertensão (p=0,003) e hipertrigliceridemia (p=0,007). Idosos com maior adiposidade abdominal apresentaram maior colesterol total (p=0,026) e prevalência de hipertrigliceridemia(p=0,011) e hipercolesterolemia (p=0,026) quando comparados com os de menor adiposidade abdominal. Aqueles com excesso de gordura (total, ou abdominal ou ambos), com exceção da glicemia (p=0,877), apresentaram alta prevalência de FRC. Aqueles com ambos os excessos de gordura apresentam diferenças, com maior nível de prevalência quando comparados aqueles com apenas um ou nenhum dos excessos. Conclusão: A obesidade, sendo abdominal ou total, é associada, da mesma maneira, com FRC em sujeitos com 80 anos ou mais.

Effect of combined aerobic and resistance training in body composition of obese postmenopausal women

The aim of this study was to investigate the effects of a 16-week program of combined aerobic and resistance training on the body composition of postmenopausal women who are obese. The participants were divided into two groups: training group (TG, n = 37) and non-trained control group (CG, n = 18). The trunk fat, fat mass, percentage of fat mass and fat-free mass were estimated using DXA. Three nonconsecutive 24-hour dietary recalls were conducted. The training protocol consisted of 50 minutes of resistance training followed by 30 minutes of aerobic training. After the 16-week training program, differences were observed in trunk fat (CG= 0.064 x TG= -0.571 Kg; p-value = .020), fat mass (CG= -0.088 x TG= -1.037 Kg; p-value = .020) and fat-free mass (CG= -0.388 x TG= 1.049 Kg; p = .001). Therefore, a 16-week program of systematic combined aerobic and resistance training in obese postmenopausal women was effective in improving fat-free mass and decreasing both whole and abdominal adiposity.

O objetivo deste estudo foi investigar os efeitos de 16 semanas de treinamento aeróbio e resistido combinados na composição corporal de mulheres na pós-menopausa. As participantes foram divididas em dois grupos: grupo treinamento (GT, n = 37) e grupo controle (GC, n = 18). A gordura de tronco, massa gorda, percentual de gordura e massa livre de gordura foram estimadas pelo DEXA. O recordatório alimentar de 24 h foi realizado três dias não consecutivos para controle alimentar. O protocolo de treinamento consistiu de 50 minutos de treinamento resistido seguido por 30 minutos de treinamento aeróbio. Após 16 semanas de treinamento diferenças foram observadas na gordura de tronco (GC= 0,064 x GT= -0,571 Kg; p-valor= 0,020), massa gorda (GC= -0,088 x GT= -1,037 Kg; p-valor= 0,020) e massa livre de gordura (GC= -0,388 x GT= 1,049 Kg; p-valor=0,001). Assim, 16 semanas de treinamento aeróbio e resistido combinado em mulheres obesas na pós-menopausa é efetivo em aumentar a massa livre de gordura e reduzir adiposidade total e abdominal.

El objetivo de este estudio fue investigar los efectos de 16 semanas de entrenamiento aeróbico y de resistencia combinada en la composición corporal en mujeres posmenopáusicas obesas. Los participantes fueron divididos en dos grupos: grupo de entrenamiento (GE, n = 37) y control (C, n = 18). La grasa del tronco, la masa grasa, porcentaje de masa grasa y masa libre de grasa se ​​ utilizó el DXA. El recordatorio de 24 horas se realizó tres días no consecutivos para el control de los alimentos. El protocolo de entrenamiento consistió en 50 minutos de entrenamiento de resistencia, después 30 minutos de entrenamiento aeróbico. Después de 16 semanas de entrenamiento, no se observaron diferencias en la grasa del tronco (C= 0,064 x GE= -0,571 Kg; p-valor= 0,020), la masa grasa (C= -0,088 x GE= -1,037 Kg; p-valor = 0,020 Kg) y libre de grasa (C= -0,388 x GE= 1,049 Kg; p= 0,001). Así, 16-semana de entrenamiento aeróbico y de resistencia combinada en las mujeres posmenopáusicas con obesidad es eficaz en la mejora de la masa libre de grasa y la disminución de la masa grasa y la adiposidad abdominal.

Open-flap versus flapless esthetic crown lengthening: 12-month clinical outcomes of a randomized controlled clinical trial.

BACKGROUND: Excessive gingival display (EGD) has a negative impact on a pleasant smile. Minimally invasive therapeutic modalities have become the standard treatment in many dentistry fields. Therefore, the aim of this study is to compare the clinical outcomes of open-flap (OF) and minimally invasive flapless (FL) esthetic crown lengthening (ECL) for the treatment of EGD. METHODS: A split-mouth randomized controlled trial was conducted in 28 patients presenting with EGD. Contralateral quadrants received ECL using OF or FL techniques. Clinical parameters were evaluated at baseline and 3, 6, and 12 months post-surgery. The local levels of receptor activator of nuclear factor-κB ligand (RANKL) and osteoprotegerin (OPG) were assessed by enzyme-linked immunosorbent assay at baseline and 3 months. Patients' perceptions regarding morbidity and esthetic appearance were also evaluated. Periodontal tissue dimensions were obtained by computed tomography at baseline and correlated with the changes in the gingival margin (GM). RESULTS: Patients reported low morbidity and high satisfaction with esthetic appearance for both procedures (P >0.05). RANKL and OPG concentrations were increased in the OF group at 3 months (P <0.05). Probing depths were reduced for both groups at all time points, compared with baseline (P <0.05). There were no differences between groups for GM reduction at any time point (P >0.05). CONCLUSIONS: FL and OF surgeries produced stable and similar clinical results up to 12 months. FL ECL may be a predictable alternative approach for the treatment of EGD.

Associação entre composição corporal, equilíbrio e mobilidade de idosos com 80 anos ou mais / Association between body composition, balance and mobility of elderly aged 80 years or older

Modelo do estudo: Estudo transversal. Objetivo: O objetivo do presente estudo foi analisar a associação entre composição corporal, mobilidade e equilíbrio de idosos com idade igual ou superior a 80 anos. Métodos: A amostra foi composta por 123 idosos com idade entre 80 e 95 anos (83,2±2,7 anos), sendo 78 mulheres (83,2±2,9 anos) e 45 homens (83,2±2,4 anos) residentes na área urbana de Presidente Prudente- SP. A avaliação da composição corporal foi feita pelo método de Absorciometria por Dupla Emissão de Raios-X (DEXA). A mobilidade e o equilíbrio foram avaliados por meio dos testes de velocidade para caminhar, equilíbrio estático e força de membros inferiores. Para tratamento estatístico realizou-se o teste qui-quadrado, o software utilizado foi SPSS (13.0) e o nível de significância estabelecido foi de 5%. Resultados: No grupo masculino, os idosos com maior desempenho nos testes funcionais apresentaram maiores valores percentuais de massa muscular (MM) (35,6%) comparados aos de menor desempenho (15,6%), p=0,026. No grupo feminino, as idosas com maior desempenho nos testes apresentaram maiores valores de densidade mineral óssea (DMO) (30,8%) comparadas as de menor desempenho (20,5%) p=0,041. Conclusão: A MM para idosos do sexo masculino e a DMO para o sexo feminino foram os componentes da composição corporal que se associaram com a capacidade funcional.

Study design: cross-sectional study. Objective: The objective of this study was to analyze the association between body composition, mobility and balance of elderly aged 80 years or older. Methods: The sample consisted of 123 elderly aged 80 and 95 years (83.2 ± 2.7 years) with 78 women (83.2 ± 2.9 years) and 45 men (83.2 ± 2, 4 years) residing in the city of Presidente Prudente - SP. Assessment of body composition was made by absorpiometria dual energy X-ray (DXA). The mobility and balance were assessed by means of tests of speed walking, and static balance lower limb strength. For statistical analysis we carried out the chi-square test, the software used was SPSS (13.0) and the significance level was set at 5%. Results: In males, those with higher performance in the functional tests showed higher percentages of muscle mass (MM) (35.6%) compared to lower performance (15.6%), p = 0.026. In the female group,the elderly with higher performance on tests showed higher bone mineral density (BMD) values (30.8%) compared with those with lower performance (20.5%) p = 0.041. Conclusion: MM for elderly males and BMD for females were the components of body composition that is associated with functional capacity.

Associação entre fatores de risco cardiovascular e capacidade funcional de idosos longevos / Association between cardiovascular risk factors and functional capacity of the oldest old

Modelo do estudo: Estudo transversal. Objetivo: Analisar a associação entre a presença de fatores de risco cardiovascular (FRC) e a capacidade funcional de idosos longevos. Materiais e Método: A amostra foi composta por 91 idosos com idade entre 80 e 90 anos (83,0±2,3 anos), sendo 60 mulheres (82,9±2,1anos) e 31 homens (83,2±2,6 anos) residentes na cidade de Presidente Prudente/SP. Os FRC analisados foram: Hipertensão Arterial (HA) e excesso de gordura corporal (total e tronco). A presença de Hipertensão foi verificada por meio do questionário auto-referido baseado no Standard Health Questionnaire (SHQ). A avaliação da gordura corporal foi feita pela absorpiometria de dupla energia de raios-X (DEXA) e a capacidade funcional foi avaliada por meio dos testes funcionais (equilíbrio estático, velocidade usual de caminhada e força de membros inferiores). Para tratamento estatístico realizou-se o teste qui-quadrado, o software utilizado foi SPSS (13.0) e o nível de significância estabelecido foi de 5%. Resultados: Os idosos com a presença de HA e excesso de %GC apresentaram menor desempenho no teste de membros inferiores (83,3% menor e 16,7% maior), p=0,011 comparados aqueles com apenas um FCR. As idosas com a presença de HA e excesso de %GTron também apresentaram menor desempenho no mesmo teste (80,6% menor e 19,4% maior), p=0,018 e no teste de velocidade de caminhada (80,6% menor e 19,4% maior), p=0,034. Conclusão: A HA e o excesso de gordura corporal (total e tronco) agregados são FRC, que estão associados à redução da capacidade funcional de idosos longevos.

Study design: cross-sectional study. Objective: To assess the association between the presence of cardiovascular risk factor (CRP) and functional capacity of the oldest old. Methods: The sample 9onsisted of 91 elderly aged 80 and 90 years (83.0 ± 2.5 years) with 60 women (82.2 ± 2.1 years) and 31 men (83.2± 2,6 years) residing in the city of Presidente Prudente - SP. The FRC were analyzed: arterial hypertension(AH) and excess body fat (total and trunk). The presence of hypertension was verified by means of self reported questionnaire based on the Standard Health Questionnaire (SHQ). Assessment of body was made by absorpiometria dual energy X-ray absorptiometry (DXA) and functional capacity was assessed by the functional tests (static balance, normal walking speed and force of the lower limbs). For statistical analysis we carried out the chi-square test, the software used was SPSS (13.0) and the significance level was set at 5%. Results. In males, with hypertension and the presence of excess %BF had lower performance in the lower limbs (83.3% lower and 16.7% higher), p = 0.011 compared to those with only a VCF. The elderly women with hypertension and the presence of excess GTron% also had lower performance on the same test (80.6% lower and 19.4% higher), p = 0.018 and the test of walking speed (80.6% lower and 19.4% higher), p = 0.034. Conclusion: Arterial hypertension and excess body fat (total and trunk) aggregated are FRC, which are associated with reduced functional capacity of the oldest old.

Full-mouth disinfection as a therapeutic protocol for type-2 diabetic subjects with chronic periodontitis: twelve-month clinical outcomes: a randomized controlled clinical trial.

AIM: The aim of this randomized controlled clinical trial was to evaluate the clinical effects of chlorhexidine (CHX) application in a full-mouth disinfection (FMD) protocol in poorly controlled type-2 diabetic subjects with generalized chronic periodontitis. MATERIAL AND METHODS: Thirty-eight subjects were randomly assigned into FMD group (n=19): full-mouth scaling and root planing (FMSRP) within 24 h + local application of CHX gel + CHX rinses for 60 days or Control group (n = 19): FMSRP within 24 h + local application of placebo gel + placebo rinses for 60 days. Clinical parameters, glycated haemoglobin and fasting plasma glucose were assessed at baseline, 3, 6 and 12 months post-therapies. RESULTS: All clinical parameters improved significantly at 3, 6 and 12 months post-therapies for both groups (p < 0.05). There were no significant differences between groups for any clinical parameters, and glycemic condition at any time-point (p > 0.05). CONCLUSIONS: The treatments did not differ with respect to clinical parameters, including the primary outcome variable (i.e. changes in clinical attachment level in deep pockets), for up to 12 months post-treatments.

The expression of antioxidant enzymes in the gingivae of type 2 diabetics with chronic periodontitis.

OBJECTIVES: There is controversial evidence regarding the levels of antioxidant molecules in type 2 diabetes periodontitis patients. Thus, the aim of the present study was to evaluate the gene expression of antioxidant enzymes in the gingival tissue of poorly and well-controlled type 2 diabetic subjects with chronic periodontitis (CP). DESIGN: Gingival biopsies were harvested from systemically and periodontally healthy subjects (n=12), systemically healthy subjects with CP (n=15), well-controlled (n=8) and poorly controlled (n=14) diabetic subjects with CP. The messenger RNA (mRNA) levels of peroxiredoxin (PRDX) 1 and 2, catalase (CAT), glutathione peroxidase (GPX1) and superoxide dismutase (SOD) 1 and 2 were measured by quantitative polymerase chain reaction (qPCR). RESULTS: The results showed that PRDX1 and GPX1 were up-regulated by periodontitis (p<0.05), independently of the glycaemic status, whilst PRDX2 and SOD2 genes were slightly influenced by periodontitis, but significantly induced when periodontitis was associated with DM, especially under a poor glycaemic control (p<0.05). Moreover, CAT and SOD1 expressions were not significantly influenced by any of these inflammatory disorders (p>0.05). CONCLUSION: In conclusion, both PRDX1 and GPX1 were overexpressed in CP whilst PRDX2 and SOD2 were up-regulated especially in the poorly controlled diabetic group with CP.

Role of smoking and type 2 diabetes in the immunobalance of advanced chronic periodontitis.

BACKGROUND: This study evaluates the tissue levels of interleukin (IL)-17(+), IL-15(+), Foxp3(+) cells, fibrosis, and plasma B-cell infiltration in sites with chronic periodontitis in smokers and subjects with type 2 diabetes. METHODS: Gingival biopsies were harvested from the following groups: systemically and periodontally healthy subjects (healthy group, n = 10); non-smokers and subjects with advanced periodontitis and without diabetes (non-risk factor/periodontitis group, n = 10); heavy smokers with advanced periodontitis and without diabetes (smoking/periodontitis group, ≥20 cigarettes per day for at least the past 5 years, n = 10); and non-smoking poorly controlled subjects with diabetes (glycated hemoglobin levels ≥9%) with advanced periodontitis (diabetes mellitus/periodontitis group [DMP], n = 10). The number of IL-17(+), IL-15(+), and Foxp3(+) cells was analyzed by immunohistochemistry, whereas the amount of fibrosis and plasma B-cell infiltration in gingival tissue was analyzed by histomorphometry. RESULTS: The number of Foxp3(+) cells was significantly higher in the periodontitis groups compared to the healthy group (P <0.05). The DMP group presented higher levels of Foxp3(+) cells than other periodontitis groups (P <0.05). The levels of IL-15(+) and IL-17(+) cells and the amount of fibrosis were higher in the DMP group than in the other groups (P <0.05). There was a trend for a decreased B-cell infiltration in the DMP group (P >0.05). There was a slightly significant negative correlation between B-cell infiltration and the amount of fibrosis (P <0.05). CONCLUSION: Upregulation of IL-17(+), IL-15(+), and Foxp3(+) cells and increased amounts of fibrosis were observed in chronic periodontitis sites in subjects with type 2 diabetes, suggesting that periodontitis development in these subjects may be influenced by the T helper 17/T regulatory axis.

Histopathological study of Schistosoma mansoni infection in the murine model using the PC (Pará) and LILA (Maranhão) strains

Experimental models of Schistosoma mansoni infections in mammals have contributed greatly in understanding the pathology and pathogenesis of human infection. The absence of earlier reviews regarding specific strains of the Amazon region prompted research, which the main objective was to describe histopathological lesions in different phases of schistosomiasis in a murine model using PC (Pará) and LILA (Maranhão) S. mansoni strains. One hundred and eighty young female albino swiss mice (Mus musculus) were used and were randomly divided into five groups (PC-01, PC-02, LILA-01, LILA-02, and controls), according to the number of cercariae injected and the strain adopted. Animals were sacrificed in predetermined periods (35, 56, 112, 156, and 180 days) in an attempt to follow the evolution of the disease in the histological sections of their tissues at different phases of infection. Our findings were compatible with the data already described by others authors using different strains of S. mansoni, making it possible to identify some peculiarities, which are discussed in this work. In conclusion, the strains of parasite used did not modify the histopathological findings in the tissues of infected mice in any significant way when compared with the results of other studies using different strains.

Histopathological study of Schistosoma mansoni infection in the murine model using the PC (Pará) and LILA (Maranhão) strains.

Experimental models of Schistosoma mansoni infections in mammals have contributed greatly in understanding the pathology and pathogenesis of human infection. The absence of earlier reviews regarding specific strains of the Amazon region prompted research, which the main objective was to describe histopathological lesions in different phases of schistosomiasis in a murine model using PC (Pará) and LILA (Maranhão) S. mansoni strains. One hundred and eighty young female albino swiss mice (Mus musculus) were used and were randomly divided into five groups (PC-01, PC-02, LILA-01, LILA-02, and controls), according to the number of cercariae injected and the strain adopted. Animals were sacrificed in predetermined periods (35, 56, 112, 156, and 180 days) in an attempt to follow the evolution of the disease in the histological sections of their tissues at different phases of infection. Our findings were compatible with the data already described by others authors using different strains of S. mansoni, making it possible to identify some peculiarities, which are discussed in this work. In conclusion, the strains of parasite used did not modify the histopathological findings in the tissues of infected mice in any significant way when compared with the results of other studies using different strains.