Association between Periodontitis and Myocardial Infarction: Systematic Review and Meta-Analysis

Abstract The association between periodontitis and myocardial infarction remains unclear in the literature. Few studies have addressed periodontitis exposure as a predisposing factor for the development of myocardial infarction. Therefore, the present systematic review aims to analyze the association between periodontitis and myocardial infarction. This meta-analysis systematically searched MEDLINE, EMBASE, The Cochrane Controlled Trials Register, SCIELO, LILACS, CINAHL, Scopus, Web of Science and grey literature for studies estimating the association between periodontitis and myocardial infarction. Quality of evidence was assessed for all studies. The meta-analysis was conducted using random-effects models. Four of the six studies selected were included in the meta-analysis, including 1,035,703 subjects. The association between periodontitis and myocardial infarction was: RR: 5.99 (95% CI: 1.17-30.68), but with high heterogeneity (I2 = 100%; p <0.01). The results including only the highest quality articles, was lower: RR: 2.62 (95% CI: 1.47-4.70 3.83), but with lower heterogeneity (I2 = 85.5%; p < 0.01).The present systematic review with meta-analysis showed an association between periodontitis and acute myocardial infarction, but with a high level of heterogeneity.

Comparison of methotrexate, actinomycin D, and etoposide for treating low-risk gestational trophoblastic neoplasia.

OBJECTIVE: To compare the efficacy and toxicity of 3 single agent chemotherapeutic regimens in low-risk gestational trophoblastic neoplasia (LRGTN). METHODS: A prospective study was conducted at a referral center in Rio de Janeiro, Brazil. Patients presenting with metastatic or non-metastatic LRGTN (risk score ≤ 6) in non-probabilistic sampling were assigned to 1 of 3 treatments: methotrexate with folinic acid rescue (MTX-CF; n=20); actinomycin D (n=20); and etoposide (n=20). Women with less than 1 year of disease-free follow-up after the first normal human chorionic gonadotropin (hCG) value were excluded. Outcome measures included primary remission rate; resistance to primary and sequential chemotherapy; period between treatment initiation and remission (hCG response); and prevalence of toxic effects. RESULTS: Primary remission was achieved by 48 patients (80.0%). The remission rate with etoposide was 100.0%, while the rates with actinomycin D and MTX-CF were 90.0% and 50.0%, respectively. Efficacy of etoposide was significantly greater than the other 2 agents (P<0.001). Alopecia was the most frequent adverse effect caused by etoposide. Common to all protocols were stomatitis, nausea, and vomiting. Mean time intervals between beginning treatment and remission were similar and all 60 participants survived. CONCLUSION: Etoposide was the most effective regimen for treating metastatic and non-metastatic LRGTN.

Gestational trophoblastic disease: Regional perspective in Rio de Janeiro, Brazil.

OBJECTIVE: To give an overview of gestational trophoblastic disease in a referral center in Rio de Janeiro, Brazil. STUDY DESIGN: From January 1960 to December 2008, 4,290 registered patients were followed at the Gestational Trophoblastic Neoplasia Referral Center of Rio de Janeiro. All cases of complete and partial moles and of gestational trophoblastic neoplasia (GTN) were included and analyzed. Diagnosis, uterine evacuation, follow-up, chemotherapy and hysterectomy were reviewed in all patients. RESULTS: The historical progression of molar pregnancy to GTN was 19.1%, decreasing to 11.6% in the last 9 years. The overall survival rate was 92.5% in patients with GTN. CONCLUSION: Despite the intensive activities of the several Brazilian Referral Centers, governmental authorities do not consider gestational trophoblastic disease relevant and do not support any programs in its management. Official health data still omit vital statistics information on gestational trophoblastic disease.

Estudo comparativo entre novo teste de gravidez e dosagem plasmática de gonadotrofina coriônica / Comparative study between a new pregnancy test and plasmatic chorionic gonadotropin essay

Os autores apresentam os resultados de novo teste de gravidez, de uso domiciliar, comparando-os com determinaçöes concomitantes de beta hCG plasmática. Analisam, também, o nível de dificuldade encontrado pelas usuárias. Encontram índice de confiabilidade semelhante aos achados internacionais e concluem reconhecendo a importância e praticidade do novo teste.