Depression and associated factors among Brazilian adults: the 2019 national healthcare population-based study.

BACKGROUND: Mental disorders represent a major public health challenge worldwide, affecting 80% of people living in low- and middle-income countries. Depression, a mental disorder, is a chronic disease of long duration that causes changes in the brain, resulting from a combination of genetic, physiologic, environmental, and behavioral factors. The aim of this study was to investigate possible factors associated with depression in Brazilian adults. METHODS: A population-based, cross-sectional study was carried out using the public domain database of the 2019 National Health Survey, conducted in Brazil. Depression was considered the dependent variable, and through hierarchical analysis, predictor variables were investigated such as, at the distal level-socioeconomic variables, at the intermediate level-variables related to lifestyle behavior, health condition, and history, and at the proximal level-demographic variables. Logistic regression analysis was used to obtain the adjusted Odds Ratio and the respective 95% confidence interval to identify possible factors associated with depression. RESULTS: The study included 88,531 participant records with 10.27% diagnosed with depression. The adjusted association measurements, after selecting the independent variables in the hierarchical analysis, showed the following factors associated with depression with differing magnitudes: age, brown and white race/skin color, female sex, poor, very poor, or regular self-reported health condition, diagnosis of cardiovascular disease, work-related musculoskeletal disorder, history of smoking habit, and macroeconomic region. CONCLUSIONS: An effective strategy for preventing and managing depression in Brazilian adults must include the control of health status and lifestyle behavior factors, with actions and programs to reduce people's exposure to these factors, understanding that socioeconomic-demographic differences of each population can potentially reduce the disease burden.

Periodontitis in individuals with few remaining teeth and a high gingival bleeding index increases the probability of dyslipidemia.

BACKGROUND: Dyslipidemia, a silent multifactorial condition, is characterized by changes in blood lipid levels, affecting all socioeconomic strata, increasing the risk for atherosclerotic diseases. This study investigated whether there is an association between dyslipidemia and the combined exposure of periodontitis plus the number of remaining teeth, gingival bleeding, or caries. METHODS: A two-center cross-sectional study was conducted involving 1270 individuals, with a minimum age of 18 years. Socioeconomic and demographic data, health conditions, lifestyle parameters, and anthropometric, biochemical, and oral clinical examinations were performed. The exposures considered were the presence of periodontitis, dental caries, number of remaining teeth, and gingival bleeding. The outcome was dyslipidemia as defined by the Brazilian Guidelines on Dyslipidemia and Prevention of Atherosclerosis. The combined associations between periodontitis plus other oral health conditions and dyslipidemia were estimated using confounder-adjusted prevalence ratios (PRsingle , PRmultiple , for single and multiple covariable adjustments) with 95% confidence intervals (95% CIs), in a Poisson regression model with robust variance. RESULTS: The occurrence of dyslipidemia was 70.1% and periodontitis was 84.1%. A positive association between periodontitis and dyslipidemia existed: PRsingle  = 1.13; 95% CI: 1.01-1.26. Combined exposure of periodontitis plus <11 remaining teeth (PRmultiple  = 1.23; 95% CI: 1.05-1.43), as well as combined exposure of periodontitis plus ≥10% gingival bleeding and <11 remaining teeth (PRmultiple  = 1.22; 95% CI: 1.03-1.44), represented greater probabilities of 23% and 22% of individuals having a diagnosis of dyslipidemia. CONCLUSION: Periodontitis combined with fewer than 11 teeth doubled the likelihood of being diagnosed with dyslipidemia.

Mothers' high glycemic levels and the association between periodontitis and low birth weight.

BACKGROUND: Maternal hyperglycemia, periodontitis, and adverse gestational outcomes are important health problems. The present study investigated the hypothesis that periodontitis and the glycemic level of mothers may have opposing influences on birth weight (BW). This study evaluated the effect of high glycemic levels, albeit within the normal range, on the association between periodontitis and low birth weight (LBW). METHODS: A total of 732 women took part in this case-control study; 172 were mothers of children with LBW <2,500 g, and 560 were mothers of children with BW ≥2,500 g. The BW of newborns was obtained from medical records, and information on socioeconomic-demographic, lifestyle behavior were obtained through interviews. Glycated hemoglobin (HbA1c) levels were evaluated, and full-mouth periodontal examination was carried out within 7 days postpartum. Hierarchical and logistic regression analysis evaluated the effect of glycemic levels on the association between periodontitis and LBW by subgroups, estimating odds ratios (OR) with 95% confidence intervals (95% CI). RESULTS: In the group with HbA1c levels <5.6%, a statistically significant relationship existed between periodontitis and LBW. Using the Centre for Disease Control/American Academy of Periodontics criteria, the ORadjusted was 1.55; 95% CI: 1.04 to 2.31; using the Gomes-Filho et al. criteria the ORadjusted was 1.91; 95% CI, 1.06 to 3.45. In the group with higher HbA1c levels but still within the normal range (≥5.6% and <6.5%), the findings showed no association between periodontitis and LBW. CONCLUSION: Higher maternal glycemic levels within the normal range, inferior to those indicative of gestational diabetes, diabetes mellitus, or hyperglycemia, and periodontitis have opposing effects on BW, altering the association magnitude.

Periodontitis is a factor associated with dyslipidemia.

OBJECTIVE: To investigate the association between the severity of periodontitis (exposure) and dyslipidemia (outcome). METHODS: This was a cross-sectional study of users of public health services. Periodontitis was defined using the Center for Disease Prevention and Control and the American Academy of Periodontology criteria. Lipid evaluation used data on systemic biomarkers. Dyslipidemia diagnosis was based on the Guidelines of total cardiovascular risk of the World Health Organization. Weight, height, waist circumference, and blood pressure were measured, and socioeconomic-demographic, lifestyle behavior factors, general and oral health conditions of the participants were collected. Hierarchical and logistic regression analyzes were used to determine the association between the exposures and the outcome. Odds Ratios, unadjusted and adjusted, and 95% confidence intervals were estimated. RESULTS: Of 1,011 individuals examined, 75.17% had dyslipidemia, and 84.17% had periodontitis, 0.2% with mild, 48.56% moderate, and 35.41% severe disease. The association between periodontitis and dyslipidemia was maintained through hierarchical analysis and in the multiple regression modeling, showing that the occurrences of dyslipidemia in the group with periodontitis, and its moderate and severe levels, were, respectively, 14%, 30%, and 16% higher compared with those without periodontitis. CONCLUSIONS: The results showed a positive association between moderate and severe periodontitis and dyslipidemia.

Obesity and periodontitis are not associated in pregnant women.

OBJECTIVE: The objective of this study was to investigate an association between obesity (exposure) and periodontitis (outcome) in pregnant women. BACKGROUND: This association was investigated and only five studies were identified as showing a positive association. However, some of these studies had limitations such as reduced sample sizes, inadequate exposure criteria and outcome measures, which question the internal validity of these investigations. METHODS: A cross-sectional study was carried out with a sample of 644 pregnant women of the public health service of the municipality of Santo Antônio de Jesus, Bahia, Brazil. Data were obtained by collecting of socioeconomic-demographic information, health behavior, health conditions, and reproductive history through an interview. Obesity was evaluated using body mass index adjusted for gestational age and expected weight gain. The diagnosis of periodontitis followed two criteria: (a) Center for Disease Prevention and Control and American Academy of Periodontology (CDC/AAP); (b) Gomes-Filho et al (2018) using criterion that also evaluated bleeding upon probing; Prevalence ratios and respective 95% confidence intervals were obtained by Poisson regression analysis. RESULTS: In accordance with the outcome diagnostic criterion, the frequency of periodontitis was 17.24% (Gomes-Filho et al) and 66.92% (CDC/AAP). The participants were classified as low weight (19.72%), adequate weight (42.39%), overweight (24.84%), and obesity (13.04%), based on the exposure diagnostic criterion. The low weight and overweight groups were excluded from the data analysis, giving a final sample of 357 pregnant women. The association between obesity in pregnant women and periodontitis was not statistically significant, after adjusting for confounders such as age, schooling level, alcoholic beverage consumption, alimentary and nutritional orientation, urinary infection, and dental flossing. CONCLUSIONS: The findings showed a high frequency of periodontitis, obesity, and overweight in the studied population but no association between obesity and periodontitis in pregnant women was found.

Prevalência de excesso de peso em mulheres na pós-menopausa e fatores associados / Overweight prevalence in postmenopausal women and associated factors / Prevalencia de exceso de peso en las mujeres en la posmenopausia y los factores asociados

A prevalência de excesso de peso entre as mulheres com 50 a 60 anos de idade, habitualmente, é maior quando comparada à de outros grupos etários do mesmo gênero. Nesse período, o climatério e a menopausa parecem propiciar o ganho ponderal, contudo, não são inteiramente conhecidos os fatores associados à ocorrência de excesso de peso nesse grupo. O objetivo deste trabalho é estimar a prevalência de excesso de peso e fatores associados em mulheres na pós-menopausa por meio de estudo transversal, realizado com 184 mulheres na pós-menopausa, na faixa etária de 50 a 60 anos, cadastradas no Programa Saúde da Família do município de São Gonçalo dos Campos, Bahia. Utilizando questionários específicos, foram coletados dados sociodemográficos, reprodutivos e comportamentais. Foram feitas medidas do peso e altura para cálculo do Índice de Massa Corporal (IMC). O excesso de peso (sobrepeso e obesidade) foi considerado quando o IMC foi igual ou maior que 25kg/m2. A Razão de Prevalência foi utilizada para avaliar a associação entre as variáveis estudadas e, por análise multivariada, foi adotada a regressão de Poisson, modelo robusto. Descobriu-se que a prevalência de excesso de peso foi de 65,8%, e se mostrou associada aos fatores: escolaridade, renda familiar, terapia hormonal e tabagismo. Dessa forma, há elevada prevalência de excesso de peso na população estudada, sugerindo a necessidade de implementação de estratégias de prevenção com atenção especial às mulheres na pós-menopausa.

The prevalence of overweight among women aged 50 to 60 years is usually higher when compared with other age groups of the same gender. During this period, climacteric and menopause seem to provide weight gain; however, the factors associated with overweight in this group are not fully known. This article sought to estimate the prevalence of overweight in women and identify the associated factors. Cross-sectional study, with 184 postmenopausal women, aged between 50 to 60 years, registered in the Family Health Program in São Gonçalo dos Campos, state of Bahia. Sociodemographic, reproductive and life style-related information were collected, and body weight and height were measured. Overweight was evaluated by estimating the Body Mass Index (BMI), using as the cutoff point BMI ≥ 25kg/m2, whereas association analysis was composed by estimating the Prevalence Ratio, followed by adjusted analysis by Poisson regression, robust model in the program SPSS for Windows 17.0. The prevalence of overweight was 65,8%, which was positively associated with the education level, the monthly income, hormone therapy and tabagism. The high prevalence of overweight in postmenopausal women points to the susceptibility of this group to overweight and obesity.

La prevalencia del exceso de peso en las mujeres de entre 50 y 60 años suele ser mayor que en otros grupos de edad de este mismo género. Durante este período, el climaterio y la menopausia propician aumento de peso, y los factores asociados con el sobrepeso en este grupo no se conocen todavía por completo. El objetivo de este estudio fue identificar la prevalencia del exceso de peso y sus factores asociados en mujeres en la etapa de posmenopausia. Este es un estudio transversal, realizado con 184 mujeres con posmenopausia, con edades de entre 50 y 60 años, inscritas en el Programa de Salud de la Familia del municipio de São Gonçalo dos Campos, Bahía (Brasil). Se recopilaron informaciones sociodemográficas, reproductivas y comportamentales por medio de cuestionarios específicos. Se realizaron mediciones de peso y estatura para el cálculo del Índice de Masa Corporal (IMC). El exceso de peso (sobrepeso y obesidad) fue considerado cuando el IMC tuvo valor igual o superior a 25kg/m2. La razón de prevalencia se utilizó para evaluar la asociación entre las variables estudiadas por medio de un análisis multivariado, y se empleó el método de regresión de Poisson, modelo robusto. Hubo el predominio de exceso de peso en el 65,8% que se asoció a factores como: nivel de estudios, ingreso familiar, terapia hormonal y consumo de tabaco. La alta prevalencia de exceso de peso en mujeres en la posmenopausia apunta a la necesidad de implementación de estrategias de prevención, sobre todo, a esta población.

The impact of caries in combination with periodontitis on oral health-related quality of life in Bahia, Brazil.

BACKGROUND: Both dental caries and periodontal disease, as isolated conditions, can generate limitations and disabilities with negative repercussions on the individual's quality of life, but the combination of both oral diseases has not been investigated yet. This study aimed to evaluate the association between the combined exposure to dental caries and periodontitis and the impact on oral health-related quality of life. METHODS: A cross-sectional study was conducted among 306 individuals seen in the public health services in Feira de Santana, Bahia, Brazil. The individuals were divided into three groups: individuals without caries and periodontitis (n = 60), those with caries or periodontitis separately (n = 155), and those with both caries and periodontitis (n = 91). Information regarding sociodemographic, health conditions, behavioral aspects, and health-care characteristics were obtained through structured questionnaires. Oral clinical examination was performed to evaluate dental caries (decayed, missing, and filled teeth DMFT) and periodontal status including bleeding on probing, visible plaque index, probing depth, and clinical attachment level. The impact of oral health on quality of life was measured using the Brazilian version of the Oral Health Impact Profile (OHIP-14). RESULTS: In terms of the OHIP-14, the mean ±SD and median of the severity scores were 11.07 ±9.45 and 9, respectively, and mean ±SD of the extension score: 1.78 ±2.27. The adjusted association measurement showed that in individuals exposed simultaneously to caries and periodontitis, the occurrence of the impact on quality of life was 63% greater than among those without these diseases. CONCLUSIONS: The results suggest that the combined occurrence of dental caries and periodontitis is associated with a significant impact on oral health-related quality of life when compared with absence of these oral diseases.

Factors associated with dental caries, periodontitis and intra-oral lesions in individuals with HIV / AIDS.

This study aimed to investigate the factors associated with oral diseases in individuals with HIV/AIDS. A cross sectional study was carried out which included 312 individuals registered in the Specialized Care Services for HIV/AIDS in three municipalities of the State of Bahia: Feira de Santana, Santo Antonio de Jesus and Juazeiro, Brazil. Socioeconomic-demographic characteristics related to life style and to dental caries, periodontitis and intra-oral mucosal lesions were investigated in patients with HIV/AIDS infection. Prevalence Ratio with 95% Confidence Interval and significance level of 5% were employed for the statistical analysis. The majority of the individuals evaluated were male with a mean age (± standard deviation) of 41.5 ± 11.3 years, and a mean time of HIV infection diagnosis (± standard deviation) of 5.2 ± 4.4 years. The presence of dental caries was observed in 78.7% of the sample, periodontitis in 25.4% and 36.2% showed intra-oral lesions. Oral health status showed a statistically significant association with the following variables: gender, age, schooling level, current occupation, family income, past and current smoking, antiretroviral use time, latest viral burden dosage, latest CD4-positive T lymphocyte count, use of complete/partial dental prosthesis, need for dental prosthesis, and use of dental floss. With the exception of those factors directly related to HIV/AIDS i.e., antiretroviral use time, latest viral burden dosage and latest CD4-positive T lymphocyte count, the factors associated with oral diseases in this population were the same as those associated with oral diseases in the non-HIV/AIDS population.

Association between periodontitis and severe asthma in adults: A case-control study.

OBJECTIVE: To evaluate the association between periodontitis and severe asthma, with participants in treatment for severe asthma, controlled by therapy. METHODS: A case-control investigation was performed to compare 130 adults with severe asthma with 130 without asthma. Individuals with periodontitis were those with ≥4 teeth with ≥1 site with probing depth ≥4 mm, clinical attachment level ≥3 mm, and bleeding upon probing at the same site. Severe asthma diagnosis was based on Global Initiative for Asthma criteria. RESULTS: Association between exposure to periodontitis and severe asthma was found: ORcrude  = 2.98 (95% CI: 1.74-5.11). When confounders were considered, the association between exposure to periodontitis and severe asthma was maintained: ORadjusted  = 3.01-3.25. Individuals with periodontitis had about a threefold increased risk of severe asthma than those without periodontitis. Frequency of periodontitis in participants with severe asthma was greater than that of those without asthma (46.6% vs 22.3%, p ≤ .05). CONCLUSIONS: Association between periodontitis and severe asthma was observed. Further investigation is required to determine the direction of this relationship. It may be causal, but it may also be a consequence of the immunopathological process that characterizes asthma, or else, consequence of the medication used for treatment.

Danos cromossômicos e alterações nucleares em células esfoliadas do epitélio gengival de indivíduos com periodontite crônica moderada / Chromosomal damage and nuclear alterations in exfoliated cells of the gingival epithelium of individuals with chronic moderate periodontitis

Introdução: a periodontite é uma doença multifatorial que resulta primariamente da ação de bactérias nos tecidos que compõem o periodonto. O processo inflamatório que se desenvolve em consequência está associado ao aumento da proliferação celular que propicia a ocorrência de danos no material genético. Objetivo: avaliar, com uso do teste de micronúcleo, a ocorrência de danos genéticos e alterações nucleares em indivíduos com periodontite crônica moderada. Metodologia: a amostra incluiu dez indivíduos portadores de periodontite crônica moderada em início do tratamento no Centro de Especialidades Odontológicas (CEO) de Senhor do Bonfim/BA. Os participantes responderam a um questionário e células esfoliadas da mucosa gengival de regiões sem alterações e com periodontite crônica moderada foram coletadas. Este material foi transferido para lâmina de vidro, fixado com metanol/ácido acético (3:1), corado com reativo de Shiff e fast green e analisado sob microscopia óptica. A análise estatística foi feita com o teste condicional para comparação de proporções em situações de eventos raros. Resultados: a ocorrência de micronúcleos, alterações nucleares degenerativas (cariorréxis, cariólise, cromatina condensada, picnose) e vacúolos nucleares foi significativamente maior em células da lesão. A ocorrência de broken eggs não diferiu estatísticamente. Conclusões: a periodontite crônica moderada é uma doença na qual há comprometimento da integridade genética das células do epitélio gengival. A maior ocorrência de alterações indicativas de apoptose na área da periodontite crônica aponta para a resposta biológica do organismo ao insulto genotóxico ao qual as células nesta lesão estão submetidas.

Introduction: periodontitis is a multifactorial disease that results primarily from the action of bacteria in the tissues that compose the periodontium. The inflammatory process that develops as a consequence is associated with increased cell proliferation which facilitates the occurrence of genetic damage. Objective: to evaluate, using the micronucleus test, the occurrence of genetic damage and nuclear alterations in individuals with chronic moderate periodontitis. Methodology: the sample included ten individuals with chronic moderate periodontitis beginning the treatment in the Centro de Especialidades Odontológicas (CEO) located in Senhor do Bonfim/BA. Participants answered a questionnaire and exfoliated cells of the gingival mucosal regions without alterations and with chronic moderate periodontitis were collected. This material was transferred to slide, fixed with metanol/acetic acid (3:1), stained with Schiff reactive and fast green and analyzed using optical microscope. The statistical analysis was done using the conditional test to compare proportions in a rare events situation. Results: the occurrence of micronuclei, degenerative nuclear alterations (karyorrhexis, karyolysis, condensed chromatin, pyknosis) and nuclear vacuoles was significantly higher in cells of the lesion. The occurrence of broken eggs did not differ statistically. Conclusions: the chronic moderate periodontitis is a disease that compromises the genetic integrity of the gingival epithelium cells. The higher occurrence of nuclear apoptotic cells in the area of chronic periodontitis is indicative of the biological response to genotoxic insult.

Effects of age on the frequency of micronuclei and degenerative nuclear abnormalities / Efeitos da idade sobre as frequências de micronúcleos e alterações nucleares degenerativas

Abstract The effects of aging, gender and lifestyle factors on inducing chromosomal damage (micronuclei) and nuclear degenerative changes were assessed using the micronucleus test on exfoliated cells of the oral mucosa. The sample included 80 healthy subjects divided into four groups according to age and gender: men and women aged 19-29 years (M19, W19) and men and women aged over sixty years (M60, W60). An interview questionnaire was used to characterize the sample and to determine an index reflecting lifestyle (HLI). The frequency of micronuclei and nuclear degenerative changes was significantly higher among the elderly (p<0.001) and did not differ by gender among young people (p>0.05). The occurrence of micronuclei was similar among elderly men and women (p>0.10), but karyorrhexis and karyolysis were more frequent among men (p<0.005 and p<0.025, respectively), who also had a lower HLI than the other groups (p<0.0004). The results of the study indicate that age is the main factor associated with the induction of genetic material damage. AU

Resumo O objetivo deste estudo foi avaliar os efeitos do envelhecimento, do gênero e de fatores relacionados ao estilo de vida na indução de danos cromossômicos (micronúcleo) e de alterações nucleares degenerativas com o uso do teste de micronúcleo em células esfoliadas da mucosa oral. A amostra incluiu oitenta indivíduos saudáveis divididos em quatro grupos de acordo com a faixa etária e o gênero: homens e mulheres de 19-29 anos (H19, M19), homens e mulheres com mais de sessenta anos (H60, M60). Questionário de entrevista foi aplicado para caracterizar a amostra e para determinar um índice refletindo o estilo de vida (IVS). A frequência de micronúcleos e alterações nucleares degenerativas foi significativamente maior entre os idosos (p<0,001) e não diferiu em função do gênero entre os jovens (p>0,05). Ocorrência de micronúcleos foi similar entre homens e mulheres idosos (p>0,10), mas cariorréxis e cariólise foram mais frequentes entre os homens (p<0,005 e p<0,025, respectivamente), que também apresentaram o menor IVS em relação aos demais grupos (p<0,0004). Os resultados deste estudo permitem concluir que a idade foi o principal fator associado à indução de danos ao material genético. AU

Avaliação de danos genéticos e apoptose em mulheres menopausadas que fazem uso da terapia de reposição hormonal / Assessment of genetic damage and apoptosis in postmenopausal women under hormone replacement therapy

Objetivo: Avaliar por meio do teste de micronúcleo em células esfoliadas da mucosa oral a genotoxicidade de hormônios empregados na terapia de reposição hormonal (TRH). Material e métodos: Quarenta mulheres menopausadas foram selecionadas e distribuídas em quatro grupos de dez: G0 (não submetidas à TRH), G1 (TRH com estrógeno), G2 (TRH com estrógeno e progestágeno) e G3 (TRH com tibolona). Células esfoliadas da mucosa oral foram coletadas e processadas para análise, sob microscopia óptica, de danos cromossômicos (micronúcleos) e de apoptose, inferida pelo somatório de alterações nucleares degenerativas (picnose, cariorréxis e cromatina condensada). Duas mil células foram analisadas por participante. A análise estatística foi feita com o uso do teste condicional para comparação de proporções em situação de eventos raros. Resultados: A frequência de micronúcleo não diferiu entre os grupos (p > 0,05). As alterações nucleares indicativas de apoptose foram significativamente mais altas entre as mulheres do G0 em relação às dos demais grupos (p < 0,01). Os grupos submetidos à TRH não diferiram quanto à ocorrência de apoptose (p > 0,05). Conclusões: Esses resultados indicam que, tal como avaliado neste estudo, a TRH não induz danos cromossômicos. Entretanto, devido ao efeito antiapoptótico, permite a proliferação de células geneticamente danificadas, está assim potencialmente associada ao processo de transformação maligna.(AU)

Objective: To evaluate through the micronucleus test in exfoliated cells of oral mucosa the genotoxicity of hormones used in hormone replacement therapy (HRT). Material and methods: Forty postmenopausal women were selected and divided into four groups of ten: G0 (not submitted to HRT), G1 (HRT with estrogen), G2 (HRT with estrogen and progestogen) and G3 (HRT with tibolone). Exfoliated cells of oral mucosa were collected and processed for analysis of chromosomal damage (micronuclei) and apoptosis, inferred by the sum of nuclear degenerative alterations (picnosis, cariorréxis and condensed chromatin). Two thousand cells were analyzed by participant. Statistical analysis was performed using the conditional test to compare proportions in a situation of rare events. Results: The frequency of micronuclei did not differ between groups (p > 0.05). Apoptotic cells were significantly higher among women from G0 when compared to the other groups (p < 0.01). The groups submitted to HRT did not differ in apoptosis occurrence (p > 0.05). Conclusions: These results indicate that, as assessed in this study, TRH does not induce chromosomal damage, however, due to the anti-apoptotic effect, cells genetically damaged can proliferate, favoring the malignant transformation process.(AU)

Can periodontal infection induce genotoxic effects?

OBJECTIVE: This study aimed to evaluate the occurrence of chromosomal abnormalities, through micronuclei, and apoptosis by the sum of karyorrhexis, pyknosis and condensed chromatin in individuals with chronic periodontitis, gingivitis associated with biofilm and no periodontal disease. MATERIALS AND METHODS: This study included 72 individuals divided into three groups: gingivitis (n = 21), periodontitis (n = 24) and control (n = 27). Information on sociodemographic characteristics, health and lifestyle was obtained. Full mouth clinical examination was performed to define the periodontal condition. Exfoliated cells from gingival mucosa were collected for computation of micronuclei and nuclear changes indicative of apoptosis. The differences in the occurrence of endpoints (micronucleus, karyorrhexis, pyknosis and condensed chromatin) were evaluated using the conditional test to compare proportions in a rare events situation. RESULTS: There was no statistically significant difference in the occurrence of micronucleus (p > 0.1) between gingivitis, periodontitis and control groups. The occurrence of apoptosis was significantly higher among individuals with periodontitis compared to individuals with gingivitis (p < 0.05) and controls (p < 0.025). CONCLUSIONS: The findings showed that the inflammatory process generated by gingivitis and periodontitis is not related to a higher occurrence of chromosomal damage. However, the higher occurrence of apoptosis in individuals with periodontitis points to genotoxic effects induced by periodontal infection.

Chromosome damage, apoptosis, and necrosis in exfoliated cells of oral mucosa from androgenic anabolic steroids users.

The aim of this study was to evaluate the potential of the androgenic anabolic steroids (AAS) for inducing chromosome damage, apoptosis, and necrosis, using the micronucleus test on exfoliated cells from the oral mucosa of AAS users. The sample consisted of 55 male individuals, practitioners of physical exercise divided into two groups: 25 individuals who were users of AAS and 30 individuals in the control group. Cytological analysis included, in addition to micronuclei, counting of broken eggs and degenerative nuclear changes indicative of apoptosis (karyorrhexis, condensed chromatin, and pyknosis) and necrosis (karyolysis in addition to these changes). The statistical analysis did not show differences in occurrences of micronuclei, karyolysis, and broken eggs between the groups. The occurrence of apoptosis was significantly higher in cells from control subjects. The results obtained showed that inhibition of apoptosis was induced by AAS, suggesting that this may be one of the mechanisms contributing toward the association that has been described between use of AAS and the carcinogenic process.

Assessment of nuclear abnormalities in exfoliated cells from the oral epithelium of mobile phone users.

Transmission and reception of mobile telephony signals take place through electromagnetic wave radiation, or electromagnetic radiofrequency fields, between the mobile terminal and the radio base station. Based on reports in the literature on adverse effects from exposure to this type of radiation, the objective of this study was to evaluate the genotoxic and cytotoxic potential of such exposure, by means of the micronucleus test on exfoliated cells from the oral epithelium. The sample included 45 individuals distributed in 3 groups according to the amount of time in hours per week (t) spent using mobile phones: group I, t > 5 h; group II, t > 1 h and ≤ 5 h; and group III, t ≤ 1 h. Cells from the oral mucosa were analyzed to assess the numbers of micronuclei, broken egg structures and degenerative nuclear abnormalities indicative of apoptosis (condensed chromatin, karyorrhexis and pyknosis) or necrosis (karyolysis in addition to these changes). The occurrences of micronuclei and degenerative nuclear abnormalities did not differ between the groups, but the number of broken egg (structures that may be associated with gene amplification) was significantly greater in the individuals in group I (p < 0.05).

Fatores associados à pneumonia nosocomial em indivíduos hospitalizados / Factors associated with nosocomial pneumonia in hospitalized individuals

OBJETIVO: Identificar os fatores associados à pneumonia nosocomial em hospital público de Feira de Santana, Bahia. MÉTODOS: Este estudo caso-controle foi realizado em 211 indivíduos adultos (46 casos e 165 controles), com idade média de 41 anos, atendidos na Clínica Médica, Clínica Cirúrgica ou na Unidade de Terapia Intensiva Adulta do Hospital Geral Clériston Andrade, em Feira de Santana. Os casos foram constituídos por indivíduos que desenvolveram infecção do trato respiratório (pneumonia nosocomial) após admissão hospitalar. Os controles foram formados por não portadores de pneumonia nosocomial. Informações socioeconómicas, história médica, estilo de vida e hábitos de higiene bucal foram obtidos por meio de entrevistas. Os prontuários foram checados para registro da condição de saúde do indivíduo e diagnóstico de pneumonia. Exame clínico bucal foi realizado por cirurgião-dentista treinado. Na análise bivariada, foi estimado o odds ratio (OR) como medida de associação e seus respectivos intervalos de confiança de 95 por cento (IC 95 por cento) com uso do método de Mantel-Haenzel. RESULTADOS: A frequência de pneumonia nosocomial na amostra foi de 21,8 por cento. A ocorrência de hipertensão e o tempo de internamento foram maiores nos casos do que nos controles (p < 0,05). A falta de uso de fio dental e de enxaguatório bucal foram maiores no grupo controle (p = 0,01). CONCLUSÃO: Os achados apontam a hipertensão, tempo de internamento > 5 dias e ausência do fio dental e enxaguatório bucal como fatores possivelmente associados à pneumonia nosocomial, apontando-os como alvos efetivos de prevenção.

OBJECTIVE: To identify factors associated with nosocomial pneumonia in individuals admitted to apublic hospital in Feira de Santana, Bahia. METHODS: This case control study was carried out in 211 adult individuals (46 cases and 165 controls), of a mean age of 41 years, treated at clinical wards, surgical wards or the adult intensive care unit of Cleriston Andrade General Hospital in Feira de Santana. The cases comprised individuals who developed respiratory tract infections (nosocomial pneumonia) after hospital admission. The controls consisted of patients without nosocomial pneumonia. Information on socioeconomic status, medical history, lifestyle and oral hygiene habits was obtained through interviews. The medical records were checked to verify subjects' health status and the diagnosis opneumonia. A clinical oral examination was performed by a trained dental surgeon. Odds ratio (OR) was estimated in the bivariate analysis as an association measurement, along with the respective 95 percent confidence interval through the Mantel-Haenszel method. RESULTS: The frequency of nosocomial pneumonia in the sample was 21.8 percent. The occurrence of hypertension was higher and hospital stay duration was longer in the cases than in controls (p ≤ 0.05). Lack of dental floss and mouthwash use were higher in the controls (p = 0.01). CONCLUSION: The findings indicate that arterial hypertension, length of hospital stay of five days and lack of dental floss and mouthwash use are factors likely associated with nosocomial pneumonia, suggesting that these factors should be targeted for effective prevention.

Fatores associados à doença periodontal em indivíduos atendidos em um hospital público de Feira de Santana, Bahia / Factors associated with periodontal disease among individuals attended at a public hospital in Feira de Santana, Bahia / Factores asociados con la enfermedad periodontal en personas tratados en un hospital público de Feira de Santana, Bahia

A doença periodontal, dentre outros fatores de riscos, pode ser um provável contribuinte de agravos sistêmicos. O objetivo deste artigo é descrever os fatores associados a doença periodontal em indivíduos hospitalizados no Hospital Geral Clériston Andrade, na cidade de Feira de Santana, Bahia. Trata-se de estudo exploratório em amostra de 100 indivíduos divididos em dois grupos, de acordo o diagnóstico da doença periodontal: Grupo 1 gengivite/periodontite leve (n igual 56); e Grupo 2 periodontite moderada/grave (n igual 44). Informações sociodemográficas e sobre saúde geral e bucal foram obtidas por meio de questionários estruturados e fichas de prontuários arquivados no hospital. Exame clínico periodontal foi realizado por único cirurgião-dentista treinado para obtenção precisa das medidas bucais. Mediante análise de regressão de Poisson múltipla hierarquizada, influência dos fatores de estudo sobre a doença periodontal foi testada separadamente por níveis. Os achados evidenciaram no modelo final que, além da precária condição bucal dos indivíduos hospitalizados, houve influência das variáveis idade, infecção do trato respiratório e hábito de fumar (p<0,10). No entanto, apenas idade apresentou-se estatisticamente associada à periodontite moderada/grave (RP igual 4,67; IC 95 porcento: 2,73-7,99). Concluiu-se que o impacto de fatores clássicos sob a condição periodontal reforça a adoção de práticas mais efetivas de educação em saúde bucal e cuidados de higiene em pacientes hospitalizados como rotina diária por equipe capacitada e multiprofissional.

Periodontal disease, among other risk factors, may be a likely contributor to systemic disease. The present study had the aim of describing factors associated with periodontal disease among individuals hospitalized at Clériston Andrade General Hospital, in the city of Feira de Santana, Bahia. This is an exploratory study was conducted on a sample of 100 individuals, who were divided into two groups according to their diagnosis of periodontal disease: Group 1: gingivitis/ mild periodontitis (n equal 56); and Group 2: moderate/severe periodontitis (n equal 44). Sociodemographic and general and oral health information was obtained from structured questionnaires and the medical files archived at the hospital. Clinical periodontal examinations were performed by asingle dental surgeon who had been trained to obtain precise oral measurements. Through hierarchical Poisson multiple regression analysis, the influence of the study factors on periodontal disease was tested separately for the hierarchical levels. The findings from the final model showed that, In addition to poor oral health among the hospitalized individuals, the variables of age, respiratory tract infection and smoking habit had an influence (p<0.10). However, only age showed a statistical association with moderate/severe periodontitis (PR equal 4.67; 95 percent CI: 2.73-7.99). It was concluded that the impact of classic factors on periodontal condition emphasizes that oral health education and hygiene care practices with greater effectiveness should be used among hospitalized patients, as the daily routine for the capacitated multiprofessional team.

La enfermedad periodontal, entre otros factores de riesgo, puede ser un factor probable que las enfermedades sistémicas El objetivo de este trabajo es describir los factores asociados con la enfermedad periodontal en individuos hospitalizados en el Hospital General deClériston Andrade, de la ciudad de Feira de Santana, Bahía. Este es un estudio exploratorio en uma muestra de 100 pacientes divididos en dos grupos, según el diagnóstico de la enfermedad periodontal: Grupo 1: gingivitis / periodontitis leve (n igual 56) y Grupo 2: periodontitis moderada /grave (n igual 44). La información sociodemográficos sobre la salud general y bucal se obtuvieron mediante cuestionarios estructurados y registros médicos presentados en los registros del hospital. El examen clínico fue realizado por un dentista calibrado para obtener medidas exactas de la boca. Mediante análisis de regresión de Poisson la influencia de múltiples factores sobre la enfermedad periodontal fue probado por niveles separados. Los resultados mostraron en el modelo final que, además del mal estado de salud bucal de los pacientes hospitalizados, hubo influencia de lãs variables edad, la infección del tracto respiratorio y el tabaquismo (p<0.10). Sin embargo, sólo la edad fue estadísticamente asociado con periodontitis moderada/grave (RP igual 4,67, IC 95por ciento: 2,73 a 7,99). Se concluyó que el impacto de los factores clásicos de la enfermedad periodontal refuerza la adopción de una educación para la salud bucal más eficaz y cuidado de la higiene bucal em pacientes hospitalizados como rutina diaria de un equipo capacitado y polivalente.

Factors associated with nosocomial pneumonia in hospitalized individuals.

OBJECTIVE: To identify factors associated with nosocomial pneumonia in individuals admitted to a public hospital in Feira de Santana, Bahia. METHODS: This case control study was carried out in 211 adult individuals (46 cases and 165 controls), of a mean age of 41 years, treated at clinical wards, surgical wards or the adult intensive care unit of Cleriston Andrade General Hospital in Feira de Santana. The cases comprised individuals who developed respiratory tract infections (nosocomial pneumonia) after hospital admission. The controls consisted of patients without nosocomial pneumonia. Information on socioeconomic status, medical history, lifestyle and oral hygiene habits was obtained through interviews. The medical records were checked to verify subjects' health status and the diagnosis of pneumonia. A clinical oral examination was performed by a trained dental surgeon. Odds ratio (OR) was estimated in the bivariate analysis as an association measurement, along with the respective 95% confidence interval through the Mantel-Haenszel method. RESULTS: The frequency of nosocomial pneumonia in the sample was 21.8%. The occurrence of hypertension was higher and hospital stay duration was longer in the cases than in controls (p ≤ 0.05). Lack of dental floss and mouthwash use were higher in the controls (p = 0.01). CONCLUSION: The findings indicate that arterial hypertension, length of hospital stay of five days and lack of dental floss and mouthwash use are factors likely associated with nosocomial pneumonia, suggesting that these factors should be targeted for effective prevention.

Critérios de medida da doença periodontal na associação com a prematuridade/baixo peso ao nascer / Criteria for measuring periodontal disease in association with prematurity/low birth weight

This study was carried out to compare the diagnostic criteria for periodontal disease used for studyng the association with prematurity/low birth weight. Two databases from previous case-control studies that investigated tha association between periodontal disease and prematurity/low birth weight were used, totaling 523 pregnant women. Their sociodemographic characteristics were evaluated using the chi-squared and Fischer exact tests. The clinical parameters adopted in these studies were based on complete periodontal clinical examination and werw obtained by a single trained examiner in each of the studies. The participants werw classified as having periodontal disease firstly using an index proposed by WHO (periodontal attachment loss (PALL) index), in which clinical attachment loss in the parameter, and secondly on the basis of complete examination, in which clinical attachment loss and probing depth ara the clinical parameters. The prevalences of periodontal disease identified according to complete examination and PAL criteria werw calculated. Comparisons between PAL and the complete examination criteria (Taken to be the gold standard) werw made using sensitivity, specificity and positive and negative predictive values. The results showed that when the PAL classification was used, the frequency of periodontal disease ranged from 50.7 % to 52.64 %. On tha other hand, when the complete examination criteria were used, this occurrence measurement ranged from 26,76% to 37.08%. The PAL index showed sensivity and positive predictive value of 100% and the specificity and negative predictive value ranged from 67.3% and from 52.8% to 70.4%, respectively. The findings suggest that PAL may overestimate the frequency of periodontal disease in certain situations, thus disthort this occurrence measurement in relation to the complete examination