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1.
Medicine (Baltimore) ; 99(35): e21939, 2020 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-32871938

RESUMO

RATIONALE: Maturity-onset diabetes of the young type 5 (MODY 5) is a form of monogenic diabetes that is often accompanied by pancreatic dysfunction. To date, no cases of MODY 5 treated with glucagon-like peptide-1 receptor agonist (GLP-1RA) have been reported. We present the first case of MODY 5 treated with GLP-1RA. PATIENT CONCERNS: A 17-year-old woman, with a history of being operated for congenital ileal atresia at birth, was admitted to our hospital due to hyperglycemia. She had been clinically diagnosed with type 1 diabetes 1 month prior, and administered 14 units of insulin glargine 300 U/mL per day. DIAGNOSIS: She had hypopotassemia, hypomagnesaemia, pancreatic body, and tail defects, multiple renal cysts, and a family history of diabetes, and urogenital anomaly. Genetic testing revealed heterozygous deletion of hepatocyte nuclear transcription factor-1 beta, leading to the diagnosis of MODY 5. INTERVENTIONS: The patient was treated with multiple daily insulin injections for 9 days (22 units/d) before administration of GLP-1RA, and then liraglutide was initiated. OUTCOMES: Liraglutide treatment (0.6 mg/d) alone maintained the patient's glycated hemoglobin level below 7.0% for at least 12 months after discharge. A higher dose, 0.9 mg/d, of liraglutide was not tolerated by the patient due to nausea. Serum levels of C-peptide immunoreactivity were 1.15 ng/mL and 1.91 ng/mL, respectively, after 6 and 12 months of liraglutide therapy. LESSONS: GLP-1RA might be effective at regulating glucose metabolism by utilizing residual pancreatic endocrine function in patients with MODY 5. Imaging and genetic screening were helpful in the diagnosis of MODY 5.


Assuntos
Doenças do Sistema Nervoso Central/tratamento farmacológico , Esmalte Dentário/anormalidades , Diabetes Mellitus Tipo 2/tratamento farmacológico , Receptor do Peptídeo Semelhante ao Glucagon 1/agonistas , Hipoglicemiantes/uso terapêutico , Doenças Renais Císticas/tratamento farmacológico , Liraglutida/uso terapêutico , Adolescente , Doenças do Sistema Nervoso Central/diagnóstico por imagem , Esmalte Dentário/diagnóstico por imagem , Diabetes Mellitus Tipo 2/diagnóstico por imagem , Feminino , Humanos , Hipoglicemiantes/farmacologia , Doenças Renais Císticas/diagnóstico por imagem , Liraglutida/farmacologia , Pâncreas/diagnóstico por imagem
2.
Cient. dent. (Ed. impr.) ; 17(2): 107-114, mayo-ago. 2020. tab, ilus, graf
Artigo em Espanhol | IBECS | ID: ibc-195098

RESUMO

La mucopolisacaridosis tipo IV (MPS-IV) también conocida como enfermedad de Morquio en recuerdo del pediatra uruguayo Luis Morquio que la describió por primera vez, es una enfermedad congénita causada por la deficiencia de la enzima N-acetilgalactosamina 6 sulfatasa o de la enzima B-Galactosidasa. Estas anomalías enzimáticas tienen como consecuencia que se acumulen en diferentes tejidos del organismo cantidades elevadas de mucopolisacaridos. En la bibliografía se describe con detalle los defectos del esmalte que presentan los pacientes diagnosticados del síndrome de Morquio. Estos defectos son una característica aparentemente constante en la enfermedad y, por lo tanto, hace necesaria las visitas al odontólogo para su control evitándose problemas mayores. Dichos defectos consisten en un esmalte anormalmente delgado, que es áspero debido a los numerosos hoyos diminutos y a una superficie irregular. La delgadez del esmalte da como resultado una forma alterada y decoloración de los dientes que, añadido a los diastemas interdentales, provocan alteraciones en la oclusión. Aparte de estos defectos, el esmalte es histológicamente normal y tiene una du-reza y radiodensidad normales. El trata-miento odontológico de los pacientes con MPS-IV requiere colaboración multidisciplinar, debido a que las manifestaciones orales de la enfermedad pueden aparecer a cualquier edad, resultando en ocasiones tedioso para el paciente y complicado para el profesional. Especial mención merecen las terapias utilizadas como trata-miento sintomático de la enfermedad, así como el manejo de la vía aérea en el caso de intervenciones bajo anestesia general o sedación para tratar ciertas patologías del territorio bucomaxilodental


Mucopolysaccharidosis type IV (MPS-IV) also known as Morquio’s disease in memory of the Uruguayan pediatrician Luis Morquio who described it for the first time, is a congenital disease caused by the deficiency of the enzyme N-acetylgalactosamine 6 sulfatase or enzyme B -Galactosidase. These enzymatic anomalies result in high amounts of mucopolysaccharides accumulating in different tissues of the organism. The enamel defects presented by patients diagnosed with Morquio syndrome are described in detail in the bibliography. These defects are an apparently constant feature in the disease and, therefore, make visits to the dentist necessary for their control, avoiding major problems. These defects consist of an abnormally thin enamel that is rough due to numerous tiny holes and an irregular surface. The thinness of the enamel results in an altered form and discoloration of the teeth, which added to the interdental diastemas, cause alterations in the occlusion. Apart from these defects, the enamel is histologically normal and has a normal hardness and radiodensity.Dental treatment of patients with MPS-IV requires multidisciplinary collaboration, because the oral manifestations of the disease can appear at any age, being sometimes tedious for the patient and complicated for the professional. Special mention should be made of the therapies used as a symptomatic treatment of the disease, as well as the management of the airway in the case of interventions under general anesthesia or sedation to treat certain pathologies of the bucomaxillodental territory


Assuntos
Humanos , Anormalidades Dentárias/etiologia , Anormalidades Dentárias/patologia , Mucopolissacaridoses/genética , Mucopolissacaridoses/fisiopatologia , Anormalidades Dentárias/terapia , Mucopolissacaridoses/classificação , Mucopolissacaridoses/etiologia , Acuidade Visual , Caixa Torácica/diagnóstico por imagem , Caixa Torácica/fisiopatologia , Esqueleto/anormalidades , Esqueleto/diagnóstico por imagem , Esmalte Dentário/anormalidades
3.
Medicine (Baltimore) ; 99(31): e21438, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32756155

RESUMO

RATIONALE: Mutations in the hepatocyte nuclear factor-1-beta (HNF1B) gene result in a very variable presentation, including maturity onset diabetes of the young (MODY), renal cysts, renal dysplasia, and autosomal dominant tubulointerstitial kidney disease (ADTKD), which is characterized by tubular damage, renal fibrosis, and progressive renal dysfunction. PATIENT CONCERNS: A 22-year-old man came to the hospital presenting with hyperglycemia, hyperuricemia and elevated serum creatinine. His urine protein was within the normal range. The ultrasound examination revealed shrunken kidneys with renal cysts. The patient's mother was diagnosed with diabetes mellitus when she was 25 years old. Her laboratory results showed elevated serum creatinine. Her ultrasonography revealed shrunken kidneys with renal cysts and hydronephrosis without kidney stones. The next-generation sequencing revealed that the proband and his mother held the same heterozygous missense mutation (c.530G>A, NM_000458, p.R177Q) in the HNF1B gene. Bioinformatic analyses predicted that the mutation was likely pathogenic. DIAGNOSIS: The patient and his mother were diagnosed as ADTKD and MODY5 due to HNF1B mutation. INTERVENTION: The proband was administered metformin at a dose of 500 mg/day. OUTCOMES: The patient had well-controlled blood glucose levels and a stable renal function at his 12-month follow-up. LESSONS: We should take into account the diagnoses of ADTKD and MODY5 if patients present with early onset diabetes and multiple renal cysts or evidence of renal tubulointerstitial dysplasia, especially those with negative proteinuria results. Genetic testing helps detect the HNF1B gene mutations.


Assuntos
Doenças do Sistema Nervoso Central/genética , Esmalte Dentário/anormalidades , Diabetes Mellitus Tipo 2/genética , Fator 1-beta Nuclear de Hepatócito/genética , Doenças Renais Císticas/genética , Nefrite Intersticial/genética , Assistência ao Convalescente , Doenças do Sistema Nervoso Central/complicações , Doenças do Sistema Nervoso Central/tratamento farmacológico , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/tratamento farmacológico , Heterozigoto , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Humanos , Hiperglicemia/etiologia , Hiperuricemia/etiologia , Hipoglicemiantes/administração & dosagem , Hipoglicemiantes/uso terapêutico , Rim/diagnóstico por imagem , Rim/patologia , Rim/fisiopatologia , Doenças Renais Císticas/complicações , Doenças Renais Císticas/tratamento farmacológico , Doenças Renais Císticas/patologia , Masculino , Metformina/administração & dosagem , Metformina/uso terapêutico , Mutação de Sentido Incorreto , Nefrite Intersticial/complicações , Nefrite Intersticial/patologia , Linhagem , Ultrassonografia/métodos , Adulto Jovem
4.
Acta Odontol Latinoam ; 33(1): 6-13, 2020 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-32621593

RESUMO

Dental enamel defects (DED) are lesions that occur due several factors. Proper care is needed to promote their treatment and prevention. The aim of this study was to evaluate the occurrence of DED in permanent teeth of children who used antimicrobial drugs in the first four years of life. This is a crosssectional study carried out in a Primary Health Care (PHC) service, which included children from six to 12 years of age. DED were evaluated by oral examination, and data on the use of antimicrobials in early childhood were collected based on medical records. Data were analyzed with the chi-square test and Fisher's exact test. The sample included 144 children. In relation to DED, 50% (72) and 20.1% (29) presented opacity and hypoplasia, respectively. Amoxicillin was the most frequently prescribed drug, followed by sulfamethoxazole + trimethoprim. Among the children, 78.5% (113) were prescribed antimicrobial drugs at least once during the first 4 years of life, and 55% (79) of them presented some type of DED. There was no statistically significant association between the variables analyzed. In conclusion, there was high prevalence of children with DED, and amoxicillin was the most commonly prescribed antibiotic.


Assuntos
Antibacterianos/uso terapêutico , Cárie Dentária , Hipoplasia do Esmalte Dentário/induzido quimicamente , Esmalte Dentário/anormalidades , Esmalte Dentário/efeitos dos fármacos , Dente Decíduo/anormalidades , Antibacterianos/efeitos adversos , Criança , Hipoplasia do Esmalte Dentário/epidemiologia , Feminino , Humanos , Masculino , Prevalência , Atenção Primária à Saúde
5.
Artigo em Inglês | MEDLINE | ID: mdl-32516977

RESUMO

BACKGROUND: Developmental enamel defects (DDE) exert significant effects both on esthetics and occlusal function and prevention should be the general clinical approach to DDE. The purpose of this cross-sectional study was, therefore, to detect, within a pediatric sample, any significant association between DDE and children's psychosocial attitudes towards home oral hygiene, as well as potential associations between primary preventive procedures and DDE. METHODS: 394 schoolchildren (197 males and 197 females, 8.9 ± 1.4 years) underwent an intra-oral examination; they were then interviewed with a brief questionnaire. RESULTS: 5-6% and 12-14% of participants had, respectively at least one molar and one incisor affected by DDE. In general, no associations were observed in the examined clinical categories (caries and other oral health indices). A strong relationship was found between the presence of molar DDE and children's positive vs. negative psychosocial attitudes towards home oral hygiene. CONCLUSIONS: The probability of finding DDE in our sample of examined children was approximately more than doubled for children with negative psychosocial attitudes towards home oral hygiene, than for children with positive attitudes towards home oral hygiene.


Assuntos
Cárie Dentária , Esmalte Dentário/anormalidades , Saúde Bucal , Atitude , Criança , Estudos Transversais , Diclorodifenil Dicloroetileno , Feminino , Humanos , Masculino , Higiene Bucal , Prevalência , Serviços Preventivos de Saúde
6.
Libyan J Med ; 15(1): 1705633, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31873070

RESUMO

Background: Enamel defects (EDs) are commonly reported dental findings in preterm/low birthweight children. EDs potentially increase caries susceptibility.Aim: To assess the prevalence of EDs and dental caries in a group of preterm children (aged 5-10 years) in Dubai, United Arab Emirates (UAE).Methodology: A retrospective cohort study of medical records of 62 preterm children (mean age 8.1 ± 1.54) and 62 full-term children (mean age 8.1 ± 1.73) of both genders born in a UAE children's hospital were studied. These children were dentally assessed for EDs and caries by a calibrated examiner.Results: EDs were 4.34 times more prevalent among preterm children [odd ratio (OR) = 4.338, CI 95% [2.010-9.366]. The prevalence of EDs in the pre-term group was 58.15%, significantly higher (P < 0.01) than the full-term control group (24.2%). Birth weight, intubation and type of delivery were statistically significant factors contributing to EDs. In the primary dentition, the mean dmft was 4.61 ± 4.30, while in the permanent dentition DMFT was 0.38 ± 0.99. There was a statistically significant difference in permanent teeth caries experience amongst pre-term children compared to the full-term control as measured by DMFT (P = 0.008).Conclusion: EDs and dental caries in permanent dentition in the pre-term group were significantly higher than the full-term group.


Assuntos
Cárie Dentária/epidemiologia , Hipoplasia do Esmalte Dentário/complicações , Esmalte Dentário/anormalidades , Criança , Pré-Escolar , Parto Obstétrico/tendências , Dentição Permanente , Feminino , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Intubação/efeitos adversos , Intubação/estatística & dados numéricos , Masculino , Prevalência , Estudos Retrospectivos , Fatores de Risco , Dente Decíduo , Emirados Árabes Unidos/epidemiologia
7.
Braz Oral Res ; 33: e094, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31618294

RESUMO

This study aimed to analyze the association of sociodemographic, child health, healthcare service, and access indicators with developmental defects of enamel (DDE) acquired outside the uterus, based on gestational factors. A cohort of births was carried out, and 982 children aged 12 to 30 months were examined. A total of 1,500 women were followed up as of the 5th month of gestation, and the child's gestational age was evaluated at follow-up. The clinical examination was performed as recommended by the World Health Organization, and defects were classified using the modified DDE index. Six models were considered: presence of DDE (Model 1) or opacities (Model 4), number of teeth with DDE (Model 2) or opacities (Model 5), and incidence rate of DDE (Model 3) or opacities (Model 6). Associations were estimated by relative risk (RR) in Poisson regression models. In the adjusted analysis, the mother's lowest education level was associated with the highest occurrence of DDE in Models 1 (RR = 26.43; p = 0.002), 2 (RR = 9.70; p = 0.009), and 3 (RR = 5.63; p = 0.047). Breastfeeding for over 12 months (RR = 0.45; p = 0.030) and recent use of anti-infection drugs (RR = 0.20; p = 0.039) had a protective effect on DDE (Model 1). The factors associated with the highest incidence of opacities were not having health insurance (RR = 2.00; p = 0.043) (Model 5), and belonging to a family of poor social class (RR = 4.67; p = 0.007) (Model 6). Children in a situation of socioeconomic vulnerability have a higher risk of presenting extrauterine DDE. Breastfeeding was a protection factor for DDE development.


Assuntos
Hipoplasia do Esmalte Dentário/epidemiologia , Hipoplasia do Esmalte Dentário/etiologia , Esmalte Dentário/anormalidades , Brasil/epidemiologia , Aleitamento Materno , Pré-Escolar , Hipoplasia do Esmalte Dentário/prevenção & controle , Feminino , Idade Gestacional , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Incidência , Lactente , Masculino , Modelos Teóricos , Estudos Prospectivos , Análise de Regressão , Medição de Risco , Fatores de Risco , Fatores Socioeconômicos , Populações Vulneráveis
8.
BMC Res Notes ; 12(1): 701, 2019 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-31661020

RESUMO

OBJECTIVE: Canine tooth bud removal is a process of gouging out an infant's canine tooth buds, using unsterile tools such as Sharpe blade, garlic, or knitting needle, without anesthesia. The aim of the study was to reveal dental complications of canine tooth bud removal among children who visited the dental clinic of the University of Gondar hospital. This study was an institution-based cross-sectional conducted from January 2015 to September 2016 at the University of Gondar hospital on 2-12 years children. The tooth was assessed for whether it had previously oral mutilated or not. In addition to this, the oral cavity was evaluated for the presence of missed, malformed or normal canine. RESULTS: A group of 355 children aged 2-12 years was examined clinically. The mean age of the children was 7.32 ± 3.12 (SD). The prevalence of canine tooth bud removal was 86.8% which was high in 6-9 years old (54.87%) and first position children (40.26%). The most common dental complications were; malformed enamel (hypoplastic) canine (48.5%) and missed/unerupted canine (38.6%).


Assuntos
Dente Canino/cirurgia , Medicina Tradicional Africana/efeitos adversos , Extração Dentária/efeitos adversos , Criança , Pré-Escolar , Estudos Transversais , Dente Canino/lesões , Esmalte Dentário/anormalidades , Etiópia , Feminino , Hemorragia/epidemiologia , Hemorragia/etiologia , Humanos , Infecções/epidemiologia , Infecções/etiologia , Masculino , Boca , Complicações Pós-Operatórias
9.
Niger J Clin Pract ; 22(8): 1157-1162, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31417061

RESUMO

Background: The aims of this study are to present sociodemographic and familial characteristics, clinical and systemic findings, dental treatment needs, and concomitant dental anomalies in patients with amelogenesis imperfecta (AI) and to evaluate time-varying conditions in these long-term follow-up patients. Materials and Methods: Records of patients with AI who were examined in the Department of Pediatric Dentistry between 1999 and 2017 were reviewed. Information about sociodemographic characteristics, history of AI and consanguinity in family, systemic conditions, reasons for referral to the clinic, oral hygiene habits and gingival health, occlusion findings, and performed treatments were gathered. Dental anomalies in radiographs were also evaluated. Baseline and final situations of the patients were assessed. Statistical analyses were performed. Results: Of 75 patients aged 3-15 years with follow-ups up to 12 years, 34 had AI in their families and 15 were born from consanguineous marriages. Nephrocalcinosis has been observed in 5 patients. Main reasons for referral to the clinic were related to esthetic and hypersensitivity concerns. Twenty-two patients had gingivitis, and during follow-up process, gingival problems could not be completely prevented due to poor oral hygiene habits. Vertical dimension loss, open-bite, and cross-bite were seen in 16, 15, and 10 patients, respectively. Of the patients, 63% experienced restorative, 33% stainless steel crown, 17% endodontic, 8% prosthetic treatments, and 24% had retreatment needs. Concomitant dental anomalies were dens invaginatus, taurodontism, ectopic eruption, delayed eruption, hypodontia, and pulpal calcification. Conclusion: Early diagnosis and interventions considering the time-varying conditions with long-term follow-ups provide significant improvements in clinical maintenance of patients with AI.


Assuntos
Amelogênese Imperfeita/diagnóstico por imagem , Amelogênese Imperfeita/terapia , Esmalte Dentário/anormalidades , Reabilitação Bucal/métodos , Radiografia Panorâmica , Adolescente , Amelogênese Imperfeita/genética , Criança , Pré-Escolar , Cárie Dentária/terapia , Sensibilidade da Dentina/epidemiologia , Sensibilidade da Dentina/terapia , Estética Dentária , Feminino , Gengivite/epidemiologia , Humanos , Masculino , Má Oclusão , Nefrocalcinose/epidemiologia , Nefrocalcinose/terapia , Índice de Higiene Oral , Aço Inoxidável
10.
Arch Oral Biol ; 104: 1-6, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31151029

RESUMO

OBJECTIVE: The staircase (Sc) pattern enamel microstructure is an expression of an impaired ameloblast function. It has been reported to appear in the neonatal line (NNL), the accentuated stria evincing live birth in deciduous tooth enamel. Our objective was to investigate the prevalence of Sc NNL in deciduous tooth types and its possible association with perinatal circumstances. DESIGN: Sc in the NNL of 88 teeth, a collection derived from a long-term, prospectively followed population cohort, was recorded with linear polarised transmitted light and analysed for tooth type, duration and mode of delivery, and pain medication used during labour. RESULTS: Sc prevalence in the NNL differed highly significantly between tooth types (p < 0.0001). An increase in Sc prevalence was significantly associated with an increased ratio of prenatal to total crown enamel (p < 0.001), when buccal and lingual crown walls were analysed separately. No significant association was found between Sc prevalence and duration or mode of delivery or pain-relieving medication (p = 0.57, p = 0.65, p = 0.58, respectively). CONCLUSION: This research indicates that the NNL location within tooth crown enamel has a strong impact on microstructural changes along the NNL. Considering our results of Sc prevalence, deciduous canines, having the least Sc appearance, could be used in studies that aim to investigate factors associated with NNL width. In addition, Sc prevalence variation in first deciduous molars might enable to investigation of physiological stressors strong enough to cause ameloblast impairment, such as Sc.


Assuntos
Esmalte Dentário , Dente Decíduo , Estudos de Coortes , Esmalte Dentário/anormalidades , Feminino , Humanos , Recém-Nascido , Dente Molar , Gravidez , Prevalência , Dente Decíduo/anormalidades
11.
Clin Exp Nephrol ; 23(9): 1119-1129, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31131422

RESUMO

BACKGROUND: Hepatocyte nuclear factor 1ß (HNF1B), located on chromosome 17q12, causes renal cysts and diabetes syndrome (RCAD). Moreover, various phenotypes related to congenital anomalies of the kidney and urinary tract (CAKUT) or Bartter-like electrolyte abnormalities can be caused by HNF1B variants. In addition, 17q12 deletion syndrome presents with multi-system disorders, as well as RCAD. As HNF1B mutations are associated with different phenotypes and genotype-phenotype relationships remain unclear, here, we extensively studied these mutations in Japan. METHODS: We performed genetic screening of RCAD, CAKUT, and Bartter-like syndrome cases. Heterozygous variants or whole-gene deletions in HNF1B were detected in 33 cases (19 and 14, respectively). All deletion cases were diagnosed as 17q12 deletion syndrome, confirmed by multiplex ligation probe amplification and/or array comparative genomic hybridization. A retrospective review of clinical data was also conducted. RESULTS: Most cases had morphological abnormalities in the renal-urinary tract system. Diabetes developed in 12 cases (38.7%). Hyperuricemia and hypomagnesemia were associated with six (19.3%) and 13 cases (41.9%), respectively. Pancreatic malformations were detected in seven cases (22.6%). Ten patients (32.3%) had liver abnormalities. Estimated glomerular filtration rates were significantly lower in the patients with heterozygous variants compared to those in patients harboring the deletion (median 37.6 vs 58.8 ml/min/1.73 m2; p = 0.0091). CONCLUSION: We present the clinical characteristics of HNF1B-related disorders. To predict renal prognosis and complications, accurate genetic diagnosis is important. Genetic testing for HNF1B mutations should be considered for patients with renal malformations, especially when associated with other organ involvement.


Assuntos
Síndrome de Bartter/genética , Doenças do Sistema Nervoso Central/genética , Deleção Cromossômica , Cromossomos Humanos Par 17 , Esmalte Dentário/anormalidades , Diabetes Mellitus Tipo 2/genética , Deleção de Genes , Fator 1-beta Nuclear de Hepatócito/genética , Doenças Renais Císticas/genética , Anormalidades Urogenitais/genética , Refluxo Vesicoureteral/genética , Adolescente , Adulto , Síndrome de Bartter/diagnóstico , Doenças do Sistema Nervoso Central/diagnóstico , Criança , Pré-Escolar , Hibridização Genômica Comparativa , Diabetes Mellitus Tipo 2/diagnóstico , Progressão da Doença , Predisposição Genética para Doença , Hereditariedade , Humanos , Lactente , Japão , Doenças Renais Císticas/diagnóstico , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase Multiplex , Linhagem , Fenótipo , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Anormalidades Urogenitais/diagnóstico , Refluxo Vesicoureteral/diagnóstico
12.
Pediatr Dent ; 41(2): 95-112, 2019 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-30992106

RESUMO

Purpose: The purpose of this study was to perform a systematic review to assess current evidence for association between various risk factors and the prevalence or incidence of early childhood caries (ECC). Methods: Two reviewers searched various databases until January 2019. The Newcastle-Ottawa scale was used to perform risk of bias assessment. The included studies were categorized according to the World Bank classification. Data were summarized in a meta-analysis using fixed and random effects inverse-generic meta-analyses. Results: A total of 7,034 records involving 89 studies that evaluated 1,352,097 individuals were included; 23 were high, 46 were moderate, and 20 were of low quality. A total of 123 risk factors were found. Meta-analysis revealed that the strongest risk factors found in the high-income countries were presence of dentinal caries (dmft greater than zero; odds ratio [OR] equals 4.21 [2.18 to 8.16]) and high levels of mutans streptococci (OR equals 3.83 [1.81 to 8.09]). In upper-middle-income countries, presence of enamel defects (OR equals 14.62 [6.10 to 35.03]) was found to be the strongest risk factor. Conclusion: The strongest risk factors associated with early childhood caries was the presence of enamel defects, presence of dentinal caries and high levels of mutans streptococci.


Assuntos
Cárie Dentária/etiologia , Índice CPO , Esmalte Dentário/anormalidades , Humanos , Fatores de Risco , Streptococcus mutans/isolamento & purificação
13.
Arch Oral Biol ; 101: 147-155, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30939297

RESUMO

OBJECTIVE: To document and describe the occurrence of an enamel pearl on the distal root surface of the maxillary M3 of the fossil hominin specimen from Florisbad, South Africa that is dated to ca. 259,000 years B.P., and is an early representative of Homo sapiens or as a member of the evolutionary line that was directly ancestral to modern humans. DESIGN: The molar was examined macroscopically and by micro-computed tomography (µCT) to enable accurate measurement and visualization of the structure of the enamel pearl. RESULTS: The single pearl has a diameter of 0.97 mm; it is a Type 2 "composite" pearl comprising an enamel cap and dentine core without pulp chamber involvement. The size of the Florisbad pearl falls within or just below the size ranges of this anomaly in modern human samples. Type 2 pearls are most commonly encountered in recent human populations, and the location of the pearl on the distal root surface of the Florisbad M3 is consistent with its most frequent location in recent humans. Pearls in recent human populations affect between 0.2-4.8% of individuals, and 1.7-6.8% of permanent molars. Pearls have been documented in several prehistoric human dentitions, and all examples are less than 4000 years old. CONCLUSIONS: Enamel pearls have been associated with periodontal disease, but it is not possible to relate its presence to the advanced periodontal inflammation and alveolar bone loss in the Florisbad fossil. Florisbad presents the earliest evidence of this anomaly in the fossil record pertaining to modern humans.


Assuntos
Esmalte Dentário/anormalidades , Fósseis , Hominidae , Animais , Esmalte Dentário/diagnóstico por imagem , Humanos , África do Sul , Microtomografia por Raio-X
14.
Methods Mol Biol ; 1922: 511-523, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30838597

RESUMO

Epidemiological investigations of early childhood oral health rely upon the collection of high-quality clinical measures of health and disease. However, ascertainment of valid and accurate clinical measures presents unique challenges among young, preschool-age children. The paper presents a clinical research protocol for the conduct of oral epidemiological examinations among children, implemented in ZOE 2.0, a large-scale population-based genetic epidemiologic study of early childhood caries (ECC). The protocol has been developed for the collection of information on tooth surface-level dental caries experience and tooth-level developmental defects of the enamel in the primary dentition. Dental caries experience is recorded using visual criteria modified from the International Caries Detection and Assessment System (ICDAS), and measurement of developmental defects is based upon the modified Clarkson and O'Mullane Developmental Defects of the Enamel Index. After a dental prophylaxis (toothbrushing among all children and flossing as needed), children's teeth are examined by trained and calibrated examiners in community locations, using portable dental equipment, compressed air, and uniform artificial light and magnification conditions. Data are entered directly onto a computer using a custom Microsoft Access-based data entry application. The ZOE 2.0 clinical protocol has been implemented successfully for the conduct of over 6000 research examinations to date, contributing phenotype data to downstream genomics and other "omics" studies of ECC and DDE, as well as traditional clinical and epidemiologic dental research.


Assuntos
Cárie Dentária/patologia , Esmalte Dentário/patologia , Saúde Bucal , Dente Decíduo/patologia , Pré-Escolar , Cárie Dentária/diagnóstico , Esmalte Dentário/anormalidades , Esmalte Dentário/crescimento & desenvolvimento , Pesquisa em Odontologia/métodos , Humanos , Manejo de Espécimes/métodos , Dente Decíduo/anormalidades , Dente Decíduo/crescimento & desenvolvimento
15.
Compend Contin Educ Dent ; 40(3): 172-177, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30829499

RESUMO

This case report describes the management of a mandibular first molar with an additional distolingual root (radix entomolaris) and grade III cervical enamel projection through a multidisciplinary approach. Diagnosis for the case was endodontic-periodontal lesion due to non-vitality and associated advanced periodontal destruction. The patient was treated with drainage of the periodontal abscess with adjunct antibiotics, phase I periodontal therapy, endodontic therapy, radiculoplasty, regenerative periodontal therapy, replacement of the missing right mandibular second molar, and long-term maintenance. Follow-up of the patient up to 9 months has been uneventful. Cases of advanced periodontal destruction typically show some degree of tooth mobility, which was absent in this case. The article discusses the tripod effect as well as the increased surface area for periodontal attachment provided by the additional root contributing to the non-mobility of the involved tooth.


Assuntos
Esmalte Dentário/anormalidades , Dente Molar/anormalidades , Abscesso Periodontal/terapia , Anormalidades Dentárias/terapia , Grupo com Ancestrais do Continente Asiático , Humanos , Masculino , Mandíbula , Pessoa de Meia-Idade , Dente Molar/diagnóstico por imagem , Abscesso Periodontal/diagnóstico por imagem , Abscesso Periodontal/etiologia , Radiografia Dentária , Anormalidades Dentárias/complicações , Anormalidades Dentárias/etnologia
16.
Indian J Pathol Microbiol ; 62(1): 95-98, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30706867

RESUMO

Glomerulocystic kidney disease (GCKD) is an uncommon type of cystic renal disease affecting children. It has both sporadic and familial occurrence and is characterized by cortical microcysts associated with dilatation of Bowman's spaces. In some instances, GCKD is an early manifestation of autosomal dominant polycystic kidney disease. Here, we present three cases of GCKD, two in infants and one in a perinatal postmortem. The first one is a case of GCKD with unilateral involvement, diagnosed on surgical biopsy. GCKD is a morphological expression of several hereditary and nonhereditary disorders that differ vastly in their management and long-term outcome. Hence, accurate morphological diagnosis of this entity is important for prognostication and genetic counseling.


Assuntos
Doenças do Sistema Nervoso Central/diagnóstico , Esmalte Dentário/anormalidades , Diabetes Mellitus Tipo 2/diagnóstico , Doenças Renais Císticas/diagnóstico , Rim Policístico Autossômico Dominante/diagnóstico , Biópsia , Doenças do Sistema Nervoso Central/patologia , Esmalte Dentário/patologia , Diabetes Mellitus Tipo 2/patologia , Feminino , Humanos , Lactente , Recém-Nascido de muito Baixo Peso , Rim/diagnóstico por imagem , Rim/patologia , Doenças Renais Císticas/patologia , Doenças Renais Císticas/cirurgia , Masculino , Nefrectomia , Rim Policístico Autossômico Dominante/patologia , Rim Policístico Autossômico Dominante/cirurgia , Ultrassonografia
17.
Sci Rep ; 9(1): 2225, 2019 02 18.
Artigo em Inglês | MEDLINE | ID: mdl-30778115

RESUMO

Renal Cysts and Diabetes Syndrome (RCAD) is an autosomal dominant disorder caused by mutations in the HNF1B gene encoding for the transcriptional factor hepatocyte nuclear factor-1B. RCAD is characterized as a multi-organ disease, with a broad spectrum of symptoms including kidney abnormalities (renal cysts, renal hypodysplasia, single kidney, horseshoe kidneys, hydronephrosis), early-onset diabetes mellitus, abnormal liver function, pancreatic hypoplasia and genital tract malformations. In the present study, using capillary electrophoresis coupled to mass spectrometry (CE-MS), we investigated the urinary proteome of a pediatric cohort of RCAD patients and different controls to identify peptide biomarkers and obtain further insights into the pathophysiology of this disorder. As a result, 146 peptides were found to be associated with RCAD in 22 pediatric patients when compared to 22 healthy age-matched controls. A classifier based on these peptides was generated and further tested on an independent cohort, clearly discriminating RCAD patients from different groups of controls. This study demonstrates that the urinary proteome of pediatric RCAD patients differs from autosomal dominant polycystic kidney disease (PKD1, PKD2), congenital nephrotic syndrome (NPHS1, NPHS2, NPHS4, NPHS9) as well as from chronic kidney disease conditions, suggesting differences between the pathophysiology behind these disorders.


Assuntos
Biomarcadores , Doenças do Sistema Nervoso Central/metabolismo , Esmalte Dentário/anormalidades , Diabetes Mellitus Tipo 2/metabolismo , Doenças Renais Císticas/metabolismo , Proteoma , Proteômica , Adolescente , Biomarcadores/urina , Doenças do Sistema Nervoso Central/diagnóstico , Doenças do Sistema Nervoso Central/urina , Criança , Pré-Escolar , Esmalte Dentário/metabolismo , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/urina , Diagnóstico Diferencial , Feminino , Humanos , Doenças Renais Císticas/diagnóstico , Doenças Renais Císticas/urina , Masculino , Espectrometria de Massas , Peptídeos/urina , Fenótipo , Proteômica/métodos , Reprodutibilidade dos Testes
18.
J Diabetes Investig ; 10(4): 1112-1115, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30637974

RESUMO

Here, we report phenotypic differences and similarities of monozygotic twins with maturity-onset diabetes of the young type 5 harboring a partial deletion of chromosome 17q12. The proband and her twin sister manifested complete aplasia and marked hypoplasia, respectively, of the body and tail of the pancreas. Whereas both twins showed marked hypoplasia of the right kidney and multiple cysts in both kidneys, only the proband's sister showed hydronephrosis in the left kidney. The proband had profound defects in insulin and glucagon secretion, as well as mild renal dysfunction, whereas her sister had pronounced renal dysfunction accompanied by mild defects in insulin and glucagon secretion. Both twins manifested hypomagnesemia and hyperuricemia, but no apparent liver dysfunction or intellectual disability. The severity of renal and pancreatic defects differed between monozygotic twins with maturity-onset diabetes of the young type 5, suggesting that the phenotypes of this condition are determined not solely by genetic factors.


Assuntos
Biomarcadores/análise , Doenças do Sistema Nervoso Central/fisiopatologia , Esmalte Dentário/anormalidades , Diabetes Mellitus Tipo 2/fisiopatologia , Fator 1-beta Nuclear de Hepatócito/genética , Doenças Renais Císticas/fisiopatologia , Nefropatias/diagnóstico , Pancreatopatias/diagnóstico , Adulto , Esmalte Dentário/fisiopatologia , Feminino , Deleção de Genes , Humanos , Incidência , Secreção de Insulina , Nefropatias/epidemiologia , Pancreatopatias/epidemiologia , Fenótipo , Gêmeos Monozigóticos
19.
Oral Dis ; 25(2): 543-549, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30537164

RESUMO

OBJECTIVE: Developmental defects of enamel (DDE) in preterm infants still require clarification and may favour dental caries, lower food intake and greater difficulty with weight-height gain. We evaluated factors associated with DDE in preterm infants. SUBJECTS AND METHODS: In this prospective cohort study, we monitored 54 prematurely born infants from birth to 24 months of age. Trained and calibrated dentists examined the oral cavity of these children to identify and categorize DDE. Information on perinatal variables was collected from the infants' medical records and interviews with their mothers. The data were analysed using Student's t test, a chi-squared test and Pearson's product-moment correlation coefficient. RESULTS: A total of 46.3% of the 54 children presented DDE, which was observed more frequently in the left hemiarch in children born extremely (<28 weeks of gestation) or very preterm (28 to <32 weeks; RR = 2.2; 95% CI 1.3-3.6), with very low birthweight (<1,500 g; RR = 2.0; 95% CI 1.1-3.5), who were admitted to the neonatal intensive care unit (RR = 1.3; 95% CI 1.0-1.7), and who were intubated (RR = 1.6; 95% CI 1.1-2.2). CONCLUSIONS: The high incidence of incisor enamel defects, particularly on the left side, was related to higher risk prematurity and to local trauma from intubation.


Assuntos
Esmalte Dentário/anormalidades , Incisivo/anormalidades , Intubação Intratraqueal , Nascimento Prematuro/epidemiologia , Anormalidades Dentárias/epidemiologia , Dente Decíduo/anormalidades , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Recém-Nascido de muito Baixo Peso , Unidades de Terapia Intensiva Neonatal , Masculino , Admissão do Paciente , Estudos Prospectivos , Fatores de Risco
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