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PURPOSE: The incidence of breast cancer in young women (BCYW) has increased in recent decades. Malignant disease in this subset is characterized by its aggressiveness and poor prognosis. Ovarian function suppression (OFS) in these patients improves survival especially in hormone receptor-positive (HR +) cases. The Regan Composite Risk (RCR) is a prognostic tool to identify high-risk HR + BC candidates for OFS. Our study sought to characterize a Chilean cohort of early HR + BCYW assessing the use of OFS and its related prognosis and the utility of RCR in our patients. METHODS: This was a retrospective population cohort study that included ≤ 35-year-old early HR + /human epidermal growth factor receptor 2 -negative (HER2-) BC patients treated between 2001 and 2021. Analysis included clinical-pathological characteristics, treatment strategies, and survival. Also, we evaluated the association between RCR and survival. RESULTS: A total of 143 patients were included into our study, representing 2.9% of all early BC cases in our registry. Median age was 31 years old (range: 19-35). Most patients (93%) received endocrine therapy (ET). Of these, 18% received OFS. No survival differences were observed among treatment strategies. Median RCR score for patients treated with CT plus ET was significantly higher vs. ET alone (2.95 vs. 1.91; p = 0.0001). Conversely, patients treated with tamoxifen alone had significantly lower RCR scores vs. OFS (2.72 vs. 3.14; p = 0.04). Higher RCR scores were associated with poorer overall survival. CONCLUSION: Less than 20% of very young women with early HR + /HER2-BC in our cohort received OFS, in most cases, this involved surgical oophorectomy. RCR score was higher in patients that underwent CT and OFS and was associated with survival, regardless of treatment. We confirm the RCR score as a valuable prognostic tool to identify high-risk BC patients who could benefit from OFS.
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Neoplasias da Mama , Feminino , Humanos , Adulto , Neoplasias da Mama/terapia , Neoplasias da Mama/tratamento farmacológico , Antineoplásicos Hormonais/uso terapêutico , Estudos Retrospectivos , Estudos de Coortes , Quimioterapia Adjuvante , Pré-Menopausa , Receptor ErbB-2/metabolismoRESUMO
BACKGROUND: Latin American (LA) studies on triple-negative breast cancer (TNBC) and their characteristics are scarce. This forces physicians to make clinical decisions based on data obtained from studies that include non-Hispanic patients. Our study sought to obtain local epidemiological data, including risk factors and clinical outcomes from a Chilean BC registry. METHODS: This was a retrospective population-cohort study that included patients treated at a community hospital (mid-low income) or an academic private center (high income), in the 2010-2021 period. Univariate and multivariate analyses were performed to identify prognostic factors associated with survival. RESULTS: 647 out of 5,806 BC patients (11.1%) were TNBC. These patients were younger (p = 0.0001) and displayed lower rates of screening-detected cases (p = 0.0001) compared to non-TNBC counterparts. Among TNBC patients, lower income (i. e., receiving treatment at a community hospital) was associated with poorer overall survival (HR: 1.53; p = 0.0001) and poorer BC specific survival (HR: 1.29; p = 0.004). Other risk factors showed no significant differences between TNBC and non-TNBC. As expected, 5-year OS was significantly shorter on TNBC versus non-TNBC patients (p = 0.00001). In our multivariate analyses TNBC subtype (HR: 2.30), locally advanced stage (HR: 7.04 for stage III), lower income (HR: 1.64), or non-screening detected BC (HR: 1.32) were associated with poorer OS. CONCLUSION: To the best of our knowledge, this is the largest LA cohort of TNBC patients. Interestingly, the proportion of TNBC among Chileans was smaller compared to similar studies within LA. As expected, TNBC patients had poorer survival and higher risk for early recurrence versus non-TNBC. Other relevant findings include a higher proportion of premenopausal patients among TNBC. Also, mid/low-income patients that received medical attention at a community hospital displayed lower survival versus private health center counterparts.
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Neoplasias da Mama , Neoplasias de Mama Triplo Negativas , Humanos , Feminino , Estudos de Coortes , Estudos Retrospectivos , Neoplasias de Mama Triplo Negativas/epidemiologia , Neoplasias de Mama Triplo Negativas/terapia , Neoplasias de Mama Triplo Negativas/diagnóstico , Chile/epidemiologia , Fatores de Risco , PrognósticoRESUMO
OBJECTIVES: To (1) investigate dental anxiety (DA) and oral health-related quality of life (OHRQOL) before and after non-surgical periodontal treatment (NSPT) and (2) determine correlations between these patient-reported measures. MATERIALS AND METHODS: Demographics, smoking habits, dental pain, Modified Corah's Dental Anxiety Scale (MDAS), and Oral Health Impact Profile (OHIP-14) were assessed in eighty-two participants. RESULTS: Mean age was 48.3 years ± 11.5. At baseline, 8.5% reported being active smokers. Of non-smokers, 11% reported being an ex-smoker. After NSPT, 11.0% reported smoking. Patients' maximal pain in the last month decreased after therapy. Before treatment, participants reported higher DA. Extreme DA was observed in 8.5% of participants before therapy. Afterwards, 2.4% of participants reported extreme DA. Fear of having a foreign object in the mouth decreased after NSPT. All OHIP-14 scores, except functional limitation, improved post-treatment. Higher DA was associated with worse OHRQoL before treatment. After treatment, total MDAS score was associated with OHIP-14 global score, physical pain, psychological disability, and social disability. Worse MDAS sub-scores were associated with a higher OHIP-14 global score. Individuals with "normal/slight anxiety" had a significant improvement in OHRQoL, whereas people in the "moderate and extreme anxiety" group did not report a significant improvement. Patients diagnosed with generalized periodontitis (GP) stage III grade B and GP stage IV grade B reported less anxiety after NSPT. CONCLUSIONS: Associations of MDAS subcategories with OHIP-14 domain scores were found before and after therapy. DA decreases and OHRQoL enhances after NSPT in patients with "normal/slight" anxiety to dental treatment. Dental practitioners should plan strategies to cope with anxiety to dental treatment and prevent decreases in OHRQoL. CLINICAL RELEVANCE: Within the limitations of this study, DA and OHRQoL were positively correlated in patients with periodontitis, before and after NSPT, using the MDAS and OHIP-14 questionnaires. The results of our study suggest that treatment is effective in terms of alleviating DA and improving oral health, along with quality of life, in patients that report "normal/slight" anxiety to dental treatment. Nonetheless, results must be interpreted with caution since patients are generally anxious before any type of dental treatment. DA may not just be confined to NSPT per se. According to our results, evaluation of both outcomes should be an integral part of routine periodontal clinical evaluation and periodontal reevaluation of initial therapy. It is important that clinicians learn to identify patients that suffer from anxiety and take time to explain the treatment procedures to the patient, to strive for patient's emotional well-being before, during, and after dental care services. The use of specific questionnaires for both DA and OHRQoL may be more appropriate to demonstrate the psychological and quality of life differences due to periodontal disease and NSPT.
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Ansiedade ao Tratamento Odontológico , Periodontite , Humanos , Pessoa de Meia-Idade , Ansiedade ao Tratamento Odontológico/psicologia , Qualidade de Vida/psicologia , Odontólogos , Papel Profissional , Saúde Bucal , Inquéritos e Questionários , Assistência OdontológicaRESUMO
BACKGROUND: Gingivitis is a common oral health problem. Untreated gingivitis may progress to periodontitis, a common cause of tooth loss. The prevalence of gingivitis and calculus among Puerto Rican children is unknown. Understanding this prevalence can support early public health preventative strategies. This study aims to estimate the prevalence of gingivitis and calculus among 12-year-old Puerto Ricans by health region and to explore differences in distribution by school type (proxy for socio-economic status) and gender. METHODS: A probability-based sample of 113 schools was selected proportional to enrollment size and stratified by health region, school type, and gender. Two trained examiners evaluated the presence of gingivitis and both supragingival and subgingival dental calculus. Gingivitis was defined as the presence of gingival bleeding upon gentle probing (BOP) in at least one site, and the extent of the problem was classified according to the percentage of teeth whose gingiva presented BOP (limited: 25-49% of the teeth tested; extensive: >50% of teeth tested). Logistic and linear regression models, adjusted for health regions, were used to compare gingivitis and calculus prevalence and extent between genders and school types. RESULTS: Gingivitis was found in 80.41% of the 1586 children evaluated. Urban-public schoolchildren had a slightly higher prevalence (83.24%) compared to private (79.15%, p = 0.16); those in rural-public (77.59%) and private schools had similar prevalence (p = 0.15). Extensive gingivitis was present in 60.81% of all children. The mean percentage of sites presenting BOP (BOP%) was 17.79%. Rural and urban public schoolchildren presented significantly higher BOP% compared to children from private schools (p = 0.0005, p = 0.002, respectively). Dental calculus was detected in 61.59% of the sample, boys presenting significantly higher (p = 0.005) total and supragingival calculus. Rural-public schoolchildren had a significantly higher prevalence of subgingival calculus compared to private schoolchildren (p = 0.02). CONCLUSIONS: Gingivitis prevalence is higher among 12-year-old Puerto Ricans compared to data reported for U.S. adolescents. Public schoolchildren presented significantly higher BOP% sites compared to private schoolchildren. Boys presented a significantly higher total and supragingival calculus prevalence than girls. Oral health disparities related to gender and school type were identified by this study. Studies exploring the reasons for these disparities are recommended.
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Cálculos Dentários/epidemiologia , Gengivite/epidemiologia , Criança , Estudos Transversais , Humanos , Índice Periodontal , Prevalência , Porto Rico/epidemiologia , População Rural/estatística & dados numéricos , Instituições Acadêmicas/estatística & dados numéricos , Fatores Sexuais , População Urbana/estatística & dados numéricosRESUMO
In Chile breast cancer (BC) is the first cause of death in women. While the most important risk factor for its development is estrogenic stimulation, environmental factors and lifestyles also contribute to its pathogenesis. Epidemiological studies show a direct relationship between physical activity (PA), incidence and recurrence of BC. Supervised PA practice is recommended in most cancer patients to improve their quality of life, to reduce adverse effects from treatment and eventually to improve the prognosis of the disease. We review the epidemiological evidence linking PA and BC and the biological basis of this relationship. We also review the relevant interventional studies and we explore some practical indications of PA in patients with BC, as a model for other tumors of epidemiological importance.
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Neoplasias da Mama/terapia , Exercício Físico , Neoplasias da Mama/etiologia , Neoplasias da Mama/prevenção & controle , Feminino , Humanos , Estilo de Vida , Terapia Neoadjuvante , Qualidade de Vida , Fatores de RiscoRESUMO
In order to relieve anxiety and depression accompanying stress, physicians resort to tricyclic antidepressants, such as imipramine. We had previously shown that imipramine reversed stress-induced social avoidance behavior, and down-regulated microglial activation 24days after stress cessation. To further characterize the effects of imipramine on stress induced neuroimmune dysregulation and associated changes in behavior, the aims of this study were to determine if imipramine 1) ameliorated stress-induced inflammation in the periphery and central nervous system, and 2) prevented stress related anxiety- and depressive-like behaviors. C57BL/6 mice were treated with imipramine (15mg/kg) in their drinking water, and exposed to repeated social defeat (RSD). Imipramine attenuated stress-induced corticosterone and IL-6 responses in plasma. Imipramine decreased the percentage of monocytes and granulocytes in the bone marrow and circulation. However, imipramine did not prevent splenomegaly, stress-related increased percentage of granulocytes in this organ, and the production of pro-inflammatory cytokines in the spleen, following RSD. Moreover, imipramine abrogated the accumulation of macrophages in the brain in mice exposed to RSD. Imipramine blocked neuroinflammatory signaling and prevented stress-related anxiety- and depressive-like behaviors. These data support the notion that pharmacomodulation of the monoaminergic system, besides exerting anxiolytic and antidepressant effects, may have therapeutic effects as a neuroimmunomodulator during stress.
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Antidepressivos Tricíclicos/farmacologia , Ansiedade , Corticosterona/sangue , Depressão , Imipramina/farmacologia , Inflamação , Interleucina-6/sangue , Células Progenitoras Mieloides/efeitos dos fármacos , Baço , Estresse Psicológico , Animais , Antidepressivos Tricíclicos/administração & dosagem , Ansiedade/etiologia , Ansiedade/imunologia , Ansiedade/metabolismo , Ansiedade/prevenção & controle , Comportamento Animal , Depressão/etiologia , Depressão/imunologia , Depressão/metabolismo , Depressão/prevenção & controle , Imipramina/administração & dosagem , Inflamação/tratamento farmacológico , Inflamação/etiologia , Inflamação/imunologia , Inflamação/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Baço/efeitos dos fármacos , Baço/imunologia , Baço/metabolismo , Estresse Psicológico/complicações , Estresse Psicológico/tratamento farmacológico , Estresse Psicológico/imunologia , Estresse Psicológico/metabolismoRESUMO
OBJECTIVE: Psychosocial stress is associated with altered immunity, anxiety, and depression. Repeated social defeat (RSD), a model of social stress, triggers egress of inflammatory myeloid progenitor cells (MPCs; CD11b(+)/Ly6C(hi)) that traffic to the brain, promoting anxiety-like behavior. In parallel, RSD enhances neuroinflammatory signaling and long-lasting social avoidant behavior. Lorazepam and clonazepam are routinely prescribed anxiolytics that act by enhancing GABAergic activity in the brain. Besides binding to the central benzodiazepine binding site (CBBS) in the central nervous system (CNS), lorazepam binds to the translocator protein (TSPO) with high affinity causing immunomodulation. Clonazepam targets the CBBS and has low affinity for the TSPO. Here the aims were to determine if lorazepam and clonazepam would: (1) prevent stress-induced peripheral and central inflammatory responses, and (2) block anxiety and social avoidance behavior in mice subjected to RSD. METHODS: C57/BL6 mice were divided into experimental groups, and treated with either lorazepam (0.10mg/kg), clonazepam (0.25mg/kg) or vehicle (0.9% NaCl). Behavioral data and tissues were collected the morning after the last cycle of RSD. RESULTS: Lorazepam and clonazepam were effective in attenuating mRNA expression of CRH in the hypothalamus and corticosterone in plasma in mice subjected to RSD. Both drugs blocked stress-induced levels of IL-6 in plasma. Lorazepam and clonazepam had different effects on stress-induced enhancement of myelopoiesis and inhibited trafficking of monocytes and granulocytes in circulation. Furthermore, lorazepam, but not clonazepam, inhibited splenomegaly and the production of pro-inflammatory cytokines in the spleen following RSD. Additionally, lorazepam and clonazepam, blocked stress-induced accumulation of macrophages (CD11b(+)/CD45(high)) in the CNS. In a similar manner, both lorazepam and clonazepam prevented neuroinflammatory signaling and reversed anxiety-like and depressive-like behavior in mice exposed to RSD. CONCLUSION: These data support the notion that lorazepam and clonazepam, aside from exerting anxiolytic and antidepressant effects, may have therapeutic potential as neuroimmunomodulators during psychosocial stress. The reversal of RSD-induced behavioral outcomes may be due to the enhancement of GABAergic neurotransmission, or some other off-target effect. The peripheral actions of lorazepam, but not clonazepam, seem to be mediated by TSPO activation.
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Ansiolíticos/administração & dosagem , Ansiedade/imunologia , Encéfalo/efeitos dos fármacos , Encéfalo/imunologia , Clonazepam/administração & dosagem , Moduladores GABAérgicos/administração & dosagem , Lorazepam/administração & dosagem , Estresse Psicológico/imunologia , Animais , Ansiedade/etiologia , Comportamento Animal/efeitos dos fármacos , Medula Óssea/efeitos dos fármacos , Antígeno CD11b/metabolismo , Corticosterona/sangue , Hormônio Liberador da Corticotropina/metabolismo , Granulócitos/efeitos dos fármacos , Hematopoese/efeitos dos fármacos , Hipocampo/efeitos dos fármacos , Hipocampo/imunologia , Hipotálamo/efeitos dos fármacos , Hipotálamo/imunologia , Interleucina-6/sangue , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Microglia/efeitos dos fármacos , Microglia/imunologia , Monócitos/efeitos dos fármacos , RNA Mensageiro/metabolismo , Esplenomegalia/etiologia , Esplenomegalia/prevenção & controle , Estresse Psicológico/complicaçõesRESUMO
Psychosocial stress is associated with altered immunity, anxiety and depression. Previously we showed that repeated social defeat (RSD) promoted microglia activation and social avoidance behavior that persisted for 24days after cessation of RSD. The aim of the present study was to determine if imipramine (a tricyclic antidepressant) would reverse RSD-inducedsocial avoidance and ameliorate neuroinflammatory responses. To test this, C57BL/6 mice were divided into treatment groups. One group from RSD and controls received daily injections of imipramine for 24days, following 6 cycles of RSD. Two other groups were treated with saline. RSD mice spent significantly less time in the interaction zone when an aggressor was present in the cage. Administration of imipramine reversed social avoidance behavior, significantly increasing the interaction time, so that it was similar to that of control mice. Moreover, 24days of imipramine treatment in RSD mice significantly decreased stress-induced mRNA levels for IL-6 in brain microglia. Following ex vivo LPS stimulation, microglia from mice exposed to RSD, had higher mRNA expression of IL-6, TNF-α, and IL-1ß, and this was reversed by imipramine treatment. In a second experiment, imipramine was added to drinking water confirming the reversal of social avoidant behavior and decrease in mRNA expression of IL-6 in microglia. These data suggest that the antidepressant imipramine may exert its effect, in part, by down-regulating microglial activation.
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Antidepressivos Tricíclicos/farmacologia , Comportamento Animal/efeitos dos fármacos , Encéfalo/efeitos dos fármacos , Imipramina/farmacologia , Comportamento Social , Estresse Psicológico/metabolismo , Animais , Encéfalo/imunologia , Encéfalo/metabolismo , Interleucina-1beta/genética , Interleucina-1beta/metabolismo , Interleucina-6/genética , Interleucina-6/metabolismo , Lipopolissacarídeos/farmacologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Microglia/efeitos dos fármacos , Microglia/imunologia , Microglia/metabolismo , Estresse Psicológico/imunologia , Fator de Necrose Tumoral alfa/genética , Fator de Necrose Tumoral alfa/metabolismoRESUMO
Background/purpose: Information on the systemic medication profiles of patients with periodontitis is limited. Therefore, this retrospective cross-sectional study aimed to analyze the relationship between the severity and rate of progression of periodontitis and systemic medication intake using a database of patients who attended the Clinic of Periodontics of the Faculty of Dentistry of the University of Costa Rica. Methods: Electronic health records of patients diagnosed with periodontitis based on the Classification of Periodontal and Peri-Implant Diseases and Conditions (2017) were evaluated. Individuals were further categorized based on the severity (stage) and rate of progression (grade). Data extracted from the patient records included age, sex, and self-reported medication intake. Results: In total, 930 records were included. Most of the studied population was middle-aged (36-64 years old); 43.01% were male, and 56.99% were female. Four hundred and fifty-seven patients (49.14%) reported taking at least one systemic medication for a chronic condition. Regarding the periodontal treatment phase, 62.37% underwent steps 1-3, and 37.63% underwent step 4. The most common systemic medications taken were for cardiovascular diseases (42.28%), followed by medications for diabetes (14.46%) and neurologic disorders (14.46%). Most patients (59.35%) were diagnosed with Stage III periodontitis. Grade B (48.28%) was the most prevalent. Calcium channel blockers demonstrated a disease severity-dependent association with the periodontal stage (p = 0.021). In addition, systemic medications for diabetes mellitus were associated with periodontal disease severity and rate of progression (all Ps < 0.05). Conclusions: This study provides indirect evidence of the association between systemic diseases and periodontitis. The positive association between medications used to treat diabetes and the severity and rate of progression of periodontitis may be due to the underlying disease rather than the medications per se.
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OBJECTIVE: Estimate the DGC dimensions and determine whether the DGC dimension varies by gingival biotype. METHODS: A cross-sectional study was performed in the Undergraduate and Prosthodontic Graduate Program clinics of the School of Dental Medicine, University of Puerto Rico from August 2011 to April 2012. A total of 53 participants who needed restorative crowns in their teeth were recruited. Prior to crown preparation, the gingiva was classified as having a thin, mixed or thick biotype, according to transparency, using a standardized 15 UNC Hu-Friedy periodontal probe. The DGC dimension was measured by transulcus probing. Descriptive statistics were calculated in mesial, medial, and distal sites by phenotypes. Differences between and within the sites' DGC dimension mean were determined using a Friedman test. The level of significance was 0.05. RESULTS: Mean DGC dimensions, in millimeters, for all sites measured were: 3.09 (95% CI: 2.91-3.27), 3.40 (95% CI: 3.18-3.62), 2.70 (95% CI: 2.51-2.89), and 3.17 (95% CI: 2.94-3.41) in mesial, medial, and distal sites, respectively. In thick, mixed, and thin biotypes the mesial sites showed greater DGC dimension means than the medial and distal (p<0.05) sites. Mean DGC dimension was greater for the thin compared to mixed and thick biotypes at mesial, medial and distal sites (p<0.001). Nevertheless, the thick biotype presented the smallest DGC mean dimensions compared to mixed and thin biotypes at the same sites. CONCLUSION: The DGC dimensions in all sites were similar to those reported in the literature. DGC dimensions are different for thin, mixed and thick gingival biotypes.
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Antropometria , Periodonto/anatomia & histologia , Adulto , Idoso , Classificação , Tecido Conjuntivo/anatomia & histologia , Estudos Transversais , Coroas , Inserção Epitelial/anatomia & histologia , Feminino , Gengiva/anatomia & histologia , Humanos , Masculino , Pessoa de Meia-Idade , Odontometria , Adulto JovemRESUMO
Abstract Since 2013, the Faculty of Dentistry of the University of Costa Rica has provided a preventive and restorative oral health program at Carmen Lyra Public School. The first generation of students that received dental care from this project were examined in 2019 for caries status. A total of 62 twelve-year-old schoolchildren were examined (31 boys and 31 girls). First, all teeth surfaces were cleaned with a brush and then rinsed. Subsequently, examination was performed in each person by a calibrated examiner using the International Caries Detection and Assessment System (ICDAS). Prevalence of dental caries was 59.7%. ICDAS code 2 was the most prevalent (68.8%), followed by 1 (19.3%), 5 (4.5%), 3 (3.5%), 6 (2.5%), and 4 (1.4%). Regarding number of carious surfaces, the highest prevalence was observed in the occlusal surfaces (77.3%), followed by the vestibular (13.9%), mesial (4.2%), palatal/ lingual (4,1%) and distal (0.5%). Of these carious surfaces, 7% were caries associated with restorations and were present only on the occlusal surfaces. Boys had more cavities than girls (54.1% compared to 45.9%), however, this difference was not significant. Regarding the condition of restorations in teeth, 92 dental restorations (resin or amalgam) were found in the population studied and were well adjusted. Most of these restorations were found on the occlusal surfaces (82.6%), followed by vestibular surfaces (8.7%,) palatal/lingual (5.4%) surfaces, mesial surfaces (3.3%), and no restorations were detected on the distal surfaces. Sealants were identified in 11.3% schoolchildren; 98% were identified on the occlusal surfaces and the other 2% were found on the palatal/lingual surfaces. DMFT Index was 1.6±0.71. The prevalence of dental caries in this sample was low compared to other studies in twelve-year-old schoolchildren in Costa Rica. This may suggest that the oral health program had a positive impact in the studied population.
Resumen Desde el año 2013, la Facultad de Odontología de la Universidad de Costa Rica ha brindado un programa de prevención y rehabilitación oral en la Escuela Carmen Lyra. La primera generación de estudiantes que recibieron atención dental por parte de este programa, fueron examinados en el año 2019 para determinar la prevalencia de caries. Se examinó a 62 escolares de 12 años (31 niños y 31 niñas). Primero, todas las superficies de los dientes se limpiaron con un cepillo y luego se enjuagaron. Posteriormente, el examen fue realizado en cada participante por un examinador calibrado utilizando el Sistema Internacional de Detección y Evaluación de Caries (ICDAS). La prevalencia de caries dental fue del 59,7%. El código ICDAS 2 fue el más prevalente (68,8%), seguido de 1 (19,3%), 5 (4,5%), 3 (3,5%), 6 (2,5%) y 4 (1,4%). En cuanto al número de superficies cariadas, la mayor prevalencia se observó en las superficies oclusales (77,3%), seguidas de las vestibulares (13,9%), mesiales (4,2%), palatinas/linguales (4,1%) y distales (0,5%). De estas superficies cariadas, el 7% eran caries asociadas con restauraciones y estaban presentes solo en las superficies oclusales. Los niños tenían más caries que las niñas (54,1% en comparación con el 45,9%), sin embargo, esta diferencia no fue significativa. En cuanto al estado de las restauraciones dentales, se encontraron 92 restauraciones dentales (resina o amalgama) en la población estudiada y se encontraban bien ajustadas. La mayoría de estas restauraciones se encontraron en las superficies oclusales (82,6%), seguidas de las superficies vestibulares (8,7%), superficies palatinas/linguales (5,4%), superficies mesiales (3,3%) y no se detectaron restauraciones en las superficies distales. Se identificaron sellantes de fosas y fisuras en el 11,3% de los escolares. El 98% de estos sellantes se identificó en las superficies oclusales y el otro 2% se encontró en las superficies palatino/lingual. El índice CPOD fue de 1,6±0.71. La prevalencia de caries dental en esta muestra fue baja en comparación con otros estudios en escolares de doce años en Costa Rica. Esto sugiere que el programa de salud bucal tuvo un impacto positivo en la población estudiada.
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Humanos , Masculino , Feminino , Criança , Adolescente , Saúde Bucal , Cárie Dentária/prevenção & controleRESUMO
Psychosocial stress is capable of causing immune dysregulation and increased neuroinflammatory signaling by repeated activation of the neuroendocrine and autonomic systems that may contribute to the development of anxiety and depression. The stress model of repeated social defeat (RSD) recapitulates many of the stress-driven alterations in the neuroimmune system seen in humans experiencing repeated forms of stress and associated affective disorders. For example, RSD-induced neuronal and microglia activation corresponds with sympathetic outflow to the peripheral immune system and increased ability of bone marrow derived myeloid progenitor cells (MPC) to redistribute throughout the body, including to the central nervous system (CNS), reinforcing stress-associated behaviors. An overview of the neuroendocrine, immunological, and behavioral stress-induced responses will be reviewed in this chapter using RSD to illustrate the mechanisms leading to stress-related alterations in inflammation in both the periphery and CNS, and stress-related changes in behavioral responses.
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Ansiedade/imunologia , Sistema Nervoso Central/imunologia , Depressão/imunologia , Inflamação/imunologia , Microglia/imunologia , Monócitos/imunologia , Sistema Nervoso Periférico/imunologia , Estresse Psicológico/imunologia , Animais , HumanosRESUMO
Abstract Chlorhexidine was introduced almost seven decades ago and has a myriad of applications in dentistry. Few studies have evaluated the antimicrobial and antifungal capacity of different concentrations of chlorhexidine mouthwashes. Therefore, the aim of this study, was to evaluate in vitro, the antibacterial and antifungal capacity of three commercially available mouthwashes in Costa Rica, with different concentrations of chlorhexidine, 0.12%, 0.06%, and 0.03%. The experimental method selected was the Kirby-Bauer method to evaluate the antibacterial and antifungal effect of each compound by measuring the inhibitory effect on Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, and Candida albicans strains, exposed to the antiseptic solutions. All samples showed some degree of antibacterial and antifungal effect. Even though we provide in vitro results, our findings are of relevance since all the species used in our experiment are microorganisms that may be present in dental plaque. Our results further support evidence that oral hygiene regimens may include mouthwashes with low doses of chlorhexidine and maintain reasonable antibacterial and antifungal efficacy.
Resumen La clorhexidina se introdujo hace casi siete décadas y tiene una gran variedad de aplicaciones en odontología. Pocos estudios han evaluado la capacidad antimicrobiana y antifúngica de diferentes concentraciones de enjuagues bucales con clorhexidina. Por lo tanto, el objetivo de este estudio fue evaluar in vitro, la capacidad antibacteriana y antifúngica de tres enjuagues bucales disponibles comercialmente en Costa Rica, con diferentes concentraciones de clorhexidina, 0.12%, 0.06% y 0.03%. El método experimental seleccionado fue el método Kirby-Bauer para evaluar el efecto antibacteriano y antifúngico de cada compuesto midiendo el efecto inhibidor sobre Staphylococcus aureus, Enterococcus faecalis, Escherichia coli y Candida albicans, expuestos a la solución antiséptica. Todas las muestras mostraron algún grado de efecto antibacteriano y antifúngico. Aunque proporcionamos resultados in vitro, nuestros hallazgos son de relevancia, ya que todas las especies utilizadas en nuestro experimento son microorganismos que pueden estar presentes en la placa dental. Nuestros resultados respaldan aún más la evidencia de que los regímenes de higiene bucal pueden incluir enjuagues bucales con dosis bajas de clorhexidina y mantener una eficacia antibacteriana y antifúngica razonable.
Assuntos
Clorexidina/análise , Antissépticos Bucais/uso terapêuticoRESUMO
Abstract The objective of this study was to determine the gingival state and presence of red complex bacteria in saliva samples of 12-year-old schoolchildren. A calibrated periodontist evaluated biofilm index (BI) (Silness and Löe, 1964), presence of calculus, and gingival index (GI) (Silness and Löe, 1967) in sixty two 12-year-old students of Carmen Lyra School. Saliva samples were collected from each student. The DNA of each sample was extracted and amplified by the polymerase chain reaction (PCR) technique, using specific primers. The BI was 1.18. Calculus was present in 40.40% of the schoolchildren examined; 19.4% was supragingival calculus and 21% both supragingival and subgingival calculus. The GI was 0.97, which according to Silness and Löe is mild gingivitis. Gingivitis was present in 96.8% of the children examined. Regarding the PCR tests: 18 of the samples (31.58%) did not present any of the bacteria analyzed and the remaining 39 samples (68.42%) were positive for at least the presence of red complex bacteria. Within the limitations of this study, it is concluded that the prevalence of gingivitis and calculus is high in the sample examined, and the gingival state observed in the study population, may be related to the presence of red complex bacteria.
Resumen El objetivo de este estudio era determinar el estado gingival y la presencia de bacterias del complejo rojo en muestras de saliva de niños de 12 años de la Escuela Carmen Lyra. Una periodoncista calibrada evaluó en 62 estudiantes de 12 años de la Escuela Carmen Lyra, el índice de biofilme (IB) (Silness y Löe, 1964), la presencia de cálculo y el índice gingival (IG) (Silness y Löe, 1967). Se recolectaron muestras de saliva de cada estudiante. El ADN de cada muestra fue extraído y amplificado por medio de la prueba PCR, empleando primers específicos, para determinar la presencia de bacterias del complejo rojo. El IB fue de 1.18. El cálculo estuvo presente en el 40.40% de la muestra, se encontró 19.4% de cálculo en supragingival y 21% tanto en supragingival como en subgingival. El IG fue de 0.97, que de acuerdo con Silness y Löe es una gingivitis leve. La gingivitis estuvo presente en el 96.8 % de los niños examinados. Con respecto a las pruebas PCR: 18 de las muestras (31.58 %) no presentaron ninguna de las bacterias analizadas y las 39 muestras restantes (68.42%) fueron positivas por lo menos a la presencia de las bacterias del complejo rojo. Dentro de las limitaciones de este estudio, se concluye que la prevalencia de gingivitis y cálculo es alta en la muestra examinada y el estado gingival observado puede estar relacionado con la presencia de bacterias del complejo rojo.
Assuntos
Humanos , Criança , Doenças da Gengiva , Gengivite/diagnóstico , Costa RicaRESUMO
Abstract: Research on gingival health of 12-year-old schoolchildren in Costa Rica is scarce. Since nutrition is an integral component of oral health, this study aimed to determine gingival status of 12-year-olds at Carmen Lyra Public School, San José, Costa Rica, and correlate these variables with the frequency of intake of different types of food and body mass index (BMI (kg/m2)). Sixty-two 12-year-old schoolchildren were recruited. A periodontist assessed Plaque Index (Silness and Löe,1964), presence of calculus, and Gingival Index (Löe and Silness, 1967). Gingivitis was defined as the presence of bleeding on probing (BOP) on at least one site, and the extent was classified according to the percentage of teeth whose gingiva presented BOP limited: 25-49% of teeth tested; extensive >50% of teeth tested. A semi-quantified food consumption frequency questionnaire was administered. BMI was calculated for each participant. Overall Plaque Index was 1.18. Calculus was present on 40.40% of the sample, 19.4% had supragingival calculus and 21% had either supragingival/subgingival calculus or both. Presence of calculus was related with number of bleeding surfaces (p=0.030). Number of teeth with calculus was related to bleeding(p=0.029), and number of bleeding surfaces (p=0.009). Gingival Index was 0.97, mild gingivitis. Gingivitis was present on 96.8% of children examined. Limited gingivitis was present in 11.5% of children and extensive gingivitis in 88.5%. None of the variables measured differed by gender. No relationships were found between the consumption of starchy foods, animal and vegetable protein sources, fruit, vegetables, fast foods, sugar sweetened beverages and desserts with Plaque Index, calculus, Gingival Index, and BOP. Teeth calculus was related with being overweight (chi- square=0.038). BMI for males was 20.21 and females 20.11. BMI was not related to BOP or calculus. Within the limitations of this pilot study, we concluded the prevalence of gingivitis and calculus is high in the sample examined. A greater sample is needed to determine correlations between the frequency of foods evaluated and gingival health.
Resumen: La investigación sobre la salud gingival en escolares de 12 años en Costa Rica es escasa. Dado que la nutrición es un componente integral de la salud oral, este estudio tuvo como objetivo determinar el estado de salud gingival de los niños de 12 años de la escuela Carmen Lyra, San José, Costa Rica, y correlacionar estas variables con la frecuencia de ingesta de diferentes tipos de alimentos y el índice de masa corporal (IMC (kg/m2)). Sesenta y dos escolares de 12 años fueron reclutados. Una periodoncista calibrada, evaluó el índice de placa (Silness y Löe, 1964), la presencia de cálculo y el índice gingival (Löe y Silness, 1967). La gingivitis se definió como la presencia de sangrado al sondaje en al menos un sitio. La extensión se clasificó de acuerdo con el porcentaje de dientes que presentaba sangrado al sondaje. Entre un 25-49% de los dientes con sangrado al sondaje, gingivitis limitada y extensiva, si presentaba más del 50% de dientes con sangrado al sondaje. Se administró un cuestionario de frecuencia de consumo de alimentos. El IMC se calculó para cada participante. El índice de placa fue de 1,18. El cálculo estuvo presente en el 40.40% de la muestra, el 19.4% tenía cálculo supragingival y el 21% tenía cálculo supragingival / subgingival o ambos. La presencia de cálculo se relacionó con el número de superficies sangrantes (p=0.030). El número de dientes con cálculo, se relacionó con el sangrado (p=0.029) y el número de superficies sangrantes (p=0.009). El índice gingival fue de 0.97, gingivitis leve. La gingivitis estuvo presente en el 96,8% de los niños examinados. La gingivitis limitada estuvo presente en el 11.5% de los niños y la gingivitis extensa en el 88.5%. Ninguna de las variables evaluadas difirió por género. No se encontraron relaciones entre el consumo de harinas, fuentes de proteínas animales y vegetales, frutas, verduras, comidas rápidas, bebidas azucaradas y postres con el índice de placa, cálculo, índice gingival y sangrado al sondaje. El cálculo se relacionó con el sobrepeso (chi-cuadrado=0.038). El IMC para los hombres fue 20.21 y las mujeres 20.11. El IMC no estaba relacionado con el sangrado al sondaje o cálculo. Dentro de las limitaciones de este estudio piloto, concluimos que la prevalencia de gingivitis y cálculo es alta en la muestra examinada. Se necesita una muestra mayor para determinar las correlaciones entre la ingesta de los diferentes tipos de alimentos evaluados y la salud gingival.
Assuntos
Humanos , Masculino , Feminino , Criança , Índice de Massa Corporal , Hemorragia Gengival , Alimentos, Dieta e Nutrição , Costa RicaRESUMO
Abstract 19. Lipopolysaccharide (LPS) is a component of the outer membrane of Gram-negative bacteria. In animals, intraperitoneal administration of LPS, stimulates innate immunity and the production of proinflammatory cytokines. LPS provides an inflammatory stimulus that activates the neuroimmune and neuroendocrine systems resulting in a set of responses termed sickness behavior. The purpose of this protocol is to describe step-by-step the preparation and procedure of application of intraperitoneal injection of LPS in rats, as a guide for those researchers that want to use this assay to mount an inflammatory response. LPS intraperitoneal challenge in rats has been widely used to evaluate antiinflammatory reagents and to address basic scientific questions.
Resumen 23. El lipopolisacárido (LPS) es un componente de la membrana externa de las bacterias Gram negativas. En animales, la administración intraperitoneal de LPS estimula la inmunidad innata y la producción de citoquinas proinflamatorias. El LPS proporciona un estímulo inflamatorio que activa el sistema neuroinmunológico y el sistema neuroendocrino, lo que da como resultado un conjunto de respuestas denominadas conductas de enfermedad. El propósito de este protocolo es describir paso a paso la preparación y el procedimiento de aplicación de la inyección intraperitoneal de LPS en ratas, como una guía para aquellos investigadores que desean utilizar este método para estimular una respuesta inflamatoria en el animal. La estimulación con LPS en ratas, aplicada intraperitonealmente, se ha utilizado ampliamente para evaluar reactivos antiinflamatorios y para abordar preguntas básicas de investigación científica.
Assuntos
Animais , Ratos , Lipopolissacarídeos/análise , Injeções Intraperitoneais/métodos , Endotoxinas/análise , Bactérias Gram-NegativasRESUMO
Elizabeth Kubler Ross y la Psicología Gestáltica asumen la música como una expresión terapéutica en la elaboración del duelo, cuando se pierde a un ser querido: expresar el propio estado de ánimo hasta regularizarlo es un medio profundo de acceso a lo real y un elemento que permite representar bellamente aun los contenidos emocionales, como ocurre con Julie Vignon de Courcy, personaje protagónico de la película Tres colores: azul, quien en un accidente de tránsito pierde a su esposo, un célebre compositor, y a su pequeña hija Anna. Aunque experimenta deseos autodestructivos, logra desprenderse de ellos gracias a la música como factor protector, lo cual contribuye a que elabore su duelo y descubra algo esencial: su valía y libertad personal.
Elizabeth Kubler Ross and Gestalt Psychology assume music as a therapeutic expression in the elaboration of mourning, when a loved one is lost: expressing one's state of mind until regularizing it is a profound means of accessing the real and an element that allows beautifully represent even the emotional contents, as it happens with Julie Vignon de Courcy, protagonist of the movie Three colors: blue, who in a traffic accident loses her husband, a famous composer, and his little daughter Anna. Although he experiences self-destructive desires, he manages to get rid of them thanks to music as a protective factor, which helps him to elaborate his grief and discover something essential: his worth and personal freedom.
Assuntos
Humanos , Musicoterapia , Pesar , Fatores de Proteção , Terapia GestaltRESUMO
OBJECTIVE: Evaluate the efficacy of three regimens integrating toothpaste, toothbrush and mouthwash in reducing dentine hypersensitivity. METHODS: Eight-week single-centre, three-cell, double-blind, randomized study was conducted in the Dominican Republic. Subjects entered one of the three regimens: (1) toothpaste containing 8% arginine and 1450 ppm mono-fluorophosphate, in a calcium carbonate base, a soft-bristle toothbrush followed by a mouthwash containing 0.8% arginine, PVM/MA copolymer, pyrophosphates, and 0.05% sodium fluoride; (2) toothpaste containing 5% potassium nitrate and 1450 ppm sodium fluoride, a soft-bristle toothbrush, followed by a mouthwash containing 0.51% potassium chloride and 230 ppm sodium fluoride; and (3) toothpaste containing 1450 ppm mono-fluorophosphate, a soft-bristle toothbrush followed by a fluoride/arginine free mouthwash. Tactile and Air-Blast dentine hypersensitivity measurements were performed at baseline, two, four, and eight weeks. For treatment group comparisons, ANCOVA and post hoc Tukey's pair-wise (α=0.05) were used. Kaplan-Meier survival analysis was performed to evaluate Time to Treatment Improvement. RESULTS: 120 subjects were enrolled, 118 completed the study. The Tactile hypersensitivity mean scores showed statistically significant improvement at two, four and eight (p ≤ 0.001) weeks in the arginine regime; the potassium regime did not show significant (p ≥ 0.05) improvement. Air-Blast Hypersensitivity scores had a statistically significant decrease at two (p=0.006), four (p=0.006) and eight (p=0.002) weeks in arginine and potassium regimes (p ≤ 0.05). The most effective treatment proved to be arginine (p ≤ 0.05) compared to the potassium regime. CONCLUSION: Arginine regimen provided the greatest reduction in Tactile and Air-Blast dentine hypersensitivity compared to potassium and negative control regimens; and provides faster dentine hypersensitivity relief than potassium regimen.
Assuntos
Arginina/uso terapêutico , Carbonato de Cálcio/uso terapêutico , Dessensibilizantes Dentinários/uso terapêutico , Sensibilidade da Dentina/tratamento farmacológico , Difosfatos , Fluoretos/uso terapêutico , Maleatos/uso terapêutico , Antissépticos Bucais/uso terapêutico , Fosfatos/uso terapêutico , Polietilenos/uso terapêutico , Cremes Dentais/uso terapêutico , Adolescente , Adulto , Idoso , Ar , Análise de Variância , Arginina/química , Carbonato de Cálcio/química , Dessensibilizantes Dentinários/química , Difosfatos/uso terapêutico , Método Duplo-Cego , Combinação de Medicamentos , Feminino , Fluoretos/química , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Antissépticos Bucais/química , Fosfatos/química , Potássio/uso terapêutico , Estudos Prospectivos , Fluoreto de Sódio/uso terapêutico , Estatísticas não Paramétricas , Fatores de Tempo , Escovação Dentária/instrumentação , Cremes Dentais/química , Tato , Adulto JovemRESUMO
In Chile breast cancer (BC) is the first cause of death in women. While the most important risk factor for its development is estrogenic stimulation, environmental factors and lifestyles also contribute to its pathogenesis. Epidemiological studies show a direct relationship between physical activity (PA), incidence and recurrence of BC. Supervised PA practice is recommended in most cancer patients to improve their quality of life, to reduce adverse effects from treatment and eventually to improve the prognosis of the disease. We review the epidemiological evidence linking PA and BC and the biological basis of this relationship. We also review the relevant interventional studies and we explore some practical indications of PA in patients with BC, as a model for other tumors of epidemiological importance.