The bidirectional relationship between obesity and periodontal disease – a narrative review

Periodontal diseases (PD) are multifactorial, chronic and infectious-inflammatory diseases that destroy periodontal attachment tissues and bacterial biofilms. Obesity is a chronic, multifactorial disease in which there is an excessive accumulation of body fat that harms the health and well-being of an individual. Periodontal diseases are important in the context of general health since they may be linked to several systemic diseases, such as obesity. This article aims to highlight the bidirectional relationship between obesity and periodontal disease. Materials and methods: The bibliographic review covered the PubMed, LILACS, and SciELO databases, and comprised studies and articles about the possible correlation between obesity and periodontal diseases between 2017 and 2021. In this context, periodontal diseases and obesity are similarly chronic, multifactorial, inflammatory and complex diseases which may interact with each other. The biological mechanisms responsible for the pathophysiology between periodontal diseases and obesity have not been fully understood. Their possible correlation is based on the production of hormones and cytokines via adipose tissue, altering the inflammatory response and interfering with the immune system. The data from this review demonstrate a lack of clinical studies assessing the role of periodontal diseases as a risk factor and as aggravation of obesity. Moreover, these data may support clinical research in this context

Étude du microenvironnement médullaire et des complexes d adhérence focale dans le myélodysplasies et leucémies

Les syndromes myélodysplasiques (SMD) sont considérés comme des maladies clonales des cellules souches hématopoïétiques (CSH). Le microenvironnement joue un rôle important par ses contacts direct avec les cellules progénitrices hématopoïétiques (CPH). Notre objectif était d'évaluer les défauts de croissance des cellules stromales mésenchymateuses (CSM) dans les MDS, d explorer les molécules d adhérence impliquées, et d'effectuer des corrélations avec leurs dysfonctionnements de croissance et les anomalies des CPH. Les CSM de MDS sont intrinsèquement pathologiques, montrant une baisse continue de la prolifération pendant 14 jours de culture et une capacité clonogénique réduite. Ces anomalies sont corrélés à une diminution des molécules d'adhérence CD44 et CD49e. Par ailleurs, le potentiel clonogénique des CPH est contrôlé par des mécanismes d'adhérence dépendant du stroma, CD49e pouvant être une des molécules impliquées. L analyse en immunofluorescence des protéines d'adhérence focale (FA), paxilline et pFAK [Y397], et des deux protéines régulatrices, HSP90ab et p130CAS permet l'identification d anomalies qualitatives et quantitatives. Une expression accrue de paxilline, pFAK et HSP90ab et leur forte co-localisation nucléaire dans les CSM d'anémie réfractaire avec excès de blastes (AREB) sont corrélées avec un avantage prolifératif et un impact négatif sur la capacité clonogénique de CPH. Ces résultats ouvrent des possibilités intéressantes : la signalisation via les protéines FA pourrait être impliquée dans les interactions HPC-MSC ; par ailleurs, FAK étant une protéine cliente d HSP90, les inhibiteurs d HSP90 sont une potentielle thérapie adjuvante dans les myélodysplasiesMyelodysplastic syndromes (MDS) are regarded as clonal disorders of haematopoietic stem cells (HSC). Recent evidence demonstrates that stromal microenvironment, in addition to HSC defects, plays a particular role via its direct contact with haematopoietic precursor cells (HPC). This thesis aims at evaluating the putative growth deficiencies of mesenchymal stromal cells (MSC) from MDS individuals compared with normal controls, exploring their adhesion profile, assessing the adhesion process-involved molecular substrates, and establishing correlations with their growth patterns and HPC dysfunctions. Functional assays revealed that MSC from MDS are intrinsically pathological, show a continuous decline of proliferation over a 14-day culture and a reduced clonogenic capacity in the absence of signals from HPC. MSC growth defects significantly correlate with decreased CD44 and CD49e expression. Moreover, stroma-dependent adhesion mechanisms control HPC clonogenic potential and CD49e might be one of the molecules involved in this process. Qualitative and quantitative abnormalities of focal adhesion (FA) proteins paxillin and pFAK [Y397] and of two regulatory proteins, HSP90ab and p130CAS were identified via immunofluorescence analysis. Paxillin, pFAK [Y397] and HSP90ab increased expression, besides its stronger nuclear colocalization in MSC from RAEB correlates with a consistent proliferative advantage and has a negative impact on HPC clonogenic capacity. These results open interesting opportunities, e.g. HPC-to-MSC interactions involve FA proteins signalling, and, as FAK is an HSP90ab-client protein, it may enhance the utility of HSP90ab inhibitors as adjuvant therapy in MDSST ETIENNE-Bib. électronique (422189901) / SudocSudocFranceF

Mastectomia versus tratamento cirúrgico conservador: impacto na qualidade de vida de mulheres com câncer mamário

OBJECTIVES: to compare the impact of mastectomy and conservative surgery on the quality of life of patients with breast cancer. METHODS: an assessment was made of the quality of life of patients undergoing mastectomy or segmentary mastectomy, at the Pouso Alegre Clinical Hospital, in the Brazilian State of Minas Gerais, using SF-36. The patients were grouped by age (50 years) and years of schooling (8 years). The Mann-Whitney test was used to compare the groups with regard to the age and schooling domains of SF-36. RESULTS: a significant difference between the two groups was found in the domains of physical functioning (p=0.04) and pain (p=0.01): with the patients undergoing a mastectomy registering the worst scores. Young patients who had undergone a mastectomy displayed the worst quality of life in terms of physical functioning (p=0.03), pain (p=0.01) and social functioning (p=0.01); those undergoing conservative surgery aged over 50 years scored worst on role emotional (p=0.05). Patients undergoing a mastectomy with lower levels of schooling scored lower in physical functioning (p=0.01), role physical (p=0.05) and pain (p=0.05). Among those who had attended school for more than eight years, those having undergone a mastectomy scored less in the pain domain (p=0.04). CONCLUSIONS: patients who had undergone a mastectomy had worse results in the physical component of the evaluation of quality of life and this negative impact was more strongly felt among younger patients and those with lower levels of schooling.OBJETIVOS: comparar o impacto da mastectomia e da cirurgia conservadora na qualidade de vida de pacientes com câncer mamário. MÉTODOS: avaliou-se qualidade de vida de pacientes submetidas à mastectomia ou à mastectomia segmentar, no Hospital das Clínicas de Pouso Alegre, Minas Gerais, Brasil, utilizando-se o SF-36. As pacientes foram estratificadas quanto à idade (50 anos) e escolaridade (8 anos). Aplicou-se o teste de Mann-Whitney para comparar os grupos quanto aos domínios do SF-36, idade e escolaridade. RESULTADOS: observou-se diferença significante entre os grupos nos domínios capacidade funcional (p=0,04) e dor (p=0,01): as pacientes mastectomizadas com piores resultados. Pacientes mastectomizadas mais jovens apresentaram pior qualidade de vida em capacidade funcional (p=0,03), dor (p=0,01) e aspectos sociais (p=0,01); as submetidas à cirurgia conservadora, com mais de 50 anos, resultado pior em aspectos emocionais (p=0,05). Pacientes mastectomizadas com menor escolaridade apresentaram escores menores em capacidade funcional (p=0,01), aspectos físicos (p=0,05) e dor (p=0,05). Entre as que frequentaram a escola por mais de oito anos, as mastectomizadas pontuaram menos no domínio dor (p=0,04). CONCLUSÕES: pacientes mastectomizadas apresentaram piores resultados no componente físico da qualidade de vida, e este impacto negativo foi mais acentuado entre pacientes mais jovens e com menor escolaridade.Universidade do Vale do SapucaíUniversidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

Ethics Guidelines for the Creation and Use of Registries for Biomedical Research Purposes

La información clínica almacenada en registros de diverso tipo constituye una herramienta fundamental para la investigación biomédica. Hasta hace pocos años la creación y uso de registros epidemiológicos, o la utilización de información procedente de registros pre-existentes con fines de investigación, apenas tenía limitaciones. Esta situación ha cambiado de modo sustancial debido básicamente a la creciente importancia que las leyes actuales conceden a la protección de la intimidad, la privacidad y la confidencialidad de los datos de carácter personal. Aunque el marco legal es ya muy explícito, hay un cierto espacio para la deliberación ética y el consejo prudente, al objeto de realizar con dicha información una investigación válida y útil y que, al mismo tiempo, respete los derechos de los sujetos y la legalidad vigente. En las presentes directrices se abordan aquellos aspectos que se han considerado relevantes desde un punto de vista ético en el manejo de registros con fines de investigación, incluyendo no sólo el uso sino la creación misma del registro. Se proporcionan 24 recomendaciones agrupadas en 10 apartados: justificación de la creación de un registro, organización y definición de responsabilidades, validez científica del proyecto de investigación, requisitos éticos de las colecciones de datos anónimos y de los registros anonimizados, requisitos éticos de los registros que contienen datos de carácter personal, usos de la historia clínica con fines de investigación, uso de registros históricos y de personas fallecidas, contacto con los sujetos de investigación, comunicación de resultados y revisión por un Comité de Ética de la Investigación.The clinical information stored in registries and records of different types is a fundamental tool for biomedical research. Up until just a few years ago, hardly any limitations existed on the creation and use of epidemiological registries or the use of information from pre-existing records for research purposes. This situation has changed substantially due mainly to the growing importance current laws place upon the safeguarding of the privacy and confidentiality of personal data. Although the legal framework is already quite explicit, a certain degree of leeway exists for ethical debate and prudence advice for the purpose of conducting valid, useful research with this information which will also respect the rights of the subjects and the laws in force. These guidelines deal with those aspects which have been considered relevant from an ethical standpoint in the handling of records and registries for research-related purposes, including not only the use but also the creation proper of the registries. A total of twenty-four recommendations are provided, grouped into ten sections: warranting of the creation of registry, organization and definition of responsibilities, scientific validity of the research project, ethical requirements of the collections of anonymous and anonymized data, ethical requirements of the registries including personal data, uses of medical records for research purposes, use of historical records of deceased individuals, contact with the research subjects, notification of results and review by a Research Ethics Committee

Formative research in critical epidemiology of infectious diseases in Latin America 2010 to 2020

Epidemiology has been an essential interpretative tool to understand the collective health of society, especially in the case of infectious diseases, but its diagnostic role in public health is permanently subjected to diametrically opposed reasoning, epidemiological practices, and social demands. It provides the equipment to evaluate the quality of life of the population and its success depends on its economic and political providers, paradigms and applied research models, many of them merely the result of the free will and autonomous decisions of its specialists, academics or not academics. The purpose of this research was to describe the current situation of Latin American scientific production in the period 2010 to 2020 in relation to formative research on epidemiology. The bibliometric study is based on the descriptive-retrospective analysis of contributions collected in Scopus indexed journals. In this sense, a total of 120 publications were collected, with Colombia being the country that contributes the highest scientific production, amounting to 23.33%, followed by Mexico and Peru with values of 18.33% and 17.50%, respectively. Likewise, there are 83 international institutions that have participated in the production of the topic in question, highlighting the institutions of Mexico, Peru and Colombia, with four or more published articles. In short, as a region, a progressive growth is perceived in terms of scientific production, a favorable situation to use formative research as a transversal and integral strategy in contribution to the development of the research component, the latter being a transcendental and mandatory function in universities. of our country

Mutations related to Antiretroviral Resistance identified by ultra-deep sequencing in HIV-1 infected children under Structured Interruptions of HAART

Altres ajuts: CONACYT/GCPS/44519Although Structured Treatment Interruptions (STI) are currently not considered an alternative strategy for antiretroviral treatment, their true benefits and limitations have not been fully established. Some studies suggest the possibility of improving the quality of life of patients with this strategy; however, the information that has been obtained corresponds mostly to studies conducted in adults, with a lack of knowledge about its impact on children. Furthermore, mutations associated with antiretroviral resistance could be selected due to sub-therapeutic levels of HAART at each interruption period. Genotyping methods to determine the resistance profiles of the infecting viruses have become increasingly important for the management of patients under STI, thus low-abundance antiretroviral drug-resistant mutations (DRM's) at levels under limit of detection of conventional genotyping (<20% of quasispecies) could increase the risk of virologic failure. In this work, we analyzed the protease and reverse transcriptase regions of the pol gene by ultra-deep sequencing in pediatric patients under STI with the aim of determining the presence of high- and low-abundance DRM's in the viral rebounds generated by the STI. High-abundance mutations in protease and high- and low-abundance mutations in reverse transcriptase were detected but no one of these are directly associated with resistance to antiretroviral drugs. The results could suggest that the evaluated STI program is virologically safe, but strict and carefully planned studies, with greater numbers of patients and interruption/restart cycles, are still needed to evaluate the selection of DRM's during STI

Ethics guidelines for the creation and use of registries for biomedical research purposes

The clinical information stored in registries and records of different types is a fundamental tool for biomedical research. Up until just a few years ago, hardly any limitations existed on the creation and use of epidemiological registries or the use of information from pre-existing records for research purposes. This situation has changed substantially due mainly to the growing importance current laws place upon the safeguarding of the privacy and confidentiality of personal data. Although the legal framework is already quite explicit, a certain degree of leeway exists for ethical debate and prudence advice for the purpose of conducting valid, useful research with this information which will also respect the rights of the subjects and the laws in force. These guidelines deal with those aspects which have been considered relevant from an ethical standpoint in the handling of records and registries for research-related purposes, including not only the use but also the creation proper of the registries. A total of twenty-four recommendations are provided, grouped into ten sections: warranting of the creation of registry, organization and definition of responsibilities, scientific validity of the research project, ethical requirements of the collections of anonymous and anonymized data, ethical requirements of the registries including personal data, uses of medical records for research purposes, use of historical records of deceased individuals, contact with the research subjects, notification of results and review by a Research Ethics Committee. La información clínica almacenada en registros de diverso tipo constituye una herramienta fundamental para la investigación biomédica. Hasta hace pocos años la creación y uso de registros epidemiológicos, o la utilización de información procedente de registros pre-existentes con fines de investigación, apenas tenía limitaciones. Esta situación ha cambiado de modo sustancial debido básicamente a la creciente importancia que las leyes actuales conceden a la protección de la intimidad, la privacidad y la confidencialidad de los datos de carácter personal. Aunque el marco legal es ya muy explícito, hay un cierto espacio para la deliberación ética y el consejo prudente, al objeto de realizar con dicha información una investigación válida y útil y que, al mismo tiempo, respete los derechos de los sujetos y la legalidad vigente. En las presentes directrices se abordan aquellos aspectos que se han considerado relevantes desde un punto de vista ético en el manejo de registros con fines de investigación, incluyendo no sólo el uso sino la creación misma del registro. Se proporcionan 24 recomendaciones agrupadas en 10 apartados: justificación de la creación de un registro, organización y definición de responsabilidades, validez científica del proyecto de investigación, requisitos éticos de las colecciones de datos anónimos y de los registros anonimizados, requisitos éticos de los registros que contienen datos de carácter personal, usos de la historia clínica con fines de investigación, uso de registros históricos y de personas fallecidas, contacto con los sujetos de investigación, comunicación de resultados y revisión por un Comité de Ética de la Investigación

Autochthonous cases of schistosomiasis in children in Recife, Northeastern Brazil

OBJETIVO : Investigar criadouros com moluscos hospedeiros e casos humanos autóctones para esquistossomose. MÉTODOS : Entre julho de 2010 e setembro de 2012 foram realizados: (1) levantamento malacológico para busca ativa de criadouros, coleta e identificação de caramujos Biomphalaria positivos para Schistosoma mansoni em Recife, PE; (2) inquérito de prevalência com 2.718 escolares, de sete a 14 anos, para diagnóstico de casos de esquistossomose; (3) exame clínico e ultrassonografia nos casos positivos para S. mansoni. Os casos foram investigados quanto à sua autoctonia e avaliados clinicamente. Os casos e criadouros foram georreferenciados e espacializados. RESULTADOS : Foram identificados 30 criadouros de B. straminea , quatro deles potenciais focos de transmissão, uma vez que os testes moleculares identificaram DNA de S. mansoni nos caramujos coletados. Foram diagnosticadas 14 crianças com esquistossomose; entre elas, cinco foram consideradas casos autóctones da doença. CONCLUSÕES : Ações emergenciais pela vigilância em saúde são necessárias para evitar que a esquistossomose se endemize em Recife, como acontece em localidades litorâneas do estado de Pernambuco.OBJETIVO Investigar criaderos con moluscos hospedadores y casos humanos autóctonos para esquistosomiasis. MÉTODOS Se ejecutaron: estudio malacológico para búsqueda activa de criaderos, colecta e identificación de caracoles Biomphalaria positivos para S. mansoni en Recife, PE, entre julio de 2010 y septiembre de 2012, pesquisa de prevalencia con 2.718 escolares, de siete a 14 años, para diagnóstico de casos de esquistosomiasis, examen clínico y de ultrason en los casos positivos para S. mansoni. Los casos fueron investigados con respecto a su autoctonía y evaluados clínicamente. Los casos y criaderos fueron geo-referenciados y espacializados. RESULTADOS Se identificaron 30 criaderos de B. straminea, cuatro de ellos potenciales focos de transmisión, luego que las pruebas moleculares identificaron DNA de S. mansoni en los caracoles colectados. Se diagnosticaron 14 niños con esquistosomiasis, entre ellas cinco fueron considerados casos autóctonos de la enfermedad. CONCLUSIONES Acciones de emergencia para vigilancia de salud son necesarias para evitar que la esquistosomiasis se vuelva endémica en Recife como sucede en localidades del litoral de Pernambuco.OBJECTIVE : Investigate breeding sites with host snails and autochthonous human cases of schistosomiasis. METHODS : Between July 2010 and September 2012 were performed: (1) malacological survey searching for breeding sites, collection and identification of Biomphalaria snails positive for Schistosoma mansoni in Recife, PE, Northeastern Brazil; (2) prevalence survey in 2,718 schoolchildren aged from seven to 14 years old to identify cases of schistosomiasis, clinical examination and ultrasound in positive cases of S. mansoni. The autochthony of the cases was investigated and the case were clinically evaluated. The cases and breeding sites were georeferenced and spatially described. RESULTS : The results identified 30 breeding with B. straminea, four of which were potential foci of transmission, as molecular testing identified snails with S. mansoni DNA. There were 14 children diagnosed with schistosomiasis, of which five were considered to be autochthonous cases of the disease. CONCLUSIONS : Urgent measures are required in order to avoid schistosomiasis becoming endemic to Recife, as has happened in other coastal areas of the state of Pernambuco