Dental caries and bacterial load in saliva and dental biofilm of type 1 diabetics on continuous subcutaneous insulin infusion

Objectives: Since most of the studies evaluates diabetics on multiple daily injections therapy and continuous subcutaneous insulin infusion may help gain better metabolic control and prevent complications, the objective of this study was to evaluate the prevalence of dental caries, the unstimulated salivary flow rate and the total bacteria load, Streptococcus spp. levels and Lactobacillus spp. levels in saliva and supragingival dental biofilm of type 1 diabetics on insulin pump. Material and Methods: Sixty patients with type 1 diabetes on insulin pump and 60 nondiabetic individuals were included. The dental caries evaluation was performed using ICDAS and the oral hygiene was assessed according to Greene and Vermillion Simplified Oral Hygiene Index. Unstimulated saliva and supragingival dental biofilm were collected. Total bacteria, Streptococcus spp. and Lactobacillus spp. was quantified by qPCR. Results:Patients with type 1 diabetes had a higher prevalence of dental caries and filled and missing teeth when compared with the control group. These patients were associated with more risk factors for the development of dental caries, namely a lower unstimulated salivary flow rate and a higher bacterial load in saliva and dental biofilm. Conclusion: Some risk factors related to dental caries were associated with type 1 diabetics. An early diagnosis combined with the evaluation of the risk profile of the diabetic patient is imperative, allowing the dental caries to be analyzed through a perspective of prevention and the patient to be integrated into an individualized oral health program

Exposição ocupacional a medicamentos citotóxicos: consequências a longo prazo e prevenção

Apesar do objetivo do tratamento quimioterápico antineoplásico consistir no combate às células malignas, certo é que atua também sobre as células benignas, afetando, desta forma, o genoma das células normais. Os principais efeitos nefastos detetados a longo prazo foram: infertilidade, malformações congénitas, mutagenicidade e abortos espontâneos. Assim, os profissionais que trabalham nesta área têm diferentes tipos de exposição aos citotóxicos, o que constitui motivo de preocupação tendo em conta a gravidade das consequências. Está comprovado que a adesão aos procedimentos de trabalho adequados e recomendados diminuem substancialmente a exposição dos profissionais aos medicamentos citotóxicos e que o conhecimento destes procedimentos de segurança é de extrema importância para diminuir os riscos de exposição. Deste modo, pretende-se com esta dissertação, analisar os riscos advenientes da exposição ocupacional de medicamentos citotóxicos bem como a utilização de sistemas que isolem os medicamentos do operador durante o processo de manipulação, com a finalidade de diminuir exponencialmente os danos para a saúde de profissionais, pacientes e demais intervenientes no circuito dos medicamentos citotóxicos, com especial relevância na prevenção.Although the objective of antineoplastic chemotherapy treatment is to fight against malignant cells, it is certain that it also acts on benign cells, thus affecting the genome of normal cells. The main long-term adverse effects are: infertility, congenital malformations, mutagenicity and miscarriages. Thus, personnel working in this area have different types of exposure to cytotoxic drugs, which is a cause for concern given the severity of the consequences. It has been proven that the access to appropriate and recommended work procedures substantially reduce the exposure of personnel to cytotoxic drugs and that knowledge of these safety procedures is extremely important to reduce the risks. Thus, it is intended with this dissertation, to analyze the inherent risks of occupational exposure to cytotoxic drugs as well as the use of systems that isolate the operator from the medicines during the manipulation process, in order to exponentially reduce the damage to patient, professional and other actors health, that act in the cytotoxic drugs circuit, with special relevance in prevention

A participação política dos assistentes sociais em Portugal

A presente comunicação decorre de uma investigação acerca da policy practice (Carrilho, 2018) que procurou compreender qual o nível de envolvimento dos assistentes sociais em Portugal em atividades profissionais visando influenciar as políticas de bem-estar, bem como os fatores potenciadores ou limitadores desse envolvimento. O apuramento e análise dos dados recolhidos revelaram um baixo nível de envolvimento em atividades de policy practice e um desligamento entre os profissionais e as estruturas do sistema político, aferido pela falta de confiança nas instituições, pela perceção de que os responsáveis políticos não consideram a opinião dos Assistentes Sociais e pela fraca participação em movimentos políticos. Verificando-se uma baixa participação política por parte dos Assistentes Sociais, coloca-se a questão de perceber os impactos que essa fraca participação tem no papel do Serviço Social na capacitação dos utentes para a cidadania. Assim, emergiu da pesquisa referida a questão: de que modo poderão os assistentes sociais motivar os utentes a participar na vida cívica e política de modo a consubstanciar os seus direitos de cidadania, quando os próprios Assistentes Sociais não o fazem? Atendendo a que noutros países os Assistentes Sociais são um grupo profissional com um maior nível de participação política, quando comparado com o nível de participação médio dos cidadãos em geral, o estudo sugeriu a necessidade de aprofundar a questão da participação política dos Assistentes Sociais em Portugal numa perspetiva comparativa com o nível de participação política dos portugueses em geral. A hipótese subjacente a este projeto é a de que a um maior envolvimento dos profissionais na esfera política, poderá corresponder a melhoria da qualidade do seu envolvimento no processo das políticas públicas e, eventualmente a diminuição do aparente desligamento entre a natureza política da profissão e o sistema político em que atua.info:eu-repo/semantics/acceptedVersio

Sealing efficacy of system B versus Thermafil and Guttacore obturation techniques evidenced by scintigraphic analysis

This study compared root canal sealing ability, filled by Continuous Wave compaction and two carrier-based obturation systems, using the nuclear medicine approach. Fifty-five single-rooted extracted teeth were selected. The crowns were sectioned and each tooth was instrumented using rotary Protaper® Universal system. The roots were divided into 3 experimental groups and two control groups. Forty-five root canals were filled, using Continuous Wave, GuttaCore or Thermafil system and TopSeal sealer. Ten teeth were used as control. On the 7th days the apices were submersed in a solution of sodium pertechnetate 99mTc for 3 hours and the radioactivity was counted. Although apical leakage in the Continuous Wave group was lower compared with GuttaCore and Thermafil groups, there was no statistical difference (p>0.05). System B, GuttaCore and Thermafil techniques showed a similar sealing effect

Bulletin number 2014-15

The South Carolina Department of Insurance issues periodic bulletins explaining different aspects and rule interpretations of state insurance

SAÚDE NO CÁRCERE: PERFIL EPIDEMIOLÓGICO DA POPULAÇÃO CARCERÁRIA DA CADEIA PÚBLICA DO MUNICÍPIO DE QUIXADÁ-CE

Visto que a saúde, nos ambientes prisionais, ainda não contemplava na íntegra os princípios do SUS, em 2003, foi aprovando o Plano Nacional de Saúde no Sistema Penitenciário (PNSSP), destinado a prover a atenção integral à saúde da população prisional em unidades masculina e feminina bem como nas psiquiátricas (BRASIL, 2003). O objetivo do estudo foi caracterizar o perfil epidemiológico e sociodemográfico da população carcerária da cadeia pública do município de Quixadá-CE. Tratou-se de um estudo de caráter descritivo, com abordagem quantitativa.Os dados foram coletados mediante a uma entrevista estruturada com o diretor geral da cadeia pública do município de Quixadá. As informações também foram levantadas através do banco de dados de estabelecimentos prisionais do Conselho Nacional da Justiça (CNJ). O período do estudo e coleta de dados ocorreu entre Setembro e Novembro de 2017.foram respeitados todos os aspectos éticosda pesquisa. Foram observados que as doenças com maior incidência foram tuberculose, aids, sífilis e sarnas. Não sendo registrado nenhum óbito por morte natural ou homicídio no estabelecimento. Com base nos dados coletados conclui-se que é necessária uma intervenção mais eficaz dos órgãos federativos, para práticas de promoção a saúde mais eficazes nesses estabelecimentos

The Impact of Prolonged Use of Continuous Subcutaneous Insulin Infusion in the Control of Type-1 Diabetes

Introduction: The use of continuous subcutaneous insulin infusion therapy in type 1 diabetes mellitus has increased due to its benefits on glycemic control and on the lifestyle flexibility. The aim of this study was to assess the impact of continuous subcutaneous insulin infusion therapy on glycemic control, body mass index, total daily dose of insulin and complications associated with this therapy, during 20 years of experience in Centro Hospitalar e Universitário de Coimbra. Material and Methods: This retrospective study included patients with type 1 diabetes mellitus who started continuous subcutaneous insulin infusion therapy up until 2005, followed at Centro Hospitalar e Universitário de Coimbra. Glycated hemoglobin A1c, body mass index, total daily dose of insulin and acute complications associated with continuous subcutaneous insulin infusion therapy were evaluated immediately prior to initiation of continuous subcutaneous insulin infusion therapy with follow-up at six months, one year, five, 10, 15 and 20 years. The frequency of acute complications associated with this type of therapy was also evaluated. Results: This study included 20 patients (seven males, 13 females) with mean disease duration up to the start of continuous subcutaneous insulin infusion therapy of 16.1 ± 7.9 years, mean age of onset of continuous subcutaneous insulin infusion therapy of 31.1 ± 8.4 years and follow-up during 13.2 ± 2.3 years. The reasons for initiating pump therapy were: inadequate metabolic control in 15 patients, history of asymptomatic or severe hypoglycemia in four patients, and pregnancy/pregnancy planning in one patient. The previous median of glycated hemoglobin A1c was 9.3% (6.5 – 16.0) and, at six months, decreased to the minimum value of 7.2% (5.3 – 9.8); p < 0.0125. The reduction of glycated hemoglobin A1c remained statistically significant in the first 10 years of follow-up. There was a statistically significant difference in the body mass index variation at 10 years with continuous subcutaneous insulin infusion therapy compared to previous body mass index; 24.7 kg/m2 (18.9 – 31.8) vs 25,5 kg/m2 (18.9 – 38.9), p < 0.0125. Daily insulin requirements were reduced from 56.5 U (32.0 – 94.0) to 43.8 U (33.0 – 64.0) (p < 0.0125) at six months and no statistical differences were found in the remaining follow-up. There were two severe episodes of hypoglycemia (incidence 0.0095/patient/year), five episodes of diabetic ketoacidosis (0.0238/patient/year) and no infections at the site of catheter insertion. Discussion: This study shows that continuous subcutaneous insulin infusion therapy improved glycemic control, especially during the first 10 years of follow-up and allowed a significant decrease in total daily dose of insulin in the first six months. The rate of acute complications was low. Conclusion: Treatment with continuous subcutaneous insulin infusion therapy seems effective in achieving metabolic control in selected patients with type 1 diabetes mellitus

ANÁLISE DOS FATORES DECISIVOS NA SATISFAÇÃO DOS ALUNOS DE UM CENTRO UNIVERSITÁRIO EM BRASÍLIA

A ser adicionado

Vitamin C and Vitamin E in Prevention of Nonalcoholic Fatty Liver Disease (NAFLD) in Choline Deficient Diet Fed Rats

AIM: Oxidative stress has been implicated in the pathogenesis of Nonalcoholic Fatty Liver Disease (NAFLD). Vitamin C and vitamin E are known to react with reactive oxygen species (ROS) blocking the propagation of radical reactions in a wide range of oxidative stress situations. The potential therapeutic efficacy of antioxidants in NAFLD is unknown. The aim of this study was to evaluate the role of antioxidant drugs (vitamin C or vitamin E) in its prevention. METHODS: Fatty liver disease was induced in Wistar rats by choline-deficient diet for four weeks. The rats were randomly assigned to receive vitamin E (n = 6) – (200 mg/day), vitamin C (n = 6) (30 mg/Kg/day) or vehicle orally. RESULTS: In the vehicle and vitamin E-treated rats, there were moderate macro and microvesicular fatty changes in periportal area without inflammatory infiltrate or fibrosis. Scharlach stain that used for a more precise identification of fatty change was strong positive. With vitamin C, there was marked decrease in histological alterations. Essentially, there was no liver steatosis, only hepatocellular ballooning. Scharlach stain was negative. The lucigenin-enhanced luminescence was reduced with vitamin C (1080 ± 330 cpm/mg/minx10(3)) as compared to those Vitamin E and control (2247 ± 790; 2020 ± 407 cpm/mg/minx10(3), respectively) (p < 0.05). Serum levels of aminotransferases were unaltered by vitamin C or vitamin E. CONCLUSIONS: 1) Vitamin C reduced oxidative stress and markedly inhibited the development of experimental liver steatosis induced by choline-deficient diet ; 2)Vitamin E neither prevented the development of fatty liver nor reduced the oxidative stress in this model

Can we rely on iFR for avoiding FFR? Conclusions of a 5-year experience

Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017Background: Recently, the instantaneous wave free ratio (iFR), has been proposed an alternative or complementary method to fractional flow reserve (FFR). This new method does not require the use of adenosine and may expedite the speed of functional assessment. The iFR “hybrid strategy” relies on values 0,93 as definitive results which would not require the use of FFR. However, this strategy is much less consensual than FFR alone. Purpose: We aimed to assess the concordance of FFR and iFR results using the principle of the “hybrid strategy”, based on the 5-year experience of a single center. We also aimed to analyse the effect of iFR in the operator's decision to proceed to FFR, and its impact on procedure duration and radiation time/dosage. Methods: Single-center registry of all patients undergoing functional coronary lesion assessment during 5 years. FFR was used as a gold standard (with a cut-off point for intervention ≤0,80) for assessing the diagnostic accuracy of iFR in every patient who underwent measurements with both techniques. For analysis purposes, an iFR value 0,93 was considered negative (i.e. defer intervention). Values in between were deemed inconclusive. For statistical analysis we used the T student and Chi-Square tests. Results: Functional testing was undertaken in 326 patients (67±11 years, 65,6% male), encompassing 402 lesions. 154 lesions underwent assessment with both techniques, 222 by FFR only and 26 cases iFR only. The average iFR was 0,9±0,1. 60 lesions had an iFR >0,93 and 21 an iFR <0,86. An iFR value between 0,86 and 0,93 was strongly associated with the decision to proceed to FFR (χ2=30,1; p0,93 (71,4% vs 68%; p=0,792). In these cases, there was a statistically significant concordance of 87% between the iFR and FFR results (χ2=22,43; p<0,001). Notwithstanding, there were 4 out of 13 cases (30,7%) of positive iFR with negative FFR and 3 out of 42 (7,1%) cases of negative iFR and positive FFR. This difference was statistically significant (p=0,026). Regarding procedural time, radiation time and radiation dose, there were no statistically significant differences between patients who only underwent iFR, FFR only, or both techniques. Conclusions: The iFR results were inconclusive (i.e. between 0,86 and 0,93) in most cases. There was a high degree of concordance between the iFR and FFR values. However, a significant proportion of patients, particularly in cases of positive iFR (<0,86), were classified as negative by FFR. The use of iFR had no impact on procedural time, radiation time and radiation dose.info:eu-repo/semantics/publishedVersio