Evaluation of an oral preventive protocol in children with acute lymphoblastic leukemia

O objetivo do presente estudo foi verificar a eficácia de um protocolo oral preventivo em crianças com leucemia linfoblástica aguda (LLA), submetidas ao tratamento antineoplásico, antes de iniciar um estudo mais abrangente. Durante um período de sete meses, foram avaliadas, consecutivamente, quatorze crianças com LLA, de dois a dez anos de idade. As crianças com LLA que fizeram bochechos com a solução de clorexidina 0,12% (sete crianças) foram comparadas com aquelas do grupo controle (sete crianças) no que diz respeito ao surgimento de lesões orais. Todas as crianças do estudo receberam diariamente orientação de higiene oral e foram igualmente examinadas pelo odontopediatra. Observou-se uma diminuição significativa na incidência de mucosite e ulceração oral nas crianças que fizeram bochecho profilático com clorexidina 0,12% (p < 0,05, teste exato de Fisher). Os achados obtidos no presente estudo são satisfatórios, e sugerem que uma aplicação sistemática de um protocolo preventivo reduza a incidência de complicações orais em crianças com LLA submetidas à quimioterapia.This study was designed to assess the effectiveness of a preventive oral protocol in children receiving antineoplastic treatment for acute lymphoblastic leukemia (ALL) before initiating a larger intervention study. During a seven month period, fourteen children from two to ten years old with a diagnosis of ALL were evaluated. Patients with ALL who received a 0.12% chlorhexidine mouth rinse (seven children) were compared to a control group of patients who were not given the same preventive treatment (seven children) as to the occurrence of oral mucosal complications. Children in both groups received daily oral hygiene care, and were examined daily by the pediatric dentistry team until discharge. A significant decrease in the incidence of oral mucositis and ulceration was observed in the children who received a 0.12% chlorhexidine mouth rinse (p < 0.05 by Fisher's exact test). The findings obtained in the present trial are encouraging, and suggest that the systematic application of a preventive protocol reduces the incidence of oral complications in children with ALL receiving chemotherapy

Factors Associated with Hyposalivation in Brazilian Adults

Objective:&nbsp;To determine the occurrence of hyposalivation in Brazilian adults and its association with individual determinants, such as the use of medications, systemic conditions, smoking, and alcohol consumption.&nbsp;Material and Methods:&nbsp;A cross-sectional study with 402 adults was developed. Information was collected on sociodemographic and general health characteristics, and sialometry was performed with stimulated salivary flow. It indicated low salivary flow when ≤ 0.7 mL/min. Bivariate and multivariate analyses were conducted using a decision tree (p&lt;0.05).&nbsp;Results: The sample was comprised predominantly of women (68.2%) aged ≤ 29 years (25.4%). Most participants did not use medication (56.7%). Among systemic diseases, the most cited was hypertension (25.1%). More than a third of the participants presented hyposalivation (40.3%), being associated with the following variables: age between 50 to 59 years (p=0.011), female sex (p&lt;0.001), menopause (p=0.001), use of alcohol (p=0.033), systemic disease (p=0.002) and medication use (p&lt;0.001). In multivariate analysis, in addition to sex (p&lt;0.001) and hypertension (p=0.005), an association was also found between hyposalivation and diabetes (p=0.014).&nbsp;Conclusion:&nbsp;Factors associated with hyposalivation in adults were sex and the presence of hypertension or diabetes

Influência do Fator Socioeconômico no Comportamento dos Adolescentes em Relação à Saúde Bucal

The objective of this study was to analyze the behavior of adolescents in respect to the habits of oral hygiene and the influence of the socioeconomic variable in the city of Caruaru-PE. 279 students were interviewed with a semi-structured form, with open and closed questions, 139 from a public school and 140 from a private school, in 2006. The statistical test used was the Chi-square. The dental surgeon was the main source of information on mouth diseases ( 80.2%). The number of daily brushing presented a significant difference in each type of school, the majority receiving orientation from the dental surgeon on the subject (96.1%) and a smaller number on the type of toothbrush (58.1%), although these without a significant difference. 94.9% answered that there are situations in which they take longer brushing (p>0.05), but the answers when going out and halitosis showed a significant difference in the two types of school. A percentage of 66.1% reported to use dental floss (p0.05. The period of the last consult to the dental surgeon (less than a year, 62.2%), prevention (52.2%) and fillings (21%) as motive for the consult were the data that presented significant difference in the types of school. Regional studies, with the intent of contributing to the implementation of oral health programs, attempting to reverse unsatisfactory indexes, as well as to make possible the elaboration of oral health indicators in adolescence are necessary.O objetivo deste estudo foi analisar o comportamento do adolescente em relação aos hábitos de higiene oral e a influência da variável socioeconômica no município de Caruaru-PE. Para isso foram entrevistados com um formulário semi-estruturado com perguntas abertas e fechadas, 279 alunos, 139 de uma escola pública e 140 de uma escola particular no ano de 2006. O teste estatístico utilizado foi o Qui-quadrado. O cirurgião-dentista foi à principal fonte de informação sobre doenças bucais (80,2%). O número de escovações diárias, apresentou diferença significativa entre os dois tipos de escola, sendo que a maioria recebeu orientações do cirurgião-dentista sobre o assunto (96,1%) e um menor número quanto ao tipo de escova (58,1%), porém estes últimos sem diferença significativa. 94,9% respondeu que há situações em que demoram mais na escovação (p0,05. O período da última consulta ao cirurgião-dentista (menos de um ano, 62,2%), a prevenção (52,2%) e a obturação (21%) como motivo da consulta foram os dados que apresentaram diferença significativa entre os dois tipos de escola. Estudos regionais, com vistas a contribuir com a implementação de programas em saúde bucal, na tentativa de reversão dos índices insatisfatórios, assim como possibilitar a elaboração de indicadores de saúde bucal na adolescência se fazem necessários

Yeast-Host Interactions: Anadenanthera Colubrina Modulates Virulence Factors of C. Albicans and Inflammatory Response In Vitro

Oral candidiasis is one of the most common fungal infections in humans. Its incidence has increased widely, as well as the antifungal resistance, demanding for the search for novel antifungal therapeutic agents. Anadenanthera colubrina (Vell.) Brenan is a plant species that has been proven to possess pharmacological effects, including antifungal and anti-inflammatory activities. This study evaluated in vitro the effects of standardized A. colubrina extract on virulence factors of Candida albicans and its regulation on immune response through C. albicans-host interaction. Antifungal activity was evaluated by Broth Microdilution Method against reference Candida strains (C. albicans, C. glabrata, C. tropicalis; C. dubliniensis). Anti-biofilm effect was performed on C. albicans mature biofilm and quantified by CFU/mL/g of biofilm dry weight. Proleotlytic enzymatic activities of proteinase and phospholipase were assessed by Azocasein and Phosphatidylcholine assays, respectively. Cytotoxicity effect was determined by Cell Titer Blue Viability Assay on Human Gingival Fibroblasts. Co-cultured model was used to analyze C. albicans coexisting with HGF by Scanning Electron Microscopy and fluorescence microscopies; gene expression was assessed by RT-PCR of C. albicans enzymes (SAP-1, PLB-1) and of host inflammatory cytokines (IL-6, IL-8, IL-1β, IL-10). Cytokines secretion was analysed by Luminex. The extract presented antifungal effect with MIC<15.62 μg/ml against Candida strains. Biofilm and proteolytic activity were significant reduced at 312.4 μg/ml (20 × 15.62 μg/ml) extract concentration. Cell viability was maintained higher than 70% in concentrations up to 250 μg/ml (LD(50) = 423.3 μg/ml). Co-culture microscopies demonstrated a substantial decreased in C. albicans growth and minimal toxicity against host cells. Gene expressions of SAP-1/PLB-1 were significantly down-regulated and host immune response was modulated by a significant decreased on IL-6 and IL-8 cytokines secretion. A. colubrina had antifungal activity on Candida strains, antibiofilm, and anti-proteolytic enzyme effects against C. albicans. Presented low cytotoxicity to the host cells and modulatory effects on the host immune response

Chemical Composition, Antibacterial and Antifungal Potential of an Extract From the Leaves of Guapira Graciliflora Mart. Against Oral Microorganisms of Dental Interest

Objective: To perform an in vitro analysis of antibacterial and antifungal potential of an alcoholic extract from the leaves of Guapira Graciliflora Mart. against oral microorganisms and determine its chemical composition. Material and Methods: A hydroalcoholic extract of the leaves form G.  graciliflora was obtained through maceration, vacuum concentration and freeze-drying. Antibacterial and antifungal activities were evaluated against Streptococcus mutans, Streptococcus salivarius, Streptococcus oralis, Streptococcus parasanguinis, Streptococcus mitis and strains of Candida albicans using broth microdilution method. Phytochemical analysis determined the total phenolic compounds, protein concentration and total of sugars present in the extract. Results: G. Graciliflora demonstrated antifungal activity against the LM 11 and LM 410 clinical isolates of C. albicans (MIC 0.5 mg/mL and 2 mg/mL, respectively). The other microorganisms tested were resistant to the extract. The phytochemical analysis revealed 3% proteins, 13% total sugars and 17% phenolic compounds. Conclusion: G. Graciliflora has antifungal activity against clinical strains of C. albicans and exhibits proteins, sugars and phenolic compounds in its chemical composition

Factors Associated with Hyposalivation in Brazilian Adults

Objective: To determine the occurrence of hyposalivation in Brazilian adults and its association with individual determinants, such as the use of medications, systemic conditions, smoking, and alcohol consumption. Material and Methods: A cross-sectional study with 402 adults was developed. Information was collected on sociodemographic and general health characteristics, and sialometry was performed with stimulated salivary flow. It indicated low salivary flow when ≤ 0.7 mL/min. Bivariate and multivariate analyses were conducted using a decision tree (p<0.05). Results: The sample was comprised predominantly of women (68.2%) aged ≤ 29 years (25.4%). Most participants did not use medication (56.7%). Among systemic diseases, the most cited was hypertension (25.1%). More than a third of the participants presented hyposalivation (40.3%), being associated with the following variables: age between 50 to 59 years (p=0.011), female sex (p<0.001), menopause (p=0.001), use of alcohol (p=0.033), systemic disease (p=0.002) and medication use (p<0.001). In multivariate analysis, in addition to sex (p<0.001) and hypertension (p=0.005), an association was also found between hyposalivation and diabetes (p=0.014). Conclusion: Factors associated with hyposalivation in adults were sex and the presence of hypertension or diabetes

Antimicrobial and antiproliferative potential of Anadenanthera colubrina (vell.) Brenan

The aim of the present study was to perform an in vitro analysis of the antimicrobial and antiproliferative potential of an extract from Anadenanthera colubrina (Vell.) Brenan (angico) and chemically characterize the crude extract. Antimicrobial action was evaluated based on the minimum inhibitory concentration (MIC), minimum bactericidal/fungicidal concentration, and the inhibition of formation to oral biofilm. Cell morphology was determined through scanning electron microscopy (SEM). Six strains of tumor cells were used for the determination of antiproliferative potential. The extract demonstrated strong antifungal activity against Candida albicans ATCC 18804 (MIC = 0.031 mg/mL), with similar activity found regarding the ethyl acetate fraction. The extract and active fraction also demonstrated the capacity to inhibit the formation of Candida albicans to oral biofilm after 48 hours, with median values equal to or greater than the control group, but the difference did not achieve statistical significance (P > 0.05). SEM revealed alterations in the cell morphology of the yeast. Regarding antiproliferative activity, the extract demonstrated cytostatic potential in all strains tested. The present findings suggest strong antifungal potential for Anadenanthera colubrina (Vell.) Brenan as well as a tendency toward diminishing the growth of human tumor cells.The aim of the present study was to perform an in vitro analysis of the antimicrobial and antiproliferative potential of an extract from Anadenanthera colubrina (Vell.) Brenan (angico) and chemically characterize the crude extract. Antimicrobial action was evaluated based on the minimum inhibitory concentration (MIC), minimum bactericidal/fungicidal concentration, and the inhibition of formation to oral biofilm. Cell morphology was determined through scanning electron microscopy (SEM). Six strains of tumor cells were used for the determination of antiproliferative potential. The extract demonstrated strong antifungal activity against Candida albicans ATCC 18804 ( mg/mL), with similar activity found regarding the ethyl acetate fraction. The extract and active fraction also demonstrated the capacity to inhibit the formation of Candida albicans to oral biofilm after 48 hours, with median values equal to or greater than the control group, but the difference did not achieve statistical significance . SEM revealed alterations in the cell morphology of the yeast. Regarding antiproliferative activity, the extract demonstrated cytostatic potential in all strains tested. The present findings suggest strong antifungal potential for Anadenanthera colubrina (Vell.) Brenan as well as a tendency toward diminishing the growth of human tumor cells201

Probiotics as Potential Antimicrobials for the Treatment of Infections: Current Reality or Remote Future?

Probiotics are microorganisms that live in symbiosis with the human body. The intake of probiotics in adequate amounts can improve biological functions bringing improvements in the health of the host. Many studies have demonstrated the indisputable antimicrobial activity of probiotics and their potential for an alternative treatment of infections. Nevertheless, the forms of encapsulation, as well as clinical trials on the clinical use of these microorganisms as a recognized and well-established protocol, are still incipient. In this chapter, we provide a general approach to the topic and point to future directions in the probiotics field for this purpose. Moreover, microbial resistance is a current public health problem and the search for new therapeutic alternatives is urgent. Probiotics and other natural therapies have been considered very promising. The approaches of future research should focus mainly on the isolation of new probiotic microorganisms, the definition of inoculum, forms of encapsulation for controlled delivery, and clinical trials for the definition of doses and mechanism of action in the fight against infections

Perfil de pacientes y factores relacionados con la clasificación clínica del carcinoma de células escamosas en la cavidad oral

Objective The aim of the present study was to identify the profile of patients diagnosed with oral squamous cell carcinoma (SCC) and factors associated with the clinical stage of the disease.Materials and Method A cross-sectional study was conducted with a sample of 293 medical charts of patients with SCC treated at an oncology reference center in the city of Campina Grande (Brazil) between 2000 and 2006. Descriptive and inferential statistics were performed with robust Poisson regression (α=5%).Results Males (56.6%), non-white individuals (49.0%) and individuals over than 60 years of age (74.1%) were the most affected by SCC. The tongue (35.1%) and palate (21.5%) were the most common sites. A large portion of the patients were smokers (37.6%) and 60.2% were in an advanced stage of the disease. Clinical staging was not associated with sex, age, skin color or drinking and/or smoking habits.Conclusion There was a higher incidence of SCC in men, older patients, non-white individuals and smokers. Clinical staging was not associated with the variables analyzed.Objetivos Identificar el perfil de los pacientes con diagnóstico de carcinoma de células escamosas (CCE) de la boca y los factores asociados a la estadificación clínica de la enfermedad.Métodos Estudio transversal con muestra de 293 historias de pacientes portadores de CEC, atendidos en un Centro de Referencia de Oncología del municipio de Campina Grande (PB), de 2000 a 2006. Se utilizó estadística descriptiva e inferencial por medio de la Regresión Robusta de Poisson (α=5%).Resultados El sexo masculino (56,6%), los no blancos¿? (49,0%) y el grupo de más de 60 años (74,1%) fueron los más afectados por la neoplasia; la lengua (35,1%) y el paladar (21,5%) fueron los sitios más afectados; la mayoría poseía hábito de tabaquismo (37,6%) y el 60,2% presentaba etapa avanzada de la enfermedad. La estadificación clínica no se asoció al sexo, la edad, el color de la piel y a los hábitos de beber y/o fumar.Conclusiones Se observó una mayor ocurrencia de CEC en hombres, en pacientes con edad más avanzada, no blancos y que poseían hábitos de tabaquismo, pero sin asociación estadística