Indicações e testes diagnósticos para infecção por Helicobacter Pylori em adultos: Indications and diagnostic tests for Helicobacter Pylori infection in adults

Na prática da clinica médica é muito comum ver o diagnóstico de H. Pylori, entretanto, muitas vezes testes mais invasivos são adotados sem necessidade. Dessa forma esse artigo, aborda as indicações para diagnóstico com base em evidencias. O teste para Helicobacter pylori deve ser realizado somente se o médico planeja oferecer tratamento para resultados positivos. A escolha do teste usado para diagnosticar o H. pylori depende se o paciente requer uma endoscopia digestiva alta para avaliação dos sintomas ou vigilância. A endoscopia não é indicada apenas com o propósito de estabelecer o status de H. pylori . Em pacientes que não necessitam de avaliação endoscópica, o diagnóstico inicial de H. pylori deve ser feito com um teste para infecção ativa (antígeno fecal ou teste respiratório com uréia). O teste respiratório de uréia e o teste de antígeno fecal têm alta sensibilidade e especificidade para identificar infecção ativa por H. pylori 

Modulation of blood redox status by the progression of induced apical periodontitis in rats

This study aimed to investigate if apical periodontitis in different periods changes systemic levels of the antioxidant and pro-oxidant parameters in Wistar rats. Twenty-four rats were randomly allocated into healthy animals, apical periodontitis at 14 days (AP14) and apical periodontitis at 28 days (AP28). The first mandibular molars were accessed in the AP groups, and the pulp chamber was exposed to the oral environment, inducing the apical lesion. After 14 and 28 days, the animals were anesthetized, euthanized, and hemimandibles were collected for micro-computed tomography (micro-CT) analysis to measure lesion volume, bone volume (BV), percent of bone to total tissue volume (BV/TV), trabecular thickness (Tb.Th), trabecular number (Tb.N), and trabecular space (Tb.Sp). A histological examination of the remaining bone was also performed. Finally, blood samples were collected for oxidative biochemistry analysis, investigating glutathione (GSH), Trolox equivalent antioxidant capacity (TEAC), and lipid peroxidation (TBARS). The lesion volume was greater at 28 than at 14 days, as shown by micro-CT. AP14 and AP28 had decreased BV and Tb.Th, but only AP28 showed a reduction in BV/TV. Tb.N and Tb. Sp were increased in apical periodontitis at 28 days. In the histopathological analysis, AP14 had focal regions of moderate mononuclear inflammatory infiltrate, and AP28 had an intense inflammatory infiltrate with bacterial colonies. In the biochemical evaluation, GSH, TEAC, and TBARS were increased after 14 days. However, GSH returned to control levels, TEAC was similar to AP14, and TBARS increased significantly after 28 days. Therefore, the oxidative biochemistry response was modulated according to the progression of periapical damage. After 14 days, the organism could still react to the injury. However, at 28 days, the antioxidant response decreased, associated with an increase in TBAR

Effects of inorganic mercury exposure in the alveolar bone of rats: an approach of qualitative and morphological aspects

Pró-Reitoria de Pesquisa (PACI/PROPESP/UFPA/ Brazil), Brazilian National Council for Scientific and Technological Development (CNPq), Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brazil (CAPES) – Finance Cod 001Background: In comparison to organic mercury (MeHg), the environmental inorganic mercury (IHg) can be found in some skin-lightening cosmestics were considered “harmless” for a long time. However, recent studies have shown that long-term exposure to low doses of IHg may affect biological systems. Therefore, this study investigated the effects of IHg long-term exposure to the alveolar bone of adult rats. Methods: Adult Wistar rats were distributed in control and HgCl2 exposed (0.375 mg/kg/day). After 45 days, the rats were euthanized and both blood and hemimandibles were collected. Total blood Hg levels were measured and both inorganic and organic components of the alveolar bone were determined through XRD and ATR-FTIR. The microstructure of the alveolar bone was assessed by using micro-CT and the morphometric analysis was performed by using stereomicroscopy. Results: Alterations in the physicochemical components of the alveolar bone of exposed animals were observed. The bone changes represented a tissue reaction at the microstructural level, such as bone volume increase. However, no significant dimensional changes (bone height) were observed. Conclusion: Exposure to IHg at this dose can promote microstructural changes and alteration in the organic and inorganic components in the alveolar bone.publishersversionpublishe

Association between respiratory diseases and molar-incisor hypomineralization: A systematic review and meta-analysis

The molar-incisor permineralização (MIH) is a qualitative enamel developing abnormality involving the occlusal and/or incisal third of one or more molars or permanent incisors, caused by systemic factors. Several systemic disorders and environmental factors, such as respiratory diseases, have been reported as probable causes of MIH. Thus, this work aimed to evaluate whether respiratory diseases and MIH are associated. The searches were carried out in electronic databases, including PubMed, Scopus, Web of Science, the Cochrane Library, LILACS, OpenGrey, and Google Scholar. The acronym PECO was used, in which the P (population) was humans in permanent dentition stage; (E-exposure) molar-incisor hypomineralization; (C-comparison) reference population and (O - outcome) respiratory diseases. After the search retrieval, the duplicates were removed, and the articles were evaluated by title and abstract; then, the papers were read and thoroughly assessed. After selection, the risk of bias assessment was performed using the Newcastle-Ottawa Scale (NOS) for observational studies. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) tool was used to assess the level of evidence. Three thousand six hundred and sixty six were found through the searches. After exclusion by duplicates, title, abstract, and full-reading, 13 articles remained. The articles included in this review evaluated the association of MIH with asthma, tonsilitis, pneumonia, and bronchitis. Most reports showed a low risk of bias. When exploring through GRADE, a very low level of evidence was found. We observed that the included studies showed that children with MIH had more respiratory diseases than the group that did not have MIH.Systematic review registrationhttps://osf.io/un76d

Modulation of blood redox status by the progression of induced apical periodontitis in rats

This study aimed to investigate if apical periodontitis in different periods changes systemic levels of the antioxidant and pro-oxidant parameters in Wistar rats. Twenty-four rats were randomly allocated into healthy animals, apical periodontitis at 14 days (AP14) and apical periodontitis at 28 days (AP28). The first mandibular molars were accessed in the AP groups, and the pulp chamber was exposed to the oral environment, inducing the apical lesion. After 14 and 28 days, the animals were anesthetized, euthanized, and hemimandibles were collected for micro-computed tomography (micro-CT) analysis to measure lesion volume, bone volume (BV), percent of bone to total tissue volume (BV/TV), trabecular thickness (Tb.Th), trabecular number (Tb.N), and trabecular space (Tb.Sp). A histological examination of the remaining bone was also performed. Finally, blood samples were collected for oxidative biochemistry analysis, investigating glutathione (GSH), Trolox equivalent antioxidant capacity (TEAC), and lipid peroxidation (TBARS). The lesion volume was greater at 28 than at 14 days, as shown by micro-CT. AP14 and AP28 had decreased BV and Tb.Th, but only AP28 showed a reduction in BV/TV. Tb.N and Tb. Sp were increased in apical periodontitis at 28 days. In the histopathological analysis, AP14 had focal regions of moderate mononuclear inflammatory infiltrate, and AP28 had an intense inflammatory infiltrate with bacterial colonies. In the biochemical evaluation, GSH, TEAC, and TBARS were increased after 14 days. However, GSH returned to control levels, TEAC was similar to AP14, and TBARS increased significantly after 28 days. Therefore, the oxidative biochemistry response was modulated according to the progression of periapical damage. After 14 days, the organism could still react to the injury. However, at 28 days, the antioxidant response decreased, associated with an increase in TBARS

Is obesity associated with taste alterations? a systematic review

BackgroundObesity is a growing chronic public health problem. The causes of obesity are varied, but food consumption decisions play an important role, especially decisions about what foods to eat and how much to consume. Food consumption decisions are driven, in part, by individual taste perceptions, a fact that can influence eating behavior and, therefore, body mass.MethodologyThe searches were conducted in the electronic databases PubMed, Web of Science, Scopus, Lilacs, and the grey literature (Google Scholar and Open Grey). The acronym PECO will be used, covering studies with adult humans (P) who have obesity (E) compared to adult humans without obesity (C), having as an outcome the presence of taste alterations (O). After searching, duplicates were removed. The articles were first evaluated by title and abstract, following the inclusion and exclusion criteria; then, the papers were read in full. After the studies were selected, two reviewers extracted the data and assessed the individual risk of bias and control statements for possible confounders and bias consideration. The narrative GRADE system performed the methodological quality assessment using the New Castle Ottawa qualifier and analysis of certainty of evidence.ResultsA total of 3782 records were identified from the database search, of these 19 were considered eligible. Forty percent of the eligible studies show that there was an association between obesity and different taste alterations for different flavors comparing with normal weights adults. In the methodological quality analysis of the nineteen studies, which assesses the risk of bias in the results, fifteen showed good methodological reliability, three showed fair methodological reliability, and one showed low methodological reliability.ConclusionDespite methodological limitations, the results of the studies suggest the existence of a association between obesity and taste alterations, but further investigations with more sensitive methodologies are necessary to confirm this hypothesis.Systematic review registrationhttps://osf.io/9vg4h/, identifier 9vg4h

Is there any association between the presence of biomarkers and apical periodontitis? A systematic review

This systematic review aimed to verify whether there is evidence of an association between apical periodontitis and the presence of systemic biomarkers. This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses - PRISMA. For this, the acronym PECO was used; population (P) of adult humans exposed (E) to the presence of apical periodontitis, compared (C) to adult humans without apical periodontitis, and the outcome (O) of the presence of biomarkers was observed. The articles were searched in PubMed, Scopus, Web of Science, LILACS, Cochrane Library, OpenGray, and Google Scholar grey databases. Subsequently, studies were excluded based on title, abstract, and full article reading, following the eligibility criteria. The methodological quality of the selected studies was evaluated using the Newcastle-Ottawa qualifier. After exclusion, 656 studies were identified, resulting in 17 final articles that were divided into case-control, cross-sectional, and cohort studies. Eight studies were considered to have a low risk of bias, one had a medium risk of bias, and eight had a high risk of bias. In addition, 12 articles evaluated biomarkers in blood plasma, four evaluated them in saliva, and only one evaluated them in gingival crevicular fluid. The results of these studies indicated an association between apical periodontitis and the systemic presence of biomarkers. These markers are mainly related to inflammation, such as interleukins IL-1, IL-2, and IL-6, oxidative markers, such as nitric oxide and superoxide anions, and immunoglobulins IgG and IgM.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier (CRD42023493959)

Are Dental Caries Associated with Oxidative Stress in Saliva in Children and Adolescents? A Systematic Review

This systematic review aimed to assess whether dental caries is associated with oxidative salivary stress. The searches were carried out in electronic databases, including PubMed, Scopus, Web of Science, the Cochrane Library, LILACS, OpenGrey, and Google Scholar, without restrictions on the date of publication and language. The acronym PECO was used, in which the participants (P) were children and adolescents exposed (E) to dental caries compared (C) to those without dental caries, with the outcome (O) of modulation of oxidative biochemical parameters. After the search retrieval, the duplicates were removed, and the articles were evaluated by title and abstract, following the inclusion and exclusion criteria. Then, the papers were read and thoroughly assessed. After selection, the risk of bias assessment and qualitative synthesis were performed using the Newcastle-Ottawa Scale (NOS) for observational studies. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) tool was used to assess the level of evidence. A total of 5790 studies were found, and 30 articles were considered eligible and were included for the qualitative synthesis and the level of evidence assessment. The studies showed an imbalance of the antioxidant and pro-oxidant parameters in individuals with dental caries, with primarily increases in both total antioxidant capacity and lipid peroxidation. Most articles showed a low risk of bias, having comparability as the main issue. When exploring through GRADE, a very low level of evidence was found. It was possible to observe an association between oxidative stress and dental caries, showing a disbalance of antioxidants and pro-oxidants, but the evidence level was still very low