Prospects for the development of probiotics and prebiotics for oral applications

There has been a paradigm shift towards an ecological and microbial community-based approach to understanding oral diseases. This has significant implications for approaches to therapy and has raised the possibility of developing novel strategies through manipulation of the resident oral microbiota and modulation of host immune responses. The increased popularity of using probiotic bacteria and/or prebiotic supplements to improve gastrointestinal health has prompted interest in the utility of this approach for oral applications. Evidence now suggests that probiotics may function not only by direct inhibition of, or enhanced competition with, pathogenic micro-organisms, but also by more subtle mechanisms including modulation of the mucosal immune system. Similarly, prebiotics could promote the growth of beneficial micro-organisms that comprise part of the resident microbiota. The evidence for the use of pro or prebiotics for the prevention of caries or periodontal diseases is reviewed, and issues that could arise from their use, as well as questions that still need to be answered, are raised. A complete understanding of the broad ecological changes induced in the mouth by probiotics or prebiotics will be essential to assess their long-term consequences for oral health and disease

Osteochondritis dissecans of the temporomandibular joint

A case is reported of a 43-year-old female patient presenting bilateral osteochondritis dissecans (OCD) of the temporomandibular joint (TMJ), in different stages for each side, associated with avascular necrosis (AVN) of the right condyle. Additionally observed was anterior disk displacement without reduction for both sides. We have proposed an adaptation of the previous classification of OCD for cases affecting, the TMJ. We have also stressed the fundamental role of panoramic radiography on the diagnosis of stage 3 and stage 4 OCD of the TMJ. In relation to MRI, we have recommended sagittal (slice thickness of 2 mm) and coronal (slice thickness of I mm) fast spin-echo proton density-weighted sequences to better identify bone lesions (stage I and 2) and also localize osteochondral loose bodies; and coronal (slice thickness of I mm) fat-suppressed fast spinecho T-2 weighted sequence to better evaluate OCD (stable or unstable) and the features of the occasionally associated AVN (acute or chronic).o TEXTO COMPLETO DESTE ARTIGO, ESTARÁ DISPONÍVEL À PARTIR DE AGOSTO DE 2015.34319319

The association between periodontal disease and seizure severity in refractory epilepsy patients

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Purpose: Periodontal diseases are common in most populations and affect people at all socioeconomic levels. Evidence suggests that patients with epilepsy actually have higher risks of dental disease and increased oral health needs, but the frequency and consequences of poor controlled seizures on dental and periodontal health have not been reported before. We aimed to assess the impact of seizure frequency on periodontal status and oral hygiene in a sample of epilepsy patients. Methods: One hundred and nine consecutive patients treated for epilepsy at the outpatient clinic of our University Hospital were invited to take part in an oral examination to determine their periodontal disease status, together with a control group. In addition, seizure frequency and use of medication were documented. Results: In logistic regression model, patients were significantly more susceptible to bad oral hygiene, gingivitis and periodontitis that controls (p < 0.001); seizure frequency was significantly related to bad oral hygiene (p = 0.010), gingivitis (p < 0.001) and periodontitis (p < 0.001). Tooth brushing habits and presence of caries were associated with oral health in patients group. Conclusion: Our study found a significant positive correlation between periodontal disease and seizure severity. Epilepsy patients need to focus more on their oral health and quality of oral hygiene. (C) 2013 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.233227230Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)FAPESP [2007/59340-4

In situ detection of Chlamydia pneumoniae,&nbsp;C. trachomatis,&nbsp;and cytokines among cardiovascular diseased patients from the Amazon region of Brazil

Larissa S Freitas,1 N&uacute;bia Caroline C Almeida,1 Maria Alice Freitas Queiroz,1 Marcelo M Zaninotto,2 Hellen T Fuzii,3 Alfredo Ribeiro-Silva,4 Antonio CR Vallinoto,1 Marlu&iacute;sa OG Ishak,1 Juarez AS Quaresma,3 Ricardo Ishak1 1Virus Laboratory, Institute of Biological Sciences, Federal University of Para, 2Hospital of Clinic Gaspar Viana, 3Laboratory of Immunopathology, Nucleus of Tropical Medicine, Federal University of Para, Bel&eacute;m, 4Departament of Pathology, Medical School of Ribeir&atilde;o Preto, University of Sao Paulo, S&atilde;o&nbsp;Paulo,&nbsp;Brazil Background: Chronic coronary artery disease has been associated, as a consequence of the local inflammatory reaction with previous or persistent infection with Chlamydia pneumoniae, which led to the investigation of the association of cardiovascular disease and previous infection with C. trachomatis and the role of cytokine profile (in situ) markers in the vascular system tissues. Methods: Sixty-nine biopsies were collected for immunohistochemical analysis for the presence of IL-6, IL-8, TNF-&alpha;, IFN-&gamma;, TGF-&beta;, and IL-10, in 16 fragments from atheromatous plaques, 32 aorta fragments, and 21 valve fragments, using a tissue microarray technique for paraffin embedded tissues. Results: Most patients undergoing revascularization surgery were men &gt;50 years, while those undergoing valve replacement were mostly women &lt;50 years. TNF-&alpha; was the most prevalent marker, detected in 91.7% (55/60) of the samples. The mean percent area stained was greater in patients infected with C. pneumoniae (3.81% vs 1.92%; p=0.0115) and specifically in the aorta (4.83% vs 2.25%; p=0.0025); C. trachomatis infection was higher in valves, and C. pneumoniae in plaques, both without statistical significance. There was no significant difference in the cytokine staining profile between patients previously infected with both species and uninfected patients. Conclusion: Although there was no difference in the cytokine profile between patients previously infected with both species of Chlamydia, and uninfected patients, the presence of the bacteria antigens in the three biological specimens indicates it is important to focus on the role of C. trachomatis. It is necessary to improve the understanding of the natural history of chronic coronary artery disease and the clinical history of the patients and cytokine dynamics in cardiac disease in the presence or absence of infectious agents. Keywords: Chlamydia, C. pneumoniae, C. trachomatis, atherosclerosis, cytokine

Artropatia ocronótica Ochronotic arthropathy

Os autores apresentam o relato de caso de um paciente com artropatia ocronótica. A ocronose é uma doença rara, de herança autossômica recessiva, manifestação clínica da alcaptonúria. O paciente apresenta clinicamente dor crônica lombar, fraqueza e limitação funcional dos ombros e joelhos, associada a urina de cor escura. O objetivo do tratamento ortopédico é o controle da dor e melhora das funções das articulações acometidas, realizando artroplastias quando necessário.<br>The authors report the case of a patient with ochronotic arthropathy. This rare, inherited disease of autossomal recessive trait is the clinical manifestation of alkaptonuria. The patient presented clinically with chronic low back pain, disability, pain and weakness / stiffness in his shoulders and knees associated with dark urine. The main purpose of the orthopaedic approach in this disease is to control the pain and improve the function of the affected joints by performing arthroplasties when necessary