O Atendimento odontológico do paciente renal terminal submetido a dialise: uma revisão atual da literatura médica vigente.

Chronic renal failure is a progressive disease characterized by a gradual destruction of the nephrons and a consequent reduction in renal function. End-stage kidney disease (ESRD) requires renal replacement therapy such as peritoneal dialysis, hemodialysis or transplantation. Patients affected by ESRD or on hemodialysis are at risk of developing a series of comorbidities, including hypertension, anemia, risk of bleeding, susceptibility to infection, side effects of medications and oral manifestations associated with the disease itself and treatment on hemodialysis. In this context, oral diseases represent a potential and preventable cause of poor health outcomes in people with ESRD due to their relationship with infection, inflammation and malnutrition.A insuficiência renal crônica é uma doença progressiva caracterizada por uma destruição gradual dos néfrons e uma conseqüente redução da função renal. A doença renal em estágio terminal (DRT) requer terapia de substituição renal como diálise peritoneal, hemodiálise ou transplante. Os pacientes afetados pela DRT ou em hemodiálise correm risco de desenvolver uma série de comorbidades, incluindo hipertensão, anemia, risco de sangramento, suscetibilidade à infecção, efeitos colaterais dos medicamentos e manifestações orais associadas à própria doença e ao tratamento em hemodiálise. Nesse contexto, as doenças bucais representam uma causa potencial e evitável de maus resultados de saúde em pessoas com DRT devido à sua relação com infecção, inflamação e desnutrição

Gallbladder carcinoma late metastases and incisional hernia at umbilical port site after laparoscopic cholecystectomy

A potentially serious complication of laparoscopic cholecystectomy is the inadvertent dissemination of unsuspected gallbladder carcinoma. There are increasing reports of seeding of tumor at the trocar sites following laparoscopic cholecystectomy in patients with unexpected or inapparent gallbladder carcinoma. Although the mechanism of the abdominal wall recurrence is still unclear, laparoscopic handling of the tumor, perforation of the gallbladder, and extraction of the specimen without an endobag may be risk factors for the spreading of malignant cells. The Authors report the case of late development of umbilical metastasis after laparoscopic cholecystectomy; the presence of an incisional hernia and the finding of a stone in subcutaneous tissue demonstrate the diffusion of tumor cells into subcutaneous tissue during the extraction of gallbladder. The patient underwent an excision of the metastases. She is disease free two years after surgical treatment

Citomegalovirus nei pazienti trapiantati d\u2019organo

aim of the work Calprotectin (CalP) and myeloperoxidase (MPO) are biochemical markers in the gingival crevicular fluid (GCF). Their increased concentration indicates the onset of an inflammatory process. The aim of this study was to valuate the correlation between the levels of calprotectin and myeloperoxidase detected in the crevicular fluid (GCF) at different probing depth (PPD). Materials and methods In a total of 11 subjects with chronic periodontitis, non smokers enjoying good health and who had not undergone periodontal nor antibiotic therapy in the 6 months prior the study, 60 sites were randomly selected and bleeding on probing (BOP), PPD, quantity of GCF and concentration of MPO and CalP were recorded. The volume of GCF was assessed through inserting PerioCol paper strips in the periodontal pockets for 10 seconds, then analyzed with a micro-moisture meter electronic instrument (Periotrom 6000, Siemens). The determination of the CalP was performed by enzyme immunoassay. The determination of MPO in the crevicular fluid was performed using the spectrophotometric reading of optical density. The results were statistically analyzed (SPSS16). Results PPD 5 mm (GCF=0,72 \u3bcg/\u3bcl; CalP=10,06 \u3bcg/\u3bcl; MPO=3,69 \u3bcg/\u3bcl); PPD 6 mm (GCF=0,78 \u3bcg/\u3bcl; CalP=10,64 \u3bcg/\u3bcl; MPO=5,45 \u3bcg/\u3bcl); PPD 657 mm (GCF=1,32 \u3bcg/\u3bcl; CalP=7,20 \u3bcg/\u3bcl; MPO=5,55 \u3bcg/\u3bcl). There were no statistically significant differences in the concentrations of MPO and CalP in the deeper periodontal pocket. Conclusion The concentration ofmyeloperoxidase seems significantly related to the increased presence of neutrophils into the deepest pockets

Effectiveness of adjunctive subgingival administration of amino acids and sodium hyaluronate gel on clinical and immunological parameters in the treatment of chronic periodontitis

Aims. The aim of this clinical trial was to compare clinical and biochemical healing outcomes following ultrasonic mechanical instrumentation versus ultrasonic mechanical instrumentation associated with topical subgingival application of amino acids and sodium hyaluronate gel. Methods. Eleven systemically healthy subjects with moderate-severe chronic periodontitis, who had four sites with pocket probing depth and clinical attachment level greater than or equal to 5 mm were randomly assigned to two different types of treatment: two pockets were treated with ultrasonic debridement (Control Group) and two pockets with ultrasonic mechanical instrumentation associated with 0,5 ml of amino acids and sodium hyaluronate gel (Test Group). Probing depth, clinical attachment level, plaque index and bleeding on probing were recorded at baseline, 45 and 90 days. Levels of calprotectin and myeloperoxidase activity in gingival crevicular fluid were assessed at baseline and on day 7 and 45. Results. Statistical significance was found between baseline and day 45 in relation to probing depth reduction and bleeding on probing between groups for both of the tested treatments. Significant reductions in μg/sample of calprotectin and myeloperoxidase were found after 1-week and an increase at 45 days in both groups. There were no statistically significant differences between other variables evaluated in this study. Conclusions. These data suggest that subgingival application of hyaluronic acid following ultrasonic mechanical instrumentation is beneficial for improving periodontal parameters

Heavy Metal Levels in Milk and Serum of Dairy Cows from Different Farms Located near an Industrial Area

Background: Heavy metals are toxic, non-biodegradable substances able to enter the food chain of cows and then transfer to their milk. This study investigated the relationship between the heavy metal concentrations in serum and milk and the environmental pollutants exposure at two different farms in Ragusa, Italy. Methods: To evaluate the concentrations of aluminum (Al), chromium (Cr), iron (Fe), copper (Cu), zinc (Zn), arsenic (As), cadmium (Cd), and lead (Pb), milk and serum samples were collected from 40 Friesian dairy cows from farm 1 at about 3.7 km from an industrial area (group 1) and 40 Friesian dairy cows from farm 2 at about 400 mt from a greenhouse and 6.0 km from a chemical fertilizer factory (group 2). Results: The concentrations of heavy metals measured in serum and milk showed no statistically significant differences between group 1 and group 2. No significant correlation between heavy metals in serum and milk in group 1 was observed. A positive correlation between Zn concentrations measured in milk and serum samples was observed in group 2 (r = 0.35, p = 0.03). Conclusions: The determination of heavy metals in serum and milk can be an important tool to detect the exposure to environmental pollutants and in monitoring the hygienic state of the environment in which milk is produced

Dental Care for Patients with End-Stage Renal Disease and Undergoing Hemodialysis

Chronic renal failure is a progressive disease characterized by a gradual destruction of nephrons and a consequent reduction of kidney function. End-stage renal disease (ESRD) necessitates renal replacement therapy as peritoneal dialysis, hemodialysis, or transplantation. Patients affected by ESRD or in hemodialysis are at risk for developing a number of comorbidities including hypertension, anemia, risk of bleeding, susceptibility to infection, medication side effects, and oral manifestations associated with the disease itself and with hemodialysis treatment. In this context, oral diseases represent a potential and preventable cause of poor health outcomes in people with ESRD due to their relation to infection, inflammation, and malnutrition. The aim of this article was to review ESRD and hemodialysis-associated manifestations and to describe the dental operative protocols for patients awaiting kidney transplantation in light of the most recent literature

Minoranze migranti

Si affronta la doppia valenza dei nuclei di migranti extracomunitari: popoli in movimento da una parte e minoranze etniche dall'altra. Con conseguenze proprie della doppia valenza: esigenza di integrarsi e bisogno di coltivare la propria identità.The double value of migrant peoples: peoples in migration, by one hand, and ethnic minorities, by the other. With specific consequencies of the double value: to integrate to the majorities and to reaffirm originary identity