Associated Factors With Self-reported Systemic Arterial Hypertension and Diabetes in Brazilian Older Adults: Populational-Based Cross-Sectional Study

Objective: This cross-sectional study aimed to assess the prevalence and associated factors of Systemic Arterial Hypertension (SAH) and Diabetes Mellitus (DM) in older adults.Materials and Methods: Self-reported SAH and DM (outcomes) were obtained through a structured questionnaire. This questionnaire also collected the independent variables (sociodemographic characteristics, use of medication and access to the oral health service). Obesity, physical activity, and tooth loss were assessed using validated instruments. Crude and adjusted Poisson regression with a robust error variance were performed to determine the prevalence ratio (PR) and 95% confidence interval (CI).Results: A total of 282 older adults were included, with the prevalence of 71.28% and 21.63% for SAH and DM, respectively. SAH was significantly associated with increase in the individuals’ age (PR:1.01; 95%CI:1.00–1.02) and the positive diagnosis for obesity (PR:1.24; 95%CI:1.09–1.43). Those that do not use drugs for other conditions  (PR:0.74; 95%CI:0.60–0.71) presented significantly lower PR for SAH. Non-sedentary older adults have the lower RP of DM (PR: 0.42; 95%CI: 0.24–0.74).Conclusions: A high prevalence of SAH and DM was observed among the older adults, and the main associated factors were mainly related to demographic characteristics, general health and behavioral habits

Antimicrobial potential of essential oils mouthrinses with and without alcohol : a randomized clinical trial

Aim: This study aimed to compare the microbiological potential and gustatory perception of essential oils (EO) mouthrinses containing and not containing alcohol. Methods:Twenty healthy adult volunteers rinsed with 10mL of the following test solutions: EO with alcohol, EO without alcohol, or a control solution (saline solution with mint essence). A washout period of at least seven days was adopted after a single-use protocol of the respective solution. All participants used all three tested substances. Antimicrobial potential was assessed by counting salivary total viable bacteria both before and after each rinse. Gustatory perception was evaluated using the Visual Analogue Scale (VAS). Multiple comparisons were performed with the Wilcoxon test, using Bonferroni correction. Results: Both EO solutions presented a higher antimicrobial potential in comparison to the control solution (p<0.017). However, no significant difference in antimicrobial potential was observed between EO containing or not containing alcohol (p=0.218). VAS of EO with alcohol (median: 2.7) was similar to control solution (median: 1.6) (p=0.287). A better gustatory perception was observed of the EO without alcohol (median 7.6) when compared to the control solution (p<0.0001). When EO groups were compared, EO without alcohol also demonstrated a significantly better gustatory perception (p=0.001). Conclusion: Mouthrinse containing EO without alcohol presented a better taste perception when compared to the EO with alcohol, but no difference was observed in the antimicrobial potential of both EO solutions after a single rinse protocol

Can body mass index influence the skin temperature of adolescents? A preliminary study with the use of infrared thermography

– Infrared thermography (IRT) has been used to assess skin temperature (Tsk), especially during the COVID-19 pandemic, as an important tool in medical screening not only of the general population, but also of young athletes. However, the subcutaneous adipose tissue can act as an insulator when the Tsk is assessed by IRT, modifying the normal Tsk data and leading to their misinterpretation. Considering that the body mass index (BMI) is an important predictor of obesity, the objective of this study was to verify if the Tsk measured by IRT is affected by the BMI in adolescents. A preliminary study was carried out being four participants intentionally selected, all 16 years old, each one classified in a different BMI range according to the criteria of the World Health Organization for the adolescent population: underweight, healthy weight, overweight and obesity. Four thermograms of each participant were recorded and the ThermoHuman® software was used to evaluate 82 regions of interest (ROI), which were integrated into 6 body regions. Using healthy weight subjects as a reference, it was found a progressive reduction in Tsk in all ROI compared to overweight and obese participants, with emphasis on the anterior region of the trunk (3.04% and 6.69% less respectively), and an increase in the Tsk of all body regions for the underweight subject. There are indications that BMI can influence the Tsk value in adolescents and should be taken into account when analyzing thermograms for a correct evaluation of thermal normality

Masticatory Function and Nutritional Status in Brazilian Institutionalized Elders: Influence of Denture Use

Objective: To evaluate the influence of tooth loss and the use of removable dentures on chewing function and nutritional status of institutionalized elders. Material and Methods: Cross-sectional study with 155 elders from seven long-stay institutions in João Pessoa, Brazil. The participants were classified according to the presence of reminiscent teeth and use of dentures in four levels: toothless, without denture (1); toothless with a complete denture (2); partial toothless without denture (3) and partial toothless with a partial denture (4). Nutritional status was assessed using the Mini-Nutritional Assessment (MNA) instrument and the Body Mass Index (BMI). Swallowing threshold was used for the assessment of masticatory function, using a portion of roasted peanuts (3.7 g). Comparisons among groups were performed using Kruskal-Wallis test with Bonferroni adjustment, considering p&lt;0.05. Results: MNA (p=0.702) and BMI (p=0.884) were not modified in relation to the presence of teeth and denture use. Toothless individuals without dentures had a lower swallowing threshold (p&lt;0.001), whilst partial toothless with dentures had better masticatory function (p&gt;0.05). Conclusion: The presence of reminiscent teeth and the use of dentures do not influence the nutritional status of the elders but interfere with the masticatory function. Prosthetic rehabilitation is desirable for complete toothless individuals

Administração de metilprednisolona na esclerose multipla: revisão sistemática de literatura / Administration of methylprednisolone in multiple sclerosis: systematic literature review

Introdução: Esclerose Múltipla (EM) constitui-se uma doença inflamatória desmielinizante, com incidências cada vez mais crescentes no mundo, demandando aumento nos gastos públicos com tratamentos. Dentre eles a aplicação da Metilprednisolona (MP) constitui-se uma prática clínica muito usada, contudo seus métodos de aplicação ainda não são definidos. Objetivos: O estudo constitui uma revisão sistemática de literatura com o objetivo de avaliar os efeitos da administração metilprednisolona na esclerose múltipla. Metodologia: Constitui-se de uma revisão da literatura nos bancos de dados do Science Direct e PubMed. Foram utilizados as estratégias de busca e os critérios de inclusão, logo, foram incluídos 10 estudos para constituição da revisão sistemática. Resultados e discussões: A MP demonstra resultados significativos como terapia na EM, principalmente quando administrada nos modos que utilizam uma alta dosagem do fármaco. Conclusão: A administração da MP demonstra ser eficaz no tratamento da EM, contudo ainda são necessários mais estudos para a determinação de parâmetros de dosagem, duração e número de aplicações. 

A summary of the Brazilian Paraná Basin Ordovician

The study of the Ordovician of Paraná Basin culminated on the three-fold lithostratigraphic subdivision of the Rio Ivaí Group as follows: Alto Garças, Iapó and Vila Maria formations. The history of deposition of these rocks is linked to the transition from a marine fluvial environment into the glacial diamictites and shales with dropstones, overlain by post-glacial transgressive shales, siltstones and sandstones. The OrdovicianâSilurian transition is marked by a glacial and an extinction event that impacted the marine diversity of life and the permanence of the first land plants. At least three sections, designated as the sections 1, 2 and 3 below, had their sedimentary facies, taphonomy, organic carbon content and thermal maturation analysed as well as their macro- and microfossil assemblages recognized. All studied sections were productive for macro- and microfossils, although the section 1 has limited occurrence and lower preservation of palynomorphs. The greatest fossil diversity was recovered from the section 2. To date, the diversity recovered from the OrdovicianâSilurian of the Paraná Basin comprises 12 fossil groups, namely ostracods, brachiopods, bivalves, gastropods, cryptospores, fungi, acritarchs, chitinozoans, prasinophyte algae, scole­codonts, a possible graptolite and, more recently, a trilobite of the order Dalmanitidae. 51 species of palynomorphs of terrestrial and marine origin were recognized. This is the highest diversity reported from the glacialâpostglacial transition in the OrdovicianâSilurian boundary interval of Brazil. 18 species of cryptospores, acritarchs and fungi occur in the basal diamictites (the Iapó Formation) as well as the discinoid Kosoidea australis. In the upper part of these diamictites, the palynomorph assemblage comprises 26 taxa, most of which persist also in the postglacial shales. Still, in the shales with dropstones of the Iapó Formation, brachiopods (K. australis, infaunal lingulids, ?Palaeoglossa and rhynchonelliformeans), endemic ostracods such as Satiellina paranaensis and pyritized specimens of a widely common Hirnantian index species Harpabollia harparum occur together with indeterminable ostracod species. At least two different species of bivalve mollusks were also found as well as a gastropod species (Bucanellasp.). Observing the palynomorph assemblage, it was possible to record also chitinozoans restricted to the lowermost portion of the Vila Maria Formation. This part of the formation was observed in the outcrops 2 and 3 and contains postglacial chitinozoan assemblages that are not younger than the earliest Rhuddanian. Some centimeters above this interval but still in the lower part of the Vila Maria Formation, the occurrence of Spinachitina debbajae followed by Spinachitina silurica refer to the Silurian in the Paraná Basin. In the section 1, the recovery of a trilobite thorax configures the oldest record of this group in Brazil and shows that this ancient sea was also thriving with life even after the glaciation-related Hirnantian extinction event

Avanços recentes nas terapias endoscópicas minimamente invasivas: uma revisão abrangente para o tratamento de doenças gastrointestinais

As terapias endoscópicas minimamente invasivas (TEMI) têm revolucionado o manejo de várias doenças gastrointestinais, ao proporcionar diagnóstico e tratamento eficazes com menor morbidade em comparação às abordagens cirúrgicas convencionais. Este artigo oferece uma revisão abrangente dos avanços recentes no uso das TEMI no tratamento de doenças inflamatórias intestinais (DII), condições gastrointestinais funcionais e malignidades gastrointestinais. As técnicas específicas de TEMI, incluindo dilatação endoscópica, dissecção submucosa endoscópica (DSE), endomicroscopia confocal a laser (CLE) e ecoendoscopia, são discutidas em detalhes, destacando a eficácia de cada técnica e suas implicações para a prática clínica. O papel destas técnicas no avanço do manejo das DII, condições gastrointestinais funcionais e malignidades gastrointestinais é discutido, com uma visão particular sobre como as TEMI estão reformulando o panorama terapêutico nestas áreas. O artigo também aborda as implicações clínicas dessas descobertas, as limitações atuais da pesquisa e as recomendações para o desenvolvimento futuro. Conclui-se que as TEMI têm o potencial de melhorar significativamente a qualidade de vida dos pacientes, reduzindo a necessidade de intervenções cirúrgicas invasivas e proporcionando um manejo mais eficaz da doença

Impacto da infecção puerperal nos indicadores de mortalidade materna: uma revisão da literatura

O presente artigo busca demonstrar que a infecção puerperal é uma das principais causas de mortalidade materna e são marcadas por sintomas associados à infecção como dor pélvica, febre, corrimento vaginal anormal e/ou com odor fétido e atraso na involução uterina. Além disso, existem vários fatores de risco como extremos de idade materna, IMC elevado, presença de doenças sexualmente transmissíveis, vaginose bacteriana, hipertensão, diabetes, deficiências imunológicas e confirmação de infecção pelo Streptococcus pyogenes do grupo B (tabela 01). O tipo de parto também é um ponto relevante de se observar, uma vez que as mulheres que são submetidas à cesárea estão em maior risco. As infecções puerperais são responsáveis por 10 a 15% dos óbitos maternos em todo mundo, mesmo sendo muitas vezes prevenível. Assim é imprescindível estabelecer estratégias para diminuição desse quadro. Considerando as principais opções de tratamento, temos ressuscitação volêmica e controle do foco de infecção. Nessa perspectiva, percebe-se a necessidade da triagem pré-natal, higiene adequada durante o parto e cuidados pós-parto. Entretanto, no que concerne aos índices de mortalidade materna associados à infecção puerperal, carece-se da identificação precoce e tratamento imediato no intuito de evitar complicações mais graves e reduzir a mortalidade materna relacionada a elas

Revisão sobre a eficácia e segurança no uso de inibidores de co-transportadores de sódio-glicose-2 na fisiopatologia da diabetes mellitus tipo II / Review on the effectiveness and safety in the use of sodium-glucose-2 co-carrier inhibitors in the pathophysiology of diabetes mellitus type II

A fisiopatologia da diabetes mellitus tipo 2 consiste em uma síndrome relacionada com a disfunção da insulina no processo de regulação da glicose sérica, no qual é a de maior prevalência na população diabética, correspondendo a cerca de 90 a 95% dos casos. Seu controle pode ser feito pela alimentação saudável, prática de exercícios físicos, e em caso de não controle o apelo pela medicação afim de obter controle da hiperglicemia. Contudo, alguns pacientes não se adequam a determinadas medicações, e fármacos da classe dos inibidores de SGLT-2 tem se demonstrado eficazes em seu controle. O objetivo do estudo foi analisar a eficácia e segurança de sua farmacoterapia em estudos de ensaios clínicos. As classes avaliadas em estudos de ensaios clínicos foram: dapagliflozina, canagliflozina, empagliflozina, ipragliflozina, luseogliflozina e tofogliflozina em monoterapia, terapias complementares e comparativos. Sendo assim, se demonstraram eficazes no controle da DM2, com alguns eventos adversos que precisam ser bem avaliados dependente de sua dose, idade e condições clínicas do paciente