Xerostomia na população idosa, do diagnóstico ao tratamento: revisão da literatura

Saliva is important for the preservation and maintenance of normal physiological conditions of oral tissues, and factors influencing its decrease are associated with the risk for oral diseases. Xerostomia is the subjective sensation of oral dryness, which can be influenced by etiological factors including the use of several types of medications, Sjogren’s and metabolic syndromes, head and neck irradiation, among others. Treatment methods for xerostomia vary and can be local or systemic. The aim of this article is to present the results of a literature review addressing the correlation between xerostomia and its incidence and prevalence in the older adult population. Results of this review highlight the importance of diagnosis and appropriate management, and briefly describe treatment modalities and etiological factors such as medications, Sjogren’s syndrome, metabolic syndrome, and head and neck irradiation.A saliva é importante para a preservação e manutenção das condições fisiológicas normais dos tecidos bucais, e os fatores que influenciam sua diminuição estão associados ao risco de doenças bucais. Xerostomia é a sensação subjetiva de secura oral, que pode ser influenciada por fatores etiológicos, incluindo o uso de vários tipos de medicamentos, síndromes metabólicas e de Sjögren, irradiação de cabeça e pescoço, entre outros. Os métodos de tratamento para xerostomia variam e podem ser locais ou sistêmicos. O objetivo deste artigo é apresentar os resultados de uma revisão bibliográfica abordando a correlação entre xerostomia e sua incidência e prevalência na população idosa. Os resultados desta revisão destacam a importância do diagnóstico e do manejo adequado e descrevem brevemente as modalidades de tratamento e fatores etiológicos, como medicamentos, síndrome de Sjögren, síndrome metabólica e irradiação de cabeça e pescoço

Imagem por ressonância magnética das glândulas salivares: uma revisão da literatura

Salivary glands tumors account for 2-5% of tumors in the head and neck region, possibly being benign or malignant. Magnetic resonance imaging (MRI) presents high soft tissue contrast resolution, thus being an excellent method for salivary gland analysis. The objective of this literature review is to analyze MRI as an evaluation instrument for the diagnosis of salivary glands lesions. Compared to other imaging techniques, MRI can better evaluate the relationship between adjacent anatomical structures, presenting greater sensitivity and specificity.Os tumores das glândulas salivares são responsáveis por 2-5 % dos tumores da região da cabeça e pescoço, podendo ser benignos ou malignos. A Ressonância Magnética (RM) possui uma alta resolução de contraste dos tecidos moles, sendo assim um excelente método para a análise das glândulas saliva­res. O objetivo dessa revisão de literatura consiste na análise da RM para a avaliação no diagnóstico de lesões das glândulas salivares. Comparando com outras técnicas de imagem, a RM consegue avaliar melhor a relação entre estruturas anatômicas adjacentes e possui maior sensibilidade e especificidade

Single-inhaler triple therapy fluticasone furoate/umeclidinium/vilanterol versus fluticasone furoate/vilanterol and umeclidinium/vilanterol in patients with COPD: results on cardiovascular safety from the IMPACT trial

BACKGROUND: This analysis of the IMPACT study assessed the cardiovascular (CV) safety of single-inhaler triple therapy with fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) versus FF/VI and UMEC/VI dual therapy. METHODS: IMPACT was a 52-week, randomized, double-blind, multicenter Phase III study comparing the efficacy and safety of FF/UMEC/VI 100/62.5/25 mcg with FF/VI 100/25 mcg or UMEC/VI 62.5/25 mcg in patients ≥40 years of age with symptomatic chronic obstructive pulmonary disease (COPD) and ≥1 moderate/severe exacerbation in the previous year. The inclusion criteria for the study were intentionally designed to permit the enrollment of patients with significant concurrent CV disease/risk. CV safety assessments included proportion of patients with and exposure-adjusted rates of on-treatment CV adverse events of special interest (CVAESI) and major adverse cardiac events (MACE), as well as time-to-first (TTF) CVAESI, and TTF CVAESI resulting in hospitalization/prolonged hospitalization or death. RESULTS: Baseline CV risk factors were similar across treatment groups. Overall, 68% of patients (n = 7012) had ≥1 CV risk factor and 40% (n = 4127) had ≥2. At baseline, 29% of patients reported a current/past cardiac disorder and 58% reported a current/past vascular disorder. The proportion of patients with on-treatment CVAESI was 11% for both FF/UMEC/VI and UMEC/VI, and 10% for FF/VI. There was no statistical difference for FF/UMEC/VI versus FF/VI or UMEC/VI in TTF CVAESI (hazard ratio [HR]: 0.98, 95% confidence interval [CI]: 0.85, 1.11; p = 0.711 and HR: 0.92, 95% CI: 0.78, 1.08; p = 0.317, respectively) nor TTF CVAESI leading to hospitalization/prolonged hospitalization or death (HR: 1.19, 95% CI: 0.93, 1.51; p = 0.167 and HR: 0.96, 95% CI: 0.72, 1.27; p = 0.760, respectively). On-treatment MACE occurred in ≤3% of patients across treatment groups, with similar prevalence and rates between treatments. CONCLUSIONS: In a symptomatic COPD population with a history of exacerbations and a high rate of CV disease/risk, the proportion of patients with CVAESI and MACE was 10-11% and 1-3%, respectively, across treatment arms, and the risk of CVAESI was low and similar across treatment arms. There was no statistically significant increased CV risk associated with the use of FF/UMEC/VI versus FF/VI or UMEC/VI, and UMEC/VI versus FF/VI. TRIAL REGISTRATION: NCT02164513 (GSK study number CTT116855)

Single-inhaler triple therapy fluticasone furoate/umeclidinium/vilanterol versus fluticasone furoate/vilanterol and umeclidinium/vilanterol in patients with COPD:results on cardiovascular safety from the IMPACT trial

BACKGROUND: This analysis of the IMPACT study assessed the cardiovascular (CV) safety of single-inhaler triple therapy with fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) versus FF/VI and UMEC/VI dual therapy. METHODS: IMPACT was a 52-week, randomized, double-blind, multicenter Phase III study comparing the efficacy and safety of FF/UMEC/VI 100/62.5/25 mcg with FF/VI 100/25 mcg or UMEC/VI 62.5/25 mcg in patients ≥40 years of age with symptomatic chronic obstructive pulmonary disease (COPD) and ≥1 moderate/severe exacerbation in the previous year. The inclusion criteria for the study were intentionally designed to permit the enrollment of patients with significant concurrent CV disease/risk. CV safety assessments included proportion of patients with and exposure-adjusted rates of on-treatment CV adverse events of special interest (CVAESI) and major adverse cardiac events (MACE), as well as time-to-first (TTF) CVAESI, and TTF CVAESI resulting in hospitalization/prolonged hospitalization or death. RESULTS: Baseline CV risk factors were similar across treatment groups. Overall, 68% of patients (n = 7012) had ≥1 CV risk factor and 40% (n = 4127) had ≥2. At baseline, 29% of patients reported a current/past cardiac disorder and 58% reported a current/past vascular disorder. The proportion of patients with on-treatment CVAESI was 11% for both FF/UMEC/VI and UMEC/VI, and 10% for FF/VI. There was no statistical difference for FF/UMEC/VI versus FF/VI or UMEC/VI in TTF CVAESI (hazard ratio [HR]: 0.98, 95% confidence interval [CI]: 0.85, 1.11; p = 0.711 and HR: 0.92, 95% CI: 0.78, 1.08; p = 0.317, respectively) nor TTF CVAESI leading to hospitalization/prolonged hospitalization or death (HR: 1.19, 95% CI: 0.93, 1.51; p = 0.167 and HR: 0.96, 95% CI: 0.72, 1.27; p = 0.760, respectively). On-treatment MACE occurred in ≤3% of patients across treatment groups, with similar prevalence and rates between treatments. CONCLUSIONS: In a symptomatic COPD population with a history of exacerbations and a high rate of CV disease/risk, the proportion of patients with CVAESI and MACE was 10-11% and 1-3%, respectively, across treatment arms, and the risk of CVAESI was low and similar across treatment arms. There was no statistically significant increased CV risk associated with the use of FF/UMEC/VI versus FF/VI or UMEC/VI, and UMEC/VI versus FF/VI. TRIAL REGISTRATION: NCT02164513 (GSK study number CTT116855)

Compared to conventional, ecological intensive management promotes beneficial proteolytic soil microbial communities for agro-ecosystem functioning under climate change-induced rain regimes

Projected climate change and rainfall variability will affect soil microbial communities, biogeochemical cycling and agriculture. Nitrogen (N) is the most limiting nutrient in agroecosystems and its cycling and availability is highly dependent on microbial driven processes. In agroecosystems, hydrolysis of organic nitrogen (N) is an important step in controlling soil N availability. We analyzed the effect of management (ecological intensive vs. conventional intensive) on N-cycling processes and involved microbial communities under climate change-induced rain regimes. Terrestrial model ecosystems originating from agroecosystems across Europe were subjected to four different rain regimes for 263 days. Using structural equation modelling we identified direct impacts of rain regimes on N-cycling processes, whereas N-related microbial communities were more resistant. In addition to rain regimes, management indirectly affected N-cycling processes via modifications of N-related microbial community composition. Ecological intensive management promoted a beneficial N-related microbial community composition involved in N-cycling processes under climate change-induced rain regimes. Exploratory analyses identified phosphorus-associated litter properties as possible drivers for the observed management effects on N-related microbial community composition. This work provides novel insights into mechanisms controlling agro-ecosystem functioning under climate change

Evaluation of Lionex TB kits and mycobacterial antigens for IgG and IgA detection in cerebrospinal fluid from tuberculosis meningitis patients

To evaluate commercial Lionex TB together with four antigens of Mycobacterium tuberculosis (MPT-64, MT10.3, 16 kDa and 38 kDa) for IgG and IgA cerebrospinal fluid (CSF) detection in the diagnosis of tuberculosis meningitis (TBM) with CSF negative acid-fast bacilli staining, 19 cases of TBM, 64 cases of other infectious meningoencephalitis and 73 cases of other neurological disorders were tested by enzyme linked immunosorbent assay. IgA-MPT-64 and IgG Lionex showed the highest sensitivities, specificities, positive predictive value and negative predictive value (63.2%, 47.4%; 95%, 93.7%; 40%, 98% and 28.4%, 97.1%, respectively). However, while grey zone was 12.7% and 6%, respectively, lowering sensitivity but maintains high specificity (> 95%). High protein concentration in CSF was associated with antibody positivity CSF/HIV+ which did not influence the sensitivity of both tests. To our knowledge, this is the first description of IgA-MPT-64 and IgG Lionex antibodies in CSF-TBM and, although there is good specificity, adjustments are needed based on antigen composition to enhance sensitivity

Legacy effects of drought on plant-soil feedbacks and plant-plant interactions

• Interactions between aboveground and belowground biota have the potential to modify ecosystem responses to climate change, yet little is known about how drought influences plant–soil feedbacks with respect to microbial mediation of plant community dynamics. • We tested the hypothesis that drought modifies plant–soil feedback with consequences for plant competition. We measured net pairwise plant–soil feedbacks for two grassland plant species grown in monoculture and competition in soils that had or had not been subjected to a previous drought; these were then exposed to a subsequent drought. To investigate the mechanisms involved, we assessed treatment responses of soil microbial communities and nutrient availability. • We found that previous drought had a legacy effect on bacterial and fungal community composition that decreased plant growth in conspecific soils and had knock-on effects for plant competitive interactions. Moreover, plant and microbial responses to subsequent drought were dependent on a legacy effect of the previous drought on plant–soil interactions. • We show that drought has lasting effects on belowground communities with consequences for plant–soil feedbacks and plant–plant interactions. This suggests that drought, which is predicted to increase in frequency with climate change, may change soil functioning and plant community composition via the modification of plant–soil feedbacks

Canapa: prodotti derivati e prospettive della canapicoltura in Italia

Dalla canapa si ottiene un’ampia gamma di prodotti, come olio a uso alimentare, cosmetici, farina, fibra tessile, carta e persino materiali per l’edilizia e bioplastiche. È una coltura ideale per le piccole aziende e che dà una mano all’ambient

Il ritorno della coltivazione della canapa in Italia

Coltivata già nell’antichità, sino a metà Novecento la produzione italiana di canapa era la prima al mondo per la qualità dei prodotti ottenuti. Dopo un periodo di oblio, negli ultimi anni è ripresa la sua coltivazione, regolata da specifi che normativ