The nutritional state of children and adolescents with cerebral palsy is associated with oral motor dysfunction and social conditions: a cross sectional study

Abstract\ud \ud Background\ud Cerebral palsy (CP) is the main cause of severe physical impairment during childhood and has commonly shown oral motor association. It has been considered as the main cause of the high prevalence of problems in children’s nutrition. Respiration, chewing, swallowing, speaking and facial expressionare part of the orofacial motor functions and when affected they can interfere in children’s well-being. The aim of this study was to correlate two methods of orofacial motor evaluation, analyze the influence of orofacial motor functional impairment on the nutritional status of children and adolescents with CP, and the association between socioeconomic factors.\ud \ud \ud Methods\ud Seventy children and adolescents with CP were selected, age range 6–16 years and following the exclusion criteria previously determined; 129 normoreactive children (control group), sex and age-matched to patients with CP. For the orofacial motor analysis two evaluation instruments were applied, the “Oral Motor Assessment Scale” (OMAS) and “Nordic Orofacial Test-Screening” (NOT-S). The anthropometric evaluation was based on the World Health Organization (WHO) and followed the criteria recommended by the Brazilian Ministry of Health.\ud \ud \ud Results\ud There was statistically significant correlation between the oral motor methods of evaluation (r = -0.439, p < 0.0001). Concerning the nutritional status evaluation, being overweight was associated with dystonic and mixed CP forms variables (p = 0.034), mother with no partnership (p = 0.045) and mild oral motor impairment (p = 0.028).\ud \ud \ud Conclusion\ud It could be concluded that, the weight’s gain by children and adolescents might be favored by a better functional oral motor performance and social factors

PCC32 - Atendimento odontológico a paciente com microdeleção no cromossomo 2 – relato de caso

A microdeleção do cromossomo 2 caracteriza-se por grande variabilidade clínica. Frouxidão ligamentar inclusive com luxação aguda e subluxação articulares são frequentes. Grande porcentagem dos afetados apresenta hipotonia e dificuldades alimentares, as quais são comuns na primeira infância, além de alterações imunológicas, cognitivas e neurológicas. Paciente HOG, gênero feminino, 3 anos, leucoderma foi referida ao GEAPE para tratamento odontológico

ESTUDO DO METABOLOMA DE BIOFLUIDOS EM PACIENTES PEDIÁTRICOS NEFROPATAS E SUA ASSOCIAÇÃO COM A DOENÇA PERIODONTAL.

INTRODUÇÃO: Metabolômica é a técnica que analisa metabólitos endógenos e exógenos de baixa massa molecular encontrados em biofluidos e tecidos. Diversos estudos têm mostrado a importância da saúde bucal em pacientes com doença renal crônica (DRC). OBJETIVO: Identificar e interpretar a função de metabólitos salivares e de urina de pacientes com DRC e sua possível associação com a doença periodontal (DP). MÉTODOS: 30 adolescentes e adultos jovens com DRC, 12-18 anos, cadastrados no CAPE /FOUSP e no ICrFMUSP, fizeram parte deste estudo. O grupo controle foi composto por 30 indivíduos clinicamente saudáveis. Os espécimes clínicos foram coletados e armazenados a -80°C até a realização da análise de cromatografia gasosa acoplada ao espectrômetro de massa (GC-MS). no laboratório Dempster da EPUSP. A análise periodontal foi realizada por meio do índice de higiene oral simplificado (OHI-S), sangramento à sondagem e profundidade de sondagem. RESULTADOS: As análises estatísticas foram realizadas por meio da análise de componentes principais (PCA), testes de Mann-Whitney e Kruskal-Wallis. A quantificação relativa de cada metabólito mostrou maiores concentrações entre pacientes com DRC sem DP e com DRC e com DP, de alanina (p&lt;0.0001), glicina (p&lt;0.0001), tirosina (p=0.021),serina (p&lt;0.0001),prolina (p&lt;0.0002),leucina (p&lt;0.0003), citrulina (p&lt;0.0001), arginina (p&lt;0.0002), p-Cresol(p&lt;0.0003) e acetofenona (p&lt;0.0003). Grupos com DRC mostraram concentrações alteradas de ácidos carboxílicos e dimetilarginina. CONCLUSÕES: Ambas as patologias estimulam o processo oxidativo sintetizando metabólitos que podem potencializar a severidade da DRC. Verificamos que, apesar do perfil metabólico ser diferente, alguns metabólitos são compartilhados por todos os grupos

Metabolomics study of biofluids of paediatric patients with chronic kidney disease and its association with periodontitis

Metabolômica é a técnica que analisa quantitativamente metabólitos endógenos e exógenos de baixa massa molecular encontrados em biofluidos e tecidos. Estas pequenas moléculas representativas encontradas em um sistema biológico abrangem carboidratos, ácidos graxos, nucleotídeos, aminoácidos entre outras classes de compostos. Alguns estudos têm mostrado a importância da manutenção da saúde bucal para pacientes com doença renal crônica (DRC). DRC, um problema mundial de saúde pública, pode ser definida em função da presença de danos renais ou de uma taxa de filtração glomerular < 60 mL/min por 1.73m2 por 3 meses, independente da causa. Desta forma, o objetivo deste estudo foi identificar e interpretar a função de metabólitos salivares e de urina de pacientes com DRC e sua possível associação com a doença periodontal (DP). Trinta adolescentes e adultos jovens, 12-18 anos, diagnóstico médico definitivo de DRC, cadastrados no CAPE (Centro de atendimento a pacientes especiais) da Faculdade de Odontologia e no Instituto da Criança da Faculdade de Medicina - Universidade de São Paulo (USP), fizeram parte deste estudo. O grupo controle também foi composto por 30 indivíduos, porém, clinicamente saudáveis. Todos os participantes receberam informações prévias à coleta de urina e saliva. As amostras de saliva e a primeira urina da manhã foram coletadas e armazenadas a -80°C até a realização da análise. A análise periodontal foi realizada por meio do índice de higiene oral simplificado (OHI-S), sangramento à sondagem e profundidade de sondagem. Todas as amostras foram avaliadas no departamento de Engenharia Química da Escola Politécnica da USP por meio de análise de cromatografia gasosa acoplada ao espectrômetro de massa (GC-MS). As análises estatísticas foram realizadas por meio da análise de componentes principais (PCA), testes de Mann-Whitney e Kruskal-Wallis. A quantificação relativa de cada metabólito mostrou maiores concentrações estatisticamente significativas entre pacientes com DRC sem DP e com DRC e com DP, de alanina (p<0.0001), glicina (p<0.0001), tirosina (p=0.021), serina (p<0.0001), prolina (p<0.0002), leucina (p<0.0003), citrulina (p<0.0001) e arginina (p<0.0002). Os valores médios da concentração de p-Cresol também mostraram-se alterados para os mesmos grupos citados acima. Grupos com DRC mostraram concentrações alteradas de ácidos carboxílicos como ácido butírico e de dimetilarginina. Concluímos, portanto, que ambas as patologias estimulam o processo oxidativo sintetizando metabólitos como ácido butírico, L-prolina, dentre outros, os quais podem potencializar a severidade da DRC. Verificamos também que, apesar do perfil metabólico ser diferente, alguns metabólitos como uréia, creatinina, ácido octadecanóico, ciclohexano, são compartilhados por todos os grupos.Metabolomics is a quantitative analysis of biofluids and tissue for low molecular mass organic endogenous / exogenous metabolites. These representative small molecules found within a system cover a broad range of small molecules, such as carbohydrates, fatty acids, nucleotides, amino acids among many other classes of compounds. A few studies have been published focusing on the oral health of chronic kidney disease (CKD) patients. CKD, a public health problem worldwide, can be defined based on the presence of kidney damage or glomerular filtration rate (GFR) < 60 mL/min per 1.73m2 for 3 months, regardless of cause. On account of that, the aim of this study was to identify and interpret the role of saliva and urine metabolites of CKD individuals and their possible association with periodontitis (PD). Thirty adolescents and young adults, aged 12-18 years, with definite medical diagnosis of CKD and attending the CAPE (Center of Attendance for Special Needs Patients) of the Dental School and the Children Institute of the Medical School - University of São Paulo (USP), comprised the study. The control group was comprised of 30 clinically healthy individuals. Participants were asked to refrain from oral activities for 2 h prior to saliva collection. The first morning urine was also collected and both specimens were frozen at -80°C until assay. Periodontal evaluation was carried out by means of the simplified oral hygiene index (OHI-S), bleeding on probing and probing depth. All samples were analyzed in the Chemical Engineering Department of the Polytechnics School of USP, by means of the Gas-chromatography - mass spectrometry (GC-MS) technique. Statistical analyses were performed by means of the principal component analysis (PCA), Mann-Whitney and Kruskal-Wallis tests. The relative quantification showed higher levels of alanine (p<0.0001), glycine (p<0.0001), tyrosine (p=0.021), serine (p<0.0001), proline (p<0.0002) ,leucine (p<0.0003), citrulline (p<0.0001) and arginine (p<0.0002) for groups II and IV. The mean concentration of p-Cresol was also greater and statically significant when comparing groups II and IV. Groups with CKD displayed higher concentrations of carboxylic acids such as butyric acid, and also of dimetilarginine. In conclusion, it could be verified that both pathologies stimulate oxidative stress which synthetises metabolites such as butyric acid and L-proline which can potentialise the severity of CKD. Additionally, despite being possible to distinguish the metabolic profile of patients with PD, PD and CKD and only CKD from clinically healthy individuals, some of these metabolites such as acetic acid, urea, creatinine, octadecanoic acid and cyclohexane were shared among all groups

In vitro evaluation of the microhardness of bovine enamel exposed to acid solutions after bleaching

Acid erosion is a superficial loss of enamel caused by chemical processes that do not involve bacteria. Intrinsic and extrinsic factors, such as the presence of acid substances in the oral cavity, may cause a pH reduction, thus potentially increasing acid erosion. The aim of this study was to evaluate the microhardness of bleached and unbleached bovine enamel after immersion in a soda beverage, artificial powder juice and hydrochloric acid. The results obtained for the variables of exposure time, acid solution and substrate condition (bleached or unbleached enamel) were statistically analyzed by the ANOVA and Tukey tests. It was concluded that a decrease in microhardness renders dental structures more susceptible to erosion and mineral loss, and that teeth left unbleached show higher values of microhardness compared to bleached teeth

Manejo quirúrgico de dientes supernumerarios en adolescente con Tetralogía de Fallot: Reporte de caso

La tetralogía de Fallot (TOF) se ha asociado con varios defectos genéticos y puede presentarse simultáneamente con manifestaciones craneofaciales. El paciente odontológico con TOF puede requerir algunos cambios en el plan de tratamiento. El objetivo del presente reporte de caso es mostrar que las extracciones dentales se pueden llevar a cabo en personas con TOF bajo anestesia local, una vez que se realiza la correcta planificación. Cinco dientes supernumerarios fueron extraídos de un paciente adolescente con TOF y se realizó profilaxis antibiótica para evitar la endocarditis infecciosa. La paciente regresó para una nueva evaluación al 7mo día postoperatorio. Él informó que no había sentido molestias o dificultades para comer. El examen bucal postoperatorio confirmó la reparación eficiente de los tejidos en todas las regiones expuestas al procedimiento quirúrgico, sin ninguna señal de infección

Patterns of Internet and smartphone use by parents of children with chronic kidney disease.

BackgroundSmartphones have become a part of universal technology by combining mobile and handheld functions, enabling expanded access to health information sources available on the Internet. The purpose of this study was to describe the pattern of smartphones and Internet use to search for health information by parents of children with chronic kidney disease (CKD).MethodsIn a cross-sectional study, a questionnaire was applied to 111 parents of patients in a Brazilian pediatric nephrology center. Descriptive assessments were performed on Internet use patterns, and associative analyses were made of the influence of the smartphone use pattern on the search for health information.ResultsOf the 111 participants, 91% (101/111) accessed the Internet, 88% (89/101) searched for health information, and 90% (80/89) searched for CKD information. Smartphones were the most commonly used devices to access the Internet. There was no significant difference between age groups, schooling levels, places of residence and smartphone use to search information about CKD. Physicians continue to be primary sources of information (87%, 88/101), but now they share space with the Internet, which surpassed traditional sources such as books and other health professionals. There seems to be some discomfort on the part of the parents in admitting their research habit to the physician, considering that 65% (52/80) said they did not discuss the fact that they had looked for information on the Internet with their doctor. Obtaining more information about the disease and gaining knowledge regarding its complications were the main reasons that led to performing a search on the Internet, whose results were considered useful by 93% (74/80).ConclusionParents of children with CKD have been using the Internet largely through smartphones to research about CKD, irrespective of age, schooling and place of residence. Given its wide use, the Internet can be an important vehicle for health education and contribute to providing the support needed by parents and patients to cope with the disease