Uso do laser cirúrgico de alta potência em lesões bucais: considerações clínicas e histopatológicas

TCC (graduação) - Universidade Federal de Santa Catarina. Centro de Ciências da Saúde. Odontologia.Desde as primeiras aplicações do LASER na Odontologia, em 1964, até os dias atuais, ocorreram muitos avanços tecnológicos que nos permitem utilizar a laserterapia com mais segurança. As indicações do uso desta tecnologia têm aumentado muito em Odontologia. O laser de baixa intensidade tem sido muito estudado em Odontologia e já estão comprovadas suas indicações e vantagens como um instrumento para tratamento de dor, redução de edema e inflamação de lesões da mucosa bucal. No entanto, a utilização do laser de alta intensidade em Odontologia ainda exige maior número de pesquisas. Os estudos publicados indicam muitas vantagens na sua utilização em situações cirúrgicas de pacientes com baixa capacidade hemostática; contrapondo-se a isto, apenas seus efeitos térmicos gerando possíveis efeitos adversos sobre os tecidos adjacentes às áreas operadas. Este trabalho objetivou avaliar a ação do laser de alta potência em lesões de tecidos moles bucais removidas cirurgicamente bem como analisar o efeito térmico sobre as margens nas lesões de tecidos moles biopsiadas afim de verificar se o comprometimento das margens interfere no diagnósitico histopatológico. A pesquisa foi realizada com 21 lesões bucais removidas de pacientes do Núcleo de Odontologia Hospitalar do Hospital Universitário/UFSC com o laser cirúrgico de alta potência do tipo diodo, no período entre janeiro de 2015 e março de 2017, incluindo pacientes de ambos os sexos e sem preferência por faixa etária ou diagnóstico clínico da lesão. Nenhuma das lesões biopsiadas a laser foi excluída da amostra. Após a localização das fichas de biópsia do Laboratório de Patologia Bucal/UFSC, foi feita a busca pelas lâminas histopatológicas geradas a partir das peças biopsiadas. Todos os cortes histológicos obtidos, seriados ou não, foram analisados através de microscópio óptico em aumentos de 50, 100 e 400x. Os danos causados pelo laser na região de cortes foram avaliados por consenso, entre autora e orientadora, tendo sido classificados em pequeno, médio e grande, de acordo com o padrão do dano predominante. A amostra foi composta por 21 pacientes, 8 do sexo masculino e 13 do sexo feminino. Do total das lesões, 57% foram classificadas hiperplasia fibrosa inflamatória, seguido de granuloma piogênico (9%), hiperplasia fibrosa focal (9%), sialoadenite (5%), neuroma encapsulado em paliçada (5%), linfangioma (5%), processo inflamatório crônico inespecífico com áreas de abscedação (5%) e fragmento de mucosa com degeneração generalizada de tecido conjuntivo (5%). Os resultados mostraram que os danos predominantes foram os classificados como “médio”, no entanto, em nenhum dos casos analisados o corte a laser inviabilizou o diagnóstico histopatológico da lesão. Houve variações de acordo com o tecido biopsiado ser mais ou menos fibroso, provavelmente devido aos ajustes necessários na potência do laser no momento da realização do procedimento, bem como da experiência do operador em realizar tal procedimento. Os dados foram organizados em planilhas do programa Microsoft Excel e a análise descritiva foi realizada. Deve-se, portanto, considerar as indicações e vantagens clínicas da utilização desta tecnologia na tomada de decisão sobre seu uso, uma vez que, se usado corretamente, tende a trazer muitos benefícios tanto ao paciente quanto ao operador. Desta forma, mais estudos clínico-histopatológicos, randomizados, são necessários para melhor avaliar os danos térmicos que ocorrem com os tecidos bucais seccionados com laser de alta potência.Since the first applications of LASER in Dentistry in 1964 to the present day, many technological advances have occurred that allow us to use laser therapy safety. The clinical indications of this technology are increasing in Dentistry. The low level laser therapy (LLLT) has been studied in dentistry and its indications and advantages are already proven as an instrument for pain control, reduction of swelling and inflammation of lesions in the oral cavity. However, the use of high level laser therapy in dentistry still requires more research.Many studies indicate the advantages of high level laser therapy in surgical procedures, especially in patients with low hemostatic capacity. Thermal damage on adjacent tissues is the greatest contraindication of this technique. This study aims to evaluate the action of high level laser therapy on oral lesions removed under this technique, as well as analyze the thermal effects of laser in the soft tissue lesions removed. The research was performed with 21 oral lesions removed from patients from Dental Service of the University Hospital of Santa Catarina Federal University with the diode surgical laser, from January 2015 to March 2017. Are included patients of both sexes and with no preference for age or clinical diagnosis of the lesion. None of the biopsied laser lesions were excluded from the sample. After the pursuit of the biopsy files from Laboratório de Patologia Bucal/UFSC, the search for the histopathological slides generated from the biopsied specimens was made. All histological sections obtained, serial or non-serial, were analyzed under optical microscopy with increments of 50, 100 and 400 times. The laser thermal damage on the histopathological slides was evaluated by consensus, between author and supervisor, and was classified as “small, medium and large damage” according to the pattern of predominant damage. The results showed that the predominant thermal damage was "medium damage". However, in none of the cases analyzed, the laser surgical incision made the histopathological diagnosis of the lesion impossible. There were variations according to whether the biopsied tissue was more or less fibrous, probably due to the necessary adjustments in laser power at the time of the procedure, as well as the operator's experience in performing such a procedure. No statistical analysis was performed, only description analysis. Therefore, it is necessary to consider the indications and clinical advantages of the use of this technology in the decision making about its use, since if used correctly; it tends to bring many benefits to both the patient and the operator. Thus, more randomized clinical and histopathological studies are needed to better understand all the histological processes that occur with buccal tissues sectioned with high level laser therapy. Therefore, it is necessary to consider the indications and clinical advantages of the use of this technology in the decision making about its use, since if used correctly, it tends to bring many benefits to both the patient and the operator

Avaliação do consumo de suplementos nutricionais em praticantes de atividade física: revisão integrativa / Evaluation of the consumption of nutritional supplements in physical activity practitioners: an integrative review

Objetivo: avaliar o consumo de suplementos nutricionais em praticantes de atividade física. Método: revisão integrativa da literatura, realizada no Scielo, PubMed e Google Acadêmico, utilizando para a base de dados trabalhos entre 2013 e 2020. Foram selecionados os artigos completos disponíveis nos idiomas português, inglês e espanhol, excluindo-se os duplicados e os que não corresponderam à pergunta norteadora, totalizando 20 artigos. Resultados: O ano com maior número de publicações foi o de 2017, que apresentou 13 trabalhos (n=13; 65%). Observou-se o predomínio de estudos em português, com 90% (n=18). Os suplementos nutricionais mais consumidos foram os de origem proteica Whey Protein em 65% dos artigos (n=13). Ainda, 55% dos trabalhos (n=11) realizaram a pesquisa em academias. Entretanto, apenas 4 artigos (n=4, 20%) abordam os efeitos adversos do uso indiscriminado de suplementos alimentares. Em relação à prescrição da suplementação alimentar, apontados em 50% dos trabalhos inclusos (n=10), a maioria desses (n=50%) concluiu que o educador físico é o profissional que mais indica esse consumo, seguido da auto suplementação (n=4, 40%). Nenhum trabalho (n=0) inseriu o médico como o profissional que prescreveu o suplemento nutricional para o praticante de atividade física e somente 15% dos artigos incluídos (n=3) citaram o tempo de utilização desses suplementos. Conclusão: Aumento do consumo de suplementos nutricionais entre os praticantes de atividade física em especial por praticantes de musculação e, na maioria dos casos, sem orientação adequada

Estivales-2013 (Les)

Les sciences humaines et sociales, sans remonter au rapport de Sophie Barluet, Le coeur en danger, sont dans une situation d’équilibre instable : et pourtant, sans une publication régulière, intensive, de ces disciplines, quel regard sur nos sociétés ? Quel recul sur notre histoire ? Comment ne pas tomber dans le présentisme et l’effet de mode ? Sans le soutien et le devenir de la librairie, maillon indépassable de la chaîne du livre, quels seront les lecteurs et les penseurs de demain ? À l’occasion des 20 ans des Presses de l’enssib, éditeur public qui, comme beaucoup d’éditeurs privés, prend ses risques et donne à penser, Les Estivales s’ouvrent cette année sur cette focale particulière, parce qu’il nous a semblé qu’il y avait une certaine urgence. Les Estivales, manifestation annuelle de l’enssib, ont pour objectif de rassembler professionnels, chercheurs et étudiants autour de questions professionnelles et de l’actualité de la recherche en sciences de l’information et des bibliothèques

A Systematic Analysis of Metal and Metalloid Concentrations in Eight Zebrafish Recirculating Water Systems

Metals and metalloids are integral to biological processes and play key roles in physiology and metabolism. Nonetheless, overexposure to some metals or lack of others can lead to serious health consequences. In this study, eight zebrafish facilities collaborated to generate a multielement analysis of their centralized recirculating water systems. We report a first set of average concentrations for 46 elements detected in zebrafish facilities. Our results help to establish an initial baseline for trouble-shooting purposes, and in general for safe ranges of metal concentrations in recirculating water systems, supporting reproducible scientific research outcomes with zebrafish

Secretory IgA mediates retrotranscytosis of intact gliadin peptides via the transferrin receptor in celiac disease

Celiac disease (CD) is an enteropathy resulting from an abnormal immune response to gluten-derived peptides in genetically susceptible individuals. This immune response is initiated by intestinal transport of intact peptide 31-49 (p31-49) and 33-mer gliadin peptides through an unknown mechanism. We show that the transferrin receptor CD71 is responsible for apical to basal retrotranscytosis of gliadin peptides, a process during which p31-49 and 33-mer peptides are protected from degradation. In patients with active CD, CD71 is overexpressed in the intestinal epithelium and colocalizes with immunoglobulin (Ig) A. Intestinal transport of intact p31-49 and 33-mer peptides was blocked by polymeric and secretory IgA (SIgA) and by soluble CD71 receptors, pointing to a role of SIgA–gliadin complexes in this abnormal intestinal transport. This retrotranscytosis of SIgA–gliadin complexes may promote the entry of harmful gliadin peptides into the intestinal mucosa, thereby triggering an immune response and perpetuating intestinal inflammation. Our findings strongly implicate CD71 in the pathogenesis of CD

BRCA2 polymorphic stop codon K3326X and the risk of breast, prostate, and ovarian cancers

Background: The K3326X variant in BRCA2 (BRCA2*c.9976A>T; p.Lys3326*; rs11571833) has been found to be associated with small increased risks of breast cancer. However, it is not clear to what extent linkage disequilibrium with fully pathogenic mutations might account for this association. There is scant information about the effect of K3326X in other hormone-related cancers. Methods: Using weighted logistic regression, we analyzed data from the large iCOGS study including 76 637 cancer case patients and 83 796 control patients to estimate odds ratios (ORw) and 95% confidence intervals (CIs) for K3326X variant carriers in relation to breast, ovarian, and prostate cancer risks, with weights defined as probability of not having a pathogenic BRCA2 variant. Using Cox proportional hazards modeling, we also examined the associations of K3326X with breast and ovarian cancer risks among 7183 BRCA1 variant carriers. All statistical tests were two-sided. Results: The K3326X variant was associated with breast (ORw = 1.28, 95% CI = 1.17 to 1.40, P = 5.9x10- 6) and invasive ovarian cancer (ORw = 1.26, 95% CI = 1.10 to 1.43, P = 3.8x10-3). These associations were stronger for serous ovarian cancer and for estrogen receptor–negative breast cancer (ORw = 1.46, 95% CI = 1.2 to 1.70, P = 3.4x10-5 and ORw = 1.50, 95% CI = 1.28 to 1.76, P = 4.1x10-5, respectively). For BRCA1 mutation carriers, there was a statistically significant inverse association of the K3326X variant with risk of ovarian cancer (HR = 0.43, 95% CI = 0.22 to 0.84, P = .013) but no association with breast cancer. No association with prostate cancer was observed. Conclusions: Our study provides evidence that the K3326X variant is associated with risk of developing breast and ovarian cancers independent of other pathogenic variants in BRCA2. Further studies are needed to determine the biological mechanism of action responsible for these associations

The state of the Martian climate

60°N was +2.0°C, relative to the 1981–2010 average value (Fig. 5.1). This marks a new high for the record. The average annual surface air temperature (SAT) anomaly for 2016 for land stations north of starting in 1900, and is a significant increase over the previous highest value of +1.2°C, which was observed in 2007, 2011, and 2015. Average global annual temperatures also showed record values in 2015 and 2016. Currently, the Arctic is warming at more than twice the rate of lower latitudes

Massive X-ray screening reveals two allosteric drug binding sites of SARS-CoV-2 main protease

The coronavirus disease (COVID-19) caused by SARS-CoV-2 is creating tremendous health problems and economical challenges for mankind. To date, no effective drug is available to directly treat the disease and prevent virus spreading. In a search for a drug against COVID-19, we have performed a massive X-ray crystallographic screen of repurposing drug libraries containing 5953 individual compounds against the SARS-CoV-2 main protease (Mpro), which is a potent drug target as it is essential for the virus replication. In contrast to commonly applied X-ray fragment screening experiments with molecules of low complexity, our screen tested already approved drugs and drugs in clinical trials. From the three-dimensional protein structures, we identified 37 compounds binding to Mpro. In subsequent cell-based viral reduction assays, one peptidomimetic and five non-peptidic compounds showed antiviral activity at non-toxic concentrations. Interestingly, two compounds bind outside the active site to the native dimer interface in close proximity to the S1 binding pocket. Another compound binds in a cleft between the catalytic and dimerization domain of Mpro. Neither binding site is related to the enzymatic active site and both represent attractive targets for drug development against SARS-CoV-2. This X-ray screening approach thus has the potential to help deliver an approved drug on an accelerated time-scale for this and future pandemics

X-ray screening identifies active site and allosteric inhibitors of SARS-CoV-2 main protease

The coronavirus disease (COVID-19) caused by SARS-CoV-2 is creating tremendous human suffering. To date, no effective drug is available to directly treat the disease. In a search for a drug against COVID-19, we have performed a high-throughput X-ray crystallographic screen of two repurposing drug libraries against the SARS-CoV-2 main protease (M^(pro)), which is essential for viral replication. In contrast to commonly applied X-ray fragment screening experiments with molecules of low complexity, our screen tested already approved drugs and drugs in clinical trials. From the three-dimensional protein structures, we identified 37 compounds that bind to M^(pro). In subsequent cell-based viral reduction assays, one peptidomimetic and six non-peptidic compounds showed antiviral activity at non-toxic concentrations. We identified two allosteric binding sites representing attractive targets for drug development against SARS-CoV-2