Hipossalivação no Desporto: relação com a cárie dentária e performance desportiva

A prática de desporto tem vindo a crescer na população em geral e é de realçar a importância de perceber que impactos podem representar na qualidade de vida e neste caso na cavidade oral. A redução do fluxo salivar no exercício faz com que a cavidade oral sofra alterações, caso não sejam aplicadas medidas de prevenção. A cárie dentária é uma das mais prevalentes consequências de hipossalivação. Como doença ativa, a presença de cáries dentárias pode alterar a condição e performance do atleta. O principal objetivo deste trabalho foi perceber o impacto que a hipossalivação tem no aparecimento de cáries dentárias e consequentemente o impacto que esta doença tem na performance desportiva. Entender a fisiologia do fluxo salivar, perceber quais as zonas mais propícias ao aparecimento de cárie e aprender como podemos agir em situações de hipossalivação no desporto. Para a realização deste trabalho foram utilizados 27 artigos (perquisados na base de dados Pubmed) e um livro: “Sport and Oral Health” da autoria de Siobhan C. Budd e Jean-Christophe Egea. Conseguimos concluir que a hipossalivação tem influência direta no aparecimento de doença cárie e que este interfere de forma ativa na qualidade de vida e na performance do atleta. Percebemos que a saliva desempenha um papel crucial em várias funções na cavidade oral. Como prevenção, visitas ao medico dentista, hidratação e cuidado na dieta são fundamentais para manter um fluxo salivar normal

ANÁLISE DA INFLUÊNCIA DA HIPERTENSÃO ARTERIAL SISTÊMICA E DA INSUFICIÊNCIA CARDÍACA NO AGRAVO DO QUADRO CLÍNICO DE PACIENTES COM DOENÇA RENAL CRÔNICA: uma revisão de literatura

Introduction: systemic arterial hypertension (SAH) and heart failure, epidemiologically, are diseases that model consequences for other systems of the human body, for example chronic kidney disease (CKD). The development of this appears to be a social consequence of lack of knowledge, as its secondary outcomes are controllable and treatable. Countries like Brazil have exorbitant expenses when it comes to financing dialysis and transplant procedures, with an increase in these numbers, especially in young patients decompensated for their underlying diseases. The objective of this work is to observe the incidence in the literature of SAH and heart failure in patients related to the worsening of CKD. Methodology: descriptive study in narrative review, which seeks to answer the PICO acromion “What is the influence of systemic arterial hypertension and heart failure on the worsening of the clinical condition of patients with chronic kidney disease? ”. Discussion: CKD's pathophysiology is the loss of kidney function, where they lose functionality and destroy their specific cells, resulting in the inability to maintain metabolic balance. It proves to be a problem of public responsibility, where more and more deaths in the population are reported. The main risk factors for CKD are highly prevalent chronic diseases such as hypertension and heart failure, the first being the most described in the literature as a triggering factor. Thus resulting in worsening of renal function laboratory results, resulting in chronic kidney injury (CRF). Results: Analyzing the databases, articles in the last 10 years were observed, where 38.6% had the descriptors systemic arterial hypertension and heart failure, describing them as their main secondary outcome. Conclusion: to the scientific society, it contributes summarized and updated indexes reporting the relationship between these precursor pathologies. To society, it informs the problem and a way to inform the patient about their health condition and better understanding.Introdução: hipertensão arterial sistêmica (HAS) e Insuficiência cardíaca, epidemiologicamente são doenças modeladoras de consequências a outros sistemas do corpo humano, por exemplo a doença renal crônica (DRC). O desenvolvimento desta mostra-se como consequência social a falta de conhecimento, pois seus desfechos secundários são controláveis e tratáveis. Países como o Brasil, possuem gastos exorbitantes quando ao custeio de procedimentos de diálise e transplante, sendo observado uma crescente nestes números, principalmente em pacientes jovens descompensados das doenças de base. O objetivo deste trabalho são observar a incidência na literatura, sobre a HAS e insuficiência cardíaca em pacientes relacionadas ao agravo da DRC. Metodologia: estudo descritivo em revisão de narrativa, que procura responder ao acrômio PICO “Qual é a influência da hipertensão arterial sistêmica e da insuficiência cardíaca no agravo do quadro clínico de pacientes com doença renal crônica? ”. Discussão: DRC tem como fisiopatologia a perda da função renal, onde estes perdem a funcionalidade e destroem suas células especificas, resultando na incapacidade em manter o equilíbrio metabólico. Mostra-se uma mazela de responsabilidade pública, onde cada vez mais relados de morte na população são relatados. Os principais fatores de risco para a DRC são doenças crônicas de alta prevalência como HAS e insuficiência cardíaca, sendo a primeira a mais descrita na literatura como fator desencadeante. Assim resultando na piora dos resultados laboratoriais de função renal, resultando em uma injúria renal crônica (IRC). Resultados: Analisando as bases de dados, foi observado artigos nos últimos 10 anos, onde 38,6% tinham os descritores hipertensão Arterial sistêmica e insuficiência cardíaca, descrevendo como seu principal desfecho secundário. Conclusão: à sociedade científica, contribui com índices resumidos e atualizados relatando a relação entre estas patologias precursoras. À sociedade, informa sua problemática e uma maneira em informar o paciente sobre a sua condição de saúde e melhor compreensão

Health-status outcomes with invasive or conservative care in coronary disease

BACKGROUND In the ISCHEMIA trial, an invasive strategy with angiographic assessment and revascularization did not reduce clinical events among patients with stable ischemic heart disease and moderate or severe ischemia. A secondary objective of the trial was to assess angina-related health status among these patients. METHODS We assessed angina-related symptoms, function, and quality of life with the Seattle Angina Questionnaire (SAQ) at randomization, at months 1.5, 3, and 6, and every 6 months thereafter in participants who had been randomly assigned to an invasive treatment strategy (2295 participants) or a conservative strategy (2322). Mixed-effects cumulative probability models within a Bayesian framework were used to estimate differences between the treatment groups. The primary outcome of this health-status analysis was the SAQ summary score (scores range from 0 to 100, with higher scores indicating better health status). All analyses were performed in the overall population and according to baseline angina frequency. RESULTS At baseline, 35% of patients reported having no angina in the previous month. SAQ summary scores increased in both treatment groups, with increases at 3, 12, and 36 months that were 4.1 points (95% credible interval, 3.2 to 5.0), 4.2 points (95% credible interval, 3.3 to 5.1), and 2.9 points (95% credible interval, 2.2 to 3.7) higher with the invasive strategy than with the conservative strategy. Differences were larger among participants who had more frequent angina at baseline (8.5 vs. 0.1 points at 3 months and 5.3 vs. 1.2 points at 36 months among participants with daily or weekly angina as compared with no angina). CONCLUSIONS In the overall trial population with moderate or severe ischemia, which included 35% of participants without angina at baseline, patients randomly assigned to the invasive strategy had greater improvement in angina-related health status than those assigned to the conservative strategy. The modest mean differences favoring the invasive strategy in the overall group reflected minimal differences among asymptomatic patients and larger differences among patients who had had angina at baseline

Initial invasive or conservative strategy for stable coronary disease

BACKGROUND Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain. METHODS We randomly assigned 5179 patients with moderate or severe ischemia to an initial invasive strategy (angiography and revascularization when feasible) and medical therapy or to an initial conservative strategy of medical therapy alone and angiography if medical therapy failed. The primary outcome was a composite of death from cardiovascular causes, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. A key secondary outcome was death from cardiovascular causes or myocardial infarction. RESULTS Over a median of 3.2 years, 318 primary outcome events occurred in the invasive-strategy group and 352 occurred in the conservative-strategy group. At 6 months, the cumulative event rate was 5.3% in the invasive-strategy group and 3.4% in the conservative-strategy group (difference, 1.9 percentage points; 95% confidence interval [CI], 0.8 to 3.0); at 5 years, the cumulative event rate was 16.4% and 18.2%, respectively (difference, 121.8 percentage points; 95% CI, 124.7 to 1.0). Results were similar with respect to the key secondary outcome. The incidence of the primary outcome was sensitive to the definition of myocardial infarction; a secondary analysis yielded more procedural myocardial infarctions of uncertain clinical importance. There were 145 deaths in the invasive-strategy group and 144 deaths in the conservative-strategy group (hazard ratio, 1.05; 95% CI, 0.83 to 1.32). CONCLUSIONS Among patients with stable coronary disease and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of ischemic cardiovascular events or death from any cause over a median of 3.2 years. The trial findings were sensitive to the definition of myocardial infarction that was used

Guidelines for the use and interpretation of assays for monitoring autophagy (4th edition)

In 2008, we published the first set of guidelines for standardizing research in autophagy. Since then, this topic has received increasing attention, and many scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Thus, it is important to formulate on a regular basis updated guidelines for monitoring autophagy in different organisms. Despite numerous reviews, there continues to be confusion regarding acceptable methods to evaluate autophagy, especially in multicellular eukaryotes. Here, we present a set of guidelines for investigators to select and interpret methods to examine autophagy and related processes, and for reviewers to provide realistic and reasonable critiques of reports that are focused on these processes. These guidelines are not meant to be a dogmatic set of rules, because the appropriateness of any assay largely depends on the question being asked and the system being used. Moreover, no individual assay is perfect for every situation, calling for the use of multiple techniques to properly monitor autophagy in each experimental setting. Finally, several core components of the autophagy machinery have been implicated in distinct autophagic processes (canonical and noncanonical autophagy), implying that genetic approaches to block autophagy should rely on targeting two or more autophagy-related genes that ideally participate in distinct steps of the pathway. Along similar lines, because multiple proteins involved in autophagy also regulate other cellular pathways including apoptosis, not all of them can be used as a specific marker for bona fide autophagic responses. Here, we critically discuss current methods of assessing autophagy and the information they can, or cannot, provide. Our ultimate goal is to encourage intellectual and technical innovation in the field