Study of wound healing in rat skin treated with extract of Hedera helix, L / Estudo da cura de feridas na pele de rato tratada com extrato de Hedera helix, L

The Hera (Hedera helix L) is part of the ARALIACEAE family, is included in the group of plants that produce saponins, has antifungal action, is hypocholesterolemic, has anti-inflammatory activity, is expectorant, antispasmodic and purifying. It was evaluated, by histological studies, the wound healing action of the extract of Hera leaves on skin wounds, as well as changes in the epithelial tissue and wound healing period. 75 Wistar rats were used and divided into five groups, according to the treatment: negative control (PBS), Hera 10 mg/ml, Hera 30 mg/ml, Hera 50 mg/ml and the positive control (Nebacetin). The animals were anesthetized and undergone through a cut of 4 cm in the dorsal region, exposing their muscle fascias. Right after, daily, the suitable substance to each group was applied in the lesion. After periods of 3, 7, 14, 21 days after the surgery, the animals were killed to collect fragments of the lesion. The material was prepared in stained slides with H&E and toluidine blue for histologic analysis. The results showed that at day 14 of treatment, the animals under effect of 30 mg/ml and 50 mg/ml of Hera extract did not present edema. It was also observed a reduction in vascular congestion in the Hera of 30 mg/ml, Hera 50 mg/ml and Nebacetin groups compared to the other groups analyzed. All groups treated with Hera extract showed a reduction of inflammatory cells in day 14 post-lesion, besides the increase of fibroblast this period, showing acceleration in the chronicity of the lesion. Regarding the number of mast cells, a significant increase in the early lesion, in the 3 and 7 days periods was observed, in Hera 50 mg/ml and 30 mg/ml groups, respectively. According to the results, the Hera extract, especially at concentrations of 30 mg/ml and 50 mg/ml accelerated the healing process; based on the decreased permanence period of the edema and congestion of the vessels, as well as changes in the number of cells related to inflammation of lesions

The new paradigms in the time of care to patients with head and neck cancer during the Covid-19 pandemic: a literature review

Introdução: O novo coronavirus SARS-CoV2 é uma ameaça de saúde mundial que tem como um de seus principais grupo de risco os pacientes com câncer de cabeça e pescoço. Na atual conjuntura e em caso de uma segunda onda de infecção, há necessidade de um novo protocolo de quando tratar esses pacientes. Objetivo: Relatar os protocolos de manejo e atendimento dos pacientes com câncer de cabeça e pescoço, facilitando a decisão do clínico no cenário de pandemia. Materiais e Métodos: Uma busca bibliográfica foi realizada no PubMed. Uma estratégia de busca com descritores foi aplicada, onde os artigos alcançados tiveram seus títulos e resumos lidos em busca da adequação ao objetivo proposto. Foram selecionados artigos científicos publicados entre 1 de dezembro de 2019 e 10 de julho de 2020, sem restrição de país ou idioma. Revisão da literatura: Novos protocolos foram criados baseados no tipo e estágio de câncer, classificando-os para saber o momento ideal de intervir com segurança. O protocolo se dá em níveis de inicial ao avançado onde o inicial compreende as neoplasias benignas, ou seja, cânceres de pele menores de 2 mm e casos em estágios iniciais assintomáticos, e o nível avançado compreende neoplasias malignas, agressivas, com sintomatologia dolorosa e/ou que estejam comprometendo os outros sistemas e órgãos. Conclusão: Há necessidade de seguir o protocolo de atendimento detalhado que norteie o andamento dos serviços oncológicos de cabeça e pescoço, atendendo os pacientes imediatamente ou adiando o tratamento dependendo do caso e severidade.Introduction: SARS-CoV2 is a worldwide health threat, which has as its main risk group patients with head and neck cancer. In the time being and in the chance of an emerging second wave of infection, a new protocol based on when to treat patients with head and neck cancer must be implemented. Aim: Reporting the handling protocols for patients with head and neck cancer, facilitating the clinician's decision in the pandemic scenario. Materials and Methods: A bibliographic search was performed in PubMed. A search strategy with descriptors was applied to the database, aiming at reaching scientific articles. The articles reached in such database had their titles and abstracts read in search for the adequacy to the objective proposed. Only scientific articles published between December 1st 2019, and July 10th 2020, were chosen. There was no restriction either on country or language. Literature review: New protocols were created based on the type and stage of cancer, classifying them in order to identify the ideal time to operate safely. Thus, the protocol has levels from initial to advanced, where the initial level comprises benign neoplasms, skin cancers smaller than 2 mm and cases in asymptomatic early stages, and the advanced level comprises malignant, aggressive neoplasms, with painful symptoms and/or that are compromising the other systems and organs. Conclusion: It is necessary to follow the detailed care protocol to guide the progress of head and neck cancer services, by operating patients immediately or postponing surgery, depending on the case and seriousness

Avaliação quantitativa de expansão rápida maxilar em portador de fissura transforame incisivo unilateral: Caso clínico / Quantitative evaluation of rapid maxillary expansion in a patient with unilateral transforamen incisor cleft: Clinical case

A realização da expansão maxilar é de extrema importância durante o tratamento de um paciente portador de fissura. A fissura transforame incisivo unilateral é a variante mais comum entre as fissuras orais, prejudicando o desenvolvimento maxilar, comprometendo a função e a estética facial. O objetivo deste trabalho é avaliar os efeitos da expansão rápida de maxila utilizando o aparelho expansor de Haas e quantificar as alterações das medidas. O caso foi realizado no paciente K.B.O.P, com idade de 11 anos, na Sociedade Especializada em Atendimento ao Paciente Fissurado do Estado de Sergipe (SEAFESE), durante o período de um ano. Entre os resultados, observamos que após a expansão rápida da maxila, houve alteração imediata e significativa no sentido transversal, vertical e anteroposterior da maxila, tanto em área anterior, quanto posterior. Desta forma conclui-se, a eficácia do método de expansão rápida e do expansor de Haas em casos de fissura

Comparação entre métodos cirúrgicos e conservadores para o tratamento de granuloma central de células gigantes descritos na literatura

Aim: To present, through a literature review, more conservative methods of treatment for Granuloma, establishing comparisons between them, in order to provide the scientific community with more clarity and more effective and safer options for the patient. Literature review: The Central Giant Cell Granuloma (GCCG) is a benign proliferative intraosseous lesion of uncertain etiology and variable clinical behavior that has surgical methods as the most used form of treatment, however, it was observed that surgical methods have a high recurrence rate and a great aesthetic and functional compromise. On the other hand, more conservative methods show complete regression of the lesion and a low recurrence rate, but with the disadvantage of presenting a long period of treatment and some adverse effects. Discussion: There is no protocol for managing GCCG, its clinical management should consider the possibility of combining two or more therapies aiming at better results. Conclusion: Conservative methods are promising for reducing treatment time and preserving aesthetics and function, in addition to having the possibility of being used together according to the patient's need, although no individual treatment is ideal.Objetivo: Apresentar, através de uma revisão de literatura, métodos de tratamento do Granuloma mais conservadores, estabelecendo comparações entre estes, afim de fornecer à comunidade científica mais clareza e opções mais eficazes e seguras para o paciente. Revisão da literatura: O Granuloma Central de Células Gigantes (GCCG) é uma lesão proliferativa benigna intraóssea de etiologia incerta e comportamento clínico variável que possui como forma de tratamento mais utilizado os métodos cirúrgicos, entretanto, observou-se que os métodos cirúrgicos apresentam alta taxa de recidiva e um grande comprometimento estético e funcional. Em contrapartida, métodos mais conservadores mostram regressão completa da lesão e baixa taxa de recidiva, porém com a desvantagem de apresentar um longo período de tratamento e alguns efeitos adversos. Discussão: Ainda não existe um protocolo de gerenciamento de GCCG, seu manejo clínico deve levar em consideração a possibilidade de combinação de duas ou mais terapias objetivando melhores resultados. Conclusão: Os métodos conservadores são promissores por diminuir o tempo de tratamento e preservar a estética e função, além de ter a possibilidade de serem empregados juntos conforme a necessidade do paciente, apesar de nenhuma forma de tratamento individual ser a ideal

HESITAÇÃO À VACINA NO PERÍODO DE ISOLAMENTO NA PANDEMIA COVID-19

From the moment that COVID-19 was considered a pandemic disease, it began a constant search for a vaccine and/or medicine that would bring relief or quick recovery to individuals affected by the virus. Although there are several scientific evidences that justify the general benefits of immunization, vaccine hesitation remains in constant growth among the Brazilian population, due to beliefs and imprecise and misleading content that rapidly proliferates online, favoring the resurgence of pathologies that can be avoided through vaccination. The acceptance of the Covid-19 vaccine by the Brazilian population will also be a guide for future vaccination studies in Brazil. The aim of this study is to describe the profile of the Brazilian population regarding vaccine hesitation and its supposed future risks. From the data that were collected, future research and intervention actions can be traced. The sample consisted of 158 participants from various regions of the country, aged 18 years or over. Data were obtained through forms in electronic format, made possible by the free tool offered by Google: Google Forms. Through the data obtained, it was possible to show that although several attitudinal, political, and religious beliefs associated with vaccination generate vaccine hesitation in the population, most participants in this study did not show significant hesitation about the vaccine. The results indicated a favorable sample for vaccination, it is believed that these results are related to the characteristics of the sample, which is formed by individuals with a high level of education.Desde el momento en que el COVID-19 fue considerado una enfermedad pandémica, comenzó una búsqueda constante de una vacuna y/o medicamento que brindara alivio o recuperación rápida a las personas afectadas por el virus. A pesar de que existen varias evidencias científicas que justifican los beneficios generales de la inmunización, la vacilación de la vacunación sigue creciendo constantemente entre la población brasileña, debido a las creencias y el contenido inexacto y engañoso que prolifera rápidamente en línea, favoreciendo el resurgimiento de patologías que pueden ser evitadas a través de la vacunación.  La aceptación de la vacuna contra el Covid-19 por parte de la población brasileña también será una guía para los próximos estudios de vacunación en Brasil. El objetivo de este estudio es describir el perfil de la población brasileña en relación a la vacilación de la vacuna y sus supuestos riesgos futuros. A partir de los datos recogidos, se pueden elaborar futuras acciones de investigación e intervención. La muestra estuvo constituida por 158 participantes de diversas regiones del país, con 18 años o más. Los datos se obtuvieron a través de formularios en formato electrónico, posibilitados por la herramienta gratuita que ofrece Google: Google Forms. A través de los datos obtenidos, fue posible evidenciar que a pesar de que varias creencias acitidas, políticas y religiosas asociadas a la vacunación generan dudas vacunales en la población, la mayoría de los participantes en este estudio no presentaron dudas significativas a la vacuna.A partir do momento que a COVID-19 foi considerada uma doença pandêmica, deu início a uma busca constante por uma vacina e/ou medicamento que trouxesse alívio ou recuperação rápida para os indivíduos acometidos pelo vírus. Apesar de existirem diversas evidências científicas, que justifiquem os benefícios gerais da imunização, a hesitação vacinal permanece em constante crescimento entre a população brasileira, devido as crenças e ao conteúdo impreciso e enganoso que se prolifera rapidamente de forma online, favorecendo o ressurgimento de patologias que podem ser evitadas através da vacinação.  A aceitação da vacina Covid-19 pela população brasileira também será um guia para os próximos estudos de vacinação no Brasil. O objetivo deste estudo é descrever o perfil da população brasileira em relação a hesitação a vacina e seus supostos riscos futuros. A partir dos dados que foram coletados podem-se traçar em futuras pesquisas e ações de intervenção. A amostra foi composta por 158 participantes de várias regiões do país, com idade igual ou superior a 18 anos. Os dados foram obtidos através de formulários em formato eletrônico, possibilitados pela ferramenta gratuita oferecida pelo Google: o Google Forms. Através dos dados obtidos, foi possível evidenciar que apesar de diversos fatores atitudinais, políticos, crenças religiosas associadas a vacinação gerarem hesitação vacinal na população, a maioria dos participantes deste estudo não apresentaram hesitação significativa a vacina. Os resultados indicaram uma amostra favorável à vacinação, acredita-se que esses resultados tenham relação com as características da amostra, que é formada por indivíduos de alto nível de escolaridade

Dose-Response Met-RANTES Treatment of Experimental Periodontitis: A Narrow Edge between the Disease Severity Attenuation and Infection Control

Chemokines and chemokine receptors have been implicated in the selective migration of leukocyte subsets to periodontal tissues, which consequently influences the disease outcome. Among these chemoattractants, the chemokines CCL3, CCL4 and CCL5 and its receptors, CCR1 and CCR5, have been associated with increased disease severity in mice and humans. Therefore, in this study we investigated the modulation of experimental periodontitis outcome by the treatment with a specific antagonist of CCR1 and 5 receptors, called met-RANTES. C57Bl/6 mice was orally infected with Aggregatibacter actinomycetemcomitans and treated with 0.05, 0.1, 0.5, 1.5 and 5 mg doses of met-RANTES on alternate days, and evaluated by morphometric, cellular, enzymatic and molecular methods. At 0.5 mg up to 5 mg doses, a strong reduction in the alveolar bone loss and inflammatory cell migration were observed. Interestingly, 5 mg dose treatment resulted in the maximum inhibition of inflammatory cell migration, but resulted in a similar inhibition of bone loss when compared with the lower doses, and also resulted in increased bacterial load and CRP response. When 0.5 and 5 mg therapy regimens were compared it was observed that both therapeutic protocols were able to downregulate the levels of pro-inflammatory, Th1-type and osteoclastogenic cytokines, and CD3+ and F4/80+ cells migration to periodontal tissues, but the high dose modulates host response in a more pronounced and unspecific and excessive way, interfering also with the production of antimicrobial mediators such as MPO, iNOS and IgG, and with GR1+ and CD19+ cells migration. Our results demonstrate a thin line between beneficial immunoregulation and impaired host defense during experimental periodontitis, and the determination of the exact equilibrium point is mandatory for the improvement of immune-targeted therapy of periodontitis

The influence of teriparatide in induced tooth movement: a systematic review

Teriparatide is a synthetic drug similar than PTH (parathyroid hormone), which is currently used as long-term treatment option for patients with bone chronic diseases, as osteoporosis; and this drug can interfere in a positive way in orthodontic movement. Objectives: The medical literature was assessed in the present systematic review in order to determine the level of scientific evidence supporting the influence of teriparatide in induced tooth movement. The PRISMA Checklist was followed in this systematic review. Four electronic databases (PubMed; Scopus; ScienceDirect; OpenGrey) were searched without implementing restrictions of year, status, and language of publications. The inclusion criteria consisted of selecting only experimental studies comparing the influence of teriparatide in tooth movement of male Wistar rats. The exclusion criteria consisted of experiments with female rats or other experimental animals, and animals with pathologic conditions. The eligible studies were evaluated based on methodological quality. Two trained examiners performed all the research steps. The initial sample comprised 700 studies, which was reduced to 664 after the exclusion of duplicates (n=36). Three articles were selected for the final qualitative analysis. The local administration of parathyroid hormone (PTH) 1-34 or PTH 1-84 revealed major effectiveness when compared with control groups and systematic administration. Additionally, the dilution of PTH 1-34 within methyl cellulose (MC) gel increased the time range for drug release, enabling to reduce the drug concentration without decreasing the effectiveness of tooth movement. Teriparatide demonstrated potential acceleration of tooth movement in Wistar rats depending on the drug concentration; drug administration; and time for drug release

Microtomographic, histomorphometric, and molecular features show a normal alveolar bone healing process in iNOS-deficient mice along a compensatory upregulation of eNOS and nNOS isoforms

Inducible nitric oxide synthase (iNOS) is one of the enzymes responsible for the synthesis of nitric oxide (NO), which is an important signaling molecule with effects on blood vessels, leukocytes, and bone cells. However, the role of iNOS in alveolar bone healing remains unclear. This study investigated the role of iNOS in alveolar bone healing after tooth extraction in mice. Methodology: C57Bl/6 wild type (WT) and iNOS genetically deficient (iNOS-KO) mice were subjected to upper incision tooth extraction, and alveolar bone healing was evaluated by micro-computed tomography (μCT) and histological/histomorphometric, birefringence, and molecular methods. Results: The expression of iNOS had very low control conditions, whereas a significant increase is observed in healing sites of WT mice, where iNOS mRNA levels peak at 7d time point, followed by a relative decrease at 14d and 21d. Regarding bone healing, both WT and iNOS-KO groups showed the usual phases characterized by the presence of clots, granulation tissue development along the inflammatory cell infiltration, angiogenesis, proliferation of fibroblasts and extracellular matrix synthesis, bone neoformation, and remodeling. The overall micro-computed tomography and histomorphometric and birefringence analyses showed similar bone healing readouts when WT and iNOS-KO strains are compared. Likewise, Real-Time PCR array analysis shows an overall similar gene expression pattern (including bone formation, bone resorption, and inflammatory and immunological markers) in healing sites of WT and iNOS-KO mice. Moreover, molecular analysis shows that nNOS and eNOS were significantly upregulated in the iNOS-KO group, suggesting that other NOS isoforms could compensate the absence of iNOS. Conclusion: The absence of iNOS does not result in a significant modulation of bone healing readouts in iNOS-KO mice. The upregulation of nNOS and eNOS may compensate iNOS absence, explaining the similar bone healing outcome in WT and iNOS-KO strains

Avanço ortopédico da maxila com MAMP em paciente com dentadura permanente jovem padrão III – Relato de caso

A má-oclusão de Classe III é uma anomalia dento-facial, descrita inicialmente por Angle e caracterizada pela relação incorreta dos molares superiores e inferiores. Apesar da baixa incidência da má-oclusão de Classe III, sua correção é complexa, sobretudo em fases tardias do surto de crescimento ósseo. Nesses casos as opções são a compensação dentária ou a cirurgia ortognática. Nesse sentido, a ancoragem esquelética tem sido cada vez mais utilizada na Ortodontia e Ortopedia Facial devido à possibilidade de movimentações mais complexas, com maior e melhor controle da mecânica, bem como mínimos efeitos dentários indesejados. Dessa forma, este trabalho tem como objetivo relatar a correção da Classe III em paciente com dentadura permanente jovem com uso de expansor e mini-implantes extra alveolares pela Terapia MAMP. Paciente do gênero feminino, 13 anos e 11 meses, leucoderma, insatisfação estética e funcional decorrente da má-oclusão presente