Comparative analgesia between acupuncture and dipyrone in odontalgia

The aim of this study was to assess whether the effectiveness of acupuncture is similar to the use of analgesics in the management of toothache. The research included 56 volunteers who were divided into 4 groups: Real Acupuncture group, Placebo Acupuncture group, Real Dipyrone group, and Placebo Dipyrone group. The interventions of the study were performed before the dental care. Inclusion criteria were toothache of pulpal origin with pain scale (Visual Analogue Scale) above 4, absence of medication for the pain, and aged over 18 years. The Real Acupuncture volunteers received a session of acupuncture using piercing needles, while volunteers from the Placebo Acupuncture group received an acupuncture session using non-piercing sham needles. Volunteers from the Real Dipyrone group received a dipyrone tablet and the Placebo Acupuncture group received a tablet with no active ingredient. Before any therapeutic intervention, we collected samples from the volunteers’ saliva to analyze the salivary cortisol, the volunteers rated the intensity of their pain using VAS, and we measured their energy level by the Ryodoraku method. After 20 minutes of treatment, all the volunteers’ analysis parameters were collected again. The Real Acupuncture group presented a greater reduction of VAS than the reduction obtained by the Real Dipyrone group (p<0.05). There was no statistically significant difference between the groups for the salivary cortisol and energy level variables. It can be concluded that acupuncture was more effective in reducing odontalgia than the dipyrone and that it can be an alternative for odontalgia management126182191CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQ133752/2017-8The authors thank Espaço da Escrita—Pró-Reitoria de Pesquisa—UNICAMP, for the language services provided and the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq – n° 133752/2017-8) and Fundo de Apoio ao Ensino, à Pesquisa e Extensão (FAEPEX – n° 1032/2017) for the financial suppor

Oral health among preschool children in Brazil, 1999

OBJECTIVE: To assess dental decay, gum diseases and fluorosis prevalence and evaluate treatment needs of public preschool children. METHODS: A cross-sectional epidemiological survey on oral health was conducted in 2,805 public preschool children aged 5 and 6 years in Piracicaba, Brazil. Children were examined by a team of ten trained dentists. It was applied a consensus technique and intra and inter agreement among examiners was assessed using the percentage of agreement. RESULTS: Of the total, 44.3% children were free of dental decay at the age of 5 and 38.5% at the age of 6. The deciduous decay teeth index (dmf-t) was 2.64 at the age of 5 and 3.07 at the age of 6, and 31.9% and 37.9%, respectively, presented dmf-t greater than 3. The largest percent of treatment need (45.3%) was surface restoration. Regarding gum health, 68.6% and 72.6% of children aged 5 and 6 years presented gum bleeding. The prevalence of fluorosis was 2.6% at the age of 5 and 6.1% at the age of 6. CONCLUSIONS: It is necessary to develop appropriate actions and strategies for higher risk groups.OBJETIVO: Verificar a prevalência de cárie, doença gengival e fluorose e dimensionar as necessidades de tratamento dos pré-escolares. MÉTODOS: Estudo transversal realizado a partir de um levantamento epidemiológico de saúde bucal em 2.805 crianças de 5 e 6 anos, matriculadas em pré-escolas municipais de Piracicaba, SP. As crianças foram examinadas por uma equipe de dez dentistas, treinados e calibrados. Foi empregada a técnica de consenso, aferindo-se o erro intra e inter examinadores pelo cálculo de percentagem de concordância. RESULTADOS: Obteve-se 44,3% de crianças livres de cárie aos 5 anos e 38,5% aos 6 anos de idade. O índice de cárie para a dentição decídua (ceo-d) foi 2,64 aos cinco anos e 3,07 aos seis anos, sendo que 31,9% e 37,9%, respectivamente, apresentaram ceo-d maior que 3. O maior percentual de necessidade de tratamento (45,3%) foi a indicação de restauração de uma superfície dentária. Quanto à saúde gengival, 68,6% e 72,6% das crianças aos 5 e 6 anos apresentaram sangramento gengival. A prevalência de fluorose observada foi de 2,6% aos 5 e 6,1% aos 6 anos. CONCLUSÕES: Há necessidade da implementação de ações e estratégias adequadas aos grupos de maior risco.24725

Saúde bucal dos pré-escolares, Piracicaba, Brasil, 1999

OBJECTIVE: To assess dental decay, gum diseases and fluorosis prevalence and evaluate treatment needs of public preschool children. METHODS: A cross-sectional epidemiological survey on oral health was conducted in 2,805 public preschool children aged 5 and 6 years in Piracicaba, Brazil. Children were examined by a team of ten trained dentists. It was applied a consensus technique and intra and inter agreement among examiners was assessed using the percentage of agreement. RESULTS: Of the total, 44.3% children were free of dental decay at the age of 5 and 38.5% at the age of 6. The deciduous decay teeth index (dmf-t) was 2.64 at the age of 5 and 3.07 at the age of 6, and 31.9% and 37.9%, respectively, presented dmf-t greater than 3. The largest percent of treatment need (45.3%) was surface restoration. Regarding gum health, 68.6% and 72.6% of children aged 5 and 6 years presented gum bleeding. The prevalence of fluorosis was 2.6% at the age of 5 and 6.1% at the age of 6. CONCLUSIONS: It is necessary to develop appropriate actions and strategies for higher risk groups.OBJETIVO: Verificar a prevalência de cárie, doença gengival e fluorose e dimensionar as necessidades de tratamento dos pré-escolares. MÉTODOS: Estudo transversal realizado a partir de um levantamento epidemiológico de saúde bucal em 2.805 crianças de 5 e 6 anos, matriculadas em pré-escolas municipais de Piracicaba, SP. As crianças foram examinadas por uma equipe de dez dentistas, treinados e calibrados. Foi empregada a técnica de consenso, aferindo-se o erro intra e inter examinadores pelo cálculo de percentagem de concordância. RESULTADOS: Obteve-se 44,3% de crianças livres de cárie aos 5 anos e 38,5% aos 6 anos de idade. O índice de cárie para a dentição decídua (ceo-d) foi 2,64 aos cinco anos e 3,07 aos seis anos, sendo que 31,9% e 37,9%, respectivamente, apresentaram ceo-d maior que 3. O maior percentual de necessidade de tratamento (45,3%) foi a indicação de restauração de uma superfície dentária. Quanto à saúde gengival, 68,6% e 72,6% das crianças aos 5 e 6 anos apresentaram sangramento gengival. A prevalência de fluorose observada foi de 2,6% aos 5 e 6,1% aos 6 anos. CONCLUSÕES: Há necessidade da implementação de ações e estratégias adequadas aos grupos de maior risco

[oral Health Among Preschool Children In Brazil, 1999].

To assess dental decay, gum diseases and fluorosis prevalence and evaluate treatment needs of public preschool children. A cross-sectional epidemiological survey on oral health was conducted in 2,805 public preschool children aged 5 and 6 years in Piracicaba, Brazil. Children were examined by a team of ten trained dentists. It was applied a consensus technique and intra and inter agreement among examiners was assessed using the percentage of agreement. Of the total, 44.3% children were free of dental decay at the age of 5 and 38.5% at the age of 6. The deciduous decay teeth index (dmf-t) was 2.64 at the age of 5 and 3.07 at the age of 6, and 31.9% and 37.9%, respectively, presented dmf-t greater than 3. The largest percent of treatment need (45.3%) was surface restoration. Regarding gum health, 68.6% and 72.6% of children aged 5 and 6 years presented gum bleeding. The prevalence of fluorosis was 2.6% at the age of 5 and 6.1% at the age of 6. It is necessary to develop appropriate actions and strategies for higher risk groups.37247-5

[dental Caries Experience In Children At Public And Private Schools From A City With Fluoridated Water].

The aim of this study was to verify the relationship between type of school as a measure of socioeconomic conditions and caries prevalence among preschoolers and schoolchildren in Rio Claro, São Paulo State, Brazil, a city with fluoridated water supply. The data were secondary, from a sample of 888 children 5 to 12 years old enrolled in private and public schools. Caries was measured by the dmft and DMFT indices as well as the Care index. Qui-square and Mann-Whitney tests were utilized with 5% significance. In 5-year-old children, mean dmft was 2.50, and 42.20% were caries-free. At age 12, mean DMFT was 2.70 and 28.90% were caries-free. Caries prevalence rates in public schoolchildren as compared to private were 74.50% and 61.20%, respectively (p < 0.0001), and the dmft and DMFT scores were the highest in public schoolchildren (p < 0.05). The Care Index was higher in private schoolchildren (71.20%) as compared to public (52.80%). Highest caries rates were found among public schoolchildren, so the variable type of school proved sensitive for discriminating different oral health conditions; however limitations need to be recognized, suggesting that other variables should be assessed.20522-

Concentração de chumbo, defeitos de esmalte e cárie em dentes decíduos

OBJECTIVE: To verify the relationship between lead concentration in the enamel of deciduous teeth and the presence of enamel defects and, consequently, with dental caries among preschool children. METHODS: The sample consisted of 329 preschool children in Piracicaba, State of São Paulo: 132 attending municipal kindergartens close to industrial plants and 197 attending kindergartens in non-industrial areas. This sample belonged to an initial study made between 2000 and 2001, in which the lead concentration was obtained by means of enamel biopsy. Oral clinical examination of the children from both regions was performed to verify the prevalence of enamel defects, using the Developmental Defects of Enamel (DDE) Index of the World Dental Federation (FDI), and of dental caries, using the decayed, missing and filled surfaces (dmfs) index of the World Health Organization. The chi-squared test and relative risk calculation were utilized in relation to a significance level of 5%, considering each region separately. RESULTS: Among the children from the non-industrial area, there was a higher proportion with dental caries among those with higher lead concentrations in deciduous teeth (p=0.02). This was not, however, observed among the children from the industrial area (p=0.89). There was an increased relative risk (RR) of caries among the children from the non-industrial area, but this was not seen among the children from the industrial area. No relationship was observed between the presence of lead and enamel defects. CONCLUSIONS: No data was found that would give evidence of a relationship between lead concentration and enamel defects in either of the areas studied. No relationship was found between lead and dental caries in the industrial area, thus emphasizing that more studies of such relationships are needed.OBJETIVO: Verificar a relação da concentração de chumbo no esmalte de dentes decíduos com a presença de defeitos de esmalte e sua relação com cárie dental em pré-escolares. MÉTODOS: A amostra foi de 329 crianças de pré-escolas municipais de uma área próxima de indústrias (N=132) e outra não industrial (N=197) da cidade de Piracicaba, Estado de São Paulo. Essa amostra pertencente a um estudo inicial realizado entre 2000 e 2001 no qual o chumbo foi analisado por meio de biópsia de esmalte. Foram realizados exames clínicos bucais para verificação da prevalência de defeitos de esmalte (Developmental Defects of Enamel Index - DDE, da Federação Dentária Internacional - FDI) e cárie (Índice ceos, Organização Mundial da Saúde), em ambas regiões. Foram utilizados teste de qui-quadrado e cálculo do risco relativo ao nível de significância de 5%, considerando cada região separadamente. RESULTADOS: Houve maior proporção de crianças com cárie entre aquelas com maiores concentrações de chumbo nos decíduos na região não industrial (p=0,02), o que não se observou na região industrial (p=0,89). Houve risco relativo (RR) aumentado de cárie nas crianças da região não industrial o que não foi verificado nas crianças da região industrial. Não se observou relação entre a presença de chumbo e os defeitos de esmalte. CONCLUSÕES: Não foram encontados dados que evidenciassem a relação entre concentração de chumbo e defeitos no esmalte em nenhuma das regiões pesquisadas. Não foi encontrada relação entre chumbo e cárie na região industrial, ressaltando a necessidade de mais estudos dessas relações

Canagliflozin and Cardiovascular and Renal Outcomes in Type 2 Diabetes Mellitus and Chronic Kidney Disease in Primary and Secondary Cardiovascular Prevention Groups

Background: Canagliflozin reduces the risk of kidney failure in patients with type 2 diabetes mellitus and chronic kidney disease, but effects on specific cardiovascular outcomes are uncertain, as are effects in people without previous cardiovascular disease (primary prevention). Methods: In CREDENCE (Canagliflozin and Renal Events in Diabetes With Established Nephropathy Clinical Evaluation), 4401 participants with type 2 diabetes mellitus and chronic kidney disease were randomly assigned to canagliflozin or placebo on a background of optimized standard of care. Results: Primary prevention participants (n=2181, 49.6%) were younger (61 versus 65 years), were more often female (37% versus 31%), and had shorter duration of diabetes mellitus (15 years versus 16 years) compared with secondary prevention participants (n=2220, 50.4%). Canagliflozin reduced the risk of major cardiovascular events overall (hazard ratio [HR], 0.80 [95% CI, 0.67-0.95]; P=0.01), with consistent reductions in both the primary (HR, 0.68 [95% CI, 0.49-0.94]) and secondary (HR, 0.85 [95% CI, 0.69-1.06]) prevention groups (P for interaction=0.25). Effects were also similar for the components of the composite including cardiovascular death (HR, 0.78 [95% CI, 0.61-1.00]), nonfatal myocardial infarction (HR, 0.81 [95% CI, 0.59-1.10]), and nonfatal stroke (HR, 0.80 [95% CI, 0.56-1.15]). The risk of the primary composite renal outcome and the composite of cardiovascular death or hospitalization for heart failure were also consistently reduced in both the primary and secondary prevention groups (P for interaction &gt;0.5 for each outcome). Conclusions: Canagliflozin significantly reduced major cardiovascular events and kidney failure in patients with type 2 diabetes mellitus and chronic kidney disease, including in participants who did not have previous cardiovascular disease

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to &lt;90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], &gt;300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of &lt;15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P&lt;0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P&lt;0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Experiência de cárie dentária em crianças de escolas públicas e privadas de um município com água fluoretada

O objetivo deste estudo foi verificar a relação entre tipo de escola, como medida de condição sócio-econômica e a prevalência de cárie em pré-escolares e escolares de Rio Claro, São Paulo, com água fluoretada. Os dados obtidos são secundários e a amostra foi de 888 escolares de 5 a 12 anos dos ensinos público e particular. A experiência de cárie foi medida por meio dos índices ceod e CPOD ¹, além do Índice de Cuidados. Empregou-se os testes qui-quadrado e Mann-Whitney com significância de 5%. Aos cinco anos, o ceod foi de 2,50 e 42,20% não apresentaram experiência de cárie. Aos 12 anos, o CPOD foi de 2,70 e 28,90% estavam livres de cárie. A prevalência de cárie nas crianças de escolas públicas foi maior do que nas particulares, sendo respectivamente de 74,50 e 61,20% (p < 0,0001), assim como os índices ceod e CPOD (p < 0,05). O Índice de Cuidados foi maior nas crianças do ensino particular (71,20%) do que nas do ensino público (52,80%). Encontrou-se uma maior experiência de cárie nos escolares do ensino público e assim a variável tipo de escola foi sensível para discriminar diferentes condições de saúde bucal, sugerindo-se que outras variáveis também sejam avaliadas