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au:PAIVA, ANTONIO CARDOSO

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THE USE OF CRANIAL HALO TRACTION VERSUS TEMPORARY INTERNAL DISTRACTION IN STAGED SURGERY FOR SEVERE SCOLIOSIS: A COMPARATIVE STUDY
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Oliveira, José Alberto Alves

; Paiva, Antônio Cardoso

; Afonso, Pedro Paschoal Cassapis Cardoso

; Almeida, Paulo Cesar

; Visconti, Rogério dos Reis

; Meireles, Ricardo de Souza Portes

Coluna/Columna

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dec 2021, Volume 20 N. 4 Pages 254 - 259

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

RESUMO Objetivo: Determinar qual método é mais eficaz, tração com halo craniano ou distração interna temporária em cirurgias escalonadas para pacientes com escoliose grave (≥ 100°) e rígida (< 25% de flexibilidade). Métodos: Amostra com 12 pacientes com tração e 7 sem tração, operados entre janeiro de 2013 e dezembro de 2017. Os dados demográficos dos pacientes, o tipo de cirurgia realizada, as complicações e os parâmetros de alinhamento coronal e sagital foram registrados antes da cirurgia e no acompanhamento final. Os dados foram processados no SPSS 20.0. Foram feiras comparações entre as médias (teste t de Student) e as características clínicas e relacionadas com o procedimento (teste de razão de verossimilhança e de teste exato de Fisher), com nível de confiança de 0,05. Resultados: Não houve diferenças significativas entre os grupos quanto a características clínicas, complicações e grau de correção. No entanto, mais pacientes do grupo submetido à distração interna temporária necessitaram de osteotomias de ressecção vertebral durante a cirurgia definitiva (p < 0,05). Conclusões: Não se pôde estabelecer com base nos resultados qual o método mais eficaz, porém se sugere que a tração escalonada pode ser mais eficaz e mais segura, principalmente para cirurgiões com menos experiência em cirurgia de pacientes com escoliose grave e rígida. Nível de evidência: IV; Série de Casos.

ABSTRACT Objective: To determine which method is more effective – cranial halo traction or temporary internal distraction – in staged surgeries for patients with severe (≥ 100°) and stiff (<25% flexibility) scoliosis. Methods: A sample of 12 patients with traction and 7 patients without traction, operated on between January 2013 and December 2017. The patients’ demographic data, the type of surgery performed, complications, and coronal and sagittal alignment parameters were recorded before surgery and in the final follow-up. The data were processed in SPSS 20.0. Comparisons were made between the means (Student's t-test) and the clinical and procedure-related characteristics (likelihood ratio and Fisher's Exact tests), at a confidence level of 0.05. Results: There were no significant intergroup differences for clinical characteristics, complications or degree of correction. However, more patients in the group submitted to temporary internal distraction required vertebral resection osteotomies during definitive surgery (p<0.05). Conclusions: Based on the results, it was not possible to establish which is the most effective method, but it is suggested that staged traction may be more effective, and safer, particularly when the surgeon is less experienced, during surgery on patients with severe and stiff scoliosis. Level of evidence IV; Vase series.

RESUMEN Objetivo: Determinar qué método es más efectivo, tracción con halo craneal o distracción interna temporal, en cirugía escalonadas para pacientes con escoliosis severa (≥ 100°) y rígida (<25% de flexibilidad). Métodos: Muestra con 12 pacientes en el grupo de tracción y 7 en el grupo sin tracción, intervenidas entre enero de 2013 y diciembre de 2017. Los datos demográficos de los pacientes, los tipos de cirugía, las complicaciones, los parámetros de alineación coronal y sagital se registraron antes de la cirugía y en el último acompañamiento. Los datos se procesaron en SPSS 20.0. Se realizaron comparaciones entre las medias (prueba t de Student) y las características clínicas y relacionadas con el procedimiento (razón de verosimilitud y prueba exacta de Fisher), con un nivel de confianza de 0,05. Resultados: No hubo diferencias significativas entre los grupos en cuanto a características clínicas, complicaciones y grado de corrección. Sin embargo, más pacientes del grupo sometido a distracción interna temporal requirieron osteotomías de resección vertebral durante la cirugía definitiva (p < 0,05). Conclusiones: Con base en los resultados, no fue posible establecer el método más efectivo, pero se sugiere que la tracción escalonada puede ser más eficaz y más segura, especialmente para cirujanos con menos experiencia en cirugía de pacientes con escoliosis severa y rígida. Nivel de evidencia: IV; Serie de Casos

https://doi.org/10.1590/s1808-185120212004250449

Efficacy evaluation of a protocol for safe hip surgery (total hip arthroplasty)
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Barros, Antônio Augusto Guimarães

; Mendes, Carlos Henrique Cardoso

; Temponi, Eduardo Frois

; Costa, Lincoln Paiva

; Vassalo, Carlos Cesar

; Guedes, Euler de Carvalho

Revista Brasileira de Ortopedia

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2017, Volume 52 Suppl. 1 Pages 29 - 33

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Objetivo Propor um protocolo multidisciplinar para padronização do cuidado dos pacientes que serão submetidos a artroplastia total do quadril (ATQ) e avaliar sua eficácia após a implantação. Métodos Avaliação retrospectiva dos resultados de 95 pacientes consecutivos submetidos a ATQ divididos em dois grupos, um com 47 operados antes da implantação do protocolo e 48 após. Resultados Na avaliação da taxa de reinternação, tem-se que entre os 47 pacientes avaliados antes da implantação do protocolo, sete (14,9%) foram reinternados e dos 48 avaliados depois da implantação, um (2,1%) foi reinternado, mostrou-se significância estatística (p < 0,05). A chance de reinternação antes da implantação foi oito vezes maior do que a chance de internação após a implantação (IC 95%: 1,01 a 377,7). Ao comparar as complicações clínicas entre os grupos observou-se que houve menor taxa de complicações após a implantação do protocolo (p = 0,006). Conclusão A introdução de um protocolo multidisciplinar para padronização do manejo do paciente submetido a ATQ diminuiu as taxas de reinternação e de complicações clínicas após o procedimento.

Abstract Objective To propose a multidisciplinary protocol to standardize the care of patients undergoing total hip arthroplasty (THA) and evaluate it effectiveness after implementation. Methods Retrospective evaluation of 95 consecutive patients undergoing THA divided into two groups, one group of 47 patients operated before the protocol implementation and 48 after. Results Assessing the re-admission rate, among 47 patients evaluated prior to implementation of the protocol, seven (14.9%) were re-admitted, and when observing the 48 patients evaluated after implementation, one (2.1%) was re-admitted, showing statistical significance (p < 0.05). The chance of re-admission before the protocol was eight times the chance of hospitalization after implementation (95% CI: 1.01 to 377.7). By comparing the clinical complications among the groups, it was observed that there was a lower rate of complications following implementation of the protocol (p = 0.006). Conclusion The introduction of a multidisciplinary protocol to standardize the management of patients undergoing THA decreased the rates of rehospitalization and clinical complications after the procedure.

https://doi.org/10.1016/j.rboe.2017.08.004 3201 downloads

Taxonomic indexes for differentiating malignancy of lung nodules on CT images
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Silva, Giovanni Lucca França da

; Carvalho Filho, Antonio Oseas de

; Silva, Aristófanes Corrêa

; Paiva, Anselmo Cardoso de

; Gattass, Marcelo

Research on Biomedical Engineering

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sep 2016, Volume 32 N. 3 Pages 263 - 272

Abstract: En | Text: En | PDF: En

Abstract Introduction Lung cancer remains the leading cause of cancer mortality worldwide, with one of the lowest survival rates after diagnosis. Therefore, early detection greatly increases the chances of improving patient survival. Methods This study proposes a method for diagnosis of lung nodules in benign and malignant tumors based on image processing and pattern recognition techniques. Taxonomic indexes and phylogenetic trees were used as texture descriptors, and a Support Vector Machine was used for classification. Results The proposed method shows promising results for accurate diagnosis of benign and malignant lung tumors, achieving an accuracy of 88.44%, sensitivity of 84.22%, specificity of 90.06% and area under the ROC curve of 0.8714. Conclusion The results demonstrate the promising performance of texture extraction techniques by means of taxonomic indexes combined with phylogenetic trees. The proposed method achieves results comparable to those previously published.

https://doi.org/10.1590/2446-4740.04615 1102 downloads

High incidence of tuberculosis in patients treated for hepatitis C chronic infection
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de Oliveira Uehara, Silvia Naomi

; Emori, Christini Takemi

; Perez, Renata Mello

; Mendes-Correa, Maria Cassia Jacintho

; de Souza Paiva Ferreira, Adalgisa

; de Castro Amaral Feldner, Ana Cristina

; Silva, Antonio Eduardo Benedito

; Filho, Roberto José Carvalho

; de Souza e Silva, Ivonete Sandra

; Ferraz, Maria Lucia Cardoso Gomes

Brazilian Journal of Infectious Diseases

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apr 2016, Volume 20 N. 2 Pages 205 - 209

Abstract: En | Text: En | PDF: En

Abstract Brazil is one of the 22 countries that concentrates 80% of global tuberculosis cases concomitantly to a large number of hepatitis C carriers and some epidemiological risk scenarios are coincident for both diseases. We analyzed tuberculosis cases that occurred during α-interferon-based therapy for hepatitis C in reference centers in Brazil between 2001 and 2012 and reviewed their medical records. Eighteen tuberculosis cases were observed in patients submitted to hepatitis C α-interferon-based therapy. All patients were human immunodeficiency virus-negative. Nine patients (50%) had extra-pulmonary tuberculosis; 15 (83%) showed significant liver fibrosis. Hepatitis C treatment was discontinued in 12 patients (67%) due to tuberculosis reactivation and six (33%) had sustained virological response. The majority of patients had a favorable outcome but one died. Considering the evidences of α-IFN interference over the containment of Mycobacterium tuberculosis, the immune impairment of cirrhotic patients, the increase of tuberculosis case reports during hepatitis C treatment with atypical and severe presentations and the negative impact on sustained virological response, we think these are strong arguments for latent tuberculosis infection screening before starting α-interferon-based therapy for any indication and even to consider IFN-free regimens against hepatitis C when a patient tests positive for latent tuberculosis infection.

https://doi.org/10.1016/j.bjid.2015.12.003 2081 downloads

I Diretriz brasileira de cardio-oncologia pediátrica da Sociedade Brasileira de Cardiologia
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Seber, Adriana

; Miachon, Adriana Siviero

; Tanaka, Ana Cristina Sayuri

; Castro, Ângela Maria Spínola e

; Carvalho, Antônio Carlos

; Petrilli, Antônio Sergio

; Macedo, Carla Renata Donato Pacheco

; Nars, Clarissa Carvalho Fongaro

; Terzian, Claudia Naufel

; Castro Junior, Claudio Galvão de

; Santos, Cleusa Cavalcanti Lapa

; Guerra, Cristina Chaves dos Santos

; Silva, Dafne Cardoso Bourguignon da

; Bassi, Débora Ugayama

; Azeka, Estela

; Feitosa, Fabiana Aragão

; Hamamoto, Fernando

; Szarf, Gilberto

; Lederman, Henrique Manoel

; Rigon Junior, Humberto João

; Jatene, Ieda Biscegli

; Mota, Isabele Coelho Fonseca da

; Perrud, Jeferson Adriano

; Soares Junior, José

; Gutierrez, Julián Arango

; Perin, Juliana Pepe Marinho

; Soares, Juliana dos Santos

; Catani, Liane Hulle

; Tsai, Liliana Yu

; Vianna, Livia Cristina

; Paiva, Marcelo Goulart

; Santos, Marcelo José

; Ishigai, Marcia Marcelino de Souza

; Diógenes, Maria Suely Bezerra

; Alves, Maria Teresa de Seixas

; Piedade, Maria Tereza Castro

; Parreiras, Mariana

; Cypriano, Mônica

; Negrini, Nilce da Silva

; Campos Filho, Orlando

; Figueiredo, Paula Andrade

; Novaes, Paulo Eduardo

; Camargo, Paulo Roberto

; Maia, Priscila dos Santos

; Petrilli, Renata

; Arduini, Rodrigo Genaro

; Gouveia, Roseane Vasconcelos

; Teruya, Suzana Barbosa Miranda

; Moisés, Valdir Ambrosio

; Morais, Vera Lúcia Lins de

Arquivos Brasileiros de Cardiologia

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may 2013, Volume 100 N. 5 Pages 1 - 68

Abstract: Pt | Text: Pt | PDF: Pt

https://doi.org/10.5935/abc.2013S005 17336 downloads

Estudantes e usuários avaliam ferramenta de educação permanente em saúde - Sieps
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Ezequiel, Maria Cristina Diniz Gonçalves

; Noel, Bárbara Kern

; Lemos, Pedro Paulo de

; Paiva, Antonio Cardoso

; Borges, Ludmila Paczkowski

; Ferreira, Gabriela de Mesquita

; Sanzovo, Paula Sajovic

Revista Brasileira de Educação Médica

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mar 2012, Volume 36 N. 1 Pages 112 - 130

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

As Sessões Interativas em Educação Permanente em Saúde (Sieps) acontecem há quatro anos nas Unidades de Saúde da Família da Faculdade de Medicina de Petrópolis/Faculdade Artur de Sá Earp Neto (FMP/Fase). Baseiam-se nos princípios da educação permanente propostos pelo Ministério da Saúde e na metodologia de problematização. Buscam maior interdisciplinaridade dentro da unidade de saúde, trabalho em equipe, aproximação do usuário com o serviço e do estudante com a realidade. Esse trabalho objetiva compreender as reflexões feitas por estudantes de graduação em Medicina, Nutrição e Enfermagem e por usuários sobre as Sieps. Nesta pesquisa foram usados um questionário com base na escala de Likert, na amostra de estudantes, e uma entrevista, categorizada de acordo com a análise temática dentro da análise de conteúdo, usada na amostra de usuários. Foi possível concluir que os usuários e estudantes percebem positivamente as Sieps e que, em sua opinião e percepção, elas alcançam seus objetivos: melhoram o trabalho em equipe, enfatizando a interdisciplinaridade; acolhem bem os usuários; aproximam os estudantes da realidade das comunidades em que estão inseridos, com atualização e treinamento das equipes.

The Interactive Sessions in Continuing Health Education (SIEPS) have taken place for four years at the Family Health Units of the Petrópolis School of Medicine/ Artur de Sá Earp Neto School (FMP/Fase). The sessions were based on the principles of continuing education proposed by the Ministry of Health and in the problem analysis methodology. They seek a stronger interdisciplinary approach within the health unit, teamwork, and a closer approach between users and the health service and between students and the local reality. This study aimed to understand the reactions by undergraduate students in Medicine, Nutrition, and Nursing and health services users concerning the Interactive Sessions. The study used a questionnaire based on the Likert scale, within the sample of students, and an interview, categorized according to a thematic content analysis, used in the sample of users. The conclusion was that users and students had a positive perception of the Interactive Sessions and that they had achieved the objectives by improving teamwork, emphasizing interdisciplinary work, receiving users properly, and drawing students closer to the communities' reality, with updated team training.

4634 downloads

Effect of different finishing: polishing systems on the surface roughness of two heat-treated composite resins
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Lima, Gabrielle Ribeiro

; Maluf, Nathalia Cardoso Baima

; Souza, Soraia de Fátima Carvalho

; Paiva, Antonio Ernandes Macedo

; Souza, Erick Miranda

; Santana, Ivone Lima

Materials Research

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2011, Volume 14 N. 2 Pages 142 - 145

Abstract: En | Text: En | PDF: En

The aim of this study was to compare the surface roughness achieved by different finishing/polishing systems on two composite resins for direct use after thermic treatment. The specimens (n = 40 per group (G); G1 = Filtek™ P60; G2 = Fill Magic®) were set up on a matrix of stainless steel with circular internal niches (Ø = 10.0 mm; h = 2.0 mm). Next, they were subjected to thermal treatment in a heated chamber at 170 °C for 10 minutes. They were then divided randomly into four subgroups (Sg) to receive the surface treatment according to the finishing/polishing systems tested (n = 10): Sg A: Control; Sg B: Diamond® felt disc + Diamond Excel® diamond paste; Sg C: Sof-Lex® discs; and Sg D: Enhance™ silicon tips. The mean roughness (Ra) was determined using a digital surface roughnes tester. Data was analyzed by two-way ANOVA and Tukey's post-hoc test (α = 0.05). Differences between the surface treatments were found on both resins (p < 0.05). In G1, the lowest mean Ra values were observed using Sg C (0.07 μm) and the highest for Sg D (0.12 μm) (p < 0.05). There was no difference between Sg B (0.08 μm) and Sg C (0.07 μm) (p = 0.076). In G2, there was a progressive increase in mean Ra values from Sg D (0.05 μm) to Sg C (0.06 μm) and to Sg B (0.07 μm) (p < 0.05). It was concluded that the finishing/polishing systems modified Ra on both resins.

2652 downloads

Perfil da dor Neuropática: a propósito do exame neurológico mínimo de 33 pacientes
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Resende, Marco Antonio Cardoso de

; Nascimento, Osvaldo José Moreira

; Rios, Anna Amélia Silva

; Quintanilha, Giseli

; Ceballos, Luís Eduardo Sacristan

; Araújo, Fernando Paiva

Revista Brasileira de Anestesiologia

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apr 2010, Volume 60 N. 2 Pages 144 - 148

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

JUSTIFICATIVA E OBJETIVOS: Há poucos textos na literatura a lidar com o exame neurológico do paciente com dor neuropática (DN). O objetivo deste estudo foi avaliar o perfil de pacientes com DN através de exame clínico neurológico. MÉTODO: Em estudo observacional, uma série de casos de pacientes com DN foi acompanhada no período de um ano. A avaliação do exame neurológico foi efetuada durante visita ao ambulatório e através de análise prospectiva. Foram incluídos pacientes cuja intensidade da dor era igual ou maior que seis, segundo a Escala Analógica Visual. RESULTADOS: A dor em queimação predominou como descritor em 54,5% dos pacientes. A polineuropatia foi o padrão clínico-topográfico predominante (48%) com padrão distal e simétrico, em oposição a quadros de neuropatia multifocal (15,15%). As modalidades termoalgésica e tátil do exame de sensibilidade foram as mais comprometidas, logo acompanhadas por alterações motoras e reflexos profundos, enquanto modalidades de sensibilidade proprioceptiva vieram a seguir. Apesar de nenhum sinal ou sintoma ser específico de DN, a queimação como sintoma costuma ser atribuída ao acometimento de fibras finas, assim como o padrão típico destas é a alteração térmico-dolorosa. CONCLUSÕES: A história e os achados do exame físico são a chave para o diagnóstico de DN. O registro das alterações encontradas ao exame deve ressaltar o comprometimento observado e assim nortear a abordagem diagnóstica e terapêutica, se curativa ou paliativa.

BACKGROUND AND OBJECTIVES: Very few texts in the literature approach the neurologic exam of patients with neuropathic pain (NP). The objective of this study was to evaluate the profile of patients with NP through the neurological exam. METHODS: This is an observational study that followed-up patients with NP for one year. The neurologic exam was evaluated at the outpatient clinic and through prospective analysis. Patients whose pain severity was equal or greater than six on the Visual Analogue Scale were included in this study. RESULTS: Burning pain predominated, affecting 54.5% of the patients. Unlike multifocal neuropathy (15.15%), distal and symmetrical polyneuropathy was the predominant clinical-topographic pattern (48%). The thermoalgic and tactile modalities of the sensorial exam were affected the most, followed by changes in motor function and deep tendon reflexes, and proprioception. Although NP does not have specific signs and symptoms, burning pain is attributed to the involvement of thin nerve fibers and thermoalgic pain is typical of those changes. CONCLUSIONS: History and physical exam findings are key factors in the diagnosis of NP. The log of changes in the physical exam should emphasize the involvement observed, guiding the diagnostic and therapeutic approach, curative or palliative.

JUSTIFICATIVA Y OBJETIVOS: Existen pocos textos en la literatura que aborden el examen neurológico del paciente con dolor neuropático (DN). El objetivo de este estudio fue evaluar el perfil de pacientes con DN a través de examen clínico neurológico. MÉTODO: En un estudio observacional, una serie de casos de pacientes con DN tuvo un seguimiento en el período de un año. La evaluación del examen neurológico fue efectuada durante una visita al ambulatorio y a través de un análisis prospectivo. Se incluyeron pacientes cuya intensidad de dolor era igual o mayor que seis, según la Escala Analógica Visual. RESULTADOS: El dolor en quemados predominó como descriptor en un 54,5% de los pacientes. La polineuropatía fue el estándar clínicotopográfico predominante (48%) con estándar distal y simétrico, en oposición a los cuadros de neuropatía multifocal (15,15%). Las modalidades termoalgésica y táctil del examen de sensibilidad fueron las más comprometidas, y venían acompañadas de alteraciones motoras y reflejos profundos, mientras que las modalidades de sensibilidad proprioceptiva venían después de aquellas. A pesar de que no había ninguna señal o síntoma específico de DN, la quemadura como síntoma acostumbra a ser atribuida al acometimiento de las fibras finas, como también su estándar típico es la alteración térmico-dolorosa. CONCLUSIONES: La historia y los descubrimientos del examen físico son la clave para el diagnóstico de DN. El registro de las alteraciones encontradas en el examen debe resaltar el comprometimiento observado y así guiar el abordaje diagnóstico y terapéutico y decidir si es curativo o paliativo.

27669 downloads

Correlation among mutans streptococci counts, dental caries, and IgA to Streptococcus mutans in saliva
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Koga-Ito, Cristiane Yumi

; Martins, Clélia Aparecida de Paiva

; Balducci, Ivan

; Jorge, Antonio Olavo Cardoso

Brazilian Oral Research

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dec 2004, Volume 18 N. 4 Pages 350 - 355

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Duzentos e quarenta indivíduos divididos em cinco grupos foram estudados: crianças livres de cáries, crianças com cáries, crianças com cáries rampantes, adultos jovens com e sem cáries. Saliva total estimulada foi coletada, e todos os indivíduos foram investigados para CPO-D/ceo-d seguindo-se os critérios da OMS e o índice de higiene oral simplificado (IHOS). Foi também realizada a quantificação da microbiota aeróbica total e de estreptococos do grupo mutans na saliva. Além disso, o nível de IgA anti-S. mutans foi determinado por ELISA. Crianças com cárie rampante apresentaram maior valor de IHOS. A contagem total de microrganismos mais elevada foi encontrada no grupo de crianças com cárie. Nenhuma diferença estatisticamente significativa foi observada em relação a fluxo salivar, IHOS e contagens de microrganismos entre os grupos de adultos jovens. Nenhuma correlação entre contagem de estreptococos do grupo mutans e níveis de IgA anti-Streptococcus mutans foi observada em nenhum dos grupos estudados. Foi encontrada uma correlação entre níveis mais altos de IgA anti-S. mutans e ausência de cáries entre os adultos jovens, mas não entre as crianças.

Two-hundred and forty individuals were studied, divided into five groups as follows: caries-free children, children with caries, children with rampant caries, young adults with and without caries. Whole stimulated saliva was collected and all individuals were investigated for DMFT/dmft according to the WHO criteria and the simplified oral hygiene index (OHI-S). Quantitative analysis of the total aerobic flora and mutans streptococci in saliva was performed. Also, the level of salivary anti-S. mutans IgA was determined by ELISA. Children with rampant caries showed the highest OHI-S value. The highest total counts of microorganisms were found in the group of children with caries. No statistically significant differences were observed for salivary flow, OHI-S and microorganism counts between the groups of young adults. No correlation between mutans streptococci counts and anti-Streptococcus mutans IgA levels was observed in the studied groups. A correlation between increased anti-Streptococcus mutans IgA levels and caries-free status was observed among young adults but not among children.

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Staphylococcus spp. in the oral cavity and periodontal pockets of chronic periodontitis patients
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Loberto, Jussara Cia S.

; Martins, Clélia Ap. de Paiva

; Santos, Silvana S. Ferreira dos

; Cortelli, José Roberto

; Jorge, Antonio Olavo Cardoso

Brazilian Journal of Microbiology

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jun 2004, Volume 35 N. 1-2 Pages 64 - 68

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Staphylococcus spp. não são usualmente isolados a partir da cavidade bucal. Quando presentes, são considerados pertencentes à microbiota transitória. Indivíduos que apresentam doença periodontal representam possíveis reservatórios dessas bactérias oportunistas na cavidade bucal. O uso de antibióticos para o tratamento da doença periodontal ou outras infecções pode predispor o aumento do número de Staphylococcus spp. na boca, pois estes adquirem facilmente resistência aos antibióticos, podendo resultar em superinfecção. O objetivo deste estudo foi verificar a presença de Staphylococcus spp. na cavidade bucal e nas bolsas periodontais de pacientes com periodontite crônica; identificar as cepas isoladas; verificar a relação entre a presença de Staphylococcus spp. na cavidade bucal e presença de bolsa periodontal. Participaram deste estudo 88 pacientes, entre 25 e 60 anos de idade e apresentando periodontite crônica, com pelo menos dois sítios com profundidade de sondagem maior ou igual a 5mm. Após anamnese e exame clínico periodontal foram feitas coletas de material da bolsa periodontal com cones de papel e da cavidade bucal por meio de bochechos. Do total de pacientes 37,50% apresentaram Staphylococcus spp. na bolsa periodontal e 61,36% na cavidade bucal, sendo que 27,27% apresentaram a bactéria nos 2 sítios. S. epidermidis foi a espécie mais prevalente para bolsa periodontal (15,9%) e cavidade bucal (27,27%). Não houve diferença estatística significante quanto à presença desses microrganismos entre as faixas etárias e aumento da profundidade de sondagem. A presença de bactérias oportunistas na cavidade bucal pode representar dificuldades para a manutenção do tratamento periodontal.

Staphylococcus spp are not usually isolated from the oral cavity, and when this occurs, they are considered to belong to the transitory microbiota. Individuals with periodontal disease represent possible reservoirs of these opportunistic bacteria in the oral cavity. The use of antibiotics for treatment of periodontal disease or other infections may predispose to the increase of the number of Staphylococcus spp. in the oral cavity. These microorganisms easily become resistant to antibiotics, and may result in superinfection. The purpose of this study was to evaluate the presence of Staphylococcus spp. in the oral cavity and in periodontal pockets of patients with chronic periodontitis, identify the isolates and verify the relationship between the presence of Staphylococcus spp. in the oral cavity and presence of periodontal pockets. The study included eighty-eight patients, 25-60 years of age, with chronic periodontitis, and at least two sites with probing depth > 5 mm. Individual data examination was assessed. Then, samples were colleted from the periodontal pocket with the aid of paper tips and from the oral cavity through mouth rinses. Out of the total of patients, 37.50% presented Staphylococcus spp. in the periodontal pocket and 61.36% in the oral cavity, 27.27% presented the bacteria in both sites. S. epidermidis was the most prevalent specie in the periodontal pocket (15.9%) and oral cavity (27.27%). The occurrence of higher proportions of nonresident's microorganisms in subgingival samples and oral sites may represent significant problem in causing and maintaining periodontal infections.

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11.

In vitro antifungal susceptibility of Candida spp. isolates from patients with chronic periodontitis and from control patients
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Ito, Cristiane Yumi Koga

; Martins, Clélia Aparecida de Paiva

; Loberto, Jussara Cia Sanches

; Santos, Silvana Soléo Ferreira dos

; Jorge, Antonio Olavo Cardoso

Brazilian Oral Research

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mar 2004, Volume 18 N. 1 Pages 80 - 84

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Em certas situações, tal como em pacientes imunocomprometidos, superinfecção por Candida pode ocorrer e ser refratária ao tratamento periodontal convencional. Nesses casos, a terapia sistêmica com antifúngicos pode ser indicada. O objetivo deste trabalho foi estudar a suscetibilidade aos antifúngicos de cepas de leveduras do gênero Candida isoladas de pacientes com periodontite crônica e de indivíduos controle. Um total de 39 isolados de C. albicans, 9 de C. tropicalis, 2 de C. glabrata e 5 de Candida spp. provenientes de indivíduos controle e 30 de C. albicans, 3 de C. tropicalis e 2 de C. glabrata de pacientes com periodontite foram testados. No grupo controle, uma amostra de C. glabrata foi resistente ao cetoconazol e uma de Candida spp. mostrou-se resistente a anfotericina B, cetoconazol e miconazol. Dentre as amostras do grupo com periodontite, uma (3,33%) amostra de C. albicans foi resistente à 5-fluorocitosina e ao cetoconazol. A partir dos resultados obtidos, concluiu-se que fluconazol foi o fármaco mais eficaz contra as várias espécies de Candida estudadas. Não foram observadas diferenças expressivas na sensibilidade de isolados de pacientes com periodontite e de indivíduos controle.

Superinfection by Candida can be refractory to conventional periodontal treatments in specific situations, such as in immunocompromised patients. In these cases, the systemic therapy with antifungal drugs could be indicated. The aim of this study was to analyse antifungal susceptibility of Candida spp. strains isolated from chronic periodontitis patients and from control individuals. A total of 39 C. albicans isolates, 9 C. tropicalis, 2 C. glabrata and 5 Candida spp. from control individuals and 30 C. albicans, 3 C. tropicalis and 2 C. glabrata from periodontitis patients were tested. In the control group, 1 isolate of C. glabrata was resistant to ketoconazole and 1 Candida spp. was resistant to amphotericin B, ketoconazole and miconazole. Among the isolates of periodontitis group, 1 (3.33%) C. albicans isolate was resistant to flucytosine and ketoconazole. According to the obtained results, it could be concluded that fluconazole was the most effective drug against the several Candida species studied. There were not expressive differences in the susceptibility of isolates from periodontitis patients or from control individuals.

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12.

Presence of Staphylococcus spp. and Candida spp. in the human oral cavity
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Martins, Clélia Aparecida de Paiva

; Koga-Ito, Cristiane Yumi

; Jorge, Antonio Olavo Cardoso

Brazilian Journal of Microbiology

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sep 2002, Volume 33 N. 3 Pages 236 - 240

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

A presença de leveduras do gênero Candida e Staphylococcus na cavidade bucal humana é de extrema importância, pois podem atuar como microbiota suplementar e em determinadas situações causar doença bucal ou sistêmica. O objetivo do presente trabalho foi estudar a prevalência de Candida spp. e Staphylococcus spp. na cavidade bucal humana. Enxagüe bucal foi coletado de 68 indivíduos segundo a técnica proposta por Samaranayake e MacFarlane e a seguir semeados em ágar Sabouraud dextrose com cloranfenicol e ágar Baird-Parker. Após crescimento, os microrganismos foram isolados e identificados através de provas bioquímicas. Os dados foram analisados através de análise de variância (ANOVA). Leveduras do gênero Candida foram encontradas em 61,76% dos indivíduos examinados, sendo C. albicans a mais frequentemente isolada. Staphylococcus spp. foram isolados em 95,60% das cavidades bucais, sendo 41 cepas (63%) coagulase-negativas. Das cepas coagulase-positivas, nove eram S. aureus, 11 S. hyicus, e quatro S. schleiferi subespécie coagulans. Não foi observada correlação entre as contagens (UFC) de Candida spp. e Staphylococcus spp. encontradas nos enxagües bucais dos indivíduos examinados.

The presence of yeasts and staphylococci in the oral cavity is important because they can act as supplementary microbiota and in certain situations can cause oral or systemic diseases. The aim of this work was to study the prevalence of Candida spp. and Staphylococcus spp. in the human oral cavity. Oral rinses were collected from sixty-eight individuals according to the technique described by Samaranayake and MacFarlane and then cultured on Sabouraud medium supplemented with chloramphenicol and Baird-Parker agar. After the incubation period, the microorganisms were isolated and identified through biochemical tests. The data obtained were statistically analysed by ANOVA. Candida spp. were isolated from 61.76% of the examined individuals and C. albicans was the more frequently isolated specie. Staphylococcus spp. were isolated from 95.60% of the individuals and 41 strains were coagulase negative (63%). Among the coagulase positive strains, nine were S. aureus, 11 S. hyicus and 4 S. schleiferi subspecie coagulans. No correlation was observed between the counts (cfu) of the isolated Candida spp. and Staphylococcus spp.

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