Made available in DSpace on 2014-12-17T14:13:40Z (GMT). No. of bitstreams: 1 LibiaAMG.pdf: 2793431 bytes, checksum: 15d705282b36a1a3bdebdd35264e791c (MD5) Previous issue date: 2009-03-27 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / Introduction: The chronic immunosuppression promotes the development of changes in the oral cavity of the kidney transplant recipients (KTR), however with the exception of gingival overgrowth, little is known regarding the prevalence of oral lesions in this population. Objective: To evaluate the prevalence of clinical and microbiological conditions of the oral cavity of the recipients of kidney transplantation and the associated factors. Methods: This was a cross-sectional study which examined 96 clinical KTR and experimental where collected saliva stimulated them to identify Candida sp. Data collection consisted of evaluation stomatologic, socio-demographic, clinical aspects of transplantation, condition of oral hygiene and dental caries, yonder to questions about knowledge of oral alteration after transplantation. Results: Of the total, 66.7% of KTR had some type of oral manifestation. The most common was saburral tongue, followed by gingival overgrowth, with both oral manifestations related to gender and concomitant use of cyclosporine and nifedipine (p <0.05). Tacrolimus showed a protective effect for gingival overgrowth (OR = 0.13). The oral hygiene was associated with saburral tongue(p = 0.03) and severity of gingival overgrowth (p = 0.0001). Oral candidiasis was diagnosed in 17.7% of patients and Candida albicans was isolated most frequently in the saliva of RTR with a colonization of 58.3%. The average DMF-T increased with age. The method of oral hygiene was most used brush and toothpaste to 61.5%. Changes in the oral cavity was seen in 54.2% of KTR, citing as the main growth and gingival ulcers. Instructions for oral hygiene after transplantation were neglected for 61.5% of RTR. Dry mouth and halitosis were reported in 30.2% and 36.5% respectively. Conclusions: More the half of the KTR had at least one injury of the mouth, the immunosuppressive drugs and oral hygiene are associated with these alterations. Prospective cohort studies are needed to elucidate the relationship between oral manifestations and levels of drug and risk of oral manifestations occur over time. The kidney transplant recipients showed to be aware of oral alterations occurred after transplantation and uninformed about the oral hygiene instructions. With regard to hygiene, the incidence of caries was considered high, conditions of risk were identified and improvements in primary attention should be encouraged and reflected in the monitoring of renal transplant / Introdu??o: A imunossupress?o cr?nica propicia o desenvolvimento de altera??es na cavidade oral de receptores de transplante renal (RTR), no entanto com exce??o do crescimento gengival, pouco se conhece em rela??o ? preval?ncia de les?es orais nessa popula??o. Objetivo: Avaliar a preval?ncia das condi??es cl?nicas e microbiol?gicas da cavidade oral dos receptores de transplante renal e os fatores associados. M?todos: tratou-se de um estudo seccional em que se examinou clinicamente 96 RTR e experimental onde se coletou saliva estimulada dos mesmos para identifica??o de Candida sp. A coleta dos dados foi realizada atrav?s de anamese e exame cl?nico dos pacientes, constando informa??es s?cio-demogr?ficas, aspectos cl?nicos do transplante, avalia??o estomatol?gica, condi??es de higiene oral e c?rie dent?ria, al?m de perguntas acerca do conhecimento das altera??es orais ap?s o transplante. Ap?s o exame, coletou-se saliva estimulada para identifica??o de Candida sp. Resultados: Do total, 66,7% dos RTR apresentaram algum tipo de manifesta??o oral. A mais freq?ente foi l?ngua saburrosa, seguida pelo crescimento gengival, estando ambas as manifesta??es bucais relacionadas ao sexo e ao uso concomitante de ciclosporina e nifedipina (p<0,05). O tacrolimus exibiu efeito protetor para o crescimento gengival (OR=0,13). A higiene oral esteve associada ? l?ngua saburrosa (p=0,03) e ? severidade do crescimento gengival (p=0,0001). Candid?ase oral foi diagnosticada em 17,7% dos pacientes e Candida albicans foi o isolado mais freq?ente na saliva dos RTR, com uma coloniza??o de 58,3%. O CPO-D m?dio aumentou com o avan?ar da idade. O m?todo de higiene oral mais usado era escova e creme dental para 61,5%. Altera??es na cavidade oral foi percebida por 54,2% dos RTR, citando como principais o crescimento gengival e as aftas. Instru??es de higiene oral ap?s o transplante foram negligenciadas para 61,5% dos RTR. Xerostomia e halitose foram relatadas em 30,2% e 36,5%, respectivamente. Conclus?es: Mais da metade dos receptores de transplante renal apresentaram pelo menos uma les?o de boca, as drogas imunossupressoras e higiene oral est?o relacionadas com essas altera??es. Estudos de coorte prospectivo s?o necess?rios para melhor elucidar a rela??o entre as manifesta??es orais e n?veis de droga e o risco das manifesta??es orais ocorrerem no decorrer do tempo. Os receptores de transplante renal mostraram-se conscientes das altera??es orais ocorridas ap?s o transplante e desinformados quanto ?s instru??es de higiene oral. No que diz respeito higiene, o ?ndice de c?rie foi considerado alto, condi??es de risco foram detectadas e melhorias na aten??o prim?ria devem ser refletidas e estimuladas no acompanhamento dos transplantados renais.

Made available in DSpace on 2014-12-17T15:32:18Z (GMT). No. of bitstreams: 1 EmelineNAL.pdf: 2548007 bytes, checksum: d30f88fa3814f13a0bc3ee25b49d05fb (MD5) Previous issue date: 2010-02-18 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / Bone marrow transplantation (BMT) is currently the best therapeutic option for patients with hematologic diseases, solid tumors or autoimmune disorders. It is characterized by intravenous infusion of hematopoietic stem cells in order to restore marrow function. However, this procedure requires concomitant immunosuppression treatment, which favors the development of certain complications, often manifested in the oral cavity. This study aimed to evaluate the incidence of oral changes in patients undergoing BMT and to correlate these results with clinical aspects related to the patients and the transplants performed. This is a prevalence study, with cross-sectional design, carried out in a BMT service at the Institute of Onco-Hematology of Natal (ION) and Natal Hospital Center. Data collection was based on questionnaires, clinical examination of the oral cavity and consultation in the medical records. The sample consisted of 51 patients undergoing BMT. After the analysis, was found a general status with good health conditions and presence of oral changes in about half of patients who composed the sample. The manifestations observed were, in decreasing order of frequency: mucositis; gingival alteration and thrombocytopenic purpura; mucosal pigmentation; lichenoid reaction and candidiasis. The oral changes were observed more frequently in cases of allogeneic TMO, in different periods post-transplant, without significant differences related to the source of cells. It was found statistically significant association between the presence of graft-versus-host disease (GVHD) and oral changes (p < 0,001). Therefore, it is concluded that there is a relatively high incidence of changes in oral cavity of patients receiving bone marrow transplantation, a fact which confirms the need to consider this site for examination, diagnosis, treatment and prognosis of possible complications of BMT / O transplante de medula ?ssea (TMO) atualmente constitui a melhor op??o terap?utica para pacientes com doen?as hematol?gicas, tumores s?lidos ou desordens autoimunes. Caracteriza-se pela infus?o intravenosa de c?lulas progenitoras hematopo?ticas com o objetivo de restabelecer a fun??o medular. No entanto, esse procedimento requer tratamento concomitante de imunossupress?o, o que favorece o desenvolvimento de determinadas complica??es, as quais freq?entemente se manifestam na cavidade oral. Este estudo objetivou avaliar a incid?ncia de altera??es orais em pacientes submetidos ao TMO e correlacionar esses resultados com aspectos cl?nicos referentes aos pacientes e aos transplantes realizados. Trata-se de um estudo de preval?ncia, com desenho do tipo seccional, realizado no servi?o de TMO do Instituto de Onco-Hematologia de Natal (ION) e Natal Hospital Center. A coleta de dados baseou-se em aplica??o de question?rio, exame cl?nico da cavidade oral e consulta de informa??es nos prontu?rios m?dicos. A amostra foi constitu?da por 51 pacientes submetidos ao TMO. Ap?s a an?lise, constatou-se quadro geral com boas condi??es de sa?de e presen?a de altera??es orais em aproximadamente metade dos pacientes que compunham a amostra. As manifesta??es observadas foram, em ordem decrescente de frequ?ncia: mucosite; altera??o gengival e p?rpura trombocitop?nica; pigmenta??o da mucosa; rea??o liquen?ide e candid?ase. As altera??es orais foram mais frequentes em casos de TMO alog?nico, em diferentes per?odos p?s-transplantes, sem diferen?a significativa quanto ? origem das c?lulas. Constatou-se associa??o estatisticamente significante entre a presen?a de doen?a do enxerto contra hospedeiro (DECH) e altera??es orais (p < 0,001). Portanto, conclui-se que h? uma incid?ncia relativamente alta de altera??es na cavidade oral de pacientes transplantados de medula ?ssea, fato que confirma a necessidade de se considerar a import?ncia desse s?tio para exame, diagn?stico, tratamento e progn?stico de poss?veis complica??es do TMO

Submitted by Ricardo Cedraz Duque Moliterno (ricardo.moliterno@uefs.br) on 2015-11-17T23:09:48Z No. of bitstreams: 1 Disserta??o Anderson Final Corre??es Banca Impress?o.pdf: 1523045 bytes, checksum: 814474d8f39dbb0905905b6e3a5d0af2 (MD5) / Made available in DSpace on 2015-11-17T23:09:48Z (GMT). No. of bitstreams: 1 Disserta??o Anderson Final Corre??es Banca Impress?o.pdf: 1523045 bytes, checksum: 814474d8f39dbb0905905b6e3a5d0af2 (MD5) Previous issue date: 2013-03-23 / After the discovery of the Human Immunodeficiency Virus (HIV), in the 1980s, the clinical and epidemiological characteristics of Acquired Immunodeficiency Syndrome (AIDS) have changed over the years, mainly from the second half of the 1990s, with the emergence of new drugs for its treatment. Objective: to investigate the oral condition and the HIV infection condition factors associated in individuals living with HIV/Aids. Method: a cross-sectional, descriptive, exploratory study. Single examiner used a data collection instrument in Assistance Specialized Services (SAE - STD/HIV/Aids) users in three municipalities in the Bahia State. The information derived from primary data (interviews and oral clinical examination) and secondary data (clinical records). Socio-demographic, lifestyle and health condition characteristics, HIV/Aids infection and oral condition were researched. Individuals registered in these services, with age greater than or equal to eighteen years old, gender both and that participate accepted voluntarily in the research were evaluated. Sample size was determined by convenience, from the data collection availability time. For statistical analysis, the Stata 10 statistical package used, the Chi-square test was used for categorical variables, with 5% significance level. Results: preliminary results in 228 individuals showed that the majority was male gender, browns, with a mean age 41.6 years old and the average HIV infection diagnosis time was 5.4 years. The HIV/Aids infection condition, as assessed by CD4 T-lymphocyte count showed statistically significant association with: current occupation, antiretroviral drugs use duration, last viral load determination and intra-oral injury presence. As for the oral condition, in relation to dental caries, the following factors significantly associated: age, race, current occupation, family income, average number of cigarettes per day, total and / or partial prosthesis use, prosthesis dental use, gingivitis and flossing. For intra-oral lesion presence was associated with age, educational level, current smoking, antiretroviral medications duration, dosage last viral load last count CD4 + T lymphocytes, CD4/CD8 ratio, gingivitis , periodontitis and flossing. Regarding the periodontitis, the following factors were associated: sex, residence county, past smoking, current smoking and flossing. Conclusions: the preliminary findings point to association between socio-demographic, lifestyle characteristics and HIV infection condition and oral condition, suggesting the need for better understanding of the influence of these variables in the individuals living with HIV/Aids monitoring, contributing to preventive measures, treatment and survival of the infection diagnosed individuals. / Ap?s a descoberta do V?rus da Imunodefici?ncia Humana (HIV), na d?cada de 1980, as caracter?sticas cl?nicas e epidemiol?gicas da S?ndrome da Imunodefici?ncia Adquirida (Aids) se modificaram ao longo dos anos, principalmente a partir da segunda metade da d?cada de 1990, com o surgimento de novos medicamentos para seu tratamento. Objetivo: Investigar fatores associados ? condi??o bucal e ? condi??o de infec??o pelo HIV em indiv?duos vivendo com HIV/Aids. M?todo: Foi realizado estudo do tipo transversal, de car?ter explorat?rio, atrav?s da coleta de dados com o uso de um instrumento de coleta aplicado por um ?nico examinador em usu?rios de Servi?os de Assist?ncia Especializada (SAE ? DST/HIV/Aids) de tr?s munic?pios do Estado da Bahia. As informa??es foram provenientes de dados prim?rios (entrevista e exame cl?nico bucal) e de dados secund?rios (prontu?rios cl?nicos). Foram pesquisadas caracter?sticas s?cio-demogr?ficas, relacionadas ao estilo de vida, ? condi??o de sa?de, ? infec??o HIV/Aids e ? condi??o bucal. Duzentos e vinte e oito indiv?duos cadastrados nesses Servi?os, com idade igual ou superior a dezoito anos, de ambos os sexos e que aceitaram, voluntariamente, participar da pesquisa foram avaliados. O tamanho da amostra foi determinado por conveni?ncia, a partir da disponibilidade de tempo para a coleta de dados. Para a an?lise estat?stica, foi utilizado o pacote estat?stico Stata 10, empregando-se o teste de Qui-quadrado para vari?veis categ?ricas, com n?vel de signific?ncia de 5%. Resultados: Os resultados preliminares mostraram que a maioria dos indiv?duos avaliados era do sexo masculino, pardos, com m?dia de idade de 41,6 anos e com tempo m?dio de diagn?stico da infec??o pelo HIV de 5,4 anos. A condi??o de infec??o HIV/Aids, avaliada pela contagem de linf?citos T CD4+ mostrou associa??o estatisticamente significante com: ocupa??o atual, tempo de uso de medica??es antirretrovirais, ?ltima dosagem de carga viral e presen?a de les?o intra-oral. Quanto ? condi??o bucal, em rela??o ? presen?a de c?rie dent?ria, os seguintes fatores apresentaram associa??o estatisticamente significante: idade, ra?a/cor, ocupa??o atual, renda familiar, quantidade m?dia de cigarros por dia, uso de pr?tese dent?ria total e/ou parcial, necessidade de uso de pr?tese dent?ria, presen?a de gengivite e uso de fio dental. Para a presen?a de les?o intra-oral, houve associa??o com: idade, n?vel de escolaridade, tabagismo atual, tempo de uso de medica??es antirretrovirais, ?ltima dosagem de carga viral, ?ltima contagem de linf?citos T CD4+, rela??o CD4/CD8, presen?a de gengivite, presen?a de periodontite e uso de fio dental. Com rela??o ? presen?a de periodontite, os seguintes fatores apresentaram associa??o: sexo, munic?pio de resid?ncia, tabagismo no passado, tabagismo atual e uso de fio dental. Conclus?o: Os achados preliminares apontam para a associa??o entre fatores s?cio-demogr?ficos e de estilo de vida ? condi??o de infec??o HIV e ao estado bucal, sugerindo a necessidade de melhor conhecimento da influ?ncia destas vari?veis no acompanhamento dos indiv?duos que vivem com HIV/Aids, contribuindo para medidas preventivas, tratamento e sobrevida daqueles com diagn?stico da referida infec??o.