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Otávio T Nóbrega,1 Alessandra M Campos-Staffico,2 Elayne Kelen Oliveira,3 Daniel B Munhoz,3 Filipe A Moura,3 Luis Sérgio F Carvalho,4 Alexandre Anderson SM Soares,1,5 Ciro M Gomes,1,6 Audrey C Tonet-Furioso,7 Andrei C Sposito1,3 On behalf of Brasilia Heart Study and the Brasilia Heart Study Group1Programa de Pós-Graduação em Ciências Médicas, Faculdade de Medicina, Universidade de Brasília (UnB), Brasília, DF, Brazil; 2Departamento de Farmácia, Faculdade de Ciências da Saúde, Universidade de Brasília (UnB), Brasília, DF, Brazil; 3Departamento de Cardiologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brazil; 4Centro de Inovação, Ensino e Pesquisa, Instituto de Gestão Estratégica em Saúde do Distrito Federal, Brasília, DF, Brazil; 5Serviço de Cardiologia, Instituto Biocárdios, Brasília, DF, Brazil; 6Laboratório de Dermatomicologia, Faculdade de Medicina, Universidade de Brasília (UnB), Brasília, DF, Brazil; 7Programa de Pós-Graduação em Gerontologia, Universidade Católica de Brasília (UCB-DF), Taguatinga, DF, BrazilCorrespondence: Andrei C SpositoLaboratório de Biologia Vascular e Aterosclerose (AteroLab), Departamento de Cardiologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (Unicamp), 126 Rua Tessália Vieira de Camargo, Campinas, 13083-887, SP, BrazilTel +55 19 3521 9590Fax +55 19 3289 4107Email andreisposito@gmail.comBackground: Glycemic disorders are strong predictors of mortality in ST-elevation myocardial infarction (STEMI) patients, and disruption in nitric oxide (NO) production is associated with insulin-resistant states. We evaluated whether a defective allele of the neuronal nitric oxide synthase (nNOS) gene (NOS1) might influence insulin response and blood-glucose balance during the acute phase of STEMI and if post-infarction total plasma-NO levels and vasodilation scores varied across nNOS genotypes.Methods: Consecutive patients with STEMI (n=354) underwent clinical evaluations and genotyping for the promoter variation rs41279104. In-hospital clinical and blood evaluations were performed at admission and five days after STEMI, with glycemic, insulinemic, and disposition indices assessed at the same times. Flow-mediated dilation (FMD) was assessed by reactive hyperemia on the 30th day.Results: Homozygotes for the defective allele (A) showed lower glycemia and insulin sensitivity on day 1 while showing the highest β-cell function and no changes in the circulating NO pool, which is compatible with hyperresponsive β cells counteracting the inherent glucose-resistant state of AA patients. At day 5, glycemic scores had shifted to indicate greater insulin sensitivity among A homozygotes, paralleled by a significant yet poor increase in NO bioavailability compared to that among G carriers. All in all, defective homozygotes showed greater insulin resistance at admission that had reversed by 5 days after STEMI. Even so, A carriers developed lower FMD scores compared to G homozygotes after the acute phase.Conclusion: A defective nNOS allele (and due decline in NO production) seemed to elicit a hyperinsulinemia response to compensate for an insulin-resistant state during the acute phase of STEMI and to be associated with poor endothelial function after the acute phase.Keywords: nitric oxide, insulin, blood glucose, vasodilation, polymorphism, myocardial infarction

Objectives: To assess feasibility and maintenance of bone after alveolar cleft reconstructions using graft from iliac crest and mandibular symphysis., Methods: 51 alveolar clefts grafted with iliac crest and 51 ones grafted with mandibular symphysis bones were selected from patients aged between 7 and 12 years. At three (T1) and 12 months (T2) after surgeries, periapical radiographs were performed to measure the height of the grafted bone based on the modified Bergland scale. Chi-square and Mann-Whitney-Wilcoxon tests compared differences between T1 and T2 according to each bone graft., Results: From the clefts grafted with mandibular symphysis bone, 47 were classified as type I (92.5%) and 04 as type II (7.84%) at T1. At T2, 36 were classified as type II (25.49%) and 02 as type III (3.92%). In the analysis of the clefts grafted with iliac crest at T1, 48 were classified as type I (94.11%) and three as type II (5.88%). At T2, 37 classifieds as type I (72.54%), 12 as type II (23.52%) and two as type III (3.92%). There was no statistically significant difference between treatments., Conclusions: It was concluded that iliac crest and mandibular symphysis are adequate areas from which bone grafts can be obtained for reconstruction of alveolar cleft., Competing Interests: Conflict of interestThe authors declare that they have no known competing financial interests or personal relationships which could have appeared to influence the work reported in this article., (© The Association of Oral and Maxillofacial Surgeons of India 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Objective: To compare the effect of photobiomodulation (PBM) and transcutaneous electrical nerve stimulation (TENS) in the treatment of burning mouth., Materials and Methods: Randomized clinical trial of 25 patients with burning mouth treated by TENS (n=12) and PBM (n=13). The patients were treated weekly for 8 weeks. Two-factor ANOVA was used to determine whether the two interventions promoted significant differences in symptoms (measured with a visual analogue scale), unstimulated salivary flow, xerostomia, and dysgeusia between T0 (baseline), T1 (after the 4th treatment session), T2 (after the 8th treatment session), and T3 (30 days after the end of treatment)., Results: Intragroup comparison of VAS scores for pain showed a significant difference between T0xT1, T0xT2, and T0xT3 in the TENS group and between T0xT2 and T0xT3 in the PBM group (p˂0.001). Intergroup comparison of VAS scores for pain between T2xT3 showed a better response to PBM than to TENS (p=0.003). Patients of the TENS group showed an increase in salivary flow between T1 and T2 (p=0.052). There were no expressive variations in xerostomia or dysgeusia in the two groups analyzed., Conclusion: TENS and PBM were effective in reducing the symptoms of burning mouth during and after treatment. The PBM group showed a better response during follow-up., Trial Registration: This clinical trial was registered at http://clinicaltrials.gov (Number: NCT05816200)., Clinical Relevance: TENS was found to be a safe and effective therapy for burning mouth. Trial registration number (TRN) and date of registration: This clinical trial was registered at http://clinicaltrials.gov (Number: NCT05816200; date: May 08, 2023)., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background/purpose: Actually, many individuals have opted for the vegetarian diet. The objective of this study was to evaluate the impact of the vegetarian diet on the oral epithelium through cytopathology., Methods: Oral smears of the tongue and buccal mucosa of 60 adult subjects (30 vegetarians and 30 controls) were collected. Smears were analyzed morphologically and for three morphometric variables: nucleus area (NA), cytoplasm area (CA) and nucleus/cytoplasm ratio., Results: Vegetarians were classified as ovolactovegetarian (53.3%), vegans (30%) and strict vegetarians (16.7%). The NA and CA of the epithelial cells of vegetarian individuals were smaller when compared to controls both in the region of the buccal mucosa and tongue. However, there was no statistically significant difference according to the Student's t-test. For the NA/CA ratio, cells in the oral mucosa region were larger for vegetarians compared to controls. For the tongue, both groups had the same value and the Mann-Whitney U test confirmed that there is no difference between the groups for this cytomorphometric variable., Results: Vegan individuals had a smaller (but not larger) area of CA when compared to controls for the tongue (vegan = 2604.2 ± 179.2 versus control = 3256.7 ± 463.8 p = 0.013). Most smears showed normal epithelial cells and some individuals had changes of an inflammatory nature, mainly in the tongue., Conclusion: Despite the small sample size, the results of this study raise the hypothesis that the vegetarian diet (especially the vegan diet) can compromise the thickness of the oral epithelium of the tongue., Competing Interests: Declaration of competing interest The authors have no conflicts of interest relevant to this article., (Copyright © 2021 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.)

Natal teeth are infrequent at birth. Dental extraction is the most recommended treatment to avoid complications. Reactive soft tissue lesions associated to natal tooth or its incomplete removal are rare. A five-month-old female presented natal teeth #71 and #81 which were removed the day after the birth. The baby evolved with two nodules in the region of #71 and #81, pedunculated, 10 and 9 mm, respectively, covered by a pink mucosa, firm in consistency. Periapical radiography showed two radiopaque areas, suggestive of root fragments. After 30 days the nodule located in the region of #81 became purple in color and ulcerated. Both lesions were removed with high intensity diode laser. Histopathological analysis was compatible with inflammatory fibrous hyperplasia (#71) and pyogenic granuloma (#81). Early diagnosis of oral lesions in newborns by means of histopathological examination and a minimum invasive treatment, such as laser surgery, should be of primary concern.

Aim: In patients with type 2 diabetes mellitus (T2DM) a progressive thinning in the central retinal thickness (CRT) is mainly related to neuroretinal degeneration and occurs before the decline in visual acuity or capillary density. We investigated the change in CRT by optical coherence tomography (OCT) in T2DM patients after 12 weeks of treatment with dapagliflozin or glibenclamide., Methods: Ninety-seven patients (57 ± 7 years) with T2DM and clinical or subclinical atherosclerosis were randomized 1:1 to dapagliflozin (10 mg/day) or glibenclamide (5 mg/day) on top of metformin XR 1.5 g/day. OCT was obtained in all patients enrolled in the study, both at the time of randomization and at the end of the study., Results: Baseline and post-treatment values of fasting glucose and glycated hemoglobin were equivalent in the two arms. There was no difference in change in diabetic retinopathy status after therapy. The center subfield thickness changed by +2(6)μm in the dapagliflozin group and by -1(7) μm in the glibenclamide group (P = 0.001)., Conclusion: A short-term treatment with dapagliflozin may increase CRT as compared with equivalent glycemic control with glibenclamide., Competing Interests: Declaration of Competing Interests None of the authors had competing interests in this trial., (Copyright © 2021 Elsevier Masson SAS. All rights reserved.)

Background: Schizophrenia (SCZ) presents complex challenges related to diagnosis and clinical monitoring. The study of conditions associated with SCZ can be facilitated by using potential markers and patterns that provide information to support the diagnosis and oral health., Methods: The salivary composition of patients diagnosed with SCZ (n = 50) was evaluated and compared to the control (n = 50). Saliva samples from male patients were collected and clinical parameters were evaluated. The concentration of total proteins and amylase were determined and salivary macro- and microelements were quantified by ICP OES and ICP-MS. Exploratory data analysis based on artificial intelligence tools was used in the investigation., Results: There was a significant increase in the salivary concentrations of Al, Fe, Li, Mg, Na, and V, higher prevalence of caries (p < 0.001), periodontal disease (p < 0.001), and reduced salivary flow rate (p = 0.019) in SCZ patients. Also, samples were grouped into six clusters. As, Co, Cr, Cu, Mn, Mo, Ni, Se, and Sr were correlated with each other, while Fe, K, Li, Ti, and V showed the highest concentrations in the samples distributed in the clusters with the highest association between SZC patients and controls., Conclusions: The results obtained indicate changes in salivary flow, organic composition, and levels of macro- and microelements in SCZ patients. Salivary concentrations of Fe, Mg, and Na may be related to oral conditions, higher prevalence of caries, and periodontal disease. The exploratory analysis showed different patterns in the salivary composition of SCZ patients impacted by associations between oral health conditions and the use of medications. Future studies are encouraged to confirm the results investigated in this study., (Copyright © 2021 Elsevier GmbH. All rights reserved.)

We compared the effect of dapagliflozin versus glibenclamide on the ratio of lean-to total mass in patients with type 2 diabetes mellitus, carotid subclinical atherosclerosis, HbA1c 7.0-9.0% and 40-70 years-old. Ninety-eight patients (61% male; mean age 57 ± 7 years) were randomized into dapagliflozin 10 mg/day or glibenclamide 5 mg/day on top of metformin. Body composition was measured by Dual Energy X-Ray at randomization and after 12 weeks of treatment. Glycemic control was equivalent in both groups. Dapagliflozin decreased total body mass (-2741 g [95% CI: -3360 to 1945]; p < 0.001) and lean mass (-347 g [95% CI: -761 to -106]; p < 0.001), while glibenclamide increased total body mass (1060 g [95% CI: 140 to 1836]; p < 0.001) and lean mass (929 g [95% CI: 575 to 1283]; p < 0.001) for the differences between arms. The lean-to-total mass ratio increased by 1.2% in the dapagliflozin group and 0,018% in the glibenclamide group (p < 0.001). Dapagliflozin reduced the risk of a negative balance in the lean-to total mass ratio [OR: 0.16 (95% CI: 0.05 to 0.45); p < 0.001] even after adjustment for baseline lean-to total mass ratio, waist circumference, HOMAIR, HbA1c, mean of the two hands handgrip strength and gait speed [OR: 0.13 (95% CI: 0.03-0.57); p < 0.007]. In conclusion, under equivalent glycemic control, dapagliflozin reduced total body mass but increased the ratio of lean-to-total mass when compared with glibenclamide.

Background: This study aimed to investigate the morphology and chemical composition of dental caries related to ionizing radiation (DCIR), an aggressive and progressive disease that affects dental hard tissues., Materials and Methods: Eight human teeth with DCIR were paired with sixteen control teeth (8 teeth with conventional caries and 8 without caries) and included in this study. An analysis of the morphology of the lesions was performed using the following techniques: periapical radiography, cone beam computed tomography, computed microtomography, and scanning electron microscopy. The chemical composition was assessed using X-ray dispersive spectroscopy., Results: There was more demineralization in DCIR lesions when compared to conventional dental caries, even though there was no cavitation in the cervical region of the teeth. The superficial roughness and topography of DCIR lesions were similar to those of healthy teeth. On the other hand, lesions of conventional dental caries showed greater surface and topographic irregularity when compared to DCIR and healthy teeth (p = 0.001). Calcium (Ca) and phosphorus (P) levels were lower in DCIR lesions when compared to controls. However, higher levels of carbon (C) have been observed in DCIR lesions. There was a greater loss of the mineral matrix in DCIR followed by conventional caries. The reduction in the mineral matrix (Ca and P) was compatible with the imaging patterns observed in teeth with DCIR and conventional caries., Conclusion: Despite their rapid evolution, DCIR presents an irregular, apparently intact surface with significant changes in the amount of Ca, P, and C., Competing Interests: Conflict of interests None declared., (© 2021 Greater Poland Cancer Centre.)

Background: The glucose-lowering independent effect of sodium glucose cotransporter-2 inhibitors (SGLT2i) on arterial wall function has not yet been clarified. This study aims to assess whether SGLT2i treatment can attenuate endothelial dysfunction related to type 2 diabetes mellitus (T2D) compared with glucose-lowering equivalent therapy., Methods: In a prospective, open-label, single-center, randomized clinical trial, 98 patients with T2DM and carotid intima-media thickness above the 75th percentile were randomized 1:1 to 12 weeks of therapy with dapagliflozin or glibenclamide in addition to metformin in glucose-lowering equivalent regimens. The coprimary endpoints were 1-min flow-mediated dilation (FMD) at rest and 1-min FMD after 15 min of ischemia followed by 15 min of reperfusion time (I/R)., Results: Ninety-seven patients (61% males, 57 ± 7 years) completed the study. The median HbA1c decreased by - 0.8 (0.7)% and -0.7 (0.95)% following dapagliflozin and glibenclamide, respectively. The first coprimary endpoint, i.e., rest FMD changed by + 3.3(8.2)% and - 1.2(7.5)% for the dapagliflozin and glibenclamide arms, respectively (p = 0.0001). Differences between study arms in the second coprimary endpoint were not significant. Plasma nitrite 1 min after rest FMD was higher for dapagliflozin [308(220) nmol/L] than for glibenclamide (258[110] nmol/L; p = 0.028). The resistive indices at 1 min [0.90 (0.11) vs. 0.93 (0.07); p = 0.03] and 5 min [0.93 (0.07) vs. 0.95 (0.05); p = 0.02] were higher for the glibenclamide group than for the dapagliflozin group. Plasma biomarkers for inflammation and oxidative stress did not differ between the treatments., Conclusions: Dapagliflozin improved micro- and macrovascular endothelial function compared to glibenclamide, regardless of glycemic control in patients with T2DM and subclinical carotid atherosclerotic disease.

Aims: The aim of the present study was to evaluate the taste perception in patients with upper complete dentures., Methods and Results: One hundred seventy male and female patients (45-83 years old) upper denture wearers were evaluated for their gustatory function by the paper strips technique in relation to the four basic tastes. The taste test was performed with and without the presence of the denture on the palate. Through Shapiro-Wilk and Kolmogorov-Smirnov tests, the results were analyzed by their normal distribution. The t-test for paired samples was used to evaluate if there was a statistical difference on the taste perception and itself revealed that there is a significant difference (p < 0.01) when the taste perception was analyzed for the absence and presence of the prosthesis (alone and compared) (p < 0.01). The results revealed that patients with dentures had great difficulty to recognize the bitter taste, followed by the salty, sweet, and sour., Conclusion: The presence of the denture was able to modify the perception of taste when compared to its absence, especially for the bitter taste., (© 2021 Special Care Dentistry Association and Wiley Periodicals LLC.)

Aims: The aim of this study was to compare individuals with and without schizophrenia through the characteristics of the palate, such as width, length, depth, palate shape, and upper dental arch shape., Methods and Results: The sample was divided into one case group (n = 45) and two control groups (n = 90; 45 individuals each group). Groups were paired by variables: sex, age, and malocclusion type. All analyses were performed on upper dental arch plaster models. All individuals were male and the mean age was 28.56 (SD: 7.82) years. The frequency of the malocclusion type observed was 54.1% (Class I), 22.2% (Class II), and 23.7% (Class III). Statistically significant difference was observed between the case and control groups for the variables palate shape (P = .004) and upper dental arch shape (P = .003). The case group had a higher frequency of the deep or grooved palate shape (57.8%) and parabolic dental arch shape (48.9%). There was no statistically significant difference for the palate width, length, and depth (P > .05)., Conclusions: There was an evidence that the deep or grooved palate shape and parabolic dental arch shape are morphological characteristics of the palate in men with schizophrenia., (© 2020 Special Care Dentistry Association and Wiley Periodicals, Inc.)

Background: Saliva is a complex secretion produced daily by the salivary glands. Saliva consists mainly of water, enzymes, ions and amino acids and performs several important functions in oral health., Objective: The aim of this study was to investigate the flow rate and concentrations of amylase and total proteins in the saliva of hospitalized patients due to AIDS complications., Methods: Ninety-three men and women (20-64 years of age) were divided into two groups (46 HIV-infected patients and 47 controls) and had salivary flow rate and levels of amylase enzyme and total proteins evaluated., Result: The mean salivary flow rate was lower in individuals with HIV when compared to controls (P < 0.05). No significant difference between amylase enzyme levels and total proteins were observed in the saliva of patients with HIV infection when compared to controls., Conclusion: Individuals with HIV / AIDS infection (in hospital treatment) suffer no interference in levels of amylase and total salivary proteins, but they have significantly reduced salivary flow., (© 2020 Carina de Oliveira N et al.)

Aims: To assess dental maturation in children with amelogenesis imperfecta (AI) and compare their estimated dental age with the age of non-AI children., Methods and Results: Panoramic radiographs of children with (n = 27) and without (n = 54) AI were retrospectively collected in the ratio of 1:2. The former consisted of case group, while the latter figured as control group. Both groups were paired by sex and age (P > .05). Dental maturation was assessed in each radiograph using Demirjian's staging technique and Willems' method. Intra- and interexaminer reproducibility reached >0.8. The mean estimated dental age in subjects with AI was 12.5 ± 2.69 years, while in subjects without AI it was 11.73 ± 2.48 years (P = .21). The comparison of mean chronological (12.26 ± 2.6 years) and estimated dental age (12.5 ± 2.69 years) in subjects with AI did not reveal statistically significant differences (P = .38)., Conclusion: This study highlights the similarity of dental maturation between subjects with and without AI from the radiographic perspective of crown-root formation., (© 2020 Special Care Dentistry Association and Wiley Periodicals, Inc.)

Introduction: Pulp stones are mineral structures that develop in the pulp tissue triggered by several clinical conditions. The exact biochemical process behind the occurrence of pulp stones is uncertain. This study aimed to perform a structural and crystallographic characterization of pulp stones and dentin from extracted human teeth., Methods: The sample consisted of 13 erupted and unerupted permanent human teeth diagnosed with pulp stones. The teeth were analyzed with scanning electron microscopy with secondary and backscattered electrons, energy-dispersive spectroscopy, micro-Raman spectroscopy, micro-X-ray diffraction, and inductively coupled plasma atomic emission spectroscopy., Results: The pulp stones revealed a heterogeneous morphology and structure compared with each other. Compared with the adjacent dentin, the pulp stones had a similar structure. From a chemical point of view, oxygen, calcium, carbon, and phosphorus were the most prevalent chemical elements in the inner part of the stones, whereas on the surface carbon, nitrogen, sulfur, chlorine, aluminum, potassium, zinc, copper, and lead were the most prevalent. Copper, iron, and zinc were higher in the stones than the dentin (P < .05). Statistically significant differences between the chemical structure of stones from erupted and unerupted teeth were not detected (P > .05)., Conclusions: Pulp stones have structural and chemical properties that are similar to dentin. Variations in morphology are common., (Copyright © 2019 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Aims: This study aimed to investigate the morphology of the palate, palatal rugae pattern, and dental arch form in patients with schizophrenia., Methods and Results: An observational case-control study was designed following the STROBE statement and checklist. The sample consisted of 132 patients (39 diagnosed with schizophrenia and 93 controls). Dental casts of the patients were classified based on the pattern of their palatal rugae, their dental arch form, and the area of their palate. The palatal rugae in patients with schizophrenia had a more random distribution and shape compared to the control group (P = .027). Oval dental arches were the most prevalent in both groups (P = .473). The palate area was slightly larger in the control group (3.2318 ± 0.549 mm 2 ) compared with the group of patients with schizophrenia (3.060 ± 0.470 mm 2 ) (P = .090)., Conclusion: Palatal rugae pattern may feature as a potential minor physical anomaly for schizophrenia. Additional studies with alternative sampling and classification systems are necessary to understand this finding and its applications in practice., (© 2019 Special Care Dentistry Association and Wiley Periodicals, Inc.)

Despite decades of therapeutic advances, myocardial infarction remains a leading cause of death worldwide. Recent studies have identified HDLs (high-density lipoproteins) as a potential candidate for mitigating coronary ischemia/reperfusion injury via a broad spectrum of signaling pathways. HDL ligands, such as S1P (sphingosine-1-phosphate), Apo (apolipoprotein) A-I, clusterin, and miRNA, may influence the opening of the mitochondrial channel, insulin sensitivity, and production of vascular autacoids, such as NO, prostacyclin, and endothelin-1. In parallel, antioxidant activity and sequestration of oxidized molecules provided by HDL can attenuate the oxidative stress that triggers ischemia/reperfusion. Nevertheless, during myocardial infarction, oxidation and the capture of oxidized and proinflammatory molecules generate large phenotypic and functional changes in HDL, potentially limiting its beneficial properties. In this review, new findings from cellular and animal models, as well as from clinical studies, will be discussed to describe the cardioprotective benefits of HDL on myocardial infarction. Furthermore, mechanisms by which HDL modulates cardiac function and potential strategies to mitigate postmyocardial infarction risk damage by HDL will be detailed throughout the review.

Background: Endothelial dysfunction (ED) is a hallmark in type 2 diabetes mellitus (T2DM) that favor both atherogenesis and ischemia and reperfusion injury (IRI). Sodium-glucose-2 co-transporter inhibitors (SGLT2i) may hypothetically improve microvascular and macrovascular functions via a broad spectrum of mechanisms, being superior to traditional antidiabetic therapy such as sulfonylurea, even in subjects under equivalent glycemic control. Hence, the present clinical trial was designed to compare the effect of these two treatments on markers of arterial wall function and inflammation in T2DM patients as well as on the potential mediating parameters., Method and Results: ADDENDA-BHS2 is a prospective, single-center, active-controlled, open, randomized trial. Ninety-eight participants (40-70 years old) with HbA1c 7-9% were randomized (1:1, stratified by gender, BMI and HbA1c levels) to either dapagliflozin 10 mg/day or glibenclamide 5 mg/day on top of metformin. The primary endpoint was the change of flow-mediated dilation (FMD) after a 12-week period of treatment evaluated at rest and after IRI between dapagliflozin and glibenclamide arms. Secondary outcomes were defined as the difference between treatments regarding: plasma nitric oxide (NO) change after FMD, plasma isoprostane, plasma levels of vascular inflammatory markers and systemic inflammatory markers, plasma levels of adipokines, anthropometric measures, glucose control parameters, office and ambulatory BP control. Safety endpoints were defined as systolic and diastolic function assessed by echocardiography and retinopathy change. Serious adverse events were recorded. The study protocol was approved by the Independent Scientific Advisory Committee., Conclusion: The ADDENDA-BHS2 trial is an investigator-initiated clinical trial comparing the effect of dapagliflozin versus glibenclamide on several aspects of vascular function in high cardiovascular risk T2DM patients. Besides, a large clinical and biochemical phenotype assessment will be obtained for exploring potential mediations and associations. Trial registration Clinical trial registration: NCT02919345 (September, 2016)., Competing Interests: Competing interestsThe BHS received grant support from AstraZeneca to conduct the Addenda trial. The authors declare that they have no competing interests.

Background and Aims: Coronary reperfusion with HDL from healthy volunteers attenuates ischemia and reperfusion injury in animal models. In myocardial infarction (MI) patients, such an interaction is unclear. Hence, our first objective was to verify if there is interaction between HDL-C and MI mass in patients and the role of coronary reperfusion in the interaction. Furthermore, we investigated whether the effect in MI size of reperfusion with HDL obtained from healthy participants or MI patients could differ., Methods: HDL-C was measured the first day after MI and MI mass was quantified by cardiac magnetic resonance (n = 94) and peak CKMB (n = 393). In an ex vivo rat heart model, we compared MI area and dP/dt max after coronary reperfusion with HDL from MI patients or healthy volunteers., Results: HDL-C above the median (35 mg/dL) was associated with higher peak CKMB [255 (145-415) vs. 136 (84-287) UI/L; p = 0.02], higher MI mass [17 (9-21) vs. 10 (6-14) g; p < 0.01] and lower left ventricular ejection fraction [47 (34-53) vs. 51 (43-59); p = 0.02] than their counterparts. In restricted cubic spline and multivariate linear regression, HDL-C was directly associated with peak CKMB (p < 0.01) and MI mass (p < 0.01) only in reperfused patients with time to reperfusion <4 h. Reperfusion with healthy HDL, but not from MI patients, reduced MI mass (p < 0.01) and improved dP/dt max (p = 0.02)., Conclusions: In MI patients undergoing early coronary reperfusion, HDL-C levels at admission are directly associated with MI size. In contrast to healthy HDL, reperfusion with HDL from MI patients do not reduce MI area in an ex vivo animal model., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Objective: Diabetes is one of the leading causes of cardiovascular mortality. Over the last years, mortality has decreased significantly, more in individuals with diabetes than in healthy ones. That is mostly due to the control of other cardiovascular risk factors. The objective of our study was to analyze the dyslipidemia control in two diabetes cohorts., Methods: Patients from two distinct cohorts were studied, 173 patients from the BHS (Brasília Heart Study) and 222 patients from the BDS (Brazilian Diabetes Study). The data on dyslipidemia control were studied in both different populations. All patients had diabetes., Results: There are significant differences concerning comorbidities between the LDL-C and BDS groups. The average glycated hemoglobin is of 8.2 in the LDL-C > 100 group in comparison with 7.7 and 7.5 in the 70-100 and < 70 groups, respectively (p = 0.024). There is a higher percentage of hypertensive patients with LDL between 70-100 (63.9%), when comparing the < 70 and > 100 groups (54.3% and 54.9%, respectively; p = 0.005). Diastolic pressure is higher in the group with LDL > 100, with an average of 87 mmHg, in comparison with 82.6 mmHg and 81.9 mmHg in the 70-100 and < 70 groups, respectively (p = 0.019). The group with LDL > 100 has the greatest percentage of smokers (8.7%) in comparison with the groups with LDL between 70-100 and < 70 (5.6% and 4.3%, respectively; p = 0.015). There is also a difference in the previous incidence of coronaropathy. In the group with LDL < 70, 28.3% of patients had already experienced a previous infarction, compared with 11.1% and 10.6% in the 70-100 and > 100 groups, respectively (p < 0.001)., Conclusions: The data in our study have shown that the dyslipidemia control in diabetic patients is inadequate and there is a tendency of direct association between lack of blood glucose control and lack of dyslipidemia control, in addition to the association with other cardiovascular risk factors, such as diastolic hypertension and smoking. This worsened control might be related to the plateau in the descending curve of mortality, and investments in this regard can improve the cardiovascular health in diabetic patients.

Background: This study investigated the association between sociodemographic, behavioral, oral health, variables of drug consumption, and the short version of the Oral Health Impact Profile (OHIP-14), in Southern Brazilian drug users., Methods: In this cross-sectional study, 202 drug users aged 18 or over admitted for treatment at the Institute for Research and Treatment of Alcoholism ( Instituto de Pesquisa e Tratamento do Alcoolismo -IPTA) from the municipality of Campo Largo, PR, Brazil, from 2012 to 2014, were involved. They answered a questionnaire and were examined by a calibrated researcher. Data were collected and bivariate (Chi-square test) and multivariate (logistic regression and Wald's test) analyses were performed., Results: There was statistical difference ( P <0.05) in bivariate analysis and the worst impacts were reported by non-whites, those who reported feeling metallic taste in mouth and tooth mobility, which use cigarettes for over 15 yr and consume more than 3 g of crack/day, with DMFT >10, and number of teeth in mouth ≤27. In the multivariate analysis, statistical difference remained, except for ethnicity ( P =0.207)., Conclusion: Self-perception of oral health was associated with the variables explored, which suggests the need for strategies focused on this population., Competing Interests: Conflict of interest The authors declare that there is no conflict of interests.

Background: The transport of lipids from the artery wall is one of the most essential anti-atherogenic functions of high-density lipoprotein (HDL). Recent reports of changes in the HDL composition, during myocardial infarction (MI), suggest that this function may be altered., Methods: Forty-one consecutive patients with ST-segment elevation MI enrolled at the Brasilia Heart Study were selected. The following HDL-related measures were determined upon admission (D1) and on the fifth day (D5) after MI: C-reactive protein, CETP and PLTP activity, HDL composition, efflux of cholesterol from J774 macrophages to HDL, and transfer of unesterified and esterified cholesterol, triglycerides and phospholipids from a donor nanoemulsion to HDL., Results: From D1 to D5, the activity of CETP decreased by 25%, but PLTP activity remained unchanged. Esterified cholesterol (-23%) and phospholipid (-9.5%) contents of HDL decreased. Transfer of triglycerides (-36.5%) and esterified cholesterol (-14.7%) to HDL from nanoemulsions was reduced, but other lipids transfers were unchanged. Cholesterol efflux to HDL was also diminished by 8.5% (p=0.04) on D5 compared to D1. It was more pronounced in patients above the 75th percentile of C-reactive protein., Conclusions: After an MI, a simultaneous decrease in lipid transfer to HDL and in the capacity of HDL to efflux cholesterol from cells occurs. Thus, HDL with inferior atheroprotective properties may be generated in the acute post-MI period., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Aims: To evaluate cytological alterations, inflammation, and microbial charge of the oral mucosa epithelium in crack users in in terms of the amount and duration of use., Methods: Two hundred thirty four crack users (case group) and 120 non-users (control group) participated in this study. Clinically healthy epithelial cells were collected from the posterior mouth floor, using the conventional exfoliative cytology. Some of the aspects evaluated were as follows: Papanicolaou classification, nuclear area (NA), cytoplasmic area (CA), nuclear/cytoplasmic area ratio (NA/CA), inflammation, microbial charge, keratinization, enucleated superficial cells, and binucleation., Results: The average time of crack consumption was 9.8 years (±7.1) and the average quantity of use was 13.97 g/week (±18.5). The average NA values and NA/CA ratio were increased and CA values were decreased in the case group compared to those in the controls (p < 0.05). Papanicolaou class II, intense inflammation, and intense microbial charge were more prevalent in the case group than in the controls (p < 0.05). There was a significant association between high quantity of smoked crack rocks per week and increased CA values, absence of keratinization, and presence of enucleated superficial cells (p < 0.05)., Conclusion: Crack use seemed to induce inflammatory alterations and early indicators of malignant transformation on the oral mucosa epithelium., (© 2017 S. Karger AG, Basel.)

Objective: To analyze the clinical and histopathologic features of all cases diagnosed as lipomas in the oral cavity in a Brazilian population., Method and Materials: From 2002 to 2006, 26 cases of intraoral lipoma were studied. Clinical features obtained from biopsy records and microscopic slides were reviewed according to the World Health Organization and other cases previously described., Results: Mean age was 54.6 years (range, 29 to 91 years) with predilection for women. The buccal mucosa was the most common location (n= 9), followed by the tongue (n= 7), lower lip (n= 4), floor of the mouth (n= 3), retro-molar area (n= 2), and buccalsulcus(n= 1).Histologically, the lesions were defined as classic lipomas(n= 15),fibrolipomas(n= 7), intramuscular lipoma(n= 2), spindle-cell lipoma(n= 1), and sialolipoma(n= 1). Follow-up information was available in 20 cases. No case recurred during a 6- to 12-month period., Conclusion: The benign nature of intraoral lipomas is supported by its bland histopathologic appearance and the absence of recurrences following complete local excision