In general, infectious diseases are more frequent and/or serious in patients with diabetes mellitus, which potentially increases their morbimortality. The greater frequency of infections in diabetic patients is caused by the hyperglycemic environment that favors immune dysfunction (e.g., damage to the neutrophil function, depression of the antioxidant system, and humoral immunity), micro- and macro-angiopathies, neuropathy, decrease in the antibacterial activity of urine, gastrointestinal and urinary dysmotility, and greater number of medical interventions in these patients. The infections affect all organs and systems. Some of these problems are seen mostly in diabetic people, such as foot infections, malignant external otitis, rhinocerebral mucormycosis, and gangrenous cholecystitis. In addition to the increased morbidity, infectious processes may be the first manifestation of diabetes mellitus or the precipitating factors for complications inherent to the disease, such as diabetic ketoacidosis and hypoglycemia. Immunization with anti-pneumococcal and influenza vaccines is recommended to reduce hospitalizations, deaths, and medical expenses.

RESUMOObjetivo: Revisão sistemática do conhecimento atual sobre a associação entre diabetes melito (DM) e doença periodontal (DP) com ênfase na sua fisiopatogenia. Fonte de dados: Pesquisa bibliográfica, nos últimos cinco anos, através dos bancos de dados MEDLINE e LILACS, usando as palavras-chaves "diabetes mellitus", "periodontal disease" e "periodontitis". Síntese dos dados: Os tecidos periodontais são as estruturas bucais mais afetadas pelo DM. O DM predispõe ao desenvolvimento da DP, a qual leva ao descontrole glicêmico, o que ressalta a importância da relação bidirecional entre essas duas doenças. Vários mecanismos estão envolvidos na fisiopatologia da DP associada ao DM: produção de produtos de glicosilação avançada, deficiente resposta imune, herança de determinados polimorfismos genéticos, alterações dos vasos sanguíneos, tecido conjuntivo e composição salivar. Na fase inicial predominam a gengivite e periodontite. Se não detectados precocemente, esses problemas podem evoluir para doença periodontal avançada. Puberdade, maior duração da doença, mau controle metabólico e higiene bucal inadequada são fatores que contribuem para progressão e agressividade da DP. Conclusão: O melhor conhecimento dos mecanismos envolvidos na fisiopatogenia da DP associada ao DM auxiliará na instituição de medidas preventivas e terapêuticas precoces. É importante que médicos e dentistas orientem os pacientes com DM sobre a necessidade de bom controle glicêmico e higiene bucal adequada para minimizar os riscos de doença periodontal. Objective: Systematic review of present knowledge about the association between diabetes mellitus (DM) and periodontal disease (PD) with emphasis on their physiopathogenesis. Data sources: Bibliographic search through MEDLINE and LILACS databases, in the last five years, using the following descriptors: "diabetes mellitus", "periodontal disease", and "periodontitis". Summary of data: Periodontal tissues are the oral structures most affected by DM. DM predisposes to the development of PD, which leads to loss of glycemic control, which emphasizes the importance of the two-way relationship between these two diseases. Several mechanisms are involved in the physiopathology of PD associated with DM: production of advanced glycosilation products, deficient immune response, inheritance of certain genetic polymorphisms, alterations in blood vessels, conjunctive tissue and salivary composition. In the initial phase, gingivitis and periodontitis predominate. If not detected early, these problems can develop into advanced periodontal disease. Puberty, with its hormonal alterations, longer duration of the disease, poor metabolic control and inadequate oral hygiene are factors that contribute to PD progression and aggressiveness. Conclusion: Better knowledge about the mechanisms involved in the physiopathogenesis of PD associated with DM would help to institute early preventive and therapeutic measures. It is important for doctors and dentists to instruct their patients with DM about the need for good glycemic c...

The lower salivary flow rate in diabetics could have been related to their higher GBI. The higher GBI in the diabetics is a matter of concern in the diabetics and is a sign for higher chances of developing periodontal problems.

This study evaluated the oral health knowledge and habits in Brazilian children with type 1 diabetes mellitus (T1DM). A cross-sectional study was performed between November of 2005 and April of 2006 in a public health university hospital, interviewing 55 diabetic children and 55 non-diabetic control children with a semi-structured questionnaire. As much as 55% of the diabetic children and 35.5% of the non-diabetic children were males with mean age of 11.3 ± 3.7 years and 11.2 ± 3.8 years, respectively. The mean duration of the T1DM was of 4.5 ± 0.8 years. Almost half of the diabetic and non-diabetic children brushed their teeth three times a day. Dental floss was used once a day by 30.9% of diabetics and 18.0% of control subjects. A total of 27% of the diabetics vs. 54.5% of non-diabetics had gingival bleeding. The dentist was aware of the T1DM in 74.5% of the cases. As much as 63.8% of the diabetic subjects had been to the dentist within the previous 12 months. In conclusion, although the diabetic children seemed to have better oral health habits than the control children, there is a need for more information regarding oral hygiene and healthy habits.

<strong style="text-align: justify;"><span style="font-size: 10pt; font-family: 'Times New Roman', serif;">Introdução</span></strong><span style="text-align: justify; font-size: 10pt; font-family: 'Times New Roman', serif;">: Após a implantação do Programa Nacional de Atenção à Saúde Auditiva (PNASA), em 2004, houve incontestáveis avanços na assistência ao deficiente auditivo. Porém, existem divergências na execução desse programa que dificultam o seu progresso e limitam o acesso à Saúde Auditiva. Tais evidências ilustram a necessidade da criação de uma rotina para avaliá-lo a fim de reorientar e monitorar as práticas dos atores envolvidos. <strong>Objetivo:</strong> Analisar os progressos e entraves da Política de Saúde Auditiva do país na atual conjuntura brasileira. <strong>Metodologia</strong>: Trata-se de um estudo exploratório com abordagem quantitativa realizado no período de junho a agosto de 2013, através da análise de dados secundários (SAI/SUS e CNES). <strong>Conclusão</strong>: Observou-se que a implantação do PNASA não é uniforme no país. A disparidade está evidenciada na cobertura nacional e distribuição local desse serviço, o que denota um imenso contingente de deficientes auditivos não contemplados com a assistência à Saúde Auditiva, ferindo os princípios de integralidade e universalidade do SUS.</span>

Many studies have tried to identify genetic markers for infectious diseases, some of them have focused on human leukocyte antigens (HLA). The products of HLA genes interact with surfacespecific receptors of T lymphocytes, resulting in activation of the host's immune response. Association of bacterial, viral, parasitic and fungal infections with the host's HLA has been widely investigated. The type and strength of this association differs among distinct populations, as well as among racial and/or ethnic groups. The new molecular methods for the identification of the HLA alleles, and the resulting new nomenclature, have contributed to a better understanding of this system. Unfortunately, this information has not been adequately transmitted to clinicians, which hampers the understanding of the association between the HLA system and diseases. We revised relevant studies on the association of HLA genes with infectious diseases, demonstrating their importance in the pathogenic mechanisms, through increased susceptibility or protection against infections and their complications.

No abstract

The evaluation of the salivary flow rate is important in several situations of dental practice. However, weighing the collected salivary volume it is not a practical method in public health services. This work evaluated the use of hypodermic graduated syringes as a simpler alternative method to measure the salivary flow rate. Saliva samples were obtained from 50 individuals (31 females and 19 males) aged 8 to 32 years (mean age: 12.4 years), recruited at the outpatient dental clinics of two public health centers. After collection, the saliva was weighed in a graduated scale and the results compared with the volume obtained through its measurement, in mL, in graduated hypodermic syringes. There was a positive and significant relationship between the two methods of measuring salivary flow rates as demonstrated by the Pearson's correlation coefficient (r = 0.996, with p<0.05). Measurement of the salivary flow rate using graduated syringes demonstrated to be a reliable method, with lower cost and more practical than the traditional method of salivary weighing.