Background and objectives The calcimimetic cinacalcet reduced the risk of death or cardiovascular (CV) events in older, but not younger, patients with moderate to severe secondary hyperparathyroidism (HPT) who were receiving hemodialysis. To determine whether the lower risk in younger patients might be due to lower baseline CV risk and more frequent use of cointerventions that reduce parathyroid hormone (kidney transplantation, parathyroidectomy, and commercial cinacalcet use), this study examined the effects of cinacalcet in older ($65 years, n=1005) and younger (,65 years, n=2878) patients.Design, setting, participants, & measurements Evaluation of Cinacalcet HCl Therapy to Lower Cardiovascular Events (EVOLVE) was a global, multicenter, randomized placebo-controlled trial in 3883 prevalent patients on hemodialysis, whose outcomes included death, major CV events, and development of severe unremitting HPT. The age subgroup analysis was prespecified.Results Older patients had higher baseline prevalence of diabetes mellitus and CV comorbidity. Annualized rates of kidney transplantation and parathyroidectomy were .3-fold higher in younger relative to older patients and were more frequent in patients randomized to placebo. In older patients, the adjusted relative hazard (95% confidence interval) for the primary composite (CV) end point (cinacalcet versus placebo) was 0.70 (0.60 to 0.81); in younger patients, the relative hazard was 0.97 (0.86 to 1.09). Corresponding adjusted relative hazards for mortality were 0.68 (0.51 to 0.81) and 0.99 (0.86 to 1.13). Reduction in the risk of severe unremitting HPT was similar in both groups. ConclusionsIn the EVOLVE trial, cinacalcet decreased the risk of death and of major CV events in older, but not younger, patients with moderate to severe HPT who were receiving hemodialysis. Effect modification by age may be partly explained by differences in underlying CV risk and differential application of cointerventions that reduce parathyroid hormone.

Aim To report a well succeeded use of cyanoacrylate adhesive for fixating a resorbable membrane during a guided tissue regeneration procedure (GTR). Background The immobilization of membranes in GTR is essential for establishing proper environment for cell differentiation and tissue regeneration. However, some membranes are very difficult to be kept in position by sutures and its fixation by mini screws or pins may be time consuming and expensive. Case description A 47-year-old woman presenting a vertical bone defect at the palatal aspect of the left central incisor was treated by GTR using particulate autogenous bone graft associated to a collagen membrane. The membrane was glued to the bone surrounding the defect and to the tooth surface with cyanoacrylate adhesive. The postoperative period was uneventful and 4 years later, excellent results in terms of radiographic filling of the defect and reduction of the probing depth were seen. For illustrative purposes, histological findings obtained during a previous experiment in calvaria of guinea pigs is shown, characterizing a foreign body granuloma and proving that the cyanoacrylate adhesive is a safe tool in GTR. Conclusion The use of a membrane glued with cyanoacrylate to immobilize membranes in GTR is viable and safe from both technical and biological standpoints and may be advantageous for clinical and research purposes. Clinical significance The alternative method for membrane fixation shown in this case report can contribute to simplify the technique in GTR procedures. How to cite this article de Rezende MLR, de Oliveira Cunha P, Damante CA, Santana ACP, Greghi SLA, Zangrando MSR. Cyanoacrylate Adhesive as an Alternative Tool for Membrane Fixation in Guided Tissue Regeneration. J Contemp Dent Pract 2015;16(6):512-518.

Os fatores de risco já identificados para o desenvolvimento de complicações decorrentes da infecção por COVID-19 são idade, sexo e comorbidades como diabetes, hipertensão, obesidade e doenças cardiovasculares. Devido às manifestações bucais encontradas em pacientes mais graves, a carga viral do COVID-19 pode estar relacionada à doença periodontal. A doença periodontal é uma doença infecciosa caracterizada pela destruição da estrutura de suporte dentária, permitindo que as bactérias entrem na corrente sanguínea e se espalhem para órgãos distantes, afetando assim o aparecimento e o desenvolvimento de infecções pulmonares. Acredita-se que as bolsas periodontais sirvam de depósito para o vírus SARS-CoV-2, ocasionando o agravamento dos sintomas de pacientes infectados. Essas alterações sistêmicas representam um risco aumentado e podem levar a um mau prognóstico da COVID-19. Conclusão: É necessário enfatizar que manter a higiene oral e a doença periodontal sob controle reduz a gravidade dos sintomas da COVID-19 e a morbidade relacionada.

Objective: Gestational diabetes mellitus (GDM) causes maternal and infant morbidity. Periodontitis is associated with adverse pregnancy outcomes. The aim of this study was to evaluate periodontal status, prematurity and associated factors in pregnant women with and without GDM. Subjects and methods: This observational cross-sectional study included 80 pregnant women with GDM (G1 = 40) and without GDM (G2 = 40). Demographic and socioeconomic status, systemic and periodontal health condition, prematurity and newborns' birth weight were analyzed. For bivariate analysis, Mann-Whitney U-test, t test and Chi-squared test were used. Binary logistic regression analyzed independent variables for periodontitis and prematurity (p < 0.05). Results: Patients from G1 presented lower socioeconomic status, higher weight and body mass index (BMI). Prematurity (G1 = 27.5%; G2 = 2.5%; p < 0.05) and severe periodontitis percentages (G1 = 22.5%; G2 = 0; p = 0.001) were higher in G1 than in G2. Logistic regression analysis showed that household monthly income (OR = 0.65; 95% CI 0.48 -0.86; p = 0.003) and maternal BMI (adjusted OR = 1.12; 95% CI 1.01-1.25; p = 0.028) were significant predictors of periodontitis during the third trimester of pregnancy. Presence of GDM remained in the final logistic model related to prematurity (adjusted OR = 14.79; 95% CI 1.80-121.13; p = 0.012). Conclusions: Pregnant women with GDM presented higher severity of periodontitis, lower socioeconomic status, higher overweight/obesity and a 10-fold higher risk of prematurity. Socioeconomic-cultural status and BMI were significant predictors for periodontitis, and GDM was a predictor to prematurity.

Aos meus pais, Eudes Cunha e Silvia de Oliveira, pelo apoio, incentivo, compreensão e torcida durante todos os anos que estive ausente. Sabendo das histórias de vocês durante a vida escolar até a obtenção do nível Superior, regozijome em dizer que vocês conseguiram mais uma vez. Esse título é nosso.Ao meu irmão, Eudes Junior, pela paciência e assistência em todos meus pedidos (desesperados) por ajuda com notebooks, tabelas, configurações, impressora, arquivo que some, quando ele mesmo tinha dificuldades técnicas por morar no interior do Amazonas. Desculpa, mas os pedidos ainda vão continuar. À minha irmã, Maria Fernanda (MF), que mesmo tão pequena mandava ânimo através de seus áudios e fotos. Agora não precisa mais me convidar para o seu aniversário com 6 meses de antecedência.

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