RESUMO A esclerose múltipla é uma doença imunomediada do sistema nervoso central. Seu tratamento tem sido focado no controle da inflamação o mais cedo possível para evitar incapacidade. O transplante autólogo de células tronco hematopoiéticas (TACTH) vem sendo usado para tratar esclerose múltipla desde 1996, e recentes resultados foram decisivos a respeito do benefício na eficácia a longo prazo. Cinco pacientes seguidos num centro de esclerose múltipla de Belo Horizonte, Brasil, que apresentavam forma clínica remitente recorrente com alta atividade de doença foram submetidos a esse tratamento de 2009 a 2011. Após o transplante foram avaliados clinicamente e com ressonância magnética, e escala de EDSS, a cada seis meses até julho de 2018. Os pacientes eram quatro mulheres e um homem, com idade entre 25 e 50 anos e tempo de doença variando de 4 a 17 anos na época do procedimento. Quatro pacientes melhoraram após a primeira avaliação e um manteve-se estável. Todos os pacientes permaneceram sem evidência de doença clínica ou radiológica de 5 a 9 anos após. Com uma seleção cada vez mais criteriosa de pacientes o TACTH pode interromper a disseminação do epítopo e controlar a progressão da doença. Apesar de várias outras opções terapêuticas aprovadas para esclerose múltipla o TACTH continua a ser uma forma de tratamento a ser considerada em casos de doença muito agressiva.

ABSTRACT Multiple sclerosis (MS) is an immune-mediated disease of the central nervous system. Its treatment has focused on inflammation control as early as possible to avoid disability. Autologous hematopoietic stem cell transplantation (AHSCT) has been used for treating MS since 1996, with recent decisive results regarding benefits in long-term efficacy. Five patients followed up at an MS center in Belo Horizonte, Brazil, who had relapsing-remitting MS with high disease activity, underwent AHSCT between 2009 and 2011. They were evaluated clinically, with magnetic resonance imaging, and by the EDSS every six months after transplantation, up to July 2018. The patients were four women and one man, with ages ranging from 25-50 years, and time since disease onset ranging from 4-17 years at the time of the procedure. Four patients improved, one patient was stabilized, and all patients were free of disease activity after 5-9 years. Through improving patient selection and decreasing the time from disease onset, AHSCT could stop epitope spreading and disease progression. Despite multiple other therapeutic choices being approved for relapsing-remitting MS, AHSCT continues to be a treatment to consider for aggressive MS disease.

Resumo Na busca do tratamento ideal da doença periodontal varias são técnicas não-cirúrgicas que podem ser consideradas. O objetivo deste estudo foi avaliar a eficácia da técnica de desinfecção total de boca (FMD, na sigla em Inglês) por parâmetros clínicos e microbiológicos. Foram avaliados 670 indivíduos com 230 indivíduos atendendo aos critérios de seleção e divididos em dois grupos; 115 indivíduos tratados com FMD e 115 tratados com sessões semanais de raspagem e alisamento corono radicular (SRP, na sigla em Inglês). A população avaliada tinha idade média de 51,67 anos, com periodontite crônica moderada. Os sujeitos foram avaliados antes do tratamento (T1) e 90 dias após a execução da terapia (T2), quanto à profundidade de sondagem (PS), nível de inserção clínica (NIC), índice de placa (IP), índice gengival (IG) e detecção microbiana da presença de Porphyromonas gingivalis (P.g.) e Prevotella intermedia (P.i.) por método de cultura e confirmada por testes bioquímicos. Os indivíduos tratados no grupo FMD também realizaram bochechos com clorexidina 0,12% durante sete dias após o tratamento. Os resultados foram analisados utilizando o teste estatístico t de Student e o teste de qui-quadrado. Não foram observadas diferenças estatisticamente significativas para PS e NIC entre T1 e T2 em ambos os grupos. Para IG e IP observou-se diferença significativa entre os grupos. Para os parâmetros microbianos avaliados foi observada redução de P.g. e P.i., mas apenas para P.g. com uma redução significativa em ambos os grupos. A técnica FMD com a metodologia utilizada neste estudo proporcionou condições clínicas melhoradas e redução da P.g. Em indivíduos com periodontite moderada, otimizando o tempo gasto na execução terapêutica.

Abstract In the search for the ideal treatment of periodontal disease various non-surgical techniques should be considered. The objective of this study was to evaluate the efficacy of full-mouth scaling (FMS) by clinical and microbiological parameters. 670 individuals were evaluated with 230 subjects meeting the selection criteria and were divided into two groups; 115 subjects treated with FMS and 115 treated with weekly sessions of scaling and root planning (SRP). The patient population had a mean age of 51.67 years, with moderate chronic periodontitis. Subjects were evaluated prior to treatment (T1) and 90 days after execution of therapy (T2), with regards to: probing depth (PD), clinical attachment level (CAL), plaque index (PI), gingival index (GI), and microbial detection for the presence of Porphyromonas gingivalis (P.g.) and Prevotella intermedia (P.i.) by culture method and confirmed by biochemical tests. Subjects treated in the FMS group also rinsed with 0.12% chlorhexidine mouthwash for seven days following treatment. The results were analyzed using statistical Student’s t-test and chi-square test. No statistically significant differences were observed for PD and CAL between T1 and T2 in both groups. For GI and PI significant difference was observed between the groups. For the evaluated microbial parameters was observed reduction of P.g. and P.i., but only for P.g. with a significant reduction in both groups. The full mouth scaling technique with the methodology used in this study provided improved clinical conditions and reduction of P.g. in subjects with moderate periodontitis, optimizing the time spent in the therapeutic execution.

Studies have suggested that A. actinomycetemcomitans is involved in the aetiology of aggressive periodontitis as well as in chronic periodontitis. This study was aimed at elucidating the occurrence of A. actinomycetemcomitans in a Brazilian population with chronic periodontitis. A total of 555 (mean age 33.04 ± 12.45) individuals, living in two large areas of the São Paulo State, namely "Baixada Santista" and "Vale do Paraíba", and diagnosed with mild [180 (mean age 29.59 ± 10.94)], moderate [241 (mean age 31.18 ± 11.45)] or severe [134 (mean age 33.04 ± 12.45)] chronic periodontitis were enrolled in this survey. Clinical exams including measurements of Probing Depth, Clinical Attachment Loss, Plaque and Gingival indices and subgingival microbiological assessments were performed at all population. The genomic DNA of A. actinomycetemcomitans was identified by Polymerase Chain Reaction from periodontal pocket samples. The occurrence of A. actinomycetemcomitans among chronic periodontitis subjects as well as its association with age and gender were statistically analysed using the Chi-square and Odds Ratio tests. The significance of differences was established at 5% (p < 0.05). A. actinomycetemcomitans was detected in 102 (18.37%) individuals: 29 (16.11%) mild; 42 (17.42%) moderate; and 31 (23.13%) severe chronic periodontitis with no statistical difference among groups. A higher occurrence of the searched bacterium was found both in the youngest group (p < 0.05) as well as in the female group (p < 0.05). This study elucidated that A. actinomycetemcomitans harbored subgingival pockets of our target group of chronic periodontitis subjects and that this bacterium seems to be inversely related to age, but related to the female gender.

Quinze amostras de iogurtes comerciais foram analisadas quanto ao teor de ácido benzóico e sórbico, por meio de cromatografia líquida de alta performance de acordo com Ito et al. (1983). O teor de ácido sórbico em todas as amostras encontrava-se dentro dos limites estabelecidos por lei. O rótulo de três amostras não continham a especificação (P.IV). O ácido benzóico foi encontrado em todas as amostras. Devido a fermentação lática, nenhuma amostra declarava a adição do ácido benzóico no rótulo.

Fifteen samples of different commercial yogurt were analyzed for benzoic and sorbic acid contents, using the high performance liquid chromatography method of Ito et al. (1983). The leve of sorbic acid in all samples was within the legal limits. Three of the commercial yogurt did not show label specifications for sorbic acid. Benzoic acid was detected in all samples as a result of lactic fermentation but none of them showed any specifications on their label.