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- Association of periodontitis with cognitive decline and its progression : contribution of blood-based biomarkers of Alzheimer's disease to this relationshipPublication . Carballo, Álvaro; López-Dequidt, Iria; Custodia, Antía; Botelho, João; Aramburu-Núñez, Marta; Machado, Vanessa; Pías-Peleteiro, Juan Manuel; Ouro, Alberto; Romaus-Sanjurjo, Daniel; Vázquez-Vázquez, Laura; Jiménez-Martín, Isabel; Aguiar, Pablo; Rodríguez-Yáñez, Manuel; Aldrey, José Manuel; Blanco, Juan; Castillo, José; Sobrino, Tomás; Leira, YagoAim: To assess whether periodontitis is associated with cognitive decline and its progression as well as with certain blood-based markers of Alzheimer's disease. Materials and Methods: Data from a 2-year follow-up prospective cohort study (n = 101) was analysed. Participants with a previous history of hypertension and aged ≥60 years were included in the analysis. All of them received a full-mouth periodontal examination and cognitive function assessments (Addenbrooke's Cognitive Examination (ACE) and Mini-Mental State Examination [MMSE]). Plasma levels of amyloid beta (Aβ)1-40, Aβ1-42, phosphorylated and total Tau (p-Tau and t-Tau) were determined at baseline, 12 and 24 months. Results: Periodontitis was associated with poor cognitive performance (MMSE: β = −1.5 [0.6]) and progression of cognitive impairment (hazard ratio [HR] = 1.8; 95% confidence interval: 1.0–3.1). Subjects with periodontitis showed greater baseline levels of p-Tau (1.6 [0.7] vs. 1.2 [0.2] pg/mL, p < .001) and Aβ1-40 (242.1 [77.3] vs. 208.2 [73.8] pg/mL, p = .036) compared with those without periodontitis. Concentrations of the latter protein also increased over time only in the periodontitis group (p = .005). Conclusions: Periodontitis is associated with cognitive decline and its progression in elderly patients with a previous history of hypertension. Overexpression of p-Tau and Aβ1-40 may play a role in this association.
- Association of Herpesvirus and Periodontitis : a clinical and laboratorial case–control studyPublication . Picolo, Marta; Nobre, Miguel A de Araújo; Salvado, Francisco; Barroso, HelenaObjectives: A significant influence of the Herpesviridae family in the progression of periodontal disease has been suggested. The aim of this study was to investigate the potential association of four Herpesviruses (HSV-1, HSV-2, cytomegalovirus [CMV], and Epstein-Barr virus [EBV]) with periodontal disease using a qualitative test for evaluating the presence or absence of viral DNA in crevicular fluid samples of both healthy periodontal patients and periodontal compromised patients. Materials and methods: A case-control study was conducted in 100 participants at a university clinic. A qualitative test was used for evaluating the presence/absence of viral DNA in crevicular fluid samples of both healthy periodontal patients and periodontal compromised patients, and considering the periodontitis staging (stage II, stage III, and stage IV) and grading (grade A, grade B, and grade C). Statistical analysis: The distribution of the same exposure variables to the periodontitis staging and grading was compared using Chi-square, Fisher's exact, and Gamma tests depending on the variable characteristics. The significance level was set at 5%. The association of the variables: age, sex, diabetes, smoking, alcohol, and oral hygiene was also considered. Results: The prevalence of Herpesviridae family virus DNA was 6% for the periodontal healthy group and 60% for the periodontitis group (roughly 60% on periodontitis stages II, III, and IV, p <0.001; and twofold increase in moderate and rapid progression grades compared with the slow progression grade, p <0.001). HSV1 DNA was prevalent in all periodontitis stages and grades. HSV 2, EBV, and CMV DNA had increasing prevalence rates in more severe stages (stages III and IV, p <0.001); while considering periodontitis grade, HSV2 (p = 0.001), CMV (p = 0.019) and EBV (p <0.001) DNA were prevalent only in grades B and C, with EBV DNA registering a marked prevalence in grade C. Conclusion: A significant different distribution of Herpesviridae virus DNA per each stage of disease was registered.
- Association between periodontitis and peripheral markers of innate immunity activation and inflammationPublication . Dopico, José; Botelho, João; Ouro, Alberto; Domínguez, Clara; Machado, Vanessa; Aramburu-Nuñez, Marta; Custodia, Antía; Blanco, Teresa; Vázquez-Reza, María; Romaus-Sanjurjo, Daniel; Blanco, Juan; Leira, Rogelio; Sobrino, Tomás; Leira, YagoBackground: Immune response leading to increased systemic inflammation is one of the mechanisms linking periodontitis to chronic inflammatory diseases. The aim of this study was to compare the expression of toll-like receptors 2 and 4 in monocytes and neutrophils (TLR2M, TLR2N, TLR4M, and TLR4N) and its endogenous ligands (cellular fibronectin [cFN] and heat shock protein 60 [HSP60]) in patients with and without periodontitis. Additionally, the relationship between cFN and HSP60 expression with innate immunity activation and systemic inflammatory response (interleukin 6 [IL-6]) was also evaluated. Methods: A case-controlled study was designed in which 30 patients with periodontitis (cases) and 30 age- and sex-matched participants without periodontitis (controls) were included. Fasting blood samples were collected to determine: (1) expression of TLR2N, TLR2M, TLR4N, and TLR4M by flow cytometry; and (2) serum concentrations of cFN, HSP60, and IL-6 by ELISA technique. Results: Expression of TLR2M (411.5 [314.2, 460.0] vs. 236.5 [204.0, 333.0] AFU), TLR2N (387.0 [332.0, 545.5] vs 230.0 [166.2, 277.7] AFU), TLR4M (2478.5 [1762.2, 2828.0] vs 1705.0 [1274.5, 1951.2] AFU), and TLR4N (2791.0 [2306.7, 3226.2] vs. 1866.0 [1547.5, 2687.2] AFU) as well as serum levels of cFN (301.1 [222.2, 410.9] vs. 156.4 [115.3, 194.0] ng/ml) and IL-6 (10.4 [6.5, 11.5] vs. 3.5 [2.6, 4.9] pg/ml) were significantly higher in periodontitis patients than those without periodontitis. A positive association was found between periodontitis and cFN (odds ratio [OR] = 1.028, p < 0.001), TLR2N (OR = 1.026, p < 0.001), TLR4M (OR = 1.001, p = 0.002), and IL-6 (OR = 1.774, p < 0.001). Conclusions: Periodontitis patients exhibited high expression of TLRs, cFN, and IL-6.
- Association between culture and the preference for, and perceptions of, 11 routes of medicine administration : a survey in 21 countries and regionsPublication . Murdan, Sudaxshina; Wei, Li; Riet-Nales, Diana A. van; Gurmu, Abyot Endale; Usifoh, Stella Folajole; Tăerel, Adriana-Elena; Yıldız-Peköz, Ayca; Krajnović, Dušanka; Azzopardi, Lilian M.; Brock, Tina; Fernandes, Ana I.; Santos, André Luis Souza dos; Anto, Berko Panyin; Vallet, Thibault; Lee, Eunkyung Euni; Jeong, Kyeong Hye; Akel, Marwan; Tam, Eliza; Volmer, Daisy; Douss, Tawfik; Shukla, Sharvari; Yamamura, Shigeo; Lou, Xiaoe; Riet, Bauke H.G. van; Usifoh, Cyril O.; Duwiejua, Mahama; Ruiz, Fabrice; Furnham, AdrianMedicines can be taken by various routes of administration. These can impact the effects and perceptions of medicines. The literature about individuals' preferences for and perceptions of the different routes of administration is sparse, but indicates a potential influence of culture. Our aim was to determine: (i) any association between one's culture and one's preferred route of medicine administration and (ii) individual perceptions of pain, efficacy, speed of action and acceptability when medicines are swallowed or placed in the mouth, under the tongue, in the nose, eye, ear, lungs, rectum, vagina, on the skin, or areinjected. A cross-sectional, questionnaire-based survey of adults was conducted in 21 countries and regions of the world, namely, Tunisia, Ghana, Nigeria, Turkey, Ethiopia, Lebanon, Malta, Brazil, Great Britain, United States, India, Serbia, Romania, Portugal, France, Netherlands, Japan, South Korea, Hong Kong, mainland China and Estonia, using the Inglehart–Welzel cultural map to ensure coverage across all cultures. Participants scored the pain/discomfort, efficacy, speed of onset and acceptability of the different routes of medicine administration and stated their preferred route. Demographic information was collected. A total of 4435 participants took part in the survey. Overall, the oral route was the most preferred route, followed by injection, while the rectal route was the least preferred. While the oral route was the most preferred in all cultures, the percentage of participants selecting this route varied, from 98% in Protestant Europe to 50% in the African-Islamic culture. A multinomial logistic regression model revealed a number of predictors for the preferred route. Injections were favoured in the Baltic, South Asia, Latin America and African-Islamic cultures while dermal administration was favoured in Catholic Europe, Baltic and Latin America cultures. A marked association was found between culture and the preference for, and perceptions of the different routes by which medicines are taken. This applied to even the least favoured routes (vaginal and rectal). Only women were asked about the vaginal route, and our data shows that the vaginal route was slightly more popular than the rectal one.
- Automedicação : algumas reflexões sociológicasPublication . Lopes, Noémia MendesCom base num projecto de investigação em curso, apresentam-se neste artigo algumas reflexões sociológicas sobre a automedicação, que representam um primeiro patamar de aproximação analítica a este fenómeno e à sua constituição em objecto sociológico. Numa primeira linha de reflexão, equacionam-se as estratégias profissionais de poder que se desenvolvem em torno da automedicação, procurando dar visibilidade às transmutações sociais de que a mesma vem sendo objecto. Numa segunda linha de reflexão, e a partir de alguns dados empíricos já analisados, o fenómeno é enunciado como uma expressão da apropriação leiga dos saberes profissionais, em que se revelam diferentes modalidades de apropriação e de percepção social do risco, com desiguais configurações em diferentes grupos sociais. Numa última linha de reflexão, equaciona-se um conjunto de contributos teóricos para a interpretação das pistas analíticas encontradas.
- Polícias, trabalho e consumos de performancePublication . Gonçalves, Carlos Manuel; Tavares, David; Lopes, Noémia; Elias, RúbenO equacionamento das relações entre natureza do trabalho e os consumos de performance (medicamentos, suplementos alimentares e outros produtos naturais) para a melhoria do desempenho físico, intelectual e social do grupo profissional dos polícias, que integram a Polícia de Segurança Pública, é o objeto central do presente artigo. O recurso a tal tipo de consumos é um fenómeno social com relativa disseminação cultural no âmbito dos processos de farmacologização. O presente estudo baseou-se numa metodologia mista que incluiu análise documental, entrevistas semidiretivas, grupos focais e inquérito por questionário. Conclui-se que os fatores de pressão social integrantes da natureza e condições do trabalho policial configuram um contexto laboral, diverso em tarefas, permeado pelo risco e pelo julgamento público e institucional, em que os consumos de performance são relevantes no desempenho profissional.
- Nurses under pressure : the demands of professional performance and their management through the use of medicationPublication . Raposo, Hélder; Egreja, Catarina; Lopes, NoémiaThis article discusses the relationship between the demands on nurses’ professional performance and adherence to the use of medicines and supplements for their management. This approach allows us to analyze the transformations of nursing work and how nurses use various natural and pharmaceutical resources to cope with the pressures they face in their professional activities. To understand the interconnection between the transformations in nursing work and what we refer to here as the process of pharmaceuticalisation of work contexts, we use the results of a sociological mixed methods study on the use of medicines and food supplements for managing professional performance. The results show some of the main pressure factors in nursing work and how the increase in professional pressure substantially affects performance-related medicine use, as these become more frequent when nurses perceive their work as more intense, demanding, and exposed to risks.
- Medicines and medication literacy : social practices and use of informationPublication . Lopes, Noémia; Pegado, Elsa; Egreja, Catarina; Rodrigues, Carla; Fernandes, Ana IsabelThis article discusses results from a sociological study on (i) the sources and use of information on medicines and/or supplements and (ii) the self-assessment of how informed participants were about the last medicine or supplement they purchased. It seeks to demonstrate the plurality of information sources (expert and lay) that individuals call upon—with which they build up their medication literacy—and their perception of the information they have. While these social components of literacy are scarcely visible in available studies, the need to produce knowledge on them is a requisite for a more laypeople-centred approach in public policies seeking to promote medication literacy. A questionnaire was applied in-person (n = 1107) in urban pharmacies in Lisbon and Porto (Portugal). Results show expert information (medical and pharmaceutical) as the dominant reference, followed by lay sources (family/friends/colleagues), while digital sources were less valued than interpersonal ones. This interpersonal dimension was a relevant factor in the building of trust in information. The self-assessment of the information on medication was higher in functional literacy and lower in comprehensive literacy. Studies on medication literacy are particularly relevant in the current context of the expansion and diversification of medicines’ use and of individuals’ growing autonomy in their consumption habits.
- Medication literacy and its social contextualityPublication . Lopes, Noémia; Rodrigues, Carla; Pegado, ElsaThis article aims to contribute to the discussion about medication literacy, by focussing on the social contextuality of the information mobilised in the use of medicines. We aim to explore the social construction processes of medication literacy, as an essential dimension for a more layperson-centred approach in the promotion of literacy in this field. This approach is justified by the growing social and cultural dissemination of medication use, the diversification of its uses beyond health and illness, and the increasing degree of lay autonomy in managing its use. The article is organised in two main sections. In the first section, we review the social history of medication literacy, including a discussion of the social contextuality of literacy phenomena. In the second section, the analysis of social contextuality is operationalised with a focus on information, covering: (i) ways of relating to institutional information and sources of information about medication; (ii) contexts of sociability in which information is shared and validated. This analysis is empirically supported by selected results from two research projects, conducted in Portugal, on the consumption of medicines and dietary supplements for performance purposes – that is, for the management and/or improvement of cognitive, bodily or relational performance.
- Medication use for the management of professional performance : between invisibility and social normalisationPublication . Lopes, Noémia; Tavares, David; Pegado, Elsa; Raposo, Hélder; Rodrigues, CarlaThis article aims to explore pharmaceuticalisation processes in professional work contexts. The approach focuses on identifying patterns of medicine and dietary supplement use for managing work performance, and on discussing the relationship between these consumption practices and work-related pressure factors. This analysis adapts the notions of ‘normalisation’ to understand the extent of cultural acceptability of these practices, and the notion of ‘differentiated normalisation’ to capture the tension between the trend towards normalisation of such consumption and its partial social (in)visibility within work settings. Empirical support for this analysis is based on a sociological study conducted in Portugal on professions under high performance pressures. The study involved three professional groups – nurses, journalists and police officers. A mixed methods approach was used, including focus groups, questionnaires and semi-structured interviews. Overall, the results show a trend towards the use of medicines and supplements for performance management, which reveals itself as a cultural response to work-related social pressures. Such consumption coexists with irregular patterns of either occasional or long-term use, as well as heterogeneous processes of ‘normalisation’ and ‘hidden’ consumption. Conclusions point to a social interconnection between the intensification of work pressures and the pharmaceuticalisation of work performance.