Relação entre condição periodontal, marcadores do metabolismo glicêmico e parâmetros bioquímicos e hematológicos em pacientes transplantados renais
Ano de defesa: | 2023 |
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Autor(a) principal: | |
Orientador(a): | |
Banca de defesa: | , , , , |
Tipo de documento: | Tese |
Tipo de acesso: | Acesso aberto |
Idioma: | por |
Instituição de defesa: |
Universidade Federal do Maranhão
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Programa de Pós-Graduação: |
PROGRAMA DE PÓS-GRADUAÇÃO EM ODONTOLOGIA/CCBS
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Departamento: |
DEPARTAMENTO DE ODONTOLOGIA II/CCBS
|
País: |
Brasil
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Palavras-chave em Português: | |
Palavras-chave em Inglês: | |
Área do conhecimento CNPq: | |
Link de acesso: | https://tedebc.ufma.br/jspui/handle/tede/tede/5132 |
Resumo: | The high prevalence of periodontal disease in individuals with chronic kidney disease has been consistently reported in the literature. Evidence has reinforced that there is a possible relationship between periodontal inflammation and systemic changes in chronic kidney disease patients. However, there was a lack of intervention studies that aim to analyze whether there is an impact of non-surgical periodontal therapy (NSPT) on these systemic markers. Thus, the present thesis had the following objectives: [1] to investigate the relationship between the periodontal status and markers of the glycemic level in kidney transplant recipients; and [2] to analyze the effect of NSPT on clinical outcomes and serum markers of individuals after kidney transplantation (KTx). This thesis consists of two chapters. In the first one, the objective was to investigate the relationship between periodontal condition and hyperglycemia in patients after KTx, through a cross-sectional study that analyzed 44 kidney transplant patients, 25 men and 19 women with a median age of 43 years. The severity of periodontitis was categorized into stages I to IV and hyperglycemia was analyzed at different fasting blood glucose (FBG) cutoff points (100 mg/dL, 110 mg/dL, 120 mg/dL, 126 mg/dL, 140 mg/dL). Age, smoking history, previous type 2 diabetes mellitus (DM2) and previous cardiovascular disease (CVD) were considered cofactors. Multivariate logistic regression modeling was performed with periodontitis as exposure and hyperglycemia as outcome. Pathway analysis was performed with the FBG as a continuous outcome. As results, it was observed that patients with periodontitis had increased odds of hyperglycemia from 120 mg/dL FBG cutoff in KTx recipients, even after adjustments. Additionally, periodontitis severity was positively associated with FBG level (β = 0.323, SE = 0.127, P = 0.011) in KTx recipients. These findings suggest that periodontitis may be related to increased hyperglycemia and FBG levels in KTx patients. The second chapter presents an intervention study, carried out with 20 kidney transplant patients (9 women and 11 men, with an average age of 44.4 years), which aimed to analyze the effect of NSPT on white blood cell (WBC) count, fasting blood glucose, hemoglobin, hematocrit, creatinine and uric acid in these patients. Periodontal and serum data collection was performed at baseline (before NSPT) and 90 days after NSPT. Periodontal assessment included: Probing Depth (PD), Clinical Attachment Level (CAL), Bleeding on Probing (BOP) and Visible Plaque Index (VPI). Patients with or without periodontitis and categorized into stages (1 to 4) according to the criteria of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. Patients were classified with periodontitis when they presented interdental CAL detectable at ≥2 non-adjacent teeth, or buccal or oral CAL ≥3 mm with pocketing >3mm detectable in at least two teeth. NSPT (scaling and root planing) followed by dental polishing was performed in a single session using Gracey periodontal curettes and an ultrasound device. Delta values (Δ = 90 days after NSPT – before NSPT) were calculated. Parametric tests were included in the statistical analysis. The significance level adopted was 5%. Patients showed a reduction in the percentage of sites with PD ≥3 mm, in the percentage of sites with PD ≥4 mm and BOP 90 days after NSPT. The delta of WBC count showed a direct correlation with the percentage of sites with CAL ≥3 mm (r = 0.645, P = 0.002) and BOP (r = 0.663, P = 0.001); and the delta of uric acid showed a direct correlation with the percentage of sites with CAL ≥3 mm (r = 0.562; P = 0.010). In conclusion, NSPT seems to have an impact on the reduction of serum levels of WBC count and uric acid, suggesting a beneficial effect on systemic health in kidney transplant recipients. These results reinforce the importance of including dental care in the follow-up of these patients to maintain periodontal and systemic health. |
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RODRIGUES, Vandilson Pinheirohttp://lattes.cnpq.br/1918728073955146RODRIGUES, Vandilson Pinheirohttp://lattes.cnpq.br/1918728073955146COSTA, Moan Jéfter Fernandes7068268268110586GONDINHO, Brunna Verna Castrohttp://lattes.cnpq.br/3960499754358231BENATTI, Bruno Bragahttp://lattes.cnpq.br/7662017198142149MARQUES, Consuelo Penha Castrohttp://lattes.cnpq.br/1798891921776793http://lattes.cnpq.br/0493652791298409GOMES, Samira Vasconcelos2024-02-06T13:13:55Z2023-11-27GOMES, Samira Vasconcelos. Relação entre condição periodontal, marcadores do metabolismo glicêmico e parâmetros bioquímicos e hematológicos em pacientes transplantados renais. 2023.106 f. Tese (Programa de Pós-Graduação em Odontologia/CCBS) - Universidade Federal do Maranhão, São Luís, 2023.https://tedebc.ufma.br/jspui/handle/tede/tede/5132The high prevalence of periodontal disease in individuals with chronic kidney disease has been consistently reported in the literature. Evidence has reinforced that there is a possible relationship between periodontal inflammation and systemic changes in chronic kidney disease patients. However, there was a lack of intervention studies that aim to analyze whether there is an impact of non-surgical periodontal therapy (NSPT) on these systemic markers. Thus, the present thesis had the following objectives: [1] to investigate the relationship between the periodontal status and markers of the glycemic level in kidney transplant recipients; and [2] to analyze the effect of NSPT on clinical outcomes and serum markers of individuals after kidney transplantation (KTx). This thesis consists of two chapters. In the first one, the objective was to investigate the relationship between periodontal condition and hyperglycemia in patients after KTx, through a cross-sectional study that analyzed 44 kidney transplant patients, 25 men and 19 women with a median age of 43 years. The severity of periodontitis was categorized into stages I to IV and hyperglycemia was analyzed at different fasting blood glucose (FBG) cutoff points (100 mg/dL, 110 mg/dL, 120 mg/dL, 126 mg/dL, 140 mg/dL). Age, smoking history, previous type 2 diabetes mellitus (DM2) and previous cardiovascular disease (CVD) were considered cofactors. Multivariate logistic regression modeling was performed with periodontitis as exposure and hyperglycemia as outcome. Pathway analysis was performed with the FBG as a continuous outcome. As results, it was observed that patients with periodontitis had increased odds of hyperglycemia from 120 mg/dL FBG cutoff in KTx recipients, even after adjustments. Additionally, periodontitis severity was positively associated with FBG level (β = 0.323, SE = 0.127, P = 0.011) in KTx recipients. These findings suggest that periodontitis may be related to increased hyperglycemia and FBG levels in KTx patients. The second chapter presents an intervention study, carried out with 20 kidney transplant patients (9 women and 11 men, with an average age of 44.4 years), which aimed to analyze the effect of NSPT on white blood cell (WBC) count, fasting blood glucose, hemoglobin, hematocrit, creatinine and uric acid in these patients. Periodontal and serum data collection was performed at baseline (before NSPT) and 90 days after NSPT. Periodontal assessment included: Probing Depth (PD), Clinical Attachment Level (CAL), Bleeding on Probing (BOP) and Visible Plaque Index (VPI). Patients with or without periodontitis and categorized into stages (1 to 4) according to the criteria of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. Patients were classified with periodontitis when they presented interdental CAL detectable at ≥2 non-adjacent teeth, or buccal or oral CAL ≥3 mm with pocketing >3mm detectable in at least two teeth. NSPT (scaling and root planing) followed by dental polishing was performed in a single session using Gracey periodontal curettes and an ultrasound device. Delta values (Δ = 90 days after NSPT – before NSPT) were calculated. Parametric tests were included in the statistical analysis. The significance level adopted was 5%. Patients showed a reduction in the percentage of sites with PD ≥3 mm, in the percentage of sites with PD ≥4 mm and BOP 90 days after NSPT. The delta of WBC count showed a direct correlation with the percentage of sites with CAL ≥3 mm (r = 0.645, P = 0.002) and BOP (r = 0.663, P = 0.001); and the delta of uric acid showed a direct correlation with the percentage of sites with CAL ≥3 mm (r = 0.562; P = 0.010). In conclusion, NSPT seems to have an impact on the reduction of serum levels of WBC count and uric acid, suggesting a beneficial effect on systemic health in kidney transplant recipients. These results reinforce the importance of including dental care in the follow-up of these patients to maintain periodontal and systemic health.A grande prevalência de doença periodontal em indivíduos com doença renal crônica tem sido consistentemente relatada na literatura. Evidências têm reforçado que há uma possível relação entre a inflamação periodontal e alterações sistêmicas em pacientes renais crônicos. Entretanto, verificou-se uma escassez de estudos de intervenção com o intuito de analisar se há impacto da terapia periodontal não cirúrgica (TPNC) nestes marcadores sistêmicos. Dessa forma, a presente tese teve como objetivos: [1] investigar a relação entre a condição periodontal e os marcadores do nível glicêmico em transplantados renais; e [2] analisar o efeito da TPNC nos desfechos clínicos e nos marcadores séricos de indivíduos após o transplante renal (KTx). Esta tese é composta por dois capítulos. No primeiro deles, o objetivo foi investigar a relação entre a condição periodontal e a hiperglicemia em pacientes após o KTx, através de um estudo transversal que analisou 44 pacientes transplantados renais, 25 homens e 19 mulheres com idade mediana de 43 anos. A gravidade da periodontite foi categorizada em estágios de I a IV e a hiperglicemia foi analisada em diferentes pontos de corte de glicemia em jejum (FBG) (100 mg/dL, 110 mg/dL, 120 mg/dL, 126 mg/dL, 140 mg/dL). Idade, histórico de tabagismo, diabetes mellitus tipo 2 prévio (DM2) e doença cardiovascular prévia (DCV) foram considerados cofatores. Foi realizada modelagem de regressão logística multivariada com periodontite como exposição e hiperglicemia como desfecho. Análise de caminho foi realizada com a variável FBG como um desfecho contínuo. Como resultado, observou-se que pacientes com periodontite tiveram maior probabilidade de apresentar hiperglicemia a partir do ponto de corte de 120 mg/dL de FBG nos pacientes após o KTx, mesmo após ajustes. Adicionalmente, a gravidade da periodontite foi positivamente associada ao nível de FBG (β = 0,323, SE = 0,127, P = 0,011) nos pacientes transplantados renais. Esses achados sugerem que a periodontite pode estar relacionada ao aumento da hiperglicemia e dos níveis de FBG em pacientes KTx. O segundo capítulo apresenta um estudo de intervenção, realizado com 20 pacientes transplantados renais (9 mulheres e 11 homens, com idade média de 44,4 anos), que teve como objetivo analisar o efeito da TPNC sobre a contagem de leucócitos, glicemia em jejum, hemoglobina, hematócrito, creatinina e ácido úrico nestes pacientes. A coleta de dados periodontais e séricos foi realizada no início (antes da TPNC) e 90 dias após a TPNC. A avaliação periodontal incluiu: Profundidade de Sondagem (PS), Nível de Inserção Clínica (NIC), Índice de Sangramento à Sondagem (ISS) e Índice de Placa Visível (VPI). Os pacientes foram classificados como periodontite presente ou ausente e realizado o estadiamento (Estágio 1 a 4) de acordo com os critérios do 2017 World Workshop on the Classification of Periodontal and Peri‐Implant Diseases and Conditions. O paciente foi classificado com periodontite quando apresentasse NIC interdental detectável em ≥2 dentes não adjacentes, ou NIC vestibular ou lingual de ≥3 mm e profundidade de bolsa >3 mm detectável em pelo menos dois dentes. A TPNC (raspagem e alisamento radicular) seguida de polimento dental, foi realizada em sessão única e com curetas periodontais tipo Gracey e aparelho ultrassom. Foram calculados os valores delta (Δ = 90 dias após a TPNC – antes da TPNC). Testes paramétricos foram incluídos na análise estatística. O nível de significância adotado foi de 5%. Os pacientes apresentaram redução no percentual de sítios com PS ≥3 mm, no percentual de sítios com PS ≥4 mm e ISS 90 dias após a TPNC. O delta dos leucócitos séricos mostrou uma correlação direta com o percentual de sítios com NIC ≥3 mm (r = 0,645, P = 0,002) e ISS (r = 0,663, P = 0,001); e o delta do ácido úrico apresentou correlação direta com o percentual de sítios com NIC ≥3 mm (r = 0,562; P = 0,010). Em conclusão, a TPNC parece ter impacto na redução dos níveis séricos de leucócitos totais e ácido úrico, sugerindo um efeito benéfico na saúde sistêmica em pacientes receptores de transplante renal. Estes resultados reforçam a importância da inclusão da assistência odontológica no acompanhamento destes pacientes para a manutenção da saúde periodontal e sistêmica.Submitted by Daniella Santos (daniella.santos@ufma.br) on 2024-02-06T13:13:55Z No. of bitstreams: 1 SamiraVasconcelos.pdf: 2507677 bytes, checksum: 8211c5a31db36c36784c7c3fa2855d3a (MD5)Made available in DSpace on 2024-02-06T13:13:55Z (GMT). No. of bitstreams: 1 SamiraVasconcelos.pdf: 2507677 bytes, checksum: 8211c5a31db36c36784c7c3fa2855d3a (MD5) Previous issue date: 2023-11-27CAPESapplication/pdfporUniversidade Federal do MaranhãoPROGRAMA DE PÓS-GRADUAÇÃO EM ODONTOLOGIA/CCBSUFMABrasilDEPARTAMENTO DE ODONTOLOGIA II/CCBSperiodontite;desbridamento periodontal;hiperglicemia;biomarcadores;transplante de rim;periodontitis;periodontal debridement;hyperglycemia;biomarkers;kidney transplantation.PeriodontiaRelação entre condição periodontal, marcadores do metabolismo glicêmico e parâmetros bioquímicos e hematológicos em pacientes transplantados renaisRelationship between periodontal condition, markers of glycemic metabolism and biochemical and hematological parameters in kidney transplant patientsinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da UFMAinstname:Universidade Federal do Maranhão (UFMA)instacron:UFMAORIGINALSamiraVasconcelos.pdfSamiraVasconcelos.pdfapplication/pdf2507677http://tedebc.ufma.br:8080/bitstream/tede/5132/2/SamiraVasconcelos.pdf8211c5a31db36c36784c7c3fa2855d3aMD52LICENSElicense.txtlicense.txttext/plain; charset=utf-82255http://tedebc.ufma.br:8080/bitstream/tede/5132/1/license.txt97eeade1fce43278e63fe063657f8083MD51tede/51322024-02-06 10:13:55.07oai:tede2: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Biblioteca Digital de Teses e Dissertaçõeshttps://tedebc.ufma.br/jspui/PUBhttp://tedebc.ufma.br:8080/oai/requestrepositorio@ufma.br||repositorio@ufma.bropendoar:21312024-02-06T13:13:55Biblioteca Digital de Teses e Dissertações da UFMA - Universidade Federal do Maranhão (UFMA)false |
dc.title.por.fl_str_mv |
Relação entre condição periodontal, marcadores do metabolismo glicêmico e parâmetros bioquímicos e hematológicos em pacientes transplantados renais |
dc.title.alternative.eng.fl_str_mv |
Relationship between periodontal condition, markers of glycemic metabolism and biochemical and hematological parameters in kidney transplant patients |
title |
Relação entre condição periodontal, marcadores do metabolismo glicêmico e parâmetros bioquímicos e hematológicos em pacientes transplantados renais |
spellingShingle |
Relação entre condição periodontal, marcadores do metabolismo glicêmico e parâmetros bioquímicos e hematológicos em pacientes transplantados renais GOMES, Samira Vasconcelos periodontite; desbridamento periodontal; hiperglicemia; biomarcadores; transplante de rim; periodontitis; periodontal debridement; hyperglycemia; biomarkers; kidney transplantation. Periodontia |
title_short |
Relação entre condição periodontal, marcadores do metabolismo glicêmico e parâmetros bioquímicos e hematológicos em pacientes transplantados renais |
title_full |
Relação entre condição periodontal, marcadores do metabolismo glicêmico e parâmetros bioquímicos e hematológicos em pacientes transplantados renais |
title_fullStr |
Relação entre condição periodontal, marcadores do metabolismo glicêmico e parâmetros bioquímicos e hematológicos em pacientes transplantados renais |
title_full_unstemmed |
Relação entre condição periodontal, marcadores do metabolismo glicêmico e parâmetros bioquímicos e hematológicos em pacientes transplantados renais |
title_sort |
Relação entre condição periodontal, marcadores do metabolismo glicêmico e parâmetros bioquímicos e hematológicos em pacientes transplantados renais |
author |
GOMES, Samira Vasconcelos |
author_facet |
GOMES, Samira Vasconcelos |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
RODRIGUES, Vandilson Pinheiro |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/1918728073955146 |
dc.contributor.referee1.fl_str_mv |
RODRIGUES, Vandilson Pinheiro |
dc.contributor.referee1Lattes.fl_str_mv |
http://lattes.cnpq.br/1918728073955146 |
dc.contributor.referee2.fl_str_mv |
COSTA, Moan Jéfter Fernandes |
dc.contributor.referee2Lattes.fl_str_mv |
7068268268110586 |
dc.contributor.referee3.fl_str_mv |
GONDINHO, Brunna Verna Castro |
dc.contributor.referee3Lattes.fl_str_mv |
http://lattes.cnpq.br/3960499754358231 |
dc.contributor.referee4.fl_str_mv |
BENATTI, Bruno Braga |
dc.contributor.referee4Lattes.fl_str_mv |
http://lattes.cnpq.br/7662017198142149 |
dc.contributor.referee5.fl_str_mv |
MARQUES, Consuelo Penha Castro |
dc.contributor.referee5Lattes.fl_str_mv |
http://lattes.cnpq.br/1798891921776793 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/0493652791298409 |
dc.contributor.author.fl_str_mv |
GOMES, Samira Vasconcelos |
contributor_str_mv |
RODRIGUES, Vandilson Pinheiro RODRIGUES, Vandilson Pinheiro COSTA, Moan Jéfter Fernandes GONDINHO, Brunna Verna Castro BENATTI, Bruno Braga MARQUES, Consuelo Penha Castro |
dc.subject.por.fl_str_mv |
periodontite; desbridamento periodontal; hiperglicemia; biomarcadores; transplante de rim; |
topic |
periodontite; desbridamento periodontal; hiperglicemia; biomarcadores; transplante de rim; periodontitis; periodontal debridement; hyperglycemia; biomarkers; kidney transplantation. Periodontia |
dc.subject.eng.fl_str_mv |
periodontitis; periodontal debridement; hyperglycemia; biomarkers; kidney transplantation. |
dc.subject.cnpq.fl_str_mv |
Periodontia |
description |
The high prevalence of periodontal disease in individuals with chronic kidney disease has been consistently reported in the literature. Evidence has reinforced that there is a possible relationship between periodontal inflammation and systemic changes in chronic kidney disease patients. However, there was a lack of intervention studies that aim to analyze whether there is an impact of non-surgical periodontal therapy (NSPT) on these systemic markers. Thus, the present thesis had the following objectives: [1] to investigate the relationship between the periodontal status and markers of the glycemic level in kidney transplant recipients; and [2] to analyze the effect of NSPT on clinical outcomes and serum markers of individuals after kidney transplantation (KTx). This thesis consists of two chapters. In the first one, the objective was to investigate the relationship between periodontal condition and hyperglycemia in patients after KTx, through a cross-sectional study that analyzed 44 kidney transplant patients, 25 men and 19 women with a median age of 43 years. The severity of periodontitis was categorized into stages I to IV and hyperglycemia was analyzed at different fasting blood glucose (FBG) cutoff points (100 mg/dL, 110 mg/dL, 120 mg/dL, 126 mg/dL, 140 mg/dL). Age, smoking history, previous type 2 diabetes mellitus (DM2) and previous cardiovascular disease (CVD) were considered cofactors. Multivariate logistic regression modeling was performed with periodontitis as exposure and hyperglycemia as outcome. Pathway analysis was performed with the FBG as a continuous outcome. As results, it was observed that patients with periodontitis had increased odds of hyperglycemia from 120 mg/dL FBG cutoff in KTx recipients, even after adjustments. Additionally, periodontitis severity was positively associated with FBG level (β = 0.323, SE = 0.127, P = 0.011) in KTx recipients. These findings suggest that periodontitis may be related to increased hyperglycemia and FBG levels in KTx patients. The second chapter presents an intervention study, carried out with 20 kidney transplant patients (9 women and 11 men, with an average age of 44.4 years), which aimed to analyze the effect of NSPT on white blood cell (WBC) count, fasting blood glucose, hemoglobin, hematocrit, creatinine and uric acid in these patients. Periodontal and serum data collection was performed at baseline (before NSPT) and 90 days after NSPT. Periodontal assessment included: Probing Depth (PD), Clinical Attachment Level (CAL), Bleeding on Probing (BOP) and Visible Plaque Index (VPI). Patients with or without periodontitis and categorized into stages (1 to 4) according to the criteria of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. Patients were classified with periodontitis when they presented interdental CAL detectable at ≥2 non-adjacent teeth, or buccal or oral CAL ≥3 mm with pocketing >3mm detectable in at least two teeth. NSPT (scaling and root planing) followed by dental polishing was performed in a single session using Gracey periodontal curettes and an ultrasound device. Delta values (Δ = 90 days after NSPT – before NSPT) were calculated. Parametric tests were included in the statistical analysis. The significance level adopted was 5%. Patients showed a reduction in the percentage of sites with PD ≥3 mm, in the percentage of sites with PD ≥4 mm and BOP 90 days after NSPT. The delta of WBC count showed a direct correlation with the percentage of sites with CAL ≥3 mm (r = 0.645, P = 0.002) and BOP (r = 0.663, P = 0.001); and the delta of uric acid showed a direct correlation with the percentage of sites with CAL ≥3 mm (r = 0.562; P = 0.010). In conclusion, NSPT seems to have an impact on the reduction of serum levels of WBC count and uric acid, suggesting a beneficial effect on systemic health in kidney transplant recipients. These results reinforce the importance of including dental care in the follow-up of these patients to maintain periodontal and systemic health. |
publishDate |
2023 |
dc.date.issued.fl_str_mv |
2023-11-27 |
dc.date.accessioned.fl_str_mv |
2024-02-06T13:13:55Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/doctoralThesis |
format |
doctoralThesis |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
GOMES, Samira Vasconcelos. Relação entre condição periodontal, marcadores do metabolismo glicêmico e parâmetros bioquímicos e hematológicos em pacientes transplantados renais. 2023.106 f. Tese (Programa de Pós-Graduação em Odontologia/CCBS) - Universidade Federal do Maranhão, São Luís, 2023. |
dc.identifier.uri.fl_str_mv |
https://tedebc.ufma.br/jspui/handle/tede/tede/5132 |
identifier_str_mv |
GOMES, Samira Vasconcelos. Relação entre condição periodontal, marcadores do metabolismo glicêmico e parâmetros bioquímicos e hematológicos em pacientes transplantados renais. 2023.106 f. Tese (Programa de Pós-Graduação em Odontologia/CCBS) - Universidade Federal do Maranhão, São Luís, 2023. |
url |
https://tedebc.ufma.br/jspui/handle/tede/tede/5132 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Universidade Federal do Maranhão |
dc.publisher.program.fl_str_mv |
PROGRAMA DE PÓS-GRADUAÇÃO EM ODONTOLOGIA/CCBS |
dc.publisher.initials.fl_str_mv |
UFMA |
dc.publisher.country.fl_str_mv |
Brasil |
dc.publisher.department.fl_str_mv |
DEPARTAMENTO DE ODONTOLOGIA II/CCBS |
publisher.none.fl_str_mv |
Universidade Federal do Maranhão |
dc.source.none.fl_str_mv |
reponame:Biblioteca Digital de Teses e Dissertações da UFMA instname:Universidade Federal do Maranhão (UFMA) instacron:UFMA |
instname_str |
Universidade Federal do Maranhão (UFMA) |
instacron_str |
UFMA |
institution |
UFMA |
reponame_str |
Biblioteca Digital de Teses e Dissertações da UFMA |
collection |
Biblioteca Digital de Teses e Dissertações da UFMA |
bitstream.url.fl_str_mv |
http://tedebc.ufma.br:8080/bitstream/tede/5132/2/SamiraVasconcelos.pdf http://tedebc.ufma.br:8080/bitstream/tede/5132/1/license.txt |
bitstream.checksum.fl_str_mv |
8211c5a31db36c36784c7c3fa2855d3a 97eeade1fce43278e63fe063657f8083 |
bitstream.checksumAlgorithm.fl_str_mv |
MD5 MD5 |
repository.name.fl_str_mv |
Biblioteca Digital de Teses e Dissertações da UFMA - Universidade Federal do Maranhão (UFMA) |
repository.mail.fl_str_mv |
repositorio@ufma.br||repositorio@ufma.br |
_version_ |
1809926286439612416 |