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HYDROLOGICAL DISASTERS AND HUMAN HEALTH: SCOPING REVIEW
The objective of this scoping review is to evaluate literature between 2013 and 2023 focused on human health and hydrological disasters. The research databases were: Lilacs, Medline via PubMed, Scopus, Web of Science, ScienceDirect. Eligibility was determined using inclusion and exclusion criteria, and the search strategy included: (Health) AND (Hydrologic Disaster), (Health Risk) AND (Hydrologic Disaster). Initially, 58 articles were selected, but after systematic screening, only 12 were relevant to the topic. The results indicated that the prevalence of post-disaster infectious diseases is a recurring and relevant theme in the literature. In short, scientific collaboration highlighted the need for more comprehensive and multidisciplinary work, with the potential to act in the formulation of public policies and international partnerships, preparation of health managers and professionals, development of plans, research and interventions in the relationship between health and hydrological disasters.
Stormwater Drainage and Healthcare Professionals
Copyright (c) 2026 https://creativecommons.org/licenses/by-nc/4.0
IMPACT OF POLYPHARMACY ON THE HEALTH OF THE ELDERLY PERSON: NURSING STRATEGIES
Objective: To analyze the impacts of polypharmacy on the health of elderly people and the nursing strategies for the prevention of adverse events. Methodology: This is an integrative literature review, conducted in the Medical Literature Analysis and Retrieval System Online (MEDLINE/PubMed), SciELO, and Google Scholar databases, considering publications from 2020 to 2025. Controlled descriptors from DeCS were used, combined by Boolean operators: Elderly (Aged) AND Polypharmacy (Polypharmacy) AND Nursing Care (Nursing Care). Results: A total of 225 studies were identified in the databases. After applying the inclusion and exclusion criteria and reading titles and abstracts, 33 articles remained. After removing duplicates, 27 studies were selected for full-text reading, resulting in a final sample of 12 articles that met the research objective. Conclusion: Polypharmacy constitutes an important challenge for the health of the elderly population, being a multifactorial phenomenon associated with the presence of chronic diseases, physiological aging, and vulnerabilities in healthcare. The fundamental role of nursing in preventing adverse events is highlighted, through strategies such as nursing consultations based on the Nursing Process, health education, and the Systematization of Nursing Care, contributing to safer care and the improvement of the elderly person's quality of life.
USE OF CANNABIDIOL IN THE PREVENTION OF POSTOPERATIVE COMPLICATIONS AFTER THIRD MOLAR EXTRACTIONS
Third molar extraction is among the most frequently performed procedures in Oral and Maxillofacial Surgery and is commonly associated with postoperative complications such as pain, edema, trismus, and functional limitation. In this context, cannabidiol (CBD) has attracted growing scientific interest due to its analgesic, anti-inflammatory, and endocannabinoid system-modulating properties, emerging as a potential therapeutic alternative for postoperative management in oral surgery. This study aimed to analyze, through an integrative literature review, the current scientific evidence regarding the use of cannabidiol in the prevention and control of postoperative complications associated with third molar extractions. The methodological framework was based on the stages proposed by Whittemore and Knafl (2005). The bibliographic search was conducted in the PubMed/MEDLINE, Scopus, Web of Science, and SciELO databases, considering studies published between 2015 and 2025 in English, Portuguese, and Spanish. Clinical trials, systematic reviews, observational studies, and experimental research related to the use of CBD in orofacial pain, inflammation, and oral surgery were included. The findings demonstrated that cannabidiol presents relevant analgesic and anti-inflammatory potential by modulating nociception and inflammatory responses through mechanisms associated with CB1 and CB2 receptors, in addition to reducing pro-inflammatory cytokines and nociceptive sensitization. Clinical studies reported reduction of postoperative pain, functional improvement, and possible reduction in the need for conventional analgesics. However, important methodological limitations remain, including heterogeneity among therapeutic protocols, differences in dosage and routes of administration, small sample sizes, and lack of clinical standardization. It is concluded that cannabidiol demonstrates promising therapeutic potential in the prevention and control of postoperative complications following third molar extractions, although further robust and standardized clinical studies are still required to consolidate its applicability in contemporary dental practice.
TOWARDS AN ANTI-RACIST PEDAGOGY IN EARLY CHILDHOOD EDUCATION
This article discusses the importance of constructing an anti-racist pedagogy in early childhood education as a fundamental strategy for confronting racial inequalities present in Brazilian society. Starting from the recognition that racism has individual, institutional, and structural dimensions, according to the theoretical perspective of Almeida (2019), and with the contribution of researchers such as Leocadio and Reis (2019; 2020), Martins (2006), and Santana (2006), the study analyzes how these dynamics prematurely impact the identity formation of children. The research engages with studies on child development, education on ethnic-racial relations, and the formation of Black identity, highlighting empirical evidence that demonstrates the presence of racialized perceptions in the first years of life. Based on this finding, the work argues that early childhood education schools should assume an active role in promoting equity, valuing cultural diversity, and strengthening the self-esteem of Black children. The article also presents pedagogical foundations inspired by concepts from the African worldview, such as Ubuntu and Sankofa, proposing their application as ethical and methodological references for a decolonizing educational practice. It concludes that the implementation of anti-racist pedagogical practices requires permanent institutional actions, ongoing teacher training, and the construction of curricula that recognize Brazilian ethnic and cultural plurality.
DIAGNOSIS AND PROPOSAL FOR IMPLEMENTING ENVIRONMENTAL AND SOCIAL PRACTICES IN THE CHEMISTRY AND BIOLOGY TEACHING LABORATORIES OF IFFAR CAMPUS SANTA ROSA
The proper management of chemical and biological waste in higher education institutions is fundamental to minimizing environmental impacts and promoting sustainable practices. In this context, the present study aimed to identify, manage, and minimize the waste generated in the Chemistry and Biology teaching laboratories of the Farroupilha Federal Institute, using the Biological Sciences Degree Course as a pilot study. The research has an exploratory character, with a qualitative and quantitative approach, based on the collection of data regarding the waste produced during practical classes in the second semester of 2024. The results showed that the greatest generation of waste occurred in the activities of the Chemistry for Biological Sciences discipline, especially acid-base solutions and chemical waste containing solvents and laboratory reagents. Organic waste from Botany, Plant Physiology, and Microbiology practices was also identified. The study highlighted the importance of segregation, neutralization, and proper storage of waste, as well as the need to improve quantitative and qualitative control through standardized monitoring spreadsheets. The integration of Environmental, Social and Governance (ESG) principles and the Sustainable Development Goals (SDGs) contributed to strengthening more responsible and sustainable laboratory practices, promoting environmental awareness among undergraduate students. It is concluded that the implementation of waste minimization and management strategies in the academic environment favors the training of professionals more committed to sustainability and allows for the replication of these practices in other courses and campuses of the institution.
ROBUST H∞ CONTROL VIA LMIS FOR AN ARTIFICIAL PANCREAS SYSTEM WITH ACTUATOR SATURATION IN THE LUR’E STRUCTURE
This work presents a robust control approach via linear matrix inequalities applied to an artificial pancreas system described in the Lur'e framework. The adopted glucose-insulin model is based on the Bergman minimal model, considering parametric uncertainties, actuator saturation, and food disturbances. The nonlinearity associated with insulin pump saturation is treated as a sector-specific static nonlinearity, allowing the system to be represented as the interconnection between an uncertain linear block and a feedback nonlinearity. The controller synthesis is performed using a quadratic Lyapunov function, the Bounded Real Lemma, and the S-procedure, resulting in conditions of absolute stability and robust performance expressed in LMIs. Numerical results show that the proposed controller reduces the glycemic peak, decreases settling time, and satisfies the condition , even at the worst vertex of the uncertainty polytope. It is concluded that the proposed methodology constitutes a promising alternative for the development of robust, safe artificial pancreas systems compatible with real physical constraints.
LEADERSHIP AND TECHNOLOGICAL-ENVIRONMENTAL LITERACY: THE SCIENCE CLUB WITHIN THE FULL-TIME EDUCATION PROGRAM IN HUMAITÁ, AMAZONAS
Pedagogical management in full-time institutions within the Amazon region faces the critical challenge of converting extended school hours into a period of emancipatory education. This study analyzes the potential of the Science Club, based at the Integrated Center for Complementary Activities (CIAC) in Humaitá-AM, as an ecosystem for technological-environmental literacy. The investigation problematizes the invisibility of environmental stressors in daily school life—such as noise pollution and inadequate waste management—proposing digital instrumentation as a means for diagnosis and intervention. Grounded in the principles of Scientific Literacy and Maker Culture, this action-research describes a pedagogical engineering process in which elementary students utilize open-source hardware and microcontrollers to transmute subjective sensory perceptions into measurable empirical data. The methodological path integrated cycles of virtual simulation, C++ programming, and the assembly of sonometric and sanitary automation devices. The results demonstrate that the materialization of technological artifacts promotes an epistemological transition, shifting the student from a technology consumer to an active diagnostician of their territory. The study concludes that the symbiosis between instrumental accuracy and ethical purpose enhances the full-time curriculum, consolidating youth leadership and providing technical support for the management of collective well-being in the Amazonian context.
PROTOTYPING AND SMART TRASH CAN IN THE 5TH GRADE OF ELEMENTARY SCHOOL: A CONNECTION BETWEEN TECHNOLOGICAL PRACTICE AND ENVIRONMENTAL EDUCATION IN FULL-TIME EDUCATION
Waste management in the school environment is frequently approached in a merely theoretical manner within teaching schedules. This study analyzed the development of an automated (Smart) trash can prototype, based on the Arduino platform, aiming to integrate ecological awareness with digital experimentation. The qualitative action research was conducted at the Centro Integrado de Atividades Complementares (CIAC), in Humaitá, Amazonas, as part of the "Science Workshop" with 5th-grade Elementary School students. The application of maker culture and electronic prototyping allowed students to diagnose waste production in their classrooms and propose automated solutions. The construction of the artifact fostered critical thinking regarding sustainability and school hygiene, demonstrating that the symbiosis between environmental education and technological practice enhanced the full-time curriculum and promoted investigative protagonism from the early grades.
TECHNOLOGICAL PRACTICE IN FULL-TIME EDUCATION: MICROCLIMATIC INSTRUMENTATION WITH ARDUINO IN THE SOUTHERN AMAZON
Considering that the teaching of climate dynamics often occurred in an abstract manner, disconnected from the students' local reality within the full-time school schedule. This study aimed to report and analyze the construction of a low-cost automated microclimatic monitoring station, using the Arduino platform, as a tool for integrating ecological awareness and digital experimentation. To this end, a qualitative action research approach was conducted at the Centro Integrado de Atividades Complementares (CIAC), in the municipality of Humaitá, Amazonas, through the "Science Workshop: Environmental Education and Sustainability" with Elementary School students; the practical activity of electronic prototyping and programming logic allowed students to make technical decisions and directly recognize the characteristics of the school microclimate. Thus, it was observed that the collection and interpretation of real-time biometeorological data contextualized ecological concepts within the Amazonian reality, stimulating critical thinking and student protagonism, which led to the conclusion that the articulation between environmental education and technological practice qualified the full-time curriculum, transforming the school into an active space for socio-environmental diagnosis.
SONOMETRIC MONITORING IN THE SCHOOL ENVIRONMENT: AN EXPERIMENTAL APPROACH THROUGH ELECTRONIC PROTOTYPING IN FULL-TIME EDUCATION
Noise pollution in the school environment is often neglected within extended school hours. This study analyzed the development of an automated technological artifact for measuring sound pressure levels, based on the Arduino platform, to integrate hearing comfort with digital instrumentation. Qualitative action research was conducted at the Integrated Center for Complementary Activities (CIAC) in Humaitá, Amazonas, as part of the "Science Workshop: Environmental Education and Sustainability" with Elementary School students. The application of maker culture and programming logic allowed students to technically diagnose the acoustic environment of their classrooms. Real-time decoding of sound data fostered critical thinking about public health and school ergonomics within the Amazonian reality, showing that the symbiosis between environmental education and technological practice enhanced the full-time curriculum and promoted the epistemological emancipation of the student.
IMPACT OF MATERIAL PLANNING ON THE REDUCTION OF LOGISTICS COSTS IN THE MANUFACTURING INDUSTRY
The study analyzes the impact of material planning on the reduction of logistics costs within the manufacturing industry, highlighting the strategic role of tools such as Material Requirements Planning (MRP). Using a quantitative, correlational, and cross-sectional approach applied to 32 manufacturing companies in Guanajuato, the relationship between material management, inventories, transportation, and storage was evaluated. The results showed that adequate material planning significantly contributes to reducing logistics costs, optimizing inventories, decreasing obsolescence, and improving operational coordination. Likewise, it was identified that synchronization between supply, production, and distribution promotes organizational efficiency. However, limitations still persist regarding the reduction of urgent transportation and the achievement of full logistics integration. It is concluded that material planning constitutes a strategic element for strengthening the competitiveness and resilience of manufacturing organizations.
REINVENTION IN TIMES OF CRISIS: BRAZILIAN ENTREPRENEURSHIP BOOSTED BY THE COVID-19 PANDEMIC
Considering the relevance of entrepreneurship to the economic and social development of the country, in different sectors of activity, this study sought to examine, through a literature review, how the COVID-19 pandemic influenced the emergence of new entrepreneurs in Brazil. Furthermore, it aimed to identify the segments that stood out most during this period and the main challenges faced by new entrepreneurs. The justification for this research is based on the importance of understanding the role of entrepreneurship in crisis contexts, especially in the face of adverse scenarios that demand innovation, resilience, and adaptation. The research, of a qualitative and descriptive nature, was structured through an integrative review of scientific production published between 2020 and 2024. The content analysis of the studies sought to identify, select, evaluate, and synthesize the evidence on the growth of entrepreneurship in Brazil impacted by the COVID-19 pandemic. The results indicated that the pandemic acted as an accelerator for the emergence of new entrepreneurs in Brazil, driven mainly by income loss, unemployment, and the need to adapt to the digital market. It was concluded that, despite the difficulties imposed by the health crisis, the pandemic context fostered both necessity-driven and opportunity-driven entrepreneurship, strengthening innovation and reinvention in small businesses.
IMPLEMENTATION OF PARFOR AND PARFOR EQUITY AT UFMA: CONTRIBUTIONS AND LIMITS TO THE DEMOCRATIZATION OF TEACHER EDUCATION
Teacher education in basic education in Brazil has historically presented profound regional, social, and institutional inequalities, especially in states marked by educational vulnerabilities, such as Maranhão. In this context, public policies aimed at democratizing access to higher education become strategic for teacher appreciation and for improving the quality of basic education. The National Program for the Training of Basic Education Teachers (PARFOR) and, more recently, PARFOR Equity, were created to expand access to higher education for in-service teachers, prioritizing inland regions and historically marginalized groups. This study aimed to analyze the implementation processes of these programs at the Federal University of Maranhão (UFMA), highlighting their contributions and limitations regarding the democratization of teacher education. The research adopted a qualitative, descriptive, and exploratory approach, based on documentary analysis and bibliographic review. Institutional reports, legislation, public calls, and official documents from CAPES and UFMA were examined. The results indicate that the programs contributed to expanding access to teacher education courses, strengthening the interiorization of higher education, valuing cultural diversity, and reducing educational inequalities. Despite administrative, financial, and pedagogical challenges, PARFOR and PARFOR Equity demonstrate potential to consolidate equity policies and strengthen teacher education in Maranhão.
INTEGRATION OF DIDACTIC AUDIO DESCRIPTION INTO THE SCHOOL CURRICULUM
This article aims to discuss the integration of didactic audio description into the school curriculum, justifying the need for its inclusion in the educational context. The objective is to identify the challenges and difficulties that emerge from pedagogical practices during the implementation process of this strategy. This is a bibliographic research, which is based on the academic production developed in the country, especially in the works of Motta (2010) and Mianes (2023), as well as in the current legislation that regulates and guides the use of audio description as a tool for accessibility and inclusion of public students of special education. It is noteworthy that advances have been recorded in Brazil regarding the use of audio description in the school environment, promoting inclusion and equity in learning. However, it is important to highlight that there are still many challenges to be overcome, especially with regard to the initial and continuing training of teachers, in order to promote understanding about the possibilities of curricular flexibility, focusing on pedagogical practices that address the learning diversity of students.
SPECIAL EDUCATION AND ITS ROLE IN THE CONTEMPORARY SCENARIO
Considering the challenges of school inclusion for students with disabilities in Brazil, this article aims to understand the role of contemporary Special Education, highlighting barriers and pathways toward equitable inclusion. The objective is to analyze how public policies and inclusive pedagogical practices can contribute to accessible and welcoming school environments. To this end, a literature review was conducted in the CAPES Digital Library of Theses and Dissertations (BDTD), with works defended between 2019 and 2023. A total of 221 studies were identified, of which 17 were selected for meeting criteria of thematic relevance, timeliness, and contribution to the field. Thus, advances are observed, but also persistent challenges in inclusion policies: gaps in teacher training, obstacles in the implementation of inclusive pedagogical practices, and the permanence of attitudinal, structural, and curricular barriers. The data highlight the importance of listening to students, teachers, and families as an indispensable step toward building truly inclusive school environments. The productions also evidence the strategic role of assistive technologies, intersectional approaches, and intersectoral practices as solutions to everyday challenges. This allows us to conclude that, despite significant legal advances, effective school inclusion remains a trajectory under construction, requiring joint efforts between public policies, ongoing teacher training, and school management to ensure access, permanence, and learning for all students in a democratic, equitable, and plural school.
ALLELOPATHIC EFFECT OF COVER CROP EXTRACTS ON GERMINATION AND INITIAL GROWTH OF WEEDS
The intensive use of herbicides has contributed to the selection of resistant weed populations, highlighting the need for alternative weed management strategies. In this context, allelopathy from cover crops may represent a complementary tool for weed suppression. This study aimed to evaluate the allelopathic potential of aqueous extracts from the shoot biomass of brachiaria (Brachiaria ruziziensis), sunn hemp (Crotalaria ochroleuca), and pearl millet (Pennisetum glaucum) on the germination and early development of Italian ryegrass (Lolium multiflorum), wild radish (Raphanus sativus L.), and beggarticks (Bidens pilosa). The experiment was conducted in a completely randomized design, using aqueous extracts at 10% (w/v). Germination percentage and speed, shoot and root length, and fresh and dry biomass accumulation were evaluated. Brachiaria and sunn hemp extracts significantly reduced all evaluated variables for the three weed species. Pearl millet extract showed a less pronounced allelopathic effect, with no significant interference on germination and dry biomass accumulation of wild radish. These results indicate that brachiaria and sunn hemp exhibit high allelopathic potential and may be used as complementary tools for sustainable weed management.
SELECTIVITY OF THE HERBICIDE DICAMBA (XTENDICAM) APPLIED AT THE TILLERING STAGE OF WHEAT
The use of hormonal herbicides in wheat requires evaluation regarding selectivity, especially for molecules without registered recommendations for this crop. This study aimed to evaluate the effect of different doses of dicamba (Xtendicam) applied at the tillering stage of wheat on phytotoxicity and yield components. The experiment was conducted under field conditions in Verê, Paraná, Brazil, using a randomized complete block design with four replications and five treatments (0; 0.4; 0.6; 0.8; and 1 L ha⁻¹). The evaluated variables included phytotoxicity, plant height, number of tillers, number of grains per spike, thousand-grain weight, dry biomass, and yield. Increasing doses resulted in higher phytotoxicity, reaching 15.5% at 42 days after application at the highest dose, which was considered low and reversible. Reductions were observed in plant height, number of tillers, and number of grains per spike at higher doses. Grain yield was reduced at all doses, with a significant difference at 0.8 L ha⁻¹, showing a reduction of up to 34.9% compared to the control. The number of plants per linear meter, dry biomass, and thousand-grain weight were not affected. The results indicate that, although visual phytotoxicity was low, dicamba negatively affects wheat yield components. The dose of 0.4 L ha⁻¹ showed the lowest impact on the crop and was considered the safest under the evaluated conditions.
CLINICAL AND LABORATORY PARAMETERS AS PROGNOSTIC AND MONITORING BIOMARKERS IN PATIENTS WITH CARDIOVASCULAR AND METABOLIC DISEASES
Non-communicable chronic diseases represent one of the greatest contemporary challenges to public health due to their high prevalence, impact on morbidity and mortality, and the need for continuous care. In this context, systemic arterial hypertension and type 2 diabetes mellitus play a central role, both because of their frequency in the population and the complexity of their cardiovascular, renal, and metabolic complications. This chapter highlights the importance of using clinical and laboratory biomarkers as tools to support risk stratification, prognosis, and monitoring of these conditions, especially in Primary Health Care. Among the clinical parameters, anthropometric measurements, blood pressure, and cardiovascular assessment stand out, while, in the laboratory field, blood glucose, glycated hemoglobin, lipid profile, renal and hepatic markers, as well as hematological and inflammatory indices derived from complete blood count analyses, gain relevance. The integration of these different parameters makes it possible to increase the sensitivity of clinical assessment, promote the early identification of subclinical alterations, and support individualized management strategies. Thus, the combined use of clinical and laboratory biomarkers constitutes a promising strategy to improve health care quality, especially in resource-limited settings, contributing to the prevention of complications and to better outcomes in patients with chronic diseases.
TYPE 2 DIABETES MELLITUS AND SYSTEMIC ARTERIAL HYPERTENSION: ETIOLOGICAL, PATHOGENIC, AND PATHOPHYSIOLOGICAL ASPECTS
Non-communicable chronic diseases represent a major challenge to public health due to their high prevalence, impact on morbidity and mortality, and association with modifiable risk factors such as physical inactivity, inadequate diet, smoking, obesity, and alcohol consumption. Among these diseases, systemic arterial hypertension and type 2 diabetes mellitus stand out because of their increasing frequency and direct relationship with cardiovascular, renal, and metabolic complications. Systemic arterial hypertension has a multifactorial etiology involving genetic predisposition, sympathetic hyperactivity, activation of the renin-angiotensin-aldosterone system, and endothelial dysfunction, whereas type 2 diabetes mellitus results from the interaction between insulin resistance, progressive pancreatic beta-cell dysfunction, and chronic low-grade inflammation. The diagnosis and monitoring of these conditions require careful clinical evaluation and specific laboratory tests, such as blood pressure measurement, fasting blood glucose, glycated hemoglobin, and oral glucose tolerance test. Treatment is based on lifestyle modification, the use of antihypertensive and antidiabetic drugs, as well as continuous follow-up in programs such as HIPERDIA. Therefore, an integrated understanding of these disorders is essential for adequate control, prevention of complications, and improvement of patients’ quality of life.
AUTISM SPECTRUM DISORDER IN THE CONTEXT OF PUBLIC SCHOOLS: CONTRIBUTIONS OF PHYSICAL EDUCATION TO THE DEVELOPMENT OF LANGUAGE: MEDIATION, BODY AND EMBODIED COGNITION
This article analyzes the contributions of school Physical Education to the development of language in students with Autism Spectrum Disorder (ASD) in the context of public schools. This is qualitative research with a theoretical-bibliographic approach, grounded in Bardin's Content Analysis (2016), with a corpus composed of 38 scientific works selected from indexed databases SciELO, ERIC, Scopus and CAPES Journals Portal, published between 2020 and 2025, following a protocol compatible with PRISMA guidelines. The theoretical framework articulates Gardner's Theory of Multiple Intelligences (1995), critically repositioned in light of contemporary studies on embodied cognition and language, with Vygotsky's mediation perspective and recent literature on ASD, linguistic development, and school inclusion. Results indicate that Physical Education, when organized with pedagogical intentionality and grounded in inclusive principles, constitutes a relevant space for language mediation, enabling forms of expression that transcend orality including the articulated use of bodily practices and Augmentative and Alternative Communication (AAC) resources. The analysis reveals a productive tension between structured behavioral approaches and sociointeractionist perspectives, whose integration tends to produce more consistent outcomes in school contexts. It is concluded that the integration of body, movement, and language constitutes a relevant pedagogical axis for expanding the communicative repertoire of students with ASD, with direct implications for teacher education and inclusive education policies.
Augmentative and Alternative Communication
USE OF DAPAGLIFLOZIN (FORXIGA) IN THE TREATMENT OF HEART FAILURE: CURRENT EVIDENCE AND CLINICAL EFFICACY
Heart failure remains one of the leading causes of cardiovascular morbidity and mortality worldwide, being associated with high hospitalization rates, progressive functional impairment, and significant socioeconomic burden. In this context, dapagliflozin, a sodium-glucose cotransporter-2 (SGLT2) inhibitor, has emerged as an important therapeutic strategy in the contemporary management of heart failure, demonstrating cardiovascular and cardiorenal benefits that extend beyond glycemic control. This study aimed to analyze current scientific evidence regarding the clinical efficacy of dapagliflozin in the treatment of heart failure, emphasizing its effects on cardiovascular mortality, hospitalizations, quality of life, functional capacity, and renal protection. This is an integrative literature review with a qualitative and descriptive approach, conducted through searches in PubMed, SciELO, and ScienceDirect databases using descriptors related to dapagliflozin, heart failure, and cardiovascular outcomes. Studies published between 2019 and 2023 were included, comprising randomized clinical trials, systematic reviews, meta-analyses, and international guidelines. The main findings demonstrated significant reductions in heart failure hospitalizations, cardiovascular mortality, and episodes of clinical worsening, in addition to improvements in quality of life and preservation of renal function across different phenotypes of the disease. The DAPA-HF and DELIVER trials were particularly highlighted as milestones in consolidating SGLT2 inhibitors as a fundamental therapeutic component in heart failure management. It is concluded that dapagliflozin represents an important advancement in the treatment of heart failure, promoting consistent clinical benefits and contributing to a more integrated and multidimensional therapeutic approach aimed at optimizing cardiovascular and cardiorenal outcomes.
PERIODONTITIS AS A MANIFESTATION OF SYSTEMIC DISEASES: BASIC CONCEPTS
Periodontitis as a manifestation of systemic diseases represents a condition in which systemic alterations directly influence the susceptibility, progression, and severity of periodontal destruction. This chapter discusses the inflammatory mechanisms involved in periodontitis, highlighting the participation of pro-inflammatory cytokines, prostaglandins, metalloproteinases, and the RANK/RANKL/OPG system in alveolar bone loss. Furthermore, it addresses the relationship between systemic diseases—such as diabetes mellitus, leukemia, HIV/AIDS, genetic syndromes, autoimmune diseases, and immunological disorders—and their periodontal repercussions. The 2017 classification reinforces the importance of recognizing these systemic manifestations in periodontal diagnosis, emphasizing the need for a multidisciplinary approach, based on detailed anamnesis, clinical, radiographic, and laboratory examinations, for comprehensive and individualized patient management.
INITIAL PERIODONTAL THERAPY: NON-SURGICAL THERAPY
Initial periodontal therapy, also known as non-surgical therapy, forms the fundamental basis of periodontal disease treatment, with the main objective of controlling bacterial infection and periodontal inflammation through the removal of biofilm and dental calculus. This chapter describes in detail the steps of periodontal treatment, including anamnesis, clinical and radiographic examination, patient motivation, oral hygiene instruction, scaling and root planing, as well as the complementary use of antimicrobial chemical agents. The importance of identifying and correcting local plaque-retentive factors is also highlighted, as well as periodontal reassessment after initial therapy to determine the need for maintenance or surgical intervention. An integrated and individualized approach is emphasized as essential for stabilizing the disease and maintaining long-term periodontal health.
ETIOLOGY OF PERIODONTAL DISEASE – MICROBIOLOGY AND BIOFILM
The etiology of periodontal disease is directly related to dental biofilm, an organized microbial community that, when unbalanced, triggers inflammatory processes responsible for the destruction of dental support tissues. Understanding the disease has evolved from theories focused solely on the amount of bacterial plaque to ecological models that emphasize microbial dysbiosis, the interaction between key pathogens, and the host response. Furthermore, local, systemic, and environmental factors influence the formation, maturation, and pathogenicity of biofilm, making its control essential for the prevention and treatment of periodontal diseases.
The pathogenesis of periodontal disease results from the complex interaction between a dysbiotic microbial biofilm and the host's immune-inflammatory response, with chronic inflammation being the main mechanism responsible for the destruction of periodontal tissues. Disease progression occurs from gingivitis to periodontitis, involving attachment loss, bone resorption, and eventual tooth loss, mediated by bacterial virulence factors and the release of inflammatory cytokines and destructive enzymes. Furthermore, systemic, genetic, behavioral, and local risk factors modulate the susceptibility and severity of the disease, reinforcing the importance of therapeutic strategies aimed at biofilm control, modulation of the inflammatory response, and long-term periodontal maintenance.
PERIODONTAL PLASTIC SURGERY: BASIC CONCEPTS
Periodontal Plastic Surgery aims to correct gingival and mucogingival deformities, promoting aesthetic and functional improvement and greater patient comfort. Its main indications include coverage of gingival recessions, augmentation of keratinized gingiva, correction of interdental papillae, removal of aberrant frenula, and clinical crown lengthening. Techniques such as free gingival grafts, subepithelial connective tissue grafts, and displaced flaps show predictable results when associated with adequate planning and correct surgical and postoperative management.
REGENERATIVE PERIODONTAL THERAPY: ESSENTIAL CONCEPTS
Regenerative Periodontal Therapy aims to restore periodontal tissues lost due to disease, promoting the formation of new cementum, periodontal ligament, and alveolar bone. Unlike simple repair, regeneration seeks to recover the original structure and function of the periodontium, improving dental prognosis and reducing the progression of periodontal disease. Therapeutic success depends on clot stability, selective cell exclusion, and proper root surface management. Several biomaterials and techniques can be used, such as bone grafts, membranes for guided tissue regeneration, and enamel matrix derivatives, with intraosseous defects being the most favorable for regeneration. Biofilm control, adequate surgical planning, and postoperative follow-up are fundamental for predictable and lasting results.
This chapter addresses biofilm-induced gingival diseases, highlighting gingivitis as the initial and reversible manifestation of periodontal inflammation, characterized by the absence of clinical attachment loss. The biological mechanisms involved in the inflammatory response to dental biofilm are discussed, including the participation of cytokines, prostaglandins, and metalloproteinases. The text also explores the developmental stages of gingivitis, the new 2017 classification of periodontal diseases, and the main systemic, pharmacological, and local factors that can modify the gingival response. Furthermore, it differentiates biofilm-induced gingival diseases from non-plaque-induced conditions, reinforcing the importance of early diagnosis and biofilm control for the prevention of periodontal progression.
Periodontitis is a multifactorial chronic inflammatory disease characterized by the irreversible destruction of dental support tissues, including the periodontal ligament and alveolar bone. Its etiopathogenesis involves the interaction between a dysbiotic biofilm and an exacerbated host immune-inflammatory response, mediated by pro-inflammatory cytokines, prostaglandins, and metalloproteinases. This chapter describes the mechanisms of tissue destruction, the evolution of the disease, and the participation of the RANK/RANKL/OPG system in bone resorption. It also addresses the 2017 classification of periodontal diseases, highlighting the staging and grading system for periodontitis, as well as necrotizing periodontal diseases. Finally, it emphasizes the importance of clinical and radiographic evaluation for diagnosis, prognosis, and individualized therapeutic planning.
PERIODONTAL SURGERY: SURGICAL ACCESS AND COMPLEMENTARY TECHNIQUES
Periodontal surgery represents a fundamental step in the corrective phase of periodontal treatment, being indicated mainly in cases where initial periodontal therapy was insufficient to eliminate deep periodontal pockets and complex anatomical defects. This chapter addresses the principles of periodontal surgical access, highlighting incision techniques, flap types, and the modified Widman flap as a classic approach for root debridement under direct vision. Complementary techniques, such as osteoplasty, ostectomy, and distal wedge procedures, aimed at bone remodeling and elimination of factors that hinder periodontal maintenance, are also discussed. Furthermore, the importance of preoperative preparation, adequate suturing, postoperative management, and continuous periodontal maintenance for achieving clinical stability, reducing periodontal pockets, and preserving dental support tissues is emphasized.