Targeting Myeloperoxidase Ameliorates Gouty Arthritis: A Virtual Screening Success Story.

This study presents a new approach for identifying myeloperoxidase (MPO) inhibitors with strong in vivo efficacy. By combining inhibitor-like rules and structure-based virtual screening, the pipeline achieved a 70% success rate in discovering diverse, nanomolar-potency reversible inhibitors and hypochlorous acid (HOCl) scavengers. Mechanistic analysis identified RL6 as a genuine MPO inhibitor and RL7 as a potent HOCl scavenger. Both compounds effectively suppressed HOCl production in cells and neutrophils, with RL6 showing a superior inhibition of neutrophil extracellular trap release (NETosis). In a gout arthritis mouse model, intraperitoneal RL6 administration reduced edema, peroxidase activity, and IL-1ß levels. RL6 also exhibited oral bioavailability, significantly reducing paw edema when administered orally. This study highlights the efficacy of integrating diverse screening methods to enhance virtual screening success, validating the anti-inflammatory potential of potent inhibitors, and advancing the MPO inhibitor research.

An integrated analysis of the structural changes and gene expression of spleen in human visceral leishmaniasis with and without HIV coinfection.

The spleen plays a pivotal role in the pathogenesis of visceral leishmaniasis. In severe forms of the disease, the spleen undergoes changes that can compromise its function in surveilling blood-circulating pathogens. In this study, we present an integrated analysis of the structural and gene expression alterations in the spleens of three patients with relapsing visceral leishmaniasis, two of whom were coinfected with HIV. Our findings reveal that the IL6 signaling pathway plays a significant role in the disorganization of the white pulp, while BCL10 and ICOSLG are associated with spleen organization. Patients coinfected with HIV and visceral leishmaniasis exhibited lower splenic CD4+ cell density and reduced expression of genes such as IL15. These effects may contribute to a compromised immune response against L. infantum in coinfected individuals, further impacting the structural organization of the spleen.

The spleen is the graveyard of CD4+ cells in patients with immunological failure of visceral leishmaniasis and AIDS.

BACKGROUND: Visceral leishmaniasis (VL), or kala-azar, is a common comorbidity in patients with AIDS in endemic areas. Many patients continue to experiences relapses of VL despite virological control, but with immunological failure. These patients remain chronically symptomatic with hypersplenism, for example with anemia, leukopenia, and thrombocytopenia, and are at risk of severe co-infection due to low CD4+ count. Therefore, in this study, splenectomized patients with VL and HIV infection were investigated to understand why the CD4+ count fails to recover in these patients, evaluating the importance of spleen mass for hypersplenism and immunological failure. METHODS: From a retrospective open cohort of 13 patients who had previously undergone splenectomy as salvage therapy for relapsing VL, 11 patients with HIV infection were investigated. This study compared the patients' complete blood cell count (CBC) and CD4+ and CD8+ cell counts before and after splenectomy with respect to spleen weight. RESULTS: CBC was substantially improved after splenectomy, indicating hypersplenism. However, to the best of our knowledge, this is the first study to show that spleen mass is strongly and negatively correlated with CD4+ cell count (ρ = -0.71, P = 0.015). CONCLUSIONS: This finding was unexpected, as the spleen is the most extensive lymphoid tissue and T-lymphocyte source. After reviewing the literature and reasoning, we hypothesized that the immunological failure was secondary to CD4+ loss initially by apoptosis in the spleen induced by productive HIV infection and, subsequently, by pyroptosis sustained by parasitic infection in spleen macrophages.

Influences of sociality and maternal size on reproductive strategies: trade-offs between offspring size and quantity in five Anelosimus species (Araneae, Theridiidae).

Individuals can experience accentuated disputes for resources when living with many conspecifics, even in situations in which cooperative behaviors assure benefits associated with an increase in the frequency of food acquisition and in diet breadth. Thus, intraspecific competition may exert a significant selective pressure on social animals. Theoretical models suggest that females of social species could improve their fitness by producing relatively large offspring, since body size can provide competitive advantages during foraging activities. As female reserves are limited, the production of large offspring would occur at the expense of their number. Using five Anelosimus (Araneae, Theridiidae) species, we assessed whether the social ones produce fewer and larger eggs than the subsocials. In addition, we tested the effect of female size on the adoption of each particular reproductive strategy. Small females could hypothetically invest in producing large offspring since they cannot produce as many offspring as large females. Our results suggested that, indeed, sociality influences reproductive strategies. Females of social species produced fewer and larger offspring than females of subsocial species. Subsociality, in turn, would benefit the production of many small spiderlings, possibly because a large number of siblings is important to maintain and expand new webs and to subdue prey during their initial instars. Our results also indicated that large females produce more eggs without necessarily reduce their sizes. We discussed how the costs and benefits of group living may influence reproductive strategies.

A pilot-scale study of a novel system for simultaneous nitrogen and carbon removal: technological advancement of a structured bed reactor with intermittent aeration (SBRIA) in real domestic sewage treatment.

This study outlines the development of an effective pilot-scale simultaneous denitrification and nitrification (SDN) system using intermittent aeration for the removal of carbon and nitrogen from real domestic sewage. Given the limited research in this area, the main objective was to evaluate the overall performance of the SBRIA system on a pilot scale and show its benefits in domestic wastewater treatment. The structured bed reactor with intermittent aeration (SBRIA) notably achieved 57% efficiency in removing total nitrogen without requiring external carbon sources. It also demonstrated impressive removal rates of 56% for total chemical oxygen demand (CODT) and 82% for biochemical oxygen demand (BOD5), indicating its effectiveness in degrading organic matter. In addition, the SBRIA showed high pH control and managed the consumption of alkalinity without the need for an alkalizer, maintaining consistent mean values of 7.7 ± 0.8 for pH and 166.8 ± 79.8 mg·L-1 for alkalinity. The system also proved resilient against toxic shocks caused by significant variations in influent characteristics. This study offers valuable insights and compelling results into a cost-effective and efficient treatment approach using an innovative technology not previously applied at the pilot scale. Its potential to remediate polluted water is substantial.

Avaliação da qualidade da assistência à saúde oftalmológica na percepção dos usuários / Evaluation of the quality of ophthalmic health care according to the perception of users

RESUMO Objetivo Avaliar e caracterizar a qualidade da assistência oftalmológica ofertada em uma unidade de serviços ambulatoriais da Atenção Secundária do Sistema Único de Saúde na percepção dos usuários e/ou dos responsáveis por esses usuários. Métodos Foi realizado estudo seccional de prevalência analítica entre usuários assistidos no período de setembro de 2019 a março de 2020 em um dos seis serviços de assistência oftalmológica ofertado pelo Sistema Único de Saúde, no município de Vitória da Conquista (BA). Foram avaliadas as condições demográficas e socioeconômicas e a autopercepção da saúde. Também foram avaliadas as características e os níveis de qualidade da assistência à saúde oftalmológica. A coleta das informações ocorreu por meio de entrevista telefônica. Resultados Participaram do estudo 389 usuários e/ou responsáveis. Observaram-se elevados níveis de satisfação, considerando as perguntas que compõem o constructo do instrumento. Identificaram-se níveis de qualidade comprometidos em relação à liberdade de escolher seu prestador de cuidado ocular (154; 39,7%). Menores níveis de satisfação associaram-se com as variáveis sexo masculino (razão de chance de 1,66; IC95% 1,04-2,65; p=0,033) e raça autodeclada branca (razão de chance de 6,89; IC95% 4,00-11,86; p=0,000). Conclusão Os usuários relataram bons níveis de satisfação da assistência à saúde oftalmológica. Observaram-se maiores chances de menores níveis de satisfação entre homens e aqueles com raça autodeclarada branca.

ABSTRACT Objective To evaluate and characterize the quality of ophthalmic care offered in an outpatient service unit of the SUS secondary care according to the perception of users and/or those responsible for these users. Methods A cross-sectional study of analytical prevalence was carried out among users assisted from September 2019 to March 2020, in one of the six ophthalmic care services offered by the SUS, in the municipality of Vitória da Conquista (BA), Brazil. Demographic and socioeconomic conditions, as well as self-perception of health, were evaluated. The characteristics and quality levels of ophthalmic health care were also evaluated. Data collection took place through a telephone interview. Results A total of 389 users and/or guardians participated in the study. Participants reported high levels of satisfaction, considering the questions that make up the instrument's construct. Compromised quality levels were observed in relation to the freedom to choose their eye care provider (n=154; 39.7%). Lower levels of satisfaction were associated with the variables male gender (OR=1.66; 95%CI=1.04-2.65; p=0.033) and self-reported white race (OR=6.89; 95%CI=4, 00-11.86; p=0.000). Conclusion Users reported good levels of satisfaction with eye health care. There were greater chances of lower levels of satisfaction among men and among those with a self-reported white race.

Naturally-Occurring Radioactive Materials at water treatment plant on the Poços de Caldas Plateau Region, Brazil / Materiais Radioativos de Ocorrência Natural em estações de tratamento de água no Planalto de Poços de Caldas, Brasil

ABSTRACT Oil and gas, mining, among others, are examples of facilities where naturally occurring radioactive materials can be found. This study aims to evaluate the presence of natural radioactive series, especially those of 238U and 232Th, in the water treatment plants of Poços de Caldas City, Minas Gerais. The presence of these series was investigated in samples of raw water, treated water, sludge from decanters, and scale from Parshall gutters. The sludge, input, and scale samples were submitted to the gamma spectrometry technique to determine the 226Ra, 228Ra, and 210Pb radionuclides. For U and Th, ultraviolet visible spectrophotometry was performed, and for the alpha and beta total values, radiochemical separation and subsequent alpha and beta total counts were performed. The results indicate that water samples are within the Ministry of Health Ordinance n° 5 (2017). Due to the different concentrations of radionuclide activity in the sludge, it was not possible to affirm the same order of magnitude with the sediment from the catchments. However, the values are in accordance with those established by the European Union Council for Naturally-Occurring Radioactive Materials. In the scale, the contents of 1192, 1704, and 301 Bq kg−1 were identified for 226Ra, 228Ra, and 210Pb, respectively. In the inputs of aluminum sulfate and calcium hydroxide, no relevant activities were identified. The results obtained in the study can serve as an indicative regarding the need for a more detailed evaluation of the radiological issue in question concerning public water supplies.

RESUMO Petróleo e gás, mineração, estações de tratamento de água, entre outros, são exemplos de instalações que podem apresentar Materiais Radioativos de Ocorrência Natural. Neste estudo, objetivou-se avaliar a presença de séries radioativas naturais, especialmente as de 238U e 232Th nas estações de tratamento de água da cidade de Poços de Caldas/MG. Foram investigadas as presenças dessas séries em amostras de água bruta, de água tratada, no lodo dos decantadores e nas incrustações das calhas Parshall, além dos principais insumos utilizados. As amostras de lodo, insumos e incrustações foram submetidas à técnica de espectrometria gama para a determinação dos radionuclídeos 226Ra, 228Ra e 210Pb. Para U e Th, realizou-se espectrofotometria ultravioleta-visível, e para os valores de Alfa e Beta totais foram realizadas separação radioquímica e posterior contagem Alfa e Beta total. Os resultados indicaram que as amostras de águas estão em conformidade com a Portaria de Consolidação n° 5 de 2017 do Ministério da Saúde. Dadas as diferentes concentrações de atividade dos radionuclídeos no lodo, não foi possível afirmar a mesma ordem de magnitude com o sedimento das captações. Entretanto, os valores estão consonantes com o estabelecido pelo conselho da União Europeia para Materiais Radioativos de Ocorrência Natural. Nas incrustações foram identificados teores de 1.192 Bq.kg-1, 1.704 Bq.kg-1 e 301 Bq.kg-1 para 226Ra, 228Ra e 210Pb, respetivamente. Já para os insumos Sulfato de Alumínio (Al4(SO4)3) e Hidróxido de Cálcio Ca(OH)2 não foram identificadas atividades relevantes. Os resultados obtidos no estudo podem servir como indicativos da necessidade de uma avaliação mais detalhada sobre a questão radiológica em foco, em relação ao abastecimento público de águas.

Consentimento informado para a testagem do HIV em unidades de pronto-socorro e direitos humanos dos pacientes: à procura de equilíbrio / Informed consent for HIV screening in the emergency departments and human rights in patient care: seeking the right balance

Resumo O "excepcionalismo" da infecção pelo HIV diz respeito ao fato de essa doença ser considerada tão diferente das demais e de que sua testagem necessita de uma abordagem especial em relação ao consentimento informado. Frequentemente, pessoas infectadas pelo HIV visitam unidades de assistência à saúde, sobretudo prontossocorros, anos antes de receberem um diagnóstico, sem terem sido testadas nessas oportunidades. Existe considerável interesse público em ampliar a testagem para o HIV em prontos-socorros. Por se tratar de ambiente sensível, cuja missão principal é o cuidado de urgências e emergências, há questionamentos quanto a esse ser um local apropriado para um programa de rastreamento universal, notadamente por questões éticas. Assim, os "direitos humanos dos pacientes" (DHP) constituem referencial teórico essencial para a análise de conflitos éticos que surgem no encontro clínico, fortalecendo a efetiva aplicação dos direitos humanos ao cuidado em saúde.

Abstract HIV exceptionalism refers to the fact that the illness is so different from other diseases that testing needs a special approach to informed consent. HIV infected people often visit health clinics, especially emergency departments, years before receiving a diagnosis without being tested for HIV. There is considerable public interest in increasing HIV testing in emergency departments. However, because these departments are sensitive environments that primarily provide urgent and emergency care, a number of ethical questions have been raised about the appropriateness of these settings for the implementation of universal screening programs. Human rights in patient care therefore constitutes an essential theoretical framework for analyzing ethical and legal dilemmas that arise in clinical encounters, thus strengthening the application of human rights principles to the context of patient care.

Transporte de material dissolvido em superfície impermeável sob chuva artificial analisado com a aplicação do delineamento experimental das faces centradas / Transport of dissolved material on impermeable surface under artificial rainfall analyzed with the application of face-centered experimental design

RESUMO O estudo do escoamento superficial e transporte de poluentes é de grande importância, pois ajuda na prevenção de impactos ambientais, auxiliando em planejamentos a serem realizados pelo poder público. Neste trabalho, teve-se como objetivo estudar, em laboratório, a dinâmica do transporte de material (cloreto de sódio - NaCl) disposto sobre uma superfície impermeável, dissolvido pela aplicação de água via simulador de chuva, tendo como fonte de variação três variáveis independentes: declividade, intensidade de precipitação e posição do material. Utilizou-se o delineamento experimental de faces centradas, que contemplou diferentes cenários reproduzidos nos experimentos, onde se avaliou a influência das três variáveis independentes sobre às dependentes (tempo de transporte, valor de pico, tempo de pico e massa total transportada), cujas respostas foram monitoradas no exutório do modelo experimental. A análise de resultados obtidos permitiu identificar o efeito significativo da declividade e posição do material sobre todas as variáveis dependentes estudadas e ainda o efeito quadrático da declividade para o tempo de transporte e a massa total transportada. Já para a intensidade de precipitação, verificou-se influência apenas para o tempo de transporte, dentro dos intervalos de estudo com nível de significância de 95%. O modelo produzido para o tempo de transporte é capaz de explicar 90% da variabilidade dos dados, enquanto o para o valor de pico possui uma capacidade de explicação de 67,9%. O tempo de pico possui um modelo capaz de explicar 74,2% da variabilidade dos dados, e o modelo produzido para a massa total transportada possui uma capacidade de explicação de 62,4% da variabilidade dos dados.

ABSTRACT The study of surface runoff and transport of pollutants is of major importance, as it helps preventing environmental impacts, and supports planning tasks carried out by public authorities. The goal of this research was to study the dynamics of the transport of material (NaCl) on an impermeable surface, dissolved by the application of water through a rainfall simulator, having as its source of variation three independent variables: slope, rainfall intensity and position of the material. Face-centered experimental design was used, which contemplated different scenarios reproduced in the experiments, where the influence of the three independent variables on the dependent variables (transport time, peak value, peak time and total mass transported) was evaluated, whose responses were monitored at the outlet of the experimental model. The analysis of the results allowed to identify the significant effect of the slope and position of the material on all the dependent variables studied, as well as the quadratic effect of the slope for the transportation time and total mass transported. As for the rainfall intensity, only influence was observed for transportation time, within the study intervals with a level of significance of 95%. The resulting model is capable of explaining: 90% for transport time, 67.9% for peak value, 74.2% for peak time and 62.4% total mass transported.

Violência contra a mulher em tempos de pandemia da COVID-19 no Brasil: uma revisão integrativa / Violence against women in covid-19 pandemic times in Brazil: literature narrative review

Objetivo: sintetizar as informações contidas em artigos originais publicados no ano de 2020 sobre violência doméstica em tempos de pandemia da COVID-19 no Brasil e identificar que medidas, inclusive jurídicas, podem ser tomadas para amparar a mulher frente a essa situação. Método: revisão integrativa de literatura realizada por meio de buscas entre os meses de abril e julho de 2020 nas bases de dados LILACS, BDENF, MEDLINE, no motor de buscas PUBMED, e em um buscador acadêmico (Google Scholar). Utilizou-se palavras chaves presentes nos Descritores em Ciências da Saúde (DeCS) e no Medical Subject Headings (MeSH), bem como revisão legislativa sobre a temática. Foram incluídos no estudo artigos originais que abordaram o tema violência doméstica em tempos de pandemia. Resultados: dos estudos encontrados, dois atenderam aos critérios pré-estabelecidos para a inclusão neste estudo. Após análise dos textos foi possível organizar as informações obtidas em duas abordagens: o que já se sabe sobre o aumento da violência doméstica em tempos de pandemia e o que pode ser feito, considerando medidas jurídicas, para amparar as mulheres vítimas de violência doméstica durante a pandemia da COVID-19. Conclusão: foram selecionados dois artigos originais cujos resultados e conclusões associados às produções científicas, legislações e relatórios de organizações nacionais e internacionais, consideradas na revisão podem subsidiar a prática de gestores e profissionais de saúde no enfrentamento da violência contra a mulher no Brasil em tempos de pandemia. Ficou evidente a necessidade de estudos originais sobre o tema.

Objective:to synthesize the information contained in scientific productions, legislation and reports of national and international organizations published in the year 2020 on domestic violence in the pandemic times of COVID-19 in Brazil and to identify what measures, including legal ones, can be taken to support women in this situation. Method:literature narrative review carried out through searches between the months of April and July 2020 in the LILACS, BDENF, MEDLINE databases, in the PUBMED search engine, and in an academic search engine (Google Scholar). Keywords used in the Health Sciences Descriptors (DeCS) and Medical Subject Headings (MeSH) were used, as well as a legislative review on the subject. Scientific productions, legislation and reports of national and international organizations that addressed the issue of domestic violence in times of pandemic were included in the study. Results:of the studies found, eighteen met the pre-established criteria for inclusion in this study. After analyzing the texts, it was possible to organize the information obtained in two approaches: what is already known about the increase in domestic violence in times of pandemic and what can be done, considering legal measures, to support women victims of domestic violence during the COVID-19 pandemic. Conclusion:The scientific productions, legislation and reports of national and international organizations considered in the review can support the practice of managers and health professionals in confronting violence against women inBrazil in times of pandemic. The need for original studies on the topic was evident.

HIV prevalence in recently incarcerated adult males in the Federal District, Brasilia, Brazil

Abstract INTRODUCTION: This study intends to describe a HIV intake screening strategy in recently incarcerated adults in Distrito Federal, Brasilia, Brazil. METHODS: We tested 455 recently incarcerated adults in Distrito Federal in 2016 using rapid tests (RT) applied to oral samples (OS). RESULTS: The estimated frequency of positive tests was 0.88% (95% confidence interval [CI] 0.34% to 2.24%). CONCLUSIONS: The present findings reveal the potential significance of detecting new HIV infection cases in a vulnerable population using point-of-care rapid diagnostic tests.

Cutaneous parasitism in patients with American visceral leishmaniasis in an endemic area

Abstract INTRODUCTION: Visceral leishmaniasis (VL) represents a public health concern in several areas of the world. In the American continent, VL transmission is typically zoonotic, but humans with active VL caused by Leishmania infantum are able to infect sandflies. Thus, individuals with cutaneous parasitic infections may act as reservoirs and allow interhuman transmission. Additionally, the skin may be responsible for reactivation of the disease after therapy. This study's objective was to evaluate cutaneous parasitism in humans with VL in an American endemic area. METHODS: A cross-sectional hospital-based study was conducted in northeast Brazil from October 2016 to April 2017. Biopsies of healthy skin for histopathology and immunohistochemistry were performed prior to treatment in all study patients. RESULTS: Twenty-two patients between the ages of five months to 78 years were included in the study. Seven patients (31.8%) tested positive for HIV. Only one patient had cutaneous parasitism, as confirmed by immunohistochemistry prior to treatment. Parasitism was not detected after treatment. CONCLUSIONS: Cutaneous parasitism in the healthy skin of humans with visceral leishmaniasis, although unusual, may be a source of infection for phlebotomine sandflies.

Carcinoma metaplásico de mama com diferenciação osteossarcomatosa: um relato de caso / Metaplastic breast carcinoma with osteosarcomatoid differentiation: a case report

Relato de caso de um osteossarcoma metaplásico da mama em um hospital de Teresina, com resumo e discussão de literatura. O carcinoma metaplásico da mama é mais comum em mulheres entre 55 e 60 anos. Apresenta-se em forma de uma massa palpável sem preferência por quadrante, com rápido crescimento e geralmente é mais largo do que outros tipos de tumores mamários. Os carcinomas têm poucos receptores para hormônios sexuais. No caso de carcinoma metaplá- sico com diferenciação osteossarcomatosa, sua apresentação é bem agressiva. A decisão sobre o tratamento apresenta di culdades em função do baixo número de casos relatados na literatura. Neste relato, apresenta-se uma paciente com carcinoma metaplásico e diferenciação osteossarco- matosa no quadrante superior da mama direita. Foi realizada uma mastectomia com ressecção da pele do quadrante e do segmento do músculo peitoral in ltrado pelo tumor, com preservação do restante da pele e do complexo papiloareolar. Serão discutidas as descobertas patológicas. Devido às diversas opções de tratamento disponíveis para a paciente, conclui-se que mais estudos devem ser realizados sobre qual terapêutica possui maior impacto no prognóstico do paciente, bem como o papel da radioterapia/quimioterapia no paciente.

is is a case report of an osteosarcomatoid metaplastic breast carcinoma in a hospital in Teresina, Brazil, with review and discussion on the theme. Breast metaplastic carcinoma is more common in women aged 55 and 60 years old. It is usually in the form of a palpable mass with no predilection for any quadrant and rapid growth and is generally larger than other types of breast tumors. ese tumors have few receptors for sex hormones. In the case of metaplastic carcinoma with osteosarcomatoid di erentiation, its presentation is quite aggres- sive. A decision on the treatment procedure presents di culties due to the low number of cases reported in the literature. In this report, we present a patient with metaplastic carcinoma and sarcomatoid di erentiation in the right upper quadrant of the right breast. It was performed a mastectomy with quadrant skin resection and segment of the pectoral muscle in ltration by the tumor with preservation of the rest of the skin and papiloareolar complex. It will be discussed the pathological ndings. Due to the several treatment options available to the patient, it can be concluded that more studies must be done on what kind of treatment has the greatest impact on patient prognosis, as well as the role of radiotherapy/chemotherapy on patient.

Sarcoma de Kaposi no trato gastrintestinal alto em paciente infectado por HIV / Upper gastrointestinal Kaposi's sarcoma in HIV-infected patient

Introdução: o Sarcoma de Kaposi (SK) é a neoplasia mais comum em portadores da Síndrome da Imunodeficiência Adquirida (SIDA). É raro o acometimento exclusivo do trato gastrointestinal por essa afecção, ocorrendo em 3,5% dos casos. O objetivo desse estudo é relatar o caso de um paciente portador de SIDA com anemia e vômitos, diagnosticado com SK gastrointestinal. Relato de caso: paciente do gênero masculino, 29 anos, foi admitido no Hospital Universitário (HU/UFPI) devido a sintomas inespecíficos com 1 mês de evolução. Paciente tinha antecedente pessoal de retrovirose. Para investigação dos sintomas, o paciente realizou endoscopia digestiva alta que revelou lesões violáceas sésseis de antro gástrico e duodeno. A análise histopatológica constatou fragmentos de mucosa gástrica e entérica exibindo, em lâmina própria, proliferação de capilares sanguíneos em fenda, células fusiformes atípicas com núcleos hipercromáticos e extravasamento de hemácias. O estudo imuno-histoquímico mostrou que as células neoplásicas expressaram o antígeno nuclear latente-1 do herpesvírus humano 8 (HHV8 LNA1; clone LN53, diluição 1:25, Diagnostic Biosystems, Pleasanton, CA) em padrão nuclear, confirmando o diagnóstico de SK. Em decorrência de múltiplas complicações e agravamento clínico, o paciente foi a óbito após 15 dias da admissão. Discussão e Conclusão: incidência de SK gastrointestinal é subestimada. Estômago, duodeno e o trato biliar são os locais mais comumente acometidos. A detecção do HHV-8 por imuno-histoquímica é uma ferramenta útil, especialmente na lesão inicial em que o caráter neoplásico não é evidente. A mortalidade dos pacientes com SK gastrointestinal exclusivo é significantemente maior em relação aos que não têm esse tipo de acometimento. Tal fato pode explicar o prognóstico reservado do paciente relatado no presente caso.

Introduction: Kaposi sarcoma (KS) is the most common malignancy in patients with Acquired Immunodeficiency Syndrome (AIDS). It is rare the exclusive involvement of the gastrointestinal tract by this condition, occurring in 3.5% of cases. The aim of this study is to report the case of an HIV-infected patient with anemia and vomiting diagnosed with gastrointestinal KS. Case report: a 29-year-old male patient admitted to the University Hospital (HU/UFPI) due to non-specific symptoms with one month of evolution. He had personal history of retrovirus. To research the symptoms, the patient underwent upper endoscopy that revealed sessile purplish lesions of gastric antrum and duodenum. Histopathological analysis found gastric and enteric mucosa fragments exhibiting in lamina propria proliferation of blood capillaries with formation of slit like spaces, atypical spindle cells with hyperchromatic nuclei and extravasation of red blood cells. Immunohistochemical study showed that tumor cells expressed human herpesvirus 8 latent nuclear antigen-1 (HHV-8 LNA1; clone LN53, dilution 1:25, Diagnostic Biosystems, Pleasanton, CA) in nuclear pattern, confirming the diagnosis of KS. Because of multiple complications and clinical worsening, the patient died after 15 days of admission. Discussion and Conclusion: the incidence of gastrointestinal KS is underestimated. Stomach, duodenum and biliary tract are the most commonly affected sites. The detection of HHV-8 for immunohistochemistry is a useful tool, particularly in the initial lesion in which the neoplastic character is not evident. The mortality of patients with exclusive gastrointestinal KS is significantly higher than those who do not have that involvement. This may explain the poor prognosis of the patient reported in this case.

Combinación quirúrgica: una necesidad en odontopediatría / Combinação cirúrgica: uma necessidade em odontopediatria / Surgical combination: a necessity in Pediatric Dentistry

Introducción: El Mesiodens es un diente supernumerario que se forma en la línea media entre los incisivos centrales superiores, más frecuentemente en la dentición permanente y en pacientes de sexo masculino. Su etiología es bastante desconocida, pero la hiperactividad de la lámina dentaria es la teoría más aceptada. Se presenta asociado a otras complicaciones, como el diastema interincisivo, que puede también estar asociado a la inserción anormal del frenillo labial superior, provocando alteraciones en la estética dentaria. El objetivo de este trabajo fue comunicar sobre un caso clínico de exodoncia de un mesiodens y de la resección del frenillo labial superior en un solo procedimiento quirúrgico, con seguimiento del cierre fisiológico del diastema luego de 1 año. Reporte de caso: El presente trabajo reporta el caso de un niño, de 11 años de edad, que ingresó a la clínica-escuela de Odontopediatría de la Facultad Independiente del Nordeste acompañado por su madre, con queja estética de separación dental. Después de la anamnesis, examen clínico y radiográfico se diagnosticó la presencia de mesiodens e inserción anormal del frenillo labial superior. Se seleccionó como tratamiento una técnica quirúrgica combinada de exodoncia del mesiodens y frenectomía en una misma sesión, con seguimiento de un año y observación del cierre progresivo del diastema entre los incisivos. Conclusión: El diagnóstico correcto de dientes supernumerarios y anormalidades del frenillo es fundamental, a través de un buen examen clínico y radiográfico para la realización del tratamiento individualizado, siendo exitoso en este caso la combinación quirúrgica.

Introdução: Mesiodens é um dente supranumerário que ocorre na linha média entre os incisivos centrais superiores, com maior frequência na dentição permanente e em pacientes do sexo masculino. Sua etiologia ainda não é completamente entendida, sendo a hiperatividade da lâmina dentária a teoria mais aceita. O mesiodens traz algumas complicações, sendo uma delas o diastema interincisal, podendo este também estar associado à inserção anormal do freio labial superior, causando alterações na estética dentária entre outros. O objetivo desse trabalho é relatar um caso clínico da remoção de mesiodens e freio labial superior em mesmo tempo cirúrgico, com avaliação do fechamento gradual fisiológico do diastema após 1 ano. Relato de caso: O presente trabalho relata um caso de uma criança, 11 anos de idade, sexo masculino, que compareceu à clínica-escola de Odontopediatria da Faculdade Independente do Nordeste (FAINOR) com sua mãe, com queixa estética de afastamento dentário; após anamnese, exame clínico e radiográfico foi diagnosticada a presença de mesiodens e inserção anormal do freio labial superior. Esse relato teve por escolha o tratamento de remoção cirúrgica do mesiodens associado à frenectomia labial superior em uma mesma sessão, com proservação de 1 ano e observação do fechamento gradual do diastema interincisal. Conclusão: O diagnóstico correto de dentes supranumerários e anomalias do freio é fundamental por meio de um bom exame clínico e radiográfico. A oportunidade individual da realização do tratamento é outro fator importante.

Introduction: Mesiodens is a supernumerary tooth that occurs on the midline between the maxillary central incisors, with a higher frequency on permanent teeth and on male patients. Its etiology is not completely understood yet, with dental lamina hyperactivity being the most accepted theory. Mesiodens may bring some complications, one of them being the interincisal diastema, which can also be associated with an abnormal superior labial frenum insertion, causing alterations in the dental aesthetics among others. The aim of this study is to report a clinical case of mesiodens removal and superior labial frenum on the same surgical time, with evaluation of the diastema's physiological gradual closure after one year. Case report: This study reports the case of a child, 11 years of age, male, who attended the Odontopediatrics teaching clinic of the Facultad Independente do Nordeste (FAINOR) with his mother, with an esthetic complaint of dental gap. After anamnesis, clinical and radiographic examination, the presence of mesiodens and abnormal insertion of the superior labial frenum were diagnosed. The treatment of choice was surgical removal of the mesiodens associated with superior labial frenectomy, with a one year follow-up and observation of the interincisal diastema's gradual closure. Conclusion: The correct diagnosis of supernumerary teeth and frenum abnormalities is fundamental, through a good clinical and radiographic examination. The individual opportunity for treatment is another important factor.

Sows' parity and coconut oil postnatal supplement on piglets performance / Número de partos y la suplementación de aceite de coco para lechones recién nacidos

Objective. The study aimed to evaluate the effect of sows' of different parities and the supplement of coconut oil for piglets, on the development of litter. Materials and methods. A total of 51 sows of different parities and their 642 piglets were used in the trial. Each piglet was weighed and identified at birth in a sequential order. They were randomly distributed in two treatments (CG=control group and TG=test group). TG piglets had the first access to a dosage of 3.0 ml of coconut oil 12 hours after birth, and the second at 36 h after the first. Piglets were weighed at 21 days. In order to analyze the effect of the coconut oil supplement as a function of the weight at birth, piglets were grouped according to their weight (0.600 to 0.900 kg; 1.000 to 1.499kg; 1.500 to 1.999 kg; and 2.000 to 2.499 kg). Results. Sows parity affected the number and weight of born piglets. Sows in 4th, 5th and 7th parity had a larger litter than those from the 2nd parity. Sows from 2nd and 3rd parity had a lower number of piglets but heavier litter. No effect of the coconut oil supplement on neonatal piglets' performance was found. Conclusions. The coconut meal was neither beneficial to neonatal piglets nor to those with low weight at birth, which usually present low body energy.

El objetivo del estudio fue evaluar el efecto del número de partos y el suplemento de aceite de coco en lechones recien nacidos. Materiales y métodos. Se utilizaron 51 cerdas de diferentes partos y sus 642 lechones. Cada lechón se pesó y se identificó al nacer en orden secuencial. Fueron distribuidos aleatoriamente en dos grupos (CG = control y TG=tratamiento). Lechones TG tenían el primer acceso a una dosis de 3.0 ml de aceite de coco 12 horas después del nacimiento, y el segunda a las 36 h después de la primera. Los lechones fueron pesados a los 21 días. Con el fin de analizar el efecto de los suplementos de aceite de coco con relación al peso al nacer. Los lechones fueron agrupados de acuerdo con su peso (0.600 a 0.900 kg; 1.000 a 1.499 kg; 1.500 a 1.999 kg y 2.000 a 2.499 kg). Resultados. El número de partos afectó el peso y el número de lechones nacidos. Cerdas en cuarto, quinto y séptimo parto, tuvieron una camada mayor que las de segundo parto. Las cerdas de segundo y tercer parto tuvieron menor número de lechones y con peso mayor. No se encontró efecto del suplemento de aceite de coco en el desarrollo de los lechones recién nacidos. Conclusiones. Lo aceite de coco no es favorable para los lechones recién nacidos, tampoco para aquellos con el bajo peso al nacer, que normalmente presentan la energía corporal baja.

Câncer de mama em mulheres muito jovens: estudo clinicopatológico de 149 pacientes (menor ou igual)25 anos de idade / Acute effects of water-based exercise versus land-based exercise on ambulatory blood pressure and heart rate variability in heart transplant recipients

O transplante cardíaco (TX) é um reconhecido procedimento de escolha para a insuficiência cardíaca refratária, resultando em melhora na sintomatologia e na qualidade de vida dos pacientes. Todavia, estes pacientes apresentam capacidade física reduzida e alta prevalência de comorbidades. A terapia imunossupressora, bem como a denervação cardíaca pós-cirurgia tornam a hipertensão arterial sistêmica (HAS) a mais prevalente das comorbidades. Avaliamos o efeito agudo do exercício aeróbio em piscina aquecida e em solo sobre a dinâmica do comportamento tensional na pressão arterial durante 24 horas (MAPA-24h) e na atividade autonômica do coração. Dezoito pacientes (6 mulheres) clinicamente estáveis (5 ± 0,7 anos de cirurgia), 45,7 ± 2,7 anos de idade, foram submetidos a 30 minutos de exercício aeróbio em piscina, exercício aeróbio em esteira rolante (solo) ou 30 minutos em repouso (controle) em ordem randômica (2 a 5 dias entre cada sessão). A intensidade do exercício foi entre 11 e 13 em uma escala subjetiva de esforço que vai de 6 a 20. Foram avaliadas a variabilidade da frequência cardíaca (VFC) no início, logo após o exercício e na fase de recuperação, bem como a MAPA-24h após cada sessão. Após o exercício em piscina, foram observadas reduções significativas em relação à sessão controle nas médias horárias da pressão arterial sistólica (PAS) nas três primeiras horas (15h = 12,2 ± 3,1 mmHg, p = 0,004; 16h = 11,1 ± 2,8 mmHg, p = 0,003; 17h = 12,3 ± 3,1 mmHg, p =0,003) e após a sétima hora (21h = 7,8 ± 1,7 mmHg, p = 0,001) de análise, e nas médias diária (4 ± 1,6 mmHg, p = 0,02) e horária da pressão arterial diastólica (PAD) na primeira (15h = 7,7 ± 2,8 mmHg, p = 0,04) e sétima hora (21h = 6,6±1,5 mmHg, p = 0,002). Após o exercício em solo foram vistas reduções significativas em relação à sessão controle nas médias horárias da PAS durante a segunda (16h = 5,3±1,6 mmHg, p = 0,01), terceira (17h = 7,3 ± 2,3 mmHg, p = 0,02) e vigésima primeira hora...

Heart transplantation (TX) is a recognized procedure of choice for refractory heart failure, resulting in improvement in symptoms and quality of life of patients. However, these patients have reduced physical capacity and high prevalence of comorbidities. Immunosuppressive therapy and post-surgery cardiac denervation make systemic hypertension (SH) the most prevalent comorbiditie. We evaluated the acute effect of aerobic heated water-based exercise and land-based exercise on the dynamic tension behavior in blood pressure for 24 hours (24-h ABP) and autonomic activity of the heart. Eighteen patients (6 females) clinically stable (5 ± 0.7 years of surgery), 45.7 ± 2.7 years old, underwent 30 minutes of aerobic exercise in the swimming pool, aerobic exercise on a treadmill (land) or non-exercise control (control) in random order (2-5 days between each session). Exercise intensity was set at 11-13 in the 6-20 rating of perceived exertion scale. We evaluated the heart rate variability (HRV) at the beginning, right after exercise and during the recovery phase, and the 24-h ABP after each session. After water-based exercise, significant reductions were observed in relation to the control session on hourly average systolic blood pressure (SBP) in the first three hours (15h = 12.2 ± 3.1 mmHg, p = 0.004; 16h = 11.1 ± 2.8 mmHg, p = 0.003; 17h = 12.3 ± 3.1 mmHg, p = 0.003) and after the seventh time (21h = 7.8 ± 1.7 mmHg, p = 0.001) analysis, and the daily averages (4 ± 1.6 mmHg, p = 0.02) and hourly average diastolic blood pressure (DBP) in the first (15h = 7.7 ± 2.8 mmHg, p = 0.04) and seventh hours ( 21h = 6.6 ± 1.5 mmHg, p = 0.002). After land-based exercise significant reductions were observed when compared to control session in the hourly averages of SBP during the second (16h = 5.3 ± 1.6 mmHg, p = 0.01), third (17h = 7.3 ± 2 , 3 mm Hg, p = 0.02) and twenty-first time (= 11h 7.8 ± 1.7 mmHg, p = 0.02) and in hourly averages DBP during the second...

An unusual pleomorphic adenoma / Adenoma pleomórfico não usual

Pleomorphic adenoma is the most common neoplasm in major and minor salivary glands. It constitutes approximately 90% of all benign salivary gland lesions and the parotid is the most affected location. When the minor salivary glands are affected, it mostly occurs at the junction of the hard and soft palates. The diagnosis is complex because of the great histological variety and biological behavior of this tumor, a histopathological examination being essential. The recommended treatment is surgical excision. For lesions located superficially in the parotid gland, superficial parotidectomy - identifying and preserving the facial nerve - is necessary. Lesions in the palate or gums sometimes demand a margin of safety, being excised below the periosteum, including the overlying mucosa. With correct surgical removal, the prognosis is excellent. The aim of this study is to report a case of an unusual minor salivary gland pleomorphic adenoma in the hard palate, describing the most important aspects of this pathology.

O adenoma pleomórfico é a neoplasia mais comum entre os tumores das glândulas salivares maiores e menores. Constitui aproximadamente 90% de todas as lesões benignas das glândulas salivares e a parótida é a mais acometida. A junção dos palatos duro e mole é o sítio de predileção mais comum, quando as glândulas salivares menores são atingidas. O diagnóstico é complexo devido a grande variedade histológica e comportamento biológico deste tumor, sendo imprescindível a realização do estudo histopatológico. O tratamento de escolha é a excisão cirúrgica. Para as lesões localizadas no lobo superficial da parótida é recomendada a parotidectomia superficial com a identificação e preservação do nervo facial. As lesões do palato ou gengiva por vezes podem exigir margem de segurança, sendo geralmente excisadas abaixo do periósteo, incluindo a mucosa sobrejacente. Com a remoção cirúrgica adequada, o prognóstico é excelente. O presente trabalho tem como objetivo relatar um caso de adenoma pleomórfico não usual de glândula salivar menor no palato duro, em região posterior direita, além de descrever os aspectos mais importantes dessa patologia.

Consejos farmacéuticos a pacientes con trastornos de humor / Pharmacist counseling for patients with mood disorders

Introducción: la atención farmacéutica consiste en la interacción directa del farmacéutico con el usuario a fin de lograr una farmacoterapia racional y obtener resultados definidos y mensurables, encaminados a la mejoría de la calidad de vida del paciente. La depresión es considerada una de las diez principales causas de incapacidad en el mundo, la cual limita el funcionamiento físico, personal y social. Sin embargo, pocas personas afligidas con estos problemas de salud reciben el tratamiento adecuado y orientaciones acerca de la enfermedad y tratamiento. Objetivo: evaluar el servicio de la atención farmacéutica mediante consejo farmacéutico sobre la efectividad y adhesión a la farmacoterapia. Métodos: se seleccionaron 19 pacientes, con edad entre 15 y 82 años, con trastornos de humor, atendidos en el Centro de Atención Psicosocial y Ambulatorio de UNIFENAS, Brasil. Se realizaron citas domiciliares, durante las cuales se les dieron a los pacientes orientaciones acerca de la enfermedad, reacciones adversas, interacciones medicamentosas, duración del tratamiento e importancia de adhesión a este. El inventario de depresión de Beck y la prueba de Morisky para evaluar la adhesión fueron aplicados antes y después del consejo farmacéutico. Resultados: la mayoría fueron mujeres, católicas, con hasta nueve años de estudio. Al comparar los resultados de la aplicación del inventario de depresión de Beck antes y después del consejo del farmacéutico, hubo una diferencia estadísticamente significativa (p= 0,0354), con reducción de aproximadamente 6 puntos en el escore de Beck (24,22 para 18). El nivel de adhesión entre los pacientes aumentó, pues el número de pacientes con alta adhesión pasó de 21,06 por ciento a 42,10 por ciento. Conclusiones: los resultados sugieren que el consejo farmacéutico puede ser útil para lograr mejores resultados de adhesión y efectividad al tratamiento(AU)

Introduction: pharmaceutical care is the direct interaction of the pharmacist and the user in order to achieve rational drug therapy and to obtain defined measurable results aimed at improving the life quality of the patient. Depression is considered one of the ten main causes of disability worldwide since it restricts the physical, social and personal functioning of the individual. However, few people having these health problems receive proper treatment and directions about their disease and therapy. Objective: to evaluate the pharmaceutical care service through counseling on the effectiveness of and adherence to drug therapy. Methods: nineteen patients were selected, aged 15 to 82 years and with mood disorders. They were all seen at the Psychosocial and Outpatient Care Center of UNIFENAS in Brazil. They were visited at home to give instructions to them about their disease, adverse reactions, and drug interactions, length of treatment and importance of adherence to therapy. Beck depression inventory and Morisky´s test were used to evaluate adherence to treatment before and after the pharmacist counseling. Results: most of patients were Catholic women, who had been under study for up to 9 years. When comparing the results of the application of the Beck depression inventory before and after the pharmacist counseling, there was observed an statistically significant difference ((p= 0.0354), with a reduction of roughly 6 point in Beck´s score (24,22 for 18). The adherence to treatment rate increased since the number of patients who showed high rate of adherence to therapy rose from 21.06 percent to 42.10 percent. Conclusions: the results suggest that the pharmacist counseling could be a useful method to achieve better outcomes in adherence to and effectiveness of treatment(AU)

Uso do acesso retromandibular para tratamento de fratura bilateral de côndilo mandibular: relato de caso / Treatment of bilateral mandibular condylar fractures: a case report

O tratamento da fratura de côndilo mandibular é um assunto de muitas controvérsias na literatura sobre as indicações e contraindicações para o tratamento cirúrgico ou conservador. Além delas, dúvidas ainda permanecem sobre qual o melhor acesso cirúrgico para o tratamento desse tipo de fratura, quando se opta pelo tratamento cirúrgico (aberto). os acessos extrabucais, descritos na literatura para o tratamento das fraturas condilares, são: pré-auricular, submandibular, ritidectomia e retromandibular (hinds). o acesso intraoral, com o auxílio da endoscopia, também pode ser utilizado com a mesma finalidade. Por meio do relato de um caso clínico, os autores apresentam um caso de fratura de côndilo mandibular bilateral em que foi utilizado o acesso retromandibular para redução e fixação da fratura.

The treatment of a mandibular condylar fracture is a subject of much controversy in the literature regarding indications and contraindications to the surgical or conservative approach. In addition, many doubts remain regarding the optimal surgical approach for treating this type of fracture when the open technique is chosen. The extra-oral approaches described in the literature for the treatment of condylar fractures are the preauricular, submandibular, ritidectomy and retromandibular (hinds).The intra-oral access, with the aid of endoscopy, can also be used for the same purpose. In this clinical report, the authors present a case of bilateral mandibular condylar fracture in which the retromandibular approach was used for the reduction and fixation of the fracture.