Effective conservation of subterranean-roosting bats.

Bats frequently inhabit caves and other subterranean habitats and play a critical role in subterranean food webs. With escalating threats to subterranean ecosystems, identifying the most effective measures to protect subterranean-roosting bats is critical. We conducted a meta-analysis to evaluate the effectiveness of conservation and management interventions for subterranean-roosting bats. We used network analyses to determine to what extent interventions for bats overlap those used for other subterranean taxa. We conducted our analyses with data extracted from 345 papers recommending a total of 910 conservation interventions. Gating of roost entrances was applied to preserve bat populations in 21 studies, but its effectiveness was unclear. Habitat restoration and disturbance reduction positively affected bat populations and bat behavior, respectively, in ≤4 studies. Decontamination was assessed in 2 studies and positively affected bat populations, particularly in studies focused on reducing fungal spores associated with white-nose syndrome in North America. Monitoring of bat populations as an effective conservation strategy was unclear and infrequently tested. Only 4% of bat studies simultaneously considered other subterranean organisms. However, effective interventions for bat conservation had similarities with all other organisms. If other subterranean organisms are considered when applying interventions to conserve bats, they might also benefit.

Conservación eficiente de murciélagos subterráneos Resumen Es común que los murciélagos habiten en cuevas y otros hábitats subterráneos y contribuyan a las redes alimenticias bajo tierra. Ya que estos ecosistemas cada vez se enfrentan a más amenazas, es importante identificar las medidas más efectivas para proteger a los murciélagos subterráneos. Realizamos un metaanálisis para evaluar la eficiencia de la conservación y las intervenciones de manejo para estos mamíferos. Usamos un análisis de redes para determinar el grado al que las intervenciones en pro de los murciélagos se traslapan con aquellas usadas para otros taxones subterráneos. Realizamos nuestros análisis con datos extraídos de 345 artículos que recomendaban 910 intervenciones de conservación. Se aplicó la colocación de compuertas en la entrada de los dormideros para conservar la población de murciélagos en 21 estudios, pero no quedó clara su efectividad. La restauración del hábitat y la reducción de las perturbaciones afectaron, respectivamente, a las poblaciones y al comportamiento de los murciélagos en ≤ 4 cuatro estudios. Se evaluó a la desinfección en dos estudios y ésta tuvo un efecto positivo sobre las poblaciones, particularmente en los estudios enfocados en la reducción de esporas micóticas asociadas con el síndrome de nariz blanca en América del Norte. La eficiencia del monitoreo de las poblaciones de murciélagos como una estrategia de conservación no fue clara y casi nunca se evaluó. Sólo el 4% de los estudios sobre murciélagos consideró simultáneamente a otros organismos subterráneos. Sin embargo, las intervenciones eficientes para la conservación de murciélagos tuvieron similitudes con las de todos los demás organismos. Otros organismos pueden beneficiarse si se les considera cuando se aplican las intervenciones para conservar a los murciélagos.

Occupational accidents involving exposure to biological material reported at a worker's health sentinel unit: 11,645 cases.

Introduction: Health professionals are exposed to various occupational biological, chemical, physical, and ergonomic risks, in addition to the risk of accidents. Understanding occupational accidents involving biological material in a specific area could be an initial step towards prioritizing correct working conditions. Objectives: To determine the profile of occupational accidents involving exposure to biological material based on data from a sentinel unit in Curitiba, Brazil. Methods: This observational, retrospective, descriptive study with quantitative methods collected disease notification system data from 2008-2018. Results: During the study period, 11,645 cases of occupational accidents involving biological material were reported. Most victims were women (80.4%) and nursing technicians (30.9%). The highest number of accidents involved material found on the floor (11.1%). Regarding personal protective equipment, 69% of the victims used procedure gloves. The years with the most reported accidents were 2016 and 2018. Treatment abandonment was high (56%). Conclusions: The number of accidents involving biological material was high, as was that of victims who abandoned serological follow-up. Prevention and awareness strategies are necessary to change this scenario.

Introdução: Na área da saúde, os profissionais estão expostos a variados riscos ocupacionais: biológico, químico, físico, ergonômico e de acidentes. O conhecimento acerca dos acidentes de trabalho com material biológico de determinado setor pode ser o passo inicial para a priorização de medidas de correção das condições de trabalho. Objetivos: Traçar um perfil dos acidentes de trabalho com exposição a material biológico, com base em dados de uma unidade sentinela de Curitiba, Paraná. Métodos: Estudo observacional, retrospectivo e descritivo com abordagem quantitativa, realizado através de levantamento de dados do Sistema de Informação de Agravos de Notificação, entre 2008 e 2018. Resultados: Durante o período, foram notificados 11.645 casos de acidentes de trabalho com exposição a material biológico. A maioria ocorreu em pessoas do sexo feminino (80,4%), e a ocupação mais envolvida foi técnico de enfermagem (30,9%). O maior número de acidentes ocorreu com materiais encontrados no chão (11,1%). Quanto ao uso de equipamentos proteção individual, 69% utilizavam luvas de procedimento. Os anos com maior número de notificações foram 2016 e 2018. Na evolução, houve alta taxa de abandono de tratamento (56%). Conclusões: O número de acidentes com material biológico é alto, assim como de profissionais que abandonam seguimento sorológico. Estratégias de prevenção e conscientização são necessárias para mudança desse cenário.

Severe occupational accidents reported at a sentinel unit from 2008 to 2018.

Introduction: Occupational accidents are a major public health problem. In addition to damages to workers' health, they are also associated with economic and social losses. Since 2004, this type of accident has become of mandatory reporting through the Notifiable Diseases Information System. However, underreporting still reaches high levels. Objectives: To identify and describe data on severe occupational accidents reported at an Occupational Health Unit. Methods: This is a retrospective observational study based on data from the Notifiable Diseases Information System. Occupational accidents that occurred from 2008 to 2018 in the state of Paraná, Brazil, and reported by the Occupational Health Unit, located in Hospital do Trabalhador in Curitiba. Results: Overall, 7,396 occupational accidents were reported, and most workers evolved with temporary disability (86%). The most frequently affected occupations were related to the area of construction industry (3.4%); however, it is worth highlighting the significant absence of this information in the reports (16.4%). Upper limbs were the most affected body region (42.5%). Conclusions: The report of occupational accidents has significantly improved in the last years, but underreporting remains a significant issue and there is a gap in data about the accident circumstances. Therefore, this study aimed to generate data to assist in the development of policies for the promotion and care of workers' health, in addition to being used for comparison in future statistics.

Analysis of oral risk factors for ventilator-associated pneumonia in critically ill patients.

OBJECTIVE: This a cross-sectional study to evaluate the association between oral health findings and ventilator-associated pneumonia (VAP) among critically ill patients in intensive care units (ICU). MATERIAL AND METHODS: Data were collected from medical records, and a detailed oral physical examination was performed on 663 critically ill patients on mechanical ventilation. Data were statistically analysed using univariate and logistic regression models relating the development of VAP with the oral findings. RESULTS: At oral physical examination, the most frequent findings were tooth loss (568-85.67%), coated tongue (422-63.65%) and oral bleeding (192-28.96%). Patients with a coated tongue or oral bleeding on the first day of ICU hospitalization developed more VAP than did patients without these conditions (20.14 vs 13.69%, p = 0.02; 23.44 vs 15.50%, p = 0.01, respectively). In the logistic regression, a coated tongue and oral bleeding were considered independent risk factors for VAP development (OR = 1.61 (1.03-2.51) and OR = 1.69 (1.08-2.66), respectively). CONCLUSIONS: The presence of a coated tongue and oral bleeding in ICU admission could be considered markers for the development of VAP. CLINICAL RELEVANCE: The results of this paper reinforce the importance of proper maintenance of oral hygiene before intubation, which may lead to a decrease in the incidence of VAP in the ICU.

Perfil epidemiológico dos portadores de sífilis entre 2010 e 2018 no Estado do Paraná, Brasil / Epidemiological profile of syphilis patients between 2010 and 2018 in Paraná State, Brazil

O objetivo desse trabalho foi analisar os casos de sífilis no Estado do Paraná, e descrever o perfil epidemiológico dos infectados, entre os anos de 2010 e 2018. O presente estudo é quantitativo, descritivo e observacional, foi desenvolvido com dados secundários do Sistema Nacional de Agravos de Notificação (SINAN), com a análise das taxas de detecção da sífilis adquirida. Entre 2010 e 2018 o Paraná registrou 39.900 casos de sífilis adquirida, sendo que 58,5% ocorreram em homens e 41,5% em mulheres. A faixa etária de maior incidência foi entre 20-29 anos (26,9%), seguida por 30-39 anos (21,4%). Quanto a escolaridade, a maioria dos infectados possuía ensino fundamental (18,5%) e médio (19%). A macrorregião leste do Estado apresentou a maior incidência de casos (59,28% dos casos em 2016). Devido ao aumento dos casos de sífilis adquirida no Paraná entre os anos de 2010 a 2018, conclui-se a necessidade do direcionamento de ações de prevenção e rastreio. (AU)

The study aimed to analyze the syphilis cases in Paraná State, and to describe the epidemiological profile of infected individuals, between 2010 and 2018. The present study is quantitative, descriptive and observational; it was developed with secondary data from the National System of Disorders notification, evaluating the detection rate of syphilis acquired. Between 2010 and 2018 Paraná registered 39,900 cases of Acquired Syphilis, being 58.5% in males and 41.5% in females. The age group with the highest incidence was between 20-29 years (26.9%), followed by 30-39 years (21.4%). As for schooling, most of the individuals in the identified cases had elementary (18.5%) and high school education (19%). The eastern macro- region of the state had the highest cases incidence (59.28% of cases in 2016). Due to the increase in syphilis cases acquired in Paraná between 2010 and 2018, it concludes the need to target prevention and screening actions. (AU)

Profile of gestational syphilis in the state of Paraná between 2010 and 2018 / Perfil da sífilis gestacional no estado do Paraná entre 2010 e 2018

Introduction: Gestational syphilis is responsible for increased fetal morbidity and mortality. It is related to intrauterine and neonatal complications, with vertical transmission being the most severe outcome. Screening and treatments are part of the prenatal routine. Objective: To describe the profile of gestational syphilis by state, regional incidence, time of diagnosis and treatment. Methods: Quantitative, descriptive, and observational study developed with secondary data from the National System of Notification of Disorders (Sistema de Informação de Agravos de Notificação ­ SINAN), to evaluate the variables: region, trimester of diagnosis and treatment of gestational syphilis. Results: Between 2010­2018, Paraná recorded 12,011 cases of gestational syphilis, corresponding to 8.5 per 1,000 live births. There was an increase in the number of cases across the state. Among infected pregnant women, most were between 20­29 years old (50.6%). Of the diagnoses, 43.6% were performed in the first trimester of pregnancy and 26.6% in the second. The most widely used treatment regimen was benzathine penicillin G 7,200,000 IU (63.7%). Conclusion: There was an increase in gestational syphilis in Paraná, however, there was greater effectiveness in diagnosis and treatment, with greater detection in the first trimester of pregnancy and prevalence of use of benzathine penicillin G. The study highlights the importance of correct clinical management and early detection, measures that prevent vertical transmission.

Introdução: A sífilis gestacional é responsável pelo aumento da morbimortalidade fetal. Está relacionada a complicações intrauterinas e neonatais, sendo a transmissão vertical o desfecho mais grave. Sua triagem e seu tratamento fazem parte da rotina do pré-natal. Objetivo: Descrever o perfil da sífilis gestacional no estado, a incidência em regionais, a época do diagnóstico e o tratamento. Métodos: Estudo quantitativo, descritivo e observacional desenvolvido com dados secundários do Sistema de Informação de Agravos de Notificação (SINAN), para avaliar as variáveis: região, trimestre do diagnóstico e tratamento da sífilis gestacional. Resultados: O Paraná registrou, entre 2010­2018, 12.011 casos de sífilis gestacional, o que corresponde a 8,5 a cada 1.000 nascidos vivos. Houve aumento no número de casos em todo o estado. Entre as gestantes infectadas, a maioria tinha entre 20­29 anos (50,6%). Dos diagnósticos, 43,6% foram realizados no primeiro trimestre de gestação e 26,6%, no segundo trimestre. O esquema terapêutico mais utilizado foi o de penicilina G benzatina 7.200.000 UI (63,7%). Conclusão: Houve aumento da sífilis gestacional no Paraná, porém, observou-se maior efetividade no diagnóstico e tratamento, com maior detecção no primeiro trimestre da gestação e prevalência do uso da penicilina G benzatina 7.200.000 UI. O estudo ressalta a importância do correto manejo clínico e da detecção precoce, medidas que evitam a transmissão vertical.

Association of insertion-deletions polymorphisms with colorectal cancer risk and clinical features.

AIM: To investigate the association between 16 insertion-deletions (INDEL) polymorphisms, colorectal cancer (CRC) risk and clinical features in an admixed population. METHODS: One hundred and forty patients with CRC and 140 cancer-free subjects were examined. Genomic DNA was extracted from peripheral blood samples. Polymorphisms and genomic ancestry distribution were assayed by Multiplex-PCR reaction, separated by capillary electrophoresis on the ABI 3130 Genetic Analyzer instrument and analyzed on GeneMapper ID v3.2. Clinicopathological data were obtained by consulting the patients' clinical charts, intra-operative documentation, and pathology scoring. RESULTS: Logistic regression analysis showed that polymorphism variations in IL4 gene was associated with increased CRC risk, while TYMS and UCP2 genes were associated with decreased risk. Reference to anatomical localization of tumor Del allele of NFKB1 and CASP8 were associated with more colon related incidents than rectosigmoid. In relation to the INDEL association with tumor node metastasis (TNM) stage risk, the Ins alleles of ACE, HLAG and TP53 (6 bp INDEL) were associated with higher TNM stage. Furthermore, regarding INDEL association with relapse risk, the Ins alleles of ACE, HLAG, and UGT1A1 were associated with early relapse risk, as well as the Del allele of TYMS. Regarding INDEL association with death risk before 10 years, the Ins allele of SGSM3 and UGT1A1 were associated with death risk. CONCLUSION: The INDEL variations in ACE, UCP2, TYMS, IL4, NFKB1, CASP8, TP53, HLAG, UGT1A1, and SGSM3 were associated with CRC risk and clinical features in an admixed population. These data suggest that this cancer panel might be useful as a complementary tool for better clinical management, and more studies need to be conducted to confirm these findings.

Bats (Mammalia, Chiroptera) from the Nísia Floresta National Forest, with new records for the state of Rio Grande do Norte, northeastern Brazil / Morcegos (Mammalia, Chiroptera) da Floresta Nacional de Nísia Floresta, com novos registros para o estado do Rio Grande do Norte, nordeste do Brasil

Abstract The state of Rio Grande do Norte is considered a data gap for bat species records in Brazil. The state is also currently target of large economic projects with potential impacts on bats, especially wind farms and mining enterprises. In addition, Rio Grande do Norte has few conservation units in which there is no systematic study on bat fauna. The Nísia Floresta National Forest (NFNF), a federally protected area of 174 hectares, is located in the eastern coast of Rio Grande do Norte and corresponds to one of the last remnants of Atlantic Forest in the state, in its northernmost limits. A bat inventory was conducted in NFNF using mist nets set at ground level, from sunset to sunrise, from December 2011 to December 2012, totaling 25 sampling nights. We captured 1,379 bats belonging to four families and 16 species. Artibeus planirostris (Phyllostomidae) was the most frequently captured species (n = 685; 50%), followed by Myotis lavali (Vespertilionidae) (n = 248; 18%) and Phyllostomus discolor (Phyllostomidae) (n = 147; 11%). Peropteryx leucoptera, Phyllostomus discolor, Phyllostomus hastatus, Lophostoma brasiliense, Lasiurus blossevillii, Myotis lavali, and Promops nasutus are new records for Rio Grande do Norte, increasing the current number of bat species from 25 to 32 in this state. Further inventories, especially using acoustic surveys with bat detectors, might add more species to the NFNF bat list.

Resumo O estado do Rio Grande do Norte é considerado uma lacuna de informações sobre ocorrência de morcegos no Brasil. O estado também é atualmente alvo de grandes empreendimentos com potencial impacto sobre a quiropterofauna, especialmente no setor de energia eólica e mineração. Além disso, apresenta poucas unidades de conservação, e estas não possuem sua quiropterofauna estudada de maneira sistematizada. A Floresta Nacional de Nísia Floresta (FNNF), uma unidade de conservação federal de 174 hectares, localiza-se na costa leste do Rio Grande do Norte e corresponde a um dos últimos remanescentes de Mata Atlântica no estado e no limite norte do bioma. Foi realizado um inventário de morcegos na FNNF com a utilização de redes de neblina armadas no nível do solo, do por do sol ao amanhecer, de dezembro de 2011 a dezembro de 2012, totalizando 25 noites de amostragem. Nós capturamos 1379 morcegos pertencentes a quatro famílias e 16 espécies. Artibeus planirostris (Phyllostomidae) foi a espécie mais frequentemente capturada (n = 685; 50%), seguida por Myotis lavali (Vespertilionidae) (n = 248; 18%) e Phyllostomus discolor (Phyllostomidae) (n = 147; 11%). Peropteryx leucoptera, Phyllostomus discolor, Phyllostomus hastatus, Lophostoma brasiliense, Lasiurus blossevillii, Myotis lavali e Promops nasutus são novos registros para o Rio Grande do Norte, aumentando o número atual de espécies de morcegos no estado de 25 para 32. Inventários adicionais, especialmente utilizando amostragens acústicas com detectores de morcegos, tendem a acrescentar novas espécies à lista de morcegos da FNNF.

Evaluation of the level of microbial contamination and prevalence of gram-negative non-fermentative rods in dental unit waterlines

Introduction: The cross infection control in dental office has received great attention from professionals and one of the critical points is the bacteriological control of water used in dental unit. Objective: To perform a microbiological evaluation of the water used in dental units, the identification of Gram-negative non-fermentative rods (GNNR) and their ability to adhere to polystyrene, and the antimicrobial activity of disinfectants on the identified strains. Material and methods: The heterotrophic bacteria count and GNNR identification were performed on water samples collected from 25 dental units (air/water syringe and reservoir). The GNNR were assessed on their capability to adhere to polystyrene and on their antimicrobial activity to the following disinfectants: sodium hypochlorite (0.06%, 0.12%, 0.25%, and0.5%) and chlorhexidine (0.03%, 0.06%, and 0.12%). Results: 88% of the air/water syringe collected samples and 68% of the reservoir collected samples were out of the potability standards. The quantity of isolated bacteria from the reservoir was lower than from the air/water syringe in 88% of the dental units. Methylobacterium spp. was found in highest percentage (19.7%) during GNNR genus isolation. There was a weak adherence to polystyrene in 85.04% of the samples. Sodium hypochlorite at 0.25%, inactivated 100% of the GNNRs in 10 minutes, while the highest tested concentration of chlorhexidine (0.12%), inactivated 98.5% of the GNNRs. Conclusion: These results provide information on the contamination problem of dental unit waterlines (DUWL) and indicate a need for treatment of the water used in dental units. The disinfection of DUWL can be performed with sodium hypochlorite at 0.25% (half the concentration recommended in the literature). However, further studies are necessary regarding DUWL frequency disinfection.

Apresentação de modelo de ficha clínica periodontal / Presentation of a model of periodontal clinical record

Introdução: a ficha clínica é uma ferramenta essencial para a execução de qualquer procedimento periodontal. Sua finalidade é obter e registrar o maior número possível de informações sobre o estado de saúde geral e bucal do paciente, além de armazenar o registro de todos os procedimentos executados desde a consulta inicial até a conclusão do tratamento. Objetivo: o propósito desse trabalho é destacar a importância da ficha clínica periodontal e propor um modelo orientador a profissionais ou instituições na elaboração de suas próprias fichas clínicas. Conclusões: através da análise dos dados contidos nas fichas clínicas de diversas instituições do estudo dos principais artigos referentes ao assunto, foi criado um modelo de ficha clínica específico para a Periodontia.

Introduction: The clinic form is an essential tool for the execution of any periodontal procedure. Its finality is to obtain and record as much information as possible about the patient’s general and oral state of health, besides storing records of all executed procedures since initial appointment until the treatment conclusion. Objective: The purpose of this work is to emphasize the importance of the periodontal clinic form and propose a guidance model for professionals and institutions on the elaboration of their own clinical forms. Methods: Through the analysis of the data contained on clinical forms of several institutions and study of the main articles related to the subject it was created an specific model of clinical form for Periodontics.

Estudo comparativo entre o esfigmomanômetro e o aparelho digital de pulso na aferição da pressão arterial e da pulsação em pacientes submetidos a tratamento periodontal / Comparative study between sphygmomanometer and the wrist digital monitor in measurement of blood pressure and pulse rate in patients submitted to periodontal treatment

A aferição da pressão arterial (PA) é um importante indicador do estado de saúde atual do paciente e permite uma atuação mais consciente, segura e eficaz do clrurgião-dentista durante os procedimentos odontológicos. 0 uso dos aparelhos digitais tornaria esta medição mais prática e rápida, se comparados com o esfigmomanômetro, permitindo o monitoramento da PA e frequênoa do pulso (FP) durante a execução dos procedimentos, sem necessidade de que o operador interrompa os mesmos para tomada das medidas. 0 objetivo deste trabalho foi comprovar, através de análise estatística, a precisão das aferições realizadas com o aparelho digital de pulso, comparando-o com o esfigmomanômetro aneróide. Foram realizadas aferições em 45 pacientes da Clínica de Especialização em Periodontia da Universidade Estadual de Londrina. Os resultados demonstraram que não houve diferença estatística significativa entre as medidas obtidas e o tempo de manuseio entre os dois aparelhos. Estes dados confirmam a viabilidade do uso do aparelho digital de pulso na rotina da prática clínica periodontal.

Retalho reposicionado apical modificado e retalho posicionado coronário. Combinação de técnicas cirúrgicas para tratamento de recessão radicular / The modified apically repositioned flap and coronally positioned flap. Combined techniques for treatment of root

Este trabalho teve por objetivo relatar um caso clínico de recobrimento radicular realizado, a longo prazo, em um dente com sensibilidade exacerbada devida a uma recessão gengival Classe I de Miller. O retalho reposicionado apical modificado foi executado com o intuito de aumentar a quantidade de tecido ceratinizado apical ao defeito, previamente ao retalho posicionado coronário. Esta combinação de técnicas foi eficiente na resolução da sensibilidade radicular, proporcionado 100% de recobrimento com menor trauma cirúrgico, ausência de tecido doador palatal e com resultado estético ideal.