Ethmoidal silent sinus syndrome after nasal swab test.

This study reported the case of a healthy male in his 40s who presented with a 3-month history of frontal headache and post-nasal drip, which did not improve with oral antibiotics. One month prior to the onset of the symptoms, he underwent a nasopharyngeal swab testing for SARS-CoV-2 (which yielded a negative result) for a history of malaise and cough. The patient claimed that the swab insertion into the nasal cavity was particularly painful on the left side. Sinus computed tomography (CT) scan showed deformity of the left middle nasal turbinate with occlusion of the osteomeatal complex, resulting in ethmoid silent sinus syndrome. This study makes a significant contribution to the literature because nasopharyngeal, midturbinate and anterior nasal swabs have been recommended as initial diagnostic specimen collection methods by the US Centers for Disease Control and Prevention (CDC) for the coronavirus disease 2019. These methods require introducing an instrument into the nasal cavity, potentially leading to adverse effects due to the delicate and complex nasal anatomy. However, complications related to swab testing for respiratory pathogens have not yet been fully discussed in the literature.

The international sinonasal microbiome study: A multicentre, multinational characterization of sinonasal bacterial ecology.

The sinonasal microbiome remains poorly defined, with our current knowledge based on a few cohort studies whose findings are inconsistent. Furthermore, the variability of the sinus microbiome across geographical divides remains unexplored. We characterize the sinonasal microbiome and its geographical variations in both health and disease using 16S rRNA gene sequencing of 410 individuals from across the world. Although the sinus microbial ecology is highly variable between individuals, we identify a core microbiome comprised of Corynebacterium, Staphylococcus, Streptococcus, Haemophilus and Moraxella species in both healthy and chronic rhinosinusitis (CRS) cohorts. Corynebacterium (mean relative abundance = 44.02%) and Staphylococcus (mean relative abundance = 27.34%) appear particularly dominant in the majority of patients sampled. Amongst patients suffering from CRS with nasal polyps, a statistically significant reduction in relative abundance of Corynebacterium (40.29% vs 50.43%; P = .02) was identified. Despite some measured differences in microbiome composition and diversity between some of the participating centres in our cohort, these differences would not alter the general pattern of core organisms described. Nevertheless, atypical or unusual organisms reported in short-read amplicon sequencing studies and that are not part of the core microbiome should be interpreted with caution. The delineation of the sinonasal microbiome and standardized methodology described within our study will enable further characterization and translational application of the sinus microbiota.

Salivary factors associated with noncarious cervical lesions: A systematic review.

OBJECTIVE: This study aimed to carry out a systematic review of observational studies searching the association between salivary factors (amount and quality of saliva) and noncarious cervical lesions (NCCL) in individuals with permanent dentition. DESIGN: Cross-sectional, case-control, and cohort studies performed in humans with permanent dentition (population) and considering noncarious cervical lesions (outcome) in association with salivary characteristics (exposure) were included. PubMed, Web of Science, Cochrane, LILACS/BBO, Scopus, Embase, IBCT, NICE, OpenGrey, and Google Scholar were searched, with no language or date restrictions. Of 6561 potentially eligible studies, 142 were selected for full-text analysis. Three reviewers independently selected the studies, performed data extraction, and quality analysis through the Newcastle-Ottawa Scale. RESULTS: Finally, ten references were included in the review, four case-control and six cross-sectional studies. Several salivary parameters were evaluated. Some parameters were considered associated with the presence of noncarious cervical lesions: salivary buffering capacity, salivary pH, citric acid, and calcium and potassium levels. The methodological quality varied across studies, with high heterogeneity among them. CONCLUSIONS: Some associations between saliva and NCCL suggesting protective factors and others risk factors were found. However, the evidence is sparse and comes from a few studies with great heterogeneity. New scientific evidence, with standardized methods, should be encouraged. Understanding salivary parameters that influence the occurrence of NCCL is important to guide dentists in relation to etiological factors that could potentially be neglected. The results may help in the development of new and early diagnostic methods and treatments for noncarious cervical lesions.

Concentration of lipids, cholesterol, and fatty acid profile in chicken breast meat affected by wooden breast myopathy frozen for up to 12 mo.

The aim of this study was to examine the effects of frozen storage for 12 mo on the concentrations of lipids and cholesterol and fatty acid profile of wooden chicken breast meat. A total of 120 samples of chicken breasts were selected, according to the degree of "wooden breast" myopathy ["severe," "moderate," and "normal" (absence of myopathy)], from male chickens slaughtered at 42 d of age, from Cobb 500 strain. Part of the samples (n = 20/grade of severity) were evaluated on the day of collection and the remainder were packaged, frozen and stored at -18°C for up to 12 mo. At the beginning (collection day) and at the end of the proposed freezing period (12 mo), analyses of lipid, cholesterol, and fatty acid profile were carried out. Percentage of saturated (SFA), monounsaturated (MUFA), and polyunsaturated (PUFA) fatty acids were evaluated. Meats affected by wooden breast myopathy had lower levels of PUFA that exert beneficial effects on health, such as DHA, EPA and ARA, and this profile is impaired by prolonged storage (12 mo), which results in important nutritional losses for the consumer.

Physical, chemical, and microbiological evaluation of sausages produced with chicken meat affected by deep pectoral myopathy.

The purpose of the present study was to characterize the chemical composition, lipid oxidation, and physical characteristics of fresh sausages produced with meat from the pectoralis major muscle affected by deep pectoral myopathy. For the characterization of myopathy, samples were collected from broiler chickens slaughtered between 42- and 46-days old in a slaughterhouse in the state of São Paulo. The experiment consisted of samples from pectoralis major muscle of birds affected or not by DPM (normal-absence of myopathy and DPM category 3-progressive degeneration of the pectoralis minor with a greenish appearance). After classification of the samples, a part of raw products with the pectoralis minor removed, was submitted to microbiological and physical analyses for the characterization of DPM. Afterward, only the pectoralis major muscle was used to manufacture fresh sausages and 2 groups were established. The evaluated parameters were: color, pH, water-holding capacity (WHC), cooking loss (CL), shear force (SF), water activity (Aw), and chemical composition. Meat pH was higher (P < 0.05) in meats with DPM, however, WHC values were lower (71.92%), which made CL value increase (25.31%). In addition, the coloring increased and the technological characteristics of raw breasts were less favorable with the presence of DPM. All fresh sausages' color (except a* higher control group), pH, and Aw values were higher in DPM group. No effect on SF values was observed between fresh sausages. In chemical composition, only protein content increased in fresh sausages with DPM. Microbiological analyses did not indicate bacterial contamination of raw samples and fresh sausages. Data obtained in the present study suggest fresh sausages produced with breasts affected by DPM are a viable alternative and may confer more favorable qualitative characteristics to sausages than the raw marketed meat.

Effect of freezing on the quality of breast meat from broilers affected by wooden breast myopathy.

The objective of the present study was to characterize possible variations in the quality of wooden chicken breast meat during freezing for 12 mo, in order to prove whether the shelf life recommended by the industry allows the storage of that type of meat without compromising its consumption. Three hundred samples of male Cobb 500 broilers slaughtered at 42 d of age were used. Part of the samples (n = 20 normal-control group; n = 20 moderate degree; n = 20 severe degree) were analyzed on the day of collection (beginning), previously kept under refrigeration (4°C). The other samples were stored (-18°C) for up to 12 mo. At the end of each proposed freezing period (3, 6, 9, and 12 mo), physical and chemical analyses were performed (per period: n = 20 normal-control group; n = 20 moderate degree; n = 20 severe degree). Color (L*, a*, and b*), pH, water-holding capacity, cooking losses, tenderness, lipid oxidation, chemical composition, cholesterol concentration, mineral profile, and collagen concentration were evaluated. The physicochemical quality of wooden chicken breast meat is significantly altered during frozen storage for 12 mo, being of inferior quality when compared to normal chicken breast meat, which can negatively affect consumer acceptance. However, it should be noted that even after 12 mo of freezing, the meats did not show oxidative rancidity.

HIV and sexually transmitted infections at the borderlands: situational analysis of sexual health in the Brazilian Amazon.

OBJECTIVES: The borderlands are considered areas of increased vulnerability to HIV and sexually transmitted infections (STI). The study aimed to determine the STI/HIV prevalence and risk factors in the triple-border area of the Brazilian Amazon. METHODS: A situational analysis of sexual health was conducted in three cities of the Alto Solimões region. This multicomponent research approach included key informant interviews, participant observations and mapping of places where people meet sexual partners. Volunteers recruited from the 'hot spots' in each city were invited for interview and STI/HIV testing. RESULTS: Over 6 months, 598 participants were recruited, 285 men of median age 28 years (IQR, 23-37) and 313 women of median age 29 years (IQR, 24-37). Overall, 49.3% reported a casual partner during the past 3 months, but only 38.5% reported consistent condom use. The respective prevalences in men and women were Neisseria gonorrhoeae (1.1% and 0.3%), Chlamydia trachomatis (1.4% and 4.8%), high-risk human papillomavirus (14.4% and 24.0%), active syphilis (3.2% and 2.6%), herpes simplex virus type-2 (51.1% and 72.1%), hepatitis B virus (by hepatitis B virus surface antigen) (7.5% and 4.6%), hepatitis C virus (0.7% and 0.7%) and HIV (1.4% and 0.0%). Risk factors for viral STIs included female sex and age. CONCLUSIONS: While the main conditions that contribute to the spread of HIV are in place in the triple-border area, the prevalence of bacterial STIs and HIV are still relatively low, providing a window of opportunity for interventions.

Bond strength of two universal adhesive systems to human dentin using different strategies.

The objective of this study was to evaluate the microtensile bond strength (µTBS) to dentin of two universal adhesive systems: Single Bond Universal (SBU) and Ambar Universal (AU), used in different adhesion strategies. MATERIALS AND METHOD: Thirty-six human teeth were prepared (n=6) and treated following different adhesive strategies: G1: SBU-etch-and-rinse, applied on dry dentin; G2: SBUetch- and-rinse, applied on moist dentin; G3: SBU-self-etching; G4: AU-etch-and-rinse, applied on dry dentin; G5: AU-etch-and-rinse, applied on moist dentin; G6: AU-self-etching. The specimens were submitted to µTBS test, failure analysis, and scanning electron microscopy (SEM). Data were analyzed with ANOVA and Tukey's tests (p<0.05). RESULTS: Microtensile bond strength was significantly lower in G1 than G2 and G3. AU adhesive performed worse than the SBU system, except in G5. Cohesive and mixed failures predominated in G1 and G2, while adhesive failures predominated in G3 and G5. CONCLUSIONS: Universal adhesives are an interesting innovation, but there are still doubts about their performance, mainly regarding the different protocols provided by the manufacturers. The conventional adhesive strategy on moist dentin demonstrated higher µTBS for both adhesives. The use of the selfetching strategy with the SBU showed promising results.

O objetivo deste estudo foi avaliar a resistência de união à microtração (µTBS) de dois sistemas adesivos universais: Single Bond Universal (SBU) e Ambar Universal (AU), utilizados em diferentes estratégias de adesão. Materiais e método: 36 dentes humanos foram preparados (n=6) e tratados seguindo diferentes estratégias adesivas: G1: SBU-condicionamento e enxágue, aplicado sobre dentina seca; G2: SBU-condicionamento e enxágue, aplicado sobre dentina úmida; G3: SBU-autocondicionante; G4: AU-condicionamento e enxágue, aplicado em dentina seca; G5: AU-condicionamento e enxágue, aplicado sobre dentina úmida; G6: AU-autocondicionante. Os espécimes foram submetidos ao teste de µTBS, análise de falhas e microscopia eletrônica de varredura (SEM). Os dados foram analisados com os testes ANOVA e Tukey (p<0,05). Resultados: A resistência de união à microtração de G1 foi significativamente menor que G2 e G3. O adesivo AU teve um desempenho pior que o sistema SBU, com exceção do G5. Falhas coesivas e mistas predominaram em G1 e G2 enquanto G3 e G5 apresentaram predominância de falhas adesivas. Conclusões: Os adesivos universais representam uma inovação interessante, mas ainda há dúvidas sobre seu desempenho, principalmente em relação aos diferentes protocolos fornecidos pelos fabricantes. A estratégia adesiva convencional em dentina úmida demonstrou maior µTBS para ambos os adesivos. O uso da estratégia autocondicionante com a SBU apresentou resultados promissores.

Microbiotyping the Sinonasal Microbiome.

This study offers a novel description of the sinonasal microbiome, through an unsupervised machine learning approach combining dimensionality reduction and clustering. We apply our method to the International Sinonasal Microbiome Study (ISMS) dataset of 410 sinus swab samples. We propose three main sinonasal "microbiotypes" or "states": the first is Corynebacterium-dominated, the second is Staphylococcus-dominated, and the third dominated by the other core genera of the sinonasal microbiome (Streptococcus, Haemophilus, Moraxella, and Pseudomonas). The prevalence of the three microbiotypes studied did not differ between healthy and diseased sinuses, but differences in their distribution were evident based on geography. We also describe a potential reciprocal relationship between Corynebacterium species and Staphylococcus aureus, suggesting that a certain microbial equilibrium between various players is reached in the sinuses. We validate our approach by applying it to a separate 16S rRNA gene sequence dataset of 97 sinus swabs from a different patient cohort. Sinonasal microbiotyping may prove useful in reducing the complexity of describing sinonasal microbiota. It may drive future studies aimed at modeling microbial interactions in the sinuses and in doing so may facilitate the development of a tailored patient-specific approach to the treatment of sinus disease in the future.

Bond strength of two universal adhesive systems to human dentin using different strategies / Resistência de união de sistemas adesivos universais à dentina humana usando diferentes estratégias

ABSTRACT The objective of this study was to evaluate the microtensile bond strength (μTBS) to dentin of two universal adhesive systems: Single Bond Universal (SBU) and Ambar Universal , used in different adhesion strategies. Materials and Method: Thirty-six human teeth were prepared (n=6) and treated following different adhesive strategies: G1: SBU-etch-and-rinse, applied on dry dentin; G2: SBUetch- and-rinse, applied on moist dentin; G3: SBU-self-etching; G4: AU-etch-and-rinse, applied on dry dentin; G5: AU-etch-and-rinse, applied on moist dentin; G6: AU-self-etching. The specimens were submitted to μTBS test, failure analysis, and scanning electron microscopy (SEM). Data were analyzed with ANOVA and Tukey's tests (p<0.05). Results: Microtensile bond strength was significantly lower in G1 than G2 and G3. AU adhesive performed worse than the SBU system, except in G5. Cohesive and mixed failures predominated in G1 and G2, while adhesive failures predominated in G3 and G5. Conclusions: Universal adhesives are an interesting innovation, but there are still doubts about their performance, mainly regarding the different protocols provided by the manufacturers. The conventional adhesive strategy on moist dentin demonstrated higher μTBS for both adhesives. The use of the selfetching strategy with the SBU showed promising results.

RESUMO O objetivo deste estudo foi avaliar a resistência de união à microtração (μTBS) de dois sistemas adesivos universais: Single Bond Universal (SBU) e Ambar Universal , utilizados em diferentes estratégias de adesão. Materiais e método: 36 dentes humanos foram preparados (n=6) e tratados seguindo diferentes estratégias adesivas: G1: SBU-condicionamento e enxágue, aplicado sobre dentina seca; G2: SBU-condicionamento e enxágue, aplicado sobre dentina úmida; G3: SBU-autocondicionante; G4: AU-condicionamento e enxágue, aplicado em dentina seca; G5: AU-condicionamento e enxágue, aplicado sobre dentina úmida; G6: AU-autocondicionante. Os espécimes foram submetidos ao teste de μTBS, análise de falhas e microscopia eletrônica de varredura (SEM). Os dados foram analisados com os testes ANOVA e Tukey (p<0,05). Resultados: A resistência de união à microtração de G1 foi significativamente menor que G2 e G3. O adesivo AU teve um desempenho pior que o sistema SBU, com exceção do G5. Falhas coesivas e mistas predominaram em G1 e G2 enquanto G3 e G5 apresentaram predominância de falhas adesivas. Conclusões: Os adesivos universais representam uma inovação interessante, mas ainda há dúvidas sobre seu desempenho, principalmente em relação aos diferentes protocolos fornecidos pelos fabricantes. A estratégia adesiva convencional em dentina úmida demonstrou maior μTBS para ambos os adesivos. O uso da estratégia autocondicionante com a SBU apresentou resultados promissores.

Position statement of the Brazilian Academy of Rhinology on the use of antihistamines, antileukotrienes, and oral corticosteroids in the treatment of inflammatory sinonasal diseases.

INTRODUCTION: Inflammatory conditions of the nose and paranasal sinuses are very prevalent in the general population, resulting in marked loss of quality of life in affected patients, as well as significant work, leisure, and social activity losses. These patients require specific and specialized treatment. A wide range of oral medications are available. OBJECTIVE: The present document is aimed to clarify, for professionals treating patients with inflammatory sinonasal diseases, both specialists and general practitioners, specific oral therapies in noninfectious nasal inflammatory conditions. METHODS: The methodology used to create this article included the search for the key words: oral corticosteroids, antihistamines, antileukotrienes, rhinitis, rhinosinusitis in the MEDLINE and EMBASE databases in the last 5 years. Since no relevant article was found for the text on the subject of interest in the last 5 years, the search was extended for another 5 years, and so on, according to the authors' needs. RESULTS: Relevant literature was found regarding the use of antihistamines, antileukotrienes and oral corticosteroids in these conditions. The Brazilian Academy of Rhinology emphasizes, after extensive discussion by the collegiate, key points in the treatment with these drugs. CONCLUSION: There is support in the literature for the use of these drugs; however, final considerations about the role of each of them have been made.

II Brazilian consensus statement on endoscopic ultrasonography.

BACKGROUND AND OBJECTIVES: At the time of its introduction in the early 80s, endoscopic ultrasonography (EUS) was indicated for diagnostic purposes. Recently, EUS has been employed to assist or to be the main platform of complex therapeutic interventions. METHODS: From a series of relevant new topics in the literature and based on the need to complement the I Brazilian consensus on EUS, twenty experienced endosonographers identified and reviewed the pertinent literature in databases. The quality of evidence, strength of recommendations, and level of consensus were graded and voted on. RESULTS: Consensus was reached for eight relevant topics: treatment of gastric varices, staging of nonsmall cell lung cancer, biliary drainage, tissue sampling of subepithelial lesions (SELs), treatment of pancreatic fluid collections, tissue sampling of pancreatic solid lesions, celiac neurolysis, and evaluation of the incidental pancreatic cysts. CONCLUSIONS: There is a high level of evidence for staging of nonsmall cell lung cancer; biopsy of SELs as the safest method; unilateral and bilateral injection techniques are equivalent for EUS-guided celiac neurolysis, and in patients with visible ganglia, celiac ganglia neurolysis appears to lead to better results. There is a moderate level of evidence for: yield of tissue sampling of pancreatic solid lesions is not influenced by the needle shape, gauge, or employed aspiration technique; EUS-guided and percutaneous biliary drainage present similar clinical success and adverse event rates; plastic and metallic stents are equivalent in the EUS-guided treatment of pancreatic pseudocyst. There is a low level of evidence in the routine use of EUS-guided treatment of gastric varices.

Position statement of the Brazilian Academy of Rhinology on the use of antihistamines, antileukotrienes, and oral corticosteroids in the treatment of inflammatory sinonasal diseases / Posicionamento da Academia Brasileira de Rinologia sobre o uso de anti-histamínicos, antileucotrienos e corticosteroides orais no tratamento de doenças inflamatórias nasossinusais

Abstract Introduction: Inflammatory conditions of the nose and paranasal sinuses are very prevalent in the general population, resulting in marked loss of quality of life in affected patients, as well as significant work, leisure, and social activity losses. These patients require specific and specialized treatment. A wide range of oral medications are available. Objective: The present document is aimed to clarify, for professionals treating patients with inflammatory sinonasal diseases, both specialists and general practitioners, specific oral therapies in noninfectious nasal inflammatory conditions. Methods: The methodology used to create this article included the search for the key words: oral corticosteroids, antihistamines, antileukotrienes, rhinitis, rhinosinusitis in the MEDLINE and EMBASE databases in the last 5 years. Since no relevant article was found for the text on the subject of interest in the last 5 years, the search was extended for another 5 years, and so on, according to the authors’ needs. Results: Relevant literature was found regarding the use of antihistamines, antileukotrienes and oral corticosteroids in these conditions. The Brazilian Academy of Rhinology emphasizes, after extensive discussion by the collegiate, key points in the treatment with these drugs. Conclusion: There is support in the literature for the use of these drugs; however, final considerations about the role of each of them have been made.

Resumo Introdução: As afecções inflamatórias do nariz e dos seios paranasais são muito prevalentes na população geral, causam acentuada perda de qualidade de vida dos pacientes afetados, geram perdas significativas das atividades de trabalho, lazer e sociais. Esses pacientes necessitam de tratamento específico e especializado e uma ampla gama de medicações orais está disponível. Objetivo: O presente documento tem por objetivo esclarecer àqueles que tratam das doenças nasossinusais inflamatórias, tanto especialistas quanto generalistas, sobre as terapêuticas orais nas afecções inflamatórias nasais não infecciosas. Método: A metodologia usada para elaboração deste artigo incluiu a busca das palavras chave: corticosteroides orais, anti-histamínicos, antileucotrienos, rinite, rinossinusite nos bancos de dados Medline e Embase nos últimos 5 anos. Como não foi achado artigo relevante para o texto sobre o assunto de interesse nos últimos 5 anos, a busca foi estendida por mais 5 anos, e assim por diante, de acordo com a necessidade dos autores. Resultados: Literatura relevante foi encontrada com relação ao uso dos anti-histamínicos, antileucotrienos e corticosteroides orais nessas afecções. A Academia Brasileira de Rinologia ressalta, após amplo debate do colegiado, pontos-chave no tratamento com esses medicamentos. Conclusão: Há respaldo na literatura para o uso desses medicamentos, entretanto considerações finais acerca do papel de cada deles foram feitas.

Natureza desumana: desmesuras do mundo ao homem / Inhuman being nature: discourtesies of world for the man

O presente artigo propõe-se a erigir um conceito de natureza imanente e paradoxal que dê sustento às práticas da psicologia social de desnaturalização das configurações sociais. A partir da problematização da natureza em autores fundamentais da filosofia, Aristóteles e Rousseau, elabora-se uma nova concepção de natureza desnaturada e livre das amarras das representações essencialistas e totalizantes do humanismo clássico e iluminista. Afirmando outra possibilidade de homem e humanidade para além da clausura de sua própria representação ideal e analítica, o conceito de natureza aqui erigido impede o esvaziamento das práticas de desnaturalização em slogan, ao fornecer para essa prática um substrato ontoepistêmico adequado às suas desmesuras ao humano. Abre-se então a possibilidade de operar conceitos fluidos como o de subjetivação e devir ao invés do de identidade e estado.

This article proposes to build a concept of immanent and paradoxical nature that gives sustenance to the practices of the social psychology of denaturalization of social configurations. From the problematization of the nature in fundamental authors in western philosophy, Aristotle and Rousseau, a new concept of an unnatural nature is created, free from the essentialistic and totalizing representations of classical and enlightened humanism. Affirming further possibility of man and humanity beyond the closing of his/her own ideal and analytical representation, the concept of nature here erected prevent the practice of emptying in denaturalization slogan, to provide for this practice a-epistemic suitable substrate onto their disproportionate to the human. Then it opens up the possibility of operating fluid concepts such as subjectivity instead of becoming an identity and status.

Superior orbital fissure syndrome due to sinusitis: report of two cases.

BACKGROUND: The potential morbidity and mortality of sphenoid sinus infectious processes are related to their proximity to vital structures within the orbit, such as the cavernous sinus and the brain. Involvement of the posterior orbit can result in superior orbital fissure syndrome, a rare entity affecting structures that cross this anatomic region. Early recognition of this syndrome is mandatory. Delays in adequate treatment may compromise the patient's prognosis. METHODS: We present two cases of incomplete superior orbital fissure syndrome due to infectious processes of the posterior ethmoid and sphenoid sinuses. CONCLUSIONS: In our experience, endoscopic decompression of the lamina papyracea shows complete recovery of extrinsic ocular motility in these patients and should be combined with intravenous antibiotic therapy.

Analgesia preemptiva: conceito e bases neurofisiologicas / Preemptive analgesia: concepts and neurophysiology

A dor pos-operatoria e queixa comum nos pacientes submetidos a procedimentos cirurgicos. Nesse contexto, a dor deixa de representar um mecanismo de defesa e passa a promover alteracoes neuroendocrinas que prejudicam a evolucao do paciente. A analgesia preemptiva, conjunto de tecnicas analgesicas iniciadas antes do ato cirurgico, que visam impedir o aparecimento de um estado de sensibilizacao central...