Collagen-based bioinks for hard tissue engineering applications: a comprehensive review.

In the last few years, additive manufacturing (AM) has been gaining great interest in the fabrication of complex structures for soft-to-hard tissues regeneration, with tailored porosity, and boosted structural, mechanical, and biological properties. 3D printing is one of the most known AM techniques in the field of biofabrication of tissues and organs. This technique opened up opportunities over the conventional ones, with the capability of creating replicable, customized, and functional structures that can ultimately promote effectively different tissues regeneration. The uppermost component of 3D printing is the bioink, i.e. a mixture of biomaterials that can also been laden with different cell types, and bioactive molecules. Important factors of the fabrication process include printing fidelity, stability, time, shear-thinning properties, mechanical strength and elasticity, as well as cell encapsulation and cell-compatible conditions. Collagen-based materials have been recognized as a promising choice to accomplish an ideal mimetic bioink for regeneration of several tissues with high cell-activating properties. This review presents the state-of-art of the current achievements on 3D printing using collagen-based materials for hard tissue engineering, particularly on the development of scaffolds for bone and cartilage repair/regeneration. The ultimate aim is to shed light on the requirements to successfully print collagen-based inks and the most relevant properties exhibited by the so fabricated scaffolds. In this regard, the adequate bioprinting parameters are addressed, as well as the main materials properties, namely physicochemical and mechanical properties, cell compatibility and commercial availability, covering hydrogels, microcarriers and decellularized matrix components. Furthermore, the fabrication of these bioinks with and without cells used in inkjet printing, laser-assisted printing, and direct in writing technologies are also overviewed. Finally, some future perspectives of novel bioinks are given.

Biofunctional Ionic-Doped Calcium Phosphates: Silk Fibroin Composites for Bone Tissue Engineering Scaffolding.

The treatment and regeneration of bone defects caused by traumatism or diseases have not been completely addressed by current therapies. Lately, advanced tools and technologies have been successfully developed for bone tissue regeneration. Functional scaffolding materials such as biopolymers and bioresorbable fillers have gained particular attention, owing to their ability to promote cell adhesion, proliferation, and extracellular matrix production, which promote new bone growth. Here, we present novel biofunctional scaffolds for bone regeneration composed of silk fibroin (SF) and ß-tricalcium phosphate (ß-TCP) and incorporating Sr, Zn, and Mn, which were successfully developed using salt-leaching followed by a freeze-drying technique. The scaffolds presented a suitable pore size, porosity, and high interconnectivity, adequate for promoting cell attachment and proliferation. The degradation behavior and compressive mechanical strengths showed that SF/ionic-doped TCP scaffolds exhibit improved characteristics for bone tissue engineering when compared with SF scaffolds alone. The in vitro bioactivity assays using a simulated body fluid showed the growth of an apatite layer. Furthermore, in vitro assays using human adipose-derived stem cells presented different effects on cell proliferation/differentiation when varying the doping agents in the biofunctional scaffolds. The incorporation of Zn into the scaffolds led to improved proliferation, while the Sr- and Mn-doped scaffolds presented higher osteogenic potential as demonstrated by DNA quantification and alkaline phosphatase activity. The combination of Sr with Zn led to an influence on cell proliferation and osteogenesis when compared with single ions. Our results indicate that biofunctional ionic-doped composite scaffolds are good candidates for further in vivo studies on bone tissue regeneration.

Osteogenic lithium-doped brushite cements for bone regeneration.

This study investigated the osteogenic performance of new brushite cements obtained from Li+-doped ß-tricalcium phosphate as a promising strategy for bone regeneration. Lithium (Li+) is a promising trace element to encourage the migration and proliferation of adipose-derived stem cells (hASCs) and the osteogenic differentiation-related gene expression, essential for osteogenesis. In-situ X-ray diffraction (XRD) and in-situ 1H nuclear magnetic resonance (1H NMR) measurements proved the precipitation of brushite, as main phase, and monetite, indicating that Li+ favored the formation of monetite under certain conditions. Li+ was detected in the remaining pore solution in significant amounts after the completion of hydration. Isothermal calorimetry results showed an accelerating effect of Li+, especially for low concentration of the setting retarder (phytic acid). A decrease of initial and final setting times with increasing amount of Li+ was detected and setting times could be well adjusted by varying the setting retarder concentration. The cements presented compressive mechanical strength within the ranges reported for cancellous bone. In vitro assays using hASCs showed normal metabolic and proliferative levels. The immunodetection and gene expression profile of osteogenic-related markers highlight the incorporation of Li+ for increasing the in vivo bone density. The osteogenic potential of Li-doped brushite cements may be recommended for further research on bone defect repair strategies.

Highly adherent bioactive glass thin films synthetized by magnetron sputtering at low temperature.

Thin (380-510 nm) films of a low silica content bioglass with MgO, B(2)O(3), and CaF(2) as additives were deposited at low-temperature (150°C) by radio-frequency magnetron sputtering onto titanium substrates. The influence of sputtering conditions on morphology, structure, composition, bonding strength and in vitro bioactivity of sputtered bioglass films was investigated. Excellent pull-out adherence (~73 MPa) was obtained when using a 0.3 Pa argon sputtering pressure (BG-a). The adherence declined (~46 MPa) upon increasing the working pressure to 0.4 Pa (BG-b) or when using a reactive gas mixture (~50 MPa). The SBF tests clearly demonstrated strong biomineralization features for all bioglass sputtered films. The biomineralization rate increased from BG-a to BG-b, and yet more for BG-c. A well-crystallized calcium hydrogen phosphate-like phase was observed after 3 and 15 days of immersion in SBF in all bioglass layers, which transformed monotonously into hydroxyapatite under prolonged SBF immersion. Alkali and alkali-earth salts (NaCl, KCl and CaCO(3)) were also found at the surface of samples soaked in SBF for 30 days. The study indicated that features such as composition, structure, adherence and bioactivity of bioglass films can be tailored simply by altering the magnetron sputtering working conditions, proving that this less explored technique is a promising alternative for preparing implant-type coatings.

Morphological and molecular analysis of metacercariae of Diphtherostomum brusinae (Stossich, 1888) Stossich, 1903 from a new bivalve host Mytilus galloprovincialis.

The digenean trematode Diphtherostomum brusinae (Stossich, 1888) Stossich, 1903 presents a complex life cycle that may involve more than one intermediate host. The present study represents the first description of the metacercariae from D. brusinae infecting the labial palps of a new intermediate host, Mytilus galloprovincialis, in the Aveiro estuary, Portugal. The morphology of this parasitic stage was studied by light (LM) and scanning electron microscopy (SEM) and some differences were reported (body and sucker sizes, and spine distribution and shape). In this work, the 18S partial region of the ribosomal DNA was sequenced from D. brusinae metacercariae isolated from M. galloprovincialis collected in different localities of the Aveiro estuary. In addition, sequences from the same region of the 18S rDNA were obtained from D. brusinae cercariae and metacercariae, hosted by Nassarius reticulatus and Cerastoderma edule, respectively. No intraspecific polymorphism was detected in the 18S partial region, since there was 100% homology among all the sequences analysed. The same comparison was made for the ITS1, and we observed intraspecific polymorphism in this region. To our knowledge, this is the first report of D. brusinae metacercariae infecting the mussel M. galloprovincialis with support from morphological and molecular data.

Porous aligned ZnSr-doped ß-TCP/silk fibroin scaffolds using ice-templating method for bone tissue engineering applications.

The bone is a complex and dynamic structure subjected to constant stress and remodeling. Due to the worldwide incidence of bone disorders, tissue scaffolds and engineered bone tissues have emerged as solutions for bone grafting, which require sophisticated scaffolding architectures while keeping high mechanical performance. However, the conjugation of a bone-like scaffold architecture with efficient mechanical properties is still a critical challenge for biomedical applications. In this sense, the present study focused on the modulating the architecture of silk fibroin (SF) scaffolds crosslinked with horseradish peroxidase and mixed with zinc (Zn) and strontium (Sr)-doped ß-tricalcium phosphate (ZnSr.TCP) to mimic bone structures. The ZnSr.TCP-SF hydrogels were tuned by programmable ice-templating parameters, and further freeze-dried, in order to obtain 3D scaffolds with controlled pore orientation. The results showed interconnected channels in the ZnSr.TCP-SF scaffolds that mimic the porous network of the native subchondral bone matrix. The architecture of the scaffolds was characterized by microCT, showing tunable pore size according to freezing temperatures (-196 °C: ∼80.2 ± 20.5 µm; -80 °C: ∼73.1 ± 20.5 µm; -20 °C: ∼104.7 ± 33.7 µm). The swelling ratio, weight loss, and rheological properties were also assessed, revealing efficient scaffold integrity and morphology after aqueous immersion. Thus, the ZnSr.TCP-SF scaffolds made of aligned porous structure were developed as affordable candidates for future applications in clinical osteoregeneration and in vitro bone tissue modelling.

Ion-doped Brushite Cements for Bone Regeneration.

Decades of research in orthopaedics has culminated in the quest for formidable yet resorbable biomaterials using bioactive materials. Brushite cements most salient features embrace high biocompatibility, bioresorbability, osteoconductivity, self-setting characteristics, handling, and injectability properties. Such type of materials is also effectively applied as drug delivery systems. However, brushite cements possess limited mechanical strength and fast setting times. By means of incorporating bioactive ions, which are incredibly promising in directing cell fate when incorporated within biomaterials, it can yield biomaterials with superior mechanical properties. Therefore, it is a key to develop fine-tuned regenerative medicine therapeutics. A comprehensive overview of the current accomplishments of ion-doped brushite cements for bone tissue repair and regeneration is provided herein. The role of ionic substitution on the cements physicochemical properties, such as structural, setting time, hydration products, injectability, mechanical behaviour and ion release is discussed. Cell-material interactions, osteogenesis, angiogenesis, and antibacterial activity of the ion-doped cements, as well as its potential use as drug delivery carriers are also presented. STATEMENT OF SIGNIFICANCE: Ion-doped brushite cements have unbolted a new era in orthopaedics with high clinical interest to restore bone defects and facilitate the healing process, owing its outstanding bioresorbability and osteoconductive/osteoinductive features. Ion incorporation expands their application by increasing the osteogenic and neovascularization potential of the materials, as well as their mechanical performance. Recent accomplishments of brushite cements incorporating bioactive ions are overviewed. Focus was placed on the role of ions on the physicochemical and biological properties of the biomaterials, namely their structure, setting time, injectability and handling, mechanical behaviour, ion release and in vivo osteogenesis, angiogenesis and vascularization. Antibacterial activity of the cements and their potential use for delivery of drugs are also highlighted herein.

Biological responses of brushite-forming Zn- and ZnSr- substituted beta-tricalcium phosphate bone cements.

The core aim of this study was to investigate zinc (Zn)- and zinc and strontium (ZnSr)-containing brushite-forming beta-tricalcium phosphate (TCP) cements for their effects on proliferation and differentiation of osteoblastic-like cells (MC3T3-E1 cell line) as well as for their in vivo behaviour in trabecular bone cylindrical defects in a pilot study. In vitro proliferation and maturation responses of MC3T3-E1 osteoblastic-like cells to bone cements were studied at the cellular and molecular levels. The Zn- and Sr-containing brushite cements were found to stimulate pre-osteoblastic proliferation and osteoblastic maturation. Indeed, MC3T3-E1 cells exposed to the powdered cements had increased proliferative rates and higher adhesiveness capacity, in comparison to control cells. Furthermore, they exhibited higher alkaline phosphatase (ALP) activity and increased Type-I collagen secretion and fibre deposition into the extracellular matrix. Proliferative and collagen deposition properties were more evident for cells grown in cements doped with Sr. The in vivo osteoconductive propertiesof the ZnCPC and ZnSrCPC cements were also pursued. Histological and histomorphometric analyses were performed at 1 and 2 months after implantation, using carbonated apatite cement (Norian SRS) as control. There was no evidence of cement-induced adverse foreign body reactions, and furthermore ZnCPC and ZnSrCPC cements revealed better in vivo performance in comparison to the control apatite cement. Additionally, the presence of both zinc and strontium resulted in the highest rate of new bone formation. These novel results indicate that the investigated ZnCPC and ZnSrCPC cements are both biocompatible and osteoconductive, being good candidate materials to use as bone substitutes.

Injectability of brushite-forming Mg-substituted and Sr-substituted alpha-TCP bone cements.

The influence of magnesium- and strontium-substitutions on injectability and mechanical performance of brushite-forming alpha-TCP cements has been evaluated in the present work. The effects of Mg- and Sr-substitutions on crystalline phase composition and lattice parameters were determined through quantitative X-ray phase analysis and structural Rietveld refinement of the starting calcium phosphate powders and of the hardened cements. A noticeable dependence of injectability on the liquid-to-powder ratio (LPR), smooth plots of extrusion force versus syringe plunger displacement and the absence of filter pressing effects were observed. For LPR values up to 0.36 ml g(-1), the percentage of injectability was always higher and lower for Mg-containing cements and for Sr-containing cements, respectively, while all the pastes could be fully injected for LPR > 0.36 ml g(-1). The hardened cements exhibited relatively high wet compressive strength values (~17-25 MPa) being the Sr- and Mg-containing cements the strongest and the weakest, respectively, holding an interesting promise for uses in trauma surgery such as for filling bone defects and in minimally invasive techniques such as percutaneous vertebroplasty to fill lesions and strengthen the osteoporotic bone.

Biomineralization capability of adherent bio-glass films prepared by magnetron sputtering.

Radiofrequency magnetron sputtering deposition at low temperature (150 degrees C) was used to deposit bioactive glass coatings onto titanium substrates. Three different working atmospheres were used: Ar 100%, Ar + 7%O(2), and Ar + 20%O(2). The preliminary adhesion tests (pull-out) produced excellent adhesion values (approximately 75 MPa) for the as-deposited bio-glass films. Bioactivity tests in simulated body fluid were carried out for 30 days. SEM-EDS, XRD and FTIR measurements were performed. The tests clearly showed strong bioactive features for all the prepared films. The best biomineralization capability, expressed by the thickest chemically grown carbonated hydroxyapatite layer, was obtained for the bio-glass coating sputtered in a reactive atmosphere with 7% O(2).

Morphological and molecular studies on life cycle stages of Diphtherostomum brusinae (Digenea: Zoogonidae) from northern Portugal.

Diphtherostomum brusinae was first recorded by the present study in the north of Portugal. Sporocysts, containing cercariae and encysted metacercariae, were observed in the gonads and digestive gland of the gastropod Nassarius reticulatus. Metacercariae were also found infecting the foot, mantle border and gills of the cockle Cerastoderma edule. The adult form was lodged in the rectum of the definitive host Diplodus sargus. The morphology of the three parasitic stages was studied by light (LM) and scanning electron microscopy (SEM). Despite the close similarity between cercaria and metacercaria, SEM data provided information that allowed their differentiation, namely the presence of a dense crown of microvilli around the oral cavity of the cercariae, which was absent in the metacercariae. In addition, the metacercariae presented a specific pre-acetabular rectangular band with conspicuous triangular spines. The adult showed characteristics of D. brusinae species, in particular the presence of acetabular lips, compact vitellaria and large elliptical eggs. Sequenced ITS1 data clearly demonstrated that the cercariae and metacercarial cysts from N. reticulatus, the cysts from C. edule and the adult isolated from D. sargus were life cycle stages that belonged to the same species, i.e. D. brusinae. Two transmission strategies in the life cycle of this species were observed: (1) cercariae encyst within the sporocysts of N. reticulatus and await ingestion by the definitive host; and (2) N. reticulatus naturally emits cercariae; they encyst in C. edule or the environment and are ingested by the definitive host.

Controlled grafting of dialkylphosphonate-based ionic liquids on γ-alumina: design of hybrid materials with high potential for CO2 separation applications.

In this work we provide a detailed study on grafting reactions of various dialkylphosphonate-based ILs. Special attention has been devoted to a comprehensive investigation on how the nature of the anion and the organic spacer composition (hydrophilic or hydrophobic groups) could impact the grafting densities and bonding modes of phosphonate-based ILs anchored to γ-alumina (γ-Al2O3) powders. For the first time, the bonding of phosphonate-based ILs with only surface hexacoordinated aluminum nuclei was established using both solid-state 31P-27Al D-HMQC and 31P NMR experiments. It has been demonstrated that the grafting of dialkylphosphonate-based ILs is competing with a hydrolysis and/or precipitation process which could be attractively hindered by changing the anion nature: bis(trifluoromethane)sulfonylimide anion instead of bromide. In additon, independently of the chosen spacer, similar reaction conditions led to equivalent grafting densities with different bonding mode configurations. The CO2 physisorption analysis on both pure ILs and grafted ILs on alumina powders confirmed that the initial sorption properties of ILs do not change upon grafting, thus confirming the attractive potential of as-grafted ILs for the preparation of hybrid materials in a form of selective adsorbers or membranes for CO2 separation applications.

An in vitro biological and anti-bacterial study on a sol-gel derived silver-incorporated bioglass system.

OBJECTIVES: The purpose of this study was to evaluate the in vitro antibacterial and biological activity of silver-incorporated bioactive glass system SiO2-CaO-P2O5-Ag2O (AgBG). The bacteriostatic and bactericidal properties of this new quaternary glass system along with the ternary sol-gel glass system SiO2-CaO-P2O5 (BG) have been studied using Escherichia coli as a test micro-organism. The AGBG system thus appears to be a promising material for dental applications, since similar effects might be produced on a film of bacteria and mucous that grows on the teeth. METHODS: The SiO2-CaO-P2O5-Ag2O and SiO2-CaO-P2O5 glass systems were synthesized by the sol-gel technique and characterized for their physicho-chemical properties. The antibacterial activity and biological properties were evaluated by determining the minimum inhibitory concentrations (MICs). Release of Ag+ into the culture medium was measured by inductively coupled plasma (ICP) analysis. RESULTS: The in vitro antibacterial action of the SiO2-CaO-P2O5-Ag2O was compared with that of its ternary counterpart glass system. The concentrations of Ag-bioglass, in the range of 0.02-0.20 mg of Ag-bioglass per millilitre of culture medium, were found to inhibit the growth of these bacteria. The Ag-bioglass not only acts bacteriostatically but it also elicited a rapid bactericidal action. A complete bactericidal effect was elicited in the early stages of the incubation at Ag-bioglass concentration of 20 mg/ml and the ternary glass system had no effect on bacterial growth or viability. The antibacterial action of Ag-bioglass was exclusively attributed to the leaching of Ag+ ions from the glass matrix. SIGNIFICANCE: One of the major advantages of incorporating silver ions into a gel glass system is that the porous glass matrix can allow for controlled sustained delivery of the antibacterial agent to dental material, used even under anaerobic conditions such as deep in the periodontal pocket. This glass system also provides long-term action required for systems which are constantly at risk of microbial contamination.

Calidad de sueño en personas adultas mayores con diabetes mellitus tipo II / Sleep quality in older adults with type II diabetes mellitus

Introducción: el dormir mal podría ser la causa de diabetes mellitus tipo II y otras enfermedades crónicas no transmisibles. Objetivo: conocer la calidad de sueño de las personas con diabetes mellitus tipo II. Material y métodos: se realizó un estudio descriptivo, la muestra 44 adultos con diabetes mellitus. Se aplicó el cuestionario de Índice de Calidad de Sueño de Pittsburgh, 19 reactivos que contiene siete componentes con una escala de 0 a 3. La suma de estos da el índice. Resultados: se evaluó la calidad de sueño en 44 personas con diabetes mellitus tipo II, de abril a agosto 2021. El promedio de edad 67 años, 73 % del sexo femenino. El 39 % tiene una mala calidad de sueño, 27 % tarda en dormir entre 30 y 60 minutos, 18 % duerme <5 horas, 79.5 % no tiene una eficiencia de sueño normal, 48% reporto tener alteraciones del sueño una o dos veces a la semana, 11 % usa medicamentos para dormir menos de una vez a la semana y 11 % tiene una disfunción diurna. En cuanto al índice de calidad de sueño 85 % tiene un índice > 5. Conclusión: las personas diabéticas tienen una mala calidad de sueño lo cual puede afectar su metabolismo, en consecuencia es necesario realizar una intervención para mejorar su calidad de sueño.

Introduction: poor sleep could be the cause of type II diabetes mellitus and other chronic non-communicable diseases. Objective: to know the quality of sleep of people with type II diabetes mellitus. Material and methods: a descriptive study was carried out, the sample consisted of 44 adults with diabetes mellitus. The 19-item Pittsburgh Sleep Quality Index questionnaire was applied, containing seven components with a scale from 0 to 3. The sum of these gives the index. Results: the quality of sleep was evaluated in 44 people with type II diabetes mellitus, from April to August 2021. The average age was 67 years old, 73% are female. 39% have a poor quality of sleep, 27% take between 30 to 60 minutes to sleep, 18% sleep <5 hours, 79.5% do not have a normal sleep efficiency, 48% reported having sleep disturbances one or twice a week, 11% use sleep medications less than once a week and 11% have a daytime dysfunction. Regarding the sleep quality index, 85% have an index> 5 Conclusion: diabetic people have a poor quality of sleep which can affect their metabolism, so it is necessary to carry out an intervention to improve their quality of sleep.

Conocimientos, prácticas y actitudes de enfermería para la atención de personas con tuberculosis / Nursing knowledge, practices, and attitudes regarding the attention of persons with tuberculosis / Conhecimentos, práticas e atitudes de enfermagem para a atenção de pessoas com tuberculose

Resumen Introducción: La tuberculosis es un padecimiento con una gran carga económica y social; representa una de las 10 causas principales de mortalidad a nivel mundial. Múltiples factores intervienen en la adherencia al tratamiento y cura de la enfermedad. La atención de enfermería estudiada desde 3 indicadores (conocimiento, práctica y actitud), que son determinantes cruciales para el cumplimiento de una atención de calidad y para la implementación de nuevas tecnologías de cuidados; es imprescindible. Objetivo: Evaluar los conocimientos, prácticas y actitudes de enfermería relacionados con la atención de pacientes con tuberculosis. Metodología: Estudio cuantitativo, descriptivo, muestra no probabilística de 19 enfermeras(os) del primer nivel de atención. Se evaluaron los conocimientos básicos generales, los relacionados con el diagnóstico y con el tratamiento. Las prácticas comprendieron la identificación de recursos para el registro, las visitas, la elaboración de planes de cuidados de enfermería, además del uso de una herramienta digital que se brindó para facilitar la elaboración de dichos planes. En actitudes, se evaluaron tres componentes: cognitivo, conductual y afectivo. Resultados: Se identificó una base débil de conocimientos en tuberculosis; la mayor parte mostró un nivel de conocimiento medio y bajo. Poco más de la mitad de los participantes se ubicó con una práctica regular y, de manera general, la actitud al brindar los cuidados fue buena. Conclusiones: Se requiere fortalecer la atención de enfermería en tuberculosis desde los tres indicadores evaluados. Sin una base consolidada de conocimientos sobre la enfermedad es difícil alcanzar los objetivos de los programas y las políticas en salud pública; esto, a su vez, repercute de manera directa en la práctica y actitud de los profesionales.

Abstract Introduction: Being one of the 10 main causes of mortality worldwide, tuberculosis causes a great economic and social burden to societies. Considering that diverse factors are involved in the treatment adherence, and consequent cure, nursing attention, assessed through the related knowledge, practices, and attitudes, becomes of paramount importance. Objective: To assess the tuberculosis-related knowledge, practices, and attitudes among nurses. Methodology: This is a quantitative and descriptive study with a non-probabilistic sample of 19 nurses in primary care. Regarding knowledge, the basic general, and diagnosis and treatment related were assessed. Regarding practices, the resources identification, visits, care plans, and digital tools use were assessed. Regarding attitudes, the cognitive, behavioral, and affective areas were assessed. Results: The majority of nurses demonstrated a fair or low level of tuberculosis related knowledge. A little more than half of the participants demonstrated a regular or fair level of tuberculosis related practice. In general, the attitudes towards providing tuberculosis care were good. Conclusions: It is necessary to strengthen the tuberculosis related nursing attention in terms of the 3 indicators assessed in this study. Without a sound base of knowledge, an expertised practice, and a good attitude related to addressing the problem of tuberculosis, it is hard to accomplish the objectives, programs, and policies of Public Health, a situation which indirectly, can also have negative impacts on the health professionals.

Resumo Introdução: A tuberculose é uma doença com uma grande carga económica e social, representa uma das 10 causas principais de mortalidade a nível mundial. Múltiplos fatores intervêm na aderência ao tratamento e cura da doença. A atenção de enfermagem estudada desde 3 indicadores (conhecimento, prática e atitude), que são determinantes cruciais para o cumprimento de uma atenção de qualidade e para a implementação de novas tecnologias de cuidados, é imprescindível. Objetivo: Avaliar os conhecimentos, práticas e atitudes de enfermagem relacionados com a atenção de pacientes com tuberculose. Metodologia: Estudo quantitativo, descritivo, amostra não probabilística de 19 enfermeiras (os) do primeiro nível de atenção. Avaliaram-se os conhecimentos básicos gerais, os relacionados com o diagnóstico e, com o tratamento. As práticas compreenderam a identificação de recursos para o registro, as visitas, a elaboração de planos de cuidados de enfermagem, além disso do uso de uma ferramenta digital que se proporcionou para facilitar a elaboração desses planos. Em atitudes avaliaram-se três componentes: cognitivo, comportamental e afetivo. Resultados: Identificou-se uma base de conhecimentos em tuberculose fraca, a maior parte mostrou um nível de conhecimento médio e baixo. Pouco mais da metade dos participantes situou-se com uma prática regular e de maneira geral, a atitude de proporcionar os cuidados foi adequada. Conclusões: É preciso fortalecer a atenção de enfermagem em tuberculose desde os três indicadores avaliados. Sem uma base consolidada de conhecimentos sobre a doença é difícil atingir os objetivos dos programas e as políticas em saúde pública; isto por sua vez, repercute de forma direta na prática e atitude dos professionais.

Description of a DNA amplification procedure for the detection of bacteriophages of Bacteroides fragilis HSP40 in environmental samples.

A molecular test based on DNA amplification by PCR was developed for the detection of bacteriophages of Bacteroides fragilis strain HSP40 in the environment. These specific phages are associated with faecal contamination of human origin. A homologous DNA region of 1.5 kb, identified previously by hybridisation, was used to design primers for the detection of B. fragilis HSP40 phages. A nested-PCR procedure for the DNA amplification of those phages was developed. The sensitivity of the nested-PCR was between 10(-1) and 10(-2) PFU for purified HSP40 phage solutions, sewage and seawater samples, and between 1 and 10 PFU for river water samples. Specific amplification of HSP40 phages was observed when viral suspensions of 10(3) PFU/ml or lower were used. Common levels of B. fragilis phages found in sewage are 10(1)-10(2) PFU/ml. A total of 24 water samples (sewage, river water and seawater) were tested both by PCR and by plaque assay, to evaluate the efficiency of the molecular method in field samples. The data obtained by PCR in environmental samples showed good concordance with the PFU counts and a higher sensitivity.

[Tuberous sclerosis: clinical characteristics and their relationship to genotype/phenotype]. / Esclerosis tuberosa: caracterización clínica e intento de correlación fenotipo/genotipo.

INTRODUCTION: Tuberous sclerosis (TS) is an inherited disorder with multisystemic involvement and a high phenotypic variability. There are two genes that cause this condition: TSC1 and TSC2. OBJECTIVES: Our goal was to clinically characterize patients with TS followed up in the Pediatric Neurology Clinic of a tertiary hospital during the last 10 years, and correlate the genotype with the severity of neurological manifestations and imaging studies. PATIENTS AND METHODS: Retrospective analysis of patients with TS, including review of medical records and available MRI imaging. RESULTS: We studied 35 cases with a median age at diagnosis of ten months. Seizures were the first manifestation in 91.4% of cases, with a predominance of epileptic spasms. Over 50% had cognitive impairment and 49% behavioral disorders. A genetic study was performed on 24 children, and TSC2 mutations identified in 58.3% of them. Of the 11 cases of refractory epilepsy, six had the TSC2 gene mutation. In the group of eight patients with moderate/severe cognitive deficits, five had TSC2 mutations. We reviewed 26 MRI scans, in which it was observed that 76.9% had diffuse involvement of cerebral lobes, which reflects a greater burden of injury. Of the patients who had an MRI scan performed and had TSC2 mutations, all had a high tuber load, and5 of them had refractory epilepsy. DISCUSSION: In our sample we observe a high percentage of mutations in the TSC2 gene. This mutation carries a worse neurological prognosis, with drug-resistant epilepsy and a more severe cognitive impairment.

Effects of Mn-doping on the structure and biological properties of ß-tricalcium phosphate.

Doping calcium phosphates with trace elements that exist in bone tissues is beneficial in terms of cell-material interactions and in vivo performance of the bone grafts made thereof. Manganese (Mn) is an essential element for normal growth and metabolism of bone tissues, but studies reporting the effects of Mn-doping calcium phosphates are scarce. The present study investigated the influence of Mn-doping on the structure, morphology and biological properties of ß-tricalcium phosphate [ß-Ca3(PO4)2] (ß-TCP). Mn-doped (MnTCP) powders, with Mn contents varying from 0 to 10 mol%, were obtained through an aqueous precipitation method followed by heat treatment at 800 °C. The successful incorporation of Mn into ß-TCP structure was proved through quantitative X-ray diffraction (XRD) phase analysis coupled with structural Rietveld refinement. Increasing Mn concentrations led to decreasing trends of a- and c-axis lattice parameters, and Mn-doping also significantly affected the morphology of ß-TCP powders. In vitro proliferation and differentiation assays of MC3T3-E1 osteoblastic-like cells, grown in the presence of the powders, revealed that the biological benefits of Mn-doped ß-TCP are limited to lower Mn incorporation levels and potentially related to their surface microstructure. The Mn1-ßTCP composition revealed the best set of bioactivity properties, potentially a good candidate for future applications of ß-TCP materials in osteoregeneration.

Burkitt lymphoma as a cause of carotidynia: imaging features. A case report.

We describe a patient with Burkitt lymphoma who developed carotidynia. MRI showed thickening of the walls of both common carotid arteries and PET CT showed increased radiotracer uptake in the same regions. MRI was essential in establishing the diagnosis of this rare clinical presentation.