Diving into the unknown: identification of antimicrobial resistance hotspots in a tropical urban estuary.

Antimicrobial resistance is widely studied and well-characterized from a clinical perspective. However, considerably less information is available regarding resistance in environmental settings, especially in aquatic habitats. This study presents data regarding the occurrence, distribution and the antimicrobial susceptibility profile of bacteria isolated from Guanabara Bay (GB), a heavily polluted tropical urban estuary and an important tourist attraction in Rio de Janeiro, Brazil. Water samples from sites characterized by growing degrees of pollution were analysed by culture-dependent methods, revealing the presence of multidrug-resistant bacteria and clinically relevant indicators of antimicrobial resistance, such as extended-spectrum beta-lactamases. Isolates were identified by mass spectrometry, which indicated the presence of potential human pathogens such as Aeromonas spp. and Vibrio spp. Bacteria harbouring beta-lactam resistance genes were also detected. Although GB is widely used as a recreational and fishing area, there is a substantial knowledge gap regarding the monitoring of antimicrobial resistance and the risk that exposure to these waters poses to public health. Thus, this study reveals new information that calls for better comprehension of antimicrobial resistance in aquatic environments, especially those used for recreational purposes.

[Determinants of prenatal care utilization among low income families in Paraíba State, Brazil]. / Determinantes de utilização do cuidado pré-natal entre famílias de baixa renda no Estado da Paraíba, Brasil.

The determinants of prenatal care in the state of Paraíba, Brazil, are examined. A population of 769 rural and urban women resident in the municipality of Caaporã and who had had a child within the five years immediately preceding the survey were interviewed. It was found that there are deficiencies in the provision of health services, especially in the rural area. While 80 percent of the women resident in the urban area had some prenatal care, more than 40 percent of women in the rural area had received no prenatal care at all. Through cross tabulations and multivariate analysis, the study assesses the differentials in the utilization or services and the net effect of sociodemographic variables on the use of prenatal care. It was found that there is a positive association between education and pregnancy of use of prenatal care and a negative association between rural residence and the use of prenatal care.

Comparative in vitro study of apically extruded material after four different root canal Instrumentation techniques.

Forty newly extracted human upper central incisors were submitted to root canal instrumentation 1 mm from the apex using four different techniques: standard, step-preparation, crown-down, and ultrasound, with distilled and deionized water as the irrigating solution. The extrusion product was collected into a collecting device constructed for this purpose. Extrusion was calculated by the determination of the mass of extruded material. The step-preparation technique caused a larger amount of extrusion than the standard technique, which in turn caused greater extrusion than the crown-down and ultrasound techniques. All techniques used caused extrusion of material beyond the apical foramen.

External and internal anatomy of mandibular molars.

The external and internal anatomy of 628 extracted, mandibular first and second molars was studied. The external anatomy was studied by measuring each tooth and by observing the direction of the root curvatures from the facial surface. The internal anatomy of the pulp cavity was studied by a method of making the teeth translucent.

[Restoration of endodontically treated teeth]. / Restaurações de dentes tratados endodónticamente.

The existing literature on the criteria and conditions for the restoration of endodontically treated teeth has been reviewed. This review shows a consensus among the various authors that the restoration depends on: the dental structure which remains, the position of the tooth in the arch, and whether or not it has been used as a support for fixed or removable partial prosthesis. When the remaining dental structure is sufficient, the tooth can be restored, aesthetically and functionally in the usual way. If the structure is inadequate it will be necessary to reinforce the crown with the help of intra-crown pins, that can be of amalgam or pre-fabricated metal, after which the crown can be reconstructed with amalgam or cast restoration metal. If the tooth to be restored has been used as a support for partial prosthesis or is located in the arch where horizontal forces are present, an intra-root reinforcement with metallic pins will be necessary. These pins can be cast or pre-fabricated and crown core. In this review are discussed also some advantages and disadvantages of the use of the two types of pins and also the criteria for preparing cast-metal post and for the use of pre-fabricated pins.

[Absorption capacity of different brands of paper points]. / Capacidade de absorção dos cones de papel absorbentes, de diferentes marcas.

The absorption ability of paper points of different brands was assessed "in vitro". All points showed absorbing ability higher than 100 per center their own weight, but differences in moistening rate were detected among brands.

Complex treatment of dens invaginatus type III in maxillary lateral incisor.

The complex anatomy and diagnosis of dens invaginatus make endodontic treatment of such teeth difficult. This case describes combined nonsurgical and surgical treatment of a maxillary lateral incisor with a normally shaped canal and a dens invaginatus type III with a lateroradicular lesion. The root canal was treated conventionally with gutta-percha and a zinc oxide-eugenol sealer. The root was surgically exposed and the canal of the dens invaginatus was cleaned, instrumented and obturated with gutta-percha and a zinc oxide-eugenol sealer. At follow-up 3 years 6 months later, the tooth was asymptomatic and radiographically showed repair of the lesion in the region of the dens invaginatus.

The prevalence of trachoma in preschool and school children in Olimpia, Guaraci and Cajobi, Sao Paulo, Brazil.

A school-based prevalence survey of trachoma was conducted in three rural municipalities in the state of Sao Paulo, Brazil, in 1989. A total of 950 children aged 4-11 years were examined. The prevalence of inflammatory trachoma was found to be 6.3%, peaking at 24.1% in the 4 year-old age group. The prevalence of trachomatous scarring was 2.7% and was more prevalent in older children. Risk factors included household sleeping arrangements and nasal discharge.

PIP: In December 1989, researchers gathered data on 950 4-11 year old children attending preschool or primary schools in the rural municipalities of Olimpia, Guaraci, and Cajobi in northwestern Sao Paulo State, Brazil to measure prevalence of active trachoma and to identify its risk factors. Overall prevalence of trachoma was 8.6%. Physicians treated all trachoma cases with topical 1% tetracycline twice daily for 6 weeks and examined them later at a local health care center. Prevalence of inflammatory trachoma stood at 6.3%. This was similar to its prevalence in an Olimpia's neighboring town called Bebedouro. Prevalence of trachomatous scarring was 2.7%. Thus the northwestern part of Sao Paulo state was an important focus of endemic trachoma infection. Inflammatory trachoma was highest among the 4 year olds (24.1%) and fell to 0 by age 11. On the other hand, trachomatous scarring was relatively rare in 4-5 year olds then increased to 7% in 10-11 year old children. In fact, the mean age for inflammatory trachoma was 6.6 years and for trachomatous scarring 8.5 years. Perhaps the recently implemented trachoma control activities in Olimpia explained the lowest prevalence of inflammatory trachoma (5.4%). Guaraci experienced the highest prevalence rate (9.6%), but did not have any cases of trachomatous scarring. Children who slept with others were significantly more likely to have inflammatory trachoma than were those who slept alone (p.005). Sleeping pattern was the only personal hygiene variable significantly associated with inflammatory trachoma. Not even face washing was significantly associated with it. The only clinical symptom significantly associated with inflammatory trachoma was nasal discharge (p.001). A considerable community-based epidemiological survey would qualify these results.