Water balance components and climate extremes over Brazil under 1.5 °C and 2.0 °C of global warming scenarios.

This work aimed to evaluate changes in water balance components (precipitation, evapotranspiration, and water availability) and precipitation extremes projected under global warming levels (GWLs) of 1.5 °C and 2 °C, in Brazil. An ensemble of eight twenty-first-century projections with the Eta Regional Climate Model and their driving Global Climate Models (CanESM2, HadGEM2-ES, MIROC5, and BESM) were used. Projections of two Representative Concentration Pathway scenarios, RCP4.5 and RCP8.5, considered intermediate and high concentration, respectively, were used. The results indicate that the RCP8.5 scenario under 2 °C GWL is likely to have a higher impact on the water balance components, amplifying trends in drier conditions and increasing the number of consecutive dry days in some regions of Brazil, particularly in the North and Northeast regions. On the other hand, the projections indicate the opposite sign for the South region, with trends toward wetter conditions and significant increases in extreme rainfall. The 0.5 °C difference between the GWLs contributes to intensifying reductions (increases) from 4 to 7% in water availability, mainly in the North-Northeast (South) regions. The projected changes could have serious consequences, such as increases in the number of drought events in hydrographic regions of the Northeast region of Brazil and increases in flood events in the South of the country. The results here presented can contribute to the formulation of adaptive planning strategies aimed at ensuring Brazil's water security towards climate change. Supplementary Information: The online version contains supplementary material available at 10.1007/s10113-023-02042-1.

The interaction between Sporothrix schenckii sensu stricto and Sporothrix brasiliensis with Acanthamoeba castellanii.

BACKGROUND: Sporotrichosis is a group of zoonotic subcutaneous mycoses, found worldwide and caused by fungi belonging to the genus Sporothrix. Protozoans of the genus Acanthamoeba are widely distributed, and some species may be pathogenic and/or opportunistic. These organisms coexist in the same environment and may interact. OBJECTIVES: This study determined the profile of interactions of S schenckii sensu stricto and S brasiliensis with A castellanii, using an in vitro co-culture model to evaluate the intrinsic characteristics of the two Sporothrix species and A castellanii. METHODS: We compared the rate of phagocytosis of S schenckii sensu stricto and S brasiliensis by A castellanii; the viability of S schenckii sensu stricto and S brasiliensis after contact with A castellanii; the viability of the amoeba after contact with a fungal species; and the influence of S schenckii sensu stricto and S brasiliensis on the encystment process of A castellanii. RESULTS: The analyses indicated that A castellanii phagocytised both S schenckii and S brasiliensis, with significantly more S schenckii than S brasiliensis in the first two hours of contact. Our results showed a significant increase in conidia and hyphae count after 72 hours of co-culture of A castellanii with S brasiliensis, and the amoebae lysed after they ingested the fungi, indicating that the fungi probably used the amoebae as a source of nutrition. CONCLUSIONS: Our results were obtained in vitro and these organisms may not behave similarly in vivo; in vivo studies of co-infections are necessary in order to gain a thorough understanding of this relationship.

Evaluation of the interaction between polymyxin B and Pseudomonas aeruginosa biofilm and planktonic cells: reactive oxygen species induction and zeta potential.

BACKGROUND: Although the most widely accepted mechanism of action for polymyxins is related to bacterial lysis via disruption, we hypothesized that this antimicrobial drug class could have other effects on Pseudomonas aeruginosa planktonic and sessile cells. Little is known regarding oxidative burst and zeta potential (ZP) data associated with the interaction between polymyxin B and P. aeruginosa cells. The present study evaluated endogenous reactive oxygen species (ROS) production and changes in the net charges of biofilm and planktonic cells in response to polymyxin B. RESULTS: Polymyxin B induced concentration-dependent killing at all concentrations tested in planktonic and sessile cells from P. aeruginosa strains. Sublethal concentrations of polymyxin B induced oxidative burst. ROS production was higher in resistant planktonic cells than in biofilm cells but this was not observed for susceptible cells. Moreover, no net surface charge alterations were observed in planktonic cells from a susceptible strain treated with polymyxin B, but a significant increase of ZP was noted in planktonic cells from a resistant strain. CONCLUSION: Oxidative burst generated by planktonic and sessile cells from P. aeruginosa strains against polymyxin B indicates that ROS may have an important role in the mechanism of action of this drug. ZP data revealed that electrostatic interactions of the cationic peptide with the anionic surface of the cells are strain-dependent. Therefore, we suggested that the intracellular effects of polymyxin B should be further investigated to understand polymyxin B-induced stress in P. aeruginosa.

Biophysical Effects of a Polymeric Biosurfactant in Candida krusei and Candida albicans Cells.

This study evaluated the effects of a polymeric biosurfactant produced by Trichosporon montevideense CLOA72 in the adhesion of Candida albicans and Candida krusei cells to human buccal epithelial cells and its interference in biofilm formation by these strains. The biofilm inhibition by biosurfactant (25 mg/mL) in C. krusei and C. albicans in polystyrene was reduced up to 79.5 and 85 %, respectively. In addition, the zeta potential and hydrodynamic diameter of the yeasts altered as a function of the biosurfactant concentration added to the cell suspension. The changes in the cell surface characteristics and the interface modification can contribute to the inhibition of the initial adherence of yeasts cells to the surface. In addition, the analyses of the biofilm matrix and planktonic cell surfaces demonstrated differences in carbohydrate and protein concentrations for the two studied strains, which may contribute to the modulation of cell adhesion or consolidation of biofilms, especially in C. krusei. This study suggests a possible application of the of CLOA72 biosurfactant in inhibiting the adhesion and formation of biofilms on biological surfaces by yeasts of the Candida genus.

Heteroresistance to Itraconazole Alters the Morphology and Increases the Virulence of Cryptococcus gattii.

Cryptococcus gattii is the main etiological agent of cryptococcosis in immunocompetent individuals. The triazole drug itraconazole is one of the antifungals used to treat patients with cryptococcosis. Heteroresistance is an adaptive mechanism to counteract the stress of increasing drug concentrations, and it can enhance the ability of a microorganism to survive under antifungal pressure. In this study, we evaluated the ability of 11 C. gattii strains to develop itraconazole heteroresistance. Heteroresistant clones were analyzed for drug susceptibility, alterations in cell diameter, capsule properties, and virulence in a murine model. Heteroresistance to itraconazole was intrinsic in all of the strains analyzed, reduced both the capsule size and the cell diameter, induced molecular heterogeneity at the chromosomal level, changed the negatively charged cells, reduced ergosterol content, and improved the antioxidant system. A positive correlation between surface/volume ratio of original cells and the level of heteroresistance to itraconazole (LHI) was observed in addition to a negative correlation between capsule size of heteroresistant clones and LHI. Moreover, heteroresistance to itraconazole increased the engulfment of C. gattii by macrophages and augmented fungal proliferation inside these cells, which probably accounted for the reduced survival of the mice infected with the heteroresistant clones and the higher fungal burden in lungs and brain. Our results indicate that heteroresistance to itraconazole is intrinsic and increases the virulence of C. gattii. This phenomenon may represent an additional mechanism that contributes to relapses of cryptococcosis in patients during itraconazole therapy.

Effect of long COVID-19 syndrome on health-related quality of life: a cross-sectional study.

Purpose: This study aimed to assess the association of anxiety, headache, and insomnia on the QoL of patients with long COVID-19. Methods: We conducted a cross-sectional survey between August 2020 and March 2023. A total of 200 participants were eligible, 53 were excluded and 147 patients with long COVID were included. QoL was evaluated across eight domains using the 36-Item Short Form Health Survey (SF-36). Standardized protocols including the Beck Anxiety Inventory (BAI) (n = 103), Pittsburgh Sleep Quality Index (PSQI) (n = 73), and Migraine Disability Assessment (MIDAS) (n = 67) were also used. Results: Participants with sleep disorders had significantly lower Vitality (p < 0.001). Participants with anxiety disorders had significantly lower Vitality (p = 0.001), poorer Mental Health (p = 0.008), and more severe Bodily Pain (p = 0.008). Participants with headache had significantly lower Vitality (p = 0.032), poorer Mental Health (p = 0.036), and poorer Physical Functioning (p = 0.016). Participants with both headache and anxiety had significantly lower Vitality (p = 0.005) and Mental Health (p = 0.043) domain scores. Correlation analysis revealed that higher scores for anxiety, sleep disorder, and headache were independently correlated with poorer QoL across various domains. The presence of sleep disorder was associated with a fourfold increase in risk of experiencing diminished Vitality (odds ratio [OR]4.47; 95% CI 1.01-19.69; p = 0.048). Conclusion: Participants with anxiety, sleep, and headache disorders tended to have a worse QoL. The Vitality and Mental Health domains were the most adversely affected in patients with long COVID. Sleep disorders were associated with a fourfold increase in the risk of poor Vitality.

Episodic-like memory impairment induced by sub-anaesthetic doses of ketamine.

Episodic-like memory refers to integration of where and when a certain event (what) happened. The glutamatergic neurotransmission, particularly AMPA and NMDA receptors, in the dorsal hippocampus mediates episodic recall. Ketamine is a non-competitive NMDA antagonist with effect on cognitive performance and plasticity. The goal of this study was to evaluate the acute action of ketamine on behavioural and neurochemical aspects of episodic-like memory (WWWhen/ELM task) through immediate-early gene expression (IEG), c-Fos, in the dorsal hippocampus. Animals received saline 0.9% or ketamine at 8 mg/kg or 15 mg/kg (i.p.) immediately after the second sample. Our data indicate that untreated and saline rats integrate the three elements of episodic-like memory. Conversely, animals treated with ketamine showed impairment of ELM formation. In addition, the highest dose of ketamine increased c-Fos expression in dorsal CA1 subregion when compared to saline rats. Our results indicate that the antagonism of NMDA concurrently impair ELM formation of all three aspects of ELM and increase neuronal activation in dorsal CA1.

The Importance of Conscious Sedation for Life-Saving Valve Procedures in Patients With Rheumatic Heart Disease From Low- to Middle-Income Countries.

BACKGROUND: Severe valve disease, which requires intervention, remains strongly associated with mortality in patients with rheumatic heart disease. Percutaneous mitral commissurotomy (PMC) is the procedure of choice for the treatment of patients with isolated or predominantly rheumatic mitral stenosis. This procedure has been performed under sedation to avoid the potential effects of general anesthesia on intracardiac pressure measurements. However, there are limited data on sedation during PMC, especially using easily available medications in low- and middle-income countries. OBJECTIVES: This study was designed to evaluate the efficacy and hemodynamic effects of conscious sedation during PMC in patients with significant mitral stenosis. METHODS: This study prospectively enrolled 23 patients who underwent PMC with the Inoue balloon technique for hemodynamically significant mitral stenosis. For conscious sedation, midazolam 25 µg/kg and fentanyl 1 µg/kg were administered, and 5 min after the infusion, the level of sedation was evaluated by Ramsay sedation scale. A range of invasive hemodynamic measurements, including cardiac output and pulmonary artery pressures, were recorded before and immediately after sedation. RESULTS: The mean age was 44.9 ± 10.8 years, and 19 patients (83%) were women. After sedation, the majority of patients were in categories 2 and 3 of the Ramsay sedation scale (cooperative, orientated, tranquil, and responding to commands). Oxygen saturation dropped from an average of 98.5% to 96.0% without supplementary oxygen. Left ventricular systolic pressure and central aortic pressures decreased after sedation. However, none of the other parameters changed significantly after sedation, including pulmonary artery pressures, pulmonary vascular resistance, and cardiac index. CONCLUSIONS: This simple model of conscious sedation was able to promote anxiolysis, analgesia, and comfort for the procedure without serious hemodynamic effects, which can be a reasonable choice in developing countries.

Emotion-oriented coping increases the risk of depression among caregivers of end-stage renal disease patients undergoing hemodialysis.

PURPOSE: We investigated the possible association between coping style and depressive feelings among caregivers of end-stage renal disease patients undergoing hemodialysis. METHODS: We studied 107 main caregivers of hemodialysis patients. Main caregiver was defined as the person on whom the patient counts for daily care or the one the patient calls upon in case of difficulties. Demographic data of caregivers and clinical data of patients were collected. The Jalowiec Coping Scale was applied to score two styles of coping: problem-oriented coping (POC) and emotion-oriented coping (EOC). Depression was screened by the 20-item version of the Center for Epidemiologic Studies Depression Scale (CES-D). A score ≥16 was used to classify depression. Comparisons were made by Student's t and Chi-square tests. The Pearson's test was used to assess correlation between scores. Linear and logistic regressions were used, respectively, to test variables as predictors of the CES-D scores and the presence of depression. RESULTS: The depression rate among caregivers was 71.9%. In the comparison between depressed and non-depressed caregivers, only EOC score differed, being higher among depressed ones (69.8 vs. 62.4; p < 0.001). EOC score was positively correlated with depression score (r = 0.368; p = <0.001). In the multivariate analysis, EOC independently predicted both the depression score (b = 0.272; p = 0.001) and the presence of depression (OR 1.221; 95% CI 1.123-1.339; p = 0.001). CONCLUSION: Our results indicate that EOC is associated with and increases the risk of depression among caregivers of HD patients. We propose that strategies aiming to strengthen POC and diminish EOC can be applied to minimize depressive feelings.

Atenção básica em saúde bucal no estado de Goiás de 2001 a 2013 / Primary care in oral health in the state of Goiás from 2001 to 2013

OBJETIVO: Analisar a atenção básica em saúde bucal do estado de Goiás considerando a evolução da cobertura populacional das equipes de saúde bucal e dos indicadores da assistência odontológica no período de 2001 a 2013. MÉTODOS: Trata-se de um estudo descritivo baseado em dados secundários sobre a cobertura populacional das equipes de saúde bucal e os indicadores da atenção básica em saúde bucal - cobertura de primeira consulta odontológica programática, cobertura da ação coletiva de escovação dental supervisionada, média de procedimentos odontológicos básicos individuais e proporção de exodontias em relação às ações odontológicas básicas individuais. RESULTADOS: Houve aumento da cobertura populacional das equipes de saúde bucal, principalmente da Modalidade I. Apesar dos avanços significativos da atenção básica em saúde bucal no estado de Goiás no período de 2001 a 2013, os indicadores revelam fragilidades no acesso e utilização dos serviços, permanecendo ainda as iniquidades no acesso e utilização dos serviços entre os municípios do estado de Goiás, além do caráter predominantemente curativo e mutilador do modelo tradicional de atenção odontológica. CONCLUSÕES: É necessário o desenvolvimento de estratégicas para que a expansão da cobertura populacional das equipes de saúde bucal seja acompanhada pela crescente oferta e utilização de serviços, com diminuição gradativa dos procedimentos mutiladores e consolidação de uma assistência integral, resolutiva e equitativa.

OBJECTIVE: To analyze the basic care in oral health in the state of Goiás, considering the evolution of the population coverage of oral healthteams and indicators of dental care in the period from 2001 to 2013. METHODS: This is a descriptive study based on secondary data on thepopulation coverage of oral health teams and indicators of primary health care in oral health - coverage of first dental programmatic consultation, coverage of collective dental brushing action, averagebasic individual dental procedures and the proportion of exodontia inrelation to individual basic dental actions. RESULTS: There was an increase in the population coverage of oral health teams, mainly in Modality I. Despite the significant advances in primary health care in the state of Goiás between 2001 and 2013, the indicators reveal weaknesses in access and use of services, and the iniquities inthe access and use of services between the municipalities of the state of Goiás, as well as the predominantly curative and mutilating nature ofthe traditional model of dental care. CONCLUSIONS: It is necessary to develop strategies so that the expansion of the population coverage of oral health teams is accompanied by theincreasing supply and use of services, with a gradual reduction of the mutilation procedures and the consolidation of an integral, resolutive and equitable assistance.

Occupational risk assessment of paint industry workers.

BACKGROUND: Thousands of chemical compounds are used in paint products, like pigments, extenders, binders, additives, and solvents (toluene, xylene, ketones, alcohols, esters, and glycol ethers). Paint manufacture workers are potentially exposed to the chemicals present in paint products although the patterns and levels of exposure to individual agents may differ from those of painters. The aim of the present study was to evaluate genome damage induced in peripheral blood lymphocytes and oral mucosa cells of paint industry workers. MATERIALS AND METHODS: Genotoxicity was evaluated using the alkaline Comet assay in blood lymphocytes and oral mucosa cells, and the Micronucleus test in oral mucosa cells. For the micronucleus test in exfoliated buccal cells, no significant difference was detected between the control and paint industry workers. RESULTS: The Comet assay in epithelia buccal cells showed that the damage index (DI) and damage frequency (DF) observed in the exposed group were significantly higher relative to the control group (P≤0.05). In the same way, the Comet assay data in peripheral blood leukocytes showed that both analysis parameters (DI and DF) were significantly greater than that for the control group (P≤0.05). CONCLUSIONS: Chronic occupational exposure to paints may lead to a slightly increased risk of genetic damage among paint industry workers.

Genotoxic evaluation of Mikania laevigata extract on DNA damage caused by acute coal dust exposure.

In the present article, we report data on the possible antigenotoxic activity of Mikania laevigata extract (MLE) after acute intratracheal instillation of coal dust using the comet assay in peripheral blood, bone marrow, and liver cells and the micronucleus test in peripheral blood of Wistar rats. The animals were pretreated for 2 weeks with saline solution (groups 1 and 2) or MLE (100 mg/kg) (groups 3 and 4). On day 15, the animals were anesthetized with ketamine (80 mg/kg) and xylazine (20 mg/kg), and gross mineral coal dust (3 mg/0.3 mL saline) (groups 2 and 4) or saline solution (0.3 mL) (groups 1 and 3) was administered directly in the lung by intratracheal administration. Fifteen days after coal dust or saline instillation, the animals were sacrificed, and the femur, liver, and peripheral blood were removed. The results showed a general increase in the DNA damage values at 8 hours for all treatment groups, probably related to surgical procedures that had stressed the animals. Also, liver cells from rats treated with coal dust, pretreated or not with MLE, showed statistically higher comet assay values compared to the control group at 14 days after exposure. These results could be expected because the liver metabolizes a variety of organic compounds to more polar by-products. On the other hand, the micronucleus assay results did not show significant differences among groups. Therefore, our data do not support the antimutagenic activity of M. laevigata as a modulator of DNA damage after acute coal dust instillation.

DNA damage after acute and chronic treatment with malathion in rats.

Malathion is an insecticide widely used in agriculture and in public health programs that when used indiscriminately in large amounts can cause environmental pollution and risk to human health. However, it is possible that during the metabolism of malathion, reactive oxygen species can be generated, and malathion may produce oxidative stress in intoxicated rats that can be responsible for alterations in DNA molecules related in some studies. As a result, the present study aimed to investigate the DNA damage of cerebral tissue and peripheral blood in rats after acute and chronic malathion exposure. We used single cell gel electrophoresis (Comet assay) to measure early damage in hippocampus and peripheral blood and the Micronucleus test in total erythrocytes samples. Malathion was administered intraperitoneally once a day for one day (acute) or for 28 days (chronic) protocols (in both protocols, malathion was administered at 25, 50, 100, and 150 mg/kg). Our results showed that malathion (100 and 150 mg/kg) increased the DNA damage index in the peripheral blood and in the hippocampus after both chronic and acute treatment. Malathion increased the frequency of micronuclei only in chronic treatment at 150 mg/kg dose, and induced a cytotoxic dose-dependent decrease in the frequency of polychromatic erythrocytes in the peripheral blood of rats. In conclusion, since malathion increased both the peripheral blood and hippocampus DNA damage index using the Comet assay and increased the frequency of micronuclei in the total peripheral blood, it can be regarded as a potential mutagen/carcinogenic agent.

Educação em serviço para eficácia da limpeza de instrumentais de videocirurgia: implantação e avaliação de protocolo / In-service education to the effectiveness of cleaning tools for videosurgery: implementation and evaluation protocol

Estudo que teve como objetivo analisar um protocolo de educação em serviço para Limpeza de instrumentais de videocirurgia, por meio de um indicador de resíduos de proteínas. trata-se de uma pesquisa-ação, do tipo relato de experiência, realizada no Centro de Material e esterilização de um hospital privado de Fortaleza, Ceará, com análise de 100 amostras, divididas em dois grupos, antes e após intervenção educativa, coletadas de forma aleatória em março e abril de 2010...

Concentraçäo de flúor na água: cárie, fluorose e teor de flúor urinário em escolares de Bauru - SP / Fluorine concentration in drinking water: dental caries, fluorosis and urinary fluoride levels in schoolchildren from Bauru - SP

O objetivo deste estudo foi realizar um monitoramento externo da concentraçäo de flúor das águas de abastecimento público da cidade de Bauru - SP, para valiar seu sistema de fluoretaçäo. Durante seis meses, de fevereiro a julho de 1997, 330 amostras de água foram coletadas e analisadas. Entäo, foi possível identificar as áreas da cidade fluoretadas e as näo-fluoretadas. Numa segunda etapa, 115 escolares de 9 a 12 anos de idade foram selecionados para um estudo comparativo entre essas áreas, quanto à prevalência de cárie dentária e de fluorose dental. Também foi verificado o teor de flúor presente na urina desses escolares, o qual foi confrontado com a concentraçäo de flúor da água de consumo

Avaliaçäo do desajuste de elementos fundidos em funçäo de diferentes técnicas de moldagem / Assessment of the castings fitness after different impression techniques

O objetivo deste estudo foi o de avaliar o comportamento de moldes obtidos de diferentes técnicas de moldagem (por reembasamento sem e com alívio de lâmina plástica, e impressäo única simultânea), utilizando siliconas por adiçäo (SA), Express-3M e por condensaçäo (SC), 3M. Foi utilizado, como padräo, um troquel metálico simulando um preparo para coroa métalica. A partir deste foram obtidos, após a realizaçäo das diferentes técnicas de moldagem, troquéis de gesso (Durone-Dentsply). Nestes, foram feitos enceramentos de coroas com abertura oclusal e, em seguida, fundidos em liga de Cu-Al. No grupocontrole as fundiçöes foram obtidas diretamente do troquel padräo. O desajuste foi medido em funçäo dasdiscrepâncias das fundiçöes no troquel padräo, por meio de um microscópio de profundidade. Os resultados obtidos em m foram: Controle (fundiçäo obtida sem processo de moldagem)- 327,6; SC reembasamento sem alívio- 1734,1; SC reembasamento com alívio- 883,8; SC impressäo única- 598,6; SA reembasamento sem alívio- 571,6; SA reembasamento com alívio- 620,7; SA impressäo única- 648,6. Estas médias foram submetidas aos testes ANOVA e Tukey (p < 0,05). A técnica de impressäo única ou simultânea com silicona de reaçäo por condensaçäo promoveu resultados similares às técnicas com silicona por adiçäo. O processo de fundiçäo exerceu uma influência significativa na adaptaçäo das restauraçöes, sendo que a silicona por adiçäo sofreu menor influência face ao tipo de técnica de moldagem