In Vitro Evaluation of Antioxidant and Anticancer Activity of Lemongrass (Cymbopogon citratus (D.C.) Stapf).

Cancer is considered a multifactorial disease and its development could be associated with several factors, for example, rotenone exposition. Unfortunately, many cancers are resistant to chemotherapy, as cervical cancer. Regarding this, lemongrass is a remarkable natural product that presents antioxidant and anticancer activities, which could show therapeutic action against rotenone and cervical cancer. Thus, this study aimed to investigate the antioxidant and anticancer action of lemongrass. An in vitro study was conducted using VERO (kidney cells) and SiHa cell lines (cervical cancer cells). VERO cells were exposed to rotenone and lemongrass extract for 24 and 72 h. While SiHa cells were exposed to lemongrass isolated and associated to chemotherapy, 5-fluorouracil, during 24 and 48 h. After, levels of viability, proliferation, and oxidative metabolism were determined. The results showed that lemongrass presents antioxidant activity on VERO cells by increasing cell viability and proliferation and decreasing oxidative stress caused by rotenone. Moreover, lemongrass showed anticancer activity by decreasing cell viability and increasing oxidative stress parameters on SiHa. Besides, lemongrass had no alteration in the chemotherapy activity. Therefore, this study revealed that lemongrass presents antioxidant and anticancer activity since it can protect against the cytotoxicity of rotenone and reduce the cell viability of cervical cancer.

Intense orthodontic force induces the three dental pulp nitric oxide synthase isoforms and leads to orofacial discomfort in rats.

OBJECTIVE: The objective of this study was to evaluate the role of nitric oxide synthase (NOS) isoforms influence during tooth movement with different forces. SETTINGS AND SAMPLE POPULATION: 100 male Wistar rats (n = 10/group) were divided into a Sham group (animals not submitted to device installation nor Induced Toot Movement [ITM]), Negative Control Group (NCG) (animals submitted to device installation but not to ITM) and three experimental groups (F1, F2 and F3) (submitted to ITM with forces of 25, 50 and 100 gF respectively). MATERIALS AND METHODS: A daily count of biting and scratching on the vibrissae and the Grimace scale were applied. After 4 (D4) and 11 (D11) days, the molar diastema was measured, and the animals were euthanized for histological (vascular parameters) and immunohistochemistry (iNOS, eNOS and nNOS) in the dental pulp. RESULTS: On D4, there was significant movement in the F3 group (P = .001) and on D11 in F1, F2 and F3 (P < .001). The number of bites (P < .001) and scratching (P = .006) was higher in F2-F3, and F3 had higher Grimace scores (P < .001) and weight loss (P < .001). At D4, there was an increase in pulp ectasia in F2-F3 (P = .021) and a reduction in the number of vessels in F3 (P = .005). In D4 and D11, there was a significant increase in immunostaining for iNOS and eNOS in F1 (P = .025 and P < .001 respectively) and F2 (P = .007 and P < .001 respectively). At D4, F2 and F3 showed higher immunostaining for nNOS (P = .027). CONCLUSION: Thus, IDM induced inflammatory changes in the dental pulp reflecting in force-dependent pain/suffering signs.

Antioxidant and cytoprotective effects of avocado oil and extract (Persea americana Mill) against rotenone using monkey kidney epithelial cells (Vero).

Oxidative stress is known to be involved in development of numerous diseases including cardiovascular, respiratory, renal, kidney and cancer. Thus, investigations that mimic oxidative stress in vitro may play an important role to find new strategies to control oxidative stress and subsequent consequences are important. Rotenone, widely used as a pesticide has been used as a model to simulate oxidative stress. However, this chemical was found to produce several diseases. Therefore, the aim of this study was to investigate the antioxidant and cytoprotective effect of avocado (Persea americana Mill) extract and oil in monkey kidney epithelial cells (VERO) exposed to rotenone. VERO cells were exposed to IC50 of rotenone in conjunction with different concentrations of avocado extract and oil (ranging from 1 to 1000 µg/ml), for 24 hr. Subsequently, cell viability and oxidative metabolism were assessed. Data demonstrated that avocado extract and oil in the presence of rotenone increased cellular viability at all tested concentrations compared to cells exposed only to rotenone. In addition, extract and avocado oil exhibited antioxidant action as evidenced by decreased levels of reactive oxygen species (ROS), superoxide ion, and lipid peroxidation, generated by rotenone. Further, avocado extract and oil appeared to be safe, since these compounds did not affect cell viability and or generate oxidative stress. Therefore, avocado appears to display a promising antioxidant potential by decreasing oxidative stress.

Tumor necrosis factor alpha mediates orofacial discomfort in an occlusal dental interference model in rats: The role of trigeminal ganglion inflammation.

BACKGROUND: Tumor necrosis factor alpha (TNF-α) is a proinflammatory cytokine that plays an important role in the early stages of inflammation. In this study, we investigated its role in orofacial discomfort in rats subjected to occlusal dental interference (ODI). METHODS: Female Wistar rats (180-200 g) were divided in three groups (n = 30/group): sham group, without ODI, and two experimental groups with ODI pre-treated with 0.1 mL/kg saline (ODI + SAL) or 5 mg/kg infliximab (ODI + INF) and treated every 3 days. The animals were euthanized after 1, 3, and 7 days. The number of bites and scratches and grimace scale scores were determined daily, and the bilateral trigeminal ganglion was histomorphometrically (neuronal body area) analyzed and submitted for immunohistochemistry for TNF-α, nitric oxide synthesis (NOS) neuronal (nNOS) and inducible (iNOS), peroxisome proliferator-activated receptors (PPAR) y (PPARy) and δ/ß (PPARδ/ß), and glial fibrillary acidic protein (GFAP). One-way/two-way ANOVA/Bonferroni tests were used (P < .05, GraphPad Prism 5.0). RESULTS: ODI + SAL showed a large number of bites (P = .002), scratches (P = .002), and grimace scores (P < .001) in the firsts days, and ODI + INF partially reduced these parameters. The contralateral and ipsilateral neuronal body area was significantly reduced on day 1 in ODI + SAL, but returned to the basal size on days 3 and 7, by increase in TNF-α, nNOS, PPARy, PPARδ/ß, and GFAP immunostaining. The infliximab treatment attenuated these alterations (P < .05). There was no iNOS immunostaining. CONCLUSION: Occlusal dental interference induced transitory orofacial discomfort by trigeminal inflammatory mediator overexpression, and TNF-α blockage attenuated these processes.

Optimal quarantine strategies for the COVID-19 pandemic in a population with a discrete age structure.

The goal of this work is to study the optimal controls for the COVID-19 epidemic in Brazil. We consider an age-structured SEIRQ model with quarantine compartment, where the controls are the quarantine entrance parameters. We then compare the optimal controls for different quarantine lengths and distributions of the total control cost by assessing their respective reductions in deaths in comparison to the same period without quarantine. The best strategy provides a calendar of when to relax the isolation measures for each age group. Finally, we analyse how a delay in the beginning of the quarantine affects this calendar by changing the initial conditions.

Unexpected soft tissue changes in response to root coverage using an acellular dermal matrix allograft: 12­year follow up.

A woman undergoing orthodontic treatment presented with recession and reduced keratinized gingiva on teeth 31 and 41. The patient declined creation of a donor site for conventional autogenous connective soft tissue grafting and opted for an acellular dermal matrix soft tissue substitute for root coverage. Orthodontic treatment followed, and the patient returned for orthognatic surgery after 12 years. Long-term follow up revealed that root coverage remained stable over time and creeping attachment on both teeth was observed. Unexpectedly, an increase in the width of keratinized gingiva was observed. No adverse effects of orthodontic treatment carried out after grafting were observed.

The impact of an enhanced health surveillance system for COVID-19 management in Serrana, Brazil.

Objective: To describe the successful implementation of an enhanced public health surveillance system based on early detection, tracing contacts, and patient follow-up and support. Study design: A prospective observational cohort study conducted in Serrana, São Paulo State, Brazil. Methods: The implementation was based on four axes: increasing the access to SARS-CoV-2 testing; correct swab collection; testing patients with mild symptoms; and patient follow-up. Positivity rate, patient demographic and clinical characteristics, dynamics of disease severity, SARS-CoV-2 genome evolution, and the impact on COVID-19 research were assessed from August 23, 2020 to February 6, 2021 (between epidemiological week 35/2020 and 5/2021, a total of 24 weeks). Results: The number of sites collecting rt-PCR for SARS-CoV-2 was increased from one to seven points and staff was trained in the correct use of personal protective equipment and in the swab collection technique. During the study period, 6728 samples were collected from 6155 participants vs. 2770 collections in a similar period before. SARS-CoV-2 RNA was detected in 1758 (26.1%) swabs vs. 1117 (36.7%) before the implementation of the surveillance system (p < 0.001). Positivity rates varied widely between epidemiological weeks 35/2020 and 5/2021 (IQR, 12.8%-31.3%). Out of COVID-19 patients, 91.1% were adults at a median age of 35 years (IQR, 25-50 years), 42.6% were men and 57.4% were women, with a SARS-CoV-2 positivity rate of 28.6% and 24.4% (p < 0.001), respectively. The most common symptoms were headache (72.6%), myalgia (65.0%), and cough (61.7%). Comorbidities were found in 20.8% of patients, the most common being hypertension and diabetes. According to the World Health Organization clinical progression scale, 93.5% of patients had mild disease, 1.6% were hospitalized with moderate disease, 3.2% were hospitalized with severe disease, and 1.4% died. The enhanced surveillance system led to the development of COVID-19 related research. Conclusions: The enhanced surveillance system in Serrana improved COVID-19 understanding and management. By integrating community and academic institutions, it was possible to monitor SARS-CoV-2 positive cases and variants, follow the epidemic trend, guide patients, and develop relevant research projects.

Extracellular Vesicles from Bothrops jararaca Venom Are Diverse in Structure and Protein Composition and Interact with Mammalian Cells.

Snake venoms are complex cocktails of non-toxic and toxic molecules that work synergistically for the envenoming outcome. Alongside the immediate consequences, chronic manifestations and long-term sequelae can occur. Recently, extracellular vesicles (EVs) were found in snake venom. EVs mediate cellular communication through long distances, delivering proteins and nucleic acids that modulate the recipient cell's function. However, the biological roles of snake venom EVs, including possible cross-organism communication, are still unknown. This knowledge may expand the understanding of envenoming mechanisms. In the present study, we isolated and characterized the EVs from Bothrops jararaca venom (Bj-EVs), giving insights into their biological roles. Fresh venom was submitted to differential centrifugation, resulting in two EV populations with typical morphology and size range. Several conserved EV markers and a subset of venom related EV markers, represented mainly by processing enzymes, were identified by proteomic analysis. The most abundant protein family observed in Bj-EVs was 5'-nucleotidase, known to be immunosuppressive and a low abundant and ubiquitous toxin in snake venoms. Additionally, we demonstrated that mammalian cells efficiently internalize Bj-EVs. The commercial antibothropic antivenom partially recognizes Bj-EVs and inhibits cellular EV uptake. Based on the proteomic results and the in vitro interaction assays using macrophages and muscle cells, we propose that Bj-EVs may be involved not only in venom production and processing but also in host immune modulation and long-term effects of envenoming.

Distance education in dentistry in Brazil: a critical STROBE-based analysis.

The COVID-19 pandemic has forced dentistry schools (DSs) to adapt their teaching techniques to digital platforms. Therefore, we aimed to evaluate distance classes in the Brazilian DS curriculum. After an online search of higher education institutions (HEIs) with DS on the e-Ministry of Education (MEC) platform, we included institutions with at least one graduated class to extract the age/localization of the DS, funding, number of authorized seats, MEC-grade, ENADE-score, and workload. HEIs' webpages were consulted to identify the curriculum, subjects offered in the distance education (DE) format, extracurricular programs, scientific events, postgraduate programs, and institutional YouTube channels. Chi-square/Fisher's tests plus binary logistic regression were performed (SPSS 20.0, p < 0.05). Of the 241 DSs evaluated, 82 (34.0%) offered distance classes, and a high prevalence was observed in the southeast region (p <0.001) and private HEIs (p = 0.001). HEIs with distance classes had lower ENADE scores (p = 0.004), lower workload (p = 0.007), and higher workload for optional subjects (p = 0.016), doctoral programs (p = 0.041), specialization courses (p = 0.017), and institutional YouTube channels (p < 0.001). Southern dental schools (p < 0.001), lower workload (p = 0.022), optional subjects (p = 0.033), and institutional YouTube channels (p = 0.005) were independently associated with distance classes. In one-third of the Brazilian DSs, distance classes and institutional YouTube channels were strongly associated variables. The association of distance learning with lower workload and low academic performance draws attention to the need for regulatory bodies for controlling the quality of DE.

Proton Pump Inhibitors and Oncologic Treatment Efficacy: A Practical Review of the Literature for Oncologists.

Proton pump inhibitors (PPIs) are the most commonly used anti-acid drugs worldwide, including among cancer patients. However, drug-drug interactions between PPIs and other agents may lead to decreased drug absorption with possible reduced therapeutic benefit, or even increased toxicity. Unfortunately, only scarce data exist regarding the safety of concomitant PPI use with anti-cancer agents. We aim at reviewing current evidence on this possible interaction by dividing anti-cancer agents by class. Until further data is available, we encourage healthcare providers to limit unnecessary PPI overuse.

Lemongrass (Cymbopogon citratus (D.C.) Stapf) Presents Antitumoral Effect and Improves Chemotherapy Activity in Prostate Cancer Cells.

BACKGROUND: Prostate cancer is the most common visceral neoplasia in men and frequently presents chemotherapy resistance. In this context, lemongrass (Cymbopogon citratus (D.C.) Stapf) has been studied since it presents many important biological activities, such as anticancer. OBJECTIVE: We investigated the antitumor effect of lemongrass and in chemotherapy activity using prostate cancer cells line (DU-145). METHODS: DU-145 cells were exposed to different concentrations of aqueous extract of lemongrass (30; 100; 300; 500 and 1000 µg/mL), isolated and in combination with docetaxel, during 24 and 72 hours. After, cell viability and proliferation, oxidative metabolism, colony formation and cell cycle analyses were performed. Also, we exposed the African green monkey kidney cell line (VERO) to the same lemongrass concentrations to investigate a possible toxicity of this extract. RESULTS: Our findings suggested that lemongrass presented an antitumor effect and improved docetaxel chemotherapy activity by decreasing cell viability and proliferation as well as colony formation. Moreover, we found an oxidative stress increased and cell cycle arresting in G0 /G1 phase. In addition, this extract presented selectivity action for cancer cells, since it did not cause cytotoxicity in normal cells, ensuring non-toxic therapeutic concentrations. CONCLUSION: Lemongrass is a promising medicinal plant that could be used during chemotherapeutic treatment, in order to potentiate the antitumor response and decrease the resistance of prostate cancer.

Antibiotics, cancer risk and oncologic treatment efficacy: a practical review of the literature.

Antibiotics have been extensively used to treat infectious diseases over the past century and have largely contributed to increased life expectancy over time. However, antibiotic use can impose profound and protracted changes to the diversity of the microbial ecosystem, affecting the composition of up to 30% of the bacterial species in the gut microbiome. By modifying human microbiota composition, antibiotics alter the action of several oncologic drugs, potentially leading to decreased efficacy and increased toxicities. Whether antibiotics interfere with cancer therapies or even increase the risk of cancer development has been under investigation, and no randomised trials have been conducted so far. The aim of the current review is to describe the possible effects of antibiotic therapies on different oncologic treatments, especially immunotherapies, and to explore the link between previous antibiotics use and the development of cancer.

Gastos do próprio bolso de usuários em hemodiálise no sul do Rio Grande do Sul / Gastos de bolsillo de usuarios de hemodiálisis en el sur de Rio Grande do Sul / Out-of-pocket expenses of hemodialysis users in the south of Rio Grande do Sul

Objetivo: relatar os gastos do próprio bolso das pessoas com doença renal crônica em hemodiálise em seis serviços de terapia de substituição renal da metade sul do Rio Grande do Sul, Brasil. Método: estudo descritivo quantitativo, originado de uma macropesquisa, realizado com usuários em hemodiálise, atendidos em seis serviços de terapia renal substitutiva da metade sul do Rio Grande do Sul. As variáveis coletadas do questionário estruturado tiverama finalidade de identificar os gastos do próprio bolso dos usuários. Os dados foram analisados utilizando os softwares Epidata e Stata. Resultados: a maioria dos 336 usuários era sexo masculino, entre 60 e79 anos, com salários-mínimos entre um e dois. Os maiores gastos do próprio bolso encontrados foram o pagamento pelos medicamentos necessários para o tratamento. Conclusões: mesmo com benefícios do sistema de saúde e políticas necessitavam recorrer aos próprios recursos para garantir saúde e uma vida digna.

Objective: to report the out-of-pocket expenses of people with chronic kidney disease undergoing hemodialysis in six renal replacement therapy services in the southern half of Rio Grande do Sul, Brazil. Method: quantitative descriptive studycarried out with hemodialysis users, served in six replacement renal therapy services from the southern half of Rio Grande do Sul. The variables collected from the structured questionnaire had the purpose of identifying the spending of users' own pockets. The data were analyzed using Epidata and Stata software.Results: the majority of the 336 users were male, between 60 and 79 years old, with minimum wages between one and two. The biggest out-of-pocket expenses found were paying for the medicines needed for treatment. Conclusions: even with benefits from the health system and policies, they needed to resort to their own resources to guarantee health and a dignified life.

Objetivo: reportar gastos de bolsillo de personas con enfermedad renal crónica en tratamiento de hemodiálisis en seis servicios de terapia de reemplazo renal en la mitad sur de Rio Grande do Sul, Brasil. Método: estudio descriptivo cuantitativo, originado a partir de una macroinvestigación, realizada con usuarios de hemodiálisis, atendidos en seis servicios de terapia renal de reemplazo. Las variables recolectadas del cuestionario estructurado tenían el propósito de identificarel gasto de los usuarios. Los datos se analizaron utilizando el software Epidata y Stata. Resultados: la mayoría de los 336 usuarios eran hombres, entre 60 y 79 años, con salarios mínimos entre uno y dos. Los mayores gastos de bolsillo encontrados fueron el pago de los medicamentos necesarios para el tratamiento. Conclusiones: incluso con beneficios del sistema y las políticas de salud, necesitaban recurrir a recursos propios para garantizar la salud y una vida digna.

The roles of PTEN, cMET, and p16 in resistance to cetuximab in head and neck squamous cell carcinoma.

There is no established biomarker for cetuximab efficacy in recurrent head and neck squamous cell carcinoma (HNSCC). The aim of the present study was to evaluate the prognostic and predictive impact of PTEN, cMET, and p16 expression in recurrent HNSCC. In this retrospective study, 112 patients with recurrent HNSCC received chemotherapy (CT) alone (n = 37) or chemotherapy with cetuximab (n = 75). PTEN, cMET, and p16 protein expression were evaluated by immunohistochemistry. The median overall survival (mOS) for the patients treated with cetuximab + CT versus CT alone was 11.4 months and 7.0 months, (p = 0.949). The median progression-free survival (mPFS) was 6.2 months versus 3.0 months (p = 0.154). Patients with PTEN loss exhibited a mOS of 5.8 months versus 10.5 months (p = 0.002) and a mPFS of 3.2 months versus 4.7 months (p = 0.019). A multivariate analysis identified an independent association between PTEN loss and OS (HR 2.27; 95% confidence 95% CI 1.27-4.08; p = 0.006) and with PFS (HR 1.85; 95% CI 1.09-2.99; p = 0.022). A negative prognostic impact of PTEN loss was observed in the patients treated with cetuximab + CT, and not in the CT only group. Expression of cMET and p16 showed no impact on OS or PFS. The present findings confirm that PTEN is a prognostic factor for metastatic HNSCC and they support further studies of PTEN expression to evaluate its predictive value to cetuximab response.

Differences between renal effects of venom from two Bothrops jararaca populations from southeastern and southern Brazil.

Components from animal venoms may vary according to the snake's age, gender and region of origin. Recently, we performed a proteomic analysis of Bothrops jararaca venom from southern (BjSv) and southeastern (BjSEv) Brazil, showing differences in the venom composition, as well as its biological activity. To continue the study, we report in this short communication the different effects induced by the BjSEv and BjSv on isolated kidney and MDCK renal cells. BjSEv decreased perfusion pressure (PP) and renal vascular resistance (RVR) and increased urinary flow (UF) and glomerular filtration rate (GFR), while BjSv did not alter PP and RVR and reduced UF and GFR. Both types of venom, more expressively BjSEv, reduced %TNa+, %TK+ and %Cl-. In MDCK cells, the two types of venom showed cytotoxicity with IC50 of 1.22 µg/mL for BjSv and 1.18 µg/mL for BjSEv and caused different profiles of cell death, with BjSv being more necrotic. In conclusion, we suggest that BjSv is more nephrotoxic than BjSEv.

Climatério e Terapia de Reposição Hormonal por mulheres em um município do Sul de Santa Catarina / Climacteric and Hormone Replacement Therapy for women in a city in southern Santa Catarina

RESUMO Introdução: O climatério corresponde ao período de transição entre a etapa reprodutiva e a não reprodutiva, onde há a menopausa caracterizada pela ausência de menstruação por 12 meses consecutivos, resultante da perda da atividade folicular ovariana. A Terapia de Reposição Hormonal (TRH) pode ser uma opção de tratamento com o intuito de melhorar as condições de saúde da mulher. O objetivo, deste estudo, foi investigar o perfil de idosas e sintomas climatéricos, além da utilização da TRH por mulheres em uma cidade do Sul de Santa Catarina. Métodos: Estudo epidemiológico com delineamento transversal quantitativo utilizando-se questionário para coleta de dados que ocorreu entre julho a setembro de 2017 e analisados no EpiInfo®. Resultados: Foram entrevistadas 107 idosas, média de idade 69,7 (± 8,9) anos. Das entrevistadas, 52,3% relataram algum sintoma climatérico, sendo mais frequente o fogacho. Pequena parcela das entrevistadas fez uso de TRH (15,9%), obtendo-se benefícios com a utilização. Destas, maioria foi administração via oral (88,2%), sendo que 35,3% usaram por mais de cinco anos, 82,4% relataram alguma reação adversa, sendo citada a mastalgia e o ganho de peso, e 64,7% realizavam consulta médica semestral. Somente 8,4% fizeram uso de chás, sendo a Amora Branca (Morus alba L) a mais citada. Conclusões: O esquema de TRH prescrito mais frequente foi a associação de estrógenos e progestógenos para administração por via oral, com acompanhamento médico semestral e obtendo-se resultados favoráveis. Medidas não farmacológicas foram adotadas por minoria das mulheres, adotando-se essencialmente o uso de planta medicinal na forma de chá. PALAVRA-CHAVE: Climatério, menopausa, terapia de reposição hormonal, saúde da mulher

ABSTRACT Introduction: The climacteric corresponds to the transition period between the reproductive and non-reproductive stages, where there is the menopause, characterized by the absence of menstruation for 12 consecutive months, resulting from the loss of ovarian follicular activity. Hormone Replacement Therapy (HRT) can be a treatment option with the aim of improving women's health conditions. The aim of this study was to investigate the profile of elderly women and climacteric symptoms, as well as the use of HRT by women in a city in southern Santa Catarina. Methods: Epidemiological study with a quantitative cross-sectional design using a questionnaire for data collection that was answered between July and September 2017 and analyzed in EpiInfo®. Results: 107 elderly women were interviewed, mean age 69.7 (± 8.9) years. Of the interviewees, 52.3% reported some climacteric symptom, with hot flashes being more frequent. A small portion of the interviewees used HRT (15.9%), obtaining benefits from its use. Of these, most were administered orally (88.2%), and 35.3% used it for more than five years, 82.4% reported some adverse reaction, mentioning breast tenderness and weight gain, and 64.7% had medical consultations every six months. Only 8.4% made use of teas, with the white blackberry (Morus alba L) being the most mentioned. Conclusions: The most frequent prescribed HRT regimen was the combination of estrogens and progestins for oral administration, with medical follow-up every six months and obtaining favorable results. Non-pharmacological measures were adopted by a minority of women, essentially adopting the use of medicinal plants in the form of tea. KEYWORDS: Climacteric, menopause, hormone replacement therapy, women's health

Ostomía intestinal: dificultades y estrategias de cuidado tras el alta hospitalaria / Estomia intestinal: adversidades e estratégias de cuidado após alta hospitalar / Intestinal ostomy: Adversities and care strategies after hospital discharge

Objective: To describe the difficulties and advantages encountered by people after undergoing an intestinal ostomy and being discharged from hospital services. Materials and methods:Qualitative, descriptive, and exploratory study conducted at a teaching hospital. The study included people with an intestinal ostomy who were discharged within 60 days from the beginning of data collection, which occurred from March and June 2018. Data collection involved a semi-structured interview and thematic content analysis, resulting in thematic categories. Results: A total of 11 people partic-ipated in the study. Factors such as the delay in defining the diagnosis, difficulties in the continuity of care at home, misinformation, and fear were identified as adversities by participants. Care actions were related to the existence of a support network and hope for the reconstruction of intestinal transit. Conclusions:The care of people with intestinal ostomy requires planning hospital discharge, health education, strengthening care strategies that involve social support, and the involvement of health professionals for the continuity of health care at home.

Objetivo: describir las dificulta-des y ventajas en el cuidado identificadas por personas con ostomía intestinal tras el alta hospitalaria. Materiales y métodos: estudio cualitativo, descriptivo y exploratorio desarrollado en un hospital universitario. La muestra estuvo compuesta por personas con ostomía intestinal que fueron dadas de alta hasta 60 días antes del inicio de la recolección de datos, lo cual ocurrió entre marzo y junio de 2018. La recolección de datos se realizó por medio de una entrevista semiestructurada y análisis de contenido, lo que dio lugar a la formulación de categorías temáticas. Resultados: el estudio contó con la participación de 11 personas, quienes identificaron a modo de dificultades aspectos como un diagnóstico tardío, limitaciones para dar continuidad a los cuidados en casa, desinformación y miedo. Las estrategias de cuidados se relacionaron con la existencia de redes de apoyo y la esperanza de recuperar el tránsito intestinal. Conclusiones: el cuidado de personas con ostomía intestinal requiere planeación para el alta hospitalaria, educación en salud, fortalecimiento de las estrategias de cuidado que involucran redes de apoyo social y la activa participación de los profesionales de salud, con lo cual será posible dar continuidad a las prácticas de cuidado desde casa.

Objetivo: descrever as adversidades vivenciadas e as estratégias de cuidado identificadas por pessoas com estomia intestinal após alta hospitalar. Materiais e métodos:estudo qualitativo, descritivo-exploratório, realizado em um hospital de ensino. Foram incluídas pessoas com estomia intestinal, que tiveram alta hospitalar em um período de até 60 dias a partir do início da coleta dos dados, que ocorreu de março a junho de 2018. Foi utilizada entrevista semies-truturada e a análise foi de conteúdo, resultando em categorias temáticas.Resultados:o estudo contou com a participação de 11 pessoas, que identificaram como adversidades a demora na definição do diagnóstico, as dificuldades na continuidade dos cuidados no domicílio, a desinformação e o medo. As estratégias de cuidado se relacionaram à existência de rede de apoio e da esperança pela reconstrução do trânsito intestinal. Conclusões: o cuidado às pessoas com estomia intestinal requer o planejamento para alta hospitalar, educação em saúde, fortalecimento de estratégias de cuidado que envolvem suporte social e envolvimento dos profissionais de saúde para continuar o cuidado no domicílio.

Distance education in dentistry in Brazil: a critical STROBE-based analysis

Abstract The COVID-19 pandemic has forced dentistry schools (DSs) to adapt their teaching techniques to digital platforms. Therefore, we aimed to evaluate distance classes in the Brazilian DS curriculum. After an online search of higher education institutions (HEIs) with DS on the e-Ministry of Education (MEC) platform, we included institutions with at least one graduated class to extract the age/localization of the DS, funding, number of authorized seats, MEC-grade, ENADE-score, and workload. HEIs' webpages were consulted to identify the curriculum, subjects offered in the distance education (DE) format, extracurricular programs, scientific events, postgraduate programs, and institutional YouTube channels. Chi-square/Fisher's tests plus binary logistic regression were performed (SPSS 20.0, p < 0.05). Of the 241 DSs evaluated, 82 (34.0%) offered distance classes, and a high prevalence was observed in the southeast region (p <0.001) and private HEIs (p = 0.001). HEIs with distance classes had lower ENADE scores (p = 0.004), lower workload (p = 0.007), and higher workload for optional subjects (p = 0.016), doctoral programs (p = 0.041), specialization courses (p = 0.017), and institutional YouTube channels (p < 0.001). Southern dental schools (p < 0.001), lower workload (p = 0.022), optional subjects (p = 0.033), and institutional YouTube channels (p = 0.005) were independently associated with distance classes. In one-third of the Brazilian DSs, distance classes and institutional YouTube channels were strongly associated variables. The association of distance learning with lower workload and low academic performance draws attention to the need for regulatory bodies for controlling the quality of DE.

Evaluation of antimicrobial, cytotoxic, and hemolytic activities from venom of the spider Lasiodora sp.

This study characterized the protein/peptide profile of venom isolated from the spider Lasiodora sp. (Mygalomorphae, Theraphosidae) found in northeastern Brazil and determined its antimicrobial activity, toxicity against human cells, and hemolytic activity. Protein concentration of the Lasiodora sp. venom was 4.53 ± 0.38 mg/mL. SDS-PAGE showed proteins with molecular masses up to 75 kDa, some of which contained disulfide bridges. RP-HPLC analysis separate at least 12 peaks that were identified by mass spectrometry as peptides U1-theraphotoxin-Lp1a (lasiotoxin-1), U1-theraphotoxin-Lp1c (lasiotoxin-3), U3-theraphotoxin-Lsp1a (LTx5), and ω-theraphotoxin-Asp3a as well as the proteins phospholipase A2 (PLA2) and hyaluronidase. The crude venom exhibited bactericidal effect against Aeromonas sp., Bacillus subtilis, and Micrococcus luteus and fungicidal effect against Candida parapsilosis and Candida albicans. In addition, the venom exerted bacteriostatic effect against Klebsiella pneumoniae, Pseudomonas aeruginosa, and Staphylococcus aureus and fungistatic effect against Candida tropicalis and Candida krusei. The minimum inhibitory (MIC), minimum bactericidal (MBC), and minimum fungicidal (MFC) concentrations ranged from 3.9 to 500 µg/mL. The Lasiodora sp. venom decreased the viability of human peripheral blood mononuclear cells (PBMCs) by 50%-90% at concentrations of 0.1, 1, 10, and 100 µg/mL, promoting apoptosis of these cells. On the other hand, the venom showed weak hemolytic activity against Mus musculus erythrocytes (EC50: 757 µg/mL). In conclusion, the Lasiodora sp. spider venom is a rich source of antimicrobial agents. Future studies will focus on identifying antimicrobial agents present in this venom and evaluating whether these agents contribute to its cytotoxic effects against PBMCs.

Combined venomics, venom gland transcriptomics, bioactivities, and antivenomics of two Bothrops jararaca populations from geographic isolated regions within the Brazilian Atlantic rainforest.

Bothrops jararaca is a slender and semi-arboreal medically relevant pit viper species endemic to tropical and subtropical forests in southern Brazil, Paraguay, and northern Argentina (Misiones). Within its geographic range, it is often abundant and is an important cause of snakebite. Although no subspecies are currently recognized, geographic analyses have revealed the existence of two well-supported B. jararaca clades that diverged during the Pliocene ~3.8Mya and currently display a southeastern (SE) and a southern (S) Atlantic rainforest (Mata Atlântica) distribution. The spectrum, geographic variability, and ontogenetic changes of the venom proteomes of snakes from these two B. jararaca phylogroups were investigated applying a combined venom gland transcriptomic and venomic analysis. Comparisons of the venom proteomes and transcriptomes of B. jararaca from the SE and S geographic regions revealed notable interpopulational variability that may be due to the different levels of population-specific transcriptional regulation, including, in the case of the southern population, a marked ontogenetic venom compositional change involving the upregulation of the myotoxic PLA2 homolog, bothropstoxin-I. This population-specific marker can be used to estimate the proportion of venom from the southern population present in the B. jararaca venom pool used for the Brazilian soro antibotrópico (SAB) antivenom production. On the other hand, the southeastern population-specific D49-PLA2 molecules, BinTX-I and BinTX-II, lend support to the notion that the mainland ancestor of Bothrops insularis was originated within the same population that gave rise to the current SE B. jararaca phylogroup, and that this insular species endemic to Queimada Grande Island (Brazil) expresses a pedomorphic venom phenotype. Mirroring their compositional divergence, the two geographic B. jararaca venom pools showed distinct bioactivity profiles. However, the SAB antivenom manufactured in Vital Brazil Institute neutralized the lethal effect of both venoms to a similar extent. In addition, immobilized SAB antivenom immunocaptured most of the venom components of the venoms of both B. jararaca populations, but did not show immunoreactivity against vasoactive peptides. The Costa Rican bothropic-crotalic-lachesic (BCL) antivenom showed the same lack of reactivity against vasoactive peptides but, in addition, was less efficient immunocapturing PI- and PIII-SVMPs from the SE venom, and bothropstoxin-I, a CRISP molecule, and a D49-PLA2 from the venom of the southern B. jararaca phylogroup. The remarkable paraspecificity exhibited by the Brazilian and the Costa Rican antivenoms indicates large immunoreactive epitope conservation across the natural history of Bothrops, a genus that has its roots in the middle Miocene. This article is part of a Special Issue entitled: Omics Evolutionary Ecolog.