The APSY-SED study: protocol of an observational, longitudinal, mixed methods and multicenter study exploring the psychological adjustment of relatives and healthcare providers of patients with cancer with continuous deep sedation until death.

BACKGROUND: Since 2016, France is the only country in the World where continuous deep sedation until death (CDSUD) is regulated by law. CDSUD serves as a response to refractory suffering in palliative situations where the patients' death is expected to occur in the following hours or days. Little is known on the psychological adjustment surrounding a CDSUD procedure for healthcare providers (HCPs) and relatives. Our study aims to gather qualitative and quantitative data on the specific processes behind the psychological adjustment of both relatives and HCPs, after the administration of CDSUD for patients with cancer. METHODS: The APSY-SED study is a prospective, longitudinal, mixed-methods and multicenter study. Recruitment will involve any French-speaking adult cancer patient for who a CDSUD is discussed, their relatives and HCPs. We plan to include 150 patients, 150 relatives, and 50 HCPs. The evaluation criteria of this research are: 1/ Primary criterion: Psychological adjustment of relatives and HCPs 6 and 13 months after the death of the patient with cancer (psychological adjustment = intensity of anxiety, depression and grief reactions, CDSUD-related distress, job satisfaction, Professional Stress and Professional experience). Secondary criteria: a)occurrence of wish for a CDSUD in patients in palliative phase; b)occurrence of wish for hastened death in patients in palliative phase; c)potential predictors of adjustment assessed after the discussion concerning CDSUD as an option and before the setting of the CDSUD; d) Thematic analysis and narrative account of meaning-making process concerning the grief experience. DISCUSSION: The APSY-SED study will be the first to investigate the psychological adjustment of HCPs and relatives in the context of a CDSUD procedure implemented according to French law. Gathering data on the grief process for relatives can help understand bereavement after CDSUD, and participate in the elaboration of specific tailored interventions to support HCPs and relatives. Empirical findings on CDSUD among patients with cancer in France could be compared with existing data in other countries and with results related to other medical fields where CDSUD is also conducted. TRIAL REGISTRATION: This protocol received the National Registration Number: ID-RCB2021-A03042-39 on 14/12/2021.

Phlebotomines (Diptera: Psychodidae) and Mosquitoes (Diptera: Culicidae) Surrounding an Environmental Protection Zone in the Metropolitan Region of Natal: Use of Light-Emitting Diode (LED) Bulbs in Entomological Surveillance.

Entomological surveillance is very important for parasite and arbovirus vector control programs. Light traps with incandescent bulbs are used to attract insects and analyze the factors that contribute to the occurrence of species surrounding an environmental protection zone. Phlebotomine and mosquito abundance and their diversity were analyzed. Captures occurred monthly using six CDC light traps with two incandescent bulbs, two blue and two red LED lights. A total of 2211 phlebotomines of seven species and 4486 mosquitoes belonging to 20 taxa were captured. Different phlebotomine and mosquito species were found in the forest and peridomestic environments, with a predominance of the sand fly Evandromyia walkeri (Newstead) and the mosquito Coquillettidia venezuelensis (Theobald). There was a significant difference in the abundance of sand flies captured with the three bulbs tested, the blue bulb being the most efficient. The Shannon-Wiener diversity index showed that the trap equipped with a red LED light obtained a higher value than that of the blue LED and incandescent bulb. Analyses showed that the potential vectors and non-vectors of the two groups circulate between the forest and the peridomestic environment, suggesting an adaptation process of species to the altered environment. An incandescent light bulb can be substituted by an LED bulb, without compromising the sensitivity of the method. A blue LED is indicated for the abundant capture of mosquitoes and sand flies, while a red LED obtains a better result in terms of species diversity per capture.

Malocclusion prevention through the usage of an orthodontic pacifier compared to a conventional pacifier: a systematic review.

AIM: This was to investigate the occurrence of malocclusion traits among children who were users of orthodontic or conventional pacifier by means of a systematic review. METHODS: Search for articles involved five electronic databases: Latin American and Caribbean Health Sciences (LILACS), PsycINFO, PubMed (including MedLine), Scopus and Web of Science. Grey literature was partially assessed. Observational studies with children aged 6-60 months who had used orthodontic or conventional pacifier were included. The risk of bias among included studies was assessed through the Joanna Briggs Institute Tool. RESULTS: From the 607 initially-identified papers only three were included after the selection process. All presented moderate risk of bias. Although an anterior open bite and accentuated overjet were identified among conventional users of pacifier in one study no differences were identified in the other two selected studies. Posterior crossbite frequency was not different in any of the included studies. There was also no difference regarding frequency and duration of use, except in the study that showed higher occurrence of open bite malocclusion in conventional pacifier users. CONCLUSIONS: The currently available evidence is insufficient to support the concept that the usage of orthodontic pacifiers is able to prevent malocclusion traits when compared to the usage of conventional pacifiers.

Efficacy of a single session protocol for endodontic treatment in primary teeth: in vivo study.

AIMS: To determine the efficacy of a single session protocol (SSP) in the reduction of septic content of primary teeth root canals and identify the persistence of bacterial species associated with unsuccessful treatment. METHODS: Primary teeth root canals (16) with pulp necrosis and peri-radicular lesions were treated. Samples were collected at baseline (T1), and after chemo-mechanical preparation, before filling (T2). Identification of the microorganisms was determined using checkerboard DNA-DNA hybridisation. STATISTICAL ANALYSIS: Wilcoxon test was applied for comparison of mean number of species, proportion and mean count of each species between the evaluation times. RESULTS: Significant reductions were found in the mean number of bacteria species between T1 and T2 (p < 0.05), but not for the reduction in proportion (p > 0.05). There was a reduction (6.0-4.6) of the mean number of species associated with failure, without statistical significance. CONCLUSION: The SSP was capable of significantly reducing the septic content, even though, many of the bacteria associated with failure persisted at the time of root canal filling.

Comparative analyses of whole genome sequences of Leishmania infantum isolates from humans and dogs in northeastern Brazil.

The genomic sequences of 20 Leishmania infantum isolates collected in northeastern Brazil were compared with each other and with the available genomic sequences of 29 L. infantum/donovani isolates from Nepal and Turkey. The Brazilian isolates were obtained in the early 1990s or since 2009 from patients with visceral or non-ulcerating cutaneous leishmaniasis, asymptomatic humans, or dogs with visceral leishmaniasis. Two isolates were from the blood and bone marrow of the same visceral leishmaniasis patient. All 20 genomic sequences display 99.95% identity with each other and slightly less identity with a reference L. infantum genome from a Spanish isolate. Despite the high identity, analysis of individual differences among the 32 million base pair genomes showed sufficient variation to allow the isolates to be clustered based on the primary sequence. A major source of variation detected was in chromosome somy, with only four of the 36 chromosomes being predominantly disomic in all 49 isolates examined. In contrast, chromosome 31 was predominantly tetrasomic/pentasomic, consistent with its regions of synteny on two different disomic chromosomes of Trypanosoma brucei. In the Brazilian isolates, evidence for recombination was detected in 27 of the 36 chromosomes. Clustering analyses suggested two populations, in which two of the five older isolates from the 1990s clustered with a majority of recent isolates. Overall the analyses do not suggest individual sequence variants account for differences in clinical outcome or adaptation to different hosts. For the first known time, DNA of isolates from asymptomatic subjects were sequenced. Of interest, these displayed lower diversity than isolates from symptomatic subjects, an observation that deserves further investigation with additional isolates from asymptomatic subjects.

Prevalence of enamel defects and association with dental caries in preschool children.

AIM: This was to evaluate the prevalence of the developmental defects of enamel (DDE) in primary teeth and its association with dental caries. METHODS: A cross-sectional study with a randomised representative sample was carried out with 1101 children aged 2-5 years enrolled in public preschools (50% prevalence of DDE in primary teeth, a standard error of 3%, and a confidence level of 95%). Three calibrated dentists (K > 0.62) performed clinical examination. Data collected were: sex, age, DDE (Modified DDE Index) and dental caries (WHO). Descriptive analysis, Chi-square test and multinomial logistic regression were applied for data analysis. RESULTS: Among children, 565 (51.3%) were boys; mean age was 3.7 (±0.9 years). The prevalence of enamel defect was 39.1%; the prevalence of diffuse opacities, demarcated opacities and enamel hypoplasia was 25.3, 19.1 and 6.1%, respectively. The prevalence of dental caries was 31.0%, with mean def-t 1.14 (±2.44). Primary teeth with enamel hypoplasia had three times the odds of having dental caries than those with absence of enamel defects (OR = 3.10; 95% CI: 1.91, 5.01). CONCLUSION: The presence of enamel defects was moderate and associated with dental caries.

Petersen's hernia as a complication of bariatric surgery: CT findings.

Referrals for bariatric surgery have currently increased due to the need for more effective interventions in the management of severely obese patients. The Roux-en-Y gastric bypass is currently one of the preferred procedures, and internal hernias are the main causes of late postoperative complication. Petersen's hernia is a less common finding in most published papers compared to transmesocolic hernia, however, it seems to be increasing in incidence (in our service, eight cases which have been tomographic diagnosed in 2 years, were confirmed by laparoscopic surgery). The clinical findings are not specific, usually with abdominal pain, associated or not with abdominal distention and vomiting. In this context, imaging exams have an important role in the early diagnosis and surgery of this condition, with multislice computed tomography being the most accurate method. The aim of this pictorial essay is to the demonstrate the main CT findings associated with Petersen's hernia in patients who underwent Roux-en-Y gastric bypass.

Vertical stratification and development aspects of phlebotomine sand flies (Diptera: Psychodidae) in an area of Atlantic Forest tree species in a metropolitan region in northeastern Brazil.

In the state of Rio Grande do Norte in northeast Brazil, cases of visceral leishmaniasis (VL) occur mainly in the periurban areas of the city of Natal. Lutzomyia longipalpis Lutz & Neiva 1912 (Diptera: Psychodidae), a vector of Leishmania chagasi (Protozoa: Trypanosomatidae) to humans, is found throughout the state. Flora and fauna influence the distribution of sand fly species, whose horizontal or vertical stratification can be used as a parameter for identifying potential vectors, considering the presence of vertebrate hosts in the area. The purpose of this study was to obtain information about the vertical stratification of phlebotomine sand flies in an endemic area of leishmaniasis in Rio Grande do Norte, and associate it with the presence of other animals in the peridomiciliary environment as well as to analyze, under laboratory conditions, aspects of L. longipalpis reproduction in wild females. The sand flies were captured with light traps hung at different heights in species of Atlantic Forest trees and in a peridomiciliary environment in animal shelters. The traps were placed between 17:30 and 6:00 of the following day, in a peridomiciliary and extradomiciliary area of a forest fragment in both dry and rainy months. In the extradomiciliary environment, the traps were installed at 1, 3 and 5 m above the ground. The biological cycle of L. longipalpis was followed from the eggs of 200 wild females. Specimens of L. lenti, L. walkeri, and L. migonei were captured. The comparison and statistical analysis showed that L. longipalpis is more abundant at a height of 3 m and L. evandroi at 1 m. In the animal shelters (chickens, horses, and armadillos), we captured mainly specimens of L. longipalpis and L. evandroi. The duration of the biological cycle of L. longipalpis was approximately 38 days at a temperature of 28 degrees C.

Characteristics of the biological cycle of Lutzomyia evandroi Costa Lima & Antunes, 1936 (Diptera: Psychodidae) under experimental conditions.

Lutzomyia evandroi Costa Lima and Antunes, 1936 is found in Rio Grande do Norte, northeastern Brazil, in areas of visceral and mucocutaneous leishmaniasis and follows the same geographic distribution of L. longipalpis. The biological cycle, oviposition, morphological and behavioral characteristics of the species were studied under experimental conditions. The average number of eggs per wild caught female varied from 21 to 50 eggs along the year, with a peak occurring between January and March and another in August, with oviposition lasting for 4 to 12 days. The mean larval phase was 24 days. Ovipositing rates were influenced by rainfall and temperature indexes, with an increase of eggs per oviposition at the beginning and at the end of the rainy season, and a decrease at the peak of the rainy season.

Distribution of phlebotomine sand flies (Diptera: Psychodidae) in the state of Rio Grande do Norte, Brazil.

Visceral and cutaneous leishmaniasis are major endemic diseases in northeast Brazil. The objective of the current study was to determine the species and geographic distribution of potential sand fly vectors of Leishmania in the state of Rio Grande do Norte. Sand flies were captured using CDC light traps in 30 municipalities distributed throughout the 8 geographic zones of the state. Twelve Lutzomyia species were identified. Lutzomyia longipalpis Lutz & Neiva was the most prevalent and accounted for 85.59% of the sand fly captured. The remaining species were distributed as follows: L. evandroi Costa Lima & Antunes (10.83%), L. oswaldoi Mangabeira (0.99%), L. sallesi Galvão & Coutinho (0.58%), L. intermedia Lutz & Neiva (0.53%), L. lenti Mangabeira (0.53%), L. migonei França (0.49%), L. walkeri Newstead (0.24%), L. goiana Martins, Falcão & Silva (0.15%), L. samueli Deane (0.04%), and L. capixaba Dias, Falcão, Silva & Martins (0.03%), and L. peresi Mangabeira (0.01%). L. longipalpis, which is known to be a vector of Leishmania chagasi Cunha & Chagas (L. donovani chagasi), was captured in 93% of municipalities distributed across all geographical areas of the state and its distribution was independent of obvious climatic and topographic parameters. It was identified in all municipalities where human visceral leishmaniasis had been reported. In contrast, climate and topography appeared to be important for other Lutzomyia species. For example, L. intermedia and L. migonei, which are known to transmit Leishmania braziliensis Viana, were geographically restricted. They were captured in municipalities where cases of cutaneous and mucosal leishmaniasis had been reported. The widespread distribution of L. longipalpis, its adaptation to peridomicillary settings, and its ability to transmit L. (d.) chagasi suggest that a large number of persons may be at risk of acquiring visceral leishmaniasis in the state of Rio Grande do Norte, Brazil.

Polarographic determination of nitrate in vegetables.

A polarographic method for the determination of nitrate in vegetables is presented. The method is based on the reduction of nitrate to nitric oxide which reacts in solution with colbalt (II) and thiocyanate ions forming an electroactive complex that is reduced at the dropping mercury electrode at -0.5 V (vs. SCE). The nitric oxide is generated outside the polarographic cell by addition of ferrous ammonium sulfate and ammonium molybdate in hydrochloric acid to the previously triturated vegetable matrices. The calibration graph was linear in the range of 2-12x10(-6) mol nitrate. The recovery of nitrate in vegetable matrices (broccoli, kale, lettuce, radish, red beet, spinach, turnip and watercress) varied from 85.4 to 107.4 % and the nitrate content, expressed as sodium nitrate, varied from 751 to 10 806 mg kg(-1) of fresh vegetable. The relative standard deviation for the proposed method is lower than 7% and considering a sample of 5.0 g, the determination limit was 39 mg of nitrate per kg fresh vegetable weight. The precision and accuracy of the polarographic method were comparable to those of the reference spectrophotometric method (official AOAC reference method for the determination of nitrate in foodstuffs).

Density of sand flies (Diptera: psychodidae) in domestic and wild animal shelters in an area of visceral Leishmaniasis in the state of Rio Grande do Norte, Brazil.

The objective of the present study was to determine the association of sand flies with the presence of domestic and wild animals in the peridomiciliary area. The sand flies were collected using direct aspiration and CDC light traps placed in animal shelters. The results suggest that different sand flies species have different behavioral characteristics in an apparent preference for animal baits and that Lutzomyia longipalpis and Lu. evandroi were the most eclectic species regarding their biotope choice. Lu. longipalpis showed a distinct preference for horses and Lu. evandroi for armadillos.

Circadian variation of methyleugenol anesthesia in albino rats.

In Wistar rats synchronized to a 12-h light/12-h dark cycle (lights on from 08:00 to 20:00 h), the ip injection of methyleugenol (200 mg/kg) at 08:00, 12:00 and 16:00 h significantly increased the sleeping time (time between loss and recovery of righting reflex) when compared to animals anesthetized at 20:00, 24:00 and 04:00 h. These data provide another example of the importance of circadian rhythms in biological systems and their practical relevance to pharmacology.

Circadian variation of methyleugenol anesthesia in albino rats

In Wistar rats synchronized to a 12-h light/12-h dark cycle (lights on from 08:00 to 20:h), the ip injection of methyleugenol (200 mg/Kg) at 08:00, 12:00 and 16:00 h significantly increased the sleeping time (time between loss and recovery of righting reflex) when compared to animals anesthetized at 20:00, 24:00 and 04:00h. These data provide another example of the importance of circadian rhythms in biological systems and their practical relevance to pharmacology

Variations of the ST segment in the rat electrocardiogram.

The characteristics of the electrocardiogram were studied by an oscilloscope method in 30 male albino rats anesthetized with methyleugenol. The results indicated that the measured QT interval remained constant despite the fall in heart rate. The ST segment was present in 50% of the animals, representing approximately 10% of the whole QT interval duration. The use of Bazzet's formula (QTc = k square root of R-R) to correct the measured QT interval for changes in heart rate revealed that 0.17 is a better choice for k in anesthetized adult rats.

Neoplasia trofoblastica gestacional: I. Imagem ultra-sonografica na neoplasia trofoblastica maligna. / Gestational trophoblastic neoplasm. I.Ultrasonographic image in malignant trophoblastic neoplasm

O exame ultra-sonografico no diagnostico da mola hidatiforme esta bem estabelecido, entretanto, e incipiente o estudo na neoplasia trofoblastica maligna. Dez pacientes foram avaliadas pela ultra-sonografia e encontramos imagem caracteristica que foi correlacionada com a arteriografia, mostrando ser um exame fiel, seguro e facilmente repetido, tanto no diagnostico como na avaliacao da resposta a quimioterapia durante e apos o tratamento

Hemangioendothelioma of the lung and pleura: report of three cases.

Three patients with hemangioendothelioma of the lung and pleura are reported. Two patients underwent removal of the pulmonary lesion: both recovered and were alive one year and eight years later. The patient with pleural involvement had a radical excision of the pleura with the vascular tumor. He died almost two years later. The main histologic feature of this lesion is the presence of neoplastic cells within the endothelium, evidenced by reticulin silver stain.

Correlacao radiologico-patologica na pielonefrite cronica. / Pathologic and radiographic correlation in chronic phylonephritis

Os autores fazem uma correlacao entre os aspectos anatomo-patologicos e os achados radiologicos da pielonefrite cronica, alem de tecerem comentarios acerca da incidencia, etiopatogenia e quadro clinico desta entidade