Diagnostic evaluation of institutions as a basis for designing the Brazilian maturity model of telehealth services.

BACKGROUND: The number and specificities of telehealth service units that expanded their services and diversified with the COVID-19 pandemic in Brazil need to be discovered. The objective of this manuscript is to present a methodology for the diagnostic evaluation of 19 telehealth units from different regions of the country for federal governmental decision-making. METHODS: A cross-sectional quantitative and qualitative study was carried out in the form of a census based on administrative records with an online survey and in-depth interviews with local telehealth managers. RESULTS: Despite the discontinuity of regular funding, the results point to a diversity of initiatives and advances. Citizenship, sustainability, security, and budget management are recurring themes in the maturity analysis of telehealth services after the advent of the pandemic. CONCLUSION: It is necessary for Brazil to build a resilient model of the maturity of telehealth services that contemplates the different regional scenarios.

Evolutionary history of an island endemic, the Azorean common quail.

Oceanic islands are characterized by conditions that favour diversification into endemic lineages that can be very different from their mainland counterparts. This can be the result of fast phenotypic divergence due to drift or the result of slower adaptation to local conditions. This uniqueness can obscure their evolutionary history. Here we used morphological, stable isotope, genetic and genomic data to characterize common quails (Coturnix coturnix) in the Azores archipelago and assess the divergence from neighbouring common quail populations. Historical documents suggested that these quails could have a recent origin associated with the arrival of humans in the last centuries. Our results show that Azorean quails constitute a well-differentiated lineage with small size and dark throat pigmentation that has lost the migratory ability and that diverged from mainland quail lineages more than 0.8 mya, contrary to the notion of a recent human-mediated arrival. Even though some Azorean quails carry an inversion that affects 115 Mbp of chromosome 1 and that has been associated with the loss of the migratory behaviour in other common quail populations, half of the analysed individuals do not have that inversion and still do not migrate. The long coexistence and evolution in isolation in the Azores of two chromosomal variants (with and without the inversion) is best explained by balancing selection. Thus, a unique and long evolutionary history led to the island endemic that we know today, C. c. conturbans.

One-day voiding diary in the evaluation of Lower Urinary Tract Symptoms in children.

INTRODUCTION: Voiding diary (VD) is an important tool in the evaluation of children with voiding symptoms. Voiding frequency, maximal voided volume (MVV), average voided volume (AVV) and nocturnal volume (NV) can be extracted and are valuable in diagnosing and monitoring these disorders. Recently, ICCS has reduced the period of data recording on VD from 3 to 2 days.We hypothesized that one day voiding diary would be enough for guiding treatment. MATERIALS AND METHODS: Children with overactive bladder (OAB) and primary monosymptomatic enuresis (PMNE) were oriented to fulfill a 3-day VD. Data obtained from VD were evaluated for the first day (1dVD), the first two days (2dVD), and all 3 days (3dVD) and compared according to the MVV, AVV, frequency, NV and expected bladder capacity (EBC). The Friedman, Student's t test and the Fisher's exact was used. ANOVA was used for multiple comparisons. We also used Pearson correlation test. RESULTS: Ninety-eight children were included, 59 had PMNE and 30 OAB. Frequency, AVV and VN were similar regardless how many days the voiding episodes were recorded. Only MVV was higher by a mean of only 32 mL on 3dVD compared to 1dVD. A 1dVD has a sensitivity of 93,9% and a positive likelihood ratio of 2.2. As for the correlation of MVV and EBC it was observed that in 83% of children, MVV was lower than EBC. MVV corresponds to 67% and 69% of EBC in children with PMNE and OAB, respectively. CONCLUSION: We believe that 1dVD is sufficient to assess these children. It has a high sensitivity and good correlation to 3dVD in evaluating these children. Bladder capacity in this population, evaluated by maximum voided volume, was close to 68% of that obtained by the EBC.

Effects of polyvinyl chloride film and oxygen-blocking gel on irradiance and depth of cure.

This study aimed to analyze the effects of polyvinyl chloride (PVC) film and oxygen-blocking gel (OBG) on the irradiance from an LED source and the depth of cure of a composite resin. Irradiance was measured with a curing radiometer, and curing depth was evaluated according to the methods described by the International Organization for Standardization (ISO 4049). Twelve experimental conditions were investigated in a 3 × 4 factorial design (n = 5 specimens per condition): no PVC film at the tip of the device, fitted PVC film, or misfit PVC film; and no OBG or a 1-, 2-, or 3-mm-thick layer of OBG. The data were analyzed using analysis of variance and Tukey tests (P < 0.05), and a linear regression test was performed between the variables (P < 0.05). The analyses showed that the variables under study influenced the irradiance (P < 0.05) but not the curing depth (P > 0.05). The 3 groups that did not have the PVC film and either did not have the OBG or had the OBG in a thickness of 1 or 2 mm were not significantly different from each other (P > 0.05) but presented the highest irradiance values among all the groups (P < 0.05). The use of the misfit PVC film with a 3-mm layer of OBG led to the lowest irradiance values (P < 0.05). The variables did not influence each other (P > 0.05). The results of this study indicated that the presence of PVC film, especially misfit film, reduced the irradiance. In addition, the greater the thickness of the OBG, the lower the irradiance. None of the PVC film barrier conditions or OBG thicknesses had an effect on the depth of cure.

Gloeothece sp.-Exploiting a New Source of Antioxidant, Anti-Inflammatory, and Antitumor Agents.

Bioactive lipidic compounds of microalgae, such as polyunsaturated fatty acids (PUFA) and carotenoids, can avoid or treat oxidation-associated conditions and diseases like inflammation or cancer. This study aimed to assess the bioactive potential of lipidic extracts obtained from Gloeothece sp.-using Generally Recognized as Safe (GRAS) solvents like ethanol, acetone, hexane:isopropanol (3:2) (HI) and ethyl lactate. The bioactive potential of extracts was assessed in terms of antioxidant (ABTS•+, DPPH•, •NO and O2•assays), anti-inflammatory (HRBC membrane stabilization and Cox-2 screening assay), and antitumor capacity (death by TUNEL, and anti-proliferative by BrdU incorporation assay in AGS cancer cells); while its composition was characterized in terms of carotenoids and fatty acids, by HPLC-DAD and GC-FID methods, respectively. Results revealed a chemopreventive potential of the HI extract owing to its ability to: (I) scavenge -NO• radical (IC50, 1258 ± 0.353 µg·mL-1); (II) inhibit 50% of COX-2 expression at 130.2 ± 7.4 µg·mL-1; (III) protect 61.6 ± 9.2% of lysosomes from heat damage, and (IV) induce AGS cell death by 4.2-fold and avoid its proliferation up to 40% in a concentration of 23.2 ± 1.9 µg·mL-1. Hence, Gloeothece sp. extracts, namely HI, were revealed to have the potential to be used for nutraceutical purposes.

Increased Risk for Carbapenem-Resistant Enterobacteriaceae Colonization in Intensive Care Units after Hospitalization in Emergency Department.

Carbapenem-resistant Enterobacteriaceae (CRE) colonization is common in hospital patients admitted to intensive care units (ICU) from the emergency department. We evaluated the effect of previous hospitalization in the emergency department on CRE colonization at ICU admission. Our case-control study included 103 cases and 201 controls; cases were patients colonized by CRE at admission to ICU and controls were patients admitted to ICU and not colonized. Risk factors were emergency department stay, use of carbapenem, Simplified Acute Physiology Score, upper digestive endoscopy, and transfer from another hospital. We found that ED stay before ICU admission was associated with CRE colonization at admission to the ICU. Our findings indicate that addressing infection control problems in EDs will help to control carbapenem resistance in ICUs.

Sensing adhesion forces between erythrocytes and γ' fibrinogen, modulating fibrin clot architecture and function.

Plasma fibrinogen includes an alternatively spliced γ-chain variant (γ'), which mainly exists as a heterodimer (γAγ') and has been associated with thrombosis. We tested γAγ' fibrinogen-red blood cells (RBCs) interaction using atomic force microscopy-based force spectroscopy, magnetic tweezers, fibrin clot permeability, scanning electron microscopy and laser scanning confocal microscopy. Data reveal higher work necessary for RBC-RBC detachment in the presence of γAγ' rather than γAγA fibrinogen. γAγ' fibrinogen-RBCs interaction is followed by changes in fibrin network structure, which forms an heterogeneous clot structure with areas of denser and highly branched fibrin fibers. The presence of RBCs also increased the stiffness of γAγ' fibrin clots, which are less permeable and more resistant to lysis than γAγA clots. The modifications on clots promoted by RBCs-γAγ' fibrinogen interaction could alter the risk of thrombotic disorders.

Stochastic NANOG fluctuations allow mouse embryonic stem cells to explore pluripotency.

Heterogeneous expression of the transcription factor NANOG has been linked to the existence of various functional states in pluripotent stem cells. This heterogeneity seems to arise from fluctuations of Nanog expression in individual cells, but a thorough characterization of these fluctuations and their impact on the pluripotent state is still lacking. Here, we have used a novel fluorescent reporter to investigate the temporal dynamics of NANOG expression in mouse embryonic stem cells (mESCs), and to dissect the lineage potential of mESCs at different NANOG states. Our results show that stochastic NANOG fluctuations are widespread in mESCs, with essentially all expressing cells showing fluctuations in NANOG levels, even when cultured in ground-state conditions (2i media). We further show that fluctuations have similar kinetics when mESCs are cultured in standard conditions (serum plus leukemia inhibitory factor) or ground-state conditions, implying that NANOG fluctuations are inherent to the pluripotent state. We have then compared the developmental potential of low-NANOG and high-NANOG mESCs, grown in different conditions, and confirm that mESCs are more susceptible to enter differentiation at the low-NANOG state. Further analysis by gene expression profiling reveals that low-NANOG cells have marked expression of lineage-affiliated genes, with variable profiles according to the signalling environment. By contrast, high-NANOG cells show a more stable expression profile in different environments, with minimal expression of lineage markers. Altogether, our data support a model in which stochastic NANOG fluctuations provide opportunities for mESCs to explore multiple lineage options, modulating their probability to change functional state.

Conversion of Cn-Unsaturated into Cn-2-Saturated LCFA Can Occur Uncoupled from Methanogenesis in Anaerobic Bioreactors.

Fat, oils, and grease present in complex wastewater can be readily converted to methane, but the energy potential of these compounds is not always recyclable, due to incomplete degradation of long chain fatty acids (LCFA) released during lipids hydrolysis. Oleate (C18:1) is generally the dominant LCFA in lipid-containing wastewater, and its conversion in anaerobic bioreactors results in palmitate (C16:0) accumulation. The reason why oleate is continuously converted to palmitate without further degradation via ß-oxidation is still unknown. In this work, the influence of methanogenic activity in the initial conversion steps of unsaturated LCFA was studied in 10 bioreactors continuously operated with saturated or unsaturated C16- and C18-LCFA, in the presence or absence of the methanogenic inhibitor bromoethanesulfonate (BrES). Saturated Cn-2-LCFA accumulated both in the presence and absence of BrES during the degradation of unsaturated Cn-LCFA, and represented more than 50% of total LCFA. In the presence of BrES further conversion of saturated intermediates did not proceed, not even when prolonged batch incubation was applied. As the initial steps of unsaturated LCFA degradation proceed uncoupled from methanogenesis, accumulation of saturated LCFA can be expected. Analysis of the active microbial communities suggests a role for facultative anaerobic bacteria in the initial steps of unsaturated LCFA biodegradation. Understanding this role is now imperative to optimize methane production from LCFA.

Post-treatment of sanitary landfill leachate by coagulation-flocculation using chitosan as primary coagulant.

Chitosan was chosen as an alternative primary coagulant in a complementary coagulation-flocculation treatment of sanitary landfill leachate with the aim of removing recalcitrant organic matter. In order to optimize the process conditions, central composite design and response surface methodology were applied. To evaluate the performance of the process using chitosan, we also carried out tests with aluminium sulphate (Al(2) (SO(4))(3).14 H(2)O) as coagulant. In addition, acute toxicity tests were carried using the duckweed Lemna minor and the guppy fish Poecilia reticulata as test organisms. The analytic hierarchy process was employed for selecting the most appropriate coagulant. Mean values of true colour removal efficiency of 80% and turbidity removal efficiency of 91.4% were reached at chitosan dosages of 960 mg L(-1) at pH 8.5. The acute toxicity tests showed that organisms were sensitive to all samples, mainly after coagulation-flocculation using chitosan. CE(50) for L. minor was not determined because there was no inhibition of the average growth rate and biomass production; LC(50) for P. reticulata was 23% (v v(-1)). Multi-criteria analysis showed that alum was the most appropriate coagulant. Therefore, chitosan as primary coagulant was not considered to be a viable alternative in the post-treatment of landfill leachate.

Effect of thermocycling on roughness of nanofill, microfill and microhybrid composites.

OBJECTIVE: This study aimed to investigate the surface roughness of composite resins subjected to thermal cycles procedure. MATERIALS AND METHODS: Two microfill, four microhybrid and four nanofill composites were used. The surface roughness (Ra) was initially measured in a profilometer using a cut-off 0f 0.25 mm, after 3000 and 10,000 thermal cycles. Data were subjected to ANOVA and Fischer's test (α = 0.05). RESULTS: Overall, 3000 thermal cycles increased the surface roughness values for all materials and there was a trend in all groups to decrease the roughness after 10,000 thermal cycles. CONCLUSIONS: The composition of material, including the type of organic matrix, could be more relevant to roughness maintenance over time than the general behavior of composites based on particles fillers. The maintenance of smooth surface in resin-based composite restorations is totally dependent of organic composition of the material.

Fluorescence intensity of composite layering combined with surface sealant submitted to staining solutions.

PURPOSE: The aim of this study was to evaluate the fluorescence intensity of a composite in different layering techniques combined to a surface sealant submitted to staining solutions. METHODS AND MATERIALS: One surface sealant and one composite resin (shades A2-0, A2, and YE) were tested. Specimens were carried out using layering with different shades of composite, and dental blocks (dentin/enamel) were obtained of human molars. Fluorescence intensity measurement performed using a spectrofluorophotometer, before and after storage in cola, orange juice, red wine, and distilled water. Data were subjected to analysis of variance and Fisher's test (α = 0.05). RESULTS: Initially, only A2-O + A2 layering showed fluorescence intensity statistically similar to the natural tooth. Overall, groups sealed showed the highest fluorescence intensity compared with unsealed groups. The aging decreased the fluorescence intensity compared with initial values. Red wine showed the highest decrease on the fluorescence intensity. CONCLUSION: The fluorescence of composite restorations is dependent of the layering technique and is affected by the diet. CLINICAL SIGNIFICANCE: The staining solutions decreased the fluorescence intensity, even when the composite resins were sealed. Different shades of the same composite showed distinct fluorescence values, so there should be greater standardization of this property for tooth reconstruction success by the layering technique with large tissue loss.

Diagnosis of Congenital Toxoplasmosis: Challenges and Management Outcomes.

Introduction Congenital toxoplasmosis (CT), despite being mostly subclinical at birth, can cause disabling disease in the fetus and lead to long-term sequelae. It is an important cause of chorioretinitis in infants and adolescents. Data on postnatal treatment are controversial, and there is a lack of universal guidelines. Methods A cross-sectional study of newborns with suspected CT was conducted between January 2007 and December 2021. Results Seventy-one patients with suspected CT were included. During pregnancy, 64 (90.1%) of the mothers underwent therapy, of which 59 (83.1%) with spiramycin. Amniocentesis identified one positive polymerase chain reaction assay. Most newborns were asymptomatic with normal laboratory, ophthalmological, and hearing screening. There was one case of hyperproteinorrachia. Fifty-seven patients (80.3%) started treatment: 42 (73.7%) with spiramycin, seven (12.3%) with pyrimethamine, sulfadiazine, and folinic acid (P+S+FA), and eight (14%) with P+S+FA intercalated with spiramycin. Adverse effects were found in 11 (19.3%) cases, mainly neutropenia. After investigation, we found three confirmed CT cases corresponding to 4.2% of suspected cases and an incidence of 0.4 per 10,000 births. All had normal clinical and laboratory exams in the neonatal period and started P+S+FA, fulfilling 12 months of therapy. During the follow-up, all presented normal psychomotor development without any long-term sequelae. Conclusion The lower incidence in our study, compared to the incidence in Europe, may be related to the decline in the prevalence of toxoplasmosis as well as the effectiveness of measures to prevent primary infection and a well-established program of antenatal screening, followed by the early initiation of treatment during pregnancy to prevent vertical transmission.

Modeling 1-D aqueous film forming foam transport through the vadose zone under realistic site and release conditions.

Aqueous film forming foams (AFFFs) have been used to extinguish fires since the 1960s, leading to widespread subsurface contamination by per- and polyfluoroalkyl substances (PFAS), an essential component of AFFF. This study presents 1-D simulations of PFAS migration in the vadose zone resulting from AFFF releases. Simulation scenarios used soil profiles from three US Air Force (USAF) installations, encompassing a range of climatic conditions and hydrogeologic environments. A three-component mixture, representative of major constituents of AFFF, facilitated the exploration of competitive and synergistic effects of co-constituents on PFAS migration. To accurately capture unsaturated transport of PFAS in porous media, the model considers (1) surfactant-induced flow, (2) non-linear sorption to the solid phase, (3) competitive accumulation at the air-water interface, and (4) the moisture-dependence of the air-water interfacial area. Defined PFAS releases were consistent with fire training exercises, emergency responses, and accidental spills of record. Simulation results illustrate the importance of hydrogeologic, climatic, geochemical, and AFFF release conditions on PFAS transport and retention. Comparison of field observations and model simulations for Ellsworth AFB indicate that much of the PFOA and PFOS mass is associated with the air-water interface and the solid phase, which limits their migration potential in the vadose zone. Results also show that rates of migration in the aqueous phase are largely controlled by hydrogeologic properties, including recharge rates and hydraulic conductivity. AFFF spill scenarios varying in volume, concentration, and frequency reveal the importance of release characteristics in determining rates of PFAS migration and concentration peaks. Variability is attributed to non-linear sorption processes, where, contrary to simple linear partitioning formulations, transport is strongly affected by the concentration of PFAS species. Simulations also demonstrate the importance of modeling the AFFF as a mixture since competitive interfacial accumulation effects are shown to enhance the mobility of less surface-active PFAS compounds.

Niobium oxyhydroxide as a bioactive agent and reinforcement to a high-viscosity bulk-fill resin composite.

OBJECTIVE: The present in vitro study incorporated niobium oxyhydroxide fillers into an experimental high-viscosity bulk-fill resin composite to improve its mechanical performance and provide it a bioactive potential. METHODOLOGY: Scanning electron microscopy synthesized and characterized 0.5% niobium oxyhydroxide fillers, demonstrating a homogeneous morphology that represented a reinforcement for the feature. Fillers were weighed, gradually added to the experimental resin composite, and homogenized for one minute, forming three groups: BF (experimental high-viscosity bulk-fill resin composite; control), BF0.5 (experimental high-viscosity bulk-fill resin composite modified with 0.5% niobium oxyhydroxide fillers), and BFC (commercial bulk-fill resin composite Beautifil Bulk U, Shofu; positive control). In total, 10 specimens/groups (8 × 2 × 2 mm) underwent flexural strength (FS) tests in a universal testing machine (Instron) (500N). Resin composites were also assessed for Knoop hardness (KH), depth of cure (DoC), degree of conversion (DC), elastic modulus (E), and degree of color change (ΔE). The bioactive potential of the developed resin composite was evaluated after immersing the specimens into a simulated body fluid in vitro solution and assessing them using a Fourier-transformed infrared spectroscope with an attenuated total reflectance accessory. One-way ANOVA, followed by the Tukey's test (p<0.05), determined FS, DC, KH, and ΔE. For DoC, ANOVA was performed, which demonstrated no significant difference between groups (p<0.05). CONCLUSIONS: The high-viscosity bulk-fill resin composite with 0.5% niobium oxyhydroxide fillers showed promising outcomes as reinforcement agents and performed well for bioactive potential, although less predictable than the commercial resin composite with Giomer technology.

[Eating Habits of People with Type 2 Diabetes Mellitus in Portugal: A Cross-Sectional Study]. / Hábitos Alimentares das Pessoas com Diabetes Mellitus Tipo 2 em Portugal: Um Estudo Transversal.

INTRODUCTION: Nutrition is a cornerstone of diabetes mellitus prevention and management; therefore, it is essential to enable patients to adopt healthy eating habits. Previous studies have not yet documented the main errors in the eating habits of Portuguese people with type 2 diabetes mellitus. This study aims to identify the main errors in the eating habits of people living with type 2 diabetes mellitus in Portugal and to evaluate its associations with sociodemographic variables. METHODS: Cross-sectional multicentric study in a convenience sample of people with type 2 diabetes mellitus in Primary Health Care Units. The UK Diabetes and Diet Questionnaire (UKDDQ) - translated and adapted, was applied from July to October 2022. Descriptive and inferential statistical analyses were conducted. RESULTS: Of the 550 participants, 52.2% were female, 68.3% were 65 years or over, 55.8 % had an education level up to the fourth grade, 24.7% had economic deprivation, and the mean time since diagnosis was 10.60 ± 8.13 years. Only 36.2% of the sample had a healthy UKDDQ score. Less than 50% of the sample had healthy scores for the items "high-fiber rice or pasta", "high-fiber bread", "butter, margarine and vegetable oils" and "vegetables and pulses". Only 8.9% of the sample had a healthy consumption of fiber. About 70.4% reported healthy scores for the consumption of "high-added-sugar foods" and 54.7% for "high-saturated fat". A statistically significant weak positive correlation was found between the UKDDQ score and age (ρ = 0.201, p < 0.001) with a more frequent choice of healthy foods with increasing age. Female respondents reported healthier habits, particularly in the consumption of "high-saturated fat" and "high-fiber foods". CONCLUSION: The majority of our sample did not take advantage of the potential benefits of healthy eating habits. The main food groups whose consumption should be emphasized or discouraged were individualized, particularly the need to encourage the consumption of high-fiber foods. Targeted educational actions must focus especially on younger and/or male patients.

Introdução: A nutrição é uma área de intervenção na prevenção e gestão da diabetes mellitus; por isso, é fulcral promover a capacitação da população para a adoção de hábitos alimentares saudáveis. Ainda que existam alguns estudos nesta área, não se conhecem os principais erros nos hábitos alimentares das pessoas com diabetes em Portugal. Os objetivos deste estudo foram identificar os principais erros nos hábitos alimentares das pessoas com diabetes mellitus tipo 2 em Portugal e avaliar a sua relação com variáveis sociodemográficas. Métodos: Estudo transversal multicêntrico, em amostra de conveniência de pessoas com diabetes mellitus tipo 2 seguidas em Unidades de Cuidados de Saúde Primários. Aplicação do UK Diabetes and Diet Questionnaire (UKDDQ) ­ traduzido e adaptado, de julho a outubro de 2022. Análise estatística descritiva e inferencial. Resultados: Amostra de 550 participantes, 52,2% do sexo feminino, 68,3% com 65 anos ou mais, 55,8% com nível de escolaridade igual ou inferior ao 1.º ciclo do ensino básico, 24,7% com insuficiência económica e tempo desde o diagnóstico médio de 10,60 ± 8,13 anos. Apenas 36,2% da amostra obteve um score UKDDQ considerado saudável. Menos de 50% obteve scores saudáveis para os itens "arroz ou massa ricos em fibras", "pão integral", "manteiga, margarina e óleos vegetais" e "vegetais e leguminosas". Somente 8,9% da amostra obteve score saudável para o consumo de fibras. Cerca de 70,4% obteve score saudável para o consumo de açúcares livres e 54,7% para o consumo de ácidos gordos saturados. Verificou-se a existência de uma correlação com significado estatístico positiva fraca entre o score UKDDQ e a idade (ρ = 0,201, p < 0,001), com escolha mais frequente de alimentos saudáveis com o aumentar da idade. As pessoas do sexo feminino reportaram hábitos alimentares mais saudáveis, particularmente no consumo de fibras e ácidos gordos saturados. Conclusão: A maior parte da nossa amostra não usufruiu do potencial efeito positivo de uma alimentação saudável. Individualizam-se grupos de alimentos cujos consumos devem ser enfatizados ou desencorajados, particularmente, a necessidade de incentivar o consumo de alimentos ricos em fibra. Ações educacionais dirigidas devem ter especial foco em pessoas mais jovens e/ou do sexo masculino.

Activity and viability of methanogens in anaerobic digestion of unsaturated and saturated long-chain fatty acids.

Lipids can be anaerobically digested to methane, but methanogens are often considered to be highly sensitive to the long-chain fatty acids (LCFA) deriving from lipids hydrolysis. In this study, the effect of unsaturated (oleate [C18:1]) and saturated (stearate [C18:0] and palmitate [C16:0]) LCFA toward methanogenic archaea was studied in batch enrichments and in pure cultures. Overall, oleate had a more stringent effect on methanogens than saturated LCFA, and the degree of tolerance to LCFA was different among distinct species of methanogens. Methanobacterium formicicum was able to grow in both oleate- and palmitate-degrading enrichments (OM and PM cultures, respectively), whereas Methanospirillum hungatei only survived in a PM culture. The two acetoclastic methanogens tested, Methanosarcina mazei and Methanosaeta concilii, could be detected in both enrichment cultures, with better survival in PM cultures than in OM cultures. Viability tests using live/dead staining further confirmed that exponential growth-phase cultures of M. hungatei are more sensitive to oleate than are M. formicicum cultures; exposure to 0.5 mM oleate damaged 99% ± 1% of the cell membranes of M. hungatei and 53% ± 10% of the cell membranes of M. formicicum. In terms of methanogenic activity, M. hungatei was inhibited for 50% by 0.3, 0.4, and 1 mM oleate, stearate, and palmitate, respectively. M. formicicum was more resilient, since 1 mM oleate and >4 mM stearate or palmitate was needed to cause 50% inhibition on methanogenic activity.

Microtensile bond strength of resin cements to caries-affected dentin.

STATEMENT OF PROBLEM: The bonding of resin materials to caries-affected dentin, especially self-adhesive cements, remains a challenge in dentistry. PURPOSE: The purpose of this study was to evaluate the bond strength of different resin cements to sound or caries-affected dentin at 24 hours and 6 months after the bonding procedure. MATERIAL AND METHODS: Thirty-six human molars were used, 18 sound and 18 affected by caries. Indirect composite resin blocks (Tescera) were bonded to dentin by using 3 different resin cements: RelyX ARC, Panavia F, and RelyX Unicem. A universal testing machine was used to measure the microtensile bond strength 24 hours and 6 months after the bonding procedure. Representative specimens were analyzed with a scanning electron microscopy. The results were submitted to 3-way analysis of variance and the Fisher test (α=.05). RESULTS: The highest values of microtensile bond strength were found with RelyX ARC for both tooth conditions (P<.001). There was no difference between RelyX Unicem and Panavia F (P>.05). There was no difference between caries-affected and sound dentin (P=.89). CONCLUSIONS: Caries did not influence the bonding strength of resin cements to dentin.

Kikuchi-Fujimoto Disease: The Unexpected Diagnosis of a Cervical Adenopathy.

Many cases of adenopathies, whose differential diagnosis includes a wide spectrum of pathologies (including some malignant conditions like lymphoproliferative diseases, e.g., lymphomas), resort to primary healthcare. Kikuchi-Fujimoto disease is a rare, benign, self-limiting entity characterized by adenopathies, mainly in the cervical region, which may be associated with constitutional symptoms. This specific pathology is very rare in primary care and is often overlooked. That is why it is essential to promote medical literacy and provide support in managing these cases, which we want to emphasize through this case presentation. This case report presents a 24-year-old female patient who sought a consultation at the Family Health Unit due to a painful swelling in the right cervical region that lasted two weeks. She denied a history of recent infections or constitutional symptoms. A painful and hard right submaxillary mass, measuring 2 cm in diameter, was identified upon palpation. An analytical study and ultrasound of the soft tissues of the cervical region were initially required. Analytically, there were no relevant changes; however, the ultrasound revealed "hypoechoic ganglion formations in the right laterocervical chains, from the retroauricular region to the lower region of the neck, the largest measuring 19x7mm". The patient was reassessed one month later, due to an increase in the number of adenopathies, and a new ultrasound was performed that revealed "supraclavicular adenopathy". After that, she was referred to Secondary Healthcare (Central Hospital), where a lymph node biopsy was performed, with histological results of Kikuchi-Fujimoto disease. The patient maintains a follow-up in a hemato-oncology consultation, with painless adenopathies that, according to her, get worse with anxiety symptoms. Currently, the patient is being treated symptomatically, with stabilization of adenopathies and anxious manifestations. These patients need long-term follow-up due to the possibility of disease recurrence or the development of autoimmune processes. Although it is a diagnosis of exclusion, this disease must always be considered, since it can be mistaken with other serious pathologies that require aggressive treatments. Regarding the relationship between anxiety disorder and the worsening of adenopathies, although no conclusive evidence was found in the literature, there are some studies that have established a connection between inflammation and the deterioration of certain depressive symptoms.