Insights into invasive fungal infection diagnostic and treatment capacities in tertiary care centres of Germany.

Introduction: In Germany, the growing incidence of invasive fungal infections (IFIs) is a significant health concern, particularly impacting individuals with compromised immune systems due to factors like increasing transplant recipients, an ageing population, and heightened use of immunosuppressive medications. Diagnosing IFI remains challenging, and the integration of biomarker assays into clinical practice is difficult. Antifungal resistance, exemplified by pan-antifungal-resistant Candida auris cases, adds complexity to treatment. This study aims to provide a concise overview of the diagnostic and treatment landscape for IFI in Germany, identifying areas for improvement and paving the way for targeted interventions. Methods: Data were collected using an online electronic case report form from October 2021 to February 2023. The survey included questions about institutional practices related to fungal infection diagnosis and treatment, with invitations extended to researchers nationwide. Results: The study surveyed 58 hospitals across Germany. Notably, 77.6% managed high-risk patients for IFI. While 86% had onsite microbiology labs, a significant difference was noted for high-risk patients (93% in specialized hospitals versus 62% in others). Microscopy services had 96% coverage, while overall access to culture was 96%. Antigen tests had 96% coverage, and antibody access was reported at 98%. PCR testing was available at 98%. Imaging access showed no significant access differences. Variability existed in amphotericin B formulations based on patient profiles. Therapeutic drug monitoring was more common in high-risk patient institutions (89.5% versus 50.0%). All analysed institutions reported access to surgery (100%). Conclusions: Addressing identified disparities in diagnostic and therapeutic resources for IFI is crucial to improving patient outcomes. The study calls for ongoing research and collaboration to optimize strategies for the prevention and treatment of IFI, emphasizing the importance of equitable access to resources, especially in high-risk patient populations.

CYP19A1 mediates severe SARS-CoV-2 disease outcome in males.

Male sex represents one of the major risk factors for severe COVID-19 outcome. However, underlying mechanisms that mediate sex-dependent disease outcome are as yet unknown. Here, we identify the CYP19A1 gene encoding for the testosterone-to-estradiol metabolizing enzyme CYP19A1 (also known as aromatase) as a host factor that contributes to worsened disease outcome in SARS-CoV-2-infected males. We analyzed exome sequencing data obtained from a human COVID-19 cohort (n = 2,866) using a machine-learning approach and identify a CYP19A1-activity-increasing mutation to be associated with the development of severe disease in men but not women. We further analyzed human autopsy-derived lungs (n = 86) and detect increased pulmonary CYP19A1 expression at the time point of death in men compared with women. In the golden hamster model, we show that SARS-CoV-2 infection causes increased CYP19A1 expression in the lung that is associated with dysregulated plasma sex hormone levels and reduced long-term pulmonary function in males but not females. Treatment of SARS-CoV-2-infected hamsters with a clinically approved CYP19A1 inhibitor (letrozole) improves impaired lung function and supports recovery of imbalanced sex hormones specifically in males. Our study identifies CYP19A1 as a contributor to sex-specific SARS-CoV-2 disease outcome in males. Furthermore, inhibition of CYP19A1 by the clinically approved drug letrozole may furnish a new therapeutic strategy for individualized patient management and treatment.

Estrategias de mejora de calidad en lactancia en recién nacidos muy bajo peso: revisión del tema / Breastfeeding quality improvement strategies in very low birth weight newborns / Revisao das estratégias de melhoria da qualidade na amamentação de recém-nascidos de muito baixo peso

El abordaje nutricional en los recién nacidos de muy bajo peso al nacimiento constituye un desafío en la práctica clínica de los neonatólogos, y muchas veces se aborda fuera del período crítico. Existe evidencia contundente de que la optimización nutricional precoz impacta en forma directamente proporcional en la sobrevida y sobrevida sin morbilidades mayores para este grupo. La implementación de lactancia materna precoz en este contexto debe ser una prioridad del equipo asistencial, siendo la mejora de calidad una herramienta de demostrada utilidad para mejorar los resultados en términos de mortalidad y morbilidad neonatal.

The nutritional approach of the very low birth weight infant poses a great challenge to most neonatologists in their clinical practice, and it is frequently delayed until de newborn is in stable clinical conditions. Currently, scientific evidence supports that early nutritional optimization impacts directly on this group's survival and on their survival without major morbidities. Initiatives fostering early breastfeeding should be prioritized by the healthcare team. Quality improvement has shown to be a very useful resource to improve outcomes regarding neonatal mortality and morbidities.

A abordagem nutricional do recém-nascido de muito baixo peso representa um grande desafio para a maioria dos neonatologistas em sua prática clínica, sendo frequentemente postergada até que o recém-nascido esteja em condições clínicas estáveis. Atualmente, evidências científicas sustentam que a otimização nutricional precoce impacta diretamente na sobrevivência desse grupo e na sobrevivência sem maiores morbidades. Iniciativas de incentivo ao aleitamento materno precoce devem ser priorizadas pela equipe de saúde. A melhoria da qualidade tem se mostrado um recurso muito útil para melhorar os desfechos em relação à mortalidade e morbidades neonatais.

Comparison of four diagnostic criteria for invasive pulmonary aspergillosis-A diagnostic accuracy study in critically ill patients.

BACKGROUND: In the absence of lung biopsy, there are various algorithms for the diagnosis of invasive pulmonary aspergillosis (IPA) in critically ill patients that rely on clinical signs, underlying conditions, radiological features and mycology. The aim of the present study was to compare four diagnostic algorithms in their ability to differentiate between probable IPA (i.e., requiring treatment) and colonisation. METHODS: For this diagnostic accuracy study, we included a mixed ICU population with a positive Aspergillus culture from respiratory secretions and applied four different diagnostic algorithms to them. We compared agreement among the four algorithms. In a subgroup of patients with lung tissue histopathology available, we determined the sensitivity and specificity of the single algorithms. RESULTS: A total number of 684 critically ill patients (69% medical/31% surgical) were included between 2005 and 2020. Overall, 79% (n = 543) of patients fulfilled the criteria for probable IPA according to at least one diagnostic algorithm. Only 4% of patients (n = 29) fulfilled the criteria for probable IPA according to all four algorithms. Agreement among the four diagnostic criteria was low (Cohen's kappa 0.07-0.29). From 85 patients with histopathological examination of lung tissue, 40% (n = 34) had confirmed IPA. The new EORTC/MSGERC ICU working group criteria had high specificity (0.59 [0.41-0.75]) and sensitivity (0.73 [0.59-0.85]). CONCLUSIONS: In a cohort of mixed ICU patients, the agreement among four algorithms for the diagnosis of IPA was low. Although improved by the latest diagnostic criteria, the discrimination of invasive fungal infection from Aspergillus colonisation in critically ill patients remains challenging and requires further optimization.

Vigilancia ambiental de la circulación de poliovirus en tres municipios considerados como punto transitorio de migrantes en Colombia 2017-2019 / Environmental surveillance of the circulation of poliovirus in municipalities considered as transitory point of migrants in Colombia 2017-2019

Resumen Objetivo: Determinar la circulación de poliovirus en tres municipios considerados como punto transitorio de migrantes en Colombia. Material y método: Se colectaron muestras de aguas residuales (n=36) de municipios fronterizos, seleccionados por mayor tránsito de migrantes regulares como irregulares, en el periodo comprendido entre el 2017-2019. Las muestras fueron concentradas y cultivadas siguiendo el algoritmo de vigilancia ambiental para la circulación de poliovirus de la Organización Mundial de la Salud (OMS). La identificación molecular se realizo mediante reacción en cadena de la polimerasa empleando cebadores específicos de grupo, de serotipo y de cepa vacunal sabin. Resultados y Discusión: Se detectó la presencia de Enterovirus no polio (EVNP) en las muestras ambientales obtenidas y no se hallo circulación de poliovirus deriva dos de la vacuna ni de poliovirus salvaje en los tres municipos evaluados; sin embargo en dos estudios previos publicados por Gonzalez y col con una metodologia similar en el año 2005 y 2015 evaluando las aguas residuales de la ciudad de Armenia-Quindio; se logró identificar la presencia de virus derivado de vacuna, con resultados negativos para la identificación de poliovirus salvaje. Conclusiones: Los hallazgos indican que el sistema de monitoreo de aguas residuales con el fin de determinar la presencia de virus es una herramienta util para realizar vigilancia ambiental.

Abstract Objective: To determine the circulation of poliovirus in three municipalities considered as transitory points for migrants in Colombia. Material and Method: Wastewater samples (n = 36) were collected from border municipalities, selected for greater transit of regular and irregular migrants, in the period between 2017-2019. The samples were concentrated and cultured following the World Health Organization (WHO) environmental surveillance algorithm for poliovirus circulation. Molecular identification was performed by polymerase chain reaction using group-specific, serotype and sabin vaccine strain primers. Results: The presence of non-polio Enterovirus (NPV) was detected in the environmental samples obtained and no circulation of poliovirus derived from the vaccine or wild poliovirus was found in the three evaluated municipalities; However, in two previous studies published by Gonzales et al with a similar methodology in 2005 and 2015 evaluating the wastewater of the city of Armenia-Quindío; It was possible to identify the presence of virus derived from vaccine, with negative results for the identification of wild poliovirus. Conclusions: The findings indicate that the wastewater monitoring system in order to determine the presence of viruses is a useful tool to carry out environmental surveillance.

Relación entre el consumo materno de carne vacuna durante el embarazo y los niveles de ferritina en el cordón umbilical / Relationship between maternal beef consumption during pregnancy and umbilical cord ferritin concentration / Relação entre o consumo materno de carne bovina durante a gravidez e os níveis de ferritina no cordão umbilical

Antecedentes: la nutrición durante el embarazo impacta en la salud del recién nacido, con efectos a nivel epigenético determinando consecuencias neurológicas a largo plazo. Las necesidades de hierro durante el embarazo se estiman en 27 mg/día. El hierro hemo que se absorbe mejor se encuentra en la carne. La determinación de ferritina en sangre de cordón umbilical permite evaluar los depósitos de hierro alcanzados durante la etapa fetal. Sus niveles se asociaron con efectos a largo plazo sobre el desarrollo infantil. Objetivos: el objetivo de este estudio de carácter exploratorio es determinar la relación entre el consumo de carnes rojas durante el tercer trimestre de gestación y el nivel de ferritina en el cordón umbilical. Métodos: se realizó un estudio observacional descriptivo con datos recolectados prospectivamente durante un año en el Departamento de Neonatología del Centro Hospitalario Pereira Rossell (CHPR) en Montevideo, Uruguay. Un total de 188 pacientes cumplieron los criterios de inclusión. Se extrajo sangre del cordón umbilical después de un pinzamiento estricto del cordón pasado un minuto de vida. La ferritina se midió utilizando el método de quimioinmunofluorescencia. Se aplicó una encuesta nutricional materna (cualitativo-cuantitativa) que midió la frecuencia de consumo de alimentos con fuente de hierro y las cantidades aproximadas consumidas durante el último trimestre del embarazo. Esta encuesta se centró en el consumo materno de carne vacuna como principal fuente de hierro hemínico en Uruguay. Se analizó la relación entre estas variables. Resultados: el déficit latente de hierro (ferritina en el cordón umbilical <100 ng/ml) se asoció con un menor consumo de carne vacuna durante el embarazo. Valor p de Fisher: 0,0133, OR: 3,71, IC del 95% (1,25-11,05). Conclusiones: este estudio considera adecuada la evidencia que relaciona que los niveles bajos de consumo total de hierro y de carne vacuna durante el tercer trimestre de gestación determinarán un mayor riesgo de déficit latente de hierro y de ferritina medido en el cordón umbilical. Los niveles descendidos de ferritina en cordón umbilical se asocian con un mayor riesgo de efectos adversos a largo plazo sobre la mielinización y el desarrollo neurocognitivo.

Background: nutrition during pregnancy impacts the foetus and the newborn health, it has consequences at the epigenetic level and determines long-term neurological consequences. Iron requirements during pregnancy are estimated at 27 mg/day. Iron is blood absorption from is most efficient from beef. Umbilical cord blood ferritin levels can be used to assess iron deposits reached during the foetal stage. Ferritin levels are linked to the child's long-term development. Objective: this exploratory study's objective is to determine the relationship between beef consumption during the first quarter of pregnancy and ferritin levels in the umbilical cord. Methods: we carried out a descriptive, observational study with prospectively collected data for one-year at the Neonatology Department of the Pereira Rossell Hospital Center (CHPR) in Montevideo, Uruguay. A total of 188 patients met the inclusion criteria. We extracted umbilical cord blood after a strict cord clamping after one minute of life. Ferritin was measured using the chemoimmunofluorescence method. We carried out a maternal nutritional survey using a qualitative-quantitative method and measured the frequency and approximate quantity of iron source food consumption during the last quarter of pregnancy. This survey was focused on maternal beef consumption as the major heme iron source in Uruguay. We analyzed the relationship between these variables. Results: latent iron deficiency (ferritin in the umbilical cord <100 ng / ml) was associated with lower beef consumption during pregnancy. Fisher p-value: 0.0133, OR: 3.71, 95% CI (1.25 - 11.05). Conclusions: this study agrees with the evidence that shows that low levels of total iron and beef consumption during pregnancy determine an increased risk of latent iron deficiency and lower levels of ferritin in newborns, and therefore, greater risk of long-term adverse effects on myelination and neurocognitive development.

Contexto: a nutrição durante a gravidez tem impacto sobre a saúde do recém-nascido, com efeitos no nível epigenético, determinando consequências neurológicas a longo prazo. As necessidades de ferro durante a gravidez são estimadas em 27 mg / dia. O ferro heme de melhor absorção e aquele encontrado na carne vacuna. A determinação da ferritina no sangue do cordão umbilical permite avaliar os depósitos de ferro atingidos na fase fetal. Seus níveis foram associados a efeitos de longo prazo no desenvolvimento das crianças. Objetivos: o objetivo deste estudo exploratório é determinar a relação entre o consumo de carne vermelha durante o terceiro trimestre de gestação e o nível de ferritina no cordão umbilical. Métodos: foi realizado um estudo observacional descritivo com dados coletados prospectivamente durante um ano no Departamento de Neonatologia do Centro Hospitalar Pereira Rossell (CHPR) em Montevidéu, Uruguai. Um total de 188 pacientes cumpriram os critérios de inclusão. O sangue do cordão umbilical foi coletado após clampeamento estrito do cordão após um minuto de vida da criança. A ferritina foi medida pelo método de quimioimunofluorescência. Aplicamos um inquérito nutricional materno (qualitativo-quantitativo) que mediu a frequência de consumo de alimentos com fonte de ferro e as quantidades aproximadas consumidas durante o último trimestre da gravidez. Esta pesquisa enfocou o consumo materno de carne bovina como principal fonte de ferro heme no Uruguai. A relação entre essas variáveis foi analisada. Resultados: a deficiência latente de ferro (ferritina no cordão umbilical <100 mg / ml) foi associada ao menor consumo de carne bovina durante a gestação. Valor de p de Fisher: 0,0133, OR: 3,71, IC 95% (1,25-11,05). Conclusões: este estudo concorda com as evidências que relacionam que os baixos níveis de ferro total e consumo de carne bovina durante o terceiro trimestre de gestação determinam um maior risco de déficit de ferro latente e ferritina mensurado no cordão umbilical. A redução dos níveis de ferritina no cordão umbilical está associada a um risco aumentado de efeitos adversos de longo prazo na mielinização e no desenvolvimento neurocognitivo.

High estradiol and low testosterone levels are associated with critical illness in male but not in female COVID-19 patients: a retrospective cohort study.

Male sex was repeatedly identified as a risk factor for death and intensive care admission. However, it is yet unclear whether sex hormones are associated with disease severity in COVID-19 patients. In this study, we analysed sex hormone levels (estradiol and testosterone) of male and female COVID-19 patients (n = 50) admitted to an intensive care unit (ICU) in comparison to control non-COVID-19 patients at the ICU (n = 42), non-COVID-19 patients with the most prevalent comorbidity (coronary heart diseases) present within the COVID-19 cohort (n = 39) and healthy individuals (n = 50). We detected significantly elevated estradiol levels in critically ill male COVID-19 patients compared to all control cohorts. Testosterone levels were significantly reduced in critically ill male COVID-19 patients compared to control cohorts. No statistically significant differences in sex hormone levels were detected in critically ill female COVID-19 patients, albeit similar trends towards elevated estradiol levels were observed. Linear regression analysis revealed that among a broad range of cytokines and chemokines analysed, IFN-γ levels are positively associated with estradiol levels in male and female COVID-19 patients. Furthermore, male COVID-19 patients with elevated estradiol levels were more likely to receive ECMO treatment. Thus, we herein identified that disturbance of sex hormone metabolism might present a hallmark in critically ill male COVID-19 patients.

Impact of Time to Castration Resistance on Survival in Metastatic Hormone Sensitive Prostate Cancer Patients in the Era of Combination Therapies.

BACKGROUND: To evaluate the impact of time to castration resistance (TTCR) in metastatic hormone-sensitive prostate cancer (mHSPC) patients on overall survival (OS) in the era of combination therapies for mHSPC. MATERIAL AND METHODS: Of 213 mHSPC patients diagnosed between 01/2013-12/2020 who subsequently developed metastatic castration resistant prostate cancer (mCRPC), 204 eligible patients were analyzed after having applied exclusion criteria. mHSPC patients were classified into TTCR <12, 12-18, 18-24, and >24 months and analyzed regarding OS. Moreover, further OS analyses were performed after having developed mCRPC status according to TTCR. Logistic regression models predicted the value of TTCR on OS. RESULTS: Median follow-up was 34 months. Among 204 mHSPC patients, 41.2% harbored TTCR <12 months, 18.1% for 12-18 months, 15.2% for 18-24 months, and 25.5% for >24 months. Median age was 67 years and median PSA at prostate cancer diagnosis was 61 ng/ml. No differences in patient characteristics were observed (all p>0.05). According to OS, TTCR <12 months patients had the worst OS, followed by TTCR 12-18 months, 18-24 months, and >24 months, in that order (p<0.001). After multivariable adjustment, a 4.07-, 3.31-, and 6.40-fold higher mortality was observed for TTCR 18-24 months, 12-18 months, and <12 months patients, relative to TTCR >24 months (all p<0.05). Conversely, OS after development of mCRPC was not influenced by TTCR stratification (all p>0.05). CONCLUSION: Patients with TTCR <12 months are at the highest OS disadvantage in mHSPC. This OS disadvantage persisted even after multivariable adjustment. Interestingly, TTCR stratified analyses did not influence OS in mCRPC patients.

Epidemiology, clinical characteristics, and outcome of candidemia in critically ill patients in Germany: a single-center retrospective 10-year analysis.

BACKGROUND: Despite advances in the management of bloodstream infections (BSI) caused by Candida spp., the mortality still remains high in critically ill patients. The worldwide epidemiology of yeast-related BSI is subject to changing species distribution and resistance patterns, challenging antifungal treatment strategies. The aim of this single-center study was to identify predictors of mortality after 28 and 180 days in a cohort of mixed surgical and medical critically ill patients with candidemia. METHODS: Patients, who had been treated for laboratory-confirmed BSI caused by Candida spp. in one of 12 intensive care units (ICU) at a University hospital between 2008 and 2017, were retrospectively identified. We retrieved data including clinical characteristics, Candida species distribution, and antifungal management from electronic health records to identify risk factors for mortality at 28 and 180 days using a Cox regression model. RESULTS: A total of 391 patients had blood cultures positive for Candida spp. (incidence 4.8/1000 ICU admissions). The mortality rate after 28 days was 47% (n = 185) and increased to 60% (n = 234) after 180 days. Age (HR 1.02 [95% CI 1.01-1.03]), a history of liver cirrhosis (HR 1.54 [95% CI 1.07-2.20]), septic shock (HR 2.41 [95% CI 1.73-3.37]), the Sepsis-related Organ Failure Assessment score (HR 1.12 [95% CI 1.07-1.17]), Candida score (HR 1.25 [95% CI 1.11-1.40]), and the length of ICU stay at culture positivity (HR 1.01 [95% CI 1.00-1.01]) were significant risk factors for death at 180 days. Patients, who had abdominal surgery (HR 0.66 [95% CI 0.48-0.91]) and patients, who received adequate (HR 0.36 [95% CI 0.24-0.52]) or non-adequate (HR 0.31 [95% CI 0.16-0.62]) antifungal treatment, had a reduced mortality risk compared to medical admission and no antifungal treatment, respectively. CONCLUSIONS: The mortality of critically ill patients with Candida BSI is high and is mainly determined by disease severity, multiorgan dysfunction, and antifungal management rather than species distribution and susceptibility. Our results underline the importance of timely treatment of candidemia. However, controversies remain on the optimal definition of adequate antifungal management.

Pro-inflammatory Ca++-activated K+ channels are inhibited by hydroxychloroquine.

Antimalarials have demonstrated beneficial effects in Systemic Lupus Erithematosus and Rheumatoid Arthritis. However, the mechanisms and the molecular players targeted by these drugs remain obscure. Although hydroxychloroquine (HCQ) is a known ion channel inhibitor, this property has not been linked to its anti-inflammatory effects. We aimed to study whether HCQ inhibits pro-inflammatory ion channels. Electrophysiology experiments demonstrated that HCQ inhibited Ca++-activated K+ conductance in THP-1 macrophages in a dose-dependent manner. In macrophages, ATP-induced K+ efflux plays a key role in activating the NLRP3 inflammasome. ATP-induced IL-1beta secretion was controlled by the KCa1.1 inhibitor iberiotoxin. NS1619 and NS309 (KCa1.1 and KCa3.1 activators respectively) induced the secretion of IL-1beta. This effect was inhibited by HCQ and also by iberiotoxin and clotrimazol (KCa3.1 inhibitor), arguing against off-target effect. In vitro, HCQ inhibited IL-1beta and caspase 1 activation induced by ATP in a dose-dependent manner. HCQ impaired K+ efflux induced by ATP. In vivo, HCQ inhibited caspase 1-dependent ATP-induced neutrophil recruitment. Our results show that HCQ inhibits Ca++-activated K+ channels. This effect may lead to impaired inflammasome activation. These results are the basis for i) a novel anti-inflammatory mechanism for HCQ and ii) a new strategy to target pro-rheumatic Ca++-activated K+ channels.

Does galactomannan testing increase diagnostic accuracy for IPA in the ICU? A prospective observational study.

BACKGROUND: An algorithm for distinguishing invasive pulmonary aspergillosis (IPA) in critically ill patients (AspICU) has been proposed but not tested. METHODS: This was a prospective observational study applying the AspICU protocol to patients with positive Aspergillus culture (PAC group) and those with negative aspergillus culture but positive galactomannan test in respiratory tract samples (only positive galactomannan (OPG group)). Patients underwent a standardized diagnostic workup with bronchoscopy, computed tomography (CT), and galactomannan determination in serum and bronchoalveolar lavage fluid (BALF). RESULTS: We included 85 patients in the study. Of these, 43 had positive aspergillus cultures and 42 patients had only a positive galactomannan test. There were no statistically significant differences in baseline characteristics, underlying conditions or ICU scores between the two groups. The galactomannan titre in BALF was significantly higher in the positive aspergillus culture (PAC) group (enzyme immunoassay (EIA) 5.9, IQR 3.2-5.7) than in the OPG group (EIA 1.7, IQR 0.9-4.5) (p < 0.001). Classic features of IPA were detected on CT in 37.5 % and 36.6 % of patients in the PAC and OPG groups, respectively. There were no statistically significant differences between the PAC and the OPG group in relation to AspICU or European Organization for the Research and Treatment of Cancer (EORTC) criteria. A positive aspergillus culture was a stronger trigger for initiating antimycotic treatment than positive BALF galactomannan: 88.4 % of patients in the PAC group were regarded by clinicians as having IPA and received antimycotic treatment as opposed to 59.5 % in the OPG group (p = 0.002). The 180-day mortality was 58.1 % in the PAC group and 59.5 % in the OPG group. CONCLUSIONS: The inclusion of BALF galactomannan as an additional entry criterion for the AspICU clinical algorithm could increase the diagnostic sensitivity for IPA in ICU patients. TRIAL REGISTRATION: The study was registered at ClinicalTrials.gov (registration number NCT01866020 ) on 27 May 2013.

Bioconcentraciones foliares de elementos minerales en Lippia alba (salvia morada) / Foliar bioconcentrations of mineral elements in Lippia alba (purple salvia)

Introducción: la salvia morada es un subarbusto aromático, que crece de modo espontáneo en América Central y del Sur. Frecuentemente es cultivada en jardines como ornamental, por su intenso aroma y sus propiedades medicinales y culinarias. No se encontraron estudios sobre parámetros nutricionales en esta especie. Objetivos: determinar las bioconcentraciones foliares de elementos minerales en Lippia alba (Mill.) N. E. Br. ex Britton & P. Wilson que crece naturalmente en el bioambiente del norte de la provincia de Corrientes. Métodos: se evaluaron muestras foliares de plantas de Lippia alba de más de 2 años de implantación. Las variables analizadas fueron las concentraciones foliares de nitrógeno, fósforo, potasio, azufre, cinc, cobre, hierro y manganeso. La determinación de nitrógeno se realizó mediante el método de Kjeldhal; el fósforo y azufre por espectrometría de absorción molecular, y el resto de los elementos por espectrometría de absorción atómica. Para el análisis de los resultados se aplicaron herramientas de estadística descriptiva, mediante el programa Infostat. Resultados: las bioconcentraciones foliares de esta especie variaron entre 2,39 y 2,33 % de N; 0,2-0,4 % de P; 1,0-3,0 % de K; 0,12-0,49 % de S; 150-300 ppm de Fe, 150-300 ppm de Mn, hasta 50 ppm de Zn; y hasta 70 ppm de Cu. Las concentraciones foliares medias de nitrógeno, manganeso y cobre resultaron mayores en los meses de primavera y verano decreciendo en los meses de otoño e invierno. Las concentraciones foliares medias de fósforo y potasio se presentaron constantes durante los 3 años. El azufre, el hierro y el cinc, se acumularon en las hojas, especialmente en los meses de invierno. Conclusiones: se observaron variaciones estacionales de las concentraciones foliares medias estudiadas.

Introduction: purple salvia is an aromatic shrub that grows wild in Central and South America. It is often found in gardens for ornamental purposes, due to its strong fragrance and medicinal and culinary properties. No studies were found about nutritional parameters for this species. Objectives: determine the foliar bioconcentrations of mineral elements in Lippia alba (Mill.) N. E. Br. ex Britton & P. Wilson, naturally growing in the bio-environment of the north of Corrientes province. Methods: an evaluation was conducted of foliar samples of Lippia alba of more than 2 years after planting. The variables analyzed were foliar concentrations of nitrogen, phosphorus, potassium, sulfur, zinc, copper, iron and manganese. Nitrogen was determined by the Kjeldahl method, phosphorus and sulfur by molecular absorption spectrometry, and the rest of the elements by atomic absorption spectrometry. Descriptive statistics tools were used for the analysis of results, which was based on the InfoStat program. Results: foliar bioconcentrations ranged between 2.39 and 2.33 % N, 0.2-0.4 % P, 1.0-3.0 % K, 0.12-0.49 % S, 150-300 ppm Fe, 150-300 ppm Mn, up to 50 ppm Zn, and up to 70 ppm Cu. Mean foliar concentrations of nitrogen, manganese and copper were higher in spring and summer months, and lower in autumn and winter months. Mean foliar concentrations of phosphorus and potassium remained stable throughout the 3 years. Concentration of sulfur, iron and zinc in leaves was higher in winter months. Conclusions: seasonal variations were found in the mean foliar concentrations studied.

Concentraciones foliares y dinámica estacional de nutrientes en Petiveria alliacea (L.) / Foliar concentrations and seasonal dynamics of nutrients in Petiveria alliacea (L.)

Introducción: Petiveria alliacea (L.) -pipí, anamú o guiné- es una planta de la familia Phytolaccaceae, utilizada como medicamento herbolario para diferentes enfermedades, comercializada como suplemento nutricional e inmunomodulador. Tiene propiedades antiinflamatorias, inmunoestimulantes, analgésicas, antimicrobianas, hipoglucemiantes, anticonvulsivantes y abortivas. El análisis químico de tejidos, como técnica de diagnóstico, permite conocer la situación nutrimental y obtener in situ los niveles nutricionales de referencia, con el fin de interpretar correctamente los análisis foliares para cada sustrato y momento fenológico del cultivo. Objetivo: determinar las concentraciones foliares y la dinámica estacional del nitrógeno, fósforo, potasio, azufre, hierro, cobre, manganeso y cinc, en plantas de P. alliacea cultivadas en el bioambiente del norte de la provincia de Corrientes. Métodos: el material genético evaluado han sido plantas de Petiveria sp. de 2 años de implantación, durante las campañas 2005-2006-2007. Para el análisis de los resultados se aplicaron herramientas de estadística descriptiva, mediante el programa Infostat. Resultados: las concentraciones foliares de nitrógeno, potasio y azufre tienden a ser mayores en los meses de primavera y verano. La concentración de fósforo se muestra constante durante el año. El hierro, el manganeso y el cinc, se acumulan especialmente en los meses de invierno, mientras que las de cobre disminuyen. Conclusiones: las concentraciones foliares de nutrientes en plantas de Petiveria alliacea que crecen en el norte de la provincia de Corrientes se encuentran dentro de los valores considerados normales para otras especies cultivadas, y su dinámica estacional está ligada a las condiciones ambientales fundamentalmente.

Introduction: Petiveria alliacea (L.) -called pipí, anamú or guiné- is a member of the family Phytolaccaceae used as herbal medicine for different illnesses and marketed as dietary supplement and immunomodulator. Its properties have been reported as anti inflammatory, immunostimulant, analgesic, antimicrobial, hypoglycemic, anticonvulsive and abortive. Chemical analysis of tissues is a diagnostic technique that allows using the mineral concentration as an indicator of nutritional status and obtaining in situ nutrient levels of reference in order to interpret foliar analysis for each substrate and phenological phase of the crop. Objective: to determine the foliar concentration and the seasonal dynamic of nitrogen, phosporus, potassium, sulphur, iron, cupper, manganese, and zinc in Petiveria alliacea plants grown in the bioenvironment on the north of Corrientes fprovince. Methods: the genetic material was 2 years-old Petiveria sp. plants and was evaluated from 2005 to 2007. Infostat program-based summary statistics served to analyze the results. Results: the foliar concentrations of nitrogen, potassium and sulfur tend to be higher in the spring and the summer. The foliar phosphorus concentration is invariable throughout the year. Iron, manganese and zinc are accumulated specially in the winter months, whereas the copper concentrations decreased significantly in the autumn and the winter. Conclusions: foliar concentrations of nutrients in Petiveria alliacea plants growing on the north of Corrientes province are within the range of normal values for other species, and the seasonal dynamics of these plants is mainly linked to the environmental conditions.

Biossegurança: grau de importância na visão dos alunos do curso de graduação de Odontologia da Univille / Biosafety: degree of importance in the point ofview of undergraduate dental students from Univille

Introdução e objetivo: O presente estudo avaliou o grau de importância da biossegurança na visão dos alunos do curso de graduação de Odontologia da Universidade da Região de Joinville (Univille).Material e métodos: A amostra deste trabalho foi constituída por 142 alunos do 1.º ao 5.º ano do curso de graduação em Odontologia,no qual foi solicitada aos estudantes a assinatura do termo de consentimento livre e esclarecido, para responder um questionário com 13 perguntas fechadas e duas perguntas abertas sobre práticas clínicas odontológicas e conceitos de biossegurança. Resultados: Dos 142 alunos pesquisados, 71,83% eram do sexo feminino e 28,17%do masculino. O fato mostra o aumento de estudantes mulheres naárea da saúde. A grande maioria dos estudantes demonstrou ter conhecimentos básicos sobre as normas de biossegurança (82,39%) ea utilização de equipamentos de proteção individual (EPIs) (75,35%).Conclusão: De acordo com os limites do presente estudo, pôde-se constatar que os alunos do curso de graduação em Odontologia da Univille demonstraram ter conhecimentos da importância das normas de biossegurança em suas atividades clínicas odontológicas diárias.

Introduction and objective: This study evaluated the degree of importance regarding biosafety in the point of view of undergraduate dental students from the University of the Region of Joinville? Univille. Material and methods: The sample was composed of142 undergraduate dental students from first to fifth year, who were asked to sign the term of free and clarified assent in order to answer a questionnaire with 13 closed-ended and 2 open-ended questions regarding dental clinical practice and concepts of biosafety. Results:71.83% of the 142 students surveyed were female while 28.17% were male, what shows the increase of female students in the health area.Most students showed to have basic knowledge of biosafety standards(82.39%) and the use of personal protection equipments PPEs(75.35%). Conclusion: Considering the limitations of this study, itwas possible to note that undergraduate dental students from Univille showed to be aware of the importance of biosafety standards in their daily clinical practices.

Molecular mechanism of antioxidant synergism of tocotrienols and carotenoids in palm oil.

During repeated deep-fat frying of potato slices at 163 degrees C in yellow or red palm olein of comparable fatty acid profiles, the oxidative stability (peroxide value and anisidine value) of the palm oleins was similar, and in yellow palm olein, the rate of antioxidant depletion decreased in the order gamma-T3 > alpha-T3 > delta-T3 (T3, tocotrienol). In red palm olein, which had a total tocopherol/tocotrienol content of 1260 vs 940 ppm in yellow palm olein and a corresponding longer induction period in the Rancimat stability test at 120 degrees C, only depletion of gamma-T3 was significant among the phenols during frying and slower as compared to that in yellow palm olein. The carotenes in the red palm olein were depleted linearly with the number of fryings, apparently yielding an overall protection of the phenols. In antioxidant-depleted palm olein and in phospholipid liposomes with added increasing concentrations of phenols, gamma-T3 was found to be a better antioxidant than alpha-T3. alpha-T3 and alpha-T (T, tocopherol) had a similar antioxidant effect in antioxidant-depleted palm olein in the Rancimat stability test, while in the liposomes the ordering as determined by induction period for the formation of conjugated dienes was gamma-T3 > alpha-T3 > alpha-T. The addition of 100-1000 ppm beta-carotene to antioxidant-depleted palm olein or liposomes (lycopene also tested) did not provide any protection against oxidation. In the liposomes, synergistic interactions were observed between beta-carotene or lycopene and alpha-T, alpha-T3, or gamma-T3 for carotene/phenol ratios of 1:10 and 1:2 but not for 1:1. In chloroform, carotenes were regenerated by tocopherols/tocotrienols from carotene radicals generated by laser flash photolysis as shown by transient absorption spectroscopy, suggesting that carotenes rather than phenols are the primary substrate for lipid-derived radicals in red palm olein, in effect depleting carotenes prior to phenols during frying. Regeneration of carotenes by the phenols also explains the synergism in liposomes. In the laser flash photolysis experiments, gamma-T3 was also found to be faster in regenerating carotenes than alpha-T3 and alpha-T.

Os efeitos dos fatores hormonais nos tecidos periodontais / The effects of sexual hormone factors in periodontal tissues

Os autores apresentam um caso clínico de gengivite associada à placa bacteriana, provavelmente influenciada por fatores hormonais (puberdade). São abordados no presente relato os aspectos clínicos, bem como o resultado obtido após a realização de tratamento adequado

The authors present a clinical case of gingivitis associated to dental plaque, probably influenced by sexual hormones (puberty) factors. Clinical aspects, as well as the results after adequate, treatment are approached in the present report

Estudo da prevalência de cárie dentária na dentição permanente em crianças de 6 a 12 anos da rede pública de ensino no município de Joinville (SC) / Evaluated the prevalence of dental caries in school children the public net education in Joinville (SC)

Este estudo avaliou a prevalência da cárie e o índice de CPO-D em 640 crianças escolares de 6 a 12 anos da rede pública de ensino, na cidade de Joinville (SC). A utilização de água de abastecimento fluoretada (método sistêmico e contínuo), somada a pastas dentais, bochechos ou suplementos, determinou baixos índices de cárie em Joinville. A cidade apresentou um CPO-F de 2, 6 a 12 anos na população estudada, o que está de acordo com o preconizado pela Organização Mundial de Saúde

This study evaluated the prevalence of caries and the index of CPOD in 640 school children between 6 and 12 years old of the public education in thecity of Joinville (SC). The fluorinated water use of supplying (systemic and continuous method), added the dental folders, mouths washing or supplements, determined low indices of caries in Joinville. The city presenteda CPOF of 2,6 to the 12 years old, what it is in accordance with the praisedone for the World-wide Organization of Health.

Estudo da incidência de fluorose dentária na dentição permanente no município de Joinville / Evaluated the incidence of dental fluoroses in school children the public net education in Joinville

Este estudo avaliou a incidência de fluorose dentária em 640 escolares, de 6 a 12 anos, da rede pública de ensino. Os dados obtidos permitiram determinar e estabelecer os índices comunitário e individual de fluorose, como preconizado por Dean e Arnold (1943), a prevalência de cárie dentária e o índice de CPO-D (dentes cariados, perdidos e obturados), relacionando cárie dentária e grau de fluorose. A utilização de água de abastecimento fluoretada, somada a pastas dentais, bochechos ou suplementos fluoretados em crianças de 6 a 12 anos, determinou baixos índices de cárie em Joinville, porém uma fluorose considerada entre leve e muito leve foi constatada na população estudada. A cidade apresentou fluorose média de 0,244 e CPO-D máximo de 2,6 aos 12 anos. O estudo concluiu que a fluoretação das águas e métodos tópicos de uso do flúor são medidas eficazes de combate a doença cárie, porém existe risco de fluorose, embora baixo. É prudente a realização de mais estudos para acompanhar a prevalência e a severidade da anomalia em Joinville, bem como o controle da concentração adequada de flúor nos sistemas públicos de fornecimento de água

This study evaluated the incidence of dental fluorosis in 640 six to twelve year-old school children of the public education net. The data allow the delimitation and establishment of community and individual fluorosis rates as preconized by Dean and Arnold (1943) [1], the prevalence of dental caries and the CPO-D rate, considering the ratio between dental caries and the fluorosis degree. It must be remembered that this net is submitted to the fluorine water application with topical application methods of fluoride. Besides this, the utilization of tooth paste, mouth rinse, or supplements, by the users, are efficient measures to prevent the caries disease, so there was a low denta lcaries rate in the studied population of Joinville, however there is alow risk of fluorosis. The city presented average fluorosis rate of 0.244 and CPO-D 2.6 to 12 years old. More studies are recommended inorder to observe the severity and prevalence of anomalies in Joinville as well as the control of the adequate fluoride concentration in thepublic water supply.