Potential of piperine for neuroprotection in sepsis-associated encephalopathy.

AIMS: Sepsis-associated encephalopathy (SAE) is a common complication that increases mortality and leads to long-term cognitive impairment in sepsis survivors. However, no specific or effective therapy has been identified for this complication. Piperine is an alkaloid known for its anti-inflammatory, antioxidant, and neuroprotective properties, which are important characteristics for treatment of SAE. The objective of this study was to evaluate the neuroprotective effect of piperine on SAE in C57BL/6 mice that underwent cecum ligation and perforation surgery (CLP). MAIN METHODS: C57BL/6 male mice were randomly assigned to groups that underwent SHAM surgery or CLP. Mice in the CLP group were treated with piperine at doses of 20 or 40 mg/kg for short- (5 days) or long-term (10 days) periods after CLP. KEY FINDINGS: Our results revealed that untreated septic animals exhibited increased concentrations of IL-6, TNF, VEGF, MMP-9, TBARS, and NLRP3, and decreased levels of BDNF, sulfhydryl groups, and catalase in the short term. Additionally, the levels of carbonylated proteins and degenerated neuronal cells were increased at both time points. Furthermore, short-term and visuospatial memories were impaired. Piperine treatment reduced MMP-9 activity in the short term and decreased the levels of carbonylated proteins and degenerated neuronal cells in the long term. It also lowered IL-6 and TBARS levels at both time points evaluated. Moreover, piperine increased short-term catalase and long-term BDNF factor levels and improved memory at both time points. SIGNIFICANCE: In conclusion, our data demonstrate that piperine exerts a neuroprotective effect on SAE in animals that have undergone CLP.

Occurrence and environmental risk assessment of 22 pesticides in Brazilian freshwaters.

Pesticide contamination in water resources is a global threat. Although usually found at low concentrations, pesticides raise considerable toxicological concerns, mainly when mixtures are considered. The occurrence of 22 pesticides (2,4 D, alachlor, aldicarb, aldrin, atrazine, carbendazim, carbofuran, chlordane, chlorpyrifos, DDT, diuron, glyphosate, lindane, mancozeb, methamidophos, metolachlor, molinate, profenofos, simazine, tebuconazole, terbufos, and trifluralin) was investigated, through consolidated database information, in surface freshwaters of Brazil. Moreover, scenarios of environmental risk assessment considering isolated compounds and mixtures were performed, as well as a meta-analytic approach for toxicity purposes. Pesticides in freshwater have been reported from 719 cities (12.9% of Brazilian cities), where 179 (3.2%) showed pesticide occurrence above the limit of detection or quantification. Considering cities with more than five quantified, 16 cities were prone to environmental risks considering individual risks. However, the number increased to 117 cities when the pesticide mixture was considered. The mixture risk was driven by atrazine, chlorpyrifos, and DDT. The national maximum acceptable concentrations (MAC) for nearly all pesticides are higher than the predicted no-effect concentration (PNEC) for the species evaluated, except aldrin. Our results show the need to consider mixtures in the environmental risk assessment to avoid underestimation and review MAC to protect aquatic ecosystems. The results presented here may guide the revision of the national environmental legislation to ensure the protection of Brazilian aquatic ecosystems.

Alcohol use disorder is associated with DNA methylation-based shortening of telomere length and regulated by TESPA1: implications for aging.

Chronic heavy alcohol consumption is associated with increased mortality and morbidity and often leads to premature aging; however, the mechanisms of alcohol-associated cellular aging are not well understood. In this study, we used DNA methylation derived telomere length (DNAmTL) as a novel approach to investigate the role of alcohol use on the aging process. DNAmTL was estimated by 140 cytosine phosphate guanines (CpG) sites in 372 individuals with alcohol use disorder (AUD) and 243 healthy controls (HC) and assessed using various endophenotypes and clinical biomarkers. Validation in an independent sample of DNAmTL on alcohol consumption was performed (N = 4219). Exploratory genome-wide association studies (GWAS) on DNAmTL were also performed to identify genetic variants contributing to DNAmTL shortening. Top GWAS findings were analyzed using in-silico expression quantitative trait loci analyses and related to structural MRI hippocampus volumes of individuals with AUD. DNAmTL was 0.11-kilobases shorter per year in AUD compared to HC after adjustment for age, sex, race, and blood cell composition (p = 4.0 × 10-12). This association was partially attenuated but remained significant after additionally adjusting for BMI, and smoking status (0.06 kilobases shorter per year, p = 0.002). DNAmTL shortening was strongly associated with chronic heavy alcohol use (ps < 0.001), elevated gamma-glutamyl transferase (GGT), and aspartate aminotransferase (AST) (ps < 0.004). Comparison of DNAmTL with PCR-based methods of assessing TL revealed positive correlations (R = 0.3, p = 2.2 × 10-5), highlighting the accuracy of DNAmTL as a biomarker. The GWAS meta-analysis identified a single nucleotide polymorphism (SNP), rs4374022 and 18 imputed ones in Thymocyte Expressed, Positive Selection Associated 1(TESPA1), at the genome-wide level (p = 3.75 × 10-8). The allele C of rs4374022 was associated with DNAmTL shortening, lower hippocampus volume (p < 0.01), and decreased mRNA expression in hippocampus tissue (p = 0.04). Our study demonstrates DNAmTL-related aging acceleration in AUD and suggests a functional role for TESPA1 in regulating DNAmTL length, possibly via the immune system with subsequent biological effects on brain regions negatively affected by alcohol and implicated in aging.

EPA/DHA and linseed oil have different effects on liver and adipose tissue in rats fed with a high-fat diet.

The incidence of cardiovascular diseases and metabolic disorders has increased worldwide. Clinical and experimental research has shown that the consumption of ω-3 FAs can be beneficial to metabolism in several ways, as they can act on metabolic pathways. Our objective was to evaluate the effect of treatment with linseed oil, a vegetable oil rich in alpha-linolenic acid, and EPA and DHA in different proportions (3:1 EPA:DHA, and 1:3 EPA:DHA), on the metabolic disorders induced by a high-fat diet (20 % lipids) in rats for 2 weeks, after 18 weeks of consumption of a high-fat diet. In 18 weeks, the high-fat diet increased blood glucose, systolic blood pressure, triglyceride concentration in the liver and adipose tissue, and impaired insulin sensibility without interfering in the weight of the animals. All treatments were effective in reducing the deposition of hepatic type III collagen, the proportion of ω-6/ω-3 in the liver and WAT (white adipose tissue), the proportion of area/number of adipocytes, and the gene expression of the ACC, FAS, and CPT1 enzymes. In addition, treatment with EPA and DHA reduced blood glucose, serum TNF-α concentration, amount of liver fat, degree of microsteatosis and type I collagen deposition in the liver, deposition of type I and III collagen in TA, gene expression of the transcription factor SREBP-1c, and increased hepatic binucleation. EPA in major proportion was more effective in reducing the area of adipocytes, hepatic triglyceride concentration, PPAR-α expression, and WAT fat weight. DHA in a major proportion reduced the concentration of MCP1 in WAT. LO treatment did not have any isolated effects. We concluded that EPA and DHA were more effective in treating metabolic damage than treatment with LO, leading to a more favorable metabolic profile.

Saúde mental de pessoas com diabetes no período da pandemia de COVID-19: revisão integrativa / Mental health of people with diabetes during the COVID-19 pandemic period: integrative review

Objetivo: Analisar estudos sobre a saúde mental de pessoas com diabetes no período da pandemia de COVID-19. Método:Revisão integrativa da literatura, com busca e seleção nas bases de dados MEDLINE via PubMed®, CINAHL-Ebsco, Web of Science, Embase, PsycINFO e Cochrane. Foram incluídos sete estudos primários, disponíveis na íntegra, sem delimitação temporal ou de idioma. Resultados: A pandemia da COVID-19 impactou negativamente na saúde mental de pessoas com diabetes, prevalecendo o desenvolvimento e a intensificação dos sintomas de ansiedade, depressão e estresse. Outros desfechos avaliados evidenciaram associação entre as medidas de isolamento adotadas para controle da infecção, o sofrimento psicológico e a presença de preocupações. Conclusão: Foi evidenciado que a pandemia da COVID-19 afetou substancialmente a saúde mental de indivíduos com diabetes, sendo o distanciamento social, o medo do contágio, os distúrbios do sono e da alimentação e as preocupações com familiares determinantes para maior prevalência de sofrimento mental

Objective: To analyze studies on the mental health of people with diabetes during the COVID-19 pandemic period. Method:Integrative literature review with search and selection in the following databases: MEDLINE via PubMed®, CINAHL-Ebsco, Web of Science, Embase, PsycINFO and Cochrane. Seven primary studies available in full without temporal or language delimitation were included. Results: The COVID-19 pandemic negatively impacted the mental health of people with diabetes. The development and intensification of anxiety, depression and stress symptoms prevailed. Other outcomes evaluated showed an association between the isolation measures adopted to control the infection, psychological distress and the presence of concerns.Conclusion: The COVID-19 pandemic substantially affected the mental health of individuals with diabetes. Social distancing, fear of contagion, sleep and eating disorders and concerns with family members were determinants of a higher prevalence of mental suffering.

Three-bestseller pesticides in Brazil: Freshwater concentrations and potential environmental risks.

Agricultural production in Brazil is favored by weather conditions and by the large amount of available land. Therefore, currently, Brazil is the second largest exporter of agricultural products globally. Pesticides are widely used in Brazilian crops due to their high efficiency, their low cost, and permissive legislation. However, pesticides tend to reach water resources threatening organisms and the water quality. Thereby, we aimed to review the surface freshwater concentrations of the three-bestseller pesticides in Brazil (glyphosate, 2,4D, and atrazine), and discuss the results with sales, legislation, toxicity and potential risks. For that, we performed a systematic review of quantitative studies of glyphosate, atrazine, and 2,4D in Brazilian freshwater and included monitoring data provided by the Brazilian Ministry of Health in our analysis. Finally, we calculated the risk assessment for the three pesticides. Only a few scientific studies reported concentrations of either of the three-bestseller pesticides in Brazilian freshwaters. Between 2009 and 2018, an increase in the sales of 2,4D, atrazine, and glyphosate was observed. It was not possible to evaluate the relation between concentrations and sales, due to limited number of studies, lack of standard criteria for sampling, individual environmental properties, and type of pesticide. Atrazine showed a higher toxicity compared to 2,4D and glyphosate. Regarding the environmental risks, 65%, 72%, and 94% of the Brazilian states had a medium to high risk to 2,4D, atrazine, and glyphosate, respectively. Finally, 80% of the Brazilian states evaluated showed a high environmental risk considering a mixture of the three pesticides. Although most of the environmental concentrations registered were below the allowed limits according to the Brazilian legislation, they are already enough to pose a high risk for the aquatic ecosystems. We, therefore, strongly recommend a revaluation of the maximum allowed values in the national surface freshwater Brazilian legislation.

Ectonucleotidases from trypomastigotes from different sources and various genetic backgrounds of Trypanosoma cruzi potentiate their infectivity and host inflammation.

Distinct populations of Trypanosoma cruzi interact with mammalian cardiac muscle cells causing different inflammation patterns and low heart functionality. During T. cruzi infection, the extracellular ATP is hydrolyzed to tri- and/or diphosphate nucleotides, based on the infectivity, virulence, and regulation of the inflammatory response. T. cruzi carries out this hydrolysis through the T. cruzi ectonucleotidase, NTPDase-1 (TcNTPDase-1). This study aimed to evaluate the role of TcNTPDase-1 in culture rich in metacyclic trypomastigote forms (MT) and cell culture-derived trypomastigote forms (CT) from Colombiana (discrete typing unit - DTU I), VL-10 (DTU II), and CL (DTU VI) strains of T. cruzi. For this, we measured TcNTPDase-1 activity in suramin-treated and untreated parasites and infected J774 cells and C57BL/6 mice with suramin pre-treated parasites to assess parasitic and inflammatory cardiac profile in the acute phase of infection. Our data indicated a higher TcNTPDase-1 activity for ATP in culture rich in metacyclic trypomastigote forms from Colombiana strain in comparison to those from VL-10 and CL strains. The cell culture-derived trypomastigote forms from CL strain presented higher capacity to hydrolyze ATP than those from Colombiana and VL-10 strains. Suramin inhibited ATP hydrolysis in all studied parasite forms and strains. Suramin pre-treated parasites reduced J774 cell infection and increased nitrite production in vitro. In vivo studies showed a reduction of inflammatory infiltrate in the cardiac tissues of animals infected with cell culture-derived trypomastigote forms from suramin pre-treated Colombiana strain. In conclusion, TcNTPDase-1 activity in trypomastigotes forms drives part of the biological characteristics observed in distinct DTUs and may induce cardiac pathogenesis during T. cruzi infection.

Effect of alcohol use disorder on cellular aging.

RATIONALE: Human telomeres consist of tandem repeats at chromosome ends which protect chromosomal DNA from degradation. Telomere shortening occurs as part of natural aging; however, life stressors, smoking, drug use, BMI, and psychiatric disorders could disrupt cell aging and affect telomere length (TL). In this context, studies have evaluated the effects of alcohol consumption on TL; however, results have been inconsistent, which may reflect diverse drinking cut-offs and categorizations. OBJECTIVES: To help clarify this, the present study addresses the association of TL with alcohol use disorder (AUD), drinking behaviors, lifetime stress, and chronological age. METHODS: TL was quantified as the telomere to albumin ratio (T/S ratio) obtained from peripheral blood DNA using the quantitative PCR assay, from 260 participants with AUD and 449 non-dependent healthy controls (HC) from an existing National Institute on Alcohol Abuse and Alcoholism (NIAAA) database. RESULTS: AUD participants showed shorter TL compared to HC with both, age, and AUD, as independent predictors as well as a significant AUD with age interaction effect on TL. TL was also associated with impulsiveness in AUD participants. We did not observe an association between TL and chronicity of alcohol use, alcohol doses ingested, or childhood trauma exposures in either AUD or HC, although very few HC reported a history of childhood trauma. CONCLUSION: Our results support previous findings of telomere shortening with chronic alcohol exposures and show both an effect of AUD on TL that is independent of age as well as a significant AUD by age interaction on TL. These findings are consistent with accelerated cellular aging in AUD.

Enriquecimento e fortificação de alimentos utilizando farinha de casca da manga (Mangifera indica) / Enrichment and fortification of foods using mango bark flour (Mangifera indica)

O Brasil é um dos maiores produtores de alimentos do mundo, mas há um desperdício desde a colheita até os centros de distribuição e durante o preparo. Os frutos adquiridos no fim da feira foram levados ao laboratório para higienização, despolpamento, as cacas foram secas, trituradas e peneiradas para obtenção da farinha e esta utilizadas na formulação dos cookies em diferentes concentrações. Os mesmos foram submetidos a análises físico-químicas, microbiológicas e sensoriais. Os resultados obtidos, pH variou 10,32 – 8,47, °brix 3,0. A aceitabilidade sensorial as formulações de 40% e 60% foram os mais aceitos pelos provadores. De acordo com os aspectos analisados o reaproveitamento da casca da manga na forma de farinha é viável, quanto à aceitabilidade do produto, além de agregar valor nutricional, aroma e o sabor natural do fruto.

Aplicação de checklist para verificar as condições higiênico-sanitárias na manipulação de alimentos fornecidos aos animais em um zoológico no Estado do Rio de Janeiro / Application of checklist to verify hygienic-sanitary conditions in the handling of foods provided to animals of a zoological in the State of Rio de Janeiro

Os zoológicos apresentam importância na conservação das espécies, tendo responsabilidade com os exemplares que são extremamente sensíveis fora do seu habitat natural. A inadequada manipulação dos alimentos pode comprometer a saúde e integridade dos animais mantidos em um zoológico. Através de checklist foram verificadas as condições de manipulação dos alimentos oferecidos aos animais em um zoológico do estado do Rio de Janeiro. Dentre as conformidades destacaram-se: Armazenamento de alimentos, Esgotamento sanitário e Controle integrado de vetores e pragas. Dentre as não conformidades: Higienização, Edificações e instalações, Documentação e registro e Manipuladores. Com 43% de adequações as dependências da cozinha foram classificadas Grupo C. Evidenciando a importância dos treinamentos dos responsáveis pela manipulação de alimentos.

Inclusão de fibra em iogurte funcional enriquecido com geleia / Inclusion of fiber in functional yoghurt enriched with jelly

O iogurte é considerado pelo mercado consumidor o derivado lácteo de maior aceitação e consumo e a incorporação de farinha de frutas ou de geleias de frutas pode ser uma alternativa que visa agregar valor tanto pelo sabor, quanto pelo aumento do tempo de vida de prateleira dos mesmos. Teve-se como objetivo formular iogurte tipo grego enriquecido com farinha de banana, saborizado com geleia de manga e avaliar as características físico-químicas e microbiológicas. As características nutritivas e físico-químicas da farinha da banana verde permitem sua utilização como fonte de fibra no iogurte preservando as características sensoriais e o emprego da geleia de manga resultou em boa aceitação.

Cultura de segurança do paciente em unidades de terapia intensiva: percepção de profissionais de saúde / Patient safety culture in intensive care units: the perception of health professionals

Objetivou-se avaliar a percepção da cultura de segurança do paciente sob a perspectiva de profissionais de Unidades de Terapia Intensiva. Trata-se de um estudo transversal realizado com 283 profissionais de saúde de hospitais de referência do estado do Ceará. Os dados foram coletados por meio do Safety Attitudes Questionnaire, o qual busca avaliar as atitudes de segurança no exercício profissional. No escore total do questionário, entre os hospitais, observou-se variação de valores entre 63,4 a 71,5, sendo considerado valor positivo escore igual ou maior que 75. Portanto, nenhuma instituição alcançou resultados positivos. Entre os seis domínios do questionário, "Clima de segurança", "Percepção da gerência" e "Condições de trabalho" apresentaram as médias mais baixas. Desta forma, constatou-se a necessidade de incentivo à cultura de segurança em diversos aspectos, principalmente nas atitudes gerenciais quanto à segurança do paciente e condições de trabalho.

The objective of this study was to evaluate how patient safety culture is perceived by professionals working in Intensive Care Units. "is is a cross-sectional study carried out with 283 health professionals from reference hospitals in the state of Ceará. "e data collection used the Safety Attitudes Questionnaire, which seeks to evaluate safety attitudes in professional activity. Among hospitals, the questionnaire showed scores ranging from 63.4 to 71.5, a positive score being equal to or greater than 75. "erefore, no institution achieved positive results. Among the six domains of the questionnaire, "Safety climate", "Management perception" and "Working conditions" presented the lowest averages. "us, this research veri!ed the need to encourage safety culture in several aspects, mainly regarding managerial attitudes towards patient safety and working conditions.

Doxycycline release and antibacterial activity from PMMA/PEO electrospun fiber mats

Abstract Objective: To investigate the use of polymethyl methacrylate (PMMA) electrospun fiber mats containing different amounts of polyethylene oxide (PEO) as a doxycycline delivery system and to test antibacterial activity against an oral pathogen. Methodology: PMMA powders or PEO (mol wt 200 Kd) (10,20,30% w/w/) were dissolved in N, N-dimethylformamide (DMF) to obtain a final polymer concentration of 15% in DMF (w/v). 2% Doxycycline monohydrate was added to the solutions and submitted to vortex mixing. The solution was transferred to a plastic syringe and fit into a nanofiber electrospinning unit. The parameters applied were: voltage at 17.2 kV; distance of 20 cm between the needle tip and the collector plate; target speed at 2 m/min; and transverse speed at 1cm/min. Syringe pump speed was 0.15 mm/min. The drug release analysis was performed by removing aliquots of the drug-containing solution (in PBS) at specific periods. Doxycycline release was quantified using RP-HPLC. Fiber mats from all groups had their antibacterial action tested against S. mutans based on inhibition halos formed around the specimens. The experiments were performed in triplicate. Gravimetric analysis at specific periods was performed to determine any polymer loss. Morphological characterization of the electrospun fibers was completed under an optical microscope followed by SEM analysis. Results: The addition of PEO to the PMMA fibers did not affect the appearance and diameter of fibers. However, increasing the %PEO caused higher doxycycline release in the first 24 h. Fibers containing 30% PEO showed statistically significant higher release when compared with the other groups. Doxycycline released from the fibers containing 20% or 30% of PEO showed effective against S. mutans. Conclusion: The incorporation of PEO at 20% and 30% into PMMA fiber mat resulted in effective drug release systems, with detected antibacterial activity against S. mutans.

Influência das variáveis antropométricas sobre a força muscular do assoalho pélvico na Incontinência Urinária / Influence of anthropometric variables on pelvic floor muscular strength in Urinary Incontinence

INTRODUÇÃO: A Incontinência Urinária (IU) é definida como qualquer perda involuntária de urina. O aumento do peso e as medidas de circunferências elevadas são fatores de risco para o desenvolvimento destes sintomas. OBJETIVO: Avaliar a influência das variáveis antropométricas (VAs) na força muscular do assoalho pélvico de mulheres com IU. MATERIAIS E MÉTODOS: Estudo transversal com amostragem de conveniência. Iniciada a avaliação com a anamnese, após aferição das VAs seguiu-se para avaliação funcional do assoalho pélvico (AFA). Aplicada correlação de Spearman, e para avaliar a influência das VAs na AFA realizou-se regressão linear múltipla. RESULTADOS: Avaliadas 12 voluntárias com IU, média de idade 56,9±13,2 anos e maior frequência 10 (83,3%) de incontinência urinária de esforço. Encontradas correlações moderadas e negativas entre VAs e a AFA [Índice de massa corporal (IMC) vs AFA (r= -0,582 p=0,020); Circunferência da Cintura (CC) vs AFA (r= -0,567 p=0,033); Circunferência do Quadril (CQ) vs AFA (r= -0,593 p=0,050); Circunferência Abdominal (CA) vs AFA (r= -0,657 p=0.001)]. Estes achados foram ratificados através da análise de regressão linear múltipla, onde há influência direta de 37% do IMC e CA na AFA das voluntárias com IU. CONCLUSÃO: Valores elevados das VAs estão relacionadas diretamente com um pior desempenho na AFA, em mulheres com incontinência urinária. [AU]

INTRODUCTION: Urinary Incontinence (UI) is defined as any involuntary loss of urine, weight gain and high circumference measures are risk factors for UI symptoms development. OBJECTIVE: To evaluate the influence of anthropometric variables on the pelvic floor muscular strength of women with UI. METHODS AND MATERIALS: Cross-sectional study with convenience sample. Data were collected during anamnesis and after obtaining anthropometric variables, pelvic floor functional evaluation (PFE) was done. A Spearman correlation was performed and to evaluate anthropometrics variables' influence on PFE we did a multiple linear regression. RESULTS: 12 volunteers with UI were evaluated, mean age of 56.9±13.2 years with a frequency of 10 (83.3%) with stress urinary incontinence. Moderate and negative correlations between anthropometrics variables and PFE were found [Body mass index (BMI) vs PFE (r= -0,582 p=0,020); Waist circumference (WC) vs PFE (r= -0.567 p=0.033); Hip circumference (HC) vs PFE (r= -0.593 p=0.050); Abdominal circumference (AC) vs PFE (r= -0.657 p=0.001)]. The correlations findings can be ratified through a multiple linear regression analysis, where there is a direct influence of 37% of BMI and AC on PFE in the volunteers with UI. CONCLUSION: Higher values of the anthropometric measures are directly related to a worse performance on PFE, High VA values are directly related to poor performance in AFA in women with urinary incontinence. [AU]

Evaluating the effects of refined carbohydrate and fat diets with acute ethanol consumption using a mouse model of alcoholic liver injury.

Alcoholism is a multifactorial and complex disorder responsible for 5.9% of deaths worldwide. Excessive consumption of ethanol (Et-OH) induces alcoholic liver disease (ALD), a condition comprising a spectrum of clinical signs and morphological changes, ranging from fatty liver (steatosis) to more severe forms of chronic liver injury. Secondary cofactors, such as nutritional and hepatotoxic comorbid conditions, can also contribute to liver disease development. Here we investigated the effects in the progression of ALD following short-term exposure to diet high in refined carbohydrates (HC), a high-sugar and -butter (HSB) hypercaloric diet and acute Et-OH consumption. HSB diet increased the body weight (BW) and adiposity independently of acute Et-OH consumption. HC diet did not affect BW but increased the adiposity, while acute Et-OH alone did not affect BW and adiposity. All groups of mice developed steatosis except the control group. Exposure to acute Et-OH and HSB diet increased the number of neutrophils and macrophages, and apoptosis in the liver. This combination also increased the number of circulating neutrophils and reduced mononuclear cells in the blood. Thus, short-term exposure to HSB diet and acute Et-OH intake is linked to increased liver injury. These findings offer important clues to understand the hepatic injuries associated with short exposure to hypercaloric diets and acute Et-OH.

One-year Clinical Evaluation of Resin Composite Restorations of Noncarious Cervical Lesions in Smokers.

PURPOSE: To evaluate the one-year clinical performance of composite restorations in noncarious cervical lesions placed in smoking and non-smokers using a multimode adhesive system with two adhesive strategies. MATERIALS AND METHODS: Among the selected cervical lesions, four experimental groups were formed based on the patients' smoking habit and bonding strategies with a multimode adhesive system (n = 38): G1: etchand- rinse in non-smokers; G2: selective enamel etching in non-smokers; G3: etch-and-rinse in smokers; G4: selective enamel etching in smokers. The restorations were paired, ie, each patient received at least two restorations. A nanofilled resin composite was applied and light cured incrementally in all groups by one operator. Two calibrated examiners evaluated the restorations at baseline, 6 and 12 months after placement. The modified USPHS criteria were used for evaluation. Data were analyzed using the chi-square (for associations between groups) and McNemar tests. RESULTS: No statistically significant difference was found between groups for the criteria of retention, marginal discoloration, color match, marginal integrity, or sensitivity after 6 and 12 months. The assessments over time showed a statistically significant difference only for marginal discoloration at 12 months for groups 1, 3, and 4 when compared to baseline (p = 0.031). There were no statistical differences for any criteria evaluated among smokers and non-smokers, except for color match, where a difference was found after the baseline evaluation. Regarding the adhesive strategy, etch-and-rinse resulted in a clinical performance similar to that of selective enamel etching over 12 months. CONCLUSION: Neither cigarette smoking habit nor adhesive strategy influenced the clinical performance of resin composite cervical restorations over the first year.

E-NTPDase (ecto-nucleoside triphosphate diphosphohydrolase) of Leishmania amazonensis inhibits macrophage activation.

Leishmania amazonensis, the causal agent of diffuse cutaneous leishmaniasis, is known for its ability to modulate the host immune response. Because a relationship between ectonucleotidase activity and the ability of Leishmania to generate injury in C57BL/6 mice has been demonstrated, in this study we evaluated the involvement of ecto-nucleoside triphosphate diphosphohydrolase (E-NTPDase) activity of L. amazonensis in the process of infection of J774-macrophages. Our results show that high-activity parasites show increased survival rate in LPS/IFN-γ-activated cells, by inhibiting the host-cell NO production. Conversely, inhibition of E-NTPDase activity reduces the parasite survival rates, an effect associated with increased macrophage NO production. E-NTPDase activity generates substrate for the production of extracellular adenosine, which binds to A2B receptors and reduces IL-12 and TNF-α produced by activated macrophages, thus inhibiting NO production. These results indicate that E-NTPDase activity is important for survival of L. amazonensis within macrophages, showing the role of the enzyme in modulating macrophage response and lower NO production, which ultimately favors infection. Our results point to a new mechanism of L. amazonensis infection that may pave the way for the development of new treatments for this neglected disease.

Prevalência de rubéola nos pacientes atendidos na unidade básica de saúde áurora, Campo Bom, RS / Prevalence of rubella in patients attended at the aurora basic unit health, Campo Bom, RS

Introdução: A rubéola é uma doença exantemática aguda, de origem viral. Sua transmissão ocorre por meio de contato de secreções de vias aéreas de pessoas infectadas ou por transmissão vertical. A síndrome da rubéola congênita (SRC) ocorreem função de infecção materna, durante os três primeiros meses de gestação, quando pode haver a invasão da placenta pelo vírus, com disseminação pelos tecidos embrionários, acarretando aborto espontâneo, natimortos e efeitos congênitos. A determinação dos anticorpos IgG e IgM específicos são muito importantes para o diagnóstico sorológico das infecções pela rubéola congênita pós-natal ou primária. O tratamento é relativo aos sintomas apresentados e o período de gestação da mãe. A vacinação é o procedimentomais eficaz, onde se adquire a munidade, que é duradoura. Objetivos: Verificar a prevalência de rubéola nos pacientes atendidos na Unidade Básica de Saúde (UBS), em Campo Bom, no Rio Grande do Sul (RS), e examinar os fatores de risco da doença e susceptibilidade na população estudada. Metodologia: Estudo transversal, utilizando dados de 94 pacientes atendidos na UBS, em Campo Bom (RS), entre maio de 2005 e maio de 2009. Para a realização dos testes, foram coletadas 5 mL de sangue periféricocom o paciente em jejum. Utilizou-se soro para dosar IgG e IgM antirrubéola, através do teste de ELISA. As amostras foram processadas no Laboratório de Biomedicina do Centro Universitário Feevale, em Novo Hamburgo (RS). Resultados: Dos 94 pacientes com faixa etária dos 2 aos 51 anos, 87 (92,5%) eram do sexo feminino, sendo que, 15destes (17,2%) estavam em período gestacional e 7 (7,4%) eram do sexo masculino. Dos pacientes analisados, 89 (94%) apresentaram IgG positivo. Conclusão: O presente estudo demonstrou que a população avaliada pode ter adquirido imunidade através deinfecção primária ou por vacinação, diminuindo, dessa maneira, o contágio nos grupos de risco

Introduction: Rubella is an acute exanthematous disease of viralorigin. It is transmission occurs through contact of airway secretionsof infected people or by vertical transmission. The congenital rubellasyndrome (CRS) occurs due to maternal infection during the first 3months of pregnancy, can occur when the invasion of the placentaby the virus to spread by the embryonic tissues, leading tomiscarriage, stillbirth and birth defects. The determination of IgGand IgM specific are very important for the serological diagnosis ofcongenital rubella infection by postnatal or primary. The treatmentis on the symptoms and the gestation period of the mother. Sincethe vaccination the most effective procedure, which is acquiredimmunity, which is long lasting. Objectives: To assess theprevalence of rubella in patients enrolled in the Basic Health Unitin Campo Bom, Rio Grande do Sul (RS). To examine the riskfactors and disease susceptibility in the population. Methodology:Cross-sectional study using data from 94 patients treated in theBasic Health Unit in Campo Bom (RS) between May 2005 and May2009. For the tests, were collected 5 mL of peripheral blood withthe patient fasting, serum was used for measuring rubella IgG andIgM by ELISA. The samples were processed at the Laboratory ofBiomedicine in the Feevale University Center in Novo Hamburgo(RS). Results: Of 94 patients, aged from 2 to 51, 87 (92.5%) werefemale, and 15 of these (17.2%) are in the gestational period and 7(7.4%) is male. Of the patients studied, 89 (94%) had positive IgGwhich could mean the effectiveness of public awareness of theneed for prevention of rubella. Conclusion: This studydemonstrates that the study population may have acquired immunitythrough primary infection or through vaccination, decreasing thespread of disease in risk groups.

Anormalidades no descenso da frequência cardíaca ao teste ergométrico em diabéticos / Heart rate decline anomalies during treadmil tests for diabetics

Fundamentos: Estudos demonstraram que a disfunção autonômica cardiovascular, medida através da variabilidade da frequência cardíaca, está associada a aumento do risco cardiovascular. Objetivos: Comparar a presença de disautonomia em diabéticos e não diabéticos através do teste ergométrico e determinar as variáveis preditoras de disautonomia em diabéticos. Métodos: Estudo retrospectivo, com pacientes que realizaram o teste ergométrico em caráter eletivo sob protocolo individualizado de rampa. Os pacientes foram estratificados em dois grupos: diabéticos (G1) e não diabéticos (G2). Foram definidos como disautonômicos os pacientes que obtiveram uma redução da FC no primeiro minuto da recuperação <12bpm. Os grupos G1 e G2 foram comparados. As variáveis com valores de p≤0,10 foram submetidas à análise de regressão logística. Resultados: Foram avaliados 1433 pacientes submetidos ao TE. A idade média foi 52,65±13,06 anos e variou entre 18-92 anos. Observaram-se, no G1, indivíduos mais velhos, obesos e dislipidêmicos. No teste ergométrico houve diferenças na FCR no primeiro minuto, FC do picodo esforço, número de METs e déficit cronotrópico. Submetidas as variáveis da população amostral, diabéticos e não diabéticos, à regressão logística, encontrou-se um único preditor de disautonomia: o número de METs (IC95% 0,083/0,031; p<0,0001); nos diabéticos, o único preditor independente da presença de disautonomia foi o índice de massa corporal (IC95%0,002-0,025; p=0,02). Conclusão: Indivídos diabéticos apresentam recuperação mais lenta da FC no pós-esforço que não diabéticos, evidenciando maior disautonomia e menor capacidade física; os diabéticos com excesso de peso têm maior comprometimento do sistema autonômico.