Corneal Higher Order Aberrations and Epithelial Remodeling With Femtosecond Laser-Assisted LASIK Topography-guided and Customized Asphericity Ablation in the Contralateral Eye: A Randomized, Double-Blind, Prospective Study.

PURPOSE: To evaluate refractive results, corneal higher order aberrations (HOAs), and epithelial remodeling in the preoperative and postoperative period of regular corneas that had topography-guided femtosecond laser-assisted laser in situ keratomileusis (LASIK) (Contoura WaveLight; Alcon Laboratories, Inc) and compare them with the contralateral eye that underwent ablation customized by asphericity (Custom-Q WaveLight; Alcon Laboratories, Inc) in myopic eyes with or without astigmatism. METHODS: A prospective, randomized, and double-blind study was conducted. Patients underwent preoperative and postoperative epithelial mapping and corneal tomography to assess the epithelial thickness map, HOAs of the corneal anterior surface, visual acuity, and refractive evaluation. RESULTS: This study enrolled 96 normal eyes of 48 patients. Uncorrected distance visual acuity of 20/20 or better was achieved in 97% of patients and gains in corrected distance visual acuity and effectiveness in correcting refractive astigmatism were similar in both techniques. Seventeen sectors of the corneal epithelium map were assessed by spectral-domain optical coherence tomography and no significant differences were found between techniques preoperatively and postoperatively (P > .05). HOA root mean square, coma Z3±1, trefoil Z3-3, and tissue consumption exhibited statistically significant between-technique differences (P < .05). CONCLUSIONS: The Contoura and Custom-Q techniques were similar with respect to refractive and visual outcomes after 3 months, as well as in epithelial remodeling. The Contoura provides lower postoperative HOA root mean square, coma Z3±1, and trefoil Z3-3 values, but the techniques showed no differences in the correction of the corneal astigmatic wavefront component and in the spherical aberration after 3 months. [J Refract Surg. 2023;39(11):751-758.].

O Ministério da Saúde em face da desordem da informação sobre a covid-19: uma análise do canal de informações Saúde sem Fake News / The Ministry of Health in the face of the information disorder on covid-19: an analysis of the information channel Saúde sem Fake News / El Ministerio de Salud frente al desorden informativo sobre la covid-19: un análisis del canal de información Saúde sem Fake News

A pandemia da covid-19 tem desafiado a humanidade, com implicações alarmantes. Por essa razão, também há uma forte preocupação com a circulação de informações falsas que atrapalham a luta contra a doença e comprometem o cumprimento de orientações seguras para prevenção e tratamento da infecção. Neste artigo, analisamos as ações empregadas para combater esse tipo de conteúdo através do projeto Saúde sem Fake News do Ministério da Saúde, enquanto estava ativo, e propomos a elaboração de uma nova categorização das verificações classificadas pelo canal como "Isto é fake news!", a partir do conceito e da metodologia de desordem da informação. Como resultado, identificamos que o canal adotou uma postura reativa que se limitava a atestar a veracidade ou falsidade das verificações, sem problematizar as suas especificidades, ignorando os aspectos essenciais para o efetivo combate da desinformação

The covid-19 pandemic has challenged humanity, with alarming implications. Thus, there is also a strong concern about the circulation of false information that hinders the fight against the disease and compromise the fulfillment of safe guidelines for the prevention and the treatment of infection. In this article we analyze the actions to fight against this type of content through the Saúde sem Fake News project of the Ministry of Health, while it was active, and propose the formulation of a new categorization of the checks classified by the channel as "This is fake news!", based on the concept and the methodology of information disorder. As a result, we identified that the channel adopted a reactive stance that limited itself to attesting to the veracity or the falsity of the verifications, not questioning their specificities, ignoring essential aspects for the effective fight against misinformation

La pandemia de covid-19 ha desafiado a la humanidad, con implicaciones alarmantes. Por eso, también existe una fuerte preocupación por la circulación de informaciones falsas que dificultan la lucha contra la enfermedad y compromete el cumplimiento de pautas seguras para la prevención y el tratamiento de la infección. En este artículo analizamos las acciones utilizadas para combatir este tipo de contenido a través del proyecto Saúde sem Fake News del Ministerio de Salud, mientras estuvo activo, y proponemos la elaboración de una nueva categorización de las verificaciones clasificadas por el canal como "Esta es una información falsa!" basándonos en el concepto y la metodología del desorden de la información. Como re-sultado, identificamos que el canal adoptó una postura reactiva, limitada a certificar la veracidad o falsedad de las verificaciones, sin analizar sus especificidades, ignorando aspectos esenciales para la lucha eficaz contra la desinformación

In vitro inhibition of a multispecies oral cavity biofilm by Syzygium aromaticum essential oil.

OBJECTIVE: To evaluate the anti-fungal activity of Syzygium aromaticum essential oil and its inhibition of a multispecies biofilm in patients with oral candidiasis. BACKGROUND: Inhibiting biofilm formation on the denture surface is an important practice for preventing denture stomatitis. MATERIALS AND METHODS: The anti-fungal activity against Candida albicans and non-albicans Candida species was evaluated through the microdilution method to define Minimal Inhibitory (MIC) and Fungicidal (MFC) Concentrations. Time-kill assay assessed growth kinetics of C. albicans based on pre-determined time points (0, 1, 2, 4, 6 and 24 hours). A multi-species biofilm was formed using human saliva from patients with oral candidiasis and anti-biofilm activity determined by Colony Forming Units per milliliter (CFU/mL) count, fluorescence microscopy with calcofluor white to observe yeast presence and structure, and metabolic activity by XTT (2,3-Bis-(2Methoxy-4-Nitro-5-Sulfophenyl)-2H-Tetrazolium-5-carboxanilide) reduction assay. RESULTS: The essential oil showed an anti-fungal activity against all Candida species (MIC 500-1000 µg/mL, MFC 1000-2000 µg/mL), and the time-kill assay showed that 2000 µg/mL (from 2 hours onward) and 1000 µg/mL (from 4 hours onward) concentrations had substantially lower yeast growth than the negative control. In the biofilm analysis, the essential oil had a lower CFU/mL count and a biofilm metabolic activity (91.4%) than seen with its negative control, and in both analyses, the essential oil was not significantly different from the positive control (chlorhexidine). Morphological analysis showed amorphous and fragmented cellular structures after treatment with the essential oil. CONCLUSION: Syzygium aromaticum essential oil had anti-fungal activities, reduced the Candida growth kinetics substantially and inhibited the multi-species biofilm formation.

Biological properties of Schinus terebinthifolia Raddi essential oil

Abstract Schinus terebinthifolia Raddi green fruits essential oil (EO) was evaluated regarding its phytochemical profile, antimicrobial and cytotoxic activities, and toxicity. Gas chromatography with mass spectrometry was applied to identify its constituents, thereafter the minimum inhibitory concentration, minimum bactericidal and fungicidal concentrations, and its antibiofilm activity were evaluated. The EO cytotoxicity was assessed in tumor and non-tumor human cells, and in vivo toxicity was evaluated in a Galleria mellonella model. The major constituents of S. terebinthifolia EO were alpha-phellandrene and beta-phellandrene. The EO had a weak activity against all strains of Candida albicans (MIC 1000µg/mL) and had no activity against non-albicans strains, bacteria, and C. albicans biofilm. Cytostatic activity against all tumor cell lines was shown. Additionally, cell viability remained at EO concentrations up to 62.5 µg/mL. At 16 mg/mL, 50% hemolysis was observed, and it had low toxicity in vivo. Overall, the S. terebinthifolia EO was characterized by low antimicrobial and antibiofilm activities, with no evidence of toxicity to human tumor and non-tumor cells

Tumefactive demyelinating lesions spectrum disorders and the potential role of contemporary disease modifying treatments: a case report.

Marburg disease is a fulminant variant of multiple sclerosis (MS), in which the diagnosis may be particularly difficult and with high rates of mortality. We describe the case of a women with a clinical picture, radiographic features, and neuropathological findings consistent with the classical descriptions of Marburg disease. Initially, our patient did not improved with the acute phase treatments but later showed a good response to natalizumab (NTZ) treatment. This report highlights not only the utility of brain biopsy in the accurate diagnosis of this challenging condition but also the potential role of NTZ as an effective therapeutic option.

Chemical Composition, Antibacterial and Antifungal Potential of an Extract From the Leaves of Guapira Graciliflora Mart. Against Oral Microorganisms of Dental Interest

Abstract Objective: To perform an in vitro analysis of antibacterial and antifungal potential of an alcoholic extract from the leaves of Guapira Graciliflora Mart. against oral microorganisms and determine its chemical composition. Material and Methods: A hydroalcoholic extract of the leaves form G. graciliflora was obtained through maceration, vacuum concentration and freeze-drying. Antibacterial and antifungal activities were evaluated against Streptococcus mutans, Streptococcus salivarius, Streptococcus oralis, Streptococcus parasanguinis, Streptococcus mitis and strains of Candida albicans using broth microdilution method. Phytochemical analysis determined the total phenolic compounds, protein concentration and total of sugars present in the extract. Results: G. Graciliflora demonstrated antifungal activity against the LM 11 and LM 410 clinical isolates of C. albicans (MIC 0.5 mg/mL and 2 mg/mL, respectively). The other microorganisms tested were resistant to the extract. The phytochemical analysis revealed 3% proteins, 13% total sugars and 17% phenolic compounds. Conclusion: G. Graciliflora has antifungal activity against clinical strains of C. albicans and exhibits proteins, sugars and phenolic compounds in its chemical composition.

Predição do resultado perinatal em gestações trigemelares / Prediction of perinatal outcome in triplet pregnancies

O presente estudo tem como objetivo descrever a mortalidade perinatal em gestações trigemelares, e analisar os fatores preditores dos seguintes desfechos: número de crianças vivas no momento da alta hospitalar, nenhuma criança viva no momento da alta hospitalar (desfavorável) e pelo menos uma criança viva no momento da alta hospitalar (favorável). Realizado de forma retrospectiva, envolveu pacientes com gestações trigemelares que apresentavam três fetos vivos na primeira ultrassonografia realizada após 11 semanas, no Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), no período de 1998 a 2012. Foram incluídas 67 pacientes das quais 77,6% referiam concepção espontânea. Quanto à corionicidade, 49,2% eram tricoriônicas e 50,8% eram não tricoriônicas; 16,4% apresentavam antecedente clínico prévio à gestação e 49,2% eram nulíparas. Em relação às intercorrências, a incidência de complicações obstétricas e/ou clínicas na gestação foi de 52,2%, e de intercorrências fetais, 25,2%, dentre as quais: 13,4% mal formações, 7,5% sindrome da transfusão feto fetal (STFF), 5,9% óbito fetal (OF), 4,5% insuficiência placentária, 4,4% fetos unidos, 1,5% feto acárdico. A idade gestacional média do parto foi de 31,9 ± 3,1 semanas, dos quais 83,5% foram cesáreas. O peso médio dos recém-nascidos vivos de 1.683 ± 508 g. Em relação à discordância de peso ao nascer: 57% apresentaram até 20%, 23,2% entre 20 e 30% e 19,6% acima de 30%. A taxa de óbitos fetais foi de 31,7%o nascimentos (IC95%: 11,7 - 67,8) e a mortalidade perinatal 249%o nascimentos (IC95%: 189 - 317). O tempo médio de internação dos recém-nascidos, que foram de alta vivos, foi de 29,3 ± 24,7 dias. A predição dos desfechos foi investigada por meio de regressão logística "stepwise", e incluiu as seguintes variáveis: idade materna, paridade (nulípara ou um ou mais partos anteriores), antecedente clínico, idade gestacional do primeiro ultrassonografia no HCFMUSP, corionicidade (gestações...

The present study, involving triplet pregnancies, describes perinatal mortality and investigates predictors of the following outcomes: number of children alive, no child alive (unfavorable outcome) and at least one child alive (favorable outcome) at hospital discharge. It is a retrospective study involving triplet pregnancies with live fetuses at the first ultrasound scan, performed after 11 weeks of gestation, at the Department of Obstetrics and Gynecology, São Paulo University Medical School Hospital, between 1998 and 2012. Final sample included 67 women, 77.6% reported spontaneous conception. Regarding the chorionicity, 49.2% were trichorionic; 16.4% had a medical complication prior to pregnancy, and 49.2% were nulliparous. The incidence of obstetric and/or clinical complications during pregnancy was 52.2%, and fetal complications occurred in 25.2%, (13.4% of major fetal abnormalities, 7.5% twin-to-twin transfusion syndrome, 5.9% stillbirth, 4.5% placental insufficiency, 4.4% conjoined twins and 1.5% acardic twin). The average gestational age at delivery was 31.9 ± 3.1 weeks, and 83.5% were cesarean. The average birthweight was 1683 ± 508 g and birth weight discordance up to 20% occurred in 57% of the cases; 23,2% had 20 to 30% discordance and 19.6%, was greater than 30%. The rate of stillbirth was 31.7%o births (95%CI: 11.7 - 67.8) and the perinatal mortality was 249%o births (95%CI: 189 - 317). The average hospital stay was 29.3 ± 24.7 days amongst children that were discharged alive. Stepwise logistic regression analysis was used to investigate prediction according to: maternal age, parity (nuliparous/multiparous), prior clinical history, gestational age at the first ultrasound scan at HCFMUSP, pregnancy chorionicity (trichorionic/non trichorionic), occurrence of clinical and/or obstetric complications during pregnancy, occurrence of fetal complications and gestational age at delivery. Significance level was set at 0.05. The number of children alive at...

O significado da AIDS na vida de mulheres profissionais de saúde: do indizível à realidade / The meaning of AIDS in the lives of women health professionals: from the unspeakable to the reality

Este estudo teve como objetivo compreender o significado da AIDS na vida das mulheresprofissionais se saúde. Emergiu da minha inquietação como mulher e enfermeira que, háquinze anos, busca encontrar respostas e alternativas de prevenção para enfrentar ocrescimento dos casos de AIDS em mulheres. Para o seu desenvolvimento optei pelarealização de uma pesquisa com abordagem qualitativa, tendo como referencial teórico oInteracionismo Simbólico e metodológico a Teoria Fundamentada nos Dados. Aamostragem teórica foi composta de oito mulheres profissionais de saúde, com vida sexualativa e parceria estável, por período igual ou superior a seis meses, inseridas em diferenteslocais do mercado formal de trabalho, tanto do setor público, quanto do privado, na cidadede Curitiba. A partir da análise e discussão dos dados obtidos, foi possível construir asseguintes categorias: aprendizagem sobre sexualidade; praticando a sexualidade;protegendo-se da AIDS e refletindo sobre a representação da AIDS, de onde seestabeleceu como categoria central O SIGNIFICADO DA AIDS NA VIDA DE MULHERESPROFISSIONAIS DE SAÚDE, DO INDIZÍVEL A REALIDADE. O contido neste estudoevidenciou de maneira análoga às demais mulheres, a forte herança cultural influenciandoas suas vidas a ponto de lhe conferirem certa imunidade ideológica contra esta doença.Além disso, apesar dos atores possuírem conhecimento sobre a epidemia, em relação aosdados epidemiológicos atuais que apontam para o crescimento da AIDS em mulheres comparceria estável, elas não se sentem vulneráveis e tão pouco adotam medidas deautoproteção frente ao HIV nas suas vidas.

This study has the objective of understanding the meaning of AIDS in the life of womenhealth professionals. It resulted from my uneasiness as woman and a nurse who, for fifteenyears now, has been searching for answers and prevention alternatives to face the increaseof AIDS cases in women. In developing it, I have opted for a research using the qualitativeapproach having as theoretical reference the Symbolic Interacionism and as methodologicalreference the Grounded Theory. The theoretical sampling was composed of eight healthprofessionals who have had active sexual life and a stable companion for a period equal orsuperior to six months and who are in different standings of the formal labour market, both inthe private and public sectors, in the city of Curitiba. Based on the analysis and discussion ofdata obtained it is possible to establish the following categories: learning about sexuality;practicing one's sexuality; protecting oneself from AIDS and reflecting on therepresentation of AIDS from which the central category was chose as being THEMEANING OF AIDS IN THE LIVES OF WOMEN HELTH PROFESSIONALS, FROM THEUNMENTIONABLE TO REALITY. The content of this study makes it evident that otherwomen have a similar cultural heritage influencing their lives to the point of their believingthat they have an ideological immunity to the disease. Moreover, participants don't feelvulnerable to the AIDS epidemic and do not adopt methods of self-protection against the HIVin their private lives, despite being aware of the epidemiological data available to them, whichpoint to an increase oh AIDS Cases in women with stable companions.

Ética e AIDS no local de trabalho: a construção do profissional enfermeiro / Ethics and AIDS in workplace: the contribution of the nurse

O objetivo deste ensaio é o de proporcionar uma reflexão referente às questões éticas a partir do crescente aumento nos casos de AIDS ocorrendo junto à população economicamente ativa, destacando o papel do enfermeiro do trabalho integrante de equipes de saúde ocupacional e sua importante contribuição no implemento das estretégias de prevenção para enfrentamento desta epidemia que afeta a humanidade de maneira perversa