The first instrument for complex PTSD assessment: psychometric properties of the ICD-11 Trauma Questionnaire

Objective: The ICD-11 Trauma Questionnaire (ITQ) was developed as a joint effort by researchers from several countries to evaluate post-traumatic stress (PTSD) and complex-PTSD (C-PTSD) symptoms. This study is part of a multi-center international collaborative research project that aims to provide psychometric support for this initial instrument in different languages, considering the specific contexts related to complex traumatization. This study verified the psychometric characteristics of the Portuguese version of the ITQ, evaluating symptoms beyond those described the existing literature. Methods: We examined the results of a convenience sample totaling 268 Portuguese and Angolan participants. Two instruments were applied: the ITQ, which evaluates symptoms resulting from a traumatic life event, and the Life Events Checklist (LEC), which evaluates stressful life events. The general characteristics of the scales are described, and reliability analysis and validity studies were performed. Results: Cronbach's alpha varied between 0.84 and 0.88, and the exploratory factorial analysis results were consistent with the concept of C-PTSD, with five components explaining 61.58% of scale variance. Conclusion: The results suggest good psychometric characteristics for the Portuguese version of the ITQ, and thus it can be included in protocols intended evaluating complex traumatic symptoms.

Identification and structural characterization of interneurons of the Drosophila brain by monoclonal antibodies of the würzburg hybridoma library.

Several novel synaptic proteins have been identified by monoclonal antibodies (mAbs) of the Würzburg hybridoma library generated against homogenized Drosophila brains, e.g. cysteine string protein, synapse-associated protein of 47 kDa, and Bruchpilot. However, at present no routine technique exists to identify the antigens of mAbs of our library that label only a small number of cells in the brain. Yet these antibodies can be used to reproducibly label and thereby identify these cells by immunohistochemical staining. Here we describe the staining patterns in the Drosophila brain for ten mAbs of the Würzburg hybridoma library. Besides revealing the neuroanatomical structure and distribution of ten different sets of cells we compare the staining patterns with those of antibodies against known antigens and GFP expression patterns driven by selected Gal4 lines employing regulatory sequences of neuronal genes. We present examples where our antibodies apparently stain the same cells in different Gal4 lines suggesting that the corresponding regulatory sequences can be exploited by the split-Gal4 technique for transgene expression exclusively in these cells. The detection of Gal4 expression in cells labeled by mAbs may also help in the identification of the antigens recognized by the antibodies which then in addition to their value for neuroanatomy will represent important tools for the characterization of the antigens. Implications and future strategies for the identification of the antigens are discussed.

Plasticity of recurrent inhibition in the Drosophila antennal lobe.

Recurrent inhibition, wherein excitatory principal neurons stimulate inhibitory interneurons that feedback on the same principal cells, occurs ubiquitously in the brain. However, the regulation and function of recurrent inhibition are poorly understood in terms of the contributing interneuron subtypes as well as their effect on neural and cognitive outputs. In the Drosophila olfactory system, odorants activate olfactory sensory neurons (OSNs), which stimulate projection neurons (PNs) in the antennal lobe. Both OSNs and PNs activate local inhibitory neurons (LNs) that provide either feedforward or recurrent/feedback inhibition in the lobe. During olfactory habituation, prior exposure to an odorant selectively decreases the animal's subsequent response to the odorant. We show here that habituation occurs in response to feedback from PNs. Output from PNs is necessary for olfactory habituation and, in the absence of odorant, direct PN activation is sufficient to induce the odorant-selective behavioral attenuation characteristic of olfactory habituation. PN-induced habituation occludes further odor-induced habituation and similarly requires GABA(A)Rs and NMDARs in PNs, as well as VGLUT and cAMP signaling in the multiglomerular inhibitory local interneurons (LN1) type of LN. Thus, PN output is monitored by an LN subtype whose resultant plasticity underlies behavioral habituation. We propose that recurrent inhibitory motifs common in neural circuits may similarly underlie habituation to other complex stimuli.

Sedation with intranasal midazolam of Angolan children undergoing invasive procedures.

AIM: Ambulatory surgery is a daily requirement in poor countries, and limited means and insufficient trained staff lead to the lack of attention to the patient's pain. Midazolam is a rapid-onset, short-acting benzodiazepine which is used safely to reduce pain in children. We evaluated the practicability of intranasal midazolam sedation in a suburban hospital in Luanda (Angola), during the surgical procedures. METHODS: Intranasal midazolam solution was administered at a dose of 0.5 mg/kg. Using the Ramsay's reactivity score, we gave a score to four different types of children's behaviour: moaning, shouting, crying and struggling, and the surgeon evaluated the ease of completing the surgical procedure using scores from 0 (very easy) to 3 (managing with difficulty). RESULTS: Eighty children (median age, 3 years) were recruited, and 140 surgical procedures were performed. Fifty-two children were treated with midazolam during 85 procedures, and 28 children were not treated during 55 procedures. We found a significant difference between the two groups on the shouting, crying and struggling parameters (p < 0.001). The mean score of the ease of completing the procedures was significantly different among the two groups (p < 0.0001). CONCLUSION: These results provide a model of procedural sedation in ambulatory surgical procedures in poor countries, thus abolishing pain and making the surgeon's job easier.

Neuronal activity and Wnt signaling act through Gsk3-beta to regulate axonal integrity in mature Drosophila olfactory sensory neurons.

The roles played by signaling pathways and neural activity during the development of circuits have been studied in several different contexts. However, the mechanisms involved in maintaining neuronal integrity once circuits are established are less well understood, despite their potential relevance to neurodegeneration. We demonstrate that maintenance of adult Drosophila olfactory sensory neurons requires cell-autonomous neuronal activity. When activity is silenced, development occurs normally, but neurons degenerate in adulthood. These detrimental effects can be compensated by downregulating Glycogen synthase kinase-3beta (Gsk-3beta). Conversely, ectopic expression of activated Gsk-3beta or downregulation of Wnt effectors also affect neuron stability, demonstrating a role for Wnt signaling in neuroprotection. This is supported by our observation that activated adult neurons are capable of increased Wingless release, and its targeted expression can protect neurons against degeneration. The role of Wnt signaling in this process is non-transcriptional, and may act on cellular mechanisms that regulate axonal or synaptic stability. Together, we provide evidence that Gsk-3beta is a key sensor involved in neural circuit integrity, maintaining axon stability through neural activity and the Wnt pathway.

Chip is required for posteclosion behavior in Drosophila.

Neurons acquire their molecular, neurochemical, and connectional features during development as a result of complex regulatory mechanisms. Here, we show that a ubiquitous, multifunctional protein cofactor, Chip, plays a critical role in a set of neurons in Drosophila that control the well described posteclosion behavior. Newly eclosed flies normally expand their wings and display tanning and hardening of their cuticle. Using multiple approaches to interfere with Chip function, we find that these processes do not occur without normal activity of this protein. Furthermore, we identified the nature of the deficit to be an absence of Bursicon in the hemolymph of newly eclosed flies, whereas the responsivity to Bursicon in these flies remains normal. Chip interacts with transcription factors of the LIM-HD (LIM-homeodomain) family, and we identified one member, dIslet, as a potential partner of Chip in this process. Our findings provide the first evidence of transcriptional mechanisms involved in the development of the neuronal circuit that regulates posteclosion behavior in Drosophila.

Análise da microinfiltração marginal em restaurações de cimentos ionoméricos após a utilização de Papacárie® / Analysis of marginal microleakage in glass ionomer cement restorations after the use of Papacárie®

Objetivo: Este trabalho avaliou o selamento marginal de dois cimentos ionoméricos, um convencional (Vitro Fill) e um modificado por resina (Vitro Fill LC), após o uso de dois métodos de remoção da cárie (convencional e químico-mecânico). Metodologia: Foram utilizados 40 molares decíduos cariados em suas faces oclusais, que, após a remoção do tecido cariado pelas duas técnicas, tiveram as cavidades restauradas com os cimentos de ionômero de vidro. Após preparo para teste de microinfiltração (termociclagem e fucsina básica), os dentes foram seccionados e avaliados por examinadores que atribuíram escores conforme o grau de microinfiltração observado. Resultados: Não houve diferença significantiva no grau de infiltração marginal das restaurações para as técnicas de remoção de tecido cariado (teste de Kruskal-Wallis, nível de significância de 5%). Para os materiais restauradores utilizados, o cimento ionomérico modificado por resina apresentou melhor selamento marginal independente da técnica de remoção de cárie utilizada. Conclusão: A utilização do Papacárie® não influenciou o selamento marginal dos materiais restauradores utilizados. O cimento ionomérico modificado por resina mostrou melhor selamento marginal que o cimento ionomérico convencional.

Purpose: This study evaluated the marginal sealing of cavities restored with convencional (Vitro Fill) or resin-modified (Vitro Fill LC) glass ionomer cements, after caries removal using two differents techniques (rotary instruments and chemomechanical removal). Methods: Forty deciduous human molars with caries lesions on the oclusal surface were used. After caries removal with one of the two tested techniques, the cavities were restored with each of the glass ionomer cements. The test specimens were thermocycled, immersed into basic fucsin, seccioned, and assessed by examiners to record microleakage using a score system. Results: No significant difference of microleakage was found between the two caries removal techniques (Kruskal-Wallis test, 5% significance level). For the restorative materials, resin-modified glass ionomer cement showed better marginal sealing independently from the caries removal technique used. Conclusion: Caries removal using Papacarie® did not influence the marginal sealing ability of glass ionomer restorations. The tested resin-modified glass ionomer cement had better results than the conventional glass ionomer cement.

Avaliação do selamento marginal de restaurações adesivas após o uso do gel de papaia / Evaluation of the marginal sealing of adhesive restorations after use of papain gel

Objetivo: Avaliar o selamento marginal de restaurações adesivas após a remoção do tecido cariado com o gel de papaia (Papacárie®) e através do método convencional (instrumentos rotatórios). Método: Foram utilizados dezessete pré-molares humanos extraídos, com lesões cariosas envolvendo suas faces oclusal (término em esmalte) e proximal (término em dentina). A amostra foi distribuída em dois grupos: G1 remoção do tecido cariado pela técnica convencional e G2 remoção do tecido cariado pela técnica químico-mecânica (Papacárie®). Após a remoção do tecido cariado pelas duas técnicas, foi aplicado o sistema adesivo Prime&Bond 2.1®, sendo as cavidades restauradas em resina composta fotopolimerizável (Filtek Z250®/A2). Empregou-se a metodologia para microinfiltração, na qual os espécimes foram termociclados (300 ciclos; 5ºC-55ºC, 15s. em cada banho), impermeabilizados através do selamento dos ápices e furcas, imersos em corante (fucsina básica) durante 24 horas, seccionados longitudinalmente através das restaurações e avaliados por três examinadores que atribuíram escores conforme o grau de penetração do corante na interface esmalte/restauração e dentina/restauração, das paredes oclusais e cervicais, respectivamente. Resultados: Os escores foram compilados e submetidos à análise estatística (teste Mann-Whitney com significância de 5%), evidenciando-se a ocorrência de infiltração marginal na parede cervical dos dois grupos (Papacárie® e instrumentos rotatórios) sem diferença significativa entre eles. Na parede oclusal ocorreu uma diferença significativa no grau de infiltração observado entre os grupos, pois, o grupo no qual se utilizou o Papacárie® obteve pior desempenho. Conclusão: O método de remoção químico-mecânico do tecido cariado com o gel de papaia influencia o grau de infiltração, comprometendo o selamento marginal do material restaurador adesivo utilizado.

Purpose: To evaluate the marginal sealing of adhesive restorations after removal of carious tissue with papain gel (Papac rie©) and after conventional method (rotary cutting instruments).Method: Seventeen extracted human premolars with carious lesions involving their occlusal surface (margin in enamel) and proximal surface (margin in dentin). The specimens were allocated in two groups: G1 - removal of the carious tissue by the conventional technique and G2 - removal of the carious tissue by the chemomechanical technique (Papac rie ©). After carious tissueremoval by both techniques, Prime&Bond 2.1© adhesive systemwas applied and the cavities were restored with a light-curing composed resin (Filtek Z250©/A2). The methodology for microleakage test was conducted: the specimens werethermocycled (300 cycles; 5§C-55§C, 15 s in each bath), rendered waterproof by sealing of the apexes and furcal regions, immersed in a dye solution (basic fuchsin) during 24 hours, sectioned longitudinally through the restorations and evaluated by three examiners that attributed scores according to the degree of dye penetration at enamel/restoration and dentin/restoration interface(occlusal and cervical walls, respectively).Results: The scores were compiled and analyzed statistically (Mann-Whitney test with 5% significance level), showing the occurrence of marginal leakage at the cervical wall of both groups(Papac rie© and rotary cutting instruments) with no statistically significant difference between them. At the occlusal wall, there was statistically significant difference between the groups regarding the microleakage degree; the group in which Papac rie©was used had a worse behavior.Conclusions: The chemomechanical method of removal of carious tissue with papain gel influenced the degree of leakage,compromising the marginal sealing of the adhesive restorative system employed.

Inhibitory effects of Euterpe oleracea Mart. on nitric oxide production and iNOS expression.

The palm Euterpe oleracea is a plant of great economic value in Brazil. Although the heart of palm extracted from its trunk is considered a delicacy the world over, its fruits are popular only among Brazilians. In some poor regions of Brazil, there are reports on the popular use of its juice in the treatment of several disorders, mainly those of oxidative onset as cardiovascular ones. Because of its wide utilization; because there are very few scientific studies of this species, and to discover if its use in folk medicine for problems related with oxidation is in fact justifiable, we decided, in this study, to evaluate the effects of Euterpe oleracea flowers, fruits and spikes fractions on: nitric oxide (NO) production, NO scavenger capacity, and on the expression of inducible nitric oxide synthase enzyme, as well. Results showed that the fractions obtained from fruits were the most potent in inhibiting NO production, followed by those from flowers and spikes. Only in high doses, did some fractions reduce cell viability. Reduction on NO production was not due to NO scavenger activity. These results were accompanied by inhibition of iNOS expression. The more pronounced effect was observed in the fractions in which the concentration of cyanidin-3-O-glucoside and cyanidin-3-O-rhamnoside were higher. To sum up, our results indicate that fractions from Euterpe oleracea inhibits NO production by reducing the levels of inducible nitric oxide synthase expression.

Síndrome de Prader Willi: relato de caso / Prader-Willi syndrome: a case report

A Síndrome de Prader-Willi (SPW) é uma desordem genética caracterizada por hipotonia, retardo mental, hiperfagia e compulsão para comida devido a uma disfunção hipotalâmica. O objetivo deste estudo é apresentar o caso de uma portadora da SPW, revisando a literatura sobre as principais características, etiologia e algumas considerações odontológicas de interesse. Uma adolescente de 12 anos de idade foi encaminhada à clínica odontológica da Faculdade de Odontologia da Universidade de Pernambuco, apresentando severa obesidade (grau II), apnéia noturna, hipotonia muscular, hiperfagia, comportamento compulsivo para comida associada com uma dieta rica em carboidratos refinados e pobre higiene bucal, determinando um alto número de lesões de cárie e desmineralização do esmalte dos dentes. Além disso, foi encontrada má oclusão do tipo Cl II, mordida aberta anterior e pobre cobertura labial. O tratamento odontológico foi realizado, usando-se ansiolíticos apenas para as exodontias. O distúrbio de comportamento foi controlado, usando um modelo cognitivo. O portador da SPW apresenta alterações neurocomportamentais de extremo interesse para a odontologia. Por isso, o desenvolvimento de estratégias que promovam saúde geral e bucal para seus portadores deve ser o objetivo da equipe odontológica que esteja envolvida com seu atendimento.

Distinct types of glial cells populate the Drosophila antenna.

BACKGROUND: The development of nervous systems involves reciprocal interactions between neurons and glia. In the Drosophila olfactory system, peripheral glial cells arise from sensory lineages specified by the basic helix-loop-helix transcription factor, Atonal. These glia wrap around the developing olfactory axons early during development and pattern the three distinct fascicles as they exit the antenna. In the moth Manduca sexta, an additional set of central glia migrate to the base of the antennal nerve where axons sort to their glomerular targets. In this work, we have investigated whether similar types of cells exist in the Drosophila antenna. RESULTS: We have used different P(Gal4) lines to drive Green Fluorescent Protein (GFP) in distinct populations of cells within the Drosophila antenna. Mz317::GFP, a marker for cell body and perineural glia, labels the majority of peripheral glia. An additional approximately 30 glial cells detected by GH146::GFP do not derive from any of the sensory lineages and appear to migrate into the antenna from the brain. Their appearance in the third antennal segment is regulated by normal function of the Epidermal Growth Factor receptor and small GTPases. We denote these distinct populations of cells as Mz317-glia and GH146-glia respectively. In the adult, processes of GH146-glial cells ensheath the olfactory receptor neurons directly, while those of the Mz317-glia form a peripheral layer. Ablation of GH146-glia does not result in any significant effects on the patterning of the olfactory receptor axons. CONCLUSION: We have demonstrated the presence of at least two distinct populations of glial cells within the Drosophila antenna. GH146-glial cells originate in the brain and migrate to the antenna along the newly formed olfactory axons. The number of cells populating the third segment of the antenna is regulated by signaling through the Epidermal Growth Factor receptor. These glia share several features of the sorting zone cells described in Manduca.

Estudo epidemiológico de urgências odontológicas / Epidemiologic study of urgencies in dentistry

O objetivo deste estudo retrospectivo foi determinar a razão da procura de atendimento de urgência na Faculdade de Odontologia da Universidade de Pernambuco, no segundo semestre de 2000, e relacionar o diagnóstico dos casos com o tratamento proposto, gênero e idade dos pacientes. Foram utilizados 227 prontuários de pacientes de ambos os gêneros, com idade variando de 11 a 81 anos. De posse dos dados, foram realizados as estatísticas descritivas e inferencial. A amostra consistiu de 70,5% de pacientes do gênero feminino e 29,5% do masculino. A idade média foi de 29 anos (DP = 11,75 anos). Dos casos atendidos, 33% tiveram como diagnóstico pulpite irreversível sintomática, seguida de 17,2% de pulpite reversível. A abertura coronária doi indicada nos casos de pulpite irreversível sintomática, abcesso dentoalveolar agudo e periodontite apical aguda, correspondendo a 55,1% dos tratamentos realizados. Conclui-se que o alto percentual de urgências endodônticas reflete o perfil de saúde bucal da população atendida, exibindo um alto padrão cariogênico que necessita ser revertido

Guia de silicona: uma alternativa viável na restauração de dentes anteriores fraturados / Silicone guide: a viable alternative to restore anterior fractured teeth

O objetivo deste trabalho é relatar, através da demonstração de um caso clínico, a viabilidade, simplicidade e precisão da técnica de guia de silicona na restauração de dentes anteriores fraturados, em situações em que a colagem de fragmento dental não é possível e a exigência estética é imperativa, sendo seu emprego recomendável para pacientes pediátricos. No caso descrito, um paciente de 12 anos de idade, sexo masculino, apresentava fratura horizontal, ao nível do terço médio, causada por traumatismo. Por causa da natureza policromática do elemento dental fraturado, o uso da guia de silicona facilitou a utilização de resinas compostas com diferentes tonalidades para dentina e esmalte, o que viabilizou a obtenção de um padrão satisfatório de translucidez para a restauração e favoreceu a estética final.

Combinatorial expression of Prospero, Seven-up, and Elav identifies progenitor cell types during sense-organ differentiation in the Drosophila antenna.

The Drosophila antenna has a diversity of chemosensory organs within a single epidermal field. We have some idea from recent studies of how the three broad categories of sense-organs are specified at the level of progenitor choice. However, little is known about how cell fates within single sense-organs are specified. Selection of individual primary olfactory progenitors is followed by organization of groups of secondary progenitors, which divide in a specific order to form a differentiated sensillum. The combinatorial expression of Prospero Elav, and Seven-up allows us to distinguish three secondary progenitor fates. The lineages of these cells have been established by clonal analysis and marker distribution following mitosis. High Notch signaling and the exclusion of these markers identifies PIIa; this cell gives rise to the shaft and socket. The sheath/neuron lineage progenitor PIIb, expresses all three markers; upon division, Prospero asymmetrically segregates to the sheath cell. In the coeloconica, PIIb undergoes an additional division to produce glia. PIIc is present in multiinnervated sense-organs and divides to form neurons. An understanding of the lineage and development of olfactory sense-organs provides a handle for the analysis of how olfactory neurons acquire distinct terminal fates.

Possibilidades e limites do trabalho de vigilância epidemiológica no nível local em direção à vigilância à saúde / Possibilities and limits of epidemiological surveillance at the local level towards health surveillance

O estudo tem como marco referencial o processo de trabalho em saúde e em enfermagem, e como objetivos descrever e analisar as ações de Vigilância Epidemiológica (VE) desenvolvidas em uma unidade de saúde, buscando identificar o quanto se aproximam da estratégia de Vigilância à Saúde (VS). Utilizou-secomo referência um check-list elaborado com base nas ações de VE preconizadas pelo Ministério da Saúde. Os dados obtidos demonstraram que na unidade de saúde estudada, as ações de VE restringiam-se à notificação e ao controle das doenças transmissíveis e que o trabalho da enfermeira na VE caracteriza-sepor atividades burocráticas. Conclui-sepela necessidade de se ampliarem as discussões sobre as formas de operacionalização da VS nos serviços de saúde.

The aim of this study is to describe and analyze Epidemiological Surveillance activities (ES) developed in a Health Care Unit and to identify their adherence to recommended Health Surveillance (HS) strategies. A checklist with the activities recommended by the Ministry of Health was used to conduct interviews with health professionals involved in ES activities. The data obtained from these interviews showed that Epidemiological Surveillance activities are limited to the notification and control of infectious diseases, and the nurses' labor is characterized by bureaucratic tasks. This shows that further discussion about Health Surveillance strategies is necessary to find ways to better implement them in health services.

Material restaurador temporário: estudo comparativo da infiltração marginal / Restored material temporary: a comparative study of the marginal leakage

Objetivo: O objetivo do presente trabalho foi o de avaliar a capacidade de vedamento marginal de alguns materiais seladores temporários, bem como estabelecer uma classificação de eficiência entre eles. Metodologia: Realizou-se a abertura coronária de cinquenta incisivos inferiores e após o preparo biomecânico, introduziu-se um cone de papel absorvente, e uma pelota de algodão foi adaptada na emborcadura do canal. Em seguida, os dentes foram restaurados com Óxido de zinco e eugenol (Grupo 1) ; Cavitec (Grupo 2); IRM (Grupo 3); Resina composta híbrida- Suprafill (Grupo 4) e Vitremer (Grupo 5). Após termociclagem (125 ciclos), os corpos de prova foram imersos em Fucsina básica a 0,5% por 24 horas; lavados e seccionados para verificar o grau de infiltração marginal através de valores numéricos: 0, 1, 2, 3 e 4. Resultados e Conclusões: Os dados obtidos mostraram diferenças estatisticamente significantes entre os grupos (p< 0,001), utilizando o Teste de Kruskal-Wallis, sendo os Grupos 4 e 5 com maior capacidade de selamento

Pulpotomia em molares permanentes jovens com rizogênese incompleta: caso clínico / Pulpotomy in imature permanent molars of incompletely formed root

Os autores através do relato de um caso clínico, descrevem uma sequência clínica de pulpotomia em molares permanentes jovens com rizogênese incompleta