Sofosbuvir más glecaprevir/pibrentasvir como terapia de rescate postrasplante hepático en pacientes con exposición previa a inhibidores de NS5A. Serie de casos / Sofosbuvir plus glecaprevir/pibrentasvir as salvage therapy after liver transplantation in NS5A inhibitor-experienced patients. A case series

Resumen Antecedentes: El tratamiento de la infección crónica por el virus de la hepatitis C (VHC) con antivirales de acción directa logra tasas de respuesta virológica sostenida superiores a 95 %. Sin embargo, el manejo del fracaso virológico sigue siendo un desafío clínico y la evidencia sobre el retratamiento es limitada, especialmente en poblaciones como los receptores de trasplante hepático (TH). Objetivo: Este estudio evaluó el régimen de sofosbuvir más glecaprevir/pibrentasvir (GLE/PIB) en receptores de TH en quienes falló el régimen basado en inhibidores de la proteína no estructural 5A (NS5A). Material y métodos: Estudio retrospectivo de 111 pacientes trasplantados entre enero de 2018 y diciembre de 2020; 18 pacientes presentaron infección recurrente por VHC posterior al TH, tres de ellos tuvieron antecedentes de al menos un régimen basado en inhibidores de NS5A. Se inició terapia de rescate con sofosbuvir más GLE/PIB durante 12 semanas posterior al TH; se registraron las características basales de los pacientes y sus desenlaces. Resultados: En los tres pacientes se logró obtener una carga viral indetectable de VHC a las 12 semanas de finalizar el tratamiento. No se observaron eventos adversos graves. Conclusión: En nuestra serie, sofosbuvir más GLE/PIB durante 12 semanas demostró ser una terapia de rescate efectiva y segura posterior al TH en pacientes previamente tratados con inhibidores de NS5A.

Abstract Background: Treatment of chronic hepatitis C virus (HCV) infection with direct-acting antivirals achieves a sustained virologic response rates higher than 95%. However, virologic failure remains a clinical challenge, and data on retreatment are limited, especially in special populations such as liver transplant (LT) recipients. Objective: This study evaluated the sofosbuvir plus glecaprevir-pibrentasvir (GLE/PIB) regimen in LT recipients who had failed to a nonstructural protein 5A (NS5A) inhibitor-based regimen. Material and methods: Retrospective study of 111 liver transplant recipients between January 2018 and December 2020; 18 patients presented with HCV recurrent infection after LT, out of whom three had a history of at least one NS5A inhibitor-based regimen. Salvage therapy with sofosbuvir plus GLE/PIB was started for 12 weeks; baseline characteristics and outcomes were recorded. Results: All three patients (100%) achieved an undetectable HCV viral load 12 weeks after treatment completion. No serious adverse events were observed. Conclusion: In our series, sofosbuvir plus GLE/PIB for 12 weeks is an effective and safe salvage therapy after LT in patients previously treated with NS5A inhibitors.

Práticas corporais/atividades físicas demarcadas como privilégio e não escolha: análise à luz das desigualdades brasileiras / Bodily practices/physical activities considered as privilege and not a choice: analysis in the light of Brazilian inequalities

Resumo Este artigo tem como objetivo assinalar as práticas corporais/atividades físicas como mais um privilégio no Brasil, refutando a noção de que sua prática é uma simples escolha no cuidado em saúde. Para tal, apontaremos evidências discursivas e práticas influenciadas pelas graves condições de desigualdade no país. A caixa de ferramentas utilizada reuniu as relações de saber e poder em Michel Foucault, o apelo ao ensaio a partir de Jorge Larrosa e o acúmulo teórico da Saúde Coletiva. Ao assumir que o envolvimento em práticas corporais/atividades físicas de lazer é perpassado por privilégios, colocamo-nos como defensores das políticas públicas em função do seu caráter de acesso. Há um desafio social premente, qual seja, criar condições de vida dignas, reduzir dramaticamente as desigualdades para fortalecer as ações em direção a cuidados com a saúde como direito de todas as pessoas. Conclui-se que as práticas corporais/atividades físicas são manifestações complexas e atravessadas pelas imposições de vida, em que é imperioso observar as condições e modos de viver, refutando a noção amplamente disseminada de que basta acumular minutos de atividade física para se ter saúde.

Abstract Our article seeks to denounce bodily practices/physical activities as another privilege in Brazil, refuting the hegemonic notion that physical activity practice is simply a choice in health care. To such purpose, we point out discursive evidence and practices influenced by the severe inequality conditions in the country. The toolbox used in this essay brought together Michel Foucault's views on power relations, Jorge Larrosa's perspective on essay writing, and the body of research of Collective Health. By assuming that privileges permeate the engagement in bodily practices/physical activities, we place ourselves as advocates of public policies due to their access status. There is an urgent social challenge, namely, to create decent living conditions, to dramatically reduce inequalities, to strengthen actions towards health care as the right of all people. We concluded that bodily practices/physical activities are complex manifestations affected by the impositions of life. Conditions and ways of living must be observed, refuting the widely disseminated notion that it is enough to accumulate minutes of physical activity to be healthy.

Incidental findings of temporomandibular joint osteoarthritis and its variability based on age and sex

Purpose@#This study investigated the prevalence of temporomandibular joint osteoarthritis (TMJ-OA) using the Research Diagnostic Criteria for Temporomandibular Disorders image analysis criteria, assessed the severity of incidental osteoarthritic changes affecting the TMJ, and evaluated the correlations of sex and age with the prevalence and severity of TMJ-OA. @*Materials and Methods@#This retrospective study assessed 145 randomly selected cone-beam computed tomography scans (261 TMJs) from the authors’ institutional maxillofacial radiology archive following the application of inclusion and exclusion criteria. The criteria described by Ahmad et al. were used to determine whether each TMJ was affected by OA, and the severity of the osteoarthritic changes was scored for each joint based on the method described by Alexiou et al. The chi-square, McNemar, Bhapkar chi-square, and Stuart-Maxwell chi-square tests were applied to evaluate the significance of the relationships between variables (age and sex). @*Results@#Sixteen TMJs (6.1%) had no OA, 74 (28.6%) were indeterminate for OA, and 171 (65.5%) had OA. Flattening and sclerosis were observed in 86.6% and 12.3% of cases, respectively, while resorption was observed in 7.3% of the joints. Only 21 (8.1%) of the examined TMJs had subchondral cysts. Erosion of the articular eminence was observed in 58 (22.1%) cases, while sclerosis and resorption were found in 68 (25.9%) and 16 (6.1%) TMJs, respectively. @*Conclusion@#Female patients had a higher prevalence and severity of TMJ-OA than male patients. The prevalence and severity of TMJ-OA increased with age, with peaks in the fifth and seventh decades of life.

Promoção de atividade física e as políticas públicas no combate às desigualdades: reflexões a partir da Lei dos Cuidados Inversos e Hipótese da Equidade Inversa / Promoción de la actividad física y políticas públicas en la lucha contra las desigualdades: reflexiones a partir de la Ley de Cuidados Inversos y la Hipótesis de la Equidad Inversa / Promotion of physical activity and public policies to tackle inequalities: considerarions based on the Inverse Care Law and Inverse Equity Hypothesis

O presente Ensaio apresenta uma reflexão com base em algumas formas vigentes de promoção de atividade física, propondo visibilidade a atividades de lazer e suas desigualdades. O cenário atual de (aumento das) desigualdades e a importância do seu enfrentamento, destacando a pertinência das políticas públicas, são apresentados e discutidos à luz de duas teorias: a Hipótese da Equidade Inversa e a Lei dos Cuidados Inversos. A Hipótese da Equidade Inversa busca compreender como as desigualdades tendem a se estabelecer em indicadores de saúde, partindo de aumento esperado dessas desigualdades quando surgem inovações em saúde que atingem inicialmente os mais privilegiados social e economicamente. Já a Lei dos Cuidados Inversos destaca que a disponibilidade de uma atenção adequada em saúde tende a variar inversamente à necessidade da população. Nesse sentido, ao relacionar as teorias e a promoção de atividade física de lazer, o presente ensaio defende a ampliação das políticas públicas, buscando evitar o aumento das desigualdades. São as políticas públicas e a vinculação com o Sistema Único de Saúde (SUS) e com seus princípios que precisam ser compreendidas como prioridade. É nessa perspectiva que acreditamos em um avanço de ações de promoção das atividades físicas de lazer contextualizadas socialmente que sejam capazes de priorizar aqueles que mais necessitam.

Este Ensayo propone una reflexión sobre algunas formas vigentes de promoción de la actividad física, centrándose en las actividades físicas de ocio y sus desigualdades. El escenario actual de (aumento de las) desigualdades y la importancia de su enfrentamiento, destacando la pertinencia de las políticas públicas, se presenta y discute a la luz de dos teorías: la Hipótesis de la Equidad Inversa y la Ley de Cuidados Inversos. La Hipótesis de la Equidad inversa busca comprender cómo las desigualdades tienden a establecerse en indicadores de salud, partiendo de un aumento esperado de las desigualdades, cuando surgen innovaciones en salud que alcanzan inicialmente a los más privilegiados social y económicamente. Ya la Ley de los Cuidados Inversos destaca que la disponibilidad de una atención adecuada en salud tiende a variar inversamente, en función de las necesidades de la población. En este sentido, al relacionar las teorías y la promoción de la actividad física de ocio, este ensayo defiende la ampliación de las políticas públicas, con el fin de no ampliar las desigualdades. Son las políticas públicas, su vinculación con el Sistema Único de la Salud (SUS) y con sus principios los que necesitan ser comprendidos como prioridad. Desde esta perspectiva pensamos que se debe avanzar en la promoción de acciones de actividades físicas durante el ocio, contextualizadas socialmente, y que sean capaces de priorizar a quienes más lo necesitan.

This Essay reflects on some current approaches to the promotion of physical activity, proposing greater visibility for leisure-time physical activities and inequalities in access to them. The current scenario of increasing inequalities and the importance of confronting them, highlighting the pertinence of public policies, is presented and discussed in light of two theories, the Inverse Equity Hypothesis and the Inverse Care Law. The Inverse Equity Hypothesis seeks to understand how inequalities tend to be established in health indicators, based on an expected increase in inequalities when health innovations initially reach the more socially and economically privileged groups. Meanwhile, the Inverse Care Law emphasizes that the availability of adequate healthcare tends to vary inversely to the population's need. By relating the theories and the promotion of leisure-time physical activity, the essay defends the expansion of public policies aimed at not further increasing inequalities. Public policies and their association with Brazilian Unified National Health System (SUS) and its principles should be the priority. The essay thus defends approaches to promote socially contextualized leisure-time physical activities, capable of prioritizing the groups that need them the most.

Prevalence and incidence of anal human papillomavirus infection in Mexican men: Need for universal prevention policies / Prevalencia e incidencia de infección por virus de papiloma humano en canal anal en hombres mexicanos: Necesidad de políticas de prevención universal

Abstract: Objective: Describe the natural history of anal HPV among men. Materials and methods: Prospective study among men 18-70 years (n=665), from Cuernavaca, Mexico who completed questionnaires and provided specimens (HPV genotyped) at enrollment and 1+ follow-up visit. HPV prevalence and incidence were estimated. Prevalence ratios were calculated with Poisson regression using robust variance estimation. Person-time for incident HPV infection was estimated using number of events modeled as Poisson variable for total person-months. Results: Anal infection prevalence: any HPV type=15%, high-risk=8.4%, HPV16=1.4%, tetravalent vaccine types (4vHPV)=4.4%, nonavalent vaccine types (9vHPV)=6.3%. Factors associated with prevalence: 50+ lifetime female sex partners (adjusted prevalence ratio, a PR=3.25, 95% CI:1.12-9.47), 10+ lifetime male sex partners (aPR=3.06, 95%CI:1.4-6.68), and 1+ recent male anal sex partners (aPR=2.28, 95%CI:1.15-4.5). Anal incidence rate: high-risk HPV=7.8/1 000 person-months (95%CI:6.0-10.1), HPV16=1.8/1 000 person-months (95%CI:1.1-2.9),4vHPV=3.4/1 000 person-months (95%CI:2.3-4.9) and 9vHPV=5.5/1000 person-months (95%CI:4.1-7.5). Conclusions: Implementation of universal HPV vaccination programs, including men, is a public health priority.

Resumen: Objetivo: Generar evidencia que apoye la vacunación universal contra VPH. Material y métodos: Estudio prospectivo con hombres 18-70 años (n=665) de Cuernavaca, México con cuestionarios y genotipificación de VPH en muestras (2+mediciones). Se estimó prevalencia e incidencia; se calcularon tasas de prevalencia con regresión Poisson. Se estimó persona-tiempo para infecciones incidentes. Resultados: Prevalencia de infección anal: cualquier tipo de VPH=15%, alto-riesgo=8.4%, VPH16=1.4%, tipos en vacuna tetravalente=4.4% y tipos en vacuna nonavalente=6.3%. Factores asociados con infección prevalente: 50+ parejas sexuales femeninas en la vida (tasa de prevalencia ajustada, TPa=3.25, IC95%:1.12-9.47); 10+ parejas sexuales masculinas en la vida (TPa=3.06, IC95%:1.4-6.68) y 1+ parejas masculinas (sexo anal) recientes (TPa=2.28, IC95%:1.15-4.5). Tasas de incidencia para infección anal: VPH alto-riesgo=7.8/1000 persona-meses (IC95%:6.0-10.1), VPH 16=1.8/1000 persona-meses (95%IC:1.1-2.9), tipos en vacuna tetravalente=3.4/1000 persona-meses y tipos en vacuna nonavalente=5.5/1000 persona-meses. Conclusiones: Implementación de programas de vacunación universal (incluyendo hombres) contra VPH es una prioridad en salud pública.

Prevention and control of neoplasms associated with HPV in high-risk groups in Mexico City: The Condesa Study / Prevención y control de neoplasias asociadas a VPH en grupos de alto riesgo de la Ciudad de México: el Estudio Condesa

Abstract: Objective: To evaluate the effectiveness of a combined strategy of human papillomavirus virus (HPV) vaccination and high-risk HPV screening to reduce the occurrence of anogenital and oropharyngeal neoplasms among men who have sex with men, people with HIV, homeless people, transgender women, female sex workers and rape victims. Materials and methods: This mixed methods study evaluates the effectiveness of a combined vaccination-screening strategy to reduce HPV prevalence/incidence and occurrence of cervical intraepithelial neoplasms grade 2+ and/or anal intraepithelial neoplasms grade 2+, using Kaplan-Meier. The time-to-event method will evaluate time from positive results for specific anogenital HPV to incidence of anogenital lesions containing that HPV type. Results: People vaccinated against HPV and screened for HPV as a primary test will have lower prevalence and incidence of HPV infection and consequently lower frequency of HPV-related anogenital and oropharyngeal lesions. Conclusions: This study will generate scientific evidence on effectiveness of a combined vaccination-screening strategy to reduce the burden of HPV-associated neoplasms.

Resumen: Objetivo: Evaluar la efectividad de una estrategia combinada de vacunación contra el virus de papiloma humano (VPH) y tamizaje de VPH de alto riesgo para reducir neoplasias anogenitales y orofaringeas entre hombres que tienen sexo con hombres, personas con VIH, personas en situación de calle, mujeres transgénero, trabajadoras sexuales y víctimas de violación. Material y métodos: Este estudio evaluará la efectividad de una estrategia combinada de vacunación y tamizaje para reducir la ocurrencia de neoplasias intraepiteliales cervicales grado 2+ o neoplasias intraepiteliales anales grado NIA2+ utilizando Kaplan-Meier. Se evaluará tiempo de resultados positivos para tipos específicos de VPH anogenital a incidencia de lesiones anogenitales con ese tipo de VPH. Resultados: Las personas vacunadas contra VPH y con tamizaje de VPH tendrán menor prevalencia e incidencia de infecciones por VPH y por ende menor frecuencia de lesiones anogenitales y orofaringeas relacionadas con VPH. Conclusiones: Este estudio generará evidencia científica sobre la efectividad de una estrategia combinada de vacunación y tamizaje para reducir la carga de neoplasias asociadas al VPH.

Controles alternativos para el gorgojo del frijol Acanthoscelides obtectus (Say) (Coleoptera: Bruchidae) / Alternate controls for the bean weevil Acanthoscelides obtectus (Say) (Coleoptera: Bruchidae)

Las especies del género Quercus son de importancia ecológica y económica dentro de los bosques donde se desarrollan. Pueden encontrarse desde zonas cálidas y secas hasta selvas lluviosas. Estos bosques, también son reconocidos por presentar alto grado de endemismo y gran número de interacciones ecológicas. Sin embargo, en Guatemala las especies de encino han sido poco estudiadas y están fuertemente amenazadas; a pesar de poseer un alto potencial para aprovechamiento, manejo y uso en la restauración de ecosistemas. Este estudio se orientó hacia la actualización de la riqueza y distribución geográfica de las especies de encino para Alta Verapaz, Baja Verapaz y Petén, a partir de la revisión de registros en herbarios nacionales, bases de datos en línea de herbarios extranjeros y colectas de campo. Se registraron 19 especies de encinos en Alta Verapaz, Baja Verapaz y Petén, nueve especies más de las reportadas previamente, actualizándose los rangos de distribución departamental de 18 especies a excepción de Quercus sapotifolia Liebm. De las especies registradas, 16 se encuentran con algún grado de amenaza, según el Listado de Especies Amenazadas y listas rojas de UICN. También se identificaron vacíos de información acerca de la distribución de estas especies dentro de remanentes boscosos importantes en los departamentos evaluados. Se espera que a partir de este estudio se incrementen los esfuerzos por comprenden la riqueza y distribución de las especies de encino para Guatemala.

Quercus species represent one of the genera with ecological and economic importance within the forests where they develop, since these can be found from warm and dry zones to rain forests. Oak forests also exhibit high endemism levels and a large number of ecological interactions. However, oak species in Guatemala have been briefly studied, although they represent a genus highly threatened and with a high potential for use, handling and ecosystem restoration. This study was oriented towards the actualization of richness and geographical distribution of the oak species in Alta Verapaz, Baja Verapaz and Peten from reviewing records in National Herbariums, online databases of foreign Herbariums and field collection. A total of 19 oak species in Alta Verapaz, Baja Verapaz and Peten were recorded, nine more species of those previously reported, updating the departmental distribution ranges of 18 species except Quercus sapotifolia Liebm. Of the species recorded, 16 were listed with some degree of threat according to the national List of Threatened Species and the IUCN Red List of Threatened Species. Our results evidenced that the oak species were located in important forest remnants in all of the departments evaluated. It is expected from this study to increase the efforts to understand the oak species richness and species distributions patterns for Guatemala.

Insulin binding characteristics in canine muscle tissue: effects of the estrous cycle phases / Características de ligação da insulina no tecido muscular canino: efeitos da fase do ciclo estral

Hormonal fluctuations during the different estrous cycle are a well-recognized cause of insulin resistance in bitches, and little is known about insulin receptor binding or post-binding defects associated with insulin resistance in dogs. To evaluate insulin binding characteristics in muscle tissue of bitches during the estrous cycle, 17 owned bitches were used in the study (six in anestrus, five in estrus, and six in diestrus). An intravenous glucose tolerance test (IVGTT) was performed in all patients by means of injection of 1mL/kg of a glucose 50% solution (500mg/kg), with blood sample collection for glucose determination at 0, 3, 5, 7, 15, 30, 45 and 60 minutes after glucose infusion. Muscle samples, taken after spaying surgery, were immediately frozen in liquid nitrogen and then stored at -80 ºC until the membranes were prepared by sequential centrifugation after being homogenized. For binding studies, membranes were incubated in the presence of 20,000cpm of human 125I-insulin and in increasing concentrations of unlabeled human regular insulin for cold saturation. The IVGTT showed no differences among bitches during the estrous cycle regarding baseline glycemia or glycemic response after glucose infusion. Two insulin binding sites - high-affinity and low-affinity ones - were detected by Scatchard analysis, and significant statistical differences were observed in the dissociation constant (Kd1) and maximum binding capacity (Bmax1) of the high-affinity binding sites. The Kd1 for the anestrus group (6.54±2.77nM/mg of protein) was smaller (P<0.001) than for the estrus (28.54±6.94nM/mg of protein) and diestrus (15.56±3.88nM/mg of protein) groups. Bmax1 in the estrus (0.83±0.42nM/mg of protein) and diestrus (1.24±0.24nM/mg of protein) groups were also higher (P<0.001) than the values observed in anestrus (0.35±0.06nM/mg of protein). These results indicate modulation of insulin binding characteristics during different phases of the estrous cycle in dogs, showing that muscle insulin binding affinity for its receptor is reduced during estrus and diestrus. However, this poor hormone-receptor affinity is compensated for by a greater total binding capacity, once there is no difference in patients' glycemic response after an intravenous glucose load.(AU)

As flutuações hormonais durante as diferentes fases do ciclo estral são uma causa importante de resistência insulínica em fêmeas caninas, e poucas informações são conhecidas sobre defeitos na ligação da insulina ao seu receptor, ou defeitos pós-receptor associados com resistência à insulina em cães. Para avaliar as características da ligação insulina-receptor no tecido muscular de cadelas durante o ciclo estral, dezessete pacientes foram utilizadas no estudo (seis em anestro, cinco em estro e seis em diestro). Um teste de tolerância à glicose intravenosa (IVGTT) foi realizado em todas as pacientes por meio da infusão de 1mL/kg de uma solução de glicose 50% (500mg/kg), com coletas de sangue para determinação de glicemia nos tempos 0, 3, 5, 7, 15, 30, 45 e 60 minutos da injeção de glicose. Amostras de tecido muscular foram coletadas durante ovariohisterectomia, imediatamente congeladas em nitrogênio líquido, e posteriormente armazenadas a -80°C até a preparação das membranas por meio de homogeneização e centrifugação sequencial. Para os experimentos de ligação hormônio-receptor, as membranas foram incubadas na presença de 20.000cpm de 125I-insulina humana, e concentrações crescentes de insulina regular humana não marcada para saturação fria. O IVGTT não mostrou diferenças entre as pacientes em diferentes fases do ciclo estral com relação a glicemia basal, ou na resposta glicêmica após infusão de glicose nos tempos estudados. Dois sítios de ligação da insulina, um de alta-afinidade, e outro de baixa afinidade, foram detectados pela análise de Scatchard, e diferenças significativas foram detectadas na constante de dissociação (Kd1) e capacidade de ligação máxima (Bmax1) dos sítios de ligação de alta-afinidade. O Kd1 para o grupo anestro (6,54±2,77nM/mg de proteína) foi menor (P<0,001) que os Kd1 dos grupos estro (28,54±6,94 nM/mg de proteína) e diestro (15,56±3,88nM/mg de proteína). Os Bmax1 dos grupos estro (0,83±0,42nM/mg de proteína) e diestro (1,24±0,24nM/mg de proteína) também foram maiores que os valores encontrados no grupo anestro (0,35±0,06nM/mg de proteína). Estes resultados demonstram uma modulação das características de ligação da insulina nas diferentes fases do ciclo estral em cães, evidenciando uma menor afinidade de ligação da insulina ao seu receptor no tecido muscular durante o estro e diestro. Contudo, esta menor afinidade de ligação hormônio-receptor é compensada por uma maior capacidade de ligação, o que fica também evidenciado pela ausência de diferenças na resposta glicêmica das pacientes após um desafio com glicose por via endovenosa.(AU)

Evaluation of linear measurements of implant sites based on head orientation during acquisition: An ex vivo study using cone-beam computed tomography

PURPOSE: This study evaluated the effect of various head orientations during cone-beam computed tomography (CBCT) image acquisition on linear measurements of potential implant sites. MATERIALS AND METHODS: Six dry human skulls with a total of 28 implant sites were evaluated for seven different head orientations. The scans were acquired using a Hitachi CB-MercuRay CBCT machine. The scanned volumes were reconstructed. Horizontal and vertical measurements were made and were compared to measurements made after simulating the head position to corrected head angulations. Data was analyzed using a two-way ANOVA test. RESULTS: Statistical analysis revealed a significant interaction between the mean errors in vertical measurements with a marked difference observed at the extension head position (P<0.05). Statistical analysis failed to yield any significant interaction between the mean errors in horizontal measurements at various head positions. CONCLUSION: Head orientation could significantly affect the vertical measurements in CBCT scans. The main head position influencing the measurements is extension.

Chronic osteitic rhinosinusitis as a manifestation of cystic fibrosis: A case report

A 28-year-old male patient with a history of cystic fibrosis (CF) was referred to the University of Connecticut School of Dental Medicine for an evaluation of a cystic lesion in the right maxilla using cone-beam computed tomography (CBCT). CF is an autosomal recessive disease characterized by an abnormal production of viscous mucus, affecting the mucociliary clearance. The CBCT scan revealed a large cystic lesion in the right maxilla extending from the right maxillary second molar to the midline in the region of the right central incisor with a significant buccal expansion. Further evaluation revealed complete opacification of the paranasal sinuses with medial bulging of the lateral maxillary sinus walls. The maxillary and sphenoid sinuses also appeared hypoplastic. The peculiar finding seen in this case was the presence of marked sclerosis and an increase in the thickness of the adjacent bony framework. This report aimed to describe the common sinonasal findings associated with CF and its underlying pathophysiology.

Clival lesion incidentally discovered on cone-beam computed tomography: A case report and review of the literature

An osteolytic lesion with a small central area of mineralization and sclerotic borders was discovered incidentally in the clivus on the cone-beam computed tomography (CBCT) of a 27-year-old male patient. This benign appearance indicated a primary differential diagnosis of non-aggressive lesions such as fibro-osseous lesions and arrested pneumatization. Further, on magnetic resonance imaging (MRI), the lesion showed a homogenously low T1 signal intensity with mild internal enhancement after post-gadolinium and a heterogeneous T2 signal intensity. These signal characteristics might be attributed to the fibrous tissues, chondroid matrix, calcific material, or cystic component of the lesion; thus, chondroblastoma and chondromyxoid fibroma were added to the differential diagnosis. Although this report was limited by the lack of final diagnosis and the patient lost to follow-up, the incidental skull base finding would be important for interpreting the entire volume of CBCT by a qualified oral and maxillofacial radiologist.

School environment and physical activity in children and adolescents: systematic review / Ambiente escolar e atividade física em crianças e adolescentes: revisão sistemática

The aim of this study was to identify, discuss and summarize findings from articles on the association between characteristics of the school environment and physical activity in children and adolescents. We followed the PRISMA guidelines for systematic reviews. Articles were identified in PubMed. The main inclusion criteria were: (a) studies with children and adolescents ? studies with preschool children only were excluded because they were covered in a recent review; (b) physical activity as the outcome; (c) school environment characteristics as the exposure variable. Outcome variables were heterogeneous across the 13 studies, including recess physical activity practice, extracurricular sports practice, Physical Education classes and total physical activity. Half of the studies used objective physical activity measures. The evaluation of school environments was again heterogeneous, ranging from checklists of spaces, satellite photos and interviews with school teachers and principals comprising sociocultural dimensions of the environment, policies and PE classes, but mainly measures of the built environment. No definitive conclusion about the influence of school environment on physical activity can be drawn due to the heterogeneity across studies, settings dimension assessed and the lack of prospective data. However, several features such as improvements in playgrounds, health promotion policies at school, and positive perceptions of the school environment seem to be associated with increased physical activity among children and adolescents.

O objetivo deste estudo foi identificar, discutir e sumarizar os achados sobre a associação entre características do ambiente escolar e atividade física em crianças e adolescentes. Foi utilizado o guia PRISMA para revisões sistemáticas. Artigos foram buscados na PubMed. Os principais critérios de inclusão foram: (a) estudos com crianças e adolescentes - estudos apenas com pré-escolares foram excluídos em função de uma recente revisão com este grupo; (b) atividade física como desfecho; (c) características do ambiente escolar como exposição. Os desfechos avaliados foram bastante heterogêneos entre os 13 estudos, desde atividade física no recreio, atividades extracurriculares, aula de educação física até atividade física total. Metade dos estudos utilizou medidas objetivas de atividade física. O ambiente escolar, também heterogêneo, foi avaliado a partir de listagem dos espaços físicos, fotos de satélite, entrevistas com diretores e professores, políticas e aulas de educação física, com predomínio para medidas do ambiente construído. Não foi possível ser conclusivo sobre a influência do ambiente escolar na atividade física, em função da heterogeneidade entre os estudos, dimensão ambiental avaliada e carência de dados prospectivos. Por outro lado, diversos atributos como melhorias nos parquinhos, políticas de promoção da saúde e percepções positivas do ambiente escolar parecem se relacionar com maior participação em atividades físicas em crianças e adolescentes.

Tendências temporais de atividade física no Brasil (2006-2009) / Time trends of physical activity in Brazil (2006-2009)

OBJETIVO: Analisar as tendências temporais de atividade física (AF) nas capitais brasileiras entre 2006 e 2009. MÉTODOS: A análise apresentada neste artigo é baseada nos dados do VIGITEL, totalizando uma amostra anual aproximada de 54.000 indivíduos. Foram analisados indicadores de AF no tempo livre, trabalho, em casa e no deslocamento, além do tempo assistindo à televisão e de inatividade considerando todos os domínios de AF. A variação dos indicadores no período foi aferida por meio de modelos de regressão de Poisson, tendo como variável explanatória o ano do inquérito. Foi considerada significativa a evolução correspondente a um coeficiente de regressão diferente de zero (p<0,05). RESULTADOS: O percentual de indivíduos ativos no deslocamento passou de 11,7 para 14,4 por cento (p<0,001), enquanto aqueles fisicamente inativos nos quatro domínios passaram de 11,7 para 8,7 por cento (p<0,001). Não foram observadas oscilações significantes nos demais indicadores. As mulheres foram menos ativas em todos os indicadores, exceto nos serviços domésticos. Neste domínio, houve redução das mulheres ativas de 71,4 para 67,1 por cento (p<0,001). Os níveis de AF da população brasileira entre 2006 e 2009 estão estáveis no tempo livre e nas atividades domésticas, mas aumentaram no deslocamento, acarretando uma diminuição no percentual de inativos no país. CONCLUSÃO: A continuidade do monitoramento e o fortalecimento do VIGITEL se colocam como prioridades e a área de AF se insere neste crescimento, e no longo prazo, poderá ter sua evolução temporal novamente avaliada.

OBJECTIVE: To examine time trends in physical activity (PA) in Brazilian state capitals from 2006 to 2009. METHODS: This analysis is based on data from the Telephone-based Surveillance of Risk and Protective Factors for Chronic Diseases (VIGITEL) accounting for an annual sample of approximately 54,000 individuals. PA indicators were analyzed in free time (leisure), work, home and transportation, time spent in front of the television and inactivity considering all PA domains. Poisson regression models were used to measure the variation of indicators over time. We considered the changes corresponding to a regression coefficient different from zero as being statistically significant (p<0.05). RESULTS: The percentage of active commuters increased from 11.7 to 14.4 percent (p<0.001) whereas the proportion of physically inactive individuals in the four domains decreased from 11.7 to 8.7 percent (p<0.001). There were no significant changes in the other indicators. Women were less active than men in all indicators, except for household chores. However, in this indicator the percentage of active women decreased from 71.4 to 67.1 percent (p<0.001). Between 2006 and 2009, PA levels in the Brazilian population were stable during free time and household chores, but increased in transportation, resulting in a decrease in the percentage of inactive individuals. CONCLUSION: The continued monitoring and strengthening of VIGITEL are public health priorities, and PA is a key part of it. In the long run, PA evolution may be re-evaluated.

Production of agaro- and carra-oligosaccharides by partial acid hydrolysis of galactans

Agaro- and carra-oligosaccharides were produced by partial acid hydrolysis of commercial agarose and kappa-carrageenan. Di- and tetrasaccharides were purified by gel filtration chromatography and characterized by NMR (1D and 2D) spectroscopy and ESIMS. The following oligosaccharides were obtained: agarobiose, agarotetraose, kappa-carrabiose and kappa-carratetraose. Agarobiose and agarotetraose were used as standards to develop a high performance size exclusion chromatography (HPSEC) method which was utilized to study the hydrolysis rate of agarose and oligosaccharide production. Six hours of hydrolysis (0.1 M TFA, 65 ºC) produced mainly di- and tetrasaccharides. The methodology for oligosaccharide production and evaluation developed in the present work shows good potential for the production of bioactive oligosaccharides.

Conhecimento de adultos sobre o papel da atividade física na prevenção e tratamento de diabetes e hipertensão: estudo de base populacional no Sul do Brasil / Public knowledge on the role of physical activity in the prevention and treatment of diabetes and hypertension: a population-based study in southern Brazil

O objetivo deste estudo foi avaliar o conhecimento dos adultos de Pelotas, Sul do Brasil, sobre o papel da atividade física na prevenção e tratamento de diabetes e hipertensão arterial, e os fatores associados aos conhecimentos. Foi realizado um estudo transversal de base populacional, com amostragem por conglomerados, incluindo 972 indivíduos de 20 a 69 anos. O conhecimento dos efeitos da atividade física na prevenção e tratamento foi maior para a hipertensão (82 por cento) do que para diabetes (47,2 por cento). Para a prevenção de diabetes maiores conhecimentos se associaram ao sexo feminino (RP = 1,16; IC95 por cento: 1,03-1,31), e no tratamento além destes, indivíduos ativos, obesos e de elevado nível econômico, tiveram maior conhecimento. Na prevenção da hipertensão, elevado conhecimento associou-se ao maior nível econômico (RP = 1,23; IC95 por cento: 1,11-1,36). Quanto ao tratamento, mulheres, indivíduos ativos e obesos apresentaram maior conhecimento. Em síntese, o conhecimento sobre o papel da atividade física no tratamento de diabetes e hipertensão é maior, em comparação à prevenção; tal achado merece destaque, pois a capacidade de prevenção da atividade física não parece estar tão bem difundida em termos populacionais.

The aim of this study was to evaluate public knowledge on the role of physical activity in the prevention and treatment of diabetes and hypertension, and the factors associated with such knowledge. A population-based cross-sectional study was conducted in Pelotas, southern Brazil, including 972 adults aged 20 to 69 years, selected with a clustering protocol. Knowledge on the preventive and curative benefits of physical activity was higher for hypertension (87.2 percent) than for diabetes (47.2 percent). Women were more knowledgeable on the role of physical activity in preventing diabetes (PR: 1.16; 95 percentCI: 1.03-1.31). In terms of treatment, greater knowledge was associated with female gender, current physical activity, obesity, subjects, and higher socioeconomic status. For prevention of hypertension, greater knowledge was observed in individuals with higher socioeconomic status (PR: 1.23; 95 percentCI: 1.11-1.36). For treatment of hypertension, physically active and obese subjects showed greater knowledge. Subjects were generally more knowledgeable on the curative role of physical activity than on its preventive benefits. Public health efforts should aim to raise public awareness on the preventive effects of physical activity against diabetes, hypertension, and other chronic non-communicable diseases.

Conhecimento dos acadêmicos de educação física sobre os efeitos da atividade física na prevenção etratamento do diabetes / Knowledge of physical education students on the effects of physical activity practice on diabetes prevention and treatment

O objetivo deste estudo foi investigar o conhecimento de acadêmicos de Educação Física sobre o diabetes e sua associação com a prática de atividade física e avaliar a percepção dos acadêmicos quanto à qualidade da formação para lidar com indivíduos diabéticos. Os participantes foram acadêmicos da Escola Superior de Educação Física da Universidade Federalde Pelotas. De um total de 263 acadêmicos elegíveis, 221 foram entrevistados. O percentual de acadêmicos que corretamente indicou hereditariedade, obesidade e alimentação como fatores de risco para diabetes foi elevado (>90%). Por outro lado, cerca de 1/5 dos acadêmicos não apontou corretamente a principal alteração metabólica resultante do diabetes e 14% desconheciam a associação entre prática de atividade física e diabetes. O conhecimento dosalunos tendeu a aumentar com o passar dos anos, embora os alunos do terceiro ano tenham apresentado conhecimento consistentemente superior aos do quarto ano. Pode-se concluir que o conhecimento dos acadêmicos sobre o diabetes foi satisfatório, embora alguns aspectos ainda possam ser melhorados e a maioria dos acadêmicos julgue sua formação acadêmica “não adequada” para lidar com indivíduos diabéticos.

The aim of this study was to investigate the knowledge of Physical Education students on diabetes and its association with physical activity practice and to evaluate the perception of the students of the quality of the knowledge gained at the university to deal with diabetic patients. Participants were students of the Physical Education School at the Federal University of Pelotas, Brazil. Out of 263 eligible students, 221 were interviewed. The percentage of students who correctly indicated genetics, obesity and diet as risk factors for diabetes was high (>90%). On the other hand, around 1/5 was not able to correctly identify the most important metabolic alteration a diabetic patients has and 14% were unaware of the association between physical activity practice and diabetes. Knowledge tended to improve with the year at the university, although third year students performed consistently better than fourth year ones. In conclusion,the knowledge of the students on diabetes and its association with physical activity was adequate,although some important aspects could be improved. In spite of the adequate knowledge, most students classified the knowledge gained at the Physical Education School inadequate for dealing with diabetic patients.

Research progresses on electroactive and electrically conductive polymers for tissue engineering scaffolds / 中国医学科学院学报

Electroactive and/or electrically conductive polymers have shown potential applications in the culture of excitable cells and as the electroactive scaffolds for neuronal or cardiac tissue engineering. The biocompatibility of the conductive polymer can be improved by covalently grafting or blending with oligo- or polypeptides. The new progresses in this area on two types of conductive polymers, polypyrrole and polyaniline (PANi) are reviewed in this paper. The studies of oligopeptide-modified PANi and electrospun PANi/gelatin nanofibers are highlighted.

Effect of Reproductive Status on In Vitro Developmental Competence of Bovine Oocytes

The objectives of the present study were to compare the in vitro maturation (IVM), fertilization and early embryonic development of bovine oocytes recovered from ovaries during the follicular, metestrus and diestrus stages of the estrous cycle and at anestrus and pregnancy after maturation in a serum free culture medium. Cumulus oocyte complexes (COCs) collected from ovaries at different reproductive statuses were matured in medium 199 supplemented with 10 g/ml FSH, 10 g/ml LH, 1.5 g/m estradiol, 75 g/ml streptomycin, 100 IU/ml penicillin and 10 mM HEPES. COCs were incubated in 200 microliter droplets of maturation medium 199 under oil for 24 h at 39degrees c and 5% CO2. Matured oocytes were exposed to frozen-thawed TALP swim up, heparin capacitated sperm from two bulls separately in each replicate (20 h, 39C, 5% CO2). After fertilization, the presumptive zygotes were cultured in medium 199 containing 8 mg/ml BSA-V, 100 IU/ml penicillin-G, 75 g/ml streptomycin and 10 mM HEPES for 144 h at 39C and 5% CO2 without medium freshening or change. Oocytes/embryos were fixed, stained with DAPI and evaluated under fluorescent microscope. The IVM rates were almost similar among oocytes from all reproductive statuses (range: 89.8 to 95.4%). However, IVM rates for oocytes from the metestrus (90.6%) and pregnant (89.9%) phases were lower than the other groups. The fertilization rates were lower (p<0.05) for oocytes from the diestrus phase (72.4%) than from the other phases (range: 81.1 to 86.6%). Oocytes, recovered during the metestrus phase of the estrous cycle, resulted in the highest cleavage rate (60.0%), while oocytes from the diestrus phase had the poorest embryonic development (39.8%: p<0.05). Majority of the embryos from all reproductive phases showed a developmental arrest around 8-cell stage. Although the developmental competence of oocytes from pregnant and anestrus animals was lower than that from the other reproductive stages, they could be potentially used as oocyte donors. Long term, in vitro embryo culture without medium freshening or change was hypothesized to have caused the failure to overcome the 8-cell block to development.