Two-dimensional facial photography for assessment of craniofacial morphology in sleep breathing disorders: a systematic review.

PURPOSE: Craniofacial morphology is integral to Sleep Breathing Disorders (SBD), particularly Obstructive Sleep Apnea (OSA), informing treatment strategies. This review assesses the utility of two-dimensional (2D) photogrammetry in evaluating these metrics among OSA patients. METHODS: Following PRISMA guidelines, a systematic review was conducted. PubMed, Embase, and Lilacs databases were systematically searched for studies utilizing 2D photography in SBD. Findings were narratively synthesized. RESULTS: Thirteen studies involving 2,328 patients were included. Significant correlations were found between craniofacial measurements-specifically neck parameters and facial width-and OSA severity, even after BMI adjustment. Ethnic disparities in craniofacial morphology were observed, with photogrammetry effective in predicting OSA in Caucasians and Asians, though data for other ethnicities were limited. Pediatric studies suggest the potential of craniofacial measurements as predictors of childhood OSA, with certain caveats. CONCLUSION: 2D photogrammetry emerges as a practical and non-invasive tool correlating with OSA severity across diverse populations. However, further validation in various ethnic cohorts is essential to enhance the generalizability of these findings.

Technological and sensory characteristics in development of innovative symbiotic boneless dry-cured lamb meat snack.

Novel shelf-stable and high-protein meat products that are affordable, convenient, and healthy are hot topic in current food innovation trends. To offer technological databases for developing new functional lamb meat products, this study aimed to evaluate the technological and sensory aspects of dry-cured lamb meat snacks incorporated with the probiotic culture Lactobacillus paracasei and the prebiotic lactulose. Four formulations were analyzed: control (without prebiotic or probiotic); PREB (with 2% lactulose); PROB (with 107 CFU/g of L. paracasei); and SYMB (with 2% lactulose and 107 CFU/g of L. paracasei). Fitted curves revealed that weight-loss behavior during snack ripening was not affected (P > 0.05) by treatments. Snack moisture, water activity, pH, titratable acidity, lipid oxidation, and residual nitrite were affected (P < 0.05) only by ripening time. The target probiotic strain stood out against competitive flora and was detected at 107 CFU/g in the snack-supplemented formulations (PROB and SYMB). In snacks supplemented with prebiotics (PREB and SYMB), the lactulose content was maintained at 2.17%. Significant differences were not observed in the chemical composition, texture profiles, and CIE color indices between the proposed functional snacks and the control. In addition to texture, flavor, and overall impression evaluation, only color attributes were positively impacted (P < 0.05) in the acceptance and multiple comparison tests against the control. The proposed formulation and bench process parameters produced potential nutritionally and sensory-appreciated, microbiologically stable, and safe (multi-hurdle perspective) functional high-protein restructured lamb snacks.

TNF-α blockage prevents late neurological consequences of Zika virus infection in mice.

Zika virus (ZIKV) is a neurotropic Orthoflavivirus that causes a myriad of neurological manifestations in newborns exposed in uterus. Despite the devastating consequences of ZIKV on the developing brain, strategies to prevent or treat the consequences of viral infection are not yet available. We previously showed that short-term treatment with the TNF-α neutralizing monoclonal antibody. Infliximab could prevent seizures at acute and chronic stages of ZIKV infection, but had no impact on long-term cognitive and motor dysfunction. Due to the central role of inflammation in ZIKV-neuropathology, we hypothesized that prolonged treatment with the anti-TNF-α monoclonal antibody Infliximab could provide complete rescue of long-term behavioral deficits associated with neonatal ZIKV infection in mice. Here, neonatal (post-natal day 3) Swiss mice were submitted to subcutaneous (s.c.) injection of 106 PFU of ZIKV or mock medium and were then treated with Infliximab (20 µg/day) or sterile saline intraperitoneally (i.p.), for 40 days starting on the day of infection, and behavioral assessment started at 60 days post-infection (dpi). Infliximab prevented ZIKV-induced cognitive and motor impairments in mice. In addition, microgliosis and cell death found in mice following ZIKV infection were partially reversed by TNF-α blockage. Altogether, these results suggest that TNF-α-mediated inflammation is central for late ZIKV-induced behavioral deficits and cell death and strategies targeting this cytokine may be promising approaches to treat subjects exposed to the virus during development.

S-nitrosothiols as nitrite alternatives: Effects on residual nitrite, lipid oxidation, volatile profile, and cured color of restructured cooked ham.

This study evaluated the use of the S-nitrosothiols, S-nitroso-N-acetylcysteine (NAC-SNO) and S-nitroso-N-acetylcysteine ethyl ester (NACET-SNO), at different concentrations (25-300 mg nitrite equivalent - NEq/kg) as sodium nitrite substitutes in restructured cooked hams. The pH value and instrumental cured color were not affected by the type or amount of curing agent used. Products with 25 and 50 mg/kg ingoing nitrite had lower thiobarbituric acid-reactive substance values than those with equimolar amounts of S-nitrosothiols. Products with >150 mg NEq/kg of S-nitrosothiols had residual nitrite similar to 50 mg/kg nitrite, and this resulted in the same volatile compound profile as nitrite added in equimolar amounts. A 300 mg NEq/kg of S-nitrosothiols was required to obtain a similar and minimally stable cured pink color perception as sliced samples with 50-150 mg/kg added nitrite. The results obtained reinforce the great potential of both alternative curing agents in the complete replacement of nitrite by equimolar amounts in restructured cooked products; however, differences in cured color stability should be considered.

Fatores associados à ansiedade e depressão em idosos: Uma revisão integrativa / Factors associated with anxiety and depression in the elderly: An integrative review

Objetivo: Conhecer os fatores associados à ansiedade e depressão em pessoas idosas. Método: estudo descritivo, exploratório com abordagem qualitativa do tipo revisão integrativa. Tendo como bases de dados as plataformas Scientific Eletronic Library Online (SciElo), Google Acadêmico entre outros, incluindo artigos entre 2012 a 2022. Resultados: Foram selecionados para este estudo sete artigos que se adequavam a temática e posterior ao filtro dos critérios de inclusão, todos os artigos tinham uma abordagem quantitativa e a grande maioria era descritiva, os artigos citaram como fatores associados à depressão e ansiedade o sexo, a idade e estado civil. Conclusão: A literatura é vasta quando trata a respeito de depressão, porém ainda escassa quando se trata de ansiedade. Compreendeu-se, que os sentimentos e fatores relacionados à ansiedade e depressão, assim como a importância de uma equipe apta a lidar com as questões relacionadas à saúde mental de idosos é fundamental.(AU)

Objective: To know the factors associated with anxiety and depression in the elderly. Method: descriptive, exploratory study with a qualitative approach of the integrative review type. Using the Scientific Electronic Library Online (SciElo) and Google Scholar platforms as databases, including articles from 2012 to 2022. Results: Seven articles were selected for this study that suited the theme and after the inclusion criteria filter, all articles had a quantitative approach and the vast majority were descriptive, the articles cited sex, age and marital status as factors associated with depression and anxiety. Conclusion: The literature is vast when it comes to depression, but still scarce when it comes to anxiety. It was understood that the feelings and factors related to anxiety and depression, as well as the importance of a team able to deal with issues related to the mental health of the elderly, is fundamental.

Objetivo: Conocer los factores asociados a la ansiedad y depresión en el adulto mayor. Método: estudio descriptivo, exploratorio con abordaje cualitativo del tipo revisión integradora. Teniendo como bases de datos la Scientific Electronic Library Online (SciElo), Google Scholar, entre otras, incluyendo artículos entre 2012 y 2022. Resultados: Se seleccionaron para este estudio siete artículos que se adecuaban a la temática y después del filtro de los criterios de inclusión, todos los artículos tenían un enfoque cuantitativo y en su gran mayoría fueron descriptivos, los artículos citaron el sexo, la edad y el estado civil como factores asociados a la depresión y la ansiedad. Conclusión: La literatura es amplia cuando se trata de depresión, pero aún escasa cuando se trata de ansiedad. Se entendió que los sentimientos y factores relacionados con la ansiedad y la depresión, así como la importancia de un equipo capaz de tratar los problemas relacionados con la salud mental de los ancianos, es fundamental.(AU)

Predictive factors for the diagnosis of permanent congenital hypothyroidism and its temporal changes in Sergipe, Brazil - A real-life retrospective study.

Objective: Congenital hypothyroidism (CH) can be permanent (PCH) or transient (TCH). While the importance of thyroxine in myelination of the brain is undisputed, the benefits to neurodevelopmental outcomes of TCH treatment are controversial. Our objectives were to determine predictive factors for PCH and verify its prevalence changes over time. Subjects and methods: A total of 165 children were evaluated at 3 years of age to verify the diagnosis of PCH. 130 were submitted to a two-step cluster analysis, with the aim of grouping them into homogeneous clusters. The mean incidence of PCH and TCH was calculated from 2004 to 2010 and 2011 to 2015. Results: Sixty-six children were diagnosed with PCH, and 99 were diagnosed with TCH. Eighty-one percent of PCH children and all TCH children with thyroid imaging had glands in situ. Eighty children (61.5%) were in Cluster 1, 8 children (6.2%) were in Cluster 2 and 42 children (32.3%) were in Cluster 3. No children had PCH in Cluster 1, while 87.5% of children in Cluster 2 and all children in Cluster 3 had PCH. The most important predictor for PCH was the initial serum TSH, which was marginally higher in importance than the blood spot TSH, followed by the initial serum free T4. The mean incidence of PCH (odds ratio: 1.95, 95% CI 1.36 to 2.95, p < 0.0001) and TCH (odds ratio 1.33, 95%, CI 1.02 to 1.77, p = 0,038) increased over time. Conclusion: The most important PCH predictors are the initial serum TSH and the blood spot TSH. The mean incidence of both PCH and TCH in our series increased.

Predictive factors for the diagnosis of permanent congenital hypothyroidism and its temporal changes in Sergipe, Brazil - A real-life retrospective study

ABSTRACT Objectives: Congenital hypothyroidism (CH) can be permanent (PCH) or transient (TCH). While the importance of thyroxine in myelination of the brain is undisputed, the benefits to neurodevelopmental outcomes of TCH treatment are controversial. Our objectives were to determine predictive factors for PCH and verify its prevalence changes over time. Subjects and methods: A total of 165 children were evaluated at 3 years of age to verify the diagnosis of PCH. 130 were submitted to a two-step cluster analysis, with the aim of grouping them into homogeneous clusters. The mean incidence of PCH and TCH was calculated from 2004 to 2010 and 2011 to 2015. Results: Sixty-six children were diagnosed with PCH, and 99 were diagnosed with TCH. Eighty-one percent of PCH children and all TCH children with thyroid imaging had glands in situ. Eighty children (61.5%) were in Cluster 1, 8 children (6.2%) were in Cluster 2 and 42 children (32.3%) were in Cluster 3. No children had PCH in Cluster 1, while 87.5% of children in Cluster 2 and all children in Cluster 3 had PCH. The most important predictor for PCH was the initial serum TSH, which was marginally higher in importance than the blood spot TSH, followed by the initial serum free T4. The mean incidence of PCH (odds ratio: 1.95, 95% CI 1.36 to 2.95, p < 0.0001) and TCH (odds ratio 1.33, 95%, CI 1.02 to 1.77, p = 0,038) increased over time. Conclusions: The most important PCH predictors are the initial serum TSH and the blood spot TSH. The mean incidence of both PCH and TCH in our series increased.

Growth of teeth and bones in adult subjects with congenital untreated isolated growth hormone deficiency.

OBJECTIVE: To understand the growth of teeth and mandibular and maxillary bones in subjects with isolated growth hormone deficiency (IGHD). MATERIAL AND METHODS: Mesiodistal tooth width of 28 maxillary and mandibular dental models of 14 adult IGHD subjects (9 men) were digitalized and compared to 40 models of 20 normal-statured controls (11 men). The mean SDS of the maxillary and mandibular teeth were compared with height, cephalic perimeter, total anterior facial height, total maxillary and mandibular length, and maxillary and mandibular arches. RESULTS: All average mesiodistal dimensions in absolute values of the 14 dental pairs were reduced in the IGHD group. Eight of 28 (28.6%) mesiodistal dimensions in IGHD subjects of both sexes had an average SDS below -2, thirteen of them (46.4%) had mean SDS between -1 and - 2, and seven of them (25.0%) had SDS above -1. The highest SDS values were the upper lateral incisor (-0.32 in women), and the upper canine (-0.91 in men). The lowest SDS values were the 2nd upper molar (-3.51 in men), and the 2nd upper premolar (-2.64 in women). The ascending order of the mean SDS was height, total maxillary length, total mandibular length, total anterior height of the face, cephalic perimeter, the maxillary arches width, the mesiodistal width of the mandibular teeth, the mesiodistal width of the maxillary teeth and the mandibular arches width. CONCLUSIONS: Reduction in mesiodistal width is present in untreated IGHD adults with magnitude of tooth size reduction being lower than height, cephalic perimeter, total anterior facial height, and most jaw measurements. IGHD abolishes the sexual dimorphism in mesiodistal dental measures.

Art and science: impact of semioccluded vocal tract exercises and choral singing on quality of life in subjects with congenital GH deficiency

ABSTRACT Objectives: Currently, not much is known about the interactions between voice and growth hormone (GH). We have described large kindred with isolated GH deficiency (IGHD) due to a GHRH receptor mutation, resulting in severe short stature and high-pitched voice. These IGHD individuals have little interest in GH treatment, as they consider themselves "short long-lived people", rather than patients. Interestingly, they report normal general quality of life, but they rate their Voice-Related Quality of Life (V-RQOL) as low. Here, we assessed the social and auditory-perceptual impacts of artistic-intervention voice therapy with semioccluded vocal tract exercises (SOVTE) and choral singing, on their voices. Material and methods: Seventeen GH-naïve adult IGHD individuals were enrolled in a single-arm interventional pre-post study with 13 weekly sessions of choir singing over 90 days. Outcome measures were V-RQOL scores, self-assessment of voice, and auditory-perceptual analysis (GRBAS scale, G: grade of the severity of dysphonia; R: roughness; B: breathiness; A: asthenia; and S: strain). Results: Marked improvements in total (p = 0.0001), physical (p = 0.0002), and socioemotional (p = 0.0001) V-RQOL scores and in self-assessment of voice (p = 0.004) were found. The general grades of vocal deviation (p = 0.0001), roughness (p = 0.0001), breathiness (p = 0.0001) and strain (p = 0.0001) exhibited accentuated reductions. Conclusions: Voice therapy with semioccluded vocal tract exercises and choral training improved social impact and perceptual voice assessments in IGHD subjects and markedly improved their voice-related quality of life. This is particularly important in a setting where GH replacement therapy is not widely accepted.

Art and science: impact of semioccluded vocal tract exercises and choral singing on quality of life in subjects with congenital GH deficiency.

Objective: Currently, not much is known about the interactions between voice and growth hormone (GH). We have described large kindred with isolated GH deficiency (IGHD) due to a GHRH receptor mutation, resulting in severe short stature and high-pitched voice. These IGHD individuals have little interest in GH treatment, as they consider themselves "short long-lived people", rather than patients. Interestingly, they report normal general quality of life, but they rate their Voice-Related Quality of Life (V-RQOL) as low. Here, we assessed the social and auditory-perceptual impacts of artistic-intervention voice therapy with semioccluded vocal tract exercises (SOVTE) and choral singing, on their voices. Methods: Seventeen GH-naïve adult IGHD individuals were enrolled in a single-arm interventional pre-post study with 13 weekly sessions of choir singing over 90 days. Outcome measures were V-RQOL scores, self-assessment of voice, and auditory-perceptual analysis (GRBAS scale, G: grade of the severity of dysphonia; R: roughness; B: breathiness; A: asthenia; and S: strain). Results: Marked improvements in total (p = 0.0001), physical (p = 0.0002), and socioemotional (p = 0.0001) V-RQOL scores and in self-assessment of voice (p = 0.004) were found. The general grades of vocal deviation (p = 0.0001), roughness (p = 0.0001), breathiness (p = 0.0001) and strain (p = 0.0001) exhibited accentuated reductions. Conclusion: Voice therapy with semioccluded vocal tract exercises and choral training improved social impact and perceptual voice assessments in IGHD subjects and markedly improved their voice-related quality of life. This is particularly important in a setting where GH replacement therapy is not widely accepted.

Dental arches in inherited severe isolated growth hormone deficiency.

OBJECTIVES: The growth of the dental arches depends on GH and insulin-like growth factor type 1 (IGF1), but the consequences of GH deficiency (GHD) on their growth are still unclear, probably due to the acquired etiology of GHD in most described series, often associated with additional pituitary deficits (thyrotrophic, corticotrophic and gonadotrophic hormones), and imperfections of related replacement therapies, which may affect the dental arch growth. To avoid these limitations, we took advantage of a unique cohort of subjects with isolated GH deficiency (IGHD) due the same mutation in the GH releasing hormone receptor gene, living with very low serum GH and low to undetectable circulating IGF1 levels. Our purpose was to analyze the dimensions of maxillary and mandibular dental arches. METHODS: 22 adult IGHD (15 untreated and 7 previously partially treated with GH) and 33 controls were enrolled in a cross-sectional study using the Ortho Insight 3D and MeshMixer software, RESULTS: In untreated IGHD subjects all maxillary arch measures were smaller than controls, while among mandibular arches, only the mandibular canine width and the mandibular arch length were reduced. In partially GH treated subjects only the palate depth, the maxillary canine width, the maxillary and mandibular arch lengths remained smaller than controls. CONCLUSIONS: IGHD reduces the growth of maxillary arch to a greater degree than the mandibular arch, suggesting different control of superior and inferior dental arches. GH treatment increases some of these measures.

Perception of women about telehealth during the coronavirus pandemic (SARS-CoV-2) / Percepção de mulheres sobre o teleatendimento durante o período de pandemia do coronavírus (SARS-CoV-2)

Abstract Introduction Since the new coronavirus (SARS-CoV-2) was declared a pandemic, health care was one of the fields that underwent significant changes. Telemedicine, that uses technological and communication resources to provide health care, was deemed a safe alternative to continue patient care while quarantine and social isolation measures were in place. Objective To analyze the perception of women treated at an outpatient clinic in relation to remote health care implemented during the COVID-19 pandemic. Methods Descriptive research conducted at the Women's Physiotherapy Outpatient Clinic of the Prof. Fernando Figueira Comprehensive Medicine Institute (IMIP) in Recife, Pernambuco state, Brazil. The study included women above the age of 18 years who were being remotely treated and excluded those who discontinued treatment. Data were collected from November 2020 to July 2021, using a questionnaire which was sent to the participants via WhatsApp. Results Twenty-six women with an average age of 52 ± 10.1 years were interviewed. Most (61.54%) were being treated for urinary incontinence at the outpatient clinic and 38.5% had been undergoing physiotherapy for at least six months. A total of 92.3% of the participants reported feeling safe with remote health care and 70.4% noticed an improvement in their symptoms. Conclusion Most patients noticed an improvement in their symptoms, felt comfortable and safe with teleservices and would agree to continue even after returning to in-person care. However, to ensure more effective results, patients need to be well informed and have some prior knowledge about the proposed treatment.

Resumo Introdução Desde que foi declarada a pandemia do novo coronavírus (SARS-CoV-2), a área da saúde foi um dos campos que sofreu significativas modificações. O teleatendimento em saúde, que consiste na utilização de recursos tecnológicos e de comunicação para prestar assistência em saúde, foi uma alternativa encontrada para continuar, de maneira segura, o cuidado com os pacientes enquanto vigoravam as medidas de quarentena e isolamento social. Objetivo Analisar a percepção de mulheres assistidas em um hospital-escola do nordeste do Brasil referente ao teleatendimento implantado durante a pandemia de COVID-19. Métodos Estudo descritivo transversal realizado no Ambulatório de Fisioterapia da Mulher do Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), em Recife/PE. Foram incluídas mulheres maiores de 18 anos, em assistência remota via teleatendimento, excluindo aquelas que não deram continuidade ao atendimento por telessaúde. Para a coleta de dados, realizada de novembro de 2020 a julho de 2021, utilizou-se um questionário próprio, que foi enviado via WhatsApp para as participantes do estudo. Resultados Foram entrevistadas 26 pacientes com idade média de 52 ± 10,1 anos. A maioria (61,5%) foi atendida no ambulatório para tratar incontinência urinária e 38,5% estavam em tratamento fisioterapêutico há pelo ao menos seis meses. A maioria (92,3%) relatou se sentir segura com a assistência remota e 70,4% perceberam melhora dos sintomas. Conclusão A maior parte das participantes percebeu melhora dos sintomas, sentindo-se confortável e segura com o teleatendimento, e aceitaria continuar com o tratamento à distância mesmo após o retorno das atividades presenciais. Para uma resposta mais efetiva, contudo, as pacientes precisam ser bem orientadas e ter algum conhecimento prévio acerca do tratamento a ser proposto pela fisioterapia.

Synthesis of magnetic nanoparticles functionalized with histidine and nickel to immobilize His-tagged enzymes using ß-galactosidase as a model.

The aim of this study was to synthesize iron magnetic nanoparticles functionalized with histidine and nickel (Fe3O4-His-Ni) to be used as support materials for oriented immobilization of His-tagged recombinant enzymes of high molecular weight, using ß-galactosidase as a model. The texture, morphology, magnetism, thermal stability, pH and temperature reaction conditions, and the kinetic parameters of the biocatalyst obtained were assessed. In addition, the operational stability of the biocatalyst in the lactose hydrolysis of cheese whey and skim milk by batch processes was also assessed. The load of 600 Uenzyme/gsupport showed the highest recovered activity value (~50%). After the immobilization process, the recombinant ß-galactosidase (HisGal) showed increased substrate affinity and greater thermal stability (~50×) compared to the free enzyme. The immobilized ß-galactosidase was employed in batch processes for lactose hydrolysis of skim milk and cheese whey, resulting in hydrolysis rates higher than 50% after 15 cycles of reuse. The support used was obtained in the present study without modifying chemical agents. The support easily recovered from the reaction medium due to its magnetic characteristics. The iron nanoparticles functionalized with histidine and nickel were efficient in the oriented immobilization of the recombinant ß-galactosidase, showing its potential application in other high-molecular-weight enzymes.

Production of beta-galactosidase fused to a cellulose-binding domain for application in sustainable industrial processes.

This study aimed to produce and characterize a recombinant Kluyveromyces sp. ß-galactosidase fused to a cellulose-binding domain (CBD) for industrial application. In expression assays, the highest enzymatic activities occurred after 48 h induction on Escherichia coli C41(DE3) strain at 20 °C in Terrific Broth (TB) culture medium, using isopropyl ß-d-1-thiogalactopyranoside (IPTG) 0.5 mM (108.77 U/mL) or lactose 5 g/L (93.10 U/mL) as inducers. Cultures at bioreactor scale indicated that higher product yield values in relation to biomass (2000 U/g) and productivity (0.72 U/mL.h) were obtained in culture media containing higher protein concentration. The recombinant enzyme showed high binding affinity to nanocellulose, reaching both immobilization yield and efficiency values of approximately 70% at pH 7.0 after 10 min reaction. The results of the present study pointed out a strategy for recombinant ß-galactosidase-CBD production and immobilization, aiming toward the application in sustainable industrial processes using low-cost inputs.

Formant Frequencies, Cephalometric Measures, and Pharyngeal Airway Width in Adults With Congenital, Isolated, and Untreated Growth Hormone Deficiency.

OBJECTIVE: Adult subjects with isolated growth hormone deficiency (IGHD) due to a mutation in the growth hormone releasing hormone receptor gene exhibit higher values formant frequencies. In normal subjects, a significant negative association between the formant frequencies and the reduction of linear craniofacial measurements, especially of maxilla and mandible, has been reported. This suggests smaller pharyngeal width, despite low prevalence of obstructive sleep apnea syndrome. Here we evaluate their pharyngeal airway width, its correlation with vowel formant frequencies, and the correlation between them and the craniofacial measures. SUBJECTS AND METHODS: A two-step protocol was performed. In the first case-control experiment, aimed to assess the pharyngeal width, we compared nine adult IGHD and 36 normal statured controls. Both upper and lower pharyngeal widths were measured. The second step (assessment of pharyngeal width) was performed only in the IGHD group. RESULTS: Upper and lower pharyngeal widths were similar in IGHD and controls. In IGHD subjects, the lower pharyngeal width exhibited a negative correlation with F1 [a] and a positive correlation with mandibular length. There were negative correlations between F1 and F2 with linear and positive correlations with the angular measures. CONCLUSIONS: Pharyngeal airway width is not reduced in adults with congenital, untreated lifetime IGHD, contributing to the low prevalence of obstructive sleep apnea syndrome. The formant frequencies relate more with cephalometric measurements than with the pharyngeal airway width. These findings exemplify the consequences of lifetime IGHD on osseous and nonosseous growth.

Effect of by-products from the dairy industry as alternative inducers of recombinant ß-galactosidase expression.

OBJECTIVE: The aim of the present study was to evaluate the efficiency of lactose derived from cheese whey and cheese whey permeate as inducer of recombinant Kluyveromyces sp. ß-galactosidase enzyme produced in Escherichia coli. Two E. coli strains, BL21(DE3) and Rosetta (DE3), were used in order to produce the recombinant enzyme. Samples were evaluated for enzyme activity, total protein content, and sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) analysis after induction with isopropyl-ß-D-1-thiogalactoside (IPTG) (0.05 and 1 mM) and lactose, cheese whey, and cheese whey permeate solutions (1, 10, and 20 g/L lactose) at shake-flask cultivation, and whey permeate solution (10 g/L lactose) at bioreactor scale. RESULTS: The highest specific activities obtained with IPTG as inducer (0.05 mM) after 9 h of induction, were 23 and 33 U/mgprotein with BL21(DE3) and Rosetta(DE3) strains, respectively. Inductions performed with lactose and cheese whey permeate (10 and 20 g/L lactose) showed the highest specific activities at the evaluated hours, exhibiting better results than those obtained with IPTG. Specific activity of recombinant ß-galactosidase using whey permeate (10 g/L lactose) showed values of approximately 46 U/mgprotein after 24-h induction at shake-flask study, and approximately 26 U/mgprotein after 16-h induction at bench bioreactor. CONCLUSIONS: The induction with cheese whey permeate was more efficient for recombinant ß-galactosidase expression than the other inducers tested, and thus, represents an alternative form to reduce costs in recombinant protein production.

Endodontic approach in a replanted tooth with an immature root apex and chronic apical periodontitis: a case report.

This study describes the clinical steps taken in the treatment of a patient who had an avulsed right upper central incisor that presented with incomplete root development and chronic apical periodontitis. A 7-year-old boy was referred from a private dentist to a dental office specializing in endodontics. The tooth had remained in a dry environment for 20 minutes, and tooth replantation was performed at an emergency appointment. After clinical and radiographic examinations, root canal decontamination was performed, followed by several changes in intracanal calcium hydroxide medication. Blood clot formation was attempted, but bleeding within the root canal was insufficient; therefore, we opted for an intracanal medication change to stimulate mineralized tissue formation in the apical region. Root obturation was performed 45 days after the last change of intracanal medication, and clinical, radiographic, and tomographic follow-up examinations were performed at 3, 6, 18, and 40 months after the endodontic intervention. The increase in thickness and length of the root structure and the absence of root resorption were verified through follow-up examinations. Therefore, it was concluded that the procedures used were successful for tooth replantation.

Assessment on the measurement properties of the Brazilian Portuguese language version of the International Consultation on Incontinence Questionnaire Female Sexual Matters Associated with Lower Urinary Tract Symptoms Module (ICIQ-FLUTSsex) / Avaliação das propriedades de medida da versão em português do International Consultation on Incontinence Questionnaire Female Sexual Matters Associated with Lower Urinary Tract Symptoms Module (ICIQ-FLUTSsex)

Abstract Objectives: to assess internal consistency and reliability in providing a Portuguese version of the International Consultation on Incontinence Questionnaire Female Sexual Matters Associated with Lower Urinary Tract Symptoms Module (ICIQ-FLUTSsex). Methods: a validation study was conducted by applying questionnaires for 56 women over 18 years old with active sexual life and presenting urinary incontinence, excluding those who had urinary infection in the past 6 months. Three questionnaires were used, one for personal identification; the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) and the ICIQ-FLUTSsex. SPSS software was used for data analysis. Cronbach's alpha was used to verify reliability of the items on the questionnaires and Kappa coefficient was used to assess the agreement between the questionnaires applied in the test-retest. Results: the median age was 49.1 years old, mostly were mixed colored skin and married, with a high prevalence of mixed urinary incontinence. Cronbach's alpha score was 0.80, which was considered good. Kappa value was moderate, ranging from 0.36 to 0.76. Conclusion: internal consistency was considered good and reliability moderate. The Portuguese version of ICIQ-FLUTSsex was proven to be valid to use on women with urinary incontinence, contributing for clinical practice, as it provides as a quick tool for research on sexual dysfunction.

Resumo Objetivos: avaliar a consistência interna e a confiabilidade e disponibilizar a versão em português do International Consultation on Incontinence Questionnaire Female Sexual Matters Associated with Lower Urinary Tract Symptoms Module (ICIQ-FLUTSsex). Métodos: estudo de validação, realizado por meio de questionários em 56 mulheres, maiores de 18 anos, com vida sexual ativa e apresentavam incontinência urinária, excluindo as que tiveram infecção urinária nos últimos 6 meses. Foram utilizados três questionários para coleta, um de identificação pessoal; o International Consultationon Incontinence Questionnaire-Short Form (ICIQ-SF) e o ICIQ-FLUTSsex. Para análise dos dados utilizou-se o software SPSS. Para verificar a confiabilidade dos itens do questionário utilizou o Alfa de Cronbach e para avaliar a concordância entre o questionário aplicado no teste-reteste foi utilizado o coeficiente de Kappa Ponderado. Resultados: a idade média foi de 49,1 anos, sendo a maioria parda e casada, com maior prevalência da incontinência urinaria mista. O resultado do Alfa de Cronbach foi de 0,80, considerado bom. O valor de Kappa Ponderado foi moderado, variando de 0,36 a 0,76. Conclusão: a consistência interna foi considerada boa e a confiabilidade moderada. A versão do ICIQ-FLUTSsex em português mostrou-se válida para ser utilizada em mulheres com incontinência urinária, contribuindo para a prática clínica, uma vez que fornece uma ferramenta rápida para a pesquisa sobre disfunção sexual.

Grupos de artesanato na atenção primária como apoio em saúde mental de mulheres: estudo de implementação / Community handcraft groups in Primary Care as mental health support for women: an implementation study / Grupos de artesanía en la Atención Primaria como apoyo en salud mental a mujeres: estudio de implementación

Cerca de metade dos pacientes em salas de espera na Atenção Primária à Saúde, possui algum tipo de transtorno mental. Diante disto, são imprescindiveis as ações de promoção, prevenção e cuidado em saúde mental, atuando de forma intersetorial. Analisar a implementação e desenvolvimento dos grupos de convivência. Trata-se de um estudo qualitativo da estruturação dos grupos de convivência e artesanato em unidades da Estratégia de Saúde da Família. Utilizou-se a metodologia SWOT/FOFA para análise dos dados. Estruturaram-se cinco grupos, atendendo em média 170 mulheres; cerca de 25% delas se dedicou à profissionalização. Verificou-se melhora da autoestima, empoderamento, redução da ansiedade e depressão e maior reconhecimento de suas capacidades. Foram identificados dois níveis de efeitos dos grupos: suporte social e resgate da autoestima, centrados nas atividades na Unidade de Saúde, e geração de renda, com ações externas.

About half of patients in waiting rooms in Primary Health Care have some type of mental disorder. Faced with this, the actions of promotion, prevention and care in mental health are essential, acting in an intersectoral way. To analyze the implementation and development of social groups. This is a qualitative analysis of the structuring of community handcraft groups in Family Health Strategy units. The SWOT / FOFA methodology was used for data analysis. Five groups were structured, attending an average of 170 women, about 25% of them dedicated to professionalization. There was improvement in self-esteem, empowerment, reduction of anxiety and depression, greater recognition of their abilities and achievements. Two types of effects from the groups were identified: social support and self-esteem recovery, centered in activities inside the Health Unit, and income generation, with external actions.

Cerca de mitad de los pacientes en servicios de Atención Primaria a la Salud, tiene trastorno mental. Ante esto, son imprescindibles las acciones de promoción, prevención y cuidado en salud mental, actuando de forma intersectorial. Analizar la implementación y el desarrollo de grupos de convivencia e artesania. Estudio cualitativo de la estructuración de los grupos de convivencia en unidades de la Estrategia de Salud de la Familia utilizando la metodología SWOT/FOFA. Se estructuraron cinco grupos, atendiendo a 170 mujeres, cerca del 25% se dedicó a la profesionalización. Se verificó mejora de la autoestima, empoderamiento, reducción de la ansiedad y depresión, reconocimiento de sus capacidades y conquistas. Se identificaron dos tipos de efeitos de los grupos: apoyo social y rescate de la autoestima, centrado en las actividadds en la Unidad de Salud, y generación de ingresos, con acciones externas.