Osteopontin-4 and Osteopontin-5 splice variants are expressed in several tumor cell lines.

Among osteopontin splice variants (OPN-SV), the expression profile of osteopontin-4 (OPN4) and osteopontin-5 (OPN5) has not been addressed in distinct cancer types. We herein aimed to investigate their expression in several cancer cell lines, besides comparing it in relation to the three previously described OPN-SV: OPNa, OPNb and OPNc. Total RNA from cancer cell lines, including prostate (PC3 and DU145), ovarian (A2780), breast (MCF-7 and MDA-MB-231), colorectal (Caco-2, HT-29 and HCT-116), thyroid (TT, TPC1 and 8505c) and lung (A549 and NCI-H460) was extracted, followed by cDNA synthesis. OPN-SV transcript analysis by RT-PCR or RT-qPCR were performed using OPN-SV specific oligonucleotides and gapdh and actin transcripts were used as housekeeping controls. OPN4 and OPN5 transcripts displayed co-expression in most tested cell lines. OPN4 was found expressed in similar or higher levels in relation to OPN5. Moreover, in most tested cell lines, OPN4 is also expressed in similar levels to OPNa or OPNb. The expression of OPN5 is also generally variable in relation to the other OPN-SV, but expressed in similar or higher levels in relation to OPNc, depending on each tested cell line. OPN4 and OPN5 seem to be co-expressed in several tumor types and OPN4 is one of the most overexpressed OPN-SV in distinct tumor cell lines. Once both OPN4 and OPN5 are differentially expressed and also evidence tumor-specific expression patterns, we hypothesize that similarly to the other OPN-SV, they also possibly contribute to key aspects of tumor progression, what should be further functionally investigated in distinct tumor models.

Metabolome-guided genomics to identify pathogenic variants in isocitrate dehydrogenase, fumarate hydratase, and succinate dehydrogenase genes in pheochromocytoma and paraganglioma.

PURPOSE: Metabolic aberrations have been described in neoplasms with pathogenic variants (PV) in the Krebs cycle genes encoding succinate dehydrogenase (SDH), fumarate hydratase (FH) and isocitrate dehydrogenase (IDH). In turn, accumulation of oncometabolites succinate, fumarate, and 2-hydroxyglutarate can be employed to identify tumors with those PV . Additionally, such metabolic readouts may aid in genetic variant interpretation and improve diagnostics. METHODS: Using liquid chromatography-mass spectrometry, 395 pheochromocytomas and paragangliomas (PPGLs) from 391 patients were screened for metabolites to indicate Krebs cycle aberrations. Multigene panel sequencing was applied to detect driver PV in cases with indicative metabolite profiles but undetermined genetic drivers. RESULTS: Aberrant Krebs cycle metabolomes identified rare cases of PPGLs with germline PV in FH and somatic PV in IDHx and SDHx, including the first case of a somatic IDH2 PV in PPGL. Metabolomics also reliably identified PPGLs with SDHx loss-of-function (LOF) PV. Therefore we utilized tumor metabolite profiles to further classify variants of unknown significance in SDHx, thereby enabling missense variants associated with SDHx LOF to be distinguished from benign variants. CONCLUSION: We propose incorporation of metabolome data into the diagnostics algorithm in PPGLs to guide genetic testing and variant interpretation and to help identify rare cases with PV in FH and IDHx.

Catecholamine-Induced Cardiomyopathy in Pheochromocytoma: How to Manage a Rare Complication in a Rare Disease?

Pheochromocytomas and paragangliomas (PHEOs) are rare neuroendocrine tumors. Clinical manifestations include different cardiovascular signs and symptoms, which are related to excessive secretion of catecholamines. Catecholamine-induced cardiomyopathy in PHEO (CICMPP) is a rare but dreaded complication of PHEO. Once patient is diagnosed with this condition, the prognosis is worse and a surgical risk is much higher than expected. This article focuses on how catecholamines affect the heart and the pathophysiologic mechanism of CICMPP. The cardiovascular responses to catecholamine depend mostly on which catecholamine is released as well as the amount of catecholamine that is released. The acute release of norepinephrine and epinephrine from PHEO increases heart rate, systemic vascular resistance, myocardial contractility, and reduces venous compliance. The excessive adrenergic stimulation by catecholamine results in severe vasoconstriction and coronary vasospasm, myocardial ischemia, and subsequently damage, and necrosis. Chronically elevated catecholamine levels lead to significant desensitization of cardiac ß-adrenoceptors. The increased levels of the enzyme ß-adrenoceptors kinase (ßARK) in the heart seems to mediate these biochemical and physiological changes that are consistently correlated with attenuated responsiveness to catecholamine stimulation. Through these mechanisms different types of cardiomyopathy (CMP) can be formed. This review discusses extensively the 3 types of cardiomyopathies that can be present in a PHEO patient. It also provides the clinical presentation and diagnostic and therapeutic algorithm in managing patients with CICMPP.

Quantitative 18F-DOPA PET/CT in pheochromocytoma: the relationship between tumor secretion and its biochemical phenotype.

INTRODUCTION: 18F-FDOPA illustrates the properties of uptake and storage of catecholamines in pheochromocytomas (PHEOs). Until now, the relationship between 18F-FDOPA quantitative parameters and a PHEO secretory profile has not been specifically evaluated. MATERIALS AND METHODS: Fifty-six patients (56% females, median age: 47.5 yrs) with non-metastatic PHEO, evaluated by 18F-FDOPA PET/CT, were included in this retrospective study. Forty-five patients had negative genetic testing (80.4%); five patients (8.9%) had RET, two patients (3.6%) had SDHB, two had SDHD (3.6%), one patient (1.8%) had NF1, and one patient had a VHL (1.8%) mutation. Correlation between 18F-FDOPA metabolic parameters (tumor SUVmax, tumor SUVmean, tumor SUVmax/liver SUVmax, MTV 42%, total lesion uptake), urinary metanephrines (MNs), and plasma chromogranin A (CgA) were evaluated. RESULTS: All patients had positive 18F-FDOPA PET/CT. On univariate analysis, there was a strong correlation between all metabolic parameters and urinary MNs and plasma chromogranin A (CgA). The highest correlations were observed between total lesion (TL) uptake and the value of urinary MNs regardless of their nature (p = 8.10-15 and r = 0.80) and between MTV 42% and plasma CgA levels (p = 2.10-9, r = 0.74). On multivariate analysis, the correlation of uptake parameters and CgA levels did not persist further due to the relation of CgA and tumor diameter. A correlation between TL uptake and the normetanephrine/metanephrine ratio (NMN/MN) was also found, a finding that was in accordance with in vitro studies, which were found to have a higher catecholamine content in epinephrine producing PHEOs. CONCLUSION: This retrospective study shows a correlation between 18F-FDOPA uptake, especially using TL uptake, urinary MNs, and a PHEO biochemical phenotype. This illustrates that beyond its localization value, 18F-FDOPA PET further enables PHEO characterization at a specific metabolic level.

Superiority of 68Ga-DOTATATE over 18F-FDG and anatomic imaging in the detection of succinate dehydrogenase mutation (SDHx )-related pheochromocytoma and paraganglioma in the pediatric population.

PURPOSE: To evaluate and compare diagnostic performance of 68Ga-DOTA(0)-Tyr(3)-octreotate (68Ga-DOTATATE) with 18F-fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography-computed tomography (PET/CT) and anatomic imaging using computed tomography and/or magnetic resonance (CT/MR) imaging in detection of SDHx-related pheochromocytomas and paragangliomas (PPGLs) in pediatric patients. METHODS: Nine pediatric patients (5:4, girls:boys; 14.6 ± 2.0 years) with an SDHx-related mutation (SDHB:SDHA:SDHD, n = 7:1:1) were included in this retrospective study. At the time of initial diagnosis, 7/9 patients had metastatic disease. They underwent CT/MR imaging along with PET/CT using 68Ga-DOTATATE (n = 9), 18F-FDG (n = 8), and positron emission tomography-magnetic resonance imaging (PET/MR) using 18F-FDG (n = 1). In this manuscript, 18F-FDG PET/CT refers to both 18F-FDG PET/CT and 18F-FDG PET/MR. The per-lesion, per-region, and per-patient detection rates were compared and calculated for each of the imaging modalities. A composite of all functional and anatomic imaging studies served as the imaging comparator. RESULTS: Eight out of nine patients were positive for PPGLs on the imaging studies that demonstrated 107 lesions in 22 anatomic regions on the imaging comparator. The per-lesion detection rates for 68Ga-DOTATATE PET/CT, 18F-FDG PET/CT, and CT/MR imaging were 93.5% (95%CI, 87.0% to 97.3%); 79.4% (95%CI, 70.5% to 86.6%); and 73.8% (95%CI, 64.5% to 81.9%), respectively. The per-lesion detection rate for 68Ga-DOTATATE PET/CT was significantly higher than that of 18F-FDG PET/CT (p = 0.001) or CT/MR imaging (p < 0.001). In all of the anatomic regions except abdomen, the per-lesion detection rates for 68Ga-DOTATATE PET/CT was found to be equal or superior to 18F-FDG PET/CT, and CT/MR imaging. The per-region detection rate was 100% (95%CI, 84.6% to 100%) for 68Ga-DOTATATE PET/CT and 90.9% (95%CI, 70.8% to 98.9%) for both 18F-FDG PET/CT and CT/MR imaging. The per-patient detection rates for 68Ga-DOTATATE PET/CT, 18FDG PET/CT, and CT/MR imaging were all 100% (95%CI, 63.1% to 100%). CONCLUSION: Our preliminary study demonstrates the superiority of 68Ga-DOTATATE PET/CT in localization of SDHx-related PPGLs in pediatric population compared to 18F-FDG PET/CT and CT/MR imaging with the exception of abdominal (excluding adrenal and liver) lesions, and suggests that it might be considered as a first-line imaging modality in pediatric patients with SDHx-related PPGLs.

Osteopontin Expression in Thyroid Cancer: Deciphering EMT-Related Molecular Mechanisms.

Thyroid cancer is the most common tumor arising from the endocrine system and generally presents good prognosis. However, its aggressive subtypes are related to therapeutic resistance and early metastasis. Epithelial-mesenchymal transition (EMT) and its reverse process, the mesenchymal-epithelial transition (MET), are key events mediating cancer progression, including in thyroid cancer. The matricellular protein osteopontin (OPN) has been reported as a master regulator of EMT in many tumor types. Although high OPN expression has been described and associated with important aspects of thyroid cancer progression, there is no clear evidence regarding OPN as a regulator of EMT in thyroid cancer. Thus, taking together the known roles of OPN in the modulation of EMT in cancer and the information reporting the expression of OPN in thyroid tumor progression, this review aims at summarizing and discussing data related to EMT in thyroid cancer and its putative relation to the roles of OPN in the development of thyroid cancer. These data provide new insights into the molecular mechanisms by which OPN could potentially modulate EMT in thyroid tumors, generating evidence for future studies that may contribute to new therapeutic, prognostic and/or diagnostic tools.

Bioactive compounds, antioxidant activity and antiproliferative effects in prostate cancer cells of green and roasted coffee extracts obtained by microwave-assisted extraction (MAE).

Coffee consumption has been investigated as a protective factor against prostate cancer. Coffee may be related to prostate cancer risk reduction due to its phytochemical compounds, such as caffeine, chlorogenic acids, and trigonelline. The roasting process affects the content of the phytochemicals and undesired compounds can be formed. Microwave-assisted extraction is an alternative to conventional extraction techniques since it preserves more bioactive compounds. Therefore, this study aimed to evaluate the phytochemical composition and the putative preventive effects in prostate cancer development of coffee beans submitted to four different coffee-roasting degrees extracted using microwave-assisted extraction. Coffea arabica green beans (1) were roasted into light (2), medium (3) and dark (4) and these four coffee samples were submitted to microwave-assisted extraction. The antioxidant capacity of these samples was evaluated by five different methods. Caffeine, chlorogenic acid and caffeic acid were measured through HPLC. Samples were tested against PC-3 and DU-145 metastatic prostate cancer cell lines regarding their effects on cell viability, cell cycle progression and apoptotic cell death. We found that green and light roasted coffee extracts had the highest antioxidant activity. Caffeine content was not affected by roasting, chlorogenic acid was degraded due to the temperature, and caffeic acid increased in light roasted and decreased in medium and dark roasted. Green and light roasted coffee extracts promoted higher inhibition of cell viability, caused greater cell cycle arrest in S and G2/M and induced apoptosis more compared to medium and dark roasted coffee extracts and the control samples. Coffee extracts were more effective against DU-145 than in PC-3 cells. Our data provide initial evidence that among the four tested samples, the consumption of green and light coffee extracts contributes to inhibit prostate cancer tumor progression features, potentially preventing aspects related to advanced prostate cancer subtypes.

Clinical, Diagnostic, and Treatment Characteristics of SDHA-Related Metastatic Pheochromocytoma and Paraganglioma.

Background: Pheochromocytoma and paraganglioma (PHEO/PGL) are rare neuroendocrine tumors which may cause potentially life-threatening complications, with about a third of cases found to harbor specific gene mutations. Thus, early diagnosis, treatment, and meticulous monitoring are of utmost importance. Because of low incidence of succinate dehydrogenase complex subunit A (SDHA)-related metastatic PHEO/PGL, currently there exists insufficient clinical information, especially with regards to its diagnostic and treatment characteristics. Methods: Ten patients with SDHA-related metastatic PHEO/PGL were followed-up prospectively and/or retrospectively between January 2010-July 2018. They underwent biochemical tests (n = 10), 123I-MIBG (n = 9) scintigraphy, and multiple whole-body positron emission tomography/computed tomography (PET/CT) scans with 68Ga-DOTATATE (n = 10), 18F-FDG (n = 10), and 18F-FDOPA (n = 6). Results: Our findings suggest that these tumors can occur early and at extra-adrenal locations, behave aggressively, and have a tendency to develop metastatic disease within a short period of time. None of our patients had a family history of PHEO/PGL, making them appear sporadic. Nine out of 10 patients showed abnormal PHEO/PGL-specific biochemical markers with predominantly noradrenergic and/or dopaminergic phenotype, suggesting their utility in diagnosing and monitoring the disease. Per patient detection rates of 68Ga-DOTATATE (n = 10/10), 18F-FDG (n = 10/10), 18F-FDOPA (n = 5/6) PET/CT, and 123I-MIBG (n = 7/9) scintigraphy were 100, 100, 83.33, and 77.77%, respectively. Five out of 7 123I-MIBG positive patients had minimal 123I-MIBG avidity or detected very few lesions compared to widespread metastatic disease on 18F-FDG PET/CT, implying that diagnosis and treatment with 123/131I-MIBG is not a good option. 68Ga-DOTATATE PET/CT was found to be superior or equal to 18F-FDG PET/CT in 7 out of 10 patients and hence, is recommended for evaluation and follow-up of these patients. All 7 out of 7 patients who received conventional therapies (chemotherapy, somatostatin analog therapy, radiation therapy, 131I-MIBG, peptide receptor radionuclide therapy) in addition to surgery showed disease progression. Conclusion: In our cohort of patients, SDHA-related metastatic PHEO/PGL followed a disease-course similar to that of SDHB-related metastatic PHEO/PGL, showing highly aggressive behavior, similar imaging and biochemical phenotypes, and suboptimal response to conventional therapies. Therefore, we recommend careful surveillance of the affected patients and a search for effective therapies.

Post-obturation pain and its relationship with reference time and other risk factors / Dor pós-obturação e sua relação com o tempo de referência e outros fatores de risco

Objective: To evaluate incidence and intensity of postoperative pain in patients treated in the Residency Program in Endodontics at the State University of Maringá. The influence of factors inherent to the patient and treatment on preoperative pain was also the focus of our study. Material and Methods: 99 patients participated in this study and underwent non-surgical endodontic treatment. Initially, palpation, vertical and horizontal percussion were performed on the tooth to be treated. After the root canals filling, patients received a printed Numerical Rating Scale and were instructed to record the level of pain in the postoperative periods of 24, 48 and 72 hours. For each postoperative period, the patient recorded the values. A descriptive analysis of the data and a model of generalized estimation equations were performed to verify the relationship between the variables and postoperative pain, at a significance level of 5%. Results: During the follow-up period, the pain rates found were low represented by 16%, 11% and 7% in the periods of 24, 48, and 72h, respectively. In addition, the rates significantly decreased after 72h. Only one case of flare-up was recorded. Presence of pain on palpation, use of reciprocating file and use of 2.5% sodium hypochlorite influenced the results (p<0.05), increasing the changes of post-operative pain by 3.36, 0.4 and 0.2 times, respectively. Conclusion: Incidence and intensity of postoperative pain monitored in the residency program reduced significantly after 72 hours. Postoperative pain was associated with pain on palpation, use of reciprocating files and irrigation with 2.5% hypochlorite.(AU)

Objetivo: Avaliar a incidência e intensidade da dor pós-operatória em pacientes atendidos no Programa de Residência em Endodontia da Universidade Estadual de Maringá. A dor do paciente foi monitorada após 24, 48 e 72 horas após a obturação do canal radicular. A influência de fatores inerentes ao paciente e ao tratamento na dor pré-operatória também foi foco de nosso estudo. Material e Métodos: 99 pacientes participaram deste estudo e foram submetidos a tratamento endodôntico não cirúrgico. Inicialmente, foram realizadas palpação, percussão vertical e horizontal no dente a ser tratado. A presença de dor foi classificada em uma Escala Numérica de Avaliação (NRS). Após a obturação dos canais radiculares, os pacientes receberam a NRS impressa e foram orientados a registrar o nível de dor nos pós-operatórios de 24, 48 e 72 horas. A cada pós-operatório, um pesquisador entrava em contato com o paciente e registrava os valores. Foi realizada uma análise descritiva dos dados e um modelo de equações de estimativa generalizada (GEE) para verificar a relação entre as variáveis e a dor pós-operatória, ao nível de significância de 5%. Resultados: Durante o período de acompanhamento, os índices de dor encontrados foram baixos representados por 16%, 11% e 7% nos períodos de 24, 48 e 72h, respectivamente. Além disso, as taxas diminuíram significativamente após 72h. Apenas um caso de reagudecimento foi registrado. Presença de dor à palpação, uso de lima reciprocante e uso de hipoclorito de sódio 2,5% influenciaram os resultados (p<0,05) aumentando as alterações da dor pós-operatória em 3,36, 0,4 e 0,2 vezes, respectivamente. O tempo médio de encaminhamento foi de 6,28 meses, o que não influenciou nos resultados. Conclusão: A incidência e intensidade da dor pós-operatória monitorada no programa de residência reduziram significativamente após 72 horas. A dor pós-operatória foi associada à dor à palpação, uso de limas reciprocantes e irrigação com hipoclorito a 2,5%. (AU)

Cadmium toxicity on seed germination and initial growth of chia

In recent years, there has been a growing concern related to soil and water contamination due to the constant dispersal of toxic metals. In addition to their ecotoxicological potential, these elements exhibit a cumulative character that favors their permanence in soil and passage to living organisms, which can lead to an ecological imbalance. Among toxic metals, cadmium (Cd) is an obstacle to agriculture because it can adversely affect food quality and human health, as well as diminish plant growth and productivity. Thus, the objective of this work was to evaluate the toxicity of cadmium on seed germination and initial growth of chia. The ecotoxicological effects of four Cd concentrations (15; 30; 45; and 60 mg L-1) were evaluated. The response variables were germination percentage, first count, germination speed index, total length, shoot length, root length, seedling dry mass, and tolerance index. It is concluded that the presence and accumulation of Cd in the culture substrate played an inhibitory role in seed germination and initial seedling growth of chia starting at 15 mg L-1. On the other hand, no significant effect was observed for the treatments in relation to dry mass of the chia seedlings.

Profile of victims of accidents with biological material in a course of Dentistry / Perfil das vítimas de acidentes com material biológico em um curso de Odontologia

ABSTRACT Objective: To identify the epidemiological profile of accidents with biological material occurring in the dental clinic of a university in the southern region of the country. Methods: This is a descriptive, cross-sectional, retrospective study, which analyzed the reports of the Epidemiological Surveillance (SINAN) that occurred between March 2013 and December 2016. We analyzed the demographic variables and data related to the notification of accidents with biological material in the SINAN file, such as: age, sex, race, occupation (student, teacher, oral health technician, residents), time and place of occurrence of the accident, agent causing the perforation, total or partial use of PPE (personal protective equipment) at the time of accident, contact with organic material, contact agent and up-to-date vaccination against hepatitis B and treatment withdrawal. The data obtained were analyzed in EpiInfo Software. Statistical analysis included descriptive and inferential analysis, with significance level of p?0.05 and confidence interval (CI) of 95%. Results: In total there were 55 reports of accidents with piercing-cutting materials, of which 12 were men (21.82%) and 43 were women (78.18%). The mean age of the sample population was 24.2 (± 6.3) years. Regarding the occupation, 80% (n = 44) were undergraduate students, 12.72% were residents, 5.45%, teachers and 1.82%, oral health technicians. The majority (61.8%) were perforated during the dental procedure, 21.82% during material washing and 16.36% during surgery, but 20% claimed that they did not use any personal protective equipment. Regarding the organic material, there was a high prevalence of contact with blood, 70.9%, the needle was the main agent (n = 26; 47.3%). Still, 3.7% stated that they were not vaccinated against hepatitis B. In the bivariate analysis, the site of the accident was associated with the use of personal protective equipment (p = 0.01). Conclusion: The results showed that the number of incidents is high and can be attributed to several factors, such as lack of experience of students and the non-use of personal protective equipment. As a result, it is necessary to establish a permanent education program focused on education and accident prevention strategies to minimize these problems.

RESUMO Objetivo: Identificar o perfil epidemiológico dos acidentes com material biológico ocorridos na clínica odontológica de uma universidade na região sul do país Métodos: Foi realizado um estudo descritivo, transversal, retrospectivo, analisando as notificações da Vigilância Epidemiológica (SINAN) ocorridas entre março de 2013 a dezembro de 2016. Foram analisadas as variáveis demográficas e os dados referentes a notificação de acidentes com material biológico contidas na ficha do SINAN, tais como: idade, sexo, raça, ocupação (estudante, professor, técnico em saúde bucal, residentes), momento e local da ocorrência do acidente, agente causador da perfuração, uso total ou parcial de EPI no momento do acidente, contato com material orgânico, agente do contato e vacinação em dia contra hepatite B e abandono do tratamento. Os dados obtidos foram analisados pelo Software EpiInfo. A análise estatística incluiu a análise descritiva e inferencial, com nível de significância de p?0,05 e intervalo de confiança (IC) de 95%. Resultados: No total houve 55 notificações de acidentes com materiais pérfuro-cortantes, sendo doze homens (21,82%) e 43 mulheres (78,18%). A idade média da população amostral era de 24,2 (±6,3) anos. Quanto à ocupação, 80% (n=44) eram estudantes de graduação, 12,72% residentes, 5,45% professores e 1,82% técnico em saúde bucal. A maioria (61,8%) se perfurou durante o procedimento odontológico, 21,82% durante a lavagem dos materiais e 16,36% durante uma cirurgia, porém 20% alegaram que não utilizavam o equipamento de proteção individual. Em relação ao material orgânico, houve grande prevalência do contato com o sangue 70,9%, sendo a agulha o principal agente (n=26; 47,3%). Ainda, 3,7% afirmaram não estavam vacinados contra hepatite B. Na análise bivariada, o local do acidente esteve associado com o uso do equipamento de proteção individual (p=0,01). Conclusão: Os resultados mostraram que o número de incidentes é elevado e podem ser atribuídos a diversos fatores, como a falta de experiência dos estudantes e a não utilização de equipamentos de proteção individual. Em decorrência disso, é necessário estabelecer um programa de educação permanente focado em estratégias de educação e prevenção de acidentes para minimizar esses agravos.

Complicações respiratórias secundárias a lesões inalatórias em indivíduos queimados e atuação fisioterapêutica: Uma revisão de literatura / Respiratory complications in inhalation injury in burnt individuals and physiotherapy action: A literature review / Complicaciones respiratorias secundarias a lesiones inalatórias en individuos quemados y actuación de la fisioterapia: Una revisión de literatura

OBJETIVO: Identificar as principais complicações respiratórias em pacientes queimados associadas à lesão inalatória (LI) e às condutas fisioterapêuticas empregadas com esses pacientes. MÉTODO: Foi realizada uma revisão de literatura nas bases de dados LILACS, Scielo e PubMed, e o período de publicação dos artigos foi delimitado entre 2008 e 2018. RESULTADOS: Dentre os sinais e características mais comuns em casos de LI, encontram-se escarro, tosse, falta de ar e dispneia. Os menos comuns são chiado, rouquidão, fadiga, dor de garganta e alterações do ritmo respiratório. Os achados físicos podem ser confirmados por estudos incluindo broncoscopia de fibra ótica. Quanto ao tratamento instituído, temos o emprego da ventilação mecânica e a intubação. CONCLUSÃO: A realização desse estudo de revisão de literatura evidenciou uma variedade de danos causados à mucosa respiratória em consequência a uma LI. Tais complicações podem ser fatais se não tratadas de forma rápida e eficaz; a fisioterapia respiratória, por meio de suas formas de tratamento e recursos, mostrou ter uma valiosa contribuição para identificação e tratamento das diversas complicações pulmonares causadas pela LI.

OBJECTIVE: To identify the main respiratory complications in burn patients associated with inhalation injury and the physiotherapeutic action with these patients. METHODS: A review of the literature was carried in the LILACS, Scielo and PubMed databases, where the period of publication of articles was delimited between 2008 and 2018. RESULTS: Among the signs and characteristics most common in cases of inhalation injury are sputum, cough, shortness of breath and dyspnea. The least common are wheezing, hoarseness, fatigue, sore throat and changes in breathing rhythm. Physical findings may be confirmed by studies including fiberoptic bronchoscopy. Regarding the treatment instituted, we have the use of mechanical ventilation and intubation. CONCLUSION: The performance of this literature review study revealed a variety of damage to the respiratory mucosa as a consequence of an inhalation injury. Such complications can be fatal if not treated quickly and effectively; respiratory physiotherapy through its forms of treatment and resources, has been shown to have a valuable contribution to the identification and treatment of various pulmonary complications caused by inhalation injury.

Objetivo: Identificar las principales complicaciones respiratorias en pacientes quemados asociados a lesiones inalatórias (LI) y las conductas de la fisioterapia empleadas con esos pacientes. Método: Se realizó una revisión de literatura en las bases de datos LILACS, Scielo y PubMed, en el cual el período de publicación de los artículos fue delimitado entre 2008 y 2018. Resultados: Entre las señales y características más comunes en el caso de LI se encuentran esputo, tos, falta de aire y disnea. Los menos comunes son "chillado", ronquera, fatiga, dolor de garganta y cambios del ritmo respiratorio. Los hallazgos físicos pueden ser confirmados por estudios incluyendo broncoscopia de fibra óptica. En cuanto al tratamiento instituido, tenemos el empleo de la ventilación mecánica y la intubación. Conclusión: La realización de este estudio de revisión de literatura evidenció una variedad de daños causados en la mucosa respiratoria en consecuencia a una LI. Tales complicaciones pueden ser fatales si no se tratan de forma rápida y eficaz; la fisioterapia respiratoria, por medio de sus formas de tratamiento y recursos mostró tener una valiosa contribución para la identificación y tratamiento de las diversas complicaciones pulmonares causadas por la LI.

Qualidade de ovos produzidos e submetidos à diferentes condições de armazenamento na Amazônia Ocidental, Acre - Brasil / Quality of eggs produced and submitted to different storage conditions in the western Amazon, Acre - Brazil / Calidad de huevos producidos y sometidos a diferentes condiciones de almacenamiento en Amazonia Ocidental, Acre ­ Brasil

O objetivo deste trabalho foi analisar a influência de diferentes tempos e condições de armazenamento sobre a qualidade de ovos produzidos na cidade de Rio Branco, Acre. Seis condições de armazenamento, "Temperatura ambiente, refrigerado, a vácuo, vácuo + sílica, vácuo + absorvedor de O2, vácuo + sílica + absorvedor de O2" foram analisados em sete períodos (zero, sete, 14, 21, 28, 35 e 42 dias). Avaliou-se a Unidade Haugh, Índice de gema, pH da clara e da gema. As condições e os períodos de armazenamento influenciaram de forma significativa na redução dos valores de unidade Haugh e índice de gema, e aumento do pH da clara. Os ovos sofreram menores influências das características analisadas, quando armazenados sob o sistema de refrigeração e embalados a vácuo. Os valores médios do pH da gema apresentaram certa estabilidade, variando de 6,14 até 6,78 oscilando os valores entre os períodos de armazenamento. O armazenamento a vácuo independente de ser acompanhado ou não por sílica ou absorvedor de oxigênio, apresentou resultados superiores quando comparados aqueles submetidos à temperatura ambiente.(AU)

The purpose of this paper was to analyze the influence of different storage times and conditions on the quality of eggs produced in the city of Rio Branco, in the state of Acre. Six storage conditions, namely ­ At room temperature, Refrigerated, Vacuum, Vacuum + Silica, Vacuum + O2 absorber, Vacuum + Silica + O2 absorber ­were analyzed in seven periods (zero, seven, 14, 21, 28, 35 and 42 days). Haugh Unit, Yolk Index, White and Yolk pH were evaluated. Conditions and storage periods significantly influenced the reduction of Haugh unit values and yolk index, as well as increasing the pH of the egg white. The eggs were less affected when stored under refrigeration and packed under vacuum. The pH values of the yolk presented certain stability, varying from 6.14 to 6.78, oscillating between the storage periods. Vacuum storage, whether or not accompanied by silica or oxigen absorber, presented superior results when compared to those submitted to room temperature.(AU)

El objetivo de este estudio ha sido analizar la influencia de diferentes tiempos y condiciones de almacenamiento sobre la calidad de huevos producidos en la ciudad de Rio Branco, Acre. Seis condiciones de almacenamiento, "Temperatura ambiente, refrigerado, a vacuo, vacuo + sílice, vacuo + absolvedor de O2, vacuo + sílice + absolvedor de O2" fueron analizados en siete períodos (cero, siete, 14, 21, 28, 35 y 42 días). Se evaluó la Unidad Haugh, Índice de yema, pH de la clara y de la yema. Las condiciones y los períodos de almacenamiento influyeron de forma significativa en la reducción de los valores de unidad Haugh e índice de yema, y aumento del pH de la clara. Los huevos sufrieron menores influencias de las características analizadas, cuando almacenados bajo el sistema de refrigeración y empaquetados a vacuo. Los valores medianos del pH de la yema presentaron cierta estabilidad, variando de 6,14 hasta 6,78, oscilando los valores entre los periodos de almacenamiento. El almacenamiento a vacuo independiente de ser acompañado o no por sílice o absolvedor de oxigero, presentó resultados superiores cuando comparados a los sometidos a temperatura ambiente.(AU)

Terapia fotodinâmica no controle de infecções endodônticas / Photodynamic therapy in the control of endodontic infections

Introdução: a descontaminação efetiva do sistema de canais radiculares é fundamental para o sucesso do tratamento endodôntico. A terapia fotodinâmica (TFD) pode ser uma importante ferramenta na redução de patógenos do canal radicular. Objetivo: o objetivo deste trabalho foi realizar uma revisão de literatura sobre a utilização dessa terapia na Endodontia e qual protocolo clínico tem sido utilizado. Métodos: realizou-se uma busca na literatura nos bancos de dados PubMed e SciELO, empregando-se as seguintes palavras-chave: endodontics; photodynamic therapy; photodynamic therapy endodontics; light-activated disinfection root canal; light activated disinfection endodontics; photo-activated disinfection endodontics; e photo-activated disinfection. Resultados: selecionou-se 18 artigos que se encaixavam nos critérios de inclusão: artigos originais e relevantes, pesquisas clínicas e laboratoriais, em dentes humanos permanentes e que relatassem o uso da terapia fotodinâmica como um tratamento único ou coadjuvante à desinfecção do canal radicular, bem como sua eficácia na redução bacteriana. Conclusões: a TFD mostrou-se um método eficaz na redução microbiana dos canais radiculares; entretanto, deve ser utilizada como um método adicional ao tratamento convencional. (AU)

Limitações e desafios do controle da dengue no Brasil: uma revisão / Limitations and challenges of dengue control in Brazil: a review

Introdução: Desde o surgimento dos primeiros casos de dengue no Brasil, o mosquito Aedes aegypti, vetor desta arbovirose, tem sido um grande desafio para a saúde pública brasileira, que inicialmente lidava apenas com epidemias de dengue e febre amarela. Embora, o vetor tenha sido erradicado em 1955, após a sua reintrodução em 1960, o mesmo sucesso em eliminá-lo não foi alcançado, persistindo até os tempos atuais. Além disso, nos últimos anos, o país se deparou com duas novas adversidades, a detecção dos vírus chikungunya e zika no território nacional, transmitido pelo mesmo vetor. Dados do Ministério da Saúde informam que até abril de 2019, foram notificados 451.685 casos de dengue, um aumento 339,9% em comparação com o mesmo período do ano anterior. Ao longo dos anos, diversos programas e metodologias de vigilância epidemiológica e controle vetorial foram criados, mas sem êxito. Objetivos: Este trabalho tem como objetivo principal analisar em forma de revisão bibliográfica quais as limitações e desafios no controle da dengue no Brasil. Materiais e Métodos: Levantamento bibliográfico, com dados coletados a partir de bases de fontes especializadas. Foram elegíveis artigos que apresentassem discussões pertinentes ao tema foco deste trabalho. Adicionalmente, foram utilizadas estimativas e informações disponibilizadas em sítios eletrônicos com fontes oficiais. Resultados e Conclusões: Com base nas análises realizadas a partir dos materiais selecionados, é possível observar que atualmente são utilizados diversos métodos e diretrizes para controle vetorial do Aedes aegypti, entretanto, o país não está perto de erradicar e nem controlar o transmissor da dengue. Ficam evidentes as dificuldades no controle vetorial, não existindo atalhos para combater as arboviroses e seus vetores. Além do desenvolvimento de vacinas eficazes e seguras, é necessário total envolvimento da gestão pública, participação ativa e comprometimento da comunidade, investimentos financeiros para execução das ações e para melhorias de infraestrutura de saneamento básico e moradias, contratação e treinamento de recursos humanos. É preciso, também, o reconhecimento e impulsionamento de pesquisas focadas no desenvolvimento de novas metodologias de vigilância epidemiológica e amadurecimento dos métodos de gestão integrada.