Could light be a broad-spectrum antimicrobial?

DESIGN: A review on antimicrobial resistance mechanisms discussing the main light-based antimicrobial approaches including ultraviolet light (UV), antimicrobial photodynamic therapy (aPDT), and antimicrobial blue light (aBL). AIM: To describe antimicrobial resistance mechanisms and to present potential light-based alternatives to conventional antimicrobials. METHODS: The paper was divided into different topics, starting with an approach to antimicrobial resistance mechanisms. Subsequently, emphasis was placed on innovative light-based antimicrobials approaches, including aBL, UV, and aPDT. RESULTS: The review suggests that blue light (400-470 nm) acts on endogenous porphyrins with peak absorption at 405 nm, thus not requiring the administration of photosensitizers, to trigger antimicrobial effects. In this regarding, the direct effect of aBL could be attributed to both the generation of reactive oxygen species (ROS), which induces microbicidal effects, and the inactivation of bacterial defense mechanisms. In turn, blue light combined with curcumin has been used in the treatment of dental infections. Otherwise, green light (495-570 nm) associated with the photosensitizer Rose Bengal has shown promising results both in wound closure due to the induction of additional collagen cross-link formation and in reducing the viability of Pseudomonas aeruginosa. Red light (620-750 nm) is the wavelength most commonly used in aPDT, presenting superior tissue penetration capability compared to blue and green light. Both red and infrared light act directly as photobiomodulation agents, promoting tissue repair with greater penetration depth for the infrared spectrum. Conversely, red light combined with methylene blue is the most commonly used technique in the treatment of localized infections. Meanwhile, infrared light associated with indocyanine green acts as a photothermal and photosensitizing agent, promoting thermal damage and production of ROS. Ultraviolet lights UVA, UVB, and UVC (200-400 nm) have antimicrobial potential related to inducing changes in DNA and generating both ROS and singlet oxygen. Furthermore, light can enhance the efficacy of traditional antimicrobial agents by deactivating microbial resistance, both through increasing the permeability of the cell membrane and by inhibiting the efflux pump and ß-lactamases of the bacteria. CONCLUSIONS: The antimicrobial potential of light is extensive; however, there is a limitation regarding the depth of penetration of certain wavelengths into infected areas. Furthermore, there is a need for additional studies to determine the safety and efficacy of various approaches using light at its different wavelengths.

What is the potential of antibacterial, antiviral and antifungal photodynamic therapy in dentistry?

DESIGN: A review of the principal clinical applications of antimicrobial photodynamic therapy (aPDT) in dentistry. AIM: To provide an overview of clinical applications and future perspectives of aPDT in dentistry. METHODS: A comprehensive search was conducted on PubMed, Web of Science, Scopus, and Embase up to September 2022, where only data from randomized clinical trials were included. In vitro studies, animal studies, literature reviews, and duplicate articles were excluded from the review. Out of a total of 1042 references initially identified, only 89 studies were included in the review. Six main oral conditions for which aPDT has been used were identified: periodontal and peri-implant diseases, endodontics, bacterial plaque, caries, and fungal and viral infections. RESULTS: The review suggests that aPDT can be used as an effective complementary treatment for reducing pathogenic microorganisms in bacterial plaque; carious lesions; and periodontal, peri-implant, endodontic, fungal, and viral infections. CONCLUSIONS: Despite the efficacy of aPDT against different types of microorganisms, there are no specific irradiation parameters for its respective photosensitizers due to the significant heterogeneity of clinical trials. Therefore, more studies are needed to determine irradiation protocols and development of new photosensitizers to improve the safety and efficacy of aPDT.

Identification of Urine Metabolic Markers of Stroke Risk Using Untargeted Nuclear Magnetic Resonance Analysis.

Stroke remains the second leading cause of mortality worldwide, and the third leading cause of death and morbidity combined, affecting more than 12 million people every year. Stroke pathophysiology results from complex interactions of several risk factors related to age, family history, gender, lifestyle, and the presence of cardiovascular and metabolic diseases. Despite all the evidence, it is not possible to fully prevent stroke onset. In recent years, there has been an exploration of innovative methodologies for metabolite analysis aimed at identifying novel stroke biomarkers. Utilizing Nuclear Magnetic Resonance (NMR) spectroscopy, we investigated small molecule variations in urine across different stages of stroke risk. The Framingham Stroke Risk Score was used in people over 63 years of age living in long-term care facilities (LTCFs) to calculate the probability of suffering a stroke: low stroke risk (LSR, control), moderate stroke risk (MSR), and high stroke risk (HSR). Univariate statistical analysis showed that urinary 4-hydroxyphenylacetate levels increased while glycolate levels decreased across the different stroke risk groups, from the LSR to the HSR groups. Trimethylamine N-oxide (TMAO) had average concentration values that were significantly higher in elderly people in the HSR group, while trigonelline levels were significantly lower in the MSR group. These metabolic markers can be used for early detection and to differentiate stages of stroke risk more efficiently.

What is the science underpinning the prescription of antibiotics in dentistry?

DESIGN: A critical review on the use of antimicrobials in dentistry. AIM: To provide a general overview of the use of antimicrobials in dentistry. METHODS: The paper was divided into different topics, starting with an approach to understanding both commensal and pathogenic oral microbiota. Subsequently, emphasis was placed on the main categories of antibiotics used in dentistry (ß-lactams, tetracyclines, macrolides, lincosamides, nitroimidazoles and quinolones), and the basis for their prescription. Finally, the implications between systemic diseases and the use of orally-administered antibiotics are presented. RESULTS: The study suggests that an adequate medical history can minimize the risk of systemic adverse effects, unwanted drug interactions, and allergies related to the use of antibiotics. In this regard, when facing a potential history of allergy to a particular group of antibiotics, the prescription of a different group is mandatory. In most indications, ß-lactam antibiotics represent the first-choice in dentistry. Moreover, a short-term prescription of antibiotics when treating acute oral infections is recommended. The use should be extended for 2 to 3 days following the resolution of the infection, with an average duration of 6 days in order to prevent the development of antibiotic resistance. CONCLUSIONS: Oral infections should be managed with interventions aiming at the elimination/reduction of the associated pathogens. Furthermore, inadequate prescription of antibiotics can lead to potential risks to the patient such as allergy, adverse effects, and development of microbial resistance.

How safe is off-label use of imiquimod in oral lesions?

DATA SOURCES: A comprehensive search was conducted on PubMed and Embase, adhering to the principles outlined in the PRISMA Extension for Scoping Reviews (PRISMA-ScR). The search strategy was subsequently registered on PROSPERO. STUDY SELECTION: Articles were chosen based on an analysis of titles and abstracts, with no restrictions on publication date, language, or participant age. In vitro studies, animal studies, and literature reviews were excluded from consideration. DATA EXTRACTION AND SYNTHESIS: Clinical trials in humans, case reports, or case series that reported the use of imiquimod for treating conditions in the oral or labial mucosa were included in this study. Results from duplicate articles were excluded from the analysis. RESULTS: Out of a total of 601 references initially identified, only 28 studies were included in the review. These studies were classified based on the use of imiquimod into three groups: potentially malignant disorders and oral cancer, lesions related to HPV, and autoimmune conditions. In all cases presented in the article, there is an occurrence of both local and systemic side effects. CONCLUSIONS: The study elucidated the off-label use of imiquimod in oral pathologies, whether potentially malignant, cancerous, autoimmune, or associated with HPV infection. However, it was observed that further research is warranted for the development of a specific formulation for the oral mucosa, ensuring the drug's sustained presence at its active site of action without interference from saliva and minimizing potential side effects.

Would it really be necessary to use metronidazole as an adjunct in the surgical treatment of periodontitis?

DESIGN: Prospective, parallel, randomized, double-blind, clinical trial. CASE SELECTION: Participants were at least 30 years old, who were systemically healthy, with stages III-IV, grades B-C periodontitis. DATA ANALYSIS: Of the 50 eligible individuals for the study, 40 were divided into 2 equal groups. The test group received doses of 500 mg of metronidazole, while the control group received a placebo, both administered three times a day for 7 days, commencing immediately after periodontal surgery. All patients were followed up at 3-, 6-, 9-, and 12-months post-surgery. The study utilized probing depth, clinical attachment level, bleeding on probing, and plaque index as parameters for determining the outcomes at each assessment. Microbiological samples were collected for the detection and quantification of Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, and Tannerella forsythia DNA. In order to analyze quantitative variables in a comparison between the test and control groups, Student's t-tests or Mann-Whitney U tests were utilized. For categorical results, chi-square or Fisher tests were employed. For both probing depth and clinical attachment level, repeated measures ANOVA was used. The statistical significance level was set at p ≤ 0.05. RESULTS: The study found statistically significant differences for probing depth (mean difference, MD = 0.31 mm, 95% confidence interval, CI [0.13; 0.49]; p = 0.001) and clinical attachment level (MD = 0.64 mm, 95% CI [0.02; 1.27]; p = 0.044) only 3 months after surgery, with a reduction observed in the test group. However, despite being statistically significant, these results lack clinical relevance. CONCLUSIONS: Although the study found statistically significant results for clinical attachment level (MD = 0.66 mm, 95% CI [0.01; 1.31]; p = 0.045) and probing depth (MD = 0.28 mm, 95% CI [0.09; 0.46]; p = 0.004), these findings do not represent clinically significant gains. Therefore, no evidence was demonstrated to support the use of systemic metronidazole as adjunctive therapy to periodontal surgery.

Assessing the Influence of Maternal Age in Bovine Embryos and Oocytes: A Model for Human Reproductive Aging.

In the first weeks after fertilization, embryo mortality in cattle is significantly higher. It is well known that the age of the dam is one of the crucial factors affecting the quality of embryos and oocytes in many mammalian species. In older cattle, there are several evidences that embryo quality decreases, due to a decrease in ovarian reserve, a decrease in mtDNA and ATP, a decrease in progesterone levels, and due to susceptibility to genetic mutations. Herein, we intend to provide an updated summary of recent research on the effects of maternal age on embryos and oocytes of domestic cattle which are a widely used model species for human oocytes and early embryonic development.

Exploring the Larvicidal and Adulticidal Activity against Aedes aegypti of Essential Oil from Bocageopsis multiflora.

This study investigates the chemical composition of the essential oil obtained from the leaves of Bocageopsis multiflora (Mart.) R.E.Fr (Annonaceae), examining its effectiveness in combating both the larvae and adult forms of Aedes aegypti mosquitoes. Additionally, for a deeper understanding of the insecticidal activity, toxicity properties and molecular docking calculations were conducted using the main compounds of this essential oil. GC/MS analysis revealed the presence of 26 constituents, representing 95.2% of the essential oil, with the major components identified as the sesquiterpenes α-selinene, ß-selinene, and ß-elemene. Larvicidal assays demonstrated potent activity of this essential oil with significant LC50 values of 40.8 and 39.4 µg/mL at 24 and 48 h, respectively. Adulticidal assessments highlighted strong efficacy with LC50 of 12.5 µg/mL. Molecular docking analysis identified optimal interaction activities of α-selinene and ß-selinene with key Aedes proteins. The in silico studies comparing synthetic insecticides with the major sesquiterpenes of the essential oil revealed that ß-selinene exhibited a significantly higher binding affinity compared to the other two sesquiterpenes. Also, ADMET studies of the three main sesquiterpenes indicated acceptable drug-like properties. In these findings, safety evaluations showed low toxicity and skin sensitization for the main sesquiterpenes, contrasting with commercial synthetic insecticides. Therefore, in silico analyses suggest promising interactions with Aedes proteins, indicating its potential as an effective alternative to conventional insecticides These results show the larvicidal and adulticidal potential of the essential oil from Bocageopsis multiflora against Aedes aegypti, supported by its predominant constituents, α-selinene, ß-selinene and ß-elemene.

Endophytic species of Colletotrichum associated with cashew tree in northeastern Brazil.

Anthracnose caused by Colletotrichum is the most severe and widely occurring cashew disease in Brazil. Colletotrichum species are commonly found as pathogens, endophytes and occasionally as saprophytes in a wide range of hosts. The endophytic species associated with cashew trees are poorly studied. In this study, we report the Colletotrichum endophytic species associated with cashew trees in two locations in the state of Pernambuco, their prevalence in different plant organs (leaves, veins, branches and inflorescences), and compare the species in terms of pathogenicity and aggressiveness using different inoculation methods (wounded × unwounded). Six species of Colletotrichum were identified according to multilocus phylogenetic analyses, including Colletotrichum asianum, Colletotrichum chrysophilum, Colletotrichum karsti, Colletotrichum siamense, Colletotrichum theobromicola, and Colletotrichum tropicale. There were differences in the percentage of isolation in relation to the prevalence of colonized tissues and collection locations. C. tropicale was the prevalent species in both geographic areas and plant tissues collected, with no pattern of distribution of species between areas and plant tissues. All isolates were pathogenic in injured tissues of cashew plants. The best method to test the pathogenicity of Colletotrichum species was utilizing the combination of leaves + presence of wounds + conidial suspension, as it better represents the natural infection process. C. siamense was the most aggressive species.

Clinical Characteristics of Genuine Acute Autoimmune Hepatitis.

Introduction: Autoimmune hepatitis (AIH) has a spectrum of symptoms ranging from asymptomatic disease to acute severe hepatitis, chronic hepatitis, and decompensated cirrhosis. The acute presentation is not rare and could represent genuine acute AIH (GAAIH) or acute exacerbation of chronic autoimmune hepatitis. We aimed to identify the prevalence, clinical features, and prognostic factors associated with GAAIH and compare these cases with acute exacerbation of chronic AIH. Methods: This cross-sectional observational study evaluated patients with acute AIH presentation, defined as total bilirubin >5 times the upper limit of normality (xULN) and/or alanine aminotransferase >10 xULN, and no prior history of liver disease. Histology findings of acute disease defined GAAIH. Bivariate analyses were performed to identify factors associated with the GAAIH, when compared with acute exacerbation of chronic AIH. Results: Seventy-two patients with acute presentation of AIH were included and six (8.3%) of them presented GAAIH. Comparative analysis between patients with GAAIH and patients with acute exacerbation of chronic AIH revealed that prothrombin activity (96% [74-100] vs. 61% [10-100]; p = 0.003) and albumin levels (3.9 ± 0.2 g/dL vs. 3.4 ± 0.5 g/dL; p < 0.001) were higher in patients with GAAIH. The International Autoimmune Hepatitis Group score was higher in patients with acute exacerbation of chronic AIH (18.5 [8-23] vs. 16.5 [15-17]; p = 0.010). Compared to 15.2% of acute exacerbation of chronic AIH, complete therapeutic response to treatment was achieved in 67.7% of cases with GAAIH (p = 0.018). Conclusions: GAAIH was rare (8.3%), and patients with this presentation exhibited more preserved liver function tests, suggesting that most cases presenting with loss of function are acute exacerbation of chronic AIH. Additionally, patients with GAAIH had a better complete therapeutic response, suggesting a more preserved liver function at presentation, and early diagnosis has a positive therapeutic implication.

Introdução: A hepatite autoimune (HAI) apresenta um espectro de sintomas que varia de doença assintomática a hepatite aguda grave, hepatite crónica e cirrose descompensada. A apresentação aguda não é rara e pode representar hepatite autoimune aguda genuína (HAIAG) ou exacerbação aguda de hepatite autoimune crónica (EAHAIC). O nosso objetivo foi identificar a prevalência, caraterísticas clínicas e fatores prognósticos associados à HAIAG, e comparar esses casos com EAHAIC. Métodos: Estudo observacional, transversal, incluindo doentes com apresentação aguda de HAI, definida como bilirrubina total > 5 vezes o limite superior da normalidade (xLSN) e/ou ALT > 10 xLSN, e sem história prévia de doença hepática. HAIAG foi definida pela presença de achados histológicos de doença aguda. Análises bivariadas foram realizadas para identificar fatores associados à HAIAG, quando comparado com o EAHAIC. Resultados: Foram incluídos setenta e dois doentes com apresentação aguda de HAI, dos quais seis (8.3%) com HAIAG. A análise comparativa entre doentes com HAIAG e doentes com EAHAIC mostrou que a atividade de protrombina (96% (74-100) versus 61% (10-100; p=0.003) e os níveis de albumina (3,9 ± 0,2 g/dL vs. 3,4 ± 0,5 g/dL; p < 0,001) foram significativamente mais elevados em pacientes com HAIAG. O score do Grupo Internacional de Hepatite Autoimune foi mais elevado em doentes com EAHAIC (18.5 (8-23) versus 16.5 (15-17); p=0.010). A resposta terapêutica completa ao tratamento foi alcançada em 66.7% dos casos de HAIAG (vs. 15,2% na EAHAIC, p=0,018). Conclusões: A HAIAG é rara (8.3%), e os doentes com esta apresentação mostraram testes de função hepática mais preservados, sugerindo que a maioria dos casos com perda de função são EAHAIC. Além disso, os doentes com HAIAG tiveram maior taxa de resposta terapêutica completa, sugerindo que uma função hepática mais preservada na apresentação e o diagnóstico precoce tem uma implicação terapêutica positiva.

First report of Colletotrichum siamense causing anthracnose in Oenocarpus bacaba in Brazil.

Bacaba (Oenocarpus bacaba Mart.) is a native palm tree from Brazilian Amazon and Cerrado biomes. This tree produces a small, rounded fruit with dark skin and approximately 1.5 mm thick pulp, extensively utilized for palm heart extraction, juices, and jellies (De Cól et al. 2021). However, several diseases can adversely impact fruit yield and quality. During the 2021 growing season, anthracnose symptoms were observed in Bacaba fruits, with a disease incidence of 58% in fruits collected from the Abreulândia (9°37'15″ S, 49°9'3″ W) and Gurupi (12°25'46" S; 49°16'42" W) municipalities in Tocantins state, Brazil. A total of 198 fruits exhibiting anthracnose symptoms, characterized by deep necrotic spots, were collected. In the laboratory, symptomatic fruits had their external surfaces sterilized for 30 seconds in 70% ethanol, 1 min in 1.5% NaOCl, and then rinsed with sterile distilled water. Sterilized pieces of the fruit tissue were transferred to PDA medium and incubated for 7 days at 28 ºC with a 12 h photoperiod. After this period, two isolates were obtained from the colonies and were identified both macroscopically and microscopically as Colletotrichum sp. The colonies grown at PDA showed a white to grey cottony mycelia, with straight and fusiform conidia, ranging from 14.0 to 21.0 (mean value of 15.8 ± 1.8) µm in length and 4.0 to 7.0 (mean value of 5.5 ± 0.7) µm in width, (n = 50). For species identification, the intergenic spacer between DNA lyase, mating-type locus MAT1-2-1 (APN2/MAT-IGS), glyceraldehyde-3-phosphate dehydrogenase (GAPDH), glutamine synthetase (GS), and ß-tubulin (TUB) loci were amplified and sequenced. Resulting sequences were deposited in GenBank (OR333843, OR333844, OR333845 and OR333846). BLAST analysis of the partial APN2/MAT-IGS (99%), GAPDH (99,48%), GS (99,32%) and TUB (99,48%) sequences showed highly similarity to C. siamense isolates (IIFT223 and CBS130147). Maximum likelihood multilocus analysis placed the isolate UFTC16 within the C. siamense clade with 98% bootstrap support, clearly assigning the isolate to this species. Morphological features were consistent with the description of C. siamense (Prihastuti et al., 2009). Inoculation of Bacaba fruits and seedlings was conducted to confirm pathogenicity. The surface of uninjured Bacaba fruits was inoculated with two drops (20 µL) of conidial suspension (106 conidia mL-1). The same methodology was adopted to placed healthy leaves of 35-day-old seedlings grown in plastic tubes. Two drops of sterile distilled water were inoculated on nonwounded healthy fruits and seedlings as a negative control. The fruits and seedlings were incubated for five days in a controlled chamber at 28 °C, 70-80% humidity and a "12-h photoperiod". The experiment was conducted with five replicates (five fruits and five seedlings inoculated per isolate) and repeated once. Typical symptoms of anthracnose were observed in the fruits and leaves of Bacaba seedlings five days after inoculation. No symptoms were observed in the negative control. The pathogen was reisolated from symptomatic fruits and leaves, showing similar morphological characteristics as the original isolate, fulfilling Koch's postulates. The identification of C. siamense as the causal agent of Bacaba anthracnose helps in the diagnosis and disease control strategies of the disease. Colletotrichum siamense is a cosmopolitan species and easily found in cultivated and non-cultivated species (Batista et al. 2023). However, to the best of our knowledge, this is the first report of C. siamense causing anthracnose on Bacaba.

Capacity Assessment Instrument - Health: Pilot Study of a New Tool for Adults with Dementia.

OBJECTIVES: This research comprises a pilot study of the CAI-Health, a new tool for the evaluation of decision-making capacity in healthcare. It aims to analyze the instrument's indicators of reliability and internal validity to conclude its final version. METHODS: A total of 89 participants were included, of which 22 had Alzheimer's Disease; 32 had mild cognitive impairment, and 35 were controls. Cronbach's alpha and the intercorrelation matrix were used as indicators of reliability and internal validity as well as to identify items for elimination. Repeated-measures ANOVA allowed for the analysis of differences between the vignettes that comprise CAI-Health. RESULTS: The internal consistency results were acceptable, and no items were proposed for elimination. A repeated-measures ANOVA revealed that the vignettes were unexpectedly equivalent. Despite the procedures used to develop clinical vignettes with increased levels of complexity in assessing decision-making capacity, this study showed no differences in the vignettes' level of demand. CONCLUSIONS: The extensive application of CAI-Health compromises its clinical usefulness and viability. To reduce its length while maintaining a thorough assessment of each ability, it was decided to eliminate two vignettes and retain all interview items. The final version of the CAI-Health comprises a clinical vignette and a capacity interview. CLINICAL IMPLICATIONS: CAI-Health was designed for the assessment of medical decision-making capacity in older adults.

Head-to-head comparison of [18F]-Flortaucipir, [18F]-MK-6240 and [18F]-PI-2620 postmortem binding across the spectrum of neurodegenerative diseases.

We and others have shown that [18F]-Flortaucipir, the most validated tau PET tracer thus far, binds with strong affinity to tau aggregates in Alzheimer's (AD) but has relatively low affinity for tau aggregates in non-AD tauopathies and exhibits off-target binding to neuromelanin- and melanin-containing cells, and to hemorrhages. Several second-generation tau tracers have been subsequently developed. [18F]-MK-6240 and [18F]-PI-2620 are the two that have garnered most attention. Our recent data indicated that the binding pattern of [18F]-MK-6240 closely parallels that of [18F]-Flortaucipir. The present study aimed at the direct comparison of the autoradiographic binding properties and off-target profile of [18F]-Flortaucipir, [18F]-MK-6240 and [18F]-PI-2620 in human tissue specimens, and their potential binding to monoamine oxidases (MAO). Phosphor-screen and high resolution autoradiographic patterns of the three tracers were studied in the same postmortem tissue material from AD and non-AD tauopathies, cerebral amyloid angiopathy, synucleopathies, transactive response DNA-binding protein 43 (TDP-43)-frontotemporal lobe degeneration and controls. Our results show that the three tracers show nearly identical autoradiographic binding profiles. They all strongly bind to neurofibrillary tangles in AD but do not seem to bind to a significant extent to tau aggregates in non-AD tauopathies pointing to their limited utility for the in vivo detection of non-AD tau lesions. None of them binds to lesions containing ß-amyloid, α-synuclein or TDP-43 but they all show strong off-target binding to neuromelanin and melanin-containing cells, as well as weaker binding to areas of hemorrhage. The autoradiographic binding signals of the three tracers are only weakly displaced by competing concentrations of selective MAO-B inhibitor deprenyl but not by MAO-A inhibitor clorgyline suggesting that MAO enzymes do not appear to be a significant binding target of any of them. These findings provide relevant insights for the correct interpretation of the in vivo behavior of these three tau PET tracers.

Surgical Treatment of Oral Fibrous Hyperplasia with Diode Laser: An Integrative Review / Tratamiento Quirúrgico de la Hiperplasia Fibrosa Oral con Láser de Diodo: Una Revisión Integradora

This study aimed to carry out an integrative review of the use of diode lasers in the treatment of oral fibrous hyperplasia in order to observe surgical efficacy, healing process, and main microscopic findings. The following databases-PubMed/MEDLINE, Embase, Virtual Health Library, Scopus, Web of Science, and gray literature-were searched without regard to the time of year or language. Diode laser treatment cases described in case reports and case series were included, but those who did not undergo microscopic analysis to confirm the diagnosis or who did not provide postoperative information were excluded. Twelve studies (64 patients) were included. Prevalence was observed for females (68.75 %, n=44). In view of the diagnosis, there was a prevalence of focal fibrous hyperplasia (79.68 %, n=51), followed by inflammatory fibrous hyperplasia (20.31 %, n=13). For surgical removal, a diode laser was used with a wavelength ranging from 808 to 960 nm, in continuous mode, and an average power of 2830 mW. In general, there were no intercurrences in the trans and postoperative periods and wound healing occurred by second intention, with excellent evolution. High-powered diode lasers can be an excellent therapeutic option for oral hyperplastic lesions. Long-term clinical trials should be conducted to determine laser setting parameters in various oral lesions.

El objetivo de este estudio fue realizar una revisión integradora sobre el uso del láser de diodo en el tratamiento de la hiperplasia fibrosa oral, con el fin de visualizar la eficacia quirúrgica, el patrón de cicatrización y el análisis de los principales resultados microscópicos. Se realizó una búsqueda sin restricciones de año e idioma en PubMed/MEDLINE, Embase, Virtual Health Library, Scopus, Web of Science y literatura gris. Se incluyeron reportes de casos y series de casos que brindaron información sobre pacientes diagnosticados con lesiones hiperplásicas orales tratados con láser de diodo, excluyendo aquellos a los que no se les había realizado análisis microscópico para confirmar el diagnóstico, así como aquellos que no brindaron información postoperatoria. Se incluyeron doce estudios (64 pacientes). Se observó prevalencia en el sexo femenino (68,75 %, n=44). Ante el diagnóstico, predominó la hyperplasia fibrosa focal (79,68 %, n=51), seguida de la hiperplasia fibrosa inflamatoria (20,31 %, n=13). Para la remoción quirúrgica se utilizó un láser de diodo con una longitud de onda de 808 a 960 nm, en modo continuo, y una potencia promedio de 2830 mW. En general, no hubo intercurrencias en el trans y postoperatorio y la cicatrización de la herida ocurrió por segunda intención, con excelente evolución. El uso de láseres de diodo de alta potencia puede ser una excelente alternativa terapéutica para las lesiones hiperplásicas orales. Se deben realizar más estudios clínicos a largo plazo para determinar los parámetros de ajuste del láser en diferentes lesiones orales.

Cross-Cultural adaptation and psychometric properties of SATAQ-4R for brazilian adolescents / Adaptação transcultural e avaliação psicométrica do SATAQ-4R para adolescentes brasileiros / Adaptación transcultural y evaluación psicométrica del SATAQ-4R para adolescentes brasileños

The aim of this study was to culturally adapt and to evaluate the psychometric properties of Sociocultural Attitudes Towards Appearance Questionnaire - 4R (SATAQ-4R) among Brazilian adolescents. This scale evaluates the influence from parents, peers, media and significant others on body image. In the first stage, the conceptual, semantic, operational and content equivalences were assessed. In the second stage, 285 girls (M age = 15.54; SD = 1.59 years old) and 323 boys (M age = 15.34; SD = 1.66 years old) took part. The results from Exploratory Factor Analysis showed a factorial structure composed of 7 factors for girls and 6 factors for boys. Associations between SATAQ-4R and body dissatisfaction, body change behavior, eating attitudes and self-esteem suggested good convergent validity. We concluded that the SATAQ-4R is a valid and reliable instrument for Brazilian adolescents, which is considered a good tool for the evaluation of the beauty ideal internalization and socio-cultural influences. (AU)

O objetivo deste estudo foi adaptar culturalmente e avaliar as propriedades psicométricas do Sociocultural Attitudes Towards Appearance Questionnaire - 4R (SATAQ-4R) entre adolescentes brasileiros. Essa escala avalia influência dos pais, amigos, mídia e pessoas próximas na imagem corporal. Na primeira etapa, foram atestadas as equivalências conceitual, semântica, operacional e de conteúdo. Da segunda etapa, participaram 285 meninas (M idade = 15,54; DP = 1,59 anos) e 323 meninos (M idade = 15,34; DP = 1,66 anos). Os resultados da análise fatorial exploratória apontaram estrutura fatorial com sete fatores para meninas adolescentes e seis fatores para meninos adolescentes. Associações entre SATAQ-4R e medidas de insatisfação corporal, comportamento de mudança corporal, atitudes alimentares e autoestima sugerem boa validade convergente da escala. Conclui-se que o SATAQ-4R é um instrumento válido e confiável para adolescentes brasileiros, sendo alternativa para avaliação da internalização dos padrões ideais de beleza e influências socioculturais. (AU)

El objetivo de este estudio fue adaptar culturalmente y evaluar las propiedades psicométricas del Sociocultural Attitudes Towards Appearance Questionnaire - 4R (SATAQ-4R) entre adolescentes brasileños. Esta escala evalúa la influencia de los padres, amigos, medios de comunicación y personas importantes en la imagen corporal. En la primera etapa, se atestiguaron las equivalencias conceptuales, semánticas, operativas y de contenido. En la segunda etapa, participaron 285 chicas (M edad = 15.54; DS = 1.59 años) y 323 chicos (M edad = 15.34; DS = 1.66 años). Los resultados del Análisis Factorial Exploratorio mostraron una estructura factorial de 7 factores para las chicas y 6 factores para los chicos. Las asociaciones entre el SATAQ-4R e insatisfacción corporal, la conducta del desarrollo corporal, las actitudes alimentarias y la autoestima sugieren una buena validez convergente. Se concluye que el SATAQ-4R es un instrumento válido para adolescentes brasileños y se considera una buena alternativa para la evaluación de la internalización de los ideales de belleza e influencias socioculturales. (AU)

Alterações hepáticas em transplantados renais do maior centro de transplante do Brasil / Hepatic alterations in kidney transplant recipients from the largest kidney transplant center in brazil

ABSTRACT Background Kidney transplant is the treatment of choice for patients with end-stage renal disease and is associated with lower mortality when compared to dialysis methods. Brazil is the country with the second largest number of kidney transplants in the world and among these patients it has been observed that liver abnormalities are common. The frequency of liver abnormalities ranges from 20-50% post-transplantation, and have an important impact on the survival and quality of life of these patients. There are scarce data about the frequency, causes and characteristics of these alterations. Objective To determine the prevalence of the different causes of hepatic abnormalities in kidney transplant recipients, to associate the characteristics of these abnormalities with demographic, epidemiological and clinical variables, to compare the characteristics of hepatic alterations between different etiologies, and to evaluate possible changes in diagnosis over two different periods of time. Methods Descriptive, cross-sectional observational, epidemiological study was conducted at the outpatient "Hepato-Rim"clinic of Hospital São Paulo (EPM/UNIFESP), a center providing specialized care for patients with hepatic abnormalities and underlying kidney diseases. Results Five-hundred eighty-one transplant patients were evaluated. The most prevalent etiologies of liver abnormalities were hepatitis C and B, iron overload, nonalcoholic fatty liver disease (NAFLD), and drug-induced liver injury (DILI). The most common cause — hepatitis C — was analyzed in greater detail. Compared to the other causes, this infection was more frequent in older patients, female patients, and patients with a longer time since transplantation and hemodialysis. Analysis of the two periods showed that patients of period 1 (P1 — 1993 to 2005) were older and were more frequently referred because of positive serology; referral due to aminotransferases abnormalities predominated during period 2 (P2 — 2006 to 2018). The predominant diagnoses were hepatitis C and B during P1 and NAFLD and DILI during P2. Conclusion Assessment of the main hepatic alterations in kidney transplant recipients is important because it permits better management of these patients in terms of diagnostic investigation and treatment and contributes to the prevention of complications in this special population.

RESUMO Contexto O transplante renal é o tratamento de escolha para pacientes com doença renal terminal e está associado a menor mortalidade quando comparado aos métodos dialíticos. O Brasil é o país com o segundo maior número de transplantes renais do mundo e, entre esses pacientes, observa-se que as alterações hepáticas são comuns. A frequência das alterações hepáticas varia de 20 a 50% pós-transplante e tem importante impacto na sobrevida e qualidade de vida desses pacientes. Existem poucos dados sobre a frequência, causas e características dessas alterações. Objetivo Determinar a prevalência das diferentes causas de anormalidades hepáticas em receptores de transplante renal, associar as características dessas anormalidades a variáveis demográficas, epidemiológicas e clínicas, comparar as características das alterações hepáticas entre diferentes etiologias e avaliar possíveis alterações no diagnóstico em dois períodos diferentes de tempo. Métodos Estudo epidemiológico descritivo, transversal, observacional, realizado no ambulatório "Hepato-Rim" do Hospital São Paulo (EPM/UNIFESP), centro de atendimento especializado a pacientes com anormalidades hepáticas e doenças renais de base. Resultados Quinhentos e oitenta e um pacientes transplantados foram avaliados. As etiologias mais prevalentes de anormalidades hepáticas foram hepatite C e B, sobrecarga de ferro, doença hepática gordurosa não alcoólica e lesão hepática induzida por drogas. A causa mais comum — hepatite C — foi analisada em maiores detalhes. Em comparação com as outras causas, essa infecção foi a mais frequente em pacientes mais velhos, pacientes do sexo feminino e pacientes com mais tempo de transplante e hemodiálise. A análise dos dois períodos mostrou que os pacientes do período 1 (P1 — 1993 a 2005) eram mais velhos e encaminhados com maior frequência devido à sorologia positiva; encaminhamento devido a anormalidades de aminotransferases predominou durante o período 2 (P2 — 2006 a 2018). Os diagnósticos predominantes foram hepatite C e B durante P1 e doença hepática gordurosa não alcoólica e lesão hepática induzida por drogas durante P2. Conclusão A avaliação das principais alterações hepáticas em receptores de transplante renal é importante, pois permite melhor manejo desses pacientes na investigação diagnóstica e no tratamento e contribui para a prevenção de complicações nesta população especial.

New possibilities for chromoblastomycosis and phaeohyphomycosis treatment: identification of two compounds from the MMV Pathogen Box® that present synergism with itraconazole

BACKGROUND Black fungi of the Herpotrichiellaceae family are agents of chromoblastomycosis and phaeohyphomycosis. There are few therapeutic options for these infections and it is common to associate antifungal drugs in their treatment. OBJECTIVES To investigate the Medicines for Malaria Venture (MMV) Pathogen Box® for possible compounds presenting synergism with antifungal drugs used to treat black fungal infections. METHODS An initial screening of the Pathogen Box® compounds was performed in combination with itraconazole or terbinafine at sub-inhibitory concentrations against Fonsecaea pedrosoi. Hits were further tested against eight Herpotrichiellaceae using the checkerboard method. FINDINGS No synergism was observed with terbinafine. MMV687273 (SQ109) and MMV688415 showed synergism with itraconazole against F. pedrosoi. Synergism of these compounds was confirmed with some black fungi by the checkerboard method. SQ109 and itraconazole presented synergism for Exophiala dermatitidis, F. pedrosoi, F. monophora and F. nubica, with fungicidal activity for F. pedrosoi and F. monophora. MMV688415 presented synergism with itraconazole only for F. pedrosoi, with fungicidal activity. The synergic compounds had high selectivity index values when combined with itraconazole. MAIN CONCLUSIONS These compounds in combination, particularly SQ109, are promising candidates to treat Fonsecaea spp. and E. dermatitidis infections, which account for most cases of chromoblastomycosis and phaeohyphomycosis.

Psychometric Evaluation of the Thin-Ideal Internalization Scale (TIIS) for Brazilian Young Women / Avaliação Psicométrica da Thin-Ideal Internalization Scale (TIIS) para Jovens Brasileiras / Evaluación Psicométrica de la Thin-Ideal Internalization Scale (TIIS) para Mujeres Jóvenes Brasileñas

Abstract Internalization is an important dimension of body image, which can be assessed using the Thin-Ideal Internalization Scale (TIIS). This study aims to carry out the cross-cultural adaptation and psychometric assessment of the TIIS for young Brazilian women. A total of 448 young university women participated in the research (M age = 21.4 years; SD = 2.91). Exploratory and confirmatory factor analysis, association with body dissatisfaction (Body Shape Questionnaire-8) and eating attitudes (Eating Attitudes Test-26), and assessment of reliability (internal consistency and test-retest) were performed. The instrument had its semantic, idiomatic, cultural and conceptual equivalences ensured. The factor analysis demonstrated the presence of three factors and satisfactory adjustment indexes. In addition, the scale showed adequate values for convergent validity and reliability. The final version of the TIIS (18 items) obtained adequate psychometric properties for the evaluation of the body-ideal internalization among Brazilian young women. We suggest new studies to prove the factor structure for other populations.

Resumo A internalização é uma importante dimensão da imagem corporal, que pode ser avaliada através da Thin-Ideal Internalization Scale (TIIS). O presente estudo teve como objetivo realizar a adaptação transcultural e a avaliação psicométrica da TIIS para jovens mulheres brasileiras. Participaram 448 jovens universitárias (M idade = 21.4 anos; DP = 2.91). Foram realizadas análise fatorial exploratória e confirmatória, associação com a insatisfação corporal (Body Shape Questionnaire-8) e atitudes alimentares (Eating Attitudes Test-26), e avaliação da confiabilidade (consistência interna e teste-reteste). O instrumento teve asseguradas suas equivalências semântica, idiomática, cultural e conceitual. A análise fatorial revelou presença de três fatores e índices de ajustamento satisfatórios. Além disso, a escala apresentou valores adequados para a validade convergente e confiabilidade. A versão final da TIIS (18 itens) apresentou adequadas qualidades psicométricas para a avaliação da internalização de padrões corporais ideais entre jovens brasileiras. Sugerem-se novos estudos que comprovem a estrutura fatorial para outras populações.

Resumen La internalización es una dimensión importante de la imagen corporal, que puede evaluarse utilizando la Thin-Ideal Internalization Scale (TIIS). El presente estudio tiene como objetivo realizar la adaptación transcultural y la evaluación psicométrica de la TIIS para mujeres jóvenes brasileñas. Participaron 448 jóvenes universitarias (M edad = 21.4 años; DP = 2.91). Se realizaron análisis factorial exploratorio y confirmatorio, asociación con insatisfacción corporal (Body Shape Questionnaire-8) y actitudes alimentarias (Eating Attitudes Test-26), y evaluación de la confiabilidad (consistencia interna y prueba-reprueba). El instrumento tuvo aseguradas sus equivalencias semánticas, idiomáticas, culturales y conceptuales. El análisis factorial reveló la presencia de tres factores e índices de ajuste satisfactorios. Además, la escala mostró valores adecuados de validez convergente y confiabilidad. La versión final de la TIIS (18 ítems) obtuvo propiedades psicométricas adecuadas para la evaluación de la internalización del cuerpo ideal entre las jóvenes brasileñas. Se sugieren nuevos estudios para probar la estructura factorial a otras poblaciones.

Cross-cultural adaptation of body image assessment instruments for university students: a systematic review

Abstract The theoretical-methodological process of cross-cultural adaptation of scales is fundamental for the expansion of research possibilities related to a given area and population, as instrument adequacy allows for the consistent assessment of the construct being studied. This article aims to highlight the different theoretical-methodological processes of cross-cultural adaptations of scales for assessing body image among young university students. The articles were selected in February 2020, with the following search descriptors: ("body image") and (young or "college students" or graduating or graduat *) and ("cross-cultural validation" or "cross-cultural adaptation"), in three databases—Scopus, PsycINFO, and Web of Science, without any time restrictions. Altogether, 304 studies were surveyed on the different bases mentioned above, and 14 studies published between 2010 and 2019 were evaluated. This study highlighted the methodological procedures used in the process of cross-cultural adaptation, as well as the population, the types of validity and reliability, and also the main limitations, strengths, and results reported in each study included in this review. The information presented in this review will allow new researchers to make more appropriate choices about instruments for assessing body image in young university students, in addition to presenting the methodological evolution on this theme.

Effect of combined exercise training on heart rate variability in normotensive and hypertensive postmenopausal women

Abstract Aim: This study aimed to verify and compare the effects of 10 weeks of combined exercise training on the heart rate variability of normotensive (NT) and hypertensive (HT) postmenopausal women. Methods: This is a quasi-experimental controlled clinical trial. Therefore, 14 HT and 12 NT postmenopausal women completed 10 weeks of combined exercise training. The exercise protocol consisted of 45 min of exercise, performed 3 times a week, consisting of 5 min of warm-up, 20 min of resistance exercise, and 20 min of aerobic exercise. Heart rate variability assessments were performed before and after the end of physical training. Results: Heart rate variability was assessed pre- and post-training periods. Mean RR (δNT = 95 ± 88; δHT = 38 ± 127), SDNN (δNT = 9 ± 13; δHT = 3 ± 14), RMSSD (δNT = 10 ± 12; δHT = 2 ± 18), SD1 (δNT = 7 ± 8; δHT = 1 ± 13), and SD2 (δNT = 10 ± 18; δHT = 4 ± 17) showed improvements after the intervention (time effects p < 0.05). No parameters presented group or interaction effects (p ≥ 0.05). Conclusion: In summary, 10 weeks of combined exercise training improved heart rate variability parameters similarly in both NT and HT postmenopausal women. Therefore, combined exercise training may be used to improve autonomic modulation of the heart rate of postmenopausal women, regardless of the presence of hypertension.