Cutoff Points for Grip Strength in Screening for Sarcopenia in Community-Dwelling Older-Adults: A Systematic Review.

BACKGROUND: Currently, different cutoff points for handgrip strength (HGS) have been used to estimate the prevalence of sarcopenia. In addition, the variability of equipment and protocols for this assessment can significantly influence the early detection of this important public health problem. Thus, this review aims to identify the different cutoff points for HGS adopted for older men and women in screening for sarcopenia. OBJECTIVES: this review aims to identify the different cutoff points for HGS adopted for older men and women in screening for sarcopenia. METHODS: In accordance with the PRISMA 2020 recommendations, which included published studies from the last 10 years, from 6 databases, in 3 different languages. RESULTS: 19.730 references were identified, of which 62 were included for the review. All references analyzed used algorithms and definitions of sarcopenia already known in the literature. Of the studies found, 16 chose to develop cutoff values for HGS based on their own population. The variation in cutoff points was evident when compared between gender and regions of the world. CONCLUSION: It has become evident that there is a variability of normative values for HGS in sarcopenia screening. In addition, this systematic review shows the difference in the cutoff points used between the consensuses and those developed for each population.

Baked milk tolerant patient: Is there any special feature?

BACKGROUND: Determining whether patients with cow's milk allergy (CMA) can tolerate foods produced with baked milk could provide a better quality of life, a better prognosis, and an option for desensitization. OBJECTIVES: The aim of this study was to identify which patients over four years of age with persistent CMA could tolerate baked milk, to compare the clinical and laboratory characteristics of reactive and non-reactive groups and to describe their clinical evolution. MATERIALS AND METHODS: A cross-sectional study was conducted (January/13 to November/14) that included all the patients followed at a food allergy center who met the inclusion criteria. The patients underwent an oral food challenge (OFC) with a muffin (2.8g of cow's milk protein). To exclude cow's milk (CM) tolerance, the patients were subsequently challenged with unheated CM. RESULTS: Thirty patients met all the inclusion criteria. Fourteen patients (46.7%) were considered non-reactive to baked milk and reactive to unheated CM. When the groups that were reactive and non-reactive to baked milk were compared, no statistically significant differences in clinical features were found. The prick test for α-lactalbumin (p=0.01) and casein (p=0.004) and the serum specific IgE for casein (p=0.05) presented statistical differences. After one year, none of the patients who were reactive to baked milk were ingesting CM, while 28% of the tolerant patients were consuming fresh CM (p=0.037). CONCLUSIONS: Baked milk can be tolerated by patients with CMA, especially those with lower levels of casein and α-lactalbumin. This option can improve quality of life and accelerate tolerance.

The effect of the angle of instrumentation of the Piezoelectric Ultrasonic Scaler on root surfaces.

OBJECTIVES: To evaluate the influence of variations in the working angle of the piezoelectric ultrasonic scaler (PUS) on root surfaces. MATERIAL AND METHODS: Fifty-five uniradicular bovine teeth were used, of which 25 teeth were used for the analysis of the roughness and root wear, while the remaining 30 teeth were used for the analysis of morphology (MRS) and the attachment of blood components (ABC). The teeth were randomly divided into five groups according to the type of treatment (G1-G5: piezoelectric ultrasonic scaler; G6: manual curette) and to the PUS working angle applied (G1: 0°; G2: 30°; G3: 45°; G4: 60°; G5: 90°). For statistical analysis, the data describing the MRS and ABC were analysed by the Kruskal-Wallis and Dunn's tests, and the data describing the roughness and tooth wear were analysed by anova and Tukey's tests at the significance level of 5%. RESULTS: Manual curette (MC) promoted a smoother root surface than the application of the PUS. The PUS used at the angles of 30° and 45° resulted in a high level of ABC that was comparable to that obtained by MC. Additionally, the group in which the PUS was applied at an angle of 45° exhibited less tooth wear than the other groups. CONCLUSIONS: Changes in the working angle of the PUS influenced the characteristics of root surfaces after instrumentation.

New posology of potassium iodide for the treatment of cutaneous sporotrichosis: study of efficacy and safety in 102 patients.

BACKGROUND: The first therapeutic choice for the treatment of cutaneous sporotrichosis is oral itraconazole; however, the increase in cases of zoonotic transmission outbreak necessitates a search for effective and safe treatment alternatives. OBJECTIVE: To evaluate a new potassium iodide (KI) posology as an alternative for the treatment of limited cutaneous forms of sporotrichosis. METHODS: One hundred and two patients with sporotrichosis diagnosed by isolation of Sporothrix sp. were included and were divided into 2 groups that received different doses of KI: group A received the conventional dose, and group B received the reduced dose. The cure criteria were based on clinical and serological data. RESULTS: Seventy-nine patients (77.4%) reached clinical cure: 70.6% and 84.3% of groups A and B respectively. Sixteen patients (15.6%) were lost during follow-up, and seven changed drug therapy: five in group A and two in group B. The incidence of adverse events was similar for both groups (64.7%): predominantly metallic taste (44%), followed by mild gastrointestinal intolerance and acneiform eruption (10.7% each). No serious adverse events occurred, and there were no recurrences. Analysis of the results showed no statistically significant difference between groups (P = 0.9255). The improvement in serologic titres was significant in both treatment groups. CONCLUSION: Through statistical analysis, the usual posology was not shown to be superior to the one proposed in this study. Serology for sporotrichosis may be used as a valuable tool in the clinical monitoring of these patients.

Dacryocystitis due to Sporothrix brasiliensis: a case report of a successful clinical and serological outcome with low-dose potassium iodide treatment and oculoplastic surgery.

Sporothrix brasiliensis is the main species of the S. schenckii complex implicated in the zoonotic epidemics of sporotrichosis in Rio de Janeiro, Brazil. Epidemiological features have been already described, such as zoonotic transmission by cats and increased frequency of atypical clinical aspects. The involvement of the face by contact with cats is common in childhood; as a result, ophthalmic manifestations have increased. We report a case of acute dacryocystitis in a 9-year-old girl. A calmodulin-based molecular phylogeny was used to identify the agent as S. brasiliensis. This is a rare type of presentation, usually complicated with nasolacrimal duct occlusion. The patient was cured without sequelae after treatment with a low dose of saturated solution of potassium iodide and decompressive oculoplastic surgery. Therapeutic options and considerations of aetiological agents and serology are discussed.

Craniofacial features and specific oral characteristics of Down syndrome children.

AIM: This article intends to describe the characteristics of Down syndrome children in order to facilitate their management in the dental office. METHODS: A review of literature was made limited to articles published between 2003 and 2013. The article is based on a literature search in PubMed and the authors' clinical experience with the patient group. DISCUSSION: Individuals with Down syndrome are clinically characterized by generalized hypotonia, neurological, cardiac and respiratory problems and changes in their stomatognathic system. Almost all these patients have an occlusal disharmony, including anterior open bite, anterior and posterior crossbite, anterior proclination and underdevelopment of the maxilla and the midface. Dental anomalies such as hypodontia, peg-shaped teeth and enamel hypocalcification are also found. The dentomaxillofacial features have clinical implications in speech, nutrition, posture, ventilation and aesthetics, with enormous consequences in growth, development and social integration. CONCLUSIONS: When planning the dental treatment of patients with Down syndrome, dental practitioners should always consider their general health, in order to achieve a holistic and interdisciplinary approach.

Avian hosts of Ixodes pacificus (Acari: Ixodidae) and the detection of Borrelia burgdorferi in larvae feeding on the Oregon junco.

Larval and nymphal western blacklegged tick, Ixodes pacificus Cooley & Kohls (Acari: Ixodidae), were collected from birds, rodents, and lizards at Quail Ridge Reserve located in Napa County in northwestern California. Species from three vertebrate classes were sampled simultaneously from two transects during two consecutive spring seasons. Feeding larval and nymphal ticks were removed and preserved for counting, examination and testing for the presence of Borrelia burgdorferi Johnson, Schmid, Hyde, Steigerwalt & Brenner. Mean infestations with I. pacificus subadults on lizards were 10.0, on birds 2.9, and on rodents 1.3. I. pacificus larvae (204) collected from 10 avian species and (215) collected from two rodent species were tested for the presence of B. burgdorferi s.s. via real-time polymerase chain reaction. Three B. burgdorferi-infected larvae were taken from two Junco hyemalis and two infected larvae from one Neotoma fuscipes Baird. This is the detection of B. burgdorferi ss in an Ixodes pacificus larvae feeding on a Junco hyemalis L., [corrected] in western North America.

Efficacy of a two-component compression system for the therapy of venous leg ulcers.

OBJECTIVE: The performance of a two-component compression system in daily practice was assessed in an outpatient clinic where patients with a wide variety of comorbidities and wound characteristics are treated. METHODS: In the single-centred observational study, patients with venous leg ulcers (VLUs) on one or both legs were treated with a two-component compression system for up to 12 months or until the ulcer healed. The only exclusion criteria were an ABPI <0.8, immobilisation and limited ankle joint flexibility. Study assessment parameters included ulcer size on entry into the study, the presence of skin irritations, occurrence of adverse events and ulcer recurrence. The primary outcome measure was the mean time to healing. RESULTS: In total, 136 patients with VLUs were included. Baseline median ulcer duration was 7.5 months and the baseline median size was 4.3cm(2). The average reduction in total ulcer surface was 2.9 +/- 5.5cm(2) per month. Of the wounds, 90.4% healed after 12 months; the mean healing time was three months (Kaplan-Meier, CI 95%: 3-4). The baseline wound size had a significant influence on mean healing time (Cox proportional hazards model; p<0.0001), wounds >4.3cm(2) healed within a mean of five months, while wounds <4.3cm(2) healed within a mean of two months (log rank test: p<0.00001). CONCLUSION: Healing results were encouraging and suggest a good applicability in the daily practice of VLU therapy. Further studies will include systematic assessment of patient concordance. DECLARATION OF INTEREST: None.

Inflammatory biomarkers in airways of patients with severe asthma compared with non-severe asthma.

BACKGROUND: About 5-10% of patients with asthma suffer from poorly-controlled disease despite corticosteroid (CS) therapy. OBJECTIVE: We determined whether there were any differences in inflammatory biomarkers between severe and non-severe asthma patients. METHODS: Nineteen severe and 20 non-severe asthma patients were recruited and underwent collection of induced sputum, bronchoalveolar lavage (BAL) fluid and bronchial biopsies. RESULTS: Biopsy results showed no differences in eosinophils (major basic protein positive), neutrophils, macrophages, T cells and mast cells in the bronchial submucosa. However, subbasement membrane (SBM) thickness and smooth muscle area were increased in the biopsies. No significant differences were observed in the induced sputum inflammatory cells. In BAL fluid, there was a significant increase in neutrophils but a significant decrease in macrophages. Eosinophil counts were non-significantly increased threefold in both sputum and BAL in severe asthma. Levels of IL-8 and IL-13 in sputum supernatants were similar in both groups of asthma patients. There was a significant inverse correlation between post-bronchodilator forced expiratory volume in 1 s and provocative concentration of methacholine causing a 20% fall in FEV(1) with SBM thickness. CONCLUSION: Differences in inflammatory cells were observed mainly in terms of increased neutrophils and reduction in macrophage numbers in BAL fluid with a trend towards increased eosinophils in severe asthma compared with non-severe asthma. However, the most notable features are the increase in features of airway wall remodelling of SBM thickness and smooth muscle area.

The mental health of graduate students at the Federal University of São Paulo: a preliminary report

We present data regarding the care provided to graduate level health professionals at the mental health center of the Federal University of São Paulo. From September 1996 to September 2003, 146 graduate students (99 in the Master's degree program and 47 in the Doctoral program) were attended. This population was predominantly female (68.5 percent), with a mean (± SD) age of 28.6 ± 4.42 years, not married (71.9 percent). Most of the subjects were professionals who had not graduated from the Federal University (78.1 percent). The students who sought help for psychological and/or psychiatric problems were classified into two categories: situational-adaptive crises and psychopathological crises. The main diagnoses were depression and anxiety disorders (44 percent) causing 4.5 percent of the subjects to be temporarily suspended from their graduate studies; 19.2 percent reported that they had used psychotropic drugs within the previous month, and 47.9 percent referred to sleep disturbances. Suicidal tendencies were mentioned by 18 percent of those interviewed. Students with emotional disturbances and academic dysfunctions should be recognized at an early stage, and it is fundamental for them to have access to mental health programs that provide formal, structured and confidential care. Thus, it is important that professors and advisors in graduate programs build a warm and affective learning environment. If we consider the expressive growth in Brazilian scientific production resulting from the implementation of an extensive national system of graduate education, it is important to focus efforts on enhancing and upgrading the mental health care system.

The mental health of graduate students at the Federal University of São Paulo: a preliminary report.

We present data regarding the care provided to graduate level health professionals at the mental health center of the Federal University of São Paulo. From September 1996 to September 2003, 146 graduate students (99 in the Master's degree program and 47 in the Doctoral program) were attended. This population was predominantly female (68.5%), with a mean (+/- SD) age of 28.6 +/- 4.42 years, not married (71.9%). Most of the subjects were professionals who had not graduated from the Federal University (78.1%). The students who sought help for psychological and/or psychiatric problems were classified into two categories: situational-adaptive crises and psychopathological crises. The main diagnoses were depression and anxiety disorders (44%) causing 4.5% of the subjects to be temporarily suspended from their graduate studies; 19.2% reported that they had used psychotropic drugs within the previous month, and 47.9% referred to sleep disturbances. Suicidal tendencies were mentioned by 18% of those interviewed. Students with emotional disturbances and academic dysfunctions should be recognized at an early stage, and it is fundamental for them to have access to mental health programs that provide formal, structured and confidential care. Thus, it is important that professors and advisors in graduate programs build a warm and affective learning environment. If we consider the expressive growth in Brazilian scientific production resulting from the implementation of an extensive national system of graduate education, it is important to focus efforts on enhancing and upgrading the mental health care system.

Evaluation of three concentrations of tebufenpyrad for the control of Varroa destructor (Acari: Varroidae).

We evaluated three concentrations of tebufenpyrad (17.5, 15 and 12.5%) in strip formulations for controlling varroa mites, Varroa destructor Anderson and Trueman (2000), in honey bee colonies. We also included colonies treated with Apistan, CheckMite+, and untreated colonies in our evaluation. The three concentrations we evaluated reduced varroa populations but also reduced the amount of brood and adult bees when compared with untreated colonies and colonies treated with Apistan or CheckMite+. Alternative delivery methods, lower concentrations of tebufenpyrad, and the evaluation of related compounds are logical next steps in evaluating the varroacidal potential of tebufenpyrad and related compounds.

Synthesis and evaluation of novel dipeptide-bound 1,2,4-thiadiazoles as irreversible inhibitors of guinea pig liver transglutaminase.

Herein we report the synthesis and evaluation of 14 novel peptides as potential irreversible inactivators of guinea pig liver transglutaminase (TGase). These peptides were designed to resemble Cbz-L-Gln-Gly, known to be a good TGase substrate, and to include a 1,2,4-thiadiazole group. The side chain length of the amino acid residue bearing the inhibitor group was also varied in order to permit investigation of this effect. Their inactivation rate constants were measured using a direct continuous spectrophotometric method and were found to vary between 0.330 to 0.89 microM(-1) min(-1).