Hemodialysis vascular access coordinator: Three-level model for access management.

Management of vascular access is a challenge for the dialysis team, particularly to keep the arteriovenous access working. The vascular access coordinator can positively contribute to increase the number of arteriovenous fistulas and reduce central venous catheters. In this article, we introduce a new approach to vascular access management centered on (the results of setting up) the role of vascular access coordinator. We described the three-level model (3Level_M) for vascular access management organized in three levels: vascular access nurse manager, vascular access coordinator, and vascular access consultant. We defined the instrumental skills and training required to be developed by each element and clarify the articulation between the model and all members of the dialysis team related to vascular access.

Polymeric Delivery Systems as a Potential Vaccine against Visceral Leishmaniasis: Formulation Development and Immunogenicity.

Recent studies suggest that the association of antigens in microparticles increases the anti-Leishmania vaccine immunogenicity. This study aims to investigate the in situ effect of the adjuvant performance consisting of chitosan-coated poly(D,L-lactic) acid submicrometric particles (SMP) and analyze the inflammatory profile and toxicity. Two formulations were selected, SMP1, containing poly(D,L-lactide) (PLA) 1% wt/v and chitosan 1% wt/v; and SMP2, containing PLA 5% wt/v and chitosan 5% wt/v. After a single dose of the unloaded SMP1 or SMP2 in mice, the SMPs promoted cell recruitment without tissue damage. In addition, besides the myeloperoxidase (MPO) activity having demonstrated similar results among the analyzed groups, a progressive reduction in the levels of N-acetyl-ß-D-glucosaminidase (NAG) until 72 h was observed for SMPs. While IL-6 levels were similar among all the analyzed groups along the kinetics, only the SMPs groups had detectable levels of TNF-α. Additionally, the Leishmania braziliensis antigen was encapsulated in SMPs (SMP1Ag and SMP2Ag), and mice were vaccinated with three doses. The immunogenicity analysis by flow cytometry demonstrated a reduction in NK (CD3-CD49+) cells in all the SMPs groups, in addition to impairment in the T cells subsets (CD3+CD4+) and CD3+CD8+) and B cells (CD19+) of the SMP2 group. The resulting data demonstrate that the chitosan-coated SMP formulations stimulate the early events of an innate immune response, suggesting their ability to increase the immunogenicity of co-administered Leishmania antigens.

Miconazole-loaded nanoparticles coated with hyaluronic acid to treat vulvovaginal candidiasis.

Miconazole-loaded nanoparticles coated with hyaluronic acid (miconazole-loaded nanoparticles/HA) were developed to overcome the limitations of the conventional therapy of the vulvovaginal candidiasis (VVC). They were synthesized by emulsification and solvent evaporation techniques, characterized by diameter, polydispersity index, zeta potential, encapsulation efficiency, atomic force microscopy (AFM), evaluated in terms of efficacy against C. albicans in vitro, and tested in a murine VVC model. Nanoparticles showed 211nm of diameter with a 0.32 polydispersity index, -53mV of zeta potential, and 90% miconazole encapsulation efficiency. AFM evidenced nanoparticles with a spherical shape. They inhibited the proliferation of C. albicans in vitro and in vivo after a single administration. Nanoparticles released the miconazole directly in the site of action at low therapeutic doses, which was enough to eliminate the fungal burden in the murine VVC model. These systems were rationally designed since the existence of the HA induces their adhesion on the vaginal mucus and their internalization via CD44 receptors, inhibiting the C. albicans. Therefore, miconazole-loaded nanoparticles/HA represent an innovative non-conventional pharmaceutical dosage form to treat the VVC and recurrent VVC.

Social and functional inclusion of an undergraduate student with unilateral upper limb agenesis: a case study.

INTRODUCTION: The inclusion of health professionals who have some type of disability brings benefits, such as the increase in empathy that facilitates the relationship with patients. In this work, we present a case study on the inclusion of an undergraduate Dentistry student with upper limb agenesis. PURPOSE: In order to improve the quality of life for people with upper limb agenesis, it is urgent to establish inclusion strategies in the educational field. This process included the use of assistive technologies to allow the manipulation of instruments used in the practice of dental clinical activities, enabling future Dentists with upper limb agenesis to have an equal education in relation to their academic peers. CASE SELECTION: The case study presented in this work consists of the follow-up of G., a 23-year-old female Dentistry student. The developed adaptations were made using a low-temperature thermoplastic. The expert team that participated in this process was formed by three occupational therapists and three Dentistry professors. The process included several stages, being the last one the integration, in which training sessions were performed. OUTCOMES: The process was accessed using two main tools: quantitative questionnaires and qualitative interviews. After the proposed intervention, the volunteer presented a gradual evolution in her occupational performance with the use of most adaptations, promoting her functional training. DISCUSSIONS: Most adaptations allowed G. to perform the activities satisfactorily, with the precision inherent to these tasks, even with little training time. CONCLUSIONS: This case study demonstrates the high applicability of the proposed technologies.

In order to improve the quality of life for people with upper limb agenesis, it is urgent to establish inclusion strategies in the educational field, as assessed in this study caseThe inclusion process of Dentistry students can include the use of assistive technology to allow the manipulation of instruments for the practice of clinical activitiesOur study suggests that the assistive adpatations promote a gradual evolution in the students' occupational performance, functional training and motor qualification.

How to choose the appropriate cannulation technique for vascular access in hemodialysis patients.

The cannulation technique is important for the survival of the arteriovenous access. Choosing the appropriate technique is a complex decision. Such choice must be customized to patients, considering their characteristics, the type of arteriovenous access and the experience of the hemodialysis team. We describe seven items that can help nurses to identify the appropriate cannulation technique: type of arteriovenous access; drainage vein; hygienic self-care profile; experience of the nursing staff in the cannulation technique and nurse-to-patient ratio; hemodialysis treatment method; patient's condition; and patient's decision. Such items can help nurses in decision-making on the "ideal" cannulation technique for each patient.

In vitro effect of two resin based materials for treating initial caries lesion around braces, under cariogenic challenge.

Background: Orthodontic treatment makes the patient susceptible to the development of white spot lesions (WSL) due to the greater accumulation of bacterial plaque. The purpose of this in-vitro study was to evaluate the preventive effect of two resin materials on the incidence of these lesions in the region adjacent to the fixed bracket bonded under a WSL-treated area by two resin materials. Material and Methods: 36 extracted human molars presenting natural WSL were included. They were randomly divided into 2 groups for intervention: IC (Infiltration resin Icon®) and PS (resin sealant Pro Seal ®). Braces were bonded just above the WSL. The enamel surface around the brace was treated by one of the tested materials, leaving another part to be control. The samples were submitted again to a cariogenic challenge. The exposed enamel non-treated area from booth groups comprised the control group (E). For morphological analysis, confocal images were taken at baseline, after treatment, and after pH cycling of each sample. Lesion depth were measured (µm) and compared to the enamel thickness to calculate a demineralization index. All groups were compared using the Kruskal Wallis test and Dunn's post-test. Results: PS group showed the lowest demineralization index (0.27 µm) when compared to the control area (0.39 µm) (p<0.05). IC presented a slightly higher percentage of lesions when compared to PS, however, did not differ significantly from the control exposed area. Conclusions: The resin sealant Pro Seal® had a positive protective effect under white spot environmental area and Icon® infiltrant, although showed some protection, did not statistically differ from controls. Key words:Dental Caries, Orthodontics, Dental Enamel, Sealants.

Effects of Psidium guajava L. leaves extract on blood pressure control and IL-10 production in salt-dependent hypertensive rats.

Psidium guajava (guava) leaves extract displays anti-hypertensive properties by mechanisms not yet fully understood. Here, we investigated whether sympathetic drive and immune signaling mechanisms are involved with the antihypertensive effect of the guava extract in a model of salt-dependent hypertension. Raw guava extract (rPsE) was characterized by colorimetric and UPLC-MS techniques. Two doses of rPsE (100 and 200 mg/kg) were evaluated for anti-hypertensive effect using a suspension system (PsE). Weaned male Wistar rats were put on a high-salt diet (HSD, 0.90 % Na+) for 16 weeks and received gavages of PsE for the last 4 weeks. Blood pressure (BP) was measured at the end of treatment in conscious rats. The neurogenic pressor effect was assessed by ganglionic blockade with hexamethonium. Autonomic modulation of heart rate was evaluated by spectral analysis. The effects of orally administered PsE on lumbar sympathetic nerve activity (LSNA) were assessed in anesthetized rats. Blood IL-10, IL-17A, and TNF were measured. The increased neurogenic pressor effect of HSD rats was reduced by PsE 100 mg/kg, but not by 200 mg/kg. PsE (200 mg/kg) administration in anesthetized rats produced a greater fall in BP of HSD rats compared to standard salt diet (SSD) rats. PsE hypotensive response elicited an unproportionable increase in LSNA of HSD rats compared to SSD rats. PsE (200 mg/kg) increased plasma concentrations of IL-10 but had no effect on TNF or IL-17A. Our data indicate that the antihypertensive effects of PsE may involve autonomic mechanisms and immunomodulation by overexpression of IL-10 in salt-dependent hypertensive rats.

Sodium butyrate-loaded nanoparticles coated with chitosan for the treatment of neovascularization in age-related macular degeneration: Ocular biocompatibility and antiangiogenic activity.

Sodium butyrate-loaded nanoparticles coated chitosan (NaBu-loaded nanoparticles/CS) were developed to treat the choroidal neovascularization in wet age-related macular degeneration (AMD). The nanoparticles were produced by double emulsification and solvent evaporation technique, optimized by experimental statistical design, characterized by analytical methods, investigated in terms of in vitro and in vivo ocular biocompatibility, and evaluated as an antiangiogenic system in vivo. The NaBu-loaded nanoparticles/CS were 311.1 ± 3.1 nm in diameter with a 0.208 ± 0.007 polydispersity index; had a +56.3 ± 2.6 mV zeta potential; showed a 92.3 % NaBu encapsulation efficiency; and sustained the drug release over 35 days. The NaBu-loaded nanoparticles/CS showed no toxicity to human retinal pigment epithelium cells (ARPE-19 cells); was not irritant to the chorioallantoic membrane (CAM); did not interfere in the integrity of the retinal layers of rat's eyes, as detected by the Optical Coherence Tomography and histopathology; and inhibited the angiogenesis in CAM assay. The NaBu-loaded nanoparticles/CS could be a therapeutic alternative to limit the neovascularization in AMD.

Autocuidado com a fístula arteriovenosa / Arteriovenous fistula self-care

A hemodiálise constitui uma das formas de tratamento da DRC, implicando a existência de um acesso vascular, como a fístula arteriovenosa, o acesso vascular mais recomendado para a realização de HD. Contudo, a fístula arteriovenosa requer cuidados por parte do doente, sendo da responsabilidade do enfermeiro do doente renal crónico em hemodiálise capacitar o mesmo para comportamentos de autocuidado. Objetivos: O objetivo geral deste estudo consistiu em analisar os comportamentos de autocuidado com a fístula arteriovenosa do doente renal crónico em programa de hemodiálise e os fatores associados. Métodos: Estudo transversal analítico. Participaram no estudo 131 doentes renais crónico com fístula arteriovenosa, que se disponibilizaram a participar no estudo e se apresentavam conscientes e orientados no tempo e no espaço numa população de 218 doentes. O instrumento de recolha de dados utilizado foi o questionário, constituído por três partes: caracterização de variáveis sociodemográficas, das variáveis clínicas, do doente renal crónico em programa de hemodiálise e escala de avaliação de comportamentos de autocuidado da FAV dos utentes em hemodiálise (ECAHD-FAV). O estudo obteve parecer favorável da comissão de ética nº56/2021. Para o tratamento e análise estatística recorremos ao SPSS com cálculo das frequências absolutas e relativas, médias e desvio padrão. Como as variáveis não seguiam uma distribuição normal, recorremos a testes não paramétricos U- Mann-Witney, e Kruskal-Wallis e à correlação de Spearman, consideramos com valor de prova 0,05. Resultados: Os participantes eram maioritariamente do género masculino (78; 59,5%) com uma média de idades de 67,24 anos, provenientes do meio rural (83;63, 4%). As principais causas de DRC foram a diabetes (38; 29%) e a hipertensão arterial (22;16,8%), tiveram FAV anterior (40; 19,1%), com pelo menos duas (15;37,5%) perdidas por trombose (24;45,3%) e estenose (13;24,5%). O enfermeiro foi o principal agente de ensinamento (93;36,9%). Os comportamentos de autocuidado foram em média 74,6% ±19,9. Os comportamentos de autocuidado com a fístula arteriovenosa associaram-se significativamente com o grau académico e ao agente de ensinamento (p<0,05). A prevenção de complicações, apresentou uma média de comportamentos de autocuidado de 68,26% ±18,4, associou-se, significativamente, com a idade e com o grau académico (p<0,05). A gestão de sintoma, registou uma média de comportamento de autocuidado de 85,3% ±16,5 , com associação, estatisticamente significativa, com o grau académico e com o agente de ensinamento (p>0,05). Verificamos uma correlação, estatisticamente significativa, entre a gestão de sintomas, a prevenção de complicações e a escala no geral (p<0,05), a gestão de sintoma apresenta uma média de conhecimento maior (85,27%). Conclusão: Os comportamentos de autocuidado, com a FAV, ficaram abaixo do desejado (74,5 em 100%), com melhores indicadores para a gestão de sinais e sintomas e menos bons para a prevenção de complicações. O grau académico e o agente de ensinamento influenciaram os comportamentos de autocuidado com a FAV. A idade e o grau académico influenciaram a prevenção de complicações. Sugerimos a implementação de programas de promoção de comportamentos de autocuidado em função da idade e das habilitações literárias por uma equipa multidisciplinar. Sugerimos ainda a realização de outros estudos com amostras maiores que permitam a generalização dos resultados.

Hemodialysis is one of the forms of treatment for CKD, implying the existence of a vascular access, such as arteriovenous fistula, the most recommended vascular access for HD. However, arteriovenous fistula requires care by the patient, and it is the responsibility of the nurse of the chronic kidney patient on hemodialysis to enable the same for self-care behaviors. Objectives: The general objective of this study was to analyze self-care behaviors with arteriovenous fistula in chronic kidney patients undergoing hemodialysis and the associated factors. Methods: Analytical cross-sectional study. Participated in the study 131 patients with chronic renal failure with arteriovenous fistula, who were willing to participate in the study and were conscious and oriented in time and space in a population of 218 patients. The data collection instrument used was the questionnaire, consisting of three parts: characterization of sociodemographic variables; of the clinical variables, of the chronic renal patient in hemodialysis program and scale of evaluation of self-care behaviors and maintenance of AVF of the users in hemodialysis (ECAHD-AVF). The study obtained a favorable opinion from the ethics committee nº56/2021. For the treatment and statistical analysis, we used SPSS with calculation of absolute and relative frequencies, means and standard deviation. As the variables did not follow a normal distribution, we used non-parametric U-Mann-Witney and Kruskal-Wallis tests and Spearman's correlation, which we considered with a proof value of 0.05. Results: The participants were mostly male (78; 59.5%) with a mean age of 67.24 years, coming from rural areas (83;63.4%). The main causes of CKD were diabetes (38; 29%) and arterial hypertension (22;16.8%) had previous AVF (40; 19.1%), with at least two (15;37.5%) lost due to thrombosis (24;45, 3%) and stenosis (13;24.5%). The nurse was the main teaching agent (93;36.9%). Self-care behaviors averaged 74.6 ±19.9. Self-care behaviors with arteriovenous fistula were significantly associated with academic level and teaching agent (p<0.05). The prevention of complications, presented an average of self-care behaviors of 68.26% ±18.4, was significantly associated with age and academic degree (p<0.05). Symptom management associated, registered an average of self-care behavior of 85.3% ±16.5, with association, statistically significant, with the academic degree and with the teaching agent (p>0.05). We found a statistically significant correlation between symptom management, prevention of complications and the overall scale (p<0.05), symptom management has a higher mean of knowledge (85.27 %). Conclusion: Self-care behaviors, with AVF, were below the desired (74.5% out of 100), with better indicators for the management of signs and symptoms and less good for the prevention of complications. The academic degree and the teaching agent influenced self-care behaviors with AVF. Age and academic degree influenced the prevention of complications. We suggest the implementation of programs to promote self-care behaviors according to age and educational qualifications by a multidisciplinary team. We also suggest carrying out other studies with larger samples that allow the generalization of the results.

Effect of Er:YAG Laser and Association of Protocols on the Demineralized Enamel Microhardness.

Objective: The aim of this study was to analyze the microhardness of demineralized enamel following different treatments (fluoride varnish, Er:YAG laser, and Er:YAG laser associated with fluoride varnish). Methods: Forty-eight enamel blocks (4 × 4 × 7 mm) were divided into six groups (n = 8): (S) Sound; (DE) Demineralized; (DED) DE + Duraphat® 5% (fluoride varnish); (DEL20) DE + Er:YAG laser (20 mJ pulse mode; 0.20 W; 10 Hz; 60 sec; 1.18 J/cm2; 11.83 W/cm2); (DEL50) DE + Er:YAG laser (50 mJ pulse mode; 0.50 W; 10 Hz; 60 sec; 2.95 J/cm2; 29.58 W/cm2); (DEL20D) DE + Er:YAG laser (20 mJ) + Duraphat 5%. The irradiation was performed at 1 mm distance from the surface using a tip (AS7066X, L-14 mm, D-1.3 mm in diameter) in water/air spray refrigeration (level 6). The enamel blocks were submitted to pH cycling (4 h into DES solution +20 h into RE solution for 8 days and the solutions were changed every day). Knoop microhardness was measured (50 g/15 sec, six readings per sample) and data were analyzed by Kruskal-Wallis test at 5% significance. Results: After treatments, DF group showed higher microhardness values than all the groups. Also, DEL20D group showed similar results with H group according to the microhardness analysis (p < 0.05). Conclusions: It could be concluded that Duraphat 5% treatment showed better results when compared with all tested groups, however, the association of Er:YAG Laser 20 with Duraphat 5% also showed promising results.

Beat Detection Recruits the Visual Cortex in Early Blind Subjects.

Using functional magnetic resonance imaging, here we monitored the brain activity in 12 early blind subjects and 12 blindfolded control subjects, matched for age, gender and musical experience, during a beat detection task. Subjects were required to discriminate regular ("beat") from irregular ("no beat") rhythmic sequences composed of sounds or vibrotactile stimulations. In both sensory modalities, the brain activity differences between the two groups involved heteromodal brain regions including parietal and frontal cortical areas and occipital brain areas, that were recruited in the early blind group only. Accordingly, early blindness induced brain plasticity changes in the cerebral pathways involved in rhythm perception, with a participation of the visually deprived occipital brain areas whatever the sensory modality for input. We conclude that the visually deprived cortex switches its input modality from vision to audition and vibrotactile sense to perform this temporal processing task, supporting the concept of a metamodal, multisensory organization of this cortex.

Corrigendum: Kinetics of Phenotypic and Functional Changes in Mouse Models of Sponge Implants: Rational Selection to Optimize Protocols for Specific Biomolecules Screening Purposes.

[This corrects the article DOI: 10.3389/fbioe.2020.538203.].

Kinetics of Phenotypic and Functional Changes in Mouse Models of Sponge Implants: Rational Selection to Optimize Protocols for Specific Biomolecules Screening Purposes.

The sponge implant has been applied as an important in vivo model for the study of inflammatory processes as it induces the migration, proliferation, and accumulation of inflammatory cells, angiogenesis, and extracellular matrix deposition in its trabeculae. The characterization of immune events in sponge implants would be useful in identifying the immunological events that could support the selection of an appropriate experimental model (mouse strain) and time post-implant analysis in optimized protocols for novel applications of this model such as in biomolecules screening. Here, the changes in histological/morphometric, immunophenotypic and functional features of infiltrating leukocytes (LEU) were assessed in sponge implants for Swiss, BALB/c, and C57BL/6 mice. A gradual increase of fibrovascular stroma and a progressive decrease in LEU infiltration, mainly composed of polymorphonuclear cells with progressive shift toward mononuclear cells at late time-points were observed over time. Usually, Swiss mice presented a more prominent immune response with late mixed pattern (pro-inflammatory/anti-inflammatory: IL-2/IFN-γ/IL-4/IL-10/IL-17) of cytokine production. While BALB/c mice showed an early activation of the innate response with a controlled cytokine profile (low inflammatory potential), C57BL/6 mice presented a typical early pro-inflammatory (IL-6/TNF/IFN-γ) response with persistent neutrophilic involvement. A rational selection of the ideal time-point/mouse-lineage would avoid bias or tendentious results. Criteria such as low number of increased biomarkers, no recruitment of cytotoxic response, minor cytokine production, and lower biomarker connectivity (described as biomarker signature analysis and network analysis) guided the choice of the best time-point for each model (Day5/Swiss; Day7/BALB/c; Day6/C57BL/6) with wide application for screening purposes, such as identification of therapeutic biomolecules, selection of antigens/adjuvants, and follow-up of innate and adaptive immune response to vaccines candidates.

Salt-dependent hypertension and inflammation: targeting the gut-brain axis and the immune system with Brazilian green propolis.

Systemic arterial hypertension (SAH) is a major health problem around the world and its development has been associated with exceeding salt consumption by the modern society. The mechanisms by which salt consumption increase blood pressure (BP) involve several homeostatic systems but many details have not yet been fully elucidated. Evidences accumulated over the last 60 decades raised the involvement of the immune system in the hypertension development and opened a range of possibilities for new therapeutic targets. Green propolis is a promising natural product with potent anti-inflammatory properties acting on specific targets, most of them participating in the gut-brain axis of the sodium-dependent hypertension. New anti-hypertensive products reinforce the therapeutic arsenal improving the corollary of choices, especially in those cases where patients are resistant or refractory to conventional therapy. This review sought to bring the newest advances in the field articulating evidences that show a cross-talking between inflammation and the central mechanisms involved with the sodium-dependent hypertension as well as the stablished actions of green propolis and some of its biologically active compounds on the immune cells and cytokines that would be involved with its anti-hypertensive properties.

Data on statistical experimental design to formulate amphotericin B-loaded Eudragit RL100 nanoparticles coated with hyaluronic acid for the treatment of vulvovaginal candidiasis.

Data described in this article are related to the research article entitled "Amphotericin B-loaded Eudragit RL100 nanoparticles coated with hyaluronic acid (AMP EUD nanoparticles/HA) for the treatment of vulvovaginal candidiasis" [1]. In this work, we report original data on the statistical experimental design to formulate uncoated AMP EUD nanoparticles, data on the validation of spectrophotometric method to quantify the AMP released from uncoated EUD nanoparticles and coated with HA to obtain the in vitro drug release profiles as well as the drug encapsulation efficiency. In addition, we describe original data on characterization, including diameter size, polydispersity index, zeta potential, FTIR, DSC/TG, and XRD; data on diameter of in vitro inhibition halos of Candida albicans; and on the vaginal burden of infected animals treated with uncoated AMP EUD nanoparticles and AMP EUD nanoparticles/HA. Finally, different histological sections of endocervix collected from treated and untreated animals were inserted into this manuscript.

Amphotericin B-loaded Eudragit RL100 nanoparticles coated with hyaluronic acid for the treatment of vulvovaginal candidiasis.

The treatment of vulvovaginal candidiasis (VVC) is based on oral and vaginal formulations which show limited effectiveness. In this study, amphotericin B-loaded Eudragit RL100 nanoparticles coated with hyaluronic acid (AMP EUD nanoparticles/HA) were developed to overcome the drawbacks of the conventional formulations. AMP EUD nanoparticles/HA were synthesized by nanoprecipitation, formulated by statistical experimental design, and characterized. AMP release from EUD nanoparticles/HA and its antifungal activity in a murine model of VVC were evaluated. Nanoparticles showed 147.6 ±â€¯16.7 nm of diameter, 0.301 ±â€¯0.09 of polydispersity index, - 29.9 ±â€¯3.76 mV of zeta potential, and 87.27 % of encapsulation efficiency. They released about 81 % of AMP in 96 h; and provided the elimination of 100 % of the vaginal fungal burden in 24 h. It was suggested that the AMP EUD nanoparticles/HA penetrated into the vaginal epithelium via CD44 receptors. These AMP EUD nanoparticles/HA represent a non-conventional vaginal formulation to improve the treatment of VVC.

Reliability of ICDAS to Detect Occlusal Caries among Master's Degree students of Dentistry / Confiabilidade do ICDAS para Detectar Cárie Oclusal Entre Mestrandos de Odontologia

The objective of this study was to investigate the reproducibility of the International System for the Detection and Evaluation of Caries (ICDAS) for the diagnosis of caries by students of the Master's Degree in Dentistry (n = 25). The occlusal surfaces of human third molars (n = 14) were evaluated by twenty-five (n = 25) students using the ICDAS index and later a questionnaire was applied on demographic and professional context data. The dental crowns were sectioned in mesial to distal direction to obtain slices of 1mm in thickness which were observed in a stereomicroscope (40X) to identify the greatest extension of caries lesion. Data were analyzed by the Chi-Square, Fisher's Exact and Spearman's Correlation Coefficient at a significance level of 5%. There was an influence in the diagnosis of caries among students and teeth, where the majority of those who declared themselves to be safe missed the diagnosis. There was variability between the diagnosis and the proposed treatment for caries, with a better diagnosis for tooth VII and less for X; greater fit for treatment of teeth XIII, XIV and lower for IV, VI. The histological cut showed that the teeth were more affected by caries than the ICDAS. It was concluded that the ICDAS reproducibility was partially satisfactory when the occlusal surface was evaluated by the master's degree students. (AU).

Este trabalho teve o objetivo de investigar a reprodutibilidade do Sistema Internacional de Detecção e Avaliação de Cárie (ICDAS) para o diagnóstico da cárie, por estudantes de curso de Mestrado em Odontologia (n=25). As superfícies oclusais de terceiros molares humanos (n=14) foram avaliadas por vinte e cinco (n=25) estudantes, utilizando o índice ICDAS, e posteriormente foi aplicado questionário sobre dados demográficos e de contexto profissional. As coroas dentárias foram seccionadas no sentido mésio distal para obter fatias de 1 mm de espessura, que foram observadas em estereomicroscópio (40X) para identificar a maior extensão da lesão de cárie. Os dados foram analisados pelos Testes Qui-Quadrado, Exato de Fisher e Coeficiente de Correlação de Spearman, em nível de significância de 5%. Houve influência do grau de instrução dos estudantes no diagnóstico da cárie em relação ao dente avaliado e a maioria que se declarou segura errou o diagnóstico. Houve variabilidade entre o diagnóstico e o tratamento proposto para a cárie, com maior acerto para diagnóstico do dente VII e menor para o X; maior acerto para tratamento dos dentes XIII, XIV e menor para IV, VI. O corte histológico mostrou que os dentes estavam mais comprometidos pela cárie que o ICDAS. Concluiu-se que a reprodutibilidade do ICDAS foi satisfatória quando a superfície oclusal foi avaliada pelos mestrandos. (AU).

Hydroalcoholic extract of Brazilian green propolis modulates inflammatory process in mice submitted to a low protein diet.

The occurrence of inflammation and protein malnutrition is an aggravating risk factor for morbidity and mortality in the clinical setting. The green propolis, a natural product made by Apis mellifera bees from Baccharis dracunculifolia resin, has therapeutic potential to modulate chronic inflammation. However, its effect on inflammation in an impaired nutritional status is not known. The aim of this study was to characterize the effects of the administration of the hydroalcoholic extract of the green propolis in the chronic inflammatory process of mice submitted to a low-protein diet. For this, we used the subcutaneous implantation of sponge disks as an inflammatory model and the animals were distributed in the following groups: standard protein diet (12% protein content), control treatment; standard protein diet, propolis treatment; low-protein diet (3% protein content), control treatment; low-protein diet, propolis treatment. Propolis was given daily at a dose of 500 mg/kg (p.o.) during a period of 7 or 15 days. Our main findings show that animals fed with standard protein diet and treated with propolis had low levels of red blood cells, hemoglobin, and hematocrit, with the subsequent reestablishment of these levels, in addition to monocyte count elevation and higher TNF levels after one week of treatment. In the low-protein diet group, the propolis treatment provided a significant recovery in weight and maintenance of total serum protein levels at the end of two weeks of treatment. Histological analysis showed propolis reduced the inflammatory infiltrate in the sponges of both standard and low-protein diet groups. In addition, the propolis extract presented antiangiogenic effect in both groups. Therefore, our data suggests that the hydroalcoholic extract of the green propolis promotes weight recovery and avoid the reduction of protein levels, in addition to inhibit inflammation and angiogenesis in animals fed with a low-protein diet.

Microhardness of bovine enamel after different fluoride application protocols.

The aim of the present study was to evaluate microhardness, mineral recovery and the enamel surface after the application of topical fluoride to artificial dental caries. Twenty-five bovine enamel blocks were prepared for artificial caries-like lesions and randomly divided into five groups (n=5): untreated (C control), 1.23% acidulated phosphate fluoride gel (APG), 2% neutral fluoride gel (NFG), 1.23% acidulated fluoride mousse (AFM) and fluoride varnish (5% Duraphat, DFV). Knoop microhardness (KHN) was evaluated after 7 and 14 days of treatment as well as 1 week after 28 days of treatment. Electron and confocal microscopy and energy dispersive spectroscopy were performed. KHN data were treated with two-way ANOVA (material×time) and Tukey's test at a 5% significance level. Differences were found among groups over time (p<0.001). Microhardness varied after 7 and 14 days of treatment and remained stable 1 week after 28 days of treatment. Mineral recovery and enamel topography varied among groups, with the fluoride varnish achieving the most uniform topography.

Amphotericin B-Loaded Poly(lactic-co-glycolic acid) Nanofibers: An Alternative Therapy Scheme for Local Treatment of Vulvovaginal Candidiasis.

Vulvovaginal candidiasis is an inflammation localized in the vulvovaginal area. It is mostly caused by Candida albicans. Its treatment is based on the systemic and local administration of antifungal drugs. However, this conventional therapy can fail owing to the resistance of the Candida species and noncompliance of patients. Amphotericin B-loaded poly(lactic-co-glycolic acid) nanofibers are single-use, antifungal, controlled drug delivery systems, and represent an alternative therapeutic scheme for the local treatment of vulvovaginal candidiasis. Nanofibers were characterized by analytical techniques and with an in vitro drug delivery study. In vitro and in vivo fungicidal activity of amphotericin B released from nanofibers was evaluated using the agar diffusion method and an experimental murine model of vulvovaginal candidiasis, respectively. Analytical techniques showed that amphotericin B was physically mixed in the polymeric nanofibers. Nanofibers controlled the delivery of therapeutic doses of amphotericin B for 8 consecutive days, providing effective in vitro antifungal activity and eliminated the in vivo vaginal fungal burden after 3 days of treatment and with only one local application. Amphotericin B-loaded poly(lactic-co-glycolic acid) nanofibers could be potentially applied as an alternative strategy for the local treatment of vulvovaginal candidiasis without inducing fungal resistance, yet ensuring patient compliance.