Practical training using BEWE aimed at improving the diagnosis ability of erosive tooth wear for dental students-A randomized trial.

INTRODUCTION: Erosive tooth wear (ETW) has been gaining attention due to its high prevalence. However, ETW clinical diagnosis is difficult and may go unnoticed by many professionals. The present study aimed to develop, implement and evaluate a theoretical-practical training using active methodologies in the development of undergraduate students' skills for the diagnosis of ETW compared to the traditional teaching method. MATERIALS AND METHODS: This randomized controlled study involved two parallel groups: control group (n = 22), with learning based only on theoretical content and test group (n = 24), learning by theoretical-practical activity mediated by monitors/tutors. The theoretical class covered the current concepts of ETW, aetiology, diagnosis, use of the BEWE index, prevention and treatment. The practical training included exercises and discussions based on the diagnosis using BEWE scores of a collection of images and extracted teeth. To evaluate the efficacy of the teaching-learning methods, a theoretical multiple-choice questionnaire and a practical test using images and extracted teeth were applied. The outcome was the number of correct answers. Groups were compared by Mann-Whitney (theoretical knowledge) and T tests (practical ability in diagnosis) (p < .05). RESULTS: There was no significant difference between groups in the theoretical evaluation (p = .866). The test group showed higher ability to diagnose ETW lesions compared to the control group in the practical tests (p = .001). The performance of ETW diagnosis was similar when images were used in comparison to extracted teeth (p = .570). CONCLUSION: The practical activity associated with theoretical classes can be a promising strategy to improve the development of undergraduate students' skills in the diagnosis of ETW.

Uncovering injuries in Brazilian elite women's football: A prospective cohort study.

OBJECTIVES: To elucidate the injury profile in Brazilian elite women's football. DESIGN: Prospective cohort study. METHODS: Time-loss injuries, along with match and training exposure, were monitored throughout a full season in four Brazilian elite clubs. RESULTS: Sixty-three out of 133 players (47 %) sustained 112 time-loss injuries along the season, leading to 0.8 injuries per player on average. The overall injury incidence rate was 5.0 injuries per 1000 h of exposure. Sudden onset injuries occurred at a rate of 4.2/1000 h of overall exposure, with rates of 15.9/1000 h during matches and 2.9/1000 h during training sessions. Forty-eight percent of the time-loss injuries were attributed to non-contact events. Gradual onset injuries accounted for 16 % of the injuries, resulting in a rate of 0.8/1000 h of overall exposure. The most affected locations were knee and thigh (29 % of all injuries for each), followed by ankle (17 %) and hip/groin (13 %). Muscle/tendon was the most affected tissue (47 % of all injuries), followed by ligament/joint capsule (33 %), bone (10 %), and cartilage/synovium/bursa (7 %). Ankle sprains, hamstring strains, and anterior cruciate ligament injuries accounted for over one-third of the injuries. Mild, moderate, and severe injuries account for 40 %, 43 %, and 17 % of cases, respectively. Overall, 18 % of cases were categorized as re-injuries, and 40 % of those occurred within 2 months of the index injury. CONCLUSIONS: This study provides the initial understanding into the injury profile of Brazilian elite women's football. This information should serve as a guiding resource for injury prevention programs.

Serotonin and Interleukin 10 Can Influence the Blood and Urine Viscosity in Gestational Diabetes Mellitus and Pregnancy-Specific Urinary Incontinence.

Serotonin and interleukin 10 (IL-10) may play a role in gestational diabetes mellitus. Hyperglycemic environment, the detrusor musculature of the bladder and pelvic floor muscles may become damaged, leading to urination problems and urine viscosity in pregnant women with gestational diabetes mellitus and pregnancy-specific urinary incontinence. Urine and blood samples were collected from pregnant women between 24 and 28 weeks of gestation. The serotonin concentration and cytokine IL-10 levels were evaluated in plasma and urine. In the total blood and urine, the viscosity was evaluated in the presence and absence of exogenous serotonin and IL-10. The plasma serotonin levels decreased, while the urine serotonin levels increased in the normoglycemic incontinent (NG-I), hyperglycemic continent (GDM-C), and hyperglycemic incontinent (GDM-I) groups. The IL-10 in the plasma decreased in the GDM-I group and was higher in the urine in the NG-I and GDM-I groups. The blood viscosity was higher, independently of urinary incontinence, in the GDM groups. The serotonin increased the blood viscosity from women with GDM-C and urine in the NG-I, GDM-C, and GDM-I groups. Blood and urine in the presence of IL-10 showed a similar viscosity in all groups studied. Also, no difference was observed in the viscosity in either the blood or urine when in the presence of serotonin and IL-10. These findings suggest that serotonin and IL-10 have the potential to reduce blood viscosity in pregnant women with gestational diabetes and specific urinary incontinence, maintaining values similar to those in normoglycemic women's blood.

Chemical Composition and Evaluation of Antibacterial, Antibiofilm, and Mutagenic Potentials of a Propolis Sample from the Atlantic Forest of Midwest Brazil.

Sixteen triterpenoids with various skeletal types, five phenylpropanoid derivatives, and two flavonoids were isolated from a propolis sample produced by Apis mellifera collected in the Atlantic Forest of Midwest Brazil. Among these compounds, six triterpenes, namely 3ß,20R-dihydroxylanost-24-en-3-yl-palmitate, (23E)-25-methoxycycloartan-23-en-3-one, 24-methylenecycloartenone, epi-lupeol, epi-α-amyrin, and epi-ß-amyrin are being reported for the first time in propolis, while cycloartenone, (E)-cinnamyl benzoate, and (E)-cinnamyl cinnamate are new findings in Brazilian propolis. The presence of cycloartane- and lanostane-type triterpenoids, the latter being a class of compounds of restricted distribution in propolis worldwide, has not been reported in propolis from Midwest Brazil until now. The ethyl acetate phase obtained from the ethanol extract was effective in preventing biofilm formation by Staphylococcus aureus, with an inhibition rate of about 96 % at 0.5 mg.mL-1 , and with quercetin isolated as one of its active constituents. In contrast, the hexane phase exhibited notable antibacterial activity against Pseudomonas aeruginosa, inhibiting bacterial growth by 92 % at 0.5 mg.mL-1 ; however, none of the triterpenoids isolated from this phase proved active against this pathogen. The ethanol extract was neither toxic nor mutagenic at the concentrations tested, as determined by the in vivo SMART assay on Drosophila melanogaster, even under conditions of high metabolic activation.

Citral Modulates MMP-2 and MMP-9 Activities on Healing of Gastric Ulcers Associated with High-Fat Diet-Induced Obesity.

Obesity causes low-grade inflammation that results in the development of comorbidities. In people with obesity, exacerbation of gastric lesion severity and delayed healing may aggravate gastric mucosal lesions. Accordingly, we aimed to evaluate the citral effects on gastric lesion healing in eutrophic and obese animals. C57Bl/6 male mice were divided into two groups: animals fed a standard diet (SD) or high-fat diet (HFD) for 12 weeks. Gastric ulcers were induced using acetic acid (80%) in both groups. Citral (25, 100, or 300 mg/kg) was administered orally for 3 or 10 days. A vehicle-treated negative control (1% Tween 80, 10 mL/kg) and lansoprazole-treated (30 mg/kg) were also established. Lesions were macroscopically examined by quantifying regenerated tissue and ulcer areas. Matrix metalloproteinases (MMP-2 and -9) were analyzed by zymography. The ulcer base area between the two examined periods was significantly reduced in HFD 100 and 300 mg/kg citral-treated animals. In the 100 mg/kg citral-treated group, healing progression was accompanied by reduced MMP-9 activity. Accordingly, HFD could alter MMP-9 activity, delaying the initial healing phase. Although macroscopic changes were undetectable, 10-day treatment with 100 mg/kg citral exhibited improved scar tissue progression in obese animals, with reduced MMP-9 activity and modulation of MMP-2 activation.

In sickness and in health: the intestinal microbiome of dogs / Na saúde e na doença: os efeitos do microbioma intestinal no cão

Studies on the interactions between the intestinal microbiome and its host have strengthened in the last decade. However, publications on this topic in dogs still need to be made available, reinforcing the need for new studies and literary data for consultation. Given this, this review aims to describe the intestinal microbiome and its interactions with the canine host, which can contribute to both health and morbid conditions in these animals. The definition of microbiome encompasses the collective genome of all microorganisms that live in a defined habitat (intestine). It is known that the dog's intestinal microbiota is varied, composed of bacteria, archaea, viruses, fungi, and protozoa. Under normal conditions, there is commensalism between some of these microorganisms and the host, which promotes critical physiological relationships and interactions that contribute to homeostasis and the consequent health of the animal. With this in mind, it is expected that the disturbances associated with the microbiome will result in imbalances in this commensal relationship and thus precipitate the development of diseases and aggravation of other diseases, thus characterizing intestinal dysbiosis.(AU)

Os estudos sobre as interações entre o microbioma intestinal e o seu hospedeiro ganharam força na última década. Entretanto, as publicações acerca de tal temática em cães ainda são escassas, o que reforça a necessidade de novos estudos e dados literários para consultas. Frente a isso, o objetivo da presente revisão é descrever sobre o microbioma intestinal e suas interações e principais efeitos no cão, os quais podem contribuir tanto para a higidez quanto para quadros mórbidos desses animais. A definição de microbioma engloba o genoma coletivo de todos os microrganismos que vivem em habitat definido (intestino). É sabido que a microbiota intestinal do cão é muito variada, sendo composta por bactérias, arqueas, vírus, fungos e protozoários. Em condições normais, há o comensalismo entre alguns desses microrganismos e o hospedeiro, o que promove importantes relações e interações fisiológicas que contribuem sobremaneira para a homeostasia e consequente saúde do animal. Ciente disso, é de se esperar que os distúrbios associados ao microbioma resultarão em desequilíbrios nessa relação comensal e, assim, precipitar o desenvolvimento de doenças e/ou agravamento de outras moléstias, caracterizando, assim, a disbiose intestinal.(AU)

Reconstrução de palato com malha de polipropileno e prótese acrílica para correção de fístula oronasal adquirida em cão / Palate reconstruction with polypropylene mesh and acrylic prosthesis in dog for correcton of acquired oronosal fistulae

As fístulas oronosais adquiridas são defeitos que permitem a comunicação anormal entre as cavidades oral e nasal. Inúmeras causas podem ser atribuídas à etiologia de tal defeito. O presente trabalho visa relatar o caso de um cão com fístula oronasal adquirida que foi submetido à reconstrução cirúrgica do palato com o uso de malha de polipropileno e prótese acrílica. Após estabilização do quadro clínico e remoção manual das larvas, o paciente foi encaminhado para o desbridamento cirúrgico das lesões orais e correção do defeito no palato. A palatoplastia foi realizada com o uso da malha e resina de polimetilmetacrilato autopolimerizável. A malha foi suturada sobre o defeito palatino com pontos simples separados e fio náilon 3-0 nas extremidades da ferida. Em seguida, a resina foi preparada e, ao atingir consistência adequada, foi aplicada e modelada sobre o a malha de polipropileno com o auxílio de um descolador de Molt, sendo também suturada nas bordas da fístula com pontos simples separados e fio náilon 3-0. No mesmo tempo cirúrgico foi inserida uma sonda esofágica para alimentação enteral. Devido complicações cirúrgicas no pós operatório, o paciente foi submetido a mais duas intervenções cirúrgicas para desfecho satisfatório do tratamento. Conclui-se que associação entre a tela de polipropileno e a prótese acrílica foi uma alternativa exequível para a palatoplastia em cão.

Acquired oronosal fistulae are abnormal communication between the oral and nasal cavities. A oronasal fistula can be the result of different causes, like oral myiasis. The objetctive of these paper is to report the case of a dog with acquired oronasal fistula that underwent surgical reconstruction of the palate using polypropylene mesh and acrylic prosthesis. After stabilization of the patient ́s clinical condition and mecanic removal of the larvae, the dog was referred for surgical debridement of the oral lesions and correction of the defect in the palate. Palatoplasty was performed using a mesh and polymethylmethacrylate resin. The mesh was sutured over the palatal defect with separate simple suture and 3-0 naylon thread at the ends of the wound. Then, the resin was prepared and, upon reaching adequate consistency, it was applied and shaped over the polypropylene mesh with Molt peeler. It was also sutured on the edges of the fistula with separate simple suture and 3-0 nylon suture. At the same surgical time, an esophageal tube was inserted for enteral feeding. Due to complications, the dog underwent two more surgical interventions for a satisfactory treatment outcome. It is concluded that the association between the polypropylene mesh and the acrylic prosthesis was a practical alternative for palatoplasty in dogs after oral myiasis.

Peripheral muscle strength is associated with aerobic fitness and use of antibiotics in patients with cystic fibrosis.

AIMS: Individuals with cystic fibrosis (CF) may develop muscle abnormalities, although little is known on its clinical and functional impact. This study aimed to evaluate the association of peripheral muscle strength with aerobic fitness, habitual physical activity, lung function and the use of antibiotics (ATB) in patients with CF. METHODS: A cross-sectional study where individuals aged ≥6 years underwent peripheral muscle strength evaluation (biceps, quadriceps and hamstrings) and performed a cardiopulmonary exercise test. Demographic, anthropometric, genetic, lung function and total days of ATB use within 1 year of tests were also collected. RESULTS: Correlation was found for biceps (r = .45; P = .002) strength with the peak oxygen consumption (VO2 peak). Muscle strength (biceps and quadriceps) also correlated with the ventilatory equivalent for oxygen consumption (VE /VO2 ) at anaerobic threshold (AT) and with the ventilatory equivalent for carbon dioxide production (VE /VCO2 ) both at AT and peak exercise. Negative correlations were found for quadriceps (r = -.39) and hamstrings (r = -.42) with the total days of ATB use in the following year. Patients needing to use ATB presented lower biceps strength (P = .05) and individuals with VO2 peak lower than 37 mL·kg-1 ·min-1 presented lower muscle strength for both biceps (P = .01) and quadriceps (P = .02). CONCLUSIONS: The results have shown that peripheral muscle strength is associated with aerobic fitness and the use of antibiotics in patients with CF.

The essential oil from Baccharis trimera (Less.) DC improves gastric ulcer healing in rats through modulation of VEGF and MMP-2 activity.

ETHNOPHARMACOLOGICAL RELEVANCE: Baccharis trimera (Less.) DC known as "carqueja" in Brazil has been acknowledged as a medicinal plant in folk medicine for the treatment of stomach aches and gastrointestinal disorders. AIM OF THE STUDY: The present study aimed to evaluate the gastroprotective and healing effects of essential oil from B. trimera (EOBT) against gastric ulcer lesions caused by absolute ethanol and acetic acid, respectively, and to identify the mechanism of action of this essential oil in male Wistar rats. MATERIALS AND METHODS: The plant material used to obtain EOBT was collected in the southern region of Brazil and was analyzed by chromatography-mass spectrometry (GCMS) demonstrate its characteristic chemical composition, with carquejyl acetate as its main component. Different doses of EOBT (50, 100, and 200 mg/kg) were administered orally in male Wistar rats as an acute treatment against absolute ethanol-induced gastric lesions. The gastric healing effect of EOBT (100 mg/kg) was evaluated once a day after 7, 10, and 14 days of treatment. After treatment, the stomachs of rats from all groups were collected to measure the lesion area (mm2), the activity of myeloperoxidase (MPO), and the relative expression of caspases -3, -8, -9, cyclooxygenase-1 (COX-1), cyclooxygenase-2 (COX-2), vascular endothelial growth factor (VEGF), and epidermal growth factor (EGF). The zymography method was used to elucidate the activity of matrix metalloproteinase-2 (MMP-2) and -9 (MMP-9) in the healing action of EOBT. We also analyzed toxicological parameters (body weight evolution and biochemical parameters) that could result after treatment with this essential oil for 14 days. RESULTS: Pretreatment with EOBT (100 and 200 mg/kg) significantly decreased the severity of gastric damage induced by absolute ethanol and decreased MPO activity in gastric tissue. After 10 and 14 days of treatment with EOBT (100 mg/kg) once a day, the lesion area was significantly reduced by 61% and 65.5%, respectively, compared to the negative control group. The gastric healing effect of EOBT was followed by a decrease in the expression of COX-1 compared to that in the negative control group. Notably, treatment with EOBT for 14 days increased the expression of VEGF compared to that using an anti-ulcer drug (lansoprazole). Additionally, analyses of MMP-2 and MMP-9 activities in the gastric mucosa confirmed the accelerated gastric healing effect of EOBT, with a significant decrease in the activity of pro-MMP-2. No sign of toxicity was observed after treatment with EOBT for 14 consecutive days. CONCLUSION: These findings indicated that EOBT was effective in preventing and accelerating ulcer healing by decreasing MPO activity, increasing VEGF expression, and decreasing MMP-2 activity. These actions collectively contribute to the rapid recovery of gastric mucosa following treatment with EOBT, without any observed toxicity.

Effects of lumbar myelography on subarachnoid pressure and cardiorespiratory parameters in healthy sheep / Efeitos da mielografia lombar na pressão subaracnoidea e nos parâmetros cardiorrespiratórios em ovelhas saudáveis

The purpose of this study was to evaluate the effects of lumbar myelography on subarachnoid pressure, cardiorespiratory parameters and pressure-volume index in sheep. Eight sheep were evaluated. The animals were submitted to puncture of the cisterna magna for monitoring of subarachnoid pressure (SaP). Lumbar myelography was performed through applying Iohexol (0.4mL/kg). ToC, PAS, PAD, MAP, InspISO, FeISO, SaP and CPP were recorded immediately after anesthetic stabilization (M0), during lumbar puncture (M1), and two, four and six minutes after contrast application (M2, M3 and M4, respectively). Blood pressure initially increased, then decreased, returning to basal level, similarly observed for InspISo and FeISo. The SaP rose initially thereafter remaining stable. Despite of the effect on subarachnoid pressure, lumbar myelography can be considered safe in sheep.(AU)

O objetivo foi avaliar os efeitos da mielografia lombar na pressão subaracnóidea, parâmetros cardiorrespiratórios e índice pressão-volume em ovinos. Oito ovelhas foram avaliadas. Os animais foram submetidos à punção da cisterna magna para monitoramento da pressão subaracnoidea (SaP). A mielografia lombar foi realizada com a aplicação de Iohexol (0,4mL/kg). Os momentos estudados foram: imediatamente após a estabilização anestésica (M0), durante a punção lombar (M1), dois, quatro e seis minutos após a aplicação do contraste (M2, M3 e M4, respectivamente), para avaliar as seguintes variáveis: ToC, PAS, PAD, MAP, InspISO, FeISO, Sap e CPP. A pressão arterial aumentou inicialmente, depois diminuiu, retornando aos valores iniciais, padrão também observado para o InspISo e o FeISo. O SaP subiu inicialmente, posteriormente, permanecendo estável. A mielografia lombar, apesar de influenciar a pressão subaracnoidea, pode ser considerada segura em ovinos.(AU)

Effects of lumbar myelography on subarachnoid pressure and cardiorespiratory parameters in healthy sheep

ABSTRACT: The purpose of this study was to evaluate the effects of lumbar myelography on subarachnoid pressure, cardiorespiratory parameters and pressure-volume index in sheep. Eight sheep were evaluated. The animals were submitted to puncture of the cisterna magna for monitoring of subarachnoid pressure (SaP). Lumbar myelography was performed through applying Iohexol (0.4mL/kg). ToC, PAS, PAD, MAP, InspISO, FeISO, SaP and CPP were recorded immediately after anesthetic stabilization (M0), during lumbar puncture (M1), and two, four and six minutes after contrast application (M2, M3 and M4, respectively). Blood pressure initially increased, then decreased, returning to basal level, similarly observed for InspISo and FeISo. The SaP rose initially thereafter remaining stable. Despite of the effect on subarachnoid pressure, lumbar myelography can be considered safe in sheep.

RESUMO: O objetivo foi avaliar os efeitos da mielografia lombar na pressão subaracnóidea, parâmetros cardiorrespiratórios e índice pressão-volume em ovinos. Oito ovelhas foram avaliadas. Os animais foram submetidos à punção da cisterna magna para monitoramento da pressão subaracnoidea (SaP). A mielografia lombar foi realizada com a aplicação de Iohexol (0,4mL/kg). Os momentos estudados foram: imediatamente após a estabilização anestésica (M0), durante a punção lombar (M1), dois, quatro e seis minutos após a aplicação do contraste (M2, M3 e M4, respectivamente), para avaliar as seguintes variáveis: ToC, PAS, PAD, MAP, InspISO, FeISO, Sap e CPP. A pressão arterial aumentou inicialmente, depois diminuiu, retornando aos valores iniciais, padrão também observado para o InspISo e o FeISo. O SaP subiu inicialmente, posteriormente, permanecendo estável. A mielografia lombar, apesar de influenciar a pressão subaracnoidea, pode ser considerada segura em ovinos.

Hypothermic Effect of Acute Citral Treatment during LPS-induced Systemic Inflammation in Obese Mice: Reduction of Serum TNF-α and Leptin Levels.

Citral is a mixture of monoterpenes present in the essential oil of several plants, such as Cymbopogon citratus and Zingiber officinale, possessing anti-inflammatory, anti-ulcerogenic, and antipyretic actions. We investigated the action of citral on body temperature (Tb) and inflammatory signaling in eutrophic and obese mice during Systemic Inflammation (SI) induced by Lipopolysaccharide (LPS). Thus, we assessed the effect of citral (25, 100, and 300 mg/kg) and ibuprofen in LPS-induced SI in Swiss male mice fed a standard diet (SD) or high-fat diet (HFD) for 12 weeks. Following SI induction, we measured Tb and collected the serum, hypothalamus, and gastric mucosa for biochemical measurements. Acute treatment with citral decreased the Tb of both SD and HFD-fed animals. Citral (300 mg/kg) treatment caused a significantly lower Tb variation in HFD-fed animals than in those fed the SD. Citral reduced peripheral levels of tumor necrosis factor (TNF)-α in SD and HFD mice and decreased serum leptin concentration in HFD mice 90 min after the LPS challenge. Furthermore, citral also reduced interleukin (IL)-6 levels in the hypothalamus of obese mice. In summary, citral effectively reduced Tb during SI by reducing inflammatory mediators with a distinct action profile in HFD mice when compared with SD.

Terminalia catappa L. infusion accelerates the healing process of gastric ischemia-reperfusion injury in rats.

ETHNOPHARMACOLOGICAL RELEVANCE: Terminalia catappa L. (Combretaceae), known as "amendoeira da praia" in Brazil, has been recognized as a medicinal plant in folk medicine for the treatment of gastrointestinal disorders and other inflammatory conditions. The present study aimed to investigate the preventive and healing effects of the infusion of leaves of T. catappa (ILTC) against gastric lesions caused by ischemia and reperfusion (I/R) injury and characterize its mechanism of action in the gastric mucosa of rats. MATERIALS AND METHODS: Different doses (30, 100, and 300 mg/kg) of ILTC were orally administered as acute and subacute treatments against I/R-induced gastric lesion in rats. After treatment, the stomach of rats was collected to measure the lesion area, redox parameters malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), and reduced glutathione (GSH) and inflammatory parameters myeloperoxidase activity (MPO), interleukin 1ß (IL-1ß) and tumor necrosis factor α (TNF-α). The activities of matrix metalloproteinases 2 and 9 (MMPs 2 and 9) were assessed by zymography method to clarify the mechanisms of the healing acceleration promoted by ILTC. RESULTS: Pretreatment with ILTC (100 mg/kg) was effective in preventing the aggravation of lesions in the acute model by reducing MPO activity by 38% relative to control group, despite the lack of clarity of this action at the macroscopical level at the lesion area (p < 0.05). After three days of treatment with ILTC (30 and 100 mg/kg), this infusion significantly reduced the lesion area by 95% and 89%, respectively, compared the control (p < 0.05). The gastric healing effect of all doses of ILTC was followed by a reduction in MPO activity (decrease by 70-78%). Compared to the negative control, an improvement in gastric healing owing to treatment with ILTC was observed and this was followed by an increase in MMP-2 (20-47%) (p < 0.05). CONCLUSION: Three days of treatment with ILTC could accelerate the healing process in I/R-induced lesions in rats. By decreasing MPO levels, ILTC enabled the action of MMP-2, which led to tissue recovery in the gastric mucosa.

Systematic Analysis of Monoterpenes: Advances and Challenges in the Treatment of Peptic Ulcer Diseases.

Peptic ulcer disease (PUD) is a multifactorial and complex disease caused by an imbalance of protective and aggressive factors (endogenous and exogenous). Despite advances in recent years, it is still responsible for substantial mortality and triggering clinical problems. Over the last decades, the understanding of PUD has changed a lot with the discovery of Helicobacter pylori infection. However, this disease continues to be a challenge due to side-effects, incidence of relapse from use of various anti-ulcer medicines, and the rapid appearance of antimicrobial resistance with current H. pylori therapies. Consequently, there is the need to identify more effective and safe anti-ulcer agents. The search for new therapies with natural products is a viable alternative and has been encouraged. The literature reports the importance of monoterpenes based on the extensive pharmacological action of this class, including wound healing and anti-ulcerogenic agents. In the present study, 20 monoterpenes with anti-ulcerogenic properties were evaluated by assessing recent in vitro and in vivo studies. Here, we review the anti-ulcer effects of monoterpenes against ulcerogenic factors such as ethanol, nonsteroidal anti-inflammatory drugs (NSAIDs), and Helicobacter pylori, highlighting challenges in the field.

Sex-specific effects of Eugenia punicifolia extract on gastric ulcer healing in rats.

AIM: To evaluate the sex-specific effects of a hydroalcoholic extract from Eugenia punicifolia (HEEP) leaves on gastric ulcer healing. METHODS: In this rat study involving males, intact (cycling) females, and ovariectomized females, gastric ulcers were induced using acetic acid. A vehicle, lansoprazole, or HEEP was administered for 14 d after ulcer induction. Body weight was monitored throughout the treatment period. At the end of treatment, the rats were euthanized and the following in vivo and in vitro investigations were performed: macroscopic examination of the lesion area and organ weights, biochemical analysis, zymography, and evaluation of protein expression levels. Additionally, the concentration-dependent effect of HEEP was evaluated in terms of subacute toxicity and cytotoxicity. RESULTS: Compared to the vehicle, HEEP demonstrated a great healing capacity by substantially reducing the ulcerative lesion area in males (52.44%), intact females (85.22%), and ovariectomized females (65.47%), confirming that HEEP accelerates the healing of acetic acid-induced gastric lesions and suggesting that this effect is modulated by female sex hormones. The antiulcer effect of HEEP was mediated by prostaglandin E2 only in male rats. Overall, the beneficial effect of HEEP was the highest in intact females. Notably, HEEP promoted the expression of vascular endothelial growth factor (intact vs ovariectomized females) and decreased the expression of Caspase-8 and Bcl-2 (intact female vs male or ovariectomized female). Additionally, HEEP enhanced fibroblast proliferation and migration into a wounded area in vitro, confirming its healing effect. Finally, no sign of subacute toxicity or cytotoxicity of HEEP was observed. CONCLUSION: In gastric ulcers, HEEP-induced healing (modulated by female sex hormones; in males, mediated by prostaglandin) involves extracellular matrix remodeling, with gastric mucosa cell proliferation and migration.

A episiotomia sob a perspectiva da medicina baseada em evidências / Episiotomy from the perspective of evidence-based medicine

O estudo tem como propósito reunir evidências científicas atuais sobre episiotomia com a finalidade de promover embasamento teórico ao profissional gestor/auditor/perito diante da seguinte problemática: uma parcela dos profissionais (médicos obstetras e enfermeiros obstetras) defende e prática a episiotomia de rotina, outra parte nunca a realiza e outra, a executam de forma seletiva, o que tem gerado polarização de opiniões e condutas, aumentando o descontentamento da sociedade quanto ao parto vaginal e consequentemente elevando o número de processos judiciais em obstetrícia. Esta pesquisa responde às seguintes questões: quais são as evidências científicas sobre episiotomia? Qual é a importância do diálogo entre profissional e parturiente para definir intervenção cirúrgica no parto? Como diminuir processos judiciais em obstetrícia? Como método realizou-se um estudo descritivo com abordagem qualitativa de dados por meio de revisão bibliográfica retrospectiva. Os resultados encontrados indicam que o procedimento episiotomia não deve ser empregado como rotina em todos os partos normais. Caso o profissional de saúde decida por optar pela episiotomia, deve descrever em prontuário sua indicação e se houve consentimento da parturiente.

The purpose of this study is to gather current scientific evidence on episiotomy in order to provide a theoretical basis to the professional manager / auditor / expert in view of the following problems: a portion of the professionals (obstetricians and obstetrician nurses) defend and practice routine episiotomy, never performs it and another, perform it selectively, which has generated polarization of opinions and behaviors, increasing society's displeasure about vaginal delivery and consequently increasing the number of legal processes in obstetrics. This research responds to the following questions: What are the scientific evidences about episiotomy? What is the importance of the dialogue between professional and parturient to define surgical intervention in childbirth? How to reduce court cases in obstetrics? As a methodology, a descriptive study with qualitative abortion of data was performed through a retrospective bibliographic review. The results indicate that the episiotomy procedure should not be routinely used in all normal deliveries. In case the health professional decides to opt for the episiotomy, he / she should describe in his / her medical record his / her indication and if there was consent of the parturient.

Tromboflebite jugular em equinos submetidos à laparotomia para o tratamento de afecção gastrointestinal / Jugular thrombophlebitis in horses subjected to laparotomy for the treatment of gastrointestinal disease

Afecções do trato gastrointestinal de equinos podem causar distúrbios de coagulação devido à concentração elevada de mediadores inflamatórios que estimulam a hemostasia e inibem a fibrinólise, gerando um estado de hipercoagulação. Equinos submetidos à laparotomia no tratamento da síndrome cólica permanecem com cateter venoso durante vários dias para a administração de fluidos e fármacos no período pós-operatório e, a veia jugular é o principal local para a implantação de cateteres. Assim, o trauma vascular persistente causado pelo cateter, associado ao ambiente pró-trombótico induzido pela afecção gastrointestinal, aumenta o risco para o desenvolvimento de tromboflebite jugular. Objetivou-se avaliar as características físicas e ultrassonográficas da veia jugular canulada com cateter de poliuretano durante o período pós-operatório de equinos submetidos à laparotomia. O cateter foi inserido de forma asséptica à admissão e permaneceu por sete dias. A avaliação ultrassonográfica revelou o desenvolvimento de tromboflebite em um equino, 48 após o procedimento cirúrgico. Os demais equinos demonstraram espessamento da parede vascular no local de punção e pequenos trombos junto ao cateter. A monitoração ultrassonográfica demonstrou que a cateterização prolongada em equinos submetidos à laparotomia, seguindo o protocolo proposto, minimiza a lesão vascular e pode prevenir a tromboflebite jugular.(AU)

Coagulation abnormalities are usually associated with equine gastrointestinal disease due to the increased levels of inflammatory mediators, which promotes hemostasis and inhibit fibrinolysis, creating a hypercoagulable state. Horses underwent laparotomy to treat colic usually require a venous catheter for several days to administrate fluids and drugs during the postoperative period, and the jugular vein is the most frequent site for catheterization. Therefore, the persistent vascular trauma caused by an implanted catheter, associated with the prothrombotic environment induced by the gastrointestinal disorder, increases the risk for the development of jugular thrombophlebitis. The purpose of the present investigation was to evaluate physical and ultrassonographic features of the jugular vein cannulated with a polyurethane catheter during the postoperative period of horses underwent colic surgery. The catheter was inserted aseptically on admission and dwell time was seven days. Upon ultrasound examination, one horse developed thrombophlebitis 48 hours after surgery and the other horses showed thickened venous wall at puncture site and small clots associated to the catheter. Ultrasound monitoration showed that long-term catheterization in horses underwent colic surgery following the present protocol minimizes vascular trauma and could prevent jugular thrombophlebitis.(AU)

Capacity for self-monitoring reading comprehension in Elementary School. / Capacidade de automonitoramento da compreensão leitora no Ensino Fundamental.

PURPOSE: To investigate the capacity for self-monitoring reading comprehension in Brazilian Elementary School students. METHODS: Fifty-three Elementary students in the 5th and 9th grades from two Public Schools in the city of São Paulo were assessed. They were selected based on their oral reading rate and grouped according to their performance in reading comprehension in the following categories: Group with best comprehension: students with adequate rate and accuracy, without difficulties in reading comprehension; Group with worst comprehension: students with adequate rate and accuracy but with difficulties in reading comprehension. Two narrative texts followed by eight questions to assess reading comprehension were presented. Two sentences and two words were replaced by ungrammatical elements and pseudo-words. Under the condition of spontaneous monitoring, students read the text aloud and answered the questions. The analysis considered the calculation of hesitation, self-correction, repetitions and mistakes. Under the condition of directed monitoring, students were instructed to read the text, either aloud or silently, after being told that certain parts of the text could not make sense, and they were oriented to underline such parts. The analysis was carried out by counting of underlined items. The comparisons were made with the Mann-Whitney test. RESULTS: A difference was observed between the groups only at the sentence level among the 9th grade schoolchildren under the spontaneous monitoring and among the 5th grade schoolchildren under directed monitoring. CONCLUSION: Students with worst comprehension had a poorer performance to monitor the presence of ungrammatical sentences than their peers with best comprehension.

Factors Associated With Functional Capacity in Hemodialysis Patients.

Hemodialysis patients have a marked decrease in functional capacity when compared to healthy individuals. We evaluated the factors associated with functional capacity in hemodialysis patients. A total of 102 hemodialysis patients were evaluated. The patients were submitted to a 6-min walk test, peripheral muscle strength tests, and an evaluation of quality of life, anxiety, and depression. The laboratory data were measured. The 6-min walk test distance correlated significantly with age, educational level, hemoglobin, creatinine, number of comorbidities, peripheral muscle strength, and some domains of SF-36 quality of life questionnaire and depression (P < 0.05). Multiple linear regression showed that educational level, hemoglobin, peripheral muscle strength, and depression significantly affected the 6-min walk test distance (P < 0.05). The multiple correlation coefficient was 0.74, and the squared multiple correlation coefficient adjusted was 0.52. In conclusion, functional capacity was significantly associated with educational level, hemoglobin, peripheral muscle strength, and depression in hemodialysis patients.

Capacidade de automonitoramento da compreensão leitora no Ensino Fundamental / Capacity for self-monitoring reading comprehension in Elementary School

RESUMO Purpose Investigar a capacidade de automonitoramento da compreensão leitora de escolares brasileiros do Ensino Fundamental. Método Avaliaram-se 53 alunos do 5º e 9º anos do Ensino Fundamental de escolas da rede pública de São Paulo, selecionados pelo valor de taxa de leitura oral de texto e agrupados a partir de seu desempenho em compreensão leitora em: Grupo de melhor compreensão: escolares com taxa e acurácia adequadas, sem dificuldades na compreensão leitora; Grupo de pior compreensão: escolares com taxa e acurácia adequadas e dificuldades na compreensão leitora. Dois textos narrativos acompanhados de oito questões para avaliar a compreensão leitora foram apresentados. Duas sentenças e duas palavras foram substituídas por elementos agramaticais, pseudopalavras. Na condição de monitoramento espontâneo, os escolares leram o texto oralmente e responderam a questões. A análise considerou o cômputo de hesitações, autocorreções, repetições e erros. Na condição de monitoramento dirigido, leram o texto, informados de que algumas partes poderiam não fazer sentido e que as sublinhassem. A análise se deu pelo cômputo dos itens sublinhados. Os grupos foram comparados pelo Teste de Mann-Whitney. Resultados Observou-se diferença entre os grupos em nível frasal no 9º ano, na condição de monitoramento espontâneo, e no 5º ano, na condição de monitoramento dirigido. Conclusão Escolares de pior compreensão leitora apresentaram desempenho inferior ao monitorar a presença de sentenças agramaticais.

ABSTRACT Purpose To investigate the capacity for self-monitoring reading comprehension in Brazilian Elementary School students. Methods Fifty-three Elementary students in the 5th and 9th grades from two Public Schools in the city of São Paulo were assessed. They were selected based on their oral reading rate and grouped according to their performance in reading comprehension in the following categories: Group with best comprehension: students with adequate rate and accuracy, without difficulties in reading comprehension; Group with worst comprehension: students with adequate rate and accuracy but with difficulties in reading comprehension. Two narrative texts followed by eight questions to assess reading comprehension were presented. Two sentences and two words were replaced by ungrammatical elements and pseudo-words. Under the condition of spontaneous monitoring, students read the text aloud and answered the questions. The analysis considered the calculation of hesitation, self-correction, repetitions and mistakes. Under the condition of directed monitoring, students were instructed to read the text, either aloud or silently, after being told that certain parts of the text could not make sense, and they were oriented to underline such parts. The analysis was carried out by counting of underlined items. The comparisons were made with the Mann-Whitney test. Results A difference was observed between the groups only at the sentence level among the 9th grade schoolchildren under the spontaneous monitoring and among the 5th grade schoolchildren under directed monitoring. Conclusion Students with worst comprehension had a poorer performance to monitor the presence of ungrammatical sentences than their peers with best comprehension.