The first microcaddisflies Metrichia Ross, 1938 recorded in Tocantins State, northern Brazil (Trichoptera: Hydroptilidae): Metrichia elongata sp. nov. and Metrichia vulgaris Santos, Takiya & Nessimian 2016.

The microcaddisfly Neotropical genus Metrichia Ross, is recorded for the first time from the state of Tocantins, northern Brazil, through the discovery of two species: Metrichia elongata sp. nov. and Metrichia vulgaris Santos, Takiya & Nessimian 2016. Herein, the new species is described and illustrated based on males collected in a protected and preserved area in Cerrado biome of Tocantins. Metrichia elongata sp. nov. can be recognized mainly by the type and position of setae on the inferior appendages and morphology of the dorsolateral hook. The discovery of these species increases the number of Metrichia species in the Brazilian Cerrado from seven to eight and are only the eleventh and twelfth caddisfly species reported for Tocantins State.

TNFRSF1B Gene Variants in Clinicopathological Aspects and Prognosis of Patients with Cutaneous Melanoma.

Regulatory T lymphocytes play a critical role in immune regulation and are involved in the aberrant cell elimination by facilitating tumor necrosis factor connection to the TNFR2 receptor, encoded by the TNFRSF1B polymorphic gene. We aimed to examine the effects of single nucleotide variants TNFRSF1B c.587T>G, c.*188A>G, c.*215C>T, and c.*922C>T on the clinicopathological characteristics and survival of cutaneous melanoma (CM) patients. Patients were genotyped using RT-PCR. TNFRSF1B levels were measured using qPCR. Luciferase reporter assay evaluated the interaction of miR-96 and miR-1271 with the 3'-UTR of TNFRSF1B. The c.587TT genotype was more common in patients younger than 54 years old than in older patients. Patients with c.*922CT or TT, c.587TG or GG + c.*922CT or TT genotypes, as well as those with the haplotype TATT, presented a higher risk of tumor progression and death due to the disease effects. Individuals with the c.*922TT genotype had a higher TNFRSF1B expression than those with the CC genotype. miR-1271 had less efficient binding with the 3'-UTR of the T allele when compared with the C allele of the SNV c.*922C>T. Our findings, for the first time, demonstrate that TNFRSF1B c.587T>G and c.*922C>T variants can serve as independent prognostic factors in CM patients.

Are Artificial Intelligence-Assisted Three-Dimensional Histological Reconstructions Reliable for the Assessment of Trabecular Microarchitecture?

Objectives: This study aimed to create a three-dimensional histological reconstruction through the AI-assisted classification of tissues and the alignment of serial sections. The secondary aim was to evaluate if the novel technique for histological reconstruction accurately replicated the trabecular microarchitecture of bone. This was performed by conducting micromorphometric measurements on the reconstruction and comparing the results obtained with those of microCT reconstructions. Methods: A bone biopsy sample was harvested upon re-entry following sinus floor augmentation. Following microCT scanning and histological processing, a modified version of the U-Net architecture was trained to categorize tissues on the sections. Detector-free local feature matching with transformers was used to create the histological reconstruction. The micromorphometric parameters were calculated using Bruker's CTAn software (version 1.18.8.0, Bruker, Kontich, Belgium) for both histological and microCT datasets. Results: Correlation coefficients calculated between the micromorphometric parameters measured on the microCT and histological reconstruction suggest a strong linear relationship between the two with p-values of 0.777, 0.717, 0.705, 0.666, and 0.687 for BV/TV, BS/TV, Tb.Pf Tb.Th, and Tb.Sp, respectively. Bland-Altman and mountain plots suggest good agreement between BV/TV measurements on the two reconstruction methods. Conclusions: This novel method for three-dimensional histological reconstruction provides researchers with a tool that enables the assessment of accurate trabecular microarchitecture and histological information simultaneously.

Amphotericin B-loaded natural latex dressing for treating Candida albicans wound infections using Galleria mellonella model.

Amphotericin B (AmB) is the gold standard for antifungal drugs. However, AmB systemic administration is restricted because of its side effects. Here, we report AmB loaded in natural rubber latex (NRL), a sustained delivery system with low toxicity, which stimulates angiogenesis, cell adhesion and accelerates wound healing. Physicochemical characterizations showed that AmB did not bind chemically to the polymeric matrix. Electronic and topographical images showed small crystalline aggregates from AmB crystals on the polymer surface. About 56.6% of AmB was released by the NRL in 120 h. However, 33.6% of this antifungal was delivered in the first 24 h due to the presence of AmB on the polymer surface. The biomaterial's excellent hemo- and cytocompatibility with erythrocytes and human dermal fibroblasts (HDF) confirmed its safety for dermal wound application. Antifungal assay against Candida albicans showed that AmB-NRL presented a dose-dependent behavior with an inhibition halo of 30.0 ± 1.0 mm. Galleria mellonella was employed as an in vivo model for C. albicans infection. Survival rates of 60% were observed following the injection of AmB (0.5 mg.mL-1) in G. mellonella larvae infected by C. albicans. Likewise, AmB-NRL (0.5 mg.mL-1) presented survival rates of 40%, inferring antifungal activity against fungus. Thus, NRL adequately acts as an AmB-sustained release matrix, which is an exciting approach, since this antifungal is toxic at high concentrations. Our findings suggest that AmB-NRL is an efficient, safe, and reasonably priced ($0.15) dressing for the treatment of cutaneous fungal infections.

Effect of the COVID-19 Pandemic on the Epidemiology of Pediatric Traumatic Brain Injury in Brazil.

Aim In response to the coronavirus 2019 disease (COVID-19) pandemic, governments worldwide implemented measures to prevent infection, resulting in restricted school activities, restricted children's freedom of movement, and increased risk of violence and injuries at home, including traumatic brain injury (TBI), among children. In Brazil, the consequences of the COVID-19 pandemic on the causes, severity, and mortality of pediatric TBI have not yet been investigated. Thus, our study aimed to determine whether the COVID-19 pandemic has affected the epidemiology of pediatric TBI among Brazilian children. Materials and methods We investigated the patients with TBI aged <18 years who visited a tertiary trauma center in Brazil in 2019 and 2020. TBI-related variables, such as classification, mechanism, clinical manifestations, need for intervention, morbidity, and mortality, were recorded. Furthermore, we used a nationwide databank to collect information on mortality from external causes of trauma and violence in the pediatric population in 2019 and 2020. The Mann-Whitney test was used to compare quantitative variables related to the mechanisms and severity of TBI in both periods in order to determine the impact of the COVID-19 pandemic. Results Of the patients with traumatic brain injury, 1371 visited the trauma center in 2019 and 1052 in 2020. No difference was noted in the incidence rate of abusive head trauma between these periods (p=0.142) or in mortality from violence in Brazil. Recreational causes of pediatric TBI increased during the first year of the COVID-19 pandemic in Brazil and falls from bicycles significantly increased during the pandemic (p<0.001). Conclusion A global reduction in pediatric admissions to emergency rooms as well as no impact on mortality and severity of pediatric TBI were observed during the COVID-19 pandemic in Brazil. Additionally, a public education program regarding child safety during recreational activities, particularly how to avoid falls from bicycles was recommended.

Engineered organoids for biomedical applications.

As miniaturized and simplified stem cell-derived 3D organ-like structures, organoids are rapidly emerging as powerful tools for biomedical applications. With their potential for personalized therapeutic interventions and high-throughput drug screening, organoids have gained significant attention recently. In this review, we discuss the latest developments in engineering organoids and using materials engineering, biochemical modifications, and advanced manufacturing technologies to improve organoid culture and replicate vital anatomical structures and functions of human tissues. We then explore the diverse biomedical applications of organoids, including drug development and disease modeling, and highlight the tools and analytical techniques used to investigate organoids and their microenvironments. We also examine the latest clinical trials and patents related to organoids that show promise for future clinical translation. Finally, we discuss the challenges and future perspectives of using organoids to advance biomedical research and potentially transform personalized medicine.

Effective application of immobilized second generation industrial Saccharomyces cerevisiae strain on consolidated bioprocessing.

Integrated bioprocessing strategies can facilitate ethanol production from both cellulose and hemicellulose fractions of lignocellulosic biomass. Consolidated bioprocessing (CBP) is an approach that combines enzyme production, biomass hydrolysis and sugar fermentation in a single step. However, technologies that propose the use of microorganisms together with solid biomass present the difficulty of the recovery and reuse of the biocatalyst, which can be overcome by cell immobilization. In this regard, this work applied immobilized cells of AC14 yeast, a recombinant yeast that secretes 7 hydrolytic enzymes, in the CBP process in a successful proof-of-concept for the enzyme access to the substrate polymers. The most appropriate cell load for CBP under the conditions studied with immobilized cells was selected among three optical densities (OD) 10, 55 and 100. These experiments were performed with free cells to ensure that the results were not biased by mass limitations effects. OD 10 achieved 100% of the sugar consumption and the higher specific production of enzymes, being selected for further studies. Diffusional effects were observed with immobilized cells under static conditions. However, mass transfer limitations were mitigated under agitation, with an 18.5% increase in substrate consumption rate (from 2.7 to 3.5 g/L/h), reaching the same substrate uptake rates as free cells. In addition, immobilized cells achieved 100% hydrolysis and consumption of all substrates offered within only 12 h. Overall, this is the first report of a successful application of immobilized yeast cells in CBP processes for bioethanol production, a promising technology that can be extended to other biorefinery bioproducts.

Preliminary Findings on the Salivary Metabolome of Hookah and Cigarette Smokers.

The aim of the study was to evaluate the salivary metabolomic profile of patients who habitually smoke hookah and cigarettes. The groups consisted of 33 regular and exclusive hookah smokers, 26 regular and exclusive cigarette smokers, and 30 nonsmokers. Unstimulated whole saliva was collected for the measurement of salivary metabolites by gas chromatography coupled with tandem mass spectrometry (GC-MS/MS). The MetaboAnalyst software was used for statistical analysis and evaluation of biomarkers. 11 smoking salivary biomarkers were identified using the area under receiving-operator curver criterion and threshold of 0.9. Xylitol and octadecanol were higher in cigarette smokers compared to controls; arabitol and maltose were higher in controls compared to cigarette smokers; octadecanol and tyramine were higher in hookah smokers compared to controls; phenylalanine was higher in controls compared to hookah smokers; and fructose, isocitric acid, glucuronic acid, tryptamine, maltose, tyramine, and 3-hydroxyisolvaleric acid were higher in hookah smokers compared to cigarettes smokers. Conclusions: The evaluation of the salivary metabolome of hookah smokers, showing separation between the groups, especially between the control versus hookah groups and cigarette versus hookah groups, and it seems to demonstrate that the use of hookah tobacco is more damaging to health.

Aloe vera-loaded natural rubber latex dressing as a potential complementary treatment for psoriasis.

Psoriasis is a disease that causes keratinocytes to proliferate ten times faster than normal, resulting in chronic inflammation and immune cell infiltration in the skin. Aloe vera (A. vera) creams have been used topically for treating psoriasis because they contain several antioxidant species; however, they have several limitations. Natural rubber latex (NRL) has been used as occlusive dressings to promote wound healing by stimulating cell proliferation, neoangiogenesis, and extracellular matrix formation. In this work, we developed a new A. vera-releasing NRL dressing by a solvent casting method to load A. vera into NRL. FTIR and rheological analyzes revealed no covalent interactions between A. vera and NRL in the dressing. We observed that 58.8 % of the loaded A. vera, present on the surface and inside the dressing, was released after 4 days. Biocompatibility and hemocompatibility were validated in vitro using human dermal fibroblasts and sheep blood, respectively. We observed that ~70 % of the free antioxidant properties of A. vera were preserved, and the total phenolic content was 2.31-fold higher than NRL alone. In summary, we combined the antipsoriatic properties of A. vera with the healing activity of NRL to generate a novel occlusive dressing that may be indicated for the management and/or treatment of psoriasis symptoms simply and economically.

Antimicrobial Photodynamic Therapy as a Technique for Decontamination of Acrylic Resin Devices Provided by Different Dental Laboratories.

Introduction: Dentures, occlusal splints, surgical guides and orthodontic appliances are examples of acrylic resin devices made in dental laboratories, which must be disinfected and even sterilized before insertion into the oral cavity. This study evaluated the antimicrobial effect of photodynamic therapy (PDT) applied to acrylic resin specimens received from different laboratories. Methods: Three hundred standardized specimens were ordered from six randomly selected laboratories registered in the Council of Dentistry of Ceará (n=50). The PDT consisted in the association of 22 µM erythrosine, as a photosensitizer (P), and a 520-nm LED at 38 J/cm2 (L). The specimens of each laboratory were randomly distributed into five groups: positive control, sterilized with ethylene oxide; negative control, untreated (P-L-); erythrosine control, only stained (P+L-); LED control, only irradiated (P-L+); PDT (P+L+). Then, the specimens were individually sonicated in saline solution; the suspension was diluted, plated on culture mediums (blood agar, sabouraud dextrose agar and a non-selective chromogenic agar), and incubated for 48 hours at 37°C. Colony-forming-unit (CFU) counts were done and statistical tests of Kruskal-Wallis/Dunn were carried out. Results: The specimens from all laboratories were contaminated with bacteria and yeasts. Staphylococcus aureus, Staphylococcus saprophyticus, Escherichia coli, Enterococcus spp., Klebsiella and Pseudomonas spp. were identified. The PDT significantly reduced CFU counts (P<0.0001), compared to P-L-. Conclusion: PDT was able to effectively decontaminate the acrylic resin specimens provided from dental laboratories.

Association of Clinical Aspects and Genetic Variants with the Severity of Cisplatin-Induced Ototoxicity in Head and Neck Squamous Cell Carcinoma: A Prospective Cohort Study.

BACKGROUND: Cisplatin (CDDP) is a major ototoxic chemotherapy agent for head and neck squamous cell carcinoma (HNSCC) treatment. Clinicopathological features and genotypes encode different stages of CDDP metabolism, as their coexistence may influence the prevalence and severity of hearing loss. METHODS: HNSCC patients under CDDP chemoradiation were prospectively provided with baseline and post-treatment audiometry. Clinicopathological features and genetic variants encoding glutathione S-transferases (GSTT1, GSTM1, GSTP1), nucleotide excision repair (XPC, XPD, XPF, ERCC1), mismatch repair (MLH1, MSH2, MSH3, EXO1), and apoptosis (P53, CASP8, CASP9, CASP3, FAS, FASL)-related proteins were analyzed regarding ototoxicity. RESULTS: Eighty-nine patients were included, with a cumulative CDDP dose of 260 mg/m2. Moderate/severe ototoxicity occurred in 26 (29%) patients, particularly related to hearing loss at frequencies over 3000 Hertz. Race, body-mass index, and cumulative CDDP were independent risk factors. Patients with specific isolated and combined genotypes of GSTM1, GSTP1 c.313A>G, XPC c.2815A>C, XPD c.934G>A, EXO1 c.1762G>A, MSH3 c.3133A>G, FASL c.-844A>T, and P53 c.215G>C SNVs had up to 32.22 higher odds of presenting moderate/severe ototoxicity. CONCLUSIONS: Our data present, for the first time, the association of combined inherited nucleotide variants involved in CDDP efflux, DNA repair, and apoptosis with ototoxicity, which could be potential predictors in future clinical and genomic models.

Surgical management of severe pediatric blunt abdominal trauma.

A 3-year-old male patient was brought to the Emergency Department with a traumatic blunt lesion in the liver. Due to hemodynamic instability and a severe lesion of a grade IV liver injury shown on the CT, the chosen conduct was to perform a hepatorrhaphy with oxidized cellulose.

Cuide, movimente, evite lesão por pressão no seu paciente: um relato de experiência / Care, move, avoid pressure injury in your patient: an experience report / Cuidar, mover, evitar lesiones por presión en su paciente: informe de una experiencia

Introdução: As lesões por pressão (LPP) correspondem a danos na pele ou em tecidos moles encobertos, geralmente em áreas de proeminências ósseas, ou associado ao uso de dispositivo médico ou outro tipo de artefato. Diante disso, a enfermeira deve desenvolver sua prática, baseada em evidências científicas e priorizar a prevenção da formação das lesões na pele. Objetivo: Relatar a experiência de estudantes de Enfermagem sobre o desenvolvimento de ações de promoção do cuidado seguro relacionado à prevenção de LPP em pacientes internados em um hospital público pediátrico na Bahia. Metodologia: Trata-se de um estudo de caráter descritivo, do tipo relato de experiência, realizado por seis estudantes de Enfermagem em um hospital estadual pediátrico localizado no estado da Bahia, no período de novembro 2022. Principais resultados: Percebeu-se que existem profissionais de enfermagem que possuem interesse em obter mais conhecimento sobre o assunto, porém ainda há lacunas de conhecimento por parte da equipe sobre alguns assuntos abordados, tais como a escala de Braden e a utilização do colchão caixa de ovo para todas as faixas etárias. Foi possível perceber que os passos para prevenir a lesão por pressão não são cumpridos por parte da equipe e isso pode dificultar a prevenção das lesões de forma efetiva. Conclusão: Recomenda-se, portanto, que as unidades assistenciais, juntamente com suas respectivas coordenadoras, realizem ações contínuas de educação permanente, a fim de contribuir para uma melhor qualificação profissional, promovendo, acima de tudo, a segurança do paciente.

Introduction: Pressure lesions (PPL) correspond to damage to the skin or covert soft tissue, usually in areas of bony prominence, or associated with the use of a medical device or other type of artifact. Therefore, nurses should develop their practice, based on scientific evidence and prioritize the prevention of skin lesion formation. Objective: To report the experience of nursing students on the development of actions to promote safe care related to the prevention of PPL in patients admitted to a pediatric public hospital in Bahia. Methodology: This is a descriptive study, of the type of experience report, conducted by six nursing students in a pediatric state hospital located in the state of Bahia, in the period of November 2022. Main results: It was noticed that there are nursing professionals who have an interest in obtaining more knowledge about the subject, but there are still gaps in knowledge on the part of the team on some subjects addressed, such as the Braden scale and the use of the egg box mattress for all age groups. It was possible to notice that the steps to prevent pressure injury are not met by the team and this can hinder the prevention of injuries effectively. Conclusion: It is recommended, therefore, that the care units, together with their respective coordinators, carry out continuous actions of continuing education, in order to contribute to a better professional qualification, promoting, above all, patient safety.

Introducción: Las lesiones por presión (LPP) corresponden a lesiones en la piel o tejidos blandos encubiertos, generalmente en zonas de prominencia ósea, o asociadas al uso de un dispositivo médico u otro tipo de artefacto. Por ello, el personal de enfermería debe desarrollar su práctica, basándose en la evidencia científica y priorizando la prevención de la formación de lesiones cutáneas. Objetivo: Relatar la experiencia de estudiantes de enfermería sobre el desarrollo de acciones para promover cuidados seguros relacionados a la prevención de PPL en pacientes internados en un hospital público pediátrico de Bahía. Metodología: Se trata de un estudio descriptivo, del tipo relato de experiencia, realizado por seis estudiantes de enfermería en un hospital público pediátrico localizado en el estado de Bahía, en el período de noviembre de 2022. Principales resultados: Se observó que hay profesionales de enfermería que tienen interés en obtener más conocimientos sobre el tema, pero todavía hay lagunas de conocimiento por parte del equipo en algunos temas abordados, como la escala de Braden y el uso del colchón caja de huevos para todos los grupos de edad. Se pudo notar que los pasos para prevenir lesiones por presión no son cumplidos por el equipo y esto puede dificultar la prevención de lesiones de forma efectiva. Conclusiones: Se recomienda, por lo tanto, que las unidades asistenciales, junto con sus respectivos coordinadores, realicen acciones continuas de formación continuada, con el fin de contribuir a una mejor cualificación profesional, promoviendo, sobre todo, la seguridad del paciente.

Pain, deep neck flexors performance, disability, and head posture in individuals with temporomandibular disorder with and without otological complaints.

BACKGROUND: Otological complaints (OC) are highly prevalent in subjects with temporomandibular disorders (TMD) and so is the risk of neck dysfunctions. OBJECTIVE: To evaluate pain, deep neck flexor (DNF) performance, disability, and head and neck posture of individuals with TMD with and without OC. METHODS: In this cross-sectional study, 57 individuals were divided into a group with TMD and OC (n= 31) and a group with TMD without OC (n= 26). Self-reported pain intensity, masticatory and neck muscles pressure pain thresholds, DNF performance, neck disability, and head and neck posture were evaluated. Data were compared between groups using the independent t test and Mann-Whitney test with Bonferroni correction for multiple comparisons. Effect sizes were evaluated using Cohen's index. RESULTS: The TMD with OC group presented less muscle activation [26 (24-28) vs. 24 (24-26) mmHg; p< 0.05], less endurance [105 (46-140) vs. 44 (28-78) points; p< 0.05], and greater neck disability (8.15 ± 5.89 vs. 13.32 ± 6.36 points; p< 0.05). No significant difference was observed in self-reported pain, head and neck posture, or pressure pain thresholds. CONCLUSION: Individuals with TMD with OC presented decreased DNF performance and increased neck disability compared to individuals with TMD without OC.

Filling distribution gaps and honoring great taxonomist mentors: three new species of the microcaddisfly Ochrotrichia Mosely, 1934 (Trichoptera: Hydroptilidae) from the Brazilian Cerrado and a checklist from Brazil

ABSTRACT Sixteen species of the microcaddisfly Ochrotrichia Mosely, 1934 (Hydroptilidae) have been recorded so far in Brazil, mainly distributed in the Atlantic Forest of southeastern Brazil. In order to reduce the Linnean and Wallacean shortfalls for the Ochrotrichia Brazilian fauna, we diagnose, describe, and illustrate three new species based on adult males from three protected and preserved areas of the Cerrado biome of Federal District (Central-West region), Minas Gerais (Southeast region) and Tocantins (North region) states; all of them named in honor of three great Brazilian entomologists viz., Ochrotrichia froehlichi sp. nov., Ochrotrichia machadoi sp. nov. and Ochrotrichia nessimiani sp. nov. They can be recognized mainly by the morphology of the tergum X, number, and position of the spine-like setae of the inferior appendages. This contribution represents the first record of Ochrotrichia for the Central-West region, increasing the number of species of this genus in Cerrado biome from one to four, and is the first report of a microcaddisfly for the Federal District. In addition, the genus is reported for the first time from Paraná, São Francisco, and Tocantins hydrographic basins. Finally, we provide a checklist of the Ochrotrichia species from Brazil.

Detecting Leishmania in dogs: A hierarchical-modeling approach to investigate the performance of parasitological and qPCR-based diagnostic procedures.

BACKGROUND: Domestic dogs are primary reservoir hosts of Leishmania infantum, the agent of visceral leishmaniasis. Detecting dog infections is central to epidemiological inference, disease prevention, and veterinary practice. Error-free diagnostic procedures, however, are lacking, and the performance of those available is difficult to measure in the absence of fail-safe "reference standards". Here, we illustrate how a hierarchical-modeling approach can be used to formally account for false-negative and false-positive results when investigating the process of Leishmania detection in dogs. METHODS/FINDINGS: We studied 294 field-sampled dogs of unknown infection status from a Leishmania-endemic region. We ran 350 parasitological tests (bone-marrow microscopy and culture) and 1,016 qPCR assays (blood, bone-marrow, and eye-swab samples with amplifiable DNA). Using replicate test results and site-occupancy models, we estimated (a) clinical sensitivity for each diagnostic procedure and (b) clinical specificity for qPCRs; parasitological tests were assumed 100% specific. Initial modeling revealed qPCR specificity < 94%; we tracked the source of this unexpected result to some qPCR plates having subtle signs of possible contamination. Using multi-model inference, we formally accounted for suspected plate contamination and estimated qPCR sensitivity at 49-53% across sample types and dog clinical conditions; qPCR specificity was high (95-96%), but fell to 81-82% for assays run in plates with suspected contamination. The sensitivity of parasitological procedures was low (~12-13%), but increased to ~33% (with substantial uncertainty) for bone-marrow culture in seriously-diseased dogs. Leishmania-infection frequency estimates (~49-50% across clinical conditions) were lower than observed (~60%). CONCLUSIONS: We provide statistical estimates of key performance parameters for five diagnostic procedures used to detect Leishmania in dogs. Low clinical sensitivies likely reflect the absence of Leishmania parasites/DNA in perhaps ~50-70% of samples drawn from infected dogs. Although qPCR performance was similar across sample types, non-invasive eye-swabs were overall less likely to contain amplifiable DNA. Finally, modeling was instrumental to discovering (and formally accounting for) possible qPCR-plate contamination; even with stringent negative/blank-control scoring, ~4-5% of positive qPCRs were most likely false-positives. This work shows, in sum, how hierarchical site-occupancy models can sharpen our understanding of the problem of diagnosing host infections with hard-to-detect pathogens including Leishmania.

Reabilitação e atenção à pessoa com deficiência na atenção primária à saúde no Brasil: dados do 2º e 3º ciclos do Programa de Avaliação da Qualidade a Atenção Básica / Rehabilitation and attention to persons with disabilities in primary health care in Brazil: date from 2° and 3° cycles of the Program for Quality Assessment in Primary Care

Objetivo: Descrever e comparar ações de atenção e reabilitação na Atenção Primaria à Saúde (APS) direcionados à Pessoa com Deficiência (PCD) no Brasil. Métodos: Dados do Programa de Avaliação da Qualidade na Atenção Básica (PMAQ-AB). Foi realizada uma análise com base no Módulo IV do 2º (2015) e do 3º (2018) Ciclo do PMAQ-AB. Foram realizadas comparações da avaliação positiva ("sim") dos cuidados prestados à PCD na APS, através do cálculo a Razão de Prevalência (RP), admitindo o 2º Ciclo como categoria de referência e considerando dados nacionais e das cinco regiões geográficas. Resultados: A prevalência de repostas afirmativas para atenção à PCD aumentou no 3º ciclo no cenário nacional em relação ao apoio em ações direcionadas à PCD, avaliação e adaptação no domicílio e promoção da inserção da PCD em atividades de esporte e lazer. A prevalência de ações de reabilitação na APS no Brasil também aumentou. O cenário das mudanças no cuidado à PCD foi diferente entre as regiões brasileiras. A região Nordeste foi a que mais aumentou o percentual de ações de atenção à PCD, seguindo o padrão nacional, e ainda incluindo aumento no encaminhamento para uso de próteses/órteses e dispositivos de auxílio. Conclusão: Para a maioria das atividades avaliadas, houve aumento da prevalência de sua realização entre as avaliações do 2º e 3º ciclos do PMAQ-AB, entretanto há necessidade ainda de ampliar a oferta e o serviço de algumas atividades na maioria das regiões do país, favorecendo o cuidado integral à PCD.

Objective: Describe and compare actions of attention and rehabilitation in Primary Health Care (PHC) addressed to Persons with Disabilities (PWD) in Brazil. Methods: Retrospective data from Quality Assessment Program in Primary Care (PMAQ-AB, in Portuguese) were collected and analyzed considering Module IV of the 2nd (2015) and 3rd (2018) Cycles of the PMAQ-AB. Comparisons of the positive answers (yes) of the attention provided to PWD in the PHC were conducted by establishing the Prevalence Ratio (PR). The 2nd Cycle was the reference category, and the data were analyzed as national or regional samples. Results: The prevalence of positive answers for PWD care increased in the 3rd Cycle in the national sample concerning support in activities addressed to PWD, assessment and home adaptations, and promotion of the inclusion of PWD in sports and leisure activities. The prevalence of rehabilitation actions in PHC in Brazil has also increased. Changes in PWD care were found in the different geographical regions of Brazil. The Northeast region had the highest increase in attention activities for PWD, following the national trend, including an increase in referral for prostheses/orthotics and assistive devices. Conclusion: For most of the activities evaluated, there was an increase in performance prevalence between the assessments of the 2nd and 3rd Cycles of the PMAQ-AB. However, there is still a need to expand the offer of services in most regions of the country, favoring integral care for PWD

Resinas acrílicas utilizadas em placas estabilizadoras: resistência a fraturas e ensaio microbiológico / Acrylic resins used in stabilizer plates: resistance to fractures and microbiological testing

O aprimoramento da tecnologia CAD/CAM permitiu a confecção de placas estabilizadoras digitais, no entanto, há lacunas acerca do comportamento desses dispositivos frente a variáveis mecânicas e biológicas ainda desconhecidas. Dessa forma, o objetivo desse trabalho foi verificar se as resinas utilizadas na tecnologia digital das placas fresadas e impressas são capazes de influenciar na resistência à fratura e na adesão de micro-organismos em detrimento das resinas empregadas na confecção das placas termopolimerizáveis convencionais e se as propriedades testadas se relacionam com a variação da espessura desses dispositivos. Para tanto, foi realizado um estudo in vitro que contou com as fases mecânica e microbiológica, sendo cada uma composta pelos grupos Convencional (GC) (n=30), Fresado (GF) (n=30) e Impresso (GI) (n=30), de acordo com o método de confecção, possuindo cada um três subgrupos (n=10) que variaram a espessura dos espécimes de 1 a 3 mm. Na fase mecânica, as amostras, com formato de barras de 65 mm, foram testadas quanto à resistência à fratura na máquina de ensaios universal, com célula de carga de 500 kgf e velocidade de 1 mm/min; na microbiológica, a forma foi de discos com 15 mm de diâmetro, submetidos à adesão de micro-organismos à superfície com a exposição a Streptococcus mutans e mantidos por 24h a 35 °C em estufa para sucessiva contagem de UFC, com controle positivo. Os testes foram feitos em triplicata e os dados foram armazenados no SPSS 22.0 e a análise estatística contou com a ANOVA e o pósteste de Tukey. Nos resultados da fase mecânica, o ANOVA identificou diferenças estatisticamente significativas entre os grupos (p≤0,005), mostrando que GC e GF apresentaram melhores resultados. O pós-teste de Tukey considerou diferença estatisticamente significativa entre GF e GI (p=0,031), elencando GF como superior. Para a fase microbiológica, não foram verificadas diferenças estatísticas entre os grupos (p>0,005) em nenhuma das análises. Observou-se que para a resistência a fraturas, as resinas do modo fresado descreveram resultados superiores e/ou próximos aos da técnica convencional; e que as resinas da técnica digital e convencional, quanto à adesão superficial de micro-organismos, não diferiram entre si (AU).

CAD/CAM technology allowed the stabilizing splints manufacture, however there are gaps about these devices' behavior in face of mechanical and biological variables that are still unknown. Thus, the objective of this project was to verify if the resins used in digital technology of milled and printed stabilizer splints can influence fracture resistance and microorganism adhesion, in detriment of the resin applied in manufacture of conventional thermopolymerizable splints and if the tested properties are related to thickness variation of these devices. The method included mechanical and microbiological steps, each one composed by Conventional (CG) (n=30), Milled (MG) (n=30) and Printed (PG) (n=30) groups, according to the method of preparation, each one having three subgroups (n=10) that varied the specimen thickness from 1 to 3 mm. In the mechanical step, the samples, in the form of 65 mm bars, were tested for fracture resistance in a universal testing machine, with load cell of 500 kgf and speed of 1 mm/min; in the microbiological step, the shape was in form of 15 mm diameter discs, subjected to microorganism adhesion to the surface with exposure to Streptococcus mutans and kept for 24 hours at 35 °C in oven for successive CFU counting, with positive control. The tests were performed in triplicate and data were stored in SPSS 22.0 and statistical analysis used ANOVA and Tukey's post hoc. In the results of mechanical step ANOVA had identified statistically significant differences between the groups (p≤0,005), showing CG and MG had presented better results. Tukey´s post hoc had considered statistically significant difference between MG and PG (p=0,031), listing MG as superior. For the microbiological step, they did not show statistical differences between the groups (p>0.005) in any analysis. It was observed milled resins described superior results and/or close to the conventional technique one, for fracture resistance; and resins of digital and conventional technique, regarding the microorganism adhesion to the surface, did not differ from each other (AU).

Multiparametric analysis of host and parasite elements in new world tegumentary leishmaniasis.

Tegumentary leishmaniasis is a tropical disease caused by protozoa of the genus Leishmania. Clinically, the disease presents a broad spectrum of symptoms, the mechanisms underlying the development of lesions remaining to be fully elucidated. In the present work, we performed a correlation and multiparametric analysis to evaluate how parasite- and host-related aspects associate with each other, and with the different clinical manifestations of tegumentary leishmaniasis. This cross-sectional study involved 75 individuals from endemic areas of Brazil, grouped according to their symptoms. Leishmania species were determined by DNA sequencing, and parasite load, antibody production, and cytokine profile were evaluated by kDNA qPCR, ELISA, and flow cytometry. Data were analyzed using the Chi-square test, principal component analysis, canonical discriminant analysis, and correlation analysis. Among the recruited patients, 23 (31%) were asymptomatic, 34 (45%) had primary cutaneous leishmaniasis, 10 (13%) presented recurrent cutaneous leishmaniasis, and eight (11%) had mucocutaneous leishmaniasis. Leishmania species identified included L. amazonensis, L. braziliensis, and L. guyanensis. Surprisingly, no Leishmania RNA virus infection was detected in any sample. In summary, our work showed that parasite load, antibody production, and cytokine levels alone are not determinants for tegumentary leishmaniasis symptoms. However, the correlation analysis allowed us to observe how these factors are correlated to each other within the groups, which revealed a unique network for each clinical manifestation. Our work reinforces the complexity of tegumentary leishmaniasis outcomes - which are associated with multiple host and parasite-related elements and provides a holistic model of the disease.

The Importance of Radiological Patterns and Small Airway Disease in Long-Term Follow-Up of Postacute COVID-19: A Preliminary Study.

Postacute COVID-19 has become a relevant public health problem, and radiological and pulmonary function tests are tools that help physicians in decision-making. The objectives of this study are to characterize the findings and patterns on a chest radiograph (CXR) and computed tomography (CT) that are most important in the postacute phase and to evaluate how these changes correlate with clinical data, spirometry, and impulse oscillometry (IOS). This was a retrospective study of 29 patients who underwent CXR, CT, spirometry, and IOS. The inclusion criteria were age >18 years and persistent respiratory symptoms after four weeks. The exclusion criteria were radiological exams with low technical quality and non-COVID-19 acute lung diseases. The inferential analysis was carried out with the chi-square (χ 2) or Fisher's exact test to evaluate the interrelationships between the clinical and COVID-19 variables according to spirometry, IOS, CT, and CXR. In our sample, 19 patients were women (65.5%). The predominance of abnormal spirometry was associated with CT's moderate/severe degree of involvement (p = 0.017; 69.2%, CI 95%: 44.1%-94.3%). There was no significant association between IOS and tomographic and radiographic parameters. A significant association was found between the classifications of the moderate/severe and normal/mild patterns on CT and CXRs (p = 0.003; 93.3%, CI 95%: 77.8%-100%). Patients with moderate/severe impairment on CXR were associated with a higher frequency of hospitalization (p = 0.033; 77.8%, CI 95%: 58.6%-97.0%) and had significantly more moderate/severe classifications in the acute phase than the subgroup with normal/mild impairment on CXR (p = 0.017; 88.9%, CI 95%: 74.4%-100%). In conclusion, the results of this study show that CXR is a relevant examination and may be used to detect nonspecific alterations during the follow-up of post-COVID-19 patients. Small airway disease is an important finding in postacute COVID-19 syndrome, and we postulate a connection between this pattern and the persistently low-level inflammatory state of the lung.