Early Suppression of Macrophage Gene Expression by Leishmania braziliensis.

Leishmania braziliensis is an intracellular parasite that resides mostly in macrophages. Both the parasite genome and the clinical disease manifestations show considerable polymorphism. Clinical syndromes caused by L. braziliensis include localized cutaneous (CL), mucosal (ML), and disseminated leishmaniasis (DL). Our prior studies showed that genetically distinct L. braziliensis clades associate with different clinical types. Herein, we hypothesized that: (1) L. braziliensis induces changes in macrophage gene expression that facilitates infection; (2) infection of macrophages with strains associated with CL (clade B), ML (clade C), or DL (clade A) will differentially affect host cell gene expression, reflecting their different pathogenic mechanisms; and (3) differences between the strains will be reflected by differences in macrophage gene expression after initial exposure to the parasite. Human monocyte derived macrophages were infected with L. braziliensis isolates from clades A, B, or C. Patterns of gene expression were compared using Affymetrix DNA microarrays. Many transcripts were significantly decreased by infection with all isolates. The most dramatically decreased transcripts encoded proteins involved in signaling pathways, apoptosis, or mitochondrial oxidative phosphorylation. Some transcripts encoding stress response proteins were up-regulated. Differences between L. braziliensis clades were observed in the magnitude of change, rather than the identity of transcripts. Isolates from subjects with metastatic disease (ML and DL) induced a greater magnitude of change than isolates from CL. We conclude that L. braziliensis enhances its intracellular survival by inhibiting macrophage pathways leading to microbicidal activity. Parasite strains destined for dissemination may exert a more profound suppression than less invasive L. braziliensis strains that remain near the cutaneous site of inoculation.

Low maternal schooling and severity of dental caries in Brazilian preschool children.

PURPOSE: The aim of this study was to identify the prevalence and severity of caries and of early childhood caries (ECC) in preschool children from the municipality of Capivari de Baixo, Brazil. Furthermore, the aim was to ascertain the association between these prevalences and the level of maternal schooling. MATERIALS AND METHODS: A cross-sectional study was performed involving all children aged 3 to 5 years enrolled in all municipal schools of Capivari de Baixo, Brazil. The clinical information was obtained using the World Health Organization criteria. For ECC, it was observed if the child presented with lesions with acute evolution, whitening clinical aspect and softened consistency. Non-clinical data were obtained by means of interviews with the child's mothers, by investigating the child and through questions relating to the maternal age, the maternal level of schooling and the time of weaning. Tests of association were performed using the chi-square test followed by unconditional multiple logistic regression analysis to test the independence of the association between the outcomes and the explanatory variables. RESULTS: The prevalence of caries was 64.3%, the mean dmft was 1.24 and the prevalence of ECC was 4.9%. A child was more likely to present with severe caries (dmft > or = 2) if aged 47 months or above. Low maternal schooling made the occurrence of both severe caries and ECC more likely. CONCLUSIONS: The population that was studied presented levels of oral health better than those found in other Brazilian population groups, although groups remain with a high severity of caries associated with low maternal schooling.

Avaliação da dureza de uma resina composta polimerizada por diferentes fontes de ativação (led e luz halógena) / Microhardness evaluation of a composite using halogen and led light-curing units

Este estudo avaliou in vitro a capacidade de polimerização de 2 aparelhos de luz utilizando o teste de dureza Vickers variando profundidade de polimerização. Para isso, foram utilizados o aparelho Curing Light XL3000/3M (luz halógena) e o Ultraled Dabi Atlante (à base de Led), ambos com tempo de exposição de 40 segundos. A resina composta utilizada foi a Charisma na cor A30. Em face dos resultados obtidos e da metodologia aplicada, foi possível concluir que: com relação aos aparelhos, o aparelho com luz halógena proporcionou melhores valores de dureza do que o aparelho à base de Led. Com relação à profundidade, verificou-se que para o aparelho à base de Led o 1 mm apresentou maior dureza (42,5), ficando o 2 mm (36,0) em uma posição intermediária e o 3 mm (30,0) o menor valor de dureza. Para o aparelho com luz halógena não houve diferença significativa para as profundidades de 1 mm, 2 mm e 3 mm

Posicao do tubo traqueal em recem-nascidos / Position of the tracheal tube in infant newborns

Complicacoes associadas a intubacao traqueal sao frequentes em recem-nascidos. Condicao fundamental para uma ventilacao adequada e que o tubo traqueal esteja bem posicionado, uma vez que tubos com localizacao alta estao predispostos a extubacao acidental e os colocados em posicao baixa associam-se a atelectasia, intubacao e pneumotorax. O objetivo do presente trabalho foi determinar, em nosso servico, a posicao do tubo traqueal em 910 radiografias de torax, utilizando um criterio anatomico que correlaciona a traqueia com a coluna vertebral. O primeiro RX obtido imediatamente apos a intubacao foi analisado separadamente das radiografias subsequentes por uma radiologista pediatrica. Nossos resultados demonstram que 49% dos tubos traqueais estavam mal-posicionados. A incidencia de tubos em posicao alta foi significantemente maior do que a daqueles situados em posicao baixa (35% vs 14% p < 0.005). Esta relacao nao varia em funcao da faixa de peso do recem-nascido intubado. Comparando-se o 1o. com os demais, observamos uma tendencia em se reposicionarem mais frequentemente os tubos traqueais cuja localizacao inicial era baixa .