Assessment of peripheral venous catheters microbiota and its association with phlebitis.

BACKGROUND: Peripheral venous catheters (PVCs) remain the primary mode of short-term venous access for managing intravenous fluid, obtaining blood samples, and peripheral parenteral nutrition. They may get contaminated and require regular monitoring to prevent complications. This study evaluated the occurrence of phlebitis and its associated-clinical and microbiological indicators. METHODS: The frequency of phlebitis was evaluated in hospitalized patients of both medical and surgical fields. Subsequently, the dichotomous association between the presence of phlebitis and the clinical aspects was investigated. In parallel, the bacterial contamination of PVCs was assessed through culture-based methods, microscopy observation, and 16S rRNA gene sequencing. RESULTS: Approximately one in four patients presented phlebitis (28.4%). The most frequent symptom was erythema at access site, with or without pain, corresponding to Score 1 on the phlebitis scale (17.9%). Colonization of both lumen and external surface of PVC was observed in 31.3% of the samples. Staphylococcus and Pseudomonas were the most isolated bacterial genera on the PVC surface. No significant association was observed between the presence of phlebitis and the clinical aspects, as well as the presence of microorganisms. CONCLUSION: Microorganism were present on both internal and external PVC surface, without being associated to phlebitis.

Exploring the impact of seasonal variations on the chemical composition, antinociceptive, and anti-inflammatory properties of Pogostemon heyneanus Benth. essential oil.

Background: Pogostemon heyneanus leaves infusions are relevant in ethnopharmacology for treating colds, coughs, headaches, and asthma. Purpose: The essential oil chemical composition of a Pogostemon heyneanus specimen was monthly monitored from October 2021 to July 2022 to evaluate the climatic influences on its yield and chemical composition and antinociceptive, andanti-inflammatory properties. Methods: The leaves, collected monthly over a 10-month period, were submitted to hydrodistillation. The oils obtained were analyzed by gas chromatography coupled to a mass spectrometer and gas chromatography coupled to flame ionization detector. The P. heyneanus essential oil (PhEO) was tested in vivo to evaluate its peripheral analgesic actions through the abdominal writhing test induced by acetic acid, and peripheral analgesia by tail immersion. Neurogenic and inflammatory pain were evaluated by formalin test, and acute oral toxicity of the oil was also verified. Results: PhEO presented 27 chemical constituents with the highest predominance of patchoulol (43.6%-76.9%), α-bulnesene (0.2%-12.7%), α-guaiene (0.4%-8.9%), seychellene (3.8%-5.1%) and pogostol (0.0%-8.2%). The climatic parameters insolation, humidity, rainfall, and temperature did not influence the essential oil yield or the main chemical constituents, except for pogostol, which presented a strong (r = 0.73) and statistically significant (p < 0.05) correlation with temperature. PhEO did not display toxicity at the maximum 300 mg/kg dosage. The oil showed low peripheral and central analgesic action at 100 mg/kg, while in the neurogenic and inflammatory pain inhibition tests, no actions related to PhEO were observed. In the carrageenan-induced peritonitis test, PhEO did not reduce the migration of leukocytes to the peritoneal cavity compared to the control group. Conclusion: Pogostemon heyneanus is a resistant plant to seasonal influences and a source of patchoulol. Despite ethnopharmacological indications, no in-vivo biological activities such as neurogenic or inflammatory pain were identified in the present work. So, the low influence of the climatic parameters on chemical composition can infer that the low pharmacological activity is also not subject to climatic variations, that is, it does not change due to the climate.

Do Men and Women Differ in Hematological Adaptations to 24 Weeks of Crossfit® Training?

Regular exercise can modulate the immune system functioning through changes in the number and function of leukocytes as well as in red blood cells and other typical blood markers. High intensity exercise promotes increases in cytotoxic activity, phagocytic capacity, chemotaxis and cell apoptosis. The aim of the study was to compare the chronic effects of a 24-week training program using CrossFit® methodology on hematological variables of men vs. women. Twenty-nine CrossFit® athletes (35.3 ± 10.4 years, 175.0 ± 9.2 cm, 79.5 ± 16.4 kg) participated in the study. The blood count, the lipid profile and glucose markers were measured every two months during the study period. The erythrocyte count and hemoglobin concentrations increased in months 4 and 6 in men and women, respectively. Hematocrit levels increased in men in months 2, 4 and 6, while in women only in month 6. Red cell distribution width increased in men in month 6 when compared to the value in month 2. Segmented neutrophils increased in men in month 6 and eosinophil levels increased in women in month 6. Differences between the two sexes were observed in monocytes levels at baseline, as well as in months 2, 4 and 6. Cross-Fit® training increased red cell count indicators in both sexes, which may be related to increased erythropoiesis. Some white blood cell counts were altered and these differed between sexes. The number of lymphocytes remained stable throughout the experiment.

Exercise prevents obesity by reducing gut-derived inflammatory signals to brown adipocytes in mice.

Gut dysbiosis impairs nonshivering thermogenesis (NST) in obesity. The antiobesogenic effects of exercise training might involve the modulation of gut microbiota and its inflammatory signals to the brown adipose tissue (BAT). This study evaluated whether high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) prevent overweight through reduced gut-derived inflammatory signals to BAT in high-fat-fed mice. Sixty male C57BL/6 mice (3 months old) comprised six experimental groups: control (C) diet group, C diet + HIIT (C-HIIT) group, C diet + MICT (C-MICT) group, high-fat (HF) diet group, HF diet + HIIT (HF-HIIT) group, and HF diet + MICT (HF-MICT) group. The protocols lasted for 10 weeks. HIIT and MICT restored body mass, mitigated glucose intolerance, and prevented hyperinsulinemia in HF-trained groups. A chronic HF diet caused dysbiosis, but HIIT and MICT prevented gut dysbiosis and preserved tight junction (TJ) gene expression. HF-HIIT and HF-MICT groups exhibited a similar pattern of goblet cell distribution, agreeing with the decreased plasma lipopolysaccharide concentrations and interscapular BAT (iBAT) Lbp-Cd14-Tlr4 expression. The lowered Nlrp3 and Il1ß in the HF-HITT and HF-MICT groups complied with iBAT thermogenic capacity maintenance. This study shows reliable evidence that HIIT and MICT prevented overweight by restoring the diversity of the gut microbiota phyla and TJ gene expression, thereby reducing inflammatory signals to brown adipocytes with preserved thermogenic capacity. Both exercise modalities prevented overweight, but HIIT rescued Zo-1 and Jam-a gene expression, exerting more potent anti-inflammatory effects than MICT (reduced LPS concentrations), providing a sustained increase in thermogenesis with 78% less distance traveled.

Effects of Resistance Training in Individuals with Lower Limb Amputation: A Systematic Review.

Individuals with lower-limb amputations may have a significant strength deficit. This deficit may be related to the stump length and can lead to changes in gait, reduced energy efficiency, walking resistance, altered joint load, and increased risk of osteoarthritis and chronic low back pain. This systematic review used the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) guidelines to examine the effects of resistance training in lower limb amputees. Interventions with resistance training and other training methods were sufficient to achieve muscle strength gain in muscles of the lower limbs, improved balance, and improvements in gait pattern and speed when walking. However, it was impossible to determine from the results whether resistance training was mainly responsible for these benefits or even whether the positive effects presented would be observed with only this training method. When combined with other exercises, interventions with resistance training made possible gains for this population. Accordingly, it is noteworthy that the main finding of this systematic review is that the effects may be different according to the level of amputation, with mainly transtibial and transfemoral amputations studied.

Analysis of physiological markers and risk factors for the development of rhabdomyolysis in military personnel: a systematic review.

OBJECTIVES: To analyze case reports with individual patient data belonging to the Armed Forces submitted to specific physical or military combat training that was affected by rhabdomyolysis and identify factors that influenced the diagnosis and clinical evolution of the syndrome. CONTENT: We conducted a systematic review following the PRISMA guidelines and registered on PROSPERO (CRD42021242465). We searched MedLine (via PubMed), Scopus, Cochrane, Lilacs, SciELO, CINAHL, Web of Science, SPORTDiscus, ScienceDirect, and PEDro databases for studies that reported cases of military personnel affected by rhabdomyolysis. SUMMARY AND OUTLOOK: Thirteen studies met the inclusion criteria. Forty-nine individual cases of rhabdomyolysis were analyzed. From them, it was possible to identify several associated factors, which were responsible for developing rhabdomyolysis in military personnel. Thirty military personnel (60%) practiced physical training and 20 (40%) practiced specific military combat training. The creatine kinase (CK) peak ranged from 1,040 to 410,755 U/L, with an average of 44.991 U/L, and 14 (28%) of the cases reported alteration of renal function and four militaries (8%) evolved to death condition. Physical activities performed strenuously and without proper planning conditions such as room temperature, the period without adequate water intake, the amount of equipment used during the activity contributed to the development of rhabdomyolysis in the cases of military personnel analyzed in the present study. Therefore, it is recommended that future studies investigate the relationship between the prevalence of rhabdomyolysis cases and the severity of its consequence when associated with progressive methods of training, hydration control, acclimatization to austere environments, monitoring for the existence of hereditary diseases, and control of the use of supplementary nutritional substances.

Correlating blast vibrations and geomechanical properties to determine damage profiles and improve wall conditions in open pit mining.

Slope stability is one of the biggest concerns for mining practices and to consider the rock mass response over blasting is fundamental to achieve pit geometry. This study consists in developing a methodology which connects the dynamic behavior of one lithological domain to blast designs applied at a copper mine. The central element of this study was the construction of vibration attenuation and seed wave model which, in conjunction with geomechanical properties, has allowed the characterization of this particular rock mass and the vibration attenuation phenomena. The new blast design was developed from the model simulations, once it was possible to recognize which parameters of the blast design affect most of the damage induced by blasting. To guarantee model representativeness, two blast tests were conducted: one with the usual blast design and another using the new one. Furthermore, holes were drilled behind the blasts, which were inspected before and after each blast to compare the produced fracturing with the fracturing expected by the model. The results obtained in these blast tests show a strong correlation between the modeled and the real. The modeling proved to be a useful tool providing manners to stablish a blast design, which generates stable walls.

Effects of Pilates with and without elastic resistance on health variables in postmenopausal women with low back pain.

Aim: To compare the effects of Pilates with and without accessories on biochemical markers, pain intensity, functional disability and muscle strength in postmenopausal women with nonspecific chronic low back pain. Materials & methods: Twenty-two participants were randomized to a group of Pilates without (PG; n = 11) and with elastic resistance (PAG; n = 11) for 8 weeks, twice a week. We analyzed IGF-1, IGF-binding protein-3 (IGFBP-3), cortisol, creatine kinase, pain intensity, functional disability, abdominal and back strengths. Results: Both groups had lower pain intensity and functional disability and increased lumbar strength postinterventions. PAG exhibited an increase in IGF-1/IGFBP-3 ratio and reduction in creatine kinase compared with PG. Conclusion: Both interventions were effective in the treatment of low back pain. However, PAG presented better responses than PG. Clinical Trial Registration: Brazilian Clinical Trials Registry: ReBEC (RBR-9jwcykc), www.ensaiosclinicos.gov.br/rg/RBR-9jwcykc.

Pilates is a type of exercise that has been practiced, both in health promotion and rehabilitation, including low back pain (LBP) treatment. LBP prevails in women after menopause when compared with men. Thus, we submitted postmenopausal women with chronic LBP to two groups, one that practiced Pilates with elastic resistance and the other without these accessories. These elastic bands of progressive tension increase the effort of the exercise performed. We analyzed biochemical markers, pain intensity, functional disability and muscle strength. After 8 weeks, both groups had lower pain intensity and functional disability and increased lumbar strength. Furthermore, the group that used elastic resistance during the training showed increase in IGF-1/IGFBP-3 ratio and reduction in creatine kinase compared with the other group.

Effects of sodium butyrate and Lippia origanoides essential oil blend on growth, intestinal microbiota, histology, and haemato-immunological response of Nile tilapia.

This study aimed to verify the effects of dietary supplementation with sodium butyrate and Lippia origanoides, combined and isolated, on the health and zootechnical performance of Nile tilapia juveniles Oreochromis niloticus. A total of 120 fish (5.38 ± 0.65 g) were randomly distributed in 12 experimental units and fed different experimental diets for 30 days, namely: commercial diet without supplementation (Unsupplemented); commercial diet supplemented with 0.5% sodium butyrate (Butyrate); commercial diet supplemented with 0.125% L. origanoides (Lippia) and commercial diet supplemented with a mixture of 0.5% sodium butyrate and 0.125% L. origanoides (Butyrate + Lippia). After preparing the experimental diets there was an increase in the pH of diet Butyrate when compared to the other diets. After 30 days the fish supplemented with Butyrate + Lippia showed reduction significate in the mean corpuscular haemoglobin, concentration of total heterotrophic bacteria in the intestine, and lymphocyte infiltrates in the liver. Besides that, the supplementation with Butyrate + Lippia promoted an increased number of intestinal villi compared to the fish Unsupplemented ones. Additionally, fish fed a diet containing only Lippia presented an increase in the villus perimeter in the posterior region of the gut and in the red blood cell number. Animals supplemented only with sodium butyrate demonstrated increased lactic acid bacterium in the gut and macrosteatosis in the liver, besides decreased melanomacrophages in the spleen. The use of sodium butyrate associated with essential oil had positive effects on the intestinal microbiota, intestinal structure, liver, and spleen integrity, suggesting a greater efficiency of the compounds when used together in the nutrition of Nile tilapia juveniles.

Desfechos clínicos e microbiológicos no uso de cateter venoso periférico: subsídios para assistência segura ao paciente / Clinical and microbiological outcomes in the use of peripheral venous catheters: subsidies for safe patient care

Os cateteres venosos periféricos (CVP) são produtos para saúde (PPS) comumente utilizados em pacientes hospitalizados para administração de fluidos, medicamentos, e monitoramento hemodinâmico. No entanto, podem representar fonte potencial de contaminação microbiana, formação de biofilme e infecção. O objetivo desta pesquisa foi avaliar indicadores clínicos e microbiológicos associados ao uso do CVP. Trata-se de um estudo observacional realizado em duas etapas: Etapa I - Seguimento longitudinal prospectivo dos pacientes hospitalizados em uso contínuo de CVP flexível com a caracterização dos pacientes submetidos à cateterização venosa periférica, bem como frequência dos sinais e sintomas de agravos associados ao uso de CVP. Além disso, a Etapa II - Avaliação das condições microbiológicas, incluindo a presença de biofilme em CVP flexíveis dos pacientes hospitalizados por microscopia eletrônica de varredura (MEV), e a associação entre os aspectos clínicos dos pacientes com os microbiológicos em diferentes locais dos CVP flexíveis (superfícies internas e externas). O seguimento longitudinal prospectivo de 67 pacientes hospitalizados em uso contínuo de CVP flexível, bem como a coleta das amostras de CVP flexíveis foram realizados em unidades de internação do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Ribeirão Preto, SP, Brasil. Antes da avaliação microbiológica, todas as amostras de CVP flexíveis foram examinadas em termos de integridade e aparência (sujidade). A análise estatística foi realizada pelo teste de qui-quadrado (x2) de Pearson com α=5%. Os 67 pacientes hospitalizados eram de ambos os sexos, média de idade de 55,8 anos, com tempo médio de permanência do CVP flexível de 43,0h. Ainda, em relação aos locais de inserção dos CVP flexíveis, 98,5% estavam em membros superiores: braços (44,7%), mãos (35,8%) e antebraços (17,0%), e destes, 75,0% apresentavam cobertura (curativo adesivo) transparente. Aproximadamente, um em cada quadro pacientes apresentou sinais e sintomas de agravos associados ao uso do CVP flexível. Staphylococcus spp foram os micro-organismos mais prevalente nas amostras. Além disso, não houve associação entre a avaliação clínica e a presença nas superfícies internas e externas de micro-organismo no CVP flexível, respectivamente (x² =1,522; gl=1; p=0,217) e (x²=2,405; gl=1; p=0,121). A MEV evidenciou diferenças morfológicas (textura e espessura) entre as camadas das superfícies internas e externas dos CVP flexíveis, bem como a presença de célula epitelial, matéria orgânica, extensa rede de fibrina com células sanguíneas e bactéria na forma de bastonete. Em conclusão, esta pesquisa permitiu o avanço do conhecimento acerca do uso do CVP flexível e a assistência segura ao paciente, bem como inferir que estes PPS são fonte potencial de contaminação microbiana nas superfícies internas e externas com a formação de biofilme. Entretanto, não houve associação entre os desfechos clínicos e microbiológicos quanto ao uso de CVP flexível

Peripheral venous catheters (PVC) are health products (HP) commonly used in hospitalized patients to administer fluids, medications, and hemodynamic monitoring. However, they can represent a potential source of microbial contamination, biofilm formation and infection. The objective of this research was to evaluate clinical and microbiological indicators associated with the use of PVC. This is an observational study carried out in two stages: Step I - Prospective longitudinal follow-up of hospitalized patients on continuous use of flexible PVC with the characterization of patients undergoing peripheral venous catheterization, as well as the frequency of signs and symptoms of injuries associated with the use of PVC. In addition, Step II - Assessment of microbiological conditions, including the presence of biofilms in flexible PVC from patients hospitalized by scanning electron microscopy (SEM), and the association between the clinical aspects of patients and the microbiological aspects in different locations of flexible PVC (internal and external surfaces). The prospective longitudinal follow-up of 67 hospitalized patients in continuous use of flexible PVC, as well as the collection of flexible PVC samples were performed in inpatient units at Clinical Hospital, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil. Before the microbiological evaluation, all flexible PVC samples were examined for integrity and appearance (dirt). Statistical analysis was performed using Pearson's chi-square test (x2) with α=5%. The 67 hospitalized patients were of both sexes, with a mean age of 55.8 years, with a mean length of stay of the flexible PVC of 43.0h. Moreover, in relation to the flexible PVC insertion sites, 98.5% were in the upper limbs: arms (44.7%), hands (35.8%) and forearms (17.0%), and of these, 75.0% had a transparent dressing (adhesive bandage). Approximately one in every patient presented signs and symptoms of injuries associated with the use of flexible PVC. Staphylococcus spp. were the most prevalent microorganisms in the samples. In addition, there was no association between clinical evaluation and the presence on the internal and external surfaces of microorganisms in the flexible PVC, respectively (x²=1.522; gl=1; p=0.217) and (x²=2.405; gl=1; p=0.121). SEM showed morphological differences (texture and thickness) between the layers of the internal and external surfaces of flexible PVC, as well as the presence of an epithelial cell, organic matter, extensive fibrin network with blood cells and bacteria in the form of a rod. In conclusion, this research allowed the advancement of knowledge about the use of flexible PVC and safe patient care, as well as inferring that these HP are a potential source of microbial contamination on the internal and external surfaces with the biofilm formation. However, there was no association between clinical and microbiological outcomes regarding the use of flexible PVC

Light Activation and Thermocycling Methods on the Shear Bond Strength of Brackets Bonded to Porcelain Surfaces.

The present study was evaluated the effect of different light activation and thermocycling methods on the shear bond strength (SBS) and on the adhesive remnant index (ARI) of metal brackets bonded to feldspathic ceramic. Hundred metal brackets were bonded to 20 porcelain cylinders, divided into four groups (n=25) based on light activation and thermocycling processes. The cylinders were etched with 10% hydrofluoric acid for 60 s and coated with two layers of silane. The brackets were bonded with Transbond XT composite resin. Light activation in Groups 1 and 3 was performed during 3 s using the VALO Ortho Cordless appliance with irradiance 3,200 mW/cm2 and in Groups 2 and 4 for 40 s using Optilight Max appliance with irradiance 1,200 mW/cm². The samples were stored in deionized water at 37°C for 24 h and the samples from Groups 1 and 2 were submitted to the SBS test at a rate of 1 mm/min, whereas the samples from Groups 3 and 4 were submitted to 7,000 thermal cycles (5°/55°C) before to the SBS test. The data were assessed by two-way analysis of variance and by Tukey's test (a=0.05). No significant difference was observed between SBS means in the different light activation devices used. The samples subjected to thermocycling revealed lower SBS values (p≤0.05). There was predominance of score 0 for ARI in all groups. Therefore, the different light activation methods did not interfere in SBS, but thermocycling reduced SBS.

Parasitological and histopathological diagnosis of a non-native fish (Oreochromis sp.) with a noticeable presence in a natural Brazilian river environment.

Nile tilapia is an exotic species produced in Brazilian aquaculture. The aim of this study was to constitute a pathological diagnosis in Oreochromis sp. with a noticeable presence in a river in southern Brazil, and to verify the origin of these fish in this natural habitat, an environment with high sanitary precariousness due to discharges of industrial effluents. A total of 30 fish were collected during three sampling events and their health status was assessed by parasitological fauna survey, parasitological indices and histopathological examination of the gills, liver, spleen and kidney. Five species of monogenea were identified infesting gills and stomach: Cichlidogyrus sclerosus, C. halli, C. thurstonae, Scutogyrus longicornis and Enterogyrus cichlidarum; and 4 species of trichodinidae infesting the body surface and gills: Trichodina magna, T. compacta, T. centrostrigeata and Paratrichodina africana. The results showed differences according to the seasonality of the collection, with higher parasite count and larger tissue alterations in summer. Histopathological analysis fluctuated from moderate to severe, but necrosis prevailed in all organs and in all fish, indicating that these fish did not enjoy full health.

Extracellular Vesicles Derived from Induced Pluripotent Stem Cells Promote Renoprotection in Acute Kidney Injury Model.

Induced pluripotent stem cells (iPSC) have been the focus of several studies due to their wide range of application, including in cellular therapy. The use of iPSC in regenerative medicine is limited by their tumorigenic potential. Extracellular vesicles (EV) derived from stem cells have been shown to support renal recovery after injury. However, no investigation has explored the potential of iPSC-EV in the treatment of kidney diseases. To evaluate this potential, we submitted renal tubule cells to hypoxia-reoxygenation injury, and we analyzed cell death rate and changes in functional mitochondria mass. An in vivo model of ischemia-reperfusion injury was used to evaluate morphological and functional alterations. Gene array profile was applied to investigate the mechanism involved in iPSC-EV effects. In addition, EV derived from adipose mesenchymal cells (ASC-EV) were also used to compare the potential of iPSC-EV in support of tissue recovery. The results showed that iPSC-EV were capable of reducing cell death and inflammatory response with similar efficacy than ASC-EV. Moreover, iPSC-EV protected functional mitochondria and regulated several genes associated with oxidative stress. Taken together, these results show that iPSC can be an alternative source of EV in the treatment of different aspects of kidney disease.

Acute high-intensity exercise test in soccer athletes affects salivary biochemical markers.

Saliva has been reported as a potential biological fluid for biochemical monitoring. This study investigated salivary markers of exercise intensity, oral mucosal immunity, and redox homeostasis in soccer athletes subjected to an acute high-intensity interval exercise (HIIE) protocol characterised by a repeated sprint ability test. Thirty-two professional soccer athletes were recruited and saliva aliquots were collected at rest and immediately after HIIE protocol. When compared with pre-test values we observed that HIIE protocol induced moderate changes for total protein (p = .015; effect size (ES) = 0.51; smallest worthwhile change (SWC)factor = 5.7) and for cortisol levels (p < .0001; ES = 0.49; SWCfactor = 3.9). Lactate levels showed very large changes (p < .000; ES = 1.35; SWCfactor = 10.8), while Ig-A alterations were considered unclear. Besides, transferrin changes were trivial and maintained its levels at rest and after HIIE below the proposed threshold of 0.5 mg/dL. Regarding redox homeostasis we observed unclear effects for TBARs, MDA, GSH, GSSG, CAT, and SOD while uric acid showed large decreases (p = .005; ES = 0.80; SWCfactor = -5.4). HIIE protocol as a physical test conducted in soccer athletes increased salivary concentration of exercise intensity markers, such as lactate, total protein, and cortisol, but did not affect Ig-A levels. Redox homeostasis in saliva seems to be more related with uric acid levels as a possible key factor TBARs homeostasis.

Laminados Cerâmicos pelo Sistema CEREC: do Planejamento à Cimentação / Porcelain Laminate Venners with CEREC System: from Planning to Cementation

A Odontologia tem evoluído de acordo com os padrões estéticos impostos pela sociedade. Alterações de anatomia e coloração são cada vez mais requisitadas pelos pacientes, a fim de se enquadrarem nesses parâmetros. Um dos protocolos mais utilizados atualmente pelo cirurgião-dentista para alcançar a exigência estética de seus pacientes é o de laminados cerâmicos. Os principais motivos para o uso desse material são: compatibilidade biológica, estaurações ultraconservadoras, estética e estabilidade de cor. Portanto, este relato de caso tem como objetivo descrever o processo da reabilitação dos elementos 13, 12, 11, 21, 22 e 23 com material cerâmico dissilicato de lítio, com o sistema CAD/CAM Cerec.

Dentistry has been evolving according to the aesthetic standards imposed by society. Anatomy and coloring changes are increasingly required by patients in order to fit into those standards. One of the protocols currently used by the dentist to achieve the aesthetic requirement of his patients is the porcelain laminates veener. The main reasons using this material are: biocompatibility, ultraconservative restorations, aesthetics and color stability. This case report, therefore, aims to describe the process of a rehabilitation of the elements 13, 12, 11, 21, 22, 23 using a ceramic lithium dissilicate material with the CAD / CAM system Cerec.

Biological maturation assessment methods in adolescent soccer players considering zinc status / Métodos de evaluación de la maduración biológica en jugadores adolescentes de fútbol considerando el estado de zinc

SUMMARY: The purpose of this study was to compare different methods of maturity evaluation and their relation with performance-related physical and anthropometric variables in young soccer players, with different plasma zinc status. A total of 53 healthy male young soccer players (age: 13±1 years; body mass: 48±10 kg; stature: 160±10 cm) participated in this study. Variables from physical fitness (stature, ST; fat-free mass, FFM; handgrip strength in the dominant hand, DHS), testosterone and zinc plasma concentration were measured. Biological maturity was evaluated by sexual maturity (development of: pubic hair, PH; genitals, GD; axillary hair; AH), bone maturity (TW3 method; BA), and testosterone plasma concentration methods. We observed that: (i) the frequency of hypozincemics and normozincemics children stratified by BA-CA, PH and GD were similar in each category; (ii) the BA allowed the identification of differences between the three categories, in at least two performance-related variables (FFM and DHS, p<0.0001); (iii) the AH method was able to discriminate only for DHS (p<0.0001); and (iv) the testosterone method was not able to identify differences between the four maturation categories with regard to ST, FFM, and DHS. Results suggested that Zinc deficiency did not influence the results obtained for the maturation categories defined by the different assessment methods. The assessment of biological maturation by BA seems to be the most effective for the stratification of performance-related and anthropometric variables in young soccer players. Nevertheless, the AH method should also be considered as a fair option to be used in field studies and practice.

RESUMEN: El objetivo de este estudio fue comparar diferentes métodos de evaluación de madurez y su relación con variables físicas y antropométricas relacionadas con el desempeño en jóvenes jugadores de fútbol, con diferentes niveles plasmáticos de zinc. Participaron en este estudio 53 jugadores de fútbol jóvenes sanos (edad: 13 ± 1 años, masa corporal: 48 ± 10 kg, estatura: 160 ± 10 cm). Se midieron las variables de la aptitud física (estatura, ST, masa libre de grasa, FFM, fuerza de agarre en la mano dominante, DHS), testosterona y concentración plasmática de zinc. Se evaluaron la madurez sexual (desarrollo de vello púbico, PH, genitales, DG, cabello axilar, AH), madurez ósea (método TW3, BA) y concentración plasmática de testosterona. Se observó que: (i) la frecuencia de los niños hipoxincémicos y normozincémicos estratificados por BA-CA, PH y GD fueron similares en cada categoría; (ii) el BA permitió la identificación de diferencias entre las tres categorías, en al menos dos variables relacionadas con el desempeño (FFM y DHS, p <0,0001); (iii) el método AH fue capaz de discriminar sólo para DHS (p <0,0001); y (iv) el método de testosterona no fue capaz de identificar diferencias entre las cuatro categorías de maduración con respecto a ST, FFM y DHS. Los resultados sugirieron que la deficiencia de zinc no influyó en los resultados obtenidos para las categorías de maduración definidas por los diferentes métodos de evaluación. La evaluación de la maduración biológica por BA parece ser la más efectiva para la estratificación de variables de rendimiento y antropométricas en jóvenes jugadores de fútbol. Sin embargo, el método AH también debe ser considerado como una opción justa para ser utilizado en estudios de campo y práctica.

Conhecimento dos cirurgiões-dentistas sobre o uso de bifosfonatos e sua repercussão no tratamento no programa de atenção básica em Patos (PB) / Dentists knowledge about the use of bisphosphonates and its repercussion on dental treatment in the basic care program in Patos (PB)

Objetivo: avaliar o grau de conhecimento dos cirurgiões-dentistas que atuam na atenção básica do município de Patos (PB) sobre os bifosfonatos e sua repercussão no tratamento odontológico. Material e métodos: neste estudo observacional transversal, 34 cirurgiões-dentistas responderam ao questionário sobre conhecimentos gerais dessa medicação. Resultados: os resultados do estudo evidenciaram um baixo conhecimento acerca dos bifosfonatos (52,9%). De modo geral, o estudo apontou o desconhecimento acerca da droga e sua repercussão no tratamento odontológico pelos cirurgiões-dentistas do município de estudo. Conclusão: é necessária a aquisição de conhecimentos por parte dos profi ssionais da Odontologia em relação a esses fármacos, a fi m de oferecerem aos seus pacientes um tratamento mais amplo e completo, com todas as informações e alternativas necessárias

Objective: to evaluate the degree of dental surgeons knowledge who work in the basic care of the municipality of Patos (PB) on bisphosphonates and its repercussion in dental treatment. Material and methods: in this cross-sectional observational study, 34 dental surgeons answered the questionnaire about the general knowledge of this medication. Results: the results of the study showed low knowledge about bisphosphonates (52.9%). In general, the study pointed out the unknowledge about the drug and its repercussion on dental treatment by the dental surgeons of the study municipality. Conclusion: it is necessary to acquire knowledge from dental professionals in relation to these drugs, so that they can offer their patients a wider and complete treatment, with all the necessary information and alternatives.

Mixing failures of endodontic sealers: an in vivo biocompatibility study / Falhas durante espatulação de cimentos endodônticos: um estudo de biocompatibilidade in vivo

Objectives: Evaluate, in vivo, the influence of mixing failures on endodontic sealers. Material and Methods: To alveolus analysis, 80 rats were divided into Sealapex® and AH Plus® groups. Within each group, the sealer was subjected to either partial (incomplete homogenization­ simulating handling failures) or total mixing (complete homogenization) over two periods of 7 and 30 days (n = 20). The maxillary incisor was extracted and a polyethylene tube containing the sealer was inserted. To quantify edema, 40 male rats were divided into four groups (n = 10). The animals received 2% Evans Blue intravenously, and either AH Plus® or Sealapex® was injected subcutaneously. The rats were euthanized after 3 or 6 hours and analyzed in a spectrophotometer (630 ƞm). To analyze the subcutaneous tissue, 20 rats received polyethylene tube implants with the sealers in the dorsal area (n=10), then euthanized after either 7 or 30 days, and inflammation was evaluated according to an inflammatory cells score. Results: In the alveolar 7-day group, control group presented an inflammation score 1, while all other groups presented a score 2, except AH plus® total mix group (3). After 30 days, all groups presented a score 1. The edemogenic test showed less edema in Sealapex® groups (p < 0.5). In subcutaneous 7-day period, all groups presented score 2. In 30 days, all groups revealed score 1, except AH Plus® partial mix group (2). Conclusion: Regarding mixing of the sealers, there were no significant differences among the groups (AU)

Objetivo: Avaliar, in vivo, a influência das falhas de espatulação de cimentos endodônticos. Material e Métodos: Para análise alveolar, 80 ratos foram divididos nos grupos Sealapex® e AH Plus®. Em cada grupo, o cimento foi espatulado de forma parcial (homogeneização incompleta, simulando falhas) ou total (homogeneização completa) em dois períodos de 7 e 30 dias (n=20). O incisivo superior foi extraído e um tubo de polietileno contendo o cimento foi inserido. Para quantificar edema, 40 ratos foram divididos em quatro grupos (n = 10). Os animais receberam Azul de Evans 2% intravenoso, e AH Plus® ou Sealapex® injetados no tecido subcutâneo. Após 3 ou 6 horas foram eutanasiados e analisados em espectrofotômetro (630 ƞm). Para analisar a resposta subcutânea, 20 ratos receberam implantes de tubo de polietileno com os cimentos na região dorsal (n = 10), eutanasiados após 7 ou 30 dias, e a inflamação foi avaliada de acordo com um escore de células inflamatórias. Resultados: Na análise alveolar em 7 dias, o grupo controle apresentou escore 1 de inflamação, enquanto que todos os outros grupos apresentaram 2, com exceção do AH plus® espatulação total (3). Após 30 dias, todos os grupos apresentaram escore 1. O teste edemogênico mostrou menor edema nos grupos Sealapex® (p < 0,5). No período subcutâneo de 7 dias, todos os grupos apresentaram escore 2. Em 30 dias, todos os grupos revelaram escore 1, exceto AH Plus® espatulação parcial (2). Conclusão: Não houve diferença estatística significante entre os cimentos quanto à espatulação. (AU)

Ventilator-associated pneumonia: the influence of bacterial resistance, prescription errors, and de-escalation of antimicrobial therapy on mortality rates

Abstract Ventilator-associated pneumonia is the most prevalent nosocomial infection in intensive care units and is associated with high mortality rates (14–70%). Aim This study evaluated factors influencing mortality of patients with Ventilator-associated pneumonia (VAP), including bacterial resistance, prescription errors, and de-escalation of antibiotic therapy. Methods This retrospective study included 120 cases of Ventilator-associated pneumonia admitted to the adult adult intensive care unit of the Federal University of Uberlândia. The chi-square test was used to compare qualitative variables. Student's t-test was used for quantitative variables and multiple logistic regression analysis to identify independent predictors of mortality. Findings De-escalation of antibiotic therapy and resistant bacteria did not influence mortality. Mortality was 4 times and 3 times higher, respectively, in patients who received an inappropriate antibiotic loading dose and in patients whose antibiotic dose was not adjusted for renal function. Multiple logistic regression analysis revealed the incorrect adjustment for renal function was the only independent factor associated with increased mortality. Conclusion Prescription errors influenced mortality of patients with Ventilator-associated pneumonia, underscoring the challenge of proper Ventilator-associated pneumonia treatment, which requires continuous reevaluation to ensure that clinical response to therapy meets expectations.

Ventilator-associated pneumonia: the influence of bacterial resistance, prescription errors, and de-escalation of antimicrobial therapy on mortality rates.

UNLABELLED: Ventilator-associated pneumonia is the most prevalent nosocomial infection in intensive care units and is associated with high mortality rates (14-70%). AIM: This study evaluated factors influencing mortality of patients with Ventilator-associated pneumonia (VAP), including bacterial resistance, prescription errors, and de-escalation of antibiotic therapy. METHODS: This retrospective study included 120 cases of Ventilator-associated pneumonia admitted to the adult adult intensive care unit of the Federal University of Uberlândia. The chi-square test was used to compare qualitative variables. Student's t-test was used for quantitative variables and multiple logistic regression analysis to identify independent predictors of mortality. FINDINGS: De-escalation of antibiotic therapy and resistant bacteria did not influence mortality. Mortality was 4 times and 3 times higher, respectively, in patients who received an inappropriate antibiotic loading dose and in patients whose antibiotic dose was not adjusted for renal function. Multiple logistic regression analysis revealed the incorrect adjustment for renal function was the only independent factor associated with increased mortality. CONCLUSION: Prescription errors influenced mortality of patients with Ventilator-associated pneumonia, underscoring the challenge of proper Ventilator-associated pneumonia treatment, which requires continuous reevaluation to ensure that clinical response to therapy meets expectations.