Impacto da pandemia de Covid-19 sobre os aspectos psicológicos e a sua relação com as disfunções temporomandibulares / Impact of the Covid-19 pandemic on psychological aspects and its relation with temporomandibular disorders / Impacto de la pandemia de Covid-19 en aspectos psicológicos y su relación con los trastornos temporomandibulares

Introdução: As Disfunções temporomandibulares foram definidas pela American Academy of Orofacial Pain (AAOP) como um conjunto de condições clínicas dolorosas e/ou disfuncionais relacionadas aos músculos da mastigação, às articulações temporomandibulares e estruturas associadas. A DTM apresenta etiologia multifatorial, atualmente o modelo biopsicossocial tem enfatizado a importância dos fatores psicológicos como ansiedade, estresse e depressão, na etiologia da DTM. Objetivo: O presente estudo tem como objetivo descrever o impacto da pandemia de COVID-19 nos aspectos psicológicos e sua relação com a Disfunção Temporomandibular. Metodologia: Trata-se de uma revisão integrativa da literatura, foram consultadas as bases de dados eletrônicas LILACS, Pubmed, SCIELO e SCOPUS. Resultados e Discussão: A pandemia de COVID-19 causou sofrimento significativo a bilhões de pessoas em todo o mundo, refletindo em respostas psicossociais, principalmente estresse, ansiedade e depressão. Diversos estudos têm demonstrado uma associação entre as alterações psicológicas causadas pela pandemia por COVID-19 e sua relação com a DTM, resultando no aumento da incidência dessas desordens e no agravamento de condições preexistentes. Conclusão: A pandemia por COVID-19 elevou os níveis de estresse, ansiedade e depressão, o que contribuiu diretamente para o aumento da incidência e a severidade dos sintomas de DTM.

Introduction: Temporomandibular disorders were defined by the American Academy of Orofacial Pain (AAOP) as a set of painful and/or dysfunctional clinical conditions related to masticatory muscles, temporomandibular joints and associated structures. TMD has a multifactorial etiology, currently the biopsychosocial model has emphasized the importance of psychological factors such as anxiety, stress and depression in the etiology of TMD. Objective: The present study aims to describe the impact of the COVID-19 pandemic on psychological aspects and their relationship with Temporomandibular Disorders. Methodology: This is an integrative literature review, the LILACS, Pubmed, SCIELO and SCOPUS electronic databases were consulted. Results and Discussion: The COVID-19 pandemic caused significant suffering to billions of people around the world, reflecting in psychosocial responses, mainly stress, anxiety and depression. Several studies have demonstrated an association between the psychological alterations caused by the COVID-19 pandemic and their relationship with TMD, resulting in an increased incidence of these disorders and the worsening of preexisting conditions. Conclusion: The COVID-19 pandemic raised levels of stress, anxiety and depression, which directly contributed to the increased incidence and severity of TMD symptoms.

Introducción: Los trastornos temporomandibulares fueron definidos por la Academia Americana de Dolor Orofacial (AAOP) como un conjunto de condiciones clínicas dolorosas y/o disfuncionales relacionadas con los músculos masticatorios, articulaciones temporomandibulares y estructuras asociadas. Los TTM tienen una etiología multifactorial, actualmente el modelo biopsicosocial ha enfatizado la importancia de factores psicológicos como la ansiedad, el estrés y la depresión en la etiología de los TTM. Objetivo: El presente estudio pretende describir el impacto de la pandemia COVID-19 en los aspectos psicológicos y su relación con los Trastornos Temporomandibulares. Metodología: Se trata de una revisión bibliográfica integradora, se consultaron las bases de datos electrónicas LILACS, Pubmed, SCIELO y SCOPUS. Resultados y Discusión: La pandemia de COVID-19 causó sufrimiento significativo a miles de millones de personas en todo el mundo, reflejándose en respuestas psicosociales, principalmente estrés, ansiedad y depresión. Varios estudios han demostrado una asociación entre las alteraciones psicológicas causadas por la pandemia de COVID-19 y su relación con los TTM, resultando en un aumento de la incidencia de estos trastornos y el empeoramiento de las condiciones preexistentes. Conclusiones: La pandemia de COVID-19 elevó los niveles de estrés, ansiedad y depresión, lo que contribuyó directamente al aumento de la incidencia y gravedad de los síntomas de los TTM.

Encapsulation of Bromelain in Combined Sodium Alginate and Amino Acid Carriers: Experimental Design of Simplex-Centroid Mixtures for Digestibility Evaluation.

Bromelain has potential as an analgesic, an anti-inflammatory, and in cancer treatments. Despite its therapeutic effects, this protein undergoes denaturation when administered orally. Microencapsulation processes have shown potential in protein protection and as controlled release systems. Thus, this paper aimed to develop encapsulating systems using sodium alginate as a carrier material and positively charged amino acids as stabilizing agents for the controlled release of bromelain in in vitro tests. The systems were produced from the experimental design of centroid simplex mixtures. Characterizations were performed by FTIR showing that bromelain was encapsulated in all systems. XRD analyses showed that the systems are semi-crystalline solids and through SEM analysis the morphology of the formed systems followed a pattern of rough microparticles. The application of statistical analysis showed that the systems presented behavior that can be evaluated by quadratic and special cubic models, with a p-value < 0.05. The interaction between amino acids and bromelain/alginate was evaluated, and free bromelain showed a reduction of 74.0% in protein content and 23.6% in enzymatic activity at the end of gastric digestion. Furthermore, a reduction of 91.6% of protein content and 65.9% of enzymatic activity was observed at the end of intestinal digestion. The Lis system showed better interaction due to the increased stability of bromelain in terms of the amount of proteins (above 63% until the end of the intestinal phase) and the enzymatic activity of 89.3%. Thus, this study proposes the development of pH-controlled release systems aiming at increasing the stability and bioavailability of bromelain in intestinal systems.

Strength Level of Professional Elite Soccer Players after the COVID-19 Lockdown Period: A Retrospective Double-Arm Cohort Study.

BACKGROUND: It is well known that periods of inactivity generate a loss of muscle strength, a fundamental component of sports performance in soccer. However, little information is available on the decrease in strength levels in professional soccer players after the quarantine lockdown that occurred during the COVID-19 pandemic. AIM: To compare the isokinetic peak torque profiles of professional soccer players from different teams before and after the quarantine period generated by COVID-19. METHODS: A retrospective observational study was performed using data collected from two different professional elite-level soccer teams just before and immediately after the COVID-19 quarantine period. One team gave individual instructions to its players for conditioning maintenance at home during the quarantine period, while the other team used regular video calls to maintain the player's conditioning status on home training. The main outcomes were the mean peak torque of knee extensors and flexors, from concentric and eccentric contractions of each playing position. Analysis. A two-way ANOVA analysis was used to compare peak torque before and after the quarantine period and between both teams' strategies, showing a statistically significant reduction in eccentric knee flexor peak torque from the team that did not have remote monitoring. CONCLUSIONS: Remote monitoring programs are recommended so that athletes are less affected by the deleterious effects of confinement.

Association between Concentric and Eccentric Isokinetic Torque and Unilateral Countermovement Jump Variables in Professional Soccer Players.

Isokinetic tests have been highly valuable to athletic analysis, but their cost and technical operation turn them inaccessible. The purpose of this study was to verify the correlation between unilateral countermovement jump variables and isokinetic data. Thirty-two male professional soccer players were subjected to the isokinetic testing of both knee extensors and flexors in concentric and eccentric muscle contractions. They also executed unilateral countermovement vertical jumps (UCMJ) to compare maximum height, ground reaction force, and impulse power with isokinetic peak torque. Data analysis was conducted through Pearson correlation and linear regression. A high correlation was found between dominant unilateral extensor concentric peak torque and the UCMJ maximum height of the dominant leg. The non-dominant leg jump showed a moderate correlation. No other variable showed statistical significance. Linear regression allowed the generation of two formulae to estimate the peak torque from UCMJ for dominant and non-dominant legs. Although few studies were found to compare our results, leading to more studies being needed, a better understanding of the unilateral countermovement jump may be used in the future as a substitute to the expensive and technically demanding isokinetic testing when it is unavailable, allowing the assessment of lower limb physical asymmetries in athletic or rehabilitation environments.

Differential Diagnosis of Skeletal Class II: Orthodontic-Surgical Approach with Surgery First / Diagnóstico Diferencial da Classe II esquelética: Abordagem Ortodôntico-Cirúrgica com Benefício Antecipado

Abstract Orthodontic-surgical treatment with the "Surgery First Approach" provides immediate facial aesthetic improvements and significantly reduces the patient's orthodontic treatment time, avoiding the transient worsening of the facial profile due to dental decompensation that occurs in surgical cases. Thus, this clinical case describes the retreatment of a 22-year-old female leukoderma patient, whose main complaint was related to the proclination of upper and lower incisors. The patient used a mio-relaxing plate for 30 days, which evidenced the skeletal mandibular deficiency and the ½ bilateral Class II malocclusion. Orthognathic surgery first approach associated with the extraction of the 4 premolars was chosen considering the patient's aesthetic demand. The use of a mio-relaxing plate in the diagnostic stage was essential for the real diagnosis of mandibular deficiency and the technique employed made it possible to conclude the treatment avoiding aesthetic commitment, with excellent results. (AU)

Resumo O tratamento ortodôntico-cirúrgico por meio do benefício antecipado proporciona melhorias estéticas faciais imediatas e reduz de maneira significativa o tempo de tratamento ortodôntico do paciente, evitando a piora transitória do perfil facial devido à descompensação dentária que ocorre em casos cirúrgicos. Assim, este caso clínico descreve o retratamento de uma paciente com 22 anos de idade, leucoderma, sexo feminino, que apresentava queixa principal relacionada à inclinação vestibular dos dentes anteriores. Após uso de placa miorrelaxante por 30 dias, verificou-se a presença de Classe II esquelética com deficiência mandibular e ½ Classe II dentária bilateral. Considerando a demanda estética da paciente, optou-se pela abordagem ortodôntico-cirúrgica com Benefício Antecipado associada à extração de 4 pré-molares para correção da inclinação dentária anterior. O uso da placa miorrelaxante foi fundamental para o diagnóstico real da deficiência mandibular e a técnica empregada possibilitou concluir o tratamento evitando o comprometimento estético pré-cirúrgico, com obtenção de excelentes resultados. (AU)

Projeto Terapêutico Singular (PTS) e Interprofissionalidade: um Relato de Estudantes do PET Saúde / Project of Singular Therapy and Interprofissionality (PTS): A Report by Students of Health P. E. T

Em um ambiente que trabalhe vários profissionais, com formações diferentes e com visões terapêuticas diferentes, naturalmente irá aparecer dificuldades em promover um projeto terapêutico comum ao paciente, que considere o indivíduo na sua integralidade. Nessa perspectiva, o PTS - que é uma agregação de propostas de atuações terapêuticas articuladas para um indivíduo, família ou grupo ­ é uma ferramenta que auxilia na busca de uma singularidade de ações a partir do diagnóstico firmado. A sistematização da experiência se deu em maio e junho de 2019. O objetivo foi relatar a utilização do PTS como instrumento de trabalho interprofissional. Trata-se de um ensaio descritivo do tipo relato de experiência sistematizado por integrantes do PET-Saúde Interprofissionalidade de Sobral, Ceará. O cenário do estudo foi o CAPS Damião Ximenes Lopes, Sobral-Ce. A construção do PTS no CAPS se dá por meio de uma reunião, denominada "roda de discussão", onde os diferentes atores do processo elaboram juntos estratégias de promoção à saúde. Logo, é o momento que o prontuário de algum usuário do serviço é escolhido para ser debatido entre os profissionais segundo suas especialidades, porém, as abordagens de intervenção são pensadas em equipe. Desse modo, o PTS se configura como um aliado na resolução de questões que acompanham os sujeitos assistidos no contexto da saúde mental, uma vez que o caráter dinâmico e complexo presente nos equipamentos que atuam com a interprofissionalidade exigem profissionais capazes de assegurar uma melhor atenção à saúde, dispondo de respostas necessárias para as múltiplas demandas trazidas pelos pacientes.

Strength development according with age and position: a 10-year study of 570 soccer players.

BACKGROUND/AIM: The purpose of this study was to compare the isokinetic peak torque profiles from the quadriceps and hamstrings muscles during concentric and eccentric contractions in elite Brazilian soccer players across different field positions and age categories. Our hypothesis was that soccer players from different field positions are subjected to different ageing-related effects on their isokinetic peak torque. METHODS: This is a retrospective study based on professional elite-level soccer players between the years 2009 and 2019. It included 570 adult males who played for at least 5 years on first or second Brazilian divisions. Playing positions were divided as: goalkeepers, defenders, sidebacks, midfielders and forwards. Age categories were also divided as: G1 (17-20 years old), G2 (21-24 years old), G3 (25-28 years old), G4 (29-32 years old) and G5 (33 years old or more). RESULTS: The results indicate a moderate effect of age (F(4545)=8.197; p<0.001; η2=0.057) and a small effect of playing position (F(4545)=2.993; p<0.05; η2=0.021) on torque of concentric extensors; mainly from midfielders and goalkeepers with 29 years or more. CONCLUSIONS: Soccer players from different field positions are subjected to different ageing related effects on their muscular performance during their career special attention should be given to these players to avoid reduction in physical performance.

Concentric and eccentric isokinetic hamstring injury risk among 582 professional elite soccer players: a 10-years retrospective cohort study.

BACKGROUND/AIM: Different authors have tried to correlate the peak isokinetic torque values with the incidence of soccer match injuries. However, due to the wide variety of assessment testing protocols, such an inference becomes difficult. This study aimed to verify the capacity of an isokinetic test to establish injury risk reference values for hamstring strain injuries. METHODS: A retrospective cohort study based on isokinetic data and clinical records from the last 10 years was conducted in 582 Brazilian elite-professional soccer players, who were subjected to the same isokinetic test protocol, machine, and tester. A Multivariate Logistic Regression Analysis for Complex Data Sampling was used to generate injury risk statistical indexes. RESULTS: Multivariate regression analysis of both legs provided important data to identify the cut-off values of Concentric Peak Torque (181.82 Newton/*metres), Concentric Work (236.23 watts) and Concentric Power (130.11 joules). CONCLUSIONS: The injury risk indexes indicate that an increase of just one Newton unit in CPT (Concentric Peak Torque) and CJ (Concentric Power) above those cut-off values, can reduce the risk of future injuries by 2% and 2.7%, respectively.

Perfil de expressão dos fatores de transcrição STAT-1, STAT-4 e T-bet no carcinoma escamoso de pênis / Expression profile of STAT-1, STAT-4 and T-bet transcription factors in squamous carcinoma of the penile

Introdução: O câncer de pênis (CaPe) é uma doença rara em países desenvolvidos, porém representa um problema de saúde pública em países em desenvolvimento. O Brasil tem a maior incidência de CaPe do mundo, chegando a atingir até 6,8 casos por 100.000 homens, principalmente na região norte/nordeste, onde o índice de desenvolvimento humano é o pior do país. Seu diagnóstico ocorre geralmente de forma tardia, retardando o tratamento e piorando o prognóstico. As células Th1 atuam na imunidade celular e expressam fatores de transcrição como transdutor de sinal e ativador de transcrição 1 (STAT1) e 4 (STAT4). Os fatores STAT1 e STAT4 estão relacionados a diversas funções do sistema imune e na oncogênese, além de promover o início do processo de diferenciação das células T "naive" em T efetoras do tipo Th1. A desregulação da via JAK/STAT está associada com a formação de tumores primários, assim como com a supressão da resposta imune, o que leva ao aumento da sobrevivência tumoral e da angiogênese. Objetivo: O objetivo geral deste estudo foi avaliar a expressão de STAT1, STAT4 e T-bet nos linfócitos T circulantes pacientes com carcinoma escamoso de pênis. Métodos: Foi realizado um estudo de corte transversal, com 30 pacientes com CaPe atendidos no ambulatório de Urologia do Hospital de Câncer de Pernambuco e 15 controles saudáveis do sexo masculino. As análises laboratoriais foram realizadas no Laboratório de Pesquisa Translacional do IMIP. A análise da expressão de STAT1, STAT4 e T-bet foi realizada por citometria de fluxo. Para análise estatística das variáveis numéricas foi aplicado o teste de normalidade de Shapiro-Wilk. Foi utilizado teste não paramétricos de Mann-Whitney e o de correlação de Spearman. Foi adotado o nível de significância estatística de p<0.05. Para análise de correlação foi realizado o teste de Spearman. Toda a análise estatística foi realizada através do GraphPadPrism v6.0 (GraphPad Software, San Diego, CA). Resultados: Foi observado redução dos níveis percentuais de linfócitos B no sangue periférico de pacientes com CaPe quando comparados aos controles (p=0.0002). Os níveis percentuais de linfócitos T com expressão de STAT1 e STAT4 foram elevados (p=0,004 e p=0,008, respectivamente) em comparação ao grupo controle. Os níveis de linfócitos T com expressão de T-bet nos pacientes foram inferiores quando comparados aos dos controles (p=0,02). Observou-se que pacientes com tamanho tumoral <3,5cm apresentaram níveis percentuais elevados de células T CD8+ quando comparados aos com tamanho ≥3,5 cm (p= 0,04). Verificou-se que os pacientes com IPN negativa obtiveram níveis percentuais elevados de linfócitos T CD8+ (p=0,04) e de linfócitos T com expressão de STAT1, STAT4 e T-bet quando comparados aos pacientes IPN positiva (p=0,0004, p=0,02 e p=0,0001, respectivamente). Foi observada também a correlação entre T-bet e STAT4 nos pacientes com CaPe (r=0,58; p=0.002). Conclusão: Os fatores de transcrição STAT1, STAT4 e T-bet estão associados a doença avançada, e podem estar diretamente relacionados as alterações dos níveis de linfócitos B e TCD8+ nos pacientes com câncer de pênis

Introduction: Penile cancer (CaPe) is a rare disease in developed countries, but it represents a public health problem in developing countries. Brazil has the highest incidence of CaPe in the world, reaching up to 6.8 cases per 100,000 men, mainly in the north / northeast region, where the human development index is the worst in the country. Its diagnosis usually occurs late, delaying treatment and worsening the prognosis. Th1 cells act on cellular immunity and express transcription factors such as signal transducer and transcription activator 1 (STAT1) and 4 (STAT4). The factors STAT1 and STAT4 are related to several functions of the immune system and oncogenesis, in addition to promoting the differentiation of "naive" T cells into effector T-type Th1 cells. Deregulation of the JAK / STAT pathway is associated with the formation of primary tumors, as well as with the suppression of the immune response, which leads to increased tumor survival and angiogenesis. Objective: The general objective of this study was to evaluate the expression of STAT1, STAT4 and T-bet in circulating T lymphocytes in patients with squamous carcinoma of the penis. Methods: A cross-sectional study was carried out with 30 CaPe patients seen at the Urology outpatient clinic of the Hospital de Câncer de Pernambuco and 15 healthy male controls. Laboratory analyzes were performed at the Translational Research Laboratory at IMIP. The analysis of the expression of STAT1, STAT4 and T-bet was performed by flow cytometry. For statistical analysis of numerical variables, the Shapiro-Wilk normality test was applied. Mann-Whitney non-parametric tests and Spearman's correlation tests were used. The level of statistical significance was set at p <0.05. For correlation analysis, the Spearman test was performed. All statistical analysis was performed using GraphPadPrism v6.0 (GraphPad Software, San Diego, CA). Results: A reduction in the percentage levels of B lymphocytes in the peripheral blood of patients with CaPe was observed when compared to controls (p = 0.0002). The percentage levels of T lymphocytes with STAT1 and STAT4 expression were high (p = 0.004 and p = 0.008, respectively) compared to the control group. The levels of T lymphocytes with T-bet expression in patients were lower when compared to controls (p = 0.02). It was observed that patients with tumor size <3.5 cm had high percentage levels of CD8 + T cells when compared to those with size ≥3.5 cm (p = 0.04). It was found that patients with negative IPN obtained high percentage levels of CD8 + T lymphocytes (p = 0.04) and T lymphocytes with expression of STAT1, STAT4 and T-bet when compared to patients with positive IPN (p=0.0004, p = 0.02 and p = 0.0001, respectively). The correlation between T-bet and STAT4 was also observed in patients with CaPe (r = 0.58; p = 0.002). Conclusion: The transcription factors STAT1, STAT4 and T-bet are associated with advanced disease and may be directly related to changes in the levels of B lymphocytes and TCD8 + in patients with penile cancer

Artificial Corn-Based Diet for Rearing Spodoptera frugiperda (Lepidoptera: Noctuidae).

Spodoptera frugiperda (J.E. Smith, 1797) is considered a key pest of maize. However, the artificial diets used for rearing this insect in the laboratory do not contain corn. The aim of this study was to evaluate the biology and to compare the food consumption by S. frugiperda, as well as the food preference of the larvae in the standard diet and the corn-based diet. Three of the following diets were evaluated: a standard diet based on beans (D1), a diet with corn flour as substitute for wheat germ (D2), and a diet replacing beans with green corn (D3). The biological parameters evaluated were period and survival of larvae and pupae; weight of male and female pupae; sex ratio; fecundity; egg incubation period; and adult longevity. The nutritional indices were determined and the biological data obtained were used to determine the parameters of fertility life tables; we also performed a multiple-choice test (feeding test). Larval development of S. frugiperda occurred in all three diets, although without oviposition by females developed from larval fed on D2. There was no difference among the diets in relation to the fertility life table parameters. The diet D2 resulted in better ingestion, digestion, assimilation, and conversion of food, but was associated with a metabolic cost to assimilate the food. Using a multiple-choice test, we observed that the larvae preferred diet D2. Based on our results, the most adequate diets for rearing S. frugiperda in the laboratory are D1 and D3.

Second molar intrusion: Continuous arch or loop mechanics?

INTRODUCTION: Our aim was to compare the load systems produced by rectangular loops and continuous arch mechanics on intrusion of a maxillary second molar. METHODS: An orthodontic appliance was passively bonded from second molar to second molar on a patient's model fixed to an orthodontic force tester. The second molars were extruded by 3 mm, and 2 mechanics systems were compared: beta-titanium rectangular loops and super-elastic nickel-titanium continuous arch. Vertical (Fz) and mesial (Fy) forces, and tipping moments around the buccal axis (Mx) at the tubes were collected at every 0.5 mm of deactivation. Repeated measures analysis of variance was used to detect differences between mechanics. The net Mx was also estimated at the center of resistance of each molar. RESULTS: Significant differences were found between the mechanics at the tubes, except for the Mx in the first molar, and more importantly, at the centers of resistance of the molars: Fz forces were greater in the continuous arch than in the rectangular loops, which, on the other hand, produced lower Fy forces than the continuous arch. In the second molar, net Mx was low initially and changed with deactivation. In the continuous arch, net Mx decreased from -3.6 N.mm of mesial crown tipping to clinically insignificant levels after 2 mm of deactivation. In the first molar, net Mx was lower on the rectangular loop than on the continuous arch during the first 2 mm of deactivation and became similar in the last millimeter of deactivation. Additionally, the net Mx decreased with deactivation with both mechanics. CONCLUSIONS: Both mechanics can intrude the second molars. Although the rectangular loop produced less tipping in large deflections, the continuous arch was a better approach when less intrusion was required.

Evaluation of the load system produced by a single intrusion bend in a maxillary lateral incisor bracket with different alloys.

OBJECTIVES: To evaluate if a 0.5-mm vertical bend applied on an incisor bracket produces movements in other planes and if different wires influence these effects. MATERIALS AND METHODS: An acrylic model of a treated patient with brackets passively bonded was attached to an Orthodontic Force Tester, and a load cell was attached to the left lateral incisor. Thirty 0.019 × 0.025-inch archwires were divided into three groups according to their alloy: SS (stainless steel), B-Ti (beta-titanium), and MF (beta-titanium wire coated with nickel-titanium). Step-bends of 0.5 mm high were placed on the lateral incisor bracket using a universal plier, and the forces and moments in three dimensions were statistically analyzed by analysis of variance and Tukey post hoc test. RESULTS: SS produced a larger force (3.4 N) than the B-Ti (1.41 N) and the MF (0.53 N; P < .001). Lingual forces were produced by the SS (0.82 N) and B-Ti (0.31 N) groups, while in the MF group, the force was insignificant. SS produced a mesial force of 0.24 N, while the B-Ti force was insignificant and MF produced 0.09 N. Groups produced different crown-distal tipping moments (SS = 31.48 N-mm, B-Ti = 11.7 N-mm, and MF = 4.55 N-mm) and different crown-buccal tipping moments. SS produced larger moments (3.63 N-mm) than B-Ti (1.02 N-mm) and MF (0.36 N-mm) wires. A mesial-out rotational moment was observed in all groups (SS = 7.17 N-mm, B-Ti = 3.46 N-mm, and MF = 0.86 N-mm). CONCLUSIONS: A 0.5-mm intrusion bend produced lingual and mesial side effects. In addition to the distal and buccal crown-tipping moments, there was a mesial-out moment. Compared with SS, B-Ti and MF wires produced lower forces. These more flexible wires showed side effects with lesser intensity.

Continuous arch and rectangular loops for the correction of consistent and inconsistent load systems in extruded and tipped maxillary second molars.

INTRODUCTION: The aim of this research was to compare the load systems produced by rectangular loops and continuous arches for the correction of extruded second molars with a mesial inclination (inconsistent system) and a distal inclination (consistent system). METHODS: The maxillary first molar of an acrylic model of a patient, with passive brackets and tubes bonded, was connected to a 3-dimensional load cell of an orthodontic force tester, and the second molar was replaced by its respective tube bonded to a second load cell. The second molar tube was moved 2.5 mm occlusally and tipped 20° mesially and distally, creating an inconsistent force system and a consistent force system. For each situation, ten 0.017 × 0.025-in beta-titanium, 8 × 10-mm rectangular loops were compared with 10 0.014-in nickel-titanium continuous arches. The vertical forces-F(z)-and tipping moments-M(x)-were compared using 4 t tests, at 5%. RESULTS: In the inconsistent group, the rectangular loop produced a larger M(x) in both molars: 2.11 N.mm in the second molar compared with the -0.15 N.mm of the continuous arches. On the first molar, the rectangular loops produced -5.58 N.mm against -2.08 N.mm produced by the continuous arches. The F(z) values produced at the second molar with each system were similar, whereas on the first molar they were different; the rectangular loops produced 0.41N, and continuous arches produced 0.53N. In the consistent group, the rectangular loops produced smaller M(x) values at the second molar (-3.06 N.mm) than did the continuous arch (-4.25 N.mm) (P = 0.01), as well as a smaller F(z) value (-0.52 vs -0.92 N, respectively). At the first molar, the rectangular loops produced smaller M(x) values (-2.32 N.mm) than did the continuous arch (-4.18 N.mm), as well as a smaller F(z) value (0.59 vs 1.10 N). CONCLUSIONS: In the inconsistent group, only the rectangular loop produced a system of force that could correct the second molar. In the consistent system, both group mechanics produced a system of force compatible with the correction of the second molar, but the continuous wire produced larger moments. Both groups showed a tendency for mesial crown tipping of the first molar.

Postural control analysis during a standardized kick task in soccer athletes / Análise do controle postural durante tarefa controlada do chute em atletas de futebol / Análisis del control postural durante tarea controlada del tiro en atletas de fútbol

ABSTRACT Introduction: Postural control is a determining factor for functional performance and motor skills during sports activities. Objective: The objective of this study was to investigate postural control during the controlled soccer ball kicking task through a biomechanical analysis system. Methods: The sample consisted of 11 professional male athletes recruited using convenience sampling, with a mean age of 22 years. The athletes performed twenty-five precision kicks at a target, with the ball in vertical motion released by means of a hand-held device synchronized with the computed biomechanical measurements. Marking of the lower limb segments involved in the kick and the ball were analyzed by accelerometry, while postural control measures were quantified by a force platform in three axes of movement. The support leg was investigated in single leg stance during all tests on the force platform. The main variables of postural control calculated by stabilographic analysis and computed during the 25 kicks were: center of pressure (COP) displacement area, velocity and frequency of COP oscillation in the anteroposterior and mediolateral directions. The mean was used for final analysis to determine the differences in the three phases: pre-kick, kick, and post-kick. Results: The results revealed significant differences (p <0.01) between the three phases, with the kick phase presenting higher values of postural COP oscillations than the other phases. The COP area and oscillation velocity were the variables with greatest sensitivity to changes in the kick phase, obtaining an effect size of d = 14 and d = 12, respectively. In clinical terms, the increase in COP values reached 557% between the pre-kick and kick phases; this difference was reduced to 241% when compared to post-kick (i.e., difference between kick and post-kick was 316%). Conclusion . These results have important implications for the perception of postural control responses during soccer ball kicks and consequently, for injury prevention when motor and sensory deficits are diagnosed in soccer players. Level of Evidence III; Study of nonconsecutive patients; without consistently applied reference ''gold'' standard.

RESUMO Introdução: O controle postural é um fator determinante para execução de gestos funcionais e desempenho motor durante as atividades esportivas. Objetivo: O objetivo deste estudo foi de investigar o controle postural durante a tarefa controlada do chute futebolístico por meio de um sistema de análise biomecânica. Métodos: A amostra foi constituída por 11 atletas profissionais do sexo masculino, recrutados por amostragem por conveniência, com média de idade de 22 anos. Os atletas realizaram vinte e cinco chutes de precisão em direção ao alvo, com a bola em movimento vertical lançada por meio de um dispositivo manual sincronizado com as medidas biomecânicas computadas. A marcação dos segmentos de membro inferior envolvidos no chute e a bola foram analisadas por meio da acelerometria, enquanto as medidas de controle postural foram quantificadas por meio de uma plataforma de força em três eixos do movimento. A perna de apoio foi investigada em apoio unipodal durante todos os testes sobre a plataforma de força. As principais variáveis de controle postural calculadas por uma análise estabilográfica e computadas durante os 25 chutes foram área de deslocamento do centro de pressão (COP), velocidade e frequência de oscilação do COP na direção anteroposterior e médio-lateral. A média foi utilizada para análise final para determinar as diferenças nas três fases: pré-chute, chute e pós-chute. Resultados: Os resultados revelaram diferenças significantes (p < 0,01) entre as três fases, sendo que a fase do chute apresentou valores maiores de oscilações posturais do COP do que as demais fases. A área e a velocidade de oscilação do COP foram as variáveis com maior sensibilidade às mudanças na fase do chute, obtendo magnitude de efeito em d = 14 e d = 12, respectivamente. Clinicamente, o aumento foi de 557% entre as fases pré-chute e chute; essa diferença foi reduzida para 241% na comparação com o pós-chute (ou seja, a diferença entre chute e pós-chute foi de 316%). Conclusões: Esses resultados têm implicações importantes para o reconhecimento das respostas de controle postural durante o chute futebolístico e, consequentemente, para prevenção de lesões quando déficits sensório-motores são diagnosticados em atletas de futebol. Nível de Evidência III; Estudo de pacientes não consecutivos; sem padrão de referência "ouro" aplicado uniformemente.

RESUMEN Introducción . El control postural es un factor determinante para la ejecución de gestos funcionales y desempeño motor durante las actividades deportivas. Objetivo: El objetivo de este estudio fue investigar el control postural durante la tarea controlada del tiro futbolístico por medio de un sistema de análisis biomecánico. Métodos: La muestra fue constituida por 11 atletas profesionales del sexo masculino reclutados por muestreo por conveniencia y con promedio de edad de 22 años. Los atletas realizaron veinticinco disparos de precisión en dirección al objetivo, con la pelota en movimiento vertical lanzada por medio de un dispositivo manual sincronizado con las medidas biomecánicas computadas. La marcación de los segmentos de la extremidad inferior involucrados en el tiro y la pelota fueron analizadas mediante acelerometría, mientras que las medidas de control postural fueron cuantificadas por medio de una plataforma de fuerza en tres ejes del movimiento. La pierna de apoyo fue investigada en apoyo unipodal durante todas las pruebas sobre la plataforma de fuerza. Las principales variables de control postural calculadas por un análisis estabilográfico y computadas durante los 25 disparos fueron área de desplazamiento del centro de presión (COP), velocidad y frecuencia de oscilación del COP en la dirección anteroposterior y medio-lateral. El promedio fue utilizado para análisis final para determinar las diferencias en las tres fases: pre-disparo, disparo, y post-disparo. Resultados: Los resultados revelaron diferencias significativas (p < 0,01) entre las tres fases, siendo que la fase del disparo presentó valores mayores de oscilaciones posturales del COP que las demás fases. El área y la velocidad de oscilación del COP fueron las variables con mayor sensibilidad a los cambios en la fase del disparo, obteniendo magnitud de efecto en d = 14 y d = 12, respectivamente. Clínicamente, el aumento fue del 557% entre las fases pre-disparo y disparo; esta diferencia se redujo al 241% en comparación con la fase post-disparo (es decir, la diferencia entre disparo y post-disparo fue de 316%). Conclusiones: Estos resultados tienen implicaciones importantes para el reconocimiento de las respuestas de control postural durante el tiro futbolístico y consecuentemente, para prevención de lesiones cuando se diagnostica déficit sensorio-motor en atletas de fútbol. Nivel de Evidencia III; Estudio de pacientes no consecutivos; sin patrón de referencia "oro" aplicado uniformemente.

ICD-10 impact on ascertainment and accuracy of oral cleft cases as recorded by the Brazilian national live birth information system.

We compared Brazilian oral cleft (OC) frequencies between the population-based Brazilian System of Live Birth (SINASC) and the hospital-based Latin American Collaborative Study of Congenital Malformations (ECLAMC), trying to understand the paucity of cleft of lip and palate (CLP) in the first system. SINASC uses the International Classification of Disease version 10 (ICD-10) for congenital defects coding, ECLAMC uses ICD-8 with modifications. In SINASC, the CLP frequency was 1.7 per 10,000 (95% confidence limits 1.7-1.8), cleft lip (CL) 1.6 (1.5-1.7), and cleft palate (CP) 2.0 (1.9-2.1). In ECLAMC, the CLP frequency was 10.4 per 10,000 (9.0-12.1), CL 5.5 (4.5-6.7), and CP 4.4. (4.5-6.7). In SINASC, only 33% of the oral clefts were CLP, versus 51% in ECLAMC. Part of this discrepancy may have been due to the relative excess of CP and CL cases. Although congenital defect frequencies are usually lower in population than in hospital-based registries, differences in the proportion of the main OC categories are not expected and are probably due to ICD-10 coding issues, such as lumping of unilateral CL and CL without other specifications. ICD-10 codes, whose deficiency for oral clefts is fully explained in the literature, lack modifiers for severity, or clinical subtypes. This paper shows the practical aspect of the ICD-10 system deficiency in capturing cleft lip and palate (CLP) subtypes, as demonstrated in SINASC covering three million births per year. Such errors are expected to occur in any registry that uses the ICD-10 coding system, and must be adjusted, given its relevance worldwide.

Anterior Cervical Osteophyte Presenting as a Pharyngeal Mass / Osteofito cervical anterior que se presenta como una masa faríngea

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Cell-Free DNA and Circulating Tumor Cells: Comprehensive Liquid Biopsy Analysis in Advanced Breast Cancer.

Purpose: Liquid biopsy provides a real-time assessment of metastatic breast cancer (MBC). We evaluated the utility of combining circulating tumor cells (CTC) and circulating tumor DNA (ctDNA) to predict prognosis in MBC.Experimental Design: We conducted a retrospective study of 91 patients with locally advanced breast cancer and MBC. CTCs were enumerated by CellSearch; the plasma-based assay was performed utilizing Guardant360 and the survival analysis using Kaplan-Meier curves.Results: Eighty-four patients had stage IV cancer, and 7 patients had no metastases. Eighty patients had CTC analysis: median number 2 (0-5,612). Blood samples [232 of 277 (84%)] had mutations. The average ctDNA fraction was 4.5% (0-88.2%) and number of alterations 3 (0-27); the most commonly mutated genes were TP53 (52%), PIK3CA (40%), and ERBB2 (20%). At the time of analysis, 36 patients (39.6%) were dead. The median follow-up for CTCs was 9 months; for ctDNA, it was 9.9 months. For CTCs and ctDNA, respectively, progression-free survival (PFS) was 4.2 and 5.2 months and overall survival (OS) was 18.7 and 21.5 months. There was a statistically significant difference in PFS and OS for baseline CTCs < 5 versus CTCs ≥ 5 (P = 0.021 and P = 0.0004, respectively); %ctDNA < 0.5 versus ≥ 0.5 (P = 0.003 and P = 0.012); number of alterations < 2 versus ≥ 2 (P = 0.059 borderline and P = 0.0015). A significant association by Fisher exact test was found between the number of alterations and the %ctDNA in the baseline sample (P < 0.0001).Conclusions: The study demonstrated that liquid biopsy is an effective prognostic tool. Clin Cancer Res; 24(3); 560-8. ©2017 AACR.

Shear bond strength of three different bonding systems for orthodontic brackets

Aim: The objective of this study was to compare the efficiencies of different adhesive systems used to bond orthodontic brackets as well as the fracture pattern during debonding on bovine teeth. Methods: The sample included 45 specimens assigned to 3 groups according to the adhesive system applied: Group I: Transbond XT (3M Unitek®, Monrovia/CA -USA), Group II: Orthocem (FGM® Joinville/SC-BR), and Group III: Orthobond (Morelli®, Sorocaba/SP-BR). For this purpose, metal brackets were bonded to bovine teeth following the instructions from each manufacturer. The specimens were subjected to a shear test to assess bond strength (BS). Finally, after debonding, the adhesive remnant index (ARI) was estimated. Results: The average shear strength for a tooth bonded using the adhesive system Transbond XT was 16.39 MPa, while it was 18.08 Mpa for Orthocem and 7.28 Mpa for Orthobond; The Tukey test revealed no statistically significant differences between groups I and II (p < 0.01) and group III differed statistically from groups I and II. Conclusion: In conclusion, both adhesive systems Transbond XT and Orthocem attained higher bond strength values than Orthobond; the fracture pattern was similar for all adhesive systems applied

Relationship between blast severity on seedlings and panicles of Brazilian oat cultivars / Relação entre a severidade de brusone em plântulas e panículas de cultivares brasileiras de aveia

ABSTRACT: Blast, caused by Pyricularia oryzae, threats black (Avena strigosa) and white (A. sativa) oats in Brazil. Little is known about the reaction of Brazilian oat cultivars to blast and if there is a relationship between the response of cultivars to the disease at seedling and adult plant stages. The goals of this research were to verify (a) the reaction of black and white Brazilian oat cultivars to infection of P. oryzae and (b) if the response to blast on seedling leaves and panicles was correlated. Seedlings and adult plants of 13 oat cultivars were inoculated with a conidial suspension of one P. oryzae isolate obtained from a black oat cultivar. The cultivars were classified according to blast severity on the leaf seedlings and panicles estimated by visual estimation. Two experiments were conducted for each one of the two evaluated stages. Cultivars with lower value to blast severity on seedling leaves were 'UPFA Gaudéria' (25.82%) and 'UPF 18' (24.88%) and, on panicles, 'BRS Centauro' (31.63%). Coefficients of Pearson, Spearman, and Kendall obtained from correlation analyses between blast severity on seedling leaves and panicles were -0.21232, -0.35714, and -0.30769, respectively (non-significant at 0.05). Lack of correlation between the responses of these oat cultivars to blast on seedling leaves and panicles be considered in the management of the disease in the field and the generation of new oat cultivars.

RESUMO: A brusone, causada por Pyricularia oryzae, ameaça as culturas da aveia preta (Avena strigosa) e branca (A. sativa) no Brasil. Sabe-se pouco sobre a reação das cultivares brasileiras de aveia à brusone e se existe relação entre a resposta destas cultivares à doença nos estádios de plântula e de planta adulta. Os objetivos deste trabalho foram: (a) verificar a reação de cultivares brasileiras de aveia à infecção de P. oryzae e; (b) se existe relação entre a resposta à brusone dessas cultivares nos estádios de plântula e de planta adulta. Plântulas e plantas adultas de 13 cultivares de aveia foram inoculadas com uma suspensão de conídios de um isolado de P. oryzae obtido de uma planta de uma cultivar de aveia preta. As cultivares foram classificadas de acordo com a estimativa visual da severidade da doença nas folhas das plântulas e nas panículas das plantas adultas. Dois experimentos foram conduzidos para cada um dos estádios avaliados. As cultivares com menor severidade de brusone nas plântulas foram a 'Gaudéria UPFA' (25,82%) e a 'UPF 18' (24,88%) e, nas panículas, foi a 'BRS Centauro' (31,63%). Os coeficientes de Pearson, Spearman e Kendall obtidos da análise de correlação entre os dois estádios avaliados foram -0,21232, -0,35714 e -0,30769, respectivamente (todos sem significância estatística à 0,05). A falta de correlação entre as respostas das cultivares de aveia à brusone, em plântulas e panículas, constitui-se em informação a ser considerada no manejo da doença, no campo e na geração de novas cultivares de aveia.

A comprehensive review of heregulins, HER3, and HER4 as potential therapeutic targets in cancer.

Heregulins (HRGs) bind to the receptors HER3 or HER4, induce receptor dimerization, and trigger downstream signaling that leads to tumor progression and resistance to targeted therapies. Increased expression of HRGs has been associated with worse clinical prognosis; therefore, attempts to block HRG-dependent tumor growth have been pursued. This manuscript summarizes the function and signaling of HRGs and review the preclinical evidence of its involvement in carcinogenesis, prognosis, and treatment resistance in several malignancies such as colorectal cancer, non-small cell lung cancer, ovarian cancer, and breast cancer. Agents in preclinical development and clinical trials of novel therapeutics targeting HRG-dependent signaling are also discussed, including anti-HER3 and -HER4 antibodies, anti-metalloproteinase agents, and HRG fusion proteins. Although several trials have indicated an acceptable safety profile, translating preclinical findings into clinical practice remains a challenge in this field, possibly due to the complexity of downstream signaling and patterns of HRG, HER3 and HER4 expression in different cancer subtypes. Improving patient selection through biomarkers and understanding the resistance mechanisms may translate into significant clinical benefits in the near future.