Medical school origins of award-winning surgeons; analysis of a complete national dataset.

BACKGROUND: Britain attracts doctors from all over the world to work in the National Health Service. Elucidating the educational backgrounds of award-winning doctors working in the country is potentially an important medical education issue and merit award audit. Using the British clinical merit award schemes as outcome measures, we identify medical school origins of award-winning doctors who have been identified as having achieved national or international prominence. METHODS: The Clinical Excellence Awards/Distinction Awards schemes select doctors in Britain who are classified as high achievers, with categories for national prominence and above. We used this outcome measure in a quantitative observational analysis of the 2019 dataset of all 901 award-winning doctors. Pearson's Chi-Square test was used where appropriate. RESULTS: Seven medical schools (London university medical schools, Glasgow, Edinburgh, Aberdeen, Oxford, Cambridge and Manchester) accounted for 52.7% of the surgical award-winning doctors in the 2019 round, despite the dataset representing 85 medical schools. Surgeons with the lower grade national awards came from a more diverse educational background of 43 medical schools. International medical graduates accounted for 16.1% of the award-winning surgeons and 9.8% of the award-winning non-surgeons. 87.1% of the surgical award-winners were from European medical schools, whereas 93.2% of the non-surgical award-winners were from European medical schools. CONCLUSIONS: The majority of the award-winning surgeons originated from only seven, overrepresented, medical schools. A greater diversity of medical school origin existed for the lowest grade national merit awards. These comprised 43 medical schools and indicated greater globalization effects in this category. International medical graduates contributed substantially to these award holders; surgical award-winners were more likely to be international medical graduates (16.1%) than non-surgical award-winners (9.8%). This study not only indicates educational centres associated with the production of award-winners but also provides students with a roadmap for rational decision making when selecting medical schools.

A national analysis of the medical schools of training for merit award-winning laboratory medical doctors working in Britain.

AIMS: To inform the discussion regarding the origins of Laboratory Medical Consultant clinical merit award holders (LMC) whether the awards came from the Clinical Excellence Awards (CEA) or Distinction Awards (DA) schemes. METHODS: Setting - CEA is a scheme to financially reward senior doctors in England and Wales who are assessed to be working over and above the standard expected of their role. The DA scheme is the parallel and equivalent scheme in Scotland. Participants - All of the merit award holders in the 2019 round. Design - This involved a secondary analysis of the complete 2019 published dataset of award winners. Statistical analyses were performed with Chi-square tests set at p < 0.05 level for statistical significance. RESULTS: The top five medical schools (London University, Glasgow, Edinburgh, Aberdeen and Oxford) were responsible for 68.4% of the LMC merit award holders in the 2019 round. 97.9% of the LMC merit award holders were from European medical schools, whereas 90.9% of the non-LMC award holders were from European medical schools. The LMCs with A plus or platinum awards came from only six medical schools: Aberdeen, Edinburgh, London University, Oxford, Sheffield and Southampton. In contrast, the B or silver/bronze LMC award holders came from a more diverse background of 13 medical schools. CONCLUSIONS: The majority of LMC merit award holders originated from only five university medical schools. All the LMCs with A plus or platinum awards came from only six university medical schools. There is an apparent overrepresentation of a small number of medical schools of origin amongst those LMCs that hold national merit awards.

Impact of Deep Margin Elevation Procedures Upon Periodontal Parameters: A Systematic Review.

INTRODUCTION: Deep margin elevation (DME) is an emerging technique attempting to minimize the need for surgical procedures (i.e., crown lengthening [CL]), deliver indirect restorations in one clinical session and reduce overall treatment time. The present study evaluated the impact of DME upon periodontal measurements based exclusively on human studies. METHODS: A literature search was performed by two independent reviewers in several databases including PubMed, EMBASE, and Cochrane Central up to March 2022. This review searched for randomized human trials, cohort (prospective/ retrospective) and/or case series studies using DME, reporting periodontal (i.e. marginal bone levels [MBL], probing depths [PD], bleeding on probing [BoP], recession [REC], clinical attachment level [CAL]), and the type of approach (non-surgical or surgical) with at least ⟩3 months of post-operative outcomes. RESULTS: None of the included studies reported MBL, REC or CAL, and thus, results were limited to PD and BoP. BoP was increased when the distance between restorative margin and alveolar bone was approximately ⟨2mm. Non-surgical and surgical DME approaches led to different outcomes in PD (0.26±0.77mm vs -0.39±0.85mm) and BoP (31.50% vs -22.33%). CONCLUSIONS: Limited findings of the present systematic review can be drawn and thus, the impact of DME upon the periodontium remains inconclusive.

Parasitism rate of Plutella xylostella (Lepidoptera: Plutellidae) larvae in greenhouse by Tetrastichus howardi (Hymenoptera: Eulophidae) females at different densities.

Parasitoids control insect pests, but their number per host affects their efficiency. The objective of this work was to evaluate the best density of Tetrastichus howardi (Olliff, 1893) (Hymenoptera: Eulophidae) individuals parasitizing fourth instar Plutella xylostella (Linnaeus, 1758) (Lepidoptera: Plutellidae) larvae in greenhouse conditions. These larvae were exposed to parasitism by T. howardi females with 1:1, 3:1, 6:1, 9:1, 12:1, 15:1 and 18:1 parasitoid/host ratios with 10 replications during 96 hours. After this period the larvae were kept on host plants (Brassica oleracea) until pupa formation. Tetrastichus howardi parasitized and reproduced in P. xylostella larvae at all its densities tested, but with higher values, 84% and 10 ± 2.4 individuals, respectively, with 9:1 parasitoids/host. Nine T. howardi females per P. xylostella larvae are the adequate number to manage this insect pest.

Prolonged heart rate recovery time after 6-minute walk test is an independent risk factor for cardiac events in heart failure: a prospective cohort study

OBJECTIVES: To determine whether the time for peak exercise heart rate to return to resting heart rate after the 6-minute walk test (6MWT) can predict cardiac events in patients with heart failure (HF) within 2 years. DESIGN: Prospective cohort study. SETTING: HF outpatient facility at a tertiary teaching hospital. PARTICIPANTS: Seventy-six patients with HF, New York Heart Association functional classification II and III, and left ventricular ejection fraction <50% MAIN OUTCOME MEASURES: Patients used a heart rate monitor to measure the time for peak exercise heart rate to return to resting heart rate after the 6MWT. Data were analysed using Polar Pro-Trainer 5 software (Kempele, Finland). Patients were followed for >2 years for cardiac events (hospitalisations and death). RESULTS: Thirty-four patients had cardiac events during the 2-year follow-up period. There was a significant difference in time to return to resting heart rate between the groups with and without cardiac events {with 3.6 [standard deviation (SD) A] vs without 2.8 (SD B) minutes; mean difference C; 95% confidence interval (CI) of the difference D to E; P=0.003}. No significant differences between patients with and without cardiac events were found for mean walking distance, mean heart rate recovery at 1 minute and mean heart rate recovery at 2 minutes. The receiver operating curve discriminated between patients with and without cardiac events (área under the curve 0.71, 95% CI 0.61 to 0.81; P< 0.001). Using logistic regression analysis, prolonged time to return to resting heart rate (≥3 minutes) independently increased the risk for cardiac events 6.9-fold (95% CI 2.34 to 20.12; P< 0.001). The Kaplan­Meier curve showed more cardiac events in patients with prolonged time to return to resting heart rate (P=0.028). CONCLUSIONS: Prolonged time to return to resting heart rate (≥3 minutes) after the 6MWT was an independent predictor of cardiac events in patients with HF.

Prolonged heart rate recovery time after 6-minute walk test is an independent risk factor for cardiac events in heart failure: A prospective cohort study.

OBJECTIVES: To determine whether the time for peak exercise heart rate to return to resting heart rate after the 6-minute walk test (6MWT) can predict cardiac events in patients with heart failure (HF) within 2 years. DESIGN: Prospective cohort study. SETTING: HF outpatient facility at a tertiary teaching hospital. PARTICIPANTS: Seventy-six patients with HF, New York Heart Association functional classification II and III, and left ventricular ejection fraction <50%. MAIN OUTCOME MEASURES: Patients used a heart rate monitor to measure the time for peak exercise heart rate to return to resting heart rate after the 6MWT. Data were analysed using Polar Pro-Trainer 5 software (Kempele, Finland). Patients were followed for >2 years for cardiac events (hospitalisations and death). RESULTS: Thirty-four patients had cardiac events during the 2-year follow-up period. However, there was a significant difference in the time to return to resting heart rate between the groups with and without cardiac events {with 3.6 (SD 1.1) vs without 2.8 (SD 1.1) minutes; mean difference of 0.79 (95% confidence interval (CI) of the difference 0.28 to 1.28; P=0.003}. No significant differences between patients with and without cardiac events were found for mean walking distance, mean heart rate recovery at 1minute and mean heart rate recovery at 2minutes. The receiver operating curve discriminated between patients with and without cardiac events (área under the curve 0.71, 95% CI 0.61 to 0.81; P<0.001). Using logistic regression analysis, prolonged time to return to resting heart rate (≥3minutes) independently increased the risk for cardiac events 6.9-fold (95% CI 2.34 to 20.12; P<0.001). The Kaplan-Meier curve showed more cardiac events in patients with prolonged time to return to resting heart rate (P=0.028). CONCLUSIONS: Prolonged time to return to resting heart rate (≥3minutes) after the 6MWT was an independent predictor of cardiac events in patients with HF.

Predictive demographic factors of Covid-19 vaccine hesitancy in Venezuela: A cross-sectional study.

Objective: To assess if seven demographic variables (age, gender, religion, ethnicity, income, educational level, and political views) are predictive of Covid-19 vaccine hesitancy. Material and methods: 327 participants completed a survey asking questions regarding each of the variables. Results: Age, gender and political views have no statistically significant correlation with vaccine hesitancy. Ethnicity and religion are predictive of vaccine hesitancy. Income has a weak negative correlation with Covid-19 vaccine hesitancy, and educational level has a moderate negative correlation with Covid-19 vaccine hesitancy. Conclusion: In order to curb Covid-19 vaccine hesitancy, public health authorities in Venezuela need to focus efforts on marginalized ethnic groups, Protestants, and those with lower levels of education.

Objetivo: Evaluar si 7 variables demográficas (edad, género, religión, origen étnico, ingresos, nivel educativo y opiniones políticas) son predictivas del rechazo a la vacuna del Covid-19. Material y métodos: Trescientos veintisiete participantes completaron una encuesta con preguntas sobre cada una de las variables. Resultados: La edad, el género y las opiniones políticas no tienen una correlación estadísticamente significativa con el rechazo a la vacuna. El origen étnico y la religión predicen el rechazo a las vacunas. Los ingresos tienen una correlación negativa débil con el rechazo de la vacuna Covid-19, y el nivel educativo tiene una correlación negativa moderada con el rechazo de la vacuna Covid-19. Conclusión: Para frenar el rechazo a la vacuna del Covid-19, las autoridades de salud pública en Venezuela deben concentrar sus esfuerzos en los grupos étnicos marginados, los protestantes y aquellos con niveles más bajos de educación.

Hematological and biochemical profile of captive brown-throated sloths Bradypus variegatus, Schinz 1825, feeding on ambay pumpwood Cecropia pachystachya Trécul 1847 / [Perfil hematológico e bioquímico da preguiça-de-garganta-marrom Bradypus variegatus, Schinz 1825, em cativeiro alimentando-se de embaúba Cecropia pachystachya Trécul 1847]

The aim of this study was to establish reference parameters for the hematological and biochemical levels of five healthy captive sloths of the speciesBradypus variegatus(brown-throated sloth) feeding onCecropia pachystachya(Ambay pumpwood), alternating with a period of free diet in the Dois Irmãos State Park (DISP) Recife, Pernambuco - Brazil.(AU)

O objetivo da presente pesquisa foi estabelecer parâmetros de referência para níveis hematológicos e bioquímicos, de cinco preguiças sadias, da espécie Bradypus variegatus (preguiça-de-garganta-marrom), em cativeiro, alimentando-se de Cecropia pachystachya (embaúba) em períodos alternados com dieta livre, no Parque Estadual de Dois Irmãos (PEDI) Recife, Pernambuco-Brasil.(AU)

Chondroitin sulfate from fish waste exhibits strong intracellular antioxidant potential.

Chondroitin sulfate (CS) is a type of glycosaminoglycan described as an antioxidant molecule that has been found in animal species such as fish. Tilapia (Oreochromis niloticus) represents an eco-friendly source of this compound, since its economical processing generates usable waste, reducing the negative environmental impact. This waste was used for CS extraction, purification, characterization by enzymatic degradation, and evaluation of its antioxidant effect. CS obtained from tilapia presented sulfation mainly at carbon 4 of galactosamine, and it was not cytotoxic at concentrations up to 200 µg/mL. Furthermore, 100 µg/mL of CS from tilapia reduced the levels of reactive oxygen species to 47% of the total intracellular reactive oxygen species level. The ability of CS to chelate metal ions in vitro also suggested an ability to react with other pathways that generate oxidative radicals, such as the Haber-Weiss reaction, acting intracellularly in more than one way. Although the role of CS from tilapia remains unclear, the pharmacological effects described herein indicate that CS is a potential molecule for further study of the relationship between the structures and functions of chondroitin sulfates as antioxidants.

Antibacterial activity, cytocompatibility and effect of Bio-C Temp bioceramic intracanal medicament on osteoblast biology.

AIM: To analyse the antimicrobial and biological properties of a new bioceramic intracanal medicament (Bio-C Temp), and to compare it with two calcium hydroxide-based intracanal medicaments (Calen® and UltraCal® XS). METHODOLOGY: The direct contact and the crystal violet tests were performed to assess the antimicrobial activity of intracanal medicaments against Enterococcus faecalis. The cytocompatibility and the effect of the medication on the biology of the human osteoblast-like cell line (Saos-2) were evaluated with methylthiazole tetrazolium (MTT), neutral red, alkaline phosphatase activity and mineralization (alizarin red) assays. The data were analysed using one-way anova and Tukey's tests, two-way anova and Bonferroni's tests, or Kruskal-Wallis and Dunn's tests (α = 0.05). RESULTS: Bio-C Temp had significantly less antibacterial activity and biofilm biomass reduction than the other intracanal medicaments (P < 0.05). There was no difference in the viability of Saos-2 exposed to the various intracanal medicaments, except regarding the 1 : 2 dilution, when the Bio-C Temp group had significantly lower cell viability than the UltraCal® XS and Calen® groups (P < 0.05). Bio-C Temp induced significantly greater ALP activity than the other intracanal medicaments (P < 0.05) at day 1. Calen® induced significantly greater deposition of mineralized nodules than the other intracanal medicaments (P < 0.05), and no difference was observed between Bio-C Temp and UltraCal® XS (P > 0.05). CONCLUSIONS: Bio-C Temp had similar cytocompatibility at higher dilutions, and higher or similar induction of ALP activity and deposition of mineralized nodules in comparison with Calen® and UltraCal® XS. However, it had significantly less antibacterial and antibiofilm activity than Calen® and UltraCal® XS.

Chondroitin sulfate from fish waste exhibits strong intracellular antioxidant potential

Chondroitin sulfate (CS) is a type of glycosaminoglycan described as an antioxidant molecule that has been found in animal species such as fish. Tilapia (Oreochromis niloticus) represents an eco-friendly source of this compound, since its economical processing generates usable waste, reducing the negative environmental impact. This waste was used for CS extraction, purification, characterization by enzymatic degradation, and evaluation of its antioxidant effect. CS obtained from tilapia presented sulfation mainly at carbon 4 of galactosamine, and it was not cytotoxic at concentrations up to 200 µg/mL. Furthermore, 100 µg/mL of CS from tilapia reduced the levels of reactive oxygen species to 47% of the total intracellular reactive oxygen species level. The ability of CS to chelate metal ions in vitro also suggested an ability to react with other pathways that generate oxidative radicals, such as the Haber-Weiss reaction, acting intracellularly in more than one way. Although the role of CS from tilapia remains unclear, the pharmacological effects described herein indicate that CS is a potential molecule for further study of the relationship between the structures and functions of chondroitin sulfates as antioxidants.

Effects of octenidine applied alone or mixed with sodium hypochlorite on eukaryotic cells.

AIM: To assess the effects of octenidine dihydrochloride (OCT) on eukaryotic cells and the cytotoxicity of OCT associated with sodium hypochlorite - NaOCl (NaOCl/OCT). METHODOLOGY: L929 fibroblasts and human osteoblast-like cells (Saos-2) were exposed to 0.1% OCT, 2% CHX, 2.5% NaOCl, 5.25% NaOCl and mixtures of 5.25% NaOCl and 0.1% OCT (NaOCl/OCT) at 90 : 10, 80 : 20 and 50 : 50 ratios. Cell viability was assessed by methyl-thiazol-tetrazolium (MTT) and neutral red (NR) assays; type of cell death, by flow cytometry; cytoskeleton, by actin and α-tubulin fluorescence; and alkaline phosphatase (ALP) activity, by thymolphthalein release. The data were analysed by two-way ANOVA and Bonferroni tests (α = 0.05). RESULTS: MTT and NR assays revealed that 0.1% OCT had the lowest cytotoxicity (P < 0.05), followed by 2% CHX (P < 0.05). The 2.5% NaOCl, NaOCl/OCT 80 : 20 and NaOCl/OCT 50 : 50 solutions had intermediate cytotoxicity. NaOCl 5.25% and NaOCl/OCT 90 : 10 had the highest cytotoxicity (P < 0.05). The OCT group had a higher percentage of viable cells than the NaOCl and CHX groups (P < 0.05), and induced apoptosis at higher doses. The cytoskeleton alterations were observed at 0.12%, 0.6% and 2.02% for the NaOCl, CHX and OCT groups, respectively. The solutions did not induce ALP activity. CONCLUSION: Octenidine dihydrochloride was less cytotoxic, induced apoptosis at higher doses, caused few changes in the cytoskeleton and did not induce alkaline phosphatase activity. In addition, octenidine dihydrochloride reduced the cytotoxicity of 5.25% NaOCl when combined at 20 and 50%.

Miniature transport respirator performance evaluation for ventilatory support

Abstract. In the face of the coronavirus pandemic (COVID-19), in hospital and emergency units, there is low availability of mechanical respirator for patients in need of this support, greatly improving the survival rate. In these situations, there is a need for simpler equipment, easy access, low cost, and fast manufacturing. In this study, a 3D prototype transport respirator was developed using as a model the Takaoka 600 Mini Respirator, national technology from the 1950s. The influence of adjustable parameters of the respirator was evaluated to understand it is functioning: maximum and minimum lung pressure; respirator intake pressure; respiratory rate; inspiratory and expiratory time according to the sensitivity of the mini respirator; and pressure and flow of O2 line intake. The increase in sensitivity led to an increase in maximum and minimum pulmonary pressure, decreased inspiratory and expiratory time, with margins of 1/1, 1/2, 1/3 inspiratory/expiratory time ratio (I/E ratio). The intake flow of O2 varied proportionally with the pressure of air intake into the respirator, with its increase leading to an increase in respiratory rate, without major influences on lung pressure and the I/E ratio. The O2 line intake pressure without major influences on lung pressure, showing and I/E ratio >1 in values below 3.5 kPa x 100. In conclusion, it was possible to obtain a pulmonary ventilator-dependent only on positive O2 flow, compact and effective for patient transport, and in cases of emergencies with control of maximum pressure and respiratory rate offered to the patient. Among the parameters evaluated for this respirator, an line pressure of O2 from 3.5 kPa x 100, sensitivity between 3 and 5, a flow of 5 to 15 L/min is recommended.

Descrição anatômica da artéria carótida externa e seus ramos na preguiça-comum / Anatomical description of external carotid artery and its branches in sloth

Bradypus variegatus, espécie pertencente à família Bradypodidae e à superordem Xenarthra, pode ser considerada modelo biológico de caráter multidisciplinar. Assim, realizou-se um trabalho de descrição anatômica da artéria carótida externa (ACE) e dos seus ramos no bicho-preguiça B. variegatus. Utilizaram-se 10 animais adultos, sendo todos fêmeas, que foram submetidos à dissecação, constatando-se que a artéria (a.) carótida comum se bifurca, em externa e interna, no nível do primeiro anel traqueal. A ACE, então, segue estendendo-se até a maxila, onde emite ramos para a região temporal e para o polo posterior do olho. Em todos os animais estudados, foram observados sete ramos principais da ACE, que, segundo a sua origem e localização, foram denominados como a. auricular, a. lingual, a. facial, a. alveolar, a. inferior, a. temporal, a. maxilar e a. oftálmica. Os ramos maxilar e oftálmico correspondem aos terminais e os demais são ramos colaterais. Em 50% dos animais analisados, foi verificada a presença de anastomoses arteriais e 40% deles apresentaram o acréscimo de um ramo aos principais. Desses, 30% demonstraram a presença de um ramo traqueal e 10% de um ramo sublingual, sendo esses ramos colaterais.(AU)

Bradypus variegatus is a species belonging to the family Bradypodidae and superorder Xenarthra, which should be considered as a multidisciplinary biological model. Thus, an anatomical description of the external carotid artery (ACE) and its branches in sloth B. variegatus was studied. Ten adult animals, all of them female, were submitted to dissection, and it was observed that the common carotid artery (a.) bifurcates in external and internal at the level of the first tracheal ring. Then, ACE extends through the maxilla where it launches branches to the temporal region and posterior eye side. For all sampled animals, seven principal branches of ACE were observed, and according to their origin and location were denominated as auricular, lingual, facial, bottom alveolar, temporal, maxillary and ophthalmic arteries. The maxillary and ophthalmic branches correspond to the terminals and the other branches are collateral. Presence of arterial anastomoses was observed in 50% of the sampled animals and 40% of them had increase of a branch on the principal. In these, 30% had presence of one tracheal branch and 10% of a sublingual branch, considering these branches as collateral.(AU)

Effect of immersion in distilled water or phosphate-buffered saline on the solubility, volumetric change and presence of voids within new calcium silicate-based root canal sealers.

AIM: To assess the effect of immersion in distilled water or phosphate-buffered saline (PBS) on the solubility, volumetric change and presence of voids of calcium silicate-based root canal sealers (TotalFill BC, Sealer Plus BC and Bio-C), in comparison with the gold standard epoxy resin-based sealer (AH Plus). METHODOLOGY: All properties were evaluated after immersion in distilled water or PBS. Solubility was determined by the percentage of mass loss, whereas volumetric change and presence of voids were evaluated by micro-computed tomography, after 7 days of immersion. The volumetric change and percentage of voids between the baseline (after setting) and the experimental period were calculated. Statistical analysis was performed using one-way anova and Tukey's or Student's t-tests (α = 0.05). RESULTS: The calcium silicate-based sealers had significantly greater solubility and volumetric loss than AH Plus, after immersion in distilled water or PBS (P < 0.05). Bio-C had the greatest solubility (P < 0.05), followed by TotalFill BC and Sealer Plus BC, which were similar (P > 0.05). Regarding the volumetric change, AH Plus had a volume increase, with similar values in distilled water and PBS (P > 0.05). TotalFill BC, Sealer Plus BC and Bio-C had a similar volumetric change (P > 0.05). The calcium silicate-based materials had the greatest solubility and volume loss after immersion in distilled water (P < 0.05). There was no difference in the percentage of voids amongst the sealers, before and after immersion in distilled water or PBS (P > 0.05). CONCLUSIONS: TotalFill BC, Sealer Plus BC and Bio-C had significantly greater solubility and volumetric loss than AH Plus. Although storage in PBS significantly reduced the solubility and volumetric change of calcium silicate-based sealers, their solubility remained above that recommend by ISO 6876. All the sealers evaluated had low and similar voids, even after immersion in distilled water or PBS.

Tempo de recuperação da frequência cardíaca como marcador prognóstico de eventos cardíacos / Heart rate recovery time as a prognostic marker of cardiac events

INTRODUÇÃO: O teste de caminhada de 6 minutos (TC6M) é um teste funcional amplamente utilizado em pacientes com insuficiência cardíaca crônica (IC). A distância percorrida no teste, bem como o delta de frequência cardíaca entre o repouso e a recuperação no 1° minuto (HRR1) e o delta de frequência cardíaca entre o repouso e a recuperação no 2° minuto (HRR2) têm sido propostos como marcadores prognósticos de eventos cardíacos em pacientes com IC. Nós hipotetizamos que a variação do tempo em minutos (denominado THRR) entre o pico da frequência cardíaca e o retorno à frequência cardíaca no repouso possa ser um marcador simples e de fácil obtenção no contexto clínico para estimar eventos cardíacos em pacientes com IC. OBJETIVOS: Nós investigamos se o THRR pode ser usado para estimar hospitalizações e morte ao longo de 2 anos de acompanhamento em pacientes com IC. MÉTODOS: Setenta e seis pacientes (média de idade 57 anos, NYHA II e III, IMC 25.5kg/m2, média FEVE de 33%) foram incluídos nesse estudo e divididos em Com eventos e Sem eventos. RESULTADOS: Trinta e quatro pacientes do grupo Com eventos e 42 pacientes do grupo Sem eventos tiveram, respectivamente as seguintes médias: THRR= 3.6 vs 2.8 min (p=0,003), distância percorrida= 463 vs 465 metros (p=0,930), HRR1=12 bpm para ambos grupos (p=0,952) e HRR2= 23 vs 22 bpm (p=0,723). A área sob a curva ROC para discriminar eventos e não eventos foi de 0,70 (IC95%: 0,58-0,82 e p=0,001). Usando a análise de regressão logística, o THRR ≥ 3 minutos dobrou o risco para eventos cardíacos (p=0,003). CONCLUSÃO: A variação de tempo entre o pico do exercício no TC6M e a recuperação da frequência cardíaca de repouso ≥ 3 minutos é um eficiente marcador clínico preditor de hospitalizações e morte em 2 anos para pacientes com IC. (AU)

REDUCTION OF STAFF RADIATION DOSE IN PROSTATIC ARTERY EMBOLISATION.

Prostatic artery embolisation (PAE) is used to treat patients with benign prostatic hyperplasia and with lower urinary obstructive tract symptoms. It is an interventional procedure which uses fluoroscopy equipment and can result in exposure to high doses of radiation in patients and staff. We aimed to demonstrate the reduction of radiation doses received by staff during PAE by implementing an optimised protocol called Radiation Exposure Curtailment for Embolisation (RECiFE). This protocol was implemented in cooperation with the medical team and technical team using Siemens Combined Applications to Reduce Exposure (CARE) protocol. The results showed approximately 83% reduction in the radiation doses received by the main physician during PAE. Thus, by adjusting the acquisition parameters of the angiographic equipment and implementing the RECiFE protocol, it is possible to optimise the PAE procedure and reduce the staff radiation dose.

Cytocompatibility, bioactive potential and antimicrobial activity of an experimental calcium silicate-based endodontic sealer.

AIM: To evaluate the cytocompatibility, bioactive potential, antimicrobial and antibiofilm activities of an experimental calcium silicate-based endodontic sealer, in comparison with TotalFill BC Sealer and AH Plus. METHODOLOGY: Cytocompatibility was assessed by methyltetrazolium (MTT) and neutral red (NR) assays, after exposure of the Saos-2 cells to the sealer extracts (1 : 2, 1 : 4, 1 : 8, 1 : 16 and 1 : 32 dilutions) for 24 h. The sealers were manipulated and placed in 12-well culture plates and exposed to ultraviolet light; then, 5 mL of DMEM without serum was added. Cell bioactivity was evaluated by alkaline phosphatase activity (ALP) and Alizarin red staining (ARS). Antimicrobial and antibiofilm activities were evaluated by direct contact test (DCT) on planktonic cells (DCTPC) and modified DCT on biofilm formed in bovine dentine blocks (MDCT). MTT, NR and ALP data were analysed by two-way anova and Bonferroni tests; ARS data by anova and Tukey's tests; and the microbiological data by Kruskal-Wallis and Dunn tests (α = 0.05). RESULTS: The experimental sealer, TotalFill BC and AH Plus were not cytotoxic to Saos-2, in comparison with the negative control (P > 0.05). Greater ALP was observed after 7 days of exposure of Saos-2 to AH Plus and the experimental sealer (P < 0.05) when compared to the control. Significantly greater mineralized nodule production was observed for TotalFill BC and the experimental sealer (P < 0.05). In DCTPC, the experimental sealer and TotalFill BC were associated with a significantly greater reduction of E. faecalis (P < 0.05) and eliminated C. albicans. In MDCT, the experimental sealer and TotalFill BC had significantly greater antibiofilm efficacy (P < 0.05). CONCLUSIONS: The experimental calcium silicate-based sealer was cytocompatible, bioactive, antimicrobial against E. faecalis and C. albicans and effective against E. faecalis biofilms, with potential for use in root canal treatment.

Sex steroid receptors profiling is influenced by nandrolone decanoate in the ampulla of the fallopian tube: Post-treatment and post-recovery analyses.

Anabolic androgenic steroids (AAS) are recommended for therapeutic clinic, but their use has increased in recent decades for aesthetic reasons. No study has evaluated the impact of AAS in the fallopian tube, after treatment and recovery periods. Herein, the aim of study was to investigate the effects of Nandrolone Decanoate (ND), administered in different doses (1.87; 3.75; 7.5 and 15 mg/kg) on the ampulla of the fallopian tube in rats, following post-treatment (PT; 15 consecutive days) and post-recovery (PR; 30 consecutive days) periods. The control group received mineral oil. Estrous cycle was monitored daily during both periods and in sequence the rats (n = 8/group/period) were killed. All ND-treated animals showed estral acyclicity during the PT and PR periods, but the histomorphometric changes in the fallopian tube varied according to the ND dose level. The expression of AR, ERα and ERß varied in the nucleus and cytoplasm of epithelial cells. No AR expression was observed in the stroma. The muscle cells exhibited variation in immunostaining. In conclusion, ND promoted histomorphometric and immunohistochemical changes in the ampullary portion of the fallopian tube after treatment and recovery periods in a dose-independent manner.

Frequency of enterotoxins, toxic shock syndrome toxin-1, and biofilm formation genes in Staphylococcus aureus isolates from cows with mastitis in the Northeast of Brazil.

Staphylococcus aureus is among the microorganisms more frequently associated with subclinical bovine mastitis. S. aureus may produce several virulence factors. This study aimed at determining the frequency of virulence factors such as enterotoxins, toxic shock syndrome toxin 1, and ica adhesion genes. In addition, we assessed antimicrobial drug resistance in S. aureus isolated from clinical and subclinical cases of mastitis. A total of 88 cows with clinical or subclinical mastitis were sampled, resulting in 38 S. aureus isolates, from which 25 (65.78%) carried toxin genes, including seb, sec, sed, tst, and icaD adhesion gene. These S. aureus isolates belong to 21 ribotypes and three S. aureus strains belonged to the same ribotype producing ica adhesion gene. Approximately 90% of S. aureus strains obtained in our study demonstrated multiple resistance to different antimicrobial agents. The most efficacious antimicrobial agents against the isolates were gentamicin, amoxicillin, and norfloxacin. Gentamicin was the most efficacious agent inhibiting 78.95% of the S. aureus isolates. The least efficacious were penicillin, streptomycin, and ampicillin. Our results can help in understanding the relationship between virulence factors and subclinical mastitis caused by S. aureus. Further research about diversity of S. aureus isolates and genes responsible for the pathogenicity of subclinical mastitis is essential.