Development of silanized bacterial cellulose aerogels for the incorporation of natural oils with healing properties: Copaiba (Copaifera officinalis), bourbon geranium (Pelargonium X ssp.) essential oils and buriti (Mauritia flexuosa) vegetable oil.

Bacterial cellulose (BC) represents a promising biomaterial, due to its unique and versatile properties. We report, herein, on purposely-designed structural modifications of BC that enhance its application as a wound dressing material. Chemical modification of the functional groups of BC was performed initially to introduce a hydrophobic/oleophilic character to its surface. Specifically, silanization was carried out in an aqueous medium using methyltrimethoxisilane (MTMS) as the silanizing agent, and aerogels were subsequently prepared by freeze-drying. The BC-MTMS aerogel obtained displayed a highly porous (99 %) and lightweight structure with an oil absorption capacity of up to 52 times its dry weight. The XRD pattern indicated that the characteristic crystallographic planes of the native BC were maintained after the silanization process. Thermal analysis showed that the thermal stability of the BC-MTMS aerogel increased, as compared to the pure BC aerogel (pBC). Moreover, the BC-MTMS aerogel was not cytotoxic to fibroblasts and keratinocytes. In the second step of the study, the incorporation of natural oils into the aerogel's matrix was found to endow antimicrobial and/or healing properties to BC-MTMS. Bourbon geranium (Pelargonium X ssp.) essential oil (GEO) was the only oil that exhibited antimicrobial activity against the tested microorganisms, whereas buriti (Mauritia flexuosa) vegetable oil (BVO) was non-cytotoxic to the cells. This study demonstrates that the characteristics of the BC structure can be modified, while preserving its intrinsic features, offering new possibilities for the development of BC-derived materials for specific applications in the biomedical field.

Late mesenteric ischemia after Sars-Cov-2 infection: case report.

The purpose of this article is to report the case of a 53-year-old black man, with no previous comorbidities, who presented 48 days after a confirmed diagnosis of COVID-19, complaining of an initially insidious epigastric pain that had progressed to severe pain radiating to the interscapular vertebral region, with hyporexia and episodes of projectile vomiting, with no nausea or fever. Laboratory tests revealed no signs of acute infection or pancreatic injury. Abdominal computed tomography showed dilated, fluid-filled small bowel loops with thickened walls. After clinical treatment, the patient developed persistent abdominal pain. An exploratory laparotomy was performed, finding two sites of small bowel stenosis, with no extrinsic cause, and signs of local ischemia and considerable distension of jejunal and ileal loops. After enterectomy and side-to-side enteroanastomosis, the patient recovered satisfactorily and was discharged with a prescription for oral anticoagulants for outpatient use.

O objetivo deste artigo é relatar o caso de um homem de 53 anos de idade, negro, sem comorbidades prévias, com diagnóstico confirmado de COVID-19 há 48 dias anteriores ao início do quadro de dor epigástrica insidiosa, que evoluiu para dor de forte intensidade que irradiava para região interescapulovertebral, associada a hiporexia e episódios de vômitos em jato, sem náuseas ou febre. Os exames laboratoriais não apresentavam sinais de infecção aguda ou lesão pancreática. A tomografia computadorizada do abdome mostrou alças do intestino delgado dilatadas, cheias de líquido e com paredes espessas. Após terapia de suporte, o paciente evoluiu com dor abdominal persistente. Foi realizada laparotomia exploratória, na qual foram encontrados dois sítios de estenose no intestino delgado sem causa extrínseca, ao lado de sinais de isquemia local e distensão importante das alças jejunais e ileais. Após enterectomia e enteroanastomose primária látero-lateral, o paciente evoluiu de forma satisfatória e recebeu alta hospitalar com prescrição de anticoagulantes orais para uso ambulatorial.

Late mesenteric ischemia after Sars-Cov-2 infection: case report / Isquemia mesentérica tardia após infecção por Sars-Cov-2: relato de caso

Abstract The purpose of this article is to report the case of a 53-year-old black man, with no previous comorbidities, who presented 48 days after a confirmed diagnosis of COVID-19, complaining of an initially insidious epigastric pain that had progressed to severe pain radiating to the interscapular vertebral region, with hyporexia and episodes of projectile vomiting, with no nausea or fever. Laboratory tests revealed no signs of acute infection or pancreatic injury. Abdominal computed tomography showed dilated, fluid-filled small bowel loops with thickened walls. After clinical treatment, the patient developed persistent abdominal pain. An exploratory laparotomy was performed, finding two sites of small bowel stenosis, with no extrinsic cause, and signs of local ischemia and considerable distension of jejunal and ileal loops. After enterectomy and side-to-side enteroanastomosis, the patient recovered satisfactorily and was discharged with a prescription for oral anticoagulants for outpatient use.

Resumo O objetivo deste artigo é relatar o caso de um homem de 53 anos de idade, negro, sem comorbidades prévias, com diagnóstico confirmado de COVID-19 há 48 dias anteriores ao início do quadro de dor epigástrica insidiosa, que evoluiu para dor de forte intensidade que irradiava para região interescapulovertebral, associada a hiporexia e episódios de vômitos em jato, sem náuseas ou febre. Os exames laboratoriais não apresentavam sinais de infecção aguda ou lesão pancreática. A tomografia computadorizada do abdome mostrou alças do intestino delgado dilatadas, cheias de líquido e com paredes espessas. Após terapia de suporte, o paciente evoluiu com dor abdominal persistente. Foi realizada laparotomia exploratória, na qual foram encontrados dois sítios de estenose no intestino delgado sem causa extrínseca, ao lado de sinais de isquemia local e distensão importante das alças jejunais e ileais. Após enterectomia e enteroanastomose primária látero-lateral, o paciente evoluiu de forma satisfatória e recebeu alta hospitalar com prescrição de anticoagulantes orais para uso ambulatorial.

High Frequency of Extended-Spectrum Beta-Lactamase-Producing Klebsiella pneumoniae Nosocomial Strains Isolated from a Teaching Hospital in Brazil.

The aim of this study was to investigate the frequency, antimicrobial sensitivity profile, and genetic characteristics of nosocomial strains of extended-spectrum ß-lactamase (ESBL)-producing Klebsiella pneumoniae isolated from inpatients at a teaching hospital in Brazil. The bacterial identification, phenotypic detection of ESBL, and antimicrobial susceptibility profile were performed by the VITEK 2 automated system. Matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS) mass spectrometry was used to confirm the identity of the species and genotyping of ESBL-producing K. pneumoniae was performed by pulsed-field gel electrophoresis (PFGE). Thirty-six ESBL-producing K. pneumoniae nosocomial strains isolated from November 2013 to August 2014 were analyzed. High resistance rates were observed for ceftriaxone, ceftazidime, cefepime, gentamicin, and ciprofloxacin. However, all isolates were susceptible to amikacin and meropenem. All strains harbored blaCTX-M-like and blaSHV-like genes. Molecular typing by PFGE showed a diversity of genotypes distributed among 25 clusters, but two isolates collected in different wards had the same genotypic profile and carried the same bla genes, so they were considered clones. The data showed that there was a high frequency of ESBL-producing K. pneumoniae multidrug-resistant among patients in the studied hospital. Furthermore, the detection of blaCTX-M-like genes in all isolates suggests that these enzymes are the major ESBL responsible for the beta-lactam resistance phenotypes among the analyzed strains.

[Evaluation of the level of knowledge about Aids and syphilis among the elderly from a city in the interior of the state of Ceará, Brazil]. / Avaliação do nível de conhecimento em relação à Aids e sífilispor idosos do interior cearense, Brasil.

The scope of this study was to evaluate the knowledge of the elderly about syphilis and AIDS before and after conducting educational activities. Fifty-five individuals participating in a convenience group from territory of Terrenos Novos in Sobral in the State of Ceará were selected. To collect the data, a semi-structured questionnaire about HIV/AIDS and syphilis was used, including general features and information about concept, transmission, prevention, vulnerability and treatment. The questionnaire was applied before and after the implementation of educational workshops about AIDS and syphilis. Among those surveyed, 96.4% were aware about AIDS and 67.3% did not know about syphilis. However, 38.1% believed that a kiss on the mouth and 78.1% that mosquito bites were means of HIV transmission. 70.9% did not know the mode of transmission of syphilis. After the workshops the indexes changed positively. Data analysis revealed gaps in knowledge of this group about the concept, transmission and treatment of these diseases. Educational interventions were effective for knowledge assimilation.

O propósito deste trabalho foi avaliar o conhecimento de idosos acerca da sífilis e Aids antes e após a realização de ações educativas. Foram selecionados 55 idosos que participavam de grupo de conveniência no território dos Terrenos Novos, em Sobral - CE. Para a coleta dos dados, utilizou-se um questionário semiestruturado sobre HIV/Aids e sífilis, incluindo características gerais e informações sobre conceito, transmissão, prevenção, vulnerabilidade e tratamento. O questionário foi aplicado antes e após a realização de oficinas educativas sobre Aids e sífilis. Dentre os investigados, 96,4%, tinham conhecimento sobre Aids e 67,3% desconheciam a sífilis. Entretanto, 38,1% acreditavam que beijo na boca e 78,1% que picada de mosquito eram meios de transmissão do HIV. Desconheciam a forma de transmissão da sífilis 70,9%. Após as oficinas os índices alteraram positivamente. A análise dos dados revelou lacunas no conhecimento deste grupo quanto ao conceito, transmissão e tratamento dessas doenças. As intervenções educativas mostraram-se eficazes para a assimilação de conhecimento.

Avaliação do nível de conhecimento em relação à Aids e sífilispor idosos do interior cearense, Brasil / Evaluation of the level of knowledge about Aids and syphilis among the elderly from a city in the interior of the state of Ceará, Brazil

Resumo O propósito deste trabalho foi avaliar o conhecimento de idosos acerca da sífilis e Aids antes e após a realização de ações educativas. Foram selecionados 55 idosos que participavam de grupo de conveniência no território dos Terrenos Novos, em Sobral - CE. Para a coleta dos dados, utilizou-se um questionário semiestruturado sobre HIV/Aids e sífilis, incluindo características gerais e informações sobre conceito, transmissão, prevenção, vulnerabilidade e tratamento. O questionário foi aplicado antes e após a realização de oficinas educativas sobre Aids e sífilis. Dentre os investigados, 96,4%, tinham conhecimento sobre Aids e 67,3% desconheciam a sífilis. Entretanto, 38,1% acreditavam que beijo na boca e 78,1% que picada de mosquito eram meios de transmissão do HIV. Desconheciam a forma de transmissão da sífilis 70,9%. Após as oficinas os índices alteraram positivamente. A análise dos dados revelou lacunas no conhecimento deste grupo quanto ao conceito, transmissão e tratamento dessas doenças. As intervenções educativas mostraram-se eficazes para a assimilação de conhecimento.

Abstract The scope of this study was to evaluate the knowledge of the elderly about syphilis and AIDS before and after conducting educational activities. Fifty-five individuals participating in a convenience group from territory of Terrenos Novos in Sobral in the State of Ceará were selected. To collect the data, a semi-structured questionnaire about HIV/AIDS and syphilis was used, including general features and information about concept, transmission, prevention, vulnerability and treatment. The questionnaire was applied before and after the implementation of educational workshops about AIDS and syphilis. Among those surveyed, 96.4% were aware about AIDS and 67.3% did not know about syphilis. However, 38.1% believed that a kiss on the mouth and 78.1% that mosquito bites were means of HIV transmission. 70.9% did not know the mode of transmission of syphilis. After the workshops the indexes changed positively. Data analysis revealed gaps in knowledge of this group about the concept, transmission and treatment of these diseases. Educational interventions were effective for knowledge assimilation.

Occurrence and antimicrobial susceptibility of enteric rods and pseudomonads isolated from the dental prostheses biofilm.

OBJECTIVE:: To determine the occurrence and the in vitro antimicrobial susceptibility of enteric rods and pseudomonads from the denture biofilm of 52 subjects at the Center for Dental Specialties of Sobral/ Ceara, Brazil. MATERIAL AND METHODS:: Denture biofilm was collected and samples plated on MacConkey agar. The isolated bacterial colonies were identified using the BBL Crystal enteric/non-fermenter system. Antibiotic bacterial susceptibility was assessed by the disc diffusion method of amoxicillin, amoxicillin/clavulanic acid, doxycycline, tetracycline, tobramycin, imipenem, cefotaxime, and ciprofloxacin. The Minimum Inhibitory Concentration (MIC) of cefotaxime, tobramycin, doxycycline, imipenem, and ciprofloxacin was determined for 40 species by E-test. RESULTS:: 34 subjects (65.4%) harbored enteric rods in their prostheses. Klebsiella pneumoniae (26.5%), Escherichia coli (23.5%), and Enterobacter aerogenes (23.5%) were the most prevalent species. All organisms were susceptible to ciprofloxacin and most species were resistant to amoxicillin or amoxicillin/clavulanic acid, demonstrating variable sensitivity patterns to other antimicrobials. However, the MIC showed the emergence of strains with reduced sensitivity to ciprofloxacin (MIC90≥3 µg/ mL) and cefotaxime (MIC90≥2 µg/mL). CONCLUSION:: The findings show high prevalence of nosocomial diseases-related bacterial species and low susceptibility to antimicrobial drugs. Therefore, these results imply caution against the indiscriminate use of broad spectrum antibiotics in dental practice.

Occurrence and antimicrobial susceptibility of enteric rods and pseudomonads isolated from the dental prostheses biofilm

ABSTRACT Aspiration of oral bacteria leads to cardiac and respiratory infectious diseases and dentures can act as a reservoir for pathogenic microorganisms. Objective: To determine the occurrence and the in vitro antimicrobial susceptibility of enteric rods and pseudomonads from the denture biofilm of 52 subjects at the Center for Dental Specialties of Sobral/ Ceara, Brazil. Material and Methods: Denture biofilm was collected and samples plated on MacConkey agar. The isolated bacterial colonies were identified using the BBL Crystal enteric/non-fermenter system. Antibiotic bacterial susceptibility was assessed by the disc diffusion method of amoxicillin, amoxicillin/clavulanic acid, doxycycline, tetracycline, tobramycin, imipenem, cefotaxime, and ciprofloxacin. The Minimum Inhibitory Concentration (MIC) of cefotaxime, tobramycin, doxycycline, imipenem, and ciprofloxacin was determined for 40 species by E-test. Results: 34 subjects (65.4%) harbored enteric rods in their prostheses. Klebsiella pneumoniae (26.5%), Escherichia coli (23.5%), and Enterobacter aerogenes (23.5%) were the most prevalent species. All organisms were susceptible to ciprofloxacin and most species were resistant to amoxicillin or amoxicillin/clavulanic acid, demonstrating variable sensitivity patterns to other antimicrobials. However, the MIC showed the emergence of strains with reduced sensitivity to ciprofloxacin (MIC90≥3 μg/ mL) and cefotaxime (MIC90≥2 μg/mL). Conclusion: The findings show high prevalence of nosocomial diseases-related bacterial species and low susceptibility to antimicrobial drugs. Therefore, these results imply caution against the indiscriminate use of broad spectrum antibiotics in dental practice.

Inflammatory Cytokines Interleukin-1ß and Tumour Necrosis Factor-α - Novel Biomarkers for the Detection of Periodontal Diseases: a Literature Review.

OBJECTIVES: The article aims to discuss the IL-1ß and TNF-α potential use as salivary biomarkers of periodontal diseases pathogenesis and progression. MATERIAL AND METHODS: This literature review has been registered in PROSPERO database with following number: CRD42016035729. Data investigation was performed on PubMed database as the main source of studies. The following search terms were used: "salivary biomarkers", "periodontal diseases", "TNF-alpha", "Interleukin-1 beta". Clinical trials and animal experimental models of periodontal disease were included in the discussion. In regards to inclusive dates, published studies from January 2006 to December 2015 were considered in this review along with the mentioned inclusion criteria. RESULTS: IL-1ß and TNF-α salivary levels increased in diseased groups, they were associated with onset and disease severity, and their levels reduced in response to periodontal therapy. IL-1ß and TNF-α could be promising biomarkers in the detection of periodontal diseases. CONCLUSIONS: The use of a salivary cytokine-based diagnosis appears to be a screening method capable of diagnosing periodontal diseases in an early fashion, establishing an era of individualized clinical decisions.

Serratia marcescens resistance profile and its susceptibility to photodynamic antimicrobial chemotherapy.

BACKGROUND: Some authors have reported the antimicrobial action of photodynamic antimicrobial chemotherapy (PACT) on bacteria related to nosocomial infections but there are few studies evaluating PACT on Serratia marcescens grown as planktonic cultures or as biofilms. The purpose of this study was to analyze the S. marcescens resistance profile and its susceptibility to PACT. METHODS: Initially, 55 S. marcescens strains isolated from environmental, oral and extra-oral infections were tested by antimicrobial resistance to cefotaxime (CTX), imipenem (IPM), ciprofloxacin (CIP), tobramycin (TOB) and doxycycline (DOX) using E-test(®). Following, isolates grown as planktonic cultures or biofilms were submitted to PACT using the association of a light-emitting diode and toluidine blue (TBO). The E-test(®) results demonstrated intermediated sensitive strains to CTX, IMP, TOB, and DOX; and resistant strains to CTX, TOB, DOX and CIP. Also, CTX and IMP demonstrated variation when CLSI 2007 and CLSI 2015 were compared. RESULTS: Planktonic cultures and biofilms submitted to PACT demonstrated counts varying from 10(11) to 10(7) for planktonic cultures and 10(10) to 10(7) for biofilms. There were no statistical differences in the results when planktonic cultures and biofilms were compared. CONCLUSIONS: Increase in the profile of S. marcescens resistance was observed when CLSI 2007 and CLSI 2015 were compared. Also, IMP remains as the drug with lower rate of resistance. Additionally, both S. marcescens planktonic cultures and early biofilms are susceptible to PACT under tested conditions.

The Spread of CTX-M-Type Extended-Spectrum ß-Lactamases in Brazil: A Systematic Review.

The aim of this study was evaluate the spread of CTX-M-type extended-spectrum ß-lactamase variants in microorganisms involved in both hospital- and community-acquired infections in different regions of Brazil to determine their epidemiology and identify areas for further research. Thirty-six studies were included and analyzed. Most of the studies were conducted in the southeastern (66.7%, 24/36), southern (22.2%, 8/36), and northeastern (8.3%, 3/36) regions of Brazil. No study was conducted in the northern or midwestern region. CTX-M-producing bacteria were isolated exclusively from humans in both hospital and community environments. The microorganisms that were most commonly associated with the presence of the blaCTX-M gene were Klebsiella pneumoniae and Escherichia coli. The ß-lactamases of the CTX-M family that were most frequently identified in Brazil were CTX-M-2 and CTX-M-15, especially in the southeast where these variants are often detected. In this systematic review, the microorganisms that were most commonly associated with the presence of the blaCTX-M gene were K. pneumoniae and E. coli. CTX-M-2 and CTX-M-15 were the most dominant variants of the CTX-M family, followed by CTX-M-8, CTX-M-9, and CTX-M-59. A higher frequency of CTX-M variants was found in the southeastern region, especially in the states of São Paulo and Rio de Janeiro, where CTX-M-2 and CTX-M-15 are predominant.