Accuracy of Conventional and 3D-Printed Casts for Partial Fixed Prostheses.

PURPOSE: To evaluate and compare the accuracy of conventional and 3D-printed casts using five different 3D printers. MATERIALS AND METHODS: In the control group (CG group, n = 5), five conventional impressions using light- and heavy-body polyvinyl siloxane were obtained from the master model, resulting in five stone models. In the test groups, five different scans were performed by a well-trained and experienced clinician using a TRIOS intraoral scanner. All data were exported in STL file format, processed, and sent to five 3D printers. Five casts were manufactured in each printer group: SG (CARES P20, Straumann); FG (Form 2, Formlabs); WG (Duplicator 7, Wanhao); ZG (Zenith D, Zenith); and MG (Moonray S100, Moonray). Measurements of the accuracy (trueness and precision) of the casts obtained from conventional elastomeric impressions and 3D-printing methods were accomplished using a 3D analysis software (Geomagic Control). RESULTS: The FG group showed the lowest values for trueness (indicating a value closer to real dimensions), which were similar to the SG group only (P > .05). MG, WG, and ZG groups presented higher values and were similar compared to each other. Data on precision demonstrated that all 3D-printed groups showed lower values for precision (smaller deviation) when compared to the CG. CONCLUSIONS: The trueness depends on the chosen 3D printer. All of the tested 3D printers were more precise than cast models obtained from conventional elastomeric impressions.

Global review and guidelines to avoid opportunistic predation of birds and bats in mist nets.

Mist nets are one of the most widely used techniques in the study of birds and bats worldwide. However, a number of risks are involved, including opportunistic predation. Given this potential cost, here we: (1) review the global literature to understand the factors that might contribute to predation risk for birds and bats captured in mist nets; (2) review existing guidelines for best practice use of mist nets; and (3) based on our reviews, recommend new guidelines for the use of mist nets to minimize the risk of opportunistic predation. Based on keyword in English, Spanish, Portuguese, and French, and using Google Scholar, Scopus, SciElo, and Web of Science, we found 48 articles reporting opportunistic predation. In the included articles, 178 predation events, involving 52 predator and 84 prey species, were reported. In most of the reports, the mist nets were placed at ground level, the bats and birds were preyed on from the shelf closest to the ground, the mist-net checks occurred at intervals of 1 h or 30 min and the most common predators were arboreal and scansorial species (primates and marsupials). Despite the occurrences of predation in 13 countries, guidelines for best practice mist-net use were found in only three, despite extensive searches and contact with key people in each country. Based on the existing guidelines and our results, we recommend that mist nets be fixed with the lowest shelf at least 50 cm above ground level and be checked at 15-min intervals; when predators are observed near mist nets, the nets either be constantly observed, closed, or relocated; suppressed the vegetation around the mist nets; captured animals be removed from the mist nets as soon as possible, and more than one researcher/technician should be in the field at all times.

Emergence of livestock-associated Mammaliicoccus sciuri ST71 co-harbouring mecA and mecC genes in Brazil.

The discovery and tracking of antimicrobial resistance genes are essential for understanding the evolution of bacterial resistance and restraining its dispersion. Mammaliicoccus sciuri (formerly Staphylococcus sciuri) is the most probable evolutionary repository of the mecA gene, that later disseminated to S. aureus. In this study, we describe the first double mecA/mecC homologue-positive non-aureus staphylococci and mammaliicocci (NASM) from the American continent, also representing the first report of mecC-positive NASM in Brazil. Two clonally related methicillin-resistant M. sciuri strains co-carrying mecA and mecC genes were isolated from the teat skin swab and milk sample collected from an ewe's left udder half. Both M. sciuri strains belonged to the sequence type (ST) 71. Besides mecA and mecC genes, the M. sciuri strains carried broad resistomes for clinically important antimicrobial agents, including ß-lactams, tetracyclines, lincosamide, streptogramin, streptomycin, and aminoglycosides. Virulome analysis showed the presence of the clumping factor B (clfB), ATP-dependent protease ClpP (ClpP) and serine-aspartate repeat proteins (sdrC and sdrE) virulence-associated genes. Phylogenomic analysis revealed that these M. sciuri strains are part of a globally disseminated branch, associated with farm and companion animals and even with food. Our findings suggest that M. sciuri is likely to emerge as a pathogen of global interest, carrying a broad repertoire of antimicrobial resistance genes with a remarkable co-presence of mecA and mecC genes. Finally, we strongly encourage to monitor M. sciuri under the One Health umbrella since this bacterial species is spreading at the human-animal-environment interface.

Physical and mechanical properties of four 3D-printed resins at two different thick layers: An in vitro comparative study.

OBJECTIVES: This in vitro comparative study aimed to evaluate the physical and mechanical properties of four 3D-printed resins with two different thickness layers. METHODS: Four printed resins (VarseoSmile Crown Plus, VSC; NexDent C&B MFH, MFH; Nanolab 3D, NNL; and Resilab 3D Temp, RSL) were printed with 50 µm and 100 µm layer thickness, resulting in 80 bars measuring 25 × 2×2 mm. The specimens underwent a Raman spectroscopy for degree of conversion, confocal laser scanning microscopy for surface roughness (Sa), three-point bending test for flexural strength and elastic modulus, and a Vickers hardness test (VHN). Data was tested for normality using the Shapiro-Wilk, two-way ANOVA, and Tukey test (α = 0.05) for statistical analysis. RESULTS: The layer thickness affected all performed tests, but the elastic modulus (p < 0.001). Specimens with 100 µm showed, in general, worse results outcomes than those with 50 µm (p < 0.001). However, within the limitations of this comparative in vitro study, it could be concluded that the tested resins and layer thicknesses directly influenced physical and mechanical properties. SIGNIFICANCE: The physical and mechanical properties of three-dimensional printed restorations can be affected by the layer thickness, which can interfere with the choice of the 3D printing resin for a desired clinical outcome.

Comparative physical and mechanical properties of a 3D printed temporary crown and bridge restorative material.

Background: The objective was to compare physic-mechanical properties of different materials used for temporary restorations. Material and Methods: Protemp 4/bisacrylic resin, Jet/acrylic resin, and Nexdent C&B/3D-printed resin samples (10mm diameter x 2mm thickness) were analyzed for surface roughness and color stability tests (baseline, after 5 thousand brushing cycles; and after artificial aging in water at 60oC for 24 hours) and Knoop microhardness. All data were checked for normality using Shapiro-Wilk test. Surface roughness and color stability were analyzed using two-way repeated measurements ANOVA, microhardness data was subjected to one-way ANOVA. All tests were followed by Tukey test and were performed with α=0.05. Results: For roughness, material (p=.002), time points (p=.002) and interaction between both (p<.001) were significant. All groups presented similar roughness for measurements of baseline and after brushing. After artificial aging, 3D printed resin showed decreased roughness when compared with other resins, and with its baseline reading. Acrylic resin showed an increase in surface roughness (when compared with measurement after brushing cycles). Considering color stability, only the material (p=.039) and the time (p<0.001) were significant. All groups showed similar color variation before and after artificial aging. There was an increase in color alteration after artificial aging for all groups. Considering microhardness test (p<.001), the 3D printed resin showed the highest values and acrylic resin the lowest. Bysacylic resin was similar to both 3D printed and acrylic resins. Conclusions: The tested 3D printed resins present similar or better properties than other tested temporary materials while being integrated with the digital workflow. Key words:Disinfection methods, hydroxyl radical, environment, surfaces, dentistry.

Genomic Surveillance of SARS-CoV-2 in Healthcare Workers: A Critical Sentinel Group for Monitoring the SARS-CoV-2 Variant Shift.

SARS-CoV-2 genome surveillance is important for monitoring risk groups and health workers as well as data on new cases and mortality rate due to COVID-19. We characterized the circulation of SARS-CoV-2 variants from May 2021 to April 2022 in the state of Santa Catarina, southern Brazil, and evaluated the similarity between variants present in the population and healthcare workers (HCW). A total of 5291 sequenced genomes demonstrated the circulation of 55 strains and four variants of concern (Alpha, Delta, Gamma and Omicron-sublineages BA.1 and BA.2). The number of cases was relatively low in May 2021, but the number of deaths was higher with the Gamma variant. There was a significant increase in both numbers between December 2021 and February 2022, peaking in mid-January 2022, when the Omicron variant dominated. After May 2021, two distinct variant groups (Delta and Omicron) were observed, equally distributed among the five Santa Catarina mesoregions. Moreover, from November 2021 to February 2022, similar variant profiles between HCW and the general population were observed, and a quicker shift from Delta to Omicron in HCW than in the general population. This demonstrates the importance of HCW as a sentinel group for monitoring disease trends in the general population.

Cost and effectiveness of 3-dimensionally printed model using three different printing layer parameters and two resins.

STATEMENT OF PROBLEM: When 3-dimensional printing casts, the operator can change the type of resin and the printing layer thickness, reducing the fabrication time. However, how these parameters affect the accuracy of 3-dimensionally printed casts is unknown. PURPOSE: The purpose of this in vitro study was to evaluate the accuracy of 3-dimensionally printed casts by using a stereolithography (SLA) 3-dimensional printer (Forms2) with 3 different layer thickness (25, 50, and 100 µm) and 2 different resins (Gray and Cast) and by comparing the time to obtain each cast. MATERIAL AND METHODS: One master cast was scanned, and a single file was printed several times. The printed casts were then scanned by using a laboratory scanner. The standard tessellation language (STL) files provided by the laboratory scanner were superimposed and compared by using a software program (Geomagic Control; 3D Systems). The 2-way ANOVA test was used for the trueness evaluation, followed by the Tukey test to identify differences among the groups (α=.05). RESULTS: No statistically significant differences in accuracy were found among the 3 different layers for either resin (P>.05). Printing time doubled as layer thickness decreased. CONCLUSIONS: This study showed that when printing casts, the fastest printing settings can be used without losing accuracy and that the laboratory digital workflow can be accelerated with selection of the resin and cast layer, as the type of resin and layer thickness did not influence the quality of the casts.

Emergence of livestock-associated Mammaliicoccus sciuri ST71 co-harbouring mecA and mecC genes in Brazil

The discovery and tracking of antimicrobial resistance genes are essential for understanding the evolution of bacterial resistance and restraining its dispersion. Mammaliicoccus sciuri (formerly Staphylococcus sciuri) is the most probable evolutionary repository of the mecA gene, that later disseminated to S. aureus. In this study, we describe the first double mecA/mecC homologue-positive non-aureus staphylococci and mammaliicocci (NASM) from the American continent, also representing the first report of mecC-positive NASM in Brazil. Two clonally related methicillin-resistant M. sciuri strains co-carrying mecA and mecC genes were isolated from the teat skin swab and milk sample collected from an ewe’s left udder half. Both M. sciuri strains belonged to the sequence type (ST) 71. Besides mecA and mecC genes, the M. sciuri strains carried broad resistomes for clinically important antimicrobial agents, including β-lactams, tetracyclines, lincosamide, streptogramin, streptomycin, and aminoglycosides. Virulome analysis showed the presence of the clumping factor B (clfB), ATP-dependent protease ClpP (ClpP) and serine-aspartate repeat proteins (sdrC and sdrE) virulence-associated genes. Phylogenomic analysis revealed that these M. sciuri strains are part of a globally disseminated branch, associated with farm and companion animals and even with food. Our findings suggest that M. sciuri is likely to emerge as a pathogen of global interest, carrying a broad repertoire of antimicrobial resistance genes with a remarkable co-presence of mecA and mecC genes. Finally, we strongly encourage to monitor M. sciuri under the One Health umbrella since this bacterial species is spreading at the human-animal-environment interface.

Accuracy of conventional and 3D printed casts for partial fixed prosthesis.

PURPOSE: To evaluate and compare the accuracy of conventional and 3D-printed casts using five different 3D printers. MATERIALS AND METHODS: In the control group (CG group, n = 5), five conventional impressions using light- and heavy-body polyvinyl siloxane were obtained from the master model, resulting in five stone models. In the test groups, five different scans were performed by a well-trained and experienced clinician using a TRIOS intraoral scanner. All data were exported as an STL file format, processed, and sent to five 3D printers. Five casts were manufactured in each group: SG (CARES P20, Straumann); FG (Form 2, Formlabs); WG (Duplicator 7, Wanhao); ZG (Zenith D, Zenith); and MG (Moonray S100, Moonray). Measurements of the accuracy (trueness and precision) of the casts obtained from conventional elastomeric impressions and 3D-printing methods were accomplished using a 3D analysis software (Geomagic Control). RESULTS: The FG group showed the lowest values for trueness (closer to real dimensions), which were similar to the SG group only (P > .05). Groups MG, WG, and ZG presented higher values and were similar compared to each other. Data on precision demonstrated that all 3D-printed groups showed lower values for precision (smaller deviation) when compared to the control group. CONCLUSION: The trueness depends on the chosen 3D printer. All of the tested 3D printers were more precise than cast models obtained from conventional elastomeric impressions.

Can postpolymerization for 3D-printed interim restorations be improved?

STATEMENT OF PROBLEM: Postpolymerization methods influence the properties of 3-dimensionally (3D) printed materials. Nevertheless, it is a time-consuming step that could lead dentists to avoid the chairside use of 3D printing. Information assessing the impact of different postpolymerization workflows on flexural strength and color stability is sparse. PURPOSE: The purpose of this in vitro study was to analyze the impact of different postpolymerization methods on the flexural strength and color stability of 3D-printed resins used for interim restorations. MATERIAL AND METHODS: Three resin materials: CT (Cosmos Temp; Yller Biomaterials), DT (Denture Teeth; Formlabs), and CB (C&B MFH; NextDent) were submitted to 4 methods of postpolymerization: a Form Cure polymerization chamber (FC) (Form Cure; Formlabs), a broadband LED device (Valo Grand; Ultradent Products, Inc) operating at 1000 mW/cm2 for 2 different polymerization times (40 seconds/V40 or 120 seconds/V120), and a custom-made polymerization chamber with a 24 W UV LED Strip (CC). The specimens were assessed for flexural strength using an universal testing machine immediately after polymerization or after 10 000 thermal cycles, and the color stability was evaluated using a spectrophotometer at baseline, after 7 days in dark, dry storage at 37 °C and after 24 hours of artificial aging in water at 60 °C. The data were evaluated using 3-way ANOVA (flexural strength) and 3-way repeated measurements ANOVA (color stability), followed by the Tukey HSD test (α=.05). RESULTS: Flexural strength showed significant differences for resin, postpolymerization method, time, and for the interaction between all effects. CT showed the highest overall flexural strength, while DT showed the lowest. In general, V120 produced specimens with higher flexural strength. Thermocycling did not reduce flexural strength except for CB polymerized with FC and V120, and DT polymerized with V40. For color stability, significant differences were found for resin, postpolymerized method, time, and for the interaction between all effects. The highest ΔE values were observed for DT polymerized using V40 after artificial aging. The lowest values were observed for the same resin but polymerized using V120 after 7 days in dark, dry storage at 37 °C. CONCLUSIONS: Postpolymerization with the broadband LED device for 120 seconds can produce specimens with higher flexural strength values and higher color stability when compared with the other postpolymerization workflows tested in this study.

Dual Digitally Guided Crown Lengthening in Esthetic Area Compromised by Disharmonic Implant Crown.

INTRODUCTION: A disharmonious smile results from excessive gingival exposure or gingival margin misalignment is a frequent finding in patients. The most common cause is altered passive eruption; however, in the case presented here, the esthetics of the smile is compromised also due to an inadequate implant placement and crown fabrication. CASE PRESENTATION: This case presented a combination of altered passive eruption and a buccally as well as deeply placed implant crown (#10) that led to disproportionate dimensions of an upper lateral incisor. Dual digitally guided crown lengthening surgical procedure for teeth #5 to #12 was performed aiming a better harmony of the smile. Treatment also included placement of tooth veneers and re-made of implant crown. A pleasant smile with appropriate colors and proportions was achieved. All esthetic and periodontal health parameters were maintained throughout the follow-up period (1 year). CONCLUSION: The use of dual digitally guided crown lengthening help to accomplish precision and stability of esthetic outcome, as it guides for both, bone and soft tissue removal. Particularly, in challenging cases with high esthetic demand and complicated factors present, such as the case presented here, the digital approach provides tools to attain excellent treatment outcome.

A fully digital approach for implant fixed complete dentures: A case report.

INTRODUCTIONS: Intraoral scanner has been widely used for implant impression in partially edentulous cases; however, its accuracy in the impression of full-arch implant is still questionable. CLINICAL REPORT: This clinical report presents a technique to check the accuracy of intraoral scanning for complete-arch implant restorations using an implant index cast (The Glossary of Prosthodontic Terms 9th Edition) and a three-dimensional printed cast. A clinical case of immediate loading on a maxillary edentulous patient illustrates the application of an implant index cast in implant fixed complete dentures (IFCDs). DISCUSSION: The implant index cast was fabricated based on the immediate interim prosthesis and provides effective control of the fit of scanned files and printed models. Therefore, this approach allows a more predictable and accurate fit of the final prosthesis. CLINICAL SIGNIFICANCE: In this article, we present a technique to check the accuracy of the final prosthesis without the need for a conventional impression and final cast in a digital workflow. This proposed approach is demonstrated through a case report of a maxillary edentulous patient restored with immediate loaded IFCDs.

Effect of glyphosate and P on the growth and nutrition of Coffea arabica cultivars and on weed control.

The effect of the phosphorus (P) and glyphosate interactions on the growth and nutrition of Arabica coffee cultivars (Coffea arabica), as well as on the control of Ipomoea grandifolia and Urochloa decumbens, was evaluated. Catuaí-Amarelo/IAC-62 and Catuaí-Vermelho/IAC-144 cultivars did not show glyphosate poisoning, regardless of the soil P content. However, glyphosate reduced the growth of Catuaí-Vermelho/IAC-144. In addition, the soil P content influenced the height, leaf area and dry matter of Catuaí-Amarelo/IAC-62, and the absorption of P and Ca in both cultivars. On the other hand, glyphosate efficiently controlled U. decumbens but not I. grandifolia. Glyphosate effectiveness on I. grandifolia decreased as the soil P content increased. In addition, the soil P content and the glyphosate influenced the P content in I. grandifolia and U. decumbens plants. The soil P content influenced the growth and absorption of other nutrients by coffee plants as well as glyphosate effectiveness on weed control.

Influence of operator experience, scanner type, and scan size on 3D scans.

STATEMENT OF PROBLEM: Intraoral scanners (IOSs) have some inherent distortions caused by optical and/or software imperfections. However, how other factors such as operator experience, scan time, scanner type, and scan size influence scan accuracy is not clear. PURPOSE: The purpose of this in vitro study was to evaluate the trueness and precision of scans performed by 3 professionals with different levels of experience by using 2 IOSs. MATERIAL AND METHODS: Three operators with low, medium, and high levels of experience scanned a master model 10 times by using 2 IOSs (CEREC Omnicam; Dentsply Sirona and TRIOS 3; 3Shape), resulting in 10 standard tessellation language files for each group (N=60). Each standard tessellation language file was divided into 2 areas (prepared teeth and complete arch). Precision was evaluated by comparing the 10 scans from each examiner for each system. Trueness was evaluated by comparing each scan file with a reference scan obtained from a laboratory scanner (D2000; 3Shape). A 3D analysis software program (Geomagic Control; 3D Systems) was used to perform all the comparisons and superimpositions. The 3-way ANOVA test followed by the Tukey HSD test were used to assess precision and trueness. The 2-way ANOVA followed by the Tukey HSD test was used to assess scan time. The Pearson correlation test was performed between scan time and trueness for both scanners. An additional correlation was performed between scan time and number of images, as well as between number of images and trueness for the TRIOS 3. RESULTS: Statistically significant influences of operator (P<.001), scanner (P<.001), scan size (P<.001), operator and scan size (P<.001), and scanner and scan size (P<.001) were observed. The TRIOS 3 group reported higher precision than the CEREC Omnicam group for complete-arch scans (P<.001), although no difference was observed for scans of the prepared tooth. Medium- (P=.002) and low-experience operators (P<.001) reported lower precision for complete-arch scans performed with CEREC Omnicam when compared with TRIOS 3. The low-experience operator reported significantly worse results for complete-arch scans in comparison with the medium- (P=.008 and P<.001) and high-experience operators (P<.001 and P=.001), by using TRIOS 3 and CEREC Omnicam, respectively. Medium- and high-experience operators reported similar results among themselves. The CEREC Omnicam scanner reported lower trueness for complete-arch scans when compared with the prepared tooth (P<.001); for TRIOS 3, a difference was only observed for the low-experience operator when compared with the high-experience operator (P<.001). The CEREC Omnicam reported lower trueness than the TRIOS 3, except for the medium-experience operator with the prepared tooth scan. Comparing the trueness between operators and considering the same scanner and scan size, all groups were similar. The low-experience operator had a longer scanning time than the medium- and high-experience operators. For TRIOS 3, the low-experience operator obtained the highest number of images during each scan. CONCLUSIONS: The accuracy of intraoral scans was influenced by operator experience, type of IOSs, and scan size. More experienced operators and smaller scan sizes made for more accurate scans. In addition, more experienced operators made faster scans, and the TRIOS 3 was more accurate than the CEREC Omnicam for complete-arch scans.

Denture scanning technique for computer-guided implant-supported restoration treatment of edentulous patients.

The traditional protocol for guided surgery in a completely edentulous patient is time-consuming, requiring the fabrication of a radiographic guide and a dual cone beam computed tomography (CBCT) scan. Using intraoral scanners to scan the edentulous ridge and the existing denture has been advocated to simplify the process. This technique offers a versatile, precise, and predictable method for the digital planning workflow in edentulous patients for either a fixed or removable restoration. In addition, this approach can help improve the quality of the guide produced by reducing CBCT artifacts associated with the existing denture, as well as capture the soft-tissue contour to further improve the fit of the surgical guide.

Hydrophilic titanium surface modulates early stages of osseointegration in osteoporosis.

OBJECTIVE: Using a mouse osteoporotic model, this study aimed to determine the influence of hydrophilic titanium surfaces on gene expression and bone formation during the osseointegration process. BACKGROUND: Based on the previous evidence, it is plausible to assume that osteoporotic bone has a different potential of bone healing. Therefore, implant surface modification study that aims at enhancing bone formation to further improve short- and long-term clinical outcomes in osteoporosis is necessary. MATERIAL AND METHODS: Fifty female, 3-month-old mice were included in this study. Osteoporosis was induced by ovariectomy (OVX, test group) in 25 mice. The further 25 mice had ovaries exposed but not removed (SHAM, control group). Seven weeks following the ovariectomy procedures, one customized implant (0.7 × 8 mm) of each surface was placed in each femur for both groups. Implants had either a hydrophobic surface (SAE) or a hydrophilic treatment surface (SAE-HD). Calcium (Ca) and phosphorus (P) content was measured by energy-dispersive X-ray spectroscopy (EDS) after 7 days. The femurs were analyzed for bone-to-implant contact (BIC) and bone volume fraction (BV) by nano-computed tomography (nano-CT) after 14 and 28 days. Same specimens were further submitted to histological analysis. Additionally, after 3 and 7 days, implants were removed and cells were collected around the implant to access gene expression profile of key osteogenic (Runx2, Alp, Sp7, Bsp, Sost, Ocn) and inflammatory genes (IL-1ß, IL-10, Tnf-α, and Nos2) by qRT-PCR assay. Statistical analysis was performed by ANOVA and paired t test with significance at P < .05. RESULTS: The amount of Ca and P deposited on the surface due to the mineralization process was higher for SAE-HD compared to SAE on the intra-group analysis. Nano-CT and histology revealed more BV and BIC for SAE-HD in SHAM and OVX groups compared to SAE. Analysis in OVX group showed that most genes (ie, ALP, Runx2) involved in the bone morphogenetic protein (BMP) signaling were significantly activated in the hydrophilic treatment. CONCLUSION: Both surfaces were able to modulate bone responses toward osteoblast differentiation. SAE-HD presented a faster response in terms of bone formation and osteogenic gene expression compared to SAE. Hydrophilic surface in situations of osteoporosis seems to provide additional benefits in the early stages of osseointegration.

Mortality due to COVID-19 in public and private hospitals in Florianópolis / SC / Mortalidade por COVID-19 em hospitais públicos e privados de Florianópolis/SC

Introduction: The access to COVID-19 hospital treatment is important to mitigate the impact caused by socioeconomic issues in the treatment of the disease. Objective: To analyze the difference between public and private hospital care in mortality due to COVID-19 in Florianópolis/SC, Brazil. Methods: Historical cohort with confirmed patient data with notification made between February 22nd 2020 and November 9th 2020 in hospitals in the city. Data were provided by the Municipal Health Secretariat. In order to control the socioeconomic factors that could simultaneously influence the search for the type of hospital and mortality, a double-robustness approach was used. In the first stage, pairing of notified individuals in public and private hospitals was carried out by genetic algorithm, using sample replacement. In the second stage, the probability of death was estimated, conditioned by the type of hospital (public or private), symptoms, comorbidities, socioeconomic factors, age, age squared, sex, race / skin color and month of symptom onset using a logistic regression. Finally, the difference between the densities of probability of death of the two hospital types was analyzed. Results: Data from 2,497 people, 1,244 from public hospitals and 1,253 from private hospitals were analyzed. The conditional probability of death assuming that all patients were notified in public hospitals was 0.0010 (95% CI 0.0001; 0.0046) and if all were notified in private hospitals it was 0.0009 (95% CI 0.0001; 0.0039). The difference between the two probabilities was -0,0002 (95% CI -0.0013; 0.0005). Conclusion: The probability of death from COVID-19 was similar among patients seen in public and private hospitals during the period studied.

Introdução: O acesso ao tratamento hospitalar da COVID-19 é importante para amenizar o impacto causado pelas questões socioeconômicas no tratamento da doença. Objetivo: Analisar diferença da atenção hospitalar pública ou privada na mortalidade por COVID-19 em Florianópolis/SC. Métodos: Coorte histórica com dados de pacientes confirmados com notificação realizada entre 22 de fevereiro de 2020 e 09 de novembro de 2020 em hospitais da cidade. Os dados foram fornecidos pela Secretaria Municipal de Saúde. Para controlar os fatores socioeconômicos que poderiam influenciar simultaneamente a busca do tipo de estabelecimento hospitalar e a mortalidade, utilizou-se abordagem de dupla-robustez. Na primeira etapa realizou-se pareamento de indivíduos notificados em hospitais públicos e privados por algoritmo genético. Na segunda etapa, estimou-se a probabilidade de óbito condicionada ao tipo de hospital (público ou privado), aos sintomas, comorbidades, fatores socioeconômicos, idade, idade ao quadrado, sexo, raça/cor da pele e mês do início dos sintomas por meio de regressão logística. Analisou-se, por fim, a diferença entre as densidades de probabilidade de óbito dos dois tipos hospitalares. Resultados: Foram analisados dados de 2.497 pessoas, 1.244 de hospitais públicos e 1.253 de privados. A probabilidade condicional de óbito assumindo que todos os pacientes fossem notificados em hospitais públicos foi de 0,0010 (IC 95% 0,0001; 0,0046) e se todos fossem notificados em hospitais privados foi de 0,0009 (IC 95% 0,0001; 0,0039). A diferença entre as duas probabilidades foi de -0,0002 (IC 95% -0,0013; 0,0005). Conclusão: A probabilidade de óbito por COVID-19 mostrou-se semelhante entre pacientes atendidos em hospitais públicos e privados no período estudado.

Gangrenous mastitis in sheep caused by multidrug-resistant Staphylococcus haemolyticus / Mastite gangrenosa em ovinos causada por Staphylococcus haemolyticus multirresistente

Mastitis is a multifactorial disease and considered one of the most critical problems in the dairy industry worldwide. The condition is characterized by reduced milk and several abnormalities in the mammary gland. This study aimed to report an outbreak of gangrenous mastitis caused by multidrug-resistant Staphylococcus haemolyticus in a Santa Inês sheep herd. Eighteen sheep were affected, and five of them with severe clinical pictures were examined. The clinical and pathological picture were variable and characterized by apathy, anorexia, emaciation, opaque and brittle hair, apparent and congested episcleral vessels, and hyperthermia. These ewes had enlarged, firm, and painful mammary glands. Macroscopically, these lesions consisted of severe gangrenous mastitis, and microscopically, the primary lesions consisted of necrosis, thrombosis, and fibrosis of the mammary parenchyma. Milk samples from one of the five severely affected ewes were collected and cultured under aerobic or microaerophilic incubation at 37°C for 24 hours on sheep blood agar. The obtained colonies were then submitted to MALDI-TOF for speciation. The colonies were also submitted to an antimicrobial susceptibility test, genotyping of virulence factors and resistance genes were also performed. The isolates showed antimicrobial multiresistance since they were resistant to seven out of 13 tested antibiotics. The isolates were also positive for two staphylococcal enterotoxigenic genes (sec and see) and fibronectin-binding protein B (fnbB).(AU)

A mastite é uma doença multifatorial e é considerada um dos problemas mais importantes na indústria de laticínios no mundo todo. A condição é caracterizada pela redução de leite e várias anormalidades na glândula mamária. O objetivo deste estudo foi relatar um surto de mastite gangrenosa causada por Staphylococcus haemolyticus multirresistente em um rebanho ovino Santa Inês. Dezoito ovelhas foram afetadas e cinco delas com quadro clínico severo foram examinadas. O quadro clínico-patológico era variável quanto a severidade e consistia em apatia, anorexia, magreza, pelos opacos e quebradiços e vasos episclerais aparentes e ingurgitados. As ovelhas apresentavam glândulas aumentadas, firmes e dolorosas. Macroscopicamente, as principais lesões consistiam em mastite gangrenosa e microscopicamente havia necrose do parênquima glandular, trombose e fibrose. Amostras de leite de uma das cinco ovelhas severamente afetadas foram coletadas e cultivadas sob incubação aeróbica ou microaerofílica a 37°C por 24 horas em ágar sangue de ovelha. As colônias obtidas foram então submetidas ao MALDI-TOF para especiação. Além disso, as colônias foram submetidas a um teste de suscetibilidade antimicrobiana e foi realizada a genotipagem de fatores de virulência e genes de resistência. Os isolados apresentaram multirresistência antimicrobiana por serem resistentes a sete dos 13 antibióticos testados. Os isolados também foram positivos para dois genes enterotoxigênicos estafilocócicos (sec e see) e proteína B de ligação à fibronectina (fnbB).(AU)

Antimicrobial resistance profile of non-aureus Staphylococci isolates from buffalo, goat and sheep mastitis in the Northeast region of Brazil.

The study described in this Research Communication investigated the genotypic and phenotypic profiles of resistance to beta-lactams and other antimicrobials in non-aureus Staphylococci (NAS) isolated from buffalo, goat and sheep mastitis in the Northeast region of Brazil. A total of 190 isolates were analyzed and 42.3, 43.9 and 23.6% of them were positive for blaZ gene in buffalo, goat and sheep, respectively. Regarding the animal groups, in goats, amoxicillin was the antimicrobial with highest resistance index (72.7%), followed by penicillin G in buffaloes (51.9%) and ampicillin in sheep (43.1%). With regard to multiple antimicrobial resistance, 30.8% of NAS isolates from buffalo milk samples, 25.8% from goats and 25.0% from sheep presented multidrug-resistance. In the minimum inhibitory concentration (MIC) technique, amoxicillin MIC50 and MIC90 were 64 and 128 µg/ml, respectively, among isolates of the three animal species. In conclusion, high rates of resistance to beta-lactams are presented among NAS isolated from mastitis cases in buffaloes, goats and sheep in Northeast region of Brazil. These results provide an alert to animal and human health researchers, suggesting that the frequency of NAS needs to be reduced because they carry resistance genes which might increase the existing levels of antimicrobial resistance.

Efeito clínico, radiográfico e imunológico do tratamento cirúrgico associado à terapia fotodinâmica com azul de toluidina 0,2% em peri-implantite: estudo clínico randomizado longitudinal de 1 ano / Clinical, radiographic and immunological effects of surgical treatment associated with photodynamic therapy with 0.2% toluidine blue in peri-implantitis: randomized 1-year longitudinal clinical study

O objetivo do presente estudo foi comparar os efeitos clínicos, radiográficos e imunológicos do tratamento cirúrgico para peri-implantite com ou sem terapia fotodinâmica após 1 ano. Participaram deste estudo 21 pacientes com peri-implantite (idade média 56,0 ± DP 9,6 anos). Divididos os grupos em teste e controle de forma randomizada. Foram utilizados os seguintes parâmetros clínicos: profundidade de bolsa à sondagem (PBS); índice de placa visível (IPV)e índice de sangramento à sondagem (ISS). A radiografia periapical foi utilizada como parâmetro radiográfico em baseline e 1 ano. A coleta do fluido periimplantar foi realizada com periopaper e congelada à -70°C para posterior análise. Os biomarcadores do metabolismo ósseo utilizados no fluido periimplantar foram TNF-α, SOST, PTH, OPG, OPN, OC, Leptina, IL-6, IL-1ß FGF-23. Os pacientes de ambos os grupos receberam tratamento periimplantar cirúrgico de acesso para raspagem e no grupo teste foi utilizada a terapia fotodinâmica com azul de toluidida 0,12%, na qual emite uma radiação infravermelha pulsada no comprimento de onda de 2,94 mm. Os parametros do laser foram fixados em 100 mJ / pulso (12,7 J/cm2) e 10 pps (energia de pulso na ponta: cerca de 85 mJ/pulso). Os dados clínicos foram coletados em quatro visitas em ambos os grupos (baseline, 03 meses, 6 meses e 1 ano). Os dados radiográficos e imunológicos foram coletados (baseline e 1 ano). Os biomarcadores foram mensurados por meio de um imunoensaio multiplex. Os resultados mostraram uma redução significativa dos parâmetros clínicos 3 meses após o tratamento, em ambos grupos. No baseline, os valores de PBS 8,5mm ± 0,9, ISS 100%, ISG 100% IPV 100% no grupo controle. Os valores correspondentes do grupo teste foram 8,6mm ± 0,7,100%,100% e 100%). Aos 3 meses as médias de PBS, ISS, ISG e IPV foram 5,7mm ± 0,5, 11%, 100% e 0% no grupo controle e 5,7mm, 8%, 100% e 0% no grupo teste (p<0,05). Esses valores mantiveram-se constantes até os 12 meses de acompanhamento. Aos 12 meses, foi observado uma melhora nos parâmetros ósseo estatisticamente significante no grupo controle (baseline 6,2±1 mm x 12 meses5,7± 0,6 mm) (p = 0,008). No grupo teste houve um ganho ósseo (baseline 6 ±0,8 mm x12 meses 5,9 ± 0,6 mm) (p>0,5). A análise imunológica mostrou uma redução significativa nos níveis de IL6 e OC em ambos os grupos, após 1 ano de tratamento. No entanto, no grupo teste houve uma redução significativa de Leptina (p= 0,05) e uma tendência a uma redução dos níveis de OPN (p= 0,08). Concluindo, a terapia peri-implantar cirúrgica levou a uma melhora significativa dos parâmetros clínicos periimplantares após 1 ano, um ganho ósseo no grupo controle e uma redução de biomarcadores em ambos grupos. O uso adicional da terapia fotodinânima ao acesso cirúrgico não ofereceu resultados superioresaos observados no grupo somente com acesso cirúrgico(AU)

The aim of the present study was to evaluate the clinical, radiographic and immunological effects of surgical treatment for peri-implantitis after 1 year. Twenty-one patients with peri-implantitis participated in this study (mean age 56.0 ± SD 9.6 years). Patients were divided into a test and control group at random. The following clinical parameters were used: probing depth (PS); plaque index (PI)and probing bleeding index (BOP). Periapical radiography was used as a baseline and 1-year radiographic parameter. Peri-implant fluid samples were collected with periopaper and frozen at -70° C for further analysis. Bone metabolism biomarkers included TNF-α, SOST, PTH, OPG, OPN, OC, Leptin, IL-6, IL-1ß FGF-23. Patients in both groups received peri-implant surgical treatment for scaling. The test group underwent a photodynamic therapy with 0.2% toluidide blue, in which pulsed infrared radiation is emitted at a wave length of 2.94 mm. The laser parameters were set at 100 mJ/pulse (12.7 J/cm2) and 10 pps (pulse energy at the tip: about 85 mJ/pulse). Clinical data were collected in four visits in both groups (baseline, 3 months, 6 months and 1 year). Radiographic and immunological data were collected (baseline and 1 year). Biomarkers were measured using a multiplex immunoassay. The results showed a significant reduction in clinical parameters 3 months after treatment, in both groups. In the baseline, the control group presented the values of PBS 8.5 mm ± 0.9, ISS 100%, ISG 100% VPI 100%, while the test group presented PBS 8.6 mm ± 0.700%, ISS 100% and ISG 100% After 3 months, the average values of PBS, ISS, ISG and VPI were 5.7 mm ± 0.5, 11%, 100% and 0% in the control group and 5.7 mm, 8%, 100% and 0% in the test group ( p <0.05). These values remained constant until the 12-month follow-up, at which point a statistically significant bone gain was observed in the control group (baseline 6.2 ± 1 mm x 12 months 5.7 ± 0.6 mm) (p = 0.008). In the test group there was a bone gain (baseline 6 ± 0.8 mm x 12 months 5.9 ± 0.6 mm) (p> 0.5). The immunological analysis showed a significant reduction in the levels of IL6 and OC in both groups, after 1 year of treatment. However, in the test group there was a significant reduction in Leptin (p = 0.05) and a tendency towards a reduction in OPN levels (p = 0.08). In conclusion, peri-implant surgical therapy led to a significant improvement in peri-implant clinical parameters after 1 year, a bone gain in the control group, and a reduction in biomarkers in both groups. The additional use of photodynamic therapy for surgical treatment in the test group did not present superior results to those observed in the control group(AU)