A Systematic Review of Interventions Based on Judeo-Christian Principles for Patients with Substance Dependence.

Substance use disorders have significant consequences for patients and those around them. A qualitative systematic review was conducted to examine the effectiveness of religiosity and spirituality (R/S) interventions based on Judeo-Christian principles during the multidisciplinary treatment of patients with substance dependence disorder. Studies of patients of both sexes, at any age, of any nationality, and from any geographic location who were participating in treatment programs with religious elements explicitly tied to Christianity or Judaism were eligible for inclusion. Other religious interventions were excluded. Seven electronic databases were searched to identify eligible intervention studies published in English until August 2021. Two reviewers independently screened studies and extracted data. JBI tools were used to assess risk of bias. Of 146 articles retrieved for full text reading, five were ultimately included in this review published from July 2008 to August 2021. The R/S interventions used in the included studies were music therapy in a religious context, reading of the Bible or Torah, reflexive readings, personal prayer and reflection, and religiously integrated cognitive behavioral psychotherapy with or without a comparison group. Despite the broad search, there were found only a small number of studies and little homogeneity in the data of patients that reported positive impacts of treatments. Well-designed controlled studies are needed to truly investigate the efficacy of Judeo-Christian religious interventions for helping people with substance use problems, so as to strengthen the evidence of the benefits of these type of approaches in the treatment of drug addicts.

Renal toxicity caused by diethylene glycol: an overview.

Diethylene glycol (DEG) is nephrotoxic, potentially resulting in high morbidity and mortality. Its main nephrotoxic by-product is diglycolic acid (DGA). This narrative overview summarizes selected literature with a focus on clinical findings, pathophysiology, diagnosis including morphological features of renal biopsies, and management. The kidney injury in DEG poisoning is secondary to proximal tubular necrosis caused by DGA. Marked vacuolization and edema of epithelial cells obstruct the lumen, reducing urine flow and, consequently, resulting in anuria and uremia. The clinical alterations due to DEG poisoning are dose-dependent. Patients may present with gastrointestinal symptoms and anion gap metabolic acidosis, followed by renal failure, and, later, encephalopathy and neuropathy. Although this three-phase pattern has been described, signs and symptoms may be overlapping. Data about DEG intoxication is scarce. Sometimes the diagnosis is challenging. The management includes supportive care, gastric decontamination, correction of acid-base disorders, and hemodialysis. The understanding of the metabolic processes related to DEG poisoning may contribute to its management, preventing death, serious sequels, or irreversible lesions.

Clinical-Epidemiological Characteristics and Outcomes of Latent Tuberculosis Treatment at a Tertiary Center in Central-West Brazil from 2017 to 2019.

Detailed information concerning latent tuberculosis infection (LTBI) and treatment outcomes is scarce in Brazil. This retrospective cross-sectional study aimed to describe LTB treatment (LTBT) at a tertiary center in Central-West Brazil from 2017 to 2019. We recommended the use of LTBTs before the implementation of a rifapentine-isoniazid (3HP) regimen in Brazil. We conducted a descriptive analysis using chi-square or t-tests to assess differences in the proportions and means. Of 79 notified adult patients (males, 68%; median age, 40 (interquartile range, 30-51) years), most people were living with human immunodeficiency virus (PLHIV) (82%) or receiving immunosuppressant medication (15%), and 92% were receiving their first treatment. Isoniazid (INH) for 6-9 months had previously been proposed for 95% of the patients, with only 35% completeness. Four patients treated with rifampicin (4RMP) completed the regimen (p = 0.009). Adverse events occurred in 19% of the patients. In this Brazilian tertiary center, the target population for LTBT were young PLHIV patients under immunosuppression with low education levels. However, the INH monotherapy dropout rate was 65%. Therefore, shorter courses, such as 3HP and 4RMP, are promising alternatives. Behavioral aspects, education level, and regimen length can influence the course completion, and further studies are required to evaluate the 3HP regime in Brazil.

Contextual and individual factors associated with self-reported tooth loss among adults and elderly residents in rural riverside areas: A cross-sectional household-based survey.

BACKGROUND: Tooth loss is an oral health condition with high prevalence and negative impact on quality of life. It is the result of the history of oral diseases and their treatment as well as provision of dental care and access to dental services. Socioeconomic characteristics are determinants of tooth loss and living in rural areas is also a risk factor for its incidence. OBJECTIVE: To identify contextual and individual factors associated with self-reported tooth loss among adults and elderly people living in rural riverside areas. METHODS: A cross-sectional household-based survey was conducted in 2019 with rural riverside communities on the left bank of the Rio Negro River, Manaus, Amazonas. These communities are covered by a fluvial health team and two riverside health teams. Interviews were conducted in a representative random sample of dwellers aged ≥ 18 years, using electronic forms to obtain information on oral health conditions, demographic and socioeconomic characteristics, and use of and access to health services. The outcome was self-reported tooth loss. After the descriptive analysis of the data, a multilevel Poisson regression analysis was performed to estimate the prevalence ratio for the outcome. Variables with p-value ≤0.20 in the bivariate analyses were included in the multiple analysis considering the hierarchy between individual and contextual variables in the multilevel model. Variables with p-value ≤0.10 were kept in the final model and the significance level adopted was 0.05. RESULTS: 603 individuals from 357 households were assessed (mean age 44.1 years). The average number of missing teeth was 11.2 (±11.6); 27.4% of individuals had lost more than 20 teeth (non-functional dentition) and 12.1% were completely edentulous. Contextual characteristic of primary healthcare offered was associated with the outcome. The tooth loss was lower in territories covered by riverside health teams. At individual level, tooth loss was greater in older individuals who had experienced dental pain over the past six months and whose sugar consumption was high. Black or brown individuals, individuals whose household income was higher, those who were on the Bolsa Família cash transfer program, those who consulted a dentist over the past year, and those who reported satisfaction with their teeth/oral health reported less tooth loss. CONCLUSION: Tooth loss was associated with contextual territorial factors related to the healthcare service and individual demographic, behavioral, socioeconomic, and service-related characteristics as well as self-perceived oral health conditions. The findings suggest that actions focused on the oral health of these populations involve not only changes in the healthcare service organization, but also intersectoral policies that contribute to reducing social inequalities.

Cleaning and microstructural effects of amyl acetate on pulp chamber dentin impregnated with epoxy resin-based endodontic sealer.

OBJECTIVE: To evaluate the cleaning potential of 95% ethanol, acetone, and amyl acetate solutions used solely or in association, to remove epoxy resin-based sealer residues from pulp chamber dentin and their microstructural effects. MATERIALS AND METHODS: One hundred and eighty bovine incisor specimens were divided into nine groups according to the cleaning protocol: ET (ethanol); AC (acetone); AA (amyl acetate); E1: AA+AC; E2: AA+ET; E3: AC+ET; E4: AA+AC+ET; PC (positive control), and NC (negative control). All groups were impregnated with epoxy resin-sealer, except NC. Ninety specimens were divided into groups (n = 10) for evaluation of persistence of residues and amount of open dentinal tubules by SEM analysis and evaluation of chemical compounds on the dentin surface after cleaning with electron dispersive spectroscopy. The others 90 specimens were submitted to Knoop microhardness evaluation. Persistence of residues data were submitted to the Kruskal Wallis and Dunn tests (α = 0.05). Open dentinal tubules and microhardness data were submitted to one-way ANOVA and Mann Whitney tests (α = 0.05). RESULTS: AA and E4 protocols showed the lowest persistence of residues. E4 group had the highest incidence of open dentinal tubules. E3 and E4 groups showed no changes in the atomic ratio Ca/P, which was similar to NC group. E4 group did not present W, an element presents in all the other groups. ET and E4 protocols showed the smallest reduction in dentin microhardness. CONCLUSIONS: The combination of amyl acetate, acetone and ethanol is the most effective and safe protocol to remove epoxy sealer residues on pulp chamber dentin. Moreover, it has the lowest microhardness reduction. CLINICAL SIGNIFICANCE: The combined use of amyl acetate, acetone, and ethanol enhanced the cleaning of pulp chamber dentin with minimal microstructural damage.

Impact of cleansing protocols to remove endodontic sealer residues on the adhesive interface: Bonding with universal adhesive systems.

OBJECTIVE: The aim of this study was to evaluate the effectiveness of cleansing protocols to remove sealer residues using different cleaning strategies and the effect of bond strength of two universal adhesives to dentin impregnated with epoxy resin-based sealer. MATERIALS AND METHODS: Fifty bovine dentin specimens were impregnated with epoxy resin-based sealer containing calcium hydroxide (Sealer Plus) and submitted to cleansing protocols (n = 10): negative control (NC), positive control (PC), 95% ethanol (ET), xylol (XI), and amyl acetate (AA). Specimens were evaluated by scanning electron microscope (SEM). Other 100 specimens were submitted to the same protocols (n = 20). Each protocol was divided into subgroups (n = 10) according to the universal adhesive system used: Scotchbond Universal (SU); Ambar Universal (AU). Bond strength was evaluated by micro-shear bond test (µSBT). Persistence of residues data were assessed with Kruskal-Wallis and Dunn's tests. µSBT data were analyzed with two-way ANOVA (α = 5%). RESULTS: ET presented higher persistence of residues compared to AA and XI (p < 0.05). AA and XI were similar from each other (p > 0.05). AU and SU presented similar µSBT values, regardless of the cleansing solution (p > 0.05). SU-NC presented the highest µSBT among all conditions (p < 0.05). CONCLUSION: The bond strength of universal adhesives was not affected by different amounts of sealer residues after different cleaning protocols. CLINICAL SIGNIFICANCE: Non-polar substances such as amyl acetate and xylol are effective for removing residues from epoxy resin-based endodontic sealers.

Effects of the submerged macrophyte Ceratophyllum demersum (Ceratophyllaceae) and the cladoceran Moina micrura (Cladocera: Moinidae) on microalgal interactions / Efectos de un macrófito sumergido Ceratophyllum demersum (Ceratophyllaceae) y un cladócero Moina micrura (Cladocera: Moinidae) sobre las interacciones de microalgas

Abstract Introduction: Cyanobacterial blooms in tropical water bodies are increasingly common, because of eutrophication and rising temperatures. Consequently, many freshwater systems are affected, by reducing water quality, biodiversity, and ecosystem services. With the increased frequency of harmful algal blooms, the development of biological tools to improve water quality is an urgent issue. Objective: To evaluate the effects of a submerged macrophyte and a cladoceran on the microcystin-producing cyanobacteria Microcystis aeruginosa (NPLJ-4) and the chlorophyte Raphidocelis subcapitata (BMIUFRPE-02) in mixed cultures. Methods: Two parallel experiments were carried out for ten days to evaluate the effects of the submerged macrophyte Ceratophyllum demersum and the cladoceran Moina micrura on microalgal interactions. Microalgal strains were cultivated in the ASM1 culture medium, under controlled laboratory conditions. The first experiment presented four treatments: M (C. demersum), Z (M. micrura), MZ (C. demersum and M. micrura), and C (control). Meanwhile, the second experiment consisted of five treatments, in which the microalgae were cultivated together at different Microcystis:Raphidocelis ratios: 1:0, 3:1, 1:1, 1:3, and 0:1. Biomass and growth rates of the strains were evaluated every two days, which were statistically treated with three-way or two-way repeated-measures ANOVA. Results: In the first experiment, M. aeruginosa was significantly inhibited in M and MZ treatments from the second day, and Z from the fourth, while R. subcapitata showed no reduction in its biomass in any treatment. On the other hand, R. subcapitata was stimulated from the eighth and tenth days in M treatment and only on the eighth day in Z treatment. In the second experiment, M. aeruginosa was significantly inhibited when cultivated with R. subcapitata in low ratios (Microcystis:Raphidocelis ratio of 1:3) throughout the experiment, while the chlorophyte was stimulated in that treatment. Conclusions: The coexistence of a cyanobacterium with a green alga did not alter the main negative response of M. aeruginosa to the submerged macrophyte and zooplankton but stimulated the green alga. Accordingly, the introduction of submerged macrophytes and cladocerans already adapted to eutrophic conditions, both isolated and combined, proved to be a good method to control cyanobacterial blooms without negatively affecting other coexisting phytoplankton species.

Resumen Introducción: Las proliferaciones de cianobacterias en los cuerpos de agua tropicales son cada vez más comunes, debido a la eutrofización y al aumento de las temperaturas. En consecuencia, muchos sistemas de agua dulce se ven afectados por la reducción de la calidad del agua, la biodiversidad y los servicios de los ecosistemas. Con el aumento de la frecuencia de la proliferación de algas nocivas, el desarrollo de herramientas biológicas para mejorar la calidad del agua es urgente. Objetivo: Evaluar los efectos de una macrófita sumergida y un cladócero sobre la cianobacteria productora de microcistina llamada Microcystis aeruginosa (NPLJ-4) y la clorofita Raphidocelis subcapitata (BMIUFRPE-02) en cultivos mixtos. Métodos: Se realizaron dos experimentos paralelos durante diez días para evaluar los efectos de la macrófita sumergida Ceratophyllum demersum y el cladócero Moina micrura sobre las interacciones microalgales. Se cultivaron cepas de microalgas en el medio de cultivo ASM1, en condiciones controladas de laboratorio. El primer experimento presentó cuatro tratamientos: M (C. demersum), Z (M. micrura), MZ (C. demersum y M. micrura) y C (control). El segundo experimento consistió en cinco tratamientos, en el que las microalgas se cultivaron juntas en diferentes proporciones de Microcystis:Raphidocelis: 1:0, 3:1, 1:1, 1:3 y 0:1. La biomasa y las tasas de crecimiento de las cepas se evaluaron cada dos días, y se trataron estadísticamente con ANOVA de medidas repetidas de dos o tres factores. Resultados: En el primer experimento, M. aeruginosa se inhibió significativamente en los tratamientos M y MZ a partir del segundo día, y en Z a partir del cuarto, mientras que R. subcapitata no mostró reducción de su biomasa en ningún tratamiento. Por otro lado, R. subcapitata fue estimulada a partir del octavo y décimo día en el tratamiento M y solo en el octavo día en el tratamiento Z. En el segundo experimento, M. aeruginosa se inhibió significativamente cuando se cultivó con R. subcapitata en proporciones bajas (proporción de Microcystis:Raphidocelis de 1:3) durante todo el experimento, mientras que la clorófita se estimuló en ese tratamiento. Conclusiones: La coexistencia de una cianobacteria con un alga verde no alteró la principal respuesta negativa de M. aeruginosa a la macrófita sumergida y al zooplancton, sino que estimuló al alga verde. En consecuencia, la introducción de macrófitos y cladóceros sumergidos ya adaptados a las condiciones eutróficas, tanto aislados como combinados, resultó ser un buen método para controlar las proliferaciones de cianobacterias sin afectar negativamente a otras especies de fitoplancton coexistentes.

Assessing the eco-effectiveness of a solid waste management plan using agent-based modelling.

Municipal Solid Waste Management is yet to be eco-effectively performed, especially in developing countries. In Brazil, a considerable fraction of waste has been improperly landfilled, generating environmental, social and economic problems. In 2018, the government of the state of Paraná released a revised version of its waste management plan, defining improvement strategies to be gradually implemented until 2038. However, these strategies' eco-effectiveness has not been forecasted, nor the plan was deployed to the regional level. This research aims to fill this gap, downscaling the plan to the region of Norte Pioneiro, simulating its implementation and monitoring environmental and economic benefits. The dynamics of waste generation, collection and disposal are investigated using an agent-based model, considering the four population growth scenarios addressed in the plan. Targets for strategies of waste reduction, collection, source-separation and charging of waste fees are modelled. Multiple simulation runs were performed and outputs assessed and discussed. Results show that, if the plan is thoroughly implemented since 2020, at least 650 kilotons of avoided CO2eq emissions and US$ 40 million in avoided expenditures can be achieved in the most conservative scenario by 2038. Implications from the strategies proposed in the plan are highlighted, and recommendations to improve the plan's eco-effectiveness are outlined.

Oral lesions in children/teenagers: a cross-sectional study of 225 reports in a pathology service in Amazon.

BACKGROUND: Epidemiologic studies of oral lesions in pediatric patients are scarce in Brazil, and especially in the northern region of the country. We aim to describe the distributions of oral lesions in children and teenagers diagnosed in a Pathology service of Amazon for over 15 years. METHODS: The oral pathology files were retrospectively retrieved from January 2002 to December 2016 of patients younger than 18 years old at the Pathology Service of the Federal University of Amazonas. Patient information such as gender, age, race, aspect of the lesion, anatomical site, and histological type was compiled from the file of requisitions and histopathologic reports. Oral lesions were subdivided into 11 categories. RESULTS: From a total of 2437 histopathological oral reports, 225 of them were from children. Of these, 125 (55.6%) were from male patients and 100 (44.4%) from female patients with a median age of 13 years. Of the 11 categories of oral pathologies, the one of the highest numbers was salivary gland disease (N.=50, 22.2%) with the subtype mucocele (N.=41, 18.22%) as the most prevalent followed by Miscellaneous pathology (N.=27, 12%) with the predominance of the subtype granulation tissue (N.=11, 4.89%) and finally Odontogenic tumors (N.=26, 11.6%) in third place, with odontoma (N.=16, 7.11%) as the most prevalent subtype. CONCLUSIONS: Mucocele was the most prevalent lesion found, showing that a traumatic etiology is likely to be the most common situation in children and teenagers, while neoplastic lesions are generally rare.