Evaluating the User Experience of a Smartphone-Delivered Sexual Health Promotion Program for Older Adults in the Netherlands: Single-Arm Pilot Study.

BACKGROUND: Sexual health is an important component of quality of life in older adults. However, older adults often face barriers to attaining a fulfilling sexual life because of issues such as stigma, lack of information, or difficult access to adequate support. OBJECTIVE: We aimed to evaluate the user experience of a self-guided, smartphone-delivered program to promote sexual health among older adults. METHODS: The mobile app was made available to community-dwelling older adults in the Netherlands, who freely used the app for 8 weeks. User experience and its respective components were assessed using self-developed questionnaires, the System Usability Scale, and semistructured interviews. Quantitative and qualitative data were descriptively and thematically analyzed, respectively. RESULTS: In total, 15 participants (mean age 71.7, SD 9.5 years) completed the trial. Participants showed a neutral to positive stance regarding the mobile app's usefulness and ease of use. Usability was assessed as "Ok/Fair." The participants felt confident about using the mobile app. To increase user experience, participants offered suggestions to improve content and interaction, including access to specialized sexual health services. CONCLUSIONS: The sexual health promotion program delivered through a smartphone in a self-guided mode was usable. Participants' perception is that improvements to user experience, namely in content and interaction, as well as connection to external services, will likely improve usefulness and acceptance.

Flavonoids effects against bacteria associated to periodontal disease and dental caries: a scoping review.

This scoping review focused on exploring the efficacy of flavonoids against bacteria associated with dental caries and periodontal diseases. Inclusion criteria comprise studies investigating the antibacterial effects of flavonoids against bacteria linked to caries or periodontal diseases, both pure or diluted in vehicle forms. The search, conducted in August 2023, in databases including PubMed/MEDLINE, Scopus, Web of Science, Embase, LILACS, and Gray Literature. Out of the initial 1125 studies, 79 met the inclusion criteria, majority in vitro studies. Prominent flavonoids tested included epigallocatechin-gallate, apigenin, quercetin, and myricetin. Predominant findings consistently pointed to bacteriostatic, bactericidal, and antibiofilm activities. The study primarily investigated bacteria associated with dental caries, followed by periodontopathogens. A higher number of publications presented positive antibacterial results against Streptococcus mutans in comparison to Porphyromonas gingivalis. These encouraging findings underline the potential applicability of commercially available flavonoids in materials or therapies, underscoring the need for further exploration in this field.

Exploring men's health in medium and high complexity care in Brazil: A deductive thematic analysis of social determinants.

Background: Men's health is influenced by a complex interplay of social, economic, and cultural determinants. Understanding how these aspects affect the health of adult cisgender men in medium and high-complexity healthcare settings is essential for improving healthcare services and promoting better health outcomes. Objective: This study aimed to analyze the health status of adult cisgender men in medium and high-complexity healthcare settings based on social determinants and conditioners. Methods: This study employed a qualitative design involving 45 adult cisgender men receiving care in medium/high complexity services in Bahia, Brazil. Semi-structured interviews were conducted from July 2019 to February 2020, and data were interpreted based on Dahlgren and Whitehead's Model of Social Determinants of Health using deductive thematic analysis. Results: Proximal determinants included biological aspects, preventive behaviors, lifestyle/social life, and aging processes. Intermediate factors included work conditions, access/utilization of healthcare services/medications, and psychosocial factors. Macro determinants involved income distribution, power dynamics, resource allocation, health inequalities/iniquities, morbidity, culture, political decisions, environmental factors, and structural elements. Conclusion: The health status of men in medium/high complexity care was profoundly influenced by structural social determinants. These determinants impacted healthcare attention, service organization, cultural influences, the reproduction of hegemonic masculinity patterns, lifestyle, social support, and socioeconomic conditions necessary to realize the right to health. Nursing practices should conduct comprehensive assessments that extend beyond physical health indicators.

Clinical and sociodemographic factors associated with time spent sitting in military police.

OBJECTIVE: To verify the association between clinical and sociodemographic factors and time spent sitting in military police. METHOD: This is a cross-sectional study, with 432 military police officers from Eastern Regional Policing Command units of the Military Police of Bahia de Feira de Santana. Data collection took place from August to December 2022 through Google Forms using the International Physical Activity Questionnaire. RESULTS: Men predominated (82.35%), race/color was black (87.04%), the head of the family had completed higher education (47.69%) and police officers with a partner (81.94%). The risk of time spent sitting ≥ 180 minutes per day was lower in males (IRR < 1). Increasing age was associated with a lower risk of time spent sitting ≥ 180 minutes per day (IRR < 1). CONCLUSION: Male police officers with more years of experience were less exposed to sedentary behavior. Specific interventions and health policies aimed at combating sedentary behavior become relevant, aiming to promote health and prevent diseases.

Promoting Sexual Health in Colorectal Cancer Patients and Survivors: Results from a Systematic Review.

BACKGROUND: Colorectal cancer diagnosis and treatment negatively impact sexual health. However, there is still a lack of interventions targeting the sexual healthcare needs of colorectal cancer patients and survivors. This systematic review aimed to identify and summarize the efficacy of available psychological interventions aimed at improving colorectal cancer patients' and survivors' sexual health. METHODS: This review followed PRISMA guidelines for systematic reviews. A database search was conducted for studies published until July 2023 on EBSCO Host, Web of Science, PubMed, and the Cochrane Library. Manuscripts were screened according to inclusion and exclusion criteria. The risk of bias was assessed using the Quality Assessment Tool for Quantitative Studies. RESULTS: From the 1499 records screened, four studies describing psychological interventions to improve the sexual health of the target population were identified. All studies reported on e-health programs and showed evidence of their efficacy in the improvement of participants' sexual function. The studies presented low scores on the Quality Assessment Tool for Quantitative Studies. CONCLUSIONS: Despite the evidence that tele/e-health psychological interventions have the potential to effectively promote sexual health in colorectal cancer patients and survivors, more robust research is needed to allow for generalization. Future research should further assess the efficacy of e-health interventions (eMental Health) in promoting sexual health in patients with colorectal cancer.

Effect of whitening toothpastes and activated charcoal powder on enamel wear and surface roughness.

This study aimed to evaluate surface roughness (Sa), roughness profile (Rv), and enamel wear after brushing with different whitening toothpastes and charcoal powders. Sixty (n = 10) bovine enamel blocks (6 × 6 × 3 mm) were randomly distributed into six groups according to toothpaste type: regular toothpaste (CONT), toothpaste containing 2% hydrogen peroxide (HP), toothpaste containing titanium dioxide (TiO2), toothpaste containing charcoal (COAL), toothpaste containing charcoal and TiO2 (COAL+TiO2), and activated charcoal powder (COAL_PWD). Each block was subjected to 30,000 reciprocal cycles at a 1:3 proportion slurry. After brushing, the blocks were analyzed using an optical profilometer to determine Sa, Rv, and enamel wear. In addition, representative 3D images of each group and wear profiles were obtained. Sa was analyzed using generalized linear models followed by Bonferroni correction, whereas Rv was analyzed using one-way analysis of variance. After brushing, COAL and COAL+TiO2 showed higher Sa values than COAL_PWD. However, no significant difference was observed in Sa between whitening toothpaste and COAL_PWD, and CONT (p > 0.05). In addition, no differences were observed among the groups in Rv (p > 0.05). Conversely, enamel wear was higher for TiO2, COAL, COAL+TiO2, and COAL_PWD than for CONT. CONT showed the least enamel wear, whereas HP showed intermediate values. Representative 3D images and line profiles showed lower step-height and lower mean surface losses for the CONT and HP groups than for the other groups. Whitening toothpastes and COAL_PWD did not increase Sa or Rv compared with CONT, while CONT demonstrated lower enamel wear.

Impacto do uso de dispositivos eletrônicos na visão das crianças em idade escolar / Impacto del uso de dispositivos electrónicos en la visión de los niños en edad escolar / Impact of the use of electronic devices on the view of children at school age

Objetivo:conhecer o impacto das telas sobre a acuidade visual das crianças em idade de quatroa 12 anos, na perspectiva dos pais e responsáveis. Método:estudo quantitativo, descritivo, com 176 participantes. O convite ocorreu por mensagens enviadas nas redes sociais e a coleta através de um questionário online, entre fevereiro e abril de 2021. A análise ocorreu pelas frequências simples dos dados. Resultados: 50,57% tiveram o primeiro contato com as telas, antes de dois anos de idade. As queixas mais frequentes após uso de telas são: dores de cabeça, irritação visual, olhos ressecados e lacrimejando, visão turva e tonturas. 20,45% das crianças possuem dificuldades com de visão em grandes distâncias e 60,80% das crianças, já realizaram avaliação oftalmológica. Conclusão: há um crescente número de crianças expostas precocemente e durante prolongados períodos, aos aparelhos eletrônicos de forma demasiada.

Objective:to know the impact of screens on the visual acuity of children aged 4 to 12 years, from the perspective of parents and guardians. Method:quantitative, descriptive study with 176 participants. The invitation took place through messages sent on social networks and collection by an online questionnaire, between February and April 2021. The analysis was carried out by the simple frequency of the data. Results:50,57% had their first contact with screens, before the age of two. The most frequent complaints after using screens are: headaches, visual irritation, dry and watery eyes, blurred vision and dizziness. 20,45% of children have vision difficulties at great distances and 60,80% of the children have already undergone an ophthalmological evaluation. Conclusion:there is an increasing number of children exposed early and for prolonged periods to electronic devices too much.

Objetivo: conocer el impacto de las pantallas en la agudeza visual de niños de 4 a 12 años, desde la perspectiva de padres y tutores. Método:estudio cuantitativo, descriptivo, con 176 participantes. La invitación se realizó a través de mensajes enviados en redes sociales y recogida mediante un cuestionario en línea, entre febrero y abril de 2021. El análisis se realizó por la frecuencia simple de los datos. Resultados:el 50,57% tuvo su primer contacto con las pantallas, antes de los dos años. Las quejas más frecuentestras el uso de pantallas son: dolores de cabeza, irritación visual, ojos secos y llorosos, visión borrosa y mareos. El 20,45% de los niños tienen dificultades de visión a grandes distancias y el 60,80% de los niños ya se han realizado una evaluación oftalmológica.Conclusión:hay un número creciente de niños expuestos demasiado tempranamente y durante periodos prolongados a los dispositivos electrónicos.

Clinical and sociodemographic factors associated with time spent sitting in military police / Factores clínicos y sociodemográficos asociados al tiempo de permanencia en la policía militar / Fatores clínicos e sociodemográficos associados ao tempo gasto sentado em policiais militares

ABSTRACT Objective: To verify the association between clinical and sociodemographic factors and time spent sitting in military police. Method: This is a cross-sectional study, with 432 military police officers from Eastern Regional Policing Command units of the Military Police of Bahia de Feira de Santana. Data collection took place from August to December 2022 through Google Forms using the International Physical Activity Questionnaire. Results: Men predominated (82.35%), race/color was black (87.04%), the head of the family had completed higher education (47.69%) and police officers with a partner (81.94%). The risk of time spent sitting ≥ 180 minutes per day was lower in males (IRR < 1). Increasing age was associated with a lower risk of time spent sitting ≥ 180 minutes per day (IRR < 1). Conclusion: Male police officers with more years of experience were less exposed to sedentary behavior. Specific interventions and health policies aimed at combating sedentary behavior become relevant, aiming to promote health and prevent diseases.

RESUMEN Objetivo: Verificar la asociación entre factores clínicos y sociodemográficos y el tiempo de permanencia en la policía militar. Método: Estudio transversal, con 432 policías militares de unidades del Comando de Policía Regional Este de la Policía Militar de Bahía de Feira de Santana. La recolección de datos se realizó de agosto a diciembre de 2022 a través de Google Forms utilizando el Cuestionario Internacional de Actividad Física. Resultados: Predominaron los hombres (82,35%), la raza/color fue negra (87,04%), el jefe de familia tenía estudios superiores (47,69%) y los policías con pareja (81,94%). El riesgo de pasar tiempo sentado ≥ 180 minutos por día fue menor en los hombres (IRR < 1). El aumento de la edad se asoció con un menor riesgo de pasar tiempo sentado ≥ 180 minutos por día (IRR < 1). Conclusión: Los policías varones con más años de experiencia estuvieron menos expuestos al comportamiento sedentario. Cobran relevancia intervenciones y políticas de salud específicas dirigidas a combatir el sedentarismo, con el objetivo de promover la salud y prevenir enfermedades.

RESUMO Objetivo: Verificar a associação entre fatores clínicos e sociodemográficos e o tempo gasto sentado em policiais militares. Método: Estudo transversal, com 432 policiais militares das unidades do Comando de Policiamento Regional Leste da Polícia Militar da Bahia de Feira de Santana. A coleta de dados ocorreu de agosto a dezembro de 2022 através do Google Forms constando o Questionário Internacional de Atividade Física. Resultados: Predominaram homens (82,35%), raça/cor negra (87,04%), nível de escolaridade do chefe da família superior completo (47,69%) e policiais com companheiro(a) (81,94%). O risco do tempo gasto sentado ≥ 180 minutos por dia foi menor no sexo masculino (IRR < 1). O aumento da idade foi associado a menor risco de tempo gasto sentado ≥ 180 minutos por dia (IRR < 1). Conclusão: Policiais do sexo masculino e com mais anos de vida estavam menos expostos ao comportamento sedentário. Intervenções específicas e políticas de saúde voltadas ao combate do comportamento sedentário se tornam relevantes, visando à promoção da saúde e prevenção de agravos.

A Systematic Review on Psychological Interventions for Sexual Health in Older Age.

Objectives: The present review aims to identify the existing evidence on outcome-treatment studies of psychological sexual health interventions in older age. Methods: A systematic search was conducted for studies published until October 2022. Data search was conducted on EBSCO, MEDLINE, Web of Science, and Cochrane Central Register of Controlled Trials databases. Results: From 30,840 screened records, 12 reports were selected. Results were grouped into four categories according to the intervention that was implemented. Conclusions: Despite results presenting some bias concerns, this review suggests that educational and cognitive-behavioral approaches seem to be effective for promoting sexual health in older age.

Effect of whitening toothpastes and activated charcoal powder on enamel wear and surface roughness

Abstract This study aimed to evaluate surface roughness (Sa), roughness profile (Rv), and enamel wear after brushing with different whitening toothpastes and charcoal powders. Sixty (n = 10) bovine enamel blocks (6 × 6 × 3 mm) were randomly distributed into six groups according to toothpaste type: regular toothpaste (CONT), toothpaste containing 2% hydrogen peroxide (HP), toothpaste containing titanium dioxide (TiO2), toothpaste containing charcoal (COAL), toothpaste containing charcoal and TiO2 (COAL+TiO2), and activated charcoal powder (COAL_PWD). Each block was subjected to 30,000 reciprocal cycles at a 1:3 proportion slurry. After brushing, the blocks were analyzed using an optical profilometer to determine Sa, Rv, and enamel wear. In addition, representative 3D images of each group and wear profiles were obtained. Sa was analyzed using generalized linear models followed by Bonferroni correction, whereas Rv was analyzed using one-way analysis of variance. After brushing, COAL and COAL+TiO2 showed higher Sa values than COAL_PWD. However, no significant difference was observed in Sa between whitening toothpaste and COAL_PWD, and CONT (p > 0.05). In addition, no differences were observed among the groups in Rv (p > 0.05). Conversely, enamel wear was higher for TiO2, COAL, COAL+TiO2, and COAL_PWD than for CONT. CONT showed the least enamel wear, whereas HP showed intermediate values. Representative 3D images and line profiles showed lower step-height and lower mean surface losses for the CONT and HP groups than for the other groups. Whitening toothpastes and COAL_PWD did not increase Sa or Rv compared with CONT, while CONT demonstrated lower enamel wear.

Potencial antibacteriano dos flavonoides e desenvolvimento de uma resina composta experimental a base de flavonoide / Antibacterial potential of flavonoids and development of an experimental flavonoid-based resin composite

Os flavonoides podem ser considerados substâncias fitofarmacêuticas, ou seja, são obtidas na natureza e possuem benefícios à saúde humana. Alguns desses benefícios estão relacionados ao sistema cardiovascular, doenças crônicas como diabetes e em desordens bucais como periodontite e cárie. Assim, os objetivos do presente estudo foram: analisar efeitos antibacterianos de diferentes flavonoides contra bactérias relacionadas à doença periodontal e à cárie dentária por meio de uma revisão de escopo; avaliar as propriedades físico-químicas de uma resina composta experimental adicionada de naringina. Para a revisão de escopo, 19 artigos foram incluídos, todos estudos in vitro. Para bactérias relacionadas à doença periodontal, proantocianidinas, isoliquiritigenina, liquiritigenina, galangina, quercitrina, taxifolina, crisina, diosmetina, quercetina, miricetina, naringina, apigenina, catequinas, luteolina, morina e rutina foram investigadas. Para bactérias relacionadas à cárie dentária, baicaleína, naringenina, catequina, isoliquiritigenina, liquiritigenina, miricetina, quercetina e kaempferol já foram investigados. Atividade bacteriostática, bactericida e antibiofilme foram predominantemente relatadas. Para o desenvolvimento de uma resina experimental, naringina foi adicionada em concentrações de 5, 10 e 15mM. Testes laboratoriais foram conduzidos para avaliar a resistência flexural e modulo de elasticidade, alteração de cor, sorção e solubilidade e a citotoxicidade dessas resinas, comparado ao controle sem adição do flavonoide. Os dados foram analisados quanto à normalidade e homoscedasticidade. A resistência à flexão, o módulo de flexão, a sorção de água, a solubilidade em água, os parâmetros a* e C* e a citotoxicidade de 24 horas foram analisados por ANOVA de uma via seguida pelo teste de Tukey. L*, b* e WID foram analisados por Welch ANOVA seguido pelo teste T3 de Dunnett, pois os dados eram heteroscedásticos. A citotoxicidade após 48h e 72h foi analisada pelo teste de Kruskal Wallis e Dunn porque os dados não foram normalmente distribuídos e heteroscedásticos. A revisão de escopo demonstrou um potencial de ação dos flavonoides nas bactérias relacionadas à carie e doença periodontal, sendo promissor quanto ao desenvolvimento de novas terapias e novos materiais restauradores. As resinas compostas experimentais adicionadas de naringina não apresentaram citotoxicidade e não demonstraram efeitos deletérios quanto as propriedades físico-químicas, apesar de promover uma alteração na cor final da resina.

Flavonoids can be considered phytopharmaceutical substances, that is, they are obtained in nature and have benefits to human health. Some of these benefits are related to the cardiovascular system, chronic diseases such as diabetes, and oral disorders as periodontitis and dental caries. Thus, the objectives of the present study were: to analyze the antibacterial effects of different flavonoids against bacteria related to periodontal disease and dental caries through a scoping review; to evaluate the physicalchemical properties of an experimental resin composite with naringin addition. For the scoping review, nineteen articles were included, all in vitro studies. For bacteria related to periodontal disease, proanthocyanidins isoliquiritigenin, liquiritigenin, galangin, quercetrin, taxifolin, chrysin, diosmetin, quercetin, myricetin, naringin, apigenin, catechins, luteolin, morin and rutin were investigated. For bacteria related to dental caries, baicalein, naringenin, catechin, isoliquiritigenin, liquiritigenin, myricetin, quercetin and kaempferol have been investigated. Bacteriostatic, bactericidal and antibiofilm activity were predominantly reported. For the development of an experimental composite, naringin was added in concentrations of 5, 10 and 15mM. Laboratory tests were conducted to evaluate the flexural strength and flexural modulus, color change, sorption and solubility, and the cytotoxicity of these composites, compared to the control group without flavonoids addition. Data were analyzed for normality and homoscedasticity. Flexural strength, flexural modulus, water sorption, water solubility, a* and C* parameters, and 24-hour cytotoxicity were analyzed by one-way ANOVA followed by Tukey's test. L*, b* and WID were analyzed by Welch ANOVA followed by Dunnett's T3 test, as the data were heteroscedastic. While the 48h and 72h cytotoxicity was analyzed by the Kruskal Wallis and Dunn test, because the data were not normally distributed and heteroskedastic. The scope review demonstrated a potential action of flavonoids on bacteria related to caries and periodontal disease, with potential development of new therapies and new restorative materials. The experimental composites with naringin addition did not show cytotoxicity and did not demonstrate deleterious effects in terms of physicochemical properties, despite promoting a change in the final color of the resin.

Oral metastasis intraosseous mimicking periapical lesion: a case report / Metástase oral intraóssea mimetizando lesão periapical: um relato de caso

ABSTRACT Jaw metastasis can be mistaken for inflammatory or infectious diseases. Then, they should be considered in the differential diagnosis of unknown jaw lesions. Study reported here involved metastasis of breast cancer in the mandible of a 45-year-old woman. The most important differential diagnostic was a reactive lesion in an unusual periapical location associated with a nonvital tooth. However, given patient's medical history and because paresthesia and pain were observed a few days after pulpectomy, metastasis of breast cancer could not be ruled out. When bone scintigraphy suggested the metastasis of a malignant bone tumor, incisional biopsy was performed. Histopathologic examination and immunohistochemical reaction confirmed the diagnosis of metastasis of breastcancer, and chemotherapy was thus performed as well. Unfortunately, patient died 2 years after diagnosis. Dentists as well as general physicians should therefore consider presence of oral metastasis in cases involving atypical symptoms, especially in patients with known malignant disease.

RESUMO As metástases mandibulares podem ser confundidas com doenças inflamatórias ou infecciosas. Sendo assim, elas devem ser consideradas no diagnóstico diferencial de lesões desconhecidas na mandíbula. Esse relato de caso envolveu metástase de câncer de mama na mandíbula de uma mulher de 45 anos. O diagnóstico diferencial mais importante foi uma lesão reacional, em uma localização periapical incomum, associada a um dente não vital. No entanto, dado o histórico médico da paciente e uma vez que parestesia e dor foram observadas alguns dias após a realização da pulpectomia, a metástase de câncer de mama não foi descartada. Quando a cintilografia óssea sugeriu a metástase de um tumor ósseo maligno, uma biópsia incisional foi realizada. O exame histopatológico e a reação imunohistoquímica confirmaram o diagnóstico de metástase do câncer de mama, e a quimioterapia foi então realizada. Infelizmente, a paciente morreu 2 anos após o diagnóstico. Portanto, dentistas e médicos generalistas devem considerar a presença demetástases oral em casos que envolvam sintomas atípicos, principalmente em pacientes com doença maligna conhecida.

Exploiting the Synergistic Effect of Kairomones and Light-Emitting Diodes on the Attraction of Phlebotomine Sand Flies to Light Traps in Brazil.

The synergistic effect of light-emitting diodes (LEDs) and kairomones on the attraction of sand flies to light traps was evaluated. Octenol and lactic acid were used as chemical attractants. Green LEDs and the incandescent lamps were used as light attractants. Five CDC-type light traps with the respective combination of attractants (incandescent lamp, incandescent lamp + chemical attractant, green LED, green LED + chemical attractant, and chemical attractant alone [without light]) were set between 18:00 and 06:00 following a Latin square design. A total of 6,536 sand flies and 16 species were collected. The most frequent species collected was Lutzomyia longipalpis (Lutz & Neiva, 1912) (Diptera, Psychodidae) accounting for 43.21% of all individuals. Order of success (mean, SD) of lactic acid attractant fly capture was as follows: LED + lactic acid (36.83 ± 4.74), LED alone (34.87 ± 4.61), incandescent lamp + lactic acid (22.80 ± 3.19), incandescent lamp alone (12.67 ± 2.03), and lactic acid (0.46 ± 0.13). Order of success of octenol attractant fly capture was as follows: LED + octenol (37.23 ± 5.61), LED alone (35.77 ± 5.69), incandescent lamp + octenol (18.63 ± 3.28), incandescent lamp alone (14.67 ± 2.86), and octenol alone (1.80 ± 0.65). With exception of lactic acid + incandescent light, chemical synergists played no part in significantly increasing light trap capture of phlebotomine sand flies. However, the use of LEDs, with or without such attractants, provided significantly higher capture compared to the incandescent lamp with or without such chemicals, showing that LEDs are suitable and efficient light sources for surveillance and monitoring of phlebotomine sand flies in Brazil.

Can dynamic ultrasonography replace urodynamics in the follow-up of patients with myelomeningocele? A prospective concurrent study.

AIMS: To evaluate the accuracy of dynamic ultrasonography (DUS), as a feasible alternative diagnostic method to identify detrusor overactivity (DO) in patients with neurogenic bladder. METHODS: We performed concurrent analysis of 81 pairs of urodynamic study (UDS) and DUS, in 63 patients with myelomeningocele (MMC), from June 2014 to February 2017. The assessment focused on bladder behavior during the filling phase, DO evaluation, DO with leakage, compliance, and maximum cystometric capacity (MCC). RESULTS: Patient age ranged from 3 months to 34 years (median, 84 months); 47.6% were male. Overall, 9.5% of patients had chronic kidney disease, 20.6% had recurrent urinary tract infection, 19.05% had vesicoureteral reflux, and 69.8% had constipation. Anticholinergic therapy was used by 41.3% of patients. DO was observed in 45.67% of patients and DO with leakage in 42.6%. Mean bladder compliance was 10.39 mL/cmH2 O and normal MCC was 56.79%. DUS had 91.89% sensitivity in identifying DO, 88.64% specificity, 87.18% positive predictive value, 92.86% negative predictive value, and 90.12% accuracy, with a kappa coefficient of 0.8 (P < 0.001). CONCLUSION: MMC follow-up is essential because urinary parameters can change during patient growth. The standard examination is invasive and has related complications, making noninvasive evaluation a desirable alternative, like DUS. Our data suggest that DO and MCC can be evaluated using DUS in patients with MMC. UDS should be performed in patients with abnormal findings on ultrasound evaluation or those with worsening of urinary tract function.

How do medical students defend themselves against anxiety?

OBJETIVO: A formação médica é geradora de ansiedade, tornando os estudantes de medicina vulneráveis a transtornos psiquiátricos, em particular os transtornos de ansiedade. Para lidar com a ansiedade o estudante de medicina lança mão de vários mecanismos de defesa. Objetivou-se avaliar a associação entre a presença de sintomas de ansiedade e o estilo defensivo em alunos de uma escola médica pública federal. MÉTODO: Trata-se de um estudo observacional transversal, de uma amostra de estudantes de medicina, do primeiro e sexto ano, devidamente matriculados e frequentando regularmente as aulas. No presente estudo utilizou-se um questionário sócio-demográfico, o Inventário Beck de Ansiedade e o questionário de estilo defensivo (DSQ-40). RESULTADOS: Responderam aos questionários 232 alunos, 110 do primeiro ano e 122 do sexto, representando 67,4% do total de alunos matriculados. Em relação aos mecanismos de defesa na amostra, as analises multivariadas mostraram que mecanismos de defesa neuróticos e imaturos estavam associados à presença de ansiedade (p < 0,001). CONCLUSÃO: Os dados encontrados no estudo apontam que alunos do curso médico que apresentaram sintomas de ansiedade utilizaram significativamente mais mecanismos de defesa neurótiocos e imaturos do que os que não tinham esses sintomas. Planos de prevenção, atenção e estratégias de apoio psicológico deveriam ser desenvolvidos para esse grupo, pois os mecanismos de defesa não parecem ser adaptativos em estudantes de medicina enfrentando ansiedade.(AU)

OBJECTIVE: Medical training is a generator of anxiety, making medical students vulnerable to psychiatric disorders. To deal with anxiety, medical students make use of several defense mechanisms. The aim was to assess the association between the presence of symptoms of anxiety and the defense style in students of a federal public medical school. METHOD: This is a cross-section observational study, of a sample of medical students, of the first and sixth years, duly enrolled and regularly attending classes. For the present study a socio-demographic questionnaire, the Beck Anxiety Inventory and the Defense Style Questionnaire (DSQ-40) were used. RESULTS: The questionnaires were answered by 232 students, 110 from the first year and 122 of the sixth year, representing 67.4% of the total amount of students. In relation to the defense mechanisms in the sample, the multivariate analysis showed that neurotic and immature defense mechanisms were associated with the presence of anxiety (p<0.001). CONCLUSION: The data found in this study indicate that medical students who showed symptoms of anxiety, used more neurotic or immature defense mechanisms than students who did not present these symptoms. Prevention and attention plans, as well as psychological support strategies should be developed for this group, because defense mechanisms do not appear to be adaptive in medical students experiencing anxiety.(AU)

Stress and coping in a sample of medical students in Brazil

Background Medical training is a stressing situation, making medical students vulnerable to psychiatric disorders, such as depression and anxiety. Objective The study aimed to assess the prevalence of stress and coping in students of a public medical school in Brazil, comparing the groups from the first and sixth years of training. Methods Through a cross-sectional, observational study, a sample of 232 first and sixth-year regularly registered medical students has been evaluated. Students filled a socio-demographic questionnaire, the Lipp Inventory of Stress Symptoms (ISSL), and the Coping Strategies Inventory (CSI). Results From the total sample of 232 students, 110 were first-year students and 122 sixth-year students. Stress symptoms were significantly higher in first-year students (49.1%) than in the sixth-year group (33.6%; p = 0.018). Variables significantly associated with stress were: year of the training (1st year > 6th year), income (lower > higher income), satisfaction with the training (dissatisfied > satisfied) and the use of escape/avoidance copying strategy (positive association). Discussion Considering the higher stress symptoms among first-year medical students and the positive association of the escape/avoidance copying strategy with stress, strategies must be developed to enable students starting medical school to be better at coping with this stressful situations.

Acquisition of anoikis resistance up-regulates syndecan-4 expression in endothelial cells.

Anoikis is a programmed cell death induced upon cell detachment from extracellular matrix, behaving as a critical mechanism in preventing adherent-independent cell growth and attachment to an inappropriate matrix, thus avoiding colonization of distant organs. Cell adhesion plays an important role in neoplastic transformation. Tumors produce several molecules that facilitate their proliferation, invasion and maintenance, especially proteoglycans. The syndecan-4, a heparan sulfate proteoglycan, can act as a co-receptor of growth factors and proteins of the extracellular matrix by increasing the affinity of adhesion molecules to their specific receptors. It participates together with integrins in cell adhesion at focal contacts connecting the extracellular matrix to the cytoskeleton. Changes in the expression of syndecan-4 have been observed in tumor cells, indicating its involvement in cancer. This study investigates the role of syndecan-4 in the process of anoikis and cell transformation. Endothelial cells were submitted to sequential cycles of forced anchorage impediment and distinct lineages were obtained. Anoikis-resistant endothelial cells display morphological alterations, high rate of proliferation, poor adhesion to fibronectin, laminin and collagen IV and deregulation of the cell cycle, becoming less serum-dependent. Furthermore, anoikis-resistant cell lines display a high invasive potential and a low rate of apoptosis. This is accompanied by an increase in the levels of heparan sulfate and chondroitin sulfate as well as by changes in the expression of syndecan-4 and heparanase. These results indicate that syndecan-4 plays a important role in acquisition of anoikis resistance and that the conferral of anoikis resistance may suffice to transform endothelial cells.

First- and last-year medical students: is there a difference in the prevalence and intensity of anxiety and depressive symptoms?

Objective: Medical training is considered a significant stress factor. We sought to assess the prevalence and intensity of anxiety and depressive symptoms in medical students and compare samples of first-year and sixth-year students. Method: This was a cross-sectional study of first- and sixth-year medical students who attended classes regularly. The study instruments were a sociodemographic questionnaire, the Beck Depression Inventory (BDI), and the Beck Anxiety Inventory (BAI). Results: A total of 232 students (110 first-year, 122 sixth-year) completed the questionnaires, for a response rate of 67.4%. Overall 50.4% of respondents were male (56.4% of first-year and 45.1% of sixth-year students). Anxiety symptoms were reported by 30.8% of first-year students and 9.4% of sixth-year students (p < 0.001). Female students were more affected by anxiety. There were no significant between-group differences in depressive symptoms. Conclusion: A higher prevalence of anxiety symptoms was found in first-year medical students as compared with sixth-year students. Strategies should be developed to help medical students, particularly female students, manage these symptoms at the beginning of their medical training. .

First- and last-year medical students: is there a difference in the prevalence and intensity of anxiety and depressive symptoms?

OBJECTIVE: Medical training is considered a significant stress factor. We sought to assess the prevalence and intensity of anxiety and depressive symptoms in medical students and compare samples of first-year and sixth-year students. METHOD: This was a cross-sectional study of first- and sixth-year medical students who attended classes regularly. The study instruments were a sociodemographic questionnaire, the Beck Depression Inventory (BDI), and the Beck Anxiety Inventory (BAI). RESULTS: A total of 232 students (110 first-year, 122 sixth-year) completed the questionnaires, for a response rate of 67.4%. Overall 50.4% of respondents were male (56.4% of first-year and 45.1% of sixth-year students). Anxiety symptoms were reported by 30.8% of first-year students and 9.4% of sixth-year students (p < 0.001). Female students were more affected by anxiety. There were no significant between-group differences in depressive symptoms. CONCLUSION: A higher prevalence of anxiety symptoms was found in first-year medical students as compared with sixth-year students. Strategies should be developed to help medical students, particularly female students, manage these symptoms at the beginning of their medical training.

Surface chemistry and spectroscopy studies on 1,4-naphthoquinone in cell membrane models using Langmuir monolayers.

Investigating the role of drugs whose pharmaceutical activity is associated with cell membranes is fundamental to comprehending the biochemical processes that occur on membrane surfaces. In this work, we examined the action of 1,4-naphthoquinone in lipid Langmuir monolayers at the air-water interface, which served as a model for half of a membrane, and investigated the molecular interactions involved with tensiometry and vibrational spectroscopy. The surface pressure-area isotherms exhibited a noticeable shift to a lower area in relation to 1,2-dipalmitoyl-sn-glycero-3-phosphocholine (DPPC) and 1,2-dihexadecanoyl-sn-glycero-3-phospho-l-serine (DPPS) lipid monolayers, which indicated a disruption of the monolayer structure and solubilisation of the lipids towards the aqueous subphase. To better correlate to the action of this drug in biological membrane events, cell cultures that represented tumorigenic and non-tumorigenic cells were spread onto the air-water interface, and 1,4-naphthoquinone was then incorporated. While only slight changes were observed in the non-tumorigenic cells upon drug incorporation, significant changes were observed in the tumorigenic cells, on which the organisation of the Langmuir monolayers was disrupted as evidenced by tensiometry and vibrational spectroscopy. This work then shows that this drug interacts preferentially for specific surfaces. In simplified models, it has a higher effect for the negative charged DPPS rather than the zwitterionic DPPC; and for complex cell cultures, 1,4-naphthoquinone presents a more significant effect for that representing tumorigenic cells.