Periodontal pathogen Aggregatibacter actinomycetemcomitans JP2 correlates with colonic leukocytes decrease and gut microbiome imbalance in mice.

AIM: Evidence suggests that translocation of oral pathogens through the oral-gut axis may induce intestinal dysbiosis. This study aimed to evaluate the impact of a highly leukotoxic Aggregatibacter actinomycetemcomitans (Aa) strain on the gut microbiota, intestinal mucosal integrity and immune system in healthy mice. METHODS: Eight-week-old male C57BL6 mice were divided into control (n = 16) and JP2 groups (n = 19), which received intragastric gavage with PBS and with a suspension of Aa JP2 (HK921), respectively, twice a week for 4 weeks. Colonic lamina propria, fecal material, serum, gingival tissues, and mandibles were obtained for analyses of leukocyte populations, inflammatory mediators, mucosal integrity, alveolar bone loss, and gut microbiota. Differences between groups for these parameters were examined by non-parametric tests. RESULTS: The gut microbial richness and the number of colonic macrophages, neutrophils, and monocytes were significantly lower in Aa JP2-infected mice than in controls (p < .05). In contrast, infected animals showed higher abundance of Clostridiaceae, Lactobacillus taiwanensis, Helicobacter rodentium, higher levels of IL-6 expression in colonic tissues, and higher splenic MPO activity than controls (p < .05). No differences in tight junction expression, serum endotoxin levels, and colonic inflammatory cytokines were observed between groups. Infected animals presented also slightly more alveolar bone loss and gingival IL-6 levels than controls (p < .05). CONCLUSION: Based on this model, intragastric administration of Aa JP2 is associated with changes in the gut ecosystem of healthy hosts, characterized by less live/recruited myeloid cells, enrichment of the gut microbiota with pathobionts and decrease in commensals. Negligible levels of colonic pro-inflammatory cytokines, and no signs of mucosal barrier disruption were related to these changes.

A comparative approach employing microCT for the analysis of Cenozoic foraminifera from the Brazilian carbonate equatorial platform.

Worldwide, some of the largest hydrocarbon reservoirs are located in tropical neritic carbonate deposits. Biostratigraphic and paleoenvironmental analyzes of these sedimentary records are often based on the study of foraminiferal assemblage. Foraminifera-based biozones are widely employed in the oil industry to support drilling processes that, alongside petrophysical prospecting, define interval favorable for exploiting hydrocarbon resources. Both scientific research and the petroleum industry, however, usually apply traditional petrographical and paleontological methods to analyze microfossil assemblages, especially for large benthic foraminifera. New, faster, and more accurate methods based on microCT analyzes have emerged as a valuable high-output tool to obtain high-resolution microfossil records for biostratigraphy and paleoenvironmental reconstructions. This method is also useful for the development of digital databases for artificial intelligence applications. MicroCT analyzes, therefore, lead to faster identification of foraminifera assemblage and support digital access to international foraminifera repositories and reference collections, introducing a new dimension in micropaleontological research.

Atypical antipsychotics olanzapine and clozapine increase bone loss in female rats with experimental periodontitis.

BACKGROUND AND OBJECTIVES: Periodontitis is a highly prevalent disease in psychiatric patients, including those undergoing symptomatic treatment with second-generation antipsychotics. Some of these drugs, such as clozapine (CLO) and olanzapine (OLA), have prominent metabolic effects such as weight gain, hyperglycemia, and dyslipidemia, which are risk factors for periodontitis. In addition to the metabolic effects, there are reports of changes in salivary flow, gingival bleeding, and caries. In this context, we aimed to evaluate if the metabolic effects of OLA and CLO alter periodontal parameters in an animal model of periodontitis without the environmental and psychosocial biases inherent to human diseases. METHODS: In the first set of experiments, male and female adult Wistar rats received oral administration of CLO, OLA, or vehicle for 45 days. They were evaluated for body mass composition and weight gain, blood glucose parameters (fasting and glucose tolerance and insulin resistance tests), and lipid profile (HDL, total cholesterol, and triglycerides). In a second set of experiments, the same measurements were performed in female rats exposed to the antipsychotics for 45 days and ligature-induced periodontitis on the 30th day of treatment. Macroscopic measurements of exposed roots, microtomography in the furcation region of the first molar, and histological evaluation of the region between the first and second molars were evaluated to assess bone loss. Additionally, gingival measurements of myeloperoxidase activity and pro-inflammatory cytokine TNF-α were made. RESULTS: Only females exposed to OLA had more significant weight gain than controls. They also exhibited differences in glucose metabolism. Ligature-induced periodontitis produced intense bone retraction without changing the density of the remaining structures. The bone loss was even higher in rats with periodontitis treated with OLA or CLO and was accompanied by a local increase in TNF-α caused by CLO. These animals, however, did not exhibit the same metabolic impairments observed for animals without periodontitis. CONCLUSION: The use of clozapine and olanzapine may be a risk factor for periodontal disease, independent of systemic metabolic alterations.

Relation between Shear Stresses and Flexural Tensile Stresses from Standardized Tests of Extracted Prismatic Specimens of an SFRC Bridge Girder.

Experimental research on the direct shear behavior of fiber-reinforced concrete is often carried out using prisms molded with specific dimensions for a standardized test. However, the flow of fresh concrete in these molds can be different than in the case of a full-scale structural element. This is important considering that the flow direction highly influences the distribution and orientation of fibers. In addition, most of the studies did not relate their shear results to other mechanical properties. In contrast, this study attempted to deepen the experimental knowledge of the crack propagation of a steel fiber-reinforced concrete (SFRC) used in a full-scale prototype of a bridge box girder built in the laboratory. Prismatic specimens were sawn from webs and top flanges of this prototype. Serving as references, additional specimens were molded in wooden boxes. In a previous study of our research group, both had been tested under a three-point notched bending configuration maintaining test conditions proportional to the EN14651 specifications. From each of the previously flexurally tested specimens, two prismatic specimens suitable for the Fédération Internationale de la Précontrainte (FIP) shear test setup were extracted by adopting a cutting methodology that avoided the damage induced by the flexural tests to be part of the FIP specimens. These FIP specimens were tested in almost pure shear loading conditions for assessing the performance of SFRC. Computer tomography images and photos of the shear failure faces were used to determine the distribution and density of fibers. The results demonstrated that the peak loads were proportional to the fiber density at the shear failure section. Assuming that the SFRC conditions of the webs were representative of a common batching procedure in the construction industry, the results from the tests in specimens extracted from these webs were adopted to establish shear stress/flexural tensile stress ratios vs. crack mouth opening displacement curves. The curves belonging to cross-sections of a similar fiber density in the shear and flexural cases allowed for the proposal of a normalized crack-dilatancy relation composed of three stages of the crack propagation. In addition, a trilinear crack width-slip relation was established using the same set of specimens. The relevancy of this proposal is that the shear response can be estimated from a widely accepted standardized flexural test, which demands a simpler instrumentation and is also easier to execute than the shear setup.

Bond Behavior of a Bio-Aggregate Embedded in Cement-Based Matrix.

This paper investigates the bond behavior between a bio-aggregate and a cement-based matrix. The experimental evaluation comprised physical, chemical, image, and mechanical characterization of the bio-aggregate. The image analyses about the bio-aggregate's outer structure provided first insights to understand the particularities of this newly proposed bio-aggregate for use in cementitious materials. A mineral aggregate (granitic rock), largely used as coarse aggregate in the Brazilian civil construction industry, was used as reference. The bond behavior of both aggregates was evaluated via pull-out tests. The results indicated that both aggregates presented a similar linear elastic branch up to each respective peak loads. The peak load magnitude of the mineral aggregate indicated a better chemical adhesion when compared to the bio-aggregate's. The post-peak behavior, however, indicated a smoother softening branch for the bio-aggregate, corroborated by the microscopy image analyses. Although further investigation is required, the macaúba crushed endocarp was found to be a thriving bio-material to be used as bio-aggregate.

Reassessment of Faxinalipterus minimus, a purported Triassic pterosaur from southern Brazil with the description of a new taxon.

Faxinalipterus minimus was originally described as a purported pterosaur from the Late Triassic (early Norian) Caturrita Formation of southern Brazil. Its holotype comprises fragmentary postcranial elements, whereas a partial maxilla was referred to the species. The assignment of Faxinalipterus minimus to Pterosauria has been questioned by some studies, but the specimen has never been accessed in detail after its original description. Here we provide a reassessment of Faxinalipterus minimus after additional mechanical preparation of the holotype. Our interpretations on the identity of several bones differ from those of the original description, and we found no support favoring pterosaur affinities for the taxon. The maxilla previously referred to Faxinalipterus minimus is disassociated from this taxon and referred to a new putative pterosauromorph described here from a partial skull and fragmentary postcranial elements. Maehary bonapartei gen. et sp. nov. comes from the same fossiliferous site that yielded Faxinalipterus minimus, but the lack of overlapping bones hampers comparisons between the two taxa. Our phylogenetic analysis places Faxinalipterus minimus within Lagerpetidae and Maehary bonapartei gen. et sp. nov. as the earliest-diverging member of Pterosauromorpha. Furthermore, the peculiar morphology of the new taxon reveals a new dental morphotype for archosaurs, characterized by conical, unserrated crowns, with a pair of apicobasally oriented grooves. These two enigmatic archosaurs expand our knowledge on the Caturrita Formation fauna and reinforce the importance of its beds on the understanding of Late Triassic ecosystems.

Effects of infrared light laser therapy on in vivo and in vitro periodontitis models.

BACKGROUND: This study evaluated the effects of infrared light laser therapy (ILLT) on ligature-induced periodontitis in rats using micro-computed tomography (micro-CT), histology, fibroblast migration, and viability analysis. METHODS: Forty-eight rats were randomly distributed into three groups: control (no periodontitis), PDC (periodontitis without laser therapy), and PD+L (periodontitis with laser therapy). Periodontitis was induced by ligature placement for 4 weeks. The 12-week-old rats (baseline) were subjected to laser treatment and euthanized 30 days after. After treatment, the mandibular first molars were prepared for micro-CT scanning, and histological sections were assessed as to the cementoenamel junction, alveolar bone crest, and polymorphonuclear (PMN) cell infiltration. In vitro assays were carried out to examine NIH/3T3 fibroblast viability after laser therapy. RESULTS: Migration and cell viability assays revealed that the ILLT maintained fibroblast cell viability with 4 J/cm2 , reaching 100% healing. The control group (at baseline and 30 days) presented a statistically significant difference from the PDC group at 30 days in terms of distance from the cementoenamel junction to the alveolar bone crest (CEJ-ABC). The PD+L group showed a statistically substantial difference from the PDC group at 30 days in terms of trabecular thickness (Tb.Th), degree of anisotropy (DA), and closed porosity percentage (Po%). CONCLUSION: ILLT seemed to preserve the bone structure in the in vivo periodontitis induction model at 30 days and did not reduce cell viability or increase fibroblast migration in vitro. The ILLT provides positive effects on mandibular bone microstructure.

The first edentulous ceratosaur from South America.

The recognition of ontogenetic edentulism in the Jurassic noasaurid Limusaurus inextricabilis shed new light on the dietary diversity within Ceratosauria, a stem lineage of non-avian theropod dinosaurs known for peculiar craniomandibular adaptations. Until now, edentulism in Ceratosauria was exclusive to adult individuals of Limusaurus. Here, an exceptionally complete skeleton of a new toothless ceratosaur, Berthasaura leopoldinae gen. et sp. nov., is described from the Cretaceous aeolian sandstones of the Bauru Basin, Southern Brazil. The specimen resembles adult individuals of Limusaurus by the absence of teeth but based on the unfused condition of several elements (e.g., skull, vertebral column) it clearly represents an ontogenetically immature individual, indicating that it might never have had teeth. The phylogenetic analysis performed here has nested Berthasaura leopoldinae as an early-divergent Noasauridae, not closely related to Limusaurus. It represents the most complete non-avian theropod from the Brazilian Cretaceous and preserves the most complete noasaurid axial series known so far. Moreover, the new taxon exhibits many novel osteological features, uncommon in non-avian theropods, and unprecedented even among South American ceratosaurs. These include not only toothless jaws but also a premaxilla with cutting occlusal edge, and a slightly downturned rostral tip. This indicate that B. leopoldinae unlikely had the same diet as other ceratosaurs, most being regarded as carnivorous. As the ontogenetically more mature specimens of Limusaurus, Berthasaura might have been herbivorous or at least omnivorous, corroborating with an early evolutionary divergence of noasaurids from the ceratosaurian bauplan by disparate feeding modes.

COVID-19: presentación clínica en pacientes hospitalizados en el Instituto de Medicina Tropical "Pedro Kourí" / COVID-19: clinical presentation in patients admitted to Pedro Kourí Tropical Medicine Institute

. Introducción: Con los primeros casos de COVID-19 en Cuba era necesario el reconocimiento temprano de los pacientes con riesgo de evolucionar hacia formas graves de la enfermedad. Objetivo: Describir el comportamiento clínico de la COVID-19 en pacientes hospitalizados en el Instituto de Medicina Tropical "Pedro Kourí" e identificar factores asociados a la gravedad. Métodos: Se presentaron los primeros 73 casos de COVID-19 hospitalizados en el Instituto de Medicina Tropical Pedro Kourí desde el 11 de marzo al 5 mayo de 2020. Los pacientes se clasificaron en dos grupos: graves y con enfermedad ligera. Se compararon variables clínicas, demográficas, de laboratorio e imagenológicas en el momento del ingreso, y su posible asociación con la gravedad de la enfermedad. Resultados: Hubo siete pacientes graves (9,6 por ciento), cinco fallecieron. La edad > 60 años, tener más de una comorbilidad, hipertensión arterial y asma bronquial, fueron más frecuentes en pacientes graves. La fiebre más de seis días (p= 0,00), disnea (p= 0,00), presencia de estertores húmedos (p= 0,00), frecuencia respiratoria > 24/min (p= 0,00) y valores de linfocitos < 0,8 x109/L (p= 0,00), de ferritina > 500µg/L (p =0,00), proteína C reactiva ( 10μg/L (p= 0,01) y LDH ( 500 U/L (p= 0,01) se relacionaron con la gravedad. El 18,2 por ciento de las radiografías de tórax mostró alteraciones, con predominio de focos de condensación inflamatoria bilateral. Las complicaciones más frecuentes fueron: distrés respiratorio, choque, sepsis bacteriana y afecciones cardíacas. Conclusiones: Existen características clínicas y de laboratorio, identificables al ingreso, que están relacionadas con la gravedad de la enfermedad; lo que puede ser útil para la estratificación del riesgo y el manejo adecuado de los pacientes(AU)

Introduction: Upon appearance of the first COVID-19 cases in Cuba, early identification of patients at risk of developing severe forms of the disease became a necessity. Objective: Describe the clinical behavior of COVID-19 in patients admitted to Pedro Kourí Tropical Medicine Institute and identify factors associated to severity. Methods: A presentation was made of the first 73 COVID-19 cases admitted to Pedro Kourí Tropical Medicine Institute from 11 March to 5 May 2020. The patients were divided into two groups: severe and mild disease. A comparison was made of clinical, demographic, laboratory and imaging variables at admission, and their possible association to disease severity. Results: Seven patients (9.6%) were critically ill; five died. Age > 60 years, more than one comorbidity, arterial hypertension and bronchial asthma were more common among critical patients. Fever for more than six days (p= 0.00), dyspnea (p= 0.00), presence of humid stertors (p= 0.00), respiratory rate > 24/min (p= 0.00) and lymphocytes < 0.8 x109/l (p= 0.00), ferritin > 500 µg/L (p =0.00), C-reactive protein 10 μg/l (p= 0.01) and LDH 500 U/l (p= 0.01) were related to disease severity. 18.2 percent of the chest radiographs showed alterations, with a predominance of bilateral foci of inflammatory condensation. The most common complications were respiratory distress, shock, bacterial sepsis and heart disorders. Conclusions: Some clinical and laboratory characteristics identifiable at admission may be associated to disease severity, which makes them useful for risk stratification and the appropriate management of patients(AU)

Periodontal status, vascular reactivity, and platelet aggregation changes in rats submitted to hypercholesterolemic diet and periodontitis.

BACKGROUND AND OBJECTIVES: Periodontitis can corroborate with development and progression of atherosclerosis and a possible bidirectional interaction between both pathologies has been hypothesized. The aim of this work was to study the interactions between diet-induced hypercholesterolemia and ligature-induced periodontitis in Wistar rats submitted to both conditions. MATERIAL AND METHODS: Animals were divided into four experimental groups: C (control: standard diet without periodontitis), Perio (periodontitis plus standard diet), HC (high cholesterol diet without periodontitis), and HC + Perio (high cholesterol diet plus periodontitis). The diets were offered for 45 days and a silk ligature was applied in the lower first molars of Perio and HC-Perio animals on day 34 and maintained for 11 days until euthanasia. The mandibles were excised, and alveolar bone loss was determined by macroscopic and micro-tomographic (µ-CT) imaging. Blood samples were obtained, and platelet aggregation was induced in plasma rich in platelets by adenosine diphosphate (ADP) and collagen. Endothelium-dependent vascular reactivity and protein expression of endothelial (eNOS), phosphorylated endothelial (peNOS), and inducible (iNOS) nitric oxide synthases were evaluated in aorta samples. RESULTS: The HC diet combined with periodontitis (HC + Perio group) was associated with an increased alveolar bone loss, when compared to the other groups. Both in Perio and HC groups, platelet aggregation induced by ADP or collagen was increased, while maximum aortic relaxation induced by acetylcholine was decreased. Periodontitis or HC diet alone decreased the expression of peNOS and HC diet increased the expression of iNOS. In contrast, no additive or synergistic effects were found in vascular reactivity or in platelet aggregation when the two conditions were associated (HC + Perio group). CONCLUSION: Hypercholesterolemia accelerated the process of bone loss induced by periodontitis while a high cholesterol diet or periodontitis individually increased platelet aggregation and vascular reactivity in rats without additive or synergistic effects, when associated.

Instituições de Longa Permanência para Idosos no Brasil: revisão integrativa da literatura / Long-stay Institutions in Brasil: an integrative literature review / Instituciones de largo plazo para ancianos en Brasil: una revisión integradora de literatura

Objetivou-se levantar e analisar a produção científica acerca do delineamento dos trabalhos publicados e temas estudados sobre as instituições de longa permanência para idosos no Brasil, produção essa arrolada no LILACS, MEDLINE, BDENF e SciELO no período de 2013 a 2017. O corpus constitui-se por 88 artigos. Nota-se um número insipiente de pesquisas com intervenções, visto que os pesquisadores ainda buscam descrever o perfil dos idosos institucionalizados, segundo critérios de saúde e doença.

It was aimed to review the literature about Brazilian nursing homes for seniors published at LILACS, MEDLINE, BDENF and SciELO between 2013 and 2017. The corpus consists of 90 articles. There is an incipient amount of papers about intervention research, as long as the researchers still seek to describe the profile of the resident seniors, according to health and disease criteria.

El objetivo fue encuestar y analizar la producción científica sobre la delineación de los trabajos publicados y los temas estudiados sobre las instituciones de atención a largo plazo para ancianos en Brasil. El corpus consta de 88 artículos. Existe un número incipiente de investigaciones con intervenciones, ya que los investigadores todavía buscan describir el perfil de los ancianos institucionalizados, de acuerdo con los criterios de salud y enfermedad.

Estado redox en pacientes infectados por VIH/sida con insuficiencia renal crónica sometidos a hemodiálisis / The redox state of VIH/AIDS patients suffering chronic renal failure and undergoing hemodyalisis

Introducción: el balance redox alterado en el curso de la insuficiencia renal crónica ha sido considerado un factor contribuyente a la morbilidad y mortalidad de la enfermedad y un factor asociado a la progresión de la infección por sida.Objetivo: valorar el estado redox en pacientes infectados por VIH con insuficiencia renal crónica que requirieron hemodiálisis.Métodos: se realizó un estudio de casos y controles en 20 pacientes VIH/sida con insuficiencia renal crónica y 40 individuos aparentemente sanos. Se realizaron determinaciones de malonildialdehído, glutatión, superóxido dismutasa, catalasa, productos avanzados de la oxidación de proteínas, hidroperóxidos y potencial de peroxidación, conjuntamente con los marcadores de progresión: conteo de linfocitos T CD4+ y carga viral y una serie de determinaciones hemoquímicas y hematológicas. El análisis se realizó antes, a los 30 min y a los 240 min del tratamiento dialítico. Estadísticamente se verificaron los supuestos de igualdad de varianza y normalidad de las variables, y en dependencia se aplicó una prueba paramétrica o no paramétrica. El resultado fue significativo para p< 0,05.Resultados: los indicadores del estado redox se encontraron alterados en los pacientes estudiados con respecto al grupo supuestamente sano antes de la hemodiálisis. Se mostró un valor mayor significativo (p< 0,05) de los índices malonildialdehído, productos avanzados de la oxidación de proteínas, superóxido dismutasa, y un valor menor de catalasa y glutatión a los 240 min de realizada la diálisis, con la excepción de los hidroperóxidos que no mostraron cambios. La carga viral plasmática disminuyó de manera significativa en el proceso.Conclusiones: los resultados sugieren que el proceso dialítico en este tipo de pacientes favorece el estrés oxidativo, conjuntamente con una disminución de la carga viral plasmática. El estudio aporta valor metodológico en el manejo de estos pacientes y en la búsqueda por mejorar su calidad de vida

Impacto de la prohibición de fumar en espacios cerrados sobre los ingresos por infarto agudo de miocardio en Uruguay / The impact of banning indoor smoking on hospital admissions for acute myocardial infarction

Introducción: la exposición al humo de tabaco ambiental aumenta 31 por ciento el riesgo de infarto entre no fumadores. En países desarrollados se observó reducción de los ingresos por infartoagudo de miocardio al prohibirse fumar en espacios cerrados. El presente estudio evaluó el impacto de la prohibición de fumar sobre el infarto agudo de miocardio en Uruguay, el primer país libre de humo de tabaco en las Américas. Material y método: se realizó un estudio ecológico comparando los ingresos por infarto en los 24 meses anteriores y posteriores a marzo de 2006 (fecha de la aprobación de la normativa que estableció la prohibición de fumar en espacios cerrados de uso público). Se analizaron retrospectivamente las historias clínicas de los pacientes residentes en el país que tuvieran infarto de miocardio como diagnóstico principal de ingreso. El análisis estadístico se realizó mediante el test de chi cuadrado. Resultados: en las 37 instituciones participantes ingresaron 7.949 pacientes (66,4 ± 12,6 años, 35,1 por ciento mujeres), 4.346 en los dos años previos a las medidas y 3.603 en los dos años siguientes, lo que implicó una reducción de 17,1 por ciento. Hubo mayor reducción a menor edad de los pacientes: <45 años: 38,5 por ciento; 45 a 64 años: 14,8 por ciento; > 65 años: 16,9 por ciento, p < 0,05. Los viernes y sábados los ingresos descendieron 24,2 por ciento, de domingos a jueves 14,3 por ciento (p < 0,05). En los centros privados hubo 22,0 por ciento de reducción, en los públicos 6,3 por ciento, p < 0,05. Conclusiones: la prohibición de fumar en espacios cerrados se asoció a una disminución en los ingresos por infarto agudo de miocardio en nuestro país, siendo este efecto particularmente importante entre los más jóvenes. El beneficio predominó viernes y sábado yfue menor entre quienes se asisten en el sector público.(AU)

Introduction: exposure to environmental tobacco smoke increases the risk for infarction in 31 percent among nonsmokers.A decrease in hospital admission due to acute myocardial infarction was noticed in developed countries when indoor smoking was banned. The present studyanalyzed the impact of smoking bans on acute myocardial infarction in Uruguay, the first tobacco- smoke-freecountryin the Americas. Method: we conducted an ecological study that compared hospital admissions for infarction in the 24 months prior to March 2006 to admissions during the 24 months subsequent to that date (date when the anti-smoking regulation was passed, banning indoor public spaces). We retrospectively analyzed the medical records of patients residing in the country whose main diagnosis for admission was myocardial infarction. The statistic analysis was made by using the chi square test. Results: 7,949 patients were admitted in the 37 participating institutions (66,4 ± 12,6 years old, 35,1 percent women), 4,346 were admitted over the two year period prior to the new measures, and 3,603 during the two-year period subsequent to the prohibition, what implied a 17.1 percent drop. The younger the patients, the greater the drop: <45 years old: 38,5 percent; 45 to 64 years old: 14,8 percent; > 65 years old: 16,9 percent, p < 0,05. Admissions decreased by 24.2 percent on Fridays and Saturdays, and 14.3 percent from Sundays toThursdays (p < 0,05). Decrease was 22.0 percent in private institutions and 6.3 percent in public institutions, p < 0,05. Conclusions: Indoor smoking bans were associated to a decrease in hospital admission for acute myocardial infarction in our country, being this effect particularly important in the younger people. The benefit of this new legislation was more important on Fridays and Saturday and lower in those patients seen in the public sector.

Introdução: a exposição ao fumo de tabaco ambiental aumenta 31 por cento o risco de infarto entre os não fumantes. Nos países desenvolvidos observou-se uma diminuição das internações por infarto de miocárdio depois da proibição de fumar em espaços fechados. Este estudo faz uma avaliação do impacto da proibição de fumar sobre o infarto de miocárdio no Uruguai, o primeiro país livre de fumo de tabaco nas Américas. Material e método: fez-se um estudo ecológico comparando as internações por infarto de miocárdio nos 24 meses anteriores e posteriores a março de 2006, data da aprovação da legislação que proíbe fumar em espaços públicos fechados. Fez-se uma análise retrospectiva dos prontuários médicos dos pacientes residentes no Uruguaique apresentaram infarto como diagnóstico principal; os dados foram analisados utilizando o teste de Qui quadrado Resultados: Nas 37 instituições incluídas no estudo foram internados 7.949 pacientes (66,4 ± 12,6 anos, 35,1 por cento mulheres), 4.346 nos anos anteriores às medidas de proibição e 3.603 nos dois anos seguintes, com uma redução de 17,1 por cento. A redução foi maior nos pacientes mais jovens: <45 anos: 38,5 por cento; 45 a 64 anos: 14,8 por cento; > 65 anos: 16,9 por cento, p < 0,05. As internações nas sextas-feiras e sábados caíram 24,2 por cento, e de domingo a quinta-feira 14,3 por cento (p < 0,05). Nas instituições de assistência médica privada a redução foi de 22,0 por cento e de 6,3 por cento, p < 0,05 nos públicos. Conclusões: a proibição de fumar em espaços públicos fechados mostrou uma associação com uma redução das internações por infarto agudo de miocárdio observando-se um impacto especial em pacientes mais jovens. Este benefício foi predominante nas sextas-feiras e sábados e foi menor na população atendida no setor público.

Impacto de la prohibición de fumar en espacios cerrados sobre los ingresos por infarto agudo de miocardio en Uruguay / The impact of banning indoor smoking on hospital admissions for acute myocardial infarction

Introducción: la exposición al humo de tabaco ambiental aumenta 31 por ciento el riesgo de infarto entre no fumadores. En países desarrollados se observó reducción de los ingresos por infartoagudo de miocardio al prohibirse fumar en espacios cerrados. El presente estudio evaluó el impacto de la prohibición de fumar sobre el infarto agudo de miocardio en Uruguay, el primer país libre de humo de tabaco en las Américas. Material y método: se realizó un estudio ecológico comparando los ingresos por infarto en los 24 meses anteriores y posteriores a marzo de 2006 (fecha de la aprobación de la normativa que estableció la prohibición de fumar en espacios cerrados de uso público). Se analizaron retrospectivamente las historias clínicas de los pacientes residentes en el país que tuvieran infarto de miocardio como diagnóstico principal de ingreso. El análisis estadístico se realizó mediante el test de chi cuadrado. Resultados: en las 37 instituciones participantes ingresaron 7.949 pacientes (66,4 ± 12,6 años, 35,1 por ciento mujeres), 4.346 en los dos años previos a las medidas y 3.603 en los dos años siguientes, lo que implicó una reducción de 17,1 por ciento. Hubo mayor reducción a menor edad de los pacientes: <45 años: 38,5 por ciento; 45 a 64 años: 14,8 por ciento; > 65 años: 16,9 por ciento, p < 0,05. Los viernes y sábados los ingresos descendieron 24,2 por ciento, de domingos a jueves 14,3 por ciento (p < 0,05). En los centros privados hubo 22,0 por ciento de reducción, en los públicos 6,3 por ciento, p < 0,05. Conclusiones: la prohibición de fumar en espacios cerrados se asoció a una disminución en los ingresos por infarto agudo de miocardio en nuestro país, siendo este efecto particularmente importante entre los más jóvenes. El beneficio predominó viernes y sábado yfue menor entre quienes se asisten en el sector público.

Introduction: exposure to environmental tobacco smoke increases the risk for infarction in 31 percent among nonsmokers.A decrease in hospital admission due to acute myocardial infarction was noticed in developed countries when indoor smoking was banned. The present studyanalyzed the impact of smoking bans on acute myocardial infarction in Uruguay, the first tobacco- smoke-freecountryin the Americas. Method: we conducted an ecological study that compared hospital admissions for infarction in the 24 months prior to March 2006 to admissions during the 24 months subsequent to that date (date when the anti-smoking regulation was passed, banning indoor public spaces). We retrospectively analyzed the medical records of patients residing in the country whose main diagnosis for admission was myocardial infarction. The statistic analysis was made by using the chi square test. Results: 7,949 patients were admitted in the 37 participating institutions (66,4 ± 12,6 years old, 35,1 percent women), 4,346 were admitted over the two year period prior to the new measures, and 3,603 during the two-year period subsequent to the prohibition, what implied a 17.1 percent drop. The younger the patients, the greater the drop: <45 years old: 38,5 percent; 45 to 64 years old: 14,8 percent; > 65 years old: 16,9 percent, p < 0,05. Admissions decreased by 24.2 percent on Fridays and Saturdays, and 14.3 percent from Sundays toThursdays (p < 0,05). Decrease was 22.0 percent in private institutions and 6.3 percent in public institutions, p < 0,05. Conclusions: Indoor smoking bans were associated to a decrease in hospital admission for acute myocardial infarction in our country, being this effect particularly important in the younger people. The benefit of this new legislation was more important on Fridays and Saturday and lower in those patients seen in the public sector.

Introdução: a exposição ao fumo de tabaco ambiental aumenta 31 por cento o risco de infarto entre os não fumantes. Nos países desenvolvidos observou-se uma diminuição das internações por infarto de miocárdio depois da proibição de fumar em espaços fechados. Este estudo faz uma avaliação do impacto da proibição de fumar sobre o infarto de miocárdio no Uruguai, o primeiro país livre de fumo de tabaco nas Américas. Material e método: fez-se um estudo ecológico comparando as internações por infarto de miocárdio nos 24 meses anteriores e posteriores a março de 2006, data da aprovação da legislação que proíbe fumar em espaços públicos fechados. Fez-se uma análise retrospectiva dos prontuários médicos dos pacientes residentes no Uruguaique apresentaram infarto como diagnóstico principal; os dados foram analisados utilizando o teste de Qui quadrado Resultados: Nas 37 instituições incluídas no estudo foram internados 7.949 pacientes (66,4 ± 12,6 anos, 35,1 por cento mulheres), 4.346 nos anos anteriores às medidas de proibição e 3.603 nos dois anos seguintes, com uma redução de 17,1 por cento. A redução foi maior nos pacientes mais jovens: <45 anos: 38,5 por cento; 45 a 64 anos: 14,8 por cento; > 65 anos: 16,9 por cento, p < 0,05. As internações nas sextas-feiras e sábados caíram 24,2 por cento, e de domingo a quinta-feira 14,3 por cento (p < 0,05). Nas instituições de assistência médica privada a redução foi de 22,0 por cento e de 6,3 por cento, p < 0,05 nos públicos. Conclusões: a proibição de fumar em espaços públicos fechados mostrou uma associação com uma redução das internações por infarto agudo de miocárdio observando-se um impacto especial em pacientes mais jovens. Este benefício foi predominante nas sextas-feiras e sábados e foi menor na população atendida no setor público.