Nutritional profile and risk assessment of inorganic elements in enteral and parenteral nutrition formulas.

The contents of essential (Ca, Fe, K, Na, P, and Zn) and potentially toxic inorganic elements (As, Al, Cd, Cr, Cu, Mn, and Pb) in enteral and parenteral nutrition formulas were evaluated by inductively coupled plasma optical emission spectrometry (ICP OES) and graphite furnace atomic absorption spectrometry (GFAAS). A total of 30 enteral formulas, 23 parenteral solution components, and 3 parenteral solutions were analyzed. The elements Ca and K presented the higher contents (72-2918 mg L-1 and 235-2760 mg L-1) while the lowest concentration levels were found for As and Cd (<0.68 µg L-1 and <0.01-0.62 µg L-1) in the studied samples. The validated analytical methods presented an accuracy of 75-116% and RSD values lower than 9.8%. Calcium gluconate and magnesium sulfate, which are used as raw materials in parenteral solution, are potential sources of Al and Mn contamination. A Hazard Quotient (HQ) >1 was obtained for Al (27 ± 1 µg L-1) in one of the parenteral samples, whereas the established limit is 25 µg L-1. Enteral samples were considered safe for consumption regarding the Al, As, and Cd levels. One healing-specific and pediatric formula contained Pb at levels above 0.25 µg kg-day-1, too high for safe consumption. The enteral formulas (pediatric, diabetes-specific, renal-specific, healing-specific, and standard formula with addition of fiber) presented risks in relation to the consumption of Cr and Mn (>250 µg day-1 and >11 mg day-1). The results indicate the need for strict monitoring, considering that these formulations are often the single patient's food source.

Technology Prospection of Ora-pro-Nóbis (Pereskia aculeata Mill.): A Non-conventional Food Plant.

BACKGROUND: The ora-pro-nóbis (Pereskia aculeata Mill.) is a plant from Brazilian biodiversity used for food and medicinal purposes. It has ample technological potential, however, it is still underutilized, being classified as a Non-Conventional Food Plant (PANC). Prospective studies in intellectual property banks make it possible to expand perspectives for scientific research, enhancing the generation of new products. OBJECTIVE: Evaluate the patents of products containing Pereskia aculeata Mill. for the areas of food and health in intellectual property databases. METHODS: The study was conducted through structured prospective investigation (collection, processing and analysis) in 4 patent databases: National Institute of Intellectual Property (INPI) - Brazil, United States Patent and Trademark Office, World Trade Organization Intellectual Property (WIPO) and Espacenet. RESULTS: The evaluation showed a reduced number of registered patents. In general, 8 patent applications were examined, of which 7 are directly associated with the species (and its derivatives) and 1 is related to a device specially designed for harvesting leaves/fruits and removing thorns. The focus of the patents was the use of the species in the food, pharmaceutical and biotechnological areas, with emphasis on the use of the leaves in the extraction of mucilage and proteins. CONCLUSION: This study showed that Pereskia aculeata Mill. is a technologically promising plant, because of its nutritional and medicinal composition, and it is important to encourage innovation and the development of new products with the species.

Efficacy and Safety of Oral Midazolam Sedation Compared with its Combination with Hydroxyzine Use in Pediatric Dentistry: A Systematic Review

ABSTRACT Objective: To assess the efficacy and safety of the use of midazolam as monotherapy, compared to the associated use of midazolam and hydroxyzine for minimum and moderate sedation of children in dental offices, using data obtained from clinical trials. Material and Methods: A systematic review protocol was developed and registered on PROSPERO (CR42020208633). An electronic search was carried out in Pubmed, Lilacs, Science Direct, Open Gray, Web of Science, and central Cochrane Library. No language restrictions were included. Clinical trials were carried out with children aged 0-12 years, using midazolam as monotherapy compared to the use of midazolam associated with hydroxyzine to verify the effectiveness and safety of oral sedation. The quality of the studies was individually assessed and grouped using the RoB 2 (Revised Cochrane risk-of-bias tool for randomized trials) and GRADE (Grading of Recommendations Assessment, Development and Evaluation) systems, respectively. Results: A total of 749 studies were found. After analyzing the inclusion and removal of duplicates, two studies were analyzed for the quality of evidence. Through this analysis, it was possible to verify the very low level of scientific evidence on the superiority of the efficacy and safety of the combined use of midazolam and hydroxyzine for oral sedation in children in dental offices. Conclusion: The conflicting results and limitations of the studies enabled to establish that there is insufficient evidence to support the use of these drugs combined. There is only evidence for the use of midazolam as monotherapy.

A multicentre real-world data study to assess the bleeding rate and management of patients with haemophilia A and factor VIII inhibitors in Argentina.

The development of inhibitors against factor VIII (FVIII) concentrates is a severe complication of treatment for patients with haemophilia. We investigated annualized bleeding rates (ABRs) in patients in Argentina with haemophilia A with inhibitors and analysed potential differences between treatment strategies. This multicentre, retrospective, real-world data, cohort design study comprised ambulatory paediatric and adult patients with congenital haemophilia A and FVIII inhibitors treated according to standard clinical practice, with 12-months follow-up. Of 69 included patients, 39 (56.5%) received on-demand treatment, 13 (18.8%) received prophylactic treatment, and 17 (24.6%) received immune tolerance induction (ITI) therapy. The mean overall ABR was 7.68 ±â€Š8.18, with similar rates for on-demand (8.59 ±â€Š9.69), prophylaxis (5.54 ±â€Š4.71), and ITI (7.24 ±â€Š6.23) subgroups. In the negative binomial regression model, prophylactic treatment [incidence rate ratio (IRR) 0.41, 95% confidence interval (CI): 0.21-0.79, P < 0.01] and ITI (IRR 0.47, 95% CI: 0.27-0.81, P < 0.01) therapy were significantly associated with a decrease in the ABR compared with on-demand treatment. Age (IRR 0.96, 95% CI: 0.94-0.97, P < 0.01), number of target joints (IRR 1.21, 95% CI: 1.11-1.31, P < 0.001), and history of recurring bleeding (IRR 2.3, 95% CI: 1.19-4.57, P = 0.012) were significantly and independently associated with ABR. The ABR in standard clinical practice was lower than that reported in controlled clinical trials. Patients undergoing prophylaxis and ITI therapy showed reduced ABRs compared with on-demand treatment, after controlling for bleeding predictor variables.

A New and Ecological Method to Quantify Vancomycin in Pharmaceutical Product by Infrared Spectrometry.

Vancomycin, an antimicrobial, does not present quantitative method by infrared spectrometry in the literature for the evaluation of a pharmaceutical product. This technique is considered a clean alternative because in the main, there is no solvent involved and the generation of waste is reduced. So, the aim of this study was to develop and validate a new, ecological, low cost and fast method by infrared spectrometry using KBr and band between 1450-1375 cm-1. It was linear in the range of 1.0-2.0 mg/150 mg, with a correlation coefficient of 0.9994. Selective when the spectra of vancomycin reference and sample were compared. Precise by repeatability (2.29%) and intermediate precision (3.12%). Accurate with average recovery of 99.37% and robust when strength and compression time of the pellets and KBr brand were varied. Considering all the methods found in literature, there is not one using infrared spectrometry for quantitative purpose, so the method developed and validated could be considered an innovation and clean alternative. This is due to the fact that it is fast, easy to handle, low cost, and non-toxic as well as generating minimal waste. The method can be applied in the routine analysis of vancomycin dosage form and is an important option for the current and sustainable pharmaceutical analysis.

[Acquired paraneoplastic hemophilia secondary to Vater's ampulla adenocarcinoma]. / Hemofilia paraneoplásica adquirida secundaria a adenocarcinoma de la ampolla de Vater.

Acquired hemophilia A is an unusual bleeding disorder of autoimmune origin resulting in the formation of autoantibodies directed against coagulation factor VIII. These autoantibodies can act by partially or completely neutralizing the activation or function of the factor, or they can also accelerate its elimination from the circulation. The global incidence of the disease is 1.5 cases per million inhabitants per year. In nearly 50% of cases, an underlying disease that is presumed responsible to produce autoantibodies can be detected. We report a case with acquired hemophilia A, in a patient with Vater's ampulla adenocarcinoma.

La hemofilia adquirida A es un desorden hemorrágico inusual de origen autoinmune que resulta en la formación de autoanticuerpos dirigidos contra el factor VIII de la coagulación. Estos autoanticuerpos pueden actuar neutralizando parcial o completamente la activación o función del factor, o también pueden acelerar su eliminación de la circulación. La incidencia mundial de la enfermedad es de 1.5 casos por millón de habitantes por año. En cerca del 50% de los pacientes se puede detectar una enfermedad subyacente que se presume responsable de la producción de los autoanticuerpos. Se presenta el caso de un varón con hemofilia adquirida A, en contexto de adenocarcinoma de la ampolla de Vater.

Hemofilia paraneoplásica adquirida secundaria a adenocarcinoma de la ampolla de Vater / Acquired paraneoplastic hemophilia secondary to Vater's ampulla adenocarcinoma

Resumen La hemofilia adquirida A es un desorden hemorrágico inusual de origen autoinmune que resulta en la formación de autoanticuerpos dirigidos contra el factor VIII de la coagulación. Estos autoanticuer pos pueden actuar neutralizando parcial o completamente la activación o función del factor, o también pueden acelerar su eliminación de la circulación. La incidencia mundial de la enfermedad es de 1.5 casos por millón de habitantes por año. En cerca del 50% de los pacientes se puede detectar una enfermedad subyacente que se presume responsable de la producción de los autoanticuerpos. Se presenta el caso de un varón con hemofilia adquirida A, en contexto de adenocarcinoma de la ampolla de Vater.

Abstract Acquired hemophilia A is an unusual bleeding disorder of autoimmune origin resulting in the formation of autoantibodies directed against coagulation factor VIII. These autoantibodies can act by partially or completely neutralizing the activation or function of the factor, or they can also accelerate its elimination from the circulation. The global incidence of the disease is 1.5 cases per million inhabitants per year. In nearly 50% of cases, an underlying disease that is presumed responsible to produce autoantibodies can be detected. We report a case with acquired hemophilia A, in a patient with Vater's ampulla adenocarcinoma.

The Articulation of the Indigenous Peoples of Brazil in Facing the Covid-19 Pandemic.

This article aims to analyze how the indigenous communities of Brazil have organized autonomous actions and strategies to confront the Covid-19 pandemic based on the articulation among their own historical experiences, their health conceptions, partnerships with scientific communities and other segments of society that support the indigenous struggle. The research articulates the political and theoretical modernity/coloniality/decoloniality movement with indigenous experiences and conceptions of health, body/spirituality and territory. For this task, we adopted an undisciplined methodology based on conversation, solidarity and analysis of discussions, sites, lives, bibliographic productions and official documents prepared by indigenous organizations and partner entities. The research has pointed out that the situation of greater vulnerability of indigenous populations is not only due to biological factors. Also, indigenous people have denounced the invasion of their territories, racism, the lack of sanitation policies, food insecurity, the circulation of people not belonging to the community (missionaries, miners, loggers, army), the difficult access to hospitals and the precariousness of the necessary resources for individual and collective asepsis have worsen the spread and lethality of the virus. Likewise the current indigenous struggle in this pandemic scenario, this article is not limited to a health discussion, yet it aims to contribute to think about the relationship between the pandemic and the dissemination of anti-democratic policies that simultaneously affect the right to health and the territory of these populations.

Antioxidative defense against omeprazole-induced toxicogenetical effects in Swiss mice.

BACKGROUND: Omeprazole (OME), a most frequently used proton pump inhibitor in gastric acidosis, is evident to show many adverse effects, including genetic instability. This study evaluated toxicogenic effects of OME in Mus musculus. METHODS: For this study, 40 male Swiss mice were divided into 8 groups (n = 5) and treated with OME at doses of 10, 20, and 40 mg/kg and/or treated with the antioxidants retinol palmitate (100 IU/kg) and ascorbic acid (2.0 µM/kg). Cyclophosphamide 50 mg/kg, (cytotoxic agent) and the vehicle were served as positive and negative control group, respectively. After 14 days of treatment, the stomach cells along with the bone marrow and peripheral blood lymphocytes were collected and submitted to the comet assay (alkaline version) and micronucleus test. Additionally, hematological and biochemical parameters of the animals were also determined inspect of vehicle group. RESULTS: The results suggest that OME at all doses induced genotoxicity and mutagenicity in the treated cells. However, in association with the antioxidants, these effects were modulated and/or inhibited along with a DNA repair capacity. CONCLUSIONS: Taken together, antioxidants (such as retinol palmitate and ascorbic acid) may be one of the best options to counteract OME-induced cytogenetic instability.

Photobiomodulation Therapy Partially Restores Cartilage Integrity and Reduces Chronic Pain Behavior in a Rat Model of Osteoarthritis: Involvement of Spinal Glial Modulation.

OBJECTIVE: Chronic pain associated with osteoarthritis (OA) often leads to reduced function and engagement in activities of daily living. Current pharmacological treatments remain relatively ineffective. This study investigated the efficacy of photobiomodulation therapy (PBMT) on cartilage integrity and central pain biomarkers in adult male Wistar rats. DESIGN: We evaluated the cartilage degradation and spinal cord sensitization using the monoiodoacetate (MIA) model of OA following 2 weeks of delayed PBMT treatment (i.e., 15 days post-MIA). Multiple behavioral tests and knee joint histology were used to assess deficits related to OA. Immunohistochemistry was performed to assess chronic pain sensitization in spinal cord dorsal horn regions. Furthermore, we analyzed the principal components related to pain-like behavior and cartilage integrity. RESULTS: MIA induced chronic pain-like behavior with respective cartilage degradation. PBMT had no effects on overall locomotor activity, but positive effects on weight support (P = 0.001; effect size [ES] = 1.01) and mechanical allodynia (P = 0.032; ES = 0.51). Greater optical densitometry of PBMT-treated cartilage was evident in superficial layers (P = 0.020; ES = 1.34), likely reflecting the increase of proteoglycan and chondrocyte contents. In addition, PBMT effects were associated to decreased contribution of spinal glial cells to pain-like behavior (P = 0.001; ES = 0.38). CONCLUSION: PBMT during the chronic phase of MIA-induced OA promoted cartilage recovery and reduced the progression or maintenance of spinal cord sensitization. Our data suggest a potential role of PBMT in reducing cartilage degradation and long-term central sensitization associated with chronic OA.

Cephalothin: Review of Characteristics, Properties, and Status of Analytical Methods.

BACKGROUND: Cephalothin (CET), a first generation cephalosporin, is the most efficient cephalosporin against resistant microorganisms. Many studies found in literature and pharmacopeias propose analytical methods which are most commonly HPLC and microbiological assays. OBJECTIVE: This paper shows a brief review of analytical methods to quantify CET with a green analytical chemistry approach. METHOD: The research data were collected from the literature and official compendia. RESULTS: Most of the analytical methods to determine CET were performed by HPLC and agar diffusion in pharmaceuticals, blood, urine, or water. Other analytical methods were found, such as UV-Vis, iodometry, fluorimetry, IR/Raman, electrochemical, and others in less quantity. One important aspect is that these methods use organic and toxic solvents like methanol and acetonitrile and only about 4% of the methods found use water as solvent. CONCLUSIONS: Research about analytical methods for CET focusing on green analytical chemistry is of great importance and could optimize its analysis in pharmaceutical industries and help to guarantee the quality of the product. More than just the development of new techniques, it is possible to enhance the ones that already exist, applying the green analytical chemistry principles. In this way, it will be possible to reduce the environmental impacts caused by other analytical procedures. HIGHLIGHTS: This work shows a brief review of literature and pharmacopeias of analytical methods to quantify CET. Its quality control can be updated to meet the needs of current analytical chemistry and to fit into sustainable and eco-friendly analysis.

Aprender prática baseada na evidência pelo envolvimento em atividades de investigação - autopercepção dos estudantes / Aprendizaje de prácticas basadas en evidencia por medio del involvimiento en actividades investigativas - la autopercepción de estudiantes / Learning evidence based practice through involvement in investigation activities - the self-perception of students

RESUMO Objetivo: compreender como os estudantes percepcionam o seu envolvimento em atividades de investigação e o contributo para o desenvolvimento de uma prática baseada na evidência. Método: estudo qualitativo, transversal, descritivo e exploratório, realizado em Portugal, em agosto de 2019, que recorreu ao grupo focal, com oito participantes, para responder à questão: "Quais as vantagens da participação dos estudantes de enfermagem em atividades de investigação para o desenvolvimento de conhecimentos, atitudes e competências de utilização da evidência?". A análise de conteúdo foi realizada com o software NVivo. Resultados: da análise qualitativa dos achados, emergiram cinco categorias e subcategorias: autoaprendizagem, integração teórico-prática, trabalho interdisciplinar, tomada de decisão baseada na evidência e literácia científica. Conclusão: a criação de uma experiência eficaz de aprendizagem ajuda na construção do conhecimento e potencialmente contribui para a saúde da comunidade, os resultados de aprendizagem do estágio e o desenvolvimento de competências essenciais para uma Prática Baseada na Evidência.

RESUMEN Objetivo: comprender como estudiantes perciben su envolvimiento con actividades investigativas y su contribución para desarrollar una práctica basada en evidencias. Método: estudio cualitativo, trasversal, descriptivo y exploratorio, hecho en Portugal en agosto de 2019, utilizando un grupo focal con ocho participantes para responder a la cuestión: "Cuales las ventajas de la participación de los estudiantes de enfermería en actividades de investigación para desarrollar conocimientos, actitudes y competencias de utilización de la evidencia?" Se hizo al análisis de contenido con el software NVivo. Resultados: el análisis cuantitativo de los datos generó cinco categorías y subcategorías: autoaprendizaje, integración teórico-práctica, interdisciplinariedad, tomada de decisiones basadas en evidencia, y alfabetización científica. Conclusión: la creación de una experiencia eficaz de aprendizaje ayuda en la construcción del conocimiento y potencialmente contribuye para la salud de la comunidad, para los resultados del aprendizaje en la pasantía y para el desarrollo de competencias esenciales para una Práctica Basada en Evidencias.

ABSTRACT Objective: to understand how students perceive their involvement in investigation activities and how they contribute for the development of evidence-based practices. Method: qualitative, cross-sectional, descriptive, and exploratory study, carried out in Portugal, in August 2019. A focus group of eight participants was formed to answer the question: "What are the advantages of the participation of nursing students in investigations for the development of knowledge, attitudes, and performance in the use of evidence?" The software NVivo was used for a content analysis. Results: five categories and subcategories emerged from the qualitative analysis of findings: self-learning, integration of theory and practice, interdisciplinary work, evidence-based decision making, and scientific literacy. Conclusion: creating an effective learning experience helps building knowledge and can contribute for the health of the community, for improved educational results during the internship, and for the development of the abilities necessary for Evidence Based Practice.

Nanopartículas de prata em bases de próteses de PMMA para controle de atividade microbiana / Silver nanoparticles in PMMA prosthesis bases to control microbial activity

Objetivo:Avaliar in vitro a atividade de Staphylococcus aureus e Candida albicans em bases de próteses convencionais à base de polimetilmetacrilato de metila com nanopartículas de prata incorporadas a sua composição. Métodos: Foi realizado um estudo experimental laboratorial com resinas acrílicas autopolimerizáveis comercialmente disponíveis, Vipi Flash/VIPI e JET/Clássico. Foram confeccionados 80 corpos de prova, divididos em 16 grupos (n = 5), referentes ao tipo de resina, tratamento (incorporação e imersão na solução de nanopartículas de prata) e microrganismo inoculado. As nanopartículas foram sintetizadas com ácido polimetacrílico, nitrato de prata e irradiadas com luz ultravioleta de baixa potência (~8W) por 6 horas, e as suas concentrações idealizadas pelo método de microdiluição em placas para determinação da concentração mínima inibitória frente aos microrganismos selecionados. Verificou-se ação bactericida e fungicida com concentração inicial de 25% e após fator de diluição 12,5%. Resultados: Houve dificuldade de incorporação das nanopartículas na resina acrílica, que pode decorrer da alteração da proporção 3:1 recomendada pelo fabricante ou pela redução ou inativação da ação da nanopartícula de prata pela interação com o polimetilmetacrilato. VIPI com inclusão de nanopartícula obteve menor aderência de biofilme de Candida albicans. Conclusão:A nanopartícula de prata mostrou-se eficaz na sua ação de controle de Candida albicans e Staphylococcus aureus no método de imersão, entretanto, a sua ação antimicrobiana foi comprometida após inclusão nas resinas acrílicas.

Aim:To perform an in vitro evaluation of the activity of Staphylococcus aureus and Candida albicansin conventional prosthesis bases, based on methyl polymethylmethacrylate with silver nanoparticles incorporated into the composition. Methods: An experimental laboratory study was carried out using commercially available self-curing acrylic resins, Vipi Flash/VIPI and JET/Clássico. Eighty specimens were manufactured and divided into 16 groups (n = 5), referent to the resin brand, treatment (incorporation and immersion in the silver nanoparticle solution), and inoculated microorganism. The nanoparticles were synthesized with polymethacrylic acid and silver nitrate, and were irradiated with a low power (~ 8W) ultraviolet light for 6 hours. Their concentrations were idealized by the method of microplate dilution to determine the minimum inhibitory concentration when compared to the selected microorganisms. Bactericidal and fungicidal activities were identified with an initial concentration of 25% and a subsequent dilution factor of 12.5%. Results:It was difficult to incorporate the AgNPs into the acrylic resin, which may well have resulted from the change from the 3:1 proportion recommended by the manufacturer or by reducing or inactivating the action of the silver nanoparticle by interaction with polymethylmethacrylate. VIPI with the inclusion of nanoparticles obtained a lesser Candida albicans biofilm adherence. Conclusion: Silver nanoparticles were effective in controlling Candida albicans and Staphylococcus aureus in the immersion method; however, the antimicrobial activity was compromised after inclusion in acrylic resins.

Current Status of Vancomycin Analytical Methods.

BACKGROUND: The glycopeptide antibiotics are a class of antimicrobial drugs that are an important alternative for cases of bacterial infections resistant to penicillins, besides being able to be used to treat infections in people allergic to pencilin. They have great activity against Gram-positive microorganisms, including methicillin-resistant Staphylococcus aureus (MRSA), by inhibiting the cell wall synthesis. OBJECTIVE: There are many analytical methods in the literature for determination of antimicrobial glycopeptide vancomycin in different matrixes that are very effective; however, all of them use toxic solvents, contributing to the generation of waste, causing damage to the environment and to the operator, as well as increased costs of analysis. RESULTS: The most prevailing method found was high performance liquid chromatography (HPLC), followed by microbiological assays and, in less quantity, spectrometric methods. The chromatographic methods use organic solvents that are toxic, such as acetonitrile and methanol, and buffer solutions, that can damage the equipment and the column. In the microbiological assays the disc diffusion methods are still in the majority. The spectrophotometric methods were based in the UV-Vis region using buffer solutions as a diluent. CONCLUSIONS: All these methods can become greener, following green analytical chemistry principles, which could bring benefits both to the environment and the operator, and reduce costs. HIGHLIGHTS: In this paper, a literature review regarding analytical methods for determination of vancomycin was carried out with a suggestion of greener alternatives.

Turbidimetric Method: A New, Ecological, and Fast Way to Evaluate of Vancomycin Potency.

BACKGROUND: Vancomycin, an antimicrobial, has many microbiological methods in literature, but it was not found any that follows the green chemistry principles. OBJECTIVE: The aim of this work was to develop and validate a new microbiological analytical method with a green view to determine the vancomycin potency in lyophilized powder using less quantity of diluents and culture medium, minimizing the costs and reducing the time of analysis. METHODS: The objective will be achieved using the microbiological method by turbidimetry. RESULTS: Water was used as the diluent to prepare the vancomycin solution. BHI broth as used as culture media for the growth of the S. aureus ATCC 25923. The method was linear in the range of 30, 39 and 50.7 µg/mL. It was selective, with vancomycin reference and sample absorbance values very similar. The precision of the method was proved at intraday (RSD 4.42 %), interday (RSD 3.56 %) and intermediate levels (RSD 2.03%). It was accurate with mean recovery of 100.71 % and robust when changes were performed in three parameters of the method and analyzed by the F-Test and t-Test. CONCLUSIONS: The method for evaluating the potency of vancomycin in pharmaceutical product was successfully developed and validated. HIGHLIGHTS: The method can be applied to routine quality control of vancomycin product as an alternative that contemplates the green analytical chemistry and the current pharmaceutical analyzes.

Odontogenic Infection and dental Pain negatively impact Schoolchildren's Quality of Life.

The aim of this study is to assess the prevalence of odontogenic infection in low-income Brazilian schoolchildren and evaluate its association with the subjective variables of oral health-related quality of life and dental pain. In this cross-sectional study, 230 schoolchildren aged eight to ten years old underwent a clinical oral survey in which the DMFT/dmft and PUFA/pufa indexes were measured. Afterward, children responded individually to the Child Perceptions Questionnaire (CPQ8-10) and self-reports of dental pain were collected. Data were statistically analyzed using MannWhitney or Kruskal-Wallis test with a post-test by Dunn's and Pearson correlation. Of the children evaluated, 42.6% had odontogenic infection and 80% reported experiencing dental pain. Children's age (p = 0.034) and past experience of dental pain (p < 0.002) were associated with odontogenic sepsis, in addition to impairment of their emotional well-being (p = 0.008), social welfare (p = 0.009) and overall impact on quality of life (p = 0.019). Toothache intensity (p < 0.001), frequency (p < 0.001) and duration (p < 0.001) were correlated to the overall impact on children's quality of life. The prevalence of odontogenic infection remains high among low-income Brazilian schoolchildren. Pediatric infection and its related pain induce not only various biological disorders but also impair children's self-perception of quality of life.

O objetivo deste estudo foi avaliar a prevalência de infecção odontogênica em crianças escolares brasileiras de baixa renda e analisar a sua associação com as variáveis subjetivas da autopercepção de qualidade de vida relacionada à saúde bucal e dor dentária. Neste estudo transversal, 230 crianças escolares com 8 a 10 anos de idade realizaram exame clínico bucal no qual os índices CPO-D/ceo-d e PUFA/pufa foram mensurados. Com isso, as crianças responderam individualmente ao Child Perceptions Questionnaire (CPQ8-10) e relatos de dor dentária foram coletados. Os dados foram estatisticamente analisados utilizando-se o teste Mann-Whitney ou Kruskal-Wallis, com posterior teste da correlação de Dunn e Pearson. Dentre as crianças examinadas, 42,6% apresentavam infecção odontogênica e 80% reportou experiência de dor dentária. A idade (p=0,034) e experiência de dor dentária (p<0,002) das crianças foram associadas à infecção odontogênica, bem como o seu bem-estar emocional (p=0,008) e social (p=0,009) e impacto geral na qualidade de vida (p=0,019). Além disso, a intensidade (p<0,001), frequência (p<0,001) e duração (p<0,001) da odontalgia foram correlacionadas com o impacto geral na qualidade de vida da criança. A prevalência de infecção odontogênica permanece elevada em crianças escolares brasileiras. Infecção pediátrica e sua dor relacionada induzem não apenas diversas desordens biológicas, mas também afetam negativamente a auto-percepção de qualidade de vida das crianças.

Odontogenic Infection and dental Pain negatively impact Schoolchildrens Quality of Life / Infecção odontogênica e odontalgia impactam negativamente a qualidade de vida de crianças escolares

ABSTRACT The aim of this study is to assess the prevalence of odontogenic infection in lowincome Brazilian schoolchildren and evaluate its association with the subjective variables of oral healthrelated quality of life and dental pain. In this crosssectional study, 230 schoolchildren aged eight to ten years old underwent a clinical oral survey in which the DMFT/dmft and PUFA/pufa indexes were measured. Afterward, children responded individually to the Child Perceptions Questionnaire (CPQ810) and selfreports of dental pain were collected. Data were statistically analyzed using MannWhitney or KruskalWallis test with a posttest by Dunn's and Pearson correlation. Of the children evaluated, 42.6% had odontogenic infection and 80% reported experiencing dental pain. Children's age (p = 0.034) and past experience of dental pain (p < 0.002) were associated with odontogenic sepsis, in addition to impairment of their emotional wellbeing (p = 0.008), social welfare (p = 0.009) and overall impact on quality of life (p = 0.019). Toothache intensity (p < 0.001), frequency (p < 0.001) and duration (p < 0.001) were correlated to the overall impact on children's quality of life. The prevalence of odontogenic infection remains high among lowincome Brazilian schoolchildren. Pediatric infection and its related pain induce not only various biological disorders but also impair children's selfperception of quality of life.

RESUMO O objetivo deste estudo foi avaliar a prevalência de infecção odontogênica em crianças escolares brasileiras de baixa renda e analisar a sua associação com as variáveis subjetivas da autopercepção de qualidade de vida relacionada à saúde bucal e dor dentária. Neste estudo transversal, 230 crianças escolares com 8 a 10 anos de idade realizaram exame clínico bucal no qual os índices CPOD/ ceod e PUFA/pufa foram mensurados. Com isso, as crianças responderam individualmente ao Child Perceptions Questionnaire (CPQ810) e relatos de dor dentária foram coletados. Os dados foram estatisticamente analisados utilizandose o teste MannWhitney ou KruskalWallis, com posterior teste da correlação de Dunn e Pearson. Dentre as crianças examinadas, 42,6% apresentavam infecção odontogênica e 80% reportou experiência de dor dentária. A idade (p=0,034) e experiência de dor dentária (p<0,002) das crianças foram associadas à infecção odontogênica, bem como o seu bemestar emocional (p=0,008) e social (p=0,009) e impacto geral na qualidade de vida (p=0,019). Além disso, a intensidade (p<0,001), frequência (p<0,001) e duração (p<0,001) da odontalgia foram correlacionadas com o impacto geral na qualidade de vida da criança. A prevalência de infecção odontogênica permanece elevada em crianças escolares brasileiras. Infecção pediátrica e sua dor relacionada induzem não apenas diversas desordens biológicas, mas também afetam negativamente a autopercepção de qualidade de vida das crianças.

Principais desfechos fatais em indivíduos cardiopatas acometidos por COVID-19 / Main fatal outcomes in individuals with cardiopathies stricken by covid-19

Objetivo: identificar os principais desfechos fatais em indivíduos cardiopatas acometidos por COVID-19. Método: Trata-se de um estudo de natureza qualitativa, do tipo revisão integrativa da literatura, por meio dos descritores: Cardiopatias; Evolução Fatal; Infecções por Coronavírus e COVID-19, nas bases de dados: Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e Medical Literature Analysis and Retrieval Sistem on-line (Medline); National Institutes of Health's National Library of Medicine (NIH/NLM) ­ PubMed; PubMed Central. Resultados: Dos 13 estudos incluídos após critérios de exclusão, somente oito textos na íntegra contemplaram elementos que respondiam à pergunta da pesquisa. Os mecanismos pelo quais o SARS-CoV-2 promovem lesões ao tecido miocárdico ainda não são completamente conhecidos. No entanto, acredita-se que há um risco aumentado de lesão cardíaca aguda associada à infecção mais grave por COVID-19 e essa lesão está associada ao evento fatal. Conclusão: Os achados desse estudo permitiram identificar os principais desfechos fatais em indivíduos cardiopatas acometidos por COVID-19, ademais demonstram que a atenção e o cuidado aos portadores de cardiopatias após o diagnóstico da COVID-19 precisam ser intensificados, especialmente pelo fato deste grupo de risco ter maior índice de mortalidade. (AU)

Objective: To identify the main fatal outcomes of individuals with cardiopathies stricken by COVID-19. Method: A study of a qualitative nature, of a literature integrative review using the descriptors: Heart Diseases; Fatal Outcome; Coronavirus and COVID-19 infections, on the following databases: Latin American and Caribbean Health Sciences Literature (LILACS) and Medical Literature Analysis and Retrieval System on-line (Medline); National Institutes of Health's National Library of Medicine (NIH/NLM) ­ PubMed; PubMed Central. Results: Out of the 13 studies included after the exclusion criteria, only eight texts fully contemplated elements that answered the question of the research. The mechanism through which SARS-CoV-2 caused lesions to the myocardial tissue are not yet completely known. However, it is believed that there is an increased risk of acute cardiac injury associated to a more acute infection through COVID-19 and such injury is associated to the fatal event. Conclusion: The findings of this study permit the identification of the main fatal outcomes in individuals with cardiopathies stricken by COVID-19, as well as demonstrating that the attention and care to individuals with cardiopathies after the diagnosis of the COVID-19 have to be intensified, mainly due to the fact that there is a higher mortality rate in this risk group. (AU)

Objetivo: identificar los principales resultados fatales en individuos cardiópatas acometido por COVID-19. Método: Se trata de un estudio de naturaleza cualitativa, del tipo revisión integrativa de la literatura, por medio de los descriptores: Cardiopatías; Resultado Fatal; Infecciones por Coronavirus y COVID-19, en las bases de datos: Literatura Latino-Americana y del Caribe en Ciencias de la Salud (LILACS) y Medical Literature Analysis and Retrieval System on-line (Medline); National Institutes of Health's National Library of Medicine (NIH/NLM) ­ PubMed; PubMed Central. Resultados: De los 13 estudios incluidos después de los criterios de exclusión, solamente ocho textos en la íntegra contemplaron elementos que respondían a la pregunta de la investigación. Los mecanismos por los cuales el SARS-CoV-2 promovieron lesiones al tejido miocárdico aún no son completamente conocidos. No obstante, se cree que existe un riesgo augmentado de lesión cardíaca aguda asociada a la infección más grave por COVID-19 y esa lesión está asociada al evento fatal. Conclusión: Los hallazgos de esa investigación permitieron identificar los principales resultados fatales en individuos cardiópatas acometidos por COVID-19, además demostraron que la atención y el cuidado a los portadores de cardiopatías después del diagnóstico del COVID-19 necesitan ser intensificados, especialmente por el hecho de ese grupo de riesgo tener mayor índice de mortalidad. (AU)

Delayed creatine supplementation counteracts reduction of GABAergic function and protects against seizures susceptibility after traumatic brain injury in rats.

Traumatic brain injury (TBI) is a devastating disease frequently followed by behavioral disabilities including post-traumatic epilepsy (PTE). Although reasonable progress in understanding its pathophysiology has been made, treatment of PTE is still limited. Several studies have shown the neuroprotective effect of creatine in different models of brain pathology, but its effects on PTE is not elucidated. Thus, we decided to investigate the impact of delayed and chronic creatine supplementation on susceptibility to epileptic seizures evoked by pentylenetetrazol (PTZ) after TBI. Our experimental data revealed that 4 weeks of creatine supplementation (300 mg/kg, p.o.) initiated 1 week after fluid percussion injury (FPI) notably increased the latency to first myoclonic and tonic-clonic seizures, decreased the time spent in tonic-clonic seizure, seizure intensity, epileptiform discharges and spindle oscillations induced by a sub-convulsant dose of PTZ (35 mg/kg, i.p.). Interestingly, this protective effect persists for 1 week even when creatine supplementation is discontinued. The anticonvulsant effect of creatine was associated with its ability to reduce cell loss including the number of parvalbumin positive (PARV+) cells in CA3 region of the hippocampus. Furthermore, creatine supplementation also protected against the reduction of GAD67 levels, GAD activity and specific [3H]flunitrazepam binding in the hippocampus. These findings showed that chronic creatine supplementation may play a neuroprotective role on brain excitability by controlling the GABAergic function after TBI, providing a possible new strategy for the treatment of PTE.

Atypical ß-S haplotypes: classification and genetic modulation in patients with sickle cell anemia.

ß-S globin haplotype (ßS haplotype) characterization in sickle cell anemia (SCA) patients is important because it assists individualized treatment. However, the patient with atypical haplotypes do not present detailed studies such as clinical and laboratory data. To understand the phenotypic expression of atypical haplotype patients in relation to typical haplotype ones, it may be necessary to assess the main clinical and laboratorial parameters and investigate transcription factors, as possible genetic modulators that can contribute to the improvement of the SCA patients' clinical condition. The study group was composed of 600 SCA Brazilian patients of both genders ranging in age from 1 to 68 years. The atypical haplotypes were the third most frequent (5.7%) with 11 patterns numerically ranked according to occurrence. We verified that patients with atypical 1 haplotype in combination with Bantu haplotype presented milder clinical outcomes in relation to Bantu/Bantu and Benin/Benin patients, according to improved values of hemoglobin and hematocrit. In clinical severity, we did not observe significant statistical differences between typical and atypical haplotype patients, and this result can be explained with reference to the action of transcription factors in ß-globin cluster. Thus, we presented the atypical haplotype relationship with SCA pathophysiology, reinforcing the hypothesis that individual genetic factors may be responsible for phenotypic diversity of the disease.