Detection of multidrug-resistant bacteria in the nasal cavities and evaluation of sinus disorders in patients undergoing Le Fort I osteotomy.

INTRODUCTION: Orthognathic surgery can lead to sinus alterations, including sinusitis, attributed to the exposure of maxillary sinuses during Le Fort I osteotomy. Furthermore, being a hospital-based procedure, there is potential risk of complications arising from bacteria prevalent in such environments. This study evaluated maxillary sinusitis occurrence and the presence of multidrug-resistant bacteria in the nasal cavity before and after orthognathic surgery. METHODS: Ten patients with dentofacial deformities underwent Le Fort I osteotomy. Clinical evaluations using SNOT-22 questionnaire were performed, and nasal cavity samples were collected pre-surgery and 3-6 months post-surgery to quantify total mesophilic bacteria and detect Staphylococcus aureus, Acinetobacter baumannii, and Klebsiella pneumoniae. Cone Beam Computed Tomography (CBCT) was performed pre- and post-operatively, and the results were evaluated using the Lund-Mackay system. This study was registered and approved by the Research Ethics Committee of PUCRS (No. 4.683.066). RESULTS: The evaluation of SNOT-22 revealed that five patients showed an improvement in symptoms, while two remained in the same range of interpretation. One patient developed post-operative maxillary sinusitis, which was not detected at the time of evaluation by SNOT-22 or CBCT. CBCT showed a worsening sinus condition in three patients, two of whom had a significant increase in total bacteria count in their nasal cavities. The Brodsky scale was used to assess hypertrophy in palatine tonsils, where 60% of the subjects had grade 1 tonsils, 20% had grade 2 and 20% had grade 3. None of the patients had grade 4 tonsils, which would indicate more than 75% obstruction. Two patients harboured S. aureus and K. pneumoniae in their nasal cavities. Notably, K. pneumoniae, which was multidrug-resistant, was present in the nasal cavity of patients even before surgery, but this did not result in maxillary sinusitis, likely due to the patients' young and healthy condition. CONCLUSION: There was an improvement in signs and symptoms of maxillary sinusitis and quality of life in most patients after orthognathic surgery. However, some patients may still harbour multidrug-resistant bacteria, even if they are asymptomatic. Therefore, a thorough pre-operative assessment is essential to avoid difficult-to-treat post-operative complications.

Long-term prognosis of idiopathic ventricular fibrillation: An eighteen-year experience from a tertiary center.

INTRODUCTION AND OBJECTIVES: Idiopathic ventricular fibrillation (IVF) is diagnosed in patients who survive sudden cardiac arrest (SCA), preferably with documented ventricular fibrillation (VF), without any identifiable structural or electrical abnormality. Current evidence provides limited guidance on the diagnosis and follow-up of these patients. Our aim was to assess the clinical outcomes of survivors of an aborted SCA attributed to IVF. METHODS: We retrospectively collected clinical data from all patients who survived SCA and implanted a cardiac defibrillator (ICD) between 2005 and 2023. RESULTS: A total of 38 patients, 36.8% female, with a mean age of 44±14 years old were included. Median follow-up time was 8.7 years (interquartile range (IQR) 4.7-14.7 years). All patients underwent a comprehensive diagnostic evaluation that excluded structural and coronary disease. During follow-up, underlying diagnoses were established in 34.2% of the whole cohort. Genetic testing, performed in 37.2%, revealed underlying diagnoses in 57.1% of those tested, compared to only 26.3% of patients who did not undergo genetic testing [p=0.035, OR=5.1 (95% confidence interval (CI) 1.2-21.5)]. Mortality was 10.5% (due to non-arrhythmic causes) and 36.8% patients received appropriate therapies with a median time to first ICD therapy of 39 [5.4-47.3] months. CONCLUSION(S): Etiological diagnosis and recurrence prediction in patients with IVF remains challenging, even with extensive diagnostic evaluation and long-term follow-up. In our study, genetic testing enhanced diagnostic yield. Consistent with previous findings, our cohort experienced a notable arrhythmic recurrence, with no cardiac deaths, underlining the pivotal role of ICD implantation in these patients.

Ansiedade, qualidade do sono e sonolência diurna em estudantes de enfermagem de uma instituição privada / Ansiedad, calidad del sueño y somnolencia diurna en estudiantes de enfermería de un centro privado / Anxiety, sleep quality and daytime sleepiness in nursing students at a privateinstitution

Objetivo:Avaliar a correlação entre a ansiedade com qualidade do sono e sonolência diurna dos estudantes universitários em curso de graduação em enfermagem, assim como caracterizar o perfil sociodemográfico dos estudantes. Metodologia:Estudodescritivo transversalcom abordagem quantitativa envolvendo 255 acadêmicos do curso de Enfermagem de uma instituição privada. A coleta dos dados ocorreu em Outubro de 2022 em salas de aula. Os instrumentos utilizados na coleta dos dados foram o Inventário de Ansiedade de Beck,Índice de Qualidade do Sono de Pittsburgh, Escala de Sonolência de Epwort-th e um questionário sociodemográfico. Utilizou-se o software estatístico R versão 4.0.2 e foram feitas suas correlações. Resultados: Foram encontrados padrões de ansiedade grave, com níveis de sonolência diurna anormal. A correlação entre o Inventário de Ansiedade de Beckcom a Escala de Sonolência de Epworth e o Índice de Qualidade de sono de Pittsburgh, que embora tenha sido considerada fraca a moderada, por sua vez mostrou-se significativa (r=0,29; p=0,01). Ademais, temos que, a relação entre oinventário de Becke o Índice de qualidade de sono de Pittsburgh mostrou-se também com valor de significância (r=0,35; p=0,01). Conclusões:Foi possível compreender que a ansiedade pode interferir na qualidade do sono e sonolência diurna do público de estudantes de Enfermagem (AU).

Objective: To evaluate the correlation between anxiety and sleep quality and daytime sleepiness among undergraduate nursing students, as well as to characterize the students' sociodemographic profile. Methodology: A cross-sectional descriptive study with a quantitative approach involving 255 nursing students from a private institution. Data collection took place in October 2022 in classrooms. The instruments used to collect the data were the Beck Anxiety Inventory, the Pittsburgh Sleep Quality Index, the Epwort-Th Sleepiness Scale and a sociodemographic questionnaire. Statistical software R version 4.0.2 was used and correlations were made. Results:Patterns of severe anxiety were found, with abnormal levels of daytime sleepiness. The correlation between the Beck Anxiety Inventory, the Epworth Sleepiness Scale and the Pittsburgh Sleep Quality Index, although considered weak to moderate, was significant (r=0.29; p=0.01). Furthermore, the relationship between the Beck Inventory and the Pittsburgh Sleep Quality Index was also found to be significant (r=0.35; p=0.01). Conclusions:It was possible to understand that anxiety can interfere with the quality of sleep and daytime sleepiness among nursing students (AU).

Objetivo:Evaluar la correlación entre la ansiedad y la calidad del sueño y la somnolencia diurna en estudiantes universitarios de enfermería, así como caracterizar el perfil sociodemográfico de los estudiantes. Metodología:Estudio descriptivo transversal con enfoque cuantitativo en el que participaron 255 estudiantes universitarios de enfermería de una institución privada. La recogida de datos tuvo lugar en octubre de 2022 en las aulas. Los instrumentos utilizados para la recogida de datos fueron el Inventario de Ansiedad de Beck, el Índice de Calidad del Sueño de Pittsburgh, la Escala de Somnolencia de Epwort-Th y un cuestionario sociodemográfico. Se utilizó el software estadístico R versión 4.0.2 y se realizaron correlaciones. Resultados:Se encontraron patrones de ansiedad severa, con niveles anormales de somnolencia diurna. La correlación entre el Inventario de Ansiedad de Beck con la Escala de Somnolencia de Epworth y el Índice de Calidad del Sueño de Pittsburgh, aunque se consideró de débil a moderada, fue significativa (r=0,29; p=0,01). Además, la relación entre el Inventario de Beck y el Índice de Calidad del Sueño de Pittsburgh también resultó significativa (r=0,35; p=0,01). Conclusiones: Se pudo comprender que la ansiedad puede interferir en la calidad del sueño y en la somnolencia diurna de los estudiantes de enfermería (AU).

Assessment of water quality based on statistical analysis of physical-chemical, biomonitoring and land use data: Manso River supply reservoir.

Preserving the quality of surface water has become increasingly difficult due to the intensification of human activities in watersheds. This study assessed the water quality of the Manso River reservoir, which supplies water to Brazil's third largest metropolitan region. The integration of >10,000 secondary data, comprising physico-chemical parameters, metals and microbiological indicators, together with biomonitoring and land use and occupation data, were analyzed by using statistical tools, the Water Quality Index (WQI) and the Trophic State Index (TSI). The results showed higher concentrations for solids and metals (Fe and Mn) characteristic of local geochemistry and also related to the mining activity in the region. Parameters associated with organic pollution, such as total phosphorus and Escherichia coli, were also elevated, probably due to contamination by untreated or insufficiently treated domestic sewage. The water at the tributary watercourses presented worse quality, predominantly medium WQI, compared with the stations inside the reservoir (predominantly good WQI). The TSI indicated a predominance of ultra-oligotrophic conditions for stations located in the lotic environment and mesotrophic conditions for those located in the lentic environment. In general, the same pattern was observed for the occurrence of the phytoplankton and zooplankton classes, indicating the relationship between the degree of trophy and the composition of these groups. In quantitative terms, for phytoplankton, the Euchlorophyceae and Cyanophyceae classes stood out, mainly in the rainy period (summer), whereas for zooplankton, the Crustacea and Monogonta classes were dominant. Regarding land use and occupation in the reservoir sub-basin, the positive impact of the surrounding forest cover was observed. It was also identified the effect of seasonality on the quality of aquatic environments. The integrated evaluation of the results proved to be efficient in assessing the environmental conditions of the reservoir and the tributaries, providing information for better management of these water resources.

Queilite actínica ("Lábios de Marinheiro"): uma Revisão para o Clínico / Actinic cheilitis ("sailor's lips"): A review for the clinician

A Queilite Actínica (QA), também conhecida como "lábios de marinheiro", é uma patologia com potencial de malignização e, ainda que seja de fácil diagnóstico e prevenção, casos diagnosticados tardiamente podem evoluir para carcinoma de lábios. Seu principal fator etiológico é a exposição aos raios ultravioletas, e por este motivo, indivíduos que se expõem muito ao sol, incluindo militares, podem ser considerados grupo de risco para a doença. O objetivo principal deste trabalho foi descrever os principais fatores de risco e prognósticos da QA e apresentar uma revisão para o cirurgião-dentista, facilitando a identificação e conduta. Para tal, foi realizada busca de artigos pertinentes ao tema nas bases de dados Medline, Lilacs, SciELO e PubMed, de 1987 a 2022. O seguinte perfil do paciente com QA foi identificado: homem, na quinta década de vida, pele clara, com lesões no lábio inferior e com histórico de longo tempo de atividades ocupacionais ao ar livre/intensa exposição solar. O cirurgião-dentista possui papel fundamental na identificação dos grupos de risco, no reconhecimento precoce da doença e, em casos mais avançados, realizar o diagnóstico e o correto encaminhamento para atendimento especializado.

Actinic Cheilitis (AC), also known as "sailor's lips", is a premalignant pathology, and although it is easy to diagnose and prevent, late diagnosed cases may progress to lip carcinoma. Since its main etiological factor is exposure to ultraviolet rays, individuals often exposed to the sun, including military personnel, can be considered a risk group for the disease. The aim of this study was to describe the main risk and prognostic factors of AC and to create a clinical protocol for dental surgeons, making easier to identify and conduct each case. For this purpose, a search for articles relevant to the topic was carried out in Medline, Lilacs, SciELO and PubMed databases, from 1987 to 2022. The following AC patient profile was identified: male, in the fifth decade of life, fair skinned, with lesions on the lower lip and with a long history of outdoor occupational activities/intense sun exposure. The dentist has a fundamental role in identifying risk groups, early recognition of the disease and in more advanced cases, making the correct diagnosis and recommendation to specialized care.

Artificial neural networks for performance prediction of full-scale wastewater treatment plants: a systematic review.

Wastewater treatment plants (WWTPs) are complex systems that must maintain high levels of performance to achieve adequate effluent quality to protect the environment and public health. Artificial intelligence and machine learning methods have gained attention in recent years for modeling complex problems, such as wastewater treatment. Although artificial neural networks (ANNs) have been identified as the most common of these methods, no study has investigated the development and configuration of these models. We conducted a systematic literature review on the use of ANNs to predict the effluent quality and removal efficiencies of full-scale WWTPs. Three databases were searched, and 44 records of the 667 identified were selected based on the eligibility criteria. The data extracted from the papers showed that the majority of studies used the feedforward neural network model with a backpropagation training algorithm to predict the effluent quality of plants, particularly in terms of organic matter indicators. The findings of this research may help in the search for an optimum design modeling process for future studies of similar prediction problems.

Oral clinical findings and intensive care unit prognostic scores.

OBJECTIVE: Hospitalisation in intensive care unit (ICU) may cause changes in oral environment, which may influence patients' health status. The aim of this study was to evaluate the frequency of intraoral and extraoral findings observed during ICU admission, and to verify if there is an association with clinical prognosis scores. METHODS: Data regarding clinical characteristics of patients hospitalised in an ICU were collected from medical records. The prognostic scores Sepsis Related Organ Failure Assessment (SOFA) and Simplified Acute Physiology Score (SAPS 3) were estimated with data collected from admission and SOFA on the day of the oral examination as well. Data on oral mucosa lesions, saliva, dental condition and oral hygiene were evaluated during oral examinations. RESULTS: The association of oral findings with prognostic scores was statistically verified. The majority (92.2%) of the 170 evaluated patients showed extraoral or intraoral findings during ICU admission. The most frequent findings were chapped and crusted lips, coated tongue, pale mucosa, haemorrhagic lesions, candidiasis, depapillated tongue and traumatic lesions. There were significant higher prognostic scores in the presence of the following extraoral and intraoral findings: crusted and ulcerated lips, haemorrhagic lesions, jaundice, spontaneous oral bleeding, coated and depapillated tongue. Median SAPS 3 was higher in patients with poor oral hygiene. CONCLUSIONS: Oral findings were frequent in the population of patients hospitalised in the ICU and some of them were associated with worse prognostic scores. Routine oral examinations must be performed in hospitalised patients from ICUs for detection of oral markers of worse clinical prognosis.

Hepatitis C Virus (HCV) Infection and Neurocognitive Impairment in Subjects with Mild Liver Disease.

Hepatitis C virus (HCV) infection is a leading cause of liver cirrhosis, hepatocellular carcinoma, and liver-related deaths. It is estimated that 40-74% of patients with hepatitis C will experience at least one extrahepatic manifestation within their lifetime. The finding of HCV-RNA sequences in post-mortem brain tissue raises the possibility that HCV infection may affect the central nervous system and be the source of subtle neuropsychological symptoms, even in non-cirrhotic. Our investigation aimed to evaluate whether asymptomatic, HCV-infected subjects showed cognitive dysfunctions. Twenty-eight untreated asymptomatic HCV subjects and 18 healthy controls were tested using three neuropsychological instruments in a random sequence: Symbol Digit Modalities Test (SDMT), Controlled Oral Word Association Test (COWAT), and Continuous Visual Attention Test (CVAT). We performed depression screening, liver fibrosis assessment, blood tests, genotyping, and HCV-RNA viral load. A MANCOVA and univariate ANCOVAS were performed to examine group differences (HCV vs. healthy controls) in four scores of the CVAT (omission errors, commission errors, reaction time-RT, and variability of RT-VRT), and the scores derived from the SDMT, and the COWAT. A discriminant analysis was performed to identify which test variables effectively discriminate HCV-infected subjects from healthy controls. There were no group differences in the scores of the COWAT, SDMT, and in two variables of the CVAT (omission and commission errors). In contrast, the performance of the HCV group was poorer than the controls in RT (p = 0.047) and VRT (p = 0.046). The discriminant analysis further indicated that the RT was the most reliable variable to discriminate the two groups with an accuracy of 71.7%. The higher RT exhibited by the HCV group may reflect deficits in the intrinsic-alertness attention subdomain. As the RT variable was found to be the best discriminator between HCV patients and controls, we suggest that intrinsic-alertness deficits in HCV patients may affect the stability of response times increasing VRT and leading to significant lapses in attention. In conclusion, HCV subjects with mild disease showed deficits in RT and intraindividual VRT as compared to healthy controls.

Nano-scaled surfaces and sustainable-antibiotic-release from polymeric coating for application on intra-osseous implants and trans-mucosal abutments.

Multifunctional surfaces may display the potential to accelerate and promote the healing process around dental implants. However, the initial cellular biocompatibility, molecular activity, and the release of functionalized molecules from these novel surfaces require extensive investigation for clinical use. Aiming to develop and compare innovative surfaces for application in dental implants, the present study utilized titanium disks, which were treated and divided into four groups: machined (Macro); acid-etched (Micro); anodized-hydrophilic surface (TNTs); and anodized surface coated with a rifampicin-loaded polymeric layer (poly(lactide-co-glycolide), PLGA) (TNTsRIMP). The samples were characterized regarding their physicochemical properties and the cumulative release of rifampicin (RIMP), investigated at different pH values. Additionally, differentiated osteoblasts from mesenchymal cells were used for cell viability and qRT-PCR analysis. Antibacterial properties of each surface treatment were investigated against Staphylococcus epidermidis. TNTsRIMP demonstrated controlled drug release for up to 7 days in neutral pH environments. Osteogenic cell cultures indicated that all the evaluated surfaces showed biocompatibility. The TNTs group revealed up-regulated values for bone-related gene quantification in 7 days, followed by the TNTsRIMP group. Furthermore, the antibiotic-functionalized surface revealed effectiveness to inhibit S. epidermidis and stimulate promising conditions for osteogenic cell behavior. Characteristics such as nanomorphology and hydrophilicity were determinants for the up-regulated quantification of osteogenic biomarkers related to early bone maturation, encouraging application in intra-osseous implant surfaces; in addition, antibiotic-functionalized surfaces demonstrated significant higher antibacterial properties compared to the other groups. Our findings suggest that polymeric-antibiotic-loaded coating might be applied for the prevention of early infections, favoring its application in multifunctional surfaces for intra- and/or trans-mucosal components of dental implants, while, hydrophilic nanotextured surfaces promoted optimistic properties to stimulate early bone-related cell responses, favoring its application in bone-anchored surfaces.

Increased ompW and ompA expression and higher virulence of Acinetobacter baumannii persister cells.

BACKGROUND: Acinetobacter baumannii is one of the main causes of healthcare-associated infections that threaten public health, and carbapenems, such as meropenem, have been a therapeutic option for these infections. Therapeutic failure is mainly due to the antimicrobial resistance of A. baumannii, as well as the presence of persister cells. Persisters constitute a fraction of the bacterial population that present a transient phenotype capable of tolerating supra-lethal concentrations of antibiotics. Some proteins have been suggested to be involved in the onset and/or maintenance of this phenotype. Thus, we investigated the mRNA levels of the adeB (AdeABC efflux pump component), ompA, and ompW (outer membrane proteins) in A. baumannii cells before and after exposure to meropenem. RESULTS: We found a significant increase (p-value < 0.05) in the expression of ompA (> 5.5-fold) and ompW (> 10.5-fold) in persisters. However, adeB did not show significantly different expression levels when comparing treated and untreated cells. Therefore, we suggest that these outer membrane proteins, especially OmpW, could be part of the mechanism of A. baumannii persisters to deal with the presence of high doses of meropenem. We also observed in the Galleria mellonella larvae model that persister cells are more virulent than regular ones, as evidenced by their LD50 values. CONCLUSIONS: Taken together, these data contribute to the understanding of the phenotypic features of A. baumannii persisters and their relation to virulence, as well as highlight OmpW and OmpA as potential targets for drug development against A. baumannii persisters.

Antimicrobial Prophylaxis in Dentistry: Survey among Dental Surgeons in Porto Alegre, Brazil, and the Metropolitan Region.

The irrational use of antimicrobial drugs has become a serious epidemiological problem due to the development of bacterial resistance, causing consequences for global health. In dentistry, antibiotics are the second most common pharmacological class prescribed. Thus, we evaluated the use of antimicrobial prophylaxis by dentists in Porto Alegre, Brazil, and the metropolitan region using an online questionnaire. Dentists were asked to complete an anonymous questionnaire concerning antimicrobial prescription. The questionnaire was prepared on the Microsoft Forms platform and shared with dentists through social media and was available for a period of 40 days. The questionnaire was answered by 82 dentists, and 85.3% of them reported prescribing antibiotic prophylaxis (AP). Many different protocols were observed, but the majority of dentists prescribe amoxicillin (2 g) 1 hour before a procedure. The greatest diversity was found in the prescriptions for post-procedure prophylaxis, but most professionals prescribe 500 mg of antibiotics every 8 hours for 7 days. An overwhelming 91.5% of participants think that guidelines for prescribing antibiotics in dentistry are necessary, and 62.2% believe that the use of AP can have some impact on bacterial resistance. There is a wide range of different prescriptions for antimicrobials, suggesting a need for better aligned guidelines and education of professionals on the proper use of antimicrobials and its consequences on bacterial resistance to antibiotics.

Long-term prognosis of out-of-hospital cardiac arrest due to idiopathic ventricular arrhythmias.

Life-threatening ventricular arrhythmias (VA) may occur in patients with unknown cardiac disease. A sizable part of them remains labeled as Idiopathic VA and limited data is available regarding their natural history. Our aim was to evaluate the long-term clinical outcomes of survivors of an idiopathic life-threatening VA. Patients who survived an idiopathic life-threatening VA referred to an ICD were included and followed for a median follow-up of 7 years. Clinical and device data were collected and a comparison between genders was made. A total of 29 patients, 41% female, mean age of 50 (19) years were studied; all were implanted with an ICD at index hospitalization. At follow-up, an etiological diagnosis was established in 38% of patients. Genetic testing improved the diagnosis and allowed the identification of a distinct clinical entity in 60% of patients (p=0.04, OR=7.0), especially in women. Regarding ICD data, 31% received appropriate therapies with a median time to first appropriate shock of 39 months (IQR 12-46 months). Men had a significantly higher prevalence of appropriated shocks (50% vs 8%, p=0.04), with a similar time to the first arrhythmic event between genders. Two of the patients died, both from non-arrhythmic causes. Etiologic diagnosis and recurrence prediction in patients with idiopathic VA is challenging, even with long-term follow-up and sophisticated diagnostic evaluation.  Genetic testing significantly improved the diagnostic yield, especially in women. Arrhythmia recurrence occurred in about one-third of patients and is significantly higher in men, underscoring the importance of ICD implantation.

Workshops of the Pedagogic Week 2021 of Centro Universitario FMABC / As oficinas da Semana Pedagógica de 2021 do curso de Medicina do Centro Universitário FMABC

INTRODUCTION: Delivering quality medical education is a hot topic. The current discussion essentially addresses content versus competencies. Extensive curricula and matrices, and traditional assessments are against go against the modern concepts of medical education. Remote education stimulated this discussion and brought the opportunity to review the academic load and assessment. REPORT: In January 2021, a pedagogic workshop of the Medicine course of Centro Universitário FMABC was held. It began with a lecture by a visiting professor and coordinator of the medical school accreditation system on remote activities during the pandemic. Next, the person responsible for the Progress Test made a history of the latest assessments, and a professor who is a member of the Accreditation Committee of the Medical Schools presented a summary of the main insufficient points of the last assessment. Afterward, the students presented the last internal evaluations. Finally, the matrices of the course, from the 1st to the 4th year, were presented and compared with those of three other medical schools, and each year coordinator prepared their suggestions for changes to the matrices. Lastly, students, professors, and the course coordination presented a report and proposals, encouraging the integration of the academic community, the reassessment of teaching plans, repetition of content, and recognition of matrices of each year, offering ideas and tools, to reflection on remote learning, and opportunities for change and improvement in teaching, and learning. CONCLUSION: The disciplines showed willingness for integrative activities, extension, and creation of elective disciplines, complementing failures caused by the Pandemic.

INTRODUÇÃO: A entrega da educação médica de qualidade é um tema em ebulição. A discussão atual aborda essencialmente conteúdos versus competências. Currículos e matrizes extensas, e avaliações tradicionais estão na contramão. O ensino remoto estimulou a discussão e a revisão da carga acadêmica e das avaliações. RELATO: Em janeiro de 2021 foi realizada uma oficina pedagógica do Curso de Medicina do Centro Universitário FMABC. Começou com a palestra de um professor convidado e coordenador do sistema de acreditação de escolas médicas, sobre atividades remotas durante a pandemia. A seguir, a responsável pelo Teste do Progresso fez um histórico das últimas avaliações, e um professor membro da comissão de acreditação de escolas médicas apresentaram uma síntese dos principais pontos insuficientes da última avaliação. Na sequência, os discentes apresentaram as últimas avaliações internas. Finalmente, foram apresentadas as matrizes do curso, do 1º ao 4º ano, comparadas com as de mais três escolas médicas, e cada coordenador de ano preparou suas sugestões para alterações de matrizes. Por último, discentes, docentes e a coordenação do curso apresentaram um relatório e propostas, estimulando a integração da comunidade acadêmica, a reavaliação dos planos de ensino, as repetições de conteúdo e o reconhecimento de matrizes de cada ano, oferecendo ideias e ferramentas, para a reflexão sobre o ensino remoto e as oportunidades de mudanças e aprimoramento do ensino e do aprendizado. CONCLUSÃO: As disciplinas mostraram disposição para as atividades integrativas, de extensão e de criação de disciplinas eletivas complementando falhas provocadas pela Pandemia.

Antimicrobial and bone repair effects of boric acid in a rat model of dry socket (alveolar osteitis) following dental extraction.

BACKGROUND: Alveolitis occurs after dental extraction without blood clot formation, leading to an inflammatory process and bacterial contamination. Boric acid (BA) demonstrates anti-inflammatory, antimicrobial, and osteogenic properties. This study aims to evaluate the possible antimicrobial effects and bone repair of BA in a rat model of alveolitis (dry socket). METHODS: 33 male Wistar rats were submitted to the extraction of the upper right incisor and dry socket induction. They were first divided into two groups: dry socket (n = 17) and dry socket + 0.75 % BA (n = 16). Samples for the microbiological analysis were collected immediately after dental extraction, at the detection of clinical alveolitis, 7, and 14 days after BA application. For microCT and histological analysis, samples from euthanized rats were used in 14 and 28 days after alveolitis detection. RESULTS: Higher bacterial counts were found in 4-5 days after alveolitis induction, compared to the baseline in both experimental groups, decreasing significantly after 7 and 14 days of treatment with BA (P < 0.05). The microCT evaluation displayed increased bone volume, bone volume fraction, trabecular thickness, and bone mineral density in a time-dependent manner, regardless of BA treatment. On the other hand, the number of trabeculae and total bone porosity decreased over the 28 days of the experiment in the dry-socket group and both groups, respectively (P < 0.05). Histological analysis did not differ on bone repair in both experimental groups. CONCLUSION: This was the first report investigating the effects of BA in a rat model of alveolitis regarding microbiological and bone repair aspects. The BA local application decreased the total aerobic and facultative bacteria counts and does not seem to benefit the bone repair after alveolitis development. This study paves the way for more studies involving alveolitis and different BA applications.

Novel 4-aminoquinolines: Synthesis, inhibition of the Mycobacterium tuberculosis enoyl-acyl carrier protein reductase, antitubercular activity, SAR, and preclinical evaluation.

Herein a series of 4-aminoquinolines were synthesized in an attempt to optimize and study the structural features related to LABIO-17 biological activity, a Mycobacterium tuberculosis NADH-dependent enoyl-acyl carrier protein reductase (MtInhA) inhibitor previously identified by a virtual-ligand-screening approach. Structure-activity relationships led to novel submicromolar inhibitors of MtInhA and potent antitubercular agents. The lead compound is 87-fold more potent as enzymatic inhibitors and 32-fold more potent against M. tuberculosis H37Rv strain in comparison with LABIO-17. These molecules were also active against multidrug-resistant strains, devoid of apparent toxicity to mammalian cells and showed favorable in vitro ADME profiles. Additionally, these compounds were active in an intracellular model of tuberculosis (TB) infection, showed no genotoxicity signals, satisfactory absorption parameters and absence of in vivo acute toxicity. Finally, treatment with selected 4-aminoquinoline for two weeks produced bacteriostatic effect in a murine model of TB. Taken together, these findings indicate that this chemical class may furnish candidates for the future development of drug-sensitive and drug-resistant tuberculosis treatments.

Monitoria acadêmica: uma formação docente para discentes / Academic monitorship: teacher training for undergraduates

Resumo Introdução: A monitoria acadêmica é um processo de formação e introdução à docência que é prevista nas Diretrizes Curriculares Nacionais de 2014 e tem o potencial de conferir maior competência à área de educação em saúde a qual é valorizada pelo Sistema de Acreditação de Escolas Médicas como um indicador internacional de qualidade. Objetivo: O estudo buscou identificar as principais potencialidades e desafios da monitoria acadêmica na formação médica. Método: Trata-se de um estudo observacional descritivo de caráter transversal realizado com 11 estudantes de Medicina, por meio de entrevistas semiestruturadas e com análise de dados feita a partir de uma abordagem qualitativa do tipo textual-discursiva. Resultado: Os códigos foram reunidos em quatro categorias: 1. motivações para participação, 2. desafios enfrentados, 3. aprendizados desenvolvidos e 4. carreira docente. A principal motivação foi currículo, seguido de interesse em aprender conteúdo. Os maiores desafios foram o desenvolvimento da responsabilidade e a explicação do conteúdo. Dentre os aprendizados, habilidades didáticas, aprendizagem significativa e metodologias de ensino foram as mais prevalentes. Em termos de carreira, a monitoria ao menos apresentou a docência como possibilidade para além da prática médica assistencial, e os aspectos ser facilitador, ter habilidades interpessoais e preocupar-se com o aluno constituíram a tríade - na visão dos monitores - de um "bom professor". Conclusão: A monitoria acadêmica é uma prática didático-pedagógica capaz de estimular o interesse e a profissionalização da carreira docente. Além disso, deve ser incentivada pelas políticas públicas e institucionais com o objetivo de qualificar futuros médicos para que possam atuar como educadores em e na saúde.

Abstract Introduction: Academic monitorship is a process of training and introduction to teaching that is foreseen in the National Curricular Guidelines of 2014 and has the potential to confer greater competence in the area of health education, which is valued by the Medical School Accreditation System as an international quality indicator. Objective: The study sought to identify the main potentialities and challenges of academic monitorship in medical education. Method: This is a cross-sectional descriptive observational study conducted with 11 medical students, through semi-structured interviews and data analysis performed from a qualitative approach of the textual-discursive type. Result: The codes were grouped into four categories: (1) motivations for participation, (2) challenges faced, (3) learning developed and (4) teaching career. The main motivation was curriculum, followed by interest in learning content. The biggest challenges were developing responsibility and content explanation. Among the learnings, teaching skills, meaningful learning and teaching methodologies were the most prevalent. In terms of career, monitors at least presented teaching as a possibility beyond medical care practice, and being a facilitator, having interpersonal skills and caring about the student constituted the triad - in the monitors' view - of a "good teacher". Conclusion: Academic monitorship is a didactic-pedagogical practice capable of stimulating interest and professionalization in the teaching career. In addition, it should be encouraged by public and institutional policies with the objective of qualifying future doctors to act as educators in health care.

Effect of gastric acid on the surface roughness and bacterial adhesion of bulk-fill composite resins.

The purpose of this in vitro study was to evaluate the effect of gastric acid on the surface roughness and biofilm formation of bulk-fill composite resins. Twenty-seven samples of each composite resin were obtained: G1: Filtek Z250 XT (Z250), G2: Filtek Bulk Fill (FTK), G3: Tetric N-Ceram Bulk Fill (TTC), and G4: Aura Bulk Fill (AUR). The samples were quantitatively analyzed for surface roughness (Ra) using a roughness tester (n=15) and for biofilm formation (Cn) by the counting of colony-forming units (CFUs/mL) (n=9) in three different moments: after polishing (Ra0 and Cn0), after gastric acid immersion (Ra1 and Cn1), and after gastric acid and simulated tooth brushing (Ra2 and Cn2). Qualitative analysis through surface topography (n=3) was evaluated by scanning electron microscopy (SEM). Ra values were subjected to two-way repeated measures ANOVA, followed by Tukey's test. Cn values were subjected to Kruskal-Wallis analysis, followed by multiple comparisons analysis (α=0.05). Z250 and FTK showed significant increases in surface roughness at Ra1. There were fewer CFUs/mL on TTC and AUR in relation to those of Z250 and FTK for Cn0, Cn1 and Cn2. The SEM images showed that gastric acid increased the formation of cracks, exposure of fillers and micro cavities for all composite resins. After tooth brushing, the topographical changes were more evident but did not influence biofilm formation. The gastric acid promoted both degradation of the surfaces and bacterial adhesion for all composite resins.

Effect of gastric acid on the surface roughness and bacterial adhesion of bulk-fill composite resins

Abstract The purpose of this in vitro study was to evaluate the effect of gastric acid on the surface roughness and biofilm formation of bulk-fill composite resins. Twenty-seven samples of each composite resin were obtained: G1: Filtek Z250 XT (Z250), G2: Filtek Bulk Fill (FTK), G3: Tetric N-Ceram Bulk Fill (TTC), and G4: Aura Bulk Fill (AUR). The samples were quantitatively analyzed for surface roughness (Ra) using a roughness tester (n=15) and for biofilm formation (Cn) by the counting of colony-forming units (CFUs/mL) (n=9) in three different moments: after polishing (Ra0 and Cn0), after gastric acid immersion (Ra1 and Cn1), and after gastric acid and simulated tooth brushing (Ra2 and Cn2). Qualitative analysis through surface topography (n=3) was evaluated by scanning electron microscopy (SEM). Ra values were subjected to two-way repeated measures ANOVA, followed by Tukey's test. Cn values were subjected to Kruskal-Wallis analysis, followed by multiple comparisons analysis (α=0.05). Z250 and FTK showed significant increases in surface roughness at Ra1. There were fewer CFUs/mL on TTC and AUR in relation to those of Z250 and FTK for Cn0, Cn1 and Cn2. The SEM images showed that gastric acid increased the formation of cracks, exposure of fillers and micro cavities for all composite resins. After tooth brushing, the topographical changes were more evident but did not influence biofilm formation. The gastric acid promoted both degradation of the surfaces and bacterial adhesion for all composite resins.

Resumo O objetivo deste estudo in vitro foi avaliar o efeito do ácido gástrico na rugosidade superficial e na formação do biofilme nas resinas compostas de incremento único. Vinte e sete amostras de cada resina composta foram confeccionadas: G1: Filtek Z250 XT (Z250), G2: Filtek Bulk Fill (FTK), G3: Tetric N-Ceram Bulk Fill (TTC), and G4: Aura Bulk Fill (AUR). As amostras foram analisadas quantitativamente quanto à rugosidade da superfície (Ra) usando um rugosímetro (n=15) e para formação de biofilme (Cn) pela contagem de unidades formadoras de colônias (UFC/mL) (n=9) em três diferentes momentos: após polimento (Ra0 and Cn0), após imersão em ácido gástrico (Ra1 and Cn1), e após ácido gástrico e simulação de escovação (Ra2 and Cn2). Análise qualitative da topografia superficial (n=3) foi avaliada por meio de microscopia eletrônica de varredura (MEV). Os valores de Ra foram analisados pela ANOVA de duas vias para amostras pareadas, seguido do teste de Tukey. Os valores de Cn foram submetidos ao teste de Kruskal-Wallis, seguido da análise de comparações múltiplas (α=0,05). Z250 e FTK tiveram aumento significativo na rugosidade superficial em Ra1. Houve menos CFUs/mL para TTC e AUR em relação à Z250 e FTK em Cn0, Cn1 and Cn2. As imagens em MEV mostraram que o ácido gástrico aumentou a formação de fendas, exposição das partículas e mcrocavidades para todas as resinas compostas. Após escovação, as mudanças topográficas foram mais evidentes, mas não influenciou na formação do biofilme. O ácido gástrico promoveu degradação da superfície e adesão bacteriana para todas as resinas compostas.

Copper-coated hospital surfaces: reduction of total bacterial loads and resistant Acinetobacter spp.

Healthcare-associated infections (HAIs) represent a global challenge and an even more staggering concern when related to microorganisms capable of resisting and surviving for long periods in the environment, such as Acinetobacter spp. Strategies that allow a reduction of pathogens from hospital environments represent an additional barrier in infection control protocols, minimizing transmission to hospitalized patients. Considering the antimicrobial properties of copper, here, the bacterial load and the presence of Acinetobacter spp. were monitored on high handling surfaces covered by 99.9% copper films on intensive and non-intensive care unit bedrooms in a tertiary care hospital. Firstly, copper-coated films were able to inhibit the adhesion and biofilm formation of A. baumannii strains in in vitro assays. On the other hand, Acinetobacter spp. were isolated from both copper-coated and uncoated surfaces in the hospital, although the majority was detected on surfaces without copper. All carbapenem-resistant A. baumannii isolates identified harbored the blaoxa-23 gene, while the A. nosocomialis isolates were susceptible to most antimicrobials tested. All isolates were susceptible to polymyxin B. Regarding the total aerobic bacteria, surfaces with copper-coated films presented lower total loads than those detected for controls. Copper coating films may be a workable strategy to mitigate HAIs, given their potential in reducing bacterial loads in nosocomial environments, including threatening pathogens like A. baumannii.