Caracterização de lesões de mancha branca naturais / Characterization of natural white spot lesions

O objetivo deste estudo foi caracterizar e comparar o esmalte sadio humano e lesões de mancha branca (ICDAS 2) em diferentes aspectos. Dezessete espécimes foram caracterizados por meio fluorescência com o Diagnodent®, Fluorescência quantitativa induzida pela luz (QLF®), quanto aspectos ópticos pela Tomografia de Coerência Óptica (OCT), propriedades mecânicas com a Microdureza seccional e avaliação do conteúdo inorgânico e orgânico com a Espectroscopia Raman. A ANOVA e teste de Tukey, foram utilizados com 5% como nível de significância. O Diagnodent® identificou 75% das superfícies como hígidas, 7% cárie em esmalte, 10% lesão até junção esmalte-dentina e 7% cárie em dentina. Para o QLF®, a perda de conteúdo mineral Q (%mm2) foi de 15,37%mm2 e a diferença de fluorescência (F) foi de 11,68%. O aparelho OCT captou uma média de profundidade de lesões de 174,43 m, e um coeficiente de atenuação sem diferença significante (p>0,005). A microdureza demonstrou uma diferença significante (p<0,005) quando comparados os fatores: camada superficial e corpo do esmalte (hígido e lesão), porém não existe diferença significante (p>0,005), quando comparados esses dois sítios dentro do mesmo substrato. O espectro Raman demonstrou as 4 bandas vibracionais do fosfato (v1, v2, v3, v4) com maior intensidade no esmalte hígido, sendo o maior pico em 960,3 cm-1(v1). Em 1071 cm-1, a intensidade foi maior para o esmalte hígido, correspondendo a banda do fosfato (v3) e não o carbonato tipo B. O conteúdo orgânico foi visto em 1295 cm-1 e em 1450 cm-1, com maior intensidade nas lesões. A variabilidade de características dos substratos estudados interferiu diretamente na caracterização destes pelos métodos propostos.

Antigen concentration, viral load, and test performance for SARS-CoV-2 in multiple specimen types.

The relationship between N-antigen concentration and viral load within and across different specimens guides the clinical performance of rapid diagnostic tests (RDT) in different uses. A prospective study was conducted in Porto Velho, Brazil, to investigate RDT performance in different specimen types as a function of the correlation between antigen concentration and viral load. The study included 214 close contacts with recent exposures to confirmed cases, aged 12 years and older and with various levels of vaccination. Antigen concentration was measured in nasopharyngeal swab (NPS), anterior nares swab (ANS), and saliva specimens. Reverse transcriptase (RT)-PCR was conducted on the NPS and saliva specimens, and two RDTs were conducted on ANS and one RDT on saliva. Antigen concentration correlated well with viral load when measured in the same specimen type but not across specimen types. Antigen levels were higher in symptomatic cases compared to asymptomatic/oligosymptomatic cases and lower in saliva compared to NPS and ANS samples. Discordant results between the RDTs conducted on ANS and the RT-PCR on NPS were resolved by antigen concentration values. The analytical limit-of-detection of RDTs can be used to predict the performance of the tests in populations for which the antigen concentration is known. The antigen dynamics across different sample types observed in SARS-CoV-2 disease progression support use of RDTs with nasal samples. Given lower antigen concentrations in saliva, rapid testing using saliva is expected to require improved RDT analytical sensitivity to achieve clinical sensitivity similar to rapid testing of nasal samples.

Physicochemical Property Determinants of Oral Absorption for PROTAC Protein Degraders.

Heterobifunctional PROTAC degraders are gaining attention as a differentiated therapeutic modality with the potential for oral dosing in the clinic. Belonging to the beyond Rule of Five domain of physicochemical property space, we have sought to understand the determinants of oral absorption for this class of molecules for the rapid development of novel oral agents. We have collected a large data set from PROTAC molecules that have been dosed orally and intravenously in rats to estimate the fraction absorbed from oral dosing. Through this estimation, effects from differential hepatic clearance are normalized, allowing for a better assessment of the absorption. We demonstrate that rats are less permissive to PROTAC absorption than mice. The physicochemical properties of the molecules are then evaluated once compounds are rank-ordered by the fraction absorbed. We derive suggested design constraints on physicochemical properties for PROTAC molecules that are associated with higher probability of being orally absorbed.

Enhancing the Visibility of Women in the ACS Division of Medicinal Chemistry (ACS MEDI).

On the occasion of the 2023 International Women's Day on March 8, 2023, we want to celebrate and highlight the contributions of many women volunteers in the American Chemical Society Division of Medicinal Chemistry (ACS MEDI).

Enhancing the Visibility of Women in the ACS Division of Medicinal Chemistry (ACS MEDI).

On the occasion of the 2023 International Women's Day on March 8, 2023, we want to celebrate and highlight the contributions of many women volunteers in the American Chemical Society Division of Medicinal Chemistry (ACS MEDI).

Engaging the Medicinal Chemists of Tomorrow.

The Young Medicinal Chemists Committee (YMCC) is a part of the larger ACS Division of Medicinal Chemistry (MEDI) and was formed to ensure that MEDI meets the needs of all medicinal chemists, including students and early career scientists. There is a clear need to offer additional, specific opportunities to this group of medicinal chemists within the MEDI division. Primary functions of YMCC include facilitating networking and mentorship opportunities, collaborating with international medicinal chemistry societies, and offering social programming for all MEDI members at ACS National Meetings. We are excited to continue to engage students and early career chemists through new initiatives and programming in the future. In this Editorial we highlight current initiatives relevant to early career medicinal chemists and solicit input from the larger medicinal chemistry community.

General and comparative self-rated health in chronic stroke: an important outcome measure for health professionals.

BACKGROUND: After a stroke, several aspects of health and function may influence how individuals perceive their own health. However, self-rated health (SRH), as well as its relationship with functioning, has been little explored in individuals with stroke. The aims of this study were to determine how individuals with chronic post-stroke disabilities evaluate their health, considering general, time- and age-comparative SRH questions and to investigate whether SRH measures would be influenced by the following health and functioning domains: mental/physical functions and personal factors. METHODS: Sixty-nine individuals with chronic post-stroke disabilities answered the three types of SRH questions and were assessed regarding depressive symptoms (emotional function domain), physical activity levels (physical function domain), and engagement in physical activity practice (personal factor domain). Subjects were divided into the following groups: good/poor for the general SRH question; better, similar, and "worse" for both time- and age-comparative questions. Between-group differences in the three domains for each SRH question were investigated (α = 5%). RESULTS: General SRH was rated as good by 73% of the participants. Time- and age-comparative SRH was rated as better by 36% and 47% and as similar by 31% and 28% of the subjects, respectively. Significant between-group differences in emotional function were found for both the general and age-comparative questions. For the time-comparative question, significant differences were only observed for physical function. CONCLUSION: SRH evaluation differed in individuals with chronic post-stroke disabilities according to the types of questions and health/functioning domains.

Characterization of sound enamel and natural white spot lesions / Caracterização de esmalte hígido e lesões de mancha branca naturais

Objective: To compare optical, morphological, chemical, and physical aspects of the sound enamel and white spot lesions (WSL) classified as ICDAS 2. Material and Methods: Seventeen human molars with one surface presenting WSL and a sound surface (2 x 2 mm window) were characterized by Quantitative light-induced fluorescence (QLF ®), Optical coherence tomography (OCT), microhardness, and Raman spectroscopy. The ANOVA and Tukey's test were used at 5% significance level. Results: The QLF comparison between distinct substrates yielded decreased ∆Q (integrated fluorescence loss) of -15,37%mm2 and -11,68% ∆F (fluorescence loss) for WSL. The OCT detected mean lesion depth of 174,43 µm. ANOVA could not detect differences in the optical attenuation coefficient between the substrates (p>0.05). Lower microhardness measures were observed in WSL than on sound enamel (p<0.05). The Raman spectra showed four vibrational phosphate bands (v1, v2, v3, v4), where the highest peak was at 960.3 cm-1(v1) for both substrates. However, a 40% decrease in phosphate (v1) was detected in WSL. The peak at 1071 cm-1 was higher for sound enamel, indicating the presence of a phosphate band instead of the B-type carbonate. The spectra showed higher intensity of the organic composition at 1295 cm-1 and 1450 cm -1 for WSL. Conclusion: Non-invasive QLF, OCT and Raman spectroscopy were able to distinguish differences in fluorescence, optical properties, and organic/inorganic components, respectively, between sound enamel and WSL, validated by the destructive microhardness analysis. (AU)

Objetivo: Comparar os aspectos ópticos, morfológicos, químicos e físicos do esmalte sadio e das lesões de mancha branca naturais, classificada como ICDAS 2. Material e métodos: Dezessete molares humanos com uma face apresentando uma lesão de mancha branca natural e outra face o esmalte hígido (2 x 2 mm) foram caracterizados utilizando a Fluorescência quantitativa induzida pela luz (QLF ®), Tomografia de coerência óptica (OCT), Microdureza e Espectroscopia Raman. A ANOVA e o teste de Tukey foram utilizados ao nível de significância de 5%. Resultados: A comparação entre os substratos distintos, utilizando o QLF ® demonstrou uma diminuição no ∆Q (perda de fluorescência integrada) de -15,37%mm2 e -11,68% de ∆F (Perda de fluorescência) para a lesão de mancha branca. O OCT detectou uma profundidade média de lesão de 174,43µm. A ANOVA não detectou diferenças no coeficiente de atenuação óptica entre os substratos (>0,05). Microdureza significantemente menor foi detectada nas lesões de mancha branca do que no esmalte sadio (p<0,05). Os espectros Raman mostraram quatro bandas vibracionais do fosfato (v1,v2,v3,v4), onde o maior pico foi em 960,3cm-1para ambos os substratos. No entanto, uma diminuição de 40% no fosfato (v1) foi detectada na lesão. O pico em 1071cm-1foi maior para o esmalte hígido, demonstrando tratar-se da banda do fosfato, ao invés do carbonato tipo B. Os espectros apresentaram maior intensidade da composição orgânica em 1295cm-1e 1450 cm-1para a lesão de mancha branca. Conclusão:Os métodos não invasivos QLF, OCT e espectroscopia Raman foram capazes dediferenciar a fluorescência, propriedades ópticas e conteúdo orgânico/inorgânico do esmalte sadio comparado com esmalte com lesões de mancha branca, sendo validado pela análise de microdureza. (AU)

Rating of Perceived Exertion in Three-Minute Step Test in Children with Cystic Fibrosis.

The purpose of the study was to assess whether there are differences in cardiorespiratory fitness between children with and without cystic fibrosis (CF). Ten children with CF attended at a referral center for the treatment of CF and 13 children without CF were evaluated. The average age of the children with CF was 10.40 (3.13) years and those without CF was 9.39 (3.25) years. The children performed the three-minute step test with monitoring of hemodynamic parameters and the rating of perceived exertion (RPE) every minute. Oxygen desaturation of 4% during the test occurred in three children with CF and none of the children reached a SatO2 percentage < 75%. After the step test, the findings showed that children with CF presented higher RPE scores during the test (p = 0.002) when compared to children without CF (p < 0.001). The RPE was the only parameter that changed during the test and demonstrated that children with cystic fibrosis tired more during the test when compared to children without CF despite the lack of changes in hemodynamic variables.

Caracterização de lesões de mancha branca naturais / Characterization of natural white spot lesions

O objetivo deste estudo foi caracterizar e comparar o esmalte sadio humano e lesões de mancha branca (ICDAS 2) em diferentes aspectos. Dezessete espécimes foram caracterizados por meio fluorescência com o Diagnodent®, Fluorescência quantitativa induzida pela luz (QLF®), quanto aspectos ópticos pela Tomografia de Coerência Óptica (OCT), propriedades mecânicas com a Microdureza seccional e avaliação do conteúdo inorgânico e orgânico com a Espectroscopia Raman. A ANOVA e teste de Tukey, foram utilizados com 5% como nível de significância. O Diagnodent® identificou 75% das superfícies como hígidas, 7% cárie em esmalte, 10% lesão até junção esmalte-dentina e 7% cárie em dentina. Para o QLF®, a perda de conteúdo mineral Q (%mm2) foi de 15,37%mm2 e a diferença de fluorescência (F) foi de 11,68%. O aparelho OCT captou uma média de profundidade de lesões de 174,43 m, e um coeficiente de atenuação sem diferença significante (p>0,005). A microdureza demonstrou uma diferença significante (p<0,005) quando comparados os fatores: camada superficial e corpo do esmalte (hígido e lesão), porém não existe diferença significante (p>0,005), quando comparados esses dois sítios dentro do mesmo substrato. O espectro Raman demonstrou as 4 bandas vibracionais do fosfato (v1, v2, v3, v4) com maior intensidade no esmalte hígido, sendo o maior pico em 960,3 cm-1(v1). Em 1071 cm-1, a intensidade foi maior para o esmalte hígido, correspondendo a banda do fosfato (v3) e não o carbonato tipo B. O conteúdo orgânico foi visto em 1295 cm-1 e em 1450 cm-1, com maior intensidade nas lesões. A variabilidade de características dos substratos estudados interferiu diretamente na caracterização destes pelos métodos propostos.

Discovery of Orally Active Isofuranones as Potent, Selective Inhibitors of Hematopoetic Progenitor Kinase 1.

While the discovery of immune checkpoint inhibitors has led to robust, durable responses in a range of cancers, many patients do not respond to currently available therapeutics. Therefore, an urgent need exists to identify alternative mechanisms to augment the immune-mediated clearance of tumors. Hematopoetic progenitor kinase 1 (HPK1) is a serine-threonine kinase that acts as a negative regulator of T-cell receptor (TCR) signaling, to dampen the immune response. Herein we describe the structure-based discovery of isofuranones as inhibitors of HPK1. Optimization of the chemotype led to improvements in potency, selectivity, plasma protein binding, and metabolic stability, culminating in the identification of compound 24. Oral administration of 24, in combination with an anti-PD1 antibody, demonstrated robust enhancement of anti-PD1 efficacy in a syngeneic tumor model of colorectal cancer.

Influence of biosafety materials of the laser output power.

Biosafety materials used in the correct handling of low power laser equipment may interfere on the power delivered at the target tissue and, possibly, on the effects on biological tissues. The aim of this study was to evaluate the interference of the use of polyvinyl chloride (PVC) and polyethylene (PEAD) protection materials on the output power of low power lasers. Two low power diode laser devices with different wavelengths (red and infrared) were used. For each wavelength, two protection materials and two evaluation times (before and after protection) were considered. The output power (mW) was measured with the tip positioned in close contact with the power meter receiver. Parametric statistical test, two-way ANOVA for repeated measures (protection material and time), was performed considering the level of significance of 5%. In respect to "time", all groups had the output power reduced after placing the protective material (p < 0.05). Comparing the protection materials, the PEAD showed a greater reduction in output power than the PVC for both red and infrared wavelengths. It was concluded that, among the biosafety materials tested, PVC is the most suitable for the protection of the tip of the low power lasers.

Self-rated health determinants in post-stroke individuals.

OBJECTIVE: To investigate whether variables of function and disability, which have potential to be modified by rehabilitation, are determinants of self-rated health in post-stroke individuals in the chronic phase. DESIGN: Cross-sectional exploratory study. METHODS: The dependent variable was self-rated health. The independent variables were organized according to the International Classification of Functioning, Disability and Health components: body structure and function (emotional function and motor recovery level), activity (manual and locomotion skill), and participation (participation). Logistic regression analysis was performed to identify significant associations between the independent variables and self-rated health (?=5%). RESULTS: Sixty-three individuals were included in the study: 44 (70%) rated their own health as good (excellent/very good/good) and 19 (30%) as poor (fair/poor). Significant association with self-rated health was identified only for emotional function. Individuals with impaired emotional function were 6.6 times more likely to assess their own health as poor (odds ratio (OR) 6.56; 95% confidence interval (95% CI) 1.5328.21). CONCLUSION: Emotional function was found to be a determinant of self-rated health in post-stroke individuals in the chronic phase and, therefore, must be assessed carefully in order to help provide integral healthcare and improve clinical decision-making. Future studies should investigate whether enhancing emotional function is associated with improvements in self-rated health in post-stroke individuals.

A "clínica social" em psicologia e articulações que sustentam esse fazer: uma reflexão acerca do cenário brasileiro / La "clínica social" en psicología: articulaciones que sostienen ese hacer: una reflexión sobre el escenario brasileño / The "social clinic" in psychology and articulations that support this practice: a reflection about the Brazilian scenario

Resumo: Clínica social ou atendimento social é uma prática recorrente nos atendimentos clínicos em psicologia sendo geralmente associada ao atendimento de baixo custo. Este trabalho busca provocar reflexões sobre esse fazer a partir dos múltiplos sentidos que podem ser dados a essa prática. Utilizando como referencial teórico principal a Teoria Ator-Rede e os estudos Ciência Tecnologia e Sociedade, tomamos como suporte reflexões a partir das práticas cotidianas e das convocações as quais o psicólogo recebe do campo. Pensamos em como a psicologia se manifesta e atua nesse fazer e, para além disso, como o campo atua na psicologia, provocando, questionando e atualizando o que é ser psicólogo clínico. Entendendo a psicologia como uma prática de cuidado, trazemos a importância de discutirmos esses fazeres como práticas políticas que constituem saberes e formas de atuação a partir das articulações locais, afetando tanto a sociedade quanto a própria psicologia clínica.

Resumen: Clínica social o atención social es una práctica recurrente en las atenciones clínicas en psicología, generalmente asociada a la atención de bajo costo. Este trabajo busca provocar reflexiones sobre ese hacer a partir de los múltiples sentidos que pueden ser dados a esa práctica. Utilizando como referencial teórico principal la Teoría Actor-Red y los estudios Ciencia Tecnología y Sociedad, tomamos como soporte reflexiones a partir de las prácticas cotidianas y de las convocatorias que el psicólogo recibe del campo. Pensamos en cómo la psicología se manifiesta y actúa en ese hacer y, además, cómo el campo actúa en la psicología, provocando, cuestionando y actualizando lo que es ser un psicólogo clínico. Entendiendo la psicología como una práctica de cuidado, destacamos la importancia de discutir esos hechos como prácticas políticas que constituyen saberes y formas de actuación a partir de articulaciones locales, afectando tanto a la sociedad como a la propia psicología clínica.

Abstract: Social clinic or social consultation is a recurring practice in psychological clinical appointments usually associated to a low cost consultation. This work aims to provoke reflections about a way of working from the multiple senses attributed to this practice. Using Actor-Network Theory and Science Technology and Society studies as the main theoretical references, we sustain our reflections upon everyday practices and from the summons the fields invokes to the psychologists. We think of how psychology manifests itself and acts in this practices, and beyond that, how does the field acts in psychology, provoking, questioning and updating what is to be a clinical psychologist. Acknowledging psychology as a care practice, we highlight the importance of discussing our doings as political practices that constitute knowledge and ways of acting from local articulations, affecting as society as the very own psychology.

Self-rated health after stroke: a systematic review of the literature.

BACKGROUND: Self-rated health (SRH) allows for comparison and identification of the health status of various populations. The aim of this study was to conduct a systematic review of the literature to expand the understanding of SRH after stroke. METHODS: This systematic review was registered with PROSPERO (CRD42017056194) and conducted according to PRISMA guidelines. Studies published until December 2018 that evaluated the SRH of adults with stroke were included. RESULTS: Of the 2132 identified studies, 51 were included. Only four studies had experimental designs (7.8%). In 60.7% of the studies, SRH was assessed by variations on direct questions (i.e., general and comparative SRH). Analog visual scales and quality of life instruments were also used to evaluate SRH, but there is no consensus regarding whether they are appropriate for this purpose. The results of cross-sectional and longitudinal studies revealed significant associations between poor SRH and stroke as well as between SRH, function, and disability. The power of SRH to predict stroke mortality is still uncertain. Two interventions (a home-based psychoeducational program concerning stroke health care and family involvement in functional rehabilitation) effectively improved SRH. CONCLUSIONS: Direct questions are the most common method of evaluating SRH after stroke. Studies reported significant associations between the SRH of individuals with stroke and several relevant health outcomes. However, few experimental studies have evaluated SRH after stroke. Interventions involving health education and family involvement had a significant impact on SRH.

Effect of thermal and acid challenges on the surface properties of pink restorative materials.

PURPOSE: To compare the effect of thermal cycling and erosive challenge on color change, surface roughness, surface loss and biofilm deposition of three resin-based composites. METHODS: Three resin-based composites that reproduce the color of gingival tissues [two nanohybrid composites (A and B) and a giomer (C) ] were tested before and after distinct challenges [ thermal cycling (TC) and erosive challenge (EC) ] in regard to its color stability, surface roughness, surface loss and biofilm deposition. Surface roughness and surface loss specimens (n=10) were measured with an optical profilometer and, color stability (n=10) was measured with a spectrophotometer. Biofilm deposition (n=5) was measured after 3 and 24 hours by safranin staining. RESULTS: Two-way ANOVA test was performed to analyze color change, roughness and surface loss. A significant color change was detected for resin-based composites (P< 0.05) and its interaction with tested challenges (P< 0.05). The highest color variation was observed on the giomer after erosive challenge. Surface loss was not different between tested groups (P= 0.708). The roughness was significantly higher in specimens submitted to thermal cycling (P> 0.05). For biofilm quantification, after 3 and 24 hours, ANOVA (3-way) detected significance for the interaction of challenges and resin-based composites (P< 0.05 and P< 0.05, respectively). All resin-based composites presented color changes after challenges; higher roughness was observed after thermal cycling for all resin-based composites tested, without significant surface loss; and higher biofilm deposition was observed on the giomer samples when submitted to erosive challenge after 3 and 24 hours. CLINICAL SIGNIFICANCE: Pink esthetic is as important as dental esthetics and some restorative materials can mimic gingival tissue. However, the tested giomer must be indicated with caution, since it presented significant changes after thermal and acid challenges.

High Power Laser and Photobiomodulation in Oral Surgery: Case Report.

Introduction: The labial frenum is a fold of mucous membrane that attaches the lip and the cheek to the alveolar mucosa, the gingiva, and the underlying periosteum. In some cases, its presence can cause a midline diastema, periodontal diseases related to food impaction, or retention of biofilm, among others. In such cases, lip frenectomy is indicated as treatment, which can be performed with a scalpel (conventional method), an electric scalpel, or a surgical laser. Objective: To show a clinical case performed at Laser Extension Project in Dentistry, Federal University of Maranhão grounded in a literature review. Case Presentation: A laser frenectomy was performed on a female patient, aged 20, who had a diastema between the upper central incisors and an indication for frenum removal. The high-power diode laser is excellent for procedures in soft tissue because its wavelength is well absorbed by hemoglobin and other pigments; its use also allows a reduction in the amount of anesthetic and medicines used. The parameters used were 2 W, in a continuous mode, 808 nm infrared emission; with delivery of the beam through optical fiber 300 µM; energy of 120 J; 20 pps. Conclusion: the high power diode laser allowed a satisfactory result, the procedure was safe, the technique was a simple one and of reduced clinical time, as mentioned in the literature. It is worth noting that the technique is dependent on the skill of the professional performing it.

Relação entre fatores ambientais e qualidade de vida em indivíduos com acidente vascular cerebral usuários da atenção primária do Sistema Único de Saúde / Relationship between environmental factors and quality of life in post stroke users of primary health care of the Unified Health System

O fator ambiental constitui o ambiente físico, social e atitudinal em que indivíduo vive e conduz sua vida, incluindo barreiras e/ou facilitadores. A qualidade de vida é um construto amplo que envolve vários fatores, dentre eles o ambiental. A relação entre qualidade de vida relacionada à saúde (QVRS) após Acidente Vascular Cerebral (AVC) e fatores ambientais ainda é pouco explorada. Conhecer essa relação pode facilitar o processo de avaliação e planejamento de intervenções para melhora da QVRS desses indivíduos. Objetivo: Investigar a associação entre fatores ambientais e QVRS de indivíduos com AVC, na fase crônica, usuários da atenção primária à saúde de Belo Horizonte (BH)/Brasil. Métodos: Fatores ambientais foram avaliados pelo Measure of the Quality of Environment (MQE) e a QVRS pela Escala de Qualidade de Vida Específica para Acidente Vascular Encefálico (EQVE-AVE). Correlação de Spearman foi utilizada para investigar a associação entre fatores ambientais e QVRS (escore total e dos domínios do EQVE-AVE) (α=5%). Resultados: Foram encontradas associações significantes, negativas e de fraca magnitude entre fatores ambientais considerados como obstáculos com o escore total do EQVE-AVE (p =0,001; rho = -0,33) e com os domínios de mobilidade (p =0,01 rho = -0,33) e trabalho/produtividade do EQVE-AVE (p =0,03; rho = -0,28). Conclusão: Fatores ambientais e QVRS possuem associação significante, ainda que seja de fraca magnitude. Portanto, fatores ambientais considerados como obstáculos, devem ser considerados na abordagem da QVRS de indivíduos na fase crônica após AVC, usuários da atenção primária à saúde do Brasil.

Quality of life is a broad and comprehensive construct that involves several factors, including the environmental factor. However, the relationship between health-related quality of life (HRQoL) of individuals after stroke and environmental factors is still poorly understood. Knowing this relationship can facilitate the process of evaluating and planning interventions to improve HRQoL of these individuals. Objective: To investigate the association between environmental factors and HRQoL of individuals after stroke who use the primary health care in Belo Horizonte/Brazil. Methods: Environmental factors were assessed by the Measure of the Quality of Environment (MQE) and the HRQoL by the Stroke Specific Quality of Life Scale (SS-QOL). Spearman's correlation was used to investigate the association between environmental factors and HRQoL (total score and SS-QOL domains) (α = 5%). Results: Significant, negative and low associations were found between environmental factors considered as obstacles with the total SS-QOL score (p = 0.001; rho = -0.33), with the mobility (p = 0.01 rho = -0.33) and work/productivity domains of the HRQoL(p = 0.03; rho = -0.28). Conclusion: Therefore, environmental factors and HRQoL have a significant association, even if it is of low magnitude. Thus, environmental factors considered as obstacles, should be considered, along with other factors related to health and functioning when addressing the HRQoL of individuals in the chronic phase after stroke who use the Brazilian primary health care system.

Mãe de criança com Síndrome de Down e cardiopatia: implicações socioeconômicas familiares - relato de caso / Mother of a child with Down syndrome and heart disease: family socioeconomic implications - case report

INTRODUÇÃO: Uma parcela de crianças que nasce com Síndrome de Down (SD) apresenta malformações no coração, que podem atrapalhar o seu funcionamento, conhecidas como cardiopatias congênitas. O interesse pelo relato de caso surgiu a partir da prática do assistente social, na enfermaria pediátrica. OBJETIVOS: Descrever e analisar as implicações sócio econômico familiares que envolvem a mãe de criança com SD e cardiopatia durante a hospitalização e a atuação do assistente social. METODOLOGIA: Realizado um estudo social por meio de entrevista social e de prosseguimento com a mãe, no mês de abril de 2018. Feito um estudo qualitativo, do tipo relato de caso, uma investigação sobre uma única situação, em que se busca um aprofundamento do problema. RELATO DE CASO: L, 46 anos, sexo feminino, casada, cinco filhos, do interior de São Paulo, residem em casa cedida. Renda familiar mensal de mil e quatrocentos reais. As preocupações da mãe se iniciaram ao saber que a criança nasceria com SD, a revelação do diagnóstico de cardiopatia foi um choque, pois acreditava que o cuidado com sua saúde seria redobrado e isso influenciaria a vida familiar. A assistência e dedicação integral à filha internada; distância do esposo e dos outros filhos, quebra da dinâmica familiar; a convivência diária com outras mães, o contato com diferentes profissionais, a expectativa e preocupação do que acontecerá no futuro, o afastamento constante do lar a fim de levar a criança para controle e tratamento contínuo da cardiopatia após a alta hospitalar. A intervenção do assistente social se constituiu no acolhimento e apoio à mãe com o intuito de amenizar o sofrimento e ansiedade causados pela doença e hospitalização da criança. Esclarecimento e informação sobre direitos sociais explícitos nas Políticas Públicas de inclusão como o Estatuto da Criança e do Adolescente, o Benefício de Prestação Continuada, o Tratamento Fora de Domicilio, o Passe Livre e como recorrer à Rede de Recursos Sócio Assistencial. Atuou como facilitador do suporte familiar e social, mediador de situações familiares e equipe de saúde, visando garantir e acompanhar o tratamento durante a internação até a alta hospitalar. CONCLUSÕES: O Relato de Caso apresentou a realidade socioeconômica familiar de uma mãe de criança com SD e cardiopatia internada, desvendou seu papel como ponto de apoio e equilíbrio, seu modo de lidar com as condições adversas e a maior compreensão de suas necessidades. Deu visibilidade a atuação profissional, no acompanhamento mais próximo à mãe, na escuta e na humanização do atendimento. (AU)

Effects of theobromine addition on chemical and mechanical properties of a conventional glass ionomer cement.

In vitro effect of 1% theobromine addition on the physical and chemical properties of conventional glass ionomer (GIC) cement was investigated. Conventional GIC (GIC-C) and 1% theobromine added to GIC (GIC-THEO) specimens were compared regarding the microhardness (n = 10), sorption (n = 5), solubility (n = 5), color change (n = 10), fluoride release in saliva (n = 10) and the amount of biofilm deposition (n = 20). Compared against conventional GIC, adding 1% theobromine increased microhardness (p < 0.05), while its sorption, solubility, color and fluoride release to saliva (p > 0.05) remained unchanged. On the other hand, Streptococcus mutans biofilm amount deposited on its surface decreased statistically when theobromine was added to GIC (p < 0.05). Based on the results, it could be concluded that 1% theobromine addition to GIC can be a good strategy as it keeps some of its properties and improves microhardness and biofilm deposits strengthening its role in the preventive approach of dentistry.