Antimicrobial action, cytotoxicity and erosive potential of hypochlorous acid obtained from an electrolytic device compared with sodium hypochlorite.

OBJECTIVES: This study aimed to compare the antimicrobial action, cytotoxicity, cleaning ability, and erosion of dentine of hypochlorous acid (HClO) obtained from an electrolytic device at two different concentrations (Dentaqua) and three concentrations of sodium hypochlorite (NaOCl). METHODS: Microbiological test-The root canals of sixty single-rooted extracted human teeth were inoculated with Enterococcus faecalis and divided into 6 groups (n = 10), according to decontamination protocol: DW (control); 1% NaOCl; 2.5% NaOCl; 5.25% NaOCl; 250 ppm HClO and 500 ppm HClO. The colony-forming units were counted to evaluate the decontamination potential of each group, calculating the reduction in bacterial percentage. Cytotoxicity test-Cytotoxicity was evaluated after inoculation of the same tested protocols in fibroblastic cells for 3 min, calculating the cell viability percentages. Specifical statistical analysis was performed (α = 5%). Cleaning ability and erosion-Fifty-six single-rooted bovine lower incisors were divided into seven groups of 8 roots each, being the test groups 1% NaOCl; 2.5% NaOCl; 5,25% NaOCl; 250 ppm HClO and 500 ppm HClO, and a negative and positive control. Negative control was not contaminated, and the other groups were inoculated with Enterococcus faecalis. SEM images were ranked as from the cleanest to the least clean. Erosion was also assessed, being ranked from the least to the most eroded dentine. RESULTS: The highest bacterial reduction was observed in experimental groups, with no statistical differences between them (p > 0.05). The highest number of viable cells was observed in control group, followed by 250 ppm HClO and 500 ppm HClO groups, with statistical differences between them (p < 0.05). 1% NaOCl; 2.5% NaOCl; 5.25% NaOCl and 500 ppm HClO displayed the cleanest areas. All sodium hypochlorite groups displayed erosion with higher ranks with greater concentration, while hypochlorous acid did not display any erosion regardless the concentration. CONCLUSIONS: It is possible to conclude that HClO obtained from an electrolytic device presented high antimicrobial activity and low cytotoxicity in both tested concentrations. 500 ppm HClO did not display erosion and showed great cleaning ability. CLINICAL RELEVANCE: The use of 500 ppm hypochlorous acid may reduce unfavorable behavior of sodium hypochlorite whilst maintaining its antimicrobial action.

Antimicrobial action and cytotoxicity of hypochlorous acid obtained from an innovative electrolytic device - An in vitro study.

OBJECTIVE: This study evaluated the antimicrobial effect and cytotoxicity of hypochlorous acid(HClO) obtained from an innovative electrolytic device. DESIGN: The root canals of fifty extracted human teeth were inoculated with Enterococcus faecalis and divided into 5 groups (n = 10): DW (control); 2% chlorhexidine gel(CHX); 2.5% sodium hypochlorite(NaOCl); 250 ppm HClO and 500 ppm HClO. The counting of colony forming units evaluated the decontamination potential of each group. Cytotoxicity was evaluated after inoculation of tested protocols in fibroblastic cells for 3 min, calculating the cell viability. Specific statistical analysis was performed (α = 5%). RESULTS: The highest bacterial reduction was observed in experimental groups, with no statistical differences from each other (p > 0.05). The highest number of viable cells was observed in control group, followed by 250 ppm HClO and 500 ppm HClO groups, with statistical differences from each other (p < 0.05). CONCLUSIONS: It could be concluded that HClO presented high antimicrobial activity and low cytotoxicity at both tested concentrations.

The Chemical Variability, Nutraceutical Value, and Food-Industry and Cosmetic Applications of Citrus Plants: A Critical Review.

Citrus fruits occupy an important position in the context of the fruit trade, considering that both fresh fruits and processed products are produced on a large scale. Citrus fruits are recognized as an essential component of the human diet, thanks to their high content of beneficial nutrients such as vitamins, minerals, terpenes, flavonoids, coumarins and dietary fibers. Among these, a wide range of positive biological activities are attributed to terpenes and flavonoids derivatives. In this review, a list of bibliographic reports (from 2015 onwards) on the phytochemical composition, beneficial effects and potential applications of citrus fruits and their by-products is systematically summarized. In detail, information regarding the nutraceutical and medicinal value closely linked to the presence of numerous bioactive metabolites and their growing use in the food industry and food packaging, also considering any technological strategies such as encapsulation to guarantee their stability over time, were evaluated. In addition, since citrus fruit, as well as its by-products, are interesting alternatives for the reformulation of natural cosmetic products, the sector of the cosmetic industry is also explored. More in-depth knowledge of the latest information in this field will contribute to future conscious use of citrus fruits.

Effectiveness of ultrasonic activation over glycolic acid on microhardness, cohesive strength, flexural strength, and fracture resistance of the root dentin.

OBJECTIVES: The aim of this study was to evaluate the effectiveness of ultrasonic activation (US) over glycolic acid on microhardness, cohesive strength, flexural strength, and fracture resistance of root dentin, comparing with conventional final irrigation protocols. METHODS: Samples were obtained from 140 extracted bovine teeth and distributed into four test groups: microhardness (50 teeth), cohesive strength (15 teeth), flexural strength (15 teeth), and fracture resistance (60 teeth). In all four tests, specimens were subdivided into five groups, according to final irrigation protocols: G1: distilled water (DW); G2: 17% ethylenediaminetetraacetic acid (EDTA); G3: 17% glycolic acid (GA); G4: 17% EDTA + US; and G5: 17% GA + US. The duration time of each protocol was set in 1 min. After irrigation protocols, the Vickers tester was used to evaluate microhardness and the universal testing machine was used to evaluate the cohesive strength, flexural strength, and fracture resistance of the root dentin. One-way ANOVA test and the Tukey HSD were used for multiple comparison tests in all evaluations (α = 5%). RESULTS: In general, groups 2 (EDTA), 4 (EDTA + US), and 5 (GA + US) promoted the highest reduction of microhardness, being statistically different from other groups (p < 0.05). Cohesive strength, flexural strength, and fracture resistance data revealed that no differences between groups were observed (p > 0.05). CONCLUSIONS: The association of GA and US results in microhardness reduction, with no influence on cohesive strength, flexural strength, and fracture resistance of the root dentin. CLINICAL RELEVANCE: The use of US over GA has no influence on some mechanical properties of root dentin.

Giant benign lymphangioendothelioma with positive expression of Wilms tumor 1: A case report.

Benign lymphangioendothelioma (BL, acquired progressive lymphangioma) is a rare, slow-growing lymphatic tumor, first described 40 years ago, with fewer than 50 published cases. Clinically, it presents as a skin-colored or erythematous patch. Definitive diagnosis requires histopathological examination. The immunohistochemical staining profile is still controversial regarding Wilms tumor 1 (WT1) expression, a marker of proliferative and neoplastic, rather than malformative nature. Here, we report a case of a 60-cm-long BL on the breast of an adult female. Biopsy revealed irregular vascular spaces dissecting the collagen bundles lined by swollen endothelial cells but without cellular atypia. Positivity for podoplanin (D2-40), CD31, and WT1 was observed, supporting the neoplastic nature of this lesion. Dermatologists and pathologists must be aware of this entity for early diagnosis and treatment.

NF1 microdeletion syndrome: a phenotypical characterization of a rare case of neurofibromatosis type 1.

Neurofibromatosis type 1 (NF1) is one of the most common neurocutaneous disorders, resulting from a wide spectrum of mutations in the NF1 gene. The NF1 microdeletion syndrome is characterized by a more severe clinical presentation than the majority of NF1 patients, with facial dysmorphic features, cognitive impairment, developmental delay, early-onset neurofibromas, and an increased risk of malignant tumors. This report provides the phenotypical characterization of a young boy diagnosed with this syndrome.

Organizing Pneumonia Induced by Tocilizumab in a Patient with Rheumatoid Arthritis.

Interstitial lung disease is a significant extra-articular manifestation of rheumatoid arthritis, due to its prevalence, morbidity and mortality. Biological therapies are widely used for rheumatoid arthritis treatment. However, some biological agents have been related to the induction or exacerbation of interstitial lung disease. We report a 51-year-old woman with knee arthralgia, hand and foot joint deformities. Although there were no respiratory symptoms, rheumatoid arthritis and interstitial lung disease were diagnosed. High-resolution computed tomography (HRCT) detected a radiological pattern of nonspecific interstitial pneumonia. After tocilizumab therapy for nine months, a second HRCT detected a worsening of interstitial lung disease, presenting a pattern of organizing pneumonia. Tocilizumab was discontinued and prednisone (1 mg/kg/day) was introduced. After two months, a further HRCT detected a significant improvement in organizing pneumonia. There are few similar cases in the literature of tocilizumab-induced organizing pneumonia in patients with rheumatoid arthritis. Despite being a rare adverse effect, knowledge of this association is important for monitoring the use of tocilizumab.

Literacia em saúde e adesão terapêutica em doentes renais crónicos em programa regular de hemodiálise / Health literacy and therapeutic adhesion in chronic kidney patients on a regular hemodialysis program

Health literacy can be understood as the set of cognitive and social skills that determine individuals' motivation and ability to make judgments and make decisions about health care, disease prevention, and health promotion. Therapeutic adherence may be related to a set of behaviors that coincide with the prescribed therapeutic regimen. The different capabilities of individuals to use and process health information, as well as to adhere to the proposed therapy, are of special importance in relation to chronic diseases, such as chronic kidney disease. Taking into account the relationship of this triad of concepts, it was important to know the level of literacy and therapeutic adherence in chronic kidney patients in a regular hemodialysis program. The methodology used followed a quantitative paradigm, in a cross-sectional descriptive correlational study. The sample consisted of 100 chronic kidney patients in a regular hemodialysis program at a clinic in the northern region of Portugal. The interview was used to gather information. The results obtained evidenced the existence of low levels of health literacy in 69% of the individuals that correlated with age and level of schooling. Regarding therapeutic adherence, the majority of the sample adhered to the therapy (78%), showing no relation between this and health literacy. As this is a national problem and leads to a deficiency in the sustainability of the health economy and the quality of life of our population, it is considered fundamental to provide the patient with the skills to deal with their health-disease process

No disponible

Women working in animal husbandry: a study in the agroecological transition context / Mulheres e trabalho na criação animal em contexto de transição agroecológica

ABSTRACT: This study investigated the engagement of women in animal husbandry in agroecological transitions scenarios and reflects on the advancements and challenges encountered in overcoming gender inequalities in rural areas. Semi-structured interviews and participant observation were conducted in nine properties in three municipalities in the region of Zona da Mata of Minas Gerais State. Women are involved in husbandry of different animal species, and participate in the management, processing, and marketing of products, contributing to food diversification, self-consumption, and income generation. Overcoming gender inequality in an agroecological scenario requires making the work and knowledge of women farmers visible and increasing their prominence, while ensuring economic valuation of their work and access to the market through public policies aligned with the reality of animal production in agroecological family agriculture contexts.

RESUMO: Investigou-se a participação das mulheres nas práticas de criação animal em contextos de transição agroecológica, refletindo sobre os avanços e desafios na superação das desigualdades de gênero no meio rural. Realizaram-se entrevistas semiestruturadas e observação participante em nove propriedades de três municípios da Zona da Mata Mineira. As mulheres atuam na criação de diferentes espécies animais, participando do manejo, processamento e comercialização de produtos, contribuindo para diversificação dos alimentos, autoconsumo e geração de renda. A superação das desigualdades de gênero no contexto da agroecologia implica na visibilização do trabalho, conhecimento e protagonismo da agricultora, com a valorização econômica e acesso ao mercado através de políticas públicas coerentes com a realidade da produção animal na agricultura familiar agroecológica.

Update on Atopic Dermatitis.

With an increasing prevalence during the past decades, atopic dermatitis has become a global health issue. A literature search following a targeted approach was undertaken to perform this non-systematic review, which intends to provide an overview of the epidemiology, pathophysiology, clinical features, comorbidities, and current therapies for the treatment of atopic dermatitis. In sum, this is a heterogeneous skin disorder associated with variable morphology, distribution, and disease course. Although not completely understood, its pathogenesis is complex and seems to result from a combination of genetic and environmental factors that induce skin barrier dysfunction, cutaneous and systemic immune dysregulation, skin microbiota dysbiosis, and a strong genetic influence. Diagnosis is based on specific criteria that consider patient and family history and clinical manifestations. Overall disease severity must be determined by evaluating both objective signs and subjective symptoms. Therapeutic goals require a multistep approach, focusing on reducing pruritus and establishing disease control. Patients should be advised on basic skin care and avoidance of triggers. Topical anti-inflammatory agents should be considered in disease flares or chronic/recurrent lesions. In case of inadequate response, phototherapy, systemic immunosuppressants and, more recently, dupilumab, should be added. Nevertheless, the treatment of moderate-to-severe atopic dermatitis remains challenging and novel, efficacious, safe and targeted treatments are urgently needed. In conclusion, although the last few years have seen important improvement in the understanding of the disease, future research in atopic dermatitis will continue exploring gene-environment interactions and how it affects pathophysiology, disease severity, and treatment outcomes.

Com uma prevalência crescente nas últimas décadas, a dermatite atópica tornou-se um problema de saúde global. Foi realizada uma revisão não sistemática com base numa pesquisa bibliográfica direcionada à epidemiologia, fisiopatologia, características clínicas, comorbilidades e tratamento da dermatite atópica. Em resumo, a dermatite atópica é uma patologia cutânea heterogénea associada a morfologia, distribuição e curso da doença variáveis. A sua patogénese é complexa, combinando fatores genéticos e ambientais que condicionam a disfunção da barreira epidérmica, a desregulação imune cutânea e sistémica e a disbiose do microbioma da pele. O diagnóstico baseia-se em critérios clínicos específicos, incluindo história pessoal e familiar de atopia, evolução da doença e manifestações clínicas. A gravidade da doença é determinada através da avaliação dos sinais objetivos e dos sintomas subjetivos. A sua abordagem deve ser progressiva, focada na redução do prurido e no controlo da doença. Os doentes devem ser aconselhados sobre os cuidados básicos a ter e evicção de agressores externos. Em situações de agudização ou lesões crónico-recidivantes, devem ser aplicados anti-inflamatórios tópicos. Na ausência de resposta ou controlo adequado no médio prazo, deve ponderar-se fototerapia, imunossupressores sistémicos ou, mais recentemente, dupilumab. Contudo, o tratamento da dermatite atópica moderada a grave permanece desafiador, sendo urgente o desenvolvimento de novas terapêuticas, eficazes, seguras e direcionadas. Concluindo, apesar de atualmente haver uma melhor compreensão e um maior conhecimento da doença, as investigações futuras deverão continuar a explorar a interação entre fatores genéticos e ambientais e seus efeitos na fisiopatologia e gravidade da doença, bem como nos resultados do tratamento.

Autosomal recessive hyper-IgE syndrome successfully treated with hematopoietic stem cell transplantation.

Autosomal recessive hyper-IgE syndrome is a primary immunodeficiency that results from a mutation in the DOCK8 gene. We report a case of a patient presenting with severe eczema, atopy, and recurrent skin infections since the first months of life. The diagnosis of autosomal recessive hyper-IgE syndrome was made at the age of 7 by a positive DOCK8 genetic test. The patient underwent hematopoietic stem cell transplantation, with complete remission of the various manifestations.

Green Juice in Human Metabolism: A Randomized Trial.

OBJECTIVE: Fruits and vegetables contain many compounds presenting potential antioxidant activity. The objective of this study was to evaluate the effect of a green juice recipe in adult metabolism in order to identify new preventive dietary sources. METHOD: This was a single-blind randomized controlled clinical trial. Recruitment and data were, respectively, made and collected at the Universidade Federal de Ciências da Saúde de Porto Alegre. Individuals who met all the inclusion criteria during the period of recruitment were included. Green juice (experimental group) or placebo (control group) were consumed from Monday to Friday between 8 and 9 am, in the amount of 300 mL for 60 days (except Saturdays and Sundays). To verify the effect of green juice on metabolism, the following were evaluated: (a) glycemia, plasma lipid profile, renal and liver functions, redox profile, and antioxidant enzymes; (b) anthropometry; and (c) well-being and anxiety. RESULTS: This study included 14 participants in the test group (juice group) and 13 controls (placebo group), with mean ages of 31.07 and 30.15 years, respectively. We did not observe a significant difference between the treatments. Dietary properties of vegetable and fruit juices are an area of significant interest. CONCLUSIONS: Together with an analysis of previous works, we suggest that green juice did not cause an improvement in metabolic function and there is a need for further research on this issue, mainly through different interventions and other samples.

Prevalence and reliability of treatment-based classification for subgrouping patients with low back pain.

OBJECTIVES: To observe the distribution of patients who presented with low back pain (LBP) and to determine the between therapists' interrater reliability of assessments in a private outpatient setting using treatment-based classification (TBC) subgroups. METHODS: An observational and methodological study was conducted. Four hundred and twenty-nine patients (231 male; 198 female) presenting LBP symptoms and referred to conservative treatment were assessed by 13 physical therapists who conducted a 60-min examination process utilizing TBC subgroups. Interrater reliability analyses from six raters were assessed using Fleiss' kappa and previously recorded data (n = 30). RESULTS: In this study, 65.74% of patients were classified in only one subgroup, the most prevalent being stabilization (21.91%), followed by extension (15.38%), traction (11.89%), flexion (10.96%), manipulation (5.13%), and lateral shift (0.47%). Approximately 20.98% of patients were classified in two subgroups, where the most frequent overlaps were flexion + stabilization (7.46%), extension + stabilization (6.06%), flexion + traction (4.20%), extension + manipulation (1.86%), and 13.29% of patients were not classified in any TBC subgroup. Analysis of interrater reliability showed a kappa value of 0.62 and an overall agreement of 66% between raters. DISCUSSION: LBP is a heterogeneous clinical condition and several classification methods are proposed in the attempt to observe better outcomes for patients. Eighty-five percent of patients assessed were able to be classified when using the TBC assessment and reliability analysis showed a substantial agreement between raters. LEVEL OF EVIDENCE: 2c.

A complex scenario of tuberculosis transmission is revealed through genetic and epidemiological surveys in Porto.

BACKGROUND: Tuberculosis (TB) incidence is decreasing worldwide and eradication is becoming plausible. In low-incidence countries, intervention on migrant populations is considered one of the most important strategies for elimination. However, such measures are inappropriate in European areas where TB is largely endemic, such as Porto in Portugal. We aim to understand transmission chains in Porto through a genetic characterization of Mycobacterium tuberculosis strains and through a detailed epidemiological evaluation of cases. METHODS: We genotyped the M. tuberculosis strains using the MIRU-VNTR system. We performed an evolutionary reconstruction of the genotypes with median networks, used in this context for the first time. TB cases from a period of two years were evaluated combining genetic, epidemiological and georeferencing information. RESULTS: The data reveal a unique complex scenario in Porto where the autochthonous population acts as a genetic reservoir of M. tuberculosis diversity with discreet episodes of transmission, mostly undetected using classical epidemiology alone. CONCLUSIONS: Although control policies have been successful in decreasing incidence in Porto, the discerned complexity suggests that, for elimination to be a realistic goal, strategies need to be adjusted and coupled with a continuous genetic characterization of strains and detailed epidemiological evaluation, in order to successfully identify and interrupt transmission chains.

Cutaneous Lymphangioma circumscriptum - dermoscopic features.

Lymphangiomas are congenital lymphatic malformations and cutaneous lymphangioma circumscriptum is the most common type. It is clinically characterized by clusters of translucent vesicles and the presence of dermoscopically yellow lacunae surrounded by pale septa, as well as reddish to bluish lacunae. In our case, the recently described hypopyon-like feature manifested, aiding in the sometimes difficult differential diagnosis of cutaneous lymphangioma circumscriptum with vascular lesions, further highlighting the importance of dermoscopy in what can be a diagnostic challenge.

Cutaneous Lymphangioma circumscriptum - dermoscopic features*

Lymphangiomas are congenital lymphatic malformations and cutaneous lymphangioma circumscriptum is the most common type. It is clinically characterized by clusters of translucent vesicles and the presence of dermoscopically yellow lacunae surrounded by pale septa, as well as reddish to bluish lacunae. In our case, the recently described hypopyon-like feature manifested, aiding in the sometimes difficult differential diagnosis of cutaneous lymphangioma circumscriptum with vascular lesions, further highlighting the importance of dermoscopy in what can be a diagnostic challenge.

Circumscribed morphea and breast asymmetry in an adolescent.

Morphea is a rare fibrosing disorder of the skin and underlying tissues. Circumscribed morphea presents with less than three discrete indurated plaques and breasts are commonly affected in women. We report the case of a 12-year-old female with a right infra-areolar, nontender, brownish patch and asymmetry of the right breast with 2 years of evolution. Skin biopsy showing thickening of the dermal collagen bundles confirmed the clinical diagnosis of morphea. After a 3-year follow-up period without progression of disease, reconstructive surgery is scheduled. Plaque morphea can involve all layers of the skin but associated breast deformity is rare. It can mimic benign and malignant breast disorders justifying the benefit for early tissue biopsy. Breast morphea generally has a good prognosis but hyperpigmentation and breast deformity in young girls have been rarely described. An early diagnosis can possibly lead to a therapeutic intervention with a different outcome, as it can be the source of severe psychological and social issues in a delicate period of development such as adolescence.