Dynamic model to predict the association between air quality, COVID-19 cases, and level of lockdown.

Studies have reported significant reductions in air pollutant levels due to the COVID-19 outbreak worldwide global lockdowns. Nevertheless, all of the reports are limited compared to data from the same period over the past few years, providing mainly an overview of past events, with no future predictions. Lockdown level can be directly related to the number of new COVID-19 cases, air pollution, and economic restriction. As lockdown status varies considerably across the globe, there is a window for mega-cities to determine the optimum lockdown flexibility. To that end, firstly, we employed four different Artificial Neural Networks (ANN) to examine the compatibility to the original levels of CO, O3, NO2, NO, PM2.5, and PM10, for São Paulo City, the current Pandemic epicenter in South America. After checking compatibility, we simulated four hypothetical scenarios: 10%, 30%, 70%, and 90% lockdown to predict air pollution levels. To our knowledge, ANN have not been applied to air pollution prediction by lockdown level. Using a limited database, the Multilayer Perceptron neural network has proven to be robust (with Mean Absolute Percentage Error âˆ¼ 30%), with acceptable predictive power to estimate air pollution changes. We illustrate that air pollutant levels can effectively be controlled and predicted when flexible lockdown measures are implemented. The models will be a useful tool for governments to manage the delicate balance among lockdown, number of COVID-19 cases, and air pollution.

Self-mutilation of tongue and lip in a patient with simple schizophrenia.

Self-inflicted lesions that cause mutilation are observed in schizophrenic patients. This case report describes the diagnosis and treatment of simple schizophrenia in a 31-year-old male patient who bit his own tongue and lower lip. The dental treatment proposed included the construction of a splint to prevent new lesions and to allow healing of existing ones. The treatment afforded to avoid tooth extraction before the patient responded to psychiatric drug treatment. The importance of a transdisciplinary approach to self-mutilation due to psychiatric disorders is stressed. The interaction between the two teams, stomatology and psychiatry, was crucial for the improvement of the patient's condition.

Reabsorção óssea peri-implantar: comparação radiográfica sobre a influência de diferentes tipos de antagonistas / Peri-implant bone resorption: comparative radiographic study on the influence different arch antagonists - a pilot study

O objetivo deste trabalho foi comparar o nível de reabsorção óssea peri-implantar, em função dos três diferentes tipos de antagonistas oclusais em pacientes portadores de próteses implantossuportadas. Partindo-se uma amostra de 52 arquivos, foram selecionados nove pacientes, que apresentavam um total de 29 implantes na região posterior da mandíbula, reabilitados com coroas de porcelana sobreimplante, que tinham como antagonistas dentes naturais (G1), próteses totais (G2), ou próteses implantossuportadas (G3). Não foi objeto deste estudo uma comparação entre implantes com hexágono interno e externo. Todos os implantes, incluídos nesse estudo, foram moldados 30 dias após a instalação dos abutments de cicatrização. Foram construídos 59 elementos, sendo que 89% receberam próteses parafusadas elaboradas a partir de Uclas totalmente plásticas e 11% foram próteses cimentadas confeccionadas sobre um munhão de titânio. As perdas ósseas ocorridas após a reabilitação protética foram medidas e comparadas através da digitalização das radiografias realizadas na reabertura, antes do carregamento protético e após dois anos em função. Os dados obtidos foram analisados pela análise de variância (Anova) e todos os implantes apresentaram perda óssea, independente do tipo do antagonista; como o valor de p encontrado foi maior do que 0,05, os grupos foram considerados semelhantes, não havendo diferença estatisticamente significativa entre eles, ao nível de significância de 5%.

The aim of this study was to compare the level of peri-implant bone resorption, according to the three different types of arch antagonists in patients with implant-supported prostheses. From 52 file recordings, nine patients with a total of 29 implant-supported porcelain crowns in the posterior mandible were selected, having natural teeth (G1), dentures (G2), or implant-supported prostheses (G3) as antagonists. Different implant connection types were not compared. All impressions procedures were made 30 days after implant and healing abutment installation. Fifty-nine elements were constructed, of which 89% were screwed prosthesis from plastic, burnout Ucla abutments and 11% were cemented prosthesis over titanium abutments. Bone loss after prosthetic rehabilitation was measured and compared by scanning the radiographs taken during reopening before prosthetic loading and after two years in function. The data were analyzed by analysis of variance (Anova), and all implants showed bone loss, regardless of antagonist type (p > .05).

Accuracy of clinical examination findings in the diagnosis of COPD.

OBJECTIVE: Simple diagnostic methods can facilitate the diagnosis of COPD, which is a major public health problem. The objective of this study was to investigate the accuracy of clinical variables in the diagnosis of COPD. METHODS: Patients with COPD and control subjects were prospectively evaluated by two investigators regarding nine clinical variables. The likelihood ratio for the diagnosis of COPD was determined using a logistic regression model. RESULTS: The study comprised 98 patients with COPD (mean age, 62.3+/- 12.3 years; mean FEV1, 48.3 +/- 21.6%) and 102 controls. The likelihood ratios (95% CIs) for the diagnosis of COPD were as follows: 4.75 (2.29-9.82; p < 0.0001) for accessory muscle recruitment; 5.05 (2.72-9.39; p < 0.0001) for pursed-lip breathing; 2.58 (1.45-4.57; p < 0.001) for barrel chest; 3.65 (2.01-6.62; p < 0.0001) for decreased chest expansion; 7.17 (3.75-13.73; p < 0.0001) for reduced breath sounds; 2.17 (1.01-4.67; p < 0.05) for a thoracic index > or = 0.9; 2.36 (1.22-4.58; p < 0.05) for laryngeal height < or = 5.5 cm; 3.44 (1.92-6.16; p < 0.0001) for forced expiratory time > or = 4 s; and 4.78 (2.13-10.70; p < 0.0001) for lower liver edge > or = 4 cm from lower costal edge. Inter-rater reliability for those same variables was, respectively, 0.57, 0.45, 0.62, 0.32, 0.53, 0.32, 0.59, 0.52 and 0.44 (p < 0.0001 for all). CONCLUSIONS: Various clinical examination findings could be used as diagnostic tests for COPD.

Acurácia do exame clínico no diagnóstico da DPOC / Accuracy of clinical examination findings in the diagnosis of COPD

Objetivo: A DPOC é um problema de saúde pública, e métodos diagnósticos simples podem ser úteis para facilitar o diagnóstico desta doença. O objetivo deste estudo foi avaliar a acurácia de variáveis clínicas para o diagnóstico de DPOC. Métodos: Pacientes com DPOC e controles foram prospectivamente avaliados por dois examinadores quanto a nove variáveis clínicas. A razão de verossimilhança para o diagnóstico de DPOC foi determinada utilizando-se o modelo de regressão logística. Resultados: Foram incluídos 98 pacientes com DPOC (idade média, 62,3 ± 12,3 anos; VEF1 médio, 48,3 ± 21,6%) e 102 controles. A razão de verossimilhança e IC95% para o diagnóstico de DPOC foram: 4,75 (2,29-9,82; p < 0,0001) para uso da musculatura acessória; 5,05 (2,72-9,39; p < 0,0001) para respiração com os lábios semicerrados; 2,58 (1,45-4,57; p < 0,001) para tórax em barril; 3,65 (2,01-6,62; p < 0,0001) para redução da expansibilidade torácica; 7,17 (3,75-13,73; p < 0,0001) para redução do murmúrio vesicular; 2,17 (1,01‑4,67; p < 0,05) para índice torácico ≥ 0,9; 2,36 (1,22-4,58; p < 0,05) para comprimento laríngeo ≤ 5,5 cm; 3,44 (1,92‑6,16; p < 0,0001) para tempo expiratório forçado ≥ 4 s; e 4,78 (2,13-10,70; p < 0.0001) para limite inferior do fígado ≥ 4 cm abaixo do rebordo costal. A concordância entre observadores para as mesmas variáveis foi, respectivamente, 0,57, 0,45, 0,62, 0,32, 0,53, 0,32, 0,59, 0,52 e 0,44 (p < 0,0001 para todas). Conclusões: Vários achados do exame clínico podem ser utilizados como testes diagnósticos para DPOC.

Objective: Simple diagnostic methods can facilitate the diagnosis of COPD, which is a major public health problem. The objective of this study was to investigate the accuracy of clinical variables in the diagnosis of COPD. Methods: Patients with COPD and control subjects were prospectively evaluated by two investigators regarding nine clinical variables. The likelihood ratio for the diagnosis of COPD was determined using a logisticregression model. Results: The study comprised 98 patients with COPD (mean age, 62.3± 12.3 years; mean FEV1, 48.3 ± 21.6%) and 102 controls. The likelihood ratios (95% CIs) for the diagnosis of COPD were as follows: 4.75 (2.29-9.82; p < 0.0001) for accessory muscle recruitment; 5.05 (2.72-9.39; p < 0.0001) for pursed-lipbreathing; 2.58 (1.45‑4.57; p < 0.001) for barrel chest; 3.65 (2.01-6.62; p < 0.0001) for decreased chest expansion;7.17 (3.75-13.73; p < 0.0001) for reduced breath sounds; 2.17 (1.01- .67; p < 0.05) for a thoracic index ≥ 0.9; 2.36 (1.22-4.58; p < 0.05) for laryngeal height ≤ 5.5 cm; 3.44 (1.92-6.16; p < 0.0001) for forced expiratory time ≥ 4 s; and 4.78 (2.13-10.70; p < 0.0001) for lower liver edge ≥ 4 cm from lower costal edge. Inter-rater reliability for those same variables was, respectively, 0.57, 0.45, 0.62, 0.32, 0.53, 0.32, 0.59, 0.52 and 0.44 (p < 0.0001 for all). Conclusions: Various clinical examination findings could be used as diagnostic tests for COPD.

[Antimicrobial resistance of uropathogens among outpatients, 2000-2004]. / Resistência antimicrobiana dos uropatógenos em pacientes ambulatoriais, 2000-2004.

A retrospective study based on the electronic database of a university hospital was carried out to investigate the prevalence of etiological agents and their susceptibilities to antibiotics, among adult outpatients (> 18 years old) with urinary tract infections. Nine hundred and fifty-seven positive urine cultures were identified between January 2000 and December 2004. Escherichia coli, Proteus mirabilis and Klebsiella sp were the three principal bacterial etiological agents. Trimethoprim-sulfamethoxazole presented the highest prevalence of bacterial resistance (46.9%), followed by cefalotin (46.7%), nalidixic acid (27.6%) and nitrofurantoin (22.3%). Over the study period, nalidixic acid presented annual increases of 5.9% in the rate of bacterial resistance (p = 0.02). Ciprofloxacin also showed an increasing trend, of 3.3% per year (p = 0.07). This study demonstrated that the antibiotics that are widely recommended for empirical treatment of urinary tract infection in adults presented high rates of bacterial resistance among the population studied.

Resistência antimicrobiana dos uropatógenos em pacientes ambulatoriais, 2000-2004 / Antimicrobial resistance of uropathogens among outpatients, 2000-2004

Foi realizado um estudo retrospectivo, baseado no banco de dados eletrônico de um hospital universitário, com objetivo de investigar a prevalência dos germes causadores e suas suscetibilidades aos antibióticos em adultos (idade >18 anos), com infecção do trato urinário atendidos ambulatorialmente. Foram identificados 957 exames de urocultura positiva no período entre janeiro de 2000 e dezembro de 2004. Escherichia coli, Proteus mirabillis e Klebsiella sp foram três principais bactérias causadoras. Sulfametoxazol-trimetropim apresentou a maior (46,9 por cento) prevalência de resistência bacteriana seguida por cefalotina (46,7 por cento), ácido nalidíxico (27,6 por cento) e nitrofurantoína (22,3 por cento). Durante o período estudado, o ácido nalidíxico apresentou um aumento anual de 5,9 por cento na taxa de resistência bacteriana (p= 0,02). Ciprofloxacina mostrou também a tendência de aumento, com um crescimento anual de 3,3 por cento (p= 0,07). Este estudo demonstrou que os antibióticos amplamente recomendados no tratamento empírico da infecção do trato urinário em adultos apresentaram altas taxas de resistência bacteriana na população estudada.

A retrospective study based on the electronic database of a university hospital was carried out to investigate the prevalence of etiological agents and their susceptibilities to antibiotics, among adult outpatients (> 18 years old) with urinary tract infections. Nine hundred and fifty-seven positive urine cultures were identified between January 2000 and December 2004. Escherichia coli, Proteus mirabilis and Klebsiella sp were the three principal bacterial etiological agents. Trimethoprim-sulfamethoxazole presented the highest prevalence of bacterial resistance (46.9 percent), followed by cefalotin (46.7 percent), nalidixic acid (27.6 percent) and nitrofurantoin (22.3 percent). Over the study period, nalidixic acid presented annual increases of 5.9 percent in the rate of bacterial resistance (p = 0.02). Ciprofloxacin also showed an increasing trend, of 3.3 percent per year (p = 0.07). This study demonstrated that the antibiotics that are widely recommended for empirical treatment of urinary tract infection in adults presented high rates of bacterial resistance among the population studied.