Prevalence of hyposalivation in older people: A systematic review and meta-analysis.

BACKGROUND: The proportion of elders is increasing worldwide, and hyposalivation has been associated with the ageing process. Therefore, there has been growing interest in the frequency of hyposalivation in older people since it can cause transient or permanent problems that could affect oral health. OBJECTIVE: To determine the prevalence of hyposalivation in older people (aged ≥ 60 years). METHODS: The review was registered at Prospero - International Prospective Register of Systematic Reviews under number CRD42018106322. The search was performed in six electronic databases (Embase, LILACS, Medline, PubMed, Web of Science and Abstracts in Social Gerodontology) and grey literature (Google Scholar) for articles published up to February 2019. The methodology of selected studies was evaluated using the Meta-Analysis of Statistics Assessment and Review (MAStARI) risk of bias checklist. Meta-analyses were performed using Medcalc and Stata 15. RESULTS: Thirteen studies totalising 3,885 individuals (≥60 years) were included in this systematic review. The meta-analysis showed an overall hyposalivation prevalence of 33.37% (95% confidence interval [CI] 23.90 - 43.57, P < .0001, n = 3,447). The prevalence of hyposalivation for unstimulated and stimulated methods was 33.39% (95% CI 21.08 - 46.96, P < .0001, n = 2,425 individuals) and 30.47% (95% CI 22.53-39.04, P < .0001, n = 1,495 individuals), respectively. Most of the studies were evaluated as low risk of bias. Some study limitations were related to the observational studies potential risk of bias, and different criteria to measure saliva flow rate. CONCLUSION: This study suggests that the overall prevalence of hyposalivation in older people is 33.37%. When considering stimulated methods, the prevalence of hyposalivation was slightly lower (30.47%).

Cutaneous Nodular Amyloidosis: A Disfiguring Aspect of the Face.

Primary localized cutaneous nodular amyloidosis is a rare plasma cell dyscrasia in which an amorphous material consisting of light chain amyloid is produced and deposited in the dermis, with varied clinical presentation. We describe the case with unusual and tumor lush clinical presentation in the face with no progression to systemic disease and no evidence of extracutaneous commitment.

Use of neural networks to estimate the sorption and desorption coefficients of herbicides: A case study of diuron, hexazinone, and sulfometuron-methyl in Brazil.

The use of herbicides in Brazil has been carried out based on the manufacturer's recommendation, often disregarding the high variability of soil attributes. The use of statistical methods to predict the herbicide retention processes in the soil can contribute to the improvement of weed control efficiency associated with the lower risk of environmental contamination. This research evaluated the use of Artificial Neural Networks (ANNs) to predict soil sorption and desorption, as well as the environmental contamination potential of diuron, hexazinone and sulfometuron-methyl herbicides in Brazilian soils. The sorption and desorption coefficients of the three herbicides were determined in laboratory tests for 15 soils from different Brazilian states. To predict the sorption and desorption of diuron, hexazinone and sulfometuron-methyl were used a multilayer perceptron ANNs (MLP). The inputs were the characteristics of the herbicides and the physical and chemical attributes of the soils, and the outputs of were the sorption and desorption coefficients (Kfs and Kfd). The risk of leaching of diuron, hexazinone, and sulfometuron-methyl herbicides were evaluated considering the sorption values observed and those estimated by the models. The Artificial Neural Network (ANN) models were efficient for the prediction of sorption and desorption of diuron, hexazinone, and sulfometuron-methyl herbicides. The physicochemical properties of the herbicides were more important for the modeling of multilayer perceptron ANNs than the soil attributes. The herbicides diuron, hexazinone, and sulfometuron-methyl have a high potential risk for contamination of groundwater in different Brazilian states.

Impact of Paracoccidioides brasiliensis Coinfection on the Evolution of Schistosoma mansoni-Induced Granulomatous Liver Injury in Mice.

The pathogens Schistosoma mansoni and Paracoccidioides brasiliensis share common geographic areas, determining infectious diseases with high mortality rates worldwide. Histopathological and immunological changes induced by each pathogen are well understood; however, the host responses to S. mansoni and P. brasiliensis coinfection are still unknown. Thus, we investigated liver damage and cytokines production in a murine model acutely and chronically coinfected with these pathogens. Fourty male Swiss mice were infected with S. mansoni and P. brasiliensis alone or coinfected. The animals were euthanized with 50 (acute infection) and 120 (chronic infection) days of infection. All infected animals exhibited liver inflammation. Intense granulomatous inflammation was detected in animals infected with S. mansoni alone and those coinfected. Productive and involutive granulomas were clearly observed in acute and chronic infections, respectively. Granuloma size was reduced in the acute phase and increased in the chronic phase of S. mansoni and P. brasiliensis coinfection, compared with animals infected only with S. mansoni. In the chronic phase of infection, the granulomatous inflammation in coinfected animals was characterized by intense neutrophils accumulation and reduced eosinophils number. IFN-γ, IL-2, IL-4, and IL-5 circulating levels were increased in all infected groups. Coinfected animals presented attenuated IFN-γ and IL-4 production in the acute and chronic infections. Taken together, our findings indicate that coinfected animals exhibited a differential modulation of granulomatous inflammation during the acute and chronic phases of infection, which was potentially associated with a divergent profile of cytokines production and migration of neutrophils and eosinophils in response to S. mansoni and P. brasiliensis antigenic stimulation.

A vivência em um condomínio para idosos sob a percepção de seus residentes / Living in a condominium for the elderly under the perception of their residents / La vivencia en un condominio para ancianos bajo la percepción de sus residentes

O objetivo deste estudo foi descrever a percepção do residente, sobre sua vivência, em um condomínio para idosos. Estudo descritivo, com abordagem qualitativa, realizado em um município do sudoeste goiano. A amostra foi constituída por 18 idosos; destes, 8 eram do gênero feminino e 10 do masculino. Como resultados, destacou-se que, entre os motivos que levaram os idosos a residirem no condomínio, foi por deixar de pagar aluguel. Os residentes se sentem satisfeitos e felizes em morar na instituição.

The objective of this study was to describe the perception of the elderly about their experience in a condominium for the elderly. Descriptive study, with a qualitative approach, carried out in a municipality in southwest Goiás. The sample consisted of 18 elderly, of whom 8 were female and 10 were male. As a result, it was highlighted that among the reasons that led the elderly to reside in the condominium was for not paying rent. Residents feel satisfied and happy to live in the institution.

El objetivo de este estudio fue describir la percepción del anciano sobre su vivencia en un condominio para ancianos. Estudio descriptivo, con abordaje cualitativo, realizado en un municipio del suroeste goiano. La muestra fue constituida por 18 ancianos; de estos, 8 eran del género femenino y 10 del género masculino. Como resultados, se destacó que, entre los motivos que llevaron a los ancianos a residir en el condominio, fue por dejar de pagar alquiler. Los residentes se sienten satisfechos y felices de vivir en la institución.

The natural compound 7-epiclusianone inhibits superoxide dismutase activity in Schistosoma mansoni.

Schistosomiasis - caused by trematodes from the genus Schistosoma - affects more than 200 million people worldwide. Growing resistance to therapy with praziquantel (PZQ) has encouraged the search for novel treatments against this neglected disease. The compound 7-epiclusianone (7-epi) - isolated from 'bacupari' (the fruit of the Gracinia brasiliensis tree) - has promising activity against Schistosoma mansoni in vitro, damaging the parasite's tegument. However, the target and mechanism of action of 7-epi have not been identified. Here, we examined the possibility that 7-epi harms the tegument by inhibiting parasite superoxide dismutase (SOD), which protects the tegument from damage by reactive oxygen species produced by host immune cells. Molecular docking analysis in silico suggested strong interactions between 7-epi and S. mansoni cytosolic superoxide dismutase (SmCtSOD) at allosteric cavities. Schistosoma mansoni couples were cultivated ex vivo with 12.44-198.96 µm 7-epi for 24 h, and then parasite extracts were tested for lipid peroxidation (as a surrogate for oxidative stress), and SOD activity and expression. Lipid peroxidation levels increased after incubation with concentrations ≥99.48 µm 7-epi, and this compound reduced SOD activity at concentrations ≥24.87 µm. However, contact with 7-epi did not alter SOD expression, by quantitative real-time polymerase chain reaction (qRT-PCR). Our results show that the inhibition of SmCtSOD is partly responsible for the tegument detachment observed after incubation with 7-epi, but is not the only cause of the antiparasitic action of this compound in vitro.

Epidemiology of Acne Vulgaris in 18-Year-Old Male Army Conscripts in a South Brazilian City.

BACKGROUND: Prevalence of acne varies worldwide. Several factors (age, skin color, body fat, diet, and smoking) have been investigated as risk factors. OBJECTIVE: A total of 2,201 18-year-old males living in Pelotas, South Brazil, were evaluated in order to examine the prevalence of acne and associated factors. METHODS: A cross-sectional population-based study was conducted. A dermatologist performed the clinical examination of the face and trunk for identification of acne lesions. Acne was evaluated as clinically noninflammatory, inflammatory, and acne with both types of lesions. Skin color, schooling, height, smoking, skinfolds, waist circumference, BMI, and dietary dairy intake were the independent variables used. RESULTS: A response rate of 97.2% was obtained. Individuals without any acne lesion were 241 (10.9%); 161 (7.3%) only had noninflammatory lesions, 404 (18.4%) only inflammatory lesions; and 1,395 (63.4%) presented both types of lesions. In multivariate analysis, the type of lesions was different in light and dark skin phototype adolescents, with more common inflammatory lesions in the light phototype and noninflammatory ones in the dark phototype patients. Height was directly associated with the occurrence of all types of acne, whereas lower fat mass was associated with the occurrence of noninflammatory acne. While daily consumption of whole milk or yogurt was found to be associated with inflammatory acne in crude analysis, the association with milk was not detected and that with yogurt was low in multivariate analysis. CONCLUSION: Our results suggest that future studies should explore determinants of noninflammatory and inflammatory acne separately, especially if mixed populations are studied.

Lipopolysaccharide-induced acute lung injury in mice chronically infected by Schistosoma mansoni.

We used a murine model of Schistosoma mansoni (SM) infection and lipopolysaccharide (LPS)-induced endotoxicity to investigate if these conditions can interact to modify the pathological manifestations typically observed in each condition. Swiss mice were randomized into four groups: SAL, uninfected; SM, infected; LPS, uninfected + LPS; and SM + LPS, infected + LPS. S. mansoni infection developed over 120 days, after which blood samples and lungs were collected, peritoneal leukocytes were isolated and cultivated for 6 and 24 h after LPS inoculation (1 mL/kg). Infected animals presented marked granulomatous inflammation. LPS exposure transiently modified the profile of leucocyte migration into the lung tissue and increased NO production by isolated leukocytes, without inducing any acute effect on the structure of schistosomiasis granulomas. Beyond modifying lung morphology, S. mansoni and LPS interacted to modulate the circulating levels of cytokines. S. mansoni infection restricted INF-γ upregulation 6 and 24 h after LPS administration. Conversely, 24 h after inoculation, LPS increased IL-2 and IL-5 levels. Our findings indicate that LPS impaired the lung microenvironment by acutely disrupting inflammatory homeostatic mechanisms that control lung schistosomiasis. As schistosomiasis develops as a chronic condition, long-term exposure to endotoxins could aggravate the granulomatous process, an issue that requires further investigation.

In vitro evaluation of the schistosomicidal effect of the extracts, fractions and major 3-hydroxy-2,6-dialkyl-substituted piperidine alkaloids from the flowers of Senna spectabilis (Fabaceae).

In this work, we present the in vitro schistosomicidal activity evaluation of the most active dichloromethane fraction (FDm) (ED50=83.5µg/mL) and of a mixture of the major alkaloids ((-)-cassine/(-)-spectaline, C/E) (ED50=37.4µg/mL) from the flowers of Senna spectabilis against adult worms and cercariae. We also demonstrate other toxic effects including paralysis of the adult worms, inhibition of the secretory activity, tegument lesions and cercaricidal activity. In the association test of Praziquantel (PZQ)-C/E, we observed up to 80% mortality of Schistosoma mansoni in comparison to PZQ monotherapy. Due to the diversity of the toxic effects, the schistosomicidal activity of C/E is likely a result of a multitarget mechanism involving the tegument, secretory system and neuromotor action.

Loss of PTPN12 Stimulates Progression of ErbB2-Dependent Breast Cancer by Enhancing Cell Survival, Migration, and Epithelial-to-Mesenchymal Transition.

PTPN12 is a cytoplasmic protein tyrosine phosphatase (PTP) reported to be a tumor suppressor in breast cancer, through its capacity to dephosphorylate oncogenic receptor protein tyrosine kinases (PTKs), such as ErbB2. However, the precise molecular and cellular impact of PTPN12 deficiency in breast cancer progression remains to be fully clarified. Here, we addressed this issue by examining the effect of PTPN12 deficiency on breast cancer progression in vivo, in a mouse model of ErbB2-dependent breast cancer using a conditional PTPN12-deficient mouse. Our studies showed that lack of PTPN12 in breast epithelial cells accelerated breast cancer development and lung metastases in vivo. PTPN12-deficient breast cancer cells displayed enhanced tyrosine phosphorylation of the adaptor Cas, the adaptor paxillin, and the kinase Pyk2. They exhibited no detectable increase in ErbB2 tyrosine phosphorylation. PTPN12-deficient cells were more resistant to anoikis and had augmented migratory and invasive properties. Enhanced migration was corrected by inhibiting Pyk2. PTPN12-deficient breast cancer cells also acquired partial features of epithelial-to-mesenchymal transition (EMT), a feature of more aggressive forms of breast cancer. Hence, loss of PTPN12 promoted tumor progression in a mouse model of breast cancer, supporting the notion that PTPN12 is a tumor suppressor in human breast cancer. This function was related to the ability of PTPN12 to suppress cell survival, migration, invasiveness, and EMT and to inhibit tyrosine phosphorylation of Cas, Pyk2, and paxillin. These findings enhance our understanding of the role and mechanism of action of PTPN12 in the control of breast cancer progression.

Interaction of Schistosoma mansoni Sporocysts and Hemocytes of Biomphalaria.

Human infection by Schistosoma mansoni affects more than 100 million people worldwide, most often in populations of developing countries of Africa, Asia, and Latin America. The transmission of S. mansoni in human populations depends on the presence of some species of Biomphalaria that act as an intermediate host. The compatibility between S. mansoni and its intermediate host is influenced by behavioral, physiological, and genetical factors of the mollusc and the parasite. The susceptibility level of the mollusc has been attributed to the capacity of internal defense system (IDS)-hemocytes and soluble components of the hemolymph-to recognize and destroy the parasite, and this will be the center of interest of this paper. The schistosome-resistant Biomphalaria can be an alternative strategy for the control of schistosomiasis.

Perspectivas existentes relacionadas à assistência de enfermagem de um hospital acreditado / Existing perspectives related to nursing care in an accredited hospital

Este estudo tem como objetivo levantar na literatura artigos relacionados à assistência de Enfermagem em hospitais acreditados. Trata-se de uma revisão de literatura onde foram utilizados artigos científicos publicados em periódicos nacionais e internacionais, através das bases de dados Lilacs, SciElo e Medline, livros, site, dissertações e teses que foram publicados entre 2000 a 2010, sendo utilizando como descritores: assistência de enfermagem, qualidade, serviços de saúde e acreditação hospitalar. Foram encontrados 50 artigos sendo utilizado 23 artigos. O levantamento possibilitou pensar em qualidade do cuidado implica em ultrapassar a lógica dos processos, das estruturas e dos resultados quanto à questão da responsabilidade social dos profissionais e serviço de saúde. Na revisão dos artigos ficou claro que instituições acreditadas esperam mais de seus colaboradores diretamente ligados a enfermagem. Neste processo podemos enfatizar que ao término do estudo concluímos que se espera da equipe de enfermagem uma contribuição para o desenvolvimento da qualidade assistencial e institucional, participando de processos avaliativos em situações distintas relacionadas à acreditação e da avaliação dos riscos profissionais legais.

Genetic Determinants of Methicillin Resistance and Virulence among Staphylococcus aureus Isolates Recovered from Clinical and Surveillance Cultures in a Brazilian Teaching Hospital.

Aims. To quantify the presence of SCCmec types and virulence genes among Staphylococcus aureus colonizing and infecting patients from a teaching hospital. Methods. We analyzed 225 and 84 S. aureus isolates recovered from surveillance and clinical cultures, respectively. Strains were studied for the presence and type of SCCmec, as well as for several virulence genes. Univariate and multivariable analysis were performed in order to identify predictors of invasiveness (defined as isolation from clinical cultures). Results. The presence of SCCmec types III (OR, 2.19, 95% CI, 1.08-4.45) and IV (OR, 5.28 95% CI, 1.35-20.63) and of genes coding for exfoliative toxin B (etb, OR, 6.38, 95% CI, 1.48-27.46) and Panton-Valentine leukocidin (pvl, OR, 2.38, 95% CI, 1.16-4.86) was independently associated with invasiveness. Conclusions. SCCmec types III and IV and virulence genes are associated with greater invasiveness of S. aureus. Patients colonized with methicillin-resistant S. aureus, as well as with strains harboring etb or pvl, may be prone to develop invasive disease. Infection-preventing strategies should be more intensively applied to this group.

Participation of N-acetyl-D-glucosamine carbohydrate moieties in the recognition of Schistosoma mansoni sporocysts by haemocytes of Biomphalaria tenagophila.

Lectin-carbohydrate binding may be involved in the recognition of Schistosoma mansoni sporocysts by haemocytes of Biomphalaria; therefore, we tested if this interaction is associated with snail resistance against Schistosoma infection. In vitro data showed that most of the S. mansoni sporocysts cultured with haemocytes from Biomphalaria glabrata BH, a highly susceptible snail strain, had a low number of cells that adhered to their tegument and a low mortality rate. Moreover, the addition of N-acetyl-D-glucosamine (GlcNAc) did not alter this pattern of adherence and mortality. Using haemocytes and haemolymph of Biomphalaria tenagophila Cabo Frio, we observed a high percentage of sporocysts with adherent cells, but complete encapsulation was not detected. Low concentrations of GlcNAc increased haemocyte binding to the sporocysts and mortality, which returned to basal levels with high concentrations of the carbohydrate. In contrast, haemocytes plus haemolymph from B. tenagophila Taim encapsulated cellular adhesion index of level 3 and destroyed over 30% of the S. mansoni sporocysts in culture. Interestingly, the addition of GlcNAc, but not mannose, to the culture medium resulted in the significant inhibition of cellular adhesion to the parasite tegument and the reduction of parasite mortality, suggesting that GlcNAc carbohydrate moieties are important to the recognition of S. mansoni by B. tenagophila Taim.

Participation of N-acetyl-D-glucosamine carbohydrate moieties in the recognition of Schistosoma mansoni sporocysts by haemocytes of Biomphalaria tenagophila

Lectin-carbohydrate binding may be involved in the recognition of Schistosoma mansoni sporocysts by haemocytes of Biomphalaria; therefore, we tested if this interaction is associated with snail resistance against Schistosoma infection. In vitro data showed that most of the S. mansoni sporocysts cultured with haemocytes from Biomphalaria glabrata BH, a highly susceptible snail strain, had a low number of cells that adhered to their tegument and a low mortality rate. Moreover, the addition of N-acetyl-D-glucosamine (GlcNAc) did not alter this pattern of adherence and mortality. Using haemocytes and haemolymph of Biomphalaria tenagophila Cabo Frio, we observed a high percentage of sporocysts with adherent cells, but complete encapsulation was not detected. Low concentrations of GlcNAc increased haemocyte binding to the sporocysts and mortality, which returned to basal levels with high concentrations of the carbohydrate. In contrast, haemocytes plus haemolymph from B. tenagophila Taim encapsulated cellular adhesion index of level 3 and destroyed over 30 percent of the S. mansoni sporocysts in culture. Interestingly, the addition of GlcNAc, but not mannose, to the culture medium resulted in the significant inhibition of cellular adhesion to the parasite tegument and the reduction of parasite mortality, suggesting that GlcNAc carbohydrate moieties are important to the recognition of S. mansoni by B. tenagophila Taim.

Interaction between primary and secondary sporocysts of Schistosoma mansoni and the internal defence system of Biomphalaria resistant and susceptible to the parasite.

The outcome of the interaction between Biomphalaria and Schistosoma mansoni depends on the response of the host internal defence system (IDS) and the escape mechanisms of the parasite. The aim of this study was to evaluate the responsiveness of the IDS (haemocytes and soluble haemolymph factors) of resistant and susceptible Biomphalaria tenagophila lineages and Biomphalaria glabrata lineages in the presence of in vitro-transformed primary sporocysts and secondary sporocysts obtained from infected B. glabrata. To do this, we assayed the cellular adhesion index (CAI), analysed viability/mortality, used fluorescent markers to evaluate the tegumental damage and transplanted secondary sporocysts. B. tenagophila Taim was more effective against primary and secondary sporocystes than the susceptible lineage and B. glabrata. Compared with secondary sporocysts exposed to B. tenagophila, primary sporocysts showed a higher CAI, a greater percentage of dead sporocysts and were labelled by lectin from Glycine max and Alexa-Fluor 488 fluorescent probes at a higher rate than the secondary sporocysts. However, the two B. tenagophila lineages showed no cercarial shedding after inoculation with secondary sporocysts. Our hypothesis that secondary sporocysts can escape the B. tenagophila IDS cannot be confirmed by the transplantation experiments. These data suggest that there are additional mechanisms involved in the lower susceptibilty of B. tenagophila to S. mansoni infection.