Effects of polymethyl methacrylate-based bone cement graft for treating excessive gingival display and its dimensional facial changes: 12-Month clinical study.

Objective: to present a 12-month follow-up with photographic and tomographic analyses of the effect of polymethyl methacrylate-based bone cement graft (PMMA) in gingival exposure (GE) in patients with excessive gingival display (EGD). Methods: Twelve patients with EGD were included. The PMMA was surgically placed. A frontal and lateral photograph protocol was performed at baseline (T0), 3 (T3), 6 (T6), and 12 months (T12) post-operatively. Soft tissue cone-beam computed tomography (ST-CBCT) was performed at T0 and T12. Measures included GE, length of the lip vermilion (LLV), lip shape (LS), nose width (NW), filter width (FW), nasolabial angle (NAS) while smiling, and nasolabial angle at rest (NAR). The height, thickness, and volume of the cement graft were also measured in the ST-CBCT. The comparisons were performed by Kruskal-Wallis test at 5 % of significance (p < 0.05). Results: The height, thickness, and volume of the PMMA were respectively 12.84 ± 1.59 mm, 3.83 ± 0.53, and 1532.02 ± 532.52 mm3. PMMA significantly decreased GE from 8.33 ± 1.25 mm (T0) to 6.60 ± 0.93 mm (T12) (p < 0.01). NAR was 98.34 ± 9.28° at T0 and increased to 105.13 ± 7.33° at T12; however, the angle value was not statistically different (p = 0.08). LLV, LS, NW, FW, and NAS did not exhibit statistical differences between the baseline and follow-up periods. Conclusions: PMMA significantly decreased GE in a 12-month follow-up without influencing adjacent soft tissue anatomical structures.

The pFSH dose affects the efficiency of in vivo embryo production in Santa Inês ewes.

This study compared the follicular growth, superovulatory response, and in vivo embryo production after administering two doses of porcine follicle-stimulating hormone (pFSH) in Santa Inês ewes. The estrous cycle of 36 multiparous ewes was synchronized with the Day 0 protocol and superovulated with 133 mg (G133, n=18) or 200 mg (G200, n=18) of pFSH. Ultrasonographic evaluations of the ovaries were performed, ewes were mated and submitted to non-surgical embryo recovery. Viable blastocysts were stained with Nile Red and Hoechst. The G200 had a greater number of medium and large follicles, as well as a larger size of the third largest follicle. A total of 97.2% (35/36) of the ewes came into estrus and it was possible to transpose cervix in 80.6% (29/36). There were no effects of treatments in the response to superovulation, the proportion of ewes in which was possible to transpose the cervix, the number of corpora lutea, the number of anovulatory follicles, the proportion of ewes flushed with at least one recovered structure, number of recovered structures, number of viable embryos, viability rate, and recovery rate. The G200 ewes were in estrus for a longer period of time than the G133 ewes (54.0 ± 4.5 h vs. 40.3 ± 3.6 h) and produced more freezable embryos (6.5 ± 1.6 vs. 2.3 ± 0.7) than G133. Both doses promoted an efficient superovulatory response and did not affect embryonic lipid accumulation. The dose of 200 mg of pFSH showed greater potential to increase the superovulatory response, as it increased follicular recruitment and the recovery of freezable embryos.

Analysis of the Association of IL-1A, IL-1B and IL-1RN Polymorphisms with Peri-implantitis in a Portuguese Population.

PURPOSE: The aim of this study was to investigate whether genetic variations in cytokine genes involved in the pathogenesis of peri-implantitis, could be associated with its occurrence, an issue that remains controversial and may vary according to the population evaluated. MATERIAL AND METHODS: A cross-sectional analytical study was carried out on 102 Portuguese Caucasian individuals divided into two groups: 43 individuals with peri-implantitis and 59 individuals with peri-implant health. Samples from the buccal mucosa were obtained and genetic analysis was performed using the real-time polymerase chain reaction (PCR) technique for IL-1A and IL-1B and using PCR and restriction fragment length polymorphism analysis for IL-1RN. RESULTS: The IL-1A -889 C/T polymorphism showed a higher prevalence of the less common allele (T allele) in cases of peri-implantitis than in healthy cases (27.9% vs 16.9%, respectively), but without statistical significance (p = 0.060). For the IL-1B +3954 C/T and IL-1RN (variable number of tandem repeats) polymorphisms, the analysis revealed that the allele and genotype frequencies did not differ significantly between groups. There was a significant association between a history of periodontitis and peri-implantitis (p = 0.020). CONCLUSIONS: The genetic polymorphisms evaluated had no influence on the occurrence of periimplantitis in the population studied. Further research into genetic variations in different populations is needed to elucidate the role of genetic factors in the onset and progression of periimplant disease.

The Influence of Genetic Polymorphisms on the Expression of Interleukin-1beta, Prostaglandin E2 and Tumor Necrosis Factor Alpha in Peri-Implant Crevicular Fluid: A Cross-Sectional Study.

The aim of this study was to evaluate the possible relationships between polymorphisms in the interleukin-1 (IL-1) A, IL-1B, and IL-1RN genes and concentrations of the inflammatory mediators IL-1ß, tumor necrosis factor-alpha (TNF-α), and prostaglandin E2 (PGE2) in peri-implant crevicular fluid (PICF). A cross-sectional analytical study was conducted on 51 patients with dental implants. Samples from the buccal mucosa were obtained, and genetic analysis was performed using the real-time polymerase chain reaction (PCR) technique for IL-1A and IL-1B and PCR and restriction fragment length polymorphism analysis for IL-1RN. For the biochemical analysis, the concentrations of IL-1ß and TNF-α were analyzed using multiplexed fluorescent sphere immunoassays, and PGE2 by enzyme-linked immunosorbent assay. In patients with detected IL-1RN polymorphism, there was an increase in the concentration of the three mediators with statistically significant differences in the mean values of TNF-α and PGE2, regardless of peri-implant health status (p = 0.002 and p = 0.049, respectively). The concentrations of all three mediators were positively and significantly correlated (IL-1ß vs. TNF-α Rho = 0.480, p < 0.001; IL-1ß vs. PGE2 Rho = 0.382, p = 0.006; and TNF-α vs. PGE2 Rho = 0.528, p < 0.001). We can conclude that the IL-1RN polymorphism exerts an influence on the PICF immune response, which may explain the influence of this genetic polymorphism on the occurrence of peri-implantitis.

Biocompatibility of bulk-fill resins in vitro.

OBJECTIVES: This study aims to evaluate the cytotoxicity and genotoxicity of three different extracts obtained from Filtek™ One Bulk Fill, Tetric Evoceram® Bulk Fill and Coltene Fill-Up! resins. MATERIALS AND METHODS: The cytotoxicity was determined on 3T3 fibroblast cells using the MTT and crystal violet assays. The genotoxicity was determined using a cytokinesis-block micronucleus assay. RESULTS: The cytotoxicity of the resin extracts on 3T3 mouse fibroblasts was found to be dose-dependent with both the MTT and crystal violet assays. Extracts concentrated above 1% were cytotoxic according to the MTT assay. The Filtek™ One Bulk Fill, Tetric Evoceram® Bulk Fill, and Coltene Fill-Up! resins reached the LD50 at concentrations of 60%, 50%, and 20%, respectively, and showed genotoxicity rates that were 2-5 times, 3-8 times, and 4-15 times higher than the negative control, respectively. CONCLUSIONS: Coltene Fill-Up! resin extracts were the most cytotoxic and genotoxic, followed by Tetric Evoceram® Bulk Fill and Filtek™ One Bulk Fill. CLINICAL RELEVANCE: The analyzed bulk-fill resins showed differences in in vitro biocompatibility, and the Filtek™ One Bulk Fill was found to be the safest for clinical use.

Use of meloxicam with or without dipyrone in non-surgical embryo recovery in hair sheep: Effects on animal welfare.

The aim of this study was to determine the effectiveness of meloxicam with or without dipyrone on the welfare of ewes subjected to non-surgical embryo recovery (NSER). Two studies were carried out using 51 multiparous Santa Inês ewes. All animals received a standard oestrous synchronization treatment and a superovulatory protocol. In Study 1, 12 ewes received meloxicam (GM) before cervical transposition (1 mg kg-1 , i.v.), repeated 24 h after (1 mg kg-1 , i.m.), while the other 10 received a saline solution, remaining as a control group (GC1). In Study 2, ewes were allocated into a group of 15 ewes treated as GM of Study 1 associated with dipyrone (GMD; 50 mg kg-1 , i.m.) before cervical transposition, 12 h, and 24 h after, or a control group (GC2) of 14 ewes treated with saline solution. In both studies, heart and respiratory rates (RR), cortisol, glucose, total proteins, albumin and globulins blood concentration were recorded before sedation (BS), after sedation (AS), after cervical transposition, immediately after collection (IAC), and 0.5, 1.5, 3, 6, 12, 24 and 48 h after embryo collection (hAC). In Study 1, RR tended to be greater in GC1 (p = .08), serum total proteins and globulins values were lower and serum albumin values were greater in this group than GM (p = .003, p < .0001, and p < .0001, respectively). In Study 2, treatment of GMD tended to reduce the glycaemia at AS (p = .052) and reduced it at 3hAC (p < .0001), and 6hAC (p = .03). It also tended to reduce cortisol concentrations (p = .10). The other variables varied with NSER without interaction with the experimental treatments. In conclusion, in this study condition, NSER in sheep induced transient changes indicative of stress and possibly pain, therefore, affecting animal welfare. The administration of meloxicam was ineffective to reduce those responses, and the association of dipyrone had only slight effects without modifying the main welfare indicative responses in ewes subjected to NSER.

Desafios à segurança do paciente na terapia intensiva: uma teoria fundamentada / Desafíos para la seguridad del paciente en cuidados intensivos: una teoría fundamentada / Challenges to patient safety in intensive care: a grounded theory

Resumo Objetivo Compreender, na perspectiva de enfermeiros de unidades de terapia intensiva, os desafios à segurança do paciente confrontados neste contexto. Métodos Pesquisa qualitativa realizada com 20 enfermeiros em dois grupos amostrais de duas unidades de terapia intensiva (UTI) do Norte do Brasil. Os dados foram coletados mediante entrevista semiestruturada. O método adotado foi a Teoria fundamentada nos dados, enfatizando-se neste artigo uma categoria e suas subcategorias no que concerne às condições. O estudo foi aprovado pelos comitês de ética de duas instituições sob os pareceres de número: 2.755.619 e número 2.829.210, no ano de 2018. Resultados Três subcategorias explicitaram desafios à segurança do paciente, a saber: estando imerso em processos de trabalho não sistematizados; falhando a comunicação entre os profissionais; e constatando lacunas na educação permanente. Conclusão A desorganização dos processos de trabalho, a comunicação falha e ações de educação permanente insuficientes correspondem aos principais desafios apontados pelos enfermeiros na rotina da UTI, gerando encadeamentos que incidem diretamente na gestão da segurança do paciente.

Resumen Objetivo Comprender, bajo la perspectiva de enfermeros de unidades de cuidados intensivos, los desafíos para la seguridad del paciente que enfrentan este contexto. Métodos Estudio cualitativo realizado con 20 enfermeros en dos grupos de muestras de dos unidades de cuidados intensivos (UCI) del norte de Brasil. Los datos fueron recopilados mediante entrevista semiestructurada. El método adoptado fue la teoría fundamentada en los datos, con énfasis en una categoría y sus subcategorías en lo que respecta a las condiciones. El estudio fue aprobado por los comités de ética de las dos instituciones, con los números de informe 2.755.619 y 2.829.210, en el año 2018. Resultados Tres subcategorías explicitaron los desafíos para la seguridad del paciente, a saber: estar inmerso en procesos de trabajo no sistematizados, fallar en la comunicación entre los profesionales, y constatar vacíos en la educación permanente. Conclusión La desorganización de los procesos de trabajo, la comunicación defectuosa y las acciones de educación permanente insuficientes son los principales desafíos indicados por los enfermeros en la rutina de la UCI, lo que genera una serie de eventos que inciden directamente en la gestión de la seguridad del paciente.

Abstract Objective To understand, from Intensive Care Unit nurses' perspective, the challenges to patient safety. Methods This is qualitative research conducted with 20 nurses in two sample groups of two Intensive Care Units (ICU) in northern Brazil. Data were collected through semi-structured interviews. The method adopted was the Grounded Theory, emphasizing in this article a category and its subcategories with regard to conditions. The study was approved by the Research Ethics Committees of two institutions, under Opinions 2,755,619 and 2,829,210, in 2018. Results Three subcategories explained challenges to patient safety, namely: Being immersed in non-systematized work processes; Communication failure among professionals; and Finding gaps in continuing education. Conclusion The disorganization of work processes, faulty communication and insufficient continuing education actions correspond to the main challenges pointed out by nurses in the ICU routine, generating chains that directly affect patient safety management.

Ultrasound Diagnosis in Small Ruminants: Occurrence and Description of Genital Pathologies.

This study reports the occurrence and appearance of various reproductive tract pathologies of small ruminants diagnosed using ultrasound. An eight-year retrospective study of collected ultrasound data was carried out in Rio de Janeiro State, Brazil from September 2012 to July 2020. A total of 3463 animals from 16 sheep flocks and 10 dairy goat flocks, raised under extensive and intensive management systems, respectively, were used in the study. All animals were submitted to an ultrasound examination of their reproductive tract. Data were analyzed using Fisher's exact test (p < 0.05), to compare disorder frequencies within and between species. Ewes (4.14%) had fewer reproductive disorders than does (8.98%), while rams (43.63%) and bucks (56.25%) presented no significant differences. Hydrometra was the most frequent finding in does, represented by 50.98% of cases; while, in ewes, recent fetal loss (22.85%) and cystic endometrial hyperplasia (20.00%) were the most frequent. In bucks, the findings showed no clear differences; while, for rams, the most frequent finding was testicular microlithiasis (75.00%). Ultrasonography offers clinically useful information about the reproductive tract via the images it provides; knowledge of which makes it possible to improve the diagnosis, therapy, and prognosis of genital pathologies.

Influence of eCG and reproductive management in the resynchronization of ovulation in dairy goats.

Resynchronization protocols have been proposed as a way of shortening females' unproductive time in the flock, with good results in cattle and sheep. In goats, initial studies have shown that a second progestogen device inserted before luteolysis and pregnancy diagnosis does not interfere with the corpus luteum lifespan or functionality. This study aimed to evaluate the follicular growth, ovulation pattern and pregnancy rate after insertion of a second and new progestogen device for resynchronizing, with or without equine Chorionic Gonadotrophin (eCG), submitted to natural mating (NM) or artificial insemination (AI) to propose a viable resynchronization protocol for dairy goats. A total of 38 multiparous Saanen goats underwent a short-term progesterone protocol [six days exposed to medroxyprogesterone acetate (MAP) intravaginal sponges + 200 IU eCG and 0.12 mg of cloprostenol sodium on the 5th day + 0.025 mg of lecirelin 34 hours after sponge withdrawal] and, on day 16th after the ovulation, received a new MAP device which was retained until day 21. At this moment females were split into four groups: GeCG+NM - 100 IU eCG with NM; GSal+NM - saline solution with NM; GeCG+AI - 100 IU eCG with AI; and GSal+AI - saline solution with AI. Ultrasound scans were performed every 12 h from sponge withdrawal (day 21) until 108 h after sponge withdrawal (day 25) for follicular dynamics evaluation, at 240 h (day 31) for assessing the presence of active corpus luteum, and on day 60 for pregnancy diagnosis. No differences were found regarding ovulation time, synchronization and follicle size. However, GeCG+NM presented a greater estrus manifestation rate (100%) and pregnancy rate (62.5%) when compared to GSal+AI. In conclusion, resynchronization protocols in dairy goats may present satisfactory results.

Association between IL-1A and IL-1B gene polymorphisms with peri-implantitis in a Portuguese population-a pilot study.

Background: Scientific evidence indicates that biological complications in dental implants tend to be concentrated in a subset of individuals, which seems to imply that the host response may play a determining role in implant success. Over the last few decades, several polymorphisms have been studied. Polymorphisms in the interleukin (IL) 1 gene cluster have been associated with periodontitis. There are some similar features in the sequence of immunopathological events in peri-implant and periodontal infections. We aimed to investigate if individuals carrying the genetic single nucleotide polymorphism (SNP) in the IL-1A (rs1800587) and IL-1B (rs1143634) genes are more susceptible to develop peri-implantitis. Methods: A cross-sectional analytic pilot study was conducted in 20 Caucasian Portuguese subjects divided into two groups: 10 subjects with peri-implantitis and 10 subjects with peri-implant health (control group). Samples containing cells from the buccal mucosa were stored at -20 °C and later submitted to the DNA extraction process. Genetic analysis was performed using the polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) analysis. Data were analyzed by using descriptive and inferential statistical methodologies. Results: For the IL-1A (-889) gene polymorphism, it was observed that the mutated allele was present in a higher percentage in the peri-implantitis group compared to the control group (30% vs 15% respectively, Fisher's exact test, p = 0.45). For the IL-1B (+3954) gene polymorphism, it was also observed that the altered allele was present in a higher percentage in the disease group compared to the control group (35% vs 10% respectively, Fisher's exact test, p = 0.13). The positive genotype (at least one allele with nucleotide sequence changed in both genes) was detected in six patients, five belonging to the disease group and one to the health group. Conclusions: Regarding IL-1 gene polymorphisms, there was no statistically significant difference between the health and disease group, however a trend should be highlighted, showing a potential link between the IL-1 genotype and peri-implantitis. More studies are needed to clarify the role of genetic polymorphisms in the development of peri-implantitis.

Biostimulation with the ram effect increases the follicle recruitment, ovulatory diameter, and embryo viability rate in superovulated ewes.

The aim of this study was to compare the preovulatory follicular development and superovulatory outcomes in superovulated ewes which were either stimulated or not stimulated by placement with rams. The treatment regimen to super-stimulate ovarian follicular development was imposed to 28 ewes on "Day 0", from which 14 were stimulated with active rams for 48 h, starting at the time of the fifth FSH dose, with the ram being removed from the pen with the ewes and replaced which other ram every 12 h, using four different rams (group GRE). The other 14 ewes remained isolated from rams throughout the protocol (group GCON). All ewes were administered 133 mg of FSH, into six doses in decreasing quantities, every 12 h. The follicular development and number of ovulations were determined using ultrasonography. Biostimulation resulted in an increased number of large follicles, follicle diameter, and embryo viability rate (viable embryos/recovered structures∗100) was greater in ewes of the GRE than GCON group. The number of corpora lutea, follicular cysts, recovered structures, viable embryos, and degenerated and unfertilized structures was similar in ewes of the GRE and GCON group. Structures were recovered from more GRE than GCON ewes. In conclusion, biostimulation with rams during the last phase of the treatment regimen to induce superovulation enhanced the follicular growth and increased the embryo viability rate in ewes.

APOBEC3B Potently Restricts HIV-2 but Not HIV-1 in a Vif-Dependent Manner.

Vif is a lentiviral accessory protein that counteracts the antiviral activity of cellular APOBEC3 (A3) cytidine deaminases in infected cells. The exact contribution of each member of the A3 family for the restriction of HIV-2 is still unclear. Thus, the aim of this work was to identify the A3s with anti-HIV-2 activity and compare their restriction potential for HIV-2 and HIV-1. We found that A3G is a strong restriction factor of both types of viruses and A3C restricts neither HIV-1 nor HIV-2. Importantly, A3B exhibited potent antiviral activity against HIV-2, but its effect was negligible against HIV-1. Whereas A3B is packaged with similar efficiency into both viruses in the absence of Vif, HIV-2 and HIV-1 differ in their sensitivity to A3B. HIV-2 Vif targets A3B by reducing its cellular levels and inhibiting its packaging into virions, whereas HIV-1 Vif did not evolve to antagonize A3B. Our observations support the hypothesis that during wild-type HIV-1 and HIV-2 infections, both viruses are able to replicate in host cells expressing A3B but using different mechanisms, probably resulting from a Vif functional adaptation over evolutionary time. Our findings provide new insights into the differences between Vif protein and their cellular partners in the two human viruses. Of note, A3B is highly expressed in some cancer cells and may cause deamination-induced mutations in these cancers. Thus, A3B may represent an important therapeutic target. As such, the ability of HIV-2 Vif to induce A3B degradation could be an effective tool for cancer therapy. IMPORTANCE Primate lentiviruses encode a series of accessory genes that facilitate virus adaptation to its host. Among those, the vif-encoded protein functions primarily by targeting the APOBEC3 (A3) family of cytidine deaminases. All lentiviral Vif proteins have the ability to antagonize A3G; however, antagonizing other members of the A3 family is variable. Here, we report that HIV-2 Vif, unlike HIV-1 Vif, can induce degradation of A3B. Consequently, HIV-2 Vif but not HIV-1 Vif can inhibit the packaging of A3B. Interestingly, while A3B is packaged efficiently into the core of both HIV-1 and HIV-2 virions in the absence of Vif, it only affects the infectivity of HIV-2 particles. Thus, HIV-1 and HIV-2 have evolved two distinct mechanisms to antagonize the antiviral activity of A3B. Aside from its antiviral activity, A3B has been associated with mutations in some cancers. Degradation of A3B by HIV-2 Vif may be useful for cancer therapies.

Saberes e experiências de idosos sobre a cirurgia de catarata: um diálogo com uma profissional de enfermagem / Saberes y experiencias de personas mayores sobre la cirugía de cataratas: un diálogo con el profesional de enfermería / Knowledge and experiences of the elderly about cataract extraction: a dialogue with a professional nurse

RESUMO Objetivo: Descrever o conhecimento e experiências de idosos sobre a cirurgia de catarata e os cuidados pré e pós-operatórios. Método: Estudo qualitativo-descritivo feito com 24 idosos em hospital privado no Rio de Janeiro e em domicílio. Realizaram-se entrevistas individuais, seguidas de discussão com cada participante, entre setembro e dezembro de 2017. Aplicou-se análise de conteúdo temática na organização dos dados. Resultados: Categorias de análise: concepções sobre a doença e a cirurgia, fontes de acesso à informação, a cultura do silêncio no contexto do cuidado em saúde, e expectativas dos idosos sobre a cirurgia e seus resultados. Os idosos apresentaram lacunas sobre o que sabem sobre a cirurgia e os cuidados pré e pós-operatórios; trouxeram situações que reiteram, por vezes, a cultura do silêncio na relação com os profissionais de saúde e fizeram proposições sobre o que consideravam importante na educação em saúde sobre o tema. Conclusões: A partir da reunião com os idosos, foi possível evidenciar não apenas seus conhecimentos sobre a patologia enfrentada e o procedimento cirúrgico de catarata, como também avaliar, de forma integral, o processo e as mudanças necessárias no âmbito da promoção da saúde.

RESUMEN Objetivo: describir el conocimiento y las experiencias de personas mayores sobre la cirugía de cataratas y los cuidados prey postoperatorios. Método: estudio cualitativo-descriptivo llevado a cabo con 24 ancianos en hospital privado en Rio de Janeiro-Brasil y en domicilio. Se realizaron entrevistas individuales, seguidas de discusión con cada participante, entre septiembre y diciembre de 2017. Se aplicó el análisis de contenido temático en la organización de los datos. Resultados: categorías de análisis: concepciones sobre la enfermedad y la cirugía, fuentes de acceso a la información, la cultura del silencio en el contexto del cuidado en salud, y expectativas de las personas mayores sobre la cirugía y sus resultados. Los ancianos presentaron lagunas sobre lo que saben respecto a la cirugía y los cuidados pre y post operatorios; trajeron situaciones que reiteran, aveces, la cultura del silencio en la relación con los profesionales de salude hicieron proposiciones sobre qué consideraban importante en la educación en salud sobre el tema. Conclusiones: a partir de la reunión con los ancianos, fue posible evidenciar no solo sus conocimientos sobre la patología enfrentada yel procedimiento quirúrgico de cataratas, sino también evaluar, de forma integral, el proceso y los cambios necesarios en el ámbito de la promoción de la salud.

ABSTRACT Aim: To describe the knowledge and experiences of the elderly about cataract surgery and pre- and post-operative care. Method: This qualitative-descriptive study was conducted with 24 elderly people in a private hospital in Rio de Janeiro and at their homes. Individual interviews were held, followed by a discussion with each participant, between September and December 2017. Thematic content analysis was applied in the organization of the data. Results: Categories of Analysis: concepts of the disease and surgery, sources of access to information, the culture of silence in the context of health care, and expectations of the elderly about surgery and its results. The elderly had gaps in their knowledge about the surgery and pre- and post-operative care; spoke about situations that sometimes reiterated the culture of silence in their relationships with health professionals and made proposals about aspect of the topic that they considered important in health education. Conclusions: Based on meetings with the elderly, it was possible to show not only their knowledge about the pathology they faced and surgical procedure [for the treatment of cataracts], but also to fully assess the process and the changes required in the scope of health promotion.

Ocular manifestations of intermediate cystinosis: To treat or not to treat?

PURPOSE: To report a case of intermediate cystinosis with an atypical presentation in which a delayed non-treatment decision has been proved right over a large period of time. METHODS: This is a unique case report of a patient who underwent full ophthalmologic evaluations including anterior chamber optical coherence tomography on a regular basis during a 7-year follow-up period. RESULTS: A 30-year-old woman with photophobia was being studied by the Department of Nephrology with a suspicion of Alport syndrome. Slit-lamp examination showed iridescent deposits throughout the corneal anterior stroma and the inferior tarsal conjunctiva bilaterally. Anterior chamber optical coherence tomography showed stromal hyperreflectivity. CTNS gene was found to be positive for c.416C>T (Ser139Phe) mutation. The patient was offered oral and topical cysteamine which was refused. After a period of 5 years of follow-up, general health status remained stable, corneal disease showed no progression and photophobia complaints diminished. However, the patient was advised to start systemic and topical cysteamine because of the unknown development of the disease. CONCLUSION: In this reported case, a delayed non-treatment decision has been proved right contrary to published evidence of active treatment of photophobia. The decision whether to treat or not to treat corneal involvement of the disease is not straightforward. Besides biomicroscopic evaluations, patients' complaints and expectations should be taken into account.

Population Approach to Efavirenz Therapy.

Efavirenz (EFV) is a nonnucleoside reverse transcriptase inhibitor commonly used as first-line therapy in the treatment of human immunodeficiency virus (HIV), with a narrow therapeutic range and a high between-subject variability which can lead to central nervous system toxicity or therapeutic failure. To characterize the sources of variability and better predict EFV steady-state plasma concentrations, a population pharmacokinetic model was developed from 96 HIV-positive individuals, using a nonlinear mixed-effect method with Monolix® software. A one-compartment with first-order absorption and elimination model adequately described the data. To explain between-subject variability, demographic characteristics, biochemical parameters, hepatitis C virus-HIV coinfection, and genetic polymorphisms were tested. A combination of the single-nucleotide polymorphisms rs2279343 and rs3745274, both in the CYP2B6 gene, were the only covariates influencing clearance, included in the final model. Oral clearance was estimated to be 19.6 L/h, 14.15 L/h, and 6.08 L/h for wild-type, heterozygous mutated and homozygous mutated individuals, respectively. These results are in accordance with the current knowledge of EFV metabolism and also suggest that in homozygous mutated individuals, a dose adjustment is necessary. Hepatitis C virus-HIV coinfection does not seem to be a predictive indicator of EFV pharmacokinetic disposition.

Functional analysis of Vif protein shows less restriction of human immunodeficiency virus type 2 by APOBEC3G.

Viral infectivity factor (Vif) is one of the human immunodeficiency virus (HIV) accessory proteins and is conserved in the primate lentivirus group. This protein is essential for viral replication in vivo and for productive infection of nonpermissive cells, such as peripheral blood mononuclear cells (PBMC). Vif counteracts an antiretroviral cellular factor in nonpermissive cells named CEM15/APOBEC3G. Although HIV type 1 (HIV-1) Vif protein (Vif1) can be functionally replaced by HIV-2 Vif protein (Vif2), its identity is very small. Most of the functional studies have been carried out with Vif1. Characterization of functional domains of Vif2 may elucidate its function, as well as differences between HIV-1 and HIV-2 infectivity. Our aim was to identify the permissivity of different cell lines for HIV-2 vif-minus viruses. By mutagenesis specific conserved motifs of HIV-2 Vif protein were analyzed, as well as in conserved motifs between Vif1 and Vif2 proteins. Vif2 mutants were examined for their stability, expression, and cellular localization in order to characterize essential domains of Vif2 proteins. Viral replication in various target cells (PBMC and H9, A3.01, U38, and Jurkat cells) and infectivity in single cycle assays in the presence of APOBEC3G were also analyzed. Our results of viral replication show that only PBMC have a nonpermissive phenotype in the absence of Vif2. Moreover, the HIV-1 vif-minus nonpermissive cell line H9 does not show a similar phenotype for vif-negative HIV-2. We also report a limited effect of APOBEC3G in a single-cycle infectivity assay, where only conserved domains between HIV-1 and HIV-2 Vif proteins influence viral infectivity. Taken together, these results allow us to speculate that viral inhibition by APOBEC3G is not the sole and most important determinant of antiviral activity against HIV-2.

A natureza do poder: técnica e açäo social / The nature of power: technique and social action

O texto interroga o caráter polissêmico da noçäo de rede, procurando distinguir os usos atuais desta noçäo dos classicamente formulados pelas Ciências Sociais. Com base nesta indicaçäo, trata a noçäo de rede por meio de duas opçöes analíticas: a reflexäo do poder e o teor das relaçöes societárias estimuladas pelas redes técnicas. A análise acontece, sobretudo, pela reflexäo do sentido da açäo social, sendo registrado o predomínio da açäo instrumental na modernidade radicalizada.

Tecnologias de informaçäo e comunicaçäo, saúde e vida metropolitana / Information and communication technologies, health and urban life

A autora parte da idéia de que os avanços técnicos e a vida urbana comandam a modernizaçäo do território e a administraçäo das relaçöes sociais. Analisa as características do processo de urbanizaçäo no capitalismo periférico, marcado pela concentraçäo demográfica sem o decorrente acesso à técnica. Discute de que modo esta reduzida incorporaçäo da técnica e, mais exatamente, sua distribuiçäo desigual, cria obstáculos para a humanizaçäo e enriquecimento cultural da vida metropolitana; discute, ainda, o impacto dessas transformaçöes na vida social, tanto em nível da construçäo dos seres sociais, quanto na emergência de novas tendências e desafios para a área saúde.