Musician's dystonia in a percussionist - clinical video analysis and botulinum toxin intervention: a case report.

OBJECTIVE: Musician's focal hand dystonia is a painless task-specific focal dystonia, which presents with involuntary movements, abnormal postures, and loss of fine motor dexterity. We report here the case of a 63-year-old male, percussionist, with african ethnicity, with musician's focal hand dystonia who was treated with botulinum toxin, and describe the results at 4-weeks follow up. METHODS: Clinical examination and video analysis revealed abnormal flexion of the 3rd finger, followed by flexion of the 4th and 5th fingers while playing the congas. Based on these findings, a diagnosis of musician's focal hand dystonia was established. Ten units of botulinum toxin were injected into the muscle fibres of the flexor digitorum superficialis corresponding to the 4th finger using electromyography and ultrasound guidance. Four weeks later, the patient reported a subjective 60% improvement in his performance. He emphasized the effect of botulinum toxin on performance speed and tension over the forearm and hand. CONCLUSION: Botulinum toxin is not a definitive treatment for musician's focal hand dystonia, but it may potentiate other definitive rehabilitation techniques. More research is needed to determine the long-term effects of botulinum toxin on function enhancement in musician's focal hand dystonia.

Cardioproteomics: Insights on Cardiovascular Diseases.

Cardiovascular diseases (CVDs) remain a global health challenge and are the leading cause of deaths worldwide. Proteomics has emerged as a valuable tool for unraveling the complex molecular mechanisms underlying CVDs, offering insights into biomarker discovery, drug targets, and personalized medicine. This review explores key breakthroughs in proteomic applications related to CVDs, mainly coronary artery disease (CAD), ischemic heart diseases such as myocardial infarction (MI), and cardiomyopathies. Notable findings include potential biomarkers, therapeutic targets, and insights into disease pathogenesis. The review highlights the importance of proteomics in advancing our understanding of CVDs and shaping future therapeutic approaches.

A oferta dos conteúdos de Odontologia Legal no ensino superior do estado do Paraná / The provision of Forensic Dentistry content in higher education in the state of Paraná

Com as crescentes ações indenizatórias e infrações cometidas no meio odontológico, para que cirurgiões dentistas exerçam sua profissão de forma segura, a odontologia legal deve ser abordada nas Faculdades de odontologia. O presente estudo analisou os currículos dos cursos de Odontologia das faculdades do estado do Paraná, avaliando se estão adequadas às diretrizes do ensino da Odontologia Legal, propostas pela ABOL e ABENO. Foi realizada uma pesquisa descritiva de análise documental dos dados coletados de IES do Paraná cadastradas no e-MEC. O levantamento das informações ocorreu no período entre junho e agosto de 2021. Foi feita a análise dos currículos em comparação com as Diretrizes Curriculares Nacionais e com as diretrizes da ABENO e ABOL. Todas as 30 IES que disponibilizam as informações completas para estudo possuem em seu currículo ao menos uma disciplina relacionada ao conteúdo de Odontologia Legal, com carga horária média para Odontologia Legal de 60,1h. Destas, 26 (86,7%) IES ofertam apenas uma disciplina de Odontologia Legal. O Oeste paranaense (69h) e a região metropolitana de Curitiba (68,9h) obtiveram as maiores médias de horas para a disciplina e o Sudoeste paranaense a menor (39,5h). As IES do Estado do Paraná oferecem conteúdo de Odontologia Legal com carga horária abaixo da recomendada pelas diretrizes ABOL/ABENO. A grande maioria das IES oferece apenas uma disciplina que aborda conteúdos de Odontologia Legal.

With the growing claims for damages and infractions committed in the dental field, legal dentistry must be addressed in Dental Schools for dentists to exercise their profession safely. The present study analyzed the curricula of Dentistry courses at colleges in the state of Paraná, assessing whether they are adequate to the teaching guidelines of Forensic Dentistry, proposed by ABOL and ABENO. Descriptive document analysis research was carried out, and data collected from HEIs in Paraná was registered in the e-MEC. The survey of information took place between June and August 2021. The curricula were analyzed in comparison with the National Curriculum Guidelines and with the ABENO and ABOL guidelines. All 30 HEIs that provide complete information for study have in their curriculum at least one discipline related to the content of Forensic Dentistry, with an average workload for Forensic Dentistry of 60.1 hours. Of these, 26 (86.7%) HEIs offer only one course in Forensic Dentistry. West Paraná (69h) and the metropolitan region of Curitiba (68.9h) obtained the highest average hours for the discipline and Southwest Paraná had the lowest (39.5h). HEIs in the State of Paraná offer Forensic Dentistry content with a workload below what the ABOL/ABENO guidelines recommended. The vast majority of HEIs offer only one discipline that addresses Forensic Dentistry content.

Ewing's sarcoma of the head and neck: A systematic review.

OBJECTIVE: The aim of the present study was to conduct a systematic review of head and neck Ewing sarcoma (ES) concerning patients' demographic and clinical features, histopathological findings, treatment, follow-up, and survival rate. MATERIALS AND METHODS: An electronic search was undertaken in four databases. Articles describing case reports or case series were included. Outcomes were evaluated by the Kaplan-Meier method along with Cox regression. RESULTS: The search yielded 186 studies describing 227 ES cases. The mean age was 22.7 years, and males were slightly more affected. Interestingly, more than half the cases were diagnosed up to 20 years. The respiratory tract was the most reported site, followed by the jawbones. Clinically, symptomatic swelling or nodules were described, with a mean duration of 4 months. Management involved multimodal treatment regimens. Local recurrence, lymph node and distant metastasis were observed in 10.7%, 12.6%, and 20.3% of cases, respectively. Statistical analysis revealed that older patients with distant metastasis had a lower overall survival rate (p < 0.05). CONCLUSION: This study provides an overall view of head and neck ES that can assist oral and maxillofacial pathologists with the diagnosis and extend the knowledge of surgeons and oncologists about this condition.

Diagnosis, Treatment, and Total Rehabilitation of a Secondary Type Ameloblastic Carcinoma.

Ameloblastic carcinoma (AC) is an uncommon malignant odontogenic tumor, with about 200 cases published in the literature. Here, we report a case of AC occurring in the maxilla - at the same anatomical location of an ameloblastoma 8 years earlier. A 23-year-old woman with maxillary swelling of 6-month duration was referred to our service. Extraoral examination revealed a swelling over the right side of the face, lifting her lip and nose. Intraorally, a firm, reddish, nodular swelling involving the right maxilla was observed. Computed tomography showed a hypodense image invading the right maxilla, maxillary sinus, and nasal fossa. An incisional biopsy was performed, followed by histopathologic examination and an immunohistochemical panel, which led to the diagnosis of AC. The lesion was treated with partial maxillectomy followed by immediate rehabilitation. Neither local recurrence of the tumor nor distant metastasis was observed during a 4-year follow-up. AC is a highly malignant lesion which requires aggressive therapy. Its diagnosis should be based on combined clinical, imaging, and pathological manifestations in order to improve diagnostic accuracy.

A review of socioeconomic factors associated with acute myocardial infarction-related mortality and hospital readmissions.

BACKGROUND: Risk-adjustment models are widely used methodological approaches within the healthcare industry to measure hospital performance and quality of care. However, the Centers for Medicare and Medicaid Services (CMS) do not fully adjust for socioeconomic status (SES) in acute myocardial infarction (AMI) models. A review and evidence synthesis was conducted to identify associations of SES factors with hospital readmission and mortality in AMI patients. METHODS: Multiple electronic databases were queried to identify studies assessing risk for AMI-related mortality or hospital readmissions and SES factors. Identified studies were screened by title and abstract. Full-text reviews followed for articles meeting the inclusion criteria, including quality assessments. Data were extracted from all included studies, and evidence synthesis was performed to identify associations between SES factors and outcome variables. RESULTS: Ten studies were included in the review. One study showed that Black patients had higher AMI-related readmission rates compared to White patients (mean difference 4.3% [SD 1.4%], p < 0.001). Another study showed that income inequality was associated with increased risk of AMI-related readmissions (RR 1.18 [95% CI], 1.13-1.23). One study found that unemployed individuals experienced significantly greater rates of AMI-related mortality than those working full-time (HR 2.08, 1.51-2.87). According to another study, lack of health insurance was associated with worse rates for in-hospital AMI-related mortality (OR 1.77, 1.72-1.82). Based on one study, AMI-related mortality was higher in those with <8 years of education compared to those with >16 years (17.5% vs. 3.5%, p < 0.0001). Five of six studies found a significant association between ZIP code/neighborhood/location and AMI-related readmission or mortality. CONCLUSION: Race, ZIP code/neighborhood/location, insurance status, income/poverty, and education comprise SES factors found to be associated with AMI-related mortality and/or readmission outcomes. Including these SES factors in future updates of CMS's risk-adjusted models has the potential to provide more appropriate compensation mechanisms to hospitals.

O sofrimento psíquico de trabalhadores em situação de desemprego em Porto Velho ­ RO / The psychic suffering of unemployed workers in Porto Velho - RO

O estudo teve como objetivo analisar o sofrimento psíquico dos trabalhadores em situação de desemprego atendidos pelo Sistema Nacional do Empregado - SINE Municipal de Porto Velho - RO. Trata-se de uma pesquisa de cunho quantitativo, descritiva e transversal, com 50 trabalhadores em situação de desemprego. Aplicou-se uma entrevista sociodemográfica e o teste Self-Reporting Questionnaire - SRQ-20. O estudo foi aprovado pelo Comitê de Ética em Pesquisa da instituição. A amostra constituiu-se de 60% do sexo masculino e 40% do sexo feminino, 14% deles estavam a mais de um ano sem emprego e 84% estavam fazendo "bicos". Observou-se a prevalência de transtorno mental comum (TMC) em 50% dos trabalhadores, 75% apresentam humor depressivo/ansioso, 52% demonstram decréscimo de energia vital, 35% aparecem sintomas somáticos e 34% manifestam pensamentos depressivos. Os resultados demonstram elevadas prevalências de TMC e sintomas depressivos, ansiosos e somatoformes entre os trabalhadores em situação de desemprego no SINE. Conclui-se que, é importante direcionar ações de prevenção e enfrentamento ao cuidado com a saúde dos trabalhadores no estado.

The objective of this study was to analyze the psychic suffering of workers in unemployment situations attended by the National System of Employee - SINE Municipal of Porto Velho - RO. It is a quantitative, descriptive and cross-sectional survey with 50 unemployed workers. A sociodemographic interview and the Self-Reporting Questionnaire (SRQ-20) were applied. The study was approved by the Research Ethics Committee of the institution. The sample consisted of 60% male and 40% female, 14% of them were more than a year without work and 84% were making "beaks". The prevalence of common mental disorder (CMD) was found in 50% of the workers, 75% had depressed / anxious moods, 52% showed a decrease in vital energy, 35% had somatic symptoms and 34% had depressive thoughts. The results demonstrate a high prevalence of TMC and depressive, anxious and somatoform symptoms among unemployed workers in the SINE. It is concluded that it is important to direct actions of prevention and coping with the health care of workers in the state.

Insights of Outcome after Resection of Small Nonfunctioning Neuroendocrine Pancreatic Tumors.

BACKGROUND: The incidence of small nonfunctioning neuroendocrine pancreatic tumors (NF-PNETs) has been increasing systematically in the last few decades. Surgical resection was once considered the treatment of choice but has been questioned in the direction of a more conservative approach for selected patients. Our aim was to analyze the outcome of surgical resection of small (≤3cm) NF-PNETs. METHODS: We retrospectively evaluated 14 patients with sporadic NF-PNETs who underwent pancreatic resection. Data were collected from patients' medical records. RESULTS: Of the 14 patients included, 35.71% were men, and the average age was 52.36 ± 20.36 years. Comorbidities were present in 92.86% of the cases. The incidence of postoperative complications was 42.86%, the 30-day mortality was zero, and the length of follow-up was 3.31 ± 3.0 years. The results of pathological evaluations revealed WHO grade I in 42.86% of cases, II in 21.43%, and neuroendocrine carcinoma in 35.71%. The median tumor size was 1.85cm (range, 0.5-3cm), and 2 cases had synchronous metastasis. The median TNM stage was IIa (range, I-IV). The disease-free and patient survival rates were 87.5% and 100% at 3 years and 43.75% and 75% at 10 years, respectively. The tumor pathological grade was significantly higher in head tumors than body-tail tumors, but there were no differences with respect to tumor size and TNM staging. CONCLUSION: A surgical approach to treat small sporadic NF-PNETs is safe with low mortality and high patient survival. Based on these data, small pancreatic head tumors can be more aggressive, suggesting that surgical resection is still the best option to treat small nonfunctioning PNETS. Thus, conservative treatment should be indicated very cautiously for only cases with absolute contraindications for surgery.

3D-printing for forensic chemistry: voltammetric determination of cocaine on additively manufactured graphene-polylactic acid electrodes.

Cocaine is probably one of the most trafficked illicit drugs in the world. For this reason, police forces require fast, selective, and sensitive methods for cocaine detection at crime scenes. Taking benefit of additive manufacturing, we demonstrate that 3D-printed graphene-polylactic acid (G-PLA) electrodes using the affordable fused deposition modelling technique can identify and quantify cocaine in seized drugs. The detection of cocaine based on its electrochemical oxidation on such electrodes was dramatically improved after an electrochemical surface treatment that generates reduced graphene oxide (anodic followed by a cathodic treatment). Square-wave voltammetric determination of cocaine was achieved in the concentration range between 20 and 100 µmol L-1, with a detection limit of 6 µmol L-1, and free from the interference of paracetamol, caffeine, phenacetin, lidocaine, benzocaine and levamisole, which are common adulterants found in seized drugs. The analytical characteristics obtained using 3D-printed G-PLA electrodes were comparable with those of previously reported electrochemical sensors, but presented the inherent advantages of the 3D-printing technology that enables low-cost, reproducible, and large-scale production of such electrodes in remote areas combined with the use of an environmentally-friendly biopolymer.

Immunoexpression of BDNF, TrkB, and p75NTR receptors in peripheral neural lesions of the head and neck.

BACKGROUND: Brain-derived neurotrophic factor (BDNF) and neurotrophin receptors have been recognized as fundamental regulators of normal brain development, homeostasis, and plasticity. They have also been studied in the behavior of central nervous system tumors. Here, we studied the pattern of BDNF, TrkB and p75NTR immunoexpression in peripheral benign and malignant neural lesions in head and neck. METHODS: This cross-sectional analytical study included 79 cases of head and neck neural lesions. Nineteen cases of traumatic neuromas (TN), 20 cases of granular cell tumors (GCT), 16 cases of neurofibromas (NF), 20 cases of schwannomas (SC), and 4 malignant peripheral nerve sheath tumor (MPNST) were submitted to immunohistochemistry with BDNF, TrkB, and p75NTR antibodies. A semi-quantitative analysis was performed. RESULTS: The analysis of BDNF demonstrated a high percentage of positive cells in TN, GCT and SC with a decrease in cases of NF and MPNST. TrkB presented a lower significant immunoexpression in GCT in relation to the TN, NF, SC, and MPNST (P < .0001); and TN showed less percentage of positive cell compared to SC (P = .0017). Regarding p75NTR, the percentage of positive cell was significantly reduced in MPNST compared GCT (P = .009), NF (P = .0138) and SC (P = .0069). Also, a decrease in TN compared to GCT (P = .007) was observed. CONCLUSIONS: Our results showed the immunoreactivity of BDNF, TrkB, and p75NTR in head and neck peripheral neural lesions. Reduction of BDNF and p75NTR in MPNST might suggest down-regulation during the acquisition of malignant phenotype.

Characteristics and outcomes of patients with COVID-19 admitted to the ICU in a university hospital in São Paulo, Brazil - study protocol.

OBJECTIVES: We designed a cohort study to describe characteristics and outcomes of patients with coronavirus disease (COVID-19) admitted to the intensive care unit (ICU) in the largest public hospital in Sao Paulo, Brazil, as Latin America becomes the epicenter of the pandemic. METHODS: This is the protocol for a study being conducted at an academic hospital in Brazil with 300 adult ICU beds dedicated to COVID-19 patients. We will include adult patients admitted to the ICU with suspected or confirmed COVID-19 during the study period. The main outcome is ICU survival at 28 days. Data will be collected prospectively and retrospectively by trained investigators from the hospital's electronic medical records, using an electronic data capture tool. We will collect data on demographics, comorbidities, severity of disease, and laboratorial test results at admission. Information on the need for advanced life support and ventilator parameters will be collected during ICU stay. Patients will be followed up for 28 days in the ICU and 60 days in the hospital. We will plot Kaplan-Meier curves to estimate ICU and hospital survival and perform survival analysis using the Cox proportional hazards model to identify the main risk factors for mortality. ClinicalTrials.gov: NCT04378582. RESULTS: We expect to include a large sample of patients with COVID-19 admitted to the ICU and to be able to provide data on admission characteristics, use of advanced life support, ICU survival at 28 days, and hospital survival at 60 days. CONCLUSIONS: This study will provide epidemiological data about critically ill patients with COVID-19 in Brazil, which could inform health policy and resource allocation in low- and middle-income countries.

Análise da ocorrência dos critérios de Favrot e das comorbidades apresentadas por cães com dermatite atópica atendidos no Hospital Veterinário da Universidade Federal Fluminense / Analysis of the occurrence of Favrot's criteria and comorbidities presented by dogs with atopic dermatitis treated at the Veterinary Hospital of Universidade Federal Fluminense

O objetivo desse trabalho foi analisar a ocorrência dos critérios de Favrot em cães diagnosticados com Dermatite Atópica Canina (DAC) no Hospital Veterinário Professor Firmino Mársico Filho da Universidade Federal Fluminense, bem como sua associação com doenças concomitantes. Foram analisadas 2199 fichas propedêuticas com queixas dermatológicas, dos anos de 2016 e 2017. Do total, 165 (7,5%) animais foram diagnosticados com DACdos quais 94 (57%) eram fêmeas e 71 (43%) machos. Embora os cães mestiços fossem a maioria dos casos (22,4%), a raça pura mais frequentemente acometida foi a Poodle (12,5%). Foram identificados 134 (81,2%) cães com cinco ou mais critérios de Favrot, sendo 32,7% animais com seis critérios, 26,7% com cinco critérios, 17,0% com sete critérios e 4,8% com oito critérios. Enfatiza-se o aparecimento em mais de 90% dos casos os critérios intradomiciliado, com prurido primário, responsivo à corticoterapia e com bordas das pinas não acometidas. Dos 165 animais avaliados, 115 (69,7%) eram portadores de uma ou mais afecções concomitantes à DAC, sendo a otite externa a principal (73%). Considera-se que os critérios de Favrot podem ser aplicados para a triagem dos pacientes com suspeita de dermatite atópica canina atendidos no HUVET-UFF.

The objective of this study was to analyze the occurrence of Favrot criteria in dogs diagnosed with Canine Atopic Dermatitis (CAD) at the Veterinary Hospital Professor Firmino Mársico Filho of Universidade Federal Fluminense, as well as its association with concomitant diseases. A total of 2199 propaedeutic records with dermatological complaints from 2016 and 2017 were analyzed. Of the total, 165 (7.5%) animals were diagnosed with CAD. Among those diagnosed with CAD, 94 (57%) were females and 71 (43%) males. Although crossbreed dogs were the majority of cases (22.4%), the purebred dog most frequently affected by CAD was the Poodle (12.5%). One hundred and thirty four (81.2%) animals were identified with five or more Favrot criteria, 32.7% animals with six criteria, 26.7% with five criteria, 17.0% with seven criteria and 4.8% with eight criteria. It emphasizes the appearance in more than 90% of criteria, dog living mostly indoors,alesional pruritus, glucocorticoid-responsive pruritus and nonaffected ear margins. Of the 165 animals evaluated, 115 (69.7%) had one or more conditions concomitant with CAD, with otitis externa being the main one (73%). It is considered that the Favrot criteria can be applied for the screening of patients with suspected canine atopic dermatitis treated at HUVET-UFF.

Análise da ocorrência dos critérios de Favrot e das comorbidades apresentadas por cães com dermatite atópica atendidos no Hospital Veterinário da Universidade Federal Fluminense / Analysis of the occurrence of Favrot’s criteria and comorbidities presented by dogs with atopic dermatitis treated at the Veterinary Hospital of Universidade Federal Fluminense

O objetivo desse trabalho foi analisar a ocorrência dos critérios de Favrot em cães diagnosticados com Dermatite Atópica Canina (DAC) no Hospital Veterinário Professor Firmino Mársico Filho da Universidade Federal Fluminense, bem como sua associação com doenças concomitantes. Foram analisadas 2199 fichas propedêuticas com queixas dermatológicas, dos anos de 2016 e 2017. Do total, 165 (7,5%) animais foram diagnosticados com DAC dos quais 94 (57%) eram fêmeas e 71 (43%) machos. Embora os cães mestiços fossem a maioria dos casos (22,4%), a raça pura mais frequentemente acometida foi a Poodle (12,5%). Foram identificados 134 (81,2%) cães com cinco ou mais critérios de Favrot, sendo 32,7% animais com seis critérios, 26,7% com cinco critérios, 17,0% com sete critérios e 4,8% com oito critérios. Enfatiza-se o aparecimento em mais de 90% dos casos os critérios intradomiciliado, com prurido primário, responsivo à corticoterapia e com bordas das pinas não acometidas. Dos 165 animais avaliados, 115 (69,7%) eram portadores de uma ou mais afecções concomitantes à DAC, sendo a otite externa a principal (73%). Considera-se que os critérios de Favrot podem ser aplicados para a triagem dos pacientes com suspeita de dermatite atópica canina atendidos no HUVET-UFF.

The objective of this study was to analyze the occurrence of Favrot criteria in dogs diagnosed with Canine Atopic Dermatitis (CAD) at the Veterinary Hospital Professor Firmino Mársico Filho of Universidade Federal Fluminense, as well as its association with concomitant diseases. A total of 2199 propaedeutic records with dermatological complaints from 2016 and 2017 were analyzed. Of the total, 165 (7.5%) animals were diagnosed with CAD. Among those diagnosed with CAD, 94 (57%) were females and 71 (43%) males. Although crossbreed dogs were the majority of cases (22.4%), the purebred dog most frequently affected by CAD was the Poodle (12.5%). One hundred and thirty four (81.2%) animals were identified with five or more Favrot criteria, 32.7% animals with six criteria, 26.7% with five criteria, 17.0% with seven criteria and 4.8% with eight criteria. It emphasizes the appearance in more than 90% of criteria, dog living mostly indoors,alesional pruritus, glucocorticoid-responsive pruritus and nonaffected ear margins. Of the 165 animals evaluated, 115 (69.7%) had one or more conditions concomitant with CAD, with otitis externa being the main one (73%). It is considered that the Favrot criteria can be applied for the screening of patients with suspected canine atopic dermatitis treated at HUVET-UFF.

Safety and Effectiveness of Copaiba Oleoresin (C. reticulata Ducke) on Inflammation and Tissue Repair of Oral Wounds in Rats.

In traditional communities of the Brazilian Amazon, the copaiba oleoresin (C. reticulata Ducke) is widely known for its therapeutic activity, especially its wound healing and anti-inflammatory actions. Our study aimed to evaluate these effects in oral lesions and the safety of the dosage proposed. A punch biopsy wound was induced on the ventral surface of the tongue of forty-five male Wistar rats under anesthesia. Animals were randomly allocated to one of three groups based on the treatment: control, corticoid and copaiba. A daily dose of each treatment and vehicle was administrated by oral gavage for three consecutive days. Sample collections took place on the third, seventh and 15th days post-wounding for clinical and histopathological analyses. Blood was collected on the third and seventh days for kidneys and liver function tests. Semi-quantitative analyses were performed based on scores of inflammation and reepithelization. Tissue collagen deposition was detected by PicroSirius red staining. Copaiba-treated wounds revealed a smaller wound area, decreased of acute inflammatory reaction and enhanced reepithelization. The levels of kidney and liver function tests did not reveal presence of damage post-treatments. Our findings suggest that copaiba oleoresin is a safe and effective alternative therapy for inflammation and tissue repair of oral wounds in this animal model.

Comparison of photobiomodulation using either an intraoral or an extraoral laser on oral mucositis induced by chemotherapy in rats.

PURPOSE: The aim of the present study was to compare the effect of intraoral (IO) and extraoral (EO) diode laser irradiation on oral mucositis (OM) induced by 5-fluorouracil (5-FU) in rats. METHODS: Animals (n = 78) were divided into the following groups: negative control (NC), positive control (PC), IO 6 J/cm2, EO with 6 J/cm2 (EO 6 J/cm2), and 12 J/cm2 (EO 12 J/cm2). OM was induced with an intraperitoneal injection of 5-FU and scarification of the buccal mucosa. Over the following 14 days, animals received photobiomodulation (PBM) daily. Clinical and histological evaluation was done by scores at days 8, 10, and 14. The redox state was evaluated by reactive species levels, antioxidant network, and immunohistochemistry analysis. RESULTS: Clinically, on day 8, PBM groups showed lower scores of OM with EO 6 J/cm2 presenting a significantly lower degree compared to PC (p < 0.05). On days 10 and 14, all PBM groups exhibited improvement of OM compared to PC (p < 0.01). On day 8, all PBM groups exhibited an accelerated healing process compared to PC (p < 0.01) and reduction of reactive species (p < 0.001). Also, all PBM groups demonstrated higher levels of antioxidant GPx compared to PC (p < 0.001). Analysis of nitrotyrosine revealed that on day 14, this protein damage marker was significantly reduced in the EO 6 J/cm2 group (p > 0.05). CONCLUSIONS: An EO diode laser protocol promoted positive effects in the clinical, histopathological, and redox state in OM induced by 5-FU in rats. Among the EO protocols, EO 6 J/cm2 showed the most encouraging results.

Development of a chitosan hydrogel containing flavonoids extracted from Passiflora edulis leaves and the evaluation of its antioxidant and wound healing properties for the treatment of skin lesions in diabetic mice.

This study aimed to develop a chitosan-based hydrogel containing a mixture of flavonoids isolated from the leaves of Passiflora edulis Sims and to evaluate its stability, antioxidant properties, and wound healing effects on cutaneous lesions in diabetic rats. in vitro studies were carried out to evaluate the biocompatibility and flavonoid release from the chitosan hydrogel. in vivo wound healing studies were conducted on male Wistar rats, where the injured tissue was removed for histological analysis and determination of lipid peroxidation, superoxide dismutase activity, and glutathione peroxidase activity. From the histological analysis and macroscopic evaluation of the contraction of the wounds, it was observed that the formulation presented wound healing properties. In addition, treatment of the wound with the formulation stimulated the antioxidant defense system, suggesting a beneficial effect during the treatment of skin lesions in diabetic rats, especially in the first few days after wounding. According to these results, we can conclude that the chitosan hydrogel containing the flavonoid analyzed in this study has potential use as dressings in the treatment of wounds.

Characteristics and outcomes of patients with COVID-19 admitted to the ICU in a university hospital in São Paulo, Brazil - study protocol

OBJECTIVES: We designed a cohort study to describe characteristics and outcomes of patients with coronavirus disease (COVID-19) admitted to the intensive care unit (ICU) in the largest public hospital in Sao Paulo, Brazil, as Latin America becomes the epicenter of the pandemic. METHODS: This is the protocol for a study being conducted at an academic hospital in Brazil with 300 adult ICU beds dedicated to COVID-19 patients. We will include adult patients admitted to the ICU with suspected or confirmed COVID-19 during the study period. The main outcome is ICU survival at 28 days. Data will be collected prospectively and retrospectively by trained investigators from the hospital's electronic medical records, using an electronic data capture tool. We will collect data on demographics, comorbidities, severity of disease, and laboratorial test results at admission. Information on the need for advanced life support and ventilator parameters will be collected during ICU stay. Patients will be followed up for 28 days in the ICU and 60 days in the hospital. We will plot Kaplan-Meier curves to estimate ICU and hospital survival and perform survival analysis using the Cox proportional hazards model to identify the main risk factors for mortality. ClinicalTrials.gov: NCT04378582. RESULTS: We expect to include a large sample of patients with COVID-19 admitted to the ICU and to be able to provide data on admission characteristics, use of advanced life support, ICU survival at 28 days, and hospital survival at 60 days. CONCLUSIONS: This study will provide epidemiological data about critically ill patients with COVID-19 in Brazil, which could inform health policy and resource allocation in low- and middle-income countries.

Cuidados Paliativos: Prática dos Médicos da Estratégia Saúde da Família / Palliative Care: Practice of Family Health Strategy Physicians

RESUMO Com o avanço do conhecimento científico e aumento da expectativa de vida, criou-se a ilusão de que o ser humano é imortal. Ademais, existe uma deficiência na educação médica atual, que forma profissionais tecnicistas e sem preparo para cuidar de um paciente com doença grave e incurável. Por volta da metade do século XX, surgiram movimentos voltados para a humanização dos atendimentos em saúde, que levavam em consideração a integralidade do indivíduo. Cuidado paliativo é uma abordagem que melhora a qualidade de vida de pacientes e familiares diante de doenças que ameacem a continuidade da vida, por meio do alívio do sofrimento, tratamento da dor e de outros sintomas de natureza física, psicossocial e espiritual. Considerando que esse tipo de cuidado pode ser oferecido em diferentes contextos, ressalta-se que a Atenção Primária em Saúde é uma possibilidade recente para a assistência em cuidados paliativos. Entretanto, ainda existe uma dificuldade dos serviços de Atenção Primária no Brasil em oferecer essa modalidade de assistência. Assim, a pesquisa teve como objetivo compreender a percepção dos médicos da Estratégia Saúde da Família acerca dos cuidados paliativos. Trata-se de estudo descritivo, com abordagem qualitativa, em que foi utilizada a metodologia da análise temática. Os participantes foram 16 médicos que atuam nas Unidades Estratégia Saúde da Família do município de Lavras, Minas Gerais. Os dados foram coletados por meio de entrevista semiestruturada. Com base na análise dos dados identificou-se que os médicos possuem conhecimento incipiente sobre o conceito de cuidados paliativos e que, embora tenham tido algum tipo de experiência com esse tipo de paciente, apresentam dificuldade para abordá-lo de maneira holística. Isto se deve, principalmente, à deficiência na formação acadêmica, que ainda privilegia o conhecimento biomédico e a cura das doenças em detrimento do alívio do sofrimento humano. Conclui-se que é imprescindível abordar o tema durante a formação médica, bem como discuti-lo entre os profissionais já atuantes nos serviços de saúde para que seja possível proporcionar melhor qualidade de vida e de morte.

ABSTRACT With the advance of scientific knowledge and increased life expectancy, the illusion has been created that the human being is immortal. In addition, there is a deficiency in current medical training, whereby professional technicians are trained without being prepared to take care of a patient with serious and incurable disease. Towards the middle of the 20th century, there were movements aimed at the humanization of health care, which took into account the integrality of the individual. Palliative care is an approach that improves the quality of life of patients and their families in the face of life-threatening illnesses by relieving suffering, treating pain, and other symptoms of a physical, psychosocial and spiritual nature. Considering that this type of care can be offered in different contexts, it has recently been highlighted that Primary Health Care can be a suitable setting for palliative care assistance. However, there is still a difficulty for Primary Care services in Brazil to offer this kind of assistance. Thus, the research was aimed at understanding the perception of physicians of the Family Health Strategy about palliative care. A descriptive study, with a qualitative approach, using thematic analysis method. The participants were 16 physicians who work in the Family Health Strategy Units of the city of Lavras, Minas Gerais. Data were collected through a semi-structured interview. From the data analysis it was identified that the doctors have incipient knowledge regarding the concept of palliative care and that although they had some type of experience with this type of patient, they encounter difficulties in approaching it in a holistic way. This is mainly due to the deficiency in academic training, which still favors biomedical knowledge and the cure of diseases to the detriment of the relief of human suffering. It is concluded that it is essential that this topic be addressed during medical training, as well as discussed among the professionals already working in the health services so as to provide a better quality of life and death.

The Importance of Coordinated Actions in Preventing the Spread of Yellow Fever to Human Populations: The Experience from the 2016-2017 Yellow Fever Outbreak in the Northeastern Region of São Paulo State.

Yellow fever (YF) is a zoonotic arthropod-borne disease that is caused by the yellow fever virus (YFV) and characterized by a sylvatic and urban cycle. Its most severe presentation is manifested as a hemorrhagic disease, and it has been responsible for thousands of deaths in the last decades. This study describes the public health approaches taken to control the 2016-2017 YF outbreak in nonhuman primates (NHPs) that took place in the northeastern region of São Paulo state, Brazil. NHPs recovered from the field were necropsied, and YF diagnoses were made at the Laboratory of Molecular Virology, Ribeirão Preto Medical School and the Center of Pathology, Adolfo Lutz Institute of São Paulo. NHP samples were inoculated into Vero cells for YFV isolation. RNA extraction was performed directly from NHP tissues and tested by RT-qPCR. YFV-positive samples were confirmed by sequencing. Based on the rapid RT-qPCR results, surveillance actions were implemented in the entire region. Confirmatory histopathology and immunohistochemistry for YFV were also performed. Among nine NHPs, gross hepatic involvement was observed in six animals, five of which were YFV-RT-qPCR-positive. One YFV was isolated from the serum of an infant NHP. YFV RNA sequences diverged from the virus responsible for the last epizootic that occurred in São Paulo state, but it was similar to the current Brazilian epizootic. Public health actions included dissemination of information on YF transmission, investigation of the probable location of NHP infection, characterization of the environment, and subsequent creation of the blueprint from which prevention and control measures were implemented. The YFV sylvatic cycle occurred in the periurban areas of the northeastern region of São Paulo state, but no human cases were reported during this period, showing that integrated actions between human, animal, and environmental health professionals were critical to restrain the virus to the sylvatic cycle.

Recent Patents Applications in Red Biotechnology: A Mini-Review.

BACKGROUND: The different fields of biotechnology can be classified by colors, as a "rainbow" methodology. In this sense, the red biotechnology, focused on the preservation of health, has been outstanding in helping to solve this challenge through the provision of technologies, including diagnostic kits, molecular diagnostics, vaccines, innovations in cancer research, therapeutic antibodies and stem cells. OBJECTIVE: The main goal of this work is to highlight the different areas within the red Biotechnology. In this sense, we revised some patents regarding red biotechnology as examples to cover this subject. METHODS: A literature search of patents was performed from the followings Patents Database: INPI, USPTO, Esp@cenet, WIPO and Google Patents. RESULTS: Our analysis showed the following numbers from patents found: cancer research (8), diagnosis kit (9), vaccines (8), stem cells (9) and therapeutic antibodies (5), where the United States is the leader for most filled patents in Red Biotechnology. CONCLUSION: This mini-review has provided an update of some patents on Recent Patents in Red Biotechnology. As far as we know, this is the first mini-review report on Red Biotechnology based on patents.