Lignans Isolated from Piper truncatum Act as New Potent Antitrypanosomal Compounds.

The hexane extract from twigs of Piper truncatum Vell (Piperaceae) displayed activity against Trypanosoma cruzi and was subjected to chromatographic steps to afford six dibenzylbutyrolactolic lignans, being four knowns: cubebin (1), (-)-9α-O-methylcubebin (2), (+)-9ß-O-methylcubebinin (3) and 3,4-dimethoxy-3,4-demethylenedioxycubebin (4) as well as two new, named truncatin A (5) and B (6). Initially, in vitro activity against trypomastigotes was evaluated and compounds 1, 4 and 6 exhibited EC50 values of 41.6, 21.0 and 39.6 µM, respectively. However, when tested against amastigotes, the relevant clinical form in the chronic phase of Chagas disease, compounds 1-6 displayed activities with EC50 values ranging from 1.6 to 13.7 µM. In addition, the mammalian cytotoxicity of compounds 1-6 was evaluated against murine fibroblasts (NCTC). Compounds 2, 3 and 4 exhibited reduced toxicity against NCTC cells (CC50>200 µM), resulting in SI values of>21.9,>14.5 and>121.9, respectively. Compound 4 showed the highest potency with an SI value twice superior to that determined by the standard drug benznidazole (SI>54.6) against the intracellular amastigotes. These data suggest that lignan 4 can be considered a possible scaffold for designing a new drug candidate for Chagas disease.

Accuracy of trial restorations from virtual planning: A comparison of two fabrication techniques.

STATEMENT OF PROBLEM: Different technologies have been used to fabricate trial restorations. However, studies investigating the accuracy of trial restorations fabricated with different techniques in comparison with the initial 3-dimensional virtual design are lacking. PURPOSE: The purpose of this clinical study was to evaluate completely digital workflows for managing the esthetic outcome through the production of trial restorations with 2 different technologies: stereolithography apparatus (SLA 3D) and computer-aided design and computer-aided manufacturing (CAD-CAM). The aim was to determine which of them provided trial restorations more similar to those of the 3D virtual design. MATERIAL AND METHODS: Thirty participants who did not meet ideal esthetic proportions for the anterior maxillary teeth were enrolled. For each, 2 intraoral and extraoral frontal photographs and intraoral digital scans were made. The digital images were processed by using the Digital Smile System (DSS) software program to have a smile preview after the treatment. Virtual designs were matched with the surface tessellation language (STL) files from the intraoral scans and edited by exocad DentalCAD to create custom trial restorations using SLA 3D and CAD-CAM technologies. Two independent examiners measured the virtual restorations by using virtual calipers in the software program and then the trial restorations by using digital calipers. The measurements were carried out from the incisal edge to the gingival margin, mesial-distal widths of the central incisors, and the distance from the distal margins of maxillary right and left canines. The trial restorations were evaluated intraorally for fit. The participants approved the definitive treatment outcome after the evaluation. The normality of data was verified with the Shapiro-Wilk test, and the Friedman test for matched groups with the Bonferroni and Dunn tests for multiple comparisons were used (α=.05). RESULTS: Comparing the 3D designs with the printed trial restorations, a significant increase was only found in the mesial-distal width of central incisors (P<.05), while the milled trial restorations showed a significant increase (P<.05) of all measurements except for the maxillary right and left canines. Comparing printed trial restorations with the milled ones, the only significant difference was found in height measures of maxillary right central incisor, with the milled trial restorations exhibiting higher values than the printed ones (P<.05). The printed trial restorations showed good clinical fit, and the milled restorations had poor clinical adaptation. CONCLUSIONS: The accuracy of printed trial restorations was higher than that of milled trial restorations, except for the canine to canine width of maxillary anterior teeth. However, this difference did not compromise the fit of the printed trial restorations. The milled trial restorations had increased dimensions in comparison with the measurements made in 3D designs, and consequently, their clinical fit was compromised. SLA 3D- printing technology provided the best fit.

The step further smile virtual planning: milled versus prototyped mock-ups for the evaluation of the designed smile characteristics.

BACKGROUND: Mock-up based approach allows the preview of the aesthetic rehabilitation, however, it is crucial that the mock-up does not differ from the expected aesthetic outcomes. With CAD-CAM technologies, it is possible to directly create mock-ups from virtual planned smile project, with greater accuracy and efficiency compared to the conventional moulded mock-ups. In this study, we investigated the trueness of mock-ups obtained with milling and 3D printing technology and a full digital work-flow system. METHODS: Ten adults subjects were included and digital smile design/digital wax-up were performed to enhance the aesthetic of maxillary anterior region. Ten milled mock-ups and 10 prototyped mock-ups were obtained from the original .stl file and a digital analysis of trueness was carried out by superimposing the scanned-milled mock-ups and the scanned-prototyped mock-ups to the digital wax-up, according to the surface-to-surface matching technique. Specific linear measurements were performed to investigate and compare the dimensional characteristics of the physical manufactures, the 3D project and the scanned mock-ups. All data were statistically analyzed. A clinical test was also performed to assess the fitting of the final manufacture. RESULTS: The prototyped mock-ups showed a significant increment of the transversal measurements (p < 0.001) while the milled mock-ups showed a significant increment of all vertical and transversal measurements (p < 0.001). The prototyped mock-ups showed good fitting after clinical tests while none of the milled mock-ups showed good adaptation (no fitting or significant clinical compensation required). Deviation analysis from the original 3D project reported a greater matching percentage for the scanned-milled mock-ups (80,31% ± 2.50) compared to the scanned-prototyped mock-ups (69,17% ± 2.64) (p < 0.001). This was in contrast with the findings from linear measurements as well as from the clinical test and may have been affected by a reductive algorithmic computation after digitization of physical mock-ups. CONCLUSION: Both prototype and milled mock-ups showed a slight dimensional increment comparing to the original 3D project, with milled-mock-ups showing less fitting after clinical tests. Caution must be taken when assessing the trueness of scanned manufacture since an intrinsic error in the system can underestimate the dimensions of the real object.

[The role of gut microbiota in the regulation of the immune response]. / Rol de la microbiota gastrointestinal en la regulación de la respuesta inmune.

The gastrointestinal tract hosts around 10(14) bacterial microorganisms, in a constantly growing density from the stomach to the distal colon. This microbiota is composed by more than 500 species of bacteria, which are quickly acquired after birth, fairly stable during the host’s life, and essential for human homeostasis. These bacteria have important functions, such as stimulating the immune system, protecting the host from invading bacteria and viruses, and improving digestion, especially of complex carbohydrates. Also, the gut microbiota interacts directly with the immune system. However, the interaction of the intestinal epithelium and its microbiota with the immune system has yet to be fully understood. Secretory immunoglobulin A, produced by the plasma cells in Peyer’s patches and in the lamina propria, maintains non-invasive commensal bacteria and neutralize invasive pathogens. Dendritic cells migrate from the lamina propria of the secondary lymphoid organs to regulate gut immunity. They also have a key role maintaining luminal IgA and inducing the growth of regulatory T cells. Dendritic cells supervise the gut microenvironment too, keeping an immunological equilibrium and tolerance. The importance of the gut microbiota in regulating the immune system lies mostly in the homeostasis-or positive equilibrium. Thus, many diseases are a consequence of poor interactions or a loss of this equilibrium.

Effective Weight Loss for Children: A Meta-analysis of Intervention Studies 2002-2015.

BACKGROUND: Investigators have implemented a variety of strategies for managing and treating childhood overweight and obesity over the past decade, yet the high prevalence of childhood overweight or obesity remains. The aim of this meta-analysis was to examine the effectiveness of childhood overweight or obesity interventions addressing weight loss from 2002-September 2015. METHODS: The population focused on in this review were children who were overweight. The treatment group interventions focused on weight loss for overweight children, and included dietary, physical activity, life style changes, or a combination of treatments. Control groups received no treatment other than what they would usually receive in their normal daily lives including standard healthcare assessments. Outcomes for the studies were focused on whether the overweight children in the treatment groups lost weight. RESULTS: The criteria for the meta-analysis were met by 16 intervention studies, with a total of 19 outcomes reported within those studies. Two thousand, three hundred and seventeen participants ranged from 6 to 15 years of age with a mean age of 12 years or less. The majority of the 16 studies were conducted outside the United States (n = 13), with half reporting data on the cost of running the programming (n = 8) and were overwhelmingly conducted by interdisciplinary teams without nurses as members of the team (n = 13). The M effect was g = .732, p < .001 with a 95% confidence interval of 0.351 to 1.113, with quality scores ranging from 20 to 29 out of a possible 41. The heterogeneity analyses overall Q score was 378, an I-squared of 95, with a fail-safe N of 415. LINKING EVIDENCE TO ACTION: Diverse interventions included in this meta-analysis had a significant positive effect on weight loss in overweight children. Future research needs to focus on the role of the nurse in ensuring development and translation of the effective interventions in real world settings, at a scale that would move beyond small segments of the affected populations of overweight children.

Myriocin, a serine palmitoyltransferase inhibitor, blocks cytokinesis in Leishmania (Viannia) braziliensis promastigotes.

We studied the effect of myriocin, an inhibitor of serine palmitoyltransferase, on cultured Leishmania (Viannia) braziliensis promastigotes. Myriocin significantly reduced synthesis of inositol phosphorylceramide, the major sphingolipid expressed in promastigotes as characterized by thin layer chromatography and electrospray ionization mass spectrometry. Log-phase promastigotes treated with 1 µM myriocin showed a 52% reduction in growth rate and morphological alterations such as more rounded shape and shorter flagellum. Promastigotes treated with myriocin also displayed a variety of aberrant cell phenotypes. The percentage of cells with one nucleus and one kinetoplast (1N1K), following treatment with 1 or 5 µM myriocin, decreased from 89% (control value) to 27% or 3%, respectively. The percentage of cells with two nuclei (2N2K) varied from 7% (control value) to 19% and 6% for 1 or 5 µM myriocin-treated parasites, respectively. High percentage of myriocin-treated parasites exhibited large atypical cells presenting three or more nucleus (32% and 89% for 1 or 5 µM myriocin, respectively). Transmission electron microscopy following treatment with 1 µM myriocin showed the presence of 4N parasites possibly as a result of an incomplete cytokinesis. Addition of 3-ketodihidrosphingosine to myriocin-treated promastigotes rescue parasite growth and morphology. Addition of ethanolamine did not rescue the myriocin effect on parasite. Our findings indicate that sphingolipids are essential for the completion of cytokinesis, and may play a major role in cell proliferation in L. (V.) braziliensis, thus, differing from data described for Leishmania major sphingolipid-free mutant, where addition of ethanolamine rescue wild-type parasite characteristics.

Evaluation of first and second trimester maternal thyroid profile on the prediction of gestational diabetes mellitus and post load glycemia.

Maternal thyroid alterations have been widely associated with the risk of gestational diabetes mellitus (GDM). This study aims to 1) test the first and the second trimester full maternal thyroid profile on the prediction of GDM, both alone and combined with non-thyroid data; and 2) make that prediction independent of the diagnostic criteria, by evaluating the effectiveness of the different maternal variables on the prediction of oral glucose tolerance test (OGTT) post load glycemia. Pregnant women were recruited in Concepción, Chile. GDM diagnosis was performed at 24-28 weeks of pregnancy by an OGTT (n = 54 for normal glucose tolerance, n = 12 for GDM). 75 maternal thyroid and non-thyroid parameters were recorded in the first and the second trimester of pregnancy. Various combinations of variables were assessed for GDM and post load glycemia prediction through different classification and regression machine learning techniques. The best predictive models were simplified by variable selection. Every model was subjected to leave-one-out cross-validation. Our results indicate that thyroid markers are useful for the prediction of GDM and post load glycemia, especially at the second trimester of pregnancy. Thus, they could be used as an alternative screening tool for GDM, independently of the diagnostic criteria used. The final classification models predict GDM with cross-validation areas under the receiver operating characteristic curve of 0.867 (p<0.001) and 0.920 (p<0.001) in the first and the second trimester of pregnancy, respectively. The final regression models predict post load glycemia with cross-validation Spearman r correlation coefficients of 0.259 (p = 0.036) and 0.457 (p<0.001) in the first and the second trimester of pregnancy, respectively. This investigation constitutes the first attempt to test the performance of the whole maternal thyroid profile on GDM and OGTT post load glycemia prediction. Future external validation studies are needed to confirm these findings in larger cohorts and different populations.

Machine learning applied in maternal and fetal health: a narrative review focused on pregnancy diseases and complications.

Introduction: Machine learning (ML) corresponds to a wide variety of methods that use mathematics, statistics and computational science to learn from multiple variables simultaneously. By means of pattern recognition, ML methods are able to find hidden correlations and accomplish accurate predictions regarding different conditions. ML has been successfully used to solve varied problems in different areas of science, such as psychology, economics, biology and chemistry. Therefore, we wondered how far it has penetrated into the field of obstetrics and gynecology. Aim: To describe the state of art regarding the use of ML in the context of pregnancy diseases and complications. Methodology: Publications were searched in PubMed, Web of Science and Google Scholar. Seven subjects of interest were considered: gestational diabetes mellitus, preeclampsia, perinatal death, spontaneous abortion, preterm birth, cesarean section, and fetal malformations. Current state: ML has been widely applied in all the included subjects. Its uses are varied, the most common being the prediction of perinatal disorders. Other ML applications include (but are not restricted to) biomarker discovery, risk estimation, correlation assessment, pharmacological treatment prediction, drug screening, data acquisition and data extraction. Most of the reviewed articles were published in the last five years. The most employed ML methods in the field are non-linear. Except for logistic regression, linear methods are rarely used. Future challenges: To improve data recording, storage and update in medical and research settings from different realities. To develop more accurate and understandable ML models using data from cutting-edge instruments. To carry out validation and impact analysis studies of currently existing high-accuracy ML models. Conclusion: The use of ML in pregnancy diseases and complications is quite recent, and has increased over the last few years. The applications are varied and point not only to the diagnosis, but also to the management, treatment, and pathophysiological understanding of perinatal alterations. Facing the challenges that come with working with different types of data, the handling of increasingly large amounts of information, the development of emerging technologies, and the need of translational studies, it is expected that the use of ML continue growing in the field of obstetrics and gynecology.

The inhibitory activity of Lactobacillus spp. isolated from breast milk on gastrointestinal pathogenic bacteria of nosocomial origin.

Milk acts as a mean for transporting many essential substances from the mother to the child. In human beings, milk includes several predominant bacteria, such as staphylococci, streptococci, micrococci, lactobacilli, enterococci, lactococci and bifidobacteria. Besides, its intake favors the predominance of bifidobacteria and lactobacilli in the child's intestinal microbiota. The present work explores the isolation and selection of lactobacilli strains with probiotic potential, focusing in their degree of hydrophobicity and antagonism against important gastrointestinal nosocomial pathogens. 98 lactobacilli were isolated from 48 breast milk samples, with most strains belonging to the obligately homofermentative group (36.7%). 63% of the isolated strains showed a high degree of hydrophobicity when tested on three solvents and were selected for detecting antimicrobial activity against gastrointestinal pathogens, including Escherichia coli, Shigella spp, Pseudomonas spp and Salmonella spp strains. When applying the agar diffusion test, many isolated strains presented inhibitory activity against pathogenic strains. We observed that: Salmonella enteriditis was the most inhibited pathogen, and the strains with the most inhibitory power were AR2 and O1 (both highly hydrophobic lactic acid bacteria), which showed an opposing effect against all nosocomial pathogens tested. Although more in vitro, in vivo or clinical data would be needed before any conclusion on the probiotic properties of the strains can be drawn, our results demonstrate that some of the tested strains may have good probiotic potential for their inclusion in products targeting infants.

[Prevalence of bacterial vaginosis in Chilean sex workers]. / Prevalencia de vaginosis bacteriana en trabajadoras sexuales chilenas.

OBJECTIVE: To determine the prevalence of bacterial vaginosis (BV) in Chilean sex workers and relate the findings to sociodemographic, sexual, and clinical variables. METHODS: A sample of 379 sex workers seen in Chilean Sexual Health Monitoring and Care Units for check-ups was studied. All of them were interviewed to obtain their sociodemographic and sexual history. A clinical examination was performed that included the characteristics of vaginal discharge, pH, and amine test. A vaginal sample was taken for Gram stain. The Nugent criteria were used for the diagnosis of BV. The data was analyzed with EPI-INFO 3.4.1 and BioStat, using a degree of significance of P < 0.005. RESULTS: BV prevalence was 69.1%. The syndrome was not associated with the sociodemographic variables, age or education. BV was less common in women (married or unmarried) who lived with their partners than in single women (P < 0.001). There were no sexual variables associated with BV, whereas use of intrauterine devices was related (P < 0.0001). The presence of vaginal discharge, abnormal vaginal pH, and positive amine test were associated with infection (P < 0.0001). CONCLUSIONS: Like other studies conducted in different countries, this study observed that Chilean sex workers have a high prevalence of BV, with greater risk for women who use IUDs for birth control or women (married or unmarried) who do not live with their partners.

High levels of maternal total tri-iodothyronine, and low levels of fetal free L-thyroxine and total tri-iodothyronine, are associated with altered deiodinase expression and activity in placenta with gestational diabetes mellitus.

Gestational Diabetes Mellitus (GDM) is characterized by abnormal maternal D-glucose metabolism and altered insulin signaling. Dysregulation of thyroid hormones (TH) tri-iodethyronine (T3) and L-thyroxine (T4) Hormones had been associated with GDM, but the physiopathological meaning of these alterations is still unclear. Maternal TH cross the placenta through TH Transporters and their Deiodinases metabolize them to regulate fetal TH levels. Currently, the metabolism of TH in placentas with GDM is unknown, and there are no other studies that evaluate the fetal TH from pregnancies with GDM. Therefore, we evaluated the levels of maternal TH during pregnancy, and fetal TH at delivery, and the expression and activity of placental deiodinases from GDM pregnancies. Pregnant women were followed through pregnancy until delivery. We collected blood samples during 10-14, 24-28, and 36-40 weeks of gestation for measure Thyroid-stimulating hormone (TSH), Free T4 (FT4), Total T4 (TT4), and Total T3 (TT3) concentrations from Normal Glucose Tolerance (NGT) and GDM mothers. Moreover, we measure fetal TSH, FT4, TT4, and TT3 in total blood cord at the delivery. Also, we measured the placental expression of Deiodinases by RT-PCR, western-blotting, and immunohistochemistry. The activity of Deiodinases was estimated quantified rT3 and T3 using T4 as a substrate. Mothers with GDM showed higher levels of TT3 during all pregnancy, and an increased in TSH during second and third trimester, while lower concentrations of neonatal TT4, FT4, and TT3; and an increased TSH level in umbilical cord blood from GDM. Placentae from GDM mothers have a higher expression and activity of Deiodinase 3, but lower Deiodinase 2, than NGT mothers. In conclusion, GDM favors high levels of TT3 during all gestation in the mother, low levels in TT4, FT4 and TT3 at the delivery in neonates, and increases deiodinase 3, but reduce deiodinase 2 expression and activity in the placenta.

Lignans isolated from Piper truncatum act as new potent Antitrypanosomal compounds

The hexane extract from twigs of Piper truncatum Vell (Piperaceae) displayed activity against Trypanosoma cruzi and was subjected to chromatographic steps to afford six dibenzylbutyrolactolic lignans, being four knowns: cubebin (1), (−)-9α-O-methylcubebin (2), (+)-9β-O-methylcubebinin (3) and 3,4-dimethoxy-3,4-demethylenedioxycubebin (4) as well as two new, named truncatin A (5) and B (6). Initially, in vitro activity against trypomastigotes was evaluated and compounds 1, 4 and 6 exhibited EC50 values of 41.6, 21.0 and 39.6 μM, respectively. However, when tested against amastigotes, the relevant clinical form in the chronic phase of Chagas disease, compounds 1–6 displayed activities with EC50 values ranging from 1.6 to 13.7 μM. In addition, the mammalian cytotoxicity of compounds 1–6 was evaluated against murine fibroblasts (NCTC). Compounds 2, 3 and 4 exhibited reduced toxicity against NCTC cells (CC50>200 μM), resulting in SI values of>21.9,>14.5 and>121.9, respectively. Compound 4 showed the highest potency with an SI value twice superior to that determined by the standard drug benznidazole (SI>54.6) against the intracellular amastigotes. These data suggest that lignan 4 can be considered a possible scaffold for designing a new drug candidate for Chagas disease.

Antioxidants and Oxidative Stress: Focus in Obese Pregnancies.

The prevalence of obesity in women of childbearing age around the globe has dramatically increased in the last decades. Obesity is characterized by a low-state chronic inflammation, metabolism impairment and oxidative stress, among other pathological changes. Getting pregnant in this situation involves that gestation will occur in an unhealthy environment, that can potentially jeopardize both maternal and fetal health. In this review, we analyze the role of maternal obesity-induced oxidative stress as a risk factor to develop adverse outcomes during gestation, including reduced fertility, spontaneous abortion, teratogenesis, preeclampsia, and intrauterine growth restriction. Evidences of macromolecule oxidation increase in reactive oxygen species generation and antioxidant defense alterations are commonly described in maternal and fetal tissues. Thus, antioxidant supplementation become an interesting prophylactic and therapeutic tool, that yields positive results in cellular, and animal models. However, the results from most meta-analysis studying the effect of these therapies in complicated gestations in humans are not really encouraging. It is still to be analyzed whether these therapies could work if applied to cohorts of patients at a high risk, such as those with low concentration of antioxidants or obese pregnant women.

High Frequency of Chlamydia trachomatis Mixed Infections Detected by Microarray Assay in South American Samples.

Chlamydia trachomatis is one of the most common sexually transmitted infections worldwide. Based on sequence variation in the ompA gene encoding the major outer membrane protein, the genotyping scheme distinguishes 17 recognized genotypes, i.e. A, B, Ba, C, D, Da, E, F, G, H, I, Ia, J, K, L1, L2, and L3. Genotyping is an important tool for epidemiological tracking of C. trachomatis infections, including the revelation of transmission pathways and association with tissue tropism and pathogenicity. Moreover, genotyping can be useful for clinicians to establish the correct treatment when LGV strains are detected. Recently a microarray assay was described that offers several advantages, such as rapidity, ease of standardization and detection of mixed infections. The aim of this study was to evaluate the performance of the DNA microarray-based assay for C. trachomatis genotyping of clinical samples already typed by PCR-RFLP from South America. The agreement between both typing techniques was 90.05% and the overall genotype distribution obtained with both techniques was similar. Detection of mixed-genotype infections was significantly higher using the microarray assay (8.4% of cases) compared to PCR-RFLP (0.5%). Among 178 samples, the microarray assay identified 10 ompA genotypes, i.e. D, Da, E, F, G, H, I, J, K and L2. The most predominant type was genotype E, followed by D and F.

Comparison of multilocus sequence typing and multilocus typing microarray of Chlamydia trachomatis strains from Argentina and Chile.

This study compared conventional ompA genotyping of Chlamydia trachomatis with multilocus sequence typing (MLST) and multilocus typing (MLT) DNA microarray. DNA extracts of 104 C. trachomatis positive specimens were analyzed by ompA sequencing and MLST and of these 76 by MLT array. Obtained MLST sequence types (STs) were compared to sequences in the database http://mlstdb.uu.se. The resolution obtained for MLST (35 STs) was 2.1 higher than for ompA sequencing (17 variants) and 1.3 higher than MLT array (27 MLT groups). Among the 104 samples the predominant genotype E could be divided into 5 ompA variants and 23 STs of which 16 had not been reported in previous studies. The most common STs, ST3 and ST56, were identified as founders and are common in several countries on a global scale. The MLST and the MLT array provided similar strain discrimination capacity and showed considerably higher resolution than conventional ompA sequencing.

Rol de la microbiota gastrointestinal en la regulación de la respuesta inmune / The role of gut microbiota in the regulation of the immune response

The gastrointestinal tract hosts around 10(14) bacterial microorganisms, in a constantly growing density from the stomach to the distal colon. This microbiota is composed by more than 500 species of bacteria, which are quickly acquired after birth, fairly stable during the host’s life, and essential for human homeostasis. These bacteria have important functions, such as stimulating the immune system, protecting the host from invading bacteria and viruses, and improving digestion, especially of complex carbohydrates. Also, the gut microbiota interacts directly with the immune system. However, the interaction of the intestinal epithelium and its microbiota with the immune system has yet to be fully understood. Secretory immunoglobulin A, produced by the plasma cells in Peyer’s patches and in the lamina propria, maintains non-invasive commensal bacteria and neutralize invasive pathogens. Dendritic cells migrate from the lamina propria of the secondary lymphoid organs to regulate gut immunity. They also have a key role maintaining luminal IgA and inducing the growth of regulatory T cells. Dendritic cells supervise the gut microenvironment too, keeping an immunological equilibrium and tolerance. The importance of the gut microbiota in regulating the immune system lies mostly in the homeostasis-or positive equilibrium. Thus, many diseases are a consequence of poor interactions or a loss of this equilibrium.

Sobre o ensaísmo de Robert Musil / On Robert Musil's Essayism

Mais do que um princípio formal, a noção de ensaísmo de Robert Musil adquire o duplo estatuto de uma "utopia" e de uma atitude diante da realidade. é esse duplo viés que permitirá à arte preservar-se como potência crítica e epistemológica num contexto de crise cultural e de valores na Europa no início do XX. Este artigo aborda a noção de ensaísmo de Musil a partir de seus textos críticos e de seu romance O homem sem qualidades, demonstrando como as idéias expostas no registro estritamente "ensaístico" se configuram no âmbito da representação poética, consumando assim a "utopia" pretendida pelo autor, de fundar novas relações entre as esferas da razão e do sentimento, da ciência e da arte, da objetividade e da subjetividade.(AU)

Robert Musil's essayism concept is more than a formal principle: in his work this concept becomes at the same time a "utopia" and an attitude towards reality. This double aspect allows the art to preserve its critical and episthemological power in a European crisis context at the beginning of the 20th century. This paper deals with Musil's essayism in his critical essays and in his novel, Der Mann ohne Eigenschaften, pointing out how the essayistic ideas are outlined in the poetical representation, showing how one of the aspects of Musils "utopia" takes effect through the foundation of a new relation between reason and feeling, science and art, objectivity and subjectivity.(AU)

Prevalencia de vaginosis bacteriana en trabajadoras sexuales chilenas / Prevalence of bacterial vaginosis in Chilean sex workers

OBJETIVO: Determinar la prevalencia de vaginosis bacteriana (VB) en trabajadoras sexuales chilenas y relacionar los hallazgos con variables sociodemográficas, sexuales y clínicas. MÉTODO: Se estudió una muestra de 379 trabajadoras sexuales que asistían para control a Unidades de Atención y Control de Salud Sexual de Chile. A todas se las entrevistó para obtener antecedentes sociodemográficos y sexuales, se les realizó evaluación clínica que incluyó características del flujo vaginal, pH y prueba de aminas, y se les tomó una muestra vaginal para tinción de Gram. Para el diagnóstico de VB se empleó el criterio de Nugent. Los datos fueron analizados con EPI-INFO 3.4.1 y BioStat, utilizándose un grado de significación de P < 0,005. RESULTADOS: La prevalencia de VB fue de 69,1 por ciento. El síndrome no se asoció a las variables sociodemográficas edad y escolaridad. Las mujeres que vivían (casadas o no) con su pareja tuvieron menos frecuencia de VB en comparación con las mujeres solteras (P < 0,001). No hubo variables sexuales asociadas a VB, en tanto que el empleo del dispositivo intrauterino (DIU) sí lo estuvo (P < 0,0001). La presencia de descarga vaginal, pH vaginal alterado y prueba de aminas positiva se asociaron a la infección (P < 0,0001). CONCLUSIONES: En coincidencia con otros estudios realizados distintos países, el presente trabajo observó que las trabajadoras sexuales chilenas tienen una alta prevalencia de VB, con mayor riesgo para aquellas que usan DIU como método de anticoncepción o que no conviven (casadas o no) con su pareja.

OBJECTIVE: To determine the prevalence of bacterial vaginosis (BV) in Chilean sex workers and relate the findings to sociodemographic, sexual, and clinical variables. METHODS: A sample of 379 sex workers seen in Chilean Sexual Health Monitoring and Care Units for check-ups was studied. All of them were interviewed to obtain their sociodemographic and sexual history. A clinical examination was performed that included the characteristics of vaginal discharge, pH, and amine test. A vaginal sample was taken for Gram stain. The Nugent criteria were used for the diagnosis of BV. The data was analyzed with EPI-INFO 3.4.1 and BioStat, using a degree of significance of P < 0.005. RESULTS: BV prevalence was 69.1 percent. The syndrome was not associated with the sociodemographic variables, age or education. BV was less common in women (married or unmarried) who lived with their partners than in single women (P < 0.001). There were no sexual variables associated with BV, whereas use of intrauterine devices was related (P < 0.0001). The presence of vaginal discharge, abnormal vaginal pH, and positive amine test were associated with infection (P < 0.0001). CONCLUSIONS: Like other studies conducted in different countries, this study observed that Chilean sex workers have a high prevalence of BV, with greater risk for women who use IUDs for birth control or women (married or unmarried) who do not live with their partners.

Estudo da efetividade de um meio de desinfecção no controle de contaminação cruzada durante o polimento de próteses / A study of the effectiveness of a desinfection method on the cross-contamination control during prosthesis polishing

Os meios de desinfecção empregados em prótese dentária visam prevenir contaminação cruzada durante todas as etapas clínicas e laboratoriais do tratamento protético. O presente estudo avaliou a efetividade da mistura da pedra-pomes utilizada para polimento com um desinfetante químico, associada à desinfecção prévia da prótese. Por meio da realização de testes microbiológicos das próteses e da pedra-pomes utilizada verificou-se que o meio de polimento sem tratamento desinfectante é uma fonte potencial de contaminação cruzada, mesmo quando a prótese a ser polida é previamente desinfectada, evidenciada pela alta prevalência de pactérias não-orais, principanmente Acinetobacter e Bacillus Gram-negativos. Por outro lado, comprovou-se que a desinfecção prévia da prótese, seguida de polimento em meio desinfectado elimina os riscos de contaminação cruzada durante o polimento. Dessa forma, concluiu-se que a associação da pedra-pomes com o hipoclorito de sódio é um meio efetivo de prevenção de contaminação cruzada no laboratório de prótese e entree o laboratório e o consultório odontológico