Cafeteria Diet Can Affect Bone Microarchitecture in Sedentary and Trained Male Rats.

INTRODUCTION: Poor eating habits and a sedentary lifestyle can impair health. Regular physical activity improves the quality of life and is essential for bone health. Therefore, the present study aimed to evaluate the effects of the cafeteria diet on bone quality of sedentary and exercised rats. METHODS: Sixty young male Wistar rats were divided into six groups (n=10) according to diet composition and activity level, being: SD+CON, standard diet and control; SD+SED, standard diet and sedentary; SD+EX, standard diet and exercised; CD+CON, cafeteria diet and control; CD+SED, cafeteria diet and sedentary; CD+EX, cafeteria diet and exercised. The exercise protocol consisted of 10 ladder-climbing sessions/day, 5 days/week, and the sedentary rats were maintained in individual cages with limited mobility. Body mass and food intake were evaluated weekly. After 10 weeks, the animals were euthanized, and white adipose tissue was collected. The bone structure was evaluated by densitometry, mechanical tests, histomorphometric, and micro-computed tomography analyses. RESULTS: The cafeteria diet increased adipose tissue (p<0.001), decreased bone mineral density (p=0.004), and impaired biomechanical properties (p<0.05) and histomorphometry parameters (p=0.044). The sedentarism decreased bone mineral density (p<0.001) and biomechanical properties (p<0.05), and the exercise did not improve bone properties. CONCLUSION: In this experimental model, it was concluded that the cafeteria diet and a sedentary lifestyle negatively affect bone, and ladder-climbing exercise could not prevent the effects of the unhealthy diet.

Effect of disinfectants on multispecies biofilm, the physical and mechanical properties of polymethyl methacrylate, and the corrosion of cobalt chromium alloy.

STATEMENT OF PROBLEM: The optimal disinfection protocol that controls adverse effects and promotes effective antimicrobial action on removable prostheses is unclear. PURPOSE: This in vitro study investigated the effect of disinfectant solutions on the biological, physical, mechanical, and chemical properties of removable prosthesis materials. MATERIAL AND METHODS: Specimens of polymethyl methacrylate (PMMA) and cobalt chromium (Co-Cr) alloy were immersed in distilled water (PMMA) or artificial saliva (Co-Cr) as the control and in 0.25% sodium hypochlorite (NaOCl0.25%), 0.5% chloramine T (CT0.5%), and 0.15% Triclosan (TR0.15%). The antibiofilm activity was evaluated by microbial load and cell metabolisms of the mixed biofilm. Physical (color change, sorption, solubility, and surface roughness), mechanical (hardness, flexural, and impact strength), and chemical (corrosion) properties were analyzed before and after simulating a 5-year immersion. Laser confocal microscopy, scanning electron microscopy (SEM), and dispersive energy spectroscopy (EDS) complemented the analyses. The data were analyzed by using the Mann-Whitney U test, Kruskal-Wallis with Dunn posttests, 1-way ANOVA, and repeated measures ANOVA (α=.05). RESULTS: All solutions were effective against bacteria, but only NaOCl0.25% eliminated Candida spp. TR0.15%, and CT0.5% increased cell metabolisms. For interaction (time and solution), there was a reduction in PMMA hardness in the control and TR0.15%. Color, sorption, solubility, and flexural strength did not change. CT0.5% and TR0.15% were similar for impact resistance. CT0.5% caused the lowest roughness. NaOCl0.25% showed the greatest corrosive potential. Dark spots were seen under SEM in Co-Cr stored with NaOCl0.25% and TR0.15%. EDS indicated different proportions of oxygen, cobalt, chromium, and molybdenum. CONCLUSIONS: NaOCl0.25% had the best antimicrobial action. CT0.5% and TR0.15% have potential. Hardness and roughness changes were clinically acceptable, and the other properties remained unchanged. All the solutions caused color changes. NaOCl0.25% was unsatisfactory for use with Co-Cr, CT0.5% was intermediate, and TR0.15% was suitable.

An in vitro study using confocal laser scanning microscopy to evaluate the marginal misfits of different implant-supported frameworks.

PURPOSE: This study aimed to develop and evaluate a simple, non-destructive method for assessing the misfit and passivity of implant-retained prostheses frameworks. MATERIALS AND METHODS: To simulate the rehabilitation of a mandible posterior partially edentulous area using 3-unit screw-retained frameworks supported by two implants were fabricated and divided into the following five groups (n = 10 in each group): OP = one-piece framework cast in Co-Cr with the conventional method (control-group); Co-Cr frameworks sectioned and welded by laser (=LAS) or tungsten inert gas (=TIG); Co-Cr CAD-CAM = milled Co-Cr framework; Zir CAD-CAM = milled zirconia framework. The horizontal |X| and vertical |Y| misfits were measured using confocal laser scanning microscopy with one or both screws tightened. Data were analyzed by a two-way ANOVA with repeated measures and Bonferroni correction (α = 0.05). RESULTS: The greatest |X| misfit was observed in the OP group with both screws tightened (290 µm) and one screw tightened (388 and 340 µm). The conventional casting groups sectioned and welded by laser or TIG had lower mean values (235.35 µm, both screws tightened; and 275 µm, one screw tightened) than the OP framework. However, these values still exceeded those of the milled Co-Cr and zirconia frameworks (190 and 216 µm with both screws tightened). Across all reading conditions, every framework subjected to testing consistently maintained vertical |Y| misfit levels below the threshold of 53 µm; however, the milled frameworks exhibited higher vertical misfits than the frameworks obtained by the conventional cast method. CONCLUSIONS: The frameworks, whether cast and sectioned with laser welding or milled from Co-Cr, exhibit improved marginal misfit and enhanced passive fit when compared to other fabrication methods. Additionally, the use of confocal laser scanning microscopy is highly effective for passivity and misfit analysis.

Psychometric properties analysis of helping relationships skills inventory for Portuguese nurses and doctors.

This paper answered some authors' requests to analyze the Helping Relationships Skills Inventory psychometric properties, a four dimensions measure. At this level, the study contributed to accessing the first reliable and valid instrument headed to Portuguese nurses and doctors. Methods: An online survey with Portuguese nurses and doctors (n = 262) was managed to assess the psychometrics properties analysis of the Helping Relationships Skills Inventory. Data were analyzed using descriptive statistics, confirmatory factor analysis, the average variance extracted (AVE), the heterotrait-monotrait ratio of correlations (HTMT), Cronbach's Alpha, and McDonald's Omega were computed. Results: The four-factor of the original Helping Relationships Skills Inventory was only supported by Exploratory Factor Analysis, with good internal consistency. Our study accepted this correlational structure hypothesis, which demonstrated acceptable to good sensitivity, convergent validity (AVE: 0.84-0.67), and reliability (Cronbach's Alpha: 0.92-0.88; McDonald'Omega: 0.93-0.79). Also stays verified discriminant validity for the majority of the factors with some reserves between Generics and Emphatics dimensions (HTMT: 0.90), revealing high commonality among them (r = 0.84; p < .001) Conclusions: The findings support the sensitivity, construct validity, and reliability of the Helping Relationships Skills Inventory among Portuguese nurses and doctors. However, will be useful to associate qualitative methodologies to explore the phenomenon better.

Sleep Disorders and Subjective Well-Being in Portuguese Adults: Evidence from a Representative Study.

Objective The quality and quantity of sleep affect people's well-being, as chronic sleep disorders are associated with social, physical, and psychological problems, as well as low self-reported life satisfaction. The present cross-sectional study examined the associations of sleep disorders with self-reported life satisfaction in Portuguese adults. Materials and Methods Data from a representative sample of the Portuguese population (14,341 participants, aged ≥ 18 years) extracted from the Sixth Portuguese National Health Survey was analyzed. Data on subjective well-being and sleep disorders was collected through a questionnaire, and multivariable regression models were performed to examine the associations between these variables, adjusted for potential confounders such as age, gender, level of schooling, degree of urbanization, and family income. Results Sleep disorders were negatively associated with self-reported life satisfaction. Having at least one sleep disturbance in the last two weeks was significantly associated with a 3-point decrease in life satisfaction: ß = -3.0 (95% confidence interval = -3.2--2.7). Discussion Among Portuguese adults, sleep disorders were associated with a decline in life satisfaction. The present study provides new evidence from a representative sample to support the promotion of good sleep hygiene intervention programs.

Evaluation of surface roughness, wettability and adhesion of multispecies biofilm on 3D-printed resins for the base and teeth of complete dentures.

OBJECTIVE: This study evaluated the surface roughness, wettability and adhesion of multispecies biofilms (Candida albicans, Staphylococcus aureus and Streptococcus mutans) on 3D-printed resins for complete denture bases and teeth compared to conventional resins (heat-polymerized acrylic resin; artificial pre-fabricated teeth). METHODOLOGY: Circular specimens (n=39; 6.0 mm Ø × 2.0 mm) of each group were subjected to roughness (n=30), wettability (n=30) and biofilm adhesion (n=9) tests. Three roughness measurements were taken by laser confocal microscopy and a mean value was calculated. Wettability was evaluated by the contact angle of sessile drop method, considering the mean of the three evaluations per specimen. In parallel, microorganism adhesion to resin surfaces was evaluated using a multispecies biofilm model. Microbial load was evaluated by determining the number of Colony Forming Units (CFU/mL) and by scanning electron microscopy (SEM). Data were subjected to the Wald test in a generalized linear model with multiple comparisons and Bonferroni adjustment, as well as two-way ANOVA (α=5%). RESULTS: The roughness of the conventional base resin (0.01±0.04) was lower than that of the conventional tooth (0.14±0.04) (p=0.023) and 3D-printed base (0.18±0.08) (p<0.001). For wettability, conventional resin (84.20±5.57) showed a higher contact angle than the 3D-printed resin (60.58±6.18) (p<0.001). Higher microbial loads of S. mutans (p=0.023) and S. aureus (p=0.010) were observed on the surface of the conventional resin (S. mutans: 5.48±1.55; S. aureus: 7.01±0.57) compared to the 3D-printed resin (S. mutans: 4.11±1.96; S. aureus: 6.42±0.78). The adhesion of C. albicans was not affected by surface characteristics. The conventional base resin showed less roughness than the conventional dental resin and the printed base resin. CONCLUSION: The 3D-printed resins for base and tooth showed less hydrophobicity and less adhesion of S. mutans and S. aureus than conventional resins.

DHA and EPA in Sickle Cell Disease Favor Clinical Improvement and Contribute to Better Quality of Life: A Qualitative Systematic Review.

BACKGROUND: Sickle cell disease is a severe genetic disorder, and searching for therapeutic strategies is indispensable for prolonged and improved life for people affected by this condition. OBJECTIVE: This qualitative systematic review aimed to highlight the therapeutic potential of omega- 3 (n-3) in people with sickle cell disease. METHODS: The search was performed by combining sickle cell disease and n-3 descriptors in DeCS/ MeSH databases, including Scopus, PubMed, ScienceDirect, Web of Science, and Virtual Health Library. The risk of bias assessment in the primary studies was performed using the Cochrane risk of bias tool for randomized controlled trials. The evidence quality was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool. RESULTS: From the 187 records identified, seven were selected for data collection. Based on the evidence, n-3 supplementation contributes to lower activation of pro-inflammatory biomarkers, improves the concentration of docosahexaenoic and eicosapentaenoic acids in the erythrocyte membrane, provides better hemostatic response, and helps in vaso-occlusive crisis, pain episodes, and hospitalization reduction. CONCLUSION: The findings suggest that n-3 adjuvant therapy favors the clinical and general aspects of people with sickle cell disease.

Effectiveness of experimental dentifrices based on essential oils on biofilm on complete dentures: an in vitro study.

Specific products containing natural resources can contribute to the innovation of complete denture hygiene. OBJECTIVE: To conduct an in vitro evaluation of experimental dentifrices containing essential oils of Bowdichia virgilioides Kunth (BvK), Copaifera officinalis (Co), Eucalyptus citriodora (Ec), Melaleuca alternifolia (Ma) and Pinus strobus (Ps) at 1%. METHODOLOGY: The variables evaluated were organoleptic and physicochemical characteristics, abrasiveness (mechanical brushing machine) simulating 2.5 years, and microbial load (Colony Forming Units - CFU/mL), metabolic activity (XTT assay) and cell viability (Live/Dead® BacLight™ kit) of the multispecies biofilm (Streptococcus mutans: Sm, Staphylococcus aureus: Sa, Candida albicans: Ca and Candida glabrata: Cg). Specimens of heat-polymerized acrylic resins (n=256) (n=96 specimens for abrasiveness, n=72 for microbial load count, n=72 for biofilm metabolic activity, n=16 for cell viability and total biofilm quantification) with formed biofilm were divided into eight groups for manual brushing (20 seconds) with a dental brush and distilled water (NC: negative control), Trihydral (PC: positive control), placebo (Pl), BvK, Co, Ec, Ma or Ps. After brushing, the specimens were washed with PBS and immersed in Letheen Broth medium, and the suspension was sown in solid specific medium. The organoleptic characteristics were presented by descriptive analysis. The values of density, pH, consistency and viscosity were presented in a table. The data were analyzed with the Wald test in a generalized linear model, followed by the Kruskal-Wallis test, Dunn's test (mass change) and the Bonferroni test (UFC and XTT). The Wald test in Generalized Estimating Equations and the Bonferroni test were used to analyze cell viability. RESULTS: All dentifrices showed stable organoleptic characteristics and adequate physicochemical properties. CN, Ec, Ps, Pl and PC showed low abrasiveness. There was a significant difference between the groups (p<0.001) for microbial load, metabolic activity and biofilm viability. CONCLUSIONS: It was concluded that the BvK, Ec and Ps dentifrices are useful for cleaning complete dentures, as they have antimicrobial activity against biofilm. The dentifrices containing Bowdichia virgilioides Kunth showed medium abrasiveness and should be used with caution.

Rho-Kinase Is Differentially Expressed in the Adipose Tissue of Rodent and Human in Response to Aging, Sex, and Acute Exercise.

White adipose tissue (WAT) controls energy storage, expenditure, and endocrine function. Rho-kinase (ROCK) is related to impaired thermogenesis, downregulation of preadipocyte differentiation, and adipokine production. Furthermore, WAT ROCK responds to metabolic stress from high-fat diets or diabetes. However, ROCK distribution in adipose depots and its response to aging and sex remain unclear. Thus, we aim to investigate ROCK function in adipose tissue of rodent and human in response to aging and sex. We observed specific differences in the ROCK1/2 distribution in inguinal WAT (ingWAT), perigonadal WAT (pgWAT), and brown adipose tissue of male and female rodents. However, ROCK2 expression was lower in female ingWAT compared with males, a fact that was not observed in the other depots. In the pgWAT and ingWAT of male and female rodents, ROCK activity increased during development. Moreover, middle-aged female rodents and humans showed downregulation in ROCK activity after acute physical exercise. Interestingly, ROCK levels were associated with several inflammatory markers both in rats and humans WAT (Nfkb1, Tnf, Il1b, Il6, and Mcp1). Induction of cell senescence by etoposide elevates ROCK activity in human preadipocytes; however, silencing ROCK1/2 demonstrates improvement in the inflammatory and cell senescence state. Using public databases, several pathways were strongly associated with ROCK modulation in WAT. In summary, WAT ROCK increases with development in association with inflammatory markers. Further, ROCK activity was attenuated by acute physical exercise, implicating it as a possible therapeutic target for metabolism improvement mediated by adipose tissue inflammatory state changes.

Influence of the frameworks of implant-supported prostheses and implant connections on stress distribution.

BACKGROUND: The maintenance of marginal bone integrity around dental implants continues to be a clinical challenge. It is still unclear whether loading multiple implant-supported prostheses that have different implant connections influences bone resorption. OBJECTIVES: The aim of this in vitro study was to compare stress distribution around residual edentulous ridges supported by external hexagon (EH) and Morse taper (MT) implants with screw-retained frameworks obtained with the use of different methods. MATERIAL AND METHODS: Three-element implant-supported prostheses with distal cantilevers were manufactured according to different techniques of obtaining the framework: LAS - framework sectioned and welded with a laser; TIG - framework sectioned and welded with tungsten inert gas (TIG); and CCS - framework obtained using a computer-aided design/computer-aided manufacturing (CAD/CAM) system. Occlusal and punctual loading (150 N) was applied to the cantilevers. In the photoelastic stress analysis, the fringe orders (n) were quanitified using the Tardy method, which calculates the maximum shear stress value (τ) at each selected point. RESULTS: High stress around the implants and tightening were observed in the TIG group, mainly in the crestal bone region for the EH and MT implant connections. The LAS and CCS frameworks exhibited lower stress for the MT connection under occlusal and punctual loading. CONCLUSIONS: The comparative analysis of the models showed that the MT connection type associated with the laser-welded or CAD/CAM frameworks resulted in lower stress values in the crestal bone area, suggesting the preservation of bone tissue in this region.

Relation between the risk factors for the severity of denture stomatitis and quality of life of complete edentulous individuals: a cross-sectional study.

OBJECTIVE: To assess the association between risk factors for developing denture stomatitis (DS) and oral health-related quality of life (OHRQoL) in complete denture wearers. METHODOLOGY: Participants of both sexes, wearing complete dentures, were classified using the modified Newton classification for the absence or the severity of DS and allocated to groups Normal or zero, IA, IB, II, and III. Lifestyle, oral and denture history, and medication use were assessed using specific questionnaires; clinical parameters such as anatomical characteristics of support were evaluated with the Kapur classification; salivary flow (SF) was calculated by the volume of unstimulated saliva per minute; and microbial load was determined by counting colony forming units (CFU) of target microorganisms present in the biofilm collected from dentures and palate. OHIP-EDENT assessed the OHRQoL. Kendall's tau_b and Spearman tests were applied with a significance level of 5%. RESULTS: 184 patients (143 female and 41 male) aged 65.5 ± 6.8 years were evaluated. Positive correlations were found for sex (women; p=0.013, r=0.16), individuals who started to consume alcoholic beverages as a young adult (18-27 years) (p=0.008, r=0.22), CFU of Candida spp. (p<0.001, r=0.27 denture; p<0.001, r=0.31 palate); Candida albicans (p=0.004, r=0.22 denture; p=0.003, r=0.25 palate), and Candida glabrata (p=0.004, r=0.22 denture; p=0.001, r=0.27 palate). Moreover, negative correlations with DS were found for CFU of Staphylococcus spp. (p=0.004, r=-0.20 palate) and enterobacteria (p=0.002, r=-0.24 palate), as well as a negative correlation between SF (p=0.009, r=-0.193) and DS. The CFU of Staphylococcus spp. and enterobacteria on the palate significantly correlated with OHRQoL. CONCLUSION: Being female, consuming alcoholic beverages as a young adult, CFU of Candida spp., Candida albicans, Candida glabrata, and salivary flow may be the most significant risk factors for DS. The microbial load of Staphylococcus spp. and enterobacteria seems to influence the quality of life for complete denture wearers.

Evaluation of surface roughness, wettability and adhesion of multispecies biofilm on 3D-printed resins for the base and teeth of complete dentures

Abstract Studies evaluating the roughness, wettability and microbial adhesion of 3D-printed resins for complete denture bases and teeth are scarce. Objective This study evaluated the surface roughness, wettability and adhesion of multispecies biofilms (Candida albicans, Staphylococcus aureus and Streptococcus mutans) on 3D-printed resins for complete denture bases and teeth compared to conventional resins (heat-polymerized acrylic resin; artificial pre-fabricated teeth). Methodology Circular specimens (n=39; 6.0 mm Ø × 2.0 mm) of each group were subjected to roughness (n=30), wettability (n=30) and biofilm adhesion (n=9) tests. Three roughness measurements were taken by laser confocal microscopy and a mean value was calculated. Wettability was evaluated by the contact angle of sessile drop method, considering the mean of the three evaluations per specimen. In parallel, microorganism adhesion to resin surfaces was evaluated using a multispecies biofilm model. Microbial load was evaluated by determining the number of Colony Forming Units (CFU/mL) and by scanning electron microscopy (SEM). Data were subjected to the Wald test in a generalized linear model with multiple comparisons and Bonferroni adjustment, as well as two-way ANOVA (α=5%). Results The roughness of the conventional base resin (0.01±0.04) was lower than that of the conventional tooth (0.14±0.04) (p=0.023) and 3D-printed base (0.18±0.08) (p<0.001). For wettability, conventional resin (84.20±5.57) showed a higher contact angle than the 3D-printed resin (60.58±6.18) (p<0.001). Higher microbial loads of S. mutans (p=0.023) and S. aureus (p=0.010) were observed on the surface of the conventional resin (S. mutans: 5.48±1.55; S. aureus: 7.01±0.57) compared to the 3D-printed resin (S. mutans: 4.11±1.96; S. aureus: 6.42±0.78). The adhesion of C. albicans was not affected by surface characteristics. The conventional base resin showed less roughness than the conventional dental resin and the printed base resin. Conclusion The 3D-printed resins for base and tooth showed less hydrophobicity and less adhesion of S. mutans and S. aureus than conventional resins.

Effectiveness of experimental dentifrices based on essential oils on biofilm on complete dentures: an in vitro study

Abstract Specific products containing natural resources can contribute to the innovation of complete denture hygiene. Objective: To conduct an in vitro evaluation of experimental dentifrices containing essential oils of Bowdichia virgilioides Kunth (BvK), Copaifera officinalis (Co), Eucalyptus citriodora (Ec), Melaleuca alternifolia (Ma) and Pinus strobus (Ps) at 1%. Methodology: The variables evaluated were organoleptic and physicochemical characteristics, abrasiveness (mechanical brushing machine) simulating 2.5 years, and microbial load (Colony Forming Units - CFU/mL), metabolic activity (XTT assay) and cell viability (Live/Dead® BacLight™ kit) of the multispecies biofilm (Streptococcus mutans: Sm, Staphylococcus aureus: Sa, Candida albicans: Ca and Candida glabrata: Cg). Specimens of heat-polymerized acrylic resins (n=256) (n=96 specimens for abrasiveness, n=72 for microbial load count, n=72 for biofilm metabolic activity, n=16 for cell viability and total biofilm quantification) with formed biofilm were divided into eight groups for manual brushing (20 seconds) with a dental brush and distilled water (NC: negative control), Trihydral (PC: positive control), placebo (Pl), BvK, Co, Ec, Ma or Ps. After brushing, the specimens were washed with PBS and immersed in Letheen Broth medium, and the suspension was sown in solid specific medium. The organoleptic characteristics were presented by descriptive analysis. The values of density, pH, consistency and viscosity were presented in a table. The data were analyzed with the Wald test in a generalized linear model, followed by the Kruskal-Wallis test, Dunn's test (mass change) and the Bonferroni test (UFC and XTT). The Wald test in Generalized Estimating Equations and the Bonferroni test were used to analyze cell viability. Results: All dentifrices showed stable organoleptic characteristics and adequate physicochemical properties. CN, Ec, Ps, Pl and PC showed low abrasiveness. There was a significant difference between the groups (p<0.001) for microbial load, metabolic activity and biofilm viability. Conclusions: It was concluded that the BvK, Ec and Ps dentifrices are useful for cleaning complete dentures, as they have antimicrobial activity against biofilm. The dentifrices containing Bowdichia virgilioides Kunth showed medium abrasiveness and should be used with caution.

Finite element analysis of a new intervertebral disc prosthesis developed for the canine cervical spine / Elementos finitos de uma nova prótese de disco intervertebral desenvolvida para a coluna cervical canina

Cervical spondylomyelopathy (CSM) is a disease that affects mostly large- and giant-breed dogs. It is characterized by abnormalities of the cervical spine that may cause damage to the spinal cord and nerve roots. Cervical disc arthroplasty has been proposed as a treatment option in veterinary medicine. The current study evaluated the main stresses in a novel canine vertebral disc prosthesis and vertebral bodies using finite element analysis. Two experimental groups were created based on the material used for the prosthesis: stainless steel group (SSG) and titanium alloy group (TAG). Vertebral and prosthetic average equivalents von-Mises stress (VMS) and minimum principal stress (MiPS) were assessed while compressive, tensile, and lateral bending shear loads were applied. The stainless steel group had greater VMS distribution on all the evaluated parameters while the titanium alloy group had greater MiPS. Stresses were more concentrated on the lateral and ventral surfaces of the vertebral bodies than on their endplates. The average prosthetic stresses were more concentrated on the bone/implant contact surface than on the prosthesis/screw interface. Maximum stresses were concentrated in the screws' cranial surface. The novel prosthesis allows even distribution along the vertebral body. Comparing prosthesis materials, titanium alloy was marginally superior regarding average stresses in all directions and should be less likely to suffer subsidence.

Espondilomielopatia cervical (EMC) é uma doença que geralmente afeta cães de raças grandes e gigantes. Ela é caracterizada por anormalidades da coluna cervical que podem causar danos à medula espinhal ou às raízes nervosas. Artroplastia cervical com prótese de disco tem sido proposta como opção de tratamento na medicina veterinária. O presente estudo teve como objetivo avaliar os principais estresses em uma nova prótese de disco intervertebral canina e corpos vertebrais por meio da análise de elementos finitos. Foram compostos dois grupos experimentais que representaram o material constituinte da nova prótese: grupos aço inoxidável (SSG) e o liga de titânio (TAG). Tensões equivalente de von-Mises (VMS) e tensão principal mínima (MiPS) média foram avaliadas sob forças de compressão, tração e torção para vértebras e prótese. O grupo SSG teve maior distribuição de VMS para todos parâmetros avaliados, enquanto o grupo TAG teve maior MiPS. Estresses estiveram mais concentrados nas superfícies lateral e ventral dos corpos vertebrais do que nas placas terminais. Os estresses médios da prótese foram mais concentrados na superfície de contato osso/implante do que na interface prótese/parafuso. Estresses máximos foram concentrados na superfície cranial do parafuso. A nova prótese permitiu distribuição uniforme do estresse ao longo do corpo vertebral. Comparando os materiais da prótese, a liga de titânio foi marginalmente superior quanto aos estresses médios em todas as direções, sendo menos provável que sofra afundamento da prótese.

Development of an intervertebral disc prosthesis prototype for the canine cervical spine / Desenvolvimento de um protótipo de prótese de disco intervertebral para a coluna vertebral cervical de cães

Cervical arthroplasty with disc prosthesis has been proposed as a treatment option for dogs with Cervical Spondylomyelopathy. The present study developed a novel vertebral disc prosthesis for dogs. Sixteen Functional Spinal Units (C5-C6) were collected from dog cadavers with body weights ranging between 25 and 35 kg, and their vertebral measurements were used to design a prosthetic disc. The sizing of the prosthesis was performed based on the averages of the measurements of width, height, and length of the vertebral bodies from C5-C6 of all specimens. The prosthesis was developed using the Rhinoceros 3D® and SolidWorks® programs, and 3D prototyping was carried out to define the best design. The developed prosthesis consisted of two independent parts that are fixed to the cranial and caudal vertebral bodies, in the intervertebral space, and fitted together by metal-to-metal surfaces capable of moving in the lateral, ventral, and dorsal directions. Each part of the prosthesis is angled in two portions: vertically, in the intervertebral space, and horizontally, in contact with the ventral surface of the vertebral bodies, both of which are fixed by means of monocortical locking screws. The design of the developed prototype allowed a good fit in the intervertebral space between C4-C5, C5-C6, and C6-C7.

A artroplastia cervical com prótese de disco tem sido proposta como uma opção de tratamento para cães com Espondilomielopatia Cervical. O presente estudo teve como objetivo desenvolver uma nova prótese de disco intervertebral para cães. Dezesseis Unidades Funcionais de Coluna Vertebral (C5-C6) foram coletadas de cadáveres de cães com peso corporal variando entre 25 e 35 kg, e suas medidas vertebrais foram usadas para projetar um disco intervertebral protético. O dimensionamento da prótese foi realizado com base nas médias das mensurações da largura, altura e comprimento dos corpos vertebrais de C5-C6 de todos os espécimes. A prótese foi desenvolvida nos programas Rhinoceros 3D® e SolidWorks® e utilizou-se prototipagem em 3D para a definição do melhor design. A prótese desenvolvida é formada por duas partes independentes que se fixam às espífises dos corpos vertebrais cranial e caudalmente ao espaço intervertebral, e se encaixam entre si por superfícies de metal-metal com capacidade de movimentação nas direções lateral, ventral e dorsal. Cada parte da prótese é angulada em duas porções: a vertical, que fica no espaço intervertebral, e a horizontal, que fica em contato com a superfície ventral dos corpos vertebrais, ambas as quais são fixadas por meio de parafusos bloqueados monocorticais. O design do protótipo desenvolvido permitiu bom encaixe no espaço intervertebral entre C4-C5, C5-C6 e C6-C7.

Finite element analysis of a new intervertebral disc prosthesis developed for the canine cervical spine / Elementos finitos de uma nova prótese de disco intervertebral desenvolvida para a coluna cervical canina

ABSTRACT: Cervical spondylomyelopathy (CSM) is a disease that affects mostly large- and giant-breed dogs. It is characterized by abnormalities of the cervical spine that may cause damage to the spinal cord and nerve roots. Cervical disc arthroplasty has been proposed as a treatment option in veterinary medicine. The current study evaluated the main stresses in a novel canine vertebral disc prosthesis and vertebral bodies using finite element analysis. Two experimental groups were created based on the material used for the prosthesis: stainless steel group (SSG) and titanium alloy group (TAG). Vertebral and prosthetic average equivalents von-Mises stress (VMS) and minimum principal stress (MiPS) were assessed while compressive, tensile, and lateral bending shear loads were applied. The stainless steel group had greater VMS distribution on all the evaluated parameters while the titanium alloy group had greater MiPS. Stresses were more concentrated on the lateral and ventral surfaces of the vertebral bodies than on their endplates. The average prosthetic stresses were more concentrated on the bone/implant contact surface than on the prosthesis/screw interface. Maximum stresses were concentrated in the screws' cranial surface. The novel prosthesis allows even distribution along the vertebral body. Comparing prosthesis materials, titanium alloy was marginally superior regarding average stresses in all directions and should be less likely to suffer subsidence.

RESUMO: Espondilomielopatia cervical (EMC) é uma doença que geralmente afeta cães de raças grandes e gigantes. Ela é caracterizada por anormalidades da coluna cervical que podem causar danos à medula espinhal ou às raízes nervosas. Artroplastia cervical com prótese de disco tem sido proposta como opção de tratamento na medicina veterinária. O presente estudo teve como objetivo avaliar os principais estresses em uma nova prótese de disco intervertebral canina e corpos vertebrais por meio da análise de elementos finitos. Foram compostos dois grupos experimentais que representaram o material constituinte da nova prótese: grupos aço inoxidável (SSG) e o liga de titânio (TAG). Tensões equivalente de von-Mises (VMS) e tensão principal mínima (MiPS) média foram avaliadas sob forças de compressão, tração e torção para vértebras e prótese. O grupo SSG teve maior distribuição de VMS para todos parâmetros avaliados, enquanto o grupo TAG teve maior MiPS. Estresses estiveram mais concentrados nas superfícies lateral e ventral dos corpos vertebrais do que nas placas terminais. Os estresses médios da prótese foram mais concentrados na superfície de contato osso/implante do que na interface prótese/parafuso. Estresses máximos foram concentrados na superfície cranial do parafuso. A nova prótese permitiu distribuição uniforme do estresse ao longo do corpo vertebral. Comparando os materiais da prótese, a liga de titânio foi marginalmente superior quanto aos estresses médios em todas as direções, sendo menos provável que sofra afundamento da prótese.

Relation between the risk factors for the severity of denture stomatitis and quality of life of complete edentulous individuals: a cross-sectional study

Abstract Objective To assess the association between risk factors for developing denture stomatitis (DS) and oral health-related quality of life (OHRQoL) in complete denture wearers. Methodology Participants of both sexes, wearing complete dentures, were classified using the modified Newton classification for the absence or the severity of DS and allocated to groups Normal or zero, IA, IB, II, and III. Lifestyle, oral and denture history, and medication use were assessed using specific questionnaires; clinical parameters such as anatomical characteristics of support were evaluated with the Kapur classification; salivary flow (SF) was calculated by the volume of unstimulated saliva per minute; and microbial load was determined by counting colony forming units (CFU) of target microorganisms present in the biofilm collected from dentures and palate. OHIP-EDENT assessed the OHRQoL. Kendall's tau_b and Spearman tests were applied with a significance level of 5%. Results 184 patients (143 female and 41 male) aged 65.5 ± 6.8 years were evaluated. Positive correlations were found for sex (women; p=0.013, r=0.16), individuals who started to consume alcoholic beverages as a young adult (18-27 years) (p=0.008, r=0.22), CFU of Candida spp. (p<0.001, r=0.27 denture; p<0.001, r=0.31 palate); Candida albicans (p=0.004, r=0.22 denture; p=0.003, r=0.25 palate), and Candida glabrata (p=0.004, r=0.22 denture; p=0.001, r=0.27 palate). Moreover, negative correlations with DS were found for CFU of Staphylococcus spp. (p=0.004, r=-0.20 palate) and enterobacteria (p=0.002, r=-0.24 palate), as well as a negative correlation between SF (p=0.009, r=-0.193) and DS. The CFU of Staphylococcus spp. and enterobacteria on the palate significantly correlated with OHRQoL. Conclusion Being female, consuming alcoholic beverages as a young adult, CFU of Candida spp., Candida albicans, Candida glabrata, and salivary flow may be the most significant risk factors for DS. The microbial load of Staphylococcus spp. and enterobacteria seems to influence the quality of life for complete denture wearers.

Gerenciamento dos resíduos de serviços de saúde em um hospital público do Maranhão / Management of waste health services in a public hospital in Maranhão / Gestión de residuos de servicios de salud en un hospital público de Maranhão

Objetivo: descreveras etapas do gerenciamento dos resíduos de serviços de saúde de um hospital público do Maranhão, considerando o ambiente/investigando os profissionais. Métodos:estudo transversal descritivo, com visitas às enfermarias e postos de enfermagem, cada local observado durante umahora (com cincoréplicas) seguindo um roteiro pré-estabelecido e com aplicação de questionário semiestruturado com a equipe de enfermagem. Resultados:os postos de enfermagem apresentaram maior quantidade de geraçãode resíduos perfurocortantes, com destaque para agulhas e seringas; o Descartex apresentava localização e posição adequada e segura, mas com volume excedido; resíduos infectantes, biológicos e de lixo comum, foram acondicionados em sacos plásticos segundoo normatizado. A frequência de coleta e limpeza estava de acordo com a normatização, embora as lixeiras estivessem sem tampa e pedal. O transporte foi realizado em containersadequados embora o tempo de remoção dos resíduos até o armazenamento externo estivesse em desacordo com o estabelecido. 88% dos técnicos e 100% dos enfermeiros relataram que há diferença no manejo dos diferentes grupos de resíduos, tendo como resíduos mais gerados os perfurocortantes, máscaras, luvas e papel. 94% dos técnicos e todos os enfermeiros afirmaram existir a etapa de segregação. 36,3% dos técnicos e 20% dos enfermeiros afirmaram já terem sofrido algum acidente ocupacional envolvendo resíduos perfuro cortantes. Conclusões: Observou-se maior produção dos resíduos biológicos,perfurocortantese comuns, com determinados pontos em desacordo com a legislação normativa, ressaltando a necessidade dos profissionais da equipe de enfermagem conhecerem as etapas do gerenciamento dos resíduos.

Objective: to describethe stages of waste management from health services in a public hospital in Maranhão, considering the environment/investigating professionals. Methods:descriptive cross-sectional study, with visits to the wards and nursing stations, with each location being observed for onehour (with fivereplicas) following a pre-established script and applying a semi-structured questionnaire with the nursing team. Results:the nursing stations showed a greater amount of generation of sharp waste, especially needles and syringes; Descartex had an adequate and safe location and position, but with excess volume; infectious, biological andcommon garbage residues were packed in plastic bags in accordance with regulations. The frequency of collection and cleaning was in accordance with regulations, although the bins had no lid and pedal. Transport was carried out in suitable containers, although the time from waste removal to external storage was not in accordance with what was established. 88% of technicians and 100% of nurses reported that there is a difference in the management of different groups of waste, with sharps, masks, gloves and paper as the most generated waste. 94% of technicians and all nurses stated that there was a segregation stage. 36.3% of the technicians and 20% of the nurses said they had already suffered an occupational accident involving sharp waste. Conclusions:There was agreater production of biological, sharp and common waste, with certain points at odds with normative legislation, highlighting the need for nursing staff professionals to know the stages of waste management.

Objetivo: describir las etapas de la gestión de residuos de los servicios de salud en un hospital público de Maranhão, considerando el medio ambiente/investigando a los profesionales. Métodos:estudio descriptivo transversal, con visitas a las salas y puestos de enfermería, cada local observado durante una hora (con cinco repeticiones) siguiendo un guión preestablecido y aplicación de un cuestionario semiestructurado con el equipo de enfermería. Resultados:los puestos de enfermería tuvieron mayor generación de residuos cortopunzantes, especialmente agujas y jeringas; Descartex tenía una ubicación y posición adecuada y segura, pero con volumen rebasado; Los residuos infecciosos, biológicos y de desecho común fueron empacados en bolsas plásticas de acuerdo a normatividad. La frecuencia de recogida y limpieza fue conforme a la normativa, aunque las papeleras no tenían tapa ni pedales. El transporte se realizó en contenedores adecuados, aunque el tiempo desde la retirada de los residuos hasta el almacenamiento externo no se ajustaba a lo establecido. El 88% de los técnicos y el 100% de las enfermeras informaron que existe diferencia en el manejo de los diferentes grupos de residuos, siendo los punzantes, mascarillas, guantes y papel los residuos más generados. El 94% de los técnicos y todos los enfermeros manifestaron que hubo una etapa de segregación. El 36,3% de los técnicos y el 20% de los enfermeros afirmaron haber sufrido ya un accidente de trabajo con residuos cortantes. Conclusiones:Hubo una mayor producción de desechos biológicos, cortopunzantes y comunes, con ciertos puntos en desacuerdo con la legislación normativa, destacando la necesidad de que los profesionales del equipo de enfermería conozcan las etapas de la gestión de desechos.

Aplicação de feixes de intervenção numa unidade de terapia intensiva portuguesa / Aplicación de vigas de intervención en una unidad portuguesa de cuidados intensivos / Application of intervention bundles in a portuguese intensive care unit

Objetivo identificar a associação entre a aplicação de Feixes de Intervenção e características sociodemográficas e profissionais de enfermeiros em uma unidade de terapia intensiva portuguesa. Método estudo descritivo e transversal, com amostra de 44 enfermeiros de uma Unidade de Terapia Intensiva Portuguesa. Na coleta de dados, aplicou-se questionário de maio a junho de 2019. Tratamento incluiu estatística descritiva e inferencial. Resultados a maioria da amostra não executava auditorias (86,4%) quanto às infeções em estudo. A pontuação do Feixe de Intervenção da Infeção do Trato Urinário e da Pneumonia Associada à Intubação diferiu significativamente entre os sexos (T de Student: p<0,047 e p<0,037), bem como entre o exercício profissional total e tempo de exercício na Unidade de Terapia Intensiva, respetivamente (T de Student: p<0,001 e p<0,026). Conclusão a aplicação dos Feixes de Intervenção associou-se às características sociodemográficas e ao tempo de exercício profissional de enfermeiros de unidade de terapia intensiva portuguesa.

Objetivo identificar la asociación entre la aplicación de Vigas de Intervención y las características sociodemográficas y los profesionales de enfermería en una unidad de cuidados intensivos portuguesa. Método estudio descriptivo y transversal, con una muestra de 44 enfermeras de una Unidad de Cuidados Intensivos portuguesa. Se aplicó un cuestionario de mayo a junio de 2019 en la recolección de datos. El tratamiento incluyó estadísticas descriptivas e inferenciales. Resultados la mayoría de la muestra no realizó auditorías (86,4%) respecto a las infecciones en estudio. La puntuación del Vigas de Intervención de Infección urinaria y Neumonía Asociada a Intubación difirió significativamente entre los sexos (T de Student: p<0,047 y p<0,037), así como entre el ejercicio profesional total y el tiempo de ejercicio en la Unidad de Cuidados Intensivos, respectivamente (T de Student: p<0,001 y p<0,026). Conclusión la aplicación de los Vigas de Intervención se asoció con características sociodemográficas y tiempo de práctica profesional de las enfermeras de una unidad de cuidados intensivos portuguesa.

Objective to identify the association between the application of Intervention Bundles and sociodemographic and professional characteristics of nurses in a Portuguese intensive care unit. Method descriptive and cross-sectional study, with a sample of 44 nurses from a Portuguese Intensive Care Unit. A questionnaire was applied from May to June 2019 in the data collection. Treatment included descriptive and inferential statistics. Results the majority of the sample did not perform audits (86.4%) regarding the infections under study. The score of the Intervention Bundle of Urinary Tract Infection and Pneumonia Associated with Intubation differed significantly between the genders (Student's T: p<0.047 and p<0.037), as well as between the total professional exercise and exercise time in the Intensive Care Unit, respectively (Student's T: p<0.001 and p<0.026). Conclusion the application of the Intervention Bundles was associated with sociodemographic characteristics and time of professional practice of nurses from a Portuguese intensive care unit.

Evaluation of misfit and stress distribution in implant-retained prosthesis obtained by different methods

Abstract This study evaluated the vertical misfit, passivity, and stress distribution after tightening the screws of different prosthesis. Two implants were used to simulate the rehabilitation of partially edentulous mandible space from the second premolar to the second molar. 40 three-element screw-retained fixed dental prosthesis with distal cantilever were fabricated and divided into four groups according to the method of production of framework (n = 10): G1 = conventional casting one-piece framework, G2 = conventional casting sectioned and laser welding, G3 = conventional casting sectioned and tungsten inert gas (TIG) welding and G4 = framework obtained by CAD/CAM (computer-aided design/computer-aided manufacturing) system. The vertical misfits (both screws tightened) and the passive fit (one screw tightened) were measured under a comparator optical microscope. The data was submitted to Shapiro-Wilk test to enable comparison with ANOVA followed by Tukey with Bonferroni adjust (α = .05). The qualitative analysis of the stress distribution was performed by the photoelastic method. The vertical misfit (both screws tightened) of the G2 (24 μm) and G3 (27 μm) were significantly higher than G4 (10 μm) (p = 0,006). The passive fit (for the non-tightened) of the G1(64 μm) and G3 (61 μm) were significantly higher than the G4 (32 μm) (p=0,009). G1 showed high stress between the implants in the photoelastic analysis and G4 presented lower stress. In conclusion, CAD/CAM method results in less vertical misfit, more passivity, and consequently better stress distribution to the bone.

Resumo Neste estudo foi avaliado desajuste vertical, a passividade e a distribuição de tensões após o aperto dos parafusos de diferentes próteses. Dois implantes foram usados ​​para simular a reabilitação do espaço edêntulo da mandíbula do segundo pré-molar ao segundo molar. Quarenta próteses dentárias fixas parafusadas de três elementos com cantilever distal foram confeccionadas e separadas em quatro grupos de acordo com o método de obtenção da infraestrutura (n = 10): G1 = fundição convencional estrutura monobloco, G2 = fundição convencional seccionada e soldagem a laser, G3 = fundição convencional seccionada e soldagem com gás inerte de tungstênio (TIG) e G4 = infraestrutura obtida pelo sistema CAD / CAM (computer-aided design/computer-aided manufacturing). Os desajustes verticais com ambos os parafusos apertados e os desajustes relativos à avaliação de passividade com um parafuso apertado foram medidos com microscópio comparador óptico. Os dados foram submetidos ao teste de Shapiro-Wilk para comparação com ANOVA seguida de ajuste de Tukey com Bonferroni (α = 0,05). A análise qualitativa da distribuição de tensões foi realizada pelo método fotoelástico. G2 (24 μm) e G3 (27 μm) apresentaram valores significativamente maiores que G4 (10 μm) (p = 0,006) de desajuste vertical (ambos os parafusos apertados). Os valores de desajustes nos G1 (64 μm) e G3 (61 μm), do lado não apertado, foram significativamente maiores que no G4 (32 μm) (p = 0,009). G1 apresentou maior tensão entre os implantes na análise fotoelástica e G4 apresentou menor tensão. O método CAD/CAM resultou em menor desajuste, maior passividade e melhor distribuição de tensões no osso.