RESUMO
BACKGROUND AND AIMS: Ovum pick-up (OPU) is an intrinsic step of in vitro fertilization procedures. Nevertheless, it can cause ovarian lesions and compromise female fertility in bovines. Recently, we have shown that intraovarian injection of adipose-derived mesenchymal stromal cells (AD-MSCs) effectively preserves ovarian function in bovines. Given that MSC-derived extracellular vesicles (MSC-EVs) have been shown to recapitulate several therapeutic effects attributed to AD-MSCs and that they present logistic and regulatory advantages compared to AD-MSCs, we tested whether MSC-EVs would also be useful to treat OPU-induced lesions. METHODS: MSC-EVs were isolated from the secretome of bovine AD-MSCs, using ultrafiltration (UF) and ultracentrifugation methods. The MSC-EVs were characterized according to concentration and mean particle size, morphology, protein concentration and EV markers, miRNA, mRNA, long noncoding RNA profile, total RNA yield and potential for induction of the proliferation and migration of bovine ovarian stromal cells. We then investigated whether intraovarian injection of MSC-EVs obtained by UF would reduce the negative effects of acute OPU-induced ovarian lesions in bovines. To do so, 20 animals were divided into 4 experimental groups (n = 5), submitted to 4 OPU cycles and different experimental treatments including vehicle only (G1), MSC-EVs produced by 7.5 × 106 AD-MSCs (G2), MSC-EVs produced by 2.5 × 106 AD-MSCs (G3) or 3 doses of MSC-EVs produced by 2.5 × 106 AD-MSCs, injected after OPU sessions 1, 2 and 3 (G4). RESULTS: Characterization of the MSC-EVs revealed that the size of the particles was similar in the different isolation methods; however, the UF method generated a greater MSC-EV yield. MSC-EVs processed by both methods demonstrated a similar ability to promote cell migration and proliferation in ovarian stromal cells. Considering the higher yield and lower complexity of the UF method, UF-MSC-EVs were used in the in vivo experiment. We evaluated three therapeutic regimens for cows subjected to OPU, noting that the group treated with three MSC-EV injections (G4) maintained oocyte production and increased in vitro embryo production, compared to G1, which presented compromised embryo production following the OPU-induced lesions. CONCLUSIONS: MSC-EVs have beneficial effects both on the migration and proliferation of ovarian stromal cells and on the fertility of bovines with follicular puncture injury in vivo.
RESUMO
BACKGROUND: Clinical importance of mitral annulus disjunction (MAD) is not well established. PURPOSE: Characterize a population of MAD all-comers diagnosed by cardiac magnetic resonance imaging (MRI). STUDY TYPE: Retrospective. POPULATION: MAD confirmed in 222 patients, age of 49.2 ± 19.3 years, 126 (56.8%) males. FIELD STRENGTH/SEQUENCE: 1.5 T and 3 T/steady-state free precession and inversion recovery. ASSESSMENT: Clinical history, outcomes, imaging, and arrhythmia data. MAD defined as a separation ≥2 mm between left ventricular myocardium and mitral annulus. Presence and pattern of late gadolinium enhancement (LGE) were analyzed. LGE in the papillary muscles and adjacent to MAD were identified as MAD related. Ventricular arrhythmias (VA) were grouped into non-sustained ventricular arrhythmias (NSVA) or sustained. Cardiovascular death assessed. STATISTICAL TESTS: Differences between baseline characteristics were compared. Univariate regression was used to investigate possible associations between ventricular arrhythmia and cardiovascular death with characteristics associated with the severity of MAD. A multivariable logistic regression included significant variables from the univariate analysis and was performed for MAD-related and global LGE. RESULTS: MAD extent 5.0 ± 2.6 mm. MV annulus expanded during systole for MAD ≥6 mm. Systolic expansion associated with prolapse, billowing, and curling. LGE present in 82 patients (36.9%). Twenty-three patients (10.4%) showed MAD-related LGE by three different observers. No association of LGE with MAD extent (P = 0.545) noted. Follow-up 4.1 ± 2.4 years. No sustained VA observed. In univariable analysis, NSVA was more prevalent in patients with MAD ≥6 mm (33.3% vs. 9.9%), but this was attenuated on multivariate analysis (P = 0.054). The presence of NSVA was associated with global LGE but not MAD-related LGE in isolation (P = 0.750). Three patients died of cardiovascular causes (1.4%) and none had MAD-related LGE. None died of sudden cardiac arrest. CONCLUSION: In patients referred for cardiac MRI, mitral valve dysfunction was associated with MAD severity. Scar was not related to the extent of MAD, but associated with NSVA. The risk of sustained arrhythmias and cardiovascular death was low in this population. EVIDENCE LEVEL: 4 TECHNICAL EFFICACY: Stage 2.
RESUMO
Fungal infections represent a serious health problem worldwide. The study evaluated the antifungal activity of 4-chlorobenzyl p-coumarate, an unprecedented semi-synthetic molecule. Docking molecular and assay experiments were conducted to determine the Minimum Inhibitory Concentration (MIC) and Minimum Fungicidal Concentration (MFC), mode of action, effect on growth, fungal death kinetics, drug association, effects on biofilm, micromorphology, and against human keratinocytes. The investigation included 16â strains of Candida spp, including C. albicans, C. krusei, C. glabrata, C. tropicalis, C. dubliniensis, C. lusitaniae, C. utilis, C. rugosa, C. guilhermondi, and C. parapsilosis. Docking analysis predicted affinity between the molecule and all tested targets. MIC and MFC values ranged from 3.9â µg/mL (13.54â µM) to 62.5â µg/mL (217.01â µM), indicating a probable effect on the plasma membrane. The molecule inhibited growth from the first hour of testing. Association with nystatin proved to be indifferent. All concentrations of the molecule reduced fungal biofilm. The compound altered fungal micromorphology. The tested compound exhibited an IC50 of 7.90±0.40â µg/mL (27.45±1.42â µM) for keratinocytes. 4-chlorobenzyl p-coumarate showed strong fungicidal effects, likely through its action on the plasma membrane and alteration of fungal micromorphology, and mildly cytotoxic to human keratinocytes.
Assuntos
Antifúngicos , Biofilmes , Candida , Testes de Sensibilidade Microbiana , Antifúngicos/farmacologia , Antifúngicos/química , Antifúngicos/síntese química , Humanos , Biofilmes/efeitos dos fármacos , Candida/efeitos dos fármacos , Relação Estrutura-Atividade , Simulação de Acoplamento Molecular , Queratinócitos/efeitos dos fármacos , Estrutura Molecular , Relação Dose-Resposta a Droga , Ácidos Cumáricos/farmacologia , Ácidos Cumáricos/química , Ácidos Cumáricos/síntese química , Sobrevivência Celular/efeitos dos fármacosRESUMO
Objective: We aimed to investigate the accuracy of remote examination by photographs compared to in-person clinical examination for detecting potentially malignant oral lesions (PMOLs). Methods: The Reporting Guide and Guidelines for Writing Systematic Reviews (Preferred Reporting Items for Systematic Reviews and Meta-Analysis [PRISMA]) guided the reporting of findings. The search was conducted by two independent reviewers in six databases with no language restriction until November 2022. The Population, Test-Index, Reference Standard, Outcome and Study Design (PIROS) strategy guided the eligibility criteria, and studies with adult patients (P) examined remotely (I) and in-person (R) to verify the detection of PMOLs (O) were considered. The methodological quality was assessed by QUADAS-2, and the certainty of the evidence was measured by the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). Results: A total of 769 files were identified. After removing duplicates and reading titles and abstracts, 16 were read in full, from which 6 articles then comprised the qualitative synthesis. The oral clinical examination was the reference standard in four studies. Five studies presented high risk of bias in at least one assessment domain. A high probability of detection of PMOL by remote examination (97.37%) was observed for the three studies included in the meta-analysis, which presented high heterogeneity among them. The certainty of evidence for the outcome was considered very low. Conclusions: Remote tools for detecting PMOLs may be feasible and assertive, but new studies are required to incorporate them into clinical practice. Clinical Relevance: Remote examination for the detection of PMOLs has the potential to favoring the early diagnosis of malignant lesions.
Assuntos
Neoplasias Bucais , Consulta Remota , Humanos , Neoplasias Bucais/diagnóstico , FotografaçãoRESUMO
Pregnancy and lactation are important stages of fetal development. Therefore, this study investigated how different maternal diets offered during gestation and lactation periods affect adipose tissue inflammation and liver tissue oxidative stress of dams and their female offspring. Female BALB/c albino mice (60 days old) were randomized into three groups receiving a standard (CONT), hypercaloric (HD), or restricted (RD) diet during the pregnancy. After birth, female offspring weaned at 21 days were divided into two groups that received a standard or restricted diet (CONT/CONT, CONT/RD, RD/CONT, RD/RD, HD/CONT, and HD/RD) until 100 days old. Histological, oxidative parameters and inflammatory infiltrate of dams' and offspring's liver and adipose tissue were evaluated. HD dams presented non-alcoholic steatohepatitis (NASH) diagnosis and an increase in tumor necrosis factor-alpha (TNF-α) concentrations when compared to the RD and CONT dams, indicating a pro-inflammatory state. High concentrations of malondialdehyde (MDA) formation and catalase (CAT) activity in HD when compared to the CONT in the liver. SOD activity decreased in RD mice compared to CONT, and the SOD/CAT ratio was decreased in the RD and HD in comparison to the CONT. The maternal diet leads to an increase in SOD in RD/RD compared to HD/RD. RD-fed dams showed an increase in inflammatory infiltrates compared to CONT, evidencing changes caused by a restrictive diet. In the HD/CONT offspring, we verified an increase in inflammatory infiltrates in relation to the offspring fed a standard diet. In conclusion, HD, and RD, during pregnancy and lactation, altered the liver and adipose tissues of mothers. Furthermore, the maternal diet negatively impacts the offspring's adipose tissue but does not cause liver damage in these animals in adult life.
RESUMO
Laser acupuncture can be used to treat neurosensory alterations and motor disorders caused by dental treatments. This study aimed to review the existing literature on the effects of laser acupuncture on neuropathies in the context of dentistry and to search for treatment modalities in which this technique is used. This systematic review was conducted in accordance with the Cochrane Collaboration guidelines and the PICOS strategy. Randomized clinical trials that evaluated laser acupuncture as a primary intervention for facial neuropathy were included. We searched the database for relevant studies and manually searched the gray literature until April 2022, and finally included four studies. The study was considered eligible if it included patients with paresthesia, facial paralysis, or neuralgia, neuropathies within dentistry, and referred to the application of laser acupuncture as a treatment method. The risk of bias was assessed using the RoB 2 tool. It was observed that the recommended wavelengths ranged from 790 nm to 810 nm, with a frequency of at least two applications per week, and to a greater or lesser degree, all evaluated studies obtained an improvement in sensory or motor recovery of the facial nerves. The use of laser acupuncture presented itself as a viable alternative in dentistry for the treatment of paresthesia and facial paralysis due to its therapeutic potential in neuropathic treatment (CRD42022344339).
Assuntos
Terapia por Acupuntura , Paralisia de Bell , Paralisia Facial , Humanos , Parestesia , Terapia por Acupuntura/métodos , Odontologia , LasersRESUMO
PURPOSE: To identify factors associated with the presence of internalized stigma in people with Common Mental Disorders (CMD) using Family Health Strategy. METHOD: Quantitative study carried out with 529 users with CMD answered the sociodemographic questionnaire and the scales Self-Reporting Questionnaire and scale on Internalized Stigma of Mental Illness. RESULTS: Internalized stigma was associated with education level, medication use, treatment for mental disorders, suicidal ideation, attendance at a psychosocial care center and psychiatric hospital. CONCLUSION: The adequate identification and treatment of psychological distress constitute effective prevention strategies to safeguard life and ensure the stigma reduction and better quality of life.
Assuntos
Transtornos Mentais , Qualidade de Vida , Humanos , Saúde da Família , Autoimagem , Estigma Social , Transtornos Mentais/psicologiaRESUMO
OBJECTIVE: The Bacille Calmette-Guérin (BCG) vaccine is routinely applied in Brazil. Adverse events (AE) may occur in patients with inborn or acquired immunodeficiencies, varying between local (BCGitis) or disseminated (BCGosis) reactions. We evaluated 53 individuals with local or disseminated adverse events to BCG vaccination to assess if they had inborn errors of immunity (IEI). METHODS: Patients diagnosed with an adverse event following BCG vaccination between 2014 and 2017 were included in the study. We collected clinical data, immunophenotyped T and B lymphocytes, and natural killer cells (NK), assessed oxidative function of neutrophils through dihydrorhodamine (DHR) 123 testing, and genotyped 361 genes related to IEI through targeted (panel) sequencing. RESULTS: The median age of the 53 individuals was four months (IQ 1.5-12), and 52.8% were male. Forty-eight (90.6%) individuals presented only locoregional AE and five (9.4%) presented both locoregional and disseminated AE. Nine (16.9%) patients were diagnosed with an IEI. Four of them presented BCGitis and five presented BCGosis after BCG vaccination. Clinically, four presented chronic granulomatous disease (CGD), three Mendelian susceptibility to mycobacterial disease (MSMD), and two severe combined immunodeficiency (SCID). Patients with IEI had a higher frequency of systemic symptomatology (p = 0.002), history of other infections (p < 0.001), parental consanguinity (p = 0.01), familial history of sick siblings (p < 0.001), or early deaths in the family (p < 0.01). CONCLUSION: There is a high frequency of IEI in patients with locoregional and disseminated adverse events to BCG vaccination, revealing the need for the investigation of IEI accompanied by clinical and familial inquiry.
Assuntos
Vacina BCG , Imunodeficiência Combinada Severa , Tuberculose , Pré-Escolar , Feminino , Humanos , Masculino , Vacina BCG/efeitos adversos , Brasil/epidemiologia , Imunodeficiência Combinada Severa/genética , Tuberculose/diagnóstico , Vacinação/efeitos adversosRESUMO
PURPOSE: To assess the available evidence regarding the quality of life (QoL) of informal caregivers of stroke survivors, by identifying the instruments used to assess QoL, and its associated characteristics. METHODS: A scoping review was performed, following PRISMA-ScR guidelines. The electronic databases PubMed, ISI Web of Science, PsycINFO, and SciELO were searched for empirical, peer-reviewed, original, and full-length studies on the characteristics influencing the QoL of informal caregivers of stroke survivors. Eligibility and data extraction were conducted by two independent researchers. The main quantitative findings were synthesized, and qualitative data were explored by thematic content analysis. RESULTS: The included studies, 56 quantitative, 1 qualitative, and 1 mixed methods, were published between 1999 and 2020. A high heterogeneity was found regarding the assessment of QoL, and the characteristics influencing it. Only one study used an instrument specifically designed to assess the stroke caregivers' QoL. The QoL of informal caregivers was inversely associated with physical and mental health of stroke survivors and caregivers, while stroke characteristics with a better prognosis, caregivers' positive relationships, and a more supportive and participative social context were positively associated to QoL. CONCLUSION: There is a need for standardizing the assessment of the QoL of informal caregivers of stroke survivors, as well as for investing in cross-country/cultural studies with robust mixed methods designs to allow a deeper understanding of the experiences of caregivers. Further research, policies, and practices should consider the diversity and complexity of the characteristics influencing QoL, to empower informal caregivers and improve their QoL.
Assuntos
Qualidade de Vida , Acidente Vascular Cerebral , Cuidadores/psicologia , Humanos , Saúde Mental , Qualidade de Vida/psicologia , Acidente Vascular Cerebral/psicologia , Sobreviventes/psicologiaRESUMO
As soon as they are taken prisoner, children and adolescents in times of war are inserted into a spiral of cruelty that progresses to rape or other countless forms of physical and psychological torture using sex as a weapon. Were these children and adolescents war sex slaves? Oral sex and other sexual barbarities are part of spaces of abuse and humiliation. The damage to the personality structure of these children and adolescents is severe. The psychological consequences are numerous. Over the years, a vicious circle has been observed around this brutality.
Assuntos
Maus-Tratos Infantis , Estupro , Tortura , Adolescente , Criança , Humanos , GuerraRESUMO
Conventional in silico modeling is often viewed as 'one-target' or 'single-task' computer-aided modeling since it mainly relies on forecasting an endpoint of interest from similar input data. Multitasking or multitarget in silico modeling, in contrast, embraces a set of computational techniques that efficiently integrate multiple types of input data for setting up unique in silico models able to predict the outcome(s) relating to various experimental and/or theoretical conditions. The latter, specifically, based upon the Box-Jenkins moving average approach, has been applied in the last decade to several research fields including drug and materials design, environmental sciences, and nanotechnology. The present review discusses the current status of multitasking computer-aided modeling efforts, meanwhile describing both the existing challenges and future opportunities of its underlying techniques. Some important applications are also discussed to exemplify the ability of multitasking modeling in deriving holistic and reliable in silico classification-based models as well as in designing new chemical entities, either through fragment-based design or virtual screening. Focus will also be given to some software recently developed to automate and accelerate such types of modeling. Overall, this review may serve as a guideline for researchers to grasp the scope of multitasking computer-aided modeling as a promising in silico tool.
Assuntos
Desenho de Fármacos , Software , Simulação por ComputadorRESUMO
At the core of the development of more efficient and reliable fuel cells (FCs), there are several essential chemical reactions, namely carbon monoxide (CO) oxidation. This reaction is a keystone in the cleaning of hydrogen fuel used in fuel cells due to strong poisoning by this species of the platinum catalyst used in these devices. The present work aims to provide insight regarding the activation of CO oxidation by gold or silver microfacets possessing low coordinated atoms. To achieve this, density functional theory (DFT) quantum calculations, which determined two competing reaction pathways for CO oxidation, i.e., by molecularly adsorbed oxygen, and by dissociated oxygen, are combined with first-principles kinetic Monte Carlo (1p-kMC) simulations, which employed the resulting DFT parameters in order to address the effect of temperature and partial pressures and the interplay of the elementary reaction events. The use of 1p-kMC is a step further from available works regarding the CO oxidation on gold- and silver-based catalysts for cleansing of hydrogen that is used as a fuel in FCs. Indeed, this research contributes to the conclusion that CO oxidation should preferentially occur on silver microfacets, while the obtained turnover frequencies (TOFs) reinforced such a conclusion.
RESUMO
Any condition leading to chronic liver disease is a potential oncogenic agent for hepatocellular carcinoma (HCC). Alterations in the expression of antioxidant enzymes could alter the redox balance. Our aim was to evaluate the expression of the genes GPX1, GPX4, SEP15, SELENOP, SOD1, SOD2, GSR, CAT, and NFE2L2 in patients with HCC. Differential gene expression analysis was performed using RNA-Seq data from the TCGA and GTEx databases, and RT-qPCR data from HCC patient samples. Bioinformatic analysis revealed significant differential expression in most genes. GPX4 expression was significantly increased (p=0.02), while SOD2 expression was significantly decreased (p=0.04) in experimental data. In TCGA samples, alpha-fetoprotein levels (mg/dL) were negatively correlated with the expression of SEP15 (p<0.001), SELENOP (p<0.001), SOD1 (p<0.001), SOD2 (p<0.001), CAT (p<0.001), and NFE2L2 (p=0.004). Alpha-fetoprotein levels were positively correlated with the expression of GPX4 (p=0.02) and SELENOP (p=0.01) in the experimental data. Low expression of GPX1 (p=0.006), GPX4 (p=0.01), SELENOP (p=0.006), SOD1 (p=0.007), CAT (p<0.001), and NFE2L2 (p<0.001), and higher levels of GSR, were associated with low overall survival at 12 months. These results suggest a significant role for these antioxidant enzymes in HCC pathogenesis and severity.
RESUMO
In the last two decades, many European countries allowed the sale of over-the-counter (OTC) drugs outside pharmacies. This was expected to lower retail prices through increased competition. Evidence of such price reductions is scarce. We assess the impact of supermarket and outlet entry in the OTC drug market on OTC prices charged by incumbent pharmacies using a difference-in-differences strategy. We use price data on five popular OTC drugs for all retailers located in Lisbon for three distinct points in time (2006, 2010, and 2015). Our results suggest that competitive pressure in the market is mainly exerted by supermarkets, which charge, on average, 20% lower prices than pharmacies. The entry of a supermarket among the main competitors of an incumbent pharmacy is associated with an average 4% to 6% decrease in prices relative to the control group. These price reductions are long-lasting but fairly localized. We find no evidence of price reductions following OTC outlet entry. Additional results from a reduced-form entry model and a propensity score matching difference-in-differences approach support the view that these effects are causal.
Assuntos
Competição Econômica , Medicamentos sem Prescrição , Comércio , Custos de Medicamentos , Europa (Continente) , Humanos , PortugalRESUMO
Patients with Parkinson's disease (PD) manifest visual losses. However, it is not known whether these losses are equivalent in both early-onset (EOPD) and late-onset (LOPD) patients. We evaluated contrast sensitivity and color vision in EOPD and LOPD patients and in age-matched controls. Losses occurred in both patient groups but were more pronounced in EOPD, consistent with the notion that non-motor symptoms are affected by age of symptom onset. More studies of visual function in EOPD and LOPD patients are needed to understand how aging is related to the pathophysiology of non-motor PD symptomatology. This would permit earlier diagnosis and, perhaps, better management of the disease.
Assuntos
Defeitos da Visão Cromática/etiologia , Sensibilidades de Contraste/fisiologia , Doença de Parkinson/complicações , Baixa Visão/etiologia , Adulto , Idade de Início , Idoso , Testes de Percepção de Cores , Defeitos da Visão Cromática/diagnóstico , Feminino , Humanos , Pressão Intraocular/fisiologia , Masculino , Pessoa de Meia-Idade , Tonometria Ocular , Baixa Visão/fisiopatologiaRESUMO
Cafeteria diet (CAF) mimics human Western diet and has been used in animal models to study obesity. The purpose of this study is to demonstrate that our CAF model induces metabolic disorder related to obesity and affects recognition memory in Wistar rats. We also compared the intake of two different soft drinks, as part of the CAF, on recognition memory. Our results demonstrate that CAF-fed rats increased weight gain and visceral adiposity, and exhibited hyperglycemia, hypertriglyceridemia, high leptin and low insulin plasma levels. Moreover, CAF animals showed higher lipid peroxidation in the liver and developed non-alcoholic fatty liver disease. Surprisingly, the group fed with cola-based soft drinks presented an improvement in recognition memory, whereas animals fed with orange-based soft drinks showed worse performance in this task. Our data indicates that CAF induces obesity and affects recognition memory, but the composition of the diet interfere when the neurological function is evaluated.
Assuntos
Dieta Ocidental/efeitos adversos , Preferências Alimentares , Transtornos da Memória/fisiopatologia , Obesidade/complicações , Animais , Bebidas Gaseificadas/efeitos adversos , Peroxidação de Lipídeos/fisiologia , Fígado/patologia , Fígado/fisiopatologia , Masculino , Transtornos da Memória/etiologia , Memória de Longo Prazo/fisiologia , Hepatopatia Gordurosa não Alcoólica/etiologia , Hepatopatia Gordurosa não Alcoólica/fisiopatologia , Reconhecimento Visual de Modelos/fisiologia , Ratos WistarRESUMO
We assess the relative importance of demand and supply factors as determinants of regional variation in healthcare expenditures in the Netherlands. Our empirical approach follows individuals who migrate between regions. We use individual data on annual healthcare expenditures for the entire Dutch population between the years 2006 and 2013. Regional variation in healthcare expenditures is mostly driven by demand factors, with an estimated share of around 70%. The relative importance of different causes varies with the groups of regions being compared.
Assuntos
Gastos em Saúde/tendências , Migrantes , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Países BaixosRESUMO
The present article aims to describe and discuss the actions implemented from 2014 to 2018 at the federal level in the context of the Intersectoral Strategy to Prevent and Control Obesity issued by the Brazilian federal government. The goal of the Intersectoral Strategy is to prevent and control obesity based on six action plans: 1) availability and access to adequate and healthy foods; 2) education, communication, and information; 3) promotion of healthy lifestyles in specific environments/territories; 4) food and nutrition surveillance; 5) comprehensive care for individuals presenting obesity in the health care network; and 6) regulation and control of the quality and harmlessness of food. To gather information, semi-structured questionnaires were submitted to representatives from the ministries of Education, Health, Planning, Citizenship, and Agrarian Development. The actions implemented in the period were described in terms of the six action plans. Positive results were achieved through the shared management model adopted, even though many challenges still remain. The agenda for action proposed in the Intersectoral Strategy is attuned to the Brazilian context, and intersectoral management was still in place until the writing of the present article.
El objetivo del presente artículo es describir las actividades realizadas a nivel federal en el período 2014-2018 dentro del marco de la estrategia intersectorial de prevención y control de la Obesidad, publicada por el Gobierno Federal de Brasil, y hacer algunos comentarios pertinentes. La estrategia tiene por objetivo prevenir y controlar la obesidad y se ha organizado en seis grandes ejes de acción: 1) disponibilidad de alimentos adecuados y saludables y acceso a los mismos; 2) educación, comunicación e información; 3) promoción de estilos de vida saludables en entornos y territorios específicos; 4) vigilancia alimentaria y nutricional; 5) atención integral a la salud de las personas con sobrepeso y obesidad en la red asistencial, y 6) regulación y control de la calidad y la inocuidad de los alimentos. Para recopilar información se enviaron cuestionarios semiestructurados a representantes de los Ministerios de Educación, Salud, Planificación, Ciudadanía y Desarrollo Agrario. Las actividades realizadas se presentan según los ejes de acción de la estrategia. Se lograron resultados positivos a partir del modelo de coordinación adoptado, con gestión compartida, aunque fue preciso superar varios desafíos. El programa de trabajo sobre los ejes de acción propuestos en la estrategia está en consonancia con el contexto brasileño y el modelo intersectorial de gestión permaneció vigente hasta el momento de preparación de este artículo.
RESUMO
Obesity is a serious public health problem whose increase has been associated with the growing consumption of ultra-processed foods in several world regions, including Latin America. Food guides are official guidelines used to promote healthy eating habits and may serve as a tool to prevent obesity. Brazil was the first country to adopt the level of processing to categorize food items and make recommendations based on these categories in its food guides. Thus, the objective of the present article is to share the Brazilian experience with incorporating processed food recommendations as official guidelines and with the development of food guides. In the development of Brazilian food guides, the Ministry of Health emphasized a collective construction, with participation and discussion of contents by strategic stakeholders. The process was refined in the Food Guide for Brazilian Children below 2 Years of Age, with establishment of a management committee and a political monitoring committee, public call for participation by researchers and health care professionals, and input workshops with key stakeholders to define scope. The validation process relied on additional input workshops with key stakeholders, in addition to workshops held in all Brazilian states for debate and mobilization for online public consultation. Highlights of this learning process included the involvement of key stakeholders and the importance of transparency across all steps of development and validation of food guides.
La obesidad es un grave problema de salud pública cuyo aumento se ha relacionado con el incremento del consumo de alimentos ultraprocesados en diversas regiones del mundo, incluida América Latina. Las guías alimentarias son directrices oficiales usadas para promover la alimentación saludable y pueden servir de herramienta para prevenir la obesidad. Brasil fue el primer país en adoptar el grado de procesamiento como criterio para clasificar los alimentos y formular recomendaciones en sus guías alimentarias usando como base esa clasificación. El objetivo de este artículo es compartir la experiencia brasileña al incorporar esas recomendaciones como directrices oficiales y elaborar las guías alimentarias. En la elaboración de las guías alimentarias brasileñas, el Ministerio de Salud valoró la construcción colectiva, a saber, la participación de actores estratégicos y el debate que estos actores entablaron sobre sus contenidos. En la Guía alimentaria para los niños brasileños menores de dos años, el proceso se perfeccionó gracias al establecimiento de un comité gestor y un comité de monitoreo político, un llamamiento público a la participación de investigadores y profesionales de salud, y la realización de talleres participativos con actores clave para definir el objetivo de la directriz. Para el proceso de validación se realizaron otros talleres, con la presencia de actores estratégicos, así como talleres realizados en todos los estados del país a fin de fomentar un debate y promover la participación en una consulta pública en línea. Como resultado de este aprendizaje, se destaca la importancia de que participen los actores estratégicos y la necesidad de que el proceso de elaboración y validación de las guías alimentarias sea transparente.
RESUMO
AIM: The aim of this study is to assess three protocols for removing a eugenol-based filling endodontic sealer from root dentin and the bond strength of fiberglass posts luted with resin cement. MATERIALS AND METHODS: Sixty single-rooted bovine teeth were prepared and filled with the Endofill endodontic sealer and gutta-percha cones. After 7 days, 9 mm of the filling was removed and divided into five groups (n = 12) according to the cleaning protocol: G1 (negative control), unfilled; G2 (positive control), saline solution; G3, 95% alcohol; G4, amyl acetate; and G5, Largo bur. The canals were hybridized and fiberglass posts were luted with resin cement. They were cross-sectioned in slices of 1 mm and subjected to the push-out test. The other samples were sectioned longitudinally and visualized in a scanning electron microscope (SEM), and the existing chemical elements were quantified by energy dispersive spectroscopy (EDS). The statistical analysis used variance analysis (ANOVA)-one way and Fisher's test, at a 5% significance level. RESULTS: The 95% alcohol was more effective for cleaning the canal, resulting in a clean dentinal surface and bond strength statistically similar to the negative control. The Largo bur was also statistically similar to the negative control, with only a few debris impregnated on the wall. Amyl acetate showed more sealer residues on the canal walls, with a consequent lower bond strength value than the other groups, only higher than the positive control. CONCLUSION: The 95% alcohol and Largo burs may be used after removing the canal filling, so that the bond strength is improved when using the eugenol-based sealer.