Seasonal variation of Batrachochytrium dendrobatidis in a threatened anuran species from Uruguay.

Chytridiomycosis, an emergent infectious disease caused by the fungus Batrachochytrium dendrobatidis (Bd), is considered one of the drivers of the current amphibian biodiversity loss. To inform endangered species conservation efforts, it is essential to improve our knowledge about the abiotic and biotic factors that influence Bd infection dynamics in the wild. Here, we analyzed variation of Bd infection in the redbelly toad Melanophryniscus montevidensis, a threatened bufonid from Uruguay. We tested the influence of temperature, precipitation, season, and host population size on Bd prevalence and intensity. Additionally, considering the sub-lethal effects of Bd, we tested if these variables, potentially through their effect on Bd, also explain the variation in host body condition. We determined a high Bd prevalence of 41% (100/241), and that population size influenced both Bd prevalence and infection intensity. We identified an effect of precipitation and season on Bd infection intensity and an effect of season on toad body condition. In addition, we found a negative effect of infection intensity on body condition; moreover, while some toads cleared the infection, their body condition did not improve, suggesting a long-term cost. This is the first report on host population size as an important factor in Bd infection dynamics in a threatened anuran species, and seasonal demographic changes appear to play an important role in the dynamics. Finally, we highlight the need for monitoring Bd in this and other endangered amphibian populations, especially those within the genus Melanophryniscus, which includes several Endangered and Data Deficient species in South America.

Use of Reproductive Microhabitat by Melanophryniscus montevidensis (Anura: Bufonidae) from Uruguay.

This study describes the reproductive microhabitat of Melanophryniscus montevidensis and its use in two water bodies (WBs) in Barra de la Laguna de Rocha, Uruguay. Monthly field trips were performed between March 2012 and February 2013. Variables related to the WBs and vegetation, as well as parameters linked to the usage the amphibians make of the site (e.g: distance to the border of the pond, water depth and the vegetation use) were recorded. The behavior shown by the individuals during the breeding activity was recorded. This activity occurs in shallow temporary WBs with abundant hydrophilic vegetation. The individuals were found more frequently in areas near the edge of the pond, which has denser vegetation. The calling males were found closer to the border of the pond, and they showed better body condition than the non-calling males. In addition to calling activities, males used alternative tactics to find couples, such as active search of females, and aggressive behaviors, such as male displacing and physical combat. Such behaviors are common in anurans with explosive reproductive dynamics. The characterization of the reproductive microhabitats permits the proposal of strategies for the conservation of the species in Uruguay, given that the loss and fragmentation of habitats is one of the main causes considered for the decrease in their populations.

Streptococcus mutans glutamate binding protein (GlnH) as antigen target for a mucosal anti-caries vaccine.

BACKGROUND: In recent years, several studies have demonstrated that bacterial ABC transporters present relevant antigen targets for the development of vaccines against bacteria such as Streptococcus pneumoniae and Enterococcus faecalis. In Streptococcus mutans, the glutamate transporter operon (glnH), encoding an ABC transporter, is associated with acid tolerance and represents an important virulence-associated factor for the development of dental caries. RESULTS: In this study, we generated a recombinant form of the S. mutans GlnH protein (rGlnH) in Bacillus subtilis. Mice immunized with this protein antigen elicited strong antigen-specific antibody responses after sublingual administration of a vaccine formulation containing a mucosal adjuvant, a non-toxic derivative of the heat-labile toxin (LTK63) originally produced by enterotoxigenic Escherichia coli (ETEC) strains. Serum anti-rGlnH antibodies reduced adhesion of S. mutans to the oral cavity of naïve mice. Moreover, mice actively immunized with rGlnH were partially protected from oral colonization after exposure to the S. mutans NG8 strain. CONCLUSIONS: Our results indicate that S. mutans rGlnH is a potential target antigen capable of inducing specific and protective antibody responses after immunization. Overall, these observations raise the prospect of the development of mucosal anti-caries vaccines.

Impact of gastroesophageal reflux control through tailored proton pump inhibition therapy or fundoplication in patients with Barrett's esophagus.

AIM: To determine the impact of upwards titration of proton pump inhibition (PPI) on acid reflux, symptom scores and histology, compared to clinically successful fundoplication. METHODS: Two cohorts of long-segment Barrett's esophagus (BE) patients were studied. In group 1 (n = 24), increasing doses of PPI were administered in 8-wk intervals until acid reflux normalization. At each assessment, ambulatory 24 h pH recording, endoscopy with biopsies and symptom scoring (by a gastroesophageal reflux disease health related quality of life questionnaire, GERD/HRLQ) were performed. Group 2 (n = 30) consisted of patients with a previous fundoplication. RESULTS: In group 1, acid reflux normalized in 23 of 24 patients, resulting in improved GERD/HRQL scores (P = 0.001), which were most pronounced after the starting dose of PPI (P < 0.001). PPI treatment reached the same level of GERD/HRQL scores as after a clinically successful fundoplication (P = 0.5). Normalization of acid reflux in both groups was associated with reduction in papillary length, basal cell layer thickness, intercellular space dilatation, and acute and chronic inflammation of squamous epithelium. CONCLUSION: This study shows that acid reflux and symptom scores co-vary throughout PPI increments in long-segment BE patients, especially after the first dose of PPI, reaching the same level as after a successful fundoplication. Minor changes were found among GERD markers at the morphological level.

LT adjuvant modulates epitope specificity and improves the efficacy of murine antibodies elicited by sublingual vaccination with the N-terminal domain of Streptococcus mutans P1.

In this study, we evaluated the immunogenicity, protective efficacy and peptide-based immune signatures of antibodies raised in mice after sublingual immunization with a recombinant form of the P1 (aka AgI/II, PAc) adhesin (P139-512) of Streptococcus mutans, a major etiological agent of dental caries. Sublingual administration of P139-512 in combination with the mucosal adjuvant LTK4R (a derivative of heat-labile LT toxin) induced strong and long-lasting systemic and mucosal immune responses. Incorporation of the adjuvant resulted in an enhancement of the anti-adhesive and anti-colonization activity against S. mutans as evaluated both under in vitro and in vivo conditions. Incorporation of the adjuvant to the vaccine formulation also changed the epitope specificity of the induced antibodies as determined by immunological signatures of sera collected from vaccinated mice. Use of a peptide microarray library led to the identification of peptide targets recognized by antibodies in serum samples with enhanced anti-adhesive effects. Altogether, the results presented herein showed that the sublingual administration of a P1-based subunit vaccine represents a promising approach for the prevention of dental caries caused by S. mutans. In addition, the present study disclosed the role of adjuvants on the epitope specificity and functionality of antibodies raised by subunit vaccines.

Efetividade do EDTA 17% na remo??o da smear layer e da medica??o intracanal de hidr?xido de c?lcio das paredes dos canais radiculares: parte II / Effect of 17% EDTA on removal of canal wall smear layer and calciumhydroxide dressing: part II

Objective: the aim of this study was to evaluate, by scanning electron microscopy, the effectiveness of 17% EDTA on removal of canal wall smear layer and calcium hydroxide dressing in different thirds of root canal. Methods: Ttwenty-four premolars were instrumented in the cervical and middle thirds using Gates-Glidden drills. At the working length, the canal was widened up to # 35 file, followed by scaling up to file # 50. After instrumentation, the teeth were divided into four groups according to the treatment received: GI - irrigation performed with 5 ml of NaOCl 2.5 % ; GII - irrigation with 5 ml of 17% EDTA for 2 and a half minutes , submitted to agitation with file # 15, followed by irrigation with 5 ml of 2.5% NaOCl ; GIII - irrigation with 5 ml of NaOCl 2.5% , drying , application of temporary dressing of Ca (OH )2 with propylene glycol and sealing. After 5 days , removing the sealing irrigation with 5 ml of 17% EDTA for 2 and a half minutes , submitted to agitation with file # 15, followed by a final flush with 5 ml of 2.5% NaOCl ; GIV - irrigation with 5 ml of 17% EDTA for 2 and a half minutes , submitted to agitation with file # 15 , followed by irrigation with 5 ml of 2.5% NaOCl , drying and after use of the medication in Ca (OH )2 with the sealing and propylene glycol which was removed after 5 days performing the irrigation with 5 ml of 17% EDTA for 2 and a half minutes , submitted to agitation with file # 15, followed by using 5 ml 2.5% NaOCl . Next, the teeth were prepared and taken to the scanning electron microscope. Results: The images revealed: Group I - a marked presence of smear layer in all three thirds, Group II - removal of almost all of the smear layer in the cervical third and removal of large quantity in the middle third, whereas in the apical third a large quantity of smear layer still remained however, in comparison with the other groups, this was shown to be cleaner; Group III - in the three thirds, the presence of smear layer was observed, which was shown to be much less compacted than that observed in Group 1; Group IV- in all the thirds there was reduction of smear layer and Ca(OH)2-based medication, and presence of several unobstructed dentinal tubules could be observed, demonstrating the second best result observed. Conclusion: It could be concluded that the use of 17% EDTA favored removal of the smear layer and intracanal medication residues in all thirds of the root canal.

Objetivo: Avaliar atrav?s de Microscopia Eletr?nica de Varredura, a efic?cia do EDTA a 17% na remo??o da smear layer e da medica??o de hidr?xido de c?lcio nos diferentes ter?os do canal radicular. M?todos: Vinte e quatro pr?-molares foram instrumentados nos ter?os cervical e m?dio utilizando-se brocas Gates-Glidden. No comprimento de trabalhorealizou-se o alargamento at? a lima #35 seguido do escalonamento at? a lima #50. Ap?s, os dentes foram divididos em quatro grupos de acordo como tratamento recebido: GI - irriga??o realizada com 5 ml de hipoclorito de s?dio a 2,5%; GII - irriga??o com 5 ml de EDTA 17%, durante 2 minutose meio, submetidos a agita??o com a lima #15, seguidos de uma irriga??o com 5 ml de NaOCl a 2,5%; GIII - irriga??o com 5 ml de hipoclorito des?dio a 2,5%, secagem, aplica??o de medica??o intracanal de Ca(OH)2 associado ao propilenoglicol e selamento, ap?s 5 dias, remo??o do selamento, irriga??o com 5 ml de EDTA 17%, durante 2 minutos e meio, submetidos a agita??o com a lima #15, seguida de irriga??o final com 5 ml de NaOCl a 2,5%; GIV - irriga??o com 5 ml de EDTA 17%, durante 2 minutos e meio, submetidos a agita??o com a lima #15, seguidos de uma irriga??o com 5 ml de NaOCl a 2,5%, secagem e ap?s o uso da medica??o intracanal de Ca(OH)2 associado ao propilenoglicol e selamento que foi removido ap?s 5 dias realizando-se a irriga??o com 5 ml de EDTA 17%, durante 2 minutos e meio, submetidos a agita??o com a lima #15, seguida da utiliza??o de 5 ml de NaOCl a 2,5%. A seguir, os dentes foram preparados e levados ao microsc?pio eletr?nico de varredura. Resultados: As imagens revelaram: grupo I - presen?a marcante de smear layer nos tr?s ter?os; grupo II - nota-se a menor quantidade de smear layer no ter?ocervical e m?dio enquanto no apical h? presen?a mais marcante; grupo III- no ter?o cervical e apical h? presen?a de smear layer compactada nas paredes do canal e o aspecto mais disperso da medica??o enquanto no ter?o m?dio nota-se presen?a da medica??o no interior dos canal?culos; grupo IV- em todos os ter?os houve redu??o da smear layer e da medica??o e a presen?a de v?rios canal?culos dentin?rios desobstru?dos.Conclus?o: Pode-se concluir que o uso do EDTA a 17% favoreceu a remo??o da lama dentin?ria e dos res?duos da medica??o intracanal em todos os ter?os do canal radicular.

Effectiveness of EDTA 17% in the removal of smear layer and calcium hydroxide dressing from the root canal walls / Efetividade do EDTA 17 porcentos na remoção da smear layer e da medicação intracanal de hidróxido de cálcio das paredes dos canais radiculares

Objective: To evaluate the effectiveness of EDTA 17% on the removal of the smear layer and the calcium hydroxide dressing in different thirds of the root canal. Methods: Forty canines were instrumented in the cervical and middle thirds using Gates-Glidden drills. In the working length, enlargements were carried out with files up to #35 followed by scaling up to #50. After instrumentation, the teeth were divided into four groups according to the type of final irrigation: Group I - irrigation with 5 ml NaOCl 2.5%, Group II - irrigation with 5 ml EDTA 17% followed by irrigation with 5 ml NaOCl 2.5%; Group III - irrigation with 5 ml NaOCl 2.5%; Group IV - irrigation with 5ml EDTA 17% followed by one with NaOCl 2.5%. The teethwere filled and radiographed. The teeth were then submitted to the clearing technique and photographed by means of a camera coupled toa stereomicroscope. Results: The images showed: Group I - the presence of smear layer in the three thirds and fewer accessory canals filled; group II - the smaller amount of smear layer on the cervical, middle and apical third and filling of the accessory canals; group III - there are residues from the dressing in the cervical, middle and apical third, and group IV - in all of the thirds there was a reduction in the presence of dressing remnants and the largest number of filled accessory canals.Conclusion: It can be concluded that the use of EDTA 17% favored the removal of the smear layer and the remnants of the intracanal dressing in all thirds of the root canal.

Objetivo: Avaliar a eficácia do EDTA a 17% na remoção da smear layer e da medicação de hidróxido de cálcio nos diferentes terços do canal radicular. Métodos: Quarenta caninos inferiores foram instrumentados nos terços cervical e médio utilizando-se brocas Gates-Glidden. No comprimento de trabalho realizou-se o alargamento até a lima #35 seguido do escalonamento até a lima #50. Após os dentes foram divididos em quatro grupos de acordo com a irrigação final: grupo I - irrigação com 5ml de NaOCl 2,5%; grupo II - irrigação com 5 ml de EDTA 17% seguidos de5ml de NaOCl 2,5%; grupo III - irrigação com 5ml de NaOCl 2,5%; grupo IV - irrigação com 5ml de EDTA 17% seguidos de NaOCl 2,5%. Os dentes foram obturados e radiografados. Posteriormente os dentes foram diafanizados e fotografados por meio de máquina fotográficaacoplada em lupa estereoscópica. Resultados: As imagens revelaram: grupo I - presença de smear layer nos três terços e o menor número de canais acessórios preenchidos; grupo II - nota-se a menor quantidade de smear layer no terço cervical, médio e apical e a obturação de canais acessórios; grupo III - há presença de resíduos da medicação no terço cervical, médio e apical; grupo IV - em todos os terços houve redução da presença de resíduos da medicação e o maior número de canais acessórios preenchidos. Conclusão: Pode-se concluir que o uso do EDTA a 17% favoreceu a remoção dos resíduos da medicação intracanal do canal radicular.

Perfil dos idosos atendidos em um centro de atenção psicossocial - álcool e outras drogas / Profile of the elderly assisted in a psychosocial care center - alcohol and other drugs / Perfil de los ancianos asistido en el centro de atención psicosocial - alcohol y otras droga

O objetivo do estudo foi identificar o perfil dos idosos usuários de substâncias psicoativas atendidos no Centro de Atenção Psicossocial de álcool e drogas no interior paulista, no período de 1996 a 2009. O desenho metodológico é descritivo, do tiporetrospectivo, baseado em dados secundários. A amostra foi composta por 191 clientes com idade acima de 60 anos, que correspondem a 3,2 por cento de todos os atendidos no referido serviço. Os idosos caracterizaram-se por serem predominantemente do sexo masculino; a média de idade foi 64 anos, com baixo nível de escolaridade; 78,4 por cento tinham até o ensino fundamental; e 86 por centoeram aposentados. As drogas de maior uso foram: o álcool, a maconha, o crack e a cocaína. Conclui-se que o número de idosos que buscam assistência especializada é muito baixo. Estudos dessa natureza são importantes para avaliar as necessidades dessegrupo em evidente crescimento, bem como o uso de substâncias psicoativas para o planejamento de práticas efetivas.

Condición post-quirúrgica relacionada al cumplimiento del protocolo de procedimientos de exodoncia en unidades comunitarias de salud familiar, SIBASI centro octubre 2013-enero 2014 / Post-surgical condition related to compliance with the protocol of extraction procedures in community family health units, SIBASI center October 2013-January 2014

Objetivo: Evaluar el cumplimiento del protocolo de procedimientos de exodoncia y su relación en la evolución de la condición post-quirúrgica en Unidades Comunitarias de Salud Familiar del SIBASI CENTRO. Metodología: Es una investigación de tipo descriptiva asociativa, en la que se observó la aplicación del protocolo de exodoncia simple; y su relación con las condiciones post operatorias que pueda presentar el paciente. La población fue de 88 pacientes de 20-59 años; durante el periodo octubre 2013-enero 2014. Para recolectar datos se utilizaron dos guías de observación una dirigida al cumplimiento en gran medida, buena medida y en escasa medida del protocolo de exodoncia y la segunda guía a la condición post-quirúrgica del paciente en buen estado y mal estado. Como prueba estadística se utilizó el Chi Cuadrado para determinar la relación de las variables. Resultados: El 71.6% de las exodoncias se realizaron bajo un cumplimiento del protocolo de exodoncia en gran medida, 28.4% bajo un cumplimiento del protocolo de exodoncia en buena medida. En relación a la condición postquirúrgica de 88 pacientes que asistieron a la realización de tratamientos de exodoncias a 25 se les aplicó un protocolo en buena medida, 10 presentaron una condición post-quirúrgica en mal estado y 15 pacientes llegaron en buen estado; a 63 pacientes que se les ejecutó un protocolo de exodoncia en gran medida, 18 llegaron en mal estado y 45 en buen estado. Conclusiones: Ningún odontólogo ejecutó el protocolo de exodoncia en escasa medida. Determinando que el riesgo de tener una condición postquirúrgica en mal estado es 1.42 veces más en los que recibieron un protocolo en buena medida (regular), que el que lo recibió en gran medida, siendo este último a quien se le aplicó entre un 90 a 100 % el protocolo vigente en el Ministerio de Salud. Por lo que estos resultados indican que, no solamente aplicar en gran medida el protocolo de exodoncia simple basta para tener una buena condición post-quirúrgica. Ya que este podría depender de otros factores.

Objective: To evaluate the compliance of the procedures of dental extraction protocol and its relationship with evolution of post-surgical condition in Family Health Community Centers of SIBASI Centro. Methodology: This is a descriptive-associative investigation, in which studies the application of the of the simple dental extraction protocol; and its relationship with the post-surgical condition presented by patient. The sample of this investigation was conformed by 88 patients from 20 to 59 years old; during the period from October, 2013 to January, 2014. To collect the data there were used two observation format documents, one of these led to determine great extent, large extent and small extent of dental extraction protocol accomplishment and the second instrument guide led to check the post-surgical condition of the patient in good condition and bad condition. It was used the Chi-squared to determinethe connection of the variables. Results: 71.6% of the dental extraction were executed under the compliance of the dental extraction protocol in great extent, 28.4% was executed under compliance of the dental extraction protocol in large extent. In relation to the post-surgical condition of the 88 patients who attended to be treated with simple dental extraction, to 25 of them was applied a protocol in large extent, 10 of them presented a bad post-surgical condition and 15 a good condition; to 63 patient whose was applied a dental extraction protocol in great extent, 18 presented bad condition and 45 a good condition. Conclusions: Not dentist executed the dental extraction protocol in small extent. Having established that the risk of suffering bad post-surgical condition is 1.4 times more in those who were treated with a protocol in large extent, in comparison to those who was applied between 90 to 100% of Ministerio de Salud's current protocol. In addition data were obtained (p>0.05) does not confirm that a patient who was exposed to a proper implementation of the dental extraction protocol will have impact in the post- surgical condition in good or bad condition, for the ultimate result could depend on other factors not included in this study

Você conhece esta síndrome? / Do you know this syndrome?

Os autores apresentam caso de criança de dois anos, com história de cabelos negros e lisos ao nascimento que, aos seis meses de idade, desenvolveram alterações da textura e da cor, tornando-se mais claros e impenteáveis. A rara síndrome dos cabelos impenteáveis é caracterizada pelo surgimento de cabelos de crescimento lento, loiro-prateados, desordenados, em indivíduos com cabelos previamente normais. A microscopia óptica é normal e a microscopia eletrônica é diagnóstica. Não há tratamento efetivo.

Centro de referência em saúde mental em região urbana central / Mental health reference center at downtown city

Os autores apresentam a experiência de implantação do Centro Regional de Referência em Saúde Mental na região urbana central da cidade de Juiz de Fora, MG. Comentam sua inserção no Sistema Municipal de Saúde Mental, integrado à estrutura hierarquizada e regionalizada já existente, mudando a sistemática de atendimento antes realizada. Expõem dados numéricos da clientela, índices demográficos, biográficos, perfil de diagnóstico, tratamentos propostos e encaminhamentos. Concluem pela importância dos serviços públicos de saúde, destinados à população central urbana, notando que esta, após relutância e descrença inicial, apresentou boa receptividade graças ao serviço organizado e integrado.