The use of rubber dam in the survival of RMGIC restorations in primary molars: a 30-month randomized controlled clinical trial

Abstract This study was a randomized controlled clinical trial with two parallel arms and the objective was to compare the survival of resin modified glass ionomer (RMGIC) restorations in primary teeth using rubber dam or cotton roll isolation after a 30-month follow-up period. Ninety-two children (mean age 6.8 ± 1.37) and 200 primary molars with occlusal or occluso-proximal cavitated dentin caries lesions were randomly assigned into two groups: cotton rolls and rubber dam. All lesions were restored using RMGIC (RIVA Light Cure) after selective caries removal. Restorative failure and lesion arrestment were evaluated by two independent, trained, and calibrated examiners through clinical and radiographic examinations. The Kaplan-Meier test was used to assess the survival of restorations and Cox regression was used to assess the association of risk factors with restorative failure. There was no significant difference in survival rates between groups (p = 0.17). Older age (HR = 2.81 [95%CI: 1.47-5.44]) and higher rate of gingival bleeding (HR = 0.47 [95%CI: 0.23-0.99]) were associated with restorative failure. No patient had painful symptoms, pulp outcomes, or radiographic changes compatible with lesion progression. The use of rubber dam isolation did not increase the survival rate of occlusal and occluso-proximal restorations using RMGIC in primary molars after 30 months of follow-up. Since the survival is not influenced by the type of isolation, the professional can safely choose the appropriate technique for each case, considering his experience and preferences, as well as those of the patient.

Vitimização por bullying e fatores associados entre escolares de um município do Sul do Brasil / Bullying victimization and associated factors among schoolchildren in a city in the south of Brazil

Resumo O objetivo foi avaliar a prevalência de vitimização por bullying e seus fatores associados entre adolescentes da cidade de Pelotas, RS. Estudo transversal de base escolar realizado com 795 alunos do 9o ano do ensino fundamental de 25 escolas municipais urbanas vinculadas ao PSE. O bullying foi avaliado por meio de perguntas que abordaram a ocorrência, a frequência, o local, o tipo de violência sofrida e o quanto isso incomoda as vítimas. Análises bruta e ajustada foram feitas por regressão de Poisson. Aproximadamente 71% dos estudantes relataram ter sofrido bullying, a escola foi o local de maior ocorrência (86,7%). Entre os tipos de agressões sofridas, "apelidos" foi a queixa mais recorrente (88,4%), seguida por exclusão ou isolamento (26,6%). A vitimização foi mais frequente entre as meninas (RP 1,13; IC95% 1,02-1,27), estudantes com cor da pele/raça não branca (RP 1,16; IC95% 1,05-1,29), que já experimentaram tabaco (RP 1,14; IC95% 1,03-1,27), insatisfeitos (RP 1,42; IC95% 1,27-1,58) ou indiferentes (RP 1,21; IC95% 1,02-1,43) em relação ao corpo e que apresentavam excesso de peso (RP 1,15; IC95% 1,04-1,27). Os resultados mostram que o bullying é uma prática frequente no ambiente escolar, apontando para a necessidade de práticas educativas voltadas para a redução e prevenção desse tipo de violência.

Abstract The objective was to assess the prevalence of bullying victimization and associated factors among adolescents in the city of Pelotas, Rio Grande do Sul. A cross-sectional school-based study was conducted with 795 ninth grade students from 25 urban municipal schools linked to the School Health Program. Bullying was assessed using questions that addressed the occurrence, frequency, location, type of violence suffered and how much it bothers the victims. Gross and adjusted analyses were performed by Poisson regression. Approximately 71% of the students reported having suffered bullying, and school was the location of greatest occurrence (86.7%). Among the types of aggression suffered, "nicknames" was the most recurrent complaint (88.4%), followed by exclusion or isolation (26.6%). Victimization was more frequent among girls (PR 1.13; 95%CI 1.02-1.27), students with non-white skin color/race (PR 1.16; 95%CI 1.05-1.29), who have already tried tobacco (PR 1.14; 95%CI 1.03-1.27), dissatisfied (PR 1.42; 95%CI 1.27-1.58) or indifferent (PR 1.21; 95%CI 1.02-1.43) about their bodies, and who were overweight (PR 1.15; 95%CI 1.04-1.27). The results show that bullying is a frequent practice in the school environment, pointing to the need for educational practices aimed at reducing and preventing this type of violence.

Marcadores de alimentação saudável entre adolescentes da rede municipal de ensino de Pelotas, Rio Grande do Sul, 2019: estudo transversal / Healthy eating markers among adolescents from the municipal school system in Pelotas, Rio Grande do Sul, Brazil, 2019: a cross-sectional study / Marcadores de alimentación saludable entre adolescentes del sistema escolar municipal de Pelotas, Rio Grande do Sul, Brasil, 2019: estudio transversal

Objetivo: analisar o consumo de marcadores de alimentação saudável entre adolescentes escolares de Pelotas, Rio Grande do Sul, Brasil, em 2019. Métodos: estudo transversal, realizado nas escolas vinculadas ao Programa Saúde na Escola; o consumo dos cinco marcadores (feijão, leite, frutas, vegetais cozidos, saladas cruas) em até cinco dias antecedentes ao estudo, obtido mediante questionário autoaplicado, foi definido como regular; a associação de variáveis demográficas, socioeconômicas e comportamentais com os desfechos foi analisada por regressão de Poisson. Resultados: entre os 797 entrevistados, 2,8% (IC95% 1,8;4,1) referiram consumo regular; o feijão foi o alimento mais consumido regularmente (48,3%); frutas, vegetais cozidos e saladas cruas foram consumidos regularmente por menos de 30% dos escolares; praticar atividade física, tomar café da manhã e realizar refeições com a família estiveram associados ao consumo regular dos alimentos avaliados. Conclusão: o consumo regular de alimentos saudáveis, encontrado baixo nessa população, associou-se com fatores comportamentais.

Objective: to analyze the consumption of healthy eating markers among adolescent students in Pelotas, Rio Grande do Sul, Brazil, in 2019. Methods: this was a cross-sectional study carried out in schools taking part in the Health at School Program. Consumption of the five markers (beans, milk, fruit, cooked vegetables and raw salads) within five days prior to the study, obtained through a self-administered questionnaire, was defined as regular. Association between demographic, socioeconomic and behavioral variables and the outcomes was analyzed using Poisson regression. Results: among the 797 respondents, 2.8% (95%CI 1.8;4.1) reported regular consumption. Beans were the most regularly consumed food (48.3%); fruit, cooked vegetables and raw salads were consumed regularly by less than 30% of the students. Doing physical activities, having breakfast and having meals with the family were associated with regular consumption of the foods assessed. Conclusion: regular consumption of healthy foods was low in this population, and was associated with behavioral factors.

Objetivo: analizar el consumo de marcadores de alimentación saludable entre estudiantes adolescentes de Pelotas, Rio Grande do Sul, Brasil, en 2019. Métodos: estudio transversal realizado en escuelas vinculadas al Programa Salud en la Escuela. Se definió como regular el consumo de los cinco marcadores (porotos, leche, frutas, vegetales cocidos y ensaladas crudas) dentro de los cinco días previos al estudio, obtenidos a través de un cuestionario autoadministrado. La asociación entre variables demográficas, socioeconómicas y conductuales con los resultados se analizó mediante la regresión de Poisson. Resultados: entre los 797 encuestados, el 2,8% (IC95% 1,8; 4,1) informó un consumo regular. Los porotos fueron el alimento más consumido (48,3%). Frutas, verduras cocidas y ensaladas crudas fueron consumidas regularmente por menos del 30% de los estudiantes. La práctica de actividad física, el desayuno y las comidas en familia se asociaron con mayor consumo de los alimentos evaluados. Conclusión: el consumo regular de alimentos saludables fue bajo en esta población y se asoció con factores conductuales.

Rede de apoio às famílias de crianças com transtorno do espectro autista / Red de apoyo a las familias de niños con trastorno del espectro autista / Support network for families of children with autism spectrum disorder

RESUMO Objetivo: identificar a rede social de apoio das famílias de crianças com Transtorno do Espectro Autista (TEA). Métodos: trata-se de uma pesquisa descritiva, abordagem qualitativa, com a participação de 22 familiares de crianças com TEA. A coleta de dados ocorreu por meio de entrevista semiestruturada, entre os meses de agosto de 2018 e março de 2020. Os depoimentos foram transcritos e submetidos à análise de conteúdo, com apoio do software WebQDA ® . Resultados: emergiram as seguintes categorias e subcategorias: apoio familiar (elementos da rede familiar, rede restrita e funções da rede) e apoio comunitário (serviços utilizados, ajuda material e de serviços, recursos comunitários, guia cognitivo e de conselhos). Considerações Finais: a rede de apoio familiarevidencia-se restrita e fragilizada devido ao suporte limitado da família extensa ou de outros membros da comunidade. Além disso, foram identificadas lacunas no acesso aos serviços de saúde e recursos de assistência social assegurados por Lei às pessoas com TEA, revelando a importância do papel da equipe multiprofissional em articular a rede de atenção, com vistas ao fortalecimento das famílias, transformando-se em agentes de proteção aos direitos e ampliação da rede da criança com TEA e sua família.

RESUMEN Objetivo: identificar la red social de apoyo de las familias de niños con Trastorno del Espectro Autista (TEA). Métodos: se trata de una investigación descriptiva, con abordaje cualitativo, con la participación de 22 familiares de niños con TEA. La recolección de datos se realizó por medio de entrevista semiestructurada, entre los meses de agosto de 2018 y marzo de 2020. Los relatos fueron transcritos y sometidos al análisis de contenido, con el apoyo del software WebQDA®. Resultados: han surgido las siguientes categorías y subcategorías: apoyo familiar (elementos de la red familiar, red restricta y funciones de la red) y apoyo comunitario (servicios utilizados, ayuda material y de servicios, recursos comunitarios, apoyo cognitivo y de consejos). Consideraciones finales: la red de apoyo familiar se evidencia restricta y fragilizada debido al soporte limitado de la familia extensa o de otros miembros de la comunidad. Además, se identificaron lagunas en el acceso a los servicios de salud y recursos de asistencia social asegurados por Ley a las personas con TEA, revelando la importancia del papel del equipo multiprofesional en articular la red de atención, a fin de fortalecer a las familias, transformándose en agentes de protección a los derechos y ampliación de la red del niño con TEA y su familia.

ABSTRACT Objective: to identify the social support network for families of children with Autism Spectrum Disorder (ASD). Methods: descriptive study with a qualitative approach, with the participation of 22 family members of children with ASD. Data collection was conducted through semi-structured interviews between August 2018 and March 2020. Statements were transcribed and submitted to content analysis, with the support of the WebQDA® software. Results: the following categories and subcategories emerged: family support (elements of family network, restricted network, and network functions) and community support (services used, material support and services, community resources, cognitive guide and advice). Final Considerations: the family support network is restricted and weakened due to limited support from the extended family or other community members.In addition, barriers were identified in the access to health services and social assistance resources ensured by law for people with ASD, revealing the importance of the role of multidisciplinary teams in connecting the care network, with a view to strengthening the families, becoming agents forthe protection of rights and expansion of the network for the child with ASD and their family.

Repercussões da pandemia de COVID-19 no exame preventivo de câncer de colo uterino: percepção de enfermeiros / Repercusiones de la pandemia de COVID-19 en el tamizaje del cáncer de cuello uterino: percepción de los enfermeros / Repercussions of the COVID-19 pandemic on cervical cancer screening: nurses' perception

Resumo Objetivo compreender a percepção de enfermeiros da atenção primária sobre as repercussões da pandemia na realização do exame citopatológico do colo-uterino. Método estudo qualitativo, descritivo, com dados analisados pela Análise de Conteúdo. Foram entrevistados 12 enfermeiros, atuantes na atenção primária de Foz do Iguaçu, PR, entre fevereiro e março de 2022. Resultados emergiram três categorias temáticas que discorreram sobre os prejuízos da pandemia para o rastreamento do câncer de colo-uterino; necessidade de reorganização do serviço, destacando a baixa adesão; e falta de estratégias para o retorno das práticas em saúde. Conclusão e implicações para a prática na pandemia houve a suspensão da coleta de preventivo e após o período crítico, o medo da contaminação pelas mulheres, falta de insumos e recursos humanos dificultaram a retomada do serviço. Torna-se relevante para a prática, desenvolver ações e estratégias que incentivem a realização do exame, para assim reduzir a morbimortalidade por essa neoplasia.

Resumen Objetivo comprender la percepción de los enfermeros de atención primaria sobre las repercusiones de la pandemia en la realización de exámen citopatológico cervical. Método estudio cualitativo, descriptivo, con datos analizados por Análisis de Contenido. Fueron entrevistadas doces enfermeras que actúan en la atención primaria en Foz do Iguaçu, PR, entre febrero y marzo de 2022. Resultados surgieron tres categorías temáticas que discutieron los daños de la pandemia para el tamizaje del cáncer de cuello uterino; necesidad de reorganizar el servicio, destacando la baja adherencia; y falta de estrategias para el retorno de las prácticas de salud. Conclusión e implicaciones para la práctica en la pandemia hubo una suspensión de la recolección preventiva y después del período crítico, el miedo a la contaminación por parte de las mujeres, la falta de insumos y recursos humanos dificultó la reanudación del servicio. Se vuelve relevante para la práctica desarrollar acciones y estrategias que favorezcan la realización del examen, con el fin de disminuir la morbimortalidad por esta neoplasia.

Abstract Objective to understand the perception of primary care nurses about the repercussions of the pandemic on the performance of cervical cytopathological exam. Method qualitative, descriptive study, with data analyzed by Content Analysis. Twelve nurses working in primary care in Foz do Iguaçu, PR, between February and March of 2022, were interviewed. Results three thematic categories emerged that discussed the damages of the pandemic for cervical cancer screening; need to reorganize the service, highlighting the low adherence; and lack of strategies for the return of health practices. Conclusion and implications for practice in the pandemic, there was a suspension of preventive collection and after the critical period, the fear of contamination by women, lack of inputs and human resources made it difficult to resumption of service. It's relevant for practice to develop actions and strategies that encourage the performance of the exam, in order to reduce morbidity and mortality from this neoplasm.

A Auriculoterapia como cuidado singular em saúde da população idosa

Objetivo Analisar os efeitos e significados da auriculoterapia na perspectiva do cuidado em saúde das pessoas idosas. Metodologia Estudo qualitativo em que realizou-se o tratamento com auriculoterapia e, posteriormente, entrevistas semiestruturadas com referencial teórico-metodológico no cuidado em saúde e na qualidade de vida dos idosos. A análise foi executada a partir da Teoria Fundamentada nos Dados. Resultados Obteve-se uma categoria principal: A singularidade da qualidade de vida e sua relação com a auriculoterapia. Os participantes relataram melhora da qualidade de vida e relacionaram isso aos benefícios físicos, mentais e sociais do tratamento. Seis subcategorias revelaram a auriculoterapia como prática para uma Clínica Ampliada, construtora de vínculo entre profissional e usuário, produtora de autonomia e autocuidado; além dos benefícios da auriculoterapia nas condições crônicas, majoritariamente redução de dor, ansiedade e sentimentos depressivos. Conclusão Autocuidado e promoção da qualidade de vida devem assumir centralidade das práticas profissionais em saúde, assim como devem assumir capilaridade pelos serviços de saúde e pelas situações de vida de todos.

Qualidade da dieta de adolescentes da rede pública de ensino de um município do sul do Brasil: estudo transversal, 2019 / Calidad de la dieta de los adolescentes del sistema de escuelas públicas de un municipio del sur de Brasil: estudio transversal, 2019 / Diet quality among adolescents in the public education system in a municipality in Southern Brazil: a cross-sectional study, 2019

Objetivo: Identificar os fatores associados à qualidade da dieta de estudantes do 9º ano da rede municipal de ensino de Pelotas, Rio Grande do Sul, Brasil. Métodos: Estudo transversal, realizado em 2019. As informações alimentares foram coletadas por formulário de frequência alimentar, e a qualidade da dieta foi avaliada mediante índice desenvolvido pelos autores. A dieta foi classificada como de baixa, intermediária ou alta qualidade. A associação foi avaliada por regressão logística multinomial. Resultados: Os 808 adolescentes avaliados obtiveram média de 16,0 pontos (desvio-padrão=4,1) no índice desenvolvido. A alta qualidade da dieta mostrou-se associada a experimentação de tabaco [razão de chances, ou odds ratio (OR) 2,92; intervalo de confiança de 95% (IC95%) 1,74;4,92] e prática de atividade física no lazer (OR=1,65; IC95% 1,15;2,38). Conclusão: Destaca-se a importância do incentivo à prática de atividade física, monitoramento de comportamentos de riscos nos adolescentes e promoção do consumo de alimentos considerados saudáveis.

Objetivo: Identificar factores asociados a calidad de la dieta de estudiantes de 9º ano de escuelas municipales de Pelotas, Rio Grande do Sul. Métodos: Estudio transversal, realizado en 2019. La información dietética se recopiló mediante Formulario de Frecuencia de Alimentos y la calidad de la dieta se evaluó mediante índice desarrollado por los autores. La dieta fue clasificada como de baja, intermedia o de alta calidad. La asociación se investigó mediante regresión logística multinomial. Resultados: Los 808 adolescentes evaluados tuvieron en media 16,0 puntos (desvío-estándar=4,1) en el índice desarrollado. La alta calidad de la dieta se asoció con experimentación de tabaco [OR=2,92; intervalo de confianza del 95% (IC95%) 1,74;4,92] y práctica de actividad física en el tiempo libre (OR=1,65; IC95% 1,15;2,38). Conclusión: Se destaca la importancia de fomentar la práctica de actividad física, el seguimiento de conductas de riesgo en adolescentes y promover el consumo de alimentos saludables.

Objective:To identify the factors associated with the diet quality among 9th grade students in the municipal education system of Pelotas, state of Rio Grande do Sul, Brazil. Methods: This was a cross-sectional study, conducted in 2019. Food information was collected using a food frequency questionnaire, and diet quality was assessed through an index developed by the authors. Diet was classified as low, intermediate or high quality. The association was assessed using multinomial logistic regression. Results:The 808 adolescents evaluated obtained a mean score of 16.0 points (deviation-standard=4.1) according to the developed index. The high diet quality was associated with tobacco experimentation [odds ratio (OR) 2.92; 95% confidence interval (95%CI) 1.74;4.92] and leisure-time physical activity (OR=1.65; 95%CI 1.15;2.38). Conclusion: We highlighted the importance of encouraging physical activity practice, monitoring risk behaviors among adolescents and promoting the consumption of healthy food.

Validação de informações para construção de cartilha interativa para famílias de crianças com autismo / Validation of diverse information to prepare an interactive booklet for families of autistic children / Validación de información para elaborar una cartilla interactiva para familias de niños con autismo

RESUMO Objetivo validar conteúdo e aparência de informações para construção de cartilha interativa para famílias de crianças com Transtorno do Espectro Autista. Método pesquisa metodológica, realizada em Curitiba-PR, Brasil, com 86 experts entre junho a novembro de 2020 com uso da técnica Delphi. Para coleta dos dados, utilizou-se um instrumento contendo variáveis sobre a relevância do conteúdo; clareza e objetividade; e atualização científica. Na análise dos dados, determinou-se o índice de validade de conteúdo ≥75%. Resultados o conteúdo sobre as características da criança com autismo, diagnóstico, comportamento e direitos foi considerado válido pelos experts na primeira rodada. As informações sobre os sinais da criança com autismo e futuro foram validadas no segundo round, após reformulações sugeridas pelos experts. Conclusão este recurso educacional tem potencial para contribuir na educação em saúde para famílias de criança com autismo.

ABSTRACT Objective to validate content and face of diverse information to prepare an interactive booklet for families of children with Autism Spectrum Disorder. Method a methodological research study conducted in Curitiba-PR, Brazil, with 86 experts between June and November 2020 and using the Delphi technique. An instrument with variables about relevance of the content, clarity and objectivity and scientific topicality was used for data collection. In data analysis, the Content Validity Index was set at ≥75%. Results the content about the characteristics of autistic children, their diagnosis, behavior and rights was considered valid by the experts in the first round. The diverse information about the signs in autistic children and their future were validated in the second round, after the reformulations suggested by the experts. Conclusion this educational resource has the potential to contribute in health education for the families of autistic children.

RESUMEN Objetivo validar el contenido y el aspecto de diversa información para preparar una cartilla interactiva para familias de niños con Trastorno del Espectro Autista. Método investigación metodológica realizada en Curitiba-PR, Brasil, con 86 especialistas entre junio y noviembre de 2020 empleando la técnica Delphi. Para recolectar los datos se utilizó un instrumento con variables sobre la relevancia del contenido, claridad y objetividad y actualización científica. En el análisis de los datos se determinó un Índice de Validez de Contenido ≥75%. Resultados los especialistas consideraron válido el contenido sobre las características de los niños con autismo, su diagnóstico comportamiento y derechos en la primera ronda. La diversa información sobre las señales presentes en niños con autismo y sobre su futuro se validó en la segunda ronda, luego de las reformulaciones sugeridas por los especialistas. Conclusión este recurso educativo tiene potencial para contribuir a la educación en salud para las familias de niños con autismo.

Envelhecimento e vulnerabilidades: a odontogeriatria na graduação como estratégia de valorização da vida / Aging and vulnerabilities: the geriatric dentistry in graduation as strategy of life valuation

O envelhecimento populacional suscita desafios sociais que se tornam mais evidentes pela pandemia de COVID-19, e o Brasil tem observado a morte de seus idosos e de jovens que não terão a oportunidade de envelhecer. A gerontologia, nesse contexto, faz-se imperativa e sua inserção na formação de profissionais de saúde é uma demanda urgente que a Faculdade de Odontologia da Universidade Federal do Rio Grande do Sul atende por meio de estágios curriculares voltados à pessoa idosa, construindo e consolidando conhecimentos relacionados ao envelhecimento na formação de estudantes de graduação em odontologia. As atividades ocorrem no curso diurno em unidades de saúde e em instituições de longa permanência para idosos, e no curso noturno através de visitas domiciliares a idosos vinculados a unidades de saúde. A problematização que esses estágios geram parece ter um impacto positivo no processo de formação, pois proporciona aos estudantes a possibilidade de desenvolverem outras formas de cuidado, que vão além da clínica biomédica tradicional e que os capacita como atores sociais. Essas diferentes práticas de ensino fortalecem a valorização da vida e do envelhecer, a autonomia e a participação do idoso como agente de formação e transformação social, e o protagonismo do próprio estudante.

Qualidade microbiológica e perfil de sensibilidade a antimicrobianos em águas de poços artesianos em um município do noroeste do Rio Grande do Sul / Microbiological quality and sensitivity profile to antimicrobials in artesian well waters in a municipality in the northwest of Rio Grande do Sul

RESUMO A qualidade da água utilizada para consumo tem influência direta sobre a saúde e o bem-estar das pessoas, demonstrando a necessidade de criação de mecanismos de controle e acompanhamento de potenciais contaminações. Este estudo teve como objetivo determinar e quantificar coliformes totais e Escherichia coli, bem como avaliar o seu perfil de sensibilidade a antimicrobianos em águas de poços artesianos da área rural de um município do noroeste do Rio Grande do Sul. Foram realizadas coletas e análises microbiológicas em amostras de 40 poços artesianos cadastrados no Sistema de Informação de Vigilância da Qualidade da Água para Consumo Humano (SISAGUA). Os resultados mostraram que 85% das amostras apresentaram resultados positivos para coliformes totais e 22,5% foram identificadas como E. coli. Dos 8 antibióticos testados, apenas amoxicilina, ampicilina e nitrofurantoína apresentaram 100% de inibição do crescimento bacteriano. Conclui-se que a maioria dos poços analisados apresentou água fora dos padrões de qualidade para consumo, sendo necessárias ações corretivas do poder público como forma de prevenção de doenças infecciosas. Além disso, deve-se buscar racionalizar o tratamento farmacológico com antibióticos, em função de indicativos de resistência bacteriana apresentada pelas cepas isoladas neste estudo.

ABSTRACT The quality of water used for consumption has a direct influence on people's health and quality of life, demonstrating the need to create mechanisms to control and monitor potentials contaminations. This study aimed to determine and quantify total coliforms, Escherichia coli, and to evaluate their antimicrobial susceptibility profile in waters from rural wells in a northwestern municipality of Rio Grande do Sul State. Microbiological collections and analyses were carried out in samples from 40 artesian wells, registered in the Water Quality Surveillance Information System for Human Consumption (Sistema de Informação de Vigilância da Qualidade da Água para Consumo Humano - SISAGUA). The results show that 85% of the samples were positive for total coliforms and 22.5% were identified as E. coli. Of the eight antibiotics tested, only Amoxicillin, Ampicillin, and Nitrofurantoin showed 100% inhibition of bacterial growth. It is concluded that an important part of the analyzed wells did not present water with quality standards for consumption, requiring corrective actions by public authorities as a way of preventing infectious diseases. In addition, one must seek to rationalize the pharmacological treatment with antibiotics, due to indications of bacterial resistance presented by the strains isolated in this study.

Dopamina e comportamento alimentar: polimorfismos em receptores dopaminérgicos e fenótipos relacionados à obesidade / Dopamine and eating behavior: dopaminergic receptor polymorphisms and obesity related phenotypes

Dentre os sistemas neurais responsáveis pela ingestão dos alimentos, destaca-se a via dopaminérgica mesolímbica que, através da liberação de dopamina nos núcleos de accumbens, desperta prazer e motivação para recompensas químicas e naturais. Esta via de recompensa age através dos receptores dopaminérgicos transmembranares, que variam de DRD1 a DRD5. Desta forma, considerando os efeitos prazerosos despertados pela ingestão alimentar, é plausível que variações genéticas em genes do sistema dopaminérgico possam ter um papel na arquitetura genética da obesidade. Este estudo tem como objetivo realizar uma revisão narrativa da literatura sobre a influência de variantes genéticas nos receptores dopaminérgicos em fenótipos relacionados com a obesidade. Em conjunto, os principais achados desta revisão indicaram que os genes codificadores dos receptores DRD2 e DRD4 possam ser os mais relevantes no contexto da obesidade e fenótipos relacionados. No entanto, a obesidade é uma doença complexa e multifatorial e novos estudos são ainda necessários para uma melhor compreensão do impacto da dopamina nos desfechos relacionado à obesidade. É importante também destacar que esses efeitos podem ser específicos para subgrupos de pacientes e que outros fatores, além das variantes genéticas, devem ser considerados. (AU)

Among the neural systems responsible for food ingestion, the mesolimbic dopaminergic pathway stands out by eliciting pleasure and motivation for chemical and natural rewards through the release of dopamine in the nucleus accumbens. This reward pathway is regulated by transmembrane dopaminergic receptors, which range from DRD1 to DRD5. Thus, considering the pleasurable effects aroused by food intake, it is plausible that genetic variations in genes of the dopaminergic system may have a role in the genetic architecture of obesity. This study aims to conduct a narrative review of the literature on the influence of genetic variants of dopaminergic receptors on obesity-related phenotypes. Taken together, the main findings of this review indicated that the genes encoding the DRD2 and DRD4 receptors may be the most relevant in the context of obesity and related phenotypes. However, obesity is a complex and multifactorial disease and new studies are still being conducted to better understand the impact of dopamine on obesity-related outcomes. It is also important to note that these effects can be specific to subgroups of patients and that other factors, in addition to genetic variants, must be considered. (AU)

Multilayer stents affect the final diameter of aortic aneurysms and maintain renal artery patency for a short time in a swine experimental model

OBJECTIVES: We sought to analyze the hemodynamic effects of the multilayer flow-modulated stent (MFMS) in Thoracoabdominal aortic aneurysms (TAAAs). METHODS: The hemodynamic effects of MFMS were analyzed in aortic thoracoabdominal aneurysms in experimental swine models. We randomly assigned 18 pigs to the stent or control groups and underwent the creation of an artificial bovine pericardium transrenal aneurysm. In the stent group, an MFMS (Cardiatis, Isnes, Belgium) was immediately implanted. After 4 weeks, we evaluated aneurysm sac thrombosis and renal branch patency by angiography, duplex scan, and morphological analysis. RESULTS: All the renal arteries remained patent after re-evaluation in both groups. Aneurysmal sac thrombosis was absent in the control group, whereas in the stent group it was present in 66.7% of aneurysmal sacs (p=0.061). The mean final aneurysm sac diameter was significantly lower in the stent group (mean estimated reduction, 6.90 mm; p=0.021). The proximal neck diameter decreased significantly in the stent group (mean difference, 2.51 mm; p=0.022) and grew significantly in the control group (mean difference, 3.02 mm; p=0.007). The distal neck diameter increased significantly in the control group (mean difference, 3.24 mm; p=0.017). There were no significant findings regarding distal neck measurements in the stent group. CONCLUSION: The MFMSs remained patent and did not obstruct the renal arteries within 4 weeks. In the stent group, the device was also associated with a significant decrease in aneurysmal sac diameter and a large proportion (albeit non-significant) of aneurysmal sac thrombosis.

Efeito da isquemia renal unilateral no rim contralateral avaliada pela expressão de Caspase 3 / Effect of unilateral renal ischemia on the contralateral kidney assessed by Caspase 3 expression

Resumo Contexto Estudos demonstraram, por análise histológica e Dopplerfluxométrica, a interferência da isquemia renal unilateral, realizada em algumas cirurgias, sobre o rim contralateral, identificando o fenômeno de kidney-kidney crosstalk. Objetivos Identificar o efeito da isquemia de duas estratégias de oclusão da vasculatura renal esquerda sobre o rim contralateral através do volume de células renais positivas para Caspase 3. Métodos Suínos foram divididos em 2 grupos: A (n = 8), artéria renal esquerda clampeada, e AV (n = 8), artéria e veia renais esquerdas clampeadas. Foi realizado o estudo imuno-histoquímico (anti-Caspase 3), com o material de biópsias coletadas do rim isquêmico e contralateral em 0, 30, 60 e 90 minutos de isquemia, e análise morfométrica, sendo que a média representou o volume de área de Caspase 3 positiva (%). Resultados A análise morfométrica do rim contralateral nos tempos 30, 60 e 90 minutos de isquemia mostrou que a média da área marcada por Caspase 3 foi estatisticamente superior à média do rim isquêmico nos dois grupos: artéria renal clampeada (A) e artéria e veia renais clampeadas (AV). Comparando o rim isquêmico e contralateral nos dois tipos de clampeamento, não houve diferença estatisticamente significante da área marcada por Caspase 3. Conclusões No modelo experimental de isquemia renal unilateral, o rim não isquêmico apresentou dano celular, demonstrado pela expressão da Caspase 3 de forma aguda em decorrência da isquemia contralateral. O tipo de clampeamento do hilo não parece ter influência sobre o volume de área marcada por Caspase 3.

Abstract Background Studies have demonstrated with histological analysis and Doppler flow measurement analysis that unilateral renal ischemia, which is performed in some surgeries, interfered with the contralateral kidney, identifying the phenomenon of kidney-kidney crosstalk. Objectives To identify the effects on the ischemic and contralateral kidney of renal ischemia induced by two types of clamping technique by analyzing the volume of kidney cells positive for Caspase 3. Methods Sixteen pigs were divided into 2 groups, as follows: A (n = 8) - clamping of left renal artery only and AV (n = 8) - clamping of left renal artery and vein. Immunohistochemical analyses (anti Caspase 3) were conducted with biopsy specimens collected from the ischemic and contralateral kidney at 0, 30, 60, and 90 minutes of ischemia and morphometric analysis was performed, taking the mean to represent the volume of the Caspase 3 positive area (%). Results Morphometric analysis of specimens collected at 30, 60, and 90 minutes of ischemia showed that the mean area marked for Caspase 3 was statistically larger in the contralateral kidney than the ischemic kidney in both groups: clamped renal artery (A) and clamped renal artery and vein (AV). Comparing the ischemic and contralateral kidney, there was no statistically significant difference in the area marked for Caspase 3 between the two types of clamping. Conclusions In the experimental model of unilateral renal ischemia, the non-ischemic kidney exhibited cell damage, demonstrated by Caspase 3 expression. The type of hilum clamping does not appear to influence the area marked for Caspase 3.

Audiogram in Response to Stimulation Deliveredto Fluid Applied to the External Meatus

Hearing can be elicited in response to vibratory stimuli deliveredto fluid in the external auditory meatus. To obtain a complete audiogram in subjects withnormal hearing in response to pure tone vibratory stimuli delivered to fluid applied to the externalmeatus. Subjects and Methods: Pure tone vibratory stimuli in the audiometric range from0.25 to 6.0 kHz were delivered to fluid applied to the external meatus of eight participants withnormal hearing (15 dB or better) using a rod attached to a standard clinical bone vibrator. Thefluid thresholds obtained were compared to the air conduction (AC), bone conduction (BC;mastoid), and soft tissue conduction (STC; neck) thresholds in the same subjects. Results:Fluid stimulation thresholds were obtained at every frequency in each subject. The fluid andSTC (neck) audiograms sloped down at higher frequencies, while the AC and BC audiogramswere flat. It is likely that the fluid stimulation audiograms did not involve AC mechanisms oreven, possibly, osseous BC mechanisms. Conclusions: The thresholds elicited in responseto the fluid in the meatus likely reflect a form of STC and may result from excitation of the innerear by the vibrations induced in the fluid. The sloping fluid audiograms may reflect transmissionpathways that are less effective at higher frequencies.J Audiol Otol 2020;24(2):79-84

Entre padres e hijos con autismo: la experiencia de la intersubjetividad en el atrincherado aislamiento del niño / Between parents and children with autism: experience of intersubjectivity in the child's entrenched isolation

El artículo es una síntesis operada sobre un trabajo de investigación cuyo objeto de estudio es el tratamiento de niños pequeños, con signos clínicos de condición autista y sus padres. Plantea nexos entre la vulnerabilidad innata a desarrollar un proceso autístico y las modalidades con que los padres ejercen su función. Dicha investigación se llevó a cabo en el ámbito de la Universidad de Ciencias Sociales y Empresariales (UCES) Buenos Aires, 2007, bajo la forma de tesis de doctorado, y fue actualizada con el material clínico de diez pacientes que recibieron atención psicoterapéutica en consultorio privado, entre 2008 y 2016. Se comprobó que en niños con signos clínicos de autismo el proceso de regulación emocional entre él y sus padres está alterado. Ambos tienen dificultades para anticipar lo que el otro siente, piensa o desea. Es decir que tanto el niño como sus padres carecen de una teoría acerca de lo que recíprocamente les sucede. El marco teórico referencial está conformado por conceptualizaciones psicodinámicas que toman en cuenta la experiencia intersubjetiva en la emergencia de la subjetividad. (Freud, 1895; Maldavsky,1995; Rizzolatti,2004; Fonagy, 2007)(AU)

The article is an synthesis operated of research work whose subject matter is the treatment of young children with clinical signs of autistic condition and their parents. It raises links between the innate vulnerability to developing an autistic process and the ways in which parents exercise their role. This research was carried out in the field of the University of Social and Business Sciences(UCES) Buenos Aires, 2007, in the form of a doctoral thesis, and was updated with the clinical of ten patients who received psychotherapeutic care in private office, between 2008 and 2016. It was found that in children with clinical signs of autism the process of emotional regulation between him and his parents is altered. Both have difficulty anticipating what the other feels, thinks, or desires. In other words, both the child and his parents lack a theory about what happens to them. The referential theoretical framework consists of psychodynamic conceptualizations that take into account the intersubjective experience in the emergence of subjectivity. (Freud, 1895; Maldavsky,1995; Rizzolatti,2004; Fonagy, 2007)(AU)

Study of kidney morphologic and structural changes related to different ischemia times and types of clamping of the renal vascular pedicle

ABSTRACT Purpose This study aimed to study morphological and renal structural changes in relation to different ischemic times and types of renal vascular pedicle clamping. Methods Sixteen pigs were divided into two groups (n = 8): Group AV - unilateral clamping of the renal artery and vein and Group A - unilateral clamping of the renal artery only, both with the contralateral kidney used as control. Serial biopsies were performed at 0, 10, 20, 30, 40, 50, 60, 70, 80, and 90 minutes after clamping. Results there is a correlation between the occurrence of renal damage as a function of time (p <0.001), with a higher frequency of Group A lesions for cellular alterations (vascular congestion and edema, interstitial inflammatory infiltrate, interstitial hemorrhage and cell degeneration), with the exception of in the formation of pigmented cylinders that were evidenced only in the AV Group. Conclusion the number of lesions derived from ischemia is associated with the duration of the insult, there is a significant difference between the types of clamping, and the AV Group presented a lower frequency of injuries than Group A. The safety time found for Group A was 10 minutes and for Group AV 20 minutes.

Randomized two dimensional between patient response surface pathway design with two interventional and one response variable in estimating minimum efficacy dose

Background:The aim of this paper is to introduce and evaluate the RSP design with two interventional and one response variable exemplified by estimating minimum efficacy dose (MED) of osteopathic manual therapy (OMT) in treatment of gastroesophageal reflux disease (GERD).Methods:15 GERD patients, divided in three design-level with three, five and seven patients. The study was performed as a randomized two-dimensional, between-patient RSP designed multicenter study with two interventional–and one response variable. The interventional variables “Number of OMT’s” and “Treatment Interval” with common response variable, formed two independent one-dimensional randomized between-patient RSP studies. The response variable was percent reduction in sum of the five GERD score from baseline. Three GERD patients were allocated on the first design level and given six OMT with five days’ interval. Based on results obtained in the first and second design level, five patients were included to the second design level and seven to the third.Results:The two-dimensional randomized between-patient RSP-design with the combined outcome procedure worked as expected. The percent reduction in GERD score increased with increasing number of OMT’s and time intervals. This increase leveled out after three to five OMT’s and three to four days between treatments. A clinical interaction between the two interventional variables was obtained. The estimated MED of OMT in treatment of GERD was three treatments with two days between treatments.Conclusions: The suggested two-dimensional, randomized between-patient RSP-design worked as expected and estimated MED of OMT in GERD patient sufficiently

Possíveis mecanismos de ação dos microRNAs na doença periodontal / Possible mechanisms of action of microRNAs in periodontal disease

Objetivo: o propósito deste estudo foi revisar os possíveis mecanismos de ação dos microRNAs na doença periodontal. Material e Métodos: o estudo foi baseado em artigos científicos encontrados na base de dados PubMed. Resultados: a recente descoberta de microRNAs (miRNAs) revolucionou a maneira como a regulação gênica é analisada. Estudos demonstram que os miRNAs podem atuar na resposta inata, em vários estágios, entre eles na sinalização de receptores Toll-like. Os miRNAs também estão relacionados à regulação de elementos centrais da resposta imune adaptativa, como apresentação de antígenos. No entanto, muito ainda precisa ser estudado para identificar a atividade de miRNAs na regulação gênica. A doença periodontal é uma doença bucal causada por patógenos bacterianos, com resposta inflamatória e imune agressiva, que afeta os tecidos ao redor dos dentes, podendo levar à sua perda. Conclusão: concluiu-se que os recentes achados do papel dos microRNAs na resposta inflamatória, incluindo tanto a imunidade inata como a adaptativa, ocorrem na doença periodontal

Objective: the purpose of this study was to review the role of possible mechanisms of action of microRNAs in periodontal disease. Material and Methods: the study was based on PubMed scientific papers. Results: the recent discovery of microRNAs (miRNAs) has revolutionized the way that gene regulation is analyzed. Studies demonstrate that they can act on the innate response, in several stages, among them the signaling of Toll-like receptors. The miRNAs are also related to the regulation of central elements of the adaptive immune response, such as antigen presentation. However, much still needs to be studied to identify miRNAs activity in gene regulation. Periodontal disease is an oral disease caused by bacterial pathogens, with an aggressive immune and inflammatory response, which affects the tissues around the teeth, which may lead to their loss. Conclusion: it was concluded that the recent findings of the role of microRNAs in the inflammatory response, including both innate and adaptative immunity, that occurs in periodontal disease

A randomized trial comparing limited-excision conisation to Large Loop Excision of the Transformation Zone (LLETZ) in cervical dysplasia patients / 부인종양

OBJECTIVE: To show noninferiority of a limited-excision (resection of the dysplastic lesion only) vs. classical Large Loop Excision of the Transformation Zone (LLETZ). METHODS: In this prospective, randomized, multicenter trial, women with human papillomavirus (HPV) positive cervical intraepithelial neoplasia grade 3 were randomized into two groups (1:1). Primary outcome was the rate of negative HPV tests after 6 months, secondary outcomes included cone size, complete resection rates as well as cytological and histological results after 6 and 12 months. A sample size of 1,000 was calculated to show noninferiority of the limited-excision compared to the LLETZ group using a noninferiority margin of 5%. Enrollment was stopped after 100 patients due to slow accrual. RESULTS: Patients in the limited-excision group did not show a lower number of negative HPV tests (78% [LLETZ]−80% [limited-excision]=−2%; 90% confidence interval=−15%, 12%). The limited-excision resulted in a substantially lower cone size (LLETZ: 1.97 mL vs. limited-excision: 1.02 mL; p < 0.001) but higher numbers of involved margins (LLETZ: 8% vs. limited-excision: 20%). Although postoperative cytological results slightly differed, histological results were similar in both groups. One limited-excision patient received immediate re-conisation, whereas one patient in each group was scheduled for re-conisation after 6 months. CONCLUSION: The limited-excision could represent a promising option to reduce the surgical extent of conisations while maintaining oncological safety. The trial was not sufficiently powered to reach statistical significance due to early termination. Nevertheless, the study provides important insights in the feasibility of a limited-excision and could serve as a pilot study for future trials. TRIAL REGISTRATION: German Clinical Trials Register Identifier: DRKS00006169

Urodynamic Mechanisms Underlying Overactive Bladder Symptoms in Patients With Parkinson Disease / 대한배뇨장애요실금학회지

PURPOSE: To assess the urodynamic findings in patients with Parkinson disease (PD) with overactive bladder symptoms. METHODS: We performed a retrospective chart review of all PD patients who were seen in an outpatient clinic for lower urinary tract symptoms (LUTS) between 2010 and 2017 in a single-institution. Only patients who complained of overactive bladder (OAB) symptoms and underwent a video-urodynamic study for these symptoms were included. We excluded patients with neurological disorders other than PD and patients with voiding LUTS but without OAB symptoms. RESULTS: We included 42 patients (29 men, 13 women, 74.5±8.1 years old). Seven patients (16.7%) had a postvoid residual (PVR) bladder volume >100 mL and only one reported incomplete bladder emptying. Detrusor overactivity (DO) was found in all 42 patients (100%) and was terminal in 19 (45.2%) and phasic in 22 patients (52.4%). Eighteen patients had detrusor underactivity (DU) (42.3%). Later age of PD diagnosis was the only parameter associated with DU (P=0.02). Patients with bladder outlet obstruction (BOO) were younger than patients without BOO (70.1 years vs. 76.5 years, P=0.004), had later first sensation of bladder filling (173.5 mL vs. 120.3 mL, P=0.02) and first involuntary detrusor contraction (226.4 mL vs. 130.4 mL, P=0.009). CONCLUSIONS: DO is almost universal in all patients with PD complaining of OAB symptoms (97.1%). However, a significant percentage of patients also had BOO (36.8%), DU (47%), and increased PVR (16.7%) indicating that neurogenic DO may not be the only cause of OAB symptoms in PD patients.