Tempo de tela, qualidade da dieta de adolescentes e características do entorno escolar / Screen time, quality of the adolescent diet, and profile of the school environment

Resumo Objetivou-se investigar a associação entre o tempo de uso excessivo de diferentes telas, a qualidade da dieta em adolescentes e características do entorno escolar. Adolescentes de 30 escolas estaduais de Curitiba/PR relataram tempo de tela: televisão, videogame e portáteis. A qualidade da dieta foi avaliada pela frequência de consumo de alimentos. A renda do entorno escolar foi obtida do Censo. O ambiente construído para atividade física investigado por observação sistemática do entorno escolar. A regressão de Poisson multinível foi empregada para estimar associações com as variáveis de exposição. Entre 1.200 adolescentes, 50,9% do sexo masculino, 74,4% tiveram tempo excessivo de tela. O tempo excessivo de TV (56,5%) esteve associado à pior qualidade da alimentação. O tempo excessivo de videogame (22,0%) foi menor no sexo feminino (RP 0,25; IC95% 0,18;0,36), associado à pior qualidade da alimentação, à menor renda do entorno escolar, e à pior classificação do ambiente construído para atividade física. O tempo excessivo de telas portáteis (53,2%) apresentou tendência de aumento com a renda do entorno escolar. O uso excessivo de TV e telas portáteis foi amplamente praticado por adolescentes, com diferentes variáveis demográficas e contextuais associadas de acordo com o tipo de dispositivo utilizado.

Abstract Adolescents from 30 state schools in Curitiba, State of Paraná, reported total screen time, namely television, video games and laptops. Diet quality was assessed by the frequency of food consumption. The income of the school environment was taken from the Census. The built environment for physical activity was investigated by systematic observation of the school surroundings. Multilevel Poisson Regression was used to estimate associations with the exposure variables. Among 1,200 adolescents, 50.9% being male, and 74.4% were found to be exposed to excessive screen time. Excessive TV screen time (56.5%) was associated with poor diet quality. Excessive video game time (22.0%) was lower among females (PR 0.25; 95%CI 0.18;0.36), associated with poor diet quality, lower school environment income, and the worst classification of the built environment for physical activity. Excessive use of portable screens (53.2%) tended to increase with the income of the school environment. Excessive use of TV and laptops was widespread among adolescents, with different demographic and contextual variables associated according to the type of device used.

C-reactive Protein, Albumin, Urea, CRP/Albumin Ratio, and Urea/Albumin Ratio: A Retrospective Evaluation in COVID-19 Patients

@#Introduction: C-reactive protein (CRP), urea, albumin, CRP/albumin ratio (CAR) and urea/albumin ratio (UAR) could be valuable biomarkers for determining the severity of illness in patients with COVID-19. This study aimed to determine the association between these markers and disease severity in COVID-19 patients on admission and days five to seven after admission. Methods: This retrospective study includes 153 adult COVID-19 patients admitted to Hospital Raja Perempuan Zainab II and Hospital Ampang from January 2021 to December 2021. Patients’ serum CRP, urea, albumin and creatinine levels were recorded on admission and on days five to seven after admission. The patients were categorised based on the Annex 2e guidelines published by the Ministry of Health, Malaysia and further classified as mild to moderate disease (stages 1-3) and severe to critical illness (stages 4-5). Results: On admission, urea, creatinine, CRP, UAR and CAR were significantly higher in the severe to critical group (p<0.001). The optimal cut-off value for the UAR was 0.16; the area under the curve (AUC) was 0.760, and sensitivity and specificity were 63.6% and 85.7%, respectively. The AUC of the CAR was 0.752, with 54.2% sensitivity and 91.4% specificity at an optimal cut-off value of 1.63. In severe to critical COVID-19 patients, albumin levels decreased significantly on days five to seven after admission, while urea levels remained significantly higher in this group (p<0.001, p<0.05, respectively). Conclusion: CRP, urea, albumin, CAR and UAR are promising biomarkers for predicting the severity of disease in COVID-19 patients.

Cytogenomic Profiling of Chronic Lymphocytic Leukaemia Patients Using DNA Microarray

@#Introduction: Chronic lymphocytic leukaemia (CLL) is the most frequent adult leukaemia in the Western world. The clinical presentation varies greatly, from very indolent cases to those with aggressive and fast advancing disease. This variation has significant implications for clinical approaches, therapeutic tactics, and, ultimately, survival durations from diagnosis. Acquired chromosomal aberrations play a key role in CLL aetiology. Due to difficulty to obtain abnormal metaphases for analysis, few methods such as fluorescence in-situ hybridization (FISH) and multiplex ligation-dependent probe assay (MLPA) were employed to detect chromosomal aberration however the methods are limited to specific locus only. Thus, this study is aimed to detect the chromosomal aberrations using DNA microarray platform. Methods: In this retrospective study, DNA archive obtained from 7 CLL patients which collected at diagnosis and subjected to Affymetrix CytoScan® 750K single nucleotide polymorphism (SNP) array following the manufacture procedure. The raw data obtained were analysed using the Chromosome Analysis Suite (ChAS) software (Affymetrix) using annotations of genome version GRCh38 (hg38). Result: Out of 7 patients, 4 of them showing deletion of 13q while 3 of them showing deletion of 14q in various region . Some of the deleted loci were too small (0.42-0.6Mb) to be detected by conventional cytogenetic analysis (CCA). There was also the presence of additional chromosomal aberrations that could be missed by CCA, FISH, or MLPA due to cryptic deletion or duplication that was as small as 0.4MB in size. Conclusion: The present study showed that low resolution chromosomal aberration was able to be detected using DNA microarray platform in comparison to CCA, FISH and MLPA.

Validation of a classification and scoring system for the diagnosis of laryngeal and pharyngeal squamous cell carcinomas by confocal laser endomicroscopy

Abstract Introduction: Confocal laser endomicroscopy is an optical imaging technique that allows in vivo, real-time, microscope-like images of the upper aerodigestive tract's mucosa. The assessment of morphological tissue characteristics for the correct differentiation between healthy and malignant suspected mucosa requires strict evaluation criteria. Objective: This study aims to validate an eight-point score for the correct assessment of malignancy. Methods: We performed confocal laser endomicroscopy between March and October 2020 in 13 patients. 197 sequences (11.820 images) originated from the marginal area of pharyngeal and laryngeal carcinomas. Specimens were taken at corresponding locations and analyzed in H&E staining as a standard of reference. A total of six examiners evaluated the sequences based on a scoring system; they were blinded to the histopathological examination. The primary endpoints are sensitivity, specificity, and accuracy. Secondary endpoints are interrater reliability and receiver operator characteristics. Results: Healthy mucosa showed epithelium with uniform size and shape with distinct cytoplasmic membranes and regular vessel architecture. Confocal laser endomicroscopy of malignant cells demonstrated a disorganized arrangement of variable cellular morphology. We calculated an accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of 83.2%, 81.3%, 85.5%, 86.7%, and 79.7%, respectively, with a κ-value of 0.64, and an area under the curve of 0.86. Conclusion: The results confirm that this scoring system is applicable in the laryngeal and pharyngeal mucosa to classify benign and malignant tissue. A scoring system based on defined and reproducible characteristics can help translate this experimental method to broad clinical practice in head and neck diagnosis.

Application of HRM Analysis in Detection of PDGFRA Exon 10 Polymorphism in CML Patients with Imatinib Resistance

@#Introduction: Imatinib mesylate has been widely used as a standard treatment for chronic myeloid leukemia (CML). It acts as a selective competitive inhibitor of the BCR-ABL tyrosine kinase. Despite the excellent efficacy on CML treatment, some patients developed resistance to the treatment. Mutation in the PDGFRA may be one of the factors involved in the mechanism of resistance that affects the response to imatinib. The mutational status of PDGFRA is highly relevant for prognosis and treatment prediction in CML patients. Thus, this study is intended to establish and validate a High Resolution Melting (HRM) analysis for PDGFRA exon 10 c.1432 T>C polymorphism in CML patients. Methods: High resolution melting (HRM) analysis was used to identify the c.1432 T > C polymorphism in PDGFRA exon 10 (n =86; response = 43; resistance = 43). The results from HRM analysis were compared and validated with Sanger sequencing. The association between the polymorphism and treatment response was assessed by statistical analysis using binomial logistic regression analysis. Results: HRM analyses showed two different melt curves. One curve followed the shape of the reference, homozygous wild type (TT) and the other curve showed a different melting profile than the reference with the TC genotype (heterozygous variant). The results revealed that heterozygous variant (TC) genotype showed a high risk of acquiring resistance with an OR of 3.795; 95% CI: 1.502-9.591, with a statistically significant association, p = 0.005. HRM analysis also showed 100% sensitivity and specificity in the detection of PDGFRA exon 10. Conclusion: The HRM analysis of PDGFRA exon 10 c.1432 T>C was successfully established. The exon 10 c.1432 T>C polymorphism shows a higher risk for the development of resistance toward imatinib treatment.

Investigating Medical Cost and Mortality Among Psychiatric Patients Involuntary Admissions: A Nationwide Propensity Score-Matched Study

Objective@#Involuntary admission to psychiatric inpatient care can protect both patients with severe mental illnesses and individuals around them. This study analyzed annual healthcare costs per person for involuntary psychiatric admission and examined categories of mental disorders and other factors associated with mortality. @*Methods@#This retrospective cohort study collected 1 million randomly sampled beneficiaries from the National Health Insurance Database for 2002–2013. It identified and matched 181 patients with involuntary psychiatric admissions (research group) with 724 patients with voluntary psychiatric admissions (control group) through 1:4 propensity-score matching for sex, age, comorbidities, mental disorder category, and index year of diagnosis. @*Results@#Mean life expectancy of patients with involuntary psychiatric admissions was 33.13 years less than the general population. Average annual healthcare costs per person for involuntary psychiatric admissions were 3.94 times higher compared with voluntary admissions. The general linear model demonstrated that average annual medical costs per person per compulsory hospitalization were 5.8 times that of voluntary hospitalization. Survival analysis using the Cox proportional hazards model found no significant association between type of psychiatric admission (involuntary or voluntary) and death. @*Conclusion@#This study revealed no significant difference in mortality between involuntary and voluntary psychiatric admissions, indicating involuntary treatment’s effectiveness.

Epidemiological analysis of elderly viral pneumonia in Inner Mongolia Autonomous Region in 2018-2019 / 公共卫生与预防医学

Objective To investigate the epidemiological characteristics of elderly viral pneumonia in Inner Mongolia Autonomous Region from 2018 to 2019 and analyze the pathogenic distribution, and to provide reference for the prevention and treatment of elderly viral pneumonia. Methods A total of 797 elderly patients with viral pneumonia admitted to our hospital from January 2018 to December 2019 were enrolled as the research subjects. All patients were tested for respiratory viral pathogens. According to the test results, the patients were divided into two groups, positive group (n=345) and negative group (n=452). The pathogenic characteristics of patients in the positive group were analyzed. The combined basic diseases, clinical characteristics, laboratory indicators, and distribution of viral pneumonia in different seasons were compared between the two groups. Results Among the 345 patients in the positive group, 319 (92.46%) were infected with single virus, mainly influenza virus (n=221, 64.06%), followed by parainfluenza virus (n=42, 12.17%). There were 26 cases infected with two or more viruses, accounting for 7.54%, mainly influenza virus + parainfluenza virus (n=15, 4.35%). The proportion of patients complicated with diabetes, cardiovascular and cerebrovascular diseases, and malignant tumors in the positive group was significantly higher than that in the negative group (P0.05). The Lym value of the positive group was higher than that of the negative group (P<0.05), while CRP and PCT values were significantly lower than those of the negative group (P<0.05). The incidence rate in the positive group was significantly higher than that in the negative group in winter (P<0.01), and it was significantly lower than that in the negative group in spring (P<0.01). Conclusion In Inner Mongolia Autonomous Region, elderly patients with viral pneumonia are complicated with many basic diseases, but the clinical symptoms are not typical, with high incidence in winter. The infection is mainly caused by influenza virus and parainfluenza virus. Laboratory indicators such as Lym, CRP and PCT can be used to identify viral pneumonia.

Knowledge, Awareness and Practices on the Risk Factors of Cardiovascular Diseases Among Community in Gombak, Kuala Lumpur

@#Introduction: Cardiovascular disease (CVD) is a group of disease which are related to the heart and its circulations. The main modifiable risk factors of the CVD disease are hypertension, hyperglycemia and obesity. This study aims to evaluate the knowledge, awareness and practice on cardiovascular disease risk factors among Gombak community in Kuala Lumpur. Methods: This was a cross-sectional study using self-administered questionnaire and anthropometric measurement among 388 subjects in Gombak District, Kuala Lumpur. Descriptive data analysis and multivariate binary logistic regression were carried to identify demographic and factors associated. Results: The prevalence of the risk factors was high among study subjects, including obesity (24.2%), hypertension (42.3%) and hyperglycemia (26.8%). More than half (64.4%) of the study subjects having at least one of the risk factor. The multivariate binary logistic model factor illustrated that compare to Malays, Chinese were 37% less likely to have obesity (CPR=0.67; 95% Cl: 0.26-1.69). Gombak district community are more likely to have the knowledge on the CVD risk factor but lack of awareness and poor in practicing the prevention action. The Indian ethnic group was less likely to be aware (APR: 0.33, Cl: 0.05-2.31) and others bumiputera ethnic group were less likely to prevent (APR: 0.58, CI: 0.20-1.65) the risk of CVD. The Chinese ethnic less likely to have the knowledge (APR: 0.88, Cl: 0.35-2.22). Conclusion: Gombak community was more likely to have the knowledge but less likely to be aware and lack of practice of prevention of the risk factors of CVD.

Antioxidant Enzymes in Tears Among Malay Age-related Macular Degeneration Patients

@#Introduction: Age-related macular degeneration (ARMD) is an ocular degenerative disorder that associated with impairment of central vision. Oxidative stress plays an important role in the pathogenesis of ARMD. The aim of this study was to determine the level of antioxidant enzymes (catalase and glutathione peroxidase) in tears among Malay ARMD patients. Methods: A cross sectional study was conducted between September 2015 and November 2017 among Malay ARMD patients. Schirmer paper was used to collect the tear samples. The level of catalase and glutathione peroxidase level in tears was evaluated using commercially available oxidative stress marker kits. Results: A total of 136 Malay ARMD patients were recruited into the study with 68 controls. Mean tear catalase and glutathione peroxidase levels were significantly lower in ARMD patients (1348.97 SD 109.11 µM and 453.87 SD 41.96 U/L respectively) as compared to the control group (1453.38 SD 38.87 µM and 502.28 SD 34.29 U/L respectively) (P<0.001 and P<0.001 respectively). Late ARMD has lower mean of catalase level in tears as compared to early ARMD (P=0.044). Based on subtypes of neovascular late ARMD, neovascular ARMD has lower mean catalase level in tears compared to idiopathic polypoidal choroidal vasculopathy (IPCV) (P=0.031). Conclusion: This study showed that antioxidant enzyme might play an important factor in the pathogenesis of ARMD.

Analysis of Programs and Guidelines on Traditional Chinese Medicine (TCM) for COVID-19 to Provide Suggestions for Future Development of TCM Clinical Practice Guidelines / 中国实验方剂学杂志

Objective:To comprehensively analyze the diagnosis and treatment programs and prevention and treatment programs on tratidional Chinese medicine (TCM) for coronavirus disease-2019 (COVID-19), and to provide suggestions for further development of TCM clinical guidelines. Method:Diagnosis and treatment programs on TCM for COVID-19 pneumonia, as well as prevention and treatment programs, clinical practice guidelines and expert consensus, were retrieved till Feb 19, 2020. The information about TCM syndrome differentiation, state of disease, and TCM treatments (decoction and Chinese patent medicines) were extracted and analyzed. Result:A total of 24 TCM programs/guidelines were included containing 23 diagnosis and treatment programs or prevention and treatment programs and one rapid advice guideline. Of the 23 TCM programs, 14 programs described the classification of TCM syndromes and the stages of disease，22 programs described the composition of the TCM decoction; seven programs described how to add and subtract the herbs according to different TCM syndromes,17 programs described the weight/volume of the herbs of TCM decoctions, three programs described the decoction method，six programs described the usage and dosage of TCM decoction， two programs clarified the course of treatment; none of the 23 programs indicated the source of evidence. The TCM treatment within the rapid advice guideline was in reference to the fourth edition of the COVID-19 pneumonia TCM diagnosis and treatment program issued by the National Health Commission. A total of 41 Chinese patent medicines were recommended in 23 programs, of which 12 Chinese patent medicines were off-label recommended. Conclusion:In most TCM programs, TCM decoction and Chinese patent medicines are recommended based on TCM syndrome differentiation in combination with the state of disease, and the dosage of the TCM decoctions are clearly described. Some Chinese patent medicines in the TCM programs are off-label recommended. Expert experience and opinions are valued when developing TCM programs/ guidelines. All of these provide reference for developing TCM programs/guidelines in future.

The pathogenic characteristics and ethnic differences of diabetic retinopathy / 解放军医学杂志

Diabetic retinopathy (DR) is one of the most common microangiopathies of diabetes mellitus (DM). It is due to abnormal blood glucose metabolism caused by insufficient insulin secretion or decreased activity. Its pathogenesis is complex, related to multi-gene inheritance and environmental factors. At present, the etiologic study of DR has been gradually deepened at home and abroad, but the epidemiological study of minority DR is lacking. This paper reviews DR's characteristics, ethnic differences and its characteristics in ethnic minority.

Localized unilateral basaloid follicular hamartoma along Blaschko's lines on face

Basaloid follicular hamartoma (BFH) is a rare hamartoma of hair follicle. Clinical presentations may vary but are united by the same histopathological features in the form of folliculocentric basaloid or squamoid cell proliferation in the superficial dermis, which represents malformed and distorted hair follicles. It is important to recognize this entity as its simulant is basal cell carcinoma, a low-grade malignancy. Here, we report a case of localized unilateral BFH in a Blaschkoid distribution on the face of a 14-year-old female.

Perfil neuropsicológico de las pacientes con trastornos de la conducta alimentaria / Neuropsychological profile of patients with eating disorders

Los trastornos de la conducta alimentaria (TCA), entre los que se encuentran la anorexia nerviosa (AN) y la bulimia nerviosa (BN), presentan una gran relevancia social, económica y sanitaria. Recientemente se ha observado que las alteraciones conductuales típicas de estas pacientes podrían ser explicadas, al menos en parte, por determinados déficits cognitivos. Es por ello que la evaluación neuropsicológica parece ser necesaria para obtener una mayor comprensión de esta clase de trastornos. El objetivo de este estudio fue evaluar si existían diferencias en el funcionamiento neuropsicológico de un grupo de mujeres jóvenes con AN y BN en comparación con otro grupo de mujeres sanas sin TCA (grupo control). Los resultados obtenidos pusieron de manifiesto que las pacientes con TCA presentaron una peor ejecución en la memoria audio-verbal y episódica, una menor flexibilidad cognitiva y una peor capacidad de planificación, en comparación con un grupo de mujeres normativas. No obstante, las pacientes de este estudio se encontraban dentro de los parámetros de normalidad en la memoria visoespacial, en la atención, en la velocidad de procesamiento, en la memoria de trabajo, en la capacidad de inhibición de respuestas automáticas, en la fluidez verbal y en la cognición social. En conclusión, la identificación y caracterización de estas alteraciones cognitivas podría ayudar a identificar nuevos objetivos terapéuticos y desarrollar estrategias de tratamiento más específicas para los pacientes con TCA. De hecho, sería importante desarrollar e implementar programas de rehabilitación cognitiva coadyuvantes a la psicoterapia para este tipo de pacientes.

Eating disorders (ED) such as anorexia nervosa (AN) and bulimia nervosa (BN) have great social, economic, and healthcare relevance. It was recently observed that the typical behavioral alterations of these patients could be explained, at least partly, by certain cognitive deficits. For this reason, neuropsychological evaluations might contribute to better understanding these types of disorders. This study aims to evaluate whether there were differences in the neuropsychological functioning of a group of young women with AN and BN, compared to another group of healthy women without eating disorders (control group). The results obtained showed that patients with eating disorders had worse performance on audio-verbal and episodic memory, less cognitive flexibility, and worse planning capacity than the control group. However, cognitive functioning was unimpaired for visuospatial memory, attention, processing speed, working memory, ability to inhibit automatic responses, verbal fluency, and social cognition. In conclusion, the identification and characterization of these cognitive alterations could help to identify new therapeutic objectives and develop more specific treatment strategies for patients with ED. In fact, it would be important to develop and implement adjuvant cognitive rehabilitation programs alongside the current psychotherapy for these patients.

Disability relating to instrumental activities of daily living in the elderly with rheumatic diseases / Incapacidade funcional para atividades instrumentais da vida diária em idosos com doenças reumáticas

Objective: to characterize the sociodemographic profile of elderly persons with arthritis/rheumatism in relation to gender, as well as to estimate the prevalence and factors associated with functional disability for the performance of instrumental activities of daily living (IADL). Method: a cross-sectional population-based study with a sample of 1,136 elderly persons (≥65 years old) from seven Brazilian municipal regions was carried out. Functional capacity was assessed by the self-reports of the elderly in terms of the performance of IADL, using the Lawton Scale. Differences between the genders, according to sociodemographic variables, were verified by the chi-squared test (p<0.05). The prevalence of inability to perform IADL was calculated and the independent associations were verified through multiple logistic regression. Results: the mean age was 72.4 years, 79.1% of the sample were women, and 45.9% of the elderly with arthritis/rheumatism were dependent for the performance of IADL. Differences were observed between the genders in relation to age, marital status, income and household arrangements (p<0.05). A higher prevalence of disability was observed among older elderly persons, those with no schooling and lower incomes, who lived in multigenerational households and who were frail. In the evaluation of the performance of specific activities, elderly persons with arthritis/rheumatism had greater difficulty taking medication (OR: 1,90; CI 95%: 1.19 - 3.06), after adjusting for gender and age. Conclusion: associations were found between functional disability and sociodemographic variables and frailty. Independence in daily activities such as those evaluated in this study is one of the primary conditions for the well-being of the elderly, even in conditions of frailty or chronic diseases.

Objetivo: caracterizar o perfil sociodemográfico de idosos com artrite/reumatismo em relação ao sexo, bem como estimar a prevalência e os fatores associados à incapacidade funcional para a realização de atividades instrumentais da vida diária (AIVD). Método: estudo transversal de base populacional com amostra de 1.136 idosos (≥65 anos), procedentes de sete municípios brasileiros. A capacidade funcional foi avaliada pelo autorrelato dos idosos quanto à execução das AIVD, pela Escala de Lawton. Diferenças entre os sexos, segundo variáveis sociodemográficas, foram verificadas pelo teste qui-quadrado (p<0,05). Estimou-se a prevalência de incapacidade para a realização das AIVD e as associações independentes foram verificadas por meio de regressão logística múltipla. Resultados: a média de idade foi 72,4 anos, 79,1% eram mulheres e 45,9% dos idosos com artrite/reumatismo apresentaram dependência para a realização das AIVD. Observaram-se diferenças entre os sexos em relação à faixa etária, estado conjugal, renda e arranjo domiciliar (p<0,05). Maior prevalência de incapacidade foi observada entre os mais idosos, naqueles sem escolaridade, com pior renda, nos que viviam em arranjos multigeracionais e com fragilidade. Na avaliação da realização de atividades específicas, os idosos com artrite/reumatismo apresentaram maior dificuldade quanto ao uso de medicação (OR: 1,90; IC95%: 1,19 - 3,06), mesmo após ajuste por sexo e idade. Conclusão: foram encontradas associações entre incapacidade funcional com variáveis sociodemográficas e fragilidade. A independência para a realização de atividades cotidianas como as avaliadas neste estudo torna-se uma das condições primordiais para o bem-estar dos idosos na velhice, mesmo que sob condições de fragilidade ou doenças crônicas.

Effects of porcelain thickness on the flexural strength and crack propagation in a bilayered zirconia system

Abstract Objective: This study evaluated the influence of porcelain (VM9, VITA Zahnfabrik, Germany) thickness on the flexural strength and crack propagation in bilayered zirconia systems (YZ, VITA Zahnfabrik, Germany). Material and Methods: Thirty zirconia bars (20.0x4.0x1.0 mm) and six zirconia blocks (12.0x7.5x1.2 mm) were prepared and veneered with porcelain with different thickness: 1 mm, 2 mm, or 3 mm. The bars of each experimental group (n=10) were subjected to four-point flexural strength testing. In each ceramic block, a Vickers indentation was created under a load of 10 kgf for 10 seconds, for the propagation of cracks. Results: The results of flexural strength were evaluated by One-way ANOVA and Tukey's test, with a significance level of 5%. The factor "thickness of the porcelain" was statistically significant (p=0.001) and the l-mm group presented the highest values of flexural strength. The cracks were predominant among the bending specimens with 1 and 2 mm of porcelain, and catastrophic failures were found in 50% of 3-mm-thick porcelain. After the indentation of blocks, the most severe defects were observed in blocks with 3-mm-thick porcelain. Conclusion: The smallest (1 mm) thickness of porcelain on the zirconia infrastructure presented higher values of flexural strength. Better resistance to defect propagation was observed near the porcelain/ zirconia interface for all groups. Higher flexural strength was found for a thinner porcelain layer in a bilayered zirconia system. The damage caused by a Vickers indentation near and far the interface with the zirconia shows that the stress profiles are different.

Infección por Sporothrix schenckii en agricultores del caserío "Peñón de Gabante": Municipio Tovar. Estado Aragua. Venezuela / Infection caused by Sporothrix schenckii in farmers from the village "Peñón de Gabante": Tovar municipality. Aragua state. Venezuela

In Aragua state (Venezuela) there are farming communities such as the Tovar municipality that meet geographical and climatic conditions favourable for the development of the fungus Sporothrix schenckii, in which farmer workers would be particularly exposed and at risk of infection and development of sporotrichosis. Accordingly, it was determined the prevalence of this infection in 148 farmers of both sexes from the village "Peñón de Gabante" through the intradermoreaction to esporotrichin. The overall prevalence was 24% and the frequency of infection increased with the age of the farmers, the time working as farmers and it was higher in men (27.6%) than in women (20.8%), reaching values of 39.1% in persons of 50 years and older and 28% in those with more than 10 years occupied in agriculture, although it was independent of these variables. Also, it was found a lower percentage of intradermal positivity (21.8%) in farmers that reported regular use of protective equipment in compare to those whom used it irregularly (27.9%) even though the differences weren't statistically significant. Statistically significant association (p< 0.005) was found between the clinical signs referred by farmers and the intradermopositivity to the esporotrichin, direct contact with plants with thorny branches and/or fruits of prickly shell (p< 0.001) and direct contact with the soil during the process of preparation, fertilization and sowing the crops (p<0.005). These findings suggest that the studied area is endemic to Sporothrix schenckii and farmers found in occupational risk of acquiring this infection.

En el estado Aragua, Venezuela, existen comunidades agrícolas como las del municipio Tovar, que reúnen condiciones geográficas y climáticas favorables para el desarrollo del hongo Sporothrix schenckii, en las que los agricultores estarían particularmente expuestos y a riesgo de adquirir la infección y desarrollar esporotricosis. En conse cuencia, se determinó la prevalencia de esta infección en 148 agricultores de ambos sexos del caserío "Peñón de Gabante", mediante la intradermorreacción a la esporotriquina. La prevalencia fue 24% y la frecuencia de infección incrementó con la edad de los agricultores, el tiempo desarrollando esta labor y fue mayor en hombres (27,6%) que en mujeres (20,8%), alcanzando valores de 39,1% en las personas con edades de 50 años o más y de 28% en aquellos con más de 10 años laborando en la agricultura, aunque resultó independiente de estas variables. Se halló un menor porcentaje de positividad (21,8%) en los agricultores que utilizan en forma regular equipos de protección en comparación con aquellos que lo hacen irregularmente (27,9%), aunque las diferencias no fueron estadísticamente significativas. Se encontró asociación estadísticamente significativa entre la intradermopositividad a la esporotriquina y los signos clínicos relacionados a la esporotricosis (p< 0,005), el contacto directo tanto con plantas de ramas espinosas y/o frutos de cáscara espinosa (p< 0,001) y con el contacto directo con la tierra durante el proceso de preparación, abono y/o siembra de sus cultivos (p< 0,005). Estos hallazgos sugieren que la zona estudiada es endémica para Sporothrix schenckii y los agricultores se encuentran en riesgo ocupacional de contraer esta infección.

Colonização bacteriana na região marginal de restaurações cerâmicas: efeito do método de remoção do cimento e do polimento / Bacterial colonization in the marginal region of ceramic restorations: effects of cement removal methods and polishing

O presente estudo teve como objetivo avaliar o efeito de diferentes métodos de remoção do excesso de cimento e do polimento na formação de biofilme e micromorfologia na região de margem dente/restauração. A partir de dentes bovinos, foram obtidos 96 blocos de dentina (4 mm x 8 mm x 2 mm) que foram moldados e reproduzidos em gesso tipo IV, sobre os quais foram produzidos 96 blocos prensados de cerâmica (Vita PM9,Vita Zahnfabrik; 4 mm x 8 mm x 2 mm) pela técnica de cera perdida. Os blocos de dentina e seus respectivos blocos cerâmicos foram cimentados com um cimento resinoso auto-adesivo (RelyX U200, 3M ESPE) e o excesso de cimento foi removido utilizando diferentes técnicas: MBr:micro brush e fotoativação, MBr-Pol: micro brush, fotoativação e polimento,Pi: pincel e fotoativação, Pi-Pol: pincel, fotoativação e polimento, Foto-Expl: 5 s de fotoativação inicial, explorador e fotoativação final, Foto-Expl- Pol: 5 s de fotoativação inicial, explorador, fotoativação final e polimento, Foto-Bi: 5 s de fotoativação inicial, bisturi e fotoativação final, Foto-Bi-Pol: 5s de fotoativação inicial, bisturi, fotoativação final e polimento. Após 24 h, a rugosidade da região de margem das amostras foi analisada utilizando um rugosímetro (Mitutoyo SJ-400 Tóquio, Japão; três medições em cada amostra). Análise micromorfológica da região foi obtida por microscópio estereoscópico e MEV. Em seguida, as amostras foram contaminadas em caldo de sacarose com suspensão padronizada com Streptococcus mutans, Staphylococcus aureus e Candida albicans e incubados por um período de 48 h. As amostras foram analisadas quantitativamente para aderência bacteriana na região da margem por microscopia de varredura confocal a laser e contagem das unidades formadoras de colônias(UFC/mL), e analisadas qualitativamente usando MEV. Os dados de rugosidade superficial (Ra) foram submetidos à análise de variância (2- way), teste de Tukey (5%) e teste t-student. Os dados de UFC, biomassa e ...

This study evaluated the effects of excess cement removal techniques,with or with out posterior polishing, on the biofilm formation and micromorphology in the marginal region of the tooth/restoration. From bovine teeth, 96 dentin blocks (4 x 8 x 2 mm) were produced, molded andre produced in type IV gyps um, on which 96 pressed ceramic blocks (VitaPM9 4 mm x 8 mm x 2 mm, Vita Zahnfabrik) were produces via lost wax technique. The dentin blocks and their respective ceramic blocks were cemented with a self-adhesive resin-cement (RelyX U200, 3M ESPE) and cement excess was removed using different techniques, followed by polishing with silicone tips or, in some cases, not polished at all: MBr:microbrush and photo activation, MBr-Pol: MBr + polishing, Pi: brush andphotoa ctivation, Pi-Pol: PI + polishing, Photo-Expl: 5 s initial photo activation, explorer and final curing, Photo-Expl-Pol: Photo-Expl +polishing, Photo-Bi: 5 s initial photo activation, scalpel and final curing,Photo-Bi-Pol: Photo-Bi + polishing. After 24 hours, the samples marginal region roughness was analyzed using a profilometer (Mitutoyo SJ-400 Tokyo, Japan; three measurements on each sample). Micromorphological analyses of the region were performed by stereoscopic microscope andSEM. Then the samples were contaminated with sucrose broth standardized suspension with Streptococcus mutans, Staphylococcus aureus and Candida albicans and incubated for a period of 48 hours. The samples were quantitatively analyzed for bacterial adherence in the marginal region by confocal laser scanning microscopy and counting ofcolony forming units (CFU/ml), and qualitatively analyzed using SEM.Roughness data (Ra) were submitted to 2-way ANOVA, Tukey test (5%)and Student's-t tests. CFU, Biomass and bio thickness data were analyzedby Kruskal Wallis’, Mann-Whitney’s e Dunn’s tests. The removing technique statistically influenced the roughness (Ra; p ˂ 0.05), when comparing polished and un polished groups. The MBr and ...

The relationship between household income and dietary intakes of 1-10 year old urban Malaysian

BACKGROUND/OBJECTIVES: Diet plays an important role in growth and development of children. However, dietary intakes of children living in either rural or urban areas can be influenced by household income. This cross-sectional study examined energy, nutrient and food group intakes of 749 urban children (1-10 years old) by household income status. SUBJECTS/METHODS: Children's dietary intakes were obtained using food recall and record for two days. Diet adequacy was assessed based on recommended intakes of energy and nutrients and food group servings. RESULTS: For toddlers, all nutrients except dietary fiber (5.5 g) exceeded recommended intakes. Among older children (preschoolers and school children), calcium (548 mg, 435 mg) and dietary fiber (7.4 g, 9.4 g) did not meet recommendations while percentage of energy from total fat and saturated fats exceeded 30% and 10%, respectively. The mean sodium intakes of preschoolers (1,684 mg) and school children (2,000 mg) were relatively high. Toddlers in all income groups had similar energy and nutrient intakes and percentages meeting the recommended intakes. However, low income older children had lowest intakes of energy (P < 0.05) and most nutrients (P < 0.05) and highest proportions that did not meet recommended energy and nutrient intakes. For all food groups, except milk and dairy products, all age groups had mean intakes below the recommended servings. Compared to middle and high income groups, low income preschoolers had the lowest mean intake of fruits (0.07 serving), meat/poultry (0.78 serving) and milk/dairy products (1.14 serving) while low income toddlers and school children had the least mean intake of fruits (0.09 serving) and milk/dairy products (0.54 serving), respectively. CONCLUSION: Low socioeconomic status, as indicated by low household income, could limit access to adequate diets, particularly for older children. Parents and caregivers may need dietary guidance to ensure adequate quantity and quality of home food supply and foster healthy eating habits in children.

Colonização bacteriana na região marginal de restaurações cerâmicas: efeito do método de remoção do cimento e do polimento / Bacterial colonization in the marginal region of ceramic restorations: effects of cement removal methods and polishing

O presente estudo teve como objetivo avaliar o efeito de diferentes métodos de remoção do excesso de cimento e do polimento na formação de biofilme e micromorfologia na região de margem dente/restauração. A partir de dentes bovinos, foram obtidos 96 blocos de dentina (4 mm x 8 mm x 2 mm) que foram moldados e reproduzidos em gesso tipo IV, sobre os quais foram produzidos 96 blocos prensados de cerâmica (Vita PM9,Vita Zahnfabrik; 4 mm x 8 mm x 2 mm) pela técnica de cera perdida. Os blocos de dentina e seus respectivos blocos cerâmicos foram cimentados com um cimento resinoso auto-adesivo (RelyX U200, 3M ESPE) e o excesso de cimento foi removido utilizando diferentes técnicas: MBr:micro brush e fotoativação, MBr-Pol: micro brush, fotoativação e polimento,Pi: pincel e fotoativação, Pi-Pol: pincel, fotoativação e polimento, Foto-Expl: 5 s de fotoativação inicial, explorador e fotoativação final, Foto-Expl- Pol: 5 s de fotoativação inicial, explorador, fotoativação final e polimento, Foto-Bi: 5 s de fotoativação inicial, bisturi e fotoativação final, Foto-Bi-Pol: 5s de fotoativação inicial, bisturi, fotoativação final e polimento. Após 24 h, a rugosidade da região de margem das amostras foi analisada utilizando um rugosímetro (Mitutoyo SJ-400 Tóquio, Japão; três medições em cada amostra). Análise micromorfológica da região foi obtida por microscópio estereoscópico e MEV. Em seguida, as amostras foram contaminadas em caldo de sacarose com suspensão padronizada com Streptococcus mutans, Staphylococcus aureus e Candida albicans e incubados por um período de 48 h. As amostras foram analisadas quantitativamente para aderência bacteriana na região da margem por microscopia de varredura confocal a laser e contagem das unidades formadoras de colônias(UFC/mL), e analisadas qualitativamente usando MEV. Os dados de rugosidade superficial (Ra) foram submetidos à análise de variância (2- way), teste de Tukey (5%) e teste t-student...

This study evaluated the effects of excess cement removal techniques,with or with out posterior polishing, on the biofilm formation and micromorphology in the marginal region of the tooth/restoration. From bovine teeth, 96 dentin blocks (4 x 8 x 2 mm) were produced, molded andre produced in type IV gyps um, on which 96 pressed ceramic blocks (VitaPM9 4 mm x 8 mm x 2 mm, Vita Zahnfabrik) were produces via lost wax technique. The dentin blocks and their respective ceramic blocks were cemented with a self-adhesive resin-cement (RelyX U200, 3M ESPE) and cement excess was removed using different techniques, followed by polishing with silicone tips or, in some cases, not polished at all: MBr:microbrush and photo activation, MBr-Pol: MBr + polishing, Pi: brush andphotoa ctivation, Pi-Pol: PI + polishing, Photo-Expl: 5 s initial photo activation, explorer and final curing, Photo-Expl-Pol: Photo-Expl +polishing, Photo-Bi: 5 s initial photo activation, scalpel and final curing,Photo-Bi-Pol: Photo-Bi + polishing. After 24 hours, the samples marginal region roughness was analyzed using a profilometer (Mitutoyo SJ-400 Tokyo, Japan; three measurements on each sample). Micromorphological analyses of the region were performed by stereoscopic microscope andSEM. Then the samples were contaminated with sucrose broth standardized suspension with Streptococcus mutans, Staphylococcus aureus and Candida albicans and incubated for a period of 48 hours. The samples were quantitatively analyzed for bacterial adherence in the marginal region by confocal laser scanning microscopy and counting ofcolony forming units (CFU/ml), and qualitatively analyzed using SEM.Roughness data (Ra) were submitted to 2-way ANOVA, Tukey test (5%)and Student's-t tests. CFU, Biomass and bio thickness data were analyzedby Kruskal Wallis’, Mann-Whitney’s e Dunn’s tests. The removing technique statistically influenced the roughness (Ra; p ˂ 0.05), when comparing polished and un polished groups...