Ischemic stroke risk factors not included in the CHADS-VASC score in patients with non-valvular atrial fibrillation / Fatores de risco de AVC isquêmico não incluídos no escore CHADS-VASC em pacientes com fibrilação atrial não valvar

Abstract Background In patients with atrial fibrillation, the CHA2DS2-VASC score guides stroke prevention using anticoagulants, but it is an imperfect score. Other potential risk factors such as renal failure, the type of atrial fibrillation, active smoking, cancer, sleep apnea or systemic inflammation have less well been investigated. Objective To assess the impact of these factors on ischemic stroke risk in patients with non-valvular atrial fibrillation. Methods On a population of 248 patients (124 patients with acute ischemic stroke and 124 controls), we performed a logistic regression to assess the impact of multiple non-classic risk factors for the prediction of acute ischemic stroke. Their impact on mortality was assessed by performing a survival analysis. Results A high CHA2DS2-VASc score (OR 1.75; 95% CI 1.13-2.70; p = 0.032), treatment with anticoagulants (OR 0.19; 95% CI 0.07-0.51; p < 0.001) and permanent atrial fibrillation (OR 6.31; 95% CI 2.46-16.19; p < 0.001) were independently associated with acute ischemic stroke. Renal failure and chronic obstructive pulmonary disease predicted a higher mortality. After adjusting for age, sex, the CHA2DS2-VASc score and the use of anticoagulants, the only risk factor predictive for acute ischemic stroke was the permanent type of AF (OR: 8.0 [95% CI 2.5-25.5], p < 0.001). Conclusions The CHA2DS2-VASc score, the absence of anticoagulants and the permanent type of atrial fibrillation were the main predictive factors for the occurrence of acute ischemic stroke. Larger studies are necessary for conclusive results about other factors.

Resumo Antecedentes Em pacientes com fibrilação atrial, o escore CHA2DS2-VASC orienta a prevenção de AVC com anticoagulantes, mas é um escore imperfeito. Outros fatores de risco potenciais, como insuficiência renal, o tipo de fibrilação atrial, tabagismo ativo, câncer, apnéia do sono ou inflamação sistêmica foram menos bem investigados. Objetivo Avaliar o impacto desses fatores no risco de AVC isquêmico em pacientes com fibrilação atrial não valvular. Métodos Em uma população de 248 pacientes (124 pacientes com AVC isquêmico agudo e 124 controles), realizamos uma regressão logística para avaliar o impacto de múltiplos fatores de risco não clássicos na predição de AVC isquêmico agudo. O seu impacto na mortalidade foi avaliado através da realização de uma análise de sobrevivência. Resultados Escore CHA2DS2-VASc alto (OR 1,75; IC 95% 1,13-2,70; p = 0,032), tratamento com anticoagulantes (OR 0,19; IC 95% 0,07-0,51; p < 0,001) e fibrilação atrial permanente (OR 6,31; 95% CI 2,46-16,19; p < 0,001) foram independentemente associados ao AVC isquêmico agudo. Insuficiência renal e doença pulmonar obstrutiva crônica previram maior mortalidade. Após ajuste para idade, sexo, pontuação CHA2DS2-VASc e uso de anticoagulantes, o único fator de risco preditivo para AVC isquêmico agudo foi o tipo permanente de FA (OR: 8,0 [IC 95% 2,5-25,5], p < 0,001). Conclusões O escore CHA2DS2-VASc, a ausência de anticoagulantes e o tipo permanente de fibrilação atrial foram os principais fatores preditivos para a ocorrência de AVC isquêmico agudo. Estudos maiores são necessários para resultados conclusivos sobre outros fatores.

Hibiscus Tea and its Therapeutic Potential in Weight Reduction: Integrative Review / Chá de Hibiscus e seu Potencial Terapêutico na Redução de Peso: Revisão Integrativa

The calyx of the Hibiscus plant are used in the form of an infusion in popular medicine with the purpose of contributing to the weight loss of its users. Therefore, the objective of this work was to verify in the literature the therapeutic potential of Hibiscus sabdariffa tea for weight loss. This is an integrative review done in the following databases: Scopus, PubMed, Science Direct, Web of Science. The final sample consisted of 6 articles. Half of the selected articles had the clear objective of evaluating weight loss, the others evaluated anti-metabolic and anti-stress properties, obesity-related adipogenesis and control of lipid indicators. In the selected studies, the most used part of the plant was the calyx, being fresh and dry. Factors such as the concentration and form of supply of the Hibiscus sabdariffa extract seem to be points to be taken into account in experiments that have food intake as an influence on the other variables. The studies brought evidence that Hibiscus sabdariffa extracts contribute to weight loss and to the suppression of weight gain in human and animal groups with metabolic disorders, without change for the healthy human/animal group. However, studies on the long-term maintenance of weight loss, once achieved, the efficacy and safety of its use, are still insufficient according to the collected evidence.(AU)

Os cálices da planta Hibiscus são utilizados na forma de infusão na medicina popular com o propósito de contribuir na perda ponderal de seus usuários. Diante disto, o trabalho teve como objetivo verificar na literatura o potencial terapêutico do chá de Hibiscus sabdariffa para a perda ponderal. Trata-se de uma revisão integrativa realizada nas bases: Scopus, PubMed, Science Direct, Web of Science. A amostra final foi formada por 6 artigos. Metade dos artigos selecionados tinham como objetivo claro avaliar a perda de peso, os demais avaliavam as propriedades antimetabólicas e antiestresse, adipogênese relacionada à obesidade e controle dos indicadores lipídicos. Nos estudos selecionados, a parte da planta mais utilizada foi o cálice, sendo eles frescos e secos. Fatores como a concentração e a forma de fornecimento do extrato do Hibiscus sabdariffa parecem ser pontos a serem levados em consideração em experimentos que tenham a ingestão alimentar como influência sobre as demais variáveis. Os estudos trouxeram evidencias de que os extratos de Hibiscus sabdariffa contribuem para a perda de peso e para a supressão do ganho de peso em grupos humanos e animais com disfunções metabólicas, sem alteração para o grupo de humanos/animais saudáveis. No entanto, estudos sobre a manutenção a longo prazo da perda de peso, uma vez alcançada, a eficácia e segurança de seu uso, ainda são insuficientes de acordo com as evidências coletadas.(AU)

The value of CHA2DS2-VASc score for predicting percutaneous coronary intervention prognosis in patients with coronary chronic total occlusion / 中国基层医药

Objective:To investigate the value of CHA2DS2-VASc score for predicting percutaneous coronary intervention (PCI) prognosis in patients with coronary chronic total occlusion.Methods:The clinical data of 139 patients with coronary chronic total occlusion who underwent PCI at the Second Hospital of Anhui Medical University from January 2019 to December 2020 were retrospectively analyzed. These patients were divided into good prognosis and poor prognosis groups according to prognosis outcomes. Univariate and multivariate Cox regression analysis was performed to evaluate the influential factors of adverse events after PCI in patients with coronary chronic total occlusion. The receiver operating characteristic curves were plotted to evaluate the value of the CHA2DS2-VASc score for predicting the occurrence of adverse events in patients with coronary chronic total occlusion undergoing PCI.Results:Among the 139 patients with coronary chronic total occlusion, the average follow-up time was (19.88 ± 7.90) months, 19 (13.7%) patients had a poor prognosis, and 120 (86.3%) patients had a good prognosis. The age, uric acid, and CHA2DS2-VASc score in the poor prognosis group were 73 (65.0, 77.0) years, (383.26 ± 120.60) μmol/L, and 4 (3, 5) points, respectively, which were significantly higher than 66 (57.0, 71.8) years, (322.68 ± 91.88) μmol/L, and 3 (2, 4) points in the good prognosis group ( U = -2.74, t = 2.24, U = -3.09, all P < 0.05). However, the proportion of patients with the successful opening of the occluded coronary artery and albumin, hemoglobin, and triacylglycerol levels in the poor prognosis group were 11 (57.9%), 36.7 (34.4, 38.3) g/L, (120.26±19.74) g/L, and 1.03 (0.85, 1.49) mmol/L, respectively, which were significantly lower than 98 (81.7%)( χ2 = 4.16, P = 0.041), 39.3 (36.78, 42.1) g/L ( U = -2.85, P = 0.004), (133.62 ± 16.84) g/L ( t = 1.52, P = 0.002), and 1.52 (1.09, 2.25) mmol/L ( U =-2.13, P = 0.033) in the good prognosis group. Multivariate Cox regression analysis showed that CHA2DS2-VASc score was a risk factor for poor prognosis of patients with coronary chronic total occlusion undergoing PCI (95% CI: 1.137-2.274, P = 0.007). The receiver operating characteristic curve analysis results showed that the area under the receiver operating characteristic curve plotted for CHA2DS2-VASc score predicting poor prognosis in patients with coronary chronic total occlusion undergoing PCI was 0.716 (95% CI: 0.588-0.844, P = 0.003), with the cut-off point of 3.5, the sensitivity of 68.4%, and specificity of 66.7%, respectively. Conclusion:Compared with those with a good prognosis, patients with a poor prognosis have a higher CHA2DS2-VASc score. The CHA2DS2-VASc score has a certain application value for predicting mid- and long-term prognosis in patients with coronary chronic total occlusion who undergo PCI.

Determination of Physical-chemical Parameters in Bee Products: A Preliminary Investigation from Africa’s Most Renewed Bee Village in Tanzania

Aim: The main objective of this study was to evaluate the determination of physical-chemical parameters in bee products: a preliminary investigation from Africa’s most renewed bee village in Tanzania; specifically, the study presents preliminary findings of an inquiry that examined pesticide contamination in bee products from Kijiji cha Nyuki located in Tanzania. The study measured the levels of physical-chemical parameters in honey products harvested from the selected bee apiaries. Material and Methods: A mixed methods approach was adopted for this study and collected data both primary and secondary data were collected using physical observation and survey, interviews, and questionnaires, purposive and random sampling techniques were used in this study to select a total of 104 participants who was taken as a sample from universal populations. Qualitative and quantitative data were analyzed using IBM Statistical Package for Social Sciences (SPSS) Computer Programme version 25, where the statistics aspect was determined from the results obtained from both questionnaires and laboratory experiments. A preliminary investigation from Africa’s most renewed bee village in Tanzania; Collected samples were analyzed at TBS & SGS laboratories. Results: The results show all studied areas met honey quality assurance guidelines stipulated by the ministry of natural resources and tourism suggesting moisture content in honey should not exceed 21%. pH test showed honey sample from Egypt apiaries had higher pH of 4.3 and honey from Kijiji cha Nyuki had a low pH of 3.54 implying honey from the studied areas falls within the pH applicable range. Test of Hydroxylmethly furfural mg/kg discovered an average of 13.65 mg/kg in honey samples from 4 studied areas out of the 5, with 107.13 mg/kg of HMF in honey samples from Egypt. Suggesting that honey samples from the 4 study areas with exception of samples from Egypt met the TZS 851:2006 standards and national’s guidelines of 40mg/kg Hydroxylmethly furfural. Finally, the Test of total reducing sugar as inverted sugar % m/m, from five samples as per Tanzania Bureau of Statistics (TBS) laboratory results found a maximum of 68.91 % m/m and 64.4 % m/m minimum. The amount of physical-mechanical contaminations that were identified in honey from 4 areas with the exemption of samples from Egypt apiaries poses no risk to consumers. Contribution to Policy Implication: This study recommends interventions among farmers and beekeepers on the safe use of pesticides, good hygienic handling, and the storage practices. It has contributed to the understanding of how the regulations outlining the use of insecticides is being implemented, and the current economic condition of studied farms. This calls on policymakers to rethink ways of engaging the beekeepers, and to have an ongoing discussion with beekeepers and concerned stakeholders about a model that could be used to enhance pesticides regulation in Tanzania.

Alternativas fitoterápicas no controle da obesidade / Phytotherapy alternatives in obesity control / Alternativas herbales en el control de la obesidad

Nos últimos anos, a obesidade vem aumentando consideravelmente entre adultos e crianças e, segundo a OMS, estima-se que em 2025 o número de obesos ultrapasse a 2,3 milhões em todo o mundo. O indivíduo obeso apresenta maiores riscos de desenvolver doenças crônicas não transmissíveis, como diabetes, doenças cardiovasculares, dislipidemias e ainda alguns tipos de cânceres. O tratamento para a obesidade é variado e inclui mudanças no estilo de vida como: hábitos alimentares e prática de atividade física, tratamento medicamentoso, cirurgia bariátrica e fitoterápicos com o potencial de auxiliar no tratamento. O objetivo deste trabalho foi realizar uma revisão bibliográfica a fim de avaliar os benefícios da utilização de medicamentos fitoterápicos como auxiliar no tratamento da obesidade, seus principais ativos, mecanismos de ação e sua utilização popular. Dentre as plantas pesquisadas e que demonstraram potencial para atuar no tratamento da obesidade encontram-se Camelia sinensis, Citrus aurantium, Hibiscus sabdariffa, Coffea arabica, Ephedra sinica, Zingiber oficinale e Senna alexandrina. Os principais mecanismos de ação envolvidos no potencial anti-obesidade das plantas medicinais são a capacidade de controle do apetite e ingestão de energia, estímulo da termogênese, inibição da lipase pancreática e redução da absorção de gordura, diminuição da lipogênese e aumento da lipólise. Desta forma, conclui-se que as plantas selecionadas neste estudo apresentaram efeitos positivos nos parâmetros bioquímicos e físicos, podendo ser incluídas nos protocolos como coadjuvantes nos tratamentos de emagrecimento.

In recent years, obesity has increased considerably among adults and children and according to the WHO, it is estimated that in 2025 the number of obese people will exceed 2.3 million worldwide. The obese individual is at greater risk of developing non-communicable chronic diseases, such as diabetes, cardiovascular disease, dyslipidemia and even some types of cancer. The treatment for obesity is varied, including changes in lifestyle such as eating habits and physical activity, drug treatment, bariatric surgery and phytotherapy with the potential to aid in the treatment. The objective of this work was to carry out a literature review, evaluating the benefits of using herbal medicines as an aid in the treatment of obesity, their main assets, mechanisms of action and their popular use. Among the plants researched and that have shown potential to act in the treatment of obesity are Camelia sinensis, Citrus aurantium, Hibiscus sabdariffa, Coffea arabica, Ephedra sinica, Zingiber officiale and Senna alexandrina. The main mechanisms of action involved in the antiobesity potential of medicinal plants are the ability to control appetite and energy intake, thermogenesis stimulation, pancreatic lipase inhibition and reduction of fat absorption, lipogenesis decrease and lipolysis increase. Thus, it is concluded that the plants selected in this study showed positive effects on biochemical and physical parameters, and can be included in the protocols as adjuvants in weight loss treatments.

En los últimos años, la obesidad ha aumentado considerablemente entre adultos y niños y, según la OMS, se estima que en 2025 el número de obesos superará los 2,3 millones en todo el mundo. Los individuos obesos tienen un mayor riesgo de desarrollar enfermedades crónicas no transmisibles, como la diabetes, las enfermedades cardiovasculares, las dislipidemias e incluso algunos tipos de cáncer. El tratamiento de la obesidad es variado e incluye cambios en el estilo de vida como: hábitos alimenticios y práctica de actividad física, tratamiento farmacológico, cirugía bariátrica y medicamentos a base de hierbas con potencial para ayudar en el tratamiento. El objetivo de este trabajo fue realizar una revisión bibliográfica para evaluar los beneficios del uso de las hierbas medicinales como ayuda en el tratamiento de la obesidad, sus principales activos, mecanismos de acción y su uso popular. Entre las plantas investigadas y que mostraron potencial para actuar en el tratamiento de la obesidad están Camelia sinensis, Citrus aurantium, Hibiscus sabdariffa, Coffea arabica, Ephedra sinica, Zingiber oficinale y Senna alexandrina. Los principales mecanismos de acción implicados en el potencial antiobesidad de las plantas medicinales son la capacidad de controlar el apetito y la ingesta de energía, estimular la termogénesis, inhibir la lipasa pancreática y reducir la absorción de grasas, disminuir la lipogénesis y aumentar la lipólisis. Por lo tanto, se concluye que las plantas seleccionadas en este estudio mostraron efectos positivos sobre los parámetros bioquímicos y físicos, y pueden ser incluidas en los protocolos como coadyuvantes en los tratamientos de pérdida de peso.

Association between CHA2DS2-VASc Score and Right Ventricular Dysfunction in Patients with Acute Pulmonary Embolism

Background: Acute right ventricular dysfunction (RVD) is a leading cause of death in the setting of acute pulmonary embolism (PE). Therefore, several studies investigated the predisposing factors of RVD. However, at present, little is known about the clinical predictors of RVD in the patients presented with acute PE. Objective: To assess the association of CHA2DS2-VASc Score with the PE severity, RVD and the in-hospital mortality in patients presented with acute PE. Methods: This study was conducted on 50 patients admitted with acute PE at Tanta University Hospitals. We studied the association of different variables including demographic data, common risk factors, clinical presentation, management and the in-hospital mortality with the PE clinical subgroups (massive, sub-massive and non-massive) based on the severity of clinical presentation and also the association of these variables with the thromboembolic risk (high, moderate and low) based on the CHA2DS2-VASc scores. The independent predictors of the RVD were then investigated by the univariate and multivariate regression analyses. Results: The massive PE presentation was associated with higher CHA2DS2-VASc scores (P value = 0.02). Also, the incidence of RVD was higher among the high risk group of patients (CHA2DS2-VASc scores ?3) with P value = 0.009. TAPSE, MPI, FAC, and E`/A` ratio were found to be more significant in the high risk group (P value = 0.032, 0.002, 0.007 and 0.001), respectively. The independent predictors of RVD were demonstrated to be tachycardia, lower systolic blood pressure and CHA2DS2-VASc score (P value = 0.022, 0.007, 0.021), respectively. The CHA2DS2-VASc score predicted the presence of RVD with 66.7 % sensitivity and 78.6% specificity as demonstrated by the receiver operating characteristic (ROC) analysis, with area under the curve (AUC) of 0.776 (CI 0.636-0.882, P value < 0.001). This study demonstrated no statistically significant difference between the different risk groups regarding the in-hospital mortality. Conclusion: Being independent of other factors, the CHA2DS2-VASc score can be used as a new, simple, and reliable tool to predict the development of RVD in patients with acute PE.

CHA2DS2-VASc-HSF Score as a Predictor of Severity of Coronary Artery Disease in Patients Undergoing Coronary Angiography

Background: Cardiovascular atherosclerosis, particularly coronary artery disease (CAD), represents the main reason for death prematurely over the world. Risk stratification and prevention by risk factor modification are crucial aspects of CAD therapy. The CHADS2 and CHA2DS2-VASc scores are effective in determining the risk of thrombosis in non-valvular atrial fibrillation (AF). The current research aimed to determine the CHA2 DS2-VASc-HSF score as a predictor for CAD severity in CAD patients after coronary angiography. Methods: This cross-sectional study was assessed on 100 patients who attended the coronary care unit and underwent coronary angiography. They were categorised into three groups: Group I: Low syntax scores (2-13), Group II: Intermediate syntax score (14-20), and Group III: High syntax score (21-40). Results: Our study showed that the SYNTAX score revealed a statistically significant relation with patient's age, gender, and presentation. Regarding the medical history of the studied participant in relation to SYNTAX score, most patients reported a history of HTN, DM, Dyslipidemia, CHF, and previous history of vascular disease showed intermediate and high SYNTAX score in comparison to those with normal blood pressure, glucose level, lipid profile, no CHF history and those no previous history. SYNTAX score showed significant relation with ejection fraction and CHA2 DS2-VASc-HSF score of the patient. Significant low ejection fraction in high SYNTAX score patients compared to low SYNTAX score patients. Significant high average of CHA2 DS2-VASc-HSF score among those with high and intermediate SYNTAX score compared to those with low SYNTAX score. Conclusions: CHA2DS2-VASc-HSF should be constituted as the ideal scoring scheme for predicting the severity of CAD. Risk scoring systems may be effective as predictors due to their simplicity and easy employment by physicians in ordinary practice without incurring additional costs

The prognostic value of the CHA2DS2-VASc score in coronary collateral circulation and long-term mortality in coronary artery disease

SUMMARY BACKGROUND: The CHA2DS2-VASc score is used to determine thromboembolic risk in cases of atrial fibrillation. The predictive value of this score in predicting coronary collateral circulation in chronic total occlusion is unknown. OBJECTIVE: The aim of this study was to investigate the relationship between the CHA2DS2-VASc score and coronary collateral circulation in patients with chronic total occlusion. METHODS: A total of 189 patients, who underwent coronary angiography and had a chronic total occlusion in at least one coronary artery, were enrolled in this study. The Rentrop scoring system was used for grouping the patients, and patients were classified as having poorly developed coronary collateral circulation (Rentrop grade 0 or 1) or well-developed coronary collateral circulation (Rentrop grade 2 or 3). RESULTS: The CHA2DS2-VASc score of the good coronary collateral circulation group was significantly lower than the other group (3.1±1.7 vs. 3.7±1.7, p=0.021). During the follow-up period, 30 (32.2%) patients in the poorly developed coronary collateral circulation group and 16 (16.7%) patients in the well-developed coronary collateral circulation group died (p=0.028). According to the multivariable Cox regression model, the CHA2DS2-VASc score [hazard ratio (HR): 1.262, p=0.009], heart rate (HR: 1.049, p=0.003), LVEF (HR: 0.975, p=0.039), mean platelet volume (HR: 1.414, p=0.028), and not taking acetylsalicylic acid during admission (HR: 0.514, p=0.042) were independently associated with a higher risk of mortality. CONCLUSIONS: The CHA2DS2-VASc score is closely related to coronary collateral development and predicts mortality in patients with chronic total occlusion.

The predictive value of the CHA 2DS 2-VASc score for in-hospital outcomes in patients with acute myocardial infarction: China PEACE-retrospective acute myocardial infarction study / 中华内科杂志

Objectives:This study aimed to evaluate the predictive value of the CHA 2DS 2-VASc score for in-hospital outcomes of patients with acute myocardial infarction (AMI). Methods:Data of 23 728 patients from the China patient-centered Evaluative Assessment of cardiac Events (China PEACE)Retrospective Acute Myocardial Infarction Study were analyzed retrospectively. The patients were categorized into 3 groups according to the CHA 2DS 2-VASc scores: the low score group (score 1-3), the middle score group (score 4-6) and the high score group (score 7-9). The in-hospital outcomes included major adverse cardiovascular events (MACE), death, death or withdrawal from treatment, reinfarction, ischemic stroke,etc. The CHA 2DS 2-VASc score was incorporated into multivariate Cox regression analyses to determine its independent impact on in-hospital outcomes. Receiver operating Characteristic (ROC) curves were constructed, and the area under the curve (AUC) was used to evaluate the predictive value of the CHA 2DS 2-VASc score for in-hospital mortality and death or withdrawal from treatment, respectively. Results:The patients had a median age of 66 (56,75) years, and 30.7% of them were females. Patients with higher CHA 2DS 2-VASc scores had a higher in-hospital mortality and more in-hospital complications (all P<0.001). After adjustment of baseline covariates, the subjects in the high score group were associated with high risks of in-hospital mortality ( OR=6.13, 95% CI 4.77-7.87, P<0.001), death or treatment withdrawal ( OR=6.43, 95% CI 5.16-8.00, P<0.001) and MACE ( OR=4.94, 95% CI 4.06-6.01, P<0.001). The AUCs of the CHA 2DS 2-VASc score were comparable with those of the mini-global registry of acute coronary events(mini-GRACE)score in evaluation of in-hospital mortality (0.699 vs. 0.696, P=0.752) and the death or treatment withdrawal risk (0.708 vs. 0.713, P=0.489). Conclusions:The CHA 2DS 2-VASc score is an independent predictor of in-hospital outcomes for patients with AMI. Its predictive value was comparable with the mini-GRACE score, which could be used as a simple tool for early and rapid outcome evaluation for AMI patients.

Correlação entre suporte social percebido e conflito trabalho-família em agentes comunitários de saúde / Correlation between perceived social support and work-family conflict in community health agents / Correlación entre apoyo social percibido y conflicto trabajo-familia en ACS

Este estudo tem como objetivo avaliar se existe correlação entre conflito trabalho-família e suporte social percebido em Agentes Comunitários de Saúde (ACS). Ademais, este é um estudo transversal e correlacional com delineamento quantitativo, em que foram ocupadas a Escala Multidimensional de Conflito Trabalho-Família (EMCT-F) e a Escala de Percepção de Suporte Social (2-Way SSS). Os participantes da pesquisa foram 139 ACS atuantes em quatro municípios do interior do Rio Grande do Sul. Para a análise dos dados, foram utilizadas a Estatística Descritiva, Estatística Paramétrica e Correlação de Pearson. Os resultados entre as correlações das escalas foram estatisticamente significativos (p<0,05) nos fatores dar suporte emocional e conflito família-trabalho, e receber suporte instrumental e conflito família trabalho. Assim, o estudo permitiu compreender melhor a relação entre as variáveis destacadas, sendo que esse entendimento poderá subsidiar intervenções baseadas na Psicologia Positiva para os ACS.(AU)

This study aimed to assess whether there is a correlation between work-family conflict and perceived social support in Community Health Agents (CHA). Moreover, this is a cross-sectional and correlational study with quantitative design, in which the Multidimensional Work-Family Conflict Scale (MWFCS) and the 2-Way Social Support Scale (2-Way SSS) were used. The participants in this study were 139 CHA workers in four municipalities in the interior of Rio Grande do Sul. Descriptive Statistics, Parametric Statistics, and Pearson Correlation were used to analyze the data. The results between the correlations of the scales were statistically significant (p<0.05) in the factors give emotional support and work family conflict, and receive instrumental support and work family conflict. Therefore, the study allowed us to better understand the relationship between the variables highlighted, and this understanding may support interventions based on Positive Psychology for the CHA.(AU)

El presente estudio tuvo como objetivo evaluar si existe correlación entre conflicto trabajo-familia y apoyo social percibido en trabajadores Agentes Comunitarios de Salud. Además, este es un estudio transversal y correlacional con delineamiento cuantitativo, en que fueron empleadas la Escala Multidimensional de Conflicto Trabajo-Familia (EMCT-F) y la Escala de Percepción de Suporte Social (2-Way SSS). Los participantes de este estudio fueron 139 trabajadores que actúan como agentes comunitarios de salud (ACS) en cuatro municipios del interior de Rio Grande do Sul. Para el análisis de los datos fueron empleadas la Estadística Descriptiva, Estadística Paramétrica y Correlación de Pearson. Los resultados entre las correlaciones de las escalas fueron estadísticamente significativos (p<0,05) en los factores dar apoyo emocional y conflicto familia trabajo y recibir apoyo instrumental y conflicto familia trabajo. Por tanto, el estudio permitió comprender mejor la relación entre las variables destacadas, siendo que ese entendimiento podrá subsidiar intervenciones basadas en la Psicología Positiva para los ACS.(AU)

Determinants of Rulindo tea farmers' perception towards organic farming: a MASS::stepAIC() approach / Determinates da percepção dos cafeicultores de Rulindo em relação à agricultural orgânica: uma abordagem MASS::stepAIC

ABSTRACT: The current study determined the factors influencing the perception of tea farmers towards organic tea production in Rulindo District, Rwanda. This study used both qualitative and quantitative data from face to face interviews and questionnaires completed with 156 tea farmers and other key informants in the tea sector who were randomly selected in 2019. Using function step AIC in R's MASS package, the final multiple logistic regression model showed that generating income from tea production, participation in Umuganda, conveying messages at Ihangari, participation to agricultural shows, and receiving training from Farmers Field Schools (FFS) influenced farmers' perceptions towards organic tea production. Thus, the results of this study could be useful to stakeholders in Rwanda's tea sector, such as policymakers and decision-makers. They can act as a source of information when developing a more sustainable research-based tea extension program. Moreover, the results of this study can be used during the capacity building of farmers about organic tea production.

RESUMO: O objetivo deste estudo é determinar os fatores que influenciam a percepção dos produtores de chá em relação à produção de chá orgânico no distrito de Rulindo, Ruanda. Esta pesquisa utilizou dados qualitativos e quantitativos de entrevistas e questionários presenciais preenchidos com 156 cafeicultores e outros informantes-chave do setor de chá que foram alocados aleatoriamente em 2019. Usando a etapa de função AIC no pacote MASS de R, o modelo final de regressão logística múltipla mostrou que a participação em Umuganda, transmitindo mensagens na ihangari, discussões com um revendedor Agro nas aldeias, obtendo renda com as vendas de folhas de chá verde fresco, acesso dos cafeicultores à Internet, participação na exposição agrícola e treinamento em escolas agrícolas da Cooperativa Os cafeicultores tiveram à previsão da percepção da produção orgânica de chá. Assim, os resultados deste estudo podem ser úteis para as partes interessadas no setor de chá de Ruanda, como formuladores de políticas e tomadores de decisão. Eles podem atuar como fonte de informação ao desenvolver um programa de extensão do chá mais sustentável, baseado em pesquisa. Além disso, os resultados deste estudo podem ser utilizados durante a capacitação dos agricultores sobre o cultivo de chá orgânico.

Effect of Black and Green Tea on Salivary pH: a Double Blinded Cross-Over Study / Efeito do Chá Preto e Verde no pH Salivar: um Estudo Duplo Cego Cross-Ove

Introdução: Alguns produtos à base de plantas podem afetar o pH salivar e a prevenção da cárie dentária. O consumo de chá tem efeitos inibidores sobre algumas bactérias orais. Objetivo: O objetivo deste estudo foi avaliar o efeito dos chás verde e preto sobre o pH salivar. Material e Métodos: neste estudo duplo-cego cruzado, amostras salivares de 50 estudantes saudáveis do sexo masculino da Faculdade de Odontologia de Zahedan, com idades entre 20-22 anos, foram coletadas para avaliação do pH salivar. Todos os voluntários foram solicitados a consumir chá preto comercial no primeiro dia e, em seguida, amostras de saliva foram coletadas antes de beber o chá, imediatamente após beber o chá, 5 e 10 minutos após o consumo do chá. Alternando com o consumo do chá verde, no segundo dia, as amostras de saliva foram coletadas novamente. Em seguida, o pH salivar foi estimado com um medidor de pH digital. Os dados foram analisados por meio de teste t independente e teste t de amostras pareadas. Resultados: O pH salivar médio antes e após o consumo de chá verde foi de 7,15 ± 0,05 e 7,56 ± 0,09, respectivamente, o que apresentou uma diferença notável (p <0,001). Foi de 7,14 ± 0,05 e 7,51 ± 0,10, respectivamente, para o chá preto, com diferença significativa (p <0,0001). O pH salivar médio após o consumo de chá verde foi significativamente maior do que o chá preto (p = 0,006). Conclusão: A ingestão de chá verde e preto levou a um aumento significativo no pH salivar, que foi maior após o consumo de chá verde em comparação com o chá preto. Este estudo sugere os efeitos benéficos de beber chá em fornecer um ambiente alcalino na cavidade oral (AU)

Background: Some herbal products could affect on salivary pH and prevention of dental caries. Tea consumption has inhibition effects on some oral bacteria. Objective: The aim of this study was to evaluate the effect of green and black tea on salivary pH. Material and Methods: In this double blinded cross-over trial, salivary samples of 50 healthy male students of Zahedan Faculty of Dentistry, aged 20-22 years old were collected for evaluation of salivary pH. All volunteers were asked to consume commercially black tea on the first day and then saliva samples were collected before drinking tea and immediately after drinking tea and 5 and 10 minutes after tea consumption. With replacing consumption of green tea, at the second day, saliva samples were collected again. Then the salivary pH was estimated with a digital pH-meter. Data were analyzed through independent t-test and paired samples t-test. Results: Mean salivary pH before and after green tea consumption were 7.15±0.05 and 7.56±0.09, respectively, which showed a remarkable difference (p<0.001). It was 7.14±0.05 and 7.51 ± 0.10, respectively, for black tea, with significant difference (p<0.001). Mean salivary pH after green tea consumption was significantly higher than black tea (p= 0.006). Conclusion:Both green and black tea intake led to a significant rise in salivary pH, which was higher after green tea consumption compared to black tea. This study suggests the beneficial effects of drinking tea in providing an alkaline environment in oral cavity (AU)

Comparative evaluation of antimicrobial potential of herbal extracts on Streptococcus mutans and Enterococcus faecalis An in vitro study / Avaliação comparativa do potencial antimicrobiano de extratos de ervas em Streptococcus mutans e Enterococcus faecalis: estudo in vitro

Though aloe vera extract, green tea extract and coriander oil are proven antimicrobial agents, very little information is available regarding its effects on oral bacteria, Streptococcus mutans, which is responsible for initiating caries and Enterococcus faecalis, responsible for failure of root canal treatment. Objective: To find the antimicrobial activity of aloe vera extract, black tea extract and coriander oil against S. mutans and E. faecalis. Materials and Methods: The agar well diffusion method was used to determine the antibacterial activity of Aloe vera extract, black tea extract and coriander oil. Different concentration of prepared plant extracts and coriander seed oil (50 & 100 µl) was incorporated into the wells and the plates containing S. mutans and E. faecalis were incubated at 37 °C for 24 h. The antibiotic (amoxicillin 30 µl) was used as positive control. Zone Of Inhibition (ZOI) was recorded in each plate. Results: For S. mutans, the maximum ZOI was created by coriander oil with a diameter of 25.00±0.58 mm at 50 µl and for E. faecalis, maximum ZOI was created by aloe vera extract 16.00±0.58 mm at 100 µl concentration which were far better than the control: amoxicillin 30 µl concentration. Conclusion: The extracts of Aloe vera, black tea and coriander oil, showed significant activity against the investigated microbial strains, Streptococcus mutans and Enterococcus faecalis which further helps in the development of new topical agents that help in reducing the numbers of these organisms present in the oral cavity. (AU)

Embora o extrato de aloe vera, extrato de chá verde e óleo de coentro sejam agentes antimicrobianos comprovados, há pouca informação disponível sobre seus efeitos nas bactérias orais, Streptococcus mutans, que é responsável por iniciar cáries e Enterococcus faecalis, responsável pela falha do tratamento de canal radicular. Objetivo: Avaliar a atividade antimicrobiana do extrato de aloe vera, extrato de chá preto e óleo de coentro contra S. mutans e E. faecalis. Materiais e Métodos: O método de difusão em agar foi usado para determinar a atividade antibacteriana do extrato de Aloe vera, extrato de chá preto e óleo de coentro. Diferentes concentrações dos extratos de plantas e óleo de semente de coentro (50 e 100 µl) foram preparados e colocados nos poços e nas placas contendo S. mutans e E. faecalis e foram incubadas a 37°C por 24 h. O antibiótico (amoxicilina 30 µl) foi utilizado como controle positivo. A zona de inibição (ZOI) foi registrada em cada placa. Resultados: Para S. mutans, a ZOI máxima foi obtida com o óleo de coentro com um diâmetro de 25,00 ± 0,58 mm a 50 µl e para E. faecalis, a ZOI máxima foi obtiada pelo extrato de aloe vera 16,00 ± 0,58 mm na concentração de 100 µl, as quais foram melhores do que o controle: concentração de 30 µl de amoxicilina. Conclusão: Os extratos de Aloe vera, chá preto e óleo de coentro apresentaram atividade significativa contra as cepas microbianas investigadas, Streptococcus mutans e Enterococcus faecalis auxiliando no desenvolvimento de novos agentes tópicos visando a redução do número desses organismos presentes no cavidade oral. (AU)

Predictive effect of CHA2DS2-VASc score on long-term prognosis of acute pulmonary embolism by using propensity score matching method / 中国医师杂志

Objective:To explore the predictive effect of CHA2DS2-VASc score on the long-term prognosis of acute pulmonary embolism (APE).Methods:Patients who were diagnosed with acute pulmonary embolism in the department of respiratory medicine of Binzhou Second People′s Hospital and Hebei Provincial People′s Hospital from October 2014 to October 2018 were continuously included, and the included patients were divided into two groups according to the CHA2DS2-VASc score: 319 cases in the low CHA2DS2-VASc group (<4 points), and 79 cases in the high CHA2DS2-VASc group (≥4 points). Then the propensity score matching method was used to balance the covariates between the two groups, and then the CHA2DS2-VASc score was used to predict the long-term prognosis of acute pulmonary embolism.Results:The Geneva score, D-dimer level and APE-related adverse events in high CHA2DS2-VASc group were significantly higher than those with low CHA2DS2-VASc group, with statistically significant differences ( P<0.05). The multiple COX regression model showed that the incidence of pulmonary embolism associated adverse events was significantly increased 2.820-fold (95% CI: 1.366-5.822) in the high CHA2DS2-VASc group compared with in the low CHA2DS2-VASc group. After propensity score matching, high CHA2DS2-VASc score was still a strong predictor of poor prognosis in patients with acute pulmonary embolism ( HR: 3.421, 95% CI: 2.164-5.408). Conclusions:After using propensity score matching method balances confounding bias, high CHA2DS2-VASc score is still an independent prognostic risk factors of acute pulmonary embolism.

A meta-analysis of the effects of green tea combined with physical activity on blood lipids in humans / Metanálise dos efeitos do chá verde combinado com atividade física sobre lípides sanguíneos em seres humanos / Metaanálisis de los efectos del té verde combinado con actividad física sobre lípidos sanguíneos en seres humanos

ABSTRACT Introduction: Most studies of green tea extract (GTE) combined with physical activity have reported a preventative effect for cardiovascular disease; however, the findings regarding the effects on serum lipids are controversial. Objective: This meta-analysis aimed to examine the evidence of the effects of GTE combined with physical activity on the serum lipid content in humans. Methods: In June 2017, we conducted electronic searches of PubMed, Web of Science, and Cochrane Library to identify pertinent studies: those with an experiment period exceeding two weeks, human randomized controlled trials (RCTs), and those that only assessed GTE with physical activity were included. A random effects model meta-analysis was used in this review. Results: A total of 271 citations were retrieved in our search of the electronic literature, and 7 RCTs, which included 608 individuals, were identified. Overall, there was no significant decrease in low-density lipoprotein cholesterol (LDL-C) (SMD:-0.169; 95% confidence interval [CI]:-0.414 to 0.076; I2=22.7%; p=0.177) or total cholesterol (TC) levels between the GTE and placebo combined with the physical activity group. Similar results were also observed for high density-lipoprotein cholesterol (HDL-C) and triglycerides (TG). In the subgroup and sensitivity analyses of the five studies, the TC levels of the subjects who received a lower dose of epigallocatechin gallate (EGCG) together with performing physical activity were significantly decreased. Conclusion: Current evidence suggests that green tea combined with physical activity does not improve the lipid and lipoprotein levels in humans. Level of evidence I; Systematic review.

RESUMO Introdução: A maioria dos estudos sobre extrato de chá verde (ECV) em combinação com atividade física relata efeito preventivo em doenças cardiovasculares; entretanto, os achados sobre os efeitos sobre lípides séricos são controversos. Objetivo: Esta metanálise tem como objetivo examinar as evidências dos efeitos do ECV em combinação com atividade física sobre o teor de lípides séricos no ser humano. Métodos: Em junho de 2017, realizamos pesquisas eletrônicas nos bancos de dados PubMed, Web of Science e Cochrane Library para identificar estudos pertinentes; foram incluídos os que tinham período experimental superior a duas semanas, estudos clínicos randomizados (ECRs) e que avaliaram apenas ECV com atividade física. Neste trabalho, empregamos o modelo de metanálise de efeitos aleatórios. Resultados: Um total de 271 citações foi recuperado em nossa busca, e sete ECRs foram identificados, totalizando 608 indivíduos incluídos. No geral, não houve redução significativa nos níveis da lipoproteína de baixa densidade do colesterol (LDL-C) (DMP: -0,169; 95% de intervalo de confiança [IC]: -0,414 a 0,076; I2 = 22,7%; p = 0,177) ou no colesterol total (CT) entre o ECV e placebo combinados com o Grupo atividade física. Resultados semelhantes foram observados também para a lipoproteína de alta densidade do colesterol (HDL-C) e para os triglicérides (TG). No subgrupo e nas análises de sensibilidade de cinco estudos, os níveis de CT dos indivíduos que receberam dose mais baixa de epigalocatequina-3-galato (EGCG) em combinação com atividade física foram significativamente reduzidos. Conclusão: A evidência atual sugere que o chá verde em combinação com atividade física não melhora os níveis de lípides e lipoproteínas no ser humano. Nível de Evidência I; Revisão sistemática.

RESUMEN Introducción: La mayoría de los estudios sobre extracto de té verde (ETV) en combinación con actividad física relata efecto preventivo en enfermedades cardiovasculares; entretanto, los hallazgos sobre los efectos sobre lípidos séricos son controvertidos. Objetivo: Este metaanálisis tiene como objetivo examinar las evidencias de los efectos del ETV en combinación con actividad física sobre el tenor de lípidos séricos en el ser humano. Métodos: En junio de 2017, realizamos búsquedas electrónicas en los bancos de datos PubMed, Web of Science y Cochrane Library para identificar estudios pertinentes; fueron incluidos los que tenían período experimental superior a dos semanas, estudios clínicos aleatorizados (ECAs) y que evaluaron sólo ETV con actividad física. En este trabajo, empleamos el modelo de metaanálisis de efectos aleatorios. Resultados: Un total de 271 citaciones fue recuperado en nuestra búsqueda, y siete ECAs fueron identificados, totalizando 608 individuos incluidos. En general, no hubo reducción significativa en los niveles de la lipoproteína de baja densidad del colesterol (LDL-C) (DPE: -0,169; 95% de intervalo de confianza [IC]: -0,414 a 0,076; I2 = 22,7%; p = 0,177) o en el colesterol total (CT) entre el ETV y placebo combinados con el Grupo actividad física. Fueron observados resultados semejantes también para la lipoproteína de alta densidad del colesterol (HDL-C) y para los triglicéridos (TG). En el subgrupo y en los análisis de sensibilidad de cinco estudios, los niveles de CT de los individuos que recibieron dosis más baja de epigalocatequina-3-galato (EGCG) en combinación con actividad física fueron significativamente reducidos. Conclusión: La evidencia actual sugiere que el té verde en combinación con actividad física no mejora los niveles de lípidos y lipoproteínas en el ser humano. Nivel de Evidencia I; Revisión sistemática.

Vivências de acolhimento na unidade de saúde da família: a experiência do cantinho do chá na UBS do Grotão, João Pessoa/PB

Este trabalho traz uma primeira aproximação aos trabalhos do Projeto Cantinho do Chá e da Horta Agroecológica, espaços de vivências onde são realizados diálogos de saberes entre a comunidade, profissionais e estudantes de instituições de ensino superior na cidade de João Pessoa. Nesses ambientes são servidos chás medicinais nas segundas, terças e quartas feiras, produtos estes resultantes do plantio e colheita das ervas na horta da Unidade de Saúde da Família (USF) do Grotão em João Pessoa. O trabalho foi realizado no período de no ano de 2017 ao projeto de extensão do Departamento de Promoção da Saúde -CCM-UFPB. As ações realizadas envolveram equipe multiprofissional, comunidade e estudantes dos cursos de Medicina, Fisioterapia e Terapia Ocupacional, de modo que as atividades desenvolvidas propiciaram o fortalecimento de um conjunto de conceitos e percepções sobre os fundamentos das práticas integrativa e do acolhimento na atenção básica. Buscou-se, também, identificar as dinâmicas estabelecidas na escuta qualificada entre usuários e profissionais de saúde, na perspectiva de detectar os limites e as possibilidades existentes nos processos de trabalho das equipes. De acordo com os dados obtidos é possível destacar que o uso do chá é um dispositivo importante para estreitar os vínculos entre usuários, profissionais, estudantes e demais atores sociais relacionados nos processos de trabalho. Além disso, também resgata os usos, sentidos, costumes e conhecimentos das plantas medicinais no cuidado a saúde, contribuindo para melhoria do acolhimento aos usuários, ancorado na Política Nacional de Práticas Integrativas Complementares em Saúde (PNPICS)

Quantificação de compostos fenólicos, poder antioxidante e teor de açúcares em produtos comerciais a base de Camellia sinensis L / Quantification of phenolic compounds, antioxidant power sugar content in commercial products based on Camellia sinensis L

Objetivo: Analisar e comparar quantitativamente compostos fenólicos, capacidade antioxidante e açúcares presentes em infusões e extratos solúveis de Camellia sinensis L. Método: O estudo apresenta delineamento inteiramente casualizado, utilizando amostras por conveniência. Foram adquiridas três amostras aleatórias de cada tipo de chá. As análises de compostos fenólicos totais e flavonoides foram determinadas pelo método colorimétrico de Folin-Ciocalteu e cloreto de alumínio, respectivamente, taninos totais por complexação com caseína e os condensados pelo método do butanol-HCl. A capacidade antioxidante, pela metodologia do ferricianeto e sequestro de radicais livres pelo radical 2,2-difenil-1-picril-hidrazil, e os açúcares redutores e não redutores, através do reagente ácido 3-5-dinitrossalicílico. Resultado: Os extratos infusos apresentaram quantidades significativamente maiores de compostos fenólicos totais e flavonoides em comparação ao solúvel. Esse comportamento foi o mesmo para os taninos e atividade antioxidante. As infusões obtiveram maior poder redutor e capacidade de redução do radical livre. Os extratos solúveis foram destaque, com maior presença de açúcares. Esses resultados foram confirmados pela literatura e não houve trabalhos realizados com extratos solúveis e metodologias semelhantes ao realizado aqui para comparação. Conclusão: As infusões estudadas no presente trabalho foram mais ricas em compostos bioativos e antioxidantes, favorecendo seus benefícios para a população, tendo os extratos solúveis maior presença de açúcares adicionais. (AU)

Objective: To analyze and quantitatively compare phenolic compounds, antioxidant capacity and sugars present in infusions and soluble extracts of Camellia sinensis L, Methods: The study presents a completely randomized design, using samples for convenience, Three random samples of each type of tea, The analyzes of total phenolic compounds and flavonoids were determined by the Folin-Ciocalteu colorimetric method and aluminum chloride, respectively, total tannins by complexation with casein and condensates by the butanol-HCl method, The antioxidant capacity, by ferricyanide methodology and free radical scavenging by the radical 2,2-diphenyl-1- picryl-hydrazil, and reducing and non-reducing sugars, through the reagent 3-5 dinitrosalicylic acid, Result:: The infused extracts showed significantly higher amounts of total phenolic compounds and flavonoids compared to the soluble, This behavior was the same for tannins and antioxidant activity, The infusions obtained greater reducing power and capacity to reduce free radicals, Soluble extracts were highlighted, with a greater presence of sugars, These results were confirmed by the literature and there were no studies carried out with soluble extracts and methodologies similar to that performed here for comparison, Conclusion: The infusions studied in the present study were richer in bioactive and antioxidant compounds, favoring their benefits for the population, with soluble extracts having a greater presence of additional sugars. (AU)

The thromboembolism risk of low-risk atrial fibrillation patients with different clinical characteristics / 中华心血管病杂志

Objective: This study explored the thromboembolism risk of low-risk atrial fibrillation (AF) patients (CHA2DS2-VASc score of 0 or 1 for male and 1 or 2 for female) with different clinical characteristics to provide the basis for anticoagulation decision-making in these patients. Methods: We prospectively enrolled consecutive 2 862 nonvalvular low-risk AF patients between August 2011 to December 2018 in China-AF (China Atrial Fibrillation Registry) Study, their CHA2DS2-VASc score was 0 or 1 for male and 1 or 2 for female. According to their age, sex, presence or absence of hypertension, diabetes mellitus, congestive heart failure, and vascular disease at the time of enrolling, patients were divided into CHA2DS2-VASc score 0 score group, 1 score group, and 2 score group. Patients were followed up every 6 months by outpatient clinic visit or telephone interview. The outcome was a thromboembolic event, including ischemic stroke and systemic embolism. Univariate Cox regression analysis was used to compare the thromboembolism risk between the patients with different risk factors and CHA2DS2-VASc score 0 group. Results: A total of 2 862 low-risk atrial fibrillation patients were enrolled in this study. 915 patients (32.0%) were female, and age was (55.0±10.7) years old. There were 933 patients (32.6%) in CHA2DS2-VASc score 0 group, 1 401 patients (49.0%) in score 1 group and 528 patients (18.5%) in score 2 group. During follow-up (median 1.5 years, 5 811.82 person-years), 33 cases of thromboembolic events were recorded, the annual rate of thromboembolism was 0.57% (95%CI 0.40%~0.80%). The number of thromboembolic events in patients with CHA2DS2-VASc score 0, 1 and 2 were 8, 11 and 14, respectively, and the annual thromboembolism event rates were 0.40% (95%CI 0.20%-0.81%), 0.39% (95%CI 0.22%-0.71%) and 1.34% (95%CI 0.80%-2.27%), respectively. The risk of thromboembolism of CHA2DS2-VASc score 2 group (HR=3.53, 95%CI 1.48-8.44; P=0.005), especially female patients aged 65-74 years in CHA2DS2-VASc score 2 group (HR=2.67, 95%CI 1.63-4.38; P<0.000) was significantly higher than that in patients of CHA2DS2-VASc score 0 group. Conclusion: Low-Risk Atrial Fibrillation patients with CHA2DS2-VASc score 2, especially female patients aged 65-74 years old with CHA2DS2-VASc score 2 are at higher risk of thromboembolism in low-risk AF patients. For such patients, intensified oral anticoagulant therapy might be helpful to reduce the risk of thrombolism.

Evaluation the Effect of Different Antioxidants Applied After Bleaching on Teeth Color Stability / Avaliação do efeito de diferentes antioxidantes aplicados após o clareamento na estabilidade da cor dos dentes

Objective: Vital bleaching is a popular treatment option for discolored teeth; but at post-treatment stage, loss of adhesion is highly reported. Literature focused on antioxidant application for the answer of this issue. The aim of this study was to compare the effects of six different antioxidants on color stability of bleached teeth. Material and Methods: This study included total of 84 extracted intact non-carious lower incisors. 35% hydrogen peroxide was applied on the labial surfaces of specimens in accordance with manufacturer's instructions. The bleached teeth were divided into 7 groups. No antioxidants were applied to the control group. For the experimental groups, the following antioxidants were applied for 10 minutes each: 5% proanthocyanidin, 5% sodium ascorbate, 5% lycopene, %5 green tea, %5 white tea and %5 α-tocopherol. CIE L*, a* and b* values of the teeth were measured by a spectrophotometer. One-way ANOVA was used to determine the differences among the groups. Multiple comparisons were examined with Tukey HSD. Results: The one-way ANOVA test revealed a statistically significant difference between the groups (p < 0.005). Highest color change was observed in lycopene group and the lowest in green tea group. Conclusion: Proanthocyanidin, white tea and green tea could be considered as post-bleaching antioxidant alternatives based on their herbal nature. (AU)

Objetivo: O clareamento vital é uma opção popular de tratamento para dentes descoloridos, mas na fase pós-tratamento, a perda de adesão é altamente relatada. A literatura enfocou a aplicação de antioxidantes para a resposta desta questão. O objetivo deste estudo foi comparar os efeitos de seis diferentes antioxidantes na estabilidade da cor de dentes clareados. Material e Métodos: Este estudo incluiu um total de 84 incisivos inferiores extraídos, intactos e não cariados. Peróxido de hidrogênio a 35% foi aplicado nas superfícies labiais dos espécimes de acordo com as instruções do fabricante. Os dentes clareados foram divididos em 7 grupos. Nenhum antioxidante foi aplicado ao grupo controle. Para os grupos experimentais, os seguintes antioxidantes foram aplicados por 10 minutos cada: proantocianidina a 5%, ascorbato de sódio a 5%, licopeno a 5%, chá verde a 5%, chá branco a 5% e α-tocoferol a 5%. Os valores CIE L *, a * e b * dos dentes foram medidos por um espectrofotômetro. ANOVA um fator foi usada para determinar as diferenças entre os grupos. As comparações múltiplas foram examinadas com Tukey HSD. Resultados: O teste ANOVA revelou uma diferença estatisticamente significativa entre os grupos (p <0,005). A maior mudança de cor foi observada no grupo do licopeno e a menor no grupo do chá verde. Conclusão: Proantocianidina, chá branco e chá verde podem ser considerados como alternativas antioxidantes pós-clareamento com base em sua natureza fitoterápica. (AU)

Value of CHADS-VASc score in predicting stroke recurrence in first-ever ischemic stroke survivors without atrial fibrillation / 南方医科大学学报

OBJECTIVE@#To test the performance of CHADS-VASc score in predicting stroke recurrence in first-ever ischemic stroke survivors without atrial fibrillation (AF).@*METHODS@#A total of 768 patients were included in this study, including 475 male (61.85%) and 293 female patients (38.15%) with a mean age of 61.52±12.59 years (17-90 years). The baseline information of the patients was collected by face-to-face questionnaire survey and electronic medical record review, and their follow-up information was collected by telephone follow-up once every 3 months. Chi-square test and Wilcoxon rank sum test were used to compare the baseline characteristics between the patients regularly followed up and those withdrawn from the study. The area under the ROC curve (AUC), sensitivity, specificity, positive likelihood ratio and other indicators of CHADS-VASc score were determined, and C-index based on Cox proportional hazards model was used to evaluate the performance of CHADS- VASc score in predicting the risk of stroke recurrence in patients at different time points during the follow-up.@*RESULTS@#The 1-year, 3-year, and 5-year recurrence rate of stroke was 10.59%, 20.45%, and 29.46% in these patients, respectively. The AUC value, Optimal Operating Point (OOP) and the corresponding positive likelihood ratios (LR+) for predicting stroke recurrence were 0.558 (95%: 0.492-0.624), 4.5, and 1.256 at 1 year; 0.574 (95%: 0.517-0.630), 4.5, and 1.397 at 3 years; and 0.604 (95%: 0.548-0.661), 4.5, and 1.655 at 5 years, respectively. Sensitivity analysis of congestive heart failure showed that the predictive effect of CHADS-VASc score was basically unchanged.@*CONCLUSIONS@#CHADS-VASc score can be used to predict the 3-year and 5-year risk of stroke recurrence in first-ever ischemic stroke survivors without AF. The score has a better prediction ability for long-term stroke recurrence, but the prediction value remains low, suggesting the need to further improve the score or establish a new score for predicting stroke recurrence.