Avaliação da sonolência e queixas de sono dos estudantes de odontologia da Universidade Federal do Ceará / Evaluation of sleepness and sleep complaints among dentistry students from the federal University of Ceará / Evaluación de somnolencia y quejas de sueño en estudiantes de odontología de la Universidad Federal de Ceará

O sono é um estado essencial para sobrevivência humana, ele exerce função biológica, restauradora e de conservação energética do organismo, promovendo equilíbrio físico e mental. Alta prevalência da má qualidade de sono e sonolência diurna excessiva (SDE) têm sido relatadas por estudantes universitários de diversos cursos, ocasionando prejuízos na concentração e queda dos rendimentos acadêmicos. O objetivo deste trabalho foi avaliar a qualidade de sono, a SDE e suas possíveis associações com sintomas depressivos em estudantes de odontologia. Foi realizado um estudo transversal e descritivo com 251 alunos do curso de odontologia da Faculdade de Farmácia, Odontologia e Enfermagem da Universidade Federal do Ceará. Os instrumentos utilizados foram o Índice de Qualidade de Sono de Pittsburgh (IQSP), Escala de Sonolência de Epworth (ESE) e Inventário de Depressão de Beck (IDB). Verificou-se uma alta prevalência de má qualidade de sono (53,4%) e SDE (35,1%) entre os estudantes, sem diferença significante em relação ao sexo para ambas. Foi encontrada correlação positiva entre IDB com IQSP e ESE (r = 0,478; p = 0,000 e r = 0,202; p = 0,000, respectivamente). Os resultados mostraram uma alta prevalência de má qualidade de sono e SDE e ambos os achados apresentaram associação com sintomas depressivos.

Sleep is an essential state for human survival. It has a biological, restorative and energy conservation function for the organism, promoting physical and mental balance. A high prevalence of poor sleep quality and excessive daytime sleepiness (EDS) has been reported among university students from different courses, causing impaired concentration and a drop in academic performance. This study evaluates sleep quality, EDS and their possible associations with depressive symptoms in dentistry students. A cross-sectional descriptive research was conducted with 251 students from the Dentistry Course at the School of Pharmacy, Dentistry and Nursing, Federal University of Ceará. Variables of interest were assessed by Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS) and Beck Depression Inventory (BDI). Results show a high prevalence of poor sleep quality (53.4%) and EDS (35.1%) among students, with no significant difference regarding gender. BDI had a positive correlation with PSQI and ESS (r= 0.478, p= 0.000; and r= 0.202, p =0.000, respectively). Both findings were associated with depressive symptoms.

El sueño es un estado esencial para la supervivencia humana, tiene una función biológica, reparadora y de conservación de energía para el organismo, favoreciendo el equilibrio físico y mental. Se ha reportado una alta prevalencia de mala calidad del sueño y somnolencia diurna excesiva (SDE) en estudiantes universitarios de diferentes carreras que provoca alteración de la concentración y caída del rendimiento académico. El objetivo de este trabajo fue evaluar la calidad del sueño, la SDE y sus posibles asociaciones con síntomas depresivos en estudiantes de odontología. Se realizó un estudio descriptivo transversal con 251 estudiantes de la carrera de Odontología de la Facultad de Farmacia, Odontología y Enfermería de la Universidad Federal de Ceará. Los instrumentos utilizados fueron el Índice de Calidad del Sueño de Pittsburgh (PSQI), la Escala de Somnolencia de Epworth (ESS) y el Inventario de Depresión de Beck (BDI). Hubo una alta prevalencia de mala calidad del sueño (53,4%) y SDE (35,1%) entre los estudiantes, sin diferencia significativa en relación con el género para ambos. Se encontró una correlación positiva entre BDI con PSQI y ESS (r= 0,478; p= 0,000 y r= 0,202; p = 0,000, respectivamente). Los resultados mostraron una alta prevalencia de mala calidad del sueño y SDE, y ambos hallazgos se asociaron con síntomas depresivos.

Salivary immunoglobulin levels and periodontal indices in Brazilian children with and without type 1 diabetes

Abstract This cross-sectional study evaluated the association between salivary immunoglobulins, plaque index, and gingival index in Brazilian children with and without type 1 diabetes mellitus (DM1). The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for the reporting of observational studies was followed. The DM1 group had 38 children, and an equal number of volunteers matched by sex and age were recruited as controls. Clinical examination was performed for plaque index and gingival index determination. Non-stimulated whole saliva was collected. Concentrations of IgA, IgG, and IgM were determined by ELISA test. Data were tested by the Kolmogorov-Smirnov, Mann-Whitney, and Spearman tests and a multiple linear regression model (p<0.05) was performed. Gingival index was higher in the Control (DM1: 0.16±0.17; Control: 0.24±0.23, p=0.040). In DM1, there was a correlation between IgA and age (rho=0.371, p=0.024), IgM and IgG (rho=0.459, p=0.007), and IgM and gingival index (rho=0.394, p=0.014). In DM1, multiple linear regression showed that age (p=0.041; β=0.363), gingival index (p=0.041; β=0.398), and plaque index (p=0.008; β=-0.506) were good predictors of IgA levels in saliva. Thus, IgA was the only researched immunoglobulin that was directly associated with plaque and gingival indices in Brazilian children with DM1, but not in control subjects.

Mandibular assessment of panoramic radiographs for sex identification / Análise do dimorfismo sexual através de índices radiomorfométricos em radiografias panorâmicas

ABSTRACT Sex determination plays a crucial role in the post-mortem identification of human remains. One effective approach for obtaining sex-related data is to use measurements of anatomical structures such as the mandible. This study aimed to evaluate the potential of mandibular radiomorphometric indices from panoramic radiographs (PRs) for the identification of sexual dimorphism. The study sample included 300 PRs of individuals aged 51 to 80 years from the northeastern region of Brazil. Four linear measures and three numerical indices were analyzed with Inkscape® version 1.0.1 for Windows by two blinded evaluators. After statistical analysis, the results showed that the linear measurements obtained from PRs are a reliable method for sex identification. However, the calculated indices of these measurements exhibited lower efficacy for the same purpose. Therefore, PRs proved to be a valuable method for sexual identification through mandibular assessment.

RESUMO A determinação do sexo é um dado importante para a identificação post-mortem de um indivíduo ou de restos mortais humanos. Uma maneira de adquirir dados quanto ao sexo é utilizar mensurações de estruturas como a mandíbula. O objetivo principal deste estudo é avaliar a utilização de índices radiomorfométricos de mandíbulas para a identificação de dimorfismo sexual, através de radiografias panorâmicas. O estudo foi realizado em exames radiográficos panorâmicos de 300 indivíduos entre 51 e 80 anos, residentes do Nordeste brasileiro. Foram analisadas quatro medidas lineares e três índices numéricos no software Inkscape® versão 1.0.1 para Windows, por dois avaliadores cegos. Após análise estatística, os resultados demostraram que as medidas lineares obtidas se configuram como um método seguro para a identificação sexual. Entretanto, os índices obtidos através destas medidas demostraram menor eficiência para o mesmo fim. Logo, as radiografias panorâmicas podem ser utilizadas como método eficaz para a obtenção da caracterização sexual através da mandíbula.

Does Postpartum Hypopituitarism Influence the Craniofacial Pattern? A Case-Control Study with Sheehan's Syndrome Patients

This study aimed to assess the craniofacial morphologic aspects of Sheehan's syndrome (SHS) patients.An observational study was performed with 19 women diagnosed with SHS and 19 controls matched by age and sex. Lateral cephalometric radiographs were obtained, and 30 linear and angular measurements were analyzed using the Radiocef Studio 2 software. The mean age of patients was 65.47 ± 10.19 years. The main findings were propositioned maxilla (52.63 %) and mandible (52.63 %) relative to the cranial base, mandibular prognathism in 73.68 %, deep growth pattern in 42.1 %, increased mandibular plane in 36.84 %, and reduction in anterior facial height. The SHS group showed statistically significant differences in SNB (p=0.026), N-Me (p=0.006), soft palate length (p=0.011), and Ena-Me (p<0.001) in comparison with controls. The standard deviation score analysis revealed altered values in relation to total maxillary and mandibular lengths. SHS showed altered craniofacial morphology, characterized by maxillo- mandibular prognathism, brachyfacial type, increased mandibular plane, and reduction in soft palate length. This study reports novel findings in SHS.

Este estudio tuvo como objetivo evaluar los aspectos morfológicos craneofaciales de los pacientes con síndrome de Sheehan (SHS). Se realizó un estudio observacional con 19 mujeres diagnosticadas con SHS y 19 controles asociados por edad y sexo. Se obtuvieron radiografías cefalométricas laterales y se analizaron 30 medidas lineales y angulares mediante el software Radiocef Studio 2. La edad media de los pacientes fue de 65,47 ± 10,19 años. Los principales hallazgos fueron proposición maxilar (52,63 %) y mandíbula (52,63 %) con respecto a la base del cráneo, prognatismo mandibular en 73,68 %, patrón de crecimiento profundo en 42,1 %, aumento del plano mandibular en 36,84 % y reducción de la altura facial anterior. El grupo SHS mostró diferencias estadísticamente significativas en SNB (p=0,026), N-Me (p=0,006), longitud del paladar blando (p=0,011) y Ena-Me (p<0,001) en comparación con los controles. El análisis de la puntuación de la desviación estándar reveló valores alterados en relación con las longitudes maxilares y mandibulares totales. El SHS mostró una morfología craneofacial alterada, caracterizada por prognatismo maxilomandibular, tipo braquifacial, aumento del plano mandibular y reducción de la longitud del velo del paladar. Este estudio informa hallazgos novedosos en SHS.

Anesthesia strategy for factor X deficiency coagulopathy: case report

Abstract Factor X deficiency ranks among the rarest coagulopathies and has a variable presentation spectrum. We intend to present a proposal for anesthesia protocol for individuals with the coagulopathy. The excision of an ovarian neoplasm was proposed for a 26-year-old, female, ASA II patient, with congenital Factor X deficiency. Physical examination and lab tests were normal, except for Prothrombin Time (PT) 22.1s (VR: 8-14s), International Normalized Ratio (INR) 1.99 (VR: 0.8-1.2) and Activated Partial Thromboplastin Time (aPTT) 41.4s (VR: 25-37s). We concluded that a history of bleeding should always be investigated, along with a pre-anesthetic coagulation study.

Concepções sobre imagem corporal da mulher negra entre alunas do ensino médio em Teresina/PI / Body image of black woman between high school conceptions about the students in Teresina / PI / Concepciones sobre imagen corporal de la mujer negra entre alumnas de la enseñanza medio en Teresina / PI

Objetivou-se, neste estudo, analisar concepções de alunas do ensino médio acerca da imagem corporal da mulher negra. Empregou-se os métodos estatístico e descritivo, sendo pesquisadas 26 alunas. Nos resultados, constatou-se que a maioria das alunas não considera qualquer aspecto corporal da mulher negra como feio. Contudo, existem opiniões que suscitam estigmas sobre a noção de beleza voltada para padrões eurocêntricos. Concluiu-se que a concepção de imagem corporal das alunas encontra-se permeada por incertezas e sentidos de beleza fluidos e contraditórios, construídos na ausência de uma educação corporal consistente, capaz de abolir comportamentos e concepções preconceituosas (AU)

The objective of this study was to analyze conceptions of high school students about the black woman's body image. The statistical and descriptive methods were employed, with 26 students being surveyed. In the results, it was verified that the majority of the students does not consider any corporal aspect of the black woman as ugly. However, there are opinions that raise stigmas about the notion of beauty focused on Eurocentric standards. It was concluded that the students' body image conception is permeated by fluid and contradictory uncertainties and senses of beauty, built in the absence of a consistent corporal education capable of abolishing prejudiced behaviors and conception (AU).

Se objetivó en este estudio, analizar concepciones de alumnas de la enseñanza media acerca de la imagen corporal de la mujer negra. Se emplearon los métodos estadístico y descriptivo, siendo investigadas 26 alumnas. En los resultados, se constató que la mayoría de las alumnas no considera ningún aspecto corporal de la mujer negra como feo. Sin embargo, existen opiniones que suscitan estigmas sobre la noción de belleza orientada hacia patrones eurocéntricos. Se concluyó que la concepción de imagen corporal de las alumnas se encuentra permeada por incertidumbres y sentidos de belleza fluidos y contradictorios, construidos en la ausencia de una educación corporal consistente, capaz de abolir comportamientos y concepciones preconcebidas (AU).

Determinantes da capacidade funcional em pacientes com doença de chagas / Determinants of functional capacity in patients with chagas disease

Resumo Fundamento: A doença de Chagas leva à redução da capacidade funcional. Entretanto, o estágio em que o comprometimento funcional é detectável permanece obscuro. Objetivos: O presente estudo teve como objetivo comparar a capacidade funcional de pacientes em diferentes estágios da doença de Chagas e de indivíduos saudáveis e verificar os determinantes do consumo de oxigênio de pico (VO2pico). Métodos: Em um estudo transversal, foram selecionados 160 indivíduos, 35 saudáveis e 125 com doença de Chagas. No grupo chagásico, 61 (49%) estavam na forma indeterminada da doença, 45 (36%) com cardiomiopatia chagásica (CC) e função cardíaca preservada e 19 (15%) com disfunção cardíaca e CC dilatada. Os dados foram analisados por meio de análise de regressão univariada e multivariada. A significância estatística foi fixada em 5%. Resultados: Pacientes na forma indeterminada da doença apresentaram capacidade funcional semelhante a indivíduos saudáveis (p> 0,05). Pacientes com ChC e função cardíaca preservada apresentaram VO2pico menor que os pacientes na forma indeterminada (p <0,05), mas apresentaram valores de VO2pico semelhantes ao ChC dilatado (p = 0,46). A idade, sexo masculino, classe funcional da NYHA, pressão arterial diastólica, razão entre a velocidade do fluxo transmitral diastólico precoce e a velocidade anular mitral diastólica precoce, a fração de ejeção do ventrículo esquerdo (FEVE) e o diâmetro diastólico final do ventrículo esquerdo foram associados à capacidade funcional. Porém, apenas idade, sexo masculino, FEVE e classe funcional da NYHA permaneceram associados ao VO2pico no modelo final (R2 ajustado = 0,60). Conclusão: Pacientes com CC apresentam menor capacidade funcional do que pacientes na forma indeterminada. FEVE, idade, sexo masculino e classe funcional da NYHA foram determinantes do VO2pico em pacientes com doença de Chagas.

Abstract Background: Chagas disease leads to reduced functional capacity. However, the stage at which functional impairment is detectable remains unclear. Objectives: The present study was addressed to compare the functional capacity of patients at different stages of Chagas disease and healthy individuals and to verify the determinants of peak oxygen uptake (VO2peak). Methods: In a cross-sectional study, 160 individuals were selected, 35 healthy and 125 with Chagas disease. In the Chagasic group, 61 (49%) were in the indeterminate form of the disease, 45 (36%) with Chagas cardiomyopathy (ChC) and preserved cardiac function and 19 (15%) with cardiac dysfunction and dilated ChC. The data were analyzed using univariate and multivariate regression analysis. Statistical significance was set at 5%. Results: Patients in the indeterminate form of disease showed similar functional capacity to healthy individuals (p>0.05). Patients with ChC and preserved cardiac function had lower VO2peak than patients in the indeterminate form (p<0.05), but showed similar VO2peak values than dilated ChC (p=0.46). The age, male sex, NYHA functional class, diastolic blood pressure, ratio of the early diastolic transmitral flow velocity to early diastolic mitral annular velocity, left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter were associated with functional capacity. However, only age, male sex, LVEF and NYHA functional class, remained associated with VO2peak in the final model (adjusted R2=0.60). Conclusion: Patients with ChC had lower functional capacity than patients in the indeterminate form. LVEF, age, male sex and NYHA functional class were determinants with VO2peak in patients with Chagas disease.

Clinical evolution of a severe asthmatics group in the use of immunobiological therapy in a Brazilian Public Hospital

SUMMARY OBJECTIVE: A small portion of the asthmatic population (3.6%) has severe asthma (SA), presenting high morbimortality rates and demanding more financial resources than other asthmatic populations. The use of immunobiological therapy is an effective tool in controlling symptoms, decreasing the number of exacerbations, and reducing the use of systemic corticosteroids in these patients. In Brazil, epidemiological data regarding this asthmatic population using immunobiologicals and their evolution are scarce. METHODS: This is an observational, analytical, cross-sectional, and retrospective study. The sample consisted of adult patients with SA in follow-up at the pulmonology service of the Complexo Hospital de Clínicas of the Federal University of Paraná, from January 2011 to August 2019. The analyzed variables were as follows: the number of exacerbations that required hospitalization in the previous year, forced expiratory volume in one second (FEV1), and asthma control test (ACT) scores before and after the start of immunobiological therapy. RESULTS: We studied 20 patients with SA using omalizumab or mepolizumab. We observed an increase in the mean ACT score of 4.8 points, a nonsignificant reduction in the number of exacerbations that required hospitalization, and a slight improvement in the FEV1. Regarding the patients using chronic systemic corticosteroid therapy, 14.2% (n=1) of patients had the medication discontinued and 57% (n=4) of patients had the dose reduced by half. CONCLUSION: The use of omalizumab and mepolizumab as additional therapy in SA provided a significant improvement in the ACT and allowed the dose reduction of systemic corticosteroids, without significant improvement in FEV1 and in the frequency of severe exacerbations.

Orthodontic Records Helping to Identify A Victim of Execution

ABSTRACT: Human identification is the process that identifies an individual as a unique being, differentiating him/ her from all others. The participation of Odontology in the processes of identification is fundamental in situations of human remains. This paper aims to report a case of positive identification, through dentistry, in human remains. The forensic odontologist performed a post-morten (PM) examination, which consisted of the collection of post-mortem dental findings in human bones, collection of ante-mortem (AM) dental findings in the patient's orthodontic records, and the comparison between AM and PM information. Dental elements are widely used in the processes of human identification, since they are resistant to time and to physical, chemical and mechanical impacts. Positive identification is guided by the presence of individualizing characteristics, easily detected in dental records. It is concluded that human identification through dentistry is a safe and reliable method, since dental elements have individualizing characteristics that make the process possible.

RESUMEN: La identificación humana es el proceso que identifica a un individuo como un ser único, diferenciándolo de todos los demás. La participación de la Odontología en los procesos de identificación es fundamental en situaciones de restos humanos. Este trabajo tiene como objetivo reportar un caso de identificación positiva, a través de la odontología, en restos humanos. El odontólogo forense realizó un examen post-morten (PM), que consistió en la recolección de hallazgos dentales post-mortem en huesos humanos, recolección de hallazgos dentales ante-mortem (AM) en los registros de ortodoncia del paciente y la comparación entre AM y Información de PM. Los elementos dentales son ampliamente utilizados en los procesos de identificación humana, ya que son resistentes al tiempo y a los impactos físicos, químicos y mecánicos. La identificación positiva está guiada por la presencia de características individualizantes, que se detectan fácilmente en los registros dentales. Se concluye que la identificación humana a través de la odontología es un método seguro y confiable, ya que los elementos dentales tienen características individualizantes que hacen posible el proceso.

Gerenciamento de resultados e ciclo eleitoral em municípios brasileiros / Gestión de ganancias y ciclo electoral en municipios brasileños / Earnings management and electoral cycle in Brazilian municipalities

Resumo O regime de competência tem sido gradualmente implementado no setor público brasileiro, ampliando o uso de estimativas para sua aplicação. Apesar de ter o objetivo de contribuir para a tomada de decisão, sabe-se que julgamentos também podem ser empregados para gerenciar a percepção sobre a performance. Assim, este estudo tem como objetivo avaliar a relação entre o ciclo eleitoral e a prática de gerenciamento de resultados nos municípios brasileiros. Os testes de análise da distribuição de frequência indicam que há descontinuidade em torno do resultado nulo, além de uma relação positiva entre o nível de gerenciamento de resultados e a probabilidade de o município apresentar um superávit logo acima de zero ("pequeno superávit"). Também foi evidenciado o aumento dos níveis de gerenciamento em períodos pré-eleitorais, bem como ambientes de maior nível de competição política. Portanto, há evidências de práticas de gerenciamento de resultados em função do ciclo eleitoral. O trabalho pretende suprir um pouco da falta de informação sobre o tema no setor público, bem como da identificação de padrões de comportamento oportunista por parte dos gestores locais brasileiros e sua inter-relação com os ciclos eleitorais.

Resumen El régimen de competencia se está implementando gradualmente en el sector público brasileño, lo que resulta en el uso de estimaciones para su aplicación. Aunque el objetivo principal es contribuir a la toma de decisiones, los juicios también se pueden utilizar para gestionar las percepciones sobre el rendimiento. Por lo tanto, el propósito de este estudio es evaluar la relación entre el ciclo electoral y las prácticas de gestión de ingresos en los municipios brasileños. Las pruebas basadas en la distribución de frecuencias indican que hay una discontinuidad alrededor de cero ganancias y que los municipios con "pequeños excedentes" presentan niveles más altos de los accruals discrecionales. Finalmente, presentamos evidencia empírica de que hay un aumento en el nivel de gestión de ingresos en los períodos preelectorales, que se mitiga en entornos con mayor competencia política. En conjunto, la evidencia empírica indica que existe una relación entre las prácticas de gestión de ingresos y el ciclo electoral. El estudio contribuye a la literatura cada vez mayor sobre la calidad de los ingresos en el sector público, ayudando a identificar circunstancias que pueden conducir a un comportamiento oportunista por parte de los administradores públicos, especialmente en relación con las elecciones.

Abstract The accruals basis of accounting is gradually being implemented in the Brazilian public sector, which has increased the use of estimates. Although the judgments' main objective is to contribute to decision-making, they can also be used to manage perceptions on performance. This study aims to evaluate the relationship between the electoral cycle and earnings management practices in Brazilian municipalities. Tests based on frequency distribution were conducted, indicating a discontinuity around zero earnings and suggesting that municipalities with 'small surpluses' present higher levels of discretionary accruals. Finally, we gathered empirical evidence of an increase in the level of earnings management in the pre-electoral periods, which is mitigated in environments with strong political competition. The empirical findings indicate a correlation between earnings management practices and the electoral cycle. The study contributes to a growing literature about earnings management in the public sector, helping to identify circumstances that can lead to opportunistic behavior by public managers, especially in relation to elections.

Concepções sobre imagem corporal da mulher negra entre alunas do ensino médio em Teresina/PI / Body image of black woman between high school conceptions about the students in Teresina / PI / Concepciones sobre imagen corporal de la mujer negra entre alumnas de la enseñanza medio en Teresina / PI

Objetivou-se, neste estudo, analisar concepções de alunas do ensino médio acerca da imagem corporal da mulher negra. Empregou-se os métodos estatístico e descritivo, sendo pesquisadas 26 alunas. Nos re-sultados, constatou-se que a maioria das alunas não considera qualquer aspecto corporal da mulher negra como feio. Contudo, existem opiniões que suscitam estigmas sobre a noção de beleza voltada para padrões eu-rocêntricos. Concluiu-se que a concepção de imagem corporal das alunas encontra-se permeada por incertezas e sentidos de beleza fluidos e con-traditórios, construídos na ausência de uma educação corporal consisten-te, capaz de abolir comportamentos e concepções preconceituosas.

The objective of this study was to analyze conceptions of high school students about the black woman's body image. The statistical and descriptive methods were employed, with 26 students being surveyed. In the results, it was verified that the majority of the students does not consider any corporal aspect of the black woman as ugly. However, there are opinions that raise stigmas about the notion of beauty focused on Eurocentric standards. It was concluded that the students' body image conception is permeated by fluid and contradictory uncertainties and senses of beauty, built in the absence of a consistent corporal education capable of abolishing prejudiced behaviors and conceptions.

Se objetivó en este estudio, analizar concepciones de alumnas de la enseñanza media acerca de la imagen corporal de la mujer negra. Se emplearon los métodos estadístico y descriptivo, siendo investigadas 26 alumnas. En los resultados, se constató que la mayoría de las alumnas no considera ningún aspecto corporal de la mujer negra como feo. Sin embargo, existen opiniones que suscitan estigmas sobre la noción de belleza orientada hacia patrones eurocéntricos. Se concluyó que la concepción de imagen corporal de las alumnas se encuentra permeada por incertidumbres y sentidos de belleza fluidos y contradictorios, construidos en la ausencia de una educación corporal consistente, capaz de abolir comportamientos y concepciones preconcebidas.

Transmission-blocking compound candidates against Plasmodium vivax using P. berghei as an initial screening

BACKGROUND Different strategies for improvement of malaria control and elimination are based on the blockage of malaria parasite transmission to the mosquito vector. These strategies include the drugs that target the plasmodial sexual stages in humans and the early developmental stages inside mosquitoes. OBJECTIVES Here we tested Malaria Box compounds in order to evaluate their activity against male and female gametocytes in Plasmodium berghei, mosquito infection in P. vivax and ookinete formation in both species. METHODS/FINDINGS The membrane feeding assay and the development of ookinetes by a 24 h ex vivo culture and the ookinete yield per 1000 erythrocytes were used to test transmission-blocking potential of the Malaria Box compounds in P. vivax. For P. berghei we used flow cytometry to evaluate male and female gametocyte time course and fluorescence microscopy to check the ookinete development. The two species used in this study showed similar results concerning the compounds' activity against gametocytes and ookinetes, which were different from those in P. falciparum. In addition, from the eight Malaria Box compounds tested in both species, compounds MMV665830, MMV665878 and MMV665941 were selected as a hit compounds due the high inhibition observed. CONCLUSION Our results showed that P. berghei is suitable as an initial screening system to test compounds against P. vivax.

Ensino das mudanças climáticas: a questão das enchentes no bairro Jardim Botânico na cidade do Rio de Janeiro/RJ / Teaching climate change: the issue of floods in the Jardim Botânico neighborhood in the city of Rio de Janeiro/RJ

As enchentes são fenômenos frequentes no bairro Jardim Botânico durante o verão carioca. Como as escolas da região trabalham este tema com os alunos? Para responder a esta questão, o objetivo deste trabalho foi descrever como o tema "mudanças climáticas" tem sido abordado na escola básica, em um território que enfrenta o problema das enchentes na cidade do Rio de Janeiro. Essa pesquisa foi realizada em uma escola pública de educação infantil do bairro Jardim Botânico/RJ, atingida diretamente pela enchente do verão de 2019. A pesquisa foi realizada em três etapas: a primeira destinou-se a identificar os fatores ambientais e sociais associados à questão das enchentes no bairro Jardim Botânico na cidade do Rio de Janeiro; a segunda analisou, por meio da análise textual discursiva, a temática mudanças climáticas com foco nas enchentes em materiais didáticos de escolas da educação infantil e ensino fundamental (1º ciclo) e por último analisou como os temas ambientais foram tratados em sala de aula, baseadas nas experiências vividas pelas professoras, após perdas consubstanciais da estrutura por uma enchente. Os resultados socioambientais do problema do bairro apontam para ineficácia da gestão das comportas locais, relacionadas ao extravasamento das águas fluviais, bem como do impacto do crescimento desordenado na poluição dos rios advindos do descarte inadequado do lixoQuanto à temática das mudanças climáticas abordadas nos 17 materiais didáticos analisados verificou-se que o tema enchente não foi frequente no material utilizado na educação infantil e no ensino fundamental. No entanto, a questão das enchentes foi abordada na práxis pedagógica das professoras da educação infantil. As professoras (66,6%) disseram que os alunos associaram as enchentes com a quantidade de chuva/ excesso de lixo. As metodologias mais utilizadas para abordagem deste tema foram contação de histórias e "rodinhas'' (de conversa e de vivências) (57,1%) e os sentimentos relatados pelos alunos relacionados ao fenômeno enchente foram tristeza, medo e susto. A maioria das professoras associaram o ensino das mudanças climáticas à educação ambiental (83%) e enfatizaram que os anos iniciais são importantes para a construção da cidadania. Conclui-se que há uma grande preocupação das docentes pelas questões ambientais ainda transversas ao ensino. Entretanto, de forma lúdica, conseguem construir pontes entre o ensino formal, a educação ambiental e a problematização do entorno da escola, de acordo com a realidade de seus alunos. (AU)

Floods are frequent phenomena in Botanic Garden neighbourhood during the summer in Rio. How do schools in the region work with students on this topic? To answer this question, the objective of this paper was to describe how the theme "climate change" has been approached in elementary school, in a territory that faces the problem of flooding in the city of Rio de Janeiro. This research was carried out in a public early childhood school in the Botanic Garden neighbourhood / RJ, directly affected by the flood of the summer of 2019. The research was carried out in three stages: the first was aimed at identifying the environmental and social factors associated with the issue the floods in the Botanic Garden neighbourhood in the city of Rio de Janeiro; the second analysed, through discourse textual analysis, the theme of climate change with a focus on floods in didactic materials from schools for early childhood education and elementary school (1st cycle) and lastly analysed how environmental issues were treated in the classroom, based on in the experiences lived by the teachers, after consubstantial losses of the structure by a flood. The socio environmental results of the neighbourhood problem point to ineffective management of the local floodgates, related to the overflow of river waters, as well as the impact of uncontrolled growth on the pollution of rivers resulting from inadequate waste disposalAs for the theme of climate change addressed in the 17 didactic materials analysed, it was found that the theme of flooding was not frequent in the material used in early childhood education and elementary education. However, the issue of flooding was addressed in the pedagogical praxis of early childhood teachers. The teachers (66.6%) said that the students associated the floods with the amount of rain / excess garbage. The most used methodologies to approach this theme were storytelling and "wheels" (of conversation and experiences) (57.1%) and the feelings reported by students related to the flood phenomenon were sadness, fear and fright. teachers associated the teaching of climate change with environmental education (83%) and emphasized that the early years are important for the construction of citizenship, concluding that there is a great concern of teachers for environmental issues that are still transversal to teaching. ludic, they are able to build bridges between formal education, environmental education and the problematization of the school's surroundings, according to the reality of their students. (AU)

Prevalence of apical periodontitis and root-filled teeth in 2500 panoramic radiographs of a Brazilian population sample / Prevalência de periodontite apical e dentes obturados em 2500 radiografias panorâmicas de uma amostra da população brasileira

Objective: This study aimed to evaluate the prevalence of teeth with apical periodontitis (AP), root-filled teeth with (RFTAP), and without apical periodontitis (RFT) in 2500 digital panoramic radiographs from an adult Northeastern Brazilian population sample. Methods: A retrospective study was conducted on 2500 panoramic radiographs from a private dental imaging center. Data regarding sex, age, RFT, AP, and RFTAP were collected. A descriptive statistical analysis was performed adopting p<0.05 as significant. Results: The female sex was more significantly associated with RFT and RFTAP than the male sex (p=0,023; p=0.040). The maxilla showed a higher association with RFTAP in the anterior region (p=0.023) and RFT in the posterior region (p=0.023). AP showed a higher prevalence in individuals aged ≥ 31 years (p<0.001). RFTAP showed higher prevalence in the age group 30-70 years (p<0.001). RFT exhibited a significant prevalence in individuals aged ≥21 years (p<0.001). Conclusion: This study showed a higher prevalence of RFT and a low prevalence of AP and RFTAP. Female patients presented a significantly higher prevalence of RFT and RFTAP. Age was an important factor associated with the prevalence of RFT, AP, and RFTAP.

Objetivo: Este estudo teve como objetivo avaliar a prevalência de dentes com periodontite apical (PA), dentes obturados com (DOPA) e sem periodontite apical (DO) em 2.500 radiografias panorâmicas digitais de uma amostra da população adulta do Nordeste brasileiro. Métodos: Um estudo retrospectivo foi realizado em 2.500 radiografias panorâmicas de um centro privado de imagem odontológica. Dados sobre sexo, idade, DO, PA e DOPA foram coletados. Foi realizada análise estatística descritiva, adotando-se p<0,05 como significante. Resultados: O sexo feminino associou-se mais significativamente com DO e DOPA do que o sexo masculino (p = 0,023; p = 0,040). A maxila apresentou maior associação com DOPA na região anterior (p = 0,023) e DO na região posterior (p = 0,023). A PA apresentou maior prevalência em indivíduos com idade ≥ 31 anos (p <0,001). O DOPA apresentou maior prevalência na faixa etária de 30 a 70 anos (p <0,001). DO exibiu uma prevalência significativa em indivíduos com idade ≥21 anos (p <0,001). Conclusão: Este estudo mostrou maior prevalência de DO e baixa prevalência de PA e DOPA. Pacientes do sexo feminino apresentaram prevalência significativamente maior de DO e DOPA. A idade foi um fator importante associado à prevalência de DO, PA e DOPA.

Mindfulness-based treatment for smoking cessation: a randomized controlled trial / Tratamento baseado em atenção plena (mindfulness) para cessação do tabagismo: ensaio clínico controlado randomizado

ABSTRACT Objective: To evaluate the efficacy of a mindfulness-based treatment (MBT) for smoking cessation or reduction and compare it with that of cognitive behavioral therapy (CBT). Methods: This was a single-center randomized controlled clinical trial including 113 patients divided into two groups: MBT (n = 54) and CBT (n = 59). The interventions comprised eight 90-min sessions. The primary outcome was smoking cessation at 16 weeks after program initiation. Secondary outcomes included reduction in the mean number of cigarettes smoked/day at 16 weeks after treatment initiation, as well as smoking cessation and reduction in the number of cigarettes smoked/day at the last program session. Participants had to attend ≥ 50% of the sessions to be included in the primary outcome analysis. An intention-to-treat analysis was also performed. Results: There was no difference between the groups regarding the primary outcome (30.4% in the MBT group vs. 31.6% in the CBT group, p = 0.68) or immediate abstinence rates (47.8% in the MBT group vs. 36.8% in the CBT group, p = 0.47). Both treatments were equally effective in reducing the number of cigarettes smoked/day at the last program session (a reduction of 93.33% [0-100%] in the MBT group and of 70% [33.3-100%] in the CBT group, p = 0.92) and at 16 weeks after program initiation (a reduction of 57.1% [0-100%] in the MBT group and of 70% [25-100%] in the CBT group, p = 0.49). Conclusions: MBT appears to be as effective as CBT for smoking cessation or reduction and can be an option for the treatment of tobacco use disorders in Brazil (Brazilian Registry of Clinical Trials identifier: RBR-3w2scz [http://www.ensaiosclinicos.gov.br])

RESUMO Objetivo: Avaliar a eficácia de um mindfulness treatment (MT, tratamento baseado em atenção plena) para a cessação ou redução do tabagismo e compará-la à da terapia cognitivo-comportamental (TCC). Métodos: Ensaio clínico controlado randomizado realizado em um único centro, com 113 pacientes divididos em dois grupos: MT (n = 54) e TCC (n = 59). As intervenções consistiram em oito sessões de 90 min cada. O desfecho primário foi a cessação do tabagismo 16 semanas após o início do programa. Os desfechos secundários foram a redução da média de cigarros fumados/dia em 16 semanas após o início do programa, bem como a cessação do tabagismo e redução do número de cigarros fumados/dia na última sessão do programa. Os participantes deveriam comparecer a ≥ 50% das sessões para que fossem incluídos na análise do desfecho primário. Foi também realizada uma análise por intenção de tratamento. Resultados: Não houve diferença entre os grupos quanto ao desfecho primário (30,4% no grupo MT vs. 31,6% no grupo TCC, p = 0,68) ou às taxas de abstinência imediata (47,8% no grupo MT vs. 36,8% no grupo TCC, p = 0,47). Ambos os tratamentos foram igualmente eficazes na redução do número de cigarros fumados/dia na última sessão do programa [redução de 93,33% (0-100%) no grupo MT e de 70% (33,3-100%) no grupo TCC, p = 0,92] e em 16 semanas após o início do programa [redução de 57,1% (0-100%) no grupo MT e de 70% (25-100%) no grupo TCC, p = 0,49]. Conclusões: A MT parece ser tão eficaz quanto a TCC para a cessação ou redução do tabagismo e pode ser uma opção para o tratamento do tabagismo no Brasil. [Registro Brasileiro de Ensaios Clínicos - ReBEC; número de identificação: RBR-3w2scz (http://www.ensaiosclinicos.gov.br)]

Antigenicity and adhesiveness of a Plasmodium vivax VIR-E protein from Brazilian isolates

BACKGROUND Plasmodium vivax, the major cause of malaria in Latin America, has a large subtelomeric multigene family called vir. In the P. vivax genome, about 20% of its sequences are vir genes. Vir antigens are grouped in subfamilies according to their sequence similarities and have been shown to have distinct roles and subcellular locations. However, little is known about vir subfamilies, especially when comes to their functions. OBJECTIVE To evaluate the diversity, antigenicity, and adhesiveness of Plasmodium vivax VIR-E. METHODS Vir-E genes were amplified from six P. vivax isolates from Manaus, North of Brazil. The presence of naturally acquired antibodies to recombinant PvBrVIR-E and PvAMA-1 was evaluated by ELISA. Binding capacity of recombinant PvBrVIR-E was assessed by adhesion assay to CHO-ICAM1 cells. FINDINGS Despite vir-E sequence diversity, among those identified sequences, a representative one was chosen to be expressed as recombinant protein. The presence of IgM or IgG antibodies to PvBrVIR-E was detected in 23.75% of the study population while the presence of IgG antibodies to PvAMA-1 antigen was 66.25% in the same population. PvBrVIR-E was adhesive to CHO-ICAM1. MAIN CONCLUSIONS PvBrVIR-E was antigenic and adhesive to CHO-ICAM1.

Diversity and spatio-temporal variation of Anopheles (Diptera: Culicidae) before and after the construction of the Jirau hydroelectric plant, state of Rondônia, Brazil

ABSTRACT The objective of this study was to evaluate the effect of the construction of the Jirau hydroelectric plant on the anopheline species, in Porto Velho, Rondônia, Brazil. For this, sampling was carried out in 23 locations in the pre (2004) and 23 after construction (2018) phases in the hydroelectric dam's coverage area, performed by human landing catch between 6:00 pm and 10:00 pm. We found 14 anopheline species. In the pre-construction phase, An. darlingi (73%) was the most abundant and after construction An. braziliensis (31.5%) was the most abundant. The T test indicated that there were no differences in the indexes - diversity (H '), richness (Sjack 1), equitability (J') and dominance (d) of anophelines species - evaluated between the phases (p > 0.05). The spatio-temporal distribution of An. darlingi proved to be wide, with the highest density values observed in March ( x ¯w = 27.1) in the pre-construction phase and in the months of May ( x ¯w = 4) and July ( x ¯w = 3.1), post-construction. Differences in hematophagic activity peaks were observed between species and between phases. According to the data obtained in this study, the construction of the hydroelectric plant had little influence on the composition of anopheline species, however changes were observed in the spatio-temporal distribution of the An. darlingi and in the pattern of hematophagic activity of the species, which directly influenced the dynamics of malaria in the region.

Prevalence of calcified triticeous cartilage-compatible images on 2500 digital panoramic radiographs of a Brazilian population sample / Prevalência de imagens compatíveis com calcificação da cartilagem tritícea em 2500 radiografias panorâmicas de uma amostra populacional brasileira

Objective: To investigate the prevalence of calcified triticeous cartilage (CTC)-compatible images on digital panoramic radiographs of a significant Brazilian population sample. Methods: In this retrospective study, 2500 digital panoramic radiographs were analyzed by a trained examiner using contrast and brightness adjustments of the Adobe® Photoshop® CC 2015 software. Data were collected and exported for statistical analysis (p-value <0.05 was considered statistically significant). Results: The prevalence of CTC-compatible images was 4.5% (61.1% in women and 38.9% in men). The most prevalent age ranged between 51 and 60 years (32.7%), and bilateral occurrence had a higher prevalence (46.9%). Women between the ages of 61 and 70 years showed a significantly higher prevalence of CTC-compatible images (p=0.027). Conclusion: This study showed a low prevalence of CTC-compatible images, which mainly occurred in women close to 70 years of age.

Objetivo: Investigar a prevalência de imagens compatíveis com calcificação da cartilagem tritícea (CCT) em radiografias panorâmicas digitais de uma significante amostra populacional brasileira. Métodos: Neste estudo retrospectivo, 2500 radiografias panorâmicas digitais foram analisadas por um examinador treinado utilizando ajustes de contraste e brilho através do software Adobe® Photoshop® CC 2015. Os dados foram coletados e exportados para análise estatística (p<0,05 foi considerado como valor estatisticamente significante). Resultados: A prevalência de imagens compatíveis com CCT foi de 4,5% (61.1% em mulheres e 38.9% em homens). A idade mais prevalente variou entre 51 e 60 anos (32,7%), sendo a ocorrência bilateral a mais comum (46,9%). Mulheres com idade entre 61 e 70 anos apresentaram prevalência significativamente maior de imagens compatíveis com CCT (p=0,027). Conclusão: O presente estudo evidenciou uma baixa prevalência de imagens compatíveis com CCT, que ocorreram, principalmente, em mulheres com idade próxima aos 70 anos.

Prevalence and determinants of depressive symptoms in patients with Chagas cardiomyopathy and predominantly preserved cardiac function

Abstract INTRODUCTION: Chagas cardiomyopathy (ChC) is highly stigmatized, and the presence of depressive symptoms may be a common feature. However, its determinants remain unclear. Therefore, the present study aimed to verify the prevalence of depression and the clinical, echocardiographic, functional, and quality of life factors associated with depressive symptoms in patients with ChC and predominantly preserved cardiac function. METHODS: Thirty-five patients with ChC (aged 40 to 60 years, 66% men, NYHA I-III) were evaluated by echocardiography, cardiopulmonary exercise testing, 6-minute walk test (6MWT), and Mini-Mental State Examination. Physical activity level was assessed using the Human Activity Profile (HAP) and health-related quality of life was assessed using the Short-Form Health Survey (SF-36). Depressive symptoms were evaluated using the Beck Depression Inventory. A cutoff point greater than 9 was indicative of depression. RESULTS: Depression was detected in 13 patients (37%). In the univariate analysis, female sex, NYHA functional class, body mass index, HAP score, mental summary of SF-36, peak oxygen uptake, and 6MWT distance were associated with depressive symptoms. The final model showed that only the HAP score (B = -0.533; 95% confidence interval [CI]: -0.804 to -0.262) and SF-36 mental summary (B = -0.269; 95% CI: -0.386 to -0.153) remained as independent predictors of depressive symptoms in patients with ChC. CONCLUSIONS: Depression was prevalent in patients with ChC and predominantly preserved cardiac function. Physical activity and mental health were independent risk factors for depressive symptoms.

Increased platelet distribution width and reduced IL-2 and IL-12 are associated with thrombocytopenia in Plasmodium vivax malaria

BACKGROUND Thrombocytopenia in malaria involves platelet destruction and consumption; however, the cellular response underlying this phenomenon has still not been elucidated. OBJECTIVE To find associations between platelet indices and unbalanced Th1/Th2/Th17 cytokines as a response to thrombocytopenia in Plasmodium vivax infected (Pv-MAL) patients. METHODS Platelet counts and quantification of Th1/Th2/Th17 cytokine levels were compared in 77 patients with uncomplicated P. vivax malaria and 37 healthy donors from the same area (endemic control group - ENCG). FINDINGS Thrombocytopenia was the main manifestation in 55 patients, but was not associated with parasitaemia. The Pv-MAL patients showed increases in the mean platelet volume (MPV), which may be consistent with larger or megaplatelets. Contrary to the findings regarding the endemic control group, MPV and platelet distribution width (PDW) did not show an inverse correlation, due the increase in the heterogeneity of platelet width. In addition, the Pv-MAL patients presented increased IL-1β and reduced IL-12p70 and IL-2 serum concentrations. Furthermore, the reduction of these cytokines was associated with PDW values. MAIN CONCLUSIONS Our data demonstrate that an increase in MPV and the association between reductions of IL-2 and IL-12 and PDW values may be an immune response to thrombocytopenia in uncomplicated P. vivax malaria.