Monitoring arthropods under the scope of LIFE-SNAILS project: I - Santa Maria Island baseline data with implementation of the Index of Biotic Integrity.

Background: The database we introduce is a pivotal component of the LIFE SNAILS project (Support and Naturalisation in Areas of Importance for Land Snails). This initiative is dedicated to safeguarding three endangered species of terrestrial molluscs, specifically, two snails (Oxychilusagostinhoi Martins 1981 and Leptaxisminor Backhuys, 1975) and a semi-slug (Plutoniaangulosa (Morelet, 1860)), all of which are single island endemics from Santa Maria Island and face significant threats towards their populations.In this study, we established a comprehensive database derived from a long-term arthropod monitoring campaign utilising SLAM (Sea, Land, Air, Malaise) traps. Although molluscs were not the primary focus, our findings serve as a credible proxy for evaluating the overall habitat quality for endemic invertebrates, with arthropods serving as principal indicators. From September to December of 2022, a total of 11 SLAM traps were installed and monitored monthly in eleven sites of mixed forests of Santa Maria Island. New information: Based on the 33 available samples (11 sites x 3 sampling periods), we recorded a total of 118 taxa of arthropods (of which 94 were identified at species or subspecies level), belonging to three classes, 14 orders and 62 families. From the 94 identified taxa, a total of 21 species were endemic, 31 native non-endemic, 32 introduced and 10 indeterminate. We also provide additional information of the habitat quality (Index of Biotic Integrity), including general habitat and dominant species composition.We registered three new records to the Island, the native bug Piezodoruslituratus (Fabricius, 1794) (Hemiptera, Pentatomidae), the Azorean endemic beetle Phloeosinusgillerforsi Bright, 1987 (Coleoptera, Curculionidae) and the exotic ant Hypoponerapunctatissima (Roger, 1859) (Hymenoptera, Formicidae) and one new record for the Azores Archipelago, the native beetle Cephenniumvalidum Assing & Meybohm, 2021 (Coleoptera, Staphylinidae, Scydmaeninae).This publication not only contributes to the conservation of highly threatened endemic molluscs, through an assessment of habitat quality, based on arthropod communities and habitat description (e.g. native or exotic vegetation), but also provides an updated inventory of arthropods from Santa Maria Island.

Determinants of HIV late presentation among men who have sex with men in Portugal (2014-2019): who's being left behind?

Introduction: HIV late presentation (LP) remains excessive in Europe. We aimed to analyze the factors associated with late presentation in the MSM population newly diagnosed with HIV in Portugal between 2014 and 2019. Methods: We included 391 newly HIV-1 diagnosed Men who have Sex with Men (MSM), from the BESTHOPE project, in 17 countrywide Portuguese hospitals. The data included clinical and socio-behavioral questionnaires and the viral genomic sequence obtained in the drug resistance test before starting antiretrovirals (ARVs). HIV-1 subtypes and epidemiological surveillance mutations were determined using different bioinformatics tools. Logistic regression was used to estimate the association between predictor variables and late presentation (LP). Results: The median age was 31 years, 51% had a current income between 501-1,000 euros, 28% were migrants. 21% had never been tested for HIV before diagnosis, with 42.3% of MSM presenting LP. 60% were infected with subtype B strains. In the multivariate regression, increased age at diagnosis, higher income, lower frequency of screening, STI ever diagnosed and higher viral load were associated with LP. Conclusion: Our study suggests that specific subgroups of the MSM population, such older MSM, with higher income and lower HIV testing frequency, are not being targeted by community and clinical screening services. Overall, targeted public health measures should be strengthened toward these subgroups, through strengthened primary care testing, expanded access to PrEP, information and promotion of HIV self-testing and more inclusive and accessible health services.

MicroRNA-216a is essential for cardiac angiogenesis.

While it is experimentally supported that impaired myocardial vascularization contributes to a mismatch between myocardial oxygen demand and supply, a mechanistic basis for disruption of coordinated tissue growth and angiogenesis in heart failure remains poorly understood. Silencing strategies that impair microRNA biogenesis have firmly implicated microRNAs in the regulation of angiogenesis, and individual microRNAs prove to be crucial in developmental or tumor angiogenesis. A high-throughput functional screening for the analysis of a whole-genome microRNA silencing library with regard to their phenotypic effect on endothelial cell proliferation as a key parameter, revealed several anti- and pro-proliferative microRNAs. Among those was miR-216a, a pro-angiogenic microRNA which is enriched in cardiac microvascular endothelial cells and reduced in expression under cardiac stress conditions. miR-216a null mice display dramatic cardiac phenotypes related to impaired myocardial vascularization and unbalanced autophagy and inflammation, supporting a model where microRNA regulation of microvascularization impacts the cardiac response to stress.

MicroRNA-124-3p-enriched small extracellular vesicles as a therapeutic approach for Parkinson's disease.

Parkinson's disease is a neurodegenerative disease characterized by the loss of dopaminergic neurons in the substantia nigra with no effective cure available. MicroRNA-124 has been regarded as a promising therapeutic entity for Parkinson's disease due to its pro-neurogenic and neuroprotective roles. However, its efficient delivery to the brain remains challenging. Here, we used umbilical cord blood mononuclear cell-derived extracellular vesicles as a biological vehicle to deliver microRNA (miR)-124-3p and evaluate its therapeutic effects in a mouse model of Parkinson's disease. In vitro, miR-124-3p-loaded small extracellular vesicles induced neuronal differentiation in subventricular zone neural stem cell cultures and protected N27 dopaminergic cells against 6-hydroxydopamine-induced toxicity. In vivo, intracerebroventricularly administered small extracellular vesicles were detected in the subventricular zone lining the lateral ventricles and in the striatum and substantia nigra, the brain regions most affected by the disease. Most importantly, although miR-124-3p-loaded small extracellular vesicles did not increase the number of new neurons in the 6-hydroxydopamine-lesioned striatum, the formulation protected dopaminergic neurons in the substantia nigra and striatal fibers, which fully counteracted motor behavior symptoms. Our findings reveal a novel promising therapeutic application of small extracellular vesicles as delivery agents for miR-124-3p in the context of Parkinson's disease.

HIV-1-Transmitted Drug Resistance and Transmission Clusters in Newly Diagnosed Patients in Portugal Between 2014 and 2019.

Objective: To describe and analyze transmitted drug resistance (TDR) between 2014 and 2019 in newly infected patients with HIV-1 in Portugal and to characterize its transmission networks. Methods: Clinical, socioepidemiological, and risk behavior data were collected from 820 newly diagnosed patients in Portugal between September 2014 and December 2019. The sequences obtained from drug resistance testing were used for subtyping, TDR determination, and transmission cluster (TC) analyses. Results: In Portugal, the overall prevalence of TDR between 2014 and 2019 was 11.0%. TDR presented a decreasing trend from 16.7% in 2014 to 9.2% in 2016 (p for-trend = 0.114). Multivariate analysis indicated that TDR was significantly associated with transmission route (MSM presented a lower probability of presenting TDR when compared to heterosexual contact) and with subtype (subtype C presented significantly more TDR when compared to subtype B). TC analysis corroborated that the heterosexual risk group presented a higher proportion of TDR in TCs when compared to MSMs. Among subtype A1, TDR reached 16.6% in heterosexuals, followed by 14.2% in patients infected with subtype B and 9.4% in patients infected with subtype G. Conclusion: Our molecular epidemiology approach indicates that the HIV-1 epidemic in Portugal is changing among risk group populations, with heterosexuals showing increasing levels of HIV-1 transmission and TDR. Prevention measures for this subpopulation should be reinforced.

Extracellular vesicles enriched with an endothelial cell pro-survival microRNA affects skin tissue regeneration.

Endothelial cell (EC) activity is essential for tissue regeneration in several (patho)physiological contexts. However, our capacity to deliver in vivo biomolecules capable of controlling EC fate is relatively limited. Here, we screened a library of microRNA (miR) mimics and identified 25 miRs capable of enhancing the survival of ECs exposed to ischemia-mimicking conditions. In vitro, we showed that miR-425-5p, one of the hits, was able to enhance EC survival and migration. In vivo, using a mouse Matrigel plug assay, we showed that ECs transfected with miR-425-5p displayed enhanced survival compared with scramble-transfected ECs. Mechanistically, we showed that miR-425-5p modulated the PTEN/PI3K/AKT pathway and inhibition of miR-425-5p target genes (DACH1, PTEN, RGS5, and VASH1) phenocopied the pro-survival. For the in vivo delivery of miR-425-5p, we modulated small extracellular vesicles (sEVs) with miR-425-5p and showed, in vitro, that miR-425-5p-modulated sEVs were (1) capable of enhancing the survival of ECs exposed to ischemia-mimic conditions, and (2) efficiently internalized by skin cells. Finally, using a streptozotocin-induced diabetic wound healing mouse model, we showed that, compared with miR-scrambled-modulated sEVs, topical administration of miR-425-5p-modulated sEVs significantly enhanced wound healing, a process mediated by enhanced vascularization and skin re-epithelialization.

Intercellular transfer of miR-200c-3p impairs the angiogenic capacity of cardiac endothelial cells.

As mediators of intercellular communication, extracellular vesicles containing molecular cargo, such as microRNAs, are secreted by cells and taken up by recipient cells to influence their cellular phenotype and function. Here we report that cardiac stress-induced differential microRNA content, with miR-200c-3p being one of the most enriched, in cardiomyocyte-derived extracellular vesicles mediates functional cross-talk with endothelial cells. Silencing of miR-200c-3p in mice subjected to chronic increased cardiac pressure overload resulted in attenuated hypertrophy, smaller fibrotic areas, higher capillary density, and preserved cardiac ejection fraction. We were able to maximally rescue microvascular and cardiac function with very low doses of antagomir, which specifically silences miR-200c-3p expression in non-myocyte cells. Our results reveal vesicle transfer of miR-200c-3p from cardiomyocytes to cardiac endothelial cells, underlining the importance of cardiac intercellular communication in the pathophysiology of heart failure.

Real-World Characterization of the Portuguese Population Living with HIV who Initiated Raltegravir Based-Regimens: The REALITY Study.

INTRODUCTION: Although raltegravir has been available since 2007, data are lacking on the Portuguese population living with HIV who initiated this antiretroviral therapy. Hence, this study aimed to characterize the patients who initiated raltegravir-based regimens between January 2015 and December 2017, on sociodemographics, clinical features, and treatment satisfaction. MATERIAL AND METHODS: Observational, retrospective, multicentre study conducted at 11 reference sites. Sociodemographic and clinical data were collected retrospectively from hospital medical records. For participants continuing raltegravir at study inclusion, the HIV Treatment Satisfaction Questionnaire was administered to assess satisfaction with raltegravir-based therapy. Descriptive statistics were performed. Treatment-naïve and treatment-experienced subgroups were compared for demographic and clinical variables. RESULTS: A total of 302 patients were included; mostly men (69.5%) with a mean age of 49 years old. Approximately half of the patients had at least one non-AIDS-related comorbidity at baseline (53.3%), such as hypercholesterolemia, arterial hypertension, diabetes mellitus, and depression. Moreover, 52.3% were treatment-experienced patients with up to two treatments prior to raltegravir. Across the study time points, there was a reduction in the viral load and improvement in CD4 counts in both the treatment-naïve and treatment-experienced subgroups. Continuing users of raltegravir reported high treatment satisfaction (55.4 ± 7.2 points). CONCLUSION: Raltegravir-based regimens seem like a valid therapeutic option in heterogeneous populations of HIV-infected patients, in patients with previous ART experience and as part of first-line therapeutic options alongside with the latest generation of drugs from its class.

Introdução: Apesar de o raltegravir estar disponível desde 2007, os dados na população portuguesa com VIH que iniciou esta terapêutica antirretroviral são escassos. Deste modo, este estudo teve por objetivo caracterizar os doentes que iniciaram um regime terapêutico baseado em raltegravir entre janeiro de 2015 e dezembro de 2017, relativamente a dados sociodemográficos, características clínicas e satisfação com o tratamento. Material e Métodos: Estudo observacional, retrospetivo, multicêntrico conduzido em 11 centros de referência. Os dados sociodemográficos e clínicos foram recolhidos retrospetivamente nos processos clínicos. Os participantes que continuaram o regime com raltegravir após a inclusão no estudo preencheram o HIV Treatment Satisfaction Questionnaire para avaliar a satisfação com a terapêutica. Foram efetuadas análises de estatística descritiva e comparações para as variáveis sociodemográficas e clínicas nos subgrupos de doentes naïve de tratamento e de doentes com experiência terapêutica. Resultados: Foram incluídos 302 doentes, maioritariamente do sexo masculino (69,5%) com idade média de 49 anos. Aproximadamente metade dos doentes tinha pelo menos uma comorbilidade não relacionada com SIDA no início do estudo (53,3%), tais como hipercolesterolemia, hipertensão arterial, diabetes mellitus ou depressão. Adicionalmente, 52,3% eram doentes com experiência terapêutica com até dois tratamentos anteriores ao raltegravir. Ao longo do estudo verificou-se uma redução na carga viral e uma melhoria nas contagens de CD4 em ambos os subgrupos de doentes (doentes naïve de tratamento e doentes com experiência terapêutica). Os doentes com uso continuado de raltegravir reportaram uma elevada satisfação com o tratamento (55,4 ± 7,2 pontos). Conclusão: Os regimes terapêuticos baseados em raltegravir parecem ser uma opção terapêutica válida em populações heterogéneas de doentes infetados com VIH, em doentes com experiência em ART e como tratamento de primeira linha, em paralelo com outras terapêuticas de última geração.

Fracture resistance and stress distribution of weakened teeth reinforced with a bundled glass fiber-reinforced resin post.

OBJECTIVES: To make an in vitro assessment of fracture resistance of weakened and non-weakened teeth receiving intraradicular reinforcement using Rebilda bundled glass fiber-reinforced composite posts (GT), Rebilda conventional glass fiber posts (RP), or both systems combined (GT + RP). MATERIALS AND METHODS: Eighty sound bovine incisors were prepared and divided randomly into eight groups as follows: (a) nWnR: without simulating weakness, and without intraradicular reinforcement; (b) WnR: simulating weakness, but without intraradicular reinforcement; (c) nWGT: without simulating weakness, but with GT; (d) WGT: simulating weakness, and with GT; (e) nWRP: without simulating weakness, but with RP; (f) WRP: simulating weakness, and with RP; (g) nWGTRP: without simulating weakness, but with GT + RP; (h) WGTRP: simulating weakness, and with GT + RP. The specimens were subjected to the load-to-fracture test using the DL-2000MF universal testing machine. The finite element method assessed the mechanical behavior and stress distribution in endodontically treated teeth. RESULTS: The groups nWGTRP and WGTRP presented the best results in the load-to-fracture test, with the former being better than the latter, but with no statistically significant difference (P > 0.05). However, there was a significant difference between these and the other groups (P < 0.05), except for nWRP. Stress distribution inside the canal wall was different among the groups, with promising mechanical behavior for nWGTRP and nWRP. CONCLUSIONS: The Rebilda conventional fiber post (RP), combined with the Rebilda bundled glass fiber-reinforced composite post (GT) improves the resistance and stress distribution of immature teeth. CLINICAL RELEVANCE: Longitudinal fracture is less frequent in teeth restored with GT and RP posts.

Effect of Passive Ultrasonic Irrigation over Organic Tissue of Simulated Internal Root Resorption.

This study aimed to evaluate the efficacy of passive ultrasonic irrigation (PUI) on dissolving the organic tissue inside simulated internal root resorption (IRR) using sodium hypochlorite (NaOCl) or chlorhexidine (CHX). A total of 40 human lower premolars were collected based on dimensional and morphological similarities. The roots were embedded in cylinders (3 cm diameter; 2.5 cm height) of self-cured acrylic resin, and then an IRR was simulated. The specimens were divided into 4 groups (n = 10) according to irrigation protocols: group 1: CHX + PUI; group 2: CHX; group 3: NaOCl + PUI; group 4: NaOCl. The total irrigation time was 150 s at a flow rate of 5 mL/min. A tissue mass of porcine palatine mucosa was used to simulate the organic tissue, it was weighed before and after the irrigation using an analytic balance, and the difference between both readings was calculated and transferred to percentage values. Data were submitted to statistical analysis using two-way ANOVA (factors: irrigant type and with/without PUI) and Tukey's test for multiple comparisons among the experimental groups (α = 0.05). There was a significant difference in both factors (irrigant: p=0.04; PUI: p ≤ 0.001). The groups that used PUI were more effective in dissolving the organic tissue of the IRR simulation than the groups without PUI. PUI is more effective than the syringe and needle irrigation in organic tissue dissolution.

Effect of Nonsurgical Versus Surgical Management on Geriatric Hip Fracture Mortality of Hispanic-American Male Veterans.

INTRODUCTION: The effect of surgical vs nonsurgical management on hip fracture mortality of Hispanic-American male veterans has not been rigorously studied. Hence, we examined the mortality and life expectancy effect of nonsurgical vs surgical management after hip fracture in a geriatric Hispanic-American male veterans' population. MATERIAL AND METHODS: This was a retrospective cohort study of Hispanic-American male veterans who were 65 years of age or older and suffered a femoral neck or intertrochanteric fracture from January 2008 to December 2015. Analysis between a surgical cohort (cannulated screw fixation, hemiarthroplasty, total hip arthroplasty, or cephalomedullary nail) and a non-surgical cohort was performed. In-hospital, 30-day, one-year, and two-year mortality were compared between both groups. RESULTS: Out of 268 patients with hip fracture, 159 (59.2%) were treated surgically and 109 (40.8%) non-surgically. The overall in-hospital (9.2% vs 1.9%, P = .009), 30-day (17.4% vs 5.0%, P = .002), one-year (48.6% vs 23.3%, P < .001), and two-year (63.3% vs 36.5%, P < .001) mortality rate was found to be higher for the nonoperative group. The average life expectancy of the nonoperative cohort was significantly shorter than those who were managed surgically (216 days vs 260 days, P < .001). DISCUSSION AND CONCLUSION: This study shows a higher mortality rate and lower life expectancy in geriatric male patients who were treated nonsurgically in a Veterans Health Affair hospital facility that mostly serves Hispanic-American veterans. Our results provide an expansion to the findings of other geriatric studies on hip fracture with focus in a Hispanic-American veteran male population.

Exogenous loading of miRNAs into small extracellular vesicles.

Small extracellular vesicles (sEVs), through their natural ability to interact with biological membranes and exploit endogenous processing pathways to convey biological information, are quintessential for the delivery of therapeutically relevant compounds, such as microRNAs (miRNAs) and proteins. Here, we used a fluorescently-labelled miRNA to quantify the efficiency of different methods to modulate the cargo of sEVs. Our results showed that, compared with electroporation, heat shock, permeation by a detergent-based compound (saponin) or cholesterol-modification of the miRNA, Exo-Fect was the most efficient method with > 50% transfection efficiency. Furthermore, qRT-PCR data showed that, compared with native sEVs, Exo-Fect modulation led to a > 1000-fold upregulation of the miRNA of interest. Importantly, this upregulation was observed for sEVs isolated from multiple sources. The modulated sEVs were able to delivery miR-155-5p into a reporter cell line, confirming the successful delivery of the miRNA to the target cell and, more importantly, its functionality. Finally, we showed that the membrane of Exo-Fect-loaded sEVs was altered compared with native sEVs and that enhanced the internalization of Exo-Fect-loaded sEVs within the target cells and decreased the interaction of those modulated sEVs with lysosomes.

Native and bioengineered extracellular vesicles for cardiovascular therapeutics.

Extracellular vesicles (EVs) are a heterogeneous group of natural particles that are relevant to the treatment of cardiovascular diseases. These endogenous vesicles have certain properties that allow them to survive in the extracellular space, bypass biological barriers and deliver their biologically active molecular cargo to recipient cells. Moreover, EVs can be bioengineered to increase their stability, bioactivity, presentation to acceptor cells and capacity for on-target binding at both cell-type-specific and tissue-specific levels. Bioengineering of EVs involves the modification of the donor cell before EV isolation or direct modification of the EV properties after isolation. The therapeutic potential of native EVs and bioengineered EVs has been only minimally explored in the context of cardiovascular diseases. Efforts to harness the therapeutic potential of EVs will require innovative approaches and a comprehensive integration of knowledge gathered from decades of research into molecular-compound delivery. In this Review, we outline the endogenous properties of EVs that make them natural delivery agents as well as the features that can be improved by bioengineering. We also discuss the therapeutic applications of native and bioengineered EVs to cardiovascular diseases and examine the opportunities and challenges that need to be addressed to advance this research area, with an emphasis on clinical translation.

Tuberculosis associated with diabetes mellitus by age group in Brazil: a retrospective cohort study, 2007-2014.

Diabetes mellitus (DM) has important implications for tuberculosis (TB), as it increases the risk for disease activation and is associated with unfavorable TB treatment outcomes. This study analyzed the association between TB and DM (TBDM) in Brazil from 2007 to 2014. This was a retrospective cohort study carried out in 709,429 new cases of TB reported to the national disease notification system of the Brazilian Ministry of Health. Sociodemographic and clinical data, test results, and treatment outcomes were analyzed. TBDM was found in 6.0% of TB cases, mostly in men aged 18-59 years. The lethality rate was 5.1% higher in all age groups with diabetes, except in those older than 60 years of age. The frequency of multi-drug-resistant tuberculosis (MDR-TB) in patients with DM was higher in those without DM, with a 1.6- to 3.8-fold increase in the odds of MDR-TB. The elderly showed an increase in the prevalence of TBDM from 14.3% to 18.2%. Women were more likely to have DM, and elderly women had 41.0% greater chance of having DM. Relapse was significant among patients younger than 17 years of age. TBDM was high in Brazil, affected all age groups, and was associated with unfavorable TB treatment outcomes. We emphasize the need for strategies for the clinical management of diabetic tuberculosis patients in Brazil aiming at minimizing relapses, deaths, and MDR-TB.

Tuberculosis associated with diabetes mellitus by age group in Brazil: a retrospective cohort study, 2007-2014

ABSTRACT Diabetes mellitus (DM) has important implications for tuberculosis (TB), as it increases the risk for disease activation and is associated with unfavorable TB treatment outcomes. This study analyzed the association between TB and DM (TBDM) in Brazil from 2007 to 2014. This was a retrospective cohort study carried out in 709,429 new cases of TB reported to the national disease notification system of the Brazilian Ministry of Health. Sociodemographic and clinical data, test results, and treatment outcomes were analyzed. TBDM was found in 6.0% of TB cases, mostly in men aged 18-59 years. The lethality rate was 5.1% higher in all age groups with diabetes, except in those older than 60 years of age. The frequency of multi-drug-resistant tuberculosis (MDR-TB) in patients with DM was higher in those without DM, with a 1.6- to 3.8-fold increase in the odds of MDR-TB. The elderly showed an increase in the prevalence of TBDM from 14.3% to 18.2%. Women were more likely to have DM, and elderly women had 41.0% greater chance of having DM. Relapse was significant among patients younger than 17 years of age. TBDM was high in Brazil, affected all age groups, and was associated with unfavorable TB treatment outcomes. We emphasize the need for strategies for the clinical management of diabetic tuberculosis patients in Brazil aiming at minimizing relapses, deaths, and MDR-TB.

Tuberculosis and diabetes: association with sociodemographic characteristics and diagnosis and treatment of tuberculosis. Brazil, 2007-2011. / Tuberculose e diabetes: associação com características sociodemográficas e de diagnóstico e tratamento. Brasil, 2007-2011.

INTRODUCTION: Tuberculosis and diabetes comorbidity remains a challenge for global public health. OBJECTIVE: To analyze the sociodemographic profile and the diagnostic and treatment characteristics of tuberculosis cases with and without diabetes in Brazil. METHODS: This is a cross-sectional study with data from the Notifiable Diseases Information System and the Hypertension and Diabetes Mellitus Primary Care Clinical Management System, from 2007 to 2011. We adopted a Poisson regression model with robust variance to estimate the prevalence ratios (PR) and their respective confidence intervals. RESULTS: We found the studied comorbidity in 7.2% of cases. The hierarchical model showed a higher PR among women (PR=1.31; 95% confidence interval - 95%CI 1.27-1.35); a greater association in the age groups 40-59 years and ≥ 60 years (PR=11.70; 95%CI 10.21-13.39, and PR=17.49; 95%CI 15.26-20.05), and in those with positive sputum smear microscopy results - 1st sample (PR=1.40; 95%CI 1.35-1.47). Return after treatment discontinuation and treatment discontinuation were inversely associated with comorbidity (PR=0.66; 95%CI 0.57-0.76 and PR=0.79; 95%CI 0.72-0.87). CONCLUSION: The findings, such as the inverse relationship with tuberculosis treatment discontinuation in the group of people with comorbidity, reinforce the importance of integrated actions in health services to change the scenario of this challenging comorbidity.

INTRODUÇÃO: A comorbidade tuberculose e diabetes ainda continua um desafio para a saúde pública mundial. OBJETIVO: Analisar o perfil sociodemográfico e as características do diagnóstico e tratamento dos casos de tuberculose com e sem diabetes no Brasil. MÉTODOS: Estudo transversal, com dados do Sistema de Informação de Agravos de Notificação e do Sistema de Gestão Clínica de Hipertensão Arterial e Diabetes Mellitus da Atenção Básica, no período de 2007 a 2011. Modelo de regressão de Poisson com variância robusta foi utilizado para estimar a razão de prevalência (RP) e seus respectivos intervalos de confiança. RESULTADOS: A comorbidade estudada foi encontrada em 7,2% dos casos. Modelo hierárquico mostrou maior RP entre indivíduos do sexo feminino (RP = 1,31; intervalo de confiança de 95% - IC95% 1,27 - 1,35); maior associação nas faixas etárias 40-59 anos e ≥ 60 anos (RP = 11,70; IC95% 10,21 - 13,39 e RP = 17,49; IC95% 15,26-20,05) e com resultado positivo da baciloscopia - primeira amostra (RP = 1,40; IC95% 1,35 - 1,47). Reingresso após abandono e abandono foram inversamente associados na comorbidade (RP = 0,66; IC95% 0,57 - 0,76 e RP = 0,79; IC95% 0,72 - 0,87). CONCLUSÃO: Os achados, como a relação inversa do abandono ao tratamento da tuberculose no grupo das pessoas com comorbidade, reforçam a importância de ações integradas nos serviços para mudar o cenário dessa desafiadora comorbidade.

Bond strength of cemented fiber posts to teeth with simulated internal root resorption.

BACKGROUND: Teeth with internal root resorption (IRR) have guarded prognosis, considering that IRR defect could influence on the post bond strength. The aim of this study was to evaluate the bond strength and the bond interface between different glass fiber-reinforced posts (FRP) after cementation in teeth with simulated internal root resorption (IRR). MATERIAL AND METHODS: Forty-five (45) human premolar roots with simulated IRR were embedded in acrylic resin blocks and cross-sectioned into two segments, enabling them to be re-approximated by screws. Intracanal medication was inserted for 15-days, removed by passive ultrasonic irrigation (PUI) and examined by stereomicroscopy. The push-out bond strength of two fiber reinforced composite posts (Rebilda Post - RP) and Rebilda Post GT - GT, (VOCO) were evaluated at the cervical and IRR regions (n = 20). And, the bonded interface between resin cement and root dentine was analysed by scanning electron microscopy (SEM). RESULTS: 62.5% of IRR were not completely cleaned by PUI. Bond strength values at the cervical region (9.8 and 14.6 MPa) were higher than the IRR region (6.3 and 4.2 MPa). Micrographies showed bubbles in the cement and spaces in the bonded interface. CONCLUSIONS: RP post showed better bond strength at the cervical region while GT had better bond strength at the IRR region. Key words:Endodontics, root canal filling materials, root resorption, X-Ray microtomography.

Tuberculose e diabetes: associação com características sociodemográficas e de diagnóstico e tratamento. Brasil, 2007-2011 / Tuberculosis and diabetes: association with sociodemographic characteristics and diagnosis and treatment of tuberculosis. Brazil, 2007-2011

RESUMO: Introdução: A comorbidade tuberculose e diabetes ainda continua um desafio para a saúde pública mundial. Objetivo: Analisar o perfil sociodemográfico e as características do diagnóstico e tratamento dos casos de tuberculose com e sem diabetes no Brasil. Métodos: Estudo transversal, com dados do Sistema de Informação de Agravos de Notificação e do Sistema de Gestão Clínica de Hipertensão Arterial e Diabetes Mellitus da Atenção Básica, no período de 2007 a 2011. Modelo de regressão de Poisson com variância robusta foi utilizado para estimar a razão de prevalência (RP) e seus respectivos intervalos de confiança. Resultados: A comorbidade estudada foi encontrada em 7,2% dos casos. Modelo hierárquico mostrou maior RP entre indivíduos do sexo feminino (RP = 1,31; intervalo de confiança de 95% - IC95% 1,27 - 1,35); maior associação nas faixas etárias 40-59 anos e ≥ 60 anos (RP = 11,70; IC95% 10,21 - 13,39 e RP = 17,49; IC95% 15,26-20,05) e com resultado positivo da baciloscopia - primeira amostra (RP = 1,40; IC95% 1,35 - 1,47). Reingresso após abandono e abandono foram inversamente associados na comorbidade (RP = 0,66; IC95% 0,57 - 0,76 e RP = 0,79; IC95% 0,72 - 0,87). Conclusão: Os achados, como a relação inversa do abandono ao tratamento da tuberculose no grupo das pessoas com comorbidade, reforçam a importância de ações integradas nos serviços para mudar o cenário dessa desafiadora comorbidade.

ABSTRACT: Introduction: Tuberculosis and diabetes comorbidity remains a challenge for global public health. Objective: To analyze the sociodemographic profile and the diagnostic and treatment characteristics of tuberculosis cases with and without diabetes in Brazil. Methods: This is a cross-sectional study with data from the Notifiable Diseases Information System and the Hypertension and Diabetes Mellitus Primary Care Clinical Management System, from 2007 to 2011. We adopted a Poisson regression model with robust variance to estimate the prevalence ratios (PR) and their respective confidence intervals. Results: We found the studied comorbidity in 7.2% of cases. The hierarchical model showed a higher PR among women (PR=1.31; 95% confidence interval - 95%CI 1.27-1.35); a greater association in the age groups 40-59 years and ≥ 60 years (PR=11.70; 95%CI 10.21-13.39, and PR=17.49; 95%CI 15.26-20.05), and in those with positive sputum smear microscopy results - 1st sample (PR=1.40; 95%CI 1.35-1.47). Return after treatment discontinuation and treatment discontinuation were inversely associated with comorbidity (PR=0.66; 95%CI 0.57-0.76 and PR=0.79; 95%CI 0.72-0.87). Conclusion: The findings, such as the inverse relationship with tuberculosis treatment discontinuation in the group of people with comorbidity, reinforce the importance of integrated actions in health services to change the scenario of this challenging comorbidity.

A rare presentation of Listeria monocytogenes infection: Perianal abscess associated with lumbar spine osteitis.

Listeria monocytogenes is a ubiquitous, rapidly growing, gram-positive bacterium causing infections in humans and animals. It is responsible for a variety of symptoms depending on the infection site and the integrity of the host's immune system. Case reports of skin and soft tissues infections by Listeria are rare. The authors present a case of a 65-year-old diabetic male with recurrent skin abscess diagnosed with a perianal abscess due to Listeria monocytogenes associated with lumbar spine osteitis. At the time of this publication and to our knowledge, this case represents the first Listeria monocytogenes infection involving skin and bone in a diabetic man with recurrent skin abscess.

Non-AIDS-related comorbidities in people living with HIV-1 aged 50 years and older: The AGING POSITIVE study.

OBJECTIVE: To characterize the profile of non-AIDS-related comorbidities (NARC) in the older HIV-1-infected population and to explore the factors associated with multiple NARC. METHODS: This was a multicentre, cross-sectional study including HIV-1-infected patients aged ≥50 years, who were virologically suppressed and had been on a stable antiretroviral therapy (ART) regimen for at least 6 months. A multiple regression model explored the association between demographic and clinical variables and the number of NARC. RESULTS: Overall, 401 patients were enrolled. The mean age of the patients was 59.3 years and 72.6% were male. The mean duration of HIV-1 infection was 12.0 years and the median exposure to ART was 10.0 years. The mean number of NARC was 2.1, and 34.7% of patients had three or more NARC. Hypercholesterolemia was the most frequent NARC (60.8%), followed by arterial hypertension (39.7%) and chronic depression/anxiety (23.9%). Arterial hypertension and diabetes mellitus were the most frequently treated NARC (95.6% and 92.6% of cases, respectively). The linear regression analysis showed a positive relationship between age and NARC (B=0.032, 95% confidence interval 0.015-0.049; p=0.0003) and between the duration of HIV-1 infection and NARC (B=0.039, 95% confidence interval 0.017-0.059; p=0.0005). CONCLUSIONS: A high prevalence of NARC was found, the most common being metabolic, cardiovascular, and psychological conditions. NARC rates were similar to those reported for the general population, suggesting a larger societal problem beyond HIV infection. A multidisciplinary approach is essential to reduce the burden of complex multi-morbid conditions in the HIV-1-infected population.