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1.
Sci Total Environ ; 622-623: 140-151, 2018 May 01.
Article in English | MEDLINE | ID: mdl-29212051

ABSTRACT

Land use and climate change can influence runoff and soil erosion, threatening soil and water conservation in the Cerrado biome in Brazil. The adoption of a process-based model was necessary due to the lack of long-term observed data. Our goals were to calibrate the WEPP (Water Erosion Prediction Project) model for different land uses under subtropical conditions in the Cerrado biome; predict runoff and soil erosion for these different land uses; and simulate runoff and soil erosion considering climate change. We performed the model calibration using a 5-year dataset (2012-2016) of observed runoff and soil loss in four different land uses (wooded Cerrado, tilled fallow without plant cover, pasture, and sugarcane) in experimental plots. Selected soil and management parameters were optimized for each land use during the WEPP model calibration with the existing field data. The simulations were conducted using the calibrated WEPP model components with a 100-year climate dataset created with CLIGEN (weather generator) based on regional climate statistics. We obtained downscaled General Circulation Model (GCM) projections, and runoff and soil loss were predicted with WEPP using future climate scenarios for 2030, 2060, and 2090 considering different Representative Concentration Pathways (RCPs). The WEPP model had an acceptable performance for the subtropical conditions. Land use can influence runoff and soil loss rates in a significant way. Potential climate changes, which indicate the increase of rainfall intensities and depths, may increase the variability and rates of runoff and soil erosion. However, projected climate changes did not significantly affect the runoff and soil erosion for the four analyzed land uses at our location. Finally, the runoff behavior was distinct for each land use, but for soil loss we found similarities between pasture and wooded Cerrado, suggesting that the soil may attain a sustainable level when the land management follows conservation principles.

2.
Braz J Phys Ther ; 21(2): 77-84, 2017.
Article in English | MEDLINE | ID: mdl-28460714

ABSTRACT

BACKGROUND: This masterclass introduces the topic of core outcome sets, describing rationale and methods for developing them, and providing some examples that are relevant for clinical research and practice. METHOD: A core outcome set is a minimum consensus-based set of outcomes that should be measured and reported in all clinical trials for a specific health condition and/or intervention. Issues surrounding outcome assessment, such as selective reporting and inconsistency across studies, can be addressed by the development of a core set. As suggested by key initiatives in this field (i.e. OMERACT and COMET), the development requires achieving consensus on: (1) core outcome domains and (2) core outcome measurement instruments. Different methods can be used to reach consensus, including: literature systematic reviews to inform the process, qualitative research with clinicians and patients, group discussions (e.g. nominal group technique), and structured surveys (e.g. Delphi technique). Various stakeholders should be involved in the process, with particular attention to patients. RESULTS AND CONCLUSIONS: Several COSs have been developed for musculoskeletal conditions including a longstanding one for low back pain, IMMPACT recommendations on outcomes for chronic pain, and OMERACT COSs for hip, knee and hand osteoarthritis. There is a lack of COSs for neurological, geriatric, cardio-respiratory and pediatric conditions, therefore, future research could determine the value of developing COSs for these conditions.


Subject(s)
Consensus , Low Back Pain/physiopathology , Surveys and Questionnaires/standards , Delphi Technique , Humans , Research Design , Treatment Outcome
3.
Ann Emerg Med ; 69(3): 378, 2017 Mar.
Article in English | MEDLINE | ID: mdl-28231996
5.
Future Microbiol ; 10(4): 517-26, 2015.
Article in English | MEDLINE | ID: mdl-25865191

ABSTRACT

AIM: To evaluate the gut microbial profile in chronic kidney disease (CKD) patients and evaluate the possible relationship with inflammation and cardiovascular risk. PATIENTS & METHODS: Markers inflammation plasma and bacterial community profile (denaturing gradient gel electrophoresis) were analyzed. RESULTS: The average number of bands was not different in healthy individuals and CKD patients. The number of bands was negatively associated with plasma levels of VCAM-1 in patients. Flavobacteriaceae bacterium and Listeria monocytogenes were found in patients and Lachnospiraceae bacterium and Butyrivibrio crossotus in healthy individuals. CONCLUSION: Although CKD patients did not present altered gut microbial profile, the sequencing of bands suggested a different microbiota between groups. The result suggests a possible relationship between gut microbiota and cardiovascular risk in CKD patients.


Subject(s)
Biota , Cardiovascular Diseases/epidemiology , Gastrointestinal Microbiome , Gastrointestinal Tract/microbiology , Renal Insufficiency, Chronic/complications , Blood Chemical Analysis , Denaturing Gradient Gel Electrophoresis , Humans , Risk Assessment , Sequence Analysis, DNA
6.
J Clin Pathol ; 68(3): 222-8, 2015 Mar.
Article in English | MEDLINE | ID: mdl-25586380

ABSTRACT

AIMS: This cross-sectional study investigated the association between eight herpesviruses and the bacterial community profiles from the oral cavity of children with and without leukaemia. METHODS: Sixty participants (aged 3-13), divided into the leukaemia group (LG) and healthy group (HG), were evaluated. Collection of medical data, intraoral examination and collection of clinical specimens were carried out. Single PCR and nested-PCR techniques were used to identify the viral types; denaturing gradient gel electrophoresis (DGGE) and real-time PCR techniques were used to evaluate the profile and abundance of bacterial communities. RESULTS: All the children with leukaemia were positive for at least one type of herpesvirus, compared with healthy participants (33.3%; p<0.000). Human cytomegalovirus (HCMV; 46.7%), human herpesvirus-7 (HHV-7; 20%) and HHV-8 (77.3%) were in higher prevalence in the LG (p ≤ 0.01). Children with leukaemia had positive associations with the presence of HCMV, HHV-7 and HHV-8 in the oral cavity when under chemotherapy (p<0.05). There was a qualitative (means of DGGE bands) and quantitative (means of 16S rRNA gene abundance) difference in relation to the bacterial community between the two groups (p<0.05). CONCLUSIONS: Based on the results, the prevalence of herpesviruses and the qualitative bacterial profiles was higher in children with leukaemia and HCMV, HHV-7 and HHV-8 were related to the use of chemotherapy. Moreover, HHV-6 was correlated with an increased bacterial community profile in patients with leukaemia (p<0.05). More attention should be paid to the oral health of these individuals, mainly those under chemotherapy, in order to prevent infections by opportunistic pathogens.


Subject(s)
Antineoplastic Agents/therapeutic use , Bacteria/drug effects , Herpesviridae Infections/virology , Herpesviridae/drug effects , Leukemia/drug therapy , Mouth/drug effects , Oral Health , Adolescent , Antineoplastic Agents/adverse effects , Bacteria/classification , Bacteria/genetics , Bacteria/isolation & purification , Case-Control Studies , Child , Child, Preschool , Cross-Sectional Studies , DNA, Bacterial/isolation & purification , DNA, Viral/isolation & purification , Denaturing Gradient Gel Electrophoresis , Female , Herpesviridae/classification , Herpesviridae/genetics , Herpesviridae/isolation & purification , Herpesviridae Infections/diagnosis , Humans , Leukemia/diagnosis , Male , Mouth/microbiology , Mouth/virology , Real-Time Polymerase Chain Reaction
7.
Reg Anesth Pain Med ; 39(6): 478-86, 2014.
Article in English | MEDLINE | ID: mdl-25304476

ABSTRACT

BACKGROUND AND OBJECTIVES: The incidence of chronic pain after cesarean delivery (CD) has been estimated to range between 0.3% and 18%. This wide range may be explained by differing study methodologies. Furthermore, a comprehensive characterization of pain quality is lacking. The aim of this study was to evaluate persistent pain in a healthy obstetric population undergoing planned CD and to provide a comprehensive description of pain quality. METHODS: Three hundred eighty-one women with no pain history undergoing CD were included in this prospective, observational cohort study. Spinal anesthesia was standardized, and postoperative pain was recorded at 24 hours. In each woman, pain was assessed at 8 weeks, and 6 and 12 months using questionnaires of pain intensity and interference. Pain quality was assessed using the Short-Form McGill Pain Questionnaire-Revised. RESULTS: The incidence of persistent pain at 8 weeks was 11% (95% confidence interval, 8%-14%), with pain reported as being mild and interfering with common daily activities by 32% of women. At 6 and 12 months, the incidence was 3% (95% confidence interval, 2%-6%) and 0.6% (95% confidence interval, 0%-2%) respectively, with pain rarely interfering with daily activities. However, 22% of women described other surgery-related symptoms at 12 months. CONCLUSIONS: The incidence of chronic pain at 12 months after planned CD is low (0.6%) and if present symptoms are mostly mild and not interfering with common daily activities. Using Short-Form McGill Pain Questionnaire-Revised, this study provides a comprehensive evaluation of pain quality that can be used as a basis in future post-CD pain trials.


Subject(s)
Cesarean Section/adverse effects , Chronic Pain/epidemiology , Pain Measurement , Pain, Postoperative/epidemiology , Surveys and Questionnaires , Activities of Daily Living , Adult , Analgesics/therapeutic use , Brazil/epidemiology , Chronic Pain/diagnosis , Chronic Pain/drug therapy , Elective Surgical Procedures , Female , Humans , Incidence , Pain, Postoperative/diagnosis , Pain, Postoperative/drug therapy , Pregnancy , Prospective Studies , Severity of Illness Index , Time Factors , Treatment Outcome
9.
Cochrane Database Syst Rev ; (8): CD004959, 2013 Aug 27.
Article in English | MEDLINE | ID: mdl-23983011

ABSTRACT

BACKGROUND: The use of opioids in the long-term management of chronic low-back pain (CLBP) has increased dramatically. Despite this trend, the benefits and risks of these medications remain unclear. This review is an update of a Cochrane review first published in 2007. OBJECTIVES: To determine the efficacy of opioids in adults with CLBP. SEARCH METHODS: We electronically searched the Cochrane Back Review Group's Specialized Register, CENTRAL, CINAHL and PsycINFO, MEDLINE, and EMBASE from January 2006 to October 2012. We checked the reference lists of these trials and other relevant systematic reviews for potential trials for inclusion. SELECTION CRITERIA: We included randomized controlled trials (RCTs) that assessed the use of opioids (as monotherapy or in combination with other therapies) in adults with CLBP that were at least four weeks in duration. We included trials that compared non-injectable opioids to placebo or other treatments. We excluded trials that compared different opioids only. DATA COLLECTION AND ANALYSIS: Two authors independently assessed the risk of bias and extracted data onto a pre-designed form. We pooled results using Review Manager (RevMan) 5.2. We reported on pain and function outcomes using standardized mean difference (SMD) or risk ratios with 95% confidence intervals (95% CI). We used absolute risk difference (RD) with 95% CI to report adverse effects. MAIN RESULTS: We included 15 trials (5540 participants). Tramadol was examined in five trials (1378 participants); it was found to be better than placebo for pain (SMD -0.55, 95% CI -0.66 to -0.44; low quality evidence) and function (SMD -0.18, 95% CI -0.29 to -0.07; moderate quality evidence). Transdermal buprenorphine (two trials, 653 participants) may make little difference for pain (SMD -2.47, 95%CI -2.69 to -2.25; very low quality evidence), but no difference compared to placebo for function (SMD -0.14, 95%CI -0.53 to 0.25; very low quality evidence). Strong opioids (morphine, hydromorphone, oxycodone, oxymorphone, and tapentadol), examined in six trials (1887 participants), were better than placebo for pain (SMD -0.43, 95%CI -0.52 to -0.33; moderate quality evidence) and function (SMD -0.26, 95% CI -0.37 to -0.15; moderate quality evidence). One trial (1583 participants) demonstrated that tramadol may make little difference compared to celecoxib (RR 0.82, 95% CI 0.76 to 0.90; very low quality evidence) for pain relief. Two trials (272 participants) found no difference between opioids and antidepressants for either pain (SMD 0.21, 95% CI -0.03 to 0.45; very low quality evidence), or function (SMD -0.11, 95% -0.63 to 0.42; very low quality evidence). The included trials in this review had high drop-out rates, were of short duration, and had limited interpretability of functional improvement. They did not report any serious adverse effects, risks (addiction or overdose), or complications (sleep apnea, opioid-induced hyperalgesia, hypogonadism). In general, the effect sizes were medium for pain and small for function. AUTHORS' CONCLUSIONS: There is some evidence (very low to moderate quality) for short-term efficacy (for both pain and function) of opioids to treat CLBP compared to placebo. The very few trials that compared opioids to non-steroidal anti-inflammatory drugs (NSAIDs) or antidepressants did not show any differences regarding pain and function. The initiation of a trial of opioids for long-term management should be done with extreme caution, especially after a comprehensive assessment of potential risks. There are no placebo-RCTs supporting the effectiveness and safety of long-term opioid therapy for treatment of CLBP.


Subject(s)
Analgesics, Opioid/therapeutic use , Chronic Pain/drug therapy , Low Back Pain/drug therapy , Adult , Analgesics, Opioid/adverse effects , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Female , Humans , Male , Middle Aged , Randomized Controlled Trials as Topic
10.
J Endod ; 39(2): 190-4, 2013 Feb.
Article in English | MEDLINE | ID: mdl-23321229

ABSTRACT

INTRODUCTION: This in vivo study used molecular microbiology methods to evaluate the effects of passive ultrasonic irrigation (PUI) as a supplementary disinfecting step after root canal preparation. METHODS: Samples were taken from 10 necrotic root canals of teeth with apical periodontitis before (S1) and after rotary nickel-titanium instrumentation using 2.5% NaOCl as the irrigant (S2) and then after PUI for NaOCl activation (S3). The parameters examined included the incidence of positive broad-range polymerase chain reaction (PCR) results for bacterial presence, the impact on bacterial diversity evaluated by PCR-denaturing gradient gel electrophoresis (DGGE), the quantitative bacterial reduction determined by real-time PCR, and the identification of persistent species by clone library analysis. RESULTS: All S1 samples were positive for bacteria in all tests. Treatment procedures were significantly effective in reducing the incidence of positive results for bacteria, the number of bacterial cells (infectious bioburden), and the bacterial diversity (number of species and abundance). However, the supplementary PUI approach did not succeed in significantly enhancing disinfection beyond that achieved by chemomechanical preparation. Several bacterial species/phylotypes were identified in post-treatment samples that were positive for bacteria. CONCLUSIONS: Findings from this clinical study including a small sample size suggest that PUI can be ineffective in significantly improving disinfection of the main root canal after chemomechanical procedures.


Subject(s)
Bacteria/drug effects , Dental Pulp Cavity/microbiology , Root Canal Irrigants/therapeutic use , Sonication/methods , Actinobacteria/drug effects , Actinobacteria/isolation & purification , Bacteria/isolation & purification , Bacterial Load/drug effects , Campylobacter/drug effects , Campylobacter/isolation & purification , Dental Alloys/chemistry , Dental Pulp Cavity/drug effects , Dental Pulp Necrosis/microbiology , Dental Pulp Necrosis/therapy , Electrophoresis/methods , Fusobacterium nucleatum/drug effects , Fusobacterium nucleatum/isolation & purification , Gram-Positive Bacteria/drug effects , Gram-Positive Bacteria/isolation & purification , Humans , Nickel/chemistry , Periapical Periodontitis/microbiology , Periapical Periodontitis/therapy , Pseudomonas aeruginosa/drug effects , Pseudomonas aeruginosa/isolation & purification , RNA, Bacterial/analysis , RNA, Ribosomal, 16S/analysis , Real-Time Polymerase Chain Reaction/methods , Root Canal Preparation/instrumentation , Root Canal Preparation/methods , Smear Layer , Sodium Hypochlorite/therapeutic use , Sonication/instrumentation , Therapeutic Irrigation/instrumentation , Therapeutic Irrigation/methods , Titanium/chemistry , Ultrasonics/instrumentation
11.
Article in English | MEDLINE | ID: mdl-25374892

ABSTRACT

BACKGROUND/OBJECTIVE: To date, pharmacotherapy trials of depressed alcoholics (MDD/AUD) have focused on SSRI medications, with disappointing results, so effective treatments for that comorbid population are lacking. Mirtazapine is an FDA-approved medication for treating MDD with a unique pharmacological profile whose efficacy may exceed that of SSRIs. Results from our recent open label study suggest robust acute phase efficacy for mirtazapine for decreasing both the depression and the drinking of that population. However, to date, no studies have evaluated the longer-term efficacy of mirtazapine in that population. We now report findings from a first long-term (two-year) naturalistic follow-up evaluation involving subjects from the acute phase trial. We hypothesized that the improvements would persist at follow-up. METHODS: An eight-week open label study of mirtazapine and motivation therapy was conducted involving persons 18 to 55 years of age with DSM-IV diagnoses of comorbid MDD/AD. Two years after entry into the acute phase study, a long-term evaluation was conducted using the same instruments that had been used at baseline to assess whether the improvements seen during the acute phase trial had persisted. RESULTS: Ten of the twelve patients who entered the acute phase study participated in the follow-up study. The large magnitude improvements (p<.01) in depressive symptoms (BDI), drinking (TLFB), and sleep disturbance (HDRS) persisted at the follow-up evaluation. Two of the subjects demonstrated MDD on structured interview at follow-up, while all ten had demonstrated MDD at baseline. Six of the ten used antidepressants during the follow-up period. At baseline, three were employed, while at follow-up seven were employed. CONCLUSIONS: These findings suggest long-term efficacy for mirtazapine for decreasing the drinking and depression of depressed alcoholics. Double-blind, placebo-controlled studies are warranted to clarify the efficacy of mirtazapine in depressed alcoholics.

12.
DST j. bras. doenças sex. transm ; 24(4): 267-271, 2012. ilus
Article in Portuguese | LILACS | ID: lil-677803

ABSTRACT

A infecção pelo vírus T-linfotrópico humano (HTLV) caracteriza-se como uma doença sexualmente transmissível (DST), que pode também ser adquirida pelas vias parenteral e vertical. Subdivide-se em dois tipos: o HTLV-I, relacionado com doenças como mielopatia associada a HTLV/paraparesia espástica tropical (HAM/TSP) e a leucemia/linfoma de células T do adulto (ATL). Já o HTLV-II ainda não foi correlacionado cientificamente com nenhuma patologia na atualidade. Seu diagnóstico é realizado pela triagem sorológica para a detecção de anticorpo anti-HTLV-I/II, sendo o exame confirmatório o western blot. Neste contexto, o objetivo do presente estudo foi descrever um relato de caso em que a mielopatia foi a manifestação clínica sinalizadora da infecção pelo HTLV, em consequência do diagnóstico tardio da infecção por este patógeno, na qual a paciente apresentou os sintomas, progrediu lentamente e recebeu o diagnóstico apenas no último estágio da patologia (HAM/TSP), quando se tornou cadeirante. Embora a paciente realize na atualidade a terapêutica proposta e o acompanhamento ambulatorial segundo o protocolo estabelecido para o manejo desta infecção viral, membros de sua família também foram avaliados e diagnosticados e apenas um se apresentou positivo para a infecção. Este estudo visa demonstrar a importância do rastreio laboratorial para a infecção pelo HTLV, na mesma dimensão do diagnóstico da sífilis e do HIV, de modo que o mesmo não ocorra de forma tardia, quando associado a suas manifestações clínicas nos pacientes ou a infecções oportunistas relacionadas.


The human T-lymphotropic virus (HTLV) is characterized as a sexually transmitted disease (STD), it can also be transmitted by parenteral and vertical routes. It is subdivided into two types: the HTLV-I related diseases such as myelopathy/tropical spastic paraparesis (HAM/TSP) and adult T-cell leukemia/lymphoma (ATL). HTLV-II has not been scientifically correlated with pathology yet. This diagnosis is made by serological screening for detection of HTLV antibody, and the western blot confirmatory test. In this context, the objective of this study was to describe a case in which myelopathy was signaling to the clinical manifestation of HTLV, as a result of delayed diagnosis of infection by this pathogen in which the patient had symptoms progressed slowly and received diagnosis only in the last stage of pathology (HAM/TSP), becoming a wheelchair user. Although nowadays the patient performs the therapeutic proposed and outpatient treatment according to the established protocol for the management of this viral infection, members of her family were also diagnosed and only one had a positive diagnosis of infection. This study aims to demonstrate the importance of laboratory screening for HTLV infection, in the same dimension of the diagnosis of syphilis and HIV, so that it does not occur so late, when it is associated to clinical manifestations in patients or related opportunistic infections


Subject(s)
Humans , Spinal Cord Diseases/diagnosis , HTLV-I Infections/transmission , Prenatal Care , Breast Feeding , Human T-lymphotropic virus 1 , Paraparesis, Tropical Spastic
13.
J Endod ; 38(9): 1202-6, 2012 Sep.
Article in English | MEDLINE | ID: mdl-22892736

ABSTRACT

INTRODUCTION: The ability of 2 different approaches to supplement the antimicrobial effects of chemomechanical debridement in infected root canals was compared in vivo. METHODS: Samples from necrotic root canals of teeth with apical periodontitis were taken at the baseline (S1), after preparation with rotary nickel-titanium BioRaCe instruments and 2.5% NaOCl irrigation (S2), and then after either passive ultrasonic irrigation (PUI) for activation of NaOCl (n = 13) or a final rinse with 2% chlorhexidine (CHX) (n = 14) (S3). The incidence of positive culture for bacteria and fungi as well as positive broad-range polymerase chain reaction (PCR) results for bacteria, fungi, and archaea was determined. RESULTS: All S1 samples were positive for bacteria in all methods. Fungi were not detected, and archaea occurred in only one S1 sample. Treatment procedures were significantly effective in reducing the incidence of positive culture and PCR results. Although both supplementary approaches reduced the incidence of positive bacteriologic results when compared with postinstrumentation samples, reduction was not statistically significant (P > .05). There was no significant difference for intergroup comparisons either (P > .05). CONCLUSIONS: Although supplementary disinfection with either PUI or a final rinse with CHX can reduce the number of cases with positive culture and PCR results for bacteria, many cases still remain with detectable bacteria in the main root canal. Research on alternative or supplementary antimicrobial methods or substances should be encouraged.


Subject(s)
Anti-Infective Agents, Local/therapeutic use , Chlorhexidine/therapeutic use , Root Canal Irrigants/therapeutic use , Root Canal Preparation/methods , Therapeutic Irrigation/methods , Archaea/isolation & purification , Bacteria/isolation & purification , Dental Alloys/chemistry , Dental Pulp Cavity/drug effects , Dental Pulp Necrosis/therapy , Equipment Design , Fungi/isolation & purification , Humans , Iodine/therapeutic use , Microbiological Techniques , Nickel/chemistry , Periapical Periodontitis/therapy , Polymerase Chain Reaction , Root Canal Preparation/instrumentation , Smear Layer , Sodium Hypochlorite/therapeutic use , Titanium/chemistry , Ultrasonics
14.
Nature ; 486(7403): 405-9, 2012 Jun 20.
Article in English | MEDLINE | ID: mdl-22722202

ABSTRACT

Breast carcinoma is the leading cause of cancer-related mortality in women worldwide, with an estimated 1.38 million new cases and 458,000 deaths in 2008 alone. This malignancy represents a heterogeneous group of tumours with characteristic molecular features, prognosis and responses to available therapy. Recurrent somatic alterations in breast cancer have been described, including mutations and copy number alterations, notably ERBB2 amplifications, the first successful therapy target defined by a genomic aberration. Previous DNA sequencing studies of breast cancer genomes have revealed additional candidate mutations and gene rearrangements. Here we report the whole-exome sequences of DNA from 103 human breast cancers of diverse subtypes from patients in Mexico and Vietnam compared to matched-normal DNA, together with whole-genome sequences of 22 breast cancer/normal pairs. Beyond confirming recurrent somatic mutations in PIK3CA, TP53, AKT1, GATA3 and MAP3K1, we discovered recurrent mutations in the CBFB transcription factor gene and deletions of its partner RUNX1. Furthermore, we have identified a recurrent MAGI3-AKT3 fusion enriched in triple-negative breast cancer lacking oestrogen and progesterone receptors and ERBB2 expression. The MAGI3-AKT3 fusion leads to constitutive activation of AKT kinase, which is abolished by treatment with an ATP-competitive AKT small-molecule inhibitor.


Subject(s)
Breast Neoplasms/classification , Breast Neoplasms/genetics , Mutation/genetics , Translocation, Genetic/genetics , Algorithms , Breast Neoplasms/pathology , Core Binding Factor Alpha 2 Subunit/genetics , Core Binding Factor beta Subunit/genetics , DNA Mutational Analysis , Exome/genetics , Female , Gene Fusion/genetics , Humans , Membrane Proteins/genetics , Mexico , Proto-Oncogene Proteins c-akt/antagonists & inhibitors , Proto-Oncogene Proteins c-akt/genetics , Proto-Oncogene Proteins c-akt/metabolism , Vietnam
15.
DST j. bras. doenças sex. transm ; 23(3): 149-151, 2011.
Article in Portuguese | LILACS | ID: lil-613344

ABSTRACT

Introdução: a sífilis é uma doença relatada desde o século XV e que ainda hoje representa um sério desafio para a Saúde Pública. Mais de 12 milhões de novos casos são registrados por ano, especialmente nos países em desenvolvimento. Com a comercialização da penicilina, à qual o Treponema pallidum é suscetível, acreditou-se na possibilidade de sua erradicação, o que não se concretizou. Em certas doenças infecciosas a primeira dose de um tratamento antimicrobiano eficaz pode desencadear uma resposta inflamatória no hospedeiro. Neste trabalho apresenta-se o caso de uma gestante, de classe socioeconômica baixa, nulípara, com feto morto com 24 semanas por sífilis congênita, que ao receber o tratamento para sífilis recente apresentou Reação de Jarisch-Herxheimer, ocorrida na maternidade do Hospital da Mulher Heloneida Stuart, em São João do Meriti, Rio de Janeiro.


Introduction: syphilis is a disease which has been reported since the fifteenth century and still represents a reasonable challenge to public health care sistem. More than 12 million new cases are reported every year, especially in developing countries. With the commerce of penicillin, to which Treponema pallidum is susceptible, the possibility of eradication had been considered true, which however, did not happen. In certain infectious diseases, the first dose of an effective antimicrobial treatment can initiate an inflammatory response in the host. This work presents the case of a pregnant woman, low socioeconomic status, nulllipara, with a dead fetus with 24 weeks, upon receiving therapy for early syphilis, triggered Jarisch-Herxheimer reaction, which occurred at the Hospital for Women Heloneida Stuart, in São João de Meriti, Rio de Janeiro.


Subject(s)
Humans , Female , Pregnancy , Syphilis, Congenital/complications , Syphilis, Congenital/therapy , Pregnant Women , Stillbirth
16.
Article in English | MEDLINE | ID: mdl-21831677

ABSTRACT

OBJECTIVE: Herpesvirus infection can cause immunosuppression and then act as a modifier of apical periodontitis, influencing the disease severity and response to treatment. The purpose of this study was to investigate if herpesvirus infection, as inferred by salivary carriage, may influence the endodontic treatment outcome. STUDY DESIGN: The study population included 72 patients who had root canals treated more than 1 year previously because of necrotic pulps and apical periodontitis. At the follow-up examination, 27 of these patients presented with posttreatment apical periodontitis (failure) and 45 individuals exhibited healed/healing periradicular tissues (success). Saliva was collected from these individuals, DNA was extracted, subjected to multiple displacement amplification, and screened by polymerase chain reaction (PCR) assays for the presence of 6 herpesviruses: herpes simplex virus types 1 and 2 (HSV-1/2), Epstein-Barr virus (EBV), human cytomegalovirus (HCMV), human herpesvirus-6 (HHV-6), and human herpesvirus-8 (HHV-8). RESULTS: Except for HSV-1/2, all other herpesviruses were detected in saliva from both healed/healing and diseased groups. HHV-8 was the most frequent herpesvirus found in saliva (84% in success, 89% in failure), followed by HCMV (22% in success, 30% in failure), EBV (16% in success, 18.5% in failure) and HHV-6 (7% in success, 15% in failure). No significant association of herpesvirus carriage in saliva with poor treatment outcome was discernible in the population studied (P > .05). CONCLUSIONS: Data from the present study suggest that herpesvirus infection may not influence the outcome of endodontic treatment. Further longitudinal studies are warranted to confirm these findings.


Subject(s)
Dental Restoration Failure , Herpesviridae/isolation & purification , Periapical Periodontitis/therapy , Root Canal Therapy , Saliva/virology , Adult , Chi-Square Distribution , DNA, Viral/isolation & purification , Female , Follow-Up Studies , Herpesviridae/genetics , Herpesviridae/immunology , Humans , Male , Middle Aged , Periapical Periodontitis/immunology , Periapical Periodontitis/virology , Statistics as Topic , Statistics, Nonparametric , Treatment Outcome
17.
Article in English | MEDLINE | ID: mdl-21507684

ABSTRACT

OBJECTIVE: Viral-bacterial and bacterial synergism have been suggested to contribute to the pathogenesis of several human diseases. This study sought to investigate the possible associations between 9 candidate endodontic bacterial pathogens and 9 human viruses in samples from acute apical abscesses. STUDY DESIGN: DNA extracts from purulent exudate aspirates of 33 cases of acute apical abscess were surveyed for the presence of 9 selected bacterial species using a 16S ribosomal RNA gene-based nested polymerase chain reaction (PCR) approach. Single or nested PCR assays were used for detection of the human papillomavirus (HPV) and herpesviruses types 1 to 8. RESULTS: Two-thirds of the abscess samples were positive for at least one of the target viruses. Specifically, the most frequently detected viruses were HHV-8 (54.5%); HPV (9%); and varicella zoster virus (VZV), Epstein-Barr virus (EBV), and HHV-6 (6%). Bacterial DNA was present in all cases and the most prevalent bacterial species were Treponema denticola (70%), Tannerella forsythia (67%), Porphyromonas endodontalis (67%), Dialister invisus (61%), and Dialister pneumosintes (57.5%). HHV-8 was positively associated with 7 of the target bacterial species and HPV with 4, but all these associations were weak. Several bacterial pairs showed a moderate positive association. Viral coinfection was found in 6 abscess cases, but no significant viral association could be determined. CONCLUSIONS: Findings demonstrated that bacterial and viral DNA occurred concomitantly in two-thirds of the samples from endodontic abscesses. Although this may suggest a role for viruses in the etiology of apical abscesses, the possibility also exists that the presence of viruses in abscess samples is merely a consequence of the bacterially induced disease process. Further studies are necessary to clarify the role of these viral-bacterial interactions, if any, in the pathogenesis of acute apical abscesses.


Subject(s)
Gram-Negative Bacterial Infections/microbiology , Herpesviridae Infections/virology , Periapical Abscess/microbiology , Adolescent , Adult , Bacteroidaceae Infections/microbiology , Bacteroides Infections/microbiology , DNA, Bacterial/analysis , DNA, Viral/analysis , Epstein-Barr Virus Infections/virology , Gram-Negative Anaerobic Straight, Curved, and Helical Rods/classification , Herpes Zoster/virology , Herpesviridae/classification , Herpesvirus 6, Human/isolation & purification , Herpesvirus 8, Human/isolation & purification , Humans , Middle Aged , Papillomavirus Infections/virology , Periapical Abscess/virology , Polymerase Chain Reaction , Porphyromonas gingivalis/isolation & purification , RNA, Bacterial/analysis , RNA, Ribosomal, 16S/analysis , Roseolovirus Infections/virology , Treponema denticola/isolation & purification , Treponemal Infections/microbiology , Young Adult
18.
Article in Portuguese | LILACS | ID: lil-603889

ABSTRACT

Introdução: a equipe de saúde ocupacional possui a responsabilidade de exercer o cuidado e a atenção integral de indivíduos infectados pelo HIV, noque diz respeito à saúde bucal, que perpassa desde a assistência até a realização de campanhas informativas e preventivas nas empresas em que prestam serviço. Objetivo: descrever os aspectos preventivos e educativos relacionados à infecção pelo HIV/aids por meio de uma visão da atuação prática da Odontologia do Trabalho através de uma revisão da literatura. Métodos: foi realizado um levantamento bibliográfico que utilizou periódicos científicos,livros técnicos, notas técnicas, publicações de organismos nacionais e internacionais (Medline, SciELO e Lilacs no período de 1988 até 2010). Resultados:as atribuições do cirurgião-dentista na odontologia do trabalho perpassam desde a observação e o controle de infecções da cavidade oral, bem como depossíveis manifestações orais provenientes da infecção pelo HIV, além do trabalho de promoção da saúde bucal, até a realização de campanhas informativase preventivas nas empresas em que prestam serviços. Conclusão: a busca pela atualização dos conhecimentos técnico-científicos é prevista por norma regulamentadora e dará ao profissional a segurança necessária para não agir de forma preconceituosa e discriminatória, capacitando-o para a realização deum trabalho educativo junto aos demais componentes do seu ambiente laboral e social, incluindo indivíduos infectados pelo HIV.


Introduction: the occupational health team has the responsibility of taking comprehensive care of individuals infected by HIV in relation to oral health care since that comprehends the informative campaigns and preventive actions in companies that provide service. Objective: to describe the preventive and educational aspects related to HIV/aids through an over view of the performance practice of dentistry labour through the literature review. Methods:we conducted a literature review that used scientific journals, technical books, technical notes, publications, national and international (Medline, SciELO and Lilacs in the period between 1988 to 2010). Results: the tasks of the dentist in dental work permeate the observation and control of infections of theoral cavity, as well as oral manifestations of HIV infection, in addition to efforts to promote oral health, the informative and preventive campaigns in the companies they serve. Conclusion: the search for the updating of technical and scientific knowledge is provided by regulation and professional will secureenough acting not to prejudicial and discriminatory way, enabling him to carry out educational work with the other components of their work environmentand social, including individuals infected by HIV.


Subject(s)
Humans , Sexually Transmitted Diseases , Health Education, Dental/ethics , Acquired Immunodeficiency Syndrome/prevention & control , HIV , Ethics, Dental/education , Occupational Dentistry/legislation & jurisprudence , Occupational Risks
19.
J Immigr Minor Health ; 13(3): 426-33, 2011 Jun.
Article in English | MEDLINE | ID: mdl-20640918

ABSTRACT

(1) Describe gestational diabetes mellitus (GDM) prevalence time trends in USborn (USWH) and Mexico-born (MWH), white Hispanic Colorado women and (2) Determine effect of maternal birthplace on GDM prevalence. Retrospective population-based study of 1995-2004 Colorado birth certificate data for live, singleton births to white, Hispanic mothers estimated prevalence, trends, and association of GDM and maternal birthplace. Univariate, bivariate and logistic regression analyses were conducted. GDM prevalence in 154,957 births increased in both USWH (1.77-2.53%, P < 0.0001) and MWH (2.38-3.08%, P < 0.0001). Over study years, MWH had higher crude odds (OR = 1.30; 95% CI = 1.22-1.38) for developing GDM than USWH. Adjustment for maternal age and maternal education reduced GDM risk by birth country (OR = 1.05; 95% CI = 0.98-1.13, P = ns). GDM prevalence increased in both US-born and Mexico-born, white, Hispanic Colorado women. Mexico-born immigrant women may have increased risk for GDM compared with their USborn counterparts. Lower education attainment may be determinant of disease risk.


Subject(s)
Diabetes, Gestational/epidemiology , Hispanic or Latino , Mothers , Adolescent , Adult , Child , Colorado/epidemiology , Emigrants and Immigrants , Female , Humans , Mexico/ethnology , Models, Statistical , Pregnancy , Retrospective Studies , Young Adult
20.
J Endod ; 37(1): 10-6, 2011 Jan.
Article in English | MEDLINE | ID: mdl-21146068

ABSTRACT

INTRODUCTION: It has been suggested that viruses, especially herpesviruses, can play a role in the pathogenesis of marginal and apical periodontitis. This study aimed to detect herpesviruses types 1 to 8, namely herpes simplex virus (HSV-1/2), varicella zoster virus (VZV), Epstein-Barr virus (EBV), human cytomegalovirus (HCMV), human herpesvirus-6 (HHV-6), human herpesvirus-7 (HHV-7), and human herpesvirus-8 (HHV-8) as well as human papillomavirus (HPV) in acute apical abscesses. METHODS: Twenty-four samples were taken by aspiration of the purulent exudate from acute apical abscesses. DNA extracted from clinical samples served as a template in single or nested polymerase chain reaction (PCR) assays for the detection of the target viruses. RESULTS: Control PCR reactions with ß-globin gene primers revealed that all samples but one had detectable human DNA. Of the 23 abscess samples positive for the ß-globin gene, 14 (61%) were positive for at least one of the target human viruses. Thirteen (56.5%) cases had herpesvirus: HHV-8 occurred in 11 (48%), VZV and HHV-6B in two (9%), and HHV-7 and HSV-1/2 in one (4%). EBV and HCMV were not present in any of the examined samples. HPV was detected in three (13%) abscess samples. Viral coinfection was found in five cases, with one case harboring three of the targeted viruses. CONCLUSION: A large number of abscess samples were positive for at least one target virus. Unexpectedly, HHV-8 was for the first time detected and in a high prevalence. Papillomavirus and other herpesviruses were also found for the first time in endodontic abscesses. Although these findings suggest an association, the specific role of viruses in the pathogenesis of acute apical abscesses awaits further clarification.


Subject(s)
Herpesviridae Infections/complications , Herpesviridae/isolation & purification , Papillomaviridae/isolation & purification , Papillomavirus Infections/complications , Periapical Abscess/virology , Acute Disease , DNA, Viral/analysis , Herpesviridae/classification , Herpesviridae/genetics , Herpesviridae Infections/virology , Humans , Papillomaviridae/genetics , Pulpitis/virology
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