Hansen's disease and COVID-19 co-infection in Brazil.

BACKGROUND: The implications of COVID-19 co-infection in patients under treatment for Hansen's disease (HD, leprosy) remain uncertain. We aimed to describe clinical characteristics, treatments, and outcomes in patients with HD and COVID-19 in Brazil. METHODS: Cross-sectional study recruiting adult HD patients with PCR-confirmed COVID-19 from five HD treatment centers in Brazil between March 1, 2020, and March 31, 2021. At the time of this study, no patient had received COVID-19 vaccine. RESULTS: Of 1377 patients under treatment for HD, 70 (5.1%) were diagnosed with COVID-19. Of these, 41 (58.6%) had PCR-confirmed COVID-19, comprising 19 men and 22 women, aged 24-67 (median 45) years. HD was multibacillary in 39/41 patients. Eight patients ceased WHO Multi-Drug Therapy for HD, three for lack of drugs, two because of COVID-19, and three for other reasons. Of the 33 who continued treatment, 26 were on the standard regimen and seven an alternative regimen. Seventeen patients were receiving oral prednisone, including nine patients with type 1 reaction, four with type 2 reaction, three with neuritis, and one with rheumatologic disease. Twelve patients were hospitalized for COVID-19, and six patients died, of whom three had hypertension and one also had type 2 diabetes and obesity. CONCLUSIONS: COVID-19 and Hansen's disease co-infection did not appear to change the clinical picture of either disease in this cross-sectional study. The wider impact of the pandemic on persons affected by HD requires follow-up and monitoring.

Using hypnoanalysis and guided imagery to identify and manage emotional aspects of multiple sclerosis.

BACKGROUND: To date, no studies have used hypnosis to examine and manage the potential emotional causes of multiple sclerosis (MS) in the scientific field; therefore, we decided to compare the effectiveness of hypnoanalysis and guided imagery for determining and manage these emotional causes. METHODS: Fifteen participants with severe MS were included and assigned into 2 groups: hypnoanalysis and guided imagery. In the hypnoanalysis group, the participants underwent 10 hypnotic sessions to understand events related to the cause of the disease, which were restructured (the events were modified by adding the psychological resources that each involved person needed); in addition, other techniques were used to investigate the causes and solutions according to the participants' unconscious. The guided imagery group received 10 group sessions of body relaxation and guided imagery, which were recorded for practice at home. Outcome measures, namely, disability (the Expanded Disability Status Scale, EDSS), quality of life (QoL, measured with the SF-36) and number of relapses, were evaluated 4 months previous the intervention, at baseline, post-intervention, and 3 months later. RESULTS: Hypnoanalysis revealed that stressful events and psychoemotional maladaptive patterns acted as causal, detonating, or aggravating factors of disease, and psychoemotional changes were the most frequent and varied solutions. No changes were observed in disability between the two groups. The guided imagery group showed an improvement in 2 subscales of QoL when compared with the hypnoanalysis group (which disappeared at the follow-up); this difference is probably due to the increased number of sessions and probably due to psychoemotional maladaptive patterns being more frequently mentioned than difficult circumstances in life and/or unsolved past events. However, the techniques used in hypnoanalysis were effective in understanding the potential emotional causes of MS, which showed high intra- and inter-participant consistency. CONCLUSIONS: The daily use of guided imagery overcame the restructuring of negative past events to improve QoL in patients with MS. TRIAL REGISTRATION: ACTRN12618002024224 (retrospectively registered).

Improving treatment outcomes for leprosy in Pernambuco, Brazil: a qualitative study exploring the experiences and perceptions of retreatment patients and their carers.

BACKGROUND: Brazil has a high leprosy burden and poor treatment outcomes (TOs), manifesting in high relapse rates. Pernambuco, an impoverished Brazilian state suffering notable geographical health inequalities, has 'hyperendemic' leprosy. Although current literature identifies barriers and facilitators influencing leprosy treatment compliance, inadequate investigation exists on other factors influencing TOs, including carers' roles and psycho-dermatological impact. This qualitative study explores experiences and perceptions of leprosy patients and their carers in Pernambuco, Brazil; to identify location-specific factors influencing TOs, and consequently inform future management. METHODS: 27, semi-structured, in-depth interviews were conducted with 14 patients and 13 carers. Participants were recruited using maximum variation and snowball sampling from three clinics in Petrolina, Pernambuco. Transcripts and field notes from both participant groups were separately analysed using conventional thematic and deviant case analysis. The University of Birmingham Internal Research Ethics Committee and Instituto Lauro de Souza Lima provided ethical approval. RESULTS: Two homologous sets of four, primary, interdependent themes influencing leprosy TOs emerged: 'personal factors'; 'external factors'; 'clinical factors'; and 'the healthcare professional (HCP)-patient-carer relationship'. Poor participant knowledge and lack of symptomatic relief caused patients to distrust treatment. However, because participants thought HCP-led interventions were vital for optimal TOs, patients were effectively persuaded to adhere to pharmaceutical treatments. High standard patient and population education facilitated treatment engagement by encouraging evidence-based medicine belief, and dispelling health myths and stigma. Healthcare, on occasions, was perceived as disorganised, particularly in resource-scarce rural areas, and for those with mental health needs. Participants additionally experienced incorrect/delayed diagnoses and poor contact tracing. Leprosy's negative socio-economic impact on employment - together with stigma, dependency and changing relationships - caused altered senses of identity, negatively impacting TOs. Better dialogue between patients, HCPs and carers facilitated individualised patient support. CONCLUSION: This study highlights the importance of: effective evidence-based leprosy education; communication between HCPs, patients and carers; state-funded support; and healthcare resource distribution. These findings, if prioritised on governmental scales, provide the valuable insight needed to inform location-specific management strategies, and consequently improve TOs. Future research should evaluate the effectiveness of these implementations. Failure to address these findings will hinder regional elimination efforts.

Improving treatment outcomes for leprosy in Pernambuco, Brazil: a qualitative study exploring the experiences and perceptions of retreatment patients and their carers

Background: Brazil has a high leprosy burden and poor treatment outcomes (TOs). Pernambuco, an impoverished Brazilian state suffering from notable geographical health inequalities, has 'hyperendemic' leprosy. Although current literature identifies the barriers and facilitators influencing leprosy treatment compliance, there is inadequate investigation into other factors influencing TOs, including carers' roles. This qualitative study explores the experiences, perceptions and beliefs of leprosy patients and their carers in Pernambuco, Brazil; to identify location-specific factors influencing TOs, and consequently appropriately inform future management strategies. Methods: 27, semi-structured, in-depth interviews were conducted with 14 patients and 13 carers. Participants were recruited using maximum variation and snowball sampling from three clinics in Petrolina, Pernambuco. Transcripts and field notes from both participant groups were separately analysed using conventional thematic and deviant case analysis. Ethical approval was obtained from the University of Birmingham Internal Research Ethics Committee and the Instituto Lauro de Souza Lima, Brazil. Results: Two homologous sets of four, primary, interdependent themes influencing leprosy TOs emerged: 'personal factors'; 'external factors'; 'clinical factors'; and 'the HCP-patient-carer relationship'. Poor participant knowledge and lack of symptomatic relief caused patients to distrust treatment. However, because participants thought HCP-led interventions were vital for optimal TOs, patients were effectively persuaded to adhere to pharmaceutical treatments. High standard patient and population education facilitated treatment engagement by encouraging evidence-based medicine belief, and dispelling health myths and stigma. Healthcare, on occasions, was perceived as disorganised, particularly in resource-scarce rural areas, and for those with mental health needs. Participants additionally experienced incorrect/delayed diagnoses and poor contact tracing. Leprosy's negative socio-economic impact on employment ­ together with stigma, dependency and changing relationships ­ caused an altered sense of identity, negatively impacting TOs. Better dialogue between patients, HCPs and carers facilitated individualised patient support. Conclusion: This study highlights the importance of: effective evidence-based leprosy education; communication between HCPs, patients and carers; state-funded support; and healthcare resource distribution. These findings, if prioritised on governmental scales, provide the valuable insight needed to inform location-specific management strategies, which are required to improve TOs. Future research should evaluate the effectiveness of these implementations. Failure to address these findings will hinder regional elimination efforts.

Effect of monomer type on the CC degree of conversion, water sorption and solubility, and color stability of model dental composites.

OBJECTIVE: This study has investigated the influence of BisGMA, BisEMA, BisEMA 30, and two UDMA-based monomers (UDMA and Fit 852), with TEGDMA as co-monomer, on the degree of conversion, water sorption, water solubility, and optical properties of experimental dental composites. METHODS: Materials were formulated at 70/30 molar rations using BisGMA, BisEMA, BisEMA 30, UDMA or FIT 852, as base monomers, combined with TEGDMA. 60wt% of silanated-glass particles was added. Degree of conversion (DC) and polymerization kinetics were monitored using Fourier-transformed infrared spectroscopy in the near-IR range. Water sorption (Wsp) and solubility (Wsl) were assessed using mass variation after 60days water storage. Color was evaluated using a digital spectrophotometer, applying the CIELab parameters 24h after dry storage and 60days after water immersion to calculate ΔE values. All data were analyzed using ANOVA and Tukey's test (pre-set alpha=0.05). RESULTS: The BisGMA-based co-monomer mixture presented the lowest DC (62±1%), whereas BisEMA 30 had the highest DC value (95±2%). The highest Wsp was observed for BisEMA 30 (12.2±0.8%), and the lowest for BisEMA (0.4±0.1%). BisEMA has shown the lowest Wsl (0.03±0.01%) and BisEMA 30 the highest one (0.97±0.1%). The ΔE values showed that BisEMA 30 (7.3 color units) and Fit 852 (3.8 color units) altered the color stability providing ΔE>3.3, which is considered clinically unacceptable. CONCLUSIONS: The chemical composition and structure of the base monomer influenced the degree of conversion, water sorption, water solubility, and color stability. Considering the overall results, it is possible to state that the base monomer BisEMA mixed with the co-monomer TEGDMA presented the best performance in terms of all the parameters tested. SIGNIFICANCE: The resin matrix composition might influence physical property degradation processes and color stability of dental resin composites. Formulations based on BisEMA seem most promising for materials' development.

The Effectiveness of Anticholinergic Therapy for Overactive Bladders: Systematic Review and Meta-Analysis.

The overactive bladder (OAB) has a significant negative impact on the quality of life of patients. Antimuscarinics have become the pharmacological treatment of choice for this condition. The objective of this systematic review and meta-analysis is to examine the evidence from randomized clinical trials about the outcomes of the antimuscarinic drugs available in Brazil on OABs. We searched MEDLINE and the Cochrane Central Register of Controlled Trials from the inception of these databases through to September 2015. The primary outcome measures were the mean decrease in urge urinary incontinence episodes and the mean decrease in the frequency of micturition. The results suggest that there is a moderate to high amount of evidence supporting the benefit of using anticholinergic drugs in alleviating OAB symptoms when compared with placebo. It is still not clear whether any of the specific drugs that are available in Brazil offer advantages over the others. These drugs are associated with adverse effects (dry mouth and constipation), although they are not related to an increase in the number of withdrawals.

The Effectiveness of Anticholinergic Therapy for Overactive Bladders: Systematic Review and Meta-Analysis / Eficácia da terapia anticolinérgica na bexiga hiperativa: revisão sistemática e metanálise

Abstract The overactive bladder (OAB) has a significant negative impact on the quality of life of patients. Antimuscarinics have become the pharmacological treatment of choice for this condition. The objective of this systematic review and meta-analysis is to examine the evidence from randomized clinical trials about the outcomes of the antimuscarinic drugs available in Brazil on OABs. We searched MEDLINE and the Cochrane Central Register of Controlled Trials from the inception of these databases through to September 2015. The primary outcome measures were the mean decrease in urge urinary incontinence episodes and the mean decrease in the frequency of micturition. The results suggest that there is a moderate to high amount of evidence supporting the benefit of using anticholinergic drugs in alleviating OAB symptoms when compared with placebo. It is still not clear whether any of the specific drugs that are available in Brazil offer advantages over the others. These drugs are associated with adverse effects (dry mouth and constipation), although they are not related to an increase in the number of withdrawals.

Resumo A bexiga hiperativa determina um impacto negativo na qualidade de vida dos nossos pacientes. Os antimuscarínicos tornaram-se o tratamento farmacológico de escolha para essa condição. O objetivo desta revisão sistemática e metanálise é examinar as melhores evidências científicas sobre estas medicações disponíveis no Brasil no tratamento de mulheres com bexiga hiperativa. As bases de dados utilizadas foram MEDLINE e a biblioteca da Cochrane, das quais selecionamos os ensaios clínicos randomizados até setembro de 2015. Os principais desfechos analisados foram a diminuição dos episódios de incontinência urinária de urgência e a diminuição da frequência de micção. Os resultados sugerem que as drogas existentes no Brasil sustentam o benefício dos anticolinérgicos no alívio dos sintomas da bexiga hiperativa quando comparadas como placebo. Emtermos de eficácia, as medicações apresentam resultados semelhantes no controle dos sintomas. Essas drogas estão associadas a efeitos adversos importantes, tais como boca seca e constipação, e esses efeitos adversos não influenciaram no uso da medicação.

Cultural adaptation and validation of the Wexner scale in patients with anal incontinence in a Brazilian population.

INTRODUCTION AND HYPOTHESIS: Jorge and Wexner devised a questionnaire for anal incontinence (AI), known as the Wexner scale (WS). Specific validated questionnaires are essential for the assessment of symptom severity. The objective was to accomplish the cultural adaptation and validation of the Portuguese version of the WS. METHODS: The WS was validated according to the international criteria. A Brazilian version was tested, including the item "I do not understand" at the end of each question. If this answer was reported at a rate higher than 15 %, the item would be considered difficult to understand and would thus be modified. The final version of the WS and the Fecal Incontinence Quality of Life (FIQL) were completed by 50 women. Convergent validity was assessed by comparing the data from the first interview of the WS with the FIQL using Spearman's test. Reproducibility was assessed by means of a 2-week test-retest procedure using Cronbach's alpha coefficient. RESULTS: In the initial version of the questionnaire, we did not obtain a response of "I do not understand" at a rate greater than 15 % and this version was considered definitive. A significant negative relationship (r = -0.63) was found between the FIQL total score and the WS. The answers obtained on the "test-re-est" questionnaires showed a significant correlation according to the intraclass correlation coefficient (ICC). A high level of internal consistency was found, as demonstrated by a Cronbach's alpha of 0.932. CONCLUSION: The Brazilian Portuguese version of the WS is a reliable, consistent, and valid instrument.

Shrinkage, stress, and modulus of dimethacrylate, ormocer, and silorane composites.

PURPOSE: to evaluate the shrinkage, polymerization stress, elastic and bulk modulus resulting from composites formulated by siloranes, 2(nd) generation ormocers, and dimethacrylates. MATERIALS AND METHODS: The bonded disc method was used to evaluate volumetric shrinkage. The polymerization stress was evaluated by mean of the Bioman. Cylindrical specimens (5 mm thickness and 6 mm diameter) were submitted to gradual loading. Young's and bulk modulus were obtained from the slope of the stress/strain curve. Data were analyzed using one-way analysis of variance and Tukey's test (5%). RESULTS: Grandio and ormocer showed significant higher elastic and bulk modulus. Silorane presented significant lowest bulk modulus and maximum shrinkage. Ormocer and silorane presented lower values for the maximum rate of shrinkage. Extra-low shrinkage (ELS) composite presented the greatest maximum shrinkage. The higher maximum rate of shrinkage was attained by Grandio and ELS, statistically similar from each other. The silorane showed lower values of maximum stress and maximum rate of stress. The higher values of maximum stress were presented by ELS and Grandio, statistical similar between them. Grandio showed the significantly greatest maximum rate of stress. CONCLUSION: Silorane showed to promote lower shrinkage/stress among the composites, with the lowest elastic modulus. Ormocer showed lower shrinkage/stress than methacrylates despite of its high modulus.

Photolabile protection for amino acids: studies on the release from novel benzoquinolone cages.

The synthesis of a novel fused nitrogen heterocycle, benzoquinolone, for evaluation as a photocleavable protecting group is described for the first time by coupling to model amino acids (alanine, phenylalanine and glutamic acid). Conversion of the phenylalanine ester conjugate to the thionated derivative was accomplished by reaction with Lawesson's reagent. Photocleavage studies of the carbonyl and thiocarbonyl benzoquinolone conjugates in various solvents and at different wavelengths (300, 350 and 419 nm) showed that the most interesting result was obtained at 419 nm for the thioconjugate, revealing that the presence of the thiocarbonyl group clearly improved the photolysis rates, giving practicable irradiations times for the release of the amino acids (less than 1 min).

Effect of Diamond Bur Grit Size on Composite Repair.

PURPOSE: This study investigated the effect of diamond bur grit size on the repair bond strength of fresh and aged resin composites. MATERIALS AND METHODS: Blocks of microhybrid composite (Opallis, FGM) were stored in distilled water at 37°C for 24 h (fresh composite) or subjected to 5000 thermal cycles (aged composite). The surfaces were roughened using diamond-coated, flame-shaped carbide burs with medium grit (#3168), fine grit (#3168F), or extra-fine grit (#3168FF). The control group underwent no surface treatment. Surface roughness, water contact angle, and surface topography by scanning electron microscopy (SEM) were evaluated (n = 3). Samples were restored with resin composite and sectioned into beam-shaped specimens, which were subjected to microtensile bond testing. Failure modes were classified using a stereomicroscope. Data were statistically analyzed using the Student- Newman-Keuls test and two-way ANOVA, with significance set at p < 0.05. RESULTS: Higher surface roughness was observed for groups treated with the medium- and fine-grit burs; aged composites were rougher than fresh composites. The water contact angle formed on the aged composite was lower than that on the fresh composite. The highest repair bond strength was observed for the fine-grit bur group, and the lowest was recorded for control. Interfacial failures were more predominant. SEM images showed that the surfaces treated with fine- and extra-fine-grit burs had a more irregular topography. CONCLUSION: Surface roughening of fresh or aged resin composites with diamond burs improved retention of the repair material. Fine-grit burs generally performed better than medium- and extra-fine-grit burs.

Vulvodínia: diagnóstico e tratamento / Vulvodynia: diagnosis and treatment

A vulvodínia é uma condição de desconforto vulvar crônico que afeta milhares de mulheres a cada ano. Trata-se de síndrome multifatorial com grande impacto na qualidade de vida das mulheres afetadas. Seu tratamento representa atualmente um desafio para o médico assistente que, apesar de estar mais atento ao seu diagnóstico, ainda não encontra evidências científicas para tratamento dessas pacientes. Ainda não é possível encontrar revisões sistemáticas ou metanálises pela heterogeneidade dos artigos. A abordagem multidisciplinar parece trazer melhores resultados. Habitualmente essas mulheres passam por vários especialistas à procura de alívio dos seus sintomas, na maioria das vezes sem sucesso. Este artigo objetiva fazer uma revisão atualizada do diagnóstico e tratamento da vulvodínia para orientar a prática clínica.(AU)

Vulvodynia is a vulvar discomfort and chronic condition that affects millions of women each year. It is a multifactorial syndrome with great impact on the quality of life of women affected by it. Its treatment is currently a challenge for the physician. Despite being closer to the diagnosis, scientific evidence for treating these patients has not yet been found. Systematic reviews and meta-analysis cannot be found due to the heterogeneity of the articles. A multidisciplinary approach seems to bring the best results. Usually these women consult several specialists seeking relief of their symptoms, most of the time without success. The aim of this article is to review the current diagnosis and treatment of vulvodynia to guide clinical practice.(AU)

The effect of time between handling and photoactivation on self-adhesive resin cement properties.

PURPOSE: To evaluate the degree of conversion, absorption, and solubility in water of self-adhesive resin cements subjected to different time intervals between material preparation and the photoactivation procedure. MATERIALS AND METHODS: Two dual self-adhesive resin cements were tested: RelyX Unicem and SmartCem2. The degree of conversion as a function of time was evaluated by Fourier-transformed infrared spectroscopy using the attenuated total reflectance technique. Three time intervals between handling and photoactivation were applied: Group 1 = immediately; Group 2 = a 1-minute interval; Group 3 = a 4-minute interval. All specimens were irradiated with a light-emitting diode source for 40 seconds. Thirty discs of each cement (1 mm thick × 6 mm diameter, n = 10) were prepared for the absorption and solubility tests. These specimens were stored in distilled water at 37°C for 90 days. The results were subjected to ANOVA with two factors (material and activation time intervals) and Tukey's test (95% significance). RESULTS: The 4-minute interval significantly reduced the degree of conversion of SmartCem2 (30.6% ± 8.3%). No other significant changes were observed for the degree of conversion; however, the time intervals before photoactivation interfered significantly in the water absorption of the RelyX Unicem specimens but not the SmartCem2 specimens. The time intervals did not affect the solubility of either cement. In all cases, SmartCem2 had higher solubility than RelyX Unicem. CONCLUSION: The time interval between handling and photoactivation significantly influenced the degree of conversion and water sorption of the resin-based cements. In general, one can say that the self-adhesive resin cements should be photoactivated as soon as possible after the material handling process.

Efeito agudo da suplementação de cafeína sobre o desempenho físico durante teste incremental de esforço / Acute effect of caffeine suplementation on physical performance during an incremental effort test

O presente estudo teve como objetivo investigar os efeitos da ingestão de cafeína (CAF) sobre a velocidade de corrida (VC) referente à intensidade do primeiro limiar ventilatório (LV1) e velocidade máxima de corrida (Vmáx). Para tanto, oito mulheres saudáveis, ativas fisicamente, realizaram dois testes incrementais máximos (TImáx) em esteira ergométrica em duas condições diferentes, sob ingestão de CAF e placebo (PLA). Para contrastar os dados, utilizou-se o teste t de Student pareado. Houve diferença significativa (P ≤0,05) na VC (PLA 7,87 ± 1,72 km/h, CAF 8,50 ± 1,69 km/h), na frequência cardíaca (PLA 152,37 ± 21,41 bpm, CAF 167,00 ± 14,71 bpm) e na VE (PLA 31,40 ± 8,53 L/min, CAF 34,46 ± 9,52 L/min), na intensidade referente ao LV1. Diferentemente, na Vmáx não foram observadas diferenças significativas na VC, FC e vetilação (VE) em ambas as condições. É possível concluir que a VC, FC e VE foram modificadas com a suplementação de CAF na intensidade do LV1, mas não na Vmáx.

The present study aimed to investigate the effects of caffeine (CAF) ingestion on running speed (RS) on the intensity of the first ventilatory threshold (VT1) and maximum running speed (Vmax). Therefore, eight healthy women, physically active performed two maximal incremental tests (TImax) on the treadmill at two different conditions under CAF intake and placebo (PLA). To contrast the data, we used the paired Student t test. There were statistically significant differences (P ≤ 0.05) in RS (PLA 7.87 ± 1.72 km / h, 8.50 ± 1.69 CAF km / h), heart rate (PLA 152.37 ± 21.41 bpm, CAF 167.00 ± 14.71 bpm) and LV (PLA 31.40 ± 8.53 L / min, CAF 34.46 ± 9.52 L / min), the intensity for the VT1. In contrast, the Vmax were not significant differences in VC, HR and ventilation (VE) in both conditions. It is possible to conclude that the VC, VE and HR were modified with the supplementation of CAF in the intensity of VT1, but not in the Vmax.

Do new matrix formulations improve resin composite resistance to degradation processes?

The aim of this study was to determine the degradation resistance of three new formulations-silorane-, Ormocer- and dimer-acid-based materials-and compare them to the traditional dimethacrylate-based materials. One silorane- (Filtek P90, P90), one Ormocer- (Ceram-X, CX), one dimer-acid- (N'Durance, ND) and two dimethacrylate-based (Filtek P60, P60; Tetric Ceram, TC) materials were investigated. Water sorption (Wsp) and solubility (Wsl) were determined after the materials were immersed in water for 28 days. Knoop hardness (KH) was determined before and after 24 h immersion in pure ethanol. The flexural-strength (FS) was determined by the bending test after one-week storage in a dry environment or after one-week immersion in pure ethanol. Data were submitted to analysis of variance (ANOVA) and Tukey's test (95%). The three new formulations showed lower Wsp than the dimethacrylate-based formulation. CX (0.50 ± 0.17%) and ND (0.72 ± 0.19%) exhibited the lowest Wsp, whereas P90 (0.02 ± 0.03%) and P60 (0.04 ± 0.03%) showed the lowest Wsl. All resins showed reduced Knoop hardness number (KHN) after ethanol immersion. P60 presented the lowest decrease in KH value (19 ± 5%). TC (48 ± 3%) and P90 (39 ± 9%) showed the highest KHN decrease after ethanol storage. The FS of CX, ND and TC were affected by ethanol storage. The new formulations did not improve the degradation resistance, as compared with the traditional methacrylate-based materials.

Do new matrix formulations improve resin composite resistance to degradation processes?

The aim of this study was to determine the degradation resistance of three new formulations-silorane-, Ormocer- and dimer-acid-based materials-and compare them to the traditional dimethacrylate-based materials. One silorane- (Filtek P90, P90), one Ormocer- (Ceram-X, CX), one dimer-acid- (N'Durance, ND) and two dimethacrylate-based (Filtek P60, P60; Tetric Ceram, TC) materials were investigated. Water sorption (Wsp) and solubility (Wsl) were determined after the materials were immersed in water for 28 days. Knoop hardness (KH) was determined before and after 24 h immersion in pure ethanol. The flexural-strength (FS) was determined by the bending test after one-week storage in a dry environment or after one-week immersion in pure ethanol. Data were submitted to analysis of variance (ANOVA) and Tukey's test (95%). The three new formulations showed lower Wsp than the dimethacrylate-based formulation. CX (0.50 ± 0.17%) and ND (0.72 ± 0.19%) exhibited the lowest Wsp, whereas P90 (0.02 ± 0.03%) and P60 (0.04 ± 0.03%) showed the lowest Wsl. All resins showed reduced Knoop hardness number (KHN) after ethanol immersion. P60 presented the lowest decrease in KH value (19 ± 5%). TC (48 ± 3%) and P90 (39 ± 9%) showed the highest KHN decrease after ethanol storage. The FS of CX, ND and TC were affected by ethanol storage. The new formulations did not improve the degradation resistance, as compared with the traditional methacrylate-based materials.

Estabilidade fenotípica de genótipos de morangueiro submetidos a número variável de subcultivos in vitro / Phenotypic stability of strawberry genotypes subjected to variable number of in vitro subcultures

Objetivando analisar o número de subcultivos que permita a multiplicação do morangueiro, sem que ocorram alterações nas características fenotípicas dos clones submetidos a esse processo, explantes dos genótipos 'Aromas', 'Camarosa' e 'Camino Real' foram submetidos, em uma primeira etapa, a 12 ciclos de subcultivos in vitro e, no ano seguinte, explantes dos mesmos genótipos, das mesmas plantas matrizes, foram subcultivados por três ciclos. Após a fase de aclimatização, as mudas foram transplantadas para canteiros, e o experimento conduzido segundo delineamento em blocos casualizados em esquema fatorial 3x2 (genótipos e níveis de subcultivos). As características avaliadas foram: altura da planta e comprimento da raiz (cm), massas fresca e seca da parte aérea e da raiz (g) e número de estolões por planta. Na avaliação a campo das características fenotípicas, não foram observadas diferenças significativas entre os dois níveis de subcultivos. As cultivares 'Camarosa' e 'Camino Real' apresentaram maior variação entre os dois níveis de subcultivos, sendo as maiores variações observadas em plantas submetidas a três subcultivos. Com 12 subcultivos in vitro de plantas de morangueiro, das cultivares 'Aromas', 'Camarosa' e 'Camino Real', é possível obter maior número de mudas micropropagadas sem alterações nas características fenotípicas. A cultivar 'Aromas' apresentou uma maior estabilidade nas características fenotípicas estudadas em relação aos diferentes ciclos de subcultivo in vitro.

In order to increase the availability of healthy strawberry seedlings, this study aimed to analyze the number of subcultures that enables multiplication on a large scale, without the occurrence of changes in phenotypic characteristics of clones through the process of in vitro micropropagation. In a first step, explants of the cultivars 'Aromas', 'Camarosa' and 'Camino Real', at the Laboratory of Plant Tissue Culture, were submitted to twelve subculture cycles, and in the following year, explants of the same cultivars, from the same mother plants, were subcultured for three cycles. The acclimatization and evaluation of the plants in the field were conducted in a greenhouse at the Horticulture Sector of the Instituto of Agronomia of the Universidade Federal Rural do Rio de Janeiro. The experimental design was randomized blocks in a 3x2 factorial, (genotypes and subculture levels). The characteristics evaluated were plant height and root length (cm), fresh mass and dry mass of shoots and roots (g) and number of stolons per plant. In the field evaluation, no differences between the two levels of subcultures were observed. Cultivars 'Camarosa' and 'Camino Real' showed the highest variation between the two levels of subcultures, with the greatest variations observed in plants subjected to three subcultures. With twelve in vitro subcultures of strawberry plants, of cultivars 'Aromas', 'Camarosa' and 'Camino Real', it is possible to obtain greater number of plantlets without changes in phenotypic characteristics. The cultivar 'Aromas' showed greater stability in phenotypic characteristics studied in relation to different cycles of in vitro subculture.

Análise dos recursos para reabilitação da musculatura do assoalho pélvico em mulheres com prolapso e incontinência urinária / Analysis of the resources for rehabilitation of pelvic floor muscles in women with prolapse and urinary incontinence / Análisis de los recursos para rehabilitación de la musculatura del suelo pélvico en mujeres con prolapso e incontinencia urinaria

Esta revisão teve como objetivo analisar os recursos e sua eficácia na reabilitação do assoalho pélvico no tratamento dos prolapsos genitais e incontinência urinária. As buscas foram realizadas nas bases de dados MEDLINE/PubMed, LILACS/SciELO e Biblioteca Cochrane. Foram encontrados 886 artigos, dos quais foram utilizados 34 estudos clínicos relevantes que respondiam às perguntas construídas pelos autores. Os estudos analisados mostraram que o treinamento do assoalho pélvico pode ser usado no tratamento dos prolapsos, porém são necessários mais estudos randomizados para sustentar essa evidência. Para a incontinência urinária a reabilitação do assoalho pélvico é eficiente e deve ser o tratamento de primeira escolha.

This review aimed to assess the capabilities and effectiveness of pelvic floor rehabilitation in the treatment of genital prolapse and urinary incontinence. The research was conducted in MEDLINE/PubMed, LILACS/SciELO and Cochrane Library. There were found 886 articles, of which were used 34 relevant clinical trials that answered the questions constructed by the authors. The studies analyzed showed that pelvic floor training can be used in prolapse treatment, but further randomized studies are necessary to support this evidence. For urinary incontinence pelvic floor, rehabilitation is effective and should be the treatment of first choice.

Esta revisión tiene como objetivo analizar los recursos y su eficacia en la rehabilitación del suelo pélvico en el tratamiento de los prolapsos genitales y la incontinencia urinaria. Las búsquedas fueron realizadas en las bases de datos Medline/Pubmed, LILACS/SciELO y Cochrane. Fueron encontrados 886 artículos, de los cuales fueron utilizados 34 estudios clínicos relevantes y que respondían las preguntas construidas por los autores. Los estudios analizados mostraron que el entrenamiento del suelo pélvico puede ser usado en el tratamiento de los prolapsos, sin embargo, son necesarios más estudios randomizados para sustentar esta evidencia. Para la incontinencia urinaria la rehabilitación del suelo pélvico es eficiente y debe ser el tratamiento de primera opción.