Clinical effects of Lactobacillus reuteri probiotic in chronic periodontitis - a systematic review.

OBJECTIVE: This systematic review examines the effectiveness of Lactobacillus reuteri as an adjunct to scaling and root planing in the treatment of chronic periodontitis. MATERIALS AND METHODS: Scopus, PubMed, and Web of Science databases were searched according to specific inclusion and exclusion criteria in October 2022. Randomized control trials that evaluated the effects of Lactobacillus reuteri in patients with periodontitis were included. The primary outcome was pocket depth and clinical attachment levels, while the secondary outcome considered was bleeding on probing, microbial levels, and gingival index score. Study quality was assessed based on the Cochrane Handbook for Systematic Reviews of Interventions and the ROB2 tool. RESULTS: A total of eleven studies that examined 369 subjects were included in the review. Adults in the age group of 18-70 years of age suffering from chronic periodontitis were evaluated. Eight out of the eleven studies reported statistically significant improvement in the intergroup pocket depths, whereas seven studies showed a statistically significant reduction in the clinical attachment levels in the probiotic group. Three studies showed no significant improvement in the pocket depth levels in the probiotic group as compared to the controls. Four studies showed no significant reduction in clinical attachment levels between the two groups. The overall risk of bias was high in four studies, while seven studies reported some concerns about the risk of bias. CONCLUSIONS: Based on the limited evidence available, the adjunctive use of Lactobacillus reuteri to scaling and root planing may provide some additional benefit in improving periodontal parameters.

Diode laser targeting red-complex bacteria in periodontitis: a systematic review.

OBJECTIVE: This systematic review examines the effectiveness of diode laser irradiation in reducing the levels of red complex bacteria as well as periodontal parameters of pocket depth and clinical attachment level. MATERIALS AND METHODS: We conducted electronic searches across databases such as Scopus, Embase, Medline, and Web of Science databases in July 2022. Randomized controlled trials that evaluated the reduction of red-complex bacteria in patients with periodontitis using diode lasers were included. The primary focus was the reduction in the microbial count of red complex bacteria, whereas probing depth and attachment level were considered secondary outcomes. Articles in languages other than English were excluded. Study quality was assessed based on the Cochrane Handbook for Systematic Reviews of Interventions and the ROB2 tool. RESULTS: After searching the databases, eight independent studies were included, with a sample size of 210 subjects. The average age group of the study population was 30-60 years, and there was a lack of consensus on the antimicrobial effect of diode lasers. Out of the eight studies, four studies reported no significant difference in the levels of red complex bacteria before and after laser application. Three studies reported significantly lower levels of red complex bacteria in the intergroup comparison. One study reported that laser had no significant effect on intergroup bacterial levels. The combination of diode laser irradiation with scaling reduced the count of red complex bacteria and improved the clinical parameters, although not significantly. CONCLUSIONS: Based on the limited evidence available, the adjunctive use of diode laser for scaling and root planning may provide some additional benefit in terms of reduction of red complex bacterial count and clinical parameters. Further well-designed trials and the use of objective measures are necessary before outlining universal guidelines for best practice. The adjunctive use of diode laser in non-surgical periodontal therapy may provide a reduction in the red complex microbial count and improvement in clinical parameters, decreasing the need for periodontal surgery.

Increasing impact of COVID-19 on young adults: evidence from hospitalisations in Brazil.

OBJECTIVES: Concerns about the increasing impact of severe COVID-19 in younger individuals in Brazil came after a recent synchronised country-wide wave of cases in Brazil. This communication analyses how hospitalisations due to COVID-19 changed in the age groups 18-49 years and ≥70 years. STUDY DESIGN: Longitudinal study based on secondary data. METHODS: Data from SIVEP-Gripe, a public and open-access database of Severe Acute Respiratory Illness records (including COVID-19 notifications), were used in this study. Statistical control charts examined changes in the magnitude and variation of younger (18-49 years) and older (≥70 years) adults who were hospitalised between 15th March 2020 and 19th June 2021. RESULTS: During the few first weeks of the pandemic in Brazil, the number of COVID-19 hospitalisations increased in older adults but decreased in younger adults. Subsequently, hospitalisations reached statistical control zones in epidemiological weeks (EW) 19-48 of 2020 (EW 19-48/2020) and EW 03-05/2021 (18-49 y, mean = 26.1%; ≥70 y, mean = 32.8%). Between EW 49/2020 and EW 02/2021, the number of hospitalisations of younger adults dropped to levels below the lower control limit. In contrast, the number of hospitalisations of older adults surpassed the upper limit of the corresponding statistical control zones. However, from EW 06/2021, numbers of hospitalisations changed from statistical control zones, with hospitalisations of younger adults increasing and reaching 44.9% in EW 24/2021 and hospitalisations of older adults decreasing until EW 19/2021 (14.1%) and reaching 17.3% in EW 24/2021. CONCLUSIONS: An increasing number of COVID-19 hospitalisations were observed in younger adults from EW 06/2021. This could be a result of the successful vaccination programme in older adults, who were initially prioritised, and possibly an increased exposure to highly transmissible variants of COVID-19 in younger adults who had to go to work in the absence of social protection (i.e. government financial support). Potential consequences of COVID-19 hospitalisations in younger adults could include a reduced life expectancy of the population and an increased number of people unable to perform daily activities due to post-COVID-19 conditions.

Physical rehabilitation in the context of a landslide that occurred in Brazil.

BACKGROUNDS: The efforts to develop research and training on physical rehabilitation in regards to disasters is considered recent worldwide. In the late evening of the 11th up until the 12th of January of 2011, the most massive natural disaster occurred in Brazil with extremely heavy downpour, abrupt flood, as well as landslides on multiple areas of the Mountain Region of Rio de Janeiro. The objective of this research was to investigate the challenges in terms of physical rehabilitation provided by this event METHODS: The cross-sectional mixed method's study, which was conducted in the city of Nova Friburgo, used two different data sources: hospital records on traumatic injuries pre and post disaster, and interviews with key informants - victims who suffered injuries related to the disaster, professionals from rehabilitation services in the municipality, and also the city's health service management. Pearson's chi-squared test was performed to evaluate statistical significance between the week of a given incident and the type of injury. Interviews were transcribed and analysed through content analysis. RESULTS: A total of 2326 hospital records and 27 interviews were analysed. The proportion of traumatic injury in the municipal emergency service increased from 16% in the prior week, to 40% in the week post-disaster (p <  0.0001). Different injuries were identified: multiple fractures, crushing, amputation, perforation of soft tissues, inhalation of dust and establishment of chronic conditions through stress. Despite this scenario, out of the 16 health professionals interviewed, twelve did not observe an increase in the demand for outpatient rehabilitation services after the disaster. Interviews with the victims revealed that the pathways for care ran into different barriers. From 11 victims interviewed, only one received complete physiotherapy care through the public health services in the city, while all others hired additional assistance, received volunteer services, had assistance in other cities or remained without rehabilitation. CONCLUSIONS: The needs for rehabilitation increased after the disaster; however, the demand was repressed due to different barriers such as competing needs and possible lack of medical referral. Recommendations were made, including the action of performing a search of victims with rehabilitation needs.

Fluoxetine induces lean phenotype in rat by increasing the brown/white adipose tissue ratio and UCP1 expression.

The serotonergic system plays a crucial role in the energy balance regulation. Energy balance is mediated by food intake and caloric expenditure. Thus, the present study investigated the mechanisms that might be associated with fluoxetine treatment-induced weight reduction. Wistar male rat pups received daily injections with subcutaneous fluoxetine (Fx-group) or vehicle solution (Ct-group) from day 1 until 21 days of age. Several analyses were conducted to verify the involvement of mitochondria in weight reduction. We found that body weight in the Fx-group was lower compared to control. In association to lower fat mass in the Fx-group (25%). Neither neonatal caloric intake nor food intake reveals significant differences. Evaluating caloric expenditure (locomotor activity and temperature after stimulus), we did not observe differences in locomotor activity. However, we observed that the Fx group had a higher capacity to maintain body temperature in a cold environment compared with the Ct-group. Since brown adipose tissue-(BAT) is specialized for heat production and the rate of heat production is related to mitochondrial function, we found that Fx-treatment increases respiration by 36%, although after addition of GDP respiration returned to Ct-levels. Examining ROS production we observe that Fx-group produced less ROS than control group. Evaluating uncoupling protein (UCP) expression we found that Fx-treatment increases the expression by 23%. Taken together, our results suggest that modulation of serotonin system results in positive modulation of UCP and mitochondrial bioenergetics in brown fat tissue.

Biological parameters of larvae, nymphs, and engorged females of Amblyomma cajennense (Fabricius, 1787) (Acari: Ixodidae) obtained from artificial and successive infestations on Oryctolagus cuniculus (Linnaeus, 1758) (Lagomorpha: Ochotonidae) / Parâmetros biológicos de larvas, ninfas e fêmeas ingurgitadas de Amblyomma cajennense (Fabricius, 1787) (Acari:Ixodidae) obtidas de infestações artificiais e sucessivas em Oryctolagus cuniculus (Lagomorpha:Ochotonidae)

The development of acquired resistance to Amblyomma cajennense ticks was evaluated. A total of 18 rabbits were uniformly distributed into three groups named GL, GN, and GA that were submitted to three consecutive infestations with, respectively, larvae, nymphs, and adults of A. cajennense. After the infestations, the parasitic and reproductive parameters of recovered instars were evaluated. A significant reduction of recovery rates of inoculated ticks was observed only after the third infestation of animals in groups GL and GN (P<0.01). The modal day for drop-off of engorged larvae and nymphs increased along the infestations. The recovered engorged nymphs presented a significant reduction of the mean body weight between the first and the third infestations (P<0.01). A significant reduction in the mean recovery rate of engorged females was only observed during the third infestation. However, significant reductions (P<0.05) in body weight, egg mass weight, and larva eclosions were observed for recovered engorged females after the second infestation onwards. The results suggest the occurrence of resistance of rabbits to A. cajennense infestations, being more evident against the adult stage.

Avaliou-se o desenvolvimento de resistência adquirida frente ao parasitismo por Amblyomma cajennense. Para tanto, 18 coelhos foram uniformemente distribuídos em três grupos denominados GL, GN e GA e submetidos a três infestações consecutivas por, respectivamente, larvas, ninfas ou adultos de A. cajennense. Após a infestação, estudaram-se os parâmetros parasitários e reprodutivos dos exemplares recuperados. Apenas a partir da terceira infestação dos animais dos grupos GL e GN, pôde-se observar uma queda significativa na taxa de recuperação dos ixodídeos inoculados (P<0,01). O dia modal de queda das larvas e ninfas recuperadas aumentou com o decorrer das infestações. As ninfas ingurgitadas recuperadas apresentaram uma redução significativa (P<0,01) no peso médio corporal entre a primeira e terceira infestação. Observou-se uma queda significativa na taxa média de recuperação das fêmeas ingurgitadas somente na terceira infestação (P<0,01). Todavia, a partir da segunda infestação observou-se nas teleóginas recuperadas, uma redução significativa no peso corporal, peso da postura e eclodibilidade das larvas (P<0,05). Os dados sugerem a ocorrência de resistência em coelhos à infestação por A. cajennense que foi mais evidente contra o estádio adulto.

Seasonal dynamics of the Cayenne tick, Amblyomma cajennense on horses in Brazil.

The population dynamics of all stages of the Cayenne tick, Amblyomma cajennense (Fabricius) (Acari: Ixodidae) on horses was evaluated over a period of 2 years in the district of Pedro Leopoldo, State of Minas Gerais, Brazil. Every 14 days, the left side of 20 horses was brushed for collection of immature stages; counts of adults were also undertaken. Infestation by larvae was detected from April to August, whereas nymphs were observed from June to October. Infestation by adults was detected throughout the year, and the highest population density occurred from September to March. The number of males was always higher than the number of females, but with considerable reduction in the male : female ratio between April and July. It was observed that 25% of the horses carried 41% of the infesting ticks, and 20% carried only 10% of the ticks during the entire period of the study.

Chemical safety and governance in Brazil.

Chemical safety is recognized in Agenda 21(UNCED--Rio 92), as one of the most serious problems to be faced worldwide being a problem not just of governability, restricted more to the role of states and governments, but of governance at the national and international levels. It poses greater challenges for countries like Brazil where the issues of democracy, security, sustainability and equity, which are fundamental to governance, are merely incipient and still far from solved. Taking as references the analysis of four cases in the Brazilian context, we illustrate the situation from less densely populated areas (as in the cases of mercury use by gold miners in the Amazon and pesticides in agricultural producing areas), through medium-sized towns (as in the accident with cesium 137 in Goiânia), to the major urban and industrial centers (as in the cases of lead from battery renovators and benzene in the oil and steel industries and oil refineries). What can be seen is a situation where problems connected with chemical safety have grown in intensity and extent far more than the capacity to deal with them. In industrializing countries, the formulation of chemical safety policies must take into account not only the complexity and uncertainties involved in understanding the problems, but also the aspects relating to the different modes and levels of vulnerability. This is necessary in order to attempt to build better contextualized and more participatory knowledge and decision-making processes at the local and global levels, which we take as basic prerequisites for governance.

[Work-related accidents on oil drilling platforms in the Campos Basin, Rio de Janeiro, Brazil]. / Acidentes de trabalho em plataformas de petróleo da Bacia de Campos, Rio de Janeiro, Brasil.

The offshore oil industry is characterized by complex systems in relation to technology and organization of work. Working conditions are hazardous, resulting in accidents and even occasional full-scale catastrophes. This article is the result of a study on work-related accidents in the offshore platforms in the Campos Basin, Rio de Janeiro State. The primary objective was to provide technical back-up for both workers' representative organizations and public authorities. As a methodology, we attempt to go beyond the immediate causes of accidents and emphasize underlying causes related to organizational and managerial aspects. The sources were used in such a way as to permit classification in relation to the type of incident, technological system, operation, and immediate and underlying causes. The results show the aggravation of safety conditions and the immediate need for public authorities and the offshore oil industry in Brazil to change the methods used to investigate accidents in order to identify the main causes in the organizational and managerial structure of companies.

[The Institutional Program for Health and Environment in the development process of the Oswaldo Cruz foundation]. / O Programa Institucional sobre Saúde e Ambiente no Processo de Desenvolvimento da Fundação Oswaldo Cruz.

The objective of this paper is to show the development program about health and environment in an institution of academic research and teaching, technological development and services. We analyse data from the register of projects in health and environment in the development process as the thematic axis for this program. We show the sectors which the projects are related, the key words of research and teaching, the construction of thematic axis that should guide and the different approach of interdisciplinary. At the end we show the challenges and perspectives for an interdisciplinar work about health and environment in an academic research and teaching institution.

Metabolic responses to different glucose and glutamine levels in baby hamster kidney cell culture.

In this work, a BHK21 clone producing a recombinant antibody/cytokine fusion protein was used to study the dependence of cell metabolism on the glucose and glutamine levels in the culture medium. Results obtained indicate that both glucose and glutamine consumptions show a Michaelis-Menten dependence on glucose and glutamine concentrations respectively. A similar dependence is also observed for lactate and ammonia productions. The estimated value of the Michaelis constant for the dependence of lactate production on glucose (KLacGlc) was 1.4 +/- 0.1 mM and for the dependence of ammonia production on glutamine (KAmmGln) was 0.25 +/- 0.11 mM and 0.10 +/- 0.03 mM, at glucose concentrations of 0.28 mM and 5.6 mM respectively. At very low glucose concentrations, the glucose to lactate yield decreased markedly, showing a metabolic shift towards lower lactate production. This metabolic shift was also confirmed by the significant increase in the specific oxygen consumption rate also observed at low glucose concentrations. Although it was highly dependent on glucose concentration, the oxygen consumption also increased with the increase in glutamine concentration. At very low glutamine concentrations, the glutamine to ammonia yield increased, showing a more efficient glutamine metabolism.

Host specificity of Amblyomma cajennense (Fabricius, 1787) (Acari: Ixodidae) with comments on the drop-off rhythm.

The parasitic specificity of larval, nymph and adult Amblyomma cajennense on six different host species: Oryctolagus cuniculus, Rattus norvegicus, Gallus gallus domesticus, Anas platyrhynchus, Coturnix coturnix and Streptopelia decorata is described. In terms of the numbers of larvae and nymphs recovered, O. cuniculus was the best host species. The modal day for drop-off of larvae and nymphs was day three for the mammal hosts, but variable in the birds. We conclude that adult A. cajennense have a strong degree of specificity due to the fact that the tick failed to complete its life cycle on any of the evaluated hosts. The immature stages, on the other hand, showed a low level of specificity, most especially in the larval stage, indicating the existence of secondary hosts which probably serve as dispersers in the wild. The results also indicated a variable drop-off rhythm for larvae and nymphs in two periods, diurnal (6-18 hr) and nocturnal (18-6 hr), which differed depending upon the host.

Major chemical accidents in industrializing countries: the socio-political amplification of risk.

Accidents in the chemical industry, such as those that took place in Seveso (1976) and Bhopal (1984), may kill or injure thousands of people, cause serious health hazards and irreversible environmental damage. The aim of this paper is to examine the ever-increasing risk of similar accidents becoming a frequent ocurrence in the so-called industrializing countries. Using figures from some of the worst chemical accidents in the last decades, data on the Bhopal disaster, and Brazil's social and institutional characteristics, we put forward the hypothesis that present social, political and economic structures in industrializing countries make these countries much more vulnerable to such accidents and create the type of setting where--if and when these accidents occur--they will have even more catastrophic consequences. The authors argue that only the transformation of local structures, and stronger technical cooperation between international organizations, industrialized and industrializing countries could reduce this vulnerability.

[Amplified chemical disasters: a challenge for public health]. / Acidentes químicos ampliados: um desafio para a saúde pública.

Chemical accidents involving explosions, large fires and leakages of hazardous substances occurring during transport, storage and industrial production of chemicals constitute a real challenge to health, environmental and industrial safety professionals. The aim of this article is to discuss the main questions that this kind of accident provokes, in terms of public health, particularly in developing countries such as Brazil. The paper defines and characterises these accidents and the various health risk they involve excluding the leakages of hazardous substances during "normal" production in industry--through the combination of quantitative and qualitative information drawn from the international literature on the subject. From some examples of chemical accidents such as occurred in Bhopal (India), Vila Socó (Brazil), São Paulo (México) and data of the World Health Organization (WHO), the authors seek to show that these events present a worsening, in terms of immediate deaths and injuries, in developing countries. The statistics of chemical accidents which occurred during the last ten years (1984 to 1993) in the State of Rio de Janeiro are used taken as a frame reference for the purpose of bringing to light the great number of occurrences made with no registration of basic information regarding assessment or surveillance. The complexity of causes and consequences, together with the structural problems of developing countries, present public health professionals and institutions, with some important tasks especially those of health risk assessment and the formulation of strategies to prevent and control future major chemical accidents.