Demanda de cuidado nutricional de crianças com transtorno do espectro autista em uma região de acesso remoto / Demandas de atención nutricional de niños con trastorno del espectro autista en una región de acceso remoto / Nutritional care demands of children with autism spectrum disorder in a remote access region

Introdução: O transtorno do espectro autista é uma condição neuropsiquiátrica que demanda atenção interdisciplinar e multiprofissional. A abordagem nutricional é necessária frente aos possíveis sintomas associados, como seletividade alimentar e alterações do hábito intestinal. Famílias residentes em locais de acesso limitado à serviços de saúde podem possuir dificuldades para o adequado acompanhamento. Objetivo: Relatar a experiência de atendimentos em nutrição realizados pela Liga Acadêmica de Nutrição e Saúde Coletiva a crianças com transtorno do espectro autista explorando as principais demandas identificadas e enfrentadas em uma região de acesso remoto. Metodologia: Abordagem descritiva, do tipo relato de experiência, de atendimentos realizados no município de Coari, interior do Amazonas. Os encontros foram realizados com vista a identificar demandas e refletir sobre a melhor maneira de auxiliar as crianças com essas comorbidades. Resultados: Foram atendidas 9 crianças, nem todas com o diagnóstico fechado. Seletividade alimentar, distúrbios gastrointestinais e excesso de peso foram desafios recorrentes. Nota-se a carência da percepção da importância do acompanhamento nutricional, em um cenário de relatos importantes sobre as dificuldades no acesso a medicações, por falta no município ou por ausência de recursos para aquisição, assim como terapias especializadas. Aspectos que se tornam ainda mais desafiadores frente à distância geográfica e carência de profissionais especializados e que realizem uma atenção multiprofissional. Conclusões: O acompanhamento nutricional adequado é essencial para atender às necessidades específicas e melhorar a qualidade de vida dessas crianças. Diante das limitações identificadas na região, são necessários esforços contínuos para desenvolver soluções que garantam uma assistência inclusiva e eficaz às crianças com transtorno do espectro autista no interior do Amazonas. A colaboração entre instituições, a conscientização da comunidade e o fortalecimento da rede de saúde local são cruciais para promover uma abordagem abrangente e de alta qualidade para essas crianças e suas famílias (AU).

Introduction: Autism spectrum disorder is a neuropsychiatric condition that demands interdisciplinary and multidisciplinary attention. Nutritional intervention is necessary in the face of possible associated symptoms, such as food selectivity and changes in bowel habits. Families living in places with limited access to health services may have difficulties in obtaining adequate support and follow-up.Objective: Reporting the experience of nutrition services provided by the Academic League of Nutrition and Public Health to children with autism spectrum disorder, exploring the main identified demands and challengesfaced in a remote access region. Methodology:Descriptive approach, experience of an report, of services provided in the municipality of Coari, in the interiorof Amazonas. The meetings were held with the aim identifying demands and reflecting on the best way to assistchildren with these comorbidities. Results: Ninechildren attended to, not all with a confirmed diagnosis. Food selectivity, gastrointestinal disorders and overweight were recurring challenges. There is a lack of perception of the importance of nutritional monitoring, in a scenario where there areimportant reportsofdifficulties in accessing medications, either due to lack of availability in the municipality or lack of resources for acquisition, as well as specialized therapies. Theseaspects become even more challenging given the geographical distance and scarcity of specialized professionals whocanprovide multidisciplinary care. Conclusions: Adequate nutritional monitoring is essential to meet the specific needs and improve the quality of life of these children. Given the limitations identified in the region, continuous efforts are needed to develop solutions that guarantee inclusive and effective assistance for children with autism spectrum disorder in the interior of Amazonas. Collaboration between institutions, community awareness, and strengthening the local health network are crucial to promoting a comprehensive, high-quality approach for these children and their families (AU).

Introducción: El trastorno del espectro autista es una condiciónneuropsiquiátrica que requiere atención interdisciplinaria y multidisciplinaria. El enfoque nutricionales frente a losposibles síntomas, como selectividad alimentaria y alteraciones delhábitosintestinales. Las familias que viven en lugares con accesolimitado a los servicios de salud pueden tener dificultades para recibir un seguimiento adecuado. Objetivo: Reportar la experiencia de los servicios de nutrición brindados por la Liga Académica de Nutrición y Salud Pública a niños con trastorno del espectro autista, explorando las principales demandas identificadas y enfrentadas en una región de acceso remoto.Metodología: Enfoque descriptivo, relato de experiencia, de los servicios prestados en Coari, en el interior de Amazonas. Los encuentros se realizaron con el objetivo de identificar demandas y reflexionar sobre la mejor manera de ayudar. Resultados:Se atendieron 9 niños, no todos con diagnóstico confirmado. Selectividad alimentaria, trastornos gastrointestinales y exceso de peso fueron desafíos recurrentes. Se observa una falta percepción de la importancia del seguimiento nutricional, en un escenario de informes importantes sobre las dificultades en el acceso a medicamentos, debido a lafaltade suministro en el municipio o a la falta de recursos para su adquisición, así como terapias especializadas. Estosaspectos que se vuelven aún más desafiantes dada la distancia geográfica y falta de profesionales especializados que brinden una atención multidisciplinaria.Conclusiones: Un adecuado seguimiento nutricional es fundamental para satisfacerlas necesidades específicas y mejorar la calidad de vida de estos niños. Antelas limitaciones identificadas, se necesitan esfuerzos continuos para desarrollar soluciones que garanticen una atención inclusiva y efectiva estosniños en el interior de Amazonas. Colaboración entre instituciones, concientización comunitaria y fortalecimiento de la red de salud local son cruciales para promover un enfoque integral y de alta calidad para estos niños com trastorno del espectro autista y sus familias (AU).

Review: Fish bile, a highly versatile biomarker for different environmental pollutants.

Ecotoxicological assessments encompass a broad spectrum of biochemical endpoints and ecological factors, allowing for comprehensive assessments concerning pollutant exposure levels and their effects on both fish populations and surrounding ecosystems. While these evaluations offer invaluable insights into the overall health and dynamics of aquatic environments, they often provide an integrated perspective, making it challenging to pinpoint the precise sources and individual-level responses to environmental contaminants. In contrast, biliary pollutant excretion assessments represent a focused approach aimed at understanding how fish at the individual level respond to environmental stressors. In this sense, the analysis of pollutant profiles in fish bile not only serves as a valuable exposure indicator, but also provides critical information concerning the uptake, metabolism, and elimination of specific contaminants. Therefore, by investigating unique and dynamic fish responses to various pollutants, biliary assessments can contribute significantly to the refinement of ecotoxicological studies. This review aims to discuss the multifaceted utility of bile as a potent biomarker for various environmental pollutants in fish in targeted monitoring strategies, such as polycyclic aromatic hydrocarbons, metals, pesticides, pharmaceuticals, estrogenic compounds, resin acids, hepatotoxins and per- and polyfluorinated substances. The main caveats of this type of assessment are also discussed, as well as future directions of fish bile studies.

Trabecular micro-bypass implant (iStent®) in a case of bilateral acute depigmentation of the iris / Micro implante trabecular (iStent®) em um caso de despigmentação aguda bilateral da íris

ABSTRACT We report a case of bilateral acute depigmentation of the iris in which satisfactory intraocular pressure control was obtained after resolution of the acute disease with a trabecular implant (iStent®). A 62-year-old woman presented with bilateral simultaneous acute eye pain, photophobia, increased intraocular pressure (34 mmHg), circulating pigment in the anterior chamber, areas of depigmentation in the iris, and posterior synechiae. She had received oral amoxicillin-clavulanate and moxifloxacin for pneumonia 2 months previously. Bilateral acute depigmentation of the iris was suspected as well as a viral etiology. She received oral acetazolamide, aciclovir, and prednisone, besides topical prednisolone, betaxolol, brimonidine, dorzolamide, and atropine. The disease gradually resolved in 4 months but, after 1 year, she developed bilateral cataracts, and still needed three drugs for intraocular pressure control (16/18 mmHg). Cataract-iStent® combined surgery was performed in both eyes. One year after surgery, intraocular pressure was 11/12 mmHg, without medication. iStent® was safe and effective on this secondary glaucoma.

RESUMO Relatamos um caso de despigmentação aguda bilateral da íris, no qual obtivemos adequado controle da pressão intraocular com o implante do iStent®, após resolução da fase aguda da doença. Paciente feminina, 62 anos, atendida com quadro agudo, bilateral e simultâneo de dor ocular, fotofobia, hipertensão ocular (34 mmHg), pigmentos circulantes na câmara anterior, áreas de despigmentação iriana e sinéquias posteriores. Havia recebido amoxicilina-clavulanato e moxifloxacina orais para pneumonia 2 meses antes. Suspeitando-se de despigmentação aguda bilateral da íris ou de etiologia viral, recebeu acetazolamida, aciclovir e prednisona orais, e colírios prednisolona, betaxolol, brimonidina, dorzolamida e atropina. O quadro se resolveu gradualmente em 4 meses, porém, após 1 ano, desenvolveu catarata bilateral e ainda usava 3 colírios hipotensores (pressão intraocular 16/18 mmHg). A cirurgia combinada de catarata-iStent® foi realizada em ambos os olhos. Um ano depois, a pressão intraocular mantinha-se 11/12 mmHg, sem medicação. O iStent® foi seguro e eficaz no controle deste glaucoma secundário.

Drug-Drug Interactions Involving Dexamethasone in Clinical Practice: Myth or Reality?

Concomitant administration of multiple drugs frequently causes severe pharmacokinetic or pharmacodynamic drug-drug interactions (DDIs) resulting in the possibility of enhanced toxicity and/or treatment failure. The activity of cytochrome P450 (CYP) 3A4 and P-glycoprotein (P-gp), a drug efflux pump sharing localization and substrate affinities with CYP3A4, is a critical determinant of drug clearance, interindividual variability in drug disposition and clinical efficacy, and appears to be involved in the mechanism of numerous clinically relevant DDIs, including those involving dexamethasone. The recent increase in the use of high doses of dexamethasone during the COVID-19 pandemic have emphasized the need for better knowledge of the clinical significance of drug-drug interactions involving dexamethasone in the clinical setting. We therefore aimed to review the already published evidence for various DDIs involving dexamethasone in vitro in cell culture systems and in vivo in animal models and humans.

Red sacaca essential oil-loaded nanostructured lipid carriers optimized by factorial design: cytotoxicity and cellular reactive oxygen species levels.

Amazonian flora includes several species with the potential to develop pharmaceutical and biotechnological products. The essential oils from Amazonian species possess some biological properties, such as antioxidant, antibacterial, and cytotoxic activities. The essential oil of red sacaca (RSO), Croton cajucara Benth., contains metabolites characterized by antioxidant and anti-inflammatory activities. Nanostructured lipid carriers (NLC) are an advantageous alternative for the effective delivery of drugs because they can solubilize lipophilic actives and reduce their cytotoxicity. This study aimed to optimize the synthesis of RSO-loaded nanostructured lipid carriers (NLC-RSO) using a 23 factorial design and investigate their antioxidant and cytotoxic effects. The red sacaca essential oil (RSO) metabolite profile was characterized using gas chromatography coupled with a mass spectrometer (GC-MS), identifying 33 metabolites, with linalool and 7-hydroxy-calamenene as the major ones, as reported in the literature. The optimized NLC-RSO formulation had a particle size less than 100 nm and a polydispersity index lower than 0.25. After characterizing NLC-RSO using Fourier-transform infrared spectroscopy, powder X-ray diffraction, zeta potential, moisture content, and wettability, in vitro cytotoxicity were performed in A549 and BEAS-2B cell lines using the resazurin metabolism assay. The data indicated a lower IC50 for RSO than for NLC-RSOs in both cell lines. Furthermore, low cytotoxicity of blank nanoparticles (blank NP) and medium chain triglycerides-loaded nanostructured lipid carriers (NLC-MCT) towards both pulmonary cell lines was noted. At a concentration of 50-100 µg/mL, free RSO exhibited higher cytotoxicity than NLC-RSO, demonstrating the protective effect of this lipid carrier in reducing cytotoxicity during metabolite delivery. Similarly, free RSO showed higher 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging than NLC-RSO, also indicating this protective effect. The 2',7'-dichlorofluorescein diacetate (DCFH-DA) intracellular reactive oxygen species (ROS) level assay did not show differences between the treatments at higher but non-cytotoxic dosages. Taken together, our results suggest that NLC-RSOs are potential RSO delivery systems for applications related to cancer treatment.

Ecotoxicology applied to conservation: Potential negative metal and metalloid contamination effects on the homeostatic balance of the critically endangered Brazilian guitarfish, Pseudobatos horkelii (Elasmobranchii: Rhinobatidae).

Metal contamination poses a significant threat to elasmobranchs, underscoring the need for targeted conservation approaches. The critically endangered Brazilian guitarfish, Pseudobatos horkelii, confronts an array of challenges, notably overexploitation, putting its survival at risk. Our study investigated the potential toxicity arising from arsenic (As), cadmium (Cd), mercury (Hg), and lead (Pb) contamination across various adult guitarfish tissues from southeastern Brazil. Serological stress indicators, nutritional metabolites, and creatinine, an organ function marker, were also assessed, and Selenium (Se) levels were also investigated for possible protective effects. Our investigation unveiled significant correlations between metal concentrations and the determined physiological markers, shedding light on potential adverse effects. Remarkably, six correlations were indicative of how Hg and Pb negatively impact hepatic metabolite assimilation, while As was shown to influence renal phosphorus dynamics, Cd to affect rectal gland phosphorus regulation, and Pb to influence creatinine production in muscle tissue. Furthermore, Se demonstrated protective properties against Cd, Hg, and Pb, suggesting a role in alleviating the toxicity of these elements. Despite probable protective Se influences, the detected elemental interactions still suggest potential for organ impairment. These findings gain heightened significance within the context of the cumulative stressors faced by the Brazilian guitarfish, with metal contamination exhibiting the capacity to erode this species resilience against both anthropogenic and environmental pressures, thereby disrupting systemic equilibrium and jeopardizing wild populations. By investigating the intricate balance between metal accumulation and physiological consequences, our study contributes with crucial insights into potential conservation strategy formulations towards pollution for this critically endangered elasmobranch species.

CRISPR/Cas-9 vector system: targets UL-39 and inhibits Simplexvirus humanalpha1 (HSV-1) replication in vitro.

Simplexvirus humanalpha1 (HSV-1) affects approximately 67% of the world's population. Here, we sought to use the CRISPR / Cas9 system with the UL39 target, essential for virus replication. The sgRNA sequence was inserted into the plasmid (PX459-UL39). Vero cells were transfected with PX459-UL39, and inhibition of viral replication was assessed 24 and 48 hours later using plaque assays and fluorescence and qPCR. Fluorescence analyses revealed the presence of anti-HSV-1 CRISPR/Cas9 within Vero cells, and qPCR showed that the viral load decreased by> 95% of cells transfected with anti-HSV-1 CRISPR / Cas 9. Our data demonstrate the usefulness of the PX459-UL39 to inhibit HSV-1 infection.

A Novel One Health Approach concerning Yeast Present in the Oral Microbiome of the Endangered Rio Skate (Rioraja agassizii) from Southeastern Brazil.

The current climate change scenario caused by anthropogenic activities has resulted in novel environmental pressures, increasing the occurrence and severity of fungal infections in the marine environment. Research on fungi in several taxonomic groups is widespread although not the case for elasmobranchs (sharks and rays). In this context, the aim of the present study was to screen the oral fungal microbiota present in artisanally captured Rioraja agassizii, a batoid that, although endangered, is highly fished and consumed worldwide. Oropharyngeal samples were obtained by swabbing and the samples were investigated using morphological and phenotypic methods by streaking on Sabouraud Dextrose Agar (SDA) and subculturing onto CHROMagar Candida (BD Difco) and CHROMagar Candida Plus (CHROMagarTM), as well as molecular techniques by amplification of the ITS1-5.8S-ITS2 ribosomal DNA region and a MALDI-TOF MS assessment. The findings indicated the presence of Candida parapsilosis (seven isolates), Candida duobushaemulonii (one isolate) and Rhodotorula mucilaginosa (three isolates), several of these reported for the first time in Rioraja agassizii. In addition, a 100% agreement between the MALDI-TOF results and partial ITS region sequencing was noted, demonstrating that the MALDI-TOF MS is a rapid and effective alternative for yeast identification in Rioraja agassizii isolates and potentially in other elasmobranch species. These findings highlight the need for further research to determine the potential impact on elasmobranch health, ecology, and commercial fisheries. Furthermore, this research is paramount in a One Health framework and may be employed to predict elasmobranch responses to an evolving ocean, keep healthy populations in check, monitor species, and assess the public health consequences of consuming these species.

Radiological assessment of the disposal of bulk oil NORM waste: Case study from Brazil.

The oil and gas industries are the largest producers of NORM wastes that are continuously generated during production and extraction activities. In addition, an increasing trend is observed in waste production worldwide due to the decommissioning of oil platforms. The problem is that most of these wastes are in activity concentration levels above the exemption and the clearance limits and are being accumulated in storage sites because no repositories exist in Brazil for NORM wastes generated by oil industries. There are regulations for radioactive wastes and for the licensing of repositories for managing wastes with low and intermediate levels of radiation but the current regulations apply only to packaged wastes. Therefore an initial radiological assessment was carried out with the RESRAD-OFFSITE code to show that bulk NORM wastes (not packaged wastes) could be disposed of in repositories near the surface without causing additional risk to the public above the criteria used. The results can also support decision-making by the Regulatory Authority to change the current regulations and allow for the disposal of wastes in bulk form.

First metal and metalloid study assessment for the Black Triggerfish Melichthys niger (Bloch, 1786): Baseline data from a pristine South Atlantic oceanic island.

Metal and metalloid concentrations in Black Triggerfish, Melichthys niger (Tetraodontiformes, Balistidae), and sediments from Trindade Island, an isolated, pristine, and understudied environment in the Southwestern Atlantic Ocean were determined. Several elements were detected in sediment, including Rare Earth Elements (REE). Hg and the REE Nd were, however, not detected. Elements determined in triggerfish are indicative of systemic circulation and the presence of toxic elements indicates an exposure source. No significant associations were detected between elements in fish organs and total length, suggesting no bioaccumulation with age, nor between organs and sediment, indicating probable dietary origin. Biliary excretion indicated a local chronic source of As and Cd and non-quantifiable REE elimination. Hg concentrations were over thresholds that affect fish biochemistry processes. These baseline data are valuable concerning elemental contamination in remote oceanic islands, with the potential to be applied to future biomonitoring efforts and conservation measures for reef ecosystems worldwide.

Quantification of in vitro replication kinetics of Alagoas vesiculovirus isolates by digital droplet RT-PCR.

Vesicular stomatitis caused by Alagoas vesiculovirus (VSAV) has generated disease outbreaks in Brazil, mainly in the northeast region. Phylogenetic studies divide the isolates into three distinct genotypes (A, B, and C). However, there is no description of how this genetic divergence reflects on the phenotype of VSAV isolates such as in vitro replication fitness. Therefore, the objective of this work was to evaluate the ability of three distinct genotypes of Brazilian isolates of VSAV to grow in different cell-culture lines (BHK-21, Vero, and NCI-H1299). Quantification of viral RNA was performed using RT-PCR digital droplet from supernatant of cell culture collected every 4 h for a period of 24 h of viral growth in three different cell lines (BHK-21, Vero, and NCI-H1299). It was observed that the genotype C isolate has the lowest replication efficiency among the three analyzed viruses, without major changes in the copies of viral RNA over the entire time of the study.

Barrier Discharge Ionization Detector in Gas Chromatography: A Review on Applications.

The barrier discharge ionization detector (BID) is one of the latest detection technologies used in gas chromatography (GC). 306 papers from 2012 to 2021 with GC-BID analyses were considered. An overview of the main applications with the BID, considering the trends for the most common analyses, explored compounds, extraction methods, and comparative studies with other detectors is shown. Interest in BID applications has grown, and the number of publications reflects this. Despite having the potential to analyze different compounds, gases are more explored, mainly H2, CH4, and CO. The BID should be further explored for water analysis, as studies show its good performance in larger quantities and at the level of traces. Most of the determinations of these compounds were applied in studies focused on CO2 reduction (by photocatalysis or electro-reduction) and biogas (for CH4). BID is effective for determinations on the order of mmol to µmol. Headspace extraction (HS) is most often applied BID analysis. Reduced dynamic range and nonlinear response to carbon mass are some disadvantages to BID. On the other hand, the BID has a signal-to-noise ratio (S/N) 100 times higher than thermal conductivity detector (TCD) (for inorganic gases and water), a high linear sensitivity for dodecane (LOD less than 1.0 pgC/sec) and other compounds (being able to reach µg/L). Combined with simple extraction methods such as HS, the BID allows quick and simple analysis with great sensitivity, in addition, it is a good alternative for the analysis of inorganic gases and water compared to usual detectors.

Food safety concerns on polycyclic aromatic hydrocarbon contamination in fish products from estuarine bays throughout the American continent.

Estuarine environments are highly productive ecosystems exhibiting high fish biodiversity and richness. Estuarine bays yield significant fisheries catches, making them the target of extractive activities by both artisanal and industrial fisheries. These areas, however, are highly vulnerable to chemical contamination, such as polycyclic aromatic hydrocarbons (PAH) associated with oil spills and other anthropogenic activities, which can jeopardize animal health and consumer welfare. In this context, this systematic review aimed to evaluate PAH levels detected in seafood from estuarine bays throughout the entire American continent and assess potential human health risks. The PICO methodology was applied, and 27 experimental papers were evaluated. The findings indicate that naphthalene and pyrene are routinely detected at high concentrations in several species, such as white mullet and catfish, and that biliary metabolites concentrations tend to be higher than tissue levels. Although the effects of PAH on animal health are well defined due to several decades of assessments, food safety evaluations are still not routine, evidencing a significant knowledge gap and the need for legislative measures based on toxicological data.

Low Occurrence of Salmonella spp. in Wild Animals in Bahia, Brazil-Population Assessment and Characterization in the Caatinga and Atlantic Forest Biomes.

Salmonella spp. are known to persist in the environment. Wild animals are believed to act as important reservoirs, with antimicrobial resistance frequently occurring in the environment. However, little is known about the role of the wildlife in Bahia as a reservoir for Salmonella in Brazil. This study aimed to isolate and characterize Salmonella spp. from wildlife in the Atlantic Forest and Caatinga biomes considering indicators such as the animal species, degree of anthropization, sampling area, and feeding habits. Convenience wildlife sampling and characterization were conducted, followed by microbiological and molecular identification of Salmonella isolates, serotyping, and antimicrobial susceptibility testing. A total of 674 fecal samples were collected from 12 municipalities during 2015-2021, and 4 were positive for the following Salmonella species: Salmonella enterica subspecies enterica serovar Agona (n = 1), Salmonella enterica subsp. enterica serogroup O:16 (n = 2), and Salmonella enterica subsp. enterica serovar Muenchen (n = 1). Antimicrobial susceptibility analysis revealed that one isolate was resistant to six antibiotics, including extended-spectrum penicillins and beta-lactamase inhibitors. These results indicated a low frequency of Salmonella spp. in the sampled forest fragments. The presence of Salmonella in wild animals increases the risk to public health and biodiversity and indicates that they can act as sentinels of environmental contamination or indicators of preservation.

Energy-lowering and constant-energy spin flips: Emergence of the percolating cluster in the kinetic Ising model.

After a sudden quench from the disordered high-temperature T_{0}→∞ phase to a final temperature well below the critical point T_{F}≪T_{c}, the nonconserved order parameter dynamics of the two-dimensional ferromagnetic Ising model on a square lattice initially approaches the critical percolation state before entering the coarsening regime. This approach involves two timescales associated with the first appearance (at time t_{p_{1}}>0) and stabilization (at time t_{p}>t_{p_{1}}) of a giant percolation cluster, as previously reported. However, the microscopic mechanisms that control such timescales are not yet fully understood. In this paper, to study their role on each time regime after the quench (T_{F}=0), we distinguish between spin flips that decrease the total energy of the system from those that keep it constant, the latter being parametrized by the probability p. We show that observables such as the cluster size heterogeneity H(t,p) and the typical domain size ℓ(t,p) have no dependence on p in the first time regime up to t_{p_{1}}. Furthermore, when energy-decreasing flips are forbidden while allowing constant-energy flips, the kinetics is essentially frozen after the quench and there is no percolation event whatsoever. Taken together, these results indicate that the emergence of the first percolating cluster at t_{p_{1}} is completely driven by energy decreasing flips. However, the time for stabilizing a percolating cluster is controlled by the acceptance probability of constant-energy flips: t_{p}(p)∼p^{-1} for p≪1 (at p=0, the dynamics gets stuck in a metastable state). These flips are also the relevant ones in the later coarsening regime where dynamical scaling takes place. Because the phenomenology on the approach to the percolation point seems to be shared by many 2D systems with a nonconserved order parameter dynamics (and certain cases of conserved ones as well), our results may suggest a simple and effective way to set, through the dynamics itself, t_{p_{1}} and t_{p} in such systems.

Trabecular micro-bypass implant (iStent®) in a case of bilateral acute depigmentation of the iris.

We report a case of bilateral acute depigmentation of the iris in which satisfactory intraocular pressure control was obtained after resolution of the acute disease with a trabecular implant (iStent®). A 62-year-old woman presented with bilateral simultaneous acute eye pain, photophobia, increased intraocular pressure (34 mmHg), circulating pigment in the anterior chamber, areas of depigmentation in the iris, and posterior synechiae. She had received oral amoxicillin-clavulanate and moxifloxacin for pneumonia 2 months previously. Bilateral acute depigmentation of the iris was suspected as well as a viral etiology. She received oral acetazolamide, aciclovir, and prednisone, besides topical prednisolone, betaxolol, brimonidine, dorzolamide, and atropine. The disease gradually resolved in 4 months but, after 1 year, she developed bilateral cataracts, and still needed three drugs for intraocular pressure control (16/18 mmHg). Cataract-iStent® combined surgery was performed in both eyes. One year after surgery, intraocular pressure was 11/12 mmHg, without medication. iStent® was safe and effective on this secondary glaucoma.

Oral lichenoid lesion in association with chemotherapy treatment for non-Hodgkin lymphoma or lichen planus? Review of the literature and report of two challenging cases.

BACKGROUND: The diagnosis of oral lichenoid lesions (OLL) remains a challenge for clinicians and pathologists. Although, in many cases, OLL cannot be clinically and histopathologically distinguishable from oral lichen planus (OLP), one important difference between these lesions is that OLL has an identifiable etiological factor, e.g. medication, restorative material, and food allergy. The list of drugs that can cause OLL is extensive and includes anti-inflammatory drugs, anticonvulsants, antihypertensives, antivirals, antibiotics, chemotherapeutics, among others. This work aimed to perform a literature review of OLL related to chemotherapy drugs and to report two cases of possible OLL in patients with B-cell and T-cell non-Hodgkin lymphomas in use of chemotherapy and adjuvant medications. We also discuss the challenge to clinically and histopathologically differentiate OLL and OLP. CASE PRESENTATION: In both cases, oral lesions presented reticular, atrophic, erosive/ulcerated, and plaque patterns. The diagnosis of OLL was initially established in both cases by the association of histopathology and history of onset of lesions after the use of medications. Although the patients have presented a significant improvement in the oral clinical picture for more than 2 years of follow-up, they still have some lesions. CONCLUSION: A well-detailed anamnesis associated with the drug history, temporal relationship of the appearance of the lesions, and follow-up of patients are fundamental for the diagnosis of OLL related to drugs. Nevertheless, its differentiation from OLP is still a challenge.