Global representativeness and impact of funding sources in cost-effectiveness research on systemic therapies for advanced breast cancer: A systematic review.

BACKGROUND: Breast cancer (BC) is the most incident tumor and, consequently, any new intervention can potentially promote a considerable budget impact if incorporated. Cost-effectiveness (CE) studies assist in the decision-making process but may be influenced by the country's perspective of analysis and pharmaceutical industry funding. METHODS: A systematic review of Medline, Scopus, and Web of Science from January 1st, 2012 to July 8th, 2022 was conducted to identify CE studies of tumor-targeted systemic-therapies for advanced BC. Articles without incremental cost-effectiveness ratio calculations were excluded. We extracted information on the country and class of drug studied, comparator type, authors' conflicts of interest (COI), pharmaceutical industry funding, and authors' conclusions. RESULTS: 71 studies comprising 204 CE assessments were included. The majority of studies were from the United States and Canada (44%), Asia (32%) and Europe (20%). Only 8% were from Latin America and none from Africa. 31% had pharmaceutical industry funding. The most studied drug classes were cyclin-dependent-kinase inhibitors (29%), anti-HER2 therapy (23%), anti-PD(L)1 (11%) and hormone therapy (11%). Overall, 34% of CE assessments had favorable conclusions. Pharmaceutical industry-funded articles had a higher proportion of at least one favorable conclusion (82% vs. 24%, p-value<0.001), European countries analyzed (45% vs. 9%, p-value = 0.003), and CE assessments with same class drug comparators (56% vs. 33%, p-value = 0.004). CONCLUSIONS: Breast cancer CE literature scarcely represents low-and-middle-income countries' perspectives and is influenced by pharmaceutical industry funding which targets European countries', frequently utilizes comparisons within same-drug class, and is more likely to have favorable conclusions.

B-Cell Epitopes-Based Chimeric Protein from SARS-CoV-2 N and S Proteins Is Recognized by Specific Antibodies in Serum and Urine Samples from Patients.

The impact of the COVID-19 pandemic caused by the SARS-CoV-2 virus underscored the crucial role of laboratorial tests as a strategy to control the disease, mainly to indicate the presence of specific antibodies in human samples from infected patients. Therefore, suitable recombinant antigens are relevant for the development of reliable tests, and so far, single recombinant proteins have been used. In this context, B-cell epitopes-based chimeric proteins can be an alternative to obtain tests with high accuracy through easier and cheaper production. The present study used bioinformatics tools to select specific B-cell epitopes from the spike (S) and the nucleocapsid (N) proteins from the SARS-CoV-2 virus, aiming to produce a novel recombinant chimeric antigen (N4S11-SC2). Eleven S and four N-derived B-cell epitopes were predicted and used to construct the N4S11-SC2 protein, which was analyzed in a recombinant format against serum and urine samples, by means of an in house-ELISA. Specific antibodies were detected in the serum and urine samples of COVID-19 patients, which were previously confirmed by qRT-PCR. Results showed that N4S11-SC2 presented 83.7% sensitivity and 100% specificity when using sera samples, and 91.1% sensitivity and 100% specificity using urine samples. Comparable findings were achieved with paired urine samples when compared to N and S recombinant proteins expressed in prokaryotic systems. However, better results were reached for N4S11-SC2 in comparison to the S recombinant protein when using paired serum samples. Anti-N4S11-SC2 antibodies were not clearly identified in Janssen Ad26.COV2.S COVID-19-vaccinated subjects, using serum or paired urine samples. In conclusion, this study presents a new chimeric recombinant antigen expressed in a prokaryotic system that could be considered as an alternative diagnostic marker for the SARS-CoV-2 infection, with the potential benefits to be used on serum or urine from infected patients.

Effect of postoperative tranexamic acid on recurrence rate and complications in chronic subdural hematomas patients: preliminary results of a randomized controlled clinical trial.

Chronic subdural hematoma (CSDH) is a frequent neurosurgical disease which mainly affects elderly patients. Tranexamic acid (TXA) has been hypothesized as an oral agent to avoid CSDH progression and/or recurrence. We performed an evaluation to determine whether the postoperative use of TXA reduces recurrence rate. A prospective, randomized, and controlled trial. Patients with unilateral or bilateral chronic subdural hematoma undergoing surgical treatment by burr-hole were randomized as to whether or not to use TXA in the postoperative period. We evaluated image and clinical recurrence of CSDH at follow up of 6 months and potential clinical and/or surgical complications impact of TXA. Twenty-six patients were randomized to the control group (52%) and twenty-four patients to the TXA group (48%). Follow-up ranged from 3 to 16 months. There were no significant difference between baseline data in groups regarding to age, gender, use of antiplatelet or anticoagulants, smoking, alcoholism, systemic arterial hypertension, diabetes mellitus, hematoma laterality, hematoma thickness, and drain use. Clinical and radiological recurrence occurred in three patients (6%), being two cases in TXA group (8.3%) and 1 in control group (3.8%). Postoperative complications occurred in two patients during follow-up (4%), being both cases in TXA group (8.3%), and none in the control group. Although TXA group had a higher recurrence rate (8.3%), there was no statistically significant difference between the two groups. Moreover, TXA group had two complications while control group had no complications. Although limited by experimental nature of study and small sample, our current data suggest that TXA should not be used as a potential agent to avoid recurrences of CSDH and might increase complication odds.

Digital mapping of the soil available water capacity: tool for the resilience of agricultural systems to climate change.

Soil available water capacity (AWC) is a key function for human survival and well-being. However, its direct measurement is laborious and spatial interpretation is complex. Digital soil mapping (DSM) techniques emerge as an alternative to spatial modeling of soil properties. DSM techniques commonly apply machine learning (ML) models, with a high level of complexity. In this context, we aimed to perform a digital mapping of soil AWC and interpret the results of the Random Forest (RF) algorithm and, in a case study, to show that digital AWC maps can support agricultural planning in response to the local effects of climate change. To do so, we divided this research into two approaches: In the first approach, we showed a DSM using 1857 sample points in a southeastern region of Brazil with laboratory-determined soil attributes, together with a pedotransfer function (PTF), remote sensing and DSM techniques. In the second approach, the constructed AWC digital soil map and weather station data were used to calculate climatological soil water balances for the periods between 1917-1946 and 1991-2020. The result showed the selection of covariates using Shapley values as a criterion contributed to the parsimony of the model, obtaining goodness-of-fit metrics of R2 0.72, RMSE 16.72 mm m-1, CCC 0.83, and Bias of 0.53 over the validation set. The highest contributing covariates for soil AWC prediction were the Landsat multitemporal images with bare soil pixels, mean diurnal, and annual temperature range. Under the current climate conditions, soil available water content (AW) increased during the dry period (April to August). May had the highest increase in AW (∼17 mm m-1) and decrease in September (∼14 mm m-1). The used methodology provides support for AWC modeling at 30 m resolution, as well as insight into the adaptation of crop growth periods to the effects of climate change.

Índice de Fitoquímicos da Dieta: Aplicação em Pacientes em Tratamento Oncológico / Diet Phytochemical Index: Application in Patients under Oncological Treatment / Índice Fitoquímico Dietético: Aplicación en Pacientes en Tratamiento Oncológico

Introdução: O tratamento do câncer provoca efeitos adversos que podem alterar o consumo alimentar e, consequentemente, a ingestão de vitaminas, minerais, fibras e fitoquímicos. Objetivo: Aplicar o Índice de Fitoquímicos (IF) da dieta nos registros alimentares de pacientes em tratamento oncológico. Método: Estudo transversal com indivíduos em tratamento oncológico. Foram coletadas informações sociodemográficas e clínicas dos participantes para caracterização da população. Os dados alimentares foram obtidos por meio de recordatório alimentar de 24 horas e inseridos no software Nutrabem Pro® para obtenção dos valores de macro e micronutrientes, bem como dos fitoquímicos. Para avaliar o IF, aplicou-se a fórmula proposta por McCarty. Resultados: Participaram do estudo 50 pacientes predominantemente do sexo feminino e com média da idade de 58±12,1 anos. A média geral do IF foi de 20,44±11,55, e a ordem crescente de consumo foi: luteína-zeaxantina, alfacaroteno, licopeno, criptoxantina e betacaroteno. Os alimentos que mais contribuíram para a ingestão dos fitoquímicos foram: beterraba, cenoura e abóbora-japonesa para beta e alfacaroteno; laranja e mamão para betacriptoxantina; molho de tomate, melancia e mamão para licopeno; almeirão e beterraba para luteína/zeaxantina; e maçã, banana e azeite para fitoesterol. O IF não se associou com as variáveis sociodemográficas e clínicas da população. Conclusão: Os pacientes em tratamento oncológico apresentaram baixo consumo de fitoquímicos. Esse resultado condiz com a ingestão insuficiente de frutas e hortaliças, as quais representam as principais fontes de carotenoides nas refeições, além do baixo consumo de oleaginosas e sementes, que configuram uma importante fonte de fitoesteróis

Introduction: Cancer treatment causes adverse effects that can change food consumption and consequently the intake of vitamins, fiber and phytochemicals. Objective: To apply the dietary Phytochemical Index (PI) in the food records of patients undergoing cancer treatment. Method: Cross-sectional study with individuals in cancer treatment. The participants' sociodemographic and clinical information was collected to characterize the population. Feeding was obtained through a 24-hour dietary recall and entered into the Nutrabem Pro® software to obtain macro and microchemical values, as well as phytochemical data. To evaluate the study with PI, the formula proposed by McCarty was applied. Results: Ten patients, predominantly females, with an average age of 58±2.1 years participated of the study. The overall mean of PI was 20.44±11.55, and the rising order of consumption was: lutein-zeaxanthin, alpha-carotene, lycopene, cryptoxanthin and beta-carotene. The foods that contributed the most for the intake of phytochemicals were: beetroot, carrots and Japanese pumpkin for beta and alpha-carotene; orange and papaya for beta-cryptoxanthin; tomato sauce, watermelon and papaya for lycopene; chicory and beetroot for lutein/zeaxanthin; and apple, banana and olive oil for phytosterol. PI was not associated with sociodemographic and clinical variables of the population. Conclusion: Patients in cancer treatment had a low consumption of phytochemicals. This result is consistent with an insufficient intake of fruits and vegetables, as they represent the main sources of carotenoids in meals, in addition to the low consumption of oilseeds and seeds, which are an important source of phytosterols

Introducción: El tratamiento del cáncer provoca efectos adversos que pueden modificar el consumo de alimentos y consecuentemente la ingesta de vitaminas, minerales, fibra y fitoquímicos. Objetivo: Aplicar el Índice Fitoquímico dietético (IF) en los registros alimentarios de pacientes en tratamiento oncológico. Método: Estudio transversal con individuos en tratamiento oncológico. Se recopiló la información sociodemográfica y clínica de los participantes para caracterizar la población. Los datos alimentarios se obtuvieron a través de un registro alimentario de 24 horas y se ingresaron al software Nutrabem Pro® para obtener valores de macro y micronutrientes, así como fitoquímicos. Para evaluar la FI se aplicó la fórmula propuesta por McCarty. Resultados: Participaron del estudio 50 pacientes, predominantemente del sexo femenino, con una edad media de 58±12,1 años. La media general de FI fue de 20,44±11,55, y el orden creciente de consumo fue: luteína-zeaxantina, alfacaroteno, licopeno, criptoxantina y betacaroteno. Los alimentos que más contribuyeron a la ingesta de fitoquímicos fueron: remolacha, zanahoria y calabaza japonesa para beta y alfacaroteno; naranja y papaya para betacriptoxantina; salsa de tomate, sandía y papaya para licopeno; achicoria y remolacha para luteína/ zeaxantina; y manzana, plátano y aceite de oliva para fitosterol. El FI no se asoció con las variables sociodemográficas y clínicas de la población. Conclusión: Los pacientes en tratamiento oncológico presentaron un bajo consumo de fitoquímicos. Este resultado es consistente con el consumo insuficiente de frutas y verduras, que representan las principales fuentes de carotenoides en las comidas, además del bajo consumo de oleaginosas y semillas, que son una fuente importante de fitoesteroles

Exuberant bullous vasculitis associated with SARS-CoV-2 infection.

We described a case of exuberant cutaneous small-vessel vasculitis in a 27-year-old male with mild CoVID-19 in Brazil. The patient presented painful purpuric papules and vesicobullous lesions with hemorrhagic content located in the larger amount in the lower limbs and, to a lesser extent in the region of the back and upper limbs, saving palms and soles of the feet. Influenza-like syndrome with anosmia and ageusia was reported seven days before the skin lesions. A real-time reverse transcription polymerase chain reaction was positive on a nasopharyngeal swab for SARS-CoV-2. Histopathological study showed leukocytoclastic cutaneous vasculitis affecting small vessels and microthrombi occluding some vessels. The patient presented an improvement in skin lesions by the fifth day of prednisone therapy. This case highlights the importance of the SARS-CoV-2 test in investigating the etiology of cutaneous vasculitis during this pandemic.

Oral features of systemic sclerosis: A case-control study.

OBJECTIVE: The aim of this study was to evaluate the orofacial parameters of systemic sclerosis (SSc) and its related systemic features. SUBJECTS AND METHODS: A descriptive case-control study was performed from November 2015 to October 2016. Ninety-three individuals were included and divided into SSc group (n = 50) and healthy controls (C, n = 43). RESULTS: Systemic sclerosis individuals were mostly women (43/50, 86%), with a mean age of 46 years (±11.6 years). Telangiectasia (42/50, 84%) and reduced mouth opening (35/50, 70%) were the most frequent orofacial findings. The periodontitis frequency was much higher in SSc individuals than in healthy controls (90.7% × 48.83%; p < .001). In addition, SSc individuals presented a distinctive pattern of periodontitis, with low probing pocket depth (2 ± 0.65 mm × 2 ± 0.24; p < .001), higher gingival recession (4 ± 2.13 × 0.14 ± 0,22; p < .001), higher periodontal attachment loss (6 ± 1.34 mm × 2 ± 0.43, p < .001), and lower gingival bleeding index values (7.05 ± 7.25 × 21.57 ± 15.66; p < .001). CONCLUSIONS: Orofacial manifestations were common in SSc and included a unique pattern of periodontal manifestation, characterized by lower gingival bleeding index, higher periodontal attachment loss, and low probing depth.

Evaluation of the effect of cafeteria diet on the kidney Na,K-ATPase activity, and oxidative stress.

In this study, renal tissue, subdivided into the cortex and medulla of Wistar rats subjected to a cafeteria diet (CAF) for 24 days or to normal diet, was used to analyze whether the renal enzyme Na,K-ATPase activity was modified by CAF diet, as well as to analyze the α1 subunit of renal Na,K-ATPase expression levels. The lipid profile of the renal plasma membrane and oxidative stress were verified. In the Na,K-ATPase activity evaluation, no alteration was found, but a significant decrease of 30% in the cortex was detected in the α1 subunit expression of the enzyme. There was a 24% decrease in phospholipids in the cortex of rats submitted to CAF, a 17% increase in cholesterol levels in the cortex, and a 23% decrease in the medulla. Lipid peroxidation was significantly increased in the groups submitted to CAF, both in the cortical region, 29%, and in the medulla, 35%. Also, a reduction of 45% in the glutathione levels was observed in the cortex and medulla with CAF. CAF showed a nearly two-fold increase in glutathione peroxidase (GPX) activity in relation to the control group in the cortex and a 59% increase in the GPx activity in the medulla. In conclusion, although the diet was administered for a short period of time, important results were found, especially those related to the lipid profile and oxidative stress, which may directly affect renal function.

Existe associação entre o uso de glicocorticoides e a presença de fraturas? estudo comparativo em um hospital de trauma / Is there an association between glucocorticoid use and fractures? a comparative study in a trauma hospital

RESUMO Objetivo: Avaliar se houve associação entre a ocorrência de fratura após trauma físico e o uso de glicocorticoides nos 12 meses precedentes ao trauma, em crianças e adolescentes atendidos em uma emergência. Métodos: No período de abril a outubro de 2015 foi conduzido em uma emergência pediátrica um estudo tipo caso controle, em pacientes de 3 a 14 anos incompletos, vitimados por trauma físico, com e sem fratura. Os dados analisados foram obtidos pela consulta dos prontuários, pelo exame físico dos pacientes e por entrevista dos responsáveis, comparando-se uso de glicocorticoides nos últimos 12 meses, características demográficas, índice de massa corpórea, ingesta de leite, intensidade do trauma, prática de exercício físico e tabagismo passivo domiciliar nos dois grupos de pacientes. Resultados: Estudaram-se 104 pacientes com trauma físico, 50 com fratura e 54 sem fratura. O uso de glicocorticoides ocorreu em 15,4% dos pacientes estudados, sem diferença estatisticamente significante entre os dois grupos. A faixa etária de 10 a 14 anos incompletos, o trauma grave e a prática de exercício físico predominaram entre os pacientes com fratura. Conclusões: Este estudo não mostrou associação entre o uso prévio de glicocorticoides e a ocorrência de fraturas em crianças e adolescentes. A faixa etária de 10 a 14 anos incompletos, o trauma grave e a prática de exercício físico associaram-se com maior risco para fraturas.

ABSTRACT Objective: To assess the association between traumatic fractures and glucocorticoids taken 12 months prior to a trauma, in children and adolescents seen at an emergency room. Methods: A case-control study was conducted from April to October 2015, at a pediatric emergency hospital with patients aged 3- to 14 years-old, who had suffered physical trauma. Some of the patients had a fracture and some did not. The data analyzed were obtained from medical records, physical examination of the patients, and interview with the patients' caregivers. Glucocorticoid use in the past 12 months, demographic variables, body mass index, milk intake, trauma intensity, physical activity and smoking in the household were compared between the two patient groups. Results: A total of 104 patients with physical trauma were studied - 50 had a fracture and 54 did not. Of all the patients, 15.4% had previously used glucocorticoids, and there were no statistically significant differences between the groups. The age range of 10- to 14 years-old, severe trauma and physical activity were more prevalent among patients with a bone fracture. Conclusions: This study did not find an association between previous glucocorticoid use and the occurrence of fractures in children and adolescents. The age range of 10- to 14 years-old, severe trauma, and physical activity were associated with an increased risk for fractures.

IS THERE AN ASSOCIATION BETWEEN GLUCOCORTICOID USE AND FRACTURES? A COMPARATIVE STUDY IN A TRAUMA HOSPITAL. / EXISTE ASSOCIAÇÃO ENTRE O USO DE GLICOCORTICOIDES E A PRESENÇA DE FRATURAS? ESTUDO COMPARATIVO EM UM HOSPITAL DE TRAUMA.

OBJECTIVE: To assess the association between traumatic fractures and glucocorticoids taken 12 months prior to a trauma, in children and adolescents seen at an emergency room. METHODS: A case-control study was conducted from April to October 2015, at a pediatric emergency hospital with patients aged 3- to 14 years-old, who had suffered physical trauma. Some of the patients had a fracture and some did not. The data analyzed were obtained from medical records, physical examination of the patients, and interview with the patients' caregivers. Glucocorticoid use in the past 12 months, demographic variables, body mass index, milk intake, trauma intensity, physical activity and smoking in the household were compared between the two patient groups. RESULTS: A total of 104 patients with physical trauma were studied - 50 had a fracture and 54 did not. Of all the patients, 15.4% had previously used glucocorticoids, and there were no statistically significant differences between the groups. The age range of 10- to 14 years-old, severe trauma and physical activity were more prevalent among patients with a bone fracture. CONCLUSIONS: This study did not find an association between previous glucocorticoid use and the occurrence of fractures in children and adolescents. The age range of 10- to 14 years-old, severe trauma, and physical activity were associated with an increased risk for fractures.

OBJETIVO: Avaliar se houve associação entre a ocorrência de fratura após trauma físico e o uso de glicocorticoides nos 12 meses precedentes ao trauma, em crianças e adolescentes atendidos em uma emergência. MÉTODOS: No período de abril a outubro de 2015 foi conduzido em uma emergência pediátrica um estudo tipo caso controle, em pacientes de 3 a 14 anos incompletos, vitimados por trauma físico, com e sem fratura. Os dados analisados foram obtidos pela consulta dos prontuários, pelo exame físico dos pacientes e por entrevista dos responsáveis, comparando-se uso de glicocorticoides nos últimos 12 meses, características demográficas, índice de massa corpórea, ingesta de leite, intensidade do trauma, prática de exercício físico e tabagismo passivo domiciliar nos dois grupos de pacientes. RESULTADOS: Estudaram-se 104 pacientes com trauma físico, 50 com fratura e 54 sem fratura. O uso de glicocorticoides ocorreu em 15,4% dos pacientes estudados, sem diferença estatisticamente significante entre os dois grupos. A faixa etária de 10 a 14 anos incompletos, o trauma grave e a prática de exercício físico predominaram entre os pacientes com fratura. CONCLUSÕES: Este estudo não mostrou associação entre o uso prévio de glicocorticoides e a ocorrência de fraturas em crianças e adolescentes. A faixa etária de 10 a 14 anos incompletos, o trauma grave e a prática de exercício físico associaram-se com maior risco para fraturas.

Sociodemographic characteristics, clinical factors, and genetic polymorphisms associated with Alzheimer's disease.

OBJECTIVE: Alzheimer's disease (AD) has a multifactorial etiology involving an interaction of genetic and environmental factors. The Apolipoprotein E ε4 (ApoE ε4) is the single most important genetic risk factor for sporadic AD. Our aim was to study the association between sociodemographic, clinical data and gene polymorphisms in patients with sporadic AD in a heterogeneous genomic Brazilian population with low educational levels. METHODS: We selected 169 sporadic AD patients and 97 controls older than 65 years and compared co-variables between them: age, years of education, vascular risk factors, genomic ancestry, and functional polymorphisms of ApoE, BDNF, COMT, and 5-HTTLPR. We also determined the genomic ancestry of all individuals. RESULTS: The average years of education was significantly smaller in the patient's group (p = 0.003), and they had a history of depression when compared with controls (p < 0.001). The carriers of ApoE ε4 have an earlier onset of the disease (76.9 years) (p = 0.001) than ApoE ε3 (79.5 years) (p = 0.024). Patients with Met allele of Val66Met have a tendency to later onset of disease (p = 0.056). There were no differences in the genomic ancestry between groups. CONCLUSION: Low level of education and history of depression were associated with AD. Public policies and intensive observation of old-age patients with lifetime history of depression, especially APOE ε4 carriers, could improve the well-being of our population.

Morphological aspects of the embryonic development of the TMJ in rats (Rattus norvegicus albinus) treated with fluoxetine / Aspectos morfológicos del desarrollo embrionario de la ATM en ratas (Rattus norvegicus albinus) tratadas con fluoxetina

The TMJ has been to the Dental community a key point in the search of knowledge, being it part of the temporomandibular joint complex and of the estomatognathic system which are in charge of the mastication, speech, swallowing, as well as participation in breathing and taste perception. For the majority of the women in serious state of depression, which do not respond psychotherapeutic treatment, pharmacological treatment it's applied. The antidepressants serotonin selective reuptake inhibitors (SSRIs) are the most recommended in these cases. The teratogenic effect of the SSRIs is considered controversial, studies done with women who used these drugs during the pregnancy showed that the respiratory and central nervous systems are the most affected, was also recorded a deficit of body growth and the decrease of the encephalon and skull measures. In the present study, our goal was to assess whether the administration of Fluoxetine during the pregnancy modified the embryology and morphology of the TMJ of rats. For that, 16 Wistar female rats from the Nutrition Department of the UFPE vivarium were selected; 8 for the control group, which received daily 0.9 percent of saline in subcutaneous dose of 10ml/g, with schedules previously established after daily weighing and 8 for the experimental one that were treated with fluoxetine hydrochloride with the dose of 10mg/Kg in a volume 10ml/g of weight, were injected subcutaneously with the same standards established for the control group. It was observed, with this dose that the embryological development of the TMJ, especially of the mandibular condyle, does not present any difference between the degree of maturation of the tissue that forms the TMJ, especially of the condyle between the treated and control groups.

La ATM ha sido para la comunidad odontológica un punto clave en la búsqueda del conocimiento, dado que forma parte del complejo articular temporomandibular y del sistema estomatognático, los cuales se encargan de la masticación, fonación y deglución, así como la participación en la respiración y de la percepción gustativa. Para la mayoría de las mujeres con cuadros graves de depresión, que no responden al tratamiento psicoterapéutico, el tratamiento farmacológico es aplicado. Los antidepresivos del grupo de los Inhibidores Selectivos de Recaptación de Serotonina (ISRSs) son los más comúnmente recomendados en estos casos. El efecto teratogénico de los ISRSs es considerado controversial. Estudios realizados en mujeres que utilizaron estas drogas durante la gestación mostraron que los sistemas respiratorios y nervioso central son los más afectados, también fue constatado un déficit de crecimiento corporal, encefálico y disminución de las medidas craneales. En el presente estudio, nuestro objetivo fue evaluar si la administración de fluoxetina durante la gestación modifica la embriología y la morfología de la ATM de ratas de laboratorio. Para este fin, 16 ratas Wistar del bioterio de nutrición de la UFPE fueron seleccionadas: 8 para el grupo de control, las cuales recibieron diariamente solución fisiológica a 0,9 por ciento en aplicaciones subcutáneas en la dosis de 10ml/g, en horarios previamente establecidos después de pesaje diario y 8 para el experimental, las que fueron tratadas con clorhidrato de fluoxetina en la dosis de 10mg/kg, en un volumen de 10ml/g, inyectados por vía subcutánea en los mismos estándares establecidos para el grupo de control. Se observó, que con esta dosis el desarrollo embriológico de la ATM, especialmente del cóndilo mandibular, no presentó ninguna diferencia entre el grado de maduración de los tejidos que forman la ATM, especialmente del cóndilo, entre los grupos tratado y grupo control.

Abordagem atual sobre hipertensão arterial sistêmica no atendimento odontológico: [revisão] / Current aproach on arterial sistemic hypertension in dental office: [review]

A hipertensão arterial sistêmica é geralmente um distúrbio assintomático que faz parte das doenças do aparelho circulatório, sendo um importante fator de risco para doenças decorrentes de ateroesclerose e trombose, que se exteriorizam, predominantemente, por acometimento cardíaco, cerebral, renal e vascular periférico. O diagnóstico é basicamente estabelecido pelo encontro de níveis tensionais acima dos limites da normalidade (120/80 mmHg), quando a pressão arterial é determinada através de metodologia adequada e em condições apropriadas. O tratamento médico geralmente consiste no controle da dieta e na utilização de medicações anti-hipertensivas. A importância do conhecimento da hipertensão arterial para o tratamento odontológico reside no fato desta patologia sistêmica ser cionsiderada um fator de risco para estes pacientes durante o atendimento. O paciente hipertenso deve ter sua pressão monitorizada a cada consulta, devendo ser maior o cuidado com a escolha do anestésico, devido à concentração de vasoconstrictor. É recomendado o protocolo de redução de ansiedade, com uso de ansiolíticos, o que vai reduzir o nível de catecolaminas circulantes. O objetivo deste trabalho é realizar revisão de literatura para nortear a prática clínica odontológica.

The arterial systemic hypertension is usually asymptomatic commotion of circulatory system disease and is an important risk factor for illness from atherosclerosis and thrombosis that occurs with cardiac, neurological, renal and peripheral vascular onset. Diagnosis is essentially establlished with a high pression above the normal limit (120/80 mmHg) and the arterial hypertension is measured through an appropriate condition and methodology. The medical management generally consists in an adequate diet and using anti-hypertensive medications. The importance of knowing arterial hypertension in dental compartment is to avoid this risk factor during the consult. Every consult must monitor the arterial pression of theses patients. Moreover, beware with the choice of local anesthetic due to the vasoconstrictor type. It is recommended the reduction anxiety's protocol, with anxyolitics. The objective of this paper is realize a literature review to guide the clinical practice in dentistry.

Health team training and active community surveillance: strategies for the detection of TB cases.

OBJECTIVE: To evaluate the impact that Family Health Program (FHP) team training and active surveillance have on the detection of TB cases in a low-income community in the city of Fortaleza, Brazil. METHODS: The study was performed in an area with approximately 25,000 inhabitants, served by a health care center with five FHP teams, in the city of Fortaleza, Brazil. Although all of the teams were trained, active surveillance was carried out only in one of the areas (area 5). We compared the number of TB cases detected in each of the five areas prior to and after the intervention. We also compared the number of TB cases detected in area 5 to the number of those detected in the other areas, as well as to the citywide number of reported TB cases in Fortaleza, within the same period. RESULTS: The number of TB cases detected in the area studied increased from 1 in 2002 to 22 in 2004 (p < 0.05). There was no significant difference between the number of TB cases in area 5 and that observed for each of the other four areas (p > 0.05). There was a significant increase in the number of TB cases detected in the area studied when compared to the city as a whole (p < 0.05). CONCLUSIONS: Training and sensitization of FHP professionals were effective in promoting an increase in the number of TB cases detected in a low-income community.

Treinamento da equipe de saúde e busca ativa na comunidade: estratégias para a detecção de casos de TB / Health team training and active community surveillance: strategies for the detection of TB cases

OBJETIVO: Avaliar o impacto do treinamento da equipe do Programa Saúde da Família (PSF) e da busca ativa domiciliar na detecção de casos de TB em uma comunidade de baixa renda de Fortaleza. MÉTODOS: Intervenção realizada na área de abrangência de um centro de saúde de Fortaleza, Ceará, com cinco equipes do PSF, responsáveis por cerca de 25.000 pessoas. Treinaram-se todas as equipes de saúde do centro de saúde e implantou-se a busca ativa domiciliar apenas na área de abrangência da Equipe 5. Comparou-se o número de casos detectados em cada uma das cinco áreas antes e depois da intervenção, bem como os casos na área 5 com os das outras áreas e com os casos notificados no município de Fortaleza durante o mesmo período. RESULTADOS: Observou-se um aumento no número de casos de TB detectados na área do estudo: de 1 caso em 2002 para 22 em 2004 (p < 0,005), sem diferença entre a área em que foi feita a busca domiciliar e as outras quatro (p > 0,05). Houve um aumento significativo no número de casos detectados na área do estudo em comparação com aquele no município como um todo (p < 0,05). CONCLUSÕES: O treinamento e a sensibilização da equipe de saúde da família foram capazes de promover um aumento na detecção de casos de TB em uma comunidade de baixa renda.

OBJECTIVE:To evaluate the impact that Family Health Program (FHP) team training and active surveillance have on the detection of TB cases in a low-income community in the city of Fortaleza, Brazil. METHODS: The study was performed in an area with approximately 25,000 inhabitants, served by a health care center with five FHP teams, in the city of Fortaleza, Brazil. Although all of the teams were trained, active surveillance was carried out only in one of the areas (area 5). We compared the number of TB cases detected in each of the five areas prior to and after the intervention. We also compared the number of TB cases detected in area 5 to the number of those detected in the other areas, as well as to the citywide number of reported TB cases in Fortaleza, within the same period. RESULTS: The number of TB cases detected in the area studied increased from 1 in 2002 to 22 in 2004 (p < 0.05). There was no significant difference between the number of TB cases in area 5 and that observed for each of the other four areas (p > 0.05). There was a significant increase in the number of TB cases detected in the area studied when compared to the city as a whole (p < 0.05). CONCLUSIONS: Training and sensitization of FHP professionals were effective in promoting an increase in the number of TB cases detected in a low-income community.

Conhecimento sobre reprodução e sexo seguro de adolescentes de uma escola de ensino médio e fundamental de Fortaleza - Ceará / Knowledge of reproduction and safe sex among teenagers from a highschool in Fortaleza - Ceará

Avalia o conhecimento de adolescentes a respeito da fisiologia do aparelho reprodutor, identifica fatores de risco para infecção por DST/HIV, como a conduta sexual, e avalia a frequência do uso rotineiro de preservativo