Translation, cross-cultural adaptation and validation of the Short Screening Instrument for Psychological Problems in Enuresis for use in Brazil (SSIPPE-Br)

Abstract Objective: Enuresis is associated with attentional and emotional comorbidities in 20 to 30 % of cases. The Short Screening Instrument for Psychological Problems in Enuresis (SSIPPE) is a questionnaire that allows the initial screening of these comorbidities. This study aimed to translate, culturally adapt, and validate the SSIPPE for Brazilian children and adolescents (SSIPPE-Br). Methods: Six steps were performed for translation and cross-cultural adaptation: translation, synthesis of translations, back-translation, preparation of the pre-final version of the translated instrument, test of comprehensibility of the pre-final version of the tool, and elaboration of the instrument cross-culturally adapted for Brazil, named 13-itens version SSIPPE-Br. To validate the SSIPPE-Br, a cross-sectional study was carried out, in which the validated Brazilian version of the Child and Adolescent Behavior Inventory (CABI) was used. Results: Validation was performed on 127 children and adolescents with a mean age of 9.7 ± 2.8 years, 48 % male. The reliability was estimated using Cronbach's alpha, ranging from 0.86 to 0.89, indicating good internal consistency. The factorial analysis had a good agreement adjustment (KMO 0.755, Bartlett's test < 0.001) and explained 70.5 % of the data variability. In the reproducibility analysis, the Kappa coefficient ranged from 0.94 to 1, which can be considered almost perfect. A highly significant (p-value < 0.001) and direct correlation existed between the three SSIPPE-Br domains and all evaluated CABI domains. Conclusion: The SSIPPE-Br is a valid and reliable tool for emotional problems screening and ADHD symptoms in children and adolescents with enuresis whose first language is Brazilian Portuguese.

Translation, cross-cultural adaptation and validation of the Short Screening Instrument for Psychological Problems in Enuresis for use in Brazil (SSIPPE-Br).

OBJECTIVE: Enuresis is associated with attentional and emotional comorbidities in 20 to 30 % of cases. The Short Screening Instrument for Psychological Problems in Enuresis (SSIPPE) is a questionnaire that allows the initial screening of these comorbidities. This study aimed to translate, culturally adapt, and validate the SSIPPE for Brazilian children and adolescents (SSIPPE-Br). METHODS: Six steps were performed for translation and cross-cultural adaptation: translation, synthesis of translations, back-translation, preparation of the pre-final version of the translated instrument, test of comprehensibility of the pre-final version of the tool, and elaboration of the instrument cross-culturally adapted for Brazil, named 13-itens version SSIPPE-Br. To validate the SSIPPE-Br, a cross-sectional study was carried out, in which the validated Brazilian version of the Child and Adolescent Behavior Inventory (CABI) was used. RESULTS: Validation was performed on 127 children and adolescents with a mean age of 9.7 ± 2.8 years, 48 % male. The reliability was estimated using Cronbach's alpha, ranging from 0.86 to 0.89, indicating good internal consistency. The factorial analysis had a good agreement adjustment (KMO 0.755, Bartlett's test < 0.001) and explained 70.5 % of the data variability. In the reproducibility analysis, the Kappa coefficient ranged from 0.94 to 1, which can be considered almost perfect. A highly significant (p-value < 0.001) and direct correlation existed between the three SSIPPE-Br domains and all evaluated CABI domains. CONCLUSION: The SSIPPE-Br is a valid and reliable tool for emotional problems screening and ADHD symptoms in children and adolescents with enuresis whose first language is Brazilian Portuguese.

Brazilian porcupinepox virus infection in a free-ranging neotropical porcupine in Mato Grosso, Brazil.

Although the novel Brazilian porcupinepox virus (BPoPV) can infect wild porcupines, its lethality and zoonotic potential are not well-established. In May 2021, a free-ranging neotropical porcupine (Coendou longicaudatus boliviensis) rescued from the natural savanna in the Brazilian Cerrado, Mato Grosso State, was presented with a lethal poxviral infection. Clinical signs and PCR detection of BPoPV supported the diagnosis. Poxviral lesions included erythema, exfoliative dermatitis, and erosions involving mainly the face, hindlimb, and vulva. Histologically, the lesions consisted of proliferative and necrotic dermatitis, intraepidermal and follicular pustules, and intracytoplasmic inclusion bodies in keratinocytes. Phylogenetic analysis revealed BPoPV strains closely related to other rodent-infecting poxviruses. This poxviral infection resulted in the death of a specimen of C. l. boliviensis; the effect on species conservation, and the potential of spillover into humans and other vertebrates remain unknown.

Antibiotic resistance profiles and activity of clove essential oil (Syzygium aromaticum) against Pseudomonas aeruginosa isolated of canine otitis.

Background and Aim: Pseudomonas aeruginosa is often isolated from acute and chronic otitis and deep pyoderma in dogs. The increase in bacterial resistance to antibiotics induced the need for alternative therapies to treat infections, with an emphasis on essential oils (EOs). This study aimed to investigate clove oil's in vitro bactericidal action as a therapeutic alternative against strains of P. aeruginosa isolated from canine otitis. Materials and Methods: The antibacterial activity of clove oil was evaluated by determining the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) using the broth microdilution technique in 96-well plates. Serial concentrations of 10-0.31% of the oil were used, equivalent to 104.5-3.26 mg/mL. The susceptibility of isolates to different classes of antibiotics was determined by the disk diffusion technique using 20 antibiotics belonging to eight classes. Isolates resistant to at least one antibiotic of three different classes were considered multidrug-resistant (MDR). Results: A high occurrence of resistance was observed for three antibiotics belonging to the cephalosporin classes (cefadroxil, cephalexin, and ceftriaxone), namely, sulfamethoxazole + trimethoprime, doxycycline, and enrofloxacin. The lowest resistance rates were observed for meropenem (4.88%), amikacin (12.20%), and tobramycin (12.2%). All isolates were susceptible to clove oil with an equivalent MIC and MBC from 3.26 to 6.53 mg/mL. Eugenol was the major component of the oil. Conclusion: Clove EO was effective against MDR strains of P. aeruginosa, indicating an alternative for developing an efficient and low-cost antimicrobial agent to treat canine otitis.

Saúde mental da equipe de enfermagem na pandemia da COVID-19 / Mental health of the nursing team in the COVID-19 / Pandemic salud mental del equipo de enfermería en la pandemia de COVID-19

Objetivo: analisar os fatores estressores e de prevenção percebidos pela equipe de enfermagem durante a pandemia da COVID-19 em uma unidade hospitalar darede pública de Fortaleza, Cearáno ano de 2021. Métodos: trata-sede uma pesquisa com abordagem qualitativa e transversal, de caráter descritivo com exposição de dados coletados em campo. Composta pelas duas categorias principais na enfermagem (quatro técnicos de enfermagem e quatro enfermeiros), os participantes responderam a um questionário semiestruturado através de uma entrevista realizada ainda no período da pandemia. Resultados: identificou-seinúmeras formas de definir o adoecimento psíquico e que houve a presença de fatores estressores no período da pandemia do COVID-19: medo, ansiedade, cenário de guerra, mortes e privações. Os participantes relataram o choro como manifestação física do sofrimento e que a pandemia interferiu na saúde mental. Por outro lado, os fatores protetivos ao adoecimento psíquico apresentados foram: o apoio da família, dos amigos e da própria equipe de trabalho, o apoio espiritual e o acompanhamento terapêutico com psicólogo. Destacaram-se ainda a organização e as estratégiasde proteção no trabalho à saúde mental dos profissionais, dentre elas: a relação de trabalho na equipe, a relação pessoal com o paciente e a vacina contra a COVID-19. Considerações finais: os fatores que podem levar ao adoecimento psíquico são múltiplos eos cuidados promovidos para a proteção são mínimos à equipe de enfermagem.Diante disso, destaca-sea relevância do cuidado com a saúde mental, devido aos inúmeros riscos e a sobrecarga de trabalhona enfermagem.

Objective:to analyze the stressors and prevention factors perceived by the nursing team during the COVID-19 pandemic in a public hospital unit in Fortaleza, Ceará in the year 2021. Methods: this is a research with a qualitative and transversal approach, of a descriptive nature with exposition of data collected in the field. Comprising the two main categories in nursing (four nursing technicians and four nurses), the participants answered a semi-structured questionnaire through an interview carried out during the pandemic period. Results:numerous ways of defining psychological illness were identified and that there were stressors in the period of the COVID-19 pandemic: fear, anxiety, war scenario, deaths and deprivations. Participants reported crying as a physical manifestation of suffering and that the pandemic interfered with mental health. On the other hand, the protective factors for mental illness presentedwere: support from family, friends and the work team itself, spiritual support and therapeutic follow-up with a psychologist. The organization and strategies to protect the mental health of professionals at work were also highlighted, among them: the working relationship in the team, the personal relationship with the patient and the vaccine against COVID-19. Final considerations:the factors that can lead to mental illness are multiple and the care provided for protection is minimal for the nursing team. In view of this, the relevance of mental health care is highlighted, due to the numerous risks and work overload in nursing.

Objetivo:analizar losestresores y factores de prevención percibidos por el equipo de enfermería durante la pandemia de COVID-19 en una unidad hospitalaria pública de Fortaleza, Ceará en el año 2021. Métodos:se trata de una investigación con abordaje cualitativo y transversal, de carácter descriptivo naturaleza con exposición de datos recolectados en campo. Compuesto por las dos categorías principales en enfermería (cuatro técnicos de enfermería y cuatro enfermeros), los participantes respondieron un cuestionario semiestructurado a través de una entrevista realizada durante el período de pandemia. Resultados:se identificaron numerosas formas de definir la enfermedad psicológica y que hubo estresores en el período de la pandemia de COVID-19: miedo, ansiedad, escenario de guerra, muertes y privaciones. Los participantes relataron el llanto como una manifestación física de sufrimiento y que la pandemia interfería en la salud mental. Por otro lado, los factores protectores de enfermedad mental presentados fueron: apoyo de familiares, amigos y del propio equipo de trabajo, apoyo espiritual y seguimiento terapéutico con psicólogo. También se destacaron la organización y estrategias para proteger la salud mental de los profesionales en el trabajo, entre ellas: la relación laboral en elequipo, la relación personal con el paciente y la vacuna contra la COVID-19. Consideraciones finales:los factores que pueden conducir a la enfermedad mental son múltiples y los cuidados prestados para la protección son mínimos para el equipo de enfermería. Frente a eso, se destaca la relevancia del cuidado de la salud mental, debido a los numerosos riesgos y sobrecarga de trabajo en enfermería.

Ansiedade e/ou depressão em pessoas com diabetes mellitus tipo 2: uma revisão integrativa / Anxiety and/or depression in people with type 2 diabetes mellitus: an integrative review / Ansiedad y/o depresión en personas con diabetes mellitus tipo 2: una revisión integradora

Objetivo: identificar a prevalência e fatores associados à ansiedade e/ou depressão em pessoas com diabetes mellitus tipo 2 a partir da literatura científica. Métodos: trata-se de uma revisão integrativa da literatura. A busca dos artigos foi realizada por meio das bases de dados disponíveis na Biblioteca Virtual em Saúde e na National Library of Medicine/PubMed, através dos descritores Anxiety, Depression, Diabetes Mellitus e Prevalence. A seleção de artigos se deu mediante aplicação de critérios de inclusão e exclusão. Resultados: foram selecionados 15 artigos para compor a amostra. Dentre os transtornos psiquiátricos, a depressão foi o mais prevalente em pessoas com diabetes mellitus tipo 2 no estudo. Estavam associados à ansiedade e/ou depressão, sexo feminino, idade avançadae complicações relacionadas ao diabetes mellitus tipo 2. Considerações finais: conhecer a prevalência e os fatores associados à depressão e ansiedade em pessoas com diabetes mellitus tipo 2 é importante para conhecer a magnitude do problema, bem como prevenir ou amenizar a sua ocorrência. Uma forma de reduzir o impacto dessas comorbidades psiquiátricas é por meio do diagnóstico e tratamento precoce. Para isso, é fundamental que o profissional atue pautado nos princípios de humanização e integralidade da assistência.

Objective: to identify the prevalence and factors associated with anxiety and/or depression in people with type 2 diabetes mellitus from the scientific literature. Methods:this is an integrative literature review. The search for articles was carried out through the databases available in the Biblioteca Virtual em Saúde and in the National Library of Medicine/PubMed, using the descriptors Anxiety, Depression, Diabetes Mellitus and Prevalence. The selection of articles was done by applying inclusion and exclusion criteria. Results:15 articles were selected to compose the sample. Among psychiatric disorders, depression was the most prevalent in people with type 2 diabetes mellitus in the study. They were associated with anxiety and/or depression, female gender, advanced age and complications related to type 2 diabetes mellitus. Final Considerations:knowing the prevalence and factors associated with depression and anxiety in people with type 2 diabetes mellitus is important to know the magnitude of the problem, as well as preventing or mitigating its occurrence. One way to reduce the impact of these psychiatric comorbidities is through early diagnosis and treatment. For this, it is essential that the professional acts based on the principles of humanization and comprehensive care.

Objetivo: identificar la prevalencia y los factores asociados a la ansiedad y/o depresión en personas con diabetes mellitus tipo 2 a partir de la literatura científica. Métodos:se trata de una revisión integrativa de la literatura. La búsqueda de artículos se realizó a través de las bases de datos disponibles en la Biblioteca Virtual em Saúde y en la National Library of Medicine/PubMed, utilizando los descriptores Anxiety, Depression, Diabetes Mellitus y Prevalence. La selección de artículos se basó en la aplicación de criterios deinclusión y exclusión. Resultados:15 artículos fueron seleccionados para componer la muestra. Entre los trastornos psiquiátricos, la depresión fue la más frecuente en las personas con diabetes mellitus tipo 2 del estudio. Se asociaron con ansiedad y/o depresión, sexo femenino, edad avanzada y complicaciones relacionadas con la diabetes mellitus tipo 2. Consideraciones finales:conocer la prevalencia y los factores asociados a la depresión y la ansiedad en personas con diabetes mellitus tipo 2 es importante para conocer la magnitud del problema, así como para prevenir o mitigar su ocurrencia. Una forma de reducir el impacto de estas comorbilidades psiquiátricas es a través del diagnóstico y tratamiento tempranos. Para ello, es fundamental que el profesionalactúe con base en los principios de humanización y atención integral.

Traumatic brain injury biomarkers in pediatric patients: a systematic review.

Traumatic brain injury (TBI) is the main cause of pediatric trauma death and disability worldwide. Recent studies have sought to identify biomarkers of TBI for the purpose of assessing functional outcomes. The aim of this systematic review was to evaluate the utility of TBI biomarkers in the pediatric population by summarizing recent findings in the medical literature. A total of 303 articles were retrieved from our search. An initial screening to remove duplicate studies yielded 162 articles. After excluding all articles that did not meet the inclusion criteria, 56 studies were gathered. Among the 56 studies, 36 analyzed serum biomarkers; 11, neuroimaging biomarkers; and 9, cerebrospinal fluid (CSF) biomarkers. Most studies assessed biomarkers in the serum, reflecting the feasibility of obtaining blood samples compared to obtaining CSF or performing neuroimaging. S100B was the most studied serum biomarker in TBI, followed by SNE and UCH-L1, whereas in CSF analysis, there was no unanimity. Among the different neuroimaging techniques employed, diffusion tensor imaging (DTI) was the most common, seemingly holding diagnostic power in the pediatric TBI clinical setting. The number of cross-sectional studies was similar to the number of longitudinal studies. Our data suggest that S100B measurement has high sensitivity and great promise in diagnosing pediatric TBI, ideally when associated with head CT examination and clinical decision protocols. Further large-scale longitudinal studies addressing TBI biomarkers in children are required to establish more accurate diagnostic protocols and prognostic tools.

Maternal care and child physical health: Impact of the exposure to adverse experiences during the first year of life of vulnerable children.

INTRODUCTION: Adverse childhood experiences (ACEs) can negatively affect children's current and future health. OBJECTIVES: This study aims to analyse the impact of ACE on the health of 12-month-old infants assessed by a Physical Health and Maternal Care Indicator (ISCM). METHODS: We conducted a retrospective cohort including 170 infants born in two public services for high-risk births in Brazil. ISCM gathers information that reflects maternal care and the child's health throughout the first year of life, such as vaccination, nutrition, growth, illnesses and accidents. The ACE impact on ISCM was analysed by multiple linear regression, and the d-Cohen test estimated its effect size. Spearman's correlation was used to analyse the cumulative ACE effect, measured by a score reflecting events such as family dysfunction, maternal mental health, poverty and exposure to violence. RESULTS: Most infants were born prematurely (71.7%), had low birthweight (64.7%) and were exposed to three ACEs on average. The ISCM was lower in children exposed to maternal depression (P < 0.001, d-Cohen = 0.08), substance abuse by family members (P = 0.02, d-Cohen = 0.6) and marital conflicts (P = 0.03, d-Cohen = 0.7). The Spearman's correlation showed that the greater the exposure to ACEs, the lower the ISCM (r = -0.40, P < 0.0001). CONCLUSION: Exposure to ACE, especially in the family environment, had negative effect on maternal care and child health. The impact could be detected in the first year of life and had cumulative effect. Our findings indicate the need for a broader approach to child health to minimize ACE's impacts.

Sepsis in cougar (Puma concolor) associated with Chromobacterium violaceum.

The genus Chromobacterium is widely distributed in the environment and is composed of Gram-negative, aerobic, or facultative anaerobic bacilli that occur in violet-colored colonies. These bacteria rarely cause infections, but when it occurs, it spreads quickly and has a high mortality. Because diseases are infrequent, the diagnosis is often delayed, and it takes time for suitable treatment to be initiated, leading to increased mortality due to the rapid progression of the disease. After the death of a cougar, serologically positive for feline leukemia virus, at the Center for Medicine and Research on Wild Animals of the Federal University of Mato Grosso, an autopsy was carried out, and fragments of its organs were sent for bacterial culture. Significant lesions were found, mainly in the liver and lungs, and upon bacterial isolation, violet-colored colonies were obtained from all of the referred organs, suggestive of C. violaceum, which was later confirmed by 16S DNA sequencing. The objective of this study was to report a case of death associated primarily with disseminated infection caused by C. violaceum in a FeLV-positive wild cougar in July 2018; no other occurrence in this species has yet been described.

Blunted blood pressure response to exercise and isolated muscle metaboreflex activation in patients with cirrhosis.

We sought to test the hypothesis that the cardiovascular responses to isolated muscle metaboreflex activation would be blunted in patients with cirrhosis. Eleven patients with cirrhosis and 15 healthy controls were evaluated. Blood pressure (BP; oscillometric method), contralateral forearm blood flow (FBF; venous occlusion plethysmography), and heart rate (HR; electrocardiogram) were measured during baseline, isometric handgrip at 30% of maximal voluntary contraction followed by postexercise ischemia (PEI). Forearm vascular conductance (FVC) was calculated as follows: (FBF / mean BP) × 100. Changes in HR during handgrip were similar between groups but tended to be different during PEI (controls: Δ 0.5 ± 1.1 bpm vs. cirrhotic patients: Δ 3.6 ± 1.0 bpm, P = 0.057). Mean BP response to handgrip (controls: Δ 20.9 ± 2.7 mm Hg vs. cirrhotic patients: Δ 10.6 ± 1.5 mm Hg, P = 0.006) and PEI was attenuated in cirrhotic patients (controls: Δ 16.1 ± 1.9 mm Hg vs. cirrhotic patients: Δ 7.2 ± 1.4 mm Hg, P = 0.001). In contrast, FBF and FVC increased during handgrip and decreased during PEI similarly between groups. These results indicate that an abnormal muscle metaboreflex activation explained, at least partially, the blunted pressor response to exercise exhibited by cirrhotic patients. Novelty: Patients with cirrhosis present abnormal muscle metaboreflex activation. BP response was blunted but forearm vascular response was preserved. HR response was slightly elevated.

Clinical-dermatological, histological abnormalities and prevalence of Trypanosoma caninum and Leishmania infantum in dogs from Midwest region of Brazil.

Leishmania infantum is a trypanosomatid that causes parasitic dermatopathy in dogs. Trypanosoma caninum is another trypanosomatid, which infects the skin of dogs, although cutaneous abnormalities are absent. This study aimed to investigate the occurrence of T. caninum infection and its associated cutaneous and histological changes and compare it with the occurrence of L. infantum infection in dogs. The study included 150 dogs, of which T. caninum infection was identified in 3 (2%) and L. infantum infection in 15 (10%) of them, with no association (p>0.05) of these infections with the breed, gender, age, or cutaneous abnormalities. The cutaneous abnormalities were based on 1 (4.8%) and 12 (57.1%) dogs infected by T. caninum and L. infantum, respectively. The dermatohistopathological abnormalities in the dogs infected with T. caninum included mild perivascular lymphohistioplasmacytic infiltrates in the clinically asymptomatic ones, while in those with dermatological abnormalities, acanthosis, epidermal orthokeratotic hyperkeratosis, melanomacrophages, and co-infection with Microsporum sp. and Trichophyton sp. were observed. InL. infantum infected, the histopathological findings included chronic granulomatous inflammatory infiltrates and structures compatible with amastigotes. Despite the low frequency of T. caninum infection, our findings suggest that this trypanosomatid, unlike L. infantum, does not cause any macroscopic skin abnormalities.

Clinical-dermatological, histological abnormalities and prevalence of Trypanosoma caninum and Leishmania infantum in dogs from Midwest region of Brazil / Anormalidades clínico-dermatológicas, histológicas e prevalência de Trypanosoma caninum e Leishmania infantum em cães da região Centro-Oeste do Brasil

Abstract Leishmania infantum is a trypanosomatid that causes parasitic dermatopathy in dogs. Trypanosoma caninum is another trypanosomatid, which infects the skin of dogs, although cutaneous abnormalities are absent. This study aimed to investigate the occurrence of T. caninum infection and its associated cutaneous and histological changes and compare it with the occurrence of L. infantum infection in dogs. The study included 150 dogs, of which T. caninum infection was identified in 3 (2%) and L. infantum infection in 15 (10%) of them, with no association (p>0.05) of these infections with the breed, gender, age, or cutaneous abnormalities. The cutaneous abnormalities were based on 1 (4.8%) and 12 (57.1%) dogs infected by T. caninum and L. infantum, respectively. The dermatohistopathological abnormalities in the dogs infected with T. caninum included mild perivascular lymphohistioplasmacytic infiltrates in the clinically asymptomatic ones, while in those with dermatological abnormalities, acanthosis, epidermal orthokeratotic hyperkeratosis, melanomacrophages, and co-infection with Microsporum sp. and Trichophyton sp. were observed. InL. infantum infected, the histopathological findings included chronic granulomatous inflammatory infiltrates and structures compatible with amastigotes. Despite the low frequency of T. caninum infection, our findings suggest that this trypanosomatid, unlike L. infantum, does not cause any macroscopic skin abnormalities.

Resumo Leishmania infantum é um tripanosomatídeo que causa dermatopatia parasitária em cães. Trypanosoma caninum é outro tripanosomatídeo, que infecta a pele de cães, embora anormalidades cutâneas sejam ausentes. Este estudo teve como objetivo investigar a ocorrência da infecção por T. caninum e suas alterações cutâneas e histológicas associadas e compará-las com a ocorrência da infecção por L. infantum em cães. O estudo incluiu 150 cães, dos quais a infecção por T. caninum foi identificada em 3 (2%) e a infecção por L. infantum em 15 (10%) deles, sem associação (p>0,05) dessas infecções com a raça, sexo, idade ou anormalidades cutâneas. As alterações cutâneas foram observadas em 1 (4,8%) e 12 (57,1%) cães infectados por T. caninum e L. infantum, respectivamente. As anormalidades dermato-histopatológicas nos cães infectados por T. caninum incluíram infiltrados linfo-histioplasmocitários perivasculares leves nos clinicamente assintomáticos, enquanto naqueles com anormalidades dermatológicas, foram observados acantose, hiperqueratose ortoqueratótica epidermal e melanomacrófagos e co-infecção por Microsporum sp. e Trichophyton sp. Nos cães infectados por L. infantum, os achados histopatológicos incluíram infiltrados inflamatórios granulomatosos crônicos e estruturas compatíveis com amastigotas. A despeito da baixa frequência da infecção por T. caninum, nossos achados sugerem que esse tripanosomatídeo, diferentemente de L. infantum, não causa anormalidades macroscópicas na pele.

Vancomycin susceptibility profiles of Staphylococcus spp. isolates from domestic and wild animals / Perfil de suscetibilidade à Vancomicina de isolados de Staphylococcus spp. de animais domésticos e silvestres

ABSTRACT: Staphylococcus spp. are bacteria involved in human and animal infections. They are resistant to antimicrobials and have become a major public health concern. In recent years, there has been a significant increase in methicillin-resistant Staphylococcus strains and vancomycin is the drug of choice for the treatment of such isolates. However, the minimum inhibitory concentration (MIC) of vancomycin ​​necessary to combat this microorganism has been showing an increase. The aim of the present study was to determine the susceptibility profile of the Staphylococcus spp. of domestic and wild animals to vancomycin, using the microdilution in broth and E-test® techniques, as well as comparing the results of both tests. Of the 50 isolates tested, 47 (94 %) were sensitive to vancomycin in the microdilution and 43 (86 %) were sensitive to vancomycin in the E-test®. Seven (14 %) isolates had an intermediate result showing a risk to public health since the detection of these isolates may precede the occurrence of isolates resistant to vancomycin. In addition, the mecA gene was detected in 78 % of the tested samples. Six of the seven isolates with intermediate resistance to vancomycin were carriers of the mecA gene, showing that these isolates had a potential risk of becoming resistant. Thus, control measures must be taken to prevent the spread of these isolates with intermediate resistance and preserve the effectiveness of this antimicrobial for the treatment of infections caused by multiresistant Staphylococcus spp.

RESUMO: Staphylococcus spp. são bactérias envolvidas em infecções de humanos e animais, resistentes a antimicrobianos e tem se tornado uma grande preocupação em saúde pública. Nos últimos anos houve um aumento significativo de Staphylococcus resistentes à meticilina e a vancomicina é a droga de escolha para o tratamento desses isolados, porém vem apresentando elevação nos valores de Concentração Inibitória Mínima (CIM) necessários para combater este microrganismo. O objetivo do presente trabalho foi determinar o perfil de suscetibilidade à vancomicina para isolados de Staphylococcus spp. de animais domésticos e silvestres pelas técnicas de Microdiluição em caldo e E-test®, bem como comparar os resultados de ambos os testes. Dos 50 isolados testados 47 (94%) foram sensíveis à vancomicina na Microdiluição e 43 (86%) foram sensíveis à vancomicina no E-test®. Sete (14%) isolados tiveram resultado intermediário demonstrando um risco à saúde pública visto que a detecção destes isolados pode preceder a ocorrência de isolados resistentes à vancomicina. Ademais o gene mecA foi detectado em 78% das amostras testadas, sendo que dos sete isolados com resistência intermediária à vancomicina, seis eram portadores do gene mecA, evidenciando que esses isolados possuem potencial risco de se tornarem resistentes. Dessa forma medidas de controle devem ser tomadas para evitar a propagação destes isolados com resistência intermediária e preservar a eficácia deste antimicrobiano para o tratamento de infecções causadas por Staphylococcus multirresitentes.

Inflammatory biomarkers in children with cerebral palsy: A systematic review.

BACKGROUND: An exacerbated systemic inflammatory response has been associated with the occurrence of central nervous system injuries that may determine, in long term, motor, sensorial and cognitive disabilities. Persistence of this exacerbated inflammatory response seems to be involved in the pathophysiology of cerebral palsy (CP). METHODS: A systematic search was conducted in Bireme, Embase, PubMed and Scopus including studies that were published until August 2019. The key words used were "cerebral palsy", "brain injury", "inflammation", "oxidative stress", "cytokines", "chemokines", "neuropsychomotor development", "neurodevelopment outcomes" and "child". The quality of the eligible studies was determined according to the criteria suggested by the Newcastle-Ottawa Scale (NOS). RESULTS: Fourteen eligible studies aimed to investigate the association between peripheral inflammatory molecules and neurodevelopment in infants. The studies differed regarding CP-related risk factors and its classification. Inflammatory proteins were measured in blood, plasma, serum, cerebrospinal fluid or urine. In ten studies, higher circulating levels of cytokines, including IL-1ß, IL-6, TNF and CXCL8/IL-8, were associated with abnormal neurological findings. CONCLUSION: The investigation of the potential association between inflammatory molecules and neurological development in children with CP requires further original studies in order to clarify the influence of prenatal and perinatal inflammation on neurological outcomes.

Soluble tumor necrosis factor receptors are associated with severity of kidney dysfunction in pediatric chronic kidney disease.

BACKGROUND: In adult chronic kidney disease (CKD) patients, there is a positive association between inflammation and progressive renal dysfunction. Higher levels of soluble receptors of tumor necrosis factor (sTNFR) have been related to worst prognosis of adult CKD patients. Therefore, the present study aimed to evaluate soluble TNF receptors in children and adolescents with CKD and to search for an association with clinical and laboratory features. METHODS: Demographic, clinical, anthropometric, and laboratory data were evaluated in 34 pediatric patients with CKD and in 34 healthy sex- and age-matched controls. Blood samples were collected in both groups to measure sTNFR by enzyme-linked immunosorbent assay. The modified Schwartz formula was used to estimate glomerular filtration rate (GFR). RESULTS: Pediatric patients with CKD had significantly higher plasma concentrations of soluble TNF receptors types 1 and 2 (sTNFR1 and sTNFR2) in comparison to sex- and age-matched healthy controls. Plasma levels of sTNFR1 and sTNFR2 increased progressively as renal function worsened, being inversely and significantly correlated with GFR (r = - 0.853 for sTNFR1 and GFR, r = - 0.729 for sTNFR2 and GFR). CONCLUSIONS: Children and adolescents with CKD exhibited higher plasma levels of sTNFR1 and sTNFR2 than healthy controls, which increased in relation to renal function deterioration. Plasma levels of sTNFR1 and sTNFR2 emerge as markers of progressive CKD in pediatric patients.

Inflammatory molecules and neurotrophic factors as biomarkers of neuropsychomotor development in preterm neonates: A Systematic Review.

OBJECTIVE: To provide a systematic review investigating the role of inflammatory molecules and neurotrophic factors as biomarkers of neuropsychomotor development in preterm neonates. DATA SOURCE: Databases including PubMed, BIREME, and Scopus were systematically searched. Observational studies, as well as transversal, and cohort studies using human subjects published from 1990 to September 2017 were eligible for inclusion. Two authors independently identified eligible studies and analyzed their characteristics, quality, and accuracy in depth. DATA SYNTHESIS: 11 eligible studies clearly investigated the association between peripheral inflammation and motor and/or cognitive development in preterm infants. However, the selected populations differed in relation to the events associated with prematurity and the risk factors to abnormal motor and/or cognitive development. These studies measured circulating levels of cytokines, chemokines, adhesion molecules, acute phase proteins, and growth factors. The most commonly analyzed proteins were IL-1ß, IL-6, TNF, CCL5/RANTES, CXCL8/IL-8, IGFBP-1, and VEGF. In seven of the eligible studies, plasma levels of IL-6 correlated with development delay. Two studies reported correlation between CXCL8/IL-8 plasma levels with cognitive and motor delay. In one study, higher levels of MCP-1/CCL2 were associated with better cognitive and motor outcome. CONCLUSION: There is preliminary evidence indicating that circulating inflammatory molecules are associated with motor and cognitive development in preterm neonates, even considering different populations.

Urinary Levels of IL-1ß and GDNF in Preterm Neonates as Potential Biomarkers of Motor Development: A Prospective Study.

Objectives. To evaluate the association between inflammatory biomarkers, neurotrophic factors, birth conditions, and the presence of motor development abnormalities in preterm neonates. Methods. Plasma and urinary levels of cytokines (IL-1ß, IL-6, IL-10, TNF, and IL-12p70), chemokines (CXCL8/IL-8, CCL2/MCP-1, CCL5/RANTES, CXCL10/IP-10, and CXCL9/MIG), and neurotrophic factors (BDNF and GDNF) were evaluated in 40 preterm neonates born between 28 and 32 incomplete weeks of gestation, at four distinct time points: at birth (umbilical cord blood) (T0), at 48 (T1), at 72 hours (T2), and at 3 weeks after birth (T3). Biomarkers levels were compared between different time points and then associated with Test of Infant Motor Performance (TIMP) percentiles. Results. Maternal age, plasma, and urinary concentrations of inflammatory molecules and neurotrophic factors were significantly different between groups with normal versus lower than expected motor development. Higher levels of GDNF were found in the group with lower than expected motor development, while IL-1ß and CXCL8/IL-8 values were higher in the group with typical motor development. Conclusion. Measurements of cytokines and neurotrophic factors in spot urine may be useful in the follow-up of motor development in preterm neonates.

Effect of Dental Pigmentation Intensity on the Transenamel and Transdentinal Penetration of Hydrogen Peroxide.

Abastract This study aimed to evaluate the transenamel and transdentinal penetration of hydrogen peroxide (H202) applied to bovine teeth pigmented with black tea at different intensities. The following groups were formed DW: immersion in distilled water; BT100: immersion in an infusion of 1.6 g of black tea per 100 mL distilled water; BT10: immersion in an infusion of 1.6 g black tea per 10 mL distilled water. All groups were immersed for 6 days. To quantify the penetration of H202, the specimens were placed in artificial pulp chambers (APCs) and subjected to bleaching treatment with 38% H2O2 once per week for 3 weeks. After bleaching treatment, the acetate buffer solution of APCs with peroxidase enzyme was evaluated in a reflection spectrophotometer. The transenamel and transdentinal penetration of H2O2 and the L* values obtained at T1, T2 and T3 were subjected to Kruskal-Wallis and Friedman statistical tests. At T1, the H2O2 diffusion in DW was higher than that in BT100 and BT10. At the other evaluation times, the penetration values in BT100 and BT10 increased and remained similar. The L* values increased significantly in all groups at T1. At T2, the L* values were higher in DW, while the values in BT100 and BT10 were similar to each other. At the end of the experiment, BT10 showed the lowest L* values. The pigmentation level did not affect the penetration of H2O2 through the enamel and dentin and the bleaching agent effectively changed the color of the teeth.

Zika virus challenges for neuropsychiatry.

Before 2007, Zika virus (ZIKV) was generally considered as an arbovirus of low clinical relevance, causing a mild self-limiting febrile illness in tropical Africa and Southeast Asia. Currently, a large, ongoing outbreak of ZIKV that started in Brazil in 2015 is spreading across the Americas. Virus infection during pregnancy has been potentially linked to congenital malformations, including microcephaly. In addition to congenital malformations, a temporal association between ZIKV infection and an increase in cases of Guillain-Barré syndrome is currently being observed in several countries. The mechanisms underlying these neurological complications are still unknown. Emerging evidence, mainly from in vitro studies, suggests that ZIKV may have direct effects on neuronal cells. The aim of this study was to critically review the literature available regarding the neurobiology of ZIKV and its potential neuropsychiatric manifestations.

Effect of Dental Pigmentation Intensity on the Transenamel and Transdentinal Penetration of Hydrogen Peroxide

Abastract This study aimed to evaluate the transenamel and transdentinal penetration of hydrogen peroxide (H202) applied to bovine teeth pigmented with black tea at different intensities. The following groups were formed DW: immersion in distilled water; BT100: immersion in an infusion of 1.6 g of black tea per 100 mL distilled water; BT10: immersion in an infusion of 1.6 g black tea per 10 mL distilled water. All groups were immersed for 6 days. To quantify the penetration of H202, the specimens were placed in artificial pulp chambers (APCs) and subjected to bleaching treatment with 38% H2O2 once per week for 3 weeks. After bleaching treatment, the acetate buffer solution of APCs with peroxidase enzyme was evaluated in a reflection spectrophotometer. The transenamel and transdentinal penetration of H2O2 and the L* values obtained at T1, T2 and T3 were subjected to Kruskal-Wallis and Friedman statistical tests. At T1, the H2O2 diffusion in DW was higher than that in BT100 and BT10. At the other evaluation times, the penetration values in BT100 and BT10 increased and remained similar. The L* values increased significantly in all groups at T1. At T2, the L* values were higher in DW, while the values in BT100 and BT10 were similar to each other. At the end of the experiment, BT10 showed the lowest L* values. The pigmentation level did not affect the penetration of H2O2 through the enamel and dentin and the bleaching agent effectively changed the color of the teeth.

Resumo Este estudo teve como objetivo avaliar a penetração trans-amelodentinária do peróxido de hidrogênio (H2O2) aplicados em dentes bovinos pigmentados com chá preto em diferentes intensidades. Divisão dos grupos: AD em água destilada; CP100 em uma infusão de 1,6 g de chá preto para 100 mL de água destilada; CP10 em uma infusão de 1,6 g de chá preto para 10 mL de água destilada. Todos os grupos foram imersos por 6 dias. Para quantificar a penetração de H2O2, as amostras foram colocadas em câmaras pulpares artificiais (CPAs) e submetidas a um tratamento clareador com PH a 38%, uma vez por semana durante 3 semanas. Após o tratamento clareador, a solução tampão de acetato das CPAs com a enzima da peroxidase, foi avaliada num espectrofotômetro de reflexão. A penetração trans-amelodentinária de PH e os valores de L* obtidos em T1, T2 e T3 foram submetidos ao teste estatístico de Kruskal-Wallis e Friedman. Em T1, a difusão de H2O2 no AD foi mais elevada do que em CP100 e CP10. Nos outros tempos de avaliação, os valores de penetração no CP100 e CP10 aumentaram e permaneceram semelhantes. Os valores L* aumentaram significativamente em todos os grupos no T1. No T2, os valores L* foram maiores no AD e os valores em CP100 e CP10 foram semelhantes entre si. No último tempo, o CP10 apresentou os menores valores de L*. Diferentes níveis de pigmentação não afetaram a penetração de H2O2 através do esmalte e dentina e o agente de clareador foi eficaz na alteração cromática.