Fatores associados ao baixo apgar em recém-nascidos angolanos / Factors associated with low apgar in angolan newborn / Factores asociados con apgar bajo en recién nacidos angolanos

Objetivo:avaliar os fatores associados ao baixo Apgar em recém-nascidos de Angola. Método:estudo analíticoe transversal, quali-quantitativo, em umHospital Geral de Luanda, Angola, entre março e maio de 2021. Realizou-se entrevistas em sala de observação e consulta aos prontuários das parturientes. Os dados foram analisados pelo teste qui-quadrado (X2) e regressão logística. Resultados:prevaleceu parturientes entre 19-35 anos (70,0%), 7º-9º ano (57,5%), multíparas (75%), multigestas (75,0%), sem histórico de aborto (72,5%), idade gestacional de 40 semanas (60,0%), usuárias de bebidas alcoólicas (77,5%), baixa frequência de consultas pré-natais (52,5%), com parto natural (82,5%) e recém-nascidos com peso normal (52,5%). Mulheres de região periurbana [OR:6,85 (95% CI:0.65-71,2), p=0,108] e rural [OR:4,47 (95% CI:0.47-48,4), p=0,184] apresentaram maior chance de terem recém-nascidos com baixo Apgar, assim como as usuárias de álcool [OR:3,28 (95% CI:0,58-18,3), p=0,176] e recém-nascidos que nasceram com peso normal [OR:1,75 (95% CI:0,49­6,22), p=0,387]. Não houve associação estatística entre os dados sociodemográficos e maternos. Conclusão:a faixa etária, local de residência, consumo de álcool materno e peso do recém-nascido podem implicar em baixo Apgar.

Objective: to evaluate the factors associated with low Apgar in newborns in Angola. Method:analytical and cross-sectional, quali-quantitative study, in a General Hospital in Luanda, Angola, between March and May 2021. Interviews were carried out in an observation room and consultation of the parturients' medical records. Data were analyzed using the chi-square test (X2) and logistic regression.Results: pregnant women aged 19-35 years (70.0%), 7th-9th year(57.5%), multiparous (75%), multiparous (75.0%), without a history of abortion (72.5%), prevailed. gestational age of 40 weeks (60.0%), users of alcoholic beverages (77.5%), low frequency of prenatal consultations (52.5%), with natural childbirth (82.5%) and newborns with normal weight (52.5%). Women from peri-urban regions [OR:6.85 (95% CI:0.65-71.2), p=0.108] and rural [OR:4.47 (95% CI:0.47-48.4), p=0.184] were more likely to have low Apgar newborns, as well as alcohol users [OR:3.28 (95% CI:0.58-18.3), p=0.176] and newborns who were born with normal [OR:1.75 (95% CI:0.49­6.22), p=0.387]. There was no statistical association between sociodemographic and maternal data.Conclusion: age group, place of residence, maternal alcohol consumption and newborn weight may imply low Apgar.

Objetivo: evaluar los factores asociados al Apgar bajo en recién nacidos en Angola.Método: estudio analítico y transversal, cuali-cuantitativo, en un Hospital General de Luanda, Angola, entre marzo y mayo de 2021. Se realizaron entrevistas en sala de observación y consulta de las historias clínicas de las parturientas. Los datos se analizaron mediante la prueba de chi-cuadrado (X2) y regresión logística. Resultados: gestantes de 19 a 35 años (70,0%), de 7° a 9° año (57,5%), multíparas (75%), multíparas (75,0%), sin antecedente de aborto (72,5%), predominó la edad gestacional de 40 semanas (60,0%), usuarias de bebidas alcohólicas (77,5%), baja frecuencia de consultas prenatales (52,5%), con parto natural (82,5%) y recién nacidos con normopeso (52,5%). Las mujeres de regiones periurbanas [OR:6,85 (IC 95%:0,65-71,2), p=0,108] y rurales [OR:4,47 (IC 95%:0,47-48,4), p=0,184] tenían más probabilidades de tener bajo Recién nacidos Apgar, así como consumidores de alcohol [OR:3,28 (IC 95%:0,58-18,3), p=0,176] y recién nacidos que nacieron con normalidad [OR:1,75 (IC 95%:0,49-6,22), p=0,387]. No hubo asociación estadística entre datos sociodemográficos y maternos. Conclusión: el grupo de edad, el lugar de residencia, el consumo materno de alcohol y el peso del recién nacido pueden implicar un Apgar bajo.

Whole Tooth Regeneration: Can Animal Studies be Translated into Clinical Application?

Tooth loss leads to several oral problems and although a large number of treatments have been proposed to rehabilitate partially or totally edentulous patients, none of them is based on replacement of a missing tooth by a new natural whole tooth. In the field of tissue engineering, some animal models have been developed to regenerate a natural tooth in the oral cavity. This review shows the state of the art in whole tooth regeneration based on data from in vivo studies. A systematic scoping review was conducted to evaluate studies that described whole-tooth regeneration and eruption in the oral cavity. The data demonstrated that over 100 animals were used in experimental studies and all of them received implants of tooth germs constructed by bioengineering processes. Mini pigs and pigs were used in four studies followed by mice (n = 1) and dog (n = 1). Over 58 (44%) animals showed whole tooth eruption around 3.5 months after tooth germ implantation (1 to 13.5 months). Most of specimens revealed the presence of odontoblasts, dentin, dentinal tubules, dental pulp, root analogue, cementum, blood vessels, and alveolar bone. It could be concluded that in vivo whole tooth regeneration was proved to be possible, but the challenge to overcome translational barriers and test these approaches in humans still remains. Impact Statement Advances in tissue engineering have led to the development of new methods to regenerate and replace tissues and organs, including teeth. Tooth regeneration is the main goal for the replacement of tooth loss and therefore current evidence showed that tissue engineering might provide this treatment in future.

The Influence of Recombinational Processes to Induce Dormancy in Trypanosoma cruzi.

The protozoan Trypanosoma cruzi is the causative agent of Chagas disease, a neglected tropical disease that affects around 8 million people worldwide. Chagas disease can be divided into two stages: an acute stage with high parasitemia followed by a low parasitemia chronic stage. Recently, the importance of dormancy concerning drug resistance in T. cruzi amastigotes has been shown. Here, we quantify the percentage of dormant parasites from different T. cruzi DTUs during their replicative epimastigote and amastigote stages. For this study, cells of T. cruzi CL Brener (DTU TcVI); Bug (DTU TcV); Y (DTU TcII); and Dm28c (DTU TcI) were used. In order to determine the proliferation rate and percentage of dormancy in epimastigotes, fluorescent-labeled cells were collected every 24 h for flow cytometer analysis, and cells showing maximum fluorescence after 144 h of growth were considered dormant. For the quantification of dormant amastigotes, fluorescent-labeled trypomastigotes were used for infection of LLC-MK2 cells. The number of amastigotes per infected LLC-MK2 cell was determined, and those parasites that presented fluorescent staining after 96 h of infection were considered dormant. A higher number of dormant cells was observed in hybrid strains when compared to non-hybrid strains for both epimastigote and amastigote forms. In order to investigate, the involvement of homologous recombination in the determination of dormancy in T. cruzi, we treated CL Brener cells with gamma radiation, which generates DNA lesions repaired by this process. Interestingly, the dormancy percentage was increased in gamma-irradiated cells. Since, we have previously shown that naturally-occurring hybrid T. cruzi strains present higher transcription of RAD51-a key gene in recombination process -we also measured the percentage of dormant cells from T. cruzi clone CL Brener harboring single knockout for RAD51. Our results showed a significative reduction of dormant cells in this T. cruzi CL Brener RAD51 mutant, evidencing a role of homologous recombination in the process of dormancy in this parasite. Altogether, our data suggest the existence of an adaptive difference between T. cruzi strains to generate dormant cells, and that homologous recombination may be important for dormancy in this parasite.

Sistematização da assistência de enfermagem no pós-operatório imediato de cirurgias ortopédicas / Nursing care systematization in the immediate postoperative period after orthopedic surgeries

Objetivos: descrever os principais diagnósticos de enfermagem à luz da teoria das necessidades humanas básicas, proposta por Wanda de Aguiar Horta, segundo a taxonomia da NANDA-I, e propor intervenções e resultados de acordo com a Nursing Interventions Classification (NIC) e a Nursing Outcomes Classification(NOC) para os 5 diagnósticos de enfermagem mais frequentes documentados em um serviço de recuperação pós-anestésica de um hospital de referência em traumatologia. Método: estudo quantitativo, transversal, retrospectivo, descritivo de registro dos principais diagnósticos de enfermagem identificados em prontuários, sendo constituído por 3 etapas: construção do instrumento de coleta de dados; coleta de dados; e processamento e análise dos dados. Resultados: os 5 diagnósticos mais frequentes foram: Risco de infecção(100%); Integridade da pele prejudicada (96,9%); Integridade tissular prejudicada (93,8%); Dor aguda (87,9%);e Déficit no autocuidado para banho/higiene (69,2%). Conclusão: os diagnósticos contribuíram para melhor aplicabilidade do processo de enfermagem de forma individual e holística, para que possam ser implementadas intervenções com resultados mais específicos e direcionados às necessidades prioritárias desses pacientes.

Effects of a peripheral enamel margin on the long-term bond strength and nanoleakage of composite/dentin interfaces produced by self-adhesive and conventional resin cements.

PURPOSE: This study evaluated the effects of peripheral enamel margins on the long-term bond strength (µTBS) and nanoleakage in resin/dentin interfaces produced by self-adhesive and conventional resin cements. MATERIALS AND METHODS: Five self-adhesive [RelyX-Unicem (UN), RelyX-U100 (UC), GCem (GC), Maxcem (MC), Set (SET)] and 2 conventional resin cements [RelyX-ARC(RX), Panavia F(PF)] were used. An additional group included the use of a two-step self-etching adhesive (SE Bond) with Panavia F (PS). One hundred ninety-two molars were assigned to 8 groups according to luting material. Five-mm-thick composite disks were cemented and assigned to 3 subgroups according to water-exposure condition (n = 6): 24-h peripheral exposure (24h-PE-enamel margins), or 1 year of peripheral (1 yr-PE) or direct exposure (1 yr-DE-dentin margin). Restored teeth were sectioned into beams and tested in tension at 1 mm/min. Data were analyzed by two-way ANOVA and Tukey's test. Two additional specimens in each group were prepared for nanoleakage evaluation. Nanoleakage patterns were observed under SEM/TEM. RESULTS: Except for RX, no significant reduction in µTBS was observed between 24h-PE and 1 yr-PE. 1 yr-DE reduced µTBS for RX, PF, GC, MC, and SET. No significant reduction in µTBS was observed for PS, UC, and UN after 1 year. After 1 yr-DE, RX and PS presented the highest µTBS, and SET and MC the lowest. Nanoleakage was reduced when there was a peripheral enamel margin. SET and MC presented more silver deposition than other groups. CONCLUSION: The presence of a peripheral enamel margin reduced the degradation rate in resin/dentin interfaces for most materials. The µTBS values produced by the multi-step luting agents RX and PS were significantly higher than those observed for self-adhesive cement.

A utilidade da broncofibroscopia em pacientes submetidos à ventilação mecânica em uma unidade de terapia intensiva de um hospital universitário. Análise de 109 exames. / Utility of fiberoptic bronchoscopy in ventilated patients in a unit care intensive of university hospital. Analysis of 109 procedures.

Introdução: a pneumonia associada à ventilação mecânica (PAVM) contribui para a morbi-mortalidade e para os custos relacionados aos cuidados de pacientes criticamente enfermos. O objetivo deste trabalho foi avaliar o impacto e a utilidade clínica da broncofibroscopia (BFC) com lavado broncoalveolar (LBA) na evolução clínica para pacientes com PAVM. Materiais e métodos: os resultados de 109 exames broncoscópicos foram retrospectivamente analisados. Entre 1 de Janeiro e 31 de dezembro de 2001, oitenta e nove pacientes em VM e suspeita clínica de PAVM internados na Unidade de Terapia Intensiva do Hospital Universitário Clementino Fraga Filho da Universidade Federal do Rio de Janeiro foram submetidos a BFC com LBA. As amostras coletadas foram submetidas à cultura quantitativa. Considerou-se pneumonia quando havia crescimento superior a 10 4 e 10 5 UFC/ml no LBA e aspirado traqueal, respectivamente. Foram avaliados a evolução clínica e o número de casos cuja antibioticoterapia foi modificada como consequência do resultado da cultura, além da mortalidade. Resultados: Pseudomas aeruginosa (21/61), Acinetobacter calcoaceticus (9/61) e em 69% (61/88) episódios suspeitos de PAVM. Os resultados do LBA propiciaram troca na antibioticoterapia empírica em 52% (46/88) casos. A mortalidade total foi de 62,9% (56/89). Conclusão: o diagnóstico etiológico da PAVM obtido através da BFC com LBA modificou a conduta em um significativo número de casos.

Introduction: ventilator-associated pneumonia (VAP) contributes to the morbidity, mortality, and costs of caring for critically ill patients. Objective: evaluate clinical utility of bronchoalveolar lavage (BAL) for patients with VAP. Materials and methods: the results of 109 bronchoscopic procedures were studied. Between January 1, 2001 and December 31, 2001 eight nine mechanically ventilated patients with clinical suspicion of VAP in the Intensive Care Unit of Hospital Universitário Clementino Fraga Filho da Universidade Federal do Rio de Janeiro were underwent to a bronchoscopy with bronchoalveolar lavage (BAL). Samples collected were cultured quantitatively. Pneumonia was considered if the growth of bacteria was > 10 4 UFC/ml in BAL or > 10 UFC/ml in tracheal aspiration. Outcome variables studied included the change of the antibiotic because the result of culture were sisolated more frequently from patients with VAP. Bacterial pneumonia was diagnosed in 69% (61/88) suspected VAP episodes. The antibiotic prescription was changed in 52% (46/88) cases because the BAL results. Overall mortality was 63%. Conclusion: the etiologic diagnosis of VAP obtained through bronchoscopy with modified the antibiotic prescription in a significant number of cases.