Gardnerella pickettii sp. nov. (formerly Gardnerella genomic species 3) and Gardnerella greenwoodii sp. nov. (formerly Gardnerella genomic species 8) isolated from female urinary microbiome.

During an ongoing female urinary microbiome research study, strains c17Ua_112T and c31Ua_26T isolated from urine samples of a patient diagnosed with overactive bladder and a healthy postmenopausal woman, respectively, could not be allocated to any Gardnerella species with valid names. In this work, we aimed to characterize these strains. The 16S rRNA gene sequences confirmed that these strains are members of the genus Gardnerella. Phylogenetic analysis based on cpn60 strongly supported two clades, one encompassing c17Ua_112T and nine other strains from the public database, and the other including c31Ua_26T and three other strains, which were distinct from currently recognized species of the genus Gardnerella. Likewise, the phylogenomic tree also showed that strains c17Ua_112T and c31Ua_26T formed independent and robust clusters. Average nucleotide identity (ANI) and digital DNA-DNA hybridization (dDDH) values between c17Ua_112T and c31Ua_26T were 79.27 and 27.4 %, respectively. Strain c17Ua_112T showed the highest ANI (94.8 %) and dDDH values (59.8 %) with Gardnerella piotii UGent 18.01T, and strain c31Ua_26T revealed highest ANI (84.2 %) and dDDH (29.1 %) values with Gardnerella swidsinskii GS 9838-1T. Based on the data presented here, the two strains c17Ua_112T and c31Ua_26T represent two novel species of the genus Gardnerella, for which the names Gardnerella pickettii (c17Ua_112T=DSM 113414T=CCP 71T) and Gardnerella greenwoodii (c31Ua_26T=DSM 113415T=CCP 72T) are proposed.

Resting-state fMRI functional connectivity and clinical correlates in Afro-descendants with schizophrenia and bipolar disorder.

Schizophrenia (SCZ) and bipolar disorder (BD) exhibited altered activation in several brain areas, including the prefrontal and temporal cortex; however, a less explored topic is how brain connectivity and functional disturbances occur in non-Caucasian samples of SCZ and BD. Individuals with SCZ (n=20), BD (n=21), and healthy controls (HC, n=21) from indigenous and African ethnicity were submitted to clinical screening and functional assessments. Mood, compulsive and psychotic symptoms were also correlated to network dysfunction in each group. Two distinct networks' subcomponents demonstrated significant lower global efficiency (GE) in SCZ versus HC, corresponding to left posterior dorsal attention and medial left ventral attention (VA) networks. Lower GE was found in BD versus controls in four subcomponents, including the left medial and right VA. Higher compulsion scores correlated in BD with lower GE in the left VA, whereas increased report of alcohol abuse was associated with higher GE in left default mode network. Although preliminary, differences in the activation of specific networks, notably the left hemisphere, in SCZ versus controls, and lower activation in VA areas, in BD versus controls. Results highlight default mode and salient network as relevant for the emotional processing of SCZ and BD of indigenous and black ethnicity. Abstract: schizophrenia, bipolar disorder, functional neuroimaging, ethnicity, default network.

Radiolucent image in lower third molar: hidden caries or pre-eruptive resorption?: a case report / Imagem radiolucente em terceiro molar inferior: cárie oculta ou reabsorção pré-eruptiva?: um relato de caso

ABSTRACT Caries is a multifactorial disease due to the imbalance of the de/re-mineralization process. Complementary radiographic examinations are able to detect hidden caries. The purpose of this short communication was to investigate the radiolucent image suggestive of hidden caries in lower third molar. The extraction of the tooth, decalcification, inclusion and preparation were performed for histological analysis of the lesion. Histological findings revealed a pre-eruptive resorption, and the etiological factors of this coronary resorption were undefined. The professional should be aware of the occurrences of these lesions to early diagnose and propose appropriate treatment to avoid future complications to the patient.

RESUMO A cárie é conceituada como uma doença multifatorial condicionada ao desequilíbrio no processo de desmineralização e remineralização das estruturas dentárias. O propósito desse trabalho foi investigar a imagem radiolúcida sugestiva de cárie oculta em terceiro molar. Foi realizado a exodontia do elemento dentário, descalcificação e confecção de lâminas para posterior estudo histológico da lesão. O achado histológico conclui-se tratar de uma reabsorção pré-eruptiva. O profissional deve estar atento às ocorrências dessas lesões para diagnosticar precocemente e propor o tratamento adequado, evitando complicações futuras ao paciente.

Urinary Microbiome of Reproductive-Age Asymptomatic European Women.

The knowledge of bacterial species diversity within the female urinary microbiome (FUM) is essential for understanding the role of the FUM in urinary tract health and disease. This study aimed to characterize the bacterial species diversity of the FUM of asymptomatic reproductive-age European women by combining extended culturomics and long-read sequencing of the near-full-length 16S rRNA gene. A total of 297 bacterial species (median of 53 species/sample) were identified, yet only 22% of the species were detected by both culture and sequencing methods. Recently recognized Gardnerella, Lactobacillus, and Limosilactobacillus species and 5 new putative Corynebacterium species were identified by culturomics, while anaerobic species (e.g., 11 Peptoniphilus spp.) were mostly detected by amplicon sequencing. Notably, there was not a single species common to all samples, although members of the genus Lactobacillus were detected in all. Lactobacillus crispatus, Lactobacillus iners, and Lactobacillus mulieris were observed in high relative abundance in several samples, as well as other species (e.g., Streptococcus agalactiae, Fannyhessea vaginae, Gardnerella vaginalis, Gardnerella swidsinskii), while low-abundance members (e.g., Finegoldia magna) were often more prevalent. A moderate correlation (Mantel test; r = 0.5) between community structure types captured by culturomics and amplicon sequencing was observed, highlighting the benefit of combining both methodologies. This study provided a detailed FUM structure at the species level, which is critical to unveil the potential relationship between specific microbiome members and urinary diseases/disorders. Moreover, the different capacity to characterize microbiome profiles of culturomic and amplicon sequencing is described, providing valuable insights for further urinary microbiome studies. IMPORTANCE The bacterial species diversity within the female urinary microbiome (FUM) has been insufficiently characterized. This study demonstrated that complementarity between optimized culture-dependent and -independent approaches is highly beneficial for comprehensive FUM species profiling by detecting higher FUM species diversity than previously reported, including identification of unreported species belonging to the genera Lactobacillus, Limosilactobacillus, and Latilactobacillus and putative novel Corynebacterium species. Although some species were present in high relative abundance, low-abundance members were more prevalent. FUM classification into community structure types demonstrated high interindividual differences in urinary microbiome composition among asymptomatic women. We also report moderate correlation between culture-dependent and -independent derived data-highlighting drawbacks of each methodological approach. Our findings suggest that FUM bacterial diversity reported from previous studies may be underestimated. Finally, our results contribute to the fundamental knowledge of the FUM required for further exploration of the urinary microbiome role in urinary tract diseases.

Dramatic secukinumab-mediated improvements in refractory leprosy-related neuritis via the modulation of T helper 1 (Th1) and T helper 17 (Th17) immune pathways.

A 39-year-old woman was diagnosed with relapsed multibacillary leprosy and refractory neuritis. Here, we describe an evident loss of therapeutic effectiveness after the third pulse of corticosteroids, which may be attributed to tachyphylaxis and the posterior modulation of interferon- γ (IFN-γ), tumor necrosis factor- α (TNF-α,) interleukin-17A (IL-17A), and IL-12/23p40 after the induction phase of secukinumab. In this case, plasma cytokine analysis showed that secukinumab induced a reduction in IL-17 concomitant with impressive clinical improvements in the patient's neural function. Interestingly, secukinumab induced reductions in cytokines related to Th1 responses and earlier stages of the Th17 response, including IL-23/12.

Dramatic secukinumab-mediated improvements in refractory leprosy-related neuritis via the modulation of T helper 1 (Th1) and T helper 17 (Th17) immune pathways

Abstract A 39-year-old woman was diagnosed with relapsed multibacillary leprosy and refractory neuritis. Here, we describe an evident loss of therapeutic effectiveness after the third pulse of corticosteroids, which may be attributed to tachyphylaxis and the posterior modulation of interferon- γ (IFN-γ), tumor necrosis factor- α (TNF-α,) interleukin-17A (IL-17A), and IL-12/23p40 after the induction phase of secukinumab. In this case, plasma cytokine analysis showed that secukinumab induced a reduction in IL-17 concomitant with impressive clinical improvements in the patient's neural function. Interestingly, secukinumab induced reductions in cytokines related to Th1 responses and earlier stages of the Th17 response, including IL-23/12.

Antinociceptive Effect of the Essential Oil of Schinus terebinthifolius (female) Leaves on Adult Zebrafish (Danio rerio).

Schinus terebinthifolius Raddi (Anacardiaceae) is popularly known in Brazil as aroeira-da-praia and has pharmacological use as an astringent, antidiarrheal, anti-inflammatory, depurative, diuretic, and antifebrile agent. Although the neuropathic antinociceptive potential of S. terebinthifolius fruits has already been investigated, this study is the first one to analyze the acute antinociceptive effect of the essential oil of S. terebinthifolius (female) leaves (EOFSt) on adult zebrafish. EOFSt was submitted to antioxidant activity evaluation by two methods (ferrous ion-chelating capacity [FIC] and ß-carotene). The animals (n = 6/group) were treated orally (20 µL) with EOFSt (0.1, 0.5, or 1.0 mg/mL) or vehicle (0.9% sodium chloride [NaCl]; 20 µL), and submitted to nociception (formalin, cinnamaldehyde, capsaicin, glutamate, acidic saline, and hypertonic saline). Possible neuromodulation mechanisms, as well motor alterations and toxicity were also evaluated. In the FIC assay, EOFSt showed ferrous ion-chelating capacity in ∼40% to 90%. Regarding the ß-carotene bleaching assay, EOFSt showed inhibition in a 58% to 80% range. Oral administration of EOFSt showed no acute toxicity and did not alter the locomotor system of aZF, and reduced the nociceptive behavior in all tested models. These effects of EOFSt were significantly similar to those of morphine, used as a positive control. The antinociceptive effect of EOFSt was inhibited by naloxone, L-NAME, ketamine, camphor, ruthenium red, and amiloride. The antinociceptive effect of the EOFSt cornea was inhibited by capsazepine. EOFSt has the pharmacological potential for acute pain treatment and this effect is modulated by the opioid system, NMDA receptors, and transient receptor potential ankyrin 1 (TRPA1), transient receptor potential vanilloid 1 (TRPV1), and acid-sensing ion channels. The EOFSt also has the pharmacological potential for corneal pain treatment and this effect is modulated by the TRPV1 channel.

Práticas interdisciplinares no enfrentamento da COVID-19 na estratégia saúde da família / Interdisciplinary practices in coping with covid-19 in the family health strategy

Objetivo: Descrever as experiências de residentes multiprofissionais na Estratégia Saúde da Família acerca da aplicação de ações interdisciplinares no enfrentamento do novo Coronavírus. Método: Estudo descritivo, do tipo relato de experiência realizado por residentes multiprofissionais do núcleo Saúde da Família em uma Estratégia Saúde da Família. O estudo foi desenvolvido em três fases: levantamento das problemáticas enfrentadas pela equipe; formulação do plano de contingência local com base a teoria da interdisciplinaridade e implementação das ações. Resultados: Evidenciou-se uma maior adesão da população as recomendações da equipe de saúde, observados na demarcação do fluxo de indivíduos que mostrou bons resultados, reduzindo o risco da transmissão viral entre pacientes e os profissionais da saúde, bem como possibilitou uma diminuição significativa da permanência dos usuários na unidade de modo que a população continuasse a ser assistida, garantindo a segurança de todos os atores envolvidos. Considerações finais: As práticas interdisciplinares têm se destacado nos mais diversos serviços de saúde como método de ascensão essencial para gestores, profissionais de saúde e estudantes na produção de relações mais atuantes de forma integrada no campo da saúde como um todo, principalmente no enfrentamento da pandemia. (AU)

Objective: To describe the experiences of multiprofessional residents in the Family Health Strategy regarding the application of interdisciplinary actions for coping with the new Coronavirus. Method: This is an experience report by multiprofessional Family Health residents. The descriptive study was developed in three phases: the first, the survey of the problems faced by the team; the second stage was the formulation of a local contingency plan based on the theory of interdisciplinarity and the third was the implementation of these actions. Results: The population adherence to the recommendations from the health team was observed in the demarcation of the flow of individuals. Which showed good results, reducing the risk of viral transmission among patients and health professionals, as consequence of a significant decreased in permanence of users in the unit. Additionally, the population continues to be assisted, ensuring the safety of all actors involved. Conclusion: Interdisciplinary practices have stood out in the most diverse health services as an essential ascension method for managers, health professionals and students in the production of more active relationship in an integrated manner in the field of health as a whole, especially of coping with the pandemic. (AU)

Objetivo: Describir las experiencias del equipo de profesionales multidisciplinario en la Estrategia de Salud Familiar con respecto a la aplicación de acciones interdisciplinarias para enfrentar el nuevo Coronavirus. Método: Un estudio descriptivo, un informe de experiencia realizado por profesionales de la Unidad de Salud de la Familia. El estudio fue desarrollado en tres fases: la primera, la encuesta de los problemas que enfrenta el equipo; la segunda etapa fue la formulación del plan de contingencia local basado en la teoría de la interdisciplinariedad y la tercera fue la implementación de acciones. Resultados: Se observó una mayor adherencia de la población a las recomendaciones del equipo de salud, observada en la demarcación del flujo de individuos que mostró buenos resultados, reduciendo el riesgo de transmisión viral entre pacientes y profesionales de la salud, así como permitiendo una disminución significativa en permanencia de los usuarios en la unidad para que la población continúe siendo asistida, garantizando la seguridad de todos los actores involucrados. Conclusión: Las prácticas interdisciplinarias se han destacado en los servicios de salud más diversos como un método esencial para los gerentes, profesionales de la salud y estudiantes en la producción de relaciones más activas de manera integrada en el campo de la salud en general, y especialmente en este contexto para enfrentar la pandemia. (AU)

Genotoxic endpoints in a Pb-accumulating pea cultivar: insights into Pb2+ contamination limits.

Lead (Pb) persists among the most hazardous contaminant metals. Pb-induced genotoxic effects remain a matter of debate as they are a major cause of plant growth impairment, but assessing Pb genotoxicity requires the selection of Pb-sensitive genotoxic biomarkers. Seedlings of the ecotoxicological model species Pisum sativum L. were exposed to Pb2+ (≤ 2000 mg L-1). Flow cytometry (FCM) revealed that 28 days after, Pb2+ arrested root cell cycle at G2 but no eu/aneuploidies were found. Comet assay and FCM-clastogenicity assays showed that Pb2+ increased DNA breaks in roots at concentrations as low as 20 mg L-1. Leaves showed no variation in DNA-ploidy or cell cycle progression but had increased DNA breaks at the highest Pb2+ dose. We conclude that both Comet assay and the full-peak coefficient of variation (FPCV) were the most relevant endpoints of Pb-phytogenotoxicity. Also, the Pb-induced DNA breaks may be related with the arrest at the G2-checkpoint. Data will be relevant to better define Pb2+ ecogenotoxicological effects and their measuring tools and may contribute to a regulatory debate of this pollutant limits.

Tempo de jejum para exames e as implicações no estado nutricional de pacientes hospitalizados / Fasting time for examinations and implications on the nutritional status of hospitalized patients

Introdução: O comprometimento do estado nutricional em pacientes hospitalizados pode ser desencadeados por diversos fatores, podendo está relacionado com o tempo de jejum prolongado. O jejum extenso para realizações de exames implica em queixas, além de riscos de desequilíbrio hidroeletrolítico, metabólico e nutricional. Objetivo: Avaliar o tempo de jejum para exames e o estado nutricional através de indicadores antropométricos e bioquímicos de pacientes internalizados em um hospital universitário do Nordeste brasileiro. Métodos: Trata-se de um estudo transversal, com pacientes internados em um hospital universitário, no período de março à junho de 2015. Os pacientes foram avaliados em dois momentos distintos: no período que antecede o jejum para o primeiro exame e no momento da alta hospitalar. Foi avaliado o estado nutricional dos pacientes utilizando métodos de triagem nutricional, dados antropométricos, bioquímicos, tempo de internamento, número de episódios em que o paciente ficou em jejum e diagnóstico que motivou o internamento. Os dados foram analisados no programa SPSS 18.0. A Avaliação da evolução nutricional da amostra foi realizada através do teste de 't' de Student e o teste 't'pareado, a associação foi verificada por meio do teste de Correlação de Pearson. Para os resultados foi considerado o nível de significância de 5%. Resultados: Foram analisados 34 pacientes com uma média de idade de 50,4 ± 16,4 anos, sendo 53% do sexo masculino. Os principais diagnósticos de internação foram doenças infectocontagiosas (26,5%) e câncer (23,5%). Encontrou-se uma proporção elevada de pacientes desnutridos por meio da ASG e MAN. O tempo médio de internação foi 18 ± 9 dias e foi observado que esse tempo se correlacionou com IMC final dos adultos (r = 0,830; p <0,001) e idosos (r = 0,990; p <0,001). O tempo de jejum para exames foi aproximadamente 13,84 ± 3,65 horas e esse se correlacionou com IMC final dos adultos (r=0,602; p <0,001). Conclusões: Observou-se que o tempo médio de jejum para exames foi superior ao preparo convencional, a amostra demostrou elevada prevalência de desnutrição e o estudo revela a importância do desenvolvimento de novos trabalhos relacionados ao jejum para exames e a influência no estado nutricional em pacientes hospitalizados e a complementaridade dos métodos aplicados, para prevenir as complicações associadas a desnutrição e permitir a implementação precoce da terapia nutricional (AU)

Introduction: Nutritional state commitment of hospitalized patients can be onset by several factors, potentially related to prolonged fasting periods. The prolonged fasting for examinations implies in complaints, besides hydroelectric unbalance, metabolic and nutritional risk. Goal: Evaluate fasting periods for exams and nutritional state through anthropometric and biochemical indicators in hospitalized patients from a teaching hospital in the northeast of Brazil. Methods: The current study has a transversal model with hospitalized patients in a teaching hospital, during the period between March to June of 2015. Patients were evaluated in two distinct moments: the period before fasting for the first examination and in hospital discharge. Nutritional state of patients were estimated using nutritional screening, anthropometric and biochemical data, hospitalization period, number of episodes in which the patient was submitted to fasting and admission diagnostic. Data were analyzed in SPSS 18.0 software. The Nutritional State Evaluation of the sample was carried out by paired Student t test, association was verified by Pearson Correlation test, considering significance level of 5%. Results: 34 patients were analyzed with an average age of 50.4 ± 16.4 years, being 53% male. The main admission diagnostic were infectious diseases (26.5%) and cancer (23.5%). A high proportion of malnourished patients was found using SGA and MNA. The average hospitalization period was of 18 ± 9 days and it was seen that this period was directly related to final BMI of adults (r = 0.830; p < 0.001) and elderlies (r = 0.990; p < 0.001). Fasting periods for examinations was around 13.84 ± 3.65 hours and this was related to final adult BMI (r = 0.602; p < 0.001). Conclusions: Average fasting period in the exams was superior to conventional, the sample showed a high prevalence of malnourishment and the study highlights the importance of further developing research on fasting for exams and the influence in nutritional state in hospitalized patients besides the relevance of methods used in prevention of complications associated to malnourishment which would further allow the implementation of early nutritional therapy (AU)

Adequação do suporte nutricional em pacientes em uso de terapia nutricional enteral / Nutritional support adequacy in patients under enteral nutritional therapy

Introdução: Pacientes críticos necessitam de um intenso cuidado na oferta de nutrientes devido a estados hipercatabólicos, que comumente levam a prejuízos nutricionais. Objetivo: Analisar, através de indicadores antropométricos e bioquímicos, a evolução nutricional e adequação do suporte nutricional em pacientes críticos em Terapia Nutricional Enteral exclusiva. Métodos: Estudo transversal realizado com pacientes de dois hospitais públicos de Aracaju-SE. Os pacientes foram avaliados em dois momentos: no início e ao final da Terapia Nutricional Enteral. Foram aferidos o peso e a estatura ou estimados por equações preditivas nos acamados. Mediram-se também as circunferências do braço e da panturrilha. Para avaliar a adequação de calorias e macronutrientes foram calculadas as Necessidades Energéticas Estimadas e utilizados os valores de referência de ingestão da Acceptable Macronutrient Distribution Range/ Dietary Reference Intakes e estes foram comparados com a média de valores prescritos. O percentual ≥ 90% foi utilizado como meta para a oferta calórica. Foi adotado um nível de significância de 95% ou p<0,05. Resultados: A amostra foi composta por 50 pacientes. Os diagnósticos mais frequentes foram Hipertensão Arterial Sistêmica, Traumatismo Crânio-Encefálico e Diabetes Mellitus. Apenas 30% dos pacientes atingiram as necessidades energéticas na avaliação inicial, evoluindo para 38% na final. Houve diferença significativa entre a média calórica inicial e final (p = 0,013) e na oferta de carboidratos (p = 0,000) e proteínas (p = 0,000). O percentual médio de adequação calórica inicial foi 73,44%, evoluindo para 79,77%. Discussão: O paciente hospitalizado, frequentemente, se encontra em estado hipermetabólico, tal estado acompanhado de déficit na oferta energética pode participar da gênese ou do agravo do comprometimento nutricional. Conclusão: Encontrou-se um percentual de adequação de calorias inferior à meta. Foram observados baixos valores médios das circunferências mensuradas, indicando a presença de desnutrição nos pacientes do estudo (AU)

Introduction: Critical patients need intensive care on their nutrient income due to hypercatabolic state, which commonly lead to nutritional impairment. Objective: To analyze through anthropometric and biochemical indicators, the nutritional status and adequacy of nutritional support in critically ill patients under exclusive Enteral Nutritional Therapy. Methods: Cross-sectional study of patients from two hospitals of Aracaju-SE, was carried out. Patients were evaluated at two times: at the beginning and the end of Enteral Nutritional Therapy. Weight and height were measured or estimated by predictive equations for the case of bedridden patients. Arm and calf circumferences were measured. To assess the adequacy of calories and macronutrients intake, caloric goal was calculated taking into account the reference values for intake presented at Acceptable Macronutrient Distribution Range/ Dietary Reference Intakes and these were compared with the mean prescribed values. Target for energy intake was considered ≥ 90%. A significance level of 95% or p <0.05 was adopted. Results: The sample consisted of 50 patients. The most frequent diagnoses were systemic hypertension, Traumatic Brain Injury and Diabetes Mellitus. Only 30% of patients met the needs at the initial assessment, by the end this 38% met the calorie intake adequacy. There was a significant difference between the initial and final average caloric intake (p = 0.013) and for carbohydrate (p = 0.000) and protein (p = 0.000) delivery. The average percentage of initial caloric adequacy was 73.44%, evolving to 79.77%. Discussion: Hospitalized patients are frequently in hypermetabolic state, which followed by a deficit in energy delivery can contribute for genesis or the increase in nutritional impairment. Conclusion: A percentage of calories adequacy lower than the target was found. Low values of circumferences measurements indicating the presence of malnutrition in the patients studied were also seen (AU)

Correlation between nutritional, hematological and infectious characteristics and classification of the type of epidermolysis bullosa of patients assisted at the Dermatology Clinic of the Hospital Universitário de Brasília.

Epidermolysis bullosa comprises a group of phenotypically different genodermatosis, hereditary or acquired, characterized by skin fragility and subsequent formation of blisters in response to mechanical trauma, and which may also affect mucous membranes. This study aimed to analyze the relation between the nutritional, hematologic, infectious characteristics and the type of epidermolysis bullosa, through a descriptive case study based on data from medical records of 10 patients with epidermolysis bullosa assisted regularly at the Dermatology Clinic of the Hospital Universitário de Brasília. The old classification of the type of epidermolysis bullosa, weight and height, blood count, white blood cell count, platelet count and description of the type and frequency of secondary infections during the service were considered. We verified a predominance of iron deficiency anemia, chronic leukocytosis, thrombocytosis, chronic malnutrition, low height for age and thinness, and people with epidermolysis bullosa simplex exhibited appropriate relation between height/age and BMI/age. The non-specific skin infection was the most prevalent in both sexes. The severity of the type of epidermolysis bullosa and frequency of secondary infections did not form a directly proportional relation. The absence of direct proportion in all cases between the type of epidermolysis bullosa and the analysis parameters suggest a possible significant interference from other aspects such as the extent of the affected skin area, extracutaneous type of engagement and specific genetic mutation. The inclusion of these factors in the new classification proposed by Fine et al can contribute significantly to a better correlation of clinical parameters and appropriate preventive and therapeutic approaches.

Antioxidant potential and cytotoxic activity of two red seaweed species, Amansia multifida and Meristiella echinocarpa, from the coast of Northeastern Brazil.

Natural antioxidants found in marine macroalgae are bioactive compounds known to play an important role in the prevention of diseases associated with aging cells protecting them against the oxidative damage. The purpose of this study was to evaluate the antioxidant and cytotoxic activity of ethanolic extracts of two species of red seaweeds, Amansia multifida and Meristiella echinocarpa. In vitro antioxidant activity was determined by DPPH radical scavenging assay, ferric-reducing antioxidant power (FRAP) assay, ferrous ion chelating (FIC) assay, ß-carotene bleaching (BCB) assay and total phenolic content (TPC) quantification. Cytotoxicity was evaluated with the brine shrimp Artemia sp. lethality test. The TPC values observed in the present study indicated that both species A. multifida and M. echinocarpa are rich in phenolic compounds, reaching values of 45.40 and 28.46 mg gallic acid equivalent (GAE) g-1 of ethanolic extract, respectively. DPPH radical scavenging and ferrous ion chelating showed values of 60% and 17%, respectively. Both seaweed extracts inhibited ß-carotene oxidation by approximately 40%. None of the algal extracts were potentially cytotoxic. The results have showed that extracts of both species of marine red algae exhibit antioxidant potential and low toxicity. They are sources of natural antioxidant compounds.

Pyoderma gangrenosum leading to bilateral involvement of ears.

Pyoderma gangrenosum is a destructive inflammatory disease that commonly occurs in an idiopathic way. Its occurrence in the auricular area is very rare, although this fact does not seem to determine a different behavior of the disease with regard to ulcer aspects and response to treatment. The authors report the case of a patient with pyoderma gangrenosum affecting both earlobes. The patient responded well to treatment with oral prednisone and has not shown relapses after a six-month follow-up.

The use of ablative lasers in the treatment of facial melasma.

Melasma represents a pigmentary disorder that is difficult to treat. This study aims to broadly review the use of ablative lasers (Er:YAG and CO2) in the treatment of melasma, presenting the level of evidence of studies published to date. A total of 75 patients were enrolled in four case series studies (n=39), one controlled clinical trial (n=6) and one randomized controlled clinical trial (n=30). Studies on the Er:YAG laser showed better results with the use of short square-shaped pulses, which determined low rates of post-inflammatory hyperpigmentation and long-lasting maintenance of results. Likewise, studies on the CO2 laser proved the benefits of short pulse duration along with low-density energy. Post-treatment maintenance with the use of antipigmenting creams was necessary and effective to sustain long-term results. Ablative lasers may represent another useful and effective tool against melasma. Postinflammatory hyperpigmentation and difficulty in sustaining long-term results still represent the main limitations to a broader use of ablative lasers. Based on actual evidence, the use of this technology should be restricted to patients with recalcitrant disease. Further studies will help establish optimal laser parameters and treatment regimens.

The use of ablative lasers in the treatment of facial melasma / O uso de lasers ablativos no tratamento do melasma facial

Melasma represents a pigmentary disorder that is difficult to treat. This study aims to broadly review the use of ablative lasers (Er:YAG and CO2) in the treatment of melasma, presenting the level of evidence of studies published to date. A total of 75 patients were enrolled in four case series studies (n=39), one controlled clinical trial (n=6) and one randomized controlled clinical trial (n=30). Studies on the Er:YAG laser showed better results with the use of short square-shaped pulses, which determined low rates of post-inflammatory hyperpigmentation and long-lasting maintenance of results. Likewise, studies on the CO2 laser proved the benefits of short pulse duration along with low-density energy. Post-treatment maintenance with the use of antipigmenting creams was necessary and effective to sustain long-term results. Ablative lasers may represent another useful and effective tool against melasma. Postinflammatory hyperpigmentation and difficulty in sustaining long-term results still represent the main limitations to a broader use of ablative lasers. Based on actual evidence, the use of this technology should be restricted to patients with recalcitrant disease. Further studies will help establish optimal laser parameters and treatment regimens.

O melasma representa desordem pigmentar de difícil tratamento. O presente estudo tem como propósito apresentar ampla revisão da literatura acerca do uso de laser ablativos (Er:YAG e CO2) no tratamento do melasma, estabelecendo o nível de evidência dos estudos publicados até o instante. Um total de 75 pacientes foram envolvidos entre quatro séries de casos (n=39), um ensaio clínico controlado (n=6) e um ensaio clínico controlado e randomizado (n=30). Os estudos acerca do laser de Er:YAG demonstraram melhores resultados com o uso de pulsos de forma quadrada, os quais determinaram menores taxas de hiperpigmentação pós-inflamatória. Ademais, os estudos com laser de CO2 também demonstraram benefício no uso de pulsos curtos com baixa densidade de energia. O uso de cremes despigmentantes no período pós-tratamento se mostrou necessária e efetiva na manutenção de resultados à longo prazo. Os lasers ablativos, por conseguinte, podem representar ferramenta efetiva e de grande utilidade no manejo do melasma. Entretanto, hiperpigmentação pós-inflamatória e dificuldade na manutenção de resultados à longo prazo parecem representar as principais limitações atuais ao seu amplo uso. Por conseguinte, com base nas atuais evidências, o uso de tais tecnologias ainda deve ser restrita à casos de doença recalcitrante. Novos estudos ainda são necessários para o estabelecimento de parâmetros e regimes ideais de tratamento.

Gerenciamento de riscos e segurança no trabalho em unidades de saúde da família / Risk management and work safety in family health units

Objetivo: Caracterizar os riscos ocupacionais existentes no ambiente de trabalho que interferem na segurança e saúde de profissionais que atuam na rede de Unidades de Saúde da Família no município de João Pessoa-PB, Brasil. Material e Métodos: Estudo exploratório realizado em nove unidades de saúde do Distrito Sanitário III, no período de novembro de2011 a janeiro de 2012, envolvendo 36 profissionais. Na coleta de dados, utilizou-se um roteiro de entrevista semi estruturado. Para análise do material empírico, adotaram se procedimentos de estatística descritiva. Resultados: Constou-se que 66% dos riscos ocupacionais segundo os participantes são biológicos e físicos e 44% das causas de acidentes são atribuídas a riscos psicossociais, mecânicos e ergonômicos. Conclusão: Os profissionais estão expostos às situações de risco de diferentes naturezas pela não utilização de medidas adequadas de biossegurança, sendo necessário desenvolver um programa de gestão de risco e segurança para vencer os obstáculos a adesão de precauções padrão.

Objective: To characterize existing occupational hazards inthe workplace that might affect the safety and health ofprofessionals working in the Family Health Units Network inthe city of João Pessoa, Brazil. Material and Methods: Thiswas an exploratory study performed in nine health units ofthe Sanitary District III from November 2011 to January 2012, For data collection, we used a semi-structured interview script. For the empirical analysis,we adopted descriptive statistics procedures. Results: We verified that according to participants 66% of the occupational hazards were of biological and physical nature, and 44% of the causes of accidents were attributed to psycho social, mechanical and ergonomic risks. Conclusion: The professionals are exposed to hazards of different nature bynot following appropriate biosecurity measures. Thus, it is necessary to develop a program for risk management and work security to overcome such barriers hindering compliance to default precautions.

Sequential anaerobic/aerobic treatment of dye-containing wastewaters: colour and COD removals, and ecotoxicity tests.

Colour and COD removals of the azo dyes Congo Red (CR) and Reactive Black 5 (RB5) were individually evaluated in a sequential anaerobic/aerobic treatment system. Additionally, dye toxicity was assessed by using acute ecotoxicity tests with Daphnia magna as the indicator-organism. The anaerobic reactor was operated at approximately 27 °C and with hydraulic retention times of 12 and 24 h. The aerobic reactor was operated in batch mode with a total cycle of 24 h. During anaerobic step, high colour removals were obtained, 96.3% for CR (400 mg/L) and 75% for RB5 (200 mg/L). During the aerobic phase, COD effluent was considerably reduced, with an average removal efficiency of 52% for CR and 85% for RB5, which resulted in an overall COD removal of 88% for both dyes. Ecotoxicity tests with CR revealed that the anaerobic effluent presented a higher toxicity compared with the influent, and an aerobic post-treatment was not efficient in reducing toxicity. However, the results with RB5 showed that both anaerobic and aerobic steps could decrease dye toxicity, especially the aerobic phase, which removed completely the toxicity in D. magna. Therefore, the anaerobic/aerobic treatment is not always effective in detoxifying dye-containing wastewaters, sometimes even increasing dye toxicity.

Associação de gravidez na adolescência e prematuridade / Association of pregnancy in adolescence and prematurity

OBJETIVO: Analisar a associação da gravidez na adolescência com prematuridade. MÉTODOS: Foram incluídas todas as pacientes que pariram num hospital terciário universitário do Maranhão, no período de julho a dezembro de 2006, alocando-as em dois grupos: adolescentes (10 a 19 anos de idade) e adultas (20 a 34 anos). As variáveis estudadas foram: escolaridade, situação conjugal, número de consultas no pré-natal, idade gestacional no início do pré-natal, duração da gestação, tipo de parto e peso ao nascer. Os dados foram processados no programa Epi-Info, versão 3.4.1, e foram analisadas as associações entre as variáveis pela razão dos produtos cruzados, a odds ratio (OR), com intervalo de confiança (IC) de 95 por cento; utilizaram-se também modelos de regressão logística. O nível de significância adotado foi de 0,05. RESULTADOS: Foram avaliadas 1.978 pacientes. Verificou-se frequência de 25,4 por cento de partos em adolescentes, que apresentaram baixa escolaridade, ausência de companheiro, menor número de consultas no pré-natal, início tardio do pré-natal, baixo peso ao nascer (BPN) e prematuridade. Realizando a análise, tendo como variável desfecho a prematuridade, verificou-se nítida associação com baixo número de consultas do pré-natal (OR 3,0; IC95 por cento 2,2-4,0) e início tardio do pré-natal (OR 1,9; IC95 por cento 1,3-2,6), baixa escolaridade (OR 1,9; IC95 por cento 1,4-2,5) em relação com a adolescência (OR 1,5; IC95 por cento 1,1-1,9). As adolescentes tiveram menor incidência de cesárea (33,3 por cento) que as adultas (49,4 por cento), com diferença significativa, além de menor associação com pré-eclâmpsia e desproporção cefalopélvica. CONCLUSÕES: A gravidez na adolescência esteve associada a início tardio do pré-natal e baixo número de consultas pré-natal, além de baixa escolaridade, BPN, prematuridade e menor incidência de desproporção cefalopélvica e pré-eclâmpsia.

PURPOSE: To analyze the association of pregnancy in adolescence and prematurity. METHODS: The study included all the patients who delivered at a teaching hospital in Maranhão State, from July to December 2006. The patients were divided into two groups: adolescents (10 to 19 years old) and adults (20 to 34 years old). The variables studied were: educational level, marital status, number of prenatal visits, gestational age at the onset of prenatal care, duration of gestation, delivery route and birth weight. Statistical analysis was performed using the Epi-Info software, version 3.4.1, and the associations between variables were analyzed by the odds ratio (OR), with a 95 percent confidence interval (CI). Models of logistic regression were also used. The level of significance adopted was 0.05. RESULTS: The study evaluated 1,978 patients. The frequency of deliveries in adolescents was 25.4 percent. This group presented low educational level, no mates, low number of prenatal visits, late onset of prenatal care, low birth weight and prematurity. In the analysis of prematurity as the outcome variable, there was a clear association with low number of prenatal visits (OR 3.0; 95 percentCI 2.2-4.0) and late onset of prenatal care (OR 1.9; 95 percentCI 1.3-2.6) and low educational level (OR 1.9; 95 percentCI 1.4-2.5) related to adolescence (OR 1.5; 95 percentCI 1.1-1.9). The incidence of caesarean delivery was significantly lower among adolescents (33.3 percent) than among adults (49.4 percent), with a lower association with pre-eclampsia and cephalo-pelvic disproportion. CONCLUSIONS: Pregnancy in adolescence was associated with late onset of prenatal care and low number of visits, as well as low educational level, low birth weight, prematurity and a lower incidence of cephalo-pelvic disproportion and pre-eclampsia.

Teores de β-caroteno em suplementos e biomassa de Spirulina / Contents of β-carotene in supplements and biomass of Spirulina

A cianobactéria Spirulina tem sido utilizada há séculos, tendo em vista suas propriedades nutricionais e medicinais. Neste trabalho, objetivou-se analisar os teores de β-caroteno tanto em suplementos alimentares a base de Spirulina comercializados em estabelecimentos de produtos naturais no mercado varejista, quanto em S. platensis cultivada em laboratório. Alguns pigmentos carotenóides possuem atividade de vitamina A e, dentre eles, o β-caroteno é o que apresenta maior atividade biológica. A extração de β-caroteno foi feita com metanol:água (90:10 v/v), seguida de saponificação e partição em n-hexano. As análises cromatográficas foram realizadas em coluna Waters Spherisorb S5 ODS 2 (4,6 x 250 mm), usando metanol:tetrahidrofurano (90:10, v/v) bombeado a 2 mL min-1, com registro dos cromatogramas em 450 nm. Os suplementos alimentares a base de Spirulina apresentaram baixos teores de β-caroteno. A maior concentração foi encontrada em S. platensis cultivada a 24º C com fotoperíodo de 16 h claro e 8 h escuro. Considerando sua atividade provitamínica, os teores de retinol equivalente (RE) nas microalgas analisadas no presente trabalho foram calculados a partir do β-caroteno para classificá-las como fonte excelente ou fonte útil de vitamina A.

Spirulina is a cyanobacterium that has been used for several centuries due to its nutritional and medicinal properties. This work has evaluated the contents of β-carotene both in Spirulina commercialized as food supplement, purchased from natural product shops, and in S. platensis reared under laboratory conditions. Some carotenoids exhibit pro-vitamin A activity, and β-carotene presents the greatest biological activity. β-Carotene of microalgae was extracted in 90 percent aqueous methanol. These extracts were saponified and partitioned in n-hexane. Chromatographic analyses were carried out in a Spherisorb column S5 ODS 2 (4.6 x 250 mm), with a mobile phase of methanol:tetrahydrofuran (90:10, v/v) delivered at 2 mL min-1 and chromatograms registered at 450 nm absorbance. Food supplement made with Spirulina presented low content of β-carotene. The highest content of β-carotene was detected in S. platensis cultivated under 24º C with photoperiod of 16 h light and 8 h dark. Considering its pro-vitamin activity, retinol equivalent (RE) was calculated from β-carotene to determine whether alga material could be claimed as an useful or an excellent source of the vitamins A.