Tratamento de má oclusão de Classe II por meio de distalização sequencial posterior com alinhadores ortodônticos ClearCorrect / Treatment of Class II malocclusion through upper distalization with ClearCorrect aligners

Resumo A segunda mais prevalente má oclusão de Angle na população é a de Classe II. Dentre as abordagens de tratamento consideradas pelos profissionais, está a distalização dos dentes posteriores superiores ou exodontias. A distalização, dependendo do nível de complexidade do caso, pode ser desafiadora e necessitar de mecânicas auxiliares para realizar movimentos translacionais e não somente de inclinação coronária. A escolha da abordagem para esses tratamentos depende diretamente da colaboração do paciente, severidade da má oclusão, caracterização da Classe II, idade do paciente e habilidade técnica do profissional responsável. Com o aumento da procura por tratamentos ortodônticos mais estéticos, os alinhadores ortodônticos têm sido frequentemente uma alternativa aos pacientes. Dependendo da severidade da má oclusão, pode-se associar aos auxiliares comumente utilizados na Ortodontia convencional fixa. Portanto, o objetivo deste trabalho é apresentar a resolução de uma má oclusão de Classe II, divisão 1, com impactação do canino superior direito e desvio de linha média superior para a direita tratada com alinhadores ortodônticos ClearCorrect. (AU)

Abstract The second more prevalent Angle's malocclusion on the population is Class II. Among the continuously considered treatment approaches by clinicians, is the distalization of upper teeth or extractions. The distalizations, depending on the case's complexity, can be challenging and need auxiliary mechanics to perform translation movements and not just crown tipping. The choose of the appliance for these treatments relies directly on the option/collaboration of the patient, malocclusion severeness, patient's age, and technical ability of the main professional taking care of the case. With the crescent search for more aesthetic orthodontic treatments, the clear aligners have been frequently looked for by the patients as an alternative and, regularly related to auxiliaries commonly associated to the conventional fixed appliances. Regarding this context, the objective of this study is to present the case report of a patient with Class II, division 1, upper midline deviation to the right and unerupted upper right canine through the ClearCorrect aligners' system. (AU)

VPS38/UVRAG and ATG14, the variant regulatory subunits of the ATG6/Beclin1-PI3K complexes, are crucial for the biogenesis of the yolk organelles and are transcriptionally regulated in the oocytes of the vector Rhodnius prolixus.

In insects the reserve proteins are stored in the oocytes into endocytic-originated vesicles named yolk organelles. VPS38/UVRAG and ATG14 are the variant regulatory subunits of two class-III ATG6/Beclin1 PI3K complexes that regulate the recruitment of the endocytic (complex II) and autophagic (complex I) machineries. In a previous work from our group, we found that the silencing of ATG6/Beclin1 resulted in the formation of yolk-deficient oocytes due to defects in the endocytosis of the yolk proteins. Because ATG6/Beclin1 is present in the two above-described PI3K complexes, we could not identify the contributions of each complex to the yolk defective phenotypes. To address this, here we investigated the role of the variant subunits VPS38/UVRAG (complex II, endocytosis) and ATG14 (complex I, autophagy) in the biogenesis of the yolk organelles in the insect vector of Chagas Disease Rhodnius prolixus. Interestingly, the silencing of both genes phenocopied the silencing of ATG6/Beclin1, generating 1) accumulation of yolk proteins in the hemolymph; 2) white, smaller, and yolk-deficient oocytes; 3) abnormal yolk organelles in the oocyte cortex; and 4) unviable F1 embryos. However, we found that the similar phenotypes were the result of a specific cross-silencing effect among the PI3K subunits where the silencing of VPS38/UVRAG and ATG6/Beclin1 resulted in the specific silencing of each other, whereas the silencing of ATG14 triggered the silencing of all three PI3K components. Because the silencing of VPS38/UVRAG and ATG6/Beclin1 reproduced the yolk-deficiency phenotypes without the cross silencing of ATG14, we concluded that the VPS38/UVRAG PI3K complex II was the major contributor to the previously observed phenotypes in silenced insects. Altogether, we found that class-III ATG6/Beclin1 PI3K complex II (VPS38/UVRAG) is essential for the yolk endocytosis and that the subunits of both complexes are under an unknown transcriptional regulatory system.

Silencing of RpATG6 impaired the yolk accumulation and the biogenesis of the yolk organelles in the insect vector R. prolixus.

In oviparous animals, the egg yolk is synthesized by the mother in a major metabolic challenge, where the different yolk components are secreted to the hemolymph and delivered to the oocytes mostly by endocytosis. The yolk macromolecules are then stored in a wide range of endocytic-originated vesicles which are collectively referred to as yolk organelles and occupy most of the mature oocytes cytoplasm. After fertilization, the contents of these organelles are degraded in a regulated manner to supply the embryo cells with fundamental molecules for de novo synthesis. Yolk accumulation and its regulated degradation are therefore crucial for successful development, however, most of the molecular mechanisms involved in the biogenesis, sorting and degradation of targeted yolk organelles are still poorly understood. ATG6 is part of two PI3P-kinase complexes that can regulate the recruitment of the endocytic or the autophagy machineries. Here, we investigate the role of RpATG6 in the endocytosis of the yolk macromolecules and in the biogenesis of the yolk organelles in the insect vector Rhodnius prolixus. We found that vitellogenic females express high levels of RpATG6 in the ovaries, when compared to the levels detected in the midgut and fat body. RNAi silencing of RpATG6 resulted in yolk proteins accumulated in the vitellogenic hemolymph, as a consequence of poor uptake by the oocytes. Accordingly, the silenced oocytes are unviable, white (contrasting to the control pink oocytes), smaller (62% of the control oocyte volume) and accumulate only 40% of the yolk proteins, 80% of the TAG and 50% of the polymer polyphosphate quantified in control oocytes. The cortex of silenced oocytes present atypical smaller vesicles indicating that the yolk organelles were not properly formed and/or sorted, which was supported by the lack of endocytic vesicles near the plasma membrane of silenced oocytes as seen by TEM. Altogether, we found that RpATG6 is central for the mechanisms of yolk accumulation, emerging as an important target for further investigations on oogenesis and, therefore, reproduction of this vector.

Uso irracional e resistência a antimicrobianos em hospitais / Irrational use of antimicrobials and resistance in hospitals

Os antimicrobianos são uma das classes de medicamentos mais prescritas em todo o mundo. São utilizados para inibir ou combater o crescimento de determinados microrganismos, mas quando são indicados sem necessidade ou com imprecisão, facilitam o desenvolvimento da resistência bacteriana. Atualmente, os antimicrobianos estão entre os fármacos mais prescritos em hospitais, e uma das consequências mais importantes do uso indiscriminado é a resistência bacteriana. Visando contribuir com medidas que facilitem o controle do problema, este trabalho teve como objetivo, analisar o uso racional de antimicrobianos e a resistência bacteriana em hospitais, através de estudo bibliográfico. As causas que levam a não efetividade de tratamento com antimicrobiano se deve a diversos fatores como, prescrição inadequada, erro na dose, posologia e/ou tempo de tratamento, escolha inapropriada, entre outros. Medidas preventivas devem ser tomadas, como conscientização dos prescritores, determinação de protocolos e cursos de atualização, bem como uma maior fiscalização dos órgãos competentes e comissões atuante nesta área como a CCIH.

Antimicrobials are one of the most widely prescribed drug classes in the world. They are used to inhibit or combat the growth of some microorganisms, but if prescribed unnecessarily or inaccurately, they can help develop bacterial resistance. Currently, antimicrobials are among the most prescribed drugs in hospitals, and one of the most important consequences of its indiscriminate use is bacterial resistance. This paper aimed to analyze the rational use of antimicrobials and the bacterial resistance in hospitals by carrying out a bibliographic review. There are several factors that lead to non-effective antimicrobial treatments, among them unsuitable prescribing, dosage, treatment time, inappropriate choice of drugs. Preventive measures should be taken, such as awareness of prescribers, definition of protocols and refresher courses, as well as greater oversight of relevant bodies and committees acting in this area such as CCIH.

Eggshell ultrastructure and delivery of pharmacological inhibitors to the early embryo of R. prolixus by ethanol permeabilization of the extraembryonic layers.

Most vectors of arthropod-borne diseases produce large eggs with hard and opaque eggshells. In several species, it is still not possible to induce molecular perturbations to the embryo by delivery of molecules using microinjections or eggshell permeabilization without losing embryo viability, which impairs basic studies regarding development and population control. Here we tested the properties and permeability of the eggshell of R. prolixus, a Chagas disease vector, with the aim to deliver pharmacological inhibitors to the egg cytoplasm and allow controlled molecular changes to the embryo. Using field emission scanning and transmission electron microscopy we found that R. prolixus egg is coated by three main layers: exochorion, vitelline layer and the plasma membrane, and that the pores that allow gas exchange (aeropiles) have an average diameter of 10 µm and are found in the rim of the operculum at the anterior pole of the egg. We tested if different solvents could permeate through the aeropiles and reach the egg cytoplasm/embryo and found that immersions of the eggs in ethanol lead to its prompt penetration through the aeropiles. A single five minute-immersion of the eggs/embryos in pharmacological inhibitors, such as azide, cyanide and cycloheximide, solubilized in ethanol resulted in impairment of embryogenesis in a dose dependent manner and DAPI-ethanol solutions were also able to label the embryo cells, showing that ethanol penetration was able to deliver those molecules to the embryo cells. Multiple immersions of the embryo in the same solutions increased the effect and tests using bafilomycin A1 and Pepstatin A, known inhibitors of the yolk proteolysis, were also able to impair embryogenesis and the yolk protein degradation. Additionally, we found that ethanol pre-treatments of the egg make the aeropiles more permeable to aqueous solutions, so drugs diluted in water can be carried after the eggs are pre-treated with ethanol. Thus, we found that delivery of pharmacological inhibitors to the embryo of R. prolixus can be performed simply by submersing the fertilized eggs in ethanol with no need for additional methods such as microinjections or electroporation. We discuss the potential importance of this methodology to the study of this vector developmental biology and population control.

Profissionalização de pessoas com deficiência: reflexões e possíveis contribuições da psicologia / Professionalization of disabled people: reflections and possible contributions from psychology / La profesionalización de las personas con discapacidad: reflexiones y posibles contribuciones de la psicología

O fenômeno da profissionalização de pessoas com deficiência é complexo e perpassa as contradições do sistema capitalista, a estrutura e interações sociais, o comportamento e psiquismo humano. Entre os desafios para a profissionalização de pessoas com deficiência elencam-se: postos precários, informais, baixa ou nenhuma remuneração, baixas escolaridade e qualificação técnica. A legislação traz avanços, porém o cumprimento é frágil e reducionista. Este trabalho apresenta possibilidades de contribuições da psicologia nos diferentes contextos: junto aos sujeitos com deficiências e seus familiares, à comunidade empresarial, às instituições e à sociedade civil, por meio da educação. Discute-se o tema expondo as limitações a partir dos diferentes sujeitos sociais e as contradições que coexistem nas políticas públicas, mas, sobretudo, aponta-se caminhos e propõe-se na psicologia importantes instrumentos para a inclusão.

The phenomenon of professionalization of disabled people is complex and goes beyond the contradictions of the capitalist system, social structure and interactions, behavior and the human psyche. Among the professionalization challenges for people with disabilities, we list the following: insecure and informal positions, minimal or no compensation, low education and qualifications. Legislation brings advances but its compliance is fragile and reductionist. This paper presents potential contributions from psychology, through education, in different contexts: together with disabled persons and their families, the business community, institutions, and civil society. We discuss the professionalization of people with disabilities; the limitations are exposed considering the different social subjects and the contradictions that exist in public policies. But mainly, direction is offered and important instruments in psychology are proposed for greater inclusion.

El fenómeno de la profesionalización de las personas con discapacidad es complejo y va más allá de las contradicciones del sistema capitalista, de la estructura y de las interacciones sociales, de las conductas y del psiquismo humano. Entre los desafíos para la profesionalización de las personas con discapacidad destacan: los empleos precarios e informales, la baja o nula remuneración, el bajo nivel educativo y de cualificación técnica. La legislación trae avances pero su cumplimiento es frágil y reduccionista. El presente trabajo presenta posibles contribuciones de la psicología, a través de la educación, a diferentes contextos: las personas con discapacidad y sus familias, la comunidad empresarial, las instituciones y la sociedad civil. Discute el tema exponiendo las limitaciones a partir de los diferentes sujetos sociales y las contradicciones que coexisten en las políticas públicas, pero, sobre todo, apunta caminos y propone, en la psicología, importantes instrumentos para la inclusión.

Acinetobacter baumannii Multirresistente: Aspectos Clínicos e Epidemiológicos / Multidrug-resistant Acinetobacter baumannii: Clinical and Epidemiological Aspects

Demonstrar o perfil clínico e epidemiológico dasinfecções associadas à Acinetobacter baumannii produtorde carbapenemases, com enfoque nos relatos descritos noBrasil. Material e Métodos: Este estudo consiste em umarevisão bibliográfica, na qual foram avaliados artigos originaise artigos de revisão publicados em português ou em inglêsentre 2001 e 2013. Após consulta às bases de dadoseletrônicas Pubmed/MEDLINE e SciELO mediante o empregodos descritores “Acinetobacter baumannii”,“carbapenemases”, “infecção”, “epidemiologia”, 33 artigosforam selecionados para análise. Resultados: A. baumanniié um patógeno oportunista comumente associado a surtosde infecções nosocomiais, incluindo pneumonia associada àventilação mecânica, com incidência mais elevada emunidades de terapia intensiva (UTIs). A habilidade destepatógeno em desenvolver mecanismos de resistência limitaa disponibilidade de opções terapêuticas, dificultando otratamento destas infecções e elevando os índices demortalidade. Metalo-beta-lactamases e, maisprevalentemente, oxacilinases são a causa mais preocupantede resistência adquirida a carbapenens neste patógeno. Oprimeiro surto relatado no Brasil ocorreu em 1999 e, desdeentão, houve uma crescente disseminação de clonesepidêmicos desta bactéria no país. Conclusão: A emergênciamundial de cepas de A. baumannii multirresistentesprodutoras de carbapenemases tem se tornado um problemade saúde pública. Portanto, o desenvolvimento de novasopções terapêuticas e a maior ênfase na prevenção detransmissão desta bactéria em meio hospitalar sãoessenciais...

To evaluate the clinical and epidemiological profileof infections associated with carbapenemase-producingAcinetobacter baumannii, focusing on reports described inBrazil. Material and Methods: This study consists of aliterature review evaluating research papers and literaturereviews published in Portuguese or English between 2001and 2013. A total of 33 articles were selected for analysisbased on searches carried out in the databases PubMed andSciELO using the descriptors: “Acinetobacter baumannii”,“carbapenemases”, “infection” and “epidemiology”. Results:A. baumannii is an opportunistic pathogen commonlyassociated with outbreaks of nosocomial infections, includingventilator-associated pneumonia, with higher incidence inintensive care units (ICUs). The ability of this pathogen todevelop resistance mechanisms limits the availability oftreatment options, making it difficult to treat these infectionsand increasing mortality rates. Metallo-beta-lactamases and,more prevalently, oxacilinases are the most worrisome causeof acquired resistance to carbapenens in this pathogen. Thefirst outbreak reported in Brazil occurred in 1999 and sincethen there has been a growing spread of epidemic clones ofthis bacterium in the country. Conclusion: The worldwideemergence of multi-drug resistant strains of carbapenemaseproducingA. baumannii has become a public health problem.Therefore, the development of new therapeutic options anda greater emphasis on prevention of transmission of thisbacterium in the hospital setting are essential...

Behavioral and neurochemical studies in mice pretreated with garcinielliptone FC in pilocarpine-induced seizures.

Garcinielliptone FC (GFC) isolated from hexanic fraction seed extract of species Platonia insignis Mart. It is widely used in folk medicine to treat skin diseases in both humans and animals as well as the seed decoction has been used to treat diarrheas and inflammatory diseases. However, there is no research on GFC effects in the central nervous system of rodents. The present study aimed to evaluate the GFC effects at doses of 25, 50 or 75 mg/kg on seizure parameters to determine their anticonvulsant activity and its effects on amino acid (γ-aminobutyric acid (GABA), glutamine, aspartate and glutathione) levels as well as on acetylcholinesterase (AChE) activity in mice hippocampus after seizures. GFC produced an increased latency to first seizure, at doses 25mg/kg (20.12 ± 2.20 min), 50mg/kg (20.95 ± 2.21 min) or 75 mg/kg (23.43 ± 1.99 min) when compared with seized mice. In addition, GABA content of mice hippocampus treated with GFC75 plus P400 showed an increase of 46.90% when compared with seized mice. In aspartate, glutamine and glutamate levels detected a decrease of 5.21%, 13.55% and 21.80%, respectively in mice hippocampus treated with GFC75 plus P400 when compared with seized mice. Hippocampus mice treated with GFC75 plus P400 showed an increase in AChE activity (63.30%) when compared with seized mice. The results indicate that GFC can exert anticonvulsant activity and reduce the frequency of installation of pilocarpine-induced status epilepticus, as demonstrated by increase in latency to first seizure and decrease in mortality rate of animals. In conclusion, our data suggest that GFC may influence in epileptogenesis and promote anticonvulsant actions in pilocarpine model by modulating the GABA and glutamate contents and of AChE activity in seized mice hippocampus. This compound may be useful to produce neuronal protection and it can be considered as an anticonvulsant agent.

Linfedema entre mulheres submetidas a tratamento de câncer de mama em um hospital de Belo Horizonte – MG / The development of lymphedema among women undergoing treatment for breast cancer treated at the oncology clinic of a hospital in Belo Horizonte

Introdução: Uma das frequentes sequelas e a que mais interfere na vida da mulher em tratamento para câncer de mama é o linfedema. Este efeito colateral pode ter seu início durante qualquer fase do tratamento para câncer de mama, apesar de geralmente não oferecer risco de vida, ameaça a qualidade de vida da sobrevivente por causar deformidade estética, desconforto físico e perda da habilidade funcional. Estudos mostram que a educação para prevenção e controle do linfedema entre sobreviventes de câncer de mama é importante para melhorar a funcionalidade e promover qualidade de vida. Para que o desenvolvimento do linfedema seja prevenido e controlado, é importante que a mulher possua conhecimentos básicos sobre esta sequela. Objetivo geral: Analisar o desenvolvimento de linfedema entre mulheres submetidas a tratamento de câncer de mama atendidas em ambulatório de oncologia de um hospital de Belo Horizonte. Material e Método: Trata-se de um estudo quantitativo, seccional. Foi desenvolvido no ambulatório de oncologia de um hospital de Belo Horizonte, onde 125 mulheres, em tratamento para câncer de mama, foram entrevistadas durante consulta de segmento ou previamente a administração de quimioterápicos, utilizando-se de questionários traduzidos e adaptados da língua inglesa. Foi realizada consulta ao prontuário para coleta de dados referentes a história clínica da paciente. Resultados: 34,4% das mulheres tinham diagnóstico de linfedema, com média de idade de 53,3 ± 10 anos, casadas, com menos de quatro anos de estudo e renda familiar entre um e três salários mínimos. A prevalência de linfedema no período do estudo foi de 34,4%. O nível de conhecimento sobre linfedema e como preveni-lo foi considerado baixo e somente 69,6% das pacientes relatam haver recebido orientação acerca de como prevenir o linfedema, sendo o enfermeiro pouco envolvido nesse processo. Conclusão: Entende-se como essencial a atuação do enfermeiro como educador, uma vez que receber orientação...

Introduction: One of the most frequent sequelae, and the one that interferes the most in the life of women treating for cancer is the lymphedema. This side effect may have its onset during any phase of breast cancer treatment; although, in general, it isn't life-threatening. However, it may decrease survivor’s life quality due to aesthetics deformities, physical discomfort and loss of functional ability. Studies indicate that educating breast cancer survivors about how to prevent and control lymphedema is important to improve the functionality and to promote life quality. To prevent and control the lymphedema progression it is important that the woman has the basic knowledge about this sequela. General objective: Studying the development of lymphedema among women undergoing treatment for breast cancer treated at the oncology clinic of a hospital in Belo Horizonte. Materials and Methods: This is a quantitative, sectional study. It was accomplished in the oncology ambulatory of a large hospital in Belo Horizonte, in which 125 women, in breast cancer treatment, were interviewed at the time of the medical follow-up appointment or before the chemotherapeutics administration. The interviews were conducted using questionnaires translated and adapted from English. Also, the medical records were consulted to collect data related to the patient's clinical history. Results: 34.4% of women were diagnosed with lymphedema, with an average age of 53.3 ± 10 years old, married, with less than four years of education and family income from one to three minimum wages. The prevalence of lymphedema in the study period was 34,4%.The knowledge level about lymphedema and how to prevent it was considered low and only 69.6% of patients report having received orientation about how to prevent lymphedema, being the nurses not very involved in this process. Conclusion: It is understood as essential the role of the nurse as an educator, since receiving orientation was...

Corpo, afecto e sexualidade: uma experiência da abordagem das sexualidades a partir das artes / Body, afection and sexuality: an experience with arts and sexuality in sex education

Este trabalho, realizado no primeiro semestre de 2004 junto a 15 professoras de Educação Artística e outras disciplinas da rede pública de Ensino Fundamental e Médio, consistiu em um ciclo de oficinas sobre Corpo, Afectos e Sexualidades eliciadas a partir de imagens de esculturas, quadros ou materiais da mídia representativas de diversas culturas do ocidente e do oriente, com as quais abordamos temas como gênero, sexo, gravidez na adolescência, paternidade responsável, prazer, erotismo, violência doméstica, orientação sexual, direitos humanos e cidadania... (AU)

This paper is about an experience with 15 schoolteachers of Arts and other disciplines from Public Schools that happened in the first semester of 2004. To do so, a cycle of workshops on Body, Affection and Sexuality started from images of sculptures, paintings or media that represented different eastern and western cultures was held. With these workshops we discussed themes such as genre, sex, pregnancy in adolescence, parental responsibilities, pleasure, eroticism, domestic violence, sexual orientation, human and sexual rights and citizenship... (AU)