Unlocking the molecular realm: advanced approaches for identifying clinically and environmentally relevant bacteria.

Rapid, effective, and specific identification of clinical and environmental bacterial pathogens is of major importance for their control. Traditionally, bacteria have been identified by phenotypic methods based on morphological, biochemical, and metabolic properties. While these methods are very useful in clinical practice, they have limitations including a poor ability to differentiate within and between species and time-consuming workflows. Newly developed molecular methods can greatly improve the accuracy of taxonomic characterization, identifying specific strains of medical or environmental importance. However, due to high costs and the need for trained professionals, these methods are not yet routine in diagnostic laboratories. Thus, disseminating knowledge on advances in molecular identification techniques is pivotal to make these methodologies accessible. The objective of this work was to review and discuss current molecular techniques for bacteria identification aiming to track and monitor microbial agents in clinical and environmental samples.

Evidence of Antineutrinos from Distant Reactors Using Pure Water at SNO.

The SNO+ Collaboration reports the first evidence of reactor antineutrinos in a Cherenkov detector. The nearest nuclear reactors are located 240 km away in Ontario, Canada. This analysis uses events with energies lower than in any previous analysis with a large water Cherenkov detector. Two analytical methods are used to distinguish reactor antineutrinos from background events in 190 days of data and yield consistent evidence for antineutrinos with a combined significance of 3.5σ.

Unlocking the molecular realm: advanced approaches for identifying clinically and environmentally relevant bacteria

Rapid, effective, and specific identification of clinical and environmental bacterial pathogens is of major importance for their control. Traditionally, bacteria have been identified by phenotypic methods based on morphological, biochemical, and metabolic properties. While these methods are very useful in clinical practice, they have limitations including a poor ability to differentiate within and between species and time-consuming workflows. Newly developed molecular methods can greatly improve the accuracy of taxonomic characterization, identifying specific strains of medical or environmental importance. However, due to high costs and the need for trained professionals, these methods are not yet routine in diagnostic laboratories. Thus, disseminating knowledge on advances in molecular identification techniques is pivotal to make these methodologies accessible. The objective of this work was to review and discuss current molecular techniques for bacteria identification aiming to track and monitor microbial agents in clinical and environmental samples.

The evolution of ADAM gene family in eukaryotes.

The ADAM (A Disintegrin And Metalloprotease) gene family encodes proteins with adhesion and proteolytic functions. ADAM proteins are associated with diseases like cancers. Twenty ADAM genes have been identified in humans. However, little is known about the evolution of the family. We analyzed the repertoire of ADAM genes in a vast number of eukaryotic genomes to clarify the main gene copy number expansions. For the first time, we provide compelling evidence that early-branching green algae (Mamiellophyceae) have ADAM genes, suggesting that they originated in the last common ancestor of eukaryotes, before the split of plants, fungi and animals. The ADAM family expanded in early metazoans, with the most significative gene expansion happening during the first steps of vertebrate evolution. We concluded that most of mammal ADAM diversity can be explained by gene duplications in early bone fish. Our data suggest that ADAM genes were lost early in green plant evolution.

Functional dimorphic enantiostyly in monomorphic enantiostylous species of the subtribe Cassiinae (Fabaceae-Caesalpinioideae).

Monomorphic enantiostylous species produce flowers with a displacement of the style to the left (L) or right (R) on the same individual, and may exhibit different dynamics for the production of these floral types, which may influence levels of selfing. We investigated the production dynamics of L and R floral types in seven species and a variety of monomorphic enantiostylous species of the genera Senna and Chamaecrista. Our hypothesis was that most species present similar proportions of floral morphs each day. Individuals were classified daily over a period of 7 days according to the functional status, i.e. the proportion of floral morphs as functionally L, R or reciprocal (REC, i.e. similar proportions of the two floral morphs), and also according to the number of consecutive days in which they exhibited the same functional status. All species presented low daily flower production. Most species had individuals classified as functionally R, L and REC, and tend to repeat the same functional status over a few days, although they may change functional status during the flowering period. All species exhibited individuals that were classified as functionally reciprocal when both the daily and total number of flowers produced over 7 days was considered. The occurrence of different functional status has not yet been reported in the literature for enantiostylous species. The distinct strategies observed in the dynamics of floral morph production seemed likely to minimise geitonogamy and to favour cross-pollination between individuals (xenogamy).

Occupational group, educational level, marital status and deleterious habits among individuals with maxillofacial fractures: retrospective study.

BACKGROUND: To investigate the occupational profile, educational level, marital status and deleterious habits to the health of patients with maxillofacial fractures of a population of northeastern Brazil. MATERIAL AND METHODS: A retrospective study of patients records admitted to the Division of Oral and Maxillofacial Surgery at the Walter Cantidio University Hospital (Fortaleza, Brazil) who sustained maxillofacial fractures was conducted in the period between 2006 and 2015. RESULTS: A total of 338 patients rendered 355 fractures. Males were the most affected (p <0.001), with prevalence in the third decade of life (p <0.001). There was a predominance of motorcycle accidents (p <0.001), home workers (p <0.001), low educational status (p = 0.032), and no cigarette use (p <0.001) or alcohol (p = 0.023). Fractures of the zygomatic-orbital complex were the most prevalent in the sample (p <0.001). CONCLUSION: The sociodemographic profile exerted a significant influence on the epidemiological profile of maxillofacial fractures in a Brazilian population during the study period.

Does pterygomaxillary disjunction in surgically assisted rapid maxillary expansion influence upper airway volume? A prospective study using Dolphin Imaging 3D.

Surgically assisted rapid maxillary expansion has been used for the treatment of transverse maxillary deficiency. This prospective study aimed to evaluate the effect of this surgery (with or without pterygomaxillary disjunction) on the upper airway volume. The patients were randomly divided into two groups: without pterygomaxillary disjunction (-PD) and with pterygomaxillary disjunction (+PD). Eleven patients per group were estimated to obtain a representative sample (90% of power and 95% of confidence level). Volumetric images of cone beam computed tomography scans were obtained preoperatively, immediately after Hyrax screw stabilization and 6 months after Hyrax screw stabilization. Volumetric measurements of the nasal cavity, maxillary sinuses, nasopharynx, and oropharynx, and of the minimum oropharynx cross-sectional area were obtained using Dolphin 3D Imaging Software. The final sample consisted of 25 adult individuals (+PD group, n=12; -PD group, n=13). In the +PD group, we observed a statistically significant increase immediately after Hyrax screw stabilization for the nasopharynx volume (P=0.003), oropharynx volume (P=0.007) and oropharynx cross-sectional area (P=0.001). Pterygomaxillary disjunction resulted in a significant (P <0.05) increase in volumetric measurements of the nasopharynx and minimum oropharynx cross-sectional area 6 months after the expander device stabilization.

Prospective open-label evaluation of long-term low-dose doxycycline for difficult-to-treat chronic rhinosinusitis with nasal polyps.

BACKGROUND: This study aimed to assess clinical outcomes of long-term low-dose oral doxycycline therapy in difficult-to-treat chronic rhinosinusitis with polyps (CRSwNP). METHODS: This was a prospective, open-label study of 60 patients with difficult-to-treat CRSwNP who had undergone endoscopic sinus surgery. Patients were divided into two groups: 28 received nasal steroids, saline irrigation, and doxycycline (200 mg on the first day, followed by 100 mg once daily) for 12 weeks, while 30 received only nasal steroids and saline irrigation. The main outcome measure was an adequate effect size of doxycycline treatment on clinically meaningful significant improvement of SNOT-20. Other outcome measures were the SNOT-20, NOSE, and Lund-Kennedy scores. The following parameters were also analyzed: asthma, rhinitis, non-steroidal-exacerbated respiratory disease (NERD), and baseline serum IgG, IgA, IgE, IgM, ANCA, and eosinophil count. RESULTS: There was an adequate effect size of doxycycline treatment on clinically meaningful significant improvement of SNOT-20. Patients who received doxycycline also had significantly better outcomes regarding SNOT-20, NOSE, and Lund-Kennedy scores. There was a negative association among a clinically significant improvement of SNOT-20 and presence of asthma, NERD, and elevated serum IgE levels before treatment. CONCLUSION: These findings suggest that doxycycline may have a beneficial role for CRSwNP patients, especially for patients without asthma, NERD or high levels of serum IgE before treatment.

Plasma mepivacaine concentrations in patients undergoing third molar surgery.

BACKGROUND: Local anaesthetic-related systemic toxicity mainly results from elevated plasma concentrations of these drugs. We hypothesized that intraoral injection of submaximal doses of mepivacaine does not lead to toxic levels of this drug in blood. This study evaluated the plasma levels of mepivacaine in third molars surgeries. METHODS: Twenty-one patients were randomly assigned into two groups: group I (two unilateral third molars; submaximal dose of mepivacaine 108 mg with epinephrine 54 µg) and group II (four third molars; submaximal dose of mepivacaine 216 mg with epinephrine 108 µg). Blood samples were collected before anaesthesia, and 5, 10, 15, 20, 30, 40, 60, 90 and 120 min after anaesthesia. RESULTS: Individual peak plasma concentrations ranged 0.77-8.31 µg/mL (group I) and from 2.36-7.72 µg/mL (group II). An increase in the average dose of mepivacaine from 1.88 ± 0.12 mg/kg (group I) to 3.35 ± 0.17 mg/kg (group II) increased the mean mepivacaine peak plasma levels from 2.33 ± 0.58 to 4.01 ± 0.69 µg/mL, respectively. Four patients obtained plasma levels of mepivacaine above the threshold for toxicity (5 µg/mL). CONCLUSIONS: Toxic levels of mepivacaine are possible, even when a submaximal dose is used. A twofold increase in the dose of mepivacaine caused the mean peak plasma concentration to increase proportionally, indicating that they may be predicted based on the relation of dose per bodyweight.

A split-mouth, randomized, triple-blind, placebo-controlled study to analyze the pre-emptive effect of etoricoxib 120 mg on inflammatory events following removal of unerupted mandibular third molars.

Pain after third molar extraction has been considered the most suitable pharmaceutical model to evaluate acute pain. This study aimed to evaluate the pre-emptive analgesic/anti-inflammatory efficacy of etoricoxib 120 mg following mandibular third molar surgery. A split-mouth, randomized, triple-blind, placebo-controlled study was conducted with patients undergoing the surgical removal of mandibular third molars. All volunteers were allocated randomly to receive either etoricoxib 120 mg or placebo 1h preoperatively, and inflammatory events were evaluated. An estimated sample of 18 surgical units per group was required based on a pilot study (95% confidence level and 80% statistical power). Rescue medication was analyzed by Kaplan-Meier method through log-rank Mantel-Cox test and Pearson linear correlation (P<0.05). Pre-emptive etoricoxib reduced postoperative pain scores significantly in comparison to placebo (P<0.001), with a pain score peak at 6h after surgery (P<0.001). The mean rescue medication consumption was lower in the etoricoxib group compared to the placebo group over the study period (P<0.05). There was no statistically significant difference between groups related to swelling and trismus. The pre-emptive administration of etoricoxib 120 mg significantly reduced the postoperative pain intensity and the need for rescue medication, but did not reduce swelling or trismus.

Comparative efficacy of nimesulide and ketoprofen on inflammatory events in third molar surgery: a split-mouth, prospective, randomized, double-blind study.

This study aimed to compare the effect of nimesulide and ketoprofen on inflammatory parameters related to the surgical removal of third molars. A split-mouth, prospective, randomized, double-blind study was conducted in patients undergoing removal of four third molars. Eighteen eligible patients were allocated to one of two groups to receive treatment two times a day with either ketoprofen 100 mg or nimesulide 100 mg for a period of 3 days. The rescue medication intake (number) and pain intensity were evaluated at 6, 12, 24, and 48 h, and at 7 days postoperatively. Swelling and maximum mouth opening were evaluated at 24 h, 72 h, and 7 days postoperatively. The peak pain score occurred at 6h after surgery in the nimesulide group and at 12h in the ketoprofen group. There was no statistically significant difference between the groups, although pain relief was observed after 48 h in the nimesulide group and after 7 days in the ketoprofen group. For each group, there was a statically significant difference in pain scores among the studied periods (P<0.0001). None of the patients required rescue medication. There was a statistically significant difference in maximum mouth opening between the preoperative and postoperative periods (P<0.0001). Ketoprofen and nimesulide were effective at controlling pain, swelling, and trismus after the surgical removal of third molars.

Mechanical disfunction in the mucosal oedema formation of patients with nasal polyps.

BACKGROUND: Nasal polyposis (NP) is characterized by an anomalous tissue growth with oedema and a lack of extracellular matrix. In this study, we investigated whether a mechanical disfunction of the forces that act in oedema formation is present in NP. METHODS: We compared the interstitial hydrostatic pressure behaviour during a saline solution infusion between healthy nasal mucosa (inferior and middle turbinate from 10 patients) and inflamed nasal mucosa from NP patients (inferior, middle turbinate and a nasal polyp from 6 patients). We used Controlled Disc Stimulation equipment to compare the curve Pressure/Volume created during the saline solution infusion. RESULTS: The pressure at 0.2 ml infusion was lower in the middle turbinate of NP patients than in the middle turbinate of control patients. The lowest P/V mean assessed was in the polypoid tissue. CONCLUSIONS: The interstitial hydrostatic pressure showed different behaviour during liquid infusion in nasal mucosa from NP patients when compared with healthy nasal mucosa. This study allows us to cogitate on a new pathophysiological mechanism contributing to the development of the NP.

Shelf life of cooked goat blood sausage prepared with the addition of heart and kidney.

This study focused on the effect of two packaging formats (vacuum packaging and over-wrap packaging) on the shelf life of cooked sausage prepared with blood, heart, kidney and goat meat fragments under storage at 4±1°C for a period of 90 days. The storage time and type of packaging significantly affected the chemical (pH, moisture, protein and TBARS number), physical (shear force) and microbial (mould and yeast) parameters of cooked sausage. Vacuum packaging maintained the microbiological and chemical qualities of cooked goat blood sausage for a longer period of time (63 days) compared to over-wrap packaging (41 days) and could be a viable alternative to refrigerated storage of the product for quality maintenance.

The chemical and sensory qualities of smoked blood sausage made with the edible by-products of goat slaughter.

The aim was to evaluate smoked blood sausage prepared using goat blood (50%), viscera (10%) and meat fragments (20%). Microbiological, chemical and sensory evaluations were conducted. The quality analyses showed that smoked goat blood sausage is rich in high biological value proteins, amino acids, essential fatty acids, and iron (26.65mg/100g). The smoked goat blood sausage was rated to have a sensory acceptance of greater than 80%. The use of edible by-products from the slaughter of goats in the formulation of smoked blood sausage is viable because it uses low-cost raw materials; furthermore, the utilisation of these by-products can generate income for producers, allowing them to offer a meat product of high nutritional and sensory quality.

Do erupted third molars weaken the mandibular angle after trauma to the chin region? A 3D finite element study.

It has been suggested that third molars increase mandibular fragility because they do not contribute to its strength. For ethical reasons, a human study design that would permit the elucidation of this interference is not possible. This study evaluated the impact of the presence of erupted third molars on the mandibular angle of resistance when submitted to trauma. A three-dimensional (3D) mandibular model was obtained through finite element methodology using computed tomography (CT) with the geometry and mechanical properties to reproduce a normal mandibular structure. Human mandibles with no, one or two erupted third molars were evaluated. Whenever the third molar was present there was a greater concentration of tensions around the cervical part of its alveolus. Approximated Von Mises equivalent stress of the third molar region was 107.035 MPa in the mandible with teeth and 64.6948 MPa in the mandible without teeth. In the condylar region it was 151.65 MPa when the third molar was present and 184.496 MPa when it was absent. The digital models created proved that the mandibular angle becomes more fragile in the presence of third molars. When they are absent the energy concentrates on the lateral e posterior aspect of the condylar neck.

Indication of reactor ν(e) disappearance in the Double Chooz experiment.

The Double Chooz experiment presents an indication of reactor electron antineutrino disappearance consistent with neutrino oscillations. An observed-to-predicted ratio of events of 0.944±0.016(stat)±0.040(syst) was obtained in 101 days of running at the Chooz nuclear power plant in France, with two 4.25 GW(th) reactors. The results were obtained from a single 10 m(3) fiducial volume detector located 1050 m from the two reactor cores. The reactor antineutrino flux prediction used the Bugey4 flux measurement after correction for differences in core composition. The deficit can be interpreted as an indication of a nonzero value of the still unmeasured neutrino mixing parameter sin(2)2θ(13). Analyzing both the rate of the prompt positrons and their energy spectrum, we find sin(2)2θ(13)=0.086±0.041(stat)±0.030(syst), or, at 90% C.L., 0.017

Prevalence of chronic rhinosinusitis in Sao Paulo.

INTRODUCTION: Studies designed to investigate chronic rhinosinusitis (CRS) epidemiology play an important role to assess population`s distribution and risk factors to result in the development and promotion of public health policies. METHOD: This study design is a survey carried out with a complex two-stage cluster sampling plan. Personal interviews were carried out with 2,003 individuals. The questionnaire included the epidemiological criteria for CRS. Demographic data, history of physician-diagnosed respiratory diseases (asthma, sinusitis, rhinitis), smoking, family income, educational attainment, and household characteristics were also evaluated. RESULTS: The overall response rate was 93.9% of the households. Mean age was 39.8 +- 21 years; 45.33% were male. The overall prevalence of CRS in the city of Sao Paulo was 5.51%. We found a significant association between diagnosis of CRS and diagnosis of asthma and CRS and diagnosis of rhinitis and a significant association between presence of CRS and belonging to the low-income subgroup. CONCLUSION: The municipality of Sao Paulo has an urban population of 11 million. According to the present study, the prevalence of CRS is 5.51%, which represents more than 500,000 individuals affected by this condition in the city.

[Foreign body in the maxillary sinus. Considerations on maxillary sinus approaches wound closure]. / Corps étranger du sinus maxillaire. Considérations sur la fermeture des abords maxillaires.

INTRODUCTION: Paranasal intra-sinus foreign bodies are often related to wounding agents or to penetrating trauma, as caused by car crashes. The maxillary sinus is the most often affected region. We present an atypical clinical case of a foreign body in the maxillary sinus. CASE REPORT: A 27-year-old male patient, consulted for right facial pain associated to a yellow and fetid nasal discharge. Tooth no. 16 had been extracted five months before. Twenty days after extraction, there was an oro-antral fistula which was closed with surgical dental cement. At consultation, the fistula was patent in the tooth alveolus. A "cone beam" CT scan showed a 2-cm long hyper dense image with well-defined margins within the right maxillary sinus, associated with sinusal mucosa thickening. The diagnosis was an oro-antral fistula complicated by maxillary sinusitis due to a foreign body. The foreign body was removed under general anesthesia and antibiotic therapy, through an antero-lateral antrotomy, and sinus curettage was performed. The anterior cortical wall was fixed with a titanium miniplate. The fistula was closed with a buccal fat pad. There was no complication during the 24-month follow-up. DISCUSSION: Foreign bodies may be found in the sinuses, especially in the maxillary sinus. They are often of iatrogenic origin. CT scan may confirm the diagnosis. The treatment is surgical removal.

Cross-cultural adaptation and validation of a quality of life questionnaire: the Nasal Obstruction Symptom Evaluation questionnaire.

BACKGROUND: The Nasal Obstruction Symptom Evaluation (NOSE) instrument is a disease-specific questionnaire for assessing the outcome of an intervention in nasal obstruction in trials. This instrument is only available in the English language and cross-culturally valid questionnaires are very important for all research, including nasal obstruction. The aim of the current study was to reproduce the cross-cultural adaptation process for the NOSE questionnaire in the Portuguese language (NOSE-p). METHODOLOGY/PRINCIPAL: Cross-cultural adaptation and validation of the instrument were divided into two stages. Stage 1 involved four bilingual professionals, an expert committee and the author of the original instrument. In Stage 2, the NOSE-p was tested on 33 patients undergoing septoplasty for internal consistency, test-retest reliability, construct validity, discriminant validity, criterion validity, and response sensitivity. RESULTS: The cross-cultural adaptation process was completed and the NOSE-p was demonstrated to be a valid instrument with satisfactory construct validity. It showed an adequate internal consistency reliability and adequate test-retest reliability. It could discriminate between patients with and without nasal obstruction and it has a high response sensitivity to change. CONCLUSIONS: The cross-cultural adaptation and validation process demonstrated to be valid and the NOSE-p proved to be applicable in Brazil.