"H" is not for hydroxychloroquine-"H" is for heparin: lack of efficacy of hydroxychloroquine and the role of heparin in COVID-19-preliminary data of a prospective and interventional study from Brazil.

BACKGROUND: COVID-19 pandemic is the major public health problem in the world actually. It's associated with high morbidity and mortality. To date, no therapeutic measure has a curative potential. Hydroxychloroquine (HCQ) is a drug with immunomodulatory properties that has demonstrated antiviral efficacy in in vitro experiments, with conflicting results in in vivo studies. METHODS: A single-center, prospective and interventional study, that evaluates the impact on mortality of the HCQ use in 154 patients hospitalized with COVID-19 in a Brazilian public hospital. The study also aims to determine prognostic factors that predict mortality, ICU admission and endotracheal intubation in this population. RESULTS: 154 patients diagnosed with COVID-19 confirmed by RT-PCR and hospitalized were included. There was a male predominance (87/154, 56.5%), median age 60 years and 88% (136/154) had comorbidities. Among these, 76% (117/154) were admitted to the ICU and 29.2% (45/154) experienced EOT. The OMR was 51.3% (79/154). There was no difference in mortality between patients treated with HCQ (N = 95) and non-HCQ (N = 59) (44.1% × 55.8%, p = 0.758). In univariate analysis, age ≥ 60 years (HR 3.62, p < 0.001), need for mechanical ventilation (HR 2.17, p = 0.001), ≥ 2 comorbidities (HR 1.83, p = 0.049), SAH (HR: 1.56, p = 0.054) were predictors of mortality, as well as no use of prophylactic or therapeutic heparin (HR 3.60, p = 0.02). Multivariate analysis identified admission to the ICU (HR 8.98, p = 0.002) and advanced age (HR 3.37, p < 0.01) as independent predictors of mortality, although, use of heparin (HR 0.25, p = 0.001) was independently associated with a favorable outcome. CONCLUSION: This study confirmed the absence of a benefit associated with the use of HCQ in Brazilian patients hospitalized with COVID-19. However, prophylactic or therapeutic heparin was an independent predictor for reducing mortality in this population.

Prevalência e aspectos epidemiológicos da COVID-19 na 9ª Região de Saúde de Alagoas / Prevalence and epidemiological aspects of COVID-19 in the 9th Health Region of Alagoas

Objetivo: verificar a taxa de prevalência e realizar uma caracterização epidemiológica dos casos de COVID-19 na 9ª Região de Saúde de Alagoas, incluídos todos os casos registrados até 30 de setembro 2020. Métodos: os dados foram obtidos por meio da Secretaria de Estado da Saúde do Governo Estadual de Alagoas. Após a obtenção dos dados, realizou-se o cálculo de prevalência da doença para cada município da região, e, posteriormente, fez-se uma análise descritiva das principais características epidemiológicas, dos sintomas e das comorbidades relatadas pelos pacientes; o Odds Ratio dos óbitos e comorbidades também foi calculado. Resultados: 5.564 casos de COVID-19 foram registrados na região no período estudado. Santana do Ipanema foi o município com maior número de casos (1.295), Palestina apresentou a maior prevalência (5082,4/100.000 hab.). A maioria dos pacientes, de cor parda, com idade entre 31 e 40 anos, relatou ter tosse e febre. A diabetes foi a comorbidade mais relatada, e doenças cardiovasculares, hipertensão e diabetes as comorbidades significativamente associadas aos óbitos. Conclusões: os resultados aqui encontrados auxiliam na adoção de medidas e práticas preventivas, levando em consideração a taxa de prevalência da doença, dando importância, assim, aos municípios prioritários neste momento.

Introduction: policies to confront COVID-19, a disease caused by Coronavirus-19, require data on the actual prevalence of infection in the population, mainly to define actions aimed at preventing transmissibility. Objective: To verify the prevalence rate and perform an epidemiological characterization of the COVID-19 cases in the 9th Health Region of Alagoas, including all cases registered until September 31, 2020. Methods: the data were obtained from the State Health Secretariat of the State Government of Alagoas. After obtaining the data the prevalence of the disease was calculated for each municipality in the region, and subsequently a descriptive analysis of the main epidemiological characteristics, symptoms and comorbidities reported by the patients was made; the Odds Ratio of deaths and comorbidities was also calculated. Results: a total of 5.564 cases of COVID-19 were recorded in the region during the studied period, Santana do Ipanema was the municipality with the highest number of cases (1,295) and Palestina presented the highest prevalence (5082,4/100.000 inhab.). Most of the patients were brown in color and aged between 31 and 40 years old, and reported cough and fever. The diabetes was the most reported comorbidity and cardiovascular diseases, hypertension and diabetes were significantly associated with deaths. Conclusions: the results found here assist in the adoption of preventive measures and practices, taking into account the prevalence rate of the disease, thus giving importance to the priority municipalities at this time.

O diagnóstico das síndromes mielodisplásicas: revisão da literatura / The diagnosis of myelodysplastic syndromes: literature review

A síndrome mielodisplásica (SMD) é uma doença de diagnóstico complexo e, com bases nas contribuições encontradas na literatura, reunimos as principais ferramentas diagnósticas disponíveis na atualidade e sua aplicação, bem como o avanço nos métodos de diagnóstico, contribuindo para melhor compreensão da doença e futuras pesquisas. Este trabalho teve como objetivo apresentar as características da SMD, e apontar os exames realizados para o diagnóstico e seu avanço laboratorial, expondo as novas tecnologias para diagnóstico. Para realizar uma revisão bibliográfica, foi realizado um levantamento de artigos científicos publicados a partir de banco de dados confiáveis como PubMed, Bireme e SciELO, de 2000 a 2016. Foram utilizados os seguintes termos para a pesquisa: síndrome mielodisplásica, displasia e diagnóstico. Incluindo-se publicações no idioma Inglês e Português. A SMD, por se tratar de uma doença clonal ou não clonal, deve ser avaliada desde uma análise de sangue periférico, no qual observa-se uma alteração, e com o isso realizar uma investigação baseando-se em dados clínicos, histopatológicos, citogenéticos e na evolução do paciente. Sendo assim, requer profissionais altamente capacitados e que acompanhem a evolução dos critérios para o diagnóstico.

Cytocompatibility of a self-adhesive gutta-percha root-filling material.

CONTEXT: A novel root-filling material based on the incorporation of ultrafine alkaline bioactive glass particles (bioactive gutta-percha, [BGP]) was developed to work without sealer. AIM: In the present study, the objective was to verify the in vitro biological response to this material by assessing its cytocompatibility. MATERIALS AND METHODS: Prototypes of BGP were compared to conventional gutta-percha (GP), dense polystyrene beads as a negative control and fragments of latex as a positive control. Extracts of each material were prepared according to ISO 10993-5:2009, and human osteoblast-like cells in primary culture were exposed to all extracts for 24 h. Cell viability was assayed sequentially for three different parameters: mitochondrial activity, membrane integrity, and cell density. STATISTICAL ANALYSIS USED: Nonparametric analysis (using Kruskal-Wallis test combined with post hoc Dunn's test) was performed for comparison among groups, with significance established at 5%. RESULTS: BGP reduced mitochondrial activity to 62% of control, but presented no toxicity on membrane integrity and proliferation assays. BGP effect on metabolism was dose-dependent and reduced to acceptable levels with dilution. CONCLUSION: The novel GP material presented slight dose-dependent effects on cell metabolism but did not affect cell survival.

BiodentineTM is cytocompatible with human primary osteoblasts.

Calcium silicate-based materials have been widely studied due to their resemblance to, and similar applicability of, mineral trioxide aggregate (MTA). Among these, Biodentine™ (BD) was specifically designed as a "dentin replacement" material for applications such as root perforations, apexification, treatment of resorptive lesions, and as a retrograde filling material. The present study aimed to assess the in vitro response of human primary osteoblasts to BD using MTA AngelusTM as a reference material, by simultaneously analyzing three different cell viability parameters, namely mitochondrial activity, membrane integrity, and cell density. BD and MTA extracts were prepared by incubation on culture media for 24 h or 42 days after mixing. Primary human osteoblasts were exposed to extracts for 24 h, at 37oC with 5% CO2, and cell viability was evaluated by the XTT, NRU, and CVDE assays. Both materials induced cell viability levels higher than 70% when extracted for 24 h. However, when cells were exposed to extracts with increased conditioning times, MTA presented significant cytotoxic effects (p < 0.05) in comparison to the control and MTA at 24 h. After 42 days, the XTT assay identified a significant reduction in cell viability by BD when compared to the control (p<0.05), despite the fact that levels above the 70% viability cutoff were attained for biocompatible materials. It can be concluded that BD is cytocompatible with human primary osteoblasts, indicating its adequacy in direct contact with bone tissues.

Malaria epidemiology in the State of Piauí, Northeastern Brazil: a retrospective study with secondary data.

UNLABELLED: INTRODUCTION Malaria is not considered endemic in State of Piauí. METHODS Malaria epidemiology was examined using surveillance data. RESULTS: During 2002-2013, of the 484 cases of malaria, 217 were classified as probably acquired in Piauí, most frequently in the Campo Largo, Buriti dos Lopes, and Luzilândia municipalities, and 267 were considered probably imported, from the States of Pará, Maranhão, Amazonas, Roraima, and Rondônia. Probably-imported cases occurred throughout the year, while 80.2% of the probably-acquired cases occurred in April-August, peaking at the end of the rainy season. CONCLUSIONS Malaria surveillance should be intensified. Further ecoepidemiological and entomological studies are needed.

Riscos ocupacionais no exerc¡cio da Odontologia – revisÆo sistem tica / Occupational hazards in Dentistry – systematic review

O presente trabalho teve como objetivo levantar evidˆncias relacionadas …s doen‡as profissionais e/ou ocupacionais que os cirurgiães-dentistas estÆo vulner veis. Elaborou-se mediante a aplica‡Æo de m‚todos expl¡citos e sistematizados de busca, aprecia‡Æo cr¡tica e s¡ntese da informa‡Æo selecionada, uma revisÆo da literatura sobre o tema. Os trabalhos foram selecionados das bases de dados eletr“nicas (PubMed, Bireme, Nature, Scielo e Cochrane), sendo consultados no per¡odo de 1990 a 2013 sobre as seguintes tem ticas: “doen‡as ocupacionais na Odontologia”, “risco ocupacional odontol¢gico”, “Odontologia do trabalho”, “occupational disease Dentistry”, “occupational hazards”, “dentist”, “cirurgiÆo-dentista”, nos idiomas portuguˆs e inglˆs. Selecionaram-se 21 artigos de um total de 40 potencialmente relevantes, identificados nas pesquisas de base de dados, que reportaram sobre as diversas doen‡as ocupacionais. Concluiu-se que os cirurgiães-dentistas devem conscientizar-se dos riscos ocupacionais e que trabalhos educativos no sentido de preven‡Æo das doen‡as profissionais sÆo necess rios.

The present study aimed to collect evidence related to occupational diseases to which dental surgeons are exposed. A literature review on the subject was elaborated through the application of explicit and systematic search methods, critical appraisal, and synthesis of selected information. The studies were chosen from electronic databases (Pubmed, Bireme, Nature, SciELO and Cochrane), consulted in the period from 1990 to 2013 on the following topics: “occupational diseases in Dentistry”, “occupational hazards in Dentistry”, “dental work”, “occupational disease Dentistry”, “occupational hazards”, “dentist”, “dental surgeon”, in Portuguese and English. Twenty-one articles were selected from a total of 40 potentially relevant studies identified in the databases concerning various occupational diseases. It was concluded that dentists should become aware of occupational hazards and that further educational programs towards the prevention of occupational diseases are still necessary.