Low-level laser or LED photobiomodulation on oral mucositis in pediatric patients under high doses of methotrexate: prospective, randomized, controlled trial.

PURPOSE: The objective of the present study was to compare the efficacy of photobiomodulation with low-level laser therapy (LLLT) or light-emitting diode therapy (LEDT) devices for the prevention and treatment of oral mucositis in pediatric patients diagnosed with acute lymphoblastic leukemia undergoing chemotherapy with high doses of methotrexate (MTX). METHODS: Eighty patients were randomly divided into two groups: LLLT and LEDT. Both protocols were applied with the same energy and radiant exposure. The protocols started in the beginning of high doses MTX and finished when the patients were discharged from the hospital or there was oral mucositis resolution. The oral mucositis was assessed during each session in accordance to the World Health Organization (WHO) score. The patients' self-assessed pain was scored on a visual analog scale (VAS). RESULTS: The incidence of oral mucositis was similar to LLLT and LEDT, 10% and 12.5%, respectively. Both groups required the same number of days to reach score of zero for mucositis and pain (p > 0. 05), and there was no significant difference in mean VAS between the groups. CONCLUSIONS: These findings suggest that LEDT has similar effects to LLLT to avoid and treat oral mucositis. Brazilian Clinical Trial Registry with #U1111-1221-5943.

Effects of Dexamethasone and Photobiomodulation on Pain, Swelling, and Quality of Life After Buccal Fat Pad Removal: A Clinical Trial.

PURPOSE: In this study we aimed to compare the effects of photobiomodulation (PBM) and dexamethasone (DXM) on pain, swelling, and the quality-of-life (QOL) of patients submitted to buccal fat pad removal. PATIENTS AND METHODS: A total of 20 patients with pseudoherniation of buccal fat pad were included in the present study. The patients were divided randomly into 2 groups: the PBM group (660 nm, 100 mW, 6 seconds, 2 J/cm2) and the DXM group (4 mg every 8 hours for 3 days after the procedure). Pain levels were evaluated using a visual analog scale at days 2 and 4 after surgery, whereas the edema was evaluated by measuring the distance between 6 reference points: tragus, pogonion of the soft tissue, lateral eye commissure, the gonial angle, nose wing, and mouth commissure at days 2, 4, 7, 15, 30, 60, and 90. The QOL was evaluated using the Oral Health Impact Profile 14 questionnaire at days 2 and 4 after surgery. RESULTS: There were no differences between the PBM and DXM groups in pain or edema. In terms of the QOL, the PBM group was significantly more comfortable when chewing than the DXM group (P < .05) CONCLUSION: The use of PBM at a power of 100 mW and 2 J/cm2 per point had similar effects to oral DXM for the control of pain and edema, as well as in the QOL, except for masticatory function, which was significantly better in the PBM group.

Geometric morphometrics in mosquitoes: what has been measured?

The field of morphometrics is developing quickly. Recent advances have enabled geometric techniques to be applied to many zoological problems, particularly those involving epidemiologically-relevant mosquitoes. Herein, we briefly introduce geometric morphometric (GM) techniques and then review selected groups of mosquitoes (Culicidae) to which those techniques have been applied. In most of the reviewed cases, GM was capable of satisfactorily discriminating among the tested groups primarily when the studies considered differences within and among species, sexual dimorphism, treatments and the separation of laboratory strains. Although GM approaches have developed quite rapidly, some caution must be taken during data processing for a reliable biometrical approach, such as allometry and asymmetry analyses, scale removal and wing clarification staining for landmark digitization. We also critically forecast directions in this field and discuss how the creation of image databases should enhance species identification in culicids.

Effects of wolbachia on ovarian apoptosis in culex quinquefasciatus (Say, 1823) during the previtellogenic and vitellogenic periods

Background: Apoptosis is programmed cell death that ordinarily occurs in ovarian follicular cells in various organisms. In the best-studied holometabolous insect, Drosophila, this kind of cell death occurs in all three cell types found in the follicles, sometimes leading to follicular atresia and egg degeneration. On the other hand, egg development, quantity and viability in the mosquito Culex quinquefasciatus are disturbed by the infection with the endosymbiont Wolbachia. Considering that Wolbachia alters reproductive traits, we hypothesised that such infection would also alter the apoptosis in the ovarian cells of this mosquito. The goal of this study was to comparatively describe the occurrence of apoptosis in Wolbachia-infected and uninfected ovaries of Cx. quinquefasciatus during oogenesis and vitellogenesis. For this, we recorded under confocal microscopy the occurrence of apoptosis in all three cell types of the ovarian follicle. In the first five days of adult life we observed oogenesis and, after a blood meal, the initiation step of vitellogenesis. Results: Apoptoses in follicular cells were found at all observation times during both oogenesis and vitellogenesis, and less commonly in nurse cells and the oocyte, as well as in atretic follicles. Our results suggested that apoptosis in follicular cells occurred in greater numbers in infected mosquitoes than in uninfected ones during the second and third days of adult life and at the initiation step of vitellogenesis. Conclusions: The presence of Wolbachia leads to an increase of apoptosis occurrence in the ovaries of Cx. quinquefasciatus. Future studies should investigate if this augmented apoptosis frequency is the cause of the reduction in the number of eggs laid by Wolbachia-infected females. Follicular atresia is first reported in the previtellogenic period of oogenesis. Our findings may have implications for the use of Wolbachia as a mosquito and pathogens control strategy.

A socialização da medicina na era do adhemarismo / The socialization of medicine in the era of São Paulo Governor Adhemar de Barros

A análise observa as conexões entre o processo de profissionalização dos médicos paulistas e políticas de saúde do governo estadual de Adhemar de Barros em São Paulo (1947-1951), em meio a amplas mudanças na área de saúde denominadas pelos médicos paulistas “socialização da medicina”. Reconhecemos aspectos ambivalentes para o profissionalismo médico diante desse governo populista, como: a luta médica pela equiparação ante os advogados servidores públicos estaduais; a criação de uma secretaria de saúde estadual; e certos elos contraditórios entre a área de saúde adhemarista e a ideologia e a organização profissionais da medicina paulista. Nesse particular, o artigo aprofunda a análise de manifestações ideológicas de importantes lideranças médicas paulistas.

The article analyzes how the process of the professionalization of physicians in São Paulo related to healthcare policy under the administration of São Paulo governor Adhemar de Barros (1947-1951) during a period of broad change in the realm of health known by São Paulo physicians as the “socialization of medicine.” Medical professionalism confronted certain ambivalences under this populist administration, including doctors’ struggle to achieve pay equal to that of state public attorneys; the establishment of a state health department; and some contradictory ties between the area of health under Adhemar and the professional ideology and organization of medicine in São Paulo. The article undertakes a more in-depth analysis of the ideological manifestations of important leaders in the state’s medical community.

[The socialization of medicine in the era of São Paulo Governor Adhemar de Barros]. / A socialização da medicina na era do adhemarismo.

The article analyzes how the process of the professionalization of physicians in São Paulo related to healthcare policy under the administration of São Paulo governor Adhemar de Barros (1947-1951) during a period of broad change in the realm of health known by São Paulo physicians as the "socialization of medicine." Medical professionalism confronted certain ambivalences under this populist administration, including doctors' struggle to achieve pay equal to that of state public attorneys; the establishment of a state health department; and some contradictory ties between the area of health under Adhemar and the professional ideology and organization of medicine in São Paulo. The article undertakes a more in-depth analysis of the ideological manifestations of important leaders in the state's medical community.

Formação de Comissão de Ouvidoria da UBS/ESF Vila Pirituba / Ombudsman Formation Commission of UBS / ESF Vila Pirituba

A UBS/ESF Vila Pirituba, preocupada em se apropriar da opinião do usuário que usufrui dos seus serviços, propõe a criação de uma Comissão de Ouvidoria para receber e propor sugestões à coordenação da unidade (AU)

Low genetic diversity in Wolbachia-Infected Culex quinquefasciatus (Diptera: Culicidae) from Brazil and Argentina / Baixa diversidade genética em Culex quinquefasciatus (Diptera: Culicidae) infectado por Wolbachia do Brasil e Argentina

Culex quinquefasciatus is a vector of human pathogens, including filarial nematodes and several viruses. Although its epidemiological relevance is known to vary across geographical regions, an understanding of its population genetic structure is still incipient. In light of this, we evaluated the genetic diversity of Cx. quinquefasciatus and Cx. pipiens x Cx. quinquefasciatus hybrids collected from nine localities in Brazil and one site in Argentina. We used mitochondrial genes cox1 and nd4, along with the coxA and wsp genes of the maternally-inherited Wolbachia endosymbiont. The nd4 fragment was invariant between samples, whilst cox1 exhibited four haplotypes that separated two types of Cx. quinquefasciatus, one clustered in southern Brazil. Low sequence diversity was generally observed, being discussed. Both Brazilian and Argentinian mosquitoes were infected with a single Wolbachia strain. As reported in previous studies with these populations, cox1 and nd4 diversity is not congruent with the population structure revealed by nuclear markers or alar morphology. Future Cx. quinquefasciatus research should, if possible, evaluate mtDNA diversity in light of other markers.

Culex quinquefasciatus é vetor de patógenos humanos, incluindo nematódeos filarídeos e vários vírus. Embora a sua relevância epidemiológica varie entre as diferentes regiões geográficas, o conhecimento da estrutura genética da população é ainda incipiente. Em vista disso, foram avaliados os níveis de diversidade genética de Cx. quinquefasciatus e de híbridos Cx. quinquefasciatus x Cx. pipiens de nove cidades do Brasil e em La Plata, na Argentina. Para os testes foram utilizados fragmentos dos genes mitocondriais cox1 e nd4, juntamente com coxA e wsp do endossimbionte Wolbachia, herdado maternalmente. O fragmento nd4 não apresentou variação entre as amostras, e o cox1 exibiu quatro haplótipos que separaram dois tipos de Cx. quinquefasciatus, com um deles agrupado no sul do Brasil. Os dados de sequência mostraram baixa diversidade, sendo esta discutida. Ambas as amostras de mosquitos brasileiros e argentinos estão infectados com uma única cepa de Wolbachia. A diversidade apresentada por nd4 e cox1 não é congruente com a estrutura da população revelada por marcadores nucleares e morfologia alar de estudos anteriores com estas mesmas populações. Pesquisas com Cx. quinquefasciatus devem, se possível, avaliar a diversidade por DNA mitocondrial na luz de outros marcadores.

Low genetic diversity in Wolbachia-Infected Culex quinquefasciatus (Diptera: Culicidae) from Brazil and Argentina.

Culex quinquefasciatus is a vector of human pathogens, including filarial nematodes and several viruses. Although its epidemiological relevance is known to vary across geographical regions, an understanding of its population genetic structure is still incipient. In light of this, we evaluated the genetic diversity of Cx. quinquefasciatus and Cx. pipiens x Cx. quinquefasciatus hybrids collected from nine localities in Brazil and one site in Argentina. We used mitochondrial genes cox1 and nd4, along with the coxA and wsp genes of the maternally-inherited Wolbachia endosymbiont. The nd4 fragment was invariant between samples, whilst cox1 exhibited four haplotypes that separated two types of Cx. quinquefasciatus, one clustered in southern Brazil. Low sequence diversity was generally observed, being discussed. Both Brazilian and Argentinian mosquitoes were infected with a single Wolbachia strain. As reported in previous studies with these populations, cox1 and nd4 diversity is not congruent with the population structure revealed by nuclear markers or alar morphology. Future Cx. quinquefasciatus research should, if possible, evaluate mtDNA diversity in light of other markers.

Effects of Wolbachia on fitness of Culex quinquefasciatus (Diptera; Culicidae).

Wolbachia are α-proteobacteria that were first reported in Culex pipiens mosquitoes early in the twentieth century. Since then, the effect of Wolbachia on their host's reproduction has drawn attention and has been increasingly investigated. Given the extreme complexity of this interaction, new study cases are welcomed to enhance its understanding. The present work addressed the influence of Wolbachia on Cx. quinquefasciatus, the cosmopolitan member of the Cx. pipiens complex. Samples of a Cx. quinquefasciatus colony (wPip(+)) originated from individuals naturally infected by Wolbachiapipientis B strain, were cured with tetracycline, yielding a Wolbachia-free colony (wPip(-)). Both the presence of bacteria and the efficiency of bacterial elimination were checked by PCR of the wsp gene. Total reproductive unidirectional incompatibility occurred when wPip(-) females were crossed with wPip(+) males, whereas the other three types of reciprocal crosses were viable. Reproductive aspects were also comparatively evaluated between colonies. Concerning oviposition time during the first gonotrophic cycle, wPip(+) females developed and laid eggs earlier than did wPip(-) females. Reproductive fitness was higher among wPip(-) than wPip(+) females regarding the following parameters: fertility: egg rafts/fed females; fecundity: eggs/raft, and viability: larvae/eggs. Conversely, longevity of wPip(-) females was lower. Summarising, although the infected mosquitoes have the advantage of a higher longevity, they have lower reproductive fitness. Our results are partly distinct from all other reports on Aedes and Culex mosquitoes previously published.

Effects of Wolbachia on fitness of Culex quinquefasciatus (Diptera Culicidae)

Wolbachia are á-proteobacteria that were first reported in Culex pipiens mosquitoes early in the twentieth century. Since then, the effect of Wolbachia on their host’s reproduction has drawn attention and has been increasingly investigated. Given the extreme complexity of this interaction, new study cases are welcomed to enhance its understanding. The present work addressed the influence of Wolbachia on Cx. quinquefasciatus, the cosmopolitan member of the Cx. pipiens complex.

Culex quinquefasciatus vitellogenesis: morphological and biochemical aspects

The vitellogenic process in Culex quinquefasciatus, which is triggered by a blood meal, involves the synthesis, distribution and storage of the nutrients necessary for embryo development. The fat body of an adult female Cx. quinquefasciatus revealed two cell types: large trophocytes and small, eosinophilic, "oenocyte-like" cells, which show no morphological changes throughout the gonotrophic cycle. Trophocytes, which only begin to synthesise vitellogenin (Vg) 12 h post-blood meal (PBM), undergo a series of morphological changes following engorgement. These changes include the expansion of the rough endoplasmic reticulum (RER) and Golgi complex, which are later destroyed by autophagosomes. At 84 h PBM, trophocytes return to their pre-engorgement morphology. The ovarian follicles of non-blood-fed Cx. quinquefasciatus contain a cluster of eight undifferentiated cells surrounded by follicular epithelium. After engorgement, the oocyte membrane facing the perioocytic space increases its absorptive surface by microvilli development; large amounts of Vg and lipids are stored between 24 and 48 h PBM. Along with yolk storage in the oocyte, follicular cells exhibit the development of RER cisternae and electron-dense granules begin to fill the perioocytic space, possibly giving rise to endochorion. Later in the gonotrophic cycle, electron-dense vesicles, which are possible exochorion precursors, fuse at the apical membrane of follicular cells. This fusion is followed by follicular cell degeneration.

Reforma sanitária e política paulista: as relações entre o processo de profissionalização dos médicos de São Paulo e políticas de saúde do governo estadual de Adhemar de Barros (1947-1951) / Sanitary reform and São Paulo State policy: the relationship between the professionalization of the doctors of São Paulo and health policies of the state government of Adhemar de Barros (1947-1951)

Esta pesquisa investiga, no Estado de São Paulo, as relações entre o processo de profissionalização dos médicos paulistas e o fenômeno de liderança política do adhemarismo, que foi muito influente sobre a dinâmica política da era populista brasileira (1930-64). Em seus mandatos como chefe do executivo paulista, Adhemar Pereira de Barros empreendeu políticas de saúde que interferiram no processo de profissionalização dessa carreira em São Paulo. Em especial, tratamos da organização da Secretaria de Saúde Pública e Assistência Social, realização do segundo mandato de Adhemar de Barros como governador (1947-1951). Assim, a pesquisa avalia as conexões entre profissionalismo e política em termos das formas como essa profissão relacionou-se com o Estado e quanto as suas injunções diante da política adhemarista. Neste contexto, acreditamos que a ideologia predominante que permeou o grupo médico de São Paulo foi uma mescla entre a ideologia da neutralidade do saber, como base de uma atitude anti-política diante dos custos da política populista do adhemarismo, e uma relativa aproximação, em termos das linhas mais gerais, com a presença maior do Estado na oferta de serviços de saúde, linha que também marcou as políticas adhemaristas. Acreditamos que seria possível entender esse relativo anti-populismo dos médicos paulistas como uma atitude anti-política típica de profissionais que, baseados na neutralidade profissional, estabelecem uma estratégia de relativo distanciamento da política convencional populista, a fim de preservar sua autonomia técnica dos custos do embate político puro (Halliday, 1999). Contudo, de acordo com nossos dados, uma visão representativa da medicina paulista sobre a necessidade de maior participação do Estado na oferta de serviços de saúde, colocou-a numa posição ambivalente frente à tendência de maior presença estatal na área da saúde das políticas adhemaristas.

Reforma sanitária e política paulista: as relações entre o processo de profissionalização dos médicos de São Paulo e políticas de saúde do governo estadual de Adhemar de Barros (1947-1951) / Sanitary reform and São Paulo State policy: the relationship between the professionalization of the doctors of São Paulo and health policies of the state government of Adhemar de Barros (1947-1951)

Esta pesquisa investiga, no Estado de São Paulo, as relações entre o processo de profissionalização dos médicos paulistas e o fenômeno de liderança política do adhemarismo, que foi muito influente sobre a dinâmica política da era populista brasileira (1930-64). Em seus mandatos como chefe do executivo paulista, Adhemar Pereira de Barros empreendeu políticas de saúde que interferiram no processo de profissionalização dessa carreira em São Paulo. Em especial, tratamos da organização da Secretaria de Saúde Pública e Assistência Social, realização do segundo mandato de Adhemar de Barros como governador (1947-1951). Assim, a pesquisa avalia as conexões entre profissionalismo e política em termos das formas como essa profissão relacionou-se com o Estado e quanto as suas injunções diante da política adhemarista. Neste contexto, acreditamos que a ideologia predominante que permeou o grupo médico de São Paulo foi uma mescla entre a ideologia da neutralidade do saber, como base de uma atitude anti-política diante dos custos da política populista do adhemarismo, e uma relativa aproximação, em termos das linhas mais gerais, com a presença maior do Estado na oferta de serviços de saúde, linha que também marcou as políticas adhemaristas. Acreditamos que seria possível entender esse relativo anti-populismo dos médicos paulistas como uma atitude anti-política típica de profissionais que, baseados na neutralidade profissional, estabelecem uma estratégia de relativo distanciamento da política convencional populista, a fim de preservar sua autonomia técnica dos custos do embate político puro (Halliday, 1999). Contudo, de acordo com nossos dados, uma visão representativa da medicina paulista sobre a necessidade de maior participação do Estado na oferta de serviços de saúde, colocou-a numa posição ambivalente frente à tendência de maior presença estatal na área da saúde das políticas adhemaristas. (AU)