Antifungal Susceptibility and Candida sp. Biofilm Production in Clinical Isolates of HIV-Positive Brazilian Patients under HAART Therapy.

The aim of the present study was to characterize biofilms formed by Candida spp. clinical isolates (n = 19), isolated from the oral mucosa of HIV-positive patients. For characterizing the biofilms formed by several Candida sp. strains, isolated from HIV-positive patients, in terms of formed biomass, matrix composition and antifungal susceptibility profile, clinical isolates (n = 19) were collected from oral mucosa and identified. The biofilm of the samples was cultured with fluconazole (1250 mg/L), voriconazole (800 mg/L), anidulafungin (2 mg/L) or amphotericin B (2 mg/L). Afterwards, the quantification of the total biomass was performed using crystal violet assay, while the proteins and carbohydrates levels were quantified in the matrix. The results showed a predominance of C. albicans, followed by C. krusei. Around 58% of the Candida spp. biofilm had susceptibility to fluconazole and voriconazole (800 mg/L), 53% to anidulafungin and 74% to amphotericin B. C. krusei presented both the lowest and the highest biofilm matrix contents in polysaccharides and proteins. The low resistance to antifungal agents reported here was probably due to the fact that none of the participants had a prolonged exposure to these antifungals. A predominance of less virulent Candida spp. strains with low or no resistance to antifungals was observed. This can be attributed to a low fungal selective pressure. This most probably happened due to a low fungal selective pressure but also due to a good adherence to HAART therapy, which guarantees a stable and stronger immune patient response.

Determinantes sociais de saúde de crianças em consulta de puericultura: das condições socioeconômicas aos aspectos relacionados à saúde bucal / Social determinants of health of children in child care consultation: from socioeconomic conditions to aspects related to oral health / Determinantes sociales de la salud de los niños en la consulta infantil: de las condiciones socioeconómicas a los aspectos relacionados con la salud bucal

A imaturidade do sistema imunológico, associado a Determinantes Sociais de Saúde (DSS), promove doenças na infância. Especificamente, na cavidade oral, os DSS, representados pelo consumo elevado de açúcar, limitado acesso aos serviços de saúde e deficiência na higiene bucal, favorecem transtornos locais e sistêmicos. Assim, o estudo objetivou associar os DSS, no contexto das condições socioeconômicas, do acompanhamento pelo serviço de saúde e dos aspectos relacionados à saúde bucal de crianças atendidas em Unidades Básicas de Saúde (UBS) de um município cearense. Trata-se de estudo observacional, analítico, transversal e de abordagem quantitativa, conduzido com crianças e suas mães em Acarape - CE. Após consentimento, essas preencheram um questionário. Os dados foram analisados. Das 70 mães, 87,14% e 90,00% tinham idade inferior ou igual a 30 anos e renda de até um salário mínimo, respectivamente. Das 70 crianças, 87,14% tinham seus dentes/gengiva higienizados por seus pais ou responsável. Do total, 94,29% nunca se submeteram a atendimento odontológico. Observou-se associação significativa entre a mãe ter escolaridade superior ao ensino fundamental incompleto e higienizar os dentes/gengiva do filho com escova dental e dentifrício. Constatou-se associação significativa entre a criança ingerir bolacha doce/recheada, não consumir refrigerante e usar escova dental e dentifrício na higienização oral. Conclui-se que as crianças eram acompanhadas nas UBS regularmente; no entanto, esse serviço não esteve relacionado ao atendimento odontológico. Apesar da ausência desse tipo de acompanhamento e do consumo de alimentos cariogênicos, as mães se preocupavam com a saúde bucal das crianças, higienizando a cavidade oral diariamente, com meios adequados.

The immaturity of the immune system, associated with Social Determi- nants of Health (SDH), promotes diseases in childhood. Specifically, in the oral cavity, SDH, represented by high sugar consumption, limited access to health services, and poor oral hygiene, favors local and systemic disorders. Thus, the study aimed to associate the SDH, in the context of socioeconomic conditions, monitoring by the health service and aspects related to children's oral health assisted in Basic Health Units (BHU) of a muni- cipality in Ceará. This is an observational, analytical, cross-sectional study with a quan- titative approach conducted with children and their mothers in Acarape - CE. After con- sent, they filled out a questionnaire. Data were analyzed. Of the 70 mothers, 87.14% and 90.00% were aged less than or equal to 30 years and had income up to one minimum wage, respectively. Of the 70 children, 87.14% had their teeth/gums cleaned by their pa- rents or guardian. Of the total, 94.29% never underwent dental care. There was a signifi- cant association between the mother having higher education than incomplete elementary school and cleaning the child's teeth/gums with a toothbrush and toothpaste. A significant association was found between the child eating sweet/stuffed biscuits, not consuming soft drink, and using a toothbrush and dentifrice for oral hygiene. It is concluded that the chil- dren were regularly monitored at the BHU; however, this service was not related to dental care. Despite the absence of this type of follow-up and the consumption of cariogenic foods, the mothers were concerned about their children's oral health, cleaning the oral cavity daily with adequate means.

La inmadurez del sistema inmunológico, asociada a los Determinantes So- ciales de la Salud (DSS), promueve enfermedades en la infancia. Específicamente, en la cavidad bucal, los DSS, representados por el alto consumo de azúcar, el acceso limitado a los servicios de salud y la mala higiene bucal, favorecen los trastornos locales y sisté- micos. Así, el estudio tuvo como objetivo asociar el DSS, en el contexto de las condicio- nes socioeconómicas, el seguimiento por el servicio de salud y los aspectos relacionados con la salud bucal de los niños atendidos en las Unidades Básicas de Salud (UBS) de un municipio de Ceará. Se trata de un estudio observacional, analítico, transversal con enfo- que cuantitativo, realizado con niños y sus madres en Acarape ­ CE. Después del consen- timiento, completaron un cuestionario. Los datos fueron analizados. De las 70 madres, 87,14% y 90,00% tenían edad menor o igual a 30 años e ingresos hasta un salario mínimo, respectivamente. De los 70 niños, al 87,14% se les limpió los dientes/encías por sus pa- dres o tutores. Del total, el 94,29% nunca realizó atención odontológica. Hubo una aso- ciación significativa entre la madre con educación superior a la primaria incompleta y la limpieza de los dientes/encías del niño con cepillo y pasta dental. Se encontró una asoci- ación significativa entre el niño que come galletas dulces/rellenas, no consume gaseosas y usa cepillo de dientes y dentífrico para la higiene bucal. Se concluyó que los niños eran monitoreados periódicamente en la UBS; sin embargo, este servicio no estaba relacionado con el cuidado dental. A pesar de la ausencia de este tipo de seguimiento y del consumo de alimentos cariogénicos, las madres se preocupan por la salud bucal de sus hijos, reali- zando la limpieza de la cavidad bucal diariamente, con medios adecuados.

Characterization of Oral Candida spp. Biofilms in Children and Adults Carriers from Eastern Europe and South America.

BACKGROUND: Candida albicans and non-Candida albicans Candida species (NCACs) are known to colonize and invade various tissues, including the oral mucosa. In this work, we aimed to characterize mature biofilms of several Candida spp. clinical isolates (n = 33) obtained from the oral mucosa of children, adults, and elders of Eastern Europe and South America. METHODS: Each strain was evaluated for its capacity to form biofilms in terms of total biomass using the crystal violet assay and for matrix components production (proteins and carbohydrates) using the BCA and phenol-sulfuric tests, respectively. The effect of different antifungals on biofilm formation was studied. RESULTS: in the children's group, a predominance of C. krusei (81%) was observed, while, among adults, the main species was C. albicans (59%). Most strains showed a reduced response to antimicrobial drugs when in biofilm form (p < 0.01). Moreover, it was observed that strains isolated from children produced more matrix, with higher levels of protein and polysaccharides. CONCLUSIONS: children were more likely to be infected by NCACs than adults. More importantly, these NCACs were able to form biofilms richer in matrix components. This finding is of clinical importance, particularly in pediatric care, since stronger biofilms are highly associated with antimicrobial resistance, recurrent infections, and higher therapeutic failure.

Pacientes hipertensos e diabéticos atendidos em ambiente hospitalar e maternidade: dos fatores sociodemográficos e econômicos aos clínicos e relacionados à saúde bucal / Hypertensive and diabetic patients assisted in a hospital and maternity environment: from sociodemographic and economic factors to clinical and oral health-related factors / Pacientes hipertensos y diabéticos atendidos en un entorno hospitalario y de maternidad: de los factores sociodemográficos y económicos a los factores clínicos y relacionados con la salud bucodental

O estudo objetivou determinar as características e associações entre os fatores sociodemográficos, econômicos, clínicos e relacionados à saúde bucal de hipertensos e diabéticos atendidos em hospital e maternidade de um município cearense. Trata-se de estudo observacional analítico transversal e de abordagem quantitativa realizado com pacientes hipertensos e diabéticos atendidos em hospital e maternidade do município de Redenção - CE, no período de dezembro de 2019 a fevereiro de 2020. Após consentimento, aplicou-se um questionário, abordando desde a presença e história clínica de Hipertensão Arterial Sistêmica (HAS) e Diabetes Mellitus (DM) aos aspectos relacionados à saúde bucal e consumo de alimentos cariogênicos. Em seguida, os participantes foram submetidos à verificação da pressão arterial sistólica e diastólica. Os dados foram tabulados e analisados. Dos 42 participantes, 73,80% tinham história familiar de HAS, 92,85% desconheciam as doenças bucais e 73,80% não sabiam como preveni-las. Observou-se associação significativa entre ser participante que não admitia a influência da HAS e DM sobre a saúde bucal e não ser acompanhado pelo odontólogo, assim como ser hipertenso e/ou diabético com idade igual ou superior a 60 anos e conhecer os meios preventivos de doenças bucais. Conclui-se que os pacientes apresentavam HAS e DM controladas, desconheciam as doenças bucais e não acreditavam na influência da HAS e DM sobre a saúde bucal, apesar da consciência quanto à interferência da saúde oral sobre a saúde geral.

study aimed to determine the characteristics and associations between sociodemographic, economic, clinical, and oral health-related factors of hypertensive and diabetic patients treated at a hospital and maternity hospital in a municipality in Ceará. This is a cross-sectional analytical observational study with a quantitative approach carried out with hypertensive and diabetic patients treated at a hospital and maternity hospital in Redenção - CE, from December 2019 to February 2020. After consent, a questionnaire was applied, ranging from the presence and clinical history of Systemic Arterial Hypertension (SAH) and Diabetes Mellitus (DM) to aspects of oral health and consumption of cariogenic foods. Then, the participants underwent verification of systolic and diastolic blood pressure. Data were tabulated and analyzed. Of the 42 participants, 73.80% had a family history of SAH, 92.85% were unaware of oral diseases, and 73.80% did not know how to prevent them. A significant association was observed between being a participant who did not admit the influence of SAH and/or DM on oral health and not being accompanied by a dentist, as well as being hypertensive and diabetic aged 60 years or older and knowing the preventive means of oral diseases. It was concluded that the patients who had controlled SAH and DM were unaware of oral diseases and did not believe in the influence of SAH and DM on oral health, despite being aware of the interference of oral health on general health.

El estudio tuvo como objetivo determinar las características y asociaciones entre factores sociodemográficos, económicos, clínicos y relacionados a la salud bucal de pacientes hipertensos y diabéticos atendidos en un hospital y maternidad de un municipio de Ceará. Se trata de un estudio observacional analítico transversal con abordaje cuantitativo realizado con pacientes hipertensos y diabéticos atendidos en un hospital y maternidad de Redenção - CE, de diciembre de 2019 a febrero de 2020. Tras el consentimiento, se aplicó un cuestionario que abarcaba desde la presencia e historia clínica de Hipertensión Arterial Sistémica (HAS) y Diabetes Mellitus (DM) hasta aspectos de salud bucal y consumo de alimentos cariogénicos. A continuación, los participantes se sometieron a la verificación de la presión arterial sistólica y diastólica. Los datos se tabularon y analizaron. De los 42 participantes, el 73,80% tenía antecedentes familiares de HSA, el 92,85% desconocía las enfermedades bucodentales y el 73,80% no sabía cómo prevenirlas. Se observó una asociación significativa entre ser un participante que no admitía la influencia de la HSA y/o la DM en la salud bucodental y no estar acompañado por un dentista, así como ser hipertenso y diabético de 60 años o más y conocer los medios preventivos de las enfermedades bucodentales. Se concluyó que los pacientes que tenían controlada la HSA y la DM desconocían las enfermedades bucodentales y no creían en la influencia de la HSA y la DM en la salud bucodental, a pesar de ser conscientes de la interferencia de la salud bucodental en la salud general.

Cell-Penetrating Antimicrobial Peptides with Anti-Infective Activity against Intracellular Pathogens.

Cell-penetrating peptides (CPPs) are natural or engineered peptide sequences with the intrinsic ability to internalize into a diversity of cell types and simultaneously transport hydrophilic molecules and nanomaterials, of which the cellular uptake is often limited. In addition to this primordial activity of cell penetration without membrane disruption, multivalent antimicrobial activity accompanies some CPPs. Antimicrobial peptides (AMPs) with cell-penetrability exert their effect intracellularly, and they are of great interest. CPPs with antimicrobial activity (CPAPs) comprise a particular class of bioactive peptides that arise as promising agents against difficult-to-treat intracellular infections. This short review aims to present the antibacterial, antiparasitic, and antiviral effects of various cell-penetrating antimicrobial peptides currently documented. Examples include the antimicrobial effects of different CPAPs against bacteria that can propagate intracellularly, like Staphylococcus sp., Streptococcus sp., Chlamydia trachomatis, Escherichia coli, Mycobacterium sp., Listeria sp., Salmonella sp. among others. CPAPs with antiviral effects that interfere with the intracellular replication of HIV, hepatitis B, HPV, and herpes virus. Additionally, CPAPs with activity against protozoa of the genera Leishmania, Trypanosoma, and Plasmodium, the etiological agents of Leishmaniasis, Chagas' Disease, and Malaria, respectively. The information provided in this review emphasizes the potential of multivalent CPAPs, with anti-infective properties for application against various intracellular infections. So far, CPAPs bear a promise of druggability for the translational medical use of CPPs alone or in combination with chemotherapeutics. Moreover, CPAPs could be an exciting alternative for pharmaceutical design and treating intracellular infectious diseases.

Perfil sociodemográfico e econômico e comportamento sexual de brasileiros e estrangeiros recém-ingressos em uma universidade pública / Sexual behavior, sociodemographic and economic profile of both first-year brazilian and international students at a public university / Perfil sociodemográfico y económico y comportamiento sexual de brasileños y extranjeros recien-ingresaron una universidad pública

Objetivo: Caracterizar, comparar e associar o perfil sociodemográfico e econômico, bem como o comportamento sexual e o conhecimento e presença de Infecções Sexualmente Transmissíveis (IST) entre universitários brasileiros e estrangeiros recém-ingressos a uma universidade pública. Métodos: Pesquisa exploratória, descritiva e quantitativa, conduzida com 131 estudantes. Resultados: Houve o predomínio de participantes do sexo masculino, brasileiros e guineenses, solteiros, com parceria eventual e renda familiar de até um salário mínimo. Mais da metade dos participantes brasileiros e estrangeiros tinha iniciado a vida sexual antes dos 18 anos e tinha tido, no mínimo, 2 parceiros. A maior parte dos estudantes sabia o conceito de IST e não tinha contraído qualquer uma delas. Foi observada associação entre ser estrangeiro, ter tido a 1ª relação sexual e conhecer IST. Conclusão: Percebe-se que a realidade dos universitários estrangeiros se assemelha à realidade dos brasileiros, sendo ambos vulneráveis às IST

Objective: To characterize, compare and associate the sociodemographic and economic profile, as well as the sexual behavior and the knowledge and presence of Sexually Transmissible Infections (STI) among Brazilian university students and foreigners recently admitted to an public university. Method: Exploratory, descriptive and quantitative research was conducted with 131 students. Results: There was a predominance of male participants, Brazilian and Guinean, single, with eventual partnership and family income of up to one minimum wage. More than half of the Brazilian and foreign participants had started their sexual life before the age of 18 and had had at least 2 partners. Most students knew the concept of STI and hadn't contracted any of them. An association was observed between being a foreigner, having had the first intercourse and knowing STI. Conclusion: It's perceived that the reality of foreign university students is similar to the reality of Brazilians

Objetivo: Caracterizar, comparar y asociar el perfil sociodemográfico y económico, así como el comportamiento sexual y el conocimiento y presencia de Infecciones Sexualmente Transmisibles (IST) entre universitarios brasileños y extranjeros recién ingresados a uma universidad pública. Métodos: Investigación exploratoria, descriptiva y cuantitativa, conducida con 131 estudiantes. Resultados: Hubo el predominio de participantes del sexo masculino, brasileños y guineanos, solteros, con asociación eventual y renta familiar de hasta un salario mínimo. Más de la mitad de los participantes brasileños y extranjeros había iniciado la vida sexual antes de los 18 años y había tenido al menos 2 socios. La mayoría de los estudiantes sabía el concepto de IST y no había contraído ninguna de ellas. Se observó asociación entre ser extranjero, haber tenido la 1ª relación sexual y conocer IST. Conclusión: La realidade de los universitarios extranjeros se asemeja a la realidad de los brasileños, siendo ambos vulnerables a las IST

Candidose na medicina veterinária: um enfoque micológico, clínico e terapêutico / Candidosis on veterinary medicine: a mycological, clinical and therapeutic approuch

O gênero Candida é composto por leveduras que vivem como comensais na microbiota de homens e animais. Em geral, não causam nenhum dano aos seus hospedeiros, entretanto, em virtude de desequilíbrios nas defesas química, física e imunológica, esses microrganismos podem se tornar patogênicos. Infecções por Candida spp. são pouco frequentes na Medicina Veterinária no entanto, nos últimos anos, tem sido observado aumento considerável de relatos de enfermidades causadas por essas leveduras, acometendo diferentes animais. Várias espécies do gênero são implicadas em quadros infecciosos, sendo a C. albicans a principal delas, seguida por C. tropicalis e C. parapsilosis. Considerando-se o potencial patogênico do gênero Candida, aliado ao surgimento de cepas resistentes a derivados azólicos, in vitro, o presente trabalho se propôs a realizar detalhada revisão de literatura, abordando os aspectos clínico-laboratoriais, etiológicos e terapêuticos da candidose na Medicina Veterinária.

The Candida genus is composed by yeasts that live as commmensal on human and animals' microbiota. In general, they do not cause any damage to their hosts. However, due instability on chemical, physical and immunological defenses, these microorganisms can become pathogens. Candida spp. infections are rare on Veterinary Medicine. However, on the last years, a considerable raise of illness caused by these yeasts has been related on varied animal species. Several species of this genus has been mentioned as responsible for infectious diseases in animals, being C. albicans the main of them, followed by C. tropicalis and C. parapsilosis. Considering the pathogenic role of the genus Candida, allied to the emerging of resistant strains to the azole derivatives, in vitro, the present research proposed to perform a detailed review, approaching clinic-laboratorial, etiologic and therapeutic aspects of the candidosis on Veterinary medicine.

Chemical composition, toxicity and larvicidal and antifungal activities of Persea americana (avocado) seed extracts.

The present study had the aim of testing the hexane and methanol extracts of avocado seeds, in order to determine their toxicity towards Artemia salina, evaluate their larvicidal activity towards Aedes aegypti and investigate their in vitro antifungal potential against strains of Candida spp, Cryptococcus neoformans and Malassezia pachydermatis through the microdilution technique. In toxicity tests on Artemia salina, the hexane and methanol extracts from avocado seeds showed LC50 values of 2.37 and 24.13 mg mL-1 respectively. Against Aedes aegypti larvae, the LC50 results obtained were 16.7 mg mL-1 for hexane extract and 8.87 mg mL-1 for methanol extract from avocado seeds. The extracts tested were also active against all the yeast strains tested in vitro, with differing results such that the minimum inhibitory concentration of the hexane extract ranged from 0.625 to 1.25mg L-(1), from 0.312 to 0.625 mg mL-1 and from 0.031 to 0.625 mg mL-1, for the strains of Candida spp, Cryptococcus neoformans and Malassezia pachydermatis, respectively. The minimal inhibitory concentration for the methanol extract ranged from 0.125 to 0.625 mg mL-1, from 0.08 to 0.156 mg mL-1 and from 0.312 to 0.625 mg mL-1, for the strains of Candida spp., Cryptococcus neoformans and Malassezia pachydermatis, respectively.

Chemical composition, toxicity and larvicidal and antifungal activities of Persea americana (avocado) seed extracts / Composição química, toxicidade, atividade larvicida e antifúngica de extratos de semente de Persea americana (abacate)

The present study had the aim of testing the hexane and methanol extracts of avocado seeds, in order to determine their toxicity towards Artemia salina, evaluate their larvicidal activity towards Aedes aegypti and investigate their in vitro antifungal potential against strains of Candida spp, Cryptococcus neoformans and Malassezia pachydermatis through the microdilution technique. In toxicity tests on Artemia salina, the hexane and methanol extracts from avocado seeds showed LC50 values of 2.37 and 24.13mg mL-1 respectively. Against Aedes aegypti larvae, the LC50 results obtained were 16.7mg mL-1 for hexane extract and 8.87mg mL-1 for methanol extract from avocado seeds. The extracts tested were also active against all the yeast strains tested in vitro, with differing results such that the minimum inhibitory concentration of the hexane extract ranged from 0.625 to 1.25mg L-¹, from 0.312 to 0.625mg mL-1 and from 0.031 to 0.625mg mL-1, for the strains of Candida spp, Cryptococcus neoformans and Malassezia pachydermatis, respectively. The minimal inhibitory concentration for the methanol extract ranged from 0.125 to 0.625mg mL-1, from 0.08 to 0.156mg mL-1 and from 0.312 to 0.625mg mL-1, for the strains of Candida spp., Cryptococcus neoformans and Malassezia pachydermatis, respectively.

O presente estudo teve como objetivo testar os extratos hexânico e metanólico das sementes do abacate, a fim de determinar sua toxicidade em Artemia salina, avaliar a atividade larvicida frente ao Aedes aegypti, bem como verificar o potencial antifúngico in vitro contra cepas de Candida spp, Cryptococcus neoformans e Malassezia pachydermatis, através da técnica de microdiluição. Os extratos hexânico e metanólico das sementes de abacate apresentaram no teste de toxicidade frente à Artemia salina, valores de LC50 2,37 e 24,13mg L-1, respectivamente; contra as larvas do Aedes aegypti os resultados obtidos foram LC50 16,7mg L-1 para o extrato hexânico e 8,87mg L-1 para o extrato metanólico das sementes do abacate. Os extratos testados também foram ativos contra todas as cepas de leveduras, testadas in vitro, apresentando diferentes resultados, onde o MIC do extrato hexânico variou de 0,625 a 1,25mg mL-1, de 0,312 a 0,625mg mL-1 e de 0,031 a 0,625mg mL-1 para as cepas de Candida spp., Cryptococcus neoformans e Malassezia pachydermatis, respectivamente. O intervalo de MIC para o extrato metanólico foi de 0,125 a 0,625mg mL-1, 0,08 a 0,156mg mL-1 e de 0,312 a 0,625mg mL-1, para as exemplares de Candida spp., Cryptococcus neoformans e Malassezia pachydermatis, respectivamente.