Compositional boundaries for functional dental composites containing calcium orthophosphate particles.

OBJECTIVES: To investigate the interrelationships among handling, degree of conversion (DC), mechanical behavior and Ca2+ release of composites containing dicalcium phosphate dihydrate (DCPD, CaHPO4.2H2O), as a function of total inorganic content and DCPD: glass ratio. METHODS: Twenty-one formulations (1 BisGMA: 1 TEGDMA, in mols) with inorganic fractions ranging from zero to 50 vol% and different DCPD: glass ratios were evaluated for viscosity (parallel plate rheometer, n = 3), DC (near-FTIR spectroscopy, n = 3), fracture toughness/K1C (single-edge notched beam, n = 7-11) and 14-day Ca2+ release (inductively coupled plasma optical emission spectroscopy, n = 3). Data were analyzed by ANOVA/Tukey test (except viscosity, where Kruskal-Wallis/Dunn tests were used, α: 0.05). RESULTS: Viscosity and DC increased with DCPD: glass ratio among composites with the same inorganic content (p < 0.001). At inorganic fractions of 40 vol% and 50 vol%, keeping DCPD content at a maximum of 30 vol% did not compromise K1C. Ca2+ release showed an exponential relationship with DCPD mass fraction in the formulation (R2 = 0.986). After 14 days, a maximum of 3.8% of the Ca2+ mass in the specimen was released. CONCLUSION: Formulations containing 30 vol% DCPD and 10-20 vol% glass represent the best compromise between viscosity, K1C and Ca2+ release. Materials with 40 vol% DCPD should not be disregarded, bearing in mind that Ca2+ release will be maximized at the expense of K1C.

O cuidado do idoso com alzheimer e a resiliência do cuidador informal / El cuidado de los mayores con alzheimer y la resiliencia del cuidador informal / The care of the elderly with Alzheimer and the resilience of the informal caregiving

Objetivo:compreender o cuidado com o idoso com a doença de Alzheimer e a resiliência do cuidador informal. Método:pesquisa qualitativa com 20 cuidadores de idosos realizada de agosto a dezembro de 2019 através de um roteiro sociodemográfico-econômico e questões norteadoras analisadas pela Análise de conteúdo e Teoria das Representações Sociais. Resultados:foi observada a complexidade, singularidade e dualidade de sentimentos no cuidado com o idoso com a doença de Alzheimer. Apesar dos cuidadores não compreenderem o significado de resiliência, existe o desenvolvimento de habilidades para o enfrentamento do cotidiano de cuidados. Conclusões:o cuidador convive com a ambivalência de sentimentos e experiências, de caráter semelhante ou oposto, que interferem inteiramente no cuidado prestado e que contribuem na construção do processode resiliência deste cuidador informal familiar.

Objective: to understand the care of the elderly with Alzheimer's disease and the resilience of the informal caregiver. Method: qualitative research with 20 caregivers of the elderly carried out from August to December 2019 through a sociodemographic-economic script and guiding questions that were analyzed by Content Analysis and Theory of Social Representations. Results: the complexity, uniqueness and duality of feelings in the care of the elderly with Alzheimer's disease were observed. Although caregivers do not understand the meaning of resilience, there is the development of skills to cope with daily care. Conclusions: the caregiver lives with the ambivalence of feelings and experiences, of a similar or opposite nature, that interfere entirely in the care provided and that contribute to the construction of the resilience process of this informal family caregiver.

Objetivo: comprender el cuidado del anciano con enfermedad de Alzheimer y la resiliencia del cuidador informal. Método: investigación cualitativa con 20 cuidadores de ancianos realizada de agosto a diciembre de 2019 a través de un guión sociodemográfico-económico y preguntas orientadoras que fueron analizadas por Análisis de Contenido y Teoría de las Representaciones Sociales. Resultados: se observó la complejidad, singularidad ydualidad de sentimientos en el cuidado de ancianos con enfermedad de Alzheimer. Aunque los cuidadores no comprendan el significado de resiliencia, existe el desarrollo de habilidades para afrontar el cuidado diario. Conclusiones: el cuidador vive con la ambivalencia de sentimientos y vivencias, de naturaleza análoga o contraria, que interfieren totalmente en el cuidado prestado y que contribuyen a la construcción del proceso de resiliencia de este cuidador familiar informal.

Influence of the calcium orthophosphate:glass ratio and calcium orthophosphate functionalization on the degree of conversion and mechanical properties of resin-based composites.

The study verified the influence of calcium orthophosphate (CaP):glass ratio on the degree of conversion and mechanical properties of resin-based composites containing either TEGDMA-functionalized dicalcium phosphate anhydrous (DCPA) or non-functionalized DCPA particles. The null hypotheses were that the evaluated variables are not affected by (1) CaP:glass ratio or (2) DCPA functionalization. DCPA particles were synthesized and half of them were functionalized with TEGDMA. Particle characterization included x-ray diffraction, elemental analysis, laser scattering, helium picnometry and scanning electron microscopy. Two series of composites were prepared containing either DCPA-NF (non-functionalized) or DCPA-F (functionalized), with total inorganic content of 50 vol % and DCPA:silanized barium glass (BG) ratios from 10:40 to 50:0. A composite containing 50 vol % BG was tested as control. DC was determined using FTIR spectroscopy. Biaxial flexural strength and modulus were tested after 24 h in water. Data were analyzed using Kruskal-Wallis/Dunn (flexural properties) or analysis of variance/Tukey tests (DC). Materials with similar actual DCPA contents were compared using Student's t test (alpha: 0.05). DC was higher for materials with DCPA-F, except for the 10:40 ratio. DCPA-F resulted in higher strength than DCPA-NF only at 40:10 ratio. Modulus was not affected by functionalization. Materials with similar actual DCPA contents showed differences in DC (F > NF), while no difference in flexural properties was observed between materials with 28%-30% DCPA. Both null hypotheses were rejected.

Repercussões da pandemia por COVID-19 no perfil de saúde dos acadêmicos de Fisioterapia / Repercussions of the COVID-19 pandemic on the health profile of Physiotherapy students

A pandemia da doença por coronavírus (COVID-19), teve seus primeiros casos localizados em Wuhan, na China, em dezembro de 2019. Por ser considerada infecciosa e altamente contagiosa causando problemas respiratórias, levou à inúmeras mudanças no calendário letivo das instituições de ensino. O presente estudo tem como objetivos rastrear o perfil dos acadêmicos de Fisioterapia reconhecendo os impactos da pandemia em sua saúde geral, bem como examinar as maiores dificuldades acadêmicas durante esse período. Trata-se de um levantamento de dados de caráter qualitativo, cuja fonte foi o Centro Universitário São Camilo (CUSC) durante os meses de agosto, setembro e outubro de 2021, totalizando 169 respostas. Foi observado que durante a pandemia, 45 (26,6%) dos estudantes apresentaram algum problema de saúde. Quanto às atividades diárias, 111 (65,7%) afirmaram que conseguiram adaptar atividades de lazer em casa, 84 (49,7%) tiveram seus hábitos alimentares piorados e 57 (33,7%) afirmaram ter menos de oito horas de sono. Em relação ao ensino à distância, 68 (40,2%) consideraram seu rendimento acadêmico regular e 156 (92,3%) se sentiram prejudicados de alguma forma. Além disso, 111 (65,7%) consideraram o ensino remoto extremamente estressante, onde a maioria optou pelo retorno presencial, sendo que 77 (45,6%) gostariam de retomar as atividades presenciais de forma completa e 76 (45,0%) optaram pelo retorno gradual. Foi constatado que o perfil dos acadêmicos de fisioterapia do CUSC passou por mudanças significativas em diversos aspectos, como sono, alimentação e principalmente referente à questões psicológicas e acadêmicas, havendo pontos positivos e negativos dessa forma de ensino.

The first case of the coronavirus disease (COVID-19) pandemic was located in Wuhan, China, in December 2019. As it is considered infectious and highly contagious, causing respiratory problems, it has led to numerous changes in the academic calendar of educational institutions. The present study aims to track the profile of physiotherapy students, recognizing the impacts of the pandemic on their overall health, as well as examining the greatest academic difficulties during this period. This is a qualitative data survey, collected from Centro Universitário São Camilo (CUSC) students during the months of August, September, and October 2021, totaling 169 responses. It was observed that during the pandemic, 45 (26.6%) students had some health problems. As for daily activities, 111 (65.7%) stated that they managed to adapt leisure activities at home, 84 (49.7%) worsened their eating habits, and 57 (33.7%) stated that they had less than eight hours of sleep. Regarding online learning, 68 (40.2%) considered their academic performance regular and 156 (92.3%) felt impaired in some way. In addition, 111 (65.7%) considered remote learning extremely stressful, where the majority opted for in-person classes, with 77 (45.6%) wanting to resume in-person activities completely, and 76 (45.0%) opted for a gradual return. It was found that the profile of CUSC physiotherapy students underwent significant changes in several aspects, such as sleep and diet, but mainly psychological and academic issues were referred to, with positive and negative points concerning online learning.

Toxoplasma gondii exposure in felines: an alarming factor to public health from mineiros, Goiás / Exposição ao toxoplasma gondii em felinos: um fator alarmante para a saúde pública de Mineiros, Goiás / Exposición a toxoplasma gondii en felinos: un factor alarmante para la salud pública de Mineiros, Goiás

Toxoplasmosis is a cosmopolitan disease caused by Toxoplasma gondii, an obligate protozoan that affects endothermic animals, including man. Being a zoonosis that can cause abortions, fetal malformations and blindness. Cats are the definitive hosts, acting as a source of dissemination. In order to collect epidemiological data on the distribution of T. gondii in Mineiros, Goiás, samples of domestic cats were analyzed to verify the circulation of the protozoan and reinforce preventive measures. Ninety-four samples of domestic cats, regardless of gender, age and breed, were randomly processed in the neighborhoods of Mineiros, Goiás. They were submitted to the indirect fluorescent antibody test for antibodies against T. gondii, using tachyzoites as antigens and anti-cat IgG conjugate (1:16 were positive). Of the 94 samples analyzed, 35 (37.2%) were reagents, of which four had a titration of 1:16, ten of 1:32, eleven of 1:64, eight of 1:128 and two of 1:256. All cats were semi-domiciled, but lifestyle and diet were not assessed. T. gondii infection is rarely symptomatic and the severity depends on the pathophysiological state. Brazil has high prevalence rates and requires effective care in the management of cats. In Mineiros, 29 reports of infected pregnant women were identified. Although infection in humans occurs primarily through consumption of undercooked meat, ingestion of oocysts in feces of cats is a possibility. Therefore, state public health institutions and veterinarians should promote health education, highlighting food hygiene. Since, when symptomatic, the disease presents severe clinical conditions and, in some cases, irreversible.

A toxoplasmose é uma doença cosmopolita causada pelo Toxoplasma gondii, um protozoário obrigatório que afeta animais endotérmicos, incluindo o homem. Sendo uma zoonose que pode causar abortos, malformações fetais e cegueira. Os gatos são os hospedeiros definitivos, atuando como fonte de disseminação. Para coletar dados epidemiológicos sobre a distribuição do T. gondii em Mineiros, Goiás, amostras de gatos domésticos foram analisadas para verificar a circulação do protozoário e reforçar as medidas preventivas. Noventa e quatro amostras de gatos domésticos, independente de sexo, idade e raça, foram processadas aleatoriamente nos bairros de Mineiros, Goiás. Foram submetidos ao teste de anticorpo fluorescente indireto para pesquisa de anticorpos contra T. gondii, utilizando como antígenos taquizoítos e conjugado anti-cat IgG (1:16 foram positivos). Das 94 amostras analisadas, 35 (37,2%) eram reagentes, das quais quatro tiveram titulação de 1:16, dez de 1:32, onze de 1:64, oito de 1:128 e duas de 1:256. Todos os gatos eram semi-domiciliados, mas o estilo de vida e a dieta não foram avaliados. A infecção por T. gondii raramente é sintomática e a gravidade depende do estado fisiopatológico. O Brasil possui altas taxas de prevalência e requer cuidados efetivos no manejo dos gatos. Em Mineiros, foram identificadas 29 notificações de gestantes infectadas. Embora a infecção em humanos ocorra principalmente pelo consumo de carne mal cozida, a ingestão de oocistos nas fezes de gatos é uma possibilidade. Portanto, as instituições estaduais de saúde pública e os médicos veterinários devem promover a educação em saúde, destacando a higiene alimentar. Já que, quando sintomática, a doença apresenta quadros clínicos graves e, em alguns casos, irreversíveis.

La toxoplasmosis es una enfermedad cosmopolita causada por Toxoplasma gondii, un protozoario obligado que afecta a animales endotérmicos, incluido el hombre. Ser una zoonosis que puede provocar abortos, malformaciones fetales y ceguera. Los gatos son los huéspedes definitivos, actuando como fuente de diseminación. Con el fin de recolectar datos epidemiológicos sobre la distribución de T. gondii en Mineiros, Goiás, se analizaron muestras de gatos domésticos para verificar la circulación del protozoario y reforzar las medidas preventivas. Noventa y cuatro muestras de gatos domésticos, independientemente de género, edad y raza, fueron procesadas al azar en los barrios de Mineiros, Goiás. Se sometieron a la prueba de anticuerpos fluorescentes indirectos contra T. gondii, utilizando como antígenos taquizoítos e IgG anti-cat conjugada (1:16 fueron positivos). De las 94 muestras analizadas, 35 (37,2%) fueron reactivos, de los cuales cuatro tuvieron una titulación de 1:16, diez de 1:32, once de 1:64, ocho de 1:128 y dos de 1:256. Todos los gatos tenían domicilio parcial, pero no se evaluó el estilo de vida ni la dieta. La infección por T. gondii rara vez es sintomática y la gravedad depende del estado fisiopatológico. Brasil tiene altas tasas de prevalencia y requiere una atención eficaz en el manejo de los gatos. En Mineiros se identificaron 29 casos de mujeres embarazadas infectadas. Aunque la infección en los seres humanos se produce principalmente a través del consumo de carne poco cocida, la ingestión de ovoquistes en las heces de los gatos es una posibilidad. Por lo tanto, las instituciones estatales de salud pública y los veterinarios deben promover la educación sanitaria, destacando la higiene alimentaria. Dado que, cuando sintomática, la enfermedad presenta cuadros clínicos severos y, en algunos casos, irreversibles.

Novel Ehrlichia canis genogroup in dogs with canine ehrlichiosis in Cuba.

BACKGROUND: Canine monocytic ehrlichiosis (CME) is caused by the tick-borne pathogen Ehrlichia canis, an obligate intracellular Gram-negative bacterium of the family Anaplasmataceae with tropism for canine monocytes and macrophages. The trp36 gene, which encodes for the major immunoreactive protein TRP36 in E. canis, has been successfully used to characterize the genetic diversity of this pathogen in different regions of the world. Based on trp36 sequence analysis, four E. canis genogroups, United States (US), Taiwan (TWN), Brazil (BR) and Costa Rica (CR), have been identified. The aim of this study was to characterize the genetic diversity of E. canis in Cuba based on the trp36 gene. METHODS: Whole blood samples (n = 8) were collected from dogs found to be infested with the tick vector Rhipicephalus sanguineus sensu lato (s.l.) and/or presenting clinical signs and symptoms of CME. Total DNA was extracted from the blood samples and trp36 fragments were amplified by PCR. Nucleotide and protein sequences were compared using alignments and phylogenetic analysis. RESULTS: Four of the trp36 sequences obtained (n = 8) fall within the phylogenetic cluster grouping the US genogroup E. canis strains. The other E. canis trp36 sequences formed a separate and well-supported clade (94% bootstrap value) that is phylogenetically distant from the other major groups and thus represents a new genogroup, herein designated as the 'Cuba (CUB) genogroup'. Notably, dogs infected with the CUB genogroup presented frequent hemorrhagic lesions. CONCLUSIONS: The results of this study suggest that genetic diversification of E. canis in Cuba is associated with the emergence of E. canis strains with increased virulence.

Oral health-related quality of life determinants throughout adolescence: a cohort study in Brazil.

PURPOSE: Oral health-related quality of life (OHRQoL) is a complex construct that reflects the interaction among well-being, socioeconomic, oral health status, and also contextual factors. This study aimed to verify the association between poorer socioeconomic background and oral health condition on OHRQoL throughout adolescence. METHODS: A cohort study followed a random sample of 1134 participants aged 12 years in 2012 (T1), 770 adolescents with an average age of 14 years in 2014 (T2; retention rate, 67.9%), and 768 adolescents with an average age of 17.5 years in 2018 (T3; retention rate, 67.8%). OHRQoL was collected three times using the Brazilian short version of the Childhood Perception Questionnaire 11-14 (CPQ 11-14). At baseline, the adolescents were clinically assessed by dentists, and their demographic data, socioeconomic status, use of dental services, and toothache were evaluated. The mean income of the neighborhood was used as a proxy of contextual factors. This variable was obtained from an official municipal publication. Poisson multilevel regression analyses were performed using a hierarchical approach to assess the predictors of OHRQoL over time. RESULTS: Adolescents living in a neighborhood with low mean income, low household income, low education levels, girls, and nonwhite individuals reported poor OHRQoL. Clinical variables such as gingival bleeding and malocclusion were also associated with higher overall scores on CPQ11-14, indicating poor OHRQoL. CONCLUSION: Our results showed that the unfavorable contextual and individual socioeconomic environment, and oral disease negatively influenced OHRQoL during adolescence.

Effect of the addition of fique bagasse microparticles in obtaining a biobased material based on cassava starch.

The indiscriminate accumulation of plastic waste has prompted research that leads to obtaining biobased materials. The research aim was to evaluate the effect of incorporating fique bagasse microparticles (FBM) in a cassava starch-based foamed material. First, the FBM extraction conditions were established by acid hydrolysis, for which the effect of acid concentration (5, 10 and 15% H2SO4), temperature (70, 80 and 90 °C) and extraction time (3, 5 and 7 h) on particle size, functional groups, color, and thermal properties was evaluated. The addition of FBM to the foamed material was then carried out. To do this, a completely randomized design with five treatments (0, 0.5, 0.75, 1.0 and 1.25% FBM) was evaluated. The response variables were the apparent density, expansion and spring index, compressibility, water absorption, thermal properties and FTIR. The results showed that the acid concentration, temperature and time had an effect on the morphological, chemical and thermal properties of FBM, with 10%, 70 °C and 7 h being the conditions that allowed obtaining the smallest particle size (61.69 ± 12.88 µm2). Moreover, the FBM concentration had a significant effect on the physical and mechanical properties of the foam, unleashing the treatment properties of 0.75%. This indicates that FBM have potential for use in obtaining biobased materials.

CPR and DPANN Have an Overlooked Role in Corals' Microbial Community Structure.

Understanding how microbial communities are structured in coral holobionts is important to estimate local and global impacts and provide efficient environment management strategies. Several studies investigated the relationship between corals and their microbial communities, including the environmental drivers of shifts in this relationship, associated with diseases and coral cover loss. However, these studies are often geographically or taxonomically restricted and usually focused on the most abundant microbial groups, neglecting the rare biosphere, including archaea in the group DPANN and the recently discovered bacterial members of the candidate phyla radiation (CPR). Although it is known that rare microbes can play essential roles in several environments, we still lack understanding about which taxa comprise the rare biosphere of corals' microbiome. Here, we investigated the host-related and technical factors influencing coral microbial community structure and the importance of CPR and DPANN in this context by analyzing more than a hundred coral metagenomes from independent studies worldwide. We show that coral genera are the main biotic factor shaping coral microbial communities. We also detected several CPR and DPANN phyla comprising corals' rare biosphere for the first time and showed that they significantly contribute to shaping coral microbial communities.

Lesão inalatória confirmada por broncoscopia nos pacientes admitidos em uma UTI de queimados / Inhalation injury confirmed by bronchoscopy in patients admitted to a burns ICU

OBJETIVO: Verificar a incidência de lesão inalatória confirmada por broncoscopia em pacientes com queimaduras faciais e/ou histórico de exposição a fumaça em uma Unidade de Terapia Intensiva para Queimados. MÉTODO: Estudo transversal retrospectivo baseado em coleta de prontuários de pacientes internados entre agosto de 2015 e maio de 2020. Na análise estatística realizou-se a caracterização dos dados categóricos e contínuos, teste exato de Fisher, teste de Shapiro-Wilk e teste de Kruskal-Wallis sendo avaliados no software STATA® 14 com nível de significância de 5%. RESULTADOS: 82 pacientes com lesão inalatória foram classificados em grupos de nenhuma lesão/leve, moderada e grave, com incidência de 19,2 casos de lesão inalatória a cada 100 internações na unidade de terapia intensiva de queimados e tempo médio de internação de 35,6 dias; destes, 27 faleceram. Os pacientes com lesão grave ficaram por menor tempo em ventilação mecânica. CONCLUSÕES: A avaliação por broncoscopia no atendimento inicial imediato ou em até 24h da admissão do paciente com queimadura facial pode ser adotada para otimizar o diagnóstico e realizar a classificação da lesão inalatória aprimorando a visualização do prognóstico, o atendimento e tratamento a estes pacientes.

OBJECTIVE: To verify the incidence of inhalation injury confirmed by bronchoscopy in patients with facial burns and/or a history of exposure to smoke in a Burns Intensive Care Unit. METHODS: Retrospective cross-sectional study based on the collection of medical records of patients hospitalized between August 2015 and May 2020. In the statistical analysis the categorical and continuous data were characterized, Fisher's exact test, Shapiro-Wilk test, and Kruskal-Wallis test were evaluated in STATA® 14 software with a 5% significance level. RESULTS: 82 patients with inhalation injury were classified into groups of no/mild, moderate and severe injuries, with an incidence of 19.2 cases of inhalation injury for every 100 admissions in the intensive care unit for burns patients with an average length of stay of 35.6 days; of these 27 died. Patients with severe injuries were on mechanical ventilation for a shorter time. CONCLUSIONS: The bronchoscopy evaluation in the immediate initial care or within 24 hours of admission of patients with facial burns can be adopted to optimize the diagnosis and perform the classification of the inhalation injury improving the visualization of the prognosis, care and treatment of these patients.

Sistematização de reconstrução da parede abdominal pós-reconstrução com TRAM / Systematization of reconstruction of the abdominal wall after reconstruction with TRAM

Introdução: O TRAM (retalho do músculo reto abdominal transverso) manteve-se o método mais utilizado de reconstrução autóloga de mama ao longo dos últimos 30 anos. Descrito pela primeira vez por Holmström, o retalho permite a reconstrução mamária com tecido análogo, proporcionando aparência e consistência natural e resultados duradouros. A reconstrução da parede abdominal do defeito instalado após a transposição do retalho é um grande desafio e não há consenso sobre qual é a forma para elevação ou fechamento do retalho da parede abdominal. O artigo tem como objetivo apresentar um método prático para reconstruções de parede abdominal, visando diminuir a morbidade em pacientes submetidos à reconstrução de mama com TRAM. Métodos: Esse é um trabalho descritivo de uma técnica sistemática de reconstrução de parede abdominal com utilização de tela de propileno. Resultado: Aplicada a técnica teremos uma parede abdominal coberta com uma tela de polipropileno, totalmente fixa e bem adaptada, foi realizada a sistematização na reconstrução de parede abdominal após reconstrução com TRAM que se caracteriza por ser de fácil reprodução e aplicabilidade.Conclusão: A técnica se mostra uma boa alternativa em reconstruções de parede abdominal para o cirurgião, sistematizando a adaptação da tela de polipropileno.

Introduction: Tram (transverse abdominal rectum flap) has remained the most used autologous breast reconstruction method over the last 30 years. First described by Holmström, the flap allows breast reconstruction with analogous tissue, providing natural appearance and consistency and lasting results. Reconstruction of the abdominal wall of the defect installed after flap transposition is a major challenge, and there is no consensus on the form for elevation or closure of the abdominal wall flap. The article aims to present a practical method for abdominal wall reconstructions to reduce morbidity in patients undergoing breast reconstruction with TRAM. Methods: This is a descriptive work of a systematic abdominal wall reconstruction technique using propylene mesh. Result: Once the technique is applied, we have an abdominal wall covered with polypropylene fabric, fully fixed and well adapted. The systematization of abdominal wall reconstruction after reconstruction with TRAM was performed, which is characterized by being easy to reproduce and applicable. Conclusion: The technique is a good alternative in abdominal wall reconstructions for the surgeon, systematizing polypropylene mesh adaptation.

Susceptibility of the patients infected with Sars-Cov2 to oxidative stress and possible interplay with severity of the disease.

Several recent reviews have suggested a role of oxidative stress in the pathophysiology of COVID-19, but its interplay with disease severity has not been revealed yet. In the present study, we aimed to investigate the association between the severity of COVID-19 and oxidative stress parameters. Clinical data of 77 patients with COVID-19 admitted to the hospital were analyzed and divided into moderate (n = 44) and severe (n = 33) groups based on their clinical condition. Production of oxidant (hydrogen peroxide) and defense antioxidants (total antioxidant capacity, reduced and oxidized glutathione, glutathione s-transferase), and oxidative damage (malondialdehyde, carbonyl, and sulfhydryl) were assessed using the serum samples. The results revealed that severe patients who presented high serum leukocyte count and CRP level stayed for a longer period in the hospital. However, there was no correlation observed between the oxidative stress parameters and degree of COVID-19 severity in the present study. In conclusion, these results indicate that the disease severity may not be a detrimental factor contributing to the changes in the redox profile of hospitalized patients with COVID-19.

Histological study and immunohistochemical location of cytoskeletal proteins in the ovaries of the three species of lizards of the family Leiosauridae (Reptilia: Squamata).

The aim of the study is to expand information on the histological aspect, presence, and distribution of cytoskeletal proteins: smooth muscle alpha-actin (α-SMA), desmin and vimentin in ovaries of three lizards Leiosauridae. In all analysed species, the ovaries were paired organs, located inside the coelomic cavity, covered in a simple cubic epithelium. Below the surface was the tunica albuginea. The organs can be divided into two regions: the cortex and the medulla. The pre-vitellogenic follicles consist of an oocyte surrounded by the pellucid zone periodic acid schiff positive, the granulosa layer consisting of three cell types: small, intermediate, and large and the theca layer. The vitellogenic follicles presented only a single layer of cubic granulosa cells. In the three lizards, α-SMA microfilaments (MFs) were verified along the theca layer and in endothelial cells of the blood vessels of the analysed follicles. Researchers have observed desmin intermediate filaments immunostaining exclusively muscle fibers of the albuginea and the ovarian stroma of Enyalius perditus. There was no immunostaining for vimentin in the ovaries of all the lizards studied. Results obtained revealed that the MFs of α-SMA could be responsible for a contractile activity present in the lizards assessed.

A novel evaluation method for Ki-67 immunostaining in paraffin-embedded tissues.

The Ki-67 labeling index is traditionally used to investigate tumor aggressiveness. However, no diagnostic or prognostic value has been associated to the heterogeneous pattern of nuclear positivity. The aims of this study were to develop a classification for the patterns of Ki-67-positive nuclei; to search scientific evidence for the Ki-67 expression and location throughout the cell cycle; and to develop a protocol to apply the classification of patterns of Ki-67-positive nuclei in squamous epithelium with different proliferative activities. Based on empirical observation of paraffin sections submitted to immunohistochemistry for the determination of Ki-67 labeling index and literature review about Ki-67 expression, we created a classification of the patterns of nuclear positivity (NP1, NP2, NP3, NP4, and mitosis). A semi-automatic protocol was developed to identify and quantify the Ki-67 immunostaining patterns in target tissues. Two observers evaluated 7000 nuclei twice to test the intraobserver reliability, and six evaluated 1000 nuclei to the interobserver evaluation. The results showed that the immunohistochemical patterns of Ki-67 are similar in the tumoral and non-tumoral epithelium and were classified without difficulty. There was a high intraobserver reliability (Spearman correlation coefficient > 0.9) and moderate interobserver agreement (k = 0.523). Statistical analysis showed that non-malignant epithelial specimens presented a higher number of NP1 (geographic tongue = 83.8 ± 21.8; no lesion = 107.6 ± 52.7; and mild dysplasia = 86.6 ± 25.8) when compared to carcinoma in Situ (46.8 ± 34.8) and invasive carcinoma (72.6 ± 37.9). The statistical evaluation showed significant difference (p < 0.05). Thus, we propose a new way to evaluate Ki-67, where the pattern of its expression may be associated with the dynamics of the cell cycle. Future proof of this association will validate the use of the classification for its possible impact on cancer prognosis and guidance on personalized therapy.

Technosociality and health promotion in the daily lives of primary care users: a scoping review / Tecnosocialidad y promoción de la salud en la vida diaria de los usuarios de atención primaria: scoping review / Tecnossocialidade e promoção da saúde no quotidiano de usuários da atenção primária: scoping review

ABSTRACT Objective: to map available evidence on the use of technologies by Primary Health Care users in the context of health promotion. Method: this is a scoping review according to Joanna Briggs Institute, and the recommendations of the international guide Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews were followed. The PCC strategy (participants, concept and context) was used. The search in the databases was carried out from January to April 2020. Results: a total of 5,267 studies were retrieved and 28 articles were selected for review. The article origin was diverse, with the largest number being from the United States of America (7), the predominant language is English, the year was 2018 and the level of evidence 2. Studies show that users obtain benefits in health care through the use of technologies. Conclusion: health interventions, using technology, positively impact people's behavior and lifestyle, focusing on the prevention and control of chronic diseases. It is noteworthy that technologies used in isolation cannot overcome behavioral barriers and their use does not replace one-to-one care and monitoring.

RESUMEN Objetivo: mapear la evidencia disponible sobre el uso de tecnologías por los usuarios de la Atención Primária de Salud en el contexto de la promoción de la salud. Método: esta es una revisión de alcance según el Instituto Joanna Briggs, y se siguieron las recomendaciones de la guía internacional Preferred Reporting Items for Systematic Reviews y la extensión de metaanálisis para Scoping Reviews (PRISMA-ScR). Se utilizó la estrategia PCC (participants, concept y context). La búsqueda en las bases de datos se realizó de enero a abril de 2020. Resultados: se recuperaron un total de 5.267 estudios y se seleccionaron 28 artículos para su revisión. El origen de los artículos fue diverso, con el mayor número de los Estados Unidos de América (7), el idioma predominante es el inglés, el año fue 2018 y el nivel de evidencia 2. Estudios muestran que los usuarios obtienen beneficios en la atención a la salud a través de el uso de tecnologías. Conclusión: las intervenciones en salud, utilizando tecnología, impactan positivamente en el comportamiento y estilos de vida de las personas, enfocándose en la prevención y control de enfermedades crónicas. Cabe señalar que las tecnologías utilizadas de forma aislada no pueden superar las barreras conductuales y su uso no reemplaza la atención y el seguimiento cara a cara.

RESUMO Objetivo: mapear a evidência disponível sobre o uso de tecnologias por usuários da Atenção Primária à Saúde no contexto da promoção da saúde. Método: trata-se de um scoping review segundo Joanna Briggs Institute, e foram seguidas as recomendações do guia internacional Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Foi utilizada a estratégia PCC (participants, concept e context). A busca nas bases de dados foi realizada no período de janeiro a abril de 2020. Resultados: foram recuperados um total de 5.267 estudos e selecionados 28 artigos para a revisão. A origem dos artigos foi diversa, sendo dos Estados Unidos da América o maior número (7), o idioma predominante é o inglês, o ano foi o de 2018 e o nível de evidência 2. Os estudos evidenciam que os usuários obtêm benefícios no cuidado à saúde pelo uso das tecnologias. Conclusão: as intervenções em saúde, com uso de tecnologias, impactam positivamente comportamentos e estilos de vida das pessoas, focando na prevenção e controle de doenças crônicas. Ressalta-se que as tecnologias usadas de forma isolada não conseguem superar as barreiras comportamentais e seu uso não substitui o atendimento e acompanhamento presencial.

Canonical correlative analyses among an enzyme-linked immunosorbent assay using synthetic peptides, an indirect fluorescent antibody test, and hematologic measurements in dogs infected with Ehrlichia canis.

BACKGROUND: Immunoreactive tandem repeat proteins (TRPs) in amino acid sequences were identified and employed in the serologic diagnosis of canine monocytic ehrlichiosis (CME). OBJECTIVES: This study evaluated using TRP19 and TRP36 synthetic protein antigens with enzyme-linked immunosorbent assays (ELISAs) and compared the results with an indirect fluorescent antibody test (IFAT) to diagnose CME in the serum of dogs with suspected CME. METHODS: The sera of 243 dogs that exhibited clinical and hematologic signs suggestive of CME had IFATs performed. An ELISA with synthetic TRP19 and TRP36 antigens from two E canis genotypes (USTRP36 and BrTRP36) that circulate in Brazil were also performed. Canonical correlations and chi-square tests were evaluated on the results of these tests. RESULTS: Among the 243 dogs, 179 (73.6%) were reactive at an IFAT ≥ 40, 167 (68.72%) reacted at the cut-off ≥160, and 149 (61.31%) reacted at ≥640. The ELISA revealed that 172 (70.8%) dogs reacted to TRP19 peptide, 163 (67.1%) reacted to USTRP36, and 114 (46.9%) reacted to BrTRP36. The canonical correlation analyses showed that the TRP19 ELISA was the most effective diagnostic method. Serum total protein levels showed strong positive correlations with the USTRP36 peptide. Qualitative analyses revealed an association between the TRP19 peptide and the presence of anemia, thrombocytopenia, and hyperproteinemia. The IFAT results at titers of ≥160 and ≥640 were associated with thrombocytopenia. CONCLUSIONS: The results of this study indicated that the TRP19 peptide was an excellent antigen and that the IFAT was diagnostically important in confirming the diagnosis of CME in serum samples.

Geographic Distribution of Ehrlichia canis TRP Genotypes in Brazil.

Tandem repeat proteins (TRPs) are major immunoreactive proteins of Ehrlichia canis, which have been used in the serological diagnosis of different genotypes of the microorganism. TRP19 is preserved among different E. canis isolates expressed on both reticulate and dense-core cells and observed in the extracellular matrix or associated with the morula membrane. TRP36 is differentially expressed only on the surface of the dense-core form of the bacterium and exhibits more divergence among isolates. The aim of this study was to evaluate the distribution of the American (USTRP36), Brazilian (BrTRP36) and Costa Rican (CRTRP36) genotypes of E. canis in Brazil, using ELISA assays. Serum samples of 814 dogs from 49 municipalities from all over Brazil were analyzed. Our results showed that 33.9% of the samples were reactive to the USTRP36 genotype and 32.6% to the BrTRP36 genotype. The two genotypes appeared to occur equally throughout Brazil, although the frequency of seropositivity was lower in the south than in the country's other regions. Dogs that reacted to at least one of the synthetic peptides (TRP19 and TRP36) were 456 (56%). A few dogs (n = 5; 0.6%) reactive to the E. canis TRP36 genotype (CRTRP36) were also detected in the northeast and southern regions. We concluded that the American and Brazilian genotypes of E. canis are distributed evenly in Brazil, especially in the tropical region, while the temperate region in the south presented the lowest prevalence rates. This study offers the first report of dogs seropositive for the Costa Rican genotype in Brazil.

Tick-borne pathogens in dogs, wild small mammals and their ectoparasites in the semi-arid Caatinga biome, northeastern Brazil.

Caatinga is a biome exclusive to the semiarid zone of Brazil, where studies on ticks and tick-borne diseases are scarce. Herein, we investigated the occurrence of Rickettsia, Ehrlichia, and Coxiella in wild mammals, domestic dogs and their ectoparasites using molecular and serological techniques. During 2014-2016, blood samples and ectoparasites were collected from 70 small mammals (51 rodents, 18 marsupials, 1 wild canid) and 147 domestic dogs in three areas of the Caatinga. Through serological analyses of domestic dogs of the three areas, 8 to 11 % were seropositive for Rickettsia rickettsii, 9 to 37 % for Rickettsia amblyommatis, 61 to 75 % for Ehrlichia canis, and 0-5% for Coxiella burnetii. All wild mammals were seronegative for Rickettsia spp. and C. burnetii, except for one rodent (Wiedomys pyrrhorhinos) and one marsupial (Didelphis albiventris) that were seroreactive to C. burnetii, one wild canid (Cerdocyon thous) for R. amblyommatis, and two Rattus rattus for Rickettsia spp. Through PCR targeting DNA of Rickettsia, Ehrlichia or Coxiella, all blood samples were negative, except for the presence of Ehrlichia canis DNA in 8.8 % of the domestic dogs, and a recently reported novel agent, Ehrlichia sp. strain Natal, in one marsupial (Gracilinanus agilis). A total of 222 ticks, 84 fleas, and six lice were collected. Ticks were mostly Rhipicephalus sanguineus sensu lato, some Ixodes loricatus, Ornithodoros rietcorreai, Haemaphysalis sp., and Amblyomma spp.; fleas were Ctenocephalides felis felis, Pulex sp. and Polygenis (Polygenis) bohlsi jordani; and lice were Polyplax sp. and Gyropus sp. Through molecular detection of microorganisms, 9% of C. felis felis contained Rickettsia felis, 20 % of A. auricularium contained R. amblyommatis and 13 % of A. parvum contained 'Candidatus Rickettsia andeanae', whereas Ehrlichia canis DNA was detected in at least 6% of the R. sanguineus s.l. from one area. We report a variety of ectoparasites infesting small mammals and domestic dogs in the Caatinga biome, where these ectoparasites probably act as vectors of rickettsiae, ehrlichial agents (E. canis and Ehrlichia sp. strain Natal) and C. burnetii. Our results highlight to the potential risks of human infection by these tick-borne agents in the Caatinga biome.

Effect of calcium orthophosphate: Reinforcing glass ratio and prolonged water storage on flexural properties of remineralizing composites.

OBJECTIVES: To compare the effects of replacing reinforcing barium glass particles by DCPD (dicalcium phosphate dihydrate), as opposed to simply reducing glass filler content, on composite flexural properties and degree of conversion (DC). On a second set of experiments, composites with different "DCPD: glass" ratios were exposed to prolonged water immersion to verify if the presence of DCPD particles increased hydrolytic degradation. METHODS: Two series of composites were prepared: 1) composites with total inorganic content of 50 vol% and "DCPD: glass" ratios ranging from zero (glass only) to 1.0 (DCPD only), in 0.25 increments, and 2) composites containing only silanized glass (from zero to 50 vol%). Disk-shaped specimens were fractured under biaxial flexural loading after 24 h in water. Another set of specimens of composites with different "DCPD: glass" ratios was stored in water for 24 h, 30, 60, 90 and 120 days and tested in flexure. DC was determined using FTIR spectroscopy. Data were analyzed using Kruskal-Wallis/Dunn test (flexural properties) or ANOVA/Tukey test (DC, alpha: 0.05). RESULTS: For glass-only composites, reducing inorganic content caused a linear decrease in strength. The presence of DCPD did not affect composite strength up until a "DCPD: glass" ratio of 0.5. On the other hand, materials with 0.75 and 1.0 DCPD showed significantly lower strength than the glass-only composite with 12.5 vol% filler and the unfilled resin, respectively (p < 0.001). Except for the 0.25 DCPD composite, the presence of DCPD did not contribute to increase flexural modulus. After water storage, composites containing DCPD showed higher percent reductions in properties than the control, but only in a few cases the effect was statistically significant (strength: 0.5 DCPD, modulus: 0.25 and 1.0 DCPD). DC was only marginally affected by DCPD fraction. SIGNIFICANCE: For composites with "DCPD: glass" of 0.25 and 0.5, reductions in strength were related to the lower glass content, and not due to the presence of DCPD. Flexural modulus was primarily defined by glass content. Overall, composites containing DCPD particles presented higher reductions in properties after water storage, but it remained within limits reported for commercial materials.

Complicações vasculares dos preenchimentos faciais com ácido hialurônico: confecção de protocolo de prevenção e tratamento / Vascular complications from facial fillers with hyaluronic acid: preparation of a prevention and treatment protocol

Introdução: Ao longo das últimas duas décadas, houve um avanço exponencial no tratamento dos sinais causados pelo envelhecimento facial. A procura crescente por terapias menos invasivas estimulou a evolução dos biomateriais em direção ao produto ideal, buscando preencher os critérios de segurança, tais como biocompatibilidade e reversibilidade. O ácido hialurônico é o produto mais utilizado mundialmente para preenchimento facial, sendo rotineiro nos consultórios de cirurgia plástica. Mesmo com baixos índices de complicações, é prudente que o cirurgião plástico esteja atento aos sinais de oclusão vascular, pois a interrupção da evolução em direção à necrose e sequela permanente depende da rápida atuação médica. Sendo assim, o nosso serviço vislumbrou a necessidade da confecção de um protocolo de prevenção e tratamento, uma vez que tais intercorrências são graves e algumas vezes até mesmo irreversíveis. Métodos: Revisão sistemática da literatura entre janeiro de 2003 a janeiro de 2018, utilizando descritores de complicações vasculares após preenchimento facial com AH e o respectivo tratamento. Resultados: O preenchimento com AH apresenta baixo potencial de complicação quando realizado por profissionais habilitados. A hialuronidase, atualmente utilizada off-label, é capaz de hidrolisar o ácido hialurônico, mesmo na sua forma cross-linked. Se utilizada corretamente em tempo hábil, pode tratar possíveis complicações vasculares que naturalmente evoluiriam para danos irreversíveis. Para tanto, confeccionamos um protocolo de tratamento à luz das evidências atuais. Conclusão: Todo cirurgião plástico que atua com preenchimentos e ácido hialurônico, deve ter em mãos um protocolo e o material necessário para intervenção precoce.

Introduction: Over the past two decades, there has been an exponential advancement in treating signs of facial aging. The growing demand for less invasive therapies has stimulated the development of biomaterials toward better products, seeking to fulfill safety criteria, such as biocompatibility and reversibility. Hyaluronic acid (HA) is the most widely used facial filler worldwide, being routine in plastic surgery clinics. Even with low complication rates, it is prudent for the plastic surgeon to be attentive to the signs of vascular occlusion because the interruption of the progression towards necrosis and permanent sequelae depends on rapid medical action. Thus, our service saw the need to create a prevention and treatment protocol, since such complications are serious and sometimes even irreversible. Methods: A systematic review of the literature was conducted from January 2003 to January 2018, using descriptors of vascular complications after facial filling with HA and its treatment. Results: Filling with HA presents a low potential for complications when performed by qualified professionals. Hyaluronidase, which is currently used offlabel, can hydrolyze HA, even in its cross-linked form. If used correctly in a timely manner, it can treat possible vascular complications that would progress to irreversible damage. Accordingly, we prepared a treatment protocol given the current evidence. Conclusion: Every plastic surgeon who works with fillers and HA must have a protocol and be aware of the necessary material for early intervention.