Perfil do estudante e fatores que influenciam o interesse pela medicina de família e comunidade / Profile of medical students and factors that influence theirinterest in the family and community medicine residency

RESUMO Introdução: A medicina de família e comunidade (MFC) apresenta-se como uma carreira médica de importância social, porém seu crescimento nas regiões do Brasil ainda é pouco representativo, sendo necessário identificar os fatores que influenciam o estudante do curso de Medicina na escolha dessa carreira profissional. Objetivo: Este estudo teve como objetivo analisar fatores que influenciam o interesse pela residência em MFC pelos alunos do internato do curso de Medicina. Método: Trata-se de um estudo transversal, descritivo, de análise quantitativa, realizado com os alunos matriculados nos estágios do penúltimo e último anos dos cursos de Medicina de uma capital brasileira. Resultado: Participaram da pesquisa 229 estudantes matriculados no internato de Medicina. Aqueles que demonstraram interesse pela MFC eram, em sua maioria, jovens, de ambos os gêneros, na faixa etária entre 26 e 35 anos, casados, com filhos e renda familiar menor que cinco salários mínimos. Duas variáveis estiveram associadas à opção pela MFC: a faixa etária e a avaliação positiva acerca da especialidade. Conclusão: Compreender os fatores que influenciam na escolha da MFC pode contribuir para aprimorar a formação médica, alinhando as preferências dos estudantes com as necessidades da sociedade e do Sistema Único de Saúde.

ABSTRACT Introduction: Family and community medicine (FCM) is presented as a socially important medical career; however, its growth in regions of Brazil remains relatively low. It is necessary to identify the factors that influence medical students in their choice of this professional path. Objective: To analyse factors that influence interest in FCM residency among medical interns. Methods: A cross-sectional, descriptive, quantitative analysis study was conducted with students enrolled in the penultimate and final years of medical courses in a Brazilian capital city. Results: 229 medical interns participated in the research. Those interested in FCM are mostly young, of both genders, aged between 26 and 35, married, with children, and have a family income of less than five minimum wages. Two variables were associated with choosing FCM: age and positive evaluation of the specialty. Conclusion: Understanding the factors that influence the choice of FCM can contribute to improving medical education, aligning student preferences with the needs of society and the Public Healthcare System.

Standardization of DNA extraction from paraffinized spleen samples: molecular diagnosis of human malaria.

BACKGROUND: Plasmodium vivax is the main species responsible for human malaria in Brazil, and one of its manifestations is splenic malaria, though there are still challenges in its diagnosis. The present study aimed to standardize Plasmodium sp. DNA extraction from histological slices of spleen and diagnosis using real-time qPCR. METHODS: This study performed a microtomy of a paraffin-embedded spleen as a positive control for P. vivax from a patient who had been previously diagnosed with the parasite. The sample was deparaffinized with xylol and ethanol, then DNA extraction was performed with two commercial kits. qPCR was carried out with the Taqman system for detection of Plasmodium sp. and was made species-specific using PvmtCOX1 gene. From 2015 to 2019, 200 spleen samples were obtained from trauma patients subjected to splenectomy in Manaus, Amazonas. All the samples were tested for cell-free human DNA (cfDNA). RESULTS: The deparaffinization and the Plasmodium vivax DNA extraction method was successfully standardized, and the control sample was positive for P. vivax. Of the 200 samples, all qPCRs were negative, but they were positive for human PCR. CONCLUSION: Paraffinization is practical and efficient for the preservation of samples, but the formation of bonds between proteins and DNA makes extraction difficult. Despite this, in this study, it was possible to standardize a method of DNA extraction for detecting P. vivax.

Prevalence of sleep disorders in children with Congenital Zika Syndrome.

Studies have reported that children with Congenital Zika Syndrome (CZS) experience changes in their sleep patterns, which can result in mood disturbances, behavioral issues and delays in growth and development. This systematic review synthesized the available evidence on the prevalence of sleep disorders in children with CZS. Eligible studies were those with an observational design that reported sleep disorders in children with CZS using validated questionnaires, polysomnography/electroencephalographic recording or parent/caregiver reports. Searches were conducted in PubMed, Web of Science, SCOPUS and Embase, as well as a gray literature search using Google Scholar. The Freeman-Tukey double-arcsine transformation with a random-effects model was used to estimate the pooled prevalence of sleep disorders with a 95% confidence interval (CI). Five studies were included and data from 340 Brazilian children with CZS were analyzed. The overall prevalence of sleep disorders was 27.4% (95% CI 16.7-39.4), without differences among studies using validated questionnaires (29.4%, 95% CI 21.4-37.8) or report from parents and caregivers (27.4%, 95% CI 11.5-47.0). Sleep disorders are prevalent in children with CZS, impacting their development and quality of life. It is critical to examine the quality of sleep in these children to develop appropriate interventions that can mitigate these issues.

The article discusses a systematic review of studies that have explored the prevalence of sleep disorders in children with Congenital Zika Syndrome (CZS), a condition caused by the Zika virus. The study found that children with CZS often experience changes in their sleep patterns, which can lead to mood disturbances, behavioral issues and delays in growth and development. The review included five studies with a total of 340 Brazilian children with CZS, and the overall prevalence of sleep disorders was found to be 27.4%. This indicates that sleep disorders are prevalent in children with CZS and can significantly impact their development and quality of life. The authors suggest that further research is needed to develop appropriate interventions to mitigate these issues.

Molecular diagnosis of opportunistic infections in the central nervous system of HIV-infected adults in Manaus, Amazonas.

Background: Opportunistic infections in the central nervous system (CNS) of people with HIV/AIDS (PLWHA) remain significant contributors to morbidity and mortality, especially in resource-limited scenarios. Diagnosing these infections can be challenging, as brain imaging is non-specific and expensive. Therefore, molecular analysis of cerebrospinal fluid (CSF) may offer a more accurate and affordable method for diagnosing pathogens. Methods: We conducted extensive real-time PCR testing (qPCR) on CSF to evaluate etiological agents in PLWHA with neurological manifestations. Primers targeting DNA from specific pathogens, including cytomegalovirus (CMV), herpes simplex virus (HSV), varicella-zoster virus (VZV), Epstein-Barr virus (EBV), John Cunningham virus (JCV), Toxoplasma gondii, and human T-lymphotropic virus types 1 and 2 (HTLV-1 and HTLV-2), were used. Results: Cerebrospinal fluid samples revealed 90 pathogens (36.7%). Toxoplasma gondii was the most frequently detected pathogen, found in 22 samples (30.5%). Other pathogens included Cryptococcus sp. (7.7%), EBV (5.3%), CMV, VZV, and JCV (4.0% each). Conclusion: Despite antiretroviral therapy and medical follow-up, opportunistic central nervous system infections remain frequent in PLWHA. Herpesviruses are commonly detected, but T. gondii is the most prevalent opportunistic pathogen in our study population. Therefore, molecular diagnosis is a crucial tool for identifying opportunistic infections, even in patients undergoing treatment.

Pediatric central nervous system infections in the Amazon: clinical and laboratory profiles.

Background: Central nervous system (CNS) infections are important causes of mortality and morbidity in children, and they are related to severe problems such as hearing loss, neurological sequelae, and death. The objective was to describe clinical and laboratory exam profiles of children who were diagnosed with CNS infections. Methods: We conducted a cross-sectional study based on medical records, which included pediatric patients aged from 3 months to 15 years, with a clinical suspicion of CNS infection between January 2014 to December 2019. The pathogens were confirmed in cerebrospinal fluid (CSF) samples using Gram staining, cell culture, molecular diagnostics (PCR and qPCR), and serology. Results: Out of the 689 enrolled patients, 108 (15.6%) had laboratory-confirmed infections in CSF. The most common bacterial pathogens isolated from the culture were Neisseria meningitidis serogroup C in 19, Streptococcus pneumoniae in 11, and Haemophilus influenzae in seven samples. The viruses identified were Enterovirus, Cytomegalovirus, Varicella-zoster virus, Epstein-Barr virus, and arbovirus. No patient was found to be positive for Herpes simplex virus 1 and 2. Patients with viral infections showed altered levels of consciousness (p = 0.001) when compared to bacterial infections. Conclusion: This study shows the presence of important vaccine-preventable pathogens, and different families of viruses causing CNS infections in the pediatric patients of Manaus.

Sleep in children with microcephaly due to Zika virus infection: a systematic review.

OBJECTIVE: To review the literature on sleep changes and brain function in children with microcephaly due to Zika virus. METHOD: Systematic review conducted in the databases MEDLINE (PubMed), Scopus, Web of Science, CINAHL, EMBASE, LILACS, and SciELO and the grey databases Google Scholar and OpenGrey. RESULTS: Ten Brazilian primary studies with observational research design were included. These were published between 2017 and 2020 with 516 children with microcephaly due to Zika virus infection aged 4 months to 4 years. Out of these, 4 investigated qualitative aspects of sleep using the questionnaires Brief Infant Sleep Questionnaire or Infant Sleep Questionnaire and 6 investigated changes in brain activities during sleep using the Electroencephalogram or Video-Electroencephalogram exams. The children's quality of sleep was not compromised in most studies. Changes in brain activity during sleep were frequent, with epileptogenic activity being a common finding among the studies. CONCLUSION: The quality of sleep of children with microcephaly due to Zika virus has shown to be similar to that of children with typical development and the presented behavioral changes may be related to changes in electric brain activity.

Sleep in children with microcephaly due to Zika virus infection: a systematic review / Sueño en niños con microcefalia debido a la infección por el virus Zika: revisión sistemática / Sono em crianças com microcefalia por infecção do Zika vírus: revisão sistemática

ABSTRACT Objective: To review the literature on sleep changes and brain function in children with microcephaly due to Zika virus. Method: Systematic review conducted in the databases MEDLINE (PubMed), Scopus, Web of Science, CINAHL, EMBASE, LILACS, and SciELO and the grey databases Google Scholar and OpenGrey. Results: Ten Brazilian primary studies with observational research design were included. These were published between 2017 and 2020 with 516 children with microcephaly due to Zika virus infection aged 4 months to 4 years. Out of these, 4 investigated qualitative aspects of sleep using the questionnaires Brief Infant Sleep Questionnaire or Infant Sleep Questionnaire and 6 investigated changes in brain activities during sleep using the Electroencephalogram or Video-Electroencephalogram exams. The children's quality of sleep was not compromised in most studies. Changes in brain activity during sleep were frequent, with epileptogenic activity being a common finding among the studies. Conclusion: The quality of sleep of children with microcephaly due to Zika virus has shown to be similar to that of children with typical development and the presented behavioral changes may be related to changes in electric brain activity.

RESUMEN Objetivo: Revisar la literatura sobre la alteración del sueño y de la función cerebral en niños con microcefalia por infección del virus Zika. Método: Revisión sistemática realizada en las bases de datos MEDLINE (PubMed), Scopus, Web of Science, CINAHL, EMBASE, LILACS y SciELO y en las bases de datos de literatura gris Google Académico y OpenGrey. Resultados: Se incluyeron 10 estudios primarios brasileños con diseño de investigación observacional, publicados entre 2017 y 2020, con 516 niños con microcefalia debido a la infección por el virus Zika con edades comprendidas entre los 4 meses y los 4 años. De ellos, 4 investigaron los aspectos cualitativos del sueño mediante el Brief Infant Sleep Questionnaire o el Infant Sleep Questionnaire y 6 investigaron los cambios en las actividades cerebrales durante el sueño mediante exámenes de Electroencefalograma o Video-Encefalograma. La calidad del sueño de los niños no estaba comprometida en la mayoría de los estudios. Las alteraciones de la actividad cerebral durante el sueño fueron frecuentes, siendo la actividad epileptógena un hallazgo común entre los estudios. Conclusión: La calidad del sueño en los niños con microcefalia por el virus Zika resultó similar a la de los niños con desarrollo típico. Los cambios de comportamiento presentados pueden estar relacionados con cambios en la actividad eléctrica cerebral.

RESUMO Objetivo: Revisar a literatura sobre a alteração do sono e da função cerebral em crianças com microcefalia por Zika vírus. Método: Revisão sistemática realizada nas bases de dados MEDLINE (PubMed), Scopus, Web of Science, CINAHL, EMBASE, LILACS e SciELO e nas bases de dados cinzentas Google Scholar e OpenGrey. Resultados: Foram incluídos 10 estudos primários brasileiros com delineamento de pesquisas observacionais, publicados entre 2017 e 2020, com 516 crianças com microcefalia por infecção do Zika vírus com idades entre 4 meses e 4 anos. Destes, 4 investigaram aspectos qualitativos do sono utilizando os questionários Brief Infant Sleep Questionnaire ou Infant Sleep Questionnaire e 6 investigaram alterações nas atividades cerebrais durante o sono utilizando os exames Eletroencefalograma ou Vídeo-Encefalograma. A qualidade do sono das crianças não estava comprometida na maioria dos estudos. Alterações na atividade cerebral durante o sono foram frequentes, sendo a atividade epileptogênica um achado comum entre os estudos. Conclusão: A qualidade do sono em crianças com microcefalia por Zika vírus demonstrou ser semelhante à de crianças com desenvolvimento típico e as alterações comportamentais apresentadas podem estar relacionadas a alterações na atividade elétrica cerebral.

Association Between Arthrogryposis and Mortality in Infants With Congenital Zika Syndrome: A Systematic Review and Meta-analysis.

BACKGROUND: Intrauterine Zika virus infection is associated with neurological disorders and other problems, including such as impaired visual and hearing function and orthopedic abnormalities, including arthrogryposis. We systematically investigated the prevalence of arthrogryposis in infants with congenital Zika syndrome and the respective risk of mortality. METHODS: We conducted a systematic review and meta-analysis of reports published in PubMed, Web of Science, SCOPUS, and World Health Organization Global Index Medicus databases, using the keywords Zika virus and arthrogryposis and related terms. RESULTS: After screening titles and abstracts, a total of four studies were included. Arthrogryposis was not associated with increased risk for fetal demise (risk ratio, 3.33; 95% confidence interval, 0.73 to 15.26). However, arthrogryposis was associated with a 13-fold increased risk of mortality in neonates with congenital Zika syndrome (risk ratio, 13.11; 95% confidence interval, 3.74 to 45.92) than neonates with congenital Zika syndrome but without arthrogryposis. CONCLUSIONS: Neonates with both congenital Zika syndrome and arthrogryposis had higher morbidity and mortality risks, making it necessary to implement protocols for the early identification of neuromuscular changes and appropriate management of patients.

Changes in Occupational Roles and Common Mental Disorders in Mothers of Children With Congenital Zika Syndrome.

IMPORTANCE: The functional limitations and long-term dependence of children with congenital Zika syndrome (CZS) may lead to changes in maternal occupational roles, which can have a negative impact on mothers' well-being and mental health. OBJECTIVE: To investigate changes in occupational roles and their effects on the mental health of mothers who have a child with CZS. DESIGN: Cross-sectional study. SETTING: Rehabilitation centers of the Brazilian Unified Health System in Alagoas, Northeast Brazil. PARTICIPANTS: Forty mothers of children with CZS. OUTCOMES AND MEASURES: The Role Checklist and the Self-Reporting Questionnaire-20 were used to assess the mothers' involvement in occupational roles and common mental disorders (CMDs), respectively. The relationship between changes in occupational roles and CMDs was analyzed using a logistic regression model. RESULTS: Our study showed that loss of paid work (p = .026) is associated with poor mental health of mothers of children with CZS. CONCLUSIONS AND RELEVANCE: Strengthening public policies to reduce the economic impact of CZS on families, offering multidisciplinary counseling, and implementing psychoeducational strategies for promoting maternal psychological adjustment are needed. WHAT THIS ARTICLE ADDS: The time and money spent by mothers in daily care activities for children with CZS contribute to a reduction in family income and social well-being and have a negative impact on mothers' mental health.

Perfil sociodemográfico e participação paterna nos cuidados diários de crianças com microcefalia / Sociodemographic profile and participation in the daily care of children with microcephaly

Resumo Introdução: A família vivencia transformações socioculturais, solicitando mais do homem nos cuidados diários dos filhos com deficiência, pois comumente são as mães que se envolvem nesta tarefa, ocasionando assim uma sobrecarga da mulher nos cuidados com o filho. Objetivo Verificar a participação paterna no cuidado diário da criança com microcefalia, traçar o perfil sociodemográfico paterno, conhecer as principais atividades desempenhadas pelos pais e analisar a percepção destes na sua participação nos cuidados diários do filho. Método Estudo quantitativo e qualitativo, ocorrido em três Centros Especializados em Reabilitação na cidade de Maceió, AL, Brasil, com 23 pais de crianças com microcefalia, no período de setembro de 2017 a fevereiro de 2018. Para o componente quantitativo utilizou-se questionário específico e a análise por meio de estatística descritiva. No componente qualitativo utilizou-se entrevista semiestruturada, que foi analisada por meio da Análise de Conteúdo. Resultados A maioria dos pais reside com a criança, 70% disponibilizam duas horas de seu tempo para cuidado diário do filho, sendo verificado maior engajamento paterno nas atividades de brincar (74%) e participação social (91%). No componente qualitativo, quatro pais participaram da entrevista e três categorias temáticas emergiram: percepção e auto avaliação dos pais em relação à participação nos cuidados diários da criança com microcefalia; fatores associados ao engajamento no cuidado diário; e identificação das atividades desempenhadas pelos pais no cuidado à criança com microcefalia. Conclusão Os pais se envolvem nos cuidados diários de maneira auxiliar às mães e não como protagonistas. Ressalta-se a necessidade de estratégias que favoreçam a participação dos pais nas dimensões do cuidado à criança com deficiência.

Abstract Introduction: The family lives sociocultural transformations requesting more of the man in the children's daily cares with deficiency because commonly the mothers wrap up in the tasks causing an overload in the daily tasks. Objective To verify the paternal participation in the daily care to the child with microcephaly, to trace the paternal socio-demographic profile, to know the main activities performed by the fathers and to analyze their perception in the participation of the children daily cares. Method This is a quantitative and qualitative study, held in 3 Specialized Centers in Rehabilitation in the city of Maceio, AL, Brazil, with 23 fathers of children with microcephaly, in the period of September of 2017 to February of 2018. For the quantitative component, a specific questionnaire and analysis through descriptive statistics, arithmetic average and percentage were used. In the qualitative component, a semi-structured interview was used that was analyzed through the Analysis of Content. Results Most of the fathers live with the child, 70% make available 2 hours of time for the son's daily care, and there was a larger paternal engagement in the activities of playing on 74% and social participation on 91%. In the qualitative component, 4 parents participated in the interview, and three thematic categories emerged: Paternal perception and self-assessment regarding the participation in the daily care of the child with microcephaly; Factors associated with paternal engagement in the daily care; and Identification of the activities performed by the fathers in the care to the child with microcephaly. Conclusion The fathers engaged in daily care to assist the mothers and not as the protagonist. It stands out the need for strategies that favor such participation in the dimensions of the care to the child with a disability.

Telomere length and frailty in older adults-A systematic review and meta-analysis.

Telomere shortening has been proposed as a potentially useful biomarker of human ageing and age-related morbidity and mortality. We performed a systematic review and meta-analysis to summarize results from individual studies on the telomere length according to the frailty status and frailty index in older adults. We searched the PubMed, SCOPUS and Web of Science databases to identify studies that evaluated the telomere length in frail and non-frail older adults and the relationship between telomere length and frailty index score. We used the base pairs (bp) as a measure of the telomere length. Summary estimates were calculated using random-effects models. Nine studies were included in the present systematic review and a total of 10,079 older adults were analyzed. We found that the frail older adults (n = 355) had shorter telomeres than the non-frail (n = 1894) (Standardized Mean Difference [SMD] -0.41; 95% CI -0.73 to -0.09; P = 0.01; I2 = 82%). Significant differences in telomere length between frail and non-frail older adults were identified in Hispanic (SMD -1.31; 95% CI -1.71 to -0.92; P < 0.0001; I2 = 0%) but not in Non-Hispanic countries (SMD -0.13; 95% CI -0.26 to 0.00; P = 0.06; I2 = 0%). Similar results were found in the adjusted meta-analysis (SMD -0.56; 95% -1.12 to 0.00; P = 0.05; I2 = 85%). A significant but weak relationship was found between telomere length and frailty index analyzing 8244 individuals (SMD -0.06; 95% IC -0.10 to 0.01; P = 0.01; I2 = 0%). The current available evidence suggests that telomere length may be not a meaningful biomarker for frailty. Because the potential influence of ethnicity in shortening of telomeres and decline in physiologic reserves associated with aging, additional multiethnic studies are needed.

Clinical and Toxicological Profile of NBOMes: A Systematic Review.

BACKGROUND: NBOMes are a new class of potent hallucinogens widely present in illicit drugs. Little is known about this class of drugs, regarding its detection and clinical manifestations of intoxication. OBJECTIVE: This study aims to enhance care involving NBOMes by reviewing the literature on their clinical manifestations and laboratorydetection. METHODS: A systematic review was performed on the clinical manifestations and laboratory tests of NBOMEs ingestion. Embase, Pubmed, PsycINFO, and Cochrane databases were employed in this analysis. RESULTS: Forty-five articles met the inclusion criteria out of the 2814 nonduplicated studies on the theme. Seventy case reports of intoxication were found in the analyzed articles (64.3% were men and 11.4% were women, mean age of 22.5). The technique most employed for NBOMes identification was chromatography of blood, urine, and oral fluids. Moreover, the studies identified 13 chemical structures differentfrom the NBOMes on their toxicological analyses.According to these studies, most of these drugs were ingested orally-nasal use was the second preferred administration route, followed by intravenous administration. CONCLUSION: Better identification of the clinicalmanifestations and laboratory profile of NBOMes is crucial to the recognition of intoxication as well as to its effective treatment.

Instrumentación mecanizada en molares primarios: ¿opción o necesidad? / Instrumentação mecanizada em molares primarios: ¿opção ou necessidade? / Mechanized instrumentation in deciduous molars: option or necessity?

Objetivo: Analizar el tiempo de instrumentación radicular en molares primarios artificiales por la técnica manual y mecanizada y comparar a través de radiografía digital la calidad de la obturación de los canales radiculares. Materiales y métodos: La muestra fue de 65 dientes, siendo 5 destinados a la calibración del estudio (G1), 30 en la instrumentación mecanizada reciprocante (G2) y 30 en la instrumentación manual (G3). El tiempo de instrumentación fue cronometrado. Después de la instrumentación, se realizó la obturación de los canales radiculares en ambos grupos. Para el análisis de la calidad de la obturación, se utilizaron radiografías digitales. La prueba D 'Agostino fue utilizada, y los datos presentaron distribución no normal. Para evaluar el tiempo de instrumentación y la calidad de la obturación se utilizó el test estadístico Mann-whitney. El nivel de significancia establecido fue del 5%. Resultados: El tiempo de instrumentación por la técnica mecanizada fue más rápido que la instrumentación manual (p <0,05), y el grado de la calidad de la obturación se mostró más eficaz en los dientes instrumentados por la técnica mecanizada (p <0,05). Conclusión: La técnica de instrumentación mecanizada se mostró más eficaz en la reducción del tiempo y en el grado de llenado de los canales radiculares, siendo que su uso proporcionó ventajas en la rutina clínica pediátrica.

Objetivo: Analisar o tempo de instrumentação radicular em molares decíduos artificiais pela técnica manual e mecanizada e comparar, através de radiografia digital, a qualidade da obturação dos canais radiculares. Material e Métodos: A amostra consistiu de 65 dentes, sendo 5 destinados a calibração do estudo (G1), 30 na instrumentação mecanizada reciprocante (G2) e 30 na instrumentação manual (G3). O tempo de instrumentação foi cronometrado. Após a instrumentação, foi realizada a obturação dos canais radiculares em ambos os grupos. A análise da qualidade da obturação, foi medida por meio de radiografias digitais. O teste D' Agostino foi utilizado, e os dados apresentaram distribuição não normal. Para avaliar o tempo de instrumentação e a qualidade da obturação foi utilizado o teste estatístico Mann-whitney. O nível de significância estabelecido foi 5%. Resultados: O tempo de instrumentação pela técnica mecanizada foi mais rápido que a instrumentação manual (p<0,05), e o grau da qualidade da obturação mostrou-se mais eficaz nos dentes instrumentados pela técnica mecanizada (p<0,05). Conclusão: A técnica de instrumentação mecanizada mostrou-se mais eficaz na redução do tempo e no grau de preenchimento dos canais radiculares, sendo que seu uso proporcionou vantagens na rotina clínica pediátrica.

Aim: To analyze instrumentation time in artificial deciduous molars by manual and mechanized technique and to compare the quality of root canal filling using digital radiography. Material and Methods: The sample consisted of 65 teeth, of which 5 were used for calibration of the study (G1), 30 for reciprocating mechanized instrumentation (G2) and 30 for manual instrumentation (G3). The instrumentation time was timed. After the instrumentation, the root canals were obturated in both groups. In order to analyze the quality of the obturation, digital radiographs were used. The D 'Agostino test was used, and the data presented a non-normal distribution. The Mann-Whitney test was used to evaluate the instrumentation time and the quality of the obturation. The level of significance was set at 5%. Results: Mechanized instrumentation time was faster than manual instrumentation (p <0.05), and the degree of obturation quality was more effective in the teeth instrumented by the mechanized technique (p <0.05). Conclusion: The mechanized instrumentation technique proved to be more effective in reducing the time and degree of filling of the root canals, and its use provided advantages in the pediatric clinical routine.

Primary lipoma arborescens of the knee.

Lipoma arborescens is a rare and benign intra-articular lesion of unknown etiology; it is characterized by synovial villous proliferation and sub-synovial connective tissue replacement by mature fatty tissue. It is part of the differential diagnosis in patients with an articulation affected by a slow, progressive, and chronically inflamed affection. We report primary knee involvement in a patient without significant articulate antecedents. Lipoma arborescens was diagnosed after knee magnetic resonance imaging and was confirmed by an anatomopathological study of the surgical specimen.

Avaliação da capacidade funcional de adolescentes portadores de Mucopolissacaridose do tipo II / Assessment of functional capacity of teens who are Mucopolysaccharidosis type II carriers

[{"text": "Introdução: A Mucopolissacaridose II (MPS II) é uma doença genética, ligada ao cromossomo X e que\r\nafeta quase que exclusivamente o sexo masculino. Apresenta-se de forma multissistêmica, ocasionada pelo acúmulo progressivo de glicosaminoglicanos (GAG) em tecidos e órgãos, o que causa atraso no desenvolvimento neuropsicomotor, ocasionando limitações na realização de atividades de vida diária. Objetivo: O objetivo deste estudo foi a identificação das áreas de desempenho nas quais os portadores de MPS II apresentam maior comprometimento, além da análise do perfil socioeconômico da respectiva família. Método: A pesquisa se deu através de entrevista com a responsável por três irmãos adolescentes, A1-19 anos, A2-16 anos e A3-15anos, portadores de MPS II, no Estado de Alagoas. A coleta foi efetuada por profissional capacitado, utilizando a Medida de Independência Funcional (MIF) como questionário para identificação de perdas funcionais, e ABEP, para análise do perfil socioeconômico. Resultados: Os resultados\r\napontaram que, em termos socioeconômicos, a família está inserida na classe C1. Em relação ao desempenho, verificou-se que, entre os irmãos, A1 apresenta dependência total nas habilidades investigadas; A2 apresenta perdas funcionais mais incapacitantes, necessitando de auxílio moderado, e A3 possui boa parte das habilidades físicas e cognitivas preservada, porém possui dependência modificada. Conclusão: Diante das dificuldades identificadas neste estudo, foi analisada a importância do diagnóstico precoce e das terapias de reabilitação aliadas à terapia enzimática, para que haja um retardo na progressão da doença.", "_i": "pt"}, {"text": "Introduction: Mucopolysaccharidosis II (MPS II) is an X-linked genetic disease which almost exclusively\r\naffects males. The disease presents a multisystem form, caused by the progressive accumulation of glycosaminoglycans (GAGs) in tissues and organs. It causes developmental delays resulting in limitations on the performance of day-to-day activities. Objective: The aim of this study was to identify occupational performance areas in which people with MPS II have greater impairment and analyze their family's socioeconomic profile. Method: The research was done through interviews with an individual responsible for three adolescent brothers, (A1-19 years, A2-16 years and A3-15 years) who are MPS II carriers from Alagoas, Brazil. Data collection was performed by a trained professional using the Functional\r\nIndependence Measure (FIM) as a questionnaire to identify the functional losses and the ABEP for socioeconomic profile analysis. Results: The results showed that the family is included in the C1 socioeconomic class. Among the siblings, A1 presents total dependence on the investigated skills; A2 presents the most disabling functional losses requiring moderate assistance and A3 has much of his physical and cognitive skills preserved, but has modified dependence. Conclusion: Taking into consideration the difficulties identified in this study, we highlighted the importance of early\r\ndiagnosis and rehabilitation therapies combined with enzyme therapy, which can delay disease progression.", "_i": "en"}]

Essential oil composition and antichemotactic activity of stenachaenium benth species native to south Brazil / Composición y actividad antiquimiotaxica del aceite esencial de especies stenachaenium benth. nativas de sur de Brasil

Chemical composition of essential oils from four Stenachaenium species from South Brazil were established by gas chromatography coupled with mass spectrometry (GC/MS). The major compounds identified in the oil of S. megapotamicum were a coumarin derivative, 2H-1-benzopyran-2-one,7-(3-methylbutoxy) (24.0 percent), beta-bisabolene (12.8 percent) and thymol methyl ether (7.1 percent). The oil of S. adenanthum contained mainly pogostol (14.0 percent). S. riedelli oil showed significant presence of aliphatic compounds, with predominance of hexadecanoic acid in all samples (leaves, inflorescence and leaves collected during of inflorescence period). Hexadecanoic acid (23.8 percent) was also the main component in S. macrocephalum. Concerning antichemotactic activity, all the oil samples tested showed a significant leukocyte migration inhibition compared to chemotactic stimulant (lipopolysaccharide from Escherichia coli - LPS), at concentrations of 1 to 5 μg/mL, except for S. adenanthum. These results suggest that the essential oils of some Stenachaenium species could inhibit acute inflammatory process, because the migration of neutrophils occurs mainly in the early inflammatory process.

Se estableció la composición química de los aceites esenciales de cuatro especies de Stenachaenium del Sur de Brasil mediante cromatografía de gases acoplada a espectrometría de masas (CG/EM). Los compuestos mayoritarios identificados en el aceite de S. megapotamicum fueron: un derivado de cumarina, 2H-1-benzopiran-2-ona,7- (3-metilbutoxi) (24,0 por ciento), beta-bisaboleno (12,8 por ciento) y éter metil timol (7,1 por ciento). El aceite de S. adenanthum presentó principalmente pogostol (14,0 por ciento). El aceite de S. riedelli mostró una significativa presencia de compuestos alifáticos, con predominio de ácido hexadecanoico en todas las muestras (hojas, inflorescencias y hojas recolectadas durante del período de la inflorescencia). También el ácido hexadecanoico (23,8 por ciento) fue el principal componente en S. macrocephalum. En cuanto a la actividad antichemotaxica, todas las muestras de aceites ensayadas a concentraciones de 1 a 5 μg/ml, excepto para S. adenanthum, mostraron una inhibición significativa en la migración de leucocitos en comparación con agente quimiotáctico (lipopolisacárido de Escherichia coli – LPS). Estos resultados sugieren que los aceites esenciales provenientes de diferentes especies de Stenachaenium podrían inhibir procesos inflamatorios agudos, debido a que la migración de los neutrófilos se produce principalmente en el proceso inflamatorio temprano.

Seized cannabis seeds cultivated in greenhouse: A chemical study by gas chromatography-mass spectrometry and chemometric analysis.

Cannabis sativa L. is cultivated in most regions of the world. In 2013, the Brazilian Federal Police (BFP) reported 220 tons of marijuana seized and about 800,000 cannabis plants eradicated. Efforts to eradicate cannabis production may have contributed to the development of a new form of international drug trafficking in Brazil: the sending of cannabis seeds in small amounts to urban centers by logistics postal. This new and increasing panorama of cannabis trafficking in Brazil, encouraged the chemical study of cannabis seeds cultivated in greenhouses by gas-chromatography coupled with mass spectrometry (GC-MS) associated with exploratory and discriminant analysis. Fifty cannabis seeds of different varieties and brands, seized by the BFP were cultivated under predefined conditions for a period of 4.5 weeks, 5.5 weeks, 7.5 weeks, 10 weeks and 12 weeks. Aerial parts were analyzed and cannabigerol, cannabinol, cannabidiol, cannabichromene Δ9-tetrahydrocannabinol (THC) and other terpenoids were detected. The chromatographic chemical profiles of the samples were significantly different, probably due to different variety, light exposition and age. THC content increased with the age of the plant, however, for other cannabinoids, this correlation was not observed. The chromatograms were plotted in a matrix with 50 rows (samples) and 3886 columns (abundance in a retention time) and submitted to PCA, HCA and PLS-DA after pretreatment (normalization, first derivative and autoscale). The PCA and HCA showed age separation between samples however it was not possible to verify the separation by varieties and brands. The PLS-DA classification provides a satisfactory prediction of plant age.