Risk of chronic kidney disease in 260 patients with lupus nephritis-analysis of a nationwide multicentre cohort with up to 35 years of follow-up.

OBJECTIVES: To compare proliferative (PLN) and membranous (MLN) lupus nephritis (LN) regarding clinical and laboratory presentation and long-term outcomes; To investigate predictors of progression to chronic kidney disease (CKD). METHODS: Multicentre observational study, with retrospective analysis of a prospective cohort, using data from the Rheumatic Diseases Portuguese Registry-Reuma.pt. Patients with biopsy-proven PLN, MLN and mixed LN were included. Cox regression survival analysis was used to investigate predictors of CKD. RESULTS: 260 patients were included. Median follow-up was 8 years (IQR 11; minimum 1, maximum 35 years). MLN patients presented with significantly lower serum creatinine (0.70 (IQR 0.20; minimum 0.50, maximum 1.30) mg/dl vs 0.80 (IQR 0.31; minimum 0.26, maximum 2.60) in PLN, p= 0.003). Proteinuria levels did not differ between groups (p= 0.641). Levels of complement were reduced in PLN but nearly normal in MLN patients, and there were fewer patients with positive anti-dsDNA antibodies in the MLN group (p< 0.001). One year after the beginning of treatment, 62% of the patients achieved EULAR/ERA-EDTA complete response, with further 5% achieving partial response. Patients with lower proteinuria at diagnosis were more likely to achieve a complete renal response at one year, however, proteinuria at diagnosis or at one year did not predict long term CKD. Estimated glomerular filtration rate (eGFR) ≤75 mL/min/1.73 m2 at one year was the strongest predictor of progression to CKD (HR 23 [95% CI 8-62], p< 0.001). Other possible predictors included the use of azathioprine for induction of remission, older age at diagnosis and male sex. CONCLUSION: Proteinuria levels did not predict LN histologic class in our cohort. eGFR cutoff of 75 mL/min/1.73 m2 after one year of treatment was strongly predictive of progression to CKD.

Gamma Knife Stereotactic Radiosurgery for Cerebral Cavernous Malformations: Meta-Analysis of Reconstructed Time-to-Event Data.

INTRODUCTION: Cavernomas are vascular lesions with a genetic heritage that can be spotted on the central nervous system. Whenever these lesions are localized in eloquent regions, surgical resection is not recommended. In this type of situation, Gamma Knife stereotactic radiosurgery (GKSRS) could be a feasible option for treating patients. Thus, we aimed to explore the outcomes associated with this procedure. METHODS: We performed a systematic review and meta-analysis of reconstructed time-to-event data based on Kaplan-Meier curves. A thorough search was conducted on PubMed, Cochrane, Web of Science, and Embase databases targeting papers that provided information regarding hemorrhagic outcomes associated with GKSRS through Kaplan-Meier curves. RESULTS: After a systematic search in the specific databases, seven studies were included in this review. Notably, a total of 1,071 patients had 1,104 cavernomas treated by GKSRS. Assessment of short-term and long-term post-procedure outcomes was performed, with the estimated overall events-free rate at 2 years being 89.8% (95% CI: 87.7-91.5), while, at 10 years, the estimated overall events-free rate was 71.3% (95% CI: 67.2-75.1). CONCLUSION: GKSRS seems to be a good alternative for the control of symptomatic events in early and long-term follow-up, despite the need for further investigation provided by future studies.

The Darwin wasp Camera thoracica (Szpligeti, 1916) (Ichneumonidae) as a natural enemy of the dreaded Brazilian wandering spider Phoneutria nigriventer (Keyserling, 1891) (Ctenidae).

Wandering spiders (genus Phoneutria) hold a prominent position as some of the worlds most medically significant venomous arachnids, especially in Brazil. In this study, we record and illustrate for the first time, the Darwin wasp Camera thoracica (Szpligeti, 1916) as a natural enemy of the ctenid Phoneutria nigriventer (Keyserling, 1891). Furthermore, we provide a description of the previously unknown male wasp, update and standardize the description of the female, and provide biological notes.

Late pregnancy maternal naringin supplementation affects the mitochondria in the cerebellum of Wistar rat offspring via sirtuin 3 and AKT.

Dietary polyphenol consumption is associated with a wide range of neuroprotective effects by improving mitochondrial function and signaling. Consequently, the use of polyphenol supplementation has been investigated as an approach to prevent neurodevelopmental diseases during gestation; however, the data obtained are still very inconclusive, mostly because of the difficulty of choosing the correct doses and period of administration to properly prevent neurodegenerative diseases without undermining normal brain development. Thus, we aimed to evaluate the effect of naringin supplementation during the third week of gestation on mitochondrial health and signaling in the cerebellum of 21-day-old offspring. The offspring born to naringin-supplemented dams displayed higher mitochondrial mass, membrane potential, and superoxide content in the cerebellum without protein oxidative damage. Such alterations were associated with dynamin-related protein 1 (DRP1) and phosphorylated AKT (p-AKT) downregulation, whereas the sirtuin 3 (SIRT3) levels were strongly upregulated. Our findings suggest that high dietary polyphenol supplementation during gestation may reduce mitochondrial fission and affect mitochondrial dynamics even 3 weeks after delivery via SIRT3 and p-AKT. Although the offspring born to naringin dams did not present neurobehavioral defects, the mitochondrial alterations elicited by naringin may potentially interfere during neurodevelopment and need to be further investigated.

Macrophage immunometabolism in diabetes-associated atherosclerosis.

Macrophages play fundamental roles in atherosclerotic plaque formation, growth, and regression. These cells are extremely plastic and perform different immune functions depending on the stimuli they receive. Initial in vitro studies have identified specific metabolic pathways that are crucial for the proper function of pro-inflammatory and pro-resolving macrophages. However, the plaque microenvironment, especially in the context of insulin resistance and type 2 diabetes, constantly challenges macrophages with several simultaneous inflammatory and metabolic stimuli, which may explain why atherosclerosis is accelerated in diabetic patients. In this mini review, we discuss how macrophage mitochondrial function and metabolism of carbohydrates, lipids, and amino acids may be affected by this complex plaque microenvironment and how risk factors associated with type 2 diabetes alter the metabolic rewiring of macrophages and disease progression. We also briefly discuss current challenges in assessing macrophage metabolism and identify future tools and possible strategies to alter macrophage metabolism to improve treatment options for diabetes-associated atherosclerosis.

The idiopathic inflammatory myopathies module of the Rheumatic Diseases Portuguese Register.

AIMS: To characterise the idiopathic inflammatory myopathies (IIM) module of the Rheumatic Diseases Portuguese Register (Reuma.pt/myositis) and the patients in its cohort. METHODS: Reuma.pt is a web-based system with standardised patient files gathered in a registry. This was a multicentre open cohort study, including patients registered in Reuma.pt/myositis up to January 2022. RESULTS: Reuma.pt/myositis was designed to record all relevant data in clinical practice and includes disease-specific diagnosis and classification criteria, clinical manifestations, immunological data, and disease activity scores. Two hundred eighty patients were included, 71.4% female, 89.4% Caucasian, with a median age at diagnosis and disease duration of 48.9 (33.6-59.3) and 5.3 (3.0-9.8) years. Patients were classified as having definite (N=57/118, 48.3%), likely (N=23/118, 19.5%), or possible (N=2/118, 1.7%) IIM by 2017 EULAR/ACR criteria. The most common disease subtypes were dermatomyositis (DM, N=122/280, 43.6%), polymyositis (N=59/280, 21.1%), and myositis in overlap syndromes (N=41/280, 14.6%). The most common symptoms were proximal muscle weakness (N=180/215, 83.7%) and arthralgia (N=127/249, 52.9%), and the most common clinical signs were Gottron's sign (N=75/184, 40.8%) and heliotrope rash (N=101/252, 40.1%). Organ involvement included lung (N=78/230, 33.9%) and heart (N=11/229, 4.8%) involvements. Most patients expressed myositis-specific (MSA, N=158/242, 65.3%) or myositis-associated (MAA, 112/242, 46.3%) antibodies. The most frequent were anti-SSA/SSB (N=70/231, 30.3%), anti-Jo1 (N=56/236, 23.7%), and anti-Mi2 (N=31/212, 14.6%). Most patients had a myopathic pattern on electromyogram (N=101/138, 73.2%), muscle oedema in magnetic resonance (N=33/62, 53.2%), and high CK (N=154/200, 55.0%) and aldolase levels (N=74/135, 54.8%). Cancer was found in 11/127 patients (8.7%), most commonly breast cancer (N=3/11, 27.3%). Most patients with cancer-associated myositis had DM (N=8/11, 72.7%) and expressed MSA (N=6/11) and/or MAA (N=3/11). The most used drugs were glucocorticoids (N=201/280, 71.8%), methotrexate (N=117/280, 41.8%), hydroxychloroquine (N=87/280, 31.1%), azathioprine (N=85/280, 30.4%), and mycophenolate mofetil (N=56/280, 20.0%). At the last follow-up, there was a median MMT8 of 150 (142-150), modified DAS skin of 0 (0-1), global VAS of 10 (0-50) mm, and HAQ of 0.125 (0.000-1.125). CONCLUSIONS: Reuma.pt/myositis adequately captures the main features of inflammatory myopathies' patients, depicting, in this first report, a heterogeneous population with frequent muscle, joint, skin, and lung involvements.

Determining the Prevalence of Avian Chlamydiosis in Wild Amazona Species From Brazil Using Molecular Testing and Clinical Signs.

Avian chlamydiosis is a disease that occurs in birds, especially parrots, and is caused by the Gram-negative bacterium Chlamydia psittaci. Wild Animal Screening Centers in Brazil receive, maintain, treat, and place (preferably to nature) wild animals recovered from illegal trafficking. We performed molecular testing for avian chlamydiosis in parrots from the genus Amazona that were presented to these centers. Cloacal swab samples were collected from 59 parrots (Amazona species) and transported in aqueous or culture medium. The samples were subsequently submitted for DNA extraction by the boiling method, polymerase chain reaction (PCR) amplification using CPF/CPR primers, and agarose gel electrophoresis. Conjunctivitis, nasal discharge, and poor body condition were the clinical signs associated with a differential disease diagnosis of avian chlamydiosis. Transport medium did not have an effect on the test results. The prevalence of C psittaci in the samples was 37% (22/59, 95% confidence interval: 25-49). There was a significant (P = 0.009) association between the PCR test results and clinical signs. Follow-up testing was conducted on a subgroup of 14 individuals that initially tested negative on PCR; 50% (7/14) of these birds were found to be positive within 24 days of the first test. The results of this study confirm the feasibility of using the CPF/CFP primer-based PCR to detect C psittaci in Amazona species, describe a less costly method of transporting biological material for DNA extraction, and evaluate the temporal aspect for obtaining positive results through molecular testing for C psittaci in Amazona species.

Predictors of cardiac involvement in idiopathic inflammatory myopathies.

Objectives: Idiopathic inflammatory myopathies (IIM) are a group of rare disorders that can affect the heart. This work aimed to find predictors of cardiac involvement in IIM. Methods: Multicenter, open cohort study, including patients registered in the IIM module of the Rheumatic Diseases Portuguese Register (Reuma.pt/Myositis) until January 2022. Patients without cardiac involvement information were excluded. Myo(peri)carditis, dilated cardiomyopathy, conduction abnormalities, and/or premature coronary artery disease were considered. Results: 230 patients were included, 163 (70.9%) of whom were females. Thirteen patients (5.7%) had cardiac involvement. Compared with IIM patients without cardiac involvement, these patients had a lower bilateral manual muscle testing score (MMT) at the peak of muscle weakness [108.0 ± 55.0 vs 147.5 ± 22.0, p=0.008] and more frequently had oesophageal [6/12 (50.0%) vs 33/207 (15.9%), p=0.009] and lung [10/13 (76.9%) vs 68/216 (31.5%), p=0.001] involvements. Anti-SRP antibodies were more commonly identified in patients with cardiac involvement [3/11 (27.3%) vs 9/174 (5.2%), p=0.026]. In the multivariate analysis, positivity for anti-SRP antibodies (OR 104.3, 95% CI: 2.5-4277.8, p=0.014) was a predictor of cardiac involvement, regardless of sex, ethnicity, age at diagnosis, and lung involvement. Sensitivity analysis confirmed these results. Conclusion: Anti-SRP antibodies were predictors of cardiac involvement in our cohort of IIM patients, irrespective of demographical characteristics and lung involvement. We suggest considering frequent screening for heart involvement in anti-SRP-positive IIM patients.

Key innovations and the diversification of Hymenoptera.

The order Hymenoptera (wasps, ants, sawflies, and bees) represents one of the most diverse animal lineages, but whether specific key innovations have contributed to its diversification is still unknown. We assembled the largest time-calibrated phylogeny of Hymenoptera to date and investigated the origin and possible correlation of particular morphological and behavioral innovations with diversification in the order: the wasp waist of Apocrita; the stinger of Aculeata; parasitoidism, a specialized form of carnivory; and secondary phytophagy, a reversal to plant-feeding. Here, we show that parasitoidism has been the dominant strategy since the Late Triassic in Hymenoptera, but was not an immediate driver of diversification. Instead, transitions to secondary phytophagy (from parasitoidism) had a major influence on diversification rate in Hymenoptera. Support for the stinger and the wasp waist as key innovations remains equivocal, but these traits may have laid the anatomical and behavioral foundations for adaptations more directly associated with diversification.

Tratamento multidisciplinar de paciente adulto padrão face curta ­ relato de caso / Interdisciplinary treatment of short-face adult patient ­ case report

Resumo Introdução: As más-oclusões do Padrão Face Curta são responsáveis por prejuízos estéticos e funcionais, entretanto o diagnóstico tardio impede o tratamento ortopédico preventivo e a cirurgia ortognática pode ser uma opção para os pacientes desfuncionados. Objetivo: Descrever por meio de um relato de caso o tratamento ortodôntico descompensatório cirúrgico associado à reabilitação estética de um paciente Padrão Face Curta. Descrição: Paciente Padrão Face Curta, sexo masculino, 26 anos, leucoderma, relação de Classe II total de molar e canino, sobremordida e sobressalência aumentada, protrusão dentária superior, relação de lábio comprimido, terço inferior da face diminuído. O tratamento proposto foi o tratamento ortodôntico descompensatório cirúrgico associado à reabilitação estética, considerando a gravidade dos sinais apresentados e a queixa do paciente. No final do tratamento, houve o resgate do equilíbrio estético e oclusal, com a solução total das queixas do paciente. Conclusão: Neste relato de caso, pôde se verificar a necessidade da participação interdisciplinar para obter um melhor resultado em um paciente Padrão Face Curta. O diagnóstico e planejamento realizado pelo ortodontista e pelo cirurgião bucal foram essenciais para alcançar um bom acabamento estético e funcional. (AU)

Abstract Introduction: Short-face Pattern malocclusions are responsible for aesthetic and functional impairments; however, late diagnosis excludes preventive orthopedic treatment, and orthognathic surgery can be an option for dysfunctional patients. Objective: To describe through a case report the surgical decompensatory orthodontic treatment associated with aesthetic rehabilitation of a Short-faced Pattern patient. Description: Short-face Pattern patient, male, 26 years old, leucoderma, total Class II molar and canine relationship, increased overbite and overjet, maxillary teeth protrusion, compressed lip relationship, decreased lower third of the face. The proposed treatment was a surgical decompensatory orthodontic treatment associated with aesthetic rehabilitation, considering the severity of the signs presented and the patient's complaint. At the end of the treatment there was aesthetic and occlusal balance rescue, with total solution of the patient's complaints. Conclusion: In this case report, we can verify the need for interdisciplinary participation to obtain a better result in a Short-faced Pattern patient. The diagnosis and planning performed by the orthodontist and the oral surgeon were essential to reach a good aesthetic and functional finishing.(AU)

Enhancing DNA barcode reference libraries by harvesting terrestrial arthropods at the Smithsonian's National Museum of Natural History.

The use of DNA barcoding has revolutionised biodiversity science, but its application depends on the existence of comprehensive and reliable reference libraries. For many poorly known taxa, such reference sequences are missing even at higher-level taxonomic scales. We harvested the collections of the Smithsonian's National Museum of Natural History (USNM) to generate DNA barcoding sequences for genera of terrestrial arthropods previously not recorded in one or more major public sequence databases. Our workflow used a mix of Sanger and Next-Generation Sequencing (NGS) approaches to maximise sequence recovery while ensuring affordable cost. In total, COI sequences were obtained for 5,686 specimens belonging to 3,737 determined species in 3,886 genera and 205 families distributed in 137 countries. Success rates varied widely according to collection data and focal taxon. NGS helped recover sequences of specimens that failed a previous run of Sanger sequencing. Success rates and the optimal balance between Sanger and NGS are the most important drivers to maximise output and minimise cost in future projects. The corresponding sequence and taxonomic data can be accessed through the Barcode of Life Data System, GenBank, the Global Biodiversity Information Facility, the Global Genome Biodiversity Network Data Portal and the NMNH data portal.

A workflow for expanding DNA barcode reference libraries through 'museum harvesting' of natural history collections.

Natural history collections are the physical repositories of our knowledge on species, the entities of biodiversity. Making this knowledge accessible to society - through, for example, digitisation or the construction of a validated, global DNA barcode library - is of crucial importance. To this end, we developed and streamlined a workflow for 'museum harvesting' of authoritatively identified Diptera specimens from the Smithsonian Institution's National Museum of Natural History. Our detailed workflow includes both on-site and off-site processing through specimen selection, labelling, imaging, tissue sampling, databasing and DNA barcoding. This approach was tested by harvesting and DNA barcoding 941 voucher specimens, representing 32 families, 819 genera and 695 identified species collected from 100 countries. We recovered 867 sequences (> 0 base pairs) with a sequencing success of 88.8% (727 of 819 sequenced genera gained a barcode > 300 base pairs). While Sanger-based methods were more effective for recently-collected specimens, the methods employing next-generation sequencing recovered barcodes for specimens over a century old. The utility of the newly-generated reference barcodes is demonstrated by the subsequent taxonomic assignment of nearly 5000 specimen records in the Barcode of Life Data Systems.

Prevalence and Risk Factors for HTLV-1/2 Infection inRiverside and Rural Populations of the State of Pará.

Human T-lymphotropic viruses 1 and 2 (HTLV-1 and HTLV-2) infection has been described in several Amazonian populations; however, there is still a lack of data on the prevalence of the virus in riparian populations living in rural areas of the state of Pará. The present study aimed to evaluate the prevalence of HTLV-1/2 infection in four riverine communities and one rural area in the state of Pará and to describe the possible risk factors for infection. A total of 907 individuals responded to an epidemiological survey and gave blood samples collected for anti-HTLV-1/2 antibodies by immunoenzymatic assay (EIA). The serum-reactive samples were subjected to confirmation by an in-line assay (Inno-Lia) and by proviral DNA screening using real-time PCR (qPCR). The total prevalence was 0.8% (7/907) for HTLV-1/2 (CI: 0.2-1.3%), with 0.66% HTLV-1 and 0.11% HTLV-2. The prevalence by sex was 0.7% in women (4/565) and 0.9% in men (3/342). Among seropositive patients, 83.3% (5/7) reported being sexually active, and 57.1% (4/7) reported not having the habit of using condoms during their sexual relations. Intrafamily infection was also observed. The results reinforce the need for public policies to prevent and block the spread of HTLV, especially in riparian communities that are subject to difficulties in accessing the Unified Health System (Sistema Único de Saúde/SUS) because infected individuals need clinical monitoring for surveillance and early diagnosis of symptoms associated with HTLV-1.

Changes in the seroprevalence and risk factors between the first and second waves of COVID-19 in a metropolis in the Brazilian Amazon.

In Brazil, the coronavirus disease 2019 (COVID-19) epidemic spread rapidly in a heterogeneous way, mainly due to the different socioeconomic and behavioral characteristics of different regional populations and different evaluation periods. We performed a cross-sectional study including 1,337 individuals (first wave = 736/second wave = 601) after the first two waves of COVID-19 in the city of Belém, the capital of the state of Pará. The detection of IgG anti-SARS-CoV-2 antibodies was performed using an enzyme-linked immunosorbent assay test followed by statistical analysis using the RStudio program. Our results showed an increase in the seroprevalence (first wave= 39.1%/second wave= 50.1%) of anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) IgG antibodies in the population of Belém from the first to the second pandemic wave. Advanced age, primary or secondary education level, lack of social isolation, and a low frequency of protective mask use were considered risk factors for SARS-CoV-2 infection during the first wave compared to the second wave. This study is one of the firsts to provide important information about the dynamics of virus circulation and the groups vulnerable to exposure in the two major periods. Our data emphasize the socioeconomic characteristics of the affected population and that nonpharmacological prevention measures are crucial for combating the pandemic.

Impact of Cognitive Demand on Eye Movement Pattern in Patients with Alzheimer's Disease.

BACKGROUND: Eye-movement behavior has been used as a reliable tool to identify cognitive and behavioral patterns in individuals with different neuropsychiatric disorders including Alzheimer's disease (AD). Most studies in the field have been dedicated to evaluating eye-movement behavior during cognitive tasks in different protocols using multiple parameters. OBJECTIVE: We aimed to evaluate the differences of eye-movement behavior in healthy subjects, subjects with mild cognitive impairment (MCI), and those with AD in a simple color task with and without cognitive demand. METHODS: 91 subjects: 18 AD, 47 MCI, and 26 healthy controls had their oculomotor parameters assessed during baseline (no cognitive demand involved) and during a simple computational color memory task using an eye-tracker. RESULTS: Baseline showed statistically different and heterogeneous results between normal cognition and MCI groups. Familiarization phase of the task could not discriminate between groups in any of the analyzed parameters. AD subjects made longer fixations and visits on distractors, and more frequent fixations and visits on the target areas than other groups during the response phase. CONCLUSION: Eye-tracking time-related parameters differentiate AD subjects from other groups under cognitive demand even in a simple color memory task.

Influence of working length and anatomical complexities on the apical root canal filling: a nano-CT study

Abstract The present study aimed to compare the filled volume by gutta-percha and sealer in the apical region of the main canal and ramifications, after instrumentation at two different working lengths using nano-computed tomography (nano-CT). Twenty-two premolars with apical ramifications were selected after micro-computed tomography evaluation and were randomly divided into groups for further endodontic instrumentation at two different working lengths: G1 - Root canals shaped 1 mm short of the apical foramen (n=11), and G2 - Root canals shaped at the apical foramen (n=11). After completing root treatment, nano-CT images were acquired, and the filled volume by gutta-percha and sealer in the main canal apical 0-4 mm and 0-1 mm ranges, and apical ramifications were objectively measured by an operator specialized in both radiology and endodontics, blinded for both groups. The Mann-Whitney test was applied to compare both groups regarding the filling of the main canal apical ranges and apical ramifications with a significance level of 5% (α ≤ 0.05). It was observed that root canals shaped at the apical foramen had a larger volume of the main canal filled than root canals shaped 1 mm short of the apical foramen, at both apical ranges (0-4 and 0-1 mm) (p<0.05). Regarding the filling of the apical ramifications, there was no significant difference between groups (p>0.05). In conclusion, the root canals shaped at apical foramen exhibited increased filling volume of the main canal in the apical region. However, neither of both working lengths influenced filling of the apical ramifications.

Resumo O presente estudo teve como objetivo comparar o volume preenchido por guta-percha e cimento na região apical do canal principal e ramificações, após instrumentação em dois comprimentos de trabalho diferentes, por meio de nano tomografia computadorizada (nano-TC). Vinte e dois pré-molares com ramificações apicais foram selecionados após avaliação por micro-tomografia computadorizada e foram divididos aleatoriamente em grupos para posterior instrumentação endodôntica em dois comprimentos de trabalho diferentes: G1 - Canais radiculares instrumentados 1 mm aquém do forame apical (n = 11) e G2 - Canais radiculares instrumentados até o forame apical (n = 11). Após a obturação dos canais radiculares, imagens de nano-CT foram adquiridas, e o volume preenchido por guta-percha e cimento nas faixas apicais de 0-4 mm e 0-1 mm do canal principal, e ramificações apicais, foram avaliadas objetivamente por um especialista em radiologia e endodontia, cego para ambos os grupos. O teste de Mann-Whitney foi aplicado para comparar os dois grupos quanto ao preenchimento das faixas apicais do canal principal e ramificações com nível de significância de 5% (α ≤ 0,05). Observou-se que canais radiculares instrumentados até o forame apical apresentaram maior volume do canal principal preenchido do que canais radiculares instrumentados 1 mm aquém do forame apical, em ambas as faixas apicais (0-4 e 0-1 mm) (p <0,05) Em relação ao preenchimento das ramificações apicais, não houve diferença significativa entre os grupos (p> 0,05). Em conclusão, os canais radiculares instrumentados até o forame apical mostraram um maior volume de preenchimento na região apical do canal principal. No entanto, os dois diferentes comprimentos de trabalho não influenciaram o preenchimento das ramificações apicais.

Influence of working length and anatomical complexities on the apical root canal filling: a nano-CT study.

The present study aimed to compare the filled volume by gutta-percha and sealer in the apical region of the main canal and ramifications, after instrumentation at two different working lengths using nano-computed tomography (nano-CT). Twenty-two premolars with apical ramifications were selected after micro-computed tomography evaluation and were randomly divided into groups for further endodontic instrumentation at two different working lengths: G1 - Root canals shaped 1 mm short of the apical foramen (n=11), and G2 - Root canals shaped at the apical foramen (n=11). After completing root treatment, nano-CT images were acquired, and the filled volume by gutta-percha and sealer in the main canal apical 0-4 mm and 0-1 mm ranges, and apical ramifications were objectively measured by an operator specialized in both radiology and endodontics, blinded for both groups. The Mann-Whitney test was applied to compare both groups regarding the filling of the main canal apical ranges and apical ramifications with a significance level of 5% (α ≤ 0.05). It was observed that root canals shaped at the apical foramen had a larger volume of the main canal filled than root canals shaped 1 mm short of the apical foramen, at both apical ranges (0-4 and 0-1 mm) (p<0.05). Regarding the filling of the apical ramifications, there was no significant difference between groups (p>0.05). In conclusion, the root canals shaped at apical foramen exhibited increased filling volume of the main canal in the apical region. However, neither of both working lengths influenced filling of the apical ramifications.

Seroprevalence and risk factors for COVID-19 in the metropolis of the Brazilian Amazon.

The devastating effect of health system overload was observed after cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) peaked in April 2020 in Belém, a capital metropolis in the Brazilian Amazon. Our results showed a high seroprevalence (39.24%) of anti-SARS-CoV-2 IgG antibodies among the population of the capital of the state of Pará after the first wave of the pandemic. Old age, mixed race, a high school education level, low income and contact with infected individuals are risk factors and may be driving seropositivity and exposure to SARS-CoV-2 in this population. This study is one of the first to provide important information to understand the socioeconomic inequalities, behavioral characteristics and viral transmission dynamics associated with the risk of SARS-CoV-2 infection in the capital of the state of Pará, northern Brazil.