Presence of Merkel cell polyomavirus DNA and large-T antigen in keratinocyte carcinomas and its correlation with immunohistochemical markers p16, p53 and ki67.

BACKGROUND: Merkel cell polyomavirus (MCPyV), a human polyomavirus that is unequivocally linked to merkel cell carcinoma (MCC), has been found in association with keratinocytes carcinomas (KC), especially basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC). Nevertheless, there is scarce information about the possible involvement of MCPyV in the development of KC. OBJECTIVES: To assess the presence of MCPyV DNA and Large-T Antigen (LT-Ag) via Polymerase Chain Reaction (PCR) and Immunohistochemistry (IHC) in cases of KC, and to correlate its presence with immunohistochemical markers p16, p53, and ki67, tumor type and subtype, sun-exposed location, and epidemiological data. METHODS: The prevalence of MCPyV DNA, LT-Ag, and immunohistochemical markers p16, p53, and ki67 was assessed by PCR and Immunohistochemistry (IHC) in 127 cases of KC, these results were correlated with tumor type and subtype, sun-exposed location, and epidemiological data. RESULTS: The MCPyV DNA was detected in 42.57% (43 of 101) cases by PCR, the LT-Ag was detected in 16.4% (20 of 122) of cases, p16 in 81.5% (97 of 119), p53 in 66.4% (83 of 125), ki67 in 89% (73 of 82). No correlation between MCPyV LT-Ag and DNA confronted with tumor type, subtype, location site, and immunohistochemical markers was found. A single correlation between the MCPyV LT-Ag and cSCC tumors and peri-tumoral lymphocyte cells was noted. STUDY LIMITATIONS: Further steps need to be taken to better evaluate the MCPyV influence and its possible role in KC carcinogenesis, as the evaluation of the virus genome state, the gene sequence that encodes LT-Ag in the KC tumor cells, and in situ hybridization for viral DNA or RNA in these cells. CONCLUSIONS: Despite the frequent detection of MCPyV in KC, the data available so far does not support the hypothesis of a causal relationship between them.

Universal neonatal hearing screening before and during the COVID-19 pandemic.

OBJECTIVE: To verify the frequency of risk factors for hearing loss in newborns and their possible associations with universal neonatal hearing screening results before and during the COVID-19 pandemic. METHODS: Historical cohort study with data analysis of newborns attended in a reference hearing health service of the Unified Health System (SUS) between January 2017 and December 2021. RESULTS: Those born in 2020 and 2021 were 91% less likely to fail the screening than those born in 2017, 2018, and 2019; therefore, they had a lower percentage of referrals for a retest. There was a decrease in congenital syphilis (1.00%), decrease in HIV (0.95%), and an increase in toxoplasmosis (0.58%) and increase in rubella cases in 2021 in relation to 2017. Syphilis had lower frequency rates during the COVID-19 pandemic (2020-2021). CONCLUSION: Newborns born in the pandemic year compared to those born pre-pandemic showed a reduction in the presence of two risk indicators for hearing loss and, consequently, a lower chance of failing the UNHS and a lower percentage of referral for retest.

Is Walk Score Associated With Physical Activity and Screen Time in Brazilian Older Adults?

This study aimed to examine the relationship between Walk Score index with walking to commuting, moderate-to-vigorous physical activity, and screen time in older adults. Georeferenced addresses were entered into the Walk Score platform. Walking to commute and moderate-to-vigorous physical activity were assessed using the International Physical Activity Questionnaire and categorized according to the World Health Organization recommendations. Screen time was analyzed through self-reported time watching television/being on the computer. We used binary logistic regression to estimate the association between variables. Older adults who lived in places with higher Walk Score had a higher prevalence of walking to commuting (odds ratio = 1.73; 95% confidence interval [1.18, 2.55]) and engaging in moderate-to-vigorous physical activity (odds ratio = 1.76; 95% confidence interval [1.05, 2.98]). A relationship also was observed between higher Walk Score and more time in screen time (odds ratio = 1.67; 95% confidence interval [1.19, 2.34]). The results showed that residing in a more walkable neighborhood increased the chances of the older adults spending 3 hr or more in front of a screen.

Distribution, toxicity and bioaccumulation of trace metals in environmental matrices of an estuary in a protected area.

Mangroves are productive ecosystems that are highly threatened by anthropogenic activities. We investigated the environmental quality of the Serinhaém river estuary located in a legally protected area. Through chemical analysis of sediments and tissues of Cardisoma guanhumi, in addition to bioassays with elutriate involving Nitokra sp. and Thalassiosira pseudonana, we determined the contamination status and risk factors related to trace metals in the estuary. For the sediment, the concentrations of Cr and Ni were above the limit established by CONAMA n° 454/2012 in the "City" site, and Cr above the TEL in all sampling sites. Ecotoxicological tests showed high toxicity in samples from "City" and "Tributary". The elements Cr, Mn, Ni and Zn were also higher in crabs from these sites. Cr levels exceeded the Brazilian limit for food consumption. The bioaccumulation factor was not significant. However, the overall analysis proved that this estuary is increasingly impacted by anthropogenic pressure.

ASO Author Reflections: PSMA PET in the Prostate Cancer Primary Staging Scenario-A Reliable Method with a Remarkable Decision-Making Impact.

Prostate cancer (PCa) is the second most common malignant tumor in men in Brazil and worldwide. Although positron emission tomography (PET) prostate-specific membrane antigen (PSMA) has been used for over 10 years and several studies have been published regarding its superior performance in PCa primary staging and other scenarios, the management decision is often still based on conventional imaging information. A retrospective analysis was performed in 35 patients with PCa in the primary staging scenario with conventional exams as well as with PET PSMA. The findings of our study showed changes on the staging classification and significant impact on the therapeutic choice. PET PSMA is a dependable imaging exam and has already proved its worth and superiority when compared with conventional methods to evaluate PCa patients in primary staging and biochemical relapse, in addition to other potential roles. Prospective studies are needed to assess the outcome of patients whose management was guided by PSMA.

Impact of Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography on the Therapeutic Decision of Prostate Carcinoma Primary Staging: A Retrospective Analysis at the Brazilian National Public Health System.

BACKGROUND: Prostate cancer (PCa) is the most common malignant tumor in males and conventional imaging does not provide accurate primary staging. Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) presents superior performance and strongly affects therapeutic choice. OBJECTIVE: The aim of this study was to evaluate the impact of PSMA PET, compared with conventional imaging methods, on the therapeutic approach in primary staging scenarios in patients with PCa treated at the Brazilian National Public Health System. METHODS: Overall, 35 patients diagnosed with PCa were evaluated using PSMA after conventional staging imaging with multiparametric magnetic resonance (MMR) and/or total abdominal computed tomography (CT) scan and bone scintigraphy (BS). The PCa extension identified by PET was compared with conventional imaging; staging changes and the management impact were then determined. PET comparison with conventional imaging, staging, and decision-making changes was analyzed using descriptive statistics. RESULTS: PET revealed local disease (LD) in 15 (42.9%) patients, seminal vesicle invasion (SVI) in 5 (14.3%) patients, pelvic nodal impairment (PNI) in 7 (20%) patients, pelvic and distant nodes in 3 (8.6%) patients, pelvic nodes and bone metastasis in 4 (11.4%) patients, and pelvic and distant nodes and bone metastasis in 1 (2.8%) patient. Staging changes were observed in 60% of patients, with downstaging predominance (76.2%). Volume increase was identified in 11 (31.4%) patients (only 4 related to upstaging, 36.4%). The board changed management decisions for 60% of the patients. The main limitations of this study were the sample size and its retrospective nature. CONCLUSIONS: PSMA findings changed the management decisions in more than half of the patients, which made the majority eligible for locoregional treatment and avoided unnecessary procedures in the systemic disease scenario.

Photodynamic antimicrobial therapy (A-PDT) using 1,9-Dimethyl-Methylene Blue zinc chloride double salt - DMMB and λ640 ± 5ηm LED light in patients undertaking orthodontic treatment.

Orthodontic treatment involves the use of apparatuses that impairs oral hygiene making patients susceptible to periodontal diseases and caries. To prevent increased antimicrobial resistance A-PDT has shown itself a feasible option. The aim of this investigation was to assess the efficiency of A-PDT employing 1,9-Dimethyl-Methylene Blue zinc chloride double salt - DMMB as a photosensitizing agent combined with red LED irradiation (λ640 ± 5 ηm) against oral biofilm of patients undertaking orthodontic treatment. Twenty-one patients agreed to participate. Four biofilm collections were carried out on brackets and gingiva around inferior central incisors; first was carried out before any treatment (Control); second followed five minutes of pre-irradiation, the third was immediately after the first AmPDT, and the last after a second AmPDT. Then, a microbiological routine for microorganism growth was carried out and, after 24-h, CFU counting was performed. There was significant difference between all groups. No significant difference was seen between Control and Photosensitizer and AmpDT1 and AmPDT2 groups. Significant differences were observed between Control and AmPDT1 and AmPDT2 groups, Photosensitizer and AmPDT1 and AmPDT2 groups. It was concluded that double AmPDT using DMBB in nano concentration and red LED was capable to meaningfully decrease the number of CFUs in orthodontic patients.

Parental Perception of the Oral Health-Related Quality of Life of Children and Adolescents with Autism Spectrum Disorder (ASD).

This study evaluated the parental perception of the oral health-related quality of life (OHRQoL) of children and adolescents with autism spectrum disorder (ASD) and their family functioning. Moreover, sociodemographic factors associated with parental ratings of OHRQoL were assessed. A hundred parents/guardians of children and adolescents aged 6 to 14 years with ASD (ASD group) and 101 unaffected children and adolescents (UCA group) participated. Data collection was carried out using a Google form, containing three sections: (1st) Socioeconomic data and health history; (2nd) Oral health assessment by parental report; (3rd) The short forms of the Parental-Caregiver Perceptions Questionnaire (16-P-CPQ) and the Family Impact Scale (4-FIS). The scores of 16-P-CPQ total and subscales and 4-FIS were significantly higher for the ASD group (p < 0.02), except for the oral symptoms subscale (p > 0.05). Older ages (OR = 1.24), brushing 0/1x day (OR = 2.21), teeth grinding (OR = 2.20), gingival bleeding (OR = 3.34), parents with an elementary school degree (OR = 0.314) and family incomes less or equal to the minimum wage (OR = 3.049) were associated with a worse OHRQoL. Parents in the ASD group had a worse perception of QHRQoL when compared to the UCA group. 'Frequency of tooth brushing', 'gingival bleeding', and 'teeth grinding' were predictors of the worst parental perception of their children's OHRQoL. Families with low socioeconomic conditions were more strongly affected by the oral conditions of their children.

Dificuldades na prevenção do câncer de colo uterino: discurso de mulheres quilombolas / Dificultades en la prevención del cáncer cervicouterino: discurso de las mujeres quilombolas / Difficulties in Preventing Cervical Cancer: Discourse of Quilombola Women

Introdução: observa-se que a população negra está mais vulnerável para algumas enfermidades devido a questões genéticas, ambientais, econômicas e sociais. Na saúde da mulher negra evidencia-se a necessidade de maior atenção ao desenvolvimento do câncer do colo uterino. Objetivo: identificar as dificuldades para prevenção do câncer do colo uterino a partir do discurso de mulheres quilombolas. Método: pesquisa descritiva de abordagem qualitativa, mediatizada pela metodologia da pesquisa-ação, realizada na comunidade remanescente de quilombolas intitulada "Os Quarenta", localizada na cidade de Triunfo, Paraíba, Brasil, no ano de 2019. Resultados: Notou-se, a partir dos discursos das participantes, duas Ideias Centrais acerca dos problemas ou dificuldades que impossibilitam o diagnóstico precoce do câncer do colo de útero: vergonha como obstáculo para à prática do exame preventivo e autonegligência como fator determinante na ausência da procura pelos serviços de saúde. Conclusões: percebe-se que ao inserir às informações em saúde é importante levar em consideração os fatores sociais e culturais da comunidade visando adequar às práticas de acordo com representações a respeito do tema.

Introducción: se observa que la población negra es más vulnerable frente a algunas enfermedades por cuestiones genéticas, ambientales, económicas y sociales. En la salud de la mujer negra se evidencia la necesidad de una mayor atención al desarrollo del cáncer de cuello uterino. Objetivo: identificar las dificultades en la prevención del cáncer de cuello uterino desde el discurso de las mujeres quilombolas. Método: investigación descriptiva con enfoque cualitativo, mediada por la metodología de investigación acción, realizada en la comunidad quilombola remanente denominada Os Quarenta, ubicada en la ciudad de Triunfo, Paraíba, Brasil, en 2019. Resultados: se constató en los discursos de las participantes, dos ideas centrales sobre los problemas o dificultades que impiden el diagnóstico precoz del cáncer de cuello uterino: la vergüenza como obstáculo para la práctica del examen preventivo y la auto negligencia como factor determinante en la ausencia de demanda de servicios de salud. Conclusiones: se advierte que al insertar información de salud es importante tener en cuenta los factores sociales y culturales de la comunidad para adecuar las prácticas de acuerdo con las representaciones sobre el tema.

Introduction: It is observed that black population is more vulnerable to some diseases due to genetic, environmental, economic and social issues. In the health of black women, the need for greater attention to the development of cervical cancer is evident. Objective: To identify the difficulties in preventing cervical cancer from the discourse of quilombola women. Method: Descriptive research with a qualitative approach, mediated by the action research methodology. It was carried out in the remaining quilombola community entitled Os Quarenta, located in the city of Triunfo, Paraíba, Brazil, in 2019. Results: In the participant's discourse two central ideas were noted about the problems or difficulties that prevent early diagnosis of cervical cancer: shame as an obstacle to the practice of preventive examination and self-negligence as a determining factor in the absence of demand for health services. Conclusions: It is noticed that when inserting health information, it is important to consider the social and cultural factors of the community in order to adapt practices according to representations on the subject.

In silico development of adenosine A2B receptor antagonists for sickle cell disease.

Sickle cell disease (SCD) is a disease resulting from mutation in the globin portion of hemoglobin caused by the replacement of adenine for thymine in the codon of the ß globin gene. In Brazil, SCD affects about 0.3% of the black and Caucasian population. Until now, there is no specific treatment and the available drugs have several serious adverse effects which makes the search for new drugs an emergently need. The use of computational techniques can accelerate the drug development process by prioritization of molecules with affinity against essential targets. Adenosine A2b receptor (rA2b) has been studied in SCD due to its relationship with red blood cells concentration of 2,3-diphosphoglycerate which reduces the hemoglobin affinity for oxygen (O2), facilitating its availability for the tissues. Then, development of rA2b antagonists could be helpful for the treatment of SCD. However, there is still no 3D structure of rA2b and to overcome this limitation, homology modeling should be applied. In this scenario, this study aims to build a suitable 3D model of rA2b by SWISS MODEL and to evaluate the structural aspects of rA2b with known antagonists that may be useful for the identification of new potential antagonists by molecular dynamics on a lipid bilayer environment using GROMACS 5.1.4. The complexes with antagonists ZINC223070016 and ZINC17974526 interacted with key residues by hydrophobic contacts and hydrogen bonds which stabilized them at the rA2b binding site. This intermolecular profile can contribute to the development of more potent rA2b antagonists. Communicated by Ramaswamy H. Sarma.

Sensitive LC-MS/MS Methods for Amphotericin B Analysis in Cerebrospinal Fluid, Plasma, Plasma Ultrafiltrate, and Urine: Application to Clinical Pharmacokinetics.

Neurocryptococcosis, a meningoencephalitis caused by Cryptococcus spp, is treated with amphotericin B (AmB) combined with fluconazole. The integrity of the brain-blood barrier and the composition of the cerebrospinal fluid (CSF) may change due to infectious and/or inflammatory diseases such as neurocryptococcosis allowing for the penetration of AmB into the central nervous system. The present study aimed to develop LC-MS/MS methods capable of quantifying AmB in CSF at any given time of the treatment in addition to plasma, plasma ultrafiltrate, with sensitivity compatible with the low concentrations of AmB reported in the CSF. The methods were successfully validated in the four matrices (25 µl, 5-1,000 ng ml-1 for plasma or urine; 100 µl, 0.625-250 ng ml-1 for plasma ultrafiltrate; 100 µl, 0.1-250 ng ml-1 for CSF) using protein precipitation. The methods were applied to investigate the pharmacokinetics of AmB following infusions of 100 mg every 24 h for 16 days administered as a lipid complex throughout the treatment of a neurocryptococcosis male patient. The methods allowed for a detailed description of the pharmacokinetic parameters in the assessed patient in the beginning (4th day) and end of the treatment with AmB (16th day), with total clearances of 7.21 and 4.25 L h-1, hepatic clearances of 7.15 and 4.22 L h-1, volumes of distribution of 302.94 and 206.89 L, and unbound fractions in plasma ranging from 2.26 to 3.25%. AmB was quantified in two CSF samples collected throughout the treatment with concentrations of 12.26 and 18.45 ng ml-1 on the 8th and 15th days of the treatment, respectively. The total concentration of AmB in plasma was 31 and 20 times higher than in CSF. The unbound concentration in plasma accounted for 77 and 44% of the respective concentrations in CSF. In conclusion, the present study described the most complete and sensitive method for AmB analysis in plasma, plasma ultrafiltrate, urine, and CSF applied to a clinical pharmacokinetic study following the administration of the drug as a lipid complex in one patient with neurocryptococcosis. The method can be applied to investigate the pharmacokinetics of AmB in CSF at any given time of the treatment.

Creating a transformative space for change: A qualitative evaluation of the RHS Wellbeing Programme for people with long term conditions.

PURPOSE: Our research aimed to evaluate the impact of the RHS Wellbeing (WB) Programme on people with long-term conditions. FINDINGS: A thematic analysis identified how the WB programme facilitated improved social connectivity, sense of wellbeing and purpose through the creation of a 'healthy, natural and safe space' predicated on 'person-centred approaches'. Participants felt they were 'part of something larger' which enabled 'transformation of their health and wellbeing'. CONCLUSIONS: The WB Programme offered space to grow, heal and reconnect. Losing oneself in a nature-based space can have a lasting transformative impact on individuals.

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.

The use of photobiomodulation therapy or LED and mineral trioxide aggregate improves the repair of complete tibial fractures treated with wire osteosynthesis in rodents.

The repair of large bone defects is lengthy and complex. Both biomaterials and phototherapy have been used to improve bone repair. We aimed to describe histologically the repair of tibial fractures treated by wiring (W), irradiated or not, with laser (λ780 nm, 70 mW, CW, spot area of 0.5 cm2, 20.4 J/cm2 (4 × 5.1 J/cm2, Twin Flex Evolution®, MM Optics, Sao Carlos, SP, Brazil) per session, 300 s, 142.8 J/cm2 per treatment) or LED (λ850 ± 10 nm, 150 mW, spot area of 0.5 cm2, 20.4 J/cm2 per session, 64 s, 142.8 J/cm2 per treatment, Fisioled®, MM Optics, Sao Carlos, Sao Paulo, Brazil) and associated or not to the use of mineral trioxide aggregate (MTA, Angelus®, Londrina, PR, Brazil). Inflammation was discrete on groups W and W + LEDPT and absent on the others. Phototherapy protocols started immediately before suturing and repeated at every other day for 15 days. Collagen deposition intense on groups W + LEDPT, W + BIO-MTA + LaserPT and W + BIO-MTA + LEDPT and discrete or moderate on the other groups. Reabsorption was discrete on groups W and W + LEDPT and absent on the other groups. Neoformation varied greatly between groups. Most groups were partial and moderately filed with new-formed bone (W, W + LaserPT, W + LEDPT, W + BIO-MTA + LEDPT). On groups W + BIO-MTA and W + BIO-MTA + LaserPT bone, neoformation was intense and complete. Our results are indicative that the association of MTA and PBMT (λ = 780 nm) improves the repair of complete tibial fracture treated with wire osteosynthesis in a rodent model more efficiently than LED (λ = 850 ± 10 nm).

Evaluation of microbiological and physical parameters of water from dental clinics in a brazilian university / Evaluación de parámetros microbiológicos y físicos del água de clínicas odontológicas en una universidad brasileña / Avaliação de parâmetros biológicos e físicas da água de clínicas odontológicas de uma universidade brasileira

Abstract Introduction and objective : Contamination of the water used in health care units can induce adverse individual and collective consequences. The objective of this study was to evaluate the water quality in dental clinics of a dentistry program of a university in Brazil, calculating the total coliforms, thermotolerant coliforms, heterotrophic bacteria and pH. Materials and methods: In each clinic, water samples were collected for analysis at different points: external cistern, clinic faucet, dental chair tank and triple syringe. After sample collection, analysis was performed: the presence of total coliforms and thermotolerant coliforms was determined by chromogenic substrate technique, the presence or absence of Escherichia coli by fluorescence in ultraviolet light, the count of heterotrophic bacteria through the number of colonies and the determination of pH. Results: In all studied sites, the presence of total coliforms, Escherichia coli and thermotolerant coliforms was observed in at least 26% of the samples. In relation to CFU / ml, all mean values were much higher than the maximum established by legislation (500 CFU / ml). It was verified a statistically significant difference was found in the external cistern and tap when compared to the chair tank and triple syringe (p < 0.05). All pH samples were within the standards. Conclusion : The global analysis showed that 100% of the samples were inadequate, which classified the water potability as nonstandard in regard to the current Brazilian legislation.

Resumen Introducción y objetivo : La contaminación del agua utilizada en las unidades de salud puede inducir malas consecuencias individuales y colectivas. El objetivo de esta investigación fue evaluar la calidad del agua en clínicas odontológicas de una universidad en Brasil, a través del análisis de coliformes totales, coliformes termotolerantes, bacterias heterotróficas y pH. Materiales y métodos: En cada clínica, las muestras de agua fueron recolectadas para análisis en diferentes puntos: cisterna externa, grifo clínico, reservatorio de la silla odontológica y jeringa tríplice. Después de la recolección de las muestras, el análisis fue realizado: la presencia de coliformes totales y coliformes termotolerantes fue determinada por la técnica del sustrato cromogénico; la presencia o ausencia de Escherichia coli por fluorescencia en luz ultravioleta; el recuento de bacterias heterotróficas a través del número de colonias y de la determinación del pH. Resultados: En todos los puntos estudiados, se observó la presencia de coliformes totales, Escherichia coli y coliformes termotolerantes en al menos el 26% de las muestras. Respecto a la UFC / ml, todos los valores medios fueron muy superiores al máximo establecido por la legislación (500 UFC / ml). Todas las muestras de pH estaban dentro de los patrones. Conclusión : El análisis global mostró que el 100% de las muestras fueron inadecuadas, lo que clasificó la capacidad de agua como fuera del estándar en relación a la legislación brasileña actual.

Resumo Introdução e objetivo: A contaminação da água utilizada nas unidades de saúde pode induzir consequências adversas individuais e coletivas. O objetivo deste estudo foi avaliar a qualidade da água em clínicas odontológicas de um curso de odontologia de uma universidade no Brasil, através da análise de coliformes totais, coliformes termotolerantes, bactérias heterotróficas e pH. Materiais e métodos: Em cada clínica, amostras de água foram coletadas para análise em diferentes pontos: cisterna externa, torneira clínica, reservatório da cadeira odontológica e seringa tríplice. Após a coleta das amostras, a análise foi realizada: a presença de coliformes totais e coliformes termotolerantes foi determinada pela técnica do substrato cromogênico; a presença ou ausência de Escherichia coli por fluorescência em luz ultravioleta; a contagem de bactérias heterotróficas através do número de colônias e a determinação de pH. Resultados : Em todos os pontos estudados, a presença de coliformes totais, Escherichia coli e coliformes termotolerantes foi observada em pelo menos 26% das amostras. Em relação à UFC/ml, todos os valores médios foram muito superiores ao máximo estabelecido pela legislação (500 UFC/ml). Todas as amostras de pH estavam dentro dos padrões. Conclusão: A análise global mostrou que 100% das amostras foram inadequadas, o que classificou a capacidade de água como fora do padrão em relação à legislação brasileira atual.

Changes in porcine cauda epididymal fluid proteome by disrupting the HPT axis: Unveiling potential mechanisms of male infertility.

Male infertility or subfertility is frequently associated with disruption of the hypothalamic-pituitary-testis axis events, like secondary hypogonadism. However, little is known how this condition affects the proteomic composition of the epididymal fluid. In the present study, we evaluated the proteomic changes in the cauda epididymal fluid (CEF) in a swine model of secondary hypogonadism induced by anti-GnRH immunization using multidimensional protein identification technology. Seven hundred and eighteen proteins were identified in both GnRH-immunized and control groups. GnRH immunization doubled the number of proteins in the CEF, with 417 proteins being found exclusively in samples from GnRH-immunized boars. CEF from GnRH-immunized boars presented an increase in the number of proteins related to cellular and metabolic processes, with affinity to organic cyclic compounds, small molecules, and heterocyclic compounds, as well changed the enzymatic profile of the CEF. Also, a significant increase in the number of proteins associated to the ubiquitin-proteasome system was identified in CEF from GnRH-immunized animals. These results bring strong evidence of the impact of secondary hypogonadism on the epididymal environment, which is responsible for sperm maturation and storage prior ejaculation. Finally, the differently expressed proteins in the CEF are putative seminal biomarkers for testicular and epididymal disorders caused by secondary hypogonadism.

Social prescribing: a 'natural' community-based solution.

This paper discusses social prescribing as part of the wider NHS England universal personalised care model, and it describes how community nurses can engage with social prescribing systems to support community resilience. A case study based on the example of gardening, as a nature-based social prescription provided by the RHS Bridgewater Wellbeing Garden, is provided to illustrate the scope, reach and impact of non-medical, salutogenic approaches for community practitioners. The authors argue that social prescribing and, in particular, nature-based solutions, such as gardening, can be used as a non-medical asset-based approach by all health professionals working in the community as a way to promote health and wellbeing. They consider how the negative impact of social distancing resulting from COVID-19 restrictions could be diluted through collaboration between a holistic, social prescribing system and community staff. The paper presents a unique perspective on how community nurses can collaborate with link workers through social prescribing to help combat social isolation and anxiety and support resilience.

Raman spectroscopic study of the effect of the use of laser/LED phototherapy on the repair of complete tibial fracture treated with internal rigid fixation.

This study aimed to assess the repair of complete surgical tibial fractures fixed with internal rigid fixation (IRF) associated or not to the use of mineral trioxide aggregate (MTA) cement and treated or not with laser (λ = 780 nm, infrared) or LED (λ = 850 ±â€¯10 nm, infrared) lights, 142.8 J/cm2 per treatment, by means of Raman spectroscopy. Open surgical tibial fractures were created on 18 rabbits (6 groups of 3 animals per group, ∼8 months old) and fractures were fixed with IRF. Three groups were grafted with MTA. The groups of IRF and IRF + MTA that received laser or LED were irradiated every other day during 15 days. Animals were sacrificed after 30 days, being the tibia surgically removed. Raman spectra were collected via the probe at the defect site in five points, resulting in 15 spectra per group (90 spectra in the dataset). Spectra were collected at the same day to avoid changes in laser power and experimental setup. The ANOVA general linear model showed that the laser irradiation of tibial bone fractures fixed with IRF and grafted with MTA had significant influence in the content of phosphate (peak ∼960 cm-1) and carbonated (peak ∼1,070 cm-1) hydroxyapatites as well as collagen (peak 1,452 cm-1). Also, peaks of calcium carbonate (1,088 cm-1) were found in the groups grafted with MTA. Based on the Raman spectroscopic data collected in this study, MTA has been shown to improve the repair of complete tibial fractures treated with IRF, with an evident increase of collagen matrix synthesis, and development of a scaffold of hydroxyapatite-like calcium carbonate with subsequent deposition of phosphate hydroxyapatite.

Avaliação do diagnóstico de enfermagem Padrão de sono prejudicado em puérperas / Evaluación del diagnóstico de enfermería Patrón de sueño perjudicado en puérperas / Assessment of the Nursing Diagnosis of Affected Sleep Pattern in Puerperal Women

Introdução: O puerpério é o período em que a mulher passa por diversas mudanças, que pode contribuir para a diminuição da quantidade e qualidade do sono. Nesse contexto, destaca-se o diagnóstico de enfermagem "Padrão de sono prejudicado". Objetivo: Identificar os fatores relacionados e as características definidoras do diagnóstico de enfermagem "padrão de sono prejudicado", bem como suas associações, em puérperas cadastradas e acompanhadas em Unidades Básicas de Saúde. Métodos: Trata-se de um estudo transversal, realizado em Unidades Básicas de Saúde, no período de janeiro a abril de 2016. A amostra foi constituída por 30 puérperas e a coleta de dados foi realizada por meio de uma entrevista estruturada com questões sobre a presença ou ausência de fatores relacionados e características definidoras do diagnóstico em estudo. Os dados foram analisados quantitativamente e foi aplicado o teste exato de Fisher para verificar a associação entre as variáveis. Resultados: Apenas o fator relacionado "padrão conflitante do sono materno infantil" mostrou associação estatística com o diagnóstico. As características definidoras significativas foram: insatisfação com o sono, relatos verbais de não se sentir bem descansado, relatos de ficar acordado, relato de dificuldade para dormir e capacidade funcional diminuída. Conclusão: A identificação do fator relacionado e das características definidoras mais significativas auxilia o enfermeiro na identificação do diagnóstico em puérperas, bem como na seleção das intervenções que devem ser implementadas na assistência(AU)

Introducción: El puerperio es el período en el que la mujer experimenta varios cambios, lo que puede contribuir a la disminución de la cantidad y calidad del sueño. En este contexto destaca el diagnóstico de enfermería "alteración del sueño". Objetivo: Identificar los factores relacionados y las características definitorias del diagnóstico de enfermería "alteración del patrón de sueño", así como sus asociaciones, en pacientes puerperales registrados y monitoreados en las Unidades de Salud Básicas. Métodos: Estudio transversal realizado en Unidades Básicas de Salud, en el período de enero a abril de 2016. La muestra fue constituida por 30 puérperas y la recolección de datos fue realizada por medio de una entrevista estructurada con cuestiones sobre la presencia o ausencia de factores relacionados y características definitorias del diagnóstico en estudio. Los datos fueron analizados cuantitativamente y se aplicó la prueba exacta de Fisher para verificar la asociación entre las variables. Resultados: Solo el factor relacionado "patrón conflictivo del sueño materno infantil" mostró asociación estadística con el diagnóstico. Las características definitorias significativas fueron: insatisfacción con el sueño, relatos verbales de no sentirse bien descansado, relatos de estar despierto, relato de dificultad para dormir y capacidad funcional disminuida. Conclusiones: La identificación del factor relacionado y las características definitorias más significativas ayudan a la enfermera a identificar el diagnóstico en mujeres puérperas, así como a seleccionar las intervenciones que deben implementarse en la atención(AU)

Introduction: The puerperium is the period in which the woman experiences several changes, which can contribute to the decrease in the quantity and quality of sleep. In this context, the nursing diagnosis of sleep disturbance stands out. Objective: To identify the related factors and the defining characteristics of the nursing diagnosis of alteration of the sleep pattern, as well as its associations, in puerperal patients registered and monitored in basic health units. Methods: Cross-sectional study carried out in basic health units, in the period from January to April 2016. The sample was made up of 30 puerperal women and the data collection was carried out through a structured interview with questions about the presence or absence of related factors and defining characteristics of the diagnosis under study. The data were quantitatively analyzed and Fisher's exact test was applied to verify the association between the variables. Results: Only the related factor of conflictive pattern of maternal and child sleep showed statistical association with the diagnosis. The significant defining characteristics were dissatisfaction with sleep, verbal reports of not feeling well after resting, reports of being awake, reports of difficulty sleeping, and decreased functional capacity. Conclusions: The identification of the related factor and the most significant defining characteristics help the nurse identify the diagnosis in puerperal women, as well as select the interventions that should be implemented in the care(AU)