Thoracic Spine Mobility and Posture: Correlation and Predictive Values in Physically Independent Older Adults.

The posture undergoes changes during aging and may serve as a marker for the evaluation of the thoracic spine. This study aimed to correlate the variables for the evaluation of thoracic spine mobility and propose predictive equation models from the measurements of the thoracic Schober test and the digital inclinometer in older adults. The mobility of thoracic flexion and extension by levels (T1, T8 and T12) of 41 older adult subjects (66 ± 7 years) was quantified with a digital inclinometer (degrees) and Schober's test (cm). There was a moderate positive correlation between the digital inclinometer and the Schober test at T1 (r = .69), T12 (r = .60), and total flexion levels T1 to T12 (r = .74). Simple linear regression equations showed that thoracic Schober predicts thoracic mobility measures for these same levels. Moderate to strong correlations were observed between the inclinometer and the Schober Test measurements. The development of predictive equation models based on the thoracic Schober test could potentially enhance the ability to predict spinal mobility in physically independent older adults.

Improving pharmaceutical practice in diabetes care using point-of-care glycated haemoglobin testing in the community pharmacy.

OBJECTIVES: To evaluate the use of point-of-care testing to detect new cases of diabetes mellitus at a Brazilian public community pharmacy. METHODS: This cross-sectional study included individuals without a previous diagnosis of diabetes mellitus who met the criteria for screening according to the Brazilian Diabetes Society, which were identified during their presence at a Brazilian public community pharmacy. The measurements of HbA1c were performed using a Cobas b101 device (Roche Diagnostics) and were categorized according to the following classification established by the Brazilian Society of Diabetes: HbA1c <5.7%, normal; HbA1c between 5.7% and 6.4%, pre-diabetes; and HbA1c >6.4%, new diagnosis of T2DM. KEY FINDINGS: One hundred and eight users met the inclusion criteria. The patients' mean age was 54.4 (± 15.4) years old, ranging from 22 to 80 years old. Eighty (74.1%) participants presented with glycated haemoglobin levels over the standard threshold, of which 58 (72.5%) were in the pre-diabetes range (glycated haemoglobin levels between 5.7% and 6.4%), and 22 (27.5%) had glycated haemoglobin levels >6.4%, which corresponds to a new diagnosis of type 2 diabetes mellitus. CONCLUSIONS: The use of point-of-care glycated haemoglobin testing allowed community pharmacists at a Brazilian public community pharmacy to identify health system users with glycated haemoglobin alterations that corresponded to the pre-diabetes state or a new diagnosis of type 2 diabetes mellitus. This presented a good opportunity to refer these users to diabetes diagnosis and treatment services.

Eicosanoid profiles in an arthritis model: Effects of a soluble epoxide hydrolase inhibitor.

Rheumatoid arthritis is a common systemic inflammatory autoimmune disease characterized by damage to joints, inflammation and pain. It is driven by an increase of inflammatory cytokines and lipids mediators such as prostaglandins. Epoxides of polyunsaturated fatty acids (PUFAs) are lipid chemical mediators in a group of regulatory compounds termed eicosanoids. These epoxy fatty acids (EpFA) have resolutive functions but are rapidly metabolized by the soluble epoxide hydrolase enzyme (sEH) into the corresponding diols. The pharmacological inhibition of sEH stabilizes EpFA from hydrolysis, improving their half-lives and biological effects. These anti-inflammatory EpFA, are analgesic in neuropathic and inflammatory pain conditions. Nonetheless, inhibition of sEH on arthritis and the resulting effects on eicosanoids profiles are little explored despite the physiological importance. In this study, we investigated the effect of sEH inhibition on collagen-induced arthritis (CIA) and its impact on the plasma eicosanoid profile. We measured the eicosanoid metabolites by LC-MS/MS-based lipidomic analysis. The treatment with a sEH inhibitor significantly modulated 11 out of 69 eicosanoids, including increased epoxides 12(13)-EpODE, 12(13)-EpOME, 13-oxo-ODE, 15-HEPE, 20-COOH-LTB4 and decreases several diols 15,6-DiHODE, 12,13-DiHOME, 14,15-DiHETrE, 5,6-DiHETrE and 16,17-DiHDPE. Overall the inhibition of sEH in the rheumatoid arthritis model enhanced epoxides generally considered anti-inflammatory or resolutive mediators and decreased several diols with inflammatory features. These findings support the hypothesis that inhibiting the sEH increases systemic EpFA levels, advancing the understanding of the impact of these lipid mediators as therapeutical targets.

Euglossini bee diversity is driven by forest cover in coastal Amazon.

Habitat loss and fragmentation are drivers of biodiversity loss, such as Euglossini bees in continental regions. Knowledge about these effects on this group of pollinators in coastal regions is still incipient and needs to be further investigated. This study aimed to evaluate the effects of landscape structure on the abundance, richness, diversity and species composition of Euglossini bees on the coast of the Brazilian Amazon. We mapped the surrounding landscape around 48 sampling points in the east of the island of Marajó, Pará, Brazil where we collected bees using chemical baits. We used Generalized Linear Models (GLMs) to evaluate the effects of landscape structure (composition and configuration) on the abundance, richness, diversity and composition of Euglossini bees. We collected a total of 1017 males belonging to four genera and 22 species. Forest cover (%) and landscape heterogeneity were the best predictors of the bee community. Increased forest cover positively affected the abundance, richness and diversity of bees at a local scale. On the other hand, abundance, richness and diversity decreased with increasing landscape heterogeneity, also at a local scale. The hypothesis that the amount of habitat favors Euglossini communities was corroborated by our results. Based on our conclusions, landscapes with greater forest cover can effectively contribute to the conservation of these bees and their pollination services along the Amazon coast.

Creating an HLA-homozygous iPS cell bank for the Brazilian population: Challenges and opportunities.

Identifying human leukocyte antigen (HLA) haplotype-homozygous donors for the generation of induced pluripotent stem (iPS) cell lines permits the construction of biobanks immunologically compatible with significant numbers of individuals for use in therapy. However, two questions must be addressed to create such a bank: how many cell lines are necessary to match most of the recipient population and how many people should be tested to find these donors? In Japan and the UK, 50 and 100 distinct HLA-A, -B, and -DRB1 triple-homozygous haplotypes would cover 90% of those populations, respectively. Using data from the Brazilian National Registry of Bone Marrow Donors (REDOME), encompassing 4,017,239 individuals, we identified 1,906 distinct triple-homozygous HLA haplotypes. In Brazil, 559 triple-homozygous cell lines cover 95% of the population, and 3.8 million people would have to be screened. Finally, we show the contribution of the 30 most frequent triple-homozygous HLA haplotypes in Brazil to populations of different countries.

Analysis of handgrip strength, pulling force using the upper limbs, and ground reaction forces in the task of boarding a bus between healthy elderly individuals and those with Parkinson's disease.

INTRODUCTION: Elderly individuals with neurodegenerative diseases, such as Parkinson's disease (PD), may experience difficulties when performing functional tasks. OBJECTIVE: To analyze the handgrip strength, pulling force, and ground reaction forces (GRF) of individuals with and without PD when boarding a bus while performing both simple (ST) and dual tasks (DT). METHOD: This case-control study addressed 31 individuals with PD (GPD) and 30 healthy individuals (GHI). Assessments were performed in ST and DT situations using a bus model (prototype). Handgrip strength and pulling force were measured in both upper limbs using a dynamometer, and GRF was measured using a force platform. The GPD's and GHI's performances were compared in both ST and DT, and the individuals were classified as fallers according to the Falls Efficacy Scale. RESULTS: In the inter-group comparison, the GPD presented significantly lower maximum force using their right hand, in handgrip strength (30.43 vs. 36.62, P = .022), and pulling force (10.77 vs 12.81, P = .037). The left hand's pulling force proved to be the most demanding for the GPD, during ST (6.35 vs. 4.76, P = .006) and DT (6.32 vs 4.74, P = .008). The GPD also took longer to perform ST (6.14 vs. 4.67, P < .001) and DT (6.08 vs. 4.81, P = .002). Additionally, the GPD was more afraid of falling compared to the GHI (34.74 vs. 24.77, P < .001). CONCLUSION: Boarding a bus is a complex task for individuals with PD because they present lower maximum strength in the upper limbs and more significant functional expenditure than their healthy counterparts.

Retrospective Analysis of the SARS-CoV-2 Infection Profile in COVID-19 Positive Patients in Vitoria da Conquista, Northeast Brazil.

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is responsible for causing Coronavirus Disease-2019 (COVID-19), a heterogeneous clinical condition that manifests varying symptom severity according to the demographic profile of the studied population. While many studies have focused on the spread of COVID-19 in large urban centers in Brazil, few have evaluated medium or small cities in the Northeast region. The aims of this study were: (i) to identify risk factors for mortality from SARS-CoV-2 infection, (ii) to evaluate the gene expression patterns of key immune response pathways using nasopharyngeal swabs of COVID-19 patients, and (iii) to identify the circulating SARS-CoV-2 variants in the residents of a medium-sized city in Northeast Brazil. A total of 783 patients infected with SARS-CoV-2 between May 2020 and August 2021 were included in this study. Clinical-epidemiological data from patients who died and those who survived were compared. Patients were also retrospectively divided into three groups based on disease severity: asymptomatic, mild, and moderate/severe. Samples were added to a qPCR array for analyses of 84 genes involved with immune response pathways and sequenced using the Oxford Nanopore MinION technology. Having pre-existing comorbidity; being male; having cardiovascular disease, diabetes, and/or chronic obstructive pulmonary disease; and PCR cycle threshold (Ct) values under 22 were identified as risk factors for mortality. Analysis of the expression profiles of inflammatory pathway genes showed that the greater the infection severity, the greater the activation of inflammatory pathways, triggering the cytokine storm and downregulating anti-inflammatory pathways. Viral genome analysis revealed the circulation of multiple lineages, such as B.1, B.1.1.28, Alpha, and Gamma, suggesting that multiple introduction events had occurred over time. This study's findings help identify the specific strains and increase our understanding of the true state of local health. In addition, our data demonstrate that epidemiological and genomic surveillance together can help formulate public health strategies to guide governmental actions.

Revision of the Tetragona clavipes (Fabricius, 1804) species-group (Hymenoptera: Apidae: Meliponini).

The Neotropical bee genus Tetragona Lepeletier Serville, 1828 is characterized among stingless bees by having a yellow pigmented maculation on body, especially on the clypeus, lower region of the paraocular area and mesosome, velvety genal area, a long and slender mesotibial spur and a glabrous propodeal triangle. The T. clavipes species-group is mainly characterized by having workers with elongated setae on T6, with about 2x the length of setae on T5 and hyaline wings. This group is composed of five species, two of which are described here as new: T. clavipes (Fabricius, 1804), T. perangulata (Cockerell, 1917), T. quadrangula (Lepeletier, 1936), T. mourei sp. nov. and T. korotaii sp. nov.). In this study, we synonymize T. dissecta Moure, 2000 and T. elongata Lepeletier Serville, 1828 under T. clavipes and we provide an identification key for the workers to the species in T. clavipes species-group.

Challenges to reducing post-consumer plastic rejects from the MSW selective collection at two MRFs in São Paulo city, Brazil.

​The present study is concerned with an overview of the main aspects of the selective collection from the municipal solid waste in São Paulo City and the limitations of its two automated Material Recovery Facilities (MRFs) to tackle the problem of reducing recyclable plastic waste sent to landfills as rejects. The research aimed to characterize the composition of screened mass flows of as-received mixes from the selective collection at the two MRFs through in situ random collection campaigns. The results of the gravimetric analysis have shown that both MRFs provided higher recovery yields (> 40%) for paper, cardboard, Tetrapack®, ferrous and non-ferrous metals (aluminium), akin to some post-consumer plastics (PET, HDPE/LDPE and PP) that ranged from 38% for PP up to 89% for HDPE, Losses in recovery yields of recyclable plastics after the screening process resulted from lack of clear resin label identification, inefficient materials sortation by households and poor recognition capabilities of the MRFs screening devices to target and segregate specific types of plastics such as PS and vinylic. Packaging design complexity, multi-layered material diversity, and food contaminated post-consumer packaging pose further challenges to improve the plastics recovery capabilities of the two MRFs.

Geo-environmental and geotechnical characterization of municipal solid waste from the selective collection in São Paulo city, Brazil.

This paper presents the characterization of municipal solid waste (MSW) randomly collected from two material recovery facilities in São Paulo city, before (input - recyclables) and after (output - rejects) the sorting processes. Geo-environmental and geotechnical tests were performed on shredded samples and a digestion method was applied to detect the metals As, Cd, Cr, Cu, Fe, Mn, Ni, Pb, and Zn concentrations using an ICP OES. The objective was to assist future activities of integrated solid waste management and soil pollution. Results showed different particle sizes comparing the input (44.6%) and the output MSW (75.1%) passing through the 100-mm sieve. Organic matter and ash contents indicated the influence of inorganic carbon due to the plastics' presence, with values varying between 6 and 13%. The pH values obtained were neutral and the electrical conductivity of the MSW rejects suggested a higher amount of ions, with values above 1000 µS/cm. Metals analyses show that Cd, Cu, Ni, Pb, and Zn are present in high concentrations, depending on the types of the materials. Standard Proctor compaction curves yielded maximum dry unit weight varying from 6.6 to 10.0 kN/m3 and optimum moisture contents from 20 to 42%. Cohesion ranged from 1.3 to 31.3 kPa and friction angle from 3.2 to 42.9°. The results are comparable with those obtained for other countries using different MSW treatments and contribute to the data basis for MSW from the selective collection, aiming the integrated solid waste management, serving for other countries that adopt MSW sorting and recycling.

Does invasion by Pteridium aquilinum (Dennstaedtiaceae) affect the ecological succession in Atlantic Forest areas after a fire?

Pteridium aquilinum (Dennstaedtiaceae) colonization affects ecological and restoration processes. The knowledge of the impacts on the ecological succession by this species allows the use of restoration strategies in invaded environments. This work aimed to evaluate the floristic composition, diversity, structure, density, basal area, height, and diameter of natural regeneration in three areas of the Atlantic Forest in the Serra do Espinhaço Biosphere Reserve in an area invaded by P. aquilinum after a fire. Three environments with different coverage intensities by P. aquilinum were studied, and the plants over 10 cm in height or 5 cm in canopy diameter were measured. The floristic composition and diversity were analyzed using indices presented by Chao, Fisher, Margalef, Pielou, Shannon-Weaver, and Simpson, and similarity was evaluated by the Jaccard index. Species density, basal area, height, and canopy diameter classes were also evaluated. The floristic composition, diversity, structure of natural regeneration, density, and basal area were higher in post-fire areas with a lower coverage by P. aquilinum. The topsoil coverage with plant litter and the possible effect of P. aquilinum allelopathy probably reduced the species richness and diversity. The proportion of plants from the lowest height and canopy diameter classes was higher under moderate coverage by P. aquilinum. The reduction in the floristic composition, diversity, number of species, and basal area in post-fire areas colonized by P. aquilinum is probably due to this species aggressiveness. The population of this plant is high, accumulating large quantities of plant litter as a physical barrier preventing light and propagules from reaching the soil, reducing the germination of the seed bank and, consequently, the natural regeneration. The floristic composition, diversity, structure of natural regeneration, density, and basal area were lower in areas with higher coverage by P. aquilinum. The proportion of plants in the most significant height and canopy diameter classes was higher with reduced coverage by P. aquilinum. The P. aquilinum reduced forest succession in areas after a fire.

FIRST REPORT OF GENUS Cryptosporidium IN CERVIDS SPECIES: Mazama americana, Mazama nana AND Blastocerus dichotomus.

We analyzed Cryptosporidium spp. in fecal samples of wild cervids (Ozotoceros bezoarticus, Blastocerus dichotomus, Mazama nana, Mazama americana, and Mazama bororo) from many Brazilian regions, a fact unprecedented in the literature. Sniffer dogs were used to collect 936 fecal samples of cervids from 14 Brazilian localities. Cervids species were identified using polymerase chain reaction (PCR) performed from genomic DNA extracted from 563 fecal samples of Ozotoceros bezoarticus, Blastocerus dichotomus, Mazama nana, Mazama americana, and Mazama bororo. Cryptosporidium spp. oocyst screening was performed using malachite green negative staining. Nested PCR (nPCR) protocols targeting the 18S rRNA and GP60 genes followed by genetic sequencing were performed for Cryptosporidium spp. detection and Cryptosporidium parvum subtyping, respectively. Nested PCR targeting actin gene and genetic sequencing were performed in samples with non-identified Cryptosporidium species by 18S rRNA amplicon sequencing. The association between the occurrence of Cryptosporidium and the presence of bovines in the same locality was evaluated using Fisher's exact test. The positivity rates of diagnostic methods were compared by McNemar test and the Kappa correlation coefficient. The prevalence rates of Cryptosporidium spp. in cervids were 1.42% (8/563) and 0.36% (2/563) by nPCR and malachite green negative staining, respectively. C. parvum IIaA16G3R1 isolate was identified in three fecal samples from M. americana, two from M. nana and one from B. dichotomus. Cryptosporidium ryanae were found in one sample from B. dichotomus. We identified a new Cryptosporidium genotype, named Cryptosporidium deer genotype BR, from one M. americana fecal sample.

The Impact of Parkinson's Disease on Postural Control in Older People and How Sex can Mediate These Results: A Systematic Review.

INTRODUCTION: Parkinson's disease is most prevalent among elderly people, 65 years and over, and leads to an alteration in motor control associated with postural instability. Current evidence shows that postural control decreases with the aging process. In addition, postural control is more altered in healthy aged men than in women. Until today, few studies have evaluated the combined impact of Parkinson's disease and sex on postural control. This review has allowed to evaluate the impact of Parkinson's disease and sex on postural control measurements in elderly people. METHODOLOGY: Studies have been selected from two main databases: PubMed and EBSCO using the keywords "Parkinson", "postural control OR balance" and "sex". Articles related to the evaluation of postural control, including men and women with Parkinson's aged over 65 years old, regardless of stage, were included (n = 179). Articles were excluded if not written in French or English or not presenting original content. RESULTS: Ten (10) studies out of 179 that fulfilled inclusion and exclusion criteria were reported in the final analysis, which cumulates a total of 944 individuals with Parkinson's (410 women). In general, results show greater postural instability among people with Parkinson's compared to healthy subjects, and this according to different objective measurements using stabilographic parameters from force platforms. Only two studies out of ten evaluated postural control while briefly considering distinctions between sex, but without showing a significant difference between men and women with Parkinson's. Parkinson's severity, length of time of Parkinson's disease and cognitive state of the person are the three variables with a negative impact on postural control. CONCLUSION: Older people with Parkinson's disease have greater postural instability. Sex does not seem to influence the postural control of elderly people with Parkinson's, although more studies are necessary.

Acute effect of core stability and sensory-motor exercises on postural control during sitting and standing positions in young adults.

Core stability exercises and exercises that stimulate sensory-motor information are recommended for the prevention of injuries and the maintenance and rehabilitation of deficits related to postural control (PC). However, the comparison of results between core stability and sensory-motor exercises in the literature is limited to sitting and standing positions. OBJECTIVE: To determine the acute effect of core stability and sensory-motor exercises on PC during sitting and standing in young adults. METHODS: A total of 39 participants, with a mean age of 23 years, were randomly divided into three groups (1) Core stability exercises; (2) Sensory-motor exercises; (3) Control. Each group performed a sequence of five specific exercises of core stability and sensory-motor exercises (except controls). PC was evaluated before and after exercise in the seated and the one-legged stance conditions using a force platform. RESULTS: No significant difference was found for any variables of postural oscillation (P > 0.05) among the three groups studied. The magnitude of the effect of interventions in general was a small to moderate effect (d = 0.02/-0.48). CONCLUSION: The findings show that acute intervention with core stability and sensory-motor exercises did not produce any significant effects (reduction of postural oscillation) on PC during sitting and standing positions in young adults.

Liquen plano pigmentoso en la cavidad oral / Lichen planus pigmentosus in oral cavity

Introducción: El liquen plano pigmentoso es una lesión autoinmune de etiología desconocida, aunque tiene mayor incidencia en mujeres de mediana edad, a las que afecta principalmente la cara y el cuello y, en menor medida, la cavidad oral. Objetivo: Describir las características clínicas e histopatológicas de un caso de liquen plano pigmentoso en la cavidad oral. Presentación del caso: Mujer de 21 años, negra, que acudió al servicio quejándose de una mancha en la cavidad oral. Las lesiones presentaban un mes de evolución, crecimiento radial y sin síntomas dolorosos. Consistían en placas ennegrecidas de contorno regular con estrías blanquecinas en su periferia, forma redondeada, bordes afilados, en mucosa yugal bilateral, que medían aproximadamente 25 mm en el derecho y 13 mm en el lado izquierdo. Después de la biopsia incisional y el análisis histopatológico, se confirmó la sospecha de liquen plano pigmentoso oral. El tratamiento propuesto para las lesiones fue conservador mediante un estricto seguimiento clínico. Conclusiones: El diagnóstico del liquen plano pigmentoso, debido a su baja ocurrencia en la cavidad oral y sus características clínicas atípicas y semejantes a otras lesiones orales, es complejo. En este contexto, se ratifica la relevancia del examen histopatológico y se destaca la necesidad de otros estudios para aclarar los factores etiológicos involucrados en esta lesión(AU)

Introduction: Pigment lichen planus is an autoimmune lesion of unknown etiology, with preference for middle-aged women, which mainly affects the face and neck, being rare in the oral cavity. Objective: To report a case of pigment lichen planus in the oral cavity, with emphasis on its clinical and histopathological characteristics. Case report: 21 years old woman, black, who came to the service complaining about a spot in the oral cavity. The lesions presented a month of evolution, radial growth and no painful symptoms. They consisted of blackened plates of regular contour with whitish stretch marks on their periphery, rounded shape, sharp edges, on bilateral jugular mucosa, which measured approximately 13 mm on the left side and 25 mm on the right. After the incisional biopsy and histopathological analysis, the suspicion of oral pigment lichen planus was confirmed. The proposed treatment for the lesions was conservative through strict clinical follow-up. Conclusion: The importance and difficulty of the diagnosis of pigment lichen planus is emphasized, especially due to its low occurrence in the oral cavity and its atypical clinical characteristics and similar to other oral lesions. In this context, the relevance of the histopathological examination is ratified and the need for further studies to clarify the etiological factors involved in this pathology is highlighted(AU)

Práticas de cuidado para doenças não transmissíveis na Estratégia Saúde da Família / Prácticas de cuidado para enfermedades no transmisibles en la Estrategia Salud de la Familia / Care practices for non-communicable diseases in the Family Health Strategy

Objetivo: realizar uma reflexão crítica e analítica acerca das práticas de cuidado em saúde no Brasil voltadas para as doenças não transmissíveis no contexto da Estratégia Saúde da Família. Síntese do conteúdo: as reflexões sobre as práticas de cuidado revelaram importantes avanços materializados pela instituição de referências legais no âmbito políticonormativo e assistencial, refletindo em melhor controle das doenças crônicas por longo período. Contudo, o cenário de crise global impôs sérias restrições orçamentárias com implicações político-econômicas e técnico-assistenciais, constituindo, portanto, uma ameaça ao controle das doenças crônicas e um prejuízo para a qualidade de vida da população brasileira. Conclusões: maior sinergia de esforços entre distintos atores sociais será necessária para garantir a defesa da universalidade, a resolutividade, a equidade e a gratuidade das práticas de cuidado em saúde na Estratégia Saúde da Família com foco nas doenças crônicas.

Objetivo: realizar una reflexión crítica y analítica sobre las prácticas de atención en salud dirigidas a las enfermedades no transmisibles a partir del contexto de la Estrategia Salud de la Familia en Brasil. Síntesis de contenido: las reflexiones sobre las prácticas de cuidado revelaron importantes avances materializados por la institución de referencias legales en el ámbito político-normativo y asistencial, los cuales dan cuenta de un mejor control de las enfermedades crónicas durante un mayor período. No obstante, el escenario de crisis global impuso graves restricciones presupuestarias con implicaciones políticoeconómicas y de asistencia técnica, constituyendo una amenaza para el control de las enfermedades crónicas y un perjuicio para la calidad de vida de la población brasileña. Conclusiones: una mayor sinergia entre los diferentes actores sociales será necesaria para garantizar la defensa de la universalidad, resolución, equidad y las prácticas gratuitas de atención en salud promovidas por la Estrategia Salud de la Familia con enfoque en las enfermedades crónicas.

Objective: To provide a critical and analytical reflection on health care practices in Brazil aimed at non-communicable diseases in the context of the Family Health Strategy. Content synthesis: the reflections on the care practices revealed important advances materialized by the institution of legal references in the political-normative and assistance scope, reflecting in a better control of chronic diseases for a long period. However, the global crisis scenario imposed serious budgetary restrictions with political-economic and technical-assistance implications, thus constituting a threat to the control of chronic diseases and a detriment to the quality of life of the Brazilian population. Conclusions: Greater synergy between different social actors and their efforts will be necessary to guarantee the defense of universality, resolution, equity, and free health care practices in the Family Health Strategy with a focus on chronic diseases.

Evaluation of anteroposterior and vertical stability 25 years after Angle class II division 1 treatment with cervical headgear.

PURPOSE: The goal was to investigate long-term (minimum 20 years) skeletal and dental changes in Angle class II division 1 patients treated with full-fixed orthodontic appliances and cervical pull headgear. METHODS: A longitudinal retrospective study was performed with 20 orthodontic patients, who were treated exclusively by one experienced clinician and whose treatment had been completed a minimum of 20 years ago. Former patients who had been treated from the mid-1970s to the early 1990s were actively sought. After the recall, 20 patients agreed to participate in the study. Lateral cephalometric radiographs at pretreatment (T1), posttreatment (T2), and long-term follow-up (T3) were digitized and measurements were performed. Angular variables used were SNA, SNB, ANB, OcclPl-FH, PalPl-FH, GoMe-FH, 1­NA, and Y axis. Linear measures were A­NPerp, Pg-NPerp, 1­NAmm, Wits, and LAFH. RESULTS: From T1 to T2, a significant reduction (p < 0.01) in ANB angle from 4.70 to 2.48° and in Wits value from 3.42 to 0.98 mm were observed. It was also noticed a significant increase (p < 0.01) in LAFH from 62.02 to 67.39 mm, probably due to normal facial growth. From T2 to T3, these variables remained stable. No significant changes were observed for any other measure in any of the periods studied. CONCLUSIONS: In the assessed sample, Angle class II division 1 patients treated with cervical pull headgear presented cephalometric outcome stability of treatment, even after a long-term follow-up of a mean of 25 years postretention.

Morphological changes in the temporomandibular joints in women with fibromyalgia and myofascial pain: A case series.

Objective: This study investigated the temporomandibular joint (TMJ) morphological changes in women with fibromyalgia (FM) through clinical and tomographic evaluation.Methods: Ten women diagnosed with myofascial pain who were being treated for FM in a university hospital were included in this study. The data were collected through clinical examination and cone beam computed tomography evaluation of the TMJ in closed and open mouth positions.Results: All patients had crackling in the joint, a habit of grinding teeth during sleep, muscle stiffness, and tinnitus. The tomographic findings revealed a higher frequency of condylar bone wear, reduction of joint space, and posterior positioning of the mandibular condyle. The temporomandibular disorders with the highest prevalence were osteoarthritis and disc displacement with reduction.Conclusion: The findings suggest that women with FM have a high frequency of TMD related to the displacement of the articular disc, condyle position, and occurrence of osteoarthritis.

Cryptosporidium parvum in brown brocket (Mazama gouazoubira) from Brazil: First report of the subtype IIaA16G3R1 in cervids.

This research had as objective to evaluate the occurrence and to characterize genetically the infections by Cryptosporidium in Mazama gouazoubira. By a non-invasive harvest methodology using trained sniffer dogs to locate fecal samples of cervids, 642 fecal samples were obtained from six Brazilian localities. The cervids species responsible for the excretion of each fecal sample were identified by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), using the mitochondrial cytochrome b target gene (cyst b) and the restriction enzymes Sspl, AflIII and BstN. From this identification, 437 fecal samples of M. gouazoubira were selected for research of Cryptosporidium spp. performed through negative staining with malachite green and polymerase chain reaction (nPCR), with the subunit of 18S rRNA gene, followed by sequencing the amplified products. In the samples that were diagnosed the presence of parasite species with zoonotic potential, genotyping was also performed using nPCR with the subunit of GP60 gene. Statistical analysis consisted of the Fisher exact test to verify the association of the presence of the enteroparasite in relation to the presence of cattle in each locality, and the McNemar tests and Kappa correlation coefficient used to compare the results obtained between the two diagnostic techniques. In the fecal samples of M. gouazoubira the occurrences of Cryptosporidium were diagnosed in 1.6% (7/437) and 1.1% (5/437), respectively, through nPCR and microscopy. Cryptosporidium. parvum was diagnosed in 100% (7/7) of the samples submitted to sequencing (18S gene). The IIaA16G3R1 subtype was diagnosed in five of the C. parvum samples submitted to genotyping (GP60 gene). This is the first world report of C. parvum in M. gouazoubira and subtype IIaA16G3R1 in cervids.

Low-Back Pain and Knee Position-Related Differences on Postural Control Measures During a One-Legged Stance in Athletes.

CONTEXT: Chronic low-back pain (CLBP) may be associated with changes in postural balance in athletes as poor postural control during sports practice. OBJECTIVE: To compare the postural control of athletes with and without CLBP during 2 one-legged stance tasks and identify the center of pressure (COP) cutoff values to determine the main differences. Designed: A cross-sectional study. SETTING: Laboratory of functional evaluation and human motor performance. PARTICIPANTS: A total of 56 male athletes, 28 with and 28 without CLBP (mean age = 26 y). INTERVENTION: The one-legged stance with knee extension and with the knee at 30° flexion tasks were measured and analyzed on a force platform. The participants completed three 30-second trials (30 s of rest between each trial). MAIN OUTCOME MEASURES: The COP parameters: the area of COP, mean COP sway velocity in both the anteroposterior and mediolateral directions, and total COP displacement were computed, and a receiver operating characteristics curve analysis was applied to determine the group differences. RESULTS: Athletes with CLBP had poorer postural control (P < .01) in both tasks. The 30° knee flexion reported more postural instability than the knee extension for all COP parameters (a large effect size d = 0.80).The knee extension cutoffs identified were >7.1 cm2 for the COP area, >2.6 cm/s for the COP sway velocity in the anterior-posterior direction, and >3.2 cm/s for the mediolateral direction. Whereas, the 30° knee flexion cutoffs were >10.9 cm2 for the COP area, >2.9 cm/s for the COP sway velocity in the anterior-posterior direction, and >4.1 cm/s for the mediolateral direction. Both measures showed enough sensitivity and specificity (ie, area under the curve = 0.88 in and 0.80, respectively) to discriminate both groups. CONCLUSIONS: The athletes with CLBP had poorer postural control than the healthy athletes and obtained specific cutoff scores from the COP values.