Hemophore-like proteins produced by periodontopathogens are recognized by the host immune system and react differentially with IgG antibodies.

Aims: Hemophore-like proteins sequester heme from host hemoproteins. We aimed to determine whether the host immune system can recognize not only Porphyromonas gingivalis HmuY but also its homologs expressed by other periodontopathogens, and how periodontitis influences the production of respective antibodies. Methods: The reactivity of total bacterial antigens and purified proteins with serum IgG antibodies of 18 individuals with periodontitis and 17 individuals without periodontitis was examined by enzyme-linked immunosorbent assay (ELISA). To compare IgG reactivity between groups with and without periodontitis and within the various dilutions of sera, statistical analysis was performed using the Mann-Whitney U-test and two-way ANOVA test with the post-hoc Bonferroni test. Results: Individuals with periodontitis produced IgG antibodies reacting more strongly not only with total P. gingivalis antigens (P = 0.0002; 1:400) and P. gingivalis HmuY (P = 0.0016; 1:100) but also with Prevotella intermedia PinA (P = 0.0059; 1:100), and with low efficiency with P. intermedia PinO (P = 0.0021; 1:100). No increase in the reactivity of IgG antibodies with Tannerella forsythia Tfo and P. gingivalis HusA was found in individuals with periodontitis. Conclusions: Although hemophore-like proteins are structurally related, they are differentially recognized by the host immune system. Our findings point to specific antigens, mainly P. gingivalis HmuY and P. intermedia PinA, whose immunoreactivity could be further investigated to develop markers of periodontitis.

Pathological Evaluation by Microtomography of Ranula. Clinical Case Report

ABSTRACT: This study aims to demonstrate, through a clinical case report, the applicability of the use of microtomography (µCT) in the histopathological evaluation of a ranula lesion on the oral floor and to evaluate the use of 2 % elemental iodine solution as a contrast agent, in order to obtain a better contrast effect in a tissue sample, thus facilitating the identificat ion of anatomical structures, the histomorphological evaluation and the potential use of µCT in the imaging diagnosis of lesions. Different parameters were evaluated for obtaining images in SkyScan 1172, in a biopsied piece, when impregnated in a 10 % formalin solution and in a 2 % elemental iodine solution, when impregnated for 24h and 48h. Contrast agent impregnation was evaluated using the Hounsfield unit. The use of µCT allowed the identification of sialoliths dispersed inside the biopsy specimen, while the impregnation with Elemental iodine 2 % for 24h resulted in a better contrast when compared to the other conditions. The use of the Hounsfield unit allowed an adequate evaluation of the contrast obtained when the different parameters of impregnation and image acquisition were applied. The comparison between the 3D images with and without a specific marker highlighted a better evidencing of the soft tissues, with an improvement in the contrast of the images, also allowing the ident ification of the glandular duct obstructed by the sialoliths, allowing a conclusive histopathological evaluation of the biopsied lesion.

RESUMEN: Este estudio tiene como objetivo demostrar, a través de un reporte de caso clínico, la aplicabilidad del uso de la microtomografía (µCT) en la evaluación histopatológica de una lesión de ránula en el piso de la cavidad oral y evaluar el uso de solución de yodo elemental al 2 % como agente de contraste, con el fin de obtener un mejor efecto de contraste en una muestra de tejido, facilitando así la identificación de estructuras anatómicas, la evaluación histomorfológica y el potencial uso de µCT en el diagnóstico por imágenes de lesiones. Se evaluaron diferentes parámetros para la obtención de imágenes en SkyScan 1172, en una pieza biopsiada, cuando se impregna en una solución de formalina al 10 % y en una solución de yodo elemental al 2 %, durante 24 h y 48 h. La impregnación del agente de contraste se evaluó utilizando la unidad Hounsfield. El uso de µCT permitió la identificación de sialolitos dispersos dentro de la muestra de la biopsia, mientras que la impregnación con Yodo Elemental al 2 % durante 24 h resultó en un mejor contraste en comparación con las otras condiciones. El uso de la unidad Hounsfield permitió una adecuada evaluación del contraste obtenido cuando se aplicaron los diferentes parámetros de impregnación y adquisición de imágenes. La comparación entre las imágenes 3D con y sin marcador específico destacó una mejor evidenciación de los tejidos blandos, con una mejora en el contraste de las imágenes, permitiendo además identificar el conducto glandular obstruido por los sialolitos, permitiendo una evaluación histopatológica concluyente de la lesión sometida a biopsia.

Comparação da especificidade e sensibilidade entre os métodos de triagem nutricional Nutritional Risk Screening 2002 e Graz Malnutrition Screening em pacientes oncológicos hospitalizados / Comparison of specificity and sensitivity among Nutritional Risk Screening 2002 and Graz Malnutrition Screening methods in hospitalized cancer patients

INTRODUÇÃO: Para a população oncológica, a Avaliação Subjetiva Global Produzida pelo Próprio Paciente (ASG-PPP) é padrão ouro, contudo outros métodos, como a Nutritional Risk Screening 2002 (NRS 2002) e a Graz Malnutrition Screening (GMS), parecem ser úteis. OBJETIVO: Comparar os métodos de triagem nutricional NRS 2002 e GMS em pacientes oncológicos hospitalizados em um hospital público do Recife-PE. METODOLOGIA: Estudo observacional descritivo, com pacientes oncológicos internados no Hospital dos Servidores do Estado de Pernambuco (HSE-PE) no período de julho a outubro de 2017, submetidos a ferramentas de triagem nutricional: NRS 2002, GMS e a ASG-PPP. RESULTADOS: 68 pacientes foram avaliados, sendo 63% do sexo feminino e 63% idosos.78% estavam internados na enfermaria oncológica, 19% na enfermaria de clinica Médica e 3% na enfermaria cirúrgica. As frequências de risco nutricional foram 91% pela GMS, 88% pela ASG-PPP e 85% pela NRS 2002. A sensibilidade encontrada para o NRS 2002 foi de 91,7% e, para GMS, 98,3%. Para especificidade, valor semelhante foi observado para ambos os instrumentos (62,5%). DISCUSSÃO: Na amostra estudada, foi observado que entre as ferramentas GMS e NRS 2002, a GMS mostrou-se mais sensível, sendo assim um instrumento útil para o adequado diagnóstico do risco nutricional em pacientes oncológicos. CONCLUSÃO: As triagens nutricionais GMS e NRS 2002 apresentaram excelente sensibilidade em relação a ASG-PPP na identificação do risco nutricional, com destaque para a GMS, porém reduzida especificidade ao identificar o grupo sem risco nutricional, quando comparadas à ASG-PPP que é a triagem validada para o paciente oncológico

INTRODUCTION: For the oncological population, Subjective Global Evaluation Produced by the Patient (ASG-PPP) is gold standard, but other methods, such as Nutritional Risk Screening 2002 (NRS 2002) and Graz Malnutrition Screening (GMS), seem to be useful. OBJECTIVE: To compare the nutritional screening methods NRS 2002 and GMS in oncology patients hospitalized in a public hospital in Recife-PE. METHODOLOGY: A descriptive, observational study with oncologic patients hospitalized at the Hospital Servidores do Estado de Pernambuco (HSE-PE) from July to October 2017, submitted to nutritional screening tools: NRS 2002, GMS and ASG-PPP. RESULTS: 68 patients were evaluated, being 63% female and 63% elderly.78% were hospitalized in the oncology ward, 19% in the medical clinic ward and 3% in the surgical ward. The frequencies of nutritional risk were 91% for GMS, 88% for ASG-PPP and 85% for NRS 2002. The sensitivity found for NRS 2002 was 91.7% and, for GMS, 98.3%. For specificity, a similar value was observed for both instruments (62.5%). DISCUSSION: In the sample studied, it was observed that between the GMS and NRS 2002 tools, MSG was more sensitive and therefore a useful tool for the adequate diagnosis of nutritional risk in cancer patients. CONCLUSION: GMS and NRS 2002 showed excellent sensitivity in relation to ASG-PPP in the identification of nutritional risk, with emphasis on MSG, but a reduced specificity when identifying the group without nutritional risk, when compared to the ASG-PPP, which is the validated screening for cancer patients

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Microbial diversity of soils on the banks of the Solimões and Negro rivers, state of Amazonas, Brazil.

Analysis of bacterial diversity in soils along the banks of the Solimões and Negro rivers, state of Amazonas, Brazil, was by partial sequencing of the genes codifying the rDNA16S region. Diversity of operational taxonomic units (OTU) and of the divergent sequences obtained were applied in comparative analysis of microbiological diversity in the two environments, based on richness estimators and OTU diversity indices. The higher OTU diversity in the Solimões was based on the higher number of parameters that evoke this. The interaction between the nucleotide sequences of bacteria inhabiting the two riverine environments indicated that the two microrganism communities are similar in composition.

Health services users with diabetes mellitus: from knowledge to the use of healthcare rights.

This descriptive study with qualitative approach analyzes the knowledge of individuals with diabetes mellitus (DM) concerning their health rights. Open interviews were conducted with 12 individuals with DM in a university center in the interior of Sao Paulo, Brazil. Content analysis enabled the identification of two categories: the users' (lack of) knowledge concerning their rights and the unaware exercise of their rights. The results revealed that despite the legal advancements achieved in public policies, most users with DM are unaware of their rights, although they use the benefits that accrue from law in an unconscious way. Providing complete and sufficient information is essential so that individuals are able to make the best decision in relation to their treatment, preserving their autonomy.

[Care according to diabetes patients and their main caregivers]. / O cuidado sob a ótica do paciente diabético e de seu principal cuidador.

This case study aims to describe how diabetes patients and their main caregivers perceive the difficulties faced to control the disease. Data were collected through audio records made at the Nursing Education Center for Adults and Elderly in April 2003 and submitted to thematic content analysis. The following themes emerged from the analysis: dietary transgressions, medication-related problems and interpersonal influences. These themes are interconnected with interpersonal influence from family members and the peer group, which are based on a set of beliefs and values that interfere in the patients' motivation and capacity to face the decease. The results reveal the need to get to know the patients' and caregivers' pattern of answers related to feelings, conflicts and needs, so as to establish an effective link that offers conditions to develop collaborative strategies to achieve metabolic control.