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Statement of problem Knowledge about the location and dimensions of the mental foramen is important for surgical planning and implant placement in the posterior mandibular region. Purpose The purpose of this clinical study was to assess the location and dimensions of the mental foramen in individuals of different facial type, skeletal class, and sex by means of cone beam computed tomography (CBCT) images. Material and methods CBCT images of 142 individuals (72 women and 70 men) were classified according to the facial type (dolichocephalic, mesocephalic, or brachycephalic) and skeletal class (I, II, or III). The vertical and horizontal locations of each mental foramen were evaluated on panoramic reconstructions, and the greatest height and width of the mental foramen were determined on multiplanar reconstructions. Also, the distances from the mental foramen to the alveolar crest and to the inferior cortex of the mandible were obtained. The data were compared by using the Kruskal-Wallis test and multiway analysis of variance (α=.05). Results The facial type, skeletal class, and sex did not influence the vertical (P=1.00) or the horizontal (P>.15) location of the mental foramen. The most frequent location of the mental foramen was between the first and second premolars and below their apices. The dimensions of the mental foramen were not influenced by the studied factors in men (P>.07); conversely, the mental foramen dimensions were influenced for women (P Conclusions The most frequent location of the mental foramen was between the first and second premolars and below their apices. An influence of the facial type and skeletal class was observed on the dimensions of the mental foramen in women.

Tuberous sclerosis complex (TSC) and autosomal dominant polycystic kidney disease (ADPKD) are conditions related to renal failure that can rarely occur in association as a contiguous gene syndrome. Angiomyolipomas (AMLs) are renal tumors strongly related to TSC that may rupture and cause life-threatening bleedings. We present a patient with TSC, ADPKD, and renal AMLs with persistent hematuria requiring blood transfusion. The persistent hematuria was successfully treated through endovascular embolization, a minimally invasive nephron sparing technique. Keywords: Tuberous Sclerosis; Polycystic [...]

A 78-year-old woman with hypertension, diabetes mellitus type 2 and bilateral sensorineural hearing loss was referenced to geriatric psychiatry consultation. She presented cognitive dysfunction, erotomanic delusion and complex musical hallucinations (MH), described as hearing her neighbour singing a familiar church song along with bells in the background, making comments and talking to her. A computed tomography (CT) of the brain detected small right nucleocapsular and bilateral external capsules hypodensities of presumed vascular aetiology during hospitalisation. MH are a rare phenomenon with heterogeneous aetiology. Most frequently, the cause is hearing impairment; other causes include social isolation, cognitive dysfunction, vascular risk factors and medication. Studies suggest that some brain areas related to musical memory circuitry might be related and not fully mapped. Auditory verbal hallucinations with a voice that either comments, talks or sings to the patient have never been described in the literature, making this clinical case attractive. info:eu-repo/semantics/publishedVersion

SUMMARY OBJECTIVE: The aim of this study was to analyze the effectiveness of the distance education course in family health in the knowledge of physicians from the Mais Médicos program. METHOD: This is a quantitative, quasi-experimental study, without a pretest and posttest control group, carried out from August 2019 to September 2021. In all modules, physicians responded to a pretest and posttest to verify their knowledge of the subject. RESULTS: There was a statistically significant difference in all modules with higher average scores in the posttests; the modules with the greatest emphasis are child health care: growth and development; approach to cancer in primary health care; and family health strategy and territorialization. CONCLUSION: The effectiveness of the distance education course was verified, as evidenced by the significant improvement of knowledge in all the modules studied.

The objective of this study is to investigate the effects of an intervention based on Acceptance and Commitment Therapy (ACT), compared to an intervention based on Psychoeducation and Cognitive Behavioral Therapy (CBT) on objective (weight and body mass index [BMI]) and self-reported measures (binge eating and psychological flexibility) in overweight or obese people. It’s a mixed 2x3 factorial design: Intervention (ACT x Psychoeducation/CBT) and Time (before, after, and five-month follow-up). Seventy-two people were randomly assigned to the groups. The ACT group presented differences in the development of cognitive defusion and food awareness – emotional response, as well as changing binge eating intensity. The other results, including a weight reduction close to 3%, did not show any significant differences between groups. The results indicate that ACT can be an auxiliary modality for the modification of the eating behavior function.

Northeast Brazil has the world’s highest rate of Zika-related microcephaly. Yet, in this hard-hit region, traditional case counts of Zika cannot accurately describe Zika risk. Reporting of Zika cases only became mandatory after its association with microcephaly in neonates, when the Zika epidemic was already declining in the region. To advance the study of the Brazilian Zika epidemic and its impacts, we identified hotspots of Zika in Pernambuco state, Northeast Brazil, using Aedes-borne diseases (dengue, chikungunya and Zika) and microcephaly data. We used the Kulldorff’s Poisson purely spatial scan statistic to detect low- and high-risk clusters and combined the results to identify the municipalities most affected by the Zika epidemic. Municipalities were classified as hotspots if they were part of any high-risk cluster, and classified according to a gradient of Zika burden during the epidemic, considering the strength of the evidence. In Pernambuco, officials confirmed 123,934 dengue cases, 167 Zika cases, and 32,983 chikungunya cases between 2014-2017, and 800 microcephaly cases between 2015-2017. We identified 26 Aedes-borne diseases clusters (11 high-risk), and 5 microcephaly cases clusters (3 high-risk). Combining the results, sixty-three out of 184 municipalities were identified as hotspots for Zika. The northeast of Pernambuco and the Sertão region were hit hardest by the Zika epidemic. The first is the most populous area, while the second has one of the highest rates of social and economic inequality in Brazil. The identification of Sertão as a Zika hotspot was only possible because the clusters results were combined. The under-reporting of acute infectious diseases is expected to be higher in poor areas. Therefore, using only Aedes-borne data does not correctly identify the high-risk areas. We successfully identified hidden Zika hotspots using a simple methodology combining Aedes-borne diseases and microcephaly information.

Objectives The objective of this systematic review and meta-analysis was to evaluate rates of ulcer healing following ultrasound-guided foam sclerotherapy (UGFS). Methods The MEDLINE, CENTRAL and Embase databases were used to search for relevant studies using the terms ' (sclerotherapy AND ulcer) OR (vein AND ulcer) OR (sclerotherapy AND vein)'. Heterogeneity between studies was quantified using the I2 statistic. A random effects model was used to calculate risk ratios where substantial heterogeneity was found. Results The initial search yielded 8266 articles. 8 studies were included in the qualitative synthesis and 3 in the meta-analysis. Superior complete ulcer healing rates were noted in patients treated with foam sclerotherapy versus compression therapy alone (pooled OR 6.41, 95% CI = 0.3–148.2, p = 0.246, random effects method). A marked degree of heterogeneity was observed between studies (I2 = 81%). Conclusion A prospective, trial is warranted in order to determine the true merits of UGFS in the setting of venous ulceration.

PURPOSE To generate and present survey results on important issues relevant to treatment and follow-up of localized and locally advanced, high-risk prostate cancer (PCa) focusing on developing countries. METHODS A panel of 99 PCa experts developed more than 300 survey questions of which 67 questions concern the main areas of interest of this article: treatment and follow-up of localized and locally advanced, high-risk PCa in developing countries. A larger panel of 99 international multidisciplinary cancer experts voted on these questions to create the recommendations for treatment and follow-up of localized and locally advanced, high-risk PCa in areas of limited resources discussed in this article. RESULTS The panel voted publicly but anonymously on the predefined questions. Each question was deemed consensus if 75% or more of the full panel had selected a particular answer. These answers are based on panelist opinion and not on a literature review or meta-analysis. For questions that refer to an area of limited resources, the recommendations considered cost-effectiveness as well as the possible therapies with easier and greater access. Each question had five to seven relevant answers including two nonanswers. Results were tabulated in real time. CONCLUSION The voting results and recommendations presented in this article can guide physicians managing localized and locally advanced, high-risk PCa in areas of limited resources. Individual clinical decision making should be supported by available data; however, as guidelines for treatment of localized and locally advanced, high-risk PCa in developing countries have not been defined, this article will serve as a point of reference when confronted with this disease.

PURPOSE A group of international urology and medical oncology experts developed and completed a survey on prostate cancer (PCa) in developing countries. The results are reviewed and summarized, and recommendations on consensus statements for very low-, low-, and intermediate-risk PCa focused on developing countries were developed. METHODS A panel of experts developed more than 300 survey questions of which 66 questions concern the principal areas of interest of this paper: very low, low, and intermediate risk of PCa in developing countries. A larger panel of 99 international multidisciplinary cancer experts voted on these questions to create the recommendations for treatment and follow-up for very low-, low-, and intermediate-risk PCa in areas of limited resources discussed in this manuscript. RESULTS The panel voted publicly but anonymously on the predefined questions. Each question was deemed consensus if 75% or more of the full panel had selected a particular answer. These answers are based on panelist opinion not a literature review or meta-analysis. For questions that refer to an area of limited resources, the recommendations consider cost-effectiveness and the possible therapies with easier and greater access. Each question had five to seven relevant answers including two nonanswers. The results were tabulated in real time. CONCLUSION The voting results and recommendations presented in this document can be used by physicians to support management for very low, low, and intermediate risk of PCa in areas of limited resources. Individual clinical decision making should be supported by available data; however, as guidelines for treatment for very low, low, and intermediate risk of PCa in developing countries have not been developed, this document will serve as a point of reference when confronted with this disease.

Background The electroencephalogram (EEG) is a common diagnostic tool used to investigate patients for various indications including seizure disorders. In our study we investigate factors that predict the presence of epileptiform abnormalities on EEG and review the common indications for ordering an EEG. Methods We retrospectively reviewed all routine adult EEGs performed in a hospital over a six-month period. Data collated included patient demographics, clinical indication for EEG, setting in which EEG was performed, activation procedures utilised, history of epilepsy, and whether the patient was on antiepileptic medication. Our primary objective was to evaluate the factors that were predictive of an EEG with epileptiform abnormalities. Results 239 routine EEGs were included with indications including first seizure (25.9%), known epilepsy (25.1%), cognitive change (15.9%), syncope (15.0%), movement disorder (6.7%), psychogenic non-epileptic events (5.4%), unresponsiveness/ICU (4.6%), and psychiatric presentation (1.3%). Most EEGs were normal (48.1%). 8.9% of EEGs demonstrated epileptiform abnormalities. Using multivariate logistic regression, three variables proved significant in predicting an EEG with epileptiform abnormalities. Any seizure as an indication (first seizure or seizure in known epileptic), increasing patient age, and EEGs conducted in an inpatient setting and within 48 hours of seizure event were all statistically more likely to yield epileptiform abnormalities on EEG. Conclusions Our findings suggest that careful selection of patients based on appropriate indications for EEG referral would likely improve the yield of an EEG. Depending on the indication, a normal EEG result can be of similar usefulness to an abnormal EEG demonstrating epileptiform abnormalities. This article is protected by copyright. All rights reserved.

Background: Rubella is an infection caused by rubella virus (RV) and is generally regarded as a mild childhood disease. The disease continues to be of public health importance mainly because when the infection is acquired during early pregnancy, it often results in fetal abnormalities, which are classified as congenital rubella syndrome (CRS). An accurate diagnosis of rubella is thus of pivotal importance for proper treatment. Objective: The aim of the study was to produce a recombinant multiepitope protein (rMERUB) for the diagnosis of rubella, based on conserved immunodominant epitopes of glycoprotein E1 and E2. Methods: A synthetic gene was designed and cloned into vector pET21a with a 6xHis tag at the C-terminal for affinity purification and overexpressed in Escherichia coli cells. Biophysical analysis of rMERUB was performed by circular dichroism. Biological activity was assessed using an in-house ELISA assay. Results: Expression in Escherichia coli showed a ~22 kDa protein that was purified and used to per-form structural assays and an IgG ELISA. Structural analyses reveal that rMERUB has a β leaf pattern that promotes the exposure of epitopes, thus allowing antibody recognition. Evaluation of 33 samples (22=positive; 11=negative) was performed using in-house ELISA and this was compared with a com-mercial kit. The sensitivity was 100% (95% CI: 85-100) and specificity 90.91% (95% CI: 62-99). Excellent agreement (Kappa index = 0.9) was obtained between ELISA assays. Conclusions: The careful choice of epitopes and the high epitope density, coupled with simple-step purification, pinpoints rMERUB as a promising alternative for rubella diagnosis, with potential for the development of a diagnostic kit.

Graphical abstract, Background The COVID-19 pandemic raises health issues worldwide. Infected pregnant women may have negative mental health outcomes, but little is known about their emotional experiences. Aim We aimed to understand the experience of women infected with COVID-19 during pregnancy, regarding their feelings, their relationships, and the influence of social media. Methods We conducted a qualitative study among 22 women infected with COVID-19 during pregnancy, from a tertiary hospital during the first wave of the pandemic in Brazil (May–August 2020). We applied semi-directed interviews, sociodemographic and health data sheets, and field diaries. We built the sample purposefully. Interviews were audio-recorded and transcribed verbatim. We used thematic analysis and discussed data considering the health psychology framework. Results We created five categories following a timeline perspective, from before infection to the experience after recovering. Pregnant women were resistant to believing the diagnosis. They described a fear of serious symptoms or death, concerns about the fetus, sorrow from being isolated, and worries about stigma. Family relationships were ambiguous, generating either support or tension. The attachment to the health team through telemedicine or support during hospitalization produced a feeling of security. Conclusions Participants psychologically denied the COVID-19 diagnosis and did not accomplish isolation properly, even upon medical recommendations. The illness may produce a traumatic experience, regardless of mild or severe symptoms, but family/friend support and contact with the health team helped them to cope. We offer important insights for the clinical approach and future research, emphasizing that infected pregnant women require emotional support.

E-cigarette use is prohibited in most smoke-free environments. The effect of this policy on tobacco consumption could be examined using the Experimental Tobacco Marketplace (ETM). The ETM allows observation of policy on smokers' purchasing behavior under conditions that simulate "real-world" circumstances. A within-subject design was used to evaluate the effect of workplace policy (Vaping Allowed vs. Not Allowed) and nicotine concentration (24 mg/mL vs. 0 mg/mL) on tobacco product consumption. Participants (n = 31) completed one sampling and two ETM/workplace sessions per week for 2 weeks. During the sampling session, participants were given an e-cigarette with a 2-day supply of a commercially available e-liquid of their preferred flavor. Before purchasing, participants were informed whether e-cigarette use was permitted. During the four ETM sessions, participants purchased for the following 24 hr, including the 4-hr work shift that started immediately after buying products in the ETM. The workplace session consisted of data entry tasks in a mock office environment. Participants could use any purchased tobacco products during two 15-min breaks. Condition order was counterbalanced. The results show that permitting E-cigarette use in the workplace increased e-liquid purchase on average, but nicotine concentration had no effect on e-liquid demand. Cigarette demand was unaltered across conditions. The present study suggests that allowing e-cigarette use in the workplace would increase demand for e-liquid regardless of nicotine strength. However, it would not change conventional cigarette demand. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Background and objectives Traditionally, the health-related quality of life (HRQoL) of patients with systemic lupus erythematosus (SLE) has been assessed using instruments that neglect the specific characteristics of the disease. This study determines the validity of the Lupus Quality of Life (LupusQoL) questionnaire as a psychometrically stable instrument to measure the HRQoL of patients with SLE in Venezuela and establishes the cutoff points of the questionnaire for the Venezuelan population. Patients and methods A cross-sectional study was conducted that included patients with SLE from April to July 2018. Patients completed the LupusQoL and the “Generalitat de Catalunya” (GENCAT) scale; sociodemographic data, activity index (SLEDAI) and accumulated damage (SLICC), were obtained. Reliability was evaluated by internal consistency and the convergent validity of the LupusQoL was determined with the GENCAT scale. Results Of the 100 patients, 93% were women, the mean age was 42 years old (SD: 13) and the mean duration of the disease was 11 years (SD: 9); the mean of SLEDAI and SLICC was 3 and 1, respectively. The cutoff point that defined a “better” or “worse” HRQoL for LupusQoL was 64.55 points. A moderate convergence was found after grouping, according to the cutoff points, of the LupusQoL with the GENCAT scale (Cohen’s kappa coefficient = .556; p = .000). Conclusions The LupusQoL is a valid psychometrically stable instrument to measure the HRQoL of patients with SLE in Venezuela. Cutoff points were established to stratify the HRQoL in the Venezuelan population with LES, being useful to complement a comprehensive evaluation.

Resumen La mastocitosis se caracteriza por la expansion clonica de mastocitos, con acumulacion anormal en diferentes organos. Perioperatoriamente, numerosos estimulos pueden originar la liberacion de sustancias vasoactivas por parte de los mastocitos. Las parturientas con mastocitosis sistemica plantean una dificultad al anestesiologo: por un lado, el dolor y el estres del parto pueden causar una mayor activacion de los mastocitos y, por otro, la administracion de farmacos puede desencadenar posiblemente la liberacion de mediadores de los mastocitos. Los autores describen un caso de una embarazada de 34 anos de edad con mastocitosis sistemica que solicita analgesia para el parto. Se realizo analgesia epidural tras la induccion del parto, una vez consideradas las particularidades anestesicas. El procedimiento epidural, el parto y la expulsion transcurrieron sin incidentes. Se aporta una revision de la mastocitosis sistemica y se abordan sus consideraciones anestesicas.

Background: Rheumatoid arthritis is an inflammatory disease with joint manifestations. In the presence of extra-articular manifestations, the morbidity and severity of the disease increases. Glucocorticoid is used as a treatment and may result in side effects related to cardiovascular risk. Methods: This was a cross-sectional study including 59 volunteers with rheumatoid arthritis receiving treatment at a Hospital of Campos Gerais, that aimed to establish the relation between cardiovascular risk, glucocorticoid treatment and myeloperoxidase in these patients. Subjects were divided into two groups: using (n = 39) and without glucocorticoids (n = 20). They underwent clinical evaluation, physical examination and blood samples were taken. Statistical analysis was performed using Student's t-test and Mann-Whitney test. Logistic regression was performed to assess cardiovascular risk. The significance level was 5% (α = 0.05). Calculations were performed using the Statistical Package for the Social Science version 21.0. Results: There has been a significant difference between groups in blood glucose values (p = 0.012), that can be explained by the different percentage of diabetic patients in the groups. When assessed cardiovascular risk using the predictors of glucocorticoid dose, time of glucocorticoid use, myeloperoxidase, and C-reactive protein together, these were responsible for significantly predicting cardiovascular risk (p = 0.015). Conclusions: A significant relation between the predictor myeloperoxidase alone was also demonstrated (p = 0.037), may it be an important predictor of cardiovascular risk among individuals with rheumatoid arthritis.

Zika virus (ZIKV) has the ability to cross placental and brain barriers, causing congenital malformations in neonates and neurological disorders in adults. However, the pathogenic mechanisms of ZIKV-induced neurological complications in adults and congenital malformations are still not fully understood. Gas6 is a soluble TAM receptor ligand able to promote flavivirus internalization and downregulation of immune responses. Here we demonstrate that there is a correlation between ZIKV neurological complications with higher Gas6 levels and the downregulation of genes associated with anti-viral response, as type I IFN due to Socs1 upregulation. Also, Gas6 gamma-carboxylation is essential for ZIKV invasion and replication in monocytes, the main source of this protein, which was inhibited by warfarin. Conversely, Gas6 facilitates ZIKV replication in adult immunocompetent mice and enabled susceptibility to transplacental infection. Our data indicate that ZIKV promotes the upregulation of its ligand Gas6, which contributes to viral infectivity and drives the development of severe adverse outcomes during ZIKV infection.

Made available in DSpace on 2022-05-01T12:40:46Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-09-27 This cross-sectional study evaluates the presence of antibodies against Neospora caninum and Toxoplasma gondii in cattle raised in Realeza, PR. There was a seroprevalence of N. caninum and T. gondii of 87.5% and 67.9%, respectively in the properties assessed. The frequencies of T. gondii and N. caninum in the animals were 41.1% and 55.1%, respectively. The studied coccidia are widely distributed in dairy cows reared on family farms in the municipality of Realeza, PR. Sanitary control for reproductive diseases must be adopted to prevent miscarriages and the economic damage caused by the disease. Future studies should be performed to investigate how widespread these pathogens are in cattle herds in southwestern Parana. Universidade Federal da Fronteira Sul Campus Realeza Universidade Estadual Paulista Campus Jaboticabal Universidade Estadual Paulista Campus Jaboticabal

The use of the bacterial efflux pump mechanism to reduce the concentrations of antibiotics in the intracellular to the extracellular region is one of the main mechanisms by which bacteria acquire resistance to antibiotics. The present study aims to evaluate the antibacterial activity of the α,β-amyrin mixture isolated from Protium heptaphyllum against the multidrug-resistant strains of Escherichia coli 06 and Staphylococcus aureus 10, and to verify the inhibition of the efflux resistance mechanisms against the strains of S. aureus 1199B and K2068, carrying the NorA and MepA efflux pumps, respectively. The α,β-amyrin did not show clinically relevant direct bacterial activity. However, the α,β-amyrin when associated with the gentamicin antibiotic presented synergistic effect against the multidrug-resistant bacterial strain of S. aureus 10. In strains with efflux pumps, α,β-amyrin was able to inhibit the action of the efflux protein NorA against Ethidium Bromide. However, this inhibitory effect was not observed in the MepA efflux pump. In addition, when evaluating the effect of standard efflux pump inhibitors, clorptomazine and CCCP, α,β-amyrin showed a decrease in MIC, demonstrating the presence of the efflux mechanism through synergism. Docking studies indicate that α, β-amyrin have a higher affinity energy to MepA, and NorA than ciprofloxacin and norfloxacin. Also, α, β-amyrin bind to the same region of the binding site as these antibiotics. It was concluded that the α, β-amyrin has the potential to increase antibacterial activity with the association of antibiotics, together with the ability to be a strong candidate for an efflux pump inhibitor. Communicated by Ramaswamy H. Sarma

Objetivo: analisar os casos de Sí­ndrome da Rubéola Congênita notificados no Brasil durante o perí­odo de 1990 a 2016. Método: estudo transversal realizado no Brasil, cuja amostra foi de 122 casos notificados com Sí­ndrome da Rubéola Congênita. Os dados foram disponibilizados pelo Departamento de Informática do Sistema Único de Saúde. A coleta de dados foi realizada durante os meses de fevereiro e março de 2021. O tratamento dos dados se deu por análise estatí­stica uni-variada. Resultados: observa-se prevalência no Estado de São Paulo cuja capital apresentou o maior número destas notificações. O ano em que houve prevalência do diagnóstico foi em 2008 e o mês de maior notificação foi dezembro. Todos os pacientes apresentavam idade menor que um ano, sexo feminino, com confirmação final para a doença por meio de critérios laboratoriais, e evolução para a cura. Conclusão: a idade apresentou significância no estudo. A terapêutica mostrou-se eficiente para um melhor prognóstico de cura, bem como a vacinação como medida preventiva.

The prelimbic division (PrL) of the medial prefrontal cortex (mPFC) is a cerebral division that is putatively implicated in the chronic pain and depression. We investigated the activity of PrL cortex neurons in Wistar rats that underwent chronic constriction injury (CCI) of sciatic nerve and were further subjected to the forced swimming (FS) test and mechanical allodynia (by von Frey test). The effect of blockade of synapses with cobalt chloride (CoCl2), and the treatment of the PrL cortex with cannabidiol (CBD), the CB1 receptor antagonist AM251 and the 5-HT1A receptor antagonist WAY-100635 were also investigated. Our results showed that CoCl2 decreased the time spent immobile during the FS test but did not alter mechanical allodynia. CBD (at 15, 30 and 60 nmol) in the PrL cortex also decreased the frequency and duration of immobility; however, only the dose of 30 nmol of CBD attenuated mechanical allodynia in rats with chronic NP. AM251 and WAY-100635 in the PrL cortex attenuated the antidepressive and analgesic effect caused by CBD but did not alter the immobility and the mechanical allodynia when administered alone. These data show that the PrL cortex is part of the neural substrate underlying the comorbidity between NP and depression. Also, the previous blockade of CB1 cannabinoid receptors and 5-HT1A serotonergic receptors in the PrL cortex attenuated the antidepressive and analgesics effect of the CBD. They also suggest that CBD could be a potential medicine for the treatment of depressive and pain symptoms in patients with chronic NP/depression comorbidity.

BackgroundThe relevance of local twitch response (LTR) during dry needling technique (DNT) is controversial, and it is questioned whether LTR is necessary for successful outcomes. Furthermore, because the LTR during the deep DNT may be evoked with different intensities, it is unknown whether the magnitude of LTR intensity is associated with optimal clinical results, especially concerning to the effects of joint maximal range of motion (ROM). This study aimed to (i) determine whether visual inspections can quantify the LTR intensity during the DNT through a qualitative ultrasonography scale of LTR intensity (US-LTR scale), and (ii) assess the differences of US-LTR scale associated with changes in the maximal joint ROM.MethodsUsing a cross-sectional design, seven asymptomatic individuals were treated with DNT in the latent myofascial trigger point in both medial gastrocnemius muscles. During DNT, three consecutive LTRs were collected. The US-LTR scale was used to classify the LTRs into strong, medium, and weak intensities. The categories of US-LTR were differentiated by the velocity of LTRs using the optical flow algorithm. ROM changes in ankle dorsiflexion and knee extension were assessed before and immediately after DNT.ResultsThe US-LTR scale showed the third LTR was significantly smaller than the first one (p p p ConclusionsThe present findings suggest that the LTR intensity can be assessed using a qualitative US-LTR scale, and the effects of DNT on joint maximal ROM is maximized with higher LTR intensity. This study reports a novel qualitative method for LTR analysis with potential applications in research and clinical settings. However, further research is needed to achieve a broader application.

Patients with hallux rigidus (HR) tend to develop a characteristic alteration in walking to lessening pain and compensate for the limited range of motion at the first metatarsophalangeal (MTP1) joint that might be affected balance and gait. The goal of this study was to perform an integrated biomechanical description of gait and balance of symptomatic patients with either grade as III or IV HR in comparison with healthy subjects. Eleven patients (7 men) with HR (60 ± 7 years, 1.60 ± 0.07 m, and 70 ± 13 kg) and 16 (7 men) healthy subjects (70 ± 8 years, 1.66 ± 0.10 m, and 74 ± 14 kg) were included. Subjects performed 2 tasks: walking (5 trials of straight walking for at least 6 meters) and bipedal quiet standing for 30 seconds. For these 2 tasks the following variables were measured: range of motion of the MTP1 joint, plantar pressure distribution during the stance phase of walking, and the postural sway during quiet standing. Plantar pressure was measured in up 15 walking trials with a mat pressure sensor. The MTP1 joint range of motion for flexion/extension during walking was significantly smaller for the patients with HR than for the control group (HR: 14 ± 8°, control: 44 ± 5°; t(17) = -9.7, p.001). The forefoot plantar pressure distribution among different regions of the foot in patients with HR was not statistically different than the control group, but there was a tendency of higher pressures in the lateral metatarsal heads (p = .06). As description of the postural sway during quiet standing, the center of pressure area was not different between HR and the control group (p.05). Decreased MTP1 joint range of motion for flexion/extension during walking in symptomatic high-grade HR patients can be associated with higher pressure in the lateral metatarsal heads while the impact on postural sway is not affected.

To compare bone marrow fat quantification using magnetic resonance spectroscopy (MRS) and six-point DIXON (6PD) techniques in patients with sickle cell disease (SCD) and healthy subjects.Prospective study, with 43 SCD patients (24 homozygous [SS], 19 double heterozygous [SC), and 41 healthy subjects paired by age, weight and sex with SCD patients. All participants underwent magnetic resonance imaging with 6PD and single voxel MRS in the L3 vertebral body. Pearson's correlation, ROC curve, and bland-altman analysis were performed, p-values ​​≤0.05 were considered statistically significant for all tests.Significant linear correlation was found between fat fraction (FF) by 6PD and Total Lipids (TL) (r = 0.932; p0.001) and Saturated Lipids (SL) (r = 0.934; p0.001), in all subjects. Strong correlations were also identified considering subjects of the SS/SC subgroups. Despite high correlations, no significant difference was observed only between FF and SL in the SS subgroup (Bland-Altman analysis), indicating excellent agreement between the fat estimations in this specific situation. Significant differences were observed in all variables (FF, TL, SL) comparing the SCD and healthy subjects. The ROC curve between SCD and healthy subjects showed the following areas under the curve: FF(0.924)TL(0.883)SL(0.892).The comparison between fat quantification by the 6PD with MRS demonstrated an excellent correlation in SCD patients, especially in the SS subgroup, which usually has a higher degree of hemolysis. The diagnostic performance of 6PD and MRS is similar, with advantages of shorter imaging processing time and larger studied area with the 6PD.

Introduction Neurological alterations can generate swallowing disorders and fiberoptic endoscopic evaluation of swallowing is one of the tests performed for its diagnosis, as well as assistance in dysphagia management. Objective To identify and describe a fiberoptic endoscopic evaluation of swallowing standardized protocol for the neurological adult population and its stages. Methods Systematic review registered on the PROSPERO platform (CRD42018069428), carried out on the websites: MEDLINE, Cochrane Library and Scielo; published between 2009 and 2020. Randomized clinical trials, cross-sectional, and longitudinal studies were included. Two independent judges evaluated the study design and extracted the data from the selected studies. Doubts regarding inclusion or not of the studies were evaluated by a third judge. Scientific articles included were those with adult neurological remained patients with outcomes: (1) diagnosis of swallowing disorder (2) change in sensitivity in laryngeal region (3) penetration of food offered (4) aspiration of food offered. Results 3724 articles were initially selected, after personalized search for patients with neurological alterations 101 studies remained. In the end, 21 qualitative studies from 2009 to 2020 remained in the systematic review and they were described in detail and compared. Seven articles used protocols of the institutions in which the research took place and four mentioned using the same protocol. The reliable reproducibility of the protocols is feasible only in three of the articles, even presenting different protocols. Conclusion There is no standard or validated protocol to assess the swallowing function of adults with neurological diseases. Resumo Introdução As alterações neurológicas podem gerar distúrbios deglutitórios e a videoendoscopia da deglutição é um dos exames feitos para o seu diagnóstico e auxílio no manejo da disfagia. Objetivo Identificar e descrever o protocolo para videoendoscopia da deglutição padronizado para a população adulta com transtornos neurológicos e suas etapas. Método Revisão sistemática registrada na plataforma Prospero (CRD42018069428), realizada nos sites: Medline, Cochrane Library e Scielo; publicados entre 2009 e 2020. Foram incluídos ensaios clínicos randomizados, estudos transversais e longitudinais. Dois avaliadores independentes analisaram o delineamento do estudo e extrairam os dados dos estudos selecionados. As dúvidas de inclusão ou não dos estudos foram avaliadas por um terceiro avaliador. Artigos científicos incluídos englobam pacientes adultos neurológicos. Os desfechos avaliados: 1) diagnóstico de distúrbio deglutitório ou disfagia; (2) alteração de sensibilidade em região laríngea; (3) penetração laríngea do bolo alimentar ofertado; (4) aspiração traqueal do bolo alimentar ofertado. Resultados Foram selecionados inicialmente 3.724 artigos, após busca personalizada para pacientes com alterações neurológicas permaneceram 101 estudos. Ao final, 21 estudos qualitativos de 2009 a 2020 permaneceram na revisão sistemática e foram descritos detalhadamente e comparados. Sete estudos usaram protocolos das instituições promotoras e quatro citaram usar o mesmo protocolo. A reprodutibilidade fidedigna dos protocolos é viável apenas em três dos artigos, mesmo com protocolos diferentes. Conclusões Não há protocolo padronizado ou validado para avaliar a deglutição da população adulta neurológica.

Crop infestation species have acquired resistance to herbicides, stimulating the search for new control methods. Plants secondary metabolites can hold more sustainable alternatives, as they can be used for development of natural herbicides. This study evaluated phytotoxic effects of aqueous extracts of Ilex paraguariensis leaves on Conyza bonariensis, an infesting species of Brazilian crops. Different concentrations of decoction and infusion extracts were tested in germination and growth bioassays. Adult plants were evaluated for leaf anatomy effects caused by the yerba mate extract. HPLC analysis was used to quantify the three major chemical constituents. The most effective aqueous extract (decoction 1.0%) decreased the percentage of seed germination, germination speed index, and percentage of germination-derived seedling formation, and increased the time for seedling formation. Shoot and root growth were not affected by this extract. In adult plants, the same extract damaged epidermis and palisade/lacunous parenchyma six hours after exposure. Caffeine was found as the major compound of this extract, followed by rutin and quercetin. Therefore, aqueous extract by decoction 1.0 % of I. paraguariensis leaves showed potential for control of C. bonariensis infestation and rather promising for the development of a natural herbicide.

Made available in DSpace on 2021-06-25T10:56:45Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) Smith–Magenis syndrome (SMS) is a rare neurodevelopmental disorder with mild-to-moderate intellectual disability. Speech and language impairments have not been well described as part of the SMS phenotype. This study reports the speech and language characteristics presented by a classical SMS case, a 20-year-old woman with positive deletion in the region 17p11.2. The case presented a borderline IQ on verbal and performance Wechsler scales. Language standardized tests (i.e., Peabody, Token test, CEG test and Boehm test) and naturalistic language sample (i.e. conversation and story generation) were used to assess speech and language performance. Speech characteristics included imprecise speech, with a high speech rate, hoarse voice, hypernasality and intelligibility deficits. The performance in all standardized tests was poor. Socio-communicative deficits included repetitive and persistent verbal behavior, difficulties in the use of linguistic strategies to repair communication breakdowns, limited vocabulary production and short overall length utterances with reduced grammatical components. The results contribute to expanding knowledge about the SMS phenotype, also to highlight the need to include speech and language evaluation as part of the clinical assessment of SMS and, at the same time, to draw attention to the need to include early communications skills in language intervention programs. Departamento de Lingüística Facultad de Filosofía y Letras Universidad autónoma de Madrid Universidad Autónoma de Madrid Universidad de Castilla La Mancha Centro de Educación Superior CUNIMAD Universidad de Alcalá de Henares, Calle de Almansa 101 Departamento de Fonoaudiologia Faculdade de Filosofia e Ciências (FFC) Universidade Estadual Paulista (UNESP), Campus de Marília Departamento de Fonoaudiologia Faculdade de Filosofia e Ciências (FFC) Universidade Estadual Paulista (UNESP), Campus de Marília CNPq: Pq-CNPq 2013-2016

Made available in DSpace on 2022-04-28T17:22:20Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-09-09 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Seminal plasma has several components that protect the sperm cells and assist in the fertilization process. In contrast, the exact role carried out by seminal plasma during the cooling of canine semen remains controversial. Moreover, concerning the long estrus period, the possibility to store chilled semen at 5 degrees C for more than 72 hours and maintain good sperm quality for additional inseminations could increase fertilization rates. Thus, this study aimed to evaluate the seminal plasma influence on quality and oxidative stress of the extended canine semen stored at 5 degrees C for 7 days. Three ejaculate pools from eight healthy dogs were collected by digital manipulation of the penis. The sperm kinetics, sperm vitality (eosin/nigrosin stain), integrity of plasma and acrosomal membranes, morphology, superoxide and hydrogen peroxide production, mitochondrial potential, lipid peroxidation, and oxygen reactive species production (induced and spontaneous thiobarbituric acid [thiobarbituric acid reactive substances, TBARS] assay) were evaluated every 48 hours (M0, M48, M96, and M168) until 7 days (168 hours) in cooled extended (TRIS egg yolk) semen of dogs at 5 degrees C with (+SP) or without (-SP) autologous seminal plasma. No statistical difference was found for sperm kinetics in cooled samples with +SP and -SP during the experimental time period, except for the progressive motility of +SP samples that was higher at M48 than M96 (p = 0.023). The seminal plasma did not influence any other evaluated sperm characteristics. Finally, our results demonstrated that the presence or lack of seminal plasma during cooling the semen of dogs does not influence sperm quality at 5 degrees C. Moreover, the components of the semen extender may contribute to maintaining good sperm quality and low reactive oxygen species production during the long period of the dog's semen cooling, even after semen centrifugation. Sao Paulo State Univ UNESP, Fac Vet Med & Anim Sci, Dept Vet Surg & Anim Reprod, Rua Prof Dr Walter Mauricio Correa S-N, BR-18681681 Botucatu, SP, Brazil Univ Brasilia, Inst Biol Sci, Dept Physiol Sci, Brasilia, DF, Brazil Univ Sao Paulo, Fac Vet Med & Anim Sci, Dept Anim Reprod, Sao Paulo, Brazil Sao Paulo State Univ UNESP, Biosci Inst, Dept Biostat, Botucatu, SP, Brazil Sao Paulo State Univ UNESP, Fac Vet Med & Anim Sci, Dept Vet Surg & Anim Reprod, Rua Prof Dr Walter Mauricio Correa S-N, BR-18681681 Botucatu, SP, Brazil Sao Paulo State Univ UNESP, Biosci Inst, Dept Biostat, Botucatu, SP, Brazil FAPESP: 2017/02530-8 CAPES: 33004064086P1

Background: Diseases associated to Candida spp. are recurrent and can be difficult to treat, mainly due to the new strains resistant to the limited number of available antifungals. Objective: The objective of this study is to evaluate the in vitro and in vivo activity of Brazilian green propolis (GrProp) and red propolis (RdProp) ethanolic extracts against standard strains of Candida albicans, C. tropicalis, C. krusei, C. glabrata, C. parapsilosis and 10 clinical isolates of C. albicans. Methods: Antifungal activity in vitro was tested using the M-27-A3/CLSI protocol. The in vivo antifungal activity was evaluated using Tenebrio molitor model and, the effect of extracts on adhesion of C. albicans in human buccal epithelial cells (BECs) was also studied. Results: GrProp and RdProp exhibited antifungal activity against at least one of the Candida strains tested. The adhesion inhibition of C. albicans in BECs was 45% (GrProp28), 60% (Gr- Prop50) and 82% (RdProp), in comparison to amphotericin B (82%). All propolis extracts showed synergistic activity with fluconazole and amphotericin B. GrProp50 (10 mg/kg) showed better protection of T. molitor, blocking the progression of C. albicans infection, increasing survival and delayed the larvae death. Conclusion: Brazilian GrProp and RdProp extracts inhibit the in vitro C. albicans growth and protect T. molitor against infection by this yeast. The physiochemical parameters found for the analyzed samples were in accordance to the standards established by the Brazilian Legislation for propolis and derivatives. GrProp and RdProp have potential to be used against Candida spp. infections, mainly in association with fluconazole or amphotericin B.

By allowing for the creation of embryo banks, reproductive biotechnologies play an essential role in the preservation of endangered goat breeds' genetic diversity. This study focused on comparing both available embryo collection methods [laparotomy (LAP) vs. nonsurgical embryo recovery (NSER)] in Canindé goats to create an embryo bank for later use in a breed conservation program. Twelve females were superovulated and subjected to either the LAP or NSER technique for embryo recovery. The recovery rate was similar (

Objetivo: analisar na literatura os hábitos associados à mordida aberta anterior em crianças. Metodologia: realizou-se uma pesquisa bibliográfica referente aos artigos publicados de 2015 a 2020 nos bancos de dados on-line PubMed (National Libary of Medicine) e Embase, utilizando descritores e sinônimos MeSH, com as seguintes etapas: identificação dos trabalhos, triagem, elegibilidade e inclusão. Foram incluídos ensaios clínicos randomizados, estudos clínicos transversais ou de coorte, artigos que demonstrassem hábitos associados à mordida aberta anterior em crianças de 2 a 12 anos de idade. Relatos de caso e revisões da literatura foram excluídos. Resultados: de um total de 394 artigos encontrados apenas 9 foram selecionados para o estudo. Mediante a análise, observou-se que a manutenção de hábitos orais como sucção digital, de acordo com o que foi afirmado em 66,6% dos trabalhos, de chupeta (77,7%), uso de mamadeira (33,3%) e duração do tempo de aleitamento materno (22,2%), pode ocasionar alterações na oclusão, fala, respiração, crescimento craniofacial, afetando diretamente a qualidade de vida da criança. Conclusão: uma vez que a infância é a fase adequada para a implementação de novos hábitos saudáveis e tratamentos, é imprescindível que o cirurgião-dentista conheça essa associação e adote medidas terapêuticas e preventivas.

Gout arthritis commonly affects joint regions by deposition of crystals, promoting functional damage mainly during periods of exacerbation. Cryotherapy is a commonly used resource to contain inflammatory processes, however, its use during a gout crisis is not yet well understood. Therefore, the objective was to evaluate the parameters of Wistar rats submitted to an experimental gout model and treated with dual cryotherapy protocol. Twenty-one male Wistar rats were used, separated into three groups: control group (CG), lesion group (LG), and lesion + cryotherapy group (LCG). Gout model induction was through intra-articular injection, with urate crystal solution, in the right knee and cryoimmersion treatment was performed for 20 minutes at a temperature of 5° ± 2°C. Seven evaluations and two treatment moments were performed, and the following parameters were analyzed: joint edema, grip strength, joint disability, motor function, and leukocyte migration through synovial lavage. In the statistical analysis we used SPSS 20.0 with Generalized Linear Models, with least significant difference posttest, always with 5% significance level. The treatment reduced edema, promoted strength recovery, and was effective in reducing total leukocytes in the synovial fluid. No difference was observed between the injured groups for joint disability and motor function. Cryotherapy promoted edema reduction and increased pelvic limb grip strength in Wistar rats during the acute period.

Introduction: Endolymphatic hydrops is the pathophysiological substrate of Ménière’s disease. The changes in the inner ear, transmitted to the middle ear through changes in the ossicular chain mobility, can be quantified by wideband tympanometry, through the measurement of the acoustic absorbance at multiple frequencies, represented by the sound energy absorbed by the middle ear, even at its early stages. Studying the behavior of the middle ear through the absorbance in patients with endolymphatic hydrops under ambient pressure and under peak pressure can be useful for detecting Ménière’s disease. Objective: To characterize acoustic absorbance behavior in subjects with symptomatic and asymptomatic Ménière’s disease compared to controls, in order to verify the ability of wideband tympanometry to detect Ménière’s disease. Methods: We carried out a cross-sectional study with a diagnostic approach comparing the findings of wideband tympanometry at ambient pressure and peak pressure between the ears of the control group (n = 30), the asymptomatic group (n = 21) and the symptomatic group (n = 9). Results: Different peak pressure values were found between the ears of the control group (0daPa), the asymptomatic group (−11 daPa) and the symptomatic group (−192 daPa), with p < 0.05 by the Kruskal-Wallis test, Mann Whitney test and Bonferroni correction. Different absorbance values were found between the ears of the symptomatic group and the asymptomatic group compared to the control group for low frequencies at ambient pressure and peak pressure, with p < 0.05 by the Kruskal-Wallis test, Mann Whitney test and Bonferroni correction. Conclusions: The Wideband Tympanometry test was capable of identifying the presence of Ménières disease, and to differentiate between asymptomatic and symptomatic patients, when comparing them with healthy individuals. Resumo Introdução: A hidropsia endolinfática é o substrato fisiopatológico da doença de Ménière. As alterações desencadeadas na orelha interna, transmitidas à orelha média pelas modificações na mobilidade da cadeia ossicular, podem ser quantificadas pela timpanometria de banda larga, através da medida da absorvância acústica sob múltiplas frequências, representadas pela energia sonora absorvida pela orelha média, mesmo em estágios iniciais de sua instalação. Estudar o comportamento da orelha média através da absorvância em pacientes com hidropisia endolinfática sob pressão ambiente e sob o pico de pressão pode ser útil na detecção da doença de Ménière. Objetivo: Caracterizar o comportamento da absorvância em indivíduos com diagnóstico da doença de Ménière sintomáticos e assintomáticos, comparados com controles, a fim de verificar a capacidade da timpanometria de banda larga em detectar variações clínicas relacionadas a possível hidropisia endolinfática. Método: Foi realizado um estudo transversal, com enfoque diagnóstico, que comparou os achados da timpanometria de banda larga na pressão ambiente e no pico de pressão entre orelhas do grupo controle (n = 30), grupo assintomático (n = 21) e grupo sintomático (n = 9). Resultados: Foram encontrados valores do pico de pressão diferentes entre orelhas do grupo controle (0 daPa), do grupo assintomático (-11 daPa) e do grupo sintomático (-192 daPa), com p

Background and aim This study investigated the effect of Kava extract (Piper methysticum), a medicinal plant that has been worldly used by its anxiolytic effects, on monoamine oxidase (MAO) activity of mice brain after 21 days of treatment as well as anxiolytic and locomotor behavior. Furthermore, the in vitro inhibitory profile of Kava extract on MAO-B activity of mouse brain was evaluated. Experimental procedure Mice were treated with Kava extract (10, 40, 100 and 400 mg/kg) for 21 days by gavage. After behavioral analysis (plus maze test and open field), MAO activity in different mouse brain structures (cortex, hippocampus, region containing the substantia nigra and striatum) were performed. MAO-B inhibitory profile was characterized in vitro. Results The treatment with Kava extract (40 mg/kg) increased the percentage of entries of mice into the open arms. Ex vivo analysis showed an inhibition on MAO-B activity caused by Kava extract in cortex (10 mg/kg) and in the region containing the substantia nigra (10 and 100 mg/kg). In vitro, Kava extract also reversibly inhibited MAO-B activity with IC50 = 14.62 μg/mL and, increased Km values at the concentrations of 10 and 30 μg/mL and decreased Vmax value at 100 μg/mL. Conclusion Kava extract showed different effects on MAO-B isoform depending on the brain structure evaluated. Therefore, the use of Kava extract could be promissory in pathologies where MAO-B is the pharmacological target.

Neuromyelitis optica spectrum disorders (NMOSD) are immune-mediated inflammatory diseases of the central nervous system (CNS), which preferentially affect the optic nerves and the spinal cord. Anti-aquaporin 4 antibody is a specific serological marker. Systemic lupus erythematosus (SLE) is a rheumatologic disease that may affect the CNS. There are several reports about the coexistence of NMOSD and autoimmune diseases, mainly those of rheumatologic origin. We describe three different cases in which SLE and NMOSD subsequently occurred, drawing attention to the clinical heterogeneity, the challenge and the importance of recognizing this possible association.

Introduction: Chronic kidney disease (CKD) is a serious public health problem worldwide, leading to a series of physical and psychological comorbidities, in addition to costly treatments, lifestyle and dietary restrictions. There is evidence that mindfulness-based interventions (MBIs) offer complementary treatment for people with chronic illnesses, including CKD, with the aim of improving overall health, reducing side effects and treatment costs. This review aims to investigate the MBIs impact on people with CKD undergoing hemodialysis, and to identify the methodological quality of the current literature in order to support future studies. Methods: We ran searches in five databases (MEDLINE via PubMed, PsycINFO, Embase, Web of Science and Scopus) in July 2020. The papers were selected and evaluated by two reviewers independently, using predefined criteria, including the Cochrane Group's risk of bias tool and its recommendations (CRD42020192936). Results: Of the 175 studies found, 6 randomized controlled trials met the inclusion criteria, and ranged from 2014 to 2019. There were significant improvements in symptoms of anxiety, depression, self-efficacy, sleep quality, and quality of life (n=3) in the groups submitted to the intervention, in addition to physical measures such as blood pressure, heart rate and respiratory rate (n=1). Conclusions: MBIs can offer a promising and safe complementary therapy for people with CKD undergoing hemodialysis, acting on quality of life and physical aspects of the disease. Resumo Introdução: A doença renal crônica (DRC) é reconhecida como um sério problema de saúde pública a nível mundial, levando a uma série de comorbidades físicas e psicológicas, além de tratamentos custosos e restrições no estilo de vida e alimentares. Há evidências de que as intervenções baseadas em mindfulness (IBMs) oferecem opções complementares ao tratamento de pessoas com doenças crônicas, incluindo DRC, com o objetivo de melhorar a saúde geral, reduzir os efeitos colaterais e custos do tratamento. Esta revisão objetiva investigar o impacto de IBMs em pessoas com DRC em hemodiálise, e identificar a qualidade metodológica da literatura atual a fim de auxiliar pesquisas futuras. Métodos: As pesquisas foram realizadas em cinco bases de dados (MEDLINE via PubMed, PsycINFO, Embase, Web of Science e Scopus), em julho de 2020. Os artigos foram selecionados e avaliados por dois revisores de forma independente, utilizando critérios predefinidos, incluindo a ferramenta de risco de viés do grupo Cochrane e suas recomendações (CRD42020192936). Resultados: Dos 175 estudos encontrados, 6 ensaios clínicos randomizados estavam de acordo com os critérios de inclusão, e variaram entre os anos de 2014 a 2019. Foram encontradas melhoras significativas para os sintomas de ansiedade, depressão, autoeficácia, qualidade de sono, e qualidade de vida (n=3) nos grupos que realizaram a intervenção, além de medidas físicas como pressão arterial, frequência cardíaca e taxa respiratória (n=1). Conclusões: As IBMs podem oferecer uma terapêutica complementar promissora e segura para pessoas com DRC em hemodiálise, atuando na qualidade de vida e em aspectos físicos da doença.

Introdução: O grande desafio do controle sanitário é avaliar o risco potencial de seus múltiplos objetos de ação, utilizando os resultados para selecionar as melhores estratégias, tarefa difícil de ser operacionalizada no cotidiano da Vigilância Sanitária (Visa). Objetivo: Apresentar a operacionalização do Modelo de Avaliação de Riscos Potenciais (MARP) em serviços de saúde do estado de Santa Catarina, de modo a subsidiar reflexões acerca da aplicabilidade desse método. Método: Estudo descritivo de casos múltiplos holísticos. A unidade de análise foi o controle sanitário de serviços de saúde realizado pela Visa de Santa Catarina, na Grande Florianópolis, tendo sido estudados 15 (42,9%) dos 35 hospitais dessa região. A estratégia de avaliação de risco foi o MARP com aplicação de Roteiros Objetivos de Inspeção, nos Centros Cirúrgicos (CC), nas Centrais de Material Esterelizado (CME) e nas Unidades de Terapia Intensiva (UTI), nos anos 2017 a 2019. Resultados: As UTI apresentaram os maiores percentuais de risco aceitável e os menores de risco não aceitável, enquanto as CME apresentaram os menores percentuais de risco aceitável e os maiores de risco não aceitável. Os percentuais de risco potencial aceitável são maiores nos CC dos hospitais de grande porte, nas UTI dos hospitais de médio porte e ausente nas CME e nos CC dos hospitais de pequeno porte. Conclusões: O MARP favorece o gerenciamento dos riscos em Visa e o direcionamento de suas ações de controle sanitário. Possui limitações, ao necessitar de um sistema de informação e requer compreensão dos resultados dos dados, tendo em vista que risco e benefício são conceitos desafiadores e devem ser analisados num contexto definido.