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Objective: To investigate the association between probable sleep bruxism (PSB) and associated factors in schoolchildren., Materials and Methods: A case-control study was conducted with a representative sample of 320 schoolchildren aged 8 to 10 years. The case group (160 children with PSB) and the control group (160 children without PSB) were matched for sex and age at a proportion of 1:1. Information on audible characteristics of PSB, harmful oral habits, and socio-demographic characteristics as collected through questionnaires answered by the parents/caregivers. The family functioning of children was measured through The Family Adaptability and Cohesion Evaluation Scales (FACES III). Mothers self-administered the Lipp Stress Symptoms Inventory (LSSI) for adults to measure mothers' stress and the children filled out the Child Stress Scale (CSS) to measure the children stress. Data analysis used descriptive and logistic regression analyses (p < 0.05)., Results: Among the children with stress, 67.3% had PSB. Children with stress (OR = 2.22, 95% CI 1.18-4.19), those with a history of nail biting (OR = 2.22, 95% CI 1.39-3.55), and biting objects (OR = 1.77, 95% CI 1.09-2.87) were more likely to have PSB., Conclusion: Childhood stress and a history of nail biting or biting objects are important signs to be considered in schoolchildren with PBS., Clinical Relevance: These results alert that the PBS might be a sign of stress and other psychological problems such as tension and anxiety related to the presence of harmful oral habits. Furthermore, the results could help in the targeting of anamnesis, improved prevention and treatment strategies for sleep bruxism which should involve an interdisciplinary approach.

Sublethal exposures to environmental pollutants may cause changes in physiological parameters. Thus, knowledge of basal physiological rates of the species and the development of methods to quantify these rates are extremely important. Considering the scarcity of cardiac and muscle physiological studies in native Amazonian fish species and that no evaluation of electrophysiological responses by exposure to a stressor has been reported in Bryconops caudomaculatus, the aim of this study was to develop techniques of electromyographic and electrocardiographic recordings of normal responses, during toxicity induction and short-term recovery. A total of 9 animals were used, divided into two groups: control group (n = 4) and treated group (n = 5), with records lasting 5 min. The results showed that the basal electromyographic records indicate that the studied species has a very intense swimming activity, whereas the basal cardiac parameters clearly showed the patterns in P wave tracing, QRS complex, T wave and Q-T and R-R intervals. During exposure to the stressor, muscle activity ceased presenting intense decrease and myorelaxant effect expected. Electrocardiographic responses confirmed cardiotoxicity with intense bradycardia, ventricular bigeminism, prolongation of QRS complex duration and cardiac arrhythmias, indicating cardiac dysfunction. It was concluded that the electrophysiological responses are excellent biomarkers and showed the susceptibility of the species to the tested substance. In addition, the electrocardiogram and the electromyogram are excellent techniques to reflect the degree of environmental stress when organisms are exposed to toxic substances in the environment., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Background: Cannabidiol (CBD) is one of the main components of Cannabis sativa and has anxiolytic properties, but no study has been conducted to evaluate the effects of CBD on anxiety signs and symptoms in patients with Parkinson's disease (PD). This study aimed to evaluate the impacts of acute CBD administration at a dose of 300 mg on anxiety measures and tremors induced by a Simulated Public Speaking Test (SPST) in individuals with PD., Methods: A randomised, double-blinded, placebo-controlled, crossover clinical trial was conducted. A total of 24 individuals with PD were included and underwent two experimental sessions within a 15-day interval. After taking CBD or a placebo, participants underwent the SPST. During the test, the following data were collected: heart rate, systemic blood pressure and tremor frequency and amplitude. In addition, the Visual Analog Mood Scales (VAMS) and Self-Statements during Public Speaking Scale were applied. Statistical analysis was performed by repeated-measures analysis of variance (ANOVA) while considering the drug, SPST phase and interactions between these variables., Results: There were statistically significant differences in the VAMS anxiety factor for the drug; CBD attenuated the anxiety experimentally induced by the SPST. Repeated-measures ANOVA showed significant differences in the drug for the variable related to tremor amplitude as recorded by the accelerometer., Conclusion: Acute CBD administration at a dose of 300 mg decreased anxiety in patients with PD, and there was also decreased tremor amplitude in an anxiogenic situation.

Recently, there has been greater interest in adopting a more holistic approach to healthcare. However, this trend should not limit itself merely to the notion that a human being lies behind the mouth being treated. Rather, it should embrace the understanding that this human can actively participate in and contribute to the treatment process. Patient Report Outcome Measures (PROMs) and Patient Report Experience Measures (PREMs) provide means for measuring data from the patient's perspective, and enable health-related feelings and functions to be evaluated. Accordingly, this critical review aims to provide definitions, rationales and applications of patient-centered approaches in dental clinical research. Some patient-centered constructs are especially relevant to dental clinical trials, such as oral health-related quality of life, pain/discomfort, aesthetics and satisfaction concerning treatment and services. The selection and application of patient-reported measures can vary according to condition (generic, disease-specific or treatment-specific) and to the specific population evaluated (age and cognitive impairment). These measures can help weigh risks and benefits, as well as assess the cost effectiveness of treatments, thus influencing treatment recommendations and health policies. The incorporation of these measures into a professional's daily life not only represents an improvement in professional performance, but also addresses a humanitarian concern.

Purpose: To validate the Comprehensive and Brief International Classification of Functioning, Disability and Health Core Sets for obstructive pulmonary diseases from the perspective of adults with asthma. Methods: This was a qualitative, cross-sectional study. Individual interviews with questions related to the disease and its impact on the patient's life were performed. The meaning condensation procedure was used for analysis. Results: Thirty-five participants (26 females, 41 ± 13 years old) were interviewed. A total of 405 concepts were identified, and 348 were associated to the components Body Functions ( n  = 168), Body Structures ( n  = 22), Activities and Participation ( n  = 33), Environmental Factors ( n  = 125). These concepts were linked to 61 categories: second level ( n  = 25), third level ( n  = 33), fourth level ( n  = 3), which confirmed 41% and 77% of those included in the Comprehensive and Brief Core Sets, respectively. Twenty-four additional categories were identified, and 57 concepts could not be linked to the classification. Conclusions: The International Classification of Functioning, Disability and Health Core Sets for obstructive pulmonary diseases were supported by the perspective of adults with asthma. The Brief version seemed the best reference for rehabilitation, reflecting the typical disabilities and impairments of these patients. Unconfirmed and added categories have been reported, and their analysis may assist future document updates.Implications for rehabilitationThe use of the International Classification of Functioning, Disability and Health Core Sets for Obstructive Pulmonary Diseases is relevant to guide patient assessment, treatment and monitoring.The concepts related to the Body functions and Environmental factors were the most relevant according to the perspective of adults with asthma.The Comprehensive and Brief International Classification of Functioning, Disability and Health Core Sets for Obstructive Pulmonary Diseases were supported by adults with asthma.

Background: Knowledge on the association between developmental enamel defects (DED) and early childhood caries (ECC) has importance for the drafting of prevention measures and oral healthcare planning., Aim: To compare the frequency of ECC in children with and without DED and verify their association with sociodemographic factors., Design: This case-control study was carried out with Brazilian children aged one to five years. The case group made up of 98 children with ECC and the control group was made up of 98 children without ECC. DED were classified in diffuse opacity, demarcated opacity and enamel hypoplasia (Developmental Defects of Enamel Index). Sociodemographic data were collected by a questionnaire answered by parents. Statistical analysis used McNemar's test and logistic regression analyses., Results: In the bivariate analysis, ECC was more frequent among children from families with poorer socioeconomic conditions (lower monthly household income [P ≤ .001] and lower maternal schooling [P = .001]) and among those with DED (P ≤ .001). The final logistical model showed that children with DED (OR: 1.94) and a monthly household income less than two Brazilian minimum salaries (OR: 2.24) were more likely to have ECC., Conclusions: The occurrence of DED and lower household income were pre-disposing factors for the occurrence of ECC., (© 2019 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Purpose: To analyze the intratumoral immunohistochemical expression of renin and its value as a prognostic factor for recurrence in nonmetastatic clear cell renal cell carcinoma (ccRCC)., Methods: A total of 498 patients with nonmetastatic ccRCC from the Latin American Renal Cancer Group database who underwent partial or radical nephrectomy between 1990 and 2016 were selected. All cases were revised, and 2 distinct samples were obtained for tissue microarray construction. Ten years of follow-up was assessed, and disease-free survival rates (DFS) were analyzed. Renin expression was classified qualitatively as negative or positive. For the quantitative analysis, a cutoff was estimated using the maximum of the standardized log-rank statistic., Results: Nuclear renin was qualitatively positive in 360 cases (72%) and negative in 138 (28%), whereas quantitatively, an equal number of cases had ≤35% or >35% renin-positive nuclei. The absence of renin expression was associated with high-grade tumors (by ISUP and Fuhrman classification, both P < 0.001), greater microscopic venous invasion (P = 0.046), and renal vein invasion (P = 0.026). In the multivariate analyses, qualitatively negative renin expression was an unfavorable prognostic factor for DFS (RR = 2.923, P < 0.001). With regard to quantitative renin expression, a cutoff of ≤35 was associated with worse DFS (RR = 4.085, P < 0.001)., Conclusions: The intratumoral immunohistochemical expression of renin in patients with ccRCC provides valuable prognostic data regarding the likelihood of recurrence., (Copyright © 2019 Elsevier Inc. All rights reserved.)

The aim of the present study was to investigate whether the ability to recognize and read oral health terms is associated with the number of teeth with cavitated carious lesions in adolescents. A population-based cross-sectional study was conducted involving a sample of 746 adolescents representative of students aged 15 to 19 years at the public and private school systems in a city in northeast Brazil. Two examiners who had undergone a training and calibration exercise (inter-examiner and intra-examiner Kappa coefficient: 0.87 to 0.93) performed the diagnosis of caries using the Nyvad Index and evaluated the level of OHL (BREALD-30) of the adolescents. The participants answered questions regarding their history of visits to the dentist and the parents/caregivers answered a questionnaire addressing socioeconomic characteristics. A directed acyclic graph was created to direct the selection of covariables for adjustments in the Poisson multiple regression analysis to test the association between dental caries and OHL (α = 5%). Cavitated carious lesions (codes 3 to 6 on the Nyvad index) were found in 41.6% of the adolescents. Only 29.4% had a high level of OHL (BREALD-30 scores between 23 and 30); 42.3% of the families belonged to the A-B social class and 93% of the adolescents had been to the dentist at least once in their lifetimes. In the multivariate analysis, adolescents with inadequate (PR: 1.69; 95% CI: 1.18-2.41; p = 0.004) and marginal (PR; 1.42; 95% CI: 1.01-1.99; p = 0.042) OHL and those in the lower social classes (C-D-E) (PR: 1.85; 95% CI: 1.39-2.47; p<0.001) had more teeth with cavitated carious lesions. In conclusion, adolescents aged 15 to 19 years with poorer levels of OHL had a larger number of teeth with cavitated carious lesions, independently of their socioeconomic status and history of visiting a dentist., Competing Interests: The authors have declared that no competing interests exist.

Objective: To demonstrate the impact of pneumococcal conjugate vaccine in Streptococcus pneumoniae carriage status in children younger than 5 years in Latin America and the Caribbean., Methods: A systematic literature review was carried out on the direct and indirect effects of pneumococcal vaccine in the carriage status, after implementation in childhood immunization programs. Studies carried out in children younger than 5 years were selected from the PubMed® and Virtual Health Library databases, and data collected after implementation of pneumococcal vaccine in Latin America and the Caribbean, between 2008 and 2018., Results: From 1,396 articles identified, 738 were selected based on titles and abstracts. After duplicate removal, 31 studies were eligible for full-text reading, resulting in 6 publications for analysis. All selected publications were observational studies and indicated a decrease in the carriage and vaccine types, and an increase in the circulation of non-vaccine serotypes, such as 6A, 19A, 35B, 21 and 38. We did not identify changes in the antimicrobial resistance after vaccine implementation., Conclusion: A decrease in the carriage status of vaccine types and non-vaccine types was detected. The continuous monitoring of pneumococcal vaccine effect is fundamental to demonstrate the impact of the carriage status and, consequently, of invasive pneumococcal disease, allowing better targeting approaches in countries that included pneumococcal vaccine in their immunization programs. Our study protocol was registered in PROSPERO (www.crd.york.ac.uk/prospero) under number CRD42018096719.

Objective: To assess the quality of life related to health for heart failure patients and to relate sociodemographic and clinical data., Method: It is an observational and transversal study, with quantitative approach, carried out in a heart failure ambulatory in the state of Pernambuco., Results: In the sample (n=101), there was prevalence of men older than 60 years old, married and professionally inactive. The quality of life related to health, based on the Minnesota Living With Heart Failure Questionnaire, was considered moderate (34.3±21.6), being significantly related to age (p=0.004), functional class (p<0.001), and patients with chagasic cardiopathy (p=0.02)., Conclusion: The quality of life in the HF group of chagasic etiology was more compromised, specially in the emotional dimension. It is suggested that studies on the hypothesis that longer ambulatory follow-up improves quality of life and that having Chagas disease interferes negatively with the quality of life of heart failure patients.

Objective: To assess sleep bruxism prevalence and its association with circadian preference and sleep-related characteristics among dental students. Methods: Dental students of the Federal University of Minas Gerais participated in this cross-sectional study. Participants answered a scale assessing individuals' circadian preference, and a questionnaire regarding sleep-related characteristics and behaviors, history of muscle ache in the temporomandibular area, and history of bruxism. Results: One hundred fifty-two students participated in the study. Sleep bruxism was reported by 11.3%. Most students (63.2%) were classified as intermediary, 34.9% as morningness, and 1.3% as eveningness. Individuals who reported muscle ache in the temporomandibular area in the morning (PR = 3.5; 95% CI = 1.1-11.5) were more likely to be in the group with sleep bruxism. Conclusion: Muscle ache in the temporomandibular area is an important associated factor with sleep bruxism among dental students. Special attention should be paid to dental students' circadian preference.

Background: The most-cited papers help to better understand important characteristics of this specific science field., Objective: To analyse the 100 most-cited papers in the field of Paediatric Dentistry., Design: A search of the most-cited papers in Paediatric Dentistry journals was performed using journals included in the category of 'Dentistry, Oral Surgery & Medicine' in the Thompson Reuters Web of Science citation indexing database up to December 2018. Two researchers performed the data extraction, which included: number of citations, title, authors, country, year, journals, study design, and thematic area., Results: The number of citations of each paper included in the top 100 most-cited ranged from 42 to 182 (mean: 64.51). Seven papers were cited more than 100 times. Most of the papers were published in the International Journal of Paediatric Dentistry (36%), between 2006 and 2015 (55%), with a cross-sectional design (39%). Twenty-six authors participated in two or more papers. The countries with the highest number of most-cited papers were the United States (25%), Australia (11%), and Brazil (9%). Cariology was the most studied thematic area., Conclusion: The evaluation of the top 100 most-cited papers in Paediatric Dentistry journals allowed for a better understanding of the world scenario regarding this research field., (© 2019 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: An increased number of congenital Zika virus infections with neurological and musculoskeletal malformations have been diagnosed worldwide, however, there are still several gaps in the knowledge about this infection, its associated mechanism, timing of transmission, and description of throughout findings of signs and symptoms, which is described in this paper. The purpose of this study is to describe aspects of congenital Zika syndrome (CZS) beyond the central nervous system comprising detailed delineation of all the other clinical findings., Methods: A retrospective research developed using electronic medical records. We analyzed the files of 69 children with an initial diagnosis of microcephaly by Zika vírus who were born in 2015, 2016 and 2017, treated during the period from 2016 to 2017., Results: The newborns presented several neurological and musculoskeletal malformations, eye damage, hearing impairment and other malformations., Conclusions: The present study has significant impact for health care teams following lactents with Congenital Zika Syndrome.

Noninvasive approaches for early detection of bladder cancer are actively being investigated. We recently developed a urine- based molecular assay for the detection and surveillance of bladder neoplasms (UroSEEK). UroSEEK is designed to detect alterations in 11 genes that include most common genetic alterations in bladder cancer. In this study, we analyzed 527 cases, including 373 noninvasive and 154 invasive urothelial carcinomas of bladder from transurethral resections or cystectomies performed at four institutions (1991-2016). Two different mutational analysis assays of a representative tumor area were performed: first, a singleplex PCR assay for evaluation of the TERT promoter region (TERTSeqS) and second, a multiplex PCR assay using primers designed to amplify regions of interest of 10 (FGFR3, PIK3CA, TP53, HRAS, KRAS, ERBB2, CDKN2A, MET, MLL, and VHL) genes (UroSeqS). Overall, 92% of all bladder tumors were positive for at least one genetic alteration in the UroSEEK panel. We found TERT promoter mutations in 77% of low-grade noninvasive papillary carcinomas, with a relatively lower incidence of 65% in high-grade noninvasive papillary carcinomas and carcinomas in situ; p = 0.017. Seventy-two percent of pT1 and 63% of muscle-invasive bladder tumors harbored TERT promoter mutations with g.1295228C>T alteration being the most common in all groups. FGFR3 and PIK3CA mutations were more frequent in low-grade noninvasive papillary carcinomas compared with high-grade noninvasive papillary carcinomas and carcinomas in situ (p < 0.0001), while the opposite was true for TP53 (p < 0.0001). Significantly higher rates of TP53 and CDKN2A mutation rates (p = 0.005 and 0.035, respectively) were encountered in muscle-invasive bladder tumors compared with those of pT1 stage. The overwhelming majority of all investigated tumors showed at least one mutation among UroSEEK assay genes, confirming the comprehensive coverage of the panel and supporting its potential utility as a noninvasive urine-based assay.

Background: Nurses are the largest professional group in healthcare and those who make more decisions. In 2014, the Committee on Bioethics of the Council of Europe launched the "Guide on the decision-making process regarding medical treatment in end-of-life situations" (hereinafter, Guide), aiming at improving decision-making processes and empowering professionals in making end-of-life decisions. The Guide does not mention nurses explicitly., Objectives: To analyze the ethical principles most valued by nurses working in palliative care when making end-of-life decisions and investigate if they are consistent with the framework and recommendations of the Guide; to identify what disputed/controversial issues are more frequent in these nurses' current end-of-life care practices., Design: Qualitative secondary analysis., Participants/context: Three qualitative datasets including 32 interviews from previous studies with nurses working in palliative care in Portugal., Ethical Consideration: Ethical approval was obtained from the Ethics Research Lab of the Instituto de Bioética (Ethics Research Lab of the Institute of Bioethics) (Ref.04.2015). Ethical procedures are thoroughly described., Findings: All participant nurses referred to autonomy as an ethical principle paramount in end-of-life decision-making. They were commonly involved in end-of-life decision-making. Palliative sedation and communication were the most mentioned disputed/controversial issues., Discussion: Autonomy was highly valued in end-of-life care and decision-making. Nurses expressed major concerns in assessing patients' preferences, wishes, and promoting advance care planning. Nurses working in palliative care in Portugal were highly involved in end-of-life decision-making. These processes embraced a collective, inclusive approach. Palliative sedation was the most mentioned disputed issue, which is aligned with previous findings. Communication also emerged as a sensitive ethical issue; it is surprising, however, that only three nurses referred to it., Conclusion: While the Guide does not explicitly mention nurses in its content, this study shows that nurses working in palliative care in Portugal are involved in these processes. Further research is needed on nurses' involvement and practices in end-of-life decision-making.

Introduction: One of the goals of malocclusion treatment is to improve the oral health-related quality of life (OHRQoL) of patients. The aim of this trial was to assess the OHRQoL of children before, during, and after anterior open bite (AOB) correction, compared with nontreated children, in a 2-arm parallel single-blind randomized controlled trial., Methods: Eighty children with AOB aged 8-10 years were randomly assigned to 2 groups (n = 40 each): a group treated with the use of fixed palatal crib (FPC; TG) and a control group (nontreated; CG). Randomization was performed with the use of BioEstat software. The outcome (OHRQoL) was assessed with the use of the validated Brazilian Portuguese version of the Child Perceptions Questionnaire (CPQ 8-10 ) applied before (baseline, phase 1), 3 months after FPC placement (phase 2), and 1 month after FPC removal (phase 3) in the TG. In the CG, CPQ 8-10 was applied at baseline (phase 1), 3 months (phase 2), and 12 months (phase 3). Data were analyzed by means of a blinded statistic with the use of Friedman, Wilcoxon, and Mann-Whitney tests (α = 0.05)., Results: All participants finished the RCT, and demographic characteristics were similar between groups. In phase 1, the TG had lower scores for the "social well-being" domain (P = 0.02). In phase 2, the CG had higher scores than the TG for the "emotional well-being" and "social well-being" domains, but the opposite was observed for "oral symptoms" and "functional limitations" (P < 0.001). In phase 3, the TG showed a lower impact on OHRQoL than the CG in all domains and in the overall score (P < 0.001). In the 3 phases, the CG showed progressive increase (mean scores 70.37, 74.70, and 84.22, respectively; P < 0.001) and the TG a decrease (mean scores 70.20, 70.80, and 6.05, respectively; P < 0.001) in overall scores. The increase of scores in the CG was considered to represent a serious harm., Conclusions: Correction of AOB had a positive impact and failure to correct it had a negative impact on the OHRQoL of children., Registration: This trial was not registered., Protocol: The protocol was not published before trial commencement., (Copyright © 2019 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Objective: To determine whether distraction techniques (DT) reduce children's/adolescent's anxiety and fear during dental treatment., Methods: Randomized controlled trials (RCTs) in which any type of DT were used to manage dental anxiety and dental fear in children/adolescents were included. A systematic search of PubMed, Web of Science, Scopus, Cochrane Library, Lilacs, and Google Scholar was conducted. Two independent reviewers selected studies, extracted data, assessed methodological quality of studies using the Cochrane Collaboration's Risk of Bias tool (CCRBT), and approached certainty of evidence using GRADE (Grading of Recommendations, Assessment, Development and Evaluation). Data were analysed descriptively., Results: Twenty studies covering several types of DT (audio, audiovisual, instruments camouflage, biofeedback, dental operating microscope, toys) were included. Qualitative analysis showed with very low certainty of evidence that DT effectively reduced dental anxiety and fear depending on the distraction type, instrument used to measure dental anxiety and dental fear, and dental procedure. CCRBT evaluation identified many methodological issues in included studies., Conclusion: There is a very low certainty of evidence that DT can be effective in managing children's/adolescents' dental fear and anxiety during dental treatment. The heterogeneity of methodologies and findings in the studies, however, suggests more robust, and well-executed RCTs are needed., (© 2019 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objective: To evaluate the impact of the first six months of orthodontic treatment with fixed appliances on the oral health-related quality of life (OHRQoL) of adolescents, comparing boys and girls, using a specific condition questionnaire., Design: Cross-sectional., Setting: School of Dentistry of the Federal University of Minas Gerais, Belo Horizonte, Brazil., Participants: Adolescents aged 10-17 years., Methods: Forty-six adolescents participated in this study. Adolescents' OHRQoL was evaluated using the Brazilian version of the questionnaire Impact of Fixed Appliances Measure. This questionnaire comprises 43 questions distributed across nine domains: aesthetics; functional limitation; dietary impact; oral hygiene impact; maintenance impact; physical impact; social impact; time constraints; and travel/cost/inconvenience implications. The answer options follow the Likert scale, in the range of 1-5. A higher score indicates a more negative impact on the OHRQoL. Adolescents' malocclusion was assessed using the Dental Aesthetic Index. Information on family income, adolescents' age and tooth extraction was also collected. A directed acyclic graph was used to identify potential confounders. Statistical analysis involved the chi-square test, the Student's t test and the analysis of covariance. The minimal clinically important difference was also calculated., Results: Of the 46 participants, 25 were girls and 21 were boys. The female adolescents presented a more negative impact from the orthodontic treatment on the quality of life when compared to the male adolescents ( P < 0.001), regardless of the influence of the confounding variables. The most negative repercussions were identified in the domains of oral hygiene ( P = 0.002), physical impact ( P < 0.001) and social impact ( P < 0.001)., Conclusion: The impact of the first six months of orthodontic treatment on OHRQoL is more negative in female individuals than in male individuals. The results of this study may be useful for the oral healthcare provider during the counselling of adolescents undergoing fixed appliance therapy.

Objective: To evaluate the effects of Justicia acuminatissima , or Amazonian Sara Tudo , on renal hemodynamics, oxidative profile, and renal histology in rats with ischemic acute kidney injury., Method: Preclinical assay with adult male Wistar rats, weighing from 250 g to 350 g, distributed into Sham, ischemia, and ischemia + Sara Tudo groups. Hemodynamic parameters, renal function, oxidative stress, and renal histology were evaluated., Results: Pretreatment with Sara Tudo reduced the functional injury, which was shown by the increase in creatinine clearance and thiols; reduction of oxidative markers, renal vascular resistance, and tubulointerstitial injury in the renal tissue; and the significant improvement in renal blood flow., Conclusion: The renoprotection provided by Justicia acuminatissima , or Sara Tudo , in cases of ischemic acute kidney injury was characterized by a marked improvement in renal function, reducing the oxidative injury, and impacting on renal histology positively.

Objective: To evaluate the psychometric properties of the Brazilian Portuguese version of the Rapid Estimate of Adult Literacy in Dentistry (BREALD-30) administered to adolescents., Methods: The study included 750 adolescents: 375 aged 12 years and 375 aged 15-19 years, attending public and private schools in Campina Grande, state of Paraíba, Brazil, in 2017. Reliability was measured based on internal consistency and test-retest reliability. Convergent validity was measured based on correlations between BREALD-30 and Functional Literacy Indicator scores. Divergent validity was measured by comparing BREALD-30 scores with sociodemographic variables. For predictive validity, the association between BREALD-30 scores and the presence of cavitated carious lesions was tested using a multiple logistic regression model. All statistical tests were performed with a significance level of 5%., Results: BREALD-30 showed good internal consistency for the 12 year olds and 15 to19 year olds (Cronbach's alpha = 0.871 and 0.834, respectively) and good test-retest reliability [intraclass correlation coefficient (ICC) = 0.898 and 0.974; kappa = 0.804 and 0.808, respectively]. Moreover, item-total correlation was satisfactory for all items. BREALD-30 had convergent validity with the Functional Literacy Indicator for 12 year olds (rs = 0.558, p < 0.001) and for 15 to 19 year olds (rs = 0.652, p < 0.001). Participants with higher oral health literacy levels who attended private schools (p < 0.001), belonged to economic classes A and B2 (p < 0.001), and who had parents with higher education levels (p < 0.001) were included, indicating the divergent validity of the BREALD-30. Participants with lower BREALD-30 scores were more likely to have cavitated carious lesions [12 year olds: odds ratio (OR) = 2.37; 95% confidence interval (95%CI): 1.48-3.80; 15 to 19 year olds: OR = 1.96; 95%CI 1.24-3.11]., Conclusions: BREALD-30 shows satisfactory psychometric properties for use on Brazilian adolescents and can be applied as a fast, simple, and reliable measure of oral health literacy.

Human sperm show a variety of different behaviours (types of motility) that have different functional roles. Previous reports suggest that sperm may reversibly switch between these behaviours. We have recorded and analysed the behaviour of individual human sperm (180 cells in total), each cell monitored continuously for 3-3.5 min either under control conditions or in the presence of Ca2+-mobilising stimuli. Switching between different behaviours was assessed visually (1 s bins using four behaviour categories), and was verified by fractal dimension analysis of sperm head tracks. In the absence of stimuli, ~90% of cells showed at least one behavioural transition (mean rate under control conditions = 6.4 ± 0.8 transitions.min-1). Type 1 behaviour (progressive, activated-like motility) was most common, but the majority of cells (>70%) displayed at least three behaviour types. Treatment of sperm with Ca2+-mobilising agonists had negligible effects on the rate of switching but increased the time spent in type 2 and type 3 (hyperactivation-like) behaviours (P < 2*10-8; chi-square). Treatment with 4-aminopyridine under alkaline conditions (pHo = 8.5), a highly-potent Ca2+-mobilising stimulus, was the most effective in increasing the proportion of type 3 behaviour, biasing switching away from type 1 (P < 0.005) and dramatically extending the duration of type 3 events (P < 10-16). Other stimuli, including 300 nM progesterone and 1% human follicular fluid, had qualitatively similar effects but were less potent. We conclude that human sperm observed in vitro constitutively display a range of behaviours and regulation of motility by [Ca2+]i, at the level of the single cell, is achieved not by causing cells to adopt a 'new' behaviour but by changing the relative contributions of those behaviours., (© The Author(s) 2019. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology.)

Physical abuse of children is defined as any non-accidental injury or omission of their caregivers that causes risk to the child's integrity. This study aimed to evaluate whether health professionals perceive and report physical abuse in children/adolescents. A total of 62 health professionals (dentists, physicians and nurses) from Diamantina/MG who attend to children and adolescents answered a questionnaire. The collected variables were related to the identification of abuse; denunciation to the authorities and difficulties in making the complaint. Frequency analysis, chi-square test and content analysis were performed. All professionals had identified and reported the occurrence of physical abuse in children/adolescents. Significant association was observed between the specialty of the professional and the recognition of abuse as well as denunciation to the authorities. The main difficulties presented to denounce the cases to the authorities were lack of knowledge in identifying the abuse and how to make the complaint. Most participants expressed that they would like to receive training in identifying and reporting abuse. Health professionals perceive child abuse, and physicians are the ones who most report the cases.

AIDS is an advanced clinical manifestation of HIV infection. It generates severe immunodeficiency and associated infections that may lead to death. The antiretroviral therapy (ART) has reduced the morbimortality of HIV/AIDS, but its benefits depend on ART adherence. This integrative review followed the PICO method to identify factors associated with adult adherence to ART. Empirical papers published between January 2010 and December 2016 in the Medline, SciELO, Lilacs and PePSIC databases were included. We analyzed 125 papers regarding the characteristics of studies, adherence measures and associated factors. Results showed a wide variety in the definition of adherence and the use of measures for its monitoring, as well as several adherence-associated factors. These were categorized as follows: 1- Individual variables; 2- Treatment characteristics; 3- HIV/aids infection characteristics; 4- Relationship with the health services; 5- Social support. Health services should characterize the users' profiles, systematize adherence measures and regionally assess adherence-associated factors for the early detection of non-adherence to ART and implementation of effective intervention plans.

Background: Left ventricular global longitudinal strain value (GLS) can predict functional capacity in patients with preserved left ventricular ejection fraction (LVEF) heart failure (HF) and to assess prognosis in reduced LVEF HF., Objetive: Correlate GLS with parameters of Cardiopulmonary Exercise Test (CPET) and to assess if they could predict systolic HF patients that are more appropriated to be referred to heart transplantation according to CPET criteria., Methods: Systolic HF patients with LVEF < 45%, NYHA functional class II and III, underwent prospectively CPET and echocardiography with strain analysis. LVEF and GLS were correlated with the following CPET variables: maxVO2, VE/VCO2 slope, heart rate reduction during the first minute of recovery (HRR) and time needed to reduce maxVO2 in 50% after physical exercise (T1/2VO2). ROC curve analysis of GLS to predict VO2 < 14 mL/kg/min and VE/VCO2 slope > 35 (heart transplantation's criteria) was performed., Results: Twenty six patients were selected (age, 47 ± 12 years, 58% men, mean LVEF = 28 ± 8%). LVEF correlated only with maxVO2 and T1/2VO2. GLS correlated to all CPET variables (maxVO2: r = 0.671, p = 0.001; VE/VCO2 slope: r = -0.513, p = 0.007; HRR: r = 0.466, p = 0.016, and T1/2VO2: r = -0.696, p = 0.001). GLS area under the ROC curve to predict heart transplantation's criteria was 0.88 (sensitivity 75%, specificity 83%) for a cut-off value of -5.7%, p = 0.03., Conclusion: GLS was significantly associated with all functional CPET parameters. It could classify HF patients according to the functional capacity and may stratify which patients have a poor prognosis and therefore to deserve more differentiated treatment, such as heart transplantation.

Background: Sleep bruxism (SB) is a masticatory muscle activity that affects children. Parents' knowledge is important for its identification and report to dentists., Aim: To investigate parents' knowledge about SB among their children., Design: A cross-sectional study included 1325 parents of children from dental clinics of seven institutions from all regions of Brazil. Parents answered questions about child's sleep, knowledge about SB and its occurrence among children and parents. SB definition given by parents was dichotomized as "correct"/"incorrect", based on the American Academy of Sleep Medicine definition. Descriptive, bivariate and multivariate analyses were performed (P < 0.05)., Results: Most parents (57.3%) did not know what SB is and 88.9% would like to receive more information. SB prevalence among parents was 15.4% and 24.0% among children. Between parents who correctly defined SB, its prevalence increased to 27.5% among parents and 40.6% among children. Parents whose children had/have SB, who would like to receive more information about SB and were from the North, Central-West, Southeast, and South regions were more likely to define SB correctly (P > 0.05)., Conclusion: There is a lack of knowledge of parents about SB. SB among children, parents' interest in receiving more information and their location were factors associated to their knowledge., (© 2019 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objective: to analyze association between tuberculosis treatment outcome, sociodemographic characteristics and receipt of social benefits., Methods: this was a cohort study conducted in Salvador, Bahia, Brazil, in the period 2014-2016; we analyzed bivariate associations between treatment outcome, sociodemographic characteristics and social benefits., Results: 216 individuals were followed, of whom 79.6% were cured; higher cure proportion was associated with schooling >9 years (87.5%; p=0.028), marital union (86.3%; p=0.031), and household density ≤2 individuals/bedroom (84.1%; p=0.013); we took as our reference individuals with schooling ≤9 years, not in marital union, and housing density >2 people/bedroom; higher cure proportion was also found among recipients of government and non-government benefits (90.5%), and among those who only received direct benefits (81.6%)., Conclusion: schooling >9 years, marital union, and household density ≤2 individuals/bedroom were associated with higher cure; this outcome was more frequent among individuals receiving government and non-government benefits, and among individuals receiving only direct benefits.

Cutaneous delayed reactions to antihypertensive drugs have been described in a limited number of case reports but the mechanisms remain mostly unknown. We report the case of a 60-year-old female patient with a 3-week history of an itchy erythematous maculopapular eruption. Although the patient was polymedicated, irbesartan was the most likely culprit. Patch tests and a lymphocyte transformation test to irbesartan were both positive, which was useful for diagnosis and suggested an immunological reaction. No new lesions appeared after irbesartan was stopped or after the introduction of candesartan. Despite its similar chemical structure, candesartan may be tried in patients allergic to irbesartan., Learning Points: Irbesartan can induce immunological cell-mediated skin reactions.Allergy to irbesartan does not imply a class allergy.Patch tests and a lymphocyte transformation test were useful in the diagnosis of irbesartan allergy., Competing Interests: Conflicts of Interests: The Authors declare that there are no competing interests.

Paracoccidioidomycosis (PCM) is a neglected disease present in Latin America with difficulty in treatment and occurrence of serious sequelae. Thus, the development of alternative therapies is imperative. In the current work, two oxadiazole compounds (LMM5 and LMM11) presented fungicidal activity against Paracoccidioides spp. The minimum inhibitory and fungicidal concentration values ranged from 1 to 32 μg/mL, and a synergic effect was observed for both compounds when combined with Amphotericin B. LMM5 and LMM11 were able to reduce CFU counts (≥2 log10) on the 5th and 7th days of time-kill curve, respectively. The fungicide effect was confirmed by fluorescence microscopy (FUN-1/FUN-2). The hippocratic screening and biochemical analysis were performed in Balb/c male mice that received a high dose of each compound, and the compounds showed no in vivo toxicity. The treatment of experimental PCM with the new oxadiazoles led to significant reduction in CFU (≥1 log10). Histopathological analysis of the groups treated exhibited control of inflammation, as well as preserved lung areas. These findings suggest that LMM5 and LMM11 are promising hits structures, opening the door for implementing new PCM therapies., Competing Interests: The authors have declared that no competing interests exist.

Aim: To assess the prevalence of self-reported dental pain and its association with sociodemographic, clinical and behavioral/psychosocial indicators among 8- to 10-year-old Brazilian schoolchildren., Design: A cross-sectional study was carried out with 1,589 eight- to ten-year-old children randomly selected from public schools of Florianopolis, Brazil. Self-reports of dental pain were collected through a single question as follows: "In the last month, how many times have you had pain in your teeth?" Caries experience was determined by the DMFT/dmft index and its clinical consequences by the PUFA/pufa index. Dental trauma, dental fluorosis and molar-incisor hypomineralization were assessed through the Andreasen, Dean and European Academy of Pediatric Dentistry classifications, respectively. Clinical signs of dental erosion were also observed. Sociodemographic indicators were obtained through a questionnaire answered by the children's caregivers. Information about behavioral/psychosocial indicators was collected through questions from the Brazilian version of the Child Perception Questionnaire 8-10 years (CPQ8-10). Descriptive analysis, chi-square test, and hierarchically adjusted Poisson regression models were performed., Results: 819 children (51.5%) reported episodes of dental pain in the last month prior to the study, whereas 55.6% (n = 509) were girls. The presence of dental pain was significantly associated with sex, trouble sleeping, difficulty eating, school absenteeism, difficulty with paying attention in class, difficulty doing homework, staying away from recreational activities, caries experience, PUFA/pufa index and ulceration (p<0.05)., Conclusion: The prevalence of self-reported dental pain in 8- to 10- year-old Brazilian schoolchildren was high and was associated with sociodemographic, clinical and behavioral/psychosocial indicators., Competing Interests: The authors have declared that no competing interests exist.

Objective: The aim of the present study was to evaluate factors associated with the clinical consequences of untreated dental caries in children attending public and private preschools., Methods: A cross-sectional study was conducted with a complex, preschool-based sample of 769 children, 5 years of age, from public and private preschools in the city of Campina Grande, Brazil. Clinical examinations to diagnose the consequences of untreated caries were performed using the criteria of the pufa index (p - pulp exposure; u - ulceration caused by movement of tooth fragments; f - fistula; a - abscess). The psychological factor evaluated was parental/caregiver sense of coherence (SOC), which was determined using a validated assessment tool. Sociodemographic characteristics and the use of dental services were also considered. Two examiners were trained to examine the clinical consequences of untreated dental caries. The kappa statistic demonstrated a high level of agreement for the conditions evaluated. Descriptive analysis was performed, followed by the use of an inductive decision tree (J48 algorithm; α = 5%)., Results: The factors associated with the clinical consequences of untreated dental caries were toothache [prevalence ratio (PR) = 12.34; 95% confidence interval (95% CI): 7.87-19.35; P < 0.001], attending a public preschool (PR = 2.38; 95% CI: 1.83-3.09; P < 0.001), parents/caregivers younger than 30 years of age (PR = 1.45; 95% CI: 1.26-1.68; P < 0.001), parents/caregivers with more than two children (PR = 1.47; 95% CI: 1.28-1.69; P < 0.001) and parents/caregivers with a weak SOC (PR = 1.13; 95% CI: 1.01-1.28; P = 0.043)., Conclusion: The prevalence of clinical consequences of untreated dental caries was low in the present sample and was associated with sociodemographic factors (type of preschool, caregiver's age and number of children in the family) as well as psychological factors (SOC)., (© 2018 FDI World Dental Federation.)

The present study explored the consumption of ultra-processed foods and its association with food addiction in overweight children. The prevalence of food addiction was investigated using the Yale Food Addiction Scale for Children in overweight 9-11 year-old children (BMI/age ≥1 Z score) of both sexes from two schools (n = 139). Food intake was estimated by a food frequency questionnaire and the food items were classified into 4 categories: minimally processed, culinary ingredients, processed foods and ultra-processed foods (UPF), based on their degree of processing. Among the children, 95% showed at least one of the seven symptoms of food addiction and 24% presented with a diagnosis of food addiction. In analysis of covariance adjusted for age and sex, a tendency of higher consumption of added sugar (refined sugar, honey, corn syrup) and UPF was found among those diagnosed with food addiction. Multiple logistic regression adjusted for sugar, sodium and fat ingestion showed that consumption of cookies/biscuits (OR = 4.19, p = 0.015) and sausages (OR = 11.77, p = 0.029) were independently associated with food addiction. The identification of foods that may be associated with addictive behavior is very important for correctly treating and preventing childhood obesity, which continues to be one of the greatest health problems in the world., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Quasicritical exponents of one-dimensional models displaying a quasitransition at finite temperatures are examined in detail. The quasitransition is characterized by intense sharp peaks in physical quantities such as specific heat and magnetic susceptibility, which are reminiscent of divergences accompanying a continuous (second-order) phase transition. The question whether these robust finite peaks follow some power law around the quasicritical temperature is addressed. Although there is no actual divergence of these quantities at a quasicritical temperature, a power-law behavior fits precisely both ascending as well as descending parts of the peaks in the vicinity but not too close to a quasicritical temperature. The specific values of the quasicritical exponents are rigorously calculated for a class of one-dimensional models (e.g., Ising-XYZ diamond chain, coupled spin-electron double-tetrahedral chain, Ising-XXZ two-leg ladder, and Ising-XXZ three-leg tube), whereas the same set of quasicritical exponents implies a certain "universality" of quasitransitions of one-dimensional models. Specifically, the values of the quasicritical exponents for one-dimensional models are: α=α^{'}=3 for the specific heat, γ=γ^{'}=3 for the susceptibility and ν=ν^{'}=1 for the correlation length.

Chagas disease, caused by the protozoan Trypanosoma cruzi, affects millions of people worldwide, especially in Latin America. Approximately 30% of the cases evolve to the chronic symptomatic stage due to cardiac and/or digestive damage, generally accompanied by nervous system impairment. Given the higher frequency and severity of clinical manifestations related to cardiac tissue lesion, the goal of this study was the identification of proteins associated with the disease progression towards its cardiac form. Thus, T. cruzi bloodstream trypomastigotes proteins were submitted to immunoprecipitation using antibodies from patients with the asymptomatic or cardiac (stages B1 and C) forms of the disease and from healthy donors as control. Immunoreactive proteins were identified and quantified based on mass spectrometry analysis and shifts in the recognition profile were further evaluated. Compared to asymptomatic samples, IgG from stage C patients predominantly detected the I/6 autoantigen, whereas IgG from B1 patients resulted in higher yield of dihydrolipoamide acetyltransferase precursor, calpain cysteine peptidase, and two variants of CAP5.5. In this work, CAP5.5 recognition by serum immunoglobulin from patients with early cardiomyopathy generated a 23-fold abundance variation when compared to samples from asymptomatic patients, highlighting the participation of this protein in cardiac form progression of the disease. SIGNIFICANCE: While T. cruzi has become the major cause of infectious cardiomyopathy in Latin America, research groups have been struggling to find alternative treatment, vaccine candidates, and improved diagnostic tests. In addition, the absence of adequate biomarkers to assess cure and progression of disease is a major setback for clinical trials and patients monitoring. Therefore, our findings may contribute to a better understanding of T. cruzi pathogenesis and evaluation of suitable candidates for vaccine and diagnostic tests, besides the clinical applicability of the potential biomarkers for patient follow-up and prognosis. Finally, the identification of T. cruzi proteins recognized by IgG from healthy donors may contribute for the understanding and discovery of epitope conservation among a broad range of pathogens., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Chronic periodontitis (CP) and Diabetes mellitus type 2 (DMII) are chronic diseases usually treated by conventional practices. On the other hand, homeopathy can help to treat many different diseases. The aim of this study was to evaluate the effects of homeopathy (H) as an adjunct for non-surgical periodontal therapy (NSPT) in individuals with DMII and CP. Eighty individuals with CP and DM II, of both sexes and aged between 32 and 70 years, participated in this randomized, double-blind, placebo-controlled study. They were divided into two groups: control group (CG) and the test group (TG), and both groups received the NSPT. TG also received homeopathic therapy, including Berberis, Mercurius solubilis/Belladonna/Hepar sulphur and Pyrogenium, while CG received placebo. Clinical and laboratorial examinations were evaluated at baseline and after 1, 6 and 12 months of treatment. Both groups showed significant improvement throughout the study, for most of the parameters studied, but TG presented significative gain of CAL at 1 and 12 months compared to CG. Mean glucose and glycated hemoglobin significantly decreased in both groups after 6 and 12 months. However, there was a significantly further reduction of these parameters in TG, as compared to CG. In conclusion, homeopathy as supplement of NSPT may further improve health condition, including glycemic control, in DMII patients with CP.

Malocclusion is public health problem because of its high prevalence, treatment possibility, and impact on the individual's quality of life. This article aims to determining the prevalence of malocclusion in adolescents and to test its association with social vulnerability. A representative transversal study was performed with 1612 adolescents aged between 11 and 14 years old who came from public and private schools in Belo Horizonte, Brazil. The adolescents were examined by three calibrated examiners for diagnosis of malocclusion, using the Dental Aesthetic Index. The Social Vulnerability Index from Belo Horizonte was used to determine the degree of social vulnerability from adolescents. The data were analyzed using Poisson regression with robust variance (p<0,05). Most adolescents presented absence/minor malocclusion (68.7%). Dental crowding was diagnosed in 51.9% from the sample, diastema in 23.7%, anterior open bite in 7.6 %. Malocclusion was associated with social vulnerability (PR=1.25;95% CI=1.01-1.55). Dental crowding was the most prevalent type of malocclusion. The more socially vulnerable adolescents had worse indicators of malocclusion.

Background: In utero Zika virus infection resulted in many newborns with congenital defects; this public health issue was followed by unprecedented scientific productivity in this field. Many questions remain about congenital Zika virus infection and its maternal transmission, pathogenesis, clinical events, and the resulting neurological damage. There are few review articles that synthesize the current knowledge of congenital neurological complications as well as the gaps in the pediatric literature., Objective: We review the full range of data on neurological complications in the newborns and infants born to Zika virus-infected women., Methods: A research question (PCC: Population, newborns and infants of infected mothers; Concept, neurological outcomes at birth; Context, congenital Zika virus infection) was created to guide our review in searching several databases: PubMed, Lilacs, CINAHL, Cochrane Library, and OpenGrey literature. A total of 34 articles were included in the final review., Results: Central nervous system calcifications, mainly at the cortical-subcortical junction, were the most prevalent neurological birth defects related to Zika infection (104/112, 92.9% from seven studies). Also, microcephaly occurred in 39.7% of all infected infants (1561/3931 patients in all the studies) and ventriculomegaly and/or hydrocephalus occurred in 63.1% (157/249 patients analyzed in 12 studies). A total of 10 articles detailed ocular findings, including macular lesions, focal pigment mottling of the retina, chorioretinal atrophy, optic nerve abnormalities, cataract, microphthalmia, and strabismus, among others., Conclusions: Neurological and related malformations are common lesions in individuals with congenital Zika syndrome. Long-term follow-up studies in this field are lacking., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Background: Social protection interventions might improve tuberculosis outcomes and could help to control the epidemic in Brazil. The aim of this study was to evaluate the independent effect of the Bolsa Familia Programme (BFP) on tuberculosis treatment outcomes in Brazil., Methods: We prospectively recruited and followed up individuals (aged ≥18 years) who initiated tuberculosis treatment at 42 health-care centres across seven cities in Brazil, between March 1, 2014, and April 30, 2017. Patients were interviewed at health-care centres and information about individual characteristics, socioeconomic status, living conditions, lifestyle, and comorbidities was recorded. Patients were separated into two groups according to BFP beneficiary status: BFP (exposed) or non-BFP (not exposed). Treatment outcome (cure, dropout, death, or development of drug-resistant tuberculosis or treatment failure) was recorded after 6 months of therapy. Pearson's χ 2 test and ANOVA were used to compare tuberculosis treatment outcomes between the two groups, and we estimated the propensity score of being a beneficiary of the BFP using a logit model. We used multinomial regression models to evaluate the effect of the BFP on tuberculosis treatment outcomes., Findings: 1239 individuals were included in the study, of whom 196 (16%) were beneficiaries of the BFP and 1043 (84%) were not. After 6 months of treatment, 912 (87%) of 1043 patients in the non-BFP group and 173 (88%) of 196 patients in the BFP group were cured of tuberculosis, 103 (10%) patients in the non-BFP group and 17 (9%) patients in the BFP group had dropped out, and 25 (3%) patients in the non-BFP group and six (3%) patients in the BFP group had died. Three (<1%) of 1043 patients in the non-BFP group developed drug-resistant tuberculosis. Being a BFP beneficiary had a positive effect for cure (average effect 0·076 [95% CI 0·037 to 0·11]) and a negative effect for dropout (-0·070 [-0·105 to 0·036]) and death (-0·002 [-0·021 to 0·017])., Interpretation: BFP alone had a direct effect on tuberculosis treatment outcome and could greatly contribute to the goals of the WHO End TB Strategy., Funding: Brazilian National Council for Scientific and Technological Development (CNPq) and Brazilian Ministry of Health Department of Science and Technology (DECIT)., (Copyright © 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

Objective: To discuss and reflect on collective health nursing practices, presenting the work-related experience of nurses., Method: This was a reflection paper based on the labor process theory., Results: Studies conducted in research groups, discussions at scientific events, and professional experiences point to the importance of recognizing the intentionality of health work. Furthermore, it is essential t understand the health-illness-care process adopted and advocated by health professionals, and the role of social determinants and the entire historical, political, economic and social context of professional training, healthcare service organization and society., Conclusion: Collective health nursing practices play an important role in the health care provided to the population. Nurses are reference professionals in health care in all stages of life; however, further reflection is required on professional training, politicization, and the concepts of health and illness that guide professional practices.

The risk of dental caries seems to be greater in the presence of developmental defects of enamel (DDE). The aim was to determine whether the presence of DDE in the primary teeth of preschool children increases the risk of dental caries in the primary dentition after a period of approximately 2 years. This study was conducted in two stages: baseline (T0) and follow-up (T1). At T0, examinations were conducted for the diagnosis of enamel defects using the DDE index (FDI, 1992), dental caries, and oral hygiene. The participants were allocated to two groups according to the presence (affected) or absence (unaffected) of DDE. At the second evaluation (T1), examinations were performed for the diagnosis of dental caries. Poisson regression analysis with a multilevel approach was used to determine the association between DDE and dental caries. The two levels of the analysis were tooth and child. Among the 339 children (113 affected and 226 unaffected) examined at baseline (T0), 325 were re-examined at follow-up (T1). According to the multilevel analysis, teeth with enamel hypoplasia had a greater risk of having dental caries (RR: 1.99; 95% CI: 1.19-3.33). The risk of caries was greater on posterior teeth (RR: 2.59; 95% CI: 2.18-3.07) and maxillary teeth (RR: 1.48; 95% CI: 1.26-1.75) that had DDE at T0. On the child level, dental caries at T1 was associated with having dental caries at T0 (RR: 1.38; 95% CI: 1.32-1.46). In conclusion, enamel hypoplasia and previous dental caries are risk factors for carious lesions in the primary dentition., (© 2019 S. Karger AG, Basel.)

Studies have suggested that individuals affected by extrinsic black tooth stains have less dental caries experience in comparison to those without this condition. The aim of the present study was to perform a systematic review and meta-analysis to determine whether there is scientific evidence demonstrating that extrinsic black stains are a protective factor for the occurrence of dental caries. This systematic review was developed in accordance with the PRISMA statement and the research question was determined using the PECO strategy. Electronic searches were conducted in the PubMed, Science Direct, Virtual Health Library, Cochrane, Web of Science, and Google Scholar databases for relevant articles published up to September 2018. All articles included were submitted to an appraisal of methodological quality using the Newcastle-Ottawa Scale and the data were extracted for meta-analysis. The search strategy resulted in the retrieval of 9,108 publications. After the application of the eligibility criteria, 18 articles were selected for analysis, 13 of which were included in the meta-analysis. The meta-analysis demonstrated that individuals with extrinsic black stains involving primary (median, MD: -0.78 [-1.09; -0.48]; I2 = 44%) and permanent (MD: -0.50 [-0.93; -0.08]; I2 = 86%) teeth have a lower dental caries experience in comparison to those without this condition. Patients with extrinsic black tooth stains have a lower dental caries experience in cross-sectional studies., (© 2019 S. Karger AG, Basel.)

The data presented herein is related to the article entitled " Trypanosoma cruzi immunoproteome: calpain-like CAP5.5 differentially detected throughout distinct stages of human Chagas disease cardiomyopathy" [1]. Electrophoretic analyses under denaturing and reducing conditions indicate that covalent immobilization of human IgG to Protein G magnetic beads by cross-linking with 50 mM dimethyl pimelimidate hinders the recognition of T. cruzi antigens in immunoprecipitation assays.

Objectives: To investigate whether oral health literacy (OHL) impacts missing data obtained through self-reporting in oral health epidemiological research., Methods: A cross-sectional study was conducted with parents (n = 344) of 4- to 5-year-old children randomly selected from public schools within the city of Curitiba, Brazil. Parental OHL was measured using the Brazilian version of the Rapid Estimate of Adult Literacy in Dentistry (BREALD-30). Parents answered a set of questionnaires comprising 88 items concerning sociodemographic and economic data, children's access to dental services, oral hygiene behaviour, diet and mealtime behaviour. The total number of unanswered items (TUI) and the number of unanswered items in each type of question (open-ended, dichotomous, multiple choice with up to 4 options and with 5-9 options) for each participant was compared across different levels of OHL (chi-squared, Mann-Whitney, Kruskal-Wallis and Spearman's correlation test). Multiple Poisson regression was used to estimate rate ratios (RR) of TUI between OHL scores and their respective 95% confidence interval (95% CI)., Results: Approximately one-third of studied parents (37%) exhibited low OHL (BREALD-30 ≤ 21). The prevalence of missing data in at least one item was 85.5%. Low OHL was associated with failing to respond open-ended items (P = 0.003) and multiple-choice items with up to 4 (P = 0.003) and between 5 and 9 options (P = 0.030). There was a negative correlation between OHL scores and TUI (r = -0.195; P < 0.001), as well as with the number of unanswered items in all types of questions (P < 0.01), except dichotomous questions. Parents with lower OHL were more likely to show higher values of TUI (RR 0.95: 0.93-0.98), when adjusted by income and education., Conclusions: Participants with lower OHL were significantly more likely to fail to complete research questionnaires. The impact of OHL on missing data was greater with more complex types of items., (© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

We compared in vitro antimicrobial activity of four vancomycin formulations used clinically against clinical isolates of Staphylococcus aureus, including methicillin-resistant and -susceptible (MRSA and MSSA, respectively), using different susceptibility assays. The minimal inhibitory concentrations (MICs) against MRSA clinical isolates were significantly different for some vancomycin formulations by the broth microdilution and agar dilution methods. However, these variations would not compromise their clinical use, since the MICs were within the range recommended by the Clinical and Laboratory Standards Institute. Furthermore, 26.9% of MRSA clinical isolates showed a vancomycin MIC ≥1.5 μg/mL according to the Etest® method but none by broth microdilution. Regarding quality, all formulations were in accordance with United States Pharmacopeia criteria. Our results showed that all vancomycin formulations tested showed similar in vitro antimicrobial activity, making them suitable for clinical use, and that the evaluation method chosen to determine sensitivity to this antimicrobial should be carefully performed, particularly for MRSA., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Renal cell carcinoma (RCC) accounts for 2-3% of all malignant disease in adults. Hereditary RCC represents 5 to 8% of kidney tumors. Hereditary leiomyomatosis and renal cell carcinoma (HLRCC) represents an autosomal dominant syndrome that results from a germline mutation in fumarate hydratase gene (FH). HLRCC patients typically present with skin or uterine leiomyomas and renal neoplasms. HLRCC was recently recognized as a distinct renal tumor subtype by the WHO 2016 classification. Many morphological patterns such as papillary, solid, tubular, and cystic had been described as part of morphological aspects of HLRCC. In this study, we describe a case of a patient that had a history of persistence of ductus arteriosus (PDA) and cryptorchidism. In addition, the renal tumor showed a very unusual hystiocytoid morphological aspect. We confirmed the presence of a FH germline mutation both in the patient and his mother.