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Os sistemas de preparo afetam a estrutura do solo e podem influenciar o armazenamento de água disponível para as plantas. O objetivo deste estudo foi avaliar o efeito de longo prazo (17 anos) dos sistemas de preparo convencional (PC), preparo reduzido (PR) e semeadura direta (SD) sobre os atributos físicos relacionados ao armazenamento e disponibilidade de água de um Argissolo Vermelho com textura média, em Eldorado do Sul, RS. Amostras de solo (0-2,5, 2,5-7,5, 7,5-12,5, 12,5-17,5cm) foram coletadas numa seqüência ervilhaca/milho. Adicionalmente, amostrou-se uma área sob campo nativo (CN), adjacente à área experimental, como referência à condição natural do solo. O solo em SD apresentou maiores teores de carbono orgânico (CO) na camada superficial e maiores valores de resistência ao penetrômetro em profundidade, em relação ao solo em preparo convencional. Os sistemas de preparo não se diferenciaram quanto ao seu efeito na macro e microporosidade do solo, contudo o revolvimento no PC aumentou a condutividade hidráulica saturada em profundidade. Não se verificou nenhuma restrição física ao desenvolvimento radicular sob os diferentes sistemas de preparo, o que foi comprovado pelos valores de densidade (1,35 a 1,65 Mg m-3), macroporosidade (0,09 a 0,20 m³ m-3) e resistência ao penetrômetro (0,25 a 0,75 MPa). Do ponto de vista hídrico, as curvas de retenção e o volume de água disponível (AD = 10 kPa (capacidade de campo) - 1.500 kPa (ponto de murcha permanente)), não foram influenciados pelos sistemas de preparo, sendo o baixo volume de água disponível (0,05 a 0,09 m³ m-3) relacionado à textura desse solo. Nesse caso, o aumento da taxa de infiltração e a diminuição da evaporação da água decorrente da manutenção dos resíduos vegetais sobre o solo nos sistemas de preparo reduzido e semeadura direta, podem contribuir para uma maior disponibilidade hídrica na fase inicial do estabelecimento das culturas nesses sistemas conservacionistas de manejo em comparação ao preparo convencional.

O aumento do estoque de matéria orgânica do solo em sistemas conservacionistas de manejo é dependente do tipo de solo e das condições climáticas, e tem reflexos na qualidade física do solo. Neste estudo, avaliou-se um experimento de longa duração (21 anos) quanto ao efeito do sistema plantio direto (PD) sobre os estoques de carbono orgânico total (COT) e particulado (COP, >53mm), bem como a sua relação com a estabilidade de agregados de um Latossolo Bruno, em Guarapuava, PR. O solo em PD apresentou taxa de incremento de 0,15Mg ha-1 ano-1 de COT e 0,06Mg ha-1 ano-1 de COP na camada de 0-20cm, as quais foram calculadas em comparação aos estoques de carbono orgânico do solo em preparo convencional. As baixas taxas de incremento nos estoques de carbono orgânico possivelmente estejam relacionadas à alta estabilidade física da matéria orgânica neste solo argiloso e com mineralogia predominantemente gibsítica. O diâmetro médio geométrico (DMG) dos agregados de solo variou de 1,6 a 3,7mm e foi positiva e linearmente relacionado com os teores de COT e COP, o que reforça a importância da matéria orgânica na qualidade física de Latossolos subtropicais.

Background/objectives: Although the health benefits related to physical exercise for adolescents with cerebral palsy (CP) have been recognized, studies indicate that individuals with CP at school age are less involved in physical activities than their typical peers and are twice as likely to engage in sedentary behaviors. Therefore, our study aims to investigate the effects of a physical exercise program on physical fitness, stress, anxiety, and quality-of-life variables., Methods: A total of 15 teenagers with ambulatory CP ( n = 8 boys, n = 7 girls, between 12 and 18 years old; M = 14.35; SD = 1.76) completed a 12-week program based on a mixed-method approach with face-to-face and live online activities. The outcome measures were physical fitness, stress, anxiety, and quality of life., Results: The 12-week exercise program resulted in gains in muscular strength, flexibility, and aerobic endurance tests, characterized by an increase in average walking speed and average VO 2 max. There was also a significant change in the perception of emotional states of depression, anxiety, and stress reported by the participants., Conclusions: The program proved to be effective in physical fitness tests and perception of emotional states. Given the positive effects produced by the program, its design appears to meet the demands of adolescents with cerebral palsy.

Background: Nuts consumption is related to cardioprotective effects on primary cardiovascular prevention, but studies conducted in secondary prevention are small, scarce and controversial. The objective of this trial was to evaluate the effects of a regional and sustainable cardioprotective diet added or not with an affordable mixed nuts on cardiometabolic features in patients with previous myocardial infarction., Methods: DICA-NUTS study is a national, multi-center, and superiority-parallel randomized clinical trial. Males and females over 40 years old diagnosed with previous myocardial infarction in the last 2 to 6 months were included. Patients were allocated into two groups: the Brazilian Cardioprotective diet (DICA Br) supplemented with 30 g/day of mixed nuts (10 g of peanuts; 10 g of cashew; 10 g of Brazil nuts) (intervention group, n = 193); or only DICA Br prescription (control group, n = 195). The primary outcome was low-density lipoprotein cholesterol means (in mg/dL) after 16 weeks. Secondary outcomes were other lipid biomarkers, glycemic and anthropometric data and diet quality., Results: After adjustment for baseline values, participating study site, time since myocardial infarction and statin treatment regimen (high potency, moderate and low potency/no statins), no significant difference was found between the groups in low-density lipoprotein cholesterol concentrations (intervention-control difference: 3.48 mg/dL [-3.45 to 10.41], P = 0.32). Both groups improved their overall diet quality at the end of the study without differences between them after 16 weeks (intervention-control difference: 1.05 (-0.9 to 2.99); P = 0.29). Other lipids, glycemic profile and anthropometrics were also not different between study groups at the end of the study., Conclusion: Adding 30 g/day of mixed nuts to the DICA Br for 16 weeks did not change lipid, glycemic and anthropometric features in the post-myocardial infarction setting., Trial Registration: This study is registered on ClinicalTrials.gov website under number NCT03728127 and its World Health Organization Universal Trial Number (WHO-UTN) is U1111-1259-8105., (© 2024. The Author(s).)

Pre-exposure prophylaxis (PrEP) is an effective HIV prevention strategy that consists in the use of antiretroviral drugs by seronegative people at risk of HIV. Negative perceptions, inadequate understanding, and access barriers have been associated with decreased medication adherence. Manaus is the largest city in the Brazilian Amazon, where the incidence of HIV/AIDS is high, and the rates of adherence to the antiretroviral treatment for HIV and PrEP are low. In this qualitative study among PrEP users, mostly MSM, we explored perceptions, knowledge, and access barriers. We conducted 21 in-depth interviews with an intentionally sampled group of participants who had used PrEP at least once in their lifetime, selected through the snowball technique, between April and July 2022. A thematic analysis was conducted with a predominantly inductive approach. We highlight three relevant themes: (i) access to information about PrEP and its influences on users, (ii) access, monitoring, and barriers encountered, and (iii) facilitators for PrEP adherence and sexual behaviors. One of the negative perceptions identified in the study involves a misunderstanding of the association between PrEP users and the HIV/AIDS status. Participants revealed that some non-PrEP users suspect that individuals claiming PrEP usage are concealing an HIV-positive status to engage in unprotected sex. Lack of information by health professionals regarding HIV prevention methods poses significant barriers to PrEP access and adherence. Participants emphasized social media's crucial role in PrEP awareness. The results suggest a need to increase digital outreach regarding PrEP, decentralize PrEP services, and provide comprehensive healthcare training to improve the effectiveness of the preventive measure., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Batista et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

The presence of anthropogenic compounds, including organochlorine pesticides (OCPs) and polychlorinated biphenyls (PCBs), was studied in three salt marshes within the Tagus estuary, Portugal, along an anthropogenic pressure gradient. Results revealed differences in OCPs and PCBs among the marshes, with differing concentration levels. Specifically, one marsh, with surrounding agricultural activity, showed the highest OCP concentrations, while another, with a historical industrial past, exhibited elevated PCB levels. In contrast, a third marsh, part of a natural reserve, displayed comparatively lower concentrations of both substances. Sediment concentrations, likely influenced by agricultural practices, were found to be comparable to or higher than those observed in other Portuguese estuaries. The halophyte Spartina maritima was found to absorb OCPs, particularly in its aboveground tissues, suggesting bioaccumulation within the plant. Additionally, PCB levels appeared to be influenced by industrial history, with one marsh displaying notably higher concentrations. In conclusion, the persistence of organochlorine compounds in the salt marsh ecosystems notwithstanding the regulatory prohibitions implemented in the 1990s highlights the need for continuous monitoring and study of such sites and the necessity of remediation practices, which are imperative to mitigate ecological and health risks in these polluted salt marshes.

Background: Heart failure (HF), a common cause of hospitalization, is associated with poor short-term clinical outcomes. Little is known about the long-term prognoses of patients with HF in Latin America., Methods: BREATHE was the first nationwide prospective observational study in Brazil that included patients hospitalized due to acute heart failure (HF). Patients were included during 2 time periods: February 2011-December 2012 and June 2016-July 2018 In-hospital management, 12-month clinical outcomes and adherence to evidence-based therapies were evaluated., Results: A total of 3013 patients were enrolled at 71 centers in Brazil. At hospital admission, 83.8% had clear signs of pulmonary congestion. The main cause of decompensation was poor adherence to HF medications (27.8%). Among patients with reduced ejection fraction, concomitant use of beta-blockers, renin-angiotensin-aldosterone inhibitors and spironolactone decreased from 44.5% at hospital discharge to 35.2% at 3 months. The cumulative incidence of mortality at 12 months was 27.7%, with 24.3% readmission at 90 days and 44.4% at 12 months., Conclusions: In this large national prospective registry of patients hospitalized with acute HF, rates of mortality and readmission were higher than those reported globally. Poor adherence to evidence-based therapies was common at hospital discharge and at 12 months of follow-up., (Copyright © 2023 Elsevier Inc. All rights reserved.)

There is limited contemporary prospective real-world evidence of patients with chronic arterial disease in Latin America. The Network to control atherothrombosis (NEAT) registry is a national prospective observational study of patients with known coronary (CAD) and/or peripheral arterial disease (PAD) in Brazil. A total of 2,005 patients were enrolled among 25 sites from September 2020 to March 2022. Patient characteristics, medications and laboratorial data were collected. Primary objective was to assess the proportion of patients who, at the initial visit, were in accordance with good medical practices (domains) for reducing cardiovascular risk in atherothrombotic disease. From the total of patients enrolled, 2 were excluded since they did not meet eligibility criteria. Among the 2,003 subjects included in the analysis, 55.6% had isolated CAD, 28.7% exclusive PAD and 15.7% had both diagnoses. Overall mean age was 66.3 (± 10.5) years and 65.7% were male patients. Regarding evidence-based therapies (EBTs), 4% were not using any antithrombotic drug and only 1.5% were using vascular dose of rivaroxaban (2.5 mg bid). Only 0.3% of the patients satisfied all the domains of secondary prevention, including prescription of EBTs and targets of body-mass index, blood pressure, LDL-cholesterol, and adherence of lifestyle recommendations. The main barrier for prescription of EBTs was medical judgement. Our findings highlight that the contemporary practice does not reflect a comprehensive approach for secondary prevention and had very low incorporation of new therapies in Brazil. Large-scale populational interventions addressing these gaps are warranted to improve the use of evidence-based therapies and reduce the burden of atherothrombotic disease.ClinicalTrials.gov NCT04677725., (© 2024. The Author(s).)

Objective: This in vivo study, aimed to biomechanically, histomorphometrically and histologically evaluate an implant surface coated with nanostructured hydroxyapatite using the wet chemical process (biomimetic deposition of calcium phosphate coating) when compared to a dual acid-etching surface., Material and Methods: Ten sheep (2-4 years old) received 20 implants, 10 with nanostructured hydroxyapatite coating (HAnano), and 10 with dual acid-etching surface (DAA). The surfaces were characterized with scanning electron microscopy and energy dispersive spectroscopy; insertion torque values and resonance frequency analysis were measured to evaluate the primary stability of the implants. Bone-implant contact (BIC) and bone area fraction occupancy (BAFo) were evaluated 14 and 28 days after implant installation., Results: The HAnano and DAA groups showed no significant difference in insertion torque and resonance frequency analysis. The BIC and BAFo values increased significantly (p<0.05) over the experimental periods in both groups. This event was also observed in BIC value of HAnano group. The HAnano surface showed superior results compared to DAA after 28 days (BAFo, p = 0.007; BIC, p = 0.01)., Conclusion: The results suggest that the HAnano surface favors bone formation when compared to the DAA surface after 28 days in low-density bone in sheep., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Almeida et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Geographic Tongue (GT) is a benign inflammatory disorder of unknown etiology, which is characterized by the loss of epithelium due to the atrophy of filiform papillae. It usually occurs on the dorsum of the tongue and may extend to its lateral edges. It appears as an erythematous area surrounded by whitish and slightly elevated margins. In most cases, the condition is asymptomatic, although some individuals may report symptoms that include a burning sensation of the tongue., Objective: Assess whether there was a change in the clinical aspect of Geographic Tongue (GT) during the COVID-19 pandemic., Methods: Thirty-two participants were recruited from Dentistry School Universidade Federal Fluminense. Anamnesis and oral examination were performed to collect medical history. The participants were split into two groups: control group (no GT) n = 20 and test group (with GT) n = 12. In the second step, nine participants from a 12 (75%) of the test group were contacted by phone and answered a questionnaire about changes in the signs and symptoms of GT during the pandemic. The subjects were subdivided into two groups: GT with and without signs and symptoms exacerbation., Results: In the first phase of the research, no statistical difference between control and test groups was observed regarding clinical criteria such as age (p + 0.72), gender (p = 0.24), and systemic diseases (p = 0.58). In the second phase, there was a statistical difference between GT groups with or without symptom exacerbation in terms of age and stress as a factor of the oral symptoms (p = 0.3 and 0.2), respectively. Younger patients showed a worsening of the oral lesions related to GT (p = 0.3) and reported stress during the pandemic (p = 0.02)., Conclusion: Younger patients were more susceptible to stress and presented more exacerbation of the oral lesions related to GT., (© 2022. The Author(s).)

Background: The degree of biodegradation and the inflammatory response of membranes employed for guided bone regeneration directly impact the outcome of this technique. This study aimed to evaluate four different experimental versions of Poly (L-lactate-co-Trimethylene Carbonate) (PTMC) + Poly (L-lactate-co-glycolate) (PLGA) membranes, implanted in mouse subcutaneous tissue, compared to a commercially available membrane and a Sham group., Methods: Sixty Balb-C mice were randomly divided into six experimental groups and subdivided into 1, 3, 6 and 12 weeks (n = 5 groups/period). The membranes (1 cm 2 ) were implanted in the subcutaneous back tissue of the animals. The samples were obtained for descriptive and semiquantitative histological evaluation (ISO 10993-6)., Results: G1 and G4 allowed tissue adhesion and the permeation of inflammatory cells over time and showed greater phagocytic activity and permeability. G2 and G3 detached from the tissue in one and three weeks; however, in the more extended periods, they presented a rectilinear and homogeneous aspect and were not absorbed. G2 had a major inflammatory reaction. G5 was almost completely absorbed after 12 weeks., Conclusions: The membranes are considered biocompatible. G5 showed a higher degree of biosorption, followed by G1 and G4. G2 and G3 are considered non-absorbable in the studied periods.

Background: Temporomandibular disorders (TMD) are a group of painful and debilitating disorders, involving the masticatory muscles and/or the temporomandibular joint (TMJ). Chronic TMD pain can be associated with genetic changes in the key muscle development genes., Objective: To evaluate the association between polymorphisms in the PAX7 (paired box 7) gene and masticatory myalgia in patients with temporomandibular disorders (TMD)., Materials and Methods: This is a case-control study. Patients with TMD were divided into two groups: (a) presence of muscular TMD (n = 122) and (b) absence of muscular TMD (n = 49). Genomic DNA was obtained from saliva samples from all participants to allow for genotyping single nucleotide polymorphisms in PAX7 (rs766325 and rs6659735). Over-representation of alleles was tested using chi-square or Fisher's exact tests. Values of p < 0.05 were considered to be statistically significant., Results: Individuals without muscular TMD were less likely to have the PAX7 rs6659735 GG genotype (p = 0.03). No associations were found for PAX7 rs766325., Conclusions: Alterations in PAX7 may influence muscular pathophysiology and individuals with TMD and the rs6659735 homozygous genotype (GG) are seemingly associated with muscular involvement of the disorder. No associations were found in the region rs766325., (© 2021. The Author(s).)

Background: Nut consumption has been related to improvements on cardiometabolic parameters and reduction in the severity of atherosclerosis mainly in primary cardiovascular prevention. The objective of this trial is to evaluate the effects of the Brazilian Cardioprotective Diet (DIeta CArdioprotetora Brasileira, DICA Br) based on consumption of inexpensive locally accessible foods supplemented or not with mixed nuts on cardiometabolic features in patients with previous myocardial infarction (MI)., Methods: DICA-NUTS study is a national, multicenter, randomized 16-week follow-up clinical trial. Patients over 40 years old with diagnosis of previous MI in the last 2 to 6 months will be recruited (n = 388). A standardized questionnaire will be applied to data collection and blood samples will be obtained. Patients will be allocated in two groups: Group 1: DICA Br supplemented with 30 g/day of mixed nuts (10 g of peanuts, 10 g of cashew, 10 g of Brazil nuts); and Group 2: only DICA Br. The primary outcome will consist of LDL cholesterol means (in mg/dL) after 16 weeks of intervention. Secondary outcomes will consist of other markers of lipid profile, glycemic profile, and anthropometric data., Discussion: It is expected that DICA Br supplemented with mixed nuts have superior beneficial effects on cardiometabolic parameters in patients after a MI, when compared to DICA Br., Trial Registration: ClinicalTrials.gov Identifier NCT03728127 . First register: November 1, 2018; Last update: June 16, 2021. World Health Organization Universal Trial Number (WHO-UTN): U1111-1259-8105., (© 2021. The Author(s).)

Antimicrobial-resistant bacteria were isolated from muscoid dipterans collected at five different areas of Rio de Janeiro city, in proximity to hospitals. Extracts obtained by maceration of flies were diluted and used as inocula for different culture media, with or without antibiotic (ceftriaxone 1 mg/L) supplementation. Purified isolates were submitted to antimicrobial susceptibility testing (AST). Bacterial identification was performed by MALDI TOF Microflex LT (Bruker Daltonics). A total of 197 bacterial strains were obtained from 117 dipterous muscoids. Forty-two flies (35.9%) carried bacteria resistant to at least one antimicrobial, while 7 insects (5.9%) carried multidrug-resistant bacteria (MDR), which were all members of the family Enterobacteriaceae. Among 10 MDR bacteria (5%), 5 strains (2,5%) were positive by PCR for one or more of the following antibiotic resistance genes: aac(6')-Ib, bla TEM-1 , bla CTX-M-15 , bla KPC-2 and bla NDM-1 . Analysis of variance (ANOVA) and cluster analysis compared the number of resistant isolates per collection point and showed that a single location was statistically different from the others with regard to resistance. Although there are still no criteria to determine the environmental contamination by resistant bacteria the fact that they have been isolated from flies is an indication of a disseminated contamination. As such, these insects may be useful in monitoring programs of antibiotic resistance in non-hospital environments, where they could function as sentinels., (Copyright © 2021. Published by Elsevier B.V.)

Primary implant stability is a prerequisite for successful implant osseointegration. The osseodensification technique (OD) is a non-subtractive drilling technique that preserves the bone tissue, increases osteotomy wall density, and improves the primary stability. This study aimed to investigate the hypothesis that OD, through a wider osteotomy, produces healing chambers (HCs) at the implant-bone interface without impacting low-density bone primary stability. Twenty implants (3.5 × 10 mm) with a nanohydroxyapatite (nHA) surface were inserted in the ilium of ten sheep. Implant beds were prepared as follows: (i) 2.7-mm-wide using subtractive conventional drilling (SCD) technique (n = 10); (ii) 3.8-mm-wide using an OD bur system (n = 10). The sheep were randomized to two groups, with samples collected at either 14-(n = 5) or 28-days (n = 5) post-surgery and processed for histological and histomorphometric evaluation of bone-implant contact (BIC) and bone area fraction occupancy (BAFO). No significant group differences were found with respect to final insertion torque and implant stability quotient (p > 0.050). BIC values were higher for SCD after 14 and 28 days (p < 0.050); however, BAFO values were similar (p > 0.050). It was possible to conclude that the OD technique allowed a wider implant bed preparation without prejudice on primary stability and bone remodeling., (© 2021. The Author(s).)

Hepatitis C is considered a major public health problem caused by the hepatitis C virus (HCV). Viral infections are known to induce production of IL1β through the signaling pathway of inflammasomes. Emerging evidences suggest that Inflammasome genes may influence the immune response against HCV as the host genetic background may contribute to the balance between acute and chronic inflammation. We investigated in 151 patients with chronic hepatitis C and 206 healthy blood donors' individuals (HD). Polymorphisms in the IL1B and IL18 genes were genotyped by PCR-RFLP, while NLRP3, CARD8, CTSB and AIM2 by RT- PCR. Serum assay of IL-1β cytokine was performed by ELISA. 84 patients presented mild fibrosis (

Background: Diabetes mellitus (DM) is associated with a higher prevalence of metabolic syndrome (MS) and cardiovascular mortality. However, few Brazilian studies evaluated MS in diabetic individuals with cardiovascular disease (CVD). Nevertheless, the objective of this study was to compare the prevalence of MS in cardiac patients with and without DM. Methods: Cross-sectional study of BALANCE Program Trial with patients with CVD, ≥45 years old, who had been attending specialized ambulatories on cardiovascular health, in eight states in the Northeast of Brazil. The components of MS were evaluated by following the criteria of National Cholesterol Education Program's Adult Treatment Panel III (NCEP ATP III) and Joint Interim Statement (JIS). In addition, there were investigated different indexes of abdominal obesity, variables related to lifestyle, and food intake. The statistical analysis included descriptive statistics and the Student's t -test, Mann-Whitney, and chi-squared tests for the comparison of groups. There were significant values of P  < 0.05. Results: Six hundred forty-seven individuals were evaluated with average (standard deviation) age of 63.1 (9.3) years, being 50.5% females and 40.3% diabetic patients. When the groups of patients who were diabetic and the nondiabetic ones, the first showed higher percentage of obesity (38.5% vs. 23.2%, P  < 0.001), of high waist circumference (84.8% vs. 71.9%; P  < 0.001), higher waist-height ratio [0.6 (0.6-0.7) vs. 0.6 (0.5-0.6); P  < 0.001], conicity index [1.35 (1.29-1.39) vs. 1.32 (1.27-1.38); P  = 0.004], and prevalence of MS, because of the criteria of NCEP ATP III (98.8% vs. 80.4%; P  < 0.001), as well as the criteria of JIS (99.2% vs. 89.3%; P  < 0.001). The component of higher frequency was high blood pressure and/or hypertension (95.0%), followed by hypertriglyceridemia (93.0%). There were no differences regarding age, lifestyle, and food intake. Conclusions: Diabetic individuals with CVD showed more prevalence of MS and more abdominal obesity than nondiabetic individuals. ClinicalTrials.gov ID: NCT01620398.

The novel coronavirus disease (COVID-19) has infected millions of people worldwide and generated many sequels in the survivors, such as muscular pain and fatigue. These symptoms have been treated through pharmacological approaches; however, infected people keep presenting physical limitations. Besides, the COVID-19 damage to the central nervous system has also been related to the presence of some physical impairment, so strategies that focus on diverse brain areas should be encouraged. Transcranial Direct Current Stimulation (tDCS) is a non-pharmacological tool that could be associated with pharmacological treatments to improve the central nervous system function and decrease the exacerbation of the immune system response. tDCS targeting pain and fatigue-related areas could provide an increase in neuroplasticity and enhancements in physical functions. Moreover, it can be used in infirmaries and clinical centers to treat COVID-19 patients.

Background: Although several therapies are proposed for medication-related osteonecrosis of the jaw (MRONJ), to date there is no consensus or treatment protocol for MRONJ. This overview aims to summarize the available evidence on the management and outcomes of MRONJ., Methods: An electronic search without language or date restrictions occurred in five databases and gray literature for articles published until March 2020. This overview was performed according to the PICO format. The eligibility criteria comprised systematic reviews (RS) with or without meta-analyses that analyzed treatments outcomes for MRONJ. The methodological quality of each SR was evaluated using AMSTAR 2., Results: Fifteen studies published between 2014 and 2020 were included in this overview. The summary of the evidence showed that conservative treatment and low level laser therapy can yield favorable results for early stages of MRONJ whereas surgical treatment seems to be better for advanced stages. However, qualitative assessment of the SRs highlighted a global low level of quality., Conclusions: There is weak evidence to support treatment protocols for MRONJ. Because of the low quality of the SRs, highlighted by this overview, no insightful therapeutic recommendations can be issued for any intervention for MRONJ., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background/objective: Craniofacial discrepancies have been associated with congenital dental anomalies. The aim of this study was to determine if there is any scientific evidence in the literature regarding the association between dental agenesis and craniofacial morphology., Materials and Methods: A systematic review and meta-analysis following the PRISMA Statement were conducted and registered in PROSPERO database. A broad search was conducted on databases (PubMed, Virtual Health Library, Web of Science, and Scopus) and grey literature. Articles that were selected based on predetermined eligibility criteria were assessed for quality and risk of bias according to the guidelines described by Folkes and Fulton. Those articles with similarities were submitted to meta-analysis using the RevMan 5.3 program. The certainty of the evidence was tested using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation)., Results: An electronic search of 975 articles resulted in 12 articles. These and four articles identified through manual search were eligible to be assessed for methodological quality and the risk of bias. Eleven articles presented moderate to high methodological quality. The included articles observed a reduced mandibular plane, a smaller maxilla and more differences with the increase in the severity of dental agenesis. Seven articles were included in the meta-analyses. Dental agenesis presented smaller SNA angle (P < 0.0001/CI -1.74 [-2.55, -0.92]) with moderate certainty of the evidence; and smaller ANB angle (P = 0.01/CI -0.80 [-1.44, -0.17]), with low certainty of the evidence., Conclusions: This systematic review and meta-analysis demonstrated that dental agenesis may be associated with specific craniofacial morphology. Further studies are necessary due to the variation of the certainty of the evidence., Conflict of Interest: none declared., Registration: PROSPERO (CRD42017055882)., (© The Author(s) 2019. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Background and Objectives: There is still considerable controversy regarding the possibility of submitting replanted teeth to orthodontic movement (OM). The purpose of the present study was to evaluate the tissue response after orthodontic movement on replanted teeth. Materials and Methods: Sixty Wistar rats were randomly assigned to four groups ( n = 15): G1, replantation without OM after 30 days; G2, replantation with OM after 30 days; G3, replantation without OM after 60 days, and G4, replantation with OM after 60 days. The maxillary left central incisors were extracted and the teeth were stored in milk media. After 30 min, the teeth were replanted and fixed with non-rigid immobilization. All specimens were observed after 30 and 60 days of replantation and then subdivided into two subgroups (with OM or without OM). The animals were euthanized after seven days of the OM started, and the maxillary bone blocks were processed for histological evaluation. Results: The histological results showed periodontal ligament repair in both periods studied without OM; however, ankylosis and root resorption was seen in all orthodontically moved teeth. Conclusions: The orthodontic movement did not favor tissue response in all replanted teeth, regardless of the experimental periods.

Objective  To investigate the accuracy of the applied kinesiology muscle strength test for sacroiliac dysfunction and compared it with four validated orthopedic tests. Methods  This is a cross-sectional accuracy survey developed at a private practice in the city of Manaus, Brazil, during February 2017. The sample consisted of 20 individuals, with a median age of 33.5 years. Four tests were applied: distraction, thigh thrust, compression and sacral thrust, and the diagnosis was confirmed when three of these tests were positive. Soon after, the applied kinesiology test was applied to the piriformis muscle. Results  The prevalence of sacroiliac joint dysfunction was of 45%; the thigh thrust test had the highest specificity, and the sacral thrust test had the highest sensitivity. The applied kinesiology test presented good results (sensitivity: 0.89; specificity: 0.82; positive predictive value: 0.80; negative predictive value: 0.82; accuracy: 0.85; and area under the receiver operating characteristic [ROC] curve: 0.85). Conclusion  The applied kinesiology muscle strength test, which has great clinical feasibility, showed good accuracy in diagnosing sacroiliac joint dysfunction and greater discriminatory power for the existing dysfunction in comparison to other tests., Competing Interests: Conflito de Interesses Os autores declaram não haver conflito de interesses.

The therapeutic strategies used in the treatment of hepatitis C are essentially based on the combination of direct-acting antiviral agents (DAAs). This therapy has been shown to be very effective in relation to patient adherence to treatment and has shown high rates of sustained virological response (SVR). However, the immunological dynamics of patients infected with HCV is poorly understood. This fact led us to investigate the immune system of naive and experienced patients, who we followed before the therapy and three months after the end of treatment. In this study, 35 naive and experienced Brazilian patients with chronic hepatitis C and 50 healthy donors (HD group) were studied. The analysis of the soluble immunological biomarkers was performed using the flow cytometry methodology. The SVR rate was >90% among the 35 patients. Before treatment, correlations in the naive HCV group demonstrated a mix of inflammatory response occurring with moderate correlations between chemokines, inflammatory cytokines, and Th2 profile, with a strong regulation between IL-10 and IL-17A. On the other hand, experienced patients demonstrated a poor interaction between cytokines, chemokines, and cells with a strong correlation between IL-10, IL-6, CXCL-10, and CD8 + besides the interactions between IFN- γ and IL-4. Furthermore, naive and experienced patients seem to have a distinct soluble biomarker profile; therefore, a long-term follow-up is needed to evaluate patients treated with DAAs., Competing Interests: The authors declare that there is no conflict of interests regarding the publication of this paper., (Copyright © 2019 Grenda Leite Pereira et al.)

A 45-year-old man presented with a 10-year history of relapsing oedema of the lips. Moreover, he exhibited recurrent facial nerve palsy since the age of 10 years, coeliac disease since the age of 12 years, atopic eczema, allergic rhinitis and asthma. Physical examination revealed lip swelling and lingua plicata. Thus, he presented the classic triad of Melkersson-Rosenthal syndrome which includes recurrent orofacial oedema, facial nerve palsy and fissured tongue. A lip biopsy confirmed our clinical diagnosis.This case is particularly rare, as the classic triad is seen only in a minority of the cases. Moreover, allergic and coeliac diseases were observed concomitantly. This paper illustrates a potential pathophysiological interconnection between these pathologies in which interferon gamma could play a key role. To our knowledge, this is the first case report in which Melkersson-Rosenthal syndrome has been observed concurrently with coeliac disease., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Cardiovascular diseases are leading causes of death worldwide. Recent studies suggest that infection by some viruses, including the human papillomavirus (HPV), may increase the risk of developing atheromatous lesions on coronary arteries. However, there is a lack of data regarding the possible association between HPV infection and coronary artery disease (CAD) in women., Objective: To investigate whether HPV infection is associated with the occurrence of CAD among climacteric women., Methods: The presence of CAD and cervical HPV DNA was investigated in 52 climacteric women. Social and demographic variables and metabolic profiles were also investigated., Results: Among 27 women with CAD, 16 were positive for HPV, whereas 11 were negative. The presence of cervical HPV was strongly associated with CAD, after adjusting for demographic variables, health and sexual behaviors, comorbidities, and known cardiovascular risk factors. HPV-positive women showed a greater likelihood of having CAD (odds ratio [OR] = 3.74; 95% confidence interval [CI]: 1.16 to 11.96) as compared with HPV-negative women, particularly those infected with high-risk HPV types (OR = 4.90; 95% CI: 1.26 to 19.08)., Conclusion: These results support the hypothesis that HPV infection might be associated with CAD among climacteric women, though further studies are needed to investigate the mechanisms involved.

Bone development and growth is a non-going, life-long process, varying greatly among individuals and much of this variation could be modulated by genetic factors. The purpose of this study was to evaluate the association between the polymorphisms in the TNF-a gene and skeletal class II malocclusion. Single nucleotide polymorphisms in TNF-a (rs1799724; rs1800629) gene were studied in 79 skeletal class II malocclusion and 102 skeletal class I malocclusion subjects from Straight Wire Group of Studies on Orthodontics and Functional Orthopedics for Maxillary from Rio de Janeiro, Brazil. The Genotyping of these selected polymorphisms was carried out by TaqMan real-time PCR using genomic DNA extracted from buccal cells. All allele and genotype frequencies were compared between the groups using the PLINK® software in a free, in a dominant and in a recessive model using a chi-square test (p≤0.05). There was no significant association of TNF-a (rs1799724; rs1800629) genotype and allele distribution with skeletal class II malocclusion. Regardless of the dominant or recessive genetic model, the preferential genotype associations for rs1799724 and rs1800629 was insignificant. In conclusion, no evidence of association is apparent between genetic polymorphisms involving TNF-a and skeletal class II malocclusion or the position of the maxilla and mandible in the postero-anterior direction.

This study aimed to evaluate the properties of xanthan gum produced by Xanthomonas campestris pv. campestris 1866 and 1867 from lignocellulosic agroindustrial wastes. XG was produced using an orbital shaker in a culture medium containing coconut shell (CS), cocoa husks (CH), or sucrose (S) minimally supplemented with urea and potassium. The XG production results varied between the CS, CH, and S means, and it was higher with the CH in strains 1866 (4.48 g L -1 ) and 1867 (3.89 g L -1 ). However, there was more apparent viscosity in the S gum (181.88 mPas) and the CS gum (112.06 mPas) for both 1866 and 1867, respectively. The ability of XG CS and XG CH to emulsify different vegetable oils was similar to the ability of XG S . All gums exhibited good thermal stability and marked groups in the elucidation of compounds and particles with rough surfaces.

Background: Consumption of added sugars has been considered a worldwide public health concern by its association with metabolic syndrome and its comorbidities. Meanwhile, current studies have suggested high-protein diets to promote weight loss and improved metabolic outcomes. Thus, this study aimed to investigate the effects of long-term high-protein diet (HPD, 34.3% protein) intake on high-sucrose-fed rats., Methods: Weaned male Wistar rats were randomized into two groups: rats fed a standard chow (CT/CT, 10% sucrose) or rats fed a high-sucrose diet (HSD, 25% sucrose) for a 20-week observational period. Subsequently, HS/HS animals were randomized into 3 new groups: rats maintained on HSD diet (HS/HS); rats submitted to HSD replacement by standard chow (HS/CT); and those with HSD replaced by HPD (HS/HP). All groups were followed up for 12 weeks during which we investigated the effects of HPD on body weight, energy intake, obesity development, glicemic/lipid profile, glucose tolerance, insulin resistance, tissue weight (adipose tissue, liver and skeletal muscles), lipolytic activity, liver lipoperoxidation and histology, as well as serum markers of hepatic function., Results: Post-weaning exposure to HSD led to metabolic syndrome phenotype at adulthood, herein characterized by central obesity, glucose intolerance, dyslipidaemia and insulin resistance. Only HPD feeding was able to revert weight gain and adipose tissue accumulation, as well as restore adipose tissue lipolytic response to sympathetic stimulus. On the other hand, either HPD or withdrawal from HSD promoted very similar metabolic outcomes upon 12-week nutritional intervention. HS/HP and HS/CT rats showed reduced fasting serum levels of glucose, triacylglycerol and total cholesterol, which were correlated with the improvement of peripheral insulin sensitivity, as inferred from k ITT and TyG Index values. Both nutritional interventions restored liver morphofunctional patterns, but only HPD restored lipid peroxidation., Conclusions: Our data showed that 12-week intake of an isocaloric moderately high-protein diet consistently restored high-sucrose-induced central adiposity and obesity in addition to the attenuation of other important metabolic outcomes, such as improvement of glucolipid homeostasis associated to increased insulin sensitivity and reversal of hepatic steatosis. On the other hand, simple withdrawal from high-sucrose consumption also promoted the abovementioned metabolic outcomes with no impact on body weight., Competing Interests: All procedures were performed in accordance with the rules of Brazilian Council for the Control of Animal Experimentation (CONCEA) and approved by the Ethical Committee on Animal Use and Welfare (CEUA) of CEUMA University under the protocol number 177/17.Not applicable.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Background: The aim of this systematic review (SR) is to evaluate the association between asthma and periodontal disease., Methods: An electronic search without date or language restrictions was carried out in PubMed/MEDLINE, Cochrane Central Register of Controlled Trials, Web of Science, and LILACS until May 2016. In addition, manual searches and searches of the gray literature were conducted. The search process, data analysis, and quality assessment were performed by two independent reviewing authors. Eligibility criteria included prospective and retrospective cohort studies, case-controls, and randomized clinical trials., Results: The search and selection process yielded 21 studies, published between 1979 and 2017. The meta-analysis showed a statistically significant difference for the parameters of gingival bleeding, plaque index, and gingival index for participants with asthma (P < 0.001)., Conclusion: Data from this SR strongly suggest the association of asthma with periodontal disease., (© 2017 American Academy of Periodontology.)

The objective of this study was to evaluate the early osseointegration of two different implants surfaces, a sandblasted and acid-etched surface (TN) compared with same geometry and surface roughness modified to be hydrophilic/wettable by conditioning in an isotonic solution of 0.9% sodium-chloride (TA) through histological and histomorphometric analysis after sheep tibia implantation. Forty dental implants, divided in two groups (TN and TA) were placed in the left tibia of twenty healthy, skeletally mature Santa Ines sheep (n=5/experimental period). After 7, 14, 21 and 28 days post-implantation, the samples were removed and the sheep were kept alive. Analysis of resin sections (30 μm) allowed the quantification of bone area (BA) and bone-to-implant contact (BIC). TA group presented nearly 50% increase in BA at 14 days (p<0.001, ANOVA - Tukey's post test) compared with 7 days. The TA presented higher values than the TN for BA and BIC at 14, 21, and 28 days after placement, stabilizing bone healing. TA hydrophilic surface promoted early osseointegration at 14 and 21 days compared to TN, accelerating bone healing period post-implant placement in sheep tibia.

Aims: The aim of this study was to determine the rate of major clinical events and its determinants in patients with previous cardiovascular event or not, and with or without diabetes from a middle-income country., Methods: REACT study is a multicenter registry conducted between July 2010 and May 2013 in Brazil. Patients were eligible if they were over 45years old and high cardiovascular risk. Patients were followed for 12months; data were collected regarding adherence to evidence-based therapies and occurrence of clinical events (all-cause mortality, non-fatal cardiac arrest, myocardial infarction, or stroke)., Results: A total of 5006 subjects was included and analyzed in four groups: No diabetes and no previous cardiovascular event, n=430; diabetes and no previous cardiovascular event, n=1138; no diabetes and previous cardiovascular event, n=1747; and diabetes and previous cardiovascular event, n=1691. Major clinical events in one-year follow-up occurred in 332 patients. A previous cardiovascular event was associated with a higher risk of having another event in the follow-up (HR 2.31 95% CI 1.74-3.05, p<0.001), as did the presence of diabetes (HR 1.28 95% CI 1.10-1.73, p=0.005). In patients with diabetes,failure to reach HbA1c targetswas related topoorer event-free survival compared to patients with good metabolic control (HR 1.70 95% CI 1.01-2.84, p=0.044)., Conclusions: In Brazil, diabetes confers high risk for major clinical events, but this condition is not equivalent to having a previous cardiovascular event. Moreover, not so strict targets for HbA1c in patients with diabetes and previous cardiovascular events might be considered., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Purpose: To evaluate risk factors for the constitution of the reader/scribe., Methods: This is an exploratory study in which a retrospective questionnaire about the child before entering elementary school, based on preliminary indicators for the constitution of the subject reader/scribe, was applied to a population of 293 parents of elementary school students from a public school in São Paulo. The findings were crossed with the diagnostic survey of writing of students from the 1st to the 5th grade and with the evaluation of text production of students from the 3rd to the 5th grade. Data was statistically analyzed., Results and Discussion: The questionnaire showed acceptable reliability and the analysis of convergent validity presented positive correlation considered valid, statistically significant with the diagnostic survey of writing, that is, the higher the score the better the performance in the survey questionnaire. There was statistically positive correlation between the questionnaire and the performance of the students on text production in cases where parents had complaints regarding the reading and writing of their children. Exploratory factor analysis validated the proposed construct., Conclusion: The questionnaire is easy to apply and inexpensive, and the results showed acceptance by the respondents -- fundamental characteristics of instruments that serve public health and education. The research allowed validating 8 of 15 risk indicators initially proposed for the constitution of the reader/scribe. This validation confers quality to the construct and opens possibilities for its use in health promotion, prevention and rehabilitation in reading, writing and therapy.

The aim of this study was to characterize the physico-chemical properties and bone repair after implantation of zinc-containing nanostructured porous hydroxyapatite scaffold (nZnHA) in rabbits' calvaria. nZnHA powder containing 2% wt/wt zinc and stoichiometric nanostructured porous hydroxyapatite (nHA - control group) were shaped into disc (8 mm) and calcined at 550 °C. Two surgical defects were created in the calvaria of six rabbits (nZnHA and nHA). After 12 weeks, the animals were euthanized and the grafted area was removed, fixed in 10% formalin with 0.1 M phosphate buffered saline and embedded in paraffin (n=10) for histomorphometric evaluation. In addition, one sample from each group (n=2) was embedded in methylmethacrylate for the SEM and EDS analyses. The thermal treatment transformed the nZnHA disc into a biphasic implant composed of Zn-containing HA and Zn-containing β-tricalcium phosphate (ZnHA/βZnTCP). The XRD patterns for the nHA disc were highly crystalline compared to the ZnHA disc. Histological analysis revealed that both materials were biologically compatible and promoted osteoconduction. X-ray fluorescence and MEV-EDS of nZnHA confirmed zinc in the samples. Histomorphometric evaluation revealed the presence of new bone formation in both frameworks but without statistically significant differences (p>0.05), based on the Wilcoxon test. The current study confirmed that both biomaterials improve bone repair, are biocompatible and osteoconductive, and that zinc (2wt%) did not increase the bone repair. Additional in vivo studies are required to investigate the effect of doping hydroxyapatite with a higher Zn concentration.

Caryocar coriaceum Wittm. (Pequi) is found in southern Ceará, where the fruit is used as food and in folk medicine as an anti-inflammatory, and to promote healing. However, little is known about the effects of repeated administration of its oil on the biochemical parameters of the blood. This work aimed to evaluate the effects Caryocar coriaceum fixed oil (OFCC); on the lipid profiles of healthy mice, on dyslipidemia induced by tyloxapol, and to study its anti-inflammatory effect both in vivo and in vitro. The results revealed significant reduction in total serum cholesterol and triglycerides, and an increase in HDL-C. The paw edema (induced by carrageenan) and myeloperoxidase (MPO), in polymorphonuclear culture cells, was reduced at all dose levels. Results demonstrated that Caryocar coriaceum's fix oil present anti-inflammatory activity and, for the first time describe the hypolipidemic effects, supporting its traditional use and suggest that present a potential cardioprotective effect., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

Background: Muscle strength is usually measured in individuals with stroke with Portable dynamometers (gold standard). However, no studies have investigated the reliability, the standard error of measurement (SEM) and the minimal detectable difference (MDD95%) of the dynamometry for the measurement of hand grip, pinch grip and trunk strength in subjects with subacute stroke., Objective: 1) To investigate the intra and inter-rater reliability, the SEM and the MDD95% of the portable dynamometers for the measurement of grip, pinch and trunk strength in subjects with subacute stroke, and 2) to verify whether the use of different number of trials (first trial and the average of the first two and three trials) affected the results., Method: 32 subjects with subacute stroke (time since stroke onset: 3.6 months, SD=0.66 months) were evaluated. Hand grip, 3 pinch grips (i.e. pulp-to-pulp/palmar/lateral) and 4 trunk muscles (i.e. flexors, extensors, lateral flexors and rotators) strength were bilaterally assessed (except trunk flexors/extensors) with portable dynamometry by two independent examiners over two sessions (1-2 weeks apart). One-way ANOVAs and intraclass correlation coefficients (ICC2,k) were used for analysis (α=0.05). SEM and MDD95% were also calculated., Results: For all muscular groups and sources of outcome values, including one trial, after familiarization, similar results were found (0.01≤F≤0.08; 0.92≤p≤0.99) with significant and adequate values of intra-rater (0.64≤ICC≤0.99; 0.23≤95%CI≤0.99) and inter-rater (0.66≤ICC≤0.99; 0.25≤95%CI≤0.99) reliability. SEM and MDD95% were considered low (0.39≤EPM≤2.21 Kg; 0.96≤MMD95%≤6.12 Kg) for all outcome scores., Conclusion: Only one trial, following familiarization, demonstrated adequate intra-rater and inter-rater reliability of the portable dynamometers for the measurement of hand grip, pinch grip and trunk strength in subjects with subacute stroke.

Objective: To test the relaxation effect of a new adenosine receptor agonist N-acylhydrazone derivative, 3,4-dimethoxyphenyl-N-methyl-benzoylhydrazide (LASSBio-1359), on in vitro and in vivo preparation of corpus cavernosum (CC), and its interaction with type-5 phosphodiesterase enzyme inhibitor, sildenafil., Methods: For in vitro study, an increasing concentration of LASSBio-1359 was added in the solution at the plateau isometric tension recording of isolated guinea pig CC induced by phenylephrine (30 μM). Concentration-response curve was repeated in the presence of A2A receptor antagonist, ZM 241385 (10 μM). Sildenafil-induced CC relaxing effect was compared with that of LASSBio-1359. Isobolographic analysis was performed to identify possible synergistic interaction between LASSBio-1359 and sildenafil. For in vivo study, blood pressure response in the CC of guinea pig was measured after administration of LASSBio-1359 (10 mg/kg intravenously) or sildenafil (10 mg/kg intravenously)., Results: LASSBio-1359 caused relaxation of phenylephrine-induced contraction of isolated CC in a concentration-dependent manner (IC50 = 10.1 ± 1.8 μM), which was shifted to the right in the presence of ZM 241385 (IC50 = 27.1 ± 1.4 μM; P <.05). Isobolographic analysis showed synergistic interaction between LASSBio-1359 and sildenafil. As sildenafil, LASSBio-1359 increased blood pressure oscillation in the CC confirming its systemic efficacy., Conclusion: CC relaxing effects induced by the adenosine A2A receptor agonist, LASSBio-1359, demonstrated in vitro and in vivo experimental protocols, represent a promise therapeutic option for the treatment of erectile dysfunction. Synergistic interaction of LASSBio-1359 with sildenafil suggests a combined use to reach a higher population of patients with erectile dysfunction., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Introduction: Studies have shown that periodontal disease is independently associated with coronary artery disease. However, this same association has not been demonstrated with chronic apical periodontitis. The goal of this study was to establish the relationship between chronic apical periodontitis and coronary artery disease., Methods: This cross-sectional study included 103 patients who underwent coronary angiography at the University Hospital Presidente Dutra, Federal University of Maranhão, São Luís-Maranhão, Brazil. The patients answered a structured questionnaire and underwent physical and laboratory examinations. For each patient, a full-mouth set of periapical radiographs was taken. To compare numerical data, Student's t test for independent samples or the Mann-Whitney U test (nonparametric) was used. The homogeneity of variance was assessed by using Levene's test. For comparison of categorical data, the chi-square test or Fisher's exact test was used. The logistic regression analysis was performed to identify the independent predictors of coronary artery disease. The criterion for statistical significance was set at 5%. Statistical analysis was conducted by using SAS version 6.11 software., Results: The study comprised 103 patients (52 men, 51 women; mean age, 61.9 years); 31.1% were literate, and 55.3% were married. In the study sample, the prevalence of chronic apical periodontitis was 41.7% and of coronary artery disease, it was 65%. The patients with chronic apical periodontitis had a 2.79 times higher risk of developing coronary artery disease., Conclusions: In these study patients, chronic apical periodontitis was independently associated with coronary artery disease., (Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Purpose: To characterize and compare clinical, anthropometric and biochemical-metabolic variables in patients with polycystic ovary syndrome (PCOS), stratified according to body mass index (BMI)., Methods: A cross-sectional study conducted on 78 women aged 18 to 45 years with a clinical diagnosis of PCOS by the Rotterdam criteria. Patients were stratified according to BMI. The variables analyzed were: age, marital status, physical inactivity, menstrual irregularity, blood pressure (BP), anthropometric measurements, lipid profile, fasting glucose, and hormone measurements. To compare the variables between the different BMI values we used analysis of variance and the Kruskal-Wallis test. The level of significance was set at 5% for all tests., Results: The patients had a mean age of 26.3 years, 79.5% of them were sedentary and 68% had hyperandrogenism. Waist circumference, waist/hip ratio, waist/height ratio and percentage of body fat were higher in the obese group. The markers of cardiovascular risk (CVR - fasting glucose, systolic and diastolic BP and LDL-cholesterol) were directly proportional to BMI, whereas HDL-cholesterol and SHBG were inversely related to BMI., Conclusion: The presence of markers of CVR factors increased proportionally to BMI, indicating that the metabolic profile of obese women with PCOS is more unfavorable than that of non-obese patients.

Introduction: Mycotic pseudoaneurysms are an infrequent complication of infective endocarditis; most cases are secondary to arterial trauma. The commonest site involved are the intracranial arteries, followed by the abdominal aorta and then the peripheral vessels., Case Presentation: We report a case of a 36-year-old man, admitted in our institution for a subarachnoid haemorrhage, who presented with fever of unknown origin during his stay in the neurocritical care unit and whom was diagnosed infective endocarditis due to Meticilin Sensible Staphylococcus Aureus. Almost two weeks after antibiotic therapy was instituted, he presented a large, growing, pulsatile mass of the left forearm. A giant pseudoaneurysm arising from the radial artery was detected with ultrasound and surgical intervention was carried out. A large laceration of the radial artery was detected and an interposition of a vein graft was performed., Discussion: Forearm mycotic pseudoaneurysms are rare. A high index of suspicion is needed and they should always be borne in mind in the differential diagnosis of an extremity pain, swelling or motor-sensorial deficit after infective endocarditis.

Factor H (FH) is one of the most important regulatory proteins of the alternative pathway of the complement system. Patients with FH deficiency have a higher risk for development of infections and kidney diseases because of the uncontrolled activation and subsequent depletion of the central regulatory component C3 of the complement system. In this study, we investigated the consequences of the Arg(127)His mutation in FH (FH(R127H)) previously described in an FH-deficient patient, on the secretion of this protein by skin fibroblasts in vitro. We observed that, although the patient cells stimulated with IFN-γ were able to synthesize FH(R127H), the mutant protein was largely retained within the endoplasmic reticulum (ER), whereas normal human fibroblasts stimulated with IFN-γ secrete FH without retention in the ER. Moreover, the retention of FH(R127H) provoked enlargement of ER cisterns after treatment with IFN-γ. A similar ER retention was observed in Cos-7 cells expressing the mutant FH(R127H) protein. Despite this deficiency in secretion, we show that the FH(R127H) mutant is capable of functioning as a cofactor in the Factor I-mediated cleavage of C3. We then evaluated whether a treatment could increase the secretion of FH, and observed that the patient's fibroblasts treated with the chemical chaperones 4-phenylbutiric acid or curcumin increased the secretion rate of FH. We propose that these chemical chaperones could be used as alternative therapeutic agents to increase FH plasma levels in FH-deficient patients caused by secretion delay of this regulatory protein.