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Objective: This study aimed to describe the clinical and psychiatric characteristics of older outpatients with bipolar disorder (BD), including psychiatric history (age of onset of symptoms,length of time with the illness, and number of psychiatric hospitalizations), mood state, and cognitive function. Methods: This was a cross-sectional study where clinical and demographic data were obtained by a psychiatric interview with each patient and family members as well as by a review of medical records. The sample consisted of 20 individuals aged 60 years or older with a diagnosis of BD type I according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Descriptive data analysis was performed, with categorical variables expressed as absolute and relative frequencies. Results: No patient had manic or depressive symptoms at the time of the evaluation; 15(75.0%) had an early onset while 5 (25.0%) had a late onset of the disease. Nine patients(45.0%) showed no cognitive decline whereas 11 (55.0%) showed mild cognitive impairment. Conclusions: This study presents an understudied group of patients with BD. Considering the personal impact and burden on the health system related to this psychiatric condition, it is recommended that further studies be conducted in this area to better evaluate this growing population.

O presente texto versa sobre uma análise do livro Babel, de Antonia Torreão Herrera (2020), e do filme Sinônimos, de Nadav Lapid (2019), no intuito de repensar a língua e a globalização a partir do Mito de Babel. Nesse sentido, baseado no pensamento sobre língua e tradução de Jacques Derrida, no conceito de linguajamento de Water Mignolo e na discussão de Michel Foucault sobre Dom Quixote (2012) em diálogo com o filme, busca-se esboçar a problemática da concepção de globalização, em uma perspectiva decolonial, que critica a lógica binária capital-colonial. Assim, o objetivo é pensar como a poesia de Antonia Torreão Herrera e a narrativa cinematográfica de Nadav Lapid tencionam a tirania da língua e a produção de marginalizações em um contexto global. Para isso, discute-se o conceito de desbabelizar, presente no texto mítico-filosófico-poético de Antonia Torreão Herrera, relacionado à ideia de desglobalização, baseado no pensamento de Pablo Solón, no intuito de repensar os binômios globalizar-babelizar e desglobalizar-desbabelizar. Dessa forma, a partir da interpretação do poema e do filme, foi possível delinear o potencial plástico e ambivalente da língua e da linguagem artística, que rompe com o binarismo tirânico da globalização.

This text deals with an analysis of the book Babel, by Antonia Torreão Herrera (2020), and the film Synonyms, by Nadav Lapid (2019), to rethink language and globalization from the myth of Babel. In this sense, based on Jacques Derrida’s thinking about language and translation, Water Mignolo’s concept of language and Michel Foucault’s discussion of Don Quixote (2012) in dialogue with the film, we seek to outline the problem of the concept of globalization in a decolonial perspective that criticizes the capital-colonial binary logic. Thus, the objective is to think about how Antonia Torreão Herrera’s poetry and Nadav Lapid’s cinematographic narrative intend the tyranny of language and the production of marginalizations in a global context. For this, we discuss the concept of debabelizing, present in the mythical-philosophical-poetic text of Antonia Torreão Herrera, related to the idea of deglobalization, based on the thought of Pablo Solón, in order to rethink the binomials, globalize-babelize, and deglobalize-debabelize. In this way, from the interpretation of the poem and the film, it was possible to delineate the plastic and ambivalent potential of language and artistic language that breaks with the tyrannical binarism of globalization.

Transcranial direct current stimulation (tDCS) is often reported to have positive effects on brain hemodynamics as well as cognitive performance. Binaural beats (BBs) have also shown the potential to improve cognitive performance. However, we could not find any studies assessing prefrontal hemodynamics using a combination of these techniques or assessing the effects on hemodynamic response at different intensity levels of tDCS (two and three mA). This study aimed to compare the immediate hemodynamic responses to tDCS at different intensities (two and three mA) with and without 40 Hz BBs. Sixty-eight healthy young individuals of both sexes were split into four groups: the tDCS 2 mA group; tDCS 3 mA group; tDCS 2 mA + BB group; and tDCS 3 mA + BB group. All groups received 20 min tDCS (F3-Fp2) alone or combined with BBs. The hemodynamic effect was assessed using a functional near-infrared intracranial spectroscope (fNIRS) positioned on the left supraorbital region (Fp1). The mean values of rates of oxygen saturation (SatO2) were recorded at baseline, during the intervention period, and post-stimulation. The oxygenated hemoglobin rates (HbO) were also extracted. No between-group differences were observed. The within-group analysis did not show significant differences in terms of the time×groups factor. However, the time factor showed significant within-group differences. No differences were found for the HbO rates. The present findings showed that two and three mA tDCS had effects on pre-frontal cortex SatO2; however, the use of additional BBs did not change the SatO2 levels compared to the use of tDCS alone.

Despite the recommendation to treat depression using transcranial direct current stimulation (tDCS), novel findings raise doubts over the tDCS’s efficacy in managing depressive episodes. Neurophysiologic approaches to understanding the specificities of brain responses to tDCS in patients with depression remain to be explored. Objective: Our aim was to compare immediate hemodynamic responses to tDCS on the left dorsolateral prefrontal cortex (DLPFC; F3-Fp2 montage) in patients with depressive disorder and in controls (no additional stimuli). Methods: Sixteen participants were allocated to the depression group and sixteen to the control group. Both groups received 2 mA tDCS for 20 min, using the F3-Fp2 montage. The hemodynamic effect over the DLPFC was assessed using functional near-infrared intracranial spectroscopy (fNIRS) positioned on the left supraorbital region (Fp1). Mean, minimal, and maximal values of baseline and post-stimulation rates of oxygen saturation (SatO2) were recorded. The oxygenated hemoglobin rates (HbO) were extracted. Results: Between-group differences were detected for minimal baseline rates of SatO2 and HbO levels. The depression group showed lower results compared to the control group at baseline. After the protocol, only the depression group showed increased minimal rates of SatO2 and HbO. The post-tDCS minimal rates were equal for both groups. Conclusions: The findings showed immediate anodal tDCS effects over DLPFC hemodynamics. The effects were exclusive to the lowest baseline rate group and did not affect the normal oxygen rate group. The minimal increase in SatO2 and HbO rates after the protocol in the depression group suggests that those with reduced cerebral perfusion may be more affected by tDCS.

ABSTRACT Purpose: This systematic review analyzed the clinical behavior and odds of malignancy of the palatal recurrent pleomorphic adenomas. Methods: Systematic review of patients with recurrent pleomorphic adenoma arising in the palate. Database search: MEDLINE, Scopus, Web of Science, Cochrane, EMBASE, Virtual Health Library, Google Scholar, and OpenGrey. A binomial logistic regression was performed to assess the odds of detecting recurrence five, 10 and 20 years after the treatment of primary tumor. Results: Thirteen studies (n = 18 patients) out of 336 were included. The recurrent pleomorphic adenoma in palate was more common in females (61.6%), average age was 49 years old (range 9–73 years old). Four patients progressed to malignant transformation. The odds ratio (OR) of detecting a recurrence at 10 (OR = 5.57; 95% confidence interval – 95%CI 1.13–27.52), and 20 years (OR = 18.78; 95%CI 3.18–110.84) after treatment of primary pleomorphic adenoma was significantly higher than at one-year follow-up. Conclusions: The recurrence of pleomorphic adenoma in palate remains a rare event of late occurrence. It mainly affects middle-aged female and carries a risk of malignant transformation. Although uncommon, patients with palatal pleomorphic adenoma should be warned about the possibility of recurrence or malignant transformation of tumor at advanced ages.

Abstract Objective: This study evaluated the independent and combined environmental impacts of the consumption of beef and ultra-processed foods in Brazil. Design: Cross-sectional study. Setting: Brazil. Participants: We used food purchases data from a national household budget survey conducted between July 2017 and July 2018, representing all Brazilian households. Food purchases were converted into energy, carbon footprints and water footprints. Multiple linear regression models were used to assess the association between quintiles of beef and ultra-processed foods in total energy purchases and the environmental footprints, controlling for sociodemographic variables. Results: Both beef and ultra-processed foods had a significant linear association with carbon and water footprints (P < 0·01) in crude and adjusted models. In the crude upper quintile of beef purchases, carbon and water footprints were 47·7 % and 30·8 % higher, respectively, compared to the lower quintile. The upper quintile of ultra-processed food purchases showed carbon and water footprints 14·4 % and 22·8 % higher, respectively, than the lower quintile. The greatest reduction in environmental footprints would occur when both beef and ultra-processed food purchases are decreased, resulting in a 21·1 % reduction in carbon footprint and a 20·0 % reduction in water footprint. Conclusions: Although the environmental footprints associated with beef consumption are higher, dietary patterns with lower consumption of beef and ultra-processed foods combined showed the greatest reduction in carbon and water footprints in Brazil. The high consumption of beef and ultra-processed foods is harmful to human health, as well as to the environment; thus, their reduction is beneficial to both.

A 55-year-old male patient with single and well-circumscribed nodule in the lower lip. Accurate diagnosis is based only on histopathological examination using hematoxylin and eosin and immunohistochemical approach, which a large, organized thrombus within the dilated lumen of a poorly demarcated vein, associated with papillary projections of endothelial proliferation occupying vascular spaces. The final diagnosis was intravascular papillary endothelial hyperplasia (IPEH) associated with a thrombus. Oral IPEH is rare and has historically been difficult to diagnose due to its resemblance to other oral lesions. However, the distinctive histological features of oral IPEH associated with a thrombus now allow for its diagnosis through hematoxylin and eosin staining alone, without the need for additional techniques. Therefore, it is crucial for pathologists to be familiar with these unique morphological features to accurately diagnose oral IPEH and differentiate it from more common benign, malignant, or reactive vascular lesions in the oral cavity.

Background: This study aimed to determine the prevalence, beliefs, attitudes, and perceptions of hookah use in a population of undergraduate students at a large public university in Brazil. Methods: The sample consisted of 1348 undergraduate students aged over 18-year-old. They completed structured questionnaires on demographic information and close-ended questions on the past and current experiences of smoking hookah. The data underwent descriptive analysis and binary logistic regression.Findings: Finally, 1298 valid survey forms were obtained from printed and digital questionnaires. More than half (53.9%) of participants reported having tried hookah at least once, however, only 10.8% reported they had experienced it within the last 30 days. The majority of the studied population presented acceptable beliefs about the harmfulness and addictive capacity of hookah smoking. However, when comparing the perceptions of those who had smoked and those who had never smoked hookah, and also, the perceptions of users and non-users, significant differences were observed. Students who were users or had already tried hookah showed a tendency to underestimate the deleterious effects of this type of smoking.Conclusion: It could be concluded that hookah smoking was common among Brazilian university students. In addition, preoccupying misperceptions of hookah’s harmfulness and addictive capacity were found. The results showed that the epidemic of hookah smoking, especially among young people, has spread far beyond the Arab world and the Persians. Accordingly, preventive measures must be taken if this population is to be protected from addiction and other serious health problems.

An artifact is a feature present in an image which is not part of the original structure. It can occur as a consequence of several factors. It may be mistaken for pathologic conditions, leading to adverse consequences for the patients. The aim of the present study is to present a selection of the main artifacts described in brain and spinal magnetic resonance images to improve the ability of the physicians to recognize them and to reduce their interference on the final interpretation of a scan. The authors searched the scientific community for artifacts in magnetic resonance imaging (MRI), which were selected to focus on central nervous system (CNS) findings. With the Picture Archiving and Communication System (PACS) database from the center where this study was conducted, the authors designated brain and spine MRI scans with conspicuous artifacts to compose the present study. The artifacts were then classified as those that contribute to the diagnosis and those that must be distinguished from pathologic lesions. Considering the novel classification proposed by the present study, physicians might be stimulated to reevaluate their opinions regarding artifacts, perhaps considering them helpful to evaluate certain conditions even if they cannot be fully corrected, as shown by this distinct approach to artifacts with specific findings concerning differential diagnosis of CNS conditions.

El presente texto, Cifras de la lengua: la poética y el libertinaje de Antonia Torreão Herrera, trata de un análisis del libro-poema Babel, de Antonia Torreão Herrera (2020). Partiendo del perfil intelectual múltiple de Antonia Torreão Herrera, buscamos discutir cómo se construye la reflexión teórica sobre el lenguaje en la escritura poética de Babel. Así, el objetivo es discutir cómo la poética de Antonia Torreão Herrera entrelaza sus reflexiones teóricas y poéticas para posibilitar una escritura que desplaza los sentidos del lenguaje y la práctica artística, buscando una ética democrática del conocimiento y el arte. Así, se utilizará el concepto de Michel Foucault de “la técnica del yo”, para pensar en el proceso de creación de un intelectual múltiple. La discusión principal se centrará en el término “debabelizar”, partiendo de una reflexión teórica sobre el lenguaje y su configuración utilizando los conceptos suplementarios de Jacques Derrida y el pensamiento de Jacques Rousseau y Jean Starobinski, así como el concepto de grado cero de Roland Barthes. Para Herrera, el grado cero es la literatura misma, el lenguaje como pertenencia y desgarro. Así, será posible interpretar las imágenes y figuras del proyecto creativo de Babel, delimitando las coordenadas que sustentan los mecanismos de molienda de referencias artísticas y textos poéticos, posibilitando un pulso creativo de vida a través del propio lenguaje.

Electrospinning is one of the most promising fabrication techniques of nanostructured membranes for guided bone regeneration. In association with antibiotics, membranes consisting of fibers with sub-micrometric and nanometric dimensions have been tested to prevent and treat bone infections. Electrospinning was recently applied to produce metallic implant coatings for biofilm inhibition. Despite the numerous in vitro and in vivo studies conducted with nanofibers from several polymeric matrices and fabrication methods, there is no consensus on the best conditions to optimize their antimicrobial activity. This study analyzed recent advances in nanofiber fabrication by the electrospinning technique for clinical applications in the treatment of bone infections. An integrative review from MEDLINE/PubMed, Web of Science, and Scielo databases selected 16 works focused on nanofibers' in vitro and in vivo evaluations. It was found that manufacturing methods significantly influence fiber composition, structure, morphology, pore size, and biodegradability. Thus, standardizing these parameters in the production of nanofibers at an industrial scale is one of the challenges in improving drug loading control on the fiber network and its release profiles. Further in vivo studies need to be conducted to optimize the dose effect of antibiotic-loaded membranes in inhibiting the proliferation of pathogens and inflammatory processes without promoting toxicity and reducing bone regenerating capacity.

Objective: To analyze the relationship between the quality of life (QoL) of children and adolescents with Spinal Muscular Atrophy (SMA) and the burden on their parents. Methods: A cross-sectional study with 64 parents (53 women) of children and adolescents with SMA was conducted through an online questionnaire. Health-related QoL of children and adolescents with SMA according to the parents was evaluated using PedsQL 4.0, and Zarit Burden Interview (ZBI) was used to assess the burden on the parents. Correlation and association tests evaluated the relationship between the QoL of individuals with SMA, the burden on parents, and the factors related to these variables. Results: Parents aged between 21 and 52 years (mean 36.9 ± 7.3 years) were evaluated, of which 62.5% had a moderate burden. PedsQL 4.0 total score ranged from 19.6 to 93.5 points, and ZBI from 8 to 57 points. A negative correlation was observed between these variables (r = -0.4; p = 0.001). Furthermore, ZBI scores were related to the education level of parents (rho = 0.3; p = 0.02), changes in emotional or psychological health caused by SMA diagnosis in parents (rho = -0.4; p = 0.004), and family income (rho = 0.3; p = 0.03). Conclusion: Health-related QoL in children and adolescents with SMA was related to the burden on their parents. This highlights the importance of therapeutic programs focused on individuals with SMA, as well as the needs of their parents.

RESUMO A saúde ambiental se constitui o campo da saúde pública responsável pelas políticas públicas relacionadas com a interação entre a saúde humana e os fatores do meio ambiente. A gestão de risco de desastres envolve um processo de antecipação, planejamento e preparação para resposta, com atuação de diferentes áreas de governo, como o setor saúde. Este relato de experiência teve o objetivo de descrever as ações desenvolvidas pela vigilância em saúde ambiental da Secretaria de Estado de Saúde de Minas Gerais em resposta ao rompimento da barragem B1 em Brumadinho. Entre as ações desenvolvidas, destacam-se o monitoramento da qualidade da água para consumo humano nos municípios atingidos, a participação em reuniões em espaços de decisão e deliberação e a produção de documentos técnicos. As experiências vivenciadas pela equipe, durante as ações de resposta ao desastre, motivaram reflexões sobre a necessidade de fortalecer o desenvolvimento das ações de forma intra e intersetorial e a importância de qualificação dos dados registrados nos sistemas de informação e de conhecimento das informações locais de cada território, a fim de subsidiar a atuação do setor saúde de modo oportuno em situações de desastre.

Abstract Objectives: to evaluate burden, frequency of anxiety and signs and symptoms of depression in mothers of children with congenital Zika syndrome (CZS) during the COVID-19 pandemic and the social isolation period. Methods: this is a cross-sectional study conducted with mothers who care for their children with CZS. The data were collected by an online form with questions regarding mother's socioeconomic conditions and questions related with Zarit burden scale and Beck's inventories on depression and anxiety. Spearman’s correlation tests and multiple regression analyzes were performed to assess factors related to mothers' burden and mental health. Results: 41 mothers were evaluated, 51.2% had mild burden, 39% had minimal anxiety and 73.2% did not have signs and symptoms of depression. Negative correlations were observed between levels of burden and maternal schooling (p=0.01), presence of signs and symptoms of anxiety and receiving financial aid (p

ABSTRACT OBJECTIVE To evaluate the trend of household food acquisition according to the NOVA classification in Brazil between 1987–1988 and 2017–2018. METHODS We used household food acquisition data from five editions of the Pesquisas de Orçamentos Familiares (Household Budget Surveys), conducted by the Instituto Brasileiro de Geografia e Estatística (Brazilian Institute of Geography and Statistics), in the years 1987–1988, 1995–1996, 2002–2003, 2008–2009, and 2017–2018. All reported foods were categorized according to the NOVA classification. The household availability of food groups and subgroups was expressed through their share (%) in total calories, for all Brazilian families, by household situation (urban or rural), for each of the five geographic regions of the country, by fifths of the household income per capita distribution (2002–2003, 2008–2009 and 2017–2018 surveys), and for the 11 main urban regions of the country (1987–1988, 1995–1996, 2002–2003, 2008–2009 and 2017–2018 surveys). Linear regression models were used to assess the trend of increasing or decreasing food purchases. RESULTS The diet of the Brazilian population is still composed predominantly of foods in natura or minimally processed and processed culinary ingredients. However, our findings point to trends of increasing share of ultra-processed foods in the diet. This increase of 0.4 percentage points per year between 2002 and 2009 slowed down to 0.2 percentage points between 2008 and 2018. The consumption of ultra-processed food was higher among households with higher income, in the South and Southeast regions, in urban areas, and in metropolitan regions. CONCLUSION Our results indicate an increase in the share of ultra-processed foods in the diet of Brazilians. This is a worrisome scenario, since the consumption of such foods is associated with the development of diseases and the loss of nutritional quality of the diet.

Objetivo: Comparar os efeitos da Estimulação Elétrica Nervosa Transcutânea (TENS) e da crioterapia no alívio da sintomatologia dolorosa de estudantes com dismenorreia primária (DP). Métodos: Estudo transversal e quantitativo, com 20 mulheres universitárias aleatoriamente divididas em dois grupos: Grupo TENS (GT) cujas participantes foram submetidas a uma sessão de 45 min de TENS com frequência de 120 Hz e duração de pulso de 100 µs e Grupo Crioterapia (GC) cujas participantes foram submetidas a sessão de crioterapia por 20 min. Foram incluídas mulheres com ciclos menstruais regulares, nuligestas, sem relato de doença pélvica e com dismenorreia com nível de dor entre 4 e 10 durante os três primeiros dias de menstruação. Foram excluídas aquelas com contraindicação ao uso da TENS e crioterapia ou que fizeram uso de medicamentos até 24 h antes da intervenção. Foi registrado o nível de dor das participantes antes e logo depois da intervenção. Resultados: Foram avaliadas mulheres com idade variando entre 18 e 27 anos (média 22,8 ± 2,4 anos). Todas apresentaram além dos sintomas dolorosos algum outro sintoma associado, sendo os mais comuns diarreia e fadiga (80%, cada). O teste ANOVA two-way de medidas repetidas considerando como fatores grupo e avaliação, revelou efeito apenas para o fator avaliação (p < 0,001), não apresentando efeito para a interação grupo/avaliação (p = 0,09). Conclusão: TENS e crioterapia são recursos eficientes para o alívio dos sintomas álgicos de mulheres com DP, não havendo superioridade entre as abordagens.

Objetivo: avaliar a disponibilidade de acadêmicos de enfermagem para a educação interprofissional em saúde. Método: estudo realizado com acadêmicos de enfermagem de uma instituição pública de ensino superior do Distrito Federal. Os dados foram coletados no período de março a maio de 2020. Utilizou-se a escala Readiness for Interprofessional Learning Scale, versão adaptada para a língua portuguesa, composta por três fatores de avaliação. Adicionou-se uma questão aberta ao instrumento. Utilizaram-se duas técnicas de análise. Estatística, operacionalizada pelo software PSPP, e categorial. Protocolo de pesquisa aprovado pelo Comitê de ética em Pesquisa. Resultados: os 31 acadêmicos de enfermagem participantes apresentaram disponibilidade satisfatória para a educação interprofissional em saúde, observada nos três fatores avaliados. Obteve-se respostas positivas, com destaque para o item 3(87,1%) do fator 1, e o item 29 (90, 3%) do fator 3. Conclusão: a disponibilidade para a educação interprofissional em saúde foi avaliada como satisfatória. ABSTRACT Objective: to assess nursing students’ readiness for interprofessional health education. Method: in this study with nursing students from a public higher education institution in the Federal District, data were collected from March to May 2020, using a version of the Readiness for Interprofessional Learning Scale adapted for Portuguese and consisting of 3 assessment factors. An open question was added to the instrument. The data were analyzed statistically, using PSPP software, and categorically. The research protocol was approved by the research ethics committee. Results: by the three factors evaluated, the 31 nursing students displayed satisfactory readiness for interprofessional health education. Positive responses were obtained, particularly on factor 1, item 3 (87.1%), and factor 3, item 29 (90.3%). Conclusion: readiness for interprofessional health education was found to be satisfactory. RESUMEN Objetivo: evaluar la disponibilidad de estudiantes de enfermería para la educación interprofesional en salud. Método: estudio realizado con estudiantes de enfermería de una institución pública de educación superior del Distrito Federal. Los datos fueron recolectados de marzo a mayo de 2020. Se utilizó la Readiness for Interprofessional Learning Scale, una versión adaptada para el idioma portugués, que cuenta con 3 factores de evaluación. Se agregó una pregunta abierta al instrumento. Se utilizaron dos técnicas de análisis. Estadística, operadas por software PSPP, y categórica. Protocolo de investigación aprobado por el Comité de Ética en Investigación. Resultados: los 31 estudiantes de enfermería que participaron presentaron disponibilidad satisfactoria en cuanto a la educación interprofesional en salud, observada en los tres factores evaluados. Se obtuvieron respuestas positivas, con énfasis al ítem 3 (87,1%) del factor 1, y el ítem 29 (90,3%) del factor 3. Conclusión: se evaluó la disponibilidad para la educación interprofesional en salud como siendo satisfactoria.

Objective: To analyze the perception of mothers of children with Cerebral Palsy (CP) on the diagnosis moment and the child’s health. Material and Methods: Research with a qualitative approach, carried out with 19 mothers of children with CP, in a public higher education institution, in the state of Minas Gerais, Brazil. For data collection, the interview was used and for data interpretation, content analysis. Results: Mothers reported that the diagnosis of a child with CP resulted in major changes in the family’s daily life, increasing their responsibility and demands. After the diagnosis, mothers revealed oscillating feelings, with progressively replaced by her motherly ability to take care, reestablishing the psychic balance. The health associated with the absence of disease and curative practices was frequently observed. Mothers reported a great concern with oral hygiene habits and frequent visits to the dentist. Conclusion: The diagnosis of a child with CP led to changes in the family's priorities and routine. After the moment of anguish, uncertainty and fear, the mothers accepted the reality. The biomedical principle significantly influenced the mother´s perception of health, being health perceived as the absence of disease and curative practices. In relation to oral health, practices widely spread and recommended by the media and health services, such as correct tooth brushing, showed an orientation of patients to maintain oral health.

This study investigated the anti-caries and anti-inflammatory effects of mouthwash formulations containing Punica granatum (pomegranate) peel extract (PPE), sodium-trimetaphosphate, and low concentrations of fluoride. PPE was characterized using high-performance liquid chromatography (ellagic acid and punicalagin). Total phenolics were quantified among formulations, and their stability was analyzed for 28 days. The formulation effects were evaluated as follows: (1) inorganic component concentration and reduced demineralization on bovine enamel blocks subjected to pH cycling; (2) anti-biofilm effect on dual-biofilms of Streptococcus mutans ATCC 25175 and Candida albicans ATCC 10231 treated for 1 and 10 min, respectively; and (3) cytotoxicity and production of inflammatory mediators (interleukin-6 and tumor necrosis factor-alpha). The formulation containing 3% PPE, 0.3% sodium-trimetaphosphate, and 225 ppm of fluoride resulted in a 34.5% surface hardness loss; a 13% (treated for 1 min) and 36% (treated for 10 min) biofilm reduction in S. mutans; a 26% (1 min) and 36% (10 min) biofilm reduction in C. albicans; absence of cytotoxicity; and anti-inflammatory activity confirmed by decreased interleukin-6 production in mouse macrophages. Thus, our results provide a promising prospect for the development of an alcohol-free commercial dental product with the health benefits of P. granatum that have been recognized for a millennium.

Chronic stress leads to the activation of the beta-adrenergic pathway. Its activation has been implicated in the progression of different types of cancer but its role on head and neck squamous cell carcinomas (HNSCCs) remains undefined. The aim of this study was to investigate the influence of the beta-adrenergic pathway activation in the progression of HNSCCs and offer a panel of potential treatments for patients with the active beta-adrenergic pathway. Five hundred and twenty TCGA patients with primary HNSCCs were divided in two groups: ADRB2low / SLC6A2low and ADRB2high / SLC6A2high. Differentially expressed genes (DEGs) were identified through differential expression analysis. The association of clinicopathological and genomic features between the groups was analyzed using a bioinformatic approach. Potential drugs for treatment of HNSCC were identified based on the DEGs. There was association between ADRB2 and SLC6A2 expressions with age, race, tumor site, histologic grade, perineural invasion, and HPV p16 status. It was identified 898 DEGs between the groups. High ADRB2/SLC6A2 expression stimulated HNSCC proliferation, adhesion, invasion, and angiogenesis. On the other hand, genes related to cell stemness were downregulated in patients with activation of the beta- adrenergic pathway. Finally, 56 FDA-approved antineoplastic and immunotherapeutic drugs were identified as potential targets for the personalized treatment.

Abstract Background Recovery of upper limb function in individuals after a stroke remains challenging. Modified constraint-induced movement therapy (m-CIMT) has strong evidence for increasing the use and recovery of sensorimotor function of the paretic upper limb. Recent studies have shown that priming with aerobic exercise prior to task-specific training potentiates upper limb recovery in individuals with stroke. This protocol describes a randomized clinical trial designed to determine whether priming with moderate-high intensity aerobic exercise prior to m-CIMT will improve the manual dexterity of the paretic upper limb in individuals with chronic hemiparesis. Methods Sixty-two individuals with chronic hemiparesis will be randomized into two groups: Aerobic exercise + m-CIMT or Stretching + m-CIMT. m-CIMT includes 1) restraint of the nonparetic upper limb for 90% of waking hours, 2) intensive task-oriented training of the paretic upper limb for 3 h/day for 10 days and 3) behavior interventions for improving treatment adherence. Aerobic exercise will be conducted on a stationary bicycle at intervals of moderate to high intensity. Participants will be evaluated at baseline, 3, 30, and 90 days postintervention by the following instruments: Motor Activity Log, Nottingham Sensory Assessment, Wolf Motor Function Test, Box and Block Test, Nine-Hole Peg Test, Stroke Specific Quality of Life Scale and three-dimensional kinematics. The data will be tested for normality and homogeneity. Parametric data will be analyzed by two-way ANOVA with repeated measures and Bonferroni’s adjustment. For nonparametric data, the Friedman test followed by the Wilcoxon test with Bonferroni’s adjustment will be used to compare the ratings for each group. To compare the groups in each assessment, the Mann-Whitney test will be used. Discussion This study will provide valuable information about the effect of motor priming for fine upper limb skill improvement in people with chronic poststroke hemiparesis, bringing new evidence about the association of two therapies commonly used in clinical practice. Trial registration This trial was retrospectively registered (registration number RBR-83pwm3) on 07 May 2018.

Abstract Leishmaniasis is a tropical infectious disease caused by Leishmania spp. protozoa and is transmitted by insects from the Phlebotominae subfamily. It can manifest as cutaneous leishmaniasis, a painless ulcer that can develop into a more serious systemic affliction as the protozoa spreads lymphatically or hematogenously, depending on the host's immunity. In this case series, the authors present a rare form of genital mucocutaneous leishmaniasis, with consideration of epidemiologic characteristics, clinical presentation, differential diagnosis, and treatments offered.

De acordo com o mapeamento da Associação Brasileira de Ensino e Pesquisa em Serviço Social (ABEPSS) de 2018, existem 23 instituições de saúde que possuem como modalidade o Programa de Residência Multiprofissional em Oncologia, como consta na Lei n.º 11.129, de 30 de junho de 2005, que institui a Residência em Área Profissional de Saúde e cria a Comissão Nacional de Residência Multiprofissional em Saúde (CNRMS). Para os residentes do Serviço Social do hospital oncológico de referência do Brasil, há a necessidade de atualização constantemente nesse momento. Inclusive acerca das informações, as quais, muitas vezes, são instáveis do ponto de vista de permanência e na sua concretude.

Background: Atrial fibrillation (AF) is the most common arrhythmia associated with high risk of venous thromboembolism. Inflammatory mechanisms may be involved in the pathophysiology of AF and in the AF-related thrombogenesis, and patients with AF might benefit from the use of anticoagulants with anti-inflammatory properties. However, the evidence is still scarce, and it points out the need of trials seeking to investigate the levels of inflammatory mediators in patients with AF under different anticoagulant therapies. Therefore, this study was designed to define whether patients with AF treated either with an activated coagulation factor X (FXa) inhibitor (rivaroxaban) or with a vitamin K inhibitor (warfarin) present changes in peripheral levels of inflammatory mediators, mainly cytokines and chemokines.Methods: A total of 127 subjects were included in this study, divided into three groups: patients with non-valvular atrial fibrillation (NVAF) using warfarin (N = 42), patients with NVAF using rivaroxaban (N = 29), and controls (N = 56). Plasma levels of inflammatory mediators were quantified by immunoassays.Results: Patients with AF (both warfarin and rivaroxaban groups) presented increased levels of inflammatory cytokines in comparison with controls. The use of rivaroxaban was associated with decreased levels of inflammatory cytokines in comparison with warfarin. On the other hand, patients with AF using rivaroxaban presented increased levels of the chemokines (MCP-1 in comparison with warfarin users; MIG and IP-10 in comparison with controls).Conclusions: AF is associated with an inflammatory profile that was less pronounced in patients on rivaroxaban in comparison with warfarin users. Further studies are necessary to assess the clinical implications of our results and whether patients with AF would benefit from rivaroxaban anti-inflammatory effects.

Laurus nobilis L. is a large shrub belonging to the Lauracea family. Its leaves are widely used for food seasoning as well as in folk medicine. Various studies have demonstrated the antiproliferative, antifungal and antibacterial effects of Laurus nobilis, but no studies have investigated the genotoxic effect of the aqueous extract of the plant. The objective of this study was to analyze the genotoxic potential of an aqueous extract of leaves, using the Allium cepa assay and mouse peripheral blood cell micronucleus test. The results showed that the extract did not have any genotoxic activity, but cytotoxic activity was observed in the two experimental models used. The extract had an antiproliferative effect, detected through the reduction of the mitotic index and the polychromatic/normochromatic erythrocyte (PCE/NCE) ratio. The tests also demonstrated a large number of cells undergoing apoptosis and with nuclear abnormalities related to cell death processes. These results can be explained by the presence of phenolic compounds, saponins, flavonoids and alkaloids, detected in the phytochemical analysis of the extract. Therefore, the extract from L. nobilis in the form generally used by the population does not pose risks related to its genotoxic potential, and also contains components with apoptotic and antigenotoxic potential.

BackgroundThere is ample evidence that gestational diabetes mellitus has a direct influence on urinary incontinence and pelvic floor muscles. There are no standardized pelvic floor muscle exercise programs in the literature for the physiotherapy and differ in the type of exercise, intensity, type and duration of application, and the frequency and duration of treatment sessions. The aim of this systematic review will be to investigate that Pelvic Floor Muscle Training can prevent and/or decrease the pregnancy specific urinary incontinence in women with gestational diabetes mellitus or gestational hyperglycemia.MethodsWe will perform a systematic review according to the Cochrane methodology of Randomized Controlled Trials. An overall search strategy will be developed and adapted for Embase, MEDLINE, LILACS, and CENTRAL databases, with the date of consultation until June 2020. The MeSH terms used will be "Pregnancy", "Hyperglycemia", "Diabetes Mellitus, Type 2", "Diabetes Mellitus, Type 1", "Pregnancy in Diabetics", "Diabetes, Gestational", "Urinary Incontinence", "Pelvic Floor Muscle Strength". Primary outcomes: improvement or cure of pregnancy specific urinary incontinence (which can be assessed by questionnaires, and tools such as tampon test, voiding diary, urodynamic study). Secondary outcomes: improvement of pelvic floor muscle strength (pelvic floor functional assessment, perineometer, electromyography, functional ultrasonography), improved quality of life (questionnaires), presence or absence of postpartum Urinary Incontinence and adverse effects. Quality assessment by Cochrane instrument. Metanalysis if plausible, will be performed by the software Review Manager 5.3.DiscussionThe present study will be the first to analyze the effectiveness of pelvic floor exercises in pregnant women with Gestational Diabetes Mellitus or Hyperglycemia, who suffer from pregnancy specific urinary incontinence. Randomized Controlled Trials design will be chosen because they present the highest level of evidence. It is expected to obtain robust and conclusive evidence to support clinical practice, in addition to promoting studies on the theme and contributing to new studies.Trial registrationSystematic review registration: PROSPERO CRD42017065281.

Introdução: A Sociedade Europeia de Cirurgia Vascular (ESVS), de acordo com os estudos de maior validade publicados na literatura,“North American Symptomatic Carotid Endarterectomy Trial” (NASCET), “European Carotid Surgery Trial” (ECST) e “Symptomatic Veterans Affairs Co-operative Study Trial” (SVACS), determina a orientação de doentes com sintomas do território carotídeo nos seis meses precedentes e estenose carotídea moderada (50–69%) (ECM) para endarteriectomia carotídea associada ao melhor tratamento médico(1). Objetivo: Analisar os doentes admitidos com ECM, interpretar os motivos de decisão terapêutica e avaliar a adequabilidade da estratégia optada. Materiais e métodos: Os autores analisaram retrospetivamente, todos os doentes consecutivamente admitidos numa única Instituição com o diagnóstico de ECM sintomática, entre 2011 e 2016. Após a colheita de dados clínicos, os doentes foram estratificados em grupos: aqueles orientados para melhor tratamento médico (BMT) foram adjudicados ao grupo I, os que foram submetidos a endarteriectomia carotídea (CEA) + BMT ao grupo II e os que foram submetidos a stenting carotídeo (CAS) + BMT ao grupo III. Posteriormente, foi realizada uma análise estatística dos resultados obtidos durante o período de seguimento. Resultados: No grupo I foram incluídos 38 doentes, 25 do sexo masculino, com uma idade média de 74,5 anos. Durante o primeiro ano de seguimento foi registado um Acidentes Vasculares Cerebrais (AVC) e dois Acidentes Isquémicos Transitórios (AIT), perfazendo 3 eventos cerebrais (7,9%). Associadamente, 8 doentes (21%) faleceram, de causa não relacionável. No grupo II foram incluídos 29 doentes, 24 do sexo masculino, com uma idade média de 72 anos. Em termos de endpoint avaliado, foram registados 2 AVC’s peri-operatoriamente, sendo que um condicionou a morte do doente, o que perfez 2 eventos (6,5%). No grupo III, foram incluídos 19 doentes, 14 do sexo masculino, com uma idade média de 76,3 anos. Neste grupo foram registados peri-operatoriamente 2 AVC’s, sendo que um condicionou a morte do doente, o que perfez 2 eventos (10,5%). Discussão/Conclusão: A análise estatística encontrou uma diferença estatisticamente significativa (p=0,038) favorecendo CEA + BMT em detrimento de CAS + BMT o que corrobora a evidência científica. Embora a existência de um maior número de eventos registados no Grupo I, não existiu diferença estatisticamente significativa quando comparado com o Grupo II (p=0,67). Apesar do reduzido número de doentes avaliados e do seguimento temporal, requerendo novos estudos, os autores consi- deram que, na presença de uma estenose carotídea moderada e sintomática, os doentes deverão ser orientados para CEA. Ainda assim, assume-se que possa existir um grupo residual de doente nos quais a CEA seja considerado um procedimento de elevado risco. Nesse grupo, a orientação adequada poderá ser para BMT com avaliações periódicas no sentido de ponderar CEA assim que possível.

O presente ensaio busca pensar as potencialidades da arte ficcional em interpretar o hiperpresente através de uma análise do filme Ex-Machina e a sua leitura sobre a tecnologia e o cotidiano da contemporaneidade. Para isso, foi realizado um mapeamento do pensamento de Platão sobre a arte e a caracterização desta como Simulacro, para então, pensar na reversão do platonismo e afirmação do diferença a partir do pensamento de Gilles Deleuze. Em seguida, é realizada uma reflexão do cinema como uma arte do hiperpresente vinculada à análise fílmica, buscando pensar como este traduz conceitos da internet e dos algoritmos dos smartphones e das redes sociais, tais como Big Data, Internet das Coisas e Redes Neurais Artificiais. Ao fim, conclui-se que arte ficional é potente para desterritorializar, transbordar e pensar a diferença sobre as relações do seu tempo.

Infected cutaneous ulcers from diabetic rats with Candida albicans and Streptococcus aureus were treated with spray formulations containing green silver nanoparticles (GS), chemical silver nanoparticles (CS), or pomegranate peel extract (PS). After wound development and infection, the treatments were performed twice per day for 14 days. The wound healing was analyzed on days 2, 7, and 14 through the determination of CFUs, inflammatory infiltrate, angiogenesis, fibroplasia, myeloperoxidase, and collagen determination. Expressive improvement in wound healing was noted using both silver nanoparticles for 7 days. All the treatments were superior to controls and promoted significant S. aureus reduction after 14 days. CS presented better anti-inflammatory results, and GS and CS the highest number of fibroblasts. Despite the techniques’ limitations, GS and CS demonstrated considerable potential for managing infected wounds, especially considering no early strategies prior to the drugs, such as the debridement of these wounds, were included.

Introduction: there are three types of dens in dente: Type I, minimal invagination confined to the crown of the tooth which does not extend beyond the amelocemental junction; Type II, invagination extends to the pulp chamber, but remains within the root canal with no communication with the periodontal ligament; and Type III, invagination extends to the root of the affected tooth, beyond the cementoenamel junction. The term dilated odontoma is used to describe the most severe variant of invagination (Type III), which is characterized by crown and/or root dilation of the affected tooth. Objective: describe a rare case of a dilated odontoma shaped dens in dente in a mesiodens and its imaging findings, diagnosed by cone beam computed tomography. Case presentation: a 14-year-old male patient was referred for radiographic examination of the mandible and maxilla to determine the cause of abnormal tooth eruption chronology. Two mesiodens were found on the maxilla. Due to the peculiar morphology of the mesiodens on the right side, cone beam computed tomography was performed. Multiplanar reconstructions revealed an oval structure on the eruption path of the upper right central incisor, in contact with its palatal surface. Coronal and sagittal reconstructions showed that invagination extended beyond the cementoenamel junction, without any additional apical/lateral formation. Conclusions: the final diagnosis was dilated odontoma shaped type II dens invaginatus in a mesiodens.

ABSTRACT CONTEXT AND OBJECTIVE: This systematic review compared reiki and prayer with drug use for relieving pain during hospitalization for cesarean, given that the popularity of integrative medicine and spiritual healing has been increasing. It had the aim of evaluating whether reiki or prayer is effective in relieving pain during cesarean section. DESIGN AND SETTING: Systematic review with meta-analysis conducted at Botucatu Medical School, UNESP, São Paulo, Brazil. METHODS: The following databases were searched up to March 2016: MEDLINE, Embase, LILACS and CENTRAL. Randomized controlled trials published in English or Portuguese were included in the review. Two reviewers independently screened eligible articles, extracted data and assessed the risk of bias. A GRADE table was produced to evaluate the risk of bias. RESULTS: There was evidence with a high risk of bias showing a statistically significant decrease in pain score through use of reiki and prayer, in relation to the protocol group: mean difference = -1.68; 95% confidence interval: -1.92 to -1.43; P < 0.00001; I2 = 92%. Furthermore, there was no statistically significant difference in heart rate or systolic or diastolic blood pressure. CONCLUSION: Evidence with a high risk of bias suggested that reiki and prayer meditation might be associated with pain reduction.

O presente trabalho discute as representações do tombamento dos Asilos Colônias no estado de São Paulo, enquanto patrimônios difíceis, uma vez que esses espaços foram cenário do isolamento compulsório de hansenianos que teve início na primeira metade do século XX e se estendeu até meados dos anos 1980. Nesse sentido, a patrimonialização envolve um contexto de reparação pelo trauma sofrido por aqueles que sofreram o isolamento como profilaxia, fazendo com que o tombamento seja entendido como parte do reconhecimento do Estado como responsável por ter promovido tal política na saúde. Além disso, a patrimonialização de espaços marcados por experiências de sofrimento atendem uma demanda social e auxiliam na promoção de um debate com diferentes grupos para a desconstrução do estigma da hanseníase e quais os sentidos do isolamento compulsório, uma vez que não foi capaz de erradicar a doença no país.

BACKGROUND:Approximately 50 to 70% of post-stroke subjects present a reduction in the upper limb (UL) function even during the chronic phase. An adjuvant technique widely used in neurorehabilitation is elastic taping applications. However, its efficacy in UL treatment for post-stroke subjects still requires further investigation. OBJECTIVE:To verify the effects of elastic tape (ET) used on the paretic shoulder in upper limb (UL) performance during a drinking task. METHOD:A single-center randomized sham-controlled crossover trial randomized thirteen post-stroke subjects with mild to moderate UL impairment for group allocation to receive first Sham Tape (ST) or first Elastic Tape (ET), with one month of washout. Kinematic measures of a drinking task were taken before and after each intervention (elastic and sham tape), using Three-Dimensional Motion Analysis, and studied using feature analysis and Statistical Parametric Mapping. Outcome measures included spatiotemporal variables, scalar kinematic parameters (starting angles, range of motion-ROM, and endpoint angles) and time-normalized kinematic waveforms of trunk and UL joint angles (scapulothoracic, humerothoracic and elbow). RESULTS:Elastic tape provided common modifications throughout the task (shoulder more towards midline, reduced scapula protraction and trunk flexion) and important alterations at specific time-instants. At the end of the reaching phase, for both groups (ET and ST), the elastic tape increased elbow extension [ET: CI = 12.57 (6.90 to 18.17), p0.05). CONCLUSION:The ET changed UL joint motions and posture during a drinking task in chronic hemiparetic subjects, which defines its role as an adjuvant therapy.

O presente trabalho busca discutir as representações do tombamento dos Asilos Colônias no estado de São Paulo enquanto patrimônios difíceis, uma vez que esses espaços foram cenário do isolamento compulsório de hansenianos, que teve início na primeira metade do século XX e se estendeu até meados dos anos 1980. Nesse sentido, a patrimonialização envolve um contexto de reparação pelo trauma sofrido por aqueles que vivenciaram o isolamento como profilaxia, fazendo com que o tombamento seja entendido como parte do reconhecimento do Estado como responsável por ter promovido tal política na saúde. Além disso, a patrimonialização de espaços marcados por experiências de sofrimento atende uma demanda social e auxilia na promoção de um debate com diferentes grupos para a desconstrução do estigma da hanseníase e para questionar os sentidos do isolamento compulsório, uma vez que isso não foi capaz de erradicar a doença no país.

Resenha da obra: WADI, Yonissa Marmitt (org). Narrativas sobre loucuras, sofrimentos e traumas. Curitiba: Máquina de Escrever, 2016

Abstract Ornithocoris toledoi is a hematophagous insect that parasites birds, particularly, galliformes. Although the occurrence of this arthropod is relatively low in Brazil, this is an important ectoparasite associated with backyarding poultry. The objective of this study was to report the occurrence of O. toledoi in a free-range chicken farm in the state of Rio de Janeiro, Brazil, including aspects of its taxonomic identification, biology and epidemiology.

BACKGROUND AND AIM:Understanding the maturation of upper limb (UL) movement characteristics in typically developing (TD) children is key to explore UL deficits in those with neurodevelopmental disorders. Three-dimensional motion analysis (3DMA) offers a reliable tool to comprehensively evaluate UL motion. However, studies thus far mainly focused on specific pre-defined parameters extracted from kinematic waveforms. Here, we investigated age-related differences in UL movement characteristics over the entire movement cycle in TD children. PARTICIPANTS AND METHODS:We assessed the non-dominant UL of 60 TD children (mean age 10y3m±3y1m) using 3DMA during eight tasks: reaching (forwards (RF), upwards (RU), sideways (RS)), reach-to-grasp (sphere (RGS), vertical cylinder (RGV)) and activities-of-daily-living mimicking tasks (hand-to-head (HTH), hand-to-mouth (HTM), hand-to-shoulder (HTS)). We investigated differences between four age-groups (5-7y, 8-10y, 11-12y, 13-15y) in: (1) spatiotemporal parameters (movement duration, peak velocity, time-to-peak velocity and trajectory straightness), and (2) 12 UL joint angles, using Statistical Parametric Mapping (SPM). RESULTS:We found that the 5-7y children moved with lower peak velocity and less straight trajectories compared to the 11-12y group (peak velocity: RS, HTS, p

This study investigated the anti-caries and anti-inflammatory effects of mouthwash formulations containing Punica granatum (pomegranate) peel extract (PPE), sodium-trimetaphosphate, and low concentrations of fluoride. PPE was characterized using high-performance liquid chromatography (ellagic acid and punicalagin). Total phenolics were quantified among formulations, and their stability was analyzed for 28 days. The formulation effects were evaluated as follows: (1) inorganic component concentration and reduced demineralization on bovine enamel blocks subjected to pH cycling; (2) anti-biofilm effect on dual-biofilms of Streptococcus mutans ATCC 25175 and Candida albicans ATCC 10231 treated for 1 and 10 min, respectively; and (3) cytotoxicity and production of inflammatory mediators (interleukin-6 and tumor necrosis factor-alpha). The formulation containing 3% PPE, 0.3% sodium-trimetaphosphate, and 225 ppm of fluoride resulted in a 34.5% surface hardness loss; a 13% (treated for 1 min) and 36% (treated for 10 min) biofilm reduction in S. mutans; a 26% (1 min) and 36% (10 min) biofilm reduction in C. albicans; absence of cytotoxicity; and anti-inflammatory activity confirmed by decreased interleukin-6 production in mouse macrophages. Thus, our results provide a promising prospect for the development of an alcohol-free commercial dental product with the health benefits of P. granatum that have been recognized for a millennium.

Elastic tape has been widely used in clinical practice in order to improve upper limb (UL) sensibility. However, there is little evidence that supports this type of intervention in stroke patients.To verify the effect of elastic tape, applied to the paretic shoulder, on joint position sense (JPS) during abduction and flexion in subjects with chronic hemiparesis compared to sham tape (non-elastic tape). Furthermore, to verify if this potential effect is correlated to shoulder subluxation measurements and sensorimotor impairment.A crossover and sham-controlled study was conducted with post-stroke patients who were randomly allocated into two groups: 1) those who received Sham Tape (ST) first and after one month they received Elastic Tape (ET); 2) those who received Elastic Tape (ET) first and after one month they received Sham Tape (ST). The JPS was evaluated using a dynamometer. The absolute error for shoulder abduction and flexion at 30° and 60° was calculated. Sensorimotor impairment was determined by Fugl-Meyer, and shoulder subluxation was measured using a caliper.Thirteen hemiparetic subjects (average time since stroke 75.23 months) participated in the study. At baseline (before interventions), the groups were not different for abduction at 30° (p = 0.805; p = 0.951), and 60° (p = 0.509; p = 0.799), or flexion at 30° (p = 0.872; p = 0.897) and 60° (p = 0.853; p = 0.970). For the ET group, differences between pre and post-elastic tape for abduction at 30° (p

Following publication of the original article [1], the authors reported an error in Table 2 wherein the item numbering in the first column is wrong.

El objetivo fue comprender los efectos del lúdico en la punción venosa periférica de preescolar hospitalizado en la percepción del acompañante y analizar el beneficio de la inclusión del lúdico en la atención de enfermería al preescolar. Investigación cualitativa, cuyo escenario fue una enfermería del Hospital Pediátrico de Niterói-RJ, Brasil. Fueron sujetos siete madres. La coleta de datos fue realizada en febrero y marzo de 2011, consistió de orientación con uso de fantoche sobre procedimiento de punción venosa y entrevista semiestructurada, en la cual las acompañantes expresaron sus percepciones cuanto al uso del lúdico. Emergieron las unidades temáticas: opinión de las acompañantes cuanto a la utilización del lúdico; percepción de las acompañantes cuanto a los efectos del uso del lúdico sobre el niño; importancia del uso de la actividad lúdica en la atención al niño hospitalizado. El éxito de la utilización del fantoche ofrece sustentación para intervenciones de esa naturaleza.

The phytosynthesis of metal nanoparticles is nowadays attracting the increased attention of researchers and is much needed given the worldwide matter related to environmental contamination. The antimicrobial activity of colloidal and spray formulation of silver nanoparticles (AgNPs) synthesized by pomegranate peel extract against Candida albicans and Staphylococcus aureus, and their cytotoxicity in mammalian cells were tested in the present study. Dry matter, pH, total phenolics, and ellagic acid in the extract were determined. Then, AgNPs were phytosynthesized and characterized by X-ray diffraction, electron transmission microscopy, dynamic light scattering, zeta potential, and Ag+ dosage. Spray formulations and respective chemical-AgNP controls were prepared and tested. The peel extract reduced more than 99% of Ag+, and produced nanoparticles with irregular forms and an 89-nm mean size. All AgNP presented antimicrobial activity, and the spray formulation of green-AgNP increased by 255 and 4 times the effectiveness against S. aureus and C. albicans, respectively. The cytotoxicity of colloidal and spray green-AgNP was expressively lower than the respective chemical controls. Pomegranate peel extract produced stable AgNP with antimicrobial action and low cytotoxicity, stimulating its use in the biomedical field.

Nanobiomaterials combining remineralization and antimicrobial abilities would bring important benefits to control dental caries. This study aimed to produce nanocompounds containing calcium glycerophosphate (CaGP) and silver nanoparticles (AgNP) by varying the reducing agent of silver nitrate (sodium borohydride (B) or sodium citrate (C)), the concentration of silver (1% or 10%), and the CaGP forms (nano or commercial), and analyze its characterization and antimicrobial activity against ATCC Candida albicans (10231) and Streptococcus mutans (25175) by the microdilution method. Controls of AgNP were produced and silver ions (Ag+) were quantified in all of the samples. X-ray diffraction, UV-Vis, and scanning electron microscopy (SEM) analysis demonstrated AgNP associated with CaGP. Ag+ ions were considerably higher in AgCaGP/C. C. albicans was susceptible to nanocompounds produced with both reducing agents, regardless of Ag concentration and CaGP form, being Ag10%CaGP-N/C the most effective compound (19.5–39.0 µg Ag mL−1). While for S. mutans, the effectiveness was observed only for AgCaGP reduced by citrate, also presenting Ag10%CaGP-N the highest effectiveness (156.2–312.5 µg Ag mL−1). Notably, CaGP enhanced the silver antimicrobial potential in about two- and eight-fold against C. albicans and S. mutans when compared with the AgNP controls (from 7.8 to 3.9 and from 250 to 31.2 µg Ag mL−1, respectively). The synthesis that was used in this study promoted the formation of AgNP associated with CaGP, and although the use of sodium borohydride (B) resulted in a pronounced reduction of Ag+, the composite AgCaGP/B was less effective against the microorganisms that were tested.

OBJETIVO: estudar a audição e a sua relação com a qualidade de vida em motoristas de caminhão. MÉTODOS: realizou-se um estudo epidemiológico do tipo transversal de inquérito. Estudou-se 75 motoristas de caminhão, que responderam a anamnese, preencheram o questionário sobre Qualidade de vida (WHOQOL-bref) e se submeteram a audiometria tonal liminar e logoaudiometria. Classificou-se a Perda Auditiva Induzida por Ruído (PAIR), segundo o critério utilizado por Fiorini (1994). RESULTADOS: dos 75 audiogramas analisados, 50 sujeitos (66,7%) apresentaram audição dentro dos padrões de normalidade (Grupo 1) e 25 sujeitos (33,3%) apresentaram audiogramas com alterações: 20 (80,0%) foram classificados como sugestivos de PAIR (Grupo 2) e cinco (20,0%) foram sugestivos de outras causas (Grupo 3). Houve associação e/ou dependência entre os Grupos e a Idade (p=0,007) e entre os Grupos e os Anos de Profissão (p = 0,049). No Grupo 1 - Normalidade, houve correlações estatisticamente significantes para os domínios: Físico x Psicológico (pPURPOSE: to study hearing in relation to the quality of life in truck drivers. METHODS: an inquiring transversal epidemiological study was realized in 75 truck drivers, who answered to anamnesis and filled the World Health Organization questionnaire on quality of life - WHOQOL-bref, and underwent pure tone and speech audiometry. Noise induced hearing loss (NIHL) was classified, according to Fiorini's (1994) criterion. RESULTS: out of 75 evaluated audiograms, 50 subjects (66.7%) showed normal hearing (Group 1) and 25 subjects (33.3%) showed altered audiograms, being 20 (80.0%) classified as suggestive of NIHL (Group 2) and 5 (20,0%) were suggestive of other causes (Group 3). There was an association and/or dependence between groups and age (p=0,007) and between groups and years in the profession (p = 0.049). In Group 1 - Normal, there were statistically significant correlations for the domains: Physical x Psychological (p

Scientific evidence of susceptibility to dental caries in the population with Down Syndrome (DS) is limited and conflicting, making it difficult to establish firm conclusions. The aim of this systematic review and meta-analysis was to obtain scientific evidence of the possible association between dental caries and individuals with DS, compared to individuals without DS (control). An electronic search of five databases was performed, with no language or publication date restrictions. The studies were selected by two independent reviewers (Kappa = 0.83). The systematic review included 13 studies, while eight studies were included in the meta-analysis. The studies are presumably all at risk of bias given their observational character. Two of these evaluated the presence or absence of caries in permanent and deciduous teeth, and six evaluated the mean DMFT index in permanent teeth. Combined odds ratios (OR), standard difference, standard error and a 95% confidence interval (CI) were obtained. The vast majority of the studies found that individuals from control groups had more carious lesions or caries experience than those with DS. The results were statistically significant in seven studies (p

To describe and analyze the changes in anthropometric parameters in children with congenital Zika syndrome (CZS) from birth to four years of age. This prospective study evaluated 117 children diagnosed with CZS. Anthropometric indices evaluated annually were classified with respect to presence of microcephaly and adequacy of weight-for-age, length/height for-age and body mass index-for-age (BMI-for-age). At birth, 69.6% of the children had microcephaly, 90.2% had adequate weight and 72.1% had adequate length. The following year, an increase occurred in the proportion of children with microcephaly, with a reduction of those with adequate weight. In the second year, the proportion of children with microcephaly increased again, while those with adequate BMI decreased. In the third to fourth years of life, a reduction was found in the proportion of children with adequate height. Anthropometric indices are affected in children with CZS over the first four years of life and appear to be potentiated over time.

To use the International Classification of Functioning, Disability and Health (ICF) to investigate whether children with congenital Zika Syndrome (CZS) show changes in their functioning and disability profile after nine months. This study included children with CZS recruited from a support centre for children with microcephaly in Brazil. The children's functional abilities and limitations were classified using ICF Core Set for children with cerebral palsy. Each ICF category was quantified in two moments with a mean interval of nine months. The study included 81 children (mean age = 38.4 ± 3.3mo). Most children showed changes between assessments. Categories that presented improvements were in body functions (five categories), environmental factors (two categories), and activity and participation (one category) sections. Most children with CZS evaluated improved their functioning and disability profile over time, mainly in body functions. These changes can be related to the course of the disease or to the health programmes that children had access.