Search

Clinical appointment generates stress in feline patients, influencing the frequency of veterinary care with the species. The purpose of this study was to assess serum cortisol in cats submitted to oral gabapentin and integrative practices during clinical care. Twenty cats were evaluated in three clinical appointments, one week apart. All cats were submitted to treatments: placebo (PL), gabapentin (GA), and integrative practices (IP) (music therapy, pheromone therapy, and chromotherapy). GA and PL were administered by the owners 90 min before transportation to the veterinary teaching hospital, and IP were applied 30 min before clinical care. Cats were physically examined at all timepoints, and blood samples were collected for cortisol measurement. Serum cortisol levels ranged from 0.49 µg/dL to 17.99 µg/dL. Mean cortisol concentrations when cats received PL (7.6 µg/dL) were higher than when cats received GA (4.9 µg/dL) and IP (4.1 µg/dL). There was a statistical difference in cortisol levels when cats receiving PL and GA were compared (p = 0.03) and between PL and IP (p = 0.005). The study showed that feline serum cortisol levels were lower when cats received the treatments to IP (integrative practices) and GA (gabapentin), demonstrating that these are applicable methods for reducing stress of feline patients in clinical evaluation., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

Objective: Evaluate and compare the protagonism of Oral Health teams (OHt) in the teamwork process in Primary Healthcare (PHC) over five years and estimate the magnitude of disparities between Brazilian macro-regions., Methods: Ecological study that used secondary data extracted from the Sistema de Informação em Saúde para a Atenção Básica (SISAB - Health Information System for Primary Healthcare) from 2018 to 2022. Indicators were selected from a previously validated evaluative matrix, calculated from records in the Collective Activity Form on the degree of OHt's protagonism in team meetings and its degree of organization concerning the meeting agendas. A descriptive and amplitude analysis of the indicators' variation over time was carried out, and the disparity index was also calculated to estimate and compare the magnitude of differences between macro-regions in 2022., Results: In Brazil, between 3.06% and 4.04% of team meetings were led by OHt professionals. The Northeast and South regions had the highest (3.71% to 4.88%) and lowest proportions (1.21% to 2.48%), respectively. From 2018 to 2022, there was a reduction in the indicator of the "degree of protagonism of the OHt" in Brazil and macro-regions. The most frequent topics in meetings under OHt's responsibility were the work process (54.71% to 70.64%) and diagnosis and monitoring of the territory (33.49% to 54.48%). The most significant disparities between regions were observed for the indicator "degree of organization of the OHt concerning case discussion and singular therapeutic projects"., Conclusions: The protagonism of the OHt in the teamwork process in PHC is incipient and presents regional disparities, which challenges managers and OHt to break isolation and lack of integration, aiming to offer comprehensive and quality healthcare to the user of the Unified Health System (SUS).

Chronic kidney disease is one of the deadliest diseases globally and treatment methods are still insufficient, relying mostly on transplantation and dialysis. Engineering of kidney tissues in vitro from induced pluripotent stem cells (iPSCs) could provide a solution to this medical need by restoring the function of damaged kidneys. However, implementation of such approaches is still challenging to achieve due to the complexity of mature kidneys in vivo. Several strategies have been defined to obtain kidney progenitor endothelial and epithelial cells that could form nephrons and proximal tube cells, but these lack tissue maturity and vascularisation to be further implemented. Electrospinning is a technique that has shown promise in the development of physiological microenvironments of several tissues and could be applied in the engineering of kidney tissues. Synthetic polymers such as polycaprolactone, polylactic acid, and poly(vinyl alcohol) have been explored in the manufacturing of fibres that align and promote the proliferation and cell-to-cell interactions of kidney cells. Natural polymers including silk fibroin and decellularised extracellular matrix have also been explored alone and in combination with synthetic polymers promoting the differentiation of podocytes and tubular-specific cells. Despite these attempts, further work is still required to advance the applications of electrospun fibres in kidney tissue engineering and explore this technique in combination with other manufacturing methods such as bioprinting to develop more organised, mature and reproducible kidney organoids.

The use of smart materials in tissue engineering is becoming increasingly appealing to provide additional functionalities and control over cell fate. The stages of tissue development and regeneration often require various electrical and electromechanical cues supported by the extracellular matrix, which is often neglected in most tissue engineering approaches. Particularly, in cardiac cells, electrical signals modulate cell activity and are responsible for the maintenance of the excitation-contraction coupling. Addition of electroconductive and topographical cues improves the biomimicry of cardiac tissues and plays an important role in driving cells towards the desired phenotype. Current platforms used to apply electrical stimulation to cells in vitro often require large external equipment and wires and electrodes immersed in the culture media, limiting the scalability and applicability of this process. Piezoelectric materials represent a shift in paradigm in materials and methods aimed at providing electrical stimulation to cardiac cells since they can produce and deliver electrical signals to cells and tissues by mechanoelectrical transduction. Despite the ability of piezoelectric materials to mimic the mechanoelectrical transduction of the heart, the use of these materials is limited in cardiac tissue engineering and methods to characterise piezoelectricity are often built in-house, which poses an additional difficulty when comparing results from the literature. In this work, we aim at providing an overview of the main challenges in cardiac tissue engineering and how piezoelectric materials could offer a solution to them. A revision on the existing literature in electrospun piezoelectric materials applied to cardiac tissue engineering is performed for the first time, as electrospinning plays an important role in the manufacturing of scaffolds with enhanced piezoelectricity and extracellular matrix native-like morphology. Finally, an overview of the current techniques used to evaluate piezoelectricity and their limitations is provided., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Objective: To test the association between occupational stressors and work accidents due to exposure to biological material (ATbio) in health workers, considering the isolated and combined analysis of the dimensions of two models, the demand-control model (DCM) and the effort-reward imbalance model (ERI)., Methods: Cross-sectional study in a representative sample of workers with higher, technical and secondary education, including health agents from primary and medium-complexity care units in five cities in Bahia. Random sampling was selected, stratified by geographic area, level of service complexity and occupation. The outcome variable was ATbio; The main exposure was occupational stressors, assessed by the DCM and ERI. Incidences and relative risks were estimated as a function of the acute, short-term nature of the outcome of interest. Associations between ATbio and isolated and combined DCM and ERI dimensions were tested., Results: A total of 3,084 workers participated in the study. The global incidence of ATbio was 3.4% and was associated with high psychological demand, high effort and high commitment to work, adjusted for sex, age, education and work shift. High-strain work and a situation of imbalance between efforts and rewards were associated with ATbio. With the combination of the models, an increase in the measure of association with the outcome was observed. Significant associations of greater magnitude were observed in the complete combined models. ATbio's risk was 5.23 times higher among those exposed in both complete models compared to the absence of exposure in both models., Conclusions: Occupational stressors were associated with ATbio. Advantages in using the combined models were observed. The approach of different psychosocial dimensions has expanded the ability to identify exposed groups, offering a solid basis for interventions for ATbio's prevention in health.

The objective was to evaluate the relationship between job dissatisfaction and the occurrence of common mental disorders (CMD), considering the psychosocial aspects of work and personal satisfaction. Cross-sectional study, with a sample of 3,084 health workers from five municipalities in Bahia. Structural equation modeling analysis, stratified by gender, was used. Dissatisfaction with work was the main exposure variable. The CMD, the outcome variable, was assessed by the Self-Reporting Questionnaire (SRQ-20). Personal satisfaction (SAP), assessed by World Health Organization Quality of Life (WHOQOL) questions, and stressful (AE) and protective (AP) psychosocial aspects, measured by the Job Content Questionnaire (JCQ) and the Effort-Reward Imbalance scale (ERI), were treated as latent variables. Dissatisfaction with work was associated with higher CMD prevalence, among men (0.160; CI95%: 0.024; 0.295) and women (0.198; CI95%: 0.135; 0.260). AEs were associated with greater dissatisfaction and higher CMD prevalence, while APs were associated with lower dissatisfaction and lower CMD prevalence, among men and women. Dissatisfaction with work mediated the effect of psychosocial aspects and personal satisfaction on the occurrence of CMD. The final model showed good adjustment. High job dissatisfaction, stressful psychosocial aspects, lack of protective aspects, and personal dissatisfaction were associated directly or indirectly with CMD. The results reinforce the need for actions to protect mental health at work by redesigning the harmful aspects identified and strengthening the aspects associated with the lower occurrence of CMD.

We report here the regioselective 6- endo -dig cyclization of [2-(butylselanyl)phenyl]propynols promoted by the cooperative action between diorganyl diselenides and iron(III) chloride leading to the formation of 4-methylene-3-(organoselanyl)-selenochromenes. The results of the reaction condition optimization studies showed that the solvent, the iron source, and the amount of diorganyl diselenide had a fundamental influence on the reaction yields. In the presence of iron(III) chloride (1.5 equiv) and diorganyl diselenides (1.0 equiv), using dichloromethane as the solvent, at room temperature, 4-methylene-3-(organoselanyl)-selenochromenes were formed in moderate to good yields. The reaction conditions were found to be suitable for substrates bearing electron-donating and electron-withdrawing groups on the aromatic ring at both propargyl and alkyne positions. However, we observed a limitation in the reaction conditions when they were applied to other diorganyl dichalcogenides, such as diorganyl disulfides and diorganyl ditellurides, which did not give the corresponding products. We also elaborated on a mechanism proposal based on control experiments performed.

Objective: The purpose of this study is to evaluate the association between psychosocial aspects at work and dissatisfaction among health workers in five cities in Bahia, Brazil., Methods: The evaluation was based on different models proposed to measuring occupational stress and possible combinations between them: demand-control model (DCM) and effort-reward imbalance (ERI). We conducted a cross-sectional epidemiological study including 3084 health workers. The analysis considered the association between partial/full/partial (combined) occupational stress models (the variable "exposure") and job dissatisfaction (the variable "outcome")., Results: Dissatisfaction rate was 26%. Full DCM and ERI models were better than partial ones to investigate job dissatisfaction. After adjustments, the combined models presented more robust measures of prevalence ratio than models evaluated separately (PR 2.93; CI 2.26-3.80)., Conclusions: The combination of models has shown greater capacity to identify situations of job dissatisfaction and provided more potential information to support actions for workers' health.

Background: Repeated nonextreme sun exposures induce skin pigmentation by increasing melanin production and by oxidizing preexisting melanin and melanin precursors. This leads to skin disorders and skin color heterogeneity such as hyperpigmented spots. Objective: We assessed 31 randomized, controlled clinical trials to determine the potential of vitamin C to limit ultraviolet (UV) daylight-induced pigmentation, considering dose response and different skin type populations (Caucasian and Chinese). Materials and Methods: Thirty-one intraindividual, randomized, controlled clinical trials involving Caucasian and Chinese subjects (15-35 healthy male or female volunteers per study, 741 total volunteers) 18 to 50 years of age with Phototype III and individual typology angle (ITA) value between 28 and 49 degrees were analyzed. The 31 studies assessed the potential of vitamin C (formulated with the copolymer Styrène-Anhydride Maléique [SMA]) to decrease pigmentation induced by UV daylight exposure. Results were combined using a Bayesian meta-analysis to provide probabilistic evidence of the effects of vitamin C by dose and population. Results: Vitamin C was effective in reducing pigmentation induced by UV daylight-simulated expositions (4 days at 0.75 Individual Minimal Erythemal Dose [MEDi]) in a dose-dependent manner. During the depigmentation phase, no additive value was provided by the vitamin C, suggesting that the lightening properties described in the literature for vitamin C correspond to an antipigmenting quality rather than a depigmenting effect. Conclusion: Vitamin C is a valuable and safe dermocosmetic antipigmenting compound with a strong effect at 10% possibly useful in preventing signs of photoaging., Competing Interests: FUNDING:No funding was received for this study. DISCLOSURES:All authors are employees of L’Oréal.

Introduction: In this study, we quantitatively assessed 3-dimensional condylar displacement during counterclockwise maxillomandibular advancement surgery (CMMA) with or without articular disc repositioning, focusing on surgical stability in the follow-up period., Methods: The 79 patients treated with CMMA had cone-beam computed tomography scans taken before surgery, immediately after surgery, and, on average, 15 months postsurgery. We divided the 142 condyles into 3 groups: group 1 (n = 105), condyles of patients diagnosed with symptomatic presurgical temporomandibular joint articular disc displacement who had articular disc repositioning concomitantly with CMMA; group 2 (n = 23), condyles of patients with clinical verification of presurgical articular disc displacement who had only CMMA; and group 3 (n = 14), condyles of patients with healthy temporomandibular joints who had CMMA. Presurgical and postsurgical 3-dimensional models were superimposed using voxel-based registration on the cranial base. Three-dimensional cephalometrics and shape correspondence were applied to assess surgical and postsurgical displacement changes., Results: Immediately after surgery, the condyles moved mostly backward and medially and experienced lateral yaw, medial roll, and upward pitch in the 3 groups. Condyles in group 1 showed downward displacement, whereas the condyles moved upward in groups 2 and 3 (P ≤0.001). Although condylar displacement changes occurred in the 3 groups, the overall surgical procedure appeared to be fairly stable, particularly for groups 1 and 3. Group 2 had the greatest amount of relapse (P ≤0.05)., Conclusions: CMMA has been shown to be a stable procedure for patients with healthy temporomandibular joints and for those who had simultaneous articular disc repositioning surgery., (Copyright © 2018 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

The butylselanyl propargyl alcohols reacted with iodine to afford 3-iodoselenophenes. The change of nucleophile position from propargyl to homopropargyl was crucial for the aromatization and formation of selenophene rings. The experiments revealed that bromine and N-bromosuccinimide were not able to cyclize the butylselanyl propargyl alcohols; however, when the bromine source was copper(II) bromide the corresponding 3-bromoselenophenes were obtained in good yields. In addition, the reaction of butylselanyl propargyl alcohols with diorganyl diselenides catalyzed by copper(I) iodide gave the 3-(organoselanyl)selenophenes. The reaction took place with aromatic rings substituted by either electron-donating or -withdrawing groups in the alkynes and propargyl positions. The steric effects of substituents were dominant in determining the yields, whereas electronic effects had only a minor influence. Furthermore, by monitoring the reaction by 1 H NMR, we were able to identify the key intermediate, which supported the elaboration of a proposed reaction mechanism. The 3-iodoselenophenes prepared allowed the synthesis of multifunctional selenophenes via application in metal-catalyzed coupling reactions, such as Sonogashira, Ullmann and Suzuki type reactions.

This study investigated predictive risk factors of condylar remodeling changes after counterclockwise maxillomandibular advancement (CCW-MMA) and disc repositioning surgery. Forty-one female patients (75 condyles) treated with CCW-MMA and disc repositioning had cone beam computed tomography (CBCT) scans taken pre-surgery, immediately after surgery, and at an average 16 months post-surgery. Pre- and post-surgical three-dimensional models were superimposed using automated voxel-based registration on the cranial base to evaluate condylar displacements after surgery. Regional registration was performed to assess condylar remodeling in the follow-up period. Three-dimensional cephalometrics, shape correspondence (SPHARM-PDM), and volume measurements were applied to quantify changes. Pearson product-moment correlations and multiple regression analysis were performed. Highly statistically significant correlation showed that older patients were more susceptible to overall condylar volume reduction following CCW-MMA and disc repositioning (P≤0.001). Weak but statistically significant correlations were observed between condylar remodeling changes in the follow-up period and pre-surgical facial characteristics, magnitude of the surgical procedure, and condylar displacement changes. After CCW-MMA and disc repositioning, the condyles moved mostly downwards and medially, and were rotated medially and counterclockwise; displacements in the opposite direction were correlated with a greater risk of condylar resorption. Moreover, positional changes with surgery were only weakly associated with remodeling in the follow-up period, suggesting that other risk factors may play a role in condylar resorption., (Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

Background: Schistosomiasis is a parasitic disease infecting hundreds of millions of people worldwide. Treatment depends on a single drug, praziquantel, which kills the Schistosoma spp. parasite only at the adult stage. HDAC inhibitors (HDACi) such as Trichostatin A (TSA) induce parasite mortality in vitro (schistosomula and adult worms), however the downstream effects of histone hyperacetylation on the parasite are not known., Methodology/principal Findings: TSA treatment of adult worms in vitro increased histone acetylation at H3K9ac and H3K14ac, which are transcription activation marks, not affecting the unrelated transcription repression mark H3K27me3. We investigated the effect of TSA HDACi on schistosomula gene expression at three different time points, finding a marked genome-wide change in the transcriptome profile. Gene transcription activity was correlated with changes on the chromatin acetylation mark at gene promoter regions. Moreover, combining expression data with ChIP-Seq public data for schistosomula, we found that differentially expressed genes having the H3K4me3 mark at their promoter region in general showed transcription activation upon HDACi treatment, compared with those without the mark, which showed transcription down-regulation. Affected genes are enriched for DNA replication processes, most of them being up-regulated. Twenty out of 22 genes encoding proteins involved in reducing reactive oxygen species accumulation were down-regulated. Dozens of genes encoding proteins with histone reader motifs were changed, including SmEED from the PRC2 complex. We targeted SmEZH2 methyltransferase PRC2 component with a new EZH2 inhibitor (GSK343) and showed a synergistic effect with TSA, significantly increasing schistosomula mortality., Conclusions/significance: Genome-wide gene expression analyses have identified important pathways and cellular functions that were affected and may explain the schistosomicidal effect of TSA HDACi. The change in expression of dozens of histone reader genes involved in regulation of the epigenetic program in S. mansoni can be used as a starting point to look for possible novel schistosomicidal targets.

The success of fishes in different environments is related with the variation of reproductive strategies developed by the systematic group, which is reflected in the morphology of the reproductive system and can have ecological and evolutionary implications. This study comparatively analyzed the morphological characteristics of the male and female reproductive systems of ostariophysan fish species from the upper Das Velhas River in the São Francisco River basin, Brazil. In order to accomplish this, 393 specimens belonging to seven fish species were sampled between April 2010 and June 2015 for histological, ultrastructural, histochemical, and morphometric analyses. All the species examined have anastomosing tubular testes with unrestricted distribution of spermatogonia. Astyanax bimaculatus, A. fasciatus, A. scabripinnis, and Harttia torrenticola had their spermatozoa embedded in a glycoprotein secretion within the tubule lumen. Most species had type I spermiogenesis, whereas Rhamdia quelen had type III spermiogenesis. While all females examined had asynchronous oocyte development, there were remarkable morphological, histochemical, and morphometric differences in the ovarian follicles and enveloping layers. Hoplias malabaricus and H. torrenticola, which exhibit parental care behaviour, had a significantly larger diameter of vitellogenic oocytes and larger spermatozoa nuclei. Apareiodon ibitiensis, H. torrenticola, and A. scabripinnis, species that have rheophilic preferences, exhibited a thicker zona radiata than the other species examined. The follicular cells of R. quelen and H. torrenticola were columnar and produced a jelly coat and mucosubstances, respectively. The females of the seven fish species studied show a correlation of the reproductive strategies with the reproductive system morphology, while males retained more similar morphological characteristics between species. J. Morphol. 278:170-181, 2017. © 2016 Wiley Periodicals,Inc., (© 2016 Wiley Periodicals, Inc.)

The aim of this study was to investigate the incidence and risk factors for handball injuries in Brazilian elite handball players. Overall, 339 athletes from 21 handball teams who participated in the two main Brazilian championships were followed up during a season. In total, 312 injuries were reported by 201 athletes. The injury incidence rate during training was 3.7/1000 h, and during matches was 20.3/1000 matches. Ankle (19.4%, n = 46) and knee (13.5%, n = 32) were the body regions most affected by traumatic injuries. Shoulders (44.0%, n = 33) and knee (26.7%, n = 20) were the body regions most affected by overuse injuries. Muscle injuries (27.1%, n = 68) was the traumatic injury type most reported. Tendinopathy (91.8%, n = 56) was the overuse injury type most observed. Previous injury (OR: 2.42, CI 95%: 1.51-3.89) and an additional match per week (OR: 1.31, CI 95%: 1.05-1.62) were associated with a higher risk of overuse injury. Female athletes (OR: 1.56, CI 95%: 1.08-2.25) and an additional hour of training per week (OR: 1.09, CI 95%: 1.02-1.15) were associated with a higher risk of traumatic injury. This study showed that athletes with previous injury have shown a high risk of developing an overuse injury., (© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objective: To evaluate the diagnostic efficacy of transrectal ultrasonography (US) bi¬opsy with imaging fusion using multiparametric (mp) magnetic resonance imaging (MRI) in patients with suspicion of prostate cancer (PCa), with an emphasis on clini¬cally significant tumors according to histological criteria., Materials and Methods: A total of 189 consecutive US/MRI fusion biopsies were per¬formed obtaining systematic and guided samples of suspicious areas on mpMRI using a 3 Tesla magnet without endorectal coil. Clinical significance for prostate cancer was established based on Epstein criteria., Results: In our casuistic, the average Gleason score was 7 and the average PSA was 5.0ng/mL. Of the 189 patients that received US/MRI biopsies, 110 (58.2%) were positive for PCa. Of those cases, 88 (80%) were clinically significant, accounting for 46.6% of all patients. We divided the MRI findings into 5 Likert scales of probability of having clinically significant PCa. The positivity of US/MRI biopsy for clinically significant PCa was 0%, 17.6% 23.5%, 53.4% and 84.4% for Likert scores 1, 2, 3, 4 and 5, respectively. There was a statistically significant difference in terms of biopsy results between dif¬ferent levels of suspicion on mpMRI and also when biopsy results were divided into groups of clinically non-significant versus clinically significant between different lev¬els of suspicion on mpMRI (p-value < 0.05 in both analyzes)., Conclusion: We found that there is a significant difference in cancer detection using US/MRI fusion biopsy between low-probability and intermediate/high probability Likert scores using mpMRI., Competing Interests: Conflicts of Interest: None declared., (Copyright® by the International Brazilian Journal of Urology.)

Objective: To analyze calcium intake in adolescents according to sociodemographic variables, health-related behaviors, morbidities, and body mass index., Methods: This was a cross-sectional population-based study, with a two-stage cluster sampling that used data from a survey conducted in Campinas, São Paulo, Brazil, between 2008 and 2009. Food intake was assessed using a 24-hour dietary recall. The study included 913 adolescents aged 10-19 years., Results: Average nutrient intake was significantly lower in the segment with lower education of the head of the family and lower per capita family income, in individuals from other cities or states, those who consumed fruit less than four times a week, those who did not drink milk daily, those who were smokers, and those who reported the occurrence of headaches and dizziness. Higher mean calcium intake was found in individuals that slept less than seven hours a day. The prevalence of calcium intake below the recommendation was 88.6% (95% CI: 85.4-91.2)., Conclusion: The results alert to an insufficient calcium intake and suggest that certain subgroups of adolescents need specific strategies to increase the intake of this nutrient., (Copyright © 2015 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.)

Introduction: The aims of this study were to evaluate the differences between 2 regions of maxillary voxel-based registration and to test the reproducibility of the registration., Methods: Three-dimensional models were built for before-treatment (T1) and after-treatment (T2) based on cone-beam computed tomography images from 16 growing subjects. Landmarks were labeled in all T2 models of the maxilla, and voxel-based registrations were performed independently by 2 observers at 2 times using 2 reference regions. The first region, the maxillary region, included the maxillary bone clipped inferiorly at the dentoalveolar processes, superiorly at the plane passing through the right and left orbitale points, laterally at the zygomatic processes through the orbitale point, and posteriorly at a plane passing through the distal surface of the second molars. In the second region, the palate and infrazygomatic region had different posterior and anterior limits (at the plane passing through the distal aspects of the first molars and the canines, respectively). The differences between the registration regions were measured by comparing the distances between corresponding landmarks in the T2 registered models and comparing the corresponding x, y, and z coordinates from corresponding landmarks. Statistical analysis of the differences between the T2 surface models was performed by evaluating the means and standard deviations of the distances between landmarks and by testing the agreement between coordinates from corresponding landmarks (intraclass correlation coefficient and Bland-Altman method)., Results: The means of the differences between landmarks from the palate and infrazygomatic region to the maxillary region 3-dimensional surface models at T2 for all regions of reference, times of registrations, and observer combinations were smaller than 0.5 mm. The intraclass correlation coefficient and the Bland-Altman plots indicated adequate concordance., Conclusions: The 2 regions of regional maxillary registration showed similar results and adequate intraobserver and interobserver reproducibility values., (Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Objective: To quantitatively compare condylar morphology using cone beam computed tomography (CBCT) and multislice spiral computed tomography (MSCT) virtual three-dimensional surface models., Study Design: The sample consisted of secondary data analyses of CBCT and MSCT scans obtained for clinical purposes from 74 patients treated with condylar resection and prosthetic joint replacement. Three-dimensional surface models of 146 condyles were constructed from each scan modality. Across-subject models were approximated and voxel-based registration was performed between homologous CBCT and MSCT images, making it possible to create average CBCT- and MSCT-based condylar models. SPHARM-PDM software provided matching points on each corresponding model. ShapeAnalysisMANCOVA software assessed statistically significant differences between observers and imaging modalities. One-sample t-tests evaluated the null hypothesis that the mean differences between each CBCT- and MSCT-based model were not clinically significant (<.5 mm). Tests were conducted at a significance level of P < .05., Results: ShapeAnalysisMANCOVA showed no statistically significant difference between the average CBCT- and MSCT-based models (P > .68). During pairwise comparison, the mean difference observed was .406 mm (SD, .173). One sample t-test showed that mean differences between each set of paired CBCT- and MSCT-based models were not clinically significant (P = .411)., Conclusion: Three-dimensional surface models constructed from CBCT images are comparable to those derived from MSCT scans and may be considered reliable tools for assessing condylar morphology., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Background: Schistosomiasis is one of the most prevalent parasitic diseases worldwide and is a public health problem. Schistosoma mansoni is the most widespread species responsible for schistosomiasis in the Americas, Middle East and Africa. Adult female worms (mated to males) release eggs in the hepatic portal vasculature and are the principal cause of morbidity. Comparative separate transcriptomes of female and male adult worms were previously assessed with using microarrays and Serial Analysis of Gene Expression (SAGE), thus limiting the possibility of finding novel genes. Moreover, the egg transcriptome was analyzed only once with limited bacterially cloned cDNA libraries., Methodology/principal Findings: To compare the gene expression of S. mansoni eggs, females, and males, we performed RNA-Seq on these three parasite forms using 454/Roche technology and reconstructed the transcriptome using Trinity de novo assembly. The resulting contigs were mapped to the genome and were cross-referenced with predicted Smp genes and H3K4me3 ChIP-Seq public data. For the first time, we obtained separate, unbiased gene expression profiles for S. mansoni eggs and female and male adult worms, identifying enriched biological processes and specific enriched functions for each of the three parasite forms. Transcripts with no match to predicted genes were analyzed for their protein-coding potential and the presence of an encoded conserved protein domain. A set of 232 novel protein-coding genes with putative functions related to reproduction, metabolism, and cell biogenesis was detected, which contributes to the understanding of parasite biology., Conclusions/significance: Large-scale RNA-Seq analysis using de novo assembly associated with genome-wide information for histone marks in the vicinity of gene models constitutes a new approach to transcriptome analysis that has not yet been explored in schistosomes. Importantly, all data have been consolidated into a UCSC Genome Browser search- and download-tool (http://schistosoma.usp.br/). This database provides new ways to explore the schistosome genome and transcriptome and will facilitate molecular research on this important parasite.

Objectives: To investigate the 3D morphological variations in 169 temporomandibular ioint (TMJ) condyles, using novel imaging statistical modeling approaches., Setting and Sample Population: The Department of Orthodontics and Pediatric Dentistry at the University of Michigan. Cone beam CT scans were acquired from 69 subjects with long-term TMJ osteoarthritis (OA, mean age 39.1±15.7 years), 15 subjects at initial consult diagnosis of OA (mean age 44.9±14.8 years), and seven healthy controls (mean age 43±12.4 years)., Materials and Methods: 3D surface models of the condyles were constructed, and homologous correspondent points on each model were established. The statistical framework included Direction-Projection-Permutation (DiProPerm) for testing statistical significance of the differences between healthy controls and the OA groups determined by clinical and radiographic diagnoses., Results: Condylar morphology in OA and healthy subjects varied widely with categorization from mild to severe bone degeneration or overgrowth. DiProPerm statistics supported a significant difference between the healthy control group and the initial diagnosis of OA group (t=6.6, empirical p-value=0.006) and between healthy and long-term diagnosis of OA group (t=7.2, empirical p-value=0). Compared with healthy controls, the average condyle in OA subjects was significantly smaller in all dimensions, except its anterior surface, even in subjects with initial diagnosis of OA., Conclusion: This new statistical modeling of condylar morphology allows the development of more targeted classifications of this condition than previously possible., (© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

The European Research Council has recently funded HOLMES, a new experiment to directly measure the neutrino mass. HOLMES will perform a calorimetric measurement of the energy released in the decay of [Formula: see text]Ho. The calorimetric measurement eliminates systematic uncertainties arising from the use of external beta sources, as in experiments with beta spectrometers. This measurement was proposed in 1982 by A. De Rujula and M. Lusignoli, but only recently the detector technological progress allowed to design a sensitive experiment. HOLMES will deploy a large array of low temperature microcalorimeters with implanted [Formula: see text]Ho nuclei. The resulting mass sensitivity will be as low as 0.4 eV. HOLMES will be an important step forward in the direct neutrino mass measurement with a calorimetric approach as an alternative to spectrometry. It will also establish the potential of this approach to extend the sensitivity down to 0.1 eV. We outline here the project with its technical challenges and perspectives.

Leishmaniasis is an infectious disease caused by Leishmania species. Leishmania amazonensis is a New World Leishmania species belonging to the Mexicana complex, which is able to cause all types of leishmaniasis infections. The L. amazonensis reference strain MHOM/BR/1973/M2269 was sequenced identifying 8,802 codifying sequences (CDS), most of them of hypothetical function. Comparative analysis using six Leishmania species showed a core set of 7,016 orthologs. L. amazonensis and Leishmania mexicana share the largest number of distinct orthologs, while Leishmania braziliensis presented the largest number of inparalogs. Additionally, phylogenomic analysis confirmed the taxonomic position for L. amazonensis within the "Mexicana complex", reinforcing understanding of the split of New and Old World Leishmania. Potential non-homologous isofunctional enzymes (NISE) were identified between L. amazonensis and Homo sapiens that could provide new drug targets for development.

Objective: To investigate the effects of different transcutaneous electrical nerve stimulation frequencies in nociception front of a pressure pain threshold and cold in healthy individuals., Methods: Twenty healthy subjects were divided into four groups, all of which have gone through all forms of electrical stimulation at different weeks. Assessments were pre and post-therapy, 20 and 60 minutes after stimulation. To evaluate the pressure pain threshold, an algometer was used with one tapered tip, pressing the hypothenar region until voluntary report the word "pain". Cold pain intensity was assessed by immersion in water at 5°C for 30 seconds; at the end, the subject was asked to quantify the pain intensity on a Visual Analog Scale for Pain. For electrical stimulation, two electrodes were used near the elbow, for 20 minutes, with an intensity strong, but not painful. The frequency was in accordance with the group: 0Hz (placebo); 7Hz; 100Hz; and 255Hz., Results: Both for the assessment of pressure pain threshold as the cold pain intensity, there was no significant difference (p>0.05)., Conclusion: We conclude that the use of transcutaneous electrical nerve stimulation on dermatomes C6 to C8 produced no significant change in pressure pain threshold or cold discomfort.

Objective: To describe the prevalence of headache and its interference in the activities of daily living (ADL) in female adolescent students., Methods: This descriptive cross-sectional study enrolled 228 female adolescents from a public school in the city of Petrolina, Pernambuco, Northeast Brazil, aged ten to 19 years. A self-administered structured questionnaire about socio-demographic characteristics, occurrence of headache and its characteristics was employed. Headaches were classified according to the International Headache Society criteria. The chi-square test was used to verify possible associations, being significant p<0.05., Results: After the exclusion of 24 questionnaires that did not met the inclusion criteria, 204 questionnaires were analyzed. The mean age of the adolescents was 14.0±1.4 years. The prevalence of headache was 87.7%. Of the adolescents with headache, 0.5% presented migraine without pure menstrual aura; 6.7%, migraine without aura related to menstruation; 1.6%, non-menstrual migraine without aura; 11.7%, tension-type headache and 79.3%, other headaches. Significant associations were found between pain intensity and the following variables: absenteeism (p=0.001); interference in ADL (p<0.001); medication use (p<0.001); age (p=0.045) and seek for medical care (p<0.022)., Conclusions: The prevalence of headache in female adolescents observed in this study was high, with a negative impact in ADL and school attendance.

Study Objective: To determine the prevalence, characteristics and effects on the activities of daily living of menstruation disturbances among adolescent girls., Design: Descriptive, cross-sectional study., Setting: A public school in the city of Petrolina, Brazil., Participants: 218 female adolescents of ages between 12 and 17 years., Main Outcome Measure: We used a structured questionnaire addressing the socio-demographic and menstrual characteristics of the adolescents. The intensity of menstrual pain and its effect on the activities of daily living were measured using an 11-point numeric rating scale., Results: The mean age of adolescent girls was 13.7 ± 1.5 years. The menstrual cycles of 67% were regular, while 33% were irregular. Dysmenorrhea had a prevalence of 73%, and school absenteeism was observed among 31% of the adolescents. In addition, 66% of the participants considered that dysmenorrhea affected their activities of daily living. Associations were found between the intensity of pain and the variables: school absenteeism; affected activities of daily living; need to use medications; and between affected activities of daily living and school absenteeism (P < .05)., Conclusions: Among the menstrual disturbances observed dysmenorrhea stood out due to its high prevalence among adolescents with a negative effect on adolescents' activities of daily living. Early diagnosis and knowledge about menstrual disturbances are essential because in addition to reiterating the importance of implementing health education actions, they also help to choose appropriate treatments, thus minimizing the negative effects of these disturbances on the lives of adolescents., (Copyright © 2013 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.)

This cross-sectional and quantitative study analyzed the knowledge of nursing professionals regarding Adverse Events (AE) in a hemodialysis unit of a teaching hospital. Data collection was performed between February and April 2011, based on interviews with 25 professionals. Data analysis identified 517 reports of 32 types of adverse events, of which the most commonly cited were: obstructed catheter, accidental withdrawal of the needle; and clotting of the extracorporeal system. Patient-related causes were mentioned in 42.8% of the reports. The main measures adopted were the implementation/ change of protocols and continuing education; the latter is the main suggestion for prevention. The results can contribute to a critical analysis of the quality of care in hemodialysis units, resulting in the development of interventions that help promote patient safety.

Objective: To determine the minimum inhibitory concentrations (MICs) of parenteral penicillin and moxifloxacin against Streptococcus pneumoniae strains isolated at a hospital center., Methods: In-vitro, prospective study involving 100 S. pneumoniae isolates collected from patients who had been treated, between October of 2008 and July of 2010, at the Hospital das Clínicas complex of the University of São Paulo School of Medicine, located in the city of São Paulo, Brazil. The isolates were obtained from respiratory tract cultures or blood samples unrelated to meningeal infections, and they were tested for penicillin and moxifloxacin susceptibility by E-test. The MIC category interpretations were based on updated standards., Results: All isolates were fully susceptible to parenteral penicillin (MIC < 2 µg/mL), and, consequently, they were also susceptible to amoxicillin, ampicillin, third/fourth generation cephalosporins, and ertapenem. Of the S. pneumoniae strains, 99% were also susceptible to moxifloxacin, and only one strain showed an MIC = 1.5 µg/mL (intermediate)., Conclusions: Our results showed high susceptibility rates to parenteral penicillin and moxifloxacin among S. pneumoniae isolates unrelated to meningitis, which differs from international reports. Reports on penicillin resistance should be based on updated breakpoints for non-meningitis isolates in order to guide the selection of an antimicrobial therapy and to improve the prediction of the clinical outcomes.

Introduction: The Bolsa Família Program is the largest program of conditional cash transfer in Brazil, and its major goal is to reverse the current food insecurity. In spite of that, there are few studies that show the development of nutritional status for this population., Objective: This study aimed to describe the nutritional status of the adult population enrolled in the Bolsa Família program, in the municipality of Curitiba, PR., Methods: This is a cross-sectional, population-based study, performed in the health districts of the city of Curitiba, Parana, in the period from July 2006 to July 2007. We interviewed 747 adults, 18 years of age and over, of both sexes, living in the catchment area of the basic healthcare units in the city. To assess the nutritional status of this population, we measured weight (kg), height (cm), and waist circumference (WC) and calculated the body mass index. They were asked about age, marital status, occupation, number of household members, origin, and years of schooling. The association between excessive weight, waist circumference and sociodemographic co-variables was assessed by unconditional logistic regression., Results: About 40% of the population was considered of normal weight and 27.1% obese, according to BMI standards. Analyzing waist circumference data, 48.2% have measures that show a much greater risk for developing cardiovascular disease. Significant statistical association occurred between BMI increase and age (OR = 2.16; CI 95%: 1.57-2.96), sex (OR = 0.57; CI 95%: 0.33-0.97) and marital status (OR = 1.40; CI 95%: 1.03-1.88). A significant association was observed between waist circumference and age (OR = 2.93; IC 95%: 2.13-4.02) and sex., Conclusion: Most of the population presented excessive weight and abdominal fat, risks for cardiovascular diseases. The results point towards the need to build and implement regional diet public policies.

Leishmania major, Trypanosoma brucei, and Trypanosoma cruzi (Tritryps) are unicellular protozoa that cause leishmaniasis, sleeping sickness and Chagas' disease, respectively. Most drugs against them were discovered through the screening of large numbers of compounds against whole parasites. Nonhomologous isofunctional enzymes (NISEs) may present good opportunities for the identification of new putative drug targets because, though sharing the same enzymatic activity, they possess different three-dimensional structures thus allowing the development of molecules against one or other isoform. From public data of the Tritryps' genomes, we reconstructed the Genetic Information Processing Pathways (GIPPs). We then used AnEnPi to look for the presence of these enzymes between Homo sapiens and Tritryps, as well as specific enzymes of the parasites. We identified three candidates (ECs 3.1.11.2 and 6.1.1.-) in these pathways that may be further studied as new therapeutic targets for drug development against these parasites.

Background: Cardiopathies are high prevalence conditions. Among them, rheumatic carditis is of high relevance in developing countries. Left cardiac chamber changes are associated to endothelial dysfunction and ET-1 levels increase. Pulmonary circulation is then affected, and not seldom leading to pulmonary hypertension (PH). However, the presence of ET-1 and its receptors in the mitral valve itself--promoting pulmonary vascular changes, with increased rheumatic valvular deformation--has not been discussed in the literature., Objective: To determine the expression of endothelin gene and its receptors in rheumatic mitral valves through techniques of molecular genetics., Methods: Twenty-seven patients submitted to mitral valve replacement had their valvular tissue examined to determine the presence of ET-1 genes and their A and B receptors. Histological and molecular analysis of the valves was performed (divided into M1, M2 and M3 fragments), with patients' clinical and epidemiological data collected. Patients were divided into 3 groups (mitral valvopathy, mitroaortic valvopathy, and reoperation patients)., Results: The study showed endothelin-1 gene expression in 40.7% specimens and A receptor in all samples; receptor gene B had lower expression (22.2%)., Conclusion: All patients showed A receptor gene expression. No statistically significant difference was observed in regard to condition severity, expressed according to functional class, and subgroups (mitral valvopathy, mitroaortic valvopathy, and reoperation patients).

The leaf structure and micromorphology characterize plant species and reflex its interactions with the environment. Leaf epidermis sculptures aid high transpiration plants on light reflection. The form and distribution of epicuticular wax crystalloids are important to characterize the surface. Aiming to know the micromorphology and the ultrastructure of G. arborescens, G. pohlii and G. virgata, leaves of these Cerrado native species were collected in Brasília, Distrito Federal, Brazil, at the Olympic Center of the Universidade de Brasília and at Reserva Ecológica do Roncador. Leaves of G. globosa, an Indian native species, were also studied for comparison. Leaves were fractionated, fixed and treated for observation under optical and scanning electron microscope. A description of the leaf epidermis is provided, along with some quantitative data to help the species taxonomy and support future studies on their physiology: all species are amphistomatic and have Stomatal Index between 7.27 and 18.99. The Gomphrena spp. studied have epicuticular wax platelets and wax sculptures over their larger trichome, which are relevant for their taxonomy. Over the Cerrado species cuticle, epicuticular wax is damaged by fungi hyphae development. The presence of epicuticular wax on Gomphrena spp. leaves corroborates the phylogenetical alliance between Amaranthaceae and Chenopodiaceae.

Introduction: Imipenem-resistant Pseudomonas aeruginosa resulting from metallo-β-lactamases has been reported to be an important cause of nosocomial infection and is a critical therapeutic problem worldwide, especially in the case of bacteremia., Objectives: To determine the frequency of metallo-β-lactamases among imipenem-resistant Pseudomonas aeruginosa isolates and to compare methods of phenotypic and molecular detection., Methods: During 2006, 69 imipenem-resistant Pseudomonas aeruginosa samples were isolated from blood and tested for metallo-β-lactamase production using both phenotypic methods. Minimal Inhibitory Concentratrions (MIC) (μg/mL) was determined with commercial microdilution panels. Pulsed Field Gel Electrophoresis (PFGE) was performed among metallo-β-lactamase producers., Results: Of all the blood isolates, 34.5% were found to be imipenem-resistant Pseudomonas aeruginosa. Positive phenotypic tests for metallo-β-lactamases ranged from 28%-77%, and Polymerase Chain Reaction (PCR) were positive in 30% (of note, 81% of those samples were bla(SPM)₋₁ and 19% were bla(VIM)₋₂). Ethylenediamine tetracetic acid (EDTA) combinations for the detected enzymes had low kappa values; thus, care should be taken when use it as a phenotypic indicator of MBL. Despite a very resistant antibiogram, four isolates demonstrated the worrisome finding of a colistin MIC in the resistant range. PFGE showed a clonal pattern., Conclusion: Metallo-β-lactamases among imipenem-resistant Pseudomonas aeruginosa were detected in 30.4% of imipenem-resistant Pseudomonas aeruginosa isolates. This number might have been higher if other genes were included. SPM-1 was the predominant enzyme found. Phenotypic tests with low kappa values could be misleading when testing for metallo-β-lactamases. Polymerase Chain Reaction detection remains the gold standard.

Background: Systemic Arterial Hypertension (SAH), considered a public health problem due to its high prevalence and difficult control, is also described as one of the most important risk factors for cardiovascular diseases., Objective: This study aimed to determine the prevalence of SAH, as well as characteristics related to its control and treatment, among individuals aging between 18 and 90 years from the urban region of Nobres, MT., Methods: Cross-sectional, population-based study, with random sampling and with replacement. For classification of SAH, criteria included blood pressure (BP) > or =140/90 mmHg or current use of antihypertensive drugs. Individuals were interviewed with standardized questionnaires previously tested. Variables were described as means +/- standard deviations and frequencies. Means were compared with the Student s t test and associations were determined with the Pearson chi-square test, with a significance level of 5%., Results: SAH has a prevalence of 30.1% in the sample, composed of 1,003 individuals older than 18 years. Among hypertensive individuals (N = 302), 73.5% knew about their condition, 61.9% were under treatment and for 24.2% the BP was under control. A positive association was observed between SAH and age; illiteracy; less than 8 years education; BMI > or = 25 kg/m(2); high and very high waist circumference; waist-hip ratio (WHR) at risk level; sedentariness; and alcoholism., Conclusions: This study showed that SAH represents an important public health problem even in a small district in the interior region of Brazil. Levels of control and treatment of hypertension in the population were higher than those observed in similar studies, but were considered not satisfactory.

Background: Split liver transplantation (SLT) increases organ supply for hepatic transplantation. Long-term patient survival and complication rates seem to be equivalent between orthotopic liver transplantation (OLT) and SLT. There are controversies among transplant physicians due to an ethical dilemma between benefiting individual needs or those of society. Barshes and Goss (Am J Transplant 5:2047, 2005) demonstrated that the majority of adult liver transplant candidates are favorable to SLT. The aim of our study was to evaluate the opinions of patients at a Brazilian university hospital regarding SLT., Materials and Methods: A questionnaire with 14 questions was applied to 50 patients included in a hepatic transplant waiting list regarding SLT., Results: The overall attitudes of 66% of the participants were classified as utilitarian, 31% were classified as self-preserving, and 3% were undecided. Ninety-one percent of patients would be willing to share even if their expected survival after SLT was shorter than that with OLT. For 77% of patients, children must have priority over adults. However, 83% were unaware of the donors for pediatric transplantations., Conclusions: SLT is a consistent solution for organ demand despite controversies among transplant physicians. The present study demonstrated that most patients were favorable to SLT. In conclusion, attitudes toward graft sharing are not barriers to SLT.

Objective: To compare the resistance of manual suture with that of mechanical suture immediately after the suture of the left bronchial stump of dogs submitted to pneumonectomy., Methods: A total of 15 mixed-breed dogs of both genders, each weighing between 8 and 23 kg, were randomly divided into 2 groups. In group I (n = 7), the bronchial stump was sutured manually (the Sweet method) and, in group II (n = 8), it was stapled. Immediately after the closure of the bronchial stump, the intratracheal pressure was progressively increased in a controlled manner., Results: The mean rupture pressure of the bronchial stump suture line was 33.71 mmHg in group I and 89.87 mmHg in group II (p < 0.01)., Conclusion: These data allowed us to conclude that mechanical suture of the bronchial stump, submitted to pressure immediately after closure, is more resistant than is manual suture in dogs submitted to pneumonectomy.

Unlabelled: Chronic viral hepatitis is currently the most common indication for liver transplantation (OLT). Knowing the serological profile of patients on the liver transplant waiting list (LTWL) is essential to manage prophylactic and therapeutic strategies pre- and post-OLT. The aim of this study was to determine the hepatitis B virus (HBV) and hepatitis C virus (HCV) serological profile on the LTWL., Methods: Serological data were collected from 44 candidates included on the LTWL from May 2003 to November 2004. HBV and HCV serological profiles were performed by microenzyme immunoassay., Results: Twenty-eight patients (66.7%) lacked HBV serological markers. Anti-HBs was detected in 9.5% and was positive for HBsAg, anti-HBc, IgM anti-HBc, or HbeAg in 4.8% of patients, probably related to reactivation of chronic infection. In 7.1% of patients, the markers demonstrated serological cure of infection. In HCV patients, 41.5% were positive. There was HBV and HCV co-infection in 12.2% of patients., Conclusion: HBV infection in 21.4% of the patients corroborates the need to use more efficient protocols for prophylactic and therapeutic management pre- and post-OLT. The high prevalence of HCV infection reinforces the need to follow adequate protocols to avoid related complications and guarantee rational and universal use of more efficient drugs.

Background: Cyclodextrins are suitable drug delivery systems because of their ability to subtly modify the physical, chemical, and biological properties of guest molecules through labile interactions by formation of inclusion and/or association complexes. Plant cysteine proteinases from Caricaceae and Bromeliaceae are the subject of therapeutic interest, because of their anti-inflammatory, antitumoral, immunogenic, and wound-healing properties., Methods: In this study, we analyzed the association between beta-cyclodextrin (betaCD) and fraction P1G10 containing the bioactive proteinases from Carica candamarcensis, and described the physicochemical nature of the solid-state self-assembled complexes by Fourier transform infrared (FTIR) spectroscopy, thermogravimetry (TG), differential scanning calorimetry (DSC), X-ray powder diffraction (XRD), and nuclear magnetic resonance (NMR), as well as in solution by circular dichroism (CD), isothermal titration calorimetry (ITC), and amidase activity., Results and Discussion: The physicochemical analyses suggest the formation of a complex between P1G10 and betaCD. Higher secondary interactions, namely hydrophobic interactions, hydrogen bonding and van der Waals forces were observed at higher P1G10 : betaCD mass ratios. These results provide evidence of the occurrence of strong solid-state supramolecular non-covalent interactions between P1G10 and betaCD. Microcalorimetric analysis demonstrates that complexation results in a favorable enthalpic contribution, as has already been described during formation of similar betaCD inclusion compounds. The amidase activity of the complex shows that the enzyme activity is not readily available at 24 hours after dissolution of the complex in aqueous buffer; the proteinase becomes biologically active by the second day and remains stable until day 16, when a gradual decrease occurs, with basal activity attained by day 29., Conclusion: The reported results underscore the potential for betaCDs as candidates for complexing cysteine proteinases, resulting in supramolecular arrays with sustained proteolytic activity.

In the current study we describe the cases of 2 patients operated on for left-sided endocarditis, who later had myocardial ischemia develop secondary to left coronary artery compression from a pseudoaneurysm of the mitral-aortic fibrosa. Because the symptoms of angina persisted despite medical treatment, both patients had second surgeries. Myocardial revascularization was performed in 1 patient; the other patient, who had a severely depressed ventricular function, was given an orthotopic cardiac transplant.

Many athletes and active people have consumed a large variety of supplements in order to get a good shape or a better performance in competitions. Due to this, several studies have been carried out to determine if these supplements are in fact ergogenic aids. Creatine seems to be related to the performance enhance in high intensity intermittent exercises. Carnitine might probably improve the aerobic capacity by stimulating lipid oxidation on muscle cells during long term exercise. Bicarbonate is thought to increase blood pH delaying the onset of peripheral fatigue in high intensity exercises of short duration and strength training. Some other supplements like branched-chain amino acids and chromium are also involved in body composition changes as a gain of fat free mass and loss of fat mass. The effects caused by these supplements during physical activity have not been fully described in literature yet as well as their side effects.

A study of HIV-related risk behavior was carried out in 1998 among Brazilian military conscripts aged 17-20 years. A sample of 30,318 subjects was selected in three strata, pertaining to counties from: 1) the North and Central-West (N/CW); 2) South (S); and the states of Rio de Janeiro and São Paulo. HIV prevalence rates were estimated in all strata. The objective of this paper was to analyze the results according to differences in socioeconomic status (SES). The statistical analysis used an index of sexual risk behavior and logistic regression models. The N/CW stratum showed the worst indicators for SES, sexual risk behavior, and sexually transmitted infections (STIs), as well as the highest HIV seroprevalence rate. The best indicators for all variables were found in the RJ/SP stratum. The South showed intermediate results. Level of schooling also played a relevant role. In all three strata the conscripts with an incomplete high school education displayed the worst sexual risk behavior index, shown to be a relevant predictor of STI-related problems, including HIV infection.

Rationale and Objectives: The purpose of this study was to examine the effects of placing a metal stent across a bronchial orifice., Materials and Methods: Nine pigs were used as test subjects, because the right upper lobe bronchus comes directly off the trachea in these animals. One of three types of metal stents was placed into the trachea of each pig and covered the orifice of the right upper lobe bronchus. Follow-up studies were performed at 1 and 3 months to evaluate the right upper lobe for signs of bronchial obstruction, infection, and atelectasis. The animals were sacrificed at 3 months to study the histopathologic changes of the trachea and lungs., Results: Two upper lobe bronchi remained patent; seven were obstructed by granulation tissue or plugs of mucus and inflammatory cells. Right upper lobe infiltration and atelectasis were seen in eight animals. Interestingly, radiographic opacities were also common in other lung segments. There was a tendency toward fewer and less extensive lung opacities at 3 months compared with that at 1 month. At histopathologic examination, areas of both acute and chronic pneumonia were found in the right upper lobe of all animals. The segment of trachea covered by the stent was lined with a thin layer of granulation tissue containing neutrophils, monocytes, and lymphocytes. The stent luminal surface was covered with columnar, cuboidal, and stratified squamous epithelium. Tracheal stenosis was seen in three animals because of excessive granulation tissue in two and a collapsed stent in one., Conclusion: Placement of metal stents in pig trachea covering the orifice of the right upper lobe bronchus resulted in retention of secretions and secondary infection in the right upper lobe and other distant lung segments.

Objective: The aim of this study is to assess the validity of videothoracoscopy in the treatment of chronic pericardial effusions., Study Patients: We studied 13 consecutive patients with chronic pericardial effusions and an indication for surgical treatment. The patients, 10 female and 3 male, had a mean age of 48 years (21-72 years). Eleven patients had recurrent pericardial effusion and two patients had anterior mediastinal masses of unknown etiology and a large pericardial effusion., Methods: A videothoracoscopy was performed in every patient, under general anesthesia with a double-lumen endotracheal tube. The thoracic cavity was inspected, the pericardial effusion was drained and a partial pericardectomy was performed., Results: There was no postoperative mortality or morbidity. Average duration of postoperative thoracic drain and postoperative stay were, 1.2 and 2.4 days respectively. Follow-up ranged from 1 to 48 months (mean 23.3 months). One patient died due to progression of his malignant disease. There were no cases of recurrent pericardial effusions., Conclusions: Video assisted pericardectomy is a safe technique that should be considered in the treatment of chronic pericardial effusions.