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Zika virus (ZIKV) infection has recently emerged as a major concern worldwide due to its strong association with nervous system malformation (microcephaly) of fetuses in pregnant women infected by the virus. Signs and symptoms of ZIKV infection are often mistaken with other common viral infections. Since transmission may occur through biological fluids exchange and coitus, in addition to mosquito bite, this condition is an important infectious disease. Thus, understanding the mechanism of viral infection has become an important research focus, as well as providing potential targets for assertive clinical diagnosis and quality screening for hemoderivatives. Within this context, the present work analyzed blood plasma from 79 subjects, divided as a control group and a ZIKV-infected group. Samples underwent direct-infusion mass spectrometry and statistical analysis, where eight markers related to the pathophysiological process of ZIKV infection were elected and characterized. Among these, Angiotensin (1-7) and Angiotensin I were upregulated under infection, showing an attempt to induce autophagy of the infected cells. However, this finding is concerning about hypertensive individuals under treatment with inhibitors of the Renin-Angiotensin System (RAS), which could reduce this response against the virus and exacerbate the symptoms of the infection. Moreover, one of the most abundant glycosphingolipids in the nervous tissue, Ganglioside GM2, was also elected in the present study as an infection biomarker. Considered an important pathogen receptor at membrane's outer layer, this finding represents the importance of gangliosides for ZIKV infection and its association with brain tropism. Furthermore, a series of phosphatidylinositols were also identified as biomarkers, implying a significant role of the PI3K-AKT-mTOR Pathway in this mechanism. Finally, these pathways may also be understood as potential targets to be considered in pharmacological intervention studies on ZIKV infection management.

AbstractIntroduction One of the main goals of periodontal treatment is the regeneration of lost tissues, in order to improve the prognosis of the involved teeth [1–3]. Guided tissue regeneration (GTR) involves the use of a barrier with or without the use of bone substitutes [4]. Given the great diversity and constant evolution of materials, it is necessary to maintain a permanent evaluation of their clinical effectiveness. This study intends to evaluate the success and predictability of GTR using a new membrane and bone substitute of equine origin (Heart® and Mix Granules® – Bioteck SpA, Turin, Italy), in the treatment of infra-bony defects with two or three walls [5].Materials and methods This study was approved by Egas Moniz Ethics Committee and all patients signed an informed consent form. Patients were selected among those referred to the Department of Periodontology/EMDC, with indication for surgical periodontal treatment, presence of 2–3-wall infra-bony defects, probing depth (PD) ≥ 5 mm, infra-bony component ≥4 mm deep (evaluated radiographically) and attached gingiva ≥2 mm. Exclusion criteria were: cases with PIaque Index (PI) >20%, smokers, extension of the defect to the furcation zone, mobility grade III, endodontic pathology, diabetes or other pathologies that interfere with bone remodelling and metabolism or contraindicate periodontal surgery. All surgeries were performed by the same operator. The clinicians involved in the evaluation of the results had no intervention in surgery. The following clinical and radiographic parameters were evaluated at one, three and six months after surgery: PI, Gingival Index (GI), Probing pocket depth (PPD), Bleeding on Probing (BoP); Gingival recession (GR), height of keratinised gingiva (KG) and radiographic angle of the defect (RAD). In addition, the presence of possible intra-surgical or post-operative complications was also evaluated. The assessment of the defect depth reduction was based on standardised periapical radiographs obtained through the use of an individualised device (parallelizer).Results A total of six participants (83% females, 17% males), with a mean age of 61.6 (± 8.1) years, were enrolled in the study. The number of defect walls was: 3 walls (50%), 2 walls (33.3%) and 2/3 walls (16.7%). After six months, an average clinical attachment level gain of 3.3 (± 1.4) mm, mean radiographic bone filling of 72 (± 29%) and a BoP reduction of 66.6% were observed. RAD average was 21.3 (± 1.2°) and GR changed from 2.2 to 2.7 mm. Membrane exposure was observed in 33.3% of the cases, however, there were no cases of infection or severe pain.Discussion and conclusions The use of collagen membranes and corticocancellous bone grafts of equine origin seems to be a viable alternative in the regeneration of infra-bony periodontal defects.

AbstractIntroduction Breathing and swallowing are functions of the stomatognathic system, since they are vital and innate to the human being, moreover, interrelated [1,2]. Most of the breathing is nasal, however mouth-breathing can occur, being a pathological adaptation that can lead to a series of changes, often irreversible, in the growth and development of a child, for instance causing changes in swallowing [3]. This mechanism differs between children and adults and, if identified in a child, up to five years, it is considered as infantile deglutition pattern being replaced by mature deglutition pattern after this period [4]. If it continues beyond the period in which it is considered normal, it is renamed as atypical [5]. Therefore, the aim of this study was to explore the possible relation between mouth-breathing and atypical swallowing in children.Materials and methods The study took place between January 2018 to February 2019, involving patients referred to the Care Consultation of Orthodontics Egas Moniz Dental Clinic (EMDC). The sample consisted of 86 patients, that n = 46 (53.4%) were females and n = 40 (46.6%) were males, with a mean age of 12.3 years. The study was approved by an Ethics Committee of Egas Moniz. Inclusion criteria were: children of both sexes aged 5–18 years, having clinical record at EMDC and with the correspondent informed consent signed by the parents. Exclusion criteria were: children who had past orthodontic treatment and having craniofacial anomalies or syndromes. The method used to assess breathing and swallowing patterns was adapted by Marchesan [2]. Data were analysed by using descriptive and inferential methodologies (chi-square test). A significance level of 5% was established in the latter case.Results A higher prevalence of mouth-breathers was found in women n = 49 (56.5%) than in men n = 37 (43.5%). Atypical swallowing, was also more prevalent in women n = 48 (56.1%) than in men n = 38 (43.9%), however, in both cases, the differences were not found to be statistically significant (p = .594, p = .570). n = 52 (83.9%) of the mouth-breathers were identified as having atypical swallowing, conversely to n = 14 (58.3%) of the normal (nasal) breathers. Overall, there was a statistically significant association between mouth-breathing and patients with atypical swallowing (p = .012).Discussion and conclusions The results show that mouth-breathing and atypical swallowing were found to be significantly associated n = 52 (83.9%) in this study, being closed to Lemos et al. who found higher results (97.2%) [1]. Other studies reported that is not statistically significant the association between mouth-breathing and atypical swallowing [6]. The results of this study are clinically relevant and encouraging the search for early diagnosis and intervention.

Introduction: The identification of stages of dietary change and the factors affecting food choices can direct more effective nutritional intervention against coronary heart disease progression. Objective: Identify the stages of change of eating behavior and its relation with nutritional status, food consumption and previous cardiovascular events in patients who underwent coronary angioplasty. Methods: A cross-sectional study with 200 hospitalized patients from a specialized cardiology hospital, after elective coronary angioplasty. They were applied an algorithm that identifies the provision of change of eating habits for a healthier pattern. Variables measured were stages of change of eating behavior, nutritional status, food consumption and cardiovascular events (previous myocardial infarction or angioplasty). It was realized comparison of averages by analysis of variance or Student´s test and Chi-square test for qualitative variables. Value of significance was taken at 5%. Results: The patients were classified in the following stages: 36% maintenance, 26% preparation, 17% precontemplation, 12% action and 9% contemplation. It was observed higher cardiovascular events in maintenance/action group (p = 0.04), higher consumption of calories (p = 0.04), meat/eggs (p = 0.01) and sweets (p = 0.03) in preparation stage, comparing to maintenance group, and no association between nutritional status and stages of change (p = 0.13), although 62% of the individuals in maintenance stage were overweight. Conclusions: This work contributed to identifying the stages of change and conditions that favor changes in eating pattern. Even patients that classified themselves into the maintenance stage need to adjust their eating habits in order to reach a healthy weight.Introducción: La identificación de las etapas de cambio en la dieta y los factores que afectan la elección de alimentos puede dirigir una intervención nutricional más eficaz contra la progresión de la enfermedad coronaria. Objetivos: Identificar las etapas de cambio de la conducta alimentaria y su relación con el estado nutricional, consumo de alimentos y los eventos cardiovasculares anteriores en pacientes sometidos a angioplastia coronaria. Métodos: Estudio transversal con 200 pacientes de un hospital especializado en cardiología, después de angioplastia coronaria electiva. Se aplicaron un algoritmo que identifica la disposición del cambio de hábitos de alimentación para un patrón mas saludable. Las variables medidas fueron las etapas de cambio de la conducta alimentaria, estado nutricional, consumo de alimentos y eventos cardiovasculares (infarto de miocardio o angioplastia previos). Resultados: los pacientes fueron clasificados en las siguientes etapas: 36% en mantenimiento, 26% en preparación, 17% en precontemplación, 12% en acción y 9% en contemplación. Se observaron mas eventos cardiovasculares en mantenimiento/ acción (p = 0,04), mayor consumo de calorías (p = 0,04), carne y huevos (p = 0,01) y dulces (p = 0,03) en la etapa de preparación, en comparación con el de mantenimiento, y ninguna asociación entre el estado nutricional y las etapas de cambio (p = 0,13), aunque el 62% de los individuos en la etapa de mantenimiento estaban con sobrepeso. Conclusiones: Este trabajo contribuyó por la identificación de las etapas de cambio y las condiciones que favorecen los cambios en el patrón de alimentación. Mismo los pacientes que se clasificaron a la fase de mantenimiento hay la necesidad de ajustar sus hábitos alimenticios con el fin de lograr un peso saludable.

With the ever-growing data traffic in computer networks nowadays, the management of large-scale networks is a challenge for guaranteeing the quality of the provided services. This is due to the increasingly usage of connected applications, such as Internet of Things and cloud computing environments. Software-defined networking (SDN) is a new paradigm that aims to make this management process easier by centralizing the configuration of all network devices into a single programmable central controller. However, as any centralized service, this architecture is susceptible to security vulnerabilities, such as distributed denial of service (DDoS) and port scan attacks. Thus, security methods are necessary to guarantee the normal operation of SDN's central controller. Furthermore, networks are transporting an increasingly amount of information day by day, which could mean data loss in case of long network unavailability. For this reason, security mechanisms must operate online, with fast-responding countermeasures to mitigate the impact of the detected attacks over the SDN. In this paper, we present a fast SDN defense system against DDoS and port scan attacks, which runs directly into the central controller and uses a game theoretical approach for attack mitigation. For the detection, we compare three different approaches, particle swarm optimization, multi-layer perceptron neural network, and discrete wavelet transform. We test our approach over IP flow data generated over Mininet network emulator, along with floodlight controller, and the presented defense system achieved good outcomes for both detection and mitigation processes.

We sought to investigate the prevalence of potentially pathogenic bacteria in secretions and tonsillar tissues of children with chronic adenotonsillitis hypertrophy compared to controls. Prospective case-control study comparing patients between 2 and 12 years old who underwent adenotonsillectomy due to chronic adenotonsillar hypertrophy to children without disease. We compared detection of Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus, Pseudomonas aeruginosa, and Moraxella catarrhalis by real-time PCR in palatine tonsils, adenoids, and nasopharyngeal washes obtained from 37 children with and 14 without adenotonsillar hypertrophy. We found high frequency (>50%) of Haemophilus influenzae, Streptococcus pneumoniae, Moraxella catarrhalis, and Pseudomonas aeruginosa in both groups of patients. Although different sampling sites can be infected with more than one bacterium and some bacteria can be detected in different tissues in the same patient, adenoids, palatine tonsils, and nasopharyngeal washes were not uniformly infected by the same bacteria. Adenoids and palatine tonsils of patients with severe adenotonsillar hypertrophy had higher rates of bacterial coinfection. There was good correlation of detection of Moraxella catarrhalis in different sampling sites in patients with more severe tonsillar hypertrophy, suggesting that Moraxella catarrhalis may be associated with the development of more severe hypertrophy, that inflammatory conditions favor colonization by this agent. Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, and Moraxella catarrhalis are frequently detected in palatine tonsils, adenoids, and nasopharyngeal washes in children. Simultaneous detection of Moraxella catarrhalis in adenoids, palatine tonsils, and nasopharyngeal washes was correlated with more severe tonsillar hypertrophy.

To evaluate the presence of viruses and bacteria in middle ear and adenoids of patients with and without otitis media with effusion (OME).Adenoid samples and middle ear washes (MEW) were obtained from children with OME associated with adenoid hypertrophy undergoing adenoidectomy and tympanostomy, and compared to those obtained from patients undergoing cochlear implant surgery, as a control group. Specific DNA or RNA of 9 respiratory viruses (rhinovirus, influenza virus, picornavirus, syncytial respiratory virus, metapneumovirus, coronavirus, enterovirus, adenovirus and bocavirus) and 5 bacteria (S. pneumoniae, H. influenzae, M. catarrhalis, P. aeruginosa and S. aureus) were extracted and quantified by real-time PCR.37 OME and 14 cochlear implant children were included in the study. At the adenoid, virus and bacteria were similarly detected in both OME and control patients. At the middle ear washes, however, a higher prevalence of bacteria was observed in patients with OME (p = 0.01). S. pneumoniae (p = 0.01) and M. catarrhalis (p = 0.022) were the bacteria responsible for this difference. Although total virus detection was not statistically different from controls at the middle ear washes (p = 0.065), adenovirus was detected in higher proportions in adenoid samples of OME patients than controls (p = 0.019).Despite both OME and control patients presented similar rates of viruses and bacteria at the adenoid, children with OME presented higher prevalence of S. pneumonia, M. catarrhalis in middle ear and adenovirus in adenoids when compared to controls. These findings could suggest that these pathogens could contribute to the fluid persistence in the middle ear.