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Felipe José de Andrade Falcão,1 Cláudia Maria Rodrigues Alves,1 Adriano Caixeta,1 Leonardo de Freitas Guimarães,1 Juscélio Trajano de Sousa Filho,2 Juliana A Soares,2 Izo Helber,2 Antônio C Carvalho11Department of Interventional Cardiology, 2Department of Cardiology, Federal University of São Paulo, São Paulo, BrazilBackground: In the elderly, the ankle-brachial index (ABI) has greater than 90% sensitivity and specificity for peripheral artery disease identification. A well-known relation exists between peripheral artery disease and the number of diseased coronary vessels. Yet, other anatomical characteristics have important impacts on the type of treatment and prognosis.Purpose: To determine the relation between ABI and the complexity of coronary artery disease, by different anatomical classifications.Methods: This study was a prospective analysis of patients ≥65 years old who were undergoing elective coronary angiography for ischemic coronary disease. The ABI was calculated for each leg, as the ratio between the lowest ankle pressure and the highest brachial pressure. The analysis of coronary anatomy was performed by three interventional cardiologists; it included classification of each lesion with >50% diameter stenosis, according to the American Heart Association criteria, and calculation of the SYNTAX score.Results: The study recruited 204 consecutive patients (median age: 72.5 years). Stable angina was present in 51% of patients. Although only 1% of patients reported peripheral artery disease, 45% exhibited an abnormal ABI. The number of lesions per patient, the number of patients with complex lesions, and the median SYNTAX scores were greater in the group with abnormal ABI. However, among 144 patients with obstructive coronary artery disease, despite abnormal ABI being able to identify a higher rate of patients with B2 or C type lesions (70.9% versus 53.8%; P=0.039), the mean SYNTAX scores (13 versus 9; P=0.14), and the proportion of patients with SYNTAX score >16 (34.2% versus 27.7%; P=0.47), were similar, irrespective of ABI.Conclusion: In patients ≥65 years old the presence of peripheral artery disease could discriminate a group of patients with greater occurrence of B2 and C type lesions, but similar median SYNTAX score.Keywords: ankle-brachial index, coronary artery disease, peripheral artery disease, elderly health

Endodontic treatment of teeth with perforating internal root resorption represents a clinical challenge. In most cases, extraction of the tooth and subsequent replacement with an osseointegrated implant is indicated. Presented herein is a case report of a maxillary lateral incisor with advanced perforating internal root resorption in the middle third of the root and the presence of a sinus tract. Mineral Trioxide Aggregate (MTA) was used with the aid of a surgical microscope in order to fill the resorption area after conventional root canal therapy of the apical segment. At the follow-up after 11 years and 8 months, the patient was clinically asymptomatic and the sinus tract had disappeared. The radiographic examination and computerized tomography indicated periodontal bone repair. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the extraradicular diffusion of creamy 6% hydrogen peroxide (HP) associated or not with sodium perborate (SP) at the cervical region of endodontically treated teeth during intracoronal bleaching. Methods: Thirty-two endodontically treated maxillary canines and central incisors were used. The gutta-percha was removed 3 mm below the cement/enamel junction, and the external root surface was covered with cyanoacrylate except for the cervical region. The teeth were randomly allocated to 4 groups: G1: 6% HP+SP (n=11); G2: 6% HP (n=11); G3: distilled water (negative control, n=5) and G4: 30% HP (positive control, n=5). The specimens were immersed in a solution of potassium chromate (yellow), which turns blue in presence of HP. Two calibrated examiners (Kendall coefficient = 0.936) attributed scores according to the solution color (0 - unaltered color, 1 - light blue, and 2 - dark blue). Data were analyzed by Kruskal-Wallis and Mann-Whitney tests ([alpha]<0.05). Results: Eighteen percent of the 6% HP specimens with or without SP showed color alteration. Only G4 had score values statistically higher than the other groups (P=0.004). Conclusion: It can be concluded that 6% HP cream did not have significant extraradicular diffusion during intracoronal bleaching but it was not 100% safe. [ABSTRACT FROM AUTHOR]

The novel binuclear titanium(IV) complex [{TiCl(OPr i)2(HOPr i )}2(mu-OPr i)2], 1, and the first mononuclear vanadyl(IV) chloroalcoholate [VCl(O)(HOPr i)4]Cl, 2, have been prepared from 2:1:1 mixtures of [Ti(OPr i)4], KOPr i and VCl3. Products were characterised by elemental analysis, FTIR, EPR, NMR and electronic spectroscopies, magnetic susceptibility measurements and single crystal X-ray diffractometry. A third product was found to be polynuclear and to contain both titanium and vanadium. Semi-empirical quantum-mechanical calculations were carried out for the evaluation of the electronic structure of 1.

Neste breve comentário, áreas particularmente promissoras de pesquisa básica e clínica que visam elucidar a etiologia e fisiopatologia dos transtornos afetivos são sumarizadas. Perspectivas para pesquisa e desenvolvimento futuro são brevemente discutidas, com ênfase particular em possibilidades para o desenvolvimento de novas intervenções terapêuticas para esses transtornos.

Advanced internal resorption affecting the crown of teeth may result in the appearance of a 'pink tooth', which, when located in the root canal, can perforate the external root surface. Therapeutically, this condition represents a clinical challenge and normally requires a combined endodontic and surgical focus. Presented herein are cases of double 'pink tooth' which appeared at different times after orthodontic treatment. In the most severe case, upon radiographic examination and computed tomography, the maxillary right central incisor presented an internal resorption, extending from the pulp chamber to the root middle third. After pulp removal, the debridement of the defect was performed using a 2.5% sodium hypochlorite solution, a #80 Kerr file, and an ultrasonic tip ST-17, aided by a surgical microscope. During the cleaning process, various sites of periodontal communication were identified. Upon controlling the hemorrhaging, the root canal was completely filled with White mineral trioxide aggregate. Within the 3-month follow-up treatment, a pink spot appeared on the maxillary left central incisor, which received conventional root canal therapy. Clinically and radiographically, over 18 months of follow up, both cases responded favorably to the proposed treatments. Therefore, it is important to monitor the patient due to the fact that pulp and periodontal sequelae can develop at varied moments after orthodontic treatment. Furthermore, with the current technology and biomaterials, it is possible to resolve cases with extensive internal perforating resorption through endodontic treatment. [ABSTRACT FROM AUTHOR]

The 22nd genetically encoded amino acid, pyrrolysine, plays a unique role in the key step in the growth of methanogens on mono-, di-, and tri-methylamines by activating the methyl group of these substrates for transfer to a corrinoid cofactor. Previous crystal structures of the Methanosarcina barkeri monomethylamine methyltransferase elucidated the structure of pyrrolysine and provide insight into its role in monomethylamine activation. Herein, we report the second structure of a pyrrolysine-containing protein, the M. barkeri trimethylamine methyltransferase MttB, and its structure bound to sulfite, a substrate analog of trimethylamine. We also report the structure of MttB in complex with its cognate corrinoid protein MttC, which specifically receives the methyl group from the pyrrolysine-activated trimethylamine substrate during methanogenesis. Together these structures provide key insights into the role of pyrrolysine in methyl group transfer from trimethylamine to the corrinoid cofactor in MttC., (© 2023. The Author(s).)

Introduction: Congenital Muscular Dystrophy type 1D (MDC1D) is characterized by a hypoglycosylation of α-dystroglycan protein (α-DG), and this may be strongly implicated in increased skeletal muscle tissue degeneration and abnormal brain development, leading to cognitive impairment. However, the pathophysiology of brain involvement is still unclear. Low-intensity exercise training (LIET) is known to contribute to decreased muscle degeneration in animal models of other forms of progressive muscular dystrophies., Aim: The objective of this study was to analyze the effects of LIET on cognitive involvement and oxidative stress in brain tissue and gastrocnemius muscle., Methods: Male homozygous (Large myd-/- ), heterozygous (Large myd+/- ), and wild-type mice were used. To complete 28 days of life, they were subjected to a low-intensity exercise training (LIET) for 8 weeks. After the last day of training, 24 h were expected when the animals were submitted to inhibitory avoidance and open-field test. The striatum, prefrontal cortex, hippocampus, cortex, and gastrocnemius were collected for evaluation of protein carbonylation, lipid peroxidation, and catalase and superoxide dismutase activity., Results: LIET was observed to reverse the alteration in aversive and habituation memory. Increased protein carbonylation in the striatum, prefrontal cortex, and hippocampus and lipid peroxidation in the prefrontal cortex and hippocampus were also reversed by LIET. In the evaluation of the antioxidant activity, LIET increased catalase activity in the hippocampus and cortex. In the gastrocnemius, LIET decreased the protein carbonylation and lipid peroxidation and increased catalase and superoxide dismutase activity., Conclusion: In conclusion, it can be inferred that LIET for 8 weeks was able to reverse the cognitive damage and oxidative stress in brain tissue and gastrocnemius muscle in MDC1D animals., (© 2022. Fondazione Società Italiana di Neurologia.)

Multi-input multi-output (MIMO) transmission schemes have become the techniques of choice for increasing spectral efficiency in bandwidth-congested areas. However, the design of cost-effective receivers for MIMO channels remains a challenging task. The maximum likelihood detector can achieve excellent performance-usually, the best performance-but its computational complexity is a limiting factor in practical implementation. In the present work, a novel MIMO scheme using a practically feasible decoding algorithm based on the phase transmittance radial basis function (PTRBF) neural network is proposed. For some practical scenarios, the proposed scheme achieves improved receiver performance with lower computational complexity relative to the maximum likelihood decoding, thus substantially increasing the applicability of the algorithm. Simulation results are presented for MIMO-OFDM under 5G wireless Rayleigh channels so that a fair performance comparison with other reference techniques can be established.

The scope of this study was to assess the association between preoperative pain, anxiety and the impact of the oral condition on the quality of life of patients treated at the Dental Emergency Service at the Federal University of the Jequitinhonha and Mucuri Valleys. A retrospective cross-sectional study was conducted evaluating data from 240 patient charts aged from 18 to 65 years. Pain was measured by the Heft-Parker Visual Analog Scale; dental anxiety by Corah's Dental Anxiety Scale; and oral health-related quality of life by the Oral Health Impact Profile (OHIP-14). Associations were analyzed using Pearson's Chi-square test (p < 0.05). A statistically significant association was observed between pain and poorer quality of life, with impacts on psychological discomfort (p < 0.001), physical incapacity (p < 0.001) and the psychological (p < 0.001) and social (p < 0.001) domains. Anxiety influenced poorer quality of life, with impacts on the psychological discomfort (p = 0.009), physical disability (p = 0.016), psychological disability (p = 0.011) and social disadvantage (p = 0.028) domains. This study is relevant for the planning of programs and actions aimed at the oral health of patients treated in dental emergency services, prioritizing those with the greatest psychosocial impact arising from oral problems.

Objective: To quantify Enterococcus faecalis density in root canal dentin after chemomechanical preparation (CMP) using alternated irrigating regimen., Methodology: Root canals (RC) were contaminated with E. faecalis (ATCC 19433) for 3 weeks and evident biofilms were obtained. After initial sampling (S1), the CMP was aided by irrigants: saline solution (control; n=12), a conventional regimen (CR) (group 1; n=12) using 5.25% NaOCl and a final rinse with 17% EDTA, and an alternating regimen (AR) of intercalated use of NaOCl and EDTA (group 2, n=12), followed by a second sampling (S2). After 2 weeks, S3 was obtained. Two roots were analyzed by scanning electron microscopy. Each root was divided into cervical, mild, and apical segments and sampling of the superficial (n=90) and deep (n=90) dentin layers was obtained using Gates-Glidden burs. The E. faecalis density (CFU/mg) in log 10 was categorized as residual (0 > 0.2), moderate (0.2 ≥ 0.5), or elevated (> 0.5). The prevalence of positive samples in BHI and BHI-A was analyzed by Pearson's chi-square test. The data were normalized by a log 10 transformation of CFU and were analyzed by one-way ANOVA and Tukey's tests., Results: Biofilms were observed only in the control root canal walls. Topographically, the controls and CR showed similar distributions of E. faecalis in the dentin. Microbiologically positive root canals harbored much E. faecalis in the adjacent dentin ( p < 0.05). Irrigating saline provided moderate density of E. faecalis in the dentin while CR and AR resulted in a residual density of microorganisms ( p < 0.05)., Conclusions: The Enterococcus faecalis density in dentin was influenced by the irrigating regimen and the microbiological status of the root canal. The CMP aided by the alternating regimen interfered with the recolonization of the root canal and topographic distribution of Enterococcus in root dentin.

Background: The failure of endodontic treatment is linked to the presence of Enterococcus faecalis in the root canals. The scope of this study was to evaluate the influence of the energy dose and frequency of photodynamic therapy (PDT cycles), as well as the volume of bacterial suspensions (BS) in the elimination of Enterococcus faecalis in planktonic form., Methods: In four successive assays BS of Enterococcus faecalis ATCC 19433 were irradiated with a diode laser (40 mW) using the photosensitizer (PS) methylene blue (MB) (0.005 μg/mL). Group 1 - Effect of energy dose: 100 μ L of BS and 100 μ L of PS were irradiated by 1, 2.5, 5, 7.5 and 10 minute s. Group 2 - Effect of PDT cycles: The BS received 1, 2, 3 or 4 PDT cycles (in each cycle 100 m L of PS was added and irradiated by 2.5 minutes). Group 3 - Effect of energy dose and bacterial suspension volume: 10 μ L of BS and 10 μ L of PS were irradiated similar to group 1. Group 4 - Effect of energy dose, bacterial suspension volume and PDT cycles: 10 μ L of BS and 10 μL of PS were irradiated according to group 2. The laser source and MB isolated represented the controls., Results: The mean log reduction after separate applying laser light and MB were 0.01 and 0.07, respectively. It was found that wells with 100 μ L of BS irradiated with 2.4 to 24 J of energy did not cause significant bacterial elimination (p > 0.05), on the other hand PDT cycles above 12 J increased significantly bacterial elimination (p < 0.05). In 10 μ L wells irradiation from 12 J of energy provided higher bacterial elimination (p < 0.05) which combined with PDT cycle resulted in the logarithmic elimination of E. faecalis (p < 0.05)., Conclusions: The energy dose, the volume of the bacterial suspension and, especially, the PDT cycles optimized the bacterial elimination of Enterococcus faecalis in planktonic form., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Developing new restorative materials should avoid damage to tissue structures. This study evaluated the biocompatibility of a commercial dental glass ionomer cement (GIC) mechanically reinforced with cellulose microfibers (GIC+CM) or cellulose nanocrystals (GIC+CN) by implantation of three test specimens in subcutaneous tissue in the dorsal region of 15 Rattus norvegicus albinus rats. Each rat received one specimen of each cement, resulting in the following groups (n=15): Group GIC (Control), Group GIC+CM and Group GIC+NC. After time intervals of 7, 30 and 60 days, the animals were sacrificed and the following aspects were histologically evaluated: type of inflammatory cells, fibroblasts, blood vessels, macrophages, giant cells, type of inflammatory reaction and capsule thickness (µm). These events were scored as (-) absent, (+) light, (++) moderate and (+++) intense. The results were statistically analyzed by Kruskal-Wallis test and Mann-Whitney post test. At 7 days, Group GIC+NC showed more favorable tissue repair because quantitatively there were more fibroblasts (p=0.022), fewer macrophages (p=0.008) and mononuclear cells (p=0.033). Polymorphonuclear neutrophils and giant cells were absent in all experimental periods. At 60 days, test specimens in Group GIC+NC were surrounded by a fibrous tissue capsule with reduced thickness (26.72±2.87 µm) in comparison with Group GIC+CM (41.21±3.98 µm) (p=0.025). In general, all biomaterials showed satisfactory biocompatibility, but glass ionomer cement modified with cellulose nanocrystals showed a more advanced tissue repair.

Objective: The aim was to evaluate the influence of multiple factors on the periapical status of endodontically treated (ET) teeth., Methods: The patients were clinically and radiographically reevaluated after root canal therapy. The quality of the root-filled canals, coronal restorations, intraradicular posts, dental caries, and periodontal parameters were associated with the teeth's periapical status., Results: The 122 patients provided 154 ET teeth; 97.4% teeth were asymptomatic, and 75.5% had a normal periapical status. The percentage of perfect, satisfactory, and deficient root-filled canals was of the order of 41.6%, 46.1%, and 12.3%, respectively. The percentage of adequate and inadequate coronal restorations was 31.2% and 68.8%, respectively. A total of 14.9% teeth had intraradicular posts, and 29.2% had cavitated carious lesions in the dentin. Gingival bleeding was observed in 31.8% of teeth, and dental biofilm was visible in 58.4%. A total of 11.7% showed pathologic tooth mobility, and 22.1% teeth were diagnosed with periodontal disease., Conclusions: Carious lesions, gingival bleeding, and tooth mobility were significantly associated with the occurrence of periapical lesions in root-filled canals.

Self-assembly via nanoscale phase separation offers an elegant route to fabricate nanocomposites with physical properties unattainable in single-component systems. One important class of nanocomposites are optical metamaterials which exhibit exotic properties and lead to opportunities for agile control of light propagation. Such metamaterials are typically fabricated via expensive and hard-to-scale top-down processes requiring precise integration of dissimilar materials. In turn, there is a need for alternative, more efficient routes to fabricate large-scale metamaterials for practical applications with deep-subwavelength resolution. Here, we demonstrate a bottom-up approach to fabricate scalable nanostructured metamaterials via spinodal decomposition. To demonstrate the potential of such an approach, we leverage the innate spinodal decomposition of the VO 2 -TiO 2 system, the metal-to-insulator transition in VO 2 , and thin-film epitaxy, to produce self-organized nanostructures with coherent interfaces and a structural unit cell down to 15 nm (tunable between horizontally and vertically aligned lamellae) wherein the iso-frequency surface is temperature-tunable from elliptic to hyperbolic dispersion producing metamaterial behavior. These results provide an efficient route for the fabrication of nanostructured metamaterials and other nanocomposites for desired functionalities.

Introduction: The study aimed to compare the shaping and preservation of the original curvature of simulated curved root canals using the following instruments: Reciproc (Rcp), WaveOne (Wo), and the ProTaper Next system (Ptn)., Materials and Methods: A total of 45 resin blocks with simulated curved root canals were divided into three groups (n = 15), prepared using the Rcp (R25), Wo (25/0.8), and Ptn (X2) instruments. Standardized photographs were taken before and after canal instrumentation. After the superimposition of the images, the amount of resin removed from the curvature's inner and outer walls was measured at six apical levels, at intervals of 1 mm. The canals' angles of curvature before and after instrumentation were subtracted., Results: There were no significant differences between the instruments in terms of the total amount of resin removed of the inner or outer walls of the apical curvature (p > 0.05). The Rcp instruments provided the best resin removed ratios between the walls. The means of the change in angle were as follows: Wo = 2.15°, Ptn = 0.92°, and Rcp = 0.21°. WaveOne caused significantly higher deviations than Rcp., Conclusion: All of the instruments demonstrated a tendency to straighten the simulated root canal. Instruments that use rotary movement achieved an effect similar to that of the reciprocating instruments in relation to change in angle., Clinical Significance: Deviations from the original shape of the root canal could have a negative impact on the quality of a filling and consequently on the success of the endodontic treatment.

Cyst-like periapical lesions should be treated initially with conservative nonsurgical procedures. In this case series, we describe the clinical and radiographic outcomes of large cyst-like lesions that were treated by orthograde decompression and long-term intracanal use of calcium hydroxide [Ca(OH)2] mixed with 2% chlorhexidine digluconate. Ten cases of cyst-like periapical lesions involving 15 teeth from 10 patients were selected. Maximal radiographic diameters of the lesions ranged from 11 to 28 mm. Nonsurgical procedures were performed, including apical patency, orthograde puncture of cyst-like exudates, chemomechanical preparation, and placement of intracanal Ca(OH)2/CHX dressings, which were periodically replaced during 6-10 months. The root canals were then filled with gutta-percha and sealer. The follow-up periods ranged from 6 to 24 months, and the outcome was classified as healed, healing, or failure. Nine lesions drained copious exudates after canal patency. One lesion only drained bloody serous exudate after periapical overinstrumentation. In 9 patients, intracanal exudation ceased in the first follow-up visit. At the 24-month follow-up, 6 lesions (60.0%) had healed, and 3 lesions (30.0%) were healing, with the corresponding patients being without clinical signs or symptoms. The case of treatment failure was submitted to surgical treatment. Microscopically, the lesion appeared to be an apical cyst with exuberant extraradicular bacterial biofilms attached to the sectioned root apex. This case series supports the use of nonsurgical methods to resolve larger cyst-like periapical lesions., (Published by Elsevier Inc.)

Background and Objective: Photodynamic therapy (PDT) can eliminate microorganisms in a root canal. However, the parameters for disinfection remain undefined. This study assessed the effectiveness of a PDT protocol against intracanal Enterococcus faecalis biofilms., Materials and Methods: Root canals were contaminated with E. faecalis for 21 days. The instrumentation was associated to irrigation with 0.85% saline or an alternate irrigation (AI) with 5.25% NaOCl and 17% EDTA. Complementary treatments included saline/PDT and AI/PDT. Four PDT cycles were performed using a diode laser (660nm, 40mW) delivered through a tapered optical fiber. In each cycle, the root canal was filled with 1.56μM/mL methylene blue and irradiated for 150s. Microbiological samples were collected before (S1) and after (S2) instrumentation; after PDT (S3); and daily over the course of 14 days (S4-S17). Colony-forming units (CFUs) were counted, positive cultures verified, and data subjected to parametric and proportion's tests., Results: The highest bacterial load reduction was observed in S2. In regard to S3, Saline/PDT reduced 1.3 log(10) CFU counts (p=0.000 for S2) and no CFUs were recovered after AI/PDT treatment. All canals were CFU-free on the 14th day for saline/PDT, AI and AI/PDT. Positive cultures were observed in 60% of saline-irrigated canals on the 14th day, whereas the saline/PDT, AI and AI/PDT treatments resulted in germ-free canals after 10, 5 and 2 days, respectively., Conclusion: Our findings suggest immediate and delayed antibacterial effects using the PDT protocol tested., (Published by Elsevier B.V.)

A decision support framework for the management of lagoon ecosystems was tested using four European Lagoons: Ria de Aveiro (Portugal), Mar Menor (Spain), Tyligulskyi Liman (Ukraine) and Vistula Lagoon (Poland/Russia). Our aim was to formulate integrated management recommendations for European lagoons. To achieve this we followed a DPSIR (Drivers-Pressures-State Change-Impacts-Responses) approach, with focus on integrating aspects of human wellbeing, welfare and ecosystem sustainability. The most important drivers in each lagoon were identified, based on information gathered from the lagoons' stakeholders, complemented by scientific knowledge on each lagoon as seen from a land-sea perspective. The DPSIR cycles for each driver were combined into a mosaic-DPSIR conceptual model to examine the interdependency between the multiple and interacting uses of the lagoon. This framework emphasizes the common links, but also the specificities of responses to drivers and the ecosystem services provided. The information collected was used to formulate recommendations for the sustainable management of lagoons within a Pan-European context. Several common management recommendations were proposed, but specificities were also identified. The study synthesizes the present conditions for the management of lagoons, thus analysing and examining the activities that might be developed in different scenarios, scenarios which facilitate ecosystem protection without compromising future generations.

Congenital muscular dystrophies 1D (CMD1D) present a mutation on the LARGE gene and are characterized by an abnormal glycosylation of α-dystroglycan (α-DG), strongly implicated as having a causative role in the development of central nervous system abnormalities such as cognitive impairment seen in patients. However, in the animal model of CMD1D, the brain involvement remains unclear. Therefore, the objective of this study is to evaluate the cognitive involvement in the Large(myd) mice. To this aim, we used adult homozygous, heterozygous, and wild-type mice. The mice underwent six behavioral tasks: habituation to an open field, step-down inhibitory avoidance, continuous multiple trials step-down inhibitory avoidance task, object recognition, elevated plus-maze, and forced swimming test. It was observed that Large(myd) individuals presented deficits on the habituation to the open field, step down inhibitory avoidance, continuous multiple-trials step-down inhibitory avoidance, object recognition, and forced swimming. This study shows the first evidence that abnormal glycosylation of α-DG may be affecting memory storage and restoring process in an animal model of CMD1D.

Background: Acute coronary syndrome (ACS) is one of the main causes of morbidity and mortality in the modern world. A sedentary lifestyle, present in 85% of the Brazilian population, is considered a risk factor for the development of coronary artery disease. However, the correlation of a sedentary lifestyle with cardiovascular events (CVE) during hospitalization for ACS is not well established., Objective: To evaluate the association between physical activity level, assessed with the International Physical Activity Questionnaire (IPAQ), with in-hospital prognosis in patients with ACS., Methods: Observational, cross-sectional, and analytical study with 215 subjects with a diagnosis of ACS consecutively admitted to a referral hospital for cardiac patients between July 2009 and February 2011. All volunteers answered the short version of the IPAQ and were observed for the occurrence of CVE during hospitalization with a standardized assessment conducted by the researcher and corroborated by data from medical records., Results: The patients were admitted with diagnoses of unstable angina (34.4%), acute myocardial infarction (AMI) without ST elevation (41.4%), and AMI with ST elevation (24.2%). According to the level of physical activity, the patients were classified as non-active (56.3%) and active (43.7%). A CVE occurred in 35.3% of the cohort. The occurrence of in-hospital complications was associated with the length of hospital stay (odds ratio [OR] = 1.15) and physical inactivity (OR = 2.54), and was independent of age, systolic blood pressure, and prior congestive heart failure., Conclusion: A physically active lifestyle reduces the risk of CVE during hospitalization in patients with ACS.

Objective: To investigate the association between the severity of erectile dysfunction (ED) and coronary artery disease (CAD) in men undergoing coronary angiography for angina or acute myocardial infarct (AMI)., Material and Methods: We studied 132 males who underwent coronary angiography for first time between January and November 2010. ED severity was assessed by the international index of erectile function (IIEF-5) and CAD severity was assessed by the Syntax score. Patients with CAD (cases) and without CAD (controls) had their IIEF-5 compared. In the group with CAD, their IIEF-5 scores were compared to their Syntax score results., Results: We identified 86 patients with and 46 without CAD. The IIEF-5 score of the group without CAD (22.6±0.8) was significantly higher than the group with CAD (12.5±0.5; p<0.0001). In patients without ED, the Syntax score average was 6.3±3.5, while those with moderate or severe ED had a mean Syntax score of 39.0±11.1. After adjustment, ED was independently associated to CAD, with an odds ratio of 40.6 (CI 95%, 14.3-115.3, p<0.0001). The accuracy of the logistic model to correctly identify presence or absence of CAD was 87%, with 92% sensitivity and 78% specificity. The average time that ED was present in patients with CAD was 38.8±2.3 months before coronary symptoms, about twice as high as patients without CAD (18.0±5.1 months)., Conclusions: ED severity is strongly and independently correlated with CAD complexity, as assessed by the Syntax score in patients undergoing coronariography for evaluation of new onset coronary symptoms.

Cryopreservation has not been used successfully to preserve fish embryos, although chilling techniques have been used with good results. The aim of this study was to chill Piaractus brachypomus embryos at - 10°C for various storage times. Embryos at the following ontogenetic stages were used: blastoderm - 1.2 hours post-fertilization (hpf); epiboly - 5 hpf; blastopore closure - 8 hpf; and appearance of the optic vesicle - 13 hpf. One hundred embryos were selected from each ontogenetic stage and chilled at - 10°C for 6 or 10 h. The results were analysed using analysis of variance (ANOVA) and Tukey's test at a 5% significance level. A significantly greater number of completely developed live larvae were observed following embryonic treatment with a cryoprotectant solution that contained 17.5% sucrose and 10% methanol. There was no survival for embryos cooled at - 10°C in initial developmental stages (1, 2 and 5 h hpf). Furthermore, higher survival rates were observed when embryos were treated at more advanced developmental stages (8 and 13 hpf). Therefore, P. brachypomus embryos at the blastopore-closure (8 hpf) or appearance-of-optic-vesicle (13 hpf) stages should be used for embryo chilling protocols and chilling should be performed using a 17.5% sucrose with a 10% methanol solution at - 10°C for up to 6 h. The best results were obtained with 13-hpf and 8-hpf embryos and cooling at 6 h of storage.

The study aimed to compare the shaping effects, preservation of the original curvature, and transportation of the apical foramen of Reciproc (VDW, Munich, Germany), UnicOne (Medin, Nové Město na Moravě, Czech Republic), and Protaper Universal (Dentsply Maillefer, Ballaigues, Switzerland) in simulated root canals. Thirty resin blocks with simulated curved root canals were distributed into three groups (n = 10), and prepared using Reciproc (RCp), UnicOne (UnO) and the Protaper Universal (PTu). Standardized photographs were taken before and after the instrumentation, after which they were superimposed. Measurements were taken of the quantity of resin removed from the inner and outer walls of the curvature at 6 levels, the curvature angles before and after instrumentation, and the transportation of the apical foramen. RCp obtained the highest values for amount of resin removed from the inner wall while UnO demonstrated similar shaping on both the inner and outer walls. PTu produced the greatest transportation of foramen when compared to the reciprocating instruments. There was no significant difference between the groups in terms of the change in angle (P > 0.05). All the instruments were capable of maintaining the original curvature of the root canal; however, the UnO, which used reciprocating movement, produced more conservative shapes with lower foramen transportation.

Pharmacoinvasive treatment is an acceptable alternative for patients with ST-segment elevation myocardial infarction (STEMI) in developing countries. The present study evaluated the influence of gender on the risks of death and major adverse cardiovascular events (MACE) in this population. Seven municipal emergency rooms and the Emergency Mobile Healthcare Service in São Paulo treated STEMI patients with tenecteplase. The patients were subsequently transferred to a tertiary teaching hospital for early (<24 h) coronary angiography. A total of 469 patients were evaluated [329 men (70.1%)]. Compared to men, women had more advanced age (60.2 ± 12.3 vs. 56.5 ± 11 years; p = 0.002); lower body mass index (BMI; 25.85 ± 5.07 vs. 27.04 ± 4.26 kg/m2; p = 0.009); higher rates of hypertension (70.7 vs. 59.3%, p = 0.02); higher incidence of hypothyroidism (20.0 vs. 5.5%; p < 0.001), chronic renal failure (10.0 vs. 8.8%; p = 0.68), peripheral vascular disease (PVD; 19.3 vs. 4.3%; p = 0.03), and previous history of stroke (6.4 vs. 1.3%; p = 0.13); and higher thrombolysis in myocardial infarction risk scores (40.0 vs. 23.7%; p < 0.001). The overall in-hospital mortality and MACE rates for women versus men were 9.3 versus 4.9% (p = 0.07) and 12.9 versus 7.9% (p = 0.09), respectively. By multivariate analysis, diabetes (OR 4.15; 95% CI 1.86-9.25; p = 0.001), previous stroke (OR 4.81; 95% CI 1.49-15.52; p = 0.009), and hypothyroidism (OR 3.75; 95% CI 1.44-9.81; p = 0.007), were independent predictors of mortality, whereas diabetes (OR 2.05; 95% CI 1.03-4.06; p = 0.04), PVD (OR 2.38; 95% CI 0.88-6.43; p = 0.08), were predictors of MACE. In STEMI patients undergoing pharmacoinvasive strategy, mortality and MACE rates were twice as high in women; however, this was due to a higher prevalence of risk factors and not gender itself.

Background: According to some international studies, patients with acute coronary syndrome (ACS) and increased left atrial volume index (LAVI) have worse long-term prognosis. However, national Brazilian studies confirming this prediction are still lacking., Objective: To evaluate LAVI as a predictor of major cardiovascular events (MCE) in patients with ACS during a 365-day follow-up., Methods: Prospective cohort of 171 patients diagnosed with ACS whose LAVI was calculated within 48 hours after hospital admission. According to LAVI, two groups were categorized: normal LAVI (≤ 32 mL/m2) and increased LAVI (> 32 mL/m2). Both groups were compared regarding clinical and echocardiographic characteristics, in- and out-of-hospital outcomes, and occurrence of ECM in up to 365 days., Results: Increased LAVI was observed in 78 patients (45%), and was associated with older age, higher body mass index, hypertension, history of myocardial infarction and previous angioplasty, and lower creatinine clearance and ejection fraction. During hospitalization, acute pulmonary edema was more frequent in patients with increased LAVI (14.1% vs. 4.3%, p = 0.024). After discharge, the occurrence of combined outcome for MCE was higher (p = 0.001) in the group with increased LAVI (26%) as compared to the normal LAVI group (7%) [RR (95% CI) = 3.46 (1.54-7.73) vs. 0.80 (0.69-0.92)]. After Cox regression, increased LAVI increased the probability of MCE (HR = 3.08, 95% CI = 1.28-7.40, p = 0.012)., Conclusion: Increased LAVI is an important predictor of MCE in a one-year follow-up.

The objective of this experiment was to determine the standardized ileal digestibility (SID) of amino acids (AA) in 3 sources of distillers dried grains with solubles (DDGS) with different concentrations of fat. Twelve growing barrows (initial body weight: 76.1 [Formula: see text] 6.2 kg) were randomly allotted to a replicated 6 × 4 Youden square design with 6 diets and 4 periods. The fat content of the 3 sources of DDGS were 11.5, 7.5, and 6.9% respectively. Diets contained 60% DDGS and fat concentration of the diets were 7.5, 5.2, and 5.2%, respectively. Two additional diets containing the 2 sources of DDGS with 7.5 and 6.9% fat were also formulated, and corn oil was added to these diets to increase the concentration of fat in the diets to levels that were calculated to be similar to the diet containing conventional DDGS with 11.5% fat. A N-free diet was also formulated to calculate endogenous losses of crude protein (CP) and AA from the pigs. Pigs were fed experimental diets during four 7-d periods. The first 5 d of each period were an adaptation period and ileal digesta were collected on d 6 and 7 of each period. The apparent ileal digestibililty (AID) and SID of CP and all indispensable AA, except AID Pro and SID of Trp, were greater (P < 0.01) in conventional DDGS than in the 2 sources of DDGS with reduced fat. Adding oil to the diets containing the 2 sources of DDGS with reduced fat did not consistently increase SID of AA. In conclusion, conventional DDGS has greater SID values for most AA compared with DDGS that contains less fat and inclusion of additional oil to diets containing low-fat DDGS does not increase AID or SID of AA. The lower AA digestibility in low-fat DDGS could not be overcome by the inclusion of additional fat to the diets.

Dengue is currently a major public-health problem. Dengue virus (DENV) is classified into four distinct serotypes, DENV 1-4. After 28 years of absence, DENV-4 was again detected in Brazil in 2010 in Roraima State, and one year later, the virus was identified in the northern Brazilian states of Amazonas and Pará, followed by Rio de Janeiro and São Paulo. In Minas Gerais, the first confirmed case of DENV-4 occurred in the municipality of Frutal in 2011 and has now been isolated from a growing number of patients. Although DENV-2 is associated with the highest risk of severe forms of the disease and death due to the infection, DENV-4 has also been associated with severe forms of the disease and an increasing risk of hemorrhagic manifestations. Herein, the first fatal case of confirmed DENV-4 in Brazil is reported. The patient was an 11-year-old girl from the municipality of Montes Claros in northern Minas Gerais State, Brazil. She had idiopathic thrombocytopenic purpura as a comorbid condition and presented with a fulminant course of infection, leading to death due to hemorrhagic complications. Diagnosis was confirmed by detection of Dengue-specific antibodies using IgM capture enzyme-linked immunosorbent assay and semi-nested RT-PCR. Primary care physicians and other health-care providers should bear in mind that DENV-4 can also result in severe forms of the disease and lead to hemorrhagic complications and death, mainly when dengue infection is associated with coexisting conditions.

The prevalence of resistant hypertension (ReHy) is not well established. Furthermore, diuretics, angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers, and calcium channel blockers are largely used as the first 3-drug combinations for treating ReHy. However, the fourth drug to be added to the triple regimen is still controversial and guided by empirical choices. We sought (1) to determine the prevalence of ReHy in patients with stage II hypertension; (2) to compare the effects of spironolactone vs clonidine, when added to the triple regimen; and (3) to evaluate the role of measuring sympathetic and renin-angiotensin-aldosterone activities in predicting blood pressure response to spironolactone or clonidine. The Resistant Hypertension Optimal Treatment (ReHOT) study (ClinicalTrials.gov NCT01643434) is a prospective, multicenter, randomized trial comprising 26 sites in Brazil. In step 1, 2000 patients will be treated according to hypertension guidelines for 12 weeks, to detect the prevalence of ReHy. Medical therapy adherence will be checked by pill count monitoring. In step 2, patients with confirmed ReHy will be randomized to an open label 3-month treatment with spironolactone (titrating dose, 12.5-50 mg once daily) or clonidine (titrating dose, 0.1-0.3 mg twice daily). The primary endpoint is the effective control of blood pressure after a 12-week randomized period of treatment. The ReHOT study will disseminate results about the prevalence of ReHy in stage II hypertension and the comparison of spironolactone vs clonidine for blood pressure control in patients with ReHy under 3-drug standard regimen., (© 2013 Wiley Periodicals, Inc.)

Background: This study aimed to evaluate the effect of long-term high-dose tibolone on the bladders and urethras of ovariectomized rats., Methods: Bilateral ovariectomy was performed in 14 young adult rats randomly divided into 2 groups. Experimental rats (n = 9) received 1 mg/day of tibolone orally; control rats (n = 6) received a placebo. After 150 days, the bladders and urethras were removed. Bladder cell proliferation was analyzed by Ki-67 immunohistochemistry. A histomorphometric analysis was performed for epithelial thickness and the percent areas of collagen fibers and blood vessels. Data were compared using a Mann-Whitney test (significance level at p < 0.05)., Results: Urothelial thickness and the percent area of collagen fibers and blood vessels were not significantly different between the tibolone and control groups in the bladder and urethra. In addition, urothelium cell proliferation in the bladder showed a low immunopositivity in both groups. Furthermore, the glycogen and glycoprotein contents in urethral epithelium were slightly modified by tibolone and no change was observed in the bladder., Conclusion: Long-term administration of tibolone has no effect on urothelial trophism, collagen fibers, the number of vessels, or cell proliferation in the urethra and bladder of the ovariectomized rat., (© 2014 S. Karger AG, Basel.)

An experiment was conducted to determine how an E. coli challenge and dietary clays affect the intestinal barrier of pigs. Two groups of 32 pigs (initial BW: 6.9 ± 1.0 kg) were distributed in a 2 × 4 factorial arrangement of a randomized complete block design (2 challenge treatments: sham or E. coli, and 4 dietary treatments: control, 0.3% smectite A, 0.3% smectite B and 0.3% zeolite), with 8 replicates total. Diarrhea score, growth performance, goblet cell size and number, bacterial translocation from intestinal lumen to lymph nodes, intestinal morphology, and relative amounts of sulfo and sialo mucins were measured. The E. coli challenge reduced performance, increased goblet cell size and number in the ileum, increased bacterial translocation from the intestinal lumen to the lymph nodes, and increased ileal crypt depth. One of the clays (smectite A) tended to increase goblet cell size in ileum, which may indicate enhanced protection. In conclusion, E. coli infection degrades intestinal barrier integrity but smectite A may enhance it.

This case report describes successful apexification for a challenging case involving a 30-year-old man, who suffered from dental trauma involving tooth No. 7 (which had occurred several years earlier) and recently experienced acute periapical abscess in this region. Radiographic analysis revealed incomplete root formation, a wide-open apex, thin root canal walls, and an extensive periapical lesion. Chemomechanical debridement was performed gently using K-files and irrigation with a 1% sodium hypochlorite solution. The root canal was filled with a calcium hydroxide paste, which was replaced periodically. At 18 months post-treatment, an apical barrier tissue and significant reduction of periapical radiolucency were observed; at that time, the entire root canal was filled with gray mineral trioxide aggregate (MTA). At a follow-up 16 months later, the tooth had normal function and periapical repair was complete.

Background: In acute coronary syndrome (ACS), admission hyperglycemia is associated with adverse cardiovascular events in diabetic and nondiabetic patients., Objective: To assess the prognostic value of stress hyperglycemia for the in-hospital outcome of patients admitted due to ACS., Methods: This study included 152 patients admitted to the chest pain unit of a tertiary hospital diagnosed with ACS, who had admission blood glucose data, from September 2005 to February 2010. Group I comprised patients with stress hyperglycemia, defined as admission blood glucose concentration > 126 mg/dL for nondiabetic individuals and admission blood glucose concentration > 200 mg/dL for diabetic individuals. Group II was formed by patients with admission blood glucose concentration lower than those established. The association of hyperglycemia and in-hospital outcome was assessed., Results: Stress hyperglycemia associated with in-hospital complications, age increase and female sex. On multivariate analysis, only female sex (OR = 2.04; 95% CI: 1.03 - 4.06; p = 0.007) and in-hospital complications (OR = 3.65; 95% CI: 1.62 - 8.19; p = 0.002) associated independently with admission hyperglycemia., Conclusions: Stress hyperglycemia is an independent predictive factor for in-hospital complications after ACS in diabetic and nondiabetic patients. The results highlight the need to assess admission blood glucose concentration in all patients admitted due to ACS, including nondiabetic ones, aiming at identifying those at higher risk for complications.

Four experiments were conducted to evaluate the nutrient contributions and physiological health benefits of spray-dried egg (SDE) containing only unfertilized eggs as a protein source in nursery pig diets. In all experiments, all diets were formulated to the same ME and Lys content, and each pen within a block (by BW) housed the same number of barrows and gilts. In Exp. 1 and 2 (168 and 140 pigs, respectively; 5 kg BW; 16 d old; 14 replicates/experiment), conducted at a university farm, treatments were with or without 5% SDE in a nursery control diet, which included antibiotics and zinc oxide. Pigs were fed for 10 d after weaning to measure ADG, ADFI, and G:F. The SDE increased (P < 0.05) ADG (Exp. 1: 243 vs. 204 g/d; Exp. 2: 204 vs. 181 g/d) and ADFI (Exp. 1: 236 vs. 204 g/d; Exp. 2: 263 vs. 253 g/d) compared with the control diet but did not affect G:F. In Exp. 3 (1,008 pigs; 5.2 kg BW; 20 d old; 12 replicates/treatment), conducted at a commercial farm, treatments were in a factorial arrangement of with or without SDE and high or low spray-dried plasma (SDP) in nursery diets, which included antibiotics and zinc oxide. Pigs were fed for 6 wk using a 4-phase feeding program (phases of 1, 1, 2, and 2 wk, respectively) with declining diet complexity to measure ADG, ADFI, G:F, removal rate (mortality plus morbidity), and frequency of medical treatments per pen and day (MED). The diets with the SDE increased (P < 0.05) ADFI during phase 1 only (180 vs. 164 g/d) compared with the diets without the SDE but did not affect growth performance during any other phases. The diets with SDE reduced MED during phase 1 (0.75% vs. 1.35%; P < 0.05) and the overall period (0.84% vs. 1.01%; P = 0.062) compared with the diets without the SDE but did not affect removal rate. In Exp. 4 (160 pigs; 6.7 kg BW; 21 d old; 10 replicates/treatment), conducted at a university farm to determine whether SDE can replace SDP, treatments were in a factorial arrangement of with or without SDP or SDE in nursery diets, which excluded antibiotics and zinc oxide. Pigs were fed for 6 wk using the same schedule used in Exp. 3 to measure ADG, ADFI, and G:F. The diets with SDE increased (P < 0.05) ADFI during phase 1 only (195 vs. 161 g/d) compared with the diets without SDE but did not affect growth performance during any other periods. In conclusion, SDE can be an efficacious protein and energy source in nursery pig diets and improves health and, in some instances, increases growth rate.

Data concerning the relationship between hepatitis B virus (HBV) genotypes and liver histology are scarce. The aim of this study was to compare HBV non-B and non-C genotypes according to demographic features, clinical status, HBV-DNA levels and liver histology in Rio de Janeiro. One hundred twenty one consecutive chronic HBV-infected patients were enrolled during two-year period and data were prospectively collected. Sera were tested for HBV genotyping using restriction fragment length polymorphism. Liver biopsy was obtained from patients with either increased alanine aminotransferase (ALT) or HBV-DNA levels. Genotype A was the most common, found in 82 (68%) patients, followed by F in 19 (15%), D in 17 (14%), B in one (1%) and C in two (2%). There was no association between HBV genotypes A, D and F and gender (p = 0.37), age (p = 0.78), race (p = 0.22), mode of infection (p = 0.94), HB "e" antigen status (p = 0.37) and HBV-DNA levels (p = 0.47). The ALT levels were lower in genotype D (75%) compared with A (47%) and F (55%) (p = 0.05). Liver biopsy showed lower inflammation [histological activity index (HAI) = 4] and fibrosis (F) (= 0) scores in genotype D than in genotypes A (HAI = 5, p < 0.001; F = 2, p = 0.008) or F (HAI = 5, p = 0.009; F = 2, p = 0.01). Genotype A was the most prevalent in chronic HBV-infected patients and genotype D patients presented with less intense liver disease.

In this study, we tested the hypothesis that the SdiA proteins of Escherichia coli and Salmonella enterica serovar Typhimurium respond to indole. While indole was found to have effects on gene expression and biofilm formation, these effects were not sdiA dependent. However, high concentrations of indole did inhibit N-acyl-l-homoserine lactone (AHL) sensing by SdiA. We conclude that SdiA does not respond to indole but indole can inhibit SdiA activity in E. coli and Salmonella.

Distillers dried grains with solubles (DDGS) has low and variable AA digestibility. The variability is often attributed to damage during the heating process, and it has been suggested that the damage happens to the soluble components of DDGS such as reducing sugars. Combining solubles and grains sometimes produces syrup balls (SB); their digestibility is unknown. The objective of this experiment was to identify potential sources of poor and variable AA digestibility in DDGS. Specifically, our objective was to determine whether the problems are associated with the solubles component or with SB. The ingredients evaluated were DDGS, intact SB, ground SB, liquid condensed solubles (LCS), and pulse dried thin stillage (PDTS) obtained from the same ethanol plant. The LCS is produced by evaporation of thin stillage. Each ingredient was used as the only source of AA in an experimental diet. In a duplicate 6 × 6 Latin square design with 7-d adaptation and collection periods, the 6 treatments consisted of an N-free diet and the 5 test ingredients. Pigs had 5 d of adaptation to each diet, and on d 6 and 7 ileal digesta were collected from an ileal cannula for 8 h each day. Both SB treatments had apparent ileal digestibility (AID) and standardized ileal digestibility (SID) of AA that were similar or greater (P < 0.05) than those of DDGS. The AID and SID values of Lys and a few other AA were similar in LCS (SID Lys: 63.1%) and DDGS (SID Lys: 61.5%), but the digestibility values of most AA in LCS were less than in DDGS (P < 0.05). The low digestibility of AA in LCS was most pronounced for Met (SID: LCS, 41.9% vs. DDGS, 82.8%). The LCS had less (P < 0.05) AID and SID of CP (SID: 67.8%) than intact SB (SID: 85.2%) and ground SB (SID: 85.9%) as well as all AA. The PDTS generally had the least AID and SID and had less (P < 0.05) CP (SID: 55.3%) and several AA, including Lys, compared with LCS. In conclusion, the presence of SB does not decrease AA digestibility of DDGS, and the LCS evaluated has less indispensible AA digestibility than DDGS. The LCS has low digestibility of AA that seems to not be caused by heat damage.

Purpose: To verify the effects of tibolone administration on trabecular and cortical bone of ovariectomized female rats by computed radiography system (CRS)., Methods: The experiment was performed on two groups of rats previously ovariectomized, one received tibolone (OVX+T) while the other did not (OVX), those groups were compared to a control group (C) not ovariectomized. Tibolone administration (1mg/day) began thirty days after the ovariectomy and the treatment remained for five months. At last, the animals were euthanized and femurs and tibias collected. Computed radiographies of the bones were obtained and the digital images were used to determine the bone optical density and cortical thickness on every group. All results were statistically evaluated with significance set at P<0.05%., Results: Tibolone administration was shown to be beneficial only in the densitometric analysis of the femoral head, performing higher optical density compared to OVX. No difference was found in cortical bone thickness., Conclusion: Ovariectomy caused bone loss in the analyzed regions and tibolone administered in high doses over a long period showed not to be fully beneficial, but preserved bone mass in the femoral head.

Absence of periapical healing after orthograde retreatment using an apical plug with mineral trioxide aggregate (MTA) can require surgical intervention. A patient with a root-filled maxillary central incisor with chronic apical periodontitis and sinus tract was referred for endodontic retreatment. Excessive apical enlargement was verified, indicating an MTA apical plug placement; however, an unintentional extrusion of MTA occurred during this step. The root canal was filled with gutta-percha and sealer, and periodic recalls were scheduled. The sinus tract was observed after six months and the lesion remained unaltered, although the extruded MTA had resorbed; therefore, an apicoectomy and retrograde root-end filling with MTA were performed. Absence of sinus tract, normal clinical aspect, and complete repair of the lesion were observed at the two-year follow-up.

Introduction: To describe the clinical and epidemiological profile of pregnant women and children treated at a reference outpatient clinic for congenital toxoplasmosis., Methods: Pregnant women potentially exposed to Toxoplasma gondii were observed. Diagnoses were made using serologic tests compatible with acute toxoplasmosis. Children presenting with: Toxoplasma-specific antibodies (IgM or IgA or ascending IgG titers higher than maternal titers in the first 3 months of life) coupled with toxoplasmosis symptoms; intracranial calcifications (by transfontanelar ultrasound or cephalic segment tomography); or retinochoroiditis (by fundoscopy examination) in the first 8 months of life were also included in the study., Results: Fifty-eight mother-child pairs were observed (mean age of the mothers was 22.1 years). Most patients lived in urban areas (86.2%) and had attended less than 8 years of school (51.7%). Diagnosis was made after birth in 19 (32.8%) children. Thirty-four (58.6%) women received some type of treatment during pregnancy. Most (72.4%) of the children did not present with clinical alterations at birth. The main findings were ophthalmological: 20 (34.5%) children with retinochoroiditis, 17 (29.3%) with strabismus, and 7 (12.1%) with nystagmus. Of the children with retinochoroiditis, 9 presented with subnormal vision. Ten (32.3%) out of 31 children presented with intracranial calcifications by cephalic segment congenital toxoplasmosis, and 9 (42.9%) children presented with delayed psychomotor development., Conclusions: Our results highlight a critical situation. Protocols for follow-up of pregnant women and their children must be created to improve medical care and minimize sequelae.