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Introduction: An estimated 80% of the world's population use traditional and complementary medicine (T&CM) products as part of their healthcare, with many accessed through pharmacy. This cross-cultural study posed a set of professional practice responsibilities and actions to pharmacists related to T&CM products, with a view toward developing consensus, safeguarding, and promoting the health of the public. Methods : Data were collected from 2,810 pharmacists across nine countries during 2022 via a cross-sectional online survey reported in accordance with the guidelines of STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) and the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). Results : Of the 2,810 participants from nine countries, 2,341 completed all sections of the survey. Of these, most agreed (69%) that T&CM product use was common in the community they served, but most did not have adequate training to support consumer needs. Over 75% acknowledged that there were known and unknown safety risks associated with T&CM use. Of 18 professional responsibilities posed, 92% agreed that pharmacists should be able to inform consumers about potential risks, including T&CM side effects and drug-herb interactions. The provision of accurate scientific information on the effectiveness of T&CM products, skills to guide consumers in making informed decisions, and communication with other healthcare professionals to support appropriate and safe T&CM product use were all ranked with high levels of agreement. In order to effectively fulfill these responsibilities, pharmacists agreed that regulatory reforms, development of T&CM education and training, and access to quality products supported by high-quality evidence were needed. Conclusion: General agreement from across nine countries on eighteen professional responsibilities and several stakeholder actions serve as a foundation for the discussion and development of international T&CM guidelines for pharmacists., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Harnett, Desselle, Fernandes, Yao, Modun, Hallit, Dabbous, Wahab, Cavaco, Magalhães, Faller, Flores, Gabriel, Othman, Anantachoti, Sriboonruang, Sriviriyanupap, Alnezary, Alahmadi, Fallatah, Fadil and Ung.)

Neurologic disability level at hospital discharge is an important outcome in many clinical research studies. Outside of clinical trials, neurologic outcomes must typically be extracted by labor intensive manual review of clinical notes in the electronic health record (EHR). To overcome this challenge, we set out to develop a natural language processing (NLP) approach that automatically reads clinical notes to determine neurologic outcomes, to make it possible to conduct larger scale neurologic outcomes studies. We obtained 7314 notes from 3632 patients hospitalized at two large Boston hospitals between January 2012 and June 2020, including discharge summaries (3485), occupational therapy (1472) and physical therapy (2357) notes. Fourteen clinical experts reviewed notes to assign scores on the Glasgow Outcome Scale (GOS) with 4 classes, namely 'good recovery', 'moderate disability', 'severe disability', and 'death' and on the Modified Rankin Scale (mRS), with 7 classes, namely 'no symptoms', 'no significant disability', 'slight disability', 'moderate disability', 'moderately severe disability', 'severe disability', and 'death'. For 428 patients' notes, 2 experts scored the cases generating interrater reliability estimates for GOS and mRS. After preprocessing and extracting features from the notes, we trained a multiclass logistic regression model using LASSO regularization and 5-fold cross validation for hyperparameter tuning. The model performed well on the test set, achieving a micro average area under the receiver operating characteristic and F-score of 0.94 (95% CI 0.93-0.95) and 0.77 (0.75-0.80) for GOS, and 0.90 (0.89-0.91) and 0.59 (0.57-0.62) for mRS, respectively. Our work demonstrates that an NLP algorithm can accurately assign neurologic outcomes based on free text clinical notes. This algorithm increases the scale of research on neurological outcomes that is possible with EHR data., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Anthropogenic activities contribute to nearly half of current Hg emissions to the atmosphere. In the marine habitat, oceanic predator fishes bioaccumulate Hg throughout their lives, making their consumption the main route of Hg exposure in humans. In this context, several publications, between 1973 and 2022, were selected, analyzed, and duly compiled, with the objective to investigate Hg contamination in nine species of bony fish: Thunnus thynnus (8 publications), Thunnus albacares (19), Thunnus obesus (7), Thunnus atlanticus (5), Thunnus alalunga (4), Katsuwonus pelamis (8), Xiphias gladius (18), Coryphaena hippurus (7) and Euthynnus alletteratus (4), as well as two species of cartilaginous fishes Prionace glauca (13 publications) and Isurus oxyrinchus (8). These studies totaled 5973 individuals. We classified species according to taxonomic groups and region of capture and found a significant difference between sharks and bony fishes, with higher Hg concentrations in sharks. The regions of occurrence were divided into 4 large areas (North Atlantic - NAO, South Atlantic - SAO, Equatorial Atlantic Ocean - EAO, and Mediterranean - MED), but no significant differences were observed when comparing the overall Hg concentrations in fish among regions (including all species). Additionally, a thorough discussion of the risks associated with human consumption of these species was conducted, as nine of the selected species presented individuals with Hg concentration values that exceeded the safety limits (1 ppm) set by health agencies worldwide., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Interleukin-7 receptor α (encoded by IL7R) is essential for lymphoid development. Whether acute lymphoblastic leukemia (ALL)-related IL7R gain-of-function mutations can trigger leukemogenesis remains unclear. Here, we demonstrate that lymphoid-restricted mutant IL7R, expressed at physiological levels in conditional knock-in mice, establishes a pre-leukemic stage in which B-cell precursors display self-renewal ability, initiating leukemia resembling PAX5 P80R or Ph-like human B-ALL. Full transformation associates with transcriptional upregulation of oncogenes such as Myc or Bcl2, downregulation of tumor suppressors such as Ikzf1 or Arid2, and major IL-7R signaling upregulation (involving JAK/STAT5 and PI3K/mTOR), required for leukemia cell viability. Accordingly, maximal signaling drives full penetrance and early leukemia onset in homozygous IL7R mutant animals. Notably, we identify 2 transcriptional subgroups in mouse and human Ph-like ALL, and show that dactolisib and sphingosine-kinase inhibitors are potential treatment avenues for IL-7R-related cases. Our model, a resource to explore the pathophysiology and therapeutic vulnerabilities of B-ALL, demonstrates that IL7R can initiate this malignancy., (© 2021. The Author(s).)

IVIA is a joint initiative of at least 8 Latin-American countries plus Portugal and Spain to make good use of large telecommunications antennas that are out of service in these countries, because most international communications are now using submarine cables. The first step will be to refurbish the antennas and then to start doing single dish observations of radiosources. In a second step the antennas will be equipped with VLBI (Very Long Base Interferometry) equipment, to establish a VLBI network. This project will be able to effectively promote scientific integration in Ibero-America. The work is starting in several countries; here we present several scientific cases for the use of the antennas, and we report on the first Brasilian activities.

Seagrasses are regarded as indicators and first line of impact for anthropogenic activities affecting the coasts. The underlying mechanisms driving seagrass cover however have been mostly studied on small scales, making it difficult to establish the connection to seagrass dynamics in an impacted seascape. In this study, hyperspectral airborne imagery, trained from field surveys, was used to investigate broadscale seagrass cover and genus distribution along the coast of Adelaide, South Australia. Overall mapping accuracy was high for both seagrass cover (98%, Kappa = 0.93), and genus level classification (85%, Kappa = 0.76). Spectral separability allowed confident genus mapping in waters up to 10 m depth, revealing a 3.5 ratio between the cover of the dominant Posidonia and Amphibolis. The work identified the absence of Amphibolis in areas historically affected by anthropogenic discharges, which occasionally contained Posidonia and might be recovering. The results suggest hyperspectral imagery as a useful tool to investigate the interplay between seagrass cover and genus distribution at large spatial scales.

Recent evidence suggests that neural stem cell (NSC) fate is highly dependent on mitochondrial bioenergetics. Tauroursodeoxycholic acid (TUDCA), an endogenous neuroprotective bile acid and a metabolic regulator, stimulates NSC proliferation and enhances adult NSC pool in vitro and in vivo . In this study, we dissected the mechanism triggered by this proliferation-inducing molecule, namely in mediating metabolic reprogramming. Liquid chromatography coupled with mass spectrometry (LC-MS) based detection of differential proteomics revealed that TUDCA reduces the mitochondrial levels of the long-chain acyl-CoA dehydrogenase (LCAD), an enzyme crucial for β-oxidation of long-chain fatty acids (FA). TUDCA impact on NSC mitochondrial proteome was further confirmed, including in neurogenic regions of adult rats. We show that LCAD raises throughout NSC differentiation, while its silencing promotes NSC proliferation. In contrast, nuclear levels of sterol regulatory element-binding protein (SREBP-1), a major transcription factor of lipid biosynthesis, changes in the opposite manner of LCAD, being upregulated by TUDCA. In addition, alterations in some metabolic intermediates, such as palmitic acid, also supported the TUDCA-induced de novo lipogenesis. More interestingly, a metabolic shift from FA to glucose catabolism appears to occur in TUDCA-treated NSCs, since mitochondrial levels of pyruvate dehydrogenase E1-α (PDHE1-α) were significant enhanced by TUDCA. At last, the mitochondria-nucleus translocation of PDHE1-α was potentiated by TUDCA, associated with an increase of H3-histones and acetylated forms. In conclusion, TUDCA-induced proliferation of NSCs involves metabolic plasticity and mitochondria-nucleus crosstalk, in which nuclear PDHE1-α might be required to assure pyruvate-derived acetyl-CoA for histone acetylation and NSC cycle progression., (Copyright © 2020 Fernandes, Costa, Ribeiro, Siquenique, Sá Santos, Martins, Coelho, Silva, Rodrigues and Solá.)

Background: Proinflammatory biomarkers levels are increased among patients with cardiovascular disease, and it is known that both the presence of insulin resistance and diet may influence those levels. However, these associations are not well studied among patients with established cardiovascular disease. Our objective is to compare inflammatory biomarker levels among cardiovascular disease secondary prevention patients with and without insulin resistance, and to evaluate if there is any association between plasma fatty acid levels and inflammatory biomarker levels among them., Methods: In this cross-sectional sub-study from the BALANCE Program Trial, we collected data from 359 patients with established cardiovascular disease. Plasma fatty acids and inflammatory biomarkers (interleukin (IL)-1β, IL-6, IL-8, IL-10, IL-12, high sensitive C-reactive protein (hs-CRP), adiponectin, and tumor necrosis factor (TNF)-alpha) were measured. Biomarkers and plasma fatty acid levels of subjects across insulin resistant and not insulin resistant groups were compared, and general linear models were used to examine the association between plasma fatty acids and inflammatory biomarkers., Results: Subjects with insulin resistance had a higher concentration of hs-CRP (p = 0.002) and IL-6 (p = 0.002) than subjects without insulin resistance. Among subjects without insulin resistance there was a positive association between stearic fatty acid and IL-6 (p = 0.032), and a negative association between alpha-linolenic fatty acid and pro-inflammatory biomarkers (p < 0.05). Among those with insulin resistance there was a positive association between monounsaturated fatty acids and arachidonic fatty acid and adiponectin (p < 0.05), and a negative association between monounsaturated and polyunsaturated fatty acids and pro-inflammatory biomarkers (p < 0.05), as well as a negative association between polyunsaturated fatty acids and adiponectin (p < 0.05). Our study has not found any association between hs-CRP and plasma fatty acids., Conclusions: Subjects in secondary prevention for cardiovascular disease with insulin resistance have a higher concentration of hs-CRP and IL-6 than individuals without insulin resistance, and these inflammatory biomarkers are positively associated with saturated fatty acids and negatively associated with unsaturated fatty acids.

A number of genes that confer resistance to coffee leaf rust (S H 1-S H 9) have been identified within the genus Coffea, but despite many years of research on this pathosystem, the complementary avirulence genes of Hemileia vastatrix have not been reported. After identification of H. vastatrix effector candidate genes (HvECs) expressed at different stages of its lifecycle, we established an assay to characterize HvEC proteins by delivering them into coffee cells via the type-three secretion system (T3SS) of Pseudomonas syringae pv. garcae (Psgc). Employing a calmodulin-dependent adenylate cyclase assay, we demonstrate that Psgc recognizes a heterologous P. syringae T3SS secretion signal which enables us to translocate HvECs into the cytoplasm of coffee cells. Using this Psgc-adapted effector detector vector (EDV) system, we found that HvEC-016 suppresses the growth of Psgc on coffee genotypes with the S H 1 resistance gene. Suppression of bacterial blight symptoms in S H 1 plants was associated with reduced bacterial multiplication. By contrast, HvEC-016 enhanced bacterial multiplication in S H 1-lacking plants. Our findings suggest that HvEC-016 may be recognized by the plant immune system in a S H 1-dependent manner. Thus, our experimental approach is an effective tool for the characterization of effector/avirulence proteins of this important pathogen., (© 2016 The Authors. New Phytologist © 2016 New Phytologist Trust.)

Campomanesia xanthocarpa is known in Brazil as Guabiroba and is popularly used for various diseases, such as inflammatory, renal, and digestive diseases and dyslipidemia. The aim of the study was to analyze the chemical composition and investigate the effects of aqueous extract of C. xanthocarpa on the blood pressure of normotensive rats, analyzing the possible action mechanism using experimental and in silico procedures. The extract was evaluated for total phenolic compounds and total flavonoid content. The chemical components were determined by HPLC analyses. Systolic and diastolic blood pressure and heart rate were measured with extract and drugs administration. The leaves of C. xanthocarpa presented the relevant content of phenolics and flavonoids, and we suggested the presence of chlorogenic acid, gallic acid, quercetin, and theobromine. The acute administration of aqueous extract of C. xanthocarpa has a dose-dependent hypotensive effect in normotensive rats, suggesting that the action mechanism may be mediated through the renin-angiotensin system by AT1 receptor blockade and sympathetic autonomic response. Docking studies showed models that indicated an interaction between chlorogenic acid and quercetin with the AT1 receptor (AT1R) active site. The findings of these docking studies suggest the potential of C. xanthocarpa constituents for use as preventive agents for blood pressure.

Aims: Sleep bruxism (SB) and obstructive sleep apnea syndrome (OSAS) are often observed in children and may have several health implications. The aim of this paper is to evaluate their prevalence and to test for possible associations between these two conditions., Methodology: The sample consisted of 496 children randomly selected among the preschoolers of Taubaté, Brazil; 249 (50·2%) were boys and 247 (49·8%) were girls. Diagnoses of SB and OSAS were made by clinical examinations and questionnaires filled out by the children's parents in a cross-sectional design. Analysis of variance and Chi-square tests were applied to verify possible association among the variables in question., Results: The average age was 4·49 years (SD: ±1·04 years). A total of 25·6% were diagnosed with SB, while 4·83% were diagnosed with OSAS, and only 2·82% presented both conditions. A statistical association was found between SB and OSAS (P<0·001; Chi-square test): 11·03% of subjects with SB also presented with OSAS, and 97·18% of subjects without SB did not present with OSAS. No association was found among children's gender and age and the presence of SB or OSAS., Conclusions: Within the limits of this study, SB was associated with OSAS.

This study evaluated the tension force of cast frameworks made by the technique of framework cemented on prepared abutments using two different resin cements. Forty multi-unit abutment analogs were individually fixed with chemically cured acrylic resin inside PVC cylinders using a parallelometer. Brass cylindrical abutments were tightened to the multi-unit abutments to be used as spacers and then castable UCLA abutments were positioned above. These abutments were cast with Ni-Cr and then divided into 4 groups (n=10): cemented with RelyX U100(r); cemented with RelyX U100(r) and simulation of acrylic resin polymerization process; cemented with Multilink(r); and cemented with Multilink(r) and simulation of acrylic resin polymerization process. Abutments were cemented according to manufacturers' instructions. In a universal testing machine, tensile strength was applied in the direction of the long axis of the abutments at 1 mm/min crosshead speed until displacement of the luted abutments was obtained. The values of maximum tensile force (N) required for the displacement of the luted abutments were tabulated and analyzed statistically by one-way ANOVA with a 95% confidence level. No statistically significant difference was found among the groups (p>0.05). There was an increase in mean tension force when the specimens were subjected to the simulation of acrylic resin polymerization process, but the results did not differ statistically. Both resin cements presented positive results as regards the retention of luted abutments on their respective multi-unit abutments. Both materials may be indicated for the technique of framework cemented on prepared abutments when professionals pursuit better adaptation of implant-supported frameworks.

This study aimed to evaluate the in vitro antifungal susceptibility of Candida species of head-and-neck-irradiated patients (Group 1), non-institutionalized (Group 2) and institutionalized elders (Group 3) using Etest® methodology. Candida was isolated from saliva and presumptively identified by CHROMagar Candida(r), confirmed by morphological criteria, carbohydrate assimilation (API 20C AUX®) and genetic typing (OPE 18). The collection was made from 29, 34 and 29 individuals (Groups 1, 2 and 3, respectively) with 67 isolates. Etest® strips (ketoconazole, itraconazole, fluconazole, amphotericin B and flucytosine) on RPMI (Roswell Park Memorial Institute) agar, on duplicate, were used to evaluate susceptibility. ATTC (American Type Culture Collection) 10231 (Candida albicans) was used as quality control. Among the 67 isolates of Candida species, most were susceptible to azoles, flucytosine and amphotericin B. None of the isolates showed resistance and dose-dependent susceptibility to amphotericin B. There were nine strains resistant to itraconazole, six to fluconazole and two to ketoconazole and ten dose-dependent, mainly to flucytocine. The highest MIC (minimum inhibitory concentration) to C. albicans, C. tropicalis, C. parapsilosis was 2.671 μg.mL-1, 8.104 μg.mL-1, 4.429 μg.mL-1, all for flucytosine. C. krusei and C. glabrata were associated with higher MIC for azoles and C. glabrata with higher MIC to flucytosine. In summary, susceptibility to all tested antifungal agents was evident. The isolates were more resistant to itraconazole and dose-dependent to flucytosine. A comparison of C. albicans in the three groups showed no outliers. Higher MIC was associated with C. krusei and C. glabrata.

Objective: To evaluate the incidence and spectrum of abdominal computed tomography imaging findings in patients with paracoccidioidomycosis., Materials and Methods: Retrospective analysis of abdominal computed tomography images of 26 patients with disseminated paracoccidioidomycosis., Results: Abnormal abdominal tomographic findings were observed in 18 patients (69.2%), while no significant finding was observed in the other 8 (30.8%) patients., Conclusion: Computed tomography has demonstrated to play a relevant role in the screening and detection of abdominal abnormalities in patients with disseminated paracoccidioidomycosis.

Objectives: Calcineurin inhibitors are effective immunosuppressive agents, but associated adverse effects such as nephrotoxicity may limit efficacy. Dietary fish oil may minimize nephrotoxicity caused by long-term use of calcineurin inhibitors. The purpose of the present study was to evaluate the effects of omega-3 fatty acids on calcineurin inhibitor nephrotoxicity in rats that had normal kidney function or chronic kidney failure., Materials and Methods: Rats that had normal kidney function or chronic renal failure that was induced by mass reduction surgery were treated with tacrolimus without or with fish oil, fish oil alone, or olive oil. Kidney function and histology were evaluated after 14 days., Results: Mean body weight loss, serum creatinine, change in serum creatinine, and rate of decrease in creatinine clearance were greater in normal rats that received than did not receive tacrolimus. Tacrolimus nephrotoxicity was greater in rats that had chronic renal failure than normal kidney function, but the mean change in serum creatinine was significantly lower in rats with chronic renal failure that were treated with tacrolimus and fish oil than tacrolimus alone. Fish oil supplementation was associated with fewer abnormal histopathologic lesions in the kidneys of tacrolimustreated rats that had normal kidney function or chronic renal failure (not signifant)., Conclusions: Fish oil may be protective against the development of kidney dysfunction and histopathologic changes in rats treated with tacrolimus.

Objective: this study aimed to evaluate the fixation of the trabecular metal wedge in patients undergoing revision of total hip arthroplasty., Methods: twenty-three cases with minimum grading of Paprosky II-B that were operated between July 2008 and February 2013 were evaluated. These cases were evaluated based on radiographs before the operation, immediately after the operation and later on after the operation. Loss of fixation was defined as a change in the abduction angle of the component greater than 10° or any mobilization greater than 6 mm., Results: it was found that there was 100% fixation of the acetabula after a mean of 29.5 months. One case underwent removal of the implanted components due to infection., Conclusions: there is still no consensus regarding the best option for reconstructing hips with bone loss. However, revision using a trabecular metal wedge has presented excellent short- and medium-term results. This qualifies it as an important tool for achieving a fixed and stable acetabular component.

Purpose: The incidence of colorectal cancer is increasing among young patients. In these patients, colorectal cancer is believed to have a poorer prognosis because it is more aggressive and diagnosed at later stages; however, the behavior of these tumors in young patients remains to be elucidated. We investigated the impact of time interval between onset of symptoms and diagnosis (TISD) at the pathologic stage of colorectal cancer in young patients., Methods: The medical records of 215 patients with colorectal adenocarcinoma were reviewed. Patients were divided into two groups according to age. The young group (age < 50 years) consisted of 66 patients, and the older group (age ≥ 50 years) of 149 patients. Clinical variables, TISD, pathologic stage, operative mortality, and oncologic outcomes were compared between groups., Results: The older group had less abdominal pain (74.0 vs. 56.0 %, p = 0.0129). In multivariate analysis, the following variables were independently associated with tumor pathologic stage: personal history of inflammatory bowel disease (p < 0.0001), family history of familial adenomatous polyposis (p = 0.00100), and smoking (p = 0.0070). Both groups had similar rates regarding pathologic stage (I, 15 vs. 22 %; II, 22 vs. 24 %; III, 27 vs. 16 %; IV, 37 vs. 38 %, p = 0.3380). There was no difference in overall survival [45 (69 %) vs. 84 (61 %), p = 0.2482] and cancer-free survival [36 (63 %) vs. 83 (62 %), p = 0.9218] between groups., Conclusions: Young patients with colorectal cancer had clinical and pathological presentation similar to that of older patients.

Background: The repair of large bone defects is a major orthopedic challenge because autologous bone grafts are not available in large amounts and because harvesting is often associated with donor-site morbidity. Considering that bone marrow stromal cells (BMSC) are responsible for the maintenance of bone turnover throughout life, we investigated bone repair at a site of a critically sized segmental defect in sheep tibia treated with BMSCs loaded onto allografts. The defect was created in the mid-portion of the tibial diaphysis of eight adult sheep, and the sheep were treated with ex-vivo expanded autologous BMSCs isolated from marrow aspirates and loaded onto cortical allografts (n = 4). The treated sheep were compared with control sheep that had been treated with cell-free allografts (n = 4) obtained from donors of the same breed as the receptor sheep., Results: The healing response was monitored by radiographs monthly and by computed tomography and histology at six, ten, fourteen, and eighteen weeks after surgery. For the cell-loaded allografts, union was established more rapidly at the interface between the host bone and the allograft, and the healing process was more conspicuous. Remodeling of the allograft was complete at 18 weeks in the cell-treated animals. Histologically, the marrow cavity was reestablished, with intertrabecular spaces being filled with adipose marrow and with evidence of focal hematopoiesis., Conclusions: Allografts cellularized with AOCs (allografts of osteoprogenitor cells) can generate great clinical outcomes to noncellularized allografts to consolidate, reshape, structurally and morphologically reconstruct bone and bone marrow in a relatively short period of time. These features make this strategy very attractive for clinical use in orthopedic bioengineering.

The aim of this study was to evaluate the stress distribution in the bone adjacent to submerged implants during masticatory function in conventional complete dentures with different soft liners through finite element analysis. Three-dimensional models of a severely resorbed mandible with 2 and 4 submerged implants in the anterior region were created and divided into the following situations: (1) conventional complete dentures (control group); and conventional complete dentures with different soft liner materials, (2) Coe-Comfort, (3) Softliner, and (4) Molteno Hard. The models were exported to mechanical simulation software and 2 simulations were done with the load in the inferior right canine (35 N) and the inferior right first molar (50 N). The data were qualitatively evaluated using the maximum principal stress and microstrain values given by the software. The use of soft liners provides decreased levels of stress and microstrains in peri-implant bone when the load was applied to canine teeth. Considering all of the values obtained in this study, the use of softer materials is the most suitable for use during the period of osseointegration.

Purpose: To evaluate the fracture strength of endodontically treated teeth with reduced coronal structure reinforced with glass-fiber posts and cast posts and core (nickel-chromium alloy) with different thickness., Materials and Methods: Forty maxillary central incisors were sectioned at 1 mm of the cementoenamel junction and endodontically treated. The teeth were divided into four groups (n = 10) and restored with cast post and core and glass-fiber posts with diameters of 1.5 mm and 1.1 mm. The fracture strength was evaluated using a Universal Testing Machine (Instron 1144) at 45° of angulation. The results were submitted to analysis of variance two-way and Tukey's test (P < 0.05). The failure mode was also evaluated., Results: Cast post and core were statistically superior to the glass-fiber posts with the self-post diameter (P = 0.001). When the self-post material was considered, no significant difference was observed between the two post-diameters (P = 0.749). The glass-fiber post-groups presented more fractures in the cervical third than the cast post and core groups., Conclusion: Teeth restored with cast post and cores present higher fracture strength than those reinforced with glass-fiber posts. An increased post-thickness does not increase the fracture strength. Glass-fiber posts lead to less severe fractures.

Objective: To evaluate the effectiveness of the Brazilian Cardioprotective Diet Program in reducing blood pressures, fasting glucose levels and body mass indices in patients with established atherothrombotic disease., Method: This randomized controlled pilot trial included outpatients who were over 45 years of age with atherothrombotic cardiovascular disease. Group A, who received the Brazilian Cardioprotective Diet Program, had weekly sessions with dietitians. Groups B and C received the usual dietary therapy that is given to patients with cardiovascular diseases as proposed by the Brazilian guidelines. This diet had the same nutrient profile as that given to Group A, but it was customized by the integration of typical Mediterranean foods. The difference between Groups B and C was the number of sessions with the dietitian. Group B received weekly sessions, while group C only had monthly sessions. ClinicalTrials.gov: NCT 01453166., Results: There was a greater reduction in systolic (7.8%) and diastolic (10.8%) blood pressures in Group A compared with Group B (2.3% and 7.3%), and Group C (3.9% and 4.9%, respectively). Fasting glucose decreased by 5.3% and 2% in Groups A and B, respectively. Fasting glucose increased by 3.7% in Group C. The BMIs decreased by 3.5% and 3.3% in Groups A and B, respectively. Group C did not present with any changes in BMI. However, none of these data showed statistical differences between the groups, which is methodologically acceptable in pilot trials., Conclusions: The Brazilian Cardioprotective Diet Program seems to be more effective in reducing blood pressures, fasting glucose levels, weights and BMIs in patients with previous cardiovascular disease compared with the diet that has been proposed by the Brazilian guidelines.

Objective: To build a life table and determine the factors related to the time of treatment of undernourished children at a nutrition rehabilitation centre (CREN), São Paulo, Brazil., Design: Nutritional status was assessed from weight-for-age, height-for-age and BMI-for-age Z-scores, while neuropsychomotor development was classified according to the milestones of childhood development. Life tables, Kaplan-Meier survival curves and Cox multiple regression models were employed in data analysis., Setting: CREN (Centre of Nutritional Recovery and Education), São Paulo, Brazil., Subjects: Undernourished children (n 228) from the southern slums of São Paulo who had received treatment at CREN under a day-hospital regime between the years 1994 and 2009., Results: The Kaplan-Meier curves of survival analysis showed statistically significant differences in the periods of treatment at CREN between children presenting different degrees of neuropsychomotor development (log-rank = 6·621; P = 0·037). Estimates based on the multivariate Cox model revealed that children aged ≥24 months at the time of admission exhibited a lower probability of nutritional rehabilitation (hazard ratio (HR) = 0·49; P = 0·046) at the end of the period compared with infants aged up 12 months. Children presenting slow development were better rehabilitated in comparison with those exhibiting adequate evolution (HR = 4·48; P = 0·023). No significant effects of sex, degree of undernutrition or birth weight on the probability of nutritional rehabilitation were found., Conclusions: Age and neuropsychomotor developmental status at the time of admission to CREN are critical factors in determining the duration of treatment.

Background: Studies have shown that pre/postnatal undernutrition leads to higher risk of non communicable diseases such as diabetes, hypertension and obesity in adulthood., Objective: To determine whether overweight adolescents with mild stunting [height-for-age Z scores (HAZ) in the range <-1 to ≥ -2] have higher blood pressure than overweight individuals with normal stature (HAZ ≥ -1)., Methods: Participants were classified as mildly stunted or of normal stature, and further stratified according to body mass index-for-age percentiles as overweight, normal or underweight. Systolic (SBP) and diastolic (DPB) blood pressures were determined according to guidelines, and abdominal fat was analyzed by dual energy X-ray absorptiometry., Results: Mild stunted overweight individuals showed higher DBP values (p=0.001) than their underweight counterparts (69.75 ± 12.03 and 54.46 ± 11.24 mmHg, respectively), but similar to those of normal BMI. No differences were found in DBP values of normal, overweight and underweight individuals among the normal stature groups. An increase in SBP (p=0.01) among mild stunted individuals was found when those with overweight were compared to their underweight and normal BMI counterparts (114.70 ± 15.46, 97.38 ± 10.87 and 104.72 ± 12.24 mmHg, respectively). Although no differences were observed in the means of SBP between mild stunting and normal stature groups, a significant intercept was found (p=0.01), revealing higher SBP among stunted individuals. There was a correlation between SBP and abdominal fat (r=0.42, ρ=0.02) in the stunted group., Conclusion: Stunted individuals with overweight showed higher SBP than those of normal stature and overweight. These findings confirm that mild stunting increase the risk of future hypertension and alterations are evident at early age.

Children with chronic renal failure in general present growth retardation that is aggravated by corticosteroids. We describe here the effects of methylprednisolone (MP) and recombinant human growth hormone (rhGH) on the growth plate (GP) of uremic rats. Uremia was induced by subtotal nephrectomy in 30-day-old rats, followed by 20 IU kg-1 day-1 rhGH (N = 7) or 3 mg kg-1 day-1 MP (N = 7) or 20 IU kg-1 day-1 rhGH + 3 mg kg-1 day-1 MP (N = 7) treatment for 10 days. Control rats with intact renal function were sham-operated and treated with 3 mg kg-1 day-1 MP (N = 7) or vehicle (N = 7). Uremic rats (N = 7) were used as untreated control animals. Structural alterations in the GP and the expression of anti-proliferating cell nuclear antigen (PCNA) and anti-insulin-like growth factor I (IGF-I) by epiphyseal chondrocytes were evaluated. Uremic MP rats displayed a reduction in the proliferative zone height (59.08 +/- 4.54 vs 68.07 +/- 7.5 microm, P < 0.05) and modifications in the microarchitecture of the GP. MP and uremia had an additive inhibitory effect on the proliferative activity of GP chondrocytes, lowering the expression of PCNA (19.48 +/- 11.13 vs 68.64 +/- 7.9% in control, P < 0.0005) and IGF-I (58.53 +/- 0.96 vs 84.78 +/- 2.93% in control, P < 0.0001), that was counteracted by rhGH. These findings suggest that in uremic rats rhGH therapy improves longitudinal growth by increasing IGF-I synthesis in the GP and by stimulating chondrocyte proliferation.

A 71-year-old man with presumptively treated pulmonary tuberculosis ten years earlier and previous alcoholism presented with adrenal insufficiency. HIV serology was negative. A computerized tomography scan of the abdomen showed enlarged right adrenal. He recovered after emergency treatment with hydrocortisone IV. Right adrenalectomy was performed. Histoplasmosis was diagnosed and the patient was treated with itraconazole, corticosteroid replacement, and discharged with good health.

Aromatic and aliphatic fractions of black carbon (BC) solvent extracts were examined by gas chromatography/mass spectrometry to determine how differences in broad chemical and physical features are correlated with the load, composition, "extractability" and bioavailability of organic compounds. Diesel soot, urban dust and chimney soot had concentrations of n-alkanes >20 microg/g and of carcinogenic polycyclic aromatic hydrocarbons (PAHs)>8 microg/g. These high levels of solvent-extractable compounds were interpreted as resulting from combustion at temperatures below optimum values for BC formation. PAH concentrations normalized to the amount of soot carbon in chimney soot were close to values for diesel soot. However, the high proportion of polar amorphous organic matter in chimney soot suggests a higher bioavailability for associated PAHs. Carbon black, vegetation fire residues, and straw and wood charcoals had only residual concentrations of n-alkanes (<9 microg/g) and PAHs (<0.2 microg/g). PAH distributions were mostly unspecific, while the overall signature of the aliphatic fraction varied with BC origin. Molecular markers among plant-derived BC included steroid and sesquiterpenoid hydrocarbons. Molecular fingerprints suggest that compounds associated with fossil BC might be more refractory than those associated with plant-derived BC.

Sorption of the endocrine-disrupting chemical 17beta-estradiol (E(2)) from aqueous solutions to goethite, an iron oxide, and the clay minerals kaolinite, illite, and montmorillonite (K and Ca forms) was measured at 25 degrees C. The clay minerals sorbed more E(2) than the oxide, with sorption capacity increasing in the order goethite

Scanning electron microscopy, surface area determination, elemental analysis, organic matter extraction and solid-state cross polarization/magic angle spinning and Bloch decay/magic angle spinning 13C nuclear magnetic resonance (NMR) spectroscopy were used to investigate distinctive features among carbonaceous combustion residues. Black carbon (BC) samples included diesel soot, urban dust, carbon black, chimney soot, vegetation fire residues, wood and straw charcoals. Particles varied from small spheres (<50 nm) in fossil BC (>100 m(2)/g), to large layered structures in plant-derived BC (generally <8 m(2)/g). Chimney soot also included large (>1 micrometer) liquid-like structures, while spherules >100 nm were unique to urban dust. The ratios of amorphous to soot carbon (SC) (isolated by thermal degradation) were not necessarily correlated with the degree of aromaticity estimated from H/C ratios. In particular, values of SC in diesel soot were clearly overestimated. Solvent-extractable organic matter (SEOM) was <2% for charcoals and carbon black, but >13% for urban dust, chimney and diesel soot. SEOM is thought to clog pores or to form large waxy globules, hence reducing surface areas. The ratio of polar/nonpolar SEOM was generally <7 for fossil BC, but >30 for plant-derived BC. NMR analysis revealed essentially one chemical shift in the aromatic C region of charcoals, while diesel soot also showed important aliphatic contributions. Aliphatic and oxygenated C predominated over aryl C in urban dust and chimney soot. These morphological and chemical characteristics of the BC samples are discussed in terms of their environmental implications.

Polycyclic aromatic and monoaromatic (benzene, toluene and xylene, or BTX) hydrocarbons were monitored in Rio de Janeiro, Brazil, during the summer of 1998/1999. The levels of these aromatic chemicals decreased with distance from main roads, indicating mobile sources are the main pollutant emitters in this Latin American city. Benzo[ghi]perylene/indeno[1,2,3-cd]pyrene and benzene/toluene ratios corroborate this idea. However, higher benzene/toluene ratios at one of the major access routes into the city suggest pollutant inputs from a nearby refinery. Literature data were reviewed in order to outline differences and similarities among sources and levels of aromatic pollutants in large urban agglomerations worldwide. Concentrations of benzo[a]pyrene and benzene, which are well-known carcinogenic chemicals, were relatively low in Rio de Janeiro. This fact was attributed to specific atmospheric conditions during the tropical summer and differences in vehicle fuel composition.

The uptake of anthracene from dilute aqueous solutions onto goethite and kaolinite was investigated at 25 degrees C, first in the absence and then in the presence of three benzene carboxylic acids: phthalic acid (benzene-1,2-dicarboxylic acid), trimesic acid (-1,3,5-), and mellitic acid (-1,2,3,4,5,6-). Carboxylic acid concentrations were 0.20, 0.10, and 0.05 mM. Anthracene (0.20 microM) did not adsorb strongly onto the pure mineral surfaces, but in the presence of phthalic acid a substantial increase in anthracene uptake was observed, particularly for the goethite systems. Trimesic and mellitic acids did not enhance anthracene uptake. Phthalate and proton adsorption data have been used to model phthalate adsorption onto the mineral surfaces using an extended constant capacitance surface complexation model. This model was then successfully adapted to account for the observed increase in anthracene uptake, where anthracene molecules were assumed to interact with adsorbed phthalate. We propose that the enhancement of anthracene adsorption in the presence of phthalic acid is due to an increase in the hydrophobicity of the mineral surface once phthalic acid molecules adsorb. The same effect was not observed for the other benzene carboxylates because of their greater polarity.