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A gasolina é uma mistura complexa de substâncias, dentre elas estão hidrocarbonetos como o benzeno, tolueno, etilbenzeno e xilenos (BTEX), sendo esses compostos emitidos para a atmosfera, com destaque ao benzeno, por ser comprovadamente carcinogênico. Objetivamos avaliar as concentrações de BTEX no ar de postos de revenda de combustíveis no Município do Rio de Janeiro, Brasil, e calcular o risco de câncer associado a estas exposições. Foram realizados dois tipos de amostragem (fixa e móvel) adaptadas da metodologia nº 1.501 do Instituto Nacional de Segurança e Saúde Ocupacional (Estados Unidos), em seis postos de revenda de combustíveis na Zona Oeste da cidade. A amostragem fixa foi feita próxima às bombas de combustível, enquanto a móvel foi realizada através da coleta do ar na zona respiratória dos trabalhadores (frentistas), conforme estes se deslocavam pelo posto. As amostras foram analisadas por cromatografia gasosa com detecção por ionização em chama. Com os resultados das amostragens foram feitos os cálculos de risco à saúde, usando os indicadores Quociente de perigo (HQ) e Risco de câncer (CR), para avaliar os possíveis efeitos não-carcinogênicos e carcinogênicos, respectivamente, nos trabalhadores dos postos de revenda de combustíveis. As concentrações ambientais para a maioria dos compostos BTEX foram abaixo dos limites preconizados, menos para o benzeno, um composto carcinogênico, que apresentou concentrações muito acima dos limites, levando a altos valores de risco de câncer. Os resultados demonstraram que há riscos à saúde dos trabalhadores de postos de revenda de combustíveis, principalmente o risco de desenvolver câncer, devido à exposição excessiva ao benzeno.

Research on allelopathic interactions can be useful in the search for phytotoxins produced by plants that may be employed as natural herbicides. The aim of this study was to assess the phytotoxic action of aqueous leaf extract of Blepharocalyx salicifolius, Myrcia multiflora, Myrcia splendens and Myrcia tomentosa on the germination and development of three weeds. The working hypothesis was that leaf extracts of Myrtaceae may negatively influence the development of weed species. Aqueous leaf extracts at 5 and 10% (g mL-1) were tested on the germination and growth of Euphorbia heterophylla, Echinochloa crus-galli and Ipomoea grandifolia and compared with the herbicide oxyfluorfen and distilled water (control). The most extracts caused pronounced delays in seed germination and inhibited the growth of seedlings of E. heterophylla; I. grandifolia and E. crus-galli, with the last target species had no growth shoot inhibited by the extracts. In this study, the potential and efficiency of the tested aqueous leaf extracts were evident because they were more phytotoxic to the weeds than the herbicide. Thus, the aqueous extracts of leaves from Myrtaceae species show potential for the isolation of active compounds that can be used for the production of natural herbicides in the future.

Allelopathy is a type of biotic interference wherein a plant releases bioactive metabolites into an environment, thereby affecting the adjacent biota. Stressful environments stimulate the production of these metabolites. The present study tests the novel weapons hypothesis, which postulates that species belonging to the same genus and from the same environment have similar allelopathic effects. The aim of this study was to assess the allelopathic effects that the aqueous leaf extracts of 15 species belonging to five genera of the Myrtaceae family have on the seed germination and initial seedling growth of lettuce (Lactuca sativa L.), tomato (Solanum lycopersicum L.) and onion (Allium cepa L.). Germination rates, average germination times, informational entropy of germination and allelopathic effects, as quantified with a response index, were calculated. A taxonomic distance matrix based on Gower dissimilarity and a Euclidean distance matrix were constructed. The results revealed that all extracts from donor species significantly increased average germination time or reduced the germination rate of eudicotyledonous plant species. The only extracts that showed no effect on monocotyledonous seeds were those of Campomanesia pubescens O. Berg and Psidium cinereum Mart. We conclude that eudicotyledonous and monocotyledonous plants were both significantly affected by the presence of all extracts tested. Our results make it clear that each species behaves distinctly in relation to allelopathic activity, with no apparent grouping by genus or subtribe. Therefore, the hypothesis was rejected, because plants from the same environment and with taxonomic proximity do not necessarily display similar production of secondary metabolites.

This study sought to identify the effectiveness of Educational interventions in reducing exposure to pesticides. An integrative review was made and the selected data categorized and analyzed descriptively in two major thematic groups: Knowledge, Attitudes and Practices (KAP) and Active Community Participation. There is a strong evidence of the effectiveness of Educational interventions in reducing exposure to pesticides in different populations. A long-term analysis and work carried out in one location are needed. The active participation of the community sets as an important way for a critical review of pesticide use. KAP questionnaires are useful to highlight weaknesses in the use of pesticides, pointing out the need for interventions and evaluate their effectiveness. ___ O presente trabalho buscou identificar a eficácia de Intervenções Educacionais na redução da exposição aos agrotóxicos. Foi feita uma revisão integrativa, tendo sido os dados selecionados categorizados e analisados de maneira descritiva em dois grandes grupos temáticos: Conhecimentos, Atitudes e Práticas (KAP) e Participação Ativa da Comunidade. Existem evidências fortes da eficácia de Intervenções Educacionais na redução da exposição aos agrotóxicos em diferentes populações. Uma análise em longo prazo e de trabalhos realizados em um mesmo local se fazem necessários. A participação ativa da comunidade configura como importante caminho para uma revisão crítica do uso de agrotóxicos. Questionários KAP são úteis para destacar fragilidades em relação ao uso de agrotóxicos, apontar a necessidade de intervenções e avaliar suas efetividades.

Allelopathic substances can be used to develop weed control alternatives based on natural products. The objective of this study was to compare the phytotoxic activity of aqueous leaf extracts of Rapanea umbellata with the toxicity of a synthetic herbicide on the germination and growth of weed species. The weeds species barnyard grass (Echinochloa crus-galli), wild poinsettia (Euphorbia heterophylla) and morning glory (Ipomoea grandifolia) were used. The effects of the aqueous leaf extract of R. umbellata at concentrations of 10% and 5% (g mL-1) were compared to the control (distilled water) and to the synthetic herbicide oxyfluorfen. The average weed germination time was significantly lower (p < 0.05) in control than in extract and herbicide treatments. The herbicide had more significant effects than the extract on the initial growth of the aerial part. However, the initial growth of the root part was significantly more affected by the leaf extract than by the herbicide. The extract also caused many disorders in weed root anatomy. Therefore, the leaf aqueous extract of R. umbellata showed important results that indicate that it should be bioprospected and that its allelochemicals should be purified for the discovery of natural-origin herbicides.

IntroductionDespite the existing data on the Multisystem Inflammatory Syndrome in Children (MIS-C), the factors that determine these patients evolution remain elusive. Answers may lie, at least in part, in genetics. It is currently under investigation that MIS-C patients may have an underlying innate error of immunity (IEI), whether of monogenic, digenic, or even oligogenic origin.MethodsTo further investigate this hypothesis, 30 patients with MIS-C were submitted to whole exome sequencing. ResultsAnalyses of genes associated with MIS-C, MIS-A, severe covid-19, and Kawasaki disease identified twenty-nine patients with rare potentially damaging variants (50 variants were identified in 38 different genes), including those previously described in IFNA21 and IFIH1 genes, new variants in genes previously described in MIS-C patients (KMT2D, CFB, and PRF1), and variants in genes newly associated to MIS-C such as APOL1, TNFRSF13B, and G6PD. In addition, gene ontology enrichment pointed to the involvement of thirteen major pathways, including complement system, hematopoiesis, immune system development, and type II interferon signaling, that were not yet reported in MIS-C.DiscussionThese data strongly indicate that different gene families may favor MIS- C development. Larger cohort studies with healthy controls and other omics approaches, such as proteomics and RNAseq, will be precious to better understanding the disease dynamics.

Neste artigo, descrevemos o modo como se deu o processo de criação do Sistema de Informações e Monitoramento Inteligente (SIMI-SP), uma plataforma desenvolvida pelo governo do estado de São Paulo para reunir dashboards com os principais dados referentes à pandemia de covid-19. Descrevemos, ainda, o processo de construção do Índice de Isolamento Social e a sua integração ao chamado Plano São Paulo durante esse período. A partir da análise de conteúdo e da categorização das publicações, relacionadas aos 120 primeiros dias da crise, nossos estudos apontam que experiências trazidas por essas medidas não farmacológicas precisam ser mais bem avaliadas, no que diz respeito a sua integração com a vigilância em saúde e ao processo de comunicação com os cidadãos.

The aim of this study was to investigate whether simultaneous irradiation at 660 and 808 nm generates different patterns of oxidative/antioxidative activities compared to consecutive irradiation. Primary cultures of gingival keratinocytes and fibroblasts were exposed to a diose laser (660 ± 2 nm and 808 ± 2 nm, 100 mW, 0.09 cm2 spot area) using double irradiation with the two wavelengths (consecutive or simultaneous) for 6, 10, and 20 s. The two irradiation regimens did not increase cell viability in any of the experimental conditions. Lipid peroxidation was increased after consecutive irradiation in epithelial cells, which was not detected after simultaneous irradiation. After 20s of the simultaneous mode, ROS levels increased, but antioxidative balance decreased. In the fibroblasts, the two double irradiations induced ROS reduction, increase in lipid peroxidation, and improvement of antioxidative balance, mainly after the 20 s irradiation time. In conclusion, simultaneous and consecutive irradiation induced distinct oxidative stress modulation in oral epithelial cells and fibroblasts. The imbalance in the oxidative system observed after longer exposures, allied with the absence of a significant increase in the viability of the two cell types, suggests a contraindication for longer simultaneous irradiation in clinical situations that demand cellular stimulation. [ABSTRACT FROM AUTHOR]

This narrative review aims to update the reader about the current issues surrounding central aspects implicated in the relationship between oral mucositis (OM) and periodontitis. We searched Medline/PubMed database. English language publications were included in the study. Paired reviewers selected articles for inclusion and extracted data. Forty-four studies met our inclusion criteria. The majority of the studies were review (63.8%) and clinical studies (36.2%). There is a lack of studies regarding the association of periodontal disease (PD) and OM. However, there are pathogenic similarities between them. Look for scientific evidence to confirm the relationship between PD and OM is imperative. Thus, if periodontitis can actually interfere with the occurrence and severity of OM, the establishment of strategies to reduce it may contribute to better control of OM, a serious adverse effect of cancer treatment. [ABSTRACT FROM AUTHOR]

Objective: To describe the clinical, laboratory, and radiological characteristics, as well as the outcomes of children with MIS-C. Method: Multicenter, prospective cohort study, conducted in 17 pediatric intensive care units in five states in Brazil, from March to July 2020. Patients from 1 month to 19 years who met the MIS-C diagnostic criteria were included consecutively. Results: Fifty-six patients were included, with the following conditions: Kawasaki-like disease (n = 26), incomplete Kawasaki disease (n = 16), acute cardiac dysfunction (n = 10), toxic shock syndrome (n = 3), and macrophage activation syndrome (n = 1). Median age was 6.2 years (IQR 2.4−10.3), 70% were boys, 59% were non-whites, 20% had comorbidities, 48% reported a contact with COVID-19 cases, and 55% had a recent SARS-CoV-2 infection confirmed by RT-PCR and/or serology. Gastrointestinal symptoms were present in 71%, shock symptoms in 59%, and severe respiratory symptoms in less than 20%. d-Dimer was increased in 80% and cardiac dysfunction markers in more than 75%. Treatment included immunoglobulin (89%); corticosteroids, antibiotics, and enoxaparin in about 50%; and oseltamivir and antifungal therapy in less than 10%. Only 11% needed invasive mechanical ventilation, with a median duration of five days (IQR 5–6.5). The median length of PICU stay was six days (IQR 5–11), and one death occurred (1.8%). Conclusions: Most characteristics of the present MIS-C patients were similar to that of other cohorts. The present results may contribute to a broader understanding of SARS-CoV-2 infection in children and its short-term consequences. Long-term multidisciplinary follow-up is needed, since it is not known whether these patients will have chronic cardiac impairment or other sequelae.

Objective: To describe the clinical characteristics of children and adolescents admitted to intensive care with confirmed COVID‐19. Method: Prospective, multicenter, observational study, in 19 pediatric intensive care units. Patients aged 1 month to 19 years admitted consecutively (March–May 2020) were included. Demographic, clinical‐epidemiological features, treatment, and outcomes were collected. Subgroups were compared according to comorbidities, age < 1 year, and need for invasive mechanical ventilation. A multivariable logistic regression model was used for predictors of severity. Results: Seventy‐nine patients were included (ten with multisystemic inflammatory syndrome). Median age 4 years; 54% male (multisystemic inflammatory syndrome, 80%); 41% had comorbidities (multisystemic inflammatory syndrome, 20%). Fever (76%), cough (51%), and tachypnea (50%) were common in both groups. Severe symptoms, gastrointestinal symptoms, and higher inflammatory markers were more frequent in multisystemic inflammatory syndrome. Interstitial lung infiltrates were common in both groups, but pleural effusion was more prevalent in the multisystemic inflammatory syndrome group (43% vs. 14%). Invasive mechanical ventilation was used in 18% (median 7.5 days); antibiotics, oseltamivir, and corticosteroids were used in 76%, 43%, and 23%, respectively, but not hydroxychloroquine. The median pediatric intensive care unit length‐of‐stay was five days; there were two deaths (3%) in the non‐ multisystemic inflammatory syndrome group. Patients with comorbidities were older and comorbidities were independently associated with the need for invasive mechanical ventilation (OR 5.5; 95% CI, 1.43–21.12; p = 0.01). Conclusions: In Brazilian pediatric intensive care units, COVID‐19 had low mortality, age less than 1 year was not associated with a worse prognosis, and patients with multisystemic inflammatory syndrome had more severe symptoms, higher inflammatory biomarkers, and a greater predominance of males, but only comorbidities and chronic diseases were independent predictors of severity. Resumo: Objetivo: Descrever as características clínicas de crianças e adolescentes internados em unidade de terapia intensiva com COVID‐19 confirmada. Método: Estudo prospectivo, multicêntrico, observacional, em 19 unidades de terapia intensiva pediátrica. Foram incluídos pacientes entre um mês e 19 anos, admitidos consecutivamente (março a maio de 2020). As características demográficas, clínico‐epidemiológicas, o tratamento e os resultados foram coletados. Os subgrupos foram comparados de acordo com as comorbidades, idade < 1 ano e necessidade de ventilação mecânica invasiva. Um modelo de regressão logística multivariável foi utilizado para preditores de gravidade. Resultados: Setenta e nove pacientes foram incluídos (10 com síndrome inflamatória multi-ssistêmica). Mediana de idade, quatro anos; 54% eram do sexo masculino (síndrome inflamatória multissistêmica, 80%); 41% tinham comorbidades (síndrome inflamatória multissistêmica, 20%). Febre (76%), tosse (51%) e taquipneia (50%) foram comuns nos dois grupos. Sintomas graves egastrointestinais e marcadores inflamatórios mais elevados foram mais frequentes na presença de síndrome inflamatória multissistêmica. Infiltrados intersticiais pulmonares foram comuns em ambos os grupos, mas o derrame pleural foi mais prevalente no grupo com síndrome inflamatória multissistêmica (43% vs. 14%). A ventilac¸ão mecânica invasiva foi utilizada em 18% (mediana 7,5 dias); antibióticos, oseltamivir e corticosteroides foram utilizados em 76%, 43% e 23%, respectivamente, mas não a hidroxicloroquina. A mediana do tempo de permanência na unidade de terapia intensiva pediátrica foi de 5 dias; duas mortes ocorreram (3%) no grupo não- síndrome inflamatória multissistêmica. Os pacientes com comorbidades eram mais velhos, e as comorbidades foram independentemente associadas à necessidade de ventilac¸ão mecânica invasiva(OR 5,5; IC95%, 1,43-21,12; P 0,01). Conclusões: Nas unidades de terapia intensiva pediátrica brasileiras, a COVID‐19 apresentou baixa mortalidade, a idade inferior a um ano não foi associada a um pior prognóstico, os pacientes com síndrome inflamatória multissistêmica apresentaram sintomas mais graves, biomarcadores inflamatórios mais elevados e uma grande predominância no sexo masculino, mas apenas a presença de comorbidades e doenças crônicas foi um preditor independente de gravidade.

Background: Oral complications of chemotherapy are sometimes unnoticed and if not treated, they can compromise patients' health and quality of life. Methods: This study aimed to assess and characterize orofacial complaints and complications, and their impact on the oral-health-related quality of life in patients undergoing cancer chemotherapy. Results: We evaluated 28 patients with solid tumors undergoing chemotherapy, through a systematic orofacial evaluation. Eighteen patients (64.2%) developed oral complications during chemotherapy and xerostomia scored the highest incidence n = 14 (50%). About oral health data, gingival index revealed greater part of patients classified with moderate or severe gingival inflammation. The mean plaque index was 25.6%. The mean CPOD index was 15.48 and was worse in patients without oral complications. The patients presented higher plaque index and the oral health impact profile showed higher mean index in the patients group that developed oral complications. Conclusion: These data reinforce the crucial role of the dentist in the multidisciplinary team, with crucial support in the diagnosis of oral complications. Thus, a specific assistance and relieve of patient's complaints could impact positively on quality of life.

ABSTRACT Objective: To evaluate the impact of screening hyper and hypoglycemia measured by capillary glycemia and standard monitorization of hyperglycemic patients hospitalized in regular care units of Hospital Israelita Albert Einstein. Methods: The capillary glycemia was measured by the Precision PCx (Abbott) glucosimeter, using the PrecisionWeb (Abbott) software. The detection of hyper and hypoglycemia during the months of May/June were compared to those of March/April in 2009 and to the frequency of the diagnosis of diabetes in 2007. Results: There was an increase in the glycemia screening from 27.7 to 77.5% of hospitalized patients (p < 0.001), of hyperglycemia detection (from 9.3 to 12.2%; p < 0.001) and of hypoglycemia (from 1.5 to 3.3%; p < 0.001) during the months of May/June 2009. According to this action 14 patients for each additional case of hyperglycemia and 26 cases for each case of hypoglycemia were identified. The detection of hyperglycemia was significantly higher (p < 0.001) than the frequency of registered diagnosis related do diabetes in the year of 2007. Conclusions: the adoption of an institutional program of glycemia monitorization improves the detection of hyper and hypoglycemia and glycemia control in hospitalized patients in regular care units.

O equilíbrio do corpo bem como os movimentos da cabeça são originados pelo posicionamento do crânio sobre a região cervical determinando assim a postura do indivíduo. Estando a articulação temporomandibular (ATM) diretamente relacionada com a região cervical e escapular através de um sistema neuromuscular comum, alterações posturais da coluna cervical podem acarretar em distúrbios na ATM e vice-versa. O número crescente de pacientes com disfunção da articulação temporomandibular (DTM) que apresentavam alterações posturais levou ao desenvolvimento de estudos que procuram demonstrar suas relações. Este trabalho propôs-se realizar uma revisão de literatura que demonstre a relação entre má postura e DTM. Salienta ainda a necessidade de uma equipe multidisciplinar, formada pelo médico ortopedista, o cirurgião dentista e o fisioterapeuta, para realizarem juntos o diagnóstico e o tratamento de tais alterações.The position of the head over the neck determines the posture of the body and is responsible for the body balance and head movements. The temporomandibular joint (TMA) is directly related to the cervical and the scapular region by a common neuromuscular system. Changes in the cervical spine can cause lead to TMA disorders and contra wise. The increasing number of patients with TMA disorders who also had postural disorders led to the development of studies to evaluate their interactions. The present study aimed to review the papers that have shown a relationship between wrong posture and TMA disorders. It emphasizes the importance of a multidisciplinary team formed by an orthopedist, dental surgeon, and physiotherapist in the diagnosis and treatment of TMA disorders and wrong posture.

OBJETIVO: O trauma da laringe é pouco freqüente. O objetivo do presente trabalho é avaliar os procedimentos e resultados no tratamento destas lesões. MÉTODO: Este trabalho baseou-se em estudo prospectivo de 35 de pacientes com trauma de laringe atendidos no período de janeiro de 1990 a abril de 2003. RESULTADOS: A média de idade foi de 31,4 anos, sendo 30 pacientes (85,7%) do sexo masculino. O mecanismo predominante foi o trauma penetrante (30 casos - 85,7%), a maioria causada por ferimento por projétil de arma de fogo (17 casos - 48,6%). Dez pacientes (28,6%) necessitaram de intubação traqueal na admissão hospitalar e o valor médio do RTS foi de 7,28. As observações mais freqüentes no exame clínico das vítimas de trauma penetrante foram exposição de cartilagens da laringe (30%) e saída de ar pelo orifício do ferimento cervical (30%). Nos cinco pacientes (14,3%) com trauma contuso o achado mais freqüente foi enfisema subcutâneo (80%).O tratamento foi cirúrgico em 34 pacientes (97,1%), através de cervicotomia em colar na maioria dos casos (91,2%). A cartilagem tireóide foi a mais lesada (20 casos - 57,1%). Em 33 pacientes operados a lesão foi tratada com sutura, associada a traqueostomia em 24 casos (72,7%). Lesões cervicais associadas ocorreram em 20 casos (57,1%), sendo mais comum as de veia jugular (10 casos). A média do ISS e do TRISS foram, respectivamente, 16,3 e 0,93. A morbidade relacionada diretamente à lesão laríngea foi de 34,3% (12 casos), sendo mais freqüente a disfonia (seis casos). Foi necessária a reexploração cervical em dois pacientes, um devido a abscesso cervical e outro, tardiamente, por estenose supra-glótica, este último tratado com molde. Dois pacientes apresentaram complicações tardias, um com disfagia e outro com disfonia. A mortalidade pós-operatória foi de 5,7% (dois casos), decorrente de complicações não relacionadas ao trauma laríngeo. CONCLUSÕES: A utilização de condutas padronizadas na abordagem do paciente com trauma de laringe, tanto no diagnóstico como no tratamento definitivo, resulta em menor taxa de seqüelas definitivas.