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Este trabalho tem como objetivo identificar e analisar a importância do patrimônio material e imaterial e a memória no bairro do Guamá, na cidade de Belem (PA). O Bairro está inserido no contexto da cidade como um local periférico, porém, guarda riquezas patrimoniais e diversas histórias dos períodos que marcaram a expansão e modernização da cidade de Belém. Sua localização está as margens do Rio Guamá, este, possui um papel muito grande devido a descargas de produtos vindos das ilhas próximo a Belém e do interior. A cultura do bairro é diversificada através da passagem Pedreirinha, local que abriga grupos de Carimbó, cordões juninos e uma escola carnavalesca. Para o trabalho foram utilizados referenciais teóricos acerca da memória e patrimônio. Além disso, a aplicação dos questionários e a construção de um roteiro para o bairro. Em síntese, as atividades que compõem o roteiro tornam-se formas de provocação as autoridades e dos próprios moradores da área para a preservação do patrimônio.

Background/Aims Cardiovascular disease (CVD) is well-recognised in giant cell arteritis (GCA) and thoracic aortic aneurysms (TAAs) are a late complication. Although the British Society for Rheumatology acknowledge the increased risk of CVD and TAAs, guidance for the management of GCA does not recommend antithrombotic agents or vascular screening due to lack of evidence. Positron emission topography (PET-CT) is commonly used for evaluation of large vessel vasculitis (LVV) in GCA. Although not routinely reported, additional measurements including aortic calibre and presence of coronary and aortic calcification can be assessed. LVV is known to be a risk factor for TAA. Therefore, this cohort represents an enriched population to evaluate for cardiovascular abnormalities. Our aims were to: estimate the prevalence of CV abnormalities on PET-CT scans in GCA; develop a standard operating procedure of CV parameters to improve the management of cardiovascular complications in conjunction with radiology and cardiology. Methods A retrospective review of PET-CT scans in GCA patients between 2016-2022 was undertaken. We determined the prevalence of CV abnormalities. Maximum diameter of the thoracic aorta and the presence of coronary and aortic calcification were reviewed by a PET-CT radiologist. Clinical characteristics and CV risk factors were evaluated. A standardised reporting protocol was developed for GCA PET-CT scans. A local guideline for the management of CV abnormalities was formulated. Results Fifty-two consecutive patients with GCA who had undergone PET-CT were identified. Most were female (40/51; 80%). Median age at diagnosis was 71 years (interquartile range [IQR] 63-75). Median time from GCA diagnosis to PET-CT scan was 20 months (IQR 4-38). Nine patients were diagnosed with GCA by PET-CT scan. Most GCA patients (32/51; 63%) were known to have CVRFs. 17/32 (53%) took an antithrombotic and/or anticoagulant, and 10/32 (31%) had a lipid lowering therapy. Original PET-CT scans reported coronary artery and/or aortic calcification in 6/51 (12%) GCA patients. Re-examination of PET-CT scans found coronary artery calcification in 38/51 (74%) and aortic calcification in 14/51 (27%) of all GCA patients. Coronary artery calcification was found in 27/32 (84%) of GCA patients known to have CVRFs, and 12/32 (38%) had evidence of aortic calcification. For GCA patients without CVRFs, 11/19 (58%) had evidence of coronary artery calcification and 2/19 (10%) had aortic calcification. Conclusion We observed a significant burden of cardiovascular abnormalities on PET-CT in GCA patients. Ten percent of patients with aortic dilation required follow up. A significant proportion of those with coronary calcification were not on primary prevention therapy. Importantly, 58% of patients without known CV risk factors were found to have coronary artery calcification. Given the burden of abnormalities identified we have now instituted a standardised reporting policy on CV abnormalities on PET-CT for GCA indications. Local policies have been developed for the management of thoracic aneurysms in GCA. Disclosure B. Mulhearn: None. J. Ellis: None. R. Foley: None. S. Gunawardana: None. R. Wickramarachchi: None. J. Rodrigues: None. O. Watkinson: None. S. Tansley: None. R. Graham: None. S. Skeoch: None.

Introdução: A persistência de microrganismos é um dos fatores determinantes de insucesso do tratamento endodôntico, que ocorre devido às iatrogenias, patologias e negligencias. Para solucionar este problema, pode-se indicar a extração dentária ou um tratamento mais conservador, como o retratamento endodôntico. Objetivo: Frente ao exposto, o principal objetivo no presente artigo é relatar um caso clínico de insucesso do tratamento endodôntico primário e o sucesso na abordagem de retratamento que culminou para a finalização positiva do caso clínico. Relato de caso clínico: Paciente com sintomatologia dolorosa ao mastigar no dente 26 foi diagnosticada com periodontite apical crônica com radioluscência periapical por meio da propedêutica clínica e radiográfica com vistas à Endodontia. Foi realizado tratamento endodôntico e após 1 ano da finalização, o paciente apresentava fístula recorrente e foi proposto a extração do dente em questão. Descontente com o plano de tratamento, buscou uma segunda opinião e foi realizado o retratamento endodôntico em sessões múltiplas com a utilização de hidróxido de cálcio como opção para medicação intracanal. Após 60 dias de medicação intracanal, realizou-se a obturação do sistema de canais radiculares e a reabilitação dentária. Conclusão: O sucesso do tratamento endodôntico é dependente da excelente limpeza e desinfecção do sistema de canais radiculares e conseguinte obturação hermética; a persistência de microrganismos é um dos fatores que pode determinar um prognóstico desfavorável e uma nova reintervenção endodôntica pode levar ao sucesso, a despeito de alternativas radicais, como a exodontia e reabilitação com implantes. Por meio do caso clínico apresentado, conclui-se que o planejamento minucioso e a execução do tratamento baseado em evidência científica levam ao sucesso de tratamentos mais conservadores para o paciente e sua satisfatoriedade.

Contains fulltext : 286832.pdf (Publisher’s version ) (Open Access) BACKGROUND: Direct evaluation of vascular inflammation in patients with COVID-19 would facilitate more efficient trials of new treatments and identify patients at risk of long-term complications who might respond to treatment. We aimed to develop a novel artificial intelligence (AI)-assisted image analysis platform that quantifies cytokine-driven vascular inflammation from routine CT angiograms, and sought to validate its prognostic value in COVID-19. METHODS: For this prospective outcomes validation study, we developed a radiotranscriptomic platform that uses RNA sequencing data from human internal mammary artery biopsies to develop novel radiomic signatures of vascular inflammation from CT angiography images. We then used this platform to train a radiotranscriptomic signature (C19-RS), derived from the perivascular space around the aorta and the internal mammary artery, to best describe cytokine-driven vascular inflammation. The prognostic value of C19-RS was validated externally in 435 patients (331 from study arm 3 and 104 from study arm 4) admitted to hospital with or without COVID-19, undergoing clinically indicated pulmonary CT angiography, in three UK National Health Service (NHS) trusts (Oxford, Leicester, and Bath). We evaluated the diagnostic and prognostic value of C19-RS for death in hospital due to COVID-19, did sensitivity analyses based on dexamethasone treatment, and investigated the correlation of C19-RS with systemic transcriptomic changes. FINDINGS: Patients with COVID-19 had higher C19-RS than those without (adjusted odds ratio [OR] 2·97 [95% CI 1·43-6·27], p=0·0038), and those infected with the B.1.1.7 (alpha) SARS-CoV-2 variant had higher C19-RS values than those infected with the wild-type SARS-CoV-2 variant (adjusted OR 1·89 [95% CI 1·17-3·20] per SD, p=0·012). C19-RS had prognostic value for in-hospital mortality in COVID-19 in two testing cohorts (high [≥6·99] vs low [

This work aims to identify and analyze the importance of material and immaterial heritage and memory in the Guamá neighborhood. The Neighborhood is inserted in the context of the city as a peripheral place, however, it keeps riches and several histories of the periods that marked the expansion and modernization of the city of Belém. Its location is on the banks of the Guamá River, which has a very large role due to the unloading of products from the islands near Belém and inland. The neighborhood's culture is diversified through the pedreirinha passage, a place that houses groups from Carimbó, cordões juninos and a carnival school. For the work, theoretical references about memory and heritage were used. In addition, the application of questionnaires and the construction of a script for the neighborhood. In short, the activities that make up the itinerary become ways of provoking the authorities and the residents of the area for the preservation of the heritage., Este trabalho tem como objetivo identificar e analisar a importância do patrimônio material e imaterial e a memória no bairro do Guamá, na cidade de Belem (PA). O Bairro está inserido no contexto da cidade como um local periférico, porém, guarda riquezas patrimoniais e diversas histórias dos períodos que marcaram a expansão e modernização da cidade de Belém. Sua localização está as margens do Rio Guamá, este, possui um papel muito grande devido a descargas de produtos vindos das ilhas próximo a Belém e do interior. A cultura do bairro é diversificada através da passagem Pedreirinha, local que abriga grupos de Carimbó, cordões juninos e uma escola carnavalesca. Para o trabalho foram utilizados referenciais teóricos acerca da memória e patrimônio. Além disso, a aplicação dos questionários e a construção de um roteiro para o bairro. Em síntese, as atividades que compõem o roteiro tornam-se formas de provocação as autoridades e dos próprios moradores da área para a preservação do patrimônio.

Objective: The aim of this study is to describe a narrative review about the effects of chemotherapeutics agents on periodontium and emphasize the clinical importance of dentists during multidisciplinary therapy in cancer patients. Methods: A exploratory research process was performed in the electronic databases Pubmed/Medline, Embase, Scopus and Scielo, using search terms: “chemotherapy and periodontitis”, “chemotherapy and gingivitis” and “chemotherapy and periodontal disease”, and it was considered articles published until june 2022. Results and discussion: Chemotherapeutic agents do no act on specific cells, they affect rapidly proliferating cells and cause cytotoxicity to connective tissue cells. Therefore, chemotherapeutic agents causes destruction of the junctional epithelium and exacerbates the inflammatory process of the gingival connective tissue. Once periodontitis that occurs by the interaction between bacterial plaque and the host is located, chemotherapeutic agents aggravates its progression. In addition, chemotherapy drugs can affect periodontal tissues indirectly by xerostomia and increasing the amount of bacteria in the mouth. Periodontal diseases are risk factors for systemic diseases such as: cardiovascular diseases, respiratory diseases, diabetes, Alzheimer's disease and adverse pregnancy outcomes and it is up to the dentist of multidisciplinary team to monitor and identify possible risks in the oral treatment of cancer patients. Within the limits of the this literature review, it can be concluded that periodontal tissues are harmzed by chemotherapy and prevention measures or forms of treatment must be taken into account by the dentists of the multidisciplinary oncology team. Objetivo: El objetivo de este trabajo es describir una revisión narrativa de la literatura sobre los efectos de los agentes antineoplásicos en el periodoncio y enfatizar la importancia clínica de los cirujanos dentistas durante la terapia multidisciplinaria en pacientes con cáncer. Metodología: Se realizó una búsqueda bibliográfica exploratoria en las bases de datos electrónicas Pubmed/Medline, Embase, Scopus y Scielo, utilizando los términos de búsqueda “quimioterapia and periodontitis”, “quimioterapia and gingivitis” y “quimioterapia and periodontal disease”, considerándose los artículos publicados hasta junio de 2022. Resultados y discusión: Los quimioterapéuticos no actúan sobre células específicas, afectan las células que proliferan rápidamente y causan citotoxicidad en varias células del tejido conectivo. De esta forma, los quimioterápicos provocan la destrucción del epitelio de unión y exacerban el proceso inflamatorio del tejido conectivo gingival. Cuando aparece la periodontitis que se produce por la interacción entre la placa bacteriana y el huésped, los agentes antineoplásicos empeoran su progresión. Además, los medicamentos de quimioterapia pueden afectar indirectamente los tejidos periodontales al causar xerostomía y aumentar la cantidad de bacterias en la boca. Las enfermedades periodontales son factores de riesgo para enfermedades sistémicas como: enfermedades cardiovasculares, enfermedades del tracto respiratorio, diabetes, enfermedad de Alzheimer y resultados adversos del embarazo, y corresponde al cirujano dentista en el equipo multidisciplinario monitorear y identificar posibles riesgos en el tratamiento oral de pacientes con cáncer. Conclusión: Dentro de los límites de la presente revisión bibliográfica, se puede concluir que los tejidos periodontales son atacados por el uso de quimioterapia y las medidas de prevención y formas de tratamiento deben ser tenidas en cuenta por el cirujano dentista del equipo oncológico multidisciplinario Objetivo: O objetivo deste trabalho é descrever uma revisão narrativa de literatura sobre os efeitos dos agentes quimioterápicos no periodonto e salientar sobre a importância clínica dos cirurgiões dentistas durante a terapia multidisciplinar em pacientes oncológicos. Metodologia: Uma pesquisa bibliográfica exploratória foi realizada nas bases de dados eletrônicas Pubmed/Medline, Embase, Scopus e Scielo, utilizando os termos de busca “chemotherapy and periodontitis”, “chemotherapy and gingivitis” e “chemotherapy and periodontal disease”, sendo considerado os artigos publicados até junho de 2022. Resultados e discussão: Os quimioterápicos não atuam sobre células específicas, eles afetam células de rápida proliferação celular e causam citotoxicidade várias células do tecido conjuntivo. Desta forma, os quimioterápicos causam destruição do epitélio juncional e exacerbam o processo inflamatório do tecido conjuntivo gengival. Quando a periodontite que ocorre pela interação placa bacteriana e o hospedeiro se instala, os quimioterápicos agravam sua progressão. Além disso, quimioterápicos podem afetar os tecidos periodontais de maneira indireta por causar xerostomia e aumentar a quantidade de bactérias da boca. As doenças periodontais são fatores de risco para doenças sistêmicas como: doenças cardiovasculares, doenças do trato respiratório, diabetes, doença de Alzheimer e resultados adversos da gravidez e cabe ao cirurgião dentista da equipe multidisciplinar acompanhar e identificar possíveis riscos no tratamento bucal de pacientes oncológicos. Conclusão: Dentro dos limites da presente revisão de literatura, pode-se concluir que os tecidos periodontais são agredidos pela utilização dos quimioterápicos e medidas de prevenção ou formas de tratamento devem ser levadas em consideração pelo cirurgião dentista da equipe multidisciplinar oncológica.

Background: The left ventricular ejection fraction does not accurately predict exercise capacity or symptom severity and has a limited role in predicting prognosis in heart failure. A better method of assessing ventricular performance is needed to aid understanding of the pathophysiological mechanisms and guide management in conditions such as heart failure. In this study, we propose two novel measures to quantify myocardial performance, the global longitudinal active strain energy (GLASE) and its density (GLASED) and compare them to existing measures in normal and diseased left ventricles. GLASED calculates the work done per unit volume of muscle (energy density) by combining information from myocardial strain and wall stress (contractile force per unit cross sectional area). Methods: Magnetic resonance images were obtained from 183 individuals forming four cohorts (normal, hypertension, dilated cardiomyopathy, and cardiac amyloidosis). GLASE and GLASED were compared with the standard ejection fraction, the corrected ejection fraction, myocardial strains, stroke work and myocardial forces. Results: Myocardial shortening was decreased in all disease cohorts. Longitudinal stress was normal in hypertension, increased in dilated cardiomyopathy and severely decreased in amyloid heart disease. GLASE was increased in hypertension. GLASED was mildly reduced in hypertension (1.39 ± 0.65 KJ/m3), moderately reduced in dilated cardiomyopathy (0.86 ± 0.45 KJ/m3) and severely reduced in amyloid heart disease (0.42 ± 0.28 KJ/m3) compared to the control cohort (1.94 ± 0.49 KJ/m3). Conclusion: GLASED progressively decreased in the hypertension, dilated cardiomyopathy and cardiac amyloid cohorts indicating that mechanical work done and systolic performance is severely reduced in cardiac amyloid despite the relatively preserved ejection fraction. GLASED provides a new technique for assessing left ventricular myocardial health and contractile function. Graphical abstract The figure shows a graphical summary of the study with the derivation, meaning and primary results of the novel measurements GLASED and GLASE. The left-hand panel shows the calculations for peak stress and strain with the middle-panel showing the calculations for active strain energy and strain energy density. The right-hand panel shows the changes in global longitudinal active strain energy density (GLASED) and global longitudinal active strain energy (GLASE) of the left ventricle in the various cohorts. Clinical perspective Current measures of left ventricular performance such as ejection fraction and myocardial strain have important shortcomings. These limitations are attributable to the confounding effects of abnormal geometric changes and the loading conditions. This study introduces a novel measure of left ventricular systolic function called the global longitudinal active strain energy density (GLASED). GLASED combines information from left ventricular structural pattern (wall thickness and internal cavity size), systolic pressure and myocardial strain and calculates the work done (mechanical energy produced) per unit volume of myocardium during systole. GLASED should prove to be more accurate than the ejection fraction and myocardial strain in assessing left ventricular myocardial function.

BACKGROUND: The extent to which health care systems have adapted to the COVID-19 pandemic to provide necessary cardiac diagnostic services is unknown.OBJECTIVES: The aim of this study was to determine the impact of the pandemic on cardiac testing practices, volumes and types of diagnostic services, and perceived psychological stress to health care providers worldwide.METHODS: The International Atomic Energy Agency conducted a worldwide survey assessing alterations from baseline in cardiovascular diagnostic care at the pandemic's onset and 1 year later. Multivariable regression was used to determine factors associated with procedure volume recovery.RESULTS: Surveys were submitted from 669 centers in 107 countries. Worldwide reduction in cardiac procedure volumes of 64% from March 2019 to April 2020 recovered by April 2021 in high- and upper middle-income countries (recovery rates of 108% and 99%) but remained depressed in lower middle- and low-income countries (46% and 30% recovery). Although stress testing was used 12% less frequently in 2021 than in 2019, coronary computed tomographic angiography was used 14% more, a trend also seen for other advanced cardiac imaging modalities (positron emission tomography and magnetic resonance; 22%-25% increases). Pandemic-related psychological stress was estimated to have affected nearly 40% of staff, impacting patient care at 78% of sites. In multivariable regression, only lower-income status and physicians' psychological stress were significant in predicting recovery of cardiac testing.CONCLUSIONS: Cardiac diagnostic testing has yet to recover to prepandemic levels in lower-income countries. Worldwide, the decrease in standard stress testing is offset by greater use of advanced cardiac imaging modalities. Pandemic-related psychological stress among providers is widespread and associated with poor recovery of cardiac testing.

Made available in DSpace on 2022-05-01T09:47:25Z (GMT). No. of bitstreams: 0 Previous issue date: 2022-03-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Background and objective: The interaction between antineoplastic drugs used for treating cancer and non-affected tissues remains poorly assessed and may be critical for maintaining the quality of life for patients during and after treatment. This pre-clinical study evaluated the effects of cisplatin (CIS) and 5-fluorouracil (5-FU) on the peri-implant repair process around osseointegrated titanium implants installed in the tibiae of rats. Material and methods: Were used 90 male rats, randomly divided into three groups (n = 30): physiological saline solution (PSS), CIS, and 5-FU. Titanium implants (4.0 × 2.2 mm) were inserted in both tibiae of all animals at day 0. The animals received either PSS, CIS, or 5-FU at 35 and 37 days. Euthanasia was performed at 50, 65, and 95 days after surgery. Histometric (bone/implant contact [BIC]) and bone area fraction occupancy (% BAFO), histological, and immunohistochemical (for bone morphogenetic protein 2/4 [BMP2/4], Runt-related transcription factor 2 [RUNX2], osteocalcin [OCN], and tartrate-resistant acid phosphatase [TRAP]) analyses were performed. Data were statistically analyzed. Results: Groups CIS and 5-FU presented lower BIC and lower BAFO as compared with PSS in all time points. The imbalance in bone turnover was observed by the lower number of BMP2/4-, RUNX2-, and OCN-positive cells/mm2 and the higher number of TRAP-positive cells/mm in groups CIS and 5-FU as compared with PSS in all time points. Persistent and exacerbated inflammation was observed in groups CIS and 5-FU. Conclusions: Both antineoplastic agents interfered negatively in the bone turnover around osseointegrated titanium implants. Clinical relevance: Closer and more careful follow-up of patients with osseointegrated implants that will undergo chemotherapy with either CIS or 5-FU shall be performed. Department of Diagnosis and Surgery–Periodontics Division São Paulo State University (Unesp), St. José Bonifácio 1193 - Vila Mendonça, SP Nucleus of Study and Research in Periodontics and Implantology (NEPPI) School of Dentistry São Paulo State University (Unesp), SP Department of Basic Science School of Dentistry São Paulo State University (Unesp), SP Department of Diagnosis and Surgery–Periodontics Division São Paulo State University (Unesp), St. José Bonifácio 1193 - Vila Mendonça, SP Nucleus of Study and Research in Periodontics and Implantology (NEPPI) School of Dentistry São Paulo State University (Unesp), SP Department of Basic Science School of Dentistry São Paulo State University (Unesp), SP FAPESP: 2014/11427-8 FAPESP: 2017/11805-0

Peroxisomal disorders are a group of expanding genetic diseases divided into two major categories: peroxisome biogenesis defects (Zellweger spectrum disorder), and single enzymatic defects. Disorders of Peroxisome Biogenesis occur when there are biallelic pathogenic variants in any of the 13 PEX genes, which code for the peroxins, proteins required for peroxisome biogenesis. This group of disorders includes two distinct phenotypes: Rhizomelic Chondrodysplasia Punctata Type-1 and Zellweger Spectrum Disorders (ZSD), of which Zellweger syndrome is the most severe, neonatal adrenoleukodystrophy is intermediate, and infantile Refsum is the mildest. The spectrum’s most frequent defects are observed in the proteins PEX1 and PEX6, and the most common clinical presentation is Zellweger spectrum, which is often associated with craniofacial dysmorphism with neurologic abnormalities. Typically, the neuroimaging pattern shows several malformative features, including a range of cortical gyral abnormalities such as microgyria and pachygyria, and impairment of the myelination. Nevertheless, we report two siblings with peroxisomal disorder, with unexpected leukodystrophy pattern of the brain mimicking lysosomal storage disease, with classical imaging features of Krabbe disease on brain magnetic resonance image. By whole exome sequencing, we identified two pathogenic variants in compound heterozygosity in PEX6: Chr6:42.933.455 C>T (c.2435G>A), and Chr6:42.935.188 C>T (c.1802G>A). Thus, a final diagnosis of peroxisome disorder was confirmed. The index cases highlight the importance of considering peroxisome disorders as a differential diagnosis for patients with imaging features that resemble Krabbe disease.

Made available in DSpace on 2022-05-01T13:41:33Z (GMT). No. of bitstreams: 0 Previous issue date: 2022-02-01 Objective To investigate the security and effectiveness of antimicrobial photodynamic therapy (aPDT) with a citric acid-based methylene blue (MB) on the periodontal repair following the treatment of ligature-induced experimental periodontitis (EP) in rats. Material and methods Were used 120 male rats, randomly divided into 4 experimental groups (n = 30): no treatment (NT), SRP alone (SRP), SRP plus aPDT using conventional MB pH 7.0 (aPDT-pH7), SRP plus aPDT using acidic MB pH 1.0 (aPDT-pH1). EP was induced at day 0 by the placement of a ligature around the mandibular left first molars. Ten animals per group/period were euthanized at 14, 22 and 37 days. Histopathological, histometric (percentage of bone in the furcation [PBF]) and immunohistochemical (for tartrate-resistant acid phosphatase [TRAP] and osteocalcin [OCN]) analyses were performed. Data were statistically analyzed. Results aPDT-pH1 showed the highest PBF as compared with the other treatments. Collectively, tissues’ reaction to both dyes were controlled and healthy for the periodontium. Both aPDT protocols reduced the extent and intensity of the local inflammatory response, reduced the alveolar bone resorption, and promoted a better structural arrangement of the connective tissue as compared with SRP. TRAP expression was downregulated while OCN expression was upregulated by aPDT as compared with SRP alone. Conclusion Our data implicate that the novel MB pH 1.0 is as safe as the conventional MB for use in aPDT and raises its additional benefit of increasing the amount of alveolar bone in the furcation. Periodontics Division Department of Diagnosis and Surgery School of Dentistry São Paulo State University (Unesp) School of Dentistry Nucleus of Study and Research in Periodontics and Implantology (NEPPI) São Paulo State University (Unesp), SP Department of Basic Science School of Dentistry São Paulo State University (Unesp) Periodontics Division Department of Diagnosis and Surgery School of Dentistry São Paulo State University (Unesp) School of Dentistry Nucleus of Study and Research in Periodontics and Implantology (NEPPI) São Paulo State University (Unesp), SP Department of Basic Science School of Dentistry São Paulo State University (Unesp)

Introduction: Epicardial adipose tissue (EAT) is a visceral fat deposit within the pericardial sac. The automated quantification of EAT volume is possible from routine CCTA scans via deep-learning. The use of automated EAT quantification for the assessment of cardiovascular disease (CVD) risk in addition to standard measures of obesity like BMI has not been fully explored. Purpose: To use deep-learning for automated segmentation of EAT from routine CCTA scans to assess the long-term CVD risk conveyed by EAT. Methods: A deep-learning automated EAT segmentation tool using a 3D Residual-U-Net neural network architecture for 3D volumetric segmentation of CCTA data was created and trained on over 2500 consecutive CCTAs from within the Oxford Risk Factors And Non Invasive Imaging (ORFAN) Study. External validation in 817 patients demonstrated excellent correlation between machine and human expert (CCC = 0.972). The prognostic value of deep-learning derived EAT volume was assessed against 5 years outcomes from the SCOTHEART trial (n=1588), with adjustment for CVD risk factors. An optimal cutoff was selected by identifying the EAT value that maximized the Youden’s J index (sum of sensitivity and specificity) for the three outcomes of interest - high risk was deemed to be EAT ≥ 170.5cm 3 . Results: There were 35 deaths (all-cause mortality), 35 non-fatal myocardial infarctions and 8 non-fatal strokes during the 5 years follow up period. By using multi-variable cox-regression, EAT volume was predictive of all-cause mortality (Figure 1A), non-fatal MI (Figure 1B), and non-fatal stroke (Figure 1C) independently from CVD risk factors. Conclusions: Automatically segmented EAT volume measured using a deep learning network, predicts 5-year all-cause mortality, heart attacks and stroke independently of BMI and clinical risk profile of the patients. This suggests that measures of visceral obesity will be of value in the interpretation of cardiovascular computed tomography.

O acesso à água potável e ao esgotamento sanitário, necessidades primárias para manutenção da vida, são direitos humanos reconhecidos internacionalmente na Resolução Nº64/292 de 2010 da Assembleia Geral da Organização das Nações Unidas – ONU, da qual o Brasil é signatário. Assim, devem ser de forma universal e indiscriminatória. Considerando a desigualdade dos acessos a estes serviços no mundo, desigualdade esta que se acentua no Brasil, é condição para universalização que tal prestação esteja pautada, dentre outros princípios, na equidade. Devido a escala e complexidade da infraestrutura necessária ao abastecimento de água e ao esgotamento sanitário e, considerando também estes acessos como direitos sociais, é de responsabilidade do Estado o provimento. Este atua, historicamente, como agente produtor das cidades a partir da implantação da infraestrutura, em ações não neutras, que tendem a priorizar as áreas de interesse do mercado. Portanto, é necessário e urgente que as políticas públicas de abastecimento de água e de esgotamento sanitário estejam pautadas nos princípios da universalização e da equidade e no reconhecimento destes como direitos humanos universais. Assim sendo, o objetivo desta pesquisa é investigar a observância da equidade, a busca pela universalização e o reconhecimento do Direito Humano à Água e ao Esgotamento Sanitário nas políticas públicas de Pirapora/MG. Como percurso metodológico, realizou-se a busca nos instrumentos municipais de saneamento básico e do planejamento urbano evidências da observância dos princípios da equidade e dos esforços para universalização, bem como do reconhecimento dos acessos aos serviços como direitos humanos. Também foram identificadas ilhas de exclusão das redes de abastecimento de água e de esgotamento sanitário, procedendo caracterização destas como áreas de vulnerabilidade infraestrutural. Em Pirapora/MG a implantação dos serviços de abastecimento de água e de esgotamento sanitário são reflexos da realidade brasileira, apresentando primazia ao abastecimento de água, grandes déficits no esgotamento sanitário, exclusão das áreas rurais e irregulares e a falta da efetivação dos princípios da equidade nas políticas públicas. Access to drinking water and sanitary exhaustion, primary needs to maintain life, are internationally recognized human rights in Resolution Nº64/292 of 2010 of the General Assembly of the United Nations Organization - UN, of which Brazil is a signatory. Thus, they must be in a universal and indiscriminatory way. Considering the inequality of access to these services in the world, an inequality that is accentuated in Brazil, it is a condition for universalization that such provision is based, among other principles, on equity. Due to the scale and complexity of the infrastructure required for water supply and sanitary exhaustion, and also considering these accesses as social rights, it is the responsibility of the State to provide them. The State has historically acted as a producer of cities through the implementation of infrastructure, in non-neutral actions that tend to prioritize the areas of market interest. Therefore, it is necessary and urgent that public policies for water supply and sanitary exhaustion are based on the principles of universalization and equity and the recognition of these as universal human rights. Therefore, the objective of this research is to investigate the observance of equity, the search for universalization and the recognition of the Human Right to Water and Sanitation in public policies of Pirapora/MG. As a methodological approach, a search was conducted in the municipal sanitation and urban planning instruments for evidence of compliance with the principles of equity and efforts towards universalization, as well as the recognition of access to services as human rights. Islands of exclusion from water supply and sewage systems were also identified, characterizing them as areas of infrastructural vulnerability. In Pirapora/MG the implementation of water supply and sanitary exhaustion services reflects the Brazilian reality, with priority given to water supply, large deficits in sanitary sewage, exclusion of rural and irregular areas, and the lack of effectiveness of the equity principles in public policies.

To assess the interaction between chemotherapy and normal tissues is critical to assure quality of life during and after the treatment of cancer. This study evaluated the influence of cisplatin (CIS) and 5-fluorouracil (5-FU) over the peri-implant tissues around osseointegrated titanium implants in animals previously exposed to nicotine. Materials and methods One hundred twenty male rats were divided into two groups, receiving via subcutaneous injection, either physiological saline solution (PSS) (n = 30) or nicotine hemissulfate (NIC) (n = 90) for 30 days prior to implants' placement. One titanium implant (4.0 × 2.2 mm) was installed in each tibia of all animals. PSS and NIC were continued for 30 days after surgery. Five days after cessation, rats were subdivided into three subgroups in accordance with systemic treatments with either PSS, CIS, or 5-FU. Euthanasia was performed at 50, 65, and 95 days post-surgery. Histometric, histopathological, and immunohistochemical analyses were performed.NIC-CIS and NIC-5FU presented lower BIC (50, 65, and 95 days) and bone area fraction occupancy (BAFO) (65 and 95 days) than group NIC. Intense inflammatory infiltration, severe tissue breakdown, reduced expression of bone formation biomarkers, and upregulation of TRAP were observed in NIC-CIS and NIC-5FU when compared with group NIC. TRAP expression was significantly higher in NIC-5FU as compared with NIC-CIS at 50 and 95 days. Groups NIC, NIC-CIS, and NIC-5FU presented statistically significant negative impact in all outcome parameters than group PSS.CIS and 5-FU severely disrupted the peri-implant tissues around osseointegrated implants in animals previously exposed to nicotine.Assessing the interaction between chemotherapy and normal tissues is critical to assure quality of life during and after the cancer treatment.

Nifedipine is a calcium channel blocker dihydropyridine that has been used in the treatment of hypertension. The production of reactive species and calcium overload are the main contributors to myocardial ischemia-reperfusion (I / R) injury. We investigated the ability of novel dihydropyridines (DHPs) to improve the effect of protecting against the injury induced by ischemia and reperfusion in cardioblasts when compared to nifedipine. Forty three DHPs were created varying the fatty chains derived from palmitic acid, stearic acid and oleic acids and aromatic moiety in addition to the addition of chemical elements such as chlorine, nitrogen dioxide, furfural, hydroxyl and methoxy. Cytotoxicity and inhibition of linoleic oxidation were evaluated for all new DHPs and also for nifedipine. The alpha-tocopherol and butylated hydroxytoluene (BHT) were used as antioxidants controls. The compounds with the best antioxidant potential were used in the ischemia and reperfusion (I / R) induction test in cardioblasts (H9c2). Cardioblasts were treated 24 h after assembly of plates and submitted to the ischemia simulation (30 min), after which, normoxia and cellular nutrition conditions were reestablished, simulating reperfusion (additional 30 min). Right after, cell viability, apoptosis, necrosis, and the generation of reactive oxygen species (ROS) were evaluated. Cell viability during I / R was not altered in cells treated with nifedipine, BHT and the new DHP composed of palmitic acid with hydroxyl group in the aromatic substituent. The other new DHPs increased cell viability during I / R simulation and reduced levels of reactive species compared to the I / R group, demonstrating the antioxidant capacity of the new DHPs. Therefore, DHPS with palmitic and oleic acids in the C3 and C5 position with NO2 or Cl in aromatic moiety, presented the highest antioxidant potential (linoleic oxidant test). The new DHPs increased cell viability during I / R simulation and reduced levels of reactive species compared to the ischemia and reperfusion group, demonstrating the antioxidant capacity of the new DHPs. Taken together, these results indicate that those new DHPs have a greater cardioprotective antioxidant capacity to face the damages of ischemia and reperfusion.

Objetivo: O objetivo deste trabalho é descrever uma revisão narrativa de literatura sobre os efeitos dos agentes quimioterápicos no periodonto e salientar sobre a importância clínica dos cirurgiões dentistas durante a terapia multidisciplinar em pacientes oncológicos. Metodologia: Uma pesquisa bibliográfica exploratória foi realizada nas bases de dados eletrônicas Pubmed/Medline, Embase, Scopus e Scielo, utilizando os termos de busca “chemotherapy and periodontitis”, “chemotherapy and gingivitis” e “chemotherapy and periodontal disease”, sendo considerado os artigos publicados até junho de 2022. Resultados e discussão: Os quimioterápicos não atuam sobre células específicas, eles afetam células de rápida proliferação celular e causam citotoxicidade várias células do tecido conjuntivo. Desta forma, os quimioterápicos causam destruição do epitélio juncional e exacerbam o processo inflamatório do tecido conjuntivo gengival. Quando a periodontite que ocorre pela interação placa bacteriana e o hospedeiro se instala, os quimioterápicos agravam sua progressão. Além disso, quimioterápicos podem afetar os tecidos periodontais de maneira indireta por causar xerostomia e aumentar a quantidade de bactérias da boca. As doenças periodontais são fatores de risco para doenças sistêmicas como: doenças cardiovasculares, doenças do trato respiratório, diabetes, doença de Alzheimer e resultados adversos da gravidez e cabe ao cirurgião dentista da equipe multidisciplinar acompanhar e identificar possíveis riscos no tratamento bucal de pacientes oncológicos. Conclusão: Dentro dos limites da presente revisão de literatura, pode-se concluir que os tecidos periodontais são agredidos pela utilização dos quimioterápicos e medidas de prevenção ou formas de tratamento devem ser levadas em consideração pelo cirurgião dentista da equipe multidisciplinar oncológica.

O presente trabalho visa apresentar dentre os vários métodos alternativos de resolução de conflitos, um dos mais simples, eficaz e de baixa onerosidade, tendo em vista ainda, vantagens em relação ao resultado de demonstrar baixo índice de descumprimento dos acordos celebrados, esse método trata-se do instituto da Mediação. Assim, com clareza serão apresentados conceitos, implantação e as normas regulamentadoras que se utilizam para a aplicação desse instrumento de solução de conflitos extrajudicial. Discorrendo que a implantação desse método, ganhou destaque a partir da busca de solução para esvaziar os tribunais brasileiros, ou seja, devido ao elevado índice de processos, a insatisfação do jurisdicionado com decisões legalistas, tendo então adotado a mediação entre alternativas para a resolução de conflitos, sendo que apesar de ser uma pratica antiga na cultura brasileira, ganhou ênfase com a entrada em vigor da lei nº 13.140 de 26 de junho de 2015 e do Código de Processo Civil de 2015, com amparo da Constituição da República Federativa da Brasil em seu (artigo 5º, inciso XXXV). O estudo ainda traz notoriedade quanto à aplicação da mediação nos conflitos familiares e trabalhistas.

Made available in DSpace on 2022-05-01T11:39:06Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Universidade Estadual Paulista Background: Strontium Ranelate (SR) presents overlapping osteoanabolic and anti-resorptive activity. However, the effects of SR on the progression of periodontitis through the alveolar bone and its potential applicability as adjunctive therapy to scaling and root planning remain poorly accessed. The aim of this study was to evaluate the effects of systemic (SR) both on the progression of experimental periodontitis (EP) and as adjunctive therapy to SRP. Material and Methods: Eighty male rats were divided into four groups (n=20): EP-PSS: EP induction and systemic administration of physiological saline solution (PSS); EP-SR: EP induction and systemic administration of SR; EPSRP/ PSS: EP induction, SRP and systemic administration of PSS; EP-SRP/SR: EP induction, SRP and systemic administration of SR. Seven days after ligature placement, SRP was performed in EP-SRP/PSS and EP-SRP/SR, as well as the systemic administration of either PSS or SR were initiated and continued until euthanasia in all groups. Animals were euthanized at 7 and 30 days after the beginning of the systemic treatments. Histological, histometric (percentage of bone in the furcation [PBF]) and immunohistochemical (tartrate-resistant acid phosphatase [TRAP], Osteocalcin [OCN] and leukocyte common antigen [CD 45]) analyses were performed. Data were statistically analyzed. Results: EP-SRP/PSS showed a significantly more organized pattern of the connective tissue and alveolar bone structure than EP-SRP/SR. EP-SR showed significantly higher PBF than EP-PSS, however, EP-SRP/PSS showed no difference with EP-SRP/SR at 30 days. Conclusions: SR reduced the alveolar bone loss in non-treated animals and presented no standout benefits over the conventional forms of treating EP. Department of Diagnosis and Surgery-Division of Periodontics Sao Paulo State University (UNESP) School of Dentistry Nucleus of Study and Research in Periodontics and Implantology (NEPPI) São Paulo State University (Unesp) School of Dentistry Department of periodontics University of Western Sao Paulo (UNOESTE) Presidente Prudente Department of Basic Sciences School of Dentistry Sao Paulo State University (UNESP) Department of Diagnosis and Surgery-Division of Periodontics Sao Paulo State University (UNESP) School of Dentistry Nucleus of Study and Research in Periodontics and Implantology (NEPPI) São Paulo State University (Unesp) School of Dentistry Department of Basic Sciences School of Dentistry Sao Paulo State University (UNESP)

Objective: to elaborate and validate face and content of a multi-professional educational booklet for the education of caregivers of patients in use of Home Enteral Nutrition Therapy. Method: a methodological study, conducted in two stages: (1) elaboration of the educational booklet, divided in four phases; and (2) validation of the educational material by 12 experts. A minimum agreement rate of 80% was considered to ensure validation of the material. Results: the material is structured in 16 items that were considered pertinent by the experts. Content assessment by the experts presented a global Content Validity Index of 0.87. The agreement level of the categories assessed varied from 83% to 90%. The suggestions in relation to content, clarity, pertinence and relevance were addressed and modified for the final version of the material. Conclusion: the educational booklet is considered valid regarding content. It is suggested that it may contribute to the understanding in health education in caregivers and family members of patients in use of enteral nutrition therapy.

Made available in DSpace on 2021-06-25T11:09:07Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-01-01 Background: This study is designed to evaluate the potential of different formulations of hyaluronic acid (HA) to improve new bone formation in critical-size calvaria defect (CSD) when combined with a deproteinized bovine graft (DBG) material. Methods: Thirty male rats were used. A 5-mm-diameter CSD was created and three experimental groups (n = 10) were randomly assigned based on the treatments performed. Group DBG: CSD filled with a DBG; group DBG/LV: CSD filled by the combination of DBG and HA in a low-viscosity crosslinking agent; group DBG/HV: CSD filled by the combination of DBG and HA in a high-viscosity crosslinking agent. Animals were euthanized 30 days postoperatively. Histological, histometric (percentage of newly formed bone [PNFB], percentage of remaining graft particles, histochemical, and immunohistochemical (bone morphogenetic protein 2/4 [BMP2/4], osteocalcin [OCN], and tartrate-resistant acid phosphatase [TRAP]) analyses were performed. Results: The highest PNFB was observed in DBG/HV when compared with the other groups (P ≤0.05). DBG/LV and DBG/HV presented almost no inflammatory cells. In contrast, inflammation was observed in group DBG. Extensive resorption of graft particles was observed in group DBG, which was not present in DBG/LV and DBG/HV as confirmed by the larger size of the particles (P ≤0.05). BMP2/4 and OCN immunolabeling were higher in DBG/HV when compared with group DBG (P ≤0.05). Increased number of TRAP-positive cells was observed in DBG/LV and DBG/HV (P ≤0.05). Lower percentage of mature collagen fibers was observed in DBG/HV (P ≤0.05). Conclusion: The combination of HA in a high-viscosity crosslinking agent with DBG improves the bone repair process and increases the amount of newly formed bone towards CSDs in rat calvaria. Department of Diagnosis and Surgery‒Periodontics Division School of Dentistry São Paulo State University (UNESP) Department of Basic Science School of Dentistry São Paulo State University (UNESP) Private practice. Director of the Pro-clinic Nucleus of Orofacial Harmonization Department of Diagnosis and Surgery‒Periodontics Division School of Dentistry São Paulo State University (UNESP) Department of Basic Science School of Dentistry São Paulo State University (UNESP)

Submitted by DAVID JONATHAN RODRIGUES GUSMAN null (davidgusman2@gmail.com) on 2020-11-18T16:04:52Z No. of bitstreams: 1 Tese repositório.pdf: 3183861 bytes, checksum: cfe7df115c54f712a7a2f09d61c0128e (MD5) Approved for entry into archive by Claudio Hideo Matsumoto null (claudio@foa.unesp.br) on 2020-11-18T17:03:02Z (GMT) No. of bitstreams: 1 gusman_djr_dr_araca_int.pdf: 3183861 bytes, checksum: cfe7df115c54f712a7a2f09d61c0128e (MD5) Made available in DSpace on 2020-11-18T17:03:02Z (GMT). No. of bitstreams: 1 gusman_djr_dr_araca_int.pdf: 3183861 bytes, checksum: cfe7df115c54f712a7a2f09d61c0128e (MD5) Previous issue date: 2020-10-22 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Objetivo: Avaliar os efeitos da quimioterapia com Cisplatina (CIS) combinado ao uso de Zoledronato (ZOL) sobre os tecidos periodontais saudáveis e na progressão da periodontite experimental induzida em ratos. Materiais e métodos: Foram utilizados 160 ratos machos, distribuídos em 2 grupos sem periodontite experimental induzida (SPE) e com periodontite experimental induzida (PE) e subdivididos em 4 subgrupos: SS/SS: receberam duas injeções de 0,5 mL de solução salina a 0.9% (SS) (n= 20); SS/ZOL: receberam uma injeção 0,5 mL de SS e uma injeção de 100 μg/kg de ZOL diluído 0,45 mL em SS (n= 20); CIS/SS: receberam uma injeção de CIS (5mg/kg) e outra injeção de 0,5 mL de SS (n= 20); CIS/ZOL: receberam uma injeção de CIS (5mg/kg) e uma injeção de 100 μg/kg de ZOL diluído 0,45 mL em SS (n= 20). A administração ocorreu por via intraperitoneal em um intervalo de três dias, durante oito semanas. Na quarta semana, foi realizado a indução da PE no primeiro molar inferior esquerdo. Nos períodos de 14 e 28 dias após indução da PE, os animais foram eutanasiados. As mandíbulas foram processadas para coloração com Hematoxilina e Eosina e realização de reações imunoistoquímicas. Foi realizado análise histológica, histométrica de porcentagem de osso na furca (POF), porcentagem de osso necrosado (PON) e padrões de imunomarcação para TNFα, IL-1β e TRAP. Os dados obtidos foram submetidos à análise estatística (p

Made available in DSpace on 2022-04-28T19:46:41Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Background. The potent anti-inflammatory and immunosuppressive properties of glucocorticoids (GCs) might influence the progression of some disorders, such as periodontitis. Hence, this study aimed to investigate the influence of dexamethasone (DEX) on the alveolar bone loss (ABL) of healthy and periodontally compromised molars in rats. Methods. Thirty male rats were randomly assigned to two groups: physiological saline solution (PSS) and DEX. The animals received subcutaneous injections of either 0.5 mL of PSS) (group PSS) or 2 mg/kg of DEX (group DEX) from one day before experimental periodontitis (EP) induction until euthanasia. EP was induced through ligature placement around the mandibular lower first molars at day 0. Contralateral molars remained unligated. Ten animals per period were euthanized on days 3, 7, and 14. Morphometric analysis was performed to access the ABL. Data were statistically analyzed with ANOVA followed by post hoc Tukey tests (P ≤ 0.05). Results. Higher ABL was observed in both groups on days 7 and 14 than on day 3 (P ≤ 0.05). Concerning periodontitis, higher ABL was observed in group DEX on days 3, 7, and 14 days than group PSS at the same time intervals (P ≤ 0.05). Also, even in the contralateral unligated molars, group DEX exhibited higher ABL on days 3, 7, and 14 days than group PSS at the same time intervals (P ≤ 0.05). Conclusions. Collectively, it can be concluded that DEX aggravates EP and induces spontaneous ABL in the healthy periodontium. Department of Diagnosis and Surgery São Paulo State University (UNESP) School of Dentistry Department of Diagnosis and Surgery São Paulo State University (UNESP) School of Dentistry

Made available in DSpace on 2021-06-25T10:22:28Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Background: Platelet-rich fibrin (PRF) has been referred to as a second-generation platelet concentrate, associated with improvements on the healing of palatal wounds followed by FGG harvesting. The aim of this systematic review and meta-analysis was to assess the complete wound epithelialization and postoperative pain when PRF was used in palatal wounds following free gingival graft (FGG) harvesting. Material and Methods: PubMed (Medline), EMBASE and Scopus were searched by two independent individuals up to and including March 2020 in order to identify controlled and randomized controlled clinical trials on the use of PRF at palatal donor sites of FGG. The outcomes assessed were epithelialization and postoperative pain. The risk of bias of the included studies was evaluated using Cochrane Collaboration's domain-based two-part tool. Random effects meta-analyses were conducted with 95% confidence intervals. Results: The search strategy identified 555 potentially eligible articles, of which 6 randomized controlled clinical trials were included. In the qualitative analysis, most studies (83.3%) reported lower postoperative pain in treatment groups, while all studies accessing epithelialization demonstrated earlier complete wound closure in groups treated with PRF. The discomfort and complete re-epithelialization were more favorable in groups PRF when compared to control groups (P

O advento das Unidades de Conservação (UC), é visto pelo governo como uma das principais ações de preservação e conservação da biodiversidade. Dentre seus objetivos está a possibilitar que essas áreas possam evitar o uso desordenado de seu território. Dentre as classificações das UC, destaca-se neste artigo o Refúgio de Vida Silvestre (REVIS). Na Região Metropolitana de Belém – RMB (PA) destaca-se o REVIS Metrópole da Amazônia, criado no ano de 2010, em uma área de 63,67 km², estabelecendo condições ambientais para existência ou reprodução de espécies de fauna e flora. Este estudo teve como objetivo indicar uma proposta de uso turístico para a unidade de conservação, a partir da análise de seu potencial turístico e o uso sustentável. Para isso, a metodologia partiu de pesquisas bibliográficas e documentais, bem como entrevistas com moradores e com representantes dos órgãos voltados a gestão da unidade e aplicação de questionários semiestruturados com os visitantes do REVIS. Os resultados obtidos por meio da atividade de campo culminaram na contextualização da localidade durante um período de 5 anos, do ano de 2013 a 2018. Os resultados obtidos apontam que são diversas as atividades turísticas sendo praticadas na localidade, no entanto, verifica-se que o REVIS ainda não possui uma infraestrutura adequada para visitação. Ressalta-se que a população residente no entorno da UC em muitos momentos ainda desconhece o motivo pelo qual a área virou uma unidade. Por isso estima-se a necessidade de reunir a população local os gestores, para discutirem os assuntos e rumos da UC.