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Aim: To develop a β-AgVO 3 gel and evaluate its physicochemical stability and antifungal activity against Candida albicans . Materials & methods: The gel was prepared from the minimum inhibitory concentration (MIC) of β-AgVO 3 . The physicochemical stability was evaluated by centrifugation, accelerated stability (AS), storage (St), pH, syringability, viscosity and spreadability tests and antifungal activity by the agar diffusion. Results: The MIC was 62.5 μg/ml. After centrifugation, AS and St gels showed physicochemical stability. Lower viscosity and higher spreadability were observed for the higher β-AgVO 3 concentration and the minimum force for extrusion was similar for all groups. Antifungal effect was observed only for the β-AgVO 3 gel with 20xMIC. Conclusion: The β-AgVO 3 gel showed physicochemical stability and antifungal activity.

This study aimed to incorporate β-AgVO 3 and rGO into self-curing (SC) and heat-curing (HC) acrylic resins and to evaluate their physicochemical, mechanical, and antimicrobial properties while correlating them with the characterized material structure. Acrylic resin samples were prepared at 0 % (control), 0.5 %, 1 %, and 3 % for both nanoparticles. The microstructural characterization was assessed by scanning electron microscopy (SEM) (n = 1) and energy dispersive X-ray spectroscopy (EDS) (n = 1). The physicochemical and mechanical tests included flexural strength (n = 10), Knoop hardness (n = 10), roughness (n = 10), wettability (n = 10), sorption (n = 10), solubility (n = 10), porosity (n = 10), and color evaluation (n = 10). The microbiological evaluation was performed by counting colony-forming units (CFU/mL) and cell viability (n = 8). The results showed that the β-AgVO 3 samples showed lower counts of Candida albicans , Pseudomonas aeruginosa , and Streptococcus mutans due to their promising physicochemical properties. The mechanical properties were maintained with the addition of β-AgVO 3 . The rGO samples showed higher counts of microorganisms due to the increase in physicochemical properties. It can be concluded that the incorporation of β-AgVO 3 into acrylic resins could be an alternative to improve the antimicrobial efficacy and performance of the material., Competing Interests: 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., (© 2024 Published by Elsevier Ltd.)

Purpose: To verify the parameters and characteristics evaluated in 3D-printed complete denture (CD) bases and how they influence CD properties., Materials and Methods: This work was registered in Open Science Framework (osf.io/4um6v) and followed the PRISMA Extension for Scoping Reviews. A search of peer-reviewed articles published up to April 9, 2020, was performed on the PubMed, LILACS, Cochrane Library, and Science Direct databases. The review question based on the PCC (population, concept, and context) was: What printing parameters and characteristics of CD bases can influence their properties?, Results: The database search resulted in 1,945 articles, and the initial screening was carried out in 1,390 articles, 17 of which were selected for inclusion in this review. The present authors verified that cleaning the prosthesis with alcohol after printing followed by a postcuring cycle influences biocompatibility and residual monomers. The printing angle influences physicomechanical properties, microbial adhesion, and tissue adaptation. Accuracy is influenced by layer thickness and manufacturing technique, which also influences retention and tissue adaptation. The incorporation of antimicrobial agents influences physicomechanical properties and antimicrobial activity. The method of union between the denture base and teeth influences mechanical strength., Conclusions: Printed denture bases showed good adaptation to tissues and accuracy with 100-µm layer thickness, but the base must be cleaned in ethanol followed by postcuring for better biocompatibility. Nano- and microparticles can be added to provide antimicrobial activity and better resistance. The printing angle and mechanical properties must be better evaluated. Int J Prosthodont 2023;36:620-629.

This study aimed to review systematically the literature about the antimicrobial action of evaluated cleansers on the Co-Cr alloy of RPD. The search was conducted in MEDLINE/PubMed, Scopus, Lilacs, Embase and Science Direct May, 2022. The review was performed based on PRISMA guidelines and recorded in Open Science Framework. Independent reviewers performed the search, selection, extraction, and analysis of the data. The risk of bias of the in vitro and clinical trials studies was analyzed by the Joanna Briggs Institute tool. A total of 187 articles were found and 9 were included. The cleansers that showed antimicrobial action were 2% and 5.25% sodium hypochlorite, 0.12% chlorhexidine and NitrAdine effervescent tablet. Polident, Corega Tabs effervescent tablets and 5 mg/mL chitosan solution showed intermediate effects. Propolis and green tea toothpaste were not effective. Three articles presented a high risk of bias and 6, low risk. The cleansers that showed the highest antimicrobial efficacy on Co-Cr alloy were 0.12% chlorhexidine digluconate and NitrAdine and can be safely used on RPD framework.

Aim: To systematically evaluate the literature on silver (Ag) gels and their antimicrobial efficacy and physicochemical stability. Materials & methods: A search was performed in PubMed/MEDLINE, LILACS, Web of Science, Scopus, Embase and Google Scholar. Results: Gels were formulated with Ag nanoparticles, Ag oxynitrate and colloidal Ag and showed antimicrobial activity for concentrations ranging from 0.002 to 30%. Gels showed stability of their chemical components, and their physicochemical properties, including viscosity, organoleptic characteristics, homogeneity, pH and spreadability, were suitable for topical application. Conclusion: Ag-based gels show antimicrobial action proportional to concentration, with higher action against Gram-negative bacteria and physicochemical stability for oral and skin infection applications.

The action of proteases can be controlled by several mechanisms, including regulation through gene expression; post-translational modifications, such as glycosylation; zymogen activation; targeting specific compartments, such as lysosomes and mitochondria; and blocking proteolysis using endogenous inhibitors. Protease inhibitors are important molecules to be explored for the control of proteolytic processes in organisms because of their ability to act on several proteases. In this context, plants synthesize numerous proteins that contribute to protection against attacks by microorganisms (fungi and bacteria) and/or invertebrates (insects and nematodes) through the inhibition of proteases in these organisms. These proteins are widely distributed in the plant kingdom, and are present in higher concentrations in legume seeds (compared to other organs and other botanical families), motivating studies on their inhibitory effects in various organisms, including humans. In most cases, the biological roles of these proteins have been assigned based mostly on their in vitro action, as is the case with enzyme inhibitors. This review highlights the structural evolution, function, and wide variety of effects of plant Kunitz protease inhibitors, and their potential for pharmaceutical application based on their interactions with different proteases.

Background: About 40% of patients with ST-segment elevation myocardial infarction (STEMI) in Brazil do not receive reperfusion therapy., Objective: The use of a telemedicine network based on WhatsApp® could increase the percentage of patients receiving reperfusion therapy., Methods: A cross-sectional study analyzed outcomes before and after the organization of a telemedicine network to send the electrocardiogram via WhatsApp® of patients suspected of STEMI from 25 municipalities that are members of the Regional Health Department of Ribeirão Preto (DRS-XIII) to a tertiary hospital, which could authorize immediate patient transfer using the same system. The analyzed outcomes included the percentage of patients who received reperfusion therapy and the in-hospital mortality rate. A p value < 0.05 was considered statistically significant., Results: The study compared 82 patients before (February 1, 2016 to January 31, 2018) with 196 patients after this network implementation (February 1, 2018 to January 31, 2020). After implementing this network, there was a significant increase in the proportion of patients who received reperfusion therapy (60% vs. 92%), relative risk (RR): 1.594 [95% confidence interval (CI) 1.331 - 1.909], p < 0.0001 and decrease in the in-hospital mortality rate (13.4% vs. 5.6%), RR: 0.418 [95%CI 0.189 - 0.927], p = 0.028., Conclusion: The use of WhatsApp®-based telemedicine has led to an increase in the percentage of patients with STEMI who received reperfusion therapy and a decrease in the in-hospital mortality rate.

Introduction: The aim of this study was adding the nanostructured silver vanadate decorated with silver nanoparticles (AgVO 3 ) (0, 2.5, 5, and 10%) to the endodontic sealers AH-Plus, Sealer 26 and Endomethasone N, and evaluate the antimicrobial activity, solubility and pH ., Methods and Materials: The antimicrobial activity of freshly mixed sealers ( n =10) and set sealers ( n =9) against Enterococcus faecalis ( E. faecalis ) was evaluated by colony forming units per milliliter and epifluorescence microscopy. Solubility ( n =9) and pH ( n =10), 6 and 24 h and 7, 14, and 30 days were also evaluated. The Kruskal-Wallis and Dunn's post-test were applied for the antimicrobial activity of fresh sealers. ANOVA and Tukey's post-test was used for set sealers and solubility, and Friedman's two-way analysis of variance for pH ( α =0.05)., Results: The fresh sealers inhibited E. faecalis . Set Sealer 26 (5 and 10% AgVO 3 ) and Endomethasone N (2.5, 5, and 10% AgVO 3 ) presented higher activity then the corresponding controls. Modification with AgVO 3 did not influence the solubility of AH Plus and Sealer 26, but Endomethasone N (5%) presented reduced solubility. The AH-Plus groups showed acidic pH, and Sealer 26, basic pH after 30 days. Endomethasone N (5 and 10% AgVO 3 ) presented statistical difference compared to 0% ( P <0.05)., Conclusion: In this in vitro study all fresh sealers and set Sealer 26 (5 and 10%) and Endomethasone N (2.5, 5, and 10%) presented higher antimicrobial activity than controls. The modification with 5% and 10% AgVO 3 decreased solubility and pH of Endomethasone N, but did not affect the other groups., Competing Interests: ‘None declared’.

The incorporation of nanoparticles into endodontic sealers aims at increasing antimicrobial activity of the original material. Aim. The aim of this study is to incorporate the nanostructured silver vanadate decorated with silver nanoparticles (AgVO 3 , at 2.5%, 5%, and 10%) into three endodontic sealers and evaluate the antibacterial activity of freshly sealers, surface topography and chemical composition, and setting time. Material and Methods . The AgVO 3 was incorporated into AH Plus, Sealer 26, and Endomethasone N at concentrations 0%, 2.5%, 5%, and 10% (in mass). The antibacterial activity of freshly sealers was assessed by direct contact with Enterococcus faecalis and CFU/mL count (n=10), surface topography, and chemical composition were measured by SEM/EDS, and the setting time was measured by Gillmore needle (n=10). The Kruskal-Wallis and Dunn statistical tests were applied ( α =0.05). Results. All groups of sealers evaluated inhibited E. faecalis (p>0.05). The incorporation of AgVO 3 altered the atomic proportions between components of the endodontic sealers, and the percentage of silver (Ag) and vanadium (V) increased proportionally to the concentrations of AgVO 3 . Topography analysis showed differences in components distribution on the surface of the specimens. The sealers incorporated with AgVO 3 of AH Plus presented a lower setting time than the control group (p<0.05). For Sealer 26 and Endomethasone N, the incorporation of AgVO 3 increased the setting time in relation to control group (p<0.05). Conclusions. The modification of endodontic sealers by AgVO 3 increased the atomic percentage of Ag and V proportionally to the concentration of the nanomaterial and changed the atomic percentage of the sealer components and setting times. It cannot be affirmed that the AgVO 3 promote differences in the antimicrobial activity of freshly sealers, and further investigations of the antimicrobial activity of the set sealers should be carried out.

The purpose of present study was to analyze the magnitude of the effect-size in the assessment of the cognitive status of populations over 60 years of age. The search strategy included PubMed, B-on, Ebsco, Ebsco Health, Scielo, Eric, Lilacs and Sportdiscus data bases. Only observational, cohort and cross-sectional studies were included in the meta-analysis. The central descriptors were elderly-frail, older adults, cognition and geriatric assessment and other additional terms. After applying the additional search criteria, 12 manuscripts were selected from an initial universe of 1,078 identified. When comparing the mean cognitive profile scores of the participants of the pre-frail (n =11,265) and frail (n = 2,460) groups, significant statistical differences were found (p<0,001), with lower mean scores emerging in frail-group. The results showed that cognitive decline is strongly associated with frailty, being a probable main clinical outcome. In this sense, any strategy aimed at mitigating or reversing the incidence of frailty with ageing should take into account that physical and cognitive frailty seem to have similar temporal trajectories.

Objectives: The objective of the study is to incorporate the nanostructured silver vanadate (AgVO 3 ) decorated with silver nanoparticles at endodontic sealers AH Plus, Sealapex, Sealer 26, and Endofill, at concentrations of 2.5%, 5%, and 10%, and to evaluate physical-chemical properties., Materials and Methods: The study was to evaluate the radiopacity using digital radiography ( n = 5), the tooth color change in 48 incisors ( n = 3) for 7, 30, 90, and 180 days in a spectrophotometer, and the topographic distribution in a confocal laser ( n = 5). The radiopacity was analyzed by Kruskal-Wallis test and the permutation (α = 0.05) and the color and topographical distribution by descriptive statistical analysis., Results: The AgVO 3 had no effect on the radiopacity of Endofill and Sealapex ( P > 0.05) and at 2.5% concentrations increased the radiopacity of Sealer 26 and AH Plus ( P < 0.05). The Endofill 10% showed less color change, and the major changes were the modified groups in 180 days. The AgVO 3 showed a circular topographic distribution in areas of the sealers., Conclusion: It was found that the addition of AgVO 3 did not affect the radiopacity of Endofill and Sealapex however, increased the radipacity of Sealer 26 and AH Plus. For modified groups, the greatest color change was promoted after 180 days, except for Endofill with 10%. Topographic distribution of nanomaterial affected the color change of theevaluated sealers., Competing Interests: There are no conflicts of interest.

Background: The genus Acinetobacter sp. comprises more than 50 species, and four are closely related and difficult to be distinguished by either phenotypic or genotypic methods: the Acinetobacter calcoaceticus-baumannii complex (ABC). The correct identification at species level is necessary mainly due to the epidemiological aspects., Methods: We evaluated a multiplex PCR for gyrB gene to identify the species of the ABC using the sequencing of the ITS 16S-23S fragment as a gold standard. Isolates identified as Acinetobacter calcoaceticus-baumannii from three hospitals at southern Brazil in 2011 were included in this study., Results: A total of 117 isolates were obtained and 106 (90.6%) were confirmed as A. baumannii, 6 (5.1%) as A. nosocomialis and 4 (3.4%) as A. pittii by PCR for gyrB gene. Only one isolate did not present a product of the PCR for the gyrB gene; this isolate was identified as Acinetobacter genospecie 10 by sequencing of ITS. We also noted that the non-A. baumannii isolates were recovered from respiratory tract (8/72.7%), blood (2/18.2%) and urine (1/9.1%), suggesting that these species can cause serious infection., Conclusion: These findings evidenced that the multiplex PCR of the gyrB is a feasible and simple method to identify isolates of the ABC at the species level., (© 2016 Wiley Periodicals, Inc.)

Presentation of the computerized structure to implement, in a university hospital in the South of Brazil, the Patients Classification System of Perroca, which categorizes patients according to the care complexity. This solution also aims to corroborate a recent study at the hospital, which evidenced that the increasing workload presents a direct relation with the institutional quality indicators. The tools used were the Google applications with high productivity interconnecting the topic knowledge on behalf of the nursing professionals and information technology professionals.

Purpose: To extract the Melaleuca sp. oil and to assess its in vitro inhibitory effect against Staphylococcus aureus isolates obtained from lower limb wounds and resistant to several antibiotics., Methods: A total of 14 test-tubes containing Mueller-Hinton broth were used to determine the Minimum Inhibitory Concentration (MIC). The following concentrations of the Melaleuca sp. oil were added to the first 11 tubes: 8; 4; 2; 1; 0.5; 0.2; 0.1; 0.05; 0.025; 0.0125 and 0.00625%. The 12th and 13th tubes, with and without oil, were used as the positive and negative controls, respectively. The experimental study was carried out in triplicate at 37ºC for 18 hours. The Minimum Bactericidal Concentration (MBC), able of killing all the microorganisms, was also determined. Two S. aureus isolates were obtained from lower limb wounds of female patients and the identification of the microorganisms (Staphylococcus aureus) and the test for susceptibility to the antimicrobial agents were carried out by automation using the apparatus MicroScan(r). After identification, the isolates were preserved in liquid Trypticase Soy medium, and inoculated for determination of the MIC and MBC., Results: The MIC was 0.2% and the MBC was 0.4%., Conclusion: The Melaleuca sp. oil showed antimicrobial properties in vitro against strains isolated from lower limb wounds which were resistant to multiple antibiotics.

Aim: The study assessed deformation of implant components submitted to torsion tests of 80 and 120 N · cm using an optical stereomicroscope., Material and Methods: The following 3 types of Titaniumfix conical implant connections (n = 5) measuring Ø 4.0 × 11.5 mm were used: external, internal hexagon and Morse taper connections. The diagonal and lateral measurements of the hexagon implant platform were measured before and after the torsion test., Results: The torsion test using torque of 80 and 120 N · cm altered the implant dental platforms. All groups presented deformation of implant component after torque of 80 N · cm with no statistical difference among them. During torque of 120 N · cm, a difference in the Morse taper connection in relation to the internal and external hexagon connection was observed. The Morse taper connection implant, followed by the internal hex implant, underwent less deformation. Greater deformation occurred in the external hex implants., Conclusion: For all the implants, high insertion torques deformed the implant platform preventing long-term maintenance and stability of implants.

Background: Breast augmentation with silicone implants is one of the most frequently performed cosmetic surgeries worldwide. Surgical site infection (SSI) remains an important complication of this procedure. One of the most important risk factors for SSI is the presence of microorganisms on the skin surrounding the wound. Guidelines by the Centers for Disease Control (CDC) recommend that surgical wounds be covered with a sterile dressing for 24 to 48 hours. However, a recent study showed that the application of a dressing for six days after breast reduction reduced wound colonization by coagulase-negative staphylococci., Methods/design: A randomized clinical trial was designed to assess two protocols of postoperative wound care to determine how the application duration of the postoperative dressing influences wound colonization in patients undergoing breast augmentation with silicone implants. Women aged between 18 and 60 years who are candidates for breast augmentation with silicone implants will be randomly allocated to group I (n = 48), in which the dressing will be removed on the first postoperative day, or group II (n = 48), in which the dressing will be removed on the sixth postoperative day. Cutaneous colonization will be assessed by cultures of samples of skin flora taken from the wound region. The incidence of SSI, using standardized CDC criteria, and the perceptions of patients towards the dressing will be secondary outcomes., Discussion: An important component of SSI prevention is to minimize all possible risk factors, and the application of postoperative dressing plays a key role in this endeavor. The results of this clinical trial may help to standardize postoperative wound care after breast augmentation with silicone implants., Trial Registration: This trial was registered on 12 March 2012 with ClinicalTrials.gov (identifier: NCT01553604 ).

In recent years, different resistance genes have been found in Acinetobacter spp., especially in the species A. baumannii. We describe two isolates of carbapenem-resistant A. nosocomialis harboring ISAba1-blaOXA-23 and blaOXA-51 found in patients from the city of Porto Alegre, southern Brazil. To the best of the authors' knowledge, this is the first report of carbapenem-resistant A. nosocomialis in Latin America.

One hundred and twenty-four Pseudomonas aeruginosa isolates were selected for antimicrobial susceptibility testing with anti-pseudomonal agents, MIC determination for polymyxin B and metallo-beta-lactamase detection (genes blaSPM, blaVIM-1, blaNDM-1 and blaIMP). According to the imipenem and/or meropenem susceptibility profile, a set of randomly selected isolates (12 isolates carbapenem-susceptible and 12 isolates carbapenem-resistant) were evaluated for heteroresistance to polymyxin B. Heteroresistance testing was performed by plating the isolates onto increasing concentrations of polymyxin B (from 0 to 8.0 mg l(-1)). The population analysis profile (PAP) was defined as the ratio of the number of colony-forming units on the plate with the highest concentration of polymyxin B at which bacterial growth occurred against the number of colony-forming units on the plate without antibiotic. Isolates presenting subpopulations that exhibited growth at polymyxin B concentrations ≥2 mg l(-1) were considered heteroresistant. Isolates containing subpopulations that grew at polymyxin B concentrations at least twice as high as the original MIC but <2 mg l(-1) were considered heterogeneous. Antimicrobial susceptibility testing results indicated a variable degree of susceptibility: high levels of resistance to gentamicin (30.6 %) and imipenem (29.0 %); low levels of resistance to aztreonam (1.6 %) and ciprofloxacin (4.8 %). All isolates were susceptible to polymyxin B: MIC50 and MIC90 were 1 mg l(-1) and 2 mg l(-1), respectively. Thirty-seven isolates (30 %) were carbapenem-resistant. Four isolates resistant to carbapenems were positive for blaIMP. There were no heteroresistant subpopulations in the carbapenem-susceptible group, but three isolates presented heterogeneous subpopulations. The PAP frequency ranged from 2.1×10(-4) to 6.9×10(-8). In the carbapenem-resistant group, one isolate was heteroresistant. Six isolates in this group presented heterogeneous subpopulations. In the resistant population, the PAP frequency ranged from 2.1×10(-7) to 2.6×10(-4). In this study, polymyxin B heteroresistance in P. aeruginosa was uncommon and occurred in only one carbapenem-resistant isolate, despite the fact that several isolates presented heterogeneous subpopulations with increased polymyxin B MICs.

Reciprocal recurrent selection (RRS) has been successfully applied to maize breeding for more than 60 years. Our objective was to assess the relative efficiency of the genotypic value and the effects of general and specific combining abilities (GCA and SCA) on selection. The GCA effect reflects the number of favorable genes in the parent. The SCA effect primarily reflects the differences in the gene frequencies between the parents. We simulated three traits, three classes of populations, and 10 cycles of half- and full-sib RRS. The RRS is a highly efficient process for intra- and interpopulation breeding, regardless of the trait or the level of divergence among the populations. The RRS increases the heterosis of the interpopulation cross when there is dominance, and it decreases the inbreeding depression in the populations and the genetic variability in the populations and in the hybrid. When there is not dominance and the populations are not divergent, the RRS also determines population differentiation. The half-sib RRS, which is equivalent to selection based on the GCA effect, is more efficient than the full-sib RRS based on the genotypic value, regardless of the trait or the level of improvement of the populations. The full-sib RRS based on the SCA effect is not efficient for intra- and interpopulation breeding.

This study evaluated the profile of implants subjected to torsion test. Four types of implants (Conexão®) were analyzed: Master Porous (MP - external hexagon, cylindrical, double-porous surface implants; 11.5 X 3.75 mm), Master Screw (MS - external hexagon, cylindrical, machined implants; 11.5 X 3.75 mm), Conect Conic (CC - external hexagon, cylindrical, machined implants; 11.5 X 3.5 mm) and Master Conect AR (CA - internal hexagon, cylindrical, double-porous surface implants; 11.5 X 3.75 mm). The Nikon® model C profile projector was used for the analysis before and after torsion test with a Mackena® model MK-20XX digital torque meter. The measures analyzed in the profile of implants were: diameter and height of the platform, diameter of the screw/platform connection, angle of the screw/platform connection, external diameter, internal diameter, thread pitch, height and length of the thread. Statistical analysis was performed using ANOVA and Tukey test at 5% significance level. The torsion test caused a visible deformity on the external implant profile. There was a statistical difference among the implants before and after torsion (p<0.05) for the variables: platform diameter, platform height, diameter of the screw/platform connection and length. Changes were observed in platform height of CC and CA, fracture of CA implants, fracture of the MP and MS assembler/connectors, and internal thread stripping of CC. Thus, it was concluded that excessive or some unadvised torque by the manufacturer can lead to changes in different geometric measurements of implants.

The purpose of this study was to investigate the influence of shift work and chronotype on the quality of life of nursing staff at a university hospital in the state of Rio Grande do Sul, Brazil. It is an analytical and cross-sectional study, developed with a sample of 101 nursing professionals working in clinical and surgical units for adult inpatients. Chronotype and quality of life were evaluated using the Horne and Ostberg Morningness-Eveningness Questionnaire (MEQ) and the WHOQOL-Brief None of the WHOQOL-Brief domains demonstrated any association with shift work (p > 0.05). It was observed however, that individuals with a certain chronotype agreeing with the shift in which they work (67.01 +/- 10.8) showed higher means than those disagreeing (59.16 +/- 14.67) on the WHOQOL field that assesses the environment (p = 0.03). Thus, it is suggested that agreement with the chronobiological shift might be a factor determining quality of life for the nursing staff

The immune defence against Mycobacterium tuberculosis is complex and involves multiple interacting cells. Studies in subjects with polymorphisms in genes for IFN or its receptor gene evaluate their relationship with mycobacterium infections. The purpose of this study was to analyze the evidence of the effect of polymorphism +874 A/T from interferon-γ on the occurrence of tuberculosis. We performed a meta-analysis of studies published between June 2002 and April 2012. The articles analyzed assessed the relationship between the polymorphism +874 A/T and the development of tuberculosis. The meta-analysis was performed with a random effect model, considering the heterogeneity among studies. Genotype TT showed a protective effect (OR, 0.77; 95% CI = 0.67-0.88) while genotype AA may be associated with increased susceptibility to developing tuberculosis (OR, 1.51; 95% CI = 1.38-1.65). In relation to alleles, we can verify that the A allele is related to the development of tuberculosis (OR, 1.56; 95% CI = 1.42-1.71). This information reinforces the importance of host genetics in the development of infectious diseases. Studies in this area can result in the promotion of new and more accurate genetic markers.

Chronic intake of high-carbohydrate or high-lipid diets is a well-known insulin resistance inducer. This study investigates the immediate effect (1-6 h) of a carbohydrate- or lipid-enriched meal on insulin sensitivity. Fasted rats were refed with standard, carbohydrate-enriched (C), or lipid-enriched (L) meal. Plasma insulin, glucose, and non-esterified fatty acids (NEFA) were measured at 1, 2, 4, and 6 h of refeeding. The glucose-insulin index showed that either carbohydrates or lipids decreased insulin sensitivity at 2 h of refeeding. At this time point, insulin tolerance tests (ITTs) and glucose tolerance tests (GTTs) detected insulin resistance in C rats, while GTT confirmed it in L rats. Reduced glycogen and phosphorylated AKT and GSK3 content revealed hepatic insulin resistance in C rats. Reduced glucose uptake in skeletal muscle subjected to the fatty acid concentration that mimics the high NEFA level of L rats suggests insulin resistance in these animals is mainly in muscle. In conclusion, carbohydrate- or lipid-enriched meals acutely disrupt glycemic homeostasis, inducing a transient insulin resistance, which seems to involve liver and skeletal muscle, respectively. Thus, the insulin resistance observed when those types of diets are chronically consumed may be an evolution of repeated episodes of this transient insulin resistance.

Background and Objectives: The change from the sitting position to supine position, general anesthesia, and surgical procedure reduce lung volumes and this effect can be greater in obese patients. The objective of the present study was to evaluate the influence of the sitting position, 30 dorsal inclination, and horizontal dorsal decubitus on spirometry of grade III obese patients., Methods: Twenty-six adult patients in the preoperatory period were selected according to the following criteria: BMI>40kg.m(-2), age between 18 years and 60 years, and female gender. Variables analyzed included: age, weight, height, BMI, percentage of predictive values of FVC, FEV(1), and VEF(1)/FVC in the sitting position (90°), 30° dorsal elevation, and horizontal dorsal decubitus (0°). ANOVA, followed or not by Tukey test were used to compare mean predicted values on the different positions, considering significant a p value lower than 0.05., Results: Percentage values of FVC, FEV(1), and FEV(1)/FVC ratio regarding predicted values in the sitting position (90°), 30° dorsal elevation, and horizontal dorsal decubitus (0°), and p value of the corresponding statistical analysis were, respectively: FVC=92.8%, 88.2%, and 86.5%, p=0.301 (ANOVA); FEV(1): 93.1%, 83.8%, and 83.3%, p=0.023 (ANOVA), p=0.038 (Tukey test - 90°×0°); FEV(1)/FVC: 100,8%, 95.5%, and 96.8%, p=0.035 (ANOVA), p=0.035 (Tukey test - 90°×30°)., Conclusions: Changes in position produced changes in spirometry results of patients with grade III obesity., (Copyright © 2011 Elsevier Editora Ltda. All rights reserved.)

Background: The implementation of clinical guidelines on acute myocardial infarction (AMI) care produces better results., Objective: To present a multidisciplinary program to implement these guidelines in a large public emergency center and check its impact., Methods: Evaluation study on health services, with "before and after" type design, to assess the indicators of quality of AMI care before and after implementation of training strategies and to facilitate emergency teams' acceptance of clinical guidelines. This includes the development of educational and awareness-raising materials and continued supervision. Relative risk estimate (RR) and confidence intervals (95%)., Results: Pre-program group, 78 cases of AMI; post-program group, 66 cases of AMI. Most cases were treated only in the emergency room, due to small number of vacancies in the coronary care unit. We observed a significant increase (p<0.05) in the use of various interventions evaluated (process indicators): beta-blockers, 83%; angiotensin-converting enzyme inhibitors, 22%; lipid-lowering agents, 69%; intravenous nitrate, 55%; coronary reperfusion in acute myocardial infarction with ST-segment elevation, 98%. The use of aspirin from the first day of the IAM reached 95.5% of cases. The loss of opportunity of coronary reperfusion in patients with this indication, reduced from 71.4% to 17.6% post-training., Conclusion: The program achieved a significant impact and its propagation to other units may contribute to better assist IAM in the public health system.

The correct identification of Candida species is of great importance, as it presents prognostic and therapeutical significance, allowing an early and appropriate antifungical therapy. The purpose of this study was to identify isolates of Candida spp. from oral mucosa of 38 patients with oral candidosis evaluated in 2004 by phenotypic methods and PCR, discriminating C. albicans from the other Candida species. The tests used for phenotypic analysis were germ-tube and chlamydoconidia production, culture in CHROMAgar™ Candida, carbohydrate assimilation test, growth at 45ºC and culture in Tween 80 agar. Genotypic confirmation was performed by PCR. Phenotypic tests showed that 63.2% strains formed germ-tubes, 73.7% produced chlamydoconidia, and 63.2% showed green colonies in chromogenic medium, presumptively indicating C. albicans or C. dubliniensis. The carbohydrate assimilation test confirmed these results. A total of 21% strains were identified as C. krusei and 13.2% were indicative of C. tropicalis. Of these later strains, three produced chlamydoconidia. The association of other phenotypic tests with culture in Tween 80 agar identified 95.8% of strains as C. albicans and 4.2% as C. dubliniensis. All 24 strains indicative of C. albicans and C. dubliniensis were confirmed by PCR as C. albicans.

Glucose transporter 4 (GLUT4) expression in adipose tissue decreases during fasting. In skeletal muscle, we hypothesized that GLUT4 expression might be maintained in a beta-adrenergic-dependent way to ensure energy disposal for contractile function. Herein we investigate beta-blockade or beta-stimulation effects on GLUT4 expression in oxidative (soleus) and glycolytic [extensor digitorum longus (EDL)] muscles of fasted rats. Fasting increased GLUT4 mRNA in soleus (24%) and EDL (40%), but the protein content increased only in soleus (30%). beta1-beta2-, and beta1-beta2-beta3-blockade decreased (20-30%) GLUT4 mRNA content in both muscles, although GLUT4 protein decreased only in EDL. When mRNA and GLUT4 protein regulations were discrepant, changes in the mRNA poly(A) tail length were detected, indicating a posttranscriptional modulation of gene expression. These results show that beta-adrenergic activity regulates GLUT4 gene expression in skeletal muscle during fasting, highlighting its participation in preservation of GLUT4 protein in glycolytic muscle.

Background: Cardioinhibitory response (CIR) is defined as asystole >3 seconds in response to 5-10 seconds of carotid sinus massage (CSM). Pacemaker implantation is indicated for patients with unexplained syncope episodes and CIR., Objective: To determine the prevalence and predictors of CIR in patients with a high prevalence of cardiovascular disease, and assess the clinical significance of CIR in patients with a history of unexplained syncope or falls., Methods: Cross-section design study. Outpatients, aged > or =50 years, referred to the electrocardiography sector of a tertiary hospital. Those with dementia, carotid bruit, and history of myocardial infarction, stroke or transient ischemic attack in the preceding 3 months were excluded. CSM was performed by a single investigator, with the patients in the supine position. CSM was applied on the right side and then on the left side during 10 seconds each time., Results: 502 patients underwent CSM. CIR was present in 52 patients (10.4%; 95% CI: 7.7%-13%). Independent predictors of CIR were male gender (OR: 2.61%; CI 95%: 1.3%-5.1%), structural heart disease (OR: 3.28%; CI 95%: 1.3%-7.9%) and baseline heart rate (P<0.05). The sensitivity of the CIR to CSM in syncope evaluation was low (9.8%). Specificity was high (89.5%), being even better in women (95.3%) and in those without structural heart disease (96.2%)., Conclusion: CIR was detected in 10.4% of the patients aged > or = 50 years. In males and in patients with structural heart disease CIR was more common. In women and patients with no apparent structural heart disease, the presence of CIR was a highly specific finding in the evaluation of syncope or falls.

Objective: To determine the incidence of residual pneumothorax after video-assisted thoracic sympathectomy, with and without postoperative pleural drainage, and to evaluate the possible influence of this type of pneumothorax on postoperative pain within the first 28 postoperative days., Methods: All patients presenting symptoms consistent with primary palmoplantar hyperhidrosis and treated at the Thoracic Surgery Outpatient Clinic of the State Hospital of Sumaré between July and December of 2006 were included. All were submitted to sympathectomy up to the third ganglion using video-assisted thoracoscopy and were randomized to receive or not receive postoperative pleural drainage for 3 h. Chest X-rays and low-dose computed tomography scans of the chest were performed on the first postoperative day in order to determine the incidence of residual pneumothorax. At different time points up to postoperative day 28, patient pain was assessed using a visual numeric scale and by measuring the quantity of opioid analgesics required., Results: This study comprised 56 patients, 27 submitted to bilateral pleural drainage and 29 not submitted to drainage. There was no statistical difference between the two groups in terms of the incidence of post-sympathectomy residual pneumothorax. Residual pneumothorax diagnosed through any of the methods did not influence pain within the first 28 postoperative days., Conclusion: Performing closed pleural drainage for 3 h immediately after video-assisted thoracic sympathectomy did not affect lung re-expansion or the incidence of residual pneumothorax. When residual pneumothorax was present, it did not affect pain within the first 28 postoperative days.

The BioCell-Tracer (BCT) system is an automatic microscopic method used for measuring the growth rate of a single fungal hyphae, which has not yet been applied to study Fusarium spp. Considering the large resistance of Fusarium species to the available chemotherapy and that hyphae is the morphological fungal form most often seen in vivo, in this work, Amphotericin B MIC and MFC values for a Fusarium solani strain were obtained by the conventional assay method testing conidia and also by the BCT monitoring system. Both MIC and MFC values of AMB against F. solani determined by broth dilution method resulted in 4.0 microg ml(-1). By the BCT system, their values were 1.0 microg ml(-1), with an inhibition rate of 99.5% (Exp-GR) and 100.0% (Post-GR), showing that when testing hyphae directly, MIC and MFC were determined at two lower dilutions than the MIC and MFC values obtained with conidia. Using the BCT system, 4.0, 2.0 and 1.0 microg ml(-1) of AMB concentrations inhibited hyphae growth in 50 min whereas 0.5 microg ml(-1) of AMB needed 100 min to start hyphae growth inhibition. These findings lead us to conclude that antifungal susceptibility varies between conidia and hyphae. For this strain of Fusarium solani, hyphae were more susceptible to AMB than conidia.

Background and Objectives: Scales can be useful to recognize anxiety states and to indicate ways to prevent complications due to elevated levels of anxiety. The modified Yale Preoperative Anxiety Scale (YPAS-m) was developed to evaluate anxiety in preschool children at the time of the anesthetic induction. It is an observational scale, being applied and completed in a short period of time. Studies on anxiety in children in the preoperative period do not mention anxiety at the preanesthetic evaluation. This transversal study tried to evaluate the level and prevalence of anxiety at the preanesthetic evaluation and in the clinical evaluation using the YPAS-m in preschool children., Methods: One hundred children, physical status ASA I and II were evaluated; G PED = 50 children undergoing clinical evaluation; G PEC = 50 children undergoing preanesthetic evaluation for surgery. The study was conducted at the pediatric clinic and preanesthetic evaluation waiting-room while the children waited for their appointment. Two observers applied the YPAS-m independently. Parameters analyzed included the demographic data; and median and percentage of patients with anxiety (YPAS-m > 30). Statistical analysis considered a p < 0.05 significant., Results: The groups were homogenous regarding the socio-demographic data. The mean ages were: G PED 4.25 and G PEC 4.67 years. There was a significant difference in the median of the YPAS-m (G PED 23.4 and G PEC 50.0) and on the prevalence of anxiety between both groups (G PED 16.7% and G PEC 81.6%)., Conclusions: In children between 2 and 7 years the levels and prevalence of anxiety, evaluated by the YPAS-m, at the time of the outpatient preanesthetic evaluation are higher than at the time of the clinical evaluation.

Fusarium species are hyaline moulds belonging to the hyalohyphomycosis group that are usually found in the soil and plants. This organism has emerged as a cause of disseminated invasive disease. The correlation between in vitro value and clinical efficacy is low and many patients remain unresponsive to treatment despite in vitro susceptibility. We determined growth control for Fusarium solani using the BioCell-Tracer system that measures the growth rate of a single fungal hypha, and the effect of different concentrations of amphotericin B and itraconazole. The MIC for these two drugs was also determined by a broth microdilution technique, using RPMI 1640. Different MICs for amphotericin B were obtained by the two different methods. This paper describes a case of infection due to Fusarium solani in an allogeneic bone marrow transplanted patient, the microbiological diagnostic, antifungal susceptibility tests for conidia and hypha and clinical correlation.

Paracrine cell signaling is believed to be important for ovarian follicle development, and a role for some members of the fibroblast growth factor (FGF) family has been suggested. In the present study, we tested the hypothesis that FGF-8 and its cognate receptors (FGFR3c and FGFR4) are expressed in bovine antral follicles. RT-PCR was used to analyze bovine Fgf8, Fgfr3c and Fgfr4 mRNA levels in oocytes, and granulosa and theca cells. Fgf8 expression was detected in oocytes and in granulosa and theca cells; this expression pattern differs from that reported in rodents. Granulosa and theca cells, but not oocytes, expressed Fgfr3c, and expression in granulosa cells increased significantly with follicle estradiol content, a major indicator of follicle health. Fgfr4 expression was restricted to theca cells in the follicle, and decreased significantly with increasing follicle size. To investigate the potential regulation of Fgfr3c expression in the bovine granulosa, cells were cultured in serum-free medium with FSH or IGF-I; gene expression was upregulated by FSH but not by IGF-I. The FSH-responsive and developmentally regulated patterns of Fgfr3c mRNA expression suggest that this receptor is a potential mediator of paracrine signaling to granulosa cells during antral follicle growth in cattle.

Infection is a major cause of morbidity and mortality in bone marrow transplant recipients and in patients with hematological malignancies. The source of infection is almost always endogenous flora or the hospital environment. The present study evaluated bone marrow transplant recipients and patients with hematological malignancies colonized and/or infected with filamentous fungi. During 1 year, environmental air samples were also taken from the bone marrow transplant unit by a modification of gravity air-setting plate (GASP) methodology. Fusarium spp. were the most prevalent genus in the fall and Cladosporium spp. in the winter. Clinically isolated strains grew better at 37 degrees C than environmental strains. According to NCCLS M-38P methods, environmental Aspergillus strains showed higher MICs to miconazol and itraconazol, and clinical Fusarium strains were less susceptible to fluconazole.

Paracrine cell signaling is thought to be important for ovarian follicle development, and a role for some members of the fibroblast growth factor (FGF) family have been suggested. In the present study, we tested the hypothesis that FGF-8 and its cognate receptors (FGFR-3c and FGFR-4) are expressed in bovine preantral follicles. Reverse transcription-polymerase chain reaction was used to amplify bovine FGF-8, FGFR-3c, and FGFR-4 from preantral follicle samples and a variety of fetal and adult tissues. All three genes were widely expressed in fetal tissues, with a restricted expression pattern in adult tissues. FGF-8 and FGFR-3c were expressed in secondary follicles in 70% of fetuses examined, whereas FGFR-4 expression was significantly less frequent (20%). FGFR-3c expression frequency was significantly lower in primordial compared to secondary follicles, and FGF-8 expression showed a similar trend. FGFR-4 was only observed when all follicle classes of an individual were expressing both FGF-8 and FGFR-3c. We conclude that FGF-8 and its receptors are expressed in preantral follicles in a developmentally regulated manner., (Copyright 2005 Wiley-Liss, Inc.)

The DNA puff BhC4-1 gene is amplified and highly expressed in the salivary gland of Bradysia hygida late larvae. Using affinity-purified polyclonal antibodies we have identified the product of the BhC4-1 gene as a 43 kDa polypeptide which is present in extracts of salivary glands from late fourth instar larvae and in the corresponding gland secretion, but not in glands from earlier stages. We also demonstrate that this protein is produced mainly in the S1 and S3 regions of the salivary gland, where BhC4-1 amplification levels are more pronounced and larger amounts of mRNA are produced. By immunoelectron microscopy the BhC4-1 protein was detected in secretory granules of the S1 and S3 regions, and localized in fibrous structures present in the saliva., (Copyright 2004 Elsevier Ltd.)

Bone marrow transplant recipients are highly susceptible to opportunistic fungal infections. This is the report, of the first case of a Chaetomium systemic infection described in Brazil. A 34 year-old patient with chronic myeloid leukemia underwent an allogeneic sibling matched bone marrow transplant. Seven months later, he developed systemic infection with enlargement of the axillary and cervical lymph nodes. Culture of the aspirates from both lymph nodes yielded Chaetomium globosum. The infection was successfully treated with amphotericin B. The increasing population of immunosupressed patients requires a careful microbiologic investigation for uncommon fungal infections.

The aim of this study was to evaluate the effect of delaying ovulation subsequent to superstimulation of follicular growth in beef cows (Bos indicus) on embryo recovery rates and the capacity of embryos to establish pregnancies. Ovulation was delayed by three treatments using either progesterone (CIDR-B) or a GnRH agonist (deslorelin). Multiparous Nelore cows (n = 24) received three of four superstimulation treatments in an incomplete block design (n = 18 per group). Cows in Groups CTRL, P48 and P60 were treated with a CIDR-B device plus estradiol benzoate (EB, 4 mg, i.m.) on Day-5, while cows in Group D60 were implanted with deslorelin on Day-7. Cows were superstimulated with FSH (Folltropin-V, 200 mg), from Day 0 to 3, using twice daily injections in decreasing amounts. All cows were treated with a luteolytic dose of prostaglandin on Day 2 (08:00 h). CIDR-B devices were removed as follows: Group CTRL, Day 2 (20:00 h); Group P48, Day 4 (08:00 h); Group P60, Day 4 (20:00 h). Cows in Group CTRL were inseminated at 10, 20 and 30 h after first detected estrus. Ovulation was induced for cows in Group P48 (Day 4, 08:00 h) and Groups P60 and D60 (Day 4, 20:00 h) by injection of LH (Lutropin, 25 mg, i.m.), and these cows were inseminated 10 and 20 h after treatment with LH. Embryos were recovered on Days 11 or 12, graded and transferred to synchronized recipients. Pregnancies were determined by ultrasonography around Day 100. Data were analyzed by mixed procedure, Kruskal-Wallis and Chi-square tests. The number of ova/embryos, transferable embryos (mean +/- SEM) and pregnancy rates (%) were as follows, respectively: Group CTRL (10.8+/-1.8, 6.1+/-1.3, 51.5), P48 (12.6+/-1.9, 7.1+/-1.0, 52.3), P60 (10.5+/-1.6, 5.7+/-1.3, 40.0) and D60 (10.3+/-1.7, 5.0+/-1.2, 50.0). There were no significant differences among the groups (P > 0.05). It was concluded that fixed time AI in association with induced ovulation did not influence embryo recovery. Furthermore, pregnancy rates in embryos recovered from cows with delayed ovulation were similar to those in embryos obtained from cows treated with a conventional superstimulation protocol.

The present work evaluated low-cost protocols for timed artificial insemination (TAI) in beef cattle. In Experiment 1, cycling nonlactating Nelore cows (Bos indicus, n=98) were assigned to the following groups: GnRH-PGF (GP) and GnRH-PGF-GnRH (GPG), whereas cycling (n=328, Experiment 2) or anestrus (n = 225, Experiment 3) lactating (L) cows were divided into 3 groups: GP-L, GPG-L and GnRH-PGF-Estradiol benzoate (GPE-L). In Experiment 4, lactating cows (n=201) were separated into 3 groups: GP-L, GPE-L and G/2PE-L. Animals from Experiment 1, 3 and 4 were treated (Day 0), at random stages of the estrous cycle, with 8 microg of buserelin acetate (GnRH agonist) intramuscularly (i.m.), whereas in Experiment 2 half of the cows received 8 and the other half 12 microg of GnRH (i.m.). Seven days later (D 7) all animals were treated with 25 mg of dinoprost trometamine (PGF2alpha, i.m.) except those cows from the G/2PE-L group which received only 1/2 dose of PGF2alpha (12.5 mg) via intravulvo-submucosa (i.v.s.m.). After PGF2alpha injection the animals from the control groups (GP and GP-L) were observed twice daily to detect estrus and AI was performed 12 h afterwards. The cows from the other groups received a second GnRH injection (D 8 in GPG-L and d9 in GPG groups) or one injection of estradiol benzoate (EB, 1.0 mg, D 8 in GPE-L group). All cows from GPG and GPG-L or GPE-L groups were AI 20 to 24 or 30 to 34 h, respectively, after the last hormonal injection. Pregnancy was determined by ultrasonography or rectal palpation 30 to 50 days after AI. In the control groups (GP and GP-L) percentage of animals detected in heat (44.5 to 70.3%) and pregnancy rate (20 to 42%) varied according to the number of animals with corpus luteum (CL) at the beginning of treatment. The administration of a second dose of GnRH either 24 (Experiment 2) or 48 h (Experiment 1) after PGF2alpha resulted in 47.7 and 44.9% pregnancy rates, respectively, after TAI in cycling animals. However, in anestrus cows the GPG treatment induced a much lower pregnancy rate (14.9%) after TAI. The replacement of the second dose of GnRH by EB (GPE-L) resulted in a pregnancy rate (43.3%) comparable to that obtained after GnRH treatment (GPG-L, 47.7%, Experiment 2). Furthermore, the use of 1/2 dose of PGF2alpha (12.5 mg i.v.m.s., Experiment 4) resulted in pregnancy rate (43.5%) similar to that observed with the full dose (i.m.). Both protocols GPG and GPE were effective in synchronizing ovulation in cycling Nelore cows and allowed approximately a 45% pregnancy rate after TAI. Additionally, the GPE treatment is a promising alternative to the use of GPG in timed AI of beef cattle, due to the low cost of EB when compared to GnRH agonists.

A 47-year-old woman with adenocarcinoma of the right breast had bone scintigraphy with Tc-99m MDP. Bone imaging did not show any metastases. However, a large area of increased tracer uptake was seen extending from the abdomen to the pelvis. Abdominal ultrasound revealed a large solid and heterogeneous mass, measuring 18 x 11 x 14.3 cm, that originated in an empty uterus. A biopsy of the surgical specimen showed a leiomyoma of the uterus.