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ABSTRACT This study aimed to determine the antibiotic profile of microorganisms isolated from urine samples of patients with community urine tract infections (UTI) admitted to the University Hospital of the Federal University of Sao Carlos to support an appropriate local empirical treatment. A retrospective cross-sectional study was conducted from October 2018 to October 2020. Data from 1,528 positive urine cultures for bacterial pathogens and antibiograms were tabulated. Bacterial species prevalence and their resistance profile were analyzed and compared by sex and age. For Gram-negative fermenting bacteria, resistance rates were compared between patients with previous hospitalization and the total of infections caused by this group. For comparisons, the Chi-square test was performed, using Fisher’s exact test when necessary (BioEstat program, adopting p ≤ 0.05). A multivariate analysis was applied to assess the effect of the studied variables in predicting multidrug resistance. Infections were more prevalent in women and older adults. Gram-negative bacteria represented 90.44% of total cultures. In both sexes, E. coli prevalence was significantly higher in adults compared with older adults (p < 0.0001). For several antibiotics, resistance rates were higher in the older adults compared with other ages and in patients with Gram-negative fermenting infections and previous hospitalization compared with the total of infections by this group of bacteria. The closer to the hospitalization, the higher the number of antibiotics with superior resistance rates. Resistance rates for aminoglycosides, carbapenems, ceftazidime, nitrofurantoin, piperacillin+tazobactam, and fosfomycin were less than 20%, considered adequate for empirical treatment. Only hospitalization in the previous 90 days was statistically significant in predicting infections by multidrug-resistant bacteria.

https://doi.org/10.1590/s1678-9946202466003

Pain interference, neuropathic-like symptoms, pain intensity, and symptoms of central sensitization negatively impact individual’s disability after Chikungunya fever: cross-sectional study
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Dias, Paula Renata Conceição de Oliveira

; Bittencourt, Juliana Valentim

; Rio, Jéssica Pinto Martins do

; Reis, Felipe José Jandre dos

; Oliveira, Laura Alice Santos de

; Nogueira, Leandro Alberto Calazans

BrJP

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Jun 2023, Volumen 6 Nº 2 Paginas 139 - 144

Resumen: En Pt | Texto: En Pt | PDF: En | PDF: Pt

ABSTRACT BACKGROUND AND OBJECTIVES: Particular pain features, such as pain interference, neuropathic-like symptoms, and central sensitization (CS) symptoms may be present in patients with Chikungunya fever and lead to functional limitations. The present study aimed to assess the association between pain characteristics and the disability in participants affected by Chikungunya fever in the chronic phase. METHODS: A cross-sectional study was conducted with 36 participants who filled out a sociodemographic, pain characteristics (pain interference - Brief Pain Inventory, neuropathic-like symptoms - PainDETECT Questionnaire, and CS-related signs and symptoms - Central Sensitization Inventory) and disability (Health Assessment Questionnaire) questionnaires. The Spearman correlation test (rho) verified the relationship between the outcomes. RESULTS: Most of the participants were female (77%), with a mean age of 43 years. Twenty-seven (75%) participants presented nociceptive pain and 11 (30%) had central sensitization symptoms. There was a high positive correlation between the presence of neuropathic-like symptoms and disability (rho=0.71; p<0.001) and pain intensity and disability (rho=0.76; p<0.001). A moderate positive correlation was found between the central sensitization symptoms and disability (rho=0.51; p=0.002). Moreover, there is a low positive correlation between pain interference in an individual’s life and disability (rho=0.34; p=0.041). CONCLUSION: Patients in chronic phase of Chikungunya fever revealed mild pain intensity and predominance of nociceptive pain. Pain interference, neuropathic-like symptoms, and central sensitization symptoms negatively impact individual’s disability after Chikungunya fever.

RESUMO JUSTIFICATIVA E OBJETIVOS: Características particulares da dor, como interferência da dor, sintomas do tipo neuropático e sintomas de sensibilização central (SC), podem estar presentes em pacientes com febre Chicungunha e levar a limitações funcionais. O presente estudo teve como objetivo avaliar a correlação entre as características da dor e a capacidade funcional em participantes acometidos pela febre Chicungunha na fase crônica. MÉTODOS: Foi realizado um estudo transversal com 36 participantes que preencheram questionários sociodemográficos, de características de dor (interferência da dor - Inventário Breve de Dor, sintomas do tipo neuropático - questionário PainDETECT, e sinais e sintomas relacionados à SC - Inventário de Sensibilização Central) e de capacidade funcional (Health Assessment Questionnaire). O teste de correlação de Spearman (rho) verificou a relação entre os desfechos. RESULTADOS: A maioria dos participantes era do sexo feminino (77%), com média de idade de 43 anos. Vinte e sete (75%) participantes apresentaram dor nociceptiva e 11 (30%) apresentaram sintomas de sensibilização central. Houve alta correlação positiva entre a presença de sintomas do tipo neuropático e capacidade funcional (rho=0,71; p<0,001) e intensidade da dor e capacidade funcional (rho=0,76; p<0,001). Foi encontrada uma correlação positiva moderada entre os sintomas de sensibilização central e a capacidade funcional (rho=0,51; p=0,002). Além disso, há uma correlação positiva baixa entre a interferência da dor na vida do indivíduo e a capacidade funcional (rho=0,34; p=0,041). CONCLUSÃO: Pacientes em fase crônica da febre Chicungunha apresentaram intensidade de dor leve e predominância de dor nociceptiva. A interferência da dor, os sintomas do tipo neuropático e os sintomas de sensibilização central afetam negativamente a capacidade funcional do indivíduo após a febre Chicungunha.

https://doi.org/10.5935/2595-0118.20230032-en

The Chronic Care Model and its implications for Specialized Outpatient Care
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Marques, Francielle Renata Danielli Martins

; Pires, Grazieli Adrieli Rodrigues

; Santos, José Luís Guedes Dos

; Baldissera, Vanessa Denardi Antoniassi

; Salci, Maria Aparecida

Revista Brasileira de Enfermagem

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2023, Volumen 76 Nº 1 elocation e20210315

Resumen: Pt En Es | Texto: Pt En Es | PDF: Pt | PDF: En | PDF: Es

RESUMO Objetivo: avaliar a implementação do Modelo de Atenção às Condições Crônicas na Atenção Ambulatorial Especializada e suas repercussões para a atenção à saúde. Métodos: pesquisa avaliativa qualitativa, conduzida pelo Modelo de Atenção às Condições Crônicas. Foram empregadas as técnicas de observação, análise documental e entrevistas com 21 profissionais de saúde da atenção especializada. A análise foi conduzida pela triangulação, com auxílio do software MAXQDA para as codificações iniciais e focalizadas. Todos os aspectos éticos foram respeitados. Resultados: os profissionais reconheceram que o modelo reorganizou as práticas assistenciais e administrativas do serviço, apresentando repercussões positivas para a saúde das pessoas atendidas. A ausência de educação permanente para os profissionais do serviço comprometeu a completa implementação do modelo. Considerações finais: a implementação, mesmo que parcial, do modelo traz contribuições para a melhoria do serviço. As fragilidades ainda presentes são compatíveis com a dificuldade dos profissionais em se distanciarem do modelo biomédico.

ABSTRACT Objective: to assess the Chronic Care Model implementation in Specialized Outpatient Care and its repercussions for health care. Methods: qualitative evaluative research, conducted by the Chronic Care Model. We used observation techniques, document analysis and interviews with 21 health professionals from specialized care. Analysis was conducted by triangulation, with the aid of MAXQDA software for initial and focused coding. All ethical aspects were respected. Results: professionals recognized that the model reorganized service care and administrative practices, presenting positive repercussions for the health of people assisted. The absence of continuing education for service professionals compromised the complete model implementation. Final considerations: the implementation, even if partial, of the model brings contributions to service improvement. The weaknesses that are still present are compatible with professionals’ difficulty in distancing themselves from the biomedical model.

RESUMEN Objetivo: evaluar la implementación del Modelo de Atención a las Condiciones Crónicas en la Atención Ambulatoria Especializada y sus repercusiones en la atención de la salud. Métodos: investigación cualitativa evaluativa, realizada por el Modelo de Atención a las Condiciones Crónicas. Se utilizaron técnicas de observación, análisis de documentos y entrevistas a 21 profesionales de la salud de atención especializada. El análisis se realizó por triangulación, con la ayuda del software MAXQDA para la codificación inicial y focalizada. Se respetaron todos los aspectos éticos. Resultados: los profesionales reconocieron que el modelo reorganizó las prácticas asistenciales y administrativas del servicio, presentando repercusiones positivas para la salud de las personas atendidas. La ausencia de educación continua para los profesionales de los servicios comprometió la implementación completa del modelo. Consideraciones finales: la implementación, aunque sea parcial, del modelo trae contribuciones para la mejora del servicio. Las debilidades que aún están presentes son compatibles con la dificultad de los profesionales para distanciarse del modelo biomédico.

https://doi.org/10.1590/0034-7167-2021-0315

Multilevel model in the identification of behavioral and structural risk factors for HIV: integrative review
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Silva, Juliana Kelly Batista da

; Santos, Jamira Martins dos

; Moreira, William Caracas

; Romero, Renata Olívia Gadelha

; Leadebal, Oriana Deyze Correia Paiva

; Nogueira, Jordana de Almeida

Revista Brasileira de Enfermagem

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2023, Volumen 76 Nº 1 elocation e20210853

Resumen: Pt En Es | Texto: Pt En Es | PDF: Pt | PDF: En | PDF: Es

RESUMO Objetivos: investigar estudos que adotaram o modelo de análise multinível na identificação de fatores de risco comportamentais e estruturais, que estão associados a infecção pelo HIV. Métodos: revisão integrativa da literatura com estudos disponíveis na íntegra, obtidos nas bases EMBASE, CINAHL, Pubmed e Scopus, cujos descritores selecionados foram os termos constantes: “HIV”, “multilevel analysis”, “behavior”. Resultados: a pesquisa resultou em 236 artigos. Destes, dez artigos compuseram a amostra. Desvantagem econômica, características de vizinhança, instabilidade habitacional, encarceramento, sexo transacional, múltiplos parceiros, abuso de substâncias e idade da primeira relação sexual foram classificados como fatores de risco estruturais e comportamentais ao HIV. Redução da desvantagem socioeconômica, fornecimento de estabilidade habitacional e uso de preservativos foram associados a fatores de proteção à exposição ao HIV. Conclusões: com a aplicabilidade do modelo multinível nos estudos de investigação de fatores de risco, foi possível identificar os elementos estruturais e comportamentais de risco ao HIV.

ABSTRACT Objectives: to investigate studies that adopted the multilevel analysis model to identify behavioral and structural risk factors associated with HIV infection. Methods: an integrative review of the literature with studies available in full, obtained from EMBASE, CINAHL, Pubmed, and Scopus, whose selected descriptors were the indexed terms: “HIV”, “multilevel analysis” and “behavior”. Results: the search resulted in 236 studies. Out of these, ten studies comprised the sample. Economic disadvantage, neighborhood characteristics, housing instability, incarceration, transactional sex, multiple partners, substance abuse, and age at first intercourse were classified as structural and behavioral risk factors for HIV. Reduced socioeconomic disadvantage, provision of housing stability, and condom use were associated with protective factors for HIV exposure. Conclusions: by applying the multilevel model in risk factor research studies, it was possible to identify the structural and behavioral elements of HIV risk.

RESUMEN Objetivos: investigar estudios que adoptaron el modelo del análisis multinivel para identificar los factores de riesgo comportamentales y estructurales asociados al VIH. Método: es una revisión bibliográfica integradora con estudios disponibles en su totalidad, obtenidos de las bases de datos EMBASE, CINAHL, Pubmed y Scopus, cuyos descriptores fueron los términos: “HIV”, “multilevel analysis”, “behavior”. Resultados: diez artículos, de los 236 encontrados, formaron parte de la muestra. Desventajas económicas, características del vecindario, inestabilidad habitacional, encarcelamiento, sexo transaccional, parejas múltiples, abuso de sustancias y edad de la primera relación sexual se destacaron como factores de riesgo estructurales y comportamentales del VIH. La reducción de desventajas socioeconómicas, la provisión de estabilidad habitacional y el uso de preservativos están asociados a la protección contra el VIH. Conclusiones: al aplicar el modelo multinivel en los estudios de investigación de los factores de riesgo, fue posible identificar los elementos estructurales y comportamentales del riesgo del VIH.

https://doi.org/10.1590/0034-7167-2021-0853

Role of the NF-kB/parkin/vegfr-1 pathway associated with hypoxic-ischemic insult in germinal matrix samples of newborn infants
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Ghirelli, Eliane Amaral

; Silva, Felipe Paes Gomes da

; Oricil, Alessandro Gonçalves Gomes

; Paula, Caroline Busatta Vaz de

; Nagashima, Seigo

; Oldenburg Neto, Carlos Frederico

; Storti, Eduardo

; Sakiyama, Fernando Yochiteru Rolim

; Kayano, Rafael Martins

; Sakiyama, Renata Rolim

; Moreira, Vinícius da Silva

; Sotomaior, Vanessa Santos

; Noronha, Lucia de

Revista Paulista de Pediatria

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2023, Volumen 41 elocation e2022034

Resumen: En Pt | Texto: En Pt | PDF: En | PDF: Pt

Abstract Objective: Given the high proliferative activity of germinal matrix and its direct correlation with hypoxemia, it is necessary to investigate the possible molecular regulation pathways, to understand the existing clinical relationship between the hypoxic-ischemic insult and the biomarkers NF-kB, AKT-3, Parkin, TRK-C and VEGFR-1. Methods: A hundred and eighteen germinal matrix samples of the central nervous system of patients who died in the first 28 days of life were submitted to histological and immunohistochemistry analysis to identify the tissue immunoexpression of those biomarkers related to asphyxia, prematurity, and death events within 24h. Results: A significantly increased tissue immunoexpression of NF-kB, AKT-3 and Parkin was observed in the germinal matrix of preterm infants. In addition, significantly decreased tissue immunoexpression of VEGFR-1 and NF-kB was observed in patients who experienced asphyxia followed by death within 24 hours. Conclusions: The results suggest a direct involvement between the hypoxic-ischemic insult and NF-kB and VEGFR-1 markers since a decreased immunoexpression of these biomarkers was observed in asphyxiated patients. Furthermore, it is suggested that there was not enough time for VEGFR-1 to be transcribed, translated and expressed on the surface of the plasma membrane. This temporality can be observed in the relationship between NF-kB expression and the survival time of individuals who died within 24 hours, suggesting that this factor is essential for the production of VEGFR-1 and, therefore, to carry out the necessary remodeling effect to neovascularize the affected region.

RESUMO Objetivo: Dada a alta atividade proliferativa da matriz germinativa e sua correlação direta com a hipoxemia, é necessário investigar as possíveis vias de regulação molecular para entender a relação clínica existente entre o insulto hipóxico-isquêmico e os biomarcadores NF-kB, AKT -3, Parkina, TRK-C e VEGFR-1. Métodos: Cento e dezoito amostras de matriz germinativa do sistema nervoso central de pacientes que faleceram nos primeiros 28 dias de vida foram submetidas a análise histológica e imuno-histoquímica para identificar a imunoexpressão tecidual desses biomarcadores relacionados a eventos de asfixia, prematuridade e óbito em 24 horas. Resultados: Observou-se uma imunoexpressão tecidual significativamente aumentada de NF-kB, AKT-3 e Parkin na matriz germinativa de prematuros. Além disso, constatou-se uma imunoexpressão tecidual significativamente diminuída de VEGFR-1 e de NF-kB em pacientes que apresentaram asfixia seguida de morte em 24 horas. Conclusões: Os resultados sugerem o envolvimento direto entre o insulto hipóxico-isquêmico e os marcadores NF-kB e VEGFR-1, visto que se observou uma imunoexpressão diminuída destes biomarcadores nos pacientes asfixiados. Além disso, sugere-se que não houve tempo suficiente para que o VEGFR-1 fosse transcrito, traduzido e expresso na superfície da membrana plasmática. Essa temporalidade pode ser observada na relação entre a expressão de NF-kB e o tempo de vida dos indivíduos que morreram em 24 horas, o que sugere que esse fator é essencial para a produção do VEGFR-1 e, portanto, para realizar o efeito remodelador necessário para neovascularizar a região afetada.

https://doi.org/10.1590/1984-0462/2023/41/2022034

Lock terapia na prevenção e tratamento da infecção da corrente sanguínea associada ao cateter vascular: revisão integrativa
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Tresso, Karina Angélica

; Santos, Bruna Nogueira dos

; Braga, Fernanda Titareli Merizio Martins

; Margatho, Amanda Salles

; Mendes, Karina Dal Sasso

; Silveira, Renata Cristina de Campos Pereira

Acta Paulista de Enfermagem

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2023, Volumen 36 elocation eAPE01221

Resumen: En Es Pt | Texto: En Es Pt | PDF: En | PDF: Es | PDF: Pt

Abstract Objective To synthesize knowledge on the use of lock therapy for prevention and treatment of long-term central vascular access devices-associated bloodstream infection in hospitalized adult and elderly patients. Methods Integrative review conducted in CINAHL, Cochrane Central, Embase, LILACS, PubMed, Scopus, and Web of Science databases, from January 1st, 2010 to September 28th, 2021, without language restrictions. Data were analyzed descriptively. Results Sixteen studies were identified, six (37.5%) on the use of lock therapy for prevention of bloodstream infection associated with central vascular access devices, and ten (62.5%) on treatment. The articles on prevention reported the use of non-antibiotic solutions. Nine of the ten studies that addressed lock therapy as treatment used antibiotic solutions. Two studies assessed the effectiveness of lock therapy in a short duration (three to four days), seven in a longer duration (between 10 and 14 days), and one did not specify the length of time. Each study described an intervention technique and the length of stay of the intraluminal solution. Regarding the risk of bias, five randomized clinical trials, two non-randomized clinical trials, and eight observational studies were rated as low risk. Only one observational study was classified as moderate risk. Conclusion The use of non-antibiotic solutions such as ethanol was identified for prevention of bloodstream infection. For treatment, intravenous daptomycin was used. While the studies included in this review on prevention did not show statistical evidence, the ten studies on treatment demonstrated that lock therapy is an effective complement to systemic treatment, showing good catheter salvage rates.

Resumen Objetivo Sintetizar el conocimiento sobre el uso de la terapia de bloqueo en la prevención y tratamiento de infecciones del torrente sanguíneo asociadas al dispositivo de acceso vascular central de larga permanencia en pacientes adultos y adultos mayores hospitalizados. Métodos Revisión integradora con búsqueda en las bases de datos CINAHL, Cochrane Central, Embase, LILACS, PubMed, Scopus y Web of Science, en el período del 1 de enero de 2010 al 28 de septiembre de 2021 sin restricción de idioma. Los datos fueron analizados de forma descriptiva. Resultados Se identificaron 16 estudios, de los cuales seis (37,5 %) trataban sobre el uso de la terapia de bloqueo como prevención de infecciones asociadas al dispositivo de acceso vascular central y diez (62,5 %) sobre tratamiento. En los artículos sobre prevención se relató el uso de soluciones no antibióticas. En nueve de los diez estudios que abordaban la terapia de bloqueo como tratamiento, se utilizaron soluciones antibióticas. En dos estudios se evaluó la eficacia de la terapia de bloqueo de corta duración (de tres a cuatro días), siete de mayor duración (entre 10 y 14 días) y uno sin especificar la duración. En cada estudio se describió una técnica de intervención y el tiempo de permanencia de la solución intraluminal. Con relación al riesgo de sesgo, fueron evaluados con riesgo bajo: cinco ensayos clínicos aleatorizados, dos ensayos clínicos no aleatorizados y ocho estudios observacionales. Solo un estudio observacional fue clasificado con riesgo moderado. Conclusión Para la prevención, se identificó el uso de soluciones no antibióticas como el etanol. Para el tratamiento, se utilizó la daptomicina intravenosa. Aunque los estudios incluidos en esta revisión sobre prevención no hayan demostrado evidencia estadística, los diez estudios sobre tratamiento demostraron que la terapia de bloqueo es un complemento eficaz para el tratamiento sistémico y presentó buenos índices de salvamento del catéter.

Resumo Objetivo Sintetizar o conhecimento sobre o uso da lock terapia na prevenção e no tratamento da infecção da corrente sanguínea associada ao dispositivo de acesso vascular central de longa permanência em pacientes adultos e idosos hospitalizados. Métodos Revisão integrativa com busca nas bases de dados CINAHL, Cochrane Central, Embase, LILACS, PubMed, Scopus e Web of Science, no período de 1º janeiro de 2010 a 28 de setembro de 2021 sem restrições de idioma. Os dados foram analisados de forma descritiva. Resultados Foram identificados 16 estudos sendo seis (37,5%) sobre o uso da lock terapia como prevenção de infecção associada ao dispositivo de acesso vascular central e dez (62,5%) sobre tratamento. Os artigos sobre prevenção relataram o uso de soluções não antibióticas. Nove dos dez estudos que abordaram a lock terapia como tratamento, utilizaram soluções antibióticas. Dois estudos avaliaram a eficácia da lock terapia em curta duração (de três a quatro dias), sete em maior duração (entre 10 e 14 dias) e um não especificou a duração. Cada estudo descreveu uma técnica de intervenção e o tempo de permanência da solução intraluminal. Em relação ao risco de viés, foram avaliados como baixo risco: cinco ensaios clínicos randomizados, dois ensaios clínicos sem randomização e oito estudos observacionais. Apenas um estudo observacional foi classificado como risco moderado. Conclusão Na prevenção, identificou-se o uso de soluções não antibióticas como o etanol. Para o tratamento, foi utilizada a daptomicina endovenosa. Enquanto os estudos incluídos nessa revisão sobre prevenção não demonstraram evidência estatística, os dez estudos sobre tratamento demonstraram que a lock terapia é um complemento eficaz ao tratamento sistêmico, apresentando boas taxas de salvamento do cateter.

https://doi.org/10.37689/acta-ape/2023ar01221

Nb2O5 Pellets with Inactive Biomass for Adsorption of Mn2+ Ions: Kinetic, Isothermal and Reuse Study
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Giraldi, Tania Regina

; Costa, Beatriz Caroline da

; Silva, Marcos Martins

; Santos, Allef Leite dos

; Paris, Elaine Cristina

; Figueiredo, Alberthmeiry Teixeira de

; Rodriguez, Renata Piacentini

Materials Research

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2023, Volumen 26 Supl. 1 elocation e20220553

Resumen: En | Texto: En | PDF: En

This paper aims to explore the production of porous Nb2O5 pellets by pressing and adding anaerobic biomass (sludge) in order to evaluate the microstructure porosity. The thermal treatment temperature of the pellets varied between 300 ºC and 900 ºC. Their structural, morphological, and physical properties were measured, and the adsorption potential of Mn2+ and their reuse were evaluated. All samples had a monoclinic phase. Density average values of samples pressed using sludge ranged between 2.45 and 2.52 g.cm-3, while the one obtained without sludge pressing achieved higher values of around 2.72 g.cm-3. All samples presented high porosity values after the heat treatment (above 40%), which confirms the efficiency of sludge as a means to enhance porosity. These pellets were used for Mn2+ ions adsorption in aqueous medium. The Langmuir isotherm model was the one that achieved the best goodness-of-fit. In kinetic studies, the adsorption reaction was in accordance with second-order kinetics. Adsorbents in the form of pellets are environmentally friendly on account of their significant reuse and recycling potential. However, the particulate matter might become an environmental liability and incur high treatment costs. The samples proved to be reusable, promoting the adsorption of 67% of the Mn2+ after the fifth reuse cycle.

https://doi.org/10.1590/1980-5373-mr-2022-0553

Association among oral health and academic performance: a longitudinal study in a university in Southern Brazil
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CORRÊA, Yorrana Martins

; POSSER, Renata Uliana

; KARAM, Sarah Arangurem

; COSTA, Francine dos Santos

; SCHWENDICKE, Falk

; DEMARCO, Flávio Fernando

; CORRÊA, Marcos Britto

Brazilian Oral Research

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2023, Volumen 37 elocation e046

Resumen: En | Texto: En | PDF: En

Abstract This longitudinal study aimed to investigate the association between self-perceived oral health, oral-health-related quality-of-life (OHRQoL), toothache, and university students’ academic performance or dropout. A cohort of 2,089 students from 64 different courses at a public university in southern Brazil was interviewed in 2016 regarding their self-perceived oral health (Locker instrument; dichotomized into good/poor), OHRQoL (Oral Impacts on Daily Performances instrument, OIDP) and having had any toothache over the last 6 months (yes/no). After three years (2020), the academic records of 1,870 of these students were assessed, their average grade over all courses evaluated, and their dropout status was determined. Multivariable linear or logistic regression adjusting for gender, skin color, age, family income and maternal education was used to associate oral health variables (self-perceived oral health, OIDP, toothache) and academic performance or dropout. In 2016, 28.6% reported negative self-perceived oral health through the Locker instrument and 31.4% had toothache in the last 6 months. Over the next three years, 36.2% had dropped out. In multivariable regression, toothache in the last 6 months had a decrease of 0.32 (β -0.32, CI95% -0.59; -0.04) points in the final grade and were 35% (OR 1.35 CI95% 1.08; 1.69) more likely to dropout than students without toothache. In conclusion, this study showed that worse oral health conditions may be associated with worse academic performance or dropping out.

https://doi.org/10.1590/1807-3107bor-2023.vol37.0046

Different concentrations of fetal bovine serum affect cytokine modulation in Lipopolysaccharide-activated apical papilla cells in vitro
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SANTOS, Letícia Martins

; CARDOSO, Patricia e Silva

; DINIZ, Elisa Abreu

; RAHHAL, Juliana Garuba

; SIPERT, Carla Renata

Journal of Applied Oral Science

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2023, Volumen 31 elocation e20230020

Resumen: En | Texto: En | PDF: En

Abstract Fetal bovine serum (FBS) is the most used supplement in culture media; however, it may interfere with in vitro assays via effects on cell proliferation and cytokine production. The ideal FBS concentration for assays using apical papilla cells (APCs) remains unknown. Therefore, this study aimed to evaluate the effects of FBS on APC activation, cell viability/proliferation, and cytokine production. Methodology Human APCs were cultured, plated, and maintained in media containing increasing concentrations of FBS for 24 h, 48 h, 72 h, 7 days, and 14 days in the presence of Lipopolysaccharide (LPS - 1 µg/mL). At each time point, the cells were subjected to the MTT assay. The cytokines transforming growth factor (TGF)-β1, osteoprotegerin (OPG), and interleukin (IL)-6, along with the chemokine CCL2, were quantified using the enzyme-linked immunosorbent assay at the 24-h time-point. Statistical analysis was performed using two-way analysis of variance (ANOVA) followed by Tukey's post-hoc test (p<0.05). Results In general, APCs exhibited increasing metabolic activity in an FBS concentration-dependent fashion, regardless of the presence of LPS. In contrast, FBS interfered with the production of all the cytokines evaluated in this study, affecting the response induced by the presence of LPS. Conclusion FBS increased APC metabolism in a concentration-dependent manner and differentially affected the production of TGF-β1, OPG, IL-6, and CCL2 by APCs in vitro.

https://doi.org/10.1590/1678-7757-2023-0020

10.

Discriminative value of pulse wave velocity for arterial stiffness and cardiac injury in prediabetic patients
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Firmino, Stella Maris

; Goulart, Cássia da Luz

; Gregorio, João Paulo

; Wende, Klaus Werner

; Yuamoto, Fernanda Yuri

; Kummer, Lana

; Curcelli, Emílio Martins

; Heubel, Alessandro Domingues

; Kabbach, Erika Zavaglia

; Santos, Polliana Batista

; Borghi-Silva, Audrey

; Mendes, Renata Gonçalves

; Leal, Ângela Mérice de Oliveira

; Roscani, Meliza Goi

Jornal Vascular Brasileiro

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2023, Volumen 22 elocation e20230076

Resumen: En Pt | Texto: En Pt | PDF: En | PDF: Pt

Abstract Background Prediabetes (PD) is defined as impaired fasting glucose and/or impaired glucose tolerance (IGT) and may be associated with high risk of cardiovascular injury. It is recommended that PD patients be screened for signs of arterial stiffness and cardiovascular injury to reinforce therapeutic strategies. Objectives To identify pulse wave velocity values discriminative for arterial stiffness and cardiovascular injury in PD patients. Methods A cross-sectional study was conducted with PD (N=43) and normoglycemic (N=37) patients who underwent clinical evaluation, arterial stiffness assessment by carotid-femoral pulse wave velocity (cfPWV) using SphygmoCor, laboratory blood analysis, investigation of morphological and functional cardiac variables by transthoracic echocardiogram, and assessment of carotid intima-media-thickness (CIMT) by carotid ultrasonography. A statistical analysis was performed using SPSS software and values of p<0.05 were considered significant. Results A cfPWV cut-off value of 6.9 m/s was identified for IGT (Sensitivity [SE]: 74% and Specificity [SP]: 51%). Comparison of general data and risk factors between subsets with values above and below this cutoff value revealed higher rates of fasting glucose (p=0.02), obesity (p=0.03), dyslipidemia (p=0.004), early signs of left ventricle (p=0.017) and right ventricle (p=0.03) impaired diastolic function, and elevated CIMT in subjects with cfPWV ≥ 6.9m/s (p=0.04). Conclusions In PD patients, a cfPWV cutoff of 6.9 m/s was considered a discriminative value for arterial stiffness. These findings highlight the value of early investigation of cardiovascular injury and aggressive therapy strategies with good control of risk factors in PD.

Resumo Contexto O pré-diabetes (PD) é definido como glicemia de jejum alterada e/ou tolerância à glicose alterada (TGA) e pode estar associado a alto risco de lesão cardiovascular. Recomenda-se discriminar quais pacientes com PD podem apresentar sinais de rigidez arterial e lesão cardiovascular para reforçar as estratégias terapêuticas. Objetivos Identificar os valores discriminativos da velocidade de onda de pulso determinantes de rigidez arterial e lesão cardiovascular em pacientes com PD. Métodos Estudo transversal em pacientes com PD (N=43) e normoglicêmicos (N=37) submetidos a avaliação clínica, avaliação da rigidez arterial pela velocidade da onda de pulso carótido-femoral (cfPWV) utilizando SphygmoCor, análise laboratorial de sangue, investigação de alterações morfológicas e variáveis cardíacas funcionais por ecocardiograma transtorácico e avaliação da espessura íntima-média carotídea (EIMC) pela ultrassonografia da carótida. A análise estatística foi realizada no software SPSS, e valores de p<0,05 foram considerados significativos. Resultados Foi identificado um valor de corte cfPWV de 6,9 m/s para TGA (sensibilidade 74% e especificidade 51%). A comparação dos dados e fatores de risco entre valores acima e abaixo do valor de corte estabelecido revelou glicemia de jejum elevada (p=0,02), obesidade (p=0,03), dislipidemia (p=0,004), sinais precoces de função diastólica prejudicada do ventrículo esquerdo (p=0,017) e ventrículo direito (p=0,03) e maior EIMC em cfPWV ≥6,9m/s (p=0,04). Conclusões Em pacientes com PD, o cfPWV de 6,9 m/s foi considerado um valor discriminativo de rigidez arterial. Esses achados reforçam que a investigação precoce da lesão cardiovascular e uma estratégia com terapia agressiva são valiosas no controle dos fatores de risco na PD.

https://doi.org/10.1590/1677-5449.202300762

11.

Alternative measures to evaluate the accuracy and bias of genomic predictions with censored records
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Pereira, Geraldo Magela da Cruz

; Martins Filho, Sebastião

; Veroneze, Renata

; Brito, Luiz Fernando

; Santos, Vinícius Silva dos

; Glória, Leonardo Siqueira

Acta Scientiarum. Animal Sciences

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2023, Volumen 45 elocation e61509

Resumen: En | Texto: En | PDF: En

ABSTRACT. This study aimed to propose and compare metrics of accuracy and bias of genomic prediction of breeding values for traits with censored data. Genotypic and censored-phenotypic information were simulated for four traits with QTL heritability and polygenic heritability, respectively: C1: 0.07-0.07, C2: 0.07-0.00, C3: 0.27-0.27, and C4: 0.27-0.00. Genomic breeding values were predicted using the Mixed Cox and Truncated Normal models. The accuracy of the models was estimated based on the Pearson (PC), maximal (MC), and Pearson correlation for censored data (PCC) while the genomic bias was calculated via simple linear regression (SLR) and Tobit (TB). MC and PCC were statistically superior to PC for the trait C3 with 10 and 40% censored information, for 70% censorship, PCC yielded better results than MC and PC. For the other traits, the proposed measures were superior or statistically equal to the PC. The coefficients associated with the marginal effects (TB) presented estimates close to those obtained for the SLR method, while the coefficient related to the latent variable showed almost unchanged pattern with the increase in censorship in most cases. From a statistical point of view, the use of methodologies for censored data should be prioritized, even for low censoring percentages.

https://doi.org/10.4025/actascianimsci.v45i1.61509

12.

IMPACTO-MR: um estudo brasileiro de plataforma nacional para avaliar infecções e multirresistência em unidades de terapia intensiva
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Tomazini, Bruno M

; Nassar Jr, Antonio Paulo

; Lisboa, Thiago Costa

; Azevedo, Luciano César Pontes de

; Veiga, Viviane Cordeiro

; Catarino, Daniela Ghidetti Mangas

; Fogazzi, Debora Vacaro

; Arns, Beatriz

; Piastrelli, Filipe Teixeira

; Dietrich, Camila

; Negrelli, Karina Leal

; Jesuíno, Isabella de Andrade

; Reis, Luiz Fernando Lima

; Mattos, Renata Rodrigues de

; Pinheiro, Carla Cristina Gomes

; Luz, Mariane Nascimento

; Spadoni, Clayse Carla da Silva

; Moro, Elisângela Emilene

; Bueno, Flávia Regina

; Sampaio, Camila Santana Justo Cintra

; Silva, Débora Patrício

; Baldassare, Franca Pellison

; Silva, Ana Cecilia Alcantara

; Veiga, Thabata

; Barbante, Leticia

; Lambauer, Marianne

; Campos, Viviane Bezerra

; Santos, Elton

; Santos, Renato Hideo Nakawaga

; Laranjeiras, Ligia Nasi

; Valeis, Nanci

; Santucci, Eliana

; Miranda, Tamiris Abait

; Patrocínio, Ana Cristina Lagoeiro do

; Carvalho, Andréa de

; Sousa, Eduvirgens Maria Couto de

; Sousa, Ancelmo Honorato Ferraz de

; Malheiro, Daniel Tavares

; Bezerra, Isabella Lott

; Rodrigues, Mirian Batista

; Malicia, Julliana Chicuta

; Silva, Sabrina Souza da

; Gimenes, Bruna dos Passos

; Sesin, Guilhermo Prates

; Zavascki, Alexandre Prehn

; Sganzerla, Daniel

; Medeiros, Gregory Saraiva

; Santos, Rosa da Rosa Minho dos

; Silva, Fernanda Kelly Romeiro

; Cheno, Maysa Yukari

; Abrahão, Carolinne Ferreira

; Oliveira Junior, Haliton Alves de

; Rocha, Leonardo Lima

; Nunes Neto, Pedro Aniceto

; Pereira, Valéria Chagas

; Paciência, Luis Eduardo Miranda

; Bueno, Elaine Silva

; Caser, Eliana Bernadete

; Ribeiro, Larissa Zuqui

; Fernandes, Caio Cesar Ferreira

; Garcia, Juliana Mazzei

; Silva, Vanildes de Fátima Fernandes

; Santos, Alisson Junior dos

; Machado, Flávia Ribeiro

; Souza, Maria Aparecida de

; Ferronato, Bianca Ramos

; Urbano, Hugo Corrêa de Andrade

; Moreira, Danielle Conceição Aparecida

; Souza-Dantas, Vicente Cés de

; Duarte, Diego Meireles

; Coelho, Juliana

; Figueiredo, Rodrigo Cruvinel

; Foreque, Fernanda

; Romano, Thiago Gomes

; Cubos, Daniel

; Spirale, Vladimir Miguel

; Nogueira, Roberta Schiavon

; Maia, Israel Silva

; Zandonai, Cassio Luis

; Lovato, Wilson José

; Cerantola, Rodrigo Barbosa

; Toledo, Tatiana Gozzi Pancev

; Tomba, Pablo Oscar

; Almeida, Joyce Ramos de

; Sanches, Luciana Coelho

; Pierini, Leticia

; Cunha, Mariana

; Sousa, Michelle Tereza

; Azevedo, Bruna

; Dal-Pizzol, Felipe

; Damasio, Danusa de Castro

; Bainy, Marina Peres

; Beduhn, Dagoberta Alves Vieira

; Jatobá, Joana D’Arc Vila Nova

; Moura, Maria Tereza Farias de

; Rego, Leila Rezegue de Moraes

; Silva, Adria Vanessa da

; Oliveira, Luana Pontes

; Sodré Filho, Eliene Sá

; Santos, Silvana Soares dos

; Neves, Itallo de Lima

; Leão, Vanessa Cristina de Aquino

; Paes, João Lucidio Lobato

; Silva, Marielle Cristina Mendes

; Oliveira, Cláudio Dornas de

; Santiago, Raquel Caldeira Brant

; Paranhos, Jorge Luiz da Rocha

; Wiermann, Iany Grinezia da Silva

; Pedroso, Durval Ferreira Fonseca

; Sawada, Priscilla Yoshiko

; Prestes, Rejane Martins

; Nascimento, Glícia Cardoso

; Grion, Cintia Magalhães Carvalho

; Carrilho, Claudia Maria Dantas de Maio

; Dantas, Roberta Lacerda Almeida de Miranda

; Silva, Eliane Pereira

; Silva, Antônio Carlos da

; Oliveira, Sheila Mara Bezerra de

; Golin, Nicole Alberti

; Tregnago, Rogerio

; Lima, Valéria Paes

; Silva, Kamilla Grasielle Nunes da

; Boschi, Emerson

; Buffon, Viviane

; Machado, André Sant’Ana

; Capeletti, Leticia

; Foernges, Rafael Botelho

; Carvalho, Andréia Schubert de

; Oliveira Junior, Lúcio Couto de

; Oliveira, Daniela Cunha de

; Silva, Everton Macêdo

; Ribeiro, Julival

; Pereira, Francielle Constantino

; Salgado, Fernanda Borges

; Deutschendorf, Caroline

; Silva, Cristofer Farias da

; Gobatto, Andre Luiz Nunes

; Oliveira, Carolaine Bomfim de

; Dracoulakis, Marianna Deway Andrade

; Alvaia, Natália Oliveira Santos

; Souza, Roberta Machado de

; Araújo, Larissa Liz Cardoso de

; Melo, Rodrigo Morel Vieira de

; Passos, Luiz Carlos Santana

; Vidal, Claudia Fernanda de Lacerda

; Rodrigues, Fernanda Lopes de Albuquerque

; Kurtz, Pedro

; Shinotsuka, Cássia Righy

; Tavares, Maria Brandão

; Santana, Igor das Virgens

; Gavinho, Luciana Macedo da Silva

; Nascimento, Alaís Brito

; Pereira, Adriano J

; Cavalcanti, Alexandre Biasi

Revista Brasileira de Terapia Intensiva

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Dic 2022, Volumen 34 Nº 4 Paginas 418 - 425

Resumen: En Pt | Texto: En Pt | PDF: En | PDF: Pt

ABSTRACT Objective: To describe the IMPACTO-MR, a Brazilian nationwide intensive care unit platform study focused on the impact of health care-associated infections due to multidrug-resistant bacteria. Methods: We described the IMPACTO-MR platform, its development, criteria for intensive care unit selection, characterization of core data collection, objectives, and future research projects to be held within the platform. Results: The core data were collected using the Epimed Monitor System® and consisted of demographic data, comorbidity data, functional status, clinical scores, admission diagnosis and secondary diagnoses, laboratory, clinical, and microbiological data, and organ support during intensive care unit stay, among others. From October 2019 to December 2020, 33,983 patients from 51 intensive care units were included in the core database. Conclusion: The IMPACTO-MR platform is a nationwide Brazilian intensive care unit clinical database focused on researching the impact of health care-associated infections due to multidrug-resistant bacteria. This platform provides data for individual intensive care unit development and research and multicenter observational and prospective trials.

RESUMO Objetivo: Descrever o IMPACTO-MR, um estudo brasileiro de plataforma nacional em unidades de terapia intensiva focado no impacto das infecções por bactérias multirresistentes relacionadas à assistência à saúde. Métodos: Descrevemos a plataforma IMPACTO-MR, seu desenvolvimento, critérios para seleção das unidades de terapia intensiva, caracterização da coleta de dados, objetivos e projetos de pesquisa futuros a serem realizados na plataforma. Resultados: Os dados principais foram coletados por meio do Epimed Monitor System® e consistiram em dados demográficos, dados de comorbidades, estado funcional, escores clínicos, diagnóstico de internação e diagnósticos secundários, dados laboratoriais, clínicos e microbiológicos e suporte de órgãos durante a internação na unidade de terapia intensiva, entre outros. De outubro de 2019 a dezembro de 2020, 33.983 pacientes de 51 unidades de terapia intensiva foram incluídos no banco de dados principal. Conclusão: A plataforma IMPACTO-MR é um banco de dados clínico brasileiro de unidades de terapia intensiva focado na pesquisa do impacto das infecções por bactérias multirresistentes relacionadas à assistência à saúde. Essa plataforma fornece dados para o desenvolvimento e pesquisa de unidades de terapia intensiva individuais e ensaios clínicos observacionais e prospectivos multicêntricos.

https://doi.org/10.5935/0103-507x.20220209-pt

13.

EXTRAÇÃO DE CORANTES TÊXTEIS UTILIZANDO SISTEMAS AQUOSOS BIFÁSICOS COMPOSTOS POR 2-PROPANOL E SAIS DE SULFATO
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Pimentel, Juliana Gomes

; Gandolfi, Olga Reinert Ramos

; Sampaio, Vanessa Santos

; Veríssimo, Lizzy Ayra Alcântara

; Rodrigues, Luciano Brito

; Veloso, Cristiane Martins

; Fontan, Rafael da Costa Ilhéu

; Bonomo, Renata Cristina Ferreira

Química Nova

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Sep 2022, Volumen 45 Nº 9 Paginas 1039 - 1046

Resumen: Pt | Texto: Pt | PDF: Pt

Aqueous Two Phase Systems (ATPS) composed of 2-propanol + inorganic salt (Na2SO4/MgSO4) + water, at different temperatures T = (20, 30, 40 and 50) °C were applied in the partition studies of the textile dyes Yellow, Blue Royal and Red Dianix CC. The thermodynamic parameters of the free transfer energy (∆Gtr), enthalpy (∆Htr) and entropy (∆Str), respectively, were determined for dye partitioning, using the Van’t Hoff equation. The values of the partition coefficients of textile dyes Yellow, Royal Blue and Red Dianix CC, ranged from 14.21 to 1610.00, 15.15 to 994.00 and 17.32 to 311.75, respectively; and with dye extraction yields ranging from 93.17 to 99.93; 94.53 to 99.89 and 97.19 to 99.64, respectively. Based on the ∆Gtr results, it was verified that the dyes partition process was thermodynamically spontaneous, in all evaluated systems. For the 2-propanol + sodium sulfate ATPS, there was a prevalence of the enthalpic contribution over the entropic contribution (∆Htr > ∆Str), while for the 2-propanol + magnesium sulfate systems, a greater predominance of the entropic contribution was observed (∆Htr < ∆Str). The recovery yields (Y) values obtained were above 90% for all systems.

https://doi.org/10.21577/0100-4042.20170911

14.

Common mental disorders among medical students: systematic review and meta-analysis of Brazilian studies
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Soares, Silvio José Batista

; Fernandes, Cláudia Fernanda Garcez

; Tabalipa, Renata

; Kogima, Felipe

; Jubini, Marcelo Augusto Moreira

; Dias, Isabella Martins Vieira

; Soares, Victor Emanuel Miranda

; Amaral, Severina Silva

; Cruz, Michele Santos da

; Guerra, Paulo Henrique

Sao Paulo Medical Journal

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Ago 2022, Volumen 140 Nº 4 Paginas 615 - 622

Resumen: En | Texto: En | PDF: En

ABSTRACT BACKGROUND: Common mental disorders (CMDs) have been correlated with consequences in different domains of life. OBJECTIVE: To summarize the prevalence rates of CMDs and factors associated with them among students at Brazilian medical schools. DESIGN AND SETTING: Systematic review and meta-analysis of studies developed in Brazilian medical schools. METHODS: In October 2021, searches were carried out in seven electronic databases, in Google Scholar and in reference lists. Observational studies reporting prevalence rates of CMDs among students at Brazilian medical schools were sought. Variables associated with CMDs arising from multivariate regression models were included in the synthesis. A meta-analysis was developed using a random-effects model and the risk of bias was assessed using an instrument developed from previous references. RESULTS: Fourteen original studies were included. The pooled prevalence rate of CMDs among undergraduate students at Brazilian medical schools was 43.3% (95% confidence interval = 38.9% to 47.6%; I2 = 87%; n = 3,927). Among the nine studies in which multivariate analyses were conducted, five showed risk associations between CMDs and medical school-related dissatisfactions, among which the desire to abandon the medical course can be highlighted (n = 3). In three studies, CMDs were associated with sleep indicators. CONCLUSION: Considering that the prevalence of CMDs among medical students is higher than in the general population, we recommend that Brazilian medical schools should give greater attention to this topic, and should enable expansion of care offerings relating to mental health. SYSTEMATIC REVIEW REGISTRATION: Prospective Register of Systematic Reviews (PROSPERO) database (CRD42020142184).

https://doi.org/10.1590/1516-3180.2021.0851.r1.27012022

15.

Donor-derived TB after kidney transplantation: a case report
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Ulisses, Luiz Roberto de Sousa

; Cardoso, Helen Souto Siqueira

; Alves, Inara Creão Costa

; Medeiros, Isabela Novais

; Oliveira, Camilla Garcia de

; Almeida, Tiago Martins de

; Castro, Fabíola Fernandes dos Santos

; Silva, Claudia Neto Gonçalves Neves da

; Lima, Laura Viana de

; Fontoura, Renata Pereira

; Silva, Eduardo Resende Sousa e

; Araújo, Pollyana Lopes de

; Ferreira, Gustavo de Sousa Arantes

Brazilian Journal of Nephrology

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Mar 2022, Volumen 44 Nº 1 Paginas 126 - 129

Resumen: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo Introdução: A tuberculose (TB) é uma possível complicação grave do transplante de órgãos sólidos, associada à alta mortalidade e morbidade. A TB pós-transplante tem patogênese variada com muitas abordagens para sua prevenção, que é a forma mais importante de reduzir sua incidência. O tratamento da TB em receptores de órgãos é um desafio devido à toxicidade dos medicamentos e à interação com imunossupressores. Relato de caso: uma mulher de 18 anos que foi submetida a transplante renal de um doador falecido e recebeu alta com função renal adequada foi readmitida no 37º dia de pós-operatório com febre. A TC mostrou sinais de TB miliar e coleção de fluidos além de fistulização do enxerto através da pele. A paciente apresentou BAAR positivo no fluido drenado e bacilo de Koch na urina. Ela foi tratada com um esquema de quatro medicamentos (rifampicina, isoniazida, pirazinamida e etambutol), com ótima resposta e função de enxerto preservada. Fomos informados de que o receptor do rim contralateral também apresentou TB pós-transplante, implicando em uma origem derivada do doador. Conclusão: A TB é um importante diagnóstico diferencial para complicações infecciosas em pacientes após transplante de órgãos sólidos, especialmente em regiões endêmicas. Sua apresentação clínica inicial pode não ser específica e deve ser suspeitada na presença de febre ou formação de coleções de fluidos. A suspeita de TB é a chave para o diagnóstico precoce e desfechos satisfatórios na TB pós-transplante.

Abstract Introduction: Tuberculosis (TB) is a possible serious complication of solid organ transplantation, associated with high mortality and morbidity. Post-transplant TB has varied pathogenesis with many approaches to its prevention, which is the most important way to reduce its incidence. Treatment of TB in organ recipients is challenging because of drug toxicity and interaction with immunosuppressants. Case report: an 18-year-old woman that underwent kidney transplantation from a deceased donor and was discharged with fair renal function was readmitted at 37th postoperative day with fever. CT showed signs of miliary TB and fluid collection besides graft fistulization through the skin. The patient presented positive BAAR in the drained fluid and Koch's bacillus in the urine. She was treated with a four-drug regimen (rifampicin, isoniazid, pyrazinamide, and etambutol), with great response and preserved graft function. We were informed that the recipient of the contralateral kidney also presented post-transplant TB, implying in a donor-derived origin. Conclusion: TB is an important differential diagnosis for infectious complications in patients after solid-organ transplantation, especially in endemic regions. Its initial clinical presentation can be unspecific and it should be suspected in the presence of fever or formation of fluid collections. The suspicion of TB is the key to early diagnosis and satisfactory outcomes in post-transplant TB.

https://doi.org/10.1590/2175-8239-jbn-2020-0117

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