ABSTRACT Objective: To predict the risk of osteonecrosis (ON) according to the Neer and Hertel et al. classification for surgically treated proximal humeral fractures after at least one year of follow-up. Methods: This is a retrospective, cross-sectional, and observational cohort study. A total of 44 patients, 16 (36.36%) men and 28 (63.63%) women, with a mean age of 61.36 years, participated in this study. Lesions were categorized according to Neer and Hertel’s classifications, considering the preoperative prognosis for ON. After at least a year of follow-up, patients were reassessed. Data were evaluated using IBM SPSS Statistics®. Results: A total of three patients (6.8%) developed osteonecrosis. Comparisons showed no statistically significant difference, but we observed a superior association of osteonecrosis for the Hertel classification than that of Neer. Conclusion: Both classifications showed a similar ability to identify patients at low risk of developing ON. New studies with a greater number of participants and sample homogeneity may intensify the value of the evaluation of clinical applicability and predictive capacity of the studied classifications with greater significance and correlation. Level of Evidence III, Case Control Study.

RESUMO Objetivo: Prognosticar o risco de osteonecrose (ON), segundo os critérios de Hertel et al. e a classificação de Neer, para fraturas do úmero proximal tratadas cirurgicamente após, pelo menos, um ano de seguimento. Métodos: Estudo de coorte retrospectiva, transversal e observacional. Foram encontrados 44 pacientes, sendo 16 (36,36%) do sexo masculino e 28 (63,63%) do feminino, com média de idade de 61,36 anos. As lesões foram categorizadas de acordo com os critérios de Neer e de Hertel et al., considerando o prognóstico pré-operatório para ON. Após pelo menos um ano de seguimento, os pacientes foram reavaliados. Os dados foram analisados por meio do programa IBM SPSS Statistics. Resultados: Três pacientes (6,8%) evoluíram com ON. As comparações não demonstraram diferença estatística significante, embora tenha sido possível observar associação superior para a classificação de Hertel et al. em comparação com a de Neer. Conclusão: As duas classificações apresentaram habilidade semelhante para identificar pacientes com baixo risco de desenvolver ON. Sugere-se a realização de novos estudos com maior número de participantes e homogeneidade da amostra para intensificar o valor da avaliação da aplicabilidade clínica e da capacidade preditiva das classificações estudadas, com aumento da significância e da correlação. Nível de Evidência III, Estudo Caso Controle.

RESUMO Objetivo: Avaliar a concordância intra e interobservadores entre os sistemas de classificação Neer, AO e AO/OTA nas fraturas do úmero proximal de indivíduos adultos. Métodos: Após a aplicação dos critérios de inclusão e exclusão determinados para a realização deste trabalho, foram selecionadas 100 radiografias de pacientes com fratura do úmero proximal. Estas foram submetidas à avaliação de quatro examinadores com níveis diferentes de expertise. A avaliação foi realizada em dois momentos distintos, com intervalo de 21 dias entre cada análise. As imagens foram randomizadas para a segunda avaliação por um pesquisador que não participou da seleção de imagens. Foi aplicado o teste kappa de Fleiss para verificar a concordância intra e interobservador. Resultados: Na primeira avaliação obtivemos valores de k = 0,724, k = 0,490 e k = 0,599, enquanto na segunda avaliação, os valores k = 0,759, k = 0,772 e k = 0,858 para as avaliações de Neer, AO e AO/OTA, respectivamente. Isso indica que a concordância intraobservador melhorou na segunda avaliação. Conclusões: As avaliações passaram de moderada para substancial para a classificação AO e de moderada para praticamente perfeita para o sistema AO/OTA. O nível de concordância interobservadores foram considerados substanciais (0,61-0,80) com k = 0,669, k = 0,715 e k = 0,780 para as classificações de Neer, AO e AO/OTA, respectivamente. Nível de Evidência III, Estudo Transversal Observacional.

ABSTRACT Objective: Evaluating intra- and inter-observer agreement of the Neer, AO, and AO/OTA proximal humerus fractures classification systems in adults. Methods: In total, 100 X-rays of patients with proximal humerus fractures were selected according to the inclusion and exclusion criteria established in this study. They were evaluated by four evaluators with different levels of expertise. The evaluation was performed at two distinct moments, with an interval of 21 days between each analysis. Images were randomized for the second evaluation by a researcher who did not participate in the image selection process. A Fleiss Kappa test was performed to evaluate intra- and inter-observer agreement. Results: We observed a substantial agreement with k = 0.669, k = 0.715, and k = 0.780 for the Neer, AO, and AO/OTA classification systems, respectively. Conclusion: In the second evaluation, intra-observer agreement improved. In the first evaluation, we obtained values of k = 0.724, k = 0.490, and k = 0.599 for the evaluation of the Neer, AO, and AO/OTA classifications. In the second evaluation, the values k = 0.759, k = 0.772, and k = 0.858. Therefore, the evaluations went from moderate to substantial for the AO classification and from moderate to practically perfect for the AO/OTA classification. The level of inter-observer agreement was substantial (0.61-0.80), with k = 0.669, k = 0.715, and k = 0.780 for the Neer, AO, and AO/OTA classifications, respectively. Level of Evidence III, Cross-Sectional Observational Study.

RESUMO Objetivo: Determinar a eficiência do protocolo de profilaxia contra trombose venosa profunda (TVP) em pacientes de pós-operatório devido à fratura do fêmur proximal e avaliar a diferença estatística entre os tipos de fratura. Método: Estudo retrospectivo observacional a partir da análise de prontuários de pacientes submetidos à intervenção cirúrgica em razão de fratura do fêmur proximal no período de 2017 e 2021 no Hospital IFOR - Rede D’Or São Luiz. Foram selecionados 99 pacientes segundo critérios de inclusão e exclusão determinados previamente, que foram catalogados por: idade, sexo, lateralidade, dias de internação, entre outros. Conforme protocolo institucional, utilizou-se quimioprofilaxia com heparina de baixo peso molecular, associado ao uso concomitante de compressão pneumática e meias elásticas, e deambulação precoce. O diagnóstico de TVP foi determinado por meio de avaliação clínica e exames de imagem, como a ultrassonografia com Doppler venoso e exames laboratoriais. Resultados: A utilização do protocolo se mostrou eficaz neste estudo, havendo apenas um paciente (1,01%) que desenvolveu TVP. Não foi possível atingir o objetivo secundário, pois a amostragem foi insuficiente. Conclusão: O protocolo institucional para a profilaxia de TVP foi eficiente, uma vez que apenas um paciente evoluiu com tal complicação. Nível de Evidência II, Estudo Prognóstico.

ABSTRACT Objective: To determine the efficiency of the deep venous thrombosis (DVT) prophylaxis protocol in postoperative patients due to proximal femoral fractures and to assess any statistical difference between the types of fractures. Methods: A retrospective observational study based on the analysis of patients’ medical records who underwent to a surgical intervention due to proximal femoral fractures in 2017 and 2021 at Hospital IFOR - Rede D’Or São Luiz. These patients were selected according to previously determined inclusion and exclusion criteria. A total of 99 patients were included divided by sex, age, laterality, length of stay, and death. According to the institutional protocol, was used chemoprophylaxis with low-molecular-weight heparin, associated use of pneumatic compression with compression stockings, and early gait. The DVT diagnosis was determined by clinical evaluation and imaging tests such as venous Doppler ultrasonography and laboratory tests. Results: The protocol was effective in our study. Only one (1.01%) patient developed DVT. Due to the lack of samples, we could not achieve our secondary objective. Conclusion: The institutional protocol is efficient for DVT prophylaxis and essential in these cases. Level of Evidence II, Prognostic Study.

RESUMO Objetivo: Avaliar e comparar o fluxo de pacientes no pronto-socorro e o número de cirurgias, bem como determinar a incidência das doenças pelo impacto gerado pela pandemia nos meses de abril, maio, junho e julho de 2020. Métodos: Trata-se de estudo retrospectivo transversal que analisou prontuários médicos por meio do software TASY Phillips. Foram compiladas as informações do ano de 2019, que serviram como base para realizar as análises comparativas. Foi utilizado o CID-10 para determinar as diferentes afecções de maior incidência. Resultados: Houve redução nos atendimentos de 49,3%; a redução do número de cirurgias foi 34,39%; os principais diagnósticos em ordem decrescente foram: dor na coluna lombar (18,76%), dor articular (14,82%), cervicalgia (7,7%), entorse de tornozelo (4,2%) e dor no membro (3,54%). Conclusão: Houve decréscimo do número de atendimentos e da incidência global de cirurgias em nosso serviço. Nível de Evidência II, Estudo Retrospectivo.

ABSTRACT Objective: To evaluate and compare the patient flow in the emergency department and the number of surgeries performed, as well as to determine the incidence of diseases due to the impact generated by the pandemic in April, May, June, and July 2020. Methods: This is a retrospective cross-sectional study that analyzed medical records using the TASY Phillips software. The 2019 information was compiled and served as a basis accomplish our comparative analyses. The ICD-10 was used to determine the different conditions considering the highest incidence of them. Results: there was a reduction in attendance of 49.3%; the reduction in the number of surgeries was 34.39%; among the main diagnoses in decreasing order were: Pain in the Lumbar Spine (18.76%), Joint Pain (14.82%), Neck Pain (7.7%), Ankle Sprain (4.2%) and Pain in the Limb (3.54%). Conclusion: There was a decrease in the number of visits and the overall incidence of surgeries in our service. Level of Evidence II, Retrospective Study.

RESUMO Introdução: as disfunções temporomandibulares são afecções musculoesqueléticas dolorosas que afetam os músculos da mastigação, a articulação temporomandibular e diversas estruturas anatômicas do sistema estomatognático. Objetivo: caracterizar as disfunções temporomandibulares e as dores musculares em pacientes maiores de 18 anos. Métodos: foi realizado um estudo transversal descritivo em pessoas maiores de 18 anos que compareceram à consulta de prótese dentária na Clínica de Especialidades Estomatológicas “Manuel Cedeño” em Bayamo, província de Granma, no período de janeiro a dezembro de 2018. Foram utilizaram as variáveis: idade, sexo, índice de disfunção clínica e dor muscular à palpação. O diagnóstico foi feito por anamnese e exame físico, e o índice de disfunção clínica foi determinado pelo índice de Helkimo modificado por Maglione. Resultados: houve predomínio do sexo feminino (62,4%) e na faixa etária de 40-49 anos (47,2%), disfunção moderada (46,4%) predominou em ambos os sexos, feminino (47,4%) e masculino. (44,7%). 89,6% dos pacientes examinados relataram dor muscular à palpação. Conclusões: as disfunções temporomandibulares predominaram no sexo feminino e na faixa etária de 40 a 49 anos. A maioria dos pacientes apresentou índice moderado de disfunção clínica e dor muscular à palpação é um sintoma frequente nesses pacientes.

ABSTRACT Introduction: temporomandibular disorders are a painful musculoskeletal condition that affects the chewing muscles, the temporomandibular joint and various anatomical structures of the stomatognathic system. Objective: to characterize temporomandibular disorders and muscle pain in patients over 18 years of age. Methods: a cross-sectional descriptive study was carried out in people over 18 years of age who attended the dental prosthesis consultation at the “Manuel Cedeño” Stomatological Specialties Clinic in Bayamo, Granma province, in the period between January and December 2018. They were used the variables: age, sex, index of clinical dysfunction and muscle pain on palpation. Diagnosis was made by anamnesis and physical examination, and the index of clinical dysfunction was determined using the Helkimo index modified by Maglione. Results: there was a predominance of the female sex (62.4%) and the age group of 40-49 years of age (47.2%), moderate dysfunction (46.4%) predominated in both sexes, female (47, 4%) and male (44.7%). 89.6% of the patients examined reported muscle pain on palpation. Conclusions: temporomandibular disorders predominated in the female sex and the age group of 40-49 years. Most of the patients had a moderate clinical dysfunction index and muscle pain on palpation is a frequent symptom in these patients.

RESUMEN Introducción: los trastornos temporomandibulares son una condición músculo esquelética dolorosa que afecta los músculos de la masticación, la articulación temporomandibular y varias estructuras anatómicas del sistema estomatognático. Objetivo: caracterizar los trastornos temporomandibulares y el dolor muscular en pacientes mayores de 18 años. Métodos: se realizó un estudio descriptivo trasversal en mayores de 18 años que asistieron a la consulta de Prótesis estomatológica de la Clínica de Especialidades Estomatológicas “Manuel Cedeño” de Bayamo, provincia Granma, en el periodo comprendido entre enero y diciembre de 2018. Se utilizaron las variables: edad, sexo, índice de disfunción clínica y dolor muscular a la palpación. El diagnóstico se realizó mediante la anamnesis y el examen físico, además se determinó el índice de disfunción clínica utilizando el índice de Helkimo modificado por Maglione. Resultados: hubo predominio del sexo femenino (62,4%) y el grupo de edad de 40- 49 años de edad (47,2%), predominó la disfunción moderada (46,4%) en ambos sexos, femenino (47,4%) y masculino (44,7%). El 89,6% de los pacientes examinados refirieron dolor muscular a la palpación. Conclusiones: los trastornos temporomandibulares predominaron en el sexo femenino y el grupo de edad de 40- 49 años. La mayoría de los pacientes presentaron índice de disfunción clínica moderada y el dolor muscular a la palpación es un síntoma frecuente en estos pacientes.

ABSTRACT BACKGROUND: Postpoliomyelitis syndrome is a clinical condition that can affect poliomyelitis survivors. OBJECTIVE: Our aim was to evaluate knowledge of poliomyelitis and postpoliomyelitis syndrome among Brazilian healthcare professionals. DESIGN AND SETTING: Cross-sectional study conducted at a Brazilian public higher education institution located in the state of Goiás. METHODS: The participants (n = 578) were Brazilian physicians, physical therapists, nurses, nutritionists and psychologists. A self-administered questionnaire (30 questions) was designed to probe knowledge about poliomyelitis and postpoliomyelitis syndrome. From the questionnaire, we created a structured test to objectively evaluate the knowledge of these professionals. The test was composed of 20 questions and was scored over a range from 0 (totally ill-informed) to 20 (totally well-informed). RESULTS: In general, the physicians, physical therapists and nurses demonstrated better understanding of poliomyelitis and postpoliomyelitis syndrome. The healthcare professionals who had received previous information about poliomyelitis and postpoliomyelitis syndrome had significantly higher scores than those who had never received information (P < 0.001). On average, this difference was approximately 28.6%. CONCLUSIONS: The findings from the present study indicate that there is a critical need for improvement of knowledge about postpoliomyelitis syndrome among Brazilian healthcare professionals. The services provided by these professionals may therefore become compromised. Furthermore, public healthcare initiatives should be implemented to improve knowledge among healthcare professionals.

RESUMO Três espécies de Ascomycetes, gênero Camillea, foram registradas em um fragmento de floresta Amazônica na região de Santarém, Pará, Brasil. A ocorrência de C. leprieurii, C. cyclops e C. bilabiata expande a área de distribuição dessas espécies no estado. Camillea leprieurii foi registrada previamente nas regiões de Marabá, Oriximiná, Itaituba e Novo Progresso, enquanto C. cyclops havia sido registrada apenas no oeste do estado. Este é o primeiro registro de C. bilabiata no Pará. Fornecemos uma descrição morfológica dos espécimes e uma chave de identificação para as espécies de Camillea encontradas no Pará.

ABSTRACT Three species of the Ascomycetes genus Camillea were recorded in a fragment of Amazon rainforest in the region of Santarém, Pará state, Brazil. The occurrence of C. leprieurii, C. cyclops and C. bilabiata expand the range of distribution of these species in the state. Camillea leprieurii has previous records in the regions of Marabá, Oriximiná, Itaituba and Novo Progresso, while C. cyclops had been recorded in the west of the state. This is the first record of C. bilabiata for Pará. We provide a morphological description of the specimens and an identification key for Camillea species found in Pará.

ABSTRACT Introduction: Emotions are psychophysiological reactions that represent modes of adaptation to certain stimuli or events, such as illnesses or trauma, related to the need for bucomaxilofacial prosthetic treatment. Objective: To identify emotional states in patients before and after prosthetic bucomaxilofacial rehabilitation. Methods: A cross-sectional, descriptive and observational study was carried out in 48 patients cared for at Carlos Manuel de Céspedes y del Castillo General University Hospital, between June 2018 and June 2019, and who were applied psychological assessment instruments before and after they received rehabilitation treatment. Emotional experience, anxiety and depression were studied. Results: Before prosthetic treatment, patients presented sadness (66.66%), suffering (60.41%), weariness (54.16%), anguish (43.75%), and apathy (41.66%), with a high level of life experience-related intensity. After bucomaxilofacial prosthetic rehabilitation, emotional states decreased: anxiety decreased in 58.33% and depression decreased in 52.08% of the participants. Conclusions: Patients in need of bucomaxilofacial prosthesis experience sadness, suffering, weariness, anguish, apathy and high levels of anxiety and depression as a state before treatment. These emotions decrease after oral bucomaxilofacial prosthetic rehabilitation.

RESUMEN Introducción: Las emociones son reacciones psicofisiológicas que representan modos de adaptación a ciertos estímulos o eventos, como enfermedades o traumas, que se relacionan con la necesidad de tratamiento protésico bucomaxilofacial. Objetivo: Identificar los estados emocionales en pacientes antes y después de la rehabilitación protésica bucomaxilofacial. Métodos: Se realizó un estudio observacional descriptivo transversal, en 48 pacientes atendidos en el Hospital General Universitario “Carlos Manuel de Céspedes y del Castillo”, entre junio de 2018 a junio de 2019, a los cuales se le aplicaron instrumentos de evaluación psicológica antes y después del tratamiento rehabilitador. Se estudió la experiencia emocional, la ansiedad y depresión. Resultados: Antes del tratamiento protésico los pacientes presentaron: tristeza (66,66 %), sufrimiento (60,41 %), abatimiento (54,16 %), angustia (43,75 %) y apatía (41,66 %) con un alto nivel de intensidad vivencial. Luego de la rehabilitación protésica bucomaxilofacial, disminuyeron los estados emocionales: la ansiedad disminuyó en el 58,33 % de los participantes y la depresión en el 52,08 %. Conclusiones: Los pacientes con necesidad de protésica bucomaxilofacial experimentan tristeza, sufrimiento, abatimiento, angustia, apatía y altos niveles de ansiedad y depresión como estado antes del tratamiento. Estas emociones disminuyen luego de la rehabilitación protésica bucomaxilofacial.

ABSTRACT Introduction: Skeletal Class III maxillo-mandibular relationship is characterized by the non-physiological relationship between the dental arches, concave profile, maxillo-mandibular sagittal discrepancy and functional alterations that disturb the functioning of the stomatognathic system. In the national and international literature, there is no evidence of the effectiveness of treatment of Skeletal Class III maxillo-mandibular relationship with the use of twin block appliance. Objective: To evaluate the treatment of skeletal Class III maxillo-mandibular relationship with the use of twin block appliance. Material and Methods: A quasi-experimental intervention study was conducted in 43 patients with skeletal Class III maxillo-mandibular relationship at Manuel Cedeño Dental Specialties University Clinic during the period between January 2018 and June 2019. The study variables were: occlusion ratio, maxillo-mandibular skeletal classification, temporomandibular joint dysfunction and facial esthetics. The twin block appliance was applied to all patients as part of the orthopedic functional treatment. Results: Initially, 86,04 % of the patients had a mesioclusion, which was modified to neutroclusion in 81,39 %. Skeletal classification was corrected in 88,37 % of cases. Temporomandibular joint dysfunction improved to mild in 51,16 % of patients. Facial esthetics was not affected in 83,72 %. Conclusions: The ratio of dental occlusion and class III maxillo-mandibular skeletal relationship are corrected with the use of a twin block appliance, besides being a therapeutic choice that improves dysfunction of the temporomandibular joint and facial esthetics in patients with this dentomaxillofacial anomaly.

RESUMEN Introducción: la clase III esquelética máxilo-mandibular se caracteriza por la relación no fisiológica de los arcos dentarios, perfil cóncavo, discrepancia sagital máxilo-mandibular y alteraciones funcionales que perturban el funcionamiento del sistema estomatognático. En la literatura nacional e internacional no existe evidencia de la eficacia del tratamiento con twin block de la clase III esquelética máxilo-mandibular. Objetivo: evaluar el tratamiento de la clase III esquelética máxilo-mandibular con el uso de twin block. Material y Métodos: se realizó un estudio de intervención de tipo cuasi-experimental, en 43 pacientes con clase III esquelética máxilo-mandibular, en la Clínica Universitaria de Especialidades Estomatológicas “Manuel Cedeño”, en el período de enero de 2018 a junio de 2019. Se estudiaron las variables: relación de oclusión, clasificación esquelética máxilo-mandibular, disfunción de la articulación temporomandibular y estética facial. A todos los pacientes se les aplicó el twin block como parte del tratamiento ortopédico-funcional. Resultados: inicialmente el 86,04% de los pacientes tenían una mesioclusión, la que se modificó a neutroclusión en el 81,39%. La clasificación esquelética se corrigió en el 88,37% de los casos. La disfunción de la articulación temporomandibular mejoró, a leve, en el 51,16% de los pacientes. La estética facial resultó no afectada en el 83,72%. Conclusiones: Con el uso de twin block se corrige la relación de oclusión dentaria y la clase III esquelética máxilo-mandibular, además de ser una opción terapéutica que mejora la disfunción de la articulación temporomandibular y la estética facial en pacientes con esta anomalía dentomaxilofacial.

RESUMO A alta diversidade do gênero Geastrum e a dificuldade de obtenção de culturas miceliais prejudicam o estudo ecofisiológico e a exploração do potencial biotecnológico do táxon. Nesse estudo, foram testados diferentes meios de cultivo, visando a obtenção de culturas miceliais para G. lloydianum e G. subiculosum coletadas na Amazônia brasileira. A germinação dos esporos, o isolamento das culturas monocarióticas e o cruzamento sexual in vitro são apresentados, além de uma breve descrição morfológica das culturas obtidas. O meio de cultura Batata Dextrose Ágar (BDA) foi o mais promissor dentre os meios de cultura testados no cultivo das duas espécies. Reportamos o maior crescimento em cultura de ágar já registrado para esse gênero (4,9 mm por semana para G. lloydianum e 7,5 mm por semana para G. subiculosum). Nesse meio de cultivo, os esporos germinaram após 35-40 dias de incubação e o isolamento de culturas monocarióticas das duas espécies, assim com os cruzamentos sexuais in vitro, foram realizados com sucesso.

ABSTRACT The high diversity of the genus Geastrum and the difficulty of obtaining mycelial cultures impairs the study of the ecophysiology and the exploration of the biotechnological potential of the taxon. In this study, different culture media were tested to obtain mycelial cultures for G. lloydianum and G. subiculosum collected in the Brazilian Amazon. Data on spore germination, and isolation of monokaryotic cultures and in vitro sexual reproduction are presented, as well as a brief morphological description of the cultures obtained. For both species, Potato Dextrose Agar (PDA) was the most promising of the tested culture media. The highest growth in agar culture ever recorded for this genus is reported (4.9 mm per week for G. lloydianum and 7.5 mm for G. subiculosum). In the PDA culture medium, spores germinated after 35-40 days of incubation and the isolation of monokaryotic cultures of the two species, as well as in vitro sexual crosses, were successfully performed.

Coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly contagious infection that may break the healthcare system of several countries. Here, we aimed at presenting a critical view of ongoing drug repurposing efforts for COVID-19 as well as discussing opportunities for development of new treatments based on current knowledge of the mechanism of infection and potential targets within. Finally, we also discuss patent protection issues, cost effectiveness and scalability of synthetic routes for some of the most studied repurposing candidates since these are key aspects to meet global demand for COVID-19 treatment.

ABSTRACT Introduction: dental implants rehabilitation is one of the most novel treatments applied in Granma, Cuba. Its characterization favors service quality. Objective: to characterize dental implants rehabilitation at Clinical Dentistry Academy of Bayamo, Cuba from February 2014 to December 2017. Method: a descriptive and transversal study was carried out, for characterizing dental implants rehabilitation patients, attended at Manuel Cedeño Clinical Dentstry Academy, in Bayamo province, Granma, Cuba, from February 2014 to December 2017. Universe was formed by 144 patients, who attended the stomatological prosthesis consultation within the same period and received dental implants rehabilitation. Results: age group from 38 to 47 (32.64) was the most representative, in which female patients prevailed (66.67%). Implants were placed in the maxilla rather than the mandible up to (71,28-28,72%). The MIS implants (65,38%) outnumbered the Leader (34,62%). Most performed maxilla treatments were the unitary cemented prosthesis and the screwed unitary prosthesis in the jaw. We succeeded in most of our patients, with immediate or delayed loading in both commercial brands. Osseointegration process failure was the only complication. Conclusions: dental implants rehabilitation process, guarantees aesthetic and functional success in most of the patients.

RESUMEN Introducción: la rehabilitación protésica sobre implantes constituye uno de los tratamientos más novedosos aplicados en Granma y en Cuba. Su caracterización contribuye a elevar la calidad del servicio. Objetivo: caracterizar la rehabilitación con implantes dentarios en la Clínica Universitaria de Especialidades Estomatológicas de Bayamo. Método: se realizó un estudio descriptivo-transversal en 144 pacientes que recibieron rehabilitación mediante implantes dentales en la Clínica Universitaria de Especialidades Estomatológicas Manuel Cedeño, de Bayamo, provincia de Granma, durante febrero de 2014 a diciembre de 2017. Resultados: en los pacientes atendidos con implantes predominaron las mujeres, con el 66,67%, y el grupo de edad de 38-47 años (32,64%). Se colocaron mayor cantidad de implantes en el maxilar que en la mandíbula (71,28-28,72%). Los implantes MIS (65,38%) superan en número a los Leader (34,62%). El tipo de tratamiento que más se realizó en el maxilar fue la prótesis unitaria cementada, y en la mandíbula, la prótesis unitaria atornillada. Se logró éxito terapéutico en la mayoría de nuestros pacientes, tanto con la carga inmediata como con la diferida en ambas marcas comerciales. La única complicación en nuestros pacientes radicó en la falla del proceso de osteointegración. Conclusiones: la rehabilitación sobre implantes dentales garantiza el éxito estético y funcional en la mayoría de los pacientes tratados.

ABSTRACT Skeletal class II and III anomalies are a developmental condition, in most cases, not due to pathological processes, but to a moderate distortion of normal development, this causes alteration of the aesthetic that influences the levels of self-esteem of the patients. The objective of the study was to evaluate the skeletal and self-esteem modifications with twin blocks. We performed a quasi-experimental modality before and after without a control group, in 35 patients with skeletal class II and III, admitted to the Orthodontic Consultation of the University Clinic of Stomatological Specialties "Manuel Cedeño", in the period from January to November 2018.The clinical examination, the cephalometry and the Self-esteem Inventory prepared by Coppersmiths were used as diagnostic means. It was obtained as a result that 71,42% belong to the ages of 12 and 13 years, and 54,28 % are female; 65,71% of patients presented class II skeletal and 34,28% class III before treatment, after this, the skeletal anomaly was corrected in 91,42% of cases; When characterizing the population under study it was revealed that self-esteem was low in 60,00% before treatment, and then it was high in 74,28%. It was concluded that the population studied presented skeletal anomalies and low self-esteem at the beginning of the treatment, which was corrected and improved, respectively, in the majority of patients by treatment with the standard twin and class III twin blocks.

RESUMEN Las anomalías de clase II y III esqueletales son una afección del desarrollo, en la mayoría de los casos, no se debe a procesos patológicos, sino a una moderada distorsión del desarrollo normal, ello provoca alteración de la estética que influye en los niveles de autoestima de los pacientes. El objetivo del estudio fue evaluar las modificaciones esqueletales y de autoestima con bloques gemelos. Se realizó un estudio cuasi-experimental modalidad antes y después sin grupo control, en 35 pacientes con clase II y III esqueletal, ingresados en la Consulta de Ortodoncia de la Clínica Universitaria de Especialidades Estomatológicas “Manuel Cedeño”, en el período comprendido entre enero a noviembre de 2018. Como medio de diagnóstico se empleó el examen clínico, la cefalometría y el Inventario de Autoestima elaborado por Cooper smith. Se obtuvo como resultado que el 71,42 % pertenecen a las edades de 12 y 13 años, y el 54,28 % son del sexo femenino; el 65,71 % de los pacientes presentó clase II esqueletal y el 34,28 % clase III antes del tratamiento, luego de éste, la anomalía esqueletal se corrigió en el 91,42 % de los casos; al caracterizar la población objeto de estudio se reveló que la autoestima fue baja en el 60,00 % antes del tratamiento, y luego fue de alta en el 74,28 %. Se concluye que la población de estudio presentó anomalías esqueletales y baja autoestima al inicio del tratamiento que se corrigió y mejoró, respectivamente, en la mayoría de los pacientes mediante el tratamiento con los bloques gemelos estándar y clase III.

Objective: The aim of this study was to assess the effects of resistance exercise and stretching on sleep, mood, and quality of life in chronic insomnia patients. Methods: Three 4-month treatments included: resistance exercise (n=10), stretching (n=10), and control (n=8). Sleep was evaluated with polysomnography, actigraphy, and questionnaires. Mood and quality of life were assessed with the Profile of Mood States (POMS) and the Medical Outcomes Study Short-Form 36-Item Health Survey (SF-36), respectively. Results: There were no significant treatment differences between resistance exercise and stretching. However, compared with the control treatment, resistance exercise and stretching led to significantly greater improvements in Insomnia Severity Index scores (-10.5±2.3, -8.1±2.0 vs. 2.3±1.8, respectively), and actigraphic measures of sleep latency (-7.1±4.6, -5.2±1.9 vs. 2.2±2.1 min), wake after sleep onset (-9.3±2.8, -7.1±3.0 vs. 3.6±4.2 min), and sleep efficiency (4.4±1.8, 5.0±0.8 vs. -2.3±2%). Pittsburgh Sleep Quality Index (PSQI) global scores (-5.3±0.8, -3.9±1.5 vs. -0.1±0.8) and sleep duration (1.2±0.3, 1.6±0.6 vs. -0.1±0.2 h) also improved following both experimental treatments compared with control. PSQI-Sleep efficiency increased after resistance exercise compared with control (19.5±3.9 vs. 2.1±4.3%). No significant differences were observed in polysomnography or quality of life measures. Tension-anxiety was lower in the stretching group than the control group. Conclusion: Moderate-intensity resistance exercise and stretching led to similar improvements in objective and subjective sleep in patients with chronic insomnia. Clinical trial registration: NCT01571115

This article reports a novel virtual screening algorithm seeking the rational identification of novel lead anticoagulants. Seven 5-(3-methyl-1-aryl-1H-pyrazol-4-yl)-1H-tetrazoles and seven novel 1-aryl-4-(4,5-dihydro-1H-imidazol-2-yl)-3-methyl-1H-pyrazoles were obtained in three steps starting from arylhydrazine hydrochlorides as raw materials in good yields: 50-72% and 50-85%, respectively. All compounds were submitted to an in silico target-base pipeline named integrated multiplex analysis virtual screening (IMA-VS), which comprises the evaluation of their (i) fitting physicochemical properties to the chemical environment of the target enzyme; (ii) active-site homing electrostatic potential to the target enzyme; (iii) structural fitting to the target active site through molecular docking; and (iv) overall absorption, distribution, metabolism, excretion and toxicity (ADMET) profile. After the virtual selection of potential anticoagulant hits, all molecules were synthesized and candidates were evaluated in vitro for their anticoagulant and hemolytic profile. The most promising candidate pointed out by IMA-VS was compound 1-(3',4'-dichlorophenyl)-4-(4,5-dihydro-1H-imidazol-2-yl)-3-methyl-1H-pyrazole that shown to display factor Xa (FXa)-specific inhibitory activity in vitro, acting as an uncompetitive inhibitor with an inhibition constant (Ki) = 61.16 ± 12.96 µM, in addition to the lowest hemolytic activity of the series. Further experiments revealed the antithrombotic activity of this compound in an in vivo model of arterial thrombosis induced by FeCl3.