Abstract INTRODUCTION: Infective endocarditis (IE) is a systemic infectious disease requiring a multidisciplinary team for treatment. This study presents the epidemiological and clinical data of 73 cases of IE in Rio de Janeiro, Brazil. METHODS This observational prospective cohort study of endocarditis patients during an eight-year study period described 73 episodes of IE in 70 patients (three had IE twice). Community-associated (CAIE) and healthcare-acquired infective endocarditis (HAIE) were diagnosed according to the modified Duke criteria. The collected data included demographic, epidemiologic, and clinical characteristics, including results of blood cultures, echocardiographic findings, surgical interventions, and outcome. RESULTS: Analysis of data from the eight-year study period and 73 cases (70 patients) of IE showed a mean age of 46 years (SD=2.5 years; 1-84 years) and that 65.7% were male patients. The prevalence of CAIE and HAIE was 32.9% and 67.1%, respectively. Staphylococcus aureus (30.1%), Enterococcus spp. (19.1%), and Streptococcus spp. (15.0%) were the prevalent microorganisms. The relevant signals and symptoms were fever (97.2%; mean 38.6 + 0.05°C) and heart murmur (87.6%). Vegetations were observed in the mitral (41.1%) and aortic (27.4%) valves. The mortality rate of the cases was 47.9%. CONCLUSIONS: In multivariate analysis, chronic renal failure (relative risk [RR]= 1.60; 95% confidence interval [CI] 1.01-2.55), septic shock (RR= 2.19; 95% CI 1.499-3.22), and age over 60 years (RR= 2.28; 95% CI 1.44-3.59) were indirectly associated with in-hospital mortality. The best prognosis was related to the performance of cardiovascular surgery (hazard ratio [HR]= 0.51; 95% CI 0.26-0.99).

Resumo Introdução Cimentos resinosos fotopolimerizáveis são materiais de eleição para a cimentação de facetas laminadas. Devem ser biocompatíveis oferencendo riscos mínimos ao uso clínico em pacientes. Objetivo O objetivo desse trabalho foi avaliar in vitro a citotoxicidade de três cimentos resinosos: Variolink II (Ivoclar Vivadent), Allcem Veneer, (FGM) e Rely X Veneer (3M ESPE). Material e método Vinte e quatro corpos de prova de cada cimento foram confeccionados em matrizes metálicas padronizadas e inseridos em placa de cultura de células de noventa e seis poços contendo fibroblastos da linhagem 3T3. As células foram cultivadas em meio de cultivo celular RPMI 1640 com 5% de soro fetal bovino, com 0,1% de penicilina/estreptomicina em estufa a 37◦C, em atmosfera úmida com 5% de CO2. O grau de citotoxicidade de cada cimento foi avaliado após os tempos de contato de 24h, 48h e 72h através do método MTT (3-(4,5-dimetiltiazol-2yl)-2,5- difenil brometo de tetrazolina), que avalia a viabilidade celular pela função mitocondrial. Após os tempos estabelecidos, as amostras foram removidas, tratadas e levadas ao espectofotômetro de microplaca para leitura da absorbância em 570nm. Resultado O cimento Variolink apresentou em 24h viabilidade de 72,24% (±6,80), em 48h de 83,92% (± 5,26) e de 92,77% (±5,59) em 72h. Allcem Veneer apresentou viabilidade de 70,46% (± 12,91) em 24h; 85,03% (± 21,4) em 48h e 70,46% (± 12,91) em 72h. O RelyX Veneer demonstrou viabilidade de 5,06% (± 0,88) em 24h; 5,84% (± 1,18) em 48h e 6,99% (± 1,34) em 72h. Conclusão Estes resultados demonstraram que o cimento Rely-X se apresentou significativamente mais citotóxico nas condições testadas.

Abstract Introduction Light-cured resin cements are the first choice for the cementation of laminate veneers. Ideally, they should be biocompatible and offer minimum risks to patients. Objective The aim of this study was to evaluate, in vitro, the cytotoxicity of three resin cements: Variolink II, Ivoclar Vivadent (C1), Allcem Veneer, FGM (C2), and Rely X Veneer, 3M ESPE (C3). Material and method Twenty four samples of each of the cements were fabricated in a standardized metal mold, light activated, and transferred to a 96-well cell plate with culture of fibroblasts. After 24, 48, and 72h of incubation, cytotoxicity was assessed and cell viability was calculated by the methyl-thiazol-tetrazolium (MTT) colorimetric assay. Absorbance was measured at 570 nm using a microplate spectrophotometer. Result The following results were found: Variolink II presented viability of 72.24% (SD 6.80) after 24h, 83.92% (SD 5.26) after 48h, and 92.77% (SD 5.59) after 72h; Allcem Veneer exhibited viability of 70.46% (SD 12.91) after 24h, 85.03% (SD 21.4) after 48h, and 70.46% (SD 12.91) after 72h; Rely X Veneer showed viability of 5.06% (SD 0.88) after 24h, 5.84% (SD 1.18) after 48h, and 6.99% (SD 1.34) after 72h. Conclusion Under these testing conditions, Rely X Veneer presented significantly higher cytotoxicity compared with those of the other light-cured resin cements assessed.

Corynebacterium striatum is a potentially pathogenic microorganism with the ability to produce outbreaks of nosocomial infections. Here, we document a nosocomial outbreak caused by multidrug-resistant (MDR) C. striatum in Rio de Janeiro, Brazil. C. striatum identification was confirmed by 16S rRNA and rpoB gene sequencing. Fifteen C. striatum strains were isolated from adults (half of whom were 50 years of age and older). C. striatum was mostly isolated in pure culture from tracheal aspirates of patients undergoing endotracheal intubation procedures. The analysis by pulsed-field gel electrophoresis (PFGE) indicated the presence of four PFGE profiles, including two related clones of MDR strains (PFGE I and II). The data demonstrated the predominance of PFGE type I, comprising 11 MDR isolates that were mostly isolated from intensive care units and surgical wards. A potential causal link between death and MDR C. striatum (PFGE types I and II) infection was observed in five cases.

O artigo revisa a literatura sobre a emergência de infecções humanas causadas por Corynebacterium ulcerans em diversos países, incluindo o Brasil. Foi realizada análise de artigos publicados entre 1926 e 2011 nas bases Medline/PubMed e SciELO, bem como artigos e informes do Ministério da Saúde. Apresenta-se um esquema de triagem, rápido, econômico e de fácil execução, capaz de permitir a realização do diagnóstico presuntivo de C. ulcerans e C. diphtheriae na maioria dos laboratórios brasileiros públicos e privados. A circulação de C. ulcerans em vários países, aliada aos recentes casos de isolamento do patógeno no Rio de Janeiro, é um alerta a clínicos, veterinários e microbiologistas sobre a ocorrência de difteria zoonótica e a circulação do C. ulcerans em regiões urbanas e rurais do território nacional e/ou da América Latina.

The article is a literature review on the emergence of human infections caused by Corynebacterium ulcerans in many countries including Brazil. Articles in Medline/PubMed and SciELO databases published between 1926 and 2011 were reviewed, as well as articles and reports of the Brazilian Ministry of Health. It is presented a fast, cost-effective and easy to perform screening test for the presumptive diagnosis of C. ulcerans and C. diphtheriae infections in most Brazilian public and private laboratories. C. ulcerans spread in many countries and recent isolation of this pathogen in Rio de Janeiro, southeastern Brazil, is a warning to clinicians, veterinarians, and microbiologists on the occurrence of zoonotic diphtheria and C. ulcerans dissemination in urban and rural areas of Brazil and/or Latin America.

El articulo revisa la literatura sobre la emergencia de infecciones humanas causadas por Corynebacterium ulcerans en diversos países, incluyendo Brasil. Se realizó análisis de artículos publicados entre 1926 y 2011 en las bases Medline/Pubmed y SciELO, así como artículos e informes del Ministerio Brasileño de la Salud. Se presenta un esquema de selección, rápido, económico y de fácil ejecución, capaz de permitir la realización del diagnóstico presuntivo de C. ulcerans y C. diphtheriae en la mayoría de los laboratorios brasileños públicos y privados. La circulación de C. ulcerans en varios países, aliada a los recientes casos de aislamiento del patógeno en Rio de Janeiro (Sureste de Brasil), es un alerta a clínicos, veterinarios y microbiólogos sobre la ocurrencia de difteria zoológica y la circulación de C. ulcerans en regiones urbanas y rurales del territorio nacional y/o de América Latina

O artigo revisa a literatura sobre a emergência de infecções humanas causadas por Corynebacterium ulcerans em diversos países, incluindo o Brasil. Foi realizada análise de artigos publicados entre 1926 e 2011 nas bases Medline/PubMed e SciELO, bem como artigos e informes do Ministério da Saúde. Apresenta-se um esquema de triagem, rápido, econômico e de fácil execução, capaz de permitir a realização do diagnóstico presuntivo de C. ulcerans e C. diphtheriae na maioria dos laboratórios brasileiros públicos e privados. A circulação de C. ulcerans em vários países, aliada aos recentes casos de isolamento do patógeno no Rio de Janeiro, é um alerta a clínicos, veterinários e microbiologistas sobre a ocorrência de difteria zoonótica e a circulação do C. ulcerans em regiões urbanas e rurais do território nacional e/ou da América Latina.

The article is a literature review on the emergence of human infections caused by Corynebacterium ulcerans in many countries including Brazil. Articles in Medline/PubMed and SciELO databases published between 1926 and 2011 were reviewed, as well as articles and reports of the Brazilian Ministry of Health. It is presented a fast, cost-effective and easy to perform screening test for the presumptive diagnosis of C. ulcerans and C. diphtheriae infections in most Brazilian public and private laboratories. C. ulcerans spread in many countries and recent isolation of this pathogen in Rio de Janeiro, southeastern Brazil, is a warning to clinicians, veterinarians, and microbiologists on the occurrence of zoonotic diphtheria and C. ulcerans dissemination in urban and rural areas of Brazil and/or Latin America.

El articulo revisa la literatura sobre la emergencia de infecciones humanas causadas por Corynebacterium ulcerans en diversos países, incluyendo Brasil. Se realizó análisis de artículos publicados entre 1926 y 2011 en las bases Medline/Pubmed y SciELO, así como artículos e informes del Ministerio Brasileño de la Salud. Se presenta un esquema de selección, rápido, económico y de fácil ejecución, capaz de permitir la realización del diagnóstico presuntivo de C. ulcerans y C. diphtheriae en la mayoría de los laboratorios brasileños públicos y privados. La circulación de C. ulcerans en varios países, aliada a los recientes casos de aislamiento del patógeno en Rio de Janeiro (Sureste de Brasil), es un alerta a clínicos, veterinarios y microbiólogos sobre la ocurrencia de difteria zoológica y la circulación de C. ulcerans en regiones urbanas y rurales del territorio nacional y/o de América Latina

OBJECTIVE: The aim of this investigation was to evaluate the cytotoxicity of two brands of root canal sealers, epoxy-resin based and zinc oxide-eugenol based, and one commercial calcium hydroxide paste on a monocyte cell line THP-1. MATERIAL AND METHODS: Undiluted (crude extract) and diluted extracts to 10%, 1%, 0.1%, 0.01%, 0.001% and 0.0001% of the sealers were tested for cytotoxicity to THP-1 cells using the trypan blue assay. Extracts were obtained according to ISO standard. Data were analyzed statistically by the Kruskal-Wallis and Mann-Whitney tests at 5% significance level. RESULTS: Crude extract of AH Plus and Fill Canal killed approximately 90% of THP-1 cells versus 36% of THP-1 cells killed by L&C crude extract (p<0.05). Ten-fold dilutions of L&C, Fill Canal and AH Plus killed 24, 35 and 61% of THP-1 cells (p<0.05), respectively. Dilutions lesser than 1% caused minimal cell death as compared to the control groups (p>0.05), except for L&C 1% extract. CONCLUSIONS: The results revealed that the L&C paste crude extract was less cytotoxic to THP-1 cells than AH Plus or Fill Canal crude extracts.

The increasing number of pertussis cases reported on the last twenty years and the existence of new acellular vaccines reinforce the need of research for experimental models to assure the quality of available pertussis vaccines. In this study, allotments of whole-cell and acellular pertussis vaccines were tested through the Intranasal Challenge Model (INM) using conventional NIH mice. The results have been compared to those achieved by the "Gold standard" Intracerebral Challenge Model (ICM). In contrast to ICM, INM results did not show intralaboratorial variations. Statistical analysis by Anova and Ancova tests revealed that the INM presented reproducibility and allowed identification and separation of different products, including three-component and four-component accellular pertussis vaccines. INM revealed differences between pertussis vaccines. INM provides lower distress to the mice allowing the reduction of mice number including the possibility of using conventional mice (less expensive) under non-aseptic environment. Thus, INM may be used as an alternative method of verifying the consistence of allotment production, including acellular pertussis vaccines.

O objetivo do presente trabalho foi avaliar in vitro a atividade antimicrobiana do hipoclorito de sódio (1% e 5%) e da clorexidina (0,12%, 0,5% e 1%). Cepas (ATCC) de Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Porphyromonas gingivalis e Fusobacterium nucleatum foram submetidas ao teste por contato. As amostras foram analisadas em diferentes intervalos de tempo: imediatamente, 5 minutos, 15 minutos e 30 minutos após o contato com cada solução e repetidas 10 vezes. Os resultados demonstraram que a solução de clorexidina a 0,12% não foi capaz de eliminar as amostras de E. faecalis em nenhum intervalo de tempo testado enquanto que a clorexidina a 0,5% e 1% eliminaram todas as cepas testadas assim como as 2 concentrações de hipoclorito de sódio. Estes resultados nos permitem concluir que para se obter melhores respostas quanto a atividade antimicrobiana, a solução de clorexidina deve ser utilizada numa concentração superior a 0,12%.

The purpose of this study was to analyze the in vitro antimicrobial activity of sodium hypochlorite (1% and 5%) and chlorhexidine (0.12%, 0.5% and 1%). Bacterial samples (ATCC) of Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Porphyromonas gingivalis and Fusobacterium nucleatum were submitted to a contact test. Solutions were evaluated at different time intervals: immediately, 5 min, 15 min, and 30 min after contact and repeated 10 times. The results of the contact test showed that 0.12% chlorhexidine did not eliminate E. faecalis at any time interval, while 0.5% and 1% chlorhexidine and 1% and 5% sodium hypochlorite did. These results permit us to conclude that to obtain better antimicrobial activity, chlorhexidine in a concentration greater than 0.12% should be used.