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Abstract This study aimed to evaluate the effect of different concentrations of sodium hypochlorite (NaOCl) and calcium hypochlorite [Ca(OCl)2] on the bond strength and adaptation of glass fiber posts luted with a dual-curing resin cement. Fifty decoronated premolars were sectioned 14 mm from the apex and endodontically treated. The root canal filling was partially removed. The specimens were divided into 5 groups (n=10) according to the irrigant for post space irrigation: 0.9% sodium chloride (NaCl), (control); 2.5% NaOCl; 5.25% NaOCl; 2.5% Ca(OCl)2; and 5.25% Ca(OCl)2. For each group, irrigation was performed with 5 ml of solution. Afterward, the posts were luted with a dual-curing resin cement. One slice from each third was obtained and submitted to the push-out test and failure modes analysis. An additional slice from the middle third was submitted to confocal images for analysis of adaptation failures (gaps). Two-way ANOVA, Tukey’s post-hoc, Kruskal-Wallis with Bonferroni adjusted, and chi-square tests, analyzed data. The group treated with 5.25% NaOCl showed lower bond strength values and generated more cohesive failures compared to the control (p < 0.05). Bond strength decreased from coronal to apical in the post space (p < 0.001). The groups treated with NaOCl had the highest percentages of gaps compared to the control (p < 0.05). Regardless of concentration, Ca(OCl)2 did not influence the bond strength and the occurrence of gaps (P > 0.05). Ca(OCl)2 is a good option for irrigating the post space before luting a fiber post with a dual-curing resin cement.

Resumo Este estudo teve como objetivo avaliar o efeito de diferentes concentrações de hipoclorito de sódio (NaOCl) e hipoclorito de cálcio [Ca(OCl)2] na resistência de união e adaptação de pinos de fibra de vidro cimentados com um cimento resinoso dual. Cinquenta pré-molares tiveram suas coroas removidas, foram seccionados a 14 mm do ápice e tratados endodonticamente. A obturação do canal radicular foi parcialmente removida. Os espécimes foram divididos em 5 grupos (n=10) de acordo com o irrigante para irrigação do espaço do pino: cloreto de sódio 0.9% (NaCl), (controle); NaOCl 2.5%; NaOCl 5.25%; Ca(OCl)2 2.5%; e Ca(OCl)2 5.25%. Para cada grupo, a irrigação foi realizada com 5 ml da solução. Posteriormente, os pinos foram cimentados com um cimento resinoso dual. Uma fatia de cada terço foi obtida e submetida ao teste push-out e análise dos modos de falha. Um corte adicional do terço médio foi submetido a imagens confocais para análise de falhas de adaptação (gaps). Os dados foram analisados pelos testes ANOVA de duas vias, post-hoc de Tukey, Kruskal-Wallis com ajuste de Bonferroni e qui-quadrado. O grupo tratado com NaOCl 5.25% apresentou menores valores de resistência de união e gerou mais falhas coesivas em relação ao controle (p < 0.05). A resistência de união diminuiu de coronal para apical no espaço do pino (p < 0.001). Os grupos tratados com NaOCl apresentaram os maiores percentuais de gaps em relação ao controle (p < 0.05). Independentemente da concentração, o Ca(OCl)2 não influenciou a resistência de união e a ocorrência de gaps (P > 0.05). O Ca(OCl)2 é uma boa opção para irrigar o espaço do pino antes de cimentar um pino de fibra com um cimento resinoso dual.

https://doi.org/10.1590/0103-6440202305396

Impact of COVID-19 pandemic on prostate cancer outcomes at an uro-oncology referral center
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Andrade, Guilherme Miranda

; Sesconetto, Lucas

; Silva, Rafael Benjamim Rosa da

; Santos, Gabriela Guimarães Rodrigues dos

; Kayano, Paulo Priante

; Baccaglini, Willy

; Bezerra, Murilo Borges

; Bianco, Bianca

; Lemos, Gustavo Caserta

; Carneiro, Arie

International braz j urol

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apr 2023, Volume 49 N. 2 Pages 233 - 242

Abstract: En | Text: En | PDF: En

ABSTRACT Introduction To evaluate the possible effects of the coronavirus disease 2019 (COVID-19) pandemic on the oncologic results of patients with prostate cancer regarding clinical staging, presence of adverse pathological outcomes, and perioperative complications. Materials and methods This retrospective study included patients who underwent radical prostatectomy. The time between biopsy and surgery, staging tests, final histopathological evaluation after surgery, lymphadenectomy rate, postoperative complications, and prostatic specific antigen (PSA) levels (initial and 30 days after surgery) were analyzed and compared in a group of patients before and during the pandemic period. Results We included 226 patients: 88 in the pre-pandemic period and 138 during the pandemic period. There was no statistically significant difference in mean age, body mass index, ASA, pathological locally advanced disease, the proportion of patients who underwent lymphadenectomy, and ISUP grade in the biopsy between the groups. Positive surgical margins, prostatic extracapsular extension, and PSA levels at 30 days were also similar between the groups. The mean time between medical consultation and surgery was longer in the pandemic period than in the pre-pandemic (124 vs. 107 days, p<0.001), and the mean time between biopsy and medical consultation (69.5 days vs. 114 days, p<0.001) and between biopsy and surgery (198.5 days vs. 228 days, p=0.013) was shorter during the pandemic. The incidence of severe early and late perioperative complications was similar between the periods. Conclusions There was no delay between diagnosis and treatment at our institution during the COVID-19 pandemic period. No worsening of the prostate cancer features was observed.

https://doi.org/10.1590/s1677-5538.ibju.2022.0393

Percutaneous Endoscopic Gastrostomy Placement under NIV in Amyotrophic Lateral Sclerosis with Severe Ventilatory Dysfunction: A Safe and Effective Procedure
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Gaspar, Rui

; Ramalho, Rosa

; Coelho, Rosa

; Andrade, Patrícia

; Goncalves, Miguel R.

; Macedo, Guilherme

GE-Portuguese Journal of Gastroenterology

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feb 2023, Volume 30 N. 1 Pages 61 - 67

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

Abstract Introduction: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder with an inexorably progressive course which leads to a progressive neuromuscular weakness. Weight loss is one of the major bad prognostic factors in ALS. The placement of percutaneous endoscopic gastrostomy (PEG) is of paramount importance in patients with dysphagia to improve the disease outcomes, although some fear exists regarding the possible ventilatory complications during the procedure. The aim of this study was to evaluate the safety and effectiveness of PEG tube insertion under non-invasive ventilation (NIV) in patients with ALS and severe ventilatory impairment. Methods: A retrospective study of all consecutive PEGs placed in our department from May 2011 to January 2018 in patients with ALS was performed. The procedure was performed under non-invasive positive-pressure ventilation for ventilatory support. Results: We included 59 patients with ALS with severe ventilatory impairment, 58% were female, with a mean age of 67.2 ± 10.1 years and a median follow-up of 6 [2-15] months. The main indication for PEG placement was dysphagia (98%). The median time for PEG tube insertion since the established diagnosis of ALS was 12 [6-25] months and 4 [2-18] months since the beginning of bulbar symptoms. The majority of the patients had placed a 20-Fr PEG (63%) and under mild sedation with midazolam (80%), all under NIV. There were no immediate complications during and after the procedure (no episodes of aspiration or orotracheal intubation) and mortality. Conclusion: The placement of PEG is a very important procedure in patients with ALS and severe ventilatory impairment. The interdisciplinary department collaboration permitted the placement of PEG under NIV, in a safe and effective procedure in this special population.

Resumo Introdução: A esclerose lateral amiotrófica (ELA) é uma doença neurodegenerativa com um curso inexorável que leva a fraqueza neuromuscular progressiva. A perda de peso é um dos principais fatores de mau prognóstico na ELA. Apesar do receio de complicações ventilatórias durante o procedimento, a colocação de gastrostomia percutânea endoscópica em doentes com disfagia é extremamente importante para melhorar o prognóstico. O objetivo deste estudo é avaliar a segurança e eficácia da colocação de gastrostomia percutânea endoscópica (GEP) sob ventilação não invasiva (VNI) em doentes com ELA e disfunção ventilatória grave. Métodos: Estudo retrospetivo de todas as gastrostomias percutâneas endoscópicas colocadas em doentes com ELA no nosso departamento entre Maio 2011 e Janeiro 2018. O procedimento foi realizado sob VNI para suporte ventilatório. Resultados: Foram incluídos 59 doentes com ELA e disfunção ventilatória grave, 58% do sexo feminino, com uma idade média de 67.2 ± 10.1 anos e um follow-up mediano de 6 [2-15] meses. A principal indicação para colocação de gastrostomia percutânea endoscópica foi disfagia (98%). O tempo mediano para a colocação de GEP desde o diagnóstico de ELA foi 12 [6-25] meses e 4 [2-18] meses desde o início dos sintomas bulbares. A maioria dos doentes colocaram uma GEP de 20 Fr (63%) e sob sedação com midazolam (80%), todos sob VNI. Não se verificaram complicações imediatas durante e após o procedimento (sem episódios de aspiração ou entubação orotraqueal) e mortalidade. Conclusão: A colocação de GEP é um procedimento muito importante em doentes com ELA e disfunção ventilatória grave. A colaboração interdisciplinar permitiu a colocação de GEP sob ventilação não invasiva, tornando-o um procedimento seguro e eficaz nesta população especial.

https://doi.org/10.1159/000519926

Impact of COVID-19 on physical and mental functioning in adolescents with disabilities in a sports nongovernmental organization
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Laurentino, Moisés de Freitas

; Lindoso, Livia

; Astley, Camilla

; Lavorato, Sofia Simão Martins

; Ihara, Bianca Pires

; Lima, Dandara Carvalho Casado de

; Gualano, Bruno

; Queiroz, Lígia Bruni

; Pereira, Rosa Maria Rodrigues

; Polanczyk, Guilherme Vanoni

; Camargo, Olavo Pires de

; Silva, Clovis Artur

; Grangeiro, Patricia Moreno

Revista Paulista de Pediatria

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2023, Volume 41 elocation e2021334

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Objetivo: Avaliar os parâmetros de saúde física e mental, de qualidade de vida relacionada à saúde (QVRS), em adolescentes com deficiência física matriculados em organização não governamental (ONG) esportiva vs. em adolescentes sem deficiência, durante a pandemia da doença do coronavírus 2019 (COVID-19). Métodos: Este estudo transversal incluiu 30 adolescentes com deficiência e 86 adolescentes sem deficiência que responderam a questionário online com dados sociodemográficos e informações de rotina de saúde autoavaliadas durante a quarentena da COVID-19. Versões validadas de autorrelato do Strengths and Difficulties Questionnaire (SDQ), Pediatric Quality of Life Inventory 4.0 (PedsQL4.0), Pittsburgh Sleep Quality Index (PSQI) e Pediatric Outcome Data Collection Instrument (PODCI) também foram aplicadas. Resultados: A mediana de problemas emocionais [4(0–10) vs. 5(0–10),p=0,018] e pró-social [7(0–10) vs. 9(3–10),p=0,006] foi menor em adolescentes com deficiência vs. adolescentes sem deficiência. Adolescentes com deficiência tiveram função global significantemente inferior [68(21–99) vs. 94(67–100),p <0,001] e pontuações de felicidade mais altas do PODCI [90(65–100) vs. 80(0–100),p=0,016] em comparação com o grupo sem deficiências. A análise de regressão logística demonstrou que a atividade física/semana (odds ratio — OR=1,03; intervalo de confiança — IC95%=1,01–1,05,p=0,002) foi maior nos adolescentes com deficiência. No entanto, atividades domésticas (OR=0,14; IC95%=0,04–0,43,p=0,001) e tempo de tela ≥3 horas/dia (OR=0,09; IC95%=0,02–0,38,p=0,001) foram menores nos adolescentes com deficiência. Conclusões: Os adolescentes com deficiência que frequentam uma organização não governamental (ONG) esportiva não tiveram maior risco de apresentar indicadores adversos à saúde; apesar de apresentarem função física reduzida, relataram mais atividade física, maior felicidade e menos tempo de tela em comparação com adolescentes sem deficiência durante a pandemia da COVID-19.

Abstract Objective: This study aimed to assess physical and mental health, and health-related quality of life (HRQL) parameters in adolescents with physical disabilities enrolled in a sports nongovernmental organization (NGO) versus adolescents without disabilities during coronavirus disease 2019 (COVID-19) pandemic. Methods: This cross-sectional study included 30 adolescents with disabilities and 86 adolescents without disabilities who responded to an online questionnaire with sociodemographic data and self-rated healthcare routine information during the COVID-19 quarantine. Validated self-report versions of the Strengths and Difficulties Questionnaire (SDQ), Pediatric Quality of Life Inventory 4.0 (PedsQL 4.0), Pittsburgh Sleep Quality Index (PSQI), and Pediatric Outcome Data Collection Instrument (PODCI) were also applied. Results: The median of emotional [4 (0–10) vs. 5 (0–10), p=0.018] and prosocial [7 (0–10) vs. 9 (3–10), p=0.006] problems was lower in adolescents with disabilities versus adolescents without disabilities. Adolescents with disabilities had significantly lower global function [68 (21–99) vs. 94 (67–100), p<0.001] and higher happiness scores in the PODCI scale [90 (65–100) vs. 80 (0–100), p=0.016] compared to controls. Logistic regression analysis demonstrated that physical activity/week (OR=1.03; 95%CI 1.01–1.05, p=0.002) was higher in adolescents with disabilities compared to adolescents without disabilities. However, housework activities (OR=0.14; 95%CI 0.04–0.43, p=0.001) and screen time ≥3 h/day (OR=0.09; 95%CI 0.02–0.38, p=0.001) were lower in adolescents with disabilities compared to adolescents without disabilities. Conclusion: Adolescents with disabilities attending a sports NGO were not at higher risk of adverse health-related indicators; despite showing reduced physical function, they reported more physical activity, higher happiness, and less screen time compared to adolescents without disabilities during the COVID-19 pandemic.

https://doi.org/10.1590/1984-0462/2023/41/2021334

Parathyroidectomy: still the best choice for the management of severe secondary hyperparathyroidism
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Ramos, Luiz Guilherme Fernandes

; Cortes, Daniela Del Pilar Via Reque

; Reis, Luciene Machado dos

; Montenegro, Fabio Luiz de Menezes

; Arap, Sérgio Samir

; Brescia, Marília D’Elboux Guimarães

; Custódio, Melani Ribeiro

; Jorgetti, Vanda

; Elias, Rosilene Motta

; Moysés, Rosa Maria Affonso

Brazilian Journal of Nephrology

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2023, N. ahead

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

Abstract Introduction: Management of secondary hyperparathyroidism (SHPT) is a challenging endeavor with several factors contruibuting to treatment failure. Calcimimetic therapy has revolutionized the management of SHPT, leading to changes in indications and appropriate timing of parathyroidectomy (PTX) around the world. Methods: We compared response rates to clinical vs. surgical approaches to SHPT in patients on maintenance dialysis (CKD 5D) and in kidney transplant patients (Ktx). A retrospective analysis of the one-year follow-up findings was carried out. CKD 5D patients were divided into 3 groups according to treatment strategy: parathyroidectomy, clinical management without cinacalcet (named standard - STD) and with cinacalcet (STD + CIN). Ktx patients were divided into 3 groups: PTX, CIN (cinacalcet use), and observation (OBS). Results: In CKD 5D we found a significant parathormone (PTH) decrease in all groups. Despite all groups had a higher PTH at baseline, we identified a more pronounced reduction in the PTX group. Regarding severe SHPT, the difference among groups was evidently wider: 31%, 14% and 80% of STD, STD + CIN, and PTX groups reached adequate PTH levels, respectively (p<0.0001). Concerning the Ktx population, although the difference was not so impressive, a higher rate of success in the PTX group was also observed. Conclusion: PTX still seems to be the best treatment choice for SHPT, especially in patients with prolonged diseases in unresourceful scenarios.

Resumo Introdução: O manejo do hiperparat-ireoidismo secundário (HPTS) é uma tarefa desafiadora com diversos fatores que contribuem para o fracasso do tratamento. A terapia calcimimética revolucionou o manejo do HPTS, levando a alterações nas indicações e no momento apropriado da paratireoidectomia (PTX) em todo o mundo. Métodos: Comparamos taxas de resposta às abordagens clínica vs. cirúrgica do HPTS em pacientes em diálise de manutenção (DRC 5D) e pacientes transplantados renais (TxR). Foi realizada uma análise retrospectiva dos achados de um ano de acompanhamento. Pacientes com DRC 5D foram divididos em 3 grupos de acordo com a estratégia de tratamento: paratireoidectomia, manejo clínico sem cinacalcete (denominado padrão - P) e com cinacalcete (P + CIN). Os pacientes com TxR foram divididos em 3 grupos: PTX, CIN (uso de cinacalcete) e observação (OBS). Resultados: Na DRC 5D, encontramos uma redução significativa do paratormônio (PTH) em todos os grupos. Apesar de todos os grupos apresentarem um PTH mais elevado no início do estudo, identificamos uma redução mais acentuada no grupo PTX. Com relação ao HPTS grave, a diferença entre os grupos foi evidentemente maior: 31%, 14% e 80% dos grupos P, P + CIN e PTX atingiram níveis adequados de PTH, respectivamente (p< 0,0001). Com relação à população TxR, embora a diferença não tenha sido tão impressionante, também foi observada uma taxa maior de sucesso no grupo PTX. Conclusão: A PTX ainda parece ser a melhor escolha de tratamento para o HPTS, especialmente em pacientes com doenças prolongadas em cenários sem recursos.

https://doi.org/10.1590/2175-8239-jbn-2023-0024en

Adaptation to the driving simulator and prediction of the braking time performance, with and without distraction, in older adults and middle-aged adults
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Canonica, Alexandra Carolina

; Alonso, Angelica Castilho

; Brech, Guilherme Carlos

; Peterson, Mark

; Luna, Natália Mariana Silva

; Busse, Alexandre Leopold

; Jacob-Filho, Wilson

; Rosa, Juliana Leme

; Soares-Junior, Jose Maria

; Baracat, Edmund Chada

; Greve, Júlia Maria D’Andrea

Clinics

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2023, Volume 78 elocation 100168

Abstract: En | Text: En | PDF: En

Abstract Context: Many studies show the importance of evaluating the adaptation time of subjects in a virtual driving environment, looking forwards to a response as closest as a possible real vehicle. Objectives: This study aimed to identify and analyze the adaptation to the driving simulator in older adults and middle-aged adults with and without a distraction, and a secondary aim was to identify predictors of safe performance for older adults’ drives. Design: Male and female middle-aged adults (n = 62, age = 30.3 ± 7.1 years) and older adults (n = 102, age = 70.4 ± 5.8 years) were evaluated for braking time performance in a driving simulator; cognition performance assessment included the Mini-Mental State Examination; motor evaluation included ankle flexor muscle strength with the isokinetic dynamometer and handgrip strength; the postural balance was evaluated with Timed Up and Go test, with and without a cognitive distraction task. Results: Older adults (men and women) and middle-aged adult women require more time to adapt to the driving simulator. The distractor increases the adaptation time for all groups. The main predictors of braking time for older women are age, muscle strength, and postural balance associated with distraction, and for older men, muscle strength. Conclusions: Age, sex, and distractor interfere in the adaptation of the virtual task of driving in a simulator. The evaluation model developed with multi-domains demonstrated the ability to predict which skills are related to braking time with and without the presence of the distractor.

https://doi.org/10.1016/j.clinsp.2023.100168

Emotional, hyperactivity and inattention problems in adolescents with immunocompromising chronic diseases during the COVID-19 pandemic
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Campos, Reinan T.

; Lindoso, Livia

; Sousa, Renan A. de

; Helito, Alberto C.

; Ihara, Bianca P.

; Strabelli, Claudia A.A.

; Paradelas, Levi M.V.

; Carneiro, Beatriz O.L.

; Cardoso, Maria Paula R.

; Souza, Jean Paulo V. de

; Freire, Marianna R. de M.

; Astley, Camilla

; Laurentino, Moisés F.

; Buscatti, Izabel M.

; Kozu, Katia

; Aikawa, Nadia E.

; Sallum, Adriana M.E.

; Ferreira, Juliana CO.

; Simon, Juliana R.

; Viana, Vivianne S.L.

; Queiroz, Ligia B.

; Gualano, Bruno

; Roschel, Hamilton

; Pereira, Rosa Maria R.

; Toma, Ricardo K.

; Watanabe, Andréia

; Grangeiro, Patricia M.

; Casella, Caio B.

; Farhat, Sylvia C.

; Polanczyk, Guilherme V.

; Campos, Lucia Maria A.

; Silva, Clovis A.

Clinics

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2023, Volume 78 elocation 100167

Abstract: En | Text: En | PDF: En

Abstract Objective: To assess factors associated with emotional changes and Hyperactivity/Inattention (HI) motivated by COVID-19 quarantine in adolescents with immunocompromising diseases. Methods: A cross-sectional study included 343 adolescents with immunocompromising diseases and 108 healthy adolescents. Online questionnaires were answered including socio-demographic data and self-rated healthcare routine during COVID-19 quarantine and validated surveys: Strengths and Difficulties Questionnaire (SDQ), Pittsburgh Sleep Quality Index (PSQI), Pediatric Quality of Life Inventory 4.0 (PedsQL4.0). Results: The frequencies of abnormal emotional SDQ scores from adolescents with chronic diseases were similar to those of healthy subjects (110/343 [32%] vs. 38/108 [35%], p = 0.548), as well as abnormal hyperactivity/inattention SDQ scores (79/343 [23%] vs. 29/108 [27%], p = 0.417). Logistic regression analysis of independent variables associated with abnormal emotional scores from adolescents with chronic diseases showed: female sex (Odds Ratio [OR = 3.76]; 95% Confidence Interval (95% CI) 2.00–7.05; p < 0.001), poor sleep quality (OR = 2.05; 95% CI 1.08–3.88; p = 0.028) and intrafamilial violence during pandemic (OR = 2.17; 95% CI 1.12–4.19; p = 0.021) as independently associated with abnormal emotional scores, whereas total PedsQL score was inversely associated with abnormal emotional scores (OR = 0.95; 95% CI 0.93–0.96; p < 0.0001). Logistic regression analysis associated with abnormal HI scores from patients evidenced that total PedsQL score (OR = 0.97; 95% CI 0.95–0.99; p = 0.010], changes in medical appointments during the pandemic (OR = 0.39; 95% CI 0.19–0.79; p = 0.021), and reliable COVID-19 information (OR = 0.35; 95% CI 0.16–0.77; p = 0.026) remained inversely associated with abnormal HI scores. Conclusion: The present study showed emotional and HI disturbances in adolescents with chronic immunosuppressive diseases during the COVID-19 pandemic. It reinforces the need to promptly implement a longitudinal program to protect the mental health of adolescents with and without chronic illnesses during future pandemics.

https://doi.org/10.1016/j.clinsp.2023.100167

UNIVERSITIES IN SMALL BRAZILIAN CITIES: ANALYSIS OF THE IMPACT OF COVID 19 USING VALUE-FOCUSED THINKING
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Pontarolo, Marianna Cruz Campos

; de Souza, Luciano Azevedo

; de Castro, Guilherme Regal

; Aronson, Danny

; Bergiante, Níssia Carvalho Rosa

Pesquisa Operacional

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2023, Volume 43 elocation e263680

Abstract: En | Text: En | PDF: En

ABSTRACT This paper aims to support decision-making for the return of classes to determine actions to reduce the problems arising from the pandemic through a multi-methodological approach using Value-focused thinking (VFT) and Rich Picture (RP). The case study includes a Brazilian small university, in a region with social and economic vulnerability. Six stakeholders representing the students, the municipality community and the university were interviewed from which the hierarchy of fundamental objectives and an objectives’ network unfolded in education, health, and community were created. Even though health concerns were shared by all stakeholders, these networks revealed a variety of perspectives not typically discussed in large universities, such as access to information and communication technologies; awareness of biosafety measures; and real estate vacancy. These findings indicate that future research should address the specific needs of small universities in vulnerable cities, particularly those in developing and underdeveloped countries, where universities’ presence fosters the economy.

https://doi.org/10.1590/0101-7438.2023.043.00263680

Deflection of tandem archwire in a specific self-ligating metal bracket system: an in vitro study
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CATTANI, Lourenço

; CORRER-SOBRINHO, Lourenço

; NEVES, José Guilherme

; VALDRIGHI, Heloísa

; SANTOS, Eduardo César Almada

; COSTA, Ana Rosa

Brazilian Oral Research

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2023, Volume 37 elocation e065

Abstract: En | Text: En | PDF: En

Abstract The aim of this study was to quantify the force exerted by tandem archwires in a specific system of passive self-ligating bracket. Forty-eight thermo-activated nickel-titanium orthodontic archwires were separated into four groups (n = 12): G1 – two .014” + .014” round archwires; G2 – two .014” + .016” round archwires; G3 – .014” x .025” rectangular archwire; and. G4 – .016” x .022” rectangular archwire. Brackets were fixed onto teeth 1.5 to 2.5 using a device that represented the upper teeth, maintaining an interbracket distance of 6.0 mm. The deflection tests were performed using the structure representative of tooth 1.1 as support on the Instron testing machine at a speed of 2.0 mm/min. The archwires were evaluated at deflections of 0.5 mm, 1.0 mm, and 1.5 mm. The data were analyzed by a generalized linear model, considering values at different deflections as repeated measurements in the same experimental unit (α = 0.5%). At 0.5 mm, higher forces were observed in G2 and G3, which did not differ significantly (p > 0.05). The lowest force was observed in G4 (p < 0.05). At 1.0 mm and 1.5 mm, the highest force was observed in G3, followed by G4 and G2 (p < 0.05). The lowest force was observed in G1 (p < 0.05). In general, tandem archwires (same or different calibers) in a specific passive self-ligating bracket exerted lower force when compared with rectangular archwires.

https://doi.org/10.1590/1807-3107bor-2023.vol37.0065

10.

Occult macular dystrophy: brief literature review
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Godoy, Rafael

; Estacia, Carolina Tagliari

; Sturzeneker, Guilherme

; Gameiro Filho, Aluisio Rosa

Revista Brasileira de Oftalmologia

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2023, Volume 82 elocation e0026

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

ABSTRACT Occult macular dystrophy is characterized by a slowly progressive bilateral reduction of visual acuity in patients with normal fundus and fluorescein angiography. We describe a case of a 36-year-old male patient diagnosed with this condition, after extensive investigation with multimodal imaging, electrophysiology tests, and systemic screening.

RESUMO A distrofia macular oculta é caracterizada por perda visual, lentamente progressiva, em pacientes com fundoscopia e angiografia fluoresceínica normais. Relatamos o caso de um paciente de 36 anos do sexo masculino diagnosticado com essa condição após extensa investigação com exames de imagem multimodais, eletrofisiológicos e rastreio de doenças sistêmicas.

https://doi.org/10.37039/1982.8551.20230026

11.

Diversity of rickettsiae in ticks (Acari: Ixodidae) collected from wild vertebrates in part of the Amazon, Cerrado, and Pantanal biomes in Brazil
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Prati, Anny Carolina

; Maia, Maerle Oliveira

; Martins, Thiago Fernandes

; Morgado, Thaís Oliveira

; Corrêa, Sandra Helena Ramiro

; Mendes, Edson Junior Figueiredo

; Ferraz, Rosa Helena dos Santos

; Mudrek, Jessica Rhaiza

; Strüssmann, Christine

; Ramos, Dirceu Guilherme de Souza

; Semedo, Thiago Borges Fernandes

; Minetto, Make Kawatake

; Aguiar, Daniel Moura de

; Pacheco, Richard Campos

; Melo, Andréia Lima Tomé

Revista Brasileira de Parasitologia Veterinária

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2023, Volume 32 N. 4 elocation e008023

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

Abstract Ticks parasitizing 102 wild animals in the states of Mato Grosso and Goiás, Brazil were collected between 2015 and 2018. A total of 2338 ticks (865 males, 541 females, 823 nymphs, and 109 larvae) belonging to four genera (Amblyomma, Dermacentor, Haemaphysalis, and Rhipicephalus) and at least 21 species were identified. DNA extraction and a molecular survey for rickettsial agents were performed on 650 ticks. The results revealed parasitism by the following species: Rickettsia amblyommatis in Amblyomma cajennense s.s., A. cajennense s.l., Amblyomma coelebs, Amblyomma humerale, Amblyomma longirostre, Amblyomma nodosum, Amblyomma scalpturatum, Amblyomma sculptum, and Amblyomma romitii; Rickettsia parkeri in Amblyomma nodosum, Amblyomma ovale, Amblyomma scalpturatum, and Amblyomma triste; Rickettsia rhipicephali in Haemaphysalis juxtakochi; Rickettsia sp. in A. cajennense s.s., A. nodosum, and A. sculptum, and lastly, ‘Candidatus Rickettsia andeanae’ in Amblyomma parvum and Rhipicephalus microplus. This study expands the body of knowledge about tick parasitism among wild animals, including new data concerning tick-host associations, and provides information about the epidemiology of tick-borne pathogens in the Center-West region of Brazil.

Resumo Foram coletados carrapatos parasitando 102 animais silvestres nos estados de Mato Grosso e Goiás, Brasil, entre 2015 e 2018. Um total de 2338 carrapatos (865 machos, 541 fêmeas, 823 ninfas e 109 larvas) pertencentes a quatro gêneros (Amblyomma, Dermacentor, Haemaphysalis e Rhipicephalus) e pelo menos 21 espécies foram identificadas. A extração de DNA e pesquisa molecular para agentes riquétsiais foram realizadas em 650 carrapatos. Os resultados revelaram parasitismo pelas seguintes espécies: Rickettsia amblyommatis em Amblyomma cajennense s.s., A. cajennense s.l., Amblyomma coelebs, Amblyomma humerale, Amblyomma longirostre, Amblyomma nodosum, Amblyomma scalpturatum, Amblyomma sculptum e Amblyomma romitii; Rickettsia parkeri em Amblyomma nodosum, Amblyomma ovale, Amblyomma scalpturatum e Amblyomma triste; Rickettsia rhipicephali em Haemaphysalis juxtakochi; Rickettsia sp. em A. cajennense s.s., A. nodosum e A. sculptum e, por último, ‘Candidatus Rickettsia andeanae’ em Amblyomma parvum e Rhipicephalus microplus. Este estudo amplia o conhecimento sobre o parasitismo de carrapatos em animais silvestres, incluindo-se novos dados sobre associações carrapato-hospedeiro. Fornece, ainda, informações sobre a epidemiologia de patógenos transmitidos por carrapatos na região Centro-Oeste do Brasil.

https://doi.org/10.1590/s1984-29612023059

12.

Seasonality effect on the physiological and productive responses of crossbred dairy cows to the equatorial Amazon climate
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Costa, Dayana Alves da

; Santos, Vinícius Moreira dos

; Oliveira, Antônia Valcemira Domingos de

; Souza, Clebson Lucas de

; Moreira, Guilherme Rocha

; Rosa, Bruna Laurindo

; Reis, Eduardo Mitke Brandão

; Queiroz, Adriano Melo de

Ciência Animal Brasileira

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2023, Volume 24 elocation e-73559E

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

Abstract The objective of this study was to evaluate the seasonal effect of months of the year upon the physiological and productive responses of crossbred dairy cows raised in an Amazonian climate. Twenty lactating cows were evaluated, fed on Brachiaria decumbens pasture, with free access to water and mineral supplementation. Data from climate variables air temperature (AT), relative humidity (RH), rainfall (RA) and temperature and humidity index (THI) were recorded dur ing the months of January to April 2019. The physiological data collected were: respiratory rate (RR, mov/min), heart rate (HR, beats/min), rectal temperature (RT, ºC), udder surface temperature (UST, ºC), body surface temperature (BST, ºC), dorsum surface temperature (DST, ºC), front surface temperature (FST, ºC) and rear shin temperature (RST). Milk production (MP) was also measured. There was a significant difference (P<0.05) of RST and RR with values ranging from 34.8 to 35.5°C and 32.0 to 36.2 mov/min, respectively. There were no significant difference (P>0.05) for BST, and the values for MP and THI were 3.8; 3.8; 4.6; 4.1 kg and 77.7; 79.7; 80.6; 80.1, respectively. It was concluded that there was a seasonal effect of the months of the year evaluated on the respiratory rate of animals, however, it did not change the MP and the THI. The Amazon environment is conducive to causing thermal stress in lactating cows raised on pasture, requiring the use of shading to facilitate the ability of these animals to dissipate heat.

Resumo O objetivo desse estudo foi avaliar os efeitos sazonais dos meses do ano sobre as respostas fisiológicas e produtivas de vacas leiteiras mestiças criadas em clima amazônico. Foram avaliadas 20 vacas lactantes, alimentadas com pasto de Brachiaria decumbens, com acesso livre a água e suplementação mineral. Foram registrados dados das variáveis climáticas temperatura do ar (TA), umidade relativa do ar (UR), precipitação pluviométrica (PP) e índice de temperatura e Umidade (ITU) durante os meses de janeiro a abril de 2019. Os dados fisiológicos coletados foram: frequência respiratória (FR, mov/min), frequência cardíaca (FC, bat./min), temperatura retal (TR, ºC), temperatura superficial do úbere (TSU, ºC), temperatura superfície corporal (TSC, ºC), temperatura superficial do dorso (TSD, ºC), temperatura superficial da fronte (TSF, ºC) e temperatura superficial da canela (TSCA, °C). Também foi mensurada a produção de leite (PL, kg). Houve diferença significativa (P<0,05) da TSCA e FR com valores variando de 34,8 a 35,5°C e 32,0 a 36,2 mov/min, respectivamente. Não houve diferença significativa (P>0,05) para TSC e os valores observados para PL e ITU foram 3,8; 3,8; 4,6; 4,1 kg e 77,7; 79,7; 80,6; 80,1, respectivamente. Houve efeito sazonal dos meses avaliados sobre a taxa respiratória dos animais, no entanto, isso não alterou a PL nem o ITU. O ambiente amazônico é propício a causar estresse térmico em vacas lactantes mantidas a pasto, sendo necessário o uso de sombreamento para facilitar a capacidade de dissipação de calor corporal desses animais.

https://doi.org/10.1590/1809-6891v24e-73559e

13.

Inflamação Coronária Avaliada pela Atenuação de Gordura Pericoronária na Tomografia Computadorizada e Elevação de Citocinas em Usuários Jovens de Esteroides Anabólicos Androgênicos
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Souza, Francis Ribeiro de

; Rochitte, Carlos E.

; Silva, Douglas Carli

; Sampaio, Barbara

; Passarelli, Marisa

; Santos, Marcelo R. dos

; Fonseca, Guilherme W.

; Battaglia Filho, Antonio Carlos

; Correa, Kelly

; do Val, Renata Margarida

; Yonamine, Maurício

; Pereira, Rosa Maria R.

; Negrão, Carlos Eduardo

; Kalil-Filho, Roberto

; Alves, Maria Janieire de Nazaré Nunes

Arquivos Brasileiros de Cardiologia

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2023, Volume 120 N. 11 elocation e20220822

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

Abstract Background Anabolic androgenic steroid (AAS) abuse has been associated with coronary artery disease (CAD). Pericoronary fat attenuation (pFA) is a marker of coronary inflammation, which is key in the atherosclerotic process. Objective To evaluate pFA and inflammatory profile in AAS users. Methods Twenty strength-trained AAS users (AASU), 20 AAS nonusers (AASNU), and 10 sedentary controls (SC) were evaluated. Coronary inflammation was evaluated by mean pericoronary fat attenuation (mPFA) in the right coronary artery (RCA), left anterior descending coronary artery (LAD), and left circumflex (LCx). Interleukin (IL)-1 (IL-1), IL-6, IL-10, and TNF-alpha were evaluated by optical density (OD) in a spectrophotometer with a 450 nm filter. P<0.05 indicated statistical significance. Results AASU had higher mPFA in the RCA (-65.87 [70.51-60.70] vs. -78.07 [83.66-72.87] vs.-78.46 [85.41-71.99] Hounsfield Units (HU), respectively, p<0.001) and mPFA in the LAD (-71.47 [76.40-66.61] vs. -79.32 [84.37-74.59] vs. -82.52 [88.44-75.81] HU, respectively, p=0.006) compared with AASNU and SC. mPFA in the LCx was not different between AASU, AASNU, and SC (-72.41 [77.17-70.37] vs. -80.13 [86.22-72.23] vs. -78.29 [80.63-72.29] HU, respectively, p=0.163). AASU compared with AASNU and SC, had higher IL-1, (0.975 [0.847-1.250] vs. 0.437 [0.311-0.565] vs. 0.530 [0.402-0.780] OD, respectively, p=0.002), IL-6 (1.195 [0.947-1.405] vs. 0.427 [0.377-0.577] vs. 0.605 [0.332-0.950] OD, p=0.005) and IL-10 (1.145 [0.920-1.292] vs. 0.477 [0.382-0.591] vs. 0.340 [0.316-0.560] OD, p<0.001). TNF-α was not different between the AASU, AASNU, and SC groups (0.520 [0.250-0.610] vs. 0.377 [0.261-0.548] vs. 0.350 [0.182-430]), respectively. Conclusion Compared with ASSNU and controls, AASU have higher mPFA and higher systemic inflammatory cytokines profile suggesting that AAS may induce coronary atherosclerosis through coronary and systemic inflammation.

Resumo Fundamento O uso abusivo de esteroides anabólicos androgênicos (EAA) tem sido associado à doença arterial coronariana (DAC). A atenuação de gordura pericoronária (AGp) é um marcador de inflamação coronária, a qual exerce um papel chave no processo aterosclerótico. Objetivo Avaliar AGp e perfil inflamatório em usuários de EAA. Método Vinte indivíduos que realizavam treinamento de força, usuários de EAA (UEAA), 20 não usuários de EAA (NUEAA), e 10 indivíduos sedentários controle (SC) foram avaliados. Inflamação coronária foi avaliada por atenuação de gordura pericoronária média (AGPm) artéria coronária direita (ACD), artéria descendente anterior esquerda (ADA) e artéria circunflexa (ACX). Interleucina (IL)-1 (IL-1), IL-6, IL-10, e TNF-alfa foram avaliados por densidade ótica (DO) em um espectrofotômetro com um filtro de 450 nm. Um p<0,05 indicou significância estatística. Resultados Os UEAA apresentaram maior AGPm na ACD [-65,87 (70,51-60,70) vs. -78,07 (83,66-72,87) vs.-78,46 (85,41-71,99] unidades Hounsfield (HU), respectivamente, p<0,001) e AGPm na ADA [-71,47 (76,40-66,610 vs. -79,32 (84,37-74,59) vs. -82,52 (88,44-75,81) HU, respectivamente, p=0,006) em comparação aos NUEAA e CS. A AGPm na ACX não foi diferente entre os grupos UEAA, NUEAA e CS [-72,41 (77,17-70,37) vs. -80,13 (86,22-72,23) vs. -78,29 (80,63-72,29) HU, respectivamente, p=0,163). Em comparação aos NUEAA e aos CS, o grupo UEAA apresentaram maiores níveis de IL-1 [0,975 (0,847-1,250) vs. 0,437 (0,311-0,565) vs. 0,530 (0,402-0,780) DO, respectivamente, p=0,002), IL-6 [1,195 (0,947-1,405) vs. 0,427 (0,377-0,577) vs. 0,605 (0,332-0,950) DO, p=0,005) e IL-10 [1,145 (0,920-1,292) vs. 0,477 (0,382-0,591) vs. 0,340 (0,316-0,560) DO, p<0,001]. TNF-α não foi diferente entre os grupos UEAA, NUEAA e CS [0,520 (0,250-0,610) vs. 0,377 (0.261-0,548) vs. 0,350 (0,182-430)]. Conclusão Em comparação aos NUEAA e controles, os UEAA apresentam maior AGPm e maior perfil de citocinas inflamatórias sistêmicas, sugerindo que os EAA podem induzir aterosclerose por inflamação coronária e sistêmica.

https://doi.org/10.36660/abc.20220822

14.

CAN TEMPORARY ARTERY CATHETERIZATION EXTEND LIMITS OF ISCHEMIA TIME FOR MACROREPLANTATION?
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IAMAGUCHI, RAQUEL BERNARDELLI

; DIAS, GUILHERME MOREIRA

; IWASE, FERNANDA DO CARMO

; REZENDE, MARCELO ROSA DE

; MATTAR JR, RAMES

Acta Ortopédica Brasileira

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2023, Volume 31 N. 6 elocation e267476

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

ABSTRACT We observe delayed referrals to appropriate Microsurgery Unit and definitive treatment of traumatic limb amputations. Cases with wrist proximal amputations have a deadline for surgical replantation as these configure life-threatening injuries. Objective: To analyze patients with traumatic proximal wrist upper limb amputations with prolonged ischemic time who underwent temporary artery catheterization to assess stump viability and results. Methods: A case-series study including all patients with a proximal wrist upper limb amputation and a cold ischemic time equal to or above six hours from 2017 to 2021. Results: In total, two surgeons operated eight patients who had experienced forearm amputation injuries. Median ischemia time totaled eight hours. All patients required additional surgeries, most commonly split-thickness skin graft or fixation revision (three patients). This study obtained five successful macroreimplantations. The mean cold ischemia time was longer in the group with successful macroreimplantations (7.4 hours) than of the unsuccessful group (9 hours). Conclusion: Macroreplantations require immediate referral to microsurgery and, although temporary artery catheterization helps surgical decision making, the technique seems to fail to influence outcomes. Level of Evidence IV, Retrospective Case Series.

RESUMO Observa-se um atraso no referenciamento dos casos para o tratamento definitivo das amputações traumáticas de membros no Brasil. Casos com amputações proximais ao punho apresentam um prazo limite para reimplante, sendo lesões que promovem risco de vida ao paciente. Objetivo: Analisar os macrorreimplantes com tempo de isquemia prolongado submetidos à cateterização temporária da artéria, para determinar a viabilidade do coto de amputação, e seus resultados. Métodos: Série de casos de todos os pacientes com amputações traumáticas proximais ao punho, cujo tempo de isquemia fria foi igual ou superior a seis horas, entre 2017 e 2021. Resultados: A amostra foi composta por oito pacientes com amputações traumáticas de antebraço operados por dois cirurgiões. O tempo médio de isquemia foi de oito horas. Todos os pacientes necessitaram de cirurgias adicionais, sendo as mais comuns o enxerto de pele ou a revisão da fixação óssea. Sucesso do macrorreimplante foi observado em cinco pacientes. O tempo médio de isquemia fria foi maior no grupo com sucesso no macrorreimplante (7,4 horas) quando comparado com o grupo sem sucesso (9 horas). Conclusão: Os macrorreimplantes necessitam de transferência imediata para serviços especializados, e, apesar de a cateterização temporária arterial auxiliar no manejo cirúrgico, a técnica parece não interferir nos resultados. Nível de Evidência IV, Série de Casos.

https://doi.org/10.1590/1413-785220233105e267476

15.

A brazilian nationwide multicenter study on deficiency of deaminase-2 (DADA2)
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Melo, Adriana

; Carvalho, Luciana Martins de

; Ferriani, Virginia Paes Leme

; Cavalcanti, André

; Appenzeller, Simone

; Oliveira, Valéria Rossato

; Chong Neto, Herberto

; Rosário, Nelson Augusto

; Poswar, Fabiano de Oliveira

; Guimaraes, Matheus Xavier

; Kokron, Cristina Maria

; Maia, Rayana Elias

; Silva, Guilherme Diogo

; Keller, Gabriel

; Ferreira, Mauricio Domingues

; Vasconcelos, Dewton Moraes

; Toledo-Barros, Myrthes Anna Maragna

; Barros, Samar Freschi

; Rosa Neto, Nilton Salles

; Krieger, Marta Helena

; Kalil, Jorge

; Mendonça, Leonardo Oliveira

Advances in Rheumatology

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2023, Volume 63 elocation 23

Abstract: En | Text: En | PDF: En

Abstract Introduction The deficiency of ADA2 (DADA2) is a rare autoinflammatory disease provoked by mutations in the ADA2 gene inherited in a recessive fashion. Up to this moment there is no consensus for the treatment of DADA2 and anti-TNF is the therapy of choice for chronic management whereas bone marrow transplantation is considered for refractory or severe phenotypes. Data from Brazil is scarce and this multicentric study reports 18 patients with DADA2 from Brazil. Patients and methods This is a multicentric study proposed by the Center for Rare and Immunological Disorders of the Hospital 9 de Julho - DASA, São Paulo - Brazil. Patients of any age with a confirmed diagnosis of DADA2 were eligible for this project and data on clinical, laboratory, genetics and treatment were collected. Results Eighteen patients from 10 different centers are reported here. All patients had disease onset at the pediatric age (median of 5 years) and most of them from the state of São Paulo. Vasculopathy with recurrent stroke was the most common phenotype but atypical phenotypes compatible with ALPS-like and Common Variable Immunodeficiency (CVID) was also found. All patients carried pathogenic mutations in the ADA2 gene. Acute management of vasculitis was not satisfactory with steroids in many patients and all those who used anti-TNF had favorable responses. Conclusion The low number of patients diagnosed with DADA2 in Brazil reinforces the need for disease awareness for this condition. Moreover, the absence of guidelines for diagnosis and management is also necessary (t).

https://doi.org/10.1186/s42358-023-00303-5

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