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Introdução: a infecção crônica pelo vírus da hepatite C (HCV) e a obesidade podem induzir esteatose hepática e diabetes mellitus (DM). Objetivo: avaliar a prevalência de obesidade e de distúrbios metabólicos em pacientes com HCV; estudar a prevalência de HCV e os distúrbios metabólicos em pacientes obesos. Comparar o perfil glicêmico entre os grupos. Metodologia: estudo analítico, com pacientes acompanhados nos ambulatórios de Hepatite C e Obesidade. Variáveis analisadas: glicemia, hemoglobina glicada (A1C), esteatose hepática, HCV, estágio de fibrose hepática e dados sociodemográficos. Resultados: no ambulatório de obesidade 45 pacientes foram avaliados, dos quais 6,7% tinham hepatite C, 40% DM e 61-73% esteatose hepática. As médias das enzimas hepáticas (U/L) foram: AST 22,9; ALT 25,2; FAL 146,5 e GGT 63. Nos obesos com DM, 72,2% apresentavam A1C < 7%. A segunda amostra continha 159 portadores de HCV do ambulatório de hepatologia: 17,9% tinham obesidade, 18,9% DM e 27% esteatose hepática. As médias das enzimas hepáticas (U/L) consistiram em: AST 70,5; ALT 90,6; FAL 108,5 e GGT 131,7. Entre os diabéticos com HCV, 52% não apresentavam A1C < 7%. Conclusão: foi encontrada alta prevalência de hepatite C em pacientes com obesidade (6,7%) quando comparados com a população de Salvador (1,5-1,8%). Os distúrbios metabólicos foram mais frequentes entre obesos, porém os diabéticos com obesidade revelaram A1C menores do que os diabéticos com HCV, sugerindo, neste estudo, que pode existir interferência viral no controle glicídico. A esteatose hepática foi mais prevalente entre obesos.

Introduction: Hepatitis C virus infection (HCV) and Obesity can to induce hepatic steatosis and diabetes mellitus (DM). Objectives: to evaluate the prevalence of obesity and metabolic disorders in HCV viremic patients. To study the prevalence of hepatitis C and metabolic disorders in patients with obesity. To compare glycemic profile between the groups. Methods: analytical study, with patients followed up at hepatitis C and Obesity outpatient clinics patients. Variables studied: blood glucose, glycated hemoglobin (A1C), hepatic steatosis, HCV, hepatic fibrosis stage and sociodemographic data. Results: in Obesity clinic sample 45 patients were evaluated, 6,7% was hepatitis C, 40% DM and 61% -73% hepatic steatosis. Mean of liver enzymes levels (U/L) were: AST 22.9; ALT 25.2; FAL 146.5 and GGT 63. In obese with DM, 72.2% of them were able to maintain A1C < 7%. The second sample contained 159 HCV carriers at the hepatology clinic, 17,9% was Obesity, 18,9% DM and 27% hepatic steatosis. Averages of serum liver enzymes level (U/ L) were: AST 70.5; ALT 90.6; FAL 108.5 and GGT 131.7. Among diabetics with HCV, 52% are unable to maintain A1C < 7%. Conclusions: found high prevalence of hepatitis C in patients with obesity (6.7%) when compared to the population of Salvador (1.5%-1.8%). Metabolic disorders were more frequent in the obese group, but diabetics with obesity have lower A1C values than diabetics with HCV, suggesting, in this study, that there may be a viral interference with glycid control. Liver steatosis is more prevalent among obese people

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ABSTRACT Objective: Percutaneous ethanol injection (PEI) is an alternative to surgery for the treatment of thyroid nodules (TNs). However, size reductions of treated (TTNs) and untreated TN (UTNs) have not been compared. Volumetric reductions in TTNs with PEI were evaluated by comparing TTNs and UTNs in the same patient, and independent variables predicting good post-PEI outcomes were analyzed. Materials and methods: Overall, 282 patients with multinodular goiters were selected. Two nodules located in different lobes were compared for common disease behaviors. Overall, 150 nodules were selected from 75 patients (6 M: 69 F) with a mean age of 50.1 ± 17.4 years. This prospective nonrandomized intervention study prioritized treating TNs of greater volume or single hyperfunctioning TNs. A single observer experienced in PEI and an ultrasound specialist performed the interventions. Results and discussion: TTNs (mean volume: 14.8 ± 16.2 mL) were reduced by 72.6 ± 27.3% of their initial volume, while UTNs increased by a mean of 365.7 ± 1.403.8% (p < 0.00001). The patients underwent a mean of 4.0 ± 3.1 outpatient PEI sessions without relevant complications. Logistic regression analysis showed that the magnitude of the PEI induced reduction was associated with the number of treatment sessions (p = 0.03, CI [1.1-38.2]) and not with ultrasonographic characteristics of the nodules. Each PEI session increased the rate of TN reduction by a factor of 6.7. Conclusions: PEI is a well-tolerated outpatient procedure that effectively reduces the volume of TNs and is noticeably superior to conservative treatment for all ultrasonographic classifications.

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OBJECTIVE: Percutaneous ethanol injection (PEI) is an alternative to surgery for the treatment of thyroid nodules (TNs). However, size reductions of treated (TTNs) and untreated TN (UTNs) have not been compared. Volumetric reductions in TTNs with PEI were evaluated by comparing TTNs and UTNs in the same patient, and independent variables predicting good post-PEI outcomes were analyzed. METHODS: Overall, 282 patients with multinodular goiters were selected. Two nodules located in different lobes were compared for common disease behaviors. Overall, 150 nodules were selected from 75 patients (6 M: 69 F) with a mean age of 50.1 ± 17.4 years. This prospective nonrandomized intervention study prioritized treating TNs of greater volume or single hyperfunctioning TNs. A single observer experienced in PEI and an ultrasound specialist performed the interventions. RESULTS: TTNs (mean volume: 14.8 ± 16.2 mL) were reduced by 72.6 ± 27.3% of their initial volume, while UTNs increased by a mean of 365.7 ± 1.403.8% (p < 0.00001). The patients underwent a mean of 4.0 ± 3.1 outpatient PEI sessions without relevant complications. Logistic regression analysis showed that the magnitude of the PEI induced reduction was associated with the number of treatment sessions (p = 0.03, CI [1.1-38.2]) and not with ultrasonographic characteristics of the nodules. Each PEI session increased the rate of TN reduction by a factor of 6.7. CONCLUSION: PEI is a well-tolerated outpatient procedure that effectively reduces the volume of TNs and is noticeably superior to conservative treatment for all ultrasonographic classifications.

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Cladosporium spp. is a cosmopolitan fungal genus. In the literature, it has been reported as a biological agent for controlling several plant diseases, but its mechanism of action has never been clarified. The present study aims to identify Cladosporium spp. based on the DNA phylogeny of nine isolates obtained from the phylloplane of rice and their potential antagonistic activity against the main fungal pathogens that affect rice crop. Nine isolates of Cladosporium spp. were identified based on DNA phylogeny, molecular and morphological characterization, and their antagonistic effects with the rice pathogens C. miyabeanus, M. oryzae, M. albescens and S. oryzae. Four isolates were selected to study lytic enzymes such as ß-1,3-glucanase, chitinase and protease, and only one isolate was selected for a conidial germination and appressoria formation assay. The nine isolates were identified as C. cladosporioides, C. tenuissimum and C. subuliforme. Four isolates, identified as C. cladosporioides, inhibited the mycelial growth of rice pathogens such as C1H (68.59%) of S. oryzae, C5 G (74.32%) of C. miyabeanus, C11 G (75.97%) of M. oryzae and C24 G (77.39%) of M. albescens. C24 G showed a high activity of lytic enzymes, was tested against C. miyabeanus and M. oryzae, and inhibited conidial germination and appressorium formation by more than 59.36%. The characterization of C. cladosporioides suggested this species as a potential bioagent for the management of several rice diseases, especially rice blast. This is the first time that a potential biological agent from the genus Cladosporium identified at the species level was isolated from the rice phylloplane, and some of its mechanisms of action were demonstrated, such as increasing lytic enzyme activity against rice pathogens.

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Agriculture accounts for ~ 70% of all water use and the world population is increasing annually; soon more people will need to be fed, while also using less water. The use of plant-associated bacteria (PAB) is an eco-friendly alternative that can increase crop water use efficiency. This work aimed to study the effect of some PAB on increasing soybean tolerance to drought stress, the mechanisms of the drought tolerance process, and the effect of the PAB on promoting plant growth and on the biocontrol of Sclerotinia sclerotiorum. PAB were isolated from soybean rhizosphere and S. sclerotiorum sclerotia. The strains identified as UFGS1 (Bacillus subtilis), UFGS2 (Bacillus thuringiensis), UFGRB2 and UFGRB3 (Bacillus cereus) were selected on their ability to grow in media with reduced water activity. Soybean plants were inoculated with the PAB and evaluated for growth promotion, physiological and molecular parameters, after drought stress. Under drought stress, UFGS2 and UFGRB2 sustained potential quantum efficiency of PSII (Fv/Fm), while a decrease was found in the control plants. Moreover, UFGS2 and UFGRB3 maintained the photosynthetic rates in non-stressed conditions compared to the control. UFGS2-treated plants showed a higher stomatal conductance and higher transpiration than the control, after drought stress. Some PAB-treated plants also had other beneficial phenotypes, such as increases in fresh and dried biomass relative to the control. Differential gene expression analysis of genes involved in plant stress pathways shows changes in expression in PAB-treated plants. Results from this study suggest that PAB can mitigate drought stress in soybean and may improve water efficiency under certain conditions.

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RESUMO As camadas de cobertura de aterros sanitários são construídas para impedir a saída de gases para a atmosfera e a entrada de líquidos no interior do aterro, minimizando os impactos no meio ambiente. Este trabalho avaliou, por meio de ensaios de colunas de solos em laboratório, o desempenho de duas camadas de cobertura, compreendendo o comportamento dos solos em função das emissões de metano (CH4) e da infiltração de água em seu interior. Foram utilizadas duas configurações de camada de solos: Coluna 1, camada convencional com solo com espessura 0,60 m e grau de compactação de 80%; e Coluna 2, camada oxidativa, com espessura de 0,30 m de solo com grau de compactação de 80%, sobreposta por uma camada de 0,30 m de solo misturado com produto compostado na proporção de 1:1 em volume com grau de compactação de 76%. Após a confecção das colunas (dimensões úteis de 0,60 m de altura e 0,15 m de diâmetro), foi injetado CH4 em sua parte inferior com concentração de 100% na vazão de 0,5 L/h (8,3 mL/min ou 486 g/m2.dia) para se avaliar a redução das emissões. Posteriormente, foi simulada chuva de 40 mm - sendo 30 mm em 1 dia e 10 mm 3 dias após a primeira simulação - e avaliada a infiltração da água e as emissões de CH4 nas colunas. Os resultados obtidos indicam que as duas configurações de camadas de cobertura apresentaram resultados satisfatórios, diminuindo o volume de líquidos para o interior do aterro e minimizando as emissões de CH4 para a atmosfera. Observou-se que a Coluna 2 (0,30 m de solo + 0,30 m de solo + produto compostado) se mostrou mais eficiente tanto na redução de emissões como na capacidade de retenção de água em relação à Coluna 1 (0,60 m de solo), sugerindo que camadas oxidativas podem se tornar uma alternativa tecnológica para regiões onde exista escassez de solos argilosos.

ABSTRACT Landfill cover layers are built to prevent the release of gases into the atmosphere and the inflow of liquids into the landfill, minimizing impacts on the environment. This study evaluated, through the testing of soil columns in the laboratory, the performance of two cover layers, comprehending the behavior of the soils as a function of methane emissions and liquid flows in its interior. Two configurations were used in the soil layer: Column 1, conventional layer with compacted soil of 0.60 m thickness and 80% degree of compaction; and Column 2, oxidative layer with 0.30 m thickness of soil and 80% degree of compaction, stuck by a layer of 0.30 m of mixed soil with composted product in the volume ratio of 1:1 with 76% degree of compaction. After the confection of the columns (0.60 m in height and 0.15 m in diameter), methane gas was injected into the inferior part of the columns with a concentration of 100% at a flow rate of 0.5 L/h (8.3 mL/min or 486 g/m2.day) to evaluate the emission reduction. Subsequently, a rain of 40 mm was simulated - being 30 mm in one day and 10 mm three days after the first simulation -, and both the methane emissions and the infiltration of water in the columns were evaluated. The obtained results indicate that the two column configurations of landfill cover layers presented satisfactory results, reducing the volume of liquids into the landfill and minimizing the methane emissions into the atmosphere. It is observed that Column 2 (0.30 m of soil + 0.30 m of soil + composted product) was more efficient in the reduction of emissions, as well as in the retention capacity of water in relation to Column 1 (0.60 m of soil), suggesting that oxidative layers can become a technological alternative for regions where there is scarcity of clay soils.

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Avaliou-se o transcorrer da construção da identidade de uma criança afrodescendente nas Escolas Brasileiras. Trata-se de uma revisão da literatura científica realizada em abril de 2017 na Biblioteca Virtual em Educação (BVE), Periódicos Capes e o Google Acadêmico por meio dos descritores: Identidade, criança, educação infantil, racista, professor. O estudo fora dividido em três vertentes: 1. A identidade do afrodescendente; 2. Desenvolvimento da Identidade da Criança; 3. O Papel do professor na construção da Identidade da criança afrodescendente. A identidade da criança afrodescendente é construída nas séries iniciais da educação básica, ressaltando assim o papel fundamental em que a escola e os fatores que a compõem, como professores, livros didáticos, e quaisquer outros desempenham nesse processo. O professor deve se preparar para lidar com esses assuntos em sala de aula, e não apenas propagar estereótipos sobre a identidade da criança afrodescendente. Pensando nessa sociedade onde a intolerância, o desrespeito, preconceitos, racismos e discriminações têm estado tão presentes, as escolas e seus professores, são agentes com função mediadora pautam a capacidade de influenciar os cidadãos em processo de formação, assim devem lutar e buscar uma educação igualitária, que seja democrática e cidadã e valorize as identidades das crianças negras. Que essas crianças possam falar, mostrar e "vestir" sua identidade, sem medo e com orgulho.

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Analisou-se a importância e a necessidade das formas de organização e gestão escolar. Foi realizado estudo qualitativo com análise do Projeto Político Pedagógico, observações de campo na escola pesquisada e entrevista com a diretora e professora. Para análise dos dados, foram localizadas categorias que possibilitaram compreender como os processos de organização e gestão da escola tem se materializado em seu contexto real e principalmente no que se refere aos processos de democratização das relações, funções e atividades da escola. Destacam-se as concepções e os princípios de gestão que foram produzidos ao longo História da educação brasileira, com ênfase no modelo de gestão democrático participativa. Consideram-se como problemática as dificuldades encontradas pelos gestores na consolidação de uma gestão verdadeiramente democrática no âmbito das escolas públicas estaduais

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An alternative method to control rice blast (Magnaporthe oryzae) is to include biological agent in the disease management strategy. The objective of this study was to assess the leaf blast-suppressing effects of rice phylloplane fungi. One Cladosporium sp. phylloplane fungus was shown to possess biocontrolling traits based on its morphological characteristics and an analysis of its 18S ribosomal DNA. Experiments aimed at determining the optimal time to apply the bioagent and the mechanisms involved in its rice blast-suppressing activities were performed under controlled greenhouse conditions. We used foliar spraying to apply the Cladosporium sp. 48 h prior to applying the pathogen, and we found that this increased the enzymatic activity. Furthermore, in vitro tests performed using isolate C24 showed that it possessed the ability to secrete endoxylanases and endoglucanases. When Cladosporium sp. was applied either prior to or simultaneous with the pathogen, we observed a significant increase in defence enzyme activity, and rice blast was suppressed by 84.0 and 78.6 %, respectively. However, some enzymes showed higher activity at 24 h while others did so at 48 h after the challenge inoculation. Cladosporium sp. is a biological agent that is capable of suppressing rice leaf blast by activating biochemical defence mechanisms in rice plants. It is highly adapted to natural field conditions and should be included in further studies aimed at developing strategies to support ecologically sustainable disease management and reduce environmental pollution by the judicious use of fungicidal sprays.

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OBJECTIVE: To evaluate the association between Hashimoto's thyroiditis (HT) and papillary thyroid carcinoma (PTC). MATERIALS AND METHODS: The patients were evaluated by ultrasonography-guided fine needle aspiration cytology. Typical cytopathological aspects and/or classical histopathological findings were taken into consideration in the diagnosis of HT, and only histopathological results were considered in the diagnosis of PTC. RESULTS: Among 1,049 patients with multi- or uninodular goiter (903 women and 146 men), 173 (16.5%) had cytopathological features of thyroiditis. Thirty-three (67.4%) out of the 49 operated patients had PTC, 9 (27.3%) of them with histopathological features of HT. Five (31.3%) out of the 16 patients with non-malignant disease also had HT. In the groups with HT, PTC, and PCT+HT, the female prevalence rate was 100%, 91.6%, and 77.8%, respectively. Mean age was 41.5, 43.3, and 48.5 years, respectively. No association was observed between the two diseases in the present study where HT occurred in 31.1% of the benign cases and in 27.3% of malignant cases (p = 0.8). CONCLUSION: In spite of the absence of association between HT and PCT, the possibility of malignancy in HT should always be considered because of the coexistence of the two diseases already reported in the literature.

OBJETIVO: Avaliar a associação entre tireoidite de Hashimoto (TH) e carcinoma papilífero da tireoide (CPT). MATERIAIS E MÉTODOS: Pacientes foram avaliados por punção aspirativa guiada pela ultrassonografia. Para TH consideraram-se aspectos característicos da citopatologia e/ou achados histopatológicos clássicos. O diagnóstico de CPT foi considerado apenas pela histopatologia. RESULTADOS: De 1.049 pacientes portadores de bócios uni-multinodulares (903 femininos e 146 masculinos), 173 (16,5%) tinham quadro citopatológico de tireoidite. Dos 49 pacientes operados, 33 (67,4%) revelaram CPT, dos quais 9 (27,3%) tinham a glândula com quadro histopatológico de TH. Dos 16 pacientes sem malignidade, 5 (31,3%) exibiam também TH. Nos grupos TH, CPT e CPT+TH, a proporção de acometimento do gênero feminino foi, respectivamente, 100%, 91,6% e 77,8%. A distribuição da média da idade (anos) nos três grupos foi 41,5, 43,3 e 48,5. Não houve associação entre as duas doenças, neste estudo, em que a TH esteve presente em 31,3% dos casos benignos e em 27,3% dos casos malignos (p = 0,8). CONCLUSÃO: Não houve associação entre TH e CPT, mas a possibilidade de malignidade em TH deve ser sempre lembrada em razão da concomitância das duas doenças, já revelada na literatura.

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Abstract Objective: To evaluate the association between Hashimoto's thyroiditis (HT) and papillary thyroid carcinoma (PTC). Materials and Methods: The patients were evaluated by ultrasonography-guided fine needle aspiration cytology. Typical cytopathological aspects and/or classical histopathological findings were taken into consideration in the diagnosis of HT, and only histopathological results were considered in the diagnosis of PTC. Results: Among 1,049 patients with multi- or uninodular goiter (903 women and 146 men), 173 (16.5%) had cytopathological features of thyroiditis. Thirty-three (67.4%) out of the 49 operated patients had PTC, 9 (27.3%) of them with histopathological features of HT. Five (31.3%) out of the 16 patients with non-malignant disease also had HT. In the groups with HT, PTC, and PCT+HT, the female prevalence rate was 100%, 91.6%, and 77.8%, respectively. Mean age was 41.5, 43.3, and 48.5 years, respectively. No association was observed between the two diseases in the present study where HT occurred in 31.1% of the benign cases and in 27.3% of malignant cases (p = 0.8). Conclusion: In spite of the absence of association between HT and PCT, the possibility of malignancy in HT should always be considered because of the coexistence of the two diseases already reported in the literature. .

Resumo Objetivo: Avaliar a associação entre tireoidite de Hashimoto (TH) e carcinoma papilífero da tireoide (CPT). Materiais e Métodos: Pacientes foram avaliados por punção aspirativa guiada pela ultrassonografia. Para TH consideraram-se aspectos característicos da citopatologia e/ou achados histopatológicos clássicos. O diagnóstico de CPT foi considerado apenas pela histopatologia. Resultados: De 1.049 pacientes portadores de bócios uni-multinodulares (903 femininos e 146 masculinos), 173 (16,5%) tinham quadro citopatológico de tireoidite. Dos 49 pacientes operados, 33 (67,4%) revelaram CPT, dos quais 9 (27,3%) tinham a glândula com quadro histopatológico de TH. Dos 16 pacientes sem malignidade, 5 (31,3%) exibiam também TH. Nos grupos TH, CPT e CPT+TH, a proporção de acometimento do gênero feminino foi, respectivamente, 100%, 91,6% e 77,8%. A distribuição da média da idade (anos) nos três grupos foi 41,5, 43,3 e 48,5. Não houve associação entre as duas doenças, neste estudo, em que a TH esteve presente em 31,3% dos casos benignos e em 27,3% dos casos malignos (p = 0,8). Conclusão: Não houve associação entre TH e CPT, mas a possibilidade de malignidade em TH deve ser sempre lembrada em razão da concomitância das duas doenças, já revelada na literatura. .

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INTRODUCTION: This study aimed to analyze cases referred from a reference service in oral pathology that were initially misdiagnosed as periapical lesions of endodontic origin and to perform a review of the literature regarding lesions located in the apical area of teeth with a nonendodontic source. METHODS: A survey was made of clinical cases derived from the service of oral pathology from 2002 to 2012. The pertinent literature was also reviewed using ScienceDirect and PubMed databases. The lesions were grouped into benign lesions mimicking endodontic periapical lesions (BLMEPLs), malignant lesions mimicking endodontic periapical lesions (MLMEPLs), and Stafne bone cavities. The clinical presentations were divided into lesions with swelling without pain, lesions with swelling and pain, and lesions without swelling but presenting with pain. RESULTS: The results showed that 66% (37/56) of cases represented benign lesions, 29% (16/56) malignant lesions, and 5% (3/56) Stafne bone cavities. The most commonly reported BLMEPLs were ameloblastomas (21%) followed by nasopalatine duct cysts (13.5%). The most frequently cited MLMEPLs were metastatic injuries (31.5%) followed by carcinomas (25%). The main clinical presentation of BLMEPLs was pain, whereas that of MLMEPLs was swelling associated with pain; Stafne bone cavities displayed particular clinical findings. CONCLUSIONS: Clinical and radiologic aspects as well as the analysis of the patients' medical history, pulp vitality tests, and aspiration are essential tools for developing a correct diagnosis of periapical lesions of endodontic origin. However, if the instruments mentioned earlier indicate a lesion of nonendodontic origin, a biopsy and subsequent histopathological analysis are mandatory.

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OBJECTIVE: This study evaluating the lipid profile in women in post menopause using the hormone therapy (HT) with implants of estradiol and testosterone. METHOD: One year prospective cohort with 122 patients separated in group 1, not using HT, group 2 starting the use of HT, and group 3 with prior use of implants of estradiol and testosterone. All patients performed serum dosages of total cholesterol, HDL and triglycerides, in the beginning of the study and after 1 year. DISCUSSION: The use of E and T implants showed some statistically significant decrease in TC at the beginning of the HT and some decrease in LDL in the group using HT. In the group without HT there was no difference in lipid profile.

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OBJECTIVE: To assess bone mineral density (BMD) in postmenopausal women using estradiol and testosterone hormonal implants comparing to that of patients without hormonal therapy. DESIGN OF THE STUDY: Sixty-one patients were followed in prospective cohort study separated in Group 1, 34 women using implants and Group 2, 27 women without implants and BMD assessment through Dual energy X-ray absorptiometry was conducted in the beginning of follow-up and after 1 year. RESULTS: The average lumbar spine BMD in Group 1 was 1.123 ± 0.16 kg/m(2) and 1.144 ± 0.18 kg/m(2) after 1 year, p=0.39 and femur BMD was 0.922 ± 0.16 kg/m(2) and 0.957 ± 0.12 kg/m(2) after 1 year of treatment, p=0.076. In Group 2, the initial lumbar spine BMD average was 1.064 ± 0.2 kg/m(2) and after 1 year, 1.001 ± 0.23 kg/m(2), p=0.112 and femur BMD changed from 0.928 ± 0.14 kg/m(2) to 0.881 ± 0.15 kg/m(2) after 1 year, p=0.046. CONCLUSION: BMD variance between the groups in the period of 1 year showed that the combination of estradiol and testosterone promoted bone protection in post menopausal women.

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FUNDAMENTO: Alguns estudos têm sugerido redução da atividade do clopidogrel sobre a ativação e adesão plaquetárias em pacientes em uso de estatinas. OBJETIVO: Avaliar se a ativação e agregação plaquetárias diminuem com clopidogrel, e se ocorre redução da ação do clopidogrel quando associado à atorvastatina ou à sinvastatina. MÉTODOS: Estudo prospectivo que incluiu 68 pacientes com angina estável em uso prévio de sinvastatina, atorvastatina, ou nenhuma estatina (grupo controle), com indicação prévia eletiva de realização de intervenção coronária percutânea. Foi analisada a ativação plaquetária através do número de plaquetas, níveis de P-selectina e glucoproteína IIb/IIIa (com e sem estímulo de ADP) através de citometria de fluxo. Os resultados foram analisados antes e após a intervenção coronária percutânea e da administração de clopidogrel. RESULTADOS: Observamos redução da atividade plaquetária com uso de clopidogrel. Além disso, não houve diferenças entre as variáveis analisadas que comprovassem redução da atividade do clopidogrel quando associado à estatinas. Observou-se níveis de p-selectina (pré-angioplastia: 14,23±7,52 x 11,45±8,83 x 7,65±7,09; pós angioplastia: 21,49±23,82 x 4,37±2,71 x 4,82±4,47, ρ<0,01) e glicoproteína IIb/IIIa (pré-angioplastia: 98,97±0,43 x 98,79±1,25 x 99,21±0,40; pós angioplastia: 99,37±0,29 x 98,50±1,47 x 98,92±0,88, ρ=0,52), respectivamente nos grupos controle, atorvastatina e sinvastatina. CONCLUSÃO: Concluímos que a ativação plaquetária diminui com a administração de clopidogrel, e que o clopidogrel não tem seu efeito antiplaquetário reduzido na presença de sinvastatina ou atorvastatina.

BACKGROUND: Some studies have suggested reduced activity of clopidogrel on platelet activation and adherence in patients using statins. OBJECTIVE: To assess whether platelet activation and aggregation decrease with clopidogrel, and whether there is a reduction of the action of clopidogrel when associated with atorvastatin or simvastatin. METHODS: This prospective study included 68 patients with stable angina with previous use of simvastatin, atorvastatin, or no statin (control group), with previous elective indication of percutaneous coronary intervention (PCI). Platelet activation was analyzed by means of platelet count, levels of P-selectin and glycoprotein IIb/IIIa (with and without ADP stimulation) by flow cytometry. The findings were analyzed before and after percutaneous coronary intervention and the administration of clopidogrel. RESULTS: We observed reduction in platelet activity with use of clopidogrel. Furthermore, no differences were found between the variables analyzed to prove reduced activity of clopidogrel when combined with statins. We observed levels of p-selectin (pre-angioplasty: 14.23 ± 7.52 x 8.83 x 11.45 ± 7.65 ± 7.09; after angioplasty: 21.49 ± 23.82 x 4 37 ± 2.71 x 4.82 ± 4.47, ρ < 0.01) and glycoprotein IIb/IIIa (pre-angioplasty: 98.97 ± 0.43 ± 1.25 x 98.79 x 99.21 ± 0.40 after angioplasty: 99.37 ± 0.29 ± 1.47 x 98.50 x 98.92 ± 0.88, ρ = 0.52), respectively, in the control, atorvastatin and simvastatin groups. CONCLUSION: We concluded that platelet activation decreases with administration of clopidogrel, and clopidogrel has no antiplatelet effect reduced in the presence of simvastatin or atorvastatin.

FUNDAMENTO: Algunos estudios han sugerido reducción de la actividad del clopidogrel sobre la activación y adhesión plaquetarias en pacientes en uso de estatinas. OBJETIVO: Evaluar si la activación y agregación plaquetarias disminuyen con clopidogrel, y si ocurre reducción de la acción del clopidogrel cuando está asociado a la atorvastatina o a la sinvastatina. MÉTODOS: Estudio prospectivo que incluyó 68 pacientes con angina estable en uso previo de sinvastatina, atorvastatina, o ninguna estatina (grupo control), con indicación previa electiva de realización de intervención coronaria percutánea. Fue analizada la activación plaquetaria a través del número de plaquetas, niveles de P-selectina y glucoproteína IIb/IIIa (con y sin estímulo de ADP) a través de citometría de flujo. Los resultados fueron analizados antes y después de la intervención coronaria percutánea y de la administración de clopidogrel. RESULTADOS: Observamos reducción de la actividad plaquetaria con uso de clopidogrel. Además de eso, no hubo diferencias entre las variables analizadas que comprobasen reducción de la actividad del clopidogrel cuando está asociado a las estatinas. Se observaron niveles de p-selectina (pre-angioplastia: 14,23±7,52 x 11,45±8,83 x 7,65±7,09; post angioplastia: 21,49±23,82 x 4,37±2,71 x 4,82±4,47, ρ<0,01) y glicoproteína IIb/IIIa (pre-angioplastia: 98,97±0,43 x 98,79±1,25 x 99,21±0,40; post angioplastia: 99,37±0,29 x 98,50±1,47 x 98,92±0,88, ρ=0,52), respectivamente en los grupos control, atorvastatina y sinvastatina. CONCLUSIÓN: Concluimos que la activación plaquetaria disminuye con la administración de clopidogrel, y que el clopidogrel no tiene su efecto antiplaquetario reducido en la presencia de sinvastatina o atorvastatina.

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BACKGROUND: Some studies have suggested reduced activity of clopidogrel on platelet activation and adherence in patients using statins. OBJECTIVE: To assess whether platelet activation and aggregation decrease with clopidogrel, and whether there is a reduction of the action of clopidogrel when associated with atorvastatin or simvastatin. METHODS: This prospective study included 68 patients with stable angina with previous use of simvastatin, atorvastatin, or no statin (control group), with previous elective indication of percutaneous coronary intervention (PCI). Platelet activation was analyzed by means of platelet count, levels of P-selectin and glycoprotein IIb/IIIa (with and without ADP stimulation) by flow cytometry. The findings were analyzed before and after percutaneous coronary intervention and the administration of clopidogrel. RESULTS: We observed reduction in platelet activity with use of clopidogrel. Furthermore, no differences were found between the variables analyzed to prove reduced activity of clopidogrel when combined with statins. We observed levels of p-selectin (pre-angioplasty: 14.23 ± 7.52 x 8.83 x 11.45 ± 7.65 ± 7.09; after angioplasty: 21.49 ± 23.82 x 4 37 ± 2.71 x 4.82 ± 4.47, ρ < 0.01) and glycoprotein IIb/IIIa (pre-angioplasty: 98.97 ± 0.43 ± 1.25 x 98.79 x 99.21 ± 0.40 after angioplasty: 99.37 ± 0.29 ± 1.47 x 98.50 x 98.92 ± 0.88, ρ = 0.52), respectively, in the control, atorvastatin and simvastatin groups. CONCLUSION: We concluded that platelet activation decreases with administration of clopidogrel, and clopidogrel has no antiplatelet effect reduced in the presence of simvastatin or atorvastatin.

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BACKGROUND: Obesity is associated with obstructive sleep apnea (OSA) and nonalcoholic fatty liver disease (NAFLD). It has been shown that OSA could be an independent risk factor for NAFLD. OSA could cause not only insulin resistance but worse NAFLD through nocturnal hypoxemia. This study aimed to evaluate the frequency of OSA and NAFLD in obese patients and the relationship between OSA, insulin resistance, and severity of steatohepatitis (nonalcoholic steatohepatitis (NASH)). METHODS: Forty obese patients submitted to bariatric surgery were evaluated. Sleep studies, fasting blood glucose, serum insulin, homeostasis model assessment (HOMA-IR), and liver enzymes were measured. Liver biopsies were evaluated for features of NAFLD including degrees of steatosis, inflammation, cellular ballooning, and fibrosis. NASH was diagnosed in those with steatosis + ballooning or steatosis + fibrosis. The diagnosis of OSA was based on an apnea/hypopnea index (AHI) ≥ 5 events/hours. RESULTS: OSA was present in 32 (80.0%), NAFLD in 33 (82.5%), and NASH in 32 (80.0%) patients. Patients with AHI ≥ 15 ev/h had higher serum insulin levels (30.0 ± 12.8 vs. 22.6 ± 17.3 µU/ml; p = 0.015) and HOMA-IR (7.5 ± 4.0 vs. 5.4 ± 4.1; p = 0.016) when compared with those with AHI < 15 ev/h, but no association was found between AHI and NASH (81.0% vs. 78.9%; p = 1.000) or oxihemoglobin desaturation <84% and NASH (81.2% vs. 70.8%; p = 0.709) when these groups were compared. CONCLUSIONS: Obese patients had elevated OSA and NAFLD frequencies. OSA was associated with insulin resistance but not with the severity of NASH.

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OBJECTIVE: To identify factors associated with low cardiometabolic risk (CMR) in obese women (O(b)W) seen at outpatient specialty clinics of SUS (Brazilian Social Security Health System), in the City of Salvador, Bahia, Brazil. SUBJECTS AND METHODS: Case-control study, matched by age, of 306 O(b)W (BMI > or = 30 kg/m(2)), including 66 (21. 6%) cases - normotensive, normolipidemic and nondiabetic patients - and 240 (78.4%) controls. Secondary data were obtained from clinical records, and primary data were collected by means of a household survey and laboratory assays. Descriptive, bivariate, and conditional logistic regression analyses were conducted. RESULTS: A positive, statistically significant association was found between low CMR and a diet containing the desirable ingestion of fruit (AOR = 20. 1, CI 95% 5.6-71.9); 1st CRP quartile (AOR = 4. 1, CI 95% 2.0-8. 3), and 3rd and 4th AdipoQ quartiles (AOR = 2.3, CI 95% 1.1-4. 8). CONCLUSION: This study suggests that a diet rich in soluble fibers as well as lower levels of CRP, and higher levels of AdipoQ, encumber, retard or impede the emergence of other metabolic risk factors or metabolic diseases in O(b)W.

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OBJETIVO: Identificar fatores associados ao baixo risco cardiometabólico (RCM) em mulheres obesas (MOb) atendidas em ambulatórios especializados do Sistema Único de Saúde (SUS), Salvador, Bahia, Brasil. SUJEITOS E MÉTODOS: Estudo caso-controle, pareado pela idade com 306 MOb, índice de massa corporal (IMC) > 30 kg/m², sendo 66 (21,6 por cento) casos - todos não hipertensos, normolipídicos e não diabéticos e 240 (78,4 por cento) controles. Dados secundários foram obtidos dos prontuários médicos e primários por meio de inquérito domiciliar e exames laboratoriais. Foram realizadas análises descritiva, bivariada e regressão logística condicional. RESULTADOS: Associações positivas, estatisticamente significantes, foram detectadas entre baixo RCM e consumo de frutas (> 3 porções/dia) (ORaj= 20,1; IC 95 por cento: 5,6-71,9); PCR do 1º. quartil (ORaj= 4,1; IC 95 por cento: 2,0-8,3) e da adiponectina plasmática (AdipoQ) a partir do 3º. quartil (ORaj = 2,3; IC 95 por cento: 1,1-4,8). CONCLUSÃO: Este estudo sugere que dieta rica em fibras solúveis (> 3 porções de frutas/dia), valores da PCR < 3,70 mg/L e da AdipoQ > 10,00 µg/mL podem dificultar, retardar ou impedir o aparecimento de outros fatores de risco ou doenças metabólicas em MOb.

OBJECTIVE: To identify factors associated with low cardiometabolic risk (CMR) in obese women (ObW) seen at outpatient specialty clinics of SUS (Brazilian Social Security Health System), in the City of Salvador, Bahia, Brazil. SUBJECTS AND METHODS: Case-control study, matched by age, of 306 ObW (BMI > 30 kg/m²), including 66 (21. 6 percent) cases - normotensive, normolipidemic and nondiabetic patients - and 240 (78.4 percent) controls. Secondary data were obtained from clinical records, and primary data were collected by means of a household survey and laboratory assays. Descriptive, bivariate, and conditional logistic regression analyses were conducted. RESULTS: A positive, statistically significant association was found between low CMR and a diet containing the desirable ingestion of fruit (AOR = 20. 1, CI 95 percent 5.6-71.9); 1st CRP quartile (AOR = 4. 1, CI 95 percent 2.0-8. 3), and 3rd and 4th AdipoQ quartiles (AOR = 2.3, CI 95 percent 1.1-4. 8). CONCLUSION: This study suggests that a diet rich in soluble fibers as well as lower levels of CRP, and higher levels of AdipoQ, encumber, retard or impede the emergence of other metabolic risk factors or metabolic diseases in ObW.

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O objetivo deste trabalho é avaliar a eficiência de remoção do hidróxido de cálcio [Ca (OH)2] do interior do canal radicular, valendo-se de diferentes métodos. Vinte e seis incisivos inferiores foram preparados com a técnica escalonada regressiva e preenchidos com Ca(OH)2associado a soro fisiológico. As amostras foram armazenadas a 37 °C, em 100% de umidade relativa, por sete dias e foram divididas em dois grupos, de acordo com a técnica de remoção da medicação intracanal. No Grupo1 (G1): irrigação com 5 mL de hipoclorito de sódio 1%; limagem com instrumento memória por 1 minuto; irrigação com 5 mL de hipoclorito de sódio 1%; patência por 10 segundos; irrigação final com 10 mL de EDTA-T 17%. No Grupo 2 (G2), procederam-se as mesmas etapas do G1, acrescendo-se o uso do ultrassom por 1 minuto com lima #15. As amostras foram avaliadas qualitativamente em microscópio eletrônico de varredura, por meio de imagens de diferentes áreas do terço apical. De acordo com o teste de Mann-Whitney, com nível de significância de 5%, G1 não diferiu estatisticamente do G2. O teste de Friedman indicou diferenças estatisticamente significativas entre as áreas do terço apical para os dois grupos, sugerindo que à medida que se aproxima da área mais apical, menos eficaz é a remoção do hidróxido de cálcio. Os resultados mostraram que nenhuma técnica removeu completamenteo Ca (OH)2 do canal radicular.

The purpose of this study was to evaluate the efficiency of different methods of removal of calcium hydroxide [Ca (OH)2]. Twenty six inferior incisors had been prepared using the regressive technique and filled with Ca (OH)2. The samples had been stored to 37 °C in 100% of relative humidity per 7 days. The teeth had been divided in two groups in accordance with the technique of removal of the intracanal medication. In the Grupo1 (G1) ? 5 mL of 1% sodium hypochlorite (NaOCl); instrumented for 1 minute; 5 mL of 1% NaOCl; patency per 10 seconds; 10 mL of EDTA - T 17%. Group 2 (G2) follows the same stages of the G1, increasing the use of the ultrasonic for 1 minute. The samples had been evaluated qualitatively in electron microscope, through images of different areas of apical third. In accordance with the test of Mann-Whitney, with level of significance of 5%, G1 does not differ from G2. The test of Friedman indicates significant differences between the areas of apical third for the two groups. Results showed that no technique removed all Ca (OH)2.

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