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Objective: Rheumatoid arthritis causes inflammation, pain, and joint degradation, necessitating treatment with anti-inflammatory drugs and corticosteroids, posing various challenges. We aimed to evaluate the effects of photobiomodulation (PBM) at two different doses associated to platelet-rich plasma (PRP) in an in vivo model of induced acute arthritis in Wistar rats' knee. Methods: Eighty-four Wistar rats were assigned into seven groups, including animals treated with PBM and/or PRP. On day 0, arthritis was induced in sham and treated groups through the intra-articular injection of zymosan (200 µg). Twenty-four hours after induction, the PBM groups were treated with an AsGaAl laser, whereas the PRP-treated groups received intra-articular injections with a concentration of 8 × 105 platelets obtained from another four animals. After 3 days, the animals were euthanized, and the interleukin (IL)-6 and complement C3 gene and protein expression levels were analyzed. Statistical analysis was performed using the mean ± SD with analysis of variance and Tukey's posttest, with a significance level set at 5% (p < 0.05). Results: Synovial inflammation decreased in PBM-treated groups; however, PRP alone showed no significant difference. Gene expression analysis revealed a significant difference in IL-6 and C3 levels in the PBM and PBM+PRP-treated groups. Meanwhile, the PRP alone group exhibited significance for IL-6. Moreover, the PBM and PBM+PRP-treated groups showed a significant difference in C3 protein expression levels, whereas the PRP alone group showed no difference. Conclusion: The increase in cellular activity in the synovial membrane and the decrease protein expression levels are owing to the reduction in proinflammatory mediators following PBM therapy.

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PURPOSE: To evaluate morphological aspects and inducible nitric oxide synthase (iNOS) gene and protein expression in a model of acute inflammation. METHODS: Thirty-six female Wistar rats were assigned into three groups: control (saline, n = 12), sham (arthritis, n = 12), and PBM (arthritis and photobiomodulation, n = 12). Arthritis induction was performed with 200 µg of intra-articular Zymosan in sham and PBM animals. PBM was performed 24 h after induction with a laser device (λ = 808 nm, 25 mW of nominal power, fluence of 20 J/cm2, beam area of 0.02 mm2, time of 33 s, total energy of 0.825 J) with punctual and single dose application. Morphological analysis of joint structure (HE) and immunohistochemistry (anti-iNOS antibody) were performed on knee samples, and synovial tissue was submitted to RNA extraction, cDNA synthesis and gene expression analysis by quantitative polymerase chain reaction. Statistical analyses were performed with p < 0.05. RESULTS: It was observed an increase in the thickness of the synovial lining epithelium and inflammatory infiltrate in sham compared to PBM. Gene expression analysis showed higher iNOS expression in PBM, and iNOS protein expression decreased in PBM compared to sham. CONCLUSIONS: Photobiomodulation decreased inflammation in PBM animals, upregulated iNOS gene expression, however down egulated protein expression compared to sham.

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A promissory technic for reducing environmental contaminants is the production of biochar from waste reuse and its application for water treatment. This study developed biochar (CWb) and NH4Cl-modified biochar (MCWb) using cassava residues as precursors. CWb and MCWb were characterized and evaluated in removing dyes (Acid Blue 9 and Food Red 17) in a binary system. The adsorbent demonstrated high adsorption capacity at all pH levels studied, showing its versatility regarding this process parameter. The equilibrium of all adsorption experiments was reached in 30 min. The adsorption process conformed to pseudo-first-order kinetics and extended Langmuir isotherm model. The thermodynamic adsorption experiments demonstrated that the adsorption process is physisorption, exhibiting exothermic and spontaneous characteristics. MCWb exhibited highly efficient and selective adsorption behavior towards the anionic dyes, indicating maximum adsorption capacity of 131 and 150 mg g-1 for Food Red 17 and Acid Blue 9, respectively. Besides, MCWb could be reused nine times, maintaining its original adsorption capacity. This study demonstrated an excellent adsorption capability of biochars in removing dyes. In addition, it indicated the recycling of wastes as a precursor of bio composts, a strategy for utilization in water treatment with binary systems. It showed the feasibility of the reuse capacity that indicated that the adsorbent may have many potential applications.

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Purpose: To evaluate morphological aspects and inducible nitric oxide synthase (iNOS) gene and protein expression in a model of acute inflammation. Methods: Thirty-six female Wistar rats were assigned into three groups: control (saline, n = 12), sham (arthritis, n = 12), and PBM (arthritis and photobiomodulation, n = 12). Arthritis induction was performed with 200 µg of intra-articular Zymosan in sham and PBM animals. PBM was performed 24 h after induction with a laser device (λ = 808 nm, 25 mW of nominal power, fluence of 20 J/cm2, beam area of 0.02 mm2, time of 33 s, total energy of 0.825 J) with punctual and single dose application. Morphological analysis of joint structure (HE) and immunohistochemistry (anti-iNOS antibody) were performed on knee samples, and synovial tissue was submitted to RNA extraction, cDNA synthesis and gene expression analysis by quantitative polymerase chain reaction. Statistical analyses were performed with p < 0.05. Results: It was observed an increase in the thickness of the synovial lining epithelium and inflammatory infiltrate in sham compared to PBM. Gene expression analysis showed higher iNOS expression in PBM, and iNOS protein expression decreased in PBM compared to sham. Conclusions: Photobiomodulation decreased inflammation in PBM animals, upregulated iNOS gene expression, however down egulated protein expression compared to sham.

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This study explores the fabrication of nanofibers using different types of gelatins, including bovine, porcine, and fish gelatins. The gelatins exhibited distinct molecular weights and apparent viscosity values, leading to different entanglement behavior and nanofiber production. The electrospinning technique produced nanofibers with diameters from 47 to 274 nm. The electrospinning process induced conformational changes, reducing the overall crystallinity of the gelatin samples. However, porcine gelatin nanofibers exhibited enhanced molecular ordering. These findings highlight the potential of different gelatin types to produce nanofibers with distinct physicochemical properties. Overall, this study sheds light on the relationship between gelatin properties, electrospinning process conditions, and the resulting nanofiber characteristics, providing insights for tailored applications in various fields.

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Previous studies have demonstrated the role of γ-aminobutyric acid type B (GABAB) receptors in skin-related conditions and pain. However, most studies have focused on the main effects of GABAB on the central nervous system. Therefore, this study has aimed to determine the potential topical anti-inflammatory and anti-proliferative effects of baclofen cream in an inflammatory skin disease model. The effects of the baclofen cream were evaluated using acute and chronic models of 12-O-tetradecanoylphorbol-13-acetate (TPA)-induced skin inflammation in mouse ears. Histological and immunohistochemical evaluations were performed using an ear oedema assay. The effect of baclofen on keratinocyte proliferation was assessed in PAM212, the murine keratinocyte cell line. The results demonstrate that a single topical application of 5% baclofen, 7.5% baclofen, and 1% dexamethasone each inhibited acute TPA-induced ear oedema (58.94 ± 6.14%, 47.73 ± 11.26%, and 87.33 ± 4.59%, respectively). These results were confirmed by histological analysis. In the chronic model, baclofen (5%) and dexamethasone (1%) each inhibited ear oedema and the maximum inhibitory effect was reached at the end of the experiment (9th day of TPA application) with a percentage inhibition of 54.60 ± 6.15% for baclofen and 71.68 ± 3.45% for dexamethasone, when compared to the vehicle. These results were confirmed by histological analysis. Baclofen and dexamethasone also reduced proliferating cell nuclear antigen expression by 62.01 ± 6.65% and 70.42 ± 6.11%, respectively. However, baclofen did not inhibit keratinocyte proliferation in PAM212 cells. In conclusion, these results demonstrate that baclofen exhibits notable topical antiproliferative and anti-inflammatory properties and could be a potential therapeutic alternative for treating inflammatory and proliferative skin diseases.

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The adsorbed vaccine SARS-CoV-2 (inactivated) produced by Sinovac (SV) was the first vaccine against COVID-19 to be used in Brazil. To understand the metabolic effects of SV in Brazilian subjects, NMR-based metabolomics was used, and the immune response was studied in Brazilian subjects. Forty adults without (group-, n = 23) and with previous COVID-19 infection (group+, n = 17) were followed-up for 90 days postcompletion of the vaccine regimen. After 90 days, our results showed that subjects had increased levels of lipoproteins, lipids, and N-acetylation of glycoproteins (NAG) as well as decreased levels of amino acids, lactate, citrate, and 3-hydroxypropionate. NAG and threonine were the highest correlated metabolites with N and S proteins, and neutralizing Ab levels. This study sheds light on the immunometabolism associated with the use of SV in Brazilian subjects from Rio de Janeiro and identifies potential metabolic markers associated with the immune status.

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INTRODUCTION: The physiological changes in mother-infant pairs during pregnancy increase the susceptibility to a series of infections, including those of the oral cavity. Therefore, the oral and systemic health of pregnant women is related to adverse pregnancy outcomes. OBJECTIVE: This cross-sectional study aimed to evaluate the systemic profile and periodontal status of women with a high-risk pregnancy. METHODS: Eighty-nine pregnant women at risk of preterm labor admitted to a hospital in southern Brazil were interviewed and received a periodontal examination. Data related to obstetric complications during pregnancy (pre-eclampsia, infections, medication use, and gestational diabetes) and systemic diseases were collected from medical records. The periodontal parameters of probing pocket depth, bleeding on probing, and clinical attachment level were evaluated. The data were tabulated, and statistical analysis was performed (p < 0.05). RESULTS: The mean age of participants was 24 years (SD = 5.62). Gingival bleeding was recorded in 91% of the participants. The prevalence of gingivitis was 31.46%, and periodontitis was 29.21%. No association between systemic conditions and periodontal disease was observed. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Periodontal inflammation was not associated with the systemic profile during pregnancy. However, women with high-risk pregnancies showed higher levels of gingival inflammation, emphasizing the importance of dental care during pregnancy.

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Chitosan nanocapsules containing polyunsaturated fatty acid (PUFA) concentrates from tuna oil, with EPA + DHA contents around 57% (w w-1), were developed by emulsification process, using different chitosan concentration (1.0%, 1.5%, 2.0%, w v-1) and stirring speed (10,000, 15,000, 20,000 rpm). The effects of these parameters on particle size and zeta potential were evaluated. The physical and oxidative stabilities were used to measure the product quality during storage. Chitosan concentration, stirring speed and its interaction significantly affected (p < 0.05) the particle size. In addition, chitosan concentration significantly affected (p < 0.05) the zeta potential of nanocapsules emulsion. Based on the results of physical and oxidative stabilities, the nanocapsules were stable for 30 days under refrigeration temperature (7 °C), and with 1.5-2% chitosan resulted in improved protection against oil oxidation. The nanocapsules produced with 2% chitosan and 10,000 rpm showed the lowest variations of polydispersity index and nanocapsules size after 30 days of storage (221.8 ± 3.0 nm). These conditions can be considered the most suitable to produce nanocapsules of PUFA concentrates from tuna oil using chitosan as wall material. These nanocapsules showed physical characteristics and oxidative stability, which could enable their application in the food industry, representing an important source of EPA and DHA fatty acids.

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A presente dissertação foi dividida em dois estudos. O primeiro estudo teve como objetivo desenvolver uma revisão de literatura de trabalhos pré-clínicos que resumisse o papel de diversos fármacos usados para prevenção e tratamento da doença periodontal experimental e destaca a ação direcionada de todos os fármacos com propriedades antirreabsortivas. Além disso, esta revisão fornece uma avaliação oportuna e crítica para o uso científico racional dos medicamentos antirreabsortivos e imunomoduladores em estudos pré-clínicos, o que ajuda a entender a base para sua aplicação clínica. Pode-se concluir a partir dos achados descritos, que fitoterápicos, suplementação com ômega 3 e probióticos tem ganhado cada vez mais atenção devido às suas atividades moduladoras e antirreabsortivas e a ausência de efeitos colaterais, sendo considerados alternativas promissoras como adjuvantes da raspagem subgengival e alisamento radicular em pacientes suscetíveis. O segundo estudo, objetivou-se realizar uma revisão sistemática sobre os potenciais benefícios de agentes biológicos como adjuvantes no tratamento da periodontite experimental em modelos animais, respondendo a seguinte questão: qual é o potencial protetor dos agentes biológicos contra a reabsorção óssea alveolar durante a progressão da periodontite experimental? Os critérios de elegibilidade dos estudos foram baseados na estratégia PI/ECOS, ou seja, P = periodontite; I/E agentes biológicos; C mesma exposição/intervenção; I = exceto sobre o uso de agentes biológicos; e S = resultados secundários (inflamação). Como resultado, 5236 estudos foram selecionados inicialmente por meio de buscas manuais nas bases de dados incluídas . Após a leitura dos resumos e dos textos e de acordo com os critérios de inclusão, 39 estudos que atenderam aos critérios de inclusão foram incluídos neste estudo. Vinte e três agentes biológicos foram avaliados nos estudos incluídos. A maioria dos estudos utilizou o modelo de ligadura de periodontite experimental (PE) para testar o uso de produtos biológicos como estratégias preventivas ou terapêuticas. As dosagens dos produtos biológicos e os períodos de indução da doença variaram com base no modelo de periodontite utilizado. Como principal resultado de todos os estudos, a perda óssea alveolar pôde ser significativamente inibida com a aplicação de produtos biológicos e a redução de mediadores pró-inflamatórios quando comparados aos controles tratados. Em conclusão, essa revisão sistemática demonstrou que os agentes biológicos possuem efeitos benéficos na redução da perda óssea e na diminuição da inflamação durante a progressão da periodontite em modelos animais. (AU)

This MSc dissertation was divided into two studies. The first study aimed to develop a literature review including preclinical studies summarizing the role of various compounds used for the prevention and treatment of periodontitis and highlights the targeted action of all drugs with antiresorptive properties. In addition, this review provided a timely and critical assessment for the rational scientific use of antiresorptive and immunomodulatory drugs in preclinical studies, which helps to understand the basis for their clinical application. It can be concluded from the findings described, that phytotherapeutics, omega-3 supplementation, and probiotics have gained increasing attention due to their modulating and antiresorptive activities and the absence of side effects, and are considered promising alternatives as adjuvants to subgingival scaling and root planing in susceptible patients. In the second study, the aim was to perform a systematic review on the benefits of biological agents as adjuvants in the treatment of experimental periodontitis in animal models, answering the following question: What is the protective potential of biological agents against alveolar bone resorption during the course of experimental periodontitis progression? The criteria for eligibility of the studies were based in PI/ECOs strategy, as such (P) animal models with periodontitis; (I/E) biological agents with protective potential against bone resorption in periodontitis (prevention) or additional benefit as an adjunctive in the treatment of periodontitis; (C) same intervention/exposition as the intervention group (I), except for the use biological agents; (O) alveolar bone resorption (primary outcomes). Secondary outcomes: periodontal parameters, effectiveness of periodontitis-treatment, and adverse effects; (s) no restriction for study design on primary studies (exclusion criteria: randomized clinical trials, clinical studies, and different types of review studies). Study quality was assessed using Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE) Risk of Bias tool. As a result, 5236 initial results from datasets, registries, and manual searches resulted in 39 suitable studies that met the inclusion criteria. Twenty-three biological agents were evaluated in the included studies. Most studies used the ligation model of experimental periodontitis (EP) to test the use of biologics as preventive or therapeutic strategies. The dosages of the biologics and periods of disease induction varied based on the PE model used. As the main outcome of all studies, alveolar bone loss could be significantly inhibited with the application of biologics and the reduction of pro-inflammatory mediators when compared to treated controls. Taken together, this systematic review demonstrated that biologics have beneficial effects in reducing bone loss and decreasing inflammation during the progression of periodontitis in animal models. (AU)

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Abstract The nutritional status of dogs is a prominent theme nowadays because it is considered one of the five vital parameters of animals. There are several techniques that allow diagnosing disorders or disturbances in the body condition of these patients. Although it has some subjectivity, as it is a visual and palpation evaluation, the body condition score (BCS) is the most used for this purpose. The present study evaluated radiographic, sonographic and anthropometric measurements of subcutaneous fat deposited in the dorsal region over the seventh lumbar vertebra of 100 dogs, compared to a double-blind classification of patients on the numerical scale of the BMC. There was a positive correlation of the sonographic measurements with the body condition score (p-value below 2 x 10-16 and R = 0.54) and the same was observed with the radiographic measurements (p-value below 2 x 10-16 and R = 0.56) and anthropometric evaluations (whose p-value ranged from 1.55 x 10-7 to 2.34 x 10-11 and its R was 0.24 to 0.36). With this, it was possible to identify greater intensity in the relationship of imaging exams with ECC. It is concluded that radiography and ultrasonography have great potential for use in clinical routine as a more accurate and affordable way to diagnose nutritional disorders. This is the first study to use such equipment together with imaging tests to contribute to the early diagnosis of changes in nutritional status and promote improvements in the follow-up of weight gain or weight loss programs.

Resumo O estado nutricional dos cães é um tema de destaque na atualidade por ser considerado um dos cinco parâmetros vitais dos animais. Diversas são as técnicas que permitem diagnosticar afecções ou distúrbios da condição corporal desses pacientes. Embora tenha certa subjetividade, por ser uma avaliação visual e de palpação, o escore de condição corporal (ECC) é o mais utilizado para essa finalidade. O presente estudo avaliou medidas radiográficas, ultrassonográficas e antropométricas da gordura subcutânea depositada na região dorsal sobre a sétima vértebra lombar de 100 cães, comparando-se com uma classificação duplo-cega dos pacientes na escala numérica do ECC. Houve correlação positiva das medidas ultrassonográficas com o escore de condição corporal (p-valor abaixo de 2 x 10-16 e R = 0,54) e o mesmo foi observado com as medidas radiográficas (p-valor abaixo de 2 x 10-16 e R = 0,56) e avaliações antropométricas (cujo p-valor variou de 1,55 x 10-7 a 2,34 x 10-11 e seu R foi de 0,24 a 0,36). Com isso, foi possível identificar maior intensidade na relação dos exames de imagem com o ECC. Conclui-se que a radiografia e a ultrassonografia apresentam grande potencial de utilização na rotina clínica como uma forma mais precisa e acessível de diagnosticar distúrbios nutricionais. Este é o primeiro estudo a utilizar tais equipamentos juntamente com exames de imagem para contribuir para o diagnóstico precoce de mudanças no estado nutricional e promover melhorias no acompanhamento de programas de ganho ou perda de peso.

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This work focused on developing an active bilayer film based on natural extract. Thus, the jaboticaba peel extract (JPE) was produced and characterized and showed promising application as a natural additive in biopolymeric materials. The zein fiber and bilayer films were produced using a chitosan film (casting) and zein fiber (electrospinning), with and without JPE. All samples were evaluated according to thickness, solubility in water, water vapor permeability, and main diameter, and for these, zein fiber, chitosan/zein fiber, and chitosan/zein fiber + 3% JPE showed values of 0.19, 0.51, and 0.50 mm, 36.50, 12.96, and 27.38%, 4.48 × 10-9, 1.6 × 10-10, and 1.58 × 10-10 (g m-1 Pa-1 s-1), and 6.094, 4.685, and 3.620 µm, respectively. These results showed that the addition of a second layer improved the barrier properties of the material when compared to the monolayer zein fiber. The thermal stability analysis proved that the addition of JPE also improved this parameter and the interactions between the components of the zein fiber and bilayer films; additionally, the effective presence of JPE was shown through FTIR spectra. In the end, the active potential of the material was confirmed by antimicrobial analysis since the bilayer film with JPE showed inhibition halos against E. coli and S. aureus.

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The Brazilian Practice Guidelines for Stroke Rehabilitation - Part II, developed by the Scientific Department of Neurological Rehabilitation of the Brazilian Academy of Neurology (Academia Brasileira de Neurologia, in Portuguese), focuses on specific rehabilitation techniques to aid recovery from impairment and disability after stroke. As in Part I, Part II is also based on recently available evidence from randomized controlled trials, systematic reviews, meta-analyses, and other guidelines. Part II covers disorders of communication, dysphagia, postural control and balance, ataxias, spasticity, upper limb rehabilitation, gait, cognition, unilateral spatial neglect, sensory impairments, home rehabilitation, medication adherence, palliative care, cerebrovascular events related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the future of stroke rehabilitation, and stroke websites to support patients and caregivers. Our goal is to provide health professionals with more recent knowledge and recommendations for better rehabilitation care after stroke.

As Diretrizes Brasileiras de Reabilitação do Acidente Vascular Cerebral (AVC) - Parte II, desenvolvida pelo Departamento Científico de Reabilitação Neurológica da Academia Brasileira de Neurologia é voltada para intervenções específicas de técnicas de reabilitação de déficits neurológicos e incapacidades. Seguindo o mesmo modelo da Parte I, a Parte II também se baseia em estudos randomizados, revisões sistemáticas, metanálises e outras diretrizes sobre o mesmo tema. A segunda parte aborda os distúrbios da comunicação, disfagia, controle postural e equilíbrio, ataxias, espasticidade, reabilitação do membro superior, marcha, cognição, negligência espacial unilateral, déficits sensoriais, reabilitação domiciliar, aderência ao uso de medicamentos, cuidados paliativos, o futuro da reabilitação no AVC, e websites de orientação sobre AVC para pacientes e cuidadores. Nosso objetivo é fornecer aos profissionais envolvidos na reabilitação conhecimento atualizado e recomendações para um melhor cuidado no pós-AVC.

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O osteoblastoma é um tumor frequentemente visto em ossos longos, com pouco envolvimento maxilofacial e raramente localizado em osso zigomático. Devido à sua semelhança clínica e histológica com outros tumores ósseos, o osteoblastoma representa um desafio de diagnóstico para o profissional. A ressecção cirúrgica total é recomendada, sendo que a ausência de recidiva se deve ao diagnóstico correto e tratamento adequado. O objetivo deste artigo é relatar o manejo de um paciente com osteoblastoma envolvendo o osso zigomático e realizar uma breve revisão da literatura.

Osteoblastoma is a tumor often seen in long bones, with little maxillofacial involvement and rarely located in zygomatic bone. Due to its clinical and histological similarity with other bone tumors, osteoblastoma represents a diagnostic challenge for the professional. Total surgical resection is recommended, and the absence of recurrence is due to correct diagnosis and adequate treatment. The aim of this article is to report the management of a patient with osteoblastoma involving the zygomatic bone and to carry out a brief review of the literature.

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This study aimed to characterize the profile of dental anxiety in pediatric patients, identifying the effect exerted by socioeconomic factors using dental data. A cross-sectional study design with a sample of 120 children aged 7-12 years old was used. Data relating to anxiety levels prior to dental care, socioeconomic aspects (family income, education level, child's school type), and child's dental history (previous dental appointments, previous treatment, caries experience) were collected. Additionally, participants completed the Brazilian version of the Children's Fear Survey Schedule- Dental Subscale (B-CFSS-DS) to assess dental anxiety. Descriptive analyses, chi-squared (X 2 ) tests, and Mann-Whitney U tests were performed, with a significance level of 5%. A total of 51 boys (42.5%) and 69 girls (57.5%) were included. There was no significant difference in dental anxiety between them. However, younger children had higher mean B-CFSS-DS scores (p = 0.036, Mann-Whitney). A higher prevalence of dental anxiety was found in participants from low-income families (p = 0.012, X 2 ) and in patients who did not receive endodontic treatment (p=0.034, X 2 ). Higher mean B-CFSS-DS scores were also observed in participants who did not receive endodontic treatment (p=0.001, Mann-Whitney) compared with those that did receive endodontic treatment. No relationship was found between education level, patient school type, first dental appointment, caries experience, and dental anxiety data. Younger children presented a profile of greater dental anxiety. Socioeconomic factors and dental data exerted some effect on dental anxiety, where children from low-income families and those not subjected to endodontic treatment displayed higher rates of dental anxiety.

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Abstract The Brazilian Practice Guidelines for Stroke Rehabilitation - Part II, developed by the Scientific Department of Neurological Rehabilitation of the Brazilian Academy of Neurology (Academia Brasileira de Neurologia, in Portuguese), focuses on specific rehabilitation techniques to aid recovery from impairment and disability after stroke. As in Part I, Part II is also based on recently available evidence from randomized controlled trials, systematic reviews, meta-analyses, and other guidelines. Part II covers disorders of communication, dysphagia, postural control and balance, ataxias, spasticity, upper limb rehabilitation, gait, cognition, unilateral spatial neglect, sensory impairments, home rehabilitation, medication adherence, palliative care, cerebrovascular events related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the future of stroke rehabilitation, and stroke websites to support patients and caregivers. Our goal is to provide health professionals with more recent knowledge and recommendations for better rehabilitation care after stroke.

Resumo As Diretrizes Brasileiras de Reabilitação do Acidente Vascular Cerebral (AVC) - Parte II, desenvolvida pelo Departamento Científico de Reabilitação Neurológica da Academia Brasileira de Neurologia é voltada para intervenções específicas de técnicas de reabilitação de déficits neurológicos e incapacidades. Seguindo o mesmo modelo da Parte I, a Parte II também se baseia em estudos randomizados, revisões sistemáticas, metanálises e outras diretrizes sobre o mesmo tema. A segunda parte aborda os distúrbios da comunicação, disfagia, controle postural e equilíbrio, ataxias, espasticidade, reabilitação do membro superior, marcha, cognição, negligência espacial unilateral, déficits sensoriais, reabilitação domiciliar, aderênciaao usode medicamentos, cuidados paliativos,ofuturodareabilitação no AVC, e websites de orientação sobre AVC para pacientes e cuidadores. Nosso objetivo é fornecer aos profissionais envolvidos na reabilitação conhecimento atualizado e recomendações para um melhor cuidado no pós-AVC.

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Periodontitis, a highly prevalent multicausal chronic inflammatory and destructive disease, develops as a result of complex host-parasite interactions. Dysbiotic bacterial biofilm in contact with the gingival tissues initiates a cascade of inflammatory events, mediated and modulated by the host's immune response, which is characterized by increased expression of several inflammatory mediators such as cytokines and chemokines in the connective tissue. If periodontal disease (PD) is left untreated, it results in the destruction of the supporting tissues around the teeth, including periodontal ligament, cementum, and alveolar bone, which lead to a wide range of disabilities and poor quality of life, thus imposing significant burdens. This process depends on the differentiation and activity of osteoclasts, the cells responsible for reabsorbing the bone tissue. Therefore, the inhibition of differentiation or activity of these cells is a promising strategy for controlling bone resorption. Several pharmacological drugs that target osteoclasts and inflammatory cells with immunomodulatory and anti-inflammatory effects, such as bisphosphonates, anti-RANK-L antibody, strontium ranelate, cathepsin inhibitors, curcumin, flavonoids, specialized proresolving mediators, and probiotics, were already described to manage inflammatory bone resorption during experimental PD progression in preclinical studies. Meantime, a growing number of studies have described the beneficial effects of herbal products in inhibiting bone resorption in experimental PD. Therefore, this review summarizes the role of several pharmacological drugs used for PD prevention and treatment and highlights the targeted action of all those drugs with antiresorptive properties. In addition, our review provides a timely and critical appraisal for the scientific rationale use of the antiresorptive and immunomodulatory medications in preclinical studies, which will help to understand the basis for its clinical application.

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Abstract This study aimed to characterize the profile of dental anxiety in pediatric patients, identifying the effect exerted by socioeconomic factors using dental data. A cross-sectional study design with a sample of 120 children aged 7-12 years old was used. Data relating to anxiety levels prior to dental care, socioeconomic aspects (family income, education level, child's school type), and child's dental history (previous dental appointments, previous treatment, caries experience) were collected. Additionally, participants completed the Brazilian version of the Children's Fear Survey Schedule- Dental Subscale (B-CFSS-DS) to assess dental anxiety. Descriptive analyses, chi-squared (X 2 ) tests, and Mann-Whitney U tests were performed, with a significance level of 5%. A total of 51 boys (42.5%) and 69 girls (57.5%) were included. There was no significant difference in dental anxiety between them. However, younger children had higher mean B-CFSS-DS scores (p = 0.036, Mann-Whitney). A higher prevalence of dental anxiety was found in participants from low-income families (p = 0.012, X 2 ) and in patients who did not receive endodontic treatment (p=0.034, X 2 ). Higher mean B-CFSS-DS scores were also observed in participants who did not receive endodontic treatment (p=0.001, Mann-Whitney) compared with those that did receive endodontic treatment. No relationship was found between education level, patient school type, first dental appointment, caries experience, and dental anxiety data. Younger children presented a profile of greater dental anxiety. Socioeconomic factors and dental data exerted some effect on dental anxiety, where children from low-income families and those not subjected to endodontic treatment displayed higher rates of dental anxiety.

RESUMEN

La estenosis esofágica es una alteración morfofuncional que provoca una lesión inflamatoria en las capas submucosas y musculares del esófago, induciéndolas a la fibrosis y alterando el diámetro esofágico. El presente informe aborda el uso de un dilatador de balón como vía auxiliar para corregir la estenosis esofágica en un paciente canino, hembra, Pug, con antecedentes de vómitos recurrentes como principal síntoma. Mediante endoscopia se observó que el esófago torácico estaba inflamado, con mucosa engrosada y fibrótica, además de anillos fibrosos de color blanquecino, lo que dificultaba el paso de la sonda, lo que permitía determinar el diagnóstico de estenosis esofágica. En este informe se optó por el uso de balón dilatador, realizándose tres procedimientos con una semana de diferencia, para mejorar la condición sintomática. Tras el procedimiento dilatador, fue posible el desarrollo favorable del cuadro clínico presentado por el paciente.

Esophageal stenosis is a morphofunctional alteration that causes inflammatory lesion in the submucosal and muscular layers of the esophagus, inducing them to fibrosis and altering the esophageal diameter. The present report addresses the use of a balloon dilator as an auxiliary way to correct esophageal stenosis in a canine, female, Pug patient, with a history of recurrent vomiting as the main complaint. Through endoscopy, it was observed that the thoracic esophagus was inflamed, with thickened and fibrotic mucosa, in addition to whitish colored fibrous rings, which hindered the passage of the probe, enabling the determination of the diagnosis of esophageal stenosis. In this report, we opted for the use of a dilator balloon, with three procedures being performed one week apart, to improve the symptomatic condition. After the dilator procedure, the favorable development of the clinical condition presented by the patient was possible.

A estenose esofágica é uma alteração morfofuncional que ocasiona em lesão inflamatória das camadas submucosa e muscular do esôfago, induzindo-as a fibrose e que altera o diâmetro esofágico. O presente relato aborda a utilização de balão dilatador, como forma auxiliar de correção de estenose esofágica em paciente canino, fêmea, da raça Pug, apresentando histórico de vômitos recorrentes como queixa principal. Por meio da endoscopia, observou-se que o esôfago torácico estava inflamado, com a mucosa espessada e fibrótica, além de anéis fibrosos de coloração esbranquiçada, o que dificultava a passagem da sonda, possibilitando a determinação do diagnóstico de estenose esofágica. Nesse relato, optou-se pelo uso do balão dilatador, sendo feitos três procedimentos intervalados de uma semana entre eles, para a melhora da condição sintomática. Após o procedimento dilatador, foi possível o desenvolvimento favorável do quadro clínico apresentado pela paciente.

RESUMEN

A platinosomose é uma importante enfermidade hepatobiliar parasitária que acomete felinos, sendo eles de vida livre ou semi domiciliados. O agente etiológico é o trematódeo Platynosomum spp. E a doença é popularmente conhecida como "envenenamento por lagartixa". As manifestações clínicas da platinosomose são inespecíficas assim como é incomum a observação de lesões hepáticas, o que dificulta o diagnóstico. Felinos possuem o hábito de caça e ao ingerir esses pequenos invertebrados, podem dar continuidade ao ciclo da platinosomose, uma vez que esses animais são os hospedeiros definitivos deste parasito. Esse trematódeo se aloja com frequência no trato biliar dos gatos, causando lesões e possível obstrução do ducto biliar. O grau de comprometimento das lesões hepáticas está na dependência tanto da imunidade, quanto da carga parasitária do animal. O diagnóstico de eleição é o exame parasitológico de fezes, embora ainda seja considerado pouco sensível, sendo relevante a utilização de outras ferramentas diagnósticas. O exame ultrassonográfico permite a observação de alterações hepáticas e até mesmo do próprio parasito no interior do ducto biliar, contribuindo para elucidação dessa enfermidade. Foi atendido no Hospital Veterinário "Luiz Quintiliano de Oliveira", um felino com histórico de icterícia, e ao exame clínico observou-se escore corporal magro e desidratação em 8%. Após avaliação clínica do animal, o mesmo foi encaminhado para o setor de Diagnóstico por Imagem para avaliação ultrassonográfica abdominal, durante o exame visibilizou-se aumento das dimensões hepáticas, edema de parede em vesícula biliar e a presença pequena de estrutura filiforme, hiperecogênica, em seu interior.(AU)

Platinosomiasis is an importante parasitic hepatobiliary disease that affects felines, whether they live freely or semi-domiciled. The etiological agent is the trematode Platynosomum spp. And the disease is popularly known as "lizard poisoning". The clinical manifestations of platinosomiasis are non-specific and the observation of liver lesions observed are, which makes the diagnosis difficult. Felines have a hunting habit and by ingesting these small invertebrates, they can continuing the platinosomiasis cycle, since these animals are the definitive hosts of this parasite.This trematode frequently lodges in the biliary tract of cats, causing injury and possible obstruction of the bile duct. The degree of involvement of liver lesions is in dependence on both immunity and the parasite load of the animal. The diagnosis of choice is the parasitological examination of feces, although it is still considered not very sensitive, and the use of other diagnostic tools is relevant. The ultrasonographic examination allows the observation of hepatic alterations and even the parasite itself inside the bile duct, contributing to the elucidation of this disease. He was treated at the "Luiz Quintiliano de Oliveira", a feline with a history of jaundice, and the clinical examination showed a lean body score and dehydration of 8%. After clinical evaluation of the animal, he was referred to the Diagnostic Imaging Department for abdominal ultrasonography evaluation, during the exam it was seen an increase in the hepatic dimensions, edema of the gallbladder wall and the small presence of a filiform, hyperecogenic structure inside.(AU)

La platinosomosis es una importante enfermedad parasitaria hepatobiliar que afecta a los gatos, ya sean de vida libre o semi-domiciliados. El agente etiológico es el trematodo Platynosomum spp. Y la enfermedad se conoce popularmente como "envenenamiento por gecko". Las manifestaciones clínicas de la platinosomosis son inespecíficas y la observación de lesione hepáticas es poco frecuente, lo que dificulta el diagnóstico. Los felinos tienen el hábito de la caza y al ingerir estos pequeños invertebrados pueden continuar el ciclo de platinosomosis, ya que estos animales son los hospedadores definitivos de este parásito. Este trematodo se aloja con frecuencia en el tracto biliar de los gatos, provocando lesiones y posible obstrucción del conducto biliar. El grado de afectación de las lesiones hepáticas depende tanto de la inmunidad como de la carga parasitaria del animal. El diagnóstico de elección es el examen parasitológico de heces, aunque todavía se considera insensible, siendo relevante el uso de otras herramientas diagnósticas. El examen ecográfico permite la observación de alteraciones hepáticas e incluso del propio parásito fuera de la vía biliar, contribuyendo al esclarecimiento de esta enfermedad. Un felino con antecedentes de ictericia, fue atendido en el Hospital Veterinario "Luiz Quintiliano de Oliveira", y el examen clínico mostró un índice corporal magro y deshidratación en 8%. Después de la evaluación clínica del animal, se derivó al sector de Diagnóstico por Imagen para evaluación de ecografía abdominal, durante el examen se observó aumento de las dimensiones hepáticas, edema de la pared vesicular y pequeña presencia de una estructura filiforme hiperecogénica em su interior.(AU)

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