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This study was conducted to evaluate the effects of live or autolyzed yeast supplementation on dairy cow performance and ruminal fermentation. Two experiments were conducted to evaluate performance, feed sorting, total-tract apparent digestibility of nutrients, purine derivatives excretion, N utilization, ruminal fermentation, and the abundance of specific bacterial groups in the rumen. In experiment 1, 39 Holstein cows (171 ± 40 DIM and 32.6 ± 5.4 kg/d milk yield) were blocked according to parity, DIM, and milk yield and randomly assigned to the following treatments: control (CON); autolyzed yeast fed at 0.625 g/kg DM (AY; Levabon, DSM-Firmenich); or live yeast fed at 0.125 g/kg DM (LY; Vistacell, AB Vista). Cows were submitted to a 2-wk adaptation period followed by a 9-wk trial. In experiment 2, 8 ruminal cannulated Holstein cows (28.4 ± 4.0 kg/d milk yield and 216 ± 30 DIM), of which 4 were multiparous and 4 were primiparous, were blocked according to parity and enrolled into a 4 × 4 Latin square experiment with 21-d periods (the last 7 d for sampling). Cows within blocks were randomly assigned to treatment sequences: control (CON), LY (using the same product and dietary concentration as described in experiment 1), AY, or autolyzed yeast fed at 0.834 g/kg DM (AY2). In experiments 1 and 2, nutrient intake and total-tract apparent digestibility were not affected by treatments. Sorting for long feed particles (>19 mm) tended to be greater in cows fed yeast supplements than CON in experiment 1. Efficiency of N conversion into milk N was increased when feeding yeast supplements in experiment 1, and 3.5% FCM yield tended to be greater in cows fed yeast supplements than CON. Feed efficiency was increased when yeast supplements were fed to cows in relation to CON in experiment 1. In experiment 2, yield of FCM and fat were greater in cows fed yeast supplements compared with CON. Uric acid concentration and output in urine were increased when feeding yeast supplements when compared with CON. Neither ruminal pH nor total VFA were influenced by treatments. The current study did not reveal treatment differences in ruminal abundance of Anaerovibrio lipolytica, the genus Butyrivibrio, Fibrobacter succinogenes, Butyrivibrio proteoclasticus, or Streptococcus bovis. Yeast supplementation can increase feed efficiency without affecting nutrient intake and digestibility, ruminal VFA concentration, or ruminal abundance of specific bacterial groups. Supplementing live or autolyzed yeast, regardless of the dose, resulted in similar performance.

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Objetivo: Analisar a trajetória das mulheres com doença trofoblástica gestacional (DTG) até o Centro de Referência de Doença Trofoblástica Gestacional do Hospital São Paulo (CRDTG-HSP), identificando as portas de entrada ao serviço e as dificuldades que elas enfrentaram desde o diagnóstico. Métodos: Estudo de caso transversal exploratório, descritivo-analítico, com abordagem quali-quantitativa, que incluiu pacientes atendidas no período de 2015 a 2018. A coleta dos dados se deu por meio de um questionário on-line e de uma entrevista com roteiro semiestruturado. Resultados: Entre 96 pacientes, 40,63% (n = 39) tiveram acesso ao CRDTG-HSP por encaminhamento entre médicos, 31,25% (n = 30), pela página do Facebook da Associação Brasileira de Doença Trofoblástica Gestacional e 10,42% (n = 10), por meio da central de regulação de vagas do estado de São Paulo (CROSS), das quais 28,2%, 73% e 30%, respectivamente, possuíam assistência privada, na qual receberam tratamento inicial. As 12 entrevistadas relataram dificuldades, tais como a percepção da falta de preparo médico no manejo e comunicação da doença, o desconhecimento da sua situação de saúde mesmo após procedimentos cirúrgicos, a exposição a conversas inapropriadas entre médicos sobre o seu caso e o recebimento de encaminhamento sem explicação esclarecedora sobre seu quadro clínico. Por fim, as pacientes avaliaram positivamente a utilização de e-mail e WhatsApp como facilitadores no atendimento no CRDTG-HSP. Conclusão: O acesso ao CRDTG-HSP ocorreu minoritariamente pela CROSS e, mesmo tendo assistência privada, pacientes migraram para atendimento no centro especializado. Além disso, as pacientes tiveram percepção de falta de preparo médico no atendimento da DTG fora do CRDTG.(AU)

Objective: To understand and elaborate the trajectories of women with gestational trophoblastic disease from the initial entry to the healthcare system to follow-up at a public tertiary reference center. Methods: This exploratory, descriptive-analytical, cross-sectional case study included patients from 2015 to 2018. The data collected through online questionnaires and semi-structured interviews were analyzed via quantitative and qualitative approaches. Statistical analysis was performed using Pearson's chi-square test at 5% significance using software R version 4.0.2. The test power for the sample was calculated using G*power software version 3.1.9.6. Results: Overall, 96 patients completed the questionnaire. Only 10(10.42%) patients reached the reference center through the official channel, Sao Paulo State Vacancy Regulation Center, while 39(40.63%) patients through referral from physicians, and 30(31.25%) patients through the Brazilian Association of Gestational Trophoblastic Disease's Facebook fan page. Overall, 36 patients (37.5%) had private insurance and 73% of patients who reached the reference center via Facebook had private insurance. Twelve participants were interviewed and reported barriers, such as difficulties in understanding their health issues prior to arrival at the reference center, lack of professional knowledge about the disease, poor communication, and exposure to inappropriate conversations. They positively evaluated the reference center, the interaction was facilitated using email and WhatsApp. Conclusion: Although appropriate public care for these women exists, the flow from the diagnosis to specialized treatment remains unclear for both professionals and patients. The participants perceived that communication and physicians' expertise were inadequate.(AU)

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ABSTRACT Purpose: Ocular disorders are among the most frequent manifestations of psoriatic arthritis. The incidence, type, and severity of these disorders may be influenced by genetics, local environmental factors, and access to ophthalmic treatment. Here we describe the ocular manifestations of psoriatic arthritis among denizens of the Amazon region of Para, Brazil, treated by the rheumatology service of Universidade do Estado do Pará. Methods: This cross-sectional study examined 23 psoriatic arthritis patients (median age 47.78 years, no sex predominance) diagnosed according to Caspar's criteria. Disease activity was evaluated according to the Clinical Disease Activity Index for Psoriatic Arthritis. Ophthalmological examinations performed included visual acuity with distance correction, biomicroscopy, applanation tonometry, fundoscopy, Schirmer test I, tear breakup time, fluorescein staining, and lissamine green staining. Patients also completed The Ocular Surface Disease Index questionnaire. Results: The most common ophthalmic disorders were dry eye (60.9%), cataracts (56.5%), blepharitis (47.8%), keratitis (43.5%), meibomitis (30.4%), pterygium (26, 1%), and pinguecula (13%). More than half of all patients demonstrated recent onset (>5 years), the peripheral disease type, and severe symptoms according to Clinical Disease Activity Index for Psoriatic Arthritis. Conclusion: The ocular manifestations of psoriatic arthritis are varied and mainly affect the ocular surface. Regular ophthalmological follow-up is recommended for patients in the early stage with high disease activity.

RESUMO Objetivo: Descrever as manifestações oftalmológicas observadas em pacientes com artrite psoriásica atendidos no Serviço de Reumatologia da Universidade do Estado do Pará. Métodos: Estudo transversal. A amostra foi composta por 23 pacientes com artrite psoriásica, segundo os critérios de Caspar, atendidos no ambulatório de reumatologia da Universidade do Estado do Pará. Para avaliação da atividade de doença foi aplicado o Clinical Disease Activity index for Psoriatic Arthritis e, posteriormente, foi realizado o exame oftalmológico (acuidade visual com correção para distância, biomicroscopia, tonometria de aplanação de Goldmann, fundoscopia, teste de Schirmer I, tempo de ruptura do filme lacrimal, lissamina verde e questionário The Ocular Surface Disease Index). Resultados: Nesta pesquisa não houve predomínio entre os sexos e a população tinha uma mediana de idade de 47,78 anos. As manifestações mais comuns foram olho seco (60,9%), catarata (56,5%), blefarite (47,8%), ceratite (43,5%), meibomite (30,4%) e pterígio (26,1%). Conclusão: As manifestações oculares encontradas em pacientes com artrite psoriásica são variadas e afetam sobretudo a superfície ocular; no entanto, são clinicamente subestimadas; por isso recomenda-se o acompanhamento oftalmológico regular e periódico para pacientes com artrite psoriásica.

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BACKGROUND: Telemonitoring is an alternative to in-person appointments and overcomes geographic distance barriers. OBJECTIVE: The primary objective of this study was to evaluate adherence to post-molar follow-up using both WhatsApp and in-person appointments compared with standard care. The secondary objective was to evaluate the rate of completion of post-molar follow-up of complete moles, considering 6 and 3 months of duration. METHODS: This retrospective cohort study was conducted at the Gestational Trophoblastic Disease Center, São Paulo Hospital. Patients with complete or partial mole treatment between January 1, 2009 and December 31, 2018 were included in two groups: group 1 (patients from 2009 to 2013) and group 2 (from 2014 to 2018), before and after telemonitoring implementation, respectively. Complete follow-up was considered if after the first normal human chorionic gonadotropin (hCG) level (<5 mIU/mL), the patient was followed up for an additional 30 days (partial mole) or 180 days (complete mole). Loss to post-molar follow-up with positive hCG was also evaluated. Statistical analysis was performed using Pearson's Χ2 test, 5% significance level (p=0.05), and R version 4.0.2. RESULTS: A total of 308 patients were included in the study, 92 of them were assessed in group 1 and 216 patients in group 2. There was no difference between the rates of complete follow-up after telemonitoring implementation (complete mole: 42/72=58.3% group 1 vs 85/163=52.1% group 2; p=0.38; partial mole: 16/20=80% group 1 vs 37/53=69.8 group 2; p=0.3), and no increase of loss to post-molar follow-up with positive hCG (8/92=8.7% group 1 vs 14/216=6.5% group 2; p=0.49). The shortening of follow-up of complete moles to 90 days increased the rate of complete post-molar follow-up (from 127/235=54.0% to 189/235=80.4%, p<0.001). CONCLUSIONS: The association of telemonitoring with in-person appointments could have had an advantage in post-molar follow-up since it did not reduce adherence to hormonal surveillance. Shortening post-molar follow-up after complete mole to 90 days after the first normal hCG level increased the rate of complete post-molar follow-up.

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PURPOSE: Ocular disorders are among the most frequent manifestations of psoriatic arthritis. The incidence, type, and severity of these disorders may be influenced by genetics, local environmental factors, and access to ophthalmic treatment. Here we describe the ocular manifestations of psoriatic arthritis among denizens of the Amazon region of Para, Brazil, treated by the rheumatology service of Universidade do Estado do Pará. METHODS: This cross-sectional study examined 23 psoriatic arthritis patients (median age 47.78 years, no sex predominance) diagnosed according to Caspar's criteria. Disease activity was evaluated according to the Clinical Disease Activity Index for Psoriatic Arthritis. Ophthalmological examinations performed included visual acuity with distance correction, biomicroscopy, applanation tonometry, fundoscopy, Schirmer test I, tear breakup time, fluorescein staining, and lissamine green staining. Patients also completed The Ocular Surface Disease Index questionnaire. RESULTS: The most common ophthalmic disorders were dry eye (60.9%), cataracts (56.5%), blepharitis (47.8%), keratitis (43.5%), meibomitis (30.4%), pterygium (26, 1%), and pinguecula (13%). More than half of all patients demonstrated recent onset (>5 years), the peripheral disease type, and severe symptoms according to Clinical Disease Activity Index for Psoriatic Arthritis. CONCLUSION: The ocular manifestations of psoriatic arthritis are varied and mainly affect the ocular surface. Regular ophthalmological follow-up is recommended for patients in the early stage with high disease activity.

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Background: Rapidly growing mycobacteria (RGM) are a group of nontuberculous mycobacteria (NTM) implicated in difficult-to-treat pulmonary and extrapulmonary diseases, possibly associated with invasive procedures and failures in sterilization of materials and equipment. Methods: We report our experience with the laboratory identification of RGM in a routine work and give an overview of the RGM isolated in our setting. Laboratorial data from all RGM mycobacterial isolates received at Adolfo Lutz Institute of São José do Rio Preto were analyzed from January 2000 to December 2015. Results: Five hundred and seventy-nine isolates were identified with NTM, of which 193 were RGM, which affected 113 patients. Among the 113 patients, the female gender was more frequent (55%) and the average age was 50 years. Pulmonary samples were the most frequent (79%), and 54.9% of the cases were isolated from sputum. Twelve different species were found and the most identified were group Mycobacterium abscessus and Mycobacterium fortuitum, making up 77.9% of all identified RGM. The most frequent comorbidities were smoking (n = 21), alcoholism (n = 12), and human immunodeficiency virus (n = 16). Drug susceptibility test was performed for nine patients and all showed susceptibility to amikacin and seven resistances to doxycycline. Conclusions: This study showed the experience of mycobacterial diagnosis in a routine laboratory, revealing that failure to meet the bacteriological criteria generates losses in the establishment of cases of RGM and consequently its correct treatment.

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BACKGROUND: Homeopathy is a complementary medicine characterized by the use of diluted and potentized medicines. Innovations in this area are constantly being proposed in the relevant literature, such as scientific articles and patents. The objective of this study was to carry out a patent survey of homeopathic products and processes. METHODS: A free and international patent database, Espacenet, was used. The search was carried out using the keyword homeop*, with two approaches: (1) no date restrictions for the search and (2) a date limit for the publication years 2008 to 2018. The patents from the limited period were organized as depositor countries, ownerships and groups, including homeopathic formulations, equipment, packaging, production procedures, and analytical methods. RESULTS: Without date restriction, 601 patents were identified in the survey. Of these, 174 were related to homeopathy and published in the period 2008 to 2018. Technologies come mainly from the following countries: United States (55 patents), Russia (24), Germany (15), France (13), India (12), Ukraine (11), Brazil (6), and China (6). Among the ownerships, 69% of patent applications were by independent depositors, 23% by companies, 7.5% by universities, and 0.5% by company/university partnerships. New formulations represented 75.9% of technologies, whilst the others comprised 14.3% for equipment, 3.8% for drugs packaging, 3.8% for production procedures, and 2.2% for analytical methods. CONCLUSIONS: The present review helps visualize the homeopathy-related patents published in recent years, as well as the main countries and researchers investing in the field of homeopathy.

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The emergence of the COVID-19 has caused public health problems worldwide and there is no effective pharmacological treatment for this disease. Research on 3D models of proteins and the search for active molecular sites are important tools to assist in the discovery of effective antiviral drugs to combat COVID-19. To address this problem, the 3D protein structures of SARS-CoV 2 were analyzed and submitted to cavities research, evaluation of their druggabillity and liganbility, and applied to molecular docking studies with potential ligand candidates actually assayed against COVID-19. Eight druggable potential cavity sites were determined in model structures' PDB code, 6W4B, 6VWW, 6W01, 6M3M, and 6VYO, and these are the good alternatives to be characterized as targets for antiviral compounds. The good cavity model of the protease 3D structure was used in molecular docking, and this allowed verifying the theoric interactions of this protein and lopinavir and ritonavir antiviral drugs. These results may assist in the use of 3D protein models in drug design studies aiming to develop drugs against the COVID-19 pandemic.

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A anafilaxia é uma reação alérgica potencialmente fatal. Autoinjetor pode ser prescrito para tratamento precoce nesses casos. Relatamos o caso de uma criança que fez uso acidental de adrenalina autoinjetora que ao exame de imagem evidenciou falange distal com fratura. Objetivamos alertar a importância de orientar o paciente e seus familiares acerca do uso correto desse dispositivo.

Anaphylaxis is a potentially fatal allergic reaction. Autoinjection can be prescribed for early treatment in these cases. We report the case of a child who accidentally used an adrenaline autoinjector and then had a distal phalanx fracture on imaging examination. We aim to draw attention to the importance of carefully guiding patients and their families about the correct use of this device.

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Peperomia pellucida (PP) belongs to the Peperomia genus, which has a pantropic distribution. PP is used to treat a wide range of symptoms and diseases, such as pain, inflammation, and hypertension. Intriguingly, PP extract is used by different tropical countries for its anti-inflammatory and antinociceptive effects. In fact, these outcomes have been shown in animal models, though the exact bioactive products of PP that exert such results are yet to be discovered. To determine and elucidate the mechanism of action of one of these compounds, we evaluated the antinociceptive effect of the novel dimeric ArC2 compound, Pellucidin A by using in vivo and in silico models. Animals were then subjected to chemical, biphasic and thermal models of pain. Pellucidin A induced an antinociceptive effect against chemical-induced pain in mice, demonstrated by the decrease of the number of writhes, reaching a reduction of 43% and 65% in animals treated with 1 and 5 mg/kg of Pellucidin A, respectively. In the biphasic response (central and peripheral), animals treated with Pellucidin A showed a significant reduction of the licking time exclusively during the second phase (inflammatory phase). In the hot-plate test, Pellucidin A did not have any impact on the latency time of the treated animals. Moreover, in vivo and in silico results show that Pellucidin A's mechanism of action in the inflammatory pain occurs most likely through interaction with the nitric oxide (NO) pathway. Our results demonstrate that the antinociceptive activities of Pellucidin A operate under mechanism(s) of peripheral action, involving inflammatory mediators. This work provides insightful novel evidence of the biological properties of Pellucidin A, and leads to a better understanding of its mechanism of action, pointing to potential pharmacological use.

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The aim of this study was to analyze the effects of genetic group and sex on residual feed intake, performance, testicular size, carcass and morphometric traits in Santa Ines purebred and Dorper ´ Santa Ines crossbred lambs. A total of 32 lambs, with initial body weight of 18±3.7 kg were used. Analysis of variance, considering the interaction between sex and genetic group of all the traits were performed. Crossbred females (-0.018±0.06) and purebred males (-0.018±0.05) were more efficient (p<0.001) in residual feed intake than crossbred males (0.018±0.04) or purebred females (0.018±0.04). The most efficient animal in residual feed intake consumed 37.9% less feed (1.179 kg/day) than the least efficient animal (1.899 kg/day). Crossbred, when compared to purebred, showed higher values for body weight, average daily gain, testicle size, carcass traits; had greater muscle accumulation, were more compact and with more aptitude to beef. Purebred were taller, but with lower body length and thoracic perimeter than crossbred. Males had greater muscle accumulation, were more compact and with more aptitude to meat. Crossing of native (Santa Ines) with exotic breed (Dorper) is an alternative to align efficiency in feed use, testicular size, compactness, aptitude for meat and ability for muscle accumulation.

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Introdução: A Doença de Parkinson compromete a mobilidade da caixa torácica, acarretando limitação progressiva da ventilação, devido ao padrão de flexão e rigidez e fraqueza muscular. A realidade virtual propicia interação em tempo real com atividades e ambientes tridimensionais. Objetivo: Avaliar o efeito da realidade virtual no recrutamento de fibras e forças musculares respiratória e postural em pacientes com doença de Parkinson. Métodos: Estudo clínico, piloto, prospectivo, com alocação por conveniência. Dez indivíduos foram selecionados e alocados em grupo estudo (GE n=5) constituídos por idosos com DP e grupo controle (GC n=5) formado por idosos na mesma faixa etária, sem condições clínicas neurológicas e respiratórias. As variáveis mensuradas foram: independência funcional, desempenho motor, força muscular respiratória, recrutamento de fibras musculares respiratórias e posturais, e qualidade de vida. Foram realizadas 16 sessões com realidade virtual. Resultados: As Pressões Inspiratória máxima (PImáx) e Expiratória máxima (PEmáx) melhoraram em alguns momentos da intervenção. O recrutamento de fibras musculares em esternocleidomastóideo diminuiu e o recrutamento de fibras musculares no diafragma aumentou. Conclusão: A PImáx e a PEmáx melhoraram em alguns momentos do tratamento, e houve diminuição do recrutamento de fibras musculares dos músculos respiratórios acessórios nos pacientes com DP. (AU)

Introduction: Parkinson's disease commits the mobility of the rib cage, causing progressive ventilation limitation due to bending and stiffness. Virtual reality provides real-time interaction with activities and three-dimensional environments. Objective: To evaluate the effect of virtual reality on the recruitment of muscle fibers and respiratory and postural muscle strength in patients with Parkinson's disease. Methods: Clinical, pilot, prospective study, with allocation by convenience. Ten individuals were selected and allocated to a study group (EG n = 5) consisting of elderly people with Parkinson and a control group (CG n = 5) formed by elderly people in the same age group, without neurological and respiratory conditions. The measured variables were functional independence, motor performance, respiratory muscle strength, recruitment of respiratory and postural muscle fibers, and quality of life. 16 sessions were held with virtual reality. Results: The maximum inspiratory pressures (MIP) and maximum expiratory pressures (MEP) improved in some moments of the intervention. The recruitment of muscle fibers in the sternocleidomastoid decreased and the recruitment of muscle fibers in the diaphragm increased. Conclusion: MIP and MEP improved in some moments of treatment, and there was a decrease in the recruitment of muscle fibers from accessory respiratory muscles in patients with PD. (AU)

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Abstract Background: Current reproductive management of bovine elite populations involves the use of assisted reproductive technologies (ARTs), aiming to obtain the greatest genetic gain. However, inadequate use of ARTs may lead to loss of genetic diversity in the offspring. Objective: To assess the genetic diversity in elite female cattle populations used in commercial in vitro embryo production. Methods: Using genetic and ecological approaches for the study of populations based on microsatellite markers, we assessed the genetic diversity between and within populations of cows used in commercial in vitro embryo production programs in Brazil. Results: Endogamy within populations varied from zero to 9.1%, while heterozygosity between populations (FST) was <0.05 in the different population interactions. AMOVA showed 1% variation between populations, 8% between individuals and 91% within individuals. The dimensionality reduction method utilized indicated a lack of structure in the populations analyzed, identifying two main clusters in the three populations. Conclusions: Low genetic diversity between cow populations associated with commercial programs of in vitro embryo production in Brazil was evidenced. Variable levels of endogamy within the populations were observed. Approaches of population genetics as well as ecological diversity can be implemented to more thoroughly estimate genetic diversity in livestock populations.

Resumen Antecedentes: El actual manejo reproductivo en poblaciones de bovinos de élite incluye la utilización de tecnologías de reproducción asistida (ARTs) con el fin de obtener mayor ganancia genética. Sin embargo, el uso inadecuado de las ART puede llevar a la pérdida de diversidad genética en los descendientes. Objetivo: Evaluar la diversidad genética en poblaciones de vacas de élite utilizadas en la producción comercial de embriones bovinos in vitro. Métodos: Utilizando abordajes de la genética y ecología de poblaciones basados en marcadores microsatélites, evaluamos la diversidad genética entre y dentro de poblaciones de vacas participantes de programas comerciales de producción de embriones in vitro en Brasil. Resultados: La endogamia dentro de las poblaciones varió de cero a 9,1%, mientras que la heterocigosidad entre poblaciones (FST) fue <0,05 en las diferentes interacciones de la población. El AMOVA mostró variación del 1% entre poblaciones, 8% entre individuos y 91% dentro de individuos. El método de reducción de dimensionalidad utilizado indicó una falta de estructura en las poblaciones analizadas, identificando dos grupos principales en las tres poblaciones. Conclusiones: Se evidenció una baja diversidad genética entre las poblaciones de vacas asociadas a programas comerciales de producción de embriones in vitro en Brasil. Se evidenciaron niveles variables de endogamia entre las poblaciones. Abordajes de la genética poblacional, así como de diversidad ecológica pueden ser implementados para estimar de manera más amplia la diversidad genética en poblaciones animales de interés pecuario.

Resumo Antecedentes: O atual manejo reprodutivo das populações de elite em bovinos envolve o uso de tecnologias de reprodução assistida (ARTs), visando obter o maior ganho genético. No entanto, o uso inadequado de ARTs pode levar à perda de diversidade genética na prole. Objetivo: Avaliar a diversidade genética em populações de vacas de elite utilizadas na produção comercial de embriões bovinos in vitro. Métodos: Utilizando abordagens da genética e ecologia de populações baseadas em marcadores microssatélites, foi avaliada a diversidade genética entre e dentro das populações de vacas participantes de programas comercias de produção in vitro de embriões. Resultados: A endogamia dentro das populações variou de zero a 9,1%, enquanto a heterozigosidade entre populações (FST) foi <0,05 nas diferentes interações populacionais. AMOVA mostrou variação de 1% entre populações, 8% entre indivíduos e 91% dentro de indivíduos. O método de redução de dimensionalidade utilizado indicou uma falta de estrutura nas populações analisadas, identificando dois clusters principais nas três populações. Conclusões: Baixa diversidade genética entre populações de vacas associadas a programas de produção in vitro de embriões foi evidenciada. Níveis de endogamia variáveis dentro das populações foram observados. Abordagens da genética populacional assim como de diversidade ecológica podem ser implementadas na tentativa de estimar de maneira mais abrangente a diversidade genética em populações animais de interesse pecuário.

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BACKGROUND: Delays in attending to ST-elevation myocardial infarction (STEMI) are indicators or markers of quality of health services. Several records suggest gender disparity in cardiac care as a contributor to the increased mortality among women. METHODS: We prospectively enrolled all consecutive STEMI patients who were transferred to our hospital from January through December 2015. The following variables were analyzed: Symptom-to-Door Time (SDT); Time to First ECG (TECG); Transfer Time to Referring Center (TTRC); and Door-to-Cath lab time (DCT). RESULTS: Of the 133 patients, 85 (63.9%) were male and 45 (36%) female. The mean age and body mass index (BMI) between the male and female genders were 56.3 and 60.5 years for the first and 26 and 27.7 Kg/M2 for the second. Diabetes and low school education level were more prevalent in women than men, with statistical significance: 20 (48.8%) vs 18 (26.1%) with P = 0.01 and 26 (54.2%) vs 28 (32.9%) with P = 0.04, respectively. Regarding the times evaluated (SDT, TECG, TTRC and DCT), there was no statistically significant difference in relation to gender. STEMI Killip class I was more prevalent in males: 93 (86.1%) vs 12 (63.2%) cases with P = 0.01, and thrombolysis with a tendency towards the same direction: 17 (20%) vs 4 (8.3%) and P = 0.07. CONCLUSIONS: According to our results women with STEMI had significantly higher prevalence of diabetes and low school education level, as well as a higher proportion of complicated STEMI (Killip class ≥ II).

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OBJECTIVES: Enterobacter cloacae has recently emerged as an important agent of nosocomial infections owing to the dissemination of extended-spectrum ß-lactamases and carbapenemases in this species. In this context, a rise in the therapeutic use of aminoglycosides was noticed, followed by the accelerated development of resistance mechanisms. In this study, we report the draft genome sequence of a multidrug-resistant E. cloacae subsp. cloacae strain (Ec2) isolated from an active surveillance culture of a patient with Chagas disease. METHODS: Whole-genome sequencing (WGS) was performed using a Nextera XT DNA library and NextSeq platform. RESULTS: WGS analysis revealed the presence of 5527 coding genes, 62 RNA-encoding genes and 275 pseudogenes. Strain Ec2 belongs to sequence type 395 (ST395) and carries 22 transferable antibiotic resistance genes, comprising eight antimicrobial classes, including the rmtD2 gene conferring high-level aminoglycoside resistance. CONCLUSIONS: This draft genome can be used in comparative genomic analyses with different E. cloacae strains. In addition, it could help at elucidating epidemiological aspects regarding the dissemination of clinically relevant resistance genes.

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Autoimmune regulator (Aire) is a transcriptional regulator of peripheral tissue antigens (PTAs) and microRNAs (miRNAs) in medullary thymic epithelial cells (mTECs). In this study, we tested the hypothesis that Aire also played a role as an upstream posttranscriptional controller in these cells and that variation in its expression might be associated with changes in the interactions between miRNAs and the mRNAs encoding PTAs. We demonstrated that downregulation of Aire in vivo in the thymuses of BALB/c mice imbalanced the large-scale expression of these two RNA species and consequently their interactions. The expression profiles of a large set of mTEC miRNAs and mRNAs isolated from the thymuses of mice subjected (or not) to small-interfering-induced Aire gene knockdown revealed that 87 miRNAs and 4,558 mRNAs were differentially expressed. The reconstruction of the miRNA-mRNA interaction networks demonstrated that interactions between these RNAs were under Aire influence and therefore changed when this gene was downregulated. Prior to Aire-knockdown, only members of the miR-let-7 family interacted with a set of PTA mRNAs. Under Aire-knockdown conditions, a larger set of miRNA families and their members established this type of interaction. Notably, no previously described Aire-dependent PTA interacted with the miRNAs, indicating that these PTAs were somehow refractory. The miRNA-mRNA interactions were validated by calculating the minimal free energy of the pairings between the miRNA seed regions and the mRNA 3' UTRs and within the cellular milieu using the luciferase reporter gene assay. These results suggest the existence of a link between transcriptional and posttranscriptional control because Aire downregulation alters the miRNA-mRNA network controlling PTAs in mTEC cells.

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O objetivo principal do estudo é comparar o teste em 3 pontos com braquetes com o teste de resistência ao deslizamento utilizando um novo dispositivo que realiza a mensuração simultânea do coeficiente de atrito, das forças e dos momentos nos braquetes de ancoragem e da força de desativação no braquete desalinhado, exercidos por fios ortodônticos. Os objetivos secundários foram desenvolver o dispositivo e comparar, no teste em 3 pontos: (i) a influência, nas grandezas e no coeficiente de atrito cinético, da variação da simetria nas distâncias inter-braquetes, do tipo de braquete de ancoragem (canino ou 2º pré-molar), do deslocamento (3 ou 5mm) do braquete central, do sentido do desalinhamento (vestibular ou lingual) do braquete central e da marca de fio-braquete; (ii) as 3 formas de cálculo do coeficiente de atrito cinético; (iii) os 10 ciclos, para vestibular ou lingual, para verificar se eles são semelhantes ou não entre si. Foram utilizados braquetes autoligáveis (dentes 13, 14 e 15) e fios 0.014'' NiTi e CuNiTi das marcas Aditek e Ormco. O teste de resistência ao deslizamento foi realizado no desalinhamento lingual, nos dois deslocamentos e na configuração simétrica. O teste em 3 pontos com braquetes foi realizado no desalinhamento lingual e vestibular, nos dois deslocamentos e na configuração simétrica e assimétrica. Por meio da ANOVA, foram comparados, entre os dois tipos de teste: (A) as grandezas e o coeficiente de atrito e (B) o coeficiente de atrito gerado apenas no braquete de 2º pré-molar. Utilizando-se do mesmo teste estatístico foram comparados, no teste em 3 pontos com braquetes: (A) na configuração

simétrica, algumas grandezas e o coeficiente de atrito advindos da variação da marca de fio-braquete, do deslocamento, do desalinhamento e do tipo de braquete; (B) algumas grandezas e o coeficiente de atrito gerados na configuração simétrica e assimétrica; (C) os valores das 3 formas de cálculo do coeficiente de atrito na configuração simétrica; e (D) algumas grandezas e o coeficiente de atrito encontrados nos 10 ciclos. Resultados: (A) a maioria dos valores das grandezas e do coeficiente de atrito gerados pelos dois tipos de teste foram diferentes estatisticamente; (B) o braquete de 2º pré-molar apresentou valores de coeficiente de atrito diferentes entre os dois tipos de teste; (C) na configuração simétrica, as variáveis foram estatisticamente significantes na maioria dos casos para as grandezas analisadas e para o coeficiente de atrito; (D) houve diferença entre a configuração simétrica e assimétrica; (E) o coeficiente de atrito baseado nas duas normais e na força de atrito se aproximou mais da realidade clínica e foi sensível à variação da geometria da relação fio-braquete; e (F) os 10 ciclos para lingual foram semelhantes entre si em 70% dos casos e os 10 ciclos para vestibular foram diferentes em 57% dos casos. Conclusões: o teste em 3 pontos com braquetes é diferente do teste de resistência ao deslizamento; a variação das configurações geométricas e da marca de fio-braquete pode influenciar nos valores das grandezas e do coeficiente de atrito cinético; os 10 ciclos para lingual foram mais semelhantes entre si que os 10 ciclos para vestibular.

The main objective of the study is to compare the three-bracket bending test with the resistance to sliding test using a new device that performs simultaneous measurement of coefficient of friction, the forces and moments on the anchor brackets and deactivation force in misaligned bracket, exercised by orthodontic wires. Secondary objectives were to develop the device and compare, in the three-bracket bending test: (i) the influence, on the physical quantities and on the kinetic friction coefficient, of the variation of the symmetry in the inter-bracket distance, of the type of anchor bracket (canine or 2nd premolar), of displacement (3 or 5mm) and misalignment (buccal or lingual) of the central bracket, and of the wire and bracket brand; (ii) the three ways to calculate the coefficient of kinetic friction; (iii) the 10 cycles, for buccal or lingual, to see if they are similar or not. Self-ligating brackets were used (teeth 13, 14 and 15) and wires 0.014 '' NiTi and CuNiTi of Aditek and Ormco brands. The resistance to sliding test was conducted on the lingual misalignment, on both displacements and on symmetrical configuration. The three-bracket bending test was held at the lingual and vestibular misalignment, at both displacements and at the symmetrical and asymmetrical configuration. Through ANOVA, were compared, between the two types of tests: (A) the quantities and the coefficient of friction and (B) the coefficient of friction generated only in the second premolar bracket. Using the same statistical test were compared, in three-bracket bending test: (A) in symmetrical configuration, the quantities and the coefficient of friction arising from the variation in the wire and bracket brands, displacement, misalignment and the type of bracket; (B) the quantities

and the coefficient of friction generated by the symmetric and asymmetric configuration; (C) the values of the three ways of calculating friction coefficient; and (D) the quantities and the coefficient of friction encountered in 10 cycles. Results: (A) most of the values of the quantities and the coefficient of friction generated by the two types of test were statistically different; (B) the 2nd premolar bracket showed different friction coefficient values between the two types of test; (C) in the symmetrical configuration, the variables were statistically significant in the most of cases for quantities and the friction coefficient; (D) was found difference between symmetric and asymmetric configuration; (E) the friction coefficient based on both normal forces and frictional force was closer to the clinical reality and was ...

Assuntos

RESUMO

O objetivo principal do estudo é comparar o teste em 3 pontos com braquetes com o teste de resistência ao deslizamento utilizando um novo dispositivo que realiza a mensuração simultânea do coeficiente de atrito, das forças e dos momentos nos braquetes de ancoragem e da força de desativação no braquete desalinhado, exercidos por fios ortodônticos. Os objetivos secundários foram desenvolver o dispositivo e comparar, no teste em 3 pontos: (i) a influência, nas grandezas e no coeficiente de atrito cinético, da variação da simetria nas distâncias inter-braquetes, do tipo de braquete de ancoragem (canino ou 2º pré-molar), do deslocamento (3 ou 5mm) do braquete central, do sentido do desalinhamento (vestibular ou lingual) do braquete central e da marca de fio-braquete; (ii) as 3 formas de cálculo do coeficiente de atrito cinético; (iii) os 10 ciclos, para vestibular ou lingual, para verificar se eles são semelhantes ou não entre si. Foram utilizados braquetes autoligáveis (dentes 13, 14 e 15) e fios 0.014'' NiTi e CuNiTi das marcas Aditek e Ormco. O teste de resistência ao deslizamento foi realizado no desalinhamento lingual, nos dois deslocamentos e na configuração simétrica. O teste em 3 pontos com braquetes foi realizado no desalinhamento lingual e vestibular, nos dois deslocamentos e na configuração simétrica e assimétrica. Por meio da ANOVA, foram comparados, entre os dois tipos de teste: (A) as grandezas e o coeficiente de atrito e (B) o coeficiente de atrito gerado apenas no braquete de 2º pré-molar. Utilizando-se do mesmo teste estatístico foram comparados, no teste em 3 pontos com braquetes: (A) na configuração...

The main objective of the study is to compare the three-bracket bending test with the resistance to sliding test using a new device that performs simultaneous measurement of coefficient of friction, the forces and moments on the anchor brackets and deactivation force in misaligned bracket, exercised by orthodontic wires. Secondary objectives were to develop the device and compare, in the three-bracket bending test: (i) the influence, on the physical quantities and on the kinetic friction coefficient, of the variation of the symmetry in the inter-bracket distance, of the type of anchor bracket (canine or 2nd premolar), of displacement (3 or 5mm) and misalignment (buccal or lingual) of the central bracket, and of the wire and bracket brand; (ii) the three ways to calculate the coefficient of kinetic friction; (iii) the 10 cycles, for buccal or lingual, to see if they are similar or not. Self-ligating brackets were used (teeth 13, 14 and 15) and wires 0.014 '' NiTi and CuNiTi of Aditek and Ormco brands. The resistance to sliding test was conducted on the lingual misalignment, on both displacements and on symmetrical configuration. The three-bracket bending test was held at the lingual and vestibular misalignment, at both displacements and at the symmetrical and asymmetrical configuration. Through ANOVA, were compared, between the two types of tests: (A) the quantities and the coefficient of friction and (B) the coefficient of friction generated only in the second premolar bracket. Using the same statistical test were compared, in three-bracket bending test: (A) in symmetrical configuration, the quantities and the coefficient of friction arising from the variation in the wire and bracket brands, displacement, misalignment and the type of bracket; (B) the quantities...

Assuntos

RESUMO

A síndrome de Churg-Strauss é uma doença sistêmica rara caracterizada principalmente por hipereosinofilia, asma e vasculite. O pulmão é o órgão mais frequentemente envolvido. Neste relato, descrevemos uma alteração relativamente rara nesta doença - a presença de um nódulo pulmonar -, ao mesmo tempo que recordamos os principais achados obtidos em exames radiológicos e os seus diagnósticos diferenciais mais importantes.

Churg-Strauss syndrome is a rare systemic disease primarily characterized by hypereosinophilia, asthma and vasculitis. The lung is the organ most frequently involved. In the present report, the authors describe a relatively rare finding in this disease - the presence of a pulmonary nodule -, while recalling the main radiological findings and the most relevant differential diagnoses.

RESUMO

A fluorose dental manifesta-se clinicamente como manchas brancas em dentes homólogos que foram previamente expostos a altas concentrações de flúor sistêmico durante a amelogênese dentária. O grau de manchamento dentário pode variar de leve a severo, podendo levar a grande interferência estética. Por essa razão, tem sido cada vez mais comum a procura por tratamentos odontológicos conservadores capazes de minimizar tais interferências, preservando ao máximo a estrutura dentária. O objetivo deste artigo e relatar o caso de uma paciente do sexo feminino, 24 anos, com manchas severas por fluorose, que teve sua estética dental restaurada de maneira conservadora, associando-se o clareamento dental e microabrasão do esmalte, para se obter resultado estético satisfatório.

Dental fluorosis is expressed clinically as white spots in homologous teeth previously exposed to high concentrations of systemic fluoride during tooth amelogenesis. The degree of tooth staining can vary from mild to severe and may lead to significant esthetic changes. For this reason, conservative dental treatments have been increasingly demanded to minimize defects, preserving as much tooth structure as possible. The aim of this study was to report the case of a female, 24 year-old patient with severe fluorosis staining, restored conservatively through the associating of dental bleaching and enamel microabrasion, with a satisfactory esthetic result.

Assuntos