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Background: Leishmaniasis, caused by the protozoan Leishmania sp., infects phagocyte cells present in lymphatic organs. This study demonstrates the influence of nanostructured lipid carrier-loaded hydroxymethylnitrofurazone (NLC-NFOH) on lymphatic uptake using a chylomicron-blocking flow model in rats. Method: Lymphatic uptake of NFOH was assessed 1 h after oral administration of dimethyl sulfoxide with NFOH or NLC-NFOH with and without cycloheximide pretreatment. Result: Dimethyl sulfoxide with NFOH and NLC-NFOH showed NFOH serum concentrations of 0.0316 and 0.0291 µg/ml, respectively. After chylomicron blocking, NFOH was not detected. Conclusion: Despite log P below 5, NFOH was successfully taken up by the lymphatic system. Long-chain fatty acids and particle size might be main factors in these findings. NLC-NFOH is a promising and convenient platform for treating leishmaniasis via oral administration.

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OBJECTIVE: This study aimed to evaluate whether the use of desensitizing dentifrices containing obliterating agents can affect bond strength of eroded/abraded dentin. METHODOLOGY: A total of 100 dentin samples were obtained from human molars. The teeth were cut into 3 mm-thickness discs and allocated in five groups (n=20), according to the toothpaste used: WoF - abrasion with fluoride-free toothpaste (Cocoricó); Arg - toothpaste containing arginine (Colgate Sensitive Pro-Relief); Nov - calcium sodium phosphosilicate toothpaste (Sensodyne Repair and Protect); SnF - fluoride-containing toothpaste (AmF/SnCl2/SnF2 - Elmex Erosion); and Control (no erosive/abrasive process). The erosive/abrasive cycle consisted of immersion in citric acid (1%, pH 2.6, 5 min, 4×/day) and abrasion (2×/day, 120-20 sec abrasion, 100 sec immersion) with each toothpaste. During intervals, samples were immersed in artificial saliva. This cycle was performed for five days. Two resin cylinders (2 mm in diameter) were constructed on each sample for the shear bond strength test using a universal adhesive system. The self-etch and etch-and-rinse (Scotchbond Universal) strategies were employed, each in half of the total sample (n=10). Bond strength (MPa) was measured in a shear test and failure modes were assessed with a stereomicroscope. Statistical analysis was performed using the two-way analysis of variance (ANOVA) and Tukey tests (p<0.05). RESULTS: A statistically significant difference was found between the adhesive strategies tested (p<0.001), with the self-etching form showing higher values than the etch-and-rinse. Moreover, no significant differences were observed between the tested toothpastes (p=0.750) and interactions (p=0.438). CONCLUSION: The use of toothpaste containing obliterating agents does not affect bond strength to dentin subjected to erosive/abrasive conditions when a universal adhesive is used. However, the self-etch strategy might be preferred for eroded/abraded dentin.

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Epilepsy is a neurological disorder characterized by epileptic seizures resulting from neuronal hyperexcitability, which may be related to failures in Na,K-ATPase activity and oxidative stress participation. We conducted this study to investigate the impact of antioxidant therapy on oxidative stress, Na,K-ATPase activity, seizure factors, and mortality in rodent seizure/epilepsy models induced by pentylenetetrazol (PTZ), pilocarpine (PILO), and kainic acid (KA). After screening 561 records in the MEDLINE, EMBASE, Web of Science, Science Direct, and Scopus databases, 22 were included in the systematic review following the PRISMA guidelines. The meta-analysis included 14 studies and showed that in epileptic animals there was an increase in the oxidizing agents nitric oxide (NO) and malondialdehyde (MDA), with a reduction in endogenous antioxidants reduced glutathione (GSH) and superoxide dismutase (SO). The Na,K-ATPase activity was reduced in all areas evaluated. Antioxidant therapy reversed all of these parameters altered by seizure or epilepsy induction. In addition, there was a percentage decrease in the number of seizures and mortality, and a meta-analysis showed a longer seizure latency in animals using antioxidant therapy. Thus, this study suggests that the use of antioxidants promotes neuroprotective effects and mitigates the effects of epilepsy. The protocol was registered in the Prospective Register of Systematic Reviews (PROSPERO) CRD42022356960.

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Hydroxychloroquine sulfate (HCQ) and chloroquine diphosphate (CQ) have been used at increased rates to treat COVID-19 but can constitute a potential environmental risk. The objective was to evaluate the toxicity of sublethal concentrations of HCQ and CQ in zebrafish embryos/larvae. The 50% lethal concentrations (LC50) of HCQ and CQ at 96 h post-fertilization (hpf) were calculated by testing various concentrations on 2,160 embryos. The LC50 obtained were 560 and 800 µM for HCQ and CQ, respectively. Next, the embryotoxicity assay was performed, where 1,200 embryos were subjected to sublethal concentrations of HCQ and CQ. The hatching and heart rates were recorded. After euthanasia, photomicrographs of all larvae were taken to measure the total length, pericardial and yolk sac areas. The embryos exposed to sublethal concentrations of HCQ and CQ showed delayed hatching at 72 hpf, as well as an increase in the heart rate, larger pericardial and yolk sac areas, and body malformations at 96 hpf. The findings show that HCQ and CQ are toxic to fish in the early development phases. Understanding the mechanisms of toxicity will help extrapolate the effects of 4-aminoquinoline derivatives when they reach the aquatic environment in the context of the COVID-19 pandemic.

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OBJECTIVES: Knowledge about the impact of gastroplasty on oral health and salivary biomarkers is limited. The aim was to prospectively evaluate oral health status, salivary inflammatory markers, and microbiota in patients undergoing gastroplasty compared with a control group undergoing a dietary program. MATERIALS AND METHODS: Forty participants with obesity class II/III were included (20 individuals in each sex-matched group; 23-44 years). Dental status, salivary flow, buffering capacity, inflammatory cytokines, and uric acid were assessed. Salivary microbiological analysis (16S-rRNA sequencing) assessed the abundance of genus, species, and alpha diversity. Cluster analysis and mixed-model ANOVA were applied. RESULTS: Oral health status, waist-to-hip ratio, and salivary alpha diversity were associated at baseline. A subtle improvement in food consumption markers was observed, although caries activity increased in both groups, and the gastroplasty group showed worse periodontal status after three months. IFNγ and IL10 levels decreased in the gastroplasty group at 3 months, while a decrease was observed in the control group at 6 months; IL6 decreased in both groups (p < 0.001). Salivary flow and buffering capacity did not change. Significant changes in Prevotella nigrescens and Porphyromonas endodontalis abundance were observed in both groups, while alpha diversity (Sobs, Chao1, Ace, Shannon, and Simpson) increased in the gastroplasty group. CONCLUSIONS: Both interventions changed in different degrees the salivary inflammatory biomarkers and microbiota, but did not improve the periodontal status after 6 months. CLINICAL RELEVANCE: Although the observed discrete improvement in dietary habits, caries activity increased with no clinical improvement in the periodontal status, emphasizing the need of oral health monitoring during obesity treatment.

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BACKGROUND: Peripheral intravenous catheter (PIVC) insertion is the most common invasive procedure in the hospital setting. Ultrasound guided PIVC insertion in specific populations and settings has shown patient care benefits. OBJECTIVE: To compare the success rate of first attempts of ultrasound guided PIVC insertion performed by nurse specialists with conventional PIVC insertion performed by nurse assistants. METHOD: Randomized, controlled, single-center clinical trial registered on the ClinicalTrials.gov platform under registration NTC04853264, conducted at a public university hospital from June to September 2021. Adult patients hospitalized in clinical inpatient units with an indication for intravenous therapy compatible with a peripheral venous network were included. Participants in the intervention group (IG) received ultrasound guided PIVC performed by nurse specialists from the vascular access team, while those in the control group (CG) received conventional PIVC by nurse assistants. RESULTS: The study included a total of 166 patients: IG (n = 82) and CG (n = 84), mean age 59.5 ± 16.5 years, mostly women (n = 104, 62.7%) and white (n = 136, 81.9%). Success rate on the first attempt of PIVC insertion in IG was 90.2% and in CG was 35.7% (p < 0.001), with a relative risk of 2.5 (95% CI 1.88-3.40) for success in IG versus CG. Overall assertiveness rate was 100% in IG and 71.4% in CG. Regarding procedure performance time, the medians in IG and CG were 5 (4-7) and 10 (6-27.5) min respectively (p < 0.001). As for the incidence of negative composite outcomes, IG had lower rates compared to CG, 39% versus 66.7% (p < 0.001), generating a 42% lower probability of negative outcomes in IG, 0.58 (95% CI: 0.43-0.80). CONCLUSION(S): Successful first-try insertion was higher in the group receiving ultrasound-guided PIVC. Moreover, there were no insertion failures and IG presented lower insertion time rates and incidence of unfavorable outcomes.

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A lipopolysaccharide (LPS)-induced neuroinflammation rat model was used to study the effects of ouabain (OUA) at low concentrations, which can interact with the Na,K-ATPase, causing the modulation of intracellular signalling pathways in the Central Nervous System. Our study aimed to analyse the effects of OUA on glutamate transport in the hippocampus of rats with LPS-induced neuroinflammation. Adult male Wistar rats were divided into four groups: OUA (1.8 µg/kg), saline (CTR), LPS (200 µg/kg), and OUA + LPS (OUA 20 min before LPS). The animals were sacrificed after 2 h, and the hippocampus was collected for analysis. After treatment, we determined the activities of Na,K-ATPase and glutamine synthetase (GS). In addition, expression of the α1, α2, and α3 isoforms of Na,K-ATPase and the glutamate transporters, EAAT1 and EAAT2, were also analysed. Treatment with OUA caused a specific increase in the α2 isoform expression (~20%), whereas LPS decreased its expression (~22%), and treatment with OUA before LPS prevented the effects of LPS. Moreover, LPS caused a decrease of approximately 50% in GS activity compared with that in the CTR group; however, OUA pre-treatment attenuated this effect of LPS. Notably, it was found that treatment with OUA caused an increase in the expression of EAAT1 (~30%) and EAAT2 (~25%), whereas LPS caused a decrease in the expression of EAAT1 (~23%) and EAAT2 (~25%) compared with that in the CTR group. When treated with OUA, the effects of LPS were abrogated. In conclusion, the OUA pre-treatment abolished the effect caused by LPS, suggesting that this finding may be related to the restoration of the interaction between FXYD2 and the studied membrane proteins.

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OBJECTIVES: To evaluate the knowledge, attitudes, and practice (KAP) of dentists on Minimal Intervention Dentistry (MID). DATA: Cross-sectional studies that analyzed KAP outcomes on MID principles were included. SOURCES: Eight databases (Cochrane, DOSS, Embase, LILACS, PsycINFO, PubMed, Scopus, and Web of Science) and the gray literature were searched on January 2022. STUDY SELECTION: Two independent reviewers selected the included studies, initially by screening titles and abstracts and, finally, by full-text reading. The methodological quality of studies was assessed by using the Joanna Briggs Institute Critical Assessment Checklist for Prevalence Studies. Proportion meta-analysis was conducted using a random effect model for data analysis. Cochran's Q test was used to assess the heterogeneity and the I² statistic for evaluation of true variation due to heterogeneity. RESULTS: Of 2079 studies initially identified, twelve were included in the systematic review. Twenty-four statements about MID were included in the meta-analysis, based on data from ten studies (n = 1728 participants). The pooled proportion of knowledge on MID was 75.66% (95%CI: 69.33 - 81.48; p < 0.01; I²: 97%; Tau2: 0.0456) and of attitudes and practice was 47.95% (95%CI: 38.55-57.43; p < 0.01; I²: 98%; Tau2: 0.0743). The higher prevalences rates were in the "knowledge" field, and the lowest was in "attitudes and practice". CONCLUSIONS: The findings suggest that the knowledge of dentists on MID topics is acceptable, and the attitudes and practices need improvements. The studies lacked uniformity in methods and there is still a need for more studies to elucidate the KAP of dentists worldwide. CLINICAL SIGNIFICANCE: Understanding the cognizance and the way oral healthcare professionals are treating dental caries is the first step to expanding the minimal intervention evidence into a dental practice. The final goal is to change the practice and make Minimal Intervention Dentistry the standard of care for dental caries worldwide. REGISTRATION: PROSPERO CRD42021257518.

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Polyamines are low molecular weight compounds that are present in all living organisms. They are related to the pathological processes, and have been studied as biomarkers for tumor progression, being analyzed in patients' biological fluids. However, polyamines can undergo degradation in serum samples, depending on storage conditions, which impairs their quantification in these matrices. In this work, capillary electrophoresis using indirect ultraviolet detection has been developed and applied to evaluate the stability of polyamines [cadaverine (Cad), putrescine (Put), spermine (Spm), and spermidine (Spd)] in human serum at different storage temperatures. By using this method, Cad, Put, Spm, and Spd were separated in less than 4 min. The range of the correlation coefficients was 0.993-0.998. The corresponding limits of detection and quantification were as follows (in mg L-1 ): Spm: 0.209 and 0.697; Spd: 0.165 and 0.549; Put: 0.189 and 0.632; Cad: 0.125 and 0.417. Besides, the coefficient of variation was lower than 1% for all analytes and the recovery was 92%-110%. The method was successfully applied for polyamines spiked in human serum samples from healthy people. The results showed that the degradation of polyamines was lower in samples stored in a freezer (-20°C).

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The association of Ethinylestradiol 0.03 mg and Levonorgestrel 0.15 mg is a hormonal contraceptive that combines estrogen and progestogen. According to a bibliographic survey, these combined drugs present at least 18 known degradation products, which are required to control the potential impurities harmful to human health. The high number of impurities and the low concentrations of the active pharmaceutical ingredients (APIs) and their respective degradation products increase the complexity of the stability-indicating method development for this medicine. Thus, this work aimed to develop and optimize the stability-indicating method using the quality by design (QbD) approach and in-silico tools for application in samples of oral contraceptives sold in Brazil. The analysis samples were initially subjected to a forced degradation study through 7 days of exposure under acid and alkali hydrolysis, oxidative condition, and oxidation by metal ions. In addition to the chemical exposure, the sample was subjected to physical stress through 10 days of exposure under dry heat, moisture, and photolytic degradation. These exposure samples were analyzed in the development and optimization of chromatographic conditions. As a result, the developed method was able to separate 20 known substances, including the two APIs and their respective 18 degradation products, as well as unknown degradation products obtained by the forced degradation study. Finally, this stability-indicating method was successfully applied for comparative analysis of contraceptive drugs marketed in Brazil, newly purchased and subjected to accelerated stability condition at 40 °C and 75% RH over the 6-month period.

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Abstract Objective This study aimed to evaluate whether the use of desensitizing dentifrices containing obliterating agents can affect bond strength of eroded/abraded dentin. Methodology A total of 100 dentin samples were obtained from human molars. The teeth were cut into 3 mm-thickness discs and allocated in five groups (n=20), according to the toothpaste used: WoF - abrasion with fluoride-free toothpaste (Cocoricó); Arg - toothpaste containing arginine (Colgate Sensitive Pro-Relief); Nov - calcium sodium phosphosilicate toothpaste (Sensodyne Repair and Protect); SnF - fluoride-containing toothpaste (AmF/SnCl2/SnF2 - Elmex Erosion); and Control (no erosive/abrasive process). The erosive/abrasive cycle consisted of immersion in citric acid (1%, pH 2.6, 5 min, 4×/day) and abrasion (2×/day, 120-20 sec abrasion, 100 sec immersion) with each toothpaste. During intervals, samples were immersed in artificial saliva. This cycle was performed for five days. Two resin cylinders (2 mm in diameter) were constructed on each sample for the shear bond strength test using a universal adhesive system. The self-etch and etch-and-rinse (Scotchbond Universal) strategies were employed, each in half of the total sample (n=10). Bond strength (MPa) was measured in a shear test and failure modes were assessed with a stereomicroscope. Statistical analysis was performed using the two-way analysis of variance (ANOVA) and Tukey tests (p<0.05). Results A statistically significant difference was found between the adhesive strategies tested (p<0.001), with the self-etching form showing higher values than the etch-and-rinse. Moreover, no significant differences were observed between the tested toothpastes (p=0.750) and interactions (p=0.438). Conclusion The use of toothpaste containing obliterating agents does not affect bond strength to dentin subjected to erosive/abrasive conditions when a universal adhesive is used. However, the self-etch strategy might be preferred for eroded/abraded dentin.

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An ultra-fast method for the simultaneous determination of heavy metals in Passiflora incarnata tea by capillary electrophoresis (CE) using a short-end injection combined with multivariate analysis was proposed. Separation was conducted by hydrodynamic injection (5 s at 0.5 psi) using the short-end injection procedure in a fused uncoated silica capillary (50 cm total length, 10.2 cm effective length, 50 µm i.d.) with separation time less than 2 min. An indirect UV detection at 214 nm was employed by using imidazole as a chromophore. The buffer used was 6 mmol/L hydroxybutyric acid (HIBA). The optimum conditions by full factorial with a central point were achieved by 18-crown-6 concentration (23.3 mmol L−1), voltage (+11.4 kV), methanol concentration (3.8%), and temperature (20 °C). The method showed good linearity (R2 > 0.998) for both Cd and Pb, inter-day precision of less than 14.49%, and an adequate limit of quantification only for Cd (LOQ < 0.5 µg mL−1 for Cd) based on the US Pharmacopeial Convention limit requirements for elemental impurities. After method validation, the method was applied to Passiflora incarnata tea samples from a local market. Furthermore, the developed method showed great potential for the determination of metals in other samples with proper sample preparation procedures.

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The poor outcome of treatments for fungal infections is a consequence of the increasing incidence of resistance to antifungal agents, mainly due to the overexpression of efflux pumps. To surpass this mechanism of resistance, a substance able to inhibit these pumps could be administered in association with antifungals. Saccharomyces cerevisiae possesses an efflux pump (Pdr5p) homologue to those found in pathogenic yeast. Digoxin is a natural product that inhibits Na+, K+-ATPase. The aim of this study was to evaluate whether digoxin and its derivatives (i.e., DGB, digoxin benzylidene) can inhibit Pdr5p, reversing the resistance to fluconazole in yeasts. An S. cerevisiae mutant strain that overexpresses Pdr5p was used in the assays. The effects of the compounds on yeast growth, efflux activity, and Pdr5p ATPase activity were measured. All derivatives enhanced the antifungal activity of fluconazole against S. cerevisiae, in comparison to fluconazole alone, with FICI values ranging from 0.031 to 0.500. DGB 1 and DGB 3 presented combined effects with fluconazole against a Candida albicans strain, with fractional inhibitory concentration index (FICI) values of 0.625 and 0.281, respectively The compounds also inhibited the efflux of rhodamine 6G and Pdr5p ATPase activity, with IC50 values ranging from 0.41 µM to 3.72 µM. The results suggest that digoxin derivatives impair Pdr5p activity. Considering the homology between Pdr5p and efflux pumps from pathogenic fungi, these compounds are potential candidates to be used in association with fluconazole to treat resistant fungal infections.

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Objetivo: A cárie radicular é um problema da Odontologia moderna, porém é notável a falta de diretrizes sobre o seu manejo. Objetivamos elaborar e adaptar um guia a partir da tradução das recomendações do consenso in-ternacional European Organization for Caries Research (ORCA) e European Federation of Conservative Dentistry (EFCD) para as tomadas de decisão clínica na intervenção do processo de cárie na pessoa idosa, com foco na cárie radicular. Materiais e métodos: O protocolo de tradução das recomendações do consenso internacional consistiu nas etapas: (1) tradução inicial, (2) síntese da tradução, (3) retradução, (4) revisão por comitê de especialistas, com adaptação cultural. A partir da tradução, foi desenvolvido um guia com diretrizes para tratamento de cárie radicular no Brasil. Resultados: Para prevenção de novas lesões é recomendada a escovação diária com dentifrício >1.500ppm/F. Dentifrícios com 5.000ppm/F ou vernizes (>20.000ppm/F) podem ser indicados para paralisar lesões radiculares ativas e para prevenção em pessoas idosas com alta suscetibilidade à cárie radicular, e o Diamino Fluoreto de Prata (>30%) para paralisar lesões ativas. Intervenções invasi-vas diretas são indicadas dependendo da situação clínica. Discussão: Nota-se uma falta de interesse em estudos primários sobre tratamentos para cárie radicular, criando assim uma lacuna em relação ao seu manejo, que reflete no nível de evidência detectado pelo consenso. Conclusão: Guias clíni-cos são importantes para reduzir a lacuna entre a pesquisa e a prática clínica. Essa tradução para o português facilitará o acesso dos dentistas bra-sileiros em relação a evidência consolidada até o momento para o manejo de cárie radicular.

Aim: Root caries are a problem in modern dentistry, but the lack of guidelines regarding their management is notable. We aim to develop and adapt a guide based on the translation of the recommendations of the international consensus as outlined by the European Organization for Caries Research (ORCA) and the European Federation of Conservative Dentistry (EFCD) for clinical decision-making in the intervention of the caries process in the elderly, with a focus on root caries. Materials and methods: The protocol for translating the recommendations of the international consensus consisted of the following steps: (1) initial translation, (2) synthesis of the translation, (3) back-translation, (4) review by an expert committee with cultural adaptation. Based on the translation, a guide was developed with guidelines for the treatment of root caries in Brazil. Results: To prevent new lesions, daily brushing with toothpaste >1,500ppm/F is recommended. Toothpaste with 5,000ppm/F or varnishes (>20,000ppm/F) may be recommended to paralyze active root lesions and for prevention in elderly people with high susceptibility to root caries, and Silver Diamine Fluoride (>30%) to paralyze active lesions. Direct invasive interventions are indicated depending on the clinical situation. Discussion: There is a lack of interest in primary studies on treatments for root caries, thus creating a gap in relation to its management, which is reflected by the level of evidence detected in the consensus. Conclusion: Clinical guidelines are important to reduce the gap between research and clinical practice. This translation into Portuguese will facilitate access by Brazilian dentists to the consolidated evidence gathered to date for the management of root caries.

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RESUMO Objetivo: identificar os fatores relacionados à (in)satisfação no trabalho de trabalhadores da Atenção Primária à Saúde (APS). Métodos: estudo exploratório com abordagem quantitativa, conduzido em 23 unidades da APS no estado de São Paulo. Foi utilizada a Escala de Satisfação no Trabalho, que abrange o grau de contentamento com chefia, colegas, salário, promoções e trabalho realizado, além de um questionário sócio-ocupacional. Resultados: participaram 70 trabalhadoras, sendo a grande maioria auxiliares de Enfermagem e agentes comunitárias de saúde, com idade média de 45±10,6 anos. Constatou-se indiferença nos campos colegas, chefia e natureza do trabalho. Por outro lado, verificou-se insatisfação com os campos salário e promoções. Conclusão: foi constatada insatisfação no trabalho na APS, e os achados demonstram a necessidade de revisão do plano de carreira e ajustes salariais.

RESUMEN Objetivo: identificar los factores relacionados con la (in)satisfacción laboral de los trabajadores de la Atención Primaria de Salud (APS) Métodos: estudio exploratorio con enfoque cuantitativo, realizado en 23 unidades de APS del estado de São Paulo. Se utilizó la Escala de Satisfacción Laboral, que abarca el grado de satisfacción con la dirección, los compañeros, el salario, las promociones y el trabajo realizado, además de un cuestionario sociolaboral. Resultados: participaron 70 trabajadoras, la gran mayoría auxiliares de enfermería y agentes de salud comunitarios, con una edad media de 45±10,6 años. Hubo indiferencia en los compañeros de campo, el liderazgo y la naturaleza del trabajo. Por otro lado, se comprobó la insatisfacción con los campos salariales y las promociones. Conclusión: se ha constatado la insatisfacción laboral en APS, los resultados demuestran la necesidad de revisar el plano de carrera y los ajustes salariales.

ABSTRACT Objective: to identify factors related to (dis)satisfaction at work among Primary Health Care (PHC) workers. Methods: exploratory study with a quantitative approach, conducted in 23 PHC units in the state of São Paulo, Brazil. The Job Satisfaction Scale was used, which covers the degree of satisfaction with management, colleagues, salary, promotions, and work performed, in addition to a socio-occupational questionnaire. Results: 70 workers participated, most of them Nursing assistants and community healthcare agents, with a mean age of 45±10.6 years. Indifference was found in the fields of colleagues, management, and nature of work. On the other hand, there was dissatisfaction with the salary and promotions fields. Conclusion: job dissatisfaction was found in PHC, and the findings demonstrate the need to review the career plan and salary adjustments.

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BACKGROUND: IgG4-related disease is a fibroinflammatory and immune-mediated condition, which has extremely variable clinical manifestations. In this study, we aim to investigate the clinicopathological features of IgG4-related disease involving the oral and maxillofacial region. METHODS: Cases of IgG4-related disease manifesting in the oral and maxillofacial region were retrieved from three Brazilian institutions. Clinical and serological data were obtained from the patients' medical charts, while microscopic and immunohistochemical findings were revised by oral pathologists. Diagnosis followed the American College of Rheumatology/European League against Rheumatism criteria. RESULTS: Seven patients diagnosed with IgG4-related disease were included in this study. Women were affected in all analysed cases, with a mean age of 55.4 years. Two patients presented with the clinical involvement of more than one oral and maxillofacial anatomic site. Therefore, our sample comprised nine oral and maxillofacial anatomic sites affected by IgG4-related disease. The submandibular gland was affected in four cases, the tongue and the parotid gland in two cases each, and the palate in one case. In a few cases, exploratory lower lip biopsy was used as a diagnostic approach. A moderate-to-severe lymphoid infiltrate containing plasma cells and lymphocytes, with an increased IgG4/IgG ratio, was common. Treatment varied and steroids were the most frequently used (57.4%). Six patients remained alive, while one died from unknown causes. CONCLUSION: Although major salivary glands are commonly affected by IgG4-related disease, the oral cavity can also be involved, and lower lip biopsy may be an auxiliary diagnostic tool.

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Laser-photobiomodulation (L-PBM) has been widely studied and its biomodulatory effects have been established on irradiated cells, increasing viability and proliferation and on damaged tissues. In addition, L-PBM may reduce and modulate the inflammatory process. The effect of 660-nm and 808-nm laser-photobiomodulation on bone repair around titanium dental implants placed in rat's femur was evaluated by histomorphometry. Twenty-seven Wistar rats were divided into 3 groups of nine animals: group C - non-irradiated control; group R - λ=660nm irradiated; and group IR - λ=808nm irradiated. Each group was further divided in 3 subgroups of three animals each, according to histomorphometry analysis in 3 days, 7 days, and 14 days after irradiation. Histological H.E.-stained slides were photographed, and bone matrix measured in new-formed bone area. Bone matrix histomorphometry analysis indicates that at 7 days in the irradiated groups (R and IR), a bigger area matrix was observed in relation to control group (C) (p=0.04 and p=0.048 respectively). On the other hand, at 14 days, control group (C) presented a bigger area than infrared irradiated (IR) (p=0.001) and red irradiated group (R) also showed a bigger area than infrared irradiated group (IR) (p=0.019). Histological analysis indicates that irradiated groups (R and IR) exhibited a faster bone tissue matrix production than control group.

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Abstract Thiazolidinedione, often shortened to TZD or glitazone, helps lower insulin resistance, which is the underlying problem for many people with type 2 diabetes. The two most known glitazones are pioglitazone (PGZ), with the brand name medicine Actos®, and rosiglitazone (RSG), which is Avandia®. This study presented a multivariate optimization in the microextraction procedure employing Fractional Factorial Design (FFD) combined with Desirability Function (DF) to determine TZD and metabolites in biological samples. Microextraction requires several parameters to be optimized; however, most of them still use univariate optimization. Finding optimum conditions by simple response is relatively simple, but the problems, in case of microextractions, are often more complex when it has more responses. For example, changing one factor that promotes one response may suppress the effect of the others. Thus, this multivariate optimization was applied for two bioanalytical methods for determination of TZD and metabolites, one by HPLC and other by CE, both using Hollow Fiber Liquid-Phase Microextraction (HF-LPME). The results establish the optimal values and elucidate how the factors that affect HF-LPME procedure perform in extraction efficiency for TZDs. Additionally, this study demonstrates that DF can be an important tool to optimize microextraction procedures.

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A punção de um acesso venoso é o procedimento invasivo mais comum no ambiente hospitalar. O uso da ultrassonografia para orientação do cateterismo venoso periférico em populações e ambientes específicos têm demonstrado benefícios assistenciais aos pacientes submetidos ao seu uso. Resultados da aplicação desta tecnologia em pacientes clínicos fora de áreas críticas, com amostra estratificada por faixa etária são inexistentes. O objetivo geral do estudo foi comparar a assertividade na primeira tentativa de inserção de cateteres venosos periféricos orientados por ultrassom realizada por enfermeiros especialistas com a punção venosa periférica convencional (sem ultrassonografia) realizada por enfermeiros assistenciais. Trata-se de um ensaio clínico randomizado (ECR) tipo PROBE (Prospective Randomized Open Blinded End Point), paralelo, controlado e de centro único, registrado na plataforma ClinicalTrials.gov sob o registro NTC04853264, conduzido em um hospital público universitário, entre 22 de junho e 24 de setembro de 2021. Foram incluídos pacientes adultos hospitalizados em unidades de internação clínica, com indicação de terapia intravenosa compatível com rede venosa periférica. Os participantes foram divididos em grupo intervenção (GI) ­ inserção de cateter venoso periférico orientado por ultrassonografia executada por enfermeiros especializados de um programa de acesso vascular; e grupo controle (GC) ­ cateterismo venoso periférico por técnica convencional executada por enfermeiros da prática clínica. A randomização foi realizada em blocos de diferentes tamanhos e estratificados por idade, através de uma ferramenta própria do software Research Electronic Data Capture (REDCap). O desfecho primário incluiu a assertividade de punção/inserção do cateter venoso periférico. Desfechos secundários incluíram o tempo em minutos despendido para a inserção do cateter venoso periférico, classificação das condições da rede venosa periférica, tempo de permanência do cateter venoso periférico e os desfechos compostos durante o seguimento. Foram incluídos um total de 166 pacientes: GI (n = 82) e GC (n = 84), sexo feminino (62,7%), predomínio de etnia branca (81,9%) e média de idade 59,5 ± 16,5 anos. A assertividade na primeira tentativa de punção venosa periférica no GI foi de 90,2% e no GC foi de 35,7% (P < 0,001), com 2,5 (IC 95% 1,88-3,40] entre os grupos. A taxa geral de assertividade foi de 100% no GI e 71,4 % no GC. Quanto ao tempo de realização do procedimento a mediana no GI foi de 5 (4-7) minutos versus 10 (6-27,5) minutos no GC, (P < 0,001). Referente às condições da rede venosa periférica dos pacientes foi evidenciado que 58,5% do GI e 41,7 GC (P = 0,053) apresentavam alto risco de falha na primeira tentativa de punção, conforme a classificação utilizada. A mediana relativa ao tempo de permanência do acesso venoso não teve diferença significativa entre os grupos 4 (2-6) versus 2 (2- 6) dias no GI e GC, respectivamente (P = 0,256). Para os desfechos compostos, os dispositivos intravenosos periféricos do GI apresentaram menor incidência de desfechos negativos, GI com 39% versus GC com 66,7% (P < 0,001), gerando uma probabilidade 42% menor de desfechos negativos no GI, 0,58 (IC 95% 0,43-0,80). Os resultados deste ECR permitem concluir que a assertividade na primeira tentativa de inserção de um cateter venoso periférico foi superior para o grupo em que foi utilizada a ultrassonografia por enfermeiros com expertise nesse procedimento, sem falhas, com menor tempo de inserção e menos incidência de desfechos desfavoráveis.

Venipuncture is the most common invasive procedure in the hospital environment. Using ultrasound to guide peripheral venipuncture in specific populations and environments has proved beneficial to patients subjected to its use. Results on the application of this technology in clinical practices outside critical areas, with sample stratifies by age group are nonexistent. Overall, this study sought to compare the assertiveness of ultrasound-guided peripheral venipuncture performed by specialist nurses with conventional peripheral venipuncture performed by care nurses. This is a parallel, controlled, single center, PROBE (Prospective Randomized Open Blinded End Point) clinical trial registered on the ClinicalTrials.gov platform under registration NTC04853264 carries out at a public university hospital, between June 22 and September 24, 2021. Adult patients admitted to clinical inpatient units, with indication for intravenous therapy compatible with peripheral venous network were included. Participants were divided into intervention group (IG) ­ ultrasound-guided peripheral venipuncture performed by specialist nurses from a vascular access program; and control group (CG) ­ conventional peripheral venipuncture performed by clinical nurses. Randomization was performed in bloc of different sizes and stratified by age group using Research Electronic Data Capture (REDCap) software. Primary outcome included the assertiveness of peripheral venipuncture. Secondary outcomes comprised time in minutes spent for peripheral venipuncture, classification of peripheral venous network condition, peripheral venous catheter length of stay, and composite outcomes during follow-up. A total of 166 patients were included: IG (n = 82) and CG (n = 84), women (62.7%), white (81.9%) and mean age 59.5 ± 16.5 years. Assertiveness on the first attempt of peripheral venipuncture in the IG was 90.2% and in the CG was 35.7% (P < 0.001), with 2.5 (95%CI 1.88-3.40] between groups. Median time of the procedure was 5 (4-7) minutes in the IG versus 10 (6-27.5) minutes in the CG, (P < 0.001). Overall assertiveness rate was 100% in the IG and 7.4 % in the CG. Regarding the patients' peripheral venous network condition, 58.5% of the IG and 41.7% of the CG (P = 0.053) showed high risk of failure in the first attempt, according to the classification used. Median duration of venous access had no significant difference between groups: 4 (2-6) versus 2 (2-6) days in the IG and CG, respectively (P = 0.256). For the composite outcomes, the IG peripheral intravenous devices had a lower incidence of negative outcomes, with 39% versus CG with 66.7% (P < 0.001), generating a 42% lower probability of negative outcomes in the IG, 0.58 (95%CI 0.3-0.80). The results allow us to conclude that assertiveness in the first attempt of peripheral venipuncture was superior for the ultrasound-guided group, with no failures, shorter insertion time, and less incidence of unfavorable outcomes.

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