RESUMO
OBJECTIVE: This study aimed to associate the parents' perception of the need for treatment and the children's aesthetic concern, considering the influence of malocclusion severity levels. METHODS: A population-based cross-sectional study was conducted with 770 children aged 8 to 10 years in the mixed dentition stage. A closed question sent to parents assessed the subjective orthodontic treatment need (outcome). Orthodontic Aesthetic Subjective Impact Score (OASIS) evaluated children's aesthetic concerns, and the Dental Aesthetic Index (DAI) diagnosed the anterior characteristics and malocclusion severity levels. Individual analyses were performed relating the outcome as independent variables. The variables with P<0.20 in the individual analyses were tested in multiple logistic regression models, and those with P<0.10 remained in the model. The adjusted odds ratio was estimated with a 95% confidence interval. RESULTS: Parents of children with higher aesthetic concerns are 1.82 times more likely to believe that their child needs orthodontic treatment (P<0.05). Parents of children with very severe malocclusion are 1.91 times more likely to perceive their child's need for orthodontic treatment (P<0.05). CONCLUSION: Parents of children with greater aesthetic concerns are more likely to perceive the need for orthodontic treatment, and very severe malocclusion also influences parents' perception of the need for orthodontic treatment.
Assuntos
Dentição Mista , Má Oclusão , Criança , Estudos Transversais , Estética Dentária , Humanos , Má Oclusão/diagnóstico , Má Oclusão/terapia , Ortodontia Corretiva , Pais , PercepçãoRESUMO
The effectiveness of advanced technologies on eliminating antibiotic resistant bacteria (ARB) and resistance genes (ARGs) from wastewaters have been recently investigated. Solar photo-Fenton has been proven effective in combating ARB and ARGs from Municipal Wastewater Treatment Plant effluent (MWWTPE). However, most of these studies have relied solely on cultivable methods to assess ARB removal. This is the first study to investigate the effect of solar photo-Fenton upon ARB and ARGs in MWWTPE by high throughput metagenomic analysis (16S rDNA sequencing and Whole Genome Sequencing). Treatment efficiency upon priority pathogens and resistome profile were also investigated. Solar photo-Fenton (30â¯mgâ¯L-1 of Fe2+ intermittent additions and 50â¯mgâ¯L-1 of H2O2) reached 76-86% removal of main phyla present in MWWTPE. An increase in Proteobacteria abundance was observed after solar photo-Fenton and controls in which H2O2 was present as an oxidant (Fenton, H2O2 only, solar/H2O2). Hence, tolerance mechanisms presented by this group should be further assessed. Solar photo-Fenton achieved complete removal of high priority Staphylococcus and Enterococcus, as well as Klebsiella pneumoniae and Pseudomonas aeruginosa. Substantial reduction of intrinsically multi-drug resistant bacteria was detected. Solar photo-Fenton removed nearly 60% of ARGs associated with sulfonamides, macrolides, and tetracyclines, and complete removal of ARGs related to ß-lactams and fluoroquinolones. These results indicate the potential of using solar-enhanced photo-Fenton to limit the spread of antimicrobial resistance, especially in developing tropical countries.
Assuntos
Peróxido de Hidrogênio , Microbiota , Antagonistas de Receptores de Angiotensina , Inibidores da Enzima Conversora de Angiotensina , Antibacterianos/farmacologia , Resistência Microbiana a Medicamentos/genética , Concentração de Íons de Hidrogênio , Águas ResiduáriasRESUMO
This work aimed to assess the elimination and inactivation of resistance-conferring plasmids (RCPs) present in suspension in secondary wastewater by solar photo-Fenton as these are important vectors for the dissemination of antimicrobial resistance. Experiments were performed in synthetic secondary wastewater (SWW) and municipal wastewater treatment plant effluent (MWWTPE). Solar photo-Fenton (50 mg L-1 of H2O2 and 30 mg L-1 of Fe2+) was carried out for 60 min at neutral pH by applying the intermittent iron addition strategy. The removal of RCPs was assessed by Real-Time Polymerase Chain Reaction (qPCR). The transformation of competent non-resistant E. coli was used to evaluate the inactivation of target RCPs harboring antibiotic resistance genes (ARGs) to ampicillin (pSB1A2) or kanamycin (pSB1K3) after treatment and controls. Solar photo-Fenton completely removed RCPs initially present in both matrixes (SWW and MWWTPE), showing enhanced performance compared to the dark Fenton process. Both RCPs were inactivated after 30 min of solar photo-Fenton treatment, while 60 min were necessary to achieve the same effect for the dark Fenton reaction under similar conditions. These results indicate the potential of solar photo-Fenton to improve wastewater quality and reduce the spread of antimicrobial resistance in the environment by hampering the discharge of cell-free RCPs present in suspension in MWWTP onto environmental waters.
Assuntos
Águas Residuárias , Poluentes Químicos da Água , Antibacterianos , DNA , Farmacorresistência Bacteriana/genética , Escherichia coli/genética , Peróxido de Hidrogênio , Oxirredução , Plasmídeos/genéticaRESUMO
This work investigated an innovative alternative to improve municipal wastewater treatment plant effluent (MWWTP effluent) quality aiming at the removal of contaminants of emerging concern (caffeine, carbendazim, and losartan potassium), and antibiotic-resistant bacteria (ARB), as well as disinfection (E. coli). Persulfate was used as an alternative oxidant in the solar photo-Fenton process (solar/Fe/S2O82-) due to its greater stability in the presence of matrix components. The efficiency of solar/Fe/S2O82- at neutral pH using intermittent iron additions is unprecedented in the literature. At first, solar/Fe/S2O82- was performed in a solar simulator (30 W m-2) leading to more than 60% removal of CECs, and the intermittent iron addition strategy was proved effective. Then, solar/Fe/S2O82- and solar/Fe/H2O2 were compared in semi-pilot scale in a raceway pond reactor (RPR) and a cost analysis was performed. Solar/Fe/S2O82- showed higher efficiencies of removal of target CECs (55%), E. coli (3 log units), and ARB (3 to 4 log units) within 1.9 kJ L-1 of accumulated irradiation compared to solar/Fe/H2O2 (CECs, 49%; E. coli, 2 log units; ARB, 1 to 3 log units in 2.5 kJ L-1). None of the treatments generated acute toxicity upon Allivibrio fischeri. Lower total cost was obtained using S2O82- (0.6 m-3) compared to H2O2 (1.2 m-3). Therefore, the iron intermittent addition aligned to the use of persulfate is suitable for MWWTP effluent quality improvement at neutral pH.
Assuntos
Poluentes Químicos da Água , Purificação da Água , Antagonistas de Receptores de Angiotensina , Inibidores da Enzima Conversora de Angiotensina , Antibacterianos , Desinfecção , Escherichia coli , Peróxido de Hidrogênio , Concentração de Íons de Hidrogênio , Águas Residuárias , Poluentes Químicos da Água/análiseAssuntos
Doenças do Cão , Animais , Doenças do Cão/diagnóstico , Cães , Feminino , Glândulas Mamárias AnimaisRESUMO
A assistência farmacêutica compreende o conjunto de atividades relacionadas ao acesso e ao uso racional de medicamentos. A atenção
farmacêutica é a interação direta do farmacêutico com o usuário, visando uma farmacoterapia racional e a obtenção de resultados
definidos e mensuráveis, voltados para a melhoria da qualidade de vida. Esta interação também deve envolver as concepções dos seus
sujeitos, respeitadas as suas especificidades biopsicossociais, sob a ótica da integralidade das ações de saúde. A atenção farmacêutica em
pacientes de uma classe social menos favorecida e com um baixo grau de instrução, melhora a adesão ao medicamento, curando ou
controlando sua patologia(AU)
Assuntos
Humanos , Administração Farmacêutica , Serviços Comunitários de Farmácia , Saúde Pública , Saúde da FamíliaRESUMO
A assistência farmacêutica compreende o conjunto de atividades relacionadas ao acesso e ao uso racional de medicamentos. A atenção
farmacêutica é a interação direta do farmacêutico com o usuário, visando uma farmacoterapia racional e a obtenção de resultados
definidos e mensuráveis, voltados para a melhoria da qualidade de vida. Esta interação também deve envolver as concepções dos seus
sujeitos, respeitadas as suas especificidades biopsicossociais, sob a ótica da integralidade das ações de saúde. A atenção farmacêutica em
pacientes de uma classe social menos favorecida e com um baixo grau de instrução, melhora a adesão ao medicamento, curando ou
controlando sua patologia
Assuntos
Humanos , Serviços Comunitários de Farmácia , Administração Farmacêutica , Saúde Pública , Saúde da FamíliaRESUMO
Aortic root (AoR) dilatation is more frequently observed in hypertensive individuals and is independently associated with left ventricular (LV) hypertrophy. Although the LV structure has sex-specific predictors, it remains unknown whether there are gender-related differences in the determinants of AoR size. We carried out a cross-sectional analysis of clinical, laboratory, anthropometric, funduscopic and echocardiographic features of 438 hypertensive patients with LV hypertrophy (266 women and 172 men). Women with enlarged AoR had higher cardiac output (P=0.0004), decreased peripheral vascular resistance (P=0.009), higher prevalence of mild aortic regurgitation (P=0.02) and increased waist circumference (P=0.04), whereas AoR-dilated men presented with a higher prevalence of concentric LV hypertrophy (P=0.0008) and mild aortic regurgitation (P=0.005) and increased log C-reactive protein levels (P=0.02), compared with sex-matched normal AoR subjects. In women, AoR dilatation associated with cardiac output, mild aortic regurgitation and waist circumference in a multivariate model including age, body surface area, height, homeostasis model assessment index, LV mass index, diastolic blood pressure, menopause status and use of antihypertensive medications as independent variables. Conversely, AoR dilatation associated with LV relative wall thickness, log C-reactive protein and mild aortic regurgitation without contributions from diastolic blood pressure, height, body surface area, LV mass index, peripheral vascular resistance and antihypertensive medications in men. Taken together, these results suggest that both volume overload and abdominal obesity are related to AoR dilatation in hypertensive women, whereas AoR enlargement is associated more with inflammatory and myocardial growth-related parameters in hypertensive men with LV hypertrophy.