Síndrome de moyamoya associada a neurofibromatose tipo I em paciente pediátrico

CONTEXT: Neurofibromatosis type 1 (NF-1) is the most prevalent autosomal dominant genetic disorder among humans. Moyamoya disease is a cerebral vasculopathy that is only rarely observed in association with NF-1, particularly in the pediatric age range. The present study reports an occurrence of this association in an infant. CASE REPORT: An eight-month-old female presented convulsive seizures with clonic movements. The patient suffered an ischemic stroke with hemiparesis. Magnetic resonance imaging revealed radiological findings compatible with moyamoya disease. The diagnosis of NF-1 was made at the age of 20 months. CONCLUSION: Despite the rarity of this association in childhood, children with focal neurological symptoms and a diagnosis of NF-1 deserve to be investigated for moyamoya syndrome.CONTEXTO: Neurofibromatose tipo 1 (NF-1) é a doença genética autossômica dominante mais prevalente no ser humano. A doença de moyamoya é uma vasculopatia cerebral que raramente se encontra associada à NF-1, particularmente na faixa etária pediátrica. Este estudo descreve a ocorrência desta associação em um lactente. RELATO DE CASO: Paciente feminina, aos oito meses de idade, apresentou quadro de crise convulsiva com movimentos clônicos. Evoluiu com acidente vascular encefálico isquêmico e com hemiparesia à direita. Ressonância nuclear magnética mostrou achados compatíveis com a doença de moyamoya. O diagnóstico de NF-1 foi realizado aos 20 meses de vida. CONCLUSÃO: Apesar da raridade desta associação na faixa etária infantil, crianças com sintomas neurológicos focais e diagnóstico de NF-1 merecem ser investigadas para síndrome de moyamoya.The authors would like to thank Dr. Maria Sol A. Brassesco for assistance in the literature revie

SERVIÇOS MÉDICO-HOSPITALARES: FATORES DE SATISFAÇÃO DOS PACIENTES DE UM HOSPITAL PÚBLICO DE BELÉM-PA

O objetivo do presente artigo foi identificar os fatores que influenciam a satisfação dos pacientes em relação aos serviços prestados por um hospital da rede pública na Região Metropolitana de Belém. A preocupação com a satisfação dos pacientes e com a avaliação da qualidade dos serviços públicos está inserida no contexto da administração pública gerencial. O estudo foi realizado com base em 400 questionários, aleatoriamente aplicados, com perguntas abertas e fechadas relativas ao perfil e a satisfação em relação ao atendimento dos pacientes do hospital, no período de 1 a 15 de setembro de 2008. Para determinação dos fatores, utilizou-se a análise fatorial exploratória (AFE). Os resultados sugerem que os fatores que influenciam a satisfação dos pacientes são o corpo clínico, recepção, atendimento e infraestrutura, além da importância dos aspectos interpessoais nos serviços hospitalares

Photobiomodulation reduces inflammation but does not influence the hypoxia-inducible factor-1α in pulp tissue of rats after bleaching

Objectives: To evaluate the influence of photobiomodulation with infrared laser (IRL) in the rat pulp tissue after bleaching, considering the immunolabeling of interleukin (IL)-23 and hypoxia-inducible factor (HIF)-1α. Methodology: The right and left molars of forty rats were divided into groups: Control – with placebo gel and Bleached – with 35% hydrogen peroxide (H2O2). Half of the rats received one IRL application on both sides, establishing a split-mouth design, which resulted in 4 groups with 20 hemi-maxillae each: Control, Bleach, IRL, and Bleached-IRL. Rats (n=10) from each group were euthanized, at 2- and 30-days mark, and the pulp tissue was evaluated using inflammation and immunolabeling scores. Wilcoxon and Mann-Whitney statistical tests were performed (p<0.05). Results: At the 2-days mark, the Bleached group had severe inflammation and necrosis in the occlusal thirds of the pulp, and moderate to severe inflammation in cervical third, whereas the Bleached-IRL had mild to moderate inflammation (p<0.05). At the 30-days mark, there was no inflammation, but tertiary dentine formation in the bleached groups. Regarding IL-23, severe immunolabeling was observed in the Bleached group (p<0.05) at the 2-days mark; at the 30-days mark, there was a reduction in immunolabeling, in which the Bleached group had moderate and the Bleached-IRL group had mild immunolabeling (p>0.05). HIF-1α was more evident at the 2-days mark in the Bleached group, without significant difference with the Bleached-IRL (p>0.05). The difference was observed between the bleached and control groups, without immunolabeling (p<0.05); at the 30-days mark, the Bleached group had reduction in HIF-1α immunolabeling, while the Bleached-IRL had an increase; the difference remained between the bleached and the controls groups (p<0.05). Conclusion: Photobiomodulation using IRL minimized the inflammation and IL-23 immunolabeling in the pulp tissue of rats after dental bleaching, but did not influence significantly the HIF-1α immunolabeling

Antileishmanial activity of Melampodium divaricatum and Casearia sylvestris essential oils on Leishmania amazonensis

Leishmaniasis is a disease that affects millions of people and it is an important public health problem. The drugs currently used for the treatment of leishmaniasis present undesirable side effects and low efficacy. In this study, we evaluated the in vitro activity of Melampodium divaricatum (MD-EO) and Casearia sylvestris (CS-EO) essential oils (EO) against promastigote and amastigote forms of Leishmania amazonensis. Sesquiterpenes E-caryophyllene (56.0%), germacrene D (12.7%) and bicyclogermacrene (9.2%) were identified as the main components of MD-EO, whereas E-caryophyllene (22.2%), germacrene D (19.6%) and bicyclogermacrene (12.2%) were the main constituents of CS-EO. CS-EO and E-caryophyllene were active against promastigote forms of L. amazonensis (IC50 24.2, 29.8 and 49.9 µg/mL, respectively). However, MD-EO, CS-EO and E-caryophyllene were more active against amastigote forms, with IC50 values of 10.7, 14.0, and 10.7 µg/mL, respectively. E-caryophyllene presented lower cytotoxicity against macrophages J774-A1 (CC50 of 62.1 µg/mL) than the EO. The EOs and E-caryophyllene should be further studied for the development of new antileishmanial drugs

Zoologia, Animais Silvestres, e Educação Ambiental: o desenvolvimento de um projeto de extensão durante a pandemia de COVID-19.

A pandemia da COVID-19 em 2020 levou, dentre outras inúmeras consequências, ao fechamento das escolas e universidades públicas e privadas em todo o Brasil. O ensino remoto emergencial foi a estratégia adotada pelas instituições de ensino, para que o ano letivo não fosse interrompido, sem previsão de retorno. Alunos e professores precisaram se adaptar intensamente à nova realidade. É lógico pensar que o desenvolvimento de projetos científicos e extensionistas sofreram também o impacto da pandemia e do isolamento social. O objetivo do presente trabalho é relatar a experiência de um projeto de extensão desenvolvido durante a pandemia de COVID-19, e portanto, de forma remota. Alunos e professores do curso de Medicina Veterinária da FINOM se reuniram por meio de vídeo chamadas, elaboraram e aplicaram questionários digitais, programaram entrevistas com órgãos públicos e mobilizaram a população em uma troca de informações e registros sobre a aparição de animais silvestres em área urbana no município de Paracatu, Minas Gerais. Percebemos que o tema atrai a atenção das pessoas em geral, inclusive fora do ambiente acadêmico. O engajamento de estudantes vinculados ao projeto foi satisfatório e não houve impedimentos relacionados à falta de encontros e atividades presenciais. Os dados obtidos até o momento reforçam a necessidade da elaboração de uma metodologia de educação ambiental e conscientização da preservação da fauna silvestre junto à comunidade

Cytotoxic Activity of Baccharis trimera (Less.) DC. Essential Oil in Tumor Cell Lines and its Role in Associated Death Mechanisms

This study evaluated the potential of Baccharis trimera essential oil (EO) and its components in cancer therapy through the application of cytotoxicity and cell death assays. Using gas chromatography analysis, the major components of the aerial parts of the essential oil were identified as (E)-caryophyllene (18.9%), bicyclogermacrene (15.6%), and germacrene D (10.5%). Baccharis trimera essential oil (5.8 μg/mL) and α-humulene (7.8 μg/mL) presented strong cytotoxic activity, while (E)-caryophyllene (11.5 μg/mL) and caryophyllene oxide (> 100.0 μg/mL) showed moderate and low activities, respectively, against MCF-7 cell lines. Against HepG2 cell lines, B. trimera essential oil (10.4 μg/mL), α-humulene (17.1 μg/mL), and caryophyllene oxide (19.4 μg/mL) exhibited moderate activity, while (E)-caryophyllene (52.3 μg/mL) displayed low activity against HepG2 cell lines. The selectivity index values of EO (MCF-7 and HepG2), α-humulene and (E)-caryophyllene (MCF-7), and caryophyllene oxide (HepG2) were found between 1.1 and 2.8, compared with MCF-10A cells. The annexin-V and Hoechst / propidium iodide assays performed with essential oil, (E)-caryophyllene, α-humulene, and caryophyllene oxide showed apoptosis and necrosis mechanisms for all cell lines. Based on these findings, B. trimera essential oil and its components can be considered as potential therapeutic agents against cancer

Contribution of community health workers to primary health care performance in Brazil

OBJECTIVE: To associate the strength of community health workers interventions with primary health care strategies for women’s and children’s health, diabetes, and hypertension. METHODS: This is a cross-sectional study assessing 29,778 family health teams working in primary health care in Brazil in 2014. The association between community health workers activity levels and primary health care facilities was analyzed using multiple logistic regression. RESULTS: We found higher levels of community health workers activities strongly associated with primary health care practices (OR = 6.88) for those activities targeting hypertension management, followed by children’s health (OR = 6.56), and women’s health (OR = 6.21). CONCLUSIONS: At a time when Brazil discusses whether community health workers should or should not remain in the same scale-up and skill level as they currently are, our results reinforce the importance of these workers for the care model advocated by the Brazilian Unified Health System

Condutas clínicas odontológicas em pacientes portadores de diabetes mellitus: revisão de literature / Clinical dental conducts in patients with diabetes mellitus: literature review

O Diabetes Mellitus ou Diabetes Melito, é uma doença crônica descrita pelos egípcios há mais de 3500 anos. É de etiologia múltipla, que leva a alterações metabólicas e, podendo ocorrer em qualquer idade. Segundo a Associação Americana de Diabetes (ADA) a Diabetes Melito tipo1 é uma doença metabólica crônica caracterizada por uma deficiência quase absoluta de insulina por defeito das células beta do pâncreas, usualmente autoimune. A Diabetes Melito tipo 2 aparece quando o organismo não consegue usar adequadamente a insulina que produz; ou não produz insulina suficiente para controlar a taxa de glicemia. Devido ao aumento da longevidade dos pacientes diabéticos, está se tornando mais frequente o atendimento deste grupo de pacientes no consultório odontológico. É fato reconhecido que as doenças periodontais são mais prevalentes e apresentam maior severidade em portadores de diabetes melito, os quais apresentam maior perda de inserção, maior reabsorção óssea e maior sangramento gengival. O objetivo desse trabalho é revisar a literatura científica no que se refere as condutas clínicas do cirurgião-dentista em pacientes portadores de diabetes mellitus, a fim de adquirir conhecimento necessário paras as corretas condutas desde a anamnese ao tratamento

An improved folate stable isotope dilution assay of unexploited food sources from Brazil

Brazil has a diverse plant community, including underutilized non-conventional food crops (PANCs), which have the potential to be a rich source of food and contribute to food security. For assessing the folate content in a range of Brazilian PANCs, we extended the validation of an existing stable isotope dilution assay (SIDA) for the stably 13C-labelled 10-formyl-Pte[13C5]Glu (10-CHO-Pte[13C5]Glu). The SIDA method with an enzymatic treatment, purification step, and an LC–MS/MS measurement was validated regarding linearity, precision, LoD/LoQ, and recovery for 10-CHO-PteGlu. After successful validation, the study of some underutilized Brazilian non-conventional fruits and leaves from the São Paulo State University campus revealed them as an important source of folates. It provided the first insights into the folate content of unexploited food sources from Brazil. Pequi had the highest folate content among the fruits studied, with mean values of 333 μg/100 g based on fresh weight (FW). The analysis also shows that different cultivars of fruit or fruits from different growing locations have a high variability in folate content or other nutritional factors. In most fruits, the main vitamer was 5-CH3-H4folate, but jenipapo and taioba showed the highest content of 10-CHO-PteGlu with 28.22 μg/100 g (FW) in jenipapo peel and 75.64 μg/100 g (FW) in the taioba leaves. Thus, this study also provides results on the importance of the folate vitamer 10-CHO-PteGlu contributing to the total folate content

Scavenging Activity on Reactive Oxygen Species with Biological Relevance by Varronia curassavica

Varronia curassavica Jacq. is a medicinal plant found in Brazil used as anti-inflammatory. Here, we investigated the in vitro antioxidant activity of 70 % ethanol extract of V. curassavica leaves on synthetic radicals (ABTS•+/DPPH•) and reactive oxygen species (O2•-, ROO•, HOCl/OCl-, H2O2), besides its in vitro cytotoxicity. The extract was characterized by UPLC-ESI-QToF-MSE and the annotated compounds were one hydroxybenzoic acid, five phenylpropanoids, and three glycosylated quercetin derivatives, being the main compound rosmarinic acid or its isomer. The antioxidant activity was very promising in all tests, highlighting on the capture of O2•-, which EC50 value was three times lower than Trolox. This activity may be due to the presence of the major compounds, all phenolic compounds. The extract also presented low cytotoxicity. Thus, the extract from V. curassavica leaves has great potential as an antioxidant