Self-Declared Oral Health Conditions and Oral Health-Related Quality of Life of the Brazilian Homeless Population: A Cross-Sectional Study

Objective: To associate the impact of oral health-related quality of life with socio-demographic determinants, self-perception, oral health conditions and access to dental treatment among homeless adults. Material and Methods: A cross-sectional study was carried out in a medium-sized Brazilian city in Minas Gerais. Socio-demographic data on the use of dental services and access to hygiene supplies for oral health were collected. Clinical aspects were collected by clinical observation using the Community Oral Health Indicator and oral health-related quality of life using the Oral Health Impact Profile (OHIP-14). Medians and interquartile distance were compared using the Mann-Whitney and Kruskal-Wallis tests. Multiple linear regression included significant variables (p<0.05) of the bivariate analysis according to each OHIP-14 domain. Results:Women had the lowest scores for the physical and social disability domains. Oral health conditions were associated with physical and psychological limitations and disability. The presence of more teeth was associated with a negative impact on the functional and physical domains, and inflamed gums, lack of need for dental prosthesis, and use of private services were associated with a greater psychological disability. Conclusion: Oral health-related quality of life of the homeless population is affected, especially in the physical and psychological aspects. Equitable and inclusive health actions aimed at this population should include oral health

Effect of essential oils on the release of TNF-α and CCL2 by LPS-stimulated THP‑1 Cells

Plants and their constituents have been used to treat diverse ailments since time immemorial. Many plants are used in diverse external and internal formulations (infusions, alcoholic extracts, essential oils (EOs), etc.) in the treatment of inflammation-associated diseases, such as those affecting the respiratory tract or causing gastrointestinal or joint problems, among others. To support the traditional uses of plant extracts, EOs have been assessed for their alleged anti-inflammatory properties. However, the effect of EOs on the release of cytokines and chemokines has been much less reported. Considering their traditional use and commercial relevance in Portugal and Angola, this study evaluated the effect of EOs on the in vitro inhibition of the cytokine tumor necrosis factor-α (TNF-α) and the chemokine (C-C motif) ligand 2 (CCL2) by lipopolysaccharide (LPS)-stimulated human acute monocytic leukemia cells (THP-1 cells). Twenty EOs extracted from eighteen species from seven families, namely from Amaranthaceae (Dysphania ambrosioides), Apiaceae (Foeniculum vulgare), Asteraceae (Brachylaena huillensis, Solidago virgaurea), Euphorbiaceae (Spirostachys africana), Lamiaceae (Lavandula luisieri, Mentha cervina, Origanum majorana, Satureja montana, Thymbra capitata, Thymus mastichina, Thymus vulgaris, Thymus zygis subsp. zygis), Myrtaceae (Eucalyptus globulus subsp. maidenii, Eucalyptus radiata, Eucalyptus viminalis) and Pinaceae (Pinus pinaster) were assayed for the release of CCL2 and TNF-α by LPS-stimulated THP-1 cells. B. huillensis, S. africana, S. montana, Th. mastichina and Th. vulgaris EOs showed toxicity to THP-1 cells, at the lowest concentration tested (10 μg/mL), using the tetrazolium dye assay. The most active EOs in reducing TNF-α release by LPS-stimulated THP-1 cells were those of T. capitata (51% inhibition at 20 μg/mL) and L. luisieri (15–23% inhibition at 30 μg/mL and 78–83% inhibition at 90 μg/mL). L. luisieri EO induced a concentration-dependent inhibition of CCL2 release by LPS‑stimulated THP-1 cells (23%, 54% and 82% inhibition at 10, 30 and 90 μg/mL, respectively). These EOs are potentially useful in the management of inflammatory diseases mediated by CCL2 and TNF‑α, such as atherosclerosis and arthritis.The European Commission under the Seventh Framework Programme (FP7) of the European Union, Marie Curie International Research Staff Exchange Scheme (MC-IRSES). Project PEOPLE MC-IRSES, FP7-PEOPLE-2011-IRSES, PIRSES-GA-2011-295251 Fundação para a Ciência e Tecnologia (FCT/MCTES), FEDER, PT2020 PA, Compete 2020. Projects MED UIDB/05183/2020 and CESAM UIDP/50017/2020 + UIDB/50017/2020.info:eu-repo/semantics/publishedVersio

A PRESUNÇÃO DE INOCÊNCIA NOS CRIMES CONTRA A DIGNIDADE SEXUAL: O VALOR PROBATÓRIO DA PALAVRA DA VÍTIMA VS IN DUBIO PRO REO

The present research is located within a national context because it’s dedicated to the analysis of the conflict between the presumption of innocence and the differenciated  probative value of the victim’s word in the trial of sexual crimes. The research problem is to verify if the reception of this evidence with special value de-characterizes the presumption of innocence. The importance of this study lies in analyzing whether Brazilian courts act in accordance with the guaranteeing purpose of the criminal process and how the Brazilian Judiciary deals with the constitutional guarantee of presumedinnocence of the defendant. The study was developed through a bibliographical research of narrative type with a deductive approach, because the theoretical-methodological foundation is necessary for this work.La presente investigación se fundamenta en el contexto nacional, pues se dedica alanálisis del conflicto entre la presunción de inocencia y el valor probatorio diferenciadode la palabra de la víctima en el juicio de los delitos contra la dignidad sexual. Elproblema de investigación es verificar si la recepción de esta prueba con especial valor descaracteriza la presunción de inculpabilidad. La importancia de este estudio radica en analizar si los tribunales brasileños actúan de acuerdo con la finalidad garantista del proceso penal y cómo el Poder Judicial brasileño trata la garantía constitucional de no culpabilidad del imputado. El estudio se desarrolló a través de una investigación bibliográfica narrativa con enfoque deductivo, pues es necesaria la fundamentación teórico-metodológica para este trabajo.A presente pesquisa se assenta dentro do contexto nacional, pois se consagra na análise do conflito entre a presunção de inocência e o valor probatório diferenciado da palavra da vítima no julgamento de crimes contra a dignidade sexual. Tem-se por problema de pesquisa constatar se a recepção dessa prova com valor especial descaracteriza a presunção de não culpabilidade. A importância desse estudo reside em analisar se os tribunais brasileiros atuam de acordo com a finalidade garantista do processo penal e de que forma o Poder Judiciário brasileiro lida com a garantia constitucional de não culpabilidade do réu. O estudo foi desenvolvido através de pesquisa bibliográfica do tipo narrativa com abordagem dedutiva, por se fazer necessária a fundamentação teórico-metodológica para este trabalho.A presente pesquisa se assenta dentro do contexto nacional, pois se consagra na análise do conflito entre a presunção de inocência e o valor probatório diferenciado da palavra da vítima no julgamento de crimes contra a dignidade sexual. Tem-se por problema de pesquisa constatar se a recepção dessa prova com valor especial descaracteriza a presunção de não culpabilidade. A importância desse estudo reside em analisar se os tribunais brasileiros atuam de acordo com a finalidade garantista do processo penal e de que forma o Poder Judiciário brasileiro lida com a garantia constitucional de não culpabilidade do réu. O estudo foi desenvolvido através de pesquisa bibliográfica do tipo narrativa com abordagem dedutiva, por se fazer necessária a fundamentação teórico-metodológica para este trabalh

THE NEW CAP POLICY OF SUBSIDIES AND THE AGRICULTURAL PRODUCTION SYSTEMS OF THE ALENTEJO REGION

The implementation of CAP Reform introduces a new way of thinking the choices of the agricultural production systems. According to studies for the Alentejo region, CAP subsidies represent about 50% of the farmers’ total income. The objectives of this paper are to analyze the effects on the traditional agricultural systems of the CAP Reform and of several possible scenarios of agricultural policy after the potential planning horizon of the CAP Reform

Influence of drug–drug interactions on effectiveness and safety of direct-acting antivirals against hepatitis C virus

[Abstract] Objectives Direct-acting antivirals are the recommended treatment for hepatitis C-infected patients. Drug–drug interactions with concomitant treatments can cause lack of effectiveness and/or safety. The objective of this study is to characterise drug–drug interactions of direct-acting antivirals and to analyse their influence both on the effectiveness of antiviral treatment and on the overall safety of pharmacological treatment in hepatitis C-infected patients. Methods Observational and prospective cohort study for 3 years in the pharmaceutical care outpatient consultation of a general hospital, undertaking detection, evaluation and management of drug–drug interactions by clinical pharmacists and physicians. The main outcome measures were sustained virologic response at week 12 for effectiveness and serious drug-related adverse events for safety. Multivariate statistical analysis applied to: (a) patient basal characteristics related to presence of drug–drug interactions; (b) previous antiviral treatments, viral genotype, cirrhosis, decompensations and presence of drug–drug interactions related to the effectiveness of direct-acting antivirals. Results Of a total of 1092 patients, the majority of them were men, around 60 years old and HCV-genotype 1 mono-infected, with a high basal viral load, naive to antiviral treatment, treated with ledipasvir/sofosbuvir and without cirrhosis. 24.5% had drug–drug interactions. Proton pump inhibitors were the concomitant drugs that caused the most drug–drug interactions. Age ≥65 years and direct-acting antivirals based on protease inhibitors were independently related to the presence of drug-drug interactions (p≤0.012). All (100%) of the therapeutic recommendations based on detected drug–drug interactions were implemented; 97.7% of patients with interactions versus 99.0% without them reached sustained virologic failure (p=0.109). The serious adverse events rates were 1.5% and 1.3% in patients with and without drug-drug interactions, respectively (p=0.841). Conclusions Drug–drug interactions are frequent among hepatitis C-infected patients receiving treatment with direct-acting antivirals. However, the collaboration between physicians and clinical pharmacists makes it possible to detect, evaluate, avoid or clinically manage these drug–drug interactions, in order to maintain whole treatment therapeutic safety and the effectiveness of direct-acting antivirals

Benefits of Coffee and Therapy for Chronic Pain in Patients Diagnosed with Cancer

El objetivo de este estudio fue determinar mediante una revisión integradora de literatura los beneficios del café y su empleabilidad como terapia para el dolor crónico en pacientes con diagnóstico de cáncer. Materiales y método: Se utilizaron las bases de datos: PubMed, ELSERVIER, Scite, Cochrane Library, Bvs LIbrary, para la adquisición de los artículos y fueron consultadas durante el periodo de marzo de 2021 a mayo de 2022 encontrando 2336 artículos  de los cuales se escogieron 24 que  cumplieron con los criterios de inclusión, a estos artículos se les aplicó la herramienta de evaluación crítica de artículos CASPE según el tipo de articulo, Resultados :  Primero se hizo una caracterización de los estudios encontrando que según el enfoque la mayoría fueron cuantitativos 79% y cualitativos 29%, se categorizaron según nivel de evidencia y grados de recomendación ,  según el país de origen un 32%  fueron realizados en EE. UU , se analizaron las profesiones de los investigadores siendo el grupo más grande con un 17%  por médicos , los hallazgos se agruparon en 5 categorías según los objetivos específicos del estudio : Describir las sustancias protectoras que tienen el café para prevención de cáncer, Identificar el mecanismo de acción de las propiedades del café para el alivio del dolor crónico, Describir los beneficios del café en pacientes con diagnóstico de cáncer , Relacionar la dosis de café requerida para generar un efecto protector para cáncer e inhibitorio del dolor  y Proponer un plan de terapias alternativas con el uso del café para el manejo del dolor en pacientes con cáncer   . Conclusiones: Los beneficios del café van a depender del tipo de fruto, preparación, procesamiento y adición de azúcar u otras sustancias procesadas, contiene múltiples sustancias beneficiosas para la salud  y sus  mayores beneficios se obtienen al consumir la bebida sin azúcar o ninguna otra sustancia añadida, los componentes del café tales como el Cafestol y Kaweol  son las moléculas  a las cuales se les atribuye principalmente  propiedades protectoras antineoplásicas y de aumento de sobrevida en enfermedad metastásica , el contenido de cafeína del café puede ayudar a mejorar el umbral del dolor y tolerancia del calor siempre y cuando las tazas bebidas de éste contenga la dosis de cafeína entre 100-200 mg.The objective of this study was to determine, through an integrative review of the literature, the benefits of coffee and its applicability as a therapy for chronic pain in patients diagnosed with cancer. Materials and method: The following databases were used: PubMed, ELSERVIER, Scite, Cochrane Library, Bvs LIbrary, for the acquisition of the articles and were consulted during the period from March 2021 to May 2022 finding 2336 articles of which 24 were chosen that met the inclusion criteria, to these articles the critical evaluation tool of articles CASPE was applied according to the type of article, Results : First a characterization of the studies was made finding that according to the approach the majority were quantitative 79% and qualitative 29% were categorized according to the level of evidence and degrees of recommendation, according to the country of origin, 32% were carried out in the USA. The findings were grouped into 5 categories according to the specific objectives of the study: To describe the protective substances that coffee has for cancer prevention, To identify the mechanism of action of the properties of coffee for the relief of chronic pain, To describe the benefits of coffee in patients diagnosed with cancer, To relate the dose of coffee required to generate a protective effect for cancer and inhibitory pain, and To propose a plan of alternative therapies with the use of coffee for pain management in cancer patients. Conclusions: The benefits of coffee are going to depend on the type of fruit, preparation, processing and addition of sugar or other processed substances, it contains multiple beneficial substances for health and its greatest benefits are obtained when consuming the beverage without sugar or any other added substance, Coffee components such as Cafestol and Kaweol are the molecules to which are mainly attributed antineoplastic protective properties and increased survival in metastatic disease. The caffeine content of coffee can help to improve the pain threshold and heat tolerance as long as the cups drunk contain a dose of caffeine between 100-200 mg

Acidose metabólica e o estado nutricional de pacientes em hemodiálise

Introduction: The prevalence of malnutrition in hemodialysis (HD) is high, being a marker of poor prognosis in chronic kidney disease. Metabolic acidosis is common on dialysis, and has been associated with mortality. Objectives: To evaluate metabolic acidosis and the nutritional status of HD patients. Methods: A cross-sectional study was carried out in a single HD center. Data were collected from medical records, and the presence of metabolic acidosis and the nutritional status of the patients were verified by anthropometric and biochemical indicators. Results: The total sample of 63 patients, 54% male and 46% female, with 58.7% between 45 and 64 years. The mean dialysis time was of 5.4 years. The mean value of the body mass index (BMI) was 24.9kg/m2, and the mean value of albumin was 3.9g/dL. The prevalence of metabolic acidosis was of 77.8%. There was a negative linear correlation between bicarbonate and creatinine, without correlation with anthropometric and albumin indicators. Patients malnourished according to the BMI corresponded to 55.5% of the total sample and gained more interdialytic weight. Out of the total sample, 14.2% of the patients were classified as malnourished by the arm circumference index, and albumin < 4.0 g/dL was observed in 49.2% of the patients. Serum creatinine was higher in male patients aged between 45 and 64 years old. No difference in time on hemodialysis was observed regarding age, interdialytic weight gain, laboratory, and anthropometric measures. Conclusion: The prevalence of metabolic acidosis was high, and there was no correlation with the nutritional status. Bicarbonate < 22 mEq/L was correlated with higher creatinine values, but was unrelated to the nutritional status. The nutritional assessment by BMI was in agreement with the Brazilian literature, and albumin indicated elevated malnutrition

Aspectos epidemiológicos, clínicos e laboratoriais da Meningite viral: uma revisão de literatura

Infecções ocasionadas por vírus são capazes de afetar o Sistema Nervoso Central (SNC), desencadeando principalmente encefalites e meningites. O objetivo foi relatar os aspectos epidemiológicos, clínicos e laboratoriais da meningite viral. Foi realizado uma revisão de literatura narrativa, na qual foram analisados artigos científicos publicados na língua portuguesa e inglesa, utilizando os descritores: Meningites virais, líquido cefalorraquidiano, meningites. O período de coleta destas informações ocorreu entre janeiro e abril de 2022. O enterovírus é o agente etiológico mais comum nos quadros de meningite asséptica, tendo uma prevalência em pacientes infantis e adultos de até 90% dos casos, sendo mais incidentes no sexo masculino. O estudo realizado aponta que o agente etiológico com maior prevalência é o Enterovírus Echovirus, todavia na rotina clínica não é realizado um diagnóstico específico do vírus, realizando apenas um descarte de meningite bacteriana por meio da avaliação bioquímica e celular do LCR. A meningite viral, normalmente, não é grave, porém, como não há um tratamento específico, é de extrema importância o diagnóstico da doença, a fim de evitar um processo terapêutico errôneo e uma maior taxa de hospitalização, com aumento de morbimortalidade

Validation of a questionnaire to assess stress, tobacco use, physical activity, and dietary supplementation

Introduction: Given the large expansion of gyms, reliable instruments are needed to assess and obtain information about the behavior of gym members, and these instruments may be able to assist in the implementation of planning and health promotion strategies in this population. Objective: To develop and validate a questionnaire to assess the lifestyle habits, physical activity, and dietary supplementation of gym members. Materials and Methods: A 44-item questionnaire was developed. The Delphi technique was used for content and appearance validity using the content validity index (CVI). Construct validity was verified by exploratory factor analysis (EFA) in several phases. Reliability analysis was assessed by internal consistency and temporal reproducibility using Cronbach’s alpha and the intraclass correlation coefficient (ICC), respectively. Results: Two rounds of the Delphi technique identified a total CVI of 100%. The final model was composed of eight items, with excellent quality in the EFA adjustment, and distributed into four factors. Internal consistency was adequate in all factors, with ICC 0.997, 0.916, 0.698, and 0.631. Conclusions: This study provides a reliable and valid questionnaire to assess stress, smoking, physical activity, and dietary supplementation of fitness center members