Maintenance of Pulp after Horizontal Root Fractures in Three Maxillary Incisors: A Thirteen-Year Evaluation

This case report documents the clinical approach adopted for three upper incisors with horizontal root fracture in the middle or cervical third. The proposed procedures involved maintaining pulp vitality and periodontal stability of the fractured teeth with 13 years of follow-up.Keywords: Connective Tissue Cells; Dental Pulp; Tooth Fracture

Oral Sensorimotor System in Patients with Facial Lipoatrophy Living with AIDS

Introduction: Lipodystrophy Syndrome in people living with AIDS is characterized by body fat redistribution and metabolic abnormalities and is associated with the use of antiretroviral therapy (ART). It is socially and psychologically impacting once it reduces the quality of life of those who develop it. The prevalence varies from 6% to 69%.Objective: Characterize the Oral Sensorimotor System in patients with Facial Lipoatrophy living with AIDS.Methods: Cross-sectional convenience sample study. Sixty-four patients living with AIDS treated in the Lipodystrophy Clinic were clinically evaluated by the infectious disease physician and by the speech language pathologist. The Oral Sensorimotor System structures were evaluated through the Orofacial Assessment Protoco.Results: Changes in tone and mobility are associated with loss of subcutaneous fat.Conclusions: Changes presented in the morphology and function of the Oral Sensoriomotor System are associated with facial Lipoatrophy in patients living with AIDS

Spatio-temporal study of diagnosis of rabies in vampire bats in Sergipe (Brazil), between 1987 and 2014

Rabies is a zoonosis of great importance for human and animal health, being responsible for a progressive and acute encephalitis in humans and animals. Considering that the correct viral identification has serious implications for the prophylaxis and treatment, is important a diagnostic system specifically designed for monitoring the infection cases. The objective of the study was to describe the occurrence of rabies in hematophagous bats (Desmodus rotundus) analyzing many diagnoses performed in the state of Sergipe. The objective of this study was to describe the occurrence of rabies in hematophagous bats (Desmodus rotundus) from an analysis of the diagnoses performed in the state of Sergipe. An observational, descriptive and retrospective study was conducted with the evaluation of 935 rabies diagnoses in bats (D. rotundus) between 1987 and 2014. It was noticed that only one case was positive in the city of Aracaju in the year 2000 and no positive bat was identified with the rabies virus in the rural area. The results show the need to increase the monitoring of rabies in other species of non-hematophagous bats, and especially in other wild reservoirs. It is suggested that the monitoring of rabies take into account the specific ecosystem of each region, since Brazil has continental dimensions and a great biological diversity

COMPREENSÃO DA RELAÇÃO ENTRE ADOECIMENTO MENTAL E DOENÇAS CRÔNICAS: revisão integrativa

Objective: To understand the influence of chronic illnesses on patients' mental health in the available scientific literature. Methodology: an integrative literature review, associated with the acronym PICo and structured with the descriptors: Chronic illness; Mental health and Primary Health Care. The time frame was 2018 to 2023, and the inclusion criteria were: primary articles, available in full, within the time series, in Portuguese, English or Spanish. The search took place in the Virtual Health Library, Scientific Electronic Library Online and Medical Literature Analysis and Retrieval System Online databases via PUBMED. Results: an initial sample of 1,254 studies was obtained, which were screened as follows: application of the inclusion and exclusion criteria, prior reading of titles and abstracts, reading in full and alignment with the study's objective, totaling 09 articles. Discussion: The main chronic pathologies identified were cardiovascular and metabolic, causing a scenario of constant consultations, compulsory adherence to drug therapy, routine invasive tests, culminating in emotional overload, continuous stress, as well as obstacles to support networks, catalyzing rates of loneliness, depression, anxiety and treatment abandonment. The studies point to primary care as a mediator of this reality, capable of offering continuous assistance from a multi-professional team, remedying, within its attributions, the geographical and social barriers that corroborate the worsening of these situations. Mental illness was prevalent among the studies when related to chronic diseases, with greater emphasis on the elderly and children. Final considerations: the research converges in the perspective that the diagnosis of chronic illnesses, especially in their terminal presentation, is capable of inducing feelings of insecurity, anxiety and fear, implying growing cases of depression and suicidal ideation.Objetivo: Conocer la influencia de las enfermedades crónicas en la salud mental de los pacientes en la literatura científica disponible. Metodología: revisión bibliográfica integradora, asociada al acrónimo PICo y estructurada con los descriptores: Enfermedad crónica; Salud mental y Atención Primaria de Salud. El marco temporal fue de 2018 a 2023, y los criterios de inclusión fueron: artículos primarios, disponibles en su totalidad, dentro de la serie temporal, en portugués, inglés o español. La búsqueda se realizó en las bases de datos Biblioteca Virtual de Salud, Scientific Electronic Library Online y Medical Literature Analysis and Retrieval System Online a través de PUBMED. Resultados: se obtuvo una muestra inicial de 1.254 estudios, que fueron cribados de la siguiente forma: aplicación de los criterios de inclusión y exclusión, lectura previa de los títulos y resúmenes, lectura completa y adecuación al objetivo del estudio, totalizando 9 artículos. Discusión: Las principales patologías crónicas identificadas fueron cardiovasculares y metabólicas, provocando un escenario de consultas constantes, adherencia obligatoria a la terapia farmacológica, pruebas invasivas rutinarias, culminando en sobrecarga emocional, estrés continuo, así como barreras a las redes de apoyo, catalizando índices de soledad, depresión, ansiedad y abandono del tratamiento. Los estudios señalan a la atención primaria como mediadora de esta realidad, capaz de ofrecer una atención continuada por parte de un equipo multiprofesional, subsanando, dentro de sus competencias, las barreras geográficas y sociales que corroboran el agravamiento de estas situaciones. La enfermedad mental fue prevalente entre los estudios cuando se relacionó con enfermedades crónicas, con mayor énfasis en ancianos y niños. Consideraciones finales: las investigaciones convergen en la perspectiva de que el diagnóstico de enfermedades crónicas, especialmente en su presentación terminal, es capaz de inducir sentimientos de inseguridad, ansiedad y miedo, implicando casos crecientes de depresión e ideación suicida.Objetivo: compreender na literatura científica disponível a influência das doenças crônicas na saúde mental dos pacientes. Metodologia: estudo do tipo revisão integrativa da literatura, associado ao acrônimo PICo e estruturado com os descritores: Doença crônica; Saúde mental e Atenção Primária à Saúde. Estabeleceu-se o recorte temporal de 2018 a 2023, cujo os critérios de inclusão foram: artigos primários, disponíveis na íntegra, dentro da série temporal, nas línguas portuguesa, inglesa ou espanhola. A busca ocorreu nas bases de dados Biblioteca Virtual em Saúde, Scientific Electronic Library Online e Medical Literature Analysis and Retrieval System Online via PUBMED. Resultados: obteve-se uma amostra inicial de 1.254 pesquisas, passando pela seguinte triagem: aplicação dos critérios de inclusão e exclusão, leitura prévia dos títulos e resumos, leitura na íntegra e alinhamento com o objetivo do estudo, perfazendo um total de 09 artigos. Discussão: como principais patologias crônicas identificou-se as do tipo cardiovasculares e metabólicas, ocasionando um cenário de constantes consultas, adesão compulsória à terapia medicamentosa, realização rotineira de exames invasivos, culminando na sobrecarga emocional, estresse contínuo, além dos entraves nas redes de apoio, catalisando os índices de solidão, depressão, ansiedade e abandono do tratamento. Os estudos apontam a atenção primária como mediador desta realidade, capaz de ofertar assistência continuada a partir de uma equipe multiprofissional, sanando, dentro de suas atribuições, as barreiras geográficas e sociais que corroboram para o agravamento destas situações. O adoecimento mental esteve prevalente entre os estudos, quando relacionado às doenças crônicas, com maior ênfase em pessoas idosas e crianças. Considerações finais: as pesquisas convergem na perspectiva de que o diagnóstico das doenças crônicas, sobretudo na apresentação terminal, capazes de induzir sentimentos de insegurança, ansiedade e medo, implicando em crescentes casos de depressão e ideação suicida

Valor nutricional do colmo de gramíneas tropicais

The objective of this work was to evaluate the nutritional value and in vitro organic matter digestibility of stem of genotypes of Cynodon in four regrowth ages (28, 48, 63 and 79 days) in the period of autumn-winter transition. The treatments were distributed following a randomized block design, with treatments arranged in a split plot, being the genotypes studied (Tifton 68, Tifton 85, Russell, Jiggs and Vaquero) the plots, and the four ages cutting the subplots (28, 48, 63 and 79 days). The crude protein values of the stem of the analyzed genotypes daily decreased 1.36% and were higher at 28 days of age (11.22%). Fiber content of acid detergent of all genotypes increased with age, and largest daily increases were observed in Tifton 68 (1.91%) and Vaquero (1.55%) genotypes compared to the others. The highest values of total digestible nutrients and in vitro digestibility of organic matter were verified at the age of 28 days (50.40% and 72.50%, respectively) and with the advancement of plant age reductions of 2.52% and 0.71% were observed. The cutting management and/or grazing of all genotypes at the age of 28 days of regrowth have better nutritional value and in vitro digestibility of organic matter compared to other ages.Objetivou-se por meio deste trabalho avaliar o valor nutritivo e digestibilidade in vitro da matéria orgânica do colmo de genótipos do gênero Cynodon em quatro idades de rebrota (28, 48, 63 e 79 dias) no período da transição outono-inverno. Os tratamentos foram distribuídos seguindo delineamento em blocos ao acaso, com tratamentos arranjados em um esquema de parcelas subdivididas, sendo os genótipos estudadas (Tifton 68, Tifton 85, Russel, Jiggs e Vaquero) as parcelas, e as quatro idades corte, as subparcelas (28, 48, 63 e 79 dias). Os valores de proteína bruta do colmo dos genótipos analisados diminuíram diariamente 1,36% e foram maiores aos 28 dias de rebrota (11,22%). Os teores de fibra em detergente ácido de todos os genótipos aumentaram com a idade, sendo que, maiores incrementos diários foram observados nos genótipos Tifton 68 (1,91%) e Vaquero (1,55%) em relação aos demais. Os maiores valores de nutrientes digestíveis totais e digestibilidade in vitro da matéria orgânica do colmo foram verificados na idade de 28 dias (50,40% e 72,50%, respectivamente) e com o avanço da idade da planta, reduções de 2,52% e 0,71% foram verificadas. O manejo de corte e/ou pastejo de todos os genótipos na idade de 28 dias de rebrota apresenta melhor valor nutritivo e digestibilidade in vitro da matéria orgânica em comparação às demais idades

Antileishmanial Activity of Medicinal Plants Used in Endemic Areas in Northeastern Brazil

This study investigates the leishmanicidal activity of five species of plants used in folk medicine in endemic areas of the state of Alagoas, Brazil. Data were collected in the cities of Colonia Leopoldina, Novo Lino, and União dos Palmares, Alagoas state, from patients with cutaneous leishmaniasis (Leishmania amazonensis) who use medicinal plants to treat this disease. Plants extracts were tested at a concentration of 1–100 μg/mL in all experiments, except in an assay to evaluate activity against amastigotes, when 10 μg/mL was used. All plants extracts did not show deleterious activity to the host cell evidenced by LDH assay at 100, 10, and 1 μg/mL after 48 h of incubation. The plants extracts Hyptis pectinata (L.) Poit, Aloe vera L., Ruta graveolens L., Pfaffia glomerata (Spreng.) Pedersen, and Chenopodium ambrosioides L. exhibited direct activity against extracellular forms at 100 μg/mL; these extracts inhibited growth by 81.9%, 82.9%, 74.4%, 88.7%, and 87.4%, respectively, when compared with promastigotes. The plants extracts H. pectinata, A. vera, and R. graveolens also significantly diminished the number of amastigotes at 10 μg/mL, inhibiting growth by 85.0%, 40.4%, 94.2%, and 97.4%, respectively, when compared with control. Based on these data, we conclude that the five plants exhibited considerable leishmanicidal activity

Home-based exercise program in the indeterminate form of Chagas disease (PEDI-CHAGAS study): A study protocol for a randomized clinical trial

BackgroundChagas disease (CD) is a neglected endemic disease with worldwide impact due to migration. Approximately 50–70% of individuals in the chronic phase of CD present the indeterminate form, characterized by parasitological and/or serological evidence of Trypanosoma cruzi infection, but without clinical signs and symptoms. Subclinical abnormalities have been reported in indeterminate form of CD, including pro-inflammatory states and alterations in cardiac function, biomarkers and autonomic modulation. Moreover, individuals with CD are usually impacted on their personal and professional life, making social insertion difficult and impacting their mental health and quality of life (QoL). Physical exercise has been acknowledged as an important strategy to prevent and control numerous chronic-degenerative diseases, but unexplored in individuals with the indeterminate form of CD. The PEDI-CHAGAS study (which stands for “Home-Based Exercise Program in the Indeterminate Form of Chagas Disease” in Portuguese) aims to evaluate the effects of a home-based exercise program on physical and mental health outcomes in individuals with indeterminate form of CD.Methods and designThe PEDI-CHAGAS is a two-arm (exercise and control) phase 3 superiority randomized clinical trial including patients with indeterminate form of CD. The exclusion criteria are <18 years old, evidence of non-Chagasic cardiomyopathy, musculoskeletal or cognitive limitations that preclude the realization of exercise protocol, clinical contraindication for regular exercise, and regular physical exercise (≥1 × per week). Participants will be assessed at baseline, and after three and 6 months of follow-up. The primary outcome will be QoL. Secondary outcomes will include blood pressure, physical fitness components, nutritional status, fatigability, autonomic modulation, cardiac morphology and function, low back pain, depression and anxiety, stress, sleep quality, medication use and adherence, and biochemical, inflammatory and cardiac biomarkers. Participants in the intervention group will undergo a home-based exercise program whilst those in the control group will receive only general information regarding the benefits of physical activity. Both groups will receive the same general nutritional counseling consisting of general orientations about healthy diets.ConclusionThe findings from the present study may support public health intervention strategies to improve physical and mental health parameters to be implemented more effectively in this population.Clinical trial registration[https://ensaiosclinicos.gov.br/rg/RBR-10yxgcr9/], identifier [U1111-1263-0153]

SÍNDROME DE TAKOTSUBO INDUZIDA POR INIBIDORES DE CHECKPOINT IMUNOLÓGICOS

Introduction: Takotsubo syndrome (ST) is an acute cardiac syndrome characterized by typical regional wall motion abnormalities that reflect impaired myocardial contractility leading to acute heart failure in the absence of epicardial coronary artery disease. The exact etiology is not known, however, an apparent relationship is noted between the use of immune checkpoint inhibitors (ICIs) and the diagnosis of ST. Objective: To clarify the relationship between ICIs and ST, considering it to be an extremely important topic for health professionals. Materials and methods: The literature search was performed by consulting the PubMed electronic database, starting with "takotsubo syndrome" and "immune checkpoint inhibitor therapy". We delimited articles published between 2003 and 2022, with studies that answered the guiding question previously defined. After applying the inclusion and exclusion criteria, a final sample of 6 studies was obtained for the integrative review. Results and discussion: Immune checkpoint inhibitors are increasingly used to treat certain malignancies due to their greater efficacy compared to conventional chemotherapy. ICIs become toxic due to the removal of self-tolerance, which in turn induces autoimmune processes. Conclusion: In summary, this study makes it clear that, based on the currently available literature, one can conclude an association between ICIs and ST, especially when the ICI used is 5-fluorouracil.Introducción: El síndrome de Takotsubo (ST) es un síndrome cardíaco agudo caracterizado por anomalías regionales típicas del movimiento de la pared que reflejan un deterioro de la contractilidad miocárdica que conduce a una insuficiencia cardíaca aguda en ausencia de enfermedad arterial coronaria epicárdica. Se desconoce la etiología exacta, sin embargo, se observa una aparente relación entre el uso de inhibidores del punto de control inmunitario (ICI) y el diagnóstico de ST. Objetivo: Aclarar la relación entre los ICIs y la TS, considerando que es un tema de gran importancia para los profesionales de la salud. Materiales y métodos: La búsqueda bibliográfica se realizó consultando la base de datos electrónica PubMed, a partir de "takotsubo syndrome" y "immune checkpoint inhibitor therapy". Se delimitaron los artículos publicados entre los años 2003 y 2022, con estudios que respondieran a la pregunta guía previamente definida. Tras aplicar los criterios de inclusión y exclusión, se obtuvo una muestra final de 6 estudios para la revisión integradora. Resultados y discusión: Los inhibidores del punto de control inmunitario se utilizan cada vez más para tratar ciertas neoplasias malignas debido a su mayor eficacia en comparación con la quimioterapia convencional. Las ICI se vuelven tóxicas debido a la eliminación de la autotolerancia, lo que a su vez induce procesos autoinmunes. Conclusión: En resumen, este estudio deja claro que, basándose en la literatura disponible actualmente, se puede concluir una asociación entre los ICI y la TS, especialmente cuando el ICI utilizado es el 5-fluorouracilo.Introdução: A síndrome de Takotsubo (ST) é uma síndrome cardíaca aguda caracterizada por anormalidades típicas da movimentação da parede regional que refletem o comprometimento da contratilidade cardíaca que leva à insuficiência cardíaca aguda na ausência de doença  arterial coronariana epicárdica. A etiologia exata não é conhecida, porém, nota-se uma aparente relação entre o uso de inibidores de checkpoint imunológicos (ICIs) e o diagnóstico de ST. Objetivo: Esclarecer a relação entre ICIs e a ST, considerando ser um tema extremamente importante para os profissionais de saúde. Materiais e métodos: A busca na literatura se deu através da consulta na base de dados eletrônicos PubMed, a partir de “takotsubo syndrome” e “immune checkpoint inhibitor therapy”. Delimitaram-se artigos publicados entre os anos de 2003 e 2022, com estudos que respondam à questão norteadora previamente definida. Após aplicação dos critérios de inclusão e exclusão, obteve-se uma amostra final de 6 estudos para a revisão integrativa. Resultado e discussão: Os inibidores de checkpoint imunológico são cada vez mais utilizados ​​para tratar certas doenças malignas devido à sua maior eficácia em comparação com a quimioterapia convencional. Os ICIs tornam-se tóxicos devido à remoção da autotolerância, que por sua vez induz processos autoimunes. Conclusão: Em resumo, esse estudo deixa claro que, com base na literatura disponível atualmente, pode-se concluir uma associação entre ICIs e ST, principalmente quando o ICI utilizado é o 5-fluorouracil.Introdução: A síndrome de Takotsubo (ST) é uma síndrome cardíaca aguda caracterizada por anormalidades típicas da movimentação da parede regional que refletem o comprometimento da contratilidade miocárdia que leva à insuficiência cardíaca aguda na ausência de doença arterial coronariana epicárdica. A etiologia exata não é conhecida, porém, nota-se uma aparente relação entre o uso de inibidores de checkpoint imunológicos (ICIs) e o diagnóstico de ST. Objetivo: Esclarecer a relação entre ICIs e a ST, considerando ser um tema extremamente importante para os profissionais de saúde. Materiais e métodos: A busca na literatura se deu através da consulta na base de dados eletrônicos PubMed, a partir de “takotsubo syndrome” e “immune checkpoint inhibitor therapy”. Delimitaram-se artigos publicados entre os anos de 2003 e 2022, com estudos que respondam à questão norteadora previamente definida. Após aplicação dos critérios de inclusão e exclusão, obteve-se uma amostra final de 6 estudos para a revisão integrativa. Resultado e discussão: Os inibidores de checkpoint imunológico são cada vez mais utilizados ​​para tratar certas doenças malignas devido à sua maior eficácia em comparação com a quimioterapia convencional. Os ICIs tornam-se tóxicos devido à remoção da autotolerância, que por sua vez induz processos autoimunes. Conclusão: Em resumo, esse estudo deixa claro que, com base na literatura disponível atualmente, pode-se concluir uma associação entre ICIs e ST, principalmente quando o ICI utilizado é o 5-fluorouracil

Definições para a padronização da pesquisa de auto-anticorpos contra constituintes do núcleo (FAN HEp-2), nucléolo, citoplasma e aparelho mitótico e suas associações clínicas

OBJECTIVE: The Second Brazilian Consensus on Antinuclear Antibodies (ANA) in HEp-2 Cells approved and extended the decision trees developed during the First Brazilian Consensus in order to also offer information about mixed patterns of fluorescence. METHODS: Since this test elicits reactions not only to nuclear autoimmune antigens but also to different cell compartments, new denominations for the test were approved. Results and CONCLUSIONS: These new denominations encompass variations on the autoantibody testing against the nucleus (ANA HEp-2), nucleolus, cytoplasm, and mitotic apparatus issue. Furthermore, major clinical associations were described for each immunofluorescent pattern, facilitating the interpretation of laboratory results in the clinical practice.OBJETIVO: O Segundo Consenso Brasileiro de Fator Antinuclear (FAN) em Células HEp-2 ratificou os algoritmos de decisão para leitura dos padrões do FAN na imunofluorescência indireta vistos na primeira edição do Consenso Brasileiro, adicionando ainda um novo algoritmo relacionado com os padrões mistos. MÉTODOS: Tendo em vista a habilidade do teste em detectar autoantígenos nos distintos compartimentos celulares, e não apenas no núcleo, propõe-se novas denominações para este exame laboratorial. RESULTADOS E CONCLUSÕES: Como novas denominações algumas sugestões foram igualmente aceitas, dentro do tema pesquisa de auto-anticorpos contra constituintes do núcleo (FAN HEp-2), nucléolo, citoplasma e aparelho mitótico. Foram abordadas as principais relevâncias clínicas com os padrões de FAN descritos, facilitando o melhor uso do ensaio pelo médico.FMUSPUNIFESPBio-Rad Laboratório BrasilHospital Geral de GoiâniaBiomédicaUniversidade Federal de UberlândiaUFMG HCPUCRS HCNew Life Produtos HospitalaresUniversidade Católica de GoiásFMUSP HC Laboratório CentralPatologista ClínicaFMUSP HCFrischmann Aisengart Unidad InmunologíaUniversidade Católica de Goiás Laboratório de Auto-ImunidadeExame Medicina LaboratorialFMUFG HC Laboratório de Imuno-Reumatologia e HLALab. Santa LuziaMedivax/BionHSPE/SPUniversidade Católica de Goiás Laboratório da Área de SaúdeFarmacêutica-BioquímicaUniv. Fed. Mato GrossoFMUFG Serviço de ReumatologiaHospital Durand Unidad InmunologíaLaboratório ClínicoUFRGS HCPA Serviço de ReumatologiaUERJ FCMUFMG FMHospital Universitário de Brasília Laboratório de ReumatologiaUNIFESPSciEL

Antinociceptive and Anti-Inflammatory Activity from Algae of the Genus Caulerpa

Marine natural products have been the focus of discovery for new products of chemical and pharmacological interest. The aim of this study was to evaluate the antinociceptive activity of the methanolic (ME), acetate (AE), hexanic (HE) and chloroform (CE) extracts obtained from Caulerpa mexicana, and ME, CE and HE obtained from Caulerpa sertularioides. These marine algae are found all over the world, mainly in tropical regions. Models such as the writhing test, the hot plate test and formalin-induced nociception test were used to evaluate antinociceptive activity in laboratory mice. In the writhing test, all the extracts were administered orally at a concentration of 100 mg/kg, and induced high peripheral antinociceptive activity, with a reduction in the nociception induced by acetic acid above 65%. In the hot plate test, treatment with extracts from C. sertularioides (100 mg/kg, p.o.) did not significantly increase the latency of response, although the ME, AE and HE from C. mexicana showed activity in this model. This result suggests that these extracts exhibit antinociceptive activity. In the formalin test, it was observed that ME, AE and HE obtained from C. mexicana reduced the effects of formalin in both phases. On the other hand only CE from C. sertularioides induced significant inhibition of the nociceptive response in the first phase. To better assess the potential anti-inflammatory activity of the extracts, the carrageenan-induced peritonitis test was used to test Caulerpa spp. extracts on cell migration into the peritoneal cavity. In this assay, all extracts evaluated were able to significantly inhibit leukocyte migration into the peritoneal cavity in comparison with carrageenan. These data demonstrate that extracts from Caulerpa species elicit pronounced antinociceptive and anti-inflamatory activity against several nociception models. However, pharmacological and chemical studies are continuing in order to characterize the mechanism(s) responsible for the antinociceptive action and also to identify the active principles present in the Caulerpa species