The relevance of sebum composition in the etiopathogeny of acne

Acne vulgaris is an inflammatory disease that develops around the hair follicle. Many are the interconnected etiopathogenic factors involved, among which we can mention the increase in levels of androgen hormones, sebum hypersecretion, follicular hyperkeratosis with microcomedo formation, the proliferation of the bacteria Propionibacterium acnes (P. acnes) and the resulting inflammatory response. The way this bacterial growth occurs and how it is connected with the development of the inflammatory process have been themes of many clinical and experimental trials. Modifications in the sebum composition lead to a greater proliferation and differentiation of keratinocytes that obstruct the follicular ostium and favor the formation of comedones. On the other hand, these modifications alter the follicular hydration and facilitate the proliferation of the P. acnes, which not only produces chemotactic factors but also releases lipase that oxidizes the squalene. The oxidized squalene induces the formation of pro-inflammatory cytokines and boosts the innate immunity of keratinocytes and sebocytes, thus generating the inflammatory process. The aim of this study was to review the literature regarding the new concepts on the pathogenesis of acne. DOI: http://dx.doi.org/10.5281/zenodo.118413

The Effectiveness of Information in Diabetes Mellitus Treatment Adherence

Background: Diabetes Mellitus (DM) is characterized by deficiencies in insulin action and secretion, and difficulties in regulating hepatic glucose production, which may lead to significant complications. Our aim was verify if DM carriers that are recipients of communication actions have a better adherence to treatment, and, consequently, a better control of the disease. Methods: It is a quantitative study of descriptive nature. The research was conducted in a diabetes association, and the sample consisted of 112 individuals who participated in the National Diabetes Campaign, promoted by this institution. A questionnaire consisting of 56 questions was used and was divided in three parts: Demographics; level of knowledge of the disease; and communication participation. Data was processed and analyzed using the statistical software EpiInfo, version 7.2. Results: 82.1% of the sample are in the 60 to 85 age group, 56.2% are females; 31.3% had 1 to 4 years of schooling and 30.3% are employed. It was found that 21.4% frequent AD (Diabetes Association) and the main mentioned complications of DM were: amputation; blindness and kidney problems. It was evidenced that attending an AD is correlated with better glycated hemoglobin results (HbA1c ? 7%). Conclusion: It is highlighted that DM carriers who are recipients of communication actions have a better adherence to treatment, and, consequently, a better control of the disease.

The relevance of sebum composition in the etiopathogeny of acne

Acne vulgaris is an inflammatory disease that develops around the hair follicle. Many are the interconnected etiopathogenic factors involved, among which we can mention the increase in levels of androgen hormones, sebum hypersecretion, follicular hyperkeratosis with microcomedo formation, the proliferation of the bacteria Propionibacterium acnes (P. acnes) and the resulting inflammatory response. The way this bacterial growth occurs and how it is connected with the development of the inflammatory process have been themes of many clinical and experimental trials. Modifications in the sebum composition lead to a greater proliferation and differentiation of keratinocytes that obstruct the follicular ostium and favor the formation of comedones. On the other hand, these modifications alter the follicular hydration and facilitate the proliferation of the P. acnes, which not only produces chemotactic factors but also releases lipase that oxidizes the squalene. The oxidized squalene induces the formation of pro-inflammatory cytokines and boosts the innate immunity of keratinocytes and sebocytes, thus generating the inflammatory process. The aim of this study was to review the literature regarding the new concepts on the pathogenesis of acne. DOI: http://dx.doi.org/10.5281/zenodo.118413

Superficial technique for tear trough filling with cohesive polydensified matrix hyaluronic acid

Introduction: Deep tear troughs create unaesthetic hollows that often worsen the color alteration and aspect of dark undereye circles, thus giving an aged and tired appearance to the eyes, even in younger individuals. The use of dermal fillers for the restoration of volume loss in the area, with a wide variety of products and techniques, has been the most suitable treatment. Aim: Description and evaluation of the superficial intradermal injection technique for tear trough filling using cohesive polydensified matrix hyaluronic acid. Materials and Methods: 120 patients from Faculdade de Medicina do ABC’s Cosmetic Dermatology Sector and a private practice treated between the years 2011 and 2016. Results: All the patients rated the treatment result as good or very good. No important or long-lasting adverse effects were reported; the Tyndall effect was not observed either. Conclusion: The superficial technique is an easy and safe method to treat the tear trough deformity, with high rates of good aesthetic results. DOI: http://dx.doi.org/10.5281/zenodo.427243

Treatment of facial aging with calcium hydroxyapatite - filling and lifting concept

The face is organized in five different layers (skin, muscles, supportive ligaments, fat pads and bones), which are continuous and interconnected with each other from the scalp to the neck. As a result of aging, changes occur in all its tissues and structures, triggering a cascade of effects in the adjacent areas. Actually, the more it is known about the loss of volume, the better it is to establish the target spots for volume replacement, with consequent more natural- and harmonious-looking outcomes. However, the skin is the outer envelope of the face, which, in the natural process of aging, has a lower capacity to completely accommodate any underlying volume loss or displacement. The result is the formation of creases and folds due to skin sagging. To describe the effects of the injection of calcium hydroxyapatite (CaHA) targeting two objectives at the same time: the restoration of volume loss to compensate the changes in the tridimensional structure and the improvement in skin texture caused by the stimulus to collagen synthesis, thus reducing the sagging of soft tissues envelope. Owing to the mechanism of action of CaHA, its application can be done in two differentiated and little invasive ways so that these objectives can be reached simultaneously. This technique can provide safe, natural and long-lasting rejuvenating effects. DOI: http://dx.doi.org/10.5281/zenodo.356983

Prevalence and Progression of Ametropias in Medical Students

Background: Uncorrected refractive errors (Myopia, Hyperopia and Astigmatism) are one of the main causes of poor vision, attributing to 43% of vision deficiencies. Myopia is the most common visual disorder in the world and can progress up until the age of 20-25, when many people are in university. The etiological factors that cause myopia are still unclear and deserve to be studied. Our aim was to identify the prevalence of ametropias and self-perception of ophthalmic health in medical students at the Centro Universitário Saúde ABC/FMABC. Methods: This is a cross-sectional study with data collected at Centro Universitário Saúde ABC/FMABC from medical students. A total of 232 students participated in the survey, from the 1st to the 4th year of study. Data was obtained through a questionnaire, which evaluates ophthalmologic health, ametropia, and self-perception. Results: It was observed that 74.57% of the students had some type of ametropia, myopia being the most recurrent (59.05%). The study shows significant data of an increase in the grade of students from 1st to 4th grade throughout college. It was observed that the average daily study time of the students was 9.68 hours and abuse in the use of electronic devices. Conclusion: This study presented a high prevalence of ametropias among medical students at the Centro Universitário ABC/FMABC, in addition to a high prevalence of multifactorial myopia and an increased need to update their diopters (degrees) during the course of university

Is chemical exposure present in informal work associated with Sars-CoV-2 infection?

OBJECTIVE: To compare the incidence of Covid-19 symptoms between informal home-based workers and a control group and to assess the association of these cases with blood elements concentrations and other relevant risk factors for Sars-Cov-2 infection. METHODS: Welders chemically exposed to potentially toxic elements (PTEs) (n = 26) and control participants (n = 25) answered questionnaires on adherence to social distancing and signs and symptoms of the disease for five months during the Covid-19 pandemic. After follow-up, Covid-19 serology tests were performed on a subsample of 12 chemically exposed workers and 20 control participants. Before the pandemic, PTE concentrations in blood (As, Mn, Ni, Cd, Hg, Sb, Sn, Cu, Zn, and Pb) were measured by ICP-MS. RESULTS: The chemically exposed group had higher lead and cadmium levels in blood (p < 0.01). The control group presented lower adherence to social distancing (p = 0.016). Although not significant, welders had a 74% greater chance of having at least one Covid-19 symptom compared with control participants, but their adherence to social distancing decreased this chance by 20%. The use of taxis for transportation was a risk factor significantly associated with Covid-19 symptoms. CONCLUSION: The lower adherence to social distancing among the control group greatly influences the development of Covid-19. The literature lacks data linking exposure to PTEs and Sars-Cov-2 infection and/or severity. In this study, despite chemical exposure, working from home may have protected welders against Covid-19, considering that they maintained greater social distancing than control participants

Mortalidade neonatal em Luanda, Angola: o que pode ser feito para sua redução?

Introduction: One of the main health indicators is infant mortality rate, which is a metric of living conditions and population development. The goal of reducing neonatal mortality requires an adequate knowledge of the real factors at each level of health care so that maternal and human resources are efficiently channeled to the constraint. Countries that have paid special attention to improving health services for the entire pregnancy-puerperal cycle have attained the reduction of infant mortality, especially early neonatal mortality. Objective: The present study aims to describe the profile and analyze the risk factors associated with neonatal mortality in the Angolan context at a tertiary level public maternity hospital, located in Luanda. Methods: This is a retrospective cross-sectional study with a quantitative approach, using secondary data, of provincial base in hospital and ministerial registry instruments from January to December 2012. Results: The results show that the neonatal deaths are not mere occurrences, since they indicate failures of the political powers, professionals of the health system and of the families. Conclusions: This study suggests that the major risk factor for birth mortality in Luanda is the type of delivery (c-section) and that this data is not related to the age of the mother or to premature birth. We also found that there was higher mortality between May and July, during the period of lower rainfall index in the region. However, further studies are needed that may provide a logical framework and arguments for realistic policies to mitigate neonatal mortality.Introdução: Um dos principais indicadores de saúde é a taxa de mortalidade infantil, que é uma métrica de condições de vida e desenvolvimento populacional. A redução da mortalidade neonatal requer um conhecimento adequado dos fatores reais em cada nível de atenção à saúde, de modo que os recursos maternos e humanos sejam eficientemente avaliados. Os países que deram atenção especial à melhoria dos serviços de saúde para todo o ciclo gravídico-puerperal atingiram a redução da mortalidade infantil, especialmente a mortalidade neonatal precoce. Objetivo: O presente estudo tem como objetivo descrever o perfil e analisar os fatores de risco associados à mortalidade neonatal em uma maternidade pública de nível terciário localizada em Luanda, Angola. Método: Trata-se de um estudo retrospectivo de corte transversal com abordagem quantitativa, utilizando dados secundários de base provincial em instrumentos de registro hospitalar e ministerial de janeiro a dezembro de 2012. Resultados: Os resultados mostram que os óbitos neonatais não são meras ocorrências, pois indicam falhas dos poderes políticos, de profissionais do sistema de saúde e das famílias. Conslusão: Este estudo sugere que o maior fator de risco para mortalidade ao nascimento em Luanda é o tipo de parto (c-section) e que este dado não está relacionado com a idade da mãe ou com o nascimento prematuro. Identificamos também que houve maior mortalidade entre os meses de maio a julho, durante o período de menor índice de chuvas na região. No entanto, são necessários mais estudos que possam fornecer um quadro lógico e argumentos para políticas realistas para mitigar a mortalidade neonatal

A influência do isolamento social na incidência de positividade nos testes de covid-19 em região metropolitana de São Paulo, Brasil

Introduction: With the arrival of the SARS-CoV-2 (Coronavirus 2 of severe acute respiratory syndrome) pandemic in Brazil, especially in the city of São Paulo, there was a need to apply social isolation policies associated with testing, covering all municipalities. The Clinical Analysis Laboratory of Centro Universitário FMABC was one of the first laboratories to receive certification and qualification to perform RT-PCR (reverse transcriptase reaction followed by polymerase chain reaction) tests in the metropolitan region of São Paulo. Objective: Aim to analyze the influence of adopting social isolation on the incidence of positivity in COVID-19 tests in the metropolitan region of São Paulo, Brazil. Methods: a descriptive study carried out from March to May 2020, epidemiological data were collected from each unit served and organized by the data controllership team of the Clinical Analysis Laboratory of FMABC. Epidemiological, demographic, and laboratory data were extracted from the Matrix® outpatient data management system. Clinically suspected cases and confirmed by laboratory tests (RT-PCR and serological tests) were entered. The tests were divided into serological tests using the RT-PCR molecular test, on samples of nasopharyngeal mucosal scrapings collected with sterile Swab. Results: It were evaluated PCR test and antibody presence (IgA, IgM and IgG) in blood samples of 16.297 patients. 22.718 tests were performed for the diagnosis of COVID-19, both RT-PCR (10.410 tests) and serological tests to detect anti-SARS-CoV-2 antibodies, IgA, IgM and IgG, a total of 16.297 patients were assessed, 63% women and 37% men. It was observed that the social isolation policies adopted during this period contained the massive expansion of contamination, at least while the social isolation rates were above 55%. Conclusion: The data of this study demonstrated the effectiveness of social isolation in containing the positive contamination of SARS-CoV-2 in the metropolitan region of São Paulo, at least for the first three months.Introdução: com a chegada da pandemia de SARS-CoV-2 (Coronavirus 2 da síndrome respiratória aguda grave) ao Brasil, especialmente na cidade de São Paulo, houve a necessidade de aplicar medidas de distanciamento social associado a testagem, que abrangesse todos os municípios. A região metropolitana de São Paulo compreende 39 municípios e possui uma rede de laboratórios habilitados a realizar a testagem para a detecção do coronavírus, tanto testes sorológicos quanto moleculares. O Laboratório de Análises Clínicas do Centro Universitário ABC/FMABC foi um dos primeiros laboratórios a receber a certificação e habilitação para realizar os testes RT-PCR (reação da transcriptase reversa seguida pela reação em cadeia da polimerase) na região metropolitana de São Paulo. Objetivo: analisar a influência da adoção do isolamento social na incidência de positividade nos testes de COVID-19 em região metropolitana de São Paulo, Brasil. Método: estudo descritivo realizado no período de março a maio de 2020, os dados epidemiológicos foram coletados de cada unidade atendida e organizada pela equipe de controladoria de dados do Laboratório de Análises Clínicas da FMABC. Os dados epidemiológicos, demográficos e laboratoriais foram extraídos do sistema Matrix® de gerenciamento de dados ambulatoriais. Foram inseridos os casos clinicamente suspeitos e confirmados por testes de laboratório (RT-PCR e testes sorológicos). Os testes foram divididos em testes sorológicos no teste molecular RT-PCR, em amostras de raspado de mucosa nasofaríngea coletada com Swab estéril. Resultados: foram avaliados o teste de RT-PCR e a presença de anticorpos (IgA, IgM e IgG) em amostras de sangue de 16.297 pacientes. Foram realizados 22.718 testes para o diagnóstico de COVID-19, tanto RT-PCR (10.410 testes), quanto testes sorológicos para detecção de anticorpos anti-SARS-CoV-2, IgA, IgM e IgG, um total de 16.297 pacientes foram avaliados, 63% mulheres e 37% homens. Observou-se que as políticas de isolamento social adotadas nesse período continham a expansão massiva da contaminação, pelo menos enquanto as taxas de isolamento social eram superiores a 55%. Conclusão: nossos dados demonstraram a efetividade do isolamento social na retenção da positividade da contaminação do SARS-CoV-2 nas cidades contempladas pelo serviço de testagem do Centro Universitário Saúde ABC, pelo menos nos três primeiros meses

Digitoxin improves cardiovascular autonomic control in rats with heart failure

The effects of chronic treatment with digitoxin on arterial baroreceptor sensitivity for heart rate (HR) and renal sympathetic nerve activity (rSNA) control, cardiopulmonary reflex, and autonomic HR control in an animal model of heart failure were evaluated. Wistar rats were treated with digitoxin, which was administered in their daily feed (1mg/Kg/day), for 60 days. The following three experimental groups were evaluated: Sham, heart failure (HF), and HF treated with digitoxin (HF+DIG). We observed an increase in rSNA in the HF group (190±29pps,n=5) compared with the Sham group (98±14pps,n=5). Digitoxin treatment prevented an increase in rSNA (98±14pps,n=7). Therefore, arterial baroreceptor sensitivity was decreased in the HF group (-1.24±0.07bpm/mmHg,n=8) compared with the Sham group (-2.27±0.23bpm/mmHg,n=6). Digitoxin did not alter arterial baroreceptor sensitivity in the HF+DIG group. Finally, the HF group showed an increased low frequency band (LFb: 23±5ms2,n=8) and a decreased high frequency band (HFb: 77±5ms2,n=8) compared with the Sham group (LFb: 14±3ms2; HFb: 86±3ms2,n=9); the HF+DIG group exhibited normalized parameters (LFb: 15±3ms2;HFb: 85±3ms2,n=9). In conclusion, the benefits of decreasing rSNA are not directly related to improvements in peripheral cardiovascular reflexes; such occurrences are due in part to changes in the central nuclei of the brain responsible for autonomic cardiovascular control.The accepted manuscript in pdf format is listed with the files at the bottom of this page. The presentation of the authors' names and (or) special characters in the title of the manuscript may differ slightly between what is listed on this page and what is listed in the pdf file of the accepted manuscript; that in the pdf file of the accepted manuscript is what was submitted by the author