Applying to vascular specialty training in the UK: 12 tips for success

From preparation to accomplishment, maximise your chances of a career in vascular surgery

Distinctive features of the microbiota associated with different forms of apical periodontitis

Microorganisms infecting the dental root canal system play an unequivocal role as causative agents of apical periodontitis. Although fungi, archaea, and viruses have been found in association with some forms of apical periodontitis, bacteria are the main microbial etiologic agents of this disease. Bacteria colonizing the root canal are usually organized in communities similar to biofilm structures. Culture and molecular biology technologies have demonstrated that the endodontic bacterial communities vary in species richness and abundance depending on the different types of infection and different forms of apical periodontitis. This review paper highlights the distinctive features of the endodontic microbiota associated with diverse clinical conditions

Comparing the Bacterial Diversity of Acute and Chronic Dental Root Canal Infections

This study performed barcoded multiplex pyrosequencing with a 454 FLX instrument to compare the microbiota of dental root canal infections associated with acute (symptomatic) or chronic (asymptomatic) apical periodontitis. Analysis of samples from 9 acute abscesses and 8 chronic infections yielded partial 16S rRNA gene sequences that were taxonomically classified into 916 bacterial species-level operational taxonomic units (OTUs) (at 3% divergence) belonging to 67 genera and 13 phyla. The most abundant phyla in acute infections were Firmicutes (52%), Fusobacteria (17%) and Bacteroidetes (13%), while in chronic infections the dominant were Firmicutes (59%), Bacteroidetes (14%) and Actinobacteria (10%). Members of Fusobacteria were much more prevalent in acute (89%) than in chronic cases (50%). The most abundant/prevalent genera in acute infections were Fusobacterium and Parvimonas. Twenty genera were exclusively detected in acute infections and 18 in chronic infections. Only 18% (n = 165) of the OTUs at 3% divergence were shared by acute and chronic infections. Diversity and richness estimators revealed that acute infections were significantly more diverse than chronic infections. Although a high interindividual variation in bacterial communities was observed, many samples tended to group together according to the type of infection (acute or chronic). This study is one of the most comprehensive in-deep comparisons of the microbiota associated with acute and chronic dental root canal infections and highlights the role of diverse polymicrobial communities as the unit of pathogenicity in acute infections. The overall diversity of endodontic infections as revealed by the pyrosequencing technique was much higher than previously reported for endodontic infections

Antifungal activity of schinol and a new biphenyl compound isolated from Schinus terebinthifolius against the pathogenic fungus Paracoccidioides brasiliensis

<p>Abstract</p> <p>Background</p> <p>The aim of this study was to isolate and identify the antifungal compounds from the extracts of <it>Schinus terebinthifolius </it>(Anacardiaceae) against clinical isolates of the pathogenic fungus <it>Paracoccidioides brasiliensis</it>.</p> <p>Methods</p> <p>The hexane and dichlomethane fractions from leaves and stems of <it>S. terebinthifolius </it>were fractionated using several chromatography techniques to afford four compounds.</p> <p>Results</p> <p>The compounds isolated from <it>S. terebinthifolius </it>were identified as schinol (<b>1</b>), a new biphenyl compound, namely, 4'-ethyl-4-methyl-2,2',6,6'-tetrahydroxy[1,1'-biphenyl]-4,4'-dicarboxylate (<b>2</b>), quercetin (<b>3</b>), and kaempferol (<b>4</b>). Compounds <b>1 </b>and <b>2 </b>were active against different strains of <it>P. brasiliensis</it>, showing a minimal inhibitory concentration value against the isolate Pb B339 of 15.6 μg/ml. The isolate Pb 1578 was more sensitive to compound <b>1 </b>with a MIC value of 7.5 μg/ml. Schinol presented synergistic effect only when combined with itraconazole. The compounds isolated from S. <it>terebinthifolius </it>were not able to inhibit cell wall synthesis or assembly using the sorbitol assay.</p> <p>Conclusion</p> <p>This work reveals for the first time the occurrence of compound <b>2 </b>and discloses activity of compounds <b>1 </b>and <b>2 </b>against several clinical isolates of <it>P. brasiliensi</it>s. These results justify further studies to clarify the mechanisms of action of these compounds.</p

Characterisation and expression of SPLUNC2, the human orthologue of rodent parotid secretory protein

We recently described the Palate Lung Nasal Clone (PLUNC) family of proteins as an extended group of proteins expressed in the upper airways, nose and mouth. Little is known about these proteins, but they are secreted into the airway and nasal lining fluids and saliva where, due to their structural similarity with lipopolysaccharide-binding protein and bactericidal/permeability-increasing protein, they may play a role in the innate immune defence. We now describe the generation and characterisation of novel affinity-purified antibodies to SPLUNC2, and use them to determine the expression of this, the major salivary gland PLUNC. Western blotting showed that the antibodies identified a number of distinct protein bands in saliva, whilst immunohistochemical analysis demonstrated protein expression in serous cells of the major salivary glands and in the ductal lumens as well as in cells of minor mucosal glands. Antibodies directed against distinct epitopes of the protein yielded different staining patterns in both minor and major salivary glands. Using RT-PCR of tissues from the oral cavity, coupled with EST analysis, we showed that the gene undergoes alternative splicing using two 5' non-coding exons, suggesting that the gene is regulated by alternative promoters. Comprehensive RACE analysis using salivary gland RNA as template failed to identify any additional exons. Analysis of saliva showed that SPLUNC2 is subject to N-glycosylation. Thus, our study shows that multiple SPLUNC2 isoforms are found in the oral cavity and suggest that these proteins may be differentially regulated in distinct tissues where they may function in the innate immune response

Volatile constituents and behavioral change induced by Cymbopogon winterianus leaf essential oil in rodents

Cymbopogon winterianus Jowitt (‘Java citronella’) is an important essential oil yielding aromatic grass cultivated in India and Brazil and its volatile essential oils extracted from its leaves are used in perfumery, cosmetics, pharmaceuticals and flavoring industries. However, there is no report on any psychopharmacological study of C. winterianus leaf essential oil (LEO) available to date. In this study, the pharmacological effects of the LEO were investigated in animal models and its phytochemical analyses. GC-MS analysis showed a mixture of monoterpenes, as citronellal (36.19%), geraniol (32.82%) and citronellol (11.37%). LEO exhibited an inhibitory effect on the locomotor activity of mice, an antinociceptive effect by increasing the reaction time in the writhing and capsaicin tests. All doses induced a significant increase in the sleeping time of animals not having modified however, the latency. The LEO did not alter the remaining time of the animals on the rota-rod apparatus. These results suggest a possible central effect.Key words: Cymbopogon winterianus, essential oil, CNS, behavioral effects, analgesic

Promoção, prevenção e cuidado da hipertensão arterial no Brasil

OBJETIVO: Estimar a prevalência de ações de promoção, prevenção e cuidado da hipertensão arterial em adultos e identificar sua associação com estado descompensado de hipertensão. MÉTODOS: Estudo epidemiológico transversal de base populacional realizado por meio de entrevista com 12.324 adultos, de 20 a 59 anos, em 100 municípios brasileiros. As variáveis independentes, consideradas como promoção, prevenção e cuidado, foram: ter recebido orientações sobre a manutenção do peso ideal e sobre atividade física; ter consultado um médico e ter realizado eletrocardiograma no último ano. Pressão arterial acima de 140/90 mmHg foi considerada estado descompensado, sendo a variável dependente para a avaliação da qualidade do cuidado. RESULTADOS: Do total, 16,3% (n = 2.004) referiram diagnóstico médico de hipertensão. As maiores prevalências de hipertensão foram observadas na categoria de idade de 50 a 59 anos, concentradas nas regiões Sudeste e Centro-Oeste. Mais da metade (66,1%) esteve em consulta médica por hipertensão no último ano, da qual metade (52,4%) realizou eletrocardiograma. Dos hipertensos que tiveram sua pressão arterial aferida na entrevista (74,6%), menos da metade (42,4%) apresentava cifras tensionais descompensadas. CONCLUSÕES: Não houve associação entre haver consultado médico no último ano e cifras tensionais descompensadas. A proporção de hipertensos descompensados foi significativamente menor entre os que foram orientados para manter o peso ideal, realizar atividade física e os que fizeram eletrocardiograma. Ser do sexo masculino, ter idade acima de 40 anos e habitar na região Sul mostraram-se associados a estado descompensado da hipertensão.OBJECTIVE: To estimate the prevalence of promotion, prevention and arterial hypertension care actions in adults and to identify their association with decompensated hypertension. METHODS: A population-based cross-sectional epidemiological study was conducted by interviewing 12,324 adults aged from 20 to 59 years, in 100 Brazilian cities. The independent variables considered as promotion, prevention and hypertension care were as follows: to have received guidance on ideal weight maintenance and physical activity practice; to have consulted a doctor; and to have had an electrocardiogram performed in the previous year. A blood pressure higher than 140/90 mm/Hg was considered to be decompensated, being the dependent variable adopted to assess quality of care. RESULTS: Of all participants, 16.3% (n = 2,004) reported a medical diagnosis of hypertension. The highest prevalences of hypertension were observed in the 50 to 59 year age group, primarily in the Southeast and Center-West regions. More than half (66.1%) of participants had a medical consultation about hypertension in the previous year, of which half (52.4%) had an electrocardiogram. Of all those with hypertension who had their blood pressure measured during interview (74.6%), less than half (42.4%) had decompensated values. CONCLUSIONS: There was no association between having consulted a doctor in the previous year and decompensated blood pressure values. The proportion of decompensated hypertensive participants was significantly lower among those who had received guidance on ideal weight maintenance and physical activity practice and those who had had an electrocardiogram performed. The following factors were associated with decompensated hypertension: to be male, to be aged more than 40 years and to live in the South region.OBJETIVO: Estimar la prevalencia de acciones de promoción, prevención y cuidado de la hipertensión arterial en adultos e identificar la asociación con el estado descompensado de hipertensión. MÉTODOS: Estudio epidemiológico transversal de base poblacional realizado a través de entrevista en 12.324 adultos, de 20 a 59 años, en 100 municipios brasileños. Las variables independientes, consideradas como promoción, prevención y cuidado fueron: haber recibido orientaciones sobre la manutención del peso ideal y actividad física; haber consultado un médico y haber realizado el electrocardiograma en el último año. Presión arterial por encima de 140/90 mm/Hg se consideró estado descompensado, siendo la variable dependiente para la evaluación de la calidad del cuidado. RESULTADOS: del total, 16,3% (n= 2.004) refirieron diagnóstico médico de hipertensión. Las mayores prevalencias de hipertensión se observaron en la categoría de edad de 50 a 59 años, concentradas en las regiones Sureste y Centro-Oeste. Más de la mitad (66,1%) estuvo en consulta médica por hipertensión en el último año, y la mitad de estos (52,4%) realizó electrocardiograma. De los hipertensos que chequearon la presión arterial en la entrevista, 74,6%, menos de la mitad (42,4%) presentó cifras tensionales descompensadas. CONCLUSIONES: No hubo asociación entre haber consultado el médico en el último año y cifras tensionales descompensadas. La proporción de hipertensos descompensados fue significativamente menor entre los que fueron orientados para mantener el peso ideal, realizar actividad física y los que hicieron electrocardiograma. Ser del sexo masculino, tener edad por encima de 40 años y habitar en la región Sur, se evidenciaron asociados al estado descompensado de la hipertensión

Queixas musculoesqueléticas em uma Unidade Básica de Saúde: implicações para o planejamento das ações em saúde e fisioterapia

OBJETIVO: O objetivo deste estudo foi analisar a prevalência de queixas musculoesqueléticas em adultos em uma Unidade Básica de Saúde. MÉTODO: Foram avaliados os usuários atendidos na recepção espontânea no período de março de 2010 a maio de 2011. Ao todo, foram estudados 1.023 indivíduos. A caracterização das queixas foi realizada por meio de questionário com dados sociodemográficos e motivo da procura por atendimento. RESULTADOS: Os dados mostraram que a maioria dos usuários pertence ao sexo feminino (71,2%), está na faixa etária de 31 a 60 anos (50,0%), é solteira (31,6%), aposentada (14,2%) e apresenta queixas em vários sistemas (77,1%). O sistema musculoesquelético é o mais acometido (14,4%), representando o segundo motivo de procura por atendimento (31,0%). Analisando as razões de chance de ocorrência de queixas musculoesqueléticas com relação às variáveis estudadas, verificou-se que pessoas com idade entre 40 e 59 anos apresentaram 3,49 (IC95% 2,17-5,57) vezes mais chances de associação com essas dores do que as demais. Não houve associação entre outros sistemas e variáveis. CONCLUSÃO: A alta prevalência de queixas musculoesqueléticas requer um novo olhar de gestores em saúde para o atendimento destas demandas, pensando em incluir o fisioterapeuta na atenção básica para tratamento de dores de menor complexidade