Construção e validação de instrumento simplificado para diagnóstico de disfunção temporomandibular em pacientes adultos

As disfunções temporomandibulares (DTM) representam a maior causa de dor não dentária da região orofacial. Dada sua alta prevalência na população em geral e a existência de inúmeros instrumentos diagnósticos não padronizados, buscou-se elaborar e validar um questionário simples, de acessibilidade ampla e aplicação prática, com vistas a contribuir para o diagnóstico e o estudo epidemiológico das mesmas. A estratégia utilizada na montagem do instrumento foi estabelecida com base na avaliação criteriosa de questionários já existentes na literatura, validação de expertos na área de DTM, validação fatorial, de face (na primeira fase do estudo) e, frente ao padrão ouro (RDC/TMD), na segunda fase do estudo. Na primeira fase, participaram 160 indivíduos. A consistência interna resultou num Coeficiente Alfa de Cronbach de 0,752 para o questionário com sete itens; enquanto que para o questionário com cinco itens, este resultado foi de 0,694, não sendo o mesmo, considerado baixo por avaliar apenas cinco questões e ainda, em razão do tema central da pesquisa ser bastante subjetivo. A análise fatorial confirmatória apontou para uma variância total dos fatores extraídos do questionário com sete itens, de 58,2 % e do questionário com cinco itens de 70,04%. Portanto, o questionário com cinco questões, apresentou resultados estatísticos superiores ao de sete questões. Na validação frente ao padrão ouro (RDC/TMD), foram avaliados 99 indivíduos tendo sido testados os dois questionários, com sete e com cinco questões. Na estrutura com sete questões, ao se categorizar as mesmas por totais de pontos obtidos, em quatro condições, obteve-se o melhor resultado quando se considerou com DTM a faixa entre 10 e 21 pontos, sendo 85,1% positivos também no RDC/TMD, com acurácia de 90,1% e Kappa 0,817. Nesta condição, a sensibilidade encontrada foi de 95% (IC 95%, 91 a 99), especificidade de 87% (IC 95%, 81 a 93), VPP 85%, VPN 96%, LR+ 7,3 e LR- 17,4. Quando os dados foram avaliados para o questionário com cinco questões (QST/DTM), pode-se observar que o melhor ponto de corte foi quando se considerou como portadores de DTM, os indivíduos na faixa entre 7 e 15 pontos, com acurácia de 85,8% e Kappa 0,817. Nesta condição, a sensibilidade foi 88% (IC 95%, 81,6 a 94,4), especificidade 84% (IC 95%, 76,8 a 91,2), VPP 80%, VPN 90,5%, LR+ 5,5 e LR- 7,0. A simplicidade do presente questionário (QST/DTM) com apenas cinco questões, possibilita seu uso como elemento de triagem inicial na área da dor orofacial em disfunção temporomandibular, com boa compreensibilidade, confiabilidade, reprodutibilidade e possibilidade de aplicação em pesquisas epidemiológicas. Concluiu-se que o questionário aqui validado, permite sua aplicação de forma simples tanto por profissionais e pesquisadores da Odontologia como de outras áreas da saúde

IL-10 na patogênese da infecção por Leishmania infantum

Conselho Nacional de Desenvolvimento Científico e Tecnológico

Aspectos de patogenicidade e relacionamento genético de isolados clínicos vaginas e anais de Candida albicans oriundos de pacientes com candidíase vulvovaginal

Vulvovaginal candidiasis (VVC) is one of the most common causes of vaginitis and affects about 75% of women of reproductive age. The majority of cases (80 to 90%) are due to C. albicans, the most virulent species of the genus Candida. Virulence attributes are scarcely investigated and the source of infection remains uncertain. Objective: This study aimed to evaluate the virulence factors and genotypes of clinical isolates of C. albicans sequentially obtained from the anus and vagina of patients with sporadic and recurrent VVC. Materials and methods: We analyzed 62 clinical isolates of C. albicans (36 vaginal and 26 anal strains). Direct examination of vaginal and anal samples and colony forming units (CFU) counts were performed. Yeasts were identified using the chromogenic media CHROMagar Candida® and by classical methodology, and phenotypically characterized regarding to virulence factors, including the ability to adhere to epithelial cells, proteinase activity, morphogenesis and biofilm formation. The genotypes of the strains were investigated with ABC genotyping, microsatellite genotyping with primer M13 and RAPD. Results: We found 100% agreement between direct examination and culture of vaginal samples. Filamentous forms were present in most of the samples of vaginal secretion, which presented CFU counts significantly higher than the samples of anal secretion. There was no statistically significant difference between virulence factors of infecting vaginal isolates and those presented by colonizing anal isolates; as well as for the comparison of the vaginal isolates from patients with different clinical conditions (sporadic or recurrent VVC). There was a decrease in the ability to adhere to HBEC, morphogenesis and biofilm formation of the vaginal isolates during the progress of infection. There was an association between the ability to express different virulence factors and the clinical manifestations presented by the patients. Genotype A was the most prevalent (93.6%), followed by genotype C (6.4%). We found maintenance of the same ABC genotype and greater prevalence of microevolution for the vaginal strains of C. albicans sequentially obtained. Vaginal and anal isolates of C. albicans obtained simultaneously from the same patient presented the same ABC genotype and high genetic relatedness. Conclusion: It is noteworthy that the proliferation of yeast and bud-to-hypha transition are important for the establishment of CVV. The expression of virulence factors is important for the pathogenesis of VVC, although it does not seem to be determinant in the transition from colonization to infection or to the installation of recurrent condition. Genotype A seems to be dominant over the others in both vaginal and anal isolates of patients with VVC. The most common scenario was microevolution of the strains of C. albicans in the vaginal environment. It is suggested that the anal reservoir constituted a possible source of vaginal infection, in most cases assessed

Segurança Alimentar e Controle de Qualidade: um estudo da implantação do Programa Alimentos Seguros em supermercados de bairro

This study aimed to analyze the percentage of compliance, related to the requirements of Practice, achieved by 23 supermarkets in neighborhood after the deployment of Food Insurance Program. For its development research methodology adopted was the application start and end of a check-list (tool-specific SBP) in 23 supermarkets, target of this study. After the deployment of PAS was made a comparative study where it was possible to see that these companies need to improve conditions related to food safety, because according to the study, none of the 23 supermarkets evaluated met the criteria recommended by the SBP to 100% of compliance for the items critical of the check-list. Only 04 of the 23 supermarkets were in the range of 80 to 90% of the overall percentage of compliance, representing only 17.3% of the sample. Most of the sample submitted in a regular situation, according to the methodology of Cardoso (2001). Of the 23 supermarkets studied, 03 supermarkets were classified as poor (13.04%), 13 as scheduled (56.52%) as good and 07 (30.43%). You can see improvements in a small part of the sample, but the decline in the percentage of compliance of 02 companies after working for the implementation of the program, showing lack of responsibility and commitment of companies which should have as its top priority to food safety that market

Secagem de grãos de girassol em leito fixo e em leito de jorro

This work studies two methods for drying sunflower grains grown in the western region of Rio Grande do Norte, in the premises of the Instituto Federal de Educação, Ciência e Tecnologia do Rio Grande do Norte - IFRN - Campus Apodi. This initiative was made because of the harvested grain during the harvest, being stored in sheds without any control of temperature, humidity etc. Therewith, many physical, chemical and physiological characteristics are compromised and grains lose much quality for oil production as their germination power. Taking into account that most of the stored grain is used for replanting, the studied methods include drying of grains in a thin layer using an oven with air circulation (fixed bed) and drying in a spouted bed. It was studied the drying of grains in natura, i.e., newly harvested. The fixed bed drying was carried out at temperatures of 40, 50, 60 and 70°C. Experiments in spouted bed were performed based on an experimental design, 2² + 3, with three replications at the central point, where the independent variables were grains load (1500, 2000 and 2500 g) and the temperature of the inlet air (70, 80, and 90 °C), obtaining the drying and desorption equilibrium isotherms. Previously, the characteristic curves of the bed were obtained. Both in the fixed bed as in the spouted bed, drying and desorption curves were obtained by weighing the grains throughout the experiments and measurements of water activity, respectively. The grains drying in the spouted bed showed good results with significant reduction of processing time. The models of FICK and PAGE were fitted to the experimental data, models which will represent the drying of grains both in the fixed bed as in the spouted bed. The desorption curves showed no influence of the processing temperature in the hygroscopic characteristics of the grains. The models of GAB, OSWIN and LUIKOV could well represent the desorption isotherms