Caracterização do índice de biofilme oral em doentes internados no serviço de cuidados intensivos 1 do Centro Hospitalar do Porto

Introdução: A cavidade oral de um doente que esteja internado num serviço hospitalar apresenta uma flora diferente das pessoas saudáveis. Ao fim de 48 horas de internamento, a flora apresenta um maior número de microrganismos que rapidamente podem ser responsáveis por aparecimento de infeções secundárias, tais como pneumonias, resultante à proliferação bactérias que lhe está associada. Este risco é ainda superior em doentes críticos. Nesta população torna-se fundamental a implementação de um efetivo protocolo de higiene oral, procurando controlar ao máximo o desenvolvimento do biofilme oral. Objetivo: Avaliar o índice de biofilme oral dos doentes na admissão a um serviço de Cuidados Intensivos, procedendo á sua reavaliação após 7 dias de internamento e, procurando deste modo avaliar a eficácia de higienização oral efetuada no Serviço. Materiais e Métodos: Estudo prospetivo, institucional, descritivo, analítico e observacional realizado no Serviço de Cuidados Intensivos do CHP. Foram envolvidos no estudo doentes com mais de 18 anos, e com um tempo de internamento igual ou superior a 7 dias. Procedeu-se à colheita de dados demográficos, motivo de admissão, tempo de internamento, medicação prescrita, tipo de alimentação efetuada no serviço, necessidade ou não de suporte respiratório e qual o tipo de higiene realizada no serviço. Foi avaliado o índice de higiene oral simplificado de Greene & Vermillion (IHO-S) nas primeiras 24h e 7 dias após a 1ª avaliação. O IHO-S é um indicador composto que avalia 2 componentes, a componente de resíduos e a componente de cálculo, sendo cada componente avaliada numa escala de 0 a 3. São avaliadas 6 faces dentárias que são divididas em 3 porções clínicas (porção gengival, terço médio e porção oclusal). No final de cada avaliação é calculado o somatório do valor encontrado para cada face, sendo este total dividido pelo nº de faces analisadas. O cálculo do IHO-S por indivíduo corresponde à soma das componentes. Resultados: Foram avaliados 74 doentes, tendo-se excluído 42 por não terem a dentição mínima exigida. Os 32 doentes que completaram o estudo apresentaram uma idade média de 60,53 ± 14,44 anos, 53,1% eram do género masculino, e na sua maioria pertenciam a pacientes do foro médico e cirúrgico (37,5,5%). Os doentes envolvidos no estudo tiveram uma demora média de 15,69±6,69 dias de internamento, tendo-se verificado que 17 dos pacientes (53,1%) estiveram internados mais de 14 dias no Serviço de Cuidados Intensivos 1. Relativamente às características particulares da amostra verificou-se que durante o período de avaliação a maioria dos doentes estiveram sedados (75%), sob suporte ventilatório (81,3%) e a fazer suporte nutricional por via entérica por sonda nasogástrica (62,6%). O IHO-S inicial foi de 0,67±0,45tendo-se verificado um agravamento significativo ao fim de sete dias de internamento 1,04±0.51 (p<0,05).Este agravamento parece estar fundamentalmente dependente dos maus cuidados orais prestados aos doentes, não se tendo observado qualquer diferença significativa resultante dos aspetos particulares avaliados, com exceção para a nutrição entérica versus a soroterapia. Discussão e Conclusão: Apesar de vários estudos evidenciarem a necessidade de um boa higiene oral para evitar a proliferação bacteriana e o risco de infeção nosocomial, muitas das instituições de saúde continuam a não valorizar esta prática. Neste estudo observa-se que os doentes na admissão apresentam um bom índice de higiene oral tendo-se contudo observado um agravamento significativo ao fim de uma semana de internamento. Embora este agravamento possa não ser importante para o doente com uma semana de internamento ele poderá ser indicativo de um risco acrescido para infeções nosocomiais em doentes com internamentos mais prolongados, necessitando estes doentes de uma higiene oral mais eficaz.

Prótese obturadora palatina

Nos pacientes com defeitos ósseos palatinos congénitos ou adquiridos, quando a possibilidade de reconstrução cirúrgica não existe, poderá ter de se utilizar uma prótese obturadora palatina, com vista ao restabelecimento das funções do sistema estomatognático, tais como, a fonética, deglutição e mastigação. Contudo, esta necessidade não é só funcional mas também estética e psicológica, com vista a melhorar a qualidade de vida dos pacientes. As próteses obturadoras palatinas têm vindo a desenvolver há alguns séculos, com o aprimoramento das técnicas de confecção e materiais dentários que auxiliam na elaboração, cada vez mais eficientes, principalmente no que se refere a sua adaptação. Neste trabalho realizou-se uma revisão narrativa da literatura sobre próteses obturas palatinas utilizando as palavras-chave: maxillary birth bony defects; maxillary acquired bony defects; obturator prosthesis; prosthetic rehabilitation in maxillary defects; inflatable hollow obturator; prosthodontic rehabilitation of maxillary defects. Os objectivos deste trabalho foi o de conhecer os diferentes tipos de próteses obturadoras palatinas utilizadas na reabilitação de pacientes com defeitos ósseos palatinos, bem como, as suas indicações, contra-indicações, os cuidados de utilização e o protocolo clínico e laboratorial de confecção. As próteses obturadoras palatinas são assim uma solução possível na reabilitação funcional de um número grande de pacientes com defeitos ósseos palatinos, no entanto, o seu sucesso está dependente do correcto planeamento e da execução clínica e laboratorial cuidadosa.

Considerações anatómicas sobre o envelhecimento do aparelho estomatognático

Introdução: com o crescente aumento da expectativa de vida, o conhecimento das alterações anatómicas e fisiológicas que ocorrem no aparelho estomatognático durante o envelhecimento é de suma importância para a correta avaliação do paciente idoso. Objetivos: descrição e abordagem das principais estruturas anatómicas do indivíduo, adulto e idoso. Estabelece-se uma anatomia comparativa e evolutiva durante o processo de envelhecimento. Pretende-se contribuir para o conhecimento e reflexão sobre o tema em questão e demonstrar a aplicabilidade deste conhecimento em contexto clínico. Métodos: realizou-se pesquisa bibliográfica, nas bases de dados Pubmed, b-on SciElo e Elsevier, no período entre 2006-2016. Resultados: Maxila - ocorre reabsorção óssea, alteração no contorno do arco da maxila, retrusão maxilar, rotação da maxila no sentido horário, diminuição gradual e constante do ângulo maxilar e redução vertical da altura maxilar. Mandíbula - aumento do ângulo da mandíbula, diminuição da densidade e volume ósseo. Articulação gonfose e Articulação Temporo-Mandibular - pode ocorrer tanto anquilose, como perda das estruturas de suporte. Observa-se degeneração e/ou perfuração do disco radicular e alteração do formato do côndilo. Dentes - cáries radiculares, fraturas dentárias e desgaste dentário. Ocorrem modificações histológicas no esmalte, dentina e polpa dentária. Periodonto: reabsorção do osso alveolar, gengiva atrófica com tendência a migração apical, deposição apical das camadas incrementais e desgaste de cemento exposto, ligamento periodontal fino, irregular e diminuição do espaço periodontal. Conclusões: as alterações anatómicas decorrentes do envelhecimento fisiológico são múltiplas. O Médico Dentista diante de um paciente idoso, deverá conhecer e distinguir entre uma alteração decorrente do envelhecimento fisiológico e uma alteração patológica, para o correto diagnóstico clínico e uma excelente decisão terapêutica. O Médico Dentista deverá contribuir para o envelhecimento saudável e para tal deve ser conhecedor em pleno da temática do presente trabalho.

Uso de diferentes agentes ligantes no desenvolvimento de barra de cereal salgada adicionada de chia (Salvia hispânica L.)

The objective of this study was to evaluate different binders when preparing salt cereal bars and to characterize them as physical, physico-chemical and sensory parameters. Four formulations of different cereal bars using binders have been developed. The evaluated binders were collagen, guar gum, xanthan gum and psyllium. The developed cereal bars were evaluated according to their physical characteristics (color and texture), physicochemical (pH, moisture, ash, protein, lipids, Aw, crude fiber) beyond their calorie, fatty acid composition and concentration of the main minerals. Among the four binding agents evaluated, psyllium stood out due to its physicochemical characteristics. A cereal bar high in protein and fiber; low in carbohydrates and water activity. The binding agent guar gum and xanthan showed characteristics similar to psyllium, especially regarding to fiber content. Collagen as binder gave the final product a high level in protein and lipid. The color and texture analyzes showed that the salt cereal bars had the color and crispness characteristics for this type of product. Regarding to the composition in the fatty acid, the developed bars offer a good supply of essential fatty acids to the human body. The same was observed regarding to mineral contents. Sensory, salt cereal bars made with chia showed good acceptability, highlighting the elaborate bar with psyllium binder. Different binders demonstrated technological efficiency in the preparation of salt cereal bars. The binder psyllium agent over others showed better physical-chemical and sensory characteristics. However, in general the product has healthy and nutritional characteristics it may be indicated for a protein diet with high fiber content and free sugars.

An investigation of environmental conditions experienced during the life of high-value wood components and products

Australian forest industries have a long history of export trade of a wide range of products from woodchips (for paper manufacturing), sandalwood (essential oils, carving and incense) to high value musical instruments, flooring and outdoor furniture. For the high value group, fluctuating environmental conditions brought on by changes in temperature and relative humidity, can lead to performance problems due to consequential swelling, shrinkage and/or distortion of the wood elements. A survey determined the types of value-added products exported, including species and dimensions packaging used and export markets. Data loggers were installed with shipments to monitor temperature and relative humidity conditions. These data were converted to timber equilibrium moisture content values to provide an indication of the environment that the wood elements would be acclimatising to. The results of the initial survey indicated that primary high value wood export products included guitars, flooring, decking and outdoor furniture. The destination markets were mainly located in the northern hemisphere, particularly the United States of America, China, Hong Kong, Europe (including the United Kingdom), Japan, Korea and the Middle East. Other regions importing Australian-made wooden articles were south-east Asia, New Zealand and South Africa. Different timber species have differing rates of swelling and shrinkage, so the types of timber were also recorded during the survey. Results from this work determined that the major species were ash-type eucalypts from south-eastern Australia (commonly referred to in the market as Tasmanian oak), jarrah from Western Australia, spotted gum, hoop pine, white cypress, black butt, brush box and Sydney blue gum from Queensland and New South Wales. The environmental conditions data indicated that microclimates in shipping containers can fluctuate extensively during shipping. Conditions at the time of manufacturing were usually between 10 and 12% equilibrium moisture content, however conditions during shipping could range from 5 (very dry) to 20% (very humid). The packaging systems incorporated were reported to be efficient at protecting the wooden articles from damage during transit. The research highlighted the potential risk for wood components to ‘move’ in response to periods of drier or more humid conditions than those at the time of manufacturing, and the importance of engineering a packaging system that can account for the environmental conditions experienced in shipping containers. Examples of potential dimensional changes in wooden components were calculated based on published unit shrinkage data for key species and the climatic data returned from the logging equipment. The information highlighted the importance of good design to account for possible timber movement during shipping. A timber movement calculator was developed to allow designers to input component species, dimensions, site of manufacture and destination, to see validate their product design.

Amidos crioulos: caracterização fundamental e influência de biopolímeros nas propriedades funcionais do amido

O trabalho apresentado nesta tese focou-se no estudo do amido, nomeadamente na avaliação das características físico-químicas, morfológicas, térmicas e reológicas do amido de seis variedades de milho crioulo, preservadas no estado de Santa Catarina (Brasil), com o intuito de contribuir para a valorização e preservação de variedades locais que são cultivadas em sistemas de produção orgânica, também conhecidas como variedades crioulas. Estas sementes são importantes quer para a preservação da biodiversidade quer para os pequenos produtores que as conservam e as produzem fazendo uso de uma agricultura sustentável e independente comercialmente. Para além da caracterização dos amidos crioulos foram também analisadas as alterações que ocorrem nos processos de gelatinização e retrogradação do amido quando realizados na presença de outros biopolímeros, nomeadamente a quitosana e galactomananas. No Capítulo I é apresentada uma breve revisão do conhecimento científico sobre o amido e sobre a quitosana e galactomananas, os outros biopolímeros utilizados. Igualmente é feita uma sucinta abordagem sobre as principais técnicas analíticas que foram utilizadas: reologia fundamental, calorimetria diferencial de varrimento, microscopia eletrónica de varrimento e espectroscopia de infravermelho médio. No capítulo II apresenta-se o isolamento dos amidos das seis variedades de milho crioulo e a sua caracterização junto com um amido comercial usado como modelo de comparação. Os amidos apresentaram genericamente características físicoquímicas semelhantes e o amido extraído das variedades crioulas MT e MPA 01 apresentaram menor temperatura de gelatinização e maior percentagem de retrogradação, respetivamente. Os efeitos da adição da quitosana e de três galactomananas (goma guar, goma de alfarroba e goma cassia) em sistemas mistos com o amido são analisados nos Capítulos III e IV respetivamente. A adição dos biopolímeros aos amidos resultou no aumento das temperaturas de gelatinização, na alteração da retrogradação do amido pelas galactomananas e na alteração das propriedades viscoeláticas dos géis formados. Os dados de infravermelho esclareceram que nos sistemas com quitosana, o amido formou complexos com o ácido acético usado para dissolver a quitosana e que esta por sua vez formou acetato de quitosana. O comportamento durante a gelatinização do amido comercial quando comparado com o amido do milho crioulo MPA na sua interação com as galactomananas é diferenciado.

Avaliação do comportamento ingestivo utilizando eletromiografia de superfície do músculo masseter

Physiologists and animal scientists try to understand the relationship between ruminants and their environment. The knowledge about feeding behavior of these animals is the key to maximize the production of meat and milk and their derivatives and ensure animal welfare. Within the area called precision farming, one of the goals is to find a model that describes animal nutrition. Existing methods for determining the consumption and ingestive patterns are often time-consuming and imprecise. Therefore, an accurate and less laborious method may be relevant for feeding behaviour recognition. Surface electromyography (sEMG) is able to provide information of muscle activity. Through sEMG of the muscles of mastication, coupled with instrumentation techniques, signal processing and data classification, it is possible to extract the variables of interest that describe chewing activity. This work presents a new method for chewing pattern evaluation, feed intake prediction and for the determination of rumination, food and daily rest time through ruminant animals masseter muscle sEMG signals. Short-term evaluation results are shown and discussed, evidencing employed methods viability.

Funduplicatura de Nissen laparoscópico en el tratamiento de la enfermedad por reflujo gastroesofágico. Hospital Vicente Corral Moscoso. Cuenca, 1997-2008

Introducción: Alrededor del 25 a 50% de sujetos con enfermedad por reflujo gastroesofágico tienen enfermedad persistente progresiva, en ellos, la intervención quirúrgica constituye la mejor opción y el único recurso capaz de restaurar la barrera gastroesofágica. La funduplicatura de Nissen de elección, se realiza por laparoscopía desde febrero de 1997 en nuestro hospital. Objetivo: describir aspectos demográficos y clínicos de pacientes sometidos a funduplicatura de Nissen laparoscópico en el hospital Vicente Corral Moscoso. Método: análisis descriptivo y retrospectivo de videos e historias clínicas en estadística y cirugía de las funduplicaturas de Nissen laparoscópico. Resultados: de febrero 1997 a julio 2008, se realizaron 58 funduplicaturas, en 36 hombres y 22 mujeres, con un promedio de 42 años. Síntomas predominantes; pirosis, regurgitación, dolor abdominal y disfagia. Diagnosticados por: endoscopía digestiva alta y serie esófagogastroduodenal en todos. Com - plicaciones posoperatorias inmediatas: íleo 9, disfagia 5, retención urinaria 4. Tiempo operatorio promedio: 181 minutos en 1997, 102 minutos en 2008. Estancia hospitalaria: 4 días. 49 pacientes recibieron alimentación en 24 horas. No hubo conversiones ni mortalidad. Conclusiones: la cirugía laparoscópica en el tratamiento de ERGE va en aumento y constituye un tratamiento eficaz a largo plazo. Pero los cirujanos debemos también examinar los éxitos, los errores, las complicaciones y limitaciones de estas aplicaciones a largo plazo y con más variables estudiadas.

Sea otter predation and the distribution of bivalve prey in the Elkhorn Slough National Estuarine Research Reserve

The California sea otter population is gradually expanding in size and geographic range and is consequently invading new feeding grounds, including bays and estuaries that are home to extensive populations of bivalve prey. One such area is the Elkhorn Slough, where otters have apparently established a spring and summer communal feeding and resting area. In anticipation of future otter foraging in the slough, an extensive baseline database on bivalve densities, size distributions, biomasses, and burrow depths has been established for three potential bivalve prey species, Saxidomus nuttalli, Tresus nutallii, and Zirphaea pilsbryi. In 1986, the Elkhorn Slough otters were foraging predominately at two areas immediately east and west of the Highway 1 bridge (Skipper's and the PG&E Outfall). Extensive subtidal populations of Saxidomus nuttalli and Tresus nuttallii occur in these areas. Shell records collected at these study areas indicated that sea otters were foraging selectively on Saxidomus over Tresus. The reason for this apparent preference was not clear. At the Skipper's study site, 51% of the shell record was composed of Saxidomus, yet this species accounted for only 16% of the in situ biomass, and only 39% of the available clams. Tresus represented 49% of the shell record at Skipper's, yet this species accounted for 84% of the in situ biomass and 61% of the available clams. There was no difference in mean burrow depth between the two species at this site so availability does not explain the disparity in consumption. At the PG&E Outfall, Saxidomus represents 66% of the in situ biomass and 81% of the available clams, while Tresus accounts for 34% of the in situ biomass and 19% of the available clams. Saxidomus accounts for 96% of the shell record at this site vs. 4% for Tresus, again indicating that the otters were preying on Saxidomus out of proportion to their density or biomass. High densities and biomasses of a third species, Zirphaea pilsbryi, occur in areas where sea otters were observed to be foraging, yet no cast-off Zirphaea shells were found. Although it is possible this species was not represented in the shell record because the otters were simply chewing up the shells, it is more likely this species is avoided by sea otters. There were relatively few sea otters in the Elkhorn Slough in 1986 compared to the previous two years. This, coupled with high bivalve densities, precluded any quantitative comparison of bivalve densities before and after the 1986 sea otter occupation. Qualitative observations made during the course of this study, and quantitative observations from previous studies indicate that, after 3 years, sea otters are not yet significantly affecting bivalve densities in the Elkhorn Slough.

An investigation into the properties of non-digestible carbohydrates that selectively promote colonic propionate production

Short chain fatty acids (SCFA), including propionate, are produced by the bacterial fermentation of carbohydrates in the colon. Propionate has many potential roles in health, including inhibiting cholesterol synthesis, de novo lipogenesis and increasing satiety. The profile of SCFA produced is determined by both the substrate available and the bacteria present and may be influenced by environmental conditions within the lumen of the colon. Whilst it may be beneficial to increase colonic propionate production, dietary strategies to achieve this are unproven. Adding propionate to food leads to poorer organoleptic properties, and oral propionate is absorbed in the small intestine. The optimum way to selectively increase colonic propionate would be to select fermentable carbohydrates that selectively promote propionate production. To date, few studies have undertaken a systematic assessment of the factors leading to increased colonic propionate production making the selection of propiogenic carbohydrates challenging. The aim of this thesis was to identify the best carbohydrates for selectively increasing propionate production, and to explore the factors which control propionate production. This work started with a systematic review of the literature for evidence of candidate carbohydrates, which led to a screen of ‘propiogenic’ substrates using in vitro batch fermentations and mechanistic analysis of the impact of pH, bond linkage and orientation using a range of sugars, polysaccharides and fibre sources. A new unit for SCFA production was developed to allow comparison of results from in vitro studies encompassing a range different methodologies found in the literature. The systematic review found that rhamnose yielded the highest rate and proportion of propionate production whereas, for polysaccharides, β-glucan ranked highest for rate and guar gum ranked highest for molar production, but this was not replicated across all studies. Thus, no single NDC was established as highly propiogenic. Some substrates appeared more propiogenic than others and when these were screened in vitro. Laminarin, and other β-glucans ranked highest for propionate production. Legume fibre and mycoprotein fibre were also propiogenic. A full complement of glucose disaccharides were tested to examine the role glycosidic bond orientation and position on propionate production. Of the glucose disaccharides tested, β(1-4) bonding was associated with increased proportion of propionate and α(1-1) and β(1-4) increased the rate and proportion of butyrate production. In conclusion, it appears that for fibre to affect satiety, high intakes of fibre are needed, and which a major mechanism is thought to occur via propionate. Within this thesis it was identified that rather than selecting specific fibres, increasing overall intakes of highly fermentable carbohydrates is as effective at increasing propionate production. Selecting carbohydrates with beta-bonding, particularly laminarin and other β(1-4) fermentable carbohydrates leads to marginal increases in propionate production. Compared with targeted delivery of propionate to the colon, fermentable carbohydrates examined in this thesis have lesser and variable effects on propionate production. A more complete understanding of the impact of bond configurations in polysaccharides, rather than disaccharides, may help selection or design of dietary carbohydrates which selectively promote colonic propionate production substrates for inclusion in functional foods. Overall this study has concluded that few substrates are selectively propiogenic and the evidence suggests that similar changes in propionate production may be achieved by modest changes in dietary fibre intake

Contribution of plant phytochemicals to organic homeostasis: focus on the aging process and opportunistic infections

Aging process is conceived as a normal stage during human life cycle, but it is also considered a hot topic among scientists and medical community. Alarming rates of premature aging and oxidative stress-related diseases have increasingly affect human individuals. Stress, pollution and exposition to chemical substances are considered the main triggering factors for those conditions; in addition, they also suppress the immune system and, therefore, improve organic vulnerability and occurrence of opportunistic infections [I]. Apart from the associated morbidity and mortality, the increasing rates of antimicrobial resistance improve the severity of the clinical conditions [2]. Botanical preparations possess a multitude of bioactive properties, namely acting as antimicrobials, antioxidants, and homeostasis modulators. Thus, upcoming alternatives, mainly based in plant phytochemicals, are necessary to improve the wellbeing as also life expectancy of individuals. The present study aims to evaluate and to compare both antioxidant and antimicrobial properties of plant extracts rich in phenolic compounds. Among the tested plants, Glycyrrhiza glabra L. (licorice) evidenced the most pronounced free radicals scavenging and antimicrobial effects, followed by Salvia officina/is L. (sage), Thymus vulgaris L. (thyme) and Origanum vulgare L. (oregano). Eucalyptus globulus Labill. (blue gum) and Juglans regia L. (walnut) also showed a high effect, while Pterospartum tridentatum (L.) Willk. (carqueja) and Rubus ulmifolius Schott (elm leaf blackberry) displayed moderate effects, and lastly, Tabebuia impetigirwsa (Mart. ex DC) Standley (pau d'arco), Foeniculum vulgare Miller (fennel), Rosa canina L. (rose hips) and Matricaria recutita L. (chamomile) gave only slight effects. In general, the most pronounced bioactivities were observed in the plant preparations (infusion>decoction>hydromethanolic extract) with higher levels of phenolic compounds (both flavonoids and phenolic acids). The observed synergisms between the phenolic compounds present in the extracts highlight the use of phytochemicals as future health promoters. However, further studies are necessary to understand the effective mode of action of individual phenolic constituents as also the existence of polyvalence relationships between them.

Contribution of plant-derived phenolic compounds to combat Candida species biofilms

Opportunistic fungal infections, namely involving Candida species, constitute a hot topic for scientific researchers. The present wor1( aims to access antifungal potential of plant-derived phenolic extrac:ls against planktonic cells and biofilms of Candida species. Eucalyptvs globulus Labill. (blue gum), Glycyrrhiza glabra L. (licorice), Juglans regia L. (walnut) and Salvia officina/is L. (sage) evidenced to be the most effective Candida growth inhibitors, using disc diffusion assay. Minmal inhibitory (MIC) and minimal fungicidal (MFC) concentrations, and chemical composition of extracts by using HPLC-DAO-ESVMS were also determined. Blue gum and walnut mainly exerted fungistatic potential, while sage exerted an interesting anti-Candida potential. However, the most prominent candidacidal potential was observed to licorice extract, being achieved the lowest MIC and MFC values. The candidacidal potential of these phenolic extracts was mainly attributed to their high abundance in flavonoids, mainly flavones: luteolin (sage) and apigen~ derivatives (licorice), and flavanones: liQuiritin derivatives (licorice). In order to deepen the knowledge on the most effective extract. its abiity to inhibit biofilm formation was evaluated. Overall, a double concentration of MFC value was necessary to achieve similar results in biofims. Row cytometry assays were also carried out, and the obtained results revealed that primary lesion of cellular membrane appear to be most relevant mode of action. Thus, plant derived phenolic compounds evidence a promising potential to combat Candida species biofilms, both individually or combined with conventional therapy.

Combinación de diferentes estrategias de aplicación de hongos entomopatógenos para el control de Spodoptera littoralis (Boisduval) (Lepidoptera: Noctuidae) y Bemisia tabaci (Gennadius) (Hemiptera:Aleyrodidae)

Los ascomicetos mitospóricos entomopatógenos, que actúan por vía tegumentaria, han sido utilizados para el control microbiano de plagas mediante distintas estrategias que permiten el contacto de sus conidios con los insectos diana. Sin embargo, se conocen nuevos aspectos sobre su función ecológica tales como su capacidad secretora de compuestos con actividad insecticida, así como su sorprendente comportamiento como endófitos, que complementan su empleo clásico y que pueden pantag ermitir el desarrollo de nuevas estrategias de control de plagas. El empleo conjunto de estos hongos y sus extractos para el control de un insecto polífago de importancia mundial Spodoptera littoralis (Boisduval) (Lepidoptera: Noctuidae) es abordado en el capítulo II, donde se pone de manifiesto la existencia de variación intra- e interespecífica en la virulencia y estrategias patogénicas de las cepas de Beauveria bassiana y Metarhizium brunneum evaluadas frente a larvas del noctuido. La aplicación conjunta de cepas con distintas estrategias patogénicas junto con sus extractos a larvas del lepidóptero tuvo efecto aditivo, y alguno antagónico, de lo que depende su empleo conjunto. Los capítulos III y IV revelan la existencia de colonización endofítica transitoria tras la aplicación foliar de suspensiones de conidios de cepas de las especies mencionadas en alfalfa, tomate y melón, así como el impacto de esta colonización sobre dos fitófagos con diferentes hábitos de alimentación, uno masticador S. littoralis y otro picador-suctor Bemisia tabaci (Gennadius) (Hemiptera: Aleyrodidae). El capítulo III muestra la contribución aditiva de la mortalidad causada por la alimentación de larvas de S. littoralis a expensas de material vegetal colonizado endofíticamente por cepas de B. bassiana y M. anisopliae con la debida al tratamiento tópico de las mismas con las suspensiones fúngicas. El origen de la mortalidad iniciada a través de la vía digestiva en larvas de este lepidóptero permanece incierto para las cepas de B. bassiana, pero podría estar asociado a la presencia en la planta de metabolitos fúngicos en las cepas de M. brunneum como denota la presencia de destruxina (dtx) A en el 11,0% de los cadáveres. El capítulo IV revela que cepas de ambas especies fúngicas pueden iniciar ciclos de infección en insectos picadores-suctores cuando se alimentan a expensas de sustrato vegetal colonizado endofíticamente, si bien, ambas especies presentan estrategias diferentes. Así, B. bassiana muestra una gran capacidad para colonizar el melón, incluso con efecto traslaminar, que causa la infección de ninfas de B. tabaci por contacto con el tegumento. Sin embargo, la mortalidad de las mismas causada por M. brunneum, de crecimiento mucho más localizado en la hoja, está relacionada una vez mas con la presencia de dtx A en el 43,0% de los cadáveres. Estos resultados deben ser considerados para la evaluación del impacto real de los tratamientos con hongos entomopatógenos, y abren nuevas vías en el control de plagas.

Factors associated with obesity in Brazilian children enrolled in the School Health Program: a case-control study

Case-control studies evaluating the factors associated with childhood obesity are scarce in Brazil. We aimed to analyze the factors associated with obesity in Brazilian schoolchildren enrolled in the School Health Program.A case-control study was conducted on 80 schoolchildren aged 7 to 9 years, 40 of them obese and 40 of normal weight according to the cut-off points established by the World Health Organization (2007). Weight, height and waist circumference were obtained. Socioeconomic, demographic, health, eating behavior and lifestyle data were collected by applying a questionnaire to the person responsible and by determining his/her nutritional status. A binary unconditional logistic regression model (univariate and multivariate) was used for data analysis. The prevalence of obesity was 7.21%. The final model showed that duration of breast-feeding ≥6 months of age (OR 5.3; 95% CI: 1.3-22.1), excess weight of the person responsible (OR 7.1; 95% CI: 1.2-40.2), a sedentary level of physical activity (OR 4.1; 95% CI: 1.115.5), and fast chewing (OR 7.4; 95% CI: 2.1-26.9) were significantly associated with childhood obesity. The factors associated with obesity in schoolchildren were duration of breast-feeding ≥6 months, persons responsible with excess weight, and sedentary children who chew fast. The present study contributes information to be used for the health actions planned by the School Health Program.

COMMUNITY KNOWLEDGE, ATTITUDE AND PRACTICES (KAP) ON FLUOROSIS AND ITS MITIGATION IN ENDEMIC AREAS OF ETHIOPIA

Optimum fluoride intake plays an essential role in the prevention of dental caries while fluoride consumption above recommended level interferes with the normal formation of tooth enamel and bones and may increase risk of dental and skeletal fluorosis. The knowledge and practices of endemic communities on etiology of fluorosis will help in its mitigation and prevention. The objective of this study was to investigate the knowledge, attitude and practices of endemic community on fluoride contamination, fluorosis and prevention practices in order to devise coordinated and targeted prevention mechanisms. Focus group discussions (FGD) and key-informant interview were conducted in three dietary areas to collect knowledge, attitude and practices (KAP) of the endemic community in July 2013.The results indicated that health consequences of fluoride contaminated water are fairly understood. None of the discussants mentioned the word “fluoride”. The knowledge and perception of the community on fluoride ingestion is poor. Health extension workers (HEWs) did not teach about fluoride and related health consequences. Dental fluorosis was reported to start at early ages and not commonly perceived as a major problem. However, adolescents worried and felt that they might be singled out when going to other areas. Older people have a skeletal fluorosis, which interferes with their day to day activities. In severely affected people, the teeth were weak and fragile and thus create difficulty in chewing hard foods like unfermented dry flat bread, sugar cane and toasted grains. People prefer rain water rather than water from borehole because of the inconvenient taste of the latter. The endemic communities have no sufficient knowledge and skills on potential sources of fluoride intake, the debilitating effect of high fluoride ingestion, and preventive and mitigatory measures to reduce fluoride intake. The effect of fluoride contamination and mitigatory methods should get sufficient attention by the community, health workers and concerned governmental bodies. The trend of harvesting and using rain water should be encouraged as it reduces fluoride intake. Future studies should focus on information communication on possible fluoride risks, intervention and evaluation studies on defluoridation, rain water harvesting and mitigatory techniques.