Strategies for treating chronic HCV infection in patients with cirrhosis: latest evidence and clinical outcomes.

The burden of chronic hepatitis C virus (HCV) infection is significant and growing. HCV is considered one of the leading causes of liver disease worldwide and the leading cause of liver transplantation globally. While those infected is estimated in the hundreds of millions, this is likely an underestimation because of the indolent nature of this disease when first contracted. Approximately 20% of patients with HCV infection will progress to advanced fibrosis and cirrhosis. Those that do are at risk of decompensated liver disease including GI bleeding, encephalopathy, severe lab abnormalities, and hepatocellular carcinoma. Those individuals with advanced fibrosis and cirrhosis have historically been difficult to treat. The backbone of previous HCV regimens was interferon (IFN). The outcomes for IFN based regimens were poor and resulted in increased adverse events among those with advanced fibrosis and cirrhosis. Now, in the era of new direct acting antiviral (DAA's) medications, there is hope for curing chronic HCV in everyone, including those with advanced fibrosis and cirrhosis. This article provides a review on the most up to date data on the use of DAA's in patients with advanced fibrosis and cirrhosis. We are at a point where HCV could be truly eradicated, but to do so will require ensuring there are effective and safe treatments for those with advanced fibrosis and cirrhosis.

Synthesis, Modification, and Application of Siloxane Materials for Environmental Sensing

As human populations and resource consumption increase, it is increasingly important to monitor the quality of our environment. While laboratory instruments offer useful information, portable, easy to use sensors would allow environmental analysis to occur on-site, at lower cost, and with minimal operator training. We explore the synthesis, modification, and applications of modified polysiloxane in environmental sensing. Multiple methods of producing modified siloxanes were investigated. Oligomers were formed by using functionalized monomers, producing siloxane materials containing silicon hydride, methyl, and phenyl side chains. Silicon hydride-functionalized oligomers were further modified by hydrosilylation to incorporate methyl ester and naphthyl side chains. Modifications to the siloxane materials were also carried out using post-curing treatments. Methyl ester-functionalized siloxane was incorporated into the surface of a cured poly(dimethylsiloxane) film by siloxane equilibration. The materials containing methyl esters were hydrolyzed to reveal carboxylic acids, which could later be used for covalent protein immobilization. Finally, the siloxane surfaces were modified to incorporate antibodies by covalent, affinity, and adsorption-based attachment. These modifications were characterized by a variety of methods, including contact angle, attenuated total reflectance Fourier transform infrared spectroscopy, dye labels, and 1H nuclear magnetic resonance spectroscopy. The modified siloxane materials were employed in a variety of sensing schemes. Volatile organic compounds were detected using methyl, phenyl, and naphthyl-functionalized materials on a Fabry-Perot interferometer and a refractometer. The Fabry-Perot interferometer was found to detect the analytes upon siloxane extraction by deformation of the Bragg reflectors. The refractometer was used to determine that naphthyl-functionalized siloxanes had elevated refractive indices, rendering these materials more sensitive to some analytes. Antibody-modified siloxanes were used to detect biological analytes through a solid phase microextraction-mediated enzyme linked immunosorbent assay (SPME ELISA). The SPME ELISA was found to have higher analyte sensitivity compared to a conventional ELISA system. The detection scheme was used to detect Escherichia coli at 8500 CFU/mL. These results demonstrate the variety of methods that can be used to modify siloxanes and the wide range of applications of modified siloxanes has been demonstrated through chemical and biological sensing schemes.

Petri Net Siphon Analysis and Network Centrality Measures for Identifying Combination Therapies in Signaling Pathways

Aberrant behavior of biological signaling pathways has been implicated in diseases such as cancers. Therapies have been developed to target proteins in these networks in the hope of curing the illness or bringing about remission. However, identifying targets for drug inhibition that exhibit good therapeutic index has proven to be challenging since signaling pathways have a large number of components and many interconnections such as feedback, crosstalk, and divergence. Unfortunately, some characteristics of these pathways such as redundancy, feedback, and drug resistance reduce the efficacy of single drug target therapy and necessitate the employment of more than one drug to target multiple nodes in the system. However, choosing multiple targets with high therapeutic index poses more challenges since the combinatorial search space could be huge. To cope with the complexity of these systems, computational tools such as ordinary differential equations have been used to successfully model some of these pathways. Regrettably, for building these models, experimentally-measured initial concentrations of the components and rates of reactions are needed which are difficult to obtain, and in very large networks, they may not be available at the moment. Fortunately, there exist other modeling tools, though not as powerful as ordinary differential equations, which do not need the rates and initial conditions to model signaling pathways. Petri net and graph theory are among these tools. In this thesis, we introduce a methodology based on Petri net siphon analysis and graph network centrality measures for identifying prospective targets for single and multiple drug therapies. In this methodology, first, potential targets are identified in the Petri net model of a signaling pathway using siphon analysis. Then, the graph-theoretic centrality measures are employed to prioritize the candidate targets. Also, an algorithm is developed to check whether the candidate targets are able to disable the intended outputs in the graph model of the system or not. We implement structural and dynamical models of ErbB1-Ras-MAPK pathways and use them to assess and evaluate this methodology. The identified drug-targets, single and multiple, correspond to clinically relevant drugs. Overall, the results suggest that this methodology, using siphons and centrality measures, shows promise in identifying and ranking drugs. Since this methodology only uses the structural information of the signaling pathways and does not need initial conditions and dynamical rates, it can be utilized in larger networks.

Effect of type, form, and dosage of activators on strength of alkali-activated natural pozzolans

It is possible to synthesize environmentally friendly cementitious construction materials from alkali-activated natural pozzolans. The effect of the alkaline medium on the strength of alkali-activated natural pozzolans has been investigated and characterised. This paper highlights the effect of the type and form of the alkaline activator, the dosage of alkali and the SiO2/Na2O ratio (silica modulus, Ms) when using water–glass solutions and different curing conditions on the geopolymerisation of natural pozzolans. Activation of natural and calcined pozzolan for production of geopolymeric binder was verified by using Taftan andesite and Shahindej dacite from Iran as a solid precursor. The optimum range for each factor is suggested based on the different effects they have on compressive strength. The concentration of dissolving silicon, aluminium and calcium in alkaline solution, the formation of gel phase and the factors affecting this have been studied by using leaching tests, ICP–AES, and FTIR.

Engineering properties of alkali-activated natural pozzolan concrete

The development of alkali-activated binders with superior engineering properties and longer durability has emerged as an alternative to ordinary portland cement (OPC). It is possible to use alkali-activated natural pozzolans to prepare environmentally friendly geopolymer cement leading to the concept of sustainable development. This paper presents a summary of an experimental work that was conducted to determine mechanical strength, modulus of elasticity, ultrasonic pulse velocity, and shrinkage of different concrete mixtures prepared with alkali-activated Iranian natural pozzolans—namely Taftan andesite and Shahindej dacite, both with and without calcining. Test data were used for Taftan pozzolan to identify the effects of water-binder ratios (w/b) and curing conditions on the properties of the geopolymer concrete, whereas the influence of material composition was studied by activating Shahindej pozzolan both in the natural and calcined states. The results show that alkali-activated natural pozzolan (AANP) concretes develop moderate-to-high mechanical strength with a high modulus of elasticity and a shrinkage much lower than with OPC.

Effect of adding mineral additives to alkali-activated natural pozzolan paste

Natural pozzolans are raw materials from geological deposits with a range of chemical compositions that when combined with suitable alkali activators can be converted to geopolymer cement for concrete production. In this paper the concept of adding mineral additives to enhance the properties of geopolymer cement is introduced. Taftan andesite, a natural Iranian pozzolan, was used to study the effect of adding mineral additives such as kaolinite, lime and other calcined pozzolans on the compressive strength of geopolymer cement under both normal and autoclave curing. Scanning electron microscopy (SEM)/energy dispersive X-ray (EDX) was used to determine the composition of the gel phase in both alkali-activated Taftan pozzolan with and without mineral additions. The work has shown that deficiencies in SiO2, Al2O3 and CaO content in the raw natural pozzolan can be compensated for by adding mineral additives for enhanced properties.

Effect of heat treatment on reactivity-strength of alkali-activated natural pozzolans

Natural pozzolans can be activated and condensed with sodium silicate in an alkaline environment to synthesize high performance cementitious construction materials with low environmental impact. The nature of the starting materials including mineral composition, chemical composition and crystal structure groups affects the formation of the geopolymer gel phase. In this paper, the pozzolanic activities of five natural pozzolans are studied. From XRD and XRF results, most of the raw materials contain zeolite clay minerals and have a high loss on ignition. Therefore, before use, samples were calcined at 700, 800 and 900 °C, respectively. The improvement in pozzolanic properties was studied following heat treatment including calcinations and/or elevated curing temperature by using alkali solubility and compressive strength tests. The results show that pozzolan containing sodium zeolite clinoptilolite can be used to prepare a moderate to high strength binder by heat treatment and calcinations can impart disorder hornblende as a constituent of pozzolan with no amorphous phase to prepare a moderate strength binder.

Simplified model for prediction of compressive strength of alkali-activated natural pozzolans

The assessment of pozzolanic activity is essential for estimating the reaction of a material as pozzolan. Natural pozzolans can be activated and condensed with sodium silicate in an alkaline environment to synthesize high performance cementitious construction materials with low environmental impact. In this paper, the pozzolanic activities of five natural pozzolans are studied. The correlation between type and chemical composition of natural pozzolan, which affects the formation of the geopolymer gel phase, both for the calcined and untreated natural pozzolans, have been reviewed. The improvement in pozzolanic properties was studied following heat treatment including calcinations and/or elevated curing temperature by using alkali solubility, and compressive strength tests. A model was developed to allow prediction of the alkali-activated pozzolan strength versus their chemical compositions, alkali solubility, and crystallinity.

Evaluation and Testing of a Lightweight Fine Aggregate Concrete Bridge Deck in Buchanan County, Iowa, TR-648, 2016

Internal curing is a relatively new technique being used to promote hydration of Portland cement concretes. The fundamental concept is to provide reservoirs of water within the matrix such that the water does not increase the initial water/cementitious materials ratio to the mixture, but is available to help continue hydration once the system starts to dry out. The reservoirs used in the US are typically in the form of lightweight fine aggregate (LWFA) that is saturated prior to batching. Considerable work has been conducted both in the laboratory and in the field to confirm that this approach is fundamentally sound and yet practical for construction purposes. A number of bridge decks have been successfully constructed around the US, including one in Iowa in 2013. It is reported that inclusion of about 20% to 30% LWFA will not only improve strength development and potential durability, but, more importantly, will significantly reduce shrinking, thus reducing cracking risk. The aim of this work was to investigate the feasibility of such an approach in a bridge deck.

Capital 2.0 capital formation and legal risk in a new global economic order from fiat to exit: including case studies of the proposed transatlantic trade and investment partnership between the United States and the European Union and the financing relation between the United States and the People’s Republic of China

Following the intrinsically linked balance sheets in his Capital Formation Life Cycle, Lukas M. Stahl explains with his Triple A Model of Accounting, Allocation and Accountability the stages of the Capital Formation process from FIAT to EXIT. Based on the theoretical foundations of legal risk laid by the International Bar Association with the help of Roger McCormick and legal scholars such as Joanna Benjamin, Matthew Whalley and Tobias Mahler, and founded on the basis of Wesley Hohfeld’s category theory of jural relations, Stahl develops his mutually exclusive Four Determinants of Legal Risk of Law, Lack of Right, Liability and Limitation. Those Four Determinants of Legal Risk allow us to apply, assess, and precisely describe the respective legal risk at all stages of the Capital Formation Life Cycle as demonstrated in case studies of nine industry verticals of the proposed and currently negotiated Transatlantic Trade and Investment Partnership between the United States of America and the European Union, TTIP, as well as in the case of the often cited financing relation between the United States and the People’s Republic of China. Having established the Four Determinants of Legal Risk and its application to the Capital Formation Life Cycle, Stahl then explores the theoretical foundations of capital formation, their historical basis in classical and neo-classical economics and its forefathers such as The Austrians around Eugen von Boehm-Bawerk, Ludwig von Mises and Friedrich von Hayek and most notably and controversial, Karl Marx, and their impact on today’s exponential expansion of capital formation. Starting off with the first pillar of his Triple A Model, Accounting, Stahl then moves on to explain the Three Factors of Capital Formation, Man, Machines and Money and shows how “value-added” is created with respect to the non-monetary capital factors of human resources and industrial production. Followed by a detailed analysis discussing the roles of the Three Actors of Monetary Capital Formation, Central Banks, Commercial Banks and Citizens Stahl readily dismisses a number of myths regarding the creation of money providing in-depth insight into the workings of monetary policy makers, their institutions and ultimate beneficiaries, the corporate and consumer citizens. In his second pillar, Allocation, Stahl continues his analysis of the balance sheets of the Capital Formation Life Cycle by discussing the role of The Five Key Accounts of Monetary Capital Formation, the Sovereign, Financial, Corporate, Private and International account of Monetary Capital Formation and the associated legal risks in the allocation of capital pursuant to his Four Determinants of Legal Risk. In his third pillar, Accountability, Stahl discusses the ever recurring Crisis-Reaction-Acceleration-Sequence-History, in short: CRASH, since the beginning of the millennium starting with the dot-com crash at the turn of the millennium, followed seven years later by the financial crisis of 2008 and the dislocations in the global economy we are facing another seven years later today in 2015 with several sordid debt restructurings under way and hundred thousands of refugees on the way caused by war and increasing inequality. Together with the regulatory reactions they have caused in the form of so-called landmark legislation such as the Sarbanes-Oxley Act of 2002, the Dodd-Frank Act of 2010, the JOBS Act of 2012 or the introduction of the Basel Accords, Basel II in 2004 and III in 2010, the European Financial Stability Facility of 2010, the European Stability Mechanism of 2012 and the European Banking Union of 2013, Stahl analyses the acceleration in size and scope of crises that appears to find often seemingly helpless bureaucratic responses, the inherent legal risks and the complete lack of accountability on part of those responsible. Stahl argues that the order of the day requires to address the root cause of the problems in the form of two fundamental design defects of our Global Economic Order, namely our monetary and judicial order. Inspired by a 1933 plan of nine University of Chicago economists abolishing the fractional reserve system, he proposes the introduction of Sovereign Money as a prerequisite to void misallocations by way of judicial order in the course of domestic and transnational insolvency proceedings including the restructuring of sovereign debt throughout the entire monetary system back to its origin without causing domino effects of banking collapses and failed financial institutions. In recognizing Austrian-American economist Schumpeter’s Concept of Creative Destruction, as a process of industrial mutation that incessantly revolutionizes the economic structure from within, incessantly destroying the old one, incessantly creating a new one, Stahl responds to Schumpeter’s economic chemotherapy with his Concept of Equitable Default mimicking an immunotherapy that strengthens the corpus economicus own immune system by providing for the judicial authority to terminate precisely those misallocations that have proven malignant causing default perusing the century old common law concept of equity that allows for the equitable reformation, rescission or restitution of contract by way of judicial order. Following a review of the proposed mechanisms of transnational dispute resolution and current court systems with transnational jurisdiction, Stahl advocates as a first step in order to complete the Capital Formation Life Cycle from FIAT, the creation of money by way of credit, to EXIT, the termination of money by way of judicial order, the institution of a Transatlantic Trade and Investment Court constituted by a panel of judges from the U.S. Court of International Trade and the European Court of Justice by following the model of the EFTA Court of the European Free Trade Association. Since the first time his proposal has been made public in June of 2014 after being discussed in academic circles since 2011, his or similar proposals have found numerous public supporters. Most notably, the former Vice President of the European Parliament, David Martin, has tabled an amendment in June 2015 in the course of the negotiations on TTIP calling for an independent judicial body and the Member of the European Commission, Cecilia Malmström, has presented her proposal of an International Investment Court on September 16, 2015. Stahl concludes, that for the first time in the history of our generation it appears that there is a real opportunity for reform of our Global Economic Order by curing the two fundamental design defects of our monetary order and judicial order with the abolition of the fractional reserve system and the introduction of Sovereign Money and the institution of a democratically elected Transatlantic Trade and Investment Court that commensurate with its jurisdiction extending to cases concerning the Transatlantic Trade and Investment Partnership may complete the Capital Formation Life Cycle resolving cases of default with the transnational judicial authority for terminal resolution of misallocations in a New Global Economic Order without the ensuing dangers of systemic collapse from FIAT to EXIT.

Optimization of wastepaper sludge ash (WSA) in robust cementitious systems

Abstract : Wastepaper sludge ash (WSA) is generated by a cogeneration station by burning wastepaper sludge. It mainly consists of amorphous aluminosilicate phase, anhydrite, gehlenite, calcite, lime, C2S, C3A, quartz, anorthite, traces of mayenite. Because of its free lime content (~10%), WSA suspension has a high pH (13). Previous researchers have found that the WSA composition has poor robustness and the variations lead to some unsoundness for Portland cement (PC) blended WSA concrete. This thesis focused on the use of WSA in different types of concrete mixes to avoid the deleterious effect of the expansion due to the WSA hydration. As a result, WSA were used in making alkali-activated materials (AAMs) as a precursor source and as a potential activator in consideration of its amorphous content and the high alkaline nature. Moreover, the autogenous shrinkage behavior of PC concrete at low w/b ratio was used in order to compensate the expansion effect due to WSA. The concrete properties as well as the volume change were investigated for the modified WSA blended concrete. The reaction mechanism and microstructure of newly formed binder were evaluated by X-ray diffraction (XRD), calorimetry, thermogravimetric analysis (TGA), scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDX). When WSA was used as precursor, the results showed incompatible reaction between WSA and alkaline solution. The mixtures were not workable and provided very low compressive strength no matter what kinds of chemical activators were used. This was due to the metallic aluminum in WSA, which releases abundant hydrogen gas when WSA reacts with strong alkaline solution. Besides, the results of this thesis showed that WSA can activate the glassy phase contained in slag, glass powder (GP) and class F fly ash (FFA) with an optimum blended ratio of 50:50. The WSA/slag (mass ratio of 50:50) mortar (w/b of 0.47) attained 46 MPa at 28 days without heat curing assistance. A significant fast setting was noticed for the WSA-activated binder due to the C3A phase, free lime and metallic aluminum contained in the WSA. Adding 5% of gypsum can delay the fast setting, but this greatly increased the potential risk of intern sulfate attack. The XRD, TGA and calorimetry analyses demonstrated the formation of ettringite, C-S-H, portlandite, hydrogarnet and calcium carboaluminate in the hydrated binder. The mechanical performance of different binder was closely related to the microstructure of corresponding binder which was proved by the SEM observation. The hydrated WSA/slag and WSA/FFA binder formed a C-A-S-H type of gel with lower Ca/Si ratio (0.47~1.6). A hybrid gel (i.e. C-N-A-S-H) was observed for the WSA/GP binder with a very low Ca/Si ratio (0.26) and Na/Si ratio (0.03). The SEM/EDX analyses displayed the formation of expansive gel (ettringite and thaumasite) in the gypsum added WSA/slag concrete. The gradual emission of hydrogen gas due to the reaction of WSA with alkaline environment significantly increased the porosity and degraded the microstructure of hydrated matrix after the setting. In the last phase of this research WSA-PC blended binder was tailored to form a high autogenous shrinkage concrete in order to compensate the initial expansion. Different binders were proportioned with PC, WSA, silica fume or slag. The microstructure and mechanical properties of concrete can be improved by decreasing w/b ratios and by incorporating silica fume or slag. The 28-day compressive strength of WSA-blended concrete was above 22 MPa and reached 45 MPa when silica fume was added. The PC concrete incorporating silica fume or slag tended to develop higher autogenous shrinkage at low w/b ratios, and thus the ternary binder with the addition of WSA inhibited the long term shrinkage due to the initial expansion property to WSA. In the restrained shrinkage test, the concrete ring incorporating the ternary binder (PC/WSA/slag) revealed negligible potential to cracking up to 96 days as a result of the offset effect by WSA expansion. The WSA blended regular concrete could be produced for potential applications with reduced expansion, good mechanical property and lower permeability.

Mécanisme de salissage et de nettoyage en surface de matériaux polymères

Résumé: Le développement de l’industrie des polymères fourni de plus en plus de choix pour la formulation de matériaux pour les couvre-planchers. Les caoutchoucs, le PVC et le linoleum sont les polymères habituellement utilisés dans l’industrie des couvre-planchers. Ce projet répond à un problème de facilité de nettoyage des couvre-planchers de caoutchouc qui sont reconnus pour être mous, collants et ayant une surface rugueuse. L’INTRODUCTION couvrira l’état actuel de la recherche sur les couvre-planchers, surtout en regard au problème de la «nettoyabilité». La théorie pertinente et les informations générales sur les polymères, les composites polymériques et la science des surfaces seront introduites au CHAPITRE 1. Ensuite, le CHAPITRE 2 couvrira la méthode utilisée pour déterminer la nettoyabilité, l’évaluation des résultats ainsi que l’équipement utilise. Le CHAPITRE 3, discutera des premières expériences sur l’effet de la mouillabilité, la rugosité et la dureté sur la facilité de nettoyage des polymères purs. Plusieurs polymères ayant des surfaces plus ou moins hydrophobes seront investigués afin d’observer leur effet sur la nettoyabilité. L’effet de la rugosité sur la nettoyabilité sera investigué en imprimant une rugosité définie lors du moulage des échantillons; l’influence de la dureté sera également étudiée. Ensuite, un modèle de salissage/nettoyage sera établi à partir de nos résultats et observations afin de rationaliser les facteurs, ou « règles », qui détrminent la facilité de nettoyage des surfaces. Finalement, la réticulation au peroxyde sera étudiée comme une méthode de modification des polymères dans le but d’améliorer leur nettoyabilité; un mécanisme découlant des résultats de ces études sera présenté. Le CHAPITRE 4 étendra cette recherche aux mélanges de polymères; ces derniers servent habituellement à optimiser la performance des polymères purs. Dans ce chapitre, les mêmes tests discutés dans le CHAPITRE 3 seront utilisés pour vérifier le modèle de nettoyabilité établi ci-haut. De plus, l’influence de la non-miscibilité des mélanges de polymères sera discutée du point de vue de la thermodynamique (DSC) et de la morphologie (MEB). L’utilisation de la réticulation par peroxyde sera étudié dans les mélanges EPDM/ (E-ran-MAA(Zn)-ran-BuMA) afin d’améliorer la compatibilité de ces polymères. Les effets du dosage en agent de réticulation et du temps de cuisson seront également examinés. Finalement, un compatibilisant pré-réticulé a été développé pour les mélanges ternaires EPDM/ (E-ran-MAA(Zn)-ran-BuMA)/ HSR; son effet sur la nettoyabilité et sur la morphologie du mélange sera exposé.

Protocolos para a colocação e remoção de espigões

A utilização de espigões em dentes tratados endodonticamente é um dos temas mais estudados em Medicina Dentária. As opiniões são divergentes em relação aos procedimentos clínicos e materiais a serem utilizados para a colocação e remoção de espigões. O objetivo deste trabalho foi realizar uma revisão bibliográfica de forma a organizar conceitos e princípios clínicos para melhor esclarecer os fatores que determinam a necessidade de colocação, utilização e escolha do tipo de espigão, sua cimentação e técnicas para a remoção. Foram analisadas as características e propriedades dos cimentos de fosfato de zinco, ionômero de vidro, cimentos resinosos de polimerização química, polimerização dupla, foto-polimerizável e os sistemas adesivos etch and rinse, self etch e autoadesivos, bem como as técnicas para a remoção de espigões cimentados com diferentes cimentos e sistemas adesivos para depois acessar o remanescente de guta percha para o retratamento endodôntico. Foi feita uma pesquisa bibliográfica na base de dados electrónica PubMed, Google Scholar e RCAAP com as seguintes palavras chave: “Espigões”; “Retratamento Endodôntico”; “Ionómero de Vidro”; “Fosfato de Zinco”; “Cimentos Resinosos”; “Posts”; “Endodontic Retreatment”; “Glass Ionomer”; Zinc-phosphate”; “Resin Cements"; “Push Out Test”; “Posts AND Removal”. Concluiu-se que a cimentação de espigões pré-fabricados de fibra de vidro com cimentos resinosos de dupla polimerização associados aos sistemas adesivos self etch estão gradualmente substituindo os outros tipos de espigões e demais cimentos e possibilitam restaurar o dente de forma adequada e duradoura. E o uso de ultrassons apresenta maior eficácia e segurança na remoção dos espigões.

Relevância no atendimento do idoso portador de diabetes mellitus tipo 2 em Medicina Dentária

A saúde oral na terceira idade é um fator indispensável para o envelhecimento saudável e uma boa qualidade de vida. O tratamento médico dentário não se resume apenas na cura de lesões já existentes, e é necessário promover um programa preventivo, que vise controlar a incidência de problemas médico dentários, um programa curativo para tratar os problemas presentes e também a procura de um programa educativo servindo de apoio para as demais ações. O paciente idoso requer uma atenção maior durante o tratamento, por isso é preciso que o Médico Dentista conheça adequadamente a saúde geral dos idosos, pois estes podem apresentar um quadro de saúde complexo e serem portadores de diversas patologias crónicas e serem poli-medicados. São necessários cuidados especiais na consulta e uma correta anamnese desses pacientes, realizando um exame clínico oral detalhado apoiada por exames complementares. O objetivo principal do presente estudo é analisar as condições clínicas dos idosos portadores de Diabetes Mellitus e as suas complicações orais e ainda a sistematização de procedimentos de forma protocolada para o atendimento médico dentário de idosos portadores desta patologia.

Melhoria da qualidade de jerked beef pela substituição de nitrito de sódio por extratos naturais de própolis e erva mate como agente antioxidante

Jerked beef, an industrial meat product obtained from beef with the addition of sodium chloride and curing salts and subjected to a maturing and drying process is a typical Brazilian product which has been gradually discovered by the consumer. The replacement of synthetic antioxidants by natural substances with antioxidant potential due to possible side effects discovered by lab tests, consumer health, is being implemented by the meat industry. This study aimed to evaluate the lipid oxidation of jerked beef throughout the storage period by replacing the sodium nitrite by natural extracts of propolis and Yerba Mate. For jerked beef processing brisket was used as raw material processed in 6 different formulations: formulation 1 (control - in nature), formulation 2 (sodium nitrite - NO), formulation 3 (Yerba Mate - EM), formulation 4 (propolis extract - PRO), formulation 5 (sodium nitrite + Yerba Mate - MS + NO), formulation 6 (propolis extract + sodium nitrite - PRO + NO). The raw material was subjected to wet salting, dry salting (tombos), drying at 25°C, packaging and storage in BOD 25°C. Samples of each formulation were taken every 7 days for analysis of lipid oxidation by the TBARS method. In all formulations, were carried out analysis of chemical composition at time zero and sixty days of storage. The water activity analysis and color (L *, a *, b *) was monitored at time zero, thirty and sixty days of storage. The Salmonella spp count, Coliform bacteria, Termotolerant coliforms and coagulase positive staphylococci were taken at time zero and sixty days. The activity of natural antioxidants evaluated shows the decline of lipid oxidation up to 2.5 times compared with the product in natura and presented values with no significant differences between treatments NO and EM, confirming the potential in minimize lipid oxidation of Jerked beef throughout the 60 days of storage. The results also showed that yerba mate has a higher antioxidant capacity compared to the propolis except the PRO + NO formulation. When associated with yerba mate with sodium nitrate, TBARS values become close to values obtained only for the control samples with the addition of sodium nitrite. The proximal composition of the formulations remained within the standards required in the IN nº22/2000 for jerked beef. Samples that differ significantly at 5% are directly related to the established type of formulation. The count of microorganisms was within the standards of the DRC nº12/2001 required for matured meat products. The intensity of the red (a*) decreased with storage time and increase the intensity of yellow (b*) indicates a darkening of the product despite L* also have been increased. These results suggest that yerba mate is a good alternative to meat industry in reducing healing addition salts when associated with another antioxidant.