Interfacial surface charge and free accessibility to the PLA(2)-active site-like region are essential requirements for the activity of Lys49 PLA(2) homologues

Lys49 phospholipase A(2) homologues are highly myotoxic and cause extensive tissue damage but do not display hydrolytic activity towards natural phospholipids. The binding of heparin, heparin derivatives and polyanionic compounds such as suramin result in partial inhibition (up to 60%) of the myotoxic effects due to a change in the overall charge of the interfacial surface. In vivo experiments demonstrate that polyethylene glycol inhibits more than 90% of the myotoxic effects without exhibiting secondary toxic effects. The crystal structure of bothropstoxin-I complexed with polyethylene glycol reveals that this inhibition is due to steric hindrance of the access to the PLA(2)-active site-like region. These two inhibitory pathways indicate the roles of the overall surface charge and free accessibility to the PLA2-active site-like region in the functioning of Lys49 phospholipases A(2) homologues. Molecular dynamics simulations, small angle X-ray scattering and structural analysis indicate that the oligomeric states both in solution and in the crystalline states of Lys49 phospholipases A2 are principally mediated by hydrophobic contacts formed between the interfacial surfaces. These results provide the framework for the potential application of both clinically approved drugs for the treatment of Viperidae snakebites. (c) 2006 Elsevier Ltd. All rights reserved.

Influence of Y-TZP ceramic treatment and different resin cements on bond strength to dentin

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

A SAXS study of the nanostructural characteristics of TEOS-derived sonogels upon heat treatment up to 1100 degrees C

Xerogels obtained from the acid-catalyzed and ultrasound stimulated hydrolysis of TEOS were submitted to heat treatment at temperatures ranging from 60 to 1100 degreesC and studied by small-angle X-ray scattering (SAXS). The SAXS intensity as a function of the modulus of the scattering vector q was obtained in the range from q(0) = 0.19 to q(m) = 4.4 nm(-1). At 60 degreesC the xerogels exhibit an apparent surface fractal structure with a fractal dimension D-s similar to 2.5 in a length scale ranging from 1/q(1) similar to 1 to 1/q(m) similar to 0.22 nm. This structure becomes extremely rough at 120 degreesC (D-s similar to 3) and at 150 degreesC, it apparently converts to a mass fractal with a fractal dimension D similar to 2.4. This may mean an emptying of the pores with preservation of a share of the original mass fractal structure of the wet aged gel, for it had presented a mass fractal dimension D similar to 2.2. A well characterized porous structure formed by 2.0 nm mean size pores with smooth surface of about 380 m(2)/g is formed at 300 degreesC and remains stable until approximately 800 degreesC. At 900 degreesC the SAXS intensity vanishes indicating the disappearance of the pores in the probed length scale. The elimination of the nanopores occurs by a mechanism in which the number of pores diminishes keeping constant their mean size. The xerogels exhibit a foaming phenomenon above 900 degreesC and scatter following Porod's law as does a surface formed by a coarse structure. (C) 2002 Elsevier B.V. B.V. All rights reserved.

In vitro adhesion of Candida glabrata to denture base acrylic resin modified by glow-discharge plasma treatment

This study evaluated the potential of plasma treatments to modify the surface chemistry and hydrophobicity of a denture base acrylic resin to reduce the Candida glabrata adhesion. Specimens (n=54) with smooth surfaces were made and divided into three groups (n=18): control - non-treated; experimental groups - submitted to plasma treatment (Ar/50W; AAt/130W). The effects of these treatments on chemical composition and surface topography of the acrylic resin were evaluated. Surface free energy measurements (SFE) were performed after the treatments and after 48h of immersion in water. For each group, half (n=9) of the specimens were preconditionated with saliva before the adhesion assay. The number of adhered C. glabrata was evaluated by cell counting after crystal violet staining. The Ar/50W and AAt/130W treatments altered the chemistry composition, hydrophobicity and topography of acrylic surface. The Ar/50W group showed significantly lower C. glabrata adherence than the control group, in the absence of saliva. After preconditioning with saliva, C. glabrata adherence in experimental and control groups did not differ significantly. There were significant changes in the SFE after immersion in water. The results demonstrated that Ar/50W treated surfaces have potential for reducing C. glabrata adhesion to denture base resins and deserve further investigation, especially to tailor the parameters to prolong the increased wettability. © 2012 Blackwell Verlag GmbH.

Perfil de resistência genótica do HIV-1 em pacientes com falha na terapia antirretroviral atendidos pela Rede Nacional de Genotipagem (RENAGENO) na região de Botucatu, SP-Brasil

Pós-graduação em Pesquisa e Desenvolvimento (Biotecnologia Médica) - FMB

Adesão ao tratamento por cuidadores de crianças com hipotireoidismo congênito

As doenças crônicas requerem atenção e avaliações continuas e têm despertado a atenção de profissionais da área da saúde, especialmente aqueles que se dedicam à Psicologia Pediátrica, campo de aplicação que se dedica ao estudo do desenvolvimento da criança, bem como das relações entre saúde e doença e as interferências na qualidade de vida da criança e de seus familiares. Esta pesquisa teve como objetivo principal realizar um estudo descritivo, a fim de identificar variáveis que estivessem facilitando ou dificultando a adesão ao tratamento por cuidadores de crianças com Hipotireoidismo Congênito atendidas em um centro de referência no Estado do Pará. Participaram deste estudo 50 cuidadores principais, com idade entre 17 a 55 anos, com diferentes graus de parentesco com a criança. As variáveis relacionadas à adesão foram identificadas por meio de entrevistas estruturadas com os cuidadores. Características do Programa foram analisadas por meio de entrevistas realizadas com os profissionais da equipe. A análise dos relatos dos cuidadores mostrou que algumas exigências para a adesão ao tratamento não estão sendo fornecidas. Informações sobre características da doença, etiologia, diagnóstico, tratamento e prognóstico não fazem parte do repertório da maioria dos cuidadores, independente da idade, escolaridade, grau de parentesco e tempo em que a criança está no Programa de Triagem Neonatal. Diferenças significativas foram encontradas quanto ao tempo adequado para a realização do exame, o que demonstrou atraso no inicio do tratamento, As dificuldades descritas pelos profissionais quanto à adesão ao tratamento pelo cuidador foram atribuídas tanto a problemas apresentados pela própria estrutura do Programa como por falta de interesse do cuidador. O estudo traz implicações relevantes para a implantação de programas de prevenção mais efetivos e eficazes que atendam os cuidadores e promovam o adequado desenvolvimento da criança.

High efficacy in hyperthermia-associated with polyphosphate magnetic nanoparticles for oral cancer treatment

Nanotherapy applied to cancer treatment is constantly evolving, and new approaches to current techniques, such as magnetohyperthermia, are being implemented to solve and minimize the limitations of conventional therapeutic strategies. The purpose of this study was to investigate the action of polyphosphate-coated maghemite nanoparticles (MNPs) on oral squamous cell carcinoma. Human oral cancer cells (UM-SCC14A) were incubated with MNPs at various concentrations and subjected to cell proliferation tests (MTT), apoptosis assays and transmission electron image analysis. Viability and apoptotic events were time and dose dependent. These in vitro tests showed that at the intermediate concentration tested there is no significant toxicity, as confirmed by transmission electron microscopy. For this reason this MNPs concentration was chosen for the subsequent in vivo tests. Oral tumor induction was performed by applying the carcinogen DMBA to Syrian hamsters. Animals were then treated by magnetohyperthermia using MNPs. No signs of general clinical symptoms of toxicity or abnormal behavioral reactions were observed. However, animals treated with MNPs and exposed to the alternating magnetic field in the hyperthermia procedure exhibited a significant and time dependent cancer regression, as confirmed by histopathological analyses and immunohistochemistry. Actually, in quantitative terms of the magnetotherapy efficacy involving these polyphosphate-coated MNPs, 100% recovery (12/12) was observed in the oral cancer tumor bearing Syrian hamsters seven days after the treatment with the magnetohyperthermia procedure. Data supports the suggestion that the MNPs-mediated hyperthermia represents a promising strategy for the treatment of oral cancer.

Total bacterial counting and the response to treatment of bacterial vaginosis with metronidazole

Objective: To evaluate if the total bacterial count of vaginal samples with bacterial vaginosis assessed by flow cytometry influences the response to treatment with metronidazol. Methods: In this cross-sectional study, 273 low-risk reproductive aged women were enrolled. Vaginal samples were taken to evaluate the pattern of vaginal flora according to Nugent’s criteria, as well as the presence of trichomoniasis and candidosis. Cases identified of bacterial vaginosis were treated with metronidazole and controlled after 45 days. Cervical infection by Chlamydia trachomatis and Neisseria gonorrhoeae were also assessed. Flow cytometry for total bacterial counting was performed in propidium iodide stained cervicovaginal samples, using fluorescent beads at a known concentration. Non-parametric Mann-Whitney test was used to compare total bacterial count between groups of interest, at p<0.05. Results: From the total of 273 women enrolled, 50 were excluded as they presented at least one of the infections investigated. Bacterial vaginosis was detected in 79 women (35.4%), of which 33 (41.8%) returned for re-evaluation after treatment, being 21 cases successfully treated and 12 with persistent abnormal vaginal flora. Flow cytometric data showed that total bacterial counting does not differ between normal flora and bacterial vaginosis samples (p=0.14). Also, no difference was found between the cases of treated and persistent bacterial vaginosis (p=0.48). Conclusion: Total bacterial counting does not influence the response to metronidazole treatment of bacterial vaginosis

Treatment of condylar fractures with an intraoral approach using an angulated screwdriver: Results of a multicentre study

Background This multicentre study aimed to investigate long-term radiographic and functional results following the treatment of condylar fractures using an angulated screwdriver system and open rigid internal fixation with an intraoral surgical approach. Methods Twenty-nine patients with a total of 32 condylar fractures were evaluated. The patients were investigated prospectively based on the following variables: age, sex, aetiology, side, location and classification of the fracture, degree of displacement, associated fractures, surgical approach, oral health status, type of osteosynthesis plate, duration of surgery, mouth-opening, complications, and duration of follow-up. Results The fractures were classified as subcondylar (n = 25) or condylar neck (n = 7). Mean patient age was 36.38 ± 16.60 years. The median duration of postoperative follow-up was 24.39 ± 13.94 months. No joint noise, weakness of the facial nerve, joint pain, or muscle pain was observed. An additional retromandibular approach was necessary to enable the treatment of one subcondylar fracture with medial displacement. Conclusion Subcondylar or condylar neck fractures with medial or lateral displacement can be treated using an intraoral approach with satisfactory results with the advantages of the absence of visible scarring, the avoidance of facial nerve injury, and the ability to obtain rapid access to the fracture.

Treatment of condylar fractures with an intraoral approach using an angulated screwdriver: Results of a multicentre study

Background: This multicentre study aimed to investigate long-term radiographic and functional results following the treatment of condylar fractures using an angulated screwdriver system and open rigid internal fixation with an intraoral surgical approach.Methods: Twenty-nine patients with a total of 32 condylar fractures were evaluated. The patients were investigated prospectively based on the following variables: age, sex, aetiology, side, location and classification of the fracture, degree of displacement, associated fractures, surgical approach, oral health status, type of osteosynthesis plate, duration of surgery, mouth-opening, complications, and duration of follow-up.Results: The fractures were classified as subcondylar (n = 25) or condylar neck (n = 7). Mean patient age was 36.38 +/- 16.60 years. The median duration of postoperative follow-up was 24.39 +/- 13.94 months. No joint noise, weakness of the facial nerve, joint pain, or muscle pain was observed. An additional retromandibular approach was necessary to enable the treatment of one subcondylar fracture with medial displacement.Conclusion: Subcondylar or condylar neck fractures with medial or lateral displacement can be treated using an intraoral approach with satisfactory results with the advantages of the absence of visible scarring, the avoidance of facial nerve injury, and the ability to obtain rapid access to the fracture. (C) 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Influence of Nd:YAG or Er:YAG laser surface treatment on microtensile bond strength of indirect resin composites to resin cement. Lasers surface treatment of indirect resin composites

This study evaluated the influence of the surface pretreatment of indirect resin composite (Signum, Admira Lab and Sinfony) on the microtensile bond strength of a resin cement. Sixty samples made of each brand were divided into 6 groups, according to surface treatment: (1) control; (2) controlled-air abrasion with Al2O3; (3) Er:YAG Laser 200 mJ, 10 Hz, for 10s; (4) Er: YAG Laser 300 mJ, 10 Hz, for 10 s; (5) Nd:YAG 80 mJ, S15Hz for 1 min; (6) Nd:YAG 120mJ, 15 Hz for 1 min. After treatments, all the groups received an application of 37% phosphoric acid and adhesive. The pair of blocks of the same brand were cemented to each other with dual resin cement. The blocks were sectioned to obtain resin-resin sticks (1 x1 mm) and analyzed by microtensile bond testing. The bond strength values were statistically different, irrespective of the surface treatment performed, with highest values for Sinfony (43.81 MPa) and lowest values for Signum (32.33 MPA). The groups treated with the Nd:YAG laser showed the lowest bond strength values and power did not interfere in the results, both for Nd:YAG laser and Er:YAG. Controlled-air abrasion with Al203 is an efficient surface treatment method and the use of the Nd:YAG and Er:YAG lasers reduced bond strength, irrespective of the intensity of energy used.

Tuberculosis: challenges to improve the treatment

Tuberculosis is one of the leading causes of morbidity and mortality worldwide. Current treatment has several challenges including multi-drug resistance, extensively drug-resistance and HIV co-infection. Problems related to patients, treatment and health care system also contributes negatively to this panel. This review summarizes the main obstacles to treat tuberculosis and discuss several strategies to improve the treatment.

Clinical and parasitological evaluation of dogs naturally infected by Leishmania (Leishmania) chagasi submitted to treatment with meglumine antimoniate and allopurinol

Aiming to assess the efficacy of the treatment, to verify the occurrence of possible disease relapses and to search for the presence of parasites after the treatment, seven dogs naturally infected by Leishmania sp., were submitted to a treatment with meglumine antimoniate and allopurinol. For this, lymph node and bone marrow aspiration biopsies were carried out at seven moments. After the end of the six-month observation period all dogs were submitted to euthanasia. Then, spleen and liver “imprints” and in vitro cultures were carried out to search for amastigote forms of the parasite. All animals presented remission of the symptoms and during all the observation period no dog presented relapse of the disease, although amastigote forms of the parasite were observed in two of the animals at the end of the experiment. Thus, it was possible to conclude that the treatment promotes clinical healing but it does not eliminate the parasites completely.

Assessment of tuberculosis treatment accessibility for patients co-infected or not with the human immunodeficiency virus

This study aimed to evaluate accessibility to treatment for people with TB co-infected or not with HIV. This cross-sectional study addressed issues regarding accessibility to treatment in a city in the interior of Sao Paulo state, Brazil. The instrument Primary Care Assessment Tool was utilized with 95 people. To evaluate access to treatment, Student's t test was used. The mean scores of variables were analyzed separately and compared between two groups (people with TB co-infected with HIV and people with TB not co-infected with HIV). Mean scores showed that HIV co-infected people presented greater difficulties in gaining access than those not co-infected. Professionals visited co-infected people more often when compared to those not co-infected; the co-infected people almost never accessed treatment for their disease in the Health Unit nearest their home. There is, therefore, the need for greater integration and communication between the programs for treatment of Tuberculosis and STD/AIDS.

Adverse Drug Events Leading Children to Hospital Emergency Care

To determine the incidence of adverse drug events (ADE) that resulted in the need for children's emergency care, a total of 23,286 pediatric emergency case notes were analyzed. They were selected on the basis of the ICD code indicating a possible ADE. ADEs were found in 13 case notes (0.06%), predominantly among girls and mainly in the 1 to 5 year age group. About half of the observed events occurred as a result of accidental ingestion, 27.3% were suicide attempts, and 27.3% arose due to the discontinuation of treatment. Antiepileptic drugs were those most often involved. Three (23%) were serious. The results suggest that children have easy access to medications and are involved in the majority of accidental occurrences. Using drugs involves risks, and drawing attention to such risks while prescribing and dispensing them fosters the sharing of responsibility and the empowerment of the users, measures necessary to health promotion.