Notes

Structural insights in the improved thermostability of cysteine alternative mutants involving L-histidine decarboxylase via Photobacterium phosphoreum.
A high level of general and oral health are invaluable assets, a factor not always considered a basic human right for their better life quality. The mouth is a critical point of contact with the external environment, which is established when we talk, chew, swallow and when food digestion begins. From a perspective of the human condition, the mouth is crucial for the integration of sound, social appearance of the individual, and is one of the fundamental components of overall health. Therefore, not having an adequate level of oral health affects self-esteem, quality of life and people's general well-being.The epidemiological data on gingivitis and periodontitis in Latin America are scarce, as the majority of the Latin American studies have analyzed probing depth instead of clinical attachment loss. Reported data have shown high variations in results between different Latin American countries, with the main causes of these differences being the clinical case definition and methodological strategies used. In general, data have revealed that the prevalence of periodontal disease is higher in Latin Americans than in populations in the USA or Europe. Regarding its relations with other diseases and conditions, some Latin American studies have focused on the association between periodontitis and adverse pregnancy outcomes, or poor glycemic control in diabetic patients; however, these studies have reported controversial results. In Chile, reports have indicated that periodontal treatment significantly reduced the preterm birth rate; however, no association between periodontitis and perinatal outcome was found in Brazil. For diabetes mellitus, Brazilian studies have reported controversial findings; however, a Chilean interventional study reported significant reductions in the glycosylated hemoglobin levels after periodontal treatment. Although epidemiological data for Latin America are scarce, the information available at present is useful for establishing national policies on health promotion, prevention, and treatment of periodontal disease. Therefore, dental schools must play a key role in educating professionals who are highly trained in the promotion, prevention, early diagnosis and treatment of periodontal disease, with an approach to risk, and strong biopsychosocial and ethical components. Thus, future Latin American dentists would be able to face the challenge of decreasing the prevalence of periodontal diseases by leading interdisciplinary health teamwork.The art of diagnosis is of great importance in the management of any disease. This includes preventive and therapeutic strategies. To make an accurate and effective diagnosis, knowledge about the health-disease process is fundamental. This paper reviews the important aspects for periodontal diagnosis in a contemporary approach, and endeavors to establish challenges for improving periodontal diagnosis, especially in Latin America. Considering that contemporary periodontal diagnosis should be based on knowledge of the etiopathogenesis of periodontal diseases, this paper highlights that the recently proposed classification system for periodontal diseases and conditions was based on the best available evidence. This system was conceived for individual diagnosis, therefore, its use in research and epidemiological settings might be limited. The system leads to a practical implication that stresses the importance of interviewing the patient, thorough periodontal charting, and requesting any imaging and other complementary tests necessary. An important observation is that partial periodontal data recordings usable for screening are not diagnostic methods and might underestimate disease. The goals of utmost importance for Latin America are to increase the awareness of both the population and the profession and to prioritize correct periodontal diagnosis. In addition, learning how to use the new classification system will help with diagnosing periodontal diseases.OBJECTIVES The number of bariatric procedures has significantly increased in Brazil, especially in the public Unified Health System. The present study describes health outcomes and medication use in obese patients treated in a major hospital that performs publicly funded surgery in Brazil. METHODS A retrospective, single center study was conducted to collect real-world evidence of health outcomes and medication use in 247 obese patients (female, 82.2%) who underwent open Roux-en-Y gastric bypass. Changes in weight and body mass index (BMI), presence of apnea, hypertension, and type 2 diabetes (T2D), and medication use (hypertension, diabetes, and dyslipidemia) were assessed preoperatively and up to 24 months postoperatively. The mean cost of medications was calculated for the 12-month preoperative and 24-month postoperative periods. RESULTS During the surgery, the mean age of patients was 43.42 years (standard deviation [SD], 10.9 years), and mean BMI was 46.7 kg/m2 (SD, 6.7 kg/m2). At 24 months, significant declines were noted in weight (mean, -37.6 kg), BMI (mean, -14.3 kg/m2); presence of T2D, hypertension, and apnea (-29.6%, -50.6%, and -20.9%, respectively); and number of patients using medications (-66.67% for diabetes, -41.86% for hypertension, and -55.26% for dyslipidemia). The mean cost of medications (total costs for all medications) decreased by >50% in 12-24 postoperative months compared to that in 12 preoperative months. CONCLUSION Roux-en-Y gastric bypass successfully reduced weight, BMI, and comorbidities and medication use and cost at 24 months in Brazilian patients treated in the public Unified Health System.OBJECTIVES The outcomes of refractory and relapsed acute myeloid leukemia (AML) patients in developing countries are underreported, even though the similar classic regimens are widely used. METHODS We conducted a retrospective comparison of "MEC" (mitoxantrone, etoposide, and cytarabine) and "FLAG-IDA" (fludarabine, cytarabine, idarubicin, and filgrastim) in adults with first relapse or refractory AML. RESULTS In total, 60 patients were included, of which 28 patients received MEC and 32 received FLAG-IDA. A complete response (CR) rate of 48.3% was observed. Of the included patients, 16 (27%) died before undergoing bone marrow assessment. No statiscally significant difference in CR rate was found between the two protocols (p=0.447). The median survival in the total cohort was 4 months, with a 3-year overall survival (OS) rate of 9.7%. In a multivariable model including age, fms-like tyrosine kinase 3 (FLT3) status, and stem-cell transplantation (SCT), only the last two indicators remained significant FLT3-ITD mutation (hazard ratio [HR]=4.6, p less then 0.001) and SCT (HR=0.43, p=0.01). CONCLUSION In our analysis, there were no significant differences between the chosen regimens. High rates of early toxicity were found, emphasizing the role of supportive care and judicious selection of patients who are eligible for intensive salvage therapy in this setting. The FLT3-ITD mutation and SCT remained significant factors for survival in our study, in line with the results of previous studies.OBJECTIVE We aimed to estimate the overall survival (OS) and conditional survival (CS) in patients diagnosed with oral and oropharyngeal squamous cell carcinoma (SCC) and to determine their survival trends. METHODS The study included all consecutive patients treated at the A.C. Camargo Cancer Center for oral or oropharyngeal SCC between 2001 and 2012. Data were obtained from the Hospital Cancer Registry. OS and CS were analyzed using the Kaplan-Meier method to evaluate the probability of survival with Cox predictor models. RESULTS Data of 505 oral and 380 oropharyngeal SCC patients obtained in 2001-2006 and 2007-2012 were analyzed. Most of the oral SCC (59%) and oropharyngeal SCC (90%) patients had stages III-IV SCC. The 5-year OS for patients with oral SCC was 51.7%, with no significant difference between the first and second periods. The CS rates in 2007-2012 were 65% after the first year and 86% up to the fifth year. For oropharyngeal SCC, the 5-year OS rate was 45.0% in the first period. The survival rate increased to 49.1% from 2007 to 2012, with a reduction in the risk of death (HR=0.69;0.52-09.2). The CS estimates from 2007 to 2012 were 59% after the first year and 75% up to the fifth year. CONCLUSION Survival across the two time periods remained stable for oral SCC but showed a significant increase for oropharyngeal SCC, possibly because of improvements in the patients' response to radiotherapy, such as intensity-modulated radiation therapy, and the use of more accurate diagnostic imaging approaches.OBJECTIVES To compare the diagnostic accuracy of a low-cost screening test for identifying children at risk for language disorders with that of a specific language assessment. METHODS The study was conducted during a polio vaccination campaign in basic health units in western São Paulo, Brazil. The parents/guardians of 1000 children aged between 0 and 5 years were asked to answer questions of a specific screening test. The instrument consisted of a uniform set of questions about the main milestones in language development (from 0 to 5 years of age) with scaled scores to assess responses. There were no exclusion criteria. After the screening test, the children were referred to a specific language assessment by ABFW, following a determined flow of referrals. The results obtained in the screening were compared to those obtained in the specific language assessment; then, the sensitivity, specificity, accuracy, and positive and negative predictive values were determined for the screening test. Children who failed the screening test also underwent an audiological evaluation. The statistical significance was set at 5%. RESULTS The majority of the participants were aged between 4 and 5 years (21.82%) and were male (51.6%). The sensitivity and specificity values were 82.5% and 98.93%, respectively. The area under the curve was 0.907 (0.887-0.925), and the screening test showed 96% accuracy. CONCLUSIONS The screening test showed high diagnostic efficiency in determining the risk of language disorders in children aged between 0 and 5 years.The rapid increase in clinical cases of the new coronavirus disease, COVID-19, suggests high transmissibility. However, the estimates of the basic reproductive number reported in the literature vary widely. Considering this, we drew the function of contact-rate reduction required to control the transmission from both detectable and undetectable sources. Based on this, we offer a set of recommendations for symptomatic and asymptomatic populations during the current pandemic. Understanding the dynamics of transmission is essential to support government decisions and improve the community's adherence to preventive measures.OBJECTIVE In recent decades there has been an increase in the use of antidepressants (AD) and a decrease in the use of benzodiazepines (BDZ). Prevalence, cumulative incidence, and factors associated with the incidence of AD and BDZ use in a Brazilian population were estimated in this article. METHODS Data were collected with a self-administered questionnaire in a cohort of employees from a university in Rio de Janeiro. The prevalence of the use of AD and BDZ was calculated for 1999 (4,030), 2001 (3,574), 2006-07 (3,058), and 2012 (2,933). selleck compound The cumulative incidences of the use of AD and BDZ between 1999 and 2007 were estimated by the Poisson models with robust variance estimates. RESULTS In 1999, the prevalence of the use of AD and BDZ were 1.4% (95%CI 1.1-1.8) and 4.7% (95%CI 4.1-5.4), respectively; in 2012, they were 5.4% (95%CI 5.5-6.2) and 6.8% (95%CI 6.0-7.8). The incidence of use, between 1999 and 2007, was 4.9% (95%CI 4.2-5.7) for AD and 8.3% (95%CI 7.3-9.3) for BDZ. The incidences of AD and BDZ use were higher among women and participants with a positive General Health Questionnaire.
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