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Introduction: This study evaluated the impact of CO2 laser treatment and acidulated phosphate fluoride (APF) on enamel demineralization and biofilm formation, using in vitro and in situ designs. Methods: Demineralized enamel slabs were distributed among 8 groups: placebo, placebo + continuous CO2 laser, placebo + repeated CO2 laser, placebo + ultrapulsed CO2 laser, 1.23% APF, APF + continuous CO2 laser, APF + repeated CO2 laser and APF + ultrapulsed CO2 laser. In the in vitro study, 15 enamel slabs from each group were subjected to a pH-cycling regimen for 14 days. In the cross over in situ design, 11 volunteers wore palatal appliances with demineralized enamel slabs for 2 periods of 14 days each. Drops of sucrose solution were dripped onto enamel slabs 8×/day. Biofilms formed on slabs were collected and the colony-forming units (CFU) of Streptococcus mutans and Lactobacillus were determined. Results: For both in vitro and in situ studies, there was no significant difference between treatments (P>0.05). However, all treatments increased microhardness of demineralized enamel (P<0.05). After a further in situ cariogenic challenge, with the exception of the placebo, all treatments maintained microhardness values (P<0.05). Microbiological analysis showed no difference in Streptococcus mutans (P>0.05) or Lactobacillus (P>0.05) counts between groups. Conclusion: The results suggest that APF gel combined with the CO2 laser, regardless of the pulse emission mode used, was effective in controlling enamel demineralization, but none of the tested treatments was able to prevent bacterial colonization.

Background/Aims: The urinary concentration of the monocyte chemoattractant protein-1 (uMCP-1) chemokine is increased in several proteinuric and/or inflammatory renal diseases. In the present study, we evaluated the association between uMCP-1 and renal function, proteinuria, glomerular and interstitial macrophage infiltration, and renal fibrosis in patients with primary and secondary glomerulopathies diagnosed by renal biopsy. Methods: Thirty-seven patients aged 32.6 ± 7.7 years were studied. uMCP-1 was determined by ELISA. Renal macrophage expression (CD68 positive cells) is reported as number of macrophages/10 4 µm 2 of the cortical tubulointerstitial (TI) area or of glomerular capillary tuft area. Cortical interstitial fibrosis was quantitated by PicroSirius red staining under polarized light by a computerized manner. Results: The uMCP-1 ratio (pg/ml/urinary creatinine mg/ml) was positively correlated (Spearman coefficient) with proteinuria (r = 0.4629; p < 0.005) and number of macrophages in the cortical TI area (r = 0.64; p = 0.0005), and negatively correlated with creatinine clearance (r = –0.4877; p < 0.001). The uMCP-1 ratio was not significantly correlated with number of macrophages/glomerular capillary tuft area (r = 0.27; p = 0.19) or with percent cortical interstitial fibrosis (r = 0.08; p = 0.62). Conclusions: The uMCP-1 excretion is a biomarker of the inflammatory activity of the TI area, and does not reflect chronic interstitial damage.

Introduction: This study evaluated the impact of CO2 laser treatment and acidulated phosphate fluoride (APF) on enamel demineralization and biofilm formation, using in vitro and in situ designs. Methods: Demineralized enamel slabs were distributed among 8 groups: placebo, placebo + continuous CO2 laser, placebo + repeated CO2 laser, placebo + ultrapulsed CO2 laser, 1.23% APF, APF + continuous CO2 laser, APF + repeated CO2 laser and APF + ultrapulsed CO2 laser. In the in vitro study, 15 enamel slabs from each group were subjected to a pH-cycling regimen for 14 days. In the cross over in situ design, 11 volunteers wore palatal appliances with demineralized enamel slabs for 2 periods of 14 days each. Drops of sucrose solution were dripped onto enamel slabs 8×/day. Biofilms formed on slabs were collected and the colony-forming units (CFU) of Streptococcus mutans and Lactobacillus were determined. Results: For both in vitro and in situ studies, there was no significant difference between treatments (P > 0.05). However, all treatments increased microhardness of demineralized enamel (P < 0.05). After a further in situ cariogenic challenge, with the exception of the placebo, all treatments maintained microhardness values (P < 0.05). Microbiological analysis showed no difference in Streptococcus mutans (P > 0.05) or Lactobacillus (P > 0.05) counts between groups. Conclusion: The results suggest that APF gel combined with the CO2 laser, regardless of the pulse emission mode used, was effective in controlling enamel demineralization, but none of the tested treatments was able to prevent bacterial colonization.

This study evaluated in vitro the effect of input power of CO 2 laser, either associated or not to stannous fluoride (SnF 2 ) gel, for the control of intrinsic erosion in primary teeth. One hundred four enamel slabs (3 × 3 × 2 mm) from human primary molars were flattened and polished. Adhesive tapes were placed on their surface leaving a window of 3 × 1 mm. Slabs were then cycled four times in 0.01 M hydrochloric acid (pH 2, 2 min) and in artificial saliva (2 h) for creation of erosive lesions. Specimens were randomly assigned into eight groups ( n  = 13) according to fluoride application [absent (control) or 0.4 % stannous fluoride gel (SnF 2 )] and input power of CO 2 laser [unlased (control), 0.5, 1.0 or 1.5 W]. The CO 2 laser irradiation was performed in an ultra-pulse mode (100 μs of pulse duration), 4-mm working distance, for 10 s. Specimens were then submitted to further erosive episodes for 5 days and evaluated for enamel relative permeability. Fluoride did not show any protective effect for any of the laser-treated groups or control ( p  = 0.185). However, a significant effect was detected for input power of CO 2 laser ( p  = 0.037). Tukey’s test showed that there was a significant statistically difference between specimens irradiated with 0.5 and 1.5 W ( p  = 0.028). The input power of 0.5 W showed lower permeability. Variation of input power CO 2 laser can influence enamel permeability, at the power of 1.5 W which promoted greater permeability.

The aim of this study was to evaluate the effect of cavity preparation with Er:YAG laser on dentin adjacent to restorations submitted to cariogenic challenge in situ, by subsuperficial microhardness analysis. Bovine incisors were sectioned, flattened, and polished, resulting in 40 dentin slabs. The slabs were randomly assigned to four groups ( n  = 10), according to the cavity preparation method: I—high-speed handpiece (control); II—Er:YAG laser (160 mJ; 3 Hz); III—Er:YAG laser (260 mJ; 3 Hz); IV—Er:YAG laser (300 mJ; 3Hz). Cavities were restored with composite resin, and the specimens were fixed in intra-oral appliances, which were worn by 10 volunteers for 14 days for simulating cariogenic challenge in situ. During the experimental period, 20% sucrose solution was dripped over each specimen 6 times a day. Samples were removed, sectioned, and examined for subsuperficial Knoop microhardness at 100, 200, and 300 μm from the restoration and at 30 μm from dentin surface. Split-plot analysis of variance showed no significant difference among the cavity preparation techniques ( p  = 0.1129), among distances ( p  = 0.9030), as well as no difference in the interaction between the main factors ( p  = 0.7338). It was concluded that the cavity preparation with Er:YAG laser did not influence on dentin microhardness submitted to cariogenic challenge in situ.

The concept of epidemiological intelligence, as a construction of information societies, goes beyond monitoring a list of diseases and the ability to elicit rapid responses. The concept should consider the complexity of the definition of epidemiology in the identification of this object of study without being limited to a set of actions in a single government sector. The activities of epidemiological intelligence include risk assessment, strategies for prevention and protection, subsystems of information, crisis management rooms, geographical analysis, etc. This concept contributes to the understanding of policies in health, in multisectorial and geopolitical dimensions, as regards the organization of services around public health emergencies, primary healthcare, as well as disasters. The activities of epidemiological intelligence should not be restricted to scientific research, but the researchers must beware of threats to public health. Lalonde's model enabled consideration of epidemiological intelligence as a way to restructure policies and share resources by creating communities of intelligence, whose purpose is primarily to deal with public health emergencies and disasters.

This study evaluated in vitro the effect of input power of CO sub(2) laser, either associated or not to stannous fluoride (SnF sub(2)) gel, for the control of intrinsic erosion in primary teeth. One hundred four enamel slabs (332 mm) from human primary molars were flattened and polished. Adhesive tapes were placed on their surface leaving a window of 31 mm. Slabs were then cycled four times in 0.01 M hydrochloric acid (pH 2, 2 min) and in artificial saliva (2 h) for creation of erosive lesions. Specimens were randomly assigned into eight groups (n=13) according to fluoride application [absent (control) or 0.4 % stannous fluoride gel (SnF sub(2))] and input power of CO sub(2) laser [unlased (control), 0.5, 1.0 or 1.5 W]. The CO sub(2) laser irradiation was performed in an ultra-pulse mode (100 mu s of pulse duration), 4-mm working distance, for 10 s. Specimens were then submitted to further erosive episodes for 5 days and evaluated for enamel relative permeability. Fluoride did not show any protective effect for any of the laser-treated groups or control (p=0.185). However, a significant effect was detected for input power of CO sub(2) laser (p=0.037). Tukey's test showed that there was a significant statistically difference between specimens irradiated with 0.5 and 1.5 W (p=0.028). The input power of 0.5 W showed lower permeability. Variation of input power CO sub(2) laser can influence enamel permeability, at the power of 1.5 W which promoted greater permeability.

AimTo compare the impact of three different approaches to primary care mental health on the prevalence of mental disorders. Millions of people suffer from mental disorders. As entry point into the health service, primary healthcare plays an important role in providing mental health prevention and treatment. Random sample of households in three different areas of the city of Ribeirão Preto (state of São Paulo, Brazil) were selected, and 20 trained medical students conducted interviews using a mental health screening instrument, the Mini-Screening of Mental Disorders, and a socio-demographic datasheet. Primary care mental health was provided in each area through a specific approach. The influence of the area of residence and the socio-demographic variables on the prevalence of mental disorder was explored and analyzed by univariate binary logistic regression and then by a multiple logistic regression model.FindingsA total of 1545 subjects were interviewed. Comparison between the three areas showed a significantly higher number of people with mental disorders in the area covered by the primary care team that did not have physicians with specific primary care mental health training, even when this association was adjusted for the influence of age, education, and socio-economic status.Our results suggest that residing in areas with family physicians with mental health training is associated with a lower prevalence of mental disorders.

O conceito de inteligência epidemiológica, como uma construção das sociedades de informação, vai além da vigilância de uma lista de doenças e da capacidade em acionar respostas rápidas; tal conceito deve considerar a complexidade da definição de epidemiologia na identificação deste objeto de estudo, sem ser limitado a um conjunto de ações de um setor do governamental. São atividades de inteligência epidemiológica: a avaliação de risco, as estratégias de prevenção e de proteção, os subsistemas de informações, as salas de situação, a análise geográfica etc. Este conceito contribui com a compreensão sobre políticas na área da saúde, numa dimensão multisetorial e geopolítica, no que se refere à organização dos serviços em torno das emergências de saúde pública e da atenção básica, além dos desastres; as atividades de inteligência epidemiológicas não devem se restringir à pesquisa científica, mas os sujeitos devem atentar para as ameaças à saúde pública. O modelo de campo de saúde possibilitou a reflexão sobre a inteligência epidemiológica, como sendo uma forma de rearranjar as políticas e compartilhar os recursos, formando comunidades de inteligência epidemiológica, cuja finalidade é, essencialmente, enfrentar as emergências em saúde pública e os desastres. The concept of epidemiological intelligence, as a construction of information societies, goes beyond monitoring a list of diseases and the ability to elicit rapid responses. The concept should consider the complexity of the definition of epidemiology in the identification of this object of study without being limited to a set of actions in a single government sector. The activities of epidemiological intelligence include risk assessment, strategies for prevention and protection, subsystems of information, crisis management rooms, geographical analysis, etc. This concept contributes to the understanding of policies in health, in multisectorial and geopolitical dimensions, as regards the organization of services around public health emergencies, primary healthcare, as well as disasters. The activities of epidemiological intelligence should not be restricted to scientific research, but the researchers must beware of threats to public health. Lalonde's model enabled consideration of epidemiological intelligence as a way to restructure policies and share resources by creating communities of intelligence, whose purpose is primarily to deal with public health emergencies and disasters.

O conceito de inteligência epidemiológica, como uma construção das sociedades de informação, vai além da vigilância de uma lista de doenças e da capacidade em acionar respostas rápidas; tal conceito deve considerar a complexidade da definição de epidemiologia na identificação deste objeto de estudo, sem ser limitado a um conjunto de ações de um setor do governamental. São atividades de inteligência epidemiológica: a avaliação de risco, as estratégias de prevenção e de proteção, os subsistemas de informações, as salas de situação, a análise geográfica etc. Este conceito contribui com a compreensão sobre políticas na área da saúde, numa dimensão multisetorial e geopolítica, no que se refere à organização dos serviços em torno das emergências de saúde pública e da atenção básica, além dos desastres; as atividades de inteligência epidemiológicas não devem se restringir à pesquisa científica, mas os sujeitos devem atentar para as ameaças à saúde pública. O modelo de campo de saúde possibilitou a reflexão sobre a inteligência epidemiológica, como sendo uma forma de rearranjar as políticas e compartilhar os recursos, formando comunidades de inteligência epidemiológica, cuja finalidade é, essencialmente, enfrentar as emergências em saúde pública e os desastres.