Universidade de Santo Amaro

Field cancerization is a major concern in photodamaged skin due to its risk of progression to squamous cell carcinoma. The 1927-nm thulium laser has emerged as a promising therapy, but its isolated effects on this condition remain underexplored. To evaluate clinical and histopathological changes in field cancerization treated with the 1927-nm thulium laser. It was a prospective, observational, and interventional clinical study. Twenty-three patients (age average of 61.3 years), phototype I-III, with facial photodamage and multiple actinic keratosis underwent 4 monthly sessions of thulium laser, followed by a 3-month evaluation. Outcomes included lesion counts and a photoaging scale at each session, along with comprehensive histological analysis of pre- and post-treatment biopsies from 20 patients. There was a significant reduction in AK count (p < 0.001) and photoaging parameters (p < 0.001). Histologically, we observed improvement in vertical extension of keratinocyte atypia (p = 0.046), increased dermal thickness (p = 0.012), and fibroplasia (p < 0.001). No severe adverse effects occurred. The 1927-nm thulium laser is a safe, well-tolerated and has promising results as a field-directed therapy for actinic keratosis, promoting both clinical and histopathological improvement.

Abstract Diffuse large B-cell lymphoma is the most common and aggressive subtype of B-cell non-Hodgkin lymphoma, and its occurrence during pregnancy or the postpartum period is rare. Management in this setting is challenging, due to risks to the mother and infant. We herein report the case of a 37-year-old woman diagnosed with diffuse large B-cell lymphoma of the palatine tonsil during the first postpartum week following a twin pregnancy. The disease was staged as IIBE, with nodal and extranodal involvement. Treatment consisted of six cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone, combined with prophylactic intrathecal methotrexate, cytarabine, and dexamethasone. Chemotherapy required early cessation of breastfeeding to ensure maternal safety and prevent neonatal exposure to cytotoxic agents. A complete metabolic response was confirmed by 18F-fluorodeoxyglucose positron-emission tomography. At 60 months of follow-up, the patient remains disease-free. This case highlights the therapeutic challenges of managing aggressive lymphomas in the postpartum setting.

Cybersecurity is an urgent concern for small and medium enterprises (SMEs) in Uganda, driven by the rapid digital transformation of businesses and increasing dependence on online platforms. This study explores Ugandan SMEs' cybersecurity challenges, highlighting prevalent cyber threats, risk exposure, and a cyber maturity typology to mitigate cybercrime effectively. Using a qualitative, descriptive research design based on secondary data and a literature review, the study examines how Digital, Blended, and Traditional Business Models influence SMEs' cybersecurity preparedness. A key contribution of this research is the development of a context-sensitive typology of SME cyber maturity, which categorises businesses as Traditional, Transitioning, Digitally Enabled, and Digitally Mature, aligned with the National Institute of Standards and Technology (NIST) Cybersecurity Framework but adapted to Uganda's unique environment. The study identifies ongoing issues such as data breaches, financial fraud, and weak digital infrastructure, as well as gaps in policy enforcement and the disconnect between cybersecurity regulations and SME operators' literacy levels, as key cybersecurity threats. Informal responses to cybercrime, including vigilante actions, are also highlighted. This study provides a maturity typology for SMEs that guides policymakers and business owners in improving cybersecurity practices in Ugandan SMEs. The study calls for multi-stakeholder collaboration, stronger regulatory enforcement, and scalable awareness programs to build a more resilient SME sector. Overall, this study contributes to the discourse on SME cybersecurity by proposing literacy-sensitive interventions tailored to the needs of Uganda and offering a foundation for future research into the effectiveness of Uganda's cybersecurity frameworks.

ObjectivesComputer-aided design/computer-aided manufacturing (CAD/CAM)-milled glass fiber posts offer notable advantages. However, their performance compared to that of prefabricated, composite-reinforced glass fiber posts is controversial. This study aimed to evaluate the fracture strength and fracture patterns of canine roots restored with relined glass fiber posts and CAD/CAM-milled glass fiber posts.Materials and methodsIn total, 20 decoronated canine roots underwent endodontic treatment (n = 10). In the relined group (control), prefabricated glass fiber posts (Reforpost Angelus #1, Angelus, Brazil) were relined with a resin composite (Z350, 3M ESPE, USA). In the milled group, the root canal was modeled using a post (Pinjet, Angelus) and red acrylic resin (Pattern Bright Kit, Kota Ind., Brazil). The acrylic resin patterns were scanned and milled from a glass fiber block (Fiber CAD Post & Core, Angelus). A dual-cure self-adhesive resin luting agent (RelyX™ U200, 3M ESPE) was used for post cementation in both groups. The specimens were subjected to compressive loading, applied at a 45° angle to the long axis of the tooth using a universal testing machine with 200 kgf of compressive force at a crosshead speed of 1 mm/min, until failure. The failure mode was classified as catastrophic (fracture extended to the middle and/or apical third) or repairable (glass fiber post and/or coronal core or limited to the cervical region). A statistical analysis was performed using an independent samples t-test (α = 0.05).ResultsA statistically significant difference was observed in the mean fracture strength, with higher values for the milled group (p = 0.004). Furthermore, the milled group had fewer catastrophic failures.ConclusionsThe CAD/CAM-milled glass fiber posts exhibited greater fracture strength and a reduced incidence of catastrophic fractures.

Immunoglobulin G (IgG) is a central component of humoral immunity in coronavirus disease 2019 (COVID-19); however, increasing evidence suggests that infection-induced IgG repertoires exert immunomodulatory effects beyond classical antiviral functions. In this study, we investigated whether IgG from patients with moderate or severe COVID-19 directly modulates human peripheral γδ T cells and whether these effects are associated with disease severity-dependent IgG idiotype profiles. Purified IgG from non-exposed healthy controls, moderate COVID-19 patients, or severe COVID-19 patients was incubat-ed with peripheral blood mononuclear cells from healthy donors. γδ T cell phenotype, subset distribution, homing markers, and cytokine production were assessed by flow cytometry, while direct IgG-cell interactions were evaluated using fluorescent IgG binding assays. In parallel, proteomic profiling using human proteome microarrays was performed to identify γδ T cell-expressed protein targets recognized by COVID-19-induced IgG. IgG from SARS-CoV-2-infected individuals selectively reduced Vγ9+Vδ2+ γδ T cells, altered memory differentiation, downregulated CCR5, CCR6, and CD161 expression, and reshaped cytokine production in a severity-dependent manner. COVID-19 IgG bound directly to the γδ T cell membrane without inducing apoptosis, indicating a non-cytotoxic mechanism of modulation. Proteomic analysis revealed a marked expansion and diversification of γδ T cell-associated IgG targets in COVID-19, particularly in severe disease, with enrichment of pathways related to immune signaling and inflammation. Collectively, these findings identify γδ T cells as direct functional targets of SARS-CoV-2-induced IgG repertoires and demonstrate that disease severity shapes IgG idiotype networks with distinct immunomodulatory capacities. This work highlights a previously underappreciated antibody-mediated mechanism contributing to immune dysregulation in COVID-19.

This paper investigates the construction of accessible teaching resources for students with Autism Spectrum Disorder (ASD), through bibliographic research. The article presents strategies for the development of these resources, including guidelines for their selection and use, based on guidelines from specialized professionals. It also highlights the importance of knowing the individual needs of students with (ASD), to create adapted and personalized resources. Resources such as visual materials, assistive technologies and sensory activities are necessary to meet different learning styles. The implementation of these resources is crucial to promote inclusion and provide more learning and development opportunities for all students. It is concluded that the adaptation and personalization of resources, combined with the guidance of specialized professionals, are essential to ensure their effectiveness and relevance in the educational context of students with (ASD).

To clinically evaluate dermal thickness, pores, and wrinkles after using Profhilo® in perioral regions. This split-face study included 12 female participants aged 45 to 65 with visible signs of perioral aging. After selection, a blinded operator randomly allocated the right and left sides to receive either treatment (experimental group-Profhilo®) or placebo (control group-saline solution). Treatment consisted of two sessions spaced 30days apart. For the first session, 3 points were marked on the cutaneous portion of the upper lip and 2 points on the lower lip, at 5mm from the beginning of the mucosa, for each side of the face. The amount of product injected in each session was 1 ml of Profhilo®. The same proportion of saline solution was used on the opposite side of the upper and lower lips, following the same application points. After 30days, a local evaluation and application of the second session were performed, following the same protocol as the first. At 60days, digital stereophotogrammetry, ultrasound of the perioral region, and standardized photographic images were performed. In addition, the volunteers answered the Face-Q questionnaire to assess satisfaction with the treatment, signs of aging, post-procedure recovery, and psychological factors. Subsequently, the data collected were tabulated and analyzed using paired t-test and Wilcoxon test, with a significance level of 5%. Stereophotogrammetry revealed visual improvements in wrinkles and pores after the application of Profhilo®. Ultrasonography indicated an increase in dermal thickness for both Profhilo® (p = 0.016) and placebo (p < 0.001). A substantial proportion of participants expressed dissatisfaction with the decision to undergo treatment (36.4%) and the treatment outcomes (54.5%). Most participants reported mild recovery symptoms, with only one noting extreme sensitivity, discomfort, and itching. The intervention evaluated psychological function, appearance, and aging, which resulted in statistically significant improvements in psychological scores (p = 0.014) and aging assessment (p = 0.008). Profhilo® reduced wrinkles and pore size; however, its impact on dermal thickness did not exceed the placebo effect, and patients were not fully satisfied with outcomes. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

IntroductionCardiometabolic index (CMI) has been highlighted as a useful tool for predicting cardiovascular and metabolic disease, but its association with systemic inflammatory status in the aged population is not yet fully understood. Thus, we investigated the association between the CMI and the triad -metabolic profile X body mass index X inflammaging -in older adults classified as having or not having obesity.MethodsA total of 132 older adults of both sexes (women-68; men-64, mean age of 71.3±6.5 years), participated in this study. Demographic and anthropometric data, as well as blood samples, were collected to assess blood glucose, lipids, protein, and inflammatory profiles.ResultsInitially, the volunteers were separated according to the CMI values into two groups: G1 (<50% of the mean CMI value) and G2 (>50% of the mean CMI value). Volunteers in the G2 group, regardless of gender, presented not only lower HDL-c values but also higher weight, BMI, levels of total cholesterol, LDL-c, triglycerides, and the triglycerides to HDL ratio (TG/HDL) than the G1 group. The correlation analysis and linear multivariate regression, with CMI-adjustment, showed a significant positive association with BMI, as well as with pro-inflammatory cytokines, both in the G1 and G2 groups, regardless of gender. After that, the volunteers were separated according to BMI into normal weight and those with obesity. In general, the G2 subgroups with obesity showed higher levels of pro-inflammatory cytokines IL-1β, IL-6, IFN-γ, and TNF-α than the respective G1 subgroups, and also an association of CMI in favor of a pro-inflammatory systemic status, particularly in the older women group.ConclusionIn this cross-sectional study, our findings not only reinforce the potential role of CMI in cardiovascular risk assessment but also may putatively suggest that this index has an interesting association with systemic pro-inflammatory status in older adults, preferentially with obesity.