Denny Marcos Garcia

S. aureus plays a central role in chronic rhinosinusitis (CRS), contributing to acute exacerbations and persistent infections through biofilm formation. With rising antibiotic resistance, bioactive glasses such as F18 and 45S5 have emerged as potential alternative antimicrobial agents. To evaluate the antimicrobial effects of F18 and 45S5 on S. aureus isolates from CRS patients, focusing on planktonic growth, biofilm formation, and mechanisms of action. Clinical S. aureus isolates were exposed to F18 and 45S5 (0–512 μg/mL) using a modified Calgary Biofilm Device. Biofilm biomass was quantified by crystal violet staining and spectrophotometry. A pH‐controlled assay was performed to determine whether alkalinization mediated antibiofilm effects. Inductively coupled plasma analysis characterized F18 ion‐release kinetics. Expression of biofilm‐related genes (icaA, icaB, icaD, agrA, agrC) was quantified, and biofilm morphology was examined by scanning electron microscopy. Both bioglasses inhibited biofilm formation at concentrations ≥ 128 μg/mL but did not eradicate mature biofilms. At 512 μg/mL, F18 and 45S5 reduced the biofilm optical density by 78% and 67%, respectively. Although pH elevation occurred, biofilm inhibition was independent of pH variation. F18 exposure downregulated ica operon genes but not agr genes. Ion analysis demonstrated concentration‐dependent release of Ca and Si, with no evidence of apatite formation. SEM showed reduced extracellular matrix and altered bacterial organization. F18 and 45S5 inhibit S. aureus biofilm formation through pH‐independent mechanisms associated with ion release and suppression of matrix‐related genes, supporting their potential as adjunctive strategies in CRS management.

Purpose: To investigate the electromyographic activity (sEMG) of the suprahyoid/submental (SH) muscles during swallowing in adults with different OSA severities, controlled for body mass index (BMI), and to establish predictive factors for changes in muscle activity. Methods: This cross-sectional observational study included 37 adults diagnosed with OSA (AHI > 5). The patients were divided into two groups according to the apnea-hypopnea index (AHI): Group I (AHI = 5 ≤ 30) and Group II (AHI > 30). sEMG activity was recorded during the voluntary swallowing of 10 mL and 15 mL of thin liquid (water). The sEMG peak, integral, and maximum velocity (Vmax) were calculated. Groups were compared by general multivariate analysis of covariance, with BMI as a covariate. A general multivariate linear regression model (GRM) was applied to analyze the contribution of predictors to the EMG parameters. The significance level was set at p < 0.05. Results: There was a predominance of males ( n = 24, 64.9%) and obese individuals (BMI > 30, n = 25, 67.6%) in the sample. Compared with Group I, Group II presented significantly lower peak, Vmax and integral values (P ≤ 0.006). The GRM revealed that the peak and integral were explained by the AHI and BMI, whereas the tongue volume and behavior during swallowing together explained the Vmax. Conclusion: Activation of the suprahyoid (SH) muscles was reduced in patients with severe OSA. In addition to disease severity, BMI and the myofunctional condition of the tongue also contribute to impaired activation. Taken together, these findings indicate that muscle weakness and deficits in motor control compromise the activation of SH muscles during swallowing.

Ocular surface (OS) and dry eye (DE) symptoms are frequent ophthalmic complaints influenced by climate and pollution related with acute and chronic ocular surface symptoms. This study assessed their association with environmental conditions in São Paulo metropolitan area (2016–2020), including air temperature, humidity, atmospheric pressure, ozone (O₃), particulate matter (PM), using IQVIA eye drop sales data and Google search trends. Sympathomimetic decongestant sales correlated with higher temperature (r = 0.434, p = 0.0021), UV radiation (r = 0.643, p < 0.0001), and ozone (r = 0.491, p = 0.0004). Artificial tears and lubricants correlated with ozone (r = 0.452, p = 0.0012) and with searches for “red eye” (r = 0.505, p = 0.0005) and “stye” (r = 0.599, p < 0.0001). To address multicollinearity, Principal Component Analysis (PCA) was applied, with the first two components (PC1 and PC2) explaining 87.3% of variance. Regression models using these components were significant for decongestant sales and “stye” searches. Eye drop sales and search trends thus emerge as potential indicators of OS and DE symptoms, reflecting environmental conditions and informing prevention strategies.

Dry eye disease (DED) is a hallmark of primary Sjögren’s disease (SjD) and often resists conventional treatments like lubricant eye drops. Insulin nanoemulsions offer a potential solution by improving drug penetration and retention on the ocular surface. In animal models, insulin has shown benefits in promoting tear secretion and corneal healing. This study evaluated the safety and efficacy of insulin nanoemulsion eye drops (20 IU/mL, three times daily for 30 days) in patients with SjD. Thirty-two patients were randomized in a double-masked design to receive either insulin or placebo drops. Symptoms (assessed by OSDI questionnaire) and objective measures (tear film breakup time, corneal and conjunctival staining, and Schirmer Test) were recorded at baseline, after 4 weeks of treatment, and at a 4-week follow-up. Twenty-three participants completed the study. Both groups showed significant improvement in symptoms and objective signs after treatment (p < 0.05), but no significant differences were found between the insulin and placebo groups. No clinically relevant adverse effects were reported. Insulin nanoemulsion eye drops are safe for SjD patients, but their therapeutic advantage remains unclear. Further studies with larger samples, extended follow-up, and dose adjustments are needed to better understand their potential.

Background: Endoplasmic reticulum stress (ERS) and the unfolded protein response (UPR) are adaptive mechanisms for conditions of high protein demand, marked by an accumulation of misfolded proteins in the endoplasmic reticulum (ER). Rheumatic autoimmune diseases (RAD) are known to be associated with chronic inflammation and an ERS state. However, the activation of UPR signaling pathways is not completely understood in Sjögren’s disease (SD). This study evaluated the expression of ERS-related genes in glandular tissue of patients with primary SD (pSD), associated SD (aSD) with other autoimmune diseases, and non-Sjögren sicca syndrome (NSS). Methods: In a cross-sectional study, minor salivary gland biopsies were obtained from 44 patients with suspected SD and 13 healthy controls (HC). Patients were classified as pSD, aSD, or NSS based on clinical, serological, and histological assessment. Histopathological analysis and mRNA expression analysis of genes associated with ERS and UPR (PERK, XBP1, ATF-6, ATF-4, CANX, CALR, CHOP, and BIP) were performed on the samples. Differences between groups (pSD, aSD, NSS, and HC) were assessed. The influence of chloroquine (CQ) on the ER was also investigated. Results: Twenty-eight SD patients showed increased expression of PERK ( p = 0.0117) and XBP1 ( p = 0.0346), and reduced expression of ATF-6 ( p = 0.0003) and CHOP ( p = 0.0003), compared to the HC group. Increased expression of BIP ( p < 0.0001), PERK ( p = 0.0003), CALR ( p < 0.0001), and CANX ( p = 0.0111) was also observed in the SD group compared to the NSS group ( n = 16). Patients receiving CQ ( n = 16) showed a significant increase in ATF-6 ( p = 0.0317) compared to patients not taking the medication ( n = 29). Conclusions: Altogether, the results suggest a greater activation of the ERS and UPR genes in patients with SD, especially in the pSD group. Antimalarial drugs, like CQ, used to treat RAD, may affect the ER function in exocrine glands.