TLR10: An Intriguing Toll-Like Receptor with Many Unanswered Questions

BACKGROUND

Toll-like receptors (TLRs) are one of the first pattern recognition receptors found in the innate immune system. The TLR family has 12 members (TLR1-TLR9, TLR11-TLR13) in mice and 10 members (TLR1-TLR10) in humans, with TLR10 being the latest identified.

SUMMARY

Considerable research has been performed on TLRs; however, TLR10 is known as an orphan receptor for the lack of information on its signalling, role, and ligands. Even though there are recent studies pointing towards the potential TLR10 ligands, their function and signalling pathway are yet to be determined.

KEY MESSAGES

This review gives an insight into recent findings on TLR10's pro- and anti-inflammatory properties, with the goal of outlining existing results and indicating future research topics on this receptor.

Bothrops atrox venom: Biochemical properties and cellular phenotypes of three highly toxic classes of toxins

Snake venoms have a complex mixture of compounds that are conserved across species and act synergistically, triggering severe local and systemic effects. Identification of the toxin classes that are most damaging to cell homeostasis would be a powerful approach to focus on the main activities that underpin envenomation. Here, we focus on the venom of Bothrops atrox, snake responsible for most of the accidents in Amazon region of South America. We identified the key cytotoxic toxin fractions from B. atrox venom and mapped their biochemical properties, protein composition and cell damage. Five fractions were obtained by mass exclusion chromatography and contained either a single class of enzymatic activity (i.e., L-amino acid oxidases or Hyaluronidases) or different activities co-distributed in two or more protein fractions (e.g., Metalloproteinases, Serine Proteases, or Phospholipases A2). Only three protein fractions reduced cell viability of primary human cells. Strikingly, such activity is accompanied by disruption of cell attachment to substratum and to neighbouring cells. Such strong perturbation of morphological cell features indicates likely defects in tissue integrity in vivo. Mass spectrometry identified the main classes of toxins that contribute to these phenotypes. We provide here a strategy for the selection of key cytotoxic proteins for targeted investigation of their mechanism of action and potential synergism during snakebite envenomation. Our data highlights putative toxins (or combinations of) that may be the focus of future therapeutic interference.

CD34 Protein: Its expression and function in inflammation

CD34 has spear-headed the field of basic research and clinical transplantation since the first reports of its expression on hematopoietic stem cells (HSCs). Expressed in mice, humans, rats and other species, CD34 has been used for more than 40 years as a hematopoietic stem and progenitor cell marker. It was later found that muscle satellite cells and epidermal precursors can also be identified with the aid of CD34. Despite the usefulness of CD34 as a marker of HSCs, its overall purpose in animal physiology has remained unclear. This review recaptures CD34 structure, evolutionary conservation, proposed functions, and role in lung inflammation, to describe current research findings and to provide guidance for future studies on CD34.

Biological and proteomic characterization of the venom from Peruvian Andes rattlesnake Crotalus durissus

The Peruvian rattlesnake Crotalus durissus is a venomous species that is restricted to the Peruvian Departments of Puno and Madre de Dios. Although clinically meaningful in this region, Crotalus durissus venom composition remains largely elusive. In this sense, this work aimed to provide a primary description of Peruvian C. durissus venom (PCdV). The enzymatic activities (SVMP, SVSP, LAAO, Hyaluronidase and PLA₂) of PCdV were analyzed and compared to Brazilian Crotalus durissus terrificus venom (BCdtV). PCdV showed higher PLA₂ activity when compared to the Brazilian venom. PCdV also showed cytotoxicity in VERO cells. For proteomic analysis, PCdV proteins were separated by HPLC, followed by SDS-PAGE. Gel bands were excised and tryptic digested for MALDI-TOF/TOF identification. Approximately 21 proteins were identified, belonging to 7 families. Phospholipases A₂ (PLA₂, 66.63%) were the most abundant proteins of the venom, followed by snake venom serine proteinases (SVSPs, 13.37%), C-type lectins (Snaclec, 8.98%) and snake venom metalloproteinases (SVMPs, 7.13%), crotamine (2.98%) and phosphodiesterase (PDE, 0.87%). Moreover, antivenom recognition assays indicated that both Brazilian and Peruvian antivenoms recognize PCdV, indicating the presence of antigenically related proteins in crotalic venoms. The results reported here, may impact in the venom selection for the production of effective Pan-American crotalic antivenom.

Structure-activity relationship, molecular docking, and molecular dynamic studies of diterpenes from marine natural products with anti-HIV activity

HIV-1 infection is a global epidemic whose treatment is limited majorly by viral resistance and adverse effects. Natural products from algae have been studied for many years, including antiviral, being an alternative to anti-HIV drug design. Since the isolation of natural products can be a hurdle, molecular modeling is an important tool to study these compounds. Herein, structure-activity relationship, molecular docking, and molecular dynamic studies were performed to direct the studies of ten marine natural products with anti-HIV activity. In the structure-activity relationship, descriptors were identified associating the anti-HIV activity of five diterpenes with possible action on the reverse transcriptase allosteric site. These diterpenes were evaluated by molecular docking, and it was identified that only dolabelladienetriol interacted in the allosteric site. Molecular dynamics suggested that the dolabelladienetriol might interfere with the viral RNA binding to HIV-1 RT by inducing a conformational change of the enzyme. Also, in silico ADMET simulations predicts that the dolabelladienetriol present a high potential to be successfully developed as a drug. Thus, applying in silico approaches was possible to suggest potential anti-HIV compounds derived from marine natural products.Communicated by Ramaswamy H. Sarma.

Proteomic and toxinological characterization of Peruvian pitviper Bothrops brazili ("jergón shushupe"), venom

Bothrops brazili is a pitviper from Amazonian region, responsible for many accidents in Peru. Despite its relevance, its venom has not been extensively characterized. In the present work, Bothrops brazili venom (BbV) components were analyzed by RP-HPLC, SDS-PAGE and MALDI-TOF/TOF. Approximately 37 proteins were identified, belonging to 7 families. Snake venom metalloproteinases (SVMPs) were the most abundant proteins of the venom (33.05%), followed by snake venom serine proteinases (SVSPs, 26.11%), phospholipases A₂ (PLA₂, 25.57%), snake C-type lectins (CTLs, 9.61%), L-aminoacid oxidase (LAAO, 3.80%), cystein-rich secretory proteins (CRISP, 1.67%) and Bradykinin-potentiating peptide (BPP, 0.20%). In vitro enzymatic activities of BbV showed high levels of SVMP activity and reduced Hyal activity in comparison with other bothropic venoms. Furthermore, BbV reduced VERO cells viability. ELISA and Western Blotting showed that both Peruvian and Brazilian bothropic antivenoms were able to recognize BbV components. This work provides an overview of BbV venom content and indicates a potential efficiency of Peruvian and Brazilian antivenoms to treat accidents with this species.

Proteomic profile, biological activities and antigenic analysis of the venom from Bothriopsis bilineata smaragdina ("loro machaco"), a pitviper snake from Peru

In order to determine Bothriopsis bilineata smaragdina venom (BbsV) composition, proteomic approaches were performed. Venom components were analyzed by RP-HPLC, SDS- PAGE and nano LC on line with LTQ Orbitrap XL. Results showed a total of 189 identified proteins, grouped into 11 different subgroups, which include snake venom metalloproteinases (SVMPs, 54.67%), snake C-type lectins (Snaclecs, 15.78%), snake venom serine proteinases (SVSPs, 14.69%), cystein-rich secretory proteins (CRISP, 2.61%), phospholipases A₂ (PLA₂, 1.14%), phosphodiesterase (PDE, 1.17%), venom endothelial growth factor (VEGF, 1.06%) 5'nucleotidases (0.33%), L-amino acid oxidases (LAAOs, 0.28%) and other proteins. In vitro enzymatic activities (SVMP, SVSP, LAAO, Hyal and PLA₂) of BbsV were also analyzed. BbsV showed high SVSP activity but low PLA₂ activity, when compared to other Bothrops venoms. In vivo, BbsV induced hemorrhage and edema in mice and showed intraperitoneal median lethal dose (LD₅₀) of 92.74 (± 0.15) μg/20 g of mice. Furthermore, BbsV reduced cell viability when incubated with VERO cells. Peruvian and Brazilian bothropic antivenoms recognize BbsV proteins, as detected by ELISA and Western Blotting. Both antivenoms were able to neutralize in vivo edema and hemorrhage.

SIGNIFICANCE

In Peru, snakebite is a public health problem, especially in the rain forest, as a result of progressive colonization of this geographical area. This country is the second in Latin America, after Brazil, to exhibit the largest variety of venomous snakes. B. atrox and B. b. smaragdina snakes are sympatric species in Peruvian Amazon region and are responsible for approximately 95% of the envenomings reported in this region. B. b. smaragdina may cause a smaller share (3 to 38%) of those accidents, due to its arboreal habits, that make human encounters with these snakes less likely to happen. Despite B. b. smaragdina recognized medical importance, its venom composition and biological activities have been poorly studied. Furthermore, BbsV is not a component of the antigenic pool used to produce the corresponding Peruvian bothropic antivenom (P-BAV). Our results not only provide new insights on BbsV composition and biological activity, but also demonstrate that both P-BAV and B-BAV polyvalent antivenoms have a considerable recognition of proteins from BbsV and, more importantly, neutralized hemorrhage and edema, the main local effects of bothropic envenomation.

Analysis of worldwide sequence mutations in Zika virus proteins E, NS1, NS3 and NS5 from a structural point of view

Zika virus (ZIKV) is an emergent arbovirus that has attracted attention in the last year as a possible causative agent of congenital malformation; it shows a remarkably increased microcephaly risk during otherwise healthy pregnancies. We present here an analysis of all ZIKV sequences available in Genbank up to April 2016, studying the mutations in the whole polyprotein and their possible structural implications for the proteins E, NS1, NS3 and NS5. This study suggests that microcephaly is not a consequence of any particular amino acid substitution but, conceivably, is a feature of ZIKV itself. Moreover, the structural analysis of ZIKV proteins, together with the mutational landscape of ZIKV and a structure-sequence comparison with other flaviviruses, allows the suggestion of regions that could be exploited as anti-ZIKV targets, including some allosteric sites found in the NS3 and NS5 proteins of DENV.

Molecular dynamics simulations of the free and inhibitor-bound cruzain systems in aqueous solvent: insights on the inhibition mechanism in acidic pH

The major cysteine protease of Trypanosoma cruzi, cruzain (CRZ), has been described as a therapeutic target for Chagas' disease, which affects millions of people worldwide. Thus, a series of CRZ inhibitors has been studied, including a new competitive inhibitor, Nequimed176 (NEQ176). Nevertheless, the structural and dynamic basis for CRZ inhibition remains unclear. Hoping to contribute to this ever-growing understanding of timescale dynamics in the CRZ inhibition mechanism, we have performed the first study using 100 ns of molecular dynamics (MD) simulations of two CRZ systems in an aqueous solvent under pH 5.5: CRZ in the apo form (ligand free) and CRZ complexed to NEQ176. According to the MD simulations, the enzyme adopts an open conformation in the apo form and a closed conformation in the NEQ176-CRZ complex. We also suggest that this closed conformation is related to the hydrogen-bonding interactions between NEQ176 and CRZ, which occurs through key residues, mainly Gly66, Met68, Asn69, and Leu160. In addition, the cross-correlation analysis shows evidence of the correlated motions among Ala110-Asp140, Leu160-Gly189, and Glu190-Gly215 subdomains, as well as, the movements related to Ala1-Thr59 and Asp60-Pro90 regions seem to be crucial for CRZ activity.

Expression of B7-1 costimulatory molecules in patients with multibacillary leprosy and reactional states

BACKGROUND

The expression of B7 as a costimulatory molecule on the surface of antigen-presenting cells such as macrophages and on dendritic cells characterizes the efficiency of the cell-mediated immune response.

AIMS

Our purpose was to evaluate B7-1 expression in peripheral blood mononuclear cells (PBMCs) immediately after cell isolation ('spontaneous' B7 expression), and in inflammatory cells from cutaneous lesions of patients with multibacillary leprosy (MB-L) without and during the reactional states of erythema nodosum leprosum (ENL) or reversal reaction (RR).

METHODS

Peripheral blood samples and skin biopsies of eight patients without (MB-L) and with reactional episodes (ENL and RR) were studied using antibodies against B7-1, CD1b, DR and CD14 in flow-cytometry and immunohistochemistry experiments.

RESULTS

The flow-cytometry studies (mean +/- SD% of fluorescent cells) revealed significant B7-1 expression on PBMCs isolated from patients with ENL (8.0 +/- 0.6%) and RR (15.0 +/- 1.4%) compared with that observed for patients with MB-L (0.4 +/- 0.2%). Similar results were observed for cutaneous lesions of these patients by immunohistochemical assays. One patient studied before and during ENL revealed weak B7 expression before the reactional episode (0.3% of cells) compared with the marked level of B7-expressing cells detected during ENL (8.5% fluorescent cells). Interestingly, an even higher B7 expression (15% of cells) was observed in patients with RR.

CONCLUSIONS

Our results strongly suggest that B7 expression precedes reactional episodes in MB-L, which could be related to the acquisition of effective immunity to Mycobacterium leprae during reactional episodes in leprosy. We propose B7 expression as a marker of CMI response in reactional episodes in leprosy.

HIV-1 reverse transcriptase: a therapeutical target in the spotlight

Human Immunodeficiency Virus type 1 Reverse Transcriptase (HIV-1 RT) is one of the most important targets for treatment of Acquired Immune Deficiency Syndrome (AIDS). It catalyzes the reverse transcription of HIV-RNA into a double stranded DNA, and the knowledge of its substrate specificity and catalytic mechanism has guided the development of several inhibitors widely used on current HIV/AIDS therapy. However, mutations in HIV-1 RT structure can lead to the emergence of drug-resistant virus strains. The goal of this review is to summarize relevant structural features of HIV-1 RT and its inhibitors in such a way that this cost-effective target in the development of new antiretroviral drugs is particularly highlighted.

Snake venom thrombin-like enzymes: from reptilase to now

The snake venom thrombin-like enzymes (SVTLEs) comprise a number of serine proteases functionally and structurally related to thrombin. Until recently, only nine complete sequences of this subgroup of the serine protease family were known. Over the past 5 years, the primary structure of several SVTLEs has been characterized, and now this family includes several members. Of particular interest is their possible use in pathologies such as thrombosis. The aim of the present review is to summarize the state of the art concerning the evolutionary, structural and biological features of the SVTLEs.

Selective PGHS-2 inhibitors: a rational approach for treatment of the inflammation

Prostaglandin-H synthase exists in two isoforms, PGHS-1 and PGHS-2. PGHS-1 is present and is constitutively expressed in most cells and tissues, whereas PGHS-2 is mainly thought to mediate inflammation. Selective prostaglandin-H synthase-2 (or cyclooxygenase-2) inhibitors have been shown to be potent antiinflammatory agents with fewer side effects than currently marketed nonsteroidal antiinflammatory drugs (NSAIDs). This review addresses the main classes of the selective PGHS-2 inhibitors whose selectivity is documented by supporting PGHS-1 and PGHS-2 enzyme data. In addition, we also describe our experience in design, synthesis and pharmacological in vivo evaluation of new 1,2-benzodioxole derivatives as candidate of the selective PGHS-2 inhibitors, with special attention to molecular dynamics simulations of these derivatives attached to the active site of PGHS-2.

Microleakage in primary teeth restored by conventional or bonded amalgam technique

The aim of this in vitro study was to evaluate marginal leakage in class V restorations in primary teeth restored with amalgam, using three different techniques. Thirty maxillary anterior primary teeth, clinically sound and naturally exfoliated, were used. In group 1 (n = 10), two thin layers of a copal varnish (Cavitine) were applied. In group 2 (n = 10), Scotchbond Multi-Purpose Plus, a dual adhesive system, was used according to manufacturer instructions. In group 3 (n = 10), One-Step adhesive system in combination with a low-viscosity resin (Resinomer) were used according to manufacturer instructions. All samples were restored with a high-copper dental amalgam alloy (GS 80, SDI). After restoration, the samples were stored in normal saline at 37 degrees C for 72 h. The specimens were polished, thermocycled (500 cycles, 5 degrees and 55 degrees C, 30-s dwell time) and impermeabilized with fingernail polish to within 1.0 mm of the restoration margins. The teeth were then placed in 0.5% methylene blue for 4 h. Finally, the samples were sectioned and evaluated for marginal leakage. The Kruskal-Wallis test showed that the filled adhesive resin (group 3) had the least microleakage. There was no significant difference between groups 1 and 2.

Synthesis and pharmacological evaluation of novel heterotricyclic acylhydrazone derivatives, designed as PAF antagonists

This paper describes the synthesis and the antiplatelet properties of new heterotricyclic N-acylhydrazone derivatives (7a-e), structurally analogous to known hetrazepinic PAF antagonists, exploring molecular hybridization as a tool for molecular designing. The synthetic route employed to access compounds (7a-e) used, as starting material, the previously described methyl 3-hydroxy-8-methyl-6-phenyl-6H-pyrazolo[3,4-b]thieno[2, 3-d]pyridine-2-carboxylate derivative. The results from inhibitory effects of these novel acylhydrazone derivatives (7a-e) upon PAF-induced platelet aggregation, indicated that all compounds present a significant antithrombotic profile.

Design and synthesis of novel potent antinociceptive agents: methyl-imidazolyl N-acylhydrazone derivatives

This paper describes recent results of design, synthesis and pharmacological evaluation of new N-heterocyclic functionalized N-acylhydrazone compounds, belonging to the 2-methyl-imidazolyl-3-acylhydrazone class (4a-e). These compounds were planned by applying the molecular simplification strategy to propose the structural modifications on the previously described functionalized imidazo [1,2-a]pyridine 3-acylhydrazone series (2), which presented an important analgesic profile. This new series (4) was synthesized in order to investigate the possible pharmacophoric contribution of the N-heteroaromatic ring and N-acylhydrazone moieties to the analgesic activity. Compounds 4a-b are the most potent antinociceptive agents from this series.

Chiral gas chromatographic separation of 2-oxabicyclo[3.3.0]octane derivatives and their synthetic precursors

Chiral GC separation of (+/-)-2-allyl-2-carboethoxycyclopentanone (9) and the alcohols (+/-)-3-(hydroxymethyl)-5-carboethoxy-2-oxabicyclo[3.3.0]octane (7), (+/-)-2-allyl-2-carboethoxycyclopentanol (8), and their acetylated and trifluoroacetylated derivatives were investigated on three derivatized beta-cyclodextrins (CDs) diluted in SE-54 or 1701-OH: 2,3,6-tri-O-methyl-beta-CD (PMCD); 2,3-di-O-methyl-6-O-(tert-butyldimethylsilyl)-beta-CD (DIMETBCD); 2,3-di-O-acetyl-6-O-(tert-butyldimethylsilyl)-beta-CD (DIACTBCD). The understanding of these chiral separations is extremely relevant, since cyclopentanic and bicyclic cyclopentanic rings are common structural features of many important natural products and new pharmaceutical drugs. In general DIMETBCD diluted in SE-54 showed the best chiral resolution to alcohols 7 and 8 and only DIACTBCD showed enantioselectivity to 9. Hydrogen bonds prediction and dipole moments data were obtained by molecular modeling calculations for 7ab and 8ab and Ac and TFA derivatives. Comparison of these data with the chromatographic parameters for the related compounds were used to explain the differences of their elution orders and diastereo- and enantiomeric separations on the above chiral stationary phases (CSPs). The results suggest that the CSPs enantioselectivities are not affected by the carboethoxy-functionalized cyclopentanic and bicyclic cyclopentanic rings themselves but mainly by the functional group on the other stereogenic center.

Proposal of a new PAF pharmacophoric map by the AM1 method

PAF is a powerful phospholipid-derived autacoid involved in many pathophysiological processes. Many PAF antagonists have been synthesized and assayed for therapeutic purposes. We have synthesized derivatives (5-7), structurally related to WEB 2086 (1), which were rationally designed based on a planar PAF receptor model previously described by Bures et al. (1994; J. Chem. Inf. Comput. Sci. 24, 218-223). However, pharmacological studies revealed that derivatives (5-7) were inactive as PAF antagonists. AM1 quantum calculations of classical PAF antagonists (1-4), as well as of our derivatives (5-7), demonstrated that electronic features alone are unable to explain the lack of the activity of (5-7). These results induced us to propose a new tridimensional PAF receptor pharmacophoric map by analyzing all stable conformations obtained for derivatives (1-4). The interpoint distances (D1-D5) revealed that the lowest-energy conformers of (5-7) had similar geometries to derivatives (1-4). So, these aspects could not explain the inactivity of the compounds (6-7). The proposed model suggests that the best fit of antagonist compounds may involve the participation of a sulfur atom electron lone pair adequately oriented in relation to the plane of a N-aromatic ring present in the compounds investigated.

[Prevalence of iron deficiency anemia and risk indicators in children from 12 to 18 months attended at the outpatient clinic of Instituto de Puericultura e Pediatria Martagão Gesteira]

OBJECTIVES

The prevalence of iron deficiency anemia and the associated risk indicators were studied in children from 12 to 18 months at the outpatient unit of IPPMG, in order to evaluate and monitor the service.

METHODS

This is a cross-sectional descriptive study of 288 children seen at the outpatient unit of IPPMG, from January to December 1993. Anemia was diagnosed by dosage of seric hemoglobin. The studied risk indicators were: prenatal care, birth weight, pediatric follow-up, socio-economic aspects, breast-feeding pattern, nutritional status, and iron prescription. Data were computerized and analyzed by EPIINFO and EGRET softwares. Statistical analysis was performed by Pearson chi(2), and breast-feeding pattern was analyzed by the Kaplan-Meier survival curves.

RESULTS

Fifty percent of all children had anemia and 13.2% had severe anemia. Children had an early entry to follow-up at the clinic, and the number of consultations was adequate, according to the recommendations of the Ministry of Health. Only 27% of families had a "per capita" income above one minimum salary, although most had adequate housing and environmental conditions. The median duration of breast-feeding was 7.8 and of exclusive breast-feeding was 3.2 months. No association between anemia and income, early weaning, low-birth weight or undernutrition was found.

CONCLUSION

The prevalence of anemia was extremely high, indicating the need for a specific monitoring system for the occurrence of iron deficiency anemia in this service.

Reliability of the Portuguese version of the structured clinical interview for DSM-III-R (SCID) in a Brazilian sample of psychiatric outpatients

The objective of the present study was to determine the reliability of psychiatric diagnoses using a translation and adaptation of Portuguese of the "Structured Clinical Interview for DSM-III-R-patient version" (SCID-P) and the "Structured Clinical Interview for DSM-III-R Personality Disorders" (SCID-II), using the joint interviews methodology. Thirty-nine subjects were evaluated using the SCID-P and 20 of them using the SCID-II. Interrater reliability was analyzed statistically by means of the Kappa Coefficient. Agreement between results obtained with SCID-P was statistically significant for the major diagnostic categories of DSM-III-R and for 10 of the 12 specific diagnostic categories studied (a minimum of 4 subjects per diagnosis). Agreement was not statistically significant for Psychotic Disorder Not Otherwise Specified (NOS) and for Other Bipolar Disorder. The Weighted Kappa for the main diagnoses and the Overall Kappa for the entire set of 25 specific diagnostic categories proposed by the SCID-P were statistically significant. The general agreement for Personality Disorders with SCID-II was statistically significant. The Kappa Coefficient was determined for the Avoidant, Paranoid, Histrionic and Borderline Personality Disorders and for the Conduct Disorder. The remaining Personality Disorders were not analyzed statistically because of their low prevalence in the sample. Agreement was not significant only for the Histrionic Personality Disorder. These data suggest that the translation and adaptation of the SCID-P and SCID-II to Portuguese presents, in general, good reliability indices, and thus its use is recommended.

[The importance of the pediatrician in oral health care promotion]

The degree to which the pediatrician's knowledge might contribute to preventive dentistry is investigated. Questionnaires concerning aspects such as breastfeeding, diet, pacifier use, fluoride use, oral hygiene and the recommended moment for the first dental visit were sent to a random sample of 85 pediatricians in S. José dos Campos. Answers were received from 48 (56.4%) of them. Data showed that orientation about preventive dentistry was not a common procedure among the majority of the pediatricians, suggesting that better integration between physician and dentist is necessary if children are to grow up with better general and dental health.

The effect of training on the ability of children to use dental floss

The effect of training on the ability to use dental floss was evaluated in a study involving forty-eight children in the 6.5 to 7.5 age-group. Using a dental plaque index for the proximal surfaces, we observed significantly superior average results for the trained group (five weekly sessions) relative to the group with no training. We also observed a significant average difference favoring the male trained group relative to the female trained group.

Reliability, validity and factorial dimensions of the Interactive Observation Scale for Psychiatric Inpatients

The Interactive Observation Scale for Psychiatric Inpatients (IOSPI) is characterized by the necessity of interaction between the rater and the patient during the evaluation process. The reliability, validity and factor structure of the IOSPI were evaluated by using a total of 186 sets of ratings accomplished by 2 nursing aides on 34 adult psychiatric inpatients submitted to weekly evaluations during the 3 first weeks of hospitalization. The patients were observed by the 2 nursing aides simultaneously during the morning shift (5 h). In the afternoon of the same day, they were interviewed by two psychiatrists who filled in separately the Brief Psychiatric Rating Scale (BPRS). Factor analysis of the 16 IOSPI items revealed 5 distinct clusters of items, which represented higher-order constructs of social interest, psychomotor agitation, psychoticism, neatness and irritability. It was found that the IOSPI has significant interrater reliability, estimated by an intraclass correlation coefficient of total score and factor score. The total scores of the IOSPI showed a significant correlation with the total scores of the BPRS, meeting the criteria of concurrent validity. The criteria of predictive validity were also met, since the patients who could be discharged presented IOSPI scores significantly lower than the patients who could not be discharged. In conclusion, the IOSPI met the requirements of an evaluation scale and can stimulate therapeutic attitudes of the nursing staff by its characteristics of interactive observation.

The pedagogic training of graduate students at the Faculty of Medicine of Ribeirão Preto

In a discussion of the objectives of the Post-Graduate Course of the Faculty of Medicine of Ribeirão Preto, i.e., the training of future medical educators as teachers, the author describes the major effort of the School to achieve this objective during the last twenty years. Special emphasis is placed on the disciplines "Pedagogy in the Biomedical Area-Seminars I and II" which have presented persistent administrative difficulties. The author comments about the attitudes that seem to prevail in Brazilian Universities, which attribute a very high value to scientific productivity at the expense of teaching, and therefore represent an obstacle to achieving the objective in question. Some procedures that may result in changes in attitude towards medical education, with an improvement in the area, are also discussed.

[Simplified oral hygiene index for ages 4 to 6 and 7 to 10 (deciduous and mixed dentition)]

The purpose of this research is to obtain simplified index to evaluate oral hygiene in children. They are divided in two groups: 1) 4-6 years and; 2) 7-10 years. The criteria described by GREEN & VERMILLION, 1960 and 1964 were selected. Calculus was excluded. Once obtained the total data, a simplified of the total index was performed. For the ages 4 to 6 years, we selected labial surfaces of the 54, 61, 82 and the lingual surface of 75. For the mixed dentition we added the labial surface of 26 and the lingual surface of 46. In both dentition, simplified index showed significant correlation with the total index.

[Simplified caries index for ages 4 to 6 and 7 to 10 (deciduous and mixed dentition)]

The purpose of this research is to obtain a simplified caries index. Four hundred and twenty children, both sexes, 4 to 10 years of age were divided in two groups: 4-6 years and 7-10 years. For caries prevalence, on the deciduous dentition, we used a modified GR JEBBEL index and for permanente teeth, the criteria established by KLEIN et alii, 1938. Considering the cumulative effects of caries, in the mixed dentition, we considered the sum of dmfs and DMFS. A simplification of the total index was performed, for the ages 4 to 6 years considering the teeth 54, 61, 75, 82 and for mixed dentition we added the tooth 26 and 26. The results showed in both dentition, that simplified caries index showed significant correlation with the total index.

[Simplified gingival index for ages 4 to 6 and 7 to 10. (Deciduous and mixed dentition)]

The main purpose of this research is to obtain an simplified gingival index. Four hundred and twenty children, both sexes 4 to 10 years of age were selected. They are divided in two groups: 4-6 years and 7-10 years. For gingival index, the criteria based on SCHOUR & MASSLER, 1947, were used. To obtain the total data of the studied conditions, a simplification of the total index was performed. For the ages 4 to 6 years, we selected labial surfaces of the 54, 61, 75, 82. For the ages 7 to 10 years, we added the labial surfaces of 26 and 46. The means for the total and simplified index were obtained for each age group sex. The data were analysed by Pearson's correlation coefficient and linear regression. In both dentitions, the simplified index showed significant correlation with the total index.