Search

The German Hodgkin Study Group developed the escalated BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone) protocol as a treatment strategy for advanced-stage Hodgkin's lymphoma. In Brazil, as well as in other countries, procarbazine has been replaced with dacarbazine due to the limited availability of procarbazine. The Hematology Center at Irmandade da Santa Casa de Misericórdia in São Paulo adopted and modified the escalated BEACOPP protocol, substituting prednisone with dexamethasone and incorporating two different doses of dacarbazine: 375 mg/m 2 /day on Day 8 or the original dose of 250 mg/m 2 /day on Days 2 and 3. This adjustment was made in response to the anticipated toxicity profile. This study aimed to compare the two different doses in the protocols (375 mg/m 2 /cycle versus 500 mg/m 2 /cycle) administered to patients with advanced Hodgkin's lymphoma in similar periods. This retrospective study analyzed the data of 31 patients at a single center in Brazil from 2019 to 2021. Seventeen of the 31 patients received 500 mg/m 2 /cycle (500 Group), while 14 received 375 mg/m 2 /cycle (375 Group). At the end of the protocol, 71% of the patients in the 375 Group and 76% in the 500 Group achieved complete remission. On analyzing the number of cycles that patients presented with febrile neutropenia, the 500 Group had three times more events (17.9%) than the 375 Group (6.09% - p-value = 0.04). In the 500 Group, 47.1% needed to change the protocol to ABVD (doxorubicin hydrochloride, bleomycin sulfate, vinblastine sulfate, and dacarbazine) due to toxicity. In this limited cohort from a single public center in Brazil, the use of 375 mg/m 2 of dacarbazine per cycle of the modified escalated BEACOPP protocol emerged as a safer strategy, maintaining treatment efficacy without compromising response in patients with advanced Hodgkin's lymphoma., Competing Interests: Conflicts of interest The authors declare no conflicts of interest, (Copyright © 2024 Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular. Published by Elsevier España, S.L.U. All rights reserved.)

Purpose: Limited high-quality studies have compared robot-assisted laparoscopic prostatectomy (RALP) vs open retropubic radical prostatectomy. We sought to compare their postoperative outcomes in a randomized setting., Materials and Methods: In a single center, 354 men with newly diagnosed prostate cancer were assessed for eligibility; 342 were randomized (1:1). The primary outcome was 90-day complication rates. Functional outcomes and quality of life were assessed over 18 months, and oncological outcomes, biochemical recurrence-free survival, and additional treatment over 36 months., Results: From 2014 to 18, 327 patients underwent surgery (retropubic radical prostatectomy = 156, RALP = 171). Complications occurred in 27 (17.3%) vs 19 (11.1%; P = .107). Patients undergoing RALP experienced lower median bleeding (250.0 vs 719.5 mL; P < .001) and shorter hospitalization time. Urinary EPIC (Expanded Prostate Cancer Index Composite) median scores were better for RALP over 18 months, with higher continence rate at 3 months (80.5% vs 64.7%; P = .002), 6 months (90.1% vs 81.6%; P = .036) and 18 months (95.4% vs 78.8%; P < .001). Sexual EPIC and Sexual Health Inventory for Men median scores were higher with RALP up to 12 months, while the potency rate was superior at 3 months (23.9% vs 5.3%; P = .001) and 6 months (30.6% vs 6.9%; P < .001). Quality of life over the 18 months and oncological outcomes over 36 months were not significantly different between arms., Conclusions: Complications at 90 days were similar. RALP showed superior sexual outcomes at 1 year, improved urinary outcomes at 18 months, and comparable oncological outcomes at 36 months., Trial Registration: Prospective Analysis of Robot-Assisted Surgery; NCT02292914. https://clinicaltrials.gov/ct2/show/NCT02292914?cond=NCT02292914&draw=2&rank=1.

Introduction: While general conclusions of historical trials are widely recognized, the nuances regarding precise indications of Sentinel Node Biopsy (SNB) in breast cancer in complex clinical scenarios often remain a source of debate and require further elucidation., Methods: Two reviewers (JFB and GNM) independently searched electronic databases for studies including SNB as the main intervention. Filters were applied to retrieve only clinical trials (randomized or experimental non-randomized); non-oncological outcomes were excluded. The selected studies were considered to construct a narrative review focused on inclusion criteria and survival outcomes, followed by recommendations., Results: Fourteen (n = 14) trials were selected, including eleven (n = 11) randomized trials for upfront surgery, and three (n = 3) single-group clinical trials for surgery following neoadjuvant therapy. All trials for upfront surgery provided long-term survival data for SNB, that was equivalent or non-inferior to axillary dissection, in tumors without palpable adenopathy (caution for larger T3 and T4 tumors) - Grade of recommendation: A. In tumors up to 5 cm, complete axillary dissection is not necessary if up to two sentinel nodes are positive for macrometastasis, and radiation therapy is planned - Grade of recommendation: A. If there are more than two sentinel nodes positive for macrometastasis, or a positive node other than the sentinel one, complete axillary dissection is recommended - Grade of recommendation: A. Following neoadjuvant chemotherapy, considering 10% as an acceptable false negative rate, SNB might be offered for cN0 patients who have remained negative, and for cN1 (caution for cN2) patients become clinically negative; complete axillary dissection might not be necessary if at least two sentinel lymph nodes are retrieved, and there is no residual disease - Grade of recommendation: B., Conclusion: SNB can be performed in most cases of clinically negative nodes. After neoadjuvant chemotherapy, SNB is feasible and may have acceptable performance for cN0 and cN1 tumors, although prospective survival data is still awaited., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

The use of techniques based on artificial intelligence and machine learning for the simulation of many processes is becoming increasingly important in environmental sciences, with applications in the study of time series of atmospheric properties, such as pollution levels. The present work aimed to evaluate the efficiency of a model based on Artificial Neural Networks (ANN) in the simulation PM 10 from meteorological data observed between 2018 and 2019 in Guaíba, southern Brazil, thus also having an estimate of the influence of atmospheric conditions on local air pollution. For this purpose, meteorological and PM 10 data obtained from the stations Parque 35, sustained by Celulose Riograndense (CMPC), and A-801, sustained by the National Institute of Meteorology (INMET), were used. The ANN used for the simulation was of the Multilayer Perceptron type, trained by the backpropagation algorithm with cross-validation. The results obtained indicate that the simulation was satisfactory with a Nash-Sutcliffe index (NSE) of 0.64, a linear correlation coefficient (R) of 0.81, a relative error (Er) of 26% and a root mean square error (RMSE) of 7.40 µg/m 3 . Thus, even with some difficulty in estimating extreme concentrations, the model was suitable for the largest range observed, of 10 µg/m 3 to 50 µg/m 3 . For this dataset, the model proved to be an useful assessment tool and has the potential to be applied operationally to contribute to the monitoring and control of air quality levels both in the study area and in other regions of Brazil and the world., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Despite the considerable morbidity and mortality of yellow fever virus (YFV) infections in Brazil, our understanding of disease outbreaks is hampered by limited viral genomic data. Here, through a combination of phylogenetic and epidemiological models, we reconstructed the recent transmission history of YFV within different epidemic seasons in Brazil. A suitability index based on the highly domesticated Aedes aegypti was able to capture the seasonality of reported human infections. Spatial modeling revealed spatial hotspots with both past reporting and low vaccination coverage, which coincided with many of the largest urban centers in the Southeast. Phylodynamic analysis unraveled the circulation of three distinct lineages and provided proof of the directionality of a known spatial corridor that connects the endemic North with the extra-Amazonian basin. This study illustrates that genomics linked with eco-epidemiology can provide new insights into the landscape of YFV transmission, augmenting traditional approaches to infectious disease surveillance and control.

Sentinel lymph node biopsy (SLNB) at upfront surgery is the gold-standard surgical method for axillary lymph node staging in early stage breast cancer: the technique provides adequate information regarding axillary status, with similar oncological safety and lower morbidity compared to axillary dissection, despite the false negative rates. Neoadjuvant chemotherapy (NACT), traditionally used for locally advanced breast cancer, plays an important role in the treatment of early stage breast cancer, making downstaging possible in axillary lymph node and breast cancer, thus minimizing the impact of surgery and reducing morbidity, as well as enabling patients with residual disease to be selected for adjuvant treatment. In this respect, the role of SLNB has proved controversial, particularly in view of the lack of data from randomized clinical trials on this subject. Currently, the de-escalation of axillary surgery after NACT is mainly based on retrospectives studies and false negative rates. This paper reviews current evidence on the management of axillary surgery following NACT under different circumstances, with suggested recommendations in each scenario: clinically negative nodes at diagnosis and SLNB after NACT, clinically positive nodes at diagnosis and SLNB after NACT, positive SLNB following NACT and finally the possibility of omitting axillary surgery in good responders.

Purpose: The aim of this article is to do a comprehensive literature review about the current understandings of the pachychoroid disease spectrum, describing its multimodal imaging analysis, pathophysiology, differential diagnosis, and current types of management., Methods: This comprehensive literature review was performed based on a search on the PubMed database, of relevant pachychoroid published papers according to our current knowledge., Discussion: The pachychoroid disease spectrum, according to some authors, includes the following: pachychoroid pigment epitheliopathy (PPE), central serous chorioretinopathy (CSC), pachychoroid neovasculopathy (PNV), polypoidal choroidal vasculopathy (PCV)/aneurysmal type 1 neovascularization (AT1), and more recently focal choroidal excavation (FCE) and peripapillary pachychoroid syndrome (PPS). Each one of these entities will be described and discussed in this article., Conclusion: Significant advances in multimodal imaging have enabled a better understanding of the typical choroidal changes in pachychoroid disease spectrum. The clinical knowledge and managing options about this disease significantly increased in the last years. However, it is still unclear why some eyes with typical pachychoroid disease phenotype show no evidence of RPE damage and subretinal fluid (uncomplicated pachychoroid) while others present progressive tissue damage, neovascularization, and atrophy., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Diverticulitis is an acute inflammatory process that affects individuals with diverticular disease. Given the sharp increase in the diagnostic rate of such a pathological process, there was also an increased interest in elucidating the possible causes related to the development of this clinical condition. Among the main factors investigated, diet excels, the object of study of this integrative literature review., Methods: After searching the virtual health library and PubMed databases, five prospective cohort studies were selected that best answered the guiding question: "Is there a relationship between diet and the incidence of diverticulitis?"., Results: It was observed that the high intake of red meat and the low intake of dietary fiber were the most strongly associated dietary factors with the incidence of this inflammatory process., Conclusion: Therefore, it is evident that choosing healthy eating habits can considerably reduce the incidence of diverticulitis and, consequently, potentially more serious complications directly related to it.

Prenatal and early postnatal periods are important for brain development and neural function. Neonatal insults such as hypoxia-ischemia (HI) causes prolonged neural and metabolic dysregulation, affecting central nervous system maturation. There is evidence that brain hypometabolism could increase the risk of adult-onset neurodegenerative diseases. However, the impact of non-pharmacologic strategies to attenuate HI-induced brain glucose dysfunction is still underexplored. This study investigated the long-term effects of early environmental enrichment in metabolic, cell, and functional responses after neonatal HI. Thereby, male Wistar rats were divided according to surgical procedure, sham, and HI (performed at postnatal day 3), and the allocation to standard (SC) or enriched condition (EC) during gestation and lactation periods. In-vivo cerebral metabolism was assessed by means of [ 18 F]-FDG micro-positron emission tomography, and cognitive, biochemical, and histological analyses were performed in adulthood. Our findings reveal that HI causes a reduction in glucose metabolism and glucose transporter levels as well as hyposynchronicity in metabolic brain networks. However, EC during prenatal or early postnatal period attenuated these metabolic disturbances. A positive correlation was observed between [ 18 F]-FDG values and volume ratios in adulthood, indicating that preserved tissue by EC is metabolically active. EC promotes better cognitive scores, as well as down-regulation of amyloid precursor protein in the parietal cortex and hippocampus of HI animals. Furthermore, growth-associated protein 43 was up-regulated in the cortex of EC animals. Altogether, results presented support that EC during gestation and lactation period can reduce HI-induced impairments that may contribute to functional decline and progressive late neurodegeneration., (© 2020 International Society for Neurochemistry.)

The relationship between hydrometeorological disasters and the health of affected populations is still hardly discussed in Rio Grande do Sul (RS), Brazil. Hepatitis A is a disease that involves health and urban environment issue and is an avoidable disease. This study aims to analyze the relationship between flood areas and waterborne diseases, in this case, Hepatitis A. A database of confirmed cases of Hepatitis A and flood events in the municipality of Encantado-RS, Brazil between 2012 and 2014 was structured. These data were analyzed spatially from the kernel estimator of the occurrence points of Hepatitis A cases and correlated to the urban perimeter. It was verified that 44 cases were registered in the three months following the occurrence of flood, an increase of almost 300% in the records of Hepatitis A. The results identified that all the confirmed cases are in the urban area located in the floodplain. This reaffirms the importance of encouraging the formulation and implementation of policies to prevent outbreaks of waterborne diseases post hydrometeorological disaster.

Purpose: The COVID-19 pandemic has impacted early breast cancer (EBC) treatment worldwide. This study analyzed how Brazilian breast specialists are managing EBC., Methods: An electronic survey was conducted with members of the Brazilian Society of Breast Cancer Specialists (SBM) between April 30 and May 11, 2020. Bivariate analysis was used to describe changes in how specialists managed EBC at the beginning and during the pandemic, according to breast cancer subtype and oncoplastic surgery., Results: The response rate was 34.4% (503/1462 specialists). Most of the respondents (324; 64.4%) lived in a state capital city, were board-certified as breast specialists (395; 78.5%) and either worked in an academic institute or one associated with breast cancer treatment (390; 77.5%). The best response rate was from the southeast of the country (240; 47.7%) followed by the northeast (128; 25.4%). At the beginning of the pandemic, 43% changed their management approach. As the outbreak progressed, this proportion increased to 69.8% (p < 0.001). The southeast of the country (p = 0.005) and the state capital cities (p < 0.001) were associated with changes at the beginning of the pandemic, while being female (p = 0.001) was associated with changes during the pandemic. For hormone receptor-positive tumors with the best prognosis (Ki-67 < 20%), 47.9% and 17.7% of specialists would recommend neoadjuvant endocrine therapy for postmenopausal and premenopausal women, respectively. For tumors with poorer prognosis (Ki-67 > 30%), 34% and 10.9% would recommend it for postmenopausal and premenopausal women, respectively. Menopausal status significantly affected whether the specialists changed their approach (p < 0.00001). For tumors ≥ 1.0 cm, 42.9% of respondents would recommend neoadjuvant systemic therapy for triple-negative tumors and 39.6% for HER2 + tumors. Overall, 63.4% would recommend immediate total breast reconstruction, while only 3.4% would recommend autologous reconstruction. In breast-conserving surgery, 75% would recommend partial breast reconstruction; however, 54.1% would contraindicate mammoplasty. Furthermore, 84.9% of respondents would not recommend prophylactic mastectomy in cases of BRCA mutation., Conclusions: Important changes occurred in EBC treatment, particularly for hormone receptor-positive tumors, as the outbreak progressed in each region. Systematic monitoring could assure appropriate breast cancer treatment, mitigating the impact of the pandemic.

Purpose: To report two cases of coexisting keratoconus and Fuchs endothelial dystrophy treated with intrastromal corneal ring segments (ICRS) implantation and Descemet membrane endothelial keratoplasty (DMEK)., Methods: Two patients with coexisting keratoconus and Fuchs endothelial dystrophy underwent ICRS implantation and DMEK, in a two-stage procedure. Follow-up evaluation included Scheimpflug tomography and optical coherence tomography., Results: In both cases, ICRS implantation improved corneal topography and DMEK restored normal corneal thickness. Corrected distance visual acuity improved from 20/100 to 20/30 and from 20/60 to 20/25. Urrets-Zavalía syndrome was diagnosed in one case and addressed with colored contact lens fitting., Conclusions: Low vision resulting from coexisting keratoconus and Fuchs endothelial dystrophy might be addressed more selectively with posterior lamellar keratoplasty and ICRS implantation. Urrets-Zavalía syndrome must be considered a possible complication after DMEK, especially in patients with keratoconus. [J Refract Surg. 2020;36(10):703-706.]., (Copyright 2020, SLACK Incorporated.)

The present paper reports on the local treatment of breast cancer from a historical perspective. A search for articles written in English was made in the Medline and EMBASE databases, and 40 papers were selected. Over the past 10 years, various randomized, controlled clinical trials on the local treatment of breast cancer indicated that patients with the same molecular subtype may receive different individualized surgical treatments aimed at optimizing systemic adjuvant therapy. With a view to retaining the gains made in disease-free and overall survival, surgical techniques have advanced from radical surgery to conservative mastectomies, thus reducing sequelae, while adjuvant and neoadjuvant therapies have contributed toward controlling the disease, both distant metastases and local recurrence. Current studies evaluate whether future breast cancer therapy may even succeed in eliminating surgery to the breast and axilla altogether., Competing Interests: Cavalcante F. P. has received honoraria as a member of the scientific advisory boards of Roche and Pfizer and has been an invited speaker at scientific meetings for Roche, Pfizer, and Gencell Pharma. Millen E. C. has been an invited speaker for Roche, Gencell Pharma, and Bard. Zerwes F. P. has been an invited speaker for Roche and Gencell Pharma. Novita G. G. has been an invited speaker for Roche., (Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil.)

Background and Purpose: Hypoxia and cerebral ischemia (HI) events are capable of triggering important changes in brain metabolism, including glucose metabolism abnormalities, which may be related to the severity of the insult. Using positron emission microtomography (microPET) with [ 18 F]fluorodeoxyglucose ( 18 F-FDG), this study proposes to assess abnormalities of brain glucose metabolism in adult rats previously submitted to the neonatal HI model. We hypothesize that cerebral metabolic outcomes will be associated with cognitive deficits and magnitude of brain injury., Methods: Seven-day-old rats were subjected to an HI model, induced by permanent occlusion of the right common carotid artery and systemic hypoxia. 18 F-FDG-microPET was used to assess regional and whole brain glucose metabolism in rats at 60 postnatal days (PND 60). An interregional cross-correlation matrix was utilized to construct metabolic brain networks (MBN). Rats were also subjected to the Morris Water Maze (MWM) to evaluate spatial memory and their brains were processed for volumetric evaluation., Results: Brain glucose metabolism changes were observed in adult rats after neonatal HI insult, limited to the right brain hemisphere. However, not all HI animals exhibited significant cerebral hypometabolism. Hippocampal glucose metabolism was used to stratify HI animals into HI hypometabolic (HI-h) and HI non-hypometabolic (HI non-h) groups. The HI-h group had drastic MBN disturbance, cognitive deficit, and brain tissue loss, concomitantly. Conversely, HI non-h rats had normal brain glucose metabolism and brain tissue preserved, but also presented MBN changes and spatial memory impairment. Furthermore, data showed that brain glucose metabolism correlated with cognitive deficits and brain volume outcomes., Conclusions: Our findings demonstrated that long-term changes in MBN drive memory impairments in adult rats subjected to neonatal hypoxic ischemia, using in vivo imaging microPET-FDG. The MBN analyses identified glucose metabolism abnormalities in HI non-h animals, which were not detected by conventional 18 F-FDG standardized uptake value (SUVr) measurements. These animals exhibited a metabolic brain signature that may explain the cognitive deficit even with no identifiable brain damage., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Landslide susceptibility maps can be developed with artificial neural networks (ANNs). In order to train our ANNs, a digital elevation model (DEM) and a scar map of one previous event were used. Eleven attributes are generated, possibly containing redundant information. Our base model is formed by, essentially, one input (the DEM), eleven attributes, 30 neurons, and one output (susceptibility). Principal components (PCs) group information in the first projected variables, the last ones can be expendable. In the present paper, four groups of models were trained: one with eleven attributes generated from the DEM; one with 8 out of 11 attributes, in which 3 were eliminated by their high correlation with others; other, with the data projected over its PCs; and another, using 8 out of 11 PCs. The used number of neurons in hidden layer is 30, calibrated based on a complexity analysis that is an in-house developed method. The ANN models trained with the original data generated better statistical results than their counterparts trained with the PC transformed input. Keeping the original 11 attributes calculated provided the best metrics among all models, showing that eliminating attributes also eliminates information used by the model. Using 11 PC transformed attributes hindered trained. However, for the model with eight PCs, training was much faster than its counterpart with little accuracy loss. The metrics and maps achieved were considered acceptable, conveying the power of our model based on ANNs, which uses essentially one input (the DEM) for mapping areas susceptible to mass movements.

Introduction: Appendicitis is an acute inflammatory process. The purpose of this report is to describe an unusual case of acute appendicitis in adult caused by accidental ingestion of a needle, and treated with appendectomy., Presentation of Case: A 64 year-old white woman, seamstress, was admitted with abdominal pain complaints. Plain radiograph and CT scan showed metal density suggesting a foreign body in the lower right abdomen. A diagnostic laparoscopic procedure identified a perforated appendicitis due to a needle perforation. Laparoscopic appendicectomy and foreign body removal were performed., Discussion: Acute appendicitis due foreign body ingestion is extremely rare. Laparoscopy was the chosen access once it was more suitable for inventory of the gastrointestinal tract and help avoiding harm of the medical team during hand maneuvers of open access surgery., Conclusion: Foreign body ingestion should be remembered as an unusual differential diagnosis of acute appendicitis., (Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Brazil has experienced several arbovirus outbreaks in recent years, among which yellow fever stands out. The state of Minas Gerais faced outbreaks of sylvatic yellow fever in 2017 and 2018, with 1002 confirmed cases and 340 deaths. This work presents the results of survey efforts to detect the yellow fever virus in mosquitoes from two conservation areas in the metropolitan region of Belo Horizonte, Brazil. A total of 867 mosquitoes of 20 species were collected between September 2017 and May 2018, the most abundant being Psorophora ( Janthinosoma ) ferox (von Humboldt, 1819) (31.3%), Limatus durhamii Theobald, 1901 (19.1%) and Haemagogus ( Haemagogus ) janthinomys Dyar, 1921 (18.2%). Total RNA was extracted from the mosquitoes for real-time PCR analysis for yellow fever, chikungunya, mayaro, Zika and dengue viruses. The yellow fever infection rate was 8.2% for Hg. janthinomys (13 mosquitoes), which is the main vector of sylvatic yellow fever in Brazil. In addition to surveying the mosquito fauna of these conservation units, this work demonstrates the importance of monitoring the circulation of viruses near large urban centers.

Introduction: Progenitor cells cultured on biomaterials with optimal physical-topographical properties respond with alignment and differentiation. Stromal cells from connective tissue can adversely differentiate to profibrotic myofibroblasts or favorably to smooth muscle cells (SMC). We hypothesized that myogenic differentiation of adipose tissue-derived stromal cells (ASC) depends on gradient directional topographic features., Methods: Polydimethylsiloxane (PDMS) samples with nanometer and micrometer directional topography gradients (wavelength ( w ) = 464-10, 990 nm; amplitude ( a ) = 49-3, 425 nm) were fabricated. ASC were cultured on patterned PDMS and stimulated with TGF- β 1 to induce myogenic differentiation. Cellular alignment and adhesion were assessed by immunofluorescence microscopy after 24 h. After seven days, myogenic differentiation was examined by immunofluorescence microscopy, gene expression, and immunoblotting., Results: Cell alignment occurred on topographies larger than w = 1758 nm/ a = 630 nm. The number and total area of focal adhesions per cell were reduced on topographies from w = 562 nm/ a = 96 nm to w = 3919 nm/ a = 1430 nm. Focal adhesion alignment was increased on topographies larger than w = 731 nm/ a = 146 nm. Less myogenic differentiation of ASC occurred on topographies smaller than w = 784 nm/ a = 209 nm., Conclusion: ASC adherence, alignment, and differentiation are directed by topographical cues. Our evidence highlights a minimal topographic environment required to facilitate the development of aligned and differentiated cell layers from ASC. These data suggest that nanotopography may be a novel tool for inhibiting fibrosis.

Purpose: To evaluate the role of maintenance of the ileocecal valve (ICV) in intestinal adaptation mechanisms, in a weaning rat experimental model of short bowel., Methods: Forty animals were operated on to produce short bowel syndrome. They were divided into five groups: maintenance (MV) or resection of ICV (RV), kill after 4 days (MV4 and RV4) or 21 days (MV21 and RV21), and a control group (21-day-old rats). Body weights, small bowel and colon lengths and diameters, villus heights, crypt depths, lamina propria and muscle layer thickness, as well as the apoptosis index of villi and crypts and expression of pro- and anti-apoptotic genes, were studied., Results: Preservation of the ICV promoted increased weight gain (p = 0.0001) and intestinal villus height after 21 days; crypt depth was higher in comparison to controls. It was verified a higher expression of Ki-67 in bowel villi and crypts (p = 0.018 and p = 0.015, respectively) in RV4 group and a higher expression in bowel villi of MV4 group animals (p = 0.03). The maintenance of ICV promoted late increased expression of the anti-apoptotic gene Bcl-XL in the colon (p = 0.043, p = 0.002, p = 0.01)., Conclusion: The maintenance of the ICV led to positive changes in this model.

Objectives: The purpose of this study was to present an experimental model of short bowel syndrome (SBS) in weaning rats and to compare the adaptative mechanisms of the remaining bowel in weaning rats and adult animals by means of morphometric, histologic and molecular methods., Methods: Twenty-four weaning rats were divided into 3 groups of 8 animals, one control group and two short bowel groups (euthanasia after 4 and 21 days), and were compared with similar adult groups. Morphometric evaluations of the animals and histopathological and molecular studies of the remaining bowel were performed., Results: The weight of young rats increased after enterectomy, whereas that of adult rats decreased after enterectomy (p<0.0001). The ratio of intestinal length/body weight was significantly higher in weaning rats than in adults (p<0.002), showing that intestinal growth was more intense in weaning rats. Intestinal resection promoted increased thickness of the small bowel lamina propria (p=0.001) and reduced thickness of the colon lamina propria (p=0.04) in weaning rats relative to those in adults. In addition, intestinal resection promoted increased expression of the Bcl-xl gene (antiapoptotic) in adult animals compared with that in weaning rats (p=0.001)., Conclusion: Morphometric, histological and molecular differences were shown in the adaptation processes of growing and mature organisms.

Magnetic molecularly imprinted polymers (MMIPs) have become a research hotspot due to their two important characteristics: target recognition and magnetic separation. This paper presents the preparation, characterization, and optimization of an MMIP for the preconcentration of disperse red 73 dye (DR73) and its subsequent efficient degradation by photoelectrocatalytic treatment. The MMIPs were characterized by scanning electron microscopy (SEM), which revealed homogeneous distribution of the particles. Excellent encapsulation of magnetite was confirmed by transmission electron microscopy (TEM). A study of dye binding showed that the dye was retained more selectively in the MIP, compared to the NIP. The release of DR73 from the imprinted polymers into methanol and acetic acid was analyzed by UV-Vis spectrophotometry. The extracts showed higher absorbance values for MMIP, compared to MNIP, confirming greater adsorption of dye in the MMIP material. The extracts were then subjected to photoelectrocatalytic treatment. LC-MS/MS analysis following this treatment showed that the dye was almost completely degraded. Hence, the combination of MMIP extraction and photoelectrocatalysis offers an alternative way of selectively removing an organic contaminant, prior to proceeding with its complete degradation.

Context: The treatment of edema after a knee injury is usually 1 of the main objectives during rehabilitation. To assess the success of treatment, 2 methods are commonly used in clinical practice: volumetry and perimetry., Objective: To investigate the intra- and interassessor reliability of volumetry and perimetry to assess knee volume., Design: Cross-sectional., Setting: Laboratory., Participants: 45 healthy participants (26 women) with mean age of 22.4 ± 2.8 y., Main Outcome Measures: Knee volume was assessed by 3 assessors (A, B, and C) with 3 methods (lower-limb volumetry [LLV], knee volumetry [KV], and knee perimetry [KP]). Assessor A was the most-experienced assessor, and assessor C, the least experienced. LLV and KV were performed with participants in the orthostatic position, while KP was performed with participants in supine., Results: For the interassessor analysis, the ICC2,1 was high (.82) for KV and very high for LLV (.99) and KP (.99). For the intra-assessor analysis, ICC2,1 ranged from moderate to high for KV (.69-.83) and was very high for LLV (.99) and KP (.97-.99)., Conclusion: KV, LLV, and KP are reliable methods, both intra- and interassessor, to measure knee volume.

Treatment of real effluents from industries using AOPs stands to be an imperative task of crucial importance yet quite huge a challenge largely given the nature of complexity of these wastewaters. The present work sought to develop a versatile system aimed at the treatment of real wastewater using a bubbling annular reactor, which enables us to test the efficiency of photolysis; photocatalysis, photoelectrocatalysis and direct ozonation using oxygen or ozone as gas flow. A TiO2 nanotubes electrode was used as photocatalyst in photocatalytic and photoelectrocatalytic measurements with and without coupling with ozonation under pH 3.0 and pH 8.0 leading to 50% of color removal after 60 min reaction. However, the results indicated 90% of color removal upon the bubbling of ozone after 15 min of treatment. A synergistic effect was observed in all experiments using the AOPs in the presence of ozone under both pH values. Interestingly though, 85% of decolorization was obtained through direct ozonation without any change in the effluent following 10 min of treatment. The results were discussed in terms of electric energy per order and were compared to those reported previously. For real textile wastewater, ozonation appears to be a promising candidate for full-scale effluent decolorization., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Objective: To assess quality of life before and after thoracoscopic sympathectomy for treatment of primary hyperhidrosis., Methods: we conducted an observational, analytical, cross-sectional and quantitative study. We evaluated patients undergoing thoracoscopic sympathectomy for primary axillary hyperhidrosis, primary palmar hyperhidrosis, and axillary hyperhidrosis associated with palmar one. We applied a questionnaire on quality of life related to hyperhidrosis before and after the operation., Results: The questionnaire was administered to 51 patients with a mean age of 32.4 years, 45 women and six men. The average quality of life related to hyperhidrosis in a score of 0-100 before sympathectomy was 34.6 and after the operation it was 77.1. Compensatory hyperhidrosis occurred in 84.3% of patients., Conclusion: thoracoscopic sympathectomy improves the quality of life of patients with primary hyperhidrosis, with results supported over time. Compensatory hyperhidrosis occurred in most patients, but did not significantly influence the improved quality of life.

This paper presents a method for measuring gingival volume through the analysis of the tooth crown area of anterior teeth using digital photographs and computer analysis. Three photographs were taken and manipulated to simulate gingival overgrowth to perform a numeric correlation of change in gingival volume. The proposed method is easy, noninvasive, and provides rich data for statistical analysis or clinical classification of the gingival condition.

The putative phosphoporin encoded by vca1008 of Vibrio cholerae O1 is expressed in vivo during infection and is essential for the intestinal colonization of infant mice. In vitro, its expression is induced under inorganic phosphate (P(i)) limitation in a PhoB/R-dependent manner. In this work we demonstrated that VCA1008 has a strain-specific role in the physiology and pathogenicity of V. cholerae O1. Disruption of vca1008 led to a growth defect, an inability to colonize and a high susceptibility to sodium deoxycholate (DOC; the major bile compound) in the El Tor biotype strain N16961, but did not affect the classical strain O395 in the same way. Furthermore, vca1008 promoter activity was higher in N16961 cells grown under a low P(i) supply in the presence of DOC than in the absence of the detergent. In the P(i)-limited cells, vca1008 was positively regulated by PhoB, but when DOC was added to the medium, it negatively affected the PhoB-mediated activation of the gene, and enhanced vca1008 expression in a ToxR-dependent manner. These findings reveal for the first time a complex strain-specific interplay between ToxR and PhoB/R systems to control porin genes, as well as the influence of DOC on the expression of PhoB- and ToxR-regulated genes and pathogenesis in pandemic strains of V. cholerae.