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IntroductionFoot-and-mouth disease (FMD) affects multiple food-animal species and spreads rapidly among ungulate populations, posing significant challenges for disease control. Understanding the dynamics of FMD transmission and evaluating the effectiveness of control measures are critical for mitigating its impact. This study introduces a multiscale compartmental stochastic model to simulate FMD spread and assess countermeasures.MethodsWe developed a model that integrates population dynamics, including births, deaths, and species-specific transmission dynamics, at both the between-farm and within-farm levels. Four scenarios were created to evaluate different control strategies: the base scenario included vaccinating 20 farms and depopulating four infected farms, while alternative scenarios increased vaccination and depopulation capacities or omitted vaccination altogether.ResultsOur simulations showed that bovines were the most frequently infected species, followed by swine and small ruminants. After 10 days of initial spread, the number of infected farms ranged from 1 to 123, with 90.12% of simulations resulting in fewer than 50 infected farms. Most secondary spread occurred within a 25 km radius. An early response to control actions significantly reduced the time spent managing outbreaks, and increasing daily depopulation and vaccination capacities further enhanced control efforts.DiscussionEmergency vaccination effectively reduced the magnitude and duration of outbreaks, while increasing depopulation without vaccination also eliminated outbreaks. These findings highlight the importance of rapid response and capacity scaling in controlling FMD outbreaks, providing valuable insights for future decision-making processes in disease management.

OBJECTIVE: To carry out a systematic review of the literature on physical therapy interventions and their effect on frail community-dwelling elders. METHODS: Systematic review of studies published until June 2008 in the databases Medline, Embase, PEDro, SciELO, LILACS and Cochrane Library. We excluded studies with samples composed of institutionalized, hospitalized and non-frail participants, studies not aimed at treating frailty, and studies that were not specifically related to physical therapy. RESULTS: In accordance with the exclusion criteria, out of the 152 Medline articles, only 15 were considered for analysis, out of the 71 PEDro articles only one was considered as the other ten had already been selected in Medline, and out of the 461 Embase articles only two that had not been selected in others databases were included in this study. A total of seven different types of interventions were verified: 1) muscle strengthening; 2) exercises for muscle strengthening, balance, coordination, flexibility, reaction time and aerobic training; 3) functional training; 4) physical therapy; 5) at-home physical therapy; 6) environment adaptation and prescription of assistive device; 7) water exercise. The results of some studies were contradictory even with similar interventions. The analyzed studies had different definitions for fragility, which made it difficult to compare the results. CONCLUSION: There is little evidence of the effect of physical therapy intervention on frail community-dwelling elders; thus, it is not possible to reach a consensus or conclusion on the effectiveness of the therapeutic regimens proposed for this complex syndrome. [ABSTRACT FROM AUTHOR]

In spite of the efficiency increasing in the access to patient information, electronic healthcare systems are rejected by the clinicians, because the dynamic characteristics of their activities are not adequately addressed by these systems. This paper presents the architecture of a pervasive healthcare system called pEHS, which uses concepts and technologies of ubiquitous computing to approach the computational systems to the way how the clinician conducts its activities. The requirements of pEHS are: adapted to the activities of medical professionals, personalization through composition/programming tasks, context awareness and pervasive access to the patient's health history.

A educação médica deve privilegiar temas prevalentes; os transtornos relacionados ao álcool são um deles. Nosso objetivo foi determinar a freqüência dos transtornos relacionados ao consumo do álcool e verificar se um mesmo paciente apresentou mais de um transtorno, contribuindo para educação sociocêntrica. Foi estudo retrospectivo transversal em que foram analisadas as fichas de atendimento com relato de consumo de álcool, em pronto socorro, no ano 2000 (1901 casos). Os efeitos diretos do álcool foram encontrados em 80,38% dos pacientes, traumas em 28,56%, distúrbios gastrointestinais e/ou metabólicos em 27%, infecções em 6,42% e distúrbios carenciais em 5,94%. Constatou-se apenas um diagnóstico em 46,6% dos casos, e mais de um em 48,67%. Os transtornos mais freqüentes foram: intoxicação, abstinência, gastrite, cirrose, desidratação, hiper ou hipoglicemia e trauma. Os transtornos relacionados ao álcool são freqüentes e comumente associados; isso faz do consumo de álcool importante tema num programa de educação médica.

O objetivo deste trabalho foi estimar as herdabilidades e as correlações genéticas do peso (P12) e do perímetro escrotal (PE12) de machos aos 12 meses de idade, da idade de descarte (TPR, tempo de permanência no rebanho) de fêmeas e do número (ND10) e de quilogramas (QD10) de bezerros desmamados pelas fêmeas em até dez anos de idade, em um rebanho da raça Canchim. Foram utilizadas 1.370, 826, 826, 2.726 e 1.051 observações de TPR, ND10, QD10, P12 e PE12, respectivamente. As estimativas dos componentes de (co)variância foram obtidas pelo método bayesiano, para todas as características em questão, P12, PE12, TPR, ND10 e QD10. O modelo estatístico incluiu, além dos efeitos aleatórios genético aditivo direto e residual, os efeitos fixos de ano de nascimento do animal para todas as características, de mês de nascimento para P12 e PE12 e da covariável idade do animal para PE12. As estimativas de herdabilidade, obtidas pelas análises unicaráter foram iguais a 0,38; 0,52; 0,24; 0,33 e 0,34 para P12, PE12, TPR, ND10 e QD10, respectivamente, indicando que as características possuem variação genética aditiva suficiente para apresentar boa resposta à seleção. As correlações genéticas de TPR (0,33 e 0,33, respectivamente), ND10 (0,38 e 0,30, respectivamente) e QD10 (0,61 e 0,41, respectivamente) com P12 e PE12, obtidas pelas análises bicaráter, sugerem que a seleção com base no peso e no perímetro escrotal dos machos não deve resultar em decréscimo no tempo de permanência das fêmeas no rebanho e no número e quilogramas de bezerros produzidos pelas fêmeas em até dez anos de idade.

Context-awareness is a key feature for ubiquitous computing scenarios applications. Currently, technologies and methodologies have been proposed for the integration of context-awareness concepts in intelligent information systems to adapt them to the execution of services, user interfaces and data retrieval. Recent research proposed conceptual modeling alternatives to the integration of the domain modeling in RDBMS and context-awareness modeling. The research described using highly expressiveness ontologies. The present work describes the UPCaD (Unified Process for Integration between Context-Awareness and Domain) methodology, which is composed of formalisms and processes to guide the data integration considering RDBMS and context modeling. The methodology was evaluated in a virtual learning environment application. The evaluation shows the possibility to use a highly expressive context ontology to filter the relational data query and discusses the main contributions of the methodology compared with recent approaches.

Foram utilizados 32 bezerros lactentes da raça Canchim, mantidos em sistema de pastejo rotativo de Brachiaria brizantha cv. Marandu, divididos em três grupos correspondentes aos tratamentos avaliados: controle (sem creep-feeding); SAL5 (adição de 5% de NaCl ao concentrado fornecido no creep-feeding); e SAL10 (adição de 10% de NaCl ao concentrado fornecido no creep-feeding). O arraçoamento em cocho privativo teve duração de 90 dias, divididos em três subperíodos de 30 dias. O ganho de peso corporal foi maior nos subperíodos 1 e 2 para os tratamentos SAL10 e SAL5, respectivamente. Não houve diferenças no terceiro subperíodo e, no período total, o tratamento SAL10 (0,91 kg.animal-1.dia-1) foi superior ao tratamento controle (0,81 kg.animal-1.dia-1). A rentabilidade proporcionada pelos tratamentos SAL5 e SAL10 em relação ao lote controle foi de -12,5 e 6,0% ao mês, respectivamente. As diferenças de peso corporal à desmama, em relação ao lote controle, para que o creep-feeding proporcionasse rentabilidade líquida de 0; 0,6; 1,2; e 6% ao mês, deveriam ser de 10,8; 11,0; 11,2; e 12,8 kg.animal-1 para o tratamento SAL5 e de 7,6; 7,7; 7,8; e 9,0 kg.animal-1 para o tratamento SAL10. Concluiu-se que a limitação do consumo de suplemento no creep-feeding foi necessária para obtenção de viabilidade econômica no uso desta técnica de criação.

Foram utilizadas 30 vacas gestantes da raça Canchim, mantidas em sistema de pastejo rotativo intensivo de capim-marandu, que receberam suplemento alimentar para manutenção de peso corporal durante a estação seca. Para avaliar as recomendações do Agricultural and Food Research Council, quanto ao fornecimento de substrato dietético para o crescimento da microbiota ruminal, os animais foram distribuídos em um delineamento inteiramente ao acaso (três tratamentos x dez repetições), de acordo com os seguintes tratamentos: controle (sem restrição do requerimento microbiano de proteína degradável e energia fermentável); restrição do requerimento microbiano de proteína degradável; e restrição do requerimento microbiano de energia metabolizável fermentável. Os suplementos foram compostos com silagem de milho, milho moído e soja integral, cujas quantidades predeterminadas foram fornecidas aos animais diariamente às 10 h. O período de avaliação teve duração de 192 dias, durante o qual foram efetuadas pesagens dos animais no início/término de cada um dos quatro subperíodos experimentais estabelecidos. A avaliação dos resultados indicou que não houve diferença no desempenho dos animais que receberam os diferentes suplementos com médias de ganho de peso corporal de 0,18; 0,02; e 0,12 kg/cab/dia para os respectivos tratamentos descritos. Concluiu-se que a limitação do crescimento da microbiota ruminal por meio da redução dos aportes de energia fermentável ou proteína degradável não interferiu no desempenho de vacas Canchim durante o período seco.

Foram utilizadas 30 vacas da raça Canchim com 50 meses de idade e peso corporal médio de 471 kg, que receberam suplemento alimentar durante a estação seca de 1998, objetivando avaliar a precisão no desempenho estimado por diferentes sistemas de avaliação de dietas. Os suplementos, à base de silagem de milho, milho, polpa cítrica peletizada, farelo de algodão, farelo de soja e soja integral, seguiram as recomendações do Sistema de Proteína Metabolizável (MP); do Sistema de Proteína e Carboidratos Líquidos de Cornell (CNCPS); e do Sistema de Proteína Digestível no Intestino (PDI), para manutenção do peso corporal. A variação diária de peso corporal obtida não diferiu entre os tratamentos CNCPS, MP e PDI, com médias de 0,34; 0,33; e 0,19 kg/cab, respectivamente. Quando a produção de carne constituiu-se no objetivo único do sistema produtivo, a análise econômica revelou saldo de R$22,00; R$-44,73; e R$47,27/ha/ano, para os sistemas CNCPS, MP e PDI, respectivamente. Concluiu-se que os suplementos avaliados pelos sistemas proporcionaram resultados de desempenho animal compatíveis com os estimados.

No presente trabalho, 180 fêmeas da raça Nelore, provenientes de oito rebanhos, foram analisadas quanto aos marcadores microssatélites TEXAN15, BM1224 e CSFM50 e aos polimorfismos de comprimento de fragmentos de restrição (RFLP) nos locos k-caseína, beta-lactoglobulina e hormônio de crescimento (GH). Com exceção de GH, todos os marcadores foram polimórficos na amostra estudada. Os valores de heterozigosidade, diversidade gênica, conteúdo de informação polimórfica (PIC) e probabilidade de exclusão de paternidade (PE) foram estimados. Os maiores valores de PIC (0,685) e PE (0,521) foram obtidos para o marcador BM1224.

Thirty cases of human kala-azar were diagnosed by iliac crest biopsy and myeloculture. Histological analysis of 12 patients showed diffuse thickening of reticulin fibers. To the best of our knowledge, this is the third report describing secondary bone marrow fibrosis (myelofibrosis-like) associated with kala-azar. Patients with positive bone marrow fibrosis (pbmf = 12) were compared to patients without detectable bone marrow fibrosis (wbmf = 18). There were no significant differences in clinical and blood parameters following treatment. All patients showed regression of hepatosplenomegaly.Our findings suggest that associated bone marrow fibrosis is transient and did not interfere in the evolution of treated patients.

Abstract This paper presents an alternative method for determining exact expressions for the bit error probability (BEP) of modulation schemes subject to Nakagami- fading. In this method, the Nakagami- fading channel is seen as an additive noise channel whose noise is modeled as the ratio between Gaussian and Nakagami- random variables. The method consists of using the cumulative density function of the resulting noise to obtain closed-form expressions for the BEP of modulation schemes subject to Nakagami- fading. In particular, the proposed method is used to obtain closed-form expressions for the BEP of -ary quadrature amplitude modulation ( -QAM), -ary pulse amplitude modulation ( -PAM), and rectangular quadrature amplitude modulation ( -QAM) under Nakagami- fading. The main contribution of this paper is to show that this alternative method can be used to reduce the computational complexity for detecting signals in the presence of fading.

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Purpose: The surgical glue is widely used in closing cutaneous surgical wounds. Corticosteroids are indicated for their anti-inflammatory and immunomodulatory properties. The present work evaluated the pharmacological effects of triamcinolone (AT) incorporated into surgical glue (C) on the initial phase of the wound healing process in Wistar rats., Methods: Through in-vivo studies, the effects of the healing process, C or C+AT in the same rat were evaluated for seven and 14 days post-surgery., Results: The C+AT association did not change the physicochemical properties of the polymer. This association in wound healing confirmed the anti-inflammatory and immunomodulatory effects of the corticosteroid, with less neovascularization and fibrosis, in addition to the remodeling of the extracellular matrix carried out by the balance of myofibroblasts and less dense collagen fibers, culminating in tissue regeneration and possible reduction of side effects., Conclusion: This association is a powerful and innovative pharmacological tool, promising in translational medicine.

Background: Peripheral artery disease (PAD) negatively affects functional ability. Persons with PAD experience gait limitation, and changes in mobility, muscle strength, and balance. Assessing individuals with PAD with tests of lower limb performance during activities other than walking may provide information about aerobic capacity., Objective: To evaluate whether the Short Physical Performance Battery (SPPB) can discriminate aerobic capacity and level of physical activity in individuals with PAD., Methods: The SPPB, Incremental Shuttle Walking Test (ISWT), and the Human Activity Profile (HAP) were completed by 42 volunteers with PAD. The sample was stratified into tertiles by the distance walked in the ISWT and the Adjusted Activity Score (AAS) of HAP. One-way analysis of variance with a post-hoc least significant difference was used to compare the SPPB values between tertiles of ISWT and AAS of HAP. P-value < 0.05 was considered significant., Results: The mean age was 65 ± 7.7 years, the walking distance was 259.29 ± 115.28 m, and AAS of HAP was 68.36 ± 9.04. There was a significant difference in the total SPPB score and scores for gait speed and sit-to-stand for groups stratified by ISWT and AAS of HAP(p = 0.01). The balance domain was different only for groups stratified into tertiles by AAS of HAP(p = 0.04)., Conclusion: The results of this study have clinical relevance for the evaluation of individuals with PAD at different aerobic and physical activity levels. The SPPB is a viable alternative in the practice of the specialty of vascular nursing and other areas of health to assess patients whose ability to perform walking tests is often limited., Competing Interests: Declaration of competing interest The authors declare no conflicts of interest. The authors alone are responsible for the content and writing of this paper., (Copyright © 2024. Published by Elsevier Inc.)

Objective: Amyotrophic lateral sclerosis (ALS) is often shown to cause episodic memory deficits. Here, we investigated whether such memory deficits are differentially expressed according to the emotional valence of stimuli and whether they are similarly reproduced in both individuals with sporadic ALS (sALS) and familial Type 8 ALS (ALS8)., Method: Twenty individuals with sALS, 18 individuals with ALS8, and 19 healthy controls were recruited for the study. After a neuropsychological and psychopathological assessment, all participants responded to a recognition memory test wherein images varying in terms of valence were initially shown. After a short interval, the images were shown again intermixed with new images, and the participants' task was to indicate whether each image was "old" or "new" and to estimate the confidence in their responses., Results: Both the sALS and the ALS8 groups showed significantly lower recognition of positive relative to negative valence images ( d = 0.92 and d = 0.74, respectively), an effect that was completely absent for healthy controls ( d = 0.17). These effects were qualified by a significant interaction involving the factors of valence and group (η p ² = 0.12)., Conclusions: The current findings demonstrate that sALS and ALS8 are associated with decreased recognition of emotional information, an effect that is nonetheless restricted to positive valence stimuli. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Three-dimensional (3D) structures are actually the state-of-the-art technique to create porous scaffolds for tissue engineering. Since regeneration in cartilage tissue is limited due to intrinsic cellular properties this study aims to develop and characterize three-dimensional porous scaffolds of poly (L-co-D, L lactide-co-trimethylene carbonate), PLDLA-TMC, obtained by 3D fiber deposition technique. The PLDLA-TMC terpolymer scaffolds (70:30), were obtained and characterized by scanning electron microscopy, gel permeation chromatography, differential scanning calorimetry, thermal gravimetric analysis, compression mechanical testing and study on in vitro degradation, which showed its amorphous characteristics, cylindrical geometry, and interconnected pores. The in vitro degradation study showed significant loss of mechanical properties compatible with a decrease in molar mass, accompanied by changes in morphology. The histocompatibility association of mesenchymal stem cells from rabbit's bone marrow, and PLDLA-TMC scaffolds, were evaluated in the meniscus regeneration, proving the potential of cell culture at in vivo tissue regeneration. Nine New Zealand rabbits underwent total medial meniscectomy, yielding three treatments: implantation of the seeded PLDLA-TMC scaffold, implantation of the unseeded PLDLA-TMC and negative control (defect without any implant). After 24 weeks, the results revealed the presence of fibrocartilage in the animals treated with polymer. However, the regeneration obtained with the seeded PLDLA-TMC scaffolds with mesenchymal stem cells had become intimal to mature fibrocartilaginous tissue of normal meniscus both macroscopically and histologically. This study demonstrated the effectiveness of the PLDLA-TMC scaffold in meniscus regeneration and the potential of mesenchymal stem cells in tissue engineering, without the use of growth factors. It is concluded that bioresorbable polymers represent a promising alternative for tissue regeneration., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This case report addresses the treatment of excessive gingival display (EGD) in the context of maxillary asymmetry, zenith irregularities, and occlusal plane inclination. Digital planning was pivotal in formulating a precise treatment strategy by incorporating facial photographs, digital models, and cone-beam computed tomography data. Parameters, including occlusal plane inclination, teeth position, and lip-to-gingival margin relationships, were considered to ensure treatment alignment with the patient's facial characteristics. Notably, during the planning phase, it was evident that the conventional approach using the cementoenamel junction as the apical limit for incisions would result in asymmetry. Consequently, the gingival margin position was defined in accordance with facial and lip features. The chosen treatment, flapless crown lengthening, was tailored to the patient's thin phenotype and guided by measurements derived from digital planning. Postsurgery, the patient experienced a swift and painless recovery. A harmonious smile with a stable gingival margin position was achieved at the 1-year follow-up, seamlessly complementing the patient's facial attributes. This case underscores the importance of personalized EGD treatment and the value of digital planning in enhancing diagnostic accuracy and precise treatment planning, ultimately facilitating optimal treatment strategies., Competing Interests: None declared., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).)

Introduction/aims: Language is frequently affected in patients with sporadic amyotrophic lateral sclerosis (sALS), with reduced performance in naming, syntactic comprehension, grammatical expression, and orthographic processing. However, the language profile of patients with familial type 8 ALS (ALS8), linked to p.P56S VAPB mutation, remains unclear. We investigated language in patients with ALS8 by examining their auditory comprehension and verbal production., Methods: We included three groups of participants: (1) patients with sALS (n = 20), (2) patients with familial ALS8 (n = 22), and (3) healthy controls (n = 21). The groups were matched for age, sex, and education level. All participants underwent a comprehensive language battery, including the Boston Diagnostic Aphasia Examination, the reduced Token test, letter fluency, categorical fluency (animals), word definition from the Cambridge Semantic Memory Research Battery, and a narrative discourse analysis. Participants also were evaluated using Addenbrooke's Cognitive Exam-Revised Version, the Hospital Anxiety and Depression Scale, and the ALS Functional Rating Scale-Revised., Results: Compared to controls, sALS and ALS8 patients had impaired performance on oral (syntactic and phonological processing) comprehension and inappropriate discourse cohesion. sALS and ALS8 did not differ in any language measure. There was no correlation between language scores and functional and psychiatric scales., Discussion: ALS8 patients exhibit language deficits that are independent of motor features. These findings are consistent with the current evidence suggesting that ALS8 has prominent non-motor features., (© 2024 Wiley Periodicals LLC.)

Background: Traumatic esophageal perforations (TEP) are a grave medical condition and require immediate intervention. Techniques such as Esophageal Self-Expandable Metal Stent (E-SEMS) and Endoscopic Vacuum Therapy (EVT) show promise in reducing tissue damage and controlling esophageal leakage. The present study aims to compare the application of EVT to E-SEMS placement in TEP., Methods: Retrospective cohort study valuated 30 patients with TEP. The E-SEMS and EVT groups were assessed for time of hospitalization, treatment duration, costs, and clinical outcome., Results: Patients treated with EVT (24.4 ± 13.2) demonstrated significantly shorter treatment duration (p < 0.005) compared to the group treated with E-SEMS (45.8 ± 12.9) and patients submitted to E-SEMS demonstrated a significant reduction (p = 0.02) in the time of hospitalization compared to the EVT (34 ± 2 vs 82 ± 5 days). Both groups demonstrated a satisfactory discharge rate (E-SEMS 93.7% vs EVT 71.4%) but did not show statistically significant difference (p = 0.3155). E-SEMS treatment had a lower mean cost than EVT (p < 0.05). Descriptive statistics were utilized, arranged in table form, where frequencies, percentages, mean, median, and standard deviation of the study variables were calculated and counted. The Fisher's Exact Test was used to evaluate the relationship between two categorical variables. To evaluate differences between means and central points, the parametric t-test was utilized. Comparisons with p value up to 0.05 were considered significant., Conclusion: E-SEMS showed a shorter time of hospitalization, but a longer duration of treatment compared to EVT. The placement of E-SEMS and EVT had the same clinical outcome. Treatment with E-SEMS had a lower cost compared with EVT., (© 2024. The Author(s).)

The skin, the human body's largest organ, possesses a protective barrier that renders it susceptible to various injuries, including burns. Following burn trauma, the inflammatory process triggers both innate and adaptive immune responses, leading to the polarization of macrophages into two distinct phenotypes: the pro-inflammatory M1 and the anti-inflammatory M2. This dual response sets the stage for wound healing and subsequent tissue regeneration. Contributing to this transition from M1 to M2 polarization are human adipose-derived stem cells (ASCs), which employ paracrine signaling and inflammation suppression to enhance the remodeling phase. ASCs, when combined with biocompatible polymers, can be integrated into functional scaffolds. This study introduces an 1-ethyl-3-(3-dimethylaminopropyl)carbodiimide-crosslinked (EDC-crosslinked) collagen-hyaluronic acid (Col-HA) scaffold assembled with ASCs, designed as a natural biomaterial device to modulate macrophage behavior in vitro under co-culture conditions. This innovation aims to improve wound healing processes. The EDC-crosslinked Col-HA scaffold favored the release of anti-inflammatory cytokines by ASCs, which indicated the M2 prevalence. In tissue engineering, a critical objective lies in the development of functional biomaterials capable of guiding specific tissue responses, notably the control of inflammatory processes. Thus, this research not only presents original findings but also points toward a promising avenue within regenerative medicine., (© 2023 Wiley-VCH GmbH.)

SARS-CoV-2 and its different variants caused a "wave and wave" pandemic pattern. During the first wave we demonstrated that standardized Brazilian green propolis extract (EPP-AF®) reduces length of hospital stay in adult patients with COVID-19. Afterwards, we decided to evaluate the impact of EPP-AF in hospitalized patients during the third wave of the pandemic. BeeCovid2 was a randomized, double-blind, placebo-controlled clinical trial in hospitalized COVID-19 adult patients. Patients were allocated to receive an oral dose of 900 mg/day of EPP-AF® or placebo for 10 days. The primary outcome was length of hospital stay. Secondary outcomes included safety, secondary infection rate, duration of oxygen therapy dependency, acute kidney injury and need for intensive care. Patients were followed up for 28 days after admission. We enrolled 188 patients; 98 were assigned to the propolis group and 90 to the placebo group. The post-intervention length of hospital stay was of 6.5 ± 6.0 days in the propolis group versus 7.7 ± 7.1 days in the control group (95% CI - 0.74 [- 1.94 to 0.42]; p = 0.22). Propolis did not have significant impact on the need for oxygen supplementation or frequency of AKI. There was a significant difference in the incidence of secondary infection between groups, with 6.1% in the propolis group versus 18.9% in the control group (95% CI - 0.28 [0.1-0.76], p = 0.01). The use of EPP-AF was considered safe and associated with a decrease in secondary infections. The drug was not associated with a significant reduction in length of hospital stay. ClinicalTrials.gov (NCT04800224)., (© 2023. The Author(s).)

Objective: To analyze the internal consistency, reliability and measurement error of assessment measures for body structure and function (postural balance, muscle strength, cardiorespiratory function and physical fitness), activity (walking and mobility) and participation (quality of life and social reintegration) outcomes for use on pre-frail and frail older adults., Methods: Searches were performed in six databases (Medline, Embase, ScienceDirect, Web of Science, The Cochrane Library and Lilacs) and reproducibility studies were included. Cronbach's alpha and the classification proposed by Terwee et al. (2007) were used for the interpretation of internal consistency. The intraclass correlation coefficient (ICC) and the Munro classification were used for the determination of reliability. The standard error of measurement (SEM), minimal detectable change (MDC) as well as percentages of error (SEM%) and change (MDC%) were calculated. Methodological quality of the studies was appraised using Boxes 4, 6 and 7 of the COSMIN Risk of Bias checklist., Results: Six studies were included in the present systematic review, with a total of 835 (82.4 years; 582 women and 253 men) pre-frail and frail older adults analyzed. Seven measures were identified for the assessment of body structure and function, activity and participation outcomes (Hierarchical Assessment of Balance and Mobility, Self-Assessment of Physical Fitness, Sarcopenia Quality of Life, Reintegration to Normal Living Index, Two-Minute Walking test, Six-Minute Walking test and Ten-Meter Walking test). The following measurement properties were identified: internal consistency = 0.84 (mean Cronbach's alpha); reliability = 0.87 (mean ICC); SEM range = 0.06 to 10.10; MDC range = 0.13 to 28.10; SEM% range = 5.2 % to 9.5 %; and MDC% range = 10.7 % to 28.5 %., Conclusion: The present systematic review found adequate internal consistency, high reliability and an acceptable measurement error for assessment measures of body structure and function, activity and participation outcomes for use on pre-frail and frail older adults., Competing Interests: Declaration of competing interest None., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Purpose: To analyze the potential of tumor necrosis factor-α (TNF-α) and factor nuclear kappa B (NF-κB) as colorectal cancer (CRC) biomarkers in an experimental model of intestinal carcinogenesis with 1,2-dimethyhydrazine (1,2-DMH)., Methods: Twenty-four male Wistar rats were divided into two groups: sham and 1,2-DMH. First, 1,2-DMH (20 mg/kg/week) was administered for 15 consecutive weeks. In the 25th week, proctocolectomy was conducted. Histopathological analysis, immunohistochemistry, and gene expression of TNF-α and NF-κB were performed. Statistical analysis was performed using GraphPad Prism. The location of aberrant crypt foci (ACF) was analyzed by Kruskal-Wallis' test. For analyses with two groups with parametric data, the t-test was used; for non-parametric data, the Mann-Whitney's test was used. P < 0.05 was considered significant., Results: The number of ACF and macroscopic lesions was significantly higher (p < 0.5) in the 1,2-DMH group compared to the sham group, and most ACF were concentrated in the distal segment of the colon. There was a statistically significant increase (p < 0.5) in protein and gene expression of TNF-α and NF-κB in the 1,2-DMH group compared to the sham group., Conclusions: Our results provide supportive evidence that TNF-α and NF-κB pathways are strongly involved in CRC development in rats and might be used as early biomarkers of CRC pathogenesis in experimental studies.

Introduction/aims: Amyotrophic lateral sclerosis (ALS) type 8 (ALS8) is caused by VAPB gene mutations. The differences between neuropsychological and behavioral profiles of patients with sporadic ALS (sALS) and those with ALS8 are unclear. We aimed to compare cognitive performance and behavioral aspects between sALS and ALS8 patients., Methods: Our study included 29 symptomatic ALS8 patients (17 men; median age 49 years), 20 sALS patients (12 men; median age 55 years), and 30 healthy controls (16 men; median age 50 years), matched for sex, age, and education. Participants underwent neuropsychological assessments focused on executive functions, visual memory, and facial emotion recognition. Behavioral and psychiatric symptoms were evaluated using the Hospital Anxiety and Depression Scale and the Cambridge Behavioral Inventory., Results: Clinical groups (sALS and ALS8) exhibited lower global cognitive efficiency and impaired cognitive flexibility, processing speed, and inhibitory control compared with controls. ALS8 and sALS showed similar performance in most executive tests, except for poorer verbal (lexical) fluency in those with sALS. Apathy, anxiety, and stereotypical behaviors were frequent in both clinical groups., Discussion: sALS and ALS8 patients demonstrated similar deficits in most cognitive domains and had comparable behavioral profiles. These findings should be considered in the care of patients., (© 2023 Wiley Periodicals LLC.)

Background: Early-life stress affects physiological development and produces changes in various aspects of emotional behavior., Aim: We sought to examine the effects of double perinatal stress (DPS)-a combination of prenatal systemic hypoxic-ischemic (HI) insults and repeated early maternal separation-on the estrus cycle and sexual behavior of adult rats., Methods: HI was induced by clamping the uterine arteries of pregnant rats for 45 minutes on the 18th day of gestation (HI group). Sham control animals received laparotomy and anesthesia only. Pups were born at term. Maternal separation was performed from postnatal day 1 (P1) (P0 = day of birth) to P15. At P90, the sexual response of females in estrus was evaluated. Statistical analysis was performed using 2-way analysis of variance followed by Tukey's test., Outcomes: We considered the estrous cycle and sexual behavior of female rats submitted to DPS, as well as the influence of female behavior on the sexual response of male rats., Results: Rats submitted to DPS showed a reduction in the lordosis quotient and in the lordosis rate, suggesting a reduction in female sexual receptivity. DPS female rats showed a reduction in the number of hops and darts and in the genital exploration time rate, suggesting a reduction in sexual proceptivity. In addition, males that interacted with DPS females showed a reduction in the number of ejaculations and in copulatory efficiency., Clinical Implications: Developing a deeper understanding of perinatal factors that affect adult female sexual response will allow for more effective interventions to prevent and treat such changes. On the other hand, the analysis of the sexual response allows assessing the quality of life and the general state of health., Strengths and Limitations: The development of animal models to investigate the environmental factors that interfere in the female sexual response may allow researchers to propose and test new therapeutic strategies. On the other hand, care must be exercised when interpreting animal data and extrapolating these results to estimate the possible effects of perinatal stressors on the human sexual response., Conclusion: Our results revealed that females subjected to DPS showed long-term effects on sexual behavior. In conclusion, managing stressors in prenatal life and early postnatal life can prevent problems in adult sexual life and improve overall health., (© The Author(s) 2023. Published by Oxford University Press on behalf of The International Society of Sexual Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Drug delivery systems of natural antimicrobial compounds, such as copaiba oil (CO), have become relevant in the scientific community due to the recent prevalence of the public health complications related to antibiotic resistance. Electrospun devices act as an efficient drug delivery system for these bioactive compounds, reducing systemic side effects and increasing the effectiveness of the treatment. In this way, the present study aimed to evaluate the synergistic and antimicrobial effect of the direct incorporation of different concentrations of CO in a poly(L-co-D,L lactic acid) and natural rubber (NR) electrospun membrane. It was observed that CO showed bacteriostatic and antibacterial effects against S. aureus in antibiogram assays. The prevention of biofilm formation was confirmed via scanning electron microscopy. The test with crystal violet demonstrated strong bacteria inhibition in membranes with 75% CO. A decrease in hydrophilicity, observed in the swelling test, presented that the addition of CO promotes a safe environment for the recovery of injured tissue while acting as an antimicrobial agent. In this way, the study showed strong bacteriostatic effects of the CO incorporation in combination with electrospun membranes, a suitable feature desired in wound dressings in order to promote a physical barrier with prophylactic antimicrobial properties to avoid infections during tissue healing.

Dietary supplementation with pterostilbene (PS) and/or a probiotic (PRO) may ameliorate the intestinal microbiota in disease conditions. This study aims to evaluate PS and PRO for the chemoprevention of putative precursor lesions for colorectal cancer (CRC) in an experimental model of intestinal carcinogenesis with 1,2-dimethylhydrazine (1,2-DMH). Sixty male Wistar rats were equally divided into five groups: Sham, 1,2-DMH, 1,2-DMH + PS, 1,2-DMH + PRO, and 1,2-DMH + PS + PRO. PRO (5 × 10 7 /mL) was offered in water, and PS (300 ppm) was provided in the diet ad libitum. 1,2-DMH (20 mg/kg/week) was administered for 15 consecutive weeks. In the 25th week, proctocolectomy was conducted. PRO alone and PRO combined with PS were the best intervention strategies to improve experimental 1,2-DMH-induced CRC regarding several parameters of carcinogenesis. Our findings may contribute to the development of novel preventive strategies for CRC and may help to identify novel modulators of colon carcinogenesis.

Understanding the individual and global impact of pesticides on human physiology and the different stages of life is still a challenge in environmental health. We analyzed here whether administration of the organophosphate insecticide malathion before pregnancy could affect glucose homeostasis during pregnancy and, in addition, generate possible later consequences in mothers and offspring. For this, adult Wistar rats were allocated into two groups and were treated daily (intragastric) with malathion (14 or 140 mg/kg, body mass (bm)) for 21-25 days. Corn oil was used as vehicle in the Control group. Subgroups were defined based on the absence (nulliparous) or presence (pregnant) of a copulatory plug. Pregnant rats were followed by an additional period of 2 months after the term (post-term), without continuing malathion treatment. Fetuses and adult offspring of males and females were also evaluated. We ran an additional experimental design with rats exposed to malathion before pregnancy at a dose of 0.1 mg/kg bm. Malathion exposure resulted in glucose intolerance in the mothers during pregnancy and post-term period, regardless of the exposure dose. This was accompanied by increased visceral adipose tissue mass, dyslipidemia, unchanged pancreatic β-cell mass, and varying insulin responses to glucose in vivo. The number of total newborns and birthweight was not affected by malathion exposure. Adult offspring from both sexes also became glucose-intolerant, regardless of the pesticide dose their dams were exposed to. This alteration could be associated with changes at the epigenomic level, as reduced hepatic mRNA content of DNA methylases and demethylases was found. We demonstrated that periconceptional exposure to malathion with doses aiming to mimic from work environment to indirect contamination predisposes progenitors and offspring rats to glucose intolerance. Thus, we conclude that subchronic exposure to malathion is a risk factor for gestational diabetes and prediabetes later in life., 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 © 2022 Elsevier Ltd. All rights reserved.)

Background: Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease that leads to muscle weakness and paralysis. Fatigue is a disabling symptom, frequently reported in ALS, but remains under-investigated in this population. Thus, an accurate investigation of this symptom and possible associated factors in this clinical condition is needed to assist in the establishment of an adequate treatment approach., Objective: To investigate the presence of fatigue in individuals with ALS and possible factors correlated with this symptom., Methods: Sixty-five individuals with sporadic ALS participated in the present study. Demographic, clinical, and functional aspects were investigated. Evaluations involved the Fatigue Severity Scale (FSS), ALS Functional Scale (ALSRFS-R), and Quality of Life (QoL) questionnaire (ALSAQ-40). Descriptive and correlation analyses were performed with SPSS statistical program for Windows version 19.0 (IBM Corp., Armonk, NY, USA)., Results: Among the 65 individuals evaluated, 44.6% ( n  = 29) presented fatigue based on the FSS. The mean fatigue intensity was 5.4 ± 1.2 and only 10.4% used a specific medication for fatigue. Differences between the groups with and without fatigue were found regarding sex ( p  = 0.049), pain intensity ( p  = 0.026), functioning ( p  = 0.004), disease severity ( p  = 0.029), and QoL ( p  = 0.000). Fatigue was correlated with pain intensity (r = 0.425; p  = 0.001), muscle strength (r = - 0.356; p  = 0.004), functioning (r = - 0.363; p  = 0.003), and QoL (r = 0.481; p  = 0.000). No correlations were found with age, time since diagnosis, cramps, or other mobility parameters., Conclusions: Fatigue is a common symptom among individuals with ALS and may be present in all stages of the disease. This symptom was correlated with worse functioning, poorer QoL, greater pain intensity, disease severity, muscle weakness, and the female sex in individuals with ALS., Competing Interests: The authors have no conflict of interests to declare., (Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)

The present work aimed to characterize the exopolysaccharide obtained from water kefir grains (EPSwk), a symbiotic association of probiotic microorganisms. New findings of the technological, mechanical, and biological properties of the sample were studied. The EPSwk polymer presented an Mw of 6.35 × 10 5 Da. The biopolymer also showed microcrystalline structure and characteristic thermal stability with maximum thermal degradation at 250 °C. The analysis of the monosaccharides of the EPSwk by gas chromatography demonstrated that the material is composed of glucose units (98 mol%). Additionally, EPSwk exhibited excellent emulsifying properties, film-forming ability, a low photodegradation rate (3.8%), and good mucoadhesive properties (adhesion Fmax of 1.065 N). EPSwk presented cytocompatibility and antibacterial activity against Escherichia coli and Staphylococcus aureus. The results of this study expand the potential application of the exopolysaccharide from water kefir as a potential clean-label raw material for pharmaceutical, biomedical, and cosmetic applications.

Objective: Based on scientific evidence, the objective of the present study is to report the possible risks and benefits of the amber teething necklace for children who use it., Data Source: This is an integrative literature review, carried out based on the following guiding question: "Does the amber teething necklace have therapeutic properties that justify its usage during tooth eruption?". The consulted databases were LILACS (Latin American and Caribbean Health Sciences Literature) and PubMed (National Center for Biotechnology Information), with the following descriptors: "Amber," "Deciduous teeth," "Strangulation," and "Local symptoms.", Data Synthesis: A total of five scientific articles were selected, which indicates an insufficient basis regarding the benefits associated with the use of the amber teething necklace. Conversely, there is a convergence regarding the possibility of health risks such as strangulation, asphyxiation, and swallowing of beads., Conclusions: Health professionals should discourage the use of the amber teething necklace by children insofar more studies on the topic are carried out.

Background: Amyotrophic lateral sclerosis (ALS) is a motor neuron disease that results in a progressive increase in dysfunctions, limitations and restrictions over time, which can impact on quality of life (QoL). Therefore, expanding knowledge on QoL and possible factors associated with ALS can enable the development of actions to ensure greater wellbeing for the population., Objective: To investigate QoL in ALS and determine associations with demographic, functional and clinical aspects., Methods: Forty-five individuals with ALS (56.4±11.1 years) participated in the study. Demographic, clinical and functional aspects were investigated. Functioning and QoL were assessed using disease-specific tools (ALS Functional Ranting Scale-Revised/ALSFRS-R and ALS Assessment Questionnaire/ALSAQ-40). Fatigue was assessed using the Fatigue Severity Scale. Descriptive, correlation and stepwise multiple linear regression analyses were performed with the aid of the SPSS., Results: The mean ALSAQ-40 score was 279.0±118.3. QoL was significantly worse among women (p=0.001) and poor QoL was associated with the inability to walk (p=0.014), pain (p=0.021) and disease severity (p≤0.002). QoL was strongly correlated with the ALSFRS-R score (r=-0.82). Moderate to weak correlations were found for mobility [turning in bed (r=-0.62), locomotion (r=-0.33) and sit to stand (r=-0.40)], strength (r=-0.49), fatigue (r=0.35) and pain (r=-0.32) (p<0.03). The regression analysis revealed that the ALSFRS-R score (β=-0.76; p=0.00) and fatigue (β=0.20; p=0.04) were predictors of QoL., Conclusions: QoL was worse in women, older people, severe stages of ALS, patients with impaired mobility, those with a poorer physical performance and those who reported pain. Functional status and fatigue are predictors of QoL in ALS.

Background: Fruit by-products contain phytochemicals, fibers and other components that can improve the redox imbalance of obesity., Objective: The objective was to evaluate the effects of consumption of by-products of acerola, cashew and guava on the adiposity and redox homeostasis of adipose tissue in obese rats., Methods: The animals were separated into 5 groups, control (CTL), high fat (HF), HF supplemented with acerola (HFA), cashew (HFC) and guava (HFG)., Results: Thiol quantification, lipid profile, catalase (CAT) and glutathione peroxidase (GPX) test were performed. TGL and VLDL levels were increased in HF group, and the treated groups did not change the lipid profile. CAT activity was increased in HFA and HFG groups. HFA was able to reduce the weight of the subcutaneous cushion., Conclusion: Treatment with fruit by-products did not alter weight gain, energy efficiency and body weight. Thus, the by-products of acerola and guava can be used as a sustainable alternative in the treatment of obesity., Competing Interests: Declaration of competing interest No potential conflict of interest is reported by the authors., (Copyright © 2021 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)

Obesity is a major risk factor for breast cancer, especially in post-menopausal women. In the breast tissue of obese women, cyclooxygenase-2 (COX-2)-dependent prostaglandin E2 (PGE2) production has been correlated with inflammation and local estrogen biosynthesis via aromatase. Using a mouse model of 7,12-dimethylbenz[a]anthracene/medroxyprogesterone-acetate (DMBA/MPA)-induced carcinogenesis, we demonstrated that an obesogenic diet promotes mammary tissue inflammation and local estrogen production, and accelerates mammary tumor formation in a COX-2-dependent manner. High-sugar/fat (HSF) diet augmented the levels of the pro-inflammatory mediators MCP-1, IL-6, COX-2, and PGE2 in mammary tissue, and this was accompanied by crown-like structures of breast (CLS-B) formation and aromatase/estrogen upregulation. Treatment with a COX-2 selective inhibitor, etoricoxib, decreased PGE2, IL-6, MCP-1, and CLS-B formation as well as reduced aromatase protein and estrogen levels in the mammary tissue of mice fed a HSF diet. Etoricoxib-treated mice showed increased latency and decreased incidence of mammary tumors, which resulted in prolonged animal survival when compared to HSF diet alone. Inhibition of tumor angiogenesis also seemed to account for the prolonged survival of COX-2 inhibitor-treated animals. In conclusion, obesogenic diet-induced COX-2 is sufficient to trigger inflammation, local estrogen biosynthesis, and mammary tumorigenesis., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Intrauterine hypoxia-ischemia (HI) provides a strong stimulus for a developmental origin of both the central nervous system and cardiovascular diseases. This study aimed to investigate vascular functional and structural changes, oxidative stress damage, and behavioral alterations in adult male offspring submitted to HI during pregnancy. The pregnant Wistar rats had a uterine artery clamped for 45 min on the 18th gestational day, submitting the offspring to hypoxic-ischemic conditions. The Sham group passed to the same surgical procedure as the HI rats, without occlusion of the maternal uterine artery, and the controls consisted of non-manipulated healthy animals. After weaning, the male pups were divided into three groups: control, sham, and HI, according to the maternal procedure. At postnatal day 90 (P90), the adult male offspring performed the open field and forced swim tests. In P119, the rats had their blood pressure checked and were euthanized. Prenatal HI induced a depressive behavior in adult male offspring associated with a reduced vasodilator response to acetylcholine in perfused mesenteric arterial bed, and reduced superoxide dismutase and glutathione peroxidase activities in the aorta compared to control and sham groups. Prenatal HI also increased the vasoconstrictor response to norepinephrine, the media thickness, collagen deposition, and the oxidative damage in the aorta from adult male offspring compared to control and sham groups. Our results suggest an association among prenatal HI and adult vascular structural and functional changes, oxidative stress damage, and depressive behavior., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Purpose: To investigate the presence of the variants of lysyl oxygenase ( LOX ) and superoxide dismutase 1 ( SOD1 ) genes in Brazilian patients with advanced keratoconus., Methods: Donor genomic DNA extracted from blood samples was screened for 5'UTR, exonic LOX, and SOD1 variants in a subset of 26 patients presenting with advanced keratoconus (KISA > 1000% and I-S > 2.0) by Sanger sequencing. The impact of non-synonymous amino acid changes was evaluated by SIFT, PMUT, and PolyPhen algorithms. The Mutation Taster tool was used to evaluate the potential impact of formation of new donor and acceptor splice sites in the promoter region of affected volunteers carrying sequence variants. A 7-base SOD1 deletion (IVS2 + 50del7bp) previously associated with keratoconus was screened in 140 patients presenting classical keratoconus by gel fragment analysis, and positive samples were sequenced for confirmation., Results: We found an unreported missense variant in LOX exon 6 in one heterozygous patient, leading to substitution of proline with threonine at residue 392 (p. Thr392Pro) of LOX protein sequence. This mutation was predicted to be potentially damaging to LOX protein. Another LOX variant, Arg158Gln, was also detected in another patient but predicted to be non-pathogenic. Two additional new polymorphisms in LOX 5'UTR region (-116C > T and -58C > T) were found in two patients presenting with advanced keratoconus and were predicted to modulate or create donor/acceptor splice sites in LOX transcripts. Additionally, SOD1 deletion was detected in one patient presenting with severe keratoconus, not in control samples., Conclusion: We described three novel LOX polymorphisms identified for the first time in Brazilian patients with advanced keratoconus, as well as a previously described SOD1 deletion strongly associated with keratoconus. A possible role of these variants in modulating transcript levels in the cornea of affected individual requires further investigation., Competing Interests: There are no conflicts of interest., (Copyright © 2020 Gadelha et al.)

Aims: To explore the impact of GC administration periconceptionally on the glucose metabolism of adult offspring (male and female) and whether this periconception exposure might influence the metabolic outcomes when the offspring are also treated with dexamethasone in adult life., Materials and Methods: Rats received a daily injection of dexamethasone (1 mg/kg, body mass) or saline solution (1 mL/kg body mass) for 7 consecutive days prior became pregnant. Male and female offspring had glucose homeostasis assessed at 3- and 6-month-old and after dexamethasone treatment (1 mg/kg, body mass) or vehicle for 5 consecutive days. Then, murinometric, functional, biochemical, and histomorphometric analyses were performed., Key Findings: Male and female offspring born from rats treated with GC prior to becoming pregnant had none of the murinometric and metabolic outcomes (i.e., body mass, food intake, blood glucose, plasma triacylglycerol, and glucose tolerance) changed up to 6-month-old. None of the expected diabetogenic effects caused by dexamethasone treatment at 6-month of age (i.e., elevation in fasting blood glucose, plasma insulin, triacylglycerol, and albumin, glucose intolerance, insulin insensitivity, augmentation in hepatic glycogen content, and increase in pancreatic islet mass) was observed in offspring born from rats treated with dexamethasone in the prepregnancy period. However, periconceptional exposure to GC predisposed the offspring of both sexes to a higher prevalence of augmented fed blood glucose values., Significance: These results give validity for the use of GC as anti-inflammatory purposes in this critical periconceptional period, but highlight the importance to consider all parental habits when interpreting adult outcomes., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Purpose: To create a checklist to evaluate the performance and systematize the gastroenterostomy simulated training., Methods: Experimental longitudinal study of a quantitative character. The sample consisted of twelve general surgery residents. The training was divided into 5 sessions and consisted of participation in 20 gastroenterostomys in synthetic organs. The training was accompanied by an experienced surgeon who was responsible for the feedback and the anastomoses evaluation. The anastomoses evaluated were the first, fourth, sixth, eighth and tenth. A 10 item checklist and the time to evaluate performance were used., Results: Residents showed a reduction in operative time and evolution in the surgical technique statistically significant (p<0.01). The correlation index of 0.545 and 0,295 showed a high linear correlation between time variables and Checklist. The average Checklist score went from 6.8 to 9 points., Conclusion: The proposed checklist can be used to evaluate the performance and systematization of a simulated training aimed at configuring a gastroenterostomy.

Introduction: This study aimed to evaluate the child's salivary cortisol levels, clinical performance and marginal adaptation of restorations after selective removal of necrotic dentin in primary teeth using Er: YAG laser irradiation. Methods: A double-blind clinical study was performed in children at 7-10 years. Children who had at least 2 teeth with carious lesions involving the occlusal and proximal surfaces of primary molars counterparts were selected. Removal of necrotic dentin was performed by 2 methods: Er: YAG laser irradiation and bur-preparation. Cortisol levels (n =24) was evaluated by ELISA. Clinical analysis (n =20) was performed after the restorations polish, 6 and 12 months after restorative procedure using United States Public Health Service (USPHS) method and photographs. Scanning electron microscopy (SEM) was used to analyz the marginal gap formation (n =20). The analysis of the data was performed by 95% confidence interval, Shapiro-Wilk test, Friedman and Wilcoxon post hoc tests (α =5%). Results: Cortisol levels were higher during selective removal of necrotic dentin, regardless of the method used ( P >0.05). After 12 months, there was no evidence of the difference in the restorations performed on cavities prepared by both methods. SEM analysis revealed that the laser-irradiated teeth showed 10% of gaps in the full extent of restoration. For bur-prepared teeth, 20% of gaps were found at the cavosurface margin. Conclusion: The salivary cortisol levels on children that received Er: YAG laser irradiation for removal the necrotic dentin was similar to the control group. Class II restorations evaluated after 1 year period did not suffer interference by the use of Er: YAG laser irradiation.

Background and Objectives: As the number of people with tattoos has been increasing, anesthesiologists are more and more faced with the decision to perform a neuraxial blockage through tattooed skin. In this study, we evaluated the possibility of puncture through tattooed skin determines acute inflammatory changes in the meninges and spinal cord and later evolve into adhesive arachnoiditis., Method: Forty-two male rabbits were randomized into 3 groups of 14: G1, spinal puncture through non-tattooed skin and saline solution injection; G2, spinal puncture through tattooed skin and saline solution injection, captive for 30 days; G3, spinal puncture through tattooed skin and saline solution injection, captive for 360 days. The animals were anesthetized and ultrasound-guided spinal puncture was performed in the intervertebral spaces between S1 - S2. During the period of captivity, the animals were clinically assessed for sensitivity and motor function. After that, they were sacrificed and the lumbosacral portion of the spinal cord was excised for histological analysis., Results: No histological changes were found on group 1. Eleven animals from group two presented with foci of perivascular lymphocytic inflammatory infiltrate in the pia mater and/or arachnoid. In Group 3, eight rabbits presented with inflammatory changes in the meninges, which were associated with thickening and/or adhesion of the pia mater and arachnoid in some cases and five rabbits presented only thickening of pia-mater., Conclusions: Spinal puncture through tattooed skin of rabbits can trigger acute inflammatory changes in the meninges and after a prolonged period of observation evolve into adhesive arachnoiditis., Competing Interests: Competing interests: None declared., (© American Society of Regional Anesthesia & Pain Medicine 2019. No commercial re-use. See rights and permissions. Published by BMJ.)

Purpose: To evaluate the impact of the combination of BRL 37344 and tadalafil (TDF) on the reduction of overactive bladder (OB) symptoms., Methods: Thirty mice were randomized into 5 groups (G) of 6 animals each. L-NAME was used to induce DO. G1: Control; G2: L-NAME; G3: L-NAME + TDF; G4: L-NAME + BRL 37344; G5: L-NAME + TDF + BRL 37344. After 30 days of treatment, the animals were submitted to cystometry to evaluate non-voiding contractions (NVC), threshold pressure (TP), baseline pressure (BP), frequency of micturition (FM) and threshold volume (TV). Differences between the groups were analyzed with ANOVA followed by the Tukey test., Results: NVC increased in G2 (4.33±2.58) in relation to G1 (1.50±0.55). NVC decreased in G3 (2.00±1.10), G4 (1.50±1.52) and G5 (2.00±1.26) compared to G2 (p<0.05). FM decreased in G3 (0.97±0.71), G4 (0.92±0.38) and G5 (1.05±0.44) compared to G2 (p<0.05). However, the combination of TDF and BRL37344 was not more effective at increasing NVC and improving FM than either drug alone. The five groups did not differ significantly with regard to TV., Conclusion: The combination of BRL 37344 and TDF produced no measurable additive effect on reduction of OB symptoms.

There is a mutual relationship between metabolic and neurodegenerative diseases. However, the causal relationship in this crosstalk is unclear and whether Parkinson's disease (PD) causes a posterior impact on metabolism remains unknown. Considering that, this study aimed to evaluate the appearance of possible changes in metabolic homeostasis due to 6-hydroxydopamine (6-OHDA) administration, a neurotoxin that damage dopaminergic neurons leading to motor impairments that resemble the ones observed in PD. For this, male Wistar rats received bilateral 6-OHDA administration in the dorsolateral striatum, and the motor and metabolic outcomes were assessed at 7, 21, or 35 days post-surgical procedure. Dexamethasone, a diabetogenic glucocorticoid (GC), was intraperitoneally administered in the last 6 days to challenge the metabolism and reveal possible metabolic vulnerabilities caused by 6-OHDA. Controls received only vehicles. The 6-OHDA-treated rats displayed a significant decrease in locomotor activity, exploratory behavior, and motor coordination 7 and 35 days after neurotoxin administration. These motor impairments paralleled with no significant alteration in body mass, food intake, glucose tolerance, insulin sensitivity, and biochemical parameters (plasma insulin, triacylglycerol, and total cholesterol levels) until the end of the experimental protocol on days 35-38 post-6-OHDA administration. Moreover, hepatic glycogen and fat content, as well as the endocrine pancreas mass, were not altered in rats treated with 6-OHDA at the day of euthanasia (38th day after neurotoxin administration). None of the diabetogenic effects caused by dexamethasone were exacerbated in rats previously treated with 6-OHDA. Thus, we conclude that bilateral 6-OHDA administration in the striatum causes motor deficits in rats with no impact on glucose and lipid homeostasis and does not exacerbate the adverse effects caused by excess GC. These observations indicate that neurodegeneration of dopaminergic circuits in the 6-OHDA rats does not affect the metabolic outcomes.

Introduction: Endogenous thyroid-stimulating hormone-stimulated thyroglobulin collected after total thyroidectomy is a useful predictor of better prognosis in patients with differentiated thyroid carcinomas in general, but studies with microcarcinomas are scarce., Objective: To assess whether the first postoperative stimulated thyroglobulin measurement is a prognostic factor in patients with microcarcinoma., Methods: The medical data of 150 differentiated thyroid carcinoma patients were studied retrospectively, and 54 (36%) cases with microcarcinoma were selected. The first postoperative stimulated thyroglobulin (1st stimulated thyroglobulin), measured after thyroidectomy, initial presentation data, and microcarcinomas treatment were assessed regarding outcome. Worse prognosis was defined as neoplasm persistence/recurrence., Results: Persistence/recurrence occurred in 27.8% of the cases. These patients were identified according to the following parameters: receiving more than one 131 iodine dose (100% vs. 0%; p<0.0001); accumulated 131 iodine dose (232.14±99.09 vs. 144±33.61mCi; p<0.0001); presented active disease in the last assessment (53.3% vs. 0%; p<0.0001); follow-up time (103.07±61.27 vs. 66.85±70.14 months; p=0.019); and 1st stimulated thyroglobulin (19.01±44.18 vs. 2.19±2.54ng/dL; p<0.0001). After multivariate logistic regression, only the 1stSTg [odds ratio=1.242; 95% confidence interval: 1.022-1.509; p=0.029] and follow-up time (odds ratio=1.027; 95% confidence interval: 1.007-1.048; p=0.007) were independent predictors of risk of persistence/recurrence. The cutoff point of 1.6ng/dL for the 1st stimulated thyroglobulin was significantly associated with disease persistence/recurrence [area under the curve=0.713 (p=0.019)]., Conclusion: The first stimulated thyroglobulin predicted disease persistence/recurrence in patients with microcarcinoma., (Copyright © 2017 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.)

Unhealthy lifestyle persistently feeds forward inflammation in metabolic organs thus imposing senescence-associated secretory phenotype (SASP), as observed in obesity and type 2 diabetes. However, SASP blocks physiological resolution of inflammation by suppressing the anti-inflammatory and anti-senescent heat shock (HS) response, i.e., the gene program centered in heat shock factor-1 (HSF1)-dependent expression heat shock proteins (HSPs). As SASP-inducing factors are not removed, leading to the perpetuation of inflammation, we argued that SIRT1-HSF1-HSP axis might also be suppressed in atherosclerosis, which could be reversible by heat treatment (HT), the most powerful HS response trigger. LDLr -/- adult mice were fed on high-fat/high-cholesterol diet from the age of 90 days until the end of study (age of 270 days). After 120 days under atherosclerotic diet, the animals were submitted to either whole-body HT (n = 42; 40 °C) or sham (n = 59; 37 °C) treatment (15 min/session), under anesthesia, once a week, for 8 weeks, being echographically and metabolically monitored. Aortic expressions of SIRT1, HSF1, HSP27, HSP72 and HSP73 were progressively depressed in atherosclerotic animals, as compared to normal (LDLr +/+ ; n = 25) healthy counterparts, which was paralleled by increased expression of NF-κB-dependent VCAM1 adhesion molecule. Conversely, HT completely reversed suppression of the above HS response proteins, while markedly inhibiting both VCAM1 expression and NF-κB DNA-binding activity. Also, HT dramatically reduced plasma levels of TG, total cholesterol, LDL-cholesterol, oxidative stress, fasting glucose and insulin resistance while rising HDL-cholesterol levels. HT also decreased body weight gain, visceral fat, cellular infiltration and aortic fatty streaks, and heart ventricular congestive hypertrophy, thereby improving aortic blood flow and myocardial performance (Tei) indices. Remarkably, heat-treated mice stopped dying after the third HT session (= 8 human years), suggesting a curative effect. Therefore, evolution of atherosclerosis is associated with suppression of the anti-inflammatory and anti-senescent SIRT1-HSF1-HSP molecular axis, which is refreshed by chronic heat treatment., (Copyright © 2018 Elsevier B.V. and Société Française de Biochimie et Biologie Moléculaire (SFBBM). All rights reserved.)

Purpose: To discuss the use of models of hepatic retraction by laparoscopy, to present a new Hepatic Retractor (HR) and to evaluate its practicality, efficacy and safety in Esophageal Hiatus Exposure (EHE)., Methods: Experimental cross - sectional study with a quantitative character. It was carried out in the Laboratory of Health Training of Christus University Center. The sample consisted of 12 livers of adult pigs weighing between 30 and 45 kg. A circular-shaped HR, 5 cm diameter and deformable materials was developed with a polypropylene cloth, metallic guide wire, epidural needle plastic guide and nylon string. The practicality of HR management was measured by the time required to use the instrument, efficacy by exposure to the operative field and safety by macroscopic assessment of liver damage., Results: The average time to complete the procedure was 3.24 minutes and reached less than 2 minutes after 12 repetitions. In eight experiments the maximum degree of EHE was obtained. No macroscopic lesions were observed., Conclusion: The use of HR described can broaden the operative field, without causing macroscopic liver lesions and prolonging the surgical time.

Purpose: To develop a model and curriculum for simulated training of an effective and well accepted laparoscopic vesicourethral anastomosis (VUA)., Methods: Experimental longitudinal study of quantitative character. The sample consisted of 12 general surgery residents and 6 urology residents (R3). The training consisted of making twelve VUAs on synthetic organs. The training was divided into four sessions and accompanied by an instructor who performed positive feedback. The evaluation of the anastomoses considered the time and the analysis of the operative technique through the global evaluation scale Objective Structured Assessment of Technical Skills (OSATS)., Results: Residents showed a reduction in operative time and evolution in the surgical technique statistically significant (p<0.01). The best-rated items were the facilitator positive feedback and the fact that the training was carried out at the teaching hospital premises., Conclusions: The proposed training model was well accepted and proved to be effective in reducing operative time and improving laparoscopic skills. The training should be fractionated (4 sessions in 3 weeks), repetitive (12 anastomoses) and have positive feedback.

Background: Tissue engineering has been shown to exhibit great potential for the creation of biomaterials capable of developing into functional tissues. Cellular expansion and integration depends on the quality and surface-determinant factors of the scaffold, which are required for successful biological implants. The objective of this research was to characterize and evaluate the in vitro characteristics of rabbit bone marrow mesenchymal stem cells (BM-MSCs) associated with a bacterial cellulose membrane (BCM). We assessed the adhesion, expansion, and integration of the biomaterial as well as its ability to induce macrophage activation. Finally, we evaluated the cytotoxicity and toxicity of the BCM., Methods: Samples of rabbit bone marrow were collected. Mesenchymal stem cells were isolated from medullary aspirates to establish fibroblast colony-forming unit assay. Osteogenic, chondrogenic, and adipogenic differentiation was performed. Integration with the BCM was assessed by scanning electron microscopy at 1, 7, and 14 days. Cytotoxicity was assessed via the production of nitric oxide, and BCM toxicity was assessed with the MTT assay; phagocytic activity was also determined., Results: The fibroblastoid colony-forming unit (CFU-F) assay showed cells with a fibroblastoid morphology organized into colonies, and distributed across the culture area surface. In the growth curve, two distinct phases, lag and log phase, were observed at 15 days. Multipotentiality of the cells was evident after induction of osteogenic, chondrogenic, and adipogenic lineages. Regarding the BM-MSCs' bioelectrical integration with the BCM, BM-MSCs were anchored in the BCM in the first 24 h. On day 7 of culture, the cytoplasm was scattered, and on day 14, the cells were fully integrated with the biomaterial. We also observed significant macrophage activation; analysis of the MTT assay and the concentration of nitric oxide revealed no cytotoxicity of the biomaterial., Conclusion: The BCM allowed the expansion and biointegration of bone marrow progenitor cells with a stable cytotoxic profile, thus presenting itself as a biomaterial with potential for tissue engineering., Competing Interests: The authors declare there are no competing interests.

Background: The Amazon region is one of the main endemic areas of hepatitis delta in the world and the only one related to the presence of genotype 3 of the delta virus., Objective: To analyze the profile, mortality and survival of cirrhotic patients submitted to liver transplantation for chronic hepatitis delta virus and compare with those transplanted by hepatitis B virus monoinfection., Methods: Retrospective, observational and descriptive study. From May 2002 to December 2011, 629 liver transplants were performed at the Walter Cantídio University Hospital, of which 29 patients were transplanted due to cirrhosis caused by chronic delta virus infection and 40 by hepatitis B chronic monoinfection. The variables analyzed were: age, sex, MELD score, Child-Pugh score, upper gastrointestinal bleeding and hepatocellular carcinoma occurrence before the transplantation, perioperative platelet count, mortality and survival., Results: The Delta Group was younger and all came from the Brazilian Amazon Region. Group B presented a higher proportion of male patients (92.5%) compared to Group D (58.6%). The occurrence of upper gastrointestinal bleeding before transplantation, MELD score, and Child-Pugh score did not show statistical differences between groups. The occurrence of hepatocellular carcinoma and mortality were higher in the hepatitis B Group. The survival in 4 years was 95% in the Delta Group and 75% in the B Group, with a statistically significant difference (P=0.034). Patients with hepatitis delta presented more evident thrombocytopenia in the pre-transplantation and in the immediate postoperative period., Conclusion: The hepatitis by delta virus patients who underwent liver transplantation were predominantly male, coming from the Brazilian Amazon region and with similar liver function to the hepatitis B virus patients. They had a lower incidence of hepatocellular carcinoma, more marked perioperative thrombocytopenia levels and frequent episodes of upper gastrointestinal bleeding. Patients with hepatitis by delta virus had lower mortality and higher survival than patients with hepatitis B virus.

Background: Several studies have reported the use of antimicrobial photodynamic therapy (aPDT) to control biofilm but its efficacy depends on several factors, such as biofilm model used. This study aims to examine whether exposure to diode laser combined with methylene blue affects the bacterial viability and polysaccharide content in a Streptococcus mutans cariogenic biofilm model, which simulated 'feast-famine' episodes of exposure to sucrose that occur in the oral cavity., Materials and Methods: S. mutans biofilms were formed on acrylic resin discs and exposed to a 10% sucrose solution for 1min, eight times/day. After growing for 48h, the biofilms were submitted to the following treatments, twice daily (n=4): (i) 0.9% NaCl (NaCl) as the negative control; (ii) 0.12% chlorhexidine digluconate (CHX) as the positive antibacterial control; (iii) diode laser combined with methylene blue, using an energy density of 320J/cm 2 (aPDT). After 120h of growth, the biofilm formed on each disc was collected to determine the viable bacterial counts and concentration of insoluble exopolysaccharides (IEPS) and intracellular polysaccharides (IPS)., Results: Bacterial counts in the biofilms formed differed among the treatments. Compared with NaCl, aPDT significantly destabilized biofilm (p<0.0001). aPDT and CHX equally lowered the concentration of IEPS and IPS in biofilms., Conclusion: Under the experimental conditions assessed, our findings indicate that a twice-daily treatment with diode laser combined with methylene blue effectively decreased bacterial viability and the intra- and extracellular polysaccharide concentration in biofilms of S. mutans, a cariogenic bacterium., (Copyright © 2017 Elsevier B.V. All rights reserved.)