Search

Background The use of a toothbrush has a limited ability to control the dental biofilm in interproximal areas. Therefore, specialized devices, such as dental floss, may be useful for these specific areas. Objective This study aimed to investigate the efficacy of dental floss impregnated with 5% chlorhexidine gluconate on the reduction of the supragingival biofilm. Methods This research was parallel, single-blind, controlled and randomized, and contained a sample of thirty dental students from the Faculty of Pharmacy, Dentistry and Nursing of the Federal University of Ceará, Brazil, who were divided equally into three groups. The negative control group ( NC) did not utilize any kind of interproximal cleaning; the positive control group ( PC) used waxed floss without impregnation twice a day; and the test group (T) used the same dental floss, which was impregnated with 5% chlorhexidine gluconate, twice a day. For all groups, this study lasted for 15 days. The presence of a biofilm was evaluated on four surfaces (mesiobuccal, distobuccal, mesiolingual and distolingual) by the Quigley-Hein Index, resulting in four scores for each tooth. Results Group T had the lowest plaque scores, showing a significant difference compared to group NC ( P < 0.001) and group PC ( P < 0.001). Group PC also displayed a significant difference compared to NC ( P < 0.001). Conclusion It was concluded that the use of dental floss impregnated with 5% chlorhexidine gluconate resulted in additional reductions in the supragingival biofilm relative to the results achieved with conventional waxed floss on the anterior teeth of a well-motivated and well-instructed population. [ABSTRACT FROM AUTHOR]

Background and Purpose: The aim of this study was to test if corticotomy-induced osteoclastogenesis and bone remodeling underlie orthodontic tooth movement and how selective alveolar decortication enhances the rate of tooth movement. Materials and Methods: A total of 114 Sprague-Dawley rats were included in 3 treatment groups: selective alveolar decortication alone (SADc); tooth movement alone (TM); and "combined" therapy (SADc + TM). Surgery was performed around the buccal and palatal aspects of the left maxillary first molar tooth and included 5 decortication dots on each side. Tooth movement was performed on the first molar using a 25-g Sentalloy spring. Measurements were done at baseline (day 0: no treatment rendered) and on days 3, 7, 14, 21, 28 and 42. Microcomputed tomography, Faxitron analyses, and quantitative real-time polymerase chain reaction (q-PCR) of expressed mRNAs were used to assess changes. Results: The combined group showed increased tooth movement (P = 0.04) at 7 days compared with the tooth movement group with significantly decreased bone volume (62%; P = 0.016) and bone mineral content (63%; P = 0.015). RNA markers of osteoclastic cells and key osteoclastic regulators (M-CSF [macrophage colony-stimulating factor], RANKL [receptor activator of nuclear factor kappa-B ligand], OPG [osteoprotegerin], calcitonin receptor [CTR], TRACP-5b [tartrate-resistant acid phosphatase 5b], cathepsin K [Ctsk]) all showed expression indicating increased osteoclastogenesis in the combined group. RNA markers of osteoblastic cells (OPN [osteopontin], BSP [bone sialoprotein], OCN [osteocalcin]) also showed increased anabolic activity in response to the combination of alveolar decortication and tooth movement. Conclusions: The data suggest that the alveolar decortication enhances the rate of tooth movement during the initial tooth displacement phase; this results in a coupled mechanism of bone resorption and bone formation during the earlier stages of treatment, and this mechanism underlies the rapid orthodontic tooth movement. [ABSTRACT FROM AUTHOR]

Competing Interests: Conflicts of interest The authors declare no conflicts of interest.

Brazil is one of the countries most affected by COVID-19, with the highest number of deaths recorded. Brazilian Health Institutions have reported four main peaks of positive COVID-19 cases. The last two waves were characterized by the emergence of the VOC Omicron and its sublineages. This study aimed to conduct a retrospective surveillance study illustrating the emergence, dissemination, and diversification of the VOC Omicron in 15 regional health units (RHUs) in MG, the second most populous state in Brazil, by combining epidemiological and genomic data. A total of 5643 confirmed positive COVID-19 samples were genotyped using the panels TaqMan SARS-CoV-2 Mutation and 4Plex SC2/VOC Bio-Manguinhos to define mutations classifying the BA.1, BA.2, BA.4, and BA.5 sublineages. While sublineages BA.1 and BA.2 were more prevalent during the third wave, BA.4 and BA.5 dominated the fourth wave in the state. Epidemiological and viral genome data suggest that age and vaccination with booster doses were the main factors related to clinical outcomes, reducing the number of deaths, irrespective of the Omicron sublineages. Complete genome sequencing of 253 positive samples confirmed the circulation of the BA.1, BA.2, BA.4, and BA.5 subvariants, and phylogenomic analysis demonstrated that the VOC Omicron was introduced through multiple international events, followed by transmission within the state of MG. In addition to the four subvariants, other lineages have been identified at low frequency, including BQ.1.1 and XAG. This integrative study reinforces that the evolution of Omicron sublineages was the most significant factor driving the highest peaks of positive COVID-19 cases without an increase in more severe cases, prevented by vaccination boosters.

The human N-acetyltransferase 2 enzyme, encoded by the NAT2 gene, plays an important role in the metabolism of isoniazid, the main drug used to treat tuberculosis. The interindividual variation in the response of patients to drug treatment for tuberculosis may be responsible for the occurrence of unfavorable outcomes. The presence of polymorphisms in genes associated with the metabolism and transport of drugs, receptors, and therapeutic targets has been identified as a major determinant of this variability. The objective of this study was to identify the genetic profile of NAT2 in the study population. Using the obtained genomic DNA followed by PCR amplification and sequencing, the frequency of nine SNPs as well as alleles associated with slow (47.9%), intermediate (38.7%), and fast acetylation phenotypes (11.3%), in addition to those whose phenotype has not yet been characterized (2.1%), was estimated. The NAT2*5B allele was identified more frequently (31.3%). The description of SNPs in pharmacogenes and the establishment of their relationship with the pharmacokinetics of an individual offer an individualized approach that allows us to reduce the unfavorable outcomes of a therapy, ensure better adherence to treatment, prevent the emergence of MDR strains, reduce the cost of treatment, and improve the quality of patients' lives.

Biopolymers such as carboxymethyl cellulose and hyaluronic acid are alternative substrates for conformable organic light-emitting diodes (OLEDs). However, drawbacks such as mechanical stress susceptibility can hinder the device's performance under stretched conditions. To overcome these limitations, herein, we developed a nanocomposite based on CMC/HA (carboxymethyl cellulose/hyaluronic acid) and synthetic Laponite, intending to improve the mechanical strength without compromising the film flexibility and transparency (transmittance >80%; 380-700 nm) as substrates for conformable OLEDs. From XRD, FTIR, CP-MAS NMR, and TGA/DTG characterization techniques, it was possible to conclude the presence of Laponite randomly dispersed between the polymer chains. CMC/HA with 5% (w/w) Laponite, CMC/HA 5, presented a higher tensile strength (370.6 MPa) and comparable Young's modulus (51.0 ± 1.2 MPa) in comparison to the nanocomposites and pristine films, indicating a better candidate for the device's substrates. To produce the OLED, the multilayer structure ITO/MoO 3 /NPB/TCTA:Ir(ppy) 3 /TPBi:Ir(ppy) 3 /BPhen/LiF was deposited onto the CMC/HA 5 substrate. The OLEDs fabricated using CMC/HA 5 substrates showed higher luminance (12 kcd/m 2 ) and irradiance (0.9 mW/cm 2 ) values when compared with those based on commercial bacterial cellulose. However, the same device presented a lower efficiency (3.2 cd/A) due to a higher current density. Moreover, the OLED fabricated onto the Laponite-modified biopolymer presented reproducible behavior when submitted to continuous bending stress. Thus, CMC/HA 5 demonstrates potential as a transparent conductor substrate for biopolymer-based OLEDs with comparable performance to commercial bacterial cellulose features., Competing Interests: The authors declare no competing financial interest., (© 2024 The Authors. Published by American Chemical Society.)

Introduction: In today's world, digital technologies have become pervasive, impacting every aspect of our lives. Even in subjects such as Health and Physical Education (HPE), which traditionally emphasizes experiential, active, and corporeal learning, there is a growing interest in the role and influence of new technologies. These technologies not only have the potential to transform human movement and health cultures, but they also offer valuable tools to facilitate teachers' work and enhance student learning. Considering the context of the Research Network on Interactive Digital Didactic Materials, which includes researchers from Iberoamerican countries, this research examines how media and digital technologies are considered in the official Physical Education and curriculum documents from Brazil, Uruguay, Chile, Colombia, and Spain., Methods: The research comprises a content analysis of official National Curricular Proposals of the selected countries. Considering the specificities of each country to publish their curricula policies, we selected eight different documents from five countries (Brazil, Uruguay, Spain, Colombia, and Chile). We looked for indicators expressed by terms such as "media," "digital culture," and "technology" in the documents, all of them related to Physical Education., Results: The findings show arguments and proposals for using technology in Physical Education in all documents. However, the curricula trigger this theme in different forms, as an autonomous or transversal character integrated into subjects such as HPE. This fact may be highlighted by the goals of learning areas, which sometimes trigger teaching themes through technology., Discussion: Under the Media-Education theory lens, we argue that there is no standard for educational investment in curricula in media and technology. Some documents point to the technology use dimension, while others point to the critical or productive dimension that technology makes possible. The literature highlights the need for an organic approach between these dimensions, and educators and policymakers are asked to rethink their curriculum proposals., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 de Araújo, Xavier, Moya-Mata, da Costa, Canon-Buitrago, Oliverira and Carvalho.)

Purpose: Renal cell carcinoma is an aggressive disease with a high mortality rate. Management has drastically changed with the new era of immunotherapy, and novel strategies are being developed; however, identifying systemic treatments is still challenging. This paper presents an update of the expert panel consensus from the Latin American Cooperative Oncology Group and the Latin American Renal Cancer Group on advanced renal cell carcinoma management in Brazil., Methods: A panel of 34 oncologists and experts in renal cell carcinoma discussed and voted on the best options for managing advanced disease in Brazil, including systemic treatment of early and metastatic renal cell carcinoma as well as nonclear cell tumours. The results were compared with the literature and graded according to the level of evidence., Results: Adjuvant treatments benefit patients with a high risk of recurrence after surgery, and the agents used are pembrolizumab and sunitinib, with a preference for pembrolizumab. Neoadjuvant treatment is exceptional, even in initially unresectable cases. First-line treatment is mainly based on tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs); the choice of treatment is based on the International Metastatic Database Consortium (IMCD) risk score. Patients at favourable risk receive ICIs in combination with TKIs. Patients classified as intermediate or poor risk receive ICIs, without preference for ICI + ICIs or ICI + TKIs. Data on nonclear cell renal cancer treatment are limited. Active surveillance has a place in treating favourable-risk patients. Either denosumab or zoledronic acid can be used for treating metastatic bone disease., Conclusion: Immunotherapy and targeted therapy are the standards of care for advanced disease. The utilization and sequencing of these therapeutic agents hinge upon individual risk scores and responses to previous treatments. This consensus reflects a commitment to informed decision-making, drawn from professional expertise and evidence in the medical literature., (© 2024. The Author(s).)

Objectives: The study aimed to assess and compare cerebrospinal fluid (CSF)-CXCL13 levels in People with HIV (PWH) with suspected neurosyphilis (NS), those with syphilis but without NS, and patients without treponema infection. Additionally, it aimed to evaluate changes in CSF-CXCL13 concentrations before and after antibiotic treatment., Design: This was a prospective cohort study involving 93 PWH suspected of NS. All participants underwent lumbar puncture, with CSF-CXCL13 levels measured at baseline and during follow-up in patients diagnosed with NS., Methods: CSF-CXCL13 levels were quantified using ELISA. The Mann-Whitney U test was used to analyze differences between groups, while the Wilcoxon test assessed within subject changes. ROC curve analysis determined the diagnostic efficacy of CSF-CXCL13 for NS., Results: Significantly higher CSF-CXCL13 levels were observed in patients with NS compared to those with syphilis without NS and non-syphilis patients. Posttreatment, a decline in CSF-CXCL13 levels was noted in all NS cases. A CSF-CXCL13 threshold exceeding 60.0 pg/ml, in conjunction with reactive CSF-FTA-ABS, yielded a sensitivity of 88.9% and a specificity of 97.6% for NS diagnosis., Conclusions: CSF-CXCL13 emerges as a valuable adjunctive biomarker for detecting NS in PWH, especially in cases with nonreactive CSF-VDRL. Monitoring CSF-CXCL13 levels also appears effective in evaluating therapeutic response in PWH undergoing NS treatment., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Prion diseases are characterized by prion protein (PrP) transmissible aggregation and neurodegeneration, which has been linked to oxidative stress. The physiological function of PrP seems related to sequestering of redox-active Cu 2+ , and Cu 2+ dyshomeostasis is observed in prion disease brain. It is unclear whether Cu 2+ contributes to PrP aggregation, recently shown to be mediated by PrP condensation. This study indicates that Cu 2+ promotes PrP condensation in live cells at the cell surface and in vitro through copartitioning. Molecularly, Cu 2+ inhibited PrP β-structure and hydrophobic residues exposure. Oxidation, induced by H 2 O 2 , triggered liquid-to-solid transition of PrP:Cu 2+ condensates and promoted amyloid-like PrP aggregation. In cells, overexpression of PrP C initially protected against Cu 2+ cytotoxicity but led to PrP C aggregation upon extended copper exposure. Our data suggest that PrP condensates function as a buffer for copper that prevents copper toxicity but can transition into PrP aggregation at prolonged oxidative stress.

Organic light-emitting transistors (OLETs) are multifunctional optoelectronic devices that combine in a single structure the advantages of organic light-emitting diodes (OLEDs) and organic field-effect transistors (OFETs). However, low charge mobility and high threshold voltage are critical hurdles to practical OLET implementation. This work reports on the improvements obtained by using polyurethane films as a dielectric layer material in place of the standard poly(methyl methacrylate) (PMMA) in OLET devices. It was found that polyurethane drastically reduces the number of traps in the device, thereby improving electrical and optoelectronic device parameters. In addition, a model was developed to rationalize an anomalous behavior at the pinch-off voltage. Our findings represent a step forward to overcome the limiting factors of OLETs that prevent their use in commercial electronics by providing a simple route for low-bias device operation.

The aim of the present study is to report a case of periodontal Ehlers-Danlos syndrome (pEDS) in early childhood. A 3-year-old child, complaining of severe tooth mobility, gingival bleeding, and early loss of deciduous teeth sought the dental clinics. The patient was diagnosed with pEDS, and no other systematic health impairments were diagnosed. It was implemented a strict supragingival biofilm control, using mechanical and chemical strategies. However, during the treatment, the patient had to receive multiple dental extractions. Scaling and root planing were performed in the remaining teeth, and the patient is included in the periodontal maintenance program to prevent recurrence of the disease. It was concluded that, although rare, severe cases of periodontitis may occur in deciduous teeth. Strict supragingival biofilm control and periodontal maintenance are strongly recommended in those patients, along with familial monitoring., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Indian Society of Periodontology.)

Trace mineral minerals Zn, Cu, and Mn play important roles in breeder production and progeny performance. The objective of this study was to determine maternal supplementation of trace mineral minerals on breeder production and progeny growth and development. A total of 540 broiler breeders, Cobb 500 (Slow feathering; 0-66 weeks old) were assigned to one of three treatment groups with the same basal diet and three different supplemental trace minerals: ITM-inorganic trace minerals in sulfates: 100, 16, and 100 ppm of Zn, Cu, and Mn respectively; MMHAC -mineral methionine hydroxy analog chelate: 50, 8, and 50 ppm of bis-chelated MINTREX ® Zn, Cu and Mn (Novus International, Inc.), and TMAAC - trace minerals amino acid complex: 50, 8, and 50 ppm of Zn, Cu, and Mn. At 28 weeks of age, eggs from breeder treatments were hatched for progeny trial, 10 pens with 6 males and 6 female birds per pen were fed a common diet with ITM for 45 days. Breeder production, egg quality, progeny growth performance, mRNA expression of gut health associated genes in breeder and progeny chicks were measured. Data were analyzed by one-way ANOVA; means were separated by Fisher's protected LSD test. A p -Value ≤ 0.05 was considered statistically different and 0.1 was considered numerical trend. Breeders on ITM treatment had higher ( p < 0.05) body weight (BW), weight gain and lower ( p < 0.05) feed conversion ratio (FCR) from 0 to 10 weeks, when compared to birds fed MMHAC. MMHAC significantly improved egg mass by 3 g ( p < 0.05) and FCR by 34 points (0.05 < p < 0.1) throughout the reproductive period (26-66 weeks) in comparison to ITM. MMHAC improved ( p < 0.01) egg yolk color versus (vs.) ITM and TMAAC in all periods, except 28 weeks, increased ( p < 0.01) eggshell thickness and resistance vs. TMAAC at 58 weeks, and reduced ( p < 0.05) jejunal NF-κB gene expression vs. TMAAC at 24 weeks. There was a significant reduction in tibial dry matter weight, Seedor index and resistance for the breeders that received MMHAC and/or TMAAC when compared to ITM at 18 weeks. Lower seedor index but numerically wider tibial circumference was seen in hens fed MMHAC at 24 weeks, and wider tibial circumference but lower tibial resistance in hens fed TMAAC at 66 weeks. Maternal supplementation of MMHAC in breeder hens increased ( p < 0.0001) BW vs. ITM and TMAAC at hatching, reduced ( p < 0.05) feed intake vs. ITM at d14 and d28, and improved ( p < 0.01) FCR and performance index vs. TMAAC at d28, reduced ( p < 0.01) NF-κB gene expression and increased ( p < 0.05) A20 gene expression vs. TMAAC on d0 and vs. ITM on d14, reduced ( p < 0.05) TLR2 gene expression vs. ITM on d0 and vs. TMAAC on d14, increased ( p < 0.05) MUC2 gene expression vs. both ITM and TMAAC on d45 in progeny jejunum. Overall, these results suggest that supplementation with lower levels of MHA-chelated trace minerals improved breeder production and egg quality and reduced breeder jejunal inflammation while maintaining tibial development in comparison to those receiving higher inorganic mineral supplementation, and it also carried over the benefits to progeny with better growth performance, less jejunal inflammation and better innate immune response and gut barrier function in comparison to ITM and/or TMAAC., Competing Interests: JC, RA, DT, MV-A and DH were employed by Novus International Inc. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 de Arruda Roque, Chen, Araujo, Murcio, de Souza Leite, Dias Tanaka, Granghelli, Pelissari, Bueno Carvalho, Torres, Vázquez‐Añón, Hancock, Soares da Silva Araujo and Araujo.)

This experiment evaluated pregnancy rates to fixed-time artificial insemination (FTAI) in Bos indicus beef cows according to their body condition score (BCS) at calving and subsequent change until 30 days after FTAI. Non-pregnant, suckling Nelore cows (n = 593 primiparous, 461 secundiparous, and 893 multiparous) were evaluated for BCS at calving and FTAI, and at 30 days after FTAI when cow pregnancy status was verified. Cow BCS at calving was subtracted from BCS recorded at pregnancy diagnosis, and cows classified as those that lost BCS (L), maintained BCS (M), or gained BCS (G) during this period. Cows that calved with BCS ≥ 5.0 had greater (P < 0.01) BCS throughout the experiment, and greater (P < 0.01) pregnancy rates to FTAI compared with cows that calved with BCS < 5.0 (54.8 vs. 34.2%). Pregnancy rates to FTAI were greater (P < 0.01) for G and M cows compared with L cows (50.0%, 47.5%, and 36.0%, respectively), and similar (P = 0.46) between G and M cows. Moreover, pregnancy rates to FTAI in G cows that calved with BCS < 5.0 were less compared with L (tendency; P = 0.08) and M cows (P < 0.01) that calved with BCS ≥ 5.0 (42.2%, 48.3%, and 58.3%, respectively). In summary, pregnancy rates to FTAI were greater in B. indicus cows that calved with a BCS ≥ 5.0 regardless of parity and post-calving BCS change, and greater in M and G cows within those that calved with BCS < 5.0 or ≥ 5.0., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Objective: The objective of this study is to describe the first series of spinocerebellar ataxia (SCA) in Rio de Janeiro, whose population has a high proportion of mixed Portuguese and African ancestry., Methods: We reviewed the medical records of patients with progressive ataxia evaluated at the Sarah Network of Rehabilitation Hospitals (Rio de Janeiro). Clinical course, genetic tests for hereditary ataxia, brain MRI, and electroneuromyography were analyzed., Results: SCA was confirmed in 128 individuals, one-third of African descendants. SCA3 predominated (83.6%), followed by SCA7 (7%); SCA2 (3.9%); SCA1, SCA6, and SCA8 (1.6% each); and SCA10 (0.8%). Dysphagia, pyramidal signs, and neurogenic bladder occurred frequently. Oculomotor disorders occurred with SCA3, SCA7, SCA2, and SCA1; peripheral neuropathies with SCA3 and SCA1; extrapyramidal syndromes with SCA3, SCA7, and SCA2; bilateral visual impairment with SCA7; and epilepsy with SCA10. Mobility assistance was required in 75% after 11 years and wheelchair in 25%. The Scale for the Assessment and Rating of Ataxia scores at the last follow-up varied from 2 to 37 (median = 14.50) and correlated positively with duration of the disease. In SCA3, a higher CAG repeats correlated with a lower age at onset. African ethnicity was associated with earlier onset, regardless of CAG repeats. The main brain MRI abnormality was cerebellar atrophy, isolated or associated with brainstem atrophy, "hot cross bun" sign, or brain atrophy. Linear T2 hyperintensity along the medial margin of the globus pallidus occurred in SCA3, SCA2, SCA1, and SCA7. ENMG confirmed peripheral neuropathy in SCA3 and SCA1., Conclusion: Machado Joseph disease/SCA3 was the most frequent inherited dominant ataxia in Rio de Janeiro. This study revealed new aspects of ethnic influence in the clinical course and new MRI findings., (© 2022. Fondazione Società Italiana di Neurologia.)

Serological tests detect antibodies generated by infection or vaccination, and are indispensable tools along different phases of a pandemic, from early monitoring of pathogen spread up to seroepidemiological studies supporting immunization policies. This work discusses the development of an accurate and affordable COVID-19 antibody test, from production of a recombinant protein antigen up to test validation and economic analysis. We first developed a cost-effective, scalable technology to produce SARS-COV-2 spike protein and then used this antigen to develop an enzyme-linked immunosorbent assay (ELISA). A receiver operator characteristic (ROC) analysis allowed optimizing the cut-off and confirmed the high accuracy of the test: 98.6% specificity and 95% sensitivity for 11+ days after symptoms onset. We further showed that dried blood spots collected by finger pricking on simple test strips could replace conventional plasma/serum samples. A cost estimate was performed and revealed a final retail price in the range of one US dollar, reflecting the low cost of the ELISA test platform and the elimination of the need for venous blood sampling and refrigerated sample handling in clinical laboratories. The presented workflow can be completed in 4 months from first antigen expression to final test validation. It can be applied to other pathogens and in future pandemics, facilitating reliable and affordable seroepidemiological surveillance also in remote areas and in low-income countries., Competing Interests: 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., (© 2022 Elsevier B.V. All rights reserved.)

Background Catheter ablation (CA) is a safe, effective, cost-effective technique and may be considered a first-line strategy for the treatment of symptomatic supraventricular tachycardias (SVT). Despite the high prospect of cure and the recommendations of international guidelines in considering CA as a first-line treatment strategy, the average time between diagnosis and the procedure may be long. The present study aims to evaluate predictors related to non-referral for CA as first-line treatment in patients with SVT. Methods and Results The model was derived from a retrospective cohort of patients with SVT or ventricular pre-excitation referred for CA in a tertiary center. Clinical and demographical features were used as independent variables and non-referral for CA as first-line treatment the dependent variable in a stepwise logistic regression analysis. Among 20 clinical-demographic variables from 350 patients, 10 were included in initial logistic regression analysis: age, women, presence of pre-excitation on ECG, palpitation, dyspnea and chest discomfort, number of antiarrhythmic drugs before ablation, number of concomitant symptoms, symptoms' duration and evaluations in the emergency room due to SVT. After multivariable adjusted analysis, age (odds ratio [OR], 1.2; 95% CI 1.01-1.32; P =0.04), chest discomfort during supraventricular tachycardia (OR, 2.7; CI 1.6-4.7; P <0.001) and number of antiarrhythmic drugs before ablation (OR, 1.8; CI 1.4-2.3; P <0.001) showed a positive independent association for non-referral for CA as SVT first-line treatment. Conclusions The independent predictors of non-referral for CA as first-line treatment in our logistic regression analysis indicate the existence of biases in the decision-making process in the referral process of patients who would benefit the most from catheter ablation. They very likely suggest a skewed medical decision-making process leading to catheter ablation underuse.

The native marmoset of the Southeastern Atlantic Forest in Brazil is among the 25 most endangered primates of the world. Hybridization with alien species is one of its main threats registered since the early 2000s based on phenotype, so far, without genetic confirmation. Using uniparental molecular markers, we analyzed 18 putative hybrids, captured from 2004 to 2013 in different localities of the Atlantic Forest. A nine base pair deletion in the SRY gene of C. aurita was used to investigate paternal ancestry. Maternal ancestry was assessed by DNA sequencing of ca. 455 bp from the COX2 gene. Hybridization was confirmed for 16 out of the 18 marmosets since they inherited COX2 haplotypes of the alien C. penicillata or C. jacchus and the SRY deletion specific to C. aurita. Two individuals inherited both parental lineages of C. aurita, which is probably related to backcrossing or hybrid interbreeding. The direction of hybridization of females with the matrilineal lineage of invasive species with males descending from the native lineage was predominant in our sampling. This is the first time that hybridization between C. aurita and invasive species has been confirmed through genetic analysis., (© 2022. The Author(s).)

Specific partially hydrolysed whey-based infant formulas (pHF-W) have been shown to decrease the risk of atopic dermatitis (AD) in infants. Historically, AD has been associated primarily with milk allergy; however, defective skin barrier function can be a primary cause of AD. We aimed to ascertain whether oral supplementation with pHF-W can improve skin barrier function. The effect of pHF-W was assessed on transepidermal water loss (TEWL) and antibody productions in mice epicutaneously exposed to Aspergillus fumigatus . Human primary keratinocytes were stimulated in vitro, and the expression of genes related to skin barrier function was measured. Supplementation with pHF-W in neonatal mice led to a significant decrease in TEWL and total IgE, but not in allergen-specific antibody levels. The whey hydrolysate was sufficient to decrease both TEWL and total IgE. Aquaporin-3 gene expression, linked with skin hydration, was modulated in the skin of mice and human primary keratinocytes following protein hydrolysate exposure. Skin barrier improvement may be an additional mechanism by which pHF-W may potentially reduce the risk of AD development in infants. Further human studies are warranted to confirm the clinical efficacy of these observations.

Evaluate the biological action of valproic acid in the acetylation of histones and in the methylation of tumor suppressor genes via oral rinse in patients with a previous history of head and neck squamous cell carcinoma (HNSCC). Forty-two active or former smokers were included in this randomized, double-blind, placebo-controlled trial. Oral rinse samples were collected prior to treatment with valproic acid or placebo and after 90 days of treatment. The methylation status of five tumor suppressor genes and histone acetylation were evaluated by pyrosequencing and ELISA techniques, respectively. Differences between the 90-day and baseline oral rinse acetylation and methylation results were analyzed by comparing groups. Thirty-four patients were considered for analysis. The mean percentage adherence in the valproic and placebo groups was 93.4 and 93.0, respectively (p = 0.718). There was no statistically significant difference between groups when comparing the medians of the histone acetylation ratio and the methylation ratio for most of the studied genes. A significant reduction in the DCC methylation pattern was observed in the valproic group (p = 0.023). The use of valproic acid was safe and accompanied by good therapeutic adherence. DCC methylation was lower in the valproic acid group than in the placebo group., (© 2021. The Author(s).)

Chronic venous ulcers (CVU) of the lower limbs (LL) are common and cause psychological changes and significant social impact, as they make the patient susceptible to pain, absence from work and social bonds. Some materials are suggested as dressings for the treatment of CVU, but they are expensive and are generally not available for use in public health services. To evaluate the efficacy of the treatment for lower limbs (LL) chronic venous ulcer (CVU) using bacterial cellulose (BC), gel and multi-perforated film associated. A randomized controlled clinical-intervention study was performed among participants with LL CVU, divided into two groups: experimental (EG), treated with BC wound dressing and control (CG), treated with a cellulose acetate mesh impregnated with essential fatty acids (Rayon®). The participants were followed for 180 days, evaluated according to the MEASURE methodology. Thirty-nine patients were treated, 20 from the EG and 19 from the CG. In both groups, the wound area decreased significantly (p < 0.001), the healing rate was similar to the CG. The mean number of dressing changes in the SG was 18.33 ± 11.78, while in the CG it was 55.24 ± 25.81, p < 0.001. The healing dressing of bacterial cellulose, gel and associated film, when stimulating the epithelization of the lesions, showed a significant reduction in the initial area, with a percentage of cure similar to the Rayon® coverage. In addition to requiring less direct manipulation of ulcers.

Background: Oropharyngeal cancer is an important public health problem. The aim of our study was to correlatep16 immunohistochemistry in oropharynx squamous cell carcinomas(OPSCC) with clinical and epidemiological features., Material and Methods: We conducted across-sectional study on patients with OPSCC treated at a single institution from 2014 to 2019. Epidemiological and clinical-pathological data were collected from medical records and a questionnaire was applied to determine alcohol consumption, smoking, and sexual behavior. The HPV status was determined by p16 immunohistochemistry., Results: A total of 252 patients participated in the study, of these 221 (87.7%) were male. There were 81 (32.14%) p16 positive cases and 171 (67.85%) p16 negative cases. The p16positive group was significantly associated with younger patients (50-59 years), higher education level, lower clinical stage and patients who never drank or smoked. Through univariate logistic regression, we observed that female sex (OR, 3.47; 95% CI, 1.60-7.51) and higher education level (OR, 9.39; 95% CI, 2, 81-31,38) were significantly more likely to be p16 positive. Early clinical stage (AJCC8ed) was more associated with p16 positivity both in univariate (OR, 0.14; 95% CI, 0.07-0.26, p<0.001) and multivariate analysis (OR, 0.18; 95% CI, 0.06-0.49, p = 0.001)., Conclusion: This study showed that drinkers and current smokers were less likely to be p16+. Female sex, higher education level and younger age at diagnosis were associated with a higher probability of being p16+. Additionally, there was a higher proportion of patients with early clinical stage (I or II) in the p16 positive group when compared to the p16 negative group., Competing Interests: The authors have declared that no competing interests exist.

Purpose: International guideline recommendations may not always be extrapolated to developing countries where access to resources is limited. In metastatic castration-sensitive prostate cancer (mCSPC), there have been successful drug and imaging advancements that were addressed in the Prostate Cancer Consensus Conference for Developing Countries for best-practice and limited-resource scenarios., Methods: A total of 24 out of 300 questions addressed staging, treatment, and follow-up for patients with mCSPC both in best-practice settings and resource-limited settings. Responses were compiled and presented in percentage of clinicians supporting each response. Questions had 4-8 options for response., Results: Recommendations for staging in mCSPC were split but there was consensus that chest x-ray, abdominal and pelvic computed tomography, and bone scan should be used where resources are limited. In both de novo and relapsed low-volume mCSPC, orchiectomy alone in limited resources was favored and in relapsed high-volume disease, androgen deprivation therapy plus docetaxel in limited resources and androgen deprivation therapy plus abiraterone in high-resource settings were consensus. A 3-weekly regimen of docetaxel was consensus among voters. When using abiraterone, a regimen of 1,000 mg plus prednisone 5 mg/d is optimal, but in limited-resource settings, half the panel agreed that abiraterone 250 mg with fatty foods plus prednisone 5 mg/d is acceptable. The panel recommended against the use of osteoclast-targeted therapy to prevent osseous complications. There was consensus that monitoring of patients undergoing systemic treatment should only be conducted in case of prostate-specific antigen elevation or progression-suggestive symptoms., Conclusion: The treatment recommendations for most topics addressed differed between the best-practice setting and resource-limited setting, accentuating the need for high-quality evidence that contemplates the effect of limited resources on the management of mCSPC., Competing Interests: Fernando Cotait MalufHonoraria: Janssen Oncology, Astellas Pharma, Bayer Schering Pharma, Merck Sharp and Dohme,Roche/Genentech, BMS Brazil, Ipsen, Sanofi/Aventis, Merck Serono, AstraZenecaConsulting or Advisory Role: Janssen Oncology, Astellas Pharma, Bayer Schering Pharma, Merck Sharp and Dohme, Roche/Genentech, BMS Brazil, Ipsen, Merck Serono, AstraZenecaResearch Funding: Janssen-Cilag, Merck Sharp and DohmeTravel, Accommodations, Expenses: Merck Sharp and Dohme, Bayer Schering Pharma Felipe Moraes Toledo PereiraHonoraria: Janssen, Zodiac Pharma, MSD, Libbs, Bayer, AmgenConsulting or Advisory Role: Janssen Diogo Assed BastosHonoraria: MSD, Roche, Bristol-Myers Squibb, Janssen-Cilag, Astellas Pharma, AstraZeneca, BayerConsulting or Advisory Role: Roche, Bayer, Janssen-CilagResearch Funding: Janssen-Cilag, Pfizer, Astellas PharmaTravel, Accommodations, Expenses: Janssen-Cilag, Bayer Diogo Augusto Rodrigues da RosaHonoraria: RocheConsulting or Advisory Role: Janssen-Cilag, Bristol-Myers Squibb, AstraZeneca, Astellas PharmaSpeakers' Bureau: AstraZeneca, Dr. Reddy's Laboratories, Roche, MSD Oncology, BMS BrazilTravel, Accommodations, Expenses: Janssen-Cilag, Roche, BMS Brazil, Ipsen Evanius Garcia WiermannConsulting or Advisory Role: Janssen OncologySpeakers' Bureau: BayerTravel, Accommodations, Expenses: Bayer Schering Pharma Fábio A. SchutzEmployment: IpsenConsulting or Advisory Role: Bayer, Janssen Oncology, Roche, Merck Sharp and Dohme, Bristol-Myers Squibb, Pfizer, Astellas Pharma, AstraZenecaSpeakers' Bureau: Janssen Oncology, Astellas Pharma, Bayer, Pfizer, Bristol-Myers Squibb, AstraZeneca, Merck Sharp and Dohme, RocheResearch Funding: Janssen OncologyTravel, Accommodations, Expenses: Merck Sharp and Dohme, Roche, Bristol-Myers Squibb, Astellas Pharma, Janssen-Cilag Fábio Roberto KaterConsulting or Advisory Role: Janssen-Cilag, PfizerTravel, Accommodations, Expenses: Janssen-Cilag Fernando Nunes Galvão de OliveiraConsulting or Advisory Role: Janssen OncologySpeakers' Bureau: Janssen Oncology, Astellas Pharma, MSD OncologyTravel, Accommodations, Expenses: Astellas Pharma, MSD Oncology Fernando Sabino Marques MonteiroConsulting or Advisory Role: Bristol-Myers Squibb, Roche, MSD Oncology, JanssenSpeakers' Bureau: Janssen, MSD Oncology, IpsenResearch Funding: JanssenTravel, Accommodations, Expenses: Janssen, Roche, Bristol-Myers Squibb Francisco Javier OrlandiHonoraria: Roche/GenentechConsulting or Advisory Role: AstraZeneca, Roche/Genentech, Bristol-Myers Squibb, MSD Oncology, Lilly, Pfizer, Novartis, SanofiSpeakers' Bureau: AstraZeneca/MedImmune, RocheResearch Funding: AstraZeneca/MedImmune, Amgen, Genentech/Roche, Boehringer Ingelheim, Astellas Medivation, MSD Oncology, Bristol-Myers Squibb, Celltrion, Pfizer, mAbxience, Nektar, Sanofi, Genentech/Roche, AstraZeneca/MedImmune Pamela Salman BoghikianConsulting or Advisory Role: Roche/Genentech, Novartis, Lilly, Merck SeronoSpeakers' Bureau: Roche/Genentech, Novartis, Lilly Ray Manneh KoppHonoraria: Astellas Scientific and Medical Affairs,Inc., Janssen-Cilag, Bayer, Merck Sharp and Dohme, Roche, Bristol-Myers Squibb, Sanofi, AstraZeneca, PfizerConsulting or Advisory Role: Astellas Pharma, Janssen-Cilag, Roche, Merck Serono, Merck Sharp and Dohme, AstraZeneca, Sanofi, PfizerSpeakers' Bureau: San Jorge Foundation, ACHOResearch Funding: Pfizer, Merck Sharp and Dohme, NovartisTravel, Accommodations, Expenses: Merck Sharp and Dohme Rodrigo Nogueira de FogaceTravel, Accommodations, Expenses: Bayer Schering Pharma Sandro Roberto de Araújo CavalleroHonoraria: Astellas Pharma, Janssen Oncology, AstraZenecaConsulting or Advisory Role: Janssen Oncology, Astellas PharmaSpeakers' Bureau: Pfizer, Janssen-Cilag, Astellas PharmaTravel, Accommodations, Expenses: Pfizer, Roche/Genentech, Janssen-Cilag, Astellas Pharma Vinicius Carreira SouzaConsulting or Advisory Role: Janssen, Astellas Pharma, Bayer, BMS BrazilResearch Funding: JanssenTravel, Accommodations, Expenses: Janssen Silke Gillessen SommerConsulting or Advisory Role: Astellas Pharma, Advanced Accelerator Applications, Roche, Janssen, Bayer, Orion Pharma GmbH, Menarini Silicon Biosystems, Tolero Pharmaceuticals, MSD Oncology, Amgen, PfizerSpeakers' Bureau: Janssen-CilagPatents, Royalties, Other Intellectual Property: Method for biomarker (WO 3752009138392 A1)Travel, Accommodations, Expenses: ProteoMedixOther Relationship: ProteoMediX, Aranda PharmaNo other potential conflicts of interest were reported.

Purpose: To present a summary of the recommendations for the treatment and follow-up for the biochemical recurrence of castration-resistant prostate cancer (PCa) as acquired through a questionnaire administered at the Prostate Cancer Consensus Conference for Developing Countries., Methods: A total of 27 questions were identified as relating to this topic. Responses from the clinician were tallied and are presented in percentage format. Topics included the use of imaging in staging, treatment recommendations across different patient scenarios of life expectancy and prostate-specific antigen (PSA) doubling time, and follow-up for nonmetastatic castration-resistant PCa., Results: A consensus agreed that in optimal conditions, positron emission tomography-computed tomography with prostate-specific membrane antigen would be used although in limited resource situations the combined use of CT of the abdomen and pelvic (or pelvic MRI), a bone scan, and a CT of the thorax or chest x-ray was recommended. In cases when PSA levels double in < 10 months, more than 90% of clinicians agreed on the use of apalutamide or enzalutamide, regardless of life expectancy. With a doubling time of more than 10 months, > 54% of experts recommended no treatment independent of life expectancy. More than half of the experts, regardless of resources, recommended follow-up with a physical examination and PSA levels every 3-6 months and imaging only in the case of symptoms., Conclusion: The voting results and recommendations presented in this document can be used by physicians to support management for biochemical recurrence of castration-resistant PCa in areas of limited resources. Individual clinical decision making should be supported by available data., Competing Interests: Felipe Moraes Toledo PereiraHonoraria: Janssen, Zodiac Pharma, MSD, Libbs, Bayer, AmgenConsulting or Advisory Role: Janssen Adriano Gonçalves e SilvaHonoraria: MSD Oncology, Janssen Oncology, Astellas Pharma, Roche, Pfizer/EMD Serono, Bayer, Bristol-Myers Squibb BrazilConsulting or Advisory Role: Janssen Oncology, Astellas Pharma, Pfizer/EMD Serono, MSD OncologyResearch Funding: MSD Oncology, Janssen OncologyTravel, Accommodations, Expenses: Janssen Oncology, Astellas Pharma, MSD Oncology, Roche Aldo Lourenço Abbade DettinoHonoraria: Janssen-Cilag, Bayer, Astellas Pharma, RocheConsulting or Advisory Role: NovartisResearch Funding: Janssen, RocheTravel, Accommodations, Expenses: MSD Oncology Ana Paula Garcia CardosoConsulting or Advisory Role: Janssen Oncology, Pfizer, Astellas PharmaSpeakers' Bureau: Janssen Oncology, Novartis, MSD Oncology, Astellas Pharma, AstraZeneca, BayerTravel, Accommodations, Expenses: Ipsen, Janssen Oncology, Bristol-Myers Squibb Andre Deeke SasseHonoraria: Roche, Astellas Pharma, Janssen-Cilag, Bristol-Myers Squibb, Merck KGaA, MSD Oncology, NovartisConsulting or Advisory Role: Astellas Pharma, Janssen-Cilag, Merck KGaA, Novartis, RocheResearch Funding: Bristol-Myers SquibbTravel, Accommodations, Expenses: MSD Oncology, Janssen-Cilag Ariel Galapo KannConsulting or Advisory Role: Janssen OncologySpeakers' Bureau: Janssen Oncology, GlaxoSmithKline, Roche Carlos DzikConsulting or Advisory Role: Janssen-Cilag, IPSEN, NovartisSpeakers' Bureau: Janssen OncologyTravel, Accommodations, Expenses: Astellas Pharma, Janssen Oncology Daniel HerchenhornConsulting or Advisory Role: Janssen-Cilag Denis Leonardo Fontes JardimHonoraria: Janssen-Cilag, Roche/Genentech, Astellas Pharma, MSD Oncology, Bristol-Myers Squibb Brazil, Pfizer, Libbs, MerckConsulting or Advisory Role: Janssen-Cilag, Pfizer, MSDTravel, Accommodations, Expenses: MSD, Bristol-Myers Squibb Brazil, Janssen-Cilag Diego LoperaConsulting or Advisory Role: Bristol-Myers Squibb, Pfizer, NovartisSpeakers' Bureau: Dr Reddy's Laboratories, Bristol-Myers Squibb, Boehringer Ingelheim, PfizerTravel, Accommodations, Expenses: MSD Oncology Pamela SalmanConsulting or Advisory Role: Roche/Genentech, Novartis, Lilly, Merck SeronoSpeakers' Bureau: Roche/Genentech, Novartis, Lilly Ray Antonio Manneh KoppHonoraria: Astellas Scientific and Medical Affairs Inc, Janssen-Cilag, Bayer, Merck Sharp & Dohme, Roche, Bristol-Myers Squibb, Sanofi, AstraZeneca, PfizerConsulting or Advisory Role: Astellas Pharma, Janssen-Cilag, Roche, Merck Serono, Merck Sharp & Dohme, AstraZeneca, Sanofi, PfizerSpeakers' Bureau: San Jorge Foundation, ACHOResearch Funding: Pfizer, Merck Sharp & Dohme, NovartisTravel, Accommodations, Expenses: Merck Sharp & Dohme Sandro Roberto De Araujo CavalleroHonoraria: Pfizer, Astellas Pharma, Janssen Oncology, AstraZenecaConsulting or Advisory Role: Janssen Oncology, MSD Oncology, Astellas PharmaSpeakers' Bureau: Pfizer, Janssen-Cilag, Astellas PharmaTravel, Accommodations, Expenses: Pfizer, Roche/Genentech, Janssen-Cilag, Astellas Pharma Vinicius Carrera SouzaConsulting or Advisory Role: Janssen, Astellas Pharma, Bayer, Bristol-Myers Squibb BrazilResearch Funding: JanssenTravel, Accommodations, Expenses: Janssen Andrey SoaresHonoraria: Janssen, Pfizer, Bayer, Novartis, AstraZeneca, Astellas Pharma, Pierre Fabre, Merck Serono, Sanofi, Roche, MSDConsulting or Advisory Role: Astellas Pharma, Janssen, Roche, Bayer, Lilly, AstraZeneca, Novartis, MSD, Bristol-Myers SquibbResearch Funding: Bristol-Myers SquibbTravel, Accommodations, Expenses: AstraZeneca, Pfizer, Astellas Pharma, Bristol-Myers Squibb, Bayer, Roche, Janssen, Merck Serono, Sanofi, Ipsen, MSDNo other potential conflicts of interest were reported.

Background: Penile prostheses are the third option in the treatment of erectile dysfunction, however, despite their proven effectiveness, the occurrence of infections, advanced age of patients and comorbidities are the main limiting factors for this treatment modality. In the continuous search for biointegrated, clinically durable and minimally invasive treatment options, a possible model of penile prosthesis was sought through the use of intracavernous bacterial cellulose (BC) gel, in an experimental model of orchiectomized rabbits., Methods: Thirty adult New Zealand rabbits were equally distributed into three groups: BC; vehicle and control. Each group was then subdivided according to the follow-up time of 3 and 6 months. Bilateral orchiectomy was performed 3 weeks before injection in the BC and vehicle groups. Pachymetry measurements of the penile axis, diameter and length were performed in situ . Histomorphometry analyzes of the corpora cavernosa (CC), thickness of the tunica albuginea, cell density, collagen and elastic fibers post-injection were also performed, in addition to immunohistochemistry for newly formed vessels., Results: The implant of BC increased both the length and thickness of the penis three and six months after the last injection, with a consequent increase in the diameter of the CC. On the other hand, the filling effect was not observed in the control and vehicle groups, confirming the degradation of this tissue after orchiectomy and the effectiveness of BC as a filling agent. Histomorphometry analyzes corroborate the mass effect of BC integrated into the tissue, permeated by predominantly lymphomononuclear inflammatory infiltrate, multinucleated giant foreign body cells, fibroblasts, elastic fibers and newly formed vessels, without degradation or loss of volume, even after six months of implantation., Conclusions: Biocompatibility and biointegration to the host tissue make BC a prosperous penile filling material, with local application and minimally invasive., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/tau-20-1128). The authors have no conflicts of interest to declare., (2021 Translational Andrology and Urology. All rights reserved.)

Introduction: High-risk human papillomavirus infection impacts staging and prognosis of oropharyngeal squamous cell carcinomas (OPSCCs). Determination of HPV status in tumor tissue by p16-immunohistochemistry (p16-IHC) can be challenging; therefore, complementary methodologies could be useful in a clinical setting., Objective: To test for accuracy and clinical relevance of HPV-DNA detection in formalin-fixed and paraffin-embedded (FFPE) tumor samples by droplet digital PCR (ddPCR)., Materials and Methods: Fifty OPSCCs were tested for p16-IHC status followed by HPV-16/18 DNA detection/quantification in FFPE-recovered DNA using ddPCR. Accuracy for HPV status determination and association with patient information were also evaluated., Results: 32.0% (16/50) of the cases were p16-IHC positive (p16 +), 42.0% (21/50) had detectable levels of HPV-16 DNA, and none were positive for HPV-18 DNA. A higher median viral load of HPV-16 DNA was observed in p16 + cases (p < 0.0001). Concordance between p16-IHC and HPV-16 DNA ranged from 78.0 to 86.0% and accuracy rates were between 78.0 and 86.0%. P16-IHC and HPV-16 DNA detection was associated with gender, smoking status, and tumor subsite, while only HPV-16 DNA was associated with cT stage. The combination of HPV positivity by p16-IHC and ddPCR showed higher overall survival rates in comparison with p16 + /HPV-DNA- and p16 - /HPV-DNA- results., Conclusions: Type-specific HPV-DNA detection by ddPCR is highly specific but moderately sensitive for the determination of HPV status and showed clinical relevance, mainly when associated with p16-IHC status. Results highlight the importance of performing HPV-DNA testing in combination with p16-IHC for proper identification of HPV-associated OPSCC and to improve clinical management of OPSCC patients.

Human milk is a dynamic, complex fluid that offers much more than nutrition to infants. The macronutrient content of human milk has been well characterized and described. However, human milk is not a simple matrix of protein, carbohydrate, fat, and micronutrients. The National Institutes of Health have defined bioactives in food as elements that "affect biological processes or substrates and hence have an impact on body function or condition and ultimately health." Bioactives are cells, anti-infectious and anti-inflammatory agents, growth factors, and prebiotics that are naturally present in human milk. They may explain the differences in health outcomes observed between breastfed and non-breastfed infants. They influence the development of the immune and gastrointestinal systems, gut microbiota, neurodevelopment, metabolic health, and protection against infection. Human milk oligosaccharides are one bioactive that have been an increasingly popular area of research. This review provides a broad overview of some bioactive components that positively affect the immune system and touches on certain well-known growth factors present in human milk. Future research will look at the interplay of the multitude of bioactive components in human milk as a biological system and beyond singular compounds., (© 2022 S. Karger AG, Basel.)

Introduction: Patients with bilateral kidney stones and burdened by large stones are challenging cases for endourologists. Simultaneous bilateral percutaneous nephrolithotomy (sbPCNL) is an option; however, it may be accompanied by important morbidity. An alternative is a staged PCNL, operating one side each time. Herein, we compare the impact of sbPCNL and staged PCNL on complication rates and renal function., Methods: Patients who underwent sbPCNL or staged bilateral PCNL with a frame time of 6 months were searched in our prospectively collected kidney stone database. Groups were compared for age, gender, body mass index (BMI), comorbidities (classification by the American Society of Anesthesiology - ASA), stone size, Guy's score, stone-free status, renal function, blood loss, blood transfusion rate, complication rate, and length of hospital stay., Results: Twenty-six patients and 52 kidney units were enrolled. The mean operative time was 134.7 min. Only 11.3% of cases had complications, all of them minor (Clavien ≤ 2). Overall, the stone-free rate was 61.50%. Comparing the groups, there was a significantly longer operative time in the sbPCNL group (172.5 vs. 126.3 min; p=0.016), as well as a higher transfusion rate (12.5% vs. 5.6%; p=0.036). There was no statistically significant difference in creatinine levels between the groups. Regarding the stone-free rate, there was a significantly higher proportion of patients in the staged PCNL group (64.9% vs. 43.8%; p=0.012)., Conclusion: sbPCNL is a safe procedure; however, when compared to staged procedures it has a higher transfusion and lower stone-free rate.

Avulsion of the nail plate is the most accomplished surgical procedure among the nail apparatus surgeries. Since it is not possible to use the removed nail to cover the nail bed, some materials have been suggested, however, they are generally not available for use and often at a high cost. To evaluate the use of Bacterial Cellulose (BC) dressing as a biological nail (Bio-Nail) after partial or total avulsion of the nail plate. Twenty-six candidates for nail avulsion, were randomized into two groups: Control, using Vaseline with gauze (11 patients) and Experimental group, BC group, using the Bio-Nail (15 patients). The patients were followed up during the 180-day period. The distribution of the patients in the groups was homogeneous for both sociodemographic and clinical data. The occurrence of infection (1 case in the control group) was not statistically relevant. The BC group had lower pain intensity (p = 0.011) with earlier temporal resolution when compared to the control group (p = 0.003). The BC group presented earlier reepithelization (p = 0.022) and better quantitative (p = 0.021) and qualitative conditions (p = 0.011) for the exudate. Regarding satisfaction, all the patients were satisfied. Good preservation of the nail plate area was observed in the BC group at the end of the 180-day period (p = 0.024). Average time of BC dressing permanence was 16.4 ± 7.1 days. BC showed to be appropriate as a dressing after partial or total avulsion of the nail plate. BC is a Bio-Nail promising for nail bed healing.

Background: Oropharyngeal squamous cell carcinomas (OpSCCs) are commonly associated with high rates of treatment failure., Objectives: To evaluate methylation-based markers in plasma from OpSCC patients as emerging tools for accurate/noninvasive follow-up., Methods: Pretreatment formalin-fixed paraffin-embedded (FFPE) biopsies (n = 52) and paired plasma (n = 15) were tested for the methylation of CCNA1, DAPK, CDH8, and TIMP3 by droplet digital PCR (ddPCR)., Results: Seventy-one percent (37/52) of the biopsies showed methylation of at least one of the evaluated genes and tumor CCNA1 methylation was associated with recurrence-free survival. Methylated circulating tumor DNA (meth-ctDNA) was detected in 11/15 (73.3%) plasma samples; conversely, plasma samples from healthy controls were all negative for DNA methylation (area under the curve = 0.867; 95% confidence interval = 0.720-1.000). Additionally, preliminary results on the detection of meth-ctDNA in plasma collected during follow-up closely matched patient outcome., Conclusions: The results suggest the feasibility of detecting meth-ctDNA in plasma using ddPCR and a possible application on routine setting after further validation., (© 2020 Wiley Periodicals LLC.)

Background/objective: The aim was to evaluate the use of bacterial cellulose film and bile duct autograft in repairing critical common bile duct injury in pigs., Methods: A prospective experimental analytical study was carried out on 20 Sus Domesticus, Piau suidae swine, divided into a control group ( n  = 10) and an experimental group ( n  = 10) divided into two subgroups: bacterial cellulose film E1 and bacterial cellulose film E2 to which bacterial cellulose film was randomly allocated. The control group underwent two complete critical common bile duct sections 10 mm apart, while the experimental group with a single critical common bile duct defect underwent a 10 mm section of the longitudinal shaft with edge resection. The defects in the control group were treated with end-to-end conventional anastomosis using polyglycolic 6-0 surgical thread and the experimental group with bacterial cellulose film by continuous suture using the same material. The animals were clinically evaluated throughout the experiment on days D150 (bacterial cellulose film E1), D225 (control group), and D330 (bacterial cellulose film E2) and by intraoperative ultrasound examination related to histopathological and biochemical findings., Results: The intraoperative ultrasonography detected the changes resulting from the common bile duct anastomosis in the control group that produced a considerable incidence of ductal narrowing and obstruction to the biliary flow. In the bacterial cellulose film E2 group, there was an increase in inflammation intensity, granulomatous reaction, fibrosis, and vessels density, without producing bile duct dilation in the ultrasonography assessment. Biochemical analysis of liver enzymes yielded results in the normal range confirming preservation of liver function at the different post-surgery time points., Conclusion: Bacterial cellulose film, when used as a graft for bile duct repair, proved to be a biocompatible material that produced a complete healing process and biliary flow continuity.

Tobacco- or human papillomavirus- driven oropharyngeal squamous cell carcinomas (OpSCC) represent distinct clinical, biological and epidemiological entities. The aim of this study was to identify genetic variants based on somatic alterations in OpSCC samples from an admixed population, and to test for association with clinical features. The entire coding region of 15 OpSCC driver genes was sequenced by next-generation sequencing in 51 OpSCC FFPE samples. Thirty-five percent of the patients (18/51) were HPV-positive and current or past tobacco consumption was reported in 86.3% (44/51). The mutation profile identified an average of 2.67 variants per sample. Sixty-three percent of patients (32/51; 62.7%) were mutated for at least one of the genes tested and TP53 was the most frequently mutated gene. The presence of mutation in NOTCH1 and PTEN, significantly decreased patient's recurrence-free survival, but only NOTCH1 mutation remained significant after stepwise selection, with a risk of recurrence of 4.5 (HR 95% CI = 1.11-14.57; Cox Regression p = 0.034). These results show that Brazilian OpSCC patients exhibit a similar clinical and genetic profile in comparison to other populations. Molecular characterization is a promising tool for the definition of clinical subgroups, aiding in a more precise tailoring of treatment and prognostication.

A growing, global conversation, regarding realities and challenges that parents experience today is ever-present. To understand recent parent's attitudes, beliefs, and perceptions regarding infant feeding, we sought to systematically identify and synthesize original qualitative research findings. Following the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) framework, electronic databases were searched with a priori terms applied to title/abstract fields and limited to studies published in English from 2015 to 2019, inclusive. Study quality assessment was conducted using the Critical Appraisal Skills Programme (CASP) checklist, and thematic analyses performed. Of 73 studies meeting inclusion criteria, four major themes emerged. (1) Breastfeeding is best for an infant; (2) Distinct attitudes, beliefs, and perceptions of mothers that breastfeed, and those that could not or chose not to breastfeed, are evident; (3) Infant feeding behaviors are influenced by the socio-cultural environment of the family, and (4) Parent's expectations of education and support addressing personal infant feeding choices from health care providers are not always met. This systematic review, guided by constructs within behavioral models and theories, provides updated findings to help inform the development of nutrition education curricula and public policy programs. Results can be applied within scale-up nutrition and behavioral education interventions that support parents during infant feeding.

It is essential for health care providers to be familiared with the full spectrum of clinical presentations of syphilis. We present herein a case of syphilide psoriasiforme, an uncommon but well recognized clinical presentation of secondary syphilis. A 46-year-old HIV-infected female patient was referred to our attention with a presumptive diagnosis of palmoplantar psoriasis. On examination, there were exuberant pinkish-red papules and plaques covered with a thick silvery scale in the palms, flexor surfaces of the wrists, and the medial longitudinal arches of the feet. Serological and histopathological analyses uncovered the diagnosis of syphilis. Clinical remission was obtained after treatment. A detailed review of the literature on syphilide psoriasiforme, including descriptions from older syphilology textsis provided. The present case report emphasizes the need for clinicians to have a heightened awareness of the varied and unusual clinical phenotypes of syphilis.

Galectin-3 (Gal-3) controls intercellular and cell-extracellular matrix interactions during immunological responses. In chronic inflammation, Gal-3 is associated with fibrotic events, regulates B cell differentiation and delays lupus progression. Gal-3 deficient mice (Lgals3 -/- ) have intense germinal center formation and atypical plasma cell generation correlated to high levels IgG, IgE, and IgA. Here, we used pristane (2,6,10,14-tetramethylpentadecane) to induce lupus-like syndrome in Lgals3 -/- and Lgals3 +/+ BALB/c mice. Mesentery and peritoneal cells were monitored because promptly react to pristane injected in the peritoneal cavity. For the first time, mesenteric tissues have been associated to the pathogenesis of experimental lupus-like syndrome. In Lgals3 +/+ pristane-induced mice, mesentery was hallmarked by intense fibrogranulomatous reaction restricted to submesothelial regions and organized niches containing macrophages and B lymphocytes and plasma cells. In contrast, Lgals3 -/- pristane-treated mice had diffuse mesenteric fibrosis affecting submesothelium and peripheral tissues, atypical M1/M2 macrophage polarization and significant DLL1 + cells expansion, suggesting possible involvement of Notch/Delta pathways in the disease. Early inflammatory reaction to pristane was characterized by significant disturbances on monocyte recruitment, macrophage differentiation and dendritic cell (DC) responses in the peritoneal cavity of pristane-induced Lgals3 -/- mice. A correlative analysis showed that mesenteric damages in the absence of Gal-3 were directly associated with severe portal inflammation and hepatitis. In conclusion, it has suggested that Gal-3 orchestrates histological organization in the mesentery and prevents lupoid hepatitis in experimental lupus-like syndrome by controlling macrophage polarization, Notch signaling pathways and DC differentiation in mesenteric structures.

The effects of brain-derived neurotrophic factor (BDNF) in long-term synaptic potentiation (LTP) are thought to underlie learning and memory formation and are partly mediated by local protein synthesis. Here, we investigated the mechanisms that mediate BDNF-induced alterations in the synaptic proteome that are coupled to synaptic strengthening. BDNF induced the synaptic accumulation of GluN2B-containing NMDA receptors (NMDARs) and increased the amplitude of NMDAR-mediated miniature excitatory postsynaptic currents (mEPSCs) in cultured rat hippocampal neurons by a mechanism requiring activation of the protein tyrosine kinase Pyk2 and dependent on cellular protein synthesis. Single-particle tracking using quantum dot imaging revealed that the increase in the abundance of synaptic NMDAR currents correlated with their enhanced stability in the synaptic compartment. Furthermore, BDNF increased the local synthesis of Pyk2 at the synapse, and the observed increase in Pyk2 protein abundance along dendrites of cultured hippocampal neurons was mediated by a mechanism dependent on the ribonucleoprotein hnRNP K, which bound to Pyk2 mRNA and dissociated from it upon BDNF application. Knocking down hnRNP K reduced the BDNF-induced synaptic synthesis of Pyk2 protein, whereas its overexpression enhanced it. Together, these findings indicate that hnRNP K mediates the synaptic distribution of Pyk2 synthesis, and hence the synaptic incorporation of GluN2B-containing NMDARs, induced by BDNF, which may affect LTP and synaptic plasticity., (Copyright © 2019 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.)

This study aimed to analyze galectin-3 importance in endometriotic lesions development and the effect of recombinant Gal-3 carbohydrate recognition domain (Gal3C) in experimental endometriosis treatment. Experimental endometriosis was induced in WT and Gal-3-/- mice. Initially developed lesions were macroscopically and histologically analyzed, including immunohistochemical analysis. Then, WT mice were treated with Gal3C for 15 days. Gal-3 deficiency and Gal3C treatment significantly impaired endometriosis development. A significant decrease in lesions implantation and size, VEGF and VEGFR-2 expression, vascular density and macrophage distribution were observed in Gal-3 absence or inhibition. A greater presence of iNOS positive cells was observed in knockout mice lesions, while the presence of Arginase positive cells was higher in the WT animal lesions. In addition, COX-2 and TGFb1 were reduced by Gal3C treatment. Data showed here indicate a relevant role of Gal-3 in endometriosis development and highlight a target of endometriosis treatment using Gal-3 inhibitor., (Copyright © 2019 Elsevier B.V. All rights reserved.)

The objective of this experiment was to evaluate the impact of complexed trace mineral supplementation on ovum pick-up (OPU) and in vitro embryo production in lactating beef cows. Thirty days prior to fixed-time artificial insemination (FTAI; day -30), 68 postpartum cows were stratified by BW, BCS, and parity before being randomly assigned to 10 pens of either a treatment (TRT; n = 5) or a control (CNT; n = 5) group. Each group received a weekly mineral supplement allotment of 1.16 kg × week-1 × cow-calf pair-1 for 14 wk. Cows assigned to the TRT group received a mineral supplement that contained amino acid complexes of zinc, copper, and manganese, as well as cobalt glucoheptonate (Availa Plus; Zinpro Corp., Eden Prairie, MN, USA), while cows assigned to the CNT group received a mineral supplement that was formulated to contain similar concentrations of these trace minerals from inorganic sources. All cows were submitted to a 7 d CO-Synch + CIDR protocol on day -10 and bred using FTAI on day 0. Pregnancy diagnosis was performed on day 28 and nonpregnant cows were removed. All pregnant cows were subjected to ovum pick-up (OPU) on day 52 and 67 of gestation. Cumulus-oocyte complexes (COCs) were evaluated and graded prior to in vitro fertilization (IVF). Analysis of variance was conducted to determine effects of treatment on response variables, and pen was considered the experimental unit. Supplement consumption did not differ (P = 0.48) between treatments (1.16 ± 0.12 vs. 1.07 ± 0.15 kg of DM × week-1 × cow-calf pair-1 for TRT and CNT, respectively). Total COC recovery was greater (P = 0.03) from TRT when compared with CNT cows (22.4 ± 2.0 vs. 16.4 ± 1.4 COCs × pen-1, respectively) and the number of COCs meeting maturation criteria was increased in TRT cows (P = 0.05) when compared with CNT cows (15.9 ± 1.6 vs. 11.8 ± 1.0 COCs × pen-1, respectively). Production of transferable embryos tended to be greater (P = 0.06) for TRT than CNT cows (4.7 ± 0.6 vs. 2.7 ± 0.7 embryos × pen-1, respectively). Furthermore, when expressed as a ratio, the number of recovered COCs meeting maturation criteria that were required to produce a transferable embryo tended to be lower for TRT than CNT cows (3.10 ± 0.93 vs. 7.02 ± 1.60; P = 0.06). In summary, complete replacement with complexed trace mineral improved COC recovery and in vitro embryo production when compared with inorganic forms of these trace minerals in beef cows., (© The Author(s) 2019. Published by Oxford University Press on behalf of the American Society of Animal Science.)

p53 mutants can form amyloid-like structures that accumulate in cells. p53 reactivation with induction of massive apoptosis-1 (PRIMA-1) and its primary active metabolite, 2-methylene-3-quinuclidinone (MQ), can restore unfolded p53 mutants to a native conformation that induces apoptosis and activates several p53 target genes. However, whether PRIMA-1 can clear p53 aggregates is unclear. In this study, we investigated whether PRIMA-1 can restore aggregated mutant p53 to a native form. We observed that the p53 mutant protein is more sensitive to both PRIMA-1 and MQ aggregation inhibition than WT p53. The results of anti-amyloid oligomer antibody assays revealed that PRIMA-1 reverses mutant p53 aggregate accumulation in cancer cells. Size-exclusion chromatography of the lysates from mutant p53-containing breast cancer and ovarian cell lines confirmed that PRIMA-1 substantially decreases p53 aggregates. We also show that MDA-MB-231 cell lysates can "seed" aggregation of the central core domain of recombinant WT p53, corroborating the prion-like behavior of mutant p53. We also noted that this aggregation effect was inhibited by MQ and PRIMA-1. This study provides the first demonstration that PRIMA-1 can rescue amyloid-state p53 mutants, a strategy that could be further explored as a cancer treatment., (© 2019 Rangel et al.)