Uso de enzimas como tratamiento dermatológico regenerador de las líneas de expresión / Use of enzymes as a regenerative dermatological treatment of expression lines / Uso de enzimas como tratamento dermatológico regenerativo de linhas de expressão

INTRODUCCIÓN: el tratamiento con enzimas es una alternativa estética mínimamente invasiva para mejorar la apariencia facial y disminuir las líneas de expresión. OBJETIVO: Determinar el uso de las enzimas hialuronidasa, colagenasa y lipasa como tratamiento enzimático dermatológico para las líneas de expresión facial. MATERIALES Y MÉTODO: estudio de campo, prospectivo, población 457 pacientes que acudieron a la consulta dermatológica entre los años 2013 y 2018 para tratamiento con enzimas. El instrumento de recolección de datos fue la hoja de registro y la fuente documental las historias clínicas. El método estadístico fue descriptivo, la información se presenta en tablas y gráficos. RESULTADOS: la edad promedio de los pacientes fue de 45,2 ± 10,1 años, 40,9% recibió 2 kits de enzimas con los 3 componentes básicos de colagenasa, hialuronidasas y lipasas. Se encontró diferencia significativa en la relación de atención entre hombres y mujeres, de 1:14, es decir las mujeres acudieron más a la consulta solicitando la colocación de este tratamiento. CONCLUSIÓN: el tratamiento con enzimas aporta beneficios al incrementar la permeabilidad dérmica, aumenta el flujo sanguíneo y el drenaje linfático, disminuye los tabiques fibrosos de la celulitis, la flacidez, adiposidades, y rejuvenece el aspecto general. Por lo que se plantea como un tratamiento efectivo para disminuir las líneas de expresión.

INTRODUCTION: enzyme treatment represents a minimally invasive aesthetic alternative to improve facial appearance and decrease expression lines. OBJECTIVE: to determine the use of the enzymes hyaluronidase, collagenase and lipase as a dermatological enzyme treatment as a regenerative treatment for expression lines. METHODS: a prospective field study was conducted of a population made up of 457 patients who attended the UNIMEL dermatological consultation between 2013 and 2018 to be treated with enzymes. The data collection instrument was the record sheet and the documentary source was the medical records. The statistical method was descriptive, the information is presented in tables and graphs. RESULTS: the average age was 45.2 ± 10.1 years of age, to whom a majority of 40.9% were applied 2 kits of enzymes with the 3 basic components of collagenase, hyaluronidases and lipases to act synergistically each other enhancing functions and revitalizing the cells of the face. A significant difference was found in the care ratio between men and women, 1:14, that is, the women attended the consultation more requesting the placement of this treatment. CONCLUSION: the use of enzymes provides great benefits to increase skin permeability, increases lymphatic drainage, reduces fibrous septa of cellulite, sagging and fat, increases blood flow and rejuvenates the general appearance. So, it is proposed as an effective treatment to reduce expression lines

INTRODUÇÃO: o tratamento enzimático é uma alternativa estética minimamente invasiva para melhorar a aparência facial e diminuir as linhas de expressão. OBJETIVO: determinar o uso das enzimas hialuronidase, colagenase e lipase como tratamento enzimático dermatológico para linhas de expressão facial. MATERIAIS E MÉTODOS: estudo de campo em perspectiva, população de 457 pacientes que compareceram à consulta dermatológica entre 2013 e 2018 para tratamento enzimático. O instrumento de coleta de dados foi a folha de registros e a fonte documental foram os registros médicos. O método estatístico foi descritivo, as informações são apresentadas em tabelas e gráficos. RESULTADOS: a idade média dos pacientes foi de 45,2 ± 10,1 anos, 40,9% receberam 2 kits de enzimas com os 3 componentes básicos de colagenase, hialuronidases e lipases. Foi encontrada diferença significativa de 1:14 na relação de atenção entre homens e mulheres, ou seja, as mulheres compareceram mais frequentemente as consultas para a colocação desse tratamento do que aos homes. CONCLUSÃO: o tratamento enzimático oferece benefícios ao aumentar a permeabilidade dérmica, aumenta o fluxo sanguíneo e a drenagem linfática, reduz os septos fibrosos da celulite, flacidez, adiposidade e rejuvenesce a aparência geral. Por isso, é proposto como um tratamento eficaz para diminuir as linhas de expressão.

Therapy for patients with burns - an integrating review

SUMMARY OBJECTIVE: to identify, through an integrative review, national studies published over the last ten years highlighting products and therapies used in burns. METHODS: integrative research with studies published in the last ten years. Including clinical studies describing the use of the already established or innovative therapies in burns and the results obtained, published in national journals in the last ten years. Excluding articles published before 2007 and those that did not present results regarding the use of products in burns. RESULTS: ten articles that met the inclusion criteria were selected. Collagenase, 1% silver sulfadiazine, and porous cellulose membrane were some of the therapies cited. CONCLUSION: the casuistry was low; however, the good results obtained with porous cellulose membrane and silver nanocrystalline dressing are highlighted, since they were used in a larger number of patients in the studies evaluated.

RESUMO OBJETIVO: Identificar, por meio de revisão integrativa, estudos nacionais publicados nos últimos dez anos que destaquem produtos e terapêuticas utilizados nas queimaduras. MÉTODOS: Pesquisa integrativa com estudos publicados nos últimos dez anos. Incluídos os estudos clínicos que descreveram a utilização de terapias já consagradas ou inovadoras em queimaduras e os resultados obtidos e publicados em periódicos nacionais nos últimos dez anos. Excluídos os artigos publicados antes de 2007 e os que não apresentaram resultados quanto ao uso de produtos nas queimaduras. RESULTADOS: Selecionados dez artigos que atenderam aos critérios de inclusão, sendo colagenase, sulfadiazina de prata 1% e membrana celulósica porosa algumas das terapias descritas. CONCLUSÕES: A casuística foi baixa, porém, ressaltam-se os bons resultados obtidos com a membrana celulósica porosa e o curativo com prata nanocristalina, em virtude de terem sido utilizados em um maior número de pacientes nos estudos avaliados.

Evaluación de la actividad anticolagenasa del látex de Croton lechleri / Evaluation of the anti-collagenase activity of the latex of Croton lechleri latex

Objetivo. Determinar la capacidad inhibitoria del látex de Crotón lechleri (sangre de grado) frente a la enzima colagenasa, atenuando la formación de arrugas como consecuencia del efecto hidrolítico del colágeno por parte de la enzima. Materiales y métodos. Se ha utilizado el método in vitro de Thing para probar la actividad anticolagenasa, comparando la actividad del látex con el control positivo conformado por una solución epigalocatequina (EGCG) a concentraciones de 125, 250, 500 1000 ug/mL. Resultados. El porcentaje de inhibición de Látex de Croton lechleri a concentración de 0 ug/mL es 0; de 125 ug/mL es 5,67; de 250 ug/mL es 17,34, de 500 ug/mL es 33,41 y de 1000 ug/mL es 59,53. Conclusiones. El látex de Croton lechleri exhibió una actividad anticolagenasa significativa superando al control positivo, mostrando una IC50 de 908,02 y 1892,03 ug/mL respectivamente.

Objective. Determine the inhibitory capacity of Croton lechleri latex (Dragon's Blood) against the collagenase enzyme, reducing wrinkle formation as a consequence of the hydrolytic effect of the collagen by the enzyme. Materials and methods. Thing's in vitro method has been used to test the anti-collagenase activity, compared the activity of the latex with the positive control formed by an epigallocatechin solution (EGCG) at concentrations of 125, 250, 500 1000 ug/mL. Results. The percentage of Croton lechleri latex inhibition at a concentration of 0 ug/mL is 0, 125 ug/mL is 5.67, 250 ug/mL is 17.34, 500 ug/mL is 33.41 and 1000 ug / mL is 59.53. Conclusion. It has been concluded that Croton lechleri latex has exhibited significant anti collagenase activity exceeding the positive control, showing an IC50 of 908.02 and 1892.03 ug/mL respectively.

Matrix metalloproteinases 2 and 9 in rabbits with doxorubicin-induced cardiomyopathy / Metaloproteinases de matriz 2 e 9 em coelhos com cardiomiopatia induzida pela doxorrubicina

Some studies have shown the role played by matrix metalloproteinases and their inhibitors in doxorubicin cardiotoxicity. In this study, we sought to investigate how plasma and myocardial MMP 2 and 9 perform in rabbits with doxorubicin-induced cardiomyopathy, searching for a correlation between the activity of these collagenases and cardiac remodeling. Cardiomyopathy was induced by doxorubicin given intravenously twice a week for six consecutive weeks. Plasma MMP activity and the echocardiogram were assessed at baseline, and at 15 and 45 days after first injection of doxorubicin. The myocardial activity of these enzymes was solely evaluated in nine rabbits at 45 days, and results were compared with nine healthy controls. We only identified the full-length forms of both MMP 2 and 9 throughout the study. The plasma pro-MMP 2 reduced along the deterioration of cardiac function, while the pro-MMP 9 increased significantly at T45 as compared to baseline and T15. A negative significant correlation was found to exist between the plasma activity of pro-MMP 2 and mitral E-to-mitral septal annular early diastolic velocity ratio, which is an estimate of mean left atrial pressure and congestion. Only pro-MMP 2 was found in myocardial samples, and mean activity of such enzyme was statistically lower than that recorded for healthy controls. Although no active form was documented for either collagenase, the duration of the treatment with doxorubicin played a role in the alteration of plasma pro-forms activity. However, these changes could not be associated with most echocardiographic parameters that are supportive of cardiac remodeling.(AU)

Alguns estudos já demonstraram o papel exercido pelas metaloproteinases de matriz e seus inibidores na cardiotoxicidade promovida pela doxorrubicina. Assim, este estudo teve como objetivo investigar o comportamento das MMPs 2 e 9 plasmáticas e miocárdicas em coelhos com cardiomiopatia induzida pela doxorrubicina, buscando determinar se há correlação entre a atividade dessas colagenases e o remodelamento cardíaco. A cardiomiopatia foi induzida pela doxorrubicina aplicada por via intravenosa duas vezes por semana ao longo de seis semanas consecutivas. A atividade plasmática das MMPs e o ecocardiograma foram avaliados no momento basal e aos 15 e 45 dias após a primeira aplicação da doxorrubicina. A atividade miocárdica dessas enzimas foi quantificada em apenas nove coelhos aos 45 dias e os resultados comparados com outros nove controles saudáveis. Foram identificadas apenas as formas inativas das MMPs 2 e 9 durante todo o estudo. A pro-MMP 2 plasmática reduziu à medida que a função cardiaca se deteriorou, enquanto a pro-MMP 9 aumentou significativamente em T45 quando comparada aos momentos basal e T15. Houve correlação negativa significativa entre a atividade plasmática da pro-MMP 2 e a relação entre E mitral e a velocidade anular mitral no início da diástole, um parâmetro que permite estimar a pressão atrial esquerda média e a congestão. Apenas a pro-MMP 2 foi documentada nas amostras miocárdicas dos coelhos com cardiomiopatia e atividade media dessa enzima foi estatisticamente menor que aquela observada nos controles saudáveis. Embora a forma ativa de ambas as colagenases não tenha sido identificada, o tempo de tratamento com doxorrubicina interferiu na atividade das formas inativas plasmáticas. Contudo, essas alterações não se associaram com a maioria dos parâmetros ecocardiográficos que indicam remodelamento cardíaco.(AU)

Dermoabrasión como alternativa de tratamiento en quemaduras tipo AB en pacientes pediátricos. Experiencia del Servicio de Cirugía Plástica, Unidad de Quemados del Hospital Pediátrico Fernando Bareyro / Dermoabrasion for treatment in pediatric burns

La dermoabrasión en combinación con sulfadiazina de plata y lidocaína, como tratamiento para las quemaduras AB en pacientes pediátricos, presenta ventajas en cuanto a los resultados que ofrece, ya que es un método sencillo y reproducible. Como desventaja presenta que se requieren varias sesiones de tratamiento y en algunos casos, donde se produjo profundización de la lesión, se requirió cobertura con injerto de pie

Collagenolytic enzymes produced by fungi: a systematic review

Abstract Specific proteases capable of degrading native triple helical or denatured collagen have been required for many years and have a large spectrum of applications. There are few complete reports that fully uncover production, characterization and purification of fungi collagenases. In this review, authors searched through four scientific on line data bases using the following keywords (collagenolytic OR collagenase) AND (fungi OR fungus OR fungal) AND (production OR synthesis OR synthesize) AND (characterization). Scientific criteria were adopted in this review to classify found articles by score (from 0 to 10). After exclusion criteria, 21 articles were selected. None obtained the maximum of 10 points defined by the methodology, which indicates a deficiency in studies dealing simultaneously with production, characterization and purification of collagenase by fungi. Among microorganisms studied the non-pathogenic fungi Penicillium aurantiogriseum and Rhizoctonia solani stood out in volumetric and specific collagenase activity. The only article found that made sequencing of a true collagenase showed 100% homology with several metalloproteinases fungi. A clear gap in literature about collagenase production by fungi was verified, which prevents further development in the area and increases the need for further studies, particularly full characterization of fungal collagenases with high specificity to collagen.

Primary cultures of mouse small intestinal epithelial cells using the dissociating enzyme type I collagenase and hyaluronidase

The epithelium is a highly dynamic system, which plays a crucial role in the homeostasis of the intestinal tract. However, studies on the physiological and pathophysiological functions of intestinal epithelial cells (IECs) have been hampered due to lack of normal epithelial cell models. In the present study, we established a reproducible method for primary culture of mouse IECs, which were isolated from the viable small intestinal crypts of murine fetuses (on embryonic day 19), using type I collagenase and hyaluronidase in a short span of time (≤20 min). With this method, continuously growing mouse IECs, which can be subcultured over a number of passages, were obtained. The obtained cell lines formed a tight cobblestone-like arrangement, displayed long and slender microvilli, expressed characteristic markers (cytokeratin 18 and Notch-1), and generated increasing transepithelial electrical resistance and low paracellular permeability during in vitro culture. The cells also had enzymatic activities of alkaline phosphatase and sucrase-isomaltase, and secreted various cytokines (IL-1β, IL-6, IL-8, and monocyte chemoattractant protein-1), responding to the stimulation of Escherichia coli. These results show that the primary-cultured mouse IECs obtained by the method established here had the morphological and immunological characteristics of IECs. This culture system can be a beneficial in vitro model for studies on mucosal immunology and toxicology.

How has dental pulp stem cells isolation been conducted? A scoping review

Abstract: The objective of this study was to realize a scoping review the literature in order to identify the profile of DPSCs isolation and analyze the possible risk factors that could change the native behavior of these cells. An initial search was conducted using the following MeSH terms: "(dental pulp stem cell [MeSH])"; "(dental pulp [MeSH])" AND "(stem cell [MeSH])"; "("dental pulp stem cell" [MeSH]")". The electronic search was done without date restriction up to and including April 2014, in PubMed, Scopus, Scielo and ISI Web of Knowledge databases. Studies were submitted to inclusion and exclusion criteria and 222 articles were included. Data showed that over the past 15 years many studies have been conducted using DPSCs. However this is the first systematic review regarding the isolation of stem cell, and more specifically of dental pulp stem cells. The isolation of dental pulp stem cells showed great variability, hampering the development of standard protocols to achieve in vitro dental pulp stem cells with similar characteristics. This scoping review combined, for the first time, the methodologies used for dental pulp stem isolation, highlighting the most frequently used.

Proposição de uma nova metodologia para isolamento e cultivo de células-tronco mesenquimais derivadas do tecido adiposo / A new methodology proposition for isolation and culture of adipose-derived mesenchymal stem cells

Introdução: As células-tronco mesenquimais (CTM) têm despertado interesse de vários grupos de pesquisa em função do grande potencial de aplicabilidade em terapia celular e medicina regenerativa. Nesse contexto, o tecido adiposo vem recebendo grande destaque como importante fonte para obtenção de CTM. Os protocolos utilizados atualmente para o isolamento das células-tronco derivadas do tecido adiposo (ADSC) empregam, de forma geral, o método de digestão enzimática com colagenase extraída de bactéria (Clostridium histolyticun), que pode conter contaminantes, como endotoxinas e outros peptídeos que, eventualmente, poderão resultar em reações adversas nos procedimentos de terapia celular em pacientes humanos. Objetivo: Pretendeu-se no presente estudo adequar e propor uma nova abordagem empregando a metodologia de dissociação mecânica para isolamento de CTM derivadas de tecido adiposo de ratos. Métodos: As células cultivadas foram analisadas quanto ao potencial de adesão, proliferação e tempo de duplicação celular, por meio de uma curva de crescimento. As células isoladas e cultivadas a partir do tecido adiposo foram também analisadas quanto ao potencial de diferenciação in vitro nas linhagens adipogênica, condrogênica e osteogênica. Resultados: Os resultados mostraram que o tempo de duplicação (velocidade de crescimento) da população celular isolada por dissociação mecânica é mais expressivo quando comparado com a técnica de digestão enzimática. As células isoladas do tecido adiposo apresentaram potencial de diferenciação nas linhagens osteogênica, condrogênica e adipogênica. Conclusão: Os resultados obtidos permitem concluir que a metodologia de dissociação mecânica apresenta-se como uma alternativa viável, de baixo custo e, como tal, extremamente promissora no sentido de permitir que a colagenase de origem bacteriana (Clostridium histolyticun) torne-se um componente prescindível para isolamento e cultivo de células provenientes do tecido adiposo.

Background: Mesenchymal stem cells (MSCs) have attracted interest of several research groups due to the large potential applicability in cell therapy and regenerative medicine. In this context, adipose tissue has received high profile as an important source in order to obtain MSC. The protocols currently suggested for the isolation and culture of adipose- -derived stem cells (ADSC) utilize, in general, the enzymatic digestion method with bacterial collagenase (Clostridium histolyticun) which may contain contaminants such as endotoxin and other peptides that eventually may result in adverse reactions in the cell therapy procedures in human patients. Objective: In this context, it was intended in this study to propose a new methodological approach of mechanical dissociation for isolating and culture of adipose-derived mesenchymal stem cells. Methods: The cultured cells were analyzed for potential adhesion, proliferation and cell doubling time, through a growth curve lineages The cells were also analyzed according to potential for differentiation in adipogenic, chondrogenic and osteogenic lineages. Results: The results showed that the doubling time of the cell population isolated by mechanical dissociation is faster when compared to the enzymatic digestion technique. The isolated cells from adipose tissues howed potential for differentiation in cell lineages osteogenic, adipogenic and chondrogenic. Conclusion: The obtained results allow us to conclude that the methodology of mechanical dissociation, presented in this paper, is a viable, low cost and therefore an extremely promising alternative in order to permit that the bacterial collagenase, from Clostridium histolyticun, become a dispensable component for isolation and cultivation of adipose-derived stem cells.

Comparison between two different experimental models of osteoarthritis in rabbits. Intra-articular collagenase injection and anterior cruciate ligament transection

ABSTRACT PURPOSE: To compare two different experimental models of osteoarthritis in rabbits: intra-articular collagenase injection and anterior cruciate ligament transection. METHODS: Ten adult rabbits were randomly divided in two groups: COLL (collagenase group) and ACLT (anterior cruciate ligament transection). The COLL group was treated with 0.5 ml collagenase solution (2mg collagenase/0.5 ml sterile PBS), and the ACTL group was subjected to anterior cruciate ligament. After six and twelve weeks, respectively, the animals in the COLL and ACTL groups were euthanized. The gross appearance and histological examinations conducted in the cartilage articular surface was blindly scored according to the criteria developed by Yoshimi et al. (1994) and Mankin et al. (1971), respectively. RESULTS: The gross morphologic observation, macroscopic score and histological examinations have demonstrated that the ACTL group presented the highest scores, and lesions more severe than those in the COLL group. CONCLUSIONS: Both methods, anterior cruciate ligament transection and collagenase, applied to the stifle joint of the rabbits have effectively induced degenerative changes in the cartilage tissue, through statistically significant analysis (p≤0.05). The ACTL method has presented more severe lesions.

Full-genome sequences of hepatitis B virus subgenotype D3 isolates from the Brazilian Amazon Region

The Brazilian Amazon Region is a highly endemic area for hepatitis B virus (HBV). However, little is known regarding the genetic variability of the strains circulating in this geographical region. Here, we describe the first full-length genomes of HBV isolated in the Brazilian Amazon Region; these genomes are also the first complete HBV subgenotype D3 genomes reported for Brazil. The genomes of the five Brazilian isolates were all 3,182 base pairs in length and the isolates were classified as belonging to subgenotype D3, subtypes ayw2 (n = 3) and ayw3 (n = 2). Phylogenetic analysis suggested that the Brazilian sequences are not likely to be closely related to European D3 sequences. Such results will contribute to further epidemiological and evolutionary studies of HBV.

Breast cancer in Latin America: global burden, patterns, and risk factors / Cáncer de mama en América Latina: carga, patrones y factores de riesgo

Breast cancer is a major public health problem in Latin America (LA) and the most common form of cancer among women. An important variability according to ethnicity/race with respect to incidence/mortality, clinical characteristics, and prognosis is observed throughout LA. In addition, women are more likely to develop breast cancer (BC) at younger age and to be diagnosed at an advanced stage compared to western women. While little is known about specific risk factors, changes in reproductive pattern (parity, breastfeeding) and lifestyle factors including sedentary behaviours, unhealthy diet, and alcohol intake may contribute to the increase of BC incidence. In this paper we give an overview of the burden and patterns of BC, review the leading causes of BC and discuss the possible ways to improve BC prevention and control in LA.

El cáncer de mama (CaMa) es uno de los mayores problemas de salud pública en América Latina (AL) y el cáncer más frecuente en mujeres. Se observa una importante variabilidad en la incidencia/mortalidad, las características clínicas y el pronóstico según la etnia/raza a lo largo de AL. Además, las mujeres latinoamericanas son más propensas a desarrollar CaMa en edades más tempranas y a ser diagnosticadas en una etapa más avanzada, comparando con mujeres occidentales. Aunque poco se sabe sobre sus factores de riesgo específicos, cambios en los patrones reproductivos (paridad y lactancia) y estilos de vida, incluyendo los hábitos sedentarios, las dietas poco saludables y el consumo de alcohol, podrían contribuir al incremento de la incidencia del CaMa. En este artículo se da una visión general de la carga y los patrones del CaMa, se revisan las causas principales del CaMa y se discuten posibles vías para mejorar la prevención y el control del CaMa en AL.

Hematological change parameters in patients with pressure ulcer at long-term care hospital / Alterações dos parâmetros hematológicos em pacientes portadores de úlcera por pressão em um hospital de longa permanência

Objective To assess factors associated with the development of pressure ulcers, and to compare the effectiveness of pharmacological treatments. Methods The factors associated with the development of pressure ulcers were compared in lesion-carrying patients (n=14) and non-carriers (n=16). Lesion-carrying patients were treated with 1% silver sulfadiazine or 0.6IU/g collagenase and were observed for 8 weeks. The data collected was analyzed with p<0.05 being statistically relevant. Results The prevalence of pressure ulcers was about 6%. The comparison of carrier and non-carrier groups of pressure ulcers revealed no statistically significant difference in its occurrence with respect to age, sex, skin color, mobility, or the use of diapers. However, levels of hemoglobin, hematocrit, and red blood cells were found to be statistically different between groups, being lower in lesion-carrying patients. There was no significant difference found in lesion area between patients treated with collagenase or silver sulfadiazine, although both groups showed an overall reduction in lesion area through the treatment course. Conclusion Hematologic parameters showed a statistically significant difference between the two groups. Regarding the treatment of ulcers, there was no difference in the area of the lesion found between the groups treated with collagenase and silver sulfadiazine. .

Objetivo Avaliar os fatores associados ao desenvolvimento da úlcera por pressão e comparar a efetividade de tratamentos farmacológicos. Métodos Os fatores associados ao desenvolvimento de úlcera por pressão foram comparados entre pacientes portadores (n=14) e não portadores (n=16) da lesão. Os pacientes com a ferida foram tratados com sulfadiazina de prata 1% ou colagenase 0,6UI/g, sendo acompanhados durante 8 semanas. Os dados coletados foram analisados considerando-se estatisticamente significativo se p<0,05. Resultados A prevalência de úlcera por pressão foi de cerca de 6%. A comparação entre os grupos de portadores e não portadores de úlcera por pressão não revelou diferença estatística significativa entre ocorrência desta segundo idade, sexo, cor da pele, mobilidade e uso de fralda. Por outro lado, os valores de hemoglobina, hematócrito e hemácias foram estatisticamente diferentes entre os grupos, sendo menor naqueles pacientes portadores da lesão. Não houve diferença significativa na área da lesão entre aqueles pacientes tratados com colagenase ou sulfadiazina de prata, embora ambos os tratamentos tenham evidenciado uma redução média da área da lesão. Conclusão Os parâmetros hematológicos apresentaram diferença estatística entre os dois grupos avaliados, ao contrário das demais variáveis analisadas. Em relação ao tratamento das úlceras, não houve diferença na área da lesão na comparação entre a colagenase e a sulfadiazina. .

Modulación de la respuesta del huésped en el tratamiento periodontal: revisión de la literatura / Host response modulation in periodontal treatment: a review of the literature

En la enfermedad periodontal, la acumulación de bacterias gramnegativas, genera una respuesta inmunoinflamatoria que es modulada por el mecanismo de defensa del paciente. El tratamiento de modulación del huésped (TMH), ha sido incorporado como una opción farmacológica para el control de la enfermedad periodontal. El objetivo de la revisión fue investigar los efectos de los inhibidores de la colagenasa tisular y de los analgésicos antiinflamatorios no esteroides (AINES) como agentes moduladores de la enfermedad periodontal. A tal fin, se realizó una búsqueda de estudios de casos, controles y revisiones, empleando las bases de datos Medline-PubMed, LILACS y Dialnet. Se encontró que los resultados de las terapias de modulación del huésped tienen como blanco los mediadores proinflamatorios y enzimas destructivas que degradan el colágeno y destruyen tejido óseo, equilibrando y aumentando las acciones antiinflamatorias y protectivas. Los fármacos usados en el TMH regulan los procesos destructivos de la respuesta inmunoinflamatoria en presencia de placa dental, sobre todo en pacientes susceptibles.

Amniotic membrane as a biological dressing in infected wound healing in rabbits

PURPOSE: To investigate amniotic membrane as a biological dressing in infected wound healing in rabbits. METHODS: The use of preserved amniotic membranes (AMs) was examined using 15 rabbits with experimentally induced wound infections on their backs. Healing was histologically evaluated during different phases including inflammation, granulation, epithelialization, and fibroplasia. The animals were distributed into three groups for histological study at seven, 14, 21, and 28 days post-wound induction. Group A did not receive treatment: the wound was left exposed and dry; Group B received a daily exposure treatment with collagenase; and Group C received one AM, which also remained exposed. RESULTS: A marked reduction of the inflammatory phase was observed in Group C at 21 days, and the granulation phase of this healing increased at 14 days. Epithelialization was similar among the three groups, and fibroplasia was more pronounced in Group C at 14 days. Furthermore, gradual collagen organization also began for the animals in Group B at 14 days. CONCLUSION: The amniotic membrane did not significantly alter the inflammation, epithelialization, or fibroplasia phases but did increase angiogenesis up to Day 14 compared with the dry dressing and collagenase treatments. .

Cultivo de células-tronco derivadas de tecido adiposo: uma análise crítica / Culture of adipose-derived stem cells:a critical analysis

Introdução: células-tronco derivadas de tecido adiposo (ADSCs) são pluripotentes, tem coleta poucoinvasiva e apresentam alto rendimento celular em cultura, além do fato de o número de lipoaspirações, a principalfonte destas células, estar aumentando ao redor do mundo. A Cirurgia Plástica tem encontrado benefícios de seu usoem diversas áreas, o que ressalta a importância de se analisar criticamente os protocolos de cultivo atualmenteutilizados. Objetivo: descrever detalhadamente o protocolo de cultivo adotado pelo nosso laboratório para podermos realizar uma análise crítica sobre o cultivo de ADSCs. Método: excedentes de tecido adiposo foram doados ao laboratório com finalidade de pesquisa por cinco pacientes de ambos os sexos e faixa etária de 20 a 45 anos. De cada paciente, 30 mL do material gorduroso foram coletados em frasco estéril e transportados ao laboratório de cultura celular, onde foram submetidos, por 45 min, à digestão enzimática por 30 mg de colagenase tipo IA diluída em30mL de meio de Dulbecco Modificado por Eagle (DMEM) e posteriormente centrifugados para que se isolem ascélulas da matriz extracelular. A amplificação das culturas foi feita com solução de tripsina 0,05% + EDTA 0,02%. Para congelamento, utilizou-se meio de congelamento composto por 60% DMEM, 10% dimetilsulfóxido (DMSO) e 30% SBF. Resultados: o protocolo apresentado para o cultivo de ADSCs demonstrou um cultivo celularsatisfatório, completando três passagens de cultura em todas as amostras, com posterior congelamento edescongelamento. Conclusões: a literatura científica nos indica que a colagenase possibilita extração e isolamento de ADSCs, devendo-se atentar ao tipo utilizado. Quanto ao congelamento, dado a citotoxicidade do DMSO, novos protocolos com grandes amostras substituindo este crioprotetor por trealose devem ser testados, visto que este último produziu bons resultados e não apresentou efeitostóxicos nos estudos já publicados.

Introduction: adipose-derived stem cells (ADSCs) are pluripotent and present little invasive collectionand high cell yield in culture, besides the fact that the number of liposuctions, the main source of these cells, is increasing around the world. Plastic Surgery has found the benefits of the use of those cells in several areas, which increases the importance of critically analyzing the protocolscurrently used for cell cultivation. Objective: to describe in detail the cultivation protocol adopted by our laboratory in order to perform a critical analysis of the culture of ADSCs. Method: surpluses of adipose tissue were donated to the laboratory with research purposes for 5 patients of bothgenders and age between 20 and 45 years. From each patient, 30 mL of fatty material was collected in a sterile flask and transported to the laboratory for cell culture, where they were subjected during 45 min to enzymatic digestion by 30 mg of type IA collagenase diluted in 30mL of Dulbecco’s Modified Eagle Medium (DMEM) and thencentrifuged to isolate the cells from the extracellular matrix. The amplification of the cultures was made with 0.05%trypsin solution + EDTA 0.02%. For cryopreservation was used freezing media consisting of 60% DMEM, 10%dimethylsulfoxide (DMSO) and 30% FBS. Results: The above protocol for growing ADSCs obtained a satisfactorycell culture, completing three cell passages in all samples, with subsequent freezing and thawing. Conclusions: The scientific literature indicates that collagenase get the bestresults in the extraction and isolation of ADSCs, paying attention to the type used. Regarding freezing, given thecytotoxicity of DMSO, new protocols with large samples replacing this cryoprotectant by trehalose should be tested, since the latter has produced good results and showed no toxic effects in published studies.

Análisis de MMPs en fluidos orales en el diagnóstico complementario de las enfermedades periodontales / Oral-fluid MMP analysis in the complementary diagnosis of periodontal diseases

La periodontitis constituye la infección bacteriana más prevalente a nivel mundial y representa un factor de riesgo para diversas patologías sistémicas. El estado de inflamación y destrucción periodontal se manifiestan a través de la presencia de biomarcadores en el suero y fluidos orales, tales como el fluido gingival crevicular (FGC), saliva y enjuague oral. Enzimas como las metaloproteinasas de matriz (MMP) y mieloperoxidasa, constituyen biomarcadores potenciales para ensayos moleculares complementarios a la clínica de uso en el sillón dental. A continuación se presenta una revisión de la literatura respecto de la aplicación potencial del análisis de metaloproteinasas de matriz extracelular (MMPs) en el diagnóstico complementario de las enfermedades periodontales. Se ha demostrado que los niveles de MMP-9, -13 y particularmente de MMP-8, se asocian con el grado de inflamación periodontal, y pueden diferenciar entre sujetos sanos, con gingivitis, periodontitis y peri-implantitis, mientras que la mejoría de los parámetros clínicos en respuesta al tratamiento periodontal se asocia con la reducción de la activación y niveles de estas enzimas en FGC, como así también en el suero. Se concluye que la determinación, particularmente de MMP-8 en fluidos orales presenta un elevado potencial como complemento de los métodos clínicos tradicionales para identificar a los pacientes con periodontitis o en riesgo de desarrollar la enfermedad, monitorear fases del tratamiento y mejoría de signos periodontales e incluso evaluar el estado de inflamación sistémica.

Periodontal disease is the most common bacterial infection worldwide and it can contribute to enhance the risk for the development of several systemic diseases. The status of periodontal inflammation and destruction can be reflected in biomarker measurement in serum and oral fluids, like gingival crevicular fluid (GCF), saliva and mouth-rinse. Some enzymes, such as matrix metalloproteinases (MMPs) and myeloperoxidase are potential candidates for chair-side point-of-care oral fluid assays. This review is focused on the utility of matrix metalloproteinase (MMP) analysis in oral fluid as a complementary diagnostic method to chronic periodontitis. Levels of MMP-9,-13 and specially of MMP-8, reflect oral inflammatory status and discriminate among healthy, gingivitis, periodontitis and periimplantitis individuals, whereas MMP levels and activation in GCF and serum are in line with the improvement of clinical parameters in response to periodontal treatment. As a conclusion, MMP-8 assessment in GCF could represent a helpful adjunctive method to traditional diagnostics to identify periodontitis or patients at risk to develop the disease, monitor treatment phases, improvement of periodontal signs and even screen the systemic inflammation status.

Enfermedad de Dupuytren: revisión / Dupuytren disease

Background: Dupuytren disease (DD) is a connective tissue disorder that consists in fibroma-tosis of the palmar and digital fascia (in form of nodules or flanges) that leads to the development of flexion contractures of the palm and fingers. The little and ring finger are particularly affected. The disease can limit hand function, reducing the quality of life. The disease can have a traumatic origin and is also associated with conditions such as diabetes mellitus, alcoholism, dyslipidemia, epilepsy and AIDS, among others. However, none of these conditions can fully explain the genesis of DD. A hereditary component is described in 40% of patients and is attributed to an autosomal dominant gene of variable penetrance, probably related to collagen synthesis. However there are also spontaneous and recessive inheritance cases. The diagnosis is clinical and based on physical examination. Treatment ranges from observation or use of injectable collagenase to the surgical option in cases with significant functional limitations.

Tratamento de queimadura de segundo grau superficial em face e pescoço com heparina tópica: estudo comparativo, prospectivo e randomizado / Treatment of superficial second degree burn of face and neck with topical heparin: a comparative, prospective and randomized study

INTRODUÇÃO: Novas opções terapêuticas para o tratamento de lesões térmicas são constantemente buscadas, especialmente se reduzirem tempo de cicatrização e dor, sem aumentar as taxas de infecção das queimaduras. Estudos recentes sugerem que o uso tópico de heparina pode alcançar esses objetivos. Este estudo tem o objetivo de avaliar tempo de epitelização, dor e taxa de infecção, comparando o uso de heparina tópica ao uso de colagenase no tratamento de queimadura de segundo grau superficial de face e pescoço. MÉTODO: No total, 20 pacientes foram randomizados em dois grupos: grupo tratado com heparina sódica e grupo tratado com colagenase (controle). Os critérios de exclusão foram: história de sangramento, discrasia sanguínea, alergias ao produto, úlcera péptica ativa e queimadura há mais de 24 horas. O teste de Mann-Whitney foi utilizado para avaliar os resultados. A dor foi avaliada pela necessidade do uso de analgésicos opioides. RESULTADOS: A heparina não foi efetiva em diminuir o tempo de epitelização ou o uso de opioides, e a taxa de infecção não apresentou diferença estatística entre os grupos. CONCLUSÕES: A heparina pode ser usada com segurança no tratamento de queimadura de segundo grau superficial em face e pescoço, mas seus efeitos benéficos ainda precisam ser comprovados.

BACKGROUND: New treatment options for thermal injuries are very desirable, especially if they reduce healing time and pain without increase of infection rates. Recent studies suggest that heparin topical use can achieve those goals. This study has the objective to evaluate healing time, pain and infection rate comparing topical use of heparin and collagenase in the treatment of superficial second degree burns of face and neck. METHODS: Twenty patients were randomized into 2 groups: group treated with topical heparin and group treated with collagenase (control group). The exclusion criteria were: history of bleeding, blood discrasia, allergies to the product, active peptic ulcer and burns with more than 24 hours. Mann-Whitney test was applied to evaluate the results. The pain was measured by the use of opioid analgesics. RESULTS: The heparin was not effective in decrease of healing time nor the use of opioids, and the infection rate didn't present significant difference between the groups. CONCLUSIONS: The heparin can be used safely in treatment of superficial second degree burn of face and neck, but its beneficial effects need to be proven.