Serum butyrylcholinesterase activity in healthy dogs with and without exposure to diazinon.

BACKGROUND: Cholinesterase is a biomarker for poisonings by anticholinesterase agents, but its reference values are scarce, and possible interaction with collars containing parasiticides has not been studied. OBJECTIVES: We aimed to evaluate the serum cholinesterase activity of healthy dogs without a history of contact with anticholinesterase agents and healthy animals exposed to commercial collars containing organophosphate. METHODS: Ninety-nine dogs were used and included healthy animals without recent exposure to anticholinesterase agents and healthy animals previously exposed to diazinon collars. Serum quantification of the enzyme butyrylcholinesterase (BuchE) through spectrophotometry was conducted on all samples. In experiment 1, BuchE activity was quantified at time 0 and 7 days after, a time when the samples were kept at -18°C. In experiment 2, sampling times were 0, 7, 14, 21, 28, and 56 days. RESULTS: Time 0 values were 4622.38 ± 1311.53 U/L. After 7 days, a significant decay was observed, with a mean of 3934.45 ± 1430.45 U/L. Spearman's test was performed, finding a weak correlation between ALT, creatinine, total plasma proteins, age, weight, red blood cells, platelets, leukocytes, and BuchE activities. In experiment 2, the mean at time 0 was 4753 ± 454.8 U/L. With exposure to the collar, there was a decay of up to 93% after 14 days. CONCLUSIONS: Normality values of serum BuchE in healthy dogs without a history of exposure to anticholinesterase agents were 4360.8-4883.96 U/L. Freezing serum caused a decrease in BuchE activity. Exposure to commercial collars containing diazinon also reduced BuchE activity without clinical signs, indicating that previously exposed animals should be evaluated carefully.

Use of biomarkers for predicting a malignant course in acute ischemic stroke: an observational case-control study.

Acute ischemic stroke is a sudden neurological event caused by brain ischemia. Patients with large vessel occlusion are at high risk of developing significant cerebral edema, which can lead to rapid neurological decline. The optimal timing for decompressive hemicraniectomy to prevent further brain damage is still uncertain. This study aimed to identify potential predictors of severe brain edema. The data indicate that specific cytokines may help identify patients with a higher risk of developing life-threatening brain swelling in the early phase post-stroke. The association between a positive biomarker and the outcome was calculated, and three biomarkers-S100B protein, MMP-9, and IL-10-were found to be significantly associated with malignant edema. A model was derived for early predicting malignant cerebral edema, including S100B protein and IL-1 beta. These findings suggest that molecular biomarkers related to the ischemic cascade may be a helpful way of predicting the development of malignant cerebral edema in ischemic stroke patients, potentially widening the time window for intervention and assisting in decision-making. In conclusion, this study provides insights into the molecular mechanisms of severe brain edema and highlights the potential use of biomarkers in predicting the course of ischemic stroke.

Efficacy and Safety of Clazosentan After Aneurysmal Subarachnoid Hemorrhage: An Updated Meta-Analysis.

BACKGROUND AND OBJECTIVES: Clazosentan has been studied to treat cerebral vasospasm after aneurysmal subarachnoid hemorrhage (aSAH).This meta-analysis of randomized controlled trials updates the current knowledge regarding the efficacy and safety of clazosentan compared with placebo after aSAH. METHODS: Databases were systematically searched for randomized controlled trials directly comparing the use of clazosentan and placebo for the treatment of cerebral vasospasm after aSAH. Additional eligibility criteria were the report of any of the outcomes of interest (vasospasm, morbidity, functional outcome, or mortality). The primary outcome was vasospasm-related delayed cerebral ischemia (DCI). The analyses were stratified by clazosentan dosage (low or high dose) and aneurysm treatment modality (clipping or coiling). The Cochrane RoB-2 tool was used for studies quality assessment. RESULTS: Six studies comprising 7 clinical trials were included, involving 2778 patients. Clazosentan decreased the risk of vasospasm-related DCI (risk ratio [RR] 0.56, 95% CI 0.38-0.81) and delayed ischemic neurological deficit (RR 0.63, 95% 0.50-0.80). Angiographic vasospasm (RR 0.54, 95% CI 0.47-0.61) was also decreased. Functional outcomes (favorable Glasgow Outcome Scale, RR 0.99, 95% CI 0.79-1.24) and death (RR 1.03, 95% CI 0.71-1.49) did not change. Meanwhile, adverse events were increased by clazosentan (RR 1.54, 95% CI 1.35-1.76). CONCLUSION: Clazosentan decreased vasospasm-related DCI and angiographic vasospasm but did not improve functional outcomes or mortality. Adverse events were increased by clazosentan.

Functional recovery of injured cavernous nerves achieved through endogenous nerve growth factor-containing bioactive fibrous membrane.

Radical prostatectomy is a highly successful treatment for prostate cancer, among the most prevalent manifestations of the illness. Damage of the cavernous nerve (CN) during prostatectomy is the main cause of postoperative erectile dysfunction (ED). In this study, the capability of a personalized bioactive fibrous membrane to regenerate injured CN was investigated. The fibrous membrane bioactivity is conferred by the selectively bound nerve growth factor (NGF) present in the rat urine. In a rat model of bilateral CN crush, the implanted bioactive fibrous membrane induces CN regeneration and restoration of erectile function, showing a significantly increased number of smooth muscle cells and content of endothelial and neuronal nitric oxide synthases (eNOS; nNOS). In addition, the bioactive fibrous membrane promotes nerve regeneration by increasing the number of myelinated axons and nNOS-positive cells, therefore reversing the CN fibrosis found in untreated rats or rats treated with a bare fibrous membrane. Therefore, this personalized regenerative strategy could overcome the recognized drawbacks of currently available treatments for CN injuries. It may constitute an effective treatment for prostate cancer patients suffering from ED after being subject to radical prostatectomy. STATEMENT OF SIGNIFICANCE: The present work introduces a unique strategy to address post-surgical ED resulting from CN injury during pelvic surgery (e.g., radical prostatectomy, radical cystoprostatectomy, abdominoperineal resection). It comprises a bioactive and cell-free fibrous implant, customized to enhance CN recovery. Pre-clinical results in a rat model of bilateral CN crush demonstrated that the bioactive fibrous implant can effectively heal injured CN, and restore penile structure and function. This implant selectively binds NGF from patient fluids (i.e. urine) due to its functionalized surface and high surface area. Moreover, its local implantation reduces adverse side effects. This tailored regenerative approach has the potential to revolutionize the treatment of ED in prostate cancer patients following radical prostatectomy, overcoming current treatment limitations.

Ocular involvement in primary antiphospholipid syndrome: results of an extensive ophthalmological evaluation performed in the APS-Rio cohort.

OBJECTIVE: To study ophthalmological manifestations in a well-characterized primary antiphospholipid syndrome (PAPS) cohort (APS-Rio) and compare them with a healthy control group. METHODS: We examined PAPS patients and controls with an extensive ophthalmological evaluation, which included anamnesis, visual acuity, slit-lamp biomicroscopy, binocular indirect ophthalmoscopy, and retinography of the anterior and posterior segments of the eye. PAPS group also underwent angiography exam and optical coherence tomography using spectral domain technology (SD-OCT). RESULTS: 98 PAPS patients and 102 controls were included. The most common symptom in PAPS was amaurosis fugax (34.7% vs. 6.9%; p = .001). In the multivariate analyses, Raynaud's phenomenon was associated with amaurosis fugax (OR 3.71, CI:1.33-10.32; p = .012), and livedo correlated with hemianopia (OR 6.96, CI:1.11-43.72, p = .038) and diplopia (OR 3.49, CI:1.02-11.53, p = .047). After ophthalmological evaluation, 84 PAPS patients had ocular involvement (1.0% glaucoma, 94.0% posterior findings, 62.7% anterior findings, and 56.6% both posterior and anterior findings). Vascular tortuosity was more frequent in the PAPS group (63.2% vs. 42.2%; p = .002), as well as peripheral tortuosity (29.6% vs. 7.8%; p < .001). After excluding patients with atherosclerotic risk factors, peripheral vascular tortuosity was still statistically associated with PAPS (35.0 vs. 7.8%, p < .001). Triple positivity was more frequent in PAPS patients with peripheral vascular tortuosity than in those without this ocular finding (34.5% vs. 15.9%, p = .041). CONCLUSION: Vasomotor phenomena are importantly related to ocular symptoms in PAPS. Vascular tortuosity was a frequent finding in PAPS patients. Peripheral vascular tortuosity was associated with triple positivity and might be a biomarker of ischemic microvascular retinopathy due to PAPS.

Surface Functionalization of Ureteral Stents-Based Polyurethane: Engineering Antibacterial Coatings.

Bacterial colonization of polyurethane (PU) ureteral stents usually leads to severe and challenging clinical complications. As such, there is an increasing demand for an effective response to this unmet medical challenge. In this study, we offer a strategy based on the functionalization of PU stents with chitosan-fatty acid (CS-FA) derivatives to prevent bacterial colonization. Three different fatty acids (FAs), namely stearic acid (SA), oleic acid (OA), and linoleic acid (LinA), were successfully grafted onto chitosan (CS) polymeric chains. Afterwards, CS-FA derivatives-based solutions were coated on the surface of PU stents. The biological performance of the modified PU stents was evaluated against the L929 cell line, confirming negligible cytotoxicity of the developed coating formulations. The antibacterial potential of coated PU stents was also evaluated against several microorganisms. The obtained data indicate that the base material already presents an adequate performance against Staphylococcus aureus, which slightly improved with the coating. However, the performance of the PU stents against Gram-negative bacteria was markedly increased with the surface functionalization approach herein used. As a result, this study reveals the potential use of CS-FA derivatives for surface functionalization of ureteral PU stents and allows for conjecture on its successful application in other biomedical devices.

A Fibrin Coating Method of Polypropylene Meshes Enables the Adhesion of Menstrual Blood-Derived Mesenchymal Stromal Cells: A New Delivery Strategy for Stem Cell-Based Therapies.

Polypropylene (PP) mesh is well-known as a gold standard of all prosthetic materials of choice for the reinforcement of soft tissues in case of hernia, organ prolapse, and urinary incontinence. The adverse effects that follow surgical mesh implantation remain an unmet medical challenge. Herein, it is outlined a new approach to allow viability and adhesion of human menstrual blood-derived mesenchymal stromal cells (MenSCs) on PP surgical meshes. A multilayered fibrin coating, based on fibrinogen and thrombin from a commercial fibrin sealant, was optimized to guarantee a homogeneous and stratified film on PP mesh. MenSCs were seeded on the optimized fibrin-coated meshes and their adhesion, viability, phenotype, gene expression, and immunomodulatory capacity were fully evaluated. This coating guaranteed MenSC viability, adhesion and did not trigger any change in their stemness and inflammatory profile. Additionally, MenSCs seeded on fibrin-coated meshes significantly decreased CD4+ and CD8+ T cell proliferation, compared to in vitro stimulated lymphocytes (p < 0.0001). Hence, the proposed fibrin coating for PP surgical meshes may allow the local administration of stromal cells and the reduction of the exacerbated inflammatory response following mesh implantation surgery. Reproducible and easy to adapt to other cell types, this method undoubtedly requires a multidisciplinary and translational approach to be improved for future clinical uses.

Potential strategies to prevent encrustations on urinary stents and catheters - thinking outside the box: a European network of multidisciplinary research to improve urinary stents (ENIUS) initiative.

Introduction: Urinary stents have been around for the last 4 decades, urinary catheters even longer. They are associated with infections, encrustation, migration, and patient discomfort. Research efforts to improve them have shifted onto molecular and cellular levels. ENIUS brought together translational scientists to improve urinary implants and reduce morbidity.Methods & materials: A working group within the ENIUS network was tasked with assessing future research lines for the improvement of urinary implants.Topics were researched systematically using Embase and PubMed databases. Clinicaltrials.gov was consulted for ongoing trials.Areas covered: Relevant topics were coatings with antibodies, enzymes, biomimetics, bioactive nano-coats, antisense molecules, and engineered tissue. Further, pH sensors, biodegradable metals, bactericidal bacteriophages, nonpathogenic uropathogens, enhanced ureteric peristalsis, electrical charges, and ultrasound to prevent stent encrustations were addressed.Expert opinion: All research lines addressed in this paper seem viable and promising. Some of them have been around for decades but are yet to proceed to clinical application (i.e. tissue engineering). Others are very recent and, at least in urology, still only conceptual (i.e. antisense molecules). Perhaps the most important learning point resulting from this pan-European multidisciplinary effort is that collaboration between all stakeholders is not only fruitful but also truly essential.

Popular education, health promotion and active aging: an integrative literature review. / Educação popular, promoção da saúde e envelhecimento ativo: uma revisão bibliográfica integrativa.

Population ageing is a global phenomenon and requires actions to promote well-being and prevent illnesses and unnecessary hospital admissions. The objective of this study was to identify education and health promotion actions aimed at promoting active aging. An integrative literature review was conducted of relevant articles written in Portuguese, English and Spanish published between 2005 and August 2018 using the following electronic databases and virtual libraries: Lilacs, MEDLINE, SciELO, and BVS. The initial search resulted in 2,069 articles, of which 33 met the inclusion criteria. The analysis showed that the actions identified by the review promoted the adoption of healthy habits and participation of older people, characterizing them as actions that promote active aging. However, the actions were limited almost exclusively to this age group, which may lead to age segregation, and focused on old age rather than adopting a life course perspective of active aging. Despite the importance of these actions, only 11 were evaluated, suggesting that the evaluation of education and health promotion actions to demonstrate effectiveness and promote replication in other locations or services is not very common practice.

O envelhecimento populacional é um fenômeno mundial e requer ações que propiciem bem-estar e previnam agravos e hospitalizações evitáveis. O propósito deste artigo foi identificar ações educativas e de promoção de saúde voltadas ao envelhecimento ativo. Trata-se de uma revisão bibliográfica integrativa de estudos publicados no ano de 2005 a agosto de 2018 nas bases de dados Lilacs e Medline, e nas bibliotecas virtuais SciELO e BVS em português, inglês e espanhol. Foram encontrados 2.069 estudos sobre os temas, sendo selecionados 33 depois de aplicados os critérios de inclusão. A observação mostrou que as ações identificadas promovem a adoção de hábitos saudáveis e a participação dos idosos, caracterizando-as como promotoras do envelhecimento ativo. No entanto, observam-se que estão limitadas ao segmento de idosos, o que pode favorecer a segregação etária, além de considerar o envelhecimento a partir da terceira idade e não um processo contínuo da vida. Das ações aqui evidenciadas, embora importantes, apenas onze delas foram avaliadas, o que sugere que a avaliação ainda não está sedimentada nos processos de intervenções de educação e promoção da saúde para mostrar efetividade e favorecer a replicação em outros locais ou serviços.

Educação popular, promoção da saúde e envelhecimento ativo: uma revisão bibliográfica integrativa / Popular education, health promotion and active aging: an integrative literature review

Resumo O envelhecimento populacional é um fenômeno mundial e requer ações que propiciem bem-estar e previnam agravos e hospitalizações evitáveis. O propósito deste artigo foi identificar ações educativas e de promoção de saúde voltadas ao envelhecimento ativo. Trata-se de uma revisão bibliográfica integrativa de estudos publicados no ano de 2005 a agosto de 2018 nas bases de dados Lilacs e Medline, e nas bibliotecas virtuais SciELO e BVS em português, inglês e espanhol. Foram encontrados 2.069 estudos sobre os temas, sendo selecionados 33 depois de aplicados os critérios de inclusão. A observação mostrou que as ações identificadas promovem a adoção de hábitos saudáveis e a participação dos idosos, caracterizando-as como promotoras do envelhecimento ativo. No entanto, observam-se que estão limitadas ao segmento de idosos, o que pode favorecer a segregação etária, além de considerar o envelhecimento a partir da terceira idade e não um processo contínuo da vida. Das ações aqui evidenciadas, embora importantes, apenas onze delas foram avaliadas, o que sugere que a avaliação ainda não está sedimentada nos processos de intervenções de educação e promoção da saúde para mostrar efetividade e favorecer a replicação em outros locais ou serviços.

Abstract Population ageing is a global phenomenon and requires actions to promote well-being and prevent illnesses and unnecessary hospital admissions. The objective of this study was to identify education and health promotion actions aimed at promoting active aging. An integrative literature review was conducted of relevant articles written in Portuguese, English and Spanish published between 2005 and August 2018 using the following electronic databases and virtual libraries: Lilacs, MEDLINE, SciELO, and BVS. The initial search resulted in 2,069 articles, of which 33 met the inclusion criteria. The analysis showed that the actions identified by the review promoted the adoption of healthy habits and participation of older people, characterizing them as actions that promote active aging. However, the actions were limited almost exclusively to this age group, which may lead to age segregation, and focused on old age rather than adopting a life course perspective of active aging. Despite the importance of these actions, only 11 were evaluated, suggesting that the evaluation of education and health promotion actions to demonstrate effectiveness and promote replication in other locations or services is not very common practice.

Traffic safety meta-analysis of reversible lanes.

A meta-analysis was performed to review the potential effects of reversible lanes on traffic safety. A systematic review resulted in ten U.S studies, with 155 estimates of safety effects, that were selected for inclusion in the analysis. These studies employed either a simple before-after comparison or a cross-sectional comparison methodology. Study results were extracted by transforming the collision rates and frequencies of these studies into a log-odds ratio. The results of the meta-analysis suggest that the odds of a collision occurring are 30.9% higher for roads with reversible lanes when compared to roads without the treatment. The odds of a property-damage-only collision are predicted to be 16.6% higher, and injury collisions are predicted to be 34.9% higher with reversible lanes compared to no-treatment. The odds of a collision occurring during the peak period are expected to be 46.2% higher, while the odds of an off-peak period collision occurring are expected to be 12.8% higher. These results were statistically significant, with the exception of the off-peak period collision result. A meta-regression was performed, which regresses variables related to study type, collision type and operational characteristics of the study locations on the extracted log odds ratio. Peak period operations were positively and significantly correlated with an increase in crashes. Presence of left-turn restrictions and/or delineator/barrier were negatively correlated with crashes, whereas the presence of dynamic traffic control and static traffic control were positively correlated with crashes. Finally, cross sectional studies tend to find greater effects than before-after studies.

Use of hemostatic agents for surgical bleeding in laparoscopic partial nephrectomy: Biomaterials perspective.

In recent years, there was an abrupt increase in the incidence of renal tumors, which prompt up the appearance of cutting-edge technology, including minimally invasive and organ-preserving approaches, such as laparoscopic partial nephrectomy (LPN). LPN is an innovative technique used to treat small renal masses that have been gaining popularity in the last few decades due to its promissory results. However, the bleeding control remains the main challenge since the majority of currently available hemostatic agents (HAs) used in other surgical specialities are inefficient in LPN. This hurried the search for effective HAs adapted for LPN surgical peculiarities, which resulted on the emergence of different types of topical HAs. The most promising are the natural origin HAs because of their inherent biodegradability, biocompatibility, and lowest toxicity. These properties turn them top interests' candidates as HAs in LPN. In this review, we present a deep overview on the progress achieved in the design of HAs based on natural origin polymers, highlighting their distinguishable characteristics and providing a clear understanding of their hemostat's role in LPN. This way it may be possible to establish a structure-composition properties relation, so that novel HAs for LPN can be designed to explore current unmet medical needs.

New endoscopic procedure for bladder wall closure: results from the porcine model.

Upper urinary tract urothelial carcinomas are usually managed by radical nephroureterectomy (RNU), often followed by intravesical chemotherapy to minimize recurrence. Open surgery is the gold standard procedure for RNU, but it associates with high morbidity, and it has been increasingly replaced by minimally invasive strategies, such as laparoscopy and endoscopy. Although effective, endoscopic ureteral excision leaves the bladder unsutured, increasing the risk of tumor spillage, and precluding the immediate administration of intravesical chemotherapy. Here we describe a new method to close the bladder wall after ureteral excision, using barbed sutures via the endoscopic access. Our results in 8 female pigs demonstrate that this method is effective to close the bladder wall. The procedure was completed in a median time of 24 min, and no adverse events were registered in the follow-up or at the three-week necropsy. This technique improves a previous approach described by our group because the device is more flexible and allows to tie the knots inside the bladder. Barbed sutures have been used in the clinical practice for other types of surgeries, and therefore this method can further be adapted to human patients with no safety concerns. Its use may allow to administer intravesical chemotherapy, which reduces tumor recurrence and improves patient outcomes.

Bioavailability of heavy metals in mangrove soil in Alagoas, Brazil / Biodisponibilidade de metais pesados em solo de mangue em Alagoas, Brasil

The mangrove forest is an important transitional ecosystem consisted of terrestrial and marine environment located in tropical and subtropical regions with average temperatures above 20 °C. In Alagoas, the mangrove forests are found on the entire coastline from Maragogi to Piaçabuçu. In the last 20 years, due to the pollution of water resources, studies of coastal aquatic ecosystems have been developed. The objective of this study was to analyze the physicochemical properties and determine the levels of heavy metals in mangrove sediments of the Mundaú-Manguaba estuary lagoon complex (MMELC) and Meirim River in Alagoas. Zinc, copper, lead, cadmium and chromium were chosen due to their relationship with sewer, agricultural, and industrial wastes. 22 soil samples were collected in the MMELC and in the Meirim River. The samples were submitted to soil routine analyses of Embrapa. The heavy metals were extracted by the Mehlich-1 method and analyzed by atomic absorption spectrometry. The mean concentrations of these metals in thesediment samples followed the order Mn > Zn >Pb > Cr> Cu >Cd in MMELC and Zn > Mn >Pb > Cr> Cu >Cd in Meirim River. All proposed heavy metals were found in sediments, however, the cadmium levels were above the normal levels proposed by Environment National Council (CONAMA) and Canadian Council of Ministers of the Environment. The study shows that the analysis of sediment can contribute to environmental monitoring actions and development of public policies aimed to controlling the sustainable use of natural resources of the studied areas.

O manguezal é um importante ecossistema de transição entre o ambiente marinho e terrestre, localizado em regiões tropicais e subtropicais com temperaturas médias acima de 20°C. Em Alagoas podemos encontrar florestas de mangue em praticamente todo o litoral desde Maragogi até Piaçabuçu. Nosúltimos 20 anos, a poluição dos recursos hídricos tem levado ao estudo dos ecossistemas aquáticos costeiros, que são importantes para preservação e equilíbrio da vida. O objetivo deste trabalho foi analisar as propriedades físico-químicas e determinar os teores ambientalmente disponíveis de metais nos sedimentos do mangue existente na foz CELMM (e do rio Meirim em Alagoas. Foram escolhidos os metais zinco, cobre, chumbo, cádmio e crômio por estarem ligados aos despejos de esgotos, projetos agropecuários, e fontes industriais. Foram coletadas 22 amostras de solo nos estuários do CELMM e do rio Meirim. As amostras foram submetidas as análises de rotina para solos da Embrapa. As concentrações médias desses metais nas amostras de sedimento seguiram a ordem Mn > Zn >Pb > Cr> Cu >Cd in CELMM e Zn > Mn >Pb > Cr> Cu >Cd no Rio Meirim. Os metais foram extraídos pelo método Mehlich-1 e analisados por meio de espectrometria de absorção atômica. Foram encontrados nos sedimentos todos os metais propostos na pesquisa com destaque para os teores de cádmio detectados em valores absolutos acima de valores considerados normais pelo Conselho Nacional doMeio Ambiente e pelo Canadian Council of Ministers of the Environment em alguns pontos do estuário do rio Meirim. O estudo mostra que a análise dos sedimentos pode, portanto, contribuir para ações de monitoramento ambiental, subsidiando a implantação e desenvolvimento de políticas públicas que visem controlar o usoracional e sustentável dos recursos naturais das áreas do estudas.

Evaluating Efficacy of Antimicrobial and Antifouling Materials for Urinary Tract Medical Devices: Challenges and Recommendations.

In Europe, the mean incidence of urinary tract infections in intensive care units is 1.1 per 1000 patient-days. Of these cases, catheter-associated urinary tract infections (CAUTI) account for 98%. In total, CAUTI in hospitals is estimated to give additional health-care costs of £1-2.5 billion in the United Kingdom alone. This is in sharp contrast to the low cost of urinary catheters and emphasizes the need for innovative products that reduce the incidence rate of CAUTI. Ureteral stents and other urinary-tract devices suffer similar problems. Antimicrobial strategies are being developed, however, the evaluation of their efficacy is very challenging. This review aims to provide considerations and recommendations covering all relevant aspects of antimicrobial material testing, including surface characterization, biocompatibility, cytotoxicity, in vitro and in vivo tests, microbial strain selection, and hydrodynamic conditions, all in the perspective of complying to the complex pathology of device-associated urinary tract infection. The recommendations should be on the basis of standard assays to be developed which would enable comparisons of results obtained in different research labs both in industry and in academia, as well as provide industry and academia with tools to assess the antimicrobial properties for urinary tract devices in a reliable way.

The prognostic accuracy evaluation of SAPS 3, SOFA and APACHE II scores for mortality prediction in the surgical ICU: an external validation study and decision-making analysis.

BACKGROUND: The early postoperative period is critical for surgical patients. SOFA, SAPS 3 and APACHE II are prognostic scores widely used to predict mortality in ICU patients. This study aimed to evaluate these index tests for their prognostic accuracy for intra-ICU and in-hospital mortalities as target conditions in patients admitted to ICU after urgent or elective surgeries and to test whether they aid in decision-making. The process comprised the assessment of discrimination through analysis of the areas under the receiver operating characteristic curves and calibration of the prognostic models for the target conditions. After, the clinical relevance of applying them was evaluated through the measurement of the net benefit of their use in the clinical decision. RESULTS: Index tests were found to discriminate regular for both target conditions with a poor calibration (C statistics-intra-ICU mortality AUROCs: APACHE II 0.808, SAPS 3 0.821 and SOFA 0.797/in-hospital mortality AUROCs: APACHE II 0.772, SAPS 3 0.790 and SOFA 0.742). Calibration assessment revealed a weak correlation between the observed and expected number of cases in several thresholds of risk, calculated by each model, for both tested outcomes. The net benefit analysis showed that all score's aggregate value in the clinical decision when the calculated probabilities of death ranged between 10 and 40%. CONCLUSIONS: In this study, we observed that the tested ICU prognostic scores are fair tools for intra-ICU and in-hospital mortality prediction in a cohort of postoperative surgical patients. Also, they may have some potential to be used as ancillary data to support decision-making by physicians and families regarding the level of therapeutic investment and palliative care.

Biomonitoring of Heavy Metals (Fe, Zn, Cu, Mn, Cd and Cr) in Oysters: Crassostrea rhizophorae of Mangrove Areas of Alagoas (Brazil)

Abstract Mangroves are tropical and subtropical flooded forests that generally develop in estuarine areas over unstable sediments protected from the action of waves in the intertidal zone with an environment characterized by a great diversity of fauna and flora. Thus, the present study aimed to evaluate the levels of heavy metals that are absorbed by mangrove oysters, in estuarine systems in the Alagoas coast by determining the concentrations of Fe, Cu, Mn, Zn, Cd and Cr. Two areas, which consisted of both a collection during the rainy season and the dry season, were selected for sampling of mangrove oysters. In each collection, seven samples were collected, at seven different points, where each sample contained four oysters. In the laboratory the oysters were dried at 105°C for 72 hours and then macerated. It was then digested with 10 ml of a solution comprising a combination of 4:1 nitric acid and hydrochloric acid, initially in 1h at 40°C, followed by 3 hours at 140°C. In General, the medians followed the order Zn > Fe > Mn > Cu > Cr > Cd in MMELC and Zn > Cu > Fe > Mn > Cr > Cd in Meirim River. It is concluded that the Crassostrea rhizophorae oysters from the studied environments presented concentrations of all the metals proposed in the research and demonstrates its accumulating and bioindicator character.

In vivo assessment of a novel biodegradable ureteral stent.

PURPOSE: To perform an in vivo assessment of a newly developed biodegradable ureteral stent (BUS) produced with natural-based polymers. METHODS: The BUS is based on a patented technology combining the injection process with the use of supercritical fluid technology. Study was conducted at ICVS-University of Minho (Braga, Portugal) and a total of ten domestic pigs were used. In seven animals, the experimental BUS stent was inserted, whereas in the remaining a commercially available stent was used (6-Fr Biosoft® duo stents, Porges Coloplast, Denmark). Post-stenting intravenous pyelogram was used to evaluate the degree of hydronephrosis. The in vivo stent degradation was measured as function of the weight loss. Moreover, the tensile properties of the BUS were tested during in vivo degradation. After maximum 10 days, animals were killed and necropsy was performed. Tissues were compared between the stented groups as well as between the non-stented contralateral ureters and stented ureters in each group. Biocompatibility was assessed by histopathological grading. RESULTS: In all cases, the BUS was only visible during the first 24 h on X-ray, and in all cases the BUS was completely degraded in urine after 10 days, as confirmed on necropsy. During the degradation process, the mechanical properties of the BUS decreased, while the commercial ureteral stents remained constant. At all time-points after stent insertion, the level of hydronephrosis was minimal. Overall, animals stented with BUS had an average grade of hydronephrosis which was lower compared to the controls. The BUS showed better pathological conditions, and hence better biocompatibility when compared with commercial stents. CONCLUSIONS: Notwithstanding the limitations of the present study, the in vivo testing of our novel natural origin polymer-based BUS suggests this device to feature homogeneous degradation, good urine drainage, and high biocompatibility. Next steps will be to increase its stability, and to improve the radiopacity without compromising its degradation. Ultimately, clinical studies will be required to determine the safety and feasibility of its use in humans.

In Vitro and Ex Vivo Permeability Studies of Paclitaxel and Doxorubicin From Drug-Eluting Biodegradable Ureteral Stents.

A drug-eluting biodegradable ureteral stent (BUS) has been developed as a new approach for the treatment of urothelial tumors of upper urinary tract cancer. In a previous work, this system has proven to be a good carrier for anticancer drugs as a potential effective and sustainable intravesical drug delivery system. BUS has revealed to reduce in 75% the viability of human urothelial cancer cells (T24) after 72 h of contact and demonstrated minimal cytotoxic effect on human umbilical vein endothelial cells (HUVECs) which were used as a control. In this work, we studied the permeability of the anticancer drugs, such as paclitaxel and doxorubicin, alone or released from the BUS developed. We used 3 different membranes to study the permeability: polyethersulfone (PES) membrane, HUVECs cell monolayer, and an ex vivo porcine ureter. The ureter thickness was measured (864.51 µm) and histological analysis was performed to confirm the integrity of urothelium. Permeability profiles were measured during 8 h for paclitaxel and doxorubicin. The drugs per se have shown to have a different profile and as expected, increasing the complexity of the membrane to be permeated, the permeability decreased, with the PES being more permeable and the ex vivo ureter tissue being less permeable. The molecular weight has also shown to influence the permeability of each drug and a higher percentage for doxorubicin (26%) and lower for paclitaxel (18%) was observed across the ex vivo ureter. The permeability (P), diffusion (D), and partition (Kd) coefficients of paclitaxel and doxorubicin through the permeable membranes were calculated. Finally, we showed that paclitaxel and doxorubicin drugs released from the BUS were able to remain in the ex vivo ureter and only a small amount of the drugs can across the different permeable membranes with a permeability of 3% for paclitaxel and 11% for doxorubicin. The estimated amount of paclitaxel that remains in the ex vivo ureter tissue is shown to be effective to affect the cancer cell and not affect the noncancer cells.

Impact of the Chronic Omega-3 Fatty Acids Supplementation in Hemiparkinsonism Model Induced by 6-Hydroxydopamine in Rats.

Parkinson's disease (PD) is characterized by a progressive degeneration of dopaminergic neurons in the substantia nigra. The neuronal degeneration may result from the convergence of a number of different pathogenic factors, including apoptosis, excitotoxicity and oxidative stress. Many studies emphasize the importance of omega-3 polyunsaturated fatty acids (ω-3 PUFAs) in vital processes such as maintenance of the properties of cell membranes and the participation in signal transduction and biodynamic activity of neuronal membranes. In this study, the protective effect of ω-3 PUFA administration on the 6-hydroxydopamine (6-OHDA) model of PD in rats was investigated. ω-3 PUFA (1.5 and 3.0 g/kg) was orally administered by gavage during 28 consecutive days to male Wistar rats. On the 4th day, hemiparkinsonism was induced through intrastriatal injection of 6-OHDA. On the 25th day, the animals were submitted to behavioural analysis. On the 28th day, after euthanasia, the brain areas were collected for neurochemical evaluation. ω-3 PUFAs (1.5 and 3.0 g/kg) restored monoamine and amino acid levels on the striatum from hemiparkinsonian rats, followed by reduction in the number of apomorphine-induced rotations and promotion of a partial locomotor recovery. In addition, ω-3 PUFAs (1.5 and 3.0 g/kg) decreased the lipid peroxidation levels and nitrite levels in the brain areas from hemiparkinsonian rats. Thus, this study suggests that supplementation with ω-3 PUFAs prevents behavioural and neurochemical disturbances induced by 6-OHDA, presenting a potential neuroprotective action.