Preservação óssea alveolar pós exodontia: objetivos, opções técnicas, vantagens e desvantagens / Alveolar bone preservation after tooth extraction: objectives, technical options, advantages and disadvantages

A extração do elemento dentário promove uma série de eventos biológicos que resultam no colapso da estrutura alveolar, ocasionando a perda óssea volumétrica na região de extração. Preservar esse alvéolo dentário é imprescindível para uma boa reabilitação dentária do paciente. Objetivo: Realizar uma revisão de literatura abordando os objetivos, opções técnicas, vantagens e desvantagens da preservação óssea alveolar pós extração. Materiais e métodos: Foi feita uma revisão de literatura utilizando as bases de dados Biblioteca Virtual em Saúde (BVS), PubMed e Google acadêmico, usando os descritores "extração dentária", "perda do osso alveolar", "regeneração óssea". Foram incluídos 34 artigos. Resultados: A preservação alveolar pós extração começa desde a realização de uma técnica cirúrgica menos invasiva até a colocação de enxertos do tipo autógenos, alógenos, xenógenos, aloplásticos e biomateriais promotores de cicatrização e reparação tecidual. Conclusão: Existe na literatura atual uma vasta gama de textos científicos que abordam técnicas de preservação alveolar pós exodontia, com distintas respostas teciduais. Todavia, nenhum biomaterial listado nesta revisão contém todas as características que proporcionam regeneração completa do osso alveolar após exodontia(AU)

The extraction of the dental element promotes a series of biological events that results in the collapse of the alveolar structure, causing volumetric bone loss in the region of extraction. Preserving this dental alveolus is essential for a good dental rehabilitation of the patient. Objective: To conduct a literature review addressing the objectives, technical options, advantages and disadvantages of post-extraction alveolar bone preservation. Materials and methods: A literature review was carried out using the Virtual Health Library (VHL), PubMed and academic Google databases, using the descriptors "tooth extraction", "alveolar bone loss", "bone regeneration". 34 articles were included. Results: Post-extraction alveolar preservation starts from the performance of a less invasive surgical technique to the placement of autogenous, allogeneic, xenogeneic, alloplastic and biomaterials that promote healing and tissue repair. Conclusion: There´s is a wide range of scientific texts in the current literature that address post-extraction alveolar preservation techniques with different tissue responses. However, none of the biomaterials listed in this review contain all the characteristics that provide complete regeneration of alveolar bone after extraction(AU)

Concentration of inverted repeats along human DNA.

This work aims to describe the observed enrichment of inverted repeats in the human genome; and to identify and describe, with detailed length profiles, the regions with significant and relevant enriched occurrence of inverted repeats. The enrichment is assessed and tested with a recently proposed measure (z-scores based measure). We simulate a genome using an order 7 Markov model trained with the data from the real genome. The simulated genome is used to establish the critical values which are used as decision thresholds to identify the regions with significant enriched concentrations. Several human genome regions are highly enriched in the occurrence of inverted repeats. This is observed in all the human chromosomes. The distribution of inverted repeat lengths varies along the genome. The majority of the regions with severely exaggerated enrichment contain mainly short length inverted repeats. There are also regions with regular peaks along the inverted repeats lengths distribution (periodic regularities) and other regions with exaggerated enrichment for long lengths (less frequent). However, adjacent regions tend to have similar distributions.

Tumores vasculares de interesse odontológico: aspectos clínicos e formas de tratamento / Vascular tumors of dental interest: clinical aspects and forms of treatment

Os hemangiomas são neoplasias benignas dos tecidos moles. São lesões caracterizadas pela proliferação de células endoteliais. Objetivos: O objetivo deste trabalho é demonstrar por meio de uma revisão da literatura os principais hemangiomas de interesse odontológico e suas características clínicas e abordagens terapêuticas. Revisão de literatura: O estudo mostrou prevalência de até 6% na população geral, sendo o tumor mais comum na infância. Essas lesões apresentam rápido crescimento pós-natal, que pode levar meses a dois anos em média, mas geralmente após esse período ocorre sua involução. O diagnóstico é comumente baseado nas características clínicas e na história do paciente. É importante entender que o estudo histopatológico pode ser necessário nos casos em que o diagnóstico é incerto, para diferenciá-lo de outras neoplasias graves. Destacam-se as principais complicações relacionadas a lesões, ulcerações e hemorragias, além de infecções secundárias que podem causar alto índice de morbidade. Assim, é fundamental que o dentista reconheça essas patologias e tenha capacidade para tratá-las. Considerações finais: Foi possível observar que os hemangiomas são manifestações vasculares incomuns para o cirurgião-dentista, porém o profissional deve saber diagnosticá-los e tratá-los. Dentre as áreas acometidas, essas lesões são frequentes na cavidade oral e o tratamento consiste em acompanhamento com intervenções conservadoras(AU)

Hemangiomas are benign soft tissue neoplasms. These are lesions characterized by the proliferation of endothelial cells. Objectives: The objective of this work is to demonstrate through a literature review about the main hemangiomas of dental interest and clinical characteristics and therapeutic approaches. Literature review: The study showed a prevalence of up to 6% in the general population, being the most common tumor in childhood. These lesions presents a rapid postnatal growth, which may take months until two years on average, but usually after this period their involution occurs. The diagnosis is commonly based on clinical characteristics and patient's history. It is important to understand that the histopathological study may be necessary in cases that the diagnostic is uncertainty, in order to differentiate it from other serious neoplasms. Main complications related to injuries, ulceration and hemorrhage can be highlighted, in addition to secondary infections that can cause a high rate of morbidity. Thus, it is essential that dentists recognize such pathologies and be able to treat them. Final considerations: Was possible do observe that hemangiomas are uncommon vascular manifestations for the dental surgeon, however, the professional must know to diagnose and treat them. Among the affected areas, these lesions are frequently seen in the oral cavity and the treatment consists of following up with conservative interventions(AU)

Fratura complexa de teto de órbita associada disjunção traumática do complexo zigomático / Complex Orbit Roof Fracture Associated with Traumatic Disjunction of the Zygomatic Complex / Fractura Compleja del Techo de la Órbita Asociada a Disyunción Traumática del Complejo Cigomático

Objetivo: As fraturas do complexo zigomático-maxilar (CZM) constituem as principais fraturas do terço médio da face. O diagnóstico é complexo, por envolver uma área alternente sensorial e nobre da face. Portanto o tratamento não visa apenas devolver os contornos ósseos, mas também preservar as funções oculares. No presente caso paciente apresentou severo trauma facial associado a TCE com afundamento do frontal e teto de órbita. Relato de caso: Paciente do sexo masculino, 33 anos, vítima de queda da própria altura. No exame físico notou-se FCC extenso em região frontal, se estendendo para a região supra-orbital esquerda, blefaroedema periorbital esquerdo, com oclusão palpebral e distopia ocular. Escoriações em face e afundamento em região fronto parietal esquerda e perda de consciência. O diagnóstico apontou para fratura do complexo zigomático-maxilar associada a afundamento do osso frontal. Paciente submetido à osteossíntese das fraturas com por meio da ferida e complementado com acesso subciliar e caldwel luc. Foi alcançada boa reabilitação estética e funcional. Conclusão: Portanto, a redução aberta com fixação funcional estável com placas e parafusos segue sendo o padrão ouro para o tratamento de fraturas complexas do CZM. Sendo imperativo uma adequada redução e o reestabelecimento do continente orbitário... (AU)

Objective: Fractures of the zygomatic-maxillary complex are the main fractures of the middle third of the face. The diagnosis is complex, as it involves an alternating sensory and noble area of the face. Therefore, the treatment is not only aimed at restoring bone contours but also preserving ocular functions. In the present case, the patient presented severe facial trauma associated with TBI with frontal and orbital sinking. Case Report: Male patient, 33 years old, victim of a fall from standing height. Physical examination revealed extensive CCF in the frontal region, extending to the left supraorbital region, left periorbital blepharoedema, with eyelid occlusion and ocular dystopia. Excoriations on the face and sinking in the left fronto-parietal region and loss of consciousness. The diagnosis pointed to fracture of the zygomatic-maxillary complex associated with frontal bone sinking. Patient undergoing osteosynthesis of fractures through the wound and complemented with subciliary access and caldwell luc. Good aesthetic and functional rehabilitation were achieved. Conclusion: Therefore, open reduction with stable functional fixation with plates and screws remains the gold standard for the treatment of complex ZMC fractures. An adequate reduction and reestablishment of the orbiting continent is imperative... (AU)

Objetivo: Las fracturas del complejo cigomático maxilar son las principales fracturas del tercio medio de la cara. El diagnóstico es complejo, ya que involucra una zona sensorial y noble alternada de la cara. Por lo tanto, el tratamiento no solo está dirigido a restaurar los contornos óseos sino también a preservar las funciones oculares. En el presente caso, el paciente presentó trauma facial severo asociado a TCE con hundimiento frontal y orbitario. Caso Clínico: Paciente masculino, 33 años, víctima de caída desde altura de pie. A la exploración física destacaba FCC extensa en región frontal, con extensión a región supraorbitaria izquierda, blefaroedema periorbitario izquierdo, con oclusión palpebral y distopía ocular. Excoriaciones en la cara y hundimiento en la región fronto-parietal izquierda y pérdida del conocimiento. El diagnóstico apuntó a fractura del complejo cigomático-maxilar asociada a hundimiento del hueso frontal. Paciente con osteosíntesis de fractura a través de herida y complemento acceso subciliar y calwell luc. Se logró una buena rehabilitación estética y funcional. Conclusión: Por lo tanto, la reducción abierta con fijación funcional estable con placas y tornillos sigue siendo el estándar de oro para el tratamiento de fracturas CCM complejas. Es imperativo una adecuada reducción y restablecimiento del continente en órbita... (AU)

Remoção de corpo estranho impactado em região maxilofacial / Removal of impacted foreign body in maxillofacial region

Traumas na região da face são comuns devido a sua topografia e à grande exposição do local. As lesões na região maxilofacial são normalmente causadas devido a traumas por acidentes de trânsito, agressão física, acidentes cotidianos como queda da própria altura e de nível. O objetivo deste trabalho é relatar um caso clínico de trauma facial com a presença de corpo estranho impactado na face, bem como o tratamento cirúrgico empregado. Paciente do sexo feminino, 17 anos, foi regulada para o Hospital Geral Cleristón Andrade com histórico de queda de cavalo, cursando com fragmento de madeira (galho de arbusto) tranfixado em região maxilofacial. A paciente foi encaminhada ao centro cirúrgico para a remoção do galho de arbusto transfixado. O procedimento foi rápido, e sua remoção se deu por meio do movimento contrário ao mecanismo de trauma. Lesão como esta possui aspectos singulares e devem ser avaliados multidisciplinarmente na emergência. A remoção desses objetos deve ser realizada de forma a preservar as estruturas dentro do possível, levando em consideração também os fatores estéticos e funcionais envolvidos(AU)

Traumas in the face region are common due to its topography and the great exposure of the place. Injuries in the maxillofacial region are usually caused due to trauma from traffic accidents, physical aggression, everyday accidents such as falling from height and level. The aim of this paper is to report a clinical case of facial trauma with the presence of a foreign body impacted on the face, as well as the surgical treatment used. A 17-year-old female patient was treated at the Cleristón Andrade General Hospital with a history of falling from a horse, taking a wood fragment (shrub branch) transfixed in the maxillofacial region. The patient was referred to the operating room for removal of the transfixed bush branch. The procedure was quick, and its removal took place through a movement contrary to the trauma mechanism. Injuries like this have unique aspects and must be evaluated multidisciplinary in an emergency. The removal of these objects must be carried out in order to preserve the structures as much as possible, also taking into account the aesthetic and functional factors involved(AU)

Karyotypes of Manatees: New Insights into Hybrid Formation (Trichechus inunguis × Trichechus m. manatus) in the Amazon Estuary.

Great efforts have been made to preserve manatees. Recently, a hybrid zone was described between Trichechus inunguis (TIN) and the Trichechus manatus manatus (TMM) in the Amazon estuary. Cytogenetic data on these sirenians are limited, despite being fundamental to understanding the hybridization/introgression dynamics and genomic organization in Trichechus. We analyzed the karyotype of TMM, TIN, and two hybrid specimens ("Poque" and "Vitor") by classical and molecular cytogenetics. G-band analysis revealed that TMM (2n = 48) and TIN (2n = 56) diverge by at least six Robertsonian translocations and a pericentric inversion. Hybrids had 2n = 50, however, with Autosomal Fundamental Number (FNA) = 88 in "Poque" and FNA = 74 in "Vitor", and chromosomal distinct pairs in heterozygous; additionally, "Vitor" exhibited heteromorphisms and chromosomes whose pairs could not be determined. The U2 snDNA and Histone H3 multi genes are distributed in small clusters along TIN and TMM chromosomes and have transposable Keno and Helitron elements (TEs) in their sequences. The different karyotypes observed among manatee hybrids may indicate that they represent different generations formed by crossing between fertile hybrids and TIN. On the other hand, it is also possible that all hybrids recorded represent F1 and the observed karyotype differences must result from mechanisms of elimination.

Small Extracellular Vesicles Secreted by Nigrostriatal Astrocytes Rescue Cell Death and Preserve Mitochondrial Function in Parkinson's Disease.

Extracellular vesicles (EVs) are emerging as powerful players in cell-to-cell communication both in healthy and diseased brain. In Parkinson's disease (PD)-characterized by selective dopaminergic neuron death in ventral midbrain (VMB) and degeneration of their terminals in striatum (STR)-astrocytes exert dual harmful/protective functions, with mechanisms not fully elucidated. Here, this study shows that astrocytes from the VMB-, STR-, and VMB/STR-depleted brains release a population of small EVs  in a region-specific manner. Interestingly, VMB-astrocytes secreted the highest rate of EVs, which is further exclusively increased in response to CCL3, a chemokine that promotes robust dopaminergic neuroprotection in different PD models. The neuroprotective potential of nigrostriatal astrocyte-EVs is investigated in differentiated versus undifferentiated SH-SY5Y cells exposed to oxidative stress and mitochondrial toxicity. EVs from both VMB- and STR-astrocytes counteract H2 O2 -induced caspase-3 activation specifically in differentiated cells, with EVs from CCL3-treated astrocytes showing a higher protective effect. High resolution respirometry further reveals that nigrostriatal astrocyte-EVs rescue neuronal mitochondrial complex I function impaired by the neurotoxin MPP+ . Notably, only EVs from VMB-astrocyte fully restore ATP production, again specifically in differentiated SH-SY5Y. These results highlight a regional diversity in the nigrostriatal system for the secretion and activities of astrocyte-EVs, with neuroprotective implications for PD.

Acute Urinary Retention After Kidney Transplant: Effect on Graft Function, Predictive Factors, and Treatment.

BACKGROUND: Benign prostatic hyperplasia (BPH) is common in older adults. Although BPH may be asymptomatic in patients with chronic kidney disease (CKD) with low diuresis, the condition may become troublesome when diuresis resumes after transplantation. This study evaluated the effect that developing acute urinary retention (AUR) in first 4 months after kidney transplantation (KT) can have on graft function at 6 months. The study identified predictive factors and analyzed treatment of AUR in these patients. METHODS: This study retrospectively included 303 men who received KT. Independent samples Student t test was used to compare glomerular filtration rates (GFRs) at 6 months. Logistic regression was applied to identify predictors of AUR. RESULTS: The study found that 14 patients developed AUR within the first 4 months after KT. This group had lower GFR at 6 months post-KT. Nine patients required transurethral resection of the prostate, and 2 of these patients developed acute graft pyelonephritis following resection. Residual diuresis and recipient age were predictive factors. Recipient age >55 years was a risk factor. Medical therapy of BPH before transplantation was a protective factor. CONCLUSIONS: Developing AUR in the first 4 months after KT was associated with lower graft GFR at 6 months, and transurethral resection of the prostate was required in 64% of these patients, with good results. Medical therapy for BPH before the transplant was associated with a lower risk of AUR. Older patients and patients with pretransplant low urine output had a higher risk of AUR. These patients should be closely monitored in the posttransplant period for the presence of obstructive uropathy.

Early morning kidney transplantation: Perioperative complications.

INTRODUCTION: To reduce cold ischemia time (CIT), many kidney transplants are performed in the early morning. Conducting complex surgeries in the early morning may influence the surgeon's technical capacity and rate of surgical complications (SC). AIM: Evaluate the influence of surgery start hour (SSH) regarding duration of surgery (DS), immediate diuresis (ID), SC and acute rejection (AR); evaluate the influence of CIT regarding SC, ID, and AR. METHODS: 2855 cadaveric transplants performed between June 1980 and March 2018 were retrospectively evaluated. Regarding SSH, two groups were created: Group M (00: 00h-05.59h, n = 253) and Group D (06: 00h - 23: 59h, n = 2602). Analyzing the impact of SSH on DS, ID, SC and AR. Evaluate the relationship between CIT (< 18h, 18-30h and > 30h) on ID, SC and AR utilizing univariate and multivariate statistical analysis with SPSS. RESULTS AND CONCLUSION: Groups M and D were comparable in all evaluated demographic variables (p > 0.05), except cold ischemia time (Group M with higher CIT, p < 0.001). Regarding univariate analysis, Surgery start hour did not influence DS (p = 0.344), and SC (p = 0.264), but related with higher ID (p = 0.028) and AR (p = 0.018). CIT related with immediate diuresis (p = 0.020) and acute rejection (p < 0.001) but did not relate with complications (p = 0.734). Regarding multivariate analysis, SSH only influenced immediate diuresis (p = 0.026) and did not influenced acute rejection (p = 0.055). CIT influenced immediate diuresis (p = 0.019) and acute rejection (p < 0.001). Surgery start hour influences Immediate diuresis. With this study, we conclude that the priority must be a short cold ischemia time.

Neural stem cells traffic functional mitochondria via extracellular vesicles.

Neural stem cell (NSC) transplantation induces recovery in animal models of central nervous system (CNS) diseases. Although the replacement of lost endogenous cells was originally proposed as the primary healing mechanism of NSC grafts, it is now clear that transplanted NSCs operate via multiple mechanisms, including the horizontal exchange of therapeutic cargoes to host cells via extracellular vesicles (EVs). EVs are membrane particles trafficking nucleic acids, proteins, metabolites and metabolic enzymes, lipids, and entire organelles. However, the function and the contribution of these cargoes to the broad therapeutic effects of NSCs are yet to be fully understood. Mitochondrial dysfunction is an established feature of several inflammatory and degenerative CNS disorders, most of which are potentially treatable with exogenous stem cell therapeutics. Herein, we investigated the hypothesis that NSCs release and traffic functional mitochondria via EVs to restore mitochondrial function in target cells. Untargeted proteomics revealed a significant enrichment of mitochondrial proteins spontaneously released by NSCs in EVs. Morphological and functional analyses confirmed the presence of ultrastructurally intact mitochondria within EVs with conserved membrane potential and respiration. We found that the transfer of these mitochondria from EVs to mtDNA-deficient L929 Rho0 cells rescued mitochondrial function and increased Rho0 cell survival. Furthermore, the incorporation of mitochondria from EVs into inflammatory mononuclear phagocytes restored normal mitochondrial dynamics and cellular metabolism and reduced the expression of pro-inflammatory markers in target cells. When transplanted in an animal model of multiple sclerosis, exogenous NSCs actively transferred mitochondria to mononuclear phagocytes and induced a significant amelioration of clinical deficits. Our data provide the first evidence that NSCs deliver functional mitochondria to target cells via EVs, paving the way for the development of novel (a)cellular approaches aimed at restoring mitochondrial dysfunction not only in multiple sclerosis, but also in degenerative neurological diseases.

Robust rapid-setting antibacterial liquid bandages.

Bandaging is a steadfast but time-consuming component of wound care with limited technical advancements to date. Bandages must be changed and infection risk managed. Rapid-set liquid bandages are efficient alternatives but lack durability or inherent infection control. We show here that antibacterial zinc (Zn) and copper (Cu) species greatly enhance the barrier properties of the natural, waterproof, bio-adhesive polymer, shellac. The material demonstrated marked antibacterial contact properties and, in ex-vivo studies, effectively locked-in pre-applied therapeutics. When challenged in vivo with the polybacterial bovine wound infection 'digital dermatitis', Zn/Cu-shellac adhered rapidly and robustly over pre-applied antibiotic. The bandage self-degraded, appropriately, over 7 days despite extreme conditions (faecal slurry). Treatment was well-tolerated and clinical improvement was observed in animal mobility. This new class of bandage has promise for challenging topical situations in humans and other animals, especially away from controlled, sterile clinical settings where wounds urgently require protection from environmental and bacterial contamination.

Andiroba oil (Carapa guianensis Aubl) shows cytotoxicity but no mutagenicity in the ACPP02 gastric cancer cell line.

Andiroba (Carapa guianensis Aubl) is an Amazonian plant whose oil has been widely used in traditional medicine for various purposes, including anti-inflammation. Research reports indicate that the oil can confer antitumor activity due to the presence of fatty acids, which can directly influence cell death mechanisms. Thus, andiroba oil (AO) has gained interest for its potential to be used in antineoplastic therapies. Here, we report an in vitro analysis of the cytotoxic and mutagenic potential of AO in the gastric cancer cell line, ACP02. Cell survival was assessed by the MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] assay, differential staining with ethidium bromide and acridine orange assessed apoptosis-necrosis, and mutagenesis was assessed by the micronucleus test. The apolar oil was first diluted in 0.1% dimethyl sulfoxide (DMSO) and then further diluted to six concentrations (0.01, 0.1, 1, 10 and 100 µg/mL and 1 mg/mL) in RPMI medium. Controls included RPMI alone (negative control) and 0.1% DMSO diluted in medium (vehicle control). The MTT test showed that AO significantly reduced cell viability (P < .05) only when the highest tested concentration was applied for 48 hours. The apoptosis/necrosis test showed that the highest concentration of AO induced cell death by apoptosis at 24 and 48 hours. There was no statistically significant increase in the frequency of micronuclei. The ability of the AO to decrease the viability of ACP02 cells via apoptosis, without exerting mutagenic effects, suggests that the oil could be useful as an alternative therapeutic agent for primary tumors of stomach cancer.

Molecular cytogenetics characterization of Rhinoclemmys punctularia (Testudines, Geoemydidae) and description of a Gypsy-H3 association in its genome.

The wide variation found in the size of eukaryotic genomes is largely related to the accumulation of repetitive sequences. Studies show that these sequences can go through an evolutionary process (molecular co-optation) and acquire new genomic functions. Cytogenetic studies reveal a wide karyotypic variation between chelonians (order Testudines) (2n = 26-68), attributed mainly to the number of microchromosomes. The study of repetitive DNAs has the potential to provide data on the dynamics of these sequences, and how they influence the organization of the genome. Here, we reveal the first in situ mapping data of 45S rDNA, histone H3 genes, and telomeric sequences, for a species of the genus Rhinoclemmys, R. punctularia. The karyotype described here for R. punctularia is different from previous reports for the diploid complement of this species, with differences probably attributable to centric fissions and pericentric inversions or centromere repositioning. The 45S rDNA are on a single chromosome pair (like in other turtles), telomeric sequences are in terminal position on all the chromosomes, and histone H3 is dispersed in low copy number, with clusters in pericentromeric regions of three chromosome pairs. We report on the presence of a Gypsy retrotransposon insert located within H3 histone of R. punctularia, and the H3 region sequenced contained the open reading frame of the histone sequence. Comparative modeling revealed a functional pattern for the protein, thus suggesting that the Gypsy element might have been recruited for new functions in the genome of this species.

Transplantectomy in the First 3 Months After Renal Transplantation: Experience of a Reference Center.

INTRODUCTION/OBJECTIVE: Transplantation is the treatment of choice in end-stage renal disease. However, there are complications that require transplantectomy. The objective of this study was to evaluate predictive factors for transplantectomy in the first 3 months after renal transplantation. MATERIAL AND METHODS: This retrospective study included 770 kidney transplants performed between June 2011 and June 2017. Logistic regression was applied to study the relationship between independent variables and the occurrence of transplantectomy. RESULTS: Analyzing variables of the recipients, it was verified that age over 65 years; body mass index; dialysis time; history of previous transplant and comorbidities such as obesity, overweight, hypertension, diabetes mellitus, dyslipidemia, peripheral arterial disease; or history of a thrombotic episode were not predictive factors. It was found that the use of expanded criteria donors, their age, or cause of death were not predictive factors. The use of a right renal graft or grafts with multiple arteries; the duration of surgery; the performance of surgery at dawn; the need for transfusion; the cold ischemia time; and hemodynamic parameters at reperfusion (central venous pressure, systolic or diastolic blood pressure) were not predictive factors. The recipient age at transplantation (p = .014; B=-0.059; Exp(B)=0.943 [0.899-0.988]) and reoperation in the first 10 days after transplantation (p < .001; B= -2.574; Exp(B)=0.076 [0.028-0.210]) were predictive factors. CONCLUSION: Reoperation in the first 10 days after transplantation decreased the risk of transplantectomy in the first 3 months. The lower the age of the recipient, the greater the risk of transplantectomy.

Aqueous ethanol extract of Libidibia ferrea (Mart. Ex Tul) L.P. Queiroz (juca) exhibits antioxidant and migration-inhibiting activity in human gastric adenocarcinoma (ACP02) cells.

Libidibia ferrea (juca) is a plant belonging to the Fabaceae (Leguminosae) family, whose antioxidant activity has been widely described in the literature. We evaluated this parameter of Aqueous ethanol extract (AE), ethyl acetate (ACO), chloroform (CLO) and hexane (HEX) extracts of L. ferrea. We then tested the most active extract for its toxicity and ability to inhibit migratory activity in the ACP02 gastric adenocarcinoma cell line in vitro. The AE and ACO extracts both had antioxidant activity, the AE extract showing greater potential. This may reflect that both extracts contained phenolic compounds. Although AE extract showed no cytotoxic, mutagenic or genotoxic effect, it altered cell morphology and migration activity. Analysis of apoptosis/necrosis indicated that this parameter does not appear to account for the apparent ability of AE to inhibit cancer cell migration. We speculate that the morphological changes in AE-treated cells could be due to cytoskeleton alterations related to the presence of myo-inositol in AE extract. Together, our results demonstrate this extract of L. ferrea can act as an exogenous antioxidant and might prove useful in efforts to fight secondary tumors.

Making urinary extracellular vesicles a clinically tractable source of biomarkers for inherited tubulopathies using a small volume precipitation method: proof of concept.

Biomarkers of inherited tubulopathies would be useful for clarifying diagnoses in patients where genetic screening is not readily available or where disease-attributable mutations are not found. Urinary extracellular vesicles (uEVs) obtained by ultracentrifugation can be used as a source of biomarkers for inherited tubulopathies such as Gitelman Syndrome (GS), however, ultracentrifugation requires costly equipment and is thus not usually accessible. In contrast, precipitation methods can extract uEVs using standard laboratory centrifuges, thus making uEVs extracted by this method clinically tractable as a source of biomarkers for GS and other inherited tubulopathies. Here we optimise a precipitation method for extracting urinary extracellular vesicles (uEVs) and provide proof of concept that these uEVs are a source of biomarkers using GS an exemplar tubulopathy. For method optimisation, uEVs were precipitated from fresh and frozen (for up to 6 years), small volume (1-2 mL) urine samples from healthy volunteers and GS patients. Nanoparticle tracking analysis was used to calculate the concentration of uEVs. Thiazide sensitive sodium-chloride cotransporter (NCC) content was determined by densitometry of Western blots. NCC content of uEVs was lower in GS patients (n = 11) than healthy volunteers (n = 12; P = 0.001). Three of four patients clinically suspected for GS, in whom only a single SLC12A3 mutation was identified, had lower uEV NCC content than all healthy volunteers tested. In the clinical setting, sufficient uEVs can be extracted from frozen, small volume urine samples using precipitation methods to distinguish patients with GS from healthy volunteers, and thus this source of uEVs could be utilised as an additional diagnostic test for GS and similar disorders.

Correction to: Making urinary extracellular vesicles a clinically tractable source of biomarkers for inherited tubulopathies using a small volume precipitation method: proof of concept.

The original published article the section Acknowledgements is missing. The section is given below.

Melanoma Cutâneo em um Hospital Universitário, 2001-2016 / Cutaneous Melanoma in a University Hospital, 2001-2016 / Melanoma Cutáneo en un Hospital Universitario, 2001-2016

Introdução: O melanoma é a principal causa de morte entre as neoplasias malignas cutâneas primárias. Sua incidência mundial vem aumentando progressivamente, entretanto, existem escassas informações epidemiológicas nacionais. Objetivo: Analisar os perfis epidemiológico e histopatológico de melanomas cutâneos diagnosticados em hospital universitário nos últimos 16 anos. Método: Série histórica de casos de melanoma cutâneo realizada por meio da revisão de prontuários e laudos histopatológicos de 2001 a 2016. Resultados:A frequência manteve-se com média de 2,99 melanomas por mil novos atendimentos ambulatoriais. A casuística foi de 224 melanomas cutâneos em 211 pacientes, brancos (98,6%), mulheres (55,9%), com idade média de 57,3 anos. O tempo médio entre o aparecimento da lesão (desde surgimento da lesão ou desde que a lesão começou a se modificar, relatado pelo paciente) e o diagnóstico foi 4,8 anos. O tamanho predominante foi de 0,5 a 2 cm, acometendo principalmente a região cefálica em indivíduos maiores de 60 anos e troncular naqueles menores de 60 anos. "Outros melanomas" (34,8%) e melanoma extensivo superficial (31,7%) foram os subtipos mais frequentes. A maioria dos casos apresentou índice de Breslow ≤1mm (70%). Os subtipos mais finos (≤1 mm) foram extensivo superficial e lentigo maligno. Melanomas nodulares possuíam Breslow intermediário (1 a 4 mm) ou espesso (≥4 mm) com altas taxas de disseminação e metástase linfonodal. Conclusão: A frequência manteve-se estável. Houve prevalência em população maior de 60 anos. Os subtipos mais frequentes foram "outros melanomas" e extensivo superficial com localização cefálica e troncular em sua maioria.

Introduction: Melanoma is the main cause of death among primary skin neoplasms. The worldwide incidence has been increasing, however there is scarce national epidemiological information. Objective: Analyze the epidemiological and histopathological profile of cutaneous melanomas diagnosed at a university hospital in the last 16 years. Method: Historical series of cutaneous melanoma cases from review of charts and histopathological reports from 2001 to 2016. Results: The mean frequency over the years was 2.99 melanomas for every 1,000 new outpatient visits. The casuistry consisted of 224 cases of cutaneous melanomas in 211 patients, Caucasians (98.6%), women (55.9%), with mean age of 57.3 years. The mean time between onset of the lesion (time since the appearance of the lesion or since it began to change reported by the patient) and diagnosis was 4.8 years. The predominant tumor size was 0.5 to 2 cm, affecting the cephalic region in individuals older than 60 years and torso in those younger than 60 years. "Other melanomas" (34.8%) and superficial spreading melanoma (31.7%) were the predominant subtypes. Most of the cases had Breslow index ≤ 1 mm (70% of patients). The thinnest subtypes (≤ 1 mm) were superficial spreading melanoma and lentigo maligna. Nodular melanomas had intermediate Breslow (1 to 4 mm) or thick (≥ 4 mm) with high dissemination rate and lymph node metastasis. Conclusion: The frequency remained stable. Population below 60 years old had a higher prevalence. The most frequent subtypes were "other melanomas" and extensive superficial located mainly in the cephalic and torso regions.

Introdução: El melanoma es la principal causa de muerte entre las neoplasias malignas cutáneas primarias. Su incidencia mundial ha aumentado progresivamente, sin embargo, la información epidemiológica nacional es escasa. Objetivo: Analizar el perfil epidemiológico e histopatológico de los melanomas cutáneos diagnosticados en un hospital universitario en 16 años. Método: Serie histórica de casos de melanoma cutáneo obtenidos por la revisión de registros médicos e informes histopatológicos de 2001-2016. Resultados: La frecuencia se mantuvo con un promedio de 2,99 melanomas/mil nuevas consultas. La casuística consistió en 224 melanomas cutáneos en 211 pacientes, blancos (98,6%), mujeres (55,9%), con edad media de 57,3 años. El promedio entre la aparición de la lesión (desde la aparición o desde que comenzó a cambiar según informe del paciente) y diagnóstico fue 4,8 años. El tamaño predominante de 0,5 a 2 cm, afectando principalmente la región cefálica en mayores de 60 años y el tronco cuando menores de 60. "Otros melanomas" (34,8%) y melanoma extenso superficial (31,7%) fueron los subtipos más frecuentes. La mayoría de los casos tenía índice de Breslow ≤1 mm (70%). Los más delgados (≤1 mm) fueron lentigo extenso superficial y maligno. Los nodulares tenían Breslow intermedio (1 a 4 mm) o grueso (≥4 mm) con altas tasas de diseminación y metástasis para ganglios linfáticos. Conclusión: La frecuencia se mantuvo estable. Hubo mayor prevalencia en la población menor de 60 años. Los subtipos más frecuentes fueron "otros melanomas" y extensos superficiales con localización principalmente cefálica y del tronco.

Surgical Complications in Kidney Transplantation: An Overview of a Portuguese Reference Center.

INTRODUCTION: Kidney transplantation (KT) is a surgery performed worldwide and has some complications. The objective of this study is to evaluate our surgical complications, comparing the outcomes with those KTs without surgical complications. PATIENTS AND METHODS: An observational cross-sectional study of all surgical complications among 3102 kidney transplants performed between June 1980 and April 2018. RESULTS: Of 3102 kidney transplantations, 490 (15.8%) had the following complications: surgical complications (n = 527); urinary (n = 184; 5.9%); vascular (n = 140; 4.5%); wound-related (n = 78; 2.5%); lymphocele (n = 56; 1.8%); and others (n = 69; 2.2%). The most common complications were ureteral obstruction (n = 85; 2.7%) and urinary fistula (n = 72; 2.3%). The immunosuppression regimen did not influence the surgical complications rate. Surgical complications mainly occurred in male (71.4% vs 66.7%) and heavier (67.6 ± 13.9 vs 65.9 ± 13.5 kg) recipients (P < .05). The hospitalization time was also different (26.3 ± 30.6 vs 15.0 ± 38.8 days, P < .05). Serum creatinine values were different until the second year. After that, the renal function was approximately the same. Nearly 26.1% of complicated kidney transplants had delayed graft function (vs 14.8%, P < .001). Only 23.9% of complicated kidney transplants needed transplant nephrectomy (vs 6.2%, P < .001). The survival of kidneys with surgical complications was lower (64.2 ± 4.5 vs 94.09 ± 2.6 months, P < .001). DISCUSSION/CONCLUSION: Kidney transplant surgical complications occur over time, especially urinary and vascular complications, remaining a problem that leads to prolonged hospitalization and decreased graft survival.

Distribution of Distances Between Symmetric Words in the Human Genome: Analysis of Regular Peaks.

Finding DNA sites with high potential for the formation of hairpin/cruciform structures is an important task. Previous works studied the distances between adjacent reversed complement words (symmetric word pairs) and also for non-adjacent words. It was observed that for some words a few distances were favoured (peaks) and that in some distributions there was strong peak regularity. The present work extends previous studies, by improving the detection and characterization of peak regularities in the symmetric word pairs distance distributions of the human genome. This work also analyzes the location of the sequences that originate the observed strong peak periodicity in the distance distribution. The results obtained in this work may indicate genomic sites with potential for the formation of hairpin/cruciform structures.