Sex Differences in Placental Protein Expression and Efficiency in a Rat Model of Fetal Programming Induced by Maternal Undernutrition.

Fetal undernutrition programs cardiometabolic diseases, with higher susceptibility in males. The mechanisms implicated are not fully understood and may be related to sex differences in placental adaptation. To evaluate this hypothesis, we investigated placental oxidative balance, vascularization, glucocorticoid barrier, and fetal growth in rats exposed to 50% global nutrient restriction from gestation day 11 (MUN, n = 8) and controls (n = 8). At gestation day 20 (G20), we analyzed maternal, placental, and fetal weights; oxidative damage, antioxidants, corticosterone, and PlGF (placental growth factor, spectrophotometry); and VEGF (vascular endothelial growth factor), 11ß-HSD2, p22phox, XO, SOD1, SOD2, SOD3, catalase, and UCP2 expression (Western blot). Compared with controls, MUN dams exhibited lower weight and plasma proteins and higher corticosterone and catalase without oxidative damage. Control male fetuses were larger than female fetuses. MUN males had higher plasma corticosterone and were smaller than control males, but had similar weight than MUN females. MUN male placenta showed higher XO and lower 11ß-HSD2, VEGF, SOD2, catalase, UCP2, and feto-placental ratio than controls. MUN females had similar feto-placental ratio and plasma corticosterone than controls. Female placenta expressed lower XO, 11ß-HSD2, and SOD3; similar VEGF, SOD1, SOD2, and UCP2; and higher catalase than controls, being 11ß-HSD2 and VEGF higher compared to MUN males. Male placenta has worse adaptation to undernutrition with lower efficiency, associated with oxidative disbalance and reduced vascularization and glucocorticoid barrier. Glucocorticoids and low nutrients may both contribute to programming in MUN males.

Effects of Arachidonic and Docosohexahenoic Acid Supplementation during Gestation in Rats. Implication of Placental Oxidative Stress.

Arachidonic and docosahexaenoic acids (ARA and DHA) are important during pregnancy. However, the effects of dietary supplementation on fetal growth and oxidative stress are inconclusive. We aimed to assess the effect of high ARA and DHA diet during rat gestation on: (1) ARA and DHA availability in plasma and placenta, (2) fetal growth, and (3) placental oxidative stress, analyzing the influence of sex. Experimental diet (ED) was prepared by substituting soybean oil in the control diet (CD) by a fungi/algae-based oil containing ARA and DHA (2:1). Rats were fed with CD or ED during gestation; plasma, placenta, and fetuses were obtained at gestational day 20. DHA, ARA, and their precursors were analyzed in maternal plasma and placenta by gas chromatography/mass spectrophotometry. Fetuses and placentas were weighed, the proportion of fetuses with intrauterine growth restriction (IUGR) determined, and placental lipid and protein oxidation analyzed. ED fetuses exhibited lower body weight compared to CD, being >40% IUGR; fetal weight negatively correlated with maternal plasma ARA, but not DHA. Only ED female placenta exhibited higher lipid and protein oxidation compared to its CD counterparts; lipid peroxidation is negatively associated with fetal weight. In conclusion, high ARA during gestation associates with IUGR, through placental oxidative stress, with females being more susceptible.

Human Umbilical Vessels: Choosing the Optimal Decellularization Method.

There is an increasing demand of small-diameter vascular grafts for treatment of circulatory pathologies. Decellularization offers the possibility of using human blood vessels as scaffolds to create vascular grafts. Umbilical vessels have great potential because of their availability and morphological characteristics. Various decellularization techniques have been used in umbilical vessels, but consensus on which is the most appropriate has not yet been reached. The objective of this review is to analyze the morphological and biomechanical characteristics of decellularized human umbilical arteries and veins with different techniques. Evidence indicates that the umbilical vessels are a viable option to develop small-diameter vascular grafts. Detergents are the agents most often used and with most evidence. However, further studies are needed to accurately analyze the components of the extracellular matrix and biomechanical characteristics, as well as the capacity for recellularization and in vivo functionality.

A Prospective, Randomized, Controlled Clinical Trial to Assess Use of 2% Lidocaine Irrigation to Prevent Abdominal Surgical Site Infection.

Surgical site infections (SSI) are the third most common nosocomial infection, increasing morbidity and mortality rates of patients as well as their costs of care, but longer-term follow up studies and data are limited. Lidocaine, in addition to being a readily available and accessible local anesthetic, is known to have bacteriostatic properties. A prospective, descriptive, controlled, randomized clinical trial was conducted among patients scheduled to undergo abdominal sur- gery in the general surgical unit of a Mexican hospital. The purpose of the study was to assess the incidence of SSIs in general and to compare the 30-day postoperative infection outcomes of saline irrigation to saline irrigation followed by 2% lidocaine application before skin closure in wounds grade II to IV per the Centers for Disease Control and Prevention surgical wound classi cation. All patients received systemic antibiotics before surgery. Eighty-four (84) patients (40 men and 44 women; mean age 49.02 ± 19.9 years, range 18-92 years), 39 in the control and 45 in the experimental group, completed the 30-day follow-up without experiencing nonsurgery-related complications. The overall incidence of SSIs (speci cally, seromas and abscesses) was 17.86%; the incidence of abscess formation was 7.14%. The overall incidence of SSIs in the lidocaine group was 8.89% compared to 28.2% in the saline only group (P = .02); the relative risk was 1.8 (P = .02; 95% CI 1.19-2.74) and 0.45 (P = .02; 95% CI 0.19-1.06) in the saline and lidocaine groups, respectively. Hemoglobin and albumin levels were signi cantly lower in patients who did compared to those who did not develop an SSI (P = .02 and .04, respectively). No signi cant SSI rate differences were seen between patients who did and did not have a drain placed. In patients who developed an abscess, Escherichia coli was the most prevalent bacteria and present in 40% of collected uid. While carefully controlled clinical studies are needed, lidocaine appears to be a viable option to decrease the incidence of SSI if applied as irrigation before wound closure in patients undergoing abdominal surgery.

Willingness toward organ and body donation among anatomy professors and students in Mexico.

Most anatomists agree that cadaver dissection serves as a superior teaching tool in human anatomy education. However, attitudes toward body donation vary widely between different individuals. A questionnaire was developed to determine the attitudes toward body and organ donation among those who learn the most from cadavers: medical students, medical student teaching assistants, medical students involved in research, and anatomy professors. A cross-sectional, prospective study was designed in which the questionnaire was distributed among first-year human anatomy students before undertaking cadaver dissection at the beginning of the semester, and then again after a commemoration service at the end of the course. The questionnaire items included demographic data, as well as questions designed to characterize participants' attitudes regarding body/organ donation from strangers, family members, and whether participants would consider such practices with their own bodies. Out of a total of 517 students enrolled in the Human Anatomy course in the Medical School at the Universidad Autónoma de Nuevo León, Mexico during January to June 2016, 95% responded to the first (491) and second (490) surveys. Participants' opinions on their own organ donation was similar before and after exposure to cadaver dissection, with between 87% and 81% in favor of such practices, and only 3% against it, in both surveys. Participants' willingness to donate their own bodies, as well as those of family members, increased, while reluctance regarding such practices decreased by half (P < 0.0001 and P < 0.05). Professors had the highest rates of positive opinions regarding their own body donation (74.9%), with 18.8% undecided. Low opposition toward organ and body donation remains prevalent among both anatomists and physicians in training in Mexico. Anat Sci Educ 10: 589-597. © 2017 American Association of Anatomists.

Conduits Used in Coronary Artery Bypass Grafting: A Review of Morphological Studies.

There is a significant variety of vascular conduits options for coronary bypass surgery. Adequate graft selection is the most important factor for the success of the intervention. To ensure durability, permeability, and bypass function, there must be a morphological similarity between the graft and the coronary artery. The objective of this review was to analyze the morphological characteristics of the grafts that are most commonly used in coronary bypass surgery and the coronary arteries that are most frequently occluded. We included clinical information regarding the characteristics that determine the behavior of the grafts and its permeability over time. Currently, the internal thoracic artery is the standard choice for bypass surgery because of the morphological characteristics of the wall that makes less prone to developing atherosclerosis and hyperplasia. The radial and right gastroepiploic arteries are the following second and third best options, respectively. The ulnar artery is the preferred choice when other conduits are not feasible.

Near-peer teaching strategy in a large human anatomy course: perceptions of near-peer instructors.

Near-peer teaching (NPT) is a strategy in which senior students assume the instructor role with junior peers (mentees). Senior students develop unique skills and knowledge through NPT, an experience which extends their learning beyond content mastery. Different teaching modules featuring NPT were utilized in the human anatomy course at the School of Medicine, Autonomous University of Nuevo Leon in Monterrey, Mexico. Modules included: Theory, Clinical Hour, Imaging Anatomy, and Laboratory. The aim of this study was to assess instructor participants' perceptions on the benefits of the NPT strategy in the anatomy classroom. A survey was administered to anatomy course instructors who utilized NPT strategies during winter, fall, and spring semesters of the 2012-2013 school year. A total of 120 instructors were enrolled in the study. There were different perceptions of instructors' roles. Theory and Imaging Anatomy instructors considered themselves to be information providers and resource developers, whereas Clinical Hour and Laboratory instructors saw themselves more as facilitators, role models, and planners. All instructors' opinions on the benefits of NPT were positive. Thus, in this article, the authors find NPT to be a strategy that promotes self-learning, a vital skill.

Estudio morfométrico de la arteria radial y su implicación en la cirugía de revascularización miocárdica / Morphometric study of the radial artery and its involvement in bypass surgery grafting

La arteria radial (AR) es utilizada en la práctica médica para la realización de diversos procedimientos quirúrgicos, entre los que destaca la cirugía de revascularización miocárdica. En la literatura actual hay poca información acerca de la compatibilidad de esta arteria con otros conductos vasculares. El objetivo fue determinar las características anatómicas, morfométricas y distribución de la arteria radial en el antebrazo. Se disecó la arteria radial de 10 antebrazos de cadáveres embalsamados; se identificaron y registraron los ramos musculares y vasa nervorum emitidos por la arteria, se midió la longitud total y obtuvieron tres muestras (proximal, media y distal) de cada una para ser procesadas mediante técnicas histológicas y se determinaron los grosores de la túnica media y los diámetros. Se observaron modas de 8 ramos arteriales para el músculo braquiorradial, 4 para los músculos flexor superficial de los dedos y flexor radial del carpo, un ramo arterial único para el músculo pronador cuadrado y una moda de 1 vasa nervorum para el ramo superficial del nervio radial. La longitud total de la arteria fue de 21,94 cm (+/-3,34). Los grosores encontrados fueron de 196,16 µm (+/-72,35), 148,25 µm (+/-40,40) y 158,96 µm (+/-45,74) en los segmentos proximal, medio y distal respectivamente. Los diámetros luminales mostraron una media de 1,48 mm (+/-0,70) en la región proximal, 1,01mm (+/-0,35) en la media y 1,43 mm (+/-0,47) en la distal. Considerando las características morfométricas, la arteria radial es una opción que satisface los criterios de longitud, diámetro luminal y grosor para ser utilizada como injerto.

The radial artery (RA) is used in medical practiceto performdifferentsurgical procedures, of which most realized is the coronary artery bypass graftsurgery. In the current literature there is little information about the compatibility of this artery with other vascular conduits. Therefore the aim of this study was to determine the anatomical, morphometric and distribution characteristics of radial artery on the forearm. Radial artery was dissected from the forearms of 10 embalmed cadavers, muscular branches and vasa nervorum were identified and registered, total length was measured. Three samples of each artery were obtained(proximal, middle and distal) to be processedby histological techniques and to determinethe thickness of its tunica mediaand its diameters. The results show a mode of 8 arterial branches to the brachioradialis, a mode of 4 for thesuperficial flexor muscles of the fingers and flexor carpi radialis, we found an unique arterial branch to the pronator quadratus and a mode of 1 vasa nervorum of superficial branch of radial nerve. The total length of the artery was 21.94 cm (+/- 3.34). The vascular wall thickness we found were 196.16 mm (+/-72.35), 148.25 mm (+/-40.40) and 158.96 mm (+/-45.74) in the proximal, middleand distal segments respectively. The luminal diameters showed an average of 1.48 mm (+/-0.70) in the proximal region, 1.01 mm (+/-0.35) in the middle region and 1.43 mm (+/-0.47) in the distal region. In the present study we concludedthat considering the morphometric characteristics, the radial artery is an option that satisfied the criteria of length, thickness and luminal diameterto be used as a graft in the coronary artery bypass graft surgery.