Adipocyte-fatty acid binding protein and non-alcoholic fatty liver disease in the elderly.

BACKGROUND: Adipocyte-fatty acid binding protein (A-FABP) is an intracellular lipid transporter that mediates metabolically triggered inflammation, and it is associated with insulin resistance, atherogenic dyslipidemia, and cardiovascular risk. AIMS: The aim of this study was to evaluate A-FABP behavior in elderly people, and especially its association with liver steatosis at abdominal ultrasound. METHOD: Cross-sectional study of two cohort of individuals with and without steatosis, with assessment of several clinical and laboratory variables. Prospective evaluation of liver steatosis remodeling after six years of follow-up. One hundred and fifty-six subjects aged over 65 years were enrolled. RESULTS: Serum A-FABP positively correlated with body fat percentage, total cholesterol, serum triglycerides and erythrocyte sedimentation rate. Unlike expected, high A-FABP levels were associated with absence of liver steatosis, while there was no evidence of association with steatosis grade changes after 6 years of follow-up. CONCLUSION: Among individuals aging more than 65 years included in the study, A-FABP was inversely associated with liver steatosis. It can be argued, that still uncovered mechanisms modify A-FABP behavior in elderly people, especially its association with multifactorial diseases.

Functional and regenerative effects of local administration of autologous mononuclear bone marrow cells combined with silicone conduit on transected femoral nerve of rabbits.

The inoculation of cells into injury sites can accelerate and improve the quality of nerve regeneration. This study aimed to evaluate the functional and regenerative effects of mononuclear autologous bone marrow cells (MABMC) combined with silicon conduit grafting in rabbit femoral nerves. Twenty-eight animals were allocated to one of two groups: treatment group (TG) or control group (CG), divided according to the time of evaluation, at either 50 or 75 days. After neurotmesis of the femoral nerve, surgical repair was performed with nerve autografts in silicon conduits, leaving a 5mm gap in both groups. The TG received MABMC in silicon conduits, and CG received a sham saline inoculum. Histological, clinical and electrophysiological analyses detected no differences between groups, but analysis of leg diameter showed that TG diameters were larger. This cell therapy did not improve regeneration of the femoral nerve, but there was a tendency for better functional recovery.

Diastolic dysfunction and cardiovascular risk in old subjects: possible association with NAFLD?

Non-alcoholic fatty liver disease (NAFLD) is frequently associated with metabolic syndrome (MS) and may represent a cardiovascular (CV) risk factor. Functional cardiac abnormalities have been reported in patients with NAFLD. The aim of this paper is to investigate whether these findings are present also in elderly people. We tested 171 subjects aging more than 65 years, enrolled in a prospective study on CV risk reduction, for laboratory examination, abdominal ultrasound for evaluation of hepatic steatosis and standard echocardiography for determining morphological and functional cardiac parameters. Higher BMI, serum levels of glucose, triglycerides, cholesterol, insulin and visceral adipose tissue and lower serum levels of HDL-cholesterol were significantly associated with NAFLD. Furthermore, subjects with NAFLD had higher prevalence of diabetes, pathological waist-circumference, insulin-resistance and positive ATP-III criteria. While NAFLD had only a borderline significant association with higher end-diastolic thicknesses of left-ventricle posterior wall (edPW) and right-ventricle wall, higher values of edPW and end-diastolic thickness of interventricular septum were significantly correlated with glucose levels above 100mg/dl, hypertension, MS and insulin-resistance. Moreover, subjects with MS and/or pathological waist-circumference had a lower early-diastolic mitral annular motion, whereas those with insulin-resistance had lower E/A ratio and early-diastolic filling peak velocity. Regression analyses identify hypertension and pathological waist-circumference as factors independently associated to pathological edPW, and hypertriglyceridemia to pathological left-ventricle mass. In conclusion, an ultrasonographic diagnosis of NAFLD in old subjects may be an "alert" on the coexistence of multiple CV risk factors and on the presence of possible alterations of cardiac morphology and diastolic function.

Laparoscopic-assisted prepubic urethrostomy: experimental model in rabbit / Uretrostomia pré-púbica vídeo-assistida: modelo experimental em coelhos

ABSTRACT: The purpose of this study was to develop a laparoscopic-assisted prepubic urethorstomy (PPU) technique using rabbits as an experimental model. Six male New Zealand rabbits (Oryctolagus cuniculus) over six months old and weighing between 3 and 4kg (3.5kg ± 0.4) were used in this study. The animals underwent laparoscopic dissection of the pelvic urethra, which was then exposed for the laparoscopic-assisted urethrostomy procedure. The proposed model for training of laparoscopic-assisted PPU in rabbits was considered effective and feasible. It proved to be a simple technique even for surgeons under basic endosurgery skills training, with possibilities of employing the technique for the treatment of cats with loss of function of the distal urethra.

RESUMO: Este estudo objetivou o desenvolvimento de uma técnica de uretrostomia pré-púbica (UPP) vídeo-assistida, utilizando coelhos como modelo experimental. Foram utilizados seis coelhos Nova Zelândia (Oryctolagus cuniculus), machos, com peso médio de 3.5kg (± 0.4), com idade acima de seis meses. Os animais foram submetidos à dissecação laparoscópica da uretra pélvica e posterior exposição desta para a realização de uretrostomia vídeo-assistida. O modelo proposto para treinamento de UPP vídeo-assistida em coelho foi considerado eficaz e factível, mostrando-se uma técnica exequível mesmo por videocirurgiões iniciantes, havendo possibilidade de seu emprego no tratamento de gatos com perda na função da uretra distal.

Aloenxerto ósseo cortical desvitalizado com nitrogênio líquido - estudo experimental em ovelhas / Allogeneic bone graft devitalized in liquid nitrogen - sheep experimental study

O objetivo do trabalho foi avaliar a taxa e a forma de incorporação do aloenxerto ósseo cortical, submetido ao congelamento em nitrogênio líquido e inserido em tíbias de ovelhas. Foram utilizadas seis ovelhas clinicamente sadias que, aos pares, foram simultaneamente submetidas à ostectomia da diáfise tibial para a retirada de um segmento de 7cm que, após a desvitalização em nitrogênio líquido, foi implantado imediatamente no outro paciente e fixado com placa de compressão dinâmica (PCD) e parafusos corticais. Realizaram-se avaliações clínicas e radiográficas, imediatamente e a cada 30 dias, até o 180º dia de pós-operatório. Aos 180 dias, foi realizada eutanásia e coletou-se a tíbia direita para avaliação histopatológica. Aos 60 dias de pós-operatório, foi observado o uso funcional do membro operado, sendo a união radiográfica das interfaces proximal e distal verificadas, em média, aos 95 dias. Com isso, pôde-se concluir que o nitrogênio líquido é um método adequado de desvitalização de aloimplantes ósseos corticais de ovelhas, proporcionando altas taxas de incorporação óssea, em média, aos 95 dias de pós-operatório.

This study evaluated the allogeneic cortical bone graft incorporation after submission of the harvested fragment to a bout freezing in liquid nitrogen. Six adult sheep, clinically healthy, were submitted to a 7cm ostectomy of the tibial diaphysis. The fragment was submersed in a liquid nitrogen and implanted in another sheep missing a same-sized segment at the corresponding bone. Stabilization of the allograft in the host bone was accomplished by a dynamic compressive plate (DCP). Clinical and radiographic evaluations were performed in the immediate post-operatory period and in every 30 days for six months after surgery. The proximal and distal host-graft interfaces showed radiographic union at a mean postoperative time of 95 days in all the animals. The cortical bone allograft submitted to liquid nitrogen freezing provided adequate bone healing in the sheep model.

Eletroestimulação na cicatrização de feridas cutâneas experimentais em coelhos / Electrical stimulation in experimental wound healing in rabbits

Feridas cutâneas crônicas e complicadas são frequentemente encontradas na rotina da medicina veterinária e, muitas vezes, transformam os tratamentos em verdadeiro desafio. A eletroterapia tem sido indicada como alternativa aos tratamentos convencionais, devido à sua capacidade de promover cicatrização. O objetivo deste trabalho é relatar um ensaio experimental utilizando a eletroestimulação (ES) na cicatrização de feridas cutâneas em coelhos. Para tanto, foram utilizados 10 coelhos Nova Zelândia, machos, hígidos, submetidos à anestesia geral para a indução experimental de duas feridas cutâneas de 1cm² localizadas no dorso, caudal à borda das escápulas. As lesões foram higienizadas com solução salina 0,9%, sendo a do lado direito tratada por ES e a do lado esquerdo, como controle. Para ES utilizou-se a frequência de 60Hz, por 10 minutos a cada dois dias, sendo aplicadas quatro agulhas de acupuntura em pontos equidistantes ao redor da lesão, a 0,5cm da borda. Os animais foram divididos em dois grupos, de oito e de 15 dias, conforme o período de tratamento e avaliação macroscópica e histopatológica. Não houve diferença significativa no tempo de cicatrização das lesões tratadas com ES. Porém, apresentaram qualidade tecidual, tanto na avaliação macro quanto microscópica, superior às do grupo controle. Com isso, é possível indicar a ES como tratamento de feridas cutâneas, por ser uma técnica eficiente, de fácil aplicação e de relativo baixo custo.

Chronic skin wounds are frequently found in veterinary medicine routine and it becomes a challenge for clinicians. Sometimes the treatment routinely used end up failing. The electrotherapy has been indicated as an alternative to conventional treatments because of its ability to promote healing. The aim of this paper is to report an experimental study using electrical stimulation (ES) in wound healing in rabbits. It was evaluated 10 healthy New Zealand rabbits that were submitted to general anesthesia for resection of two wounds with 1cm² located in both sides of the back behind the scapula edge. It was determinate that the right wound would be treated by ES and the left would be used as a control, both cleaned with solution of NaCl 0,9%. The frequency used to ES was 60Hz for 10 minutes every two days, being applied by acupuncture needles in four equidistant points around the lesion, to 0.5cm from the edge. The animals were divided in one group of 15 days and another one of 8 days for treatment and macroscopic and histopathological evaluation. The results showed that the lesions treated by ES do not have significant difference in healing time. However, those treated had higher scarring macroscopic and microscopic quality than the control group. Therefore, it is possible to indicate the use of ES as a skin wounds treatment, whereas it was demonstrated to be an effective technique, easy to use and has relatively low cost.

Ensaio pré-clínico com desfibrilador externo / Pre-clinical trial with external defibrillator

OBJETIVOS: Avaliar a eficácia da desfibrilação em resposta à fibrilação ventricular induzida e descrever as mudanças macroscópicas ocorridas nos corações de suínos após choque de descarga capacitiva exponencial truncada aplicado por protótipo de desfibrilador produzido no Brasil e por um desfibrilador de referência, líder de mercado internacional.MÉTODOS: Dezesseis suínos foram agrupados em quatro grupos de quatro animais, para verificar a eficácia da desfibrilação em resposta à fibrilação ventricular induzida, aplicando cargas de 50 J e 100 J, assim como avaliar a segurança dos desfibriladores usados, através de análises macroscópicas da pele e do coração. Foram avaliados eritema, edema, bolhas, líquido na cavidade pericárdica, queimaduras e tecido carbonizado pós-choque.RESULTADOS: Todos os suínos, após um minuto da indução à fibrilação ventricular, desenvolveram taquicardia que progrediu à fibrilação ventricular. Quando utilizada baixa energia, o equipamento protótipo obteve 25% de sucesso com um suíno revertido, enquanto o equipamento referência obteve 50% de sucesso, com duas reversões. Entretanto, com energia a 100 J, o equipamento protótipo reestabeleceu o ritmo sinusal em três suínos (75%) e o equipamento referência realizou somente uma desfibrilação eficaz (25%). A aplicação de energia 100 J associou-se com queimadura cutânea de Grau II em apenas um suíno com o desfibrilador protótipo e em quatro suínos com o equipamento referência. As lesões do tecido cardíaco ocorreram em igual número com ambos os desfibriladores.CONCLUSÕES: O desfibrilador protótipo, quando aplicado com energia 100 J, demonstrou maior eficácia na reversão da fibrilação ventricular e apresentou menor injúria que o desfibrilador de referência com a mesma energia. Este estudo ajudará a elevar o padrão tecnológico e a ampliar a oferta qualificada de equipamentos para a saúde produzidos no Brasil, substituindo e/ou diminuindo importações e oferecendo um dispositivo seguro de última geração.

AIMS: To evaluate the efficacy of defibrillation in response to induced ventricular fibrillation and to describe the macroscopic changes in porcine hearts after truncated exponential capacitive discharge shock applied by a prototype defibrillator produced in Brazil and a reference, international market leader defibrillator.METHODS: Sixteen pigs were divided into four groups of four animals each, to verify the effectiveness of the defibrillator in response to induced ventricular fibrillation by applying loads of 50 J to 100 J, and assess the safety of the defibrillator by macroscopic analysis of the skin and heart. Erythema, edema, blistering, fluid in the pericardial cavity, burns, and post-shock charred tissue were evaluated.RESULTS: All pigs, after one minute of inducing ventricular fibrillation, developed tachycardia and progressed to ventricular fibrillation. When used low energy, the prototype equipment obtained 25% of success, with one reversed pig, while the reference equipment has obtained a success rate of 50%, with two reversals. However, with energy 100 J, the prototype equipment reestablished sinus rhythm in three pigs (75%) and the reference product only made effective defibrillation in one (25%). The application of 100 J energy was associated with skin burns Grade II in only one pig with the prototype defibrillator and four pigs with the reference equipment. The heart tissue injuries occurred in equal numbers with both defibrillators.CONCLUSIONS: The prototype defibrillator, when applied with 100 J energy, was more effective in reversing ventricular fibrillation and showed less injury than the reference defibrillator with the same energy. This study may help to raise the technological standard and to increase the supply of qualified health equipment produced in Brazil, replacing and/or decreasing imports and providing a secure next-generation device.