Correction: The Role of the Mammalian DNA End-processing Enzyme Polynucleotide Kinase 3'-Phosphatase in Spinocerebellar Ataxia Type 3 Pathogenesis.

[This corrects the article DOI: 10.1371/journal.pgen.1004749.].

Optimizing Aesthetic Outcomes after Retroglandular Breast Implant Explantation.

The safety of silicone breast implants has been questioned due to concerns such as the risk of associated lymphoma, as well as rheumatological and systemic symptoms. This has resulted in an increased demand for explantation, posing the challenge of addressing stigmas related to implant removal. There is a dearth of literature on techniques for restoring breast contour postexplantation. After implant removal, the original breast anatomy is altered, and depressed areas may manifest in random locations. To reposition the breast tissue displaced by the implant, we enlarge the retroglandular pocket and subsequently use sutures for centripetal traction, relocating the tissue back to the footprint area but now in an improved position, delineating the breast contour. This maneuver enables us to restore the breast contour to an anatomical condition akin to preimplantation; diminish the final explantation defect, creating a more suitable pocket for delicate mastopexy flaps; recruit breast tissue, allowing internal sutures to conceal tissue irregularities; and redesign the breast contour area on the chest to achieve better symmetry.

Pharmacological inhibition of acetylcholinesterase improves the locomotion defective phenotype of a SCA3 C. elegans model.

Inhibition of acetylcholinesterase (AChE) is a common used treatment option for Alzheimer's disease. However, there has been limited research on the potential use of AChE inhibitors for the treatment of Machado-Joseph disease (MJD)/Spinocerebellar Ataxia 3 (SCA3), in spite of the positive results using AChE inhibitors in patients with other inherited ataxias. MJD/SCA3, the most common form of dominant Spinocerebellar Ataxia worldwide, is caused by an expansion of the polyglutamine tract within the ataxin-3 protein, and is characterized by motor impairments. Our study shows that administration of the AChE inhibitor neostigmine is beneficial in treating the locomotion defective phenotype of a SCA3/MJD model of C. elegans and highlights the potential contribution of AChE enzymes to mutant ataxin-3-mediated toxicity.

Differential impact of diesel exhaust particles on glutamatergic and dopaminergic neurons in Caenorhabditis elegans: A neurodegenerative perspective.

The growing body of evidence links exposure to particulate matter pollutants with an increased risk of neurodegenerative diseases. In the present study, we investigated whether diesel exhaust particles can induce neurobehavioral alterations associated with neurodegenerative effects on glutamatergic and dopaminergic neurons in Caenorhabditis elegans (C. elegans). Exposure to DEP at concentrations of 0.167 µg/cm2 and 1.67 µg/cm2 resulted in significant developmental delays and altered locomotion behaviour. These effects were accompanied by discernible alterations in the expressions of antioxidant genes sod-3 and gst-4 observed in transgenic strains. Behaviour analysis demonstrated a significant reduction in average speed (p < 0.001), altered paths, and decreased swimming activities (p < 0.01), particularly at mid and high doses. Subsequent assessment of neurodegeneration markers in glutamatergic (DA1240) and dopaminergic (BZ555) transgenic worms revealed notable glutamatergic neuron degeneration at 0.167 µg/cm2 (∼30 % moderate, ∼20 % advanced) and 1.67 µg/cm2 (∼28 % moderate, ∼24 % advanced, p < 0.0001), while dopaminergic neurons exhibited structural deformities (∼16 %) without significant degeneration in terms of blebs and breaks. Furthermore, in silico docking simulations suggest the presence of an antagonistic competitive inhibition induced by DEP in the evaluated neuro-targets, stronger for the glutamatergic transporter than for the dopaminergic receptor from the comparative binding affinity point of view. The results underscore DEP's distinctive neurodegenerative effects and suggest a link between locomotion defects and glutamatergic neurodegeneration in C. elegans, providing insights into environmental health risks assessment.

In vitro and in vivo evaluation of novel chromeno[2,3-d]pyrimidinones as therapeutic agents for triple negative breast cancer.

Triple-negative breast cancer (TNBC) is the most aggressive subtype of breast cancer, and the limited therapeutic options show poor efficacy in patients, associated to severe side effects and development of resistance. Considering that chromene-based scaffolds proved to be attractive candidates for cancer therapy, herein we prepared new chromeno[2,3-d]pyrimidinone derivatives by a simple two step procedure, starting from the reaction of cyanoacetamide and a salicylaldehyde. A cell viability screening in several breast cancer cell lines allowed to identify two promising compounds with IC50 values in the low micromolar range for TNBC cells. These chromenes inhibited cell proliferation, induced cell cycle arrest and triggered cell death through apoptosis. In vivo studies revealed a safe profile in invertebrate and vertebrate animal models and confirmed their capacity to inhibit tumor growth in the CAM model, inducing significant tumor regression after 4 days of treatment. The two compounds identified in this study are promising drug candidates for TNBC treatment and valuable hits for future optimization, using the versatile synthetic platform that was developed.

Glucocorticoid receptor-dependent therapeutic efficacy of tauroursodeoxycholic acid in preclinical models of spinocerebellar ataxia type 3.

Spinocerebellar ataxia type 3 (SCA3) is an adult-onset neurodegenerative disease caused by a polyglutamine expansion in the ataxin-3 (ATXN3) gene. No effective treatment is available for this disorder, other than symptom-directed approaches. Bile acids have shown therapeutic efficacy in neurodegenerative disease models. Here, we pinpointed tauroursodeoxycholic acid (TUDCA) as an efficient therapeutic, improving the motor and neuropathological phenotype of SCA3 nematode and mouse models. Surprisingly, transcriptomic and functional in vivo data showed that TUDCA acts in neuronal tissue through the glucocorticoid receptor (GR), but independently of its canonical receptor, the farnesoid X receptor (FXR). TUDCA was predicted to bind to the GR, in a similar fashion to corticosteroid molecules. GR levels were decreased in disease-affected brain regions, likely due to increased protein degradation as a consequence of ATXN3 dysfunction being restored by TUDCA treatment. Analysis of a SCA3 clinical cohort showed intriguing correlations between the peripheral expression of GR and the predicted age at disease onset in presymptomatic subjects and FKBP5 expression with disease progression, suggesting this pathway as a potential source of biomarkers for future study. We have established a novel in vivo mechanism for the neuroprotective effects of TUDCA in SCA3 and propose this readily available drug for clinical trials in SCA3 patients.

Explante de silicone: a importância da ressonância nuclear magnética das mamas no planejamento préoperatório / Silicone explant: the importance of breast magnetic resonance imaging in preoperative planning

Introdução: A recente preocupação sobre a segurança dos implantes de silicone tem levado muitas mulheres a buscarem a retirada de seus implantes, mesmo sem aparente complicação nas mamas. Por outro lado, muitos cirurgiões não se sentem confortáveis em realizar o explante por receio de que a paciente não gostará do resultado estético após a cirurgia. A ressonância nuclear magnética (RNM) é um recurso valioso para avaliação diagnóstica das mamas e pode ser usada no planejamento do explante. O objetivo é demonstrar como a análise sistematizada das imagens da ressonância magnética das mamas pode auxiliar no planejamento do explante de silicone. Método: Uma análise detalhada dos cortes axial e sagital da RNM foi feita para avaliar a quantidade de tecido em cada mama. Essas imagens foram apresentadas às pacientes durante a consulta pré-operatória para que elas pudessem perceber, com clareza, o quanto o implante influencia no tamanho de suas mamas. No mesmo momento, foram apresentadas fotos de pós-operatório de pacientes com características semelhantes para que a paciente pudesse analisar, de forma mais objetiva, se ficaria satisfeita ou não com a estética das mamas após o explante. Resultados: As pacientes demonstraram alto grau de compreensão das imagens apresentadas e se mostraram satisfeitas com esta análise detalhada de expectativa de resultado. Conclusão: A comparação das imagens da RNM das mamas e das imagens de resultados de pós-operatório confere maior objetividade ao diálogo pré-operatório, favorecendo a compreensão do resultado esperado e trazendo maior clareza à decisão pelo explante.

Introduction: Recent concerns about the safety of silicone implants have led many women to seek the removal of their implants, even without apparent breast complications. On the other hand, many surgeons do not feel comfortable performing the explant for fear that the patient will not like the aesthetic result after surgery. Magnetic resonance imaging (MRI) is a valuable resource for diagnostic evaluation of the breast and can be used in explant planning. The objective is to demonstrate how the systematic analysis of breast MRI images can assist in planning silicone explantation. Method: A detailed analysis of the axial and sagittal MRI sections was performed to assess the amount of tissue in each breast. These images were presented to patients during the preoperative consultation so that they could clearly understand how much the implant influences the size of their breasts. At the same time, post-operative photos of patients with similar characteristics were presented so that the patient could analyze, more objectively, whether or not she would be satisfied with the aesthetics of her breasts after explantation. Results: The patients demonstrated a high degree of understanding of the images presented and were satisfied with this detailed analysis of expected results. Conclusion: The comparison of breast MRI images and postoperative results images provides greater objectivity to the preoperative dialogue, favoring the understanding of the expected result and bringing greater clarity to the decision for explantation.

Weight-loss and surface roughness of enamel after microabrasion procedure with different agents / Perda de peso e rugosidade da superfície do esmalte após procedimento de microabrasão com diferentes agentes

Introduction: Enamel microabrasion is achieved by abrasion of the enamel surface and it is a quick, practical and efficient procedure. Objective It was assessed the weight loss and surface aspect of enamel after microabrasion procedures with commercial and mixtures made in-office. Material and method Eighty bovine incisors were divided into four groups (n=10): OpalustreTM (6.6% HCl + silicon carbide); Whiteness RMTM (6% HCl + silicon carbide); 37% H3PO4 + pumice and 10% HCl + pumice. Treatment was performed by 15 applications of 10s duration. The enamel weight loss was determined by the difference in weight before and after the microabrasion. The surfaces were analyzed by a surface roughness equipment and scanning electron microscopy. Data were submitted to paired-T test, one-way ANOVA and Tukey tests (α=0.05). Result It was observed significantly weight loss for all groups. The difference in weight loss ranged from 0.037±0.012 for group 37% H3PO4 and from 0.054±0.009 for group 6,6% HCl. There was a significant increase in surface roughness for all groups and 10% HCl group showed the lower results (0.65±0.09). It was observed different patterns of enamel morphology by SEM images. Conclusion The in-office mixtures resulted in the lowest enamel structure loss (37% H3PO4) and the lowest surface roughness (10% HCl).

Introdução: A microabrasão do esmalte é realizada através da abrasão da superfície do mesmo, apresentando-se como um procedimento rápido, prático e eficiente. Objetivo Avaliar a perda de peso e o aspecto superficial do esmalte após procedimentos de microabrasão com agentes comerciais e não comerciais. Material e método Oitenta incisivos bovinos foram divididos em quatro grupos (n = 10): OpalustreTM (6,6% HCl + carboneto de silício); Whiteness RMTM (6% HCl + carboneto de silício); 37% H3PO4 + pedra-pomes e 10% HCl + pedra-pomes. O tratamento foi realizado em 15 aplicações de 10s de duração. A perda de peso do esmalte foi determinada pela diferença de peso antes e depois da microabrasão. As superfícies foram analisadas por equipamento de rugosidade superficial e microscopia eletrônica de varredura. Os dados foram submetidos ao teste T-pareado, ANOVA one-way e teste de Tukey (α = 0,05). Resultado Foi observada perda de peso significativa para todos os grupos, a diferença na perda de peso variou de -0,037±0,012 para o grupo 37% H3PO4 a -0.054±0.009 para o grupo 6.6% HCl. Houve um aumento significativo na rugosidade da superfície para todos os grupos e o grupo 10%HCl apresentou os resultados mais baixos (0,65±0,09). Foram observados diferentes padrões de morfologia do esmalte por meio de imagens MEV. Conclusão Os agentes não comerciais resultaram na menor perda de estrutura do esmalte (37% H3PO4) e na rugosidade superficial (10% HCl).

Effect of hydrochloric acid commercial presentation for microabrasion technique on loss of enamel structure and surface / Efeito da apresentação comercial de ácido clorídrico para técnica de microabrasão na perda de estrutura e superfície do esmalte

Introdução: A técnica de microabrasão pode ser realizada através de pasta pronta para uso, disponível comercialmente, ou o profissional pode manipulá-la no consultório. Objetivo: Verificar o efeito da apresentação comercial do ácido clorídrico a 10% na manipulação de pasta para microabrasão sobre a superfície do esmalte. Metodologia: Foram selecionados incisivos bovinos e divididos em dois grupos, de acordo com a apresentação comercial do ácido clorídrico (líquido ou em gel). O tratamento foi realizado através de dez aplicações com 10s de duração cada, intercaladas por lavagem de 10s. Vinte incisivos (n=10) foram utilizados para se determinar a perda de estrutura do esmalte. Cada amostra foi pesada, em balança analítica, antes e após submissão à microabrasão. Outras 20 amostras (n=10) foram utilizadas para determinação da rugosidade superficial média (Ra) utilizando-se um rugosímetro. Três amostras de cada grupo do experimento anterior foram selecionadas, aleatoriamente, e outras três amostras adicionais foram preparadas como controle (baseline) para análise em MEV. Resultados: Verificou-se diferença estatística significativa entre a massa final e a inicial e rugosidade superficial das amostras, independente da apresentação comercial do ácido. Nas imagens de MEV observou-se presença de superfície regular para o grupo controle (baseline). Nas demais imagens verificou-se superfície com considerável irregularidade e dissolução discreta do esmalte. Conclusões: O tratamento realizado causou perda significativa de estrutura e aumentou a rugosidade superficial dos espécimes, independente da apresentação comercial do ácido e sem apresentar diferença entre os grupos ao final. A apresentação comercial do ácido não parece ser um fator a interferir no tratamento. (AU)

Introduction: The microabrasion technique can be performed using a commercially available paste, or the dentist can prepare it in his office. Objective: To verify the effect of hydrochloric acid commercial presentation in the handling of microabrasion paste on the enamel surface. Methodology: Bovine incisors were divided into two groups, according to the commercial presentation of 10% hydrochloric acid (liquid or gel). The treatment was carried out through ten applications of 10 s duration each, intercalated with a 10s wash. Twenty teeth (n=10) were used to determine the loss of enamel structure. Each sample was weighed on an analytical balance before and after submission to microabrasion. Another 20 teeth (n=10) were used to determine the average surface roughness (Ra) using a rugosimeter. Three samples from each group of the previous experiment were selected, randomly, and another three additional samples were repared as a control (baseline) for SEM analysis. Results: There was a statistically significant difference between the final and initial mass and the surface roughness of the samples, regardless of the acid commercial presentation. In the SEM images, a regular surface was observed for the control group (baseline). In the other images, there was a surface with considerable irregularity and a slight dissolution of the enamel. Conclusions: The treatment carried out. (AU)

Changes in hematological and biochemical parameters of tambaqui (Colossoma macropomum ) parasitized by metazoan species / Alterações nos parâmetros hematológicos e bioquímicos de tambaqui (Colossoma macropomum) parasitado por espécies de metazoários

Abstract The aim of this study was to evaluate the impacts of metazoan parasites on hematological and biochemical parameters and relative condition factor of tambaqui (Colossoma macropomum ) farmed in northern Brazil. A total of 32 juvenile fish were captured from a commercial fish farm located in the municipality of Rio Preto da Eva, Amazonas state, Brazil. Parasite prevalence was 100% for Anacanthorus spathulatus, Mymarothecium boegeri and Notozothecium janauachensis, 100% for Neoechinorhynchus buttnerae and 53.13% for Dolops geayi. The greatest mean parasite intensity was found in acantocephalans followed by monogeneans and branchiuran crustaceans. A negative correlation was observed between abundance of N. buttnerae and hematocrit percentage, hemoglobin concentration, total thrombocyte count and glucose and between abundance of the monogenean and glucose concentration. Parasitic infections caused damage in tambaqui in terms of the observed hematological parameters that were characterized by hypochromic anemia and thrombocytopenia, which are important parameters to be used in parasitic diagnosis. This study is the first record of the occurrence of Dolops geayi in farmed tambaqui in the Amazon.

Resumo O objetivo deste estudo foi avaliar o impacto do parasitismo por metazoários sobre os parâmetros hematológicos, bioquímicos e fator de condição relativo de tambaquis (Colossoma macropomum) cultivados na região Norte do Brasil. Foram coletados 32 tambaquis em fase de engorda numa piscicultura comercial no município de Rio Preto da Eva, estado do Amazonas, Brasil. A prevalência de parasitos foi de 100% para Anacanthorus spathulatus, Mymarothecium boegeri e Notozothecium janauachensis, 100% para Neoechinorhynchus buttnerae e 53,13% para Dolops geayi. A maior intensidade média foi de acantocéfalos, seguida por monogenéticos e branquiúros. Correlação negativa significativa foi observada entre abundância de N. buttnerae e os parâmetros de hematócrito, concentração de hemoglobina, trombócitos totais e glicose, bem como entre a abundância de monogenéticos e glicose. A infecção por parasitos metazoários foi capaz de debilitar os tambaquis como observado por meio das alterações hematológicas; sendo este quadro de anemia hipocrômica e trombocitopenia importante para ser utilizado no diagnóstico destas parasitoses. Este estudo foi o primeiro registro da ocorrência de Dolops geayi em tambaquis cultivados na Amazônia.

Stocking density during the initial grow-out phase of tambatinga in net pens / Densidade de estocagem durante a recria da tambatinga em tanque-rede

ABSTRACT:The aim of this study was to determine the most adequate stocking density for tambatinga during the initial grow-out phase in net pens, considering fish growth, health, and financial aspects. Three stocking densities (400, 500, and 600 fish m-3) were evaluated for 60 days in a completely randomized design (n=4). There were no significant differences among the stocking densities for growth performance parameters, but yield was higher in the density of 600 fish m-3 (3,909.43±397.79kg m-3) compared to 400 fish m-3 (2,656.43±665.45kg m-3). Glucose, hematocrit, and total plasma proteins levels did not differ among treatments. The production was economically feasible for the three stocking densities. However, the density of 600 fish m-3 showed the highest profit. According to the results, 600 fish m-3 is the most adequate density for the initial grow-out phase of tambatinga in net pens.

RESUMO:O objetivo deste trabalho foi determinar a melhor densidade de estocagem para a tambatinga durante a fase de recria em tanques-rede, considerando o desempenho zootécnico, sanitário e econômico. Foram avaliadas três densidades de estocagem (400, 500 e 600 peixes m-3) durante 60 dias, em delineamento inteiramente ao acaso (n=4). Não houve diferença para os índices de desempenho analisados entre as densidades de estocagem avaliadas, com exceção da produtividade, que foi maior para a densidade de 600 peixes m-3 (3909,43±397,79kg m-3) em comparação à densidade de 400 peixes m-3 (2656,43±665,45kg m-3). Glicose plasmática, hematócrito e proteínas plasmáticas não diferiram entre os tratamentos. A produção foi economicamente viável nas três densidades de estocagem avaliadas. No entanto, a densidade de 600 peixes m-3 apresentou maior lucro em comparação às demais. A melhor densidade de estocagem para a recria da tambatinga em tanque-rede é de 600 peixes m-3.

The mandibular incisive canal and its anatomical relationships: a cone beam computed tomography study

BACKGROUND: To avoid postoperative injuries in the interforaminal region, presence of the Mandibular Incisive Canal (MIC), its extension and canal positioning in relation to the cortical bone and alveolar process were investigated by cone beam computed tomography (CBCT). MATERIAL AND METHODS: One hundred CBCT examinations obtained by means of the i-CAT CBCT imaging system were analyzed in multiple-plane views (axial, panoramic and cross-sectional) and three-dimensional representations were performed using iCAT CBCT software. The MIC was evaluated for its presence, measurement and proximity to the buccal and lingual plates, alveolar process and inferior border of the mandible. RESULTS: The MIC was visible in all (100%) CBCT images. The mean length of MIC was 9.8 ± 3.8 mm. The distances between the canal and buccal plate, as well as between the canal and lingual plate of the alveolar bone were 4.62 ± 1.41 mm and 6.25 ± 2.03 mm, respectively. The distances from the canal to the alveolar process, and to the inferior border of the mandible were 10.25 ± 2.27 mm and 7.06 ± 2.95 mm, respectively. CONCLUSIONS: Due to the high prevalence of MIC, its variation in length and distance up to the cortical bone, suggested that preoperative radiographic evaluation of the MIC must be carried out case-by-case using CBCT, which could clearly show the three-dimensional structure and adjacent structure of the MIC

Correlação clínico-tomográfica em patologias dos seios maxilares: avaliação por meio de tomografia computadorizada por feixe cônico / Clinical and tomographic correlation in maxillary sinus pathologies: an evaluation by cone beam computed tomography

Objetivo: Analisar os achados tomográficos fortuitos em seios maxilares por meio de exames de Tomografia Computadorizada por Feixe Cônico, bem como sua correlação com a sintomatologia clínica relatada. Método: Exames da maxila de 54 pacientes foram avaliados por dois examinadores independentes considerando os seios maxilares direito e esquerdo (n=108). Foi verificada a ocorrência de patologias sinusais nas paredes anterior, medial, lateral e posterior, assoalho e teto dos seios maxilares, utilizando o software i-CAT Vision® (versão 1.6.20). Esses dados foram correlacionados com a presença ou ausência de sintomatologia relacionada à patologia sinusal. Resultados: O achado tomográfico mais observado foi a opacificação do seio pelo acúmulo de secreções (28,70%), seguido pelo espessamento da mucosa antral do seio maxilar (20,37%) e pela presença de cisto mucoso (17,59%). Em 60,22% dos casos não houve relato de sintomatologia clínica, independente da presença de patologias. A ocorrência de sintomatologia e achados tomográficos concomitantemente foi observada em 35,20% dos seios examinados, enquanto em 45,37% o achado tomográfico estava presente, sem, contanto, haver relato de sintomatologia. As paredes dos seios mais afetadas foram o assoalho (71,30%), correlacionando fator odontogênico associado, e a parede medial (57,40%), estando relacionada à frequência de infecções das vias aéreas superiores. O protocolo de visualização multiplanar obteve total acurácia e sensibilidade (100%), seguido pelos protocolos coronal (81,50%), e axial (76%).Conclusão: O exame de Tomografia Computadorizada por Feixe Cônico mostrou- se útil para definir a presença de patologias sinusais, porém é inespecífico na correlação dos achados em pacientes sintomáticos e na intensidade destes sintomas.

Objective: To analyze the eventual tomographic findings in maxillary sinuses by cone beam computed tomography as well as its relationship with the reported clinical symptoms. Method: Maxillary exams of 54 patients were evaluated by two independent examiners considering the right and left maxillary sinuses (n=108). There were sinus pathologies on the anterior, medial, lateral and posterior walls, the floor and ceiling of maxillary sinuses, detected with the i-CAT Vision® (version 1.6.20) software. The collected data were correlated with the presence or absence of symptoms related to the sinus pathology. Results: The most frequent tomographic finding was opacification of the sinuses by accumulation of sinusoidal secretions (28.70%), followed by thickening of the antral mucosa of the maxillary sinus (20.37%) and the presence of mucous cyst (17.59%). In 60.22% of the cases, there was no report of clinical symptomatology regardless of the presence of pathology. Simultaneous presence of symptoms and tomographic findings occurred in 35.20% of the sinuses, while in 45.37% there was a tomographic finding without reported symptomatology. The most affected sinus walls were the floor (71.30%), associated with odontogenic origin, and the medial wall (57.40%) associated with upper airway infections. The multiplanar visualization protocol resulted in complete accuracy and sensitivity (100%), followed by the coronal (81.50%) and axial (76%) protocols. Conclusion: Cone beam computed tomography was proven useful for detecting the presence of sinus pathologies, but it was unspecific in the correlation of the findings in symptomatic patients and in the intensity of these symptoms.

Tração cutânea intraoperatória para fechamento de ferida após mastectomia bilateral higiênica: relato de caso / Intraoperative skin traction for closure of hygienic bilateral mastectomy wound: case report

INTRODUÇÃO: As sequelas da parede torácica após mastectomia requerem reconstrução por meio de conduta segura e eficiente. Nos casos de recidiva local, sobretudo bilateral, a intervenção cirúrgica deverá ser indicada considerando o estado geral do paciente e a expectativa de vida. A tração intraoperatória é uma técnica de baixa morbidade e rápida execução, reduzindo as cicatrizes decorrentes da utilização de retalhos. RELATO DO CASO: Paciente do sexo feminino, 45 anos que, após diagnóstico de recidiva tumoral em mama direita e novo tumor em mama esquerda, foi submetida à mastectomia bilateral higiênica com esvaziamento axilar à esquerda. Optou-se pela realização de tração cutânea intraoperatória dos bordos da ferida para fechamento primário da parede torácica devido ao estado geral da paciente. A tração foi realizada conforme a técnica de Góes et al., utilizando-se fios de prolene 2, tracionando a pele por dez minutos, com descanso de dois minutos, até que se obtivesse proximidade suficiente dos bordos das lesões para realização de sutura primária, o que foi alcançado após três ciclos de tração e relaxamento. O procedimento teve duração de duas horas, e foi colocado dreno portovac 3.2, que foi retirado após 7 dias. A paciente evoluiu sem queixas álgicas, sem deiscência ou qualquer outra complicação. CONCLUSÃO: A tração intraoperatória demonstrou ser uma técnica segura, funcionalmente eficaz, com menores custo e morbidade, para fechamento de ferida resultante de mastectomia bilateral higiênica.

INTRODUCTION: The post-mastectomy chest wall defects require reconstruction by a safe and efficient procedure. In cases of local recurrence, especially bilateral, surgical intervention should be indicated given the patient's general condition and life expectancy. The intraoperative traction is a technique with low morbidity and rapid execution, reducing the scars from the use of flaps. CASE REPORT: Female patient, 45 years old, after diagnosis of recurrence in right breast and a new tumor in left breast, was submitted to hygienic bilateral mastectomy with dissection of left axillary lymph nodes. Opted for intraoperative skin traction of the chest wall wound edges for primary closure due to the general state of the patient. Traction was performed according to the Góes et al. technique, using prolene 2 sutures, stretching the skin for ten minutes, resting for two minutes, until they gain sufficient proximity of the edges of the wound to perform primary suture. This was achieved after three cycles of tension and relaxation. The procedure lasted two hours and was used aspiratory drainage with portovac 3.2 drain, which was removed after 7 days. The patient had no pain complaints, suture without dehiscence or any other complication. CONCLUSION: The intraoperative traction proved to be a safe, functionally efficient, with lower costs and lower morbidity, to close wounds resulting from hygienic bilateral mastectomy hygienic.

Myxobolus sp. (Myxozoa) in the circulating blood of Colossoma macropomum (Osteichthyes, Characidae) / Myxobolus sp. (Myxozoa) no sangue circulante de Colossoma macropomum (Osteichthyes, Characidae)

Myxosporea parasitize many organs in fresh and saltwater fish. Species of the genus Myxobolus parasitizing the gills and other organs of the tambaqui Colossoma macropomum have been described. In the present study, blood smears were made from juvenile tambaqui and were stained with May Grunwald-Giemsa-Wright in order to identify myxozoan parasites. Out of a total of 36 fish examined, one specimen (2.7 percent) that was reared in a cage presented spores that were identified as M. colossomatis, whereas fish kept in 250 L tanks showed prevalence of 5.5 percent. This is the first report of M. colossomatis in the blood of farmed tambaqui in the Amazon region. These results indicate that myxozoan parasites should also be investigated in fish blood smears. Some myxosporean species may cause diseases in fish, and these species need to be identified so that adequate preventive sanitary control can be instituted.

Mixosporídeos parasitam diversos órgãos de peixes de água doce e salgada, tendo sido descrita espécie do gênero Myxobolus parasitando brânquias e outros órgãos de tambaqui Colossoma macropomum. No presente trabalho, extensões sanguíneas de juvenis de tambaquis foram confeccionadas e coradas com May Grunwald-Giemsa-Wright para identificação de parasitos myxozoários. Do total de 36 peixes examinados, um espécime (2,7 por cento) cultivado em tanque-rede apresentou esporos identificados como M. colossomatis, enquanto os peixes mantidos em tanques com 250 L apresentaram prevalência de 5,5 por cento. Esse é o primeiro registro de M. colossomatis no sangue de tambaqui cultivado na Amazônia. Esses resultados indicam que parasitos Myxozoa devem ser também investigados em extensões sanguíneas. Algumas espécies de mixosporídeos podem causar doença em peixes, sendo necessária a identificação da espécie para um adequado manejo sanitário preventivo.

Olhar masculino acerca do atendimento na estratégia saúde da família / Male view about the assistence care in the family health strategy / Punto de vista masculino sobre la asistencia en la estrategia salud de la familia

Trata-se de um estudo qualitativo que teve como objetivo identificar a opinião de homens sobre o atendimento recebido na Estratégia Saúde da Família. Os dados foram coletados nos meses de junho e julho de 2009, por meio de entrevista semiestruturada junto a onze homens adscritos em área de abrangência de uma equipe da Estratégia Saúde da Família, no município de Parnamirim-RN, Brasil. Os depoimentos foram trabalhados de acordo com a Análise de Conteúdo, segundo Bardin. Os resultados revelaram opiniões heterogêneas quanto aos serviços oferecidos pela referida Estratégia, com predomínio de julgamentos negativos em virtude da dificuldade em conseguir consulta médica e demora na marcação de exames, além da escassez de profissionais e médicos especialistas nos serviços de atenção primária. Constatou-se necessidade de haver reestruturação nas Unidades Básicas de Saúde, bem como na atuação dos profissionais, com vistas a atender as demandas de saúde da população masculina.

This is a qualitative study aimed to determine the opinion of men about the assistance care received at the Family Health Strategy. Datawere collected during June and July 2009 through semi structured interviews with eleven men assigned to the coverage area of a team fromthe Family Health Program in the municipality of Parnamirim-RN, Brazil. The statements were dealt with following the content analysisaccording to Bardin. The results showed to be heterogeneous as to the offered services by this Strategy, with a predominance of negativejudgments due to the difficulties in getting medical care and delay in exams, besides the shortage of professionals and specialist medicinein primary services care. There was the need for a restructuring in the Basic Health Units as well as the professionals’ actions, in order tomeet the healthcare demands of the male population.

Este es un estudio cualitativo con el objetivo de identificar la opinión de los hombres sobre la asistencia ofrecida por la Estrategia de SaludFamiliar. Los datos fueron recolectados durante junio y julio del 2009 a través de entrevista semiestructurada, con once hombres adscritosa la zona de cobertura de un equipo de la Estrategia de Salud de la Familia, en el municipio de Parnamirim-RN, Brasil. Las declaracionesfueron tratadas de acuerdo con el Análisis de Contenido según Bardin. Los resultados mostraron opiniones heterogéneas concernientes alos servicios ofrecidos por la mencionada Estrategia, predominando los juicios negativos debido a la dificultad para conseguir una consultamédica y demora para marcar fecha para realización de pruebas, además de la escasez de profesionales y médicos especialistas enlos servicios de atención primaria. Se verificó que es necesario que haya una reestructuración en las Unidades Básicas de Salud, así comoen el desempeño de los profesionales, con el fin de tener en cuenta las demandas de la población masculina, en el área de la de salud.

Avaliação da resposta inflamatória hematológica em cascavéis (Crotalus durissus Linnaeus, 1758) inoculadas com BCG / Assessment of blood inflammatory response in BCG stimulated rattlesnakes (Crotalus durissus Linnaeus, 1758)

A criação de serpentes peçonhentas em cativeiro para produção de soros antipeçonhas possui crescente importância para a saúde pública devido ao aumento do número de notificações de acidentes ofídicos a cada ano no Brasil. Iniciado no século XX, ainda hoje essa atividade apresenta alguns desafios como a instalação de doenças no plantel. O hemograma é um exame de triagem clínica que auxilia no diagnóstico de diversas moléstias que acometem diferentes espécies de animais, no entanto ainda pouco estudado em serpentes. A caracterização das alterações hematológicas em cascavéis inoculadas experimentalmente com BCG pode servir de base na utilização deste exame no auxílio ao diagnóstico de infecções bacterianas na espécie. Dessa forma, foram realizados exames hematológicos em 10 serpentes da espécie Crotalus durissus pertencentes ao plantel da Divisão de Herpetologia do Instituto Vital Brazil. Os animais foram divididos em dois grupos (Grupos 1 e 2), homogêneos entre si em relação ao peso e proporção sexual. Os dois grupos foram inoculados com BCG e submetidos à coleta de sangue antes da inoculação e em três momentos pós-inoculação (3º, 5º, e 7º dias para o Grupo 1 e 11º, 17º e 21º dias para o Grupo 2). O hemograma foi realizado por método semidireto pela utilização de líquido de Natt e Herrick e as lâminas foram coradas pelo Giemsa. Observou-se anemia discreta, com redução dos valores de concentração de hemoglobina corpuscular média e da hemoglobina globular média no Grupo 1 que foi relacionada à doença inflamatória. A trombocitopenia observada no Grupo 2 sugeriu a atuação deste tipo celular em processos inflamatórios. Um único animal do Grupo 1 apresentou granulocitose e alguns animais apresentaram discreta azurofilia. Observaram-se alterações morfológicas nos leucócitos. Os granulócitos apresentaram granulações grosseiras e os azurófilos apresentaram aumento de tamanho e grandes vacúolos. De forma geral, a inoculação de BCG em cascavéis desencadeia ...

The high demand for anti-venom production in response to the increased number of cases of snakebite envenomation highlights the importance of raising and breeding venomous snakes in captivity. Knowledge of types of venoms and anti-venoms is of great interest to public health. The maintenance of venomous serpents in captivity started in the early twentieth century, but still nowadays it is a challenge to manage and prevent diseases in captive fauna. Hematology is commonly used for general health assessment and illness detection. However, data on serpent blood analysis are still scarce. Alterations in hematological parameters were experimentally induced in rattlesnakes by the inoculation of BCG. Based on this, hemograms can be used as a health auxiliary diagnosis method for bacterial diseases in this species. In this study, blood samples were taken from 10 healthy specimens of rattlesnakes (Crotalus durissus) born and bred in captivity in the Herpetological Division of Vital Brazil Institute. Animals were divided into two groups (group 1 and 2) with similar live weight and sex proportion, and were then inoculated subcutaneously with BCG (Bacillus Calmette-Guérin). Blood samples were taken before and after inoculation at three experimental times (days 3, 5 and 7 for group 1 and days 11, 17 and 21 for group 2). Hematological analysis was performed through semi-direct technique, blood samples were diluted in Natt and Herrick solution and smears were stained by Giemsa. Serpents from group 1 developed discrete anemia due to the inflammatory syndrome, and showed significant decrease of MCH and MCHC. Granulocytes were characterized by the presence of rough granules. The azurophils varied in shape and size and showed large amount of cytoplasmic vacuoles. The thrombocytopenia observed in group 2 suggests that these cells participate in the inflammatory process. A single individual from group 1 showed granulocytosis and a few animals showed a discrete ...

Transdiciplinary approach to the follow-up of patients after myocardial infarction

OBJECTIVES: To compare conventional and transdisciplinary care in a tertiary outpatient clinic for patients after their first acute myocardial infarction. METHODS: One hundred fifty-three patients with acute myocardial infarction were randomized at hospital discharge and followed-up to compare conventional (n=75) and transdisciplinary care (n=78). They were submitted to a clinical evaluation, received a dietary plan, and were re-evaluated twice in 60-180 days by a nurse, dietitian and physician, when new clinical and laboratory data were collected. The primary outcome was clinical improvement, as evaluated by an index including reduction of body weight, lowering of blood pressure, smoking cessation, increase in physical activity and compliance with medication. RESULTS: The groups were similar at baseline: 63.4 percent were men, 89.9 percent had an acute myocardial infarction with ST-segment-elevation, 32.7 percent were diabetic, and 72.2 percent were hypertensive. The clinical improvement index was similar between the studied groups: in 33.3 percent (transdisciplinary care) vs. 30.4 percent (conventional care) of patients, the improvement was very good (P=1.000). Rates of re-hospitalization and death (p=0.127) were similar between transdisciplinary and conventional care. Compliance with diet was higher for transdisciplinary care (50.0 percent) vs. conventional care (26.1 percent) (p=0.007), as was compliance with visits (73.3 vs. 40.3 percent, respectively, p<0.001). CONCLUSIONS: Compliance with diet and visits was higher for transdisciplinary care vs. conventional care; however, the transdisciplinary approach did not provide more clinical benefits than the conventional approach after patients' first acute myocardial infarction in this setting.

Candida colonization in intensive care unit patients' urine

The objective of this study was to identify possible predisposing factors for candiduria in intensive care unit (ICU) patients from Hospital das Clínicas, Universidade Federal de Goiás, Goiânia, Brazil, during one year. Urine samples from 153 ICU patients were obtained by catheterization on admission day and every seven days. Data such as sex, age, antifungal therapy, and variables as antibiotics, underlying diseases or comorbid conditions and stay in the hospital, were collected from patients who had at least one urine culture that yielded > 10³ yeast colonies/ml. Candiduria was recovered in 68 patients and the commonest predisposing factors were antibiotic therapy (100 percent) and indwelling urinary catheter (92.6 percent). The percentage of Candida spp. isolation increased during the extended periods in which patients remained in the ICU. C. albicans was isolated in 69.1 percent, and the other species non-albicans as C. glabrata, C. kefyr, C. parapsilosis, C. famata, C. guilliermondii, C. krusei, and C. tropicalis were isolated in lower percentage. The high frequency of candiduria and the possible predisposing factors found in ICU patients show that candiduria surveillance should be performed to help reducing nosocomial infections.