Short and long-term effects of kidney donation on mineral and bone metabolism.

BACKGROUND: Living kidney donors (LKD) experience an abrupt decline in glomerular filtration rate (GFR) resulting in abnormalities of mineral and bone metabolism (MBD), and this may have implications for skeletal health. We prospectively studied acute and long term MBD adaptation of LKD from two kidney transplant centers (São Paulo, Brazil and Miami, USA). METHODS: Renal function and MBD parameters longitudinally after kidney donation (baseline - D0, day 1, 14, 180 and 360 post-operatively) were measured in 74 patients (40 y, 73% female, 54% Brazilian). A subset of 20 donors from Brazil were reassessed after 10 years of nephrectomy. RESULTS: At baseline, Brazilian donors presented lower intact FGF23 (20.8 vs. 80.1 pg/mL, P < 0.01) and higher PTH (47.4 vs. 40.1, P = 0.04) than their US counterparts. GFR decreased to 63% of its baseline levels just after donation but improved 10% during the first year. PTH levels increased on D1, returning to baseline levels on D14, while FGF23 remained higher than baseline over the first year. LKD had a significant reduction of serum phosphate on D1, which returned to baseline levels on D180. A higher fractional excretion of phosphate (FEP) was noted since D14. After 10 years of donation, 20 LKD presented a sustained reduction in GFR (74.8 ± 14mL/min). There was a return to baseline in serum FGF23 [21.8 (18-30) pg/mL] and FEP, accompanied by an increase in serum calcium. PTH remained elevated (57.9 ± 18 pg/mL), whereas serum calcitriol and Klotho were lower than before the donation. CONCLUSIONS: The abrupt decline in kidney mass is associated with an increase in PTH and FGF23 that is not explained by phosphate retention. In a long-term evaluation, LKD showed a sustained drop in GFR, with lower serum calcitriol and Klotho, and higher PTH. The effects of these changes should be investigated in further studies.

Effects of ozone therapy applied topically, by bagging, or both on the healing of clean wounds induced in rat's skin.

PURPOSE: This study aimed to evaluate the effects of ozone therapy applied topically and/or by bagging on the healing of clean wounds induced in rat's skin. METHODS: One hundred and twenty male rats of about 16 weeks old was divided into five groups: G1) saline solution (0.9%); G2) sunflower oil; G3) ozonated sunflower oil; G4) ozone bagging; G5) association of ozonated sunflower oil and ozone bagging. The wounds were evaluated through macroscopic, morphometric, histopathologic, and tensile strength analyses. RESULTS: Analysis among groups showed a lower percentage of wound contraction in G1 compared to G4 only in M7D. The tensile strength of the wounds showed differences among groups in the seventh (M7D) and the 14th (M14D) postoperative day, and among time points in G1 (M14D > M7D). The elongation of the wounds showed differences in G3 (M7D > M14D). Histological evaluation of the wounds showed significant change in bleeding, mixed to mononuclear infiltrate, congestion, and tissue disorganization for tissue organization between groups and time points. CONCLUSIONS: Ozone therapy applied topically and/or by bagging was not deleterious to the healing of clean wounds induced in rat's skin, but ozone bagging showed the best contribution to the healing process.

Regional Disparities in Kidney Transplant Allocation in Brazil: A Retrospective Cohort Study.

BACKGROUND: Brazil has a large public transplant program, but it remains unclear if the kidney waitlist criteria effectively allocate organs. This study aimed to investigate whether gender, ethnicity, clinical characteristics, and Brazilian regions affect the chance of deceased donor kidney transplant (DDKT). METHODS: We conducted a retrospective cohort study using the National Transplant System/Brazil database, which included all patients on the kidney transplant waitlist from January 2012 to December 2022, followed until May 2023. The primary outcome assessed was the chance of DDKT, measured using subdistribution hazard and cause-specific hazard models (subdistribution hazard ratio [sHR]). RESULTS: We analyzed 118 617 waitlisted patients over a 10-year study period. Male patients had an sHR of 1.07 ([95% CI: 1.05-1.10], p < 0.001), indicating a higher chance of DDTK. Patients of mixed race and Yellow/Indigenous ethnicity had lower rates of receiving a transplant compared to Caucasian patients, with sHR of 0.97 (95% CI: 0.95-1) and 0.89 (95% CI: 0.95-1), respectively. Patients from the South region had the highest chance of DDKT, followed by those from the Midwest and Northeast, compared to patients from the Southeast, with sHR of 2.53 (95% CI: 2.47-2.61), 1.21 (95% CI: 1.16-1.27), and 1.10 (95% CI: 1.07-1.13), respectively. The North region had the lowest chance of DDTK, sHR of 0.29 (95% CI: 0.27-0.31). CONCLUSION: We found that women and racial minorities faced disadvantages in kidney transplantation. Additionally, we observed regional disparities, with the North region having the lowest chance of DDKT and longer times on dialysis before being waitlisted. In contrast, patients in the South regions had a chance of DDKT and shorter times on dialysis before being waitlisted. It is urgent to implement approaches to enhance transplant capacity in the North region and address race and gender disparities in transplantation.

The impact of preservation solutions for static cold storage on kidney transplantation outcomes: Results of a Brazilian nationwide multicenter study.

This study evaluated the current practices of selecting cold storage preservation solutions in Brazil and their impact on delayed graft function (DGF) incidence and 1-year outcomes in kidney transplant recipients. A retrospective cohort study was conducted, including 3,134 brain-dead deceased donor kidney transplants performed between 2014 and 2015 in 18 Brazilian centers. The most commonly used preservation solution was Euro-collins (EC, 55.4%), followed by Histidine-tryptophan-ketoglutarate (HTK, 30%) and Institut Georges Lopez (IGL-1, 14.6%). The incidence of DGF was 54.4%, with 11.7% of patients requiring dialysis for more than 14 days, indicating prolonged DGF. Upon adjusting for confounding variables, HTK demonstrated a significantly lower risk of DGF than EC (OR 0.7350.82500.926), as did IGL-1 (OR 0.6050.7120.837). Similar protective effects were observed for prolonged DGF when comparing HTK (OR 0.4780.5990.749) and IGL-1 (OR 0.4780.6810.749) against EC. No significant association was found between preservation solutions and 1-year death-censored graft survival. In conclusion, EC was the most frequently used cold storage perfusion solution, demonstrating a higher incidence and duration of DGF compared with HTK and IGL-1, but with no impact on 1-year graft survival.

Use of Machine Perfusion to Increase the Number of Expanded Criteria Deceased Donor Kidney Transplants: A Pharmacoeconomic Analysis.

Background: The discard of expanded criteria donor (ECD) kidneys is unacceptably high, considering the growing demand for transplantation. Using machine perfusion may reduce the discard rate, increase the number of transplants, and reduce mortality on the waiting list. Methods: We developed a 5-y Markov model to simulate incorporating the pulsatile perfusion machine into the current government-funded healthcare system. The model compared the universal use of static cold storage for all kidneys with the selective use of machine perfusion for ECD kidneys. Real-life data were used to compose the cohort characteristics in this model. This pharmacoeconomic analysis aimed to determine the cost-effectiveness and budgetary impact of using machine perfusion to preserve ECD kidneys. Results: Compared with the universal use of static cold storage, the use of machine perfusion for ECD kidneys was associated with an increase in the number of kidney transplants (n = 1123), a decrease in the number of patients on the waiting list (n = 815), and decrease in mortality (n = 120), with a cost difference of US dollar 4 486 009 in the period. The budget impact analysis revealed an additional cost of US dollar 4 453 749 >5 y. The budget impact analysis demonstrated a progressive reduction in costs, becoming cost-saving during the last year of the analysis. Conclusions: This stochastic model showed that incorporating machine perfusion for ECD kidneys is most often a dominant or cost-effective technology associated with an increase in the number of transplants and a reduction in the number of patients on the waiting list, reducing mortality on the waiting list.

Analysis of testing for COVID-19 in Parnaíba city, state of Piauí, from march to December 2020 / Análise da testagem para COVID-19 na cidade de Parnaíba, estado do Piauí, de março a dezembro de 2020 / Análisis de pruebas de COVID-19 en la ciudad de Parnaíba, estado de Piauí, de marzo a diciembre de 2020

Background and Objectives: it is extremely important and necessary to assess epidemiological events through the analysis of measures adopted at the time of crises, especially those with a health impact as a way of improving the system for future events, with testing being a gold standard to be assessed during an epidemic. This study aimed to analyze tests for COVID-19 diagnosis, with a view to detecting possible false negative results, in Parnaíba, Piauí, from March to December 2020. Methods: a statistical analysis of the data reported and made available by the Municipal Health Department using the IBM SPSS Statistics® 21.0 software, in which the variables type of test, date of symptom onset and date of material collection were crossed to obtain the results. Results: a total of 9,473 tests were negative, of which 11.1% were carried out using the RT-PCR methodology, 6.5% using rapid antigen tests, and 82.3% using a rapid antibody test. The analysis revealed that only 0.47% RT-PCR tests and 1.7% rapid antigen tests had been carried out within the ideal testing interval. On the other hand, the rapid antibody test had 0.14% performed outside the range. Conclusion: the most successful diagnostic test was the rapid antibody test, but it is the least specific and not suitable for determining health crisis management policies, especially for isolation measures for infected people, which suggests improvements in testing systems and development of tests with longer and more accurate testing intervals.(AU)

Justificativa e Objetivos: é de suma importância e necessidade a avaliação dos eventos epidemiológicos por meio da análise das medidas adotadas no momento das crises, em especial aqueles de impacto sanitário como forma de melhor o sistema para eventos futuros, sendo a testagem um padrão-ouro a ser avaliado durante uma epidemia. O objetivo deste estudo foi analisar os testes para o diagnóstico de COVID-19, na perspectiva de detectar possíveis resultados falsos negativos, em Parnaíba, Piauí, de março a dezembro de 2020. Métodos: análise estatística dos dados notificados e disponibilizados pela Secretaria Municipal de Saúde a partir do software IBM SPSS® Statistics 21.0, em que as variáveis tipo de teste, data do início dos sintomas e data da coleta do material foram cruzadas para obtenção dos resultados. Resultados: 9.473 testes resultaram negativo, em que 11,1% foram realizados pela metodologia RT-PCR, 6,5%, pelos testes rápidos de antígeno, e 82,3%, por teste rápido de anticorpo. A análise revelou que apenas 0,47% testes por RT-PCR e 1,7% testes rápidos de antígeno haviam sido realizados dentro do intervalo ideal de testagem. Por outro lado, o teste rápido de anticorpo teve 0,14% realizados fora do intervalo. Conclusão: o teste com maior sucesso de diagnóstico foi o teste rápido de anticorpo, porém é o menos específico e não adequado para determinação de políticas de gerenciamento de crise sanitária, em especial para medidas de isolamento de infectados, o que sugere melhorias em sistemas de testagem e desenvolvimento de testes com intervalos de testagem maior e precisos.(AU)

Justificación y Objetivo: es sumamente importante y necesario evaluar los eventos epidemiológicos a través del análisis de las medidas adoptadas en el momento de las crisis, especialmente aquellas con impacto en la salud, como una forma de mejorar el sistema para eventos futuros, siendo las pruebas un estándar de oro a ser evaluado durante una epidemia. El objetivo de este estudio fue analizar pruebas para el diagnóstico de COVID-19, con miras a detectar posibles resultados falsos negativos, en Parnaíba, Piauí, de marzo a diciembre de 2020. Métodos: análisis estadístico de los datos reportados y puestos a disposición por la Secretaría de Salud Municipal mediante el software IBM SPSS® Statistics 21.0, en el cual se cruzaron las variables tipo de prueba, fecha de inicio de síntomas y fecha de recolección del material para obtener los resultados. Resultados: un total de 9.473 pruebas resultaron negativas, de las cuales el 11,1% se realizaron mediante la metodología RT-PCR, el 6,5% mediante pruebas rápidas de antígenos y el 82,3% mediante prueba rápida de anticuerpos. El análisis reveló que sólo el 0,47% de las pruebas RT-PCR y el 1,7% de las pruebas rápidas de antígenos se habían realizado dentro del intervalo de prueba ideal. Por otro lado, la prueba rápida de anticuerpos tuvo un 0,14% realizado fuera del rango. Conclusión: la prueba diagnóstica más exitosa fue la prueba rápida de anticuerpos, pero es la menos específica y no adecuada para determinar políticas de gestión de crisis sanitarias, especialmente para medidas de aislamiento de personas infectadas, lo que sugiere mejoras en los sistemas de pruebas y desarrollo de pruebas con tiempos más largos y precisos. intervalos de prueba.(AU)

Ruas de Lazer em Pelotas: Modelo lógico e descrição dos processos de planejamento e execução / Open streets in Pelotas: Logical model and description of the planning and execution process

O objetivo do estudo foi desenvolver o modelo lógico do projeto Ruas de Lazer na cidade de Pelotas em 2022, assim como descrever os processos de planejamento, pactuação e execução. Trata-se de um estudo qualitativo, que utilizou a técnica de observação participante e o emprego de modelo lógico. O projeto possui características de gestão compartilhada que demarcam potencial relevante na criação de vínculo entre universidade, gestão pública e população local. Em 2022, sete eventos foram realizados com proposição de atividades culturais com música e dança, atividades físicas e esportivas e de educação em saúde. O projeto está em permanente construção e evolução, apostando na ampliação de investimentos para atingir os objetivos imediatos de oferta de atividades de lazer e de ampliação da democratização de acesso aos espaços públicos para o uso da população.

The aim of this study was to develop a logical model of the Ruas de Lazer project in the city of Pelotas, Rio Grande do Sul, Brazil, in 2022, as well as to describe the processes of planning, agreement, and execution. This is a qualitative study that employed the technique of participant observation and the use of a logical model. The project has characteristics of shared management that mark a relevant potential in creating a bond between the university, public management, and the local population. In 2022, seven events were held, proposing cultural activities with music and dance, physical and sports activities, and health education. The project is in permanent construction and evolution, betting on the expansion of investments to achieve the immediate objectives of offering leisure activities and expanding the democratization of access to public spaces for the use of the population.

Organ Donation and Transplantation Registries Across the Globe: A Review of the Current State.

BACKGROUND: The current landscape of organ donation and transplantation (ODT) registries is not well established. This narrative review sought to identify and characterize the coverage, structure, and data capture of ODT registries globally. METHODS: We conducted a literature search using Ovid Medline and web searches to identify ODT registries from 2000 to 2023. A list of ODT registries was compiled based on publications of registry design, studies, and reports. Extracted data elements included operational features of registries and the types of donor and recipient data captured. RESULTS: We identified 129 registries encompassing patients from all continents except Antarctica. Most registries were active, received funding from government or professional societies, were national in scope, included both adult and pediatric patients, and reported patient-level data. Registries included kidney (n = 99), pancreas (n = 32), liver (n = 44), heart (n = 35), lung (n = 30), intestine (n = 15), and islet cell (n = 5) transplants. Most registries captured donor data (including living versus deceased) and recipient features (including demographics, cause of organ failure, and posttransplant outcomes) but there was underreporting of other domains (eg, donor comorbidities, deceased donor referral rates, waitlist statistics). CONCLUSIONS: This review highlights existing ODT registries globally and serves as a call for increased visibility and transparency in data management and reporting practices. We propose that standards for ODT registries, a common data model, and technical platforms for collaboration, will enable a high-functioning global ODT system responsive to the needs of transplant candidates, recipients, and donors.

Serum urea increase during hospital stay is associated with worse outcomes after in-hospital cardiac arrest.

BACKGROUND: Evaluate the association between serum urea at admission and during hospital stay with return of spontaneous circulation (ROSC) and in-hospital mortality in patients with in-hospital cardiac arrest (IHCA). METHODS: This retrospective study included patients over 18 years with IHCA attended from May 2018 to December 2022. The exclusion criteria were the absence of exams to calculate delta urea and the express order of "do-not-resuscitate". Data were collected from the electronic medical records. Serum admission urea and urea 24 hours before IHCA were also collected and used to calculate delta urea. RESULTS: A total of 504 patients were evaluated; 125 patients were excluded due to the absence of variables to calculate delta urea and 5 due to "do-not-resuscitate" order. Thus, we included 374 patients in the analysis. The mean age was 65.0 ± 14.5 years, 48.9% were male, 45.5% had ROSC, and in-hospital mortality was 91.7%. In logistic regression models, ROSC was associated with lower urea levels 24 hours before IHCA (OR: 0.996; CI95%: 0.992-1.000; p: 0.032). In addition, increased levels of urea 24 hours before IHCA (OR: 1.020; CI95%: 1.008-1.033; p: 0.002) and of delta urea (OR: 1.001; CI95%: 1.001-1.019; p: 0.023) were associated with in-hospital mortality. ROC curve analysis showed that the area under the ROC curve for mortality prediction was higher for urea 24 hours before IHCA (Cutoff > 120.1 mg/dL) than for delta urea (Cutoff > 34.83 mg/dL). CONCLUSIONS: In conclusion, increased serum urea levels during hospital stay were associated with worse prognosis in IHCA.

Avaliação da utilização de biomateriais aloplásticos na reconstrução orbital

Objetivo: analisar a utilização de materiais aloplásticos reabsorvíveis e não reabsorvíveis na reconstrução óssea orbital. Métodos: realizado uma revisão de literatura integrativa de natureza exploratória. Resultados: O diagnóstico e o tratamento de lesões traumáticas faciais obtiveram grande progresso nas últimas décadas, tratando-se de um trauma de abrangência multidisciplinar, que envolve especialidades odontológicas e médicas. Sequelas do inadequado tratamento das fraturas orbitárias, como exoftalmia, restrição da mobilidade ocular e distopia ocular ou orbital, representam problemas estéticos e funcionais muito difíceis, senão impossíveis de serem corrigidos. Verificou-se que em fraturas do tipo blow-out, o titânio é um material favorável a osseointegração, já em regiões estéticas a hidroxiapatita e cimentos de fosfato de cálcio são materiais que conseguem devolver uma anatomia adequada. Tratando-se de materiais reabsorvíveis, que são de fácil manipulação, deve-se tomar cuidado as possíveis reações teciduais, porém não existe um critério de escolha ideal, mas sim, a análise de suas vantagens e desvantagens em cada caso. Conclusão: ainda não existe consenso sobre o melhor material para fraturas de órbitas, por isso, deve-se sempre analisar suas vantagens e desvantagens de acordo com o grau da fratura do paciente, sendo uma decisão do cirurgião responsável.

Long-term Kidney Transplant Survival Across the Globe.

BACKGROUND: The outcomes after kidney transplantation (KT), including access, wait time, and other issues around the globe, have been studied. However, issues do vary from one country to another. METHODS: We obtained data from several countries from North America, South America, Europe, Asia, and Australia, including the number of patients awaiting KT from 2015, transplant rate per million population (pmp), proportion of living donor and deceased donor (LD/DD) KT, and posttransplant survival. We also sought opinions on key difficulties faced by each of these countries with respect to KT and long-term survival. RESULTS: Variation in access to KT across the globe was noted. Countries with the highest rates of KT pmp included the United States (79%) and Spain (71%). A higher proportion of LD transplants was noted in Japan (93%), India (85%), Singapore (63%), and South Korea (63%). A higher proportion of DD KTs was noted in Spain (90%), Brazil (90%), France (85%), Italy (85%), Finland (85%), Australia-New Zealand (80%), and the United States (77%). The 5-y graft survival for LD was highest in South Korea (95%), Singapore (94%), Italy (93%), Finland (93%), and Japan (93%), whereas for DD, it was South Korea (93%), Italy (88%), Japan (86%), and Singapore (86%). The common issues surrounding KTs are access and a limited number of LDs and DDs. Key issues identified for long-term survival were increasing age of donors and recipients, higher recipient comorbidity, and posttransplant events, such as alloimmune injury to the kidney, infection, cancer, and suboptimal adherence to therapy. CONCLUSIONS: A unified approach is necessary to improve issues surrounding KT as the demand continues to increase.

Spatial analysis of care for patients undergoing dialysis therapy in the state of Minas Gerais, Brazil, between 2015 and 2019.

OBJECTIVE: To analyze the spatial flow of care for patients undergoing dialysis therapy in the health regions of the State of Minas Gerais. METHODS: Ecological study whose population was patients undergoing dialysis therapy in public, philanthropic institutions or whose treatment was paid for by the Unified Health System in private clinics in partnership, in the State of Minas Gerais. Patients were grouped by health region of residence. The proportions of patients who underwent dialysis were calculated, as well as enrollment on the kidney transplant list in their own region of residence or outside it. Person correlations of these proportions with socioeconomic and care indicators of the health regions were estimated. Spatial exploratory techniques estimated general (Moran's I) and local (LISA) spatial correlation coefficients. RESULTS: Regions with higher GDP had a higher number of nephrologists and a higher proportion of registrations in the region of residence. A cluster of regions with low GDP was identified further to the northeast of the State (also with lower nephrologist ratio values), a cluster with a high proportion of those registered on the transplant list in the center of the State, and a cluster with a low proportion of dialysis in the same region of residence further southeast. CONCLUSION: Regional disparities were evident in relation to the proportion of patients registered on the waiting list for kidney transplantation, the proportion of patients undergoing dialysis in the same region of residence and the proportion of patients registered on the waiting list for kidney transplantation in the same region of residence. residence.

Spatial analysis of care for patients undergoing dialysis therapy in the state of Minas Gerais, Brazil, between 2015 and 2019 / Análise espacial da assistência a pacientes em terapia dialítica no Estado de Minas Gerais, Brasil, entre 2015 e 2019

ABSTRACT Objective: To analyze the spatial flow of care for patients undergoing dialysis therapy in the health regions of the State of Minas Gerais. Methods: Ecological study whose population was patients undergoing dialysis therapy in public, philanthropic institutions or whose treatment was paid for by the Unified Health System in private clinics in partnership, in the State of Minas Gerais. Patients were grouped by health region of residence. The proportions of patients who underwent dialysis were calculated, as well as enrollment on the kidney transplant list in their own region of residence or outside it. Person correlations of these proportions with socioeconomic and care indicators of the health regions were estimated. Spatial exploratory techniques estimated general (Moran's I) and local (LISA) spatial correlation coefficients. Results: Regions with higher GDP had a higher number of nephrologists and a higher proportion of registrations in the region of residence. A cluster of regions with low GDP was identified further to the northeast of the State (also with lower nephrologist ratio values), a cluster with a high proportion of those registered on the transplant list in the center of the State, and a cluster with a low proportion of dialysis in the same region of residence further southeast. Conclusion: Regional disparities were evident in relation to the proportion of patients registered on the waiting list for kidney transplantation, the proportion of patients undergoing dialysis in the same region of residence and the proportion of patients registered on the waiting list for kidney transplantation in the same region of residence. residence.

RESUMO Objetivo: Analisar o fluxo espacial da assistência de pacientes em terapia dialítica nas regionais de saúde do estado de Minas Gerais. Métodos: Estudo ecológico que teve como população pacientes incidentes em terapia dialítica em instituições públicas, filantrópicas ou que tiveram seu tratamento custeado pelo Sistema Único de Saúde em clínicas privadas conveniadas, no estado de Minas Gerais. Os pacientes foram agregados por regional de saúde de residência. Foram calculadas as proporções de pacientes que fizeram diálise, bem como a inscrição na lista de transplante renal em sua própria região de residência ou fora dela. Estimadas as correlações de Person destas proporções com indicadores socioeconômicos e assistenciais das regionais de saúde. Técnicas exploratórias espaciais estimaram coeficientes de correlação espacial geral (I de Moran) e local (LISA). Resultados: Regiões com maior PIB apresentaram maior razão de nefrologistas e maior proporção de inscrições na própria região de residência. Identificou-se um cluster de regiões com PIB baixo mais ao nordeste do estado (também com valores mais baixos de razão de nefrologistas), um cluster de alta proporção de inscritos na lista de transplante no centro do estado, e um cluster de baixa proporção de diálise na mesma região de residência mais ao sudeste. Conclusão: Evidenciou-se disparidades regionais em relação à proporção de inscritos na lista de espera para o transplante renal, proporção de pacientes que realizavam diálise na mesma região de residência e proporção de pacientes inscritos na lista de espera para o transplante renal na mesma região de residência.

Effects of ozone therapy applied topically, by bagging, or both on the healing of clean wounds induced in rat's skin

Purpose: This study aimed to evaluate the effects of ozone therapy applied topically and/or by bagging on the healing of clean wounds induced in rat's skin. Methods: One hundred and twenty male rats of about 16 weeks old was divided into five groups: G1) saline solution (0.9%); G2) sunflower oil; G3) ozonated sunflower oil; G4) ozone bagging; G5) association of ozonated sunflower oil and ozone bagging. The wounds were evaluated through macroscopic, morphometric, histopathologic, and tensile strength analyses. Results: Analysis among groups showed a lower percentage of wound contraction in G1 compared to G4 only in M7D. The tensile strength of the wounds showed differences among groups in the seventh (M7D) and the 14th (M14D) postoperative day, and among time points in G1 (M14D > M7D). The elongation of the wounds showed differences in G3 (M7D > M14D). Histological evaluation of the wounds showed significant change in bleeding, mixed to mononuclear infiltrate, congestion, and tissue disorganization for tissue organization between groups and time points. Conclusions: Ozone therapy applied topically and/or by bagging was not deleterious to the healing of clean wounds induced in rat's skin, but ozone bagging showed the best contribution to the healing process.

Dual Effect of Carnosine on ROS Formation in Rat Cultured Cortical Astrocytes.

Carnosine is composed of ß-alanine and L-histidine and is considered to be an important neuroprotective agent with antioxidant, metal chelating, and antisenescence properties. However, children with serum carnosinase deficiency present increased circulating carnosine and severe neurological symptoms. We here investigated the in vitro effects of carnosine on redox and mitochondrial parameters in cultured cortical astrocytes from neonatal rats. Carnosine did not alter mitochondrial content or mitochondrial membrane potential. On the other hand, carnosine increased mitochondrial superoxide anion formation, levels of thiobarbituric acid reactive substances and oxidation of 2',7'-dichlorofluorescin diacetate (DCF-DA), indicating that carnosine per se acts as a pro-oxidant agent. Nonetheless, carnosine prevented DCF-DA oxidation induced by H2O2 in cultured cortical astrocytes. Since alterations on mitochondrial membrane potential are not likely to be involved in these effects of carnosine, the involvement of N-Methyl-D-aspartate (NMDA) receptors in the pro-oxidant actions of carnosine was investigated. MK-801, an antagonist of NMDA receptors, prevented DCF-DA oxidation induced by carnosine in cultured cortical astrocytes. Astrocyte reactivity induced by carnosine was also prevented by the coincubation with MK-801. The present study shows for the very first time the pro-oxidant effects of carnosine per se in astrocytes. The data raise awareness on the importance of a better understanding of the biological actions of carnosine, a nutraceutical otherwise widely reported as devoid of side effects.

Relative age effect on muscle power in Brazilian youth: a population study / Efeito da idade relativa na potência muscular em jovens brasileiros: um estudo de população

Abstract This study aimed to examine the relative age effect on muscle power in a large sample of Brazilian children and adolescents. The sample consisted of 87,766 girls and boys aged 7-16 years, data collected in repeated cross-sectional surveillance carried out since 1999. The participants were grouped into four age subgroups within each chronological age based on birthdates. Upper and lower limbs muscle power were assessed using the 2-Kg medicine ball throw and horizontal jump tests, respectively. The normative distribution of physical fitness components was used for classification. The results showed a significant association between relative age and normative classification of muscle power. Among boys, there was a sequential increase in the frequency of individuals classified as "very good/excellent" as the relative age increased. A similar trend was observed among girls. The findings provided evidence of a relative age effect on muscle power in Brazilian children and adolescents. These findings have implications for the organization of structured physical activities and sports, as early-born individuals may have an advantage in performance. Further research is needed to explore the underlying mechanisms and potential interventions to mitigate the relative age effect and promote equal opportunities for all youth in physical activities and sports.

Resumo Este estudo teve como objetivo examinar o efeito da idade relativa na potência muscular em crianças e adolescentes brasileiros. A amostra foi composta por 87.766 meninas e meninos com idades entre 7 e 16 anos. Os participantes foram agrupados em quatro subgrupos etários dentro de cada idade cronológica tendo como base as datas de nascimento e da coleta dos dados. A potência muscular dos membros superiores e inferiores foi avaliada por meio dos testes de arremesso de medicine ball de 2 kg, e salto horizontal, respectivamente. A distribuição normativa (fraco; razoável; bom; muito bom; excelente) dos dois testes de potência foi utilizada para a classificação. Os resultados mostraram associação significativa entre os subgrupos etários e a classificação normativa da potência muscular. Entre os meninos, houve aumento na frequência de indivíduos classificados como "muito bom/excelente" à medida que a idade relativa aumentava. Uma tendência semelhante foi observada entre as meninas. Os achados forneceram evidências do efeito de idade relativa na potência muscular de crianças e adolescentes brasileiros. Esses resultados têm implicações práticas na organização de atividades físicas estruturadas e esportes em diferentes contextos, pois indivíduos nascidos mais cedo podem ter vantagem no desempenho em tarefas que exijam potência muscular. Mais pesquisas são necessárias para explorar os mecanismos subjacentes e intervenções que possam mitigar o efeito de idade relativa e promover oportunidades iguais para todas as crianças e adolescentes nas atividades físicas e esportes.

Pomegranate sarcotesta lectin (PgTeL) inhibits planktonic growth and disrupts biofilm formed by Cryptococcus neoformans.

AIMS: We investigated the putative fungistatic and fungicidal activities of pomegranate sarcotesta lectin (PgTeL) against Cryptococcus neoformans B3501 (serotype D), specifically the ability of PgTeL to inhibit yeast capsule and biofilm formation in this strain. METHODS AND RESULTS: PgTeL showed a minimum inhibitory concentration of 172.0 µg ml-1, at which it did not exhibit a fungicidal effect. PgTeL concentrations of 4.0-256.0 µg ml-1 reduced biofilm biomass by 31.0%-64.0%. Furthermore, 32.0-256.0 µg ml-1 PgTeL decreased the metabolic activity of the biofilm by 32.0%-93.0%. Scanning electron microscopy images clearly revealed disruption of the biofilm matrix. Moreover, PgTeL disrupted preformed biofilms. At concentrations of 8.0-256.0 µg ml-1, PgTeL reduced metabolic activity in C. neoformans by 36.0%-92.0%. However, PgTeL did not inhibit the ability of B3501 cells to form capsules under stress conditions. CONCLUSIONS: PgTeL inhibited biofilm formation and disrupted preformed biofilms, demonstrating its potential for use as an anticryptococcal agent.