Pretreatment with P2Y12 inhibitors in ST-elevation myocardial infarction: A systematic review and meta-analysis.

BACKGROUND: Pretreatment with oral P2Y12 inhibitors is a standard practice for ST-elevation myocardial infarction (STEMI) patients undergoing percutaneous coronary intervention (PCI). However, the efficacy and safety of P2Y12 inhibitors pretreatment remain unclear. OBJECTIVES: We conducted a meta-analysis to investigate the impact of P2Y12 inhibitor pretreatment on thrombotic and hemorrhagic endpoints in STEMI patients. METHODS: We searched multiple databases for studies that compared P2Y12 inhibitor pretreatment with no pretreatment in STEMI patients and reported endpoints of interest. Random effects model was used for the meta-analysis. RESULTS: Our meta-analysis included 3 randomized controlled trials and 14 observational studies, comprising 70,465 patients assigned to either P2Y12 inhibitor pretreatment (50,328 patients) or no pretreatment (20,137 patients). Compared to no pretreatment, P2Y12 inhibitor pretreatment did not result in significant reductions in all-cause mortality (risk ratio [RR] 0.73; 95% confidence interval [CI]: 0.52-1.03; p = 0.07), myocardial infarction (RR 0.75; 95% CI: 0.53-1.07; p = 0.11), or major bleeding (RR 0.80; 95% CI: 0.56-1.16; p = 0.22) at 30 days. However, our subgroup analysis revealed that P2Y12 inhibitor pretreatment administered in the pre-hospital setting was associated with a significant reduction in the incidence of myocardial infarction compared to no pretreatment (RR 0.73; 95% CI: 0.56-0.91; p < 0.01). CONCLUSION: Our analysis suggests that pretreatment with oral P2Y12 inhibitors before PCI in patients with STEMI was not associated with reduced all-cause mortality, myocardial infarction, or major bleeding. However, pretreatment with P2Y12 inhibitors in the pre-hospital setting appears to be beneficial in reducing reinfarction.

Congestive Hepatopathy Secondary to Right Ventricular Hypertrophy Related to Monocrotaline-Induced Pulmonary Arterial Hypertension.

Heart dysfunction and liver disease often coexist. Among the types of cardiohepatic syndrome, Type 2 is characterized by the chronic impairment of cardiac function, leading to chronic liver injury, referred to as congestive hepatopathy (CH). In this study, we aimed to establish a rat model of CH secondary to right ventricular hypertrophy (RVH) related to monocrotaline (MCT)-induced pulmonary arterial hypertension (PAH). Fifty male Wistar rats were divided into four groups and randomly assigned to control and experimental groups. Three experimental groups were submitted to intraperitoneal MCT inoculation (60 mg/kg) and were under its effect for 15, 30 and 37 days. The animals were then sacrificed, obtaining cardiac and hepatic tissues for anatomopathological and morphometric analysis. At macroscopic examination, the livers in the MCT groups presented a nutmeg-like appearance. PAH produced marked RVH and dilatation in the MCT groups, characterized by a significant increase in right ventricular free wall thickness (RVFWT) and chamber area. At histological evaluation, centrilobular congestion was the earliest manifestation, with preservation of the hepatocytes. Centrilobular hemorrhagic necrosis was observed in the groups exposed to prolonged MCT. Sinusoidal dilatation was markedly increased in the MCT groups, quantified by the Sinusoidal Lumen Ratio (SLR). The Congestive Hepatic Fibrosis Score and the Centrilobular Fibrosis Ratio (CFR) were also significantly increased in the MCT30 group. Hepatic atrophy, steatosis, apoptotic bodies and, rarely, hydropic swelling were also observed. SLR correlated strongly with CFR and RVFWT, and CFR correlated moderately with RVFWT. Our rat model was able to cause CH, related to monocrotaline-induced PAH and RVH; it was feasible, reproducible, and safe.

Fast growth rate of a right atrial myxoma.

Primary cardiac tumors are rare, with an incidence between 0.0017 and 0.19%, and are asymptomatic in up to 72% of cases. Approximately 75% of tumors are benign, and nearly 50% of these are myxomas. Concerning location, 75% of myxomas are in the left atrium, 15 to 20% in the right atrium, and more rarely in the ventricles. The finding of cardiac myxomas usually implies immediate surgical excision to prevent embolic events and sudden cardiac death. Reports with documented growth rate are rare, and the actual growth rate remains a controversial issue. We report the rapid growth rate of a right atrial myxoma in an oligosymptomatic 69-year-old patient, with negative previous echocardiographic history in the last two years, who refused surgery upon diagnosis, enabling monitoring of myxoma growth.

COMPARATIVE ANALYSIS OF TISSULAR RESPONSE AFTER ABDOMINAL WALL REPAIR USING POLYPROPYLENE MESH AND BOVINE PERICARDIUM MESH.

BACKGROUND: The use of polypropylene meshes for surgical repair of the abdominal wall contributes to a reduction of the of recurrence rates of hernias or defects. However, its intra-abdominal use comes along with the formation of adhesions and several complications. The study and the search for alternative materials, including bovine pericardium, have been regarded as an option for the correction and treatment of resulting hernias with better adaptations and effectiveness. AIM: Evaluating the inflammatory process of the bovine pericardium in comparison with the inflammatory process of synthetic polypropylene mesh. METHOD: Bovine pericardium mesh and polypropylene mesh were placed, both on the same animal. The first group had the mesh removed for analysis on day 20, and the second group on day 40. The variables congestion, granulation, giant cells, necrosis, acute inflammation, chronic inflammation and collagen were analyzed. RESULTS: All variables were found in greater numbers as a response to the polypropylene mesh, except for the collagen, which, on day 40, was greater in response to the bovine pericardium mesh. CONCLUSION: The data in this study suggest that there is less inflammatory reaction in response to bovine pericardium mesh when compared to polypropylene mesh.

SOFTWARE-ASSISTED IMAGE ANALYSIS FOR IDENTIFICATION AND QUANTIFICATION OF HEPATIC SINUSOIDAL DILATATION AND CENTRILOBULAR FIBROSIS.

BACKGROUND: Heart dysfunction and liver disease often coexist because of systemic disorders. Any cause of right ventricular failure may precipitate hepatic congestion and fibrosis. Digital image technologies have been introduced to pathology diagnosis, allowing an objective quantitative assessment. The quantification of fibrous tissue in liver biopsy sections is extremely important in the classification, diagnosis and grading of chronic liver disease. AIM: To create a semi-automatic computerized protocol to quantify any amount of centrilobular fibrosis and sinusoidal dilatation in liver Masson's Trichrome-stained specimen. METHOD: Once fibrosis had been established, liver samples were collected, histologically processed, stained with Masson's trichrome, and whole-slide images were captured with an appropriated digital pathology slide scanner. After, a random selection of the regions of interest (ROI's) was conducted. The data were subjected to software-assisted image analysis (ImageJ®). RESULTS: The analysis of 250 ROI's allowed to empirically obtain the best application settings to identify the centrilobular fibrosis (CF) and sinusoidal lumen (SL). After the establishment of the colour threshold application settings, an in-house Macro was recorded to set the measurements (fraction area and total area) and calculate the CF and SL ratios by an automatic batch processing. CONCLUSION: Was possible to create a more detailed method that identifies and quantifies the area occupied by fibrous tissue and sinusoidal lumen in Masson's trichrome-stained livers specimens.

Plexiform Lesions in an Experimental Model of Monocrotalin-Induced Pulmonary Arterial Hypertension. / Lesões Plexiformes em Modelo Experimental de Hipertensão Arterial Pulmonar Induzida por Monocrotalina.

BACKGROUND: The monocrotaline (MCT)-induced pulmonary arterial hypertension model is one of the most reproduced today, presenting as a limitation the absence of plexiform lesions, typical manifestations of the severe disease in humans. OBJECTIVE: To evaluate the severity of MCT-induced pulmonary arteriopathy by pathological findings of lung and heart tissue samples, clinical course and 37-day survival. METHODS: Fifty male Wistar rats were divided into one of the four groups - control (CG) (n = 10) and three intervention (MCT) groups. The MCT groups received intraperitoneal injection (60 mg/kg) of MCT and remained exposed to the substance for 15 days (G15, n = 10), 30 days (G30, n = 10) and 37 days (G37, n = 20). At the end of each period, the animals were sacrificed, and pulmonary and cardiac tissues were collected for anatomopathological and morphometric analysis. The Kruskal-Wallis test was used, considering a level of significance of 5%. RESULTS: In the lungs of MCT animals, lesions related to pulmonary arteriopathy were found, including muscularization of the arterioles, hypertrophy of the middle layer and concentric neointimal lesions. Complex lesions were observed in MCT groups, described as plexiform and plexiform-like lesions. Right ventricular hypertrophy was evidenced by increased thickness and diameter of the cardiomyocytes and a significant increase in the right ventricular wall thickness (p <0.0000). CONCLUSION: The MCT model was able to generate moderate-severe pulmonary arteriopathy associated with secondary right ventricular hypertrophy. The 37-day survival rate was 50%. To our knowledge, this study was the first to note the presence of complex vascular lesions, similar to those observed in patients with severe pulmonary arterial hypertension, in an isolated MCT model. (Arq Bras Cardiol. 2020; 115(3):480-490).

FUNDAMENTO: O modelo de hipertensão arterial pulmonar induzida por monocrotalina (MCT) é um dos mais reproduzidos atualmente, apresentando como limitação a ausência de lesões plexiformes, manifestações típicas da doença grave em humanos. OBJETIVO: Avaliar a gravidade da arteriopatia pulmonar induzida por MCT por meio dos achados anatomopatológicos pulmonares e cardíacos, evolução clínica e sobrevida em 37 dias. MÉTODOS: Foram utilizados 50 ratos machos Wistar divididos em quatro grupos, sendo um controle (n = 10). Os três grupos restantes foram submetidos à inoculação de MCT (60 mg/kg i.p.) e ficaram sob o seu efeito por 15 (n = 10), 30 (n = 10) e 37 dias (n = 20). Ao final de cada período, os animais foram sacrificados, obtendo-se tecidos pulmonar e cardíaco para análise anatomopatológica e morfométrica. Empregou-se o teste Kruskal-Wallis, considerando nível de significância de 5%. RESULTADOS: Nos pulmões dos animais MCT foram constatadas lesões referentes à arteriopatia pulmonar, incluindo muscularização das arteríolas, hipertrofia da camada média e lesões neointimais concêntricas. Lesões complexas foram observadas nos grupos MCT, descritas como plexiforme e do "tipo" plexiforme (plexiform-like). A hipertrofia do ventrículo direito foi constatada pelo aumento da espessura e diâmetro dos cardiomiócitos e pelo aumento significativo da espessura da parede do ventrículo direito (p<0,0000). CONCLUSÃO: O modelo foi capaz de gerar arteriopatia pulmonar moderada-grave associada à hipertrofia do ventrículo direito secundária, com sobrevida de 50% em 37 dias. De nosso conhecimento, este estudo foi o primeiro a constatar a presença de lesões vasculares complexas, semelhantes às observadas em pacientes com hipertensão arterial pulmonar grave, em modelo isolado de MCT. (Arq Bras Cardiol. 2020; 115(3):480-490).

CARVEDILOL AS PRIMARY PROPHYLAXIS FOR GASTRIC VARICEAL BLEEDING IN PORTAL HYPERTENSION MODEL IN RATS.

BACKGROUND: Portal hypertension (PH) can be measured indirectly through a hepatic vein pressure gradient greater than 5 mmHg. Cirrhosis is the leading cause for PH and can present as complications ascites, hepatic dysfunction, renal dysfunction, and esophagogastric varices, characterizing gastropathy. AIM: To evaluate the use of carvedilol as primary prophylaxis in the development of collateral circulation in rats submitted to the partial portal vein ligament (PPVL) model. METHOD: This is a combined qualitative and quantitative experimental study in which 32 Wistar rats were divided into four groups (8 animals in each): group I - cirrhosis + carvedilol (PPVL + C); group II - cirrhosis + vehicle (PPVL); group III - control + carvedilol (SO-sham-operated + C); group IV - control + vehicle (SO-sham-operated). After seven days of the surgical procedure (PPVL or sham), carvedilol (10 mg/kg) or vehicle (1 mL normal saline) were administered to the respective groups daily for seven days. RESULTS: The histological analysis showed no hepatic alteration in any group and a decrease in edema and vasodilatation in the PPVL + C group. The laboratory evaluation of liver function did not show a statistically significant change between the groups. CONCLUSION: Carvedilol was shown to have a positive effect on gastric varices without significant adverse effects.

Fixation of the Anterior Ligament Graft at the Tibial Pole: Biomechanical Analysis of Three Methods.

Objective Comparative biomechanical analysis of tibial fixation strength for ligament reconstruction with interference screw compared with screw post and washer, and compared with the associated fixation of both methods (hybrid fixation). Method A total of 54 specimens were used (porcine tibias and bovine flexor digital tendons), which were divided into three groups with fixation types similar to those used in anterior cruciate ligament (ACL) reconstruction: 1) fixation with interference screw; 2) fixation with screw post and toothed washer over knot and suture strand; and )- fixation with screw post and washer combined with interference screw (hybrid fixation). The analyses were performed through pull-out biomechanical tensile tests to determine the stiffness and load to system failure (yield load). Results The hybrid fixation group presented a significantly higher final stiffness (59.10 ± 3.45 N/mm) in comparison to the other groups ( p < 0.05) and a higher yield load (581.34 ± 33.48 N) compared to the interference screw group ( p < 0.05). Conclusion Hybrid fixation had biomechanical advantages over the bovine digital flexor graft fixation system in swine tibia during tensile tests.

IS SUPERFICIAL COLORECTAL LESIONS WITH LOW AND HIGH GRADES INTRAEPITHELIAL NEOPLASMS MORE PREVALENT IN OLDER ABOVE 65 YEARS?

BACKGROUND: Colorectal cancer has a higher incidence in the rectum and sigmoid. However, with the expansion of the diagnosis of superficial lesions interest in the diagnosis and in the role they play in colorectal carcinogenesis has increased. AIM: To verify the behavior of superficial lesions of the colon and rectum, comparing the pathological and endoscopic findings, below and above 65 years. METHODS: Cross-sectional study with prospective evaluation of standard protocol, where 200 patients with colorectal superficial lesions were evaluated; they were submitted to colonoscopy and mucosectomy of these lesions. They were divided in two age groups, below and above 65 years. RESULTS: One hundred-and-eight were women (54%) and 92 men (46%). Most colon lesions were localized in the right colon (95%) and the remaining (5%) in the rectum. In endoscopy, 77.20% were granular lesions in patients under 65 years and 77.90% above. Colon histology showed low grade intraepithelial neoplasia, being 69.79% in patients under and 73.70% in above 65 years. In rectum, above 65 years the incidence of high-grade intraepithelial neoplasia was higher (66.70%). CONCLUSION: The superficial colorectal lesions have been more endoscopically diagnosed today, and the highest incidence is the granular type, both in the colon and rectum, regardless of age. Regardless the age, histologically colon lesions were more as low grade intraepithelial neoplasia. In rectum, there was distinction for both age groups, being more frequent high grade intraepithelial neoplasia in patients over 65 years.

INVOLVEMENT OF CATECHOLAMINES IN THE MYOCARDIUM OF RATS SUBMITTED TO EXPERIMENTAL MODEL OF PORTAL HYPERTENSION.

BACKGROUND: The role of autonomic nervous system in the development and maintenance of portal hypertension is not fully elucidated. It is known that the gene expression of norepinephrine in the superior mesenteric artery varies with time, and it may contribute for splanchnic vasodilation and its consequent hemodynamic repercussions. It is still not known exactly how the adrenergic expression behaves at the heart level in the initial stages of this process. AIM: To evaluate the immunohistochemical expression of the enzyme tyrosine hydroxylase (tyrosine 3-monooxygenase), involved in the synthesis of norepinephrine, in the myocardium of rats submitted to partial ligation of the portal vein. METHODS: Twenty-four Wistar rats were divided into two groups: Sham Operated and Portal Hypertension. The partial ligation was performed in the Portal Hypertension group, and after 1/6/24 h and 3/5/14 days the animals were euthanized. Immunohistochemical analysis was performed to quantify the expression of the stained enzyme using the ImageJ program. RESULTS: The Portal Hypertension group expressed percentages between 4.6-6% of the marked area, while the Sham Operated group varied between 4-5%. Although there was no statistical significance, the percentage stained in the Portal Hypertension group followed an increasing pattern in the first 6 h and a decreasing pattern after 24 h, which was not observed in the Sham Operated group. CONCLUSION: The expression of noradrenaline in rat myocardium during the first two weeks after partial ligation of the portal vein, with tyrosine hydroxylase as marker, did not show differences between groups over time.

Prevalência de regurgitação paravalvar após implante transcateter de válvula aórtica / Prevalence of paravalve regurgitation after aortic valve transcatheter implantation

Introdução: Com o envelhecimento populacional brasileiro, esperase que a incidência de doenças cardiovasculares, como a estenose e insuficiência da válvula aórtica, eleve-se. Desde 2002, o implante valvar aórtico transcateter demonstrou-se método de alta eficácia no seu tratamento. No entanto, o procedimento está sujeito ao regurgitamento paravalvar. Objetivo: Avaliar quantitativamente a prevalência dessa regurgitação em pacientes submetidos ao Implante valvar aórtico transcateter. Métodos: Estudo observacional, transversal, retrospectivo que analisou 38 casos de Implante valvar aórtico transcateter. Os dados foram coletados dos prontuários, que incluíram informações antropométricas, comorbidades e procedimentos prévios à operação, e analisou-se a presença de refluxo paravalvar no 1° mês e 1° ano pós-Implante valvar aórtico transcateter. Resultados: A idade média foi de 74 ±11,2 anos; 15 pacientes dos analisados, possuíam classificação NYHA igual a III, e 1 NYHA IV, previamente à operação. Do total, 36,32% (n=8) tinham refluxo paravalvar no 1° mês e 1º. ano após o procedimento cirúrgico. Conclusão: A prevalência de refluxo paravalvar pós-operatório em pacientes submetidos ao Implante valvar aórtico transcateter, foi igual a 36,3% tanto para a avaliação realizada no 1° mês quanto no 1° ano.

Introduction: With the aging of the Brazilian population, it is expected that the incidence of cardiovascular diseases, such as stenosis and insufficiency of the aortic valve, will increase. Since 2002, transcatheter aortic valve implantation has proved to be a highly effective method of treatment. However, the procedure is subject to paravalvular regurgitation. Objective: To quantitatively assess the prevalence of paravalvular regurgitation in patients undergoing Transcatheter aortic valve implantation. Methods: Observational, cross-sectional, retrospective study that analyzed 38 Transcatheter aortic valve implantation cases. Data were collected from medical records, which included anthropometric information, comorbidities and procedures prior to the operation, and the presence of paravalvular regurgitation in the 1st month and 1st year after Transcatheter aortic valve implantation was analyzed. Results: Mean age was 74 ±11.2 years; 15 of the analyzed patients had NYHA classification equal to III, and 1 NYHA IV, prior to the operation. Of the total, 36.32% (n=8) of the patients had paravalvular regurgitation in the 1st and 1st month. year after the surgical procedure. Conclusion: The prevalence of postoperative paravalvular regurgitation in patients undergoing Transcatheter aortic valve implantation was equal to 36.3% both for the assessment carried out in the 1st month and in the 1st year

Câncer de pele não melanoma: revisão integrativa / Non-melanoma skin cancer: an integrative review

Introdução: O câncer de pele não melanoma compeende grupo de neoplasias com alta incidência na população mundial. É dividido em carcinoma basocelular e de células escamosas. Por ser de grande prevalência, entender o processo de oncogênese e a relação com íons, proteínas e receptores celulares no câncer de pele não melanoma pode contribuir para que novas terapêuticas sejam avaliadas. Objetivo: Entender o processo da oncogênese dos tumores de pele não melanomas e sua relação com a imunolocalização do IP3R. Métodos: Revisão integrativa da literatura com síntese de evidências. A base de dados foi o PubMed; a estratégia de busca: "carcinoma espinocelular, AND/ OR carcinoma basocelular, AND/OR IP3R, AND/OR imunoistoquímica". Foram considerados para revisão os trabalhos publicados entre 2018 e 2023. Foram incluídos 40 trabalhos, integralmente lidos e resumidos. Resultados: Câncer de pele não melanoma são os tumores malignos mais comuns em todo o mundo, sendo 75-80% o carcinoma basocelular, e até 25% o de células escamosas. As interações moleculares de forma geral, envolvem grande participação de moléculas supressoras tumorais, assim como de procto-oncogenes. Além disso, canais iônicos voltagem dependente controlam o fluxo citosólico de íons, dentre eles o cálcio. O IP3R (receptor do fosfatidil inositol-3) permite a saída de cálcio do retículo endoplasmático para que seja utilizado pela célula para atividades fisiológias como proliferação, angiogênese, motilidade e capacidade de invasão. Conclusão: O IP3R, pelas características de expressão imunoistoquímica, parece estar relacionado também, à fisiopatologia do câncer de pele não melanoma.

Introduction: Non-melanoma skin cancer comprises a group of neoplasms with a high incidence in the world population. It is divided into basal cell carcinoma and squamous cell carcinoma. As it is highly prevalent, understanding the process of oncogenesis and the relationship with ions, proteins and cellular receptors in nonmelanoma skin cancer can contribute to the evaluation of new therapies. Objective: To understand the oncogenesis process of non-melanoma skin tumors and its relationship with the immunolocalization of IP3R. Methods: Integrative literature review with evidence synthesis. The database was PubMed; the search strategy: "squamous cell carcinoma, AND/OR basal cell carcinoma, AND/OR IP3R, AND/OR immunohistochemistry". Works published between 2018 and 2023 were considered for review; 40 works were included, fully read and summarized. Results: Non-melanoma skin cancer is the most common malignant tumor worldwide, with 75-80% being basal cell carcinoma, and up to 25% being cell carcinoma. Molecular interactions in general involve a large participation of tumor suppressor molecules, as well as procto-oncogenes. Furthermore, voltage-dependent ion channels control the cytosolic flow of ions, including calcium. The IP3R (phosphatidyl inositol-3 receptor) allows the exit of calcium from the endoplasmic reticulum so that it can be used by the cell for physiological activities such as proliferation, angiogenesis, motility and invasion capacity. Conclusion: The IP3R, due to its immunohistochemical expression characteristics, appears may also be related to the pathophysiology of nonmelanoma skin cancer.

Tissue microarray technology and collagen evaluation to analyze surgical trauma performed with usual blade or ultrasonic harmonic scalpels in rats.

PURPOSE: To compare wound healing performed with cold blade (CSB) and ultrasonic harmonic scalpel (UHS) in the abdominal aponeurosis of rats. METHODS: Eighty Wistar rats divided into two groups and underwent midline incision in the linea alba with cold blade and harmonic ultrasonic scalpel. Analysis were performed in subgroups of 10 animals after 3, 7, 14 and 21 days. Macroscopically was observed the presence of hematoma, infection, wound dehiscence, fistula and adherences. Microscopically were used collagen and immunohistochemical staining methods. RESULTS: Macroscopic, complications showed no statistical difference. Immunohistochemical analysis for MMP-9 was more intense in UHS group (p<0.05). TGF ß presented its lower expression in UHS group at 14 and 21 days, with no statistical difference at 3 and 7 days (p<0.05). α-AML expression appeared higher in UHS group after 14 days and remained similar in others (p<0.05). Collagen deposition had no change in type I, and increased in type III in UHS; at 7th day the deposition was higher in CSB group; at 14th was similar in both groups (p<0.001). CONCLUSION: UHS compared to the CSB has higher lesion area at the time of the incision; as well as it led to the delay of regeneration and scar maturation process.

Fast growth rate of a right atrial myxoma

ABSTRACT Primary cardiac tumors are rare, with an incidence between 0.0017 and 0.19%, and are asymptomatic in up to 72% of cases. Approximately 75% of tumors are benign, and nearly 50% of these are myxomas. Concerning location, 75% of myxomas are in the left atrium, 15 to 20% in the right atrium, and more rarely in the ventricles. The finding of cardiac myxomas usually implies immediate surgical excision to prevent embolic events and sudden cardiac death. Reports with documented growth rate are rare, and the actual growth rate remains a controversial issue. We report the rapid growth rate of a right atrial myxoma in an oligosymptomatic 69-year-old patient, with negative previous echocardiographic history in the last two years, who refused surgery upon diagnosis, enabling monitoring of myxoma growth.

The Effect of Stool Transplantation on Weight Control in Obese Rats / O efeito do transplante de fezes no controle de peso em ratos obesos

Abstract Introduction Obesity is defined as a multifactorial metabolic syndrome in which there is an excessive number of fat cells within the tissues. It is discussed that intestinal microbiota might have a relevant relation with obesity, since it is relevantly altered in obese patients. Objectives To assess the effect of stool transplantation (ST) in the condition of obesity and its outcomes in an experimental model of cafeteria diet by analyzing histology and weight gain. Methods Forty male Wistar rats were randomly assigned to 5 groups: control (CO), control with antibiotics (CO+ATB), obesity (CAF+ATB), stool transplantation (ATB+ ST) and obesity with stool transplantation (CAF+ATB+ST). During the experiment, obesity induction groups received cafeteria diet, whereas the remaining groups had normal diet ad libitum. After 3 months, daily ST was carried out for 8 weeks by gavage procedure. The animals were euthanized, and the small intestine was harvested for further analysis. Results It was observed that before starting the ST, the cafeteria and normal diet groups had significant weight difference (p<0,0001). In the comparison between CAF+ATB and CAF+ATB+ST during the gavage period, the CAF+ATB+ST group presented lower weight gain (p=0.0017). The histopathological evaluation show that the ATB+ST group did not present intestinal crypt distortion. Conclusion Cafeteria diet resulted in an expected weight gain. In relation to the ST, it has been shown that the procedure is effective in reducing weekly weight gain. Apparently, there was no induction of disabsortive syndrome in nonobese animals that received ST.

Resumo Introdução A obesidade é definida como uma síndrome metabólica multifatorial, na qual existe um número excessivo de células de gordura nos tecidos. Discute-se que a microbiota intestinal pode estar relacionada com a obesidade, uma vez que ela é alterada de forma relevante em pacientes obesos. Objetivos Avaliar o efeito do transplante de fezes (TF) na obesidade induzida por um modelo experimental de dieta de cafeteria. Métodos Quarenta ratos Wistar foram distribuídos aleatoriamente em 5 grupos: controle (CO), controle com antibióticos (CO+ATB), obesidade (CAF+ATB), transplante de fezes (ATB+TF) e obesidade com transplante de fezes (CAF+ATB+TF). Durante o experimento, os grupos de indução de obesidade receberam dieta de cafeteria, enquanto os demais grupos tiveram dieta ad libitum normal. Após 3 meses, o TF diário foi realizado por 8 semanas por meio de gavagem intragástrica. Os animais foram sacrificados e o intestino delgado foi colhido para análise posterior. Resultados Observou-se que antes de iniciar o TF, os grupos de dieta de cafeteria e dieta normocalórica apresentavam diferença significativa de peso (p<0,0001). Ao comparar os grupos CAF+ATB e CAF+ATB+TF durante o período de gavagem, o grupo CAF+ATB+TF apresentou menor ganho de peso (p=0,0017). A avaliação histopatológica mostra que nenhum dos animais do grupo TF+ATB apresentou distorções nas criptas intestinais. Conclusão A dieta da cafeteria resultou em um ganho de peso esperado. Em relação ao TF, demonstrou-se que o procedimento é eficaz na redução do ganho de peso semanal. Aparentemente, não houve indução da síndrome disabsortiva em animais não obesos que receberam TF.

Infarto do miocárdio durante a pandemia de Covid-19: Análise comparativa em cinco capitais brasileiras / Myocardial infarction during the Covid-19 pandemic: Comparative analysis in five brazilian capitals

Na tentativa de controle de transmissão da COVID-19, os órgãos de saúde recomendaram isolamento domiciliar, distanciamento social e suspensão de serviços hospitalares não urgentes. Grande parte da população relutou em buscar atendimento médico. A hipótese levantada é que houve redução na incidência de internamentos e aumento na mortalidade por infarto agudo do miocárdio durante a pandemia. Este estudo procurou comparar e analisar a incidência dos internamentos e mortalidade por infarto agudo do miocárdio em cinco cidades brasileiras durante a pandemia (2020/2021) com um mesmo período (2019/2020) sem pandemia. É estudo ecológico no qual foram analisados registros comparativos da incidência de internamentos e mortalidade por infarto nas cinco capitais brasileiras. Em conclusão, houve decréscimo na incidência de internamentos durante a pandemia em todas as capitais analisadas, exceto Campo Grande, e redução na mortalidade por infarto agudo do miocárdio em todas as capitais.

In an attempt to control the transmission of COVID-19, health state agency recommended home isolation, social distancing and suspension of non-urgent hospital services. Much of the population was reluctant to seek medical attention. The hypothesis raised is that there was a reduction in the incidence of hospitalizations and an increase in mortality from acute myocardial infarction during the pandemic. This study sought to compare and analyze the incidence of hospitalizations and mortality from acute myocardial infarction in five Brazilian cities during the pandemic (2020/2021) with the same period (2019/2020) without. It is an ecological study in which comparative records of the incidence of hospitalizations and mortality from infarction in the five Brazilian capitals were analyzed. In conclusion, there was a decrease in the incidence of hospitalizations during the pandemic in all capitals analyzed, except Campo Grande, and a reduction in mortality from acute myocardial infarction in all capitals.

Dano histológico renal em modelo experimental de hipertrofia ventricular direita induzida por monocrotalina / Renal histological damage in an experimental model of monocrotalin-induced right ventricular hypertrophy

Monocrotalina, alcalóide tóxico obtido de plantas do gênero crotalaria, pode ter potencial efeito tóxico em órgãos do corpo humano, como rins, pulmões, coração, fígado e outros efeitos. O objetivo deste estudo foi avaliar o dano renal causado pela exposição à monocrotalina. Trata-se de estudo experimental em ratos divididos em 4 grupos, um dos quais recebeu injeção de soro fisiológico e os outros três inoculação de monocrotalina, com tempos diferentes para sacrifício; subsequentemente, estudo histológico foi feito a fim de evidenciar as lesões renais. Em conclusão, constatou-se que houve lesão renal. Contudo, não foi possível afirmar o mecanismo exato responsável por elas, ou seja, se foram decorrentes da ação tóxica direta da monocrotalina, ou se, também, esteve relacionado a outros fatores sistêmicos.

Monocrotaline, a toxic alkaloid obtained from plants of the Crotalaria genus, may have a potential toxic effect on human body organs, such as kidneys, lungs, heart, liver and other effects. The aim of this study was to evaluate the kidney damage caused by exposure to monocrotaline. This is an experimental study in rats divided into 4 groups, one of which received saline injection and the other three received monocrotaline inoculation, with different times for sacrifice; subsequently, a histological study was performed in order to evidence renal lesions. In conclusion, it was found that there was kidney damage. However, it was not possible to state the exact mechanism responsible for them, that is, if they were due to the direct toxic action of monocrotaline, or if it was also related to other systemic factors.

Análise dos fatores de risco para déficit neurológico em fraturas da coluna vertebral torácica e lombar / Analysis of risk factors for neurological deficit in fractures of the thoracic and lumbar vertebral spine

Responsáveis por 89% de lesões neurológicas, as fraturas de coluna vertebral torácica e lombar, quando analisadas perante os fatores de risco para déficit neurológico, apresentam associação controversa. Apesar da relação contestável, estudos apontam que as características morfológicas dessas lesões estão associadas ao grau de déficit neurológico e funcionam como guia para a estratégia terapêutica. O objetivo deste estudo foi identificar quais os fatores de risco para déficit neurológico nas fraturas da coluna vertebral torácica e lombar. É estudo transversal, observacional e individuado, no qual foram analisados 150 pacientes. Em conclusão, demonstrou-se que os subtipos de fratura A são fatores de risco para déficit neurológico e determinantes da conduta terapêutica aplicada. Além disso, indicou relação entre a classificação do déficit neurológico e energia do trauma com a necessidade de tratamento invasivo.

Responsible for 89% of neurological injuries, fractures of the thoracic and lumbar spine, when analyzed in terms of risk factors for neurological deficit, present a controversial association. Despite the debatable relationship, studies indicate that the morphological characteristics of these lesions are associated with the degree of neurological deficit and function as a guide for the therapeutic strategy. The aim of this study was to identify the risk factors for neurological deficit in thoracic and lumbar spine fractures. It is a cross-sectional, observational and individualized study, in which 150 patients were analyzed. In conclusion, it was demonstrated that fracture subtypes A are risk factors for neurological deficit and determinants of the therapeutic approach applied. In addition, it indicated a relationship between the classification of neurological deficit and trauma energy with the need for invasive treatment.

Software-assisted image analysis for identification and quantification of hepatic sinusoidal dilatation and centrilobular fibrosis / Análise da imagem histológica assistida por software para identificação e quantificação de dilatação sinusoidal e fibrose hepática centrolubular

ABSTRACT Background: Heart dysfunction and liver disease often coexist because of systemic disorders. Any cause of right ventricular failure may precipitate hepatic congestion and fibrosis. Digital image technologies have been introduced to pathology diagnosis, allowing an objective quantitative assessment. The quantification of fibrous tissue in liver biopsy sections is extremely important in the classification, diagnosis and grading of chronic liver disease. Aim: To create a semi-automatic computerized protocol to quantify any amount of centrilobular fibrosis and sinusoidal dilatation in liver Masson's Trichrome-stained specimen. Method: Once fibrosis had been established, liver samples were collected, histologically processed, stained with Masson's trichrome, and whole-slide images were captured with an appropriated digital pathology slide scanner. After, a random selection of the regions of interest (ROI's) was conducted. The data were subjected to software-assisted image analysis (ImageJ®). Results: The analysis of 250 ROI's allowed to empirically obtain the best application settings to identify the centrilobular fibrosis (CF) and sinusoidal lumen (SL). After the establishment of the colour threshold application settings, an in-house Macro was recorded to set the measurements (fraction area and total area) and calculate the CF and SL ratios by an automatic batch processing. Conclusion: Was possible to create a more detailed method that identifies and quantifies the area occupied by fibrous tissue and sinusoidal lumen in Masson's trichrome-stained livers specimens.

Resumo Racional: Tecnologias de imagem digital têm sido introduzidas ao diagnóstico patológico, permitindo avaliações quantitativas objetivas. A quantificação de tecido fibroso em biópsias de fígado é extremamente importante para a classificação, diagnóstico e graduação de doenças crônicas hepáticas. Objetivo: Criar um protocolo computadorizado semi-automático para quantificação de fibrose centrolobular e dilatação sinusoidal em amostras de fígado coradas por Tricrômico de Masson. Método: Uma vez instaurada a fibrose, amostras de fígado foram coletadas, processadas histologicamente, coradas por Tricrômico de Masson e WSI (Whole Slide Images) foram capturadas por scanner digital patológico apropriado. Uma seleção aleatória das regiões de interesse (ROI) foi realizada. Os dados foram submetidos a uma análise de imagem assistida por software (ImageJ®). Resultados: A análise de 250 ROIs permitiu obter-se empiricamente as melhores configurações capazes de identificar fibrose centrolobular (FC) e lúmen sinusoidal (LS). Após o estabelecimento das configurações de padrão de cor, uma Macro de autoria própria foi gravada para definir as medidas (área da fração e área total) e calcular as razões de FC e LS por processamento em grupo/lote (batch mode). Conclusão: Foi possível criar um método detalhado capaz de identificar e quantificar a área ocupada por tecido fibroso e lúmen sinusoidal em espécimes de fígado coradas por Tricrômico de Masson.

Modelo experimental de infarto agudo do miocárdio em coelhos / Experimental model of acute myocardial infarction in rabbits

Relacionado às doenças cardiovasculares, o infarto agudo do miocárdio (IAM) é a primeira causa de morte entre pacientes com doença coronariana em todo o mundo. Estudos com animais são utilizados devido à similaridade com a fisiologia e anatomia humanas. Relatos demostram utilização experimental com coelhos, pois a sua anatomia coronariana é similar aos humanos. Esta pesquisa teve por objetivo reproduzir e validar o modelo experimental controlado de IAM da parede apical anterolateral do ventrículo esquerdo em coelhos através da ligadura do ramo da artéria coronária esquerda. Foi selecionado um coelho macho para indução de IAM por ligadura coronariana. A intervenção cirúrgica consistiu na ligadura do ramo coronariano por meio de toracotomia póstero-lateral esquerda. O coração foi submetido à avaliação anatomopatológica e morfométrica para se estimar o volume percentual infartado. Em conclusão, o IAM foi alcançado com a ligadura coronariana controlada, histologicamente transmural extenso, mostrando-se eficaz e reprodutível para avaliação de novas intervenções terapêuticas e abordagens regenerativas.

Related to cardiovascular diseases, acute myocardial infarction (AMI) is the leading cause of death among patients with coronary artery disease worldwide. Animal studies are used because of their similarity to human physiology and anatomy. Reports demonstrate experimental use with rabbits, as their coronary anatomy is similar to humans. This research aimed to reproduce and validate the controlled experimental model of AMI of the anterolateral apical wall of the left ventricle in rabbits through ligation of the branch of the left coronary artery. A male rabbit was selected for induction of AMI by coronary ligation. Surgical intervention consisted of ligation of the coronary branch through a left posterolateral thoracotomy. The heart was submitted to anatomopathological and morphometric evaluation to estimate the infarcted percentage volume. In conclusion, AMI was achieved with controlled, histologically extensive transmural coronary ligation, proving to be effective and reproducible for the evaluation of new therapeutic interventions and regenerative approaches.