Aplicações dos óleos essenciais na odontologia: uma revisão de literatura / Applications of essential oils in dentistry: a literature review

Objetivo: Analisar as evidências disponíveis na literatura sobre o uso tópico de óleos essenciais como potencial agentes para a atividade de clínica odontológica. Métodos: Foram utilizadas as bases de dados BVS e PubMed. Selecionando artigos-chave que abordavam a aplicação de óleos essenciais em odontologia, utilizando como palavras-chave o nome científico e popular associado a "dentistry", nos idiomas português e inglês, publicados no período de 2018 a 2022. Resultados: Obteve-se uma tabela contendo os principais óleos essenciais de utilização comum ­ 54 óleos ­, sendo 34 excluídos por não possuírem ligação com a odontologia, e 20 óleos fazendo referência a utilização na prática clínica, dessa maneira analisados as suas principais propriedades, notou-se eficácia em diversas áreas como em: periodontia; endodontia; odontopediatria; cicatrização de lesões na cavidade oral; analgésicos, anti-inflamatórios e anestésicos. Conclusão: Dessa forma, pode-se observar que há aplicação de óleos essenciais na odontologia, e que possui diversos benefícios quando utilizada de maneira correta e adequada, manifestando efeitos que abordam o paciente em sua universalidade. Nesse sentido, é necessário maiores estudos nessa área, pois apresentou um número considerável de resultados positivos na utilização de óleos essenciais na atividade odontológica para poder tirar proveito dos benefícios oferecidos através dos óleos.

Objective: To analyze the available evidence in the literature regarding the topical use of essential oils as potential agents for dental clinic activities. Methods: BVS and PubMed databases were utilized. Key articles addressing the application of essential oils in dentistry were selected, using scientific and common names associated with "dentistry" as keywords in Portuguese and English, published between 2018 and 2022. Results: A table was compiled containing the main essential oils commonly used­54 oils in total. Thirty-four oils were excluded as they had no connection to dentistry, leaving 20 oils associated with clinical practice. The analysis of these oils revealed their primary properties, showing efficacy in various areas such as periodontics, endodontics, pediatric dentistry, healing of oral cavity lesions, analgesic, anti-inflammatory, and anesthetic effects. Conclusion: Thus, it can be observed that there is an application of essential oils in dentistry, and they offer various benefits when used correctly and appropriately, manifesting effects that address the patient universally. In this regard, further studies in this area are necessary as it presented a considerable number of positive results in the use of essential oils in dental practice to fully take advantage of the benefits offered by these oils.

Protein profile of purified plasma- and aqueous humor-derived extracellular vesicles from patients with ocular toxoplasmosis

ABSTRACT Purpose: To characterize the extracellular vesicle protein cargo in the aqueous humor and plasma of patients with ocular toxoplasmosis. Methods: Aqueous humor and plasma were collected from six patients with active ocular toxoplasmosis and six patients with cataract. Extracellular vesicles were isolated, and western blotting and mass spectrometry were performed for protein analysis. Results: All plasma samples from patients with ocular toxoplasmosis and cataract were positive for the tetraspanins CD63 and TSG101. However, the aqueous humor from patients with ocular toxoplasmosis was positive only for CD63. Sixty-seven new unreported proteins were identified in the aqueous humor and plasma of patients with the ocular toxoplasmosis and cataract. Of the 67 proteins, 10 and 7 were found only in the cataract and ocular toxoplasmosis groups, respectively. In general, these proteins were involved in immune system activation and retina homeostasis and were related to infections and retina-associated diseases. Conclusion: The distinct protein signatures between ocular toxoplasmosis and cataract may be helpful in the differential diagnosis of ocular toxoplasmosis. However, more studies are needed to better understand the role of these proteins in the pathogenesis of ocular toxoplasmosis.

Phylogenetic relationships of the Mangrove Hummingbird, "Amazilia" boucardi (Apodiformes: Trochilidae) of Costa Rica / Relaciones filogenéticas del Colibrí manglero "Amazilia" boucardi (Apodiformes: Trochilidae) de Costa Rica

Abstract Introduction: A recent revision of the generic classification of the Trochilidae based on DNA sequences revealed many inconsistencies with the current generic classification, largely based on plumage characters subject to homoplasy, especially in the Trochilini, the largest tribe. A thorough generic reorganization brought the classification into accord with the phylogeny, but due to lack of genetic data, two species remained unclassified. One of these was the Mangrove Hummingbird, "Amazilia" boucardi, endemic to Costa Rica and included in the IUCN red list of threatened species. Objective: To obtain molecular evidence to clarify the generic relationships of "A." boucardi. Methods: We isolated DNA from tissues of this species and amplified 4 nuclear and 4 mitochondrial fragments and compared these with homologous fragments from 56 species in the Trochilini, constructing phylogenetic trees with maximum likelihood and Bayesian methods. Results: Our phylogenetic analyses confirmed the placement of boucardi in the Trochilini and definitely excluded it from Amazilia but placed it with high confidence in the genus Chrysuronia Bonaparte, 1850, within which its closest relative is C. coeruleogularis, which also inhabits mangroves. Conclusions: Our genetic data based on nuclear and mitochondrial regions clearly indicate the relationship of A. boucardi and L. coeruleogularis. Moreover, it is also supported by their habitat distribution in the mangroves of the Pacific coast of Costa Rica and Western Panama. Therefore, we suggested to exclude A. boucardi as "incertae sedis".

Resumen Introducción: Una revisión reciente de la clasificación de la familia Trochilidae con base en secuencias de ADN demostró muchas incongruencias con la clasificación genérica previa, que había sido hecho con base en caracteres del plumaje muy sujetos a homoplasia, especialmente en la tribu más grande, Trochillini. Una reorganización de los géneros logró llevar su clasificación genérica a la concordancia con la filogenia, pero debido a la ausencia de datos genéticos, dos especies permanecieron sin clasificar. Una de estas fue el colibrí de manglar Amazilia boucardi, una especie endémica de Costa Rica, considerada como amenazada en la lista roja de la UICN. Objetivo: Obtener evidencia molecular para esclarecer las relaciones genéricas de A. boucardi. Métodos: Se aisló ADN de tejidos de esta especie y se amplificaron 4 fragmentos de ADN del núcleo y 5 de la mitocondria, y se compararon con fragmentos homólogos de 56 especies en la tribu Trochillini, generando árboles filogenéticos con métodos de máxima verosimilitud y bayesiano. Resultados: Los análisis filogénticos obtenidos confirmaron la ubicación de boucardi en Trochilini y definitivamente la excluyó del género Amazilia, pero la ubicó con un alto grado de confianza en el género Chrysuronia Bonaparte, 1850, dentro los cuales su pariente más cercano es C. coeruleogularis, que también habita manglares. Conclusiones: Nuestros datos genéticos basados en regiones nucleares y mitocondriales indican claramente la relación entre A. boucardi and L. coeruleogularis. Es más, lo anterior se sustenta por su distribución en los manglares de la costa Pacífica de Costa Rica y oeste de Panamá. Por lo tanto, sugerimos excluir a A. boucardi como "incertae sedis".

Residuo de Elaeis guineensis (Arecaceae) como absorbente de combustibles para aplicación pasiva en ingeniería contra incendios / Elaeis guineensis (Arecaceae) residue as a fuel sorbent for passive application in fire-fighting engineering

Resumen Introducción: Los vertidos de líquidos inflamables pueden producir accidentes graves, principalmente en plantas industriales y en carretera. Para prevenir la dispersión de derrames, se utilizan diversas formas de recolecta, como la absorción con sólidos porosos. Residuos agroindustriales pueden ser aprovechados como materiales sorbentes de líquidos inflamables. Objetivo: Determinar la capacidad de absorción de las biomasas residuales del pedúnculo de la palma aceitera (Elaeis guineensis) y del endocarpio del fruto de coyol (Acrocomia sp.) para cuatro líquidos orgánicos inflamables. Métodos: Las biomasas residuales de E. guineensis y de Acrocomia sp. se evaluaron como sorbentes para combustibles derramados (diésel, queroseno de aviación, queroseno comercial y gasolina). Se midió la cantidad de líquido absorbida por las biomasas a 24 ºC durante una semana, y su cinética de desorción a 50 ºC, usando balanzas de secado. Resultados: La propiedad sorbente del material de Acrocomia sp. no fue satisfactoria, comparada con el pedúnculo de E. guineensis, debido a diferencias en arquitectura residual del material orgánico. Esta última biomasa muestra una capacidad de absorción para los combustibles de 2.4 ± 0.2 cm3 g-1 a 24 ºC. La diatomita absorbe mayor cantidad de los combustibles estudiados, pero la difusión de estos fluidos a 50 ºC por la matriz mineral es solo 0.26 ± 0.09 veces lo observado para el material de E. guineensis, como resultado del mayor grado de tortuosidad de los poros de la diatomita. Conclusiones: El pedúnculo de palma aceitera (E. guineensis) mostró un adecuado potencial desempeño para la aplicación pasiva en la mitigación de los riesgos de incendio, con respecto a la diatomita. El endocarpio del fruto de Acrocomia sp. no resultó útil para esta operación de recuperación.

Abstract Introduction: Spills of flammable liquids can lead to serious accidents, mainly in industrial plants and on roads. To prevent the spread of spills, various forms of collection are used, such as absorption with porous solids. Agroindustrial waste can be used as sorbent materials for flammable liquids. Objective: To determine the sorption capacity of the residual empty-fruit bunch of oil-palm (Elaeis guineensis) and the macaw palm (Acrocomia sp.) nutshell for four organic flammable liquids. Methods: The residual biomasses of E. guineensis and Acrocomia sp. were assessed as sorbents for spilled fuels (diesel, jet fuel, commercial kerosene, and gasoline). Volumetric measurement of liquid-fuel absorption at 24 ºC was taken during a week. Desorption was measured at 50 ºC as the drying kinetics, by using moisture scales. Results: The sorption capacity of the Acrocomia sp. material was not satisfactory, compared to the E. guineensis residual material, due to differences in the residual architecture of the organic material. This last can absorb 2.4 ± 0.2 cm3 g-1 at 24 ºC, during a one-week period. Diatomite absorbs greater quantities of the organic liquids but, the fluids diffusion at 50 ºC is 0.26 ± 0.09 times more slowly in the mineral matrix, because of the greater pore tortuosity in this mineral matrix. Conclusions: The oil-palm empty fruit bunch of E. guineensis, showed lesser but adequate performance than the sorbing behavior for fire hazard mitigation of diatomite. The nutshell of macaw palm (Acrocomia sp.) did not prove to be useful for this recovery operation.

Insulin reference intervals in Brazilian adolescents by direct and indirect approaches: validation of a data mining method from laboratory data

Abstract Objective To determine reference intervals (RI) for fasting blood insulin (FBI) in Brazilian adolescents, 12 to 17 years old, by direct and indirect approaches, and to validate indirectly determined RI. Methods Two databases were used for RI determination. Database 1 (DB1), used to obtain RI through a posteriori direct method, consisted of prospectively selected healthy individuals. Database 2 (DB2) was retrospectively mined from an outpatient laboratory information system (LIS) used for the indirect method (Bhattacharya method). Results From DB1, 29345 individuals were enrolled (57.65 % female) and seven age ranges and sex partitions were statistically determined according to mean FBI values: females: 12 and 13 years-old, 14 years-old, 15 years-old, 16 and 17 years-old; and males: 12, 13 and 14 years-old, 15 years-old, 16 and 17 years-old. From DB2, 5465 adolescents (67.5 % female) were selected and grouped according to DB1 partitions. The mean FBI level was significantly higher in DB2, on all groups. The RI upper limit (URL) determined by Bhattacharya method was slightly lower than the 90 % CI URL directly obtained on DB1, except for group female 12 and 13 years old. High agreement rates for diagnosing elevated FBI in all groups on DB1 validated indirect RI presented. Conclusion The present study demonstrates that Bhattacharya indirect method to determine FBI RI in adolescents can overcome some of the difficulties and challenges of the direct approach.

Inflammatory markers in prepubertal children and their associations with abdominal fat

Abstract Objective To evaluate the association between inflammatory markers and abdominal fat assessed by ultrasound in prepubertal children with and without excess weight. Methods A cross-sectional study involving 241 prepubertal children, 156 with obesity, 37 with overweight, and 48 with normal weight, aged five to ten years, who were followed at a research unit on Childhood Obesity from a teaching hospital belonging to a public health system. The concentration of interleukin-6, tumor necrosis factor-α and C-reactive protein were assessed and regression analyses, considering outcome variables such as abdominal wall and intra-abdominal fat thickness measured by ultrasound, were performed. Results The findings highlighted an association between abdominal fat and inflammatory markers, even in children at this young age group. Subcutaneous fat showed a stronger association with inflammatory biomarkers compared to intra-abdominal fat when performing logistic regression, with a positive association between tumor necrosis factor-α and abdominal wall thickness equal to or greater than the 75th percentile in adjusted logistic regression (OR: 18.12; CI 95 %: 1.57: 209.55). Conclusions Abdominal wall fat, in contrast to what is often observed in adults, appears to have a greater impact on chronic inflammation related to excessive weight in very young children.

Riesgo de eventos embólicos en pacientes con miocardiopatía chagásica y fibrilación auricular a pesar de terapia antitrombótica: ¿es la anticoagulación suficiente? / Risk of Embolic Events in Patients with Chagasic Cardiomyopathy and Atrial Fibrillation Despite Antithrombotic Therapy: Is Anticoagulation Enough?

RESUMEN Introducción: La miocardiopatía chagásica (MC) difiere de otras causas de insuficiencia cardíaca en múltiples aspectos, destacándose el riesgo de embolias sistémicas. Sin embargo, pocos estudios han evaluado el riesgo de eventos embólicos en pacientes anticoagulados con MC en comparación con otras miocardiopatías. Objetivo: Nuestro objetivo fue analizar la incidencia de embolias sistémicas en una cohorte de pacientes anticoagulados con diagnóstico de fibrilación auricular (FA) con y sin MC. Material y métodos: Se realizó un estudio de cohorte retrospectivo en hospital de cuarto nivel en Colombia durante el periodo 2014-2020. Se incluyeron todos los pacientes con diagnóstico de miocardiopatía de cualquier etiología y FA que estuvieran en régimen de anticoagulación. El resultado primario fue la incidencia de eventos embólicos. Se realizó un análisis de supervivencia mediante modelos de riesgos proporcionales de Cox ajustados. Un valor de p <0,05 se consideró significativo. Todas las pruebas estadísticas fueron de dos colas. Resultados: Se evaluaron 149 pacientes anticoagulados con miocardiopatía (mediana de edad: 71 años; mujeres: 30,20%). La incidencia acumulada de eventos embólicos fue significativamente mayor en los pacientes con MC (17,50%) en comparación con aquellos con otras miocardiopatías (4,95%), a pesar de que estos últimos tenían una puntuación CHA2DS2-VASc significativamente mayor (p=0,013). Tras el análisis multivariado, los pacientes con MC tuvieron un riesgo significativamente mayor de eventos embólicos independientemente de la puntuación CHA2DS2-VASc y del tipo de anticoagulante prescrito (HR 5,65; IC 95% 1,46-21,83; p=0,012). Conclusiones: La MC se asoció con un riesgo significativamente mayor de eventos embólicos, a pesar del tratamiento anticoagulante en ambos grupos. Se requiere más investigación para comprender el origen de este riesgo observado y traducir este conocimiento en indicaciones específicas de anticoagulación para pacientes con MC.

ABSTRACT Background: Chagasic cardiomyopathy (CC) differs from other heart failure causes in multiple aspects, highlighting the risk of systemic embolisms. However, few studies have evaluated the risk of embolic events in anticoagulated patients with CC compared with other cardiomyopathies. Objective: We aimed to analyze the incidence of systemic embolisms in a cohort of anticoagulated patients diagnosed with atrial fibrillation (AF) with and without CC. Methods: A retrospective cohort study was carried out at a fourth level hospital in Colombia during the period 2014-2020. All patients diagnosed with cardiomyopathy of any etiology and AF, who were on an anticoagulation regimen were included. The primary outcome was the incidence of embolic events. A survival analysis was performed using adjusted Cox proportional hazard models. A p-value <0.05 was considered significant. All statistical tests were two-tailed. Results: A total of 149 anticoagulated patients with cardiomyopathy were evaluated (median age: 71 years; women: 30.20%). The cumulative incidence of embolic events was significantly higher in patients with CC (17.50%) compared with those presenting other cardiomyopathies (4.95%), despite that the latter had a significantly higher CHA2DS2-VASc score (p=0.013). After multivariate analysis, patients with CC had a significantly higher risk of embolic events regardless of the CHA2DS2-VASc score and the type of anticoagulant prescribed (HR 5.65; 95% CI 1.46-21.83; p=0.012). Conclusions: Chagasic cardiomyopathy was associated with a significantly higher risk of embolic events, despite anticoagulation therapy in both groups. More research is required to understand the origin of the risk observed in order to translate this knowledge into specific indications for anticoagulation in patients with CC.

Análisis de los últimos ensayos clínicos de soporte circulatorio mecánico en el shock cardiogénico y su potencial rol en modificar las guías de práctica / Analysis of the Latest Clinical Trials of Mechanical Circulatory Support in Cardiogenic Shock and their Potential Role in Modifying Practice Guidelines

RESUMEN El shock cardiogénico puede complicar la evolución del infarto agudo de miocardio con elevación del segmento ST en aproximadamente el 10 % de los casos, y se asocia a elevada mortalidad. Las guías de práctica recomiendan en este contexto el empleo de dispositivos de soporte circulatorio mecánico con base en opinión de expertos o estudios no aleatorizados. Entre 2023 y 2024 se han publicado 3 ensayos clínicos aleatorizados con el empleo de ECMO o Impella, cuyos resultados y posible influencia en las guías de práctica se discuten en la presente revisión.

ABSTRACT Cardiogenic shock can complicate the course of ST-segment elevation myocardial infarction in approximately 10% of cases and is associated with high mortality. In this context, practice guidelines recommend the use of mechanical circulatory support devices based on expert opinion or non-randomized studies. Between 2023 and 2024, three randomized clinical trials using ECMO or Impella have been published. The results of these trials and their potential impact on practice guidelines are discussed in the present review.

Steroidal and gonadotropin hormone profile studies of a classical ayurvedic preparation of “Saraguna Balijarita Makardhwaja” after chronic administration to male Sprague-Dawley rats

Background: Saraguna Balijarita Makardhwaja (SGM) is an Ayurvedic preparation used as a traditional antipyretic in the rural population. This research work was designed to get an overview of steroidal and gonadotropin hormone profiles after chronic administration of this drug. Methods: The acute pharmacological test of SGM recorded no death or any signs of effectivity even at the highest dose of 4000 mg/kg body weight. For chronic pharmacological evaluation, sixteen healthy Sprague-Dawley male rats were randomly divided into two groups, one group was a control group and the other was an experimental group. The experimental group was assigned to receive the drug at a dose of 400 mg/kg of body weight orally. After 28 days of treatment, blood samples were collected for biochemical tests. Results: The research showed the following effects on the steroidal and gonadotropin hormone profile. In this study, serum circulating level of dehydroepiandrosterone sulfate (DHEA-S), testosterone level, progesterone, 17-beta-estradiol (E2), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) were measured to determine safety profile study of SGM after chronic administration. There were no significant differences in any parameters which is suggesting that SGM has no effect of the steroidal and hormone profile. Conclusions: According to studies, SGM has no harmful effect on the steroid and hormone profiles after chronic treatment. Further studies are needed to establish the safety aspects of SGM.

Transurethral resection of the prostate: one-year experience in a single centre

Background: Benign prostatic hyperplasia (BPH) is the most common cause of lower urinary tract symptoms among older males. Transurethral resection of the prostate (TURP) still remains the gold standard in the treatment of benign prostatic hyperplasia. However, its availability is not widespread in most public healthcare facilities across sub-Saharan Africa. This study was designed to describe and share our experience of TURP in a single centre. Methods: This is a retrospective evaluation of 64 patients who had TURP for bladder outlet obstruction secondary to enlarged prostate. The records of men who had TURP over a period of one year (January 2022-December 2022) were retrieved and reviewed. The pre-operative prostate specific antigen (PSA), pre-operative ultrasound measured size of prostate, resected weight of prostate, duration of surgery, duration of hospital stay, indication for TURP and complications were analysed. Results: Sixty-four patients had TURP done during the period under review. The age range was 50-90 years (mean 68.33), the pre-operative prostate gland weight was 76.78gm. The mean resected weight was 53.9gm. The pre-operative serum prostate specific antigen PSA had a minimum value of 1.5ng/ml and the maximum was 50.8ng/ml with mean value of 13.8ng/ml. The mean duration of surgery was 55.73 minutes and the mean duration of hospital stay was 3 days. The most common indication for TURP was lower urinary tract symptoms. We recorded four complications; capsule perforation, clot retention, hypotension and stress incontinence, 60 patients had no complications. Conclusions: Transurethral resection of the prostate is an effective surgical treatment for benign prostatic hyperplasia, it is associated notable improvement in the patient抯 quality of life and minimal complications.

Outcomes in breast reconstruction using the BREAST-Q questionnaire at a third level hospital center in Mexico City

Background: Breast reconstruction can have a significant impact on the physical, emotional and psychological well-being of patients undergoing mastectomy. The type and timing of breast reconstruction influence the satisfaction index of reconstructed patients. Methods: A retrospective examination was carried out on patient records from 2016 to 2024 at general hospital of Mexico. The analysis encompassed 210 patients who underwent breast reconstruction during this frame time. The BREAST-Q questionnaire was administered in March 2024 and at various intervals during each patient磗 post-operative care. Patients were stratified according to multiple variables such as: oncological therapy, timing of reconstruction, type of reconstruction and educational attainment. Results: The average age of the participants was 50.3 years. In terms of reconstruction timing, 25.24% underwent immediate reconstruction, while 74.76% opted for delayed reconstruction. When it came to BMI, the average was 26.99 kg/m�. Regarding the type of flap used for reconstruction, the majority (82.86%) had a latissimus dorsi flap. The overall demonstrated a mean psychosocial well-being scale score of 76�6. Conclusions: Breast reconstruction goes beyond physical restoration; it can profoundly impact a patient's emotional recovery, self-image, and quality of life. By addressing not only the physical changes but also the emotional and psychological aspects of breast cancer treatment, reconstruction plays a vital role in helping patients move forward with confidence, resilience, and a sense of empowerment. Regardless of when we first contact the patient, it is always worthwhile to provide her with information and the option of reconstruction.

Reverse dorsal metacarpal artery flap: a review

Deep soft tissue injuries around the thumb can significantly impair hand function if not managed appropriately. Various surgical options exist for treating these complex lesions, including microsurgical flaps, local flaps, and distant pedicled flaps. The dorsal metacarpal artery (DMCA) family of flaps belongs to the latter category. These versatile flaps can be designed as racquet-shaped, island, or bilobed flaps, utilizing the first DMCA alone or in combination with the second DMCA. In this review, we explore the surgical anatomy, techniques, and clinical applications of reversal DMCA flap (RDMA).

Delayed splenic rupture following abdominal trauma: a case report

We present the case of a 20-year-old male who presents multiple traumas of the abdomen 26 days prior to his return to the emergency room. Going again to evaluation with frank data of peritoneal irritation, since there is no hemodynamic commitment, a contrasted abdomen computed tomography (CT) scan is requested, finding a grade III splenic lesion, which is why he is admitted for emergency splenectomy. This case reports a splenic injury with the need for delayed splenectomy.

Pyloric hypertrophy in adults: case report

Pyloric hypertrophy is a benign condition characterized by narrowing of the pyloric canal, which may be associated with other pathologies. It is believed to manifest as a mild form of hypertrophy from childhood into adulthood. Symptoms can be nonspecific, such as nausea, vomiting, oral intolerance, and weight loss. Diagnosis can be challenging for physicians, and accurate reporting of cases is difficult due to some patients remaining asymptomatic.

Management and repair strategies for abdominal perforations during abdominoplasty innovative techniques and clinical outcomes: a systematic review

Current suture advancements in abdominoplasty and abdominal perforation repair have enhanced surgical outcomes. Innovations include antimicrobial sutures, which use agents like triclosan and silver nanoparticles to reduce surgical site infections without compromising suture integrity. Drug-eluting sutures release therapeutic agents directly at the wound site promote healing and reducing the need for systemic medications. Bioactive sutures and those seeded with stem cells aid tissue regeneration promising confirmed success in complex surgeries. Smart sutures featuring shape-memory polymers and electronic sutures that monitor physiological parameters represent cutting-edge developments. Barbed sutures eliminate the need for knots, distribute tension evenly, and decrease operative time. Mesh repair techniques come with biocompatible materials enhancing tissue integration and reducing complications. Endoscopic and laparoscopic approaches augmented by artificial intelligence and have further refined abdominal perforation repairs and offer superior outcomes. Fibrin sealants and adhesives have also seen improvements in efficacy, safety, and biocompatibility, with advances in synthetic alternatives and bioactive formulations further enhancing surgical success.

A prospective study conducted in a tertiary care hospital in eastern Rajasthan on the function of a multimodal perioperative management protocol in colorectal cancer surgery

Background: For colorectal surgery, the enhanced recovery after surgery (ERAS) group has conducted a thorough analysis of perioperative treatment. When combined, a series of operations known as colorectal resection result in a shorter duration of stay, fewer problems, and an early recovery of gut function. Until recently, it was considered typical to stay in the hospital for 10 to 14 days after a big bowel resection. This study aimed to study the effects of a multimodal perioperative care protocol in patients undergoing surgery for colorectal cancer in a tertiary care hospital in eastern Rajasthan, India. Methods: This was prospective randomized-controlled trial. Patients who are undergoing elective colorectal cancer surgery in tertiary care hospital (Sawai Man Singh hospital, Jaipur, Rajasthan) in year 2016 -17. Results: Hospital stays were 6.64�842 (median 6-9) and 8.25�52 (median 6-12) days (p=0.002) for 30 patients (n=14 in the multimodal group and 16 in the control group), respectively. Complication rates were 13.40% and 20.31% (p=0.019), 30-day readmission rates were 14.28% and 25% (p=0.029), and mortality rates were 7.14% and 12.5% in the multimodal and control groups. Conclusions: Complications, readmission rates, and death were all considerably lower in the multimodal group compared to the control group following the implementation of the multimodal perioperative treatment protocol during the hospital stay for colorectal cancer.

Ormeloxifene in the management of abnormal uterine bleeding in tertiary care centre South Kerala

Background: AUB is the most common presentation in the reproductive age group. Many females suffer from AUB and its related effects. A study on the effectiveness of an easily available drug (ormeloxifene) with an easy dosing schedule was done and its wonderful role in controlling the symptoms and improvement of quality of life of a female with no financial burdens and surgical morbidity was studied.Methods: A hospital based prospective observational study was conducted among women attending the outpatient clinic of OBG department at Dr Somervell Memorial CSI Medical College, Karakonam, Trivandrum district.Results: Total 50 women with AUB took part in the study. 62% had menstrual duration of <7 days with regular cycles (84%). 86% of them had history of passage of clots. 48% of them had dysmenorrhea. Efficacy of ormeloxifene was assessed by using PBAC score and haemoglobin level measurement. A repeated measures ANOVA with a Greenhouse-Geisser correction determined mean PBAC score differed significantly between months. Post hoc analysis with a Bonferroni adjustment revealed PBAC score was statistically significantly decreased from pre-intervention to 3 months to 6 months. There is statistically significant difference with respect to haemoglobin level improvement.Conclusions: Ormeloxifene is an excellent drug in controlling AUB as evidenced by the PBAC score and haemoglobin levels. Ormeloxifene has better compliance and acceptability. It is cost effective with a simple dosage schedule. A significant decrease in the menstrual blood loss and marked improvement in the hemoglobin concentration.

Sobre dos casos de listeriosis sistémica sin compromiso neurológico dominante / On two cases of systemic listeriosis without dominant neurological compromise

Resumen Listeria monocytogenes es una bacteria aeróbica Gram positiva; encontrada enforma ubicua en la naturaleza; que afecta sobre todo a recién nacidos, adultos mayores, pacientes inmunodeprimidos y mujeres embarazadas. Sin embargo, la enfermedad por Listeria puede ocurrir en la población sana. La listeriosis invasiva posee 3 formas clínicas do minantes, bacteriemia, neurolisteriosis e infección materno-neonatal. Las formas localizadas se describen infrecuentemente. La enfermedad se produce fun damentalmente en forma secundaria al consumo de alimentos contaminados, incluidos leche o queso no pasteurizados, y sepresenta en forma de casos aislados o brotes, soliendo comenzar a los pocos días del con sumo de éstos; aunque se ha descripto hasta 2 meses después de ingerirlos. También existela posibilidad de transmisión directa desde animales y transmisión vertical. La listeriosis sistémica sin cuadro neurológico do minante es un evento raro. Se presentan dos casos. El primero, una espondilodiscitis en huésped normal y el segundo una bacteriemia por Listeria en un paciente inmunocomprometido febril.

Abstract Listeria monocytogenes is a Gram-positive aerobic bac terium; found ubiquitously in nature; which mainly affects newborns, older adults, immunosuppressed pa tients and pregnant women. However, Listeria disease can occur in the healthy population. Invasive listeriosis has three dominant clinical forms, bacteremia, neurolisteriosis and maternal-neonatal in fection. Localized forms are infrequently described. The disease occurs mainly secondary to the consumption of contaminated food, including unpasteurized milk or cheese, and occurs in the form of isolated cases or outbreaks, usually beginning a few days after consump tion of the contaminated food; although it has been described up to 2 months after ingesting them. There is also the possibility of direct transmission from animals and vertical transmission. Systemic listeriosis without dominant neurological symp toms is a rare event. Two cases are presented. The first was spondylodiscitis in a normal host and the second was Listeria bacteremia in a febrile immunocompromised patient.

Validación de la prueba de homonegatividad internalizada en el departamento de Nariño (Colombia) / Validation of the internalized homonegativity test in the department of Nariño (Colombia)

Resumen Este estudio se centra en analizar las propiedades psicométricas de la Prueba de Homonegatividad Internalizada en individuos homosexuales del departamento de Nariño (Colombia), con el propósito de desarrollar un instrumento pertinente y adaptado para los estudios sobre género y orientación sexual en la región. Se emplea un diseño transversal instrumental de enfoque cuantitativo, con una muestra de 161 participantes, tanto gais como lesbianas, provenientes de 25 municipios de Nariño. La edad de los participantes abarcó un rango de 15 a 87 años, seleccionados mediante un muestreo no probabilístico por conveniencia tipo Bola de Nieve. Se aplicaron la Prueba de Homonegatividad Internalizada, la Escala de Reconocimiento de la Orientación Sexual Homosexual y un Cuestionario Sociodemográfico-Generacional. Se realizaron análisis factorial exploratorio y confirmatorio, pruebas de correlación y de hipótesis, así como cálculos de Alfa de Cronbach y Omega de McDonald mediante el software JASP V 0.17.1. Los resultados indican que el instrumento muestra una estructura unifactorial que explica el 56.4 % de la varianza común de los datos y una consistencia interna adecuada, con valores de fiabilidad entre 0.828 y 0.894. Estos hallazgos respaldan la fiabilidad de la escala para medir la homonegatividad internalizada en el contexto estudiado.

Abstract This study focuses on analyzing the psychometric properties of the Internalized Homonegativity Test among homosexual individuals in the department of Nariño (Colombia), aiming to develop a relevant and adapted instrument for gender and sexual orientation studies in the region. It employs a quantitative instrumental cross-sectional design with a sample of 161 participants, including both gay and lesbian individuals from 25 municipalities in Nariño. Participants' ages ranged from 15 to 87 years, selected through convenience sampling using the Snowball method. The Internalized Homonegativity Test, the Homosexual Sexual Orientation Recognition Scale, and a Sociodemographic-Generational Questionnaire were administered. Exploratory and confirmatory factor analyses, correlation and hypothesis testing, and calculations of Cronbach's Alpha and McDonald's Omega were conducted using JASP V 0.17.1 software. The results indicate that the instrument exhibits a unifactorial structure explaining 56.4 % of the common variance in the data and adequate internal consistency, with reliability values ranging from 0.828 to 0.894. These findings support the scale's reliability for measuring internalized homonegativity in the studied context.