Assessment of the chemical composition of buriti (Mauritia flexuosa Liliopsida) and cassava (Manihot esculenta Crantz) residues and their possible application in the bioproduction of coconut aroma (6 pentyl-α-pyrone).

This work aimed to define strategies to increase the bioproduction of 6 pentyl-α-pyrone (bioaroma). As first strategy, fermentations were carried out in the solid state, with agro-industrial residues: Mauritia flexuosa Liliopsida. and Manihot esculenta Crantz in isolation, conducting them with different nutrient solutions having Trichoderma harzianum as a fermenting fungus. Physicochemical characterizations, centesimal composition, lignocellulosic and mineral content and antimicrobial activity were required. Fermentations were conducted under different humidification conditions (water, nutrient solution without additives and nutrient solutions with glucose or sucrose) for 9 days. Bioaroma was quantified by gas chromatography, assisted by solid-phase microextraction. The results showed the low production of this compound in fermentations conducted with sweet cassava (around 6 ppm (w/w)). The low bioproduction with sweet cassava residues can probably be related to its starch-rich composition, homogeneous substrate, and low concentration of nutrients. Already using buriti, the absence of aroma production was detected. Probably the presence of silicon and high lignin content in buriti minimized the fungal activity, making it difficult to obtain the aroma of interest. Given the characteristics presented by the waste, a new strategy was chosen: mixing waste in a 1:1 ratio. This fermentation resulted in the production of 156.24 ppm (w/w) of aroma using the nutrient solution added with glucose. This combination, therefore, promoted more favorable environment for the process, possibly due to the presence of fermentable sugars from sweet cassava and fatty acids from the buriti peel, thus proving the possibility of an increase of around 2500% in the bioproduction of coconut aroma.

Case report: Equine metacarpophalangeal joint partial and full thickness defects treated with allogenic equine synovial membrane mesenchymal stem/stromal cell combined with umbilical cord mesenchymal stem/stromal cell conditioned medium.

Here, we describe a case of a 5-year-old show-jumping stallion presented with severe lameness, swelling, and pain on palpation of the left metacarpophalangeal joint (MCj). Diagnostic imaging revealed full and partial-thickness articular defects over the lateral condyle of the third metacarpus (MC3) and the dorsolateral aspect of the first phalanx (P1). After the lesion's arthroscopic curettage, the patient was subjected to an innovative regenerative treatment consisting of two intra-articular injections of equine synovial membrane mesenchymal stem/stromal cells (eSM-MSCs) combined with umbilical cord mesenchymal stem/stromal cells conditioned medium (UC-MSC CM), 15 days apart. A 12-week rehabilitation program was accomplished, and lameness, pain, and joint effusion were remarkably reduced; however, magnetic resonance imaging (MRI) and computed tomography (CT) scan presented incomplete healing of the MC3's lesion, prompting a second round of treatment. Subsequently, the horse achieved clinical soundness and returned to a higher level of athletic performance, and imaging exams revealed the absence of lesions at P1, fulfillment of the osteochondral lesion, and cartilage-like tissue formation at MC3's lesion site. The positive outcomes suggest the effectiveness of this combination for treating full and partial cartilage defects in horses. Multipotent mesenchymal stem/stromal cells (MSCs) and their bioactive factors compose a novel therapeutic approach for tissue regeneration and organ function restoration with anti-inflammatory and pro-regenerative impact through paracrine mechanisms.

The genetic landscape of mitochondrial diseases in the next-generation sequencing era: a Portuguese cohort study.

Introduction: Rare disorders that are genetically and clinically heterogeneous, such as mitochondrial diseases (MDs), have a challenging diagnosis. Nuclear genes codify most proteins involved in mitochondrial biogenesis, despite all mitochondria having their own DNA. The development of next-generation sequencing (NGS) technologies has revolutionized the understanding of many genes involved in the pathogenesis of MDs. In this new genetic era, using the NGS approach, we aimed to identify the genetic etiology for a suspected MD in a cohort of 450 Portuguese patients. Methods: We examined 450 patients using a combined NGS strategy, starting with the analysis of a targeted mitochondrial panel of 213 nuclear genes, and then proceeding to analyze the whole mitochondrial DNA. Results and Discussion: In this study, we identified disease-related variants in 134 (30%) analyzed patients, 88 with nuclear DNA (nDNA) and 46 with mitochondrial DNA (mtDNA) variants, most of them being pediatric patients (66%), of which 77% were identified in nDNA and 23% in mtDNA. The molecular analysis of this cohort revealed 72 already described pathogenic and 20 novel, probably pathogenic, variants, as well as 62 variants of unknown significance. For this cohort of patients with suspected MDs, the use of a customized gene panel provided a molecular diagnosis in a timely and cost-effective manner. Patients who cannot be diagnosed after this initial approach will be further selected for whole-exome sequencing. Conclusion: As a national laboratory for the study and research of MDs, we demonstrated the power of NGS to achieve a molecular etiology, expanding the mutational spectrum and proposing accurate genetic counseling in this group of heterogeneous diseases without therapeutic options.

Semperula wallacei (Mollusca, Veronicellidae) um hospedeiro natural recém-descoberto de Angiostrongylus cantonensis (Nematoda, Angiostrongylidae) na Bacia do Pacífico.

Semperula wallacei (Issel, 1874) is a species of terrestrial slug that occurs in southeast China and the Pacific Basin and is the only species of its genus that occurs beyond the Oriental region and to the east of Wallace's line in the Australian region, where it has probably been introduced. In this study, we report for the first time S. wallacei as an intermediate host for Angiostrongylus cantonensis (Chen, 1935) based on histological and molecular analyses of slugs from Tuamasaga, Samoa, deposited at the Medical Malacological Collection (Fiocruz-CMM). DNA was obtained from the deparafinized tissues scraped from specimen slides. Polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP) targeted to the internal transcribed spacer 2 (ITS2) region were carried out using the restriction enzyme Cla I. The RFLP profile observed for our larval specimen of S. wallacei was identical to the profile previously established for A. cantonensis, demonstrating that S. wallacei can be naturally infected with A. cantonensis and is likely to be an intermediate host for this parasitic nematode species in the field. The potential for geographical range expansion of S. wallacei in the Pacific Basin, its small size, and the general role of veronicellids as crop pests and hosts of nematodes, indicate the significance of S. wallacei as an invasive species in the Pacific Basin. Our work also highlights the importance of biological collections for investigating the environmental impact of invasive species on agriculture, public health, and biodiversity conservation.

Standard and flexible tip bougie for tracheal intubation using a non-channelled hyperangulated videolaryngoscope: a randomised comparison.

Bougie impingement during tracheal intubation can increases the likelihood of prolonged intubation time, failed intubation and airway trauma. A flexible tip bougie may overcome this problem, which can occur when using a non-channelled, hyperangulated videolaryngoscope with a standard bougie. This randomised controlled study compared standard and flexible tip bougies using a non-channelled videolaryngoscope (C-MAC® D-blade) in 160 patients. The primary outcome measure was the modified intubation difficulty scale score. Secondary outcome measures were: laryngoscopy time; total tracheal intubation time; first attempt success rate; and postoperative sore throat verbal rating score. The median (IQR [range]) modified intubation difficulty scale scores for standard bougie and flexible tip bougie were 1 (0-2[0-5]) and 0 (0-1[0-3]), respectively (p = 0.001). There was no significant differences in laryngoscopy time, total tracheal intubation time, first attempt success rate and postoperative sore throat between the two groups. Both the flexible tip and standard bougies can be used with a high first attempt success rate for tracheal intubation using a C-MAC D-blade videolaryngoscope. The flexible tip bougie demonstrated a significantly better modified intubation difficulty scale score and lower incidence of bougie impingement.

Development of eight wireless automated cages system with two lick-o-meters each for rodents.

Drinking behavior has been used in basic research to study metabolism, motivation, decision-making and different aspects of health problems, such as anhedonia and alcohol use disorders. In the majority of studies, liquid intake is measured by weighing the bottles before and after the experiment. This method does not tell much about the drinking microstructure, e.g., licking bouts and periods of preference for each liquid, which could be valuable to understand drinking behavior. To improve the data acquisition of drinking microstructure, companies have developed lick-o-meters devices that acquire timestamps when animals approach or drink from a specific sipper. Nevertheless, commercially available devices have elevated costs. Here, we present a low-cost alternative for a lick-o-meter system that allows wireless data acquisition of licking from eight cages with two sippers each. We run a three-phase validation protocol to ensure 1) proper choice of the sensor to detect licks; 2) adaptation of the device to a wireless transmission and realistic in silico tests; and 3) in vivo tests to correlate the amount of licks measured by the prototype and the bottle weight. The capacitive sensor presented appropriate recall and precision for our device. After adaptation to wireless transmission, the in silico validation demonstrated low reading and transmission errors for the device even when tested in extreme simultaneous licking conditions. Finally, a positive correlation between volume consumption and lick's count in the in vivo test was observed, showing that the prototype can be used for in vivo studies interested in rodent drinking microstructure.Significant StatementThis study presents an innovative and low-cost solution for drinking behavioral studies: a lick-o-meter system based on an open-source hardware platform with a user-friendly interface software, capable of simultaneously receiving data from eight automated cages with two drinking bottles each. The lick-o-meter brings an accessible device to acquire high-quality and detailed data. This device also has the possibility to be adaptable to new types of sensors or other neuroscience tools capable of measuring brain activity simultaneously to the behavior.

Metastatic melanoma in a Saanen goat: clinical, ultrasonographic and anatomopathological aspects - case report / [Melanoma metastático em cabra Saanen: aspectos clínicos, ultrassonográficos e Anatomopatológicos - relato de caso]

This report describes clinical, ultrasonographic and anatomopathological findings in a case of metastatic melanoma in an adult Saanen goat. Clinically, the goat had apathy, an intra-abdominal palpable firm structure, and exophytic keratinized areas on the skin of the udder. Ultrasound revealed non-encapsulated oval structures, with heterogeneous echogenicity and marked central and peripheral vascularization, and hypoechoic hepatic multifocal to coalescent areas. In the udder, there were non-encapsulated oval structures with heterogeneous echogenicity and hyperechoic center surrounded by hypoechogenic tissue. Grossly, there were black multifocal to coalescent areas in the liver, as well as black nodules in mammary and mesenteric lymph nodes, uterus, spleen, and myocardium. Microscopically, multifocal melanocytic neoplastic proliferation was observed in the dermis and junction of the udder epidermis. Most of the neoplastic cells had cytoplasmic granules of melanin. In the liver there were areas of neoplastic tissue compressing the adjacent parenchyma, with central foci of necrosis, mild desmoplasia, and multifocal infiltration of malignant cells into the adjacent tissues. Similar findings were observed in the mammary and mesenteric lymph nodes, uterus, spleen, and myocardium, which characterized metastatic melanoma. Ultrasonography played a key role for establishing the diagnosis of a metastatic melanoma and helped establish a proper clinical management protocol.(AU)

Este relato descreve os achados clínicos, ultrassonográficos e anatomopatológicos em um caso de melanoma metastático em uma cabra Saanen adulta. Clinicamente, a cabra apresentava apatia, estrutura firme palpável intra-abdominal e áreas exofíticas queratinizadas na pele do úbere. A ultrassonografia revelou estruturas ovais não encapsuladas, com ecogenicidade heterogênea e marcada vascularização central e periférica, além de áreas hepáticas multifocais a coalescentes hipoecoicas. No úbere, havia estruturas ovais não encapsuladas, com ecogenicidade heterogênea e centro hiperecogênico circundado por tecido hipoecogênico. Macroscopicamente, havia áreas pretas multifocais a coalescentes no fígado, bem como nódulos pretos nos linfonodos mamários e mesentéricos, no útero, no baço e no miocárdio; microscopicamente, proliferação neoplásica melanocítica multifocal foi observada na derme e na junção da epiderme do úbere. A maioria das células neoplásicas apresentava grânulos citoplasmáticos de melanina. No fígado, havia áreas de tecido neoplásico comprimindo o parênquima adjacente, com focos centrais de necrose, desmoplasia leve e infiltração multifocal de células malignas nos tecidos adjacentes. Achados semelhantes foram observados nos nódulos linfáticos mamários e mesentéricos, no útero, no baço e no miocárdio, que caracterizaram o melanoma metastático. A ultrassonografia desempenhou um papel fundamental para estipular o diagnóstico de um melanoma metastático e ajudou a estabelecer um protocolo de manejo clínico adequado.(AU)

Temporomandibular joint dysfunction following the use of a supraglottic airway device during general anaesthesia: a prospective observational study.

Supraglottic airway devices are commonly used to manage the airway during general anaesthesia. There are sporadic case reports of temporomandibular joint dysfunction and dislocation following supraglottic airway device use. We conducted a prospective observational study of adult patients undergoing elective surgery where a supraglottic airway device was used as the primary airway device. Pre-operatively, all participants were asked to complete a questionnaire involving 12 points adapted from the Temporomandibular Joint Scale and the Liverpool Oral Rehabilitation Questionnaire. Objective measurements included inter-incisor distance as well as forward and lateral jaw movements. The primary outcome was the inter-incisor distance, an accepted measure of temporomandibular joint mobility. Both the questionnaire and measurements were repeated in the postoperative period and we analysed data from 130 participants. Mean (SD) inter-incisor distance in the pre- and postoperative period was 46.5 (7.2) mm and 46.3 (7.5) mm, respectively (p = 0.521) with a difference (95%CI) of 0.2 (-0.5 to 0.9) mm. Mean (SD) forward jaw movement in the pre- and postoperative period was 3.6 (2.4) mm and 3.9 (2.4) mm, respectively (p = 0.018). Mean (SD) lateral jaw movement to the right in the pre- and postoperative period was 8.9 (4.1) mm and 9.1 (4.0) mm, respectively (p = 0.314). Mean (SD) lateral jaw movement to the left in the pre- and postoperative period was 8.8 (4.0) mm and 9.3 (3.6) mm, respectively (p = 0.008). The number of patients who reported jaw clicks or pops before opening their mouth as wide as possible was 28 (21.5%) vs. 12 (9.2%) in the pre- and postoperative period, respectively (p < 0.001) with a difference (95%CI) of 12.3% (6.7-17.9%). There was no significant difference in the responses to the other 11 questions or in the number of patients who reported pain in the temporomandibular joint area postoperatively. No clinically significant dysfunction of the temporomandibular joint following the use of supraglottic airway devices in the postoperative period was identified by either patient questionnaires or objective measurements.

The application of Bonelike® Poro as a synthetic bone substitute for the management of critical-sized bone defects - A comparative approach to the autograft technique - A preliminary study.

The effective treatment of non-unions and critical-sized defects remains a challenge in the orthopedic field. From a tissue engineering perspective, this issue can be addressed through the application bioactive matrixes to support bone regeneration, such as Bonelike®, as opposed to the widespread autologous grafting technique. An improved formulation of Bonelike® Poro, was assessed as a synthetic bone substitute in an ovine model for critical-sized bone defects. Bone regeneration was assessed after 5 months of recovery through macro and microscopic analysis of the healing features of the defect sites. Both the application of natural bone graft or Bonelike® Poro resulted in bridging of the defects margins. Untreated defect remained as fibrous non-unions at the end of the study period. The characteristics of the newly formed bone and its integration with the host tissue were assessed through histomorphometric and histological analysis, which demonstrated Bonelike® Poro to result in improved healing of the defects. The group treated with synthetic biomaterial presented bone bridges of increased thickness and bone features that more closely resembled the native spongeous and cortical bone. The application of Bonelike® Poro enabled the regeneration of critical-sized lesions and performed comparably to the autograph technique, validating its octeoconductive and osteointegrative potential for clinical application as a therapeutic strategy in human and veterinary orthopedics.

Prevalence of infection by Cryptosporidium spp. in calves and associated risk factors in Northeastern Brazil / [Prevalência da infecção por Cryptosporidium spp. e fatores de risco associados em bezerros do Nordeste do Brasil]

Cryptosporidium spp. are zoonotic protozoa, frequently associated with diarrhea in calves, which are responsible for important economic losses. The aim of this study was to assess the prevalence of infection by Cryptosporidium spp. and its associated risk factors among calves raised in a milk production region of Northeastern Brazil. Fecal samples (n = 385) were obtained from young animals (up to ten months old) and evaluated by means of centrifugal fecal sedimentation in formalin-ether followed by the modified Ziehl-Neelsen staining technique. In addition, Odds Ratio (OR) was calculated to evaluate associations between variables and infection by these protozoa. Out of all samples analyzed, 25.7% (99/385) scored positive for the presence of Cryptosporidium spp. Contact with other species (goat and sheep) (OR = 3.33; p = 0.000), use of a semi-intensive rearing system (OR = 1.70; p = 0.024) and absence of hygienic conditions (fecal contamination of food and water) (OR = 1.64; p = 0.029) were considered to be risk factors. Data herein reported shows that the implementation of hygienic-sanitary measures on the farms studied, it is imperative to reduce Cryptosporidium spp. infection and consequently the economic impact caused by this pathogen.(AU)

Cryptosporidium spp. são protozoários zoonóticos frequentemente associados à diarreia em bezerros e responsáveis por importantes perdas econômicas. O objetivo deste estudo foi avaliar a prevalência e os fatores de risco associados à infecção por Cryptosporidium spp. em bezerros de propriedades leiteiras no Nordeste do Brasil. Amostras fecais (n = 385) foram obtidas de animais jovens (até 10 meses de idade) e avaliadas por centrífugo-sedimentação em formol éter, seguida da técnica de coloração de Ziehl-Neelsen modificada. A Odds Ratio (OR) foi calculada para avaliar a associação entre variáveis e infecção pelos protozoários. De todas as amostras analisadas, 25,7% (99/385) apresentaram oocistos de Cryptosporidium spp. Contato com outras espécies (caprino e ovino) (OR = 3,33; p = 0,000), sistema semi-intensivo de criação (OR = 1,70; p = 0,024) e ausência de condições higiênicas (contaminação fecal do alimento e da água) (OR = 1,64; p = 0,029) foram considerados fatores de risco. Com base nos resultados, é imprescindível a adoção de medidas higiênico-sanitárias nas fazendas estudadas, a fim de reduzir infecção por Cryptosporidium spp. e o impacto econômico causado por esse patógeno.(AU)

Pollen Load Spectrum of Tomato Pollinators.

Vibrating bees are the main pollinators of the tomato plant (Solanum lycopersicum L.). Knowledge of other alternative food resources for these bees is fundamental for pollinator management actions in agricultural areas. The objective of this study was to evaluate the plants used as food resources for the main pollinators Bombus morio (Swederus) and Exomalopsis analis Spinola in plantation areas. The study was conducted in 12 plantation areas in São José de Ubá, southeastern Brazil, during the flowering period of S. lycopersicum. The pollen material contained on the hind legs of 40 B. morio females and 72 E. analis females was analyzed and compared with the reference slides made from 155 flowering plant species (35 botanical families) sampled close to the plantations. The pollen material was submitted to acetolysis and mounted in glycerin gelatin and analyzed under optical microscope. From B.morio corbiculae were identified 188 pollen types (52 identified from reference slides) and 189 types from E. analis scopae (54 in reference slides). Besides tomato pollen, other most abundant types belong to Fabaceae (8%) in B. morio samples, and Hyptis and Solanum sp in E. analis samples. The trophic niche overlap was close to zero when the tomato pollen was disregarded, indicating that both pollinators use distinct sources. The results confirm the generalist character of tomato pollinators; in addition, the use of floral resources from several other plants, even at tomato flowering peak, emphasizes the importance of maintaining flowering plant composition around agricultural areas.

Unlocking the full power of electrochemical fingerprinting for on-site sensing applications.

Electrochemical sensing for the semi-quantitative detection of biomarkers, drugs, environmental contaminants, food additives, etc. shows promising results in point-of-care diagnostics and on-site monitoring. More specifically, electrochemical fingerprint (EF)-based sensing strategies are considered an inviting approach for the on-site detection of low molecular weight molecules. The fast growth of electrochemical sensors requires defining the concept of direct electrochemical fingerprinting in sensing. The EF can be defined as the unique electrochemical signal or pattern, mostly recorded by voltammetric techniques, specific for a certain molecule that can be used for its quantitative or semi-quantitative identification in a given analytical context with specified circumstances. The performance of EF-based sensors can be enhanced by considering multiple features of the signal (i.e., oxidation or reduction patterns), in combination with statistical data analysis or sample pretreatments or by including electrode surface modifiers to enrich the EF. In this manuscript, some examples of EF-based sensors, strategies to improve their performances, and open challenges are discussed to unlock the full power of electrochemical fingerprinting for on-site sensing applications. Graphical abstract Electrochemical fingerprint-based sensing strategies can be used for the detection of electroactive analytes, such as antibiotics, phenolic compounds, and drugs of abuse. These strategies show selective and sensitive responses and are easily combined with portable devices.

Changes in cardiac biomarkers in goats naturally affected by pregnancy toxemia.

Pregnancy toxemia (PT) is considered one of the most common metabolic diseases with high impact on the production of small ruminants. The objective of this study was investigate possible myocardial damage in goats affected with PT by the determination of serum myocardial biomarkers CK-MB and cTnI. A total of 44 goats affected with PT, and 10 apparently healthy goats (control group or CG) were used in the study. In goats with PT, the serum concentrations of cTnI (0.43 ng/mL) were significantly higher than that in CG goats (0.06 ng/mL). Although CK-MB showed no significant difference, it was approximately three times higher in animals with PT. The serum concentrations of insulin were significantly lower in PT goats (5.03 ppmol/L) compared to CG goats (10.66 pmol/L). The serum concentrations of cortisol in PT goats (155.41 nmol/L) were significantly higher than that in CG goats (36.58 nmol/L). Results of this study indicate that a clinically significant myocardial damage might occur in goats affected with PT leading to significant elevations in values of cTnI and CK-MB. Therefore, these parameters could be used as a potential prognostic indicator in goats affected with this important disease.

Associação entre o polimorfismo VKORC1: C. 174-136G>A (rs9934438) e a dose semanal de varfarina em pacientes idosos ­ estudo piloto / Association between VKORC1: C.174-136G> A (rs9934438) polymorphism and weekly warfarin dose in elderly patients - pilot study

A varfarina é um anticoagulante utilizado na prevenção e no tratamento de doenças tromboembólicas, com janela terapêutica estreita e, elevado risco de hemorragias. Nos idosos, a principal indicação para tratamento anticoagulante oral é fibrilação atrial, cuja prevalência aumenta com a idade, atingindo 8% após os 80 anos. O exame utilizado para controle da anticoagulação oral é o tempo de protrombina, através do cálculo da razão normalizada internacional (RNI), visando o ajuste de dose e manutenção da faixa terapêutica (RNI= 2 a 3). Os idosos requerem um monitoramento efetivo devido a fatores inerentes da idade. Embora seja conhecido que os fatores genéticos influenciam na resposta terapêutica à varfarina, na rotina da maioria dos hospitais a farmacogenética ainda não é considerada no ajuste de dose. Visando estabelecer uma conduta terapêutica personalizada, o presente estudo tem como objetivo avaliar a associação entre o polimorfismo rs9934438 do gene VKORC1, que codifica a enzima vitamina K epóxido redutase, e a dose semanal de varfarina necessária para atingir o RNI adequado. Até o momento, foram incluídos 52 pacientes com idade superior a 70 anos, de ambos os sexos e em uso de varfarina. A análise do polimorfismofoi realizada através da PCR em tempo real utilizando os reagentes TaqMan™ Sample-to-SNP™ e o sistema de detecção TaqMan® SNP Genotyping Assay. As análises estatísticas foram realizadas utilizando o pacote SPSS v. 16.0 e nível de significância adotado foi de 5%. Dos 52 pacientes incluídos até o momento, 37 (71%) permaneceram na faixa terapêutica (Time in Therapeutic Range, TTR) em pelo menos 50% do tempo de anticoagulação e, para eles a dose semanal de varfarina variou de 15mg a 62,5mg. Apesar de ser um estudo piloto, a distribuição dos genótipos está em equilíbrio gênico, segundo Hardy-Weinberg (AA=19,2%, AG=34,6%, GG= 46,2%, χ2= 3,34 e p=0,067). Para os idosos com TTR ≥50%, a frequência do alelo A foi significantemente maior entre os pacientes que utilizaram doses menores de varfarina (Exato de Fisher, p=0,005). Adicionalmente, os portadores do genótipo AA necessitaram, em média, de aproximadamente metade da dose para atingir a faixa terapêutica quando comparados aos portadores do genótipo GG, 20,5 versus 36,5 mg/semana, respectivamente (ANOVA, p=0,006/ Pós-teste Bonferroni, p=0,039). Os resultados permitem concluir que portadores de alelo A são mais responsivos ao tratamento com varfarina, sugerindo que o perfil genotípico pode ser de grande valor para o direcionamento da dose terapêutica em idosos. (AU)

Dental pulp stem cells and Bonelike® for bone regeneration in ovine model.

Development of synthetic bone substitutes has arisen as a major research interest in the need to find an alternative to autologous bone grafts. Using an ovine model, the present pre-clinical study presents a synthetic bone graft (Bonelike®) in combination with a cellular system as an alternative for the regeneration of non-critical defects. The association of biomaterials and cell-based therapies is a promising strategy for bone tissue engineering. Mesenchymal stem cells (MSCs) from human dental pulp have demonstrated both in vitro and in vivo to interact with diverse biomaterial systems and promote mineral deposition, aiming at the reconstruction of osseous defects. Moreover, these cells can be found and isolated from many species. Non-critical bone defects were treated with Bonelike® with or without MSCs obtained from the human dental pulp. Results showed that Bonelike® and MSCs treated defects showed improved bone regeneration compared with the defects treated with Bonelike® alone. Also, it was observed that the biomaterial matrix was reabsorbed and gradually replaced by new bone during the healing process. We therefore propose this combination as an efficient binomial strategy that promotes bone growth and vascularization in non-critical bone defects.

Fibreoptic-guided tracheal intubation through i-gel® and LMA® ProtectorTM supraglottic airway devices - a randomised comparison.

Fibreoptic-guided tracheal intubation using a supraglottic airway device as a conduit is a technique that can be used in anticipated and unanticipated difficult airway management. Although the i-gel® supraglottic airway device has been examined for this purpose, the LMA® ProtectorTM , a recently introduced second-generation supraglottic airway device, has not been evaluated for this use in clinical trials. This prospective, randomised clinical trial compared fibreoptic-guided tracheal intubation via i-gel and LMA Protector supraglottic airway devices in two UK hospitals. Patients who were ASA physical status 1 or 2 and undergoing elective surgery requiring tracheal intubation were recruited to the study. A block randomisation list was generated for each study site. The primary outcome measure was time to successful tracheal intubation and secondary outcomes were tracheal intubation success rate, glottic view through flexible fibrescope, ease of tracheal intubation using operator visual analogue score, supraglottic airway device insertion time and insertion success rate. Ninety patients were randomly allocated to each device, and final data analysis was carried out for 92 patients in the i-gel group and 86 patients in the LMA Protector group. Mean (SD) tracheal intubation time in the i-gel and LMA Protector groups were 54.3 (13.8) s and 52.0 (13.0) s, respectively (p = 0.240). There were no significant differences in tracheal intubation success rate, glottic view and ease of tracheal intubation between the two groups. This study demonstrates that the LMA Protector supraglottic airway device is comparable to the i-gel supraglottic airway device as a conduit for fibreoptic-guided tracheal intubation.

A survey of practice of rapid sequence induction for caesarean section in England.

BACKGROUND: In view of newer techniques of preoxygenation and laryngoscopy and recent obstetric guidelines concerning the management of difficult intubation, we aimed to evaluate the current practice of rapid sequence induction for caesarean section in England. METHODS: In 2017, 316 questionnaire surveys were posted to all 158 hospitals with caesarean section capabilities in England. At each hospital, one questionnaire was to be completed by the obstetric anaesthetic consultant lead and one by an anaesthetic trainee. Differences in responses between consultants and trainees, regardless of their place of work, were compared for all data using the chi-square and the Fisher's exact tests. RESULTS: One-hundred-and-eighty complete questionnaires were returned, with an overall response rate of 57%, 98 (54%) from obstetric anaesthetic consultant leads and 82 (45.6%) from trainees). Both head up (57%) and ramped (56%) were the preferred positions for preoxygenation. Less than half of respondents (43%) preoxygenated until the surgeon was scrubbed. Cricoid pressure was used by almost all respondents (98%). Thiopentone (67%) was the most commonly chosen anaesthetic induction agent and most respondents (82%) supported a change to the use of propofol. Suxamethonium (92%) was the neuromuscular blocker of choice but more than half the respondents (52%) supported a change to rocuronium. In the event of a failed intubation, the rescue supraglottic airway device of choice was the i-gel® (65%). CONCLUSIONS: Our survey demonstrated the significant variation in the practice of rapid sequence induction for caesarean section in obstetrics in the United Kingdom.

A randomised clinical trial comparing the 'sniffing' and neutral position using channelled (KingVision® ) and non-channelled (C-MAC® ) videolaryngoscopes.

Head and neck position is one of the factors which can be associated with difficult videolaryngoscopy and tracheal intubation. This prospective randomised clinical trial compared 'sniffing' and neutral positions using a channelled (KingVision® ) and a non-channelled (C-MAC® D-blade) videolaryngoscope in 200 adult patients randomly allocated into four groups (KingVision 'sniffing', KingVision neutral, C-MAC 'sniffing' and C-MAC neutral). The primary outcome was the ease of tracheal intubation using the modified intubation difficulty scale (mIDS) score. Laryngoscopy time, intubation time, laryngoscopic view using the percentage of glottic opening (POGO) score and success rate of tracheal intubation were secondary outcomes. The median (IQR [range]) modified difficulty scale scores for the four groups, respectively, were 0 (0-1 [0-3]), 0 (0-1 [0-4]), 1 (0-1 [0-5]) and 0 (0-1 [0-3]; p = 0.384). There was no significant difference in laryngoscopy time (p = 0.020), intubation time (p = 0.272) and success rate (p = 0.968) between the groups. The percentage of glottic opening score was lower for C-MAC neutral group as compared with other three groups (p = 0.01). There was no significant difference in the ease of intubation between the 'sniffing' and the neutral position when using the KingVision and the C-MAC videolaryngoscopes. Therefore, either of the two positions could be used with these types of videolaryngoscopes, if deemed advantageous for the patient.

Neuroprotective effect of melatonin against lipopolysaccharide-induced depressive-like behavior in mice.

Accumulating evidence indicates an interaction between inflammation and depression since increased levels of pro-inflammatory cytokines are associated with depression-related symptoms. Melatonin is a hormone synthesized and secreted by the pineal gland with antioxidant, anti-inflammatory and antidepressant-like effects. In this way, it would be interesting to evaluate the putative antidepressant-like effect of melatonin treatment in an acute inflammation mice model of depression. The present study aimed to investigate the effect of melatonin treatment on lipopolysaccharide (LPS) induced depressive-like behavior, neuroinflammation, oxidative stress and alteration on brain-derived neurotrophic fator (BDNF) levels. Mice were treated with melatonin (10 mg/kg, i.p.) 30 min before LPS (0.5 mg/kg, i.p.) injection. Twenty-four hours after LPS infusion, mice were submitted to the behavioral tests and, thereafter, biochemical determinations were performed. Melatonin treatment prevented LPS-induced depressive-like behavior in the forced swim and tail suspension tests with no alterations in locomotor activity evaluated in the open field test. Melatonin attenuated LPS-induced increase in tumor necrosis factor-α (TNF-α) and reduction of BDNF levels in the hippocampus. Treatment with melatonin also prevented LPS-induced increase in lipid peroxidation and the reduction of glutathione levels in the hippocampus. In conclusion, the present study suggests that melatonin treatment exerted neuroprotective effects against LPS-induced depressive-like behavior which may be related to reduction of TNF-α release, oxidative stress and modulation of BDNF expression.