Graphene Oxide Nanosheets for Bone Tissue Regeneration.

Bone tissue engineering is a promising alternative to repair wounds caused by cellular or physical accidents that humans face daily. In this sense, the search for new graphene oxide (GO) nanofillers related to their degree of oxidation is born as an alternative bioactive component in forming new scaffolds. In the present study, three different GOs were synthesized with varying degrees of oxidation and studied chemically and tissue-wise. The oxidation degree was determined through infrared (FTIR), X-ray diffraction (XRD), X-ray photoelectron (XPS), and Raman spectroscopy (RS). The morphology of the samples was analyzed using scanning electron microscopy (SEM). The oxygen content was deeply described using the deconvolution of RS and XPS techniques. The latter represents the oxidation degree for each of the samples and the formation of new bonds promoted by the graphitization of the material. In the RS, two characteristic bands were observed according to the degree of oxidation and the degree of graphitization of the material represented in bands D and G with different relative intensities, suggesting that the samples have different crystallite sizes. This size was described using the Tuinstra-Koenig model, ranging between 18.7 and 25.1 nm. Finally, the bone neoformation observed in the cranial defects of critical size indicates that the F1 and F2 samples, besides being compatible and resorbable, acted as a bridge for bone healing through regeneration. This promoted healing by restoring bone and tissue structure without triggering a strong immune response.

Treatment of mammary gland tumors in bitches: effects of sodium dichloroacetate as neoadjuvant therapy.

Mastectomy is the standard treatment for mammary gland tumors in dogs. In addition to traditional therapy, sodium dichloroacetate (DCA) can act as target therapy, as it may promote autophagy, reduce metastatic potential, and tumor proliferation in mammary tumor cell lines. This study aimed to analyze the effects of DCA as preoperative therapy for mammary tumors in bitches. Nineteen animals were selected, and they received DCA at a dose of 10 mg/kg orally every 12 hr, for 15 days. The periodic evaluation included hematological analysis (complete blood count and biochemical markers), evaluation of gastrointestinal adverse effects, evaluation of tumor volume, histopathological analysis, and immunohistochemical evaluation (Ki67 and cyclooxygenase-2/COX-2 markers). After treatment, there was a significant reduction in hematocrit (P=0.02) and leukocyte (P=0.04) means. Despite the variations for these two hematological parameters, the means remained within the reference range for the species. There were two cases of vomiting and one case of diarrhea. Most cases were classified as carcinoma in mixed tumor (n=7, 36.8%), followed by solid carcinoma (n=6, 31.6%). Nine cases (47.4%) showed reduced tumor volume, nine (47.4%) had stable disease, and one showed progressive disease. While there was no sample with a COX-2 score higher than 6, tumor samples with COX-2 scores 3 and 4 were significantly associated with stable disease or progression. DCA preoperative treatment for bitches with mammary gland tumors showed safety and potential cytoreduction in some cases.

Site percolation threshold of composite square lattices and its agroecology applications.

We analyze the percolation threshold of square lattices comprising a combination of sites with regular and extended neighborhoods. We found that the percolation threshold of these composed systems smoothly decreases with the fraction of sites with extended neighbors. This behavior can be well-fitted by a Tsallis q-Exponential function. We found a relation between the fitting parameters and the differences in the gyration radius among neighborhoods. We also compared the percolation threshold with the critical susceptibility of nearest and next-to-nearest neighbor monoculture plantations vulnerable to the spread of phytopathogen. Notably, the critical susceptibility in monoculture plantations can be described as a linear combination of two composite systems. These results allow the refinement of mathematical models of phytopathogen propagation in agroecology. In turn, this improvement facilitates the implementation of more efficient computational simulations of agricultural epidemiology that are instrumental in testing and formulating control strategies.

Evaluation of the Antibacterial, Anti-Cervical Cancer Capacity, and Biocompatibility of Different Graphene Oxides.

Cancer stands as one of the deadliest diseases in human history, marked by an inferior prognosis. While traditional therapeutic methods like surgery, chemotherapy, and radiation have demonstrated success in inhibiting tumor cell growth, their side effects often limit overall benefits and patient acceptance. In this regard, three different graphene oxides (GO) with variations in their degrees of oxidation were studied chemically and tissue-wise. The accuracy of the synthesis of the different GO was verified by robust techniques using X-ray photoelectron spectroscopy (XPS), as well as conventional techniques such as infrared spectroscopy (FTIR), RAMAN spectroscopy, and X-ray diffraction (XRD). The presence of oxygenated groups was of great importance. It affected the physicochemical properties of each of the different graphene oxides demonstrated in the presence of new vibrational modes related to the formation of new bonds promoted by the graphitization of the materials. The toxicity analysis in the Hep-2 cell line of graphene oxide formulations at 250 µg/mL on the viability and proliferation of these tumor cells showed low activity. GO formulations did not show high antibacterial activity against Staphylococcus aureus and Escherichia coli strains. However, the different graphene oxides showed biocompatibility in the subdermal implantation model for 30, 60, and 90 days in the biomodels. This allowed healing by restoring hair and tissue architecture without triggering an aggressive immune response.

Analysis and Bayesian estimation of a model for Chikungunya dynamics with relapse: An outbreak in Acapulco, Mexico.

Chikungunya is a vector-borne viral disease transmitted by Aedes aegypti and Aedes albopictus mosquitoes. It does not have any specific treatment, and there is no vaccine. Recent epidemiological data have indicated that a relapse of the infection can occur within three months of the initial infection; however, until now, mathematical models for the spread of the disease have not considered this factor. We propose a mathematical model for the transmission of the Chikungunya virus that considers relapse. We calculated the basic reproductive number $ (R_0) $ of the disease by using the next-generation operator method. We proved the existence of a forward bifurcation. We determined the existence and the global stability of the equilibrium points by using the Lyapunov function method. We fitted the model to data from an outbreak in 2015 in Acapulco, Mexico to estimate the model parameters and $ R_0 $ with the Bayesian approach via a Hamiltonian Monte Carlo method. In the local sensitivity analysis, we found that the fraction of infected individuals who become asymptomatic has a strong impact on the basic reproductive number and makes some control measures insufficient. The impact of the fraction of infected individuals who become asymptomatic should be considered in Chikungunya control strategies.

Biocompatibility Assessment of Polycaprolactone/Polylactic Acid/Zinc Oxide Nanoparticle Composites under In Vivo Conditions for Biomedical Applications.

The increasing demand for non-invasive biocompatible materials in biomedical applications, driven by accidents and diseases like cancer, has led to the development of sustainable biomaterials. Here, we report the synthesis of four block formulations using polycaprolactone (PCL), polylactic acid (PLA), and zinc oxide nanoparticles (ZnO-NPs) for subdermal tissue regeneration. Characterization by Fourier transform infrared spectroscopy (FT-IR) and X-ray diffraction (XRD) confirmed the composition of the composites. Additionally, the interaction of ZnO-NPs mainly occurred with the C=O groups of PCL occurring at 1724 cm-1, which disappears for F4, as evidenced in the FT-IR analysis. Likewise, this interaction evidenced the decrease in the crystallinity of the composites as they act as crosslinking points between the polymer backbones, inducing gaps between them and weakening the strength of the intermolecular bonds. Thermogravimetric (TGA) and differential scanning calorimetry (DSC) analyses confirmed that the ZnO-NPs bind to the carbonyl groups of the polymer, acting as weak points in the polymer backbone from where the different fragmentations occur. Scanning electron microscopy (SEM) showed that the increase in ZnO-NPs facilitated a more compact surface due to the excellent dispersion and homogeneous accumulation between the polymeric chains, facilitating this morphology. The in vivo studies using the nanocomposites demonstrated the degradation/resorption of the blocks in a ZnO-NP-dependant mode. After degradation, collagen fibers (Type I), blood vessels, and inflammatory cells continue the resorption of the implanted material. The results reported here demonstrate the relevance and potential impact of the ZnO-NP-based scaffolds in soft tissue regeneration.

Chitosan (CS)/Hydroxyapatite (HA)/Tricalcium Phosphate (ß-TCP)-Based Composites as a Potential Material for Pulp Tissue Regeneration.

This research focused on developing new materials for endodontic treatments to restore tissues affected by infectious or inflammatory processes. Three materials were studied, namely tricalcium phosphate ß-hydroxyapatite (ß-TCP), commercial and natural hydroxyapatite (HA), and chitosan (CS), in different proportions. The chemical characterization using infrared spectroscopy (FTIR) and X-ray diffraction (XRD) analysis confirmed the composition of the composite. Scanning electron microscopy (SEM) demonstrated that the design and origin of the HA, whether natural or commercial, did not affect the morphology of the composites. In vitro studies using Artemia salina (A. salina) indicated that all three experimental materials were biocompatible after 24 h, with no significant differences in mortality rate observed among the groups. The subdermal implantation of the materials in block form exhibited biocompatibility and biodegradability after 30 and 60 days, with the larger particles undergoing fragmentation and connective tissue formation consisting of collagen type III fibers, blood vessels, and inflammatory cells. The implanted material continued to undergo resorption during this process. The results obtained in this research contribute to developing endodontic technologies for tissue recovery and regeneration.

Mecanismos de acción y tratamiento del accidente cerebrovascular isquémico por COVID-19 / Mechanisms of action and treatment of ischemic stroke by COVID-19 / Mecanismos de ação e tratamento do AVC isquêmico pela COVID-19

Diversos mecanismos inflamatorios y protrombóticos pueden contribuir al aumento del riesgo de eventos cardiovasculares y accidentes cerebrovasculares en pacientes con COVID-19, afectando el enfoque del tratamiento y manejo de la enfermedad. La evidencia relacionada con los mecanismos fisiopatológicos del COVID-19 y su asociación con los accidentes cerebrovasculares son relevantes para guiar el tratamiento y el manejo de los pacientes, considerados como desafíos terapéuticos que surgen durante períodos de contagio masivo. Objetivo. Describir el mecanismo de acción y tratamiento del evento cerebro vascular isquémico por COVID-19. Metodología. Se realizó una revisión exhaustiva de la literatura mediante una revisión sistemática, en conformidad con las directrices establecidas por la declaración PRISMA. Se recopiló información de múltiples bases de datos científicas, utilizando términos y palabras clave ("Mecanismos de acción" OR "Mecanismos fisiopatológicos") AND ("Accidente cerebrovascular isquémico" OR "ACV isquémico") relacionados con los mecanismos de acción y tratamiento del accidente cerebrovascular isquémico asociado al COVID-19. Resultados. En total se obtuvo 41 entre PubMed y Science direct, previo a criterios 12 fueron seleccionados. Conclusión. Se determinaron los mecanismos de acción desencadenados por el COVID-19 para la formación de trombos y su relación con los accidentes cerebrovasculares. Además, se comprendió cómo el tratamiento de los accidentes cerebrovasculares afectaba a los pacientes que también padecían COVID-19. Se encontró que la tormenta de citocinas era un mecanismo influyente en la fisiopatología del COVID-19. En cuanto al tratamiento, la identificación de la enfermedad infecciosa causada por el virus SARS-CoV-2 resultó crucial en la gestión de los pacientes con accidente cerebrovascular.

Various inflammatory and prothrombotic mechanisms may contribute to the increased risk of cardiovascular events and stroke in patients with COVID-19, affecting the approach to treatment and management of the disease. Evidence regarding the pathophysiological mechanisms of COVID-19 and its association with stroke are relevant to guide the treatment and management of patients, considered as therapeutic challenges arising during periods of massive contagion. Objective. To describe the mechanism of action and treatment of ischemic cerebrovascular event by COVID-19. Methodology. A comprehensive review of the literature was performed by means of a systematic review, in accordance with the guidelines established by the PRISMA statement. Information was collected from multiple scientific databases, using terms and keywords ("Mechanisms of action" OR "Pathophysiological mechanisms") AND ("Ischemic stroke" OR "Ischemic stroke") related to the mechanisms of action and treatment of COVID-19-associated ischemic stroke. Results. A total of 41 were obtained between PubMed and Science direct, prior to criteria 12 were selected. Conclusion. The mechanisms of action triggered by COVID-19 for thrombus formation and its relation to stroke were determined. In addition, we gained insight into how stroke treatment affected patients who also had COVID-19. Cytokine storm was found to be an influential mechanism in the pathophysiology of COVID-19. In terms of treatment, identification of infectious disease caused by SARS-CoV-2 virus proved crucial in the management of stroke patients.

Vários mecanismos inflamatórios e pró-trombóticos podem contribuir para o aumento do risco de eventos cardiovasculares e acidente vascular cerebral (AVC) em pacientes com COVID-19, afetando a abordagem do tratamento e o manejo da doença. As evidências sobre os mecanismos fisiopatológicos da COVID-19 e sua associação com o AVC são relevantes para orientar o tratamento e o manejo dos pacientes, considerados como desafios terapêuticos que surgem durante períodos de contágio em massa. Objetivo. Descrever o mecanismo de ação e o tratamento do evento cerebrovascular isquêmico devido à COVID-19. Metodologia. Uma revisão abrangente da literatura foi realizada por meio de uma revisão sistemática, de acordo com as diretrizes estabelecidas pela declaração PRISMA. As informações foram coletadas de vários bancos de dados científicos, usando termos e palavras-chave ("Mechanisms of action" OR "Pathophysiological mechanisms") AND ("Ischaemic stroke" OR "Ischaemic stroke") relacionados aos mecanismos de ação e tratamento do acidente vascular cerebral isquêmico associado à COVID-19. Resultados. Foram obtidos 41 artigos no PubMed e no Science direct, e 12 foram selecionados de acordo com os critérios. Conclusão. Foram determinados os mecanismos de ação desencadeados pela COVID-19 para a formação de trombos e sua relação com o AVC. Além disso, entendemos como o tratamento do AVC afetou os pacientes que também tinham COVID-19. Descobriu-se que a tempestade de citocinas é um mecanismo influente na fisiopatologia da COVID-19. Em termos de tratamento, a identificação da doença infecciosa causada pelo vírus SARS-CoV-2 foi crucial no tratamento de pacientes com AVC.

Heterologous Expression of an Insecticidal Peptide Obtained from the Transcriptome of the Colombian Spider Phoneutria depilate.

Spider venoms are composed, among other substances, of peptide toxins whose selectivity for certain physiological targets has made them powerful tools for applications such as bioinsecticides, analgesics, antiarrhythmics, antibacterials, antifungals and antimalarials, among others. Bioinsecticides are an environmentally friendly alternative to conventional agrochemicals. In this paper, the primary structure of an insecticidal peptide was obtained from the venom gland transcriptome of the ctenid spider Phoneutria depilata (Transcript ID PhdNtxNav24). The peptide contains 53 amino acids, including 10 Cys residues that form 5 disulfide bonds. Using the amino acid sequence of such peptide, a synthetic gene was constructed de novo by overlapping PCRs and cloned into an expression vector. A recombinant peptide, named delta-ctenitoxin (rCtx-4), was obtained. It was expressed, folded, purified and validated using mass spectrometry (7994.61 Da). The insecticidal activity of rCtx-4 was demonstrated through intrathoracic injection in crickets (LD50 1.2 µg/g insect) and it was not toxic to mice. rCtx-4 is a potential bioinsecticide that could have a broad spectrum of applications in agriculture.

Use of liposomal amphotericin B in disseminated cutaneous leishmaniasis caused by Leishmania braziliensis in a pediatric patient with Down syndrome. / Uso de anfotericina B liposomal en leishmaniasis cutánea diseminada causada por Leishmania braziliensis en un paciente pediátrico con síndrome de Down.

We present a case of disseminated cutaneous leishmaniasis with extensive manifestation in a pediatric patient with Down syndrome. The case was confirmed by parasitological and immunological tests. The species was identified as Leishmania (Viannia) braziliensis by polymerase chain reaction-restriction fragment length polymorphisms (PCR-RFLP). The immune deficit that occurs as part of Down syndrome may have been the reason for the aggressive and prolonged clinical manifestations as well as the poor response to stibogluconate and deoxycholate amphotericin. The patient was treated with liposomal amphotericin B and at the end of therapy, showed clinical improvement of the lesions. This report highlights the challenges of the diagnosis and treatment of cutaneous leishmaniasis in immunosuppressed pediatric patients, especially under difficult social, economic and geographic conditions. Leishmaniasis should be considered as a differential diagnosis when treating atypical chronic dermatologic ulcers; the use of liposomal amphotericin in immunocompromised patients should also be considered in these cases.

Se presenta un caso de leishmaniasis selvática cutánea diseminada con manifestación extensa en una paciente pediátrica con síndrome de Down. El caso se confirmó a través de estudios parasitológicos e inmunológicos, mientras que la identificación se realizó mediante la técnica de reacción en cadena de la polimerasa-polimorfismos de longitud de fragmentos de restricción (PCR-RFLP, por sus siglas en inglés), determinándose la especie como Leishmania (Viannia) braziliensis. La manifestación clínica agresiva y prolongada con poca respuesta a estibogluconato y anfotericina desoxicolato pueden deberse al déficit inmunológico que se presenta como parte del síndrome de Down. La paciente eventualmente recibió tratamiento con anfotericina B liposomal y al término de la terapia, mostró mejoría clínica de las lesiones. El presente reporte ilustra los desafíos tanto de diagnóstico como tratamiento de leishmaniasis cutánea en pacientes pediátricos inmunosuprimidos, especialmente en un entorno de difícil acceso social, económico y geográfico, a los servicios de salud. Se recomienda considerar a la leishmaniasis en el diagnóstico diferencial cuando se atienda ulceras crónicas dermatológicas atípicas; así como tener en cuenta el uso de anfotericina liposomal en pacientes inmunocomprometidos.

Terapia nutricional enteral y parenteral en pacientes con diagnóstico de COVID-19 en UCI / Enteral and parenteral nutritional therapy in patients with a diagnosis of COVID-19 in ICU / Terapia nutricional enteral e parenteral em pacientes com diagnóstico de COVID-19 na UTI

Se evidencia una gran cifra de casos de enfermedad por el contagio de COVID-19, llamando la atención la desnutrición que está asociada directamente con la exposición y estancia prolongada en Unidad de Cuidados Intensivos, desencadenando a su paso un síndrome de mala alimentación o desnutrición por Sarcopenia. Objetivo. Detallar los beneficios de la nutrición enteral y parenteral en un cuadro de desnutrición en pacientes críticos con diagnóstico de COVID-19 en la Unidad de Cuidados Intensivos, rescatando los beneficios en la evolución clínica del paciente en términos de mortalidad y estancia hospitalaria. Metodología. Se realizó un estudio de revisión sistemática sobre la nutrición enteral y parenteral en pacientes críticos con diagnóstico de COVID-19, con enfoque de búsqueda de información en la base de datos como: PubMed, Lilacs, Scielo, Scopus, Web of Science. La búsqueda comprendió desde el periodo 2020-2022. Conclusión. Los pacientes en estado crítico por infecciones de COVID-19 están ligados a un estado grave de inflamación que se asocian con una serie de procesos miopáticos agudos, precoces y agresivos que desencadenan un mayor consumo calórico- proteico, menor tolerancia a la terapia nutricional y por ende a la pérdida muscular. Se determinó con esta investigación que la nutrición enteral y parenteral en pacientes críticos con diagnóstico de COVID-19 desencadenan diversos beneficios de carácter clínico al mejorar la ingesta nutricional, menor infección nosocomial, menor mortalidad en unidad de cuidados intensivos y predisposición a la mejora funcional disminuyendo la estancia hospitalaria y mejorando la evolución clínica del paciente.

There is evidence of a large number of cases of disease due to COVID-19 infection, drawing attention to the malnutrition that is directly associated with exposure and prolonged stay in the Intensive Care Unit, triggering a syndrome of malnutrition or malnutrition due to sarcopenia. Objective. To detail the benefits of enteral and parenteral nutrition in a case of malnutrition in critically ill patients diagnosed with COVID-19 in the Intensive Care Unit, highlighting the benefits in the clinical evolution of the patient in terms of mortality and hospital stay. Methodology. A systematic review study was conducted on enteral and parenteral nutrition in critically ill patients with diagnosis of COVID-19, with an information search approach in databases such as: PubMed, Lilacs, Scielo, Scopus, Web of Science. The search covered the period 2020-2022. Conclusion. Critically ill patients with COVID-19 infections are linked to a severe state of inflammation associated with a series of acute, early and aggressive myopathic processes that trigger a higher caloric-protein consumption, lower tolerance to nutritional therapy and thus muscle loss. It was determined with this research that enteral and parenteral nutrition in critical patients diagnosed with COVID-19 trigger several clinical benefits by improving nutritional intake, lower nosocomial infection, lower mortality in the intensive care unit and predisposition to functional improvement, reducing hospital stay and improving the clinical evolution of the patient.

Há evidências de um grande número de casos de doença devido à infecção por COVID-19, chamando a atenção para a desnutrição que está diretamente associada à exposição e à permanência prolongada na Unidade de Terapia Intensiva, desencadeando uma síndrome de desnutrição ou desnutrição por sarcopenia. Objetivo. Detalhar os benefícios da nutrição enteral e parenteral em um caso de desnutrição em pacientes críticos diagnosticados com COVID-19 na Unidade de Terapia Intensiva, destacando os benefícios na evolução clínica do paciente em termos de mortalidade e permanência hospitalar. Metodologia. Foi realizado um estudo de revisão sistemática sobre nutrição enteral e parenteral em pacientes graves com diagnóstico de COVID-19, com foco na busca de informações em bases de dados como: PubMed, Lilacs, Scielo, Scopus, Web of Science. A pesquisa abrangeu o período de 2020 a 2022. Conclusão. Pacientes criticamente enfermos com infecções por COVID-19 estão ligados a um estado grave de inflamação associado a uma série de processos miopáticos agudos, precoces e agressivos que desencadeiam maior consumo calórico-proteico, menor tolerância à terapia nutricional e, portanto, perda muscular. Esta pesquisa determinou que a nutrição enteral e parenteral em pacientes críticos diagnosticados com COVID-19 desencadeia vários benefícios clínicos, melhorando a ingestão nutricional, reduzindo a infecção nosocomial, reduzindo a mortalidade em unidades de terapia intensiva e predispondo à melhora funcional, reduzindo a permanência hospitalar e melhorando a evolução clínica do paciente.

Relación de triglicéridos y estimación de riesgocardiovasculares en mujeres posmenopáusicas / Triglyceride ratio and cardiovascular risk estimation inpostmenopausal women

Objetivo: Determinar la relación de triglicéridos basales, con el riesgo a desarrollar enfermedades cardiovasculares en mujeres posmenopáusicas. Método: Estudio descriptivo, observacional y transversal, donde a 31 pacientes posmenopáusicas y sin antecedentes de enfermedades cardiometabólicas, se les determinó parámetros antropométricos (peso, talla, índice de masa corporal -IMC-); perfil lipídico en ayunas (colesterol total, triglicéridos o TG, lipoproteínas de baja y alta densidad -LDL, HDL-), por método enzimático colorimétrico, apolipoproteína B 100 (Apo B-100) por inmunodifusión radial, índices matemáticos LDL/Apo B-100y TG/HDL y cálculo de colesterol no-HDL. Resultados: los promedio y desviación de las variables fueron: edad:59±5 años con tiempo de posmenopausia: 8,77±3,92 años; IMC:27,6±4,4 kg/m.; colesterol total: 194±36 mg/dl; triglicéridos: 85±35 mg/dl; HDL: 33±8 mg/dl; LDL: 144±33 mg/dl; no-HDL: 159±37 mg/dl; Apo B-100: 172±246 mg/dl; LDL/Apo B-100: 1,15±0,03 y TG/HDL: 4,46±1,28. Discusión: Las pacientes se encontraron con sobrepeso, triglicéridos normales, colesterol total y LDL aumentado y las HDL bajas. El LDL-C/Apo B-100-100, que se relaciona con el tamaño y densidad de LDL, estuvo por debajo de 1,3 indicando la presencia de partículas pequeñas-densas, mientras TG/HDL, que se usa para estimar riesgo cardiovascular, estuvo por encima del corte establecido de 3,5. Conclusiones: Al relacionar los triglicéridos basales con LDL/Apo B-100 y TG/HDL, se observa que a partir del valor de triglicéridos de 100 mg/dl, se observa la presencia de partículas de lipoproteínas pequeñas-densas, y un alto riesgo cardiovascular, por lo que es necesario en mujeres posmenopáusicas el seguimiento a partir del valor de triglicéridos en 100 mg/dL ya que pudiera implicar el desarrollo de enfermedades cardiovasculares, en esta población(AU)

Objective: To determine the relationship of basal triglycerides with the risk of developing cardiovascular disease in postmenopausal women. Method: Descriptive, observational and cross-sectional study, where 31 postmenopause patients with no history of cardiometabolic disease were determined anthropometric parameters (weight, height, BMI); fasting lipid profile (total cholesterol, triglycerides or TG, LDL,HDL, by colorimetric enzymatic method), Apo B-100 (byradial immunodiffusion), LDL/Apo B-100 and TG/HDL mathematical indices and calculation of non-HDL cholesterol. Results: the mean and deviation of the variables were: age:59±5 years with postmenopause time: 8.77±3.92 years; BMI:27.6±4.4 kg/m2; total cholesterol: 194±36 mg/dl; triglycerides:85±35 mg/dl; HDL: 33±8 mg/dl; LDL: 144±33 mg/dl; non-HDL: 159±37 mg/dl; Apo B-100: 172±246 mg/dl; LDL/Apo B-100: 1.15±0.03 and TG/HDL: 4.46±1.28. Discussion: Patients were found to be overweight, normal triglycerides, total and LDL cholesterol high, and low HDL. LDL-C/ApoB-100-100, which is related to LDL size and density, was below 1.3 indicating the presence of small-dense particles, while TG/HDL, which is used to estimate cardiovascular risk, was above the established cut-off of 3.5. Conclusions: When relating the basal triglycerides with LDL/Apo B-100 and TG/HDL, it is observed that from the triglyceride value of 100mg/dl, the presence of small-dense lipoprotein particuals anda high cardiovascular risk is observed, so it is necessary in postmenopausal women to follow up from the triglycerid evalue in 100 mg/dL since it could imply the development of cardiovascular diseases, in this population(AU)

Inexpensive Materials for Microsurgery in Middle- and Low-Income Countries.

With the continuous incorporation of new technologies and advancements in surgical technique, microsurgical procedures around the world have generated a higher success rate and innovative procedures are now possible. In this setting, limitations regarding accessibility and acquisition of medical resources and equipment for these types of operations may be difficult in developing countries. We believe the dexterities of surgeons go beyond the surgical technique, meaning that we are able to use everyday materials to re-create affordable solutions that can be used during surgery in a safe way. This manuscript presents our experience with different surgical instruments and gadgets, developed out of necessity, to improve microsurgical interventions in developing countries.

Uso de anfotericina B liposomal en leishmaniasis cutánea diseminada causada por Leishmania braziliensis en un paciente pediátrico con síndrome de Down / Use of liposomal anfotericin B in diseminated cutaneous leishmaniasis caused by Leishmania braziliensis in a pediatric patient with Down syndrome

Se presenta un caso de leishmaniasis selvática cutánea diseminada con manifestación extensa en una paciente pediátrica con síndrome de Down. El caso se confirmó a través de estudios parasitológicos e inmunológicos, mientras que la identificación se realizó mediante la técnica de reacción en cadena de la polimerasa-polimorfismos de longitud de fragmentos de restricción (PCR-RFLP, por sus siglas en inglés), determinándose la especie como Leishmania (Viannia) braziliensis. La manifestación clínica agresiva y prolongada con poca respuesta a estibogluconato y anfotericina desoxicolato pueden deberse al déficit inmunológico que se presenta como parte del síndrome de Down. La paciente eventualmente recibió tratamiento con anfotericina B liposomal y al término de la terapia, mostró mejoría clínica de las lesiones. El presente reporte ilustra los desafíos tanto de diagnóstico como tratamiento de leishmaniasis cutánea en pacientes pediátricos inmunosuprimidos, especialmente en un entorno de difícil acceso social, económico y geográfico, a los servicios de salud. Se recomienda considerar a la leishmaniasis en el diagnóstico diferencial cuando se atienda ulceras crónicas dermatológicas atípicas; así como tener en cuenta el uso de anfotericina liposomal en pacientes inmunocomprometidos.

We present a case of disseminated cutaneous leishmaniasis with extensive manifestation in a pediatric patient with Down syndrome. The case was confirmed by parasitological and immunological tests. The species was identified as Leishmania (Viannia) braziliensis by polymerase chain reaction-restriction fragment length polymorphisms (PCR-RFLP). The immune deficit that occurs as part of Down syndrome may have been the reason for the aggressive and prolonged clinical manifestations as well as the poor response to stibogluconate and deoxycholate amphotericin. The patient was treated with liposomal amphotericin B and at the end of therapy, showed clinical improvement of the lesions. This report highlights the challenges of the diagnosis and treatment of cutaneous leishmaniasis in immunosuppressed pediatric patients, especially under difficult social, economic and geographic conditions. Leishmaniasis should be considered as a differential diagnosis when treating atypical chronic dermatologic ulcers; the use of liposomal amphotericin in immunocompromised patients should also be considered in these cases.

Chitosan-Polyvinyl Alcohol Nanocomposites for Regenerative Therapy.

Tissue accidents provide numerous pathways for pathogens to invade and flourish, causing additional harm to the host tissue while impeding its natural healing and regeneration. Essential oils (EOs) exhibit rapid and effective antimicrobial properties without promoting bacterial resistance. Clove oils (CEO) demonstrate robust antimicrobial activity against different pathogens. Chitosan (CS) is a natural, partially deacetylated polyamine widely recognized for its vast antimicrobial capacity. In this study, we present the synthesis of four membrane formulations utilizing CS, polyvinyl alcohol (PVA), and glycerol (Gly) incorporated with CEO and nanobioglass (n-BGs) for applications in subdermal tissue regeneration. Our analysis of the membranes' thermal stability and chemical composition provided strong evidence for successfully blending polymers with the entrapment of the essential oil. The incorporation of the CEO in the composite was evidenced by the increase in the intensity of the band of C-O-C in the FTIR; furthermore, the increase in diffraction peaks, as well as the broadening, provide evidence that the introduction of CEO perturbed the crystal structure. The morphological examination conducted using scanning electron microscopy (SEM) revealed that the incorporation of CEO resulted in smooth surfaces, in contrast to the porous morphologies observed with the n-BGs. A histological examination of the implanted membranes demonstrated their biocompatibility and biodegradability, particularly after a 60-day implantation period. The degradation process of more extensive membranes involved connective tissue composed of type III collagen fibers, blood vessels, and inflammatory cells, which supported the reabsorption of the composite membranes, evidencing the material's biocompatibility.

Manifestaciones clínicas "no criterio" del Síndrome Antifosfolipídico. Presentación de una cohorte nacional

Introducción: El síndrome antifosfolipídico (SAF) es una afección de origen autoinmune caracterizada por trombosis, pérdidas fetales recurrentes y anticuerpos antifosfolipídicos (aFL). Existen manifestaciones clínicas no contempladas en los criterios clasificatorios, que se denominan manifestaciones no criterio. Objetivo: Analizar las manifestaciones clínicas del SAF, enfatizando las manifestaciones no criterio y su relación con el perfil de autoanticuerpos en un hospital general de Montevideo, Uruguay. Métodos: Se realizó un estudio retrospectivo de las historias clínicas de pacientes con diagnóstico definitivo o sospecha de SAF en un servicio de medicina ambulatoria de enfermedades autoinmunes, en el Hospital Maciel, asistidos entre el 2010 y 2019. Resultados: Se incluyeron 78 pacientes, con edad media de 50,3 ± 14,5 años, 69 (88,5%) correspondió a sexo femenino. Cuarenta y seis (59,0%) pacientes presentaron SAF secundario, de los cuales 28 (35,9%) asociaron LES. La trombosis venosa de miembros inferiores fue la manifestación más frecuente (51,3%). Dieciocho (24,0%) pacientes presentaron trombosis arteriales en forma de accidente cerebrovascular. Cincuenta y nueve (75.6%) casos presentaron, además de las manifestaciones clasificatorias, alguna de las manifestaciones "no criterio" y éstas se manifestaron de forma aislada en 10 (12.8%) pacientes. Las manifestaciones no clasificatorias más frecuentes fueron artralgias, livedo reticularis, migraña y trombocitopenia. Se observó una asociación significativa entre la presencia de anti-ß2GPI con manifestaciones cutáneas y de trombocitopenia con al menos una manifestación trombótica. Conclusiones: Las manifestaciones "no criterio" del SAF se presentaron en casi 3 de cada 4 casos, frecuencia similar a la observada en otras series. La presencia aislada de manifestaciones "no criterio" podrían hacer sospechar un SAF y en algunos casos, conducir a la solicitud de anticuerpos.

Introduction: Antiphospholipid syndrome (APS) is an autoimmune condition characterized by thrombosis, recurrent fetal loss, and antiphospholipid antibodies. There are clinical manifestations not contemplated in the classification criteria, which are called non-criterion manifestations. Objective: To analyze the clinical manifestations of APS, emphasizing the non-criterion manifestations and their relationship with the autoantibody profile in a general hospital in Montevideo, Uruguay. Methods: A retrospective analysis of the medical records of patients with a definitive or suspected diagnosis of APS in an outpatient medicine service for autoimmune diseases, at the Maciel Hospital, assisted between 2010 and 2019, was carried out. Results: 78 patients were included, with a mean age of 50.3 +/- 14.5 years, 69 (88.5%) were female. Forty-six (59.0%) patients presented secondary APS, of which 28 (35.9%) associated SLE. Venous thrombosis of the lower limbs was the most frequent manifestation (51.3%). Eighteen (24.0%) patients presented arterial thrombosis in the form of cerebrovascular accident. Fifty-nine (75.6%) cases presented, in addition to the classification manifestations, some of the "non-criterion" manifestations and these manifested in an isolated way in 10 (12.8%) patients. The most frequent non-classifying manifestations were arthralgia, livedo reticularis, migraine and thrombocytopenia. A significant association was observed between the presence of anti-ß2GPI with cutaneous manifestations and thrombocytopenia with at least one thrombotic manifestation. Conclusions: Non-criterion manifestations of APS occurred in almost 3 out of 4 cases, a frequency similar to that observed in other series. The isolated presence of "non-criterion" manifestations could lead to suspicion of APS and, in some cases, lead to the request for antibodies.

Introdução: A síndrome antifosfolipídica (SAF) é uma doença de origem auto-imune caracterizada por trombose, perdas fetais recorrentes e anticorpos antifosfolípidos (aFL). Existem manifestações clínicas não abrangidas pelos critérios de classificação, que são designadas por manifestações não-critério. Objetivo: Analisar as manifestações clínicas da SAF, enfatizando as manifestações não-critério e sua relação com o perfil de auto-anticorpos em um hospital geral de Montevidéu, Uruguai. Métodos: Foi realizado um estudo retrospectivo dos prontuários de pacientes com diagnóstico definitivo ou suspeita de SAF em um serviço ambulatorial de doenças autoimunes do Hospital Maciel, atendidos entre 2010 e 2019. Resultados: Foram incluídos 78 pacientes, com idade média de 50,3 +/- 14,5 anos, sendo 69 (88,5%) do sexo feminino. Quarenta e seis (59,0%) pacientes apresentavam PFS secundária, dos quais 28 (35,9%) tinham LES associado. A trombose venosa dos membros inferiores foi a manifestação mais frequente (51,3%). Dezoito (24,0%) doentes apresentaram trombose arterial sob a forma de acidente vascular cerebral. Cinquenta e nove (75,6%) casos apresentaram, para além das manifestações classificatórias, algumas das manifestações "não-critério" e estas manifestações foram isoladas em 10 (12,8%) doentes. As manifestações não classificatórias mais frequentes foram artralgias, livedo reticularis, enxaqueca e trombocitopenia. Foi observada uma associação significativa entre a presença de anti-ß2GPI com manifestações cutâneas e trombocitopenia com pelo menos uma manifestação trombótica. Conclusões: As manifestações "não-critério" de SAF ocorreram em quase 3 de cada 4 casos, frequência semelhante à observada noutras séries. A presença isolada de manifestações "não-critério" pode levantar a suspeita de SAF e, nalguns casos, levar à pesquisa de anticorpos.

Grado de oxidación en pacientes con Diabetes Mellitus Tipo 2 / Oxidation degree in patients with Type 2 Diabetes Mellitus

La peroxidación lipídica es un proceso complejo que hace referencia a la degradación oxidativa de los lípidos, a través del cual los radicales libres capturan electrones de los lípidos en las membranas celulares, lo cual compromete la integridad y la función de la membrana. Mediante una serie de reacciones en cadena, se forman los peróxidos lipídicos que se degradan para formar compuestos reactivos como el malondialdehído (MDA) y 4-hidroxinonenal, los cuáles pueden ser cuantificados por diferentes metodologías. Objetivo: El presente trabajo se realizó con la finalidad establecer el grado de oxidación en una población con diabetes tipo 2 (DM2).Métodos: Estudio descriptivo, analítico y transversal; muestra de 55 personas, conformada por 30 controles entre 25-35 años y 25 pacientes con DM2 entre 25-50 años, se les determinó glicemia, triglicéridos, colesterol total, HDL-Colesterol y LDL-Colesterol por método colorimétrico enzimático, así como se determinó la concentración de 4-hidroxinonenal como un marcador de estrés oxidativo Resultados: Los valores de 4-hidroxinonenal en la población control oscilaron entre 2,61y 6,83 µmol/L y en los diabéticos de 28,99 y 73,74 µmol/L., encontrándose diferencias estadísticamente significativas entre ambas poblaciones, así como en el perfil lipídico y en la glicemia entre ambos grupos. Conclusión: Los resultados demuestran una elevación de la peroxidación lipídica en pacientes diabéticos, lo cual es indicativo de estrés oxidativo y riesgo adicional en estos pacientes que podrían conllevar a las complicaciones crónicas dela diabetes tipo 2(AU)

Lipid peroxidation is a complexprocess that refers to the oxidative degradation of lipids, through which free radicals capture electrons from lipids incell membranes, which compromises the integrity and functionof the membrane. Trough a series of chain reactions, lipidperoxides are formed that degrade to form reactive compoundssuch as malondialdehyde (MDA) and 4-hydroxynonenal, whichcan be quantified by different methodologies. Objective: The present work was carried out with the purpose ofestablishing the degree of oxidation in a population withtype 2 diabetes (DM2). Methods: the sample was 55 people,made up of 30 controls between 25-35 years and 25 patientswith DM2 and between 25-50 years, glycemia, triglycerides,total cholesterol, HDL-Cholesterol and LDL-Cholesterol were etermined by colorimetric method. enzymatic, as well as theconcentration of 4-hydroxynonenal was determined as a markerof oxidative stress. Results: The values of 4-hydroxynonenal inthe control population ranged between 2.61 and 6.83 µmol/Land in diabetics 28.99 and 73.74 µmol/L., finding statisticallysignificant differences between both populations, as well as inthe lipid profile and glycemia between both groups. Conclusion:The results show an elevation of lipid peroxidation in diabeticpatients, which is indicative of oxidative stress and additionalrisk in these patients that could lead to chronic complications oftype 2 diabetes(AU)

Distribución geográfica de la familia de caracoles terrestres Spiraxidae (Gastropoda: Pulmonata) en México / Geographic distribution of the land snail family Spiraxidae (Gastropoda: Pulmonata) in Mexico

Resumen Introducción: Spiraxidae es la familia de gasterópodos terrestres más diversa de México con una distribución principalmente neotropical. Sin embargo, la influencia de las condiciones ambientales de esta región en su distribución aún es poco conocida. Objetivo: Determinar las afinidades zoogeográficas y la influencia de factores ambientales en la distribución de Spiraxidae en México. Métodos: Compilamos registros de distribución de museos y usamos modelos para establecer áreas con composición de especies, concentración de especies, afinidades y relaciones con variables ambientales similares. Resultados: Encontramos 231 especies y subespecies, 96 en el estado de Veracruz y 74 en la Sierra Madre Oriental. La principal afinidad zoogeográfica fue neotropical. El bosque mesófilo de montaña tuvo la mayor cantidad de especies y subespecies (93). Tres de los grupos zonales tienen una composición particular de especies y el 67 % de las especies son especialistas de hábitat. La presencia de especies sigue un gradiente ambiental, con la cubierta de árboles de hoja perenne de hoja ancha y la precipitación media anual como variables determinantes. Las especies del norte tuvieron mayor tolerancia a la aridez y menor cobertura de hojas. Conclusiones: Spiraxidae tiene su mayor diversidad en los estados del Sur de México; sin embargo, la zona nororiental tiene más registros de especies. Estos caracoles se encuentran principalmente en bosques mesófilos de montaña y bosques tropicales siempre verdes. Las especies del norte de México tuvieron una mayor tolerancia a los sitios con poca lluvia y menos cobertura de árboles de hoja perenne de hoja ancha que las especies del sur.

Abstract Introduction: Spiraxidae is the most diverse family of terrestrial gastropods in Mexico with a mainly neotropical distribution. However, the influence of environmental conditions in this region on its distribution is still poorly known. Objective: To determine zoogeographic affinities and the influence of environmental factors on the distribution of Spiraxidae in Mexico. Methods: We compiled museum distribution records and used models to establish areas with similar species composition, species concentration, affinities and relationship with environmental variables. Results: We found 231 species and subspecies, 96 in Veracruz state and 74 in Sierra Madre Oriental. The main zoogeographic affinity was neotropical. Mountain mesophyll forest had the most species and subspecies (93). Three of zone groups have a particular species composition and 67 % of the species are habitat specialists. Species presence follows an environmental gradient, with broadleaf evergreen tree cover and average annual precipitation as determining variables. Northern species had greater tolerance to aridity and reduced leaf cover. Conclusions: Spiraxidae has its greatest diversity in the Southern states of Mexico; however, the Northeastern zone has more species records. These snails mostly occur in mesophyll mountain forest and tropical evergreen forest. Species from Northern Mexico had greater tolerance to sites with low rainfall and less broadleaf evergreen tree cover than Southern species.

A atuação das Ligas Acadêmicas vinculadas à Associação Brasileira das Ligas de Cirurgia Plástica / The Performance of Academic Leagues Linked to the Brazilian Association of Plastic Surgery Leagues

Introdução: As Ligas Acadêmicas de Cirurgia Plástica (LCP) são organizações estudantis que objetivam complementar a formação acadêmica em cirurgia plástica. Atuam por meio dos pilares de ensino, pesquisa e extensão que promovem o contato dos estudantes com a realidade social em que estão inseridos, permitindo-os entender as verdadeiras necessidades da população e atuar como agentes de transformação social. No entanto, a abordagem do tema na literatura ainda é incipiente. O presente trabalho objetiva descrever a atuação das LCP vinculadas à Associação Brasileira das Ligas de Cirurgia Plástica (ABLCP). Métodos: Tratou-se de um estudo transversal, descritivo, multicêntrico de abordagem qualiquantitativa, mediante a aplicação de um questionário de 19 perguntas construídas de modo a evitar os vieses demonstrados no Catálogo de Vieses em Questionários. Resultados: Foi observado que existem 78 LCPs e 1873 ligantes, presentes em 58 cidades ao longo de 20 estados, sendo a Região Sudeste com o maior número de ligas e ligantes, já a Região Norte apresenta a menor quantidade de ligas e alunos. Além do mais, foi visto que 78,2% das ligas são vinculadas à ABLCP e apresentam atividades nos três eixos (educação, pesquisa e extensão). Em geral, as ligas têm menos participação em pesquisa. Conclusão: A ABLCP objetiva melhorar a performance das ligas, inspecionar e estimular suas atividades, uma vez que as ligas possuem um papel importante na educação médica.

Introduction: The Academic Leagues are non-profit autonomous civil and scientific student entities, of indefinite duration, which brings together medical students and professors. The Brazilian Association of Plastic Surgery Leagues (ABLCP) is an organization linked to the Brazilian Society of Plastic Surgery (SBCP), considered its academic segment, thus establishing the proximity between Academic Leagues of Plastic Surgery (PSL) and SBCP. The present study aims to describe the profile of the associated leagues. Methods: This was a cross-sectional, descriptive, multicenter study with qualitative and quantitative approach through application of an online questionnaire with 19 questions. Duplicated or unfinished records were excluded. Results: It was observed that there are 78 PSLs and 1873 binders, present in 58 cities arranged in 20 federative units, being the Southeast region with the largest number of alloys and binders and the one with the smallest number was the North region. In addition, it was observed that 78.2% of the PSLs linked to the ABLCP presented activities in the three axes (Education, Research and Extension/Assistance) simultaneously. In general, the Leagues obtained less participation in research. Conclusions: ABLCPs performance in relation to LCPs has the objective of seeking alignment, inspection and stimulus for their activities, since alloys have an important role in medical education.

Effect of the variation in the extracellular concentration of l-arginine in the physiology of Leishmania (Viannia) braziliensis and its susceptibility to some antileishmanial drugs.

The knowledge about amino acid metabolism in trypanosomatids is a valuable source of new therapeutic targets. l-arginine is an essential amino acid for Leishmania parasites, and it participates in the synthesis of polyamines, a group of essential nutrients used for nucleic acids, proteins biosynthesis, and redox modulation necessary for proliferation. In the present study, we evaluated the effect of changes in the availability of this amino acid on promastigotes and intracellular amastigotes on U937 macrophages and showed that the absence of l-arginine in culture medium negatively influences the growth and infectivity of Leishmania (Viannia) braziliensis, causing a decrease in the percentage of the infected cells and parasite load tested through light microscopy. In addition, the absence of l-arginine resulted in the parasite's inability to regulate its reactive oxygen species (ROS) production, which persisted for up to 24 h by flow cytometry following the probe H2DCF-DA dye. Moreover, the differentiation of promastigote to amastigote in axenic culture was more significant at low concentrations of l-arginine suggesting that this depletion induces a stress environment to increase this transformation under axenic conditions. No association was established between the availability of l-arginine and the effectiveness of antileishmanial drugs. All these results confirm the importance of l-arginine in L. braziliensis life cycle vital processes, such as its replication and infectivity, as documented in other Leishmania species. Based on these results, we proposed that the l-arginine uptake/metabolism route is possible in exploring new antileishmanial drugs.