Práticas profissionais no primeiro encontro dos pais com recém-nascido na unidade neonatal / Professional practices in the first meeting between parents and newborn in the neonatal unit / Prácticas profesionales en el primer encuentro entre padres y recién nacido en la unidad neonatal

Objetivo: analisar as práticas profissionais no primeiro encontro dos pais com recém-nascido na unidade neonatal. Método: estudo quantitativo, descritivo e transversal, desenvolvido com 69 profissionais de saúde da unidade de terapia intensiva neonatal de um Hospital Universitário no Rio de Janeiro, após aprovação pelo Comitê de Ética em Pesquisa. Os dados foram coletados no período de março a julho de 2021, por meio de questionário online, e analisados mediante estatística descritiva simples, percentual e média. Resultados: as práticas profissionais foram adequadas quanto possibilitar aos pais: o toque materno/paterno (91,3%); o livre acesso à unidade neonatal (86,9%); e a realização de cuidados com o bebê (81,1%). Conclusão: a maioria das práticas profissionais está alinhada às recomendações do Método Canguru. Contudo, as fragilidades relativas ao acolhimento evidenciam lacunas na abordagem da temática na formação profissional e em atividades de educação continuada.

Objective: to examine the professional practices in the first meeting between parents and newborn in the neonatal unit. Method: in this quantitative, descriptive, cross-sectional study conducted with 69 health personnel from the neonatal intensive care unit of a university hospital in Rio de Janeiro, after approval by the research ethics committee, data were collected from March to July 2021 by online survey and analyzed using simple percentage and average descriptive statistics. Results: the professional practices were appropriate in that they allowed parents: maternal/paternal touch (91.3%); free access to the neonatal unit (86.9%); and to provide care for the baby (81.1%). Conclusion: the professional practices were mostly in line with the recommendations of the Kangaroo Method. However, weaknesses in receptiveness highlighted gaps in how the subject was approached in training activities and continued professional development.

Objetivo: analizar las prácticas profesionales en el primer encuentro entre padres y recién nacido en la unidad neonatal. Método: estudio cuantitativo, descriptivo y transversal, desarrollado con 69 profesionales de la salud de la unidad de cuidados intensivos neonatales de un Hospital Universitario de Rio de Janeiro, previa aprobación del Comité de Ética en Investigación. Los datos fueron recolectados de marzo a julio de 2021, a través de una encuesta en línea, y analizados mediante estadística descriptiva simple, porcentaje y promedio. Resultados: las prácticas profesionales fueron adecuadas en cuanto a posibilitar a los padres: el toque materno/paterno (91,3%); el libre acceso a la unidad neonatal (86,9%); y la prestación de cuidados al bebé (81,1%). Conclusión: la mayoría de las prácticas profesionales está acorde con las recomendaciones del Método Canguro. Sin embargo, las debilidades relacionadas con la acogida evidencian lagunas acerca del enfoque del tema en la formación profesional y en actividades de educación continua.

Concussion severity and functional outcome using biomarkers in children and youth involved in organized sports, recreational activities and non-sport related incidents.

This prospective multicenter study evaluated differences in concussion severity and functional outcome using glial and neuronal biomarkers glial Fibrillary Acidic (GFAP) and Ubiquitin C-terminal Hydrolase (UCH-L1) in children and youth involved in non-sport related trauma, organized sports, and recreational activities. Children and youth presenting to three Level 1 trauma centersfollowing blunt head trauma with a GCS 15 with a verified diagnosis of a concussion were enrolled within 6 hours of injury. Traumatic intracranial lesions on CT scan and functional outcome within 3 months of injury were evaluated. 131 children and youth with concussion were enrolled, 81 in the no sports group, 22 in the organized sports group and 28 in the recreational activities group. Median GFAP levels were 0.18, 0.07, and 0.39 ng/mL in the respective groups (p = 0.014). Median UCH-L1 levels were 0.18, 0.27, and 0.32 ng/mL respectively (p = 0.025). A CT scan of the head was performed in 110 (84%) patients. CT was positive in 5 (7%), 4 (27%), and 5 (20%) patients, respectively. The AUC for GFAP for detecting +CT was 0.84 (95%CI 0.75-0.93) and for UCH-L1 was 0.82 (95%CI 0.71-0.94). In those without CT lesions, elevations in UCH-L1 were significantly associated with unfavorable 3-month outcome. Concussions in the 3 groups were of similar severity and functional outcome. GFAP and UCH-L1 were both associated with severity of concussion and intracranial lesions, with the most elevated concentrations in recreational activities .

Recursos del ambiente familiar y rendimiento de lectura en adolescentes / Recursos do ambiente familiar e desempenho de leitura em adolescentes / Family environment resources and reading performance by adolescents

Este estudo teve como objetivo verificar a associação entre os recursos do ambiente familiar e a leitura de adolescentes. Participaram 106 adolescentes, de ambos os sexos, de 11 a 16 anos, sem queixas de dificuldades de aprendizagem. Para a coleta de dados utilizou-se um texto narrativo, o questionário de múltipla escolha sobre o texto e o de Recursos do Ambiente Familiar, adaptado. Foi realizada a análise descritiva e inferencial por meio dos testes correlação de Spearman, Mann-Whitney e Kruskal Wallis, com nível de significância de 5%. Os recursos que promovem os processos proximais e as práticas parentais contribuíram para um melhor desempenho de leitura. Em contrapartida, a categoria de atividades previsíveis contribuiu negativamente. Assim, o ambiente e os recursos influenciaram o desempenho leitor dos adolescentes. Conclui-se que é importante a elaboração de medidas escolares e de políticas públicas, para fortalecer a relação família-escola, ampliar os recursos familiares e tornar o ambiente favorável ao ensino.

En este estudio se tuvo como objetivo verificar la asociación entre los recursos del ambiente familiar y la lectura de adolescentes. Participaron 106 adolescentes, de ambos sexos, de 11 a 16 años, sin quejas de dificultades de aprendizaje. Para la recopilación de datos se utilizó un texto narrativo, el cuestionario de múltiple elección sobre el texto y el de Recursos del Ambiente Familiar, adaptado. Se realizó el análisis descriptivo e inferencial por intermedio de las pruebas correlación de Spearman, Mann-Whitney y Kruskal Wallis, con nivel de significancia del 5%. Los recursos que promueven los procesos proximales y las prácticas parentales contribuyeron al mejor rendimiento de lectura. Por otro lado, la categoría de actividades previsibles contribuyó negativamente. Así, el ambiente y los recursos influenciaron el rendimiento lector de los adolescentes. Se concluye que es importante la elaboración de medidas escolares y de políticas públicas, para fortalecer la relación familia-escuela, ampliar los recursos familiares y tornar el ambiente favorable a la enseñanza.

This study aimed to verify the association between the resources of the family environment and teenage reading. A total of 106 adolescents of both sexes, aged between 11 and 16 years, without learning difficulties, participated in the study. For data collection, a narrative text, a multiple-choice questionnaire about the text and an adapted Family Environment Resources questionnaire were used. Descriptive and inferential analysis was performed using Spearman, Mann-Whitney and Kruskal Wallis correlation tests, with a significance level of 5%. Resources that promote proximal processes and parenting practices contributed to better reading performance. In contrast, the predictable activities category contributed negatively. Thus, the environment and resources influenced the adolescents' reading performance. It is concluded that the elaboration of school measures and public policies is important to strengthen the family-school relationship, expand family resources and make the environment favorable to teaching.

Suspect asymptomatic lesions: Congenital hypertrophy of the Retinal Pigment Epithelium (CHRPE).

Congenital hypertrophy of the retinal pigment epithelium is a rare benign tumor of the ocular fundus that may vary according to three types. It is frequently asymptomatic and diagnosed during routine ophthalmology exam. This lesion has an important differential diagnosis with retinal disease and may be related to systemic diseases, therefore, it is essential to recognize it and keep the follow-up. In this paper, three different cases of each type of CHRPE were described and documented. Abbreviations: CHRPE = Congenital hypertrophy of the Retinal Pigment Epithelium, RPE = Retinal Pigment Epithelium, CDVA = Corrected Distance Visual Acuity, PIO = Intraocular Pressure, FA = Fluorescein Angiography, FAP = Familial Adenomatous Polyposis, RPEH-FAP = Retinal Pigment Epithelial Hamartomas Associated with Familial Adenomatous Polyposis, OCT = Ocular Coherence Tomography.

Comparação da eficácia da retinografia colorida e da angiografia fluorescente no diagnóstico da retinopatia diabética / Comparing efficacy of fundus photography and fluorescein angiography in the diagnosis of diabetic retinopathy

RESUMO Objetivo: Avaliar a efetividade da retinografia colorida e a da angiografia fluorescente no diagnóstico e no rastreio da retinopatia diabética. Métodos: Estudo retrospectivo, com base na análise de resultados de ambos os exames de 398 pacientes diabéticos. Resultados: Os resultados da angiografia coincidiram com os da retinografia em 77,4% dos casos, e não houve diferença significativa no estadiamento e na identificação da retinopatia pelos dois métodos. Conclusão: Não houve diferença significativa em relação à capacidade diagnóstica da doença pelos métodos descritos, demonstrando não existir benefício em indicar a angiografia como avaliação inicial do paciente diabético.

ABSTRACT Objective: To assess effectiveness of fundus photography and fluorescein angiography in diagnosis and screening of diabetic retinopathy. Methods: A retrospective study of 398 diabetic patients, based on analysis of results of both tests. Results: Results of fluorescein angiography and fundus photography coincided in 77.4% of cases, and there was no significant difference in staging and identification of retinopathy by both methods. Conclusion: There was no significant difference between both methods regarding the capacity to diagnose the disease, showing no benefit in indicating fluorescein angiography as initial assessment of diabetic patients.

Consumo de drogas, rede e apoio social entre pacientes psiquiátricos ambulatoriais / Drug use, networking, and social support among outpatient psychiatric patients / Uso de drogas, red y apoyo social entre pacientes psiquiátricos ambulatorios

O consumo de drogas é elevado entre pessoas com quadros psicopatológicos e pode acarretar diversos prejuízos que se sobrepõem à morbidade psiquiátrica. A rede e o apoio social podem estar associados ao prognóstico desses indivíduos. O objetivo deste estudo foi identificar o uso problemático de drogas em indivíduos em tratamento psiquiátrico e verificar a associação entre o consumo e medidas de rede e do apoio social. A amostra foi composta por 178 participantes. Foram utilizados os instrumentos: Formulário de informações sociodemográficas e clínicas, ASSIST, MOS-SSS e Inventário sobre a Rede Social. Obteve-se que 41,6% dos participantes faziam uso problemático de drogas, sendo álcool, tabaco e maconha as mais utilizadas. Ter sido alvo de discriminação, não residir com parceiro fixo e não ser praticante de religião foram associados ao consumo problemático de drogas. Destaca-se a importância da avaliação de fatores ambientais na co-ocorrência do uso problemático de drogas e quadros clínicos psiquiátricos. AU

The consumption of drugs is high among people with psychopathological diagnoses and can cause harm that overlaps the psychiatric morbidity. The social network and support are associated with the prognosis of this population. The aim of this study was to identify problematic drug use among individuals undergoing psychiatric treatment and to verify the association between this problematic consumption and their social network and support measures. The sample consisted of 178 participants. An instrument composed of sociodemographic and clinical questions; the ASSIST; MOS-SSS; and the Social Networks Inventory were used for the data collection. It was found that 41.6% of the participants presented problematic drug use, the most used substances being alcohol, tobacco and marijuana. Having experienced discrimination, not living with a steady partner and not practicing religion were associated with the problematic drug use. The importance of environmental factors in the co-occurrence of problematic drug use and psychiatric diagnoses is highlighted. AU

El consumo abusivo de las drogas es grande entre las personas con cuadro clínico psicopatológico y puede generar daños que superponen con la morbilidad psiquiátrica. La red y el apoyo social pueden asociarse con el pronóstico de los individuos. El objetivo de este estudio fue identificar el uso problemático de drogas entre los individuos sometidos a tratamiento psiquiátrico y averiguar la relación entre consumo y medidas de la red y el apoyo social. La muestra fue compuesta por 178 participantes. Fueran utilizados los instrumentos: Formulario de Información Sociodemográfica y Clínica, ASSIST, MOS-SSS y el Inventario sobre Red Social. Se encontró que 41,6% de los participantes eran adictos a las drogas, siendo el alcohol, el tabaco y la marihuana las más utilizadas. Se asoció a la adicción a las drogas haber sufrido discriminación, no residir con pareja estable y no ser practicante religioso. Se resaltó la importancia de los factores ambientales en la co-ocurrencia de consumo problemático de las drogas y cuadros clínicos psiquiátricos. AU

Astrocyte glutamate transporters are increased in an early sporadic model of synucleinopathy.

α-Synuclein protein (α-syn) is a central player in Parkinson's disease (PD) and in a spectrum of neurodegenerative diseases collectively known as synucleinopathies. These diseases are characterized by abnormal motor symptoms, such as tremor at rest, slowness of movement, rigidity of posture, and bradykinesia. Histopathological features of PD include preferential loss of dopaminergic neurons in the substantia nigra and formation of fibrillar intraneuronal inclusions called Lewy bodies and Lewy neurites, which are composed primarily of the α-syn protein. Currently, it is well accepted that α-syn oligomers (αSO) are the main toxic agent responsible for the etiology of PD. Glutamatergic excitotoxicity is associated with several neurological disorders, including PD. Excess glutamate in the synaptic cleft can be taken up by the astrocytic glutamate transporters GLAST and GLT-1. Although this event is the main defense against glutamatergic excitotoxicity, the molecular mechanisms that regulate this process have not yet been investigated in an early sporadic model of synucleinopathy. Here, using an early sporadic model of synucleinopathy, we demonstrated that the treatment of astrocytes with αSO increased glutamate uptake. This was associated with higher levels of GLAST and GLT-1 in astrocyte cultures and in a mouse model of synucleinopathy 24 h and 45 days after inoculation with αSO, respectively. Pharmacological inhibition of the TGF-ß1 (transforming growth factor beta 1) pathway in vivo reverted GLAST/GLT-1 enhancement induced by αSO injection. Therefore, our study describes a new neuroprotective role of astrocytes in an early sporadic model of synucleinopathy and sheds light on the mechanisms of glutamate transporter regulation for neuroprotection against glutamatergic excitotoxicity in synucleinopathy.

Comparison of midazolam and butorphanol combined with ketamine or dexmedetomidine for chemical restraint in howler monkeys (Alouatta guariba clamitans) for vasectomy.

BACKGROUND: This study evaluated and compared cardiorespiratory and blood gas parameters, as well as sedation, analgesia and recovery of two protocols: ketamine (10 mg/kg) or dexmedetomidine (10 µg/kg), with midazolam (0.5 mg/kg) and butorphanol (0.3 mg/kg), IM (KBM and DBM, respectively) in brown howler monkeys (Alouatta guariba clamitans). MATERIAL AND METHODS: Twelve brown howler monkeys were selected in two groups and evaluated for cardiorespiratory parameters and sedation, from 5-30 minutes after latency. Blood gas and arterial lactate were taken at 5 and 30 minutes. In the end, time and quality of recovery were evaluated. RESULTS: The HR in DBM group was significantly lower at all times. The sedation score was higher in DBM. Recovery in DBM was faster. All animals had moderate hypoxaemia. CONCLUSION: Both protocols produce satisfactory anaesthesia and analgesia, but DBM provides deeper sedation with faster recovery. Oxygen supplementation is recommended in both due to hypoxaemia.

Evaluating glial and neuronal blood biomarkers GFAP and UCH-L1 as gradients of brain injury in concussive, subconcussive and non-concussive trauma: a prospective cohort study.

OBJECTIVES: To evaluate the ability of glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase (UCH-L1) to detect concussion in children and adult trauma patients with a normal mental status and assess biomarker concentrations over time as gradients of injury in concussive and non-concussive head and body trauma. DESIGN: Large prospective cohort study. SETTING: Three level I trauma centres in the USA. PARTICIPANTS: Paediatric and adult trauma patients of all ages, with and without head trauma, presenting with a normal mental status (Glasgow Coma Scale score of 15) within 4 hours of injury. Rigorous screening for concussive symptoms was conducted. Of 3462 trauma patients screened, 751 were enrolled and 712 had biomarker data. Repeated blood sampling was conducted at 4, 8, 12, 16, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156, 168 and 180 hours postinjury in adults. MAIN OUTCOMES: Detection of concussion and gradients of injury in children versus adults by comparing three groups of patients: (1) those with concussion; (2) those with head trauma without overt signs of concussion (non-concussive head trauma controls) and (3) those with peripheral (body) trauma without head trauma or concussion (non-concussive body trauma controls). RESULTS: A total of 1904 samples from 712 trauma patients were analysed. Within 4 hours of injury, there were incremental increases in levels of both GFAP and UCH-L1 from non-concussive body trauma (lowest), to mild elevations in non-concussive head trauma, to highest levels in patients with concussion. In concussion patients, GFAP concentrations were significantly higher compared with body trauma controls (p<0.001) and with head trauma controls (p<0.001) in both children and adults, after controlling for multiple comparisons. However, for UCH-L1, there were no significant differences between concussion patients and head trauma controls (p=0.894) and between body trauma and head trauma controls in children. The AUC for initial GFAP levels to detect concussion was 0.80 (0.73-0.87) in children and 0.76 (0.71-0.80) in adults. This differed significantly from UCH-L1 with AUCs of 0.62 (0.53-0.72) in children and 0.69 (0.64-0.74) in adults. CONCLUSIONS: In a cohort of trauma patients with normal mental status, GFAP outperformed UCH-L1 in detecting concussion in both children and adults. Blood levels of GFAP and UCH-L1 showed incremental elevations across three injury groups: from non-concussive body trauma, to non-concussive head trauma, to concussion. However, UCH-L1 was expressed at much higher levels than GFAP in those with non-concussive trauma, particularly in children. Elevations in both biomarkers in patients with non-concussive head trauma may be reflective of a subconcussive brain injury. This will require further study.

α-synuclein oligomers enhance astrocyte-induced synapse formation through TGF-ß1 signaling in a Parkinson's disease model.

Parkinson's disease (PD) is characterized by selective death of dopaminergic neurons in the substantia nigra, degeneration of the nigrostriatal pathway, increases in glutamatergic synapses in the striatum and aggregation of α-synuclein. Evidence suggests that oligomeric species of α-synuclein (αSO) are the genuine neurotoxins of PD. Although several studies have supported the direct neurotoxic effects of αSO on neurons, their effects on astrocytes have not been directly addressed. Astrocytes are essential to several steps of synapse formation and function, including secretion of synaptogenic factors, control of synaptic elimination and stabilization, secretion of neural/glial modulators, and modulation of extracellular ions, and neurotransmitter levels in the synaptic cleft. Here, we show that αSO induced the astrocyte reactivity and enhanced the synaptogenic capacity of human and murine astrocytes by increasing the levels of the known synaptogenic molecule transforming growth factor beta 1 (TGF-ß1). Moreover, intracerebroventricular injection of αSO in mice increased the number of astrocytes, the density of excitatory synapses, and the levels of TGF-ß1 in the striatum of injected animals. Inhibition of TGF-ß1 signaling impaired the effect of the astrocyte-conditioned medium on glutamatergic synapse formation in vitro and on striatal synapse formation in vivo, whereas addition of TGF-ß1 protected mesencephalic neurons against synapse loss triggered by αSO. Together, our data suggest that αSO have important effects on astrocytic functions and describe TGF-ß1 as a new endogenous astrocyte-derived molecule involved in the increase in striatal glutamatergic synaptic density present in early stages of PD. OPEN SCIENCE BADGES: This article has received a badge for *Open Materials* because it provided all relevant information to reproduce the study in the manuscript. The complete Open Science Disclosure form for this article can be found at the end of the article. More information about the Open Practices badges can be found at https://cos.io/our-services/open-science-badges/. Cover Image for this issue: doi: 10.1111/jnc.14514.

Influence of temperature on in vitro zoosporogenesis of Pythium insidiosum.

This study verified the influence of different temperatures on P. insidiosum in vitro zoosporogenesis. P. insidiosum isolates (n = 26) were submitted to zoosporogenesis and incubated at 5°C, 15°C, 20°C and 37°C (1st stage). Grass fragments were evaluated under optical microscopy at 4, 8, and 24 hours of incubation. Afterward, all isolates were incubated at 37°C and assessed at the same periods of time (2nd stage). The development of hyphae, presence of vesicles, zoosporangia and zoospores were checked. Only the presence of short hyphae was observed at 5°C. At 15°C, the hyphae were either under development or elongated and two isolates produced zoospores. When the isolates were submitted to 20°C for 4 hours, the presence of long and mycelial hyphae, vesicles, zoosporangia and zoospores was observed, which also happened at the other periods evaluated. In the second stage, the isolates which were initially at 5°C and 15°C evidenced long developing hyphae with the presence of vesicles, zoosporangia, and zoospores within 4 hours of incubation, and these characteristics were kept at the other evaluated periods. The isolates kept at 37°C showed evident zoosporogenesis in the first 4 hours of evaluation. It was concluded that temperatures of 20°C and 37°C support P. insidiosum zoosporogenesis process. On the other hand, 5°C and 15°C temperatures do not kill the microorganism.

Mesenchymal stem cells and cell-derived extracellular vesicles protect hippocampal neurons from oxidative stress and synapse damage induced by amyloid-ß oligomers.

Alzheimer's disease (AD) is a disabling and highly prevalent neurodegenerative condition, for which there are no effective therapies. Soluble oligomers of the amyloid-ß peptide (AßOs) are thought to be proximal neurotoxins involved in early neuronal oxidative stress and synapse damage, ultimately leading to neurodegeneration and memory impairment in AD. The aim of the current study was to evaluate the neuroprotective potential of mesenchymal stem cells (MSCs) against the deleterious impact of AßOs on hippocampal neurons. To this end, we established transwell cocultures of rat hippocampal neurons and MSCs. We show that MSCs and MSC-derived extracellular vesicles protect neurons against AßO-induced oxidative stress and synapse damage, revealed by loss of pre- and postsynaptic markers. Protection by MSCs entails three complementary mechanisms: 1) internalization and degradation of AßOs; 2) release of extracellular vesicles containing active catalase; and 3) selective secretion of interleukin-6, interleukin-10, and vascular endothelial growth factor to the medium. Results support the notion that MSCs may represent a promising alternative for cell-based therapies in AD.

Brain infusion of α-synuclein oligomers induces motor and non-motor Parkinson's disease-like symptoms in mice.

Parkinson's disease (PD) is characterized by motor dysfunction, which is preceded by a number of non-motor symptoms including olfactory deficits. Aggregation of α-synuclein (α-syn) gives rise to Lewy bodies in dopaminergic neurons and is thought to play a central role in PD pathology. However, whether amyloid fibrils or soluble oligomers of α-syn are the main neurotoxic species in PD remains controversial. Here, we performed a single intracerebroventricular (i.c.v.) infusion of α-syn oligomers (α-SYOs) in mice and evaluated motor and non-motor symptoms. Familiar bedding and vanillin essence discrimination tasks showed that α-SYOs impaired olfactory performance of mice, and decreased TH and dopamine levels in the olfactory bulb early after infusion. The olfactory deficit persisted until 45days post-infusion (dpi). α- SYO-infused mice behaved normally in the object recognition and forced swim tests, but showed increased anxiety-like behavior in the open field and elevated plus maze tests 20 dpi. Finally, administration of α-SYOs induced late motor impairment in the pole test and rotarod paradigms, along with reduced TH and dopamine content in the caudate putamen, 45 dpi. Reduced number of TH-positive cells was also seen in the substantia nigra of α-SYO-injected mice compared to control. In conclusion, i.c.v. infusion of α-SYOs recapitulated some of PD-associated non-motor symptoms, such as increased anxiety and olfactory dysfunction, but failed to recapitulate memory impairment and depressive-like behavior typical of the disease. Moreover, α-SYOs i.c.v. administration induced motor deficits and loss of TH and dopamine levels, key features of PD. Results point to α-syn oligomers as the proximal neurotoxins responsible for early non-motor and motor deficits in PD and suggest that the i.c.v. infusion model characterized here may comprise a useful tool for identification of PD novel therapeutic targets and drug screening.

Effects on insulin adsorption due to zinc and strontium substitution in hydroxyapatite.

Insulin-loaded calcium phosphate nanoparticles have been proposed as a potential drug delivery system for the oral treatment of diabetes and to stimulate bone cell proliferation and bone mineralization. The kinetics of insulin incorporation onto hydroxyapatite (HA) and Sr (SrHA)- and Zn (ZnHA)-substituted hydroxyapatite nanoparticles was investigated using X-ray photoelectron spectroscopy (XPS), Fourier transform infrared (FTIR) spectroscopy, zeta potential measurements and circular dichroism (CD) spectroscopy. The increase in insulin concentration on HA, SrHA and ZnHA was a typical physical adsorption process controlled by electrostatic forces and followed a Freundlich isotherm model. Zn substitution enhanced the capacity of the apatite surface to adsorb insulin, whereas Sr substitution inhibited insulin uptake. The surface stoichiometry and mesopore specific area induced by Zn and Sr substitution are proposed as the main causes of the difference in insulin adsorption. Despite the weak interaction between insulin and the apatite surface, the CD spectra revealed a decrease in the insulin ellipticity when the protein was adsorbed on the HA, SrHA and ZnHA nanoparticles. A reduction in alpha-helical structures and an increase in beta sheets were observed when insulin interacted with the HA surface. A less pronounced effect was found for ZnHA, for which a subtle decrease in alpha-helical structures was followed by an increase in turn structures. Interaction with the SrHA surface did not change the native insulin conformation. In vitro cell culture experiments lasting 24h using F-OST stromal cells showed that the insulin loaded on HA and ZnHA did not affect cell proliferation but the insulin loaded on SrHA improved cell proliferation. These results suggest that the stability of the native protein conformation is an important factor to consider when cells interact with insulin adsorbed on metal-substituted HA surfaces.

Neuronal Biomarker Ubiquitin C-Terminal Hydrolase Detects Traumatic Intracranial Lesions on Computed Tomography in Children and Youth with Mild Traumatic Brain Injury.

This study examined the performance of serum ubiquitin C-terminal hydrolase (UCH-L1) in detecting traumatic intracranial lesions on computed tomography (CT) scan (+CT) in children and youth with mild and moderate TBI (mmTBI) and assessed its performance in trauma control patients without head trauma. This prospective cohort study enrolled children and youth presenting to three level 1 trauma centers after blunt head trauma and a Glasgow Coma Scale (GCS) score of 9-15 as well as trauma control patients with GCS 15 that did not have blunt head trauma. The primary outcome measure was the presence of intracranial lesions on initial CT scan. Blood samples were obtained in all patients within 6 h of injury and measured by enzyme-linked immunosorbent assay ELISA for UCH-L1 (ng/mL). A total of 256 children and youth were enrolled in the study and had serum samples drawn within 6 h of injury for analysis; 196 had blunt head trauma and 60 were trauma controls. CT scan of the head was performed in 151 patients and traumatic intracranial lesions on CT scan were evident in 17 (11%), all of whom had a GCS of 13-15. The area under the receiver operating characteristic curve (AUC) for UCH-L1 in detecting children and youth with traumatic intracranial lesions on CT was 0.83 (95% confidence interval [CI], 0.73-0.93). In those presenting with a GCS of 15, the AUC for detecting lesions was 0.83 (95% CI, 0.72-0.94). Similarly, in children under 5 years of age, the AUC was 0.79 (95% CI, 0.59-1.00). Performance for detecting intracranial lesions at a UCH-L1 cut-off level of 0.18 ng/mL yielded a sensitivity of 100%, a specificity of 47%, and a negative predictive value of 100%. UCH-L1 showed good performance in infants and toddlers younger than 5 years and performed well in children and youth with a GCS score of 15. Before clinical application, further study in larger cohort of children and youth with mild TBI is warranted.

Estudo transversal dos óbitos provocados por trauma nos membros necropsiados no Instituto Médico Legal de Belo Horizonte, 2006 - 2011 / Imprimir PDF Estatísticas ARTIGO ORIGINAL Estudo transversal dos óbitos provocados por trauma nos membros necropsiados no Instituto Médico Legal de Belo Horizonte, 2006 - 2011 Cross-sectional study of trauma deaths caused by extremity trauma necropsied at the Forensic Medicine Institute of Belo Horizonte, 2006 - 2011

Introdução: Nos países industrializados, o trauma é a terceira causa de mortalidade, sendo a principal entre menores de 45 anos de idade. Em Belo Horizonte (BH), no ano de 2015, quase metade das hospitalizações relacionadas a causas externas se deveu por trauma nos membros. Entretanto, a epidemiologia do trauma fatal de extremidades em nosso meio é ainda pouco conhecida. Objetivos: Avaliar os óbitos decorrentes de trauma nos membros ocorridos em BH e região metropolitana para se estabelecer o perfil das vítimas e dos subtipos deste trauma. Métodos: Estudo transversal dos casos necropsiados no Instituto Médico Legal de BH no período de 2006 a 2011 cuja causa do óbito tenha sido trauma nos membros. Resultados: Foram recuperados 128 casos. Quanto aosmecanismos de trauma, a maioria se deveu a ação contundente, seguida pela ação pérfurocontundente. O ano de 2007, o mês de outubro e o domingo apresentaram maior proporção de necropsias. A maioria dos necropsiados era homem, possuía menos de 49 anos, era solteira, feoderma e ativa do ponto de vista ocupacional. Em quase metade dos casos havia suspeita de homicídio e a maioria das vítimas foi encaminhada de uma unidade de saúde. Conclusões: A caracterização mais detalhada dos óbitos decorrentes de trauma nos membros ocorridos em BH pode fornecer informações de saúde pública importantes para o direcionamento de recursos e delineamento de prioridades para redução das fatalidades. (AU)

Introduction: In industrialized countries, trauma is the third leading cause of mortality, with the highest rate in the young. In Belo Horizonte, nearly half of hospitalizations related to external causes were due to limb trauma. However, the epidemiology of fatal trauma caused by trauma in extremities in our setting is still poorly understood. Objectives: To evaluate the limb trauma related deaths occurred in BH and metropolitan area in order to establish the profile of the victims and the subtypes of this trauma. Methods: Cross-sectional study of the necropsy reports performed at IML/BH from 2006 to 2011, caused by limb trauma. Results: 128 reports of fatal limb trauma victims were recovered during the study period. Concerning the mechanisms of trauma, the majority was due to blunt trauma, followed by gunshot wounds. The year 2007, October and Sunday had a higher proportion of necropsies. Most victims were male, younger than 49 years old, were single, feoderm and active from an occupational point of view. In almost half of the cases, homicide was suspected. Most of the cases had trauma in the lower limbs and were referred from a health unit. Conclusions: The more detailed characterization of limb trauma related deaths in BH can provide important public health information for resource allocation and delineation of priorities for fatalities reduction. (AU)

Caudoventral hip luxation in a miniature pig / Luxação caudoventral de quadril em um mini-pig

ABSTRACT: A miniature pig was examined because of left pelvic limb lameness after falling from a short height. Clinical examination and radiographs of the pelvic region revealed a left caudoventral hip luxation. Surgical reduction of luxation was performed on the patient under general anesthesia using a transarticular pinning technique. Postoperative radiographs confirmed that the luxation was reduced, the joint was aligned, and the transarticular pinning was correct. The transarticular pin was removed 21 days after it was surgically inserted. The limb was fully functional in the immediate postoperative period. Nine months after the surgery, the patient could use the limb properly, but mild degenerative joint disease was observed via radiographic follow-up. This technique may be a viable treatment option for the repair of caudoventral hip luxation in miniature pigs.

RESUMO: Um mini-pig foi atendido devido à claudicação do membro pélvico esquerdo após pequena queda. O exame clínico e radiografias da região pélvica revelaram uma luxação caudoventral de quadril no lado esquerdo. A redução cirúrgica da luxação foi realizada, com o paciente sob anestesia geral, usando um pino transarticular. As radiografias pós-operatórias confirmaram que a luxação foi reduzida, com alinhamento e fixação transarticular corretos. O pino transarticular foi removido cirurgicamente 21 dias após de ter sido inserido. O membro se tornou totalmente funcional já no período pós-operatório imediato. Nove meses após a cirurgia, o paciente utilizava o membro corretamente, porém foi detectada doença articular degenerativa leve através de acompanhamento radiográfico. A técnica empregada foi uma opção viável de tratamento para a reparação da luxação caudoventral de quadril em mini-pig.

Time Course and Diagnostic Accuracy of Glial and Neuronal Blood Biomarkers GFAP and UCH-L1 in a Large Cohort of Trauma Patients With and Without Mild Traumatic Brain Injury.

IMPORTANCE: Glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase L1 (UCH-L1) have been widely studied and show promise for clinical usefulness in suspected traumatic brain injury (TBI) and concussion. Understanding their diagnostic accuracy over time will help translate them into clinical practice. OBJECTIVES: To evaluate the temporal profiles of GFAP and UCH-L1 in a large cohort of trauma patients seen at the emergency department and to assess their diagnostic accuracy over time, both individually and in combination, for detecting mild to moderate TBI (MMTBI), traumatic intracranial lesions on head computed tomography (CT), and neurosurgical intervention. DESIGN, SETTING, AND PARTICIPANTS: This prospective cohort study enrolled adult trauma patients seen at a level I trauma center from March 1, 2010, to March 5, 2014. All patients underwent rigorous screening to determine whether they had experienced an MMTBI (blunt head trauma with loss of consciousness, amnesia, or disorientation and a Glasgow Coma Scale score of 9-15). Of 3025 trauma patients assessed, 1030 met eligibility criteria for enrollment, and 446 declined participation. Initial blood samples were obtained in 584 patients enrolled within 4 hours of injury. Repeated blood sampling was conducted at 4, 8, 12, 16, 20, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156, 168, and 180 hours after injury. MAIN OUTCOMES AND MEASURES: Diagnosis of MMTBI, presence of traumatic intracranial lesions on head CT scan, and neurosurgical intervention. RESULTS: A total of 1831 blood samples were drawn from 584 patients (mean [SD] age, 40 [16] years; 62.0% [362 of 584] male) over 7 days. Both GFAP and UCH-L1 were detectible within 1 hour of injury. GFAP peaked at 20 hours after injury and slowly declined over 72 hours. UCH-L1 rose rapidly and peaked at 8 hours after injury and declined rapidly over 48 hours. Over the course of 1 week, GFAP demonstrated a diagnostic range of areas under the curve for detecting MMTBI of 0.73 (95% CI, 0.69-0.77) to 0.94 (95% CI, 0.78-1.00), and UCH-L1 demonstrated a diagnostic range of 0.30 (95% CI, 0.02-0.50) to 0.67 (95% CI, 0.53-0.81). For detecting intracranial lesions on CT, the diagnostic ranges of areas under the curve were 0.80 (95% CI, 0.67-0.92) to 0.97 (95% CI, 0.93-1.00)for GFAP and 0.31 (95% CI, 0-0.63) to 0.77 (95% CI, 0.68-0.85) for UCH-L1. For distinguishing patients with and without a neurosurgical intervention, the range for GFAP was 0.91 (95% CI, 0.79-1.00) to 1.00 (95% CI, 1.00-1.00), and the range for UCH-L1 was 0.50 (95% CI, 0-1.00) to 0.92 (95% CI, 0.83-1.00). CONCLUSIONS AND RELEVANCE: GFAP performed consistently in detecting MMTBI, CT lesions, and neurosurgical intervention across 7 days. UCH-L1 performed best in the early postinjury period.