Botulinum toxin A in complex incisional hernia repair: a systematic review.

PURPOSE: To evaluate the safety, efficacy, and short and long-term postoperative results of using BTA. METHODS: We conducted a systematic review following the recommendations of the PRISMA method. We systematically reviewed the MEDLINE/PubMed and SCOPUS electronic databases for studies published between January 2010 and September 2021. This systematic review was registered in PROSPERO, with registration number CRD42021252445. RESULTS: After applying the selection criteria, 11 relevant articles were selected. The total sample size was 1058 patients. Most studies aimed to assess the rate of fascial closure, followed by the rate of recurrence and reporting of postoperative complications, as well as the need for the components separation technique (CST). None of the studies reported serious complications from using BTA. Regarding fascial closure, all articles had rates above 75%, except for one. Surgical site events ranged between 19% and 29.4%. No recurrence in the group that used BTA was recorded in five studies. The other articles reported recurrence rates ranging from 6.4 to 11.4% in the groups that received BTA. The studies had varying follow-up times ranging from 1 to 49 months, with a mean of 18.6 months (± 11.2). CONCLUSION: This review described most of the key points about the preoperative use of BTA in hernia repair. It can be concluded that the use of BTA is a safe and effective practice that promotes good short and long-term results. However, the limitations of the current literature prevent more accurate conclusions on the subject.

Composição química e cinética de degradação ruminal in vitro de aveia branca cv. URS guapa sob diferentes níveis de adubação nitrogenada / Chemical compounds and kinects of in vitro ruminal degradation of white oats URS Guapa under distinct levels of nitrogen fertilization

Avaliaram-se as doses de nitrogênio 0, 60, 120 e 240kg ha-1 sobre a composição bromatológica e os parâmetros da cinética de degradação ruminal da aveia branca obtida de dois anos de cultivo (2013-2014). Foram realizadas as análises de matéria seca, matéria mineral (MM), proteína bruta (PB), extrato etéreo, fibra em detergente neutro (aFDNmo), lignina, carboidratos solúveis (CHOs) e proteína insolúvel em detergente ácido (PIDA). Não foi observado efeito da adubação nitrogenada sobre as variáveis em nenhum dos anos de cultivo. As variáveis bromatológicas foram influenciadas pelos fatores ambientais. A cinética de degradação ruminal foi correspondente à composição bromatológica. No ano de 2013, foram observados valores superiores para as variáveis PB, MM, PIDA, CHOs e carboidratos não fibrosos, o que influenciou positivamente nos parâmetros da cinética de produção de gás in vitro, Vf 1 e k 2. A composição da cultivar em 2014 tendeu a maiores teores de aFDNmo, lignina e carboidratos totais e a valores superiores para os parâmetros Vf 2 e L. O parâmetro k 1 não foi significativo nos períodos avaliados. Em 2014 o valor nutritivo foi negativamente influenciado pelo atraso na semeadura e pela soma de períodos de restrição hídrica combinados com a elevação da temperatura.(AU)

Doses of Nitrogen were evaluated: 0, 60, 120 and 240kg ha-1 on the chemical composition and rumen degradation kinetics of white oats obtained from two consecutive years (2013-2014). For nutritional characterization the following parameters were analyzed: dry matter; ash, crude protein, ethereal extract, neutral detergent fiber, lignin, soluble carbohydrates and insoluble acid detergent protein. No effect of nitrogen fertilization was observed on the variables analyzed in any of the growing years. The nutritional variables were influenced by environmental factors that occurred in the respective experimental periods and the parameters of ruminal degradation kinetics corresponded to the effects in these compounds. In year 2013, higher values were observed for the variables crude protein, ash, insoluble acid detergent protein, soluble CHO and no fibrous carbohydrates, resulting in higher values also for the in vitro gas production kinetics, Vf1 and k2. Nutritional contents in 2014 tended to higher levels of NDF, lignin and total carbohydrates, and higher values for the parameters Vf2 and L. The parameter k1 was not significant in any of the experimental periods evaluated. In 2014 the forage has its nutritive value negatively influenced by the delay in sowing and the periods of water restriction combined with higher temperatures.(AU)

Differences for T-Cell Subtypes in Aspiration Biopsies of Patients With Kidney Transplant Under Polyclonal and Monoclonal Immunosuppressive Treatments.

Thymoglobulin, or antithymocyte globulin (ATG), and anti-interleukin 2α (IL-2α) chain receptor antibody (IL-2αRAb) achieve comparable good results in kidney transplantation notwithstanding different actions on immune cells. Previously, we reported the usefulness of flow cytometry (FC) analysis of lymphocyte subsets present in peripheral blood sample (PBL) and fine-needle aspiration biopsies (FNABs) for clinical surveillance, as, FC reaches very high predictive positive values for acute rejection diagnosis. Now we report an FC study on 2 kidney transplantation (KT) groups under ATG (n = 19) and IL-2αRAb (n = 24) treatment. Both groups were further treated with calcineurin inhibitors mycophenolate mofetil (MMF) and prednisone. PBL and FNAB samples were collected on day 7 post-KT, stained for several T- and B-lymphocyte subsets, and acquired using FACScan. Statistical analysis were done by Mann-Whitney U test. FNAB results showed a significant downregulation by ATG of CD3 (P < .001), CD4 (P = .009), CD4CD29 (P = .003), and CD2 (P ≤ .001) and significant upregulation of death receptor (DR) (P = .03), CD3CD69 (P < .001), and CD3CD25 (P < .0001) as compared to groups treated with IL-2αRAb. For PBL, the same trend was seen for CD3, CD4, CD2, CD3CD25, CD3CD69, CD4CD29, and DR plus a downregulation of CD45RO (P = .001) and an upregulation of CD4CD45RA (P < .0001) in IL-2αRAb. This study shows that among stable KTs, ATG as compared to IL-2αRAb induces a significant downregulation of a subset of T-memory (CD4CD29) cells but an upregulation of antigen-experienced cells (CD45RO). Further, ATG decreases CD2, CD3, CD4, and naïve (CD45RA) and stimulates T cells as translated by CD3CD69 and DR. As it should be expected from an IL-2αRAb agent, CD25 cells were virtually eliminated.

PCR-RFLP assay as an option for primary HPV test.

Persistent human papillomavirus (HPV) infection is an essential factor of cervical cancer. This study evaluated the analytical performance of restriction fragment length polymorphism polymerase chain reaction (PCR-RFLP) assay compared to PapilloCheck® microarray to identify human papilloma virus (HPV) in cervical cells. Three hundred and twenty-five women were analyzed. One sample was used for conventional cytology and another sample was collected using BD SurePath™ kit for HPV tests. Eighty samples (24.6%) were positive for HPV gene by PCR-Multiplex and were then submitted to PCR-RFLP and PapilloCheck® microarray. There was a genotyping agreement in 71.25% (57/80) on at least one HPV type between PCR-RFLP and PapilloCheck® microarray. In 22 samples (27.5%), the results were discordant and those samples were additionally analyzed by DNA sequencing. HPV 16 was the most prevalent HPV type found in both methods, followed by HPVs 53, 68, 18, 39, and 66 using PCR-RFLP analysis, and HPVs 39, 53, 68, 56, 31, and 66 using PapilloCheck® microarray. In the present study, a perfect agreement using Cohen's kappa (κ) was found in HPV 33 and 58 (κ=1), very good for HPV 51, and good for types 16, 18, 53, 59, 66, 68, 70, and 73. PCR-RFLP analysis identified only 25% (20/80) HPV coinfection, and PapilloCheck® microarray found 62.5% (50/80). Our Cohen's kappa results indicate that our in-house HPV genotyping testing (PCR-RFLP analysis) could be applied as a primary HPV test screening, especially in low income countries. If multiple HPV types are found in this primary test, a more descriptive test, such as PapilloCheck® microarray, could be performed.

Involvement of AOX and UCP pathways in the post-harvest ripening of papaya fruits.

Enhanced respiration during ripening in climacteric fruits is sometimes associated with an uncoupling between the ATP synthesis and the mitochondrial electron transport chain. While the participation of two energy-dissipating systems, one of which is mediated by the alternative oxidase (AOX) and the other mediated by the uncoupling protein (UCP), has been linked to fruit ripening, the relation between the activation of both mitochondrial uncoupling systems with the transient increase of ethylene synthesis (ethylene peak) remains unclear. To elucidate this question, ethylene emission and the two uncoupling (AOX and UCP) pathways were monitored in harvested papaya fruit during the ripening, from green to fully yellow skin. The results confirmed the typical climacteric behavior for papaya fruit: an initial increase in endogenous ethylene emission which reaches a maximum (peak) in the intermediate ripening stage, before finally declining to a basal level in ripe fruit. Respiration of intact fruit also increased and achieved higher levels at the end of ripening. On the other hand, in purified mitochondria extracted from fruit pulp the total respiration and respiratory control decrease while an increase in the participation of AOX and UCP pathways was markedly evident during papaya ripening. There was an increase in the AOX capacity during the transition from green fruit to the intermediate stage that accompanied the transient ethylene peak, while the O2 consumption triggered by UCP activation increased by 80% from the beginning to end stage of fruit ripening. Expression analyses of AOX (AOX1 and 2) and UCP (UCP1-5) genes revealed that the increases in the AOX and UCP capacities were linked to a higher expression of AOX1 and UCP (mainly UCP1) genes, respectively. In silico promoter analyses of both genes showed the presence of ethylene-responsive cis-elements in UCP1 and UCP2 genes. Overall, the data suggest a differential activation of AOX and UCP pathways in regulation related to the ethylene peak and induction of specific genes such as AOX1 and UCP1.

Trophoblast-macrophage crosstalk on human extravillous under Toxoplasma gondii infection.

INTRODUCTION: The interaction between human extravillous trophoblasts and macrophages has an important role in implantation and placentation. However, any dysfunction in this communication system is associated with pregnancy pitfalls, and a Toxoplasma gondii infection can be a potential problem in this crosstalk. Therefore, the aim of this study was to assess the influence of infected macrophages on cytokine production and the incidence of apoptosis in T. gondii-infected extravillous trophoblast cells. METHODS: HTR-8/SVneo cells were treated with supernatant from macrophages infected or not by T. gondii (conditioned medium) in order to analyze apoptosis and cytokine production in comparison to uninfected control conditions. RESULTS: The IL-6 secretion by HTR-8/SVneo cells increased synergistically by treatment with conditioned medium and T. gondii infection. The apoptosis index of HTR-8/SVneo cells was also upregulated by treatment with conditioned medium and infection. In addition, a low expression of Fas/CD95 and a high soluble FasL release were observed during infection, although no significant change was observed in the proliferation of T. gondii. DISCUSSION: The parasite modulates the high apoptosis index in HTR-8/SVneo cells in order to favor its establishment inside its host cells. On the other hand, the conditioned medium from uninfected macrophages restores the apoptosis rates, although the effect of the infection seems to be stronger. In conclusion, our results showed that T. gondii infection in human extravillous trophoblasts is able to modulate the trophoblast-macrophage crosstalk.

Localization and spreading of diseases in complex networks.

Using the susceptible-infected-susceptible model on unweighted and weighted networks, we consider the disease localization phenomenon. In contrast to the well-recognized point of view that diseases infect a finite fraction of vertices right above the epidemic threshold, we show that diseases can be localized on a finite number of vertices, where hubs and edges with large weights are centers of localization. Our results follow from the analysis of standard models of networks and empirical data for real-world networks.

Relationship between everolimus blood concentration assessed using the Innofluor Certican Fluorescence Polarization Immunoassay and the Architect i System sirolimus chemiluminescent microparticle immunoassay.

Everolimus, an immunosuppressive macrolide derivative of sirolimus, has a narrow therapeutic index and variable bioavailability. Assessment of blood concentration of everolimus is necessary to improve immunosuppressive efficacy without increasing potential adverse effects. Recently, Seradyn, Inc (Indianapolis, Indiana) introduced a fluorescence polarization immunoassay (Innofluor Certican Fluorescent Polarization Immunoassay [FPIA]) for quantitation of everolimus blood concentration. This immunoassay has concentration-dependent cross-reactivity with sirolimus, which must be considered in patients recently treated with that drug. In this short-term study, treatment in 53 renal transplant recipients was converted from a sirolimus-based regimen to an everolimus-based regimen. Patients were followed up for 3 months. We investigated whether cross-reactivity with everolimus also occurred with the Abbott Laboratories (Abbott Park, Illinois) Architect i System, a sirolimus chemiluminescent microparticle immunoassay (CMIA) used to quantify sirolimus blood concentration. Quantification of everolimus blood concentration using both the CMIA and the FPIA demonstrated a linear regression: CMIA = 0.73 FPIA +/- 0.77 (r(2) = 0.80; P < .001). A high degree of correlation between the CMIA and FPIA methods (r = 0.90) was confirmed using the Bland-Altman test. We conclude that the Abbott Architect i System sirolimus CMIA should be considered an alternative method for everolimus drug monitoring. The cross-reactions of both the FPIA and CMIA techniques with both sirolimus and everolimus must be considered when converting therapy from one drug to the other. In these conditions, use of an equivalent dosage is of particular importance.

Intracranial aneurysm and arachnoid cyst: a rare association between two cerebral malformations.

Intracranial aneurysms and arachnoid cysts are cerebral disorders of a high prevalence. However, association between both malformations is a rare finding. The aim was to analyse this association with regard to the different clinical presentations according to the haemorrhage types, as well as the pathogenesis of this association. We searched the English language literature in MEDLINE database in order to include all manuscripts in which this association was found. A new case of a 55-year-old man with a large posterior communicating artery aneurysm and a middle cranial fossa arachnoid cyst presenting with headache and seizure was added to review of the literature and presented as an illustrative case. Nine cases were found. Six were male and three were female. The mean age was 42 years (range 29-66 years). All but one arachnoid cysts were located at middle cranial fossa, aneurysms arose from middle cerebral artery in three cases, internal carotid artery bifurcation in two cases, posterior communicating segment of carotid artery in two cases, anterior communicating artery in one case and azygos pericallosal artery in one case. Clinical presentation was related to aneurysmal rupture in six cases (subarachnoid haemorrhage in four, subdural haematoma in one and intracystic haematoma in two) and related to arachnoid cysts in three cases, where the most common symptoms were seizures and headache. Association between intracranial aneurysms and arachnoid cysts is a rare finding that can present with signs and symptoms related to aneurysm rupture, or with mass effect and seizures related to the cyst. The aneurysmal haemorrhage may be atypical, since it can be into the subarachnoid space, into the arachnoid cyst, or into the subdural space.

Brd4 is required for e2-mediated transcriptional activation but not genome partitioning of all papillomaviruses.

Bromodomain protein 4 (Brd4) has been identified as the cellular binding target through which the E2 protein of bovine papillomavirus type 1 links the viral genome to mitotic chromosomes. This tethering ensures retention and efficient partitioning of genomes to daughter cells following cell division. E2 is also a regulator of viral gene expression and a replication factor, in association with the viral E1 protein. In this study, we show that E2 proteins from a wide range of papillomaviruses interact with Brd4, albeit with variations in efficiency. Moreover, disruption of the E2-Brd4 interaction abrogates the transactivation function of E2, indicating that Brd4 is required for E2-mediated transactivation of all papillomaviruses. However, the interaction of E2 and Brd4 is not required for genome partitioning of all papillomaviruses since a number of papillomavirus E2 proteins associate with mitotic chromosomes independently of Brd4 binding. Furthermore, mutations in E2 that disrupt the interaction with Brd4 do not affect the ability of these E2s to associate with chromosomes. Thus, while all papillomaviruses attach their genomes to cellular chromosomes to facilitate genome segregation, they target different cellular binding partners. In summary, the E2 proteins from many papillomaviruses, including the clinically important alpha genus human papillomaviruses, interact with Brd4 to mediate transcriptional activation function but not all depend on this interaction to efficiently associate with mitotic chromosomes.

Degree-dependent intervertex separation in complex networks.

We study the mean length (l)(k) of the shortest paths between a vertex of degree k and other vertices in growing networks, where correlations are essential. In a number of deterministic scale-free networks we observe a power-law correction to a logarithmic dependence, (l)(k) = A ln[N/k((gamma-1)/2)]-Ck(gamma-1)/N+ in a wide range of network sizes. Here N is the number of vertices in the network, gamma is the degree distribution exponent, and the coefficients A and C depend on a network. We compare this law with a corresponding (l)(k) dependence obtained for random scale-free networks growing through the preferential attachment mechanism. In stochastic and deterministic growing trees with an exponential degree distribution, we observe a linear dependence on degree, (l)(k)approximately A ln N-Ck. We compare our findings for growing networks with those for uncorrelated graphs.

BeWo trophoblasts are unable to control replication of Toxoplasma gondii, even in the presence of exogenous IFN-gamma.

The ability of RH strain of Toxoplasma gondii to invade and grow into BeWo cells was investigated in the present study using IFN-gamma, l-tryptophan, or alpha-methyl-tryptophan treatments. HeLa cells were used in the same conditions for comparison purposes. It was demonstrated that BeWo cells are more permissive to T. gondii infection, making them more susceptible to this pathogen when compared to HeLa cells. Infection rates of BeWo cells do not show any significant alteration in different protocols using IFN-gamma. In addition, BeWo treated with l-tryptophan was unable to significantly increase parasite growth. In contrast, HeLa cells treated with IFN-gamma or IFN-gamma plus l-tryptophan are able to impair or increase, respectively, parasite replication, providing evidence that this indoleamine-2,3-dioxygenase-dependent phenomenon is operant in these cells, whereas it is inactive in BeWo. Therefore, our data support the hypothesis that the immunological mechanisms controlling infection at the maternal-fetal interface are different from those occurring in the periphery. At the same time that operating regulatory mechanisms work inside and outside the cells located at that microenvironment to prevent maternal rejection of the concept, these events might facilitate the progression of infection caused by intracellular pathogens, as T. gondii.

Nutritional status and body composition evolution in early post-renal transplantation: is there a female advantage?

OBJECTIVE: Chronic renal failure is associated with metabolic derangements, affecting proteins, amino acids, and lipids. Usually these patients follow a restricted diet. Kidney transplant patients enjoy a recovery of renal function, but their therapeutics may entail significant changes in general metabolism. We compare the anthropometric results during the first 3 months after successful transplant for male and female patients versus a healthy group. METHODS: Eighteen patients (11 men and 7 women) were studied. Anthropometry was assessed before and at month 1 and month 3 posttransplant including body weight (Wt), body mass index (BMI), triceps (TSF), biceps (BSF), subscapular (SCSF), and suprailiac skinfolds (SISF), midarm circumference (MAC), midarm muscle circumference (MAMC), corrected arm muscle area (CT.AMA), total body muscle mass (MM), body density (D), fat mass (FM), and fat-free mass (FFM). The healthy group was evaluated three times in the first year. RESULTS: Pretransplant men showed lower Wt, BMI, TSF, BSF, SCSF, SISF, MAC, MAMC, CT.AMA, MM, FM and FFM than controls, while women displayed no differences from controls. By the third month, men showed only a partial recovery and women higher TSF and SCSF than controls. CONCLUSIONS: Uremic men before transplant displayed undernutrition indices. During the first 3 months posttransplant men showed an incomplete recovery of anthropometric parameters. Quite differently, women started close to normal and had significantly increased body weight and fat content posttransplant. We suggest that nutritional requirements post-kidney grafting may be significantly different among male compared to female patients.

Antifungal activity of Ocimum gratissimum towards dermatophytes.

The development of more effective and less toxic antifungal agents is required for the treatment of dermatophytosis. Plants and their preparations have been used as medicines against infectious diseases. Extracts of Ocimum gratissimum leaves were investigated for in vitro antifungal activity, using agar dilution technique against dermatophytes. The extracts (hexane, chloroform fractions, the essential oil and eugenol) produced antifungal activities against Microsporum canis, M. gypseum, Trichophyton rubrum and T. mentagrophytes. Trichophyton rubrum, the most common aetiological agent of dermatophytosis in Goiânia, state of Goiás, Brazil, was also the most susceptible dermatophyte. The hexane fraction and eugenol were the most active. Hexane fraction inhibited the growth of 100% of dermatophytes at a concentration of 125 microg ml(-1), while eugenol inhibited the growth of 80% of dermatophytes at this same concentration. These results show that extracts of O. gratissimum are active in vitro against human pathogenic dermatophytes.

Salt sensitivity of blood pressure in patients with psoriasis on ciclosporin therapy.

BACKGROUND: Hypertension is one of the main side-effects of long-term therapy with ciclosporin. However, the influence of salt intake on the 24-h mean blood pressure of patients with psoriasis treated with ciclosporin is not known. OBJECTIVES: To evaluate, in patients with psoriasis, the sodium sensitivity of the ciclosporin-induced rise in blood pressure. METHODS: The 24-h ambulatory blood pressure was evaluated in 13 patients with psoriasis (age range 20-57 years) in two phases, before (phase I) and after the completion of 4 months of therapy with ciclosporin 3 mg kg(-1) daily (phase II). In both phases, the patients were studied in conditions of low sodium (LS) intake followed by a high sodium (HS) diet. RESULTS: Twenty-four-hour mean +/- SD blood pressure during LS and HS intake was, respectively, 86.3 +/- 1.6 mmHg and 85.5 +/- 1.8 mmHg during phase I, and 88.5 +/- 1.5 mmHg and 91.8 +/- 2.2 mmHg (P < 0.001 vs. phase I, HS; P < 0.05 vs. phase II, LS) during phase II. The median (interquartile range) sodium sensitivity index was greater during phase II than during phase I: - 0.0028 (- 0.0071 to 0.0009) vs. 0.0065 (- 0.0055 to 0.0258) (P < 0.02). The plasma levels and the daily urinary excretion of noradrenaline did not differ between phases I and II. CONCLUSIONS: The ciclosporin-induced rise in blood pressure is sodium sensitive. It is also suggested that sympathetic activation is not involved in the pathogenesis of ciclosporin-induced rise in blood pressure.

Inhomogeneous evolution of subgraphs and cycles in complex networks.

Subgraphs and cycles are often used to characterize the local properties of complex networks. Here we show that the subgraph structure of real networks is highly time dependent: as the network grows, the density of some subgraphs remains unchanged, while the density of others increase at a rate that is determined by the network's degree distribution and clustering properties. This inhomogeneous evolution process, supported by direct measurements on several real networks, leads to systematic shifts in the overall subgraph spectrum and to an inevitable overrepresentation of some subgraphs and cycles.

Roughness of sandpile surfaces.

We study the surface roughness of prototype models displaying self-organized criticality (SOC) and their noncritical variants in one dimension. For SOC systems, we find that two seemingly equivalent definitions of surface roughness yield different asymptotic scaling exponents. Using approximate analytical arguments and extensive numerical studies we conclude that this ambiguity is due to the special scaling properties of the nonlinear steady state surface. We also find that there is no such ambiguity for non-SOC models, although there may be intermediate crossovers to different roughness values. Such crossovers need to be distinguished from the true asymptotic behavior, as in the case of a noncritical disordered sandpile model studied by Barker and Mehta [Phys. Rev. E 61, 6765 (2000)].

Influência da imobilização gessada nas propriedades biomecânicas do músculo gastrocnêmio / Influence of immobilization on the biomechanical properties of the gastrocnemius muscle

The study of the effects of the immobilization on the muscular tissue is a very important issue and the measurement of the biomechanics properties provides relevant knowledgement about adaptations occurred from functional demands...

Análise biomecânica do músculo gastrocnêmio de ratas submetidas à natação e ao sedentarismo / Biomechanical analysis of gastrocnemius muscle of rats submitted to swimming and sedentary lifestyle

The purpose of this study was to investigate the influence of physical training and sedentarism on the mechanical properties of striated muscle...