Unveiling the pathophysiology of restless legs syndrome through transcriptome analysis.

The aim of this study was to analyze signaling pathways associated with differentially expressed messenger RNAs in people with restless legs syndrome (RLS). Seventeen RLS patients and 18 controls were enrolled. Coding RNA expression profiling of 12,857 gene transcripts by next-generation sequencing was performed. Enrichment analysis by pathfindR tool was carried-out, with p-adjusted ≤0.001 and fold-change ≥2.5. Nine main different network groups were significantly dysregulated in RLS: infections, inflammation, immunology, neurodegeneration, cancer, neurotransmission and biological, blood and metabolic mechanisms. Genetic predisposition plays a key role in RLS and evidence indicates its inflammatory nature; the high involvement of mainly neurotropic viruses and the TORCH complex might trigger inflammatory/immune reactions in genetically predisposed subjects and activate a series of biological pathways-especially IL-17, receptor potential channels, nuclear factor kappa-light-chain-enhancer of activated B cells, NOD-like receptor, mitogen-activated protein kinase, p53, mitophagy, and ferroptosis-involved in neurotransmitter mechanisms, synaptic plasticity, axon guidance, neurodegeneration, carcinogenesis, and metabolism.

Electrospun PCL Filtration Membranes Enhanced with an Electrosprayed Lignin Coating to Control Wettability and Anti-Bacterial Properties.

This study reports on the two-step manufacturing process of a filtration media obtained by first electrospinning a layer of polycaprolactone (PCL) non-woven fibers onto a paper filter backing and subsequently coating it by electrospraying with a second layer made of pure acidolysis lignin. The manufacturing of pure lignin coatings by solution electrospraying represents a novel development that requires fine control of the underlying electrodynamic processing. The effect of increasing deposition time on the lignin coating was investigated for electrospray time from 2.5 min to 120 min. Microstructural and physical characterization included SEM, surface roughness analysis, porosity tests, permeability tests by a Gurley densometer, ATR-FTIR analysis, and contact angle measurements vs. both water and oil. The results indicate that, from a functional viewpoint, such a natural coating endowed the membrane with an amphiphilic behavior that enabled modulating the nature of the bare PCL non-woven substrate. Accordingly, the intrinsic hydrophobic behavior of bare PCL electrospun fibers could be reduced, with a marked decrease already for a thin coating of less than 50 nm. Instead, the wettability of PCL vs. apolar liquids was altered in a less predictable manner, i.e., producing an initial increase of the oil contact angles (OCA) for thin lignin coating, followed by a steady decrease in OCA for higher densities of deposited lignin. To highlight the effect of the lignin type on the results, two grades of oak (AL-OA) of the Quercus cerris L. species and eucalyptus (AL-EU) of the Eucalyptus camaldulensis Dehnh species were compared throughout the investigation. All grades of lignin yielded coatings with measurable antibacterial properties, which were investigated against Staphylococcus aureus and Escherichia coli, yielding superior results for AL-EU. Remarkably, the lignin coatings did not change overall porosity but smoothed the surface roughness and allowed modulating air permeability, which is relevant for filtration applications. The findings are relevant for applications of this abundant biopolymer not only for filtration but also in biotechnology, health, packaging, and circular economy applications in general, where the reuse of such natural byproducts also brings a fundamental demanufacturing advantage.

Innovative Multilayer Electrospun Patches for the Slow Release of Natural Oily Extracts as Dressings to Boost Wound Healing.

Electrospinning is an advanced manufacturing strategy used to create innovative medical devices from continuous nanoscale fibers that is endowed with tunable biological, chemical, and physical properties. Innovative medical patches manufactured entirely by electrospinning are discussed in this paper, using a specific plant-derived formulation "1 Primary Wound Dressing©" (1-PWD) as an active pharmaceutical ingredient (API). 1-PWD is composed of neem oil (Azadirachta indica A. Juss.) and the oily extracts of Hypericum perforatum (L.) flowers, according to the formulation patented by the ENEA of proven therapeutic efficacy as wound dressings. The goal of this work is to encapsulate this API and demonstrate that its slow release from an engineered electrospun patch can increase the therapeutic efficacy for wound healing. The prototyped patch is a three-layer core-shell membrane, with a core made of fibers from a 1-PWD-PEO blend, enveloped within two external layers made of medical-grade polycaprolactone (PCL), ensuring mechanical strength and integrity during manipulation. The system was characterized via electron microscopy (SEM) and chemical and contact angle tests. The encapsulation, release, and efficacy of the API were confirmed by FTIR and LC-HRMS and were validated via in vitro toxicology and scratch assays.

Identification of IncA Plasmid, Harboring blaVIM-1 Gene, in S. enterica Goldcoast ST358 and C. freundii ST62 Isolated in a Hospitalized Patient.

In the present study, we analyzed the genome of two S. enterica strains TS1 and TS2 from stool and blood cultures, respectively, and one strain of C. freundii TS3, isolated from a single hospitalized patient with acute myeloid leukemia. The S. enterica Goldcoast ST358 (O:8 (C2-C3) serogroup), sequenced by the MiSeq Illumina system, showed the presence of ß-lactamase genes (blaVIM-1, blaSHV-12 and blaOXA-10), aadA1, ant(2″)-Ia, aac(6')-Iaa, aac(6')-Ib3, aac(6')-Ib-cr, qnrVC6, parC(T57S), and several incompatibility plasmids. A wide variety of insertion sequences (ISs) and transposon elements were identified. In C. freundii TS3, these were the blaVIM-1, blaCMY-150, and blaSHV-12, aadA1, aac(6')-Ib3, aac(6')-Ib-cr, mph(A), sul1, dfrA14, ARR-2, qnrVC6, and qnrB38. IncA plasmid isolated from E.coli/K12 transconjugant and C. freundii exhibited a sequence identity >99.9%. The transfer of IncA plasmid was evaluated by conjugation experiments.

Steam caps in geothermal reservoirs can be monitored using seismic noise interferometry.

Harvesting geothermal energy often leads to a pressure drop in reservoirs, decreasing their profitability and promoting the formation of steam caps. While steam caps are valuable energy resources, they also alter the reservoir thermodynamics. Accurately measuring the steam fraction in reservoirs is essential for both operational and economic perspectives. However, steam content estimations are very limited both in space and time since current methods rely on direct measurements within production wells. Besides, these estimations normally present large uncertainties. Here, we present a pioneering method for indirectly sampling the steam content in the subsurface using the ever-present seismic background noise. We observe a consistent annual velocity drop in the Hengill geothermal field (Iceland) and establish a correlation between the velocity drop and steam buildup using in-situ borehole data. This application opens new avenues to track the evolution of any gas reservoir in the crust with a surface-based and cost-effective method.

Reconstrução de defeitos nasais utilizando o retalho de Rieger / Reconstruction of nasal defects using the Rieger flap

Introdução: A reconstrução de defeitos cutâneos na porção distal do nariz sempre é um desafio. O retalho de dorso nasal, originalmente descrito por Gillies, ficou conhecido quando Rieger, em 1967, descreveu o uso de um retalho de rotação modificado que utilizava a pele redundante da glabela para reparar defeitos de espessura total da metade inferior do nariz com tamanho igual ou menor a 2cm, permitindo a reconstrução em somente um tempo cirúrgico. Métodos: Um estudo retrospectivo foi realizado, selecionando pacientes que foram atendidos no ambulatório de Cirurgia Plástica do Serviço de Cirurgia Plástica Prof. Dr. Oswaldo de Castro, no período de 2017 a 2019, que apresentavam carcinoma basocelular, em região de terço médio e/ou inferior do nariz. Resultados: O número total de pacientes foi de seis, com idade variando entre 64 a 95 anos, com média de 80,67 anos. Cinco destes pacientes eram do sexo masculino, sendo somente uma do sexo feminino. Não houve intercorrências durante ou após os procedimentos. Ainda, não ocorreram casos de infecção, sangramento, hematoma, deiscência ou necrose do retalho. Conclusão: O retalho de Rieger é uma boa opção para casos de reconstrução de defeitos localizados em metade inferior do nariz, sendo realizado em tempo único, de fácil execução e com alto nível de satisfação dos pacientes, fornecendo um adequado resultado estético da área reconstruída, em textura e cor, por utilizar tecidos próprios da cobertura nasal.

Introduction: the reconstruction of skin defects in the distal part of the nose is always a challenge. The dorsal nasal flap, initially described by Gillies, was unveiled when Rieger, in 1967, described the use of a modified rotation flap that used the redundant skin of the glabella to repair full-thickness defects of the lower half of the nose of equal or greater size of 2 cm, allowing reconstruction in a single surgical time. Methods: A retrospective study was carried out, selecting patients who had basal cell carcinoma, in the middle and/or lower third of the nose, who were treated at the Plastic Surgery outpatient clinic of the Plastic Surgery Service Prof. Dr. Oswaldo de Castro, in the period from 2017 to 2019. Results: The total number of patients was six, with ages ranging from 64 to 95 years, with an average of 80.67 years. Five of these patients were male, with only one female. There were no complications during or after the procedures. Also, there were no cases of infection, bleeding, hematoma, dehiscence, or necrosis of the flap. Conclusion: the Rieger flap is a good option for cases of reconstruction of defects located in the lower half of the nose; it is performed in a single moment, is easy to perform, and has a high level of patient satisfaction. It provides an adequate result aesthetics of the reconstructed area, in texture and color, through the use of specific tissues for the nasal covering.

Meralgia parestésica por compressão de cinta modeladora / Meralgia paresthetica by compression from a modeling girdle

Meralgia parestésica é caracterizada por dor, parestesia ou queimação e diminuição da sensibilidade tátil e dolorosa na face anterolateral da coxa. Isto ocorre por uma neuropatia do nervo cutâneo femoral lateral (NCFL). O tratamento conservador é frequentemente bem-sucedido, aliviando os sintomas na maioria dos pacientes. Descrevemos o caso de uma paciente de 44 anos de idade que apresentou os sintomas descritos após uso pós-operatório de malha modeladora por cirurgia estética.

Meralgia paresthetica is characterized by pain, paresthesia or burning sensation, and reduction of tactile and pain sensitivity in the anterolateral surface of the thigh. This disability is caused by a neuropathy of the lateral femoral cutaneous nerve (LFCN). Conservative treatment is often successful at relieving the symptoms in the majority of patients. We describe the case of a 44-year-old patient who presented with these symptoms caused by postoperative use of a surgical girdle after aesthetic surgery.

Tratamento de queimadura grave em membros inferiores realizado em centro hospitalar não especializado em queimaduras / Treatment of severe burn on lower limbs performed in hospital not specialized in burns

Este estudo tem como objetivo relatar o caso de um paciente grande queimado e demonstrar que seu tratamento pode ser realizado, com sucesso, em um centro hospitalar não especializado em queimaduras. O caso trata-se de um adulto jovem, vítima de queimadura por contato com material de aço incandescente, ocasionando amputação traumática da perna direita logo abaixo do joelho, pelo excesso de temperatura local, e queimadura de terceiro grau circunferencial em 100% do membro inferior esquerdo. O tratamento clínico e cirúrgico foi realizado em um hospital geral sem Unidade de Queimado. A extensão da queimadura representava 27% de superfície corporal queimada. O tratamento cirúrgico envolveu curativos, desbridamento e autoenxertos de pele parcial. Devido à indisponibilidade, não foram utilizados curativos biológicos. Durante a internação, o paciente evoluiu com celulite e áreas de necrose de pele no coto de amputação e infecção por Staphilococcus plasma coagulase negativa, Enterobacter aglomerans, Enterococcus sp, Pseudomonas aeruginosa, Cândida albicans e Klebsiella pneumoniae devidamente tratadas. O paciente recebeu alta após quatro meses, com resultado funcional e estético satisfatórios, demonstrando que um grande queimado pode ser tratado adequadamente fora de um centro especializado em queimaduras graves.

This report aims to relate a serious burn case and demonstrate how severe burn can be treated in a hospital without Burns Unit. One patient, victim of burn injury by contact with incandescent steel material, causing to traumatic amputation of the right leg soon below of the knee for the local excess of temperature and circumferential third degree burn in 100% of the left inferior member, presenting 27% of burnt corporal surface. Was admitted to a general hospital, without Burns Unit, for medical and surgical treatment. Surgical treatment was done by dressings, debridement and autografting. Because of unavailability, biological dressings wasn´t used. The patient presented, during treatment, abscess and areas of necrosis of skin in quote of amputation and infections by negative Staphilococcus plasma coagulase, Enterobacter aglomerans, Enterococcus sp, Pseudomonas aeruginosa, Cândida albicans and Klebsiella pneumonia, all of them successfully treated. Showing good recovering, he was discharged after four months.

Pioderma gangrenoso pós-mamoplastia redutora: relato de caso e discursão / Pyoderma gangrenosum after reduction mammaplasty: case report and discussion

We report the case of a 31-year-old woman who underwent mammoplasty and abdominoplasty and developed a rare and recurrent skin disease, of unknown etiology that was diagnosed as pyoderma gangrenosum. While the diagnosis was clinical, the treatment was empirical. An association between this disease and other systemic diseases was observed, in addition to pathergy (development of a new inflammatory lesion in are as of trauma) and changes in cellular immunity. The patient was empirically treated with antibiotics, sulfone, corticosteroids, and topical agents and experienced complete wound healing with no recurrence.

Neste artigo relata-se o caso de uma jovem de 31 anos de idade, submetida a mamoplastia e abdominoplastia, que evoluiu com uma doença cutânea rara, recorrente e de causa desconhecida: pioderma gangrenoso. O diagnóstico é clínico e o tratamento permanece empírico. Tem-se encontrado relação entre essa afecção e outras doenças sistêmicas, além de evidências do fenômeno de patergia (desenvolvimento de uma nova lesão inflamatóriana área do trauma) e de alterações da imunidade celular. A paciente foi tratada empiricamente com antibióticos, sulfona e corticoide, e com tratamento tópico, evoluindo para o fechamento completo das lesões sem apresentar recorrência.

Comparação de Custo da enoxaparina e dos novos anticoagulantes orais dabigatran e rivaroxaban na profilaxia do tromboembolismo venoso / Cost comparison between enoxaparin and new oral anticoagulants dabigatran and rivaroxaban in venous thromboembolism prophylaxis

Venous thromboembolism, an important complication that is easily prevented during surgery, is among the few clinicai entities wherein the use of prophylaxis has been found to be effective, such as in the case of antibiotic prophylaxis for the prevention of surgical site infections. The objectives of prophylaxis are to reduce the incidence of deep vein thrombosis, minimize the risk of long-term complications such as chronic venous insufficiency and pulmonary hypertension, and prevent death caused by pulmonary embolism. In this study, we aimed to provide current information to plastic surgeons on the therapeutic options for prophylaxis of venous thromboembolism as well as to compare treatment costs of the drugs enoxaparin, dabigatran, and rivaroxaban. Method: For comparison, the prophylaxis regimen was started 6 hours after the surgery and continued for 10 days. The end user price was obtained from an internet search that included leading pharmacy chains. Results: The patient costs of the new oral anticoagulants dabigatran and rivaroxaban were lower than that of enoxaparin. Conclusions: The cost of venous thromboembolism prophylaxis consisting of the new oral anticoagulants dabigatran and rivaroxaban is lower than that of low molecular weight heparin.

O tromboembolismo venoso é uma complicação importante altamente evitável em cirurgia, sendo uma das poucas entidades clínica em medicina passíveis de profilaxia comprovadamente eficiente, assim como ocorre na profilaxia antibiótica da infecções cirúrgicas. A profilaxia tem por objetivo diminuir a incidência de trombose venosa profunda minimizar os riscos das complicações a longo prazo da insuficiência venosa crônica e hipertensão pulmonar, bem como prevenir a morte consequente de embolia pulmonar. Este estudo tem por objetivo atualizar os cirurgiões plásticos quanto às medicações que podem ser adotadas na profilaxia do tromboembolismo venoso bem como comparar o custo dessas medicações (enoxaparina dabigatran e rivaroxaban). Método: Para efeito de comparação foi adotado um esquema de profilaxia iniciado 6 horas após o fim da cirurgia e mantido por 1O dias. A pequisa foi realizada na internet entre as principais redes farmacêuticas, levando em conta custo para o consumidor. Resultados: Os novos anticoagulantes orais dabigatran e rivaroxaban apresentaram custo menor para o paciente. Conclusões: Os novos anticoagulantes orais dabigatran e rivaroxaban possuem custo menor na profilaxia do tromboembolismo venoso em comparação à heparina de baixo peso molecular.