Restoring immune balance with Tregitopes: A new approach to treating immunological disorders.

The induction of immunological tolerance is a promising strategy for managing autoimmune diseases, allergies, and transplant rejection. Tregitopes, a class of peptides, have emerged as potential agents for this purpose. They activate regulatory T cells, which are pivotal in reducing inflammation and promoting tolerance, by binding to MHC II molecules and facilitating their processing and presentation to Treg cells, thereby encouraging their proliferation. Moreover, Tregitopes influence the phenotype of antigen-presenting cells by attenuating the expression of CD80, CD86, and MHC class II while enhancing ILT3, resulting in the inhibition of NF-kappa B signaling pathways. Various techniques, including in vitro and in silico methods, are applied to identify Tregitope candidates. Currently, Tregitopes play a vital role in balancing immune activation and tolerance in clinical applications such as Pompe disease, diabetes-related antigens, and the prevention of spontaneous abortions in autoimmune diseases. Similarly, Tregitopes can induce antigen-specific regulatory T cells. Their anti-inflammatory effects are significant in conditions such as autoimmune encephalomyelitis, inflammatory bowel disease, and Guillain-Barré syndrome. Additionally, Tregitopes have been leveraged to enhance vaccine design and efficacy. Recent advancements in understanding the potential benefits and drawbacks of IVIG and the discovery of the function and mechanism of Tregitopes have introduced Tregitopes as a popular option for immune system modulation. It is expected that they will bring about a significant revolution in the management and treatment of autoimmune and immunological diseases. This article is a comprehensive review of Tregitopes, concluding with the potential of these epitopes as a therapeutic avenue for immunological disorders.

A Mutation in the CACNA1F Gene Found by Whole Exome Sequencing (WES) and In Silico Analysis in an Iranian Family with Consanguineous Relationships.

BACKGROUND: X-linked mutations are highly important in clinical diagnosis, and at least 533 disorders are related to the genes located on the X chromosome. CASE PRESENTATION: A 21-year-old Caucasian woman with a 24-year-old Caucasian man as her fiancé referred Clinical genetic lab for premarital genetic counseling (carrier screening). None of them had any abnormal manifestations. Following genetic counseling, Whole Exome Sequencing (WES) test performed to find the possible pathogenic mutations. Also, after drawing the couple's pedigree, candidate mutations were examined in the woman's parents as well as her uncles. Additionally, in silico investigations were performed through SWISS-MODEL, MolProbity, ProSA, Py- Mol, and FATCAT tools. The most important mutation diagnosed in the woman (R1362Q in the 35th exon of CACNA1F), was observed in her mother and her two uncles. The mutation was also screened in both her father and her fiancé, but they had no mutations. After medical examinations of carriers, there was no sign of any eye impairment. Other mutations were TCTN2 (c.1613-2A>G), TARS (p.K319E), SPEG (p.E3020K), CPS1 (p.A1180V), MYO3A (p.I736M), NNT (p.R968Q), MED23 (p.K406T). Bioinformatics analyses indicated no alteration in the mutant structure of CACNA1F (Q1362) compared with the normal structure (R1362). CONCLUSION: Conclusively, the current study emphasizes the non-pathogenic effect of missense mutation R1362Q in the 35th exon of CACNA1F in association with ocular diseases. This will ensure the reports of this mutation as healthy instead of uncertain in the literature and databanks.

Suppression of Resistive Coupling in Nanogap Electrochemical Cell: Resolution of Dual Pathways for Dopamine Oxidation.

A nanogap cell involves two working electrodes separated by a nanometer-wide solution to enable unprecedented electrochemical measurements. The powerful nanogap measurements, however, can be seriously interfered with by resistive coupling between the two electrodes to yield erroneous current responses. Herein, we employ the nanogap cell based on double carbon-fiber microelectrodes to suppress resistive coupling for the assessment of intrinsic current responses. Specifically, we modify a commercial bipotentiostat to compensate the Ohmic potential drop shared by the two electrodes through the common current pathway with a fixed resistance in the solution. Resistive coupling through both non-Faradaic and Faradaic processes is suppressed to eliminate erroneous current responses. Our approach is applied to investigate the mechanism of dopamine oxidation at carbon-fiber microelectrodes as important electrochemical sensors for the crucial neurotransmitter. Resistive coupling is suppressed to manifest the intrinsic current responses based on the oxidation of both adsorbed and non-adsorbed forms of dopamine to the respective forms of dopamine-o-quinone. The simultaneous dual oxidation pathways are observed for the first time and can be mediated through either non-concerted or concerted mechanisms of adsorption-coupled electron transfer. The two mechanisms are not discriminated for the two-electron oxidation of dopamine because it can not be determined whether the intermediate, dopamine semi-quinone, is adsorbed on the electrode surface. Significantly, our approach will be useful to manifest intrinsic current responses without resistive coupling for nanogaps and microgaps, which are too narrow to eliminate the common solution resistance by optimizing the position of a reference electrode.

Innate immune cells: Key players of orchestra in modulating tumor microenvironment (TME).

The tumor microenvironment (TME) with vital role in cancer progression is composed of various cells such as endothelial cells, immune cells, and mesenchymal stem cells. In particular, innate immune cells such as macrophages, dendritic cells, myeloid-derived suppressor cells, neutrophils, innate lymphoid cells, γδT lymphocytes, and natural killer cells can either promote or suppress tumor progression when present in the TME. An increase in research on the cross-talk between the TME and innate immune cells will lead to new approaches for anti-tumoral therapeutic interventions. This review primarily focuses on the biology of innate immune cells and their main functions in the TME. In addition, it summarizes several innate immune-based immunotherapies that are currently tested in clinical trials.

Anticoccidial effects of tannin-based herbal formulation (Artemisia annua, Quercus infectoria, and Allium sativum) against coccidiosis in broilers.

Background: Avian coccidiosis is considered among the infectious disease of high cost in the poultry industry. Herbal extracts are safe and reliable substitute anticoccidial drugs for chemical feed additives as they do not sequel to drug resistance and tissue remnants. Objective: The current study aimed to assess the anticoccidial effect of an herbal complex of 3 plants (Artemisia annua, Quercus infectoria, and Allium sativum) in broiler chickens compared to toltrazuril anticoccidial. Methods: This experiment used one hundred twenty broiler chickens and divided them into four equally numbered groups. All the groups, except group (D), were experimentally infected with mixed Eimeria spp. (E. tenella, E. maxima, E. necatrix and E. brunetti) on day 14. Group (A) was treated with a herbal mixture, containing 75% Quercus infectoria with a minimum of 30% total tannin, 16% Artemisia annua with a minimum of 0.02% artemisinin, and 9% Allium sativum with a minimum of 0.4% total phenol contents. Group (B) was treated with toltrazuril. Group (C) did not have any treatment. Group (D) was healthy all the experiment period as a negative control group. During a 42-day breeding period, the study examined clinical signs, weight gains, feed conversion ratio, lesions scoring, casualties, and the number of oocysts in different bird groups. Results: Group (D) showed the most significant weight gain, indicating the economic damage caused by coccidiosis. The best feed conversion ratio was observed in the unchallenged group, and coccidiosis negatively affected it in other groups. Clinical signs of dysentery, diarrhea, and lethargy were seen post-challenge but improved with treatment. Group (D) showed no losses; others had casualties and coccidiosis lesions. Lesion scores were lowest in the group (D), and the herbal mixture improved performance. The herbal mixture and toltrazuril reduced oocyst counts in feces earlier than the untreated group. Conclusion: In conclusion, the anticoccidial activity of the mentioned herbal complex recommends its use as an alternative anticoccidial agent to chemotherapeutic drugs for controlling coccidiosis.

Selective and Rapid Optical Detection of Citalopram Using a Fluorescent Probe Based on Carbon Quantum Dots Embedded in Silica Molecularly Imprinted Polymer.

In this study, a citalopram optical nano-sensor was developed. Citalopram is a well-known antidepressant drug that reduces the reuptake of serotonin in neurons as a result, serotonin neurotransmission, the primary response to antidepressant treatments, increases in many parts of the brain. This study introduces a carbon quantum dots (CQDs)-based optical nanosensor for rapid detection of citalopram. This fluorescent nanosensor was made through the polymerization of tetraethyl orthosilicate in the presence of CQDs as the fluorescent materials and citalopram as the template molecule. Following the polymerization, the templated molecules were washed and removed from the structure, and the matrix of the polymer was left with some cavities that resembled citalopram in terms of size and shape. The final structure which is used as a chemical nanosensor, is named carbon quantum dots embedded silica molecularly imprinted polymer (CQDs-SMIP). The materials used in designing nano-sensors were characterized using FTIR, UV/Vis, and fluorescence spectroscopy, as well as high-resolution transmission electron microscopy (HR-TEM), and field emission scanning electron microscopy (FESEM). CQDs-SMIP showed a strong fluorescence emission at 420 nm in the absence of the template molecule. The fluorescence intensity of the nanosensor decreased in the presence of citalopram. The correlation between the extent of the fluorescence quenching and the concentration of citalopram provided the nano-sensor signal. The nano-sensor was used to measure citalopram in complex matrices such as human plasma and urine samples with remarkable selectivity and sensitivity. The detection limit of 10.3 µg.L-1 over a linear range of 100 to 700 µg.L-1, and RSD of 3.15% was obtained. This nano-sensor was applied to analyze of citalopram in plasma and human urine samples with remarkable results.

Adding a back care package to the primary healthcare; a community-based cluster-randomized trial.

Introduction: The clinical course of LBP is complex and chronicity is more frequent than once thought. Moreover, insufficient evidence was found in support of any specific approach at the level of the general population. Research question: This study aimed to evaluate the effectiveness of providing a back care package through the primary healthcare system in decreasing the rate of CLBP in the community. Material and methods: Clusters were primary healthcare units with the covered population as participants. The intervention package comprised both exercise and educational content in the form of booklets. Data regarding LBP were collected at baseline, 3 and 9-month follow-ups. The LBP prevalence and the incidence of CLBP in the intervention group compared to the control group were analyzed using logistic regression through GEE. Results: Eleven clusters were randomized including 3521 enrolled subjects. At 9 months, the intervention group showed a statistically significant decrease in both the prevalence and the incidence of CLBP, compared to the control group (OR â€‹= â€‹0.44; 95% CI â€‹= â€‹0.30-0.65; P â€‹< â€‹0.001 and OR â€‹= â€‹0.48; 95% CI â€‹= â€‹0.31-0.74; P â€‹< â€‹0.001, respectively). Discussion and conclusion: The population-based intervention was effective in reducing the LBP prevalence and CLBP incidence. Our results suggest that preventing CLBP through a primary healthcare package including exercise and educational content is achievable.

Changes in liver enzymes and association with prognosis in patients with COVID-19: a retrospective case-control study.

OBJECTIVE: COVID-19 has recently emerged as a serious threat to global health. This study examined the laboratory investigations of patients with COVID-19, with an emphasis on liver enzymes. METHODS: This retrospective, single-center study was performed on patients with COVID-19 who were admitted to Imam Reza Hospital, Iran from March 2020 to February 2021. Laboratory tests included a complete blood cell count, white blood cell (WBC) count, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), lymphocyte/monocyte ratio, and levels of aspartate aminotransferase, alanine aminotransferase (ALT), and alkaline phosphatase. Patient survival was among the outcome measures investigated in association with laboratory findings. RESULTS: We enrolled 77 patients with COVID-19 and 63 healthy controls. In comparison with the control group, patients with COVID-19 showed COVID-19 increased ALT, WBC, neutrophils, NLR, and PLR, and decreased platelet counts and lymphocytes. CONCLUSION: Although elevated levels of AST, NLR, PLR, and LMR were found in patients with COVID-19, they were not linked to mortality. Given the presence of AST in other tissues, the influence of SARS-CoV-2 on the liver should be interpreted with caution.

Role of Cultured Skin Fibroblasts in Regenerative Dermatology.

The skin, as the largest organ, covers the entire outer part of the body, and since this organ is directly exposed to microbial, thermal, mechanical and chemical damage, it may be destroyed by factors such as acute trauma, chronic wounds or even surgical interventions. Cell therapy is one of the most important procedures to treat skin lesions. Fibroblasts are cells that are responsible for the synthesis of collagen, elastin, and the organization of extracellular matrix (ECM) components and have many vital functions in wound healing processes. Today, cultured autologous fibroblasts are used to treat wrinkles, scars, wounds and subcutaneous atrophy. The results of many studies have shown that fibroblasts can be effective and beneficial in the treatment of skin lesions. On the other hand, skin substitutes are used as a regenerative model to improve and regenerate the skin. The use of these alternatives, restorative medicine and therapeutic cells such as fibroblasts has tremendous potential in the treatment of skin diseases and can be a new window for the treatment of diseases with no definitive treatment. NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description ofthese Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Surface-Enhanced Raman Spectroscopy Substrates for Food Safety and Quality Analysis.

Surface-enhanced Raman spectroscopy (SERS) has been identified as a fundamental surface-sensitive technique that boosts Raman scattering by adsorbing target molecules on specific surfaces. The application of SERS highly relies on the development of smart SERS substrates, and thus the fabrication of SERS substrates has been constantly improved. Herein, we investigate the impacts of different substrates on SERS technology including plasmonic metal nanoparticles, semiconductors, and hybrid systems in quantitative food safety and quality analysis. We first discuss the fundamentals, substrate designs, and applications of SERS. We then provide a critical review of the recent progress of SERS in its usage for screening and detecting chemical and biological contaminants including fungicides, herbicides, insecticides, hazardous colorants, and biohazards in food samples to assess the analytical capabilities of this technology. Finally, we investigate the future trends and provide practical techniques that could be used to fulfill the requirements for rapid analysis of food at a low cost.

Tracheobronchial Tree Ossification in a 5-Year-Old Boy with Keutel Syndrome: A Case Report.

Keutel syndrome (KS) as a scarce autosomal recessive disorder is characterized by hearing loss, multiple peripheral pulmonary stenoses, abnormal cartilage calcification, and morphological defects including midface hypoplasia and brachytelephalangism. We herein describe a 5-year-old boy who was referred for the evaluation of incidentally auscultated heart murmurs. He had no obvious abnormalities at birth but suffered from recurrent episodes of infectious otitis media during infancy. Physical examination revealed facial abnormalities, such as a broad nasal bridge, a sloping forehead, maxillary hypoplasia, and brachytelephalangism. Chest radiography showed tracheobronchial tree calcification. Transthoracic echocardiography illustrated peripheral pulmonary artery stenosis, moderate tricuspid regurgitation, and pulmonary hypertension. Computed tomography angiography confirmed calcification and segmental stenosis in the peripheral pulmonary arteries. The patient was diagnosed with KS. Most of these patients have a good prognosis. During the follow-up of these patients and examinations, we should pay attention to their symptoms related to upper respiratory tract infections, the extent of hearing, and the possibility of tracheal and pulmonary artery stenosis development. KS is a disease with a good prognosis, and a careful initial examination of babies, including facial appearance and heart auscultation, may lead to the early diagnosis of this disease.

Protective Effects of Auraptene against Free Radical-Induced Erythrocytes Damage.

Objectives: Auraptene is the most abundant natural prenyloxycoumarin. Recent studies have shown that it has multiple biological and therapeutic properties, including antioxidant properties. Erythrocytes are constantly subjected to oxidative damage that can affect proteins and lipids within the erythrocyte membrane and lead to some hemoglobinopathies. Due to the lack of sufficient information about the antioxidant effects of auraptene on erythrocytes, this study intended to evaluate the potential of this compound in protecting radical-induced erythrocytes damages. Methods: The antioxidant activity of auraptene was measured based on DPPH and FRAP assays. Notably, oxidative hemolysis of human erythrocytes was used as a model to study the ability of auraptene to protect biological membranes from free radical-induced damage. Also, the effects of auraptene in different concentrations (25-400 µM) on AAPH-induced lipid/protein peroxidation, glutathione (GSH) content and morphological changes of erythrocytes were determined. Results: Oxidative hemolysis and lipid/protein peroxidation of erythrocytes were significantly suppressed by auraptene in a time and concentration-dependent manner. Auraptene prevented the depletion of the cytosolic antioxidant GSH in erythrocytes. Furthermore, it inhibited lipid and protein peroxidation in a time and concentration-dependent manner. Likewise, FESEM results demonstrated that auraptene reduced AAPH-induced morphological changes in erythrocytes. Conclusion: Auraptene efficiently protects human erythrocytes against free radicals. Therefore, it can be a potent candidate for treating oxidative stress-related diseases.

SARS-CoV-2 serological assay and viral testing: a report of professional football setting.

PURPOSE OF THE STUDY: PCR is the current standard test for the diagnosis of SARS-CoV-2 infection. However, due to its limitations, serological testing is considered an alternative method for detecting SARS-CoV-2 exposure. In this study, we measured the level of SARS-CoV-2 IgM and IgG antibodies of male professional football players and compared the results with the standard PCR test to investigate the association between the two tests. STUDY DESIGN: Participants were male professional football players and team officials. Nasopharyngeal swabs and peripheral blood samples were collected for the PCR and serological tests, respectively. Also, previous records of COVID-19 testing and symptoms were gathered. Those with previous positive PCR tests who tested negative for the second time were considered to be recovered patients. RESULTS: Of the 1243 subjects, 222 (17.9%) were seropositive, while 29 (2.3%) tested positive for the SARS-CoV-2 PCR test. Sixty percent of symptomatic cases with a negative PCR were found to be seropositive. The mean level of IgM was significantly higher in PCR-positive and symptomatic subjects, whereas the recovered cases showed significantly higher levels of IgG. CONCLUSION: Our study revealed an inconsistency of results between the two tests; therefore, although application of serological assays alone seems insufficient in diagnosing COVID-19 disease, the findings are beneficial in the comprehension and the management of the disease.

GIS-based crash hotspot identification: a comparison among mapping clusters and spatial analysis techniques.

Knowing the locations of traffic crash hotspots can provide us with valuable insights into the root causes of crash occurrence over the area under study. This knowledge helps decision-makers to better assess the risk associated with road crashes and, as a result, help them to propose more effective countermeasures in order to reduce the annual crash rate. Nonetheless, identifying the areas with the highest potential of crash occurrence is a complicated task. In this regard and within this study, five various types of hotspot identification techniques, consisting of Average Nearest Neighbor, Getis-Ord Gi*, Global Moran's I, kernel density estimation (KDE) and mean centre, were compared to each other, using three different performance measures, including Predictive Accuracy Index (PAI), Recapture Rate Index (RRI) and hit rate. According to the results, the most accurate model with the highest PAI values (PAI = 1.61 and 1.76), Moran's I, had the third-highest reliability value (RRI = 1.003). On the other hand, while the Gi* method was the most precise and reliable technique with the highest RRI value (RRI = 1.121), it showed the second-lowest accuracy (PAI= 0.83 and 0.74). Overall, it seems that Moran's I method is superior to other methods in locating hotspots, which is not only the most accurate technique but also precise enough to rely on.

Detection of tartrazine in fake saffron containing products by a sensitive optical nanosensor.

A fluorescent assay for the selective analysis of tartrazine was developed. Tartrazine is a health-threatening food additive commonly used as fake saffron. An optical nanosensor was fabricated based on molecular imprinting technique in which carbon dots (CDs) as fluorophores and tartrazine as a template molecule were embedded in molecularly imprinted polymer (MIP) matrix. The synthesized CDs embedded in MIP (CDs-MIP) was characterized by various methods. The fluorescence intensity of (CDs-MIP) was selectively quenched in the presence of tartrazine in comparison with other similar food color additives. The correlation between the quenching of CD-MIP and the concentration of tartrazine was used as an optical sensing for rapid detection of tartrazine in the range of 3.3-20.0 nM (1.8-10.7 µg L-1) with detection limit of 1.3 nM (0.70 µg L-1). Eventually, the designed nanosensor was successfully applied for tartrazine detection in foodstuffs such as fake saffron, saffron tea and saffron ice cream samples.

Aldose reductase (AC)n gene polymorphism in Iranian patients with type 2 diabetic microangiopathy; a case-control study.

AIM: (AC)n promoter region of the aldose reductase (ALR) genes polymorphism has been associated with diabetic microvascular complications (MVCs). The aim of this study was to find the relationship between dinucleotide repeat (AC)n polymorphisms of the ALR gene and the occurrence of MVCs, such as diabetic retinopathy, neuropathy, and nephropathy in Iranian type 2 diabetic (T2D) patients. METHODS: This prospective case-control study was performed on T2D patients who were categorized into two groups based on the presence or absence of diabetic microangiopathy. All patients were provided informed consent. After extracting genomic DNA, the (AC)n of the ALR gene was determined using Polymerase chain reaction (PCR). RESULTS: Thirteen alleles of the (AC)n gene polymorphism were detected including Z + 16, Z + 14, Z + 8, Z + 6, Z + 4, Z + 2, Z, Z - 2, Z - 4, Z - 6, Z - 8, Z - 10, and Z - 12. The frequency of the Z - 4 allele was significantly higher in patients with retinopathy, nephropathy, and autonomic neuropathy compared with those with long-term uncomplicated diabetes (P < 0.001, P < 0.001, P = 0.031, respectively). After controlling for baseline risk factors, we found that the carrier of the Z - 4 allele of ALR (AC)n polymorphism had a higher risk of diabetic retinopathy and diabetic nephropathy (P < 0.001). The homozygosity for the Z - 4 allele was found to be associated with diabetic microangiopathy. CONCLUSION: Our results showed that ALR (AC)n gene polymorphism in Iranian patients with type 2 diabetes independently, predispose retinal, renal and neural microvascular to diabetic complications.

Relationship between pain, fatigue, and physical activity levels during a technology-based physical activity intervention.

Objective: The majority of individuals with spinal cord injury (SCI) experience chronic pain. Chronic pain can be difficult to manage because of variability in the underlying pain mechanisms. More insight regarding the relationship between pain and physical activity (PA) is necessary to understand pain responses during PA. The objective of this study is to explore possible relationships between PA levels and secondary conditions including pain and fatigue.Design: Prospective cohort analysis of a pilot study.Setting: Community.Participants: Twenty individuals with SCI took part in the study, and sixteen completed the study.Interventions: Mobile-health (mHealth) based PA intervention for two-months during the three-month study.Outcome measures: Chronic Pain Grade Scale (CPGS) questionnaire, The Wheelchair User's Shoulder Pain Index (WUSPI), Fatigue Severity Scale (FSS), and PA levels measured by the mHealth system.Results: A positive linear relationship was found between light-intensity PA and task-specific pain. However, the relationship between moderate-intensity PA and pain interference was best represented by a curvilinear relationship (polynomial regression of second order). Light-intensity PA showed positive, linear correlation with fatigue at baseline. Moderate-intensity PA was not associated with fatigue during any phase of the study.Conclusion: Our results indicated that PA was associated with chronic pain, and the relationship differed based on intensity and amount of PA performed. Further research is necessary to refine PA recommendations for individuals with SCI who experience chronic pain.Trial registration: ClinicalTrials.gov identifier: NCT03773692.

Characterization of an Enzyme-Catalyzed Crosslinkable Hydrogel as a Wound Dressing in Skin Tissue Engineering.

Introduction: Wound healing can have a very important impact on the patients' quality of life. For its treatment, wound dressings have vital and effective uses. Indeed, the use of a proper wound dressing can improve the healing process and duration. Recently, wound dressings with unique properties have been prepared using natural hydrogels. In addition to the general wound characteristics, new generations of wound dressings, such as those lasting longer on the wound, can have specific properties such as transferring allogeneic cells to enhance the healing effect and speed up the healing process. The present study aimed to prepare a gelatin-based hydrogel and to characterize it for therapeutic purposes. Methods: In this experimental-laboratory study, a gelatin hydrogel was made using a microbial transglutaminase (mTG) enzyme. The prepared hydrogel was evaluated in terms of appearance, physical, and chemical properties. To investigate the biological properties of the hydrogel, cells were cultured on it and the toxicity of the hydrogel for the cells was investigated. The location of the cells on the hydrogel was imaged via an electron microscope. The absorption and reflectance characteristics of the hydrogel were recorded by optical spectroscopy. Data were collected and statistical analysis was performed. Results: The results showed that the mTG gelatin hydrogel had a uniform pore size and good physical, chemical, and mechanical properties for use in wound healing. Cell experiments showed evident cell proliferation and high viability. The results also revealed that the cells grew vigorously and adhered tightly to the hydrogel. Conclusion: The preparation of a gelatin hydrogel under GMP conditions can be considered in the healing of diabetic wounds and burns.

[Comparison of post-operative nausea and vomiting with intravenous versus inhalational anesthesia in laparotomic abdominal surgery: a randomized clinical trial]. / Comparação entre anestesia intravenosa e inalatória na náusea e vômito pós­operatórios em laparotomia: estudo clínico randomizado.

BACKGROUND: Postoperative Nausea and Vomiting (PONV) is a multifactorial surgical complication with an unclear underlying cause. Anesthetic methods, patients' characteristics and the type of surgery are considered as factors affecting PONV. This study was designed to compare the effect of inhalational and intravenous anesthesia in abdominal surgery on the incidence and severity of PONV. METHODS: A single-blinded prospective randomized clinical trial on 105 patients aged 18-65 years was carried out. Patients were divided in two groups of Total Intravenous Anesthesia (TIVA) and Inhalational anesthesia. The incidence and severity of PONV were examined at 0, 2, 6, 12, and 24hours after the surgery. The use of a rescue antiemetic was also evaluated. RESULTS: Fifty point nine percent of the patients in the inhalation group and 17.3% of the patients in the intravenous group developed PONV (p <0.001). The incidence of vomiting was reported in 11.3% of the Inhalational group and 3.8% of the TIVA group (p=0.15), and 24.5% of patients in the Inhalation group and 9.6% of patients in the intravenous group needed an antiemetic medication (p=0.043). CONCLUSION: The incidence of postoperative nausea and vomiting and the need for administration of an antiemetic rescue drug, and the severity of nausea in patients were significantly lower in the TIVA group.

Comparison of post-operative nausea and vomiting with intravenous versus inhalational anesthesia in laparotomic abdominal surgery: a randomized clinical trial / Comparação entre anestesia intravenosa e inalatória na náusea e vômito pós-operatórios em laparotomia: estudo clínico randomizado

Abstract Background: Postoperative Nausea and Vomiting (PONV) is a multifactorial surgical complication with an unclear underlying cause. Anesthetic methods, patients' characteristics and the type of surgery are considered as factors affecting PONV. This study was designed to compare the effect of inhalational and intravenous anesthesia in abdominal surgery on the incidence and severity of PONV. Methods: A single-blinded prospective randomized clinical trial on 105 patients aged 18 − 65 years was carried out. Patients were divided into two groups of Total Intravenous Anesthesia (TIVA) and inhalational anesthesia. The incidence and the severity of PONV were examined at 0, 2, 6, 12 and 24 hours after the surgery. The use of a rescue antiemetic was also evaluated. Results: 50.9% of the patients in the inhalation group and 17.3% of the patients in the intravenous group developed PONV (p < 0.001). The incidence of vomiting was reported in 11.3% of the inhalational group and 3.8% of the TIVA group (p = 0.15). 24.5% of patients in the inhalation group and 9.6% of patients in the intravenous group needed an antiemetic medication (p = 0.043). Conclusion: The incidence of postoperative nausea and vomiting and the need for administration of an antiemetic rescue drug and the severity of nausea in patients were significantly lower in the TIVA group.

Resumo Justificativa: Náusea e Vômito no Pós-Operatório (NVPO) é uma complicação multifatorial com etiologia não esclarecida. A técnica anestésica, as características dos pacientes e o tipo de cirurgia são considerados fatores que afetam a NVPO. O presente estudo foi desenhado para comparar o efeito da anestesia inalatória com anestesia intravenosa na incidência e gravidade de NVPO na cirurgia abdominal. Método: Foi realizado estudo clínico mono-cego prospectivo randomizado com 105 pacientes com idades de 18 − 65 anos. Os pacientes foram divididos em dois grupos, Anestesia Total Intravenosa (TIVA) e anestesia inalatória. A incidência e gravidade de NVPO foram avaliadas em cinco momentos: 0, 2, 6, 12 e 24 horas pós-cirurgia. O uso de antiemético de resgate também foi avaliado. Resultados: NVPO ocorreu em 50,9% dos pacientes no grupo inalatória e 17,3% dos pacientes no grupo TIVA (p< 0,001). A incidência de vômitos relatados foi 11,3% no grupo Inalatória e 3,8% no grupo TIVA (p = 0,15). Necessitaram de medicação antiemética 24,5% dos pacientes no grupo Inalatória e 9,6% dos pacientes no grupo TIVA (p = 0.043). Conclusão: A incidência de náusea e vômito no pós-operatório, a necessidade de administração de droga antiemética de resgate e a gravidade da náusea foram significantemente mais baixas no grupo TIVA.