Insights into incipient oral squamous cell carcinoma: a comprehensive south-american study.

BACKGROUND: To describe demographic and clinicopathological aspects of a South-American cohort of incipient oral squamous cell carcinoma patients. MATERIAL AND METHODS: A cross-sectional, observational study was performed to assess demographic and clinicopathological characteristics of incipient oral squamous cell carcinoma patients from 6 South-American institutions. RESULTS: One hundred and seven patients within the histopathological spectrum of incipient oral squamous cell carcinoma (in-situ and microinvasive) were included. Fifty-eight (54.2%) patients were men with a mean age of 60.69 years. Forty-nine (45.8%) and thirty-nine (36.5%) patients had history of tobacco and alcohol use, respectively. Clinically, most of the lesions were plaques (82.2%), ≥ 2 cm in extension (72%), affecting the lateral border of the tongue (55.1%), and soft palate (12.1%) with a mixed (white and red) appearance. Eighty-two (76.7%) lesions were predominantly white and 25 (23.3%) predominantly red. CONCLUSIONS: To the best of our knowledge, this is the largest cohort of incipient oral squamous cell carcinoma patients, which raises awareness of clinicians' inspection acuteness by demonstrating the most frequent clinical aspects of this disease, potentially improving oral cancer secondary prevention strategies.

Application Of The Enzymatic Debridement Of Burn Wounds In Patients During The Covid-19 Epidemic.

The unfolding pandemic necessitated optimalization of treatment methods and assurance of the highest precautionary standards to prevent transmission of COVID-19 to burn patients. One of them included an expanded access treatment with the minimally invasive method - enzymatic burn wound debridement using Nexobrid concentrate. The study assessed the effectiveness and usefulness of the expanded treatment project using enzymatic burn wound debridement with Nexobrid concentrate in patients (n=11) during the pandemic (2020) when compared with the results of the same method in a corresponding period of 2019. The concentrate was applied to the wound on the third day following injury at the latest. All patients were treated with the same accepted standards, including initial debridement of the wound, application of Nexobrid concentrate, and removal of devitalized tissue and dressing. Clinical visual assessment of the wound sites confirmed successful debridement of dead tissue following the application of the concentrate. No allergic or adverse reaction, nor significant deterioration of CBC parameters were observed in any patient. Although surgical excision of necrosis is recognized as the method of choice, enzymatic wound debridement using Nexobrid concentrate may contribute to a reduction in epidemiological risk when treating burn patients for several reasons; the procedure can be performed at the patient's bedside, it limits the number of required surgeries, helps to improve medical equipment and supplies management, and saves human resources.

La pandémie incontrôlée a nécessité une optimisation du traitement et des précautions d'hygiène maximales vis à vis des brûlés. Une d'entre elles consistait en l'utilisation de méthodes peu invasives dont l'excision enzymatique au Nexobrid . Cette étude compare l'efficacité et l'utilité l'utilisation larga manu de Nexobrid chez 11 patients pendant la période COVID (2020), comparée à son utilisation habituelle dans la période précédente. Ils bénéficiaient tout du même protocole à savoir nettoyage des plaies, application du Nexobrid au plus tard à J3 puis dépose du tissu nécrotique avec le pansement, confirmé par l'examen de la plaie. Nous n'avons observé ni allergie ni anomalie hématologique. Bien que la technique chirurgicale reste le traitement de référence, l'excision enzymatique peut limiter le risque épidémique qui y est lié car elle peut être réalisée au lit du patient, car elle diminue le nombre d'interventions chirurgicales, car elle permet d'améliorer les équipements, car elle diminue le nombre d'intervenants.

Granulation and microbial community dynamics in the chitosan-supplemented anaerobic treatment of wastewater polluted with organic solvents.

The effect of chitosan on the development of granular sludge in upflow anaerobic sludge blanket reactors (UASB) when treating wastewater polluted with the organic solvents ethanol, ethyl acetate, and 1-ethoxy-2-propanol was evaluated. Three UASB reactors were operated for 219 days at ambient temperature with an organic loading rate (OLR) of between 0.3 kg COD m-3 d-1 and 20 kg COD m-3 d-1. One reactor was operated without the addition of chitosan, while the other two were operated with the addition of chitosan doses of 2.4 mg gVSS-1 two times. The three reactors were all able to treat the OLR tested with COD removal efficiencies greater than 90%. However, the time required to reach stable operation was considerably reduced in the chitosan-assisted reactors. The development of granules in the reactors with chitosan was accelerated and granules larger than 2000 µm were only observed in these reactors. In addition, these granules exhibited better physicochemical characteristics: the mean particle diameter (540 and 613 µm) was approximately two times greater than in the control reactor (300 µm), and the settling velocities exceeded 35 m h-1. The extracellular polymeric substances (EPS) in the reactors with the chitosan was found to be higher than in the control reactor. The protein-EPS content has been correlated with the granule size. The analyses of the microbial communities, performed through denaturing gradient gel electrophoresis and high-throughput sequencing, revealed that the syntrophic microorganisms belonging to genus Geobacter and the hydrogenotrophic methanogen Methanocorpusculum labreanum were predominant in the granules. Other methanogens like Methanosaeta species were found earlier in the chitosan-assisted reactors than in the control reactor.

Does simulation-based training facilitate the integration of human anatomy with surgery? A report of a novel Surgical Anatomy Course.

BACKGROUND: Knowledge of gross anatomy, as a basic core subject, is fundamental for medical students and essential to medical practitioners, particularly for those intending a surgical career. However, both medical students and clinical teachers have found a significant gap in teaching basic sciences and the transition into clinical skills. The authors present a Surgical Anatomy Course developed to teach the anatomical basis of surgical procedures with particular emphasis on laparo-scopic skills while incorporating medical simulation. MATERIALS AND METHODS: An evaluation of the students' satisfaction of the Surgical Anatomy Course was completed using a mix of multiple choice and open-ended questions, and a six-point Likert Scale. Questions were asked about the students' perceived improvement in surgical and laparoscopic skills. Manual skills were assessed using a laparoscopic simulator. RESULTS: Both evaluation of the course structure and the general impression of the course were positive. Most students believed the course should be an integral part of a modern curriculum. The course supported the traditional surgical classes and improved anatomical knowledge and strengthened students' confidentiality and facilitated understanding and taking surgical rotations. CONCLUSIONS: A medical course combining the practical learning of anatomy and surgical-based approaches will bring out the best from the students. Medical students positively evaluated the Surgical Anatomy Course as useful and benefi-cial regarding understanding anatomical structure and relationship necessary for further surgical education. (Folia Morphol 2018; 77, 2: 279-285).

Efeito de diferentes aditivos zootécnicos sobre a qualidade de ovos em duas fases produtivas da codorna / Effect of different zootechnical additives on egg quality in two quail production phases

Com o objetivo de avaliar a qualidade dos ovos de codornas alimentadas com diferentes aditivos em duas fases de produção, 360 codornas foram distribuídas em um delineamento inteiramente ao acaso, em esquema de parcela subdividida no tempo (de nove até 23 e de 24 até 39 semanas de idade), com cinco tratamentos e oito repetições de nove aves cada, organizados da seguinte forma: controle, antibiótico, prebiótico, probiótico e simbiótico. As variáveis analisadas foram: unidade Haugh, índice de gema, porcentagem dos componentes do ovo, espessura de casca medida pelo micrômetro e pelo MEV. O fornecimento dos aditivos no segundo período aumentou a unidade Haugh e nos dois períodos avaliados proporcionou aumento da porcentagem de gema e de casca e da espessura da casca e de suas membranas. A inclusão dos aditivos foi mais eficiente em aumentar o peso dos ovos e a porcentagem de gema e de casca no segundo período. A espessura da casca (MEV) melhorou após inclusão de antibiótico e simbiótico na ração no segundo período. A inclusão de aditivos na ração melhora a qualidade dos ovos de codornas durante toda a fase produtiva. Antibiótico e simbiótico são mais eficazes em melhorar a espessura da casca dos ovos produzidos durante o segundo período produtivo.(AU)

To evaluate the quality of eggs of quails fed with different additives in two stages of the productive period, 360 quails were distributed in a completely randomized design in a split plot scheme in time (9 to 23 and 24 to 39 weeks of age) with five treatments and eight repetitions of nine birds each, organized as follows: control, antibiotic, prebiotic, probiotic, and symbiotic. The analyzed variables were: Haugh unit, yolk index, percentage of egg components, shell thickness measured by the micrometer and the SEM. The supply of additives in the second period increased Haugh units, and in both periods provided an increase in the percentage of yolk and shell and improved the thickness of the shell and its membranes. The inclusion of additives was more effective in promoting weight gain in eggs and the percentage of egg yolk and egg shell from 24 to 39 weeks of age. The shell thickness (SEM) improved after inclusion of antibiotic and symbiotic in feed in the second period. The addition of additives in food improved the quality of Japanese quail egg throughout the productive period. Antibiotics and symbiotics proved to be more effective in improving shell thickness of the eggs produced in the second productive period.(AU)

First Direct-Detection Constraints on eV-Scale Hidden-Photon Dark Matter with DAMIC at SNOLAB.

We present direct detection constraints on the absorption of hidden-photon dark matter with particle masses in the range 1.2-30 eV c^{-2} with the DAMIC experiment at SNOLAB. Under the assumption that the local dark matter is entirely constituted of hidden photons, the sensitivity to the kinetic mixing parameter κ is competitive with constraints from solar emission, reaching a minimum value of 2.2×10^{-14} at 17 eV c^{-2}. These results are the most stringent direct detection constraints on hidden-photon dark matter in the galactic halo with masses 3-12 eV c^{-2} and the first demonstration of direct experimental sensitivity to ionization signals <12 eV from dark matter interactions.

Data-Driven Models of Foot-and-Mouth Disease Dynamics: A Review.

Foot-and-mouth disease virus (FMDV) threatens animal health and leads to considerable economic losses worldwide. Progress towards minimizing both veterinary and financial impact of the disease will be made with targeted disease control policies. To move towards targeted control, specific targets and detailed control strategies must be defined. One approach for identifying targets is to use mathematical and simulation models quantified with accurate and fine-scale data to design and evaluate alternative control policies. Nevertheless, published models of FMDV vary in modelling techniques and resolution of data incorporated. In order to determine which models and data sources contain enough detail to represent realistic control policy alternatives, we performed a systematic literature review of all FMDV dynamical models that use host data, disease data or both data types. For the purpose of evaluating modelling methodology, we classified models by control strategy represented, resolution of models and data, and location modelled. We found that modelling methodology has been well developed to the point where multiple methods are available to represent detailed and contact-specific transmission and targeted control. However, detailed host and disease data needed to quantify these models are only available from a few outbreaks. To address existing challenges in data collection, novel data sources should be considered and integrated into models of FMDV transmission and control. We suggest modelling multiple endemic areas to advance local control and global control and better understand FMDV transmission dynamics. With incorporation of additional data, models can assist with both the design of targeted control and identification of transmission drivers across geographic boundaries.

Supernumerary renal vessels: analysis of frequency and configuration in 996 computed tomography studies.

BACKGROUND: Number, course and division pattern of renal vessels is highly variable. Variant renal vasculature is of high interest in nephrectomy for the renal transplantations, both in deceased and living donors. The purpose of the study was to analyse the frequency of supernumerary renal vessels in a large cohort of patients undergoing the multiphase abdominopelvic computed tomography (CT), as well as analyse the possible patterns of coexisting supernumerary arteries in veins. MATERIALS AND METHODS: A retrospective analysis of abdominopelvic CT studies within 1 year period was performed. In each study, number of renal arteries and veins was recorded. Course of left renal vein was classified into normal, retro- or periaortic. For statistical analysis of normal distribution data, t-Student test was used. Chi-square test was used for frequency of variant vessel distribution. Pearson correlation coefficient was used for the analysis of coexistence of supernumerary vessels. RESULTS: 996 patients were included in the analysis, male to female ratio: 481:515 (48%:52%). Mean age was 57.9 ± 14.7 years. Single renal arteries were observed in 73% of cases, while single renal veins in 95%. Circumaortic or retroaortic courses of left renal veins were observed in 10% of cases. Number of renal vessels has been compared in patients with and without supernumerary vessels. In patients with supernumerary left renal artery, significantly more right renal vessels were observed. In patients with supernumerary right renal vein, mean number of all remaining vessels was significantly higher. CONCLUSIONS: Supernumerary renal vessels are a frequent finding in abdominal CT studies. Finding a supernumerary vessel should increase awareness of possible other supernumerary renal vessels.

Detection of Hammondia heydorni DNA in feces collected in and around an Ohio Wildlife Conservation Center.

This study aimed to identify DNA attributed to Hammondia heydorni oocysts in the feces of wild canids in and around an Ohio wildlife conservation center. Two hundred and eighty-five wild canid fecal samples were analyzed using PCR with melting curve analysis to detect coccidian DNA. Coccidia-positive samples were further subjected to H. heydorni-specific and N. caninum-specific PCR assays. Samples positive by the H. heydorni-specific assay were additionally analyzed with a PCR assay to distinguish H. heydorni from Hammondia triffittae. Coccidian DNA was detected in 51 of the 285 (17.9%) wildlife samples. H. heydorni DNA was detected in three of the coccidia-positive wildlife samples (1.1%) and N. caninum was detected in none. Determining the presence of H. heydorni in wild canids will contribute to a greater understanding of the role these hosts play in the ecology of this parasite.

Anatomical variations of the coeliac trunk in the homogeneous Polish population.

BACKGROUND: The abdominal vessels show a number of abnormalities and pathologies knowledge of which is important during open as well as laparoscopic surgeries. One of the most common vessels which pattern has many variations is the coeliac trunk. The present study was undertaken on homogeneous population to assess morphology of the coeliac trunk and to evaluate the possible variability of its branches. MATERIALS AND METHODS: Standard abdominal multidetector computed tomography examinations were performed on a total of 1569 patients diagnosed by 2 radiologists independently; in case of doubts common assessment was performed. RESULTS: The coeliac trunk followed the classic pattern in 92.7% of the cases (1455/1569 of patients). The gastrosplenic trunk was detected in 4.1% of cases (64/1569); the hepatosplenic trunk in 2.2% of cases (34/1569); the coeliac-mesenteric trunk was observed in 0.5% of cases (8/1569); the hepatogastric trunk in 0.2% of cases (4/1569); the splenomesenteric trunk was detected in 0.1% of cases (2/1569). In the next 0.1% the coeliac trunk was absent. The hepatosplenomesenteric and the coeliac-colic trunk were not observed in the study population. CONCLUSIONS: Vascular anatomical abnormality is usually asymptomatic hovewer, its preoperative knowledge is helpful to reduce complications like vascular bleeding when dissecting the hapato-pancreatic region. The coeliac trunk and its branches can be fast and easy evaluated in computed tomography exams performed due to various symptoms from abdominal cavity.

Occult hepatitis B virus infection among blood donors from the Brazilian Amazon: implications for transfusion policy.

BACKGROUND: Brazil requires the performance of both a test for hepatitis B surface antigen (HBsAg) and a test for antibodies to the core of hepatitis B for blood donor screening. Blood centres in regions of high HBV endemicity struggle to maintain adequate stocks in face of the high discard rates due to anti-HBc reactivity. We evaluated the potential infectivity of donations positive for anti-HBc in search of a rational approach for the handling of these collections. STUDY DESIGN AND METHODS: We tested anti-HBc reactive blood donations from the state of Amazonas for the presence of HBV DNA and for titres of anti-HBs. The study population consists of village-based donors from the interior of Amazonas state. RESULTS: Among 3600 donations, 799 were anti-HBc reactive (22·2%). We were able to perform real-time PCR for the HBV S gene on specimens from 291 of these donors. Eight of these samples were negative for HBsAg and positive for HBV DNA and were defined as occult B virus infections (2·7%). Six of those eight specimens had anti-HBs titres above 100 mIU/ml, indicating the concomitant presence of the virus with high antibody titres. CONCLUSION: A small proportion of anti-HBc reactive donors carry HBV DNA and anti-HBs testing is not useful for predicting viremia on them. This finding indicates the possibility of HBV transmission from asymptomatic donors, especially in areas of high HBV prevalence. Sensitive HBV DNA nucleic acid testing may provide another level of safety, allowing eventual use of anti-HBc reactive units in critical situations.

Simulation techniques in the anatomy curriculum: review of literature.

Modern medical education faces a problem of combining the latest technology, procedures and information with classic teaching methods. Simulation is a technique, which replaces or amplifies doctor-patient experiences in controlled conditions and therefore evokes or replicates substantial aspects of the real world in a fully interactive manner. The basic course of anatomy in medical education could be recognised as the best example of implementing new educational techniques such as simulation, into the traditional medical curriculum. The PubMed database was searched using specific key words. Finally 72 articles were accepted and were divided into 3 basic categories of teaching methods: Category 1 - cadaveric dissection, Category 2 - simulator based education and Category 3 - other. A state of the art anatomical curriculum offers numerous possibilities and solutions including the oldest like cadaveric dissection and newest like simulators. Different simulation techniques are used with different intensity; however cadaveric dissection is still the most popular method. The second most frequent method is simulation-based training, in which North America is the leading country. The identification of anatomical structures during virtual surgical procedures or laparoscopic robotic procedures can be integrated into the traditional anatomy course. New technologies are supportive and beneficial in anatomy teaching however each excitement of new technologies sometimes should be tempered and evaluated for its usefulness in making the learning process constructive for students and their future practice.

CHACO outreach project: the development of a primary health care-based medical genetic service in an Argentinean province.

Dissemination of knowledge in genetics to be applied in medicine has created a growing need for capacity building in health care workers. The CAPABILITY ARGENTINA outreach project protocol was designed as a model to introduce genetics in areas without genetic services. Our aim was for genetic health care to become part of primary care in an Argentine province lacking genetic services. The program was innovative as professionals from the referral center (Garrahan Hospital S.A.M.I.C.) traveled to remote areas to train professionals through problem-based education. A logical framework was designed for a local needs assessment. Teaching materials (Powerpoint presentations, printed syllabus, and CD) and a web page were developed. A demonstration project was carried out in the Province of Chaco, Argentina. A total of 485 health workers were trained. The number of consultations increased significantly in participating areas comparing before and after the training period. To support this increase, a complementary project was set up from a public hospital sponsored from within Argentina to build a cytogenetic laboratory in the capital of the Province of Chaco. The model was improved for reproduction in other areas in Argentina. CAPABILITY ARGENTINA is a capacity building model for training of primary care professionals in genetics that may be applied to other medical specialties. The outcomes of the programme have a direct impact on clinical practice.

Volumetric reconstruction of the right ventricle improves reproducibility of interventricular septum bowing in patients with pulmonary embolism.

Bowing of the interventricular septum (IVS) is a sign of severe pulmonary embolism(PE); however, it is affected by high interobserver variability. The aim of the study was to evaluate the application of volumetric reconstructions of the right ventricle for assessment of IVS position regarding its accuracy in identifying right ventricular dysfunction, as well as interobserver agreement in evaluating this sign.IVS bowing was evaluated with multiplanar reformations (MPR) and volumetric reconstruction (VR, volume rendering) by 2 observers. The accuracy of IVS bowing sign was better for VR-based assessment; however, it was not significantly better than the MPR-based evaluation. Interobserver agreement was found to be fair (kappa = 0.381) for the MPR-based grading of IVS position as normal orabnormal, while it was significantly better for the VR method (kappa = 0.629,p < 0.001). The VR-based method may improve utilisation of IVS bowing sign inpatients with PE.

Effects of corn replacement by sorghum in broiler diets on performance and intestinal mucosa integrity.

The effect of replacing corn with low-tannin sorghum on broiler performance, carcass yield, integrity of mucosa of small intestine segments, and activity of membrane enzymes of the jejunum is investigated. A total of 594 male Cobb-500 broiler chicks were randomly assigned to 3 dietary treatments: 100% corn (control), 50% corn replacement with low-tannin sorghum (low sorghum), and 100% corn replacement with low-tannin sorghum (high sorghum). Body weight gain, feed consumption, feed conversion, and carcass yield were determined at 7, 21, and 42 d, and segments of the small intestine were collected. Feed conversion and weight gain were impaired at d 42 in broilers fed the high-sorghum diet, but no differences were observed for carcass yield among the treatments (P > 0.05). Crypt cell mitotic index of the jejunum and ileum at d 21 and 42 was lower in broilers fed the control diet than in those fed low- and high-sorghum diets (P < 0.05). Aminopeptidase activity was higher in broilers fed the control diet than in those fed low- and high-sorghum diets irrespective of age (P < 0.05). Conversely, intestinal alkaline phosphatase activity in the small intestine did not differ among the dietary treatments (P > 0.05). Our results indicate that 50% corn replacement with low-tannin sorghum is suitable for broiler diets, whereas 100% corn replacement with low-tannin sorghum had negative effects on the intestinal mucosa and performance of broilers at 42 d.