Oncopig bladder cancer cells recapitulate human bladder cancer treatment responses in vitro.

Introduction: Bladder cancer is a common neoplasia of the urinary tract that holds the highest cost of lifelong treatment per patient, highlighting the need for a continuous search for new therapies for the disease. Current bladder cancer models are either imperfect in their ability to translate results to clinical practice (mouse models), or rare and not inducible (canine models). Swine models are an attractive alternative to model the disease due to their similarities with humans on several levels. The Oncopig Cancer Model has been shown to develop tumors that closely resemble human tumors. However, urothelial carcinoma has not yet been studied in this platform. Methods: We aimed to develop novel Oncopig bladder cancer cell line (BCCL) and investigate whether these urothelial swine cells mimic human bladder cancer cell line (5637 and T24) treatment-responses to cisplatin, doxorubicin, and gemcitabine in vitro. Results: Results demonstrated consistent treatment responses between Oncopig and human cells in most concentrations tested (p>0.05). Overall, Oncopig cells were more predictive of T24 than 5637 cell therapeutic responses. Microarray analysis also demonstrated similar alterations in expression of apoptotic (GADD45B and TP53INP1) and cytoskeleton-related genes (ZMYM6 and RND1) following gemcitabine exposure between 5637 (human) and Oncopig BCCL cells, indicating apoptosis may be triggered through similar signaling pathways. Molecular docking results indicated that swine and humans had similar Dg values between the chemotherapeutics and their target proteins. Discussion: Taken together, these results suggest the Oncopig could be an attractive animal to model urothelial carcinoma due to similarities in in vitro therapeutic responses compared to human cells.

Orthopaedic surgeons can play important role in identifying victims of domestic violence in the emergency department - narrative review of Brazilian literature.

Over the last year, with the social isolation imposed by the coronavirus disease pandemic, there has been a significant increase in complaints associated with physical violence against women. In the present study, an exploratory literature review was carried out on the role of the on-call orthopedic surgeon when faced with a suspicion of domestic violence, in accordance with Brazilian legislation. The main objective of the study was to show the role of this specialist in identifying victims of domestic violence by recognizing their profiles and associated risk factors. The secondary objectives were to demonstrate the most common skeletal and non-skeletal injuries in this type of violence and to present a quick and practical guide on how to identify, approach, and manage cases of domestic violence against women. The findings revealed that the main aggressors were close partners, such as spouses and ex-spouses. Young adult women, black or multiracial, and low socioeconomic status are major risk factors for intimate partner violence. Head and neck injuries are the most frequently observed lesions in this population, with more than one-third of victims reporting falls. Musculoskeletal injuries are present in up to 42% of victims of domestic violence, occurring predominantly in the upper limbs and chest, and are the leading cause of death in women aged 1 to 34 years. A practical guide for orthopedic surgeons who work in emergency departments is proposed, with basic information about their role and responsibility in identifying potential victims of intimate partner violence.

Epidemiological and clinical analyses of corneal transplants performed in a reference eye center in Recife, Brazil / Análise epidemiológica e clínica dos transplantes de córnea realizados em um centro de referência oftalmológica em Recife, Brasil

ABSTRACT Purpose: To evaluate the epidemiological and clinical profiles of corneal transplants performed in a reference eye center in Recife, state of Pernambuco, Northeastern Brazil. Methods: This cross-sectional study collected epidemiological and clinical data from the medical records of patients who underwent keratoplasty at the Altino Ventura Foundation between January and December 2017. Results: A total of 356 procedures were performed in 327 patients, of whom 165 (50.5%) were female. The mean age at surgery was 50.9 ± 22.6 years (range, 10-89 years). Most patients (n=152 [46.5%]) were from the capital and metropolitan areas. The mean waiting time for keratoplasty was 52.4 ± 58.9 days (range, 0-460 days). The main indications for keratoplasty were infectious keratitis (n=88 [24.7%]), keratoconus (n=80 [22.5%]), and previous transplant failure (n=75 [21.1%]). Penetrating keratoplasty was the most common surgical technique performed (n=213 [59.9%]) and more frequently performed in men (n=132 [76.7%]), whereas posterior lamellar transplant (n=143 [41.1%]) was more frequently performed in women (p<0.001). Conclusion: Infectious keratitis was the main indication for keratoplasty, which was similarly performed in economically active adults of both sexes. Penetrating keratoplasty was more frequently performed in men and lamellar transplants in women.

RESUMO Objetivo: Avaliar o perfil clínico e epidemiológico dos transplantes de córnea realizados em um centro de referência oftalmológica de Recife no estado de Pernambuco, localizado no nordeste do Brasil. Métodos: Esse estudo transversal coletou através de prontuários médicos dados clínicos e epidemiológicos de pacientes submetidos a ceratoplastia na Fundação Altino Ventura, de janeiro a dezembro de 2017. Resultados: Um total de 356 procedimentos foram realizados em 327 pacientes dos quais 165 (50.5%) eram mulheres. A média de idade na cirurgia foi de 50.9 ± 22.6 anos (variação, 10 - 89 anos). A maioria dos pacientes (n=152 [46.5%]) era da capital e região metropolitana. A média de tempo de espera na fila para o transplante de córnea foi de 52.4 ± 58.9 dias (variação, 0 - 460 dias). As principais indicações de transplante foram ceratite infecciosa (n=88 [24.7%]), ceratocone (n=80 [22.5%]) e falência de transplante prévio (n=75 [21.1%]). Transplante penetrante foi a técnica mais realizada (n=213 [59.9%]) e foi mais comum em homens (n=132 [76.7%]), enquanto os transplantes lamelares posteriores (n=143 [41.1%]) foram mais realizados nas mulheres (p<0.001). Conclusão: Ceratites infecciosas foram a causa mais comum de transplante, com prevalência similar em adultos economicamente ativos de ambos os sexos. Transplante penetrantes foram os prevalentes em homens e os transplantes lamelares em mulheres.

Epidemiological and clinical analyses of corneal transplants performed in a reference eye center in Recife, Brazil.

PURPOSE: To evaluate the epidemiological and clinical profiles of corneal transplants performed in a reference eye center in Recife, state of Pernambuco, Northeastern Brazil. METHODS: This cross-sectional study collected epidemiological and clinical data from the medical records of patients who underwent keratoplasty at the Altino Ventura Foundation between January and December 2017. RESULTS: A total of 356 procedures were performed in 327 patients, of whom 165 (50.5%) were female. The mean age at surgery was 50.9 ± 22.6 years (range, 10-89 years). Most patients (n=152 [46.5%]) were from the capital and metropolitan areas. The mean waiting time for keratoplasty was 52.4 ± 58.9 days (range, 0-460 days). The main indications for keratoplasty were infectious keratitis (n=88 [24.7%]), keratoconus (n=80 [22.5%]), and previous transplant failure (n=75 [21.1%]). Penetrating keratoplasty was the most common surgical technique performed (n=213 [59.9%]) and more frequently performed in men (n=132 [76.7%]), whereas posterior lamellar transplant (n=143 [41.1%]) was more frequently performed in women (p<0.001). CONCLUSION: Infectious keratitis was the main indication for keratoplasty, which was similarly performed in economically active adults of both sexes. Penetrating keratoplasty was more frequently performed in men and lamellar transplants in women.

Versão brasileira da ferramenta Assessing Competencies in Evidence-Based Medicine (ACE): um estudo de validação / Brazilian Version of the ACE (Assessing Competencies in Evidence-Based Medicine) Tool: a Validation Study

Resumo: Introdução: A ferramenta Assessing Competencies in Evidence-Based Medicine (ACE) é um questionário recentemente proposto para avaliação de competências em Medicina Baseada em Evidências. Este estudo teve como objetivo validar a versão brasileira da ferramenta ACE. Método: Trata-se de um estudo transversal de validação realizada em duas fases. Na primeira fase, traduziu-se o questionário. Na segunda fase, estudantes de graduação e professores/preceptores do curso de Medicina responderam ao questionário. As propriedades avaliadas foram validade, consistência e confiabilidade internas. Resultado: Incluíram-se 76 estudantes de graduação e 12 professores/preceptores. A média dos professores/preceptores foi significativamente mais alta que a dos alunos (10,25 ± 1,71 versus 8,73 ± 1,80, diferença média de 1,52, IC95% 0,47-2,57, p = 0,005), demonstrando a validade de construto. A versão brasileira da ferramenta ACE obteve consistência (alfa de Cronbach = 0,61) e confiabilidade internas (correlação item-total ≥ 0,15 em 14 dos 15 itens) adequadas. Conclusão: A versão brasileira da ferramenta ACE demonstra propriedades psicométricas aceitáveis e pode ser usada como instrumento para a avaliação de competências para a Medicina Baseada em Evidências em estudantes de Medicina brasileiros.

Abstract: Introduction: The ACE (Assessing Competencies in Evidence-Based Medicine) Tool is a recently developed questionnaire to assess competencies in Evidence-Based Medicine. The aim of this study is to validate the Brazilian version of ACE Tool. Methods: This is a cross-sectional validation study carried out in two phases. In the first phase, the questionnaire was translated. In the second phase, the questionnaire was applied to undergraduate students and teachers/preceptors of the medical course. The evaluated properties were internal validity, consistency and reliability. Results: 76 medical undergraduate students and 12 teachers/preceptors were included. The mean of teachers/preceptors was significantly higher than that of students (10.25±1.71 vs 8.73±1.80, mean difference of 1.52, 95%CI 0.47-2.57, p=0.005), demonstrating construct validity. The Brazilian version of the ACE Tool obtained adequate internal consistency (Cronbach's alpha = 0.61) and reliability (item-total correlation ≥ 0.15 in 14 of the 15 items). Conclusion: The Brazilian version of the ACE Tool shows acceptable psychometric properties and can be used as an instrument to assess competencies for Evidence-Based Medicine in Brazilian medical students.

Effect of supplementation of medium with Bauhinia forficata recombinant lectins on expression of oxidative stress genes during in vitro maturation of bovine oocytes.

The lectin of Bauhinia forficata (nBfL) is a protein able to bind reversibly to N-acetylgalactosamine, performing several functions and one of them is the antiproliferative activity in tumor cells, but its effects have not yet been evaluated in female gametes. The objective of the present study was to determine the additional effect of B. forficata recombinants lectins in the medium of maturation in vitro of bovine oocytes in expression of genes related to oxidative stress pathways. To get the proteins, the gene for this recombinant lectin (rBfL) and its truncated isoform (rtBfL) were cloned and expressed in Escherichia coli (E.coli). The oocytes obtained through follicular puncture were incubated in IVM medium for 24 h containing concentrations of 10 µg/mL, 50 µg/mL and 100 µg/mL of nBfL, rBfL and rtBfL, and a no treated group as a control. In the groups treated with the concentration of 100 µg / mL, the gene expression of genes involved in oxidative stress SOD2, CAT, GPX-1, GSR, NOS2 and apoptosis BAX, CASP3 were evaluated. The rtBfL increased the expression of the SOD2, GSR and NOS2 genes and all the tested lectins increased the expression of the CASP3 gene compared to the control group. These findings indicate that the tested concentrations of the B. forficata recombinants lectins probably influence the expression of oxidative stress genes and increase the expression of the apoptotic gene CASP3 during in vitro maturation of bovine oocytes.

Phenological responses to climate change based on a hundred years of herbarium collections of tropical Melastomataceae.

Changes in phenological events have been vastly documented in face of recent global climate change. These studies are concentrated on temperate plants, and the responses of tropical species are still little understood, likely due to the lack of long-term phenological records in the tropics. In this case, the use of herbarium specimens to gather phenological data over long periods and wide geographic areas has emerged as a powerful tool. Here, we used four Melastomataceae species endemic to the Brazilian Atlantic Forest to evaluate phenological patterns and alterations as responses to recent climate changes. Phenological data were gathered from Reflora Virtual Herbarium specimens collected between 1920 and 2018, and analyzed with circular statistics applied to the intervals 1920-1979, 1980-1999, and 2000-2018. The effects of temperature range, average temperature, precipitation, and photoperiod on flowering and fruiting of each species were tested using multiple linear regressions. Through circular statistics, we detected changes, mostly delays, in the flowering of Miconia quinquedentata, Pleroma clavatum and P. trichopodum, and in the fruiting of M. acutiflora, P. clavatum and P. trichopodum. We also found that flowering and fruiting occurrence were related to local climatic conditions from months prior to the collections. We found marked phenological variations over the decades and also that these variations are associated to global climate change, adding up to the large body of evidence from higher latitudes. Our results also support herbarium collections as an important source for long-term tropical phenological studies. The lack of consistent patterns of responses among the four species (e.g. fruiting delayed two months in P. clavatum and advanced one month in M. acutiflora) suggests that climate change has unequal effects across tropical forests. This highlights the urgent need for further research to understand and forecast the ecological implications of these changes in global ecosystems processes.

Cystic nephroma in pediatrics.

INTRODUCTION: Cystic nephroma is a rare benign renal tumor of uncertain etiology. In children, it can manifest as a palpable abdominal mass, hematuria, and recurrent urinary infections. Imaging tests such as ultra sound and computed tomography assist in the diagnosis, but confirmation is made through anatomopathological study. Treatment is surgical and may be partial or total nephrectomy, with a good prognosis. OBJECTIVE: To report a rare case of pediatric cystic nephroma, its clinical manifestations, radiological and histopathological aspects, as well as the treatment used and its evolution. CLINICAL CASE: Pre-school, male, with a history of recurrent urinary infections in the first year of life. At 2 years and 8 months, he presented nodulation in the right hypochondrium with local pain on palpation, associated with urinary disorders and hematuria. An ultrasonography showing enlarged right kidney due to multiseptated cystic formation. Computed tomography showing multiloculated cystic expan sive formation in the right kidney. At 2 years and 10 months, he underwent partial right nephrec tomy for excision and anatomopathological study, which was compatible with Cystic Nephroma. He evolved with regression of hematuria and recurrent episodes of urinary infections, maintaining renal function preserved. Currently, at 4 years and 6 months, asymptomatic. CONCLUSIONS: Cystic nephro ma is a rare entity, generally with a good prognosis. The association of clinical findings, radiological images, and anatomopathological study are fundamental for the establishment of diagnosis and a better definition of therapeutic conduct.

Case Report: Coronavirus Disease and Pulmonary Tuberculosis in Patients with Human Immunodeficiency Virus: Report of Two Cases.

Coinfection of SARS-CoV-2/Mycobacterium tuberculosis (MTB) in patients with HIV/AIDS has not been previously reported. Here, we present two cases of coinfection of SARS-CoV-2 and MTB in patients with HIV. The first case is a 39-year-old patient who was admitted with a 7-day history of fever, myalgia, headache, and cough. The second patient is a 43-year-old man who had a 1-month history of cough with hemoptoic sputum, evolving to mild respiratory distress in the last 7 days. Both patients already had pulmonary tuberculosis and subsequently developed SARS-CoV-2 infection during the 2020 pandemic. Nonadherence to antiretroviral treatment may have been a factor in the clinical worsening of the patients.

Toxicological evaluation of 3-(4-Chlorophenylselanyl)-1-methyl-1H-indole through the bovine oocyte in vitro maturation model.

The development of new bioactive molecules based on the molecular hybridization has been widely explored. In line with this, reliable tests should be employed to give information about the toxicology of these new molecules. In this sense, the use of in vitro tests is a valuable tool, especially the in vitro maturation of oocytes (IVM), which is an efficient resource to discover the potential toxicity of synthetic molecules. Thus, the aim of the present study was to evaluate the toxicological effects of the selenium-containing indolyl compound 3-(4-Chlorophenylselanyl)-1-methyl-1H-indole (CMI), on different quality parameters of bovine oocytes through the IVM. Different concentrations of the CMI compound (0, 25, 50, 100, 200 µM) were supplemented during the in vitro maturation process. After, the oocyte maturation rate, glutathione (GSH) levels, reactive oxygen species (ROS) levels, membrane, and mitochondrial integrity were evaluated. The results showed that the lowest concentration of CMI induced the highest GSH production (P < 0.05), an important marker of cytoplasmic quality and maturation. All treatments increased ROS production in relation to non-supplementation (P < 0.05). In addition, oocyte maturation was reduced only with the highest concentration of CMI (P < 0.05). Supplementation with CMI did not impact mitochondrial activity, integrity and cell membrane. To our knowledge, this is the first study that evaluates CMI on the oocyte in vitro maturation process. Importantly, our results did not find any toxic effect of CMI on bovine oocytes. CMI was efficient for cytoplasmic maturation by promoting an increase in the intracellular levels of glutathione.

Visceral leishmaniasis in pregnant women from Rio Grande do Norte, Brazil: A case report and literature review.

Visceral leishmaniasis (VL) in pregnant is considered rare. We present the case of a woman with 24 gestational weeks presenting fever, hepatosplenomegaly, pancytopenia, and inversion of albumin/globulin ratio. Anti-rK39 was positive and amastigotes were visualized on myelogram. Treatment with LAmB showed disease improvement. The newborn was born healthy at term, with delivery performed without complications. As VL in pregnancy can progress to death and complications for the mother-fetus binomial, inclusion of VL in the differential diagnosis of patients from endemic areas with compatible clinical picture is mandatory. Treatment with LAmB demonstrates safety and high cure rates in pregnancy.

Visceral leishmaniasis in pregnant women from Rio Grande do Norte, Brazil: A case report and literature review

Abstract Visceral leishmaniasis (VL) in pregnant is considered rare. We present the case of a woman with 24 gestational weeks presenting fever, hepatosplenomegaly, pancytopenia, and inversion of albumin/globulin ratio. Anti-rK39 was positive and amastigotes were visualized on myelogram. Treatment with LAmB showed disease improvement. The newborn was born healthy at term, with delivery performed without complications. As VL in pregnancy can progress to death and complications for the mother-fetus binomial, inclusion of VL in the differential diagnosis of patients from endemic areas with compatible clinical picture is mandatory. Treatment with LAmB demonstrates safety and high cure rates in pregnancy.

High doses of lipid-core nanocapsules do not affect bovine embryonic development in vitro.

The improvement of in vitro embryo production by culture media supplementation has been a potential tool to increase blastocyst quality and development. Recently, lipid-core nanocapsules (LNC), which were developed for biomedical applications as a drug-delivery system, have demonstrated beneficial effects on in vitro embryo production studies. LNCs have a core composed of sorbitan monostearate dispersed in capric/caprylic triglyceride. Based on that, we firstly investigated if LNCs supplemented during in vitro oocyte maturation had affinity to the mineral oil placed over the top of the IVM media. Also, the effects of LNC supplementation in different concentrations (0; 0.94; 4.71; 23.56; 117.80 and 589.00µg/mL) during the in vitro maturation protocol were evaluated in oocytes and blastocysts by in vitro tests. LNCs seemed not to migrate to the mineral oil overlay during the in vitro oocyte maturation. Interestingly, LNCs did not show toxic effects in the oocyte in vitro maturation rate, cumulus cells expansion and oocyte viability. The highest LNCs concentration tested (589µg/mL) generated the lowest ROS and GSH levels, and reduced apoptosis rate when compared to the control. Additionally, toxic effects in embryo development and quality were not observed. The LNC supramolecular structure demonstrated to be a promising nanocarrier to deliver molecules in oocytes and embryos, aiming the improvement of the embryo in vitro development.