Direct seeding as a recruitment alternative for the threatened tropical palm Syagrus coronata (Mart.) Beccari in Brazilian dry forest.

Habitat loss reduces biodiversity and threatens ecological services. The use of techniques for vegetation restoration such as direct seeding seems promising, mainly because it reduces costs and labor. The aim of this study was to investigate which are the main ecological filters that can inhibit the success of direct seeding, using Syagrus coronata (Mart.) Beccari (Arecaceae), a species that has great ecological and extractive importance for the Brazilian semi-arid region, and is found in habitats with different management intensities. The following hypotheses were tested: (1) managed habitat (pasture) and natural habitat (caatinga vegetation) show differences in seed fate; and (2) defleshed fruits will have greater seed germination success compared to not defleshed. Seed fate was evaluated for two consecutive years, year I (2016-2017) and year II (2017-2018). Within these years, 800 mature fruits were buried along 300 m transects, half with defleshing treatment, and monitored during 240 days. The highest seed survival occurred in year II, this result may be associated with higher rainfall recorded during the experiment, considering that there was no difference in seed germination between habitats. Defleshing facilitated germination and reduced insect predation, likely by removing invertebrate larvae before they have reached the seed. Desiccation was the major cause of mortality in the entire study and was higher in the managed habitat. Water insufficiency may have caused the deactivation of antioxidant mechanisms and affected the embryo. Although defleshing may favor germination, this procedure would not be indicated for pastures as it favors desiccation. The study showed how habitat management and fruit defleshing can affect seed fate. More studies on ecological relationships need to be carried out to increase understanding of how habitat modification affects the functioning of arid ecosystems.

Rosetas em angiossarcoma cutâneo: uma nova pista dermatoscópica / Rosettes in cutaneous angiosarcoma: a new dermoscopic clue

O angiossarcoma cutâneo é um câncer raro, de mau prognóstico, que acomete principalmente idosos do sexo masculino. Está relacionado à exposição solar crônica, linfedema crônico e procedimentos com uso de radiação. Relatamos o caso de um homem de 62 anos com presença de tumoração violácea de crescimento progressivo na região temporal esquerda. A dermatoscopia demonstrou áreas eritematosas de diferentes tons, estruturas semelhantes à pseudo-aberturas foliculares e rosetas. A biópsia e a análise imunohistoquímica confirmaram o diagnóstico de angiossarcoma cutâneo. O paciente atualmente está em tratamento quimioterápico no serviço de oncologia com melhora significativa da lesão.

Cutaneous angiosarcoma is a rare cancer with a poor prognosis that affects mainly elderly men. It is related to chronic exposure to sunlight, chronic lymphedema, and procedures using radiation. We report a case of a 62-year-old man with a progressively growing violaceous tumor in the left temporal region. Dermoscopy showed erythematous areas of different shades, pseudo-follicular openings structures, and rosettes. The biopsy and the immunohistochemical study confirmed the diagnosis of cutaneous angiosarcoma. The patient is currently undergoing chemotherapy treatment in the oncology service with significant improvement of the lesion.

[Macrovipera lebetina obtusa Snake Venom as a Modulator of Antitumor Effect in S-180 Sarcoma Mouse Model].

Macrovipera lebetina obtusa (MLO) is a venomous snake endemic to Middle East. Here we describe the therapeutic potential of the MLO snake venom. In S-180 sarcoma-bearing mouse model, we showed that the MLO snake venom inhibits tumour growth by 50%. In human dermal microvascular endothelial cells (HMVEC-D), treatment with the MLO snake venom lead to an increase of expression levels of the vascular endothelial growth factor (VEGF), while the level of the expression of caspase 8 did not change. In HMVEC-D cells MLO snake venom induces necroptosis, rather than apoptosis. In the chick embryo chorioallantoic membrane (CAM) assay, exposure to MLO snake venom inhibited bFGF-induced angiogenesis by 22%. Taken together, these results indicate that the MLO snake venom has a potent cytotoxic activity. Regulated necroptic cell death pathway, which is engaged by MLO snake venom, may become a promising novel target for antitumor therapies.

Extrusion-based 3D printing of oral solid dosage forms: Material requirements and equipment dependencies.

Extrusion-based 3D printing is steadily gaining importance as a manufacturing technique due to its flexibility and wide range of possible end-products. In the medical field, the technique is being exploited for a variety of applications and one of these is the production of personalised medicines. However, despite many proof-of-concept studies, more thorough insights in the production technique itself and the required material properties are needed before 3D printing can be fully exploited in a hospital or pharmacy setting. This research aims at clarifying the complex interplay between material properties, process parameters and printer-dependent variables. A variety of different polymers and polymer-drug blends were extruded (diameter 1.75±0.05 mm) and characterised in terms of mechanical, thermal and rheological properties. These properties, together with the processing temperature, printing speeds and different nozzle diameters of the 3D printer were linked to the quality of the end-product. Different failure mechanisms (mechanical, thermal) were assessed. Decisive material parameters (e.g. cross-over point) for optimal printing behaviour and the importance of printer construction (nozzle diameter) were clarified. In general, this study offers insight into the 3D printing process and will help to speed up future pharmaceutical formulation development for printlets.

The GUD technique: glandar urethral disassembly. An alternative for distal hypospadias repair

ABSTRACT Introduction We present an alternative procedure for distal hypospadias consisting of urethral mobilization and partial glandar disassembly, namely GUD (glandar urethral disassembly) technique. Materials and Methods A subcoronal circumcision exposes distal dysplastic urethra. We incise the Buck´s fascia on both sides of urethra releasing it partially from the corpora. We keep a thin bridge of urethral plate to the glans and disassembly almost completely the glans from the corpora, except for the bridge. The glans is incised creating two wide wings that are extremely mobile. The urethra is mobilized, advanced and sutured to the tip of the glans. The glans wings embrace the distal urethra producing a conical glans. Discussion The concept of urethral mobilization has been reported and popularized by Koff in the literature to correct distal hypospadias. One of the limitations of this procedure is the risk of urethral retraction due to extensive proximal dissection. We got inspiration from Mitchell and Bagli' s work of penile disassembly in epispadias to develop the GUD concept. We adopt minimal urethral mobilization mainly in glandar/proximal penile shaft and complete deconstruction of the glans, detaching the corpora from the glans and rotating the wide glans wings to embrace the urethra. Therefore we avoid suture urethroplasty and refurbish the glans to a better conical shape. Conclusion We are convinced that this operation can be regarded as a genuine alternative to distal hypospadias (coronal and subcoronal) but should not be addressed to midshaft forms.

Association between abdominal pain and fecal impaction grade assessed through radiography in constipated patients at a pediatric emergency service. / Asociación entre el dolor abdominal y el grado de coproestasis mediante la evaluación radiográfica en pacientes estreñidos que acuden a los servicios de urgencias pediátricas.

INTRODUCTION AND AIM: Abdominal pain in children is a frequent cause of emergency room consultation. An important group of those patients presents with chronic constipation and fecal impaction. Plain abdominal x-ray is widely used for making a diagnosis and ruling out the need for surgical treatment. The present study examined the association between pain intensity and fecal impaction grade. MATERIALS AND METHODS: An analytic cross-sectional study was conducted that compared 2 radiographic scales to determine the association between the grade of fecal impaction observed and abdominal pain intensity in patients that sought medical attention at an emergency service within a 7-month period. The analysis was carried out by 2 different observers, utilizing 2 different radiographic scales to confirm their reproducibility. The degree of interobserver agreement was measured using the Kappa coefficient and the association between abdominal pain and fecal impaction grade was measured through the Spearman correlation coefficient. RESULTS: There was a significant association between pain intensity and the radiographic grade of fecal impaction (P<.05) for the radiographic scale by segments and its interobserver agreement was high, compared with the scale by percentage. CONCLUSIONS: Radiographic scales may be useful in the evaluation and treatment of patients with abdominal pain and constipation. The segmental scale showed less interobserver variability, suggesting its proposal as an alternative in the evaluation and follow-up of patients with chronic constipation.

Real-world data from the Portuguese Nivolumab Expanded Access Program (EAP) in previously treated Non Small Cell Lung Cancer (NSCLC).

OBJECTIVE: The main aim of the study was to evaluate the efficacy and safety profile of Nivolumab, an immune-checkpoint-inhibitor antibody, in advanced, previously treated, Non-Small Cell Lung Cancer (NSCLC) patients, in a real world setting. METHODS: We performed a retrospective, multicentre data analysis of patients who were included in the Portuguese Nivolumab Expanded Access Program (EAP). Eligibility criteria included histologically or citologically confirmed NSCLC, stage IIIB and IV, evaluable disease, sufficient organ function and at least one prior line of chemotherapy. The endpoints included Overall Response Rate (ORR), Disease Control Rate (DCR), Progression Free Survival (PFS) and Overall Survival (OS). Safety analysis was performed with the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE), version 4.0, and immune-related Adverse Events (irAEs) were treated according to protocol treatment guidelines. Tumour response was assessed using the Response Evaluation Criteria in Solid Tumours (RECIST) version 1.1. Data was analysed using SPSS, version 21.0 (IBM Statistics). RESULTS: From June 2015 to December 2016, a total of 229 patients with advanced NSCLC were enrolled at 30 Portuguese centres. Clinical data were collected up to the end of July 2018. The baseline median age was 64 years (range 37-83) and the majority of patients were males (70.3%) and former/current smokers (69.4%). Patients with non-squamous histology predominated (88.1%), and 67.6% of the patients had received 2 or more prior lines of chemotherapy. Out of 229 patients, data was available for 219 patients (3 patients did not start treatment, while data was unavailable in 7 patients); of the 219 patients, 15.5% were not evaluated for radiological tumour assessment, 1.4% had complete response (CR), 21% partial response (PR), 31% stable disease (SD) and 31.1% progressive disease (PD). Thus, the ORR was 22.4% and DCR was 53.4% in this population. At the time of survival analysis the median PFS was 4.91 months (95% CI, 3.89-6.11) and median OS was 13.21 months (95% CI, 9.89-16.53). The safety profile was in line with clinical trial data. CONCLUSIONS: Efficacy and safety results observed in this retrospective analysis were consistent with observations reported in clinical trials and from other centres.

Natural Vs Managed Habitat: Effect Over the Seed-Predator Pachymerus nucleorum and Its Natural Enemies.

The licuri palm, Syagrus coronata (Martius) Beccari (Arecaceae), is widely distributed throughout the Brazilian Caatinga and has high cultural, socioeconomical, and ecological importance. The palm tree logging is prohibited by the Brazilian law, and thus isolated individuals are a common sight on managed pastures in the Brazilian semi-arid region. We aimed to compare the insect seed-predator Pachymerus nucleorum (Fabricius) (Bruchinae) abundance and its predation levels on S. coronata seeds between managed (pasture) and natural (Caatinga vegetation) habitats. We also monitored the parasitoid Heterospilus prosopodis (Viereck) (Braconidae) abundance and other P. nucleorum potential natural enemies (generalist predators and microhymenopterans). We tested the hypothesis that more complex and heterogenous habitats (i.e., with higher plant diversity) support higher abundance of potential P. nucleorum natural enemies. For such, we collected 600 fruits from each habitat and evaluated the seed predation level by P. nucleorum, as well as the P. nucleorum parasitism by H. prosopodis. The P. nucleorum abundance and its potential natural enemies were estimated using 122 sticky traps placed on the S. coronata individuals' crown. Neither the P. nucleorum and generalist predators abundance differed between habitats, whereas the H. prosopodis and microhymenopterans abundance was higher in the natural habitat. Consequently, P. nucleorum parasitism levels by H. prosopodis were also higher in the natural habitat. Our study indicated that habitat with higher plant diversity supported more natural enemies, thus confirming that increased habitat homogenization leads to decreased parasitism levels by the less parasitoids number in managed habitats. Our results may subsidize conservationist management practices in the managed habitats aiming to improve fruit exploitation techniques sustainability and land-use practices, which would thereafter allow for the S. coronata population conservation in the Brazilian Caatinga.

Physicochemical characterization and antimicrobial activity in novel systems containing buriti oil and structured lipids nanoemulsions.

Buriti oil nanoemulsions were prepared using non-interesterified buriti oil or buriti oil interesterified for 6 or 24 h (NBO, NBO6h, and NBO24 h), respectively. The aim was to investigate the effects of interesterified oils on the physicochemical and biological properties of nanoemulsions. Samples were stored at 4 and 25 °C for 30 days, and their physicochemical properties and biological activities were evaluated. The mean droplet diameter of nanoemulsions ranged from 196 to 270 nm. NBO24 h had the smallest droplet size and was the most stable during the storage period. Furthermore, NBO24 h demonstrating the good oxidative stability, had a high antioxidant capacity, and was less susceptible to droplet aggregation. NBO and NBO24 h had similar biological activity against Gram-negative bacteria (Escherichia coli O157: H7); bacterial growth was inhibited by at least 60% at 3.12 mg mL-1. The nanoemulsions have interesting properties for the production of pharmaceutical, cosmetic, and food formulations with antimicrobial activity.

An unusual presentation of urethral duplication presenting with chronic bladder retention, left scrotal transposition and left renal agenesis

ABSTRACT Introduction and objective Urethral duplication is a rare congenital anomaly, with roughly 200 cases reported in the literature (1). It is more frequent in males, with few cases reported in females. The clinical presentation differs according to the anatomical variant present. The duplication most commonly occurs in the sagittal plane with one urethra located ventrally and the other dorsally (2). Usually the ventral urethra is the more functional of both. Duplications occurring in the coronal plane are quite rare and they are usually associated with bladder duplication (3). The purpose of this paper was to present a video of a boy with an unusual urethral duplication form. Materials and Methods Patient was born premature due to oligohydramnios at 7 months-gestational age and he has initial diagnosis of hypospadia. Since then, he presented at least 7 febrile UTI and mother complained of difficult micturition and a presence of a mass at lower abdomen. Patient was referred to our institution and we identified urethral duplication with a glandar and scrotal meatus, palpable bladder and left penile-hemiscrotum transposition. US and CT-scan showed left kidney agenesis and overdistended bladder. VCUG and retrograde urethrography showed duplication, presence of contrast in the seminal vesicles and complete catheterizing of both urethras was not possible. Results The topic urethra was dysplastic and not patent to a 4Fr plastic tube so we were unable to access it endoscopically. We performed initially a Mitrofanoff procedure to allow CIC and treat chronic retention. Six months later, we assessed both urethras surgically and concluded that dorsal urethra was dysplastic after 3cm still in the penile area and scrotal urethra was not possible to be catheterized. We excised the ventral urethra because of dribbling complaints up to bulbar area and reconstructed the scrotal transposition, keeping the topic urethra for cosmetic issues. Patient had excellent outcome, performs CIC every 4 hours and has not presented further UTI episodes. Discussion and conclusion The urethral duplication is an anomaly that has multiple anatomical presentations. There are several theories about the etiology, but none can explain all types of presentations. There is also more than one rating available, and the Effmann classification is the most detailed. The case exemplifies this varied spectrum of anatomic urethral duplication. It resembles the urethral duplication type IIa-Y, however, ventral urethra meatus was located in penoscrotal area and both urethras were at least partially hypoplastic/dysplastic associated with obstruction and bladder retention. In determining how to best manage a patient with Y-type urethral duplication, the caliber and quality of the orthotopic urethra must first be assessed. Published reports suggest that best outcomes are those using the ventral duplicated urethra for the reconstruction (4). In this case, none of urethras were functional and a supravesical outlet channel had to be provided. The treatment of this condition requires an individualized planning and a vast technical knowledge of reconstructive surgery.

Finite element analysis of peri-implant bone volume affected by stresses around Morse taper implants: effects of implant positioning to the bone crest.

OBJECTIVES: The purpose of the present study was to evaluate the distribution and magnitude of stresses through the bone tissue surrounding Morse taper dental implants at different positioning relative to the bone crest. MATERIALS AND METHODS: A mandibular bone model was obtained from a computed tomography scan. A three-dimensional (3D) model of Morse taper implant-abutment systems placed at the bone crest (equicrestal) and 2 mm bellow the bone crest (subcrestal) were assessed by finite element analysis (FEA). FEA was carried out on axial and oblique (45°) loading at 150 N relatively to the central axis of the implant. The von Mises stresses were analysed considering magnitude and volume of affected peri-implant bone. RESULTS: On vertical loading, maximum von Mises stresses were recorded at 6-7 MPa for trabecular bone while values ranging from 73 up to 118 MPa were recorded for cortical bone. On oblique loading at the equiquestral or subcrestal positioning, the maximum von Mises stresses ranged from 15 to 21 MPa for trabecular bone while values at 150 MPa were recorded for the cortical bone. On vertical loading, >99.9vol.% cortical bone volume was subjected to a maximum of 2 MPa while von Mises stress values at 15 MPa were recorded for trabecular bone. On oblique loading, >99.9vol.% trabecular bone volume was subjected to maximum stress values at 5 MPa, while von Mises stress values at 35 MPa were recorded for >99.4vol.% cortical bone. CONCLUSIONS: Bone volume-based stress analysis revealed that most of the bone volume (>99% by vol) was subjected to significantly lower stress values around Morse taper implants placed at equicrestal or subcrestal positioning. Such analysis is commentary to the ordinary biomechanical assessment of dental implants concerning the stress distribution through peri-implant sites.

Finite element analysis of stress extent at peri-implant bone surrounding external hexagon or Morse taper implants.

PURPOSE: The purpose of the present study was to evaluate the distribution of stresses and consequent bone volume affected surrounding external hexagon or Morse taper dental implant systems by finite element analysis. MATERIAL AND METHODS: Two different dental implant-abutment designs were assessed: external hexagon or Morse taper joints. A mandibular bone model obtained from a computed tomography scan was used. The implant-abutment systems were axially or obliquely (45°) loaded on 150 N relatively to the central axis of the implant. The von Mises stresses were analysed in terms of magnitude and volume of affected surrounding bone. RESULTS: The von Mises equivalent values found on the cortical bone were higher than that recorded on the trabecular bone. Additionally, the bone volume associated with high stress values was higher in cortical and trabecular bone for oblique loading compared to axial loading. The values of von Mises equivalent stress around Morse taper implant-abutment system were lower on both axial and oblique loads than those recorded for external hexagon implant-abutment systems. CONCLUSIONS: Morse taper implant joints revealed a proper biomechanical behavior when compared to external hexagon systems concerning a significant volume of surrounding peri-implant bone subjected to lower stresses values.

Membrane-enriched proteome changes and prion protein expression during neural differentiation and in neuroblastoma cells.

BACKGROUND: The function of the prion protein, involved in the so-called prion diseases, remains a subject of intense debate and the possibility that it works as a pleiotropic protein through the interaction with multiple membrane proteins is somehow supported by recent reports. Therefore, the use of proteomic and bioinformatics combined to uncover cellular processes occurring together with changes in the expression of the prion protein may provide further insight into the putative pleiotropic role of the prion protein. RESULTS: This study assessed the membrane-enriched proteome changes accompanying alterations in the expression of the prion protein. A 2D-DIGE approach was applied to two cell lines after prefractionation towards the membrane protein subset: an embryonic stem cell line and the PK1 subline of neuroblastoma cells which efficiently propagates prion infection. Several proteins were differentially abundant with the increased expression of the prion protein during neural differentiation of embryonic stem cells and with the knockdown of the prion protein in PK1 cells. The identity of around 20% of the differentially abundant proteins was obtained by tandem MS. The catalytic subunit A of succinate dehydrogenase, a key enzyme for the aerobic energy metabolism and redox homeostasis, showed a similar abundance trend as the prion protein in both proteomic experiments. A gene ontology analysis revealed "myelin sheath", "organelle membrane" and "focal adhesion" associated proteins as the main cellular components, and "protein folding" and "ATPase activity" as the biological processes enriched in the first set of differentially abundant proteins. The known interactome of these differentially abundant proteins was customized to reveal four interactors with the prion protein, including two heat shock proteins and a protein disulfide isomerase. CONCLUSIONS: Overall, our study shows that expression of the prion protein occurs concomitantly with changes in chaperone activity and cell-redox homeostasis, emphasizing the functional link between these cellular processes and the prion protein.

Can a graft be placed over a flap in complex hypospadias surgery? An experimental study in rabbits

ABSTRACT Purpose: To develop a rabbit experimental study to test the hypothesis that surgical repair of hypospadias with severe ventral curvatures might be completed in one stage, if a graft, such as buccal mucosa, could be placed over the tunica vaginalis flap used in corporoplasty for ventral lengthening, with the addition of an onlay preputial island flap to complete the urethroplasty. Materials and methods: The experimental procedure with rabbits included a tunica vaginalis flap for reconstruction of the corpora after corporotomy, simulating a ventral lengthening operation. A buccal mucosa graft was placed directly on top of the flap, and the urethroplasty was completed with an onlay preputial island flap. Eight rabbits were divided into 4 groups, sacrificed at 2, 4, 8 and 12 weeks postoperatively, and submitted to histological evaluation. Results: We observed a large number of complications, such as fistula (75%), urinary retention (50%) and stenosis (50%). There were two deaths related to the procedure. Histological evaluation demonstrated a severe and persistent inflammatory reaction. No viable tunica vaginalis or buccal mucosa was identified. Conclusions: In this animal model, the association of a buccal mucosa graft over the tunica vaginalis flap was not successful, and resulted in complete loss of both tissues.

Periodontal disease and oral health-related behavior as factors associated with preterm birth: a case-control study in south-eastern Brazil.

BACKGROUND AND OBJECTIVE: Several studies have suggested a link between periodontal disease and preterm birth, but the mechanism of how this occurs remains controversial. Therefore, this study aimed to investigate whether periodontal disease, defined according to two commonly used clinical definitions, is associated with preterm birth and to examine the association regarding oral health-related behaviors during pregnancy. MATERIAL AND METHODS: This case-control study included women 18-40 years of age. Demographic and socio-economic data, information on current and previous pregnancies, and data on dental health-related behaviors and periodontal clinical parameters were collected within 48 h postpartum. Periodontal disease was assessed according to two definitions: four or more teeth with at least one site showing a probing depth of ≥ 4 mm and clinical attachment level of ≥ 3 mm (Definition 1); or at least one site with probing depth and clinical attachment level of ≥ 4 mm (Definition 2). The chi-square test was used to examine differences in the proportion of categorical variables. Bivariate analysis was performed to analyze the proportion of preterm births with respect to independent variables. Multiple logistic regression analyses were used to assess the association between periodontal disease and preterm birth. Odds ratios (ORs) were calculated with a 95% confidence interval (95% CI). RESULTS: A total of 296 postpartum women met the inclusion criteria. The case group included 74 women who delivered a preterm neonate (< 37 wk of gestation) and the control group included 222 women with deliveries at term (≥ 37 wk). Periodontal disease according to Definition 1 was not associated with fewer weeks of gestation (adjusted OR (OR adjusted ) = 1.62; 95% CI = 0.80-3.29; p = 0.178). However, a significant association was found between periodontal disease, according to Definition 2, and preterm birth (OR adjusted = 1.98; 95% CI = 1.14-3.43; p = 0.015). Increased appetite and a low number of daily toothbrushings were associated with preterm birth, regardless of the definition of periodontal disease used. CONCLUSION: Periodontal disease defined according to Definition 2 and unfavorable oral health-related behavior were factors associated with preterm birth.