Preparation of Porous Scaffold Based on Poly(3-hydroxybutyrate-co-3-hydroxyvalerate-co-3-hydroxyhexanoate) and FucoPol.

This work focused on the development of porous scaffolds based on biocomposites comprising two biodegradable and biocompatible biopolymers: a terpolyester, poly(3-hydroxybutyrate-co-3-hydroxyvalerate-co-3-hydroxyhexanoate) (PHBHVHHx), and the bacterial polysaccharide FucoPol. The PHBHVHHx terpolymer was composed of 3-hydroxybutyrate (55 wt%), 3-hydroxyvalerate (21 wt%), and 3-hydroxyhexanoate (24 wt%). This hydrophobic polyester has low crystallinity and can form elastic and flexible films. Fucopol is a fucose-containing water-soluble polysaccharide that forms viscous solutions with shear thinning behavior and has demonstrated emulsion-forming and stabilizing capacity and wound healing ability. Emulsion-templating was used to fabricate PHA-based porous structures in which FucoPol acted as a bioemulsifier. Compared with the scaffolds obtained from emulsions with only water, the use of FucoPol aqueous solutions resulted in structures with improved mechanical properties, namely higher tensile strength (4.4 MPa) and a higher Young's Modulus (85 MPa), together with an elongation at break of 52%. These features, together with the scaffolds' high porosity and pore interconnectivity, suggest their potential to sustain cell adhesion and proliferation, which is further supported by FucoPol's demonstrated wound healing ability. Therefore, the developed PHBHVHHx:FucoPol scaffolds arise as innovative porous bioactive structures with great potential for use in tissue engineering applications.

Percepção da equipe de enfermagem no manejo da dor no recém-nascido / Perception of the nursing team in pain management newborn

Introdução: Recém-nascidos de qualquer idade gestacional são capazes de reconhecer, processar e responder a estímulos dolorosos. Garantir a segurança e alívio do tratamento da dor é uma responsabilidade ética do profissional da saúde, pois é reconhecido que a maior parte da dor testada em bebês pode ser precavida ou aliviada. Objetivo: Compreender a percepção dos profissionais de enfermagem no manejo da dor no recém-nascido. Método: Trata-se de um estudo descritivo com abordagem qualitativa, realizado na Unidade de Terapia Intensiva Neonatal de um hospital escola do interior do estado de São Paulo, Brasil. A amostragem empregada foi intencional, com a participação de 11 profissionais, enfermeiros e técnicos em enfermagem. A coleta de dados se deu através de entrevista audiogravada em mídia digital portátil, guiada por uma pergunta norteadora. A análise de dados foi realizada com base na Análise de Conteúdo Temática de Bardin. Resultados: Emergiram três categorias temáticas: Métodos no manejo da dor do recém-nascido, Práticas de humanização e Percepção da avaliação da dor do recém-nascido, demonstrando que a equipe de enfermagem apresenta conhecimento e técnicas abrangentes em relação à percepção no manejo da dor do recém-nascido. Conclusão: Compreender a percepção dos profissionais de enfermagem no manejo da dor no recém nascido é importante, entretanto faz-se necessário a implantação de atividades que amplifiquem o conhecimento da equipe de enfermagem para adequado tratamento e controle da dor no RN

Introduction: Newborns of any gestational age are able to recognize, process and respond to painful stimuli. Ensuring the safety and relief of pain treatment is an ethical responsibility of the health professional, as it is recognized that most pain tested in infants can be cautious or relieved. Objective: To understand the perception of nursing professionals in the management of pain in the newborn. Method: This is a descriptive study with a qualitative approach, conducted in the Neonatal Intensive Care Unit of a teaching hospital in the state of São Paulo, Brazil. The sample used was intentional, with the participation of 11 professionals, nurses and nursing technicians. Data collection took place through an audio interview recorded on portable digital media, guided by a guiding question. Data analysis was performed based on Bardin's Thematic Content Analysis. Results: Three thematic categories emerged: Methods in the management of newborn pain, Humanization practices and Perception of newborn pain assessment nursing team presents comprehensive knowledge and techniques in relation to the perception in the management of pain of the newborn. Conclusion: Understanding the perception of nursing professionals in the management of pain in newborns is important, however, it is necessary to implement activities that expand the knowledge of the nursing team for adequate treatment and control of pain in newborns

Introducción: Los recién nacidos de cualquier edad gestacional son capaces de reconocer, procesar y responder a estímulos dolorosos. Garantizar la seguridad y el alivio del manejo del dolor es una responsabilidad ética del profesional de la salud, ya que se reconoce que la mayoría de los dolores probados en los bebés se pueden prevenir o aliviar. Objetivo: Comprender la percepción de los profesionales de enfermería sobre el manejo del dolor en el recién nacido. Método: Se trata de un estudio descriptivo con abordaje cualitativo, realizado en la Unidad de Cuidados Intensivos Neonatales de un hospital escuela del interior del estado de São Paulo, Brasil. El muestreo utilizado fue intencional, con la participación de 11 profesionales, enfermeros y técnicos de enfermería. La recolección de datos se realizó a través de entrevistas grabadas en audio en medios digitales portátiles, guiadas por una pregunta orientadora. El análisis de datos se realizó con base en el Análisis de Contenido Temático de Bardin. Resultados: Surgieron tres categorías temáticas: Métodos para el manejo del dolor en el recién nacido, Prácticas de humanización y Evaluación de la percepción del dolor en el recién nacido, demostrando que el equipo de enfermería posee conocimientos y técnicas integrales en relación a la percepción en el manejo del dolor del recién nacido. Conclusión: Comprender la percepción de los profesionales de enfermería en el manejo del dolor en el recién nacido es importante, sin embargo, es necesario implementar actividades que amplíen el conocimiento del equipo de enfermería para el adecuado tratamiento y control del dolor en el recién nacido

Extrapleural solitary fibrous tumor-a revision of three cases.

Extrapleural solitary fibrous tumors are a rare type of spindle cell neoplasm, which can occur in many locations with different histologic and immunohistochemical findings, making the diagnosis challenging. They are usually indolent and their treatment is based on complete surgical resection. There are still some issues to be clarified regarding systemic therapy (specifically when aggressive behavior exists) and long-term follow-up. We present a series of clinical cases in the same Department and review this thematic area.

Cecum perforation by plug migration: an unexpected late complication of inguinal hernia mesh repair.

Case of a 79-year-old male previously submitted to Rutkow-Robbins inguinal hernia repair. He presented himself at the Emergency Room with an inguinal inflammatory mass and bowel obstruction for 5 days. A strangulated recurrent inguinal hernia was assumed and emergency surgery was performed. Since an inguinal abscess was present, a midline laparotomy was performed. The previous polypropylene plug was found in an intraperitoneal position, fistulizing to the cecum and creating a 2 cm wide perforation, without intraperitoneal collections or bowel compromise. An en bloc atypical resection of the cecum with the plug was performed and the abdominal wall abscess was drained. The patient had a slow, but uneventful postoperative course. Given the rarity of cases, the high variability of clinical presentation and the potential seriousness of mesh migration complications, the authors review the topic of mesh migration.

Case Report: A Rare Association of Diffuse Thyroid Lipomatosis with Amyloid Deposition.

Diffuse thyroid lipomatosis is a rare histopathological condition of unknown etiology, characterized by diffuse fatty infiltration of the thyroid stroma, which can result in diffuse goiter with compressive symptoms. We report a case of a 46-year-old man with 1-year history of progressive goiter enlargement with compressive symptoms. Imaging studies revealed multiple coalescent nodules. The patient underwent surgery, and the microscopic appearance revealed a diffuse infiltration of thyroid stroma by mature adipose tissue with associated amyloid deposition. A final diagnosis of diffuse lipomatosis of the thyroid gland was established. This patient represents one of the few reported cases of diffuse lipomatosis with coexisting deposition of amyloid protein of the thyroid gland and contributes to the better understanding of this extremely rare condition.

Alpha thalassemia, but not ßS-globin haplotypes, influence sickle cell anemia clinical outcome in a large, single-center Brazilian cohort.

Alpha thalassemia and beta-globin haplotype are considered classical genetic disease modifiers in sickle cell anemia (SCA) causing clinical heterogeneity. Nevertheless, their functional impact on SCA disease emergence and progression remains elusive. To better understand the role of alpha thalassemia and beta-globin haplotype in SCA, we performed a retrospective study evaluating the clinical manifestations of 614 patients. The univariate analysis showed that the presence of alpha-thalassemia -3.7-kb mutation (αα/-α and -α/-α) decreased the risk of stroke development (p = 0.046), priapism (p = 0.033), and cholelithiasis (p = 0.021). Furthermore, the cumulative incidence of stroke (p = 0.023) and cholelithiasis (p = 0.006) was also significantly lower for patients carrying the alpha thalassemia -3.7-kb mutation. No clinical effects were associated with the beta-globin haplotype analysis, which could be explained by the relatively homogeneous haplotype composition in our cohort. Our results reinforce that alpha thalassemia can provide protective functions against hemolysis-related symptoms in SCA. Although, several genetic modifiers can impact the inflammatory state of SCA patients, the alpha thalassemia mutation remains one of the most recurrent genetic aberration and should therefore always be considered first.

Qualidade de Vida e Participação em Iniciativas de Base Comunitária: Um estudo num município da zona centro de Portugal / Quality of Life and Participation in Community-Based Programs: A study with a municipality in central Portugal / Calidad de vida y participación en iniciativas comunitarias: un estudio en un municipio del centro de Portugal

Face ao reconhecimento da importância da participação social como fator promotor de envelhecimento bem-sucedido, procura-se, através de um estudo de natureza quantitativo, analisar os efeitos de variáveis sociodemográficas e da participação social em atividades/programas de base comunitária, promovidas por um município da zona centro de Portugal, ao nível da qualidade de vida de pessoas com mais de 56 anos, residentes no concelho.

Dado el reconocimiento de la importancia de la participación social como un factor que promueve el envejecimiento exitoso, un estudio cuantitativo busca analizar los efectos de las variables sociodemográficas y la participación social en actividades / programas basados en la comunidad promovidos. por un municipio del centro de Portugal, en términos de calidad de vida de las personas mayores de 56 años, residentes en el municipio.

Considering the recognition of social participation as a relevant factor for promoting successful ageing, a study of quantitative nature was conducted in order to analyze the effects of sociodemographic variables and of social participation in community-based activities/ programs, promoted by a municipality in central Portugal, into the level of quality of life of its habitants, over 56 years of age.

Paraganglioma or pheochromocytoma? A peculiar diagnosis.

Paragangliomas and pheochromocytomas are rare catecholamine secreting neoplasms that arise in the extra-adrenal autonomic paraganglia and adrenal medulla, respectively. Although typically presenting with paroxysms of headaches, palpitations, diaphoresis and hypertension, a broad spectrum of clinical manifestations may occur. Diagnosis relies on biochemical studies followed by adequate imaging investigation. Cross sectional morphological and functional imaging modalities have improved diagnostic accuracy and are crucial in the surgical planning. The authors report on a case of a 64-year-old female that presented with severe hypertension, palpitations and fatigue as the manifestations of a catecholamine secreting neoplasm. Abdominal contrast enhanced computer tomography revealed a right sided 78 mm adrenal medullary tumor suggestive of a pheochromocytoma. Standard therapeutical strategies were initially unsuccessful, and additional investigation and therapy were required to cure the patient. The challenges faced by the multidisciplinary team in the pre-operative evaluation, medical management and surgical treatment are reported.

[Late traumatic diaphragmatic hernia complicated by intrathoracic perforation and haemorrhagic gastric cyst: a rare combination]. / Hérnia diafragmática traumática tardia complicada de perfuração intratorácica e quisto hemorrágico gástrico: Uma combinação rara.

The authors describe the clinical and imagiologic challenges faced at the Emergency Room while observing a 48-year-old woman, submitted to a Nissen fundoplication 16 months earlier. She presented herself with a one-month total progressive dysphagia, epigastric pain and regurgitation. Intraoperative findings demonstrated an intraabdominal fundoplication, closure of diaphragmatic crura and part of the gastric greater curvature and body herniated through a small posterior defect on the diaphragm, with a gigantic serosal cystic mass and associated perforation. Data from posterior clinical investigation shows a traffic accident 34 years ago. Although described before, the association of late traumatic diaphragmatic hernia and gastric intrathoracic perforation is rare (< 2.5%) and difficult to diagnose. A revision of the literature is performed concerning the pathophysiologic mechanisms of late diaphragmatic rupture, its clinical presentation and diagnosis, as for Nissen fundoplication complications, its prevention and management.

Biocompatibility of chemoenzymatically derived dextran-acrylate hydrogels.

The biocompatibility of chemoenzymatically generated dextran-acrylate hydrogels has been evaluated in vitro, using human foreskin fibroblasts, and in vivo, by subcutaneous and intramuscular implantation in Wistar rats for up to 40 days. In vitro tests show that hydrogel extracts only minimally reduced (<10%) the mitochondrial metabolic activity of fibroblasts. Direct contact of the hydrogels with cells induced a cellular proliferation inhibition index (CPII) of 50-80%, compared with a control, whereas through indirect contact, the CPII values were <16%, suggesting that the high CPII values achieved in the direct assay test were likely due to mechanical stress or limitations in oxygen diffusion. Hence, the hydrogels were noncytotoxic. Moreover, cell-material interaction studies show that these hydrogels were nonadhesive. Finally, histologic evaluation of tissue response to subcutaneous and intramuscular implants showed acceptable levels of biocompatibility, as characterized by a normal cellular response and the absence of necrosis of the surrounding tissues of the implant. In the first 10 days, the foreign-body reaction in the intramuscular implantation was more severe than in subcutaneous implantation, becoming identical after 30 days. In both cases, dextran hydrogels did not show signs of degradation 6 weeks postimplantation and were surrounded by a thin fibrous capsule and some macrophages and giant cells. This response is typical with a number of nondegradable biocompatible materials. These results indicate that dextran hydrogels are biocompatible, and may have suitable applications as implantable long-term peptide/protein delivery systems or scaffolds for tissue engineering.