Organic copper, iron, manganese and zinc: digestibility, production parameters and egg quality of layers / [Cobre, ferro, manganês e zinco orgânico: digestibilidade, parâmetros zootécnicos e qualidade dos ovos de poedeiras]

This study examined the replacement of the inorganic minerals (IM) Cu, Fe, Mn and Zn with their organic form (OM) in the diet of 67-week-old Dekalb White laying hens by comparing digestibility, production and egg quality. The experiment involved 240 birds, with 48 birds used per treatment and 12 per replicate. Isoenergetic and isonutrient diets were supplemented with 8mg Cu, 50mg Fe, 70mg Mn and 50mg Zn per kilogram of diet from an inorganic premix (IM100), from an organic premix (OM100), or the latter at the decreasing inclusion levels of 65% (OM65), 45% (OM45) and 35% (OM35). The following variables were evaluated: production, eggs per housed bird (EHB), viability, egg weight and mass, cracked and lost eggs, digestibility and egg physicochemical traits. Birds fed OM35 and OM45 showed lower production rates, and organic minerals provided the highest egg weights, regardless of their inclusion level. Accordingly, egg mass was similar between IM100, OM45 and OM35, and highest values were obtained with OM100 and OM65. Source or level had no influence on digestibility or egg quality. Supplementation with 2.8mg Cu, 17.5mg Fe, 24.5m g Mn and 17.5mg Zn per kilogram of diet (OM35) in the last third of the laying cycle provided relevant economic production indices (EHB, viability, egg weight or mass).(AU)

Estudou-se a substituição dos minerais inorgânicos (MI) Cu, Fe, Mn e Zn por minerais orgânicos (MO) na dieta de poedeiras Dekalb White com 67 semanas, comparando-se índices de produção, digestibilidade e qualidade dos ovos. Utilizaram-se 240 aves, 48 aves por tratamento e 12 por repetição. Dietas isoenergéticas e isonutrientes foram suplementadas com 8mg Cu, 50mg Fe, 70mg Mn e 50mg Zn por kg de ração MI100 e MO100 ou suplementações decrescentes MO65, MO45 e MO35. Avaliou-se produção, ovo por ave alojada (OAA), viabilidade, peso e massa dos ovos, trincados e perdidos, digestibilidade dos nutrientes e características físico-químicas dos ovos. Observaram-se menores índices de produção nas aves dos tratamentos MO35 e MO45 e maiores pesos dos ovos nos tratamentos com minerais orgânicos, independentemente da inclusão. Assim, massas de ovos foram semelhantes para os tratamentos MI100, MO45 e MO35 e maiores para MO100 e MO65. Fontes ou níveis de inclusões não influenciaram a digestibilidade e a qualidade dos ovos. Índices zootécnicos economicamente relevantes (OAA, viabilidade, peso e massa do ovo) foram obtidos com suplementação de 2,8mg Cu, 17,5mg Fe, 24,5mg Mn e 17,5mg Zn por kg de ração (MO35) em poedeiras brancas no último terço do ciclo de postura.(AU)

Screening of hydrogel-based scaffolds for dental pulp regeneration-A systematic review.

OBJECTIVE: The aim of this systematic review was to evaluate the most appropriate hydrogel scaffold type (natural, synthetic or hybrid) to be applied with stem cells for dental pulp regeneration. The findings should help clinicians make an informed choice about the appropriate scaffold to be applied for this approach. DESIGN: Three electronic databases were searched (Medline, Web of Science and Scopus). The review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA). RESULTS: From 4990 potentially relevant studies initially identified, 18 papers fulfilled the eligibility criteria and were considered for this review. Natural scaffolds were applied in most studies. Collagen was the most studied scaffold. In 5 of 10 studies, only growth factors were added to the constructs. Even without growth factors, these scaffolds containing stem cells were able to support the formation of dentin. The synthetic scaffolds were the least studied. Only 4 studies were selected, and in 3 of them, the same scaffold (Puramatrix) was evaluated. Puramatrix by itself was unable to form dental pulp when dental pulp stem cells were not present. Synthetic and hybrid hydrogels were unable to attract stem cells from the host. The presence of growth factors in these constructs seems to be of relevance since dental pulp tissue formation was achieved only when the hybrid scaffold was applied with growth factors. CONCLUSION: All types of hydrogel-based scaffolds, when containing mesenchymal stem cells, are able to form connective tissue with different degrees of similarity to dental pulp. However, current data is too heterogeneous to compare and identify the advantages of any specific scaffold.

Orthotopic liver transplantation without venovenous bypass using the conventional and piggyback techniques.

INTRODUCTION: Orthotopic liver transplantation is a widely used procedure for the treatment of irreversible liver diseases for which there is no possibility of medical treatment. When this procedure is performed by the conventional technique, the retrohepatic vena cava is removed along with the native liver. The inferior vena cava (IVC) remains clamped until the revascularization of the graft, and in this period there is a reduction in the venous return, which may induce a fall by up to 50% in the cardiac output with hemodynamic instability and a fall in renal perfusion pressure. The use of a portal-femoral-axillary venovenous bypass system, in which the blood from the femoral and portal veins returns to the heart via the axillary vein propelled by a centrifugal pump, is intended to minimize the effects of the IVC clamping. In the piggyback (PB) technique, the native liver is removed and the IVC of the recipient is preserved and only partially clamped. We have employed both techniques without the use of venovenous bypass for 10 years. The objective of this study was to compare the results obtained from the use of the two techniques. PATIENTS AND METHODS: A retrospective analysis was performed of 195 patients transplanted between 1999 and 2008: 125 by the conventional technique and 70, the PB technique. The intraoperative parameters were analyzed (surgical time, ischemia time, use of blood products, and diuresis), as well as intensive care support (duration of stay in intensive care unit and use of vasoactive drugs), period of intubation, length of hospital stay, renal function, graft function, postoperative complications, retransplantation, and patient survival. RESULTS: The PB group showed a reduction in surgical time, warm ischemia time, the use of packed red blood cells concentrates, and fresh frozen plasma, as well as mortality at 30 days (P<.05). There were no differences in relation to cold ischemia time, intraoperative diuresis; length of stay and use of vasoactive drugs in the intensive care unit; the period of intubation; the duration of hospital stay; the renal function; the graft function; the need for reoperation; the incidence of sepsis, biliary complications, vascular complications; need for retransplantation; and 1-year mortality. The cumulative survival rate at 1 year was significantly better among the PB patients. CONCLUSION: Orthotopic liver transplantation can be performed without venovenous bypass with good results, using either the conventional technique or the PB technique. Provided that there is no technical contraindication and a long ischemia period is not foreseen, the PB technique should be the technique of choice.

NOTES transvaginal cholecystectomy: preliminary clinical application.

BACKGROUND: Natural orifice translumenal endoscopic surgery (NOTES) is an emerging concept in the recent literature that could lead to potential benefits in clinical applications. Restricted to animal experiments, however, human procedures have not yet been published. Because of the technical and ethical challenges involved in perforation and closure of a healthy organ-as is also seen in operating via the transgastric route-and because of the lack of understanding of the physiopathology and infection risk with these approaches, they have not been applied in the clinical setting. Thus the present study, based on previous animal experiments, describes preliminary clinical application in four cases of transvaginal NOTES cholecystectomy, and discusses safety, feasibility, and potential benefits of the method. METHODS: Preliminary acute and survival animal experiments developed by the NOTES Research Group at our institution solved such technical problems for transvaginal NOTES as spatial orientation, insufflation, and instrumentation, making possible the introduction of NOTES as a clinical application. The trials were approved by ethics committee of our institution, and informed consent was obtained from all patients. Since 13 March 2007, four female patients with elective surgical indication for cholecystectomy have undergone transvaginal NOTES cholecystectomy. All intraoperative and postoperative parameters were documented. Vaginal access was achieved under direct vision with conventional instruments, and a 2-channel colonoscope was inserted into the abdominal cavity. After endoscopic insufflation to achieve pneumoperitoneum with CO(2), instruments were inserted through and alongside a colonoscope, allowing successful NOTES cholecystectomy in all patients, with vaginal extraction of the gallbladder. The vaginal wound was closed by direct vision using conventional instruments. RESULTS: The procedure was successful in all patients, with operative time of 45-115 min. Patients experienced low need for postoperative analgesia. Free oral intake was permitted 2 h after the procedure. There were no postoperative complications, and patients were discharged, according to the study protocol, 48 h after the procedure. CONCLUSIONS: Preliminary results showed the feasibility and safety of the transvaginal NOTES method in this small initial study population. The technique, developed in our institution, and not transgastric NOTES, may be the preferred approach to serve as the basis for clinical studies.

Anti-interleukin-8 monoclonal antibody reduces free radical production and improves hemodynamics and survival rate in endotoxic shock in rabbits.

BACKGROUND: Although high levels of interleukin-8 (IL-8) have been found in patients with sepsis and a monoclonal antibody (MoAb) against IL-8 has been successfully used in some animal models of inflammation, no specific therapeutic agent against IL-8 has been tested for the treatment of sepsis. We studied the effects of a MoAb against IL-8 in the treatment of endotoxic shock with a prospective randomized rabbit endotoxic shock model. METHODS: Twenty New Zealand white rabbits were anesthetized and divided into four groups: normal, anti-IL-8, control-Ab, and lipopolysaccharide (LPS). Anti-IL-8 and control-Ab groups received a MoAb (immunoglobulin G, 3 mg/kg) 5 minutes before the LPS injection. All groups, except the normal group, received a continuous 20-minute infusion of LPS (500 micrograms/kg). The normal group received NaCl (0.9%) rather than LPS. RESULTS: The 7-day survival rates were 100% for normal group, 80% for anti-IL-8 group, 40% for control-Ab group, and 0% for LPS group. Compared with the LPS group, anti-IL-8 rabbits had a smaller decrease in mean arterial blood pressure (p < 0.05) and increased urinary volume (p < 0.05). Anti-IL-8 rabbits had lower plasmatic levels of IL-1 beta, less free radical production (p < 0.05), and a higher survival rate (p < 0.01). CONCLUSIONS: IL-8 plays a significant role in endotoxic shock, and IL-8 blockage results in attenuation of the hypotensive and tachypneic effects of LPS, reduced free radical production, and an increased survival rate after lethal endotoxic shock.

Leiomiossarcoma parcialmente necróticoo com baixo grau de malignidade histológica e clinicamente muito agressivo / Partially necrotic leimyosarcoma with low histological malignancy degree and clinically very much severe

Os autores apresentam um caso de leiomiossarcoma uterino com diagnóstico anatomopatológico de congelaçao e em parafina de mioma uterino necrosado, ao qual seguiu-se miossarcomatose peritoneal disseminada de evoluçao absolutamente maligna e fatal. O AP da metástase peritoneal nove meses após a primeira cirurgia (com um segundo patologista) ainda conservava grande deferenciaçao histológica, impossibilitando, mesmo na metástase, diagnóstico conclusivo de malignidade.