Minced skin grafts for chronic wounds compared to conventional mesh grafts.

Background and Aims: Skin grafting is the single most effective method to close a chronic wound. The current standard of care is to use meshed split thickness skin grafts. This entails the use of surgical instruments that need to be autoclaved and to have a power source, which usually requires an OR facility. The minced skin technique uses single use, presterilized instruments and the procedure can be done under local anesthesia, by a wound care practitioner, in a wound clinic, a physician's office or even at the bedside. The current study was designed to determine if the results from micrografting were non inferior to conventional mesh grafting. Methods: In a prospective non inferiority study, 26 chronic ulcers were treated with micrografting (MSG) and 24 with conventional mesh grafts 1:3 (control group-CG) in a total of 21 patients, 10 male and 11 female. The donor site areas in the MSG group were predetermined to 2.5 × 5 cm and the mesh grafts expansion was set at 1:3. Results: In the first weeks postoperatively, micrograft healing initially lagged behind the conventional mesh grafts but at 60 days after grafting, all MSG wounds were healed. The MSG wounds had better pigmentation, less itching, and less scarring. The micrografting procedure was easy to learn and expeditious to perform. The MSG mean expansion was 9.1 compared to three times (CG). Conclusion: The MSG procedure is not inferior to conventional mesh grafting, requires smaller donor sites, and can be done with single use instruments, under local anesthesia, with early discharge.

Implicações da Pandemia para a Psicologia nas Políticas Públicas / Implications of the Pandemic for Psychology in Public Policies / Implicaciones de la Pandemia para la Psicología en las Políticas Públicas

O artigo objetivou identificar e analisar desafios e potencialidades no trabalho de psicólogas(os) nas políticas públicas brasileiras na conjuntura pandêmica. É um estudo exploratório-descritivo de abordagem mista. A coleta de dados foi realizada por meio de questionário virtual com 123 psicólogas(os) que trabalhavam nas políticas públicas no país. A análise se deu a partir da extração de medidas de tendência central e pela Análise de Conteúdo temática, em um diálogo da psicologia com a tradição marxista. Os resultados apontaram para os efeitos deletérios objetivos e subjetivos do sucateamento das políticas às(aos) profissionais, bem como o tolhimento de suas práticas. Por outro lado, também apontaram algumas potencialidades que contradizem a si próprias(os) e à realidade. Fica a premência de responsabilização do Estado em fornecer melhores condições de trabalho e fortalecer as políticas públicas para o enfrentamento à pandemia, assim como a necessidade de reflexão e transformação da psicologia e sua práxis.

The article aimed to identify and analyze the challenges and potentialities of psychologists' work in Brazilian public policies in the pandemic context. It's an exploratory-descriptive study with a mixed approach. Data collection was carried out through a virtual questionnaire with 123 psychologists working in public policies around the country. The analysis was carried out from the extraction of central tendency measures and by Thematic Content Analysis, in a dialogue between psychology and the Marxist tradition. Results pointed to numerous deleterious effects (objective and subjective) on professionals resulting from the scrapping of public policies and the hampering of their practices. On the other hand, they also pointed out some potentialities that contradict themselves and reality. There is an urgent need for state responsibility to offer better working conditions and to strengthen public policies to fight the pandemic, together with the need for reflection and transformation of psychology and its own praxis.

El artículo objetivó identificar y analizar desafíos y potencialidades del trabajo de psicólogas/os en las políticas públicas brasileñas en el contexto de la pandemia. Es un estudio exploratorio-descriptivo con enfoque mixto. La recolección de datos se realizó a través de un cuestionario virtual con 123 psicólogos que trabajaban en políticas públicas en el país. El análisis se realizó a partir de la extracción de medidas de tendencia central, y por Análisis de Contenido temática, en un diálogo entre psicología y tradición marxista. Los resultados apuntaron los efectos deletéreos (objetivos y subjetivos) del desguace de políticas a los profesionales y la obstaculización de sus prácticas. Por otro lado, también señalaron potencialidades que contradicen a sí mismos y a la realidad. Existe una necesidad urgente de rendición de cuentas del Estado para mejorar las condiciones laborales y el fortalecimiento de las políticas para combatir la pandemia y la necesidad de reflexión y transformación de la psicología y de su praxis.

CHEST CT USAGE IN COVID-19 PNEUMONIA: MULTICENTER STUDY ON RADIATION DOSES AND DIAGNOSTIC QUALITY IN BRAZIL.

We assessed variations in chest CT usage, radiation dose and image quality in COVID-19 pneumonia. Our study included all chest CT exams performed in 533 patients from 6 healthcare sites from Brazil. We recorded patients' age, gender and body weight and the information number of CT exams per patient, scan parameters and radiation doses (volume CT dose index-CTDIvol and dose length product-DLP). Six radiologists assessed all chest CT exams for the type of pulmonary findings and classified CT appearance of COVID-19 pneumonia as typical, indeterminate, atypical or negative. In addition, each CT was assessed for diagnostic quality (optimal or suboptimal) and presence of artefacts. Artefacts were frequent (367/841), often related to respiratory motion (344/367 chest CT exams with artefacts) and resulted in suboptimal evaluation in mid-to-lower lungs (176/344) or the entire lung (31/344). There were substantial differences in CT usage, patient weight, CTDIvol and DLP across the participating sites.

HMGA1 Has Predictive Value in Response to Chemotherapy in Gastric Cancer.

Gastric cancer is a serious health problem worldwide. Although its incidence is decreasing, the five-year survival rate remains low. Thus, it is essential to identify new biomarkers that could promote better diagnosis and treatment of patients with gastric cancer. High-mobility group AT-hook 1 (HMGA1) is a non-histone, chromatin-binding protein that has been found overexpressed in several tumor types. It has been correlated with invasion, metastasis, and drug resistance, leading to worse patient survival. The aim of this work was to evaluate the clinical value of HMGA1 in gastric cancer. HMGA1 expression was analyzed by immunohistochemistry in a single hospital series (n = 323) of gastric adenocarcinoma cases (stages I to IV) with clinicopathological and treatment data. In this series, HMGA1 expression showed no significant relevance as a prognostic biomarker. Nevertheless, a significantly better overall survival was observed in cases with high levels of HMGA1 when they were treated with chemotherapy, compared to the nontreated ones, implying that they can benefit more from treatment than patients with low expression of HMGA1. We thereby show for the first time that HMGA1 expression has a substantial value as a biomarker of response to chemotherapy in gastric cancer.

Diverse human VH antibody fragments with bio-therapeutic properties from the Crescendo Mouse.

We describe the 'Crescendo Mouse', a human VH transgenic platform combining an engineered heavy chain locus with diverse human heavy chain V, D and J genes, a modified mouse Cγ1 gene and complete 3' regulatory region, in a triple knock-out (TKO) mouse background devoid of endogenous immunoglobulin expression. The addition of the engineered heavy chain locus to the TKO mouse restored B cell development, giving rise to functional B cells that responded to immunization with a diverse response that comprised entirely 'heavy chain only' antibodies. Heavy chain variable (VH) domain libraries were rapidly mined using phage display technology, yielding diverse high-affinity human VH that had undergone somatic hypermutation, lacked aggregation and showed enhanced expression in E. coli. The Crescendo Mouse produces human VH fragments, or Humabody® VH, with excellent bio-therapeutic potential, as exemplified here by the generation of antagonistic Humabody® VH specific for human IL17A and IL17RA.

Fatores associados à mediastinite pós-esternotomia, caso-controle / Factors associated with post-mediastinitis. Case-control study

Fundamentos: A mediastinite é uma infecção grave pós-esternotomia mediana com prognóstico ruim, mesmo com diagnóstico e tratamento precoces. Objetivos: Avaliar o perfil dos pacientes submetidos à esternotomia, identificar fatores de risco para o desenvolvimento da mediastinite e avaliar o diagnóstico bacteriológico dos pacientes com esta infecção. Métodos: Estudo caso-controle realizado em um hospital de Belo Horizonte (MG) com pacientes submetidos à esternotomia mediana entre janeiro de 2015 e janeiro de 2016. A amostra foi de 65 pacientes, sendo 13 casos e 52 controles (1:4). Na análise estatística, foram adotados os testes t de Student, Mann-Whitney e exato de Fisher, além de regressão logística, ao nível de significância de 5%. Resultados: Houve predominância do sexo masculino (63,1%), e a idade média foi 58,8 ±10,3 anos. A evolução a óbito ocorreu em 9,2% dos pacientes e em 23,1% dos que apresentaram mediastinite. A cirurgia de revascularização do miocárdio foi realizada em 75,4% dos casos. Predominância do sexo masculino, maior tempo de internação, febre pós-cirúrgica, óbitos e maior número de fatores de risco foram características mais observadas nos pacientes que desenvolveram mediastinite. O microrganismo mais encontrado em pacientes com infecção mediastinal foi Staphylococcus aureus (30,7%), além de elevada ocorrência de bactérias Gram-negativas (46,2%). Conclusão: Esforços devem ser concentrados para o controle dos fatores de risco antes do procedimento, além do aprimoramento de medidas que possam diminuir ou eliminar o surgimento da mediastinite, visando à prevenção e ao melhor controle de infecções

Background: Mediastinitis is a severe post-median sternotomy infection with poor prognosis, even with early diagnosis and treatment. Objectives: To evaluate the profile of patients submitted to sternotomy, identify the risk factors for the development of mediastinitis and evaluate the bacteriological diagnosis of patients with this infection. Methods: Case-control study carried out in a large hospital in Belo Horizonte (MG, Brazil) in patients submitted to median sternotomy, from January 2015 to January 2018. The sample consisted of 65 patients, of which 13 were cases and 52, controls (1:4). For the statistical analysis, Student's t test, Mann-Whitney test and Fisher exact test were used, in addition to logistic regression, with a level of significance of 5%. Results: There was a predominance of males (63.1%), and the mean age was 58.8 ± 10.3 years. Evolution to death occurred in 9.2% of the patients and in 23.1% of those with mediastinitis. Myocardial revascularization was performed in 75.4% of the cases. Predominance of male gender, longer hospitalization time, post-surgical fever and death, and a greater number of risk factors were more frequent characteristics in patients who developed mediastinitis. The most common microorganism found in patients with mediastinal infection was Staphylococcus aureus (30.7%), in addition to a high occurrence of Gram-negative bacteria (46,2%). Conclusion: The results are in accordance with the literature. Efforts should be focused on the control of risk factors prior to the procedure, in addition to improving measures that can decrease or eliminate the onset of mediastinitis, aiming at infection prevention and control

Custo-efetividade do uso do curativo de colágeno e alginato no tratamento de áreas doadoras de enxerto de pele de espessura parcial / Cost-effectiveness of collagen wound dressing with alginate for the treatment of split-thickness skin graft donor sites / El costo-efectividad de la utilización del apósito de colágeno con alginato en el tratamiento de las áreas donadoras de injerto de espesor parcial de la piel

OBJETIVO: Avaliar a utilização do curativo de colágeno e alginato de cálcio em áreas doadoras de enxerto de pele parcial em relação ao curativo com gaze tipo rayon. MÉTODO: Foi realizado estudo clínico prospectivo na Divisão de Cirurgia Plástica e Queimaduras do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, no período de 2010 a 2015. Os pacientes foram selecionados de forma consecutiva e distribuídos de forma randomizada em três grupos de acordo com o tratamento usado na área doadora: rayon exposto, embebido em soro fisiológico 0,9%; rayon coberto por gaze de algodão estéril e atadura; curativo formado por 90% de colágeno bovino associado a 10% de alginato de cálcio. Foram analisados comparativamente os seguintes parâmetros: dor, tempo para epitelização, tempo de internação e custos. RESULTADOS: Foram estudados 30 pacientes, com idade variando de 12 e 60 anos. Quinze desses pacientes tiveram suas áreas doadoras cobertas com o curativo de colágeno e alginato de cálcio, os quais apresentaram redução dos níveis álgicos em 79,5% (p<0,01), menor tempo de internação e epitelização, média de 5,8 dias (p<0,01) e redução dos custos hospitalares em cerca de 47% (p<0,01) em comparação com o curativo de rayon. Nenhum apresentou infecção na área doadora. CONCLUSÃO: O curativo de colágeno e alginato apresentou melhor custo-benefício em relação ao rayon para cobertura de áreas doadoras, com importante redução da dor, do tempo de epitelização e de internação e dos custos.

OBJECTIVE: To evaluate the use of collagen calcium-alginate dressing for split-thickness skin graft donor sites in comparison with rayon dressing. METHODS: A prospective clinical study was conducted at Divisão de Cirurgia Plástica e Queimaduras do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo from 2010 to 2015. Patients were selected consecutively and randomly allocated into three groups according to the treatment used on the donor site: rayon soaked in 0.9% saline; rayon covered with sterile cotton gauze and bandage; 90% bovine collagen with 10% calcium-alginate dressing covered with transparent polyurethane film. Following parameters was comparatively analyzed: pain, time to epithelialization, length of stay and costs. RESULTS: We studied 30 patients, ranging from 12 to 60 years of age. Fifteen of these patients had their donor sites covered with collagen calcium-alginate dressing, which showed pain reduction of 79.5% (p<0.01), shorter hospital stay and epithelialization, average of 5.8 days (p<0.01) and reduction in hospital costs about 47% (p<0.01) in comparison with rayon dressing. None presented infection in the donor site. CONCLUSION: Collagen calcium-alginate dressing showed better cost-benefit than rayon to cover donor sites, with significant reduction of pain, epithelialization time, length of stay and costs.

Objetivo: Evaluar la utilización del apósito de colágeno con alginato de calcio en áreas donadoras de injerto de espesor parcial de la piel en relación a la curación con gasa tipo rayón. Método: Se realizó un estudio clínico prospectivo en la División de Cirugía Plástica y Quemadura, del Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo en el período de 2010 a 2015. Los pacientes fueron seleccionados de forma consecutiva y distribuida de forma aleatorizada en tres grupos de acuerdo con el tratamiento utilizado en la área donadora: rayón expuesto, embebido en suero fisiológico 0,9%; Rayón cubierto por gasa de algodón estéril y vendaje; apósito formado por un 90% de colágeno bovino asociado al 10% de alginato de calcio. Se analizaron comparativamente los siguientes parámetros: dolor, tiempo para epitelización, tiempo de internación y costos. Resultados: Se estudiaron 30 pacientes, con edad variando de 12 a 60 años. Quince de estos pacientes tuvieron sus áreas donantes cubiertas con el apósito de colágeno con alginato de calcio, los cuales presentaron reducción de los niveles álgicos en el 79,5% (p<0,01), menor tiempo de internación y epitelización, media de 5.8 (p<0,01) y reducción de los costos hospitalarios en 47% (p<0,01) en comparación con el apósito de rayón. Ninguno presentó infección en el área donante. Conclusión: El apósito de colágeno con alginato presentó mejor costo-efectividad en relación al rayón para cobertura de áreas donantes, con importante reducción del dolor, del tiempo de epitelización, de internación y de los costos

One for all and all for one: Linear regression from the mass of individual bones to assess human skeletal mass completeness.

OBJECTIVES: Complete and accurate human skeletal inventory is seldom possible in archaeological and forensic cases involving severe fragmentation. In such cases, skeletal mass comparisons with published references may be used as an alternative to assess skeletal completeness but they are too general for a case-by-case routine analysis. The objective is to solve this issue by creating linear regression equations to estimate the total mass of a skeleton based on the mass of individual bones. MATERIALS AND METHODS: Total adult skeletal mass and individual mass of the clavicle, humerus, femur, patella, carpal, metacarpal, tarsal, and metatarsal bones were recorded in a sample of 60 skeletons from the 21st century identified skeletal collection (University of Coimbra). The sample included 32 females and 28 males with ages ranging from 31 to 96 years (mean = 76.4; sd = 14.8). Skeletal mass linear regression equations were calculated based on this sample. RESULTS: The mass of individual bones was successfully used to predict the approximate total mass of the adult skeleton. The femur, humerus, and second metacarpal were the best predictors of total skeletal mass with root mean squared errors ranging from 292.9 to 346.1 g. DISCUSSION: Linear regression was relatively successful at estimating adult skeletal mass. The non-normal distribution of the sample in terms of mass may have reduced the predictive power of the equations. These results have clear impact for bioanthropology, especially forensic anthropology, since this method may provide better estimates of the completeness of the skeleton or the minimum number of individuals. Am J Phys Anthropol 160:427-432, 2016. © 2016 Wiley Periodicals, Inc.

Responses of the CYP1A biomarker in Jenynsia multidentata and Phalloceros caudimaculatus and evaluation of a CYP1A refractory phenotype.

The level of cytochrome P450 1A (CYP1A) in fish is used as a typical environmental biomarker for the presence of organic contaminants. We used RT-qPCR to investigate CYP1A mRNA levels in the liver, gill and gonopodium of guppies Jenynsia multidentata and Phalloceros caudimaculatus in wetlands within the Rio Grande city (RG) which is under the influence of the Patos Lagoon Estuary (RS, Brazil). The CYP1A mRNA levels evaluated in fish liver from two locations that receive non-treated wastewater effluents (S3 and S4) and another locations near an oil refinery (S6) and an industrial complex (S7), were higher than in locations remote from those sites (S1, S2 and S5). The sum of 16 priority PAHs in sediment confirmed high levels in S4 and S6 (3914.0 and 4414.0 ng g(-1) dw, respectively) comparing to S7>S2>S3>S5>S1 (119.3, 66.3, 62.8, 16.4 and 1.7 ng g(-1) dw). J. multidentata from sites S1 to S4 that were transferred to the laboratory exhibited CYP1A induction after 24 h waterborne exposure to 1 µM betanaphtoflavone (BNF) in all organs compared to controls, except in the liver of fish from site S4. This lack of CYP1A induction by BNF indicates a CYP1A refractory phenotype in guppy. Although this characteristic possibly involves the alteration in AHR signaling or control, the mechanism of resistance is unknown. The present study provides information about the use of the use of CYP1A in South American guppies as an useful biomarker tool for environmental contamination studies.

Histological analysis of the eyeball of Neotropical birds of prey Caracara plancus, Falco sparverius, Rupornis magnirostris, Megascops choliba and Athene cunicularia / Análise histológica do bulbo ocular de aves de rapina neotropicais: Caracara plancus, Falco sparverius, Rupornis magnirostris, Megascops choliba e Athene cunicularia

The growing use of ophthalmic examination as a screening tool in birds intended for reintroduction into natural environments over the last few years has given renewed significance to avian ophthalmology in the context of free-ranging and captive bird conservation. The eye plays a vital role in prey detection and capture by birds of prey. The remarkable eyesight of such birds makes them interesting subjects for avian visual system anatomical and histological investigation. This study set out to describe histological features of the eyeball of ubiquitous birds of prey in Brazil (Falconiformes, Accipitriformes and Strigiformes). Twenty enucleated cadaveric eyeballs obtained from birds with natural death, Caracara plancus, Falco sparverius, Rupornis magnirostris, Megascops choliba and Athene cunicularia were used. Routinely prepared histological slides stained with hematoxylin and eosin were analyzed under light microscopy. Similarities and variations in ocular structures between the different bird species studied were highlighted in this study, with major differences concerning the lens and retina. This study highlights the importance of determining the ocular histological pattern of the species so they can be better understood. These results may well assign baseline information of the species and assist in eye histopathological diagnostics.(AU)

Nos últimos anos a oftalmologia aviária se tornou um instrumento de grande relevância para a conservação de aves de vida livre e de cativeiro, principalmente pela crescente utilização do exame oftalmológico para a triagem de indivíduos designados para reintrodução em ambientes naturais. Os olhos das aves de rapina são estruturas imprescindíveis para detectar e capturar suas presas, e a sua notável capacidade visual torna o seu sistema de visão assunto de grande interesse para o estudo anatômico e histológico. Neste contexto, no presente trabalho foi realizada a análise histológica do bulbo ocular de aves de rapina representadas por espécies pertencentes às ordens Falconiformes, Accipitriformes e Strigiformes presentes em território brasileiro. Para realização do estudo foram utilizados vinte bulbos oculares obtidos de animais mortos por causas naturais, das espécies Caracara plancus, Falco sparverius, Rupornis magnirostris, Megascops choliba e Athene cunicularia.. As lâminas histológicas foram coradas pela técnica de hematoxilina e eosina e, analisadas por microscopia óptica. Foi constatada a existência de um padrão histológico com discreta variação entre as estruturas oculares nas diferentes espécies avaliadas, com destaque para o cristalino e a retina. Este estudo salienta a importância da determinação do padrão histológico ocular das espécies, e seus resultados atribuem informações histológicas basais auxiliares na determinação de diagnósticos histopatológicos oculares.(AU)

Predictive value of intraoperative neurophysiologic monitoring in assessing long-term facial function in grade IV vestibular schwannoma removal.

BACKGROUND: Despite routine use of intraoperative neuromonitoring in acoustic neuroma removal, its application in predicting long-term facial function is limited. METHODS: Prospective recording of facial nerve function and subsequent review of intraoperative neurophysiologic data. Stimulation of the facial nerve was performed proximal and distal to the tumor locus after tumor removal with measurement of amplitude and latency responses in the orbicularis oculi and oris muscles. Prospective review of current facial nerve function was performed using the House-Brackmann (HB) scoring system. Good facial function was determined as HB I/II and HB III-VI was considered poor facial function. Minimum follow-up time was 15 months, and averaged 40 months. RESULTS: Twenty-four grade IV acoustic neuromas (54 % larger than 4 cm) were completely removed from October 2008 to November 2013. Nine patients (37.5 %) had HB I/II and 15 (62.5 %) had HB III-VI. The poor prognosis group had a higher latency than the good prognosis group (p = 0.045). Lower proximal amplitude was detected in the poor prognosis group (p = 0.046). Lower proximal-to-distal amplitude ratio was also detected in the poor prognosis group (p = 0.052). Amplitude ratio cut-offs of 0.44 and 0.25 were able to predict poor prognosis with sensitivity of 0.73 and 0.4 and specificity of 0.78 and 1, respectively (p = 0.046). CONCLUSIONS: Lower proximal amplitude and proximal-distal amplitude ratio were previously reported as predictors of poor facial function in different sizes of vestibular schwannomas. We observed that the same applies specifically for large-sized, completely removed, grade IV tumors. Additionally, we describe a difference in proximal latency time between the good and poor prognosis groups, which was not previously reported.

Beta-naphthoflavone-inducedCYP1A expression in the guppy Jenynsia multidentata: Time-dependent response, anesthetic MS-222 effect and fin analysis.

Cytochrome P450 1A (CYP1A) expression in fish is used as a biomarker of exposure to organic contaminants, such PAHs, PCBs and dioxins, in the aquatic environment. South American guppy fish Jenynsia multidentata were exposed to the prototypical aryl hydrocarbon receptor (AHR) agonist beta-naphthoflavone (BNF; 1µM) and the fins were biopsied to characterize different aspects of CYP1A induction. RTq-PCR was used to quantify CYP1A mRNA levels in fish tissues. CYP1A induction in the gill, liver and anal fin (gonopodium) occurred within the first hour of waterborne exposure to BNF and persisted throughout 2, 4, 8, 24, 48 and 96h compared to controls (DMSO vehicle; p<0.05). The organ-specific temporal pattern of induction was marked by mRNA levels consistently augment as duration of exposure increases and tend to a sustained induction from 24h to 96h for gill and liver (∼15-fold and ∼50-fold over control, respectively). In gonopodium, there was a maximum CYP1A mRNA level at 4h (∼34-fold over control). Basal CYP1A mRNA levels and its induction following BNF exposure were not affected by administration of a chemical anesthetic (fish immersion in 100mgl(-1) MS-222 for 2-5min) in the gill, liver, gonopodium, dorsal or tail fin (p<0.05). In an ex vivo assay, in which small pieces of biopsied fins were exposed to BNF for 4h, high CYP1A induction was observed in the tail and gonopodium (∼49-fold and ∼69-fold, respectively) but not in the dorsal fin compared to controls. To our knowledge, this is the first study to show that a 1h waterborne exposure to an AHR agonist is sufficient to cause CYP1A induction in fish organs and fins. The present study added new information to the field regarding the use of MS-222 as an anesthetic on fish and the analysis of biopsied fins as an alternative non-lethalex vivo assay for evaluating the CYP1A biomarker in fish. This observation could be useful for planning fish toxicological bioassays and biomonitoring studies on the aquatic environments in South America.

Immunoblotting of soluble antigens in Paracoccidioides brasiliensis culture.

This study investigated the major soluble antigens produced by Paracoccidioides brasiliensis (Pb339) cultured in solid Sabouraud (pH 5.6 and 8.5), Sabouraud plus brain heart infusion and liquid tomato juice-enriched complex medium media at intervals of 3 days over 30 days by immunoblotting and concluded that, to optimize the source of each antigen, both time and growth conditions should be considered.

Selection of nanobodies that target human neonatal Fc receptor.

FcRn is a key player in several immunological and non-immunological processes, as it mediates maternal-fetal transfer of IgG, regulates the serum persistence of IgG and albumin, and transports both ligands between different cellular compartments. In addition, FcRn enhances antigen presentation. Thus, there is an intense interest in studies of how FcRn binds and transports its cargo within and across several types of cells, and FcRn detection reagents are in high demand. Here we report on phage display-selected Nanobodies that target human FcRn. The Nanobodies were obtained from a variable-domain repertoire library isolated from a llama immunized with recombinant human FcRn. One candidate, Nb218-H4, was shown to bind FcRn with high affinity at both acidic and neutral pH, without competing ligand binding and interfering with FcRn functions, such as transcytosis of IgG. Thus, Nb218-H4 can be used as a detection probe and as a tracker for visualization of FcRn-mediated cellular transport.

Laser fracionado de CO2 e ácido fusídico na balanite de Zoon: relato de caso / Fractional CO2 laser and fusidic acid in Zoon's balanitis: a case report

A balanite de Zoon é lesão inflamatória benigna crônica, de etiologia desconhecida. Relata-se o caso de paciente do sexo masculino de 66 anos, há dois anos com placa eritematosa localizada na glande. Observou-se redução significativa do tamanho da placa e melhora do prurido com o uso de laser fracionado de CO2 associado ao ácido fusídico. O tratamento mostrou-se tolerável e de fácil execução. Concluímos que a lesão foi pouco responsiva ao tratamento tópico conservador com corticoide e muito mais responsiva ao tratamento com laser fracionado de CO2, obtendo-se boa resposta e melhora na qualidade de vida do paciente.

Zoon's balanitis is a benign chronic inflammatory lesion of unknown etiology. This article reports the case of a 66-year-old male patient who presented a 2-year history of a erythematous plaque located on the glans penis. The lesion had not been very responsive to conservative topical treatment with corticoid. A significant reduction in the plaque's size and an improvement in the pruritus was observed with the use of fractional CO2 laser combined with fusidic acid. The treatment was well tolerated and easy to carry out, and improved the patient's quality of life.

Avaliação comparativa do uso de hidroalginato com prata e o curativo convencional em queimaduras de segundo grau / Comparative evaluation of use of silver hydroalginate and conventional dressing in second degree burns

Introdução: O tratamento do paciente queimado sempre foi um desafiopara o profissional que busca melhores resultados no que diz respeito a maiorvelocidade de restauração tecidual, redução da dor e da infecção, além demelhor aspecto estético final da ferida. Entre as novas tecnologias em curativos, destaca-se a cobertura de hidroalginato associado à prata. Objetivo: Comparar o tratamento convencional da queimadura de segundo grau superficial (curativode quatro camadas) e profunda (curativo de quatro camadas + sulfadiazina de prata a 1%) com a utilização do curativo de hidroalginato com prata, quanto aos critérios: dor, evolução da queimadura e praticidade de uso. Método: Este estudo foi conduzido na Divisão de Queimaduras do Hospital do Servidor Público Estadual de São Paulo, em 20 pacientes, de ambos os sexos, entre 5 e 60 anos de idade, vítimas de queimaduras de segundo grau superficial ou mista,com superfície corpórea queimada (SCQ) de até 5%. Resultados: As trocas de curativos convencionais foram extremamente dolorosas (escala de dor 7, 8 e 9), enquanto que, com o curativo de hidroalginato com prata, as trocas receberam notas 0, 2 e 3. Este curativo mostrou-se fácil e prático, especialmente pela reepitelizaçãomais rápida e menor número de trocas. Conclusão: O curativo de hidroalginato com prata mostrou-se de fácil aplicação e manuseio, possibilitando a troca pelo paciente em seu próprio domicílio, proporcionando maior conforto para este e comodidade para os profissionais da saúde.

Introduction: The treatment of burn patients has always been a challenge for the professionals looking better results with regard to the higher rate of tissue restoration, reduction of pain and infection, and better aesthetics final wound. Among the new technologies indressings, stands out the coverage of Alginate associated with silver. Objective: To compare the conventional treatment of superficial seconddegree burn (four-layer bandage) and deep (four-layer bandage + silver sulfadiazine 1%) of the Alginate dressing with silver, for the criteria: pain, evolution of burn and practicality of use. Methods: This study was conducted at the Division of Burns Hospital for State Civil Servants of São Paulo, in 20 patients, of both sexes, between 5 and 60 years of age, victims of superficial second-degree burnsor mixed with body surface burned (SCQ) up to 5%. Results: The conventional dressing changes were extremely painful (pain scale of 7, 8 and 9), while with the silver Alginate dressing, exchanges were scored 0, 2 and 3. This dressing was easy and convenient, especially for faster re-epithelialization and fewer exchanges. Conclusion: Alginate dressing with silver proved easy application and handling, enabling exchange by patients in their own homes, providing greater comfort for them and convenience for health professionals.

Enxerto de pele parcial para tratamento de sequela de queimadura cáustica em cavidade oral: relato de caso / Partial-thickness skin graft for treatment of sequelae of caustic burn in oral cavity: case report

Introdução: As queimaduras estão entre as principais causas de morbimortalidade em nossa sociedade, com 2 milhões de casos por ano e 2.500 óbitos no Brasil. Apesar de menos comuns, as queimaduras químicas são mais graves, principalmente quando causadas por agentes alcalinos. A cavidade oral raramente é afetada, mas, quando ocorre, pode deixar sequelas incapacitantes e permanentes. A literatura apresenta várias opções de tratamento, incluído órteses, fisioterapia, enxertos de pele, retalhos de mucosa e promissores agentes químicos inibidores de fibrose. Relato do caso: Relato de queimadura cáustica grave em face de paciente jovem, com evolução aguda para estenose oral importante, no qual foram realizadas comissuroplastia e enxertia de pele parcial com tratamento das áreas cruentas da mucosa jugal e das comissuras. Conclusão: Foi alcançada evolução satisfatória com recuperação da função estomatognática.

Introduction: Burns are one of the main causes of morbidity and mortality in our society, occurring two million cases per year and 2,500 deaths in Brazil. Although less common, chemical burns are more serious, especially when caused by alkaline agents. The oral cavity is rarely affected, but when it happens, permanent and disabling sequelae may occur. The literature presents various treatment options, including bracing, physical therapy, total skin grafts, flaps of mucosa and promising chemical inhibitors to prevent fibrosis. Case report: Case report of a severe caustic burn in the face in a young patient with acute progression to severe oral stenosis, which were performed commissuroplasties and partial skin graft as a treatment of the cruentae areas of the buccal mucosa and the commissures. Conclusion: Satisfactory outcome with recovery of the stomatognathic function were achieved.

Autologous fibroblast culture in the repair of aging skin.

BACKGROUND: Human cell cultures are being developed to replace various body tissues. OBJECTIVE: To assess the safety and efficacy of dermal regeneration with the injection of young autologous fibroblasts obtained from culture containing serum from patients themselves. MATERIALS AND METHODS: Dermal tissue from the groin of five patients was cultivated in M199 medium supplemented with 10% human serum. Four population doublings were obtained. The fibroblasts were injected intradermally into forehead wrinkles and periorbital and paranasal areas. RESULT: At the fourth population doubling, a mean of 3.85 × 10(6) cells/mL was obtained; viability was 98%. Sixty days after completing treatment, with four injections given at 15-day intervals, periorbital tonicity had improved significantly, although the quantity of fibroblasts used resulted in little improvement to surface lines and no improvement at all in deeper wrinkles. After 6 months, no further changes were found beyond the initial results obtained. CONCLUSION: Injection of skin fibroblasts cultivated in medium supplemented with human serum is a viable technique and provokes no side effects. Four injections given at 15-day intervals containing a total of 6.4 × 10(6) fibroblasts/mL resulted in significant improvement in periorbital skin flaccidity. Further studies should be conducted with larger sample sizes.

Autoeficácia e qualidade de vida de jovens adultos com doenças crônicas / Self-efficacy and quality of life in young adults with chronic disease

O presente estudo teve por objetivo avaliar a autoeficácia e a qualidade de vida de jovens adultos com doenças crônicas, examinando possíveis diferenças entre homens e mulheres. Participaram 20 pacientes com diversos tipos de doenças crônicas, com idade média de 31,5 anos (DP 3,6) e que estavam internados em um hospital geral. Os instrumentos utilizados foram: ficha de Dados biossociodemográficos; Escala de Autoeficácia Geral Percebida e Instrumento de Avaliação da Qualidade de Vida da OMS (WHOQOL-breve). Análise de correção de Spearman mostrou que os índices de autoeficácia estiveram correlacionados de forma positiva e significativa (p<0,05) com a qualidade de vida total e a dimensão ambiente. Não foram encontradas diferenças entre homens e mulheres na autoeficácia e qualidade de vida. Os resultados obtidos sugerem a importância dos aspectos positivos de saúde, especificamente a autoeficácia, para a qualidade de vida de jovens adultos com doenças crônicas.(AU)

This study aims to assess self-efficacy and quality of life in young adults with chronic disease. Also, it examines possible differences between men and women. Participants were 20 patients with different types of chronic diseases, mean age 31,5 (3,6) years, hospitalized in a general hospital. Measures obtained were: Biosociodemographic data, General Perceived Self-efficacy scale and World Health Organization Quality of Life Bref Questionnaire (WHOQOL-bref). Spearman correlation showed that self-efficacy were positively and significantly correlated (p <0.05) or partially correlated (p <0.10) with quality of life and its dimensions. No differences were found between men and women in respect to self-efficacy and quality of life. Our data suggest the importance of positive health, specifically self-efficacy in the perception of quality of life in young adults with chronic disease.(AU)

Autoeficácia e qualidade de vida de jovens adultos com doenças crônicas / Self-efficacy and quality of life in young adults with chronic disease

O presente estudo teve por objetivo avaliar a autoeficácia e a qualidade de vida de jovens adultos com doenças crônicas, examinando possíveis diferenças entre homens e mulheres. Participaram 20 pacientes com diversos tipos de doenças crônicas, com idade média de 31,5 anos (DP 3,6) e que estavam internados em um hospital geral. Os instrumentos utilizados foram: ficha de Dados biossociodemográficos; Escala de Autoeficácia Geral Percebida e Instrumento de Avaliação da Qualidade de Vida da OMS (WHOQOL-breve). Análise de correção de Spearman mostrou que os índices de autoeficácia estiveram correlacionados de forma positiva e significativa (p<0,05) com a qualidade de vida total e a dimensão ambiente. Não foram encontradas diferenças entre homens e mulheres na autoeficácia e qualidade de vida. Os resultados obtidos sugerem a importância dos aspectos positivos de saúde, especificamente a autoeficácia, para a qualidade de vida de jovens adultos com doenças crônicas.

This study aims to assess self-efficacy and quality of life in young adults with chronic disease. Also, it examines possible differences between men and women. Participants were 20 patients with different types of chronic diseases, mean age 31,5 (3,6) years, hospitalized in a general hospital. Measures obtained were: Biosociodemographic data, General Perceived Self-efficacy scale and World Health Organization Quality of Life Bref Questionnaire (WHOQOL-bref). Spearman correlation showed that self-efficacy were positively and significantly correlated (p <0.05) or partially correlated (p <0.10) with quality of life and its dimensions. No differences were found between men and women in respect to self-efficacy and quality of life. Our data suggest the importance of positive health, specifically self-efficacy in the perception of quality of life in young adults with chronic disease.