Descripción de un caso: Hallazgos prenatales del síndrome de Silver-Russell / Case description: Prenatal sonographic features of Silver-Russell Syndrome

Introducción: El síndrome de Silver-Russell es un trastorno congénito que cursa con déficit de crecimiento intrauterino y posnatal, macrocefalia relativa, frente prominente, cara triangular, clinodactilia, asimetría esquelética, problemas de alimentación y bajo índice de masa corporal. Entre las causas genéticas más comunes se encuentran la hipometilación del alelo paterno en la región de control de impronta 1 (ICR1) localizado en 11p15.5 (50% de los casos) y la disomía uniparental materna en el cromosoma 7 (7-10%). Hallazgos clínicos: Presentamos el caso de una gestante de 29 años con un cribado de cromosomopatías de primer trimestre de bajo riesgo. En la ecografía selectiva, realizada con 20+4 semanas, se evidencia un crecimiento intrauterino restringido (CIR) precoz. Se realiza amniocentesis con QF-PCR, cariotipo y array-CGH normales. A las 31+3 semanas persiste CIR tipo I con un peso fetal estimado, circunferencia abdominal y longitud de fémur inferiores al percentil 1, siendo el diámetro biparietal y la circunferencial cefálica normales. Se evidencia prominencia frontal, facies pequeña y clinodactilia del quinto dedo de la mano derecha. A las 37 semanas nace mediante cesárea un varón de 1.410g. Diagnóstico, intervención terapéutica y resultados: A la exploración física destaca fenotipo peculiar sugestivo de síndrome de Silver-Russell. El estudio genético confirma hipometilación del ICR1 en la región 11p15.5. Se incluye iconografía del estudio ecográfico prenatal. Conclusión: Es importante llegar al diagnóstico de esta entidad y conocer la correlación genotipo-fenotipo para poder ofrecer las mejores opciones terapéuticas, un adecuado seguimiento y realizar asesoramiento genético familiar.(AU)

Introduction: Silver-Russell syndrome is a congenital disorder that causes prenatal and postnatal growth restriction, relative macrocephaly, prominent forehead, triangular facies, clinodactyly, body asymmetry, severe feeding difficulties, and low body mass index. The most common underlying mechanisms are hypomethylation of the paternal allele at the imprinting control region 1 (ICR 1) located at 11p15.5 (seen in 50% of patients) and maternal uniparental disomy for chromosome 7 (seen in 7%–10% of patients). Clinical findings: We present the case of a 29-year-old pregnant woman with low risk for chromosomal abnormalities at the first trimester screening. The 20-week ultrasound shows early intrauterine growth restriction (IUGR). We performed an amniocentesis with normal QF-PCR, foetal karyotype and array-CGH. Intrauterine growth restriction Type I persists at 31+4 weeks with estimated foetal weight, abdominal circumference, and femur length below the 1st centile. The biparietal diameter and head circumference centiles were normal. Prominent forehead, small face, and fifth finger clinodactyly of right hand were detected. At 37 weeks, a boy weighing 1,410g was born by caesarean section. Diagnosis, therapeutic intervention, and results: Physical examination revealed a peculiar phenotype suggestive of Silver-Russell syndrome. The genetic study confirmed hypomethylation of ICR1 in the 11p15.5 region. Prenatal ultrasound images are shown. Conclusions: It is important to diagnose this entity and determine genotype-phenotype correlations in order to provide the best therapeutic options, ensure adequate follow-up, and offer timely family genetic counselling.(AU)

[First- and second-line hospital management of ophthalmologic emergencies: Clinical pathway study of 1360 patients]. / Prise en charge des urgences ophtalmologiques en premier et second recours hospitaliers : analyse du parcours de 1360 patients.

The general practitioner (GP) might offer a good alternative for the management of certain ophthalmologic emergencies in his or her practice, given the increasing demand for ophthalmological care and difficulties with access to ophthalmologists. The main objective of the study was to describe ophthalmological complaints and their management in general emergency departments compared to ophthalmological emergency departments in order to assess which pathologies can be treated by the GP. This was a single-center retrospective study at the University Hospital of Reims, based on consultation data from the general and ophthalmological emergency departments for all adult patients presenting for an ophthalmological problem in September 2019 and September 2020. Consultations where patients were brought back following a first emergency consultation and consultations for another non-ophthalmological reason were excluded. Out of 1360 consultations recorded, 16% of patients had initially consulted their GP. The 4 most frequent diagnoses were: "ocular trauma," "conjunctivitis," "eye pain" and "visual impairment." A prescription for medication was issued in 77% of cases, 37% of which were for antibiotics. Only 29% of consultations carried out in general emergency departments led to a request for a complementary ophthalmology consultation. The GP might therefore be able to manage certain ophthalmological emergencies in his or her practice as a first line and refer certain ophthalmologic emergencies. However, the training of GPs in this specialty must be reinforced in collaboration with ophthalmologists.

Study on the dose profile in CT-fluoroscopy.

This work aims to contribute to the description of the dose profile in Computed Tomography Fluoroscopy (CTF). Our approach uses a function model to fit the single slice dose profiles (SSDP) for any point inside the gantry of the CT unit, with special attention to points off the rotation axis. The function model was successfully tested with measurements performed using GafChromic film. The parameters of the SSDP at the rotation axis (isocenter) and at 8 cm and 16 cm off the isocenter were determined. The model allows an estimation of the slice thickness at the isocenter and for points at 8 cm and 16 cm off the isocenter. The differences between the slice thicknesses results in overestimation of the Computed Tomography Dose Index, CTDI, by values as high as 20% if the nominal slice thickness instead of the model estimated value is used. The results obtained in this work provided a good description of the dose profiles, which can be used in further studies such as comparisons with measurements performed with phantoms and patients.

Lactobacillus delbrueckii UFV-H2b20 increases IFN-γ production and CD39+CD73+ Treg cell numbers in lungs, and protects mice against experimental allergic asthma.

Asthma is a disorder characterized by airflow obstruction, inflammation, declining airway function, bronchial hyperresponsiveness and tissue remodelling. Probiotics are defined as "live microorganisms that, when administered in adequate amounts, confer a health benefit on the host". The use of probiotics is becoming increasingly studied and recent evidence has suggested that it may provide therapeutic benefits in asthma and other diseases. Lactobacillus delbrueckii UFV-H2b20 fulfils all the requirements to be classified as probiotic. Previous studies have already shown the ability of L. delbrueckii UFV-H2b20 to stimulate the immune system. Our objective was to evaluate the protective effects of L. delbrueckii UFV-H2b20 in experimental allergic asthma. We used a murine model of ovalbumin-induced allergic airway inflammation to mimic allergic asthma. Oral treatment with L. delbrueckii UFV-H2b20 improves respiratory parameters and inhibits the inflammatory response in the lungs by decreasing the numbers of inflammatory monocytes, eosinophils and alveolar macrophages, as well as IgE levels. Treatment increased the IFN-γ/IL-4 cytokine ratio. Levels of IL-10 in the lungs were also increased in treated animals. Our results also showed that the probiotic administration increases the number of CD39+CD73+ T regulatory lymphocytes in the lung, suggesting a role for purinergic signals in the regulation of inflammation promoted by the treatment. Understanding the mechanisms of modulation of the immune system by probiotics could allow the development of probiotic preparations that are safe and have a direct action. Our results suggest that oral administration of L. delbrueckii UFV-H2b20 could be helpful to treat chronic inflammatory airway diseases, such as asthma.

Eustigmatophyte strains with potential interest in cancer prevention and treatment: partial chemical characterization and evaluation of cytotoxic and antioxidant activity.

The interest in bioactive compounds from microalgae is increasing since they have medicinal and nutritional areas. The present work aims to evaluate the potential pharmaceutical interest of extracts from three eustigmatophyte strains from the Coimbra Collection of Algae (ACOI): Chlorobotrys gloeothece, Chlorobotrys regularis and Characiopsis aquilonaris. Antioxidant and antiproliferative activities were determined as well as chlorophyll a, carotenoid and phenolic total contents. In addition, major pigments and sterols were identified and quantified. The three strains were grown until the stationary phase and then the biomass was extracted. Antioxidant activity was measured by TEAC, DPPH and FRAP assays and antiproliferative effect was assessed by the MTT method on MCF-7, PC-3 and NHDF cells. The pigment and phenolic total contents were determined by spectrophotometry. Of these strains, C. aquilonaris showed the highest antioxidant activity measured by TEAC and FRAP assays (23.98 ± 0.01 µmol TE eq g-1 DW and 42.57 ± 0.04 µmol TE eq g-1 DW, respectively), a selective effect in reduting MCF-7 cells proliferation and a larger amount of chlorophyll a, carotenoids and phenolic content (18.40 ± 0.00 µg chlorophyll a mg-1 DW, 2.27 ± 0.00 mg carotenoids g-1 DW and 6.23 ± 0.01 mg GAE g-1 DW, respectively). A positive correlation between chlorophyll a and TEAC assay was observed, as well as between carotenoids and TEAC and FRAP assays, suggesting these compounds as important contributors to significant antioxidant activity. Violaxanthin, cholesterol and stigmasterol were present in larger amount in C. aquilonaris while C. regularis showed a higher amount of ß-carotene. These results suggest that these three ACOI eustigmatophytes are promising for applications in the improvement of human health, particularly in cancer prevention and treatment.

Relationship between superovulation and embryo production with ovarian follicular population before superovulatory treatment in Brazilian Bergamasca sheep / [Relação da resposta superovulatória e produção embrionária com a população folicular ovariana antes do tratamento superovulatório de ovelhas da raça Bergamácia Brasileira]

The objective of this study was to quantify the superovulatory response and embryo production of Brazilian Bergamasca sheep and to evaluate the link to the follicular condition before superovulatory treatment, as a reference for selection of donors with potential for superovulation. Follicular population of twenty-three sheep was evaluated by ultrasound during metestrus phase of the estrous cycle and divided into groups of low, medium and high follicular population. Subsequently, they were synchronized, superovulated with 133mg of pFSH, mated and subjected to embryo collection. The superovulatory response (9.0±3.3 vs 10.7±6.2 vs 13.8±7.1) and embryo production (4.0±3.8 vs 2.6±2.0 vs 1,8±4.0) were similar between groups (P>0.05). There was a positive correlation between the number of follicles during the metestrus phase and the number of corpus luteum with premature regression (PLR) (0.52) and a negative correlation between the recovery rate and PLR (-0.44) (P<0.05). The sheep that presented PLR had more follicles during metestrus (16.9±7.8 vs 12.7±3.2) and lower embryo recovery rate (38.8±29.3 vs 72.2±29.9) than those with functional CLs (P<0.05). Follicular quantification during metestrus phases was unable to identify donors with high embryo production. Animals with PLR had a larger follicular population during metestrus and lower embryo recovery rate.(AU)

O objetivo deste trabalho foi quantificar a resposta superovulatória e a produção embrionária de ovelhas Bergamácia Brasileira e relacioná-las com a condição folicular antes do tratamento superovulatório, como referência para seleção de doadoras com potencial para superovulação. Vinte e três ovelhas foram avaliadas quanto à população folicular por ultrassonografia na fase de metaestro do ciclo estral e divididas em grupos com baixa, média e alta população folicular. Posteriormente foram sincronizadas, superovuladas com 133mg de pFSH, acasaladas e submetidas à coleta de embriões. A resposta superovulatória (9,0±3,3 vs. 10,7±6,2 vs. 13,8±7,1) e a produção embrionária (4,0±3,8 vs. 2,6±2,0 vs. 1,8±4,0) foram semelhantes entre os grupos (P>0,05). Houve correlação positiva entre o número de folículos no metaestro e o número de corpos lúteos com regressão prematura (RPCL) (0,52) e correlação negativa entre a taxa de recuperação e RPCL (-0,44) (P <0,05). As ovelhas que apresentaram RPCL tiveram mais folículos no metaestro (16,9±7,8 vs. 12,7±3,2) e menor taxa de recuperação embrionária (38,8±29,3 vs. 72,2±29,9) do que as que apresentaram CLs funcionais (P<0,05). A quantificação folicular nas fases de metaestro não foi capaz de identificar doadoras com alto potencial de produção embrionária. Animais com RPCL tiveram maior população folicular no metaestro e menor recuperação de embriões.(AU)

Depression and anxiety disorders in patients with multiple sclerosis: association with neurodegeneration and neurofilaments.

There is increasing evidence that neurofilament light chain (NF-L) can be considered as a biomarker for neuro-axonal damage. This polypeptide can be released into the cerebrospinal fluid (CSF) and the blood, where it can be quantified. The concentration of NF-L is elevated in patients with multiple sclerosis (MS) and psychiatric disorders. We aimed to investigate the NF-L levels in the CSF from treated MS patients and the relationship with depression or anxiety. The study involved three groups: control group (individuals without inflammation), the relapse-remitting multiple sclerosis (RRMS)-untreated group, and the RRMS-Fingo group (RRMS patients who were treated with fingolimod). MS disability was assessed by the Expanded Disability Status Scale, and depression and anxiety were evaluated by a neuropsychologist, using the Hospital Anxiety and Depression Scale, the Beck Depression Inventory-II, and the Beck Anxiety Inventory. Individual CSF samples were collected to measure NF-L levels. The results of the statistical analysis on levels of NF-L in the CSF of control subjects, RRMS-untreated patients, and RRMS-Fingo patients were significant. The relationship between depression and anxiety in RRMS-Fingo patients and NF-L levels was not statistically significant. In conclusion, MS events such as anxiety and depression appear to contribute to the onset of clinical relapses, subclinical cases, and neurodegeneration.

Anti-Candida activity of the water-soluble lectin from Moringa oleifera seeds (WSMoL).

This work reports the effects of the water-soluble lectin from Moringa oleifera seeds (WSMoL) on growth and survival of Candida species. In addition, cellular alterations linked to the antifungal effect were investigated. The minimal inhibitory (MIC) and fungicidal (MFC) concentrations were determined and 24-h growth curves in absence and presence of lectin were established. Flow cytometry was used to evaluate the induction of apoptosis/necrosis, alterations in mitochondrial membrane potential (ΔΨm), and occurrence of lysosomal damage. WSMoL inhibited the growth of C. albicans, C. glabrata, C. krusei and C. parapsilosis with MIC of 20µg/mL. The lowest MFC (20µg/mL) was detected for C. glabrata and the highest (80µg/mL) for C. albicans and C. parapsilosis. The inhibitory effect started from the ninth to nineteenth hour of incubation depending on the fungal species. Incubation with the lectin at the MIC for 24h increased the number of cells undergoing apoptosis and necrosis. Hyperpolarization of the mitochondrial membrane was detected after 12-h treatment, followed by reduction of ΔΨm or depolarization after 24h. No lysosomal damage was detected in treated cells. In conclusion, WSMoL is a fungistatic and fungicide agent against Candida with differential effects depending on the species.

Depression and anxiety disorders in patients with multiple sclerosis: association with neurodegeneration and neurofilaments

There is increasing evidence that neurofilament light chain (NF-L) can be considered as a biomarker for neuro-axonal damage. This polypeptide can be released into the cerebrospinal fluid (CSF) and the blood, where it can be quantified. The concentration of NF-L is elevated in patients with multiple sclerosis (MS) and psychiatric disorders. We aimed to investigate the NF-L levels in the CSF from treated MS patients and the relationship with depression or anxiety. The study involved three groups: control group (individuals without inflammation), the relapse-remitting multiple sclerosis (RRMS)-untreated group, and the RRMS-Fingo group (RRMS patients who were treated with fingolimod). MS disability was assessed by the Expanded Disability Status Scale, and depression and anxiety were evaluated by a neuropsychologist, using the Hospital Anxiety and Depression Scale, the Beck Depression Inventory-II, and the Beck Anxiety Inventory. Individual CSF samples were collected to measure NF-L levels. The results of the statistical analysis on levels of NF-L in the CSF of control subjects, RRMS-untreated patients, and RRMS-Fingo patients were significant. The relationship between depression and anxiety in RRMS-Fingo patients and NF-L levels was not statistically significant. In conclusion, MS events such as anxiety and depression appear to contribute to the onset of clinical relapses, subclinical cases, and neurodegeneration.

Toxocara canis infection may impair bovine herpesvirus type 5 immunization.

Helminths have developed complex mechanisms to suppress the host immune response. These mechanisms may impair the host vaccine response. This study aimed to evaluate the effect of Toxocara spp. infection on the vaccine immune response to bovine herpesvirus type 5 (BoHV-5). First, 30 heifers received two doses of an experimental BoHV-5 vaccine. At 42nd days after the primo vaccination the vaccine efficacy was evaluated, and the presence of anti-Toxocara antibodies. Second, 20 Balb/c mice were divided into two groups, one infected with T. canis and the other without infection. After infection, both groups received two doses of vaccine. The vaccine immune response was assessed by BoHV-5 serum neutralization and splenic cytokines transcription by qPCR. All heifers positive for Toxocara spp. (40%) showed BoHV-5 SN titer ≤1:32, whereas heifers negative for Toxocara spp. (60%) had BoHV-5 SN titer ≥1: 128. Infected T. canis mice showed BoHV-5 SN titer ≤1:2, whereas mice not infected with T. canis BoHV-5 SN titer ≥1:8. Splenocytes from control mice stimulated with BoHV-5 had a significant (p < .05) mRNA transcription for the cytokines IL-12, IL-17, and IL-23, whereas the same cytokines were down-regulated in T. canis infected mice. These results suggest that Toxocara spp. infection may impair BoHV-5 immunization and should be considered for efficient herd immunization.

Dose to the interventional radiologist in CTF-guided procedures.

The aim of this work was to assess the occupational dose received by an interventional radiologist (IR) during computed tomography fluoroscopy (CTF)-guided procedures; to identify the most exposed areas of the body including the hands and fingers; to suggest recommendations for individual monitoring; and to improve radiation safety of the practice. A total of 53 CTF-guided procedures were studied. Twelve whole-body dosimeters were worn by the IR in each procedure for the assessment of the personal dose equivalent, Hp(10), on the chest, waist, and back, both over and under the lead apron, as well as the personal dose equivalent, Hp(0.07), on both arms, knees, and feet. Special gloves with casings to fit extremity dosimeters were prepared to assess Hp(0.07) to the fingers. The measured chest dose values were higher than those on the waist and back; the dominant hand or the left side was the most exposed. In general, the ring, middle, and index fingers of the dominant hand were the most exposed (maximum in the 36-39 mSv range), while wrist dose was negligible compared to finger doses. Based on the results obtained the following recommendations are suggested: protective devices (lead aprons, thyroid shield, and goggles) should be worn; Hp(10) should be assessed at the chest level both above and below the lead apron; finger doses can be measured on the basis of each middle finger; the arm closer to the beam should be monitored; and finally, a wrist dosimeter will not provide useful information.

TYPE TESTING OF LiF:Mg,Cu,P (TLD-100H) WHOLE-BODY DOSEMETERS FOR THE ASSESSMENT OF Hp(10) AND Hp(0.07).

In this work, the initial results of the type testing of the LiF:Mg,Cu,P (TLD-100H) whole-body personal dosemeters are presented. An assessment of reproducibility, linearity of the response, the residual signal as a function of the dose, energy and angular dependence of the response was performed. In general, the dosemeters show good reproducibility for different dose values and a linear behaviour for a range between 0.1 and 300 mSv. The detection limits obtained are lower than 50 µSv. The system presents a good energy and angular response for different radiation qualities.

Projeto saúde mental brincando em família: caracterizando sociodemograficamente crianças cardiopatas hospitalizadas e familiares / Mental health project toying in family: sociodemographic characterization of hospitalized cardiopathy children and of relatives

Objetivo: caracterizar o perfil sociodemográfico e de morbidade da clientela assistida, bem como os fatores associados com a qualidade do atendimento psicológico realizado entre janeiro e dezembro de 2013. Métodos: trata-se de um estudo exploratório, com 357 crianças e seus familiares, no Hospital Ana Nery em Salvador, Bahia, Brasil. Resultados: a maioria das crianças era do sexo masculino, pardas ou negras e com idade média de cinco anos. Verificou-se que aspectos relativos aos familiares, assim como o local onde ocorreram as sessões, influenciaram na qualidade das interações estabelecidas entre familiares e acolhedores do projeto. Conclusões: essa forma de cuidar demonstra a importância de incluir aspectos psicossociais capazes de ampliar as estratégias de cuidado para além do enfoque clínico, contribuindo para promoção e reabilitação em saúde mental.

Objective: characterize the sociodemographic and morbidity profile of the assisted clientele as wellas the factors associated with the quality of psychological care performed between January and December 2013. Methods: we conducted an exploratory study with 357 children and their families at the Ana Nery Hospital in Salvador, Bahia, Brazil. Results: we observed that them a majority of children were male, mixed race or black, and the average age was five years old. Family related aspects and the location in which these sessions took place influenced the quality of interactions established between family members and Play Therapists. Conclusions: this way of caring demonstrates the importance of incorporating psycho-social aspects to extend care strategies beyondthe clinical focus, contributing to the promotion and rehabilitation in mental health.

Avaliação anatômica das artérias radiais e ulnares em adultos submetidos à intervenção coronariana percutânea / Anatomical evaluation of radial and ulnar arteries in adults undergoing percutaneous coronary intervention

INTRODUÇÃO: A artéria radial tornou-se, recentemente, uma alternativa de acesso vascular muito popular nos procedimentos percutâneos coronarianos. Contudo, apesar do uso de cateteres com diâmetro maior ser fator de risco para oclusão da artéria radial, a mensuração do tamanho da mesma não é realizada rotineiramente. MÉTODOS: Com uso da ultrassonagrafia, realizou-se, prospectivamente, a mensuração do diâmetro das artérias radiais e ulnares de 317 pacientes submetidos à angiocoronariografia e/ou intervenção coronariana percutânea em serviços de referência em cardiologia no sul, sudeste e centro oeste do País. Além disso foi verificado as características demográficas e clínicas desta população. Os dados foram tabulados e analisados no programa Statistical Package for the Social Sciences (SPSS). Version 18.0, conforme frequência, média e desvio padrão. RESULTADOS: O diâmetro interno médio das artérias radial e ulnar direitas foi de 2,836±0,7mm e 2,155±0,58mm, respectivamente. Os resultados das artérias contralaterais foram similares (radial 2,53±0,63mm, ulnar 2,15±0,55mm). 20,5% dos pacientes apresentaram diâmetro da artéria radial direita inferiores à 2,3mm e 38,5% menor que 2,5mm, equivalente aos diâmetros dos introdutores Terumo® GSS 5Fr e 6Fr, respectivamente. A circunferência média do punho direito foi de 17,273±1,39cm, também semelhante ao punho esquerdo (17,33±1,39cm). A média de idade foi de 60±10,89 anos. O peso médio encontrou-se na faixa de 76,34±15 kg e a altura 164,1±8,9cm. Houve predomínio do sexo masculino (61%), a comorbidade mais prevalente foi a hipertensão (73%) e 70% dos pacientes apresentaram-se como síndrome coronariana aguda. CONCLUSÃO: Em aproximadamente 40% dos pacientes da amostra foi verificado um diâmetro inferior à 2,5mm da artéria radial direita, sendo este um valor menor ao do introdutor utilizado para sua abordagem nos casos de intervenção coronariana percutânea. (AU)

[A cross-sectional study of the impact of educational information on topical photoprotection habits in medical students]. / Estudio transversal sobre la repercusión de la información educativa en los hábitos de fotoprotección tópica en estudiantes de medicina.

OBJECTIVES: Skin cancer (melanoma and non-melanoma) is the most common cancer in humans, with melanoma being the most aggressive. Due to the fact that ultraviolet (UV) radiation exposure is the only adjustable aetiological factor, UV protection is the essential preventive measure. Based on these grounds, a study was conducted in order to compare three population groups with different levels of knowledge about UV protection, as well as to determine any differences in sun exposure habits, and the level of awareness of the damaging effects of the sun on the skin. MATERIALS AND METHODS: An observational, cross-sectional study was conducted using a questionnaire survey of 317 Spanish university students aged 18-25years old, between October and December 2015. Descriptive statistics methods and Pearson's Chi-squared were used. RESULTS: Six questions were used to evaluate the sun exposure habits. Significant differences were detected in two of them: mole self-assessment (P<.001) and the use of an appropriate sun protection factor (P=.025). Five questions were asked concerning the level of knowledge about UV protection, with differences (P<.001) being found in all cases. CONCLUSIONS: Despite having more knowledge about the risks of sun exposure in the medical dermatology students group, only two of the six habits questioned were improved. Other factors that could be involved are the aesthetic or sociocultural factors. The early prevention of skin cancer is essential, with health promotion programs needing to be established that take into account all these conditions.

Multiple correspondence analysis as a strategy to explore the association between categories of qualitative variables related to oral-maxillofacial trauma and violent crimes at the community level.

The main objective of this study was to show the applicability of multiple correspondence analysis (MCA) in the detection and representation of underlying structures in large datasets used to investigate oral-maxillofacial lesions. A cross-sectional study was conducted involving the analysis of the medical-forensic and social records of 992 people who experienced oral-maxillofacial trauma resulting from non-fatal violent crimes that occurred in the community. Based on the MCA results, two distinct victim profiles were identified. The first profile was characterized by adult men, victims of instruments of violence (such as firearms, knives, or mixed aggression), resulting in severe trauma, mainly affecting the upper or middle third of the face. The second profile was characterized by adolescent and young adult women, victims of aggression using physical force, resulting in soft tissue traumas, mainly affecting the lower third of the face or more than one region at the same time. MCA has been demonstrated to be a powerful tool for exploring complex data related to oral-maxillofacial trauma, showing whether there is a relationship and how variables are related. This multivariate method can also be very valuable in the study of several outcomes in oral and maxillofacial surgery and supporting specialties.

Systemic Inflammation and Multimodal Biomarkers in Amnestic Mild Cognitive Impairment and Alzheimer's Disease.

There is increasing evidence suggesting that one of the most relevant pathophysiological features of Alzheimer's disease (AD) is neuroinflammation, which plays an important role in the production and regulation of AD-related proteins (amyloid beta (Aß) and Tau) and exacerbates AD pathology. Neuroinflammation can also be induced by systemic influences (factors from outside the central nervous system). However, the role of systemic inflammation in AD pathophysiology is much less understood. Thus, our main objective in this study was to verify whether the presence of serum cytokines (IL-1ß, IL-6, IL-10, IL-12, and TNF-α) affects different AD biomarkers: Aß1-42 and Tau protein levels, hippocampal volumes (HV), and default mode network functional connectivity (DMN FC) in healthy elderly controls, amnestic mild cognitive impairment (aMCI) patients due to AD, and mild AD patients. To accomplish this, we acquired 3-T MRI, blood, and cerebrospinal fluid (CSF) samples from 42 healthy controls, 55 aMCI patients due to AD, and 33 mild AD patients. Comparing the groups, we found that the mild AD patients presented smaller HV, disrupted DMN FC, and proportionally less IL-1ß than the controls. The aMCI patients only differed from the controls in DMN FC. In intra-group comparison, aMCI and mild AD with detectable levels of cytokines (TNF-α, IL-1ß, IL-10, and IL-12) had decreased DMN FC. On the other hand, patients with detectable levels of IL-10 and IL-12 presented a more favorable AD biomarkers profile (larger HV, more CSF Aß1-42, and less p-Tau), indicating a possible protective role of these ILs. Our findings indicate a possible relationship between systemic inflammation with DMN FC disruption, hippocampal atrophy, and CSF protein levels in the subjects with mild AD and aMCI.

Bloqueio do plexo braquial em um tamanduá-mirim (Tamandua tetradactyla) utilizando estimulador de nervos periféricos: relato de caso / Brachial plexus block in a tamanduá-mirim (Tamandua tetradactyla) using a peripheral nerve stimulator: Case report

Objetivou-se relatar a utilização do neurolocalizador para bloqueio do plexo braquial bilateral em tamanduá-mirim (Tamandua tetradactyla). O animal, pesando 5kg, atendido pelo Centro de Reabilitação de Animais Silvestres, foi encaminhado ao Hospital Veterinário da Universidade Federal de Mato Grosso do Sul para realização de exames complementares, sendo, posteriormente, encaminhado para cirurgia de osteossíntese de úmero e rádio/ulna esquerdo e colocação de fio de cerclagem em olécrano direito. O paciente foi pré-medicado com cetamina S (5mg/kg) + midazolam (0,15mg/kg), indução anestésica com propofol (5mg/kg) e manutenção anestésica com isoflurano, com o auxílio de máscara. Os parâmetros cardiovasculares e respiratórios foram monitorados durante todo o procedimento. Realizou-se o bloqueio do plexo braquial em ambos os membros utilizando-se estimulador de nervos periféricos. Os anestésicos locais empregados foram lidocaína 2% sem vasoconstritor (3mg/kg) + ropivacaína 0,75% sem vasoconstritor (1mg/kg). O bloqueio foi realizado primeiramente no membro torácico direito, e, após realização do procedimento cirúrgico, o mesmo bloqueio foi realizado no membro contralateral. O paciente teve recuperação tranquila ausente de vocalização e expressão álgica, e a soltura ocorreu após 120 dias.(AU)

The aim of this study was to report the use of the neurolocalizer for blocking the bilateral brachial plexus in tamanduá-mirin. The subject weighing 5kg was attended by the Center for the Rehabilitation of Wild Animals and referred to the Veterinary Hospital of the Federal University of Mato Grosso do Sul for complementary tests. Through the examinations, the need to perform humerus and left radius/ulna osteosynthesis and cerclagem placement on right olecranon was established. For surgery performance, the patient was pre-medicated with ketamine S (5mg/kg-1) associated to midazolam (0.15mg/kg-1) via intramuscular and intravenous propofol (5mg/kg-1) was used for induction. The anesthetic maintenance was performed with isoflurane, provided by an oxygen mask. Cardiovascular and respiratory parameters were monitored throughout the procedure. Brachial plexus block was performed in both limbs using peripheral nerve stimulator. The local anesthetics used were lidocaine without vasoconstrictor (3mg/kg-1) plus 0.75% ropivacaine without vasoconstrictor (1mg/kg-1). Blocking was first performed on the right thoracic limb followed by the surgical procedure. The same blockage was performed on the contralateral limb. The patient had a smooth recovery, without vocalization and pain. The release to its natural habitat occurred after 120 days.(AU)