Morphometric evaluation of the linea alba in fresh corpses.

Purpose: Diastasis recti abdominis is an increase in the distance between the medial borders of the two rectus muscles. It is most often triggered after intra-abdominal pressure increases, such as postpartum or in obesity. Most publications are based on radiological studies or are done in certain subgroups, without unanimous reference values of the distance between the rectus abdominis or standardization. Methods: Forty-one cadavers were studied. Exclusion criteria: signs of abdominal trauma, major burns, presence of scar from previous abdominal surgery, clinical signs of abdominal hernia, and identification of hernia during cadaver dissection. Linea alba (LA) length, width, and thickness were measured with a flexible tape measure and digital caliper. Anatomical landmarks were established, and subdivisions were described based on them to compare the cadavers. Results: Sex and age had little effect on LA width, thickness, or length. Obesity (compared to normal weight) was the only variable that promoted an increase in the LA width (p < 0.01). The supraumbilical length varied with the total height of the evaluated cadavers (p < 0.01), but the infraumbilical length did not (p = 0.11). Conclusion: The general statistical results of this study, regarding the evaluation of LA measurements in cadavers, showed that ethnicity, sex, and age have little effect on the width, thickness, or length of the LA. LA width differed significantly with abdominal circumference.

Estrangulated obturatory hernia. Case report of a challenging diagnosis of obstructive syndrome.

INTRODUCTION AND IMPORTANCE: Obturator hernia accounts for less than 1 % of all documented cases of pelvic hernias. It most commonly presents as an obstructive syndrome in elderly, multiparous, slim women, characterized by a wider pelvis that facilitates the passage of the hernia sac through the obturator foramen alongside the obturator nerve. In this case, adhering to the SCARE (Updating Consensus Surgical CAse REport) checklist criteria, we present a typical scenario involving an elderly woman who was initially misdiagnosed with a fecaloma, concealing an obturator hernia. CASE REPORT: An 85-year-old patient, displaying prodromal signs of senile disease, presented for medical attention with incapacitating abdominal pain in the right iliac fossa, accompanied by nausea and vomiting. Rectal examination revealed the presence of a fecaloma, and glycerin administration was performed rectally. The patient's condition worsened with the development of mental confusion and hyperactive delirium. Abdominal Computer tomography scan (CT scan) revealed right obturator hernia with enteral segment insinuation and dilation of the proximal bowel. An infraumbilical laparotomy was performed. The herniation of an ileal segment and the right ovary through the obturator foramen was identified. The content proved irreducible to manual maneuvers, leading to obturator muscle section following the dissection of the Retzius space. The right round ligament of the uterus was sectioned, and we manage to preserve the Obturatory branch of the lumbar plexus throughout dissection. A polypropylene mesh was positioned and secured with non-absorbable sutures on the Cooper's ligament, iliac crest, and obturator muscle and segmental enterectomy with primary anastomosis using a linear stapler was performed. CLINICAL DISCUSSION: This demanding case brings to the spotlight the importance of reevaluating even the usual cases. We provide our experience bringing together an unusual diagnosis after the conduction of a once diagnosed fecaloma that almost went down to a perforated acute abdomen. Hence the importance of suspect obturator hernia in unknown obstructive abdomen in elderly women. CONCLUSION: With this report we aim to raise awareness of careful propaedeutic inquiry of acute abdomen. We provide our experience bringing together the diagnosis that agrees with our literature review. Elderly patients commonly challenge the clinical evaluation, especially those with signs of senile disease. Thereby, inkling hidden diagnosis in typical scenarios can improve the patient's care in emergency settings.

Bone anchor as fixation method for abdominal wall reconstruction. A case report about a ten times recurred inguinal hernia.

INTRODUCTION: While the use of bone anchor fixation for abdominal wall reconstruction for supra-pubic incisional hernia is well described (Yee et al., 2008 [1]), we show in this case report, written in line with the SCARE criteria (Agha et al., 2020 [2]), a novel use of this tool as an adjunct in the repair of a ten time recurrent inguinal hernia. CASE REPORT: A 65 years old multiparous, diabetic non-obese female, with previous abdominoplasty was submitted for left inguinal hernia for ten times, between multiples complications between infection, more than one mesh excision by anterior approach and laparoscopic approach. The wide range of procedures culminated in a destruction of the abdominal wall, making it impossible for a usual fixation of mesh in the region. Therefore, a multidisciplinary approach was planned for the patient with a bone anchor as a mesh fixation method. With a year follow up we did not observe a local hernia recurrence. CLINICAL DISCUSSION: Hernia itself is a multifactorial disease. As a anatomical defect, surgery is the only effective treatment. Our report brings a novel approach to a challenging case with many previous unsuccessful applications of conventional surgeries. Hence, we stimulate the multidisciplinary discussion for enhancing post operatory outcomes and a better point of care for the patient.

A method to reproduce pH and Eh environmental changes due to sediment resuspension.

During the last decades, metals have been released into coastal areas increasing the environmental and human health risks, however, resuspension events of trace metals polluted sediment could represent even more severe risks. Anoxic condition in the sediment is capable to stabilize the trace metals, due to the bonding with reduced anions. Although, the sediment resuspension can alter the potential redox and pH characteristics resulting in metals released from the water column. The climate change advance would impact directly on ocean chemistry, is expected the spatial increase of anoxic sites, mainly in coastal areas. Furthermore, it is mandatory and urgent to expand the knowledge over the process of sediment metals releasing in order to develop prediction and remediation tools for possible environmental impacts. This is a simple method of manipulating and simulating physicochemical alterations. The creation of microcosmos without oxygen allows the formation of a very reducible environment, common in coastal areas with low energy and high organic matter input. And further oxidation allows the assessment of the trace metals released to the water column and/or the new arrangement of these metals in different geochemical fractions. • The experimental procedure to assess trace metals mobility to potential redox and pH changes in sediment and water. • A method is suitable for a wild range of sediment characteristics.

Action potential variability in human pluripotent stem cell-derived cardiomyocytes obtained from healthy donors.

Human pluripotent stem cells (PSC) have been used for disease modelling, after differentiation into the desired cell type. Electrophysiologic properties of cardiomyocytes derived from pluripotent stem cells are extensively used to model cardiac arrhythmias, in cardiomyopathies and channelopathies. This requires strict control of the multiple variables that can influence the electrical properties of these cells. In this article, we report the action potential variability of 780 cardiomyocytes derived from pluripotent stem cells obtained from six healthy donors. We analyze the overall distribution of action potential (AP) data, the distribution of action potential data per cell line, per differentiation protocol and batch. This analysis indicates that even using the same cell line and differentiation protocol, the differentiation batch still affects the results. This variability has important implications in modeling arrhythmias and imputing pathogenicity to variants encountered in patients with arrhythmic diseases. We conclude that even when using isogenic cell lines to ascertain pathogenicity to variants associated to arrythmias one should use cardiomyocytes derived from pluripotent stem cells using the same differentiation protocol and batch and pace the cells or use only cells that have very similar spontaneous beat rates. Otherwise, one may find phenotypic variability that is not attributable to pathogenic variants.

Cyanoacrylate glue in socket repair: a comparative study.

This study aimed to compare socket repair with Nylon 5-0 suture and closure using cyanoacrylate biological glue after tooth extraction. Twenty male Wistar rats, each weighing approximately 200 g were submitted to the extraction of the right and left first molar teeth. On the right side, the alveolus was closed with 2 ethyl-cyanoacrylate glue, whereas on the left side closure was with a single interrupted Nylon 5-0 suture (Ethilon). The animals were sacrificed after 3, 7, 15, and 30 postoperative days, and images of histological sections of the alveolus were captured for analysis. Histomorphometry was performed using Image J software to quantify bone neoformation in the alveolus. The results showed that on the seventh postoperative day the side treated with 2-ethyl-cyanoacrylate presented a delay in relation to the sutured side. However, on days 15 and 30, the difference in bone neoformation between gradually decreased until the thirtieth postoperative day, with no significant difference in bone neoformation in the last period of analysis. There was no difference between neoformation in the two sides (p = 0.902) after statistical analysis of the histomorphometric results. In conclusion, socket repair after alveolus closure with 2-ethyl-cyanoacrylate allows complete bone neoformation after tooth extraction, and there is no significant difference when compared with closure with Nylon 5-0.

Factors associated with non-completion of latent tuberculosis infection treatment in Rio de Janeiro, Brazil: A non-matched case control study.

INTRODUCTION: There are scarce data on the routine latent tuberculosis infection treatment (LTBIT) and factors associated with a non-completion in high tuberculosis burden countries. Therefore, in this study we aimed to evaluate the factors associated with non-completion of LTBIT. MATERIALS AND METHODS: This was a non-matched case control study conducted at a University Hospital in Rio de Janeiro, Brazil. A total of 114 cases and 404 controls were enrolled between January/1999 and December/2009. Cases were close contacts who did not complete the LTBIT and controls were the contacts that completed it. Multivariate analysis was used to investigate risk factors associated with non-completion of LTBIT among contacts in two different periods of recruitment. RESULTS: Factors associated with non-completion LTBIT included: drug use (OR 23.33, 95% CI 1.83-296.1), TB treatment default by the index case (OR 16.97, 95% CI 3.63-79.24) and drug intolerance. TB disease rates after two years of follow up varied from 0.4% to 1.9%. The number necessary to treat to prevent one TB case among contacts was 116. CONCLUSIONS: Non-completion treatment by the index case and illicit drug use were associated with not completing latent tuberculosis infection treatment and no tuberculosis disease was identified among those who completed latent tuberculosis infection treatment.

Effects of ozone therapy on hematological, biochemical, and oxidative stress parameters of vaquejada athlete horses / Efeitos da ozonioterapia sobre os parâmetros hematológicos, bioquímicos e estresse oxidativo de cavalos atletas de vaquejada

Ozone therapy is a technique used in several specialties of equine medicine; however, there are few studies on its use in vaquejada (cowboy competition) athlete horses. This study aims to evaluate the potential effect of ozone gas administered by two different routes on hematological and biochemical values and the oxidative stress marker in vaquejada athlete horses. For this, nine healthy equines that followed a training protocol and underwent two treatments were used with an 8-day wash-out between them. The major ozonated autohemotherapy (MOA) treatment group received a volume of 600ml of the 02-03 mixture at a concentration of 60 µg/mL, and the rectal insufflation (RI) treatment group received 5mL of gas per kg of body weight at a concentration of 15µg/kg performed every 24h on three consecutive days. Results were significant for RBC, hematocrit, and hemoglobin in the hematological variables, and AST and lactate for biochemical and malondialdehyde variables. No statistically significant differences were found in comparisons between treatment groups. Thus, we can conclude that there is no difference between the two therapies, indicating that the two techniques are effective for the application of ozone therapy in horses competing for vaquejada.

A ozonioterapia é uma técnica utilizada em diversas especialidades da medicina equina, contudo, são escassos os estudos de sua utilização em cavalos atletas de vaquejada. O presente estudo tem por objetivo avaliar o potencial efeito do gás ozônio administrado por duas diferentes vias sobre os valores hematológicos, bioquímicos e no marcador de estresse oxidativo em cavalos atletas de vaquejada. Para isso, foram utilizados 9 equinos hígidos que seguiram um protocolo de treinamento e foram submetidos a dois tratamentos, com um wash-out de 8 dias entre eles. O grupo de tratamento auto-hemoterapia maior ozonizada (AHTMO) recebeu um volume de 600ml da mistura 02-03 na concentração de 60 µg/mL e o grupo de tratamento insuflação retal (IR) recebeu 5mL de gás por kg de peso vivo, na concentração de 15µg/kg, realizado a cada 24h em três dias consecutivos. Os resultados demonstraram-se significativos para hemácias, hematocrito e hemoglobina nas variáveis hematológicas, AST e lactato para as variáveis bioquímicas e para o malondialdeido. Não foram encontradas diferenças estatísticas significativas nas comparações entre grupos de tratamento. Assim, pode-se concluir que não há diferença entre as duas terapias, indicando que as duas técnicas são eficazes para a aplicação da ozonioterapia em cavalos competidores de vaquejada.

Frailty and risk of complications in head and neck oncologic surgery. Systematic review and dose-response meta-analysis.

BACKGROUND: There is emerging evidence that frail individuals present a decreased physiological reserve, decreased ability to maintain homeostasis, and increased vulnerability to stressors. The concept of frailty has become increasingly recognized as a valuable measure in oncological surgical patients, including those with head and neck cancer. Preoperative screening for frailty may provide an individualized risk assessment that can be used by an interdisciplinary team for preoperative counseling and to improve outcomes. The aim of this meta-analysis was to evaluate the relationship between frailty and the risk of major postoperative complications in frail individuals submitted to head and neck oncologic surgery. MATERIAL AND METHODS: PubMed, SCOPUS, Web of Science, Google Scholar and OpenThesis were systematically searched to identify studies that evaluated the risk of major postoperative complications in frail individuals undergoing head and neck oncologic surgery. The search was performed on August 31, 2020, without language or date restrictions. Two independent investigators screened the searched studies based on each paper's title and abstract. Relevant studies were read in full and selected according to the eligibility criteria. Frailty was assessed by modified Frailty Index (mFI-11) and major postoperative complications were measured by the Clavien-Dindo classification. We performed a categorical and dose-response meta-analysis using a random-effects model to evaluate the association between frailty and the risk of major postoperative complications in patients submitted to head and neck oncologic surgery. The results of the meta-analysis were expressed as relative risk (RR) and 95% confidence interval (95% CI). The risk of bias was assessed using the Newcastle-Ottawa Scale (NOS). RESULTS: Four studies (9,947 patients) were included in this systematic review and meta-analysis. Frail patients presented an increased risk of life-threatening complications requiring intensive care unit (ICU) admission (RR = 4.67; 95% CI 1.54-14.10) and 30-day mortality (RR = 8.10; 95% CI 2.30-28.57) compared to non-frail patients. We found evidence of dose-response trend between mFI-11 and major postoperative complications. CONCLUSIONS: Higher frailty scores are associated with a significant increase in ICU-level complications and 30-day mortality after head and neck oncologic surgery.

Efeitos tóxicos dos sedimentos do estuário do rio Capibaribe em embriões de zebrafish (Danio rerio) / Toxic effects of sediments of the Capibaribe estuary on zebrafish embryos (Danio rerio)

O presente estudo utilizou embriões de Danio rerio expostos aos elutriatos dos sedimentos estuarinos do rio Capibaribe, dos períodos chuvoso e seco, e analisou os efeitos letais, teratogênicos, bem como a frequência cardíaca. Os testes de toxicidade com os embriões seguiram as diretrizes da OECD 236. Mediante os resultados obtidos, a frequência cardíaca e a teratogenicidade foram os efeitos mais observados nos animais quando submetidos às amostras. Entre os efeitos teratogênicos, o retardo geral no desenvolvimento dos embriões foi o mais frequente durante as análises. Tais efeitos tóxicos se modificaram entre os pontos e entre os períodos de coleta. Essa variação de toxicidade pode estar relacionada à diversidade de atividades realizadas no entorno desse estuário, a influência do regime de chuvas, marés e correntes, indicando que a análise dos efeitos subletais e da teratogenicidade em embriões de D. rerio constitui bom parâmetro para avaliações de toxicidade de amostras ambientais.(AU)

The present study used Danio rerio embryos exposed to the elutriates of the estuarine sediments of the Rio Capibaribe, from the rainy and dry periods, where the lethal effects, teratogenic and heart rate were analyzed. Embryotoxicity tests followed the guidelines of OECD 236. Based on the results obtained, heart rate and teratogenicity demonstrated higher sensitivity to the samples. Among the teratogenic effects, the general delay in embryo development was the most frequent effect during the analyzes. These toxic effects changed between the points and between the collection periods. This variation of toxicity may be related to the diversity of activities carried out around this estuary, the influence of rainfall, tides, and currents, indicating the analysis of sublethal effects and teratogenicity in the D. rerio embryos are useful parameters for toxic evaluation of environmental samples.(AU)

Efeitos tóxicos dos sedimentos do estuário do rio Capibaribe em embriões de zebrafish (Danio rerio) / Toxic effects of sediments of the Capibaribe estuary on zebrafish embryos (Danio rerio)

O presente estudo utilizou embriões de Danio rerio expostos aos elutriatos dos sedimentos estuarinos do rio Capibaribe, dos períodos chuvoso e seco, e analisou os efeitos letais, teratogênicos, bem como a frequência cardíaca. Os testes de toxicidade com os embriões seguiram as diretrizes da OECD 236. Mediante os resultados obtidos, a frequência cardíaca e a teratogenicidade foram os efeitos mais observados nos animais quando submetidos às amostras. Entre os efeitos teratogênicos, o retardo geral no desenvolvimento dos embriões foi o mais frequente durante as análises. Tais efeitos tóxicos se modificaram entre os pontos e entre os períodos de coleta. Essa variação de toxicidade pode estar relacionada à diversidade de atividades realizadas no entorno desse estuário, a influência do regime de chuvas, marés e correntes, indicando que a análise dos efeitos subletais e da teratogenicidade em embriões de D. rerio constitui bom parâmetro para avaliações de toxicidade de amostras ambientais.(AU)

The present study used Danio rerio embryos exposed to the elutriates of the estuarine sediments of the Rio Capibaribe, from the rainy and dry periods, where the lethal effects, teratogenic and heart rate were analyzed. Embryotoxicity tests followed the guidelines of OECD 236. Based on the results obtained, heart rate and teratogenicity demonstrated higher sensitivity to the samples. Among the teratogenic effects, the general delay in embryo development was the most frequent effect during the analyzes. These toxic effects changed between the points and between the collection periods. This variation of toxicity may be related to the diversity of activities carried out around this estuary, the influence of rainfall, tides, and currents, indicating the analysis of sublethal effects and teratogenicity in the D. rerio embryos are useful parameters for toxic evaluation of environmental samples.(AU)

Combination therapy with benznidazole and doxycycline shows no additive effect to monotherapy with benznidazole in mice infected with the VL-10 strain of the Trypanosoma cruzi.

BACKGROUND: Chagas heart disease is the most important clinical manifestation of Trypanosoma cruzi infection. Pharmacological therapies have been proposed aiming to reduce inflammatory response and cardiac damage in infected hosts. In this study, we investigated the use of doxycycline (Dox), in a sub-antimicrobial dose, in monotherapy and in combination with benznidazole (Bz) during the acute phase of infection with the VL-10 strain of T. cruzi, evaluating the therapeutic effect during the acute and chronic phases of the infection. METHODS AND RESULTS: C57BL/6 mice were treated for 20 days with Dox (30 mg/kg), Bz (100 mg/kg), or both drugs in combination starting 9 days after infection. Parasitemia was measured during the acute phase and the animals were monitored for 12 months, after which echocardiography analysis was performed. Blood samples were obtained from euthanized mice for CCL2, CCL5, IL-10 analysis, and cardiac fragments were collected for histopathological evaluation. Dox treatment did not ameliorate parasitological/inflammatory parameters but reduced the cardiac collagen neoformation (CN) in 35%. In contrast, Bz administration reduced parasitemia, plasma levels of CCL2 and CCL5, and cardiac infiltration during acute infection, and reduced the level of IL-10 and CN (95%) at 12 months. Dox was unable to improve ejection fraction, while Bz treatment ameliorated the ejection fraction. No additive effect was observed in combination therapy. CONCLUSION: Dox monotherapy is not effective in the acute or chronic phases of experimental cardiomyopathy induced by the VL-10 strain of T. cruzi. Furthermore, combination therapy with Dox does not potentiate the effects of Bz monotherapy.

Pharyngeal airway space changes after maxillomandibular advancement: a five-year retrospective study.

The aim of this study was to compare the alterations in three regions of the airway-nasopharynx, oropharynx, and hypopharynx-in relation to the area of the midsagittal plane, volume, and minimal axial area after maxillomandibular advancement (MMA) surgery. Thirty patients who had undergone MMA surgery were evaluated at four time points: preoperative (T0), immediately postoperative (T1), 1year postoperative (T2), and ≥5 years postoperative (T3). All measurements were performed using computed tomography, analyzed in Dolphin Imaging 11.0 Premium 3D software. The area in the midsagittal plane presented a mean increase of 22.0% between T0 and T3 (P<0.001), with the highest increase in the oropharynx (24.1%, P<0.001). The total volumetric increase at T3 was 16.7% (P<0.001), with the highest increase in the nasopharynx (15.7%; P<0.001). The lowest minimal axial area was found for the oropharynx at all time points, and the highest increase in minimal axial area was found for the nasopharynx (114.9%; P<0.001). MMA surgery showed the highest increase in upper posterior airway between T0 and T1, and this was followed by a progressive reduction until T3, but with a statistically significant increase at T3 compared with T0 in all cases.

Performance, Growth Curves and Carcass Yield of Four Strains of Broiler Chicken

The objective of this study was to evaluate the performance, carcass yield and growth curves of different commercial strains of broiler chicken. 2400 day-old chicks, males and females of the Cobb500, RossAp95, Hubbard Flex and a new Francesa line were used. The birds were distributed in a completely randomized design in a factorial arrangement 4x2 (line x sex), forming eight treatments with 10 replicates each. The birds were fed with the same diet. Feed intake, weight gain and feed conversion were determined. At 42 days, it was determined at the request of carcass and cuts of each lineage. The Gompertz model was applied to a growth curve for each line. The RossAP95 line shows the best performance results. Growth curves showed lower sexual dimorphism in the Hubbard Flex line. The Hubbard Flex strain presented higher thigh yield and a Cobb500 genetics the higher breast yield. Based on the results found it was observed that the RossAP95 performed better. Hubbard Flex line exhibits the least sexual dimorphism. The Cobb500 have better yield for breast and as Hubbard Flex birds greater thigh yield.

Performance, Growth Curves and Carcass Yield of Four Strains of Broiler Chicken

The objective of this study was to evaluate the performance, carcass yield and growth curves of different commercial strains of broiler chicken. 2400 day-old chicks, males and females of the Cobb500, RossAp95, Hubbard Flex and a new Francesa line were used. The birds were distributed in a completely randomized design in a factorial arrangement 4x2 (line x sex), forming eight treatments with 10 replicates each. The birds were fed with the same diet. Feed intake, weight gain and feed conversion were determined. At 42 days, it was determined at the request of carcass and cuts of each lineage. The Gompertz model was applied to a growth curve for each line. The RossAP95 line shows the best performance results. Growth curves showed lower sexual dimorphism in the Hubbard Flex line. The Hubbard Flex strain presented higher thigh yield and a Cobb500 genetics the higher breast yield. Based on the results found it was observed that the RossAP95 performed better. Hubbard Flex line exhibits the least sexual dimorphism. The Cobb500 have better yield for breast and as Hubbard Flex birds greater thigh yield.(AU)