Peripheral nerve regeneration in rats using nerve graft in a vein conduit pre-filled with platelet-rich fibrin (PRF).

Treatment of peripheral nerve injury is not always satisfactory. To improve results, specific adjuvant methods have been used, such as platelet-rich fibrin (PRF) and vein conduits. The goal of this study was to assess whether use of PRF and vein conduits after nerve suture improves nerve regeneration as measured by a functional score and histomorphometry analysis. Ten isogenic spontaneously hypertensive rats were randomly assigned to 4 experimental procedures: 1) Sham group (n = 10); 2) Nerve graft (NG) group (n = 10); 3) Nerve graft covered with a vein conduit (NGVC) (n = 10); and 4) Nerve graft covered with a vein conduit pre-filled with PRF (NGVCP) (n = 10). Nerve repair results were evaluated on: sciatic functional index (SFI) at 0, 30, 60 and 90 days; morphometric and morphologic analysis of the distal nerve; and histological analysis of Fluoro-Gold® stained motor neurons in the anterior horn of the spinal cord. Compared to the Sham control group, the NGVC and NGVCP groups exhibited lower SFI on all measures. The NGVC group showed improvement in SFI at day 90, which was significant compared to the NG group. Fiber and axon diameters were comparable in the NGVC and NGVCP groups, which were both significantly lower than in the Sham and NG groups. Significant improvement was expected with PRF, but in fact the release of factors from this substance was not as effective as hoped.

Accuracy of silicone impressions and stone models using two laboratory scanners: a 3D evaluation.

PURPOSE: To evaluate the in vitro accuracy of impressions obtained with two silicone and corresponding stone models using two laboratory scanners. MATERIAL AND METHODS: A master model with synthetic resin teeth with two single-unit crown preparations was created and scanned using a 12-MP scanner. Five conventional impressions of the physical model were prepared with different silicone impression systems (Zhermack and Coltene) using the double-mix technique and poured with gypsum. The impressions and stone models obtained were scanned by two extraoral scanning systems (Identica T500 Medit and S600 ARTI Zirkonzahn). All best-fit superimpositions of the teeth areas were conducted between the master model and the scans of the impressions and models obtained with the two scanners. A P < .05 significance level was considered. RESULTS: The Identica T500 Medit scanner showed an accuracy of 102.34 (89.67, 115.01) µm for Coltene silicone and 79.51 (67.82, 91.21) µm for Zhermack silicone, while the S600 ARTI Zirkonzhan scanner presented 110.79 (98.24, 123.33) µm and 91.91 (81.29, 102.54) µm, respectively, with significant differences between scanners for Zhermack silicone (P = .008) and for the corresponding stone models (P = .002). Zhermack silicone presented overall discrepancies lower than Coltene silicone, with statistically significant differences in both scanners analyzed (P < .001; P = .017). However, the discrepancies found were within clinically acceptable values. With the Zirkonzahn scanner, discrepancies found in the Zhermack impressions were lower than in the corresponding stone models (P < .001). CONCLUSION: The direct digitalization of silicone impressions by laboratory scanners presented comparable results to conventional techniques with stone models.

TRANSPLANTATION OF SUBRETINAL STEM CELL-DERIVED RETINAL PIGMENT EPITHELIUM FOR STARGARDT'S DISEASE: A PHASE I CLINICAL TRIAL.

PURPOSE: To assess the safety of injecting human embryonic stem cell retinal pigment epithelial (hESC-RPE) cell dose to treat Stargardt's disease. METHODS: In this prospective, phase I clinical trial, hESC-RPE cells in suspension were injected into the subretinal space in eyes with the worse best-corrected visual acuity (BCVA). After vitrectomy/posterior hyaloid removal, a partial retinal detachment was created and the hESC-RPE cells were administered. Phacoemulsification with intraocular lens implantation was performed in eyes with lens opacity. All procedures were optical coherence tomography (OCT)-guided. The 12-month follow-up included retinal imaging, OCT, visual field/electrophysiologic testing, and systemic evaluation. The main outcome was the absence of ocular/systemic inflammation or rejection, tumor formation, or toxicity during follow-up. RESULTS: The mean baseline BCVAs in the phacoemulsification and no phacoemulsification groups were similar (1.950 ± 0.446 and 1.575 ± 0.303, respectively). One year postoperatively, treated eyes showed a nonsignificant increase in BCVA. No adverse effects occurred during follow-up. Intraoperative OCT was important for guiding all procedures. CONCLUSIONS: This surgical procedure was feasible and safe without cellular migration, rejection, inflammation, or development of ocular or systemic tumors during follow-up.

Antibacterial activity improvement of dental glass-ceramic by incorporation of AgVO3 nanoparticles.

OBJECTIVE: This study aimed to investigate the role of the incorporation of an antibacterial nanoceramic (AgVO3) on the properties of a restorative dental glass-ceramic. METHOD: A commercially available restorative glass-ceramic, commonly designated as porcelain (IPS d.SIGN) was functionalized with an antibacterial agent (nanostructured ß-AgVO3), synthesized by a hydrothermal route. Both functionalized and pristine samples were processed according to the manufacturer's instructions. All samples were characterized by X-ray diffraction, Rietveld refinement, particle size distribution, Scanning Electron Microscopy, chemical solubility, and Inductively Coupled Plasma Spectroscopy. Their antibacterial potential (Mueller-Hinton test) was analyzed against gram-positive (Staphylococcus aureus) and gram-negative bacteria (Escherichia coli). RESULTS: The commercial glass-ceramic showed leucite (KAlSi2O6) as the only detectable crystalline phase, and, for both strains, no antibacterial activity could be detected in the Mueller-Hinton agar plates test. A monophasic, needle-shaped, and nanometric ß-AgVO3 powder was successfully synthesized by a simple hydrothermal route. After thermal treatment, glass-ceramic samples containing different percentages of ß-AgVO3 showed a second crystalline phase of microline [K0.95(AlSi3O8)]. For modified samples, inhibition halos were easily visible on the Mueller-Hinton test, which ranged from 11.1 ± 0.5 mm to 16.6 ± 0.5 mm and 12.7 ± 0.3 mm to 15.5 ± 0.3 mm in the S. aureus and E.coli cultures, respectively, showing that the halos formed were dose-dependent. Also, increasing the percentage of ß-AgVO3 promoted a significant increase in chemical solubility, from 72 µg/cm2 (samples with 1 wt% of ß-AgVO3) to 136 µg/cm2 (samples with 2 wt% of ß-AgVO3), which was associated with the silver and vanadium ions released from the glass matrix. SIGNIFICANCE: Our in vitro results indicate that IPS d.SIGN, as most of the dental glass-ceramics, do not exhibit antibacterial activity per se. Nonetheless, in this concept test, we demonstrated that it is possible to modify dental veneering materials giving them antibacterial properties by adding at least 2 wt% of ß-AgVO3, a nanomaterial easily synthesized by a simple route.

Protocolo de vigilancia activa para el cáncer de próstata en Portugal / Active surveillance protocol in prostate cancer in Portugal

Objetivo: Evaluar los patrones de práctica clínica de urólogos portugueses en el manejo de pacientes incluidos en un protocolo de vigilancia activa.IntroducciónEl cáncer de próstata (CaP) es una enfermedad heterogénea, con un alto porcentaje de adenocarcinomas indolentes y con una probabilidad baja de convertirse en una enfermedad sintomática o potencialmente mortal. La vigilancia activa (VA) es una forma de tratamiento conservador, empleado con el objetivo de limitar el sobretratamiento de los pacientes con CaP de bajo riesgo. A lo largo de los años, la experiencia con VA ha ido aumentado considerablemente, siendo actualmente el manejo estándar en algunos países. Sin embargo, no existe, a día de hoy, un protocolo universal.MétodosEncuesta electrónica anónima de ámbito nacional, sobre los hábitos y prácticas en materia de VA entre urólogos portugueses. La encuesta constaba de 12preguntas y fue enviada por vía electrónica a los 368 miembros actuales de la Asociación Portuguesa de Urología.ResultadosSe encuestó a 56 urólogos (15,21% de respuestas), distribuidos geográficamente de manera uniforme y categorizados según los años de experiencia y el número de pacientes con CaP tratados mensualmente. La gran mayoría de los encuestados recomienda la VA a sus pacientes, en particular en el caso de pacientes de grado 1 de la ISUP, con un nivel sérico de PSA es inferior a 20 ng/ml. No se cuestiona el cumplimiento de los programas de VA por parte de los pacientes, pero la morbilidad psicológica de albergar la enfermedad es un factor preocupante. Según la mayoría de los encuestados, los protocolos de vigilancia propuestos por las guías internacionales son adecuados y suficientes, pero se ponen de manifiesto algunas limitaciones en cuanto a la disponibilidad de la resonancia magnética de forma periódica y al requerimiento de nuevas biopsias (AU)

Objectiv: To examine clinical practice patterns in locally managing patients under an active surveillance protocol among Portuguese urologists.IntroductionProstate cancer (PCa) is a heterogeneous disease with many prostate adenocarcinomas being indolent and a low probability of ever causing symptoms or death. Active surveillance (AS) is a form of conservative management aimed to reduce over-treatment for low-risk PCa patients. Over the years, experience with AS has grown considerably and is now standard in some countries, however a universal protocol still does not exist.MethodsNationwide anonymous e-survey concerning habits and practices on AS among Portuguese urologists, that consisted of 12questions and was sent electronically to all 368 current members of the Portuguese Urological Association.Results56 urologists were surveyed (15.21% answer rate), evenly distributed geographically and allocated according to years of experience as well as number of PCa patients managed monthly. The vast majority of respondents recommends AS to their patients, particularly ISUP grade 1 patients, whose PSA serum level is bellow 20ng/mL. Observance of AS programs by patients was not in question but concerns exist over psychological morbidity while harboring disease. Majority believed that international guidelines surveillance protocols were adequate and sufficient, but there are some constraints concerning availability of periodic MRIs and re-biopsy needs (AU)

Human-edible protein contribution of tropical beef cattle production systems at different levels of intensification.

Sustainable intensification of tropical grasslands has been identified by researchers and stakeholders as a solution to decrease greenhouse gas emissions and deforestation. However, there are concerns about food security and the role of livestock in feed-food competition between animals and humans involving land and other resources. We aimed to determine the net protein contribution (NPC), a feed-food competitiveness index, of tropical beef cattle raised on extensive systems or finished in pastures or conventional feedlots, under different levels of intensification. We modelled five scenarios, from cow-calf to slaughter, based on common beef cattle practices in Brazil, whose main production system is grazing. Scenario 1 represented the lowest level of intensification and the most extensive system. Scenario 2 represented a moderately extensive system. Scenarios 3, 4, and 5 represented different degrees and practices of intensification, with animals in cow-calf and stocker phases raised solely on well-managed permanent pastures. In Scenario 3, the animals were finished in a feedlot. In Scenarios 4 and 5, all animals in the stocker phase received a protein-energy supplement, but in Scenario 4, animals were finished in a permanent pasture with high-concentrate intake. In Scenario 5, animals were finished in a feedlot. The human-edible protein (heP) conversion efficiency (hePCE) was calculated as the ratio of heP produced (meat) to heP consumed as feed, and the NPC was the product of hePCE using the protein quality ratio, accounting for the digestible indispensable amino acid score content. An hePCE > 1 indicated that meat production did not compete with humans for food, and an NPC > 1 indicated that it contributed positively to meet human requirements. Meat production and heP intake consistently increased with intensification. The greatest hePCE values were from Scenarios 1 (9.2), 2 (2.2), and 3 (1.2), which were essentially pasture-fed systems, compared to Scenarios 4 and 5 (average of 1.0). The NPC varied from 24.1 (Scenario 1) to 2.6 (Scenario 5). The area required to produce 1 kg of carcass decreased from 147 to 45 m2, and the slaughter age decreased from 36 to 21 months from the most extensive to intensive systems. Brazilian beef cattle production contributes positively to the protein requirements of humans without limiting human food supplies. The intensification of tropical grazing beef systems is a key strategy to save land and produce more meat without limiting food for humans, playing an important role in the food security agenda.

Currently circulating genotypes of Hepatitis A virus in South West, East and North East India, 2017-2018.

Background: This study was carried out to understand the circulating genotypes of Hepatitis A virus (HAV) in South West, East and North East India during the period 2017-2018 as a part of acute febrile illness surveillance at the Manipal Institute of Virology. Methods: Archived serum samples of 48 Hepatitis A confirmed cases were subjected to RNA extraction using QIAamp® Viral RNA Mini Kit (QIAGEN, Germany). The samples with molecular confirmation for HAV by reverse transcriptase real-Time PCR (Real Star® HAV RT-PCR Kit 2.0, Altona Diagnostics, GmbH, Hamburg, Germany) were further subjected to nested conventional PCR targeting the 5' UTR region. The purified PCR products were sequenced using Big Dye Terminator Kit (Applied Biosystems, USA), in a 3500 XL genetic analyzer (Applied Biosystems, USA). The edited sequences by means of MEGA X (MEGA version 10.1) were compared with reference sequences in the NCBI nucleotide database. Results: From states of Assam, Goa, Gujarat, Karnataka, Kerala, Maharashtra, Odisha, Tamil Nadu and Tripura, 139 Hepatitis A and 33 Hepatitis E cases were reported during the study period. The median age of the acute Hepatitis A cases was 19 years (IQR 12.8-24) and most of the affected individuals were students between 10 and 19 years (52.5%). In the present study, 14 samples from Assam, Goa, Gujarat, Karnataka, Odisha, Kerala, Maharashtra and Tamil Nadu were genotyped as genotype IIIA by nested conventional polymerase chain reaction. Conclusion: The circulating HAV genotype in South West, North East and East India between 2017 and 2018 was IIIA.

Settleable atmospheric particulate matter affects cardiorespiratory responses to hypoxia in Nile tilapia (Oreochromis niloticus).

Atmospheric particulate matter (APM) emitted by iron ore processing industries has a complex composition, including diverse metallic particles and nanoparticles. Settleable APM (SePM) causes air to water cross-contamination and has recently been demonstrated to have harmful sublethal impacts on fish, eliciting stress responses, affecting the immune system, and reducing blood oxygen-carrying capacity. These findings imply potential consequences for fish aerobic performance and energy allocation, particularly in their ability to tolerate respiratory challenges such as aquatic hypoxia. To assess that potential limitation, we analyzed metabolic, cardiorespiratory, and morphological alterations after exposing tilapia, Oreochromis niloticus, to an environmentally relevant concentration of SePM (96 h) and progressive hypoxia. The contamination initiated detectable gill damage, reducing respiratory efficiency, increasing ventilatory effort, and compromising fish capacity to deal with hypoxia. Even in normoxia, the resting respiratory frequency was elevated and limited respiratory adjustments during hypoxia. SePM increased O2crit from 26 to 34% of O2 (1.84 to 2.76 mg O2·L-1). Such ventilatory inefficacy implies higher ventilatory cost with relevant alterations in energy allocation. Progression in gill damage might be problematic and cause: infection, blood loss, ion imbalance, and limited cardiorespiratory performance. The contamination did not cause immediate lethality but may threaten fish populations due to limitations in physiological performance. This was the first investigation to evaluate the physiological responses of fish to hypoxia after SePM contamination. We suggest that the present level of environmental SePM deserves attention. The present results demonstrate the need for comprehensive studies on SePM effects in aquatic fauna.

Active surveillance protocol in prostate cancer in Portugal.

OBJECTIVE: To examine clinical practice patterns in locally managing patients under an active surveillance protocol among Portuguese urologists. INTRODUCTION: Prostate cancer (PCa) is a heterogeneous disease with many prostate adenocarcinomas being indolent and a low probability of ever causing symptoms or death. Active surveillance (AS) is a form of conservative management aimed to reduce over-treatment for low-risk PCa patients. Over the years, experience with AS has grown considerably and is now standard in some countries, however a universal protocol still does not exist. METHODS: Nationwide anonymous e-survey concerning habits and practices on AS among Portuguese urologists, that consisted of twelve questions and was sent electronically to all 368 current members of the Portuguese Urological Association. RESULTS: 56 urologists were surveyed (15.21% answer rate), evenly distributed geographically and allocated according to years of experience as well as number of PCa patients managed monthly. The vast majority of respondents recommends AS to their patients, particularly ISUP grade 1 patients, whose PSA serum level is bellow 20 ng/mL. Observance of AS programs by patients was not in question but concerns exist over psychological morbidity while harboring disease. Majority believed that international guidelines surveillance protocols were adequate and sufficient, but there are some constraints concerning availability of periodic MRIs and re-biopsy needs. CONCLUSIONS: AS seems to be sustained in urologist clinical practice, although patients still lag to adhere and choose for active treatment. AS may not be an easy choice for patients and clinicians due to uncertainty of disease progression, risk of loss to follow-up and repeated biopsies but is also a cause for anxiety, depression, uncertainty and a perception of danger.

Mechanical writing of electrical polarization in poly (L-lactic) acid.

Stimuli responsive materials are found in a broad range of applications, from energy harvesters to biomolecular sensors. Here, we report the production of poly (L-lactic acid) (PLLA) thin films that exhibit a mechanical stress responsive behaviour. By simply applying a mechanical stress through an AFM tip, a local electrical polarization was generated and measured by Kelvin Probe Force Microscopy. We showed that the magnitude of the stress generated electrical polarization can be manipulated by varying the thickness or crystallization state of the PLLA thin films. Besides exhibiting a mechanical stress-response behaviour with potential for energy harvesting and sensor applications, we show by AFM that these platforms react to mechanical forces with physiological relevance: interaction forces as low as a cell sheet migrating over a substrate or larger ones as the fluid induced stresses in bone tissue. In living tissues, as most mechanical stimuli are transduced as strain gradients for the anatomical structures, these mechanically responsive substrates can be used as ex vivo platforms to study the protein and cells response over a large range of electrical stimuli amplitude. As a proof of concept, selective adsorption of a human fibronectin was demonstrated by local patterning of the stimuli responsive PLLA films. STATEMENT OF SIGNIFICANCE: Bioelectricity is inherent to the formation and repair of living tissues and electrical stimulation has been recognized for promoting regeneration. Given the proven beneficial effects of electric fields and the absence of a suitable method of stimulation, there is a clinical need for smart substrates, which can generate a polarization (charges) to promote tissue regeneration without the need of external devices. In this work, we report the fabrication of poly(L-lactic) acid platforms that exhibit a mechanical stress responsive behaviour when subjected to physiologically relevant forces. This behaviour can be tailored by varying the thickness or crystallization state of the PLLA films. We further demonstrate the biofunctionality of such platforms by exploiting the mechanically-induced charge for adhesion protein adsorption.

Subcutaneous immunotherapy with aeroallergens: safety profile assessment.

SUMMARY: Introduction. Severe systemic reactions (SR) to allergen subcutaneous immunotherapy (SCIT) are rare but local reactions (LR) are common. We aimed to characterize the type of reactions and safety profile. Methods. Retrospective analysis of medical record from patients under SCIT between 2013-2016. Results. Total of 7372 SCIT injections in 323 patients: 52% female; mean age 30 years (SD 13); mean treatment time 19 months (SD 13). There were 57 patients (17.6% of population, 70% female) with at least one adverse reaction, for 93 reactions described (1.3% injections). There were 79 LR (1.1% injections) in 46(14.2%) patients: 36 in build-up, 43 in maintenance. There were 14 SR (0.19% injections) in 12(3.7%) patients: 12 in build-up, 2 in maintenance. All SR were grade 1. The majority of reactions were caused by mite SCIT (69.9%). Conclusions. SCIT is safe and well tolerated, with no report of SR grade > 1.

Assessment of biofilm formation by Campylobacter spp. isolates mimicking poultry slaughterhouse conditions.

This research aimed to assess the biofilm formation ability of Campylobacter strains under temperature and oxygen stress conditions, similar to those found in the industrial environment, to explain the persistence of this pathogen on the poultry slaughter line. A collection of C. jejuni and C. coli isolates (n = 143) obtained from poultry samples (cecal content and neck skin), collected at slaughterhouse level, from diverse flocks, on different working days, was genotyped by flaA-restriction fragment length polymorphism (RFLP) typing method. A clustering analysis resulted in the assignment of 10 main clusters, from which 15 strains with different flaA-RFLP genotypes were selected for the assessment of biofilm formation ability and antimicrobial susceptibility. Biofilm assays, performed by crystal violet staining method, were conducted with the goal of mimicking some conditions present at the slaughterhouse environment, based on temperature, atmosphere, and contamination levels. Results indicated that many C. jejuni strains with similar flaA-RFLP profiles were present at the slaughterhouse on different processing days. All the strains tested (n = 15) were multidrug-resistant except for one. Biofilm formation ability was strain-dependent, and it appeared to have been affected by inoculum concentration, temperature, and tolerance to oxygen levels. At 10°C, adherence levels were significantly lower than at 42°C. Under microaerobic and aerobic atmospheres, at 42°C, 3 strains (C. jejuni 46E, C. jejuni 61C, and C. coli 65B) stood out, exhibiting significant levels of biofilm formation. C. jejuni strains 46E and 61C were inserted in clusters with evidence of persistence at the slaughterhouse for a long period of time. This study demonstrated that Campylobacter strains from broilers are capable of forming biofilms under conditions resembling the slaughterhouse environment. These results should be seen as a cue to improve the programs of hygiene implemented, particularly in those zones that can promote biofilm formation.

New insights into U(VI) sorption onto montmorillonite from batch sorption and spectroscopic studies at increased ionic strength.

The influence of ionic strength up to 3 mol kg-1 (background electrolytes NaCl or CaCl2) on U(VI) sorption onto montmorillonite was investigated as function of pHc in absence and presence of CO2. A multi-method approach combined batch sorption experiments with spectroscopic methods (time-resolved laser-induced fluorescence spectroscopy (TRLFS) and in situ attenuated total reflection Fourier-transform infrared spectroscopy (ATR FT-IR)). In the absence of atmospheric carbonate, U(VI) sorption was nearly 99% above pHc 6 in both NaCl and CaCl2 and no significant effect of ionic strength was found. At lower pH, cation exchange was strongly reduced with increasing ionic strength. In the presence of carbonate, U(VI) sorption was reduced above pHc 7.5 in NaCl and pHc 6 in CaCl2 system due to formation of aqueous UO2(CO3)x(2-2x) and Ca2UO2(CO3)3 complexes, respectively, as verified by TRLFS. A significant ionic strength effect was observed due to the formation of Ca2UO2(CO3)3(aq), which strongly decreases U(VI) sorption with increasing ionic strength. The joint analysis of determined sorption data together with literature data (giving a total of 213 experimental data points) allowed to derive a consistent set of surface complexation reactions and constants based on the 2SPNE SC/CE approach, yielding log K°≡SSOUO2+ = 2.42 ± 0.04, log K°≡SSOUO2OH = -4.49 ± 0.7, and log K°≡SSOUO2(OH)32- = -20.5 ± 0.4. Ternary uranyl carbonate surface complexes were not required to describe the data. With this reduced set of surface complexes, an improved robust sorption model was obtained covering a broad variety of geochemical settings over wide ranges of ionic strengths and groundwater compositions, which subsequently was validated by an independent original dataset. This model improves the understanding of U(VI) retention by clay minerals and enables now predictive modeling of U(VI) sorption processes in complex clay rich natural environments.

Co-relationship between Escherichia coli in broiler cellulitis and liver lesions / Correlação entre a presença de Escherichia coli em lesões de celulite e fígados de frango

Abstract Pathogenic strains of Escherichia coli may invade the subcutaneous tissue of poultry and cause cellulitis, whilst the pathogen may also cause lesions in internal organs such as the liver. Current paper co-relates Escherichia coli and virulence genes characteristic of Avian Pathogenic Escherichia coli (APEC) in broilers´ cellulitis and liver lesions. One hundred carcasses were retrieved from the production chain in an avian abattoir in the state of Bahia, Brazil, between August 2013 and January 2014, due to detection of cellulitis lesions. Cellulitis and liver samples were retrieved aseptically to quantify E. coli by Petrifilm™ count fast method (3M Company) (AOAC 998.8). Virulent genes iss and iutA were removed from E. coli isolates by Polymerase Chain Reaction (PCR). Escherichia coli was isolated from 82.0% of broilers removed from the production chain and the bacterium was concomitantly detected in cellulitis and liver lesions in 40.0% of broilers. E. coli counts ranged between 1.00 and 4.73 log CFU/g in liver lesions and between 2.00 and 9.00 log UFC/g in cellulitis lesions. Virulent genes iutA and iss were detected in 97.56% and 89.02% of E. coli isolates, respectively. Genotype analysis demonstrated the concomitant amplification of genes iutA and iss in 60.0% (n=40) of samples of cellulitis and liver lesions in which the simultaneous isolation of E. coli occurred. There was a positive and significant co-relationship (r=0.22; p<0.05) between the variables occurrence of E. coli isolated from liver samples and the occurrence of E. coli isolated from cellulitis lesions. There were also positive and significant co-relationships between populations of E. coli from liver isolates and cellulitis lesions (r=0.46; p<0.05) when E. coli isolated in the liver and in cellulitis lesions was detected. Since results showed a relationship between E. coli in cellulitis and liver lesions and possible systemic infection, the occurrence of cellulitis lesions as a criterion for total discarding of carcass may be suggested.

Resumo Cepas patogênicas de Escherichia coli podem invadir o tecido subcutâneo das aves e provocar celulite aviária e este patógeno pode provocar lesões nos órgãos internos, como o fígado. Desta forma, objetivou-se correlacionar a presença de Escherichia coli e os genes de virulência característicos de Escherichia coli Patogênica para Aves (APEC) nas lesões de celulite e nos fígados dos frangos. Entre agosto de 2013 a janeiro de 2014, foram retiradas 100 carcaças da linha de produção por apresentarem lesões de celulite em um matadouro avícola da Bahia (Brasil). Foram coletadas amostras de celulite e fígados de frango assepticamente para quantificação de E. coli pelo método rápido de contagem Petrifilm™ (3M Company) (AOAC 998.8). Em seguida foi realizada a pesquisa dos genes de virulência iss e iutA nos isolados de E. coli utilizando a Reação em Cadeia da Polimerase (PCR). Escherichia coli foi isolada em 82,00% das aves retiradas da linha de produção e a bactéria foi detectada concomitantemente nas lesões de celulite e fígado em 40,00% das aves. As contagens de E. coli variaram de 1,00 a 4,73 log UFC/g nos fígados e de 2,00 a 9,00 log UFC/g nas lesões de celulite. Os genes de virulência iutA e iss foram encontrados em 97,56% e 89,02% dos isolados de E. coli, respectivamente. A análise genotípica revelou a amplificação concomitante dos genes iutA e iss em 60,00% (n=40) das amostras de lesões de celulite e fígado nas quais houve o isolamento simultâneo de E. coli. Foi observada correlação positiva e significativa (r=0,22; p<0,05) entre as variáveis ocorrência de E. coli isolada das amostras dos fígados e ocorrência E. coli isolada das lesões de celulite e, nos casos em que foi detectada a ocorrência de E. coli isolada em fígado e lesões de celulite, correlações positivas e significativas também foram evidenciadas entre as populações de E. coli dos isolados dos fígados e das lesões de celulite, (r=0,46; p<0,05). Assim ficou evidenciada a relação entre E. coli presente nas lesões de celulite e no fígado e uma possível infecção sistêmica, desta forma, sugere-se que a presença de lesões de celulite seja utilizada como critério para o descarte total da carcaça.

COVID-19, corticosteroids and public health: a reappraisal.

OBJECTIVES: To assess whether regulatory guidance on the use of dexamethasone in hospitalised COVID-19 patients is applicable to the larger population of COVID-19 cases. The surge in worldwide demand for dexamethasone suggests that the guidance, although correct, has not emphasised the danger of its wider use. STUDY DESIGN: Data from the Randomised Evaluation of COVID-19 Therapy (RECOVERY) trial and the World Health Organisation (WHO) prospective meta-analysis have been deconstructed and analysed. METHODS: To provide context, relevant publications were identified in PubMed using the following keywords: COVID-19, RECOVERY trial, WHO meta-analysis, variants, immunity, public health. RESULTS: The WHO guidance 'Corticosteroids for COVID-19' was based on their prospective meta-analysis. This meta-analysis was weighted by data from the RECOVERY trial. CONCLUSIONS: In terms of COVID-19, dexamethasone has value in a narrow indication, namely, in hospitalised patients requiring respiratory support. The media blitz likely resulted in the wider use of dexamethasone in outpatients and as a preventive medication. This is reflected in the surge in worldwide demand for dexamethasone. We ask whether the use of steroids, beyond regulatory indications, may be responsible for the recent increase in mortality and especially the emergence of mucormycosis? From the public health standpoint, the current guidance for use of dexamethasone in COVID-19 could benefit from clarification and the addition of a cautionary note.

In Vitro and In Vivo Characterization of PLLA-316L Stainless Steel Electromechanical Devices for Bone Tissue Engineering-A Preliminary Study.

Bone injuries represent a major social and financial impairment, commonly requiring surgical intervention due to a limited healing capacity of the tissue, particularly regarding critical-sized defects and non-union fractures. Regenerative medicine with the application of bone implants has been developing in the past decades towards the manufacturing of appropriate devices. This work intended to evaluate medical 316L stainless steel (SS)-based devices covered by a polymer poly (L-lactic acid) (PLLA) coating for bone lesion mechanical and functional support. SS316L devices were subjected to a previously described silanization process, following a three-layer PLLA film coating. Devices were further characterized and evaluated towards their cytocompatibility and osteogenic potential using human dental pulp stem cells, and biocompatibility via subcutaneous implantation in a rat animal model. Results demonstrated PLLA-SS316L devices to present superior in vitro and in vivo outcomes and suggested the PLLA coating to provide osteo-inductive properties to the device. Overall, this work represents a preliminary study on PLLA-SS316L devices' potential towards bone tissue regenerative techniques, showing promising outcomes for bone lesion support.

Proposal of a formula mouth opening reduction assessment, for forensic purposes.

OBJECTIVES: To propose a formula for determining reduced mouth opening due to oral and maxillofacial trauma, based on the normal standard of the Brazilian population. MATERIALS AND METHODS: First, the maximum mouth opening was established, in millimeters, using a digital pachymeter, in patients between 22 and 60 years of age. The opening was measured from the upper to the lower incisor, at maximum amplitude, without pain and overbite. Second, the facial profile type and height were determined. A formula was developed to calculate the percentage of reduced mouth opening based on the normal average. RESULTS: The average mouth opening was found to be 51.71 mm in men and 47.94 mm in women, thus establishing a statistically significant difference in mouth opening between sexes. However, there was no statistically significant difference between age and profile type with mouth opening. The following formulas were developed to calculate the reduced mouth opening, based on the averages found, by using RA= [100-(A.1.93)].0.3 for males and RA= [100-(A.2,08)] .0.3 for female patients. CONCLUSION: Considering that mouth opening tends to be larger in men than in women, valid formulas can be used to determine the correct percentage of reduced mouth opening.

Analysis of adrenaline autoinjectors acquisition in Portugal over 15 years.

SUMMARY: Background. The adrenaline autoinjector (AAi) is universally recommended as the first-line treatment for anaphylactic reactions occurring outside the medical setting. The quantification of its acquisition may help estimate the prevalence of patients at risk of anaphylaxis with an indication for AAi. Objective. Evaluation of the global and regional frequency of AAi purchases in Mainland Portugal between 2003-2017 and calculate the inherent costs in 2017. Methods. AAi acquisition distribution analysis along this period. The population was divided in two age groups according to the adrenaline dosage. Results. A total of 10,993 AAi units of 0.15mg/0.3mL and 28,619 of 0.3mg/0.3mL were acquired in these 15 years, with an annual average of 733 and 1908 units, respectively. In cumulative values terms, Lisbon showed the highest number of AAI acquired and higher prevalence per region/100,000 inhabitants in both groups. In 2017, the annual cost for each age group was 64,202.71 € 187,447.70 € for patients and € 37,706.35 / 110,113.30 € for the National Health System. Conclusions. In the last 15 years, there was a progressive increase in AAi acquisition. We estimate a rate of anaphylaxis occurrence in Portugal according to AAi aquisition of 0.165%.