Efficacy of injection of autologous adipose tissue in the treatment of patients with complex and recurrent fistula-in-ano of cryptoglandular origin.

BACKGROUND: Adipose tissue injections, a rich source of mesenchymal stem cells, have been successfully used to promote anal fistula healing. This study aimed to investigate the efficacy of adipose tissue injection in treating patients with complex and recurrent fistulas of cryptoglandular origin. METHODS: We conducted a prospective, single-center, open-label, non-randomized, interventional clinical trial from January 2020 to December 2022. We enrolled nine patients, who were evaluated after at least 12 months of follow-up. All patients had seton removal, fistula tract excision or curettage, and a mucosal flap if possible or, alternatively, an internal opening suture. We used a commercially available system to collect and process adipose tissue prior to injection. This system allowed the collection, microfragmentation, and filtration of tissue. RESULTS: Selected cases included six men and three women with a median age of 42 (range 31-55) years. All patients had an extended disease course period, ranging from 3 to 13 (mean 6.6) years, and a history of multiple previous surgeries, including two to eight interventions (a mean of 4.4 per case). All fistulas were high transsphincteric, four cases horseshoe and two cases with secondary suprasphincteric or peri-elevator tract fistulas. Six cases (66%) achieved complete fistula healing at a mean follow-up of 18 (range 12-36) months. Three cases (33.3%) experienced reduced secretion and decreased anal discomfort. CONCLUSIONS: In patients with complex and recurrent fistulas, such as the ones described, many from palliative treatments with setons, the adjuvant injection of adipose tissue might help achieve complete healing or improvement in a significant percentage of cases. CLINICALTRIALS: The study protocol was prospectively registered on ClinicalTrials.gov (NCT04750499).

Individual differences in behaviour and gut bacteria are associated in collared peccary (Mammalia, Tayassuidae).

AIMS: We tested the hypothesis that the behaviour of an individual is associated with the diversity of its gut bacteria, using the collared peccary (Pecari tajacu) as a model. METHODS AND RESULTS: In all, 24 adult male collared peccaries received either low- (n = 12) or high-fibre diet (n = 12) to induce contrasting gut fermentation profiles. They were submitted to three short-term challenges, allowing us to rate the animals in a coping-style dimension named 'calmness'. At the end of the experimental period, we collected samples of peccaries' forestomach contents to characterize bacterial diversity. We found a significant positive association between individual 'calmness' z-scores and the bacterial evenness index in gut bacteria (and a similar trend with the Simpson's diversity index), suggesting a more homogeneous bacterial community of calmer individuals. We also found a positive association between fibres digestibility and gut bacterial diversity in the peccaries' forestomach, but no effect of the dietary fibre level. CONCLUSIONS: Gut bacteria evenness increases with 'calmness' z-scores, suggesting a more homogeneous bacterial community of calmer individuals, compared with the more heterogeneous of the most distressed ones. Our results also suggest associations between the digestibility of ADF with the gut bacterial diversity indices and with the relative abundance of the Actinobacteria phylum. SIGNIFICANCE AND IMPACT OF THE STUDY: Our data showed that the hosts' individual behavioural differences are potentially aligned with gut bacterial diversity. The behaviour-microbiota link is correlated with host feed efficiency and, ultimately, may have implications for animal health and welfare of farm animals.

Haploidentical stem cell transplantation in a boy with chronic granulomatous disease.

Chronic granulomatous disease is a primary immunodeficiency caused by mutations in any one of the five components of the NADPH oxidase in phagocytic leucocytes. This causes impaired microbial killing, which leads to severe life-threatening bacterial and fungal infections. Currently, allogenic hematopoietic stem cell transplantation (HSCT) is the only curative treatment for chronic granulomatous disease, although gene therapy may provide a new therapeutic option for the treatment of patients with CGD. Haploidentical HSCT provides a potentially curative treatment option for patients who lack a suitably HLA-matched donor, but only a few cases have been reported in the literature. Herein, we report a boy with X-linked chronic granulomatous disease treated successfully by haploidentical HSCT with post-transplant cyclophosphamide using a treosulfan-based conditioning regimen.

The challenges of asymmetric mating - the influence of male and female size on the reproductive output of Acanthochondria cornuta (Chondracanthidae).

The reproductive strategy of Acanthochondria cornuta, a parasitic copepod with dwarf, hyperparasitic males, is described in detail. The potential impact of male parasitism on the reproductive output was evaluated by determining the size of each sex and the female's fecundity, egg size and total reproductive effort for each pair/trio throughout the four seasons of the year. Marked seasonal differences were observed in female size and reproductive output, suggesting two distinct generations, but no differences were observed for male size. No statistically significant correlations were observed between male size and any measure of reproductive effort, but females with larger males had lower fecundity. A trade-off between egg number and egg size was recorded. Overall, the reproductive effort in A. cornuta seems to be determined mostly by female size, and larger females do not hold smaller males.

Validation of the Geriatric Oral Health Assessment Index in complete denture wearers.

To perform a validation of the Geriatric Oral Health Assessment Index (GOHAI) for complete denture wearers and present a proposal for estimation of perceived oral health. This is a cross-sectional study with non-probabilistic sampling. A total of 211 subjects with a mean age of 62·5 (s.d. = 11·4) years participated, being 169 female. The GOHAI was applied in a personal interview. The construct/convergent/discriminant validity was tested using structural equation modelling. Confirmatory factor analysis was used to verify the fit of three proposals of the GOHAI: three-factor, one-factor and second-order hierarchical models. The stability of the models was evaluated in independent samples. The three-factor model presented an inadequate fit, and items 3, 4 and 9 were removed. The new structure presented an acceptable fit and strong invariance in independent samples. The convergent, discriminant validity and internal consistency were below adequate. The one-factor model presented an adequate fit to the sample. Convergent validity was compromised. A strong invariance of the one-factor model was observed. To calculate the overall scores of the GOHAI factors (three-factor model) or of the oral health perception (one-factor model), a matrix of regression weights for each item in the model was presented as a suggestion. We found an adequate fit of the both structures of the GOHAI for denture wearers, but the three-factor structure was more parsimonious. We suggested considering the weights of the regression model to calculate the overall score of perceived oral health or of its factors in different samples.

Effects of TachoSil and 5-fluorouracil on colonic anastomotic healing.

BACKGROUND: The administration of intraperitoneal (IP) 5-fluorouracil (5-FU) during the early postoperative period after cytoreductive surgery can decrease local cancer recurrence but may also cause impairment of the anastomotic healing. This study examined the effects of the use of this therapy and of the anastomotic sealing with TachoSil, a fibrin-thrombin coated sealant (FTCS), on the healing of colon anastomoses. MATERIALS AND METHODS: Forty male rats were divided into four groups (1-4, 10 rats each) that underwent transection and anastomosis of the left colon. The anastomoses were covered with FTCS in groups 2 and 4. Saline solution (2 mL/d-groups 1 and 2) or 5-FU (20 mg/kg/d; groups 3 and 4) was administered IP once daily for 3 d. Bursting pressure (BP) was recorded, and the anastomoses were examined macroscopically and graded histologically. RESULTS: The relative weight loss was significantly higher in group 3 than in the other groups (P = 0.0004). Anastomotic dehiscence, postoperative adhesion formation, perianastomotic collections, and preanastomotic dilatation did not differ significantly among groups. BP was significantly lower in group 3 compared with all other groups (P = 0.001). Neoangiogenesis was significantly lower in group 3 compared with groups 1 and 2 (P = 0.05). Fibroblastic activity was significantly higher in group 1 compared with group 3 (P = 0.035). Inflammatory cell infiltration and collagen deposition did not differ significantly among groups. CONCLUSIONS: Our results shown that the early postoperative IP chemotherapy with 5-FU impaired the healing of colon anastomoses. However, anastomotic sealing with FTCS reversed some of the negative effects of this therapy.

Chronic pain after breast surgery: incidence, risk factors and impact on quality of life.

INTRODUCTION AND OBJECTIVES: Breast cancer is the most frequently diagnosed malignancy, and chronic pain after breast surgery (CPBS) is an increasingly recognized therapy-related problem. We evaluated CPBS incidence, characteristics, associated factors, and impact on patient quality of life (QoL). MATERIALS AND METHODS: Six-month observational prospective study conducted in patients undergoing breast surgery in a tertiary university hospital. Data were collected using several questionnaires: Pain Catastrophizing Scale, Brief Pain Inventory-Short Form, Douleur Neuropathique 4 Questionnaire, and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire and its Breast Cancer Module. RESULTS: A total of 112 patients completed the study. Approximately, one third (34.8%) developed CPBS, and almost all with potentially neuropathic pain. CPBS interfered with patients' daily life and reduced their QoL. Diabetes (p = 0.028), catastrophizing (p = 0.042), and acute postoperative pain severity (p < 0.001) were associated with CPBS. CONCLUSIONS: This study broadens our understanding of CPBS and shows the impact of this syndrome. Healthcare workers need to be aware of CPBS and take steps to prevent and treat it, and provide patients with adequate information.

Comparison of pregnancy characteristics and outcomes between HIV-infected and HIV-non-infected women in Brazil.

The aim of this study is to evaluate the characteristics of pregnant women whether they are HIV infected or not and their prenatal care. It is a cross-sectional study. HIV-infected women were derived from a cohort study of all HIV-infected pregnant women followed from 1995 to 2005, at the Instituto de Puericultura e Pediatria Martagão Gesteira - Rio de Janeiro. HIV-non-infected women were derived from a random sample of all pregnant women who gave birth at Rio de Janeiro municipality between 1999 and 2001. All relevant sociodemographic, clinical, and pregnancy outcomes data were retrieved from both studies. To evaluate the prenatal care, we calculated the Kotelchuck Modified Index (KMI). The index is based on the months of initiation of prenatal care and the proportion of visits observed in each trimester, according to gestational age at birth. Comparisons were performed using Student t- and chi-square tests. Variables with p-value < 0.25 were included in an unconditional logistic regression model. There were 713 HIV-infected women and 2145 HIV-non-infected women. Variables independently associated with HIV status were: inadequate KMI (OR=4.08, 95% CI=3.17-5.24); lower educational level (OR=1.32, 95% CI=1.04-1.68); does not live with a partner (OR=3.54, 95% CI=2.66-4.64); lower family income (OR=4.71, 95% CI=3.62-6.14); tobacco use (OR=2.17, 95% CI=1.63-2.88); and hypertension (OR=1.47, 95% CI=1.01-2.17). Prematurity was not independently associated with HIV status. Although in Brazil, the HIV care is free of charge, pregnant women are still having difficulty to reach the specialized care. Better access to care must be offered to this population and studies of prematurity in the HIV-infected women must evaluate their prenatal care.

Optical gap energy study of poly(thienylene-2,5-dialkoxyphenylene) in solid-state films.

Optical gap energy (Egap) in luminescent π-conjugated polymers presents several difficulties in its determination, particularly when using CW conventional optical spectroscopy, absorption and emission. This happens due to several physicochemical parameter's dependence. Among others, the molecular conformation, intramolecular interactions, structural defects, polymer processability and solvent interaction stand out. In addition, there is a distribution of conjugated segments along the polymeric main chains that differentiate optical absorption transition from emission processes. In other words, these processes do not necessarily occur in the same conjugated segment owing to the very efficient ratios of energy transfer or charge migration in these materials. In this work we present a systematic study of the determination of Egap for the polymer poly(thienylene-2,5-dialkoxyphenylene). We present a comparison between the solution and solid-state film, clearly showing the presence of a polymer-polymer interaction as aggregate species. The goal of this paper is to isolate and aggregate the contribution determination of each species through systematic analysis of optical spectra, as well as to obtain, even on film, the Egap of the isolated polymer which is very similar to the polymer solution at about 2.37 eV. The intersection theory and the voltammetry methods corroborate the experiment and the discussion of the results obtained.

Controlling bandgap energy and multivibronic modes of a poly(2,5-thiophene-1,4-dialkoxyphenylene) derivative by gamma photons.

In this work, the influence of γ radiation on electronic, structural, and vibrational properties of a poly(2,5-thiophene-1,4-dialkoxyphenylene) derivative is studied by optical absorption and photoluminescence. A Gaussian fit of emission spectra within Franck-Condon vertical transitions formalism was carried out in order to understand how vibronic coupling is affected by the dose, because an unexpected luminescence behavior was observed. Aiming to understand the ionizing radiation-matter interaction processes, we employed a molecular modeling procedure, through the use of a semiempirical method (AM1) applied to conjugated oligomers' conformational structure and equilibrium geometries, to clarify the defects induction for the used doses. From AM1 optimized structures, electronic transitions were calculated by ZINDO/S-CI semiempirical method to measure the chain scission degree. Moreover, with the results presented in this work, it is possible to come up with a new physical-chemical route to treat and increase conjugated polymers' efficiency. Finally, we believe that the present paper contributes to the literature about defects on conjugated polymers.

Production and properties of xylanases from Aspergillus terricola Marchal and Aspergillus ochraceus and their use in cellulose pulp bleaching.

Aspergillus terricola and Aspergillus ochraceus, isolated from Brazilian soil, were cultivated in Vogel and Adams media supplemented with 20 different carbon sources, at 30 degrees C, under static conditions, for 120 and 144 h, respectively. High levels of cellulase-free xylanase were produced in birchwood or oat spelt xylan-media. Wheat bran was the most favorable agricultural residue for xylanase production. Maximum activity was obtained at 60 degrees C and pH 6.5 for A. terricola, and 65 degrees C and pH 5.0 for A. ochraceus. A. terricola xylanase was stable for 1 h at 60 degrees C and retained 50% activity after 80 min, while A. ochraceus xylanase presented a t(50) of 10 min. The xylanases were stable in an alkali pH range. Biobleaching of 10 U/g dry cellulose pulp resulted in 14.3% delignification (A. terricola) and 36.4% (A. ochraceus). The brightness was 2.4-3.4% ISO higher than the control. Analysis in SEM showed defibrillation of the microfibrils. Arabinase traces and beta-xylosidase were detected which might act synergistically with xylanase.

Individual differences in behavior affect total tract fiber digestibility: the example of collared peccary.

Differences in how individuals cope with stressful conditions (e.g. novel/unfamiliar environment, social isolation and increases in human contact) can explain the variability in data collection from nutrient digestibility trials. We used the collared peccary (Pecari tajacu), which is under process of domestication and shows high individual behavioral distinctiveness in reactions toward humans, to test the hypothesis that behavioral differences play a role in nutrient digestibility. We assessed the individual behavioral traits of 24 adult male collared peccaries using both the 'behavioral coding' and the 'subjective ratings' approaches. For the behavioral coding assessment, we recorded the hourly frequency of behaviors potentially indicative of stress during the 30-day habituation period to the experimental housing conditions. The subjective ratings were performed based on the individuals' reactions to three short-term challenge tests (novel environment, novel object and threat from a capture net) over a period of 56 days. During the last 26 days, the collared peccaries were fed diets either high (n = 12) or low (n = 12) in dietary fiber levels, and we determined the total tract apparent digestibility of nutrients. The individual subjective ratings showed consistency in the correlated measures of 'relaxedness', 'quietness' and 'satisfaction' across the three challenge tests, which were combined to produce z score ratings of one derived variable ('calmness'). Individual frequency of BPIS/h and calmness scores were negatively correlated and both predicted the total tract digestibility of acid detergent fiber (ADF), which ranged from 0.41 to 0.79. The greater the calmness z scores (i.e. calmer individuals), the greater the total tract digestibility of ADF. In contrast, the higher the frequency of BPIS/h, the lower the total tract digestibility of ADF. Therefore, our results provide evidence that by selecting calmer collared peccaries, there will be an increase in their capacity to digest dietary fiber.

Measurement properties from the Brazilian Portuguese version of the QUIP-RS.

Parkinson's disease (PD) has numerous motor and non-motor symptoms. Among non-motor manifestations impulse control disorders (ICDs) stand out. ICDs include compulsions for gambling, shopping, eating, and sexual behavior, and "related disorders" such as hobbyism, simple motor activities, and dopamine dysregulation syndrome. There is no rating scale translated and adapted transculturally into Brazilian Portuguese language. Therefore, we cross-culturally adapted and investigated the measurement properties of the Brazilian version of the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Rating Scale (QUIP-RS). Fifty-three patients participated in the study. Inter-evaluator and test-retest (patient and health professional) reliabilities (intraclass correlation coefficient) were all excellent (0.93, 0.93, and 0.99). The internal consistency was high (α = 0.92). The Minimal detectable change (MDC) value was 5.8 (patient) and 2.3 (health professional) points. There was a floor, but no ceiling, effect. In summary, the Brazilian version of the QUIP-RS has high reliability and content validity.

Pregnancy outcome in women infected with HIV-1 receiving combination antiretroviral therapy before versus after conception.

OBJECTIVE: The potential adverse effects of antiretroviral drugs during pregnancy are discrepant and few studies, mostly from Europe, have provided information about pregnancy outcomes of those already on treatment at conception. The aim of this study was to investigate the impact of antiretrovirals (ARVs) on pregnancy outcome according to the timing of treatment initiation in a cohort of pregnant women from Brazil infected with HIV. METHODS: A prospective cohort of 696 pregnant women followed up in one single centre between 1996 and 2006 was studied. Patients who had ARV treatment before pregnancy were compared with those treated after the first trimester. The outcomes evaluated were preterm delivery (PTD) (<37 weeks), severe PTD (<34 weeks), low birth weight (LBW) (<2500 g) and very LBW (<1500 g). RESULTS: Patients who were using ARVs pre-conception had higher rates of LBW (33.3% vs 16.5%; p<0.001) and a similar trend for PTD (26.3% vs 17.7%; p = 0.09). Stratification by type of therapy (dual vs highly active antiretroviral therapy (HAART)) according to timing of initiation of ARVs showed that patients who use HAART pre-conception have a higher rate of PTD (20.2% vs 10.2%; p = 0.03) and LBW (24.2% vs 10.2%; p = 0.002). After adjusting for several factors, HAART used pre-conception was associated with an increased risk for PTD (AOR 5.0; 95% CI 1.5 to 17.0; p = 0.009) and LBW (OR 3.6; 95% CI 1.7 to 7.7; p = 0.001). CONCLUSIONS: We identified an increased risk for LBW and PTD in patients who had HAART prior to pregnancy.

Xylanases from Aspergillus niger, Aspergillus niveus and Aspergillus ochraceus produced under solid-state fermentation and their application in cellulose pulp bleaching.

This study describes the production of xylanases from Aspergillus niveus, A. niger, and A. ochraceus under solid-state fermentation using agro-industrial residues as substrates. Enzyme production was improved using a mixture of wheat bran and yeast extract or peptone. When a mixture of corncob and wheat bran was used, xylanase production from A. niger and A. ochraceus increased by 18%. All cultures were incubated at 30 degrees C at 70-80% relative humidity for 96 h. For biobleaching assays, 10 or 35 U of xylanase/g dry cellulose pulp were incubated at pH 5.5 for 1 or 2 h, at 55 degrees C. The delignification efficiency was 20%, the brightness (percentage of ISO) increased two to three points and the viscosity was maintained confirming the absence of cellulolytic activity. These results indicated that the use of xylanases could help to reduce the amount of chlorine compounds used in cellulose pulp treatment.

Investigation of charge ratio variation in mRNA - DEAE-dextran polyplex delivery systems.

mRNA pharmaceuticals represent a new class of therapeutics, with applications, in cancer vaccination, tumour therapy and protein substitution. Formulations are required to deliver messenger RNA (mRNA) to the target sites where induction of genetic transfection following receptor mediated cell uptake & translation is required. In the current study, the cationic polysaccharide diethylaminoethylen (DEAE) - Dextran was selected as a model system carrier for the investigation of polyplex nanoparticle formation together with mRNA as a function of the molar ratio of the components. The structure of the mRNA/Dextran colloids was investigated as a function of the polymer-to-mRNA ratio and correlated with the biological activity determined by cellular transfection with luciferase coding mRNA. Dynamic light scattering (DLS), small angle x-ray scattering (SAXS), and small angle neutron scattering (SANS) with deuterium contrast variation were used to achieve structural insight into the systems. Similarly to previously investigated lipid based systems, colloidally stable particles with confined size were obtained with either excess of positive or negative charge. Highest activity was obtained with positive charge excess. From the scattering experiments information on the internal organization inside the polymer/mRNA systems was derived. Indication for the presence of structural elements in the length scale of ten to 20 nm were found in the excess of dextran, which could be due to either excess or particulate polymer. Information on the molecular organization of the mRNA nanoparticle products may provide a valuable basis for defining critical quality attributes of drug products for pharmaceutical application.

Factors associated with lack of antiretroviral adherence among adolescents in a reference centre in Rio de Janeiro, Brazil.

The objective of this study was to describe the adherence to antiretroviral therapy (ART) among adolescents followed-up in Rio de Janeiro. This cross-sectional study included all adolescents (aged 10-19 years) followed at Instituto de Puericultura e Pediatria Martagão Gesteira and Hospital Universitário Clementino Fraga Filho. Adherence was determined by self-report (number of missed ART doses in three days prior to the interview). Adherence was categorized as taking > or = 95% of the ARTs (adherent), or < 95% (non-adherent). Variables related to demographics and treatment were evaluated and if P value < or = 0.15, they were selected for a logistic regression analysis. One hundred and one adolescents were interviewed. The mean time on ART was 91 months and the mean adherence was 94% of this, 21 were non-adherent, and 80 adherent. The risk factors associated with non-adherence were: if the patient was not concerned about ART, odds ratio (OR) = 3.47 (95% confidence interval [CI] = 1.13-10.68); if they do not carry an extra dose of ART, OR = 6.63 (95% CI = 1.73-25.47); if a health-care worker taught them how to take ART, OR = 0.27 (95% CI = 0.08-0.93). Adherence among adolescents was higher than expected. Factors associated with lack of adherence were: interviewees being unaware of ARTs and lack of commitment to the treatment. Interventions involving these factors must be evaluated.

Evaluation of the safety and satisfaction of rheumatic patients with accelerated infliximab infusion.

INTRODUCTION: Infliximab infusion generally occurs in 2-4 h. Recent studies have suggested the possibility of accelerated infusion (1 h) of this drug. OBJECTIVE: To evaluate the safety of accelerated infliximab infusion in patients with rheumatic diseases. In addition, patient satisfaction was also assessed. METHODS: A prospective, single-center, non-randomized study with 34 patients with rheumatic diseases was conducted from July to November 2016. Patients with the following were excluded: history of allergic reaction to biologics, asthma or severe atopy. All patients previously received a 2- to 3-h infliximab infusion. The infusion rate was accelerated to 1 h, and premedication was excluded. The infusion was monitored in all patients. RESULTS: A total of 34 patients were included in the study [rheumatoid arthritis (n = 16), ankylosing spondylitis (n = 15), psoriatic arthritis (n = 2) and enteropathic arthropathy (n = 1)], with an average age of 48.7 ± 18.6 years; 55.5% of the patients were female, and 29.4% were white. The duration of disease was 9.5 ± 9.2 years, and the duration of infliximab use was 38.9 ± 27.6 months, with a mean dose per infusion of 414.2 ± 158.1 (range, 200-800) mg. The mean infliximab infusion time prior to the study was 2.2 ± 0.4 h. A total of 6 (17.6%) patients received premedication. The premedication was suspended. There were no adverse effects during or after infusion. Ninety-seven percent of the patients and 100% of the health workers were satisfied with the accelerated infusion. CONCLUSION: Our data support the safe use of accelerated infliximab infusion in rheumatic patients, with high satisfaction among patients and health workers.

A new designed π conjugated molecule for stable single walled carbon nanotube dispersion in aqueous medium.

A molecule with a π conjugated backbone built from aromatic thiophene and dialkoxyphenylene units and substituted imidazolium groups (TPO) is designed to obtain ultra-stable single walled carbon nanotube (SWCNT) dispersion in aqueous medium. The proposed mechanism of non-covalent interaction is accompanied by individualization of SWCNT and comprises of dominant nondisruptive π-π and cation-π interaction between them and the TPO conjugated oligomer. The individualization of SWCNT and dispersibility and stability of the ultra-stable suspensions were estimated using high resolution transmission electron microscopy, UV-Visible-NIR absorption spectroscopy, Raman spectroscopy, photoluminescence and zeta potential measurement. Nuclear magnetic resonance data provides direct evidence toward possible cation-π interaction.