RESUMEN

The genus Bothrops are considered Category 1 of medical importance by the World Health Organization, responsible for approximately 85 % of snakebites occurring throughout Brazil. Main factors determining snake venom variations can be genetics, diet, gender, geographic distribution, age, or even seasonality. In this study, we compared the composition of protein profile, biochemical activities, and immunorecognition of toxins present in the venom of eight adults of Bothrops species (B. alternatus, B. atrox, B. jararaca, B. jararacussu, B. leucurus, B. moojeni, B. neuwiedi and B. pauloensis). The following methods were used to analyze the venoms: protein dosage; electrophoresis in polyacrylamide gel containing SDS; High Performance Liquid Chromatography - Reverse Phase; enzymatic activities, western blotting and Enzyme Linked Immuno Sorbent Assay. The results show inter and intraspecific differences in the electrophoretic profile. LAAO and PLA2 activities, in general, were higher in males than females and proteolytic activity was higher in females than males. The bothropic antivenom produced by Instituto Butantan recognized most of the protein bands in all Bothrops species analyzed, with only the regions between 37 and 25 kDa presenting lower intensity. A notable variability in the chromatograms was observed. Bothrops venom demonstrated inter-intraspecific disparities in protein composition and biochemical activity.

RESUMEN

OBJECTIVE: Periodontal regeneration poses challenges due to the periodontium's complexity, relying on mesenchymal cells from the periodontal ligament (hPDLSCs) to regenerate hard tissues like bone and cementum. While some hPDLSCs have high regeneration potential (HOP-hPDLSCs), most are low potential (LOP-hPDLSCs). This study analyzed hPDLSCs from a single donor to minimize inter-individual variability and focus on key differences in differentiation potentials. DESIGN: This study used RNA-seq, genomic databases, and bioinformatics tools to explore signaling pathways (SPs), biological processes (BPs), and molecular functions (MFs) guiding HOP cells to mineralized matrix production. It also investigated limitations of LOP cells and strategies for enhancing their osteo/cementogenesis. RESULTS: In basal conditions, HOP exhibited a multifunctional gene network with higher expression of genes related to osteo/cementogenesis, cell differentiation, immune modulation, stress response, and hormonal regulation. In contrast, LOP focused on steroid hormone biosynthesis and nucleic acid maintenance. During osteo/cementogenic induction, HOP showed strong modulation of genes related to angiogenesis, cell division, mesenchymal differentiation, and extracellular matrix production. LOP demonstrated neural synaptic-related processes and preserved cellular cytoskeleton integrity. CCKR map signaling and G-protein receptor bindings gained significance during osteo/cementogenesis in HOP-hPDLSCs. Both HOP and LOP shared common BPs related to gastrointestinal and reproductive system development. CONCLUSION: The osteo/cementogenic differentiation of HOP cells may be regulated by CCKR signaling, G-protein bindings, and specific hormonal regulation. LOP cells seem committed to neural mechanisms. This study sheds light on hPDLSCs' complex characteristics, offering a deeper understanding of their differentiation potential for future periodontal regeneration research and therapies.

Asunto(s)

RESUMEN

Exposure to ionizing radiation (IR) is inevitable in various X-ray imaging examinations, with computed tomography (CT) being a major contributor to increased human radiation exposure. Ionizing radiation may cause structural damage to macromolecules, particularly DNA, mostly through an indirect pathway in diagnostic imaging. The indirect pathway primarily involves the generation of reactive oxygen species (ROS) due to water radiolysis induced by IR, leading to DNA damage, including double-strand breaks (DSB), which are highly cytotoxic. Antioxidants, substances that prevent oxidative damage, are proposed as potential radioprotective agents. This Study Protocol article presents the rationale for selecting vitamin C as a preventive measure against CT-associated IR-induced DNA damage, to be investigated in a randomized placebo-controlled trial, with a full in vivo design, using an oral easy-to-use schedule administration in the outpatient setting, for the single CT examination with the highest total global IR dose burden (contrast-enhanced abdomen and pelvis CT). The study also aims to explore the mediating role of oxidative stress, and it has been written in adherence to the Standard Protocol Items recommendations.

RESUMEN

Abstract Introduction: Chronic kidney disease is usually asymptomatic, and its diagnosis depends on laboratory tests, with emphasis on serum creatinine and proteinuria. Objective: To assess knowledge on the role of serum creatinine as a biomarker of kidney function in a sample of the Brazilian population. Method: Cross-sectional observational study conducted in São Paulo (SP, Brazil), in which a random adult population was interviewed. Results: A total of 1138 subjects were interviewed, with a median age of 36 years old (27-52); 55.1% were female. Regarding the "creatinine" biomarker, 40.6% stated they had never performed such a test. When asked about their knowledge on the usefulness of this exam, only 19.6% knew its function. The other responses were "I don't know" (71.6%), evaluating heart function (0.9%) and liver function (7.8%). Of those who reported they had already taken a creatinine test, only 29.4% correctly identified the role of creatinine. When dividing the groups into "knows" and "does not know" the function of creatinine, a statistically significant difference (p < 0.05) was observed regarding level of education, female sex, being a healthcare student/worker, having ever measured creatinine, knowing someone with kidney disease and older age. In the multivariate analysis, the main variable related to knowing the creatinine role was having previously taken the test (OR 5.16; 95% CI 3.16-8.43, p < 0.001). Conclusion: There is a significant lack of knowledge about creatinine and its use in checkups. The results indicate that greater efforts are needed from healthcare professionals to raise awareness on the role of serum creatinine.

Resumo Introdução: A doença renal crônica costuma ser assintomática e seu diagnóstico depende da realização de exames laboratoriais, com destaque para a creatinina sérica e pesquisa de proteinúria. Objetivo: Avaliar em uma amostra da população brasileira o conhecimento sobre o papel da creatinina sérica como marcador de função renal. Método: Estudo observacional transversal realizado na cidade de São Paulo (SP, Brasil), em que foi entrevistada uma população adulta aleatória. Resultados: Foram entrevistados 1138 indivíduos, com idade mediana de 36 anos (27-52); 55,1% do sexo feminino. Com relação ao marcador "creatinina", 40,6% afirmaram que nunca realizaram tal dosagem. Quando questionados quanto ao conhecimento sobre a utilidade desse exame, somente 19,6% sabiam a sua função. As outras respostas foram "não sei" (71,6%), avaliar o funcionamento do coração (0,9%) e fígado (7,8%). Dos que afirmaram já terem realizado o exame de creatinina, somente 29,4% acertaram a função da creatinina. Ao dividir os grupos em "sabe" e "não sabe" a função da creatinina, percebeu-se diferença estatisticamente significante (p < 0,05) em relação ao grau de escolaridade, sexo feminino, ser aluno/trabalhador da saúde, ter dosado creatinina alguma vez, conhecer alguém com doença renal e maior idade. Na análise multivariada, a principal variável relacionada com conhecer a função da creatinina foi ter realizado o exame anteriormente (OR 5,16; IC 95% 3,16-8,43, p < 0,001). Conclusão: Há grande desconhecimento sobre a creatinina e seu uso em check-ups. Os resultados indicam que é necessário maior esforço por parte dos profissionais de saúde para divulgar o papel da creatinina sérica.

RESUMEN

OBJECTIVE: Provide a synthesis of the current literature about the effects of detraining on cognitive functions in older adults. METHODS: The PICOS acronym strategy was performed in PubMed/MEDLINE, Web of Science, Cochrane Library and PsycINFO database. The Preferred Reporting Items for Systematic Review and Meta-Analyses statement had been followed in the present study, in which the search was conducted on October 2023. The study selection consisted in original articles including older adults, detraining after training exercise period, use of tests or scales to measure cognitive function. The Downs and Black checklist had been used to assess the studies quality. Sample characteristics, type of previous training, detraining period, cognitive functions measurements and main results were extracted by 2 investigators. RESULTS: From 1927 studies, 12 studies were included, being 11 studies identified via systematic research, and 1 study by citation search. Older adults, ranged from 60 to 87 years old, were assessed after detraining. The cognitive functions most evaluated were global cognition and executive functions. One study evaluated both cognitive outcome and cerebral blood flow. Most of the studies demonstrated a decline in the cognitive function after detraining. CONCLUSION: Exercise detraining period, ranging from 10 days to 16 weeks, can effect negatively the cognitive function in older adults.

Asunto(s)

RESUMEN

Rattlesnakes belonging to the genus Crotalus are widely distributed throughout the Americas. In Brazil, symptoms commonly associated with envenomation by Crotalus durissus collilineatus include myalgia, rhabdomyolysis, renal failure, neurotoxicity, and progressive paralysis, which are related to the protein composition of this venom. Snake venom composition exhibits compositional variability that may reflect geographic distribution, age, captivity, diet, sex, and even individual genetics. Although seasonality is also considered a possible source of variation, there are few reports of such variability in snake venom. In this work, venoms of the same eight C. durissus collilineatus were extracted every three months for two years, to analyze seasonal changes in composition and activities. To this end, venom composition was analyzed by protein quantification, SDS-PAGE, and HPLC, and the LAAO, PLA2 and coagulant activities were measured. Venoms of these C. d. collilineatus showed minor seasonal differences in venom activities and no composition differences were found. LAAO and coagulant activities displayed a pattern of seasonal change, while PLA2 activity seemed to have no seasonality tendency. Also, there are sexual differences, in which males seem to be more stable than females in regard to some activities. Individual variability occurs even in seasonal variation of activities, highlighting the importance of controlling circumstances of venom extraction before comparing results between groups of snakes.

Asunto(s)

RESUMEN

OBJECTIVE: To overview the literature to answer the following question: "What is the performance of different therapies on wound healing and postoperative discomfort after palatal ASTG removal?" METHODS: SRs that evaluated the wound healing (WH), postoperative pain, bleeding, and analgesic consumption of patients submitted to de-epithelialized/free gingival grafts (FGG) or subepithelial connective tissue grafts (SCTG) removed from the palate were included. The searches were conducted on six white and two gray databases up to December 2023. Methodological quality was evaluated through AMSTAR 2. The synthesis of results was described as a narrative analysis. RESULTS: Ten SRs (involving 25 randomized clinical trials) related to low-level laser therapy (LLLT) (3), platelet-rich fibrin (PRF) (4), cyanoacrylate tissue adhesives (CTA) (2), and ozone therapy (OT) (1) were included in this overview. All techniques demonstrated improvements in WH. LLT, PRF, and CTA reduced pain and analgesic consumption. PRF and CTA reduced bleeding. Regarding methodological quality, the SRs were classified as critically low (2), low (5), moderate (2), or high quality (1). CONCLUSIONS: In SRs related to LLLT, PRF, CTA, and OT, the use of different therapies after palatal ASTG removal improved WH and postoperative discomfort. Due to the studies' low methodological quality and high heterogeneity, data should be interpreted with caution. CLINICAL RELEVANCE: The present overview compiles the evidence of SRs related to different therapies for WH and patients' postoperative experience and reveals that different treatments can significantly improve the clinical outcomes of patients who require ASTG removal for periodontal or peri-implant surgeries. REGISTRATION: PROSPERO registration number: CRD42022301257.

Asunto(s)

RESUMEN

Background: Combining osteotomies and soft tissue procedures is believed to reduce sesamoids in their anatomical position and maintain long-term correction when treating hallux valgus deformity. This study determines if a radiologic association exists between a radiolucent sign and a full percutaneous adductor tendon release (PATR), including a cadaveric study and a consecutive case series. Another aim was to determine the intra- and interobserver reliability of these observations. Methods: A prospective observational study was made between 2018 and 2019. First, a PATR was done on cadaveric specimens and, after the procedures, dissected to correlate what was seen fluoroscopically. The clinical group included 39 feet that presented mild-to-moderate HV deformity and were treated with percutaneous osteotomies associated with PATR. Results: Observers 1 and 2 saw a radioscopic radiolucent sign in 100% of cadavers and the patient population. They also observed a triangle-shaped image with an incidence of 75%, which we have named the "triangle sign." Conclusion: The triangle sign may be helpful in the intraoperative confirmation of PATR and latero-plantar capsule release using this percutaneous technique. Level of Evidence: Level II, development of diagnostic criteria.

RESUMEN

In Brazil, the genus Bothrops is responsible for most ophidian accidents. Snake venoms have a wide variety of proteins and peptides exhibiting a broad repertoire of pharmacological and toxic effects that elicit systemic injury and characteristic local effects. The snakes' natural resistance to envenomation caused by the presence of inhibitory compounds on their plasma have been extensively studied. However, the presence of these inhibitors in different developmental stages is yet to be further discussed. The aim of this study was to evaluate the ontogeny of Bothrops jararaca plasma inhibitor composition and, to this end, plasma samples of B. jararaca were obtained from different developmental stages (neonates, youngs, and adults) and sexes (female and male). SDS-PAGE, Western blotting, affinity chromatography, and mass spectrometry were performed to analyze the protein profile and interaction between B. jararaca plasma and venom proteins. In addition, the presence of γBjPLI, a PLA2 inhibitor previously identified and characterized in B. jararaca serum, was confirmed by Western blotting. According to our results, 9-17% of plasma proteins were capable of binding to venom proteins in the three developmental stages. The presence of different endogenous inhibitors and, more specifically, different PLA2 inhibitor (PLI) classes and antihemorrhagic factors were confirmed in specimens of B. jararaca from newborn by mass spectrometry. For the first time, the αPLI and ßPLI were detected in B. jararaca plasma, although low or no ontogenetic and sexual correlation were found. The γPLI were more abundant in adult female, than in neonate and young female, but similar to neonate, young and adult male according to the results of mass spectrometry analysis. Our results suggest that there are proteins in the plasma of these animals that can help counteract the effects of self-envenomation from birth.

Asunto(s)

RESUMEN

INTRODUCTION: Chronic kidney disease is usually asymptomatic, and its diagnosis depends on laboratory tests, with emphasis on serum creatinine and proteinuria. OBJECTIVE: To assess knowledge on the role of serum creatinine as a biomarker of kidney function in a sample of the Brazilian population. METHOD: Cross-sectional observational study conducted in São Paulo (SP, Brazil), in which a random adult population was interviewed. RESULTS: A total of 1138 subjects were interviewed, with a median age of 36 years old (27-52); 55.1% were female. Regarding the "creatinine" biomarker, 40.6% stated they had never performed such a test. When asked about their knowledge on the usefulness of this exam, only 19.6% knew its function. The other responses were "I don't know" (71.6%), evaluating heart function (0.9%) and liver function (7.8%). Of those who reported they had already taken a creatinine test, only 29.4% correctly identified the role of creatinine. When dividing the groups into "knows" and "does not know" the function of creatinine, a statistically significant difference (p < 0.05) was observed regarding level of education, female sex, being a healthcare student/worker, having ever measured creatinine, knowing someone with kidney disease and older age. In the multivariate analysis, the main variable related to knowing the creatinine role was having previously taken the test (OR 5.16; 95% CI 3.16-8.43, p < 0.001). CONCLUSION: There is a significant lack of knowledge about creatinine and its use in checkups. The results indicate that greater efforts are needed from healthcare professionals to raise awareness on the role of serum creatinine.

Asunto(s)

RESUMEN

Os métodos contraceptivos desempenham um papel vital na saúde sexual e reprodutiva, oferecendo opções que permitem o planejamento familiar e a prevenção de gravidezes indesejadas. Este artigo busca descrever os benefícios e desvantagens dos principais anticoncepcionais presentes na atualidade por meio de uma revisão integrativa da literatura, que buscou identificar os achados científicos publicados nos últimos 10 anos (2013 a fevereiro de 2023). A seleção de artigos foi feita nas bases eletrônicas de dados da PubMed, BVS, SciELO e no Google Acadêmico. Para a realização da revisão integrativa foi estabelecida a pergunta norteadora, para possibilitar a busca na base dados: Quais os benefícios e as desvantagens dos anticoncepcionais adesivo combinado, anel vaginal, sistema intrauterino de liberação de Levonorgestrel (SIU-LNG), contracepção de emergência (pílula de emergência), implante hormonal e anticoncepcional oral (ACO). Um dos pontos mais notáveis nesta revisão foi a grande variedade de métodos contraceptivos e suas peculiaridades, que se adequam à necessidade da usuária, sendo, portanto, preciso uma análise cuidadosa do método a ser escolhido. Outro ponto de destaque, foi que apesar dos benefícios dos contraceptivos, também estão presentes os efeitos adversos e possíveis complicações, além das precauções em sua utilização.

Contraceptive methods play a vital role in sexual and reproductive health, offering options that allow for family planning and the prevention of unwanted pregnancies. This article seeks to describe the benefits and disadvantages of the main contraceptives currently available through an integrative literature review, which sought to identify scientific findings published in the last 10 years (2013 to February 2023). The selection of articles was made in the electronic databases of PubMed, VHL, SciELO and Google Scholar. To carry out the integrative review, the guiding question was established, to enable the search in the database: What are the benefits and disadvantages of contraceptives combined patch, vaginal ring, Levonorgestrel-releasing intrauterine system (LNG-IUS), emergency contraception (emergency pill), hormonal implant and oral contraceptive (OC). One of the most notable points in this review was the wide variety of contraceptive methods and their peculiarities, which adapt to the user's needs, therefore requiring a careful analysis of the method to be chosen. Another highlight was that despite the benefits of contraceptives, adverse effects and possible complications are also present, in addition to precautions in their use.

Los métodos anticonceptivos desempeñan un papel vital en la salud sexual y reproductiva, ofreciendo opciones que permiten la planificación familiar y la prevención de embarazos no deseados. Este artículo busca describir los beneficios y desventajas de los principales anticonceptivos actualmente disponibles a través de una revisión integrativa de la literatura, que buscó identificar hallazgos científicos publicados en los últimos 10 años (2013 a febrero de 2023). La selección de artículos se realizó en las bases de datos electrónicas PubMed, BVS, SciELO y Google Scholar. Para realizar la revisión integradora se estableció la pregunta orientadora, para posibilitar la búsqueda en la base de datos: Cuáles son los beneficios y desventajas de los anticonceptivos combinados parche, anillo vaginal, sistema intrauterino liberador de levonorgestrel (SIU-LNG), anticoncepción de emergencia (emergencia píldora), implante hormonal y anticonceptivo oral (AO). Uno de los puntos más destacables de esta revisión fue la gran variedade de métodos anticonceptivos y sus peculiaridades, que se adaptan a las necesidades del usuario, requiriendo por tanto un análisis cuidadoso del método a elegir. Otro destaque fue que a pesar de los beneficios de los anticonceptivos, también están presentes efectos adversos y posibles complicaciones, además de precauciones en su uso.

Asunto(s)

RESUMEN

ABSTRACT Introduction: During basketball, players' movements represent a reaction to an unpredictable single or complex external stimulus (nonplanned agility). Objective: The present study aimed to compare the test of nonplanned agility to the planned agility test and to increase the knowledge of perception, decision-making, anticipation, and motor abilities of female basketball players. Methods: Thirty-six female basketball players (age: 18.81 ± 2.58 years) performed The Reaction Time and Defensive Sliding Test (RTADST) on the first day and the T-test the following day. Results: there were no statistically significant correlations between the RTADST and T-test at the whole sample level or between perimeter and post players. The T-test and Fat % correlation is significant at the 0.05 level, while the other analyzed correlations were insignificant. Perimeter players achieved better results on the RTADST test. There were no significant differences between perimeter and post players on the T-test. Conclusion: The RTADST and T-test are testing different abilities. We recommend the use of the RTADST to coaches and conditioning experts. Level of Evidence II; Diagnostic Study Investigating a Diagnostic Test.

RESUMEN Introducción: Durante el partido de baloncesto, los movimientos de los jugadores de baloncesto representan la reacción a un estímulo externo único o complejo impredecible (agilidad no planificada). Objetivo: El presente estudio tuvo como objetivo comparar la prueba de agilidad no planificada con la prueba de agilidad planificada y aumentar el conocimiento sobre la percepción, la toma de decisiones, la anticipación y las habilidades motoras de las jugadoras de baloncesto. Métodos: Las treinta y seis jugadoras de baloncesto (de la edad: 18.81 ± 2.58 años) realizaron la Prueba de tiempo de reacción y deslizamiento defensivo (RTADST) el primer día y el siguiente día la prueba T. Resultados obtenidos: no hubo correlaciones estadísticamente significativas entre el RTADST y la prueba T, a nivel de toda la muestra ni entre jugadoras del perímetro y del poste. La correlación entre la prueba T y el % de Grasa es significativa al nivel de 0,05, mientras que el resto de las correlaciones analizadas no resultaron significativas. Las jugadoras del perímetro lograron mejores resultados en la prueba RTADST. No hubo diferencias significativas entre las jugadoras del perímetro y las del poste en la prueba T. Conclusión: El RTADST y la prueba T están probando habilidades diferentes. Recomendamos el uso del RTADST a entrenadores y expertos en acondicionamiento. Nivel de Evidencia II; Estudio de Diagnóstico que Investiga una Prueba Diagnóstica.

RESUMO Introdução: Durante o basquete, os movimentos dos jogadores representam uma reação a um estímulo externo imprevisível, simples ou complexo (agilidade não planejada). Objetivo: O presente estudo teve como objetivo comparar o teste de agilidade não planejada com o teste de agilidade planejada no intuito de aumentar o conhecimento sobre percepção, tomada de decisão, antecipação e habilidades motoras em jogadoras de basquete. Métodos: Trinta e seis jogadoras de basquete (idade: 18,81 ± 2,58 anos) realizaram o Teste de Tempo de Reação e Deslizamento Defensivo (RTADST) no primeiro dia e o Teste T no dia seguinte. Resultados: não houve correlações estatisticamente significativas entre o RTADST e o teste T em toda a amostra ou entre jogadores de perímetro e de poste. A correlação entre o teste T e o percentual de gordura é significativa no nível de 0,05, enquanto as outras correlações analisadas foram insignificantes. Os jogadores de perímetro obtiveram melhores resultados no teste RTADST. Não houve diferenças significativas entre os jogadores de perímetro e de poste no teste T. Conclusões: O RTADST e o teste T estão testando habilidades diferentes. Recomendamos o uso do RTADST para treinadores e especialistas em condicionamento físico. Nível de Evidência II; Estudo de Diagnóstico que Investiga um Teste de Diagnóstico.

RESUMEN

The genus Bothrops are considered Category 1 of medical importance by the World Health Organization, responsible for approximately 85 % of snakebites occurring throughout Brazil. Main factors determining snake venom variations can be genetics, diet, gender, geographic distribution, age, or even seasonality. In this study, we compared the composition of protein profile, biochemical activities, and immunorecognition of toxins present in the venom of eight adults of Bothrops species (B. alternatus, B. atrox, B. jararaca, B. jararacussu, B. leucurus, B. moojeni, B. neuwiedi and B. pauloensis). The following methods were used to analyze the venoms: protein dosage; electrophoresis in polyacrylamide gel containing SDS; High Performance Liquid Chromatography – Reverse Phase; enzymatic activities, western blotting and Enzyme Linked Immuno Sorbent Assay. The results show inter and intraspecific differences in the electrophoretic profile. LAAO and PLA2 activities, in general, were higher in males than females and proteolytic activity was higher in females than males. The bothropic antivenom produced by Instituto Butantan recognized most of the protein bands in all Bothrops species analyzed, with only the regions between 37 and 25 kDa presenting lower intensity. A notable variability in the chromatograms was observed. Bothrops venom demonstrated inter-intraspecific disparities in protein composition and biochemical activity.

RESUMEN

Rattlesnakes belonging to the genus Crotalus are widely distributed throughout the Americas. In Brazil, symptoms commonly associated with envenomation by Crotalus durissus collilineatus include myalgia, rhabdomyolysis, renal failure, neurotoxicity, and progressive paralysis, which are related to the protein composition of this venom. Snake venom composition exhibits compositional variability that may reflect geographic distribution, age, captivity, diet, sex, and even individual genetics. Although seasonality is also considered a possible source of variation, there are few reports of such variability in snake venom. In this work, venoms of the same eight C. durissus collilineatus were extracted every three months for two years, to analyze seasonal changes in composition and activities. To this end, venom composition was analyzed by protein quantification, SDS-PAGE, and HPLC, and the LAAO, PLA2 and coagulant activities were measured. Venoms of these C. d. collilineatus showed minor seasonal differences in venom activities and no composition differences were found. LAAO and coagulant activities displayed a pattern of seasonal change, while PLA2 activity seemed to have no seasonality tendency. Also, there are sexual differences, in which males seem to be more stable than females in regard to some activities. Individual variability occurs even in seasonal variation of activities, highlighting the importance of controlling circumstances of venom extraction before comparing results between groups of snakes.

RESUMEN

MAIN RESULTS: It could be seen good performance of the software for the automatic selection of the underlying cause of death, increasing from 69.6% in 2016 to 78.8% in 2019. There was a correlation between this result and the use of online death certificates by physicians. IMPLICATIONS FOR SERVICES: Automatic coding and selection of causes of death improve productivity and timeliness of information, contributing to the quality of the country's information system. PERSPECTIVES: It is necessary to analyze the agreement between the medical terms in the software dictionaries used in South American countries in order to improve standardization and comparability of information on causes of death. OBJECTIVE: to describe software performance in the automatic selection of the underlying cause of death in Peru, between 2016 and 2019. METHODS: this was a descriptive study on the software performance in the automated selection of the underlying cause of death over the years (chi-square test for trend) and the correlation between the type of death certificate and software performance (correlation coefficient and coefficient of determination). RESULTS: a total of 446,217 death certificates were analyzed; the proportion of death certificates with the underlying cause of death increased from 69.6% in 2016 to 78.8% in 2019 (p-value < 0.001); it could be seen a direct linear correlation between electronic death certificates and software performance (correlation coefficient = 0.95; R2 = 0.89). CONCLUSION: the software showed good performance in the automatic selection of the underlying cause of death, with a significant increase between 2016 and 2019.

Asunto(s)

RESUMEN

PURPOSE: Knowledge of the complex anatomy of the lateral ankle ligaments is essential to understand its function, pathophysiology and treatment options. This study aimed to assess the lateral ligaments and their relationships through a 3D view achieved by digitally marking their footprints. METHODS: Eleven fresh-frozen ankle specimens were dissected. The calcaneus, talus and fibula were separated, maintaining the lateral ligament footprints. Subsequently, each bone was assessed by a light scanner machine. Finally, all the scans were converted to 3D polygonal models. The footprint areas of the talus, calcaneus and fibula were selected, analysed and the surface area was quantified in cm2. RESULTS: After scanning the bones, the anterior talofibular ligament inferior fascicle (ATFLif), calcaneofibular ligament (CFL) and posterior talofibular ligament (PTFL) footprints were continuous at the medial side of the fibula, corresponding to a continuous footprint with a mean area of 4.8 cm2 (± 0.7). The anterior talofibular ligament (ATFL) footprint on the talus consisted of 2 parts in 9 of the 11 feet, whilst there was a continuous insertion in the other 2 feet. The CFL insertion on the calcaneus was one single footprint in all cases. CONCLUSION: The tridimensional analysis of the lateral ligaments of the ankle demonstrates that the ATFLif, CFL and PTFL have a continuous footprint at the medial side of the fibula in all analysed specimens. These data can assist the surgeon in interpreting the ligament injuries, improving the imaging assessment and guiding the surgeon to repair and reconstruct the ligaments in an anatomical position.

RESUMEN

Copaíba oil-resin is extracted from the trunk of the Copaíba tree and has medicinal, cosmetic, and industrial properties. As a result, widespread knowledge about the use of Copaíba oil-resin has evolved, attracting the scientific community's attention. This paper aims to map the global knowledge production regarding the biological activities of Copaíba (Copaifera spp.). Bibliometric methodological instruments were used to conduct a search of the Web of Science-Core Collection database. The search resulted in 822 references. After screening titles and abstracts, 581 references did not meet the eligibility criteria, leaving 246 references for full-text examination. Subsequently, 15 studies were excluded, resulting in a final set of 232 records for the bibliometric analysis. In vitro was the most published study type, mainly from Brazil, from 2010 to 2020. Regarding the authors, Bastos, JK, and Ambrosio, SR were the ones with the most significant number of papers included. The most frequent keywords were Copaíba oil, Copaíba, and Copaifera. Our findings revealed global study trends about Copaíba, mainly related to its various effects and use over time. In general, all countries have conducted more research on antimicrobial and anti-inflammatory activities, also exposing its antioxidant and healing properties. Copaifera reticulata was the most investigated, followed by Copaifera langsdorffi and Copaifera multijuga in both in vitro and in vivo studies. Therefore, there is a need for human reports, given the promising results that Copaíba oils have been demonstrating.

RESUMEN

Current algorithms for diagnosing Lynch syndrome (LS) include multistep molecular tumor tests to distinguish LS-associated from sporadic colorectal cancer (CRC), which add cost and complexity to the evaluation. We hypothesized that PREMM5, a clinical LS prediction tool, could be an alternative approach to screen for LS, thereby lessening the need for specialized molecular diagnostics. We reviewed a consecutively ascertained institutional cohort of 1058 CRC patients on whom pathologic and clinical data were available, including prior LS germline testing. Data from MMR-D/MSI-H CRC patients were reviewed and PREMM5 scores were calculated for each individual. Using a PREMM5 score cutoff ≥ 2.5% to characterize the need for germline testing, we determined the rate of pathogenic/likely pathogenic germline variants (PGVs) in LS genes in patients with PREMM5 scores ≥ 2.5% versus < 2.5%. Sensitivity and negative predictive values (NPV) of PREMM5 were calculated for all MMR-D/MSI-H CRC patients, and those with MLH1-deficient CRC. MMR IHC and/or MSI results were available on 572/1058 cases. We identified 74/572 (12.9%) cases as MMR-D/MSI-H, of which 28/74 (37.8%) harbored a LS PGV. 11/49 (22.4%) patients with MLH1-deficient CRC harbored a LS PGV. PREMM5 had 100% sensitivity (95% CI: 87.7-100 for any MMR-D/MSI-H; 95% CI: 71.5-100 for MLH1-deficient CRC) and 100% NPV (95% CI: 83.2-100 for any MMR-D/MSI-H; 95% CI: 82.4-100 for MLH1-deficient CRC) for identifying LS PGVs in these cohorts. PREMM5 accurately distinguishes LS- from non-LS-associated MMR-D/MSI-H CRC without additional somatic molecular testing. These findings are particularly relevant for limited-resource settings where advanced molecular diagnostics may be unavailable.

Asunto(s)

RESUMEN

Introduction: Right ventricular remodeling with subsequent functional impairment can occur in some clinical conditions in adults and children. The triggering factors, molecular mechanisms, and, especially, the evolution over time are still not well known. Left ventricular (LV) changes associated with right ventricular (RV) remodeling are also poorly understood. Objectives: The study aimed to evaluate RV morphological, functional, and gene expression parameters in rats submitted to pulmonary artery banding compared to control rats, with the temporal evolution of these parameters, and to analyze the influence of RV remodeling by pulmonary artery banding in rats and their controls over time on LV geometry, histology, gene expression, and functional performance. Methods: Healthy 6-week-old male Wistar-EPM rats weighing 170-200 g were included. One day after the echocardiogram, depending on the animals undergoing the pulmonary artery banding (PAB) procedure or not (control group), they were then randomly divided into subgroups according to the follow-up time: 72 h, or 2, 4, 6, or 8 weeks. In each subgroup, the following were conducted: a new echocardiogram, a hemodynamic study, the collection of material for morphological analysis (hypertrophy and fibrosis), and molecular biology (gene expression). The results were presented as the mean ± standard deviation of the mean. A two-way ANOVA and Tukey post-test compared the variables of the subgroups and evolution follow-up times. The adopted significance level was 5%. Results: There was no significant difference among the subgroups in the percentage of water in both the lungs and the liver (the percentage of water in the lungs ranged from 76% to 78% and that of the liver ranged from 67% to 71%). The weight of the right chambers was significantly higher in PAB animals in all subgroups (RV PAB weighed from 0.34 to 0.48 g, and control subjects, from 0.17 to 0.20 g; right atrium (RA) with PAB from 0.09 to 0.14 g; and control subjects from 0.02 to 0.03 g). In the RV of PAB animals, there was a significant increase in myocyte nuclear volume (97 µm3-183.6 µm3) compared to control subjects (34.2 µm3-57.2 µm3), which was more intense in subgroups with shorter PAB follow-up time, and the fibrosis percentage (5.9%-10.4% vs. 0.96%-1.18%) was higher as the PAB follow-up time was longer. In the echocardiography result, there was a significant increase in myocardial thickness in all PAB groups (0.09-0.11 cm compared to control subjects-0.04-0.05 cm), but there was no variation in RV diastolic diameter. From 2 to 8 weeks of PAB, the S-wave (S') (0.031 cm/s and 0.040 cm/s), and fractional area change (FAC) (51%-56%), RV systolic function parameters were significantly lower than those of the respective control subjects (0.040 cm/s to 0.050 cm/s and 61%-67%). Furthermore, higher expression of genes related to hypertrophy and extracellular matrix in the initial subgroups and apoptosis genes in the longer follow-up PAB subgroups were observed in RV. On the other hand, LV weight was not different between animals with and without PAB. The nuclear volume of the PAB animals was greater than that of the control subjects (74 µm3-136 µm3; 40.8 µm3-46.9 µm3), and the percentage of fibrosis was significantly higher in the 4- and 8-week PAB groups (1.2% and 2.2%) compared to the control subjects (0.4% and 0.7%). Echocardiography showed that the diastolic diameter and LV myocardial thickness were not different between PAB animals and control subjects. Measurements of isovolumetric relaxation time and E-wave deceleration time at the echocardiography were different between PAB animals and control subjects in all subgroups, but there were no changes in diastolic function in the hemodynamic study. There was also increased expression of genes related to various functions, particularly hypertrophy. Conclusion: 1) Rats submitted to pulmonary artery banding presented RV remodeling compatible with hypertrophy. Such alterations were mediated by increased gene expression and functional alterations, which coincide with the onset of fibrosis. 2) Structural changes of the RV, such as weight, myocardial thickness, myocyte nuclear volume, and degree of fibrosis, were modified according to the time of exposure to pulmonary artery banding and related to variations in gene expression, highlighting the change from an alpha to a beta pattern from early to late follow-up times. 3) The study suggests that the left ventricle developed histological alterations accompanied by gene expression modifications simultaneously with the alterations found in the right ventricle.

RESUMEN

We report a fatal subdural empyema caused by Campylobacter rectus in a 66-year-old female who developed acute onset of confusion, dysarthria, and paresis in her left extremities. A CT scan showed hypodensity in a crescentic formation with a mild mid-line shift. She had a bruise on her forehead caused by a fall several days before admission, which initially raised subdural hematoma (SDH) diagnosis, and a burr hole procedure was planned. However, her condition deteriorated on the admission night, and she died before dawn. An autopsy revealed that she had subdural empyema (SDE) caused by Campylobacter rectus and Slackia exigua. Both microorganisms are oral microorganisms that rarely cause extra-oral infection. In our case, head trauma caused a skull bone fracture, and sinus infection might have expanded to the subdural space causing SDE. CT/MRI findings were not typical for either SDH or SDE. Early recognition of subdural empyema and prompt initiation of treatment with antibiotics and surgical drainage is essential for cases of SDE. We present our case and a review of four reported cases.