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We propose a theoretical model to investigate the thermodynamics of single and coupled two-state ion channels, associated with mechanoelectrical transduction (MET) and hair cell biophysics. The modeling was based on the Tsallis nonextensive statistical mechanics. The choice for a nonextensive framework in modeling ion channels is encouraged on the fact that we take into account the presence of interactions or long-range correlations in the dynamics of single and coupled ion channels. However, the basic assumptions that support Boltzmann-Gibbs statistics, traditionally used to model ion channel dynamics, state that the system is formed by independent or weakly interacting elements. Despite being well studied in many biological systems, the literature has not yet addressed the study of both entropy and mutual information related to isolated or physically interacting pairs of MET channels. Inspired by hair cell biophysics, we show how the presence of nonextensivity, or subadditivity and superadditivity modulates the nonextensive entropy and mutual information as functions of stereocilia displacements. We also observe that the magnitude of the interaction between the two channels, given by a nonextensive parameter, influences the amplitude of the nonextensive joint entropy and mutual information as functions of the hair cell displacements. Finally, we show how nonextensivity regulates the current versus displacement curve for a single and a pair of interacting two-state channels. The present findings shed light on the thermodynamic process involved in the molecular mechanisms of the auditory system.

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1. Sausages were used to assess the effects of chicken meat replacement by spent laying hen meat on the quality parameters and sensorial properties. 2. Five formulations were developed: control (CON) containing 100% chicken meat and 4 levels of chicken meat replacement with spent laying hen meat: 25% (T25), 50% (T50), 75% (T75) and 100% (T100). 3. Appearance, texture, succulence, flavour and overall consumer acceptance were analysed. Parameters such as moisture, ash, fat and protein content, pH, cooking loss and colour parameters (lightness (L*), redness (a*), yellowness (b*)) were analysed, as well as the texture properties (hardness, elasticity, cohesiveness and chewiness). 4. Statistical analysis did not reveal significant (P > 0.05) differences in chemical composition and colour parameters among formulations. On the other hand, CON treatment showed the lowest (P < 0.05) cooking loss (20.45%) that increased as spent laying hen meat increased in the formulation (24.92% vs. 27.65% vs. 28.12% vs. 33.05%, for T25, T50, T75 and T100 batches, respectively). 5. Regarding textural parameters, T75 and T100 formulations presented higher (P < 0.05) hardness and chewiness compared to the other ones. 6. Concerning to sensorial characteristics, the T100 formulation presented the lowest average scores (P < 0.05) for all attributes studied. However, the other batches (T25, T50 and T75) did not show significant differences for appearance, texture, succulence, flavour and overall acceptability attributes compared with the CON formulation. 7. The results indicated that the substitution of up to 75% of chicken meat by spent laying hen meat did not decrease the sensory acceptance of the sausages by consumers, demonstrating that this level of substitution in sausages allows better use of spent laying hen meat.

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Endothelial dysfunction is a surrogate marker of cardiovascular risk. Resveratrol is known to improve endothelial function in animals, however, clinical trials are limited. We hypothesized that the acute trans-resveratrol supplementation improves endothelial function in treated hypertensive patients with endothelial dysfunction. Twenty-four hypertensive patients between 45 and 65 years-old with baseline endothelial dysfunction were enrolled in a randomized, cross-over, double-blind, placebo-controlled trial. Individuals received either a single dose of trans-resveratrol (300 mg) or placebo and were crossed-over after a one-week washout period. Blood pressure (BP) measurements, aortic systolic blood pressure (SBP) and brachial flow-mediated dilation (FMD) were performed before and 1.5 hours after the intervention. FMD was significantly increased in women (4.2 ± 0.5 vs 7.1 ± 1.3%, p = 0.026) but not in men (4.4 ± 0.9 vs 4.9 ± 0.8%, p = 0.588) in the trans-resveratrol group. There was no statistical difference between baseline and final values of brachial BP and also no changes in aortic SBP. Patients with higher low-density lipoprotein (LDL) cholesterol had better FMD response to trans-resveratrol than patients with lower LDL cholesterol (7.4 ± 1.2 vs 4.3 ± 1.0%, p = 0.004). Our study demonstrated that the acute supplementation of trans-resveratrol promoted an improvement in endothelial function, especially in women and those with higher LDL-cholesterol, despite no changes in BP. List of Abbreviation: Aix: augmentation index; AP: augmentation pressure; BP: blood pressure; BMI: body Mass Index; CVD: cardiovascular disease; FMD: flow-mediated dilation; FRS: Framingham Risk Score; HDL: high-density lipoprotein; LDL: low-density lipoprotein; NO: nitric oxide; SPSS: Statistical Package for Social Sciences; ROS: reactive oxygen species; SBP: systolic blood pressure; TG: triglycerides.

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OBJECTIVE: This trial's objective was to investigate the effect of an exercise program with and without cognitive-behavioral therapy (CBT), compared by a control group, on weight, functional capacity, and cardiometabolic profile of morbidly obese individuals while waiting for bariatric surgery. MATERIALS AND METHODS: This randomized controlled trial investigated the effect of a 4-month low-intensity exercise program (two weekly sessions of 25 min each) on 66 morbidly obese individuals awaiting bariatric surgery. Participants were randomly divided into three groups: EXER, exercise program; EXER + CBT, exercise program plus support group sessions for lifestyle modification, with a CBT; and CONTROL, routine treatment. They were compared on weight, functional capacity, and cardiometabolic profile. RESULTS: The weight change (Kg) was -7.4 (-9.6 to 5,1); -4,2 (-6,8 to -1.6) and 2.9 (0.4 to 5.3) and the BMI change (kg/m2) was -2.7 (-3.6 to -1.8); -1.4 (-2.4 to -0.4) and 1.1 (0.1 to 2.1) for groups EXER, EXER + CBT, and CONTROL, respectively. Changes were significant when compared to the control group (p < 0.001), but there were no differences between the two intervention arms (p = 0.2). Functional capacity and cardiometabolic parameters significantly improved in the intervention arms and worsened in the control group. The adherence to the exercise program in both groups was above 78 %. CONCLUSION: A 4-month, twice-weekly supervised program of low-intensity physical activity that encourages individuals to adopt a more active lifestyle can positively interfere with weight loss and improvement in functional capacity and cardiometabolic parameters of morbidly obese individuals with and without the aid of support group sessions.

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OBJECTIVE: To determine characteristics, clinical significance, frequency, and mimics of restless legs syndrome (RLS) in a cohort of Wilson's disease (WD, n = 42/f = 18), compared to healthy, matched controls. MATERIALS AND METHODS: Structured clinical interviews (patients and caregiving family members), repeated neurological examinations (afternoon and presleep), comprehensive laboratory tests, WD-, RLS-, and sleep-specific rating scales, and video-polysomnography. RESULTS: Thirteen patients with WD (13/42 = 31.0%) clearly fulfilled the five diagnostic criteria of RLS; in eight patients (19.1%), the burden of RLS was clinically significant. The RLS was of moderate severity, equally distributed among sexes, manifested mainly in the evening and before falling asleep, and had developed mostly after clinical manifestation of WD (time elapsed 10.2 ± 14.5 years), still at a young mean age (27.5 ± 11.5 years). The known RLS-associated features were absent (normal iron and kidney parameters) or rare (positive family history, polyneuropathy). Compared to WD patients without RLS, patients with RLS were significantly elder and had suffered longer from WD. WD-specific RLS mimics as well as RLS confounding motor comorbidities (dystonia, tremor, chorea) were frequent and a diagnostic challenge; in difficult cases, the differentiation was reached by clinical observation of the motor behavior in the evening or at nighttime. CONCLUSION: RLS was frequent in this cohort of WD and might be causally related to WD. RLS should be included in the diagnostic work-up of WD. In complex motor disorders, differential diagnosis of RLS might require evening/nighttime examination and video-polysomnography. In WD patients with a clinically significant RLS, treatment with dopaminergic substances may be considered.

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The effect of natural antioxidants on physicochemical properties, lipid and protein oxidation, volatile compounds and free fatty acids (FFA) were determined in Spanish salchichón enriched with n-3 fatty acids encapsulated and stabilized in konjac matrix. Phenolic compounds of beer residue extract (BRE), chestnut leaves extract (CLE) and peanut skin extract (PSE) were also identified and quantified. Five batches of salchichón were prepared: control (CON, without antioxidants), butylated hydroxytoluene (BHT), BRE, CLE and PSE. The main phenolic compounds were catechin and benzoic acid for BRE, gallic acid and catechin for CLE and catechin and protocatechuic acid for PSE. Statistical analysis did not show significant differences on chemical composition among treatments. Reductions in luminosity (P<0.05) and pH (P<0.001) were observed with the CLE batch, whereas the other colour parameters were not affected by the addition of natural antioxidants. Finally, the inclusion of antioxidants (P<0.001) decreased the hexanal content, whereas the FFA content increased by the addition of natural extracts.

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BACKGROUND: Gastroesophageal reflux disease (GERD) is defined by the intensity and/or quality of the reflux of gastric or duodenal contents into the esophagus. Surgical treatment of GERD has shown conflicting results and unacceptable recurrence rates, mainly due to herniation of the antireflux valve into the chest. A variety of techniques has been proposed to reduce GERD recurrence, including routine use of prosthesis in cruroplasty. The prevalence of GERD in patients with hiatal hernia (HH) can reach 94 %. It is possible that the phrenoesophageal ligament (POL) engaged in the stabilization of the gastroesophageal junction in the abdomen may be an etiological factor of HH. We conducted a study to evaluate collagen in the constitution of the POL in patients with HH and cadavers without HH. METHODS: POL samples were collected from 29 patients with HH and GERD (cases) and 32 samples from cadavers without HH (controls). Total collagen was quantified through the Picrosirius red histochemical technique, and type-I and type-III collagens were quantified immunohistochemically using a monoclonal antibody. The stained slides were photographed, and images were quantified by computer software (Image Pro Plus) to count the pixels per field. RESULTS: The mean age was 49.5 (±11.5) years for the cases and 38.5 (±13) years for the controls (p < 0.01). Seventeen cases (58.6 %) and six controls (18.75 %) were female (p < 0.01). The quantity of total (p < 0.01), type-I (p < 0.01), and type-III (p < 0.05) collagens was significantly lower by about 60 % in patients with HH compared with controls. CONCLUSION: Our data indicate that the composition of POL for patients with GERD and HH includes less total, type-I, and type-III collagens than that of the POL of cadavers without HH. The quality of the POL may be an etiological factor in the development of HH.

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Recently, we demonstrated the existence of nonextensive behavior in neuromuscular transmission (da Silva et al. in Phys Rev E 84:041925, 2011). In this letter, we first obtain a maximum-likelihood q-estimator to calculate the scale factor ([Formula: see text]) and the q-index of q-Gaussian distributions. Next, we use the indexes to analyze spontaneous miniature end plate potentials in electrophysiological recordings from neuromuscular junctions. These calculations were performed assuming both normal and high extracellular potassium concentrations [Formula: see text]. This protocol was used to test the validity of Tsallis statistics under electrophysiological conditions closely resembling physiological stimuli. The analysis shows that q-indexes are distinct depending on the extracellular potassium concentration. Our letter provides a general way to obtain the best estimate of parameters from a q-Gaussian distribution function. It also expands the validity of Tsallis statistics in realistic physiological stimulus conditions. In addition, we discuss the physical and physiological implications of these findings.

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O objetivo do trabalho foi avaliar o desempenho de leitões alimentados com duas fontes de óleos (soja e palma) em associação com maltodextrina e do blend de óleo de palma microencapsulado com maltodextrina, bem como os coeficientes de digestibilidade aparente dessas dietas. Utilizaram-se 162 leitões desmamados aos 21 dias, com peso médio inicial de 5,42 ± 0,55 kg, os quais foram distribuídos em delineamento de blocos ao acaso em três tratamentos e dezoito repetições compostas de três animais. Os tratamentos avaliados foram T1: rações com óleo de soja [3,03% nas dietas pré-iniciais (I) e iniciais (II)] e maltodextrina (10,00% na I e 5,93% na II); T2: rações com óleo de palma (3,03% na I e II) e maltodextrina (10,00% na I e 5,93% na II); T3: rações com óleo de palma microencapsulado pela maltodextrina na forma de blend (10,00% na I e II) e maltodextrina adicional ao blend (4,07% na I), para que a percentagem de maltodextrina permanecesse idêntica nas rações dos três tratamentos. Os dados de desempenho e digestibilidade foram submetidos à análise de variância, respectivamente, pelo procedimento MIXED e GLM do pacote estatístico SAS, sendo as médias comparadas pelo teste de Tukey (P0,05) para o CDR, GDP e CA dos leitões submetidos aos diferentes tratamentos. O CDA da MS foi 4,25% menor (P<0,05) para a dieta com óleo de palma microencapsulado pela maltodextrina em relação à dieta com óleo de soja...

The objective of this study was to evaluate the performance of piglets fed two sources of oil (soybean and palm oil) combined with maltodextrin and a blend of palm oil microencapsulated with maltodextrin, as well as the apparent digestibility coefficients of these diets. A total of 162 piglets weaned at 21 days, with a mean initial weight of 5.42 ± 0.55 kg, were allocated in a randomized block design consisting of three treatments and 18 replicates of three animals each. The following treatments were evaluated: T1: diet containing soybean oil [3.03% in the pre-initial (I) and initial (II) diets] and maltodextrin (10.0% in I and 5.93% in II); T2: diet containing palm oil (3.03% in I and II) and maltodextrin (10.0% in I and 5.93% in II); T3: diet containing a blend of palm oil microencapsulated with maltodextrin (10.0% in I and II) and maltodextrin added to the blend (4.07% in I) so that the percentage of maltodextrin would be identical in the diets of the three treatments. The performance and digestibility data were submitted to analysis of variance using the MIXED and GLM procedures, respectively, of the SAS package and means were compared by the Tukey test (P0.05) in DFI, ADG or FC were observed between piglets submitted to the different treatments. The ADC of dry matter was 4.25% lower (P<0.05) for the diet containing palm oil microencapsulated with maltodextrin compared to the soybean oil diet. The ADC of ether extract was 54% higher (P<0.05) in the soybean oil diet compared to the palm oil diet, which negatively affected the ether extract digestibility coefficient...

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O objetivo do trabalho foi avaliar o desempenho de leitões alimentados com duas fontes de óleos (soja e palma) em associação com maltodextrina e do blend de óleo de palma microencapsulado com maltodextrina, bem como os coeficientes de digestibilidade aparente dessas dietas. Utilizaram-se 162 leitões desmamados aos 21 dias, com peso médio inicial de 5,42 ± 0,55 kg, os quais foram distribuídos em delineamento de blocos ao acaso em três tratamentos e dezoito repetições compostas de três animais. Os tratamentos avaliados foram T1: rações com óleo de soja [3,03% nas dietas pré-iniciais (I) e iniciais (II)] e maltodextrina (10,00% na I e 5,93% na II); T2: rações com óleo de palma (3,03% na I e II) e maltodextrina (10,00% na I e 5,93% na II); T3: rações com óleo de palma microencapsulado pela maltodextrina na forma de blend (10,00% na I e II) e maltodextrina adicional ao blend (4,07% na I), para que a percentagem de maltodextrina permanecesse idêntica nas rações dos três tratamentos. Os dados de desempenho e digestibilidade foram submetidos à análise de variância, respectivamente, pelo procedimento MIXED e GLM do pacote estatístico SAS, sendo as médias comparadas pelo teste de Tukey (P<0,05). O consumo diário de ração (CDR), ganho diário de peso (GDP) e conversão alimentar (CA) foram avaliados nos períodos de 0 a 16 dias e 0 a 32 dias pós-desmame. Na segunda semana experimental, os coeficientes de digestibilidade aparente (CDA) da matéria seca (MS), proteína bruta e extrato etéreo (EE) foram mensurados pelo método da coleta parcial de fezes. Não foram encontradas diferenças (P>0,05) para o CDR, GDP e CA dos leitões submetidos aos diferentes tratamentos. O CDA da MS foi 4,25% menor (P<0,05) para a dieta com óleo de palma microencapsulado pela maltodextrina em relação à dieta com óleo de soja...(AU)

The objective of this study was to evaluate the performance of piglets fed two sources of oil (soybean and palm oil) combined with maltodextrin and a blend of palm oil microencapsulated with maltodextrin, as well as the apparent digestibility coefficients of these diets. A total of 162 piglets weaned at 21 days, with a mean initial weight of 5.42 ± 0.55 kg, were allocated in a randomized block design consisting of three treatments and 18 replicates of three animals each. The following treatments were evaluated: T1: diet containing soybean oil [3.03% in the pre-initial (I) and initial (II) diets] and maltodextrin (10.0% in I and 5.93% in II); T2: diet containing palm oil (3.03% in I and II) and maltodextrin (10.0% in I and 5.93% in II); T3: diet containing a blend of palm oil microencapsulated with maltodextrin (10.0% in I and II) and maltodextrin added to the blend (4.07% in I) so that the percentage of maltodextrin would be identical in the diets of the three treatments. The performance and digestibility data were submitted to analysis of variance using the MIXED and GLM procedures, respectively, of the SAS package and means were compared by the Tukey test (P<0.05). Daily feed intake (DFI), average daily gain (ADG) and feed conversion (FC) were evaluated from 0 to 16 days and from 0 to 32 days postweaning. In the second week of the experiment, the apparent digestibility coefficients (ADC) of dry matter, crude protein and ether extract were measured by partial feces collection. No differences (P>0.05) in DFI, ADG or FC were observed between piglets submitted to the different treatments. The ADC of dry matter was 4.25% lower (P<0.05) for the diet containing palm oil microencapsulated with maltodextrin compared to the soybean oil diet. The ADC of ether extract was 54% higher (P<0.05) in the soybean oil diet compared to the palm oil diet, which negatively affected the ether extract digestibility coefficient...(AU)

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Leprosy is a contagious and chronic systemic granulomatous disease caused by the bacillus Mycobacterium leprae. To our knowledge, no case of leprosy in a childhood-onset systemic lupus erythematosus (c-SLE) patient has been reported. For a period of 31 years, 312 c-SLE patients were followed at the Pediatric Rheumatology Unit of our University Hospital. One of them (0.3%) had tuberculoid leprosy skin lesions during the disease course and is here reported. A 10-year-old boy from Northwest of Brazil was diagnosed with c-SLE based on malar rash, photosensitivity, oral ulcers, lymphopenia, proteinuria, positive antinuclear antibodies, anti-double-stranded DNA, anti-Sm and anti-Ro/SSA autoantibodies. He was treated with prednisone, hydroxychloroquine and intravenous cyclophosphamide, followed by mycophenolate mofetil. At 12-years-old, he presented asymmetric skin lesions characterized by erythematous plaques with elevated external borders and hypochromic center with sensory loss. Peripheral nerve involvement was not evidenced. No history of familial cases of leprosy was reported, although the region where the patient resides is considered to be endemic for leprosy. Skin biopsy revealed a well-defined tuberculoid form. A marked thickening of nerves was observed, often destroyed by granulomas, without evidence of Mycobacterium leprae bacilli. At that time, the SLEDAI-2K score was 4 and he had been receiving prednisone 15 mg/day, hydroxychloroquine 200 mg/day and mycophenolate mofetil 3 g/day. Paucibacillary treatment for leprosy with dapsone and rifampicine was also introduced. In conclusion, we have reported a rare case of leprosy in the course of c-SLE. Leprosy should always be considered in children and adolescents with lupus who present skin abnormalities, particularly with hypoesthesic or anesthesic cutaneous lesions.

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The objectives of this study were to evaluate the antioxidant capacity of peanut skin extract and its effect on the color and lipid oxidation of cooked chicken patties over 15 d of refrigerated storage. The extract was obtained using 80% ethanol and evaluated in terms of total phenolic content, reducing power based on the ferric reducing ability of plasma (FRAP) reagent, and 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical scavenging activity. The patties were made with ground thigh fillets, chicken skin, and 2% salt. They were homogenized and divided into the following two groups: a control treatment without antioxidants and a peanut skin treatment with 70 mg gallic acid equivalent (GAE)/kg per patty. Analyses of the fatty acid profiles, instrumental colors (L*, a*, and b*) and thiobarbituric acid reactive substances (TBARS) were performed on d 1, 8, and 15 of storage at 1±1ºC. The peanut skin extract resulted in a phenolic content of 32.6±0.7 mg GAE/g dry skin, an antioxidant activity (FRAP) of 26.5±0.8 6 µmol Trolox equivalent/g dry skin, and an efficient concentration (EC50) of 46.5 µg/mL. The total unsaturated fatty acid was approximately 73%, and 39% of this fatty acid content was monounsaturated. The peanut skin extract slowed the decrease in the a* values (P<0.05) but reduced the L* and b* values compared to the control samples during storage (P<0.05). Lipid oxidation was minimized by the peanut skin extract (P<0.05), which resulted in a maximum value of 0.97 malondialdehyde (MDA)/kg compared to values that were close 19 mg MDA/kg patties in the control sample at the end of storage period. Thus, it can be concluded that although peanut skin extract causes little color change, it can be applied as a natural antioxidant to cooked chicken patties because it efficiently inhibits lipid oxidation in this product during refrigerated storage.

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An electroanalytical method was developed to detect and quantify the sunscreen agent octocrylene (OCR) in cosmetic products. The method was based on electrochemical reduction, using voltammetric techniques. OCR was reduced at -0.97 V vs. Ag/AgCl on a glassy carbon electrode using a mixture of Britton-Robinson buffer (0.04 mol L(-1)) and ethanol (7 : 3, v/v) as the supporting electrolyte solution. Under optimized conditions and square-wave voltammetry, OCR response was linear from 5.0 × 10(-6) to 8.0 × 10(-5) mol L(-1) (r = 0.9995), with a limit of detection of 2.8 × 10(-6) mol L(-1). The proposed electroanalytical method proved simple, fast and suitable for detection and quantification of OCR in samples of cosmetic products, with satisfactory results in the recovery test and analytical determination in real samples.

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PURPOSE: The aim of this study was to substantiate the hypothesis as to whether an altered amount of elastic fibers in the linea alba aponeurosis occurs or not in anterior abdominal wall hernias (epigastric, incisional and umbilical), comparing the findings with those of a control group of cadavers without hernias. METHODS: Thirty patients (15 males and 15 females) with anterior abdominal wall hernias were evaluated for analysis of the elastin content in samples from the linea alba aponeurosis, with immunohistochemistry and orcein staining using videomorphometry. RESULTS: The results showed a greater amount of elastin in patients with abdominal wall hernias compared to the control group of cadavers without hernias (P < 0.05). The elastic fibers were greatly thickened, tortuous and fragmented in the patients. CONCLUSION: It is essential to analyze the anterior abdominal wall concerning its anatomical condition and histological components. Altered collagen and elastic fibers play an important role in hernia formation, indicating that the main factor may be biological.

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Leprosy still is an important public health problem in several parts of the world including Brazil. Unlike the diseases caused by other mycobacteria, the incidence and clinical presentation of leprosy seems little affected in immunosuppressed patients. We report the first case, to our knowledge, of a liver transplant patient who developed multi-bacillary leprosy. The patient presented with papules and infiltrated plaques with loss of sensation suggestive of leprosy 3.5 years after living-related liver transplantation for autoimmune hepatitis. A skin biopsy showing non-caseating macrophagic granulomas, neuritis, and intact acid-fast bacilli on Fite-Faraco stain, confirmed the diagnosis of borderline lepromatous leprosy. The donor of the liver did not show any evidence of leprosy. During follow-up, the patient presented 2 episodes of upgrading leprosy type I reactions, 1 mild before leprosy treatment, and 1 moderate 3 months after receiving standard multi-drug treatment (rifampicin, clofazimine, and dapsone). These reactions were accompanied by increase in liver function tests, especially of canalicular enzymes. This reaction occurred despite the patient's triple immunosuppression regimen. The moderate reaction was successfully treated with further immunosuppression (prednisone, 0.5 mg/kg). Currently, the patient is asymptomatic, off leprosy medication, with routine liver transplant follow-up. The dilemmas in diagnosis and management of such a case are discussed and the literature on leprosy in transplant recipients is reviewed.

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BACKGROUND: The treatment of hernia, independent of anatomical site and technique utilized, generally involves using prostheses, which may cause complications, despite their unarguable advantage in allowing safe reinforcement. An example of this is possible retraction, which causes discomfort and hernia recurrence. Polypropylene is still the most often used biomaterial of the great number available. The purpose of this study is to evaluate the amount of retraction of the polypropylene mesh, as well as the histological reactions that accompany this phenomenon. METHODS: Polypropylene meshes (Marlex) were inserted in an anterior position to the whole abdominal aponeurosis of 25 Wistar rats (Rattus norvegicus albinus). The animals were divided into groups and another intervention was performed 7, 28, and 90 days later to measure the dimensions of the prostheses and to calculate the final area. Histological analysis was performed with hematoxylin-eosin to evaluate neutrophils, macrophages, giant cells, and lymphocytes surrounding the mesh threads in ten random fields of each slide. RESULTS: Seven days after the mesh was inserted, the mean rate of retraction was 1.75% (P = 0.64); at 28 days, it was 3.75% (P = 0.02); and at 90 days, it was 2.5% (P = 0.01). As to the histological analysis, there was a total decline of neutrophils and a progressive increase of macrophages, giant cells, and lymphocytes proportional to the post-implant time of the mesh (P < 0.05). CONCLUSION: There was a statistically significant retraction of 3.75% at 28 days and 2.5% at 90 days after the prosthesis was inserted. There is a well-established sequence of cellular events which aim at synthesizing new connective tissue to reinforce the mesh.

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Massive gastric dilatation with necrosis and rupture is a very rare event. Here we describe the case of a 13-year-old girl with acute gastric dilatation, infarction, necrosis and perforation. It began with acute abdominal pain, but an absence of vomiting after eating a heavy meal. Laparotomy showed massive gastric dilatation with infarction and perforation. Early diagnosis is essential to reduce morbidity and mortality, and therefore treatment must be started promptly.

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Acute methemoglobinemia is an uncommon but potentially treatable disorder in witch patient can present with dramatic signs and symptoms. The early diagnostic and treatment are essentials to prevent this fatal medicine reaction.

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Two case reports of patients with human immunodeficiency virus type 1 (HIV-1) infection who developed leprosy are presented. Both developed type 1 leprosy reactions in the absence of antiretroviral therapy. Reactions have been described for a number of HIV-1- and Mycobacterium leprae-coinfected patients and have been considered to be part of an immune reconstitution inflammatory syndrome (IRIS) since the reactions were usually linked to the administration of highly active antiretroviral therapy. The reports of our two patients suggest that the type 1 reactions in patients with leprosy and HIV may not always be an IRIS manifestation but may be akin to the classical reactional state described for the natural course of leprosy infection, which occurs in leprosy patients due to the fluctuations of the antimycobacterial immune response, whether they are coinfected with HIV or not.

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