Evaluation of the immunomodulatory activity of thalidomide on tumor-associated macrophages in the 4T1 murine metastatic breast cancer model / [Avaliação do efeito imunomodulador da talidomida em macrófagos associados a tumores no modelo murino de câncer de mama metastático 4T1]

The present work evaluated the immunomodulatory effect of thalidomide (Thal) at different doses on tumor-associated macrophages (TAMs) using a mouse model of human breast cancer. Mice were inoculated with 4T1 cells in the left flank and treated with Thal once a day at concentrations of 50, 100, and 150mg/kg body weight from the 5th day until the 28th day of tumor inoculation. The tumors were sized, proliferation index and TAMs count were evaluated in primary tumors and metastatic lungs. In addition, the metastasis rate was evaluated in the lungs. Thal at 150mg/kg significantly decreased tumor growth, proliferation index, and TAMs infiltration in primary tumors. Conversely, a higher number of TAMs and lower proliferation index were observed in metastatic lungs in mice treated with 150mg/kg of Thal. Furthermore, Thal at 150mg/kg significantly decreased the metastatic nodules in the lungs. Our findings demonstrated that Thal treatment considerably decreased the primary tumor and lung metastasis in mice associated with different TAM infiltration effects in these sites.(AU)

No presente trabalho, foi avaliado o efeito imunomodulador de diferentes doses de talidomida em macrófagos associados ao tumor (TAMs), em um modelo murino de câncer de mama. Camundongos foram inoculados com células 4T1, na região do flanco esquerdo, e tratados com talidomida, uma vez ao dia, nas doses de 50, 100 e 150mg/k, por massa corporal, do quinto dia ao 28º dia de inoculação tumoral. Os tumores foram medidos, o índice de proliferação celular e a contagem de TAMs foram avaliados nos tumores primários e nos pulmões com metástases. Além disso, a taxa de metástases pulmonares também foi avaliada. A talidomida na dose de 150mg/kg diminuiu significativamente o crescimento tumoral, o índice de proliferação celular e a infiltração de TAMs nos tumores primários. Por outro lado, maior número de TAMs e menor índice de proliferação celular foram observados nos pulmões metastáticos, em camundongos tratados com 150mg/kg de talidomida. Ademais, a talidomida na dose de 150mg/kg diminuiu significativamente os nódulos metastáticos nos pulmões. Os resultados demonstraram que o tratamento com talidomida diminuiu o crescimento tumoral e as metástases pulmonares em camundongos, associado com diferentes efeitos na infiltração de TAMs nesses locais.(AU)

Determinación de Valores de Armonía del Perfil Facial en la Población Chilena

RESUMEN: El realizar un tratamiento ortodóntico sólo en base a referencias de tejidos duros, puede llevar a resultados estéticos desfavorables, debido a la gran variabilidad que existe en los tejidos blandos que los recubren. Arnett et al. (1999) presentaron un análisis basado en los tejidos blandos y determinó normas que definen un rostro armónico. Sin embargo, éstas normas se obtuvieron de pacientes norteamericanos y puede que no reflejen los conceptos estéticos de nuestra población. El objetivo del presente trabajo fue determinar valores de armonía facial para la población chilena, utilizando el análisis cefalométrico de tejidos blandos presentado por Arnett et al., y compararlos con los valores previamente establecidos para la población caucásica. Se analizaron 200 fotografías y se clasificaron los perfiles en balanceados y no balanceados según el criterio de un grupo de especialistas. Posteriormente se analizaron las telerradiografías correspondientes a los perfiles clasificados, con el análisis cefalométrico de tejidos blandos. Los valores de las diferentes variables fueron analiza dos separadamente por sexo, clase esqueletal y biotipo facial, y se determinaron las diferencias entre las variables presentadas por Arnett et al. y las obtenidas en el presente estudio. Para ello se utilizaron pruebas de significancia estadística como el test t y otros no paramétricos. Sólo se encontró diferencias significativas en dos variables respecto de las normas sugeridas por Arnett et al., correspondientes a un menor espesor del labio inferior en ambos sexos, y una mayor prominencia del pómulo en mujeres chilenas, por lo que consideramos que los valores de armonía de Arnett et al., pueden ser también aplicados como parámetro estético para la población chilena.

ABSTRACT: Performing an orthodontic treatment based only on hard tissue references can lead to unfavorable aesthetic results due to the great variability that exists in soft tissues that cover them. In 1999, W.Arnett, presented an analysis based on soft tissues and determined norms that define a harmonious face. However, these standards that were obtained from North Americans and Chilean aesthetic concepts could be different. The aim of the study was to determine the values of facial harmony for the Chilean population, using the cephalometric analysis of soft tissues presented by Arnett, and compare them with the values previously established for the Caucasian population. In this study 200 photographs were analyzed, and the profiles were classified in balanced and unbalanced according to the criteria of a group of specialists. Subsequently, teleradiographs corresponding to the classified profiles were analyzed, with the cephalometric analysis of soft tissues. The values of the different variables were analyzed separately by sex, skeletal class and facial biotype, and the differences between the variables presented by Arnett et al., and those obtained in the present study. For this purpose, statistical significance tests such as the t test and other non- parametric tests were used. There were only significant differences in two variables: inferior lip variables in both sexes, and a greater prominence of the cheekbone in Chilean women, therefore we consider that the values of harmony of Arnett, can also be applied as an aesthetic parameter for the Chilean population.

Tratamiento de la incontinencia urinaria de esfuerzo secundaria a cirugía prostática, con el uso de un cabestrillo suburetral transobturador / Retrourethral transobturator sling for the treatment of male stress urinary incontinence after prostate surgery

Los pacientes que presentan una incontinencia urinaria de esfuerzo (IOE) secundaria a una cirugía prostática, pueden llegar a experimentar un severo deterioro de su calidad de vida. Debido a esto, se han desarrollado distintos dispositivos para recuperar la continencia con diversos resultados. El objetivo de este trabajo es presentar la experiencia inicial con el uso de un cabestrillo suburetral transobturador, en hombres con una IOE secundaria a una cirugía prostática. MATERIAL Y MÉTODOS: Se presenta una serie de 16 pacientes portadores de una IOE de diversa magnitud secundarias a una cirugía prostática, en los cuales se utilizó un cabestrillo suburetral transobturador para la corrección de ésta, entre Noviembre de 2008 y Abril de 2011. Todos los pacientes fueron evaluados clínica y cistoscopicamente previo a la cirugía, también se cuantifico el Nº apósitos/día y el volumen de escape de orina en 24 horas (Pad-test). El seguimiento post-operatorio se realizo de similar manera. RESULTADOS: Con una mediana de seguimiento de 14 meses (rango 6-30), la tasa de éxito de la serie completa fue de un 63 por ciento (38 por ciento curación y un 25 por ciento mejoría). Para los pacientes con una IOE leve-moderada la tasa de éxito fue de un 100 por ciento (60 por ciento curación y un 40 por ciento mejoría). La presencia de una IOE severa se asocio con un fracaso para este tipo de cirugía (p <0.0001). El Nº apósitos/día y el volumen de escape en 24 horas de los pacientes con una IOE leve-moderada disminuyo significativamente en el post-operatorio (p < 0.005). No hubo complicaciones intra-operatorias, así como tampoco durante el seguimiento. CONCLUSIONES: El cabestrillo sub uretral transobturador es un procedimiento seguro y efectivo para el manejo de la IOE leve-moderada. Los pacientes con IOE...

Patients in whom stress urinary incontinence (SUI) develops after a prostate surgery experience a significant decrease in quality of life. For this reason, several treatment options have been developed to recover continence, with varying success. The aim of the study was present the initial experience with the use of the retrourethral transobturator sling for the treatment of male SUI after prostate surgery. MATERIAL AND METHODS: A prospective evaluation was conducted on 16 patients with mild to severe SUI secondary to a prostatic surgery, in whom a suburethral transobturator sling was implanted between November 2008 and April 2011. All patients were evaluated preoperatively and postoperatively by medical history,24-h pad test, daily pad use and a cystoscopy. RESULTS: After a median follow-up of 14 months (range, 6–30) the incontinence success rate for overall series was 63 percent (38 percent cure and 25 percent improved). The incontinence success rate for mild to moderate SUI patients was100 percent (60 percent cure and 40 percent improved). Severe SIU was associated with worse results for this surgery (p <0.0001).The 24-h pad test and the daily pad use test decreased significantly during the follow-up in the mild to moderate SUI group(p < 0.005). Neither operative complication nor post-operative complication was noted during follow-up. CONCLUSIONS: Placement of a retrourethral transobturator sling is a safe and effective procedure for patients with mild to moderate SUI. In not recommended for patients with severe SUI. Longer follow-up is required to assess long-term efficacy...

Suplementação de aminoácidos para redução da proteína bruta em dietas para leitões desmamados aos 21 dias de idade / Supplementation of amino acids to reduce crude protein in diets for piglets weaned at 21 days

Avaliou-se o efeito da suplementação de aminoácidos industriais para redução de proteína bruta (PB) em dietas para leitões desmamados aos 21 dias de idade sobre o desempenho e sobre as variáveis morfofisiológicas, utilizando-se 126 leitões com peso inicial de 6,05±0,35kg. Os animais foram distribuídos em delineamento experimental de blocos ao acaso, com seis tratamentos (24,0; 23,0; 22,0; 21,0; 20,0; 19,0% de PB), sete repetições e três animais por unidade experimental. Não houve efeito significativo da redução de proteína bruta da dieta sobre o ganho de peso médio diário, o consumo de ração diário e a conversão alimentar, e o pH do estômago também não sofreu influência, mas houve diminuição do pH do duodeno. Os pesos relativos do baço e do fígado, a altura de vilosidades e a profundidade de criptas no duodeno, jejuno e íleo não foram influenciados, enquanto o peso do pâncreas diminuiu com a redução da proteína bruta da dieta.

The objective of this work was to evaluate the effect of amino acid supplementation for the reduction of crude protein (CP) in diets for piglets weaned at 21 days of age on performance and morphophysiological parameters of 126 piglets with an initial weight of 6.05±0.35kg. The animals were divided into a randomized block experimental design with six treatments (24.0, 23.0, 22.0, 21.0, 20.0, 19.0% CP), seven replicates and three animals per experimental unit. It was found that there was no significant effect of reducing crude protein in the diet on the piglets' average daily weight gain, feed intake and feed conversion (FC). It was also found that the reduction of protein did not influence the pH of the stomach, however, the pH of the duodenum decreased with the reduction of CP. The relative weights of the spleen, liver and villus height and crypt depth in the duodenum, jejunum and ileum were not affected, whereas pancreatic weight decreased with the reduction of crude protein in diets.

Qualidade seminal e morfometria testicular de coelhos (Oryctolagus cuniculus) suplementados com geleia real / Seminal quality and testicular morphometry of rabbits (Oryctolagus cuniculus) supplemented with royal jelly

Objetivou-se avaliar o efeito da geleia real na qualidade seminal e na morfometria testicular de coelhos. Quatorze coelhos adultos da raça Nova Zelândia foram distribuídos em três grupos: com administração diária de 1mL de água, via oral (SG); administração diária de 0,5mg (0,5G) de geleia real diluída em 1mL de água, via oral; e administração diária de 1,0mL (1,0G) de geleia real diluída em 1mL de água, via oral. O fornecimento de geleia real foi iniciado 30 dias antes das coletas de sêmen, permanecendo durante todo o período de coleta, totalizando 90 dias. Utilizou-se o método da vagina artificial para coleta de sêmen. Foram avaliados os parâmetros físicos e morfológicos do sêmen e os parâmetros de morfometria testicular. Houve diferença no volume seminal do 0,5G (0,54±0,22) em relação ao SG (0,39±0,13) e ao 1,0G (0,30±0,09) (P<0,05). Para os grupos SG, 0,5G e 1,0G, não houve diferença (P>0,05) para turbilhonamento espermático, concentração espermática, motilidade progressiva e vigor espermático. Os defeitos maiores no grupo 0,5G (8,52±3,26) foram menores do que nos grupos SG (14,09±4,26) e 1,0G (16,1±3,95) (P<0,05). Não houve diferença entre os defeitos menores e os defeitos totais (P>0,05). Os pesos corporal, testicular, epididimário e o índice gonadossomático não diferiram entre os grupos (P>0,05). A ingestão diária de 0,5mg de geleia real apresentou efeitos positivos na morfologia espermática de coelhos.

A trial was carried out to evaluate the effects of royal jelly on the seminal quality and testicular morphometry of rabbits. Fourteen mature rabbits of New Zealand breed were distributed between three groups. The first group was supplied with 1mL of water only (SG), the second group was supplied with 0.5mg of royal jelly diluted in 1mL of water (0.5G), and the third group was supplied with 1mg of royal jelly also diluted in 1mL of water (1.0G). The royal jelly supply started 30 days before semen collection and lasted the entire experimental period. An artificial vagina was used to collect the rabbits' semen. Physical and morphological parameters in the semen and the testicular morphometry were evaluated. Differences were found on the seminal volume in group 0.5G(0,54±0,22) in relation to SG (0,39±0,13) and 1.0G (0,30±0,09) groups (P<0.05). For SG, 0.5G and 1.0G groups, no differences (P>0.05) were found in sperm concentration, gross motility, individual motility and vigor. The total of primary defects in group 0.5G (8,52±3,26) was lower than in groups SG (14,09±4,2) and 1.0G (16,1±3,95) (P<0.05). No significant difference was found between secondary defects and the total defects on the semen (P>0.05). Body, testicular and epididymal weights did not differ between groups, as well to the gonadosomatic index (P>0.05). The ingestion of royal jelly produced positive results on the seminal production of males.

Adrenalectomía laparoscópica bilateral sincrónica en feocromocitoma bilateral / Bilateral laparoscopic synchronous adrenalectomy in bilateral pheochromocytoma: experience in 8 patients

Aim: To evaluate 8 cases of bilateral pheochromocytoma and laparoscopic synchronous treatment. Patients and Methods: From May 1999 to May 2010, 8 patients with bilateral pheochromocytoma were found. A complete preoperative workup was done. Results: We perform 8 transperitoneal laparoscopic bilateral synchronous adrenalectomy. There was no open converted procedure. Mean operative time was 184.37 min. (range 95 to 300 min). Mean hospital stay was 3.8 days (range 3 to 5 days). Mean blood loss was 191.25 ml (range 0 to 500 min). In 7 cases the histopathological result was of pheochromocytoma and 1 as a malignant pheochomocytoma based on its histology. Conclusions: With very well establish diagnostic disease, an appropriate anesthetic strategy and as surgical skills, laparoscopic bilateral synchronic adrenalectomy is a feasible and safe surgical technique for bilateral pheochromocytomas.

Introducción: La incidencia del feocromocitoma varía entre un 0,005 y un 0,1 por ciento y de estos sólo un 10 por ciento se presenta en forma bilateral. El objetivo de este trabajo es presentar nuestra experiencia en adrenalectomía laparoscópica bilateral sincrónica en pacientes con diagnóstico de feocromocitoma bilateral. Se revisa la literatura y se analizan nuestros resultados. Material y Métodos: Se realiza una revisión retrospectiva de todos los pacientes sometidos a una adrenelectomía laparoscópica bilateral sincrónica entre mayo de 1999 y mayo de 2010, con diagnóstico de un feocromocitoma bilateral. Todos los pacientes fueron estudiados con medición de catecolaminas plasmáticas y urinarias y estudio por imágenes. Resultados: Se realizaron 8 adrenelectomías laparoscópicas bilaterales sincrónicas. El tiempo promedio de cirugía fue de 184 min (rango 95-300 min). La estadía intrahospitalaria media fue de 3,8 días (rango de 3-5 días). El promedio de sangrado fue de 83 ml (rango 0-500 ml). El diagnóstico histopatológico fue de feocromocitoma en todas las muestras, en un caso se diagnosticó un feocromocitoma maligno. No hubo conversión a cirugía abierta. Conclusiones: La adrenelectomía laparoscópica bilateral sincrónica para feocromocitomas bilaterales es un procedimiento seguro y de baja morbilidad, realizada por un cirujano con experiencia en cirugía laparoscópica. Es necesario tener previamente el diagnóstico de certeza para el manejo anestésico y postquirúrgico adecuado para estos pacientes.

Cell proliferation markers in the transplanted canine transmissible venereal tumor / Marcadores de proliferação celular no tumor venéreo transmissível canino transplantado

Adult male mongrel dogs were subcutaneously transplanted with the canine transmissible venereal tumor (TVT) on the hypogastric region. Twelve specimens of tumors were collected, half during the proliferative phase and the other half during the regressive phase. Fragments of the tumor were fixed in 10 percent buffered formalin and routinely processed for light microscopy. Sections of 4µm were stained by Schorr or AgNOR or either immunostained for MIB1 (Ki67). Schorr stain, AgNOR and MIB1 showed an increased proliferative activity through mitotic index, nuclear argyrophilic protein stain and cycling tumoral cells in the growing tumors, respectively. All of the three cell proliferation markers were able to distinguish the TVT in both evolution phases. MIB1 monoclonal antibody was the best in the morphologic evaluation of growth and regression of TVT. This resulted in higher values than AgNORs counting and mitotic index. MIB1 immunostaining was the most effective parameter of the proliferative activity of TVT. However, a significant correlation has been detected only between mitosis counting and AgNORs.

Cães machos, adultos, mestiços, foram transplantados com células do tumor venéreo transmissível canino (TVTC), na região hipogástrica. Foram coletados doze espécimes do TVTC, sendo metade durante a fase proliferativa e metade durante a fase regressiva. Fragmentos do tumor foram fixados em formol a 10 por cento, tamponado e processado rotineiramente para microscopia de luz. Secções de 4µm foram coradas pelo Shorr, ou pela AgNOR, ou ainda, imunocorado para MIB 1 (Ki67). As colorações pelo Shorr, AgNOR, ou MIB 1 mostraram um aumento do índice mitótico, coloração da proteína argirofílica nuclear e células tumorais ciclando em tumores em crescimento, respectivamente. Todos os três marcadores de proliferação celular foram capazes de distinguir o TVTC em ambas as fases de evolução. O anticorpo monoclonal MIB 1 foi o melhor na avaliação morfológica, de crescimento e regressão do TVTC. Isto resultou em um valor maior que a contagem de AgNOR e do índice mitótico. A imunomarcação com MIB1 foi o parâmetro mais efetivo da atividade proliferativa. No entanto, só foi observada uma correlação positiva entre a contagem de mitose e a AgNOR.

An MD-PhD program in Brazil: students’ concepts of science and of common sense

In 1995, a pioneering MD-PhD program was initiated in Brazil for the training of medical scientists in experimental sciences at the Federal University of Rio de Janeiro. The program’s aim was achieved with respect to publication of theses in the form of papers with international visibility and also in terms of fostering the scientific careers of the graduates. The expansion of this type of program is one of the strategies for improving the preparation of biomedical researchers in Brazil. A noteworthy absence of interest in carrying out clinical research limits the ability of young Brazilian physicians to solve biomedical problems. To understand the students’ views of science, we used qualitative and quantitative triangulation methods, as well as participant observation to evaluate the students’ concepts of science and common sense. Subjective aspects were clearly less evident in their concepts of science. There was a strong concern about "methodology", "truth" and "usefulness". "Intuition", "creativity" and "curiosity" were the least mentioned thematic categories. Students recognized the value of intuition when it appeared as an explicit option but they did not refer to it spontaneously. Common sense was associated with "consensus", "opinion" and ideas that "require scientific validation". Such observations indicate that MD-PhD students share with their senior academic colleagues the same reluctance to consider common sense as a valid adjunct for the solution of scientific problems. Overcoming this difficulty may be an important step toward stimulating the interest of physicians in pursuing experimental research.

Cirugía percutánea de la litiasis renal en la era de la litotripsia extracorpórea: experiencia en 301 pacientes / Percutaneous renal surgery: experience in 301 patients

Introduction: Percutaneous renal surgery was introduced more than 20 years ago in urological practice. Extracorporeal Shock Wave Lithotripsy (ESWL) enter the urological scene shortly after. Our objective is to show our experience in percutaneous renal surgery after the introduction of the ESWL in our institution. Material and Methods: Surgical outcomes of 301 patients who underwent percutaneous renal surgery as treatment of renal stones were analyzed. This series begins just before the introduction of ESWL in our unit. Results: Renal pelvis was the most frequent localization with 142 cases (47.2 percent). There were 51 patients with straghorn calculi. 255 (84.7 percent) were stone free after one single procedure. Residual fragments were managed with many methods, until only 16 patients (5.4 percent) had residual fragments. Complications occurred in 26 patients (8.9 percent). There was no mortality. Conclusions: Percutaneous surgery is an important tool in the management of renal stones. In general, renal stones managed with this procedure, are more complex, however the achievement of good results is possible.

Introducción: La cirugía percutánea (CP) de la litiasis renal fue introducida en la urología hace más de 20 años. Poco después lo hizo la litotripsia extracorpórea (LEC). Nuestro objetivo es mostrar la experiencia en CP luego de la introducción de la LEC en nuestro servicio. Material y Métodos: Se analizan en forma retrospectiva los resultados de 301 pacientes operados por CP por litiasis renal. La serie comienza con la adquisición de un litotriptor extracorpóreo en nuestro servicio. Resultados: La localización más frecuente fue la pelvis renal con 142 casos (47,2 por ciento). Se observó litiasis coraliforme en 51 pacientes. Doscientos cincuenta y cinco (84,7 por ciento), quedaron libres de litiasis con un procedimiento. La litiasis residual fue tratada con diversos métodos, para un total final de 16 pacientes con fragmentos residuales (5,4 por ciento). Ocurrieron complicaciones en 26 pacientes (8,9 por ciento). No hubo mortalidad. Conclusiones: La cirugía percutánea de la litiasis renal es un procedimiento que debe formar parte importante en la resolución de la litiasis renal. En general las litiasis tratadas son más complejas, sin embargo, los resultados son excelentes.

Nefrectomía simple laparoscópica NOTES y LESS con el uso de instrumentos laparoscópicos estándar: experiencia inicial en 3 casos / NOTES and LESS laparoscopic simple nephrectomy with the use of standard laparoscopic instruments: initial experience in 3 cases

Introduction: Natural orifice transluminal endoscopic surgery (NOTES) and Laparoendoscopic Single Site Surgery (LESS) are emerging technologies, which allows to performed surgical procedures avoiding any surgical scars. However there are some problems due to the lack of equipment available for these procedures. The aim of these study is to present our initial experience with the transvaginal nephrectomy NOTES and LESS using standard laparoscopic instruments. Material and Methods: Two female patients (23 and 26 years old) with diagnosis of recurrent urinary tract infection and renal atrophy. A laparoscopic simple nephrectomy with transvaginal NOTES assistance was performed, using one access port for the camera and two abdominal work ports of 10 and 3mm. In a third patient (15 years old) a transumbilical LESS nephrectomy was preformed with the use of standard laparoscopic instruments. Results: Average operative time was 110 min (40-200), with an estimated blood loss of 200 cc. There were no perioperative complications and all patients were discharged 36 hours after surgery. Conclusion: Laparoscopic simple nephrectomy with transvaginal NOTES assistance and LESS are technically feasible with the use of standard laparoscopic instruments. Special access trocars and instruments development for this procedure will allow to performed a pure technique without the use of abdominal incisions.

Introducción: La cirugía endoscópica transluminal a través de orificios naturales (NOTES) y la cirugía laparoendoscópica a través de sitio único (LESS) son tecnologías emergentes, que permiten realizar procedimientos quirúrgicos minimizando el uso de incisiones abdominales. Sin embargo, existen limitaciones respecto al equipamiento disponible para simular la cirugía tradicional. Nuestro objetivo es presentar nuestra experiencia con la técnica de nefrectomía laparoscópica NOTES y LESS con el uso de instrumentos laparoscópicos estándar. Materiales y Métodos: Dos pacientes de sexo femenino de 23 y 26 años, ambas con diagnóstico de infecciones urinarias recurrentes y atrofia renal secundaria. Se les realizó una nefrectomía simple con asistencia de NOTES, utilizando un puerto de trabajo transvaginal para la cámara y dos puertos adicionales de 10 (umbilical) y 3 mm en el abdomen. Un tercer paciente de sexo masculino de 15 a±os de edad, fue operado a través de la técnica LESS por vía transumbilical con el uso de cistoscopio flexible e instrumentos laparoscópicos estándar. Resultados: La media del tiempo operatorio fue de 110 min (40-200), la pérdida sanguínea promedio fue de 133 cc (0-200). No se reportan complicaciones, siendo todos los pacientes dados de alta antes de 36 horas. Conclusión: La nefrectomía laparoscópica con asistencia de NOTES y LESS es técnicamente posible con el uso de instrumentos laparoscópicos estándar. El desarrollo y acceso a trócares y pinzas especiales, permitirá realizar una técnica pura sin el uso de incisiones abdominales.

Shelf life and rheology of emulsions containing vitamin C and its derivatives

Ascorbic acid (AA), or vitamin C, is widely used in the pharmaceutical, cosmetic and food industries as an antioxidant and cosmetics containing AA have been gaining popularity in the last few years for the treatment of photoageing. To solve the problem of its low stability, some esters have been synthesised, such as magnesium ascorbyl phosphate (MAP), also available encapsulated in collagen-based microspheres (EMAP). The aim of this research was to study the physical and chemical stability of O/W emulsions containing AA, MAP or EMAP, by rheological and HPLC analysis, respectively. These emulsions were stored at 25, 37 and 45ºC for 28days and samples tested weekly during storage. It was concluded that all the formulations showed pseudoplastic behaviour. The presence of MAP provoked an initial rise in thixotropy. The formulation containing AA did not show any marked change in rheological behaviour. In the chemical analysis, the formulation with EMAP was more stable than those with MAP and AA. Hence, replacement of AA with EMAP in this cosmetic formulation may be a viable way to enhance the stability of the active principle.

Cosméticos contendo ácido ascórbico (AA) têm sido muito empregados nos últimos anos na prevenção e tratamento do fotoenvelhecimento cutâneo. Para solucionar o problema de sua baixa estabilidade, alguns derivados têm sido utilizados como substitutos dessa vitamina e dentre eles o Magnesium Ascorbyl Phosphate (MAP), disponível também em microesferas à base de colágeno (EMAP). O objetivo desta pesquisa foi estudar a reologia e a estabilidade química de emulsões contendo AA, MAP ou EMAP. Assim, formulações contendo AA, MAP ou EMAP foram armazenadas a 25, 37 e 45ºC durante 28 dias e avaliadas. Concluiu-se que todas as formulações apresentaram comportamento pseudoplástico. A presença de MAP provocou um aumento inicial da tixotropia e a formulação contendo AA não apresentou grande alteração no comportamento reológico. Nos estudos químicos a formulação contendo EMAP foi mais estável que o MAP e AA, com o maior prazo de validade. Desta forma, a substituição de AA pela EMAP em cosméticos pode ser uma alternativa viável do ponto de vista da estabilidade da formulação.

Displasias corticales como causa de epilepsia y sus representaciones en las imágenes: [revisión] / Cortical dysplasia as a cause of epilepsy and its images respresentation: [review]

Epilepsy is a chronic neurological disorder characterized by spontaneous recurrent seizures, which are clinically classified as generalized or partial. Approximately, 30 percent of patients with partial epilepsy is refractory to medical treatment. Within the refractory group we must discard the presence of cortical dysplasia as an underlying cause of the crisis. Cortical dysplasias are a type of malformations of cortical development (MCD) that are increasingly recognized as a cause of refractory epilepsy. From the radiological point of view this kind of pathology is of particular interest since imaging manifestations can be subtle or may show completely normal examinations. The aim of this paper is to review the literature, describing the imaging appearance of the normal cortical development, the classifications of cortical malformations, mainly cortical dysplasias, by highlighting the most frequent radiological signs. We also examine the current role of positron emission tomography (PET) in epilepsy, which in conjunction with magnetic resonance imaging findings and electrophysiological studies are used to define a possible surgical treatment. Through this treatment we expect to be provided with details of histopathological alterations found in the surgical specimen to be compared to the radiographic changes revealed in the pre-surgical study.

La epilepsia es una alteración neurológica crónica caracterizada por crisis convulsivas recurrentes y espontáneas, que clínicamente se clasifican como generalizadas o parciales, dentro de las cuales aproximadamente el 30 por ciento de los pacientes con epilepsia parcial son refractarios al tratamiento médico. Dentro del grupo refractario debemos descartar la presencia de una displasia cortical como causa subyacente de las crisis. Las displasias corticales son un tipo de malformaciones del desarrollo cortical que en forma cada vez más frecuente se reconocen como causante de epilepsia refractaria. Desde el punto de vista radiológico, este tipo de patología tiene especial interés debido a que las manifestaciones imaginológicas pueden ser sutiles o presentar exámenes completamente normales. El objetivo de este artículo es realizar una revisión de la literatura, describiendo el desarrollo cortical normal con su aspecto en imágenes, las clasificaciones de las malformaciones corticales y en especial de las displasias corticales, destacando los signos radiológicos más frecuentes. Además revisaremos el rol en la actualidad de la Tomografía por Emisión de Positrones (PET) en epilepsia, que en conjunto con las imágenes por resonancia magnética y los estudios electrofisiológicos se utilizan para definir un eventual tratamiento quirúrgico, el que una vez realizado nos da detalles del análisis de las alteraciones histopatológicas en la pieza quirúrgica versus las alteraciones radiológicas visualizadas en el estudio pre-quirúrgico.

Ureteroscopia flexible: experiencia inicial / Flexible ureteroscopy: initial experience

Introducción: El desarrollo tecnológico y el aporte a la ingeniería a la urología, han permitido un impresionante avance en el campo de la endourología. La ureteroscopia flexible ha ganado cada vez más espacio tanto como método diagnóstico y terapéutico. Presentamos nuestra experiencia inicial en ureteroscopia flexible. Material y métodos: Entre marzo y noviembre de 2009 realizamos 13 ureteroscopias flexibles. Se utilizó un ureteroscopio flexible URF-V, Olympus. Se analizaron el demográficas y quirúrgicas. Se describe la técnica quirúrgica. Resultados: Se realizaron un total de 9 ureteroscopias flexibles en 7 hombres y 6 mujeres. El promedio de edad fue de 55 años En 5 casos la indicación del procedimiento fue un defecto de llene en la tomografía axial computada. En 6 casos la indicación fue por litiasis. En un caso la indicación fue por un catéter doble j que se desplazó hacia proximal y en un caso fue por hematuria lateralizada. El manejo de las litiasis se realizó mediante litotricia intracorpórea con láser Holmium 20 Watts. El doble j desplazado se extrajo con dormia. En los defectos de llene, se realizaron biopsias y una fulguración de hemangioma en el caso de la hematuria. No se registraron complicaciones. Discusión: La constante evolución tecnológica ha permitido la expansión de la ureteroscopia flexible tanto en el uso diagnóstico como terapéutico. Las complicaciones cada vez son menos frecuentes, convirtiéndolo en un procedimiento seguro y eficaz para el manejo tanto de patología litiásica como de otras alteraciones de la vía urinaria.

Introduction: Technology developments and engineering support to urology has allowed for great progress in the field of endourology. Flexible ureteroscopy has earned its place as a therapeutic and diagnostic tool. We present our initial experience in flexible ureteroscopy. Material and Methods: Between March and November 2009 we performed 9 flexible uretroscopies. We used a URF-V Olympus flexible ureteroscope. Demographic and surgical variables were analyzed. Surgical technique is described. Results: We performed 9 flexible ureteroscopies in 7 men and 6 women. Mean age was 55 years. In 5 cases surgical indication was a filling defect on CT scan. In 6 cases the indication was urolithiasis. In one case the indication was a retained ureteral stent and in another case lateralized hematuria.Stones were managed with a 20 Watts Holmium laser. The retained ureteral stent was retrieved with a dormia. The filling defects were managed with biopsy and fulguration of a haemangioma in the case of the lateralized hematuria. There were no complications. Conclusion: Constant technology evolution allowed expansion of the use of flexible ureteroscopy, making this procedure a safe and effective alternative for the management urinary stones and other diseases of the urinary tract.

Audit of referral of obstetric emergencies in Angola: a tool for assessing quality of care

By auditing various aspects of referrals of obstetric emergencies, we wanted to study the effectiveness over time of a recently established network of peripheral birth units and two central hospitals in Luanda. 157 women referred for obstetric emergencies were studied regarding clinical outcome and process indicators like waiting time, partogramme quality and Caesarean section rate (CSR). After a change in routines at hospital admission and further partogramme education 92 referred women were compared with the former. Maternal mortality decreased from 17.8% to nil in the second. Total mean waiting time was reduced from 13.7 hours to 1.2 hours. Partogramme quality was significantly improved. CSR increased from 13 to 30%. Prolonged labour was the most common diagnosis.This study demonstrates the importance of clinic-based audit to enhance quality of care regarding referrals of patients with obstetric emergencies (Afr J Reprod Health 2009; 13[2]:75-85)

Cirugia de las epilepsias refractarias: estado del arte / Surgery for refractory epilepsy: state of the art

Las epilepsias refractarias son aquellas donde hay persistencia de crisis, que provocan invalidez, pese a un tratamiento farmacológico óptimo. Estos pacientes corresponden aproximadamente al 20 por ciento de todos los portadores de epilepsias y a lo menos la mitad de ellos son candidatos a para iniciar un estudio prequirúrgico. Este comprende: monitoreo continuo de video-EEG, examen neuropsicológico y neuroimágenes, principalmente resonancia magnética (RM). Una RM anormal y un EEG concordante, con cirugía precoz se asocian a mejor pronóstico. La cirugía tiene por objetivo eliminar las crisis (curativa) o disminuir su frecuencia (paliativa). Las cirugías de intención curativa son: epilepsia del lóbulo temporal (ELT), extra temporales lobares y hemisferectomías. El 80 por ciento de las cirugías son ELT y un 66 por ciento quedan sin crisis. Cirugías paliativas son la callosotomla y la implantación de estlmulador de nervio vago. En conclusión: La cirugía es el más efectivo tratamiento de las epilepsias refractarias especialmente focales sintomáticas.

At least 20 percent of the epilepsy patients have uncontrolled seizures with rational antiepileptic drugs. Approximately 10 percent of the whole epileptic population could be considered good candidates for epilepsy surgery Those patients need presurgical studies (PS): video-EEG, neuropsychological evaluation and neuroimaging, especially magnetic resonance imaging (MRI). The abnormal MRI and consistent localized EEG findings were associated with having undergone The success of epilepsy surgery depends upon the early identification of potential surgical candidates as well as the P5. Epilepsy surgery can be classified as curative, when the goal is seizure free patients, or palliative, when the target is to decrease the frequency of seizures. Surgeries with curative intention are: resection of temporal lobe epilepsy (TLE), extratemporal lobe epilepsy and hemispherectomies. TLE is 80 percent of the all epilepsies surgeries and 66 percent are seizure free. Palliative surgeries are callosotomies and vagus nerve stimulation. In conclusion: The surgery is the most effective treatment in focal intractable symptomatic epilepsies.

Alteraciones en el metabolismo del zinc relacionadas a la edad / Alterations of zinc metabolic related to aging

Although many studies point to alterations in the organic concentrations of zinc in elderly patients, the mechanisms by which aging might cause changes in the metabolism of this nutrient remain unclear. Thus, we assessed the changes in plasma zinc, zinc binding capacity to plasma protein (ZnBCPP) and saturation index (SI), comparing elderly individus and young adults. The zinc analyses were performed by atonde absorption spectrophotometry. A statistically significant difference (p < 0.001) was found between the two groups in relation to plasma zinc and SI, but the ZnBCPP did not differ between the younger and older subjects. In agreement with this result, it was shown in the young group that 76 percent (R² = 0.760) of the ZnBCPP variations are explained by the variations in plasma zinc and SI. In the elderly group this measure decreased to 30.5 percent (R² = 0.305). We conclude, therefore, that aging may be a factor associated to changes in control mechanisms and in zinc homeostasis, and could even alter ZnBCPP response patterns and other zinc-related indicators of nutritional status.

A pesar que muchos estudios indicarían que existen alteraciones en las concentraciones orgánicas del zinc en pacientes mayores, los mecanismos por los cuales el envejecimiento podría implicar cambios en el metabolismo de esta nutriente, aún permanecen pocos claros. Buscamos evaluar los cambios relativos al zinc plasmático, a la Capacidad de Ligación del Zinc a la Proteína Plasmática (ZnBCPP) y en el índice de Saturación (SI). Los análisis de zinc fueron realizados por espectrofotometría de absorción atómica, comparando personas mayores y adultos jóvenes. Una diferencia significativa fue encontrada (p< 0,001), entre los dos grupos, en relación al zinc plasmático e SI, siendo que la ZnBCPP no cambió entre los jóvenes y adultos mayores. Constatando este resultado, se demostró que en el grupo de jóvenes las variaciones en la ZnBCPP son explicadas en 76 por ciento (R²= 0,760) por las variaciones en el zinc plasmático en el SI. En el grupo de los mayores esta medida disminuye a 30,5 por ciento (R²= 0,305). Concluimos que el envejecimiento puede ser un factor asociado a los cambios en los mecanismos de control y homeostasis del zinc, alternando los patrones de respuesta relativos a ZnBCPP y algunos otros indicadores del estado nutricional relativo al zinc.

Estudo comparativo da cinética de degradação ruminal de forragens tropicais em bovinos e ovinos / Comparative study of ruminal degradation kinetics of tropical forages in cattle and sheep

Estimaram-se os parâmetros da cinética de degradação ruminal in situ da fibra em detergente neutro (DgFDN) da cana-de-açúcar e das silagens de capim-elefante, de milho e de sorgo em diferentes tempos de incubação, tamanhos de partícula (1 e 2mm) e espécies (ovinos e bovinos). A DgFDN foi obtida nos tempos de incubação: 3, 6, 12, 24, 36, 48, 72, 96, 120, 144 e 240 horas. A avaliação dos tamanhos de partículas e das espécies na degradabilidade foi realizada pelo teste de identidade de modelos de regressão não linear e interpretada pela análise de fatores. As taxas de degradação da FDN (k d) também foram estimadas, matematicamente, utilizando-se apenas de dois tempos de incubação in situ (tempos 6 e 24h ou 6 e 36h). Os valores de k d estimados em 2 tempos ou 11 tempos de incubação foram comparados pelo teste t com arranjo em pares. Os valores de k d estimados com dois tempos de incubação, quando comparados com os valores obtidos em vários tempos de incubação mostraram-se similares (P>0,05). Em estudos da cinética de degradação ruminal in situ da FDN, ovinos não devem ser considerados modelos experimentais para bovinos, mas o tamanho de partícula do alimento incubado, de 1 ou 2mm, tem pouca influência nos parâmetros de degradação ruminal.

The neutral detergent fiber degradability (NDFd) of sugar-cane, and elephantgrass, corn, and sorghum silages were predicted by in situ method, with different time points, sample grind sizes (1 and 2mm) and animal species (sheep and cattle). The feedstuffs were incubated at 3, 6, 12, 24, 36, 48, 72, 96, 120, 144, 240 hours. The effects of sample grind sizes and of the species in NDFd were analyzed through the test of identity of non-linear regression models and interpreted by factor analysis. The rates of degradation of NDF (k d) were also estimated for two times of incubation in situ (times 6 and 24h or 6 and 36h), and they were compared to the k d values estimated at the in situ trial, through the t statistical test. The k d values estimated by different time points and predicted by in situ incubation times were similar (P>0.05). There is little interference of particle size in degradation parameters, and the NDF degradation in situ trials in sheep can not be used as an experimental model for cattle.

Morphometric analysis of the thymus of puppies infected with the Snyder Hill Strain of canine distemper virus / Análise morfométrica do timo de cães filhotes infectados com a amostra Snyder Hill do vírus de cinomose canina

The thymic morphometry analysis was used for determining apoptosis and atrophy of the thymus of eight puppies inoculated with canine distemper virus (CDV). Three healthy dogs were used as negative controls. Sections, 5æm thick, were stained by HE and Shorr, and the latter were evaluated by morphometry. CDV nucleoprotein was detected by immunohistochemistry. Morphometric results confirmed lymphoid hypotrophy in CDV inoculated dog thymuses, more stroma, less parenchyma and higher apoptotic index/field than negative control (not inoculated) puppies. Apoptosis plays a role in the mechanism of thymus atrophy that develops in canine distemper.

Determinaram-se a apoptose e a atrofia no timo de oito cães novos, inoculados experimentalmente com o vírus de cinomose. Três cães saudáveis foram usados como controle negativo. Secções coradas pelo Shorr foram avaliadas por morfometria. A nucleoproteína viral foi detectada por imunoistoquímica. Os resultados morfométricos confirmaram a hipotrofia e mostraram que o timo dos cães inoculados tinha mais estroma, menos parênquima e maior índice apoptótico/campo que o dos animais-controle. Pode-se concluir que a apoptose desempenha importante papel no mecanismo de hipotrofia tímica que se desenvolve na cinomose.

Ultrasonido intraoperatorio en neurocirugía: aspectos técnicos / Intraoperative ultrasound in neurosurgery: technical aspects

Introducción. La ultrasonografía intraoperatoria en neurocirugía es una técnica útil, especialmente en la cirugía oncológica. Nuestro propósito es presentar los aspectos prácticos de su aplicación y a la vez describir nuestra experiencia inicial con su uso. Material y Métodos. Se empleó el ultrasonido TITAN™ de la empresa Sonosite Inc. Bothell, WA. USA con diferentes modelos de transductores. El estudio se realizó durante cuatro etapas de la cirugía: al realizar la craneotomía/laminotomía sobre la duramadre, al abrir duramadre sobre tejido neural, al resecar la lesión y posteriormente al cerrar la duramadre. Resultado. La identificación óptima de la lesión y de las estructuras anatómicas adyacentes se logró utilizando el transductor L38/5-10 Mhz. La adecuada visualización de las lesiones fue posible en todos los casos que se utilizó este transductor. No se logró una visualización adecuada en 2 casos en los cuales se utilizo el transductor C15/2-4 Mhz. Conclusión. La ultrasonografía intraoperatoria es útil en localizar lesiones e identificar estructuras anatómicas adyacentes. El transductor óptimo es uno que posea una cabeza de transductor pequeña plana (2.5cm x 1.5cm o menos) que emita frecuencias que oscilen entre 4-10 Mhz.

Fusión de imágenes en neurocirugía / Image fusion in neurosurgery

Introducción: La fusión de imágenes permite integrar el máximo de información anatómico-funcional en una sola imagen. Su aplicación es en neuronavegación y planificación de radiocirugía. Nuestro objetivo es presentar la experiencia inicial de, nuestro departamento en el uso de esta técnica. Método: Se fusionó información imagenológica anatómica-funcional en formato DICOM3.0, en una estación de trabajo SUN (ULTRAESPARC) los voxeles se transformaron a una matriz isotropica. En 4 casos se utilizó para planeación estereotáxica fusionando Tomografía Computada (TC), con Resonancia Magnética (RM). En 3 casos de cirugía de epilepsia se fusionó imágenes de zonas ictales de Tomografía Computada de Emisión de Fotones Únicos (SPECT), con RM y TC para asistir en procedimientos decirugía de epilepsia. Resultados: La fusión de imágenes de RM y TC resultó útil en cirugía estereotáxica puescombina la mejor resolución de la RM con la menor distorsión de la TC. En cirugía de epilepsia la fusión de imágenes ayudó a identificar y resecar el área de interés. Conclusión: La fusión de imágenes aparenta ser una herramienta útil para el neurocirujano. Nosotros vemos aplicación de esta tecnología para biopsias estereotáxicas de lesiones infecciosas o tumorales que no son visibles en TC pero sí en RM y también en eldespliegue de información imagenológica de aspectos anatómicos y metabólicos en cirugía de epilepsia y tumoral.