Evaluation of ex vivo melanogenic response to UVB, UVA, and visible light in facial melasma and unaffected adjacent skin.

BACKGROUND: The independent role of solar radiation in the differential melanogenesis between melasma and adjacent skin is unknown. OBJECTIVES: To assess the melanogenic responses of skin with facial melasma and of the adjacent skin to UVB, UVA, and visible light, in an ex vivo model. METHODS: This was a quasi-experimental study involving 22 patients with melasma. Facial melasma and adjacent skin samples were collected and stored in DMEM medium, at room temperature. One fragment was placed under the protection from light, while another was exposed to UVB, UVA, and visible light (blue-violet component): 166 mJ/cm2, 1.524 J/cm2, and 40 J/cm2, respectively. Subsequently, all samples were kept for 72 hours in a dark environment and stained by Fontana-Masson to assess basal layer pigmentation, dendrites, and melanin granulation. RESULTS: Effective melanogenesis was observed in the basal layer in melasma and in the normal adjacent skin after all irradiations (p < 0.01), with the following median increment: UVB (4.7% vs. 8.5%), UVA (9.5% vs. 9.9%), and visible light (6.8% vs. 11.7%), with no significant difference between anatomical sites. An increase in melanin granulation (coarser melanosomes) was observed only after irradiation with UVA and only in the skin with melasma (p = 0.05). An increase in the melanocyte dendrite count induced by UVB radiation was observed in both anatomical sites (p ≤ 0.05). STUDY LIMITATIONS: Use of an ex vivo model, with independent irradiation regimes for UVB, UVA, and visible light. CONCLUSIONS: Melanogenesis induced by UVB, UVA, and visible light was observed both in melasma and in the adjacent skin. The morphological patterns suggest that different irradiations promote individualized responses on the skin with melasma.

Standardization of organoid culture for evaluation of melanogenesis induced by UVB, UVA and visible light.

BACKGROUND: Organoid cultures are primary cultures that maintain architectural characteristics and the relationships between cells, as well as the extracellular matrix. They are alternatives for pathophysiological or therapeutic investigation rather than animal and in vitro tests. OBJECTIVE: Development of a cutaneous organoid culture model, aiming at the study of radiation-induced melanogenesis. METHOD: A validation study, which involved biopsies of the skin of the back of the adult ear. One sample was irradiated with different doses of UVB, UVA, or visible light (VL); the other was maintained in the dark for 72h. The viability of the tissues was evaluated from the morphological and architectural parameters of the histology, and the expression of the glyceraldehyde-3-phosphate dehydrogenase (GAPDH) gene, by real-time polymerase chain reaction (PCR). The radiation-induced melanin pigmentation was standardized according to the doses of each radiation and evaluated by digital image analysis (Fontana-Masson). RESULTS: The primary skin culture was standardized at room temperature using DMEM medium. The doses of UVB, UVA, and VL (blue light) that induced differential melanogenesis were: 166mJ/cm2, 1.524J/cm2, and 40J/cm2. The expression of the GAPHD constitutional gene did not differ between the sample of skin processed immediately after tissue collection and the sample cultured for 72h in the standardized protocol. STUDY LIMITATIONS: This was a preliminary study that evaluated only the viability and integrity of the melanogenic system, and the effect of the radiation alone. CONCLUSIONS: The standardized model maintained viable melanocytic function for 72h at room temperature, allowing the investigation of melanogenesis induced by different forms of radiation.

Sclerotherapy for Reticular Veins in the Lower Limbs: A Triple-Blind Randomized Clinical Trial.

Importance: Reticular veins are subdermal veins located in the lower limbs and are mainly associated with aesthetic complaints. Although sclerotherapy is the treatment of choice for reticular veins in the lower limbs, no consensus has been reached regarding to the optimal sclerosant. Objective: To compare the efficacy and safety of 2 sclerosants used to treat reticular veins: 0.2% polidocanol diluted in 70% hypertonic glucose (HG) (group 1) vs 75% HG alone (group 2). Design, Setting, and Participants: Prospective, randomized, triple-blind, controlled, parallel-group clinical trial with patients randomly assigned in a 1:1 ratio between the 2 treatment groups from March through December 2014, with 2 months' follow-up. The study was conducted in a single academic medical center. Eligible participants were all women, aged 18 to 69 years, who had at least 1 reticular vein with a minimum length of 10 cm in 1 of their lower limbs. Interventions: The patients underwent sclerotherapy in a single intervention with either 0.2% polidocanol plus 70% HG or 75% HG alone to eliminate reticular veins. Main Outcomes and Measures: The primary efficacy end point was the disappearance of the reticular veins within 60 days after treatment with sclerotherapy. The reticular veins were measured on images obtained before treatment and after treatment using ImageJ software. Safety outcomes were analyzed immediately after treatment and 7 days and 60 days after treatment and included serious adverse events (eg, deep vein thrombosis and systemic complications) and minor adverse events (eg, pigmentation, edema, telangiectatic matting, and hematomas). Results: Ninety-three women completed the study, median (interquartile range) age 43.0 (24.0-61.0) years for group 1 and 41.0 (27.0-62.0) years for group 2. Sclerotherapy with 0.2% polidocanol plus 70% HG was significantly more effective than with 75% HG alone in eliminating reticular veins from the treated area (95.17% vs 85.40%; P < .001). No serious adverse events occurred in either group. Pigmentation was the most common minor adverse event, with a 3.53% treated-vein pigmentation length for group 1 and 7.09% for group 2, with no significant difference between the groups (P = .09). Conclusions and Relevance: Sclerotherapy with 0.2% polidocanol diluted in 70% HG was superior to 75% HG alone in sclerosing reticular veins, with no statistical difference for complications. Pigmentation occurred in both groups, with no statistical difference between them. No serious adverse events occurred in either group. Trial Registration: clinicaltrials.gov Identifier: NCT02054325.

Polidocanol versus glucose in the treatment of telangiectasia of the lower limbs (PG3T): Protocol for a randomized, controlled clinical trial.

BACKGROUND: Telangiectasias are defined as small venules abnormally dilated, located in the intradermal portion of the skin, of reddish or bluish tinge, their diameter not exceeding 1 mm; they are classified by the American Venous Forum as mild venous disease CEAP C1. Conventional treatment consists of chemical sclerotherapy, considered a minimally invasive technique with rapid clinical recovery. A wide variety of sclerosing solutions can be used for this purpose. METHODS/DESIGN: This project intends to include 96 patients that will be randomized to a triple-blind study. Inclusion criteria are women between 18 and 65 years, with telangiectasia on the lateral thigh. Male patients, female patients with chronic venous disease CEAP 2 to 6, women with allergies, pregnant, breastfeeding, with any type of skin problems or any decompensated clinical disease will be excluded. All patients included will be submitted to venous ultrasound mapping in order to rule out venous disease not clinically visible, deep venous system insufficiency, and insufficiency of the ostial valve of the great saphenous vein. One group will be treated with glucose 75% solution and the other will receive polidocanol 0.2% diluted in glucose 70%. Each patient will receive only 1 treatment session in 1 single member. The volume of sclerosing solution will not exceed 5 mL and the treatment area will be limited to a region of 150 cm on the lateral thigh. Clinical follow-up will be: 1 initial visit, when the clinical report will be filled; photographic record and treatment with sclerotherapy (D0); follow-up visits after 7 and 60 days (D7 and D60, respectively), always with clinical and photographic documentation. DISCUSSION: The project intends to evaluate the efficacy and safety of sclerotherapy in eliminating telangiectasia in a predetermined area in order to establish efficacy and safety parameters for the treatments presented. CONCLUSION: This protocol for clinical trial will provide date to determine the efficacy and safety of sclerotherapy with the solutions presented. TRIAL REGISTRATION IDENTIFIER: ClinicalTrial.gov NCT02657252 Date: 01/12/2016 (retrospectively registered).

Protocol optimization and histological analysis of in vitro plant regeneration of RB92579 and RB93509 sugarcane cultivars / Otimização do protocolo e análise histológica da regeneração in vitro de plantas dos cultivares de cana-de-açúcar RB92579 e RB93509

The objectives of this study were to establish appropriate conditions for obtaining plant regeneration and acclimatization of the 'RB92579' and 'RB93509' sugarcane cultivars and to elucidate the shoots origin through histological analysis. For both cultivars, obtaining shoots showed better results with the culture of explants on a callus induction medium containing 2.0mg L-1 2,4-dichlorophenoxyacetic acid, followed by cultivation on a shoot induction medium containing 0.1mg L-1 kinetin and 0.2mg L-1 benzilaminopurine. The MS medium without growth regulators proved to be appropriate for elongation and rooting of shoots and the use of the composed substrate of vermiculite + MS salts was effective for acclimatization. Histological analysis revealed that the origin of the shoots in both cultivars occurred through indirect organogenesis.

Os objetivos deste estudo foram estabelecer condições apropriadas para a obtenção de regeneração de plantas e aclimatização das cultivares 'RB92579' e 'RB93509' de cana-de-açúcar e elucidar a origem das brotações através da análise histológica. Em ambas as cultivares, as brotações obtidas apresentaram os melhores resultados com a cultura dos explantes em um meio de indução de calo contendo 2,0mg L-1 de ácido 2,4-diclorofenoxiacético, seguido do cultivo em meio indutor de brotações, contendo 0,1mg L-1 de cinetina e 0,2mg L-1 benzilaminopurina. O meio MS sem reguladores de crescimento foi adequado para o alongamento e enraizamento das brotações e da utilização do substrato composto de vermiculite + sais do meio MS, foi eficaz para a aclimatização. A análise histológica revelou que a origem das brotações em ambas as cultivares ocorreu via organogênese indireta.

Perspectivas da Medicina Tradicional e das práticas contemplativas na faculdade de medicina de Botucatu, UNESP / Perspectives of Traditional Medicine and Contemplative Practices at the Faculty of Botucatu medicine, UNESP

Introdução: A designação de saúde como "ausência de doença" sofreu uma alteração desde a criação da OMS, definindo-a como "o estado do mais completo bem-estar físico, mental e social e não apenas a ausência de enfermidade". A partir da década de 70, houve a hipervalorização do atendimento terciário em saúde e do tecnocentrismo, evidente com o processo de hospitalização e da tecnologia de ponta. Apesar de todo o avanço alcançado, tem-se observado um movimento considerável em várias partes do mundo em relação ao ensino e utilização de terapêuticas relacionadas à Medicina Tradicional (MT) e às Práticas Contemplativas (PC). Objetivo:Descrever as perspectivas da MT e das PC na Faculdade de Medicina de Botucatu (FMB), a partir da análise das ações que iniciaram a discussão sobre o tema. Metodologia: Análise descritiva e reflexiva dos fatos acadêmicos relacionados à MT e às PC que ocorreram na FMB. Resultados: Apesar do Hospital das Clínicas de Botucatu oferecer gratuitamente, desde 2000, atendimento homeopático e acupuntura, tendo atendido mais de 7000 pacientes, os graduandos não tinham a oportunidade de acompanhar o serviço. As práticas existentes eram restritas aos ambulatórios e não havia disciplinas optativas ou matérias curriculares oferecidas aos estudantes.A partir da demanda foram formados grupos de estudo sobre Homeopatia, Medicina Antroposófica e Espiritualidade. A fim de prover uma acessibilidade maior ao tema, em 2011 foi criada a Liga da Medicina Integrativa e Complementar. No mesmo ano ocorreram ainda o "I Congresso Médico Acadêmico de Acupuntura e Homeopatia", além de uma noite dedicada ao tema da Medicina Integrativa no 20° Congresso Médico Acadêmico de Botucatu. Conclusões:Incentivar o acesso ao conhecimento das abordagens que compõem a MT e as PC, não é apenas seguir uma tendência mundial, mas sim disponibilizar aos estudantes a possibilidade de um aprendizado que pode contribuir com a promoção do bem estar e da saúde integral do ser humano.