Effectiveness and safety of biological and target synthetic drugs treatment for psoriatic arthritis: a systematic review with network meta-analysis.

BACKGROUND: Psoriatic arthritis (PA) is a chronic inflammatory systemic arthritis that can result in loss of functional capacity and joint deformation. This systematic review assessed the effectiveness and safety of biological and target synthetic drugs for treating PA. METHODS: We searched for randomized clinical trials (RCTs) that evaluated the use of Adalimumab, Etanercept, Infliximab, Golimumab, Secukinumab, Certolizumab Pegol and Tofacitinib in the main general databases and clinical trial registers databases. The primary outcomes were ACR 50, PsARC, and serious adverse events. Two independent reviewers performed study selection and data extraction. Network meta-analyses were conducted using a random effects model and frequentist approach. The CINeMA software was used to assess the certainty of evidence. RESULTS: We included 33 RCTs (n = 11,034). The results from the network meta-analysis for the ACR 50 at 6-months follow-up showed that all drugs were superior to placebo, with Secukinumab (high certainty of evidence), Infliximab (very low certainty of evidence) and Adalimumab (high certainty of evidence) ranking the highest. Regarding the PsARC (at 6-months follow-up), all drugs, except for Golimumab (very low certainty of evidence), were superior to placebo, with Etanercept (low certainty of evidence), Infliximab (low certainty of evidence) and Certolizumab Pegol (low certainty of evidence) being the most effective drugs. There were no significant differences in the risk of serious adverse events between the drugs and placebo. Golimumab (very low certainty of evidence), Secukinumab (low certainty of evidence), and Adalimumab (very low certainty of evidence) ranked the highest for safety. CONCLUSIONS: In conclusion, based on the balance between efficacy and safety, Secukinumab and Adalimumab may be the preferred options among the evaluated drugs for treating patients with PsA. However, caution is necessary when interpreting the safety findings, as they are supported by evidence of low to very low certainty. Consequently, the balance between benefits and potential risks may change as new safety evaluation studies become available. PROTOCOL REGISTRATION: PROSPERO: CRD42022315577.

Rare Case of Complete Androgen Insensitivity Syndrome.

Androgen insensitivity syndrome is a rare X-linked recessive condition in which patients present a female phenotype. After complete androgen insensitivity syndrome (CAIS) diagnosis, the timing of gonadectomy should be evaluated, considering the risks and benefits of this procedure. This paper reports an uncommon case of complete androgen insensitivity syndrome diagnosed belatedly in an adult patient. Surgical treatment was deemed necessary due to the elevated risk of gonadal malignancy.

Forced Esthetic Position: A Diagnostic Strategy for Anteroposterior Repositioning in Orthognathic Surgeries.

Considering the esthetic goals involved in orthognathic surgeries, one of the challenges is to define the horizontal projection of the jaws. Most of the cephalometric analyses are focused on the position of the upper incisor and upper lip. Planning the correction of a mandibular retrognathism can be simplified by clinical simulation asking the patient to project their mandible. A forced esthetic position protocol is presented as a starting point for the planning in orthognathic cases.

Corrigendum: Assessment of the accuracy of 11 different diagnostic tests for the detection of Schistosomiasis mansoni in individuals from a Brazilian area of low endemicity using latent class analysis.

[This corrects the article DOI: 10.3389/fmicb.2022.1048457.].

Lipid oxidation dysregulation: an emerging player in the pathophysiology of sepsis.

Sepsis is a life-threatening organ dysfunction caused by abnormal host response to infection. Millions of people are affected annually worldwide. Derangement of the inflammatory response is crucial in sepsis pathogenesis. However, metabolic, coagulation, and thermoregulatory alterations also occur in patients with sepsis. Fatty acid mobilization and oxidation changes may assume the role of a protagonist in sepsis pathogenesis. Lipid oxidation and free fatty acids (FFAs) are potentially valuable markers for sepsis diagnosis and prognosis. Herein, we discuss inflammatory and metabolic dysfunction during sepsis, focusing on fatty acid oxidation (FAO) alterations in the liver and muscle (skeletal and cardiac) and their implications in sepsis development.

Impact of switching between reference biologics and biosimilars of tumour necrosis factor inhibitors for rheumatoid arthritis: a systematic review and network meta-analysis.

What is the impact of switching between biologics and biosimilars of adalimumab, etanercept, and infliximab on efficacy and safety for rheumatoid arthritis? A systematic review and network meta-analysis were performed to compare switching and non-switching groups of treatments. Pooled Risk Relative (RR) or standardised mean differences (SMD) with 95% credible intervals (95% CrIs) were obtained. Seventeen randomized trials with a switching phase involving 6,562 patients were included. Results showed that a single switch from biologics to biosimilars compared to continuing biologics had comparable effects for primary and co-primary outcomes, the American College of Rheumatology criteria with 20% response (ACR20) (7 trials, 1,926 patients, RR 0.98, 95% CrIs 0.93 to 1.03) and the Health Assessment Questionnaire-Disability Index (HAQ-DI) (5 trials, 1,609 patients, SMD - 0.07, 95% CrIs - 0.23 to 0.1), and within the equivalence margins: ACR20 [RR 0.94, 1.06] and HAQ-DI [SMD - 0.22, 0.22]. The risk of treatment-emergent adverse events, discontinuation, and positive anti-drug antibodies were comparable after switching. Safety results were imprecise, and the follow-up period might not be sufficient to evaluate long-term effects, especially malignancies. Overall, the practice of single switching between approved biologics and biosimilars of Tumour Necrosis Factor inhibitors is efficacious and safe for rheumatoid arthritis.

Therapeutic Equivalence of Biosimilar and Reference Biologic Drugs in Rheumatoid Arthritis: A Systematic Review and Meta-analysis.

Importance: Biosimilar drugs are potentially lower-cost versions of biologics that may improve access to therapy. However, there is a lack of adequate systematic reviews demonstrating equivalence between these drugs for the treatment of rheumatoid arthritis (RA). Objectives: To assess the efficacy, safety, and immunogenicity associated with biosimilars of adalimumab, etanercept, and infliximab compared with their reference biologics in patients with RA. Data Sources: MEDLINE via PubMed, Embase, Cochrane Central Register of Controlled Trials, and LILACS databases were searched from inception to September 2021. Study Selection: Head-to-head randomized clinical trials (RCTs) of biosimilars of adalimumab, etanercept, and infliximab and their biologic reference drugs for RA were assessed. Data Extraction and Synthesis: Two authors independently abstracted all data. Meta-analysis was conducted with bayesian random effects using relative risks (RRs) for binary outcomes and standardized mean differences (SMDs) for continuous outcomes, with 95% credible intervals (CrIs) and trial sequential analysis. Specific domains were assessed for the risk of bias in equivalence and noninferiority trials. This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline. Main Outcomes and Measures: Equivalence was tested using prespecified margins for the American College of Rheumatology criteria, with at least 20% improvement in the core set measures (ACR20) (ie, RR, 0.94 to 1.06), and for the Health Assessment Questionnaire-Disability Index (HAQ-DI) (ie, SMD, -0.22 to 0.22). Secondary outcomes included 14 items measuring safety and immunogenicity. Results: A total of 25 head-to-head trials provided data on 10 642 randomized patients with moderate to severe RA. Biosimilars met equivalence with reference biologics in terms of ACR20 response (24 RCTs with 10 259 patients; RR, 1.01; 95% CrI, 0.98 to 1.04; τ2 = 0.000) and change of HAQ-DI scores (14 RCTs with 5579 patients; SMD, -0.04; 95% CrI, -0.11 to 0.02; τ2 = 0.002) considering prespecified margins of equivalence. Trial sequential analysis found evidence for equivalence for ACR20 since 2017 and HAQ-DI since 2016. Overall, biosimilars were associated with similar safety and immunogenicity profiles compared with reference biologics. Conclusion and Relevance: In this systematic review and meta-analysis, biosimilars of adalimumab, infliximab, and etanercept were associated with clinically equivalent treatment effects compared with their reference biologics for the treatment of RA.

Initial Characterization of 3D Culture of Yolk Sac Tissue.

The role of the yolk sac (YS) in miscarriage is not yet clear, largely due to ethical reasons that make in vivo studies difficult to conduct. However, 3D cultures could provide a solution to this problem by enabling cells to be arranged in a way that more closely mimics the structure of the YS as it exists in vivo. In this study, three domestic species (porcine, canine, and bovine) were chosen as models to standardize 3D culture techniques for the YS. Two techniques of 3D culture were chosen: the Matrigel® and Hanging-Drop techniques, and the 2D culture technique was used as a standardized method. The formed structures were initially characterized using scanning electron microscopy (SEM), immunohistochemistry (IHC), and quantitative real-time PCR (RT-qPCR). In general, the 3D culture samples showed better organization of the YS cells compared to 2D cultures. The formed structures from both 3D methods assemble the mesothelial layer of YS tissue. Regarding the IHC assay, all in vitro models were able to express zinc and cholesterol transport markers, although only 3D culture techniques were able to generate structures with different markers pattern, indicating a cell differentiation process when compared to 2D cultures. Regarding mRNA expression, the 3D models had a greater gene expression pattern on the Hemoglobin subunit zeta-like (HBZ) gene related to the YS tissue, although no significant expression was found in Alpha-fetoprotein (AFP), indicating a lack of endodermal differentiation in our 3D model. With the initial technique and characterization established, the next step is to maintain the cultures and characterize the diversity of cell populations, stemness, functions, and genetic stability of each 3D in vitro model.

The McKenzie method for (sub)acute non-specific low back pain.

BACKGROUND: There is widespread agreement amongst clinicians that people with non-specific low back pain (NSLBP) comprise a heterogeneous group and that their management should be individually tailored. One treatment known by its tailored design is the McKenzie method (e.g. an individualized program of exercises based on clinical clues observed during assessment). OBJECTIVES: To evaluate the effectiveness of the McKenzie method in people with (sub)acute non-specific low back pain. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase and two trials registers up to 15 August 2022. SELECTION CRITERIA: We included randomized controlled trials (RCTs) investigating the effectiveness of the McKenzie method in adults with (sub)acute (less than 12 weeks) NSLBP. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by Cochrane. MAIN RESULTS: This review included five RCTs with a total of 563 participants recruited from primary or tertiary care. Three trials were conducted in the USA, one in Australia, and one in Scotland. Three trials received financial support from non-commercial funders and two did not provide information on funding sources. All trials were at high risk of performance and detection bias. None of the included trials measured adverse events. McKenzie method versus minimal intervention (educational booklet; McKenzie method as a supplement to other intervention - main comparison) There is low-certainty evidence that the McKenzie method may result in a slight reduction in pain in the short term (MD -7.3, 95% CI -12.0 to -2.56; 2 trials, 377 participants) but not in the intermediate term (MD -5.0, 95% CI -14.3 to 4.3; 1 trial, 180 participants). There is low-certainty evidence that the McKenzie method may not reduce disability in the short term (MD -2.5, 95% CI -7.5 to 2.0; 2 trials, 328 participants) nor in the intermediate term (MD -0.9, 95% CI -7.3 to 5.6; 1 trial, 180 participants). McKenzie method versus manual therapy There is low-certainty evidence that the McKenzie method may not reduce pain in the short term (MD -8.7, 95% CI -27.4 to 10.0; 3 trials, 298 participants) and may result in a slight increase in pain in the intermediate term (MD 7.0, 95% CI 0.7 to 13.3; 1 trial, 235 participants). There is low-certainty evidence that the McKenzie method may not reduce disability in the short term (MD -5.0, 95% CI -15.0 to 5.0; 3 trials, 298 participants) nor in the intermediate term (MD 4.3, 95% CI -0.7 to 9.3; 1 trial, 235 participants). McKenzie method versus other interventions (massage and advice) There is very low-certainty evidence that the McKenzie method may not reduce disability in the short term (MD 4.0, 95% CI -15.4 to 23.4; 1 trial, 30 participants) nor in the intermediate term (MD 10.0, 95% CI -8.9 to 28.9; 1 trial, 30 participants). AUTHORS' CONCLUSIONS: Based on low- to very low-certainty evidence, the treatment effects for pain and disability found in our review were not clinically important. Thus, we can conclude that the McKenzie method is not an effective treatment for (sub)acute NSLBP.

Esthetic Considerations In Minimally Invasive Orthognathic Surgery.

Orthognathic surgery has long been successfully utilized to correct dentofacial deformities to help facilitate improved oral function and facial esthetics. The treatment, however, has been associated with a high degree of complexity and severe postoperative morbidity. More recently, minimally invasive orthognathic surgical procedures have emerged that offer potential long-term benefits such as less morbidity, a lower inflammation response, improved postoperative comfort, and better esthetic outcomes. This article examines the concept of minimally invasive orthognathic surgery (MIOS), discussing differences from traditional maxillary Le Fort I osteotomy, bilateral sagittal split osteotomy, and genioplasty procedures. MIOS protocols are described for various aspects of both the maxilla and mandible.

Ozone therapy: protocol for treating canine parvovirus infection.

Canine Parvovirus infection is a disease caused by Canine Parvovirus (CPV) that results in hemorrhagic gastroenteritis and secondary infections, mainly in puppies between six weeks and six months old that are not immunized. Since there is no specific treatment for the condition, supportive therapy based on antibiotics, antiemetics, and non-steroidal anti-inflammatory drugs is traditionally used. Ozone therapy is an economical treatment that has bactericidal, fungicidal, and antiviral properties, besides promoting oxygenation and tissue regeneration, as well as anti-inflammatory and analgesic effects, and was used as a complementary therapy in this study. Therefore, four mixed-breed dogs, aged between 2 and 3 months, with no previous immunization against CPV and testing positive for the virus in a rapid test were selected. The animals were randomly distributed into two groups, being 1: the control group (n=2) that received only supportive treatment; and 2: the experimental group (n=2), that in addition to conventional therapy received intravenously 500 mL of ozonized Ringer's Lactate solution. Before treatment and after 24 and 48 hours, the following clinical signs were evaluated: episodes of emesis and diarrhea, weight, hydration, blood glucose level, abdominal pain, and blood count. One control group animal died within the first hours of hospitalization. Both animals in the experimental group presented faster resolution of diarrheal episodes and shorter hospitalization time when compared to the surviving animal that received only supportive treatment. Although further studies are needed, ozone therapy showed promising results for the treatment of canine parvovirus.

A Parvovirose canina é uma doença infecciosa causada pelo Parvovírus Canino (CPV) que resulta em gastroenterite hemorrágica e infecções secundárias, principalmente em cachorros entre seis semanas e seis meses de idade não imunizados. Como não existe tratamento específico para a doença, utiliza-se tradicionalmente terapia de suporte baseada em antibióticos, antieméticos, e anti-inflamatórios não esteroides. A Ozonioterapia é um tratamento econômico com propriedades bactericidas, fungicidas e antivirais, além de promover a oxigenação e a regeneração dos tecidos, efeitos anti-inflamatórios e analgésicos, e foi utilizada como terapia complementar neste estudo. Neste estudo, foram selecionados quatro cães sem raça definida, com idades entre 2 e 3 meses, sem imunização prévia contra CPV, que testaram positivo para o vírus em um teste rápido. Os animais foram distribuídos aleatoriamente em dois grupos, sendo 1: o grupo controle (n=2) que recebeu apenas tratamento de suporte; e 2: o grupo experimental (n=2), que além da terapia convencional recebeu por via intravenosa 500 mL de Lactato de Ringer ozonizado. Antes do tratamento, após 24 e 48 horas, foram avaliados os seguintes sinais clínicos: episódios de êmese e diarreia, peso, hidratação, glicemia, dores abdominais, e hemograma. Um animal do grupo controle foi a óbito nas primeiras horas de internação. Ambos os animais do grupo experimental apresentaram uma resolução mais rápida dos episódios de diarreia e um tempo de internação mais curto quando comparado com o animal sobrevivente que recebeu apenas tratamento de suporte. Embora sejam necessários mais estudos, a ozonoterapia demonstrou resultados promissores para o tratamento do parvovírus canino.

No país do futebol, como se ensina a jogar? Um estudo de revisão / In the country of football, how to teach to play? A systematic review study / En el país del fútbol, ¿cómo enseñar a jugar? Un estudio de revisión sistemática

O objetivo da presente investigação consiste em identificar e descrever estudos empíricos nacionais que se debrucem sobre os processos de ensino, vivência, aprendizagem e treinamento do futebol, em diferentes níveis de prática no contexto brasileiro. Foi realizada uma revisão do tipo overview em 39 periódicos nacionais (QUALIS CAPES 2013-2016, área 21), entre os anos 2001 e 2021. Os 12 artigos selecionados, produzidos em quatro regiões do Brasil, discutiram três principais temáticas: métodos de ensino; formação e atuação de treinadores; e prática dos atletas. Os achados alinham-se aos principais temas discutidos pela Pedagogia do Esporte, mas também apontam para uma importante lacuna na agenda investigativa da área, quanto a pesquisas que visam compreender os variados aspectos constituintes dos ambientes futebolísticos brasileiros.

The aim of this investigation is to identify and describe studies national empirical studies that focus on the processes of teaching, experience, football learning and training, at different levels of practice in the context Brazilian. An overview review was carried out in 39 national journals (QUALIS CAPES 2013-2016, area 21), between the years 2001 and 2021. The 12 articles selected, produced in four regions of Brazil, discussed three main themes: teaching methods; formation and performance of coaches; and practice of athletes. The findings are in line with the main themes discussed by Sport Pedagogy, but also point to an important gap in the investigative agenda of the area, regarding the research that aims to understand the various constituent aspects of environments understand the various constituent aspects of Brazilian football environments.

El objetivo de esta investigación es identificar y describir los estudios empíricos nacionales que se centran en los procesos de enseñanza, experiencia, aprendizaje y entrenamiento de fútbol, en diferentes niveles de práctica en el contexto Brasileño. Se realizó una revisión general en 39 revistas nacionales (QUALIS CAPES 2013-2016, área 21), entre los años 2001 y 2021. Los 12 artículos seleccionados, producidos en cuatro regiones de Brasil, discutieron tres principales temas: métodos de enseñanza; formación y desempeño de entrenadores; y práctica de los atletas. Los hallazgos están en línea con los principales temas discutidos por la Pedagogía del Deporte, pero también apuntan a un importante vacío en la agenda investigativa del área, en cuanto a la investigación que tiene como objetivo comprender los diversos aspectos constitutivos de los entornos del fútbol brasileño.

Adipose and amnion-derived mesenchymal stem cells: Extracellular vesicles characterization and implication for reproductive biotechnology.

The stem cell-based research for reproductive biotechnology has been widely studied and shows promise for repairing defective tissue or degenerated cells to treat different diseases. The adipose tissue and amniotic membrane have awakened great interest in regenerative medicine and arises as a promising source of mesenchymal stem cells. Both types, adipose and amniotic derived mesenchymal stem cells (AMSCs) are multipotent cells with an enhanced ability to differentiate into multiple lineages.. We aimed to evaluate the effect of basal supplementation of exosomes in cell cultures with canine amniotic mesenchymal stem cells (MSCs). Mesenchymal stem cells derived from canine amniotic and adipose tissue were isolated and cultured performing cell passages until 80-90% confluence was reached. The growth curve was determined and peak cell growth was observed in the second passage. The cells were then characterized and differentiated into adipogenic, chondrogenic and osteogenic lineages. Extracellular vesicles from amnion were isolated using an ultracentrifugation protocol and characterized by nanosight analysis. To evaluate their ability to improve cellular viability in naturally inefficient passages, exosomes were co-cultures to the MSC cells. The results showed a 15-20% increase in the expansion rate of cultures supplemented with vesicles extracted in the first and second passages when compared to the control group. Statistical analysis using the Dunnett test (p ≤ 0.05) corroborated this result, showing a positive correlation between supplementation and expansion rate. These results indicate not only the importance of exosomes in the cell communication process but also the feasibility of the culture supplementation protocol for therapeutic purposes. The potential of the AMSCs for reproductive biotechnology is undoubted, however, their application to repair reproductive disorders and the involved mechanisms remain elusive. The strategies to enable the Adipose Stem Cells and AMSCs application in reproductive biotechnology and optimize their use for tissue regeneration open new venues using exosomes interactions.

A novel guide for minimally invasive genioplasty.

Mentoplasty or genioplasty is a simple procedure to enhance facial aesthetics. While usually considered simple, it might present certain difficulties during execution, especially when a minimally invasive approach is preferred. Drilling and cutting guides are a valuable tool to overcome such challenges but usually require larger incision and dissection to allow adequate positioning and bone rigid fixation. In this article, we describe a novel guide design that permits adequate bone repositioning while preserving minimally invasive protocols.

Secretion pattern of canine amniotic stem cells derived extracellular vesicles.

Extracellular vesicles (EVs) derived from stem cells (SCs) have regenerative potential and the possibility of being used in treating chronic diseases. EVs present lower risk of tumorigenicity and easily to isolation and storage. Therefore, this research aims to compare the morphological characteristics of the EVs (up to 150nm) derived from stem cells obtained from canine amniotic membranes in different passages during the in vitro culture. For this, cells from the amniotic membranes were isolated, cultured, and characterized. In order to answer our aim, the number of cells was normalized at each passage to generate conditioned media for EVs separation. The cells were differentiated into adipogenic, chondrogenic, and osteogenic tissue, to characterize these cells as mesenchymal stem cells (MSC). Moreover, flow cytometry analysis was performed and showed that the MSC were positive for CD90, CD105 and negative for CD34, CD45, mesenchymal and hematopoietic markers, respectively. For EVs analysis, MSC in different passages (P0-P2) were culture until 80% of confluence, then the medium was replaced by EVs depleted medium. After 48h, culture medium was collected and centrifuged to separate EVs, followed by nanoparticle tracking analysis. The EVs were also characterized by western blot and transmission electron microscopy (TEM). EVs were positive for Alix and negative for Cytochrome C as well as presented the traditional cup-shape by transmission electronic microscopy. Our results demonstrated that the concentration in the different passages was increased in P0 compared to P1 and P2 (p<0.05). No differences were found in EVs size (P0=132nm, P1=130nm and P2=120nm). Together, these results demonstrate that P0 of MSC is enriched of EVs when compared to later passages, suggesting that this passage would be the best to be applied in pre-clinical tests. Despite that, more studies are necessary to identify the EVs content and how the cells will respond to treatment with them.

Characterization of main pulmonary artery and valve annulus region of piglets using echocardiography, uniaxial tensile testing, and a novel non-destructive technique.

Characterization of cardiovascular tissue geometry and mechanical properties of large animal models is essential when developing cardiovascular devices such as heart valve replacements. These datasets are especially critical when designing devices for pediatric patient populations, as there is often limited data for guidance. Here, we present a previously unavailable dataset capturing anatomical measurements and mechanical properties of juvenile Yorkshire (YO) and Yucatan (YU) porcine main pulmonary artery (PA) and pulmonary valve (PV) tissue regions that will inform pediatric heart valve design requirements for preclinical animal studies. In addition, we developed a novel radial balloon catheter-based method to measure tissue stiffness and validated it against a traditional uniaxial tensile testing method. YU piglets, which were significantly lower weight than YO counterparts despite similar age, had smaller PA and PV diameters (7.6-9.9 mm vs. 10.1-12.8 mm). Young's modulus (stiffness) was measured for the PA and the PV region using both the radial and uniaxial testing methods. There was no significant difference between the two breeds for Young's modulus measured in the elastic (YU PA 84.7 ± 37.3 kPa, YO PA 79.3 ± 15.7 kPa) and fibrous regimes (YU PA 308.6 ± 59.4 kPa, YO PA 355.7 ± 68.9 kPa) of the stress-strain curves. The two testing techniques also produced similar stiffness measurements for the PA and PV region, although PV data showed greater variation between techniques. Overall, YU and YO piglets had similar PA and PV diameters and tissue stiffness to previously reported infant pediatric patients. These results provide a previously unavailable age-specific juvenile porcine tissue geometry and stiffness dataset critical to the development of pediatric cardiovascular prostheses. Additionally, the data demonstrates the efficacy of a novel balloon catheter-based technique that could be adapted to non-destructively measure tissue stiffness in situ.

Mouse Model of Oleic Acid-Induced Acute Respiratory Distress Syndrome.

Acute respiratory distress syndrome (ARDS) is a significant threat to critically ill patients with a high fatality rate. Pollutant exposure, cigarette smoke, infectious agents, and fatty acids can induce ARDS. Animal models can mimic the complex pathomechanism of the ARDS. However, each of them has limitations. Notably, oleic acid (OA) is increased in critically ill patients with harmful effects on the lung. OA can induce lung injury by emboli, disrupting tissue, altering pH, and impairing edema clearance. OA-induced lung injury model resembles various features of ARDS with endothelial injury, increased alveolar permeability, inflammation, membrane hyaline formation, and cell death. Herein, induction of lung injury is described by injecting OA (in salt form) directly into the lung and intravenously in a mouse since it is the physiological form of OA at pH 7. Thus, the injection of OA in the salt form is a helpful animal model to study lung injury/ARDS without causing emboli or altering the pH, thereby getting close to what is happening in critically ill patients.

Causes and characteristics of uveitis cases at a reference university hospital in Rio de Janeiro, Brazil / Causas e características das uveítes em hospital universitário de referência no Rio de Janeiro, Brasil

ABSTRACT Purpose: The aim of this study was to describe the epidemiological profile of uveitis cases treated at University Hospital Clementino Fraga Filho and to identify the presentation pattern of intraocular inflammation on the basis of clinical, anatomical, etiological, and demographic criteria. Methods: A retrospective study was conducted using data from the medical records of 408 patients with active disease who attended the ophthalmology service between March and October 2018. Age, sex, visual acuity at the time of diagnosis, anatomical and etiological diagnoses, the clinical aspect, and the main symptoms reported during anamnesis were described. Results: Of the 408 patients in the study, 52% were male and 48% were female. The patients' mean age was 42 years, and most (84%) were between 19 and 64 years old. Anterior uveitis was observed in 37.75% of the patients; posterior uveitis, in 49.75%; panuveitis, in 4.66%; and intermediate uveitis, in 3.43%. Only 18 patients (4.41%) presented with scleritis. Of the 390 patients with anatomical classifications, 76% had known etiologies, with the most prevalent diagnoses being toxoplasmosis (35.4%), followed by juvenile idiopathic arthritis (6.4%), ankylosing spondylitis (5.9%), and syphilis (4.9%). Infectious uveitis corresponded to 49.7% of the patients, while 26.6% of the cases were of noninfectious origin. Anterior uveitis had the highest number of cases classified as idiopathic (49.4%). In the cases of posterior uveitis, the etiology was established 94% of the time. The most frequent symptoms were ocular pain (71.8%) and blurring vision (56.8%). Conclusions: The present study confirmed the historical importance of infectious uveitis in our population, especially ocular toxoplasmosis. Uveitis appears to have no predilection for sex but mainly affects young people of working age, thus generating social and economic consequences. Despite the evolution of diagnostic methods, idiopathic uveitis remains one of the major etiologies. Epidemiological studies point to different presentation patterns of uveitis in different populations, but these may reflect the distinct characteristics of each institution.

RESUMO Objetivo: Descrever o perfil epidemiológico das uveítes atendidas no Hospital Universitário Clementino Fraga Filho - UFRJ. Identificando o padrão de apresentação da inflamação intraocular a partir de critérios clínicos, anatômicos, etiológicos e demográficos. Métodos: Estudo retrospectivo, com base em prontuários de 408 pacientes com doença ativa, atendidos no serviço de oftalmologia no período de março a outubro de 2018. Foram descritos a idade, sexo, acuidade visual no momento do diagnóstico, diagnóstico anatômico e etiológico, aspecto clínico, além dos principais sintomas relatados durante a anamnese. Resultados: Dos 408 pacientes do estudo, 52% eram do sexo masculino e 48% do feminino. A idade média dos pacientes foi de 42 anos, a maioria (84%) entre 19 e 64 anos. Uveíte anterior foi observada em 37,75% dos pacientes, uveíte posterior em 49,75%, panuveíte em 4,66% e uveíte intermediária em 3,43%; apenas 18 pacientes (4,41%) apresentaram diagnóstico de esclerite. Dos 390 pacientes com classificação anatômica, a etiologia foi determinada em 76% deles, com os diagnósticos mais prevalentes sendo Toxoplasmose (35,4%), artrite idiopática juvenil (6,4%), espondilite anquilosante (5,9%) e sífilis (4,9%). ) A uveíte infecciosa correspondeu a 49,7% desses pacientes, enquanto 26,6% eram de origem não infecciosa. A uveíte anterior teve o maior número de casos classificados como idiopáticos (49,4%), enquanto a uveíte posterior teve a etiologia estabelecida em 94% das vezes. Os sintomas mais frequentes foram dor ocular (71,8%) e visão embaçada (56,8%). Conclusões: O presente estudo confirmou a importância histórica da uveíte infecciosa em nossa população, principalmente a toxoplasmose ocular. As uveítes parecem não ter predileção por sexo, mas afetam principalmente jovens em idade ativa, gerando consequências sociais e econômicas. Apesar da evolução nos métodos diagnósticos, a uveíte idiopática continua sendo uma das principais causas. Estudos epidemiológicos apontam para diferentes padrões de uveíte nas populações, estes podem refletir características particulares de cada instituição.

Causes and characteristics of uveitis cases at a reference university hospital in Rio de Janeiro, Brazil.

PURPOSE: The aim of this study was to describe the epidemiological profile of uveitis cases treated at University Hospital Clementino Fraga Filho and to identify the presentation pattern of intraocular inflammation on the basis of clinical, anatomical, etiological, and demographic criteria. METHODS: A retrospective study was conducted using data from the medical records of 408 patients with active disease who attended the ophthalmology service between March and October 2018. Age, sex, visual acuity at the time of diagnosis, anatomical and etiological diagnoses, the clinical aspect, and the main symptoms reported during anamnesis were described. RESULTS: Of the 408 patients in the study, 52% were male and 48% were female. The patients' mean age was 42 years, and most (84%) were between 19 and 64 years old. Anterior uveitis was observed in 37.75% of the patients; posterior uveitis, in 49.75%; panuveitis, in 4.66%; and intermediate uveitis, in 3.43%. Only 18 patients (4.41%) presented with scleritis. Of the 390 patients with anatomical classifications, 76% had known etiologies, with the most prevalent diagnoses being toxoplasmosis (35.4%), followed by juvenile idiopathic arthritis (6.4%), ankylosing spondylitis (5.9%), and syphilis (4.9%). Infectious uveitis corresponded to 49.7% of the patients, while 26.6% of the cases were of noninfectious origin. Anterior uveitis had the highest number of cases classified as idiopathic (49.4%). In the cases of posterior uveitis, the etiology was established 94% of the time. The most frequent symptoms were ocular pain (71.8%) and blurring vision (56.8%). CONCLUSIONS: The present study confirmed the historical importance of infectious uveitis in our population, especially ocular toxoplasmosis. Uveitis appears to have no predilection for sex but mainly affects young people of working age, thus generating social and economic consequences. Despite the evolution of diagnostic methods, idiopathic uveitis remains one of the major etiologies. Epidemiological studies point to different presentation patterns of uveitis in different populations, but these may reflect the distinct characteristics of each institution.

Time to face the proofs: the BCG Moreau vaccine promotes superior inflammatory cytokine profile in vitro when compared with Russia, Pasteur, and Danish strains.

Tuberculosis (TB) has been a major public health problem worldwide, and the Bacillus Calmette-Guérin (BCG) vaccine is the only available vaccine against this disease. The BCG vaccine is no longer a single organism; it consists of diverse strains. The early-shared strains of the BCG vaccine are stronger immunostimulators than the late-shared strains. In this study, we have employed a simple in vitro human model to broadly evaluate the differences among four widely used BCG vaccines during the characterization of strain-specific host immune responses. In general, the BCG Moreau vaccine generated a higher inflammatory cytokine profile and lower TGF-ß levels compared with the Russia, Pasteur, and Danish strains in the context of early sensitization with TB; however, no changes were observed in the IL-23 levels between infected and noninfected cultures. Unsurprisingly, the BCG vaccines provided different features, and the variances among those strains may influence the activation of infected host cells, which ultimately leads to distinct protective efficacy to tackle TB.