Adipose Tissue-Derived Stem Cells: The Biologic Basis and Future Directions for Tissue Engineering.

Mesenchymal stem cells (MSCs) have been isolated from a variety of tissues using different methods. Active research have confirmed that the most accessible site to collect them is the adipose tissue; which has a significantly higher concentration of MSCs. Moreover; harvesting from adipose tissue is less invasive; there are no ethical limitations and a lower risk of severe complications. These adipose-derived stem cells (ASCs) are also able to increase at higher rates and showing telomerase activity, which acts by maintaining the DNA stability during cell divisions. Adipose-derived stem cells secret molecules that show important function in other cells vitality and mechanisms associated with the immune system, central nervous system, the heart and several muscles. They release cytokines involved in pro/anti-inflammatory, angiogenic and hematopoietic processes. Adipose-derived stem cells also have immunosuppressive properties and have been reported to be "immune privileged" since they show negative or low expression of human leukocyte antigens. Translational medicine and basic research projects can take advantage of bioprinting. This technology allows precise control for both scaffolds and cells. The properties of cell adhesion, migration, maturation, proliferation, mimicry of cell microenvironment, and differentiation should be promoted by the printed biomaterial used in tissue engineering. Self-renewal and potency are presented by MSCs, which implies in an open-source for 3D bioprinting and regenerative medicine. Considering these features and necessities, ASCs can be applied in the designing of tissue engineering products. Understanding the heterogeneity of ASCs and optimizing their properties can contribute to making the best therapeutic use of these cells and opening new paths to make tissue engineering even more useful.

Relationship between soil solution electrochemical changes and methane and nitrous oxide emissions in different rice irrigation management systems.

Rice (Oryza sativa L.) intermittent irrigation is a potential strategy to mitigate methane (CH4) and nitrous oxide (N2O) emissions, but the effects of dry-wetting intervals on soil electrochemical changes and plant characteristics should be considered. This study was conducted in a greenhouse evaluating CH4 and N2O fluxes in rice under five different irrigation management practices (continuous irrigation (CI), intermittent irrigation with flooding resumption in saturated soil condition (SSI) and soil moisture at field capacity (FCI), saturated soil and irrigation resumption with soil moisture bellow field capacity (FCS), and soil at field capacity (FCD)) and its relation to plant development and global warming potential (GWP). Soil electrochemical conditions and CH4 and N2O emissions were expressively affected by irrigation management. The CI system presented the greatest CH4 flux (20.14 g m-2) and GWP (462.7 g m-2 eq. CO2), whereas intermittent irrigation expressively reduced CH4 emissions. Overall, the N2O flux was low (bellow 20 µg m-2 h-1) even with N application, with greater emissions occurring at the FCD treatment at the beginning of the rice season. Soil moisture at field capacity had no CH4 flux but presented greater GWP (271 g m-2 eq. CO2) than intermittent irrigation systems due to N2O flux while compromising rice plant development. The best soil moisture condition to initiate a flooding cycle during intermittent irrigation is at saturated soil conditions.

Persistence of granular corneal dystrophy type-1 deposits in the predescemetic layer after big-bubble deep anterior lamellar keratoplasty.

We report intraoperative finding of Granular Corneal Dystrophy Type-1 (GCD1) deposits after stromal pneumodissection in deep anterior lamellar keratoplasty (DALK) in a 61-year-old female. Pneumodissection was performed from the center to the periphery of the cornea, characterizing a big bubble type 1 technique which dissects the deep stroma from the predescemetic layer. After stromal removal, persistence of whitish deposits inside the predescemetic layer was noted. During post-operative evaluation, anterior biomicroscopy and anterior segment optical coherence tomography showed granular opacities between the patient's Descemet's membrane and the donor cornea, suggesting possible involvement of the predescemetic layer in GCD1. This may require the surgeon's attention to choose between DALK keratoplasty or penetrating keratoplasty.

Persistence of granular corneal dystrophy type-1 deposits in the predescemetic layer after big-bubble deep anterior lamellar keratoplasty / Persistência de depósitos da distrofia corneal granular tipo-1 na camada pre-Descemet após transplante lamelar anterior profundo

ABSTRACT We report intraoperative finding of Granular Corneal Dystrophy Type-1 (GCD1) deposits after stromal pneumodissection in deep anterior lamellar keratoplasty (DALK) in a 61-year-old female. Pneumodissection was performed from the center to the periphery of the cornea, characterizing a big bubble type 1 technique which dissects the deep stroma from the predescemetic layer. After stromal removal, persistence of whitish deposits inside the predescemetic layer was noted. During post-operative evaluation, anterior biomicroscopy and anterior segment optical coherence tomography showed granular opacities between the patient's Descemet's membrane and the donor cornea, suggesting possible involvement of the predescemetic layer in GCD1. This may require the surgeon's attention to choose between DALK keratoplasty or penetrating keratoplasty.

RESUMO Relatamos o achado intraoperatório de persistência dos depósitos de Distrofia Granular Tipo 1 (GCD1) após pneumodissecção estromal no transplante de córnea lamelar anterior profundo (DALK) em uma mulher de 61 anos. A pneumodissecção começou a partir do centro para a periferia da córnea, caracterizando uma big bubble tipo 1, que disseca o estroma profundo da camada pré-Descemet. Após a remoção do estroma, notamos a persistência de depósitos esbranquiçados no interior da camada pré-Descemet. Na avaliação pós-operatória, a biomicroscopia anterior e a tomografia de coerência óptica do segmento anterior evidenciaram opacidades granulares entre a membrana de Descemet e a córnea doadora, sugerindo o possível envolvimento da camada pré-Descemet na GCD1, o que pode chamar atenção do cirurgião para decidir entre manter o DALK ou converter para transplante penetrante.

Avaliação retrospectiva de 774 implantes cônicos de hexágono externo e interno, de superfície jateada com Al2O3 seguido de três ataques ácidos: acompanhamento clínico de sete anos / Retrospective evaluation of 774 external and internal hexagonal tapered surface dental implants with Al2O3 surface treatment followed by three acid-etching protocols: a 7-year follow-up

Objetivo: analisar o sucesso do tratamento através de implantes cônicos de hexágono externo e interno, de superfície jateada com Al2O3 seguido de três ataques ácidos, com acompanhamento clínico de sete anos. Material e métodos: foi realizado um estudo retrospectivo aprovado pelo comitê de ética da Universidade de Guarulhos, entre os anos de 2009 e 2016, no qual foram selecionados 136 pacientes após os critérios de inclusão e exclusão, sendo instalados 774 implantes cônicos de hexágono externo e interno nos maxilares. Após o tempo de osseointegração, os implantes receberam as coroas protéticas finais. Resultados: a avaliação retrospectiva de 774 implantes cônicos de hexágono externo e interno, de superfície jateada com Al2O3 seguido de três ataques ácidos, com um acompanhamento clínico de sete anos, resultou em índices totais de sucesso na osseointegração de 98,39%, com uma perda óssea marginal de 1,08 mm após este período. Conclusão: a previsibilidade de sucesso no tratamento através dos implantes cônicos de hexágono externo e interno, de superfície jateada com Al2O3 seguido de três ataques ácidos, foi de 98,3%. A qualidade óssea é fundamental na previsibilidade do tratamento.

Objective: to analyze the treatment success of Al2O3 sandblasted, acid-etched, external and internal tapered connection dental implants after 7 years of follow-up. Material and methods: upon approval by the Ethics Committee of the University of Guarulhos, a retrospective study involving 136 patients receiving 774 dental implants in the jaws was performed. After the osseointegration period, definitive prosthetic restorations were delivered. Results: after 7 years of follow-up, the overall success rate was of 98.33% with a marginal bone loss of 1.08 mm. Conclusion: the treatment predictability of alumina sandblasted, external and internal tapered implants was significant. Bone quality is fundamental for treatment success.

Tacrolimus eye drops as monotherapy for vernal keratoconjunctivitis: a randomized controlled trial.

PURPOSE: To assess the efficacy of monotherapy using tacrolimus eye drops versus sodium cromoglycate for the treatment of vernal keratoconjunctivitis (VKC). METHODS: Randomized double-masked controlled trial comparing the efficacy of tacrolimus 0.03% eye drops t.i.d. (Group 1) with sodium cromoglycate 4% eye drops t.i.d. (Group 2) for the symptomatic control of VKC at days 0, 15, 30, 45, and 90 of follow-up. Visual acuity, intraocular pressure, and other complications were evaluated to assess safety and side effects. RESULTS: In total, 16 patients were included, with 8 enrolled in each group. Two patients from Group 2 were excluded from the analysis at days 45 and 90 because of corticosteroid use. Most patients were male (81.8%) and presented with limbal VKC (56.3%). There were statistically significant differences in favor of tacrolimus in the following severity scores: itching at day 90 (p=0.001); foreign body sensation at day 15 (p=0.042); photophobia at day 30 (p=0.041); keratitis at day 30 (p=0.048); and limbal activity at days 15 (p=0.011), 30 (p=0.007), and 45 (p=0.015). No relevant adverse effects were reported, except for a burning sensation with tacrolimus, though this did not compromise treatment compliance. CONCLUSION: Treatment with tacrolimus was superior to sodium cromoglycate when comparing severity scores for symptoms of itching, foreign body sensation, and photophobia, as well as for signs of limbal inflammatory activity and keratitis.

Tacrolimus eye drops as monotherapy for vernal keratoconjunctivitis: a randomized controlled trial / Colírio de Tacrolimus 0, 03% como único agente antialérgico para o tratamento de ceratoconjuntivite primaveril: ensaio clínico randomizado

ABSTRACT Purpose: To assess the efficacy of monotherapy using tacrolimus eye drops versus sodium cromoglycate for the treatment of vernal keratoconjunctivitis (VKC). Methods: Randomized double-masked controlled trial comparing the efficacy of tacrolimus 0.03% eye drops t.i.d. (Group 1) with sodium cromoglycate 4% eye drops t.i.d. (Group 2) for the symptomatic control of VKC at days 0, 15, 30, 45, and 90 of follow-up. Visual acuity, intraocular pressure, and other complications were evaluated to assess safety and side effects. Results: In total, 16 patients were included, with 8 enrolled in each group. Two patients from Group 2 were excluded from the analysis at days 45 and 90 because of corticosteroid use. Most patients were male (81.8%) and presented with limbal VKC (56.3%). There were statistically significant differences in favor of tacrolimus in the following severity scores: itching at day 90 (p=0.001); foreign body sensation at day 15 (p=0.042); photophobia at day 30 (p=0.041); keratitis at day 30 (p=0.048); and limbal activity at days 15 (p=0.011), 30 (p=0.007), and 45 (p=0.015). No relevant adverse effects were reported, except for a burning sensation with tacrolimus, though this did not compromise treatment compliance. Conclusion: Treatment with tacrolimus was superior to sodium cromoglycate when comparing severity scores for symptoms of itching, foreign body sensation, and photophobia, as well as for signs of limbal inflammatory activity and keratitis.

RESUMO Objetivo: Demonstrar a eficácia do colírio de tacrolimus 0,03% como único agente antialérgico versus o colírio de cromoglicato de sódio 4% no tratamento de ceratoconjuntivite primaveril (CCP). Métodos: Ensaio clínico randomizado duplo-mascarado comparando a eficácia do colírio de tacrolimus 0,03% 3 vezes ao dia, versus o colírio de cromoglicato 4% 3 vezes ao dia, no controle dos sintomas e sinais de pacientes com o diagnóstico de ceratoconjuntivite primaveril, durante o período de 3 meses, com avaliações nos dias 0, 15, 30, 45 e 90. Acuidade visual, pressão intraocular e outras possíveis complicações foram avaliadas para determinar segurança e efeitos adversos. Resultados: Dezesseis pacientes foram incluídos no estudo, sendo que oito fizeram uso de colírio de tacrolimus 0,03% (Grupo 1) e oito fizeram uso de colírio de cromoglicato de sódio 4% (Grupo 2). Dois pacientes do Grupo 2 foram excluídos da análise dos dias 45 e 90, devido à necessidade de utilização de corticosteroide tópico. A maioria dos pacientes era do sexo masculino (81,8%) e 56,3% apresentavam a doença em sua forma limbar. Houve diferença estatisticamente significativa entre os Grupos 1 e 2 em relação à graduação de severidade para os sintomas de prurido no dia 90 (p=0,001), sensação de corpo estranho no dia 15 (p=0,042), fotofobia no dia 30 (p=0,041) e para os sinais de atividade inflamatória limbar nos dias 15 (p=0,011), 30 (p=0,007) e 45 (p=0,015), e ceratite no dia 30 (p=0,048). Nenhum efeito adverso relevante foi notado, exceto queixa de queimação ocular quando da instilação de tacrolimus, o que não comprometeu à adesão ao tratamento. Conclusão: O colírio de tacrolimus 0,03% foi superior ao colírio de cromoglicato de sódio 4% comparando a graduação de severidade para os sintomas de prurido, sensação de corpo estranho e fotofobia, assim como para os sinais de atividade inflamatória limbar e ceratite, em determinados períodos de tempo durante o seguimento.

Update and review of Urrets-Zavalia syndrome.

For more than half a century, Urrets-Zavalia syndrome (fixed dilated pupil) has been described as a postoperative complication of ophthalmic surgery. Since first reported as a complication of penetrating keratoplasty for keratoconus in patients receiving atropine, the characteristic features of Urrets-Zavalia syndrome have been expanded. In previous literature, a total of 110 cases resulted in a fixed and dilated pupil. Increased intraocular pressure (IOP) in the immediate postoperative period, phakia, and air or gas in the anterior chamber appear to be the most important risk factors for Urrets-Zavalia syndrome following ophthalmic procedures. Mannitol, IOP control, the removal of air or gas in the anterior chamber, and iridectomy have all demonstrated utility in managing Urrets-Zavalia syndrome.

Update and review of Urrets-Zavalia syndrome / Atualizando e revisando a síndrome de Urrets-Zavalia

ABSTRACT For more than half a century, Urrets-Zavalia syndrome (fixed dilated pupil) has been described as a postoperative complication of ophthalmic surgery. Since first reported as a complication of penetrating keratoplasty for keratoconus in patients receiving atropine, the characteristic features of Urrets-Zavalia syndrome have been expanded. In previous literature, a total of 110 cases resulted in a fixed and dilated pupil. Increased intraocular pressure (IOP) in the immediate postoperative period, phakia, and air or gas in the anterior chamber appear to be the most important risk factors for Urrets-Zavalia syndrome following ophthalmic procedures. Mannitol, IOP control, the removal of air or gas in the anterior chamber, and iridectomy have all demonstrated utility in managing Urrets-Zavalia syndrome.

RESUMO Por mais de meio século, a síndrome de Urrets-Zavalia (pupila fixa e dilatada) foi descrita como uma complicação pós-operatória em oftalmologia. Desde o primeiro relato após ceratoplastia penetrante em pacientes portadores de ceratocone em uso de atropina, seu conceito foi ampliado. Na literatura, um total de 110 casos resultaram em pupila fixa e dilatada. Aumento da pressão intraocular (PIO) no pós-operatório imediato, facia, ar ou gás na câmara anterior parecem ser fatores de risco importantes para o aparecimento da síndrome. Sua prevenção pode ser alcançada com o uso de manitol, controle adequado da PIO e quantidade de ar ou gás na camâra anterior e iridectomia.

Recién nacidos hospitalizados con malformaciones congénitas, retardo de crecimiento intrauterino, proporciones corporales / Hospitalized newborns with congenital abnormalities, intrauterine growth retardation, body proportionallity

Las malformaciones congénitas (MC) son causa importante de mortalidad infantil en Chile y en Latinoamérica y su proporcionalidad corporal ha sido poco estudiada. En la maternidad Universidad Católica los RN con MC están en el grupo de RNPEG y estudiamos ahora sus proporciones corporales, 2236 RN fueron hospitalizados en Neonatología entre el 1 de julio 1987 y 31 diciembre 1991 y sus datos prospectivamente registrados en fichas y en computador. Se verificaron manualmente fichas y autopsias y se compararon 107 RN con MC vs 2129 RN sin MC. Los RN con MC tuvieron letalidad 16 porciento vs 3,3 porciento (p<0.001, Z ratio test) 15 porciento RNPEG vs 9 porciento (p<0,05, Z test), IP de Röerher >p 90 en 26 porciento vs 9 porciento (p<0,01), TN 46,6 cm vs 48,5 (p<10 ni en circunferencia craneana. Se concluye que los RN con MC estudiados se ubican en el grupo de RNPEG, con PN, TN y PN/TN2 inferiores. No está claro que tenga utilidad la clasificación en simétricos o asimétricos (IP

Riesgo de morbilidad y mortalidad en recién nacidos de término según adecuación del peso a la edad gestacional / Morbidity and mortality risk in term newborns according to the adequate gestational age growth

Se estudiaron 21 725 recién nacidos de término consecutivos con el objeto de precisar los riesgos de morbilidad y mortalidad de acuerdo con su ubicación en los perceptiles de adecuación de su peso para la edad gestacional, según las curvas de crecimiento intrauterino recomendadas por el Minsiterio de salud de Chile. Diez por ciento eran pequeños, 82 por ciento adecuados y 8 por ciento grandes para la edad gestacional. La mortalidad y la hospitalización resultaron significativamente mayores en los pequeños (1 por ciento y 19 por ciento), que en los de peso adecuado (0,23 por ciento y 13 por ciento), p<0,001. La proporción de hospitalizaciones fue mayor en los recién nacidos grandes que en los de peso adecuado, p<0,002. Los niños pequeños para la edad gestacional ubicados bajo el perceptil 2 tuvieron más hospitalizacionesy mortalidad (2,9 y 41,7 por ciento) que los ubicados entre los perceptiles 2 y 10 (0,51 y 12,8 por ciento), p<0,001 y el de estos últimos mayor que en los de peso adecuado, p<0,001. Las categorías de quiebre para riesgos significativos de morbilidad o mortalidad fueron los perceptiles 2, 10 y 90

Crecimiento intrauterino en gemelos de término sin factores de riesgo / Intrauterine growth in term twins without risk factors

Se analizan los gemelos dobles sobre la curva de CIU confeccionada para fetos únicos. Se estudia el comportamiento de gemelos en relación a tabla, peso, circunferencia craneana e índice ponderal. Se seleccionan gemelos mayores de 36 semanas, sin patologías materna o fetal. Se concluye que el embarazo gemelar "per se" constituiría un factor de riesgo para el CIU, partícularmente en relación a la curva de peso

Talla, circunferencia craneana e índice ponderal en recién nacidos chilenos de clase media / Length, head circumference and weight index in middle class healthy newborn infants

Se describen los valores de talla, circunferencia craneana e índice ponderal según edad gestacional en 11.543 RN vivos en Hospital Clínico Universidad Católica de Chile, seleccionados sin factores de retardo de crecimiento intrauterino. Los percentiles 50 fueron 50 cm, 350 mm y 2,74 para talla, circunferencia craneana e índice ponderal, respectivamente, a la edad gestacional de 40 semanas

Estudo comparativo de hipotensäo, bradicardia e vômito entre bloqueios subaracnóides e peridurais / Comparative study of hypotension, bradycardia and vomiting between subarachnoid and peridural blocks

O resultado de um estudo longitudinal retrospectivo baseado numa série de 445 bloqueios centrais consecutivos é apresentado. Os pacientes foram divididos em dois grupos : o grupo A foi constituído por 262 pacientes que receberam bloqueio subaracnóideo, e o grupo B foi constituido por 193 pacientes que receberam bloqueio peridural. Aspectos importantes dessas técnicas de anestesia condutiva, tais como a escolha do anestésico local, o local da punçäo e o nível do bloqueio sensitivo säo discutidos. A incidência e outros aspectos expressivos dos principais para-efeitos que ocorreram durante a anestesia, nas duas técnicas empregadas, säo comparados, com ênfase nas alteraçöes cordiovasculares