Physician-Modified Endovascular Grafts for Zone-2 Thoracic Endovascular Aortic Repair.

OBJECTIVE: This study aims to describe our technique and early experience with physician-modified endovascular grafts (PMEGs) for aortic arch diseases in zone 2. We used a total endovascular technique based on a single fenestrated endograft to preserve left subclavian artery (LSA) patency. METHODS: From December 2019 to August 2020, six consecutive patients with a variety of thoracic aortic diseases were treated with handmade fenestrated thoracic aortic grafts: four aortic dissections, one penetrating aortic ulcer, and one intramural hematoma. The planning, endograft modification, surgical technique, and follow-up of the patients were described. We evaluated immediate technical success and after 30 days, the LSA patency, Type-1 endoleak, and postoperative complications. RESULTS: Thoracic endovascular aortic repair (TEVAR) was performed for zone 2 in all cases. Immediate technical success, defined as successful alignment of the LSA with a covered stent and no Type-1 endoleak, was achieved in all cases. Patients had a 30-day follow-up computed tomography, which demonstrated LSA patency and no Type-I endoleaks. To date, no strokes, left arm ischemia, paraplegia, or conversions to open surgery have been reported; one patient operated for acute Type B dissection died during the early follow-up. CONCLUSION: TEVAR for zone 2 with a PMEG to maintain LSA patency achieved technical success and early durability. It is expected that with longer follow-up and a larger number of cases, these results will be confirmed.

Microbiological Species and Antibiotic Resistance in Diabetic and Nondiabetic Lower Extremity Wounds: A Comparative Cross-Sectional Study.

Severe lower extremity wounds have an increased risk of complications and limb loss. The aim of this study was to evaluate and compare the microbiological profile and antibiotic resistance of wounds in diabetic and nondiabetic patients. A cross-sectional comparative study was carried out at a public hospital including 111 patients with moderate to severe wound infections. Tissue samples were collected during a surgical procedure. One hundred and four patients (94%) had positive cultures and 88 (79%) had a Gram-negative microorganism. Among the 185 cultured microorganisms, 133 (72%) were Gram-negative species. Pseudomonas aeruginosa (23 cases) was the most isolated Gram-negative species, and Enterococcus faecalis (26 cases) was the most prevalent Gram-positive species. Among 185 isolated species, 45 (24%) were extended-spectrum beta-lactamase producers, 23 (12%) were carbapenem-resistant, and 5 (3%) were methicillin-resistant Staphylococcus aureus. Findings revealed that there was no significant difference in the microbiological profile and antibiotic resistance among patients with lower extremity wounds whether they were diabetic or nondiabetic.

Seafood Waste as Attractive Source of Chitin and Chitosan Production and Their Applications.

Chitosan is a cationic polymer obtained by deacetylation of chitin, found abundantly in crustacean, insect, arthropod exoskeletons, and molluscs. The process of obtaining chitin by the chemical extraction method comprises the steps of deproteinization, demineralization, and discoloration. To obtain chitosan, the deacetylation of chitin is necessary. These polymers can also be extracted through the biological extraction method involving the use of microorganisms. Chitosan has biodegradable and biocompatible properties, being applied in the pharmaceutical, cosmetic, food, biomedical, chemical, and textile industries. Chitosan and its derivatives may be used in the form of gels, beads, membranes, films, and sponges, depending on their application. Polymer blending can also be performed to improve the mechanical properties of the bioproduct. This review aims to provide the latest information on existing methods for chitin and chitosan recovery from marine waste as well as their applications.

Effects of source and concentration of neutral detergent fiber from roughage in beef cattle diets: Comparison of methods to measure the effectiveness of fiber.

Methods have been developed to measure the effectiveness of many roughages, but few evaluations have been conducted with tropical feeds. The objectives of this research were to determine the effectiveness of roughage sources based on bioassay and laboratory methods and identify the biological attributes of the diets that correlate with these methods. Six ruminally cannulated Nellore steers (408 ± 12 kg of BW) were randomly assigned to a 6 × 6 Latin square design within six diets: negative control diet (NC) with aNDF as 10% from corn silage (CS); positive control diet (PC) with aNDF as 20% from CS; and four diets containing 10% aNDF from CS and 10% aNDF from each of the following sources: sugarcane (SC), sugarcane bagasse (SCB), soybean hulls (SH), or low oil cottonseed hulls (LOCH). Physical effectiveness factor (pef, related to the physical characteristics of aNDF) and effectiveness factor (ef, related to the ruminal pH) were determined based on a linear model approach that uses a bioassay method in which CS aNDF was assumed to be the standard fiber source. Laboratory methods to estimate pef of roughage sources were based on the proportion of DM of roughage retained on a 1.18-mm sieve pef(>1.18 mm) or retained on the 8.0-mm Penn State Particle Separator screen pef(>8.0 mm). The pef calculated by the bioassay method (total chewing time and ruminal mat resistance) for CS, SCB, and SC were higher values (P < 0.05) compared with SH and LOCH. The pef(rumen mat) of SC and SCB were higher (P < 0.05) than that of CS, SH, and LOCH. The pef(rumen mat) of LOCH was 61% higher than SH. The ef(rumen pH) of SC and LOCH was higher (P < 0.05) than CS and SH. The pef(chewing, min/d), pef(chewing, min/kg of DM), pef(rumen mat), and ef(rumen pH) positively correlated with rumination time, total chewing time, and ruminal mat resistance (values from transit time in seconds). No correlation was observed (P > 0.05) between pef(>8.0 mm) and rumination time, chewing time, and ruminal pH. The pef calculated using the bioassay method as well as pef (>8.0 mm) were negatively correlated with rumen pH (P > 0.05). The values of the effectiveness of fiber sources obtained in this research can be used as a guideline for nutritionists aiming to replace roughage sources from tropical regions in beef cattle finishing diets. Under our conditions, the pef using the bioassay method or laboratory methods were not adequate in predicting ruminal pH.

Effects of source and concentration of neutral detergent fiber from roughage in beef cattle diets on feed intake, ingestive behavior, and ruminal kinetics.

The objectives of this research were to evaluate the effects of source and concentration of α-amylase-treated neutral detergent fiber (aNDF) from roughage on feed intake, ingestive behavior, and ruminal kinetics in beef cattle receiving high-concentrate diets. Six ruminally cannulated Nellore steers (408 ± 12 kg of body weight) were randomly assigned to a 6 × 6 Latin square design with six diets: 10% aNDF from corn silage (10CS); 20% aNDF from corn silage (20CS); or four diets containing 10% aNDF from corn silage and 10% aNDF from one of the following sources: sugarcane (SC), sugarcane bagasse (SCB), soybean hulls (SH), or low oil cottonseed hulls (LOCH). The parameters of passage and degradation kinetics were estimated based on a two-compartmental model with gamma- and exponential-distributed residence times. The nonlinear models were fitted by nonlinear least squares, and a linear mixed-effects model was fitted to all variables measured from the Latin square design that were related to intake, digestibility, digestion kinetic parameters, and residence times. Mean particle size (MPS) between roughage sources (CS, SCB, and SC) and coproducts (SH and LOCH) was affected (P < 0.05). Dry matter intake (DMI) was not affected (P > 0.05) by 20CS, SC, SH, or LOCH. Steers fed 20CS or LOCH diets had 16% and 20% greater DMI, respectively, (P < 0.05) than steers fed 10CS diet. Steers fed SCB consumed the least dry matter (DM). The SH and LOCH diets had lower MPS values (about 8.77 mm) in comparison to 20CS, SCB, and SC diets (about 13.08 mm) and, consequently, affected (P < 0.05) rumen content, ruminal in situ disappearance, nutrient digestibility, and solid fractional passage rate. Chewing time was affected (P < 0.05) by roughage sources and concentration. Lower values of distance travel inside the rumen (min/cm) were observed (P < 0.05) for the SCB and SC diets in comparison with any other diet. Except for SCB, there was no difference (P > 0.05) in rumen fill, among other treatments. Mean daily ruminal pH was not affected (P > 0.05) by 20CS, SCB, SC, and LOCH diets, and it ranged from 6.1 to 6.23. Total short-chain fatty acids concentration was affected (P < 0.05) by roughage source and concentration. Based on our results, we recommend that under Brazilian finishing diets, replacing roughage sources, except for SCB, based on aNDF concentration of the roughage in high-concentrate diets containing finely ground flint corn does not affect DMI.

Eco-Friendly Bioemulsifier Production by Mucor circinelloides UCP0001 Isolated from Mangrove Sediments Using Renewable Substrates for Environmental Applications.

The successful production of a biosurfactant is dependent on the development of processes using low cost raw materials. In the present work, an economically attractive medium composed of corn steep liquor and waste cooking oil was formulated to maximize the production of bioemulsifier by Mucor circinelloides UCP0001. A central rotational composite design was applied to statistical validation of the production. The emulsifying properties, stability under extreme conditions, its toxicity character, and the characterization of the bioemulsifier were determined. The best condition for biomolecule synthesis occurred in the assay 2 containing 4% of corn steep liquor and 3% waste soybean oil and exhibited 100% emulsification index for canola oil and petroleum, as well as excellent emulsifying activity for canola oil and burned engine oil. The nutritional factors studied showed statistical relevance, since all linear, quadratic effects and their interactions were significant. The bioemulsifier showed 2.69 g/L yield and the chemical character of the molecule structure was identified by FT-IR (Fourier Transform Infrared) spectroscopy. The bioemulsifier showed no toxicity to Artemia salina and Chlorella vulgaris. Stable emulsions were obtained under extreme conditions of temperature, pH, and salinity. These findings contribute to understanding of the relationship between production, physical properties, chemical composition, and stability of bioemulsifier for their potential applications in biotechnology, such as bioremediation of hydrocarbon-contaminated soil and water.