Management of massive hemothorax due to internal mammary pseudoaneurysm treated with angioembolization post-cesarean section involving traumatic fetal extraction: A case report.

Introduction: Pseudoaneurysm, or false aneurysm, is a clinical entity caused by rupture of the arterial wall, leading to blood leakage that is confined by sorroundig tissue. Massive hemothorax constitutes a life-threatening condition demanding timely and accurate medical response. Case report: A puerperal presented with a massive hemothorax precipitated by a traumatic cesarean section due to hemorrhage from a pseudoaneurysm of the left internal thoracic artery. Initial treatment involved a sternotomy, followed by a conclusive therapy via angioembolization. Conclusion: Precise assessment, including the measurement and localization of the ITA pseudoaneurysm is crucial to formulate an appropriate therapeutic strategy. Current medial practice favors endovascular embolization as a reliable and minimally invasive alternative to open surgery, establishing ir as the treatment of choice.

Pulmonary arteriovenous malformations in Rendu-Osler-Weber syndrome.

Rendu-Osler-Weber syndrome, also known as hereditary hemorrhagic telangiectasia, is an autosomal dominant hereditary disorder. It is characterized by presence of multiple arteriovenous malformations (AVMs) and telangiectasias. This article reports two cases of patients with Rendu-Osler-Weber syndrome who had pulmonary AVMs and underwent successful endovascular treatment. A brief review of the literature shows that up to 50% of patients with the syndrome have pulmonary AVMs and there is usually a positive family history in these patients. These pulmonary AVMs are multiple in 30% of cases and are associated with the most severe disease complications. Most patients are asymptomatic, even in the presence of AVMs with right-left shunts. When these shunts exceed 25% of the total blood volume, dyspnea, cyanosis, digital clubbing, and extracardiac murmurs may occur. Endovascular treatment is safe and offers control of complications from hereditary hemorrhagic telangiectasia and is currently the treatment of choice for these lesions.

Use of surgical videos available on social media among retina surgeons: results of a vitreoretinal specialist survey / Uso de vídeos cirúrgicos nas mídias sociais entre cirurgiões de retina: resultados de uma pesquisa com especialista em retina

ABSTRACT Purpose: This study aimed to assess and interpret how vitreoretinal surgeons use surgical videos available on social media as complementary learning tools to improve, review, or update their abilities, considering their different levels of expertise. Methods: In this cross-sectional survey, an online survey was sent to vitreoretinal specialists and fellows. Results: This survey included 258 participants, of whom 53.88% had been in practice for >10 years (senior surgeons), 29.07% between 4 and 10 years (young surgeons), and 17.05% for <3 years (surgeons in training). Retinal surgical videos available on social media were used by 98.84% of the participants (95% confidence interval, 97.52%-100%). YouTube (91%) was the most common source of videos, and surgeons in training watched more videos on YouTube than senior surgeons. Regarding the preferred method when preparing for a procedure, 49.80% of the participants watched surgical videos available on social media, 26.27% preferred to "consult colleagues", and 18.82% preferred to seek information in scientific articles. Participants valued the most the "image quality" (88%) and presence of "surgical tips and tricks" (85%). Conclusion: Surgical videos can provide benefits in acquiring strategic skills, such as decision-making, surgical planning, and situational awareness. Retina surgeons used them as teaching aids regardless of their level of expertise, despite being relatively more valuable to surgeons in training or young surgeons.

RESUMO Objetivo: Avaliar e interpretar como os cirurgiões vitreorretinianos utilizam os vídeos cirúrgicos disponíveis nas mídias sociais como ferramentas complementares de aprendizagem para melhorar, revisar ou atualizar suas habilidades, considerando seus diferentes níveis de especialização. Métodos: Nesta pesquisa transversal, um survey online foi enviado à especialistas e aprendizes na área vítreo-retiniana. Resultados: Esta pesquisa incluiu 258 participantes, dos quais 53,88% atuavam há mais de 10 anos (cirurgiões seniores), 29,07% entre 4 e 10 anos (cirurgiões jovens) e 17,05% há menos de 3 anos (cirurgiões em treinamento). Vídeos cirúrgicos de retina nas mídias sociais foram usados por 98,84% dos participantes (intervalo de confiança de 95%, 97,52%-100%). A fonte mais comum de acesso aos vídeos foi o YouTube (91%), e o grupo de cirurgiões com menos de 3 anos de experiência assistiu mais vídeos no YouTube em comparação aos cirurgiões seniores. Assistir a vídeos cirúrgicos nas redes sociais foi o método preferido na preparação para um procedimento para 49,80% dos participantes versus 26,27% que preferiram "consultar colegas" e 18,82% que preferiram buscar informações em artigos científicos. A "qualidade de imagem" (88%) e a presença de "dicas e truques cirúrgicos" (85%) foram as características dos vídeos mais valorizadas pelos participantes. Conclusão: O uso de vídeos cirúrgicos pode trazer benefícios na aquisição de habilidades estratégicas, como tomada de decisão, planejamento cirúrgico e consciência situacional. Sua aplicação como auxiliar de ensino foi utilizada por cirurgiões de retina independentemente de seu nível de especialização, apesar de ser relativamente mais valioso para cirurgiões em formação ou com menos de 10 anos de experiência.

Telementoring versus face-to-face mentoring in the training of scleral fixation surgery of intraocular lenses.

PURPOSE: To assess telementoring as a complementary tool for surgical training of a scleral fixation technique. DESIGN: Randomized, controlled, two-arm, blinded clinical trial. METHODS: Using a 3D visualization system, 132 participants were randomized in order of enrollment into traditional face-to-face mentoring (n = 66) and telementoring (n = 66). A single surgeon mentored all participants in the 2 groups. The procedure was performed in a model suitable for training in intraocular lens fixation SimulEYE® (INSEYET, WESTLAKE VILLAGE, CA, USA). In the telementoring group, the images captured on a local computer were sent to a second computer located in another room through a teleconferencing platform in real-time. Nine steps of the recorded procedure were evaluated and scored by two masked independent surgeons experienced in the technique. MAIN OUTCOMES MEASURES: The primary outcomes evaluated were the global score (the sum of each score on the rubric), surgical failure, and surgical time (in seconds). RESULTS: Surgical success was achieved in 98.5% in the face-to-face group and in 95.5% in the telementoring group (p-value = 0.619). Minimal technical problems were reported in 8 procedures in the telementoring group (12%), without interfering with the surgical result, and completion of the procedure. CONCLUSIONS: Telementoring is an encouraging educational tool that can overcome geographical barriers to ease the transfer of abilities and knowledge. We lack evidence in terms of group differences for superiority comparing face-to-face and telementoring, in addition to presenting comparable results regarding surgical success and failure. More studies are needed to explore the impact of telementoring in other ophthalmological surgeries. TRIAL REGISTRATION: The Federal University of São Paulo institution's Research Ethics Committee reviewed and approved this study protocol (approval number, 5.383.484).

The Nervous System Development Regulator Neuropilin-1 as a Potential Prognostic Marker and Therapeutic Target in Brain Cancer.

Neuropilins are transmembrane glycoproteins that regulate developmental processes in the nervous system and other tissues. Overexpression of neuropilin-1 (NRP1) occurs in many solid tumor types and, in several instances, may predict patient outcome in terms of overall survival. Experimental inhibition of NRP1 activity can display antitumor effects in different cancer models. Here, we review NRP1 expression and function in adult and pediatric brain cancers, particularly glioblastomas (GBMs) and medulloblastomas, and present analyses of NRP1 transcript levels and their association with patient survival in GBMs. The case of NRP1 highlights the potential of regulators of neurodevelopment as biomarkers and therapeutic targets in brain cancer.

Is the computed tomography exam important for planning mini-implant installation?

Background: Mini-implants are devices used to provide absolute and temporary anchorage for tooth movement. Objectives: The present study was carried out to compare the use of periapical radiographs and computed tomography (CT) for planning mini-implants performed by orthodontists. Material and Methods: Five radiographs and five CT scans of premolars and molars regions. These were analyzed by ten Orthodontists. Initially (T1), the evaluators indicated the preferred location for the insertion of a mini-implant, as well as the diameter and length of the device, using only a periapical radiograph. After 30 days (T2), the same evaluation was performed. Sixty days later (T3), the orthodontists reassessed the radiographs in association with the CT scans. Finally, after 90 days (T4), the evaluation was performed with the same exams. The comparison of the chosen diameter and length of the mini-implants was performed using the Student's t-test. The evaluation of the chosen insertion sites was analyzed by the Wilcoxon test. For both tests, the level of significance was 5%. The kappa concordance test was also performed for the intra- and inter-examiner evaluations. Results: The results of the study showed substantial or perfect intra-examiner and reasonable to perfect inter-examiner agreement. Considering the length and diameter of the mini-implants, no statistical difference was found between the groups. Regarding the insertion site, more than 20% of the treatment plans were changed when the CT scan was associated. Conclusions: The results showed that the association of a CT scan with radiography frequently leads the professional to change the insertion point for the installation of mini-implants. Key words:Orthodontic anchorage procedures. Mini Dental Implants. Bone Screws. Cone-beam computed tomography. Periapical radiography.

Use of surgical videos available on social media among retina surgeons: results of a vitreoretinal specialist survey.

PURPOSE: This study aimed to assess and interpret how vitreoretinal surgeons use surgical videos available on social media as complementary learning tools to improve, review, or update their abilities, considering their different levels of expertise. METHODS: In this cross-sectional survey, an online survey was sent to vitreoretinal specialists and fellows. RESULTS: This survey included 258 participants, of whom 53.88% had been in practice for >10 years (senior surgeons), 29.07% between 4 and 10 years (young surgeons), and 17.05% for <3 years (surgeons in training). Retinal surgical videos available on social media were used by 98.84% of the participants (95% confidence interval, 97.52%-100%). YouTube (91%) was the most common source of videos, and surgeons in training watched more videos on YouTube than senior surgeons. Regarding the preferred method when preparing for a procedure, 49.80% of the participants watched surgical videos available on social media, 26.27% preferred to "consult colleagues", and 18.82% preferred to seek information in scientific articles. Participants valued the most the "image quality" (88%) and presence of "surgical tips and tricks" (85%). CONCLUSION: Surgical videos can provide benefits in acquiring strategic skills, such as decision-making, surgical planning, and situational awareness. Retina surgeons used them as teaching aids regardless of their level of expertise, despite being relatively more valuable to surgeons in training or young surgeons.

How can public open spaces contribute to physical activity promotion? / Como os espaços públicos abertos podem contribuir para a promoção da atividade física?

Public open spaces (POSs) are means to ensure one's right to recreation and health. The objective of this essay is to present reflections and evidence on how these spaces contribute to promoting physi-cal activity (PA). Understanding how to access (proximity/distance), quantity and diversity, and the surrounding and internal conditions of places (quality, structure, aesthetics, safety) can affect the use of POSs is imperative for public management actions. Thinking of POS use beyond PA by recog-nizing its social, economic, and cultural benefits can be fundamental to reduce inequalities regarding access to these places. POS-related actions and demands are intersectoral, multiprofessional, and interdisciplinary, thus requiring political, academic, and community involvement and commitment for PA promotion

Espaços públicos abertos (EPA) são equipamentos que promovem o direito à recreação e à saúde. O objetivo deste ensaio é apresentar reflexões e evidências sobre como esses espaços contribuem para a promoção da atividade física (AF). Compreender como o acesso (proximidade/distância), a quantidade e diversidade, as condições do entorno e internas dos locais (qualidade, estrutura, estética, segurança), podem afetar o uso dos EPA é fundamental para ações da gestão pública. Pensar o uso do EPA para além da prática de AF, reconhecendo seus benefícios sociais, econômicos e culturais pode ser fundamental para diminuir as iniquidades de acesso a esses locais. Ações e demandas relacionadas aos EPA são intersetoriais, multiprofissionais e interdisciplinares, necessitando com isso envolvimento e comprometimento político, acadêmico e comunitário, a fim de promover AF

Superficial femoral vein transposition as a solution for hemodialysis vascular access.

The significant growth in the number of individuals dependent on hemodialysis for renal replacement therapy and unrestricted use of short and long-term catheters have challenged vascular surgeons in search of solutions for patients whose options for access via the upper limbs have been exhausted and for the increasing rates of central venous stenosis in these patients. When access via the upper limbs is impossible, exceptional techniques can be used and the lower limbs offer feasible alternative vascular access sites for hemodialysis. This article reports a case of superficial femoral vein transposition to make a loop arteriovenous fistula in a patient with no possibility of access via the upper limbs and presents a literature review on this technique that remains little used.

Identification of potential plant species hyperaccumulating light rare earth elements (LREE) in a mining area in Minas Gerais, Brazil.

Phytoextraction of rare earth elements (REE) from contaminated soils has gained importance during the last few decades. The Poços de Caldas municipality in Brazil is known for its mineral richness, including large reserves of REE. In this study, we report light REE (La, Ce, Sm, Pr, and Nd) in soils and plants collected in an area. Composite soil samples and plant individuals were collected, and total concentrations of LREE in soils were determined by wavelength dispersive X-ray fluorescence (WDXRF). The plant available LREE concentrations in soils were estimated upon the acetic acid method (F1 fractions) of the stepwise sequential extraction procedure, together with plant content that was analysed by inductively coupled plasma mass spectrometry (ICP-MS). The total sum concentrations of tested LREE in soils varied from 5.6 up to 37.9 g kg-1, the bioavailable fraction was ca. 1%, and a linear relationship was found between them. The only exception was Sm, whose availability was lesser and did not show a linear relationship. The concentration of LREE in non-accumulator plants varied from 1.3-950 mg kg-1 for Ce, La 1.1-99 mg kg-1, Sm 0.04-9.31 mg kg-1, Pr 0.1-24.1 mg kg-1, and Nd 0.55-81 mg kg-1. The concentration of LREE among shoots did not show a linear relation either with the available fraction or total content. The screening also revealed Christella dentata (Forssk.) Brownsey & Jermy, Thelypteridaceae family, as a promising hyperaccumulator species. The concentrations of LREE among shoots of six individuals of this species were in the ranges from 115 to 1872 mg kg-1 for Ce, La 190-703 mg kg-1, Sm 9-48 mg kg-1, Pr 32-144 mg kg-1, and Nd 105-478 mg kg-1.

Use of an Elevated Avenue for Leisure-Time Physical Activity by Adults from Downtown São Paulo, Brazil.

Leisure-time physical activity (LTPA) is associated with access and use of public open spaces. The President João Goulart Elevated Avenue, currently denominated Minhocão, is a facility for leisure activities that is open for people during the night and weekends. The aim of this study was to examine if the prevalence of LTPA among individuals living in the surroundings of Minhocão is different according to proximity to, and use of, the facility. We conducted a cross-sectional study with cluster sampling with people aged ≥18 years who lived in households up to 500 m, and between 501 m and 1500 m of Minhocão. The survey was conducted between December 2017 and March 2019 using an electronic questionnaire. We conducted a bivariate analysis and Poisson regression to examine possible differences in LTPA according to the proximity of residences and use of Minhocão. The analysis used post-stratification weights. A total of 12,030 telephone numbers of people were drawn (≤500 m = 6942; and >500 m to ≤1500 m = 5088). The final sample included 235 residents who returned the questionnaires. There was a higher prevalence of individuals engaging in at least 150 min per week of LTPA among users than non-users (Prevalence Ratio = 2.19, IC95% 1.66 to 2.90), independently of sex, age, education, the distance of houses to nearest accesses and number of barriers. The main five barriers related to the usage of the Minhocão were safety issues in and around the Minhocão, rainy weather, lack of vegetation, and lack of facilities. People who used the park had higher prevalence of all types of LTPA than non-users. The results can serve to inform government decision-making on the future of Minhocão.

Evaluation of quality and utility of YouTube vitreoretinal surgical videos.

BACKGROUND: We evaluated the utility and quality of surgical videos posted on the main retinal YouTube channels by surgeons at different career stages and assessed how well the steps of the vitrectomy videos conformed to the parameters in the Casey Eye Institute Vitrectomy Indices Tool for Skills assessment (CEIVITS) scale. METHODS: Forty-five videos were included from nine retinal YouTube channels posted from 2011 to 2021. For each surgeon, 10 videos were randomized and the utility, quality, and educational content were assessed. For each video, the surgeons also assessed how the validated CEIVITS items were presented in the videos. The surgeons were divided based on years of experience: fellows (0-3 years), young surgeons (4-10 years), and senior surgeons (more than 10 years). RESULTS: The video image quality was rated as good in 63.52% of evaluations, moderate in 30.37%, and poor in 6.11%. The quality assessment of the videos among the groups did not differ. The fellows rated the use of the videos as educational tools higher (3.99) than the young (3.87) and senior surgeons (3.47) (p < 0.0002, Kruskal-Wallis test); 34.76% of the fellows reported learning something new from the videos compared with 19.17% of the senior surgeons (p < 0.05). The CEIVITS scale item that was seen more frequently was related to core vitrectomies (72.29%) and the least represented was about checking infusion lines (80.17%). CONCLUSIONS: Vitreoretinal surgical videos are useful educational tools during all stages of surgeons' careers, and the evaluation of the quality of the images did not differ significantly among the groups, however, surgeons with expertise shorter than 10 years report significantly greater use of videos than experienced surgeons. Videos posted to the public domain on different social media, most often YouTube, are widespread and unregulated for providing complimentary surgical education. Retinal societies should formulate guidelines and improve the educational value of the surgical videos posted on the Internet. Trial Registration The Federal University of São Paulo institution's Research Ethics Committee reviewed and approved this study protocol (Approval Number, 4.726.589).

Preliminary study of rabbits as an animal model of mammalian eye transplantation and literature review / Estudo preliminar de coelhos como modelo animal para transplante de olho em mamíferos e revisão da literatura

ABSTRACT Purpose: To describe an innovative animal model of eye transplantation used in rabbits. Methods: six Dutch-belted male rabbits were submitted to lateral orbitotomy in the right eye, wide retrobulbar anatomy exposure, dissection of the structures, identification and distal section of the optic nerve followed by anastomosis either by vicryl (group 1) or fibrin glue (group 2). Electroretinography recording was performed before the section of the optic nerve and every 30 seconds after, to monitor the function of retina. Left eye was used as control group. Results: After optic nerve resection and anastomosis, stable ERG amplitude of the right eye was lost after 302 seconds in group 1 and after 296 seconds on group 2. Left eye kept longer stable ERG amplitude curves. Conclusions: The animal model of whole eye transplantation was effective in describing a novel technique to be used in rabbits, with success of the anatomic procedure. Further studies will clarify the best anastomosis methods and maintenance of function of the receptor organ. Translational relevance: this animal model of whole eye transplantation provides a novel perspective for blind patients and the research models, since we describe a novel mammal animal model. This model can be used as basis of a human model of whole eye transplantation in future studies.

RESUMO Objetivo: Descrever uma técnica cirúrgica inovadora para transplante de olho em um modelo animal em coelhos. Métodos: Seis coelhos machos com Dutch Belted foram submetidos à orbitotomia lateral do olho direito, com ampla exposição da anatomia retrobulbar, dissecção do cone muscular, exposição e secção distal do nervo óptico seguida de anastomose por vicryl (Grupo 1) ou cola de fibrina (Grupo 2). O registro da eletrorretinografia foi realizado antes da secção do nervo óptico e a cada 30 segundos após, para monitorar a função da retina. O olho esquerdo foi usado como grupo controle. Resultados: Após a ressecção do nervo óptico, a estabilidade da amplitude da eletrorretinografia foi perdida no olho direito após 302 segundos no Grupo 1 e após 296 segundos no Grupo 2. O olho esquerdo manteve eletrorretinografia estável por períodos mais longos. Conclusão: O modelo animal de transplante total de olho foi eficaz em descrever uma nova técnica cirúrgica para ser utilizada em laboratório com coelhos, com sucesso do procedimento anatômico. Novos estudos esclarecerão os melhores métodos de anastomose e manutenção da função do órgão receptor.

Transposição de veia femoral superficial como solução de acesso vascular para hemodiálise / Superficial femoral vein transposition as a solution for hemodialysis vascular access

Resumo O crescimento significativo do número de indivíduos dependentes de hemodiálise para terapia renal substitutiva e o uso irrestrito de cateteres de curta e longa permanência têm desafiado os cirurgiões vasculares em busca de soluções para a exaustão de acessos nos membros superiores e taxas crescentes de estenose venosa central nesses pacientes. Na impossibilidade do acesso em membros superiores, técnicas excepcionais podem ser utilizadas, e os membros inferiores são uma alternativa factível como sítio de acesso vascular para hemodiálise. Este artigo relata um caso de transposição de veia femoral superficial para confecção de uma fístula arteriovenosa em alça em um paciente sem possibilidade de acessos nos membros superiores, além de fazer uma revisão da literatura sobre essa técnica ainda pouco utilizada.

Abstract The significant growth in the number of individuals dependent on hemodialysis for renal replacement therapy and unrestricted use of short and long-term catheters have challenged vascular surgeons in search of solutions for patients whose options for access via the upper limbs have been exhausted and for the increasing rates of central venous stenosis in these patients. When access via the upper limbs is impossible, exceptional techniques can be used and the lower limbs offer feasible alternative vascular access sites for hemodialysis. This article reports a case of superficial femoral vein transposition to make a loop arteriovenous fistula in a patient with no possibility of access via the upper limbs and presents a literature review on this technique that remains little used.

The risks behind the widespread use of siliconized syringes in the healthcare practice.

Injections are widely performed in the healthcare practice. Silicone has long been thought to be an inert and harmless material. Although used for decades in medical implants, including heart valves, breast implants, and as a tamponade for retinal detachment surgery, silicone oil might have deleterious effects. Agitation of the syringe to expel air at the moment of drug preparation not only leads to silicone oil release but also to therapeutic protein aggregation. Lab studies have shown that silicone oil microdroplets can act as an adjuvant to promote a break in immunological tolerance and induce antibody response. Similarly, recent studies have suggested a causal link between agitation of siliconized syringes and ocular inflammation after intravitreal injection. Systemically, silicone oil has been reported in association with autoimmune diseases and skin granuloma after either direct injection of dermal fillers or secondary leakage from silicone breast implant. However, it has not been established yet a potential link between the silicone oil released by the syringes and such relevant systemic adverse events. Few professionals are aware that agitation of a siliconized syringe might lead to silicone oil release, which, in turn, acts an adjuvant to an increased immunogenicity. We strongly recommend that every healthcare professional be aware of the use of silicone oil in the syringe manufacturing process, the factors that promote its release and the potential complications to the organism. Ultimately, we recommend that safer syringes be widely available.

A bioluminescent and homogeneous SARS-CoV-2 spike RBD and hACE2 interaction assay for antiviral screening and monitoring patient neutralizing antibody levels.

Here we describe a homogeneous bioluminescent immunoassay based on the interaction between Fc-tagged SARS-CoV-2 Spike RBD and human ACE2, and its detection by secondary antibodies labeled with NanoLuc luciferase fragments LgBit and SmBit. The assay utility for the discovery of novel inhibitors was demonstrated with a panel of anti-RBD antibodies, ACE2-derived miniproteins and soluble ACE2. Studying the effect of RBD mutations on ACE2 binding showed that the N501Y mutation increased RBD apparent affinity toward ACE2 tenfold that resulted in escaping inhibition by some anti-RBD antibodies. In contrast, while E484K mutation did not highly change the binding affinity, it still escaped antibody inhibition likely due to changes in the epitope recognized by the antibody. Also, neutralizing antibodies (NAbs) from COVID-19 positive samples from two distinct regions (USA and Brazil) were successfully detected and the results further suggest the persistence of NAbs for at least 6 months post symptom onset. Finally, sera from vaccinated individuals were tested for NAbs and showed varying neutralizing activity after first and second doses, suggesting the assay can be used to assess immunity of vaccinated populations. Our results demonstrate the broad utility and ease of use of this methodology both for drug discovery and clinical research applications.

Silicone oil-free syringes, siliconized syringes and needles: quantitative assessment of silicone oil release with drugs used for intravitreal injection.

PURPOSE: This study aimed to quantify the amount of silicone oil (SO) released across a variety of syringe and needle models routinely used for intravitreal injection. METHODS: The release of SO was assessed in eight models of syringes, two of which were reported to be 'SO-free', and eleven models of needles with unknown SO content. To evaluate SO release within the context of anti-VEGF therapeutics, syringes were evaluated using aflibercept, bevacizumab, buffer, ziv-aflibercept and formulation buffer. All syringe tests were performed with or without agitation by flicking for syringes. Needles were evaluated without agitation only. Samples were fluorescently labelled to identify SO, and triplicate measurements were collected using imaging flow cytometry. RESULTS: Seven out of 8 syringe models showed a statistically significant increase in the SO particle count after agitation. The two SO-free syringe models (HSW Norm-Ject, Daikyo Crystal Zenith) released the least SO particles, with or without agitation, whereas the BD Ultra-Fine and Saldanha-Rodrigues syringes released the most. More SO was released when the syringes were prefilled with formulation buffer than with ziv-aflibercept. Syringes filled with aflibercept and bevacizumab had intermediate levels. Agitation increased the release of SO into each of the drug solutions. Silicone oil (SO) was detected in all needles. CONCLUSIONS: Agitation of the syringe by flicking leads to a substantial increase in the number of SO particles. Silicone oil (SO)-free syringes had the best performance, but physicians must also be aware that needles are siliconized and also contribute to the injection of SO into the vitreous.

Effect of nano cerium oxide on soybean (Glycine max L. Merrill) crop exposed to environmentally relevant concentrations.

This study evaluated the uptake and translocation of cerium nanoparticles (CeO2 NPs) and soluble Ce(NO3)3 by soybean plants (Glycine max L. Merrill) under the whole plant life-cycle and relevant environmental concentrations, 0.062 and 0.933 mg kg-1, which represent maximal values for 2017 in agricultural soils and sludge treated soils, respectively. The experiments were carried out using a nutrient solution. Cerium was detected in the soybean roots epidermis and cortex, leaves, and grains, but it neither impaired plant development nor grain yield. The concentration of Ce in the shoot increased as a function of time for plants treated with Ce(NO3)3, while it remained constant for plants treated with CeO2 NPs. It means that CeO2 NPs were absorbed in the same rate as biomass production, which suggests that they are taken up and transported by water mass flow. Single-particle inductively coupled plasma mass spectrometry revealed clusters of CeO2 NPs in leaves of plants treated with 25 nm CeO2 NPs (ca. 30-45 nm). The reprecipitation of soluble cerium from Ce(NO3)3 within the plant was not confirmed. Finally, bioconcentration factors above one were found for the lowest concentrated treatments. Since soybean is a widespread source of protein for animals, we draw attention to the importance of evaluating the effects of Ce entrance in the food chain and its possible biomagnification.

Genetic and chemical control of coffee rust (Hemileia vastatrix Berk et Br.): impacts on coffee (Coffea arabica L.) quality.

BACKGROUND: The occurrence of diseases can alter coffee (Coffea arabica L.) metabolism, causing changes in the composition of coffee beans and beverage quality. However, little is known about which aspects of coffee quality are actually altered by rust (Hemileia vastatrix Berk et Br.) and by its main control methods. The effect of chemical and genetic methods for the control of coffee rust on the quality of coffee beans and beverage was investigated. RESULTS: Both genetic and chemical control reduce the damage caused by the disease in the composition of coffee beans. Genotypes with resistant ancestry, even with resistance breakdown, respond better to chemical control. The combination of genetic and chemical control favors an increase in the sugar content in the beans. CONCLUSIONS: Despite the fact that both genetic and chemical control are effective in reducing disease damage regarding the chemical composition of beans, the quality potential of Timor Hybrid genotypes associated with the cancellation of rust expression through the joint action of genetic and chemical control favors the composition of beans and, consequently, the quantitative assessment of sensory attributes, adding value to the final product. © 2020 Society of Chemical Industry.

Complicações pós-operatórias em apendicectomias: análise comparativa entre as abordagens aberta e videolaparoscópica / Postoperative complications in appendectomies: comparative analysis between open and laparoscopic approaches

Introdução: A apendicectomia é o tratamento de escolha da apendicite aguda. Embora a preferência pelas técnicas minimamente invasivas seja tendência mundial, a cirurgia aberta ainda é realidade na maioria dos hospitais públicos. O índice de complicações pós-operatórias varia de acordo com a técnica cirúrgica empregada. O presente estudo objetiva comparar a incidência de complicações pós-operatórias entre a apendicectomia aberta e laparoscópica. Métodos: Coorte retrospectiva incluindo pacientes submetidos à apendicectomia no Hospital de Pronto Socorro de Porto Alegre entre novembro de 2015 a novembro de 2019. Foram avaliados dados demográficos, tempo de evolução dos sintomas, técnica cirúrgica, achados transoperatórios, necessidade de drenos ou ostomias, tempo cirúrgico, tempo de internação, experiência do cirurgião e desfechos. Resultados: Foram incluídos 358 pacientes, com idade de 32 ± 13,8 anos, e predomínio do sexo masculino (58,9%); 58,1% foram submetidos a cirurgia aberta, 41,9% a laparoscopia e 8% necessitaram conversão. As apendicites foram classificadas como complicadas em um terço dos casos. O tempo cirúrgico foi menor na cirurgia aberta (79,3 ± 38,8 vs. 104 ± 35,2 minutos; p < 0,001). O índice de complicações pós-operatórias foi de 21,2%, sendo significativamente maior na técnica aberta (26,4% vs. 13%; p = 0,003). O tempo de internação, a necessidade de reintervenção e mortalidade não apresentaram diferença entre as técnicas. Conclusão: Embora a apendicectomia aberta seja um procedimento seguro, com bons resultados e baixa morbimortalidade, a laparoscopia oferece potenciais vantagens em termos de evolução pós-operatória, inclusive em casos complicados. Deve ser indicada rotineiramente havendo disponibilidade de material e capacitação da equipe cirúrgica. (AU)

Introduction: Appendectomy is the treatment of choice for acute appendicitis. Although the preference for minimally invasive techniques is a worldwide trend, open surgery remains a reality in most public hospitals. The rate of postoperative complications varies according to the surgical technique employed. The present study aimed to compare the incidence of postoperative complications between open and laparoscopic appendectomy. Methods: This retrospective cohort study included patients undergoing appendectomy at the Hospital de Pronto Socorro de Porto Alegre between November 2015 and November 2019. Demographic and clinical data, duration of symptoms, surgical technique, intraoperative findings, use of abdominal drains or stomas, operative time, length of stay, surgeon's experience, and outcomes were assessed. Results: Three hundred and fifty-eight patients were included, predominantly male (58.9%), with a mean age of 32 ± 13.8 years; 58.1% underwent open surgery, 41.9% underwent laparoscopic surgery, and 8% required conversion. One third of the cases were classified as complicated. The mean operative time was shorter for open surgery (79.3 ± 38.8 vs. 104 ± 35.2 minutes; p < 0.001). The rate of postoperative complications was 21.2%, with a significantly higher incidence in the open technique (26.4% vs. 13%; p = 0.003). Length of stay, reoperation rate, and mortality did not differ between the techniques. Conclusions: Although open appendectomy is a safe and efficient procedure, associated with low morbidity and mortality rates, laparoscopy provides potential clinically beneficial advantages in terms of postoperative outcomes, even in complicated cases. Therefore, it should be routinely performed where laparoscopic equipment and skillful staff are available. (AU)