Morphological analysis of the jugular foramen in dry human skulls in northeastern Brazil.

The jugular foramen (JF) is located between the temporal and occipital bones. The JF is a primary pathway for venous outflow from the skull and passage of nerves. Variations are common in this region and may have clinical and surgical implications. To analyze the sexual dimorphism and JF morphology in skulls from Northeastern Brazil. 128 human skulls from the Anatomy Laboratory of the Federal University of Paraíba, 64 male and 64 female, were selected and the JFs analyzed for bone septation and the presence of a dome. Data analysis considered P<0.05 as significant. On at least one side, complete septation was observed in 26 skulls (20.3%), incomplete septation in 93 skulls (72.6%) and 61 skulls (47.6%) did not present septation. In 114 skulls (89%), 47.6% female and 41.4% male, have a unilateral presence of the dome and 71 (55.4%) have it bilaterally. Posterolateral compartment diameters and JF area had higher values on the right side in the total sample and separated by sex (P<0.05). Most morphometric variables of the anteromedial compartment were higher in male than in female (P<0.05), fact that was not observed in the posterolateral compartment (P>0.05). This study showed a higher prevalence of complete septation in males compared to females. Morphometric analysis presented a peculiar morphology of the JF in this study. These results suggests that the surgical approach to diseases that affect the JF may be peculiar to the studied population, confirming the importance of morphological analysis of the skull base.

False diagnosis of recurrent thyroid carcinoma: the importance of testing for heterophile antibodies.

Thyroglobulin (Tg) levels are important to predict recurrence in differentiated thyroid cancer patients.However, false-positive results can hence the request of unnecessary tests and treatments. We reported two cases of interference in thyroglobulin measurement and the workup to investigate them. Both patients achieved an excellent response to therapy after total thyroidectomy and one patient had also received radioiodine treatment. During the follow-up, Tg levels increased and there was no evidence of recurrent disease in the imaging studies. The Tg levels by the Access platform were positive but the results by Elecsys platform and LC-MS/MS were undetectable, leading to the hypothesis of heterophile antibodies (HAbs) interference. The possibility of HAbs interference must be considered when the Tg levels do not fit in the clinical picture. The measurement of Tg by another immunoassay or by LC-MS/MS may be useful in these situations.

SARS-CoV-2 infection and replication kinetics in different human cell types: The role of autophagy, cellular metabolism and ACE2 expression.

AIMS: This study evaluated SARS-CoV-2 replication in human cell lines derived from various tissues and investigated molecular mechanisms related to viral infection susceptibility and replication. MAIN METHODS: SARS-CoV-2 replication in BEAS-2B and A549 (respiratory tract), HEK-293 T (kidney), HuH7 (liver), SH-SY5Y (brain), MCF7 (breast), Huvec (endothelial) and Caco-2 (intestine) was evaluated by RT-qPCR. Concomitantly, expression levels of ACE2 (Angiotensin Converting Enzyme) and TMPRSS2 were assessed through RT-qPCR and western blot. Proteins related to autophagy and mitochondrial metabolism were monitored in uninfected cells to characterize the cellular metabolism of each cell line. The effect of ACE2 overexpression on viral replication in pulmonary cells was also investigated. KEY FINDINGS: Our data show that HuH7, Caco-2 and MCF7 presented a higher viral load compared to the other cell lines. The increased susceptibility to SARS-CoV-2 infection seems to be associated not only with the differential levels of proteins intrinsically related to energetic metabolism, such as ATP synthase, citrate synthase, COX and NDUFS2 but also with the considerably higher TMPRSS2 mRNA expression. The two least susceptible cell types, BEAS-2B and A549, showed drastically increased SARS-CoV-2 replication capacity when ACE2 was overexpressed. These modified cell lines are relevant for studying SARS-CoV-2 replication in vitro. SIGNIFICANCE: Our data not only reinforce that TMPRSS2 expression and cellular energy metabolism are important molecular mechanisms for SARS-CoV-2 infection and replication, but also indicate that HuH7, MCF7 and Caco-2 are suitable models for mechanistic studies of COVID-19. Moreover, pulmonary cells overexpressing ACE2 can be used to understand mechanisms associated with SARS-CoV-2 replication.

The impact of the genetic background in a patient with papillary thyroid cancer and familial adenomatous polyposis.

Thyroid cancer is the most common endocrine malignancy, and papillary thyroid carcinoma (PTC) is the main subtype. The cribriform morular variant is a histological phenotype of PTC characterized by its relationship with familial adenomatous polyposis (FAP). Description of the case: We report the genetic assessment of a 20-year-old female patient diagnosed with a cribriform-morular variant of PTC and FAP. We aimed to assess the genetic background of the reported patient, looking for variants that would help us explain the predisposition to tumorigenesis. Genomic DNA was extracted from peripheral blood lymphocytes, and whole exome sequencing was performed. We applied an overrepresentation and gene-set enrichment analysis to look for an accumulation of effects of variants in multiple genes at the genome. We found an overrepresentation of single nucleotide variants (SNVs) in extracellular matrix interactions and cell adhesion genes. Underrepresentation of SNVs in genes related to the regulation of autophagy and cell cycle control was also observed. We hypothesize that the package of alterations of our patient may help to explain why she presented colonic manifestations and thyroid cancer. Our findings suggest that multiple variants with minor impact, when considered together, may be helpful to characterize one particular clinical condition.

Ortodontia estética, ancoragem esquelética em casos cirúrgicos ortognáticos / Aesthetic orthodontics and skeletal anchorage in orthognathic surgical cases

Resumo A má oclusão de Classe III, por gerar uma maior repercussão negativa na face dos pacientes, desperta uma procura cada vez maior por tratamentos ortodônticos estéticos. O aparelho lingual surgiu no início dos anos 70 e se tornou uma alternativa bastante viável para realização dos tratamentos ortodônticos estéticos, associados ou não às cirurgias ortognáticas. Com o auxílio dos dispositivos temporários de ancoragem esquelética, o tratamento se torna ainda mais estético e com menores efeitos indesejados. O objetivo deste artigo consiste em relatar uma experiência clínica de tratamento orto-cirúrgico utilizando ortodontia estética com aparelho lingual. O relato de caso clínico trata-se de uma paciente de 29 anos, má oclusão Classe III, dolicofacial, que iniciou o tratamento com aparelho lingual superior e vestibular inferior, combinado à ancoragem esquelética com placa versátil palatina. Na mandíbula, mini-implantes foram utilizados na região retromolar. Após o preparo ortodôntico pré-operatório, a paciente foi encaminhada à cirurgia ortognática, finalizando o caso com alinhadores digitais para melhor refinamento, além de contenções removíveis. Concluiu-se que foi possível corrigir, em tempo hábil, a má oclusão adequadamente, com absoluto controle dos torques, dentro das exigências estéticas da paciente, através de aparelho lingual superior, vestibular inferior, cirurgia ortognática e finalização com poucos alinhadores. (AU)

Abstract Classe III malocclusion, as it generates a greater negative impact on the face of patients, arouses an increasing demand for aesthetic orthodontic treatments. The lingual appeared in the early 70's and became a very viable alternative for performing aesthetic orthodontic treatments, associated or not with orthognathic surgeries. With the help of temporary skeletal anchorage devices, the treatment becomes more aesthetic and with undesired effects. The aim of this article is to report a clinical experience of ortho-surgical treatment using aesthetic orthodontics with lingual braces. The clinical case report is of a 29-year-old patient in treatment, Class III malocclusion, of the lichofacial treatment who started the appliance with an upper lingual and lower buccal appliance, combined with skeletal anchorage with a versatile palatal plate. In the mandible, mini implants were used in the retromolar region. After the orthodontic-operative preparation, the case was adjusted for better orthognathic surgery, finalizing the digital preparation for refinement, in addition to removable confections. It was concluded that it was possible to correct, skillfully and aesthetically in better torque, with absolute restriction of the patient's requirements, through adequate surgery within the superior lingual torque, inferior buccal or superior lingual, orthognathic and final inferior buccal torque with few aligners. (AU)

Evaluation of neuroglobin and cytoglobin expression in adult rats exposed to silver nanoparticles during prepubescence.

Silver nanoparticles (AgNPs) are clusters of silver atoms with diameters that range from 1 to 100 nm. Due to the various shapes and large surface areas, AgNPs have been employed in the food and textile industries and medical fields. Therefore, because of the widespread use of these compounds, the aim of this study was to evaluate the effect of AgNP exposure on the gene and protein expression levels of Neuroglobin (Ngb) and Cytoglobin (Cygb), in the rat cortex, hippocampus and cerebellum. Post-natal day (PND) 21 male Wistar rats were randomly divided into three groups. One group received 15 µg/kg body weight of AgNP by gavage another group received 30 µg/kg and the control group that received saline, from PND23 to PND58. On PND102 the animals were euthanized and the cortex, hippocampus and cerebellum were isolated and evaluated for gene and protein expression levels of Nbg and Cygb. The results demonstrated that the 30 µg/kg AgNP group displayed increased gene and protein expression of Cygb in the cortex. In the Hippocampus, AgNP exposure did not modulate gene or protein expression levels of Ngb and Cygb. In cerebellum the Ngb gene and protein expression was increased with both doses of AgNP. AgNP exposure during prepubescence can modulate the gene and protein expression levels of Ngb and Cygb in adulthood. Furthermore, the observed modulation was specific to the cerebellum, and cortex, and was dose dependent.

Anatomical specificity of the brain in the modulation of Neuroglobin and Cytoglobin genes after chronic bisphenol a exposure.

The aim of this study was to investigate the influence of Bisphenol A (BPA) exposure on Neuroglobin (Ngb) and Cytoglobin (Cygb) as well as oxidative stress gene expression in the cerebellum, hippocampus, hypothalamus and cortex. Male Wistar rats were randomly divided into 3 groups: Control and two groups receiving 2 different daily BPA dosages, 5 or 25 mg/kg from postnatal day 50 (PND50) through PND90 and they were euthanized at PND105. In the cortex, we found an increase in Ngb gene expression and also in superoxide dismutase 1 and Catalase (Cat). In the cerebellum, we found an increase in Ngb and Cat, in the hypothalamus, there was a decrease in Cygb and an increase in glutathione peroxidase and Cat and in hypoxia-inducible factor 1 alpha (Hif1α) at the low dosage and a decrease in Hif1α at the high BPA dosage. Finally, in the hippocampus, we observed a decrease in Ngb and Cygb and an increase in Hif1α. In summary, BPA promotes the modulation of both Ngb and Cygb, but such changes occur by different mechanisms depending on the exposure dose and anatomical area.

Antidepressant behavior in thyroidectomized Wistar rats is induced by hippocampal hypothyroidism.

Thyroidectomy is a surgical procedure indicated in cases of several maligned or benign thyroid diseases, thus, the aim of our study was to verify how the hypothyroidism induced by thyroidectomy influences behavioral parameters and its relation to thyroid hormones metabolism and neurogenesis at hippocampus. For this purpose, Adult male Wistar rats underwent to thyroidectomy to induce hypothyroidism. Behavioral tests, the thyroid profile and hippocampal gene expression were evaluated in control and in thyroidectomized animals. It was observed that thyroidectomized group had a significant increasing in serum thyroid-stimulating hormone (TSH) and a decreasing in thyroxine (T4) levels as well as in triiodothyronine (T3) serum level. It was also observed reduction of the monocarboxylate transporter 8 (Mct8), thyroid hormone receptor alfa (Trα1), deiodinase type 2 (Dio2), ectonucleotide pyrophosphatase/phosphodiesterase 2 (Enpp2) and brain-derived neurotrophic factor (Bdnf) mRNA expression in hippocampus of thyroidectomized animals. In the forced swimming test, it was verified that thyroidectomy promotes a decrease in time of immobility and climbing when compared with the control group. In summary, we demonstrated that antidepressant behavior in thyroidectomized Wistar rats is induced by hippocampal hypothyroidism. This effect could be associated to an impaired neuronal activity in acute stress response as it is observed in forced swimming paradigm.

Thyroid hormone modulates neuroglobin and cytoglobin in rat brain.

Thyroid hormones (THs) are essential and crucial for brain development, playing a role in growth and differentiation. Two globins named neuroglobin (Ngb) and cytoglobin (Cygb) are located in the brain, and each one has different distribution and function: They seem to have similar action by providing O(2) for respiratory chain, and detoxification of reactive oxygen species (ROS) and nitric oxide (NO) protecting tissues against irreversible lesions. We aimed to investigate the influence of thyroid state in Ngb and Cygb metabolism in different brain regions and evaluate their responses in cerebellum, hippocampus and cerebral cortex (hereafter called as cortex) after supraphysiological doses at different time points of TH administration. Experiments were carried out in rats, divided in eight experimental groups Control (C), thyroidectomy (Tx), and thyroidectomy treated with jugular intravenous injection (i.v). T3 (100 µl/100 g) injection and sacrificed after 30, 60, 120 min and 6, 12 and 24 h. In cortex, we found increase in Ngb gene and protein expression in different time points compared to C group, however Cygb gene and protein expression were decreased. In hippocampus, Ngb and Cygb protein expression increased 24 h after i.v. T3 injection in comparison to Tx. In cerebellum, we found increased Ngb gene expression after 120 min, 6, 12 and 24 h after T3 administration compared to Tx, and in contrast, protein expression was found to be significantly increased only 12 and 24 h compared to Tx. Ngb and Cygb expression in brain is influenced by thyroid hormone state both by its lack or excess.

Ventilação mecânica de curta duração com altos níveis de O2 em pulmões de ratos idosos / Short courses of mechanical ventilation with high-O2 levels in elderly rat lungs

PURPOSE: To evaluate the effects of mechanical ventilation (MV) of high-oxygen concentration in pulmonary dysfunction in adult and elderly rats. METHODS: Twenty-eight adult (A) and elderly (E), male rats were ventilated for 1 hour (G-AV1 and G-EV1) or for 3 hours (G-AV3 and G-EV3). A and E groups received a tidal volume of 7 mL/kg, a positive end-expiratory pressure of 5 cm H2O, respiratory rate of 70 cycles per minute, and an inspiratory fraction of oxygen of 1. We evaluated total protein content and malondialdehyde in bronchoalveolar lavages (BAL) and performed lung histomorphometrical analyses. RESULTS: In G-EV1 animals, total protein in BAL was higher (33.0±1.9 µg/mL) compared with G-AV1 (23.0±2.0 µg/mL). Upon 180 minutes of MV, malondialdehyde levels increased in elderly (G-EV3) compared with adult (G-AV3) groups. Malondialdehyde and total proteins in BAL after 3 hours of MV were higher in elderly group than in adults. In G-EV3 group we observed alveolar septa dilatation and significative increase in neutrofiles number in relation to adult group at 60 and 180 minutes on MV. CONCLUSION: A higher fraction of inspired oxygen in short courses of mechanical ventilation ameliorates the parameters studied in elderly lungs.

OBJETIVO: Avaliar os efeitos da ventilação mecânica com alta concentração de oxigênio em animais adultos e idosos. MÉTODOS: Vinte e oito ratos machos (adultos e idosos; n=7 por grupo) foram divididos em ventilados por 1 hora (G-AV1 e G-EV1) e ventilados por 3 horas (G-AV3 e G-EV3). Os grupos receberam volume corrente de 7 mL/kg, pressão positive ao final da expiração de 5 cmH2O, frequência respiratória de 70 ciclos por minuto e fração inspirada de oxigênio de 100 por cento. Ao final do experimento avaliamos no lavado brônquio-alveolar as proteínas totais, malondialdeído, celularidade e a histomorfometria do parênquima pulmonar. RESULTADOS: Em animais idosos ventilados por 1 hora (G-EV1) as proteínas totais no lavado brônquio-alveolar aumentaram (33.0±1.9 µg/mL) quando comparados com os adultos (G-AV1; 23.0±2.0 µg/mL). Após 180 minutos de ventilação mecânica os níveis de malondialdeído e as proteínas totais estavam elevadas nos animais idosos (G-EV3) quando comparadas com os adultos (G-AV3; p<0.001). No grupo de animais idosos (G-EV3) observamos ainda dilatação dos septos alveolares e aumento significativo no número de neutrófilos em relação aos adultos ventilados, tanto aos 60 quanto aos 180 minutos de ventilação mecânica (p<0.001). CONCLUSÃO: A ventilação mecânica com alta fração inspirada de oxigênio por um curto período de tempo favoreceu os parâmetros pulmonares estudados nos animais idosos.

Short courses of mechanical ventilation with high-O2 levels in elderly rat lungs.

PURPOSE: To evaluate the effects of mechanical ventilation (MV) of high-oxygen concentration in pulmonary dysfunction in adult and elderly rats. METHODS: Twenty-eight adult (A) and elderly (E), male rats were ventilated for 1 hour (G-AV1 and G-EV1) or for 3 hours (G-AV3 and G-EV3). A and E groups received a tidal volume of 7 mL/kg, a positive end-expiratory pressure of 5 cm H2O, respiratory rate of 70 cycles per minute, and an inspiratory fraction of oxygen of 1. We evaluated total protein content and malondialdehyde in bronchoalveolar lavages (BAL) and performed lung histomorphometrical analyses. RESULTS: In G-EV1 animals, total protein in BAL was higher (33.0±1.9 µg/mL) compared with G-AV1 (23.0±2.0 µg/mL). Upon 180 minutes of MV, malondialdehyde levels increased in elderly (G-EV3) compared with adult (G-AV3) groups. Malondialdehyde and total proteins in BAL after 3 hours of MV were higher in elderly group than in adults. In G-EV3 group we observed alveolar septa dilatation and significative increase in neutrofiles number in relation to adult group at 60 and 180 minutes on MV. CONCLUSION: A higher fraction of inspired oxygen in short courses of mechanical ventilation ameliorates the parameters studied in elderly lungs.

Indicadores do Método de Rorschach para avaliação da maturidade emocional para porte de arma de fogo / Rorschach Method's indicators to evaluate emotional maturity of handgun license candidates

0 objetivo deste trabalho é estabelecer indicadores do Método de Rorschach, avaliado segundo a proposta de Aníbal Silveira (1985), para a avaliação psicológica exigida na lei para a concessão do porte de arma de fogo. A amostra foi composta por 150 sujeitos do sexo masculino, de 19 a 51 anos, divididos em três grupos: um grupo controle (GC) extraído da pesquisa de Coelho (2000), de sujeitos supostamente normais. O segundo grupo (GPA) constituiu-se de 50 candidatos ao porte de arma de fogo para o exercício da função na Guarda Civil de um município de São Paulo e o terceiro, por 50 presidiários (GPR) com histórico de violência e crimes praticados com o uso de arma de fogo e que fizeram parte da pesquisa de Morana (2003). Os protocolos de Rorschach destes três grupos foram comparados quanto aos índices: Impulsividade (IMP), Adaptação à Realidade (RMI), índice Conativo (Con), Resposta de Movimento (RM) e Resposta de Cor (RC). Para IMP o grupo controle apresentou valores próximos ao esperado, enquanto que GPA e GPR apresentaram esse índice diferente e acima do GC. O RMI não apresentou diferenças significantes entre os três grupos, mas sim nos índices que o compõem ( por cento F+, por cento V e por cento A), tanto no total das respostas quanto para as respostas às pranchas monocromáticas e coloridas. 0 índice Conativo não diferenciou nenhum dos três grupos, seja no total como nos conjuntos mono e color. Para a RM não foram encontradas diferenças significantes entre GPA e GRP porém houve diferença entre o grupo controle e os outros dois grupos. Quanto a RC, não houve diferenças entre o GC e o GPA, sendo que ambos apresentaram diferença significante com o GPR. Concluiu-se que tais indicadores, exceto o índice Conativo, podem discriminar sujeitos mais violentos os quais, por questões emocionais, poderiam ser contra-indicados para a concessão do porte de arma de fogo, contribuindo assim para a avaliação psicológica exigida daqueles que buscam o porte de arma (AU)

Thyroid stimulating hormone levels in cord blood are not influenced by non-thyroidal mothers' diseases.

CONTEXT: Screening programs not only offer the opportunity to trace and treat almost all cases of congenital hypothyroidism but also mean large savings to the health system. However, carefully planned strategies are necessary to extend their benefits and reduce costs. OBJECTIVE: To determine the possible influence of maternal diseases that affect maternal-fetal placenta dynamics on primary thyroid stimulating hormone (TSH) screening for congenital hypothyroidism. DESIGN: Prospective non-randomized clinical trial with at least 3 months of follow-up. SETTING: A public university referral center [CAISM/Hospital das Clínicas, Faculty of Medicine, University of Campinas, Campinas, SP]. PARTICIPANTS: 415 neonates divided into 5 groups: eighty-three infants born from cardiac mothers; 98 from mothers that had toxemia; 54 of the mothers had diabetes mellitus; 40 were HIV positive and 140 had no diseases. INTERVENTION: All newborns had cord blood samples collected on filter paper at birth. MAIN MEASUREMENTS: TSH was measured from dried blood spots using a homemade immunofluorescence assay (sensitivity in dried blood spots = 0.1 mU/L). RESULTS: There was no significant difference in the mean TSH levels among the 5 groups. Moreover, TSH levels were around 5 mU/L in 48% of the newborns, indicating that our region is severely deficient in iodine. CONCLUSIONS: Our results indicate that primary TSH screening programs using cord blood are not affected by maternal diseases. We suggest that, besides its technical advantages over heel punctures with T4 primary approaches, neonatal screening using primary cord blood TSH may also be used as a monitoring tool for evaluation and control of iodine deficiency disorders (IDD).