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Environmental awareness has led industries and consumers to replace products derived from oil resources with products derived from natural sources. In the case of the composite materials industry, the replacement of synthetic fibres with natural fibres has increased in recent years. To study the influence that different types of natural fibres and different textile manufacturing techniques have on the mechanical properties of composites, bio-based epoxy matrix composites reinforced with different natural animal fibres were produced, some reinforced with sheep's wool and others with dog wool, which were later subjected to bending and tensile tests. From the authors' knowledge, there are few studies of composites produced with animal fibres, and even fewer with dog hair. The textile structures used as reinforcement were created using crochet, knitting, and weaving techniques. Prior to the composites production, the fibres were characterized by X-ray Diffraction (X-RD), and the yarns produced from these fibres were subjected to tensile tests. The results obtained suggest that the number of yarns and the diameter of the needles used during the production of the reinforcement have a significant impact on the mechanical properties of the composites. The green epoxy resin composites reinforced with sheep's wool exhibit higher values of flexural strength, tensile strength, and Young's modulus than those reinforced with dog wool, with average increases of 36.97%, 45.16%, and 72.99%, respectively. It was also possible to verify that the composites reinforced with woven fabrics and crocheted fabrics exhibit the highest values of tensile strength, flexural strength, and Young's modulus. Additionally, the composites reinforced with woven fabrics exhibit the highest values of deformation at first failure/break and toughness.

Butia capitata endocarp (BCE) is a biomass residue with the potential to produce a wide variety of bio-products. The processing of BCE in a sequential process of subcritical water hydrolysis (SWH) and hydrothermal liquefaction (HTL) was investigated to obtain fermentable sugars, platform chemicals, bio-oil, and biochar. The SWH was evaluated at 230 and 260 °C and solvent: feed mass ratios (R) of 10 and 20 for the production of fermentable sugars and platform chemicals. The solid residue from SWH was sequentially submitted to the HTL at 330 and 360 °C for bio-oil and biochar production. The results were analyzed by comparing the sequential (SWH/HTL) and individual (HTL only) processes. The highest yields of fermentable sugars (5.26 g/ 100 g BCE) were obtained for SWH at 260 °C and R-20 with higher contents of xylose (2.64 g/100 g BCE) and cellobiose (1.75 g/100 g BCE). The highest yields of platform chemicals (2.44 g/100 g BCE) were obtained for SWH at 260 °C and R-10 with higher contents of acetic acid (1.78 g/100 g BCE) and furfural (0.54 g/100 g BCE). The highest yield of bio-oil (25.30 g/100 g BCE) occurred in HTL individual process at 360 °C and R-20. Sequential process SWH/HTL showed a decrease in bio-oil yield but maintained a similar biochar yield compared to HTL, in addition to the production of fermentable sugars and platform chemicals., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The environmental emergency has alerted consumers and industries to choose products derived from renewable sources over petroleum derivatives. Natural fibers of plant origin for reinforcing composite materials dominate the field of research aiming to replace synthetic fibers. The field of application of green dog wool composite materials needs to be reinforced and proven, as the industry is looking for more sustainable solutions and on the other hand this type of raw material (pet grooming waste) tends to grow. Hence, in the present work, the feasibility of applying natural fibers of dog origin (mainly composed by keratin) in green composites was studied. The green composites were developed using chemically treated dog wool of the breed Serra da Estrela (with NaOH and PVA) as reinforcement and a green epoxy resin as a matrix. The chemical treatments aimed to improve adhesion between fibers and matrix. The fibers' composition was determined using X-ray Diffraction (X-RD). Their morphology was determined using a scanning electron microscope (SEM). The wettability of the fiber was also evaluated qualitatively by analyzing drops of resin placed on the fibers treated with the different treatments. The mechanical properties of the composites were also studied through mechanical tensile, flexural, and relaxation tests. Overall, the best results were obtained for the dog wool fibers without treatment. The tensile and flexural strength of this biocomposite were 11 MPa and 26.8 MPa, respectively, while the tensile and flexural elastic modulus were 555 MPa and 1100 MPa, respectively. It was also possible to verify that the PVA treatment caused degradation of the fiber, resulting in a decrease in mechanical tensile strength of approximately 42.7%, 59.7% in flexural strength and approximately 59% of the stress after 120 min of relaxation when compared to fiber made from untreated dog wool. On the other hand, the NaOH treatment worked as a fiber wash process, removing waxes and fats naturally present on the fiber surface.

Epilepsy is a condition that affects 50 million individuals globally, significantly impacting their quality of life. Epileptic seizures, a transient occurrence, are characterized by a spectrum of manifestations, including alterations in motor function and consciousness. These events impose restrictions on the daily lives of those affected, frequently resulting in social isolation and psychological distress. In response, numerous efforts have been directed towards the detection and prevention of epileptic seizures through EEG signal analysis, employing machine learning and deep learning methodologies. This study presents a methodology that reduces the number of features and channels required by simpler classifiers, leveraging Explainable Artificial Intelligence (XAI) for the detection of epileptic seizures. The proposed approach achieves performance metrics exceeding 95% in accuracy, precision, recall, and F1-score by utilizing merely six features and five channels in a temporal domain analysis, with a time window of 1 s. The model demonstrates robust generalization across the patient cohort included in the database, suggesting that feature reduction in simpler models-without resorting to deep learning-is adequate for seizure detection. The research underscores the potential for substantial reductions in the number of attributes and channels, advocating for the training of models with strategically selected electrodes, and thereby supporting the development of effective mobile applications for epileptic seizure detection.

The economic challenges for researchers in palliative care is an emerging and challenging topic. Knowing where, how and how much is spent is fundamental for palliative care (PC) provision to be increasingly efficient and with lower costs. To accomplish this, there are three important factors to consider: early access to PC; specialised PC using standardised procedures and informal and home-based PC. Beyond costs, ethical aspects should always be present when this care is being provided in its different forms, locations and contexts. For those who want to study the economic challenges in PC, they need to comprehend the complexity of them, since they will always come from a careful articulation between ethics, the person´s needs, the cost of the care and who these costs are charged to., Competing Interests: Statement of interest: None

Background: Notwithstanding recent advances in oral squamous cell carcinoma (OSCC) management, its mortality rate is still high. It is imperative to investigate new parameters that are complementary to clinical staging for OSCC to provide better prognostic insight. The presence of isolated neoplastic cells or small clusters of up to four cells at the tumor's invasive front, called tumor budding, is a morphological marker of OSCC with prognostic value. Increased lymphatic vascular density (LVD) and a high expression of podoplanin in neoplastic cells have also been associated with worse prognosis in OSCC. To investigate these markers in OSCC, we evaluated differences in LVD and the expression of podoplanin in neoplastic cells between tumors with high-intensity tumor budding versus low-intensity or no tumor budding. In the samples of high-intensity budding, differences in those parameters between the​​ budding area and the area outside the budding were also evaluated. Furthermore, the study assessed differences in LVD and in the expression of podoplanin in neoplastic cells concerning OSCC clinicopathological characteristics., Methods: To those ends, we subjected 150 samples of OSCC to immunohistochemistry to evaluate the intensity of tumor budding (via multi-cytokeratin immunostaining). Moreover, the 150 samples of OSCC and 15 specimens of normal oral mucosa (used as a control) were employed to assess LVD and the expression of podoplanin (in neoplastic cells of OSCC and in the lining epithelium of normal oral mucosa), both via podoplanin immunostaining. Data were processed into descriptive and analytical statistics., Results: No differences were observed neither in the LVD nor in the expression of podoplanin in neoplastic cells concerning sex, age, tobacco smoking, tumor location and tumor size. The LVD was greater in OSCC and in tumors with high-intensity budding than in normal mucosa but did not differ between normal mucosa and tumors with low-intensity or no tumor budding. The data analyses also revealed that LVD was greater in tumors with high-intensity tumor budding than in tumors with low-intensity or no budding and showed no difference in LVD between the budding area and the area outside the budding. When compared to the lining epithelium of the normal mucosa, the expression of podoplanin was greater in neoplastic cells of OSCC, tumors with high-intensity budding and tumors with low-intensity or no tumor budding. The expression of podoplanin in neoplastic cells was also greater in tumors with high-intensity budding and, within those tumors, greater in the budding area than in the area outside de budding., Conclusion: Those findings support the hypothesis that tumor budding is a biological phenomenon associated with the progression and biological behavior of OSCC., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Oral squamous cell carcinoma (OSCC) is the most prevalent malignant head and neck tumor, excluding the nonmelanoma skin cancer. Despite recent advances in the diagnosis and treatment, the disease's mortality rate is nonetheless high. The presence of isolated neoplastic cells or small clusters of up to four cells at the tumor's invasive front, named tumor budding, is associated with a worse prognosis in OSCC. Angiogenesis has also been recognized as a determining factor in the progression of malignancies and in the development of metastases. Several studies have investigated the assessment of microvascular density (MVD) as a potential prognostic factor in OSCC. This study aimed to evaluate, in OSCC, differences in MVD between tumors with high-intensity tumor budding and tumors with low-intensity or no tumor budding. In samples with high-intensity tumor budding, differences in MVD between the budding area and the area outside the budding were also evaluated. Moreover, the study assessed differences in MVD concerning clinicopathological characteristics such as sex, age, tobacco smoking, tumor location and tumor size., Material and Methods: One hundred and fifty [150] samples of OSCC were subjected to immunohistochemistry to assess the intensity of tumor budding (by immunostaining for multi-cytokeratin) and MVD (by immunostaining for CD34 and CD105, independently). The data were treated using descriptive and analytical statistics., Results: There were no differences in MVD, assessed by immunostaining for CD34 or CD105, concerning clinicopathological characteristics such as sex, age, tobacco smoking, tumor location and tumor size (p > 0.05). Tumors with high-intensity tumor budding did not show differences in MVD, assessed by immunostaining for CD34 or CD105, when compared to tumors with low-intensity or no tumor budding (p > 0.05). However, in samples with high-intensity tumor budding, the MVD assessed by immunostaining for CD34 was higher in the budding area than in the area outside the budding (p < 0.05). This difference was not observed when MVD was assessed by immunostaining for CD105 (p > 0.05)., Conclusions: The higher MVD in the budding area may be an additional indication that this is a peculiar region of the tumor, associated with biological phenomena related to tumor progression.

The aims of this study were to identify mercury-associated protein spots in the liver tissue of rats exposed to low concentrations of mercury and to elucidate the physiological and functional aspects of the proteins identified in the protein spots. Therefore, proteomic analysis of the liver tissue of Wistar rats exposed to mercury chloride (4.60 μg kg -1 in Hg 2+ ) was performed for thirty days (Hg-30 group) and sixty days (Hg-60 group). The proteomic profile of the liver tissue of the rats was obtained by two-dimensional electrophoresis (2D-PAGE), and the determinations of total mercury in the liver tissue, pellets and protein spots were performed by graphite furnace atomic absorption spectrometry (GFAAS). ImageMaster 2D Platinum 7.0 software was used to identify the differentially expressed mercury-associated protein spots, which were then characterized by liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS). The determinations by GFAAS indicated a total mercury bioaccumulation of 2812% in the Hg-30 group and 3298% in the Hg-60 group and 10 mercury-associated protein spots with a concentration range of 51 ± 1.0 to 412 ± 6.00 mg kg -1 in the 2D PAGE gels from the liver tissue of the Hg-60 group. The LC-MS/MS analyses allowed the identification of 11 metal binding proteins in mercury-associated protein spots that presented fold change with upregulation >1.5, downregulation < -1.7 or that were expressed only in the Hg-60 group. Using the FASTA sequences of the proteins identified in the mercury-associated protein spots, bioinformatics analyses were performed to elucidate the physiological and functional aspects of the metal binding proteins, allowing us to infer that enzymes such as GSTM2 presented greater mercury concentrations and downregulation < -3; Acaa2 and Bhmt, which showed expression only in the Hg-60 group, among others, may act as potential mercury exposure biomarkers., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Embossing is a functional and strategic process for creating high-quality multi-sensory tissue-paper products. Embossing modifies the sheet surface by generating hill and/or valley designs, changing the third-dimension z with a compressive die. This research work specifically concerns the impact study of the engraving finishing geometry on the final properties of tissue paper. This work led us to conclude that, even though the sheets individually present a higher hand-feel (HF) value for the straight finishing geometry, the highest softness was obtained in the two-ply prototype for the round finishing geometry. Moreover, this study confirmed that the HF value reduces with the increase of the bulk, being more accentuated for the micropattern. Relevant differences could not be seen in the spreading kinetics of the liquid droplets over time. Thus, the finishing geometry of the 3D plates did not impact the absorption kinetics on these samples. The finite element model allows us to understand the effect of the plate pattern and its finishing geometry on the paper, and the simulation results were in accordance with the experimental results, showing the same trend where patterns with a round finishing geometry marked the tissue-paper sheet more than patterns with a straight finishing did.

The embossing operation is one of the processes of tissue paper converting. The embossing parameters influence the final properties of tissue products, such as mechanical, softness, and bulk. In this study, the influence of the rubber hardness used against the embossing steel rolls with a pattern created by intaglio engraving was studied. Three different configurations of rubber plates stacking, each plate with different hardness, were studied. After embossing, mechanical properties, softness, and bulk were evaluated to analyze the effect of rubbers hardness on these properties. Furthermore, a Finite Element Model of the embossing operation was used that considered the same rubber plates stacking configurations used in experiments, and it was able to replicate the experimental results. This work led us to conclude that the configuration where two rubber plates with different hardness, where the rubber plate with higher hardness is in contact with the tissue paper sheet, has shown to be the best solution to obtain higher softness. These findings support the use of embossing operations rubber rolls with a low hardness internal layer and a high hardness external layer in industry. Thus, finite element models were also shown to be reliable tools to virtually test other configurations, such as, for example, three or more rubber plates with different hardness. Since embossing is one of the tissue paper transformation operations with the greatest impact on the key properties of the final product, this study allows the producer to optimize them by varying the hardness of the rubber roll, as well as its configuration.

Embossing is a converting process in which the surface of a tissue paper sheet is changed under high pressure, allowing different functions. In this work, the authors intend to study how the embossing pressure affects the main properties of tissue paper, using a laboratory embossing system. An optimum pressure was achieved at 2.8 bar to this embossing laboratory set-up. The effect of pressure when densifying the paper sheet gives it a gain in mechanical strength but no differences in terms of liquid absorbency. The two embossing patterns present different behaviors but both evidence losses in mechanical and softness properties. On the other hand, the finite element method (FEM) does not show clear evidence of how the pressure affects the paper strength. For the deco die, it is possible to observe that the amount of yielding is slightly higher for lower pressure (2.4 bar), but this plasticity state parameter is very similar for 2.8 bar and 3.2 bar. For the micro die, FEM simulations of the manufacturing pressure do not show a considerable impact on the amount of plasticity state of the material; only for 3.2 bar, it shows a change in the pattern of the plasticity state of the paper during the embossing processes. In the end, to achieve a final product with excellent quality, it is important to make a compromise between the various properties.

A Brazilian thermo-mechanical pulp mill (TMP) was evaluating the installation of a proposed bleaching process, with changes in the qualitative and quantitative characteristics of the wastewaters and the Effluent Treatment Plant (ETP). The objectives of this research were to evaluate the treatment plant configuration for the future industrial effluent, consisting of a flotation unit followed by an upflow anaerobic sludge blanket reactor (UASB), an activated sludge process and nanofiltration (NF) using polymeric membranes, and to study the technical feasibility of recycling the treated effluents in the industrial process. The possible options for recycling the treated effluent were determined through a water balance of the mill. The pulp quality was evaluated in laboratory bleaching assays, based on brightness and brightness reversion tests after the recycling of 50%, 75% and 100% of the treated effluent. The buildup of the non-process elements (NPE) in the industrial water cycle after each effluent recycling proportion was evaluated through computer simulation, using the Aspen Plus® simulator software. The future mill effluent, considering the implementation of a proposed bleaching stage with hydrogen peroxide, was generated in the laboratory and treated in a bench-scale effluent plant, simulating the future configuration. The treatment plant removed 99.8%, 99.2% and 61.6% of soluble COD, BOD 5 and color, respectively. The water consumption was highest in the bleaching plant and, therefore, the recycling of 50%, 75% and 100% of the treated effluent for washing the pulp was simulated. The brightness and brightness reversion of the pulp, with 100% of the treated effluent used in the bleaching process, were similar to those provided by fresh water. The recycling of 100% of the treated effluent in the proposed treatment plant was possible in the TMP pulp mill without decreasing the pulp quality., Competing Interests: Declaration of competing interest We wish to confirm that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Tissue paper is defined by its physical and mechanical properties, namely: high softness, low grammage, high bulk and high liquid absorption capacity. It is expected that the production of tissue paper will continue to grow, which increases the importance of better understanding the processes involved in its production as well as its optimization [1]. The experimental data presented in this article, are the physical-mechanical characterization of a group of 13 industrial base tissue papers, which were collected at the end of the tissue paper machine on Portuguese factories. These samples vary in grammage, composition and creping [2], enabling a later evaluation of the crepe type [3] and its relationship with the final properties of the tissue paper., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships which have, or could be perceived to have, influenced the work reported in this article., (© 2020 The Author(s).)

We decided to explore the frequency of cardiovascular risk factors, according to three levels of severity of compulsive sexual behavior (CSB), namely, non-sexually compulsive (1), sexually compulsive (2), and sexually compulsive, and hypersexual (3). We also investigated the impact of a psychiatric co-morbidity on the Framingham heart risk score (FRS). 94 non-sexually compulsive, 57 sexually compulsive, and 60 hypersexual individuals underwent psychiatric interview, blood collection, self-responsiveness, and anthropometric measurement. The analyses were repeated with individuals aged up to 44 and aged more than 44 years old. Regarding the total sample, we observed significant association among those sexually compulsive, and hypersexual participants with presenting the HIV serologic status, and a greater proportion of psychiatric conditions as much as the severity of CSB increases. Individuals with substance-related disorder predicted higher Framingham scores. The analyses with people aged more than 44 years old presented some different results, such as association among presenting low FRS and the sexually compulsive participants, and sexual compulsivity predicted lower scores of the Framingham. The study points out to the relevance of comprehensive psychiatric examination of whom presenting CSB and opens an avenue forward investigation of the effect of high rates of sexual activity on cardiovascular risk.

High concentrations of mercury found in soils, sediments, fish, and humans of the Amazon region have gained prominence in scientific studies during the last decade. However, studies related to the elucidation of mercury toxicity mechanisms in ichthyofauna at the molecular and metallomic levels that seek to elucidate physiological and functional aspects, as well as the search for biomarkers of mercury exposure, are still sparse. In the search for these answers, the present study analyzed the hepatic tissue proteome of the Arapaima gigas (pirarucu) fish species collected in the Jirau hydroelectric power plant reservoir in the state of Rondônia state, Brazil, in order to identify mercury-related metal-binding proteins and to elucidate their physiological and functional aspects. The proteomic profile of the hepatic tissue of Arapaima gigas was obtained by two-dimensional electrophoresis (2D-PAGE) and the presence of mercury was mapped in the protein SPOTS by graphite furnace atomic absorption spectrometry(GFAAS). Mercury was detected in 18 protein SPOTS with concentrations ranging from 0.13 ± 0.003 to 131.00 ± 3 mg kg -1 . The characterization of the protein SPOTS associated with mercury was performed by electrospray ionisation tandem mass spectrometry (ESI-MS/MS), and 10 proteins were identified. Bioinformatics analyses showed that most of the proteins found linked to mercury were involved in cellular component processes and biological processes. For the most part, protein sequences have cellular functions comprising catalytic, binding, sense of localization, and metabolic processes., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Poly(ADP-ribose) polymerase (PARP) is involved in the pathogenesis of cell dysfunction, inflammation and organ failure during septic shock. The goal of the current study was to investigate the efficacy and safety of the clinically approved PARP inhibitor olaparib in experimental models of oxidative stress in vitro and in sepsis in vivo. In mice subjected to cecal ligation and puncture (CLP) organ injury markers, circulating and splenic immune cell distributions, circulating mediators, DNA integrity and survival was measured. In U937 cells subjected to oxidative stress, cellular bioenergetics, viability and DNA integrity were measured. Olaparib was used to inhibit PARP. The results show that in adult male mice subjected to CLP, olaparib (1-10 mg/kg i.p.) improved multiorgan dysfunction. Olaparib treatment reduced the degree of bacterial CFUs. Olaparib attenuated the increases in the levels of several circulating mediators in the plasma. In the spleen, the number of CD4+ and CD8+ lymphocytes were reduced in response to CLP; this reduction was inhibited by olaparib treatment. Treg but not Th17 lymphocytes increased in response to CLP; these cell populations were reduced in sepsis when the animals received olaparib. The Th17/Treg ratio was lower in CLP-olaparib group than in the CLP control group. Analysis of miRNA expression identified a multitude of changes in spleen and circulating white blood cell miRNA levels after CLP; olaparib treatment selectively modulated these responses. Olaparib extended the survival rate of mice subjected to CLP. In contrast to males, in female mice olaparib did not have significant protective effects in CLP. In aged mice olaparib exerted beneficial effects that were less pronounced than the effects obtained in young adult males. In in vitro experiments in U937 cells subjected to oxidative stress, olaparib (1-100 μM) inhibited PARP activity, protected against the loss of cell viability, preserved NAD + levels and improved cellular bioenergetics. In none of the in vivo or in vitro experiments did we observe any adverse effects of olaparib on nuclear or mitochondrial DNA integrity. In conclusion, olaparib improves organ function and extends survival in septic shock. Repurposing and eventual clinical introduction of this clinically approved PARP inhibitor may be warranted for the experimental therapy of septic shock., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Protozoa and metazoa biota communities in biological wastewater treatment plants (WWTP) are known to be dependent of both the plant type (oxidation ditch, trickling filter, conventional activated sludge, among others) and the working operational conditions (incoming effluent characteristics, toxics presence, organic load, aeration, hydraulic and sludge retention times, nitrification occurrence, etc.). Thus, for analogous WWTP operating in equivalent operating conditions, similar protozoa and metazoa communities can be found. Indeed, the protozoa and metazoa biota monitoring can be considered a quite useful tool for assessing the functioning of biological WWTP. Furthermore, the use of chemometric techniques in WWTP monitoring is becoming widespread to enlighten interrelationships within the plant, especially when a large collection of data can be obtained. In the current study, the protozoa and metazoa communities of three different types of WWTP, comprising one oxidation ditch, four trickling filters, and three conventional activated sludge plants, were monitored. For that purpose, metazoa, as well as the main protozoa groups (flagellates, free-swimming, crawling and sessile ciliates, and testate amoeba) were determined in terms of contents and relative abundance. The collected data was further processed by chemometric techniques, such as cross-correlation, principal components, multivariate ANOVA, and decision trees analyses, allowing to successfully identify, and characterize, the different studied WWTP, and thus, being able to help monitoring and diagnosing operational problems.

We investigated the effect of dexamethasone during the last week of pregnancy on glucose and lipid metabolism in male offspring. Twelve-week old offspring were evaluated after fasting for 12-hours (physiological) and 60-hours (prolonged). Physiological fasting resulted in glucose intolerance, decreased glucose clearance after pyruvate load and increased PEPCK expression in rats born to dexamethasone-treated mothers (DEX). Prolonged fasting resulted in increased glucose tolerance and increased glucose clearance after pyruvate load in DEX. These modulations were accompanied by accumulation of hepatic triglycerides (TG). Sixty-hour fasted DEX also showed increased citrate synthase (CS) activity, ATP citrate lyase (ACLY) content, and pyruvate kinase 2 (pkm2), glucose transporter 1 (slc2a1) and lactate dehydrogenase-a (ldha) expressions. Hepatic AKT2 was increased in 60-hour fasted DEX, in parallel with reduced miRNAs targeting the AKT2 gene. Altogether, we show that metabolic programming by prenatal dexamethasone is characterized by an unexpected hepatic TG accumulation during prolonged fasting. The underlying mechanism may depend on increased hepatic glycolytic flux due to increased pkm2 expression and consequent conversion of pyruvate to non-esterified fatty acid synthesis due to increased CS activity and ACLY levels. Upregulation of AKT2 due to reduced miRNAs may serve as a permanent mechanism leading to increased pkm2 expression.

Epidemiological, behavioral, and clinical data on sexual compulsivity in Brazil are very limited. This study sought to adapt and validate the Sexual Compulsivity Scale (SCS), the 22-item version of the Compulsive Sexual Behavior Inventory (CSBI-22), and the Hypersexual Disorder Screening Inventory (HDSI) for use in Brazil. A total of 153 participants underwent psychiatric assessment and completed self-reported measures. The adaptation process of the instruments from English to Portuguese followed the guidelines of the International Society for Pharmacoeconomics and Outcomes Research. The reliability and validity of the HDSI criteria were evaluated and the construct validity of all measures was examined. For the SCS and HDSI, factor analysis revealed one factor for each measure. For the CSBI-22, four factors were retained although we only calculated the scores of two factors (control and violence). All scores had good internal consistency (alpha >.75), presented high temporal stability (>.76), discriminated between patients and controls, and presented strong (ρ > .81) correlations with the Sexual Addiction Screening Test (except for the violence domain = .40) and moderate correlations with the Impulsive Sensation Seeking domain of the Zuckerman Kuhlman Personality Questionnaire (ρ between .43 and .55). The sensitivity of the HDSI was 71.93 % and the specificity was 100 %. All measures showed very good psychometric properties. The SCS, the HDSI, and the control domain of the CSBI-22 seemed to measure theoretically similar constructs, as they were highly correlated (ρ > .85). The findings support the conceptualization of hypersexuality as a cluster of problematic symptoms that are highly consistent across a variety of measures.

This study used metalloproteomic techniques to characterize mercury (Hg)-bound proteins in the muscle and liver tissue of Tucunaré (Cichla spp.) collected at the Jirau Hydroelectric Power Plant in Madeira River Basin, Brazil. The proteome of the muscle and liver tissue was obtained after two steps of fractional precipitation and separating the proteins by 2-D polyacrylamide gel electrophoresis. Hg was identified and quantified in the protein spots by graphite furnace atomic absorption spectrometry after acid mineralization in an ultrasound bath. Hg with a molecular weight <20 kDa and a concentration between 13.30 and 33.40 mg g(-1) was found in the protein spots. These protein spots were characterized by electrospray ionization tandem mass spectrometry after trypsin digestion. From a total of 12 analyzed spots, seven proteins showing Hg biomarker characteristics were identified: parvalbumin and its isoforms, ubiquitin-40S ribosomal protein S27a, zinc (Zn) finger and BTB domain-containing protein 24, and dual-specificity protein phosphatase 22-B.

This study aimed to identify metalloproteins that lose their metal ions in the presence of mercury (Hg) and bind to Hg in breast milk samples collected from the riverine population of the Madeira River, a tributary of the Amazon River. Initially, total Hg was determined from the hair of lactating women to identify individuals who were contaminated followed by a proteomic analysis of breast milk samples through two-dimensional polyacrylamide gel electrophoresis after acetone precipitation. The presence of Hg in the obtained protein spots was determined by cold vapor atomic absorption spectrometry and cold vapor atomic fluorescence spectrometry. These determinations indicated the presence of Hg in one protein spot, which was then characterized through electrospray ionization tandem mass spectrometry. Based on searches in the UniProt database, this protein spot was identified as lysozyme C.

Objective: To assess the effects of postconditioning remote in ischemia-reperfusion injury in rat lungs., Methods: Wistar rats (n=24) divided into 3 groups: GA (I/R) n=8, GB (R-Po) n=8, CG (control) n=8, underwent ischemia for 30 minutes artery occlusion abdominal aorta, followed by reperfusion for 60 minutes. Resected lungs and performed histological analysis and classification of morphological findings in accordance with the degree of tissue injury. Statistical analysis of the mean rating of the degree of tissue injury., Results: GA (3.6), GB (1.3) and CG (1.0). (GA GB X P<0.05)., Conclusion: The remote postconditioning was able to minimize the inflammatory lesion of the lung parenchyma of rats undergoing ischemia and reperfusion process.

Aortic dissection is a cardiovascular event of high mortality if not early diagnosed and properly treated. In Stanford type A aortic dissection, there is the involvement of the ascending aorta, whereas in type B the ascending aorta is not affected. The treatment of type A aortic dissection is mainly surgical. The hospital mortality of type B aortic dissection surgical treatment is approximately 20%, while medical therapy is 10%. However, half the patients who are discharged from hospital after medical treatment, progress to aortic complications in the following years, and the mortality in three to five years may reach 25-50%. In addition, the surgical treatment of aortic complications after medical treatment, has also a significant mortality. This way, the endovascular treatment comes up as an interesting alternative of a less invasive treatment for this disease. They presented a mortality rate lower than 10% with more than 80% success rate of occlusion and thrombosis of the false lumen. The INSTEAD TRIAL, which randomized patients with uncomplicated type B aortic dissection for optimal medical therapy and endovascular treatment in addition to optimal medical therapy, showed that after three years of follow up, patients who underwent endovascular treatment had lower mortality and aorta-related complications. Therefore, there is a current tendency to recommend the endovascular treatment as a standard for the treatment of type B aortic dissection.

In the present study, a simple, rapid and sensitive method was developed for the determination of mercury concentrations in the muscle tissue of fish from the Brazilian Amazon using graphite furnace atomic absorption spectrometry (GFAAS) following acid mineralization of the samples in an ultrasonic cold water bath. Using copper nitrate as a chemical modifier in solution and sodium tungstate as permanent modifier, we were able to attain thermal stabilization of the mercury up to the atomisation temperature of 1600 °C in the GFAAS assay. The calculated limits of detection (LOD) and quantification (LOQ) were 0.014 and 0.047 mg kg(-1), respectively., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Objective: This paper demonstrates the initial and pioneering experience implant of the Inovare prosthesis implant through transfemoral or iliac artery route., Methods: Six patients underwent transcatheter aortic valve implantation. The access was femoral or iliac through which the delivery device, a latex balloon catheter with the crimped prosthesis, was inserted. Through the femoral introducer 24 Fr Gore® DrySeal sheath, an extra stiff guide wire with non-traumatic tip was positioned in the left ventricle by passing through the valve ring. After balloon valvuloplasty, in cases of native valve stenosis, the prosthesis implantation was performed after hypotension induced by tachycardia and controlled by temporary pacemaker. The valve positioning was guided by TEE (transesophageal ecocardiography) and fluoroscopy, aiming to position a third of the length of the prosthesis into the left ventricle cavity., Results: The successful valve implantation was possible in six cases. There was no need of conversion to open surgery due to inability to access or graft migration. There were no intraoperative or hospital deaths. We observed a significant reduction in the mean gradient of 66.84115.46 mmHg to 19.74110.61 mm Hg postoperatively (P=0.002), a reduction of 70.46%., Conclusion: Inovare prosthesis, implanted by femoral or iliac artery was feasible, and determined adequate hemodynamic performance in the postoperative follow-up, showing no mortality in this small series.

Woman, 84 years-old, with Stanford type A thoracic aortic dissection committing aortic arch and descending aorta. Proposed and accepted endovascular treatment according to the severity of the clinical picture. Common femoral artery dissection bilaterally was done. Aortography confirmed the exclusion of the false lumen and patency of the coronary ostia.

Background: The gold standard surgical treatment for heart failure is cardiac transplantation, however, due to difficulties of this treatment, other surgical proposals have been reported, including the implantation of cardiac resynchronizer., Objective: To analyze the left ventricular function by echocardiography in patients with advanced heart failure with interventricular dyssynchrony undergone implantation of cardiac resynchronizer., Methods: Between June 2006 and June 2012, 24 patients with average age of 61.5 ± 11 years were evaluated, carriers of advanced congestive heart failure functional class III and IV (NYHA), interventricular dyssynchrony and optimal drug therapy, and submitted implantation of cardiac resynchronizer and postoperative echocardiographically evaluated in six months., Results: There was significant improvement of the analyzed echocardiography parameters. The average left ventricular diastolic diameter decreased from 69.6 ± 9.8 mm to 66.8 ± 8.8 mm, systolic diameters from 58.6 ± 8.8 mm to 52.7 ± 8.8 mm, and ejection fraction, average of 31 ± 8% to 40 ± 7% with level of significance, respectively, of 0.019, 0.0004 and 0.0002, statistically significant with a significance level of 0.05., Conclusion: There was a significant improvement of left ventricular function analyzed by echocardiography at six months, in patients with advanced heart failure undergone implantation of cardiac resynchronizer.

Aortic dissection type A has a great mortality in its acute phase with low annual survival without surgical treatment. Although the chronic cases are exceptions the late complications exist and should be treated.

This paper presents preliminary findings for a metallomics study of mercury in the muscle of the fish species from Amazonas, Brazil, after protein separation by two-dimensional polyacrylamide gel electrophoresis and subsequent evaluation of mercury by synchrotron radiation X-ray fluorescence. The fluorescence spectra revealed mercury in two protein spots. The mercury-containing protein spots showed molecular weights of 20.8 ± 0.7 and 19.8 ± 0.5 kDa and isoelectric points of 5.6 ± 0.2 and 7.5 ± 0.3, respectively.

We present a patient with severe aortic valvular bioprosthesis dysfunction implanted for 11 years, presenting with acute pulmonary edema due to severe valvular insufficiency with severe systolic dysfunction (EF <30%) and comorbid conditions that amounted operative risk (STS score > 10). We carried out the transcatheter aortic valve implantation (Inovare® - Braile Biomedica), which was implemented successfully by transfemoral access and good patient outcomes.

Purpose: To evaluate the effects of propofol as an inhibitor of tissue injury in testicular ischemia-reperfusion in rats., Methods: 30 Wistar rats were assigned to one of three groups of 10 animals: G1, testicular exposure alone; G2 and G3: testicular ischemia caused by left spermatic cord torsion of 720º. In G3, propofol was administered intraperitoneally at 20 mg/kg/h 45 minutes after spermatic cord torsion. In G2 and G3, spermatic cords were detorsioned after 60 min. In all three groups, testes were subsequently repositioned in the scrotum. After 90 days, bilateral orchiectomy was performed for histological examination., Results: No abnormalities in seminiferous tubules were found in G1. In G2, 86.6% of left testes exhibited abnormalities, in contrast with 67.8% for right testes. In G3, these proportions were 57.3% and 45.6%, respectively. A statistically significant difference was found between G2 and G3., Conclusion: Propofol reduced the tissue damage in rat testes subjected to ischemia-reperfusion caused by spermatic cord torsion.

Objective: Evaluate knowledge of rubella and acceptability of vaccination and identify sources of health information among brazilian adults to inform communication strategies for a national vaccination campaign to eliminate rubella and congenital rubella syndrome (CRS)., Methods: From 5-8 July 2008 a qualitative telephone survey was conducted among a nonprobabilistic sample of brazilian adults 18 to 65 years of age (n = 1 023) from all five geographic regions of Brazil to measure knowledge of rubella and willingness to receive the vaccine and to identify sources of health information. Frequencies of responses were stratified by respondents' sex, age, education, and income., Results: Although 69.9% of respondents said they knew what rubella was, actual knowledge of the disease was limited, with only 29.9% answering affirmatively when asked if they would recognize symptoms of rubella infection. Self-reported knowledge increased with increasing age, education, and income, and was higher among women than men. A total of 94.5% of the respondents expressed willingness to be vaccinated for rubella elimination. The most frequently mentioned sources of health information were television and doctors., Conclusions: Despite limited knowledge of rubella, brazilian adults expressed willingness to be vaccinated for disease elimination.

Primary cardiac tumors are infrequent, with an incidence between 0.001% and 0.2%, mostly comprising benign histological characteristics in 75% of these cases. Myxomas account for approximately 50% of these neoplasms. As regards location, 75-80% of myxomas are in the left atrium, 18% in the right atrium, and more rarely in the ventricles. We report a case of a patient in functional class (FC) IV New York Heart Association (NYHA) and postoperative histological diagnosis of multilobular myxoma originating in the posterior left atrial wall. Clinical evaluation 3 months after surgery suggested NYHA functional class I and echocardiographic absence of intracardiac masses.

The aliphatic polyesters are widely used in biomedical applications since they are susceptible to hydrolytic and/or enzymatic chain cleavage, leading to α-hydroxyacids, generally metabolized in the human body. This is particularly useful for many biomedical applications, especially, for temporary mechanical supports in regenerative medical devices. Ideally, the degradation should be compatible with the tissue recovering. In this work, the evolution of mechanical properties during degradation is discussed based on experimental data. The decrease of tensile strength of PLA-PCL fibers follows the same trend as the decrease of molecular weight, and so it can also be modeled using a first order equation. For each degradation stage, hyperelastic models such as Neo-Hookean, Mooney-Rivlin and second reduced order, allow a reasonable approximation of the material behavior. Based on this knowledge, constitutive models that describe the mechanical behavior during degradation are proposed and experimentally validated. The proposed theoretical models and methods may be adapted and used in other biodegradable materials, and can be considered fundamental tools in the design of regenerative medical devices where strain energy is an important requirement, such as, for example, ligaments, cartilage and stents., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

The blood hypercoagulability in pregnancy increases significantly the incidence of thrombosis of mechanical valves. Acquired supravalvular aortic stenosis is extremely rare. We report the case of an immediate postpartum patient with aortic mechanical prostheses and acquired supravalvular aortic stenosis who underwent emergency heart surgery, with severe hemodynamic instability, using adapted surgical technique for correction of supravalvular stenosis with satisfactory clinical and echocardiography results.

One of the most important objectives of genetic markers of cancer will be the possible identification of individuals at greatest risk in order to allow better management and prognosis. Many urological tumors were associated to various types of gene alterations with a great number of genes involved in the process, hindering gene therapy. This treatment uses specific techniques and one or several genes are manipulated in the laboratory in order to induce molecular alterations that may block the oncogenic process. The article addresses these issues emphasizing the importance of the new molecular biology techniques.

Introduction: The epsilon aminocaproic acid is an antifibrinolytic used in cardiovascular surgery to inhibit the fibrinolysis and to reduce the bleeding after CPB. [corrected], Objective: To analyze the influence of the using of epsilon aminocaproic acid in the bleeding and in red-cell transfusion requirement in the first twenty-four hours postoperative of mitral valve surgery., Methods: Prospective studying, forty-two patients, randomized and divided in two equal groups: group #1 control and group #2--epsilon aminocaproic acid. In Group II were infused five grams of EACA in the induction of anesthesia, after full heparinization, CPB perfusate after reversal of heparin and one hour after the surgery, totaling 25 grams. In group I, saline solution was infused only in those moments., Results: Group #1 showed average bleeding volume of 633.57 ± 305,7 ml, and Group #2, an average of 308.81 ± 210.1 ml, with significant statistic difference (P = 0.0003). Average volume of red-cell transfusion requirement in Groups 1 and 2 was, respectively, 942.86 ± 345.79 ml and 214.29 ± 330.58 ml, with significant difference (P < 0.0001)., Conclusion: The epsilon aminocaproic acid was able to reduce the bleeding volume and the red-cell transfusion requirement in the immediate postoperative of patients submitted to mitral valve surgery.

Objective: To compare the results of radical prostatectomy by perineal and suprapubic approaches as to operative time, procedure costs, and surgical site complications., Methods: The medical records of localized prostate cancer patients (PSA ≤ 10 ng/ml and Gleason score ≤ 6) were analyzed. Fifty-five patients were submitted to radical prostatectomy by perineal approach and 54 via suprapubic approach., Results: There were statistical differences between groups as to operative time (p < 0.05); for perineal approach it was in average 114 minutes (SD ± 0.03) and for suprapubic approach, an average of 167 minutes (SD ± 0.041). Prostatectomy via perineal approach resulted in 11 cases of surgical complications, and suprapubic approach, 3 cases., Conclusions: Radical prostatectomy via perineal approach took less time at a lower cost as compared to the suprapubic approach. However, there were more complications in patients submitted to perineal approach, mainly rectal lesions.

Purpose: To evaluate the effect of postconditioning protection in liver tissue of rats submitted to ischemia and reperfusion., Methods: 25 Wistar male rats were randomized in three groups: Group A (ischemia and reperfusion - I/R), with 10 rats, which was made ischemia by vascular clamp application in hepatic hilum for 30 minutes and reperfusion for 60 minutes by removal of the clamp; Group B (Postconditioning - IPo), with 10 rats, with same procedure plus postconditioning (3 cycles of reperfusion inserted by 3 cycles of ischemia, 30 seconds for each phase, between ischemia and reperfusion phases); and Group C (Sham), with 5 rats, which took place only laparotomy and manipulation of the hepatic hilum. Specimens were examined (histological evaluation) and dosage of serum AST and ALT was made. The statistical analysis was made with t Student test, with significant difference when p<0.05., Results: In the Sham group there was no histological or enzymatic changes; In group A the mean tissue lesion was 1.6 and in group B 1.1 (p=0.014). In group A the mean ALT level was 355U/l and in group B was 175.9U/l (p=0.016). The mean of AST was 828.8U/l in group A and 295.5U/l in group B (p=0.001)., Conclusion: The postconditioning was able to minimize the severity of liver injury in rats submitted to ischemia and reperfusion.

Purpose: The development of an experimental model of myocardiopathy induced by Doxorubicin in rats., Methods: 16 wistar male rats were randomized in two groups: Group I (placebo) and Group II (Doxorubicin - 5mg/kg). After six months, the animals were subjected to cardiotomy and their hearts were weighted and submitted to transversal cuts, from which fragments for a macro and micro study were obtained. These fragments were studied considering their external and internal diameters and the thickness of the left ventricle (LV). The histological pieces were analyzed for the presence of fibrosis, cytoplasmic vacuolization, necrosis and size of nucleus variation. Data obtained was submitted to statistical analysis with Student's t test., Results: The hearts of the animals in Group II increased 41% in relation to their weight; 33% in the internal diameter and 14% in the external diameter of the LV cavity; and 24% in the thickness of the wall. Fibrosis of the myocardial tissue was observed in 75% of the animals of Group II; all the animals presented miocyte cytoplasmatic vacuolization; myocardial necrosis was present in 75% of the animals; and 87/% presented variation in the size of myocite nuclei. The presence of polymorphonuclear cells was also observed., Conclusion: Doxorubicin was effective in the promotion of macro and microscopic alterations in the cardiac tissue of rats, possibly constituting a model for the experimental study of myocardiopathy.

Objective: To determine, even during postoperative period, the confiability of the cardiac index correlate with the data data given by a central atrial venous blood gasometry in patients who underwent cardiac surgery., Methods: From the sample of arterial and venous blood of right atrium gathered in postoperative of cardiac surgery, it was determinated the hemoglobin concentration and the gasometric study through what was observed of the venous oxygen saturation (SvO2) and the partial pressure of oxygen from venous blood gathered in right atrium (PvO2), add to the calculation of artery-venous difference of the oxygen content--radial artery / right atrium (C( a-v )O2). Afterwards, these parameters were compared with the cardiac index determined by thermodilution., Results: There was good correlation between SvO2, C(av)O2 of the venous right atrial blood and cardiac index measured by thermodilution method, with sensibility and specificity good and high positive predict value and negative predict value. The PvO2 demonstrated poor sensibility in the estimative of low output., Conclusion: In cardiac surgery postoperative, the SvO2 and the C(a-v)O2 were safe parameters correlated with low cardiac output. The PvO2 demonstrated poor sensibility in the estimative of low output in postoperative cardiac surgery.

The treatment for closure of persistent ductus arteriosus (PDA) in adults still controversial. The endovascular approach has been shown as an effective alternative to surgical treatment. We report a case of 45 years old patient submitted to endovascular approach for PDA closure.

In order to examine the role of IFN-gamma, TNFRp55 and iNOS in inflammatory reaction during toxoplasmosis, IFN-gamma(-/-), TNFRp55(-/-) and iNOS(-/-) mice were experimentally infected with Toxoplasma gondii ME-49 strain. The organs of the mice were evaluated for histology and immunohistochemistry in detection of tissue parasitism and iNOS positive cells. IFN-gamma(-/-) mice presented mild inflammation in peripheral organs associated with a high parasitism and mortality in the acute phase of infection. In contrast, the peripheral organs of WT, TNFRp55(-/-) and iNOS(-/-) mice, presented a significant inflammatory reaction and low tissue parasitism in the same period of infection. The inflammatory lesions and tissue parasitism were increased and more severe in the Central Nervous System (CNS) of TNFRp55(-/-) and iNOS(-/-) with a progression of infection, when compared to WT mice. In these knockout animals, the inflammatory changes were associated with low levels or no expression of iNOS in TNFRp55(-/-) and iNOS(-/-) mice, respectively.

Objective: To assess the preconditioning and postconditioning effect on intestinal mucosal lesions in rats undergone mesenteric ischemia and reperfusion procedure., Methods: Thirty Wistar rats were studied and divided into three groups: Group A, 10 rats undergone mesenteric ischemia (30 minutes) and reperfusion (60 minutes); Group B, 10 rats undergone mesenteric ischemia and reperfusion preceded by ischemic preconditioning for three cycles of ischemia and reperfusion for two minutes each; Group C, 10 rats undergone mesenteric ischemia and reperfusion and, preceding the beginning of reperfusion, ischemic postconditioning was performed for three cycles of reperfusion and ischemia for two minutes each. Then, a segment of small intestine was resected for histological analysis. We assessed the results by Chiu et al. score and the statistical analysis was performed., Results: According to Chiu et al. score, the means of lesion degree were: In the group A, 3.5; Group B, 1.2; Group C, 1. The difference between group A with the groups B and C was considered statistically significant (P < 0.05)., Conclusion: Ischemic pre- and postconditioning were capable of minimizing - in a similar intensity - the tissue injury on the intestinal mucosa of rats undergone mesenteric ischemia and reperfusion process.

We analyze hospital efficiency and productivity growth using an innovative approach which employs the directional distance function and the Luenberger productivity indicator. The primary advantage of our approach is that both input contractions and output expansions are considered. Our model generates a productivity indicator that is decomposed into the usual constituents of productivity growth: technological change and efficiency change. For the sake of comparison, we also use the Malmquist productivity index. The empirical results based on a sample of Portuguese hospitals from 1997 to 2004 show that, on average, those hospitals experienced very weak productivity growth over that period. In addition, the incidence of technological change was remarkably low.

Objective: To evaluate the results of the surgical treatment of atrial fibrillation for ablation of the posterior left atrial wall using electrocautery in mitral valve surgery., Methods: From May 2004 to December 2006, 23 patients underwent surgical correction of mitral valve disease and treatment of atrial fibrillation using the conventional electrocautery for the accomplishment of lines of endocardial ablation in the left atrium. The mean age of the patients was 59 years, and 60.8% were female. The left atrium mean diameter was 50.3 +/- 5.09 mm and the left ventricular ejection fraction was 53.6 +/- 11.03%., Results: The mean time of extracorporeal circulation was 52.5 +/- 13.3 min; aortic clamping, 35.6 +/- 12.9 min; atrial ablation, 3.05 +/- 0.16 min. All the patients were free of atrial fibrillation after the procedure; on hospital discharge, 69.5%; at 6 months, 91.3%; at 12 months, 76.4%; at 18 months, and at 24 months, 68.4%. At 12 months, left atrium mean diameter was 42.1 +/- 3.5 mm; left ventricular ejection fraction was 59.2 +/- 3.48%; In addition, left atrial contraction was present in 68.8% of the patients., Conclusion: The surgical treatment of the atrial fibrillation with electrocautery in mitral valve surgery was capable to determine the reversion of this arrhythmia in a significant number of patients during short- and middle-term clinical follow-up without mortality and fewer complications.

Objective: To analyze the short-term and mid-term follow-ups of patients with heart failure and moderate to severe mitral valve insufficiency and who have undergone mitral valve replacement with crossed papillopexy and annular constriction., Methods: Thirteen patients in NYHA functional class III or IV, with a mean age of 54.1 years and with idiopathic etiology, underwent mitral valve replacement with ring constriction and crossed papillopexy. Echocardiograph parameters, functional class and survival actuarial curve were analyzed., Results: There were no deaths during surgery or in the postoperative period. The mean left ventricular diastolic diameter was reduced from 71 +/- 8.6 mm to 65.3 +/- 8.6 mm (p=0.049) and the mean left ventricular systolic diameter was reduced from .1 +/- 8.5 mm to 50.4 +/- 11.1 mm (p=0.002). The atrial diameters varied from 49.4 +/- 6.4 mm to 44 +/- 5.9 mm (p=0.017); the percentage of the left ventricular shortening was 17 +/- 4 % to 24 +/- 8.3% (p=0.014); the ejection fraction varied statistically and significantly from 34 +/- 9% to 45 +/- 14% (p=0.008). Eleven (84.6%) patients were in FC I and II. At 1, 6 and 12 months after follow-up surgery, the survival rate was 100%, 82.6%, 71.6%, respectively. This rate was maintained at 7.6% for more than 36 months., Conclusion: The results obtained from patients with heart failure and moderate to severe mitral valve insufficiency and who underwent mitral valve replacement with crossed papillopexy and annular constriction presented evidence of improved heart remodeling and significant improvement in left ventricular performance.

Purpose: To evaluate the effect of the ischemic preconditioning and the ischemic postconditioning over the tissue injury in the intestinal mucosa of rats undergoing the procedure of mesenteric ischemia and reperfusion., Methods: Thirty Wistar rats were studied, divided in three groups: group A, undergoing mesenteric ischemia (30 minutes) and reperfusion (60 minutes); group B, mesenteric ischemia and reperfusion preceded by ischemic preconditioning; group C, mesenteric ischemia and reperfusion and, before the beginning of reperfusion, the ischemic postconditioning was performed. At the end, a segment of the small intestine was dissected for histological analysis. The results were evaluated using the CHIU et al.6 classification followed by the statistic treatment., Results: The mean values of the tissue injury levels were: group A, 3.5; group B, 1.2; and group C, 1. The difference between the result of group A with the results of groups B and C was considered statistically significant (p < 0,05)., Conclusion: The ischemic preconditioning and postconditioning are able to minimize the tissue injury in the intestines of rats that underwent the procedure of mesenteric ischemia and reperfusion.

Congenital granular cell tumor (CGCT), or congenital epulis, is a very uncommon benign soft tissue lesion that usually arises from the alveolar mucosa of neonates and may cause respiratory and feeding problems. We report a case of a 3-day-old female newborn, who presented an intraoral tumor mass which was protruding from her mouth, and compromising feeding. Under general anesthesia, the lesion was completely removed and the patient had an uneventful postoperative course. Clinical features and treatment approaches are presented and discussed, emphasizing the necessity of a multidisciplinary approach in such cases.