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Environmental changes in the Brazilian Pantanal and Cerrado facilitate the spread of parasitic diseases in wildlife, with significant implications for public health owing to their zoonotic potential. This study aimed to examine the occurrence and diversity of gastrointestinal parasites in wild felids within these regions to assess their ecological and health impacts. We collected and analyzed helminth-positive samples from 27 wild felids using specific taxonomic keys. Diverse parasitic taxa were detected, including zoonotic helminths, such as Ancylostoma braziliense , Ancylostoma caninum , Ancylostoma pluridentatum , Toxocara cati , Toxocara canis , Dipylidium caninum , Taenia spp., Echinococcus spp., and Spirometra spp. Other nematodes, such as Physaloptera praeputialis and Physaloptera anomala, were identified, along with acanthocephalans from the genus Oncicola and a trematode, Neodiplostomum spp. (potentially the first record of this parasite in wild felids in the Americas). Human encroachment into natural habitats has profound effects on wild populations, influencing parasitic infection rates and patterns. This study underscores the importance of continuous monitoring and research on parasitic infections as a means of safeguarding both wildlife and human populations and highlights the role of wild felids as bioindicators of environmental health.

This study aimed to evaluate the image quality assessment (IQA) and quality criteria employed in publicly available datasets for diabetic retinopathy (DR). A literature search strategy was used to identify relevant datasets, and 20 datasets were included in the analysis. Out of these, 12 datasets mentioned performing IQA, but only eight specified the quality criteria used. The reported quality criteria varied widely across datasets, and accessing the information was often challenging. The findings highlight the importance of IQA for AI model development while emphasizing the need for clear and accessible reporting of IQA information. The study suggests that automated quality assessments can be a valid alternative to manual labeling and emphasizes the importance of establishing quality standards based on population characteristics, clinical use, and research purposes. In conclusion, image quality assessment is important for AI model development; however, strict data quality standards must not limit data sharing. Given the importance of IQA for developing, validating, and implementing deep learning (DL) algorithms, it's recommended that this information be reported in a clear, specific, and accessible way whenever possible. Automated quality assessments are a valid alternative to the traditional manual labeling process, and quality standards should be determined according to population characteristics, clinical use, and research purpose., (© 2023. The Author(s), under exclusive licence to The Royal College of Ophthalmologists.)

Importance: Democratizing artificial intelligence (AI) enables model development by clinicians with a lack of coding expertise, powerful computing resources, and large, well-labeled data sets., Objective: To determine whether resource-constrained clinicians can use self-training via automated machine learning (ML) and public data sets to design high-performing diabetic retinopathy classification models., Design, Setting, and Participants: This diagnostic quality improvement study was conducted from January 1, 2021, to December 31, 2021. A self-training method without coding was used on 2 public data sets with retinal images from patients in France (Messidor-2 [n = 1748]) and the UK and US (EyePACS [n = 58 689]) and externally validated on 1 data set with retinal images from patients of a private Egyptian medical retina clinic (Egypt [n = 210]). An AI model was trained to classify referable diabetic retinopathy as an exemplar use case. Messidor-2 images were assigned adjudicated labels available on Kaggle; 4 images were deemed ungradable and excluded, leaving 1744 images. A total of 300 images randomly selected from the EyePACS data set were independently relabeled by 3 blinded retina specialists using the International Classification of Diabetic Retinopathy protocol for diabetic retinopathy grade and diabetic macular edema presence; 19 images were deemed ungradable, leaving 281 images. Data analysis was performed from February 1 to February 28, 2021., Exposures: Using public data sets, a teacher model was trained with labeled images using supervised learning. Next, the resulting predictions, termed pseudolabels, were used on an unlabeled public data set. Finally, a student model was trained with the existing labeled images and the additional pseudolabeled images., Main Outcomes and Measures: The analyzed metrics for the models included the area under the receiver operating characteristic curve (AUROC), accuracy, sensitivity, specificity, and F1 score. The Fisher exact test was performed, and 2-tailed P values were calculated for failure case analysis., Results: For the internal validation data sets, AUROC values for performance ranged from 0.886 to 0.939 for the teacher model and from 0.916 to 0.951 for the student model. For external validation of automated ML model performance, AUROC values and accuracy were 0.964 and 93.3% for the teacher model, 0.950 and 96.7% for the student model, and 0.890 and 94.3% for the manually coded bespoke model, respectively., Conclusions and Relevance: These findings suggest that self-training using automated ML is an effective method to increase both model performance and generalizability while decreasing the need for costly expert labeling. This approach advances the democratization of AI by enabling clinicians without coding expertise or access to large, well-labeled private data sets to develop their own AI models.

Einstein's general theory of relativity from 1915 1 remains the most successful description of gravitation. From the 1919 solar eclipse 2 to the observation of gravitational waves 3 , the theory has passed many crucial experimental tests. However, the evolving concepts of dark matter and dark energy illustrate that there is much to be learned about the gravitating content of the universe. Singularities in the general theory of relativity and the lack of a quantum theory of gravity suggest that our picture is incomplete. It is thus prudent to explore gravity in exotic physical systems. Antimatter was unknown to Einstein in 1915. Dirac's theory 4 appeared in 1928; the positron was observed 5 in 1932. There has since been much speculation about gravity and antimatter. The theoretical consensus is that any laboratory mass must be attracted 6 by the Earth, although some authors have considered the cosmological consequences if antimatter should be repelled by matter 7-10 . In the general theory of relativity, the weak equivalence principle (WEP) requires that all masses react identically to gravity, independent of their internal structure. Here we show that antihydrogen atoms, released from magnetic confinement in the ALPHA-g apparatus, behave in a way consistent with gravitational attraction to the Earth. Repulsive 'antigravity' is ruled out in this case. This experiment paves the way for precision studies of the magnitude of the gravitational acceleration between anti-atoms and the Earth to test the WEP., (© 2023. The Author(s).)

Introduction: Precariousness of medical work, with loss of autonomy and devaluation, in addition to unstable and non-guaranteed employment bonds, has caused health problems in professionals, hampering the assistance provided. Research shows a high prevalence of stress, burnout, depression, and suicide among physicians. This study investigated aspects of mental health in physicians from the state of Paraná, Brazil., Objectives: We aimed to evaluate indicators of stress, burnout, and work engagement measured by inventories specifically designed for each one: Stress Symptoms Inventory, Burnout Syndrome Inventory, Utrecht Work Engagement Scale, respectively., Methods: The professionals answered the questionnaires remotely, after accepting the invitation for the study and signing the consent form., Results: A total of 1,201 physicians answered the questionnaires, with mean age of 37 years; 53.9% of participants were women; 63.5% graduated in Paraná. Of the total number of participants, 97.5% and 93.4% presented psychological and physical symptoms of stress, respectively. According to the Inventário da Síndrome de Burnout, the prevalence of diagnosis of burnout was estimated at 59.4%. As for work engagement, 40% of participants showed very high levels in the overall score of the construct., Conclusions: Most physicians showed signs of stress; burnout rates were high; negative organizational conditions prevailed in the work environment; work engagement was frequent., Competing Interests: Conflicts of interest: None

Objective: The aim of this study was to carry out a systematic review of the literature with meta-analysis to evaluate the effect of using oral contraceptive and hormone replacement therapy as a protective factor in the formation of intracranial aneurysms and subarachnoid hemorrhage., Methods: This is a systematic review of the literature with meta-analysis, using PubMed and Embase as databases and the PRISMA method. Case-control and cohort studies published until December 2022 were included in this review., Results: Four studies were included in this review; three of which were eligible for meta-analysis. Regarding the use of oral contraceptive and the development of subarachnoid hemorrhage, there was a lower risk of aneurysm rupture with an odds ratio 0.65 (confidence interval 0.5-0.85). In the analysis of patients using hormone replacement therapy and developing subarachnoid hemorrhage, there was also a lower risk of aneurysm rupture with an OR 0.54 (CI 0.39-0.74). Only one article analyzed the formation of intracranial aneurysm and the use of hormone replacement therapy and oral contraceptive, and there was a protective effect with the use of these medications. oral contraceptive: OR 2.1 (CI 1.2-3.8) and hormone replacement therapy: OR 3.1 (CI 1.5-6.2)., Conclusion: The use of hormone replacement therapy and oral contraceptive has a protective effect in intracranial aneurysm rupture and formation.

Nanotechnology has been comprehensively applied as a new approach to managing wound healing. Particularly, nanoclays are being used to improve traditional wound healing approaches or new therapies. Nanoclays are nanoscale aluminosilicates with remarkable intrinsic properties, including the capacity to promote hemostatic response, anti-inflammatory effects, angiogenesis, and re-epithelization. The main purpose of the present review is focusing on skin lesions, post-surgical wounds, burn wounds, and chronic ulcer skin wounds that can be treated using nanoclays, not only as vehicles for therapeutic molecules' efficacy improvement but also alone due to their native beneficial features. A systematic search of the PubMed, ScienceDirect, Scopus, Web of Science, and Google Scholar databases revealed several studies satisfying the purpose of our study. In addition, the selected keywords were used to refine the information. Non-planar hydrous phyllosilicates have been compared with other nanoclays considering their acute specific surface area and loading capacity are strongly influenced by their structure. Nanocomposites in the powder form may be directly incorporated in polymers to form gels, biofilms, and scaffolds that may be adjustable to wound sites. Also, nanoclays can be directly incorporated into polymer mats. Regarding hydrogels/films and mats, nanoclays can improve their mechanical strength, thermal stability, viscosity, and cohesive strength. Additionally, nanoclays are able to control drug release, as well as their skin bioavailability, and seem to be promising candidates to overcome cytotoxicity problems; further in vivo toxicity studies are required., (© 2022. Controlled Release Society.)

The ABCG2 transporter plays a pivotal role in multidrug resistance, however, no clinical trial using specific ABCG2 inhibitors have been successful. Although ABC transporters actively extrude a wide variety of substrates, photodynamic therapeutic agents with porphyrinic scaffolds are exclusively transported by ABCG2. In this work, we describe for the first time a porphyrin derivative (4B) inhibitor of ABCG2 and capable to overcome multidrug resistance in vitro. The inhibition was time-dependent and 4B was not itself transported by ABCG2. Independently of the substrate, the porphyrin 4B showed an IC 50 value of 1.6 μM and a mixed type of inhibition. This compound inhibited the ATPase activity and increased the binding of the conformational-sensitive antibody 5D3. A thermostability assay confirmed allosteric protein changes triggered by the porphyrin. Long-timescale molecular dynamics simulations revealed a different behavior between the ABCG2 porphyrinic substrate pheophorbide a and the porphyrin 4B. Pheophorbide a was able to bind in three different protein sites but 4B showed one binding conformation with a strong ionic interaction with GLU446. The inhibition was selective toward ABCG2, since no inhibition was observed for P-glycoprotein and MRP1. Finally, this compound successfully chemosensitized cells that overexpress ABCG2. These findings reinforce that substrates may be a privileged source of chemical scaffolds for identification of new inhibitors of multidrug resistance-linked ABC transporters., (Copyright © 2021. Published by Elsevier B.V.)

Breast cancer (BC) is the most frequently diagnosed female cancer and second leading cause of death. Despite the discovery of many antineoplastic drugs for BC, the current therapy is not totally efficient. In this study, we investigated the potential of repurposing the well-known diabetes type II drug liraglutide to modulate epigenetic modifications in BC cells lines in vitro and in vivo via Ehrlich mice tumors models. The in vitro results revealed a significant reduction on cell viability, migration, DNMT activity and displayed lower levels of global DNA methylation in BC cell lines after liraglutide treatment. The interaction between liraglutide and the DNMT enzymes resulted in a decrease profile of DNA methylation for the CDH1, ESR1 and ADAM33 gene promoter regions and, consequently, increased their gene and protein expression levels. To elucidate the possible interaction between liraglutide and the DNMT1 protein, we performed an in silico study that indicates liraglutide binding in the catalytic cleft via hydrogen bonds and salt bridges with the interdomain contacts and disturbs the overall enzyme conformation. The in vivo study was also able to reveal that liraglutide and the combined treatment of liraglutide and paclitaxel or methotrexate were effective in reducing tumor growth. Moreover, the modulation of CDH1 and ADAM33 mouse gene expression by DNA demethylation suggests a role for liraglutide in DNMT activity in vivo. Altogether, these results indicate that liraglutide may be further analysed as a new adjuvant treatment for BC., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Purpose of Review: This article aims to discuss the current state of resources enabling the democratization of artificial intelligence (AI) in ophthalmology., Recent Findings: Open datasets, efficient labeling techniques, code-free automated machine learning (AutoML) and cloud-based platforms for deployment are resources that enable clinicians with scarce resources to drive their own AI projects., Summary: Clinicians are the use-case experts who are best suited to drive AI projects tackling patient-relevant outcome measures. Taken together, open datasets, efficient labeling techniques, code-free AutoML and cloud platforms break the barriers for clinician-driven AI. As AI becomes increasingly democratized through such tools, clinicians and patients stand to benefit greatly., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

The ATP-binding cassette transporter ABCG2 mediates the efflux of several chemotherapeutic drugs, contributing to the development of multidrug resistance (MDR) in many cancers. The most promising strategy to overcome ABCG2-mediated MDR is the use of specific inhibitors. Despite many efforts, the identification of new potent and specific ABCG2 inhibitors remains urgent. In this study, a structural optimization of indeno[1,2-b]indole was performed and a new generation of 18 compounds was synthesized and tested as ABCG2 inhibitors. Most compounds showed ABCG2 inhibition with IC 50 values below 0.5 µM. The ratio between cytotoxicity (IG 50 ) and ABCG2 inhibition potency (IC 50 ) was used to identify the best inhibitors. In addition, it was observed that some indeno[1,2-b]indole derivatives produced complete inhibition, while others only partially inhibited the transport function of ABCG2. All indeno[1,2-b]indole derivatives are not transported by ABCG2, and even the partial inhibitors are able to fully chemosensitize cancer cells overexpressing ABCG2. The high affinity of these indeno[1,2-b]indole derivatives was confirmed by the strong stimulatory effect on ABCG2 ATPase activity. These compounds did not affect the binding of conformation-sensitive antibody 5D3 binding, but stabilized the protein structure, as revealed by the thermostabilization assay. Finally, a docking study showed the indeno[1,2-b]indole derivatives share the same binding site as the substrate estrone-3-sulfate.

Purpose: To establish the prevalence and risk factors for intravitreal dexamethasone implant migration into the anterior chamber in eyes with macular edema., Methods: This was a multicenter, retrospective, observational chart review of data that included patients with macular edema who had been treated with at least one intravitreal dexamethasone injection. Patients with incomplete chart information during the follow-up period were excluded., Results: The prevalence of implant migration in 468 patients, considering the number of injections, was 1.6%, with significant associations between implant migration and cataract surgery (P = 0.043) and intraocular lens status (P = 0.005) and a trend toward statistical significance (P = 0.057) with vitrectomy. A higher rate of implant migration into the anterior chamber was observed in vitrectomized eyes (4.8%) when compared with patients who did not undergo a vitrectomy (1.6%). The implants that migrated were removed with forceps with/without viscoelastic expression or with 20-gauge cannulas connected to the vitreous cutter machine., Conclusion: The risk of implant migration into the anterior chamber was 1.6%. Risk factors were a history of cataract surgery or vitrectomy and aphakia. When anterior migration occurs, rapid removal is advised, especially if corneal edema is present.

Background: Portal hypertension is one of the complications of cirrhosis and is associated with numerous systemic manifestations, including renal, brain, pulmonary, cardiac and vascular changes. In routine ophthalmological examinations performed at our service, we observed that some children diagnosed with portal hypertension had increased retinal vascular tortuosity., Objective: 1. To evaluate the presence of retinal vascular abnormalities (vascular tortuosity) in children diagnosed with portal hypertension; 2. To investigate the association between retinal vascular tortuosity and the presence of gastroesophageal varices in these children; 3. To evaluate the use of clinical and laboratory parameters to predict the presence of gastroesophageal varices in children with portal hypertension., Methods: This was a cross-sectional and observational study that included patients aged <18 years with a diagnosis of portal hypertension. The participants included were submitted to dilated fundus examination and fundus photography with Visucam (Carl Zeiss Meditec AG) device. Besides, clinical and laboratorial data were collected from the patients' medical records., Results: A total of 72 patients were included in this study, and 36% of them had an increase in retinal vascular tortuosity. Platelet count (P=0.001), bilirubin dosage (P=0.013) and aspartate transaminase dosage (AST) (P=0.042) were associated with the presence of gastroesophageal varices in digestive endoscopy. There was no association between retinal vascular tortuosity and the presence of gastroesophageal varices (P=0.498)., Conclusion: The results of this study suggest that platelet count, bilirubin dosage, and aspartate transaminase dosage were associated with the presence of gastroesophageal varices in digestive endoscopy. Regarding the retinal findings, we found that there was an increase in retinal vascular tortuosity in 36% of pediatric patients, but no association was found with the presence of gastroesophageal varices.

This study expands the knowledge on the conformational preference of 1,3-amino alcohols in the gas phase and in solution. By employing Fourier transform infrared spectroscopy, nuclear magnetic resonance (NMR) spectroscopy, density functional theory (DFT) calculations, quantum theory of atoms in molecules (QTAIM), natural bond orbital (NBO) analysis, and molecular dynamics (MD), the compounds 3-aminopropan-1-ol ( 1 ), 3-methylaminopropan-1-ol ( 2 ), and 3-dimethylaminopropan-1-ol ( 3 ) are evaluated. The results show that the most stable conformation of each compound in the gas phase and in nonpolar solvents exhibited an O-H···N intramolecular hydrogen bond (IHB). Based on the experimental and theoretical OH-stretching frequencies, the IHB becomes stronger from 1 to 3 . In addition, from the experimental NMR J -couplings, the IHB conformers are predominant in nonbasic solvents, representing 70-80% of the conformational equilibrium, while in basic solvents, such conformers only represent 10%. DFT calculations and QTAIM analysis in the gas phase support the occurrence of IHBs in these compounds. The MD simulation indicates that the non-hydrogen-bonded conformers are the lowest energy conformations in the solution because of molecular interactions with the solvent, while they are absent in the implicit solvation model based on density. NBO analysis suggests that methyl groups attached on the nitrogen atom affect the charge transfer energy involved in the IHB. This effect occurs mostly because of a decrease in the s-character of the LPN orbital along with weakening of the charge transfer from LPN to σ*OH, which is caused by an increase in the C-C-N bond angle.

Purpose: The aim of this study was to determine the functional and anatomical success rates as well as the safety of sutureless combined surgery involving vitreous base removal and internal limiting membrane peeling after Brilliant Blue G (0.5 mg/mL) staining for the management of idiopathic macular holes after three years., Methods: Forty-six eyes of 46 patients with an idiopathic macular hole were enrolled in this retrospective study. The inclusion criteria were macular holes with a minimum linear diameter below 1,500 mm, 0.05 or better decimal best-corrected visual acuity and duration of symptoms less than two years. The exclusion criteria included pregnancy, optic nerve atrophy, advanced glaucoma, and other chronic ocular diseases. The surgical procedure included internal limiting membrane peeling after Brilliant Blue G (0.5 mg/mL) staining, along with C3F8 tamponade and face-down positioning for three days postoperatively. Ophthalmologic examinations and optical coherence tomography were performed at 1 and 7 days and 1, 6, 12, 24, and 36 months postoperatively. If no anatomic closure of the macular holes occurred within the first month, the area of the internal limiting membrane peeling was enlarged in a second procedure. Multiple logistic regression and chi-squared tests were used for data analyses, and p-values of <0.05 were considered significant., Results: Out of 46 eyes with a preoperative idiopathic macular hole, anatomic closure was achieved in 42 (91.3%) after one procedure and in 45 (97.8%) after an additional surgery. The median postoperative best-corrected visual acuity improvement was 0.378 (range: 0.050-0.900) decimal. None of the patients experienced macular hole reopening, surgery-related complications, or ocular complications related to the dye., Conclusion: Combined surgery including vitreous base removal and internal limiting membrane peeling after staining with Brilliant Blue G (0.5 mg/mL) for the management of idiopathic macular holes resulted in adequate staining, best-corrected visual acuity improvement, and macular hole closure with no signs of ocular toxicity at the three-year follow-up examination.

Purpose: To classify and quantify anthocyanins in a vital dye extracted from the acai fruit ( Euterpe oleracea ), adjust pH and osmolarity, and perform lyophilization to develop a new chromovitrectomy dye., Methods: Three dye concentrations 10%, 25%, and 35% (equivalent to 100, 250, and 350 mg of lyophilized acai fruit pulp extract samples) were evaluated when diluted in 1 ml of phosphate-buffered solution (pH 7 and 300 mOsm). The dye was analyzed by mass spectrometry and high-performance liquid chromatography (HPLC) to identify and quantify anthocyanins molecules., Results: The pH and osmolarity correction and lyophilization were performed without damaging the anthocyanin molecular structure. Mass spectrometry confirmed the presence of five anthocyanins in the three concentrations of the dye. Cyanidin-3- O -glucoside was the major anthocyanin found. HPLC showed that the concentration of anthocyanin was similar, independent of the dye concentration tested., Conclusions: Lyophilization and the correction of pH and osmolarity (7.00 and 300 mOsm, resp.) were performed successfully. Five anthocyanins are present in the dye from the acai fruit. The major anthocyanin is cyanidin-3- O -glucoside. Independent of the dye concentration tested, the anthocyanin concentration was similar. Standardized chemical characteristics of this new dye may allow its use during chromovitrectomy in humans.

Objective: The objective of the study was to describe our approach and the surgical technique and analyze its safety and the outcome for foramen magnum meningiomas (FMMs)., Methods: From 1986 to 2016, 15 FMM patients were operated on using the lateral suboccipital retrocondylar approach., Results: In this series, there were 12 (80%) female and 3 (20%) male patients. The patients ranged in age from 33 to 63 years. There was no operative dead, but two patients died during the follow-up period, which varied from 1 to 24 years (mean, 10.2 years). Twelve patients (80%) achieved Glasgow Outcome Scale 4 or 5. Gross total resection was achieved in 13 (86.6.7%) patients., Conclusions: The majority of FMM can be safely removed using the lateral suboccipital retrocondylar approach without condylar resection, associated to meticulous microsurgical technique., Competing Interests: There are no conflicts of interest.

Background and Objective: To report the efficacy, safety, and benefits of femtosecond laser-assisted cataract surgery (FLACS) combined with sutureless 23-gauge pars plana vitrectomy (PPV)., Patients and Methods: This multicenter, retrospective study evaluated patient records and videos of 43 cases with retinal pathologies and cataract who underwent the combined procedure., Results: In 44.2% and 55.8% of cases, respectively, the LenSx Laser (femtosecond machine; Alcon, Fort Worth, TX) and the Constellation (vitreous cutter; Alcon, Fort Worth, TX), and the Victus (femtosecond machine; Bausch + Lomb, Rochester, NY) and Stellaris PC (vitreous cutter; Bausch + Lomb, Rochester, NY) were used. No complications developed during capsulorrhexis, even without a red fundus reflex, retrobulbar block, or scleral indentation. Foldable intraocular lenses remained stable in the capsular bag during the vitreoretinal surgeries and postoperative visits. The mean times of femtosecond phacoemulsification, vitreoretinal surgery, and total surgery were 22.9 minutes ± 4.7 minutes, 43.1 minutes ± 9.8 minutes, and 65.3 minutes ± 8.6 minutes, respectively., Conclusion: This emerging technology is safe and offers several potential benefits for the success of the combined procedure. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:374-379.]., (Copyright 2018, SLACK Incorporated.)

The study proposes a differentiated approach to the localization of public services (unlike methods focusing solely on locational efficiency in the distribution of such services), with a nonlinear model that incorporates an accessibility indicator and allows rejecting solutions in which accessibility fails to comply with acceptably established minimum parameters. The method aims to minimize the total time spent by a region's population to reach a public services network, while controlling the range between the highest and lowest accessibility to the services. The resulting solution is not as efficient as other models (e.g., p-median) in relation to total cost for the population as a whole to access the system, but it seeks to prevent the most distant areas from experiencing greater difficulty due to their disproportional traveling time. The model was tested in a region in the hospital network of the State of Santa Catarina, Brazil, and the results show that incorporation of the indicator suggests improvement when compared to the current distribution of hospitals in that area. The proposed methodology can be a useful tool for planning balanced resource allocation during installation of health services for the population.

Fly fruit Drosophila melanogaster (DM) has been extensively employed as an in vivo model system to study pesticides toxicity. Pesticide administration to the fly traditionally involves feeding in an agar-gelled feed fly's medium (AM). However, AM method has several limitations such as uncertainty regarding the bioavailability and amount of pesticides ingested. And also high manipulation of the treated flies. We developed a new method of exposure the flies to pesticides, called Continuous Liquid Feeding (CLF). This method successfully delivers food to the flies at much higher concentrations than the AM method, and requires little manipulation of flies under treatment., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Extracts from the leaves of Bougainvillea glabra Choisy are used in traditional medicines, but their actions on the central nervous system have not been studied. In the present study, we investigated the potential neuroprotective effects of Bougainvillea glabra Choisy leaf extract (BG extract) against paraquat (PQ)-induced neurotoxicity. Male adult wild-type flies (1- 4days old) were exposed to PQ (3.5mM) and/or BG extract (120μg/mL) through food for 4days. PQ-fed flies had decreased locomotor capacity in negative geotaxis and crossing number assays and had a higher incidence of mortality than the control group. PQ neurotoxicity was also associated with a marked decrease in dopamine levels and increase in acetylcholinesterase (AChE) activity, reactive oxygen species (ROS) production and lipid peroxidation. Co-exposure to BG extract prevented mortality, and dopamine depletion, improved locomotor performance and decreased AChE activity, ROS production and lipid peroxidation. GC-MS and HPLC analyses of BG extract revealed the presence of many antioxidant compounds such as phytol, α,γ-tocopherol, squalene, stigmasterol, geranylgeraniol, quercetin, and caffeic, vanillic, coumaric, ferulic acids. Our results showed neuroprotective effects of BG extract, reflecting the presence of antioxidant compounds. Thus, we suggested that B. glabra leaves could be considered an effective agent in the prevention of neurological disorders, where dopamine depletion and/or oxidative stress are involved, as in Parkinson's disease (PD)., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)

Objective: To assess whether there the final range of motion (ROM) results achieved by patients undergoing total knee arthroplasty (TKA) with prosthesis using Medial Pivot design are predictable., Methods: Between January and August of 2014, 155 patients with primary osteoarthritis of knee who underwent TKA using the prosthesis ADVANCE ® Medial Pivot were prospectively assessed. All ROM measures were made and recorded before, during, and after surgery. All patients were clinically assessed preoperatively and postoperatively (15, 45 days, three months, six months, one year, and annually thereafter after surgery); their functional status was assessed using the WOMAC questionnaire., Results: Significant differences ( p  < 0.001) were observed between the means and medians of ROM in the preoperative when compared with those during the perioperative; the perioperative values, when compared with those after six months postoperative, were also different ( p  < 0.001). No significant differences were found between the means and medians ROM between the intraoperative period and at the 45-day assessment (ns) and between the means and medians ROM between the preoperative period and at the six-month evaluation (ns)., Conclusion: The final ROM achieved by patients that underwent TKA with medial pivot prosthesis can be predicted. The perioperative ROM correlates with that at 45 days after surgery. The final ROM is correlated with that of the pre-operative period.

Private and public partnerships are defended by both guidelines for action and legal frameworks for disaster risk management. The objective of this study is to identify a framework for action that allows joint collaborative partnership between these sectors. The theoretical discussion brings concepts that raise questions that permeate the possibility of partnership based on the new Sendai framework, as well as corporate social responsibility in the value, balance and accountability (VBA) integrative model. The presented framework is compared to the experience of the tornado which occurred in Brazil in the city of Xanxerê (Santa Catarina) in 2015. We came to the conclusion that partnership advance results from paradigm shifts in both sectors, on the one hand, with the development of management mechanisms that clearly define roles and responsibilities of those involved, and, on the other hand, motivation for responsible business conduct., Competing Interests: The authors declare that they have no financial or personal relationships which may have inappropriately influenced them in writing this article.

Objective: This study aims to assess the preoperative nutritional status of patients and the role it plays in the occurrence of clinical complications in the postoperative period of major elective cardiac surgeries., Methods: Cross-sectional study comprising 72 patients aged 20 years or older, who underwent elective cardiac surgery. The preoperative nutritional assessment consisted of nutritional screening, anthropometry (including the measurement of the adductor pollicis muscle thickness) and biochemical tests. The patients were monitored for up to 10 days after the surgery in order to control the occurrence of postoperative complications. The R software, version 3.0.2, was used to statistically analyze the data., Results: Clinical complications were found in 62.5% (n=42) of the studied samples and complications of non-infectious nature were most often found. Serum albumin appeared to be associated with renal complications (P=0.026) in the nutritional status indicators analyzed herein. The adductor pollicis muscle thickness was associated with infectious complications and presented mean of 9.39±2.32 mm in the non-dominant hand (P=0.030). No significant correlation was found between the other indicators and the clinical complications., Conclusion: The adductor pollicis muscle thickness and the serum albumin seemed be associated with clinical complications in the postoperative period of cardiac surgeries., Competing Interests: No conflict of interest.

Objective To describe a unique operative strategy, instead the classical pterional approach, and to analyses it safety and effectiveness for removal of anterior cranial fossa meningiomas. Method We identify 38 patients with tuberculum sellae and olphactory groove meningiomas operated between 1986 and 2013. Medical charts, operative reports, imaging studies and clinical follow-up evaluations were reviewed and analyzed retrospectively. The pterional craniotomy is extended toward the frontal bone providing access through the subfrontal route, besides the usual anterolateral view provided by the classical pterional approach. Results Surgical mortality occurred in one patient (2.6%). Gross total resection was achieved in 27 patients (86.8%). Median time of follow-up was 69.4 months. Conclusion The extended pterional approach allows excellent results. Total removal of meningiomas of the anterior cranial fossa was obtained in 86.8 % of patients, with low morbidity and mortality.

The objective of this study is to compare the distribution of hospital units according to different degrees of specialization in Santa Catarina State, Brazil, based on an application of the p-median hierarchical model in three levels. The p-median model is used to determine the units' location, following by a comparison of the population's mean distance to reach the medical units in two scenarios, the current one and the simulation. A quantitative indicator of accessibility is proposed and used to assess accessibility according to the current and simulated distributions. The study aims to detect underserved regions and provides a tool to aid health managers' decision-making for possible interventions in the system in order to make it more homogeneous and accessible to the population.

Unlabelled: To evaluate whether, by using an arthropump (irrigation equipment with pressure sensor), pneumatic tourniquet use could interfere with the duration of surgery, recovery of movement and joint volume in patients who underwent knee videoarthroscopy for partial meniscectomy., Methods: 103 patients divided randomly into two groups regarding use or nonuse of a pneumatic tourniquet were evaluated in five different centers by seven different surgeons. The variables were evaluated during the surgery and seven days after the operation., Results: No statistically significant differences were found among any of the variables studied., Conclusion: There are no reasons that would either justify or discredit tourniquet use in this specific situation.

Unlabelled: To evaluate whether, after total knee arthroplasty, there is any correlation between patellar height and range of motion (ROM) achieved by patients six months after the operation., Methods: Forty-five patients who underwent total knee arthroplasty were assessed at least 12 months after the operation (total of 54 knees). The maximum and minimum ROM of all the knees was recorded under fluoroscopy, along with patellar height according to the Blackburne and Peel ratio. Two possible correlations were evaluated: patellar height and ROM; and patellar height and ROM variation from before to after the operation., Results: A correlation was found between patellar height and postoperative ROM (p = 0.04). There was no correlation between patellar height and ROM variation (p = 0.182)., Conclusion: After total knee arthroplasty, the lower the patella is, the worse the ROM is.

Unlabelled: To compare the rollback of the contact point between the femoral component and the tibial polyethylene as the knee is flexed, in two types of total knee arthroplasty: one that sacrifices and the other that preserves the posterior cruciate ligament (PCL)., Methods: Under fluoroscopy, 36 knees from 32 patients who underwent total knee arthroplasty were evaluated. Using lateral images, the contact points between the femur and the tibial polyethylene with the knee in complete extension and at 90° of flexion were measured, thereby measuring the percentage rollback of the femur in arthroplasties in which the PCL was sacrificed and in those in which it was preserved., Results: The mean percentage rollback of the femur was 13.24% in the cases in which the PCL was sacrificed and 5.75% in the cases in which it was preserved. The difference between these measurements was statistically significant (p = 0.026615)., Conclusion: In total knee arthroplasty, sacrificing the PCL increased the rollback of the contact point between the femur and tibia as the knee was flexed up to 90°.

Objective: To evaluate the prevalence and type of dysesthesia around the incision used to obtain the patellar tendon for anterior cruciate ligament (ACL) reconstruction surgery., Methods: Out of a population of 1368 ACL reconstructions using the central third of the patellar tendon, 102 patients (111 knees) were evaluated by means of telephone interview., Results: The mean follow-up was 52 months (ranging from 12 to 88 months). The patients' ages ranged from 16 to 58 years (mean: 34.7 years). There was some degree of peri-incisional dysesthesia in 66 knees (59.46%). In 40.54% of the knees, this condition was not found. In all the cases of dysesthesia, the type encountered was Highet's type II., Conclusion: Peri-incisional dysesthesia following ACL reconstruction using the central third of the patellar tendon is highly prevalent. It affected more than half of the cases in this series.

Structural and electronic properties of [C12H24S6X], [C13H26S6OX], and [C14H28S6OX] (X: Ag(+), Cd(2+)) crown thioether complexes were investigated within the framework of the density functional theory (DFT) using the projector augmented wave (PAW) method. The theoretical results were compared with time-differential perturbed γ-γ angular correlations (TDPAC) experiments reported in the literature using the (111)Ag→(111)Cd probe. In the case of X=Ag(+), a refinement of the structure was performed and the predicted equilibrium structures compared with available X-ray diffraction experimental data. Structural distortions induced by replacing Ag(+) with Cd(2+) were investigated as well as the electric-field gradient (EFG) tensor at the Cd(2+) sites. Our results suggest that the EFG at Cd(2+) sites corresponds to the Ag(+) coordination sphere structure, i.e., before the structural relaxations of the molecule with X=Cd(2+) are completed. The results are discussed in terms of the characteristics of the TDPAC (111)Ag→(111)Cd probe and the time window of the measurement, and provide an interesting tool with which to probe molecular relaxations.

Introduction: Topical application of tranexamic acid to the knee joint before closure in total knee arthroplasty reduces postoperative bleeding without increase in complication. However, it is unknown the effectiveness of topic TXA performed with other topical medications, like povidone-iodine solution., Materials and Methods: One hundred and twenty-five patients were randomized to receive 100mL of povidone-iodine solution (control: group A) or 1.5 (group B) and 3.0 g (group C) of topical TXA in povidone-iodine solution applied into the knee before closure in total knee arthroplasty., Results: The patients in the TXA groups had higher mean postoperative hemoglobin levels (P=0.01 and P=0.03 in groups B and C, respectively) and a reduced postoperative blood loss in the TXA groups (P=0.07 and P=0.09 in groups B and C, respectively). No significant complications were observed., Discussion: In this study, topical application of tranexamic acid after total knee arthroplasty together with povidone-iodine solution results in higher postoperative hemoglobin levels and lower blood loss compared with those in the control group without other complications., Level of Evidence: I - I: high-powered prospective randomized trial., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)

Objective: to identify the contribution made by a refresher course on the assessment of chronic wounds, offered through the Moodle virtual learning environment (VLE), to the knowledge relating to this issue of nursing lecturers and nurses linked to higher education., Method: a prospective, quasi-experimental study, with data collection before and after the educational intervention. The study was undertaken in three stages using the Moodle VLE. The sample was made up of 28 participants who answered the pre-test on the knowledge, devised in accordance with international guidelines on chronic wounds. Afterwards, the refresher course was offered (intervention) and was accessed in accordance with individuals' schedules, during the established time period. At the end of the course, 26 participants answered the post-test. Those who did not participate in the post-tests were excluded from the study, as it is pairwise analysis of the sample., Result: the participants obtained, on average, 55.5% of correct answers in the pre-test on their knowledge, and 73.4% in the post-test, this difference being statistically significant. There was a negative correlation between the time of experience in lecturing and the performance in the test on their knowledge., Conclusion: the participation in the online refresher course contributed to improving the lecturers' performance in the test on their knowledge, in relation to the recommendations for assessing chronic wounds, based in scientific evidence.

Objective: the aim of this study is to evaluate the change in length of hospital stay postoperatively for Total Knee Arthroplasty after using femoral and sciatic nerve block., Materials and Methods: the medical records of 287 patients were evaluated, taking into account the number of hours of admission, the percentage and the reason for re-hospitalization within 30 days, as well as associated complications. All patients were divided into two groups according or not to whether they were admitted to ICU or not. During the years 2009 and 2010, isolated spinal anesthesia was the method used in the procedure. From 2011 on, femoral and sciatic nerve blocking was introduced., Results: between the years 2009 and 2012, the average length of stay ranged from 74 hours in 2009 to 75.2 hours in 2010. The average length of stay in 2011 was 56.52 hours and 53.72 hours in 2012, all in the group of patients who did not remain in the ICU postoperatively. In the same period, among those in the group that needed ICU admission, the average length of stay was 138.7 hours in 2009, 90.25 hours in 2010, 79.8 hours in 2011, and 52.91 hours in 2012. During 2009 and 2010, the rate of re-hospitalization was 0%, while in 2011 and 2012, were 3.44% and 1%, respectively., Conclusion: according to this study, the use of femoral and sciatic nerve blocking after total knee arthroplasty allowed significant reduction in hospital stay.

OBJECTIVE To analyze the methodology used for assessing the spatial distribution of specialized cardiac care units. METHODS A modeling and simulation method was adopted for the practical application of cardiac care service in the state of Santa Catarina, Southern Brazil, using the p-median model. As the state is divided into 21 health care regions, a methodology which suggests an arrangement of eight intermediate cardiac care units was analyzed, comparing the results obtained using data from 1996 and 2012. RESULTS Results obtained using data from 2012 indicated significant changes in the state, particularly in relation to the increased population density in the coastal regions. The current study provided a satisfactory response, indicated by the homogeneity of the results regarding the location of the intermediate cardiac care units and their respective regional administrations, thereby decreasing the average distance traveled by users to health care units, located in higher population density areas. The validity of the model was corroborated through the analysis of the allocation of the median vertices proposed in 1996 and 2012. CONCLUSIONS The current spatial distribution of specialized cardiac care units is more homogeneous and reflects the demographic changes that have occurred in the state over the last 17 years. The comparison between the two simulations and the current configuration showed the validity of the proposed model as an aid in decision making for system expansion.

Purpose: Distal femoral osteotomy (DFO) is the preferential treatment for the symptomatic osteoarthritis of the lateral compartment of the knee in young active patients. The objective of this study is to evaluate the physical activity and functional outcome of a group of patients presenting with lateral compartment osteoarthritis of the knee prior to and after a DFO for correction of genum valgum., Methods: Twenty-six patients who had been submitted to complete V-shaped distal femoral osteotomy were evaluated after a mean follow-up period of 48 months by interview and questionnaire. Functional and physical activities were scored according to published rating systems., Results: Twenty-two (84.6 %) patients were very satisfied or satisfied (mean satisfaction 2) with the outcome of surgery and 88.5 % of the patients had normal work duties after surgery without limitation or decline in performance. The preoperative median level for physical activity according to the Tegner activity level was 3(2-7), while the median postoperative level was 3 (1-7) (n.s.) 57.7 % had resumed physical activities at preoperative levels: some patients had increased the number and type of exercises. According to Lysholm score, the mean preoperative score for physical performance was 53.1 ± 16.2 while the mean postoperative score had increased to 77.3 ± 16.7 (p < 0.05)., Conclusion: Based on this study, distal femoral osteotomy allowed the resumption of physical activities for individuals with symptomatic osteoarthritis of the lateral compartment of the knee, resulting in improvements in clinical conditions and, consequently, in their daily working and recreational activities.

In this work, perturbed angular correlation (PAC) spectroscopy is used to study differences in the nuclear quadrupole interactions of Cd probes in DNA molecules of mice infected with the Y-strain of Trypanosoma cruzi. The possibility of investigating the local genetic alterations in DNA, which occur along generations of mice infected with T. cruzi, using hyperfine interactions obtained from PAC measurements and density functional theory (DFT) calculations in DNA bases is discussed. A comparison of DFT calculations with PAC measurements could determine the type of Cd coordination in the studied molecules. To the best of our knowledge, this is the first attempt to use DFT calculations and PAC measurements to investigate the local environment of Cd ions bound to DNA bases in mice infected with Chagas disease. The obtained results also allowed the detection of local changes occurring in the DNA molecules of different generations of mice infected with T. cruzi, opening the possibility of using this technique as a complementary tool in the characterization of complicated biological systems.

The hypothesis that outcomes of phosphorus and light competition between Cylindrospermopsis raciborskii and Microcystis aeruginosa are strain dependent was tested experimentally. Critical requirements of phosphorus (P*) and of light (I*) of two strains of each species were determined through monoculture experiments, which indicated a trade-off between species and also between Microcystis strains. Competition experiments between species were performed using the weakest predicted competitors (with the highest values of P* and of I*) and with the strongest predicted competitors (with the lowest values of P* and of I*). Under light limitation, competition between the weakest competitors led C. raciborskii to dominate. Between the strongest competitors, the opposite was observed, M. aeruginosa displaced C. raciborskii, but both strains co-existed in equilibrium. Under phosphate limitation, competition between the weakest competitors led C. raciborskii to exclude M. aeruginosa, and between the strongest competitors, the opposite was observed, M. aeruginosa displaced C. raciborskii, but the system did not reach an equilibrium and both strains were washed out. Hence, outcomes of the competition depended on the pair of competing strains and not only on species or on type of limitation. We concluded that existence of different trade-offs among strains and between species underlie our results showing that C. raciborskii can either dominate or be displaced by M. aeruginosa when exposed to different conditions of light or phosphate limitation.

Background: Despite the development of microsurgery and cranial base techniques, the surgical management of Foramen Magnum Meningiomas (FMM) continues to be a technical challenge to neurosurgeons. Controversy concerning the utility of systematic condyle drilling for approaching FMM has been raised. Our aim was to describe the surgical technique, analyze its safety, and the postoperative outcome in 12 consecutive FMM patients., Methods: From 1986 to 2011, 12 patients with FMM underwent operations in the Department of Neurosurgery at Servidores do Estado Hospital and in a private clinic. All patients were operated using a standard suboccipital craniectomy, preserving the occipital condyle, opening of the Foramen Magnum, and ipsilateral removal of the posterior arch of C1., Results: There was no operative mortality, nine patients achieved Glasgow Outcome Scale 4 or 5. Condylar resection was not deemed necessary in any case. Gross total resection was achieved in nine patients. After surgery, four patients developed lower cranial nerve weakness. There was no significant postoperative complication in the remaining patients. The average follow-up is 8.2 years., Conclusion: The vast majority of FMM can be safely removed with a retrocondylar lateral suboccipital approach without condylar resection, using meticulous microsurgical techniques.

A set of four di-imine copper(II) complexes containing pyridine, pyrazine and/or imidazole moieties, [Cu(apyhist)H2O](2+) 1 (apyhist = 2-(1H-imidazol-4-yl)-N-(1-(pyridin-2-yl)ethylidene)ethanamine), [Cu(apzhist)OH](+) 2 (apzhist = 2-(1H-imidazol-4-yl)-N-(1-(pyrazin-2-yl)ethylidene)ethanamine), [Cu(apyepy)OH](+) 3 (apyepy = 2-(pyridin-2-yl)-N-(1-(pyridin-2-yl)ethylidene)ethanamine), and [Cu(apzepy)H2O](2+) 4 (apzepy = N-(1-(pyrazin-2-yl)ethylidene)-2-(pyridin-2-yl)ethanamine), were investigated regarding their capability of interacting with serum albumin (human, HSA and bovine, BSA), by using spectroscopic techniques, CD, UV/Vis and EPR. Like other similar di-imine copper(II) complexes, most of them showed an expected preferential insertion of the metal ion at the primary N-terminal site of the protein, very selective for copper and characterized by a CD band at 560 nm. Further insertion of the copper ion at a secondary site is expected when using an excess of the metal. However, one of these studied complexes, [Cu(apyhist)H2O](2+) 1, exhibited anomalous behaviour interacting only at this secondary metal binding site of albumin, characterized by a CD band at 370 nm, and attributed to the coordination of copper at the Cys34 pocket. Analogous experiments with HSA previously treated with N-ethyl-maleimide (NEM), that oxidizes the protein Cys34 residue and obstructs the metal coordination, verified these results. Additional data obtained by EPR spectroscopy complemented those results. DFT calculations, considering some structural and electronic characteristics of such series of di-imine ligands and of the corresponding copper complexes, suggested molecular recognition of the apyhist ligand at the protein cavity as a feasible explanation for this unexpected and peculiar behaviour of complex 1.

The plant Cecropia pachystachya Trécul is widely used in Brazilian ethnomedicine to treat hypertension, asthma, and diabetes. Arginase is an enzyme with levels that are elevated in these disorders, and it is central to Leishmania polyamine biosynthesis. The aims of this study were to evaluate antileishmanial activity and inhibition of the arginase enzyme by C. pachystachya extracts, and to study changes in cellular organization using electron microscopy. The ethanol extract of C. pachystachya was tested on Leishmania (Leishmania) amazonensis promastigote survival/proliferation and arginase activity in vitro. Qualitative ultrastructural analysis was also used to observe changes in cell organization. The major bioactive molecules of the ethanol extract were characterized using liquid chromatography-electrospray ionization-mass spectrometry (LC-ESI-MS). The ethyl acetate fraction of the ethanol extract diminished promastigote axenic growth/survival, inhibited arginase activity, and altered a mitochondrial kinetoplast DNA (K-DNA) array. The bioactive compounds of C. pachystachya were characterized as glucoside flavonoids. Orientin (9) (luteolin-8-C-glucoside) was the main component of the methanol-soluble ethyl acetate fraction obtained from the ethanol extract and is an arginase inhibitor (IC50 15.9 μM). The ethyl acetate fraction was not cytotoxic to splenocytes at a concentration of 200 μg/mL. In conclusion, C. pachystachya contains bioactive compounds that reduce the growth of L. (L.) amazonensis promastigotes, altering mitochondrial K-DNA arrangement and inhibiting arginase., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

The predicted structure has been calculated for a protein-based biosensor for inorganic phosphate (Pi), previously developed by some of us (Okoh et al., Biochemistry, 2006, 45, 14764). This is the phosphate binding protein from Escherichia coli labelled with two rhodamine fluorophores. Classical molecular dynamics and hybrid Car-Parrinello/molecular mechanics simulations allow us to provide molecular models of the biosensor both in the presence and in the absence of Pi. In the latter case, the rhodamine fluorophores maintain a stacked conformation in a 'face A to face B' orientation, which is different from the 'face A to face A' stacked orientation of free fluorophores in aqueous solution (Ilich et al., Spectrochim. Acta, Part A, 1996, 52, 1323). A protein conformation change upon binding Pi prevents significant stacking of the two rhodamines. In both states, the rhodamine fluorophores form hydrophobic contact with LEU291, without establishing significant hydrogen bonds with the protein. The accuracy of the models is established by a comparison between calculated and experimental absorption and circular dichroism spectra.

Purpose: The objective of this study was to evaluate the effectiveness and long-term outcome of the treatment of patients with diffuse pigmented villonodular synovitis (PVNS) of the knee with subtotal arthroscopic and open synovectomy and subsequent external-beam radiotherapy., Methods: Eight patients diagnosed with diffuse PVNS by clinical and magnetic resonance imaging were treated surgically with subtotal arthroscopic synovectomy and an additional posterior incision for extra-articular lesions, followed by local adjuvant radiotherapy. These patients were followed up for a mean of 8.6 years to monitor remaining lesions and to detect new occurrences of the condition., Results: None of the patients presented with major postoperative complications or have had radiotherapeutic late effects. In no case was radiographic arthritis progression detected. Three patients exhibited late minor complications (peripatellar pain, articular effusion, and persistent quadricipital muscle atrophy). Only 1 patient (12.5%) presented with recurrence of the disease during the follow-up period., Conclusions: On the basis of our limited study, subtotal arthroscopic and open synovectomy with subsequent local external-beam radiotherapy had a recurrence rate of 12.5% at 8.6 years of follow-up for the treatment of diffuse PVNS of the knee joint., Level of Evidence: Level IV, therapeutic case series., (Crown Copyright © 2012. Published by Elsevier Inc. All rights reserved.)

The cavernous sinus (CS) has one of the most complex anatomical networks of the skull base and because of the diversity of its contents is involved in many pathological processes. Nevertheless, anatomical literature concerning the CS is still controversial, so a systematic literature review was performed to find out the microanatomy of the medial wall of the CS and its clinical importance on sellar pathologies. Experimental studies from English-language literature between 1996 and 2010 were identified in MEDLINE, LILACS, and Cochrane databases. After analysis, two tables were prepared exhibiting the major points of each article. Fourteen experimental studies were included in the tables. Four studies concluded that the medial wall of the CS is composed of a loose, fibrous structure, and the remaining ten presumed that the medial wall is formed by a dural layer that constitutes the lateral wall of the sella. The lack of definition standards and of methodological criteria led to variation in the results among different studies. Thus, this hindered results comparison, possibly explaining the different observations.