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ObjectiveOur objective was to check if the ICD-10 operational criteria application changes non-operational, prototype-based diagnoses obtained in a real-life scenario.MethodsPsychiatry residents applied the diagnostic criteria of the ICD-10 as a “diagnostic test” to five outpatient patients they were already following who had a prototype-based diagnosis. Tests were used to ascertain whether changes in opinion were significant and if any of the diagnostic groups were more prone to change than others. The present paper is part of the study with UTN U1111-1260-1212.ResultsSeventeen residents reviewed their last five case files, retrieving 85 diagnostic pairs of non-operational-based vs. operational-based diagnoses. The Stuart–Maxwell test did not indicate a significant opinion change (χ2 = 5.25, p = 0.39; power = 0.94) besides 30% of diagnostic changes. Despite not being statistically significant, 20.2% of all evaluations resulted in a change that would affect treatment choices. Using ICD-10 operational criteria slightly increased the number of observed diagnoses, but probably without clinical relevance. None of the non-operational diagnoses have a higher tendency to change with operational criteria application (χ2 = 11.6, p = 0.07). The female gender was associated with a higher diagnostic change tendency.ConclusionApplying ICD-10 operational criteria as a diagnostic test does not induce a statistically significant diagnostic opinion change in residents and no diagnostic group seems more sensible to diagnostic change. Gender-related differences in diagnostic opinion changes might be evidence of sunk cost bias. Although not statistically significant, using operational criteria after diagnostic elaboration might help to deal with subjects without adequate treatment response.

A glioma is a type of tumor that acts on the Central Nervous System (CNS) in a highly aggressive manner. Gliomas can occasionally be inaccurately diagnosed and treatments have low efficacy, meaning that patients exhibit a survival of less than one year after diagnosis. Due to factors such as intratumoral cell variability, inefficient chemotherapy drugs, adaptive resistance development to drugs and tumor recurrence after resection, the search continues for new drugs that can inhibit glioma cell growth. As such, analogues of endocannabinoids, such as fatty acid amides (FAAs), represent interesting alternatives for inhibiting tumor growth, since FAAs can modulate several metabolic pathways linked to cancer and, thus, may hold potential for managing glioblastoma. The aim of this study was to investigate the in vitro effects of two fatty ethanolamides (FAA1 and FAA2), synthetized via direct amidation from andiroba oil (Carapa guianensis Aublet), on C6 glioma cells. FAA1 and FAA2 reduced C6 cell viability, proliferation and migratory potential in a dose-dependent manner and were not toxic to normal retina glial cells. Both FAAs caused apoptotic cell death through the loss of mitochondrial integrity (ΔΨm), probably by activating cannabinoid receptors, and inhibiting the PI3K/Akt pathway. In conclusion, FAAs derived from natural products may have the potential to treat glioma-type brain cancer.

The pre-chilling of rabbit carcasses in an immersion tank directly interferes with microbial control. Therefore, this study was developed to examine the influence of different pre-chill tank water temperatures (4, 7, and 10 °C) on the microbiological quality of rabbit carcasses. Samples of rabbit carcasses and water and ice from the pre-chiller tank were collected; mesophilic aerobic heterotrophic microorganisms (MES), enterobacteria (EC), and coagulase-positive Staphylococcus (CPS) were counted; and the presence of Salmonella spp. was investigated. After the carcasses were immersed in the pre-chiller, there was a significant increase (p < 0.05) in MES (38.69 and 88.06 Log CFU·mL−1 at 4 and 10 °C, respectively) and EC (3.20, 4.15, and 4.84 Log CFU·mL−1 at 4, 7, and 10 °C, respectively). The average EC count tended to increase after the carcasses were immersed in the pre-chiller at different temperatures, but this increase was not significant. Water samples showed MES, EC, and CPS counts only after the immersion of the carcasses; however, the presence of these microorganisms was not detected in any of the ice samples. Salmonella spp. was not identified in the analyzed samples. The microorganisms analyzed at the three pre-chiller water temperatures evaluated did not multiply on the surface of the rabbit carcasses or in the pre-chiller water after carcass immersion. This study showed that none of the three pre-chilling temperatures were able to reduce the count of indicator microorganisms in the carcasses of rabbits. These data provide scientific support to discuss the need for specific norms and guidelines for rabbit meat production.

Gliomas are the most common primary malignant brain tumors in adults, and have a poor prognosis, despite the different types of treatment available. There is growing demand for new therapies to treat this life-threatening tumor. Quinone derivatives from plants have received increased interest as potential anti-glioma drugs, due to their diverse pharmacologic activities, such as inhibiting cell growth, inflammation, tumor invasion, and promoting tumor regression. Previous studies have demonstrated the anti-glioma activity of Eleutherine plicata, which is related to three main naphthoquinone compounds—eleutherine, isoeleutherine, and eleutherol—but their mechanism of action remains elusive. Thus, the aim of this study was to investigate the mechanism of action of eleutherine on rat C6 glioma. In vitro cytotoxicity was evaluated by MTT assay; morphological changes were evaluated by phase-contrast microscopy. Apoptosis was determined by annexin V–FITC–propidium iodide staining, and antiproliferative effects were assessed by wound migration and colony formation assays. Protein kinase B (AKT/pAKT) expression was measured by western blot, and telomerase reverse transcriptase mRNA was measured by quantitative real-time polymerase chain reaction (qRT-PCR). Eleutherine reduced C6 cell proliferation in a dose-dependent manner, suppressed migration and invasion, induced apoptosis, and reduced AKT phosphorylation and telomerase expression. In summary, our results suggest that eleutherine has potential clinical use in treating glioma.

Chromoblastomycosis (CBM) is a chronic human subcutaneous mycosis caused by various aetiologic agents. CBM does not have an established treatment but may be managed using antifungal agents, surgical removal of the lesions, or cryotherapy. Kojic acid (KA), a known tyrosinase inhibitor with a variety of biological actions, including fungistatic action against the fungus Cryptococcus neoformans, mediated by inhibiting melanin production, seems to be an alternative to improve the treatment of CBM. The aim of the present study was to analyze the action of KA against the pathogenic fungus Fonsecaea sp., an aetiological agent of CBM. The fungal culture was incubated with KA, and the amount of melanin was assessed, followed by cytochemical detection. Subsequently, the samples were analyzed by light microscopy, transmission and scanning electron microscopy. Culture analysis revealed that 100 g/mL KA significantly decreased the melanization of the fungus and the exocytosis of melanin into the culture supernatant. Additionally, KA induced less growth of biofilm formation and intense disruption of the cell wall, and decreased the number of melanin-containing vesicles in the culture supernatant. Finally, KA inhibited fungal filamentation in culture and the subsequent phagocytosis process. Thus, KA may be a promising substance to help in the treatment of CBM.

Seizures and epilepsy are some of the most common serious neurological disorders, with approximately 80% of patients living in developing/underdeveloped countries. However, about one in three patients do not respond to currently available pharmacological treatments, indicating the need for research into new anticonvulsant drugs (ACDs). The GABAergic system is the main inhibitory system of the brain and has a central role in seizures and the screening of new ACD candidates. It has been demonstrated that the action of agents on endocannabinoid receptors modulates the balance between excitatory and inhibitory neurotransmitters; however, studies on the anticonvulsant properties of endocannabinoids from plant oils are relatively scarce. The Amazon region is an important source of plant oils that can be used for the synthesis of new fatty acid amides, which are compounds analogous to endocannabinoids. The synthesis of such compounds represents an important approach for the development of new anticonvulsant therapies.

Mercury is among the ten most dangerous chemicals for public health, and is a priority concern for the 128 signatory countries of the Minamata Convention. Mercury emissions to the atmosphere increased 20% between 2010 and 2015, with South America, Sub-Saharan Africa and Southeast Asia as the main contributors. Approximately 80% of the total mercury emissions in South America is from the Amazon, where the presence of the metal is ubiquitous and highly dynamic. The presence of this metal is likely increasing, with global consequences, due to events of the last two years including extensive biomass burning and deforestation, as well as mining activities and the construction of large-scale projects, such as dams. Here we present a concise profile of this mobilization, highlighting the human exposure to this metal in areas without mining history. Mercury reaches the food chain in its most toxic form, methylmercury, intoxicating human populations through the intake of contaminated fish. Amazonian populations present levels over 6 ppm of hair mercury and, according to the 175:250:5:1 ratio for methylmercury intake : mercury hair : mercury brain : mercury blood, consume 2–6 times the internationally recognized reference doses. This exposure is alarmingly higher than that of other populations worldwide. A possible biphasic behavior of the mercury-related phenomena, with consequences that may not be observed in populations with lower levels, is hypothesized, supporting the need of improving our knowledge of this type of chronic exposure. It is urgent that we address this serious public health problem in the Amazon, especially considering that human exposure may be increasing in the near future. All actions in this region carry the potential to have global repercussions.

Abstract Purpose To evaluate the effect of N-Acetylcysteine (NAC) in newborn rats submitted to hypoxia and reoxygenation (H/R) conditions in an experimental model of necrotizing enterocolitis. Methods Eight pregnant rats and their 70 cubs were used (5 groups) and exposed to H/R conditions and received NAC at different times. The animals in the H/R groups were placed in a gas chamber (100% CO2) for 10 minutes and then reoxygenated for 10 minutes (100% O2), twice a day for the first three days of life, with a six-hour span between events. On the third day of life, the animals were anesthetized, laparotomized and the intestines were resected. Results The H/R and NAC groups showed changes in the intestinal wall in relation to the number, height and width of the villi when compared to the control group (p

Abstract Purpose: To investigate the effects of atenolol in inflammatory mediator and oxidative stress in a myocardial injury by intestinal ischemia/reperfusion in rat model. Methods: Adult Wistar male rats were randomly (n=8), anesthetized and divided in: Sham: submitted to operation only; group SS+IR: intravenous saline infusion following superior mesenteric artery occlusion during 60 minutes (ischemia) and open for 120 minutes (reperfusion); group AT+IR: intravenous atenolol infusion (2 mg/kg) following superior mesenteric artery occlusion during 60 minutes (ischemia) and open for 120 minutes (reperfusion); and group AT+I+AT+R: intravenous atenolol infusion following superior mesenteric artery occlusion during 60 minutes (ischemia) and in the time 45 minutes other atenolol doses were administrated and the artery was open for 120 minutes (reperfusion), all animals were submitted to muscular relaxation for mechanical ventilation. In the end of experiment the animals were euthanized and the hearts tissue were morphology analyzed by histology and malondialdehyde by ELISA, and the plasma were analyzed for tumor necrosis factor-alpha by ELISA. Results: The group SS+IR demonstrated the higher malondialdehyde levels when compared with the atenolol treated-groups (p=0.001) in the heart tissue. The tumor necrosis factor-alpha level in plasma decrease in the treated groups when compared with SS+IR group (p=0.001). Histology analyses demonstrate pyknosis, edema, cellular vacuolization, presence of inflammatory infiltrate and band contraction in the heart tissue of the rats. Conclusion: Atenolol significantly reduce the degree of cardiac damage after intestinal ischemia-reperfusion.

Abstract Purpose: To evaluate the effect of remote ischemic preconditioning (r-IPC) administered to pregnant rats, in the ileum of newborn rats subjected to hypoxia and reoxygenation. Methods: We used three pregnant rats and their newborn rats distributed in three groups: 1) Control (C) - Newborn rats born from a pregnant rat which did not undergo any intervention; 2) Hypoxia-Reoxygenation (H/R) - Newborn rats born from a pregnant rat which did not undergo any intervention, and were subjected to hypoxia-reoxygenation; 3) Remote Ischemic Preconditioning (r-IPC) - newborn rats born from a pregnant rat which was subjected to remote ischemic preconditioning twenty-four hours before giving birth and the newborn rats were subjected to hypoxia-reoxygenation. Segments of ileum were prepared for histological analysis by HE and immunohistochemistry by the Ki67 to evaluate cell proliferation, crypt depth and villus height and evaluation of apoptosis by cleaved caspase-3. Results: The intensity of the lesions was lower in the r-IPC than in the H/R group, showing significant difference (p H/R - p < 0.05), and higher villi, showing significant difference (r-IPC > H/R - (p

Abstract Purpose: To evaluate the functional and structural response of tadalafil effects in the intestinal mucosa, using an experimental model of hypoxia and reoxygenation injury in rats. Methods: The animals were divided into 4 groups: CTL, H/R, H/R+Td and M+Td. The newborn rats allocated in groups H/R, H/R+Td and M+Td were submitted twice a day, to a gas chamber with CO2 at 100% for 10 minutes and afterward reoxygenation with O2 at 98% for 10 minutes, in the three first days of life. Tadalafil dose was given to newborn of group H/R+Td and to the pregnant rat of group M+Td. Histological analysis was made with hematoxylin-eosin technique and oxidative stress through nitrite and nitrate levels and lipid peroxidation. Results: The histological analysis showed a reduction of mucosa alterations in the groups that received tadalafil. In the oxidative stress evaluation, occurred an increase of NO levels and less lipidic peroxidation in the ileum segments that received tadalafil. Conclusion: Tadalafil provides tissue protection when administered independently to both, pregnant or newborns.

Background: Mental State Examination (MSE) is compared with physical examination as a reliable method of objective data investigation. There is a growing concern with psychiatric clinics, nosology, and the reliability of diagnostic interview methods as a source of valid diagnostic strategy. Efforts to achieve an international diagnosis protocol have been unsuccessful or polemical. This paper focuses on psychopathology, MSE, and mental function development within Brazilian psychiatry over the last few decades.Methods: Searches, interviews, and narrative reviews were done to look for systematic ways in which to conduct MSE, mental functions, symptom clusters, orientations about data observation and records. Brazilian psychopathology textbooks were examined, if they provided access to consolidated knowledge on psychopathology examination.Results: Sixteen textbooks were selected from a 49 year span. Descriptive psychopathology with phenomenological orientation was the primary trend in the MSE. Concepts derived from different traditions, most lacking common terminology, suggested some divergence among authors. Recommendations for patient observation and how to collect objective data was clear, but MSE standardization efforts were missing. A detailed description of mental function abnormalities was the main MSE record strategy, without consensus about ways to summarize and record this data. In an examination summary, mental strata was divided into “mental functions,” and MSE subsets were frequent. All authors considered the following mental functions: consciousness, perception, thought, memory, attention, orientation, and volition.Discussion: Psychiatric competence demands MSE proficiency. Official documents are not clear about performance and recording standards. MSE data was usually recorded through descriptive psychopathology. A shift from detailed descriptive findings, to an array of observed pathological elements, described through a mental function checklist was observed over time. Clinical practice and research guidelines should consider the development of reliable MSE practices; however, it has been neglected by modern psychiatry/neuroscience through the excessive emphasis on interview protocols. Better MSE practices, and the improvement of bedside skill in psychiatry are necessary and depend on the recovery of psychopathological debates and semiological reasoning, which will allow the return of phenomenology-oriented “observational” techniques.

During tuberculosis, Mycobacterium uses host macrophage cholesterol as a carbon and energy source. To mimic these conditions, Mycobacterium smegmatis can be cultured in minimal medium (MM) to induce cholesterol consumption in vitro. During cultivation, M. smegmatis consumes MM cholesterol and changes the accumulation of cell wall compounds, such as PIMs, LM, and LAM, which plays an important role in its pathogenicity. These changes lead to cell surface hydrophobicity modifications and H2O2 susceptibility. Furthermore, when M. smegmatis infects J774A.1 macrophages, it induces granuloma-like structure formation. The present study aims to assess macrophage molecular disturbances caused by M. smegmatis after cholesterol consumption, using proteomics analyses. Proteins that showed changes in expression levels were analyzed in silico using OmicsBox and String analysis to investigate the canonical pathways and functional networks involved in infection. Our results demonstrate that, after cholesterol consumption, M. smegmatis can induce deregulation of protein expression in macrophages. Many of these proteins are related to cytoskeleton remodeling, immune response, the ubiquitination pathway, mRNA processing, and immunometabolism. The identification of these proteins sheds light on the biochemical pathways involved in the mechanisms of action of mycobacteria infection, and may suggest novel protein targets for the development of new and improved treatments.

Epilepsy is a chronic neurological disease characterized by excessive neuronal activity leading to seizure; about 30% of affected patients suffer from the refractory and pharmacoresistant form of the disease. The anticonvulsant drugs currently used for seizure control are associated with adverse reactions, making it important to search for more effective drugs with fewer adverse reactions. There is increasing evidence that endocannabinoids can pharmacologically modulate action against seizure and antiepileptic disorders. Therefore, the objective of this study is to investigate the anticonvulsant effects of fatty acid amides (FAAs) in a pentylenetetrazole (PTZ)-induced seizure model in mice. FAAs (FAA1 and FAA2) are obtained from Carapa guianensis oil by biocatalysis and are characterized by Fourier Transform Infrared Analysis (FT-IR) and Gas Chromatography-Mass Spectrometry (GC-MS). Only FAA1 is effective in controlling the increased latency time of the first myoclonic jerk and in significantly decreasing the total duration of tonic-clonic seizures relative to the pentylenetetrazol model. Also, electrocortical alterations produced by pentylenetetrazol are reduced when treated by FAA1 that subsequently decreased wave amplitude and energy in Beta rhythm. The anticonvulsant effects of FAA1 are reversed by flumazenil, a benzodiazepine antagonist on Gamma-Aminobutyric Acid-A (GABA-A) receptors, indicating a mode of action via the benzodiazepine site of these receptors. To conclude, the FAA obtained from C. guianensis oil is promising against PTZ-induced seizures.

PURPOSE: To determine the effect of a single dose of adriamycin (ADR) to induce anorectal malformations (ARMs) and determine the effect of folic acid (FA) in this model. METHODS: Ten female Wistar rats were divided randomly in two groups. Group A - ADR; Group B - FA+ADR. Dams from group B received daily, since two weeks before the pregnancy to the end of pregnancy, FA (50mg/kg) by gavage. Dams from both groups received ADR (6mk/kg) by intraperitoneal injection on gestational day (GD) 8. Their fetuses were harvested by cesarean section on GD21 and were examined looking for ARMs. The thickness of anal stratified squamous epithelium (ASSE) and intestinal epithelium (IE) were analyzed. p≤0.05*. RESULTS: 81 fetuses were harvested. The number of fetuses; number of ARMs; mean (∆%) (± SD) were determined to be, respectively: ADR - 41[29;65%(±37%)] versus FA+ADR - 40[04;16%(±36%)] (p=0.05). AMRs were significantly lower in FA+ADR group than in ADR group (p=0.05). The thickness (µm) of ASSE (± SD) and IE (± SD) were measured, respectively: ADR - [25.98(±0.74) and 19.48(±1.68)] versus FA+ADR - [24.74(±0.91) and 24.80(±0.81)] (p

PURPOSE: To investigate the effect of folic acid (FA) in an experimental model of anorectal malformations (ARMs) ethylenethiourea (ETU) induced.METHODS:Eight female Wistar rats were divided randomly in two groups. Group A - ETU; Group B - FA+ETU; Dams from group B received daily, since two weeks before pregnancy to the end of pregnancy, FA (50mg/kg) by gavage. Dams from groups A and B, received 1% ETU (125mk/kg) by gavage on gestational day (GD) 11. Their fetuses were harvested by cesarean section on GD21 and were examined looking for ARMs. The thickness of anal stratified squamous epithelium (ASSE) and intestinal epithelium (IE) were analyzed. p

PURPOSE: To evaluate the effects of maternal remote ischemic preconditioning (IPCr) in the colonic mucosa of newborn rats subjected to hypoxia and reoxygenation.METHODS:Newborn Wistar rats were divided into three groups. Control Group (CG), Hypoxia and Reoxygenation Group (HRG) and Remote Ischemic Preconditioning Group (IPCrG). Hypoxia and reoxygenation was performed 2x per day, with an interval of 6 hours, on the 1st, 2nd and 3rd days of life, with 10 minutes of CO2 at 100%, followed by 10 minutes O2 at 100%(HRG/IPCrG). The maternal IPCr was performed 24 hours before delivery by applying a rubber band tourniquet to the left hind limb (IPCrG). Segments of the colon underwent histological (HE) and immunohistochemical analysis for caspase-3 and COX - 2.RESULTS: The histological findings showed no intestinal mucosal damage in the CG group and severe lesions in HRG that was attenuated in the IPCrG (p

Tyrosinase is a key enzyme in melanin synthesis and widely distributed in plants and animals tissues. In mammals, this enzyme is related to pigment production, involved in wound healing, primary immune response and it can also contribute to catecholamines synthesis in the brain. Consequently, tyrosinase enzyme represents an attractive and selective target in the field of the medicine, cosmetics and bio-insecticides. In this paper, experimental kinetics and computational analysis were used to study the inhibition of tyrosinase by analogous of Kojic acid. The main interactions occurring between inhibitors-tyrosinase complexes and the influence of divalent cation (Cu2+) in enzymatic inhibition were investigated by using molecular docking, molecular dynamic simulations and electrostatic binding free energy by using the Linear Interaction Energy (LIE) method. The results showed that the electrostatic binding free energy are correlated with values of constant inhibition (r2 = 0.97).Thus, the model obtained here could contribute to future studies of this important system and, therefore, eventually facilitate development of tyrosinase inhibitors.

PURPOSE:To evaluate the effect of a local application of simvastatin gel in repairing bone defects in the femurs of rabbits.METHODS:Two standard surgical cavities were created in the femoral epiphysis of 18 rabbits. In the simvastatin group (SG), the cavities were filled with a collagen sponge soaked in 0.5 ml of a simvastatin (1 mg) gel, and the cavities were covered with a biological membrane. The bone cavities in the second group (control group) were filled with a blood clot and covered with a biological membrane. On the 7th, 21st and 42nd days, six animals in each group were euthanized, and the femurs were subject to histological evaluation (vascularity, fibrosis, reactive bone formation, osteoblasts, and osteoclasts) and immunohistochemical (anti-VEGF and anti-osteocalcin) analysis. The results were analyzed using a Wilcoxon test (p

PURPOSE: To evaluate hepatic morphological-histological abnormalities in newborns from female rats exposed to ethylenethiourea. METHODS: A randomized study was conducted on fifty-five newborn Wistar rats were studied: 34 in the experimental group, whose mothers had been exposed to 1% ethylenethiourea; and 21 in the control group, whose mothers had received 0.9% physiological solution. The solution was administered via gavage on the 11th day of gestation. Cesarean section was performed on the 20th day of gestation. The newborns' livers were examined and any morphological-histological abnormalities were registered. The presence of megakaryocytes was quantified in 50 microscope fields, as the total number of these cells per mm². RESULTS: The entire experimental group presented abnormalities of embryonic formation, with musculoskeletal anomalies, digestive system anomalies, hepatic congestion and friability, hydrops and delayed intrauterine growth. The histopathological analysis showed that morphological-histological hepatic destructuring had occurred in all entire experimental with removal of the hepatic trabeculae and severe hepatic megakaryocytosis. The mean megakaryocyte density ranged from 107.9 to 114.2 per mm², and it was eight times greater than in the control group, thus characterizing a situation of extramedullary hematopoiesis. CONCLUSION: The fetal exposure to ethylenethiourea caused hepatic damage characterized by severe extramedullary hematopoiesis.OBJETIVO: Avaliar alterações hepáticas morfohistológicas em recém-nascidos de ratas prenhes expostas à etilenotioureia. MÉTODOS: Realizado ensaio randomizado em animais de experimentação, onde foram estudados 55 recém-nascidos de ratas Wistar, 34 do Grupo Experimento, expostas a etilenotioureia 1% e 21 do Grupo Controle, em que a rata prenhe recebeu solução fisiológica 0,9%, ambos por gavagem no 11º dia de gestação. Realizada no 20º dia de gestação cesariana, analisados os fígados dos recém-nascidos e registradas as alterações morfohistológicas. Realizou-se a quantificação dos megacariócitos em 50 campos microscópicos, avaliando a quantidade total destas células por mm². RESULTADOS: Todos os recém-nascidos do Grupo Experimento apresentaram alterações na formação embrionária, com anomalias musculoesqueléticas, anormalidades do sistema digestório, congestão e friabilidade hepática, hidropisia e crescimento intrauterino retardado. A análise histopatológica mostrou desestruturação hepática morfohistológica em todos os recém-nascidos expostos à etilenotioureia, com destrabeculação dos hepatócitos e intensa megacariocitose hepática, apresentando média da densidade de megacariócitos de 107,9 até 114,2 por mm² sendo cerca de oito vezes maior que no Grupo Controle, caracterizando hematopoese extramedular. CONCLUSÃO: A exposição fetal a etilenotioureia provocou danos hepáticos caracterizados pela intensa hematopoese extramedular.

PURPOSE: The pathophysiology of abnormalities associated with myenteric plexus lesions remains imperfectly understood. Such abnormalities have been correlated with subocclusive intestinal conditions in children with Hirschsprung's disease, cases of chronic constipation and, postoperatively, in cases of anorectal anomalies. This study evaluated abnormalities of the myenteric plexus in fetus from female rats that received ethylenethiourea. METHODS: Female rats were exposed to ethylenethiourea on the 11th day of pregnancy (experimental group) or to 0.9% physiological solution (control group). Abnormalities were only found in the experimental group. The digestive tract muscle layer was analyzed morphometrically and changes to the frequencies of nerve plexus cells and interstitial cells of Cajal were evaluated, using hematoxylin-eosin, S-100 protein, neuron-specific enolase and C-Kit, respectively. RESULTS: Muscle and skeletal abnormalities were observed in 100%, anorectal anomalies in 86%, absent tail in 71%, short tail in 29%, duodenal atresia in 5%, esophageal atresia in 5% and persistent omphalomesenteric duct in 5%. Histopathological analysis showed a thinner muscle layer associated with lower frequencies of ganglion cells and interstitial cells of Cajal, in all gastrointestinal tract. CONCLUSION: Severe nerve plexus abnormalities associated with muscle layer atrophy were observed throughout the gastrointestinal tract in newborn rats exposed to ethylenethiourea.OBJETIVO: As anomalias associadas a lesões dos plexos mioentéricos permanecem sem plena compreensão da sua fisiopatologia. Alterações nos plexos nervosos têm sido correlacionadas com quadros suboclusivos intestinais em crianças portadoras de doença de Hirschsprung, em constipação crônica e no pós-operatório de anomalias anorretais. Este estudo avaliou as anomalias do plexo mioentérico em fetos de ratos fêmea que ingeriram etilenotioureia (ETU). MÉTODOS: Ratos fêmea foram expostos no 11º dia de gestação a ETU 1% no Grupo Experimento e a solução fisiológica 0,9% no Grupo Controle. Foram observadas anomalias apenas no Grupo experimento, sendo realizada morfometria da camada muscular e avaliadas alterações da frequência celular nos gânglios do plexo mioentérico e nas células intersticiais de Cajal (CIC) utilizando hematoxilina-eosina, P S-100, Enolase Neurônio Específica e C-KIT. RESULTADOS: Foram observadas anomalias musculoesqueléticas (100%), anorretais (86%), ausência de cauda (71%), cauda curta (29%), atresia duodenal (5%), atresia esofágica (5%) e conduto onfalomesentérico persistente (5%). A análise histopatológica mostrou adelgaçamento da camada muscular associada às alterações da frequência das células ganglionares e das CIC em todos os segmentos do trato gastrointestinal. CONCLUSÃO: Foram observadas alterações graves nos plexos nervosos associadas ao adelgaçamento da camada muscular de todo o trato gastrointestinal nos fetos expostos a ETU.

OBJETIVO: avaliar a associação entre a exposição dos genitores aos agrotóxicos e nascimentos com defeitos congênitos no Vale do São Francisco, bem como o perfil sociodemográfico e os defeitos encontrados. MÉTODOS: estudo tipo caso-controle, sendo que para cada caso (recém-nascido com defeito congênito), eram dois controles (recém-nascidos saudáveis) nascidos na cidade de Petrolina, no Vale do São Francisco, em 2009. A amostra constou de 42 casos e 84 controles. Os dados formam colhidos com uso de questionário estruturado, adaptado do Estudo Colaborativo Latino-Americano de Malformações Congênitas (ECLAMC), acrescido de questões relacionadas à exposição aos agrotóxicos, análise do prontuário e contato com a pediatra do hospital. Foi realizado o teste do χ2 com nível de significância de 5% para identificar as variáveis com maiores diferenças entre os grupos caso e controle. Em seguida, foi calculado o Odds Ratio (OR) amostral, bem como o OR obtido por análise de regressão logística e, finalmente, realizou-se uma análise de regressão logística multivariada. RESULTADOS: houve maior exposição aos agrotóxicos durante a gestação em neonatos com defeitos congênitos se comparados aos saudáveis. Maior risco foi observado quando pelo menos um dos genitores foi exposto aos agrotóxicos (OR ajustado = 1,3; IC95% = 0,4-3,9). As variáveis sociodemográficas associadas aos defeitos congênitos foram: baixa escolaridade, baixo peso, prematuridade, genitores jovens, doenças crônicas e fatores físicos. Foram encontrados com maior frequência os polimalformados e os defeitos dos sistemas musculoesquelético e nervoso. CONCLUSÃO: o presente estudo, a despeito de não apresentar significância, sugere associação entre a exposição aos agrotóxicos e a ocorrência de defeitos congênitos.PURPOSE: to evaluate associations between parental exposure to pesticides and births with congenital defects in São Francisco Valley, as well as the demographic profile and the defects found. METHODS: in this case-control study, each case (newborns with congenital defects) had two controls (healthy newborns). The subjects were born in the city of Petrolina, in São Francisco Valley, in 2009. The sample consisted of 42 cases and 84 controls. Data were gathered by a structured questionnaire adapted from Latin-American Collaborative Study of Congenital Malformations (ECLAMC), with the addition of questions related to exposure to pesticides, analysis of the medical records and contact with the hospital's pediatrician. The χ2 test was performed with a significance level of 5% to identify the variables with the greatest differences between case and control groups. Odds Ratio (OR) for the sample was calculated, as well as the OR obtained by logistic regression analysis, and finally, multivariate logistic regression analysis was performed. RESULTS: there was a greater exposure to pesticides during pregnancy in infants with congenital defects compared to healthy subjects. Increased risk was observed when at least one parent was exposed to pesticides (adjusted OR = 1.3; 95%CI = 0.4 - 3.9). The sociodemographic variables associated with congenital defects were: low school level, low weight, prematurity, young parents, chronic diseases, and physical factors. Multiple malformations and defects of the musculoskeletal and nervous systems were more frequently found. CONCLUSIONS: the present study suggests an association between exposure to pesticides and the occurrence of congenital defects, although the data were not significant.

PURPOSE: To evaluate fecal continence, anorectal manometry (AM) and profilometry (P), in patients operated for congenital megacolon, using either the modified Duhamel technique (MDT) or the modified transanal rectosigmoidectomy (MTR) technique. METHODS: 42 patients were evaluated clinically and via AM and P, for postoperative control. The resting, coughing, voluntary contraction, maintained voluntary contraction and perianal stimulation pressures were investigated. The rectosphincteric reflex was tested and the simple and enhanced pressure curves were evaluated. The three-dimensional profilometric outline was produced. Student's t, chi-squared and Fisher's exact tests were used for statistical analysis (pOBJETIVO: Avaliar a continência fecal, a manometria anorretal (MAR) e a profilometria (PFM), em pacientes submetidos a tratamento cirúrgico do megacolo congênito pelas técnicas de Duhamel modificado (DM) ou de retossigmoidectomia transanal modificada (RTM). MÉTODOS: 42 pacientes foram clinicamente avaliados e submetidos à MAR e PFM para controle pós-operatório. Foram pesquisadas as pressões no repouso (PR), à tosse (T), à contração voluntária (CV), à contração voluntária mantida (CVM) e à estimulação perianal (EPA). O reflexo reto-esficteriano (RRE) foi testado e as curvas pressóricas simples e potencializada foram avaliadas. Foi elaborado traçado tridimensional de PFM. Utilizamos os testes t de Student, Qui-Quadrado e exato de Fisher para análise estatística (p

INTRODUCTION: Two anorectal manometry techniques have commonly been utilized: the perfusion technique and the balloon technique. PURPOSE: To compare both techniques in children with intestinal constipation who had not undergone surgical treatment for its correction. METHODS: Thirty-nine children aged between four and fourteen years underwent anorectal manometry using both techniques at random. Resting pressure, pressure response to voluntary contraction, coughing and perianal stimulation, maximum pressure on the anal canal pressure curve, and presence of rectosphincteric reflex were registered and submitted to statistics. Vectorgraphy of the sphincter muscle complex was obtained by perfusion technique. RESULTS: The statistical comparison between the techniques revealed statistically significant differences in resting pressure (p=0.041), pressure response to voluntary contraction (p=0.026) and maximum pressure within the pressure curve (p=0.010). The rectosphincteric reflex was demonstrated in 21 patients by both techniques. CONCLUSIONS: The perfusion technique presented greater sensitivity in the following parameters: resting pressure, pressure response to voluntary contraction and maximum pressure within the pressure curve. The methods studied are equivalent regarding the measurement of pressure responses to coughing and perianal stimulation and the investigation of rectosphincteric reflex.INTRODUÇÃO: A manometria anorretal tem sido aceita como uma técnica objetiva de estudar a função do complexo muscular esfincteriano. Duas técnicas para o mesmo exame têm sido utilizadas: por perfusão e por balão. OBJETIVO: Comparar as técnicas entre as crianças portadoras de constipação intestinal que não foram submetidas a tratamento cirúrgico como forma de tratamento. MÉTODOS: Trinta e nove crianças com idades entre quarto e quatorze anos foram submetidas à Manometria anorretal utilizando-se ambas as técnicas de forma randomizada. Analizou-se a pressão de repouso, a pressão de contração voluntária, a pressão de contração reflexa, a pressão máxima de contração, o reflexo reto-esfincteriano. Além desses parâmetros, o vetorgrama do canal anal foi estudado pela técnica de perfusão. A análise estatística foi feita por meio de Wilcoxon signed rank test. RESULTADOS: A comparação estatística entre as técnicas revelou diferenças significantemente estatísticas nos parâmetros: pressão de repouso (p= 0.041), Pressão de contração voluntária (p= 0.026) e pressão máxima de contração (p= 0.010). Não houve diferença estatisticamente significante nos parâmetros: pressão de contração reflexa por tosse (p= 0.141) ou por estimulação perianal (p= 0.117). O reflexo reto-esfincteriano foi demonstrado em 21 pacientes em ambas as técnicas. CONCLUSÕES: A técnica de perfusão tem maior sensibilidade para os seguintes parâmetros: pressão de repouso, pressão de contração voluntária e pressão máxima de contração. As técnicas se equivalem no que diz respeito à pressão de contração reflexa e reflexo reto-esfincteriano.

PURPOSE: Evaluate by CT the use of porous vitreous carbon (PVC) and silicon (S) implants as the replacement bone in the craniofacial skeleton of rats. METHODS: 40 rats divided in: Group A (n=20) PVC submitted to the implant of a fragment in skull. After the euthanasia, the animals were divided into two subgroups: A I: 10 animals, studied in the 7th postoperative day (P.O) and AII: 10 animals, studied in the 28th P.O. In group B, S, 20 rats were submitted to S implant in the skull. All other steps were identical to group A, with designation of subgroups BI and BII. CT with beams in axial cuts of 1 mm thickness to obtain 3-D information It was used Hounsfield scale for evaluate the radio density of the implant. They were used non parametric tests to analyze the results. RESULTS: The 7th PO boss remained in the two groups, but for 28th PO, observed reduction in the volume of the implant in Group A, not observed in group B. CT studies noticed different radio densities around all of S prostheses (pseudo-capsule), that don't appeared in CPV implants. The S has remained unchanged in the CT, but the CPV has had a modification in its radio density (pOBJETIVO: Realizar avaliação através de tomografia computadorizada (TC) de implantes de carbono vítreo poroso (CVP) e silicone (S) para sua utilização na substituição óssea no esqueleto craniofacial de ratos. MÉTODOS: Foram utilizados 40 ratos Wistar divididos em: Grupo A (n=20), implantes subperiostais de CVP no crânio. Após o momento da eutanásia os animais foram divididos em dois subgrupos: A I: 10 animais, estudados no 7(0) dia pós-operatório (PO) e AII: 10 animais, estudados no 28(0) PO. No grupo B (n=20), os ratos foram submetidos ao implante de silicone no crânio. Todas outras etapas foram idênticas ao grupo A, com a designação de subgrupos BI e BII. Foi realizada tomografia computadorizada com cortes axiais de 1 mm de espessura para obtenção de imagens tridimensionais. A escala de Hounsfield foi utilizada para avaliação da radiodensidade dos implantes. Testes estatísticos não paramétricos foram utilizados para analisar os resultados. RESULTADOS: O volume do implante foi mantido ao 7(0) PO nos dois grupos, mas ao 28(0) PO, ocorreu uma redução no volume do implante no grupo A, não observada no grupo B. Os estudos tomográficos demonstraram a presença de uma pseudo-cápsula ao redor dos implantes no grupo B, não observada nos implantes de CVP. Os implantes de silicone permaneceram inalterados na TC, mas os de CVP apresentaram modificação na sua radiodensidade e deformação (p

PURPOSE: To study the ganglion cells (GC) in the terminal bowel of rats with ethylenethiourea (ETU) induced anorectal malformations (ARM). METHODS: The animals were divided into three groups: Group A - normal fetuses from pregnant rats that were not administered ETU; Group B - fetuses without ARM born from pregnant rats that were administered ETU and Group C - fetuses with ARM born from pregnant rats that received ETU. ETU was administered on the 11th day of pregnancy at the dose of 125 mg/kg body weight by gastric gavage. The rats had cesarean section on the 21st day of gestation. The fetuses’ terminal bowel tissue was analyzed by immunohistochemistry to demonstrate ganglion cells. RESULTS: Statistically significant differences were found between groups A, B and C regarding ganglion cell densities. Group A had the highest cell density, followed by Group B and the lowest density was found in Group C. CONCLUSION: Ganglion cell densities are decreased in the terminal bowel of rats with ARM.OBJETIVO: Estudar as células ganglionares (CG) no intestino terminal de ratos portadores de anomalia anorretal (AAR) induzida pela etilenotiouréia (ETU). MÉTODOS: Os animais foram distribuídos em três grupos: Grupo A - fetos normais, obtidos de ratas grávidas às quais não foi administrada ETU; Grupo B - fetos não portadores de AAR obtidos de ratas grávidas às quais foi administrada ETU e Grupo C - fetos portadores de AAR obtidos de ratas grávidas às quais foi administrada ETU. A ETU foi administrada no décimo primeiro dia de gestação na dose de 125 mg/Kg, por gavagem. As ratas foram submetidas à laparotomia e histerotomia para retirada dos fetos no vigésimo primeiro dia de gestação. O intestino terminal dos fetos foi retirado e analisado por imunohistoquímica para pesquisa de CG. RESULTADOS: Foram encontradas diferenças estatisticamente significantes entre os grupos A, B e C quanto à densidade de CG. O grupo A apresentou a maior densidade, seguida pelo grupo B, e a menor densidade foi encontrada no Grupo C. CONCLUSÃO: Existe uma menor densidade de CG no intestino terminal de ratos portadores de AAR.

PURPOSE: To study the effects on the water, electrolyte, and acid-base balances in rabbits submitted to antegrade enema with different solutions through appendicostomy. METHODS: Forty male New Zealand rabbits were submitted to appendicostomy, and distributed in 4 groups, according to the antegrade enema solution: PEG group, polyethylene glycol electrolyte solution (n=10); ISS group, isotonic saline solution (n=10); GS group, glycerin solution (n=10); SPS group, sodium phosphate solution (n=10). After being weighed, arterial blood gas analysis, red blood count, creatinine and electrolytes were measured at 4 times: preoperatively (T1); day 6 postop, before enema (T2); 4h after enema (T3); and 24h after T3 (T4). RESULTS: In PEG group occurred Na retention after 4h, causing alkalemia, sustained for 24h with HCO3 retention. In ISS group occurred isotonic water retention and hyperchloremic acidosis after 4h, which was partially compensated in 24h. GS group showed metabolic acidosis after 4h, compensated in 24h. In SPS group occurred hypernatremic dehydration, metabolic acidosis in 4h, and hypokalemia, hypocalcemia, hypomagnesemia, and metabolic alkalosis with partially compensated dehydration in 24h. CONCLUSIONS: All solutions used in this study caused minor alterations on water, electrolyte or acid-base balances. The most intense ones were caused by hypertonic sodium phosphate solution (SPS) and isotonic saline solution (ISS) and the least by polyethyleneglycol electrolyte solution (PEG) and glycerin solution 12% (GS).OBJETIVO: Estudar os efeitos no equilíbrio hídrico, eletrolítico e ácido-base, do enema anterógrado com diferentes soluções em coelhos através de apendicostomia. MÉTODOS: 40 coelhos Nova Zelândia, machos, submetidos a apendicostomia, distribuídos em quatro grupos segundo a solução de enema: grupo PEG (n = 10) solução de polietilenoglicol com eletrólitos; grupo SF (n = 10) solução fisiológica; grupo SG (n = 10) solução glicerinada; grupo FS (n = 10) solução de fosfato de sódio. Realizou-se pesagem, gasometria arterial, série vermelha, creatinina e ionograma, em quatro tempos: TI (pré-operatório); T2 (6o PO antes do enema); T3 (4h após enema); T4 (24h após T3). RESULTADOS: No PEG ocorreu retenção de Na em 4h, com alcalemia por retenção de HCO3, mantida por 24h. No SF ocorreu retenção hídrica isotônica e acidose hiperclorêmica em 4h, resolvidos parcialmente com 24h. No SG ocorreu acidose metabólica hiperclorêmica em 4h, compensada com 24h. No FS ocorreu desidratação hipenatrêmica, acidose metabólica com ânion gap elevado em 4h, hipopotassemia, hipocalcemia, hipomagnesemia e alcalose metabólica com recuperação parcial da desidratação em 24h. CONCLUSÕES: Todas as soluções empregadas neste estudo causam alterações de pouca intensidade no equilíbrio hídrico, eletrolítico ou ácido-base. As mais intensas foram causadas pela solução de fosfato de sódio e solução fisiológica, e as menos intensas pela solução de polietilenoglicol com eletrólitos e solução glicerinada.

PURPOSE: To evaluate tissue lesions, especially those of the intestinal innervation, in an excluded jejunal loop subjected to ischemia and reperfusion in rats. METHODS: To evaluate the role of ischemia and reperfusion lesions in an excluded intestinal loop, four groups of 20 rats were set up: control group (GCEI7) and three experimental groups (GIREI7, GIREI14 and GIREI28). They were all subjected to exclusion of an intestinal segment of six centimeters in length, at a distance of 10 centimeters from the Treitz angle. The 60 animals in the three experimental groups were additionally subjected to ischemia of the vascular pedicle for 30 minutes. The control group and the experimental group GIREI7 were evaluated on the 7th day after the operation. The groups GIREI14 and GIREI28 (which also underwent ischemia) were utilized to evaluate the evolution of the lesion over time, on the 14th and 28th days after the operation, respectively. From the intestinal excluded loop, we take one ring of 0,5 cm distal and proximal, that were fixed in formaline 10% solution in order to do histological (HE) and immuno-hystochemial (PS-100) evaluation (enteric nervous system.) The distal loop was exteriorized in stoma and the proximal part closed with polipropilene 6-0. RESULTS: It was observed a decrease in the number of ganglionic cells in the myenteric plexus in the group subjected to ischemia and reperfusion (GIREI7), in relation to the control group (GCEI7) at the 7th post-operative day (Mann-Whitney test: p = 0.0173 *. Comparing the numbers of ganglionic cells in the myenteric plexus before and after jejunal loop exclusion GCEI7 - (Wilcoxon test: p = 0.0577). GIREI7 - Comparing the numbers of ganglionic cells in the myenteric plexus before and after ischemia (*p = 0.0399). Comparing the percentage variations in ganglionic cells in the myenteric plexus on the 7th, 14th and 28th days after the procedure, in the groups GIREI7, GIREI14 and GIREI28, it was observed that there were no significant alterations. Kruskal-Wallis test: p = 0.6501. CONCLUSION: There was a decrease in the number of ganglionic cells in the myenteric plexus due to ischemia and reperfusion that did not recover in the late post-operative period.OBJETIVO: Avaliar lesões teciduais, especialmente aquelas da inervação intestinal em alça jejunal excluída submetida à isquemia e reperfusão em ratos. MÉTODOS: Para avaliar o papel da isquemia e reperfusão nas lesões em uma alça intestinal exclusa, quatro grupos de 20 ratos foram criados: Grupo controle (GCE17) e 3 Grupos experimentais (GIRE!7, GIREI14) e GIREI28) Todos foram submetidos à exclusão de um segmento intestinal de seis centímetros de extensão, a 10 centímetros do ângulo de Treitz . Os 60 animais dos 3 grupos experimentais foram também submetidos a isquemia do pedículo vascular por 30 minutos.O grupo controle e o grupo experimental GIREI7 foram avaliados no 7º. Dia após a operação. Os grupos GIREI14 e GIREI28 também submetidos à isquemia, foram utilizados para avaliar a evolução da lesão com o passar do tempo, no 14º. e 28º. dias respectivamente. Do segmento intestinal excluído do trânsito, foi retirada uma amostra de 0,5 cm em cada extremidade, proximal e distal, as quais foram fixadas em solução de formol 10% para posterior avaliação histológica, com HE e imuno histoquímica pela proteína PS-100 para avaliação do sistema nervoso entérico. A luz distal da alça isolada foi estomizada e a proximal fechada com pontos de prolene 6-0. Esses dados foram analisados estatisticamente. RESULTADOS: Observamos uma diminuição do número de células ganglionares no plexo mioentérico do grupo submetido à isquemia e reperfusão (GIREI7) em relação ao grupo controle (GCEI7). Mann-Whitney: p=0,0173*. Comparando a variação percentual das células ganglionares do plexo mioentérico no 7º, 14º e 28º dia após procedimento nos grupos GIREI7, GIREI14 E GIREI28 observamos que não houve alterações significantes. Kruskal-Wallis p=0,6501. CONCLUSÃO: Houve uma diminuição das células ganglionares nos plexos mioentéricos devido à isquemia e reperfusão, não havendo recuperação no período pós-operatório tardio.

PURPOSE: To evaluate an experimental model for anorectal anomalies and their principal associated malformations induced by ethylene thiourea (ETU). METHODS: Rat fetuses were utilized, divided into two groups: experimental group - fetuses from rats that received ETU on the 11th day of gestation at the dose of 125 mg/kg, diluted in distilled water to 1% concentration (12.5 ml/kg); and control group - fetuses from rats that received distilled water alone, at a volume of 12.5 ml/kg. On the 21st day of gestation, the animals were sacrificed by hypoxia in a carbon dioxide chamber, followed by laparotomy to remove the fetuses. These were initially examined externally to determine the sex and whether anorectal anomalies and malformations of the vertebral column and tail were present. Then, with the aid of microscopy, the fetuses underwent exploratory laparotomy to characterize the type of anorectal anomaly and investigate urological malformations. RESULTS: None of the fetuses in the control group presented anorectal anomaly, vertebral column malformation or urological structural alterations. In the experimental group, 71% presented anorectal anomaly, 80% presented vertebral column alterations and 35% presented urological alterations. CONCLUSION: The model described was shown to be easy to implement and presented results that allow its use in studying anorectal anomalies and associated malformations.OBJETIVO: Avaliar o modelo experimental de AAR, induzido pela Etilenotiouréia (ETU), quanto à ocorrência de anomalia anorretal e das principais malformações associadas. MÉTODOS: Foram utilizados fetos de ratos distribuídos em 2 grupos: Grupo experimental - Fetos provenientes de ratas que receberam ETU no décimo primeiro dia de gestação na dose de 125 mg/Kg, diluída em água destilada na concentração de 1% (12,5 ml/Kg) e Grupo controle - Fetos de ratas que receberam somente água destilada num volume de 12,5 ml/Kg. No 21° dia de gestação, os animais foram submetidos à eutanásia por hipóxia em câmara de gás carbônico e laparotomia para retirada dos fetos. Os fetos foram, inicialmente, examinados externamente para determinação do sexo, presença de AAR, de malformações de coluna vertebral e da cauda. A seguir, com o auxílio de microscopia, os fetos foram submetidos a laparotomia exploradora para caracterização do tipo de AAR e investigação de malformações urológicas. RESULTADOS: Nenhum dos fetos do grupo controle apresentou AAR, malformações de coluna vertebral e alterações urológicas estruturais. No grupo experimental, 71% apresentaram anomalia anorretal, 80% apresentaram alterações de coluna vertebral e 35% apresentaram alterações urológicas. CONCLUSÃO: O modelo descrito se mostrou de fácil execução e apresentou resultados que permite o seu emprego no estudo das anomalias anorretais e das malformações associadas.

PURPOSE: To assess the protective effect of glycine in an experimental model of Neonatal Necrotizing Enterocolitis (NEC). METHODS: Fifty (50) neonatal Wistar rats, from a litter of six female rats and weighing 4 to 6 grams, were used. Five animals were cannibalized and the 45 remaining were distributed into three groups: the G1 normal control group (n=12); the G2 Group (n=16), of animals that underwent hypoxia-reoxygenation (HR); the G3 Group of animals (n=17) that underwent HR following a 5% intraperitoneal glycine infusion. The animals underwent hypoxia in a CO2 chamber receiving an air flow of 100% CO2 for 5 minutes and reoxygenation receiving an O2 flow at 100% for 5 minutes. One centimeter long small bowel and colon segments were prepared for histological analysis. The rest of the bowel was removed in a block and frozen at minus 80°C for homogenization and determination of tissue malondialdehyde (MDA). Tissue lesions were classified as Grade 0 to Grade 5, according to the level of damaged mucosa. RESULTS: The animals in Group G1 had levels of small bowel and colon lesion significantly smaller as compared to the animals in Groups G2 and G3. The G2 group had mean MDA values significantly higher than the animals in the G1 (p = .015) and G3 (p=0.021) groups. MDA values did not differ significantly (p = 0.992) for the animals in groups G1 and G3. CONCLUSION: Glycine reduces tissue MDA levels (a measurement of lipid peroxidation) following HR in neonatal rats.

Objective: To assess the protective effect of glycine in liver ofneonatal hypoxia/reoxygenation-induced necrotizing enterocolitisin rats. Methods: Forty-four (44) neonatal Wistar rats weredistributed into three groups: G1 – normal control group (n=12);G2 Group (n=16) with animals that underwent hypoxiareoxygenation;G3 Group (n=17) with animals submitted tohypoxia-reoxygenation following a 5% intraperitoneal glycineinfusion. The groups were subdivided into A: euthanasia 12 h afterhypoxia-reoxygenation and B: euthanasia 72 h after hypoxiareoxygenation.The liver was removed for determination of tissuemalondialdehyde. Results: Malondialdehyde values did not differsignificantly in subgroups G1 and G3. The animals in G2A hadmean malondialdehyde values significantly lower than those inG2B. Malondialdehyde values did not differ significantly for animalsin subgroup A. In subgroup B, the malondialdehyde values did notdiffer significantly among the animals in G1 and G3. G2 animalshad mean malondialdehyde values significantly higher than G3animals. Conclusion: Glycine reduces liver lipid peroxidation inhypoxia/reoxygenation-induced necrotizing enterocolitis.

OBJETIVO: Avaliar um modelo experimental de enterocolite necrosante em ratos proposto por Okur e colaboradores em 1995. MÉTODOS: Utilizou-se 28 ratos da raça EPM-Wistar no primeiro dia de vida, com peso entre 4 a 6 gramas. Os animais foram submetidos a hipóxia (H) colocando os filhotes em uma câmara de gás CO2 para sacrifício de roedores onde receberam um fluxo de ar contendo 100% de CO2 durante 5 minutos. Após a hipóxia os animais foram reanimados (R) com fluxo de ar contendo O2 a 100%, também durante 5 minutos. Os animais divididos em dois grupos: G1: controle (n=12): ratos não submetidos a H-R; G2: (n=16): ratos submetidos a H-R. Segmentos de intestino delgado e cólon foram preparados para análise histológica. O restante do intestino foi utilizado para dosagem de malondialdeído tecidual. RESULTADOS: Dosagem de malondialdeído do G1 foi em média 1,05 (0,44-2,03) e do G2 foi em média 2,60 (0,59- 6,4) nmol MDA/mg proteína. O G2 teve média significativamente maior do que a do grupo controle (pOBJECTIVE: To evaluate an experimental model of necrotizing enterocolitis in rats proposed by OKUR e col. in 1995. METHODS: On their first day of life, 28 EPM-Wistar rats weighing between 4 and 6 grams were submitted to hypoxia (H) by placing them in a CO2 gas chamber for rodents' sacrifice, where they received a 100% CO2 air flow for 5 minutes. After the hypoxia the animals were reanimated (R) with a 100% O2 air flow, also for 5 minutes. The animals were allocated in two groups: G1: control (n=12): rats not submitted to H-R; G2: (n=16): rats submitted to H-R. Segments of the small intestine and colon were prepared for histological analysis. The remaining intestine was used to measure tissular malondialdehyde. RESULTS: Mean malondialdehyde dosages were 1.05 (0.44-2.03) and 2.60 (0.59- 6.4) nmol MDA/mg protein for G1 and G2, respectively. G2's mean value was significantly higher than in the control group (p

OBJETIVOS: Este estudo objetivou avaliar a utilidade do teste de caminhada de seis minutos como indicador prognóstico e sua contribuição na prática clínica diária de pacientes com insuficiência cardíaca. MÉTODOS: O teste de caminhada de seis minutos foi administrado a 179 pacientes (120 homens, 59 mulheres; idade média de 58,32 ± 12,7 anos), portadores insuficiência cardíaca nas classes II e III da New York Heart Association (NYHA), com fração de ejeção do ventrículo esquerdo de 34,91 ± 12,4%. Os pacientes realizaram o teste de caminhada de seis minutos e, 4 horas depois, o teste ergométrico convencional sob o Protocolo de Naughton limitado por sintomas, e foram acompanhados por um período médio de dezoito meses. RESULTADOS: A distância média percorrida no teste de caminhada seis minutos foi de 521,11 ± 76,1 metros. Durante o acompanhamento, 66 pacientes (36,9%) morreram. Houve uma correlação significativa entre a distância percorrida no teste de caminhada de seis minutos e a mortalidade (p < 0,0001). O modelo de regressão logística identificou a distância percorrida durante o teste de caminhada de seis minutos como o mais forte indicador independente de mortalidade (p = 0,0001). A distância caminhada menor que 520 metros identificou os pacientes com maior probabilidade de óbito. O número de equivalentes metabólicos alcançados no teste ergométrico convencional também correlacionou-se significativamente com a mortalidade (p = 0,0001). CONCLUSÃO: O teste de caminhada de seis minutos é um método simples, seguro e potente de avaliação prognóstica de portadores de insuficiência cardíaca nas classes II e III da NYHA. É um exame objetivo, que pode substituir o teste ergométrico convencional na avaliação prognóstica desses pacientes.

OBJETIVO: Estudar a pHmetria em oito horas, analisando variáveis como a idade, sintomatologia e esôfago-estômago-duodenografia, além dos seguintes parâmetros pHmétricos: número de episódios de refluxo, número de episódios maiores de cinco minutos, tempo de refluxo nas oito horas e episódio de maior duração, para o diagnóstico do refluxo gastroesofágico. MÉTODO: Estudo prospectivo realizado com a medição contínua do pH esofágico em oito horas em 35 pacientes, de quatro meses a 11 anos de idade. Foi utilizado aparelho de pHmetria DPS-100 Diagnosis pHmeter System com programa de acordo com a metodologia sugerida por Vandenplas e comparados com todas as variáveis e parâmetros do exame. RESULTADOS: Obtivemos diferença estatisticamente significante em todos os parâmetros pHmétricos analisados, com o índice de refluxo sendo o mais efetivo para identificar o refluxo patológico, independente da idade. Todas as variáveis qualitativas, idade, sintomatologia e esôfago-estômago-duodenografia, não mostraram diferenças estatisticamente significantes quando relacionados aos resultados da pHmetria. CONCLUSÃO: Concluímos que a pHmetria esofágica de oito horas tem seus parâmetros pHmétricos válidos para o diagnóstico do refluxo gastroesofágico.

Omentoenteropexy was developed as an alternative technique to promote neovascularization in an isolated bowel segment. OBJECTIVE: The aim of the present protocol was to study the long-term viability of an isolated jejunal segment following neovascularization by omentoenteropexy. Long-term survival of a neovascularized bowel segment is an indication that the utilization of this segment as an intestinal graft can be successful. METHODS: To test the proposed surgical technique, 13 Wistar rats were subjected to laparotomy, the jejunum was exposed at 20 cm from the angle of Treitz and a pedicle of greater omentum was isolated. An incision of 6 cm was made along the antimesenteric jejunal border, exposing the submucosa. Omentoenteropexy was performed between the incision of the jejunum and the pedicle of the greater omentum. After seven weeks, the mesentery of the jejunal segment subjected to omentoenteropexy was ligated and isolated from the rest of the jejunum by a complete proximal and distal transversal section. Subsequently, an end-to-end anastomosis was performed to restore the continuity of the bowel. RESULTS: At 10 weeks from the first surgical intervention, the isolated jejunal segment subjected to omentoenteropexy was completely neovascularized and viable. CONCLUSION: No evidence of anatomical or functional intestinal obstruction was observed.

Com objetivo de estudar os efeitos das colectomias parciais, foram operados 30 ratos Wistar distribuídos em três grupos iguais. Em dois grupos, realizou-se a ressecção do ceco e da valva ileocecal, sendo feitas colectomias proximal ou distal, com anastomose ileocólica término-terminal. No terceiro grupo, realizou-se a colectomia distal preservando-se o ceco. Em todos os animais, o cólon remanescente media 5 cm de comprimento. Foi realizada colostomia terminal, sendo o reto sepultado. Avaliaram-se o peso, a quantidade de água, lípides e proteínas nas fezes no pré-operatório, nos 10º, 20º, 30º, 40º, 50º e 60º dias pós-operatórios. Os resultados obtidos foram submetidos a tratamento estatístico, fixando-se em 5% o nível de rejeição da hipótese de nulidade. Concluiu-se não haver diferença significante entre o peso dos animais no pré-operatório e no pós-operatório tardio, em nenhum dos grupos. Também não se observou diferença, quando se comparou o peso dos três grupos nesses dois períodos. Com relação à quantidade de água, de lípides e de proteínas nas fezes, não foi observada diferença no comportamento dos grupos com anastomose ileocólica. Nos tempos tardios do experimento, esses grupos apresentam os mesmos elementos em maior quantidade do que o grupo em que se preservou a valva ileocecal, não sendo possível a demonstração estatística no sexagésimo dia para a quantidade de água e, no qüinquagésimo, para a quantidade de proteínas.

OBJETIVOS: Avaliar o estado atual do diagnóstico e tratamento da apendicite aguda em crianças operadas em dois grandes hospitais quaternários da cidade de São Paulo, no período de 30 meses. MÉTODO: Nossa casuística constou de 300 crianças operadas por apendicite aguda no período de 1998 a 2000 (65% do sexo masculino e 35% feminino). Foram analisadas as variáveis idade, sexo, manifestações clínicas, tempo gasto para o diagnóstico, achados de exame físico, laboratoriais e cirúrgicos, antimicrobianos administrados, complicações pós-operatórias e tempo de internação. Utilizou-se o teste t de Student para avaliar duas variantes e Análise de Variâncias quando mais de duas. RESULTADOS: Diagnosticou-se inicialmente apendicite aguda em apenas 63% dos casos, tendo os 35% restantes, diagnóstico de abdome agudo cirúrgico. O tempo decorrido na realização do diagnóstico foi superior a 24 horas em 57,4% dos casos, denotando retardo importante na sua elaboração. Dor abdominal (85,3%) e irritação peritoneal (82%) em fossa ilíaca direita foram os sinais e sintomas mais freqüentes. Identificou-se leucocitose em 83% dos pacientes e leucocitúria em 39,7 %. Em 92,4% das radiografias simples de abdome encontramos imagens sugestivas de apendicite aguda. A ultra-sonografia abdominal foi diagnóstica em 80,1% dos casos. Utilizaram-se esquemas antimicrobianos especialmente para agentes gram-negativos e anaeróbicos. A principal complicação foi infecção da ferida cirúrgica, não tendo sido observada mortalidade no grupo. A média de internação foi de 5.2 e 6,0 dias para meninos e meninas respectivamente. CONCLUSÃO: Mesmo com melhor conhecimento sobre apendicite aguda, refinamento técnico, laboratorial, radiológico e uso de antibioticoterapia adequada, o tempo de para diagnóstico e a morbidade ainda se mantém alta na idade pediátrica.

Objective: To evaluated the surface roughness of one microparticulate resin composite Durafill (Heraeus Kulzer Weihrheim, Germany) andfour nanoparticulate resins 4 Seasons (Ivoclar Vivadent, Schaan, Liechtenstein) Esthet x (Dentsply, Milford, DE, USA), Point 4 and Supreme (3M-ESPE, Dental Products,St. Paul, MN, USA). Methods: After finishing with a diamond bur point (F), and polishing with silicone points of gray, green and pink color Politipit (Ivoclar Vivadent,Schaan, Liechtenstein), four stages of completion were performed, simulating one of finishing and three of polishing a resin restoration. Ten samples of each composite resin were measured for surface roughness with surface profilometer (Mitutoyo Corporation, Tokyo, Japan) after each of finishing and polishing sequence.Results: The results showed that nanoparticulate and microparticulate resins presented a significant difference in the surface roughness values, in all finishing and polishing steps. Conclusion: Of the the nanoparticulate resins 4 Seasons (Ivoclar Vivadent, Schaan, Liechtenstein), Point 4 (Kerr CO, Orange, CA, USA), and also microparticulate Durafill (Heraeus Kulzer Weihrheim, Germany) presented significantly lower surface roughness values after completing all the finishing and polishing stages.

OBJETIVO: Verificar o efeito da secção distal do Gubernaculum testis como modelo experimental de criptorquidia unilateral em ratos. MÉTODO: Foram usados 36 ratos machos de linhagem Wistar-EPM, distribuídos em dois grupos: A (Grupo Experimento: animais submetidos à secção distal do gubernaculum direito) e B (Grupo Controle: operação simulada do lado direito). Cada grupo foi subdividido em 3 subgrupos com 6 animais cada : A-1, A-2 e A-3: B-1, B-2 e B-3. Os animais dos subgrupos A-1 e B-1 foram re-operados após 30 dias. Os animais dos subgrupos A-2 e B-2 foram mortos após 50 dias e os dos subgrupos A-3 e B-3 após 90 dias. RESULTADOS: Houve diferenças quanto ao peso, tamanho e posição do testículo afetado em relação ao lado controle,as quais só foram evidenciadas a partir do subgrupo A-2 (50 dias).O testículo não foi palpável na bolsa testicular em 88,9% dos casos e não houve óbito dos animais. Foram observadas alterações da maturidade celular, atrofia tubular, diminuição do diâmetro dos túbulos e ausência de espermatozóides na luz tubular no grupo A e presença de normalidade histológica para a idade nos animais do grupo B. CONCLUSÃO: O modelo experimental de produção de criptorquidia experimental unilateral pela secção do Gubernaculum testis em ratos foi eficaz e prático.

CONTEXT AND OBJECTIVE: Anorectal malformations comprise a spectrum of anomalies that continue to be difficult to treat, even today. The aim was to evaluate the fecal continence of children who underwent posterior sagittal anorectoplasty due to anorectal malformations, via computerized anorectal manometry and profilometry. DESIGN AND SETTING: Prospective study at Universidade Federal de São Paulo. METHOD: 82 patients (56.1% boys; 43.9% girls) of mean age 85.5 months were evaluated. They were divided into continent, partially continent and incontinent groups. Age, sex, manometric variables and profilometric parameters were studied. The results were statistically analyzed. RESULTS: Among the 82 patients, 37.8% were continent, 25.6% were partially continent and 36.6% were incontinent. The overall mean resting pressure was 22 mmHg, and the means for the continent, partially continent and incontinent groups were, respectively, 30.7 mmHg, 23 mmHg and 14.7 mmHg. The overall mean pressure response to voluntary contraction was 56 mmHg, and the means for the groups were 65.4 mmHg, 55.8 mmHg and 46.6 mmHg, respectively. The rectosphincteric reflex was absent in 82.9% of the cases. In the profilometry analysis for all patients together, blue (20 to 50 mmHg) and yellow (50 to 80 mmHg) were predominant, and there was a similar distribution for the continent and partially continent patients. However, among the incontinent patients, green (< 20 mmHg) and blue prevailed. CONCLUSIONS: Manometric and computerized profilometric analyses were an excellent method for postoperative evaluations on patients with intermediate and high anorectal anomalies, and for therapeutic planning.

PSARP is currently the most widely-used surgical technique for surgical correction of high and intermediary anorectal malformations, but there is much controversy in the literature about the postoperative evaluation of these cases. We studied 27 cases of anorectal malformations operated with PSARP from clinical and manometric aspects in order to analyze: 1) fecal continence; 2) the relationship between fecal continence and the associated sacral anomalies and; 3) the relationship between the postoperative manometric evaluation and fecal continence. From the analysis of 27 cases of high and intermediary anorectal malformations, we concluded that: 1) fecal continence was achieved in 48.14 percent of the cases; partial fecal continence in 25.92 percent; and fecal incontinence in 25.92 percent of the cases; 2) the presence of fecal incontinence was directly related to the association of sacral anomalies and; 3) anorectal manometry is a useful test to evaluate the patients operated by PSARP, due to the existence of a relationship between the manometric results and the degree of fecal continence.

The PSARP is today the most-used surgical technique for correction of high and intermediary anorectal malformations.There is much controversy in the literature about the post-operative evaluation of these cases. We studied 27 cases of anorectal malformations from clinical and radiological aspects, in order to analyse: 1. Fecal continence 2.Relationship between post-operative fecal continence and the associated sacral anomalies 3.Relationship between the radiological evaluation by defecogram and fecal continence From the analysis of the cases, we concluded: 1. Fecal continence was achieved in 48.14% of the cases; partial continence in 25.92%; and fecal incontinence in 25.92% of the cases. 2.The presence of fecal incontinence was directly related to the associated sacral anomalies.

OBJECTIVE: To evaluate biofeedback(BFB)responses to rehabilitation techniques and physical exercises in incontinent or partially continent anorectal malformations patients after posterior sagital anorectoplasty (PSARP). DESIGN: Prospective study. SETTING: Pediatric Surgery - Department of Surgery - UNIFESP-EPM. PATIENTS:The authors report on 14 patients with anorectal malformations (4 with partial fecal incontinence after primary PSARP; 6 with fecal incontinence after primary PSARP; 3 with partial fecal incontinence after secondary PSARP; and 1 with fecal incontinence after secondary PSARP). All patients were rehabilitated via a BFB program of exercises in order to improve the function of the anal sphincteric muscular complex for a period of 1 -3 years. MAIN OUTCOME MEASURE: Clinical and manometric control. RESULTS: After BFB, of 4 partially continent patients after primary PSARP, 3 became continent; of 6 incontinent patients after primary PSARP, 4 became continent; of 3 partially continent patients after secondary PSARP, 1 became continent,1 showed no improvement and 1 became incontinent (infection + abscess + fibrosis + important anorectal stenosis). The incontinent patient after secondary PSARP showed no improvement. CONCLUSION: The authors concluded that BFB, used at the appropriate time with patient collaboration, is an important complement to the anatomical reconstruction of anorectal malformations in order to achieve good development and contractile functioning of the sphincteric muscular complex.

A glioma is a type of tumor that acts on the Central Nervous System (CNS) in a highly aggressive manner. Gliomas can occasionally be inaccurately diagnosed and treatments have low efficacy, meaning that patients exhibit a survival of less than one year after diagnosis. Due to factors such as intratumoral cell variability, inefficient chemotherapy drugs, adaptive resistance development to drugs and tumor recurrence after resection, the search continues for new drugs that can inhibit glioma cell growth. As such, analogues of endocannabinoids, such as fatty acid amides (FAAs), represent interesting alternatives for inhibiting tumor growth, since FAAs can modulate several metabolic pathways linked to cancer and, thus, may hold potential for managing glioblastoma. The aim of this study was to investigate the in vitro effects of two fatty ethanolamides (FAA1 and FAA2), synthetized via direct amidation from andiroba oil (Carapa guianensis Aublet), on C6 glioma cells. FAA1 and FAA2 reduced C6 cell viability, proliferation and migratory potential in a dose-dependent manner and were not toxic to normal retina glial cells. Both FAAs caused apoptotic cell death through the loss of mitochondrial integrity (ΔΨm), probably by activating cannabinoid receptors, and inhibiting the PI3K/Akt pathway. In conclusion, FAAs derived from natural products may have the potential to treat glioma-type brain cancer. [ABSTRACT FROM AUTHOR]