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Introduction: Children grow up spending most of their time within the family social environment, where they can experience stressful situations such as marital conflict, a non-cohesive environment, parental alcohol use disorder, parental depression, and other parental mental health issues. All these factors are associated with children's developmental delays., Objective: We aimed to conduct a scoping review on family stress and family resilience associated with child development delays to examine familial conditions associated with child development., Methods: We conducted a scoping review of observational studies published between January 2000 to July 2023, indexed in MEDLINE and LILACS databases. We included observational studies that evaluated the history of exposure to violence, and behavioral or emotional symptoms, or mental health problems among children aged 4-12. Data were independently extracted using a structured form., Results: Database searches identified 12,990 different records. A total of 43 articles were included in the review. Three main findings emerged: (1) parental mental health problems, especially depressive symptoms in mothers, were associated with child developmental delays and mental health problems; (2) better parenting practices and cohesive home environment were positively associated with child development, and (3) Vulnerable social environments (e.g., poverty and housing insecurity) may be linked to child mental health problems., Conclusions: Studies reviewed show that promoting better family dynamics and increasing family cohesion, as well as parenting abilities, are beneficial to a child's socio-emotional development and prevention of child mental health problems. Moreover, increasing family and children's resilience improves the quality of life within family units., Competing Interests: No conflicts of interest declared concerning the publication of this article.

Fatty acids (FAs) stored as triacylglycerols (TAGs) are an important source of carbon and energy for germination and seedling development, particularly for plants with small wind-dispersed seeds, allowing greater efficiency in storing both energy and carbon. These plants should be under strong selection to produce seeds rich in FAs and with large amounts of saturated FAs. Their closely packed single-chain configuration allows greater packing, more carbon and energy per unit mass, and are less costly to produce. Efficient carbon storage would be less crucial for zoochorous species, which can reach much larger seed sizes (mass). We analysed the transesterified FA profile from seeds of 22 anemochorous and zoochorous tree species from the Cerrado savannas of Central Brazil. We tested if seed FA content covaried with seed mass and if anemochorous and zoochorous seeds differed in FA contents and distribution. Fatty acids were an important seed source of carbon and energy for most species. Fifteen different FAs were identified. Oleic, linoleic and linolenic tended to be the predominant unsaturated FAs. Oleic acid corresponded to more than 60 % of the total transesterified FAs in seeds of Kielmeyera coriacea, Qualea dichotoma and Triplaris americana . Linoleic acid corresponded to more than 50 % of total FA in Dalbergia miscolobium, Parkia platycephala and Ferdinandusa elliptica while linolenic acid was the dominant component in Inga cylindrica . Across species, palmitic and stearic were the dominant saturated FAs. The only exception was lauric acid (68 % of total FA) in seeds of Qualea grandiflora . On a log 10 scale, as the seed increased in mass, accumulation of FAs tends to proceed at a faster rate in anemochorous species than in zoochorous species. They also became increasingly richer in saturated FAs. Zoochorous species had seed TAGs with higher proportion of polyunsaturated FAs., (© The Author(s) 2023. Published by Oxford University Press on behalf of the Annals of Botany Company.)

Objective: The first-line treatment for Cushing's disease is transsphenoidal surgery, after which the rates of remission are 60 to 80%, with long-term recurrence of 20 to 30%, even in those with real initial remission. Drug therapies are indicated for patients without initial remission or with surgical contraindications or recurrence, and ketoconazole is one of the main available therapies. The objective of this study was to evaluate the safety profile of and the treatment response to ketoconazole in Cushing's disease patients followed up at the endocrinology outpatient clinic of a Brazilian university hospital., Patients and Methods: This was a retrospective cohort of Cushing's disease patients with active hypercortisolism who used ketoconazole at any stage of follow-up. Patients who were followed up for less than 7 days, who did not adhere to treatment, or who were lost to follow-up were excluded., Results: Of the 172 Cushing's disease patients who were followed up between 2004 and 2020, 38 received ketoconazole. However, complete data was only available for 33 of these patients. Of these, 26 (78%) underwent transsphenoidal surgery prior to using ketoconazole, five of whom (15%) had also undergone radiotherapy; seven used ketoconazole as a primary treatment. Ketoconazole use ranged from 14 days to 14.5 years. A total of 22 patients had a complete response (66%), three patients had a partial response (9%), and eight patients had no response to treatment (24%), including those who underwent radiotherapy while using ketoconazole. Patients whose hypercortisolism was controlled or partially controlled with ketoconazole had lower baseline 24-h urinary free cortisol levels than the uncontrolled group [times above the upper limit of normal: 0.62 (SD, 0.41) vs . 5.3 (SD, 8.21); p < 0.005, respectively] in addition to more frequent previous transsphenoidal surgery ( p < 0.04). The prevalence of uncontrolled patients remained stable over time (approximately 30%) despite ketoconazole dose adjustments or association with other drugs, which had no significant effect. One patient received adjuvant cabergoline from the beginning of the follow-up, and it was prescribed to nine others due to clinical non-response to ketoconazole alone. Ten patients (30%) reported mild adverse effects, such as nausea, vomiting, dizziness, and loss of appetite. Only four patients had serious adverse effects that warranted discontinuation. There were 20 confirmed episodes of hypokalemia among 10/33 patients (30%)., Conclusion: Ketoconazole effectively controlled hypercortisolism in 66% of Cushing's disease patients, being a relatively safe drug for those without remission after transsphenoidal surgery or whose symptoms must be controlled until a new definitive therapy is carried out. Hypokalemia is a frequent metabolic effect not yet described in other series, which should be monitored during treatment., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Viecceli, Mattos, Costa, Melo, Rodrigues and Czepielewski.)

Background: Trauma due to external causes represents one of the greatest challenges for public health services in different regions around the world. This study aimed to determine the prevalence of facial trauma, associated risk factors, and classification of body injuries in individuals who underwent forensic examination in a Brazilian center., Material and Methods: Data were collected at the Ceará State Forensic Medicine unit in a 12-year period. Sociodemographic data related to the etiological agent and lesions resulting from the bodily injury were recorded., Results: Among 1,031 physical injury exams, physical aggression ( p <0.001), male victims aged between 21 and 30 years ( p <0.001), salaried workers ( p <0.001), and soft tissue and dentoalveolar injuries were significant findings. Regarding aggression, domestic violence was prevalent ( p <0.001), perpetrated by the victim's partner ( p <0.001), using a blunt instrument during the aggression ( p <0.001), and directly associated with soft tissue injury ( p <0.001). In traffic accidents, the most common type was motorcycle accident ( p <0.001), on weekdays ( p =0.036), at nighttime ( p =0.134), showing a significant association with bone fractures ( p =0.001)., Conclusions: Oral and maxillofacial injuries obtained from a Brazilian forensic science center were significantly associated with sociodemographic and etiological factors. Key words: Forensic dentistry, facial trauma, violence, public health., Competing Interests: Conflicts of interest None declared., (Copyright: © 2020 Medicina Oral S.L.)

Species vary in seed size and content of stored reserves, which can be related to dispersal strategies and type of habitat in which they are found. We compare seed carbon and nutrient reserves of anemochorous and zoochorous trees from the Cerrado of central Brazil. We measured seed dry mass, lipids, non-structural carbohydrates (starch and total soluble sugars), carbon and mineral nutrients in ten forest and 13 savanna species, each classified as having wind- or animal-dispersed seeds. We used phylogenetically independent contrasts to test for correlations among these traits. Seeds of anemochorous species were lighter, with higher concentrations of C, N, P, Ca and Mg. Lipids were the dominant carbon reserve for most anemochorous species, underpinning the importance of allocation to compact carbon reserves. Starch, lipids or soluble sugars were the major carbon reserve in zoochorous seeds. Savanna and forest species did not differ in seed mass or in total carbon reserves. However, seeds of forest species had higher concentrations of starch than seeds of savanna species. Lipid and starch negatively correlated across species, suggesting a trade-off between starch and lipids as major seed carbon reserves. Calcium was positively correlated with Mn and B, while Mg was positively correlated with C, N, P, K, S, Zn and B. Potassium, S and Cl were positively correlated, while P was positively correlated with Mg and Zn. Dispersal mode rather than vegetation type constrained seed mass and seed storage allocation patterns in forest and savanna trees. We provide evidence that similar mechanisms are involved in seed storage of carbon and mineral nutrients across species., (© 2019 German Society for Plant Sciences and The Royal Botanical Society of the Netherlands.)

Background: Antibiotic resistance (AMR) is a growing public health problem worldwide, in part related to inadequate antibiotic use. A better knowledge of physicians' motivations, attitudes and practice about AMR and prescribing should enable the design and implementation of effective antibiotic stewardship programs (ASPs). The objective of the study was to assess attitudes and perceptions concerning AMR and use of antibiotics among surgeons who regularly perform emergency or trauma surgery., Methods: A cross-sectional web-based survey was conducted contacting 4904 individuals belonging to a mailing list provided by the World Society of Emergency Surgery. Participation was voluntary and anonymous. The survey was open for 5 weeks (from May 3, 2017, to June 6, 2017), within which two reminders were sent. The self-administered questionnaire was developed by a multidisciplinary team; reliability and validity were assessed., Results: The overall response rate was 12.5%. Almost all participants considered AMR an important worldwide problem, but 45.6% of them underrated the problem in their own hospitals. Surgeons provided with periodic reports on local AMR demonstrated a lower underrating in their hospital. Only 66.3% of the surgeons stated to receive periodic reports on local AMR data, and among them, 56.2% had consulted them to select an antibiotic in the previous month. Availability of systematic reports about AMR, availability of guidelines for therapy of infections, and advice from an infectious diseases specialist were considered very helpful measures to improve antibiotic prescribing by 68.0, 65.7, and 64.9%, respectively. Persuasive and restrictive ASPs were both considered helpful measures by 64.5%. Moreover, 86.3% considered locally developed guidelines more useful than national ones. Only 21.9% received formal training in antibiotic prescribing in the previous year; among them, 86.6% declared to be interested in receiving more training., Conclusions: Availability of periodic reports on local AMR data was considered an important tool to guide surgeons in choosing the correct antibiotic and to increase awareness of the problem of AMR. Local guidelines for therapy of infections should be implemented in every emergency surgery setting, and developed by a multidisciplinary team directly involving surgeons, infectious diseases specialists, and microbiologists, and formally established in an ASP., Competing Interests: The study was approved by the Ethics Committee of the Institute of Public Health of the University of Porto (ISPUP), which waived the need for written informed consent from the participants considering the anonymous nature of the collected data.Not applicable.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Background: Acute appendicitis (AA) is the most common surgical disease, and appendectomy is the treatment of choice in the majority of cases. A correct diagnosis is key for decreasing the negative appendectomy rate. The management can become difficult in case of complicated appendicitis. The aim of this study is to describe the worldwide clinical and diagnostic work-up and management of AA in surgical departments., Methods: This prospective multicenter observational study was performed in 116 worldwide surgical departments from 44 countries over a 6-month period (April 1, 2016-September 30, 2016). All consecutive patients admitted to surgical departments with a clinical diagnosis of AA were included in the study., Results: A total of 4282 patients were enrolled in the POSAW study, 1928 (45%) women and 2354 (55%) men, with a median age of 29 years. Nine hundred and seven (21.2%) patients underwent an abdominal CT scan, 1856 (43.3%) patients an US, and 285 (6.7%) patients both CT scan and US. A total of 4097 (95.7%) patients underwent surgery; 1809 (42.2%) underwent open appendectomy and 2215 (51.7%) had laparoscopic appendectomy. One hundred eighty-five (4.3%) patients were managed conservatively. Major complications occurred in 199 patients (4.6%). The overall mortality rate was 0.28%., Conclusions: The results of the present study confirm the clinical value of imaging techniques and prognostic scores. Appendectomy remains the most effective treatment of acute appendicitis. Mortality rate is low., Competing Interests: The data was completely anonymized, and no patient or hospital information was collected in the database. The study protocol was approved by the board of the WSES, and the study was conducted under its supervision. The board of the WSES grants the proper ethical conduct of the study.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

[This corrects the article DOI: 10.1186/s13017-016-0089-y.].

Objective: To evaluate the anti-inflammatory effect of pretreatment for three days with a fatty acid mixture with high ω-9:ω-6 ratio and low ω-6:ω-3 ratio on rats submitted to dental extraction., Material and Methods: Thirty-two male Wistar rats (270-310g) were randomly distributed in four groups (n=8/group): the sham control group and the negative control group received saline; the high omega-6/low omega-9 group received isolipid fatty acid with high ω-6:ω-3 ratio and low ω-9:ω-6 ratio; the high omega-3/low omega-6 group received fatty acid with low ω-6:ω-3 ratio and high ω-9:ω-6 ratio. Saline and oils were administered by gavage for 4days before exodontia and 3days after surgery, followed by euthanasia. Masseter edema was evaluated clinically and tissue samples were submitted to osteoclast count (H&E), myeloperoxidase assay, and western blotting (tumor necrosis factor-alpha and interleukin-1beta)., Results: In the high omega-3/low omega-6 group, a significant decrease was observed in masseter edema (p<0.0001), myeloperoxidase (p<0.0001), osteoclasts (p=0.0001) and TNF-α expression (p<0.0001), but not in IL-1β expression., Conclusion: The ingestion of fatty acid with high ω-9:ω-6 ratio and low ω-6:ω-3 ratio significantly reduced inflammatory response in rats submitted to dental extraction., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

The rete testis has a close relationship with sperm development and may have other functions besides serving as an intercalated channel. The aim of this study was to identify and characterize the proteins of rete testis fluid (RTF) from tropically-adapted Morada Nova rams. Testicles obtained from six Morada Nova rams were dissected and the head of the epididymis was separated to access the efferent ducts. Rete testis fluid was obtained by gentle massage of the testis. The fluid was centrifuged to remove cell debris and sperm. RTF samples (containing 400μg protein) were separated by 2-D SDS-PAGE and gels, analyzed using PDQuest software (Bio Rad, USA). Proteins were identified using tandem mass spectrometry. Gene ontology and protein network were analyzed using the software tool for searching annotations of proteins (STRAP) and STRING database. Gels had, on average, 227±13.5 spots and 51% of the proteins were found above 40kDa, corresponding to 65% of the intensity of all spots detected. Based on gene ontology analysis, the most common biological processes associated with RTF proteins were regulation (24.3%) and cellular process (23.3%). Binding (27.3%) and catalytic activity (19.3%) corresponded to the most frequent molecular functions. Albumin, clusterin, serotransferrin, immunoglobulin gamma-1 chain and alpha-2-HS-glycoprotein were the most abundant proteins in the ram rete testis fluid. In conclusion, proteins identified in the ram rete testis fluid are linked to several physiological processes associated with sperm protection and spermatogenesis., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Objective: to describe the characteristics of reported human anti-rabies treatment in municipalities of the 'agreste' region of Pernambuco State, Brazil, 2010-2012., Methods: this was a descriptive study using data from human anti-rabies medical records filed on the Information System for Notifiable Diseases (Sinan)., Results: 10,138 reported records of anti-rabies treatment were included; canines were the most involved species (68.1%), in good health condition (79.9%). Biting was the most common contact (83.8%), causing multiple injuries (58.3%), to hands/feet (39.4%), and deep wounds in 56.8% of cases; combined vaccine + serum administration frequency was found to be low (10.5%), even though 47.9% of injuries were considered severe and therefore required this prophylactic procedure., Conclusion: possible inadequate prophylaxis procedures were found, showing the need for health worker training aimed at ensuring correct human anti-rabies prophylaxis and the proper filling in of medical record files.

Acute left sided colonic diverticulitis is one of the most common clinical conditions encountered by surgeons in acute setting. A World Society of Emergency Surgery (WSES) Consensus Conference on acute diverticulitis was held during the 3rd World Congress of the WSES in Jerusalem, Israel, on July 7th, 2015. During this consensus conference the guidelines for the management of acute left sided colonic diverticulitis in the emergency setting were presented and discussed. This document represents the executive summary of the final guidelines approved by the consensus conference.

Intra-abdominal infections (IAI) are an important cause of morbidity and are frequently associated with poor prognosis, particularly in high-risk patients. The cornerstones in the management of complicated IAIs are timely effective source control with appropriate antimicrobial therapy. Empiric antimicrobial therapy is important in the management of intra-abdominal infections and must be broad enough to cover all likely organisms because inappropriate initial antimicrobial therapy is associated with poor patient outcomes and the development of bacterial resistance. The overuse of antimicrobials is widely accepted as a major driver of some emerging infections (such as C. difficile), the selection of resistant pathogens in individual patients, and for the continued development of antimicrobial resistance globally. The growing emergence of multi-drug resistant organisms and the limited development of new agents available to counteract them have caused an impending crisis with alarming implications, especially with regards to Gram-negative bacteria. An international task force from 79 different countries has joined this project by sharing a document on the rational use of antimicrobials for patients with IAIs. The project has been termed AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections). The authors hope that AGORA, involving many of the world's leading experts, can actively raise awareness in health workers and can improve prescribing behavior in treating IAIs.

Background: To validate a new practical Sepsis Severity Score for patients with complicated intra-abdominal infections (cIAIs) including the clinical conditions at the admission (severe sepsis/septic shock), the origin of the cIAIs, the delay in source control, the setting of acquisition and any risk factors such as age and immunosuppression., Methods: The WISS study (WSES cIAIs Score Study) is a multicenter observational study underwent in 132 medical institutions worldwide during a four-month study period (October 2014-February 2015). Four thousand five hundred thirty-three patients with a mean age of 51.2 years (range 18-99) were enrolled in the WISS study., Results: Univariate analysis has shown that all factors that were previously included in the WSES Sepsis Severity Score were highly statistically significant between those who died and those who survived (p < 0.0001). The multivariate logistic regression model was highly significant (p < 0.0001, R2 = 0.54) and showed that all these factors were independent in predicting mortality of sepsis. Receiver Operator Curve has shown that the WSES Severity Sepsis Score had an excellent prediction for mortality. A score above 5.5 was the best predictor of mortality having a sensitivity of 89.2 %, a specificity of 83.5 % and a positive likelihood ratio of 5.4., Conclusions: WSES Sepsis Severity Score for patients with complicated Intra-abdominal infections can be used on global level. It has shown high sensitivity, specificity, and likelihood ratio that may help us in making clinical decisions.

Successful germination and seedling establishment are crucial steps for maintenance and expansion of plant populations and recovery from perturbations. Every year the Amazon River and its tributaries overflow and flood the adjacent forest, exerting a strong selective pressure on traits related to seedling recruitment. We examined seed characteristics, stored reserves, germination, seedling development and survival under water of eight representative tree species from the lower portions of the flood-level gradient to identify adaptive strategies that contribute to their regeneration in this extreme ecosystem. Submerged seedlings were assessed for longevity and survival until they showed symptoms of injury. At this point, the remaining healthy seedlings were planted in unsaturated soil to monitor recovery after re-exposure to air over 30 days. All small (seed mass ≤0.17 g) seeds had epigeal phanerocotylar-type germination, a trait that would allow plants to acquire light and CO2 in the shortest time. Cell wall storage polysaccharide was a major component of all seeds, suggesting plant investment in structural reserves. Seven of the eight species germinated and formed healthy seedlings under water that endured submersion without any apparent injury for periods of 20-115 days, depending on the species. Seedlings of some species changed the direction of root growth and grew towards the surface of the water, which might have increased the uptake of oxygen to the tissues. Only one of the seven species did not survive re-exposure to air. Species able to germinate and produce seedlings under submersion, which subsequently are able to establish in aerated soils, would have more time available for terrestrial growth. This is critical for colonization of lower portions of the flood-level gradient where establishment is constrained by the short terrestrial phase that precedes the next flood., (Published by Oxford University Press on behalf of the Annals of Botany Company.)

Computed tomography (CT) imaging is the most appropriate diagnostic tool to confirm suspected left colonic diverticulitis. However, the utility of CT imaging goes beyond accurate diagnosis of diverticulitis; the grade of severity on CT imaging may drive treatment planning of patients presenting with acute diverticulitis. The appropriate management of left colon acute diverticulitis remains still debated because of the vast spectrum of clinical presentations and different approaches to treatment proposed. The authors present a new simple classification system based on both CT scan results driving decisions making management of acute diverticulitis that may be universally accepted for day to day practice.

Background: In many enterprises the semi-quantitative approach turns out to be the available and most suitable technique to perform a risk assessment. Despite its advantages, we cannot disregard the existing gap in terms of validation of this type of applications., Objective: This paper reports a study about risk assessments' reliability, namely both inter-coder (reproducibility) and intra-coder (stability) reliability of the semi-quantitative approach., Methods: This study comprised 4 fundamental stages. Data collection relied on free and systematized observations and made use of video recording, documental research, analysis grids and questionnaires specifically developed for this purpose. A set of different analysts were asked to use four semi-quantitative risk assessment methods (in two different moments) to estimate and assess six risks identified in two tasks accomplished to produce Airbags. The Krippendorff's Alpha Coefficient (α K) was the agreement measure selected to evaluate both inter-coder and intra-coder consensus., Results: The preliminary results revealed a general low concordance (α K < 0.6) for both reliability evaluations. Apparently there are no relevant differences between the risk assessment results obtained by individuals with different levels of experience or expertise., Conclusions: This study revealed that the use of the semi-quantitative approach should be done with caution.

Purpose: To evaluate the antioxidant and antiperoxidative effects of oil mixes of high ratio Omega-9:Omega-6 and low ratio Omega-6:Omega-3 in the third day after tooth extraction in rats., Methods: Thirty-two male Wistar rats (270-310 g) were randomly distributed in two groups: Control (n=24) and Test (n=8). Control group was divided into three subgroups (n=8): G1: Sham-Saline; G2: Saline; G3: Isolipid. G1 and G2 animals received NaCl 0.9% while G3 rats were treated with an isolipid mixture (alpha-linolenic acid - ALA) containing -6/-3 oils (8:1 ratio) and-9/-6 (0.4:1 ratio). Test group animals (G4) received oily mixtures (alpha-linolenic acid - ALA, docosahexaenoic acid - DHA, eicosapentaenoic acid - EPA) of -6/-3 (1.4:1 ratio) and -9/-6 (3.4:1 ratio). Saline and oils were administered by gavage during four days before and three days after first mandibular molar extraction. Following, samples (arterial blood and alveolar mucosa) were collected for glutathione (GSH) and thiobarbituric acid reactive substances (TBARS) assays., Results: Oil mixes induced a significant decrease in GSH and TBARS tissue and plasma concentrations in the third day post-surgery., Conclusion: Gavage administration of oil mixes of high ratio Omega-9:Omega-6 and low ratio Omega-6:Omega-3 after molar extraction in rats induces a significant decrease in lipid peroxidation.

Inflammatory pseudotumours (IPTs) may occur in almost every organ of the human body, the liver being the second most frequent organ which is affected. Inflammatory pseudotumours of the liver are rare benign lesions of unknown aetiology, which usually present as solitary liver masses of variable sizes. The differential diagnoses of malignant liver tumours are challenging and they usually require biopsies and histologic examinations. We are presenting the case of a patient with multiple hepatic lesions which mimicked liver metastases. Two percutaneous biopsies were inconclusive. The definitive diagnosis of multiple hepatic inflammatory pseudotumours was made after a laparoscopic exploration with an excisional biopsy of liver lesions and their pathologic evaluation. All lesions disappeared after several months, without any further treatments.

Purpose: To evaluate the effect of bioflavonoid ternatin (TRT) on rat liver regeneration and oxidative stress after 70% partial hepatectomy (PH)., Methods: Thirty six young male Wistar rats were randomly assigned to two groups of 18 animals each - control (G1) and experimental (G2) - and were submitted to PH under inhalatory diethylether anesthesia. G1 rats received daily intraperitoneal (ip) injections of saline (NaCl 0.9% solution) 0.1 mL/kg for 14 days; G2 animals received daily ip injections of TRT 0.1% 1.0mg/kg for 14 days. At 36h (T1), 168h (T2) and 336h (T3) post-PH timepoints, a subgroup of six rats in each group was chosen in a randomized way to complementary hepatectomy (CH) and blood samples haversting. Collected material was saved for laboratory analysis (total bilirubin (TB), D-Glucose, glutathione (GSH) and thiobarbituric acid reactive substances (TBARS) and assessment of liver regeneration., Results: TRT induced a significant decrease in liver and plasma GSH concentrations; liver regeneration process was not affected. TRT promoted a significant decrease in blood glucose levels 168h after partial hepatectomy compared with controls. TB levels remained unchanged., Conclusion: Intraperitoneal bioflavonoid ternatin injection in partially hepatectomized rats induces a decrease in oxidative stress and a significant hypoglycemic state, but does not promote any change in the evolution of liver regeneration.

The CIAO Study ("Complicated Intra-Abdominal infection Observational" Study) is a multicenter investigation performed in 68 medical institutions throughout Europe over the course of a 6-month observational period (January-June 2012).Patients with either community-acquired or healthcare-associated complicated intra-abdominal infections (IAIs) were included in the study.2,152 patients with a mean age of 53.8 years (range: 4-98 years) were enrolled in the study. 46.3% of the patients were women and 53.7% were men. Intraperitoneal specimens were collected from 62.2% of the enrolled patients, and from these samples, a variety of microorganisms were collectively identified.The overall mortality rate was 7.5% (163/2.152).According to multivariate analysis of the compiled data, several criteria were found to be independent variables predictive of patient mortality, including patient age, the presence of an intestinal non-appendicular source of infection (colonic non-diverticular perforation, complicated diverticulitis, small bowel perforation), a delayed initial intervention (a delay exceeding 24 hours), sepsis and septic shock in the immediate post-operative period, and ICU admission.Given the sweeping geographical distribution of the participating medical centers, the CIAO Study gives an accurate description of the epidemiological, clinical, microbiological, and treatment profiles of complicated intra-abdominal infections (IAIs) throughout Europe.

The CIAO Study is a multicenter observational study currently underway in 66 European medical institutions over the course of a six-month study period (January-June 2012).This preliminary report overviews the findings of the first half of the study, which includes all data from the first three months of the six-month study period.Patients with either community-acquired or healthcare-associated complicated intra-abdominal infections (IAIs) were included in the study.912 patients with a mean age of 54.4 years (range 4-98) were enrolled in the study during the first three-month period. 47.7% of the patients were women and 52.3% were men. Among these patients, 83.3% were affected by community-acquired IAIs while the remaining 16.7% presented with healthcare-associated infections. Intraperitoneal specimens were collected from 64.2% of the enrolled patients, and from these samples, 825 microorganisms were collectively identified.The overall mortality rate was 6.4% (58/912). According to univariate statistical analysis of the data, critical clinical condition of the patient upon hospital admission (defined by severe sepsis and septic shock) as well as healthcare-associated infections, non-appendicular origin, generalized peritonitis, and serious comorbidities such as malignancy and severe cardiovascular disease were all significant risk factors for patient mortality.White Blood Cell counts (WBCs) greater than 12,000 or less than 4,000 and core body temperatures exceeding 38°C or less than 36°C by the third post-operative day were statistically significant indicators of patient mortality.

Effects of whole-body vibration (WBV) exposure on professional drivers were predicted using a 45 subjects sample of healthy volunteers from both genders. These volunteers preformed a visual/motor accuracy evaluation test, the 'omega test', inside a vehicle (van) under three different WBV exposure conditions, van halted, van performing a circuit on asphalt, and on cobblestone. WBV levels of the stated conditions were statistically different and impairment upon subjects' performance was found. The statistical significant difference encountered between the subjects performance under the two whole-body vibration profiles (asphalt and cobblestone), seems to indicate that the vibration levels also represent a variable to be taken under consideration. No gender related difference was found.

Introduction: Cholangiocarcinoma is a rare tumor but recent data report a worldwide increase in incidence and mortality. There are several risk factors associated with cholangiocarcinoma, and chronic inflammation of billiary tree seems to be implied in the cholangiocarcinogenesis, but little is known about this process., Presentation of Case: We present a 56-year-old female with a bile duct adenoma incidentally discovered in the follow up of breast cancer that 18 months later progress to intrahepatic cholangiocarcinoma., Discussion: This is a rare presentation of intrahepatic cholangiocarcinoma that suggests the classic adenoma-carcinoma sequence in cholangiocarcinogenesis. Furthermore this case gives rise to some questions about the possible common ground on intrahepatic cholangiocarcinoma and breast cancer., Conclusion: Cholangiocarcinogenesis is a complex multi-step mechanism and further investigations are needed to fully understand this process., (Copyright © 2012 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.)

Liver abscesses are very rare complications of ulcerative colitis, with only nine cases described in the literature, to our knowledge. We report a case where a recurrence of liver abscess occurred in an ulcerative colitis patient, in two different hepatic lobes, which has not been previously described. The recurrence was in the caudate lobe having the cultures yielded Staphylococcus aureus. This is also the first case report of liver abscess in this location and caused by this microorganism in an ulcerative colitis patient. A review of the literature concerning liver abscesses involving ulcerative colitis patients is also provided., (Copyright © 2011 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.)

Objective: To study the effects of polyunsaturated fatty acids (PUFA) omega-3 and omega-6 in the oxidative stress and in liver regeneration in rats subjected to 70% partial hepatectomy (PH, 70% hepatectomy, Higgins-Anderson partial hepatectomy)., Methods: 72 young male Wistar rats were randomly divided into four equal-sized groups: control (G1), partially hepatectomized (G2), partially hepatectomized with two weeks daily intraperitoneal infusion of omega-3 (G3) and partially hepatectomized with two weeks daily intraperitoneal infusion of omega-6 (G4). In moments 36 h (T1), 168 h (T2) and 336 h (T3) post-PH, thiobarbituric acid reactive substances (TBARS) and reduced glutathione (GSH) were measured in plasma and liver tissue, while glucose and total bilirubin were measured in blood. The mass of the residual liver in the same moments was the parameter used to estimate the evolution of liver regeneration., Results: omega-3 PUFA inhibited liver regeneration and induced reduction of hepatic GSH concentration seven days post-PH. Omega-6 PUFA, in contrast, showed no inhibitory effect on regeneration. There was an increase of lipid peroxidation both in blood and liver with administration of omega-6., Conclusion: Omega-3 PUFA retarded post-PH liver regeneration, probably through inhibition of oxidative stress. Omega-6 PUFA increased TBARS concentrations in blood and liver but did not alter the evolution of the liver regenerative process.

Objective: To measure the serum levels of brain natriuretic peptide (BNP) in patients with chronic chagasic heart disease and in individuals with positive serology for Chagas' disease and no heart impairment, and to correlate the serum BNP levels with the degree of cardiac impairment, cardiac dimensions, presence of a pacemaker, and ejection fraction., Methods: Serum BNP concentrations were determined by use of the Triage-BNP Test produced by BIOSITE. Serum BNP was assessed in 25 patients from the Chagas' disease outpatient clinic of the Hospital Universitario Oswaldo Cruz, who were divided into 2 groups as follows: 1) G1--comprising 13 asymptomatic patients with positive serology for Chagas' disease and no heart disease detectable on electrocardiography, chest X-ray, and echocardiography; and 2) G2--comprising 12 patients with Chagas' disease and heart impairment., Results: Significantly more elevated BNP levels were detected in the chagasic patients with cardiac impairment: (G1=4.4 +/-4.4 pg/ml, G2=293.0+/-460.2 pg/ml); (P<0.01). In the 2 groups, the serum levels of BNP correlated neither with age nor with sex. The levels were directly proportional to functional class and cardiac area on chest X-ray. Although a trend towards an increment in systolic function impairment was observed, no linear correlation with the ejection fraction on echocardiography occurred. The presence of definitive pacemaker and electrocardiographic alterations did not change the serum BNP levels., Conclusion: Asymptomatic individuals with a positive serology for Chagas' disease and no evidence of ventricular dysfunction have serum BNP levels similar to those of the general population.

The study was carried out to assess dental caries in the primary dentition of pre-school children in Goiânia-GO, Brazil, and to assess the influence of socio-economic status. The study population comprised 0-6-yr-old pre-school children (n = 2267) attending public (low SES children) and private (higher SES children) nursery schools. Mean dmft and percent caries-free were 0.09 (96.4%) at 1 year and younger, 0.40 (87.3%) at 2, 1.14 (69.9%) at 3, 2.18 (49.5%) at 4, 3.18 (36.1%) at 5, and 3.94 (29.4%) at age 6 years respectively. Caries prevalence was higher in those attending public nursery school than in those attending private schools (P < 0.05). Amongst children from public nursery schools the highest dmf component was untreated decay while in private nurseries it was filled teeth. The results indicate that social inequalities exist, which influence dental caries experience. It was concluded that oral health programmes for pre-school children emphasizing preventive measures and dental health education should be developed mainly in areas of social deprivation.

We studied a model transesterification reaction catalyzed by subtilisin Carlsberg suspended in toluene, n-hexane, diisopropyl ether, and mixtures of these solvents. To account for solvent effects due to differences in water partitioning between the enzyme and the bulk solvents, we measured water sorption isotherms for the enzyme in each solvent. We measured catalytic activity as a function of enzyme hydration and obtained bell-shaped curves with maxima at the same enzyme hydration in all the solvents. However, the activity maxima were different in all the media, being the lowest in toluene. Differences in the partitioning of substrates and product between the bulk solvent phase and the enzyme active site were accounted for but could not explain the lower catalytic activity observed in toluene. The fact that toluene is very similar to one of the substrates suggested the possibility of competitive inhibition by this solvent. We derived a model allowing for differences in solvation of the substrates, by using thermodynamic activities instead of concentrations, as well as for competitive inhibition by toluene. The model fit the experimental data well, confirming that toluene had a direct adverse effect on the catalytic activity of the enzyme.