Abstract in English:

ABSTRACT Purpose: To evaluate the peritoneal histopathological changes and culture after the use of intravenous meropenem and intra-abdominal inoculation of 10% aqueous extract of anacardiaceae, in elderly rat model after autogenous fecal peritonitis induced. Methods: Thirty 18-month-old Wistar rats received induction of autogenous fecal peritonitis and then were stratified into two groups: study I, treated with meropenem (40 mg/kg); and study II, treated with meropenem (40 mg/kg) and intraperitoneal 10% aqueous extract of anacardiaceae. Animals were monitored for 15 days until euthanasia. Peritoneal fragments were collected for histopathological and culture. The study was approved by Ethics Committee. Results: None study-II animals died, while in study I, one died before euthanasia. In study II, 20% of the animals showed histopathological changes, none positive peritoneal culture, but one blood culture was positive (10%). In study I, 50% of the animals presented histopathological changes, 40% positive peritoneal cultures, and 50% positive blood cultures. All results when evaluated in the morbidity score showed better outcome for study-II group (p = 0,175). Conclusion: The use of meropenem associated with intraperitoneal 10% aqueous anacardiaceae extract after induction of autogenous fecal peritonitis in elderly rats showed better outcome in the set of histopathological changes, negative peritoneal and blood cultures, when compared with the use of meropenem isolated.

Abstract in English:

ABSTRACT Purpose: To mitigate ischemia-reperfusion injury (IRI) triggered in solid organ transplant procedures, we aimed to evaluate the effects of multi-organ abdominal ischemic preconditioning (MAIP) in the context of renal IRI. Methods: An experimental kidney transplant model was conducted. Rats were divided into three groups: an intervention free basal group from which physiological data was collected; a control group (CT), which consisted of transplanted animals without MAIP; and a treated group, in which a MAIP protocol was implemented in the donor during the procurement of the left kidney, monitoring the recipient for 24 hours. Results: Urea, creatinine, and lactate dehydrogenase, as well as histopathological analysis (Banff: CT 1,66 ± 0,57 vs. basal 0, and MAIP 1), showed a clear trend in favor of MAIP group. Similar results were observed for tumor necrosis factor-α, interleukin-6 and CXCL10, as well as indicators of oxidative stress, with statistically significant levels for CXCL10 [0,295 ± 0,0074 arbitrary units (AU) CT and 0,0057 ± 0,0065 AU MAIP] and TBARS (2,93 ± 0,08 nmol/μg CT; and 2,49 ± 0,23 nmol/μg MAIP; p 0.05). Conclusion: The findings indicated that the MAIP exerts a protective influence on the transplanted kidneys, functioning as an IRI-protective strategy and enhancing the parameters associated with renal graft functionality.

Abstract in English:

ABSTRACT Purpose: To evaluate intravenous meropenem and intraperitoneal 10% aqueous extract of Schinus terebinthifolius (aroeira) in elderly rats after autogenous fecal peritonitis. Methods: Thirty 18-month-old Wistar rats underwent peritonitis with 4 mL/kg of autogenous fecal solution. They were stratified into groups: control without treatment; study I, treated with meropenem (40 mg/kg); and study II, treated with meropenem at the same dose and intraperitoneal 10% aqueous extract of aroeira. The animals were monitored for 15 days until euthanasia. The study was approved by Ethics Committee. Results: There was no significant weight loss in the study-II group (p = 0.6277), while the study-I group showed partially recovered weight (p = 0.0187). The study-II group had 90% negative blood cultures, while the study-I group had in 50% of the animals (p = 0.1479). Survival in the study-II group was higher than in study-I group (p = 0.0462). The morbidity score for abdominal and thoracic cavity was lower in the study-II group as compared with study-I group (p = 0.0001). Conclusions: The use of meropenem associated with the intraperitoneal 10% aqueous aroeira extract after induction of autogenous fecal peritonitis in elderly rats produced greater survival, less weight loss, and lower morbidity compared to the use of meropenem alone.

Abstract in English:

ABSTRACT Purpose: To evaluate whether the effectiveness of topical antiseptic solutions in restoring skin continuity solutions is related to their antimicrobial action or to their action in maintaining moisture, in dogs undergoing elective surgeries. Methods: Forty dogs, 20 males and 20 females, underwent orchiectomy and oophorectomy, respectively. Thereafter, the animals were allocated into four groups (n = 5) and treated with different topical solutions: polyhexanide 0.1% (G1), chlorhexidine digluconate 0.05% (G2), povidone-iodine 0.1% (G3), and sodium chloride 0.9% (control). Macroscopically evaluation of wounds on days 1, 5, and 10 after procedures, and hematological parameters were performed. Data were subjected to statistical analysis (p 0.05) Results: No significant differences in the macroscopic evaluation of the wounds and hematological parameters were observed among groups, in the healing of clean elective surgical wounds. However, applying a topical solution dressing to maintain a moist wound promoted adequate tissue healing. Conclusion: In our experimental conditions, moisture provided by topical antiseptic solutions is an important factor compared to the antiseptic activity of these solutions, for skin wound healing in post-surgical dressings resulting from clean, short-term elective surgeries in male and female dogs. Moreover, the type of topical antiseptic solution used does not influence the development of post-surgical infection.

Abstract in English:

ABSTRACT Purpose: To evaluate the molecular evolution of endoplasmic reticulum (ER) stress during colorectal cancer carcinogenesis. Methods: Fifty-six hairless mice were divided into two groups: control (no intervention); and carcinogenesis (treated with two doses of azoxymethane at 10 mg/kg during the third and the fourth week and dextran sodium sulfate at 2.5% for seven days in the second, fifth, and eighth week). Euthanasia occurred at the fifth, 10th, 15th, and 20th week. Colons were collected, and gene expression of ER stress markers (IRE1-α, PERK, ATF6, and CHOP) was assessed via real-time quantitative polymerase chain reaction. Results: ERN1 expression was significantly higher than the control at the 10th week (1.39 ± 0.16, p 0.05) and the 20th week (1.15 ± 0.04, p 0.01). ATF6 also showed elevated expression, significantly different at the 10th week (1.71 ± 0.29, p 0.05) and the 20th week (1.14 ± 0.06, p 0.05). PERK and CHOP expressions were significantly higher than the control in the 15th (PERK = 1.30 ± 0.12, CHOP = 1.48 ± 0.23) and 20th weeks (PERK = 1.63 ± 0.20, CHOP = 1.67 ± 0.22, p 0.05). Conclusion: Upregulation of IRN1, PERK, ATF6, and CHOP demonstrates a strong ER stress response during colorectal cancer development.

Abstract in English:

ABSTRACT Purpose: We aimed to investigate the role of gallic acid treatment on spinal cord tissues after spinal cord injury (SCI) and its relationship with endoplasmic reticulum (ER) stress by histochemical, immunohistochemical, and in-silico techniques. Methods: Thirty female Wistar albino rats were divided into three groups: sham, SCI, and SCI+gallic acid. SCI was induced by dropping a 15-g weight onto the exposed T10-T11 spinal cord segment. The SCI+gallic acid group received 25 mg/kg of gallic acid intraperitoneally daily for one week. Histopathological, immunohistochemical, and silico analyses were performed. Results: Histological analysis revealed improved neural cell survival and tissue integrity in the SCI+gallic acid group compared to the SCI group. Caspase-12 expression was significantly increased in the SCI group, indicating elevated ER stress and apoptosis. Gallic acid treatment resulted in a marked reduction in caspase-12 expression in neurons, neuroglia, and endothelial cells, suggesting decreased ER stress. Conclusion: Gallic acid exhibits significant neuroprotective effects against ER stress and cellular damage in a rat model of SCI. The in-silico analysis revealed apoptotic and immune-related pathways in which gallic acid showed neuroprotective effects by regulating caspase-12. These results suggest that gallic acid may be a promising therapeutic agent for mitigating secondary damage post-SCI.

Abstract in English:

ABSTRACT Purpose: To evaluate the effect of the topical application of the ethanol extract (EESL) and the hydroethanolic fraction (HFSL) of ripe Solanum lycocarpum fruit on the healing of experimentally-induced wounds in mice. Methods: The EESL and HFSL obtained from ripe fruit of the species S. lycocarpum were obtained by percolation with ethanol. They were tested in the healing of excisional wounds in mice, which were induced in anesthetized animals using a 7-mm dermatological punch. They were divided according to the treatment period and group, n = 6, and received topical application of the EESL or HFSL daily or saline solution for one, five, seven, or 21 days. At the end of this period, the animals were euthanized, and the lesions were subjected to histopathological processing and analysis to evaluate macroscopic area of the wound and microscopic analysis by morphometry of the number of leukocytes, mast cells, fibroblasts, re-epithelialization, and matrix deposition. Results: The application of the EESL and HFSL reduced the number of leukocytes after one, five, and seven days of treatment. EESL improved re-epithelialization and tissue proliferation in wound healing from day 7. Conclusion: The study demonstrated that daily administration of EESL and HFSL exhibit wound healing activity, with this effect being more pronounced by EESL. To our knowledge, this is the first report of the anti-inflammatory and healing activity of this species through topical application.

Abstract in English:

ABSTRACT Purpose: The aims of this work were to induce anorectal anomaly in rat fetuses via the planned administration of ethylenethiourea (ETU), and to study fetuses exhibiting anorectal malformation, as well as apparently normal fetuses submitted to the effect of ETU. Methods: Time-mated pregnant Wistar rats were randomly divided into control and experimental groups. On gestational day 10, the experimental group received 10% ETU (130 mg/kg) by gavage, whereas the control rats received vehicle only. The embryos were harvested by cesarean section on gestational day 21. The fetuses exposed to ETU were divided into two groups: affected (without any clear anorectal alterations); and the malformed (with anorectal anomaly). The neuromotor plates were identified by immunohistochemistry with acetylcholinesterase, and alterations in the sacral region were evaluated by histological and morphometric studies. Results: We used 43 control fetuses, 82 affected fetuses, and 118 malformed fetuses in this study. The most frequent associated macroscopic anomalies were spina bifida (55 fetuses), encephalocele (20), and alterations in the lower limbs (5). The sacroiliac was malformed in 45% of the affected fetuses and in 53.2 % of the malformed fetuses. Conclusion: ETU leads to a reduced number of motor neurons in the pelvic musculature of both the malformed and the affected rats. The enteric neurons are altered in the malformed fetuses, but not in the affected ones. Both the affected and malformed rats exhibit sacral alterations that do not interfere with neurons.

Abstract in English:

ABSTRACT Purpose: To evaluate membranes originating from pure or oxidized bacterial cellulose (BC)/alginate/strontium apatite hydrogels regarding toxicity, biocompatibility, biodegradation and metabolism. Methods: The toxicity was measured by incubating the materials with Artemia salina for 24 h, and mortality and the 50% lethal concentration were determined in comparison to potassium dichromate by Probit analysis. Local biocompatibility and biodegradation were evaluated by subcutaneous assay in 75 Swiss mice; the test groups were compared to sham and collagen membrane at one, three and nine weeks. The histopathology of tissue irritation followed the ISO 10993-6 standard, and the integrity of the biomaterials scored by quartiles. Metabolic analysis of relative weight and the intensity of catalase, iodine and nitrite were carried out for liver, kidneys and tibias of the tested animals. Results: All cellulose-based materials were nontoxic, biocompatible, and none presented nitrosative stress. The oxidized BC was more resorbable, and the non-oxidized BC had greater renal biochemical reactivity. Conclusion: The membranes suggest applicability as regenerative barriers. However, long-term studies in bone defects are necessary to elucidate their osteopromoting efficiency.

Abstract in English:

ABSTRACT Purpose: To explore the protective effects of borneol in myocardial ischemia-reperfusion injury (MIRI) and the mechanism of apoptosis. Methods: Cell viability was detected by CCK-8. The total superoxide dismutase (T-SOD) and lactate dehydrogenase (LDH) leakage of cells were tested by biochemical assay kit. Detection of apoptosis was by flow cytometry. Serum levels of creatine kinase isoenzyme MB (CK-MB), LDH, and cardiac troponin I (cTnI) were detected by enzyme-linked immunosorbent assay. Myocardial infarction area and pathological changes were observed via 2,3,5-triphenyltetrazolium chloride (TTC) staining and hematoxylin and eosin staining. The expressions of apoptosis-related proteins in cells and myocardial tissues were detected by Western blot. Results: H9c2 cell viability was significantly increased by pretreatment with 16 and 32 μg/mL of borneol. Borneol pretreatment significantly increased the T-SOD levels and reduced LDH leakage and apoptosis. In MIRI rats, borneol pretreatment significantly reduced serum levels of CK-MB, LDH and cTnI, decreased myocardial infarction area, and improved myocardial injury in different degree. Western blot results showed that borneol pretreatment significantly reduced the expression of Bcl-2-associated X protein (Bax) and Cysteine-aspartate protease-3 (Caspase-3) in cells and myocardial tissues of rats. Conclusion: Borneol can protect myocardial injury cells and mitigate MIRI by inhibiting cardiomyocyte apoptosis.

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ABSTRACT Purpose: To evaluate gastrointestinal histological injury in pigs subjected to triple stent interposition versus a control group, hypothesizing no significant injury increase with triple stents. Methods: A prospective study with 15 pigs divided into a control group (G0, n = 5) undergoing arteriography only, and a triple stent group (G3, n = 10) undergoing arteriography and three stent implantations in the thoracoabdominal aorta. After an eight-day observation, arteriography, euthanasia, and en bloc gastrointestinal harvesting were performed. Lesions were graded using the Park/Chiu classification, and serum markers were analyzed pre- and post-procedure. Results: Arteriography confirmed mesenteric artery patency in all animals. Histological analysis showed ischemic lesions in 88.9% of G3, mainly in the colon (89%), compared to 60% in G0, primarily in the colon (60%) and stomach (40%). Most G3 lesions were grade 1, while G0 had higher-grade lesions. Serum markers showed no significant intergroup differences. Conclusion: Triple stent interposition did not significantly increase gastrointestinal injury, indicating its safety for maintaining gastrointestinal perfusion in this model.

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ABSTRACT Purpose: To investigate the effect of intraperitoneal treatment with low- and high-dose methotrexate (MTX) on wound healing in rats. Methods: The study sample consisted of 54 healthy rats. Under aseptic conditions, skin wounds were created with two circular full-thickness punch tools, 10 mm in diameter, one on the right and the other one on the left of the dorsal vertebral line. The rats were randomly assigned to one of three main treatment groups. On the 0th day (2 hours before wound creation), 7th day, and 14th day, the control group received 0.3-mL saline, the low-MTX group received 3 mg/kg MTX, and the high-MTX group received 30 mg/kg MTX, all administered intraperitoneally. The wounds were evaluated seven, 14, and 21 days after injury through morphometrical, biochemical, histopathological, and immunohistochemical analyses. Results: MTX dose-dependently decreased the degree of inflammation and angiogenesis, tissue hydroxyproline level, and HSP70 and tumor necrosis factor-α expression in the early phase of wound healing. It also suppressed epithelialization and collagen 1 expression throughout the wound-healing process. Conclusion: The wounds treated with high-dose of MTX had statistically delayed wound closure on days 7, 14 and 21 compared to the saline group, while wounds treated with low-dose of MTX only had statistically delayed wound closure on day 14. In addition, weight loss was observed in rats treated with high-dose MTX, which was thought to reflect its toxicity. The dose-dependent adverse effect of MTX on wound healing may be due to its antiproliferative, antifibrotic, anti-inflammatory, and antiangiogenic effects.

Abstract in English:

ABSTRACT Purpose: To characterize histologically and stereologically the hepatic steatosis in obese Zucker (fat, n = 6, with a mutation in the leptin receptor – Leprfa) and control Zucker (lean, n = 6) rats, analyzing macroscopic and microscopic differences to understand the influence of obesity on hepatic pathology. Methods: Zucker rats were fed standard chow for 90 days. Macroscopic, qualitative, and histoquantitative (stereological) approaches were used, involving body and liver weight measurement, morphological analysis, and histopathological classification of metabolic dysfunction-associated steatotic liver disease. Results: Zucker fat rats had higher body weight (p = 0.0022), liver weight (p = 0.0022), serum total cholesterol (p = 0.0022), and triacylglycerol (p = 0.0022) compared to Zucker lean rats. Stereological analysis showed that hepatocyte volume density (p = 0.0022) and total hepatocyte volume (p = 0.0001) were lower, and the volume density (p = 0.002) and total volume of steatosis (p = 0.002) were higher in Zucker fat rats compared to lean rats. Conclusion: The findings indicated that obesity induces significant alterations in the hepatic morphology of Zucker rats, showing that hepatocyte volume is lower in obese animals. This study reinforces the utility of the obese Zucker rat model to investigate the effects of obesity on liver health and suggests hepatic steatosis requires therapeutic strategies focused on modulating these parameters.

Abstract in English:

ABSTRACT Purpose: To evaluate cytotoxicity and tissue repair of a new chicken eggshell-derived bioceramic (hydroxyapatite/dicalcium phosphate anhydrous–HA/DCPA). Methods: Cytotoxicity was evaluated in fibroblasts (L cell, L-929) by MTT test. Tissue repair of HA/DCPA was compared to HA/β-TCP bioceramic (Maxresorb-MXR). Two critical-sized bone defects (CSDs) were drilled in the calvarial of 24 Wistar rats and filled with one of the biomaterials. The animals were euthanized after 30, 60, and 90 days, and bone specimens were examined by histomorphometric analyses, scanning electron microscopy, and energy-dispersive X-ray spectroscopy. The percentages of newly formed bone, connective tissue, remaining biomaterial, and total tissue repair area were compared between groups using Student’s t-test and analysis of variance (p ≤ 0.05). Results: HA/DCPA did not exhibit any cytotoxicity. CSDs contained newly formed bone from the defect margins and from ossification centers interspersed throughout the biomaterials. At 30 days, HA/DCPA group had a significantly larger total tissue repair area than MXR group (p = 0.047). No differences were observed between groups regarding variables studied (p > 0.05). Conclusion: HA/DCPA is non-cytotoxic. This cement promoted new bone formation and tissue filling of the entire defect area with degree of biomaterial degradation similar to HA/β-TCP, proving to be equally suitable and successful for bone regeneration.

Abstract in English:

ABSTRACT Purpose: To evaluate whether the joint use of autologous platelet-rich plasma (aPRP) and rosuvastatin (RSV) in biopsies of dermal wounds induced in rabbits results in an additive effect on the immunoexpression of collagens type I and III, optimizing the healing process and increasing collagen production during the proliferative phase of healing to improve the quality of tissue repair. Methods: Thirty-two biopsy samples from eight clinically healthy adult male New Zealand rabbits were used. They were treated with aPRP, RSV, or aPRP + RSV and analyzed zero, three, seven, ten, and 14 days post wound induction. Results: Type I collagen immunoexpression was significantly higher in wounds treated with aPRP when compared to the control group. This study demonstrated that type III collagen is predominant during the proliferation phase of the healing process, highlighting its critical role in tissue repair and regeneration. Conclusion: The association of aPRP and RSV in wound treatment may have an additive effect in the immunoexpression of type III collagen and can thus be used as an alternative in tissue repair and collagen formation, optimizing the healing process.

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ABSTRACT Purpose: To investigate the effects of supraphysiologic doses of nandrolone decanoate on the testicular morphology of rats and if these effects could be transitory or permanent. Methods: Twenty-five male rats were divided in four groups. C28 and C40 were control rats killed with 28 and 40 weeks old, respectively; and T28 and T40 were treated with nandrolone decanoate (10 mg/kg) and killed immediately after the treatment (T28) or 12 weeks after the end of treatment (T40). The testis weight and volume were measured, and the seminiferous tubule area and epithelium height were assessed by histomorphometric methods. Results: The seminiferous tubules area and epithelium height of group T28 were reduced in comparison to C28. Group T40 showed reduced testicular weight and volume, as well as seminiferous tubule area and epithelium height in comparison to C40. Conclusion: The use of nandrolone decanoate promotes major structural modifications on the testes of rats. These modifications are even worse 12 weeks after ending the use of the anabolic androgenic steroid.

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ABSTRACT Purpose: To investigate the cytotoxic and apoptotic effects of the combination of doxorubicin (Dox) and thymoquinone (TQ) on ovarian adenocarcinoma cells (OVCAR3) via the EGFR/FOXP3 signaling pathway. Methods: We used human OVCAR3 and human skin keratinocyte cells (HaCaT). Different concentrations of TQ and Dox were applied to the cells for 24, 48, and 72 hours, and the cytotoxicity level was determined via the MTT method. Expression levels of EGFR/FOXP3 for cell proliferation and apoptosis were determined by quantitative reverse transcription polymerase chain reaction (RT-qPCR) and Western blot analysis. The colony counting was performed after DAPI staining, and the effect on cell proliferation was determined. Results: Cytotoxicity was found to be highest with TQ and Dox treatments, and cell migration was prevented, especially in the group that received combined TQ and Dox treatment. Moreover, using RT-qPCR analysis, activity in the EGFR and FOXP3 pathway was found to be downregulated the most with TQ, and the amount of protein decreased with TQ and Dox. Conclusions: The findings showed that the greatest cytotoxic effect and the most apoptosis occurred during TQ treatment. Additionally, it was determined that a significant decrease in EGFR and FOXP3 levels occurred with the application of TQ and Dox.

Abstract in English:

ABSTRACT Purpose: Gastric cancer (GC) ranks as the third most common cause of cancer related mortality and as the fifth most frequently diagnosed cancer globally. Less than 30% of people with GC survive for more than five years. Methods: Nimbolide has been shown to have anticancer, anti-inflammatory, antiparasitic, and antioxidant properties. The current investigation showed the anticancer effect of nimbolide against N-methyl-N-nitrosourea (MNU) induced GC in rats. Rats were given MNU (100 mg/kg) orally to induce GC and received the oral administration of nimbolide (10, 20 and 40 mg/kg). The different biochemical parameters were estimated. Results: Nimbolide significantly (p < 0.001) altered the level of lactate dehydrogenase (LDH), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), cytochrome P450, cytochrome B5 and histone deacetylase (HDAC) activity. Nimbolide treatment significantly (p < 0.001) altered the level of antioxidant parameters like superoxide dismutase (SOD), glutathione peroxidase (GPx), catalase (CAT), malondialdehyde (MDA); cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-2, IL-6; inflammatory parameters viz., cyclooxygenase-2 (COX-2), prostaglandin E2 (PGE2), vascular endothelial growth factor (VEGF), nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) in the serum and stomach tissue. Nimbolide considerably altered (p < 0.001) the level of apoptosis parameters (Bcl-2, Bax and caspase-3), and the mRNA expression of VCAM-1, ICAM-1, TNF-α, IL-1β, IL-6, MCP-1, TLR4 and NF-κB. Conclusion: Nimbolide treatment considerably altered the GC against MNU induced GC via alteration of apoptosis and NF-κB signaling pathway.

Abstract in English:

ABSTRACT Purpose: Plastic biliary stents are a cost-effective treatment for biliary obstruction. Unfortunately, they have low patency, related to intraluminal biofilm formation. Silver nanoparticles (AgNPs) have been increasingly used in biomedicine because of its antibacterial properties. This study aimed to compare biofilm formation on stents with and without silver nanoparticle coatings when in contact with different bacterial culture medium. Methods: Different types of silver coatings were tested on plastic biliary stents. Two groups of stents were analyzed: one group with various types of silver nanoparticle coatings, and a negative control group with no coating. The stents were placed in different bacterial culture media and assessed for biofilm formation. Analysis was performed using confocal microscopy and direct colony-forming unit (CFU/cm2). Results: Quantitative analysis showed promising results with C16 coating, as Escherichia coli ATCC and Pseudomonas aeruginosa ATCC exhibited reduced growth in the AgNP-coated group (p < 0.05). However, when mixed samples, including clinical strains and Staphylococcus aureus, were tested, the AgNP coating did not inhibit bacterial growth. Conclusion: AgNP-coated stents are effective against certain strains, such as E. coli ATCC and P. aeruginosa. Further research is needed to explore potential improvements in the coating mechanism.

Abstract in English:

ABSTRACT Purpose: To determine if endoscopic retrograde cholangiopancreatography (ERCP) should be performed with surgery or as a different step, on acute cholecystitis, and which strategy has the least complications and morbimortality. Methods: Various databases (PubMed, Embase, Scopus, Web of Science, Science Direct, Cochrane Central Register of Controlled Trials, CINAHL, Latin American and Caribbean Health Sciences Literature, clinical trials, Google Scholar) were searched for randomized trials comparing the different timings for ERCP and cholecystectomy. No language or time restrictions were applied. Risk of bias was assessed with RoB 2.0 (Cochrane’s Risk of Bias 2), and evidence certainty evaluated using Grading of Recommendations Assessment, Development and Evaluation. Data synthesis used R-4.1.0 Project for Statistical Computing for Windows, with meta-analysis via fixed-effects model and I2 for heterogeneity. Results: Eleven studies was used, and meta-analysis was performed independently for each outcome. Different outcomes were evaluated, with preoperative ERCP as an intervention and intraoperative ERCP as the control: length of stays (four trials with mean differences – MD = -1.44; 95% confidence interval – 95%CI -3,87–0,98); bile leak (odds ratio – OR = 0.67; 95%CI 0.11–4.09); cholangitis (OR = 1.32; 95%CI 0.29–5.98); bleeding from sphincterotomy (OR = 0.98; 95%CI 0.20–4.86); wound infection (OR = 0.33; 95%CI 0.04–3.14); incisional bleeding (OR = 0.5; 95%CI 0.04–5.70); elevated amylase activity (OR = 5.22; 95%CI 2.17–12.59); acute pancreatitis (OR = 4.61; 95%CI 1.72–12.38); operative time (MD = -6,26; 95%CI -37.24–24.73); failure rate (OR = 1.74; 95%CI 0.99–3.05); conversion (OR = 1.34; 95%CI 0.6–2.96); morbidity (OR = 2.75; 95%CI 1.7–4.47). Conclusions: Risk of bias was significant due to lack of blindness. The morbidity, pancreatitis, and elevated amylase activity outcomes were the only ones to find statistical significance and favored the intraoperative approach.

Abstract in English:

ABSTRACT Purpose: To identify and describe the most used surgical repair methods for traumatic injuries to peripheral nerves, as well as highlight the causes of trauma to peripheral nerves and the most prevalent traumatized nerves. Methods: This is a systematic literature review using the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The searches were carried out in PubMED, in the time window from January 2018 to December 2022. Results: In total, 3,687 articles were collected, of which, after applying the inclusion and exclusion filters and analyzing the risk of bias, 34 articles remained. It was observed that the age of the injury and type of nerve repair strongly influence the recovery of patients. The most identified trauma repair procedures were neurolysis, direct suturing, grafting, and nerve transfer. Among these four procedures, direct suturing is currently preferred. Conclusion: Several repair methods can be used in peripheral nerve injuries, with emphasis on direct suturing. However, nerve transfer proves to be a differential in those cases in which repair is delayed or the first treatment options have failed, which shows that each method will be used according to the indication for each case.

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ABSTRACT Purpose: To summarize the available evidence and answer the following question: What is the current knowledge on the performance of blood concentrates in handling sequelae after lower third molar extractions with the evidence available in systematic reviews? Methods: An electronic search was conducted across nine databases. The study included systematic reviews with or without meta-analyses investigating the performance of blood concentrates in managing sequelae after lower third molar extractions. The four outcomes analyzed were pain, edema, mouth opening, and alveolar osteitis. The AMSTAR-2 tool assessed the methodological quality of the included systematic reviews, while ROBIS evaluated the risk of bias. Results: The electronic search revealed 690 records, of which 15 were eligible systematic reviews for the present study. Overall, these reviews evaluated 75 primary studies published from 2007 to 2023. According to AMSTAR-2, only one systematic review presented high methodological quality. The ROBIS tool showed two systematic reviews with a low risk, and the others had a high risk of bias. Conclusion: The current evidence is based on only one systematic review with high methodological quality and a low risk of bias, while the others exhibited a high risk of bias and low methodological quality. Therefore, the evidence regarding the efficacy of blood concentrates in controlling sequelae following lower third molar extractions is inconclusive.

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ABSTRACT Purpose: To conduct a systematic review of the mechanisms of photobiomodulation therapy (PBMT) for treating or preventing oral mucositis (OM) caused by antineoplastic therapy. Methods: Following PRISMA 2020 guidelines, a search was conducted in Medline, Latin American and Caribbean Health Sciences Literature (LILACS), Scientific Electronic Library Online (SciELO), and Bibliografia Brasileira de Odontologia from August to September 2023 using descriptors related to OM and laser therapy. Studies on the mechanisms of photobiomodulation in OM were included. Randomized (RCTs) or non-randomized trials from the past 10 years were reviewed. Risk of bias was assessed using RoB 2.0 and ROBINS-I tools. Results: A total of 355 studies was identified. After the screening, seven met the eligibility criteria. The RCTs showed a low risk of bias. PBMT reduced OM incidence in patients undergoing chemotherapy/radiotherapy. PBMT decreased pro-inflammatory cytokines (interleukin-6, tumor necrosis factor-α) and increased anti-inflammatory cytokines (interleukin-4, interleukin-10). It also modulated inflammatory mediators, enhancing the antioxidant enzyme superoxide dismutase and overexpressing genes for keratinocyte differentiation, aiding injury repair. Conclusion: The findings suggested that the mechanism of action of PBMT in OM involves modulation of the inflammatory response, balancing oxygen reactive species generation, and expression of factors related to healing or repair. Further studies are needed to elucidate these mechanisms and optimize treatment protocols.

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ABSTRACT Purpose: To determine risk factors for re-stricture after buccal mucosal graft urethroplasty (BMGU) through a systematic review and meta-analysis. Methods: Following PRISMA guidelines, we collected data from PubMed, Scientific Electronic Library Online (SciELO), and Web of Science databases. The eligibility criteria included studies with male patients over 18 years old with urethral stricture recurrence after BMGU. Results: We retrieved 646 papers from three electronic databases. Records that did not meet the eligibility criteria and duplicates were excluded, resulting in 14 papers (3,240 patients) that underwent qualitative analysis, from which nine papers were suitable for meta-analysis. The meta-analysis identified diabetes mellitus (relative risk – RR: 1.58 [95% confidence interval – 95%CI 1.02–2.46];p = 0.04), penile/peno-bulbar site (RR: 1.57 [95%CI 1.04–2.37]; p = 0.03), and stricture size higher than 7 cm (RR: 4.13 [95%CI 2.42–7.04]; p 0.00001) as a predictive factor of re-stricture. Conclusions: These findings may improve understanding the risk factors for this type of urethroplasty and help surgical decisions. For a more effective analysis, larger and better-distributed study groups and cohorts are needed in the future to clarify whether the combination of a previous disease and the urethroplasty etiology may impact a recurrence-free outcome after stricture correction.

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ABSTRACT Purpose: To create tridimensional (3D) anatomical models of diaphyseal fractures in dogs (3D AMDFD) and to evaluate the models from their radiographs. Methods: The study consisted of six stages: preparation of femur from a healthy dog cadaver; digitalization of the bone through a 3D scanner and creation of the base model; creation of a 3D AMDFD based on the image of the base model, 3D modeling carried out to reproduce five different types of diaphyseal fractures; printing the models produced on a 3D printer with a thermoplastic material; insertion of neodymium magnets in the fracture line to allow the assembly and disassembly of the parts; and radiography of 3D AMDFD in lateromedial and craniocaudal positions. Results: The base model and 3D AMDFD had high precision in the replication of bone structures, like the bone in natura. The radiopacity and radiolucency of the 3D AMDFD did not necessarily correspond to the bone densities found in the radiography of the natural canine femur. Conclusion: The 3D AMDFD and their respective radiographs accurately reproduced the anatomical structures and fracture lines.

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ABSTRACT Purpose: To investigate the relationship between the cartilage acetabular index and acetabular development and secondary dysplasia. Methods: A total of 58 hips underwent intraoperative arthrography-guided open reduction or limited open reduction due to developmental hip dysplasia between 2011 and 2015 was included in the study. We evaluated patients with acetabular angle 8º as group 2. Intraoperative acetabular cartilage index measurements were performed, and patients with low and high cartilage acetabular index were divided into two groups. Results: There was a correlation between the cartilage acetabular index value, which indicates preoperative cartilage acetabular coverage, and acetabular development and secondary acetabular development. Conclusion: The cartilage acetabular index is a technically easy and uncomplicated evaluation method that can be used to estimate acetabular development and should be used routinely together with the bone acetabular index.

Abstract in English:

ABSTRACT Purpose: The degenerative joint disease is a temporomandibular disorder. By analysing texture parameters, it becomes possible to characterize and differentiate various tissues, based on their textural properties according to cone-beam computed tomography (CBCT). This study evaluated degenerative diseases in the temporomandibular joint through texture analysis. Methods: Eighty images of the jaw condyle with three types of degenerative diseases, flattening, osteophytes, erosion and control group were analysed, obtained through CBCT. The analyses were carried out through texture analysis with three regions of interest (ROIs) corresponding to specific bone sites. The scans were exported to MaZda software, in which the ROIs were delimited following previously marked contours, and the co-occurrence matrix values were calculated for selected texture analysis parameters. Results: The erosion group showed a significantly different behaviour from the other groups for all analysed parameters. Conclusion: This study highlights the potential of texture analysis in characterizing medullary bone changes in condyles affected by erosion. Texture analysis allows for a more comprehensive assessment of bone condition on CBCT images. These results have implications for early detection and monitoring of degenerative changes in the temporomandibular joint, thus allowing preventive intervention and personalized treatment planning, improving the prognosis of the disease.

Abstract in English:

ABSTRACT Purpose: To establish a profile of the inflammatory response in the preoperative and postoperative period of pulmonary resection of patients without postoperative complications, in order to trace the inflammatory profile of lung resection surgery. Methods: Six collections of arterial and venous blood were performed for data analysis, one sample in the preoperative, immediate postoperative, 4, 8, 24, and 48 hours after surgery. Twenty-seven patients with a median age of 63 years old, ranging from 29 to 80 years old, were included. Results: The leukocyte count showed a significant increase in the times: immediate postoperative and 4 hours after surgery, in relation to the preoperative period. Concomitantly, there was an increase in lactate, heart rate, interleukin (IL)-6 and IL-8 after 4 hours of surgery. The platelet count showed a significant decrease in 48 h, associated with an increase in IL-1β and tumor necrosis factor-α. A significant increase in IL-10 was observed in the immediate postoperative. Conclusion: The study may contribute to the search for more specific and adequate alternatives for controlling the inflammatory response. In this way, the intervention would be specific to that cytokine that causes the greatest harm to the patient, as well as to the moment of the intervention.

Abstract in English:

ABSTRACT Purpose: To identify the prognostic variables related to the survival of patients operated on for adenocarcinoma of the rectum who underwent preoperative radiochemotherapy (RCT). Methods: We studied 70 patients from the Discipline of Surgical Gastroenterology at Escola Paulista de Medicina from 2000 to 2019, with rectal cancer located up to 10 cm from the anal verge and with stages II or III, submitted to preoperative RCT and curative surgery (R0) and with follow-up of at least 12 months. Clinical restaging was performed four to six weeks after the end of neoadjuvant treatment to characterize the degree of clinical tumor regression. Surgery by laparotomy or videolaparoscopy was performed six to 12 weeks after RCT. Primary endpoint were: overall survival (OS), disease-free survival (DFS), metastasis-free survival (MSS), and neoplasm-specific survival (SEN). These were compared with gender, age, carcinoembryonic antigen (CEA) dosage, distance from the tumor to the anal verge, radiation dose, radiotherapy-surgery interval, clinical regression, type of surgery, pT and pN TNM stage tumor, number of nodes, circumferential resection margin, and complete pathological response. Survival was assessed by Kaplan-Meier curves. Univariate and multivariate Cox analyses were calculated to identify factors associated with survival outcomes. Results: The mean follow-up time was 62 months. The pathological complete response rate was 18.6%. Univariate cox regression showed a significant relationship of CEA equal to or greater than 4 ng/mL with DFS and MFS, pT3/pT4 staging with DFS, MFS and SEN, pN1/N2 with DFS, MFS and SEN and stages II and III with DFS and MFS. Multivariate regression found that CEA, pT, and pN staging are independent prognostic factors for DFS, MFS, and SEN. Conclusion: Carcinoembryonic antigen level prior to radiotherapy, pT staging and pN staging were independent prognostic factors for survival in patients with rectal adenocarcinoma who are treated with preoperative radiochemotherapy.

Abstract in English:

ABSTRACT Purpose: Approximately 10% of breast cancer patients with localized operable disease experience recurrence. This study aimed to evaluate patients with early-stage breast cancer (TNM I and II) who underwent surgery without the need for neoadjuvant therapy. Methods: The total of 117 patients was included in the study: 104 without recurrence and 13 with recurrence. We analyzed various clinicopathological parameters, including body mass index, age at diagnosis, menopausal status, pesticide exposure, and tumor characteristics such as HER2 amplification, Ki67 index, molecular subtype, and histological grade. Results: Two primary subsets were identified as being associated with disease recurrence. The first subset (PC1) was characterized by HER2 amplification and metastatic disease, while the second subset (PC2) comprised premenopausal young women exposed to pesticides who had triple-negative tumors. While some of these factors are well-documented in the literature, pesticide exposure emerged as a notable regional factor contributing to poor outcomes in breast cancer patients. Conclusion: These findings underscored the significance of identifying local and regional risk factors when assessing recurrence risk in women with breast cancer, particularly in cases in which surgery is the primary treatment approach.

Abstract in English:

ABSTRACT Purpose: To assess the cost of traffic accidents in Brazil and the impact of age/location. Methods: All patients admitted to a Brazilian hospital due to traffic accidents from January 2012 to December 2022 and cost of hospital services were obtained from the Department of Information Technology of the Unified Health System. Demographic data were collected in the Brazilian Institute of Geography and Statistics database. Parametric and nonparametric data were analyzed. The Kruskal-Wallis’ test and a post-hoc test were used for data comparison. The ARIMA linear regression method for trend estimation. Results: In Brazil, 1.6 million individuals were involved in traffic accidents between 2012–2022, resulting in a cumulative hospital expenditure of US$ 38 million. The average hospital admission cost during this time was US$ 239.66, but no correlation was found between the cost per capita and driver population density increase. Hospitalization in the Midwest/South was higher. Conclusion: The economic impact of traffic accidents on the Brazilian public health system is significant. With a high number of victims admitted annually and evident regional and age-related disparities, there is a clear need for comprehensive and cost-effective healthcare strategies.

Abstract in English:

ABSTRACT Purpose: This study aimed to evaluate the epidemiological profile trends and economic impact of sickle cell disease (SCD) in Brazil from 2008 to 2022, focusing on incidence, mortality, and healthcare costs. Methods: A cross-sectional analysis was conducted using data from the Fundação Oswaldo Cruz’s platform, Plataforma de Ciência de Dados Aplicada à Saúde, encompassing hospitalizations related to SCD from January 2008 to December 2022. The International Classification of Diseases codes for SCD were used to retrieve data on incidence, mortality, procedures performed, and healthcare costs. Results: The study included 151,535 hospitalizations for SCD, with 69.92% associated with SCD crises and 22.48% without crises. The mean annual hospitalizations were higher for crises (6,883.06) compared to those without crises (2,221.12). Mortality rates were significantly higher for patients hospitalized with crises compared to those without crises (p < 0.001). The economic impact of SCD was substantial, with annual costs exceeding 413 million USD. Conclusion: This study revealed a significant burden of SCD in Brazil, characterized by high hospitalization rates, particularly among younger patients, and elevated mortality rates associated with crises. Prospective studies and public health interventions are warranted to address SCD and mitigate its impact on public health.