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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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ABSTRACT Purpose: To reveal the role and underlying mechanism of hirudin in renal fibrosis. Methods: The unilateral ureteral obstruction (UUO) rat model and ferroptosis activator RSL3-induced human kidney proximal tubular epithelial cells (HK-2) were established. Hematoxylin-eosin staining, commercial kits, and immunohistochemistry were used to assess the effect of hirudin on renal function and renal fibrosis. Cell counting kit-8 assay was employed to test cell viability. Ferroptosis indicator levels were detected using commercial kits. The protein levels were examined by Western blot. The STAT3 activator colivelin was introduced to verify the role of the STAT3/NLRP3 signaling pathway in ferroptosis. Results: Hirudin alleviated renal injury and improved renal fibrosis in UUO rats. The cell viability of RSL3-treated HK-2 cells was increased after hirudin treatment. In the model group, GPX4, SLC7A11, and glutathione expression decreased, while malondialdehyde and iron content levels increased, indicating that ferroptosis was activated. Besides, p-STAT3 and NLRP3 protein levels were also upregulated. However, hirudin treatment reversed these changes. When the STAT3 activator colivelin was added, the effect of hirudin was altered. Conclusion: Hirudin improved renal fibrosis by inhibiting ferroptosis via the STAT3/NLRP3 signaling pathway.

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ABSTRACT Purpose: To develop an experimental model of microsurgical scalp reimplantation in rabbits. Methods: Ten male albino New Zealand rabbits (Oryctolagus cuniculus) were scalped and subjected to scalp reimplantation. The rabbits’ scalp regions, including their ears, were surgically amputated. Based on a previous anatomical study, the superficial temporal artery and the central auricular vein were chosen for microanastomosis. Data on the morphometric parameters (vessel weight and caliber), surgical procedure (surgical time and number of stitches), and surgical recovery parameters (venous return, patency, and necrosis) were collected for up to 30 days postoperatively (PO) using a research protocol. Results: Morphometric and surgical recovery parameters did not significantly differ in our sample. No animals died during the intraoperative period. Three animals were euthanized because they developed partial or total scalp necrosis. The venous return was impaired from three to ten days PO, with spontaneous regression after this period, which significantly improved (p = 0.02) after 14 days PO. Superficial necrosis was observed starting at two days PO with complete resolution by day 21 PO (p <0.01). Conclusion: The rabbit provides a realistic biological model for training scalp reimplantation with high fidelity to human vascular structures.

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ABSTRACT Purpose: To evaluate the topical treatment with the ethanolic extract of Ocimum basilicum L. (OBEE) on excisional wounds in mice. Methods: The plant material was identified and collected, and the ethanolic extract was obtained from the aerial parts of O. basilicum. The OBEE was resuspended in saline at concentrations of 38 and 100 mg/kg for topical application on the left and right lesions, respectively. Mice were anesthetized, excisional wounds were made on the dorsal region and divided into four groups (n = 6) based on treatment duration: one, three, five, and 21 days. The control group received saline. After the treatments, the animals were euthanized, and the wounds were collected for histopathological analysis the inflammatory infiltrate, mast cell count, and deposition of newly synthesized collagen matrix. Results: The daily topical application of OBEE at concentrations of 38 and 100 mg/kg reduced the inflammatory response, evidenced by decreased leukocyte infiltration in the damaged tissue, and improved the deposition of newly synthesized matrix, with thicker, more intertwined collagen fibers resembling intact skin. These effects may be attributed to the phenolic compounds, tannins, flavonoids, and essential oils present in basil. Conclusion: OBEE shows promise as a potential healing agent in excisional wounds.

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ABSTRACT Purpose: To determine whether pinocembrin (PC) confers protective effects against experimentally induced intestinal ischemia-reperfusion (I/R) injury in rats. Methods: Thirty Wistar albino rats were randomly divided into three groups (n = 10 each): sham (underwent laparotomy only); I/R (superior mesenteric artery occlusion for 60 min followed by 60 min reperfusion); and I/R + PC (5 mg/kg PC intraperitoneally before ischemia and again prior to reperfusion). Total antioxidant capacity (TAC), total oxidant status (TOS), and oxidative stress index (OSI) were measured in both plasma and intestinal tissue. Histopathological evaluation was performed using hematoxylin and eosin staining and a modified Chiu scoring system. Results: Although TAC values did not show significant intergroup differences (p > 0.05), TOS and OSI values were significantly lower in the I/R + PC group than in the I/R group (p < 0.05). Histologically, the I/R + PC group displayed noticeably reduced mucosal damage compared to the untreated I/R group. These results suggest that PC alleviates oxidative stress and improves histological outcomes in intestinal I/R. Conclusion: PC exhibits a protective effect against intestinal I/R injury by decreasing oxidative stress and preserving tissue architecture. Further studies are warranted to optimize PC’s dosing, timing, and mechanistic actions for clinical application.

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ABSTRACT Purpose: To evaluate proteins from Plumeria pudica latex (LPPp) for their protective effect against ethanol-induced gastric injury in mice. Methods: The LPPp fraction was obtained by collecting P. pudica latex in tubes containing distilled water, followed by centrifugation and dialysis. The female Swiss mice (Mus musculus) received saline or LPPp (40 mg/kg) intraperitoneally 1 hour before oral administration of 500 μL of 50% ethanol. One hour later, the animals were euthanized, and their stomachs were removed for evaluation of tissue lesion area, histopathological analysis, and measurements of malondialdehyde (MDA), glutathione (GSH), superoxide dismutase (SOD), and nitrate/nitrite (NO3/NO2). An independent experiment assessed the effect of LPPp on gastric mucus production. Results: The LPPp-treated animals showed a significant reduction in the mean injured areas of gastric tissue (0.73 ± 1.01 mm2) compared to the ethanol group (37.99 ± 3.11 mm2). Histopathological analysis revealed significant preservation of tissue architecture in the LPPp group compared to ethanol group. Additionally, LPPp maintained tissue levels of MDA, GSH, SOD, and NO3/NO2 comparable to the saline group and influenced gastric mucus production favorably (p < 0.05). Conclusion: These results suggested that LPPp has a protective effect against ethanol-induced gastric lesions, likely involving antioxidant activity and increased gastric mucus production.

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ABSTRACT Purpose: To investigate the impact of grape seed proanthocyanidin B2 (GSPB2) pretreatment on hypoxia-reoxygenation model of HK-2 cells in vitro. Methods: The experiment was divided into five groups: control group (control), GSPB2 group (GSPB2), hypoxia-reoxygenation group (HR), GSPB2 + HR group (GSPB2+HR), and GSPB2 + brusatol (BRU) + HR group (GSPB2 + BRU + HR). Flow cytometry was used to detect apoptosis of cells. Transmission electron microscopy was employed to observe ultrastructural changes of cells. Mitochondrial membrane potential (MMP) was measured. Cellular immunofluorescence was used to assess intracellular Ca²+ concentration. Immunofluorescence staining and Western blotting were conducted to detect expression levels of Nrf2, HO-1, glucose-regulated protein 78 (GRP78), C/EBP homologous protein (CHOP), and cleaved-caspase3. Results: Compared to HR group, GSPB2 + HR group showed significantly increased cell viability, and reduced mitochondrial damage in the cytoplasm. MMP in GSPB2 + HR group was significantly restored, and intracellular Ca²+ concentration was significantly decreased. The expression of Nrf2 and HO-1 proteins was significantly upregulated, while the expression of GRP78, CHOP, and cleaved-caspase3 proteins was markedly downregulated. Conclusion: GSPB2 pretreatment can alleviate oxidative stress damage, mitochondrial injury, and endoplasmic reticulum stress induced by hypoxia-reoxygenation in HK-2 cells in vitro. This effect may be related to the ability of GSPB2 pretreatment to activate the endogenous antioxidant system, particularly through the activation of the Nrf2/HO-1 signaling pathway.

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ABSTRACT Purpose: To evaluate the potential protective effects of naringin on liver by oxidative parameters and signal peptide-CUB-EGF-like domain-containing protein (SCUBE)-1 and 2 in an experimental cholestatic liver ischemia reperfusion (IR) model. Methods: Twenty-four female rats were divided into three groups; sham, control, and treatment. Groups 2 and 3 underwent bile duct ligation, and one week later, 45 min of ischemia and 1 hour of relaparotomy and reperfusion were performed. To the treatment group, naringin was administered through relaparotomy. Liver tissue and blood samples were taken. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), total bilirubin (TBIL), direct bilirubin (DBIL), ischemia-modified albumin (IMA), SCUBE-1, SCUBE-2, total antioxidant status (TAS), and total oxidant status (TOS) levels were also examined. Results: Serum ALT, AST, ALP, TBIL, DBIL, and IMA levels were higher in groups 2 and 3. There was no significant difference in terms of SCUBE-1 and 2 levels (p > 0.05). TAS was the highest in group 3, and TOS was the highest in group 2 and lower in group 3. In histopathological analysis, all parameters were statistically significant between group 3 and the other groups (p < 0.05). Conclusion: Naringin has promising results in the treatment of experimental IR injury in cholestatic liver due to its antioxidant effects. We think that it can be used in clinical studies after more comprehensive studies investigating its effects on IR damage in cholestatic liver.

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ABSTRACT Purpose: To develop a holographic skull model of a deformity resulting from craniosynostosis for the HoloLens. Methods: The methodology for product creation and prototyping was the design thinking structured with the double diamond. A desk survey was conducted with a literature review and an anteriority search. Based on the desk survey results, brainstorming was performed to develop solutions to improve the surgeon’s performance in craniosynostosis using mixed reality. Results: Reports or scientific articles relating mixed reality use to craniosynostosis were not found in search engines or bibliography databases. A surgeon’s performance potential improvement was observed using mixed reality as an auxiliary tool in craniosynostosis surgery. A craniosynostosis skull hologram was developed in mixed reality, with interactivity commands controlled by gestures, facilitating a three-dimensional spatial understanding of cranial anatomy. Conclusion: A holographic skull model with a deformity resulting from craniosynostosis was developed for the HoloLens.

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ABSTRACT Purpose: To evaluate the effect of curcumin administered by gavage, on reducing intra-abdominal adhesions and attenuating the inflammatory process, assessed by a serum marker. Methods: Forty Wistar rats were randomly divided into two groups: the curcumin group, and the control group. The curcumin group received curcumin by gavage at the dose of 200 mg/kg over the seven days preceding and the seven days following surgery. In the control group, an isovolumetric administration of 0.9% saline solution was given by gavage. Both groups underwent a median laparotomy and left-sided colotomy. On the eighth postoperative day, the animals were euthanized for intracavitary adhesion analysis and left colon resection for histological examination. Intra-abdominal adhesions were classified from grade 0 to 4 based on increases in number, intensity, and ease of lysis. Results: Curcumin administration did not significantly reduce the severity of intra-abdominal adhesions (p = 0.7143) nor the severity of colonic inflammatory infiltration. However, a significant reduction in C-reactive protein levels was observed preoperatively in the curcumin group (p 0.05). Conclusion: While curcumin was not able to reduce the severity of intra-abdominal adhesions, it demonstrated the ability to attenuate the inflammatory process associated with the surgical procedure.

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ABSTRACT Purpose: To evaluate ceftriaxone’s potential in enhancing peripheral nerve injuries (PNIs) recovery. Methods: Thirty male Wistar rats were divided into control (no surgery), vehicle (sciatic nerve injury + 0.9% NaCl), and ceftriaxone (sciatic nerve injury + 50 mg/kg/day ceftriaxone) groups. Treatments were administered intraperitoneally for 12 weeks. Functional recovery was assessed using inclined plane tests and electromyography. Sciatic nerve regeneration was evaluated via histology, nerve growth factor (NGF) immunohistochemistry, and enzyme-linked immunosorbent assay. Results: Compared to the control group, inclined plane test scores, nerve action potentials, NGF expression, axon counts, and diameters were diminished in both injury groups (p 0.001). However, these parameters were significantly improved in the ceftriaxone group compared to the vehicle group (p 0.001). Increased fibrosis was observed in the ceftriaxone group. Conclusion: Ceftriaxone demonstrates potential as a pharmacological agent for PNI recovery by enhancing nerve regeneration and functional outcomes. Further studies are warranted to elucidate its mechanisms.

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ABSTRACT Purpose: To develop a pericardiocentesis (PCT) simulation model applied for undergraduate medical training. Methods: A PCT simulator consisted of a torso mannequin, a silicone rubber heart (SRH), a container, and a filling system. The mannequin was submitted to a coronal section and an 18 × 18-cm precordial area opening. The SRH was prepared in accordance with structural dimensions of a normal heart. The elaboration of a structure container to simulate the pericardial cavity consisted of a non-leakable unit inside a cardboard (PcavBox). The PcavBox filling system was connected to a 10-mm diameter tube and a total of 2.5 L of saline solution. This structure was adapted inside the mannequin and covered with a thermoformable rubber material of 2 mm in skin color. For PCT simulation, we used a 10-mL syringe connected to a 14G needle for an imaging guided puncture facilitated by a portable ultrasound. Results: A SRH was successfully developed and fixed inside the Pcav Box, connected to the fluid pressure system. It was able to simulate a cardiac tamponade scenario identified by ultrasound. A series of 50 punctures was successively performed without liquid leak. Conclusion: A low-cost PCT simulator was developed and coan be applied to healthcare education.

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ABSTRACT Purpose: To detail a technique to implant a double-lumen catheter to remove anti-pig antibodies. We transplanted fetal pig kidneys into cynomolgus monkeys using a double filtration plasma exchange (DFPP) protocol. Methods: Two approaches for double-lumen catheter insertion in monkeys (3–9.2 kg) were developed. DFPP was performed using hydroxyethyl starch (6%) as a replacement fluid. We transplanted fetal porcine kidneys, administered immunosuppressive agents, and evaluated the grafts. Results: The catheter insertion site was large, with postoperative hemostasis similar to blind subcutaneous puncture. Monkeys tolerated DFPP well, maintaining stable blood pressure. The technique reduced anti-pig antibodies by 67%, though acute rejection was not fully suppressed. Conclusion: A safe technique for double-lumen catheter placement in cynomolgus monkeys was developed, along with a DFPP protocol for reducing anti-pig antibodies.

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ABSTRACT Purpose: To evaluate the effectiveness of a new format of prophylactic mesh, with a new method of placement. Methods: Rabbits were randomly distributed into four groups: control rabbits without laparotomy group; sutured rabbits (SR); light-weight mesh rabbits (LWMR); and heavy-weight mesh rabbits (HWMR). The meshes were cut to a size of 10 cm in length by 1 cm in width. A longitudinal, median abdominal incision, 11 cm in length, was performed, followed by an incision over the linea alba, encompassing the entire thickness of the abdominal wall. On the 91st postoperative day, the animals were killed for linea alba scar evaluation. Results: There was a significant difference among the evaluated groups concerning elongation, maximum load, and elasticity modulus. HWMR and LWMR were statistically different from controls regarding elongation. As for the elasticity modulus, SR presented a higher mean when compared to the others. Microscopic visual analysis showed greater fibrotic scarring with a larger amount of implanted material in HWMR. Conclusion: The reinforcement of scars with polypropylene mesh does not increase tensile strength when compared to the use of sutures. Mesh implantation results in scar remodeling with greater fibrosis, leading to increased elongation. However, midline reinforcement using only sutures has greater elasticity than the groups reinforced with mesh.

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ABSTRACT Purpose: To examine the antiulcerative and antioxidant action of the Anacardium occidentale hydroalcoholic leaf extract (HEA) on experimentally induced colitis in rats via acetic acid (AA). Methods: Male rats were distributed into six groups (n = 10 per group): C (control), CC (colitis control), SZC (sulfasalazine 500 mg/kg), and three doses of HEA (HEA50 = 50 mg/kg, HEA100 = 100 mg/kg, HEA200 = 200 mg/kg). Results: The treatment with HEA100 for seven days decreased diarrhea, increased food intake, attenuated weight loss, and recovered the macroscopic and histological parameters of the colon, mitigating the severity of colitis and restoring the intestinal morphophysiology of animals with induced colitis. Additionally, HEA50 and HEA100 treatment increased the activity of superoxide dismutase, catalase, and thiol, and reduced the levels of thiobarbituric acid reactive substances and carbonyl, contributing to the re-establishment of antioxidant homeostasis. Conclusion: This study provided preclinical evidence of the potential of A. occidentale leaf extract, particularly at the concentration of 100 mg/kg, as an antiulcer agent for attenuating colitis in rats, likely due to the positive modulation of the antioxidant system.

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ABSTRACT Purpose: We builted a orthotopic autologous liver transplantation (OALT) model in rats to evaluate the possible mechanisms of berberine against lung injury. Methods: Forty clean grade Sprague-Dawley rats (male, healthy, 250–280 g) were divided into five groups (n = 8): sham-operated group (group S), orthotopic autologous liver transplantation group (group T), berberine group (group B), peroxisome proliferator-activated receptor gamma (PPARγ) inhibitor GW9662 group (group G), and berberine + GW9662 group (group B+G). In group S, the relevant tissues around the liver were dissociated only. Orthotopic autologous liver transplantation was used in other groups, berberine 200 mg/kg/day was given one week before surgery in group B and group B+G. GW9662 1 mg/kg was intraperitoneally injected in group G and group B+G 4 hours before surgery. Blood samples were obtained for detecting PaO2 and the concentration of serum clam cell protein (CC16), surfactant protein-D (SP-D), interleukin (IL)-1β and IL-18. The immunohistochemical method detects the expression of PPARγ and nuclear factor-kappa B (NF-κB) in lung tissues. The expression of PPARγ, NF-κBand pyroptosis-related proteins were analysed by western blotting. Results: Rats exhibited increased histological lung injury following OALT. Liver transplantation caused upregulated CC16, SP-D, IL-18 and IL-1β levels, reduced PaO2 and the PPARγ expression, upregulated the NF-κB and pyroptosis-related protein expressions. BBR pretreatment greatly alleviates these lung damages induced by OALT. However, administration of GW9662 partially reversed the beneficial effects of BBR on lung injury. Conclusion: Berberine may play protective capacities against lung injury by upregulating PPARγ to downregulate the NF-κB-mediated pyroptosis pathway.

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ABSTRACT Purpose: To scrutinize the hepatoprotective effect of Paederia foetida against paracetamol-induced hepatobiliary in rats. Methods: Rats were received the oral administration of paracetamol (3 mg/kg) empty stomach for the induction of hepatobiliary in rats except normal rats. the rats were received the oral administration of P. foetida. The hepatic, non-hepatic, antioxidant, and inflammatory parameters were estimated, as well as the mRNA expression. Results: Paederia foetida treatment remarkably suppressed the level of hepatic parameters such as alkaline phosphatase, alanine transaminase, aspartate aminotransferase; and non-hepatic parameters like creatinine, total protein, bilirubin, and blood urea nitrogen level at dose dependent manner. It also altered the level of antioxidant parameters such as lipid peroxidation, superoxide dismutase, glutathione peroxidase, glutathione, and catalase in the serum, as well as hepatic tissue, and also suppressed the level of cytokines such as tumor necrosis factor-α, interleukin-1β, interleukin-6; and inflammatory parameters such as cyclooxygenase-2, prostaglandin, and nuclear factor kappa B, respectively. Paederia foetida also altered the level of nuclear factor erythroid 2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1). Conclusion: Paederia foetida exhibited the hepatoprotective effect against paracetamol-induced hepatobiliary disease in rats via inflammatory and Nrf2/HO-1 pathway.

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ABSTRACT Purpose: To evaluate the effectiveness and biocompatibility of a three-dimensional (3D) thermoplastic elastomer (TPE) prosthesis for repairing partial tracheal defects using 3D printing with fused deposition modelling. Methods: Thirty-two rabbits underwent partial resection of five tracheal rings and were divided into two groups: the muscular flap group (GFM), which received a sternocephalic muscle flap over the defect; and the TPE group (GTPE), which received a 3D-printed TPE prosthesis. Clinical evaluations were performed at seven, 15, 30, and 60 days postoperatively. Results: Cough was significantly more frequent in the GFM group (p = 0.035). Thermography showed no significant differences in surgical site temperatures between groups or time points. Tracheoscopy revealed more intraluminal secretions in the GTPE group (p = 0.006) and more exuberant tissue formation in the GFM group (p = 0.001). Complete epithelialization was observed in the GFM group after 60 days. Conclusion: The 3D TPE prosthesis demonstrated tissue compatibility and viability as an implant for partial tracheal defects, with minimal respiratory complications during the 60-day evaluation period.

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ABSTRACT Purpose: Glioblastoma (GBM) is the most common primary brain tumor in the central nervous system. Studies revealing the molecular mechanisms regulating GBM pathogenesis are currently limited. This study aimed to investigate the expression of genes responsible for the apoptotic pathway (p21, p27, p53) after separate and combined application of the natural components resveratrol (Res) and temozolomide (TMZ) in the GBM cell line (U118). Methods: In this study, the GBM cell line U118 was used. Apoptotic activation of Res and TMZ via the p21, p27, p53 signaling pathway was evaluated by quantitative reverse transcription polymerase chain reaction and TaLi cytometry. Cell viability was also assessed using the MTT assay. Results: Res and TMZ inhibited the proliferation and migration of U118 cells. Additionally, Res induced apoptosis by arresting the cell cycle. Moreover, Res treatment upregulated the expression of p27 and p53, which are associated with apoptosis, while it significantly downregulated the expression of the p21 gene. Conclusion: These results indicated that Res and TMZ suppressed the proliferation of GBM cells through apoptotic pathways. Together, Res and TMZ may represent a promising combination for suppressing tumors through apoptotic mechanisms.

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ABSTRACT Purpose: To evaluate an experimental model of anal fistulas in rats, analyze the primary challenges associated with this model, and identify its key advantages. Methods: Twenty-six male Wistar rats underwent surgical induction of two anal fistulas each, using a metal seton. The setons remained in place for 30 days, after which they were removed. Animals were divided in two groups (n = 13 per group). Group 1 was euthanized two weeks post-seton removal, and Group 2 in four weeks post-seton removal. Two fistula tissue samples were collected from each animal for histopathological analysis. Results: All 26 animals tolerated the procedure well, with an average weight gain of 64.3 grams in 30 days. There was no animal loss during the experiment, but eight setons were lost due to poor fixation. One animal lost both setons and had to be excluded from the experiment, resulting in a 96% success rate. All 44 remaining fistulas could be identified by observing the scar on the external orifice, two and four weeks after the removal of the metal wire. Conclusion: The two groups showed no differences. The experimental model in this work proved to be quite effective, economically viable and easy to reproduce.

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ABSTRACT Purpose: To evaluate whether enemas containing sucralfate (SCF) alone or in combination with n-acetylcysteine (NAC) reduces inflammation and oxidative stress (OS) in the colonic mucosa without fecal stream. Methods: Forty-eight rats were subjected to left colostomy and distal rectal mucous fistula. During the procedure, 2 cm of the colon was collected to constitute the sham group. Twelve weeks after the surgical procedure, the animals were divided into two groups (n = 24) and received daily enemas containing saline, SCF (2 g/kg), NAC (100 mg/kg), or SCF + NAC (2 g/kg + 100 mg/kg, respectively) for two or four weeks. At the end of the intervention period, the animals were euthanized, and colonic segments without fecal stream were removed for histological and biochemical analyses. The diagnosis of colitis was made by histological analysis, and the inflammatory score was assessed using a validated scale. The neutrophilic infiltrate was evaluated by quantifying the content of myeloperoxidase (MPO) in the tissue. OS was determined by evaluating the activity of colonic antioxidant systems (superoxide dismutase, catalase, and reduced glutathione) and malondialdehyde (MDA) levels. The differences among subgroups were analyzed with the Mann-Whitney’s test, whereas changes over time were analyzed via the Kruskal-Wallis’ test, with the significance level of 5% (p < 0.05). Results: Enemas with SCF and NAC alone or in combination reduced colonic inflammation and the tissue levels of MPO and MDA and increased the levels of antioxidant enzymes. Conclusion: SCF and NAC enemas alone or in combination reduced inflammation activity and OS in colon segments without fecal stream.

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ABSTRACT Purpose: Diabetic foot ulcers (DFUs) are chronic lesions, and despite extensive research, no standardized treatment exists yet. This study aimed to evaluate the effect of frog skin application as a temporary dressing on the DFUs of diabetic rats. Methods: Diabetes was induced in male Wistar rats (n = 22) weighing 200–300 g through a streptozotocin injection (55 mg/kg). The animals received sub-doses of long-acting insulin to induce a moderate, chronic diabetic state. A DFU was surgically created on the animal’s paws (1 × 1 cm). The animals were divided into two groups: a control group treated with gauze and 0.9% saline solution (n = 10), and the frog skin group (n = 12). Both groups were further subdivided so it was possible to analyze their healing on postoperative 7 and 14 days (POD7 and POD14). The primary endpoints assessed included DFU contraction area, histological analysis, and gene expression. Results: On POD14, the frog skin group showed six times less contracture when compared to the control group. Histological analysis revealed a 30% increase in neoangiogenesis and 50% reduction in inflammation in the POD14 frog skin group when compared to the control group. Additionally, on POD7, Il10 expression was about five times higher in the frog skin group compared to the respective control (p = 0.011). Conclusion: This study suggests that the use of frog skin as temporary biological dressing can reduce DFU secondary contraction and inflammation, offering potential therapeutic benefits for chronic wound management.

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ABSTRACT Purpose: The potential of corynoline in ameliorating oxidative stress and inflammatory responses has been extensively demonstrated across various diseases. However, its specific role in the context of renal ischemia-reperfusion (IR) injury remains elusive. The aim of this study was to investigate the role of corynoline in renal IR injury and its mechanism. Methods: A rat model of renal IR injury was successfully developed. Samples of kidney tissue and blood were obtained to evaluate alterations in tissue damage, inflammatory response, oxidative stress, and apoptosis. Results: Corynoline significantly reduced renal IR injury, thus leading to improved renal function and mitigated tissue structure damage and cell apoptosis. Moreover, corynoline effectively suppressed the oxidative stress and inflammatory response induced by IR by increasing the superoxide dismutase (SOD) content, reducing the malondialdehyde (MDA) level, inhibiting neutrophil infiltration, and suppressing the release of proinflammatory cytokines. Mechanistically, corynoline successfully restored the expression of nuclear factor erythroid 2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1), which were significantly inhibited during renal IR injury. Furthermore, when coadministered with ML-385 (an Nrf2 inhibitor), the protective effect of corynoline against renal IR injury was counteracted. Conclusion: Corynoline protects against renal IR injury by suppressing oxidative stress, inflammatory responses, and apoptosis, and its mechanism of action may involve the activation of the Nrf2/HO-1 pathway.

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ABSTRACT Purpose: In this study, we scrutinized the protective effect of lotus leaf (LF) against high-fat diet (HFD) induced liver injury in rats. Methods: The rats received the HFD for the induction of non-alcoholic fatty liver disease. Rats received the oral administration of LF (25, 50, and 100 mg/kg, b.w.). The insulin level, organ index, glucose level, hepatic, oxidative stress, lipid and cytokines parameters were measured. The different mRNA expression and histopathology were performed in the hepatic tissue. Results: LF treatment suppressed the insulin, glucose and HOMA-IR along with organ index (liver index and spleen index). LF treatment altered the level of liver parameters (aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, gamma-glutamyl transferase) and oxidative stress parameters in the serum, as well as the liver tissue. LF treatment altered the level of lipid parameters and fat parameters (total fat, perirenal fat, abdominal fat, epididymal fat); cytokines (tumor necrosis factor-α, interleukin-1β, interleukin-6, interleukin-10, interleukin-17, interleukin-33); HO-1, and Nrf2. LF treatment altered the mRNA expression of tumor necrosis factor-α, interleukin-1β, interleukin-6, interleukin-10, caspase-3, caspase-9, cytochrome C, cytochrome D, AMP-activated protein kinase (AMPK), sirtuin 1 (SIRT1), FRX-1, liver X Receptor alpha, fibronectin, matrix metalloproteinase-9, inducible nitric oxide synthase, and transforming growth factor-β 1 (TGF-β1). LF treatment suppressed the necrosis of hepatocytes with less inflammatory cell infiltration in the liver tissue along with alteration of liver injury score. Conclusion: The result showed the protective effect of LF against non-alcoholic fatty liver disease via activating the AMPK/SIRT1 and Nrf2/HO-1 pathway activation.

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ABSTRACT Purpose: To investigate the protective effects of fisetin on ovarian ischemia-reperfusion injury in rats, focusing on the modulation of the TLR4-MyD88-TRAF6 signaling pathway. Methods: Wistar rats randomly divided into different groups received oral administration of fisetin (5, 10 and 15 mg/kg). Body weight and ovary weight were measured. Hormones, hematological, antioxidant, cytokines, inflammatory and apoptosis parameters were assessed. Histological and histopathologic evaluations were conducted on ovary tissue. Different mRNA expressions were estimated. Results: Dose dependent treatment significantly improved body and ovary weight along with alteration in hematological parameters such as red blood cells, white blood cells, hemoglobin, platelet, lymphocyte; antioxidant parameters, including malonaldehyde, superoxide dismutase, glutathione, glutathione peroxidase, catalase; cytokines viz., tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), interleukin-6 (IL-6), interleukin-10 (IL-10), interleukin-18 (IL-18); inflammatory parameters such as cyclooxynase-2, inducible nitric oxide synthetase (iNOS), prostaglaindin, nuclear kappa B factor (NF-κB), C reactive protein and apoptosis parameters, including Bcl-2, Bax, and caspase-3. Fisetin treatment significantly (p < 0.001) altered the mRNA expression of TNF-α, IL-6, IL-1β, IL-10, Bax, Bcl-2, caspase-3, toll-like receptor 4, myeloid differentiation primary response protein 88, tumor necrosis factor receptor-associated factor 6, endothelial nitric oxide synthase, iNOS, NF-κB, inhibitor of kappaB kinase alpha, heme oxygenase-1, and nuclear factor erythroid 2-related factor 2. Fisetin treatment altered the hemorrhage, vascular proliferation, polymorphonuclear leukocyte, edema, vascular congestion, and apoptosis. Conclusion: Fisetin ameliorated the ovary injury against ovarian ischemia-reperfusion via conquering TLR4-MyD88-TRAF6 signaling pathway.

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ABSTRACT Purpose: To evaluate the protective effect of Caesalpinia sappan and spirulina against gastritis and determine changes in the expression of CD8, CD68, and major histocompatibility complex (MHC) molecules. Methods: Gastritis was induced in 24 female Wistar albino rats on the first day using ethanol. The treatment groups were given C. sappan (250 mg/kg) and spirulina (400 mg/kg) using oral gavage for five days. Blood and stomach tissue samples of the mice were analyzed. Results: Caesalpinia sappan and spirulina increased CD8 and CD68 expression and tumor necrosis factor-alpha levels thereby decreasing the severity of inflammation. It was found that they simultaneously decreased MHC I and MHC II expressing cells, increased superoxide dismutase levels, whereas malondialdehyde, and myeloperoxidase levels decreased in the treatment group. Conclusion: This study revealed that C. sappan and spirulina can protect gastric mucosa by reducing oxidative stress and inflammation.

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ABSTRACT Purpose: Mitophagy is an important process in brain damage, and the precise impact on a traumatic brain injury (TBI) model remains unclear. AMP-activated protein kinase (AMPK) regulates mitochondrial homeostasis and mitophagy, which are closely related to the remission of early brain injury. This study sought to explore the mechanism behind AMPK/optic atrophy 1 (OPA1) pathway in TBI via experimental verifications. Methods: TBI mouse model induced by weight-drop method was applied in this study. Neurological function tests, Nissl staining, TUNEL staining, and transmission electron microscopy were undertaken to assess the effects of mitophagy on the TBI model. Levels of apoptosis-related factors and mitophagy-related indicators were detected to further reveal the molecular regulatory mechanism of mitophagy in TBI. Results: Activation of mitophagy (MK-8722 or rapamycin treatment) reduced the severity of brain damage and mitigated neurological function deficits following TBI. MK-8722 treatment reduced neuronal apoptosis, improved neuronal mitophagy, effectively inhibited the expression of proteins Bcl-2 and Bax, and increased the expression of proteins Parkin, PINK1 and OPA1. Besides, MK-8722 improved TBI through accelerating the AMPK/OPA1 pathway, resulting in increase of mitophagy. Conclusion: This study is the first to pinpoint the AMPK/OPA1 pathway’s involvement in TBI and the mechanism of mitophagy, thereby providing a good foundation for future experimental studies.

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ABSTRACT Purpose: This study analyzed the protective effects of enoxaparin in rat uteruses by exposing the uterus to experimental ischemia-reperfusion injury. Methods: Thirty female rats were homogenized by weight and cycle and divided into three groups: a control group, an ischemia-reperfusion (I/R) group, and an ischemia-reperfusion plus enoxaparin (I/R+E) group. An experimental uterine I/R model was established in the I/R and I/R+E groups. Unlike I/R group, all rats in the I/R+E group received subcutaneous enoxaparin at 0.5 mg/kg 2 hours before ischemia. In histopathological analysis, endometrial glandular and endo/myometrial stromal changes were scored according to the histopathological scoring system. Biochemically, catalase (CAT), superoxide dismutase (SOD) enzyme activities, and malondialdehyde (MDA) levels were measured in uterine tissues. Results: In histopathological analysis, all of the control group’s scores were lower than those of the other groups, except for necrosis (p 0.05). There was no significant improvement in the glandular and stromal changes between I/R and I/R+E (p 0.05). However, the I/R+E group showed significantly increased SOD and CAT activities and decreased MDA levels compared to the I/R group (p = 0.000). Conclusion: Although enoxaparin did not significantly improve histopathological injury, its potent antioxidant effects suggest a protective role against oxidative stress in uterine I/R injury.

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ABSTRACT Purpose: To investigate the potential pleiotropic effects of liraglutide (LG), a glucagon-like-peptide-1 analog, on gastric ulcer prevention in rats with diabetes induced by streptozotocin (STZ). Methods: We randomly divided 63 male Wistar rats into seven groups. STZ was administered intraperitoneally (IP) to the animals in the diabetic control (group STZ), diabetic control + indomethacin (INDO) (group STZI), STZ + INDO + omeprazole (group OMP), STZ + INDO + LG (0.2 mg/kg) (group 0.2LG), and STZ + INDO + LG (0.4 mg/kg) group (group 0.4LG). We administered OMP IP to group OMP, 0.2 mg/kg LG to group 0.2LG SC, 0.4 mg/kg LG to group 0.4LG SC, normal saline to non-diabetic control (sham group), group STZ, non-diabetic control + INDO (group KI), and group STZI SC. INDO was administered to the animals in groups KI, STZI, OMP, 0.2LG, and 0.4LG by gavage. Then, the caspase-3, epidermal growth factor (EGF), vascular endothelial growth factor-A (VEGF-A), prostaglandin E2 (PGE2), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), superoxide dismutase-1 (SOD-1), glutathione (GSH), and malondialdehyde (MDA) levels were studied. Results: LG prevented INDO-induced ulcers and decreased apoptosis in the stomach tissue. It increased the SOD-1, GSH, EGF, VEGF-A, and PGE2 levels, and reduced the MDA, IL-6, and TNF-α levels. The anti-ulcer effect of LG was lower, but close to that of OMP. Conclusion: The antioxidant, anti-inflammatory, and anti-apoptotic effects of LG, its ability to regulate EGF, VEGF-A, and PGE2 levels, and its capacity to reduce blood glucose levels in diabetic rats may contribute to its anti-ulcer effect.

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ABSTRACT Purpose: To examine the protective effect of alpinumisoflavone against streptozotocin (STZ)-induced gestational diabetes mellitus (GDM) in female rats and explored the underlying mechanisms. Methods: Female rats were used in this study, and intraperitoneal administration of STZ (55 mg/kg) was used to induce diabetes. Body weight, blood glucose level, fetuses, placental weight, and placental index were estimated. Oral glucose tolerance test (OGTT) and insulin tolerance test (ITT) were performed. The levels of resistin, glycated hemoglobin (HbA1c), hepatic glycogen, free fatty acid (FFA), adiponectin, serum C-peptide, leptin, visfatin, intercellular adhesion molecule 1 (ICAM-1), vascular cell adhesion molecule 1 (VCAM-1), lipids, oxidative stress, inflammatory cytokines, and other parameters were estimated. mRNA expression was estimated in the pancreatic tissue. Results: Alpinumisoflavone treatment significantly (p < 0.001) enhanced body weight and fetuses and decreased placental weight and placental index. Alpinumisoflavone treatment significantly (p < 0.001) decreased blood glucose levels (BGL) and improved plasma insulin levels. Alpinumisoflavone treatment significantly (p < 0.001) suppressed the glucose and insulin levels in the OGTT and ITT. Alpinumisoflavone treatment significantly (p < 0.001) altered the levels of resistin, HbA1c, hepatic glycogen, FFA, Adiponectin, serum C-peptide, leptin, visfatin, ICAM-1, and VCAM-1; lipid parameters; oxidative stress parameters; inflammatory cytokines and inflammatory parameters, viz., cyclooxygenase-2 (COX-2), and nuclear kappa B factor (NF-κB). Alpinumisoflavone treatment significantly (p < 0.001) altered the mRNA expression levels of Toll-like receptor 4, nuclear kappa B factor65 (NF-κB65), NOD-, LRR-, pyrin domain-containing protein 3 (NLRP3), MyD88, SREBP-1, stearoyl-CoA desaturase-1 (SCD1), FAS, and ACC. Conclusion: Alpinumisoflavone has a protective effect against STZ-induced GDM via alteration of the TLR4/MyD88/NF-κB signaling pathway.

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ABSTRACT Purpose: To compare and evaluate the radiologic, clinical, and histopathologic results of the treatment methods applied in diaphyseal tibial fractures. Methods: A complete tibial fracture was created in the tibial diaphysis in each rabbit. Experimentally generated fracture fragments were fixed by intramedullary pinning. In the control group (group I), the bone fracture area was left to heal without any treatment technique. Group II received low-energy laser therapy once daily to the surgical side for 30 days; group III, autologous bone marrow aspirated from the left proximal tibia; group IV, a combination of bone marrow obtained by aspiration and synthetic β-tricalcium phosphate (β-TCP); and in group V, a platelet-rich fibrin (PRF) membrane obtained from the central auricular artery was applied to the fracture side. Results: In the X-ray analysis, it was determined that group IV had the fastest score increase, while group I had the lowest scores. In group IV, no lameness that persisted until the end of the study was observed in any rabbit. When the histopathological scores of the different groups were examined, it was seen that the lowest score belonged to group I, and the highest score was in group IV. Conclusion: The highest rate of new bone formation and bone regeneration was achieved when the combination of aspirated bone marrow and β-TCP granules was applied. The experimental group with PRF membrane application exhibited the least osteogenic characteristics among all experimental groups.

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ABSTRACT Purpose: To investigate the optimal therapeutic sequence of rhGM-CSF combined with hypofractionated radiotherapy (HFRT) in treating mouse pancreatic cancer (PC) and explore the mechanisms. Methods: A PC-bearing model was established. The antitumor effects were observed under rhGM-CSF, HFRT, rhGM-CSF + HFRT, rhGM-CSF&HFRT, and HFRT + rhGM-CSF treatments. Tumor histopathological changes were examined using hematoxylin and eosin (H&E) staining. FCM was employed to detect calreticulin (CRT), mDCs, CD4+, and CD8+ T cells. Enzyme-linked immunosorbent assay (ELISA) was used to measure HMGB1, adenosine triphosphate (ATP), interleukin- (IL)-2, IL-4, IL-8, IL-10, IL-12, IFN-γ, tumor necrosis factor (TNF)-α, and iNOS levels. IF staining was performed to detect CD31 and α-smooth muscle actin, and immunohistochemistry was used to detect vascular endothelial growth factor (VEGF), soluble VEGF receptor-1 (sVEGFR-1), hypoxia-inducible factor- (HIF)-1α, and HIF-2α expression. Results: HFRT + rhGM-CSF inhibited tumor growth, promoted tumor necrosis, and increased inflammatory cell infiltration. This regimen also significantly enhanced immunogenic cell death by inducing CRT exposure and the release of HMGB1 and ATP. Furthermore, HFRT + rhGM-CSF markedly increased proportions of mDCs, CD4+ T cells, and CD8+ T cells, and upregulated expressions of IL-2, IL-8, IL-12, IFN-γ, TNF-α, and iNOS, but not IL-4 and IL-10. Additionally, rhGM-CSF synergized with HFRT to promote the normalization of blood vessels in the PC. Conclusion: HFRT followed by rhGM-CSF had the best efficacy in PC, and the molecular mechanism may be related to immunogenic cell death.

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ABSTRACT Purpose: To scrutinize the protective effect of alpinumisoflavone against the acute reflux esophagitis (RE) in the rats and to explore the underlying mechanism. Methods: RAW 264.7 cells were used for in-vitro study, and MTT assay was used to access the cell viability. The cells were treated with lipopolysaccharide (LPS) and estimation the inflammatory cytokines and parameters. A surgical procedure was performed for the induction of RE followed by the oral administration of alpinumisoflavone (5, 10 and 15 mg/kg). The esophagitis lesion score, gross esophageal score, damage ratio, pH and gastric volume, NO level, alcian blue, H2O2, free iron, calcium, antioxidant, inflammatory cytokines and inflammatory parameters were estimated. Results: Alpinumisoflavone treatment significantly (p < 0.001) suppressed cell viability and NO levels, along with a reduction in inflammatory cytokines like tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6 and inflammatory parameters such as cyclooxygenase-2 (COX-2), prostaglandin E22 (PGE2), and inducible nitric oxide synthase (iNOS) against the LPS treatment. Alpinumisoflavone treated group rats suppressed the esophagitis lesion score, gross esophageal score damage ratio, and gastric volume and improved the pH level. Alpinumisoflavone treatment significantly (p < 0.001) suppressed the level of NO level, alcian blue, H2O2, free iron and calcium. Alpinumisoflavone significantly (p < 0.001) altered the level of antioxidant parameters such as malondialdehyde, superoxide dismutase, glutathione, glutathione peroxidase, catalase; inflammatory cytokines viz., TNF-α, IL-6, IL-1β, IL-10, IL-18; and inflammatory parameters including COX-2, NF-κB, and PGE2. Conclusion: Alpinumisoflavone ameliorates the acute reflux esophagitis via suppression of inflammatory parameters.

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ABSTRACT Purpose: To evaluate the regenerative efficacy of an experimental biodegradable nerve conduit composed of polycaprolactone and açaí-derived polyurethane, used for peripheral nerve repair, in comparison with different reconstructive techniques. Methods: Wistar rats (n = 48) were allocated into six groups (n = 8): normality (NG), denervated (DG), burial (BG), nerve autograft (NAG), açaí-based neurotube (ANG), and vein autograft (VAG). Sciatic functional index, electrophysiological parameters, and histomorphometry were assessed after 12 weeks. Results: NAG and ANG showed significant functional recovery, with ANG being the only group to demonstrate progressive improvement (p = 0.009). Electrophysiological analysis revealed higher amplitude and lower latency in NAG, followed by ANG and VAG. Histomorphometric analysis showed increased axonal density in ANG and NAG compared to non-reconstructed groups (p = 0.004 and p = 0.007, respectively). Conclusion: The polycaprolactone/açaí-based conduit demonstrated regenerative performance comparable to autologous nerve grafts.

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ABSTRACT Purpose: Body weight, blood glucose, and hypothalamic ghrelin receptors were monitored in an animal model of obesity after being treated with sleeve gastrectomy. Methods: Forty-two adult male Wistar rats were randomized into two groups: a non-obese group (standard chow); and an obese group, in which obesity was induced by feeding liquid enteral formula Ensure Plus. Each group was divided according to the surgery performed (sham operation or sleeve gastrectomy) and the time of sacrifice after surgery (14 or 28 days). Body weight and capillary blood glucose were monitored throughout the pre- and postoperative periods. Microscopic sections of the parietal cortex, thalamus, hypothalamus, and hippocampus were treated by immunohistochemical reaction with polyclonal anti-ghrelin receptor antibody. Positivity was determined by identifying labeled nuclei and cytoplasm in the brain cells. Results: Sleeve gastrectomy induced effective weight loss (p < 0.001) and reduction in the hypothalamic ghrelin receptor expression (p = 0.04). Weight loss was not directly influenced by the receptor expression. There was no significant impact on capillary glycemia. Conclusion: Sleeve gastrectomy alters GHSR1a receptors, decreasing their expression and body weight. However, weight loss is not directly related to the GHSR1a expression status.

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ABSTRACT Purpose: Adequate microcirculation is essential for regeneration and survival of flaps. The perfusion pattern can be influenced by the vascular pedicle’s properties in various flap types. We aimed to describe a refined musculocutaneous flap model with viability measurements, studying local, interpolated and transferred (free) flap types in rats. Methods: Wistar rats were subjected to three experimental groups (n = 8/each). Beside controls, in two groups cutaneous maximus musculocutaneous flaps were prepared bilaterally. The right flaps were sutured back (local flap), the left one was transposed to the frontal chest wall (interpolated flap). In another group, left flap was transferred to the inguinal region performing microvascular anastomoses. Flaps’ temperature, blood flow, and microcirculation were assessed before/after operation and on the 14th postoperative day. Results: The flaps’ temperature didn’t worsen, but values moderately decreased in transferred flaps. The pedicle’s blood flow didn’t change significantly after preparation. The transferred flaps’ values lowered by the 14th day. Microcirculatory parameters decreased postoperatively, significantly in interpolated and transferred flaps, and completely normalized by the 14th day. Conclusion: Tissue perfusion and microcirculatory pattern were sufficient for flap survival and wound healing. The refined cutaneous maximus musculocutaneous flap model can be useful in studies comparing local, interpolated and transferred flaps.

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ABSTRACT Purpose: To investigate the potential protective effects of ononin on cecal ligation puncture (CLP) induced sepsis rat model. Methods: CLP was used to induce sepsis in rats and then treated with ononin at doses of 25 and 50 mg/kg intraperitoneally for seven days. The daily assessment included measurements of food and water intake, as well as body weight in the different rat groups. The study also examined the effects of ononin on survival rates, level of tumor necrosis factor (TNF)-α, interleukin (IL)-16, IL-6, C-reactive protein in the serum, and markers of oxidative stress in tissue homogenates of rats. The weight of spleen and lung tissue were also estimated in ononin-treated sepsis group. Additionally, histopathological examinations of lung and liver tissues were conducted in sepsis rats using hematoxylin and eosin staining. Results: The ononin-treated group showed significant improvements in food and water intake, as well as body weight, compared to the sepsis group of rats. Survival rate was also improved in the ononin-treated group. Ononin ameliorates oxidative stress and inflammatory mediators in sepsis rats. Histopathological changes (liver and lung tissue) were observed to be ameliorated in the group of rats treated with ononin versus the sepsis group. Conclusion: Ononin enhances survival rate in sepsis in rats by reducing inflammation and oxidative stress.

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ABSTRACT Purpose: To verify the differences in the reversibility of renal function and damage in rats of different ages with unilateral ureteral obstruction (UUO). Methods: Sixty rats were divided into three different groups, newborns, young, and adults. Twenty-one were sham operated. After UUO, the animals were subdivided into four groups: obstruction (two weeks and sacrifice O2); UUO two weeks, obstruction release for two weeks and sacrifice (R2); UUO for four weeks and sacrifice (O4); and UUO for four weeks, obstruction release for two weeks and sacrifice (R4). Urine was collected for creatinine, urea, total protein, and albumin dosages, and kidneys for morphological studies. Results: Younger rats presented more extensive destruction of renal parenchyma, with some remaining normal tissue healthier in comparison to older rats. The protein excretion by older rats was not different between the groups obstructed for different periods, albuminuria was progressively higher in rats obstructed for longer periods, and after relief of obstruction, there was no difference between newborn rats obstructed for different periods. The younger pyelostomized rats presented higher albumin excretion. Creatinine excretion was worsened in rats after obstruction. Conclusion: Shorter obstruction periods lead to better prognosis, and younger rats showed better recovery after relief of obstruction than older ones.

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ABSTRACT Purpose: To investigate the protective effect of trans-anethole in experimental traumatic brain injury (TBI) in mice. Methods: Thirty-five adult mice were divided into five groups (control, TBI, TBI+A40, TBI+A80, and TBI+A160). No treatment was performed in the control group. The treated groups (TBI+A40, TBI+A80, and TBI+A160) received 40, 80 or 160 mg/kg trans-anethole treatment, respectively. At the end of the experiment, the brains of the sacrificed animals were removed, and laboratory analyses were performed. Results: Malondialdehyde (MDA) levels in brain tissue of TBI and TBI+A40 were significantly increased, while MDA levels of TBI+A80 and TBI were similar. TBI+A160 and control tissue MDA levels were similar (p > 0.05), significantly different from TBI (p < 0.01). Immunodensity analyses showed that there was a significant difference between the control and TBI in terms of Bax, caspase 3, tumor necrosis factor-α (TNF-α) and interleukin- (IL)-1β immunoexpression. TBI+A40 immunoexpression was similar to TBI (p > 0.05), significantly different from the control groups (p < 0.05). In TBI+A80 and TBI+A160, pro-apoptotic Bax and caspase 3, pro-inflammatory TNF-α and IL-1β levels were also significantly improved. Immunoexpression levels of TBI+A160 and control were similar (p > 0.05). Conclusion: in our study, trans-anethole treatment had a dose-dependent neuroprotective potential against trauma-induced neurodegeneration.

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ABSTRACT Purpose: To examine the cardioprotective effects of myrrhone against isoproterenol (ISO)-induced myocardial injury in rats. Methods: Myocardial injury was induced in the rats through subcutaneous administration of ISO (85 mg/kg). The body weight, heart weight, electrocardiogram (ECG), cardiac, antioxidant, electrolyte, membrane-bound enzymes, antioxidant, cytokines, and inflammatory parameters were estimated. The mRNA expression of inflammatory parameters was estimated in the cardiac tissue. Results: Myrrhone treatment significantly (p < 0.001) altered ECG parameters, body weight, heart weight, and heart weight/body weight ratio. Myrrhone significantly (p < 0.001) improved the level of 5-hydroxytryptamine (5-HT) and suppressed the level of cardiac parameters like creatine kinase-MB, creatine kinase, lactate dehydrogenase, cardiac troponin I, and cardiac troponin T. It also suppressed the level of hepatic parameters such as aspartate aminotransferase, and alanine transaminase; altered the electrolyte, membrane-bound enzymes, and antioxidant parameters. Myrrhone treatment significantly (p < 0.001) altered the level of cytokines such as tumor necrosis factor-α (TNF-α), interleukin (IL)-10, IL-1β, IL-17, and IL-6; inflammatory parameters like cyclooxygenase-2, prostaglandin, inducible nitric oxide synthetase, nuclear factor kappa-light-chain enhancer of activated B cells; matrix metalloproteinases such as 2, and 9; apoptosis parameters viz., Bcl-2-associated X protein (Bax), B-cell lymphoma 2 protein (Bcl-2), and caspase-3 parameters. Myrrhone treatment significantly (p < 0.001) altered the mRNA expression IL-6, IL-1β, IL-10, TNF-α, Bcl-2, caspase-3, Bax, and caspase-9. Conclusion: Myrrhone exhibited the cardioprotective effect against ISO-induced myocardial injury in rats via alteration of kappa-light-chain enhancer of activated B cells (NF-κB) and Bax/Bcl-2/caspase-3 signaling.

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ABSTRACT Purpose: To describe the academic utilization of podcasts as an educational tool for general surgery and emergency medicine residents. Methods: This narrative report details a one-year group experience incorporating podcasts into the curriculum of the general surgery and emergency medicine residency programs, focusing on podcast-based learning within the academic emergency department of a quaternary university hospital in an urban center in São Paulo, Brazil. The authors, comprising podcast developers, preceptors, and residents, shared their experiences with implementing and utilizing the podcast in the residency curriculum. Results: Over the course of one year, 50 episodes of the podcast “Mania de Cirurgia” were delivered to residents rotating in the emergency room. The episode content consisted of 64% clinical topics, 12% summaries of scientific events, 12% interviews with specialists, and 12% soft skills development. The authors reported that both residents and preceptors expressed high satisfaction with the podcast’s integration as a consistent educational tool in the curriculum. Conclusion: The incorporation of a podcast as an educational tool was enthusiastically received by both residents and preceptors. Podcasts may serve as a valuable complement to traditional teaching methods, enabling updates on general surgery topics, fostering evidence-based practice, and enriching professional experiences.

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ABSTRACT This review covers the most recent articles on temporomandibular joint arthrocentesis, focusing on its mechanism of action, indications, clinical outcomes and efficacy, complications, comparison with other treatment modalities, and conclusions.

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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.

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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 map the literature on blood concentrates for managing postoperative sequelae after third molar extraction through a scoping review. Methods: MedLine, Latin American and Caribbean Health Sciences Literature, Scientific Electronic Library Online, EMBASE, Cochrane Library, Scopus, and Web of Science were the search databases. MedRxiv and EASY provided the grey literature. The investigation included observational studies and clinical trials reporting at least one postoperative sequela. After selecting the articles, the extracted data included study author, year, and country, study design, sample size, age distribution, the type of third molar impaction, flap design, the presence of osteotomy and/or odontosection, co-interventions, blood concentrate type, centrifuge model, centrifugation protocol, collection tubes, outcomes, and the main findings for each outcome. After data extraction, an analysis of the geographic distribution of publications was carried out based on the MapChart website. Results: This review included 63 studies. The leading countries in publications were Turkey, India, and Brazil. Common postoperative sequelae included pain, edema, trismus, alveolar osteitis, and infection. Outcomes varied regarding the effectiveness of concentrates in controlling inflammation, edema, trismus, and alveolar osteitis. Advanced platelet-rich fibrin was the most applied concentrate in recent studies and was associated with reduced edema and trismus. Conclusion: All concentrates demonstrated some effectiveness in managing sequelae after third molar extraction, but most did not show significant outcomes in controlling inflammatory signs. It emphasizes the need for further randomized clinical trials and systematic reviews to strengthen the evidence on blood concentrates for managing postoperative sequelae.

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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 demonstrate the complete process of telementoring implementation using augmented-reality smart glasses for performing a simulated medical procedure. Methods: Fifteen participants, including physicians and medical students, were recruited to participate in a telementoring session with an educational focus during simulated thoracostomy with closed pleural drainage. A questionnaire assessing technology usability and usefulness was administered, and the results were analyzed by Cronbach’s alfa and multiple correspondence analysis (MCA). Results: The mean age of the participants was 28.8 and 66.67% of them were women. The test results indicated a Cronbach’s alpha of 78% and an MCA of 49.48% for the first three dimensions. Conclusion: The results showed that smart glasses are easy to use and facilitate communication among the professionals involved, providing comfort and safety to participants of care simulations. Additionally, smart glasses were considered to have perceived usefulness.

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ABSTRACT Purpose: To describe the varicocelectomy model using bull testicles and to evaluate microsurgical practice using the surgical microscope and video magnification system. Methods: Bovine testicles and spermatic cords were used, with the medial portion of the cord left free for the microsurgical varicocelectomy technique. Twenty 3rd-year medical students were divided into two groups, the video magnification system group (VSMG) and the surgical microscope group (SMG), to simulate varicocelectomy in the proposed model. Five training sessions were carried out for both groups (D1, D7, D14, D21, and D28), as well as a reassessment (D63), with a checklist applied on the first, third, and fifth day of training and on reassessment. Results: The model provides practical support for training in instrument handling, dissection of structures, anatomical identification, and vessel ligation as an alternative to learning the surgical technique. There was a drop in training time as the weeks went by, with no significant difference between the groups. There was no statistical difference in time (D14, D28, D63) or scores between groups. Conclusion: Microsurgical varicocelectomy training using testicles and sperm cords of bovine origin in the video magnification system and surgical microscope contributed to the acquisition of skills.

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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.

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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.

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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.

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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.

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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.

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ABSTRACT Purpose: To evaluate the angiographic outcomes of the Optima™ coil system in the endovascular treatment of saccular intracranial aneurysms to present real-world experiences. Methods: The study encompassed patients with both ruptured and unruptured aneurysms who underwent treatment with the Optima™ coil system. A retrospective analysis was conducted to examine patient and aneurysm characteristics, complication rates, and angiographic outcomes. Results: The total of 326 Optima™ coil implantations was performed in 64 aneurysms, with a mean maximum diameter of 7.49 ± 3.08 mm (range: 2.5–16.5 mm), among 64 patients (37 females and 27 males, mean age: 53.34 ± 14 years old). The average number of implanted coils was 5.06 ± 1.73. The mean packing density was 26.2% (range = 19.2–34.6), observed to be significantly higher in aneurysms with complete occlusion and neck remnants compared to those with a residual dome (p < 0.01). The mean follow-up period was 15.9 ± 8.1 months. One case (1.5%) reported a coil malfunction attributed to coil stretching. The mortality rate was 3.1% (n = 2). Conclusion: The Optima™ coil system exhibited safety and efficacy in the endovascular treatment of both ruptured and unruptured intracranial aneurysms, demonstrating favorable angiographic outcomes. Nevertheless, further studies are necessary to validate these results over the long term.

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ABSTRACT Purpose: To evaluate peripheral blood mononuclear cells (PBMCs) from patients with advanced head and neck squamous cell carcinoma (HNSCC) in comparison with healthy volunteers, as they can be potential biomarkers. Methods: Immunophenotyping was performed using flow cytometry of blood mononuclear cells from two groups of adult men: group 1 (n = 14), diagnosed with HNSCC (mouth, larynx, and hypopharynx); and group 2 (n = 14), volunteers, healthy, and without the use of drugs. The cell groups studied were T lymphocytes (CD3, CD4, CD8, CD56 and CD69), B lymphocytes (CD19, CD69), neutrophils (CD11a, CD16, CD66b, HLA-DR), and monocytes (CD14, CD86). Results: In group 1, there were an increase in CD3+CD4+ T lymphocytes (p < 0.001) and NK 56+ cells (p = 0.009) and a decrease in CD3+CD8+ T lymphocytes (p = 0.02) in comparison with group 2. In patients with HNSCC, an increase was found in the expression of the CD69 marker in CD3+CD4+ T lymphocytes (p = 0.03) and CD19+ B lymphocytes (p = 0.01) when compared to healthy volunteers. Conclusion: HNSCC triggers a systemic inflammatory response with a decrease in CD8 T cells and an increase in CD4 T and CD56 natural killer cells. CD69 early activation marker was expressed by T and B cells.

Abstract in English:

ABSTRACT Purpose: To evaluate post-bariatric patients’ intentions to undergo reconstructive plastic surgery in Brazil’s public health system. Methods: This cross-sectional study, conducted between May 2022 and February 2023, contacted 539 post-bariatric patients (≥ one year post surgery) via telephone, of whom 150 completed an online survey. Participants assessed their interest in reconstructive surgery and completed the validated Body-Q instrument to evaluate body image, sexual function, and related outcomes. Results: Most respondents were female (88%) and married (68%), with an average age of 43 years old. The preoperative and postoperative body mass indices were 44.5 and 28.1, respectively, with an average weight loss of 44 ± 12.8 kg. A total of 90.7% expressed interest in reconstructive surgery, particularly for the abdomen (75.3%) and breasts (68%). Lower education level was linked to higher aesthetic expectations (p = 0.014). Patients interested in arm surgery had significantly lower sexual function scores (p = 0.006). There was no significant correlation between total weight loss and surgical interest. Conclusion: Post-bariatric patients in Brazil’s public healthcare system showed a high demand for reconstructive surgery, with education level and body satisfaction influencing interest more than weight loss. Targeted counseling may help align expectations and enhance post-bariatric care for patients.

Abstract in English:

ABSTRACT Purpose: Keloids are unaesthetic benign dermatosis characterized by a disorganized proliferation of collagen. Treatment of keloids constitutes a therapeutic challenge. The aim of this study was to evaluate the efficacy and effectiveness of topical imiquimod associated with surgical excision in the treatment of keloid. Methods: A randomized, double blind, matching-lesion (self-paired manner) clinical trial. Ten patients with two keloid lesions each in similar anatomical and contralateral areas (paired lesions) had their keloids excised, and the operative site treated with the application of 5% imiquimod cream or 0.1% methylprednisolone aceponate cream (gold standard) for eight weeks. Results: Eight patients (total = 16 lesions) completed the study. Four of the total eight keloids (50%) in the methylprednisolone group vs. 3/8 keloids (37.5%) in the imiquimod group recurred in the first post-treatment year (p 0.05). Conclusion: Surgical removal plus application of topical imiquimod was shown as safe, and its efficacy was not statistically inferior for the treatment of keloids as compared to methylprednisolone. Due to the lack of efficacy in most therapeutic modalities, surgical removal plus topical imiquimod could be recommended as an additional first line therapy and especially for recurrent keloids. Studies with larger samples are necessary to evaluatre therapies for keloids.

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ABSTRACT Purpose: To evaluate whether hematemesis is associated with increased morbidity and mortality for upper gastrointestinal bleeding. Methods: A retrospective cohort study was conducted at a quaternary university hospital from January 2022 to September 2024. Adults presenting with upper gastrointestinal bleeding, confirmed by endoscopy, were included. We excluded patients with terminal disease, patients who refused to receive blood products, and trauma. The main outcomes were all-cause mortality, need for orotracheal intubation, emergency blood transfusion, need for re-endoscopy, and length of hospital and intensive care unit (ICU) stays. Results: A total of 69 patients (65% male, mean age 58 years) were included. Hematemesis was associated with a higher need for emergency blood transfusions (73% vs. 23%; odds ratio – OR = 8.82, 95% confidence interval – 95%CI 2.44–31.94, p = 0.001), longer hospital (12 vs. 6 days; mean difference – MD = 6.02, 95%CI 2.39–9.64, p = 0.001) and ICU stays (7.7 vs. 3.2 days; MD = 4.5, 95%CI 1.73–7.26, p = 0.002). Data were sparse and imprecise on all-cause mortality, orotracheal intubation, and the need for re-endoscopy. Conclusion: Hematemesis is associated with higher transfusion requirements and longer hospital and ICU stays. These findings highlight the potential predictive value of hematemesis in acute upper gastrointestinal bleeding.

Abstract in English:

ABSTRACT Purpose: To analyze the geographical distribution of patients treated at a burn treatment unit (BTU) in Catanduva, São Paulo, Brazil, and examine the relationship between geographic and clinical variables. Methods: This is a cross-sectional study that analyzed patients hospitalized for burns between January 2018 and May 2022. Data were obtained from medical records and included patients’ residence city, age, and percentage of total body surface area burned (%TBSA). The data were processed using QGIS and R, and travel distances and times were calculated. Statistical analyses included bivariate and correlation tests. Results: The total of 1,164 patients were analyzed. Most of them resided outside Catanduva, totaling 277 cities. The average distance was 179.37 km, and the average travel time was 140.94 minutes. Patients from Catanduva had an average age of 35.55 years old, and the average %TBSA was 12.15. Patients from outside Catanduva were significantly younger and had a higher %TBSA than the local patients. A weak but significant negative correlation was found between patient age and distance to the BTU (ρ = -0.14, p < 0.05), while %TBSA showed a weak positive correlation with travel distance (ρ = 0.21, p < 0.05). No significant differences were observed between the pre- and pandemic periods. Conclusion: This study highlights regional differences in specialized burn care access and may inform policy aimed at reducing care disparities.

Abstract in English:

ABSTRACT Purpose: To evaluate correlations between anthropometric tools for visceral fat assessment, including waist circumference (WC) and sagittal abdominal diameter (SAD), by computed tomography (CT)-derived visceral fat volume in patients with rectal adenocarcinoma. Methods: This comparative cross-sectional study included 138 participants: rectal adenocarcinoma patients (group 1, n = 69) and controls (group 2, n = 69). Assessed variables were weight, body mass index (BMI), bioelectrical impedance analysis (BIA), WC, SAD, and CT-derived visceral fat volume measured with Fat Tissue (Syngo.Via VB20, Siemens). CT analysis was restricted to group 1. Results: Median ages in groups 1 and 2 were 60 and 53 years, respectively (p < 0.0008). CT revealed sex-based differences in visceral fat: 20.91 cm3 in females and 31.29 cm3 in males (p = 0.0043). WC and SAD demonstrated statistically significant correlations with CT-derived visceral fat in group 1 (p < 0.0001). Conclusion: WC and SAD correlated with CT-derived visceral fat in rectal adenocarcinoma patients. These exploratory findings require validation by larger studies with multivariable analyses to establish predictive value and clinical applicability.

Abstract in English:

ABSTRACT Purpose: To compare early- and medium-term postoperative outcomes of unilateral inguinal hernia repair performed using the Lichtenstein and Prolene hernia system (PHS) techniques in a public teaching hospital. Methods: A retrospective analysis of 897 patients undergoing primary unilateral inguinal hernioplasty (406 with Lichtenstein and 491 with PHS) from January 2011 to March 2025 was conducted. Clinical, intraoperative, and postoperative data were collected and compared. Statistical analysis included t-tests, Mann–Whitney, Fisher’s exact, and χ2 tests. Results: Groups were not entirely homogeneous in preoperative profiles. The mean age was similar (p = 0.85), with predominance of males (94.87%). The operative time was significantly shorter for the PHS group (68.83 ± 24.84 versus 76.23 ± 26.90 min; p < 0.01). No significant differences were observed in postoperative complications, chronic pain, sensory dysfunction, or recurrence. Hospitalization was less frequent with the PHS technique (4.27 versus 12.8%; p < 0.01). Greater preference for local anesthesia was observed in the PHS group (20.77 versus 4.68%; p < 0.01). Conclusion: Both techniques proved effective and safe, but the PHS technique showed advantages regarding operative time and hospitalization rate. However, limited sample size and absence of cost and return-to-activity data restrict broader generalizations. Further prospective randomized studies are needed.

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.