Background: Identifying postmenopausal women with a high risk of having osteoporosis and fractures is a current challenge. This study aimed to assess the diagnostic performance of biochemical tests in identifying secondary osteoporosis and the fracture risk assessment tool (FRAX) in identifying fracture risk. Methods: Data from biochemical tests and bone densitometry of postmenopausal women were analyzed. Additionally, the FRAX result was obtained and the patients were classified according to the National Osteoporosis Guideline Group (NOGG). Results: A total of 646 women were evaluated, of whom 201 (31.1%) had osteoporosis or a previous frailty fracture. These women had statistically different parathyroid hormone (PTH) and alkaline phosphatase serum levels (p<0.01 and p=0.02, respectively) than those without osteoporosis or fracture. However, those at high risk had a higher prevalence of hypovitaminosis D (46% vs. 36%) and hypocalciuria (17% vs. 9%). The FRAX showed an area under the curve of 0.757 (p<0.01) and 0.788 (p<0.01) for identifying women at risk for “major fractures” and “hip,” respectively. The NOGG categorization had a sensitivity of 19% to identify high-risk women, a specificity of 91.3% for low-risk women, with a positive predictive value of 57.4% and a negative predictive value of 64.6%. Conclusions The evaluation of PTH, 25-hydroxy-vitamin D, serum calcium, and 24-hr urinary calcium proved adequate for initial osteoporosis screening. The FRAX tool has a regular ability to screen women at risk for fracture, and the NOGG method has high specificity to identify those at low risk.

Background: Hystricomorpha rodents display a similar placentation model to humans.The present study was carried out considering the scarcity of information concerning the placental development in agouti. Objective: Describe the microscopy of the placenta, subplacenta and yolk sac of agoutis in early pregnancy and report on the inversion of the yolk sac. Methods: Fifteen females between the 14th –32nd day of gestation were used following euthanasia. Gestational buttons were collected, fixed, processed, stained to optical microscopy or immunohistochemistry. Results: Chorioallantoic placenta (CP) ranged from conical to a half-sphere, as follows:from the 14th to 17th day, the CP displays an inverted “V” shape, predominantly formed by cytotrophoblasts; from 20 to 22 days, formed almost entirely by cytotrophoblasts; at 28 days, a half sphere, with distinct lobes and interlobular area, numerous maternal gaps delimited by syncytiotrophoblasts and trophoblast giant cells; at 32 days, globose and undergoing the maturation process. Subplacenta, located between decidua and CP, initially presents septa consisting of simple columnar epithelium and after 17 days, comprising stratified epithelium. Visceral yolk sac (VYS) is attached to two CP projections between 14 and 17 days, formed by a simple cubic epithelium and inverted. Between 20 and 22 days, the epithelium displays apical villous projections with cytoplasmic vacuoles and a vascularized mesoderm. After the 24th day, the VYS near the placenta is pleated, very vascularized and villous, with decreased villi sizes further away from the placenta. Conclusion The agouti CP displays similar characteristics to other hystricomorpha, including placenta lobulation, a subplacenta and an inverted vitelline placenta.

Purpose: The aim of this study was to assess the ability of ultrasound biomicroscopy (UBM) to diagnose the initial stages of nonalcoholic fatty liver disease (NAFLD) in a rat model. Methods: Eighteen male Wistar rats were allocated to control or experimental groups. A high-fat diet (HFD) with 20% fructose and 2% cholesterol, resembling a common Western diet, was fed to animals in the experimental groups for up to 16 weeks; those in the control group received a regular diet. A 21 MHz UBM system was used to acquire B-mode images at specific times: baseline (T0), 10 weeks (T10), and 16 weeks (T16). The sonographic hepatorenal index (SHRI), based on the average ultrasound image gray-level intensities from the liver parenchyma and right renal cortex, was determined at T0, T10, and T16. The liver specimen histology was classified using the modified Nonalcoholic Steatohepatitis Clinical Research Network NAFLD activity scoring system. Results: The livers in the animals in the experimental groups progressed from sinusoidal congestion and moderate macro- and micro-vesicular steatosis to moderate steatosis and frequent hepatocyte ballooning. The SHRI obtained in the experimental group animals at T10 and T16 was significantly different from the SHRI of pooled control group. No significant difference existed between the SHRI in animals receiving HFD between T10 and T16. Conclusion SHRI measurement using UBM may be a promising noninvasive tool to characterize early-stage NAFLD in rat models.

Purpose: Laparoscopic complete mesocolic excision (CME) right colectomy is a technically demanding procedure infrequently employed in Western centers. This retrospective cohort study aims to analyze the safety of laparoscopic CME colectomy compared to standard colectomy for right-sided colon cancer in a Western series. Methods: Prospectively collected data from 60 patients who underwent laparoscopic CME right colectomy were compared to the ones of 55 patients who underwent laparoscopic standard right colectomy. Results: No differences in clinical characteristics were observed between the CME and standard right colectomy groups. No differences were demonstrated in terms of blood loss (P = 0.060), intraoperative complications (P = 1), conversion rate (P = 0.102), and operative time (P = 0.473). No deaths were observed in either group, while complication rate was 40.0% in the CME and 49.1% in the standard group (P = 0.353). Severe complications occurred in 10.0% vs. 9.1% (P = 0.842), redo surgery in 5.0% vs. 7.3% (P = 0.708), and unplanned readmission in 5.0% vs. 5.5% (P = 1) after CME and standard colectomy, respectively. A significant difference in favor of CME was observed in the total length of specimen (P < 0.001), proximal (P = 0.018), and distal margins (P = 0.037). The number of lymph nodes harvested was significantly higher in the CME group (27 vs. 22, P = 0.037). Conclusion In Western series, where patients have less favorable clinical characteristics, laparoscopic CME allows to obtain better quality surgical specimens and comparable short-term outcomes compared to standard right colectomy.

Purpose: Laparoscopic complete mesocolic excision (CME) right colectomy is a technically demanding procedure infrequently employed in Western centers. This retrospective cohort study aims to analyze the safety of laparoscopic CME colectomy compared to standard colectomy for right-sided colon cancer in a Western series. Methods: Prospectively collected data from 60 patients who underwent laparoscopic CME right colectomy were compared to the ones of 55 patients who underwent laparoscopic standard right colectomy. Results: No differences in clinical characteristics were observed between the CME and standard right colectomy groups. No differences were demonstrated in terms of blood loss (P = 0.060), intraoperative complications (P = 1), conversion rate (P = 0.102), and operative time (P = 0.473). No deaths were observed in either group, while complication rate was 40.0% in the CME and 49.1% in the standard group (P = 0.353). Severe complications occurred in 10.0% vs. 9.1% (P = 0.842), redo surgery in 5.0% vs. 7.3% (P = 0.708), and unplanned readmission in 5.0% vs. 5.5% (P = 1) after CME and standard colectomy, respectively. A significant difference in favor of CME was observed in the total length of specimen (P < 0.001), proximal (P = 0.018), and distal margins (P = 0.037). The number of lymph nodes harvested was significantly higher in the CME group (27 vs. 22, P = 0.037). Conclusion In Western series, where patients have less favorable clinical characteristics, laparoscopic CME allows to obtain better quality surgical specimens and comparable short-term outcomes compared to standard right colectomy.

BACKGROUND: To compare bone density accrual and markers of bone geometry and formation between female adolescents engaged and not engaged in artistic gymnastics (AGs). METHODS: This was a 12-month longitudinal study involving 20 female adolescents, including 10 controls and 10 gymnasts (AGs) aged 11 to 16 years. At baseline, the gymnasts had a minimum of 12 months of practice, and the controls reported no participation in any organized sport. Bone mineral density (BMD) was measured in the lower limbs, upper limbs, spine, and whole body. In addition, BMD and geometrical properties of the femur were assessed. As a bone formation marker, osteocalcin level was measured. RESULTS: Femoral aspects were increased in the gymnasts by 19% (P=0.009), 14% (P=0.047), and 10% (P=0.046) in the Ward's triangle, trochanter, and the overall bone, respectively, than in the control girls. Geometrical parameters, bone accrual, and osteocalcin levels were similar in both groups. The weekly training load explained 30.8% of all bone gains on the lower limbs and affected the density on parts of the femur. CONCLUSIONS: The gymnasts, after a 12-month follow-up, demonstrated a higher BMD in the Ward's triangle and whole femur than the controls, as well as an improvement in femur density. These changes were mainly due to the weekly training load. Lastly, the gymnasts had significant bone accrual (after 12 months) in the upper limbs, lower limbs, and whole body.
Adolescent ; Bone and Bones ; Bone Density ; Female ; Femur ; Follow-Up Studies ; Gymnastics ; Humans ; Longitudinal Studies ; Lower Extremity ; Osteocalcin ; Osteogenesis ; Spine ; Sports ; Upper Extremity

OBJECTIVE: To evaluate the initial maternal and perinatal outcomes of fetoscopic laser photocoagulation for the treatment of twin-to-twin transfusion syndrome (TTTS) in a referral center in Brazil. METHODS: This prospective observational study analyzed 24 fetoscopic laser photocoagulation procedures at 18–26 weeks of gestation. TTTS severity was determined using the Quintero classification. Blood vessels that crossed the interamniotic membrane were nonselectively photocoagulated. The χ2 test and Mann-Whitney U test were used for the statistical analysis. RESULTS: The mean (±standard deviation) age of pregnant women, gestational age at surgery, surgical time, gestational age at birth, and newborn weight were 32.2±4.1 years, 20.7±2.9 weeks, 51.8±16.7 minutes, 30.5±4.1 weeks, and 1,531.0±773.1 g, respectively. Using the Quintero classification, there was a higher percentage of cases in stage III (54.2%), followed by stages IV (20.8%), II (16.7%), and I (8.3%). Ten (41.7%) donor fetuses died and 14 (58.3%) donor fetuses survived until the end of gestation. Placental insertion location (anterior vs. posterior) did not affect the incidence of iatrogenic septostomy, surface bleeding, and premature rupture of membranes until the end of gestation. The death rate of donor and recipient fetuses before 24th gestational week increased with severity of TTTS. CONCLUSION: The maternal and perinatal outcomes resulting from the implementation of a new minimally invasive surgical technique are in line with those obtained in major centers worldwide, considering the learning curves and infrastructures.
Blood Vessels ; Brazil* ; Classification ; Female ; Fetofetal Transfusion* ; Fetoscopy ; Fetus ; Gestational Age ; Hemorrhage ; Humans ; Incidence ; Infant, Newborn ; Learning Curve ; Light Coagulation* ; Membranes ; Mortality ; Observational Study ; Operative Time ; Parturition ; Perinatal Mortality ; Pregnancy ; Pregnant Women ; Prospective Studies ; Referral and Consultation ; Rupture ; Tissue Donors

OBJECTIVES: Chitosan has been widely investigated and used. However, the literature does not refer to the shelf life of this solution. This study evaluated, through the colorimetric titration technique and an analysis of dentin micro-hardness, the shelf life of 0.2% chitosan solution. MATERIALS AND METHODS: Thirty human canines were sectioned, and specimens were obtained from the second and third slices, from cemento-enamel junction to the apex. A 0.2% chitosan solution was prepared and distributed in 3 identical glass bottles (v1, v2, and v3) and 3 plastic bottles (p1, p2, and p3). At 0, 7, 15, 30, 45, 60, 90, 120, 150, and 180 days, the specimens were immersed in each solution for 5 minutes (n = 3 each). The chelating effect of the solution was assessed by micro-hardness and colorimetric analysis of the dentin specimens. 17% EDTA and distilled water were used as controls. Data were analyzed statistically by two-way and Tukey-Kramer multiple comparison (α = 0.05). RESULTS: There was no statistically significant difference among the solutions with respect to the study time (p = 0.113) and micro-hardness/time interaction (p = 0.329). Chitosan solutions and EDTA reduced the micro-hardness in a similar manner and differed significantly from the control group (p < 0.001). Chitosan solutions chelated calcium ions throughout the entire experiment. CONCLUSIONS: Regardless of the storage form, chitosan demonstrates a chelating property for a minimum period of 6 months.
Calcium ; Chelating Agents ; Chitosan* ; Colorimetry* ; Dentin* ; Edetic Acid ; Glass ; Humans ; Ions ; Plastics ; Product Packaging* ; Water

Objective To evaluate the phenolic profile and antioxidant activity in vitro of peanut skin extract (PSE) and effect of PSE on characteristics of sheep patties during storage. Methods PSE phenolic profile was evaluated in LC–MS analysis and by total phenolic content, 1,1-diphenyl-2-picrylhydrazyl radical scavenging capacity and ferric reducing/antioxidant power. Patties elaborated with sheep meat were packaged in modified atmosphere and storage at (2 ± 1) °C. The analyses were performed every 5 days for 20 days on microbial counts, physico-chemical properties, lipid oxidation, protein stability and sensory characteristics. Results The major group of phenolic compounds in PSE was the proanthocyanidins followed by other flavonoids, which are related to potential phenolic content and antioxidant activity. The addition of PSE and butyl hydroxytoluene (BHT) reduced the microbial counts during the storage time, caused reduction on the loss of redness and sensory properties over time. The lipid and protein oxidation in sheep patties was effectively inhibited by PSE and BHT. Conclusions The present results showed the potential application of PSE as a natural alternative to replace synthetic antioxidants (BHT) for increasing the quality and extending the shelf-life of sheep patties.