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.

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.

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.

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.

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.

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

ABSTRACT 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.

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

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

ABSTRACT 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.

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

ABSTRACT 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.

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.