Acta cirurgica brasileira最新文献

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.