Induced Corneal Ulcers in Cats - Effects of 2% Dorzolamide on Epithelization Time and on the Expression of Matrix Metalloproteinase-9

Background: Topically administered 2% dorzolamide is among the most commonly used agents to lower IOP. As a complication of glaucoma, blind patients may develop corneal ulcers secondary to trauma. Nonetheless, in patients with a hypertensive or glaucomatous eye, in which the cornea has also been ulcerated, medical hypotensive therapy should not be discontinued. Therefore, the present study aimed to determine whether the instillation of a benzalkonium chloride (BAK)-preserved 2% dorzolamide alters corneal wound healing time and the levels of matrix metalloproteinases (MMP-9) in the tears of cats with experimentally induced corneal ulcers. Materials, Methods & Results: Sixteen cats (8/group) were randomly assigned to receive 40 µL of 2% dorzolamide (TG) or saline (CG) 3 times daily until corneal re-epithelialization. Experimental keratectomies were performed under general and topical anesthesia using an operating microscope. For this purpose, a millimitred trephine was calibrated and used to create a temporal paraxial corneal ulcer with a diameter of 6 mm and a depth of 200 µm. After corneal wounding, the ulcerated area, the healing time, blepharospasm, conjunctival hyperemia, and aqueous flare were compared between groups. Tears were collected at baseline and 24 and 48 h after keratectomy, and the total MMP-9 was quantified by ELISA. Data were assessed statistically using unpaired Student’s t test, one-way, and two-way ANOVA followed by a Bonferroni post hoc test. Statistical significance was set at P < 0.05 for all analyses.  The average time to achieve corneal wound healing did not differ between groups (P = 0.36) and was 65.50 ± 3.62 h in the CG and 71.00 ± 4.58 h in the TG. Twenty-four h after keratectomy, the ulcerated area in the CG was 3.34 mm2 larger than that observed in the TG (P = 0.04); the rest of the comparisons did not reach statistical significance at any time point between groups (P > 0.05). Higher blepharospasm scores were observed in cats of TG (P = 0.04). When compared with baseline of both groups, the levels of MMP-9 increased significantly at 24 and 48 h post-keratectomy (P < 0.001), but differences between groups were not observed at 24 and 48 h post-keratectomy (P > 0.05). Discussion: In cats, 9 mm axial corneal ulcers created by superficial debridement re-epithelize approximately 48 h post-wounding. In the present study, re-epithelialization post keratectomy occurred within an average time of 68.25 h in most cats and in a delayed manner in one cat of the TG after 96 h. In the current study, the lesions in both groups healed without corneal scarring, pigmentation, or vascularization. Although BAC was present in all topical medications used in the present study, the authors attribute the higher scores of blepharospasm in the TG to the rheological characteristics and the pH of the dorzolamide ophthalmic solution. Indeed, the pH value of dorzolamide (5.58) may cause signs of irritation, as the tear film has an approximate pH of 7.6. Previous studies showed that ulcerated corneas presented significantly higher levels of MMP-9 in tears at the early stages (8 to 36 h) post-wounding. In the current study, the levels of this enzyme after wounding did not change significantly in the tears of cats treated with 2% dorzolamide when compared to the eyes in the control group. This study showed that the instillation of a BAC-preserved 2% dorzolamide ophthalmic solution did not impair the corneal wound healing time or the early expression of MMP-9 in the tears of cats with experimentally induced corneal ulcers. However, our results warrant further investigation in patients with ocular hypertension or glaucoma presenting concomitant naturally occurring corneal ulcers to certify our findings. Keywords: carbonic anhydrase inhibitor, benzalkonium chloride, ulcerative keratitis, corneal healing, glaucoma

Pharmacological management of postoperative pain in dentistry : a review

Introdução: A dor ocorre por um processo inflamatório e apresenta diferentes intensidades em função de fatores como o tipo e a duração do procedimento odontológico. O controle da dor pós-operatória dá-se por meio do uso de medicamentos, escolhidos por causa dos seus sítios de ação, do tipo de efeito esperado, da duração do efeito e de características individuais do paciente. Outro método é a realizaçãode analgesia preventiva, utilizando medicamentos previamente aos procedimentos para prevenir ou diminuir a sensibilização nervosa no pós-operatório. Objetivos: Revisar e discutir as diferentes classes de medicamentos disponíveis e suas associações para controle da dor pós-operatória. Revisão da literatura: Os medicamentos analisados foram os corticosteroides e anti-inflamatórios não esteroides (Aines), os analgésicos opioides e não opioides, a associação desses medicamentos e aqueles utilizados para analgesia preemptiva. Resultados: Para dor leve e moderada, recomenda-se o uso de um Aine, associado ou não, a um analgésico não opioide. Para dor intensa, pode ser indicada a associação de um Aine a um analgésico opioide. Para analgesia preemptiva, sugere-se o uso de corticosteroide cerca de 1 hora antes do procedimento. Conclusão: A combinação de dois medicamentos parece alcançar melhores resultados em comparação ao uso de um individualmente, mesmo que seja uma associação ou um opioide. A analgesia preemptiva, pelo uso de corticosteroide em dose única previamente aos procedimentos, contribui para o controle efetivo da dor, bem como o uso de anestésico local a longo prazo.Introduction: Pain occurs through an inflammatory process with different intensities due to factors such as the type and duration of the dental procedure. The control of postoperative pain occurs through the use of drugs, chosen due to their sites of action, type of effect expected, effect duration, and the individual characteristics of the patient. Another method is to perform preemptive analgesia, using drugs before the procedures to prevent or decrease postoperative nerve sensitization. Objectives: To report and discuss the different classes of medication available and which associations are the most recommended for use in the dental office. Literature review: The drugs analyzed were the corticosteroids and non-steroidal anti-inflammatory drugs (NSAID), opioid and non-opioid analgesics, the association of these drugs, and those used for preemptive analgesia. Results: For mild and moderate pain, the use of an NSAID associated or not with a non-opioid analgesic is recommended, and, when facing severe pain, the association of an NSAID with an opioid analgesic may be recommended. For preemptive analgesia, it is recommended the use of a corticosteroid about 1 hour before the procedure. Conclusion: The combination of two drugs seems to achieve better results compared to the use of one individually, even if this is an association or an opioid. Preemptive analgesia, through the use of a corticosteroid in a single dose, previously to the procedures contributes in the effective control of pain, as well as the use of a long-term local anesthetic

RESPONSABILIDADE SOBRE ASSÉDIO TRABALHISTA NO METAVERSO

A discussão acerca das relações trabalhistas no metaverso é bastante inovadora, notadamente sob a ótica dos seus diversos atores: os empregados, os empregadores, a Justiça do Trabalho e o assédio. Quanto à problemática, questiona-se: como pode ser configurada a responsabilidade civil do empregador no metatrabalho devido a discriminações ou assédios. Assim, objetivo geral debater acerca da responsabilidade sobre assédio trabalhista no metaverso. No tocante aos objetivos específicos, tem-se a necessidade de expor as relações de trabalho no metaverso e a de demonstrar as modificações do trabalho humano diante do avanço das tecnologias. Nesse sentido, para suprir tais objetivos, no que se refere à metodologia, o presente trabalho possui abordagem qualitativa, método hipotético-dedutivo, procedimento técnico documental, bibliográfico e jurisprudencial, tipo teórico, natureza aplicada e objetivo descritivo. Dito isso, conclui-se que o uso contínuo da plataforma metaverso, por parte dos trabalhadores, tende a ocasionar danos à saúde física e mental. Assim, há responsabilidade civil do empregador no metatrabalho, em decorrência de discriminações ou assédios.

Guarana supplementation attenuated obesity, insulin resistance, and adipokines dysregulation induced by a standardized human Western diet via brown adipose tissue activation

Obesity is a metabolic disorder associated with adverse health consequences that has increased worldwide at an epidemic rate. This has encouraged many people to utilize nonprescription herbal supplements for weight loss without knowledge of their safety or efficacy. However, mounting evidence has shown that some herbal supplements used for weight loss are associated with adverse effects. Guarana seed powder is a popular nonprescription dietary herb supplement marketed for weight loss, but no study has demonstrated its efficacy or safety when administered alone. Wistar rats were fed four different diets (low‐fat diet and Western diet with or without guarana supplementation) for 18 weeks. Metabolic parameters, gut microbiota changes, and toxicity were then characterized. Guarana seed powder supplementation prevented weight gain, insulin resistance, and adipokine dysregulation induced by Western diet compared with the control diet. Guarana induced brown adipose tissue expansion, mitochondrial biogenesis, uncoupling protein‐1 overexpression, AMPK activation, and minor changes in gut microbiota. Molecular docking suggested a direct activation of AMPK by four guarana compounds tested here. We propose that brown adipose tissue activation is one of the action mechanisms involved in guarana supplementation‐ induced weight loss and that direct AMPK activation may underlie this mechanism. In summary, guarana is an attractive potential therapeutic agent to treat obesity

Reformulação da Educação a Distância em Tempos de Pandemia

This article aimed to analyze the necessary changes in the extension course of Special and Inclusive Education experienced by the students and team, in the modality of e-learning, of the Foundation Center of Sciences and Education of the State of Rio de Janeiro, through new referrals, particularly in times of pandemic, through practices that rescue the relevance of the continuous training process, permeated by synchronous and asynchronous activities. As a methodology, this research was conducted by the qualitative method, through collaborative research. The data collection instrument used was a semi-structured online questionnaire developed in Google Forms and the data were processed through Content Analysis, using Bardin's categorization method. The results showed that in pandemic times of mandatory social distancing, a virtual approximation becomes the right choice for the educational process in distance. Stimulating contact between all those involved is essential to increase confidence and further motivate learning. In this sense, reflecting on a dynamic online education, without ties to structured and predictable models is predominant for the quality of the courses and especially for the adequacy to the profile and needs of the students, considering that the individual's formation is directly associated with the affective and social stimuli to which they are submitted. Keywords: Distance education. Continuing education. Inclusion. Pandemic. Redesign.O presente artigo tem como objetivo analisar as mudanças necessárias no curso de extensão de Educação Especial e Inclusiva vivenciados pelos cursistas e equipe, na modalidade EaD, da Fundação Centro de Ciências e Educação do Estado do Rio de Janeiro, mediante novos encaminhamentos, em específico em tempos de pandemia, por meio de práticas que resgatem a relevância do processo de formação continuada, permeado por atividades síncronas e assíncronas. Como metodologia esta pesquisa foi conduzida pelo método qualitativo, por meio da pesquisa colaborativa. O instrumento de coleta de dados utilizado foi um questionário online semiestruturado elaborado no Google Forms e os dados foram tratados através da Análise de Conteúdo, pelo método de categorização de Bardin. Os resultados apontaram que em tempos pandêmicos de distanciamento social obrigatório, a aproximação virtual passa a ser uma escolha acertada para o processo educativo em EaD. O estímulo ao contato entre todos os envolvidos é essencial para ampliar a confiança e motivar ainda mais a aprendizagem. Nesse sentido, refletir sobre uma EaD dinâmica, sem amarras a modelos estruturados e previsíveis é preponderante para a qualidade dos cursos e principalmente para a adequação ao perfil e as necessidades dos cursistas, considerando que a formação do indivíduo está diretamente associada aos estímulos afetivos e sociais a que são submetidos. Palavras-chave: Educação a distância. Formação continuada. Inclusão. Pandemia. Replanejamento

Maternal ingestion of cocoa causes constriction of fetal ductus arteriosus in rats

Maternal consumption of polyphenol-rich foods has been associated with fetal ductus arteriosus constriction (DAC), but safety of chocolate exposure in fetal life has not been studied. This experimental study tested the hypothesis that maternal cocoa consumption in late pregnancy causes fetal DAC, with possible associated antioxidant effects. Pregnant Wistar rats, at the 21st gestational day, received by orogastric tube cocoa (720 mg/Kg) for 12 h, indomethacin (10 mg/Kg), for 8 h, or only water, before cesaren section. Immediately after withdrawal, every thorax was obtained and tissues were fixed and stained for histological analysis. The ratio of the narrowest part of the pulmonary artery to the fetal ductus inner diameter and increased ductal inner wall thickness characterized ductal constriction. Substances reactive to thiobarbituric acid were quantified. Statistical analysis used ANOVA and Tukey test. Cocoa (n = 33) and indomethacin (n = 7) reduced fetal internal ductus diameter when compared to control (water, n = 25) (p < 0.001) and cocoa alone increased ductus wall thickness (p < 0.001), but no change was noted in enzymes activity. This pharmacological study shows supporting evidences that there is a cause and effect relationship between maternal consumption of cocoa and fetal ductus arteriosus constriction. Habitual widespread use of chocolate during gestation could account for undetected ductus constriction and its potentially severe consequences, such as perinatal pulmonary hypertension, cardiac failure and even death. For this reason, dietary guidance in late pregnancy to avoid high chocolate intake, to prevent fetal ductal constriction, may represent the main translational aspect of this study

Perspectivas Atuais e Futuras nas Abordagens Terapêuticas para Hipertensão Pulmonar Persistente Neonatal.

Persistent Pulmonary Hypertension of the Newborn (PPHN) is a complex condition that represents a significant challenge in neonatology. This study reviews current therapeutic approaches for PPHN, with a focus on the efficacy and safety of sildenafil, an emerging and promising therapeutic option. An integrative review was carried out, covering articles, theses and dissertations available on scientific databases, considering the references indicated in Vancouver. Analysis of the sources included evaluation of relevance, methodology and results. Among the sources analyzed, studies such as Margotto et al. (2006), Miranda et al. (2014), and Yaseen et al. (2012) explored the efficacy of sildenafil in different clinical contexts. Carvalho et al. (2005) and Ferreira et al. (2018) highlighted the importance of correct diagnosis and the role of sildenafil in associated conditions. Rodrigues et al. (2008) and Magalhães et al. (2011) offered perspectives on etiopathogenesis and various therapeutic approaches. Sildenafil has emerged as a promising therapeutic alternative for NRHP, although more robust clinical studies are needed to validate its efficacy and safety in different clinical contexts. The ideal therapeutic approach should be individualized, taking into account the severity of the condition and other comorbidities. Interdisciplinary collaboration is vital to optimize the management of PPROM and improve outcomes for affected neonates.A Hipertensão Pulmonar Persistente do Recém-Nascido (HPPRN) é uma condição complexa que representa um desafio significativo na neonatologia. Este estudo revisa abordagens terapêuticas atuais para HPPRN, com enfoque na eficácia e segurança do sildenafil, uma opção terapêutica emergente e promissora. Realizou-se uma revisão integrativa, abrangendo artigos, teses e dissertações disponíveis em bases científicas, considerando as referências indicadas em Vancouver. A análise das fontes incluiu avaliação de relevância, metodologia e resultados. Dentre as fontes analisadas, estudos como Margotto et al. (2006), Miranda et al. (2014), e Yaseen et al. (2012) exploraram a eficácia do sildenafil em diferentes contextos clínicos. Carvalho et al. (2005) e Ferreira et al. (2018) destacaram a importância do diagnóstico correto e o papel do sildenafil em condições associadas. Rodrigues et al. (2008) e Magalhães et al. (2011) ofereceram perspectivas sobre a etiopatogenia e variadas abordagens terapêuticas. O sildenafil surge como uma alternativa terapêutica promissora para HPPRN, embora sejam necessários mais estudos clínicos robustos para validar sua eficácia e segurança em diferentes contextos clínicos. A abordagem terapêutica ideal deve ser individualizada, levando em consideração a gravidade da condição e outras comorbidades. A colaboração interdisciplinar é vital para otimizar a gestão da HPPRN e melhorar os resultados para os neonatos afetados.&nbsp

Estimating the global conservation status of more than 15,000 Amazonian tree species

Estimates of extinction risk for Amazonian plant and animal species are rare and not often incorporated into land-use policy and conservation planning. We overlay spatial distribution models with historical and projected deforestation to show that at least 36% and up to 57% of all Amazonian tree species are likely to qualify as globally threatened under International Union for Conservation of Nature (IUCN) Red List criteria. If confirmed, these results would increase the number of threatened plant species on Earth by 22%. We show that the trends observed in Amazonia apply to trees throughout the tropics, and we predict thatmost of the world’s >40,000 tropical tree species now qualify as globally threatened. A gap analysis suggests that existing Amazonian protected areas and indigenous territories will protect viable populations of most threatened species if these areas suffer no further degradation, highlighting the key roles that protected areas, indigenous peoples, and improved governance can play in preventing large-scale extinctions in the tropics in this century