Knowing the anatomy of the ribs is crucial for understanding various rib procedures. The present study is aimed at describing radiological measurements and ratios of 83 Latin American patients undergoing thoracoabdominal computed tomography (CT). A total of 83 thoracoabdominal computed tomography scans of women aged 18-35 conducted at a medical center in Lima, Peru, were reviewed from January 2022 to January 2023. The resulting measurements and ratios were used to calculate frequency distributions. All data were stored in a Microsoft Excel database and analyzed using statistical analysis software SPSS version 28. Ratios and measures of the tenth, eleventh, and twelfth ribs are shown in the different tables, and costal characteristics with an adequate statistical significance are defined. Using radiological measurements and rib ratios, we were able to find key anatomical relationships with an adequate level of significance, which could help establish objective results in rib procedures.

The taxonomy of the South American metalmark butterflies of the genus Alesa Doubleday, 1847 is reviewed. A new taxonomic arrangement for Alesa is supported after the analysis of about 600 specimens, including the recognition of two new species, described herein, A. juliae sp. nov. and A. mariae sp. nov.. Alesa negra Röber, 1931, so far recognized as a junior subjective synonym of A. telephae (Boisduval, 1836), is here recognized as a valid species (stat. rev.) and A. amethystina Gallard & Fernandez, 2015 as a junior subjective synonym (syn. nov.) of A. negra, and A. fournierae Lathy, 1958 is recognized as a junior subjective synonym (syn. nov.) of A. amesis (Cramer, 1777). Neotypes are designated for Papilio amesis Cramer, 1777, Erycina prema Godart, [1824] and Mimocastinia egeria Biedermann, 1936. Lectotypes are designated for Erycina priolas Godart, [1824], Eurybia telephae Boisduval, 1836, A. smaragdifera Westwood, 1851, A. lipara Bates, 1868, A. hemiurga Bates, 1868, A. thelydrias Bates, 1868, and Mimocastnia rothschildi Seitz, 1913. Three previously established species groups are here supported by morphological characters including the following species, "prema group": A. prema, A. esmeralda Salazar & Constantino, 2007, A. beneluzi Gallard & Fernandez, 2015, A. rothschildi and A. juliae sp. nov.; "telephae group": A. telephae, A. humilis Brévignon, 2015, A. negra stat. rev. and A. suzana Ahrenholz & Hall, 2010; and "amesis group": A. amesis, A. mariae sp. nov., A. lipara Bates, 1867, A. hemiurga Bates, 1867 and A. thelydrias Bates, 1867. Adults and their genitalia are illustrated for all species available to examination. The main diagnostic characters used to distinguish the species belonging to the "amesis group" are illustrated, and pictures of adults images in situ and distribution maps are provided. Additionally, all species are diagnosed and discussed based on their morphology.

In recent years incidence of childhood obesity has increased globally, regardless of economic status. This phenomenon is a known risk factor for cardiovascular diseases. Here we hypothesized that postnatal overfeeding, a recognized model of childhood obesity, will induce vascular dysfunction in prepubertal and adult rats in a sex-dependent manner. For this, we used the animal model of postnatal overfeeding by litter size reduction. At postnatal day (PND) 1, Wistar rat were divided into a normal litter (NL, mothers were kept with 5 female and 5 male pups) or small litter (SL, mothers were kept with 2 male and 1 female pup). The ratss were evaluated at two time points prepubertal (PND 30 for females and 40 for males due to known sexual maturation differences), and in adulthood (120 for both sex). Body weight (g) and retroperitoneal adipose tissue (fat pad weight/100g of the body n=9-13) were evaluated. Aorta was removed for wall thickness measurements via histology (n=5, μm), and vascular function was performed via pin myograph. Concentration-response curves to phenylephrine [Phenyl, 1nM-10μM, n=6, gram force (gf)] or acetylcholine (ACh 0.1nM100μM, n=7 % relaxation) were performed. To understand the role of the NADPH-derived reactive oxygen species, angiotensin-II and aldosterone, apocynin (APO 10 μM), losartan (LOS 1 μM) or spironolactone (SPR 1 μM) were used respectively. Prepubertal SL rats had higher body weight (female: NL 76±2 vs SL 91±1, g, p<0.05; male: NL 148±2 vs. SL 185±4, g, p<0.05), and adipose tissue deposition (female: NL 0.09±0.01 vs. SL 0.17±0.01, p<0.05; male: NL 0.17±0.09 vs. SL 0.32±0.03, p<0.05] regardless of sex. Interestingly, there were no differences in these parameters at PND 120 for female NL and SL. In contrast, male SL at PND 120 had higher body weight (NL 419±9 vs SL 462±5, g, p<0.05) and retroperitoneal adipose tissue (NL 1.2±0.9 vs SL 1.6±0.1, p<0.05]). No differences were observed in phenyl-induced contraction in aortas from females at PND 30 and 120. On the other hand, endothelial dysfunction was observed at PND 120 in arteries from SL females rats [Maximum response (Rmax): NL 94±1 vs SL 84±2, % p<0.05]. LOS (Rmax: SL 77±1 vs LOS 90±1, % p<0.05) and APO (SL 77±1 vs APO 87±1, % p<0.05] restored endothelial function in these animals. No changes in endothelium-dependent relaxation were observed in arteries from male rats at PND 40 or 120. However, there was an increase in vascular contractility from SL males at PND 40 (Rmax: NL 1.17±0.40 vs SL 1.47±0.06, g, p<0.05), and SPR (SL 1.50 ±0.14 vs SPR 0.93±0.09, g, p<0.05) improved this response, but no differences were observed at PND 120. Further, the aortic thickness was similar between groups at PND 120 regardless of sex. In conclusion, postnatal overfeeding in rats causes childhood obesity associated with vascular dysfunction. These differences were observed in prepubescent and adult rats, and the respective mechanisms are sex-dependent. Coordination for the Improvement of Higher Education Personnel - Brazil (CAPES) (Finance code 001). Araucária Foundation for the Support of Scientific and Technological Development of the State of Paraná - Brazil (grant: 215/2022-PBA). National Institutes of Health - R00GM118885, R01HL149762, R00HL151889, and RO1DK132948. Fulbright Program - DDRA foundation. This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

AbstractIn acute ischemic stroke (AIS), there are no data on whether lipid and protein oxidation and antioxidant biomarkers are associated with the outcome of AIS above and beyond the effects of traditional risk factors, immune and metabolic biomarkers, and measurements of stroke volume. The present study was conducted in 135 mild to moderate AIS patients and 40 controls and assessed the modified raking scale (mRS) at baseline, and 3 and 6 month later. We measured lipid hydroperoxides (LOOH), malondialdehyde (MDA), advanced oxidation protein products, paraoxonase 1 (PON1) activities and PON1 Q192R genotypes, high density lipoprotein cholesterol (HDL), sulfhydryl (-SH) groups), and diffusion-weighted imaging (DWI) stroke volume and fluid-attenuated inversion recovery (FLAIR) signal intensity. We found that a) AIS is characterized by lower chloromethyl acetate (CMPA)ase PON1 activity, HDL and -SH groups and increased LOOH and neurotoxicity (a composite of LOOH, inflammatory markers and glycated hemoglobin); b) oxidative and antioxidant biomarkers strongly and independently predict mRS scores 3 and 6 months later and DWI stroke volume and FLAIR signal intensity; c) the PON1 Q192R variant has multiple effects on stroke outcome that are mediated by its effects on antioxidant defenses and lipid peroxidation; and d) the PON1 RR variant has a protective effect against lipid peroxidation, neurotoxicity, infarct volume and stroke outcome. Increased lipid peroxidation and lowered activity of the PON1-HDL complex and -SH groups are drug targets to prevent AIS and consequent neurodegenerative processes with loss of function, and increased levels of oxidative reperfusion mediators due to ischemia-reperfusion injury.

AbstractThe top-down DSM/ICD categories of mood disorders are inaccurate, and their dogmatic nature precludes both deductive (as indisputable) and inductive (as top-down) remodeling of case definitions. In trials, psychiatric rating scale scores employed as outcome variables are invalid and rely on folk psychology-like narratives. Using machine learning techniques we developed a new precision nomothetic model of mood disorders with a recurrence of illness (ROI) index, a new endophenotype class, namely Major Dysmood Disorder (MDMD), characterized by increased ROI, a more severe phenome, and more disabilities Nonetheless, our previous studies did not compute Research and Diagnostic Algorithmic Rules (RADAR) to diagnose MDMD and score ROI, lifetime (LT), and current suicidal behaviors, as well as the phenome of mood disorders. Here we provide rules to compute bottom-up RADAR scores for MDMD, ROI, lifetime (LT) and current suicidal SI and SA, the phenome of mood disorders, and the lifetime trajectory of mood disorder patients from a family history of mood disorders and substance abuse to adverse childhood experiences, ROI, and the phenome. We also demonstrate how to plot the 12 major scores in a single RADAR graph, which displays all features in a two-dimensional plot. These graphs allow the characteristics of a patient to be displayed as an idiomatic fingerprint, allowing one to estimate the key traits and severity of the illness at a glance. Consequently, biomarker research into mood disorders should use our RADAR scores to examine pan-omics data, which should be used to enlarge our precision models and RADAR graph.

This article presents a mobile application model for the treatment tracking of in-hospital wounds. A survey of the literature on mobile apps for wound monitoring was carried out. Health professionals were interviewed and wound forms were analyzed to synthesize the application's fields and features. We designed the application model using a prototyping tool. The prototype features interfaces for patient evaluation, different functionalities according to the role of the health professional, a dashboard for monitoring the open admissions, selection of wound locations using a body model, treatment prescribing, tracking the wounds using photos, and generating wound reports. The adoption of this application could optimize wounds' treatment, increase patient safety, reduce material expenditures and time for professionals with rework in the dressing procedure.

Some of the more than 200 known HPV types are essential for cervical cancer development, the third type of cancer most incident in the female population. However, for the malignant transformation occur, some cofactors are needed, as the reactive oxygen species (ROS), which can be neutralized by the antioxidant system. The SOD2 enzyme, encoded by the same name gene, is found in mitochondria and is part of the first line of defense against oxidative stress damage. Genetic polymorphisms can act by altering the efficiency of the enzyme, among which the most studied is the rs4880. Thus, the purpose of the present study was to evaluate the association of this polymorphism with HPV infection and the development of low and high grade squamous intraepithelial lesions (LSIL and HSIL) and cervical cancer, in 407 women attended by the public health system in Brazil. HPV detection in cervical secretion samples was carried out by polymerase chain reaction (PCR) and blood samples were used for polymorphism genotyping through PCR followed by restriction fragment length polymorphism (RFLP). PCR and restriction products were subjected to 10% polyacrylamide gel electrophoresis. HPV negative group (control) included 158 women and the HPV positive group (case) 249 women. The infected group was divided into No Lesion (n = 90), LSIL (n = 20), HSIL (n = 67) and cervical cancer (n = 72). The data found on socio-epidemiological characteristics and habits corroborated with data found in the literature. The distribution of genotypes in the control group was 51.9% women TC, 29.8% TT and 18.3% CC. In the case group, the distribution was 55.0% women TC, 26.1% TT and 18.9% CC. This is the first study evaluating the influence of SOD2 rs4880 polymorphism on HPV infection, the development of cervical intraepithelial lesions and cervical cancer in a Brazilian population, although additional studies are needed to corroborate the results.

Introduction The purpose of this case report was to show the clinical long-term stability of a successful two-step root coverage procedure. A combination of two single techniques was used to treat an isolated deep-wide defect. Case Presentation. A 28-year-old female patient was referred in order to treat a single recession defect at #22. Due to her fear of dental procedures and a poor economic situation, the team developed an alternative solution. They used a modified apically repositioned flap (MARF) to increase the donor area and then a laterally positioned flap (LPF) to treat the root defect. Clinical evaluation at the three-year follow-up revealed complete resolution of the defect, a gain in clinical attachment, excellent esthetic results, and minor morbidity to the patient. Conclusion The combination of the MARF and the LPF procedures was able to successfully treat a single deep recession defect with some advantages over traditional techniques such as simplicity, ideal color match of tissues, and the absence of palatal donor tissue.

This case report aimed to discuss the multifactorial etiology and also the management of temporomandibular disorders (TMD) by addressing important associated psychosocial and biological factors, emphasizing the interaction between these factors and a probable genetic predisposition. A 21-year-old female patient was evaluated according to Research Diagnostic Criteria for TMD and diagnosed with arthralgia, myofascial pain, disc displacement without reduction, and temporomandibular joint (TMJ) degenerative disease. TMJ alterations were confirmed through magnetic resonance imaging and cone-beam computed tomography. Pressure pain threshold of masticatory structures was evaluated using a pressure algometer. Sleep bruxism, poor sleep quality, migraine with aura, mild anxiety, and history of facial trauma were also identified through anamnesis and clinical examination. Following this, genetic analysis was performed to evaluate the presence of single nucleotide polymorphisms (SNPs) already associated with TMD: SNP COMT Val158 Met (rs4680), MMP1-1607 (rs1799750), and tumor necrosis factor alpha-308 (rs1800629), which were all present. A personalized treatment for TMD management was performed, and it included self-management programs, occlusal appliance therapy, pharmacotherapy, anxiety management, and stress control. An 8-year follow-up demonstrated long-term stabilization of TMJ degenerative disease. Genetic evaluation, added to anamnesis and clinical examination, could be useful for TMD prognosis and management.

BackgroundOncoplastic surgery (OS) has added plastic surgery concepts and techniques to the breast cancer surgery. However, reports of the impact of OS on cosmesis after breast-conserving surgery (BCS) are limited in the literature. Patients and MethodsThis cross-sectional prospective study included patients who underwent BCS. The patients self-evaluated the cosmetic outcome of the breasts and had them photographed. The photos were evaluated by BCCT.core software and by 6 breast surgeons (mastologists and plastic surgeons) using the Harvard, Garbay, and Fitoussi scales. Kappa and weighted kappa tests were used to analyze agreement for categorical variables; for continuous variables, the interclass correlation index and the chi-square test to analyze the association between the OS and the symmetrization. ResultsA total of 300 patients were evaluated: 228 (76.0%) underwent traditional BCS and 72 (24.0%) underwent OS, and of these, 37 (51.4%) underwent contralateral symmetrization surgery. In the evaluation of the cosmetic result, the correlation between patients and observers (BCCT.core and surgeons) was weak; between the 2 groups of surgeons, the correlation was moderate (Fitoussi scale) and excellent (Garbay scale). Plastic surgeons are more critical for evaluating cosmetic results; they considered it good or excellent in 30.0% whereas patients, mastologists, and BCCT.core results considered it so in 78.8%, 34.0%, and 30.0%, respectively. In terms of cosmesis, OS and symmetrization did not influence the results in this study with long follow-up. ConclusionPatients’ self-evaluation reported better cosmesis than surgeons’ analyses. Plastic surgeons were the most critical. OS and symmetrization did not influence the results.