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PURPOSE: The rapid spread of the SARS-CoV-2 pandemic around the world caused most healthcare services to turn substantial attention to treatment of these patients and also to alter the structure of healthcare systems to address an infectious disease. As a result, many cancer patients had their treatment deferred during the pandemic, increasing the time-to-treatment initiation, the number of untreated patients (which will alter the dynamics of healthcare delivery in the post-pandemic era) and increasing their risk of death. Hence, we analyzed the impact on global cancer mortality considering the decline in oncology care during the COVID-19 outbreak using head and neck cancer, a known time-dependent disease, as a model. METHODS: An online practical tool capable of predicting the risk of cancer patients dying due to the COVID-19 outbreak and also useful for mitigation strategies after the peak of the pandemic has been developed, based on a mathematical model. The scenarios were estimated by information of 15 oncological services worldwide, given a perspective from the five continents and also some simulations were conducted at world demographic data. RESULTS: The model demonstrates that the more that cancer care was maintained during the outbreak and also the more it is increased during the mitigation period, the shorter will be the recovery, lessening the additional risk of dying due to time-to-treatment initiation. CONCLUSIONS: This impact of COVID-19 pandemic on cancer patients is inevitable, but it is possible to minimize it with an effort measured by the proposed model.

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Superabsorbent hydrogels (SAHs) are three dimensional networks formed by polymers that can absorb aqueous solution of over 100% of their initial weight. This work aimed to develop and characterize SAHs of Chitosan/Xanthan gum (CG), Chitosan/Alginate (CA) and controlled Chitosan (C), Xanthan gum (G), and Alginate (A) produced using "onion-like" methodology. The swelling performance, the morphological structure, the crystallinity, and the Fourier transformed infrared spectroscopy characteristics of SAH were used for the characterization of polyelectrolytes complex. Swelling analysis showed that chitosan has a strong influence on the maintenance of hydrogels structure after swelling, mainly in the acid environment (pH = 2). The chitosan hydrogel presented around 3000% of acidic fluid absorption after 24 h. The chitosan:xanthan gum (1:1 and 2:1 named as C1G1 and C2G1, respectively) hydrogels were the best combination regarding swelling performance in an acid environment, reaching 1665% and 2024%, respectively, as well at pH 7.0, presenting 1005% (C1G1) and 667% (C2G1). Scanning electron microscopy analysis showed samples with pores, and with different shapes. The X-ray diffraction showed the presence of a characteristic peak at 2θ = 20° in all developed composition because of the crystalline nature of chitosan. This work shows the possibility of developing eco-friendly biopolymer-based SAHs at a low cost with a good swelling capacity and stability.

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Tissue engineering is a multidisciplinary science that combines a structural scaffold and cells to form a construct able to promote regeneration of injured tissue. Bioactive glass foam produced by sol-gel is an osteoinductive material with a network of interconnected macropores necessary for cell colonization. The use of human adipose-derived stem cell (hASC) presents advantages as the potential for a large number of cells, rapid expansion in vitro and the capability of differentiating into osteoblasts. The use of a bioreactor in three-dimensional cell culture enables greater efficiency for cell nutrition and application of mechanical forces, important modulators of bone physiology. The hASC seeded in a bioactive glass scaffold and cultured in osteogenic Leibovitz L-15 medium in a bioreactor with a flow rate of 0.1 mL min(-1) demonstrated a significant increase in cell proliferation and viability and alkaline phosphatase (ALP) activity peak after 14 days. The immunofluorescence assay revealed an expression of osteopontin, osteocalcin and type I collagen from 7 to 21 days after culture. The cells changed from a spindle shape to a cuboidal morphology characteristic of osteoblasts. The polymerase chain reaction assay confirmed that osteopontin, osteocalcin, and ALP genes were expressed. These results indicate that hASCs differentiated into an osteogenic phenotype when cultured in bioactive glass scaffold, osteogenic Leibovitz L-15 medium and a perfusion bioreactor. Therefore, these results highlight the synergism between a bioactive glass scaffold and the effect of perfusion on cells and indicate the differentiation into an osteogenic phenotype.

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PURPOSE: Evaluate corneal endothelium by means of specular microscopy exam in patients with Keratoconus, before and after Cornealring® corneal intrastromal ring surgery. METHODS: One hundred and two eyes of 67 patients, aged between 12 and 45, with the average age of 27.31 ± 8.15 years, 30 females and 37 males, were selected to be submitted to the implant of Cornealring® corneal ring segments in pre- and post-surgery (six months after the procedure) in the External Diseases and Cornea Ward of the Instituto Panamericano da Visão. RESULTS: Of the 102 eyes treated, only those that received two rings of equal thickness up to 250 µ showed statistical significance between the initial and final mean number of endothelial cells (P = 0.008), a decrease of 10.1% in the mean coefficient of variation (P = 0.003), and a 9.75% decrease in initial and final hexagonal cell counts. The other eyes receiving rings of other thicknesses showed no statistically significant differences between the mean initial and final SM examinations. CONCLUSION: A longer segment is necessary for the confirmation or not of the alterations found in this study, particularly regarding the thickness of the ring used, because with the new technologies and the improvement in the result of deep lamellar transplantation, the decrease in the cell count might represent a problem in the indication of this procedure following thick corneal ring implants.

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Hunter syndrome, or Mucopolysaccharidosis type II (MPS II), is a rare X-linked recessive disorder caused by a deficiency of the lysosomal enzyme iduronate-2-sulfatase (IDS). The phenotypic spectrum varies from severe to attenuated clinical forms. We report a large Brazilian family with 16 affected individuals exhibiting a very attenuated form of MPS II. Fourteen female carriers were also identified. Twelve affected male patients, whose ages ranged from 1 to 35 years, were examined. Molecular analysis showed a novel missense mutation (p.A77D) in the IDS gene, confirming the diagnosis. Nine of the family members presented some degree of heart damage, though only the proband became symptomatic and required heart transplantation. One 19-year-old adult and 1-year-old twin boys each had a normal echocardiogram. Short stature was found in two adults while macrocephaly was found in one; the remaining adults had anthropometric measures within normal range. All affected adults had normal cognitive development and were able to perform normal daily activities, except one who had mild learning disability. Two patients died due to natural causes beyond 70 years of age. The female carriers did not present any signs of disease. In this large family with a mild form of MPS II and variable degree of clinical manifestations, it is noteworthy that several affected individuals have remained asymptomatic even at advanced age and even without enzyme replacement therapy.

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This work evaluated the effect of freezing on chondrocytes maintained in culture, aiming the establishment of a cell bank for future application as heterologous implant. Chondrocytes extracted from joint cartilage of nine healthy New Zealand White rabbits were cultivated and frozen with the cryoprotector 5 percent dimethylsulfoxide for six months. Phenotypic and scanning electron microscopy analyses were carried out to identify morphological and functional differences between fresh and thawed cells. After enzymatic digestion, a total of 4.8x10(5)cells per rabbit were obtained. Fresh chondrocytes showed a high mitotic rate and abundant matrix was present up to 60 days of culture. Loss of phenotypic stability was notable in the thawed chondrocytes, with a low labeling of proteoglycans and weak immunostaining of type II collagen. The present study showed important loss of chondrocyte viability under the freezing conditions. For future in vivo studies of heterologous implant, these results suggests that a high number of cells should be implanted in the host site in order to achieve an adequate number of viable cells. Furthermore, the chondrocytes should be implanted after two weeks of culture, when the highest viability rate is found.(AU)

Avaliaram-se os efeitos do congelamento sobre condrócitos mantidos em cultura, com o objetivo de se estabelecer um banco celular para futura aplicação como implante heterólogo. Condrócitos extraídos da cartilagem articular de nove coelhos saudáveis, da raça Nova Zelândia Branca, foram cultivados e submetidos ao congelamento, com o citoprotetor sulfóxido de dimetila a 5 por cento, por um período de seis meses. Análises fenotípicas e de microscopia eletrônica de varredura foram realizadas com o objetivo de identificar diferenças morfológicas e funcionais entre as células frescas e as descongeladas. Após a digestão enzimática, foram obtidas 4,8x10(5) células por coelho. Os condrócitos frescos apresentaram elevada taxa mitótica e abundante presença de matriz até os 60 dias de cultura. Nas culturas dos condrócitos descongelados, a perda de estabilidade fenotípica foi marcante, o que foi demonstrado pela baixa intensidade da coloração dos proteoglicanos e pela fraca imunomarcação do colágeno tipo II. Sob as condições de congelamento utilizadas, houve importante perda de viabilidade condrocítica. Para futuros estudos in vivo de implante heterólogo, estes resultados sugerem que o elevado número de células deve ser implantado no sítio hospedeiro, com o objetivo de se obter maior quantidade de células viáveis, e que os condrócitos deverão ser implantados com duas semanas de cultivo, período em que apresentam melhor taxa de viabilidade.(AU)

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This work evaluated the effect of freezing on chondrocytes maintained in culture, aiming the establishment of a cell bank for future application as heterologous implant. Chondrocytes extracted from joint cartilage of nine healthy New Zealand White rabbits were cultivated and frozen with the cryoprotector 5 percent dimethylsulfoxide for six months. Phenotypic and scanning electron microscopy analyses were carried out to identify morphological and functional differences between fresh and thawed cells. After enzymatic digestion, a total of 4.8x10(5)cells per rabbit were obtained. Fresh chondrocytes showed a high mitotic rate and abundant matrix was present up to 60 days of culture. Loss of phenotypic stability was notable in the thawed chondrocytes, with a low labeling of proteoglycans and weak immunostaining of type II collagen. The present study showed important loss of chondrocyte viability under the freezing conditions. For future in vivo studies of heterologous implant, these results suggests that a high number of cells should be implanted in the host site in order to achieve an adequate number of viable cells. Furthermore, the chondrocytes should be implanted after two weeks of culture, when the highest viability rate is found.

Avaliaram-se os efeitos do congelamento sobre condrócitos mantidos em cultura, com o objetivo de se estabelecer um banco celular para futura aplicação como implante heterólogo. Condrócitos extraídos da cartilagem articular de nove coelhos saudáveis, da raça Nova Zelândia Branca, foram cultivados e submetidos ao congelamento, com o citoprotetor sulfóxido de dimetila a 5 por cento, por um período de seis meses. Análises fenotípicas e de microscopia eletrônica de varredura foram realizadas com o objetivo de identificar diferenças morfológicas e funcionais entre as células frescas e as descongeladas. Após a digestão enzimática, foram obtidas 4,8x10(5) células por coelho. Os condrócitos frescos apresentaram elevada taxa mitótica e abundante presença de matriz até os 60 dias de cultura. Nas culturas dos condrócitos descongelados, a perda de estabilidade fenotípica foi marcante, o que foi demonstrado pela baixa intensidade da coloração dos proteoglicanos e pela fraca imunomarcação do colágeno tipo II. Sob as condições de congelamento utilizadas, houve importante perda de viabilidade condrocítica. Para futuros estudos in vivo de implante heterólogo, estes resultados sugerem que o elevado número de células deve ser implantado no sítio hospedeiro, com o objetivo de se obter maior quantidade de células viáveis, e que os condrócitos deverão ser implantados com duas semanas de cultivo, período em que apresentam melhor taxa de viabilidade.

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The aim of the study was to characterize clinically and biochemically mucopolysaccharidosis type II (MPS II) heterozygotes. Fifty-two women at risk to be a carrier, with a mean age of 34.1 years (range 16-57 years), were evaluated through pedigree analysis, medical history, physical examination, measurement of iduronate sulfatase (IDS) activities in plasma and in leukocytes, quantification of glycosaminoglycans (GAGs) in urine, and analysis of the IDS gene. Eligibility criteria for the study also included being 16 years of age or older and being enrolled in a genetic counselling programme. The pedigree and DNA analyses allowed the identification of 40/52 carriers and 12/52 non-carriers. All women evaluated were clinically healthy, and their levels of urinary GAGs were within normal limits. Median plasma and leukocyte IDS activities found among carriers were significantly lower than the values found for non-carriers; there was, however, an overlap between carriers' and non-carriers' values. Our data suggests that MPS II carriers show lower plasma and leukocyte IDS activities but that this reduction is generally associated neither with changes in levels of urinary GAGs nor with the occurrence of clinical manifestations.

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