Identifying Consistent Metrics from the Force-Time Curve of the Countermovement Jump in Combat Fighters and Physically Active Men.

We investigated the consistency of metrics obtained from the unweighting, braking, propulsive, and landing phases of the countermovement (CMJ) force-time curve in combat fighters and physically active men. Combat fighters (n=21) and physically actives (n=21) were tested for three days (2-7 days apart). Participants performed four maximal CMJ separated by 1-min for between-day comparisons. From force-time recording, the consistency of 16 CMJ metrics (peak and mean ground reaction forces (GRF), net impulse, and duration from each phase) was investigated using the intraclass correlation coefficient (ICC) and typical error (CVTE). We considered as "consistent" those metrics showing no systematic differences, ICC ≥ 0.75, and CVTE ≤ 10%. We further compared the CVTE between groups and pairs of trials (days). Participants demonstrated more consistency in the braking and propulsive phases, while the unweighting phase did not show any consistent metric. There was no evidence of a learning effect (systematic changes), but analysis appointed more consistency on days 2-3 than on days 1-2 (18 metrics presented lower CVTE while 11 presented higher). We identified braking and propulsive GRF (peak and mean) and propulsive impulse as consistent metrics for combat fighters, while only propulsive impulse for physically actives. The between-group analyses showed that 24 comparisons favored the combat fighters against only five favoring the physically actives. In conclusion, force-time metrics related to jumping strategy, like phase duration, are less consistent than those related to driven forces and jump output, probably because participants changed their jump strategy during testing days.

Evidence of validity and reliability of Jumpo 2 and MyJump 2 for estimating vertical jump variables.

Background: We investigated the concurrent validity and test-retest reliability of the Jumpo 2 and MyJump 2 apps for estimating jump height, and the mean values of force, velocity, and power produced during countermovement (CMJ) and squat jumps (SJ). Methods: Physically active university aged men (n = 10, 20 ± 3 years, 176 ± 6 cm, 68 ± 9 kg) jumped on a force plate (i.e., criterion) while being recorded by a smartphone slow-motion camera. The videos were analyzed using Jumpo 2 and MyJump 2 using a Samsung Galaxy S7 powered by the Android system. Validity and reliability were determined by regression analysis, typical error of estimates and measurements, and intraclass correlation coefficients. Results: Both apps provided a reliable estimate of jump height and the mean values of force, velocity, and power. Furthermore, estimates of jump height for CMJ and SJ and the mean force of the CMJ were valid. However, the apps presented impractical or poor validity correlations for velocity and power. Compared with criterion, the apps underestimated the velocity of the CMJ. Conclusions: Therefore, Jumpo 2 and MyJump 2 both provide a valid measure of jump height, but the remaining variables provided by these apps must be viewed with caution since the validity of force depends on jump type, while velocity (and as consequence power) could not be well estimated from the apps.

O ECG NA MULHER HIPERTENSA, QUAL O MELHOR CRITÉRIO DE VOLTAGEM? / THE ECG IN HYPERTENSIVE WOMEN, WHAT IS THE BEST VOLTAGE CRITERIA?

Segundo a Diretriz Brasileira de Hipertensão Arterial 2020, hipertensão arterial (HA) é uma doença crônica não transmissível (DCNT) definida por níveis pressóricos, em que os benefícios do tratamento não medicamentoso e/ou medicamentoso superam os riscos; e a falta de tratamento evolui com lesão de órgão alvo, como a hipertrofia ventricular esquerda. Neste estudo avaliamos a literatura no tocante à acurácia dos critérios eletrocardiográficos para diagnóstico de hipertrofia ventricular esquerda (HVE) e por conta das diferenças entre homens e mulheres, isso constitui um grande desafio. Dentre os fatores que mais interferem no critério sensibilidade, destacam-se a massa cardíaca e o sexo, sendo a sensibilidade do ECG maior com o aumento da massa ventricular e no sexo masculino, segundo Colossimo e Povoa. No estudo de Gasperin, onde foram utilizados critérios de voltagem, observou-se que o critério de Cornell nas mulheres foi de maior sensibilidade, de 54,90%, com alta especificidade de 81,60%. Quando a sensibilidade do critério de Cornell foi comparada à de Sokolow-Lyon-Rappaport, o segundo em sensibilidade, foi de 41,18%; sem significância estatística entre os dois. A detecção precoce da HVE tem importância prognóstica, já discutida em vários trabalhos e seus critérios de validação, um constante desafio. Definir critérios específicos em mulheres torna-se necessário para maior acurácia diagnóstica e abordagem precoce para intervenções terapêuticas sejam medicamentosas ou não. Conclui-se que o critério eletrocardiográfico de Cornell foi o método com maior sensibilidade nas mulheres, nesta revisão. São necessários estudos com análises especificas para o sexo feminino, considerando suas diferenças anatômicas e antropométricas e possivelmente ajustadas à população brasileira. Torna-se uma limitação desta análise, a lacuna resultante do pequeno número de dados e poucos estudos publicados sobre o tema.

According to the Brazilian Guidelines on Hypertension 2020, hypertension (AH) is a chronic non-communicabledisease (NCD) defined by blood pressure levels, in which the benefits of non pharmacologic and/or pharmacologic therapy out weigh The risks; and lack of treatment evolves with target-organ damage such as left ventricular hypertrophy. In this study, we evaluated the literature regarding the accuracy of the electrocardiographic criteria for the diagnosis of left ventricular hypertrophy (LVH) and, due to the differences between men and women, this represents a great challenge. Among the factors that most interfere with the sensitivity criterion, cardiac mass and gender stand out, with ECG sensitivity being greater with the increase in ventricular mass and in males, according to Colossimo and Povoa. In the study by Gasperin, where voltage criteria were used, it was observed that the Cornell criterion in women was more sensitive, 54.90%, with a high specificity of 81.60%. When the sensitivity of the Cornell criterion was compared to theSokolow-Lyon-Rappaport criterion, the latter in sensitivity was 41.18%; with no statistical significance between the two. The early detection of LVH hás prognostic importance, already discussed in several works and its validation criteria, a Constant challenge. Defining specific criteria in women becomes necessary for greater diagnostic accuracy and a nearly approach to therapeutic interventions, whether drug-related or not. It is concluded that the Cornell electrocardiographic criterion was the method with the greatest sensitivity in women in this review. However, studies with specific analyzes for females are still needed, considering their anatomical and anthropometric differences and possibly adjusted to the Brazilian population. The gap resulting from the small amount of data and few published studies on the subject becomes a limitation of this analysis

Diagnosis of Alzheimer's Disease in Developed and Developing Countries: Systematic Review and Meta-Analysis of Diagnostic Test Accuracy.

BACKGROUND: The present systematic review and meta-analysis of diagnostic test accuracy summarizes the last three decades in advances on diagnosis of Alzheimer's disease (AD) in developed and developing countries. OBJECTIVE: To determine the accuracy of biomarkers in diagnostic tools in AD, for example, cerebrospinal fluid, positron emission tomography (PET), and magnetic resonance imaging (MRI), etc. METHODS: The authors searched PubMed for published studies from 1990 to April 2020 on AD diagnostic biomarkers. 84 published studies were pooled and analyzed in this meta-analysis and diagnostic accuracy was compared by summary receiver operating characteristic statistics. RESULTS: Overall, 84 studies met the criteria and were included in a meta-analysis. For EEG, the sensitivity ranged from 67 to 98%, with a median of 80%, 95% CI [75, 91], tau-PET diagnosis sensitivity ranged from 76 to 97%, with a median of 94%, 95% CI [76, 97]; and MRI sensitivity ranged from 41 to 99%, with a median of 84%, 95% CI [81, 87]. Our results showed that tau-PET diagnosis had higher performance as compared to other diagnostic methods in this meta-analysis. CONCLUSION: Our findings showed an important discrepancy in diagnostic data for AD between developed and developing countries, which can impact global prevalence estimation and management of AD. Also, our analysis found a better performance for the tau-PET diagnostic over other methods to diagnose AD patients, but the expense of tau-PET scan seems to be the limiting factor in the diagnosis of AD in developing countries such as those found in Asia, Africa, and Latin America.

Resistome in gram-negative bacteria from soft cheese in Brazil / Resistoma em bactérias gram-negativas de queijo minas frescal no Brazil

Objective: evaluation of antibiotic resistance in Gram-negative microbiota from ready-to-eat cheese samples. Methodology: this research applied an adapted methodology to select from a food sample viable Gram-negative microbiota displaying antibiotic resistance. The selected food was a cheese that is commonly consumed without thermal processing, the Minas Frescal cheese. The evaluation was followed by a PCR screening in this resistant microbiota, for genes that provide resistance to antibiotics and also to the quaternary ammonium. Results: all cheese samples harbored a resistant microbiota. In 13.3% of the cheese samples analyzed, the resistance reached all ten different antibiotics tested and, in 80%, 8 to 10 different antibiotics. In antibiotics considered critics as the carbapenems: ertapenem presented resistant microbiota in 86.7% of the samples. In cephalosporins, the resistance reached 100% in the third generation (ceftazidime) and almost half of the samples (46.7%) in the fourth generation (cefepime). In genotypic research, seven different resistance genes were found in 69.2% of the bacterial pools, including the beta-lactamase-producing genes ctx, tem, shv, tetracycline-resistant genes, and a high rate of integrons class 1 and 2. Conclusion: the results indicate phenotypically and genotypically that the Minas Frescal cheese can harbor potential resistant microbiota. Therefore, the methodology used is a viable possibility and with a broader answer about the food microbiota role in resistance. This research corroborates the food area as an important sector to be managed to reduce the process of antibiotic resistance.

Objetivo: avaliação da resistência a antibióticos em microbiota Gram-negativa de amostras de queijo prontas para consumo. Metodologia: esta pesquisa aplicou uma metodologia adaptada para selecionar a microbiota Gram-negativa viável apresentando resistência a antibióticos em uma amostra de alimento. O alimento selecionado foi um queijo frequentemente consumido sem processamento térmico, o queijo Minas Frescal. A avaliação foi seguida de uma triagem por PCR, nesta microbiota resistente, para genes que fornecem resistência aos antibióticos e também ao quaternário de amônio. Resultados: todas as amostras de queijo apresentaram microbiota resistente. Em 13,3% dos queijos analisados essa resistência alcançou todos os 10 diferentes antibióticos testados e em 80% entre 8 e 10 antibióticos diferentes. Em antibióticos considerados críticos como os carbapenêmicos: ertapenem apresentou microbiota resistente em 86,7% das amostras. Nas cefalosporinas, a resistência atingiu 100% na terceira geração (ceftazidima) e quase a metade das amostras (46,7%) na quarta geração (cefepime). Na pesquisa genotípica, sete diferentes genes de resistência foram encontrados em 69,2% dos pools bacterianos, incluindo o genes produtores de beta-lactamase, genes de resistência à tetraciclina, ctx, tem, shv e uma alta taxa de integron classe 1 e 2. Conclusão: os resultados indicam fenotipicamente e genotipicamente que o queijo Minas Frescal pode apresentar uma potencial microbiota resistente. Portanto, a metodologia utilizada é uma possibilidade viável e com uma resposta mais ampla sobre o papel da microbiota na resistência. Esta pesquisa corrobora a área de alimentos como um setor importante a ser gerenciado para redução no processo de resistência a antibióticos.

Neurovascular coupling is not influenced by lower body negative pressure in humans.

Cerebral blood flow is tightly coupled with local neuronal activation and metabolism, i.e., neurovascular coupling (NVC). Studies suggest a role of sympathetic nervous system in the regulation of cerebral blood flow. However, this is controversial, and the sympathetic regulation of NVC in humans remains unclear. Since impaired NVC has been identified in several chronic diseases associated with a heightened sympathetic activity, we aimed to determine whether reflex-mediated sympathetic activation via lower body negative pressure (LBNP) attenuates NVC in humans. NVC was assessed using a visual stimulation protocol (5 cycles of 30 s eyes closed and 30 s of reading) in 11 healthy participants (aged 24 ± 3 yr). NVC assessments were made under control conditions and during LBNP at -20 and -40 mmHg. Posterior (PCA) and middle (MCA) cerebral artery mean blood velocity (Vmean) and vertebral artery blood flow (VAflow) were simultaneously determined with cardiorespiratory variables. Under control conditions, the visual stimulation evoked a robust increase in PCAVmean (∆18.0 ± 4.5%), a moderate rise in VAflow (∆9.6 ± 4.3%), and a modest increase in MCAVmean (∆3.0 ± 1.9%). The magnitude of NVC response was not affected by mild-to-moderate LBNP (all P > 0.05 for repeated-measures ANOVA). Given the small change that occurred in partial pressure of end-tidal CO2 during LBNP, this hypocapnia condition was matched via voluntary hyperventilation in absence of LBNP in a subgroup of participants (n = 8). The mild hypocapnia during LBNP did not exert a confounding influence on the NVC response. These findings indicate that the NVC is not influenced by LBNP or mild hypocapnia in humans.NEW & NOTEWORTHY Visual stimulation evoked a robust increase in posterior cerebral artery velocity and a modest increase in vertebral artery blood flow, i.e., neurovascular coupling (NVC), which was unaffected by lower body negative pressure (LBNP) in humans. In addition, although LBNP induced a mild hypocapnia, this degree of hypocapnia in the absence of LBNP failed to modify the NVC response.

Propuesta de valoración preoperatoria / Preoperative Assessment Proposal

Objetivos: Diseñar dos grupos diferentes operados con riesgos quirúrgicos disímiles, uno en el límite normal y otro de alto riesgo. Materiales y Métodos: Se evalúo dos grupos de pacientes de cien casos cada uno. El primer grupo de donantes renales sanos sometidos a Nefrectomía unilateral, fue estudiado en forma completa de acuerdo a un protocolo establecido. Analizamos este protocolo y establecimos doce tipos de riesgos quirúrgicos, con una escala de riesgos quirúrgicos, con una escala de riesgos de I a IV. En el segundo grupo de pacientes, de cirugía mayor abdominal de alto riesgo, establecimos un método de puntuación que nos permite establecer un pronóstico del paciente. Resultados: El estudio demostró diferencias de las evaluaciones preoperatorias. El primer grupo el 99.75 por ciento presento riesgo I, mientras que en el otro grupo más de 40 por ciento presento riesgos de II a IV. La morbi-mortalidad fue significativa en diferencia: 1 por ciento en los donantes y 19 por ciento en los de cirugía mayor. Solo en el segundo grupo se presento mortalidad que alcanzo el 4 por ciento. Conclusiones: Los pacientes del I grupo presentaron excelente evolución, los pacientes de alto riesgo presentaron alta morbimortalidad, la valoración de riesgo propuesta en este estudio debe ser usada en pacientes de alto riesgo ya que nos permite establecer el pronósticos de morbi-mortalidad

Absceso retroperitoneal post colecistectomía laparoscópica / Retroperitoneal

La perforación accidental de la vesícula biliar durante la colecistectomía laparoscópica con vaciamiento de su contenido hacia el espacio intraabdominal no es un suceso infrecuente. Es cada vez mayor la preocupación de los cirujanos sobre las posibles repercusiones que este suceso pueda traer consigo. Se ha reportado la formación de abscesos, infección, inflamación, fibrosis, adherencias, etc. Presentamos a continuación el caso de un paciente febril, con malestar general, leucocitosis y con el antecedente de haber sido sometido a una colecistectomía laparoscópica. El diagnóstico preoperatorio fue tumor retroperitoneal mixto vs. absceso retroperitoneal; comprobándose durante la operación este último. Recomendamos al cirujano tomar las precauciones necesarias para retirar la totalidad de los cálculos de la cavidad abdominal y tener presente, en pacientes que presentan sintomatología abdominal postquirúrgica tardía, la posible relación con el antecedente de haber sido sometido a una colecistectomía laparoscópica.

Enfermedad cerebral vascular estudio con tomografía computarizada en el Hospital Nacional del Sur-IPSS, Arequipa

El presente estudio retrospectivo se realizó en el Hospital Nacional del Sur - IPSS, Arequipa-Perú. Se revisaron 105 historias clínicas y 113 informes de tomografía computarizada practicada en 105 pacientes hospitalizados con diagnóstico de ingreso de accidente cerebro vascular(ACV), de los cuales 69.52 por ciento fue isquémico y 30.48 por ciento hemorrágico, luego de realizado el estudio con tomografía, 90 casos presentaron imágen positiva de lesión cerebral que explica el cuadro de ACV, en 8 casos la TC fue negativa pero correspondió a lesiones isquémicas reversibles o parcialmente reversibles, en los 7 casos restantes, correspondieron a procesos expansivos y neurocisticercosis, llegándose a un diagnóstico final de ACV en el 93.32 por ciento, de los cuales el 65.30 por ciento fue ACV isquémico, 29.52 por ciento hemorrágia intraparenquimal y 5.10 por ciento hemorrágia subaracnoidea. El inicio brusco y el déficit neurológico focal, fue el común denominador en el 76.46 por ciento y 70.40 por ciento de los casos respectivamente. Se encontró infartos lacunares en el 6.2 por ciento y 8.16 por ciento de casos presentaron foco cardiogénico en los ACV isquémicos. Los lobulos frontal, pariental y frontoparietal fueron los de mayor lesión en los ACV en general, con 46 casos, reflejándose en el cuadro clínico