Morphological study of apoptosis in granulosa cells and ovulation in a model of atresia in rat preovulatory follicles.

SummaryPrevious studies have established a model of atresia in preovulatory follicles after stimulation of immature rats with equine chorionic gonadotropin (eCG). This gonadotropin recruits a follicular pool and the deprivation of preovulatory luteinizing hormone (LH) surge induces the atresia in preovulatory follicles. The present study investigated the occurrence of ovulation and provided some morphological features of granulosa cell (GC) apoptosis of atretic follicles at 0, 48, 72 and 120 h after eCG stimulation. Histological sections of ovaries from untreated animals (0 h) showed primordial, primary, secondary and early antral follicles. After 48 h ovaries showed large antral follicles. Preovulatory follicles were observed at 72 h, and two out of five rats displayed cumulus-oocyte complexes (COCs) in the oviducts. All animals exhibited corpora lutea after 120 h. We observed increased estradiol (E2) levels 48 h after eCG treatment that might trigger an endogenous preovulatory gonadotropin surge. Higher progesterone (P4) level, which is the hallmark of a functional corpus luteum, was observed at 120 h. Atresia in secondary and antral follicles was observed by pyknotic granulosa cell nuclei in histology and positive immunolabelling for cleaved caspase 3. We also observed macrophages in secondary and antral follicles in atresia. Transmission electron microscopy revealed GCs with compacted chromatin against the nuclear envelope, nuclear fragmentation, cell shrinkage and fragmentation. No preovulatory follicles showed apoptosis of GCs. In conclusion, our results suggested the occurrence of an endogenous gonadotropin surge, promoting ovulation and preventing atresia of preovulatory follicles.

The involvement of melatonin in the clinical status of patients with fibromyalgia syndrome.

OBJECTIVES: The aim of this study was to evaluate the levels of 6-sulphatoxymelatonin (6-SMT) in the urine of patients with fibromyalgia (FM) and correlate them with the score obtained by these patients in four clinical assessment instruments. METHODS: Fifty-eight women with primary FM and 39 healthy women matched for age and body mass index were included in the study sample. The levels of 6-SMT were evaluated in urine collected from 8 pm until 8 am the next day by the immunosorbent assay. For the clinical evaluation we used the Fibromyalgia Impact Questionnaire (FIQ); Pittsburg Sleep Quality Index (PSQI); Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) and Satisfaction with Life Scale (SWLS). Data normality was assessed using the Kolmogorov-Smirnov test, the differences between groups by means of the Mann-Whitney test and correlation analysis by Spearman's correlation test. RESULTS: The levels of 6-SMT in the urine of patients with FM were significantly lower than those found in the urine of healthy controls. The score obtained by patients with FM was significantly different from the score achieved by the healthy controls in the four assessment tools. However, no significant correlation between urinary levels of 6-SMT and scores on assessment instruments was observed. CONCLUSIONS: The results of this study do not discard the involvement of melatonin in the pathophysiology of FM, but may suggest that changes in melatonin levels when associated with other neuroimmunoendocrine changes may impact directly and negatively on the manifestation of symptoms that make up the clinical picture of FM.

Increased levels of IL-17A in patients with fibromyalgia.

OBJECTIVES: The aim of this study was to evaluate the plasma levels of IL-17A in fibromyalgia patients, and to look for any correlations between this data and the concentrations of some pro- and anti-inflammatory cytokines. METHODS: We performed a study including 58 fibromyalgia patients and 39 healthy women matched for age and body mass index. The plasma levels of IL-17A and other pro- and anti-inflammatory cytokines were measured by using the technique of cytometric bead array (CBA). The analysis of differences between groups was performed using Mann-Whitney test and the analysis of the correlations by Spearman's correlation test. RESULTS: The analyses showed that fibromyalgia patients present increased levels of IL-17A. They also revealed that plasma concentrations of IL17A positively correlate with levels of IL-2, IL-4 and IL-10, TNF and IFNγ. CONCLUSIONS: As far as we are aware, this is the first study to demonstrate increased levels of IL17A in fibromyalgia patients. The positive correlation between the levels of IL-17A and of other cytokines strengthens the hypothesis of the involvement of inflammatory mechanisms in the development of this syndrome.

Impacto de um programa de fortalecimento muscular dos membros inferiores no equilíbrio e na performance funcional de idosos institucionalizados: um estudo controlado e randomizado / Impact of a muscle strengthening program for lower members on the balance and functional performance of institutionalized elderly: a controlled and randomized study

A performance funcional é maximizada através de programas de fortalecimento muscular em idosos. Contudo, poucas intervenções foram implementadas em idosos institucionalizados para avaliar os efeitos de programas de exercícios de fortalecimento muscular em desfechos como o equilíbrio, performance funcional e força muscular. Objetivo: Avaliar o impacto de um programa de fortalecimento muscular de membros inferiores no equilíbrio, performance funcional e força muscular de idosos institucionalizados. Métodos: Ensaio clínico controlado e randomizado. O equilíbrio, a performance funcional e a força muscular foram avaliados através da Escala de Equilíbrio de Berg (EEB), Marcha Tandem (MT), Short Physical Performance Battery (SPPB) e Teste do Esfigmomanômetro (TE), respectivamente. O grupo experimental (GE, n=11) participou do programa de exercícios em grupo, três vezes semanais, durante oito semanas, enquanto o grupo controle (GC, n=8) continuou sua rotina habitual. Foram calculados os intervalos de 95% de confiança para as diferenças entre os grupos experimental e controle (experimental ­ controle) e entre os dois momentos de observação (pós ­ pré). Foi realizada análise de intenção de tratar. Resultados: O GE apresentou um ganho significativo em relação ao GC para a EEB (DM=3,7 IC95% 1,0 a 6,5), MT DM=3,5 IC95% 0,7 a 6,2), FMEJ (DM=33,2 IC95% 4,9 a 61,5) e FMD (DM=37,5 IC95% 9,6 a 65,3). Conclusão: O programa de fortalecimento muscular foi capaz de melhorar o equilíbrio, a performance funcional e a força muscular em idosos institucionalizados

Functional performance is maximized through muscle strengthening programs in the elderly. However, few interventions have been implemented in institutionalized elderly to assess the effects of muscle strengthening exercise programs in outcomes such as balance, functional performance and muscle strength. Objective: Assess the impact of a lower limb muscle strengthening program at the balance, functional performance and muscle strength of institutionalized elderly. Methods: Controlled, randomized clinical trial. Balance, functional performance and muscle strength were assessed using the Berg Balance Scale (BSE), Tandem Gait (MT), Short Physical Performance Battery (SPPB) and Sphygmomanometer Test (TE) respectively. The experimental group (GE, n = 11) participated in the group exercise program, three times a week, for eight weeks, while the control group (CG, n = 8) continued their usual routine.The intervals of 95% confidence for the differences between the experimental and control groups (experimental - control) and between the two moments of observation (post - pre). Intent to treat analysis was performed. Results: EG showed a significant gain in relation to CG for BSE (DM = 3.7 IC95% 1.0 to 6.5), MT DM = 3.5 IC95% 0.7 to 6.2), FMEJ (DM = 33.2 95% CI 4.9 to 61.5) and FMD (DM = 37.5 95% CI 9.6 to 65.3). Conclusion: The muscle strengthening program was able to improve balance, functional performance and muscle strength in institutionalized elderly

Body surface infrared thermometry in patients with central venous cateter-related infections.

OBJECTIVE: To evaluate if body surface temperature close to the central venous catheter insertion area is different when patients develop catheter-related bloodstream infections. METHODS: Observational cross-sectional study. Using a non-contact infrared thermometer, 3 consecutive measurements of body surface temperature were collected from 39 patients with central venous catheter on the following sites: nearby the catheter insertion area or totally implantable catheter reservoir, the equivalent contralateral region (without catheter), and forehead of the same subject. RESULTS: A total of 323 observations were collected. Respectively, both in male and female patients, disregarding the occurrence of infection, the mean temperature on the catheter area minus that on the contralateral region (mean ± standard deviation: -0.3±0.6°C versus-0.2±0.5ºC; p=0.36), and the mean temperature on the catheter area minus that on the forehead (mean ± standard deviation: -0.2±0.5°C versus-0.1±0.5ºC; p=0.3) resulted in negative values. Moreover, in infected patients, higher values were obtained on the catheter area (95%CI: 36.6-37.5ºC versus 36.3-36.5ºC; p<0.01) and by temperature subtractions: catheter area minus contralateral region (95%CI: -0.17 - +0.33ºC versus -0.33 - -0.20ºC; p=0.02) and catheter area minus forehead (95%CI: -0.02 - +0.55ºC versus-0.22 - -0.10ºC; p<0.01). CONCLUSION: Using a non-contact infrared thermometer, patients with catheter-related bloodstream infections had higher temperature values both around catheter insertion area and in the subtraction of the temperatures on the contralateral and forehead regions from those on the catheter area.

Body surface infrared thermometry in patients with central venous cateter-related infections / Termometria infravermelha da superfície corporal em pacientes com infecção relacionada a cateter venoso central

Objective To evaluate if body surface temperature close to the central venous catheter insertion area is different when patients develop catheter-related bloodstream infections.Methods Observational cross-sectional study. Using a non-contact infrared thermometer, 3 consecutive measurements of body surface temperature were collected from 39 patients with central venous catheter on the following sites: nearby the catheter insertion area or totally implantable catheter reservoir, the equivalent contralateral region (without catheter), and forehead of the same subject.Results A total of 323 observations were collected. Respectively, both in male and female patients, disregarding the occurrence of infection, the mean temperature on the catheter area minus that on the contralateral region (mean ± standard deviation: -0.3±0.6°C versus-0.2±0.5ºC; p=0.36), and the mean temperature on the catheter area minus that on the forehead (mean ± standard deviation: -0.2±0.5°C versus-0.1±0.5ºC; p=0.3) resulted in negative values. Moreover, in infected patients, higher values were obtained on the catheter area (95%CI: 36.6-37.5ºC versus 36.3-36.5ºC; p<0.01) and by temperature subtractions: catheter area minus contralateral region (95%CI: -0.17 - +0.33ºC versus -0.33 - -0.20ºC; p=0.02) and catheter area minus forehead (95%CI: -0.02 - +0.55ºC versus-0.22 - -0.10ºC; p<0.01).Conclusion Using a non-contact infrared thermometer, patients with catheter-related bloodstream infections had higher temperature values both around catheter insertion area and in the subtraction of the temperatures on the contralateral and forehead regions from those on the catheter area.

Objetivo Avaliar se a temperatura da superfície corporal nas proximidades da área de inserção do cateter venoso central é diferente quando os pacientes desenvolvem infecções da corrente sanguínea relacionadas ao cateter.Métodos Estudo transversal observacional. Usando um termômetro infravermelho sem contato, 3 medições consecutivas de temperatura da superfície corporal foram coletadas de 39 pacientes com cateter venoso central nos seguintes locais: nas proximidades da área de inserção do cateter ou do reservatório do cateter totalmente implantável, na região contralateral equivalente (sem cateter), e na fronte do mesmo paciente.Resultados Um total de 323 observações foram coletadas. Respectivamente nos pacientes do sexo masculino e feminino, desconsiderando a ocorrência de infecção, a temperatura média na área do cateter menos a da região contralateral (média ± desvio padrão: -0,3±0,6°C versus -0,2±0,5°C; p=0,36) e a da área do cateter menos a da fronte (média ± desvio padrão: -0,2±0,5°Cversus -0,1±0,5°C; p=0,3) resultaram em valores negativos. Além disso, em pacientes infectados, foram obtidos valores mais elevados na área do cateter (IC95%: 36,6-37,5ºC versus36,3-36,5ºC; p<0,01) e nas subtrações de temperaturas: área do cateter menos região contralateral (IC95%: -0,17 - +0,33°C versus-0,33 - -0,20°C; p=0,02) e a área do cateter menos fronte (IC95%:-0,02 - +0,55°C versus -0,22 - -0,10ºC; p<0,01).Conclusão Utilizando um termômetro infravermelho sem contato, os pacientes com infecções da corrente sanguínea associadas ao cateter apresentaram valores de temperatura mais elevados, tanto ao redor da área de inserção do cateter e na subtração das temperaturas das regiões contralateral e fronte, em relação àquelas da área do cateter.