Fatigability of the thenar muscles using electrical nerve stimulation with fixed stimuli count, while varying the frequency and duty cycle.

Our aim was to compare three electrical stimulation protocols (P20, P30 and P40), with the same number of stimuli, but different stimulation frequencies (20, 30 and 40 Hz, respectively) and duty cycles [1.2:1.2 s (continuous), 0.8:1.2 s (intermittent) and 0.6:1.2 s (intermittent), respectively). Twitch force and the peak-to-peak M-wave amplitude of the thenar muscles were measured before, during and after each protocol at 1-40 Hz in random order. Twelve healthy adults (23-41 years old) were examined for each protocol in random order and in separate sessions. P20 elicited the highest mean force, and P40 the lowest decrease in percent force at the end of the protocol. Force evoked at 1 and 10 Hz decreased less after P40, compared with P20 and P30. The M-wave amplitude was significantly reduced throughout all protocols, with the largest decrease observed during P30. Although an increase in frequency typically induced earlier and greater decrement in force, this was compensated or even reversed by increasing the interval between each stimulation train, while keeping the number of pulses per stimulation cycle constant. The lesser decrease in M-wave amplitude during P40 compared with P20 indicates that longer between-train intervals may help maintaining the integrity of neuromuscular propagation.

Outcome of treatment of MDR-TB or drug-resistant patients treated with bedaquiline and delamanid: Results from a large global cohort.

The World Health Organization (WHO) recommends countries introduce new anti-TB drugs in the treatment of multidrug-resistant tuberculosis. The aim of the study is to prospectively evaluate the effectiveness of bedaquiline (and/or delamanid)- containing regimens in a large cohort of consecutive TB patients treated globally. This observational, prospective study is based on data collected and provided by Global Tuberculosis Network (GTN) centres and analysed twice a year. All consecutive patients (including children/adolescents) treated with bedaquiline and/or delamanid were enrolled, and managed according to WHO and national guidelines. Overall, 52 centres from 29 countries/regions in all continents reported 883 patients as of January 31st 2021, 24/29 countries/regions providing data on 100% of their consecutive patients (10-80% in the remaining 5 countries). The drug-resistance pattern of the patients was severe (>30% with extensively drug-resistant -TB; median number of resistant drugs 5 (3-7) in the overall cohort and 6 (4-8) among patients with a final outcome). For the patients with a final outcome (477/883, 54.0%) the median (IQR) number of months of anti-TB treatment was 18 (13-23) (in days 553 (385-678)). The proportion of patients achieving sputum smear and culture conversion ranged from 93.4% and 92.8% respectively (whole cohort) to 89.3% and 88.8% respectively (patients with a final outcome), a median (IQR) time to sputum smear and culture conversion of 58 (30-90) days for the whole cohort and 60 (30-100) for patients with a final outcome and, respectively, of 55 (30-90) and 60 (30-90) days for culture conversion. Of 383 patients treated with bedaquiline but not delamanid, 284 (74.2%) achieved treatment success, while 25 (6.5%) died, 11 (2.9%) failed and 63 (16.5%) were lost to follow-up.

Intraspecific Diversity of Monilinia fructicola and M. laxa Populations from Blossoms and Fruit of Different Hosts in Greece.

The genetic variation among 145 isolates of Monilinia fructicola and 156 isolates of M. laxa collected from two distinct regions of Greece (Imathia and Larissa) was analyzed using intersimple-sequence repeat markers. The Monilinia spp. isolates had been collected from infected fruit or blossoms of peach, apricot, sweet cherry, and plum. Calculation of Nei's gene diversity and Shannon's diversity indices showed that M. fructicola populations had higher genetic diversity compared with M. laxa populations in both regions sampled. The levels of genetic diversity were similar between populations obtained from diseased blossoms and fruit for each species and the main variances were all from within rather than between populations for the respective regions, hosts, and organ of origin. Genetic distance (Nei's analysis) was lower between peach and apricot populations than between cherry and plum populations of M. fructicola. M. fructicola isolates from peach and apricot and from sweet cherry and plum were clustered together, while M. laxa isolates clustering based on the host of origin was not possible. The analysis of index of association showed the absence of sexual recombination for both species. The derived data support the hypothesis of a long presence of M. fructicola in Greece, and provide evidence of specialization of M. fructicola populations based on their host of origin.

Fatal case of extensively drug-resistant Mycobacterium tuberculosis Beijing genotype infection in an injecting drug user, Athens, Greece, 2012.

We present the first fatal case of extensively drug-resistant tuberculosis (XDR-TB) in an injecting drug user (IDU) in Athens, Greece, co-infected with human immunodeficiency virus and hepatitis C virus and discuss the implications for public health. Despite immediate initiation of treatment, the patient's condition gradually deteriorated and he died 16 days after hospital admission because of multiple organ failure. The contact tracing investigation revealed no further infections among the patient's contacts.

Deltoid muscle characteristics in wrestlers.

The purpose of the present study was to investigate the deltoid muscle characteristics of wrestlers. Nine Greco-Roman competitive male wrestlers (mean age 20.1+/-2.7 yrs, height 175+/-0.6 cm, weight 83.2+/-12.5 kg, years of training 7.6+/-2.7 yrs) participated in this study. Six male healthy sedentary students (mean age 21.2+/-0.9 yrs, height 180+/-0.3 cm, weight 80.1+/-9.4 kg) served as controls. Muscle fibre distribution, cross-sectional area (CSA), as well as satellite cells, myonuclei and capillary density per muscle fibre area were determined by immunohistochemistry. Myosin heavy chain MHC isoform composition of single fibres was determined with protein electrophoresis. Immunohistochemical analysis showed that muscle fibre distribution of the MHC I and IIA were significantly higher in wrestlers than in controls (p<0.05). Electrophoretic analysis of single fibres revealed a significantly higher proportion of fibres containing MHC I and IIC in wrestlers (p<0.05). The mean CSA of type IIA fibres and the number of myonuclei per type II was significantly higher in wrestlers (p<0.05). We also found that the number of satellite cells was 2.5 fold higher in wrestlers than in the control group. This study suggests that the observed muscle fibre profile in the deltoid of wrestlers may represent an adaptation based on the specific mechanical and biochemical demands of the long-term training in Greco-Roman wrestling.