Influence of transducer pressure and examiner experience on muscle active shear modulus measured by shear wave elastography.

INTRODUCTION: This study examined the effects of ultrasound transducer pressure and examiner experience on the biceps femoris long head and semitendinosus muscle active shear modulus in healthy individuals (n = 28). METHODS: Active shear modulus was assessed using shear wave elastography at 20% of knee flexor maximal voluntary isometric contraction. Examiners with different experience levels measured the muscles' shear modulus with three pressure levels: mild, moderate, and hard. RESULTS: A main effect of transducer pressure was found for both biceps femoris long head (p < 0.001; η2p = 0.314) and semitendinosus muscles (p < 0.001; η2p = 0.280), whereas differences were found between mild-moderate (biceps femoris long head: p = 0.013, d = 0.23; semitendinosus: p = 0.024, d = 0.25), and mild-hard pressures (biceps femoris long head: p = 0.001, d = 0.47; semitendinosus: p = 0.002, d = 0.47). Examiners performed similar shear modulus measurements in the biceps femoris long head (p = 0.299; η2p = 0.041) and semitendinosus (p = 0.177; η2p = 0.066), although the experienced examiner showed a higher measurement repeatability (biceps femoris long head: ICC = 0.86-0.95, semitendinosus: ICC = 0.89-0.96; vs. biceps femoris long head: ICC = 0.78-0.87, semitendinosus: ICC = 0.66-0.87). CONCLUSION: Transducer pressure influences the active shear modulus measurement between mild and moderate or hard pressures. Additionally, examiner experience seems to have no influence on muscle active shear modulus measurement when assessed at the same site (using casts). IMPLICATIONS FOR PRACTICE: Future studies assessing active muscle shear modulus should use mild transducer pressure and having experienced examiners in order to improve measurement reliability.

Additional activation of the AR gene may be involved in the development of the castration resistance phenotype in prostate cancer.

INTRODUCTION: Several studies have already shown that changes in the AR gene may be associated with a more aggressive disease phenotype and even castration-resistant prostate cancer. Thus, we investigated cytogenetic and molecular alterations linked to AR. MATERIALS AND METHODS: To evaluate AR methylation, we performed a cytogenetic-molecular analysis using fluorescence in situ hybridization that uses specific probes for the AR gene (Xq11.12) and the X chromosome centromere. For AR activity, we performed a qualitative analysis of human androgen receptor activity. To analyze the expression of AR in PC3 and LNCaP cell lines, we used qPCR assays. RESULTS: In the qPCR assay, we found downregulation of AR in the PC3 cell line compared with the LNCaP. We found the presence of X chromosome polysomy in PC-3 and LNCaP cell lines by FISH assay. In the HUMARA-Q assay, we found two X chromosomes/cell and the activity of both AR in the PC-3 cell line. In LNCaP cells, we found two X chromosomes/cell and methylation of only one AR. CONCLUSION: Castration-resistant prostate cancer phenotype represents a significant challenge in the setting of urological management. The X chromosomes and AR-linked alterations may contribute to a better understanding of the disease. However, further studies should be performed in an attempt to elucidate as much as possible the role of AR in the castration-resistant prostate cancer phenotype.

Reflectance confocal microscopy for the noninvasive diagnosis of cutaneous juvenile xanthogranuloma.

Juvenile xanthogranuloma is the most common type of non-Langerhans cell histiocytosis. It appears primarily in infancy, where its differential diagnosis includes Spitz nevus, dermal nevus and molluscum contagiosum. We report the case of a 2-year-old boy with juvenile xanthogranuloma, as diagnosed using real-time, in vivo reflectance confocal microscopy.

Multiloci identification of Diaporthe fungi isolated from the medicinal plant Costus spiralis (Jacq.) Roscoe (Costaceae).

AIMS: The purpose of this study is to identify species from genus Diaporthe associated with a medicinal plant Costus spiralis by ITS, EF 1-α, TUB and CAL gens. METHODS AND RESULTS: The 30 isolates from the genus Diaporthe associated with the medicinal plant Costus spiralis were characterized based on morphological characters and the microculture technique and grouped by DNA fingerprinting with the ISSP gene. Afterwards, a total of 12 isolates were selected for the identification of the species based on the comparative research on the blast through the sequences of the ITS gene. Phylogenetic Tree of Maximum Likelihood were generated with the ITS gene individually and with the genes ITS, TUB, CAL and EF1-α combined with the Diaporthe species recognized and with the additional sequences obtained from GenBank for these species. CONCLUSIONS: It was not possible to characterize the 30 isolates microscopically and macromorphologically through the microculture technique and the macromorphological characteristics. The 12 isolates selected based on the DNA fingerprinting profile identified phylogenetically, revealed five distinct species of Diaporthe which are present in C. spiralis. SIGNIFICANCE AND IMPACT OF THE STUDY: The molecular analyses used in this study are excellent alternatives for species-level identification of Diaporthe associated with medicinal plants.

[Fresh bipolar osteochondral allograft of the ankle. Review of the literature and case report of a young patient with bilateral post-traumatic osteoarthritis]. / Aloinjerto osteocondral bipolar fresco del tobillo. Revisión de la literatura y presentación del caso de un paciente joven con artrosis bilateral postraumática.

OBJECTIVES: The treatment of severe post-traumatic ankle arthritis remains a challenge nowadays. Since patients suffering from this pathology are mainly young and active people, a correct reconstruction, if possible, of the articular cartilage defects of the tibiotalar joint is very important to achieve a good result. Fresh bipolar osteochondral allograft (FBOA) is a promising operative technique, as an alternative to arthrodesis and total ankle replacement, in pain relief, restoration of function and indefinite delay of arthritic disease progression. METHODS: The authors made a review of the literature and present a case report of a young 30 years-old man, with bilateral post-traumatic osteoarthritis of the ankle, treated with (FBOA). The patient was evaluated clinically and radiographically monthly. RESULTS: Pain relief and postoperative function was significantly improved reaching 94 points in the left ankle (preoperative of 40 points), and 92 points in the right ankle (preoperative 42 points) AOFAS score. CONCLUSIONS: Fresh tibiotalar allografting seems to be a good alternative to arthrodesis and prosthetic replacement, in the treatment of ankle arthropathy and big articular cartilage defects mainly in young and active patients. This procedure achieves a good pain relief, maintaining functional joint motion and decreasing the risk of adjacent joint arthritis.

Unusual oral leiomyoma in a child: case report.

AIM: Very few oral leiomyomas have been reported in the literature, especially in children. The aim of this article was to present a very rare new case of leiomyoma in the chin, in a seven-year-old black male, and to explain its clinical and histological features. CASE REPORT: A seven-year-old black male patient presented with a swelling mass of diameter 2.5 x 3.0 cm in the lower anterior area of the chin. The tumor was firm, painless, non-fixed and well-defined, with normal mucosa overlying it. Fine-needle aspiration prior to surgery was negative. The surgical access was intraoral and the mass was located under the skin and below the periosteal bone, within the musculature. The histological and immunohistochemical studies diagnosed an oral leiomyoma. The clinical appearance of leiomyomas is very difficult to differentiate from other mesenchymal tumors. Histological and immunohistochemical studies were crucial for achieving a definitive diagnosis. Eighteen months after the excision of the lesion, no signs of recurrence were observed. The successful treatment had several objectives, including removing the lesion with success and providing the patient with an aesthetic appearance.

Reduction of aflatoxin B1 in stored peanuts (Arachis hypogaea L.) using Saccharomyces cerevisiae.

Aflatoxin B(1) is a toxigenic and carcinogenic compound produced by Aspergillus flavus and Aspergillus parasiticus. To inhibit aflatoxin contamination of peanuts, seeds of two peanut breeds, IAC Caiapó and IAC Runner 886, were inoculated with A. parasiticus (1.0 × 10(6) spores per ml) and the yeast Saccharomyces cerevisiae (3.2 × 10(7) cells per ml) and incubated at 25°C for 7 and 15 days. Two experiments were conducted for each incubation period separately. The treatments were completely randomized, with three replications per treatment. Treatments included the two cultivars and three types of inoculation (pathogen alone, yeast and pathogen, and yeast 3 h before pathogen). Aflatoxin B(1) was quantified with a densitometer at 366 nm after thin layer chromatography. Aflatoxin B(1) contamination in peanuts was reduced after the addition of S. cerevisiae. The concentration of aflatoxin B(1) decreased by 74.4 and 55.9% after 7 and 15 days, respectively. The greatest aflatoxin reduction was observed when S. cerevisiae was inoculated 3 h before the pathogen in IAC Caiapó seeds and incubated for 7 days at 25°C. The use of S. cerevisiae is a promising strategy for biological control of aflatoxin contamination in peanuts.

Integrated control of penicillium digitatum by the predacious yeast Saccharomycopsis crataegensis and sodium bicarbonate on oranges

Our investigation of integrated biological control (IBC) started with an assay testing activity of the predacious yeast Saccharomycopsis crataegensis UFMG-DC19.2 against Penicillium digitatum LCP 4354, a very aggressive fungus that causes postharvest decay in oranges. Under unfavourable environmental conditions, the yeast showed a high potential for control (39.9 percent disease severity reduction) of this fungus. This result was decisive for the next step, in which S. crataegensis was tested in association with sodium bicarbonate salt, a generally regarded as safe (GRAS) substance. The yeast was able to survive at different concentrations of the salt (1 percent, 2 percent and 5 percent), and continued to grow for a week at the wound site, remaining viable at high population for 14 days on the fruit surface. The yeast alone reduced the severity of decay by 41.7 percent and sodium bicarbonate alone reduced severity of decay by 19.8 percent, whereas the application of both led to a delay in the development of symptoms from 2 to 10 days. Ingredients of the formulations were not aggressive to fruits since no lesions were produced in control experiments.

Integrated control of Penicillium digitatum by the predacious yeast Saccharomycopsis crataegensis and sodium bicarbonate on oranges.

Our investigation of integrated biological control (IBC) started with an assay testing activity of the predacious yeast Saccharomycopsis crataegensis UFMG-DC19.2 against Penicillium digitatum LCP 4354, a very aggressive fungus that causes postharvest decay in oranges. Under unfavourable environmental conditions, the yeast showed a high potential for control (39.9% disease severity reduction) of this fungus. This result was decisive for the next step, in which S. crataegensis was tested in association with sodium bicarbonate salt, a generally regarded as safe (GRAS) substance. The yeast was able to survive at different concentrations of the salt (1%, 2% and 5%), and continued to grow for a week at the wound site, remaining viable at high population for 14 days on the fruit surface. The yeast alone reduced the severity of decay by 41.7% and sodium bicarbonate alone reduced severity of decay by 19.8%, whereas the application of both led to a delay in the development of symptoms from 2 to 10 days. Ingredients of the formulations were not aggressive to fruits since no lesions were produced in control experiments.

Análise do perfil do paciente portador de doenca osteomuscular relacionada ao trabalho (DORT) e usuário do serviço de saúde do trabalhador do SUS em Belo Horizonte / Analysis of the patient`s profile who bears DORT and is watched by the worker`s health reference center of general health service from Belo Horizonte

O presente trabalho pretende descrever o perfil do paciente portador de DORT atendido pelo Sistema Unico de Saude(SUS) em Belo Horizonte. Conhece-lo e de fundamental importancia, pois essas patologias sao responsaveis por cerca de (85 por cento) dos afastamentos do trabalho alem, de causarem grandes impactos psicologicos e socioeconomicos. Realizou-se o levantamento de 145 prontuarios de pacientes do Centro de Referencia de Saude ddo Trabalhador (CERSAT), no periodo de 1998 a 2001. Dados como sexo, faixa etaria, escolaridade, profissao, situacao de trabalho e diagnosticos foram analisados. Os resultados apontam que as DORT acometem mais as mulheres entre 21 e 50 anos de idade com baixo grau de escolaridade. Dados importantes foram observados no item ``diagnosticos``, pois estes tem-se mostrado inconclusivos, impedindo intervencao fisioterapica adequada. Constatou-se, contudo, que as tendinites continuam sendo as mais frequentes (49 por cento) e que as tenossinovites, as epicondilites e a fibromialgia tem aumentado nos ultimos anos, sendo que, na maioria dos casos, os pacientes chegam ao tratamento em fases avancadas. Essa situacao e um problema de saude publicae tem trazido prejuizos aos trabalhadores, tornando evidente a importancia de conhecer as necessidades dos pacientes e de oferecer-lhes tratamento mais adequado

[Influence of Gilbert's syndrome on serum bilirubin levels and gallstone formation in children with chronic hemolytic disease]. / Influencia del síndrome de Gilbert en los valores de bilirrubina sérica y presencia de litiasis vesicular en pacientes con hemólisis crónica congénita.

To determine whether Gilbert's syndrome increases the risk of gallstone formation in children with chronic hemolytic disease, we studied 44 children with this diagnosis. Gallstones were detected by abdominal ultrasonography. This took place annually in scheduled examinations or in the context of acute abdominal pain. In all patients, the mean values of hemoglobin, reticulocyte and serum bilirubin in the chronic phase were recorded. In addition, TA insertion in the A(TA)nTATAA motif within the promoter region of the enzyme uridine-diphosphate-glucuronyl transferase (UGT1A1) was screened, since this is typically associated with GS.We found 10 (22.7 %) homozygotes for the mutated allele TA*7/TA*7, 12 (27.3 %) TA*6/TA*6 heterozygotes and 22 (50 %) homozygotes for the wild-type allele TA*6/TA*6. No statistically significant differences were found in the values of hemoglobin (Kruskal-Wallis test 2.496; p > 0.05) or in reticulocyte count (Kruskal-Wallis test 1.696; p > 0,05) between the three groups of patients, suggesting a similar degree of hemolysis. Patients with the UGT1A1 TA*7/TA*7 genotype showed higher mean serum bilirubin levels than did patients who were homozygous for the wild-type allele (Mann-Whitney test 35.5; p < 0.05). None of the patients with the TA*6/TA*6 genotype developed gallstones, whereas this complication was found in 2 of 12 (16.6 %) heterozygotes and 6 of 10 (60 %) homozygotes for the allele with TA insertion. In this latter group, 4 patients presented acute pancreatitis as a consequence of gallstone formation.The association between increased bilirubin load due to chronic hemolytic disease and diminished hepatic conjugation leads to raised serum bilirubin levels and consequently to an increased risk of gallstone formation. Therefore, we recommend screening for Gilbert's syndrome in children in the initial phases of chronic hemolytic diseases.

[Involuntary movement disorders as first manifestation of systemic lupus erythematosus: case report]. / Movimentos involuntários anormais como primeira manifestação do lupus eritematoso sistêmico: relato de caso.

We describe a 36 year-old woman who developed chorea two months after starting the use of oral contraceptives. She also developed thrombocytopenia, oral ulcers, arthritis, positive antinuclear antibodies (ANA), anti-Sm and anti-DNA, filling criteria for systemic lupus erythematosus, as defined by the American College of Rheumatology. The tests for lupus anticoagulant and anticardiolipin (IgG and IgM) were negative. The patient was treated with prednisone, phenitoin, phenobarbital and clonazepam, obtaining clinical and labatorial improvement. We discuss the ocurrence of chorea and other movement disorders as first manifestation of systemic lupus erythematosus, its relationship with oral contraceptives and antiphospholipid antibodies.

Recurrent spontaneous breast hematoma: report of a case and review of the literature.

BACKGROUND: Breast hematomas are common after traumas, surgeries, or contusions. They are rarely spontaneous, but they can occur spontaneously in patients with hematologic disease or with coagulation disorders. MATERIAL AND METHODS: The authors report a clinical case of a 48-year-old female with a 27-year history of paroxysmal nocturnal hemoglobinuria who underwent mammography screening because of a painless palpable moveable node in the upper inner quadrant of the right breast. RESULTS: Mammography showed a partially defined heterogeneous node of 35 mm without microcalcifications in the upper inner quadrant of the right breast which, associated with the clinical features, seemed to be an hematoma. Further mammography and ultrasound after 45 days showed retrocession of the lesion, and another mammography obtained after 60 days was normal. Seventy-five days after the first episode, the patient complained of another node with a skin bruise in the upper outer quadrant of the same breast, which seemed to be a recurrent hematoma. Two months later the mammography obtained was normal. CONCLUSION: Breast hematoma must be thought of as a differential diagnosis for a breast node, regardless of previous trauma or hematologic disorders.