Prevalence of early hip OA features on MRI in high-impact athletes. The femoroacetabular impingement and hip osteoarthritis cohort (FORCe) study.

OBJECTIVE: To compare early hip osteoarthritis (OA) features on magnetic resonance imaging (MRI) in high-impact athletes with and without hip and/or groin pain, and to evaluate associations between early hip OA features, the International Hip Outcome Tool (iHOT33) and Copenhagen Hip and Groin Outcome Score (HAGOS). DESIGN: This case-control study evaluated data of the femoroacetabular impingement and hip osteoarthritis cohort (FORCe). One hundred and eighty-two symptomatic (hip and/or groin pain >6 months and positive flexion-adduction-internal-rotation (FADIR) test) and 55 pain-free high-impact athletes (soccer or Australian football (AF)) without definite radiographic hip OA underwent hip MRI. The Scoring Hip Osteoarthritis with MRI (SHOMRI) method quantified and graded the severity of OA features. Each participant completed the iHOT33 and HAGOS. RESULTS: Hip and/or groin pain was associated with higher total SHOMRI (0-96) (mean difference 1.4, 95% CI: 0.7-2.2), labral score (adjusted incidence rate ratio (aIRR) 1.33, 95% CI: 1.1-1.6). Differences in prevalence of cartilage defects, labral tears and paralabral cysts between symptomatic and pain-free participants were inconclusive. There was a lower prevalence of effusion-synovitis in symptomatic participants when compared to pain-free participants (adjusted odds ratio (aOR) 0.46 (95% CI: 0.3-0.8). Early hip OA features were not associated with iHOT33 or HAGOS. CONCLUSIONS: A complex and poorly understood relationship exists between hip and/or groin pain and early hip OA features present on MRI in high-impact athletes without radiographic OA. Hip and/or groin pain was associated with higher SHOMRI and labral scores.

Cross-sectional and longitudinal study of the impact of posterior meniscus horn lesions on adjacent cartilage composition, patient-reported outcomes and gait biomechanics in subjects without radiographic osteoarthritis.

OBJECTIVE: The aim of this study was to assess cross-sectional and longitudinal effects of meniscal lesions on adjacent cartilage T1ρ and T2 relaxation times, patient-reported outcomes and gait biomechanics. DESIGN: Thirty patients with no cartilage morphological defects reported by Whole Organ MRI Score (WORMS) magnetic resonance imaging (MRI) grading and no radiographic osteoarthritis (OA) (Kellgren--Lawrence (KL) ≤ 1) were selected, 15 with posterior meniscus horn lesions and 15 matched controls without meniscal lesions. All were imaged on a 3T MR scanner for three consecutive years, except those who dropped from the study. Sagittal and frontal plane kinematic gait data were acquired at baseline. The Knee Injury and Osteoarthritis Outcome Score (KOOS) survey was taken each time. All images were automatically segmented and registered to an atlas for voxel-by-voxel cross-sectional and longitudinal analyses. RESULTS: Relaxation time comparisons between groups showed elevated T1ρ of the lateral tibia (LP) and elevated T2 of the medial tibia (MT) and LT at 1 and 2 years in the lesion group. Longitudinal comparisons within each group revealed greater relaxation time elevations over one and 2 years in the group with lesions. KOOS Quality of Life (QOL) was significantly different between the groups at all time points (P < 0.05), as were other KOOS subcategories. No significant differences in the frontal or sagittal biomechanics were observed between the groups at baseline. CONCLUSIONS: Individuals with healthy cartilage and posterior meniscal horn lesions have increased relaxation times when compared to matched controls, increased relaxation time changes over 2 years, and consistently report a lower KOOS QOL, yet show no difference in gait biomechanics.

Association of cartilage defects, and other MRI findings with pain and function in individuals with mild-moderate radiographic hip osteoarthritis and controls.

OBJECTIVE: To evaluate the relationship of hip radiographic osteoarthritis (ROA) and MRI findings of cartilage lesions, labral tears, bone marrow edema-like lesions (BMELs) and subchondral cysts with self-reported and physical function. DESIGN: Eighty five subjects were classified as controls (n = 55, Kellgren-Lawrence (KL) 0, 1) or having mild-moderate ROA (n = 30, KL 2, 3). T2 weighted MRI images at 3-T were graded for presence of cartilage lesions, labral tears, BMELs and subchondral cysts. Posterior wall sign, cross-over sign, center-edge angle and alpha angle were also recorded. Function was assessed using Hip dysfunction and Osteoarthritis Outcome Score (HOOS), Timed-Up and Go (TUG) test and Y-Balance Test (YBT). Analysis compared function between subjects with and without ROA and those with and without femoral or acetabular cartilage lesions, adjusted for age. Non-parametric correlations were used to assess the relationship between radiographic scores, MRI scores and function. RESULTS: Subjects with acetabular cartilage lesions had worse HOOS (Difference = 5-10%, P = 0.036-0.004), but not TUG or YBT, scores. Acetabular cartilage lesions, BMELs and subchondral cysts were associated with worse HOOS scores (ρ = 0.23-0.37, P = 0.041-0.001). Differences in function between subjects with and without ROA or femoral cartilage lesions were not significant. Other radiologic findings were not associated with function. CONCLUSIONS: Acetabular cartilage defects, but not femoral cartilage defects or ROA, were associated with greater self-reported pain and disability. BMELs and subchondral cysts were related to greater hip related self-reported pain and disability. None of the radiographic or MRI features was related to physical function.

Use of enzymes in diets with different percentages of added fat for broilers / Uso de enzimas em dietas com diferentes porcentagens de adição de gordura para frangos de corte

We assessed the extent to which the removal of fat source, and consequently its compounds, such as linoleic acid, can affect the performance of broilers. We used 600 male Cobb 500 day old chicks. The birds were distributed in a completely randomized experimental design, with five treatments and six replicates of 20 birds each. The treatments were: (T1) diet - positive control (PC), which met the nutritional needs; (T2) diet - negative control (CN), a reduction of 100kcal/kg and low linoleic acid content; (T3): diet - negative control reformulated for low linoleic acid content and a set of Quantum phytase XT and Econase XT 25 (BAL + QFit-Eco), (T4): diet - negative control reformulated, with the percentage of linoleic acid adjusted to an intermediate value between the value of the diet and diet CP and CN to use a set of Quantum phytase XT and XT Econase 25 (IAL + QFit-Eco) and (T5): diet - negative control reformulated, with the percentage of linoleic acid adjusted to a value similar to that of the positive control diet and joint use of Quantum phytase XT and XT Econase 25 (AAL + QFit-Eco). The joint use of Quantum Phytase and Econase promoted improvement in the performance of broilers from 1 to 21 days. The greatest weight gain was obtained with diets containing percentages of total fat and linoleic acids. Dietary supplementation with enzymes resulted in higher levels of calcium in the tibia, whatever the percentage of linoleic studied.

Avaliou-se até que ponto a retirada de fonte de gordura e, consequentemente, de seus compostos, como o ácido linoleico, pode afetar o desempenho dos frangos de corte. Foram utilizados 600 pintos de um dia, machos da linhagem Cobb 500. As aves foram distribuídas num delineamento experimental inteiramente ao acaso, com cinco tratamentos e seis repetições de 20 aves cada. Os tratamentos foram: (T1) dieta-controle positivo (CP), que atendeu às necessidades nutricionais; (T2) dieta-controle negativo (CN), com redução de 100kcal de EM/kg e baixo teor de ácido linoleico; (T3): dieta- controle negativo reformulada, para baixo teor de ácido linoleico e com uso conjunto de Quantum fitase XT e Econase XT 25 (BAL+ Qfit-Eco); (T4): dieta-controle negativo reformulada, com porcentagem de ácido linoleico ajustada para um valor intermediário entre o valor da dieta CN e da dieta CP e com uso conjunto de Quantum fitase XT e Econase XT 25 (IAL + Qfit-Eco) e (T5): dieta-controle negativo reformulada, com porcentagem de ácido linoleico ajustada para um valor semelhante ao da dieta-controle positivo e com uso conjunto de Quantum fitase XT e Econase XT 25 (AAL+ Qfit-Eco ). O uso conjunto de Quantum Fitase e Econase promoveu melhora no desempenho dos frangos de corte de um a 21 dias. O maior ganho de peso foi obtido com dietas que continham porcentagens de gorduras totais e de ácido linoleico. A suplementação com as enzimas resultou em maior teor de cálcio nas tíbias, independentemente da porcentagem de ácido linoleico estudada.

Avian paramyxoviruses: detection by transmission electron microscopy techniques / Paramixovirus aviario: detección por técnicas de microscopía electrónica de transmisión

Diseases caused by avian paramyxovirus (APMV) occur in commercial, captive and wild birds worldwide, demonstrating the significant economic and ecological importance of these agents. Paramyxoviruses belong to the paramyxoviridae family, paramyxovirinae subfamily and avulavirus genus. During the period 2000 to 2011, stool and small intestine samples of 1647 birds species were sent to the Laboratory of Electron Microscopy, Biological Institute of São Paulo, Brazil, for diagnosis of viral agents. The samples were processed by negative staining (rapid preparation) and resin embedding techniques. Under the transmission electron microscope by negative staining technique, in 294 (17.8 percent) samples of 1647 were visualized paramyxovirus particles pleomorphic, roughly spherical or filamentous, measuring 100 to 500 nm of diameter containing an envelope covered with spikes and characteristic helical herring-bone-like nucleocapsid measuring 15 to 20 nm in diameter. Ultrathin sections of the small intestine fragments revealed the presence of amorphous granular intracytoplasmic inclusions surrounded by membrane and containing viral nucleocapsid measuring 10-14 nm in diameter. Immature particles budding from cell membranes, pleomorphic, spherical and tubular particles containing viral nucleocapsid strands, and the complete particles measured up to 170 nm in diameter were seen in the cytoplasm. Intranuclear inclusions containing viral nucleocapsid were also visualized. Nuclei showed a marginalized chromatin.

Las enfermedades causadas por paramixovirus (APMV) ocurren mundialmente, tanto en aves de corral, en aquellas en vida libre o en cautiverio, lo que demuestra la importancia económica y ecológica de estos virus. El paramixovirus aviario pertenece a la familia paramyxoviridae, subfamilia paramyxovirinae y género avulavirus. Durante el periodo de 2000 a 2011, muestras de heces y fragmentos del intestino delgado de 1647 especies de aves han sido enviados al Laboratorio de Microscopía Electrónica, Instituto Biológico de São Paulo, para el diagnóstico de agentes virales. Las heces y fragmentos del intestino delgado, se procesaron por las técnicas de contraste negativo (preparación rápida) y la inclusión en resina. Al microscopio electrónico de transmisión mediante la técnica de contraste negativo se visualizaron en muestras de 294 aves, partículas de paramixovirus, pleomórficas, más o menos esféricas o filamentosas, de 100 a 500 nm de diámetro que contenían un sobre cubierto por púas que presentaban característica helicoidal, con nucleocapside tipo espiga, midiendo de 15 a 20 nm de diámetro. Secciones ultrafinas de los fragmentos del intestino delgado, revelaron en el citoplasma la presencia de inclusiones granulares amorfas rodeadas por una membrana, contiendo nucleocapside viral midiendo de 10-14 nm de diámetro, partículas inmaduras brotando de las membranas celulares, partículas virales tubulares, esféricas o pleomórficas que contenían filamentos nucleocapside. Estas partículas completas alcanzaban a los 170 nm de diámetro. Fueron observadas también, inclusiones intranucleares contiendo nucleocapside viral. Los núcleos mostraron una cromatina marginal.

Systemic sclerosis and bone loss: the role of the disease and body composition.

OBJECTIVES: Studies on body composition are not available in systemic sclerosis (SSc). As this variable may play an important role in bone loss we have analysed bone mineral density (BMD) and body composition in SSc patients and healthy controls. METHODS: Forty-three postmenopausal SSc patients and 47 healthy postmenopausal women were studied. Patients with intestinal malabsorption, renal failure, current or past history of smoking or using osteopenic drugs were excluded. BMD and body composition was evaluated by dual X-ray absorptiometry (DXA). RESULTS: A higher frequency of osteoporosis in the lumbar spine (32.5%) and femoral neck (51.1%) was observed in SSc patients when compared to controls (14.8% vs. 19.1%; p<0.01). Multiple linear regression analysis revealed an association between the presence of SSc and low BMD. Body composition showed a reduced lean mass (33.15 vs. 39.99 g; p<0.01) and fat mass (21.05 vs. 26.82 g; p<0.01) in SSc when compared to controls. Lean mass was an important factor related to BMD in the lumbar spine and femoral neck. CONCLUSION: SSc may be an independent factor for low BMD. The low lean mass in these patients emphasizes the need for appropriate additional therapeutic measures to reduce bone loss in SSc patients.

[Heart surgery in Brazilian Indians]. / Cirurgia cardíaca em índios brasileiros.

PURPOSE: Our experience with surgical treatment of heart diseases in Indians living in the Amazon rain forest in primitive stages was reviewed. METHODS: From 1988 to 1995, 18 patients underwent cardiovascular surgical procedures at the São Paulo Hospital of the Escola Paulista de Medicina. Seven patients had valvar disease, nine congenital heart defects, one submitral aneurysm and one arrhythmia. Thirteen Indians came from tribes of the Amazon rain forest area: three from the Xavante, two from Waiapi, two from Tucano, two from Macuxi, two from Mayoruna, and one of each tribe of Xikrin, Guajajara, Terena, Surui, Galibi, Cinta-Larga and Pataxó. RESULTS: We performed 22 operations, with two hospital deaths. Follow-up was possible in 87.5% of cases, with one late death. The majority of cases were due to congenital heart defects and in this series it was noted the absence of operations to treat coronary artery disease. The incidence of valve disease was higher in accultured or semi-accultured Indians. CONCLUSION: The surgical treatment of cardiovascular disease has made possible to the surviving indians to return to and be accepted by their fellow tribesmen.