Safety and feasibility of a functional electrical stimulation cycling-based muscular dysfunction diagnostic method in mechanically ventilated patients.

BACKGROUND: A nonvolitional diagnostic method based on FES-Cycling technology has recently been demonstrated for mechanically ventilated patients. This method presents good sensitivity and specificity for detecting muscle dysfunction and survival prognosis, even in unconscious patients. As the clinical relevance of this method has already been reported, we aimed to evaluate its safety and feasibility. METHODS: An observational prospective study was carried out with 20 critically ill, mechanically ventilated patients. The FES-cycling equipment was set in a specific diagnostic mode. For safety determination, hemodynamic parameters and peripheral oxygen saturation were measured before and immediately after the diagnostic protocol, as well as venous oxygen saturation and blood lactate. The creatine phosphokinase level (CPK) was measured before and 24, 48, and 72 h after the test. The time taken to carry out the entire diagnostic protocol and the number of patients with visible muscle contraction (capacity of perceptive muscular recruitment) were recorded to assess feasibility. RESULTS: Heart rate [91 ± 23 vs. 94 ± 23 bpm (p = 0.0837)], systolic [122 ± 19 vs. 124 ± 19 mm Hg (p = 0.4261)] and diastolic blood pressure [68 ± 13 vs. 70 ± 15 mm Hg (p = 0.3462)], and peripheral [98 (96-99) vs. 98 (95-99) % (p = 0.6353)] and venous oxygen saturation [71 ± 14 vs. 69 ± 14% (p = 0.1317)] did not change after the diagnostic protocol. Moreover, blood lactate [1.48 ± 0.65 vs. 1.53 ± 0.71 mmol/L (p = 0.2320)] did not change. CPK did not change up to 72 h after the test [99 (59-422) vs. 125 (66-674) (p = 0.2799) vs. 161 (66-352) (p > 0.999) vs. 100 (33-409) (p = 0.5901)]. The time taken to perform the diagnostic assessment was 11.3 ± 1.1 min. In addition, 75% of the patients presented very visible muscle contractions, and 25% of them presented barely visible muscle contractions. CONCLUSIONS: The FES cycling-based muscular dysfunction diagnostic method is safe and feasible. Hemodynamic parameters, peripheral oxygen saturation, venous oxygen saturation, and blood lactate did not change after the diagnostic protocol. The muscle damage marker (CPK) did not increase up to 72 h after the diagnostic protocol.

Potent Anthelmintic Activity of Chalcones Synthesized by an Effective Green Approach.

There is currently an urgent need for new anthelmintic agents due to increasing resistance to the limited available drugs. The chalcone scaffold is a privileged structure for developing new drugs and has been shown to exhibit potential antiparasitic properties. We synthesized a series of chalcones via Claisen-Schmidt condensation, introducing a novel recoverable catalyst derived from biochar obtained from the pyrolysis of tree pruning waste. Employing microwave irradiation and a green solvent, this approach demonstrated significantly reduced reaction times and excellent compatibility with various functional groups. The result was the generation of a library of functionalized chalcones, exhibiting exclusive (E)-selectivity and high to excellent yields. The chalcone derivatives were evaluated on the free-living nematode Caenorhabditis elegans. The chalcone scaffold, along with two derivatives incorporating a methoxy substituent in either ring, caused a concentration-dependent decrease of worm motility, revealing potent anthelmintic activity and spastic paralysis not mediated by the nematode levamisole-sensitive nicotinic receptor. The combination of both methoxy groups in the chalcone scaffold resulted in a less potent compound causing worm hypermotility at the short term, indicating a distinct molecular mechanism. Through the identification of promising drug candidates, this work addresses the demand for new anthelmintic drugs while promoting sustainable chemistry.

Expression of the αVß3 integrin affects prostate cancer sEV cargo and density and promotes sEV pro-tumorigenic activity in vivo through a GPI-anchored receptor, NgR2.

It is known that small extracellular vesicles (sEVs) are released from cancer cells and contribute to cancer progression via crosstalk with recipient cells. We have previously reported that sEVs expressing the αVß3 integrin, a protein upregulated in aggressive neuroendocrine prostate cancer (NEPrCa), contribute to neuroendocrine differentiation (NED) in recipient cells. Here, we examine the impact of αVß3 expression on sEV protein content, density and function. sEVs used in this study were isolated by iodixanol density gradients and characterized by nanoparticle tracking analysis, immunoblotting and single vesicle analysis. Our proteomic profile of sEVs containing αVß3 shows downregulation of typical effectors involved in apoptosis and necrosis and an upregulation of tumour cell survival factors compared to control sEVs. We also show that the expression of αVß3 in sEVs causes a distinct reposition of EV markers (Alix, CD81, CD9) to a low-density sEV subpopulation. This low-density reposition is independent of extracellular matrix (ECM) protein interactions with sEVs. This sEV subset contains αVß3 and an αVß3 downstream effector, NgR2, a novel marker for NEPrCa. We show that sEVs containing αVß3 are loaded with higher amounts of NgR2 as compared to sEVs that do not express αVß3. Mechanistically, we demonstrate that sEVs containing NgR2 do not affect the sEV marker profile, but when injected in vivo intratumorally, they promote tumour growth and induce NED. We show that sEVs expressing NgR2 increase the activation of focal adhesion kinase (FAK), a known promoter of cancer cell proliferation, in recipient cells. We also show that NgR2 mimics the effect of sEVs containing αVß3 since it displays increased growth of NgR2 transfectants in vivo, as compared to control cells. Overall, our results describe the changes that occur in cargo, density and functions of cancer cell-derived sEVs containing the αVß3 integrin and its effector, NgR2, without affecting the sEV tetraspanin profiles.

Timing and placement of cattle manure and/or gliricidia affects cotton and sunflower nutrient accumulation and biomass productivity

ABSTRACT Organic fertilizers are a viable alternative to increase oilseed productivity in family agriculture systems. The study aimed to evaluate the effects of timing and placement of cattle manure and/or gliricidia (Gliricidia sepium Jacq. Walp) prunings on cotton (Gossipium hirsutum L.) and sunflower (Helianthus annuus L.) nutrient accumulation and biomass productivity. Experiments were carried out in 2010 and 2011 in Taperoá, Paraíba, Brazil. The organic fertilization treatments were: GI - gliricidia incorporated before planting; GS - gliricidia applied on surface 45 days after planting (DAP); MI + GI - manure and gliricidia incorporated before planting; MI + GS - manure incorporated before planting and gliricídia applied on the surface 45 DAP; MI - manure incorporated before planting; and T - with no organic fertilization. In 2010, treatment MI + GS increased N, P, and K accumulation in cotton (12 and 7 kg ha-1) as well as in sunflower (20 and 29 kg ha-1). In 2011, GI and GS treatments resulted in higher N, P, K accumulations in both crops. The highest cotton productivity in 2010 was obtained with MI + GS treatment (198 kg ha-1) and in 2011 with GS treatment (594 kg ha-1). For sunflower, MI + GS treatment yielded the highest productivity in 2010 (466 kg ha-1) and GI treatment in 2011 (3542 kg ha-1). GI and MI + GS treatments increased total biomass productivity for cotton and sunflower. The treatment that combined both cattle manure incorporated into the soil before planting and gliricidia applied on the surface 45 days after planting was the most viable management strategy.

New approaches for growth improvement in pejerrey Odontesthes bonariensis (Valenciennes, 1835) culture (Atherinomorpha: Atherinopsidae)

The pejerrey is the most important recreational species in shallow temperate lakes and reservoirs of Argentina and the attempts to develop its culture have started a century ago. A common constraint of pejerrey aquaculture is its poor growth under traditional intensive rearing techniques. The aim of this study was to evaluate the possibility to achieve and maintain high growth rates of pejerrey throughout the rearing process by semi-intensive culture method . Four floating cages were installed in La Salada de Monasterio Lake and each one was stocked with 300 juveniles (10.22 ±0.38cm; 6.52 ±0.82g). From January through March all fish were exposed to natural zooplankton as food source, whereas from April to September two cages were supplied daily with artificial food. The fish exposed to artificial supplementary diets exhibited significantly higher growth (17.5 ±0.98cm; 41.05 ±8.55g) than those in the control cages (15.02 ±0cm ; 23.5 ±0.84g), and exceeded the known values in pejerrey culture. The results suggest that the species potential growth is not fully achieved by common intensive methods and it can be improved by semi-intensive techniques. Accordingly a better understanding of the species nutritional requirements is needed to improve growth rates and enhance pejerrey culture.

El pejerrey es la especie de mayor importancia deportiva en lagos someros templados y embalses de Argentina y el desarrollo de su acuicultura data de cien años atrás. Un impedimento común para el desarrollo de la acuicultura del pejerrey es el pobre crecimiento que manifiesta bajo cultivo intensivo. El objetivo de este estudio fue evaluar la posibilidad de alcanzar y mantener altas tasas de crecimiento en el pejerrrey mediante cultivo semi-intensivo. Se instalaron cuatro jaulas flotantes en la laguna La Salada de Monasterio, sembrándose cada una con 300 juveniles (10.22 ±0.38cm; 6.52 ±0.82g). Desde enero hasta marzo los peces se alimentaron con el zooplancton natural de la laguna, mientras que desde abril hasta septiembre dos jaulas fueron suplementadas diariamente con alimento balanceado, dejándose las otras dos como controles. Los peces bajo dietas suplementadas mostraron crecimientos significativamente superiores (17.5 ±0.98cm; 41.05 ±8.55g) a los de las jaulas control (15.02 ±0cm ; 23.5 ±0.84g), excediendo incluso los conocidos en el cultivo de pejerrey en períodos similares. Los resultados obtenidos sugieren que el potencial de crecimiento del pejerrey no está siendo explotado en su totalidad bajo las técnicas de cultivo tradicionales y puede mejorarse mediante el cultivo semi-intensivo. En consecuencia es necesaria una mejor comprensión de los requerimientos nutricionales del pejerrey para incrementar sus tasas de crecimiento y así mejorar su cultivo.

Osmotic induction marking with Alizarin Red S on juveniles of pejerrey, Odontesthes bonariensis (Atherinopsidae)

Juveniles of pejerrey, Odontesthes bonariensis, were exposed to 0.1% Alizarin Red S (ARS) alone or with a previous immersion in 2.2% saline solution (Osmotic Induction, OI) to enhance the ARS marking method. Fish were marked in the field and immediately released in 1 m3 cages in "La Salada de Monasterio" lagoon, Chascomús, Buenos Aires , Argentina. After 73 days, clear marks were observed in the otoliths, caudal fin rays and scales with both treatments, being the intensity of the signal in the scales of OI+ARS treated fish higher. On the other hand, no marks were observed in the control group on the same structures. Approximately one year post-treatment (385 days), only marks in caudal fin rays were found clearly in OI+ARS treated fish. After this period, no significant differences in total length or weight between marked or control fish were observed and the mortality ranged between 30-40 % in all cages. These results provide strong evidence for the potential applicability of this cost-effective marking technique in differentiation of wild and hatchery-produced pejerrey. The success in the caudal fin rays marking is also important because it is easy to do and does not require the sacrifice of fish.

Juvenis de pejerrey, Odontesthes bonariensis, foram expostos a Vermelho de Alizarina S (ARS) 0,1% de duas formas, sozinho ou com uma imersão anterior em 2,2% de solução salina (Indução osmótica, IO) para melhorar o método de marcação ARS. Os procedimentos foram realizados no campo e os peixes foram liberados em gaiolas (tanques-rede) de 1 m3 na lagoa "La Salada de Monasterio", Chascomús, Buenos Aires, Argentina. Após 73 dias, marcas claras foram observadas nos otólitos, raios da nadadeira caudal e escamas em ambos os tratamentos, sendo que a intensidade do sinal nas escalas de IO + ARS de peixe tratado foi superior. Por outro lado, não foram observados marcas no grupo controle sobre as mesmas estruturas. Aproximadamente um ano pós-tratamento (385 dias), apenas marcas nos raios da nadadeira caudal foram encontrados claramente nos peixes tratados com IO+ARS. Entre os peixes observados, após este período, não houve diferenças significativas no comprimento total ou peso entre o grupo controle e marcados, ademais, a mortalidade variou entre 30-40% em todas as gaiolas. Estes resultados fornecem fortes evidências e um grande potencial para aplicação desta técnica rentável de marcação que diferencia o pejerrey selvagem e o produzido em cativeiro. O sucesso na marcação dos raios da nadadeira caudal também é de grande importância, pois sua verificação é fácil e não requer o sacrifício de peixes.

Recomendações da sociedade brasileira de arritmias cardíacas para serviços de holter / Recommendations of the Brazilian society of cardiac arrhythmias for holter monitoring services

FUNDAMENTOS: Inúmeros indicadores são utilizados para assegurar a qualidade de um serviço; entretanto, a competência médica e o adequado fluxo de realização de um procedimento são determinantes da qualidade final. Nesse contexto, a Sociedade Brasileira de Arritmias Cardíacas pretende recomendar parâmetros mínimos necessários para garantir a excelência dos serviços de monitorização eletrocardiográfica ambulatorial. OBJETIVOS: Recomendar competências médicas mínimas e as informações necessárias para emissão do laudo de Holter. MÉTODOS: O documento foi fundamentado no conceito de medicina baseada em evidência, e nas circunstâncias em que a evidência não estava disponível a opinião de uma comissão de redação foi utilizada para a formulação da recomendação. Essa comissão foi formada por profissionais que apresentam vivência nas dificuldades do método e gestão na prestação de serviços nessa área. RESULTADOS: O profissional responsável pela análise de Holter deve conhecer as patologias cardiovasculares e ter formação consistente em eletrocardiografia, incluindo arritmias cardíacas e seus diagnósticos diferenciais. O laudo deve ser redigido de forma clara e objetiva. Os parâmetros mínimos que devem constar no laudo incluem as estatísticas do exame, assim como quantificação e análise dos distúrbios do ritmo observados durante a monitorização. CONCLUSÃO: A monitorização eletrocardiográfica ambulatorial deve ser realizada por profissionais com vivência em análise eletrocardiográfica e o laudo deve conter os parâmetros mínimos mencionados nesse documento.

BACKGROUND: There are innumerous indicators to assure the quality of a service. However, medical competence and the proper performance of a procedure determine its final quality. The Brazilian Society of Cardiac Arrhythmias recommends minimum parameters necessary to guarantee the excellence of ambulatory electrocardiographic monitoring services. OBJECTIVE: To recommend minimum medical competences and the information required to issue a Holter monitoring report. METHODS: This study was grounded in the concept of evidence-based medicine and, when evidence was not available, the opinion of a writing committee was used to formulate the recommendation. That committee consisted of professionals with experience on the difficulties of the method and management in providing services in that area. RESULTS: The professional responsible for the Holter monitoring analysis should know cardiovascular pathologies and have consistent formation on electrocardiography, including cardiac arrhythmias and their differential diagnoses. The report should be written in a clear and objective way. The minimum parameters that comprise a Holter report should include statistics of the exam, as well as quantification and analysis of the rhythm disorders observed during monitoring. CONCLUSION: Ambulatory electrocardiographic monitoring should be performed by professionals knowledgeable about electrocardiographic analysis, whose report should comprise the minimum parameters mentioned in this document.

Low-intensity resistance exercise does not affect cardiac autonomic modulation in patients with peripheral artery disease

OBJECTIVE: To analyze the effect of a single bout of resistance exercise on cardiac autonomic modulation in patients with peripheral artery disease. METHODS: Fifteen patients with peripheral artery disease (age: 58.3±4.0 years) underwent the following sessions in a random order: resistance exercise (three sets of 10 repetitions of the six resistance exercises with a workload of 5-7 in the OMNI-RES scale) and control (similar to the resistance session; however, the resistance exercises were performed with no load). The frequency domain (low frequency, high frequency and sympathovagal balance) and symbolic analysis (0V, 1V and 2V patterns) of heart rate variability were obtained before and until one hour after the interventions. RESULTS: After the resistance exercise and control sessions, similar increases were observed in the consecutive heartbeat intervals (control: 720.8±28.6 vs. 790.9±34.4 ms; resistance exercise: 712.9±30.1 vs. 756.8±37.9 ms; p<0.05) and in the pattern of the symbolic analysis with no variation (0V) (control: 25.1±3.5 vs. 33.4±4.1%; resistance exercise: 26.1±3.2 vs. 29.7±3.5%; p<0.05) until 50 min after both interventions. The pattern of two variations (2V) decreased similarly (control: 11.2±2.1 vs. 8.3±2.1%; resistance exercise: 9.5±1.7 vs. 7.8±1.7%; p<0.05). In contrast, the pattern of one variation (1V), the low and high frequency bands and sympathovagal balance did not change after the interventions (p>0.05). CONCLUSION: A single bout of resistance exercise did not alter cardiac autonomic modulation in patients with peripheral artery disease. .

Relação da pressão sistólica em artéria pulmonar com gênero, menopausa e gravidez em portadores de hipertensão arterial pulmonar associada à esquistossomose / Pulmonary artery pressure, gender, menopause, and pregnancy in schistosomiasis-associated pulmonary hypertension

FUNDAMENTO: A hipertensão arterial pulmonar associada à esquistossomose (HPAE) é uma grande preocupação no mundo todo. No entanto, o papel de fatores contribuintes específicos do gênero em HPAE é desconhecido. OBJETIVO: Investigamos os valores da pressão arterial pulmonar sistólica (PAPS) e a presença de elevação grave na PAPS relacionado ao gênero, presença de menopausa e histórico de gravidez em pacientes com HPAE. MÉTODOS: Setenta e nove pacientes diagnosticados com HPAE de 2000 a 2009 foram avaliados e 66 foram incluídos no estudo. As informações referentes à idade, status da menopausa, gravidez, PAPS derivada da ecocardiografia, e pressão arterial pulmonar média invasiva (PAPm) foram coletadas de registros médicos. A relação entre os valores de PAPS e PAPm e a correlação para doença grave foram avaliados. Os modelos de regressão avaliaram a associação de gênero, status da menopausa e histórico de gravidez com valores de PAPS e a presença de PAPS severa. RESULTADOS: Houve correlação moderada entre PAPm e PAPS, com boa concordância para classificação de doença grave. Os valores de PAPS foram semelhantes para homens e mulheres. Uma tendência a valores maiores de PAPS foi encontrada para mulheres não menopausadas em comparação a homens. Valores superiores de PAPS foram encontrados para mulheres menopausadas em comparação a mulheres não menopausadas; os valores não foram significativos após o ajuste de idade. O histórico de gravidez não teve relação com a PAPS. Presença de menopausa e passado de gravidez não mostraram associação com valores de PAPS. CONCLUSÃO: Em pacientes com HPAE, nem o gênero, nem o status da menopausa nem o histórico de gravidez apresentou uma correlação independente com valores de HPAE avaliados pela ecocardiografia.

BACKGROUND: Schistosomiasis-associated pulmonary arterial hypertension (SPAH) is a major concern worldwide. However, the role of gender-specific contributing factors in SPAH is unknown. OBJECTIVE: We investigated how systolic pulmonary artery pressure (SPAP) values and the presence of severe SPAP relate to gender, menopausal status, and pregnancy history in SPAH patients. METHODS: Seventy-nine patients diagnosed with SPAH from 2000 to 2009 were assessed and 66 were enrolled in the study. Information about age, menopausal status, pregnancy, echocardiography-derived SPAP, and invasive mean pulmonary artery pressure (mPAP) was collected from medical records. The relation between values of SPAP and mPAP and their agreement for severe disease were assessed. Regression models assessed the association of gender, menopausal status, and pregnancy history with SPAP values and the presence of severe SPAP. RESULTS: Moderate correlation and good agreement for severe disease were found between mPAP and SPAP. Mean SPAP values were similar for men and women. A trend toward higher values of SPAP was found for non-menopausal women compared to men. Higher SPAP values were found for menopausal compared to non-menopausal women; the values were non-significant after adjustment for age. Pregnancy history had no association with SPAP. Menopause and positive pregnancy had no association with severe SPAP. CONCLUSION: In SPAH patients, neither gender, nor menopausal status, nor pregnancy history showed independent correlation with SPAP values assessed by echocardiography.

Enriched environment contributes to recovery of visual acuity and increases perineuronal nets in monocular-deprived animals

The aim of the present study was to analyze the influence of enriched environment on the distribution of perineuronal nets (PNNs) using a stereogically based unbiased protocol and visual acuity in adult Swiss albino mice that underwent monocular deprivation during the critical period of postnatal development. Eight female Swiss albino mice were monocular deprived on postnatal day 10 and divided into two groups at weaning: standard environment (SE group, n = 4) and enriched environment (EE group, n = 4). After 3 months, all of the mice were subjected to grating visual acuity tests, sacrificed, and perfused with aldehyde fixative. The brains were removed and cut at 70 µm thickness in a vibratome and processed for lectin histochemical staining with Wisteria floribunda agglutinin (WFA). Architectonic limits of area 17 were conspicuously defined by WFA histochemical staining, and the optical fractionator stereological method was applied to estimate the total number of PNNs in the supragranular, granular, and infragranular layers. All groups were compared using Student's t-test at a 95 percent confidence level. Comparative analysis of the average PNN estimations revealed that the EE group had higher PNNs in the supragranular layer (2726.33 ± 405.416, mean ± standard deviation) compared with the SE group (1543.535 ± 260.686; Student's t-test, p = .0495). No differences were found in the other layers. Visual acuity was significantly lower in the SE group (0.55 cycles/degree) than in the EE group (1.06 cycles/degree). Our results suggest that the integrity of the specialized extracellular matrix PNNs of the supragranular layer may be essential for normal visual acuity development.

Assessment of condition in pejerrey Odontesthes bonariensis (Atheriniformes: Atherinopsidae) populations: which index works best?

The pejerrey Odontesthes bonariensis is the most important target species in temperate freshwater fisheries of Argentina, and assessment of condition has been a regular practice and common diagnostic tool. Most pejerrey fishery studies have used Fulton's (K) index, without testing whether underlying assumptions or requirements were met. We analyzed and contrasted the applicability of K, Kn and Wr indices to assess condition status in several pejerrey populations inhabiting Pampean lakes. Our results showed that whereas Wr and Kn displayed significant condition changes across length at some study lakes, Kn portrayed a small range of variation. We also noted that pejerrey maximum length and size structure strongly varied among populations probably due to the characteristics of trophic niche changes through lifespan, depending on lake limnological characteristics and zooplankton availability. We conclude that the K index should be disregarded in those cases where populations show allometric growth and size ranges strongly vary. In turn, the Kn index appears to be only appropriate for regular within population assessment, being difficult to apply when comparisons between populations are needed and when they exhibit different weight-length relationship slopes. Finally, the Wr index should be strongly preferred if the objective is to perform comparisons between pejerrey populations, particularly when population structure is not well known, stocking has been used for population recovery, lakes are strongly supported by limnological changes, data are limited to only one or few samplings and metaphoetesis is suspected in pejerrey populations.(AU)

O peixe-rei Odontesthes bonariensis é a espécie mais importante na pesca de água doce da região temperada da Argentina, e a avaliação de sua condição corpórea tem sido uma prática normal e uma ferramenta de diagnóstico bastante utilizada. Grande parte dos estudos sobre a pesca do peixe-rei utiliza o índice de Fulton (K), sem testar se seus pressupostos são atendidos. Nós analisamos e comparamos a aplicabilidade dos índices K, Kn e Wr para a avaliação do fator de condição em várias populações de peixe-rei em lagos dos Pampas. Nossos resultados mostram que, enquanto o Wr e o Kn dependeram significativamente do comprimento corporal em alguns lagos, o Kn apresentou uma pequena amplitude de variação. Foi também notado que o comprimento máximo e a estrutura de tamanho variaram fortemente entre populações, provavelmente devido às mudanças ontogenéticas no nicho trófico, dependendo das características limnológicas e da disponibilidade de zooplâncton. Concluímos que o índice K deve ser desconsiderado nos casos em que as populações apresentam variações alométricas marcantes no crescimento e na amplitude de tamanhos. O índice Kn parece ser apropriado apenas para avaliações de uma única população, não sendo apropriado para comparações entre populações quando elas exibem diferentes inclinações na relação peso-comprimento. Finalmente, o índice Wr é recomendado se o objetivo for fazer comparações entre populações de peixe-rei, particularmente quando a estrutura populacional não é bem conhecida, a estocagem tenha sido usada para a recuperação populacional, os lagos apresentam grandes variações limnológicas, os dados se limitam a uma ou poucas amostras e suspeita-se da ocorrência de mudanças ontogenéticas na dieta.(AU)

Lesiones tendinosas del tobillo en resonancia magnética: análisis retrospectivo en 548 estudios / Tendinous lesions of the ankle in MRI: retrospective review in 548 exams

Objetivo: Determinar la prevalencia de las diversas lesiones tendinosas del tobillo y sus características iconográficas típicas en los pacientes sometidos a Resonancia Magnética (RM). Material y métodos: Se efectuó un análisis descriptivo, retrospectivo y de corte transversal, de 548 estudios de RM de tobillo durante un período de 18 meses (entre enero de 2006 y junio de 2007), que contabiliza el total de los exámenes obtenidos en resonadores de campo cerrado en Diagnóstico por Imágenes Adrogué y en las sedes Hospital Fiorito de Avellaneda y Fundación Científica del Sur. Resultados: Del total de exámenes (n=548), el 40.3% fueron realizados a pacientes de sexo femenino (n=221) y el 59.7% a pacientes de sexo masculino (n=327), con una edad promedio de 47.6 ± 17 años. El 60.5% de los estudios (n=331) no reveló alteraciones en ningún grupo tendinoso del tobillo, mientras que el 39.5% (n=217) demostró la presencia de algún tipo de patología tendinosa. Asimismo, 64 estudios (11.7%) revelaron alteraciones en el tendón tibial posterior; 47 (8.6%) en el tendón de Aquiles; 34 (6.2%) en el tendón peroneo lateral corto; 27 (4.9%) a nivel del tendón del flexor propio del hallux; 26 (4.7%) en el tendón peroneo lateral largo; 10 (1.8%) en el tendón flexor común de los dedos; 6 (1.1%) en el tendón tibial anterior; y 3 (0.5%) en el tendón extensor común de los dedos. Conclusiones: La RM constituye una excelente herramienta en la valoración de las diversas patologías tendinosas debido a su capacidad multiplanar y a su alto contraste tisular.

Purpose: To determine the prevalence of several tendinous lesions of the ankle, and the MR imaging features that characterize these lesions. Materials and methods: MR images in 548 exams of ankle were retrospectively reviewed. These studies were performed during a 18-months period of time in 3 MR scanners at Hospital Fiorito (Avellaneda), Diagnóstico por Imágenes Adrogué, and Fundación Científica del Sur Avellaneda. Results: The ankle MR images (n=548) were taken from 221 women, and 327 men; median age, 47.6 years. In 60.5% studies (n=331), no pathologic images were identified. Sixty four exams (11.7%) showed some kind of tendon injury in the tibialis posterior tendon, 47 (8.6%) in the Achilles tendon, 34 (6.2%) in the peroneus brevis tendon, 27 (4.9%) in the flexor hallucis longus tendon, and 26 (4.7%) in the peroneus longus tendon. Additional findings included lesions in the flexor digitorum longus tendons (n=10), in the tibialis anterior tendon (n=6), and in the extensor digitorum longus tendons (n=3). Conclusions: The high-quality soft-tissue contrast resolution, noninvasive nature, and multiplanar capabilities of the MR images make it an excellent tool for the detection and evaluation of a variety of tendon disorders in the ankle.

Treadmill stress test in children and adolescents: higher tolerance on exertion with ramp protocol / Teste ergométrico em crianças e adolescentes: maior tolerância ao esforço com o protocolo em rampa

OBJETIVO: Comparar a tolerância ao exercício de crianças e adolescentes submetidos a teste ergométrico (TE) em esteira com os protocolos de Bruce ou em rampa, e descrever a velocidade e a inclinação alcançadas com o protocolo em rampa, para auxiliar na orientação do exercício com esse protocolo. MÉTODOS: Estudo observacional, tipo série de casos, com controle histórico, de 1.006 crianças e adolescentes entre 4 e 17 anos submetidos a TE entre outubro de 1986 e fevereiro de 2003, que concluíram um dos dois protocolos. Foram excluídos os que tiveram o TE interrompido por outras causas que não cansaço físico, os que estavam em uso de medicações que interferiam na freqüência cardíaca (FC) e aqueles com limitações físicas à realização do exercício. Na análise estatística dos dados foi adotado nível de significância para p < 0,05 e intervalo de confiança de 95 por cento. RESULTADOS: O tempo de exercício próximo a 10 minutos no protocolo em rampa foi significativamente maior no protocolo de Bruce. A FC máxima alcançada foi superior a 180 bpm nos dois protocolos. A inclinação foi pouco maior nas meninas mais jovens com o protocolo de Bruce, e a velocidade e o consumo máximo de oxigênio (VO2 max) foram maiores em todas as faixas etárias nos que realizaram o protocolo em rampa. CONCLUSÃO: A velocidade e a inclinação alcançadas com o protocolo em rampa podem ser utilizadas como referência para auxiliar na orientação do exercício no TE com o protocolo em rampa, que mostrou tolerância ao esforço superior à do protocolo de Bruce.

OBJECTIVE: Compare exercise tolerance by children and adolescents submitted to treadmill stress test (TST) following Bruce Protocol (BP) or Ramp Protocol (RP), as well as describe velocity and inclination reached with ramp protocol to help set protocol exercise standards. METHODS: Observational, case-based study, with history control of 1,006 children and adolescents in the 4 to 17-year-old range who were submitted to TST between October, 1986 and February, 2003, and who concluded one of the two protocols. Those who interrupted their ET for other reasons rather than physical exhaustion, those on medication that interfered in HR and those with physical constraints to exercise were excluded. Statistical analysis of data considered p<0.05 as significance level; with confidence interval at 95 percent. RESULTS: Exercise time close to 10 minutes in RP was significantly higher than in BP. HR max reached was higher than 180 bpm in both protocols. Inclination showed to be slightly higher in younger girls in Bruce Protocol. Velocity and VO2 max showed to be higher for all age ranges for those in the Ramp Protocol. CONCLUSION: Velocity and inclination reached with ramp protocol may be used as reference to help set ramp protocol exercise, which showed superior on exertion tolerance as compared to Bruce protocol.

Morphological evolution and heritability estimates for some biometric traits in the Murgese horse breed

A data set concerning 1,816 subjects entered in the Italian Horse Registry from 1925 to 2002 was analyzed to investigate the morphological evolution of the Murgese horse and to obtain useful elements to enhance breeding practices. Three basic body measurements (height at withers, chest girth, and cannon bone circumference) were considered for each subject. Heritabilities were calculated for each parameter to infer the growth and development traits of this breed. Over the past 20 years the Murgese horse has undergone considerable changes, passing from a typical mesomorphic structure (height at withers: 156.30 and 151.04 cm; chest girth: 185.80 and 176.11 cm; cannon bone: 21.10 and 19.82 cm for males and females, respectively) to a mesodolichomorphic structure (height at withers: 160.31 and 156.44 cm; chest girth: 187.89 and 182.48 cm; cannon bone: 21.07 and 20.37 cm, for males and females, respectively). Due to these changes and to its characteristic strength and power, the Murgese, which was once used in agriculture and for meat production (at the end of its life), is now involved in sports, mainly in trekking and equestrian tourism. The heritability estimates for the three body measurements were found to be 0.24, 0.39 and 0.44.

Uma nova proposta para orientar a velocidade e inclinação no protocolo em rampa na esteira ergométrica / A new proposal to guide velocity and inclination in the ramp protocol for the treadmill ergometer

OBJECTIVE: To suggest criteria to guide protocol prescription in ramp treadmill testing, according to sex and age, based on velocity, inclination, and max VO2 reached by the population studied. METHODS: Prospective study describing heart rate (HR), time, velocity, inclination, and VO2 estimated at maximum effort of 1840 individuals from 4 to 79 years old, who performed a treadmill test (TT) according to the ramp protocol. A paired Student t test was used to assess the difference between predicted and reached max VO2, calculated according to the formulas of the "American College of Sports Medicine". RESULTS: Submaximal HR was surpassed in 90.1 percent of the examinations, with a mean time of 10.0±2.0 minute. Initial and peak inclination velocity of the exercise and max VO2 were inversely proportional to age and were greater in male patients. Predicted Max VO2 was significantly lower than that reached in all patients, except for female children and adolescents (age < 20 years old). CONCLUSION: Use of velocity, inclination, and maximum VO2 actually reached, as a criterion in prescribing the ramp protocol may help in the performance of exercise in treadmill testing. The ramp protocol was well accepted in all age groups and sexes with exercise time within the programmed 8 to 12 minutes

Exercício físico e o controle da pressão arterial / Physical exercise and blood pressure control

O exercício físico provoca uma série de respostas fisiológicas, resultantes de adaptações autonômicas e hemodinâmicas que vão influenciar o sistema cardiovascular. Diversos estudos demonstraram o seu efeito benéfico sobre a pressão arterial. Sendo a hipertensão arterial sistêmica uma entidade de alta prevalência e elevada morbimortalidade na população, o exercício físico tem importante papel como elemento não medicamentoso para o seu controle ou como adjuvante ao tratamento farmacológico.