Anti-Inflammatory Effects of a Pomegranate Leaf Extract in LPS-Induced Peritonitis.

Folk medicine suggests that pomegranate (peels, seeds and leaves) has anti-inflammatory properties; however, the precise mechanisms by which this plant affects the inflammatory process remain unclear. Herein, we analyzed the anti-inflammatory properties of a hydroalcoholic extract prepared from pomegranate leaves using a rat model of lipopolysaccharide-induced acute peritonitis. Male Wistar rats were treated with either the hydroalcoholic extract, sodium diclofenac, or saline, and 1 h later received an intraperitoneal injection of lipopolysaccharides. Saline-injected animals (i. p.) were used as controls. Animals were culled 4 h after peritonitis induction, and peritoneal lavage and peripheral blood samples were collected. Serum and peritoneal lavage levels of TNF-α as well as TNF-α mRNA expression in peritoneal lavage leukocytes were quantified. Total and differential leukocyte populations were analyzed in peritoneal lavage samples. Lipopolysaccharide-induced increases of both TNF-α mRNA and protein levels were diminished by treatment with either pomegranate leaf hydroalcoholic extract (57 % and 48 % mean reduction, respectively) or sodium diclofenac (41 % and 33 % reduction, respectively). Additionally, the numbers of peritoneal leukocytes, especially neutrophils, were markedly reduced in hydroalcoholic extract-treated rats with acute peritonitis. These results demonstrate that pomegranate leaf extract may be used as an anti-inflammatory drug which suppresses the levels of TNF-α in acute inflammation.

Thermal conditions in freezing chambers and prediction of the thermophysiological responses of workers.

The present work is dedicated to the assessment of the cold thermal strain of human beings working within freezing chambers. To obtain the present results, both field measurements and a numerical procedure based on a modified version of the Stolwijk thermoregulation model were used. Eighteen freezing chambers were considered. A wide range of physical parameters of the cold stores, the workers clothing insulation, and the working and recovering periods were observed. The combination of these environmental and individual parameters lead to different levels of thermal stress, which were grouped under three categories. Some good practices were observed in the field evaluations, namely situations with appropriate level of clothing protection and limited duration of exposure to cold avoiding unacceptable level of hypothermia. However, the clothing ensembles normally used by the workers do not provide the minimum required insulation, which suggests the possibility of the whole body cooling for levels higher than admissible. The numerical predictions corroborate the main conclusions of the field survey. The results obtained with both methodologies clearly show that, for the low temperature of the freezing chambers, the clothing insulation is insufficient, the exposure periods are too long, and the recovering periods are inadequate. Thus, high levels of physiological strain can indeed be reached by human beings under such working environments.

Comparison of rumen fluid pH by continuous telemetry system and bench pH meter in sheep with different ranges of ruminal pH.

We aimed to compare the measurements of sheep ruminal pH using a continuous telemetry system or a bench pH meter using sheep with different degrees of ruminal pH. Ruminal lactic acidosis was induced in nine adult crossbred Santa Ines sheep by the administration of 15 g of sucrose per kg/BW. Samples of rumen fluid were collected at the baseline, before the induction of acidosis (T 0) and at six, 12, 18, 24, 48, and 72 hours after the induction for pH measurement using a bench pH meter. During this 72-hour period, all animals had electrodes for the continuous measurement of pH. The results were compared using the Bland-Altman analysis of agreement, Pearson coefficients of correlation and determination, and paired analysis of variance with Student's t-test. The measurement methods presented a strong correlation (r = 0.94, P < 0.05) but the rumen pH that was measured continuously using a telemetry system resulted in lower values than the bench pH meter (overall mean of 5.38 and 5.48, resp., P = 0.0001). The telemetry system was able to detect smaller changes in rumen fluid pH and was more accurate in diagnosing both subacute ruminal lactic acidosis and acute ruminal lactic acidosis in sheep.

Associating Physical and Photocatalytic Properties of Recyclable and Reusable Blast Furnace Dust Waste.

Blast furnace dust waste (BFDW) proved efficient as a photocatalyst for the decolorization of methylene blue (MB) dye in water. Structural analysis unequivocally identified α-Fe2O3 as the predominant phase, constituting approximately 92%, with a porous surface showcasing unique 10-30 nm agglomerated nanoparticles. Chemical and thermal analyses indicated surface-bound water and carbonate molecules, with the main phase's thermal stability up to 900 °C. Electrical conductivity analysis revealed charge transfer resistance values of 616.4 Ω and electrode resistance of 47.8 Ω. The Mott-Schottky analysis identified α-Fe2O3 as an n-type semiconductor with a flat band potential of 0.181 V vs. Ag/AgCl and a donor density of 1.45 × 1015 cm-3. The 2.2 eV optical bandgap and luminescence stem from α-Fe2O3 and weak ferromagnetism arises from structural defects and surface effects. With a 74% photocatalytic efficiency, stable through three photodegradation cycles, BFDW outperforms comparable waste materials in MB degradation mediated by visible light. The elemental trapping experiment exposed hydroxyl radicals (OH•) and superoxide anions (O2-•) as the primary species in the photodegradation process. Consequently, iron oxide-based BFDW emerges as an environmentally friendly alternative for wastewater treatment, underscoring the pivotal role of its unique physical properties in the photocatalytic process.

Occurrence of Toxoplasma gondii antibodies in Dasyprocta aguti from Brazil: comparison of diagnostic techniques.

In this study, the occurrence of antibodies to Toxoplasma gondii in Brazilian agouti (Dasyprocta aguti) was compared by modified agglutination test (MAT) and indirect fluorescent antibody test (IFAT) using anti-capybara conjugate. Sera from 109 animals were tested using MAT (1:25 cut-off) and IFAT (1:16 cut-off); 19% were positive by MAT, and 18% were positive by IFAT. Overall, the 17 IFAT-positive samples were also positive for MAT. The four positive MAT samples with a titer < or = 200 were IFAT negative. All negative samples obtained by MAT matched with the results of the IFAT. Comparing both tests, and considering MAT as the gold standard, the sensitivity of IFAT was 81%, the specificity was 100%, the accuracy was 97%, the positive predictive value (PPV) was 100%, and the negative predictive value 96%. The kappa value agreement was 87.3% (75.1-99.6%). The anti-capybara conjugate can be successfully used to perform IFAT in Brazilian agouti with maximum specificity and PPV.

Post-operative pain behaviour associated with surgical castration in donkeys (Equus asinus).

BACKGROUND: Recognising pain in donkeys is challenging because they are stoic. OBJECTIVES: To identify the responses of donkeys before and after surgical pain. STUDY DESIGN: Prospective, short-term longitudinal pre- and post-intervention observations. METHODS: Forty adult donkeys underwent surgical castration after sedation with intravenous (IV) xylazine, induction with guaiphenesin/thiopental IV and maintenance of anaesthesia with isoflurane and local anaesthetic blockade. Four hours after recovery from anaesthesia, flunixin meglumine 1.1 mg/kg, dipyrone 10 mg/kg and morphine 0.2 mg/kg IV were administered. Behavioural responses exhibited by the animals housed in individual stalls were recorded in four 30-min videos: before castration (M0), and 3.5-4.0 hours (M1), 5.5-6.0 hours (M2) and 23.5-24.0 hours after recovery from anaesthesia (M3). To exclude the influence of insects, the behaviour of six apparently pain-free donkeys was compared with and without the presence of faeces and urine in the stall. RESULTS: When compared with presurgical baseline behaviours (M0), after surgery (M1) donkeys raised their pelvic limbs more (P = .003). When compared with M1, after analgesia (M2), the median frequencies of ear movements (44 vs 16; P < .001), head shaking (7 vs 1; P < .001), head turning (5 vs 0; P < .001) and lifting of the both limbs (7 vs 0; P = .008) decreased; feeding (0 vs 29; P < .001) and water intake (0 vs 0, range 0-1 vs 0-7; P = .05) increased. The dirty stall increased tail (53 vs 80; P = .03), head (16 vs 30; P = .03) and ear movements (50 vs 78; P = .04). MAIN LIMITATIONS: The dirty stall and presence of insects possibly contributed to the expression of behaviours unrelated to pain. CONCLUSION: Lifting the pelvic limbs was the only specific pain behaviour after castration in donkeys. Analgesia restored appetite and water intake and reduced the frequency of head shaking and turning, ear movement and lifting the limbs. Tail, head and ear movements are unspecific responses related both to pain and a dirty stall, and are confounding factors when pain is assessed in donkeys in the presence of insects.

Anaesthetic management of intracranial hypertension and pregnancy. A case report. / Manejo anestésico de hipertensión intracraneal y embarazo. Informe de un caso.

Hydrocephalus is an active distension of the ventricular system of the brain. The improved survival rates of patients with neurosurgical pathology is accompanied by a greater number of non-neurosurgical procedures in patients who have therapeutic neurosurgical devices. The real incidence of pregnancy in patients with obstructive hydrocephalus controlled with ventriculoperitoneal shunt (VPS) is unclear. We present a case of a pregnant 34-year-old female with a VPS for obstructive hydrocephalus. Due to VPS obstruction secondary to uterus volume, she presented several episodes of neurological impairment during pregnancy. An elective caesarean section (C-section) and VPS review were planned for the same operative time. This rare case reflects the challenge that the anaesthesiologist has to face in order to provide the best and simultaneous management of the wellbeing of the mother, the mother's brain and the foetus.

Passage of uranium through human cerebral microvascular endothelial cells: influence of time exposure in mono- and co-culture in vitro models.

PURPOSE: Depleted uranium (DU) has several civilian and military applications. The effects of this emerging environmental pollutant on human health raise some concerns. Previous experimental studies have shown that uranium (U) exposure can disturb the central nervous system. A small quantity of U reaches the brain via the blood, but the effects on the blood-brain barrier (BBB) remain unclear. MATERIALS AND METHODS: In the present work, two cell culture models were exposed to DU for different times to study its cytotoxicity, paracellular permeability and extracellular concentration of U. The well-known immortalized human cerebral microvascular endothelial cells, hCMEC/D3, were cultured on the filter in the first model. In the second model, human primary cells of pericytes were cultured under the filter to understand the influence of cell environment after U exposure. RESULTS: The results show that U is not cytotoxic to hCMEC/D3 cells or pericytes until 500 µM (1.6 Bq.L-1). In addition, acute or chronic low-dose exposure of U did not disturb permeability and was conserved in both cell culture models. However, U is able to reach the brain compartment. During the first hours of exposure, the passage of U to the abluminal compartment was significantly reduced in the presence of pericytes. Electronic microscopy studies evidenced the formation of needlelike structures, like urchin-shaped precipitates, from 1 h of exposure. Analytical microscopy confirmed the U composition of these precipitates. Interestingly, precipitated U was detected only in endothelial cells and not in pericytes. U was localized in multilamellar or multivesicular bodies along the endo-lysosomal pathway, suggesting the involvement of these traffic vesicles in U sequestration and/or elimination. CONCLUSIONS: We show for the first time the in vitro passage of U across a human cerebral microvascular endothelial cells, and the intracellular localization of U precipitates without any cytotoxicity or modification of paracellular permeability. The difference between the results obtained with monolayers and co-culture models with pericytes illustrates the need to use complex in vitro models in order to mimic the neurovascular unit. Further in vivo studies should be performed to better understand the passage of U across the blood-brain barrier potentially involved in behavioral consequences.

Impact of blood storage duration on hematologic, blood gas, biochemical, and oxidative stress variables in sheep undergoing allogeneic blood transfusions.

BACKGROUND: Hemotherapy in ruminants is limited to whole blood transfusions, sometimes with stored blood for up to 42 days, but little attention has been given to the effect of blood storage times and recipient responses after transfusions. OBJECTIVES: We aimed to evaluate the hematologic and serum biochemical effects after allogeneic blood transfusion with either fresh or stored blood in sheep. We also sought to examine hematologic and biochemical analyte changes in the store blood. METHODS: Eighteen sheep underwent a single phlebotomy to remove 40% of their blood volume. The sheep were divided into three experimental groups, G0, G15, and G35, which included six animals, each receiving 20 mL/kg of either fresh blood or blood stored in citrate, phosphate, dextrose, and adenine (CPDA-1) bags for 15 and 35 days, respectively. Biochemical, hematologic, coagulation, blood gas, lipid peroxidation, and oxidative stress test evaluations were performed using the blood samples gathered at T0 (before transfusion), 30 minutes (T30m), 6, 12, 24, 48, 72, and 96 hours (T6h-T96h), 8 days (T8d), and 16 days (T16d) after transfusions. RESULTS: Sheep exhibited increases in packed cell volumes, red blood cell counts, and total hemoglobin concentrations at T30m (P < .05). G35 animals had greater plasma hemoglobin concentrations at T12h and decreased blood pH values at T6h, characterized by slight metabolic acidemia. Regarding oxidative stress, G35 animals had decreased catalase activities from T0 at T30m, T6h, T12h, and T24h, indicating that hemolysis had occurred, which was supported by concomitant increases in bilirubin. CONCLUSIONS: Sheep transfused with 35-day stored blood exhibited greater hematologic, blood gas, biochemical, and oxidative alterations; however, anemic animals without comorbidities effectively reversed those alterations.

Urinary steroid profile after the completion of concentric and concentric/eccentric trials with the same total workload.

High intensity strength training causes changes in steroid hormone concentrations. This could be altered by the muscular contraction type: eccentric or concentric. The aim of this study was to compare the effect of the completion of a short concentric (CON) and concentric/eccentric (CON/ECC) trial on the urinary steroid profile, both with the same total work. 18 males performed the trials on an isokinetic dynamometer (BIODEX III) exercising quadriceps muscles, right and left, on different days. Trial 1 (CON): 4 x 10 Concentric knee extension + relax knee flexion, speed 600/second; rest 90 seconds between each series and 4 minutes between each leg exercise. Trial 2 (CON/ECC): 4 x 5 concentric knee extension + Eccentric knee flexion under similar conditions. Urine samples were taken before the exercise and one hour after finishing it. Androsterone, Etiocholanolone, DHEA, Androstenedione, Testosterone, Epitestosterone, Dehydrotestosterone, Estrone, B-Estradiol, Tetrahydrocortisone, Tetrahydrocortisol, Cortisone and Cortisol (free, glucoconjugated and sulfoconjugated) urinary values were determined using gas chromatography/mass spectrometry techniques. No significant differences were noted in Total Work and Average Peak Torque, although Maximum Peak Torque in the CON/ECC trial was higher than in the CON trial. These results demonstrate no changes in the steroid profile before and after trials, or when comparing CON to CON/ECC trials. The data suggest that eccentric contractions do not cause hormonal changes different to the ones produced by concentric contractions, when they are performed in strength short trials with the same total workload.

Changing pattern of chronic hepatitis C in renal transplant patients over 20 years.

BACKGROUND: The prevalence and clinical epidemiological profile of hepatitis C virus (HCV) infection have changed over time. AIM: This study aimed to evaluate these changes in renal transplant recipients (RTx) comparing two different decades. MATERIALS AND METHODS: RTx with HCV referred to RTx from 1993 to 2003 (A) and from 2004 to 2014 (B) were studied retrospectively. The demographic and clinical characteristics and different outcomes were compared between groups A and B. Variables that were statistically different were tested for inclusion in a multivariate Cox proportional hazard model predicting patient survival within the group. RESULTS: Among 11 715 RTx, the prevalence of HCV was 7% in A and 4.9% in B. In the more recent period (B), the mean age was older (46.2 vs. 39.5 years), with more males (72 vs. 60.7%), larger number of deceased donors (74 vs. 55%), higher percentage of previous RTx (27 vs. 13.7%), less frequent history of blood transfusion (81 vs. 89.4%), lower prevalence of hepatitis B virus coinfection (4.7 vs. 21.4%), and higher percentage of cirrhotic patients (13 vs. 5%). Patients of group B more frequently underwent treatment of HCV (29 vs. 9%), less frequently used azathioprine (38.6 vs. 60.7%) and cyclosporine (11.8 vs. 74.7%), and more frequently used tacrolimus (91 vs. 27.3%). In the outcomes, graft loss showed no difference between periods; however, decompensation was more frequent (P = 0.007) and patients' survival was lower in the more recent period (P = 0.032) compared with the earlier one. CONCLUSION: The profile of RTx with HCV has changed over the last 20 years. Despite a decrease in the prevalence of HCV, new clinical challenges have emerged, such as more advanced age and a higher prevalence of cirrhosis.

Predictive values of aspartate aminotransferase and gamma-glutamyl transferase for the hepatic accumulation of copper in cattle and buffalo.

Ten cattle and 10 buffalo were divided into 2 groups (control [n = 8] and experimental [n = 12] that received daily administration of copper. Three hepatic biopsies and blood samples were performed on days 0, 45, and 105. The concentration of hepatic copper was determined by spectrophotometric atomic absorption, and the activities of aspartate aminotransferase (AST) and gamma-glutamyl transferase (GGT) were analyzed. Regression analyses were done to verify the possible existing relationship between enzymatic activity and concentration of hepatic copper. Sensitivity, specificity, accuracy, and positive and negative predictive values were determined. The serum activities of AST and GGT had coefficients of determination that were excellent predictive indicators of hepatic copper accumulation in cattle, while only GGT serum activity was predictive of hepatic copper accumulation in buffalo. Elevated serum GGT activity may be indicative of increased concentrations of hepatic copper even in cattle and buffalo that appear to be clinically healthy. Thus, prophylactic measures can be implemented to prevent the onset of a hemolytic crisis that is characteristic of copper intoxication.

Primary endemic Cryptococcosis gattii by molecular type VGII in the state of Pará, Brazil.

In order to study the infectious agents causing human disseminated cryptococcosis in the state of Pará, North Brazil, 56 isolates of Cryptococcusspp. (54 isolated from cerebral spinal fluid and two from blood cultures) from 43 cases diagnosed between 2003-2007 were analysed. The species were determined through morphological and physiological tests and genotypes were determined by URA5-RFLP and PCR-fingerprinting (wild-type phage M13). The following species and genotypes were identified: Cryptococcus neoformans VNI (28/56, 50%), Cryptococcus gattii VGII (25/56, 44.64%) and C. gattii VGI (3/56, 5.26%). The genotype VNI occurred in 12 out of 14 HIV-positive adults, whereas the genotype VGII occurred in 11 out of 21 HIV-negative adults (p < 0.02, OR = 6.6 IC95% 0.98-56.0). All patients less than 12 years old were HIV negative and six cases were caused by the VGII genotype, one by the VGI and one by VNI. Therefore, endemic primary mycosis in HIV-negative individuals, including an unexpectedly high number of children, caused by the VGII genotype deserves further study and suggests the need for surveillance on cryptococcal infection in the state of Pará, Eastern Amazon.

Modulation of iris sphincter and ciliary muscles by urocortin 2.

Urocortin 2 (UCN2) is a peptide related to corticotropin-releasing factor, capable of activating CRF-R2. Among its multisystemic effects, it has actions in all 3 muscle subtypes. This study's aim was to determine its potential role in two of the intrinsic eye muscle kinetics. Strips of iris sphincter (rabbit) and ciliary (bovine) muscles were dissected and mounted in isometric force-transducer systems filled with aerated-solutions. Contraction was elicited using carbachol (10(-6) M for iris sphincter, 10(-5) M for ciliary muscle), prior adding to all testing substances. UCN2 induced relaxation in iris sphincter muscle, being the effect maximal at 10(-7) M concentrations (-12.2 % variation vs. control). This effect was abolished with incubation of indomethacin, antisauvagine-30, chelerytrine and SQ22536, but preserved with L-nitro-L-arginine. In carbachol pre-stimulated ciliary muscle, UCN2 (10(-5) M) enhanced contraction (maximal effect of 18.2 % increase vs. control). UCN2 is a new modulator of iris sphincter relaxation, dependent of CRF-R2 activation, synthesis of prostaglandins (COX pathway) and both adenylate cyclase and PKC signaling pathways, but independent of nitric oxide production. Regarding ciliary muscle, UCN2 enhances carbachol-induced contraction, in higher doses.

Intensive insulin therapy versus conventional glycemic control in patients with acute neurological injury: a prospective controlled trial.

OBJECTIVE: To compare intensive insulin therapy to conventional glycemic control in patients with acute neurological injury evaluating neurological outcome and morbimortality. METHOD: Patients with two glycemias above 150 mg/dL 12 hours after admission were randomized to receive intensive insulin therapy (G1) or conventional treatment (G2). We evaluated a subgroup of patients with acute brain injury from July, 2004 to June, 2006. RESULTS: G1 patients (n=31) received 70.5 (45.1-87.5) units of insulin/day while G2 patients (n=19) received 2 (0.6-14.1) units/day (p<0.0001). The median glycemia was comparable in both groups (p=0.16). Hypoglycemia occurred in 2 patients (6.4%) in G1 and in 1 patient (5.8%) in G2 (p=1.0). Mortality in G1 was of 25.8% and of 35.2% in G2 (relative reduction of 27%). Neurological outcome was similar in both groups. CONCLUSION: A less strict intensive insulin therapy can reduce hypoglycemia and still maintain its benefits.

Vismodegib in patients with advanced basal cell carcinoma: Primary analysis of STEVIE, an international, open-label trial.

BACKGROUND: The SafeTy Events in VIsmodEgib study (STEVIE, ClinicalTrials.gov, NCT01367665), assessed safety and efficacy of vismodegib-a first-in-class Hedgehog pathway inhibitor demonstrating clinical benefit in advanced basal cell carcinoma (BCC)-in a patient population representative of clinical practice. Primary analysis data are presented. PATIENTS AND METHODS: Patients with locally advanced or metastatic BCC received oral vismodegib 150 mg/d until progressive disease, unacceptable toxicity, or withdrawal. Primary objective was safety. Efficacy variables were assessed as secondary end-points. RESULTS: Evaluable adult patients (N = 1215, 1119 locally advanced; 96 metastatic BCC) from 36 countries were treated; 147 patients (12%) remained on study at time of reporting. Median (range) treatment duration was 8.6 (0-44) months. Most patients (98%) had ≥1 treatment-emergent adverse event (TEAE). The incidence of the most common TEAEs was consistent with reports in previous analyses. No association between creatine phosphokinase (CPK) abnormalities and muscle spasm was observed. Serious TEAEs occurred in 289 patients (23.8%). Exposure ≥12 months did not lead to increased incidence or severity of new TEAEs. The majority of the most common TEAEs ongoing at time of treatment discontinuation resolved by 12 months afterwards, regardless of Gorlin syndrome status. Response rates (investigator-assessed) in patients with histologically confirmed measurable baseline disease were 68.5% (95% confidence interval (CI) 65.7-71.3) in patients with locally advanced BCC and 36.9% (95% CI 26.6-48.1) in patients with metastatic BCC. CONCLUSIONS: The primary analysis of STEVIE demonstrates that vismodegib is tolerable in typical patients in clinical practice; safety profile is consistent with that in previous reports. Long-term exposure was not associated with worsening severity/frequency of TEAEs. Investigator-assessed response rates showed high rate of tumour control. CLINICALTRIALS.GOV: NCT01367665.

Long-term cognitive outcomes among unselected ventilated and non-ventilated ICU patients.

BACKGROUND: Cognitive dysfunction is an important long-term complication of critical illness associated with reduced quality of life, increase in healthcare costs, and institutionalization. Delirium, an acute form of brain dysfunction that is common during critical illness has been shown to be associated with long-term cognitive dysfunction. The aim of this prospective cohort study was to estimate the prevalence and severity of cognitive dysfunction in an unselected population of medical and surgical ICU patients. METHODS: This prospective observational cohort study included all adult patients admitted to the surgical (13 beds) and medical (32 beds) ICUs of a tertiary hospital over a 12-month period. Patients with impaired cognition were excluded. At least 3 months after hospital discharge, patients were assessed for cognition using a validated battery of tests and were classified as having no cognitive impairment, mild to moderate cognitive impairment, or severe cognitive impairment. RESULTS: Four hundred thirteen patients were tested an average of 11 (3-18) months after discharge. Fifty-five (13.3%) patients included in the follow-up cohort had delirium. Cognitive impairment was identified in 206 (49.9%) patients, 120 (29.1%) patients had mild or moderate cognitive impairment, and 86 (20%) patients had severe cognitive dysfunction. CONCLUSIONS: This investigation in an unselected and lower severity population of critically ill patients demonstrates that cognitive dysfunction is a frequent and severe long-term complication.

[Relationships between widespread pain and thresholds pain tolerance on tender points in Portuguese women with fibromyalgia: impact on daily life]. / Relação entre a dor generalizada e o limiar de tolerância à dor nos pontos sensíveis em mulheres portuguesas com fibromialgia: impacto sobre a vida diária.

OBJECTIVES: to establish a relationship between widespread pain subjectively perceived and threshold pain tolerance on tender points, and to determine whether there are differences in threshold pain tolerance on tender points between the upper and lower body, as well as between the dominant and non-dominant side, and whether these differences have an impact on the daily life of Portuguese women with fibromyalgia (FM). MATERIAL & METHODS: thirty-one women with FM aged between 34 and 67 years volunteered for the study. Threshold pain tolerance was assessed at critical points using a digital algometer pressure; the widespread pain index (WPI) was constructed by the addition of 19 painful body regions; and the impact on the daily life assessed by the Portuguese version of the Fibromyalgia Impact Questionnaire (FIQ), with individual interviews. RESULTS: significant differences between the percentage of threshold pain tolerance of the whole body and the scales of widespread pain subjectively perceived were observed, showing that the widespread pain subjectively perceived by patients was between +25.9% and +27.5%. Also, significant differences between threshold pain tolerance of tender points located on the upper and lower body (1.9 ± 0.5 kg/cm2 vs. 2.6 ± 0.7 kg/cm2; respectively) were observed. However, no significant differences were found between threshold pain tolerance of tender points located on dominant and non-dominant sides (2.1 ± 0.5 kg/cm2 e 2.1 ± 0.6 kg/cm2; respectively). Additionally, the analysis showed significant correlations between pain and patient`s daily life in: FIQ total score, physical function, feel good, job ability and fatigue. CONCLUSIONS: the women with FM show higher widespread pain subjectively perceived than threshold pain tolerance on tender points. Furthermore, the pain suffered by the patients with FM, especially that located on the upper body, either on the dominant or on the non-dominant side, has a negative influence on physical function, job ability, fatigue and feel good, affecting daily life.

A randomized controlled trial on the effects of combined aerobic-resistance exercise on muscle strength and fatigue, glycemic control and health-related quality of life of type 2 diabetes patients.

AIM: to evaluate the effects of a 12--weeks combined aerobic--resistance exercise therapy on fatigue and isokinetic muscle strength, glycemic control and health--related quality of life (HRQoL) in moderately affected type 2 diabetes (T2DM) patients. METHODS: a randomized controlled trial design was employed. Forty--three T2DM patients were assigned to an exercise group (n = 22), performing 3 weekly sessions of 60 minutes of combined aerobic--resistance exercise for 12--weeks; or a no exercise control group (n = 21). Both groups were evaluated at a baseline and after 12--weeks of exercise therapy for: 1) muscle strength and fatigue by isokinetic dynamometry; 2) plasma glycated hemoglobin A1C (HbA1C); and 3) HRQoL utilizing the SF--36 questionnaire. RESULTS: the exercise therapy led to improvements in muscle fatigue in knee extensors (--55%) and increased muscle strength in knee flexors and extensors (+15 to +30%), while HbA1C decreased (--18%). In addition, the exercising patients showed sizeable improvements in HRQoL: physical function (+53%), vitality (+21%) and mental health (+40%). CONCLUSION: 12--weeks of combined aerobic--resistance exercise was highly effective to improve muscle strength and fatigue, glycemic control and several aspects of HRQoL in T2DM patients. These data encourage the use of aerobic and resistance exercise in the good clinical care of T2DM.

Dairy consumption is associated with a lower prevalence of metabolic syndrome among young adults from Ribeirão Preto, Brazil.

OBJECTIVE: It has been suggested that a greater dairy consumption is a contributing factor to a lower prevalence of metabolic syndrome (MetS) as a result of the possible actions of some milk nutrients. However, results remain controversial. The aim of this study was to examine the association between dairy consumption and MetS and its components. METHODS: Dairy consumption and biochemical and anthropometric parameters were determined in 2031 young adults ages 23 to 25 y. Food consumption was assessed using a food frequency questionnaire. The estimated habitual portion of dairy products consumed daily was divided into quintiles. The criteria of the International Diabetes Federation (IDF) and of the Joint Interim Statement (JIS) were used for the classification of MetS. Nonadjusted and adjusted odds ratios (ORs) were estimated by logistic regression. RESULTS: The prevalence of MetS was 11.9% by the IDF criteria and 9% by the JIS criteria. A greater dairy consumption was associated with a lower prevalence of MetS according to both IDF (OR, 0.61; 95% confidence interval [CI], 0.38-0.97) and JIS (OR, 0.62; 95% CI, 0.39-0.98) criteria when the last quintile was compared with the first. The association persisted in the model adjusted for demographic, socioeconomic, dietary, and lifestyle variables according to the IDF (OR, 0.53; 95% CI, 0.30-0.93) and was borderline according to the JIS (OR, 0.59; 95% CI, 0.34-1.00), but lost significance when data were adjusted for calcium in both models. CONCLUSIONS: A greater dairy consumption is associated with a lower prevalence of MetS, with calcium probably being the nutrient responsible for this association.