Measurement of Active Motor Threshold Using a Dynamometer During Navigated Transcranial Magnetic Stimulation in a Patient with Postoperative Brain Tumor: Technical Note.

BACKGROUND: Navigated transcranial magnetic stimulation (nTMS) is being used for different purposes in patients with brain tumors. However, the procedure requires a positive electrophysiological response. For patients with negative response in rest conditions, active motor threshold (AMT) may be used. However, sometimes it is difficult to obtain AMT measures owing to inability of the patient to sustain steady muscle contraction. Herein, we describe a simple method by using a hand dynamometer to obtain AMT measures during nTMS session. CASE DESCRIPTION: A woman aged 68 years underwent total removal of a right frontal lobe oligodendroglioma World Health Organization grade II 15 years ago. Cranial magnetic resonance imaging during follow-up revealed local recurrence. In the postoperative period, she developed left upper limb paresis. A postoperative nTMS session was performed for motor electrophysiological evaluation. However, using the standard technique for AMT measurement, the patient was unable to perform sustained muscle contraction as required. A hand dynamometer was used. It allowed sustained muscle contraction for AMT measurement. A counter force for the index finger flexion, the hand support to stabilize hand joints, and a numerical screen serving for both the examiner and the patient as a feedback parameter may explain the success obtained with this simple device. CONCLUSIONS: Although more studies are necessary to validate the method, the hand dynamometer should be considered for patients unable to sustain muscle contraction during AMT measurement.

The impact of rapid on-site evaluation on thyroid fine-needle aspiration biopsy: A 2-year cancer center institutional experience.

BACKGROUND: The impact of rapid on-site evaluation (ROSE) on thyroid aspirates has been a matter of extensive debate. In the current study, the authors reviewed all thyroid fine-needle aspiration biopsies (FNABs) performed in their service in recent years to evaluate the impact of ROSE on final adequacy and diagnostic rates. METHODS: All ultrasound-guided FNABs of the thyroid performed between July 2015 and July 2017 were included retrospectively. ROSE was performed by experienced cytopathologists, with production of Romanowsky-stained slides for immediate evaluation. When ROSE was not performed, a total of 3 needle passes were performed as the default. Final specimen adequacy and the risk of malignancy (ROM) of each The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) category were calculated in the 2 groups (ROSE and non-ROSE) and compared using the chi-square test. RESULTS: An initial search obtained 4649 cytology specimens, 3469 of which (74.6%) underwent ROSE and 1180 of which (25.4%) did not. Patients were predominantly female (85.4%), with a mean age of 53 years. Specimen adequacy was found to be significantly higher in the ROSE group (93.4% vs 69.4%; P<.0001), with a mean number of needle passes necessary for an adequate diagnosis of 1.48 ± 0.71 (median, 1.0 needle passes; range, 1-5 needle passes). No statistical difference was observed with regard to the ROM for each TBSRTC category when the 2 groups (ROSE and non-ROSE) were compared. CONCLUSIONS: The current study data support ROSE as a valuable technique in thyroid FNAB. It was proven to significantly improve specimen adequacy with a decreased mean number of needle passes necessary to achieve an adequate cytological diagnosis and no impact on the ROM for any TBSRTC category.

l-carnitine supplementation during vitrification or warming of in vivo-produced ovine embryos does not affect embryonic survival rates, but alters CrAT and PRDX1 expression.

l-carnitine is an antioxidant and ß-oxidation stimulator substance commonly used to improve metabolic performance of oocytes and embryos in in vitro systems. However, few studies have evaluated its beneficial effects in embryos produced in vivo. This study aimed to evaluate the effect of l-carnitine supplementation into vitrification or warming solutions on the post-warming character of day 6-7 in vivo-produced ovine embryos. l-carnitine (3.72 mM) was added to vitrification (Experiment 1) or warming solutions (Experiment 2). In experiments 1 and 2, the embryos were vitrified using straw and cryo-tip protocols, respectively. In vitro culture (IVC) of warmed embryos was performed for 72 h in order to evaluate survival rates, reactive oxygen species (ROS) levels, total cell number (TCN), number of apoptotic cells, apoptotic index evaluation, and gene expression analysis of carnitine palmitoyltransferase I and 2 (CPT1 and CPT2), carnitine O-acetyltransferase (CrAT), and peroxiredoxin-1 (PRDX1). In experiment 1, survival rate, ROS levels after 24 h of IVC, total cell number at 24 h and 72 h, apoptotic cells and apoptotic index at 72 h of IVC were similar in embryos vitrified in medium supplemented with LC or not. Gene expression analysis showed no differences in CPT1 and CPT2 mRNA relative abundance in embryos of both experiments compared to fresh embryos (FE); however, CrAT was downregulated (p < 0.05) in C1, and PRDX1 was downregulated (p < 0.05) in both the control (C1) and l-carnitine (LC1) groups, compared to FE. Moreover, CrAT and PRDX1 were upregulated (p < 0.05) in C2, and CrAT was downregulated (p < 0.05) in LC2, in relation to FE. Although the short-term LC supplementation at 3.72 mM did not improve survival, and quality parameters of in vivo-produced ovine embryos, it could affect their quality at a molecular level. In conclusion, further investigations with different concentrations of LC and tools are needed for improvement of the efficiency of these strategies.

Influência de diferentes taxas de crescimento de novilhas holandesas sobre a produção de leite e idade ao primeiro parto / Influency of different Holstein heifers growth rates on milk production and age at first calving

A criação de novilhas tem contribuição relevante no custo total de produção de leite e as técnicas de manejo nela adotadaspodem interferir na expressão dos parâmetros produtivos e reprodutivos do animal. Objetivou-se neste trabalho estabelecerrelações entre taxa de ganho de peso de novilhas pré-púberes, idade ao primeiro parto e produção de leite na primeiralactação. Na primeira fase do estudo foram avaliados o crescimento de 84 fêmeas bovinas da raça Holandesa PO dos 6 aos12 meses, pertencentes a duas propriedades. Na segunda fase, avaliou-se a idade ao parto e a produção de leite na 1ªlactação. Os animais foram pesados a cada 30 dias dos 6 aos 12 meses e registrou-se também a idade ao primeiro parto.Após o parto era feito o registro diário da produção de leite. De acordo com o ganho de peso dos 6 aos 12 meses os animaisforam então alocados em três grupos (tratamentos): T1 (n=28) GMD menor que 0,70 kg/dia; T2 (n=28) GMD entre 0,701 e0,80 kg/dia e T3 (n=28) GMD superiores a 0,801 kg/dia. Dos seis meses ao parto o manejo adotado nas propriedades erasemelhante. Entretanto, na fase de lactação os animais da fazenda 1 recebiam menor teor de concentrado na dieta total. Osdados foram submetidos à análise de variância, utilizando-se o programa estatístico SAS (2007) sendo as médias testadaspelo procedimento GLM do SAS. Não foi verificado efeito do ganho médio diário das novilhas sobre a produção de leitecorrigido para 305 dias; entretanto, verificou-se efeito sobre idade ao primeiro parto. Devido ao manejo diferente adotado naspropriedades, na fase de lactação, e também à genética verificou-se efeito de fazenda sobre a produção de leite. O elevadodesempenho animal durante a fase de recria pode ser responsável pela redução na idade ao primeiro parto sem, portanto,afetar a produção futura de leite

The heifers raising has an important contribution in the total cost of milk production and management techniques adopted and can interfere with the expression of the productive and reproductive parameters of the animal. The objective of this work was to avaliate the correlations among the weight gain rate of heifers in pre-puberty, age at first birth and milk production in the first lactation. In the first phase of the study they were evaluated growth of 84 Holstein heifers from 6 to 12 months belonging to two farms. In the second phase, it was evaluated the age at first calving and milk production in the first lactation. The animals were weighed every 30 days from 6 to 12 months being registered the age at first calving. After the calving it was made the record of milk production daily. According to the weight gain from 6 to 12 months the animals were then allocated into three groups (treatments): T1 (n=28)- ADG of less than 0.70 kg/day; T2 (n=28)- ADG between 0.701 and 0.80 kg/day and T3 (n=28) - ADG more than 0.801 kg/day. From six month age until the calving the management adopted was similar between farms; however in farm 1 the lactating animals received a smaller amount of concentrate in diet. The data were submitted to the analysis of variance, using the statistical program SAS (2007) and the means were tested by the GLM procedure of the SAS program. There was no effect of treatment on milk production corrected to 305 days; however, there was effect of treatment on age at first birth. Due to management adopted in different properties at the stage of lactation, and also due to the genetic there was effect of farm in milk production. The high animal performance during the growth phase may be responsible for reducing the age at birth without therefore affecting the future milk production compared with the moderate growth.