Detection of Cutibacterium acnes in Tissue Samples from Clean Primary Shoulder Surgeries - Part II.

Objective Research and identification of Cutibacterium acnes ( C. acnes ) and other microorganisms in deep tissue samples collected in clean shoulder surgeries of patients who did not undergo any previous invasive joint procedure and who had no clinical history of infection. Methods We analyzed the results of cultures of intraoperative deep tissue samples from 84 patients submitted to primary clean shoulder surgery. Tubes containing culture medium were used for storage and transport of anaerobic agents, prolonged incubation time, and mass spectrometer for diagnosis of bacterial agents. Results Bacteria growth was evidenced in 34 patients (40.4%) of the 84 included in the study. Of these, 23 had growth of C. acnes in at least one sample of deep tissue collected, corresponding to 27.3% of the total patients. The second most common agent was Staphylococcus epidermidis , present in 7.2% of the total individuals included. We showed a higher relationship between sample positivity and males, a lower mean age, absence of diabetes mellitus, ASA I score, and antibiotic prophylaxis in anesthetic induction with cefuroxime. Conclusions A high percentage of isolates of different bacteria was found in shoulder tissue samples of patients undergoing clean and primary surgeries, who had no history of previous infection. Identification of C. acnes was high (27.6%), and Staphylococcus epidermidis was the second most frequent agent (7.2%).

Detection of Cutibacterium acnes in Tissue Samples from Clean Primary Shoulder Surgeries - Part II / Detecção de Cutibacterium acnes em amostras de tecidos de cirurgias limpas primárias do ombro - Parte II

Abstract Objective Research and identification of Cutibacterium acnes (C. acnes) and other microorganisms in deeptissue samples collected in clean shoulder surgeries of patients who did not undergo any previous invasive joint procedure and who had no clinical history of infection. Methods We analyzed the results of cultures of intraoperative deep tissue samples from 84 patients submitted to primary clean shoulder surgery. Tubes containing culture medium were used for storage and transport of anaerobic agents, prolonged incubation time, and mass spectrometer for diagnosis of bacterial agents. Results Bacteria growth was evidenced in 34 patients (40.4%) of the 84 included in the study. Of these, 23 had growth of C. acnes in at least one sample of deep tissue collected, corresponding to 27.3% of the total patients. The second most common agent was Staphylococcus epidermidis, present in 7.2% of the total individuals included. We showed a higher relationship between sample positivity and males, a lower mean age, absence of diabetes mellitus, ASA I score, and antibiotic prophylaxis in anesthetic induction with cefuroxime. Conclusions A high percentage of isolates of different bacteria was found in shoulder tissue samples of patients undergoing clean and primary surgeries, who had no history of previous infection. Identification of C. acnes was high (27.6%), and Staphylococcus epidermidis was the second most frequent agent (7.2%).

Resumo Objetivo Pesquisa e identificação de Cutibacterium acnes (C. acnes) e de outros microrganismos em amostras de tecidos profundos coletados em cirurgias limpas de ombro em pacientes que não foram submetidos a nenhum procedimento invasivo articular prévio e que não possuíam antecedentes clínicos de infecção. Métodos Foram analisados os resultados das culturas de amostras de tecidos profundos intraoperatórias de 84 pacientes submetidos à cirurgia limpa primária do ombro. Foram utilizados tubos contendo meio de cultivo para armazenamento e transporte de agentes anaeróbicos, tempo prolongado de incubação e espectrômetro de massa para diagnósticos de agentes bacterianos. Resultados Foi evidenciado o crescimento de bactérias em 34 pacientes (40,4%) dos 84 incluídos no estudo. Desses, 23 apresentavam crescimento de C. acnes em pelo menos uma amostra de tecido profundo coletada, correspondendo a 27,3% do total de pacientes. O segundo agente mais encontrado foi o Staphylococcus epidermidis, presente em 7,2% do total de indivíduos incluídos. Evidenciamos maior relação da positividade de amostras com o gênero masculino, uma média de idade inferior, a ausência de diabetes mellitus, o escore ASA I e a profilaxia antibiótica na indução anestésica com cefuroxima. Conclusões Verificou-se um elevado percentual de isolados de diferentes bactérias em amostras de tecidos de ombros de pacientes submetidos a cirurgias limpas e primárias e sem histórico de infecção anterior. A identificação de C. acnes foi elevada (27,6%) e o Staphylococcus epidermidis foi o segundo agente mais frequente (7,2%).

ArtinM: Purification and Evaluation of Biological Activities.

The immunomodulatory activity of plant lectins has been evaluated because of their high selectivity for glycans linked to receptors on innate and adaptative immune cells. ArtinM is a mannosyl-binding lectin, obtained from the seeds of Artocarpus heterophyllus, that induces the differentiation of CD4+ T cells and macrophages by interacting with CD3 and TLR2/CD14, respectively. This ArtinM property ultimately favors the combat of intracellular pathogens, opening new perspectives on the lectins application as immunomodulatory agents. The current section describes protocols for purification and evaluation of ArtinM biological activity. The purification is based on the ArtinM-D-mannose affinity. The effect of inducing IL-12 production by murine macrophages cell line is adopted to evaluate the ArtinM biological activity.

Production and Characterization of MIC1: A Lectin from Toxoplasma gondii.

Some lectins of pathogens interact with host cells through the recognition of specific carbohydrates displayed on the mammals' cell surface. The microneme protein 1 (MIC1) from Toxoplasma gondii has a lectin domain that specifically binds sialic acid residues, often found in the terminal positions of N-glycans of mammalian cells. The necessary studies on the MIC1 biological roles have been limited initially by the laborious purification of the protein from T. gondii tachyzoites and the low yields verified. Then Escherichia coli has been transformed with a construct containing the MIC1 gene, and the obtained recombinant MIC1 (rMIC1) has been purified from the inclusion bodies. Herein, we detail the methodology of heterologous production and purification of rMIC1 and protocols to assay the rMIC1 lectin ability.

The role of low-frequency rTMS in the superior parietal cortex during time estimation.

The low-frequency repetitive transcranial magnetic stimulation (rTMS) application has been associated with changes in cognitive processes embedded during time perception tasks. Although several studies have investigated the influence of neuromodulation on time perception, the effect of the 1-Hz rTMS application on the superior parietal cortex is not clearly understood. This study analyzes the effect of the low-frequency rTMS on time estimation when applied in the parietal medial longitudinal fissure. For the proposed study, 20 subjects were randomly selected for a crossover study with two conditions (sham and 1 Hz). Our findings reveal that participant underestimate 1-s time interval and overestimate 4-s and 9-s time intervals after 1-Hz rTMS (p ≤ 0.05). We conclude that the 1-Hz rTMS in the parietal medial longitudinal fissure delays short interval and speed up long time intervals. This could be due to the effect of parietal inhibition on the attentional level and working memory functions during time estimation.

Low-frequency rTMS stimulation over superior parietal cortex medially improves time reproduction and increases the right dorsolateral prefrontal cortex predominance.

AIM OF THE STUDY: Previous studies have shown that several cortical regions are involved in temporal tasks in multiple timescales. However, the hemispheric predominance of the dorsolateral prefrontal cortex (DLPFC) during time reproduction after repetitive low-frequency transcranial magnetic stimulation (rTMS) is relatively unexplored. Here, we study the effects of 1 Hz rTMS and sham stimulation applied medially over the superior parietal cortex (SPC) on the DLPFC alpha and beta band asymmetry and on time reproduction. MATERIALS AND METHODS: For this purpose, we have combined rTMS with electroencephalography in 20 healthy subjects who performed the time reproduction task in two conditions (sham and 1 Hz). RESULTS: The worst performance was observed in sham and 1Hz conditions for longer time intervals (p < .05), with the 1Hz condition subjects sub-reproducing the time interval, closer to the target interval (p < .05). The right DLPFC hemispheric predominance was found in both conditions, but after low-frequency rTMS, the right hemisphere predominance increased in the 1Hz condition (p < .05). CONCLUSIONS: Results of this study suggest that rTMS applied over the SPC influences time interval interpretation and the DLPFC functions. Future studies would explore the effects of the rTMS application to other cortical areas, and study how it influences time interval interpretation.

The SLC6A3 3'-UTR VNTR and intron 8 VNTR polymorphisms association in the time estimation.

OBJECTIVE: The present study investigated the association of 3'-UTR VNTR and intron 8 VNTR polymorphisms with a time estimation task performance. MATERIALS AND METHODS: One hundred and eight men in a Brazilian Northeast population (18-32 years old) participated in the experiment. The 3'-UTR VNTR and intron 8 VNTR polymorphisms were associated alone and combined to absolute error (AE) and relative error (RE) in a time estimation task (target duration: 1 s, 4 s, 7 s and 9 s). RESULTS: We found an association of the behavioral variable with intron 8 VNTR for the time intervals of 1 s and 9 s (p < 0.001) and polymorphisms combinatorial effect for 1 s (p ≤ 0.05). CONCLUSION: The intron 8 VNTR polymorphism and the combinatorial effect can modulate the time estimate in the domain of supra seconds, and thus our study indicates a role of the dopamine transporter in the neurobiological areas related to the time intervals judgment.

Does cognitive capacity interfere with the outcome of oberlin transfer? / A capacidade cognitiva interfere no resultado da cirurgia de oberlin?

ABSTRACT Objective: To determine the relationship between the functional outcome achieved following Oberlin transfer, the cognitive level of the patient, and the time elapsed between the trauma event and surgery. Methods: Eighteen patients with a traumatic injury to the brachial plexus (C5-C6 and C5-C7) were evaluated. Seventeen (94.4%) patients were males and one (5.6%) was female, with a mean age of 29.5 years (range 17-46 years). We evaluated the active range of motion, elbow flexion strength, and Disabilities of the Arm, Shoulder and Hand (DASH) and determined the correlation between the procedural outcome and the patient's cognitive level, as assessed by the Mini-Mental State Exam (MMSE). Results: We found statistically significant correlations between the MMSE scale and strength recovery (84.4%, p<0.001), which was classified as excellent, and between the MMSE and British Medical Research Council (BMRC) scales (78.4%, p>0.001), which classified cognitive level as good. Conclusions: We found a positive correlation between cognitive capacity and functional outcome of patients submitted to Oberlin surgery. The time elapsed between trauma and the surgical procedure showed an inversely proportional correlation with the strength of recovery. Level of Evidence II, Retrospective Study.

RESUMO Objetivo: Determinar a relação entre o resultado funcional obtido com a cirurgia de Oberlin, o nível cognitivo do paciente e com o tempo decorrido entre o trauma e a cirurgia. Métodos: Foram analisados dezoito pacientes, sendo 17 homens (94,4%) e uma mulher (5,6%), com idade média de 29,5 anos (17 a 46 anos), com lesão traumática alta do plexo braquial (C5-C6 e C5-C7). Avaliamos a amplitude de movimento ativa, a força muscular de flexão do cotovelo e o questionário DASH (Disabilities of the Arm, Shoulder and Hand) e determinamos a correlação entre o resultado obtido e o nível cognitivo do paciente, avaliado pelo Mini Exame do Estado Mental (MEEM). Resultados: Observamos correlações de significância estatística entre MEEM e recuperação de força (84,4%, p<0,001), classificada como ótima; MEEM e BMRC - British Medical Research Council (78,4%, p> 0,001), classificada como boa. Conclusões: Verificamos correlação positiva entre a capacidade cognitiva e os resultados funcionais dos pacientes submetidos à cirurgia de Oberlin. O tempo decorrido entre o trauma e o procedimento cirúrgico apresenta uma relação inversamente proporcional com a recuperação da força. Nível de Evidencia II, Estudo retrospectivo.

Cognitive impairment in neuromuscular diseases: A systematic review.

Neuromuscular diseases are multifactorial pathologies characterized by extensive muscle fiber damage that leads to the activation of satellite cells and to the exhaustion of their pool, with consequent impairment of neurobiological aspects, such as cognition and motor control. To review the knowledge and obtain a broad view of the cognitive impairment on Neuromuscular Diseases. Cognitive impairment in neuromuscular disease was explored; a literature search up to October 2017 was conducted, including experimental studies, case reports and reviews written in English. Keywords included Cognitive Impairment, Neuromuscular Diseases, Motor Neuron Diseases, Dystrophinopathies and Mitochondrial Disorders. Several cognitive evaluation scales, neuroimaging scans, genetic analysis and laboratory applications in neuromuscular diseases, especially when it comes to the Motor Neuron Diseases, Dystrophinopathies and Mitochondrial Disorders. In addition, organisms model using rats in the genetic analysis and laboratory applications to verify the cognitive and neuromuscular impacts. Several studies indicate that congenital molecular alterations in neuromuscular diseases promote cognitive dysfunctions. Understanding these mechanisms may in the future guide the proper management of the patient, evaluation, establishment of prognosis, choice of treatment and development of innovative interventions such as gene therapy.

Genetic influence alters the brain synchronism in perception and timing.

BACKGROUND: Studies at the molecular level aim to integrate genetic and neurobiological data to provide an increasingly detailed understanding of phenotypes related to the ability in time perception. MAIN TEXT: This study suggests that the polymorphisms genetic SLC6A4 5-HTTLPR, 5HTR2A T102C, DRD2/ANKK1-Taq1A, SLC6A3 3'-UTR VNTR, COMT Val158Met, CLOCK genes and GABRB2 A/C as modification factor at neurochemical levels associated with several neurofunctional aspects, modifying the circadian rhythm and built-in cognitive functions in the timing. We conducted a literature review with 102 studies that met inclusion criteria to synthesize findings on genetic polymorphisms and their influence on the timing. CONCLUSION: The findings suggest an association of genetic polymorphisms on behavioral aspects related in timing. However, order to confirm the paradigm of association in the timing as a function of the molecular level, still need to be addressed future research.

Neurochemical changes in basal ganglia affect time perception in parkinsonians.

BACKGROUND: Parkinson's disease is described as resulting from dopaminergic cells progressive degeneration, specifically in the substantia nigra pars compacta that influence the voluntary movements control, decision making and time perception. AIM: This review had a goal to update the relation between time perception and Parkinson's Disease. METHODOLOGY: We used the PRISMA methodology for this investigation built guided for subjects dopaminergic dysfunction in the time judgment, pharmacological models with levodopa and new studies on the time perception in Parkinson's Disease. We researched on databases Scielo, Pubmed / Medline and ISI Web of Knowledge on August 2017 and repeated in September 2017 and February 2018 using terms and associations relevant for obtaining articles in English about the aspects neurobiology incorporated in time perception. No publication status or restriction of publication date was imposed, but we used as exclusion criteria: dissertations, book reviews, conferences or editorial work. RESULTS/DISCUSSION: We have demonstrated that the time cognitive processes are underlying to performance in cognitive tasks and that many are the brain areas and functions involved and the modulators in the time perception performance. CONCLUSIONS: The influence of dopaminergic on Parkinson's Disease is an important research tool in Neuroscience while allowing for the search for clarifications regarding behavioral phenotypes of Parkinson's disease patients and to study the areas of the brain that are involved in the dopaminergic circuit and their integration with the time perception mechanisms.

Genetic polymorphisms associated with circadian rhythm dysregulation provide new perspectives on bipolar disorder.

OBJECTIVES: The objective of this study was to present a broad view of how genetic polymorphisms in genes that control the rhythmicity and function of circadian rhythm may influence the etiology, pathophysiology and treatment of bipolar disorder (BD). METHODS: A bibliographic search was performed to identify and select papers reporting studies on variations in circadian genes and BD. A search of Medline, Google Scholar, Scopus, and Web of Science was carried out to review the literature. RESULTS: Several studies provide evidence of contributions of variations in circadian genes to disease etiology, pathophysiological variations and lithium drug response. Dysfunction of the sleep-wake cycle, an important brain function regulator, is indicated as the primary means by which circadian gene variations act in mood disorders. CONCLUSIONS: Investigations of the effects of circadian genes have suggested that the chronotype offers hope for guiding and improving management of patients with BD. However, BD is a disease of a complex nature and presents multiple endophenotypes determined by different associations between genetics and the environment. Thus, new genomic studies to delimit variations that may help improve the clinical condition of these patients are extremely important.

The dopaminergic system dynamic in the time perception: a review of the evidence.

Dopaminergic system plays a key role in perception, which is an important executive function of the brain. Modulation in dopaminergic system forms an important biochemical underpinning of neural mechanisms of time perception in a very wide range, from milliseconds to seconds to longer daily rhythms. Distinct types of temporal experience are poorly understood, and the relationship between processing of different intervals by the brain has received little attention. A comprehensive understanding of interval timing functions should be sought within a wider context of temporal processing, involving genetic aspects, pharmacological models, cognitive aspects, motor control and the neurological diseases with impaired dopaminergic system. Particularly, an unexplored question is whether the role of dopamine in interval timing can be integrated with the role of dopamine in non-interval timing temporal components. In this review, we explore a wider perspective of dopaminergic system, involving genetic polymorphisms, pharmacological models, executive functions and neurological diseases on the time perception. We conclude that the dopaminergic system has great participation in impact on time perception and neurobiological basis of the executive functions and neurological diseases.

DOES COGNITIVE CAPACITY INTERFERE WITH THE OUTCOME OF OBERLIN TRANSFER?

OBJECTIVE: To determine the relationship between the functional outcome achieved following Oberlin transfer, the cognitive level of the patient, and the time elapsed between the trauma event and surgery. METHODS: Eighteen patients with a traumatic injury to the brachial plexus (C5-C6 and C5-C7) were evaluated. Seventeen (94.4%) patients were males and one (5.6%) was female, with a mean age of 29.5 years (range 17-46 years). We evaluated the active range of motion, elbow flexion strength, and Disabilities of the Arm, Shoulder and Hand (DASH) and determined the correlation between the procedural outcome and the patient's cognitive level, as assessed by the Mini-Mental State Exam (MMSE). RESULTS: We found statistically significant correlations between the MMSE scale and strength recovery (84.4%, p<0.001), which was classified as excellent, and between the MMSE and British Medical Research Council (BMRC) scales (78.4%, p>0.001), which classified cognitive level as good. CONCLUSIONS: We found a positive correlation between cognitive capacity and functional outcome of patients submitted to Oberlin surgery. The time elapsed between trauma and the surgical procedure showed an inversely proportional correlation with the strength of recovery. Level of Evidence II, Retrospective Study.

OBJETIVO: Determinar a relação entre o resultado funcional obtido com a cirurgia de Oberlin, o nível cognitivo do paciente e com o tempo decorrido entre o trauma e a cirurgia. MÉTODOS: Foram analisados dezoito pacientes, sendo 17 homens (94,4%) e uma mulher (5,6%), com idade média de 29,5 anos (17 a 46 anos), com lesão traumática alta do plexo braquial (C5-C6 e C5-C7). Avaliamos a amplitude de movimento ativa, a força muscular de flexão do cotovelo e o questionário DASH (Disabilities of the Arm, Shoulder and Hand) e determinamos a correlação entre o resultado obtido e o nível cognitivo do paciente, avaliado pelo Mini Exame do Estado Mental (MEEM). RESULTADOS: Observamos correlações de significância estatística entre MEEM e recuperação de força (84,4%, p<0,001), classificada como ótima; MEEM e BMRC - British Medical Research Council (78,4%, p> 0,001), classificada como boa. CONCLUSÕES: Verificamos correlação positiva entre a capacidade cognitiva e os resultados funcionais dos pacientes submetidos à cirurgia de Oberlin. O tempo decorrido entre o trauma e o procedimento cirúrgico apresenta uma relação inversamente proporcional com a recuperação da força. Nível de Evidencia II, Estudo retrospectivo.

Ptose palpebral causada por Paquidermoperiostose / Palpebral ptosis caused by Pachydermoperiostosis

A paquidermoperiostose é uma síndrome caracterizada por acometimento cutâneo e ósseo, e em alguns casos ocorre comprometimento palpebral leve. É uma síndrome rara, idiopática ou hereditária, com provável herança autossômica dominante de penetrância variável. Descreve-se o caso de um paciente com ptose grave por paquidermoperiostose elucidando sua fisiopatologia e conduta cirúrgica aplicada.

Pachydermoperiostosis is a rare disorder characterized by the involvement of skin and bone, and in some cases it can have a mild adverse effect in the eyelid. Although the etiology is still unclear, idiopathic or hereditary cases, in an autossomal dominant inheritance, have been reported. This study is a case report of a patient with severe blepharoptosis due to pachydermoperiostosis, which describes the surgical procedure and the physiopathology of the condition.

Estudo comparativo das medidas manual e digital da fenda palpebral / A comparative study of the manual and digital measurements of the palpebral fissure

OBJETIVO: Comparar a medida manual do comprimento vertical da fenda palpebral e sua medida obtida por meio de processamento computadorizado de imagens de indivíduos sem alterações palpebrais. MÉTODOS: Foram analisadas 102 fendas palpebrais de 51 indivíduos normais. A faixa etária variou entre 17 e 84 anos, sendo 25 (49 por cento) do sexo masculino e 26 (51 por cento) do sexo feminino. RESULTADOS: Não houve diferença estatisticamente significativa entre as medidas manuais da fenda palpebral e as obtidas por meio de processamento computadorizado de imagens. Também não se observou diferença entre ambos os sexos e a faixa etária. CONCLUSÕES: Os resultados obtidos com estes dois métodos podem ser comparados entre si devida à equivalência estatística das medidas.

[A comparative study of the manual and digital measurements of the palpebral fissure]. / Estudo comparativo das medidas manual e digital da fenda palpebral.

PURPOSE: To compare the measurement of the palpebral fissure done either manually and by computer analysis of image of individuals without lid alterations. METHODS: One hundred two palpebral fissures from 51 normal subjects have been analyzed. The patients' age ranged from 17 to 84 years, with 25 (49%) males and 26 (51%) females. RESULTS: There was no statistically significant difference between the measurements done either manually or by computer analysis of images, neither, when we grouped the patients by sex or age. Also we did not observe difference between males and females, and regarding age. CONCLUSIONS: The results obtained by both methods are comparable and reliable due to the statistical equivalence of the obtained measurements.