Validation of the Equidyn protocol for evaluation of dynamic balance in older adults through a smartphone application.

BACKGROUND: Different tasks and proxy measurements have been employed to evaluate dynamic balance in older individuals. However, due to inherent limitations, results from most evaluations could hardly be taken as valid measurements of dynamic balance. RESEARCH QUESTION: Is the Equidyn smartphone application-based protocol valid and sensitive for assessment of dynamic balance in older adults? METHODS: Dynamic balance was evaluated in 52 physically active individuals, age range 60-80 years (M = 69.36). The dynamic tasks were one-leg sway either in the mediolateral (ML) or anteroposterior (AP) direction while supported on the contralateral leg, and cyclic sit-to-stand with a narrow support base. These tasks were performed under standardized movement amplitude and rhythm. Outcomes were correlated with unipedal quiet standing. A smartphone was attached to the trunk backside, and a custom-made application (Equidyn) was employed to provide guidance throughout evaluation, timed beeps to pace the movements, and three-dimensional trunk acceleration measurement for balance evaluation. RESULTS: Our data showed (a) that both ML and AP leg sway tasks were sensitive to aging and to direction of leg sway movements; (b) referenced to quiet unipedal stance, moderate/strong correlations for the ML/AP leg sway tasks and moderate correlations for the sit-to-stand task; and (c) moderate/strong correlations between the ML and AP leg sway tasks, and moderate correlations between the sit-to-stand and the two unipedal dynamic tasks in the ML acceleration direction. SIGNIFICANCE: The current results support the conclusion that the Equidyn protocol is a sensitive and valid tool to evaluate dynamic balance in healthy older individuals. The protocol tasks standardized in amplitude and rhythm favor their reproducibility and trunk acceleration data interpretation. As the whole assessment is made through a smartphone application, this dynamic balance evaluation could be made in a low-cost simple way both in the laboratory and clinical settings.

Soluble guanylate cyclase stimulators and activators: new horizons in the treatment of priapism associated with sickle cell disease.

Priapism, defined as a prolonged and often painful penile erection occurring without sexual stimulation or desire, is a common complication in sickle cell disease (SCD), affecting up to 48% of male patients. This condition presents significant clinical challenges and can lead to erectile dysfunction if not properly managed. Current pharmacological treatments for SCD-related priapism are primarily reactive rather than preventative, highlighting a gap in effective medical intervention strategies. A critical factor in developing priapism is the reduced basal bioavailability of nitric oxide (NO) and cyclic guanosine monophosphate (cGMP) in erectile tissues. New prevention strategies should ideally target the underlying pathophysiology of the disease. Compounds that stimulate and activate soluble guanylate cyclase (sGC) emerge as potential therapeutic candidates since these compounds have the property of inducing cGMP production by sGC. This review explores the potential of sGC stimulators and activators in treating priapism associated with SCD. We discuss the advantages of these agents in the face of the challenging pathophysiology of SCD. Additionally, the review underscores the impact of intravascular hemolysis and oxidative stress on priapism pathophysiology in SCD, areas in which sGC stimulators and activators may also have beneficial therapeutic effects.

The role of autophagy in prostate cancer and prostatic diseases: a new therapeutic strategy.

BACKGROUND: Autophagy is a well-conserved catabolic process that plays a key role in cell homeostasis. In the prostate, defective autophagy has been implicated in the genesis and progression of several pathological conditions. AIM: The present review explored the autophagy pathway in prostate-related dysfunctions, focusing on prostate cancer (PCa), benign prostatic hyperplasia (BPH) and prostatitis. RESULTS: Impaired autophagy activity has been shown in animal models of BPH and prostatitis. Moreover, autophagy activation by specific and non-specific drugs improved both conditions in pre-clinical studies. Conversely, the efficacy of autophagy inducers in PCa remains controversial, depending on intrinsic PCa characteristics and stage of progression. Intriguingly, autophagy inhibitors have shown beneficial effects in PCa suppression or even to overcome chemotherapy resistance. However, there are still open questions regarding the upstream mechanisms by which autophagy is deregulated in the prostate and the exact role of autophagy in PCa. The lack of specificity and increased toxicity associated with the currently autophagy inhibitors limits its use clinically, reflecting in reduced number of clinical data. CONCLUSION: New therapeutic strategies to treat prostatic diseases involving new autophagy modulators, combination therapy and new drug formulations should be explored. Understanding the autophagy signaling in each prostatic disease is crucial to determine the best pharmacological approach.

Nitric Oxide Resistance in Priapism Associated with Sickle Cell Disease: Mechanisms, Therapeutic Challenges, and Future Directions.

Patients with sickle cell disease (SCD) display priapism, a prolonged penile erection in the absence of sexual arousal. The current pharmacological treatments for SCD-associated priapism are limited and focused on acute interventions rather than prevention. Thus, there is an urgent need for new drug targets and preventive pharmacological therapies for this condition. This review focuses on the molecular mechanisms linked to the dysfunction of the NO-cyclic guanosine monophosphate (cGMP)-phosphodiesterase type 5 (PDE5) pathway implicated in SCD-associated priapism. In murine models of SCD, reduced NO-cGMP bioavailability in the corpus cavernosum is associated with elevated plasma hemoglobin levels, increased ROS levels that inactive NO, and testosterone deficiency that leads to eNOS downregulation. We discuss the consequences of the reduced cGMP-dependent PDE5 activity in response to these molecular changes, highlighting it as the primary pathophysiological mechanism leading to excessive corpus cavernosum relaxation, culminating in priapism. We also further discuss the impact of intravascular hemolysis on therapeutic approaches, present current pharmacological strategies targeting the NO-cGMP-PDE5 pathway in the penis, and identify potential pharmacological targets for future priapism therapies. In men with SCD and priapism, PDE5 inhibitor therapy and testosterone replacement have shown promising results. Recent preclinical research reported the beneficial effect of treatment with haptoglobin and NO donors. Significant strides have been made in understanding the pathophysiology of SCD-associated priapism. Significance Statement This review discusses the molecular changes that reduce NO-cGMP bioavailability in the penis in SCD and highlights pharmacological targets and therapeutic strategies for the treatment of priapism, including PDE5 inhibitors, hormonal modulators, NO donors, soluble guanylate cyclase stimulators, haptoglobin, hemopexin, and antioxidants.

Heme-induced corpus cavernosum relaxation and its implications for priapism in sickle cell disease: a mechanistic insight.

BACKGROUND: Patients with sickle cell disease (SCD) experience intravascular hemolysis, leading to elevated plasma heme levels. This phenomenon has been associated with increased priapism in men with SCD. The heme group can be metabolized by heme oxygenase (HO), generating carbon monoxide (CO), which is known to promote smooth muscle relaxation via soluble guanylyl cyclase (sGC)-cyclic guanosine monophosphate (cGMP). However, the effects of heme on the relaxation responses of corpus cavernosum (CC) have not been investigated. OBJECTIVES: To evaluate the functional and biochemical effects of the heme group on mouse CC smooth muscle in vitro. MATERIALS AND METHODS: Male C57BL/6 mice were used. CC tissues were mounted in organ baths. Measurement of cGMP in mice CC was evaluated. RESULTS: The cumulative addition of heme concentrations promoted the relaxation of CC. HO inhibitor (1J, 100 µM) or sGC inhibitor (ODQ, 10 µM) blocked the relaxing effect of the heme group. Pre-incubation of CC with heme (100 µM) enhanced relaxation induced by acetylcholine, sodium nitroprusside, and nitrergic relaxation (electrical field stimulation), which was abolished by 1J or ODQ. The heme group increased the cGMP production in CC, which was abolished by 1J or ODQ. cGMP levels were significantly higher in CC treated with heme, and pre-incubation with compound 1J or ODQ abolished the effect of heme in raising cGMP levels. DISCUSSION AND CONCLUSION: The HO-CO-sGC-cGMP pathway appears to play a crucial role in promoting CC relaxation. Our study provides novel insight into the role of group heme in CC relaxation and its potential contribution to priapism in SCD. Heme may serve as a pharmacological target for new therapies to prevent priapism.

Hospitalization and mortality rates of malignant prostatic neoplasms in Brazil: A cross-sectional study from 2008 to 2018

Abstract Prostate cancer (PCa) is a highly prevalent condition among men worldwide, resulting in reduced quality of life and increased costs to health systems due to hospitalization and death. This study aimed to explore and understand the evolution of PCa in Brazil from 2008 to 2018. Data were obtained from the National Health System Department of Informatics (DATASUS) using code C61 for malignant prostatic neoplasms. We presented the hospitalization and mortality rates in a temporal-, regional- and age-dependent manner. From 2008 to 2018, a year-dependent increase in hospital admissions due to PCa was reported in Brazil, in which the Southeast region showed the highest prevalence. Men aged ≥80 and those 70-79 years old had similar hospitalization rates, followed by men aged 60-69, 50-59, 40-49 and 30-39 years old. Similarly, an increase in deaths due to PCa was reported during this period, with the highest rates seen in the Southeast. Men aged ≥80 years had higher mortality rates, followed by those aged 70-79, 60-69, 50-59, 40-49 and 30-39 years old. The results obtained indicate an age- and region-dependent increase in PCa morbidity and mortality in Brazil overtime and may contribute to the ongoing discussion on the role and future perspective of the health care system in Brazil.

Hydroxyurea does not reverse functional alterations of the nitric oxide-cGMP pathway associated with priapism phenotype in corpus cavernosum from sickle cell mouse.

Sickle cell disease (SCD) is a genetic disorder that has been associated with priapism. The role of hydroxyurea, a common SCD therapy, in influencing the nitric oxide (NO)-cGMP pathway and its effect on priapism is unclear. To investigate the effect of hydroxyurea treatment on smooth muscle relaxation of corpus cavernosum induced by stimulation of the NO-cGMP pathway in SCD transgenic mice and endothelial NO synthase gene-deficient (eNOS-/-) mice, which are used as model of priapism associated with the low bioavailability of endothelial NO. Four-month-old wild-type (WT, C57BL/6), SCD transgenic, and eNOS-/- male mice were treated with hydroxyurea (100 mg/Kg/day) or its vehicle (saline) daily for three weeks via intraperitoneal injections. Concentration-response curves for acetylcholine (ACh), sodium nitroprusside (SNP), and electrical field stimulation (EFS) were generated using strips of mice corpus cavernosum. The SCD mice demonstrated an amplified CC relaxation response triggered by ACh, EFS, and SNP. The corpus cavernosum relaxation responses to SNP and EFS were found to be heightened in the eNOS-/- group. However, the hydroxyurea treatment did not alter these escalated relaxation responses to ACh, EFS, and SNP in the corpus cavernosum of the SCD group, nor the relaxation responses to EFS and SNP in the eNOS-/- group. In conclusion, hydroxyurea is not effective in treating priapism associated with SCD. It is likely that excess plasma hemoglobin and reactive oxygen species, which are reported in SCD, are reacting with NO before it binds to GCs in the smooth muscle of the corpus cavernosum, thus preventing the restoration of baseline NO/cGMP levels. Furthermore, the downregulation of eNOS in the penis may impair the pharmacological action of hydroxyurea at the endothelial level in SCD mice. This study emphasize the urgency for exploring alternative therapeutic avenues for priapism in SCD that are not hindered by high plasma hemoglobin and ROS levels.

Miconazole-loaded nanoparticles coated with hyaluronic acid to treat vulvovaginal candidiasis.

Miconazole-loaded nanoparticles coated with hyaluronic acid (miconazole-loaded nanoparticles/HA) were developed to overcome the limitations of the conventional therapy of the vulvovaginal candidiasis (VVC). They were synthesized by emulsification and solvent evaporation techniques, characterized by diameter, polydispersity index, zeta potential, encapsulation efficiency, atomic force microscopy (AFM), evaluated in terms of efficacy against C. albicans in vitro, and tested in a murine VVC model. Nanoparticles showed 211nm of diameter with a 0.32 polydispersity index, -53mV of zeta potential, and 90% miconazole encapsulation efficiency. AFM evidenced nanoparticles with a spherical shape. They inhibited the proliferation of C. albicans in vitro and in vivo after a single administration. Nanoparticles released the miconazole directly in the site of action at low therapeutic doses, which was enough to eliminate the fungal burden in the murine VVC model. These systems were rationally designed since the existence of the HA induces their adhesion on the vaginal mucus and their internalization via CD44 receptors, inhibiting the C. albicans. Therefore, miconazole-loaded nanoparticles/HA represent an innovative non-conventional pharmaceutical dosage form to treat the VVC and recurrent VVC.

Use of diffusion tensor imaging as a prognostic biomarker after decompression surgery for carpal tunnel syndrome.

BACKGROUND: Magnetic resonance diffusion tensor imaging (MR-DTI) has been increasingly applied for carpal tunnel syndrome (CTS) diagnosis, but relatively little is known about the effect of CTS treatment on median nerve (MN) integrity and functional outcome prediction. PURPOSE: To assess how structural changes in MR-DTI of the MN correlates with symptom severity, functional status, and electrophysiological parameters in patients suffering from CTS before and after decompression surgery. MATERIAL AND METHODS: Nine wrists were prospectively enrolled to perform MR-DTI pre- and postoperatively. The apparent diffusion coefficients (ADC) and fractional anisotropy (FA) of the MN were examined in three different regions-distal radioulnar joint, pisiform bone, and hamate bone-and correlated with clinical and electrophysiological parameters. RESULTS: Postoperatively, mean Boston Carpal Tunnel Questionnaire scores decreased 1.55 points (range = 0.08-3; P = 0.0172) and 1.01 points (-0.13 to 1.88; P = 0.0381) in the symptomatic and functional domains, respectively. Postoperative clinical improvement was reflected in proximal FA elevation (P = 0.0078), but not in diffusivity in comparison to baseline examination. Preoperative electrophysiological parameters were correlated with a reduction in the pre- (sensory latencies [rho = -0.6826; P = 0.0312]) and postoperative (motor latencies [rho = -0.7488; P = 0.0325]) distal FA values. Higher sensory amplitudes indicated higher postoperative proximal FA values (rho = 0.7618; P = 0.0280) ​​and lower postoperative proximal ADC values (rho = -0.9047; P = 0.0020). CONCLUSION: Our study demonstrated that pre- and postoperative proximal FA values are useful biomarkers for the structural evaluation of the MN in patients with CTS. Symptomatic improvement can be better predicted by analyzing FA changes.

Intravascular hemolysis leads to exaggerated corpus cavernosum relaxation: Implication for priapism in sickle cell disease.

Patients with sickle cell disease (SCD) display priapism. Clinical studies have shown a strong positive correlation between priapism and high levels of intravascular hemolysis in men with SCD. However, there are no experimental studies that show that intravascular hemolysis promotes alterations in erectile function. Therefore, we aimed to evaluate the corpus cavernosum smooth muscle relaxant function in a murine model that displays intravascular hemolysis induced by phenylhydrazine (PHZ), as well as the role of intravascular hemolysis in increasing the stress oxidative in the penis. Corpus cavernosum strips were dissected free and placed in organ baths. Acetylcholine and electrical field stimulation (EFS)-induced corpus cavernosum relaxations in vitro were obtained. Increased corpus cavernosum relaxant responses to acetylcholine and EFS were observed in the PHZ group. Protein expression of heme oxygenase-1 increased in the corpus cavernosum of the PHZ group, but PDE5 protein expression was not modified. Preincubation with the heme oxygenase inhibitor 1 J completely reversed the increased relaxant responses to acetylcholine and EFS in PHZ mice. Protein expression of NADPH oxidase subunit gp91phox, 3-nitrotyrosine, and 4-hydroxynonenal increased in the corpus cavernosum of the PHZ group, suggesting a state of oxidative stress. Basal cGMP production was lower in the PHZ group. Our results show that intravascular hemolysis promotes increased corpus cavernosum smooth muscle relaxation associated with increased HO-1 expression, as well as increased oxidative stress associated with upregulation of gp91phox expression. Moreover, our study supports clinical studies that point to a strong positive correlation between priapism and high levels of intravascular hemolysis in men with SCD.

Haptoglobin treatment contributes to regulating nitric oxide signal and reduces oxidative stress in the penis: A preventive treatment for priapism in sickle cell disease.

Background: In sickle cell disease (SCD), reduced bioavailability of endothelial NO and cGMP results in reduced expression of phosphodiesterase type 5 (PDE5), thus impairing the penile erection control mechanism and resulting in prolonged penile erection (priapism). In SCD, reduced NO bioavailability is associated with excess plasma hemoglobin due to intravascular hemolysis and increased oxidative stress. Haptoglobin is the plasma protein responsible for reducing plasma hemoglobin levels, but in SCD, haptoglobin levels are reduced, which favors the accumulation of hemoglobin in plasma. Therefore, we aimed to evaluate the effects of haptoglobin treatment on functional and molecular alterations of erectile function, focusing on the contractile and relaxant mechanisms of corpus cavernosum (CC), as well as oxidative stress. Methods: SCD mice were treated with haptoglobin (400 mg/kg, subcutaneous) or vehicle of Monday, Wednesday and Friday for a period of 1 month. Corpus cavernosum strips were dissected free and placed in organ baths. Cumulative concentration-response curves to the acetylcholine, sodium nitroprusside, phenylephrine and KCL, as well as to electrical field stimulation (EFS), were obtained in CC. Protein expressions of eNOS, phosphorylation of eNOS at Ser-1177, nNOS, PDE5, ROCK1, ROCK2, gp91phox, 3-nitrotyrosine, and 4-HNE were measured by western blot in CC. Results: Increased CC relaxant responses to acetylcholine, sodium nitroprusside and electrical-field stimulation were reduced by haptoglobin in SCD mice. Reduced CC contractile responses to phenylephrine and KCl were increased by haptoglobin in SCD mice. Haptoglobin prevented downregulated eNOS, p-eNOS (Ser-1177), PDE5, and ROCK2 protein expressions and reduced protein expressions of reactive oxygen species markers, NADPH oxidase subunit gp91phox, 3-nitrotyrosine and 4-HNE in penises from SCD mice. Haptoglobin treatment did not affect ROCK1 and nNOS protein expressions in penises from SCD mice. Basal cGMP production was lower in the SCD group, which was normalized by haptoglobin treatment. Conclusion: Treatment with haptoglobin improved erectile function due to up-regulation of eNOS-PDE5 expression and down-regulation of the gp91phox subunit of NADPH oxidase and oxidative/nitrosative stress in the penises of SCD mice. Treatment with haptoglobin also increased contractile activity due to up-regulation of ROCK2. Therefore, haptoglobin treatment may be an additional strategy to prevent priapism in SCD.

Sodium butyrate-loaded nanoparticles coated with chitosan for the treatment of neovascularization in age-related macular degeneration: Ocular biocompatibility and antiangiogenic activity.

Sodium butyrate-loaded nanoparticles coated chitosan (NaBu-loaded nanoparticles/CS) were developed to treat the choroidal neovascularization in wet age-related macular degeneration (AMD). The nanoparticles were produced by double emulsification and solvent evaporation technique, optimized by experimental statistical design, characterized by analytical methods, investigated in terms of in vitro and in vivo ocular biocompatibility, and evaluated as an antiangiogenic system in vivo. The NaBu-loaded nanoparticles/CS were 311.1 ± 3.1 nm in diameter with a 0.208 ± 0.007 polydispersity index; had a +56.3 ± 2.6 mV zeta potential; showed a 92.3 % NaBu encapsulation efficiency; and sustained the drug release over 35 days. The NaBu-loaded nanoparticles/CS showed no toxicity to human retinal pigment epithelium cells (ARPE-19 cells); was not irritant to the chorioallantoic membrane (CAM); did not interfere in the integrity of the retinal layers of rat's eyes, as detected by the Optical Coherence Tomography and histopathology; and inhibited the angiogenesis in CAM assay. The NaBu-loaded nanoparticles/CS could be a therapeutic alternative to limit the neovascularization in AMD.

Resveratrol-nitric oxide donor hybrid effect on priapism in sickle cell and nitric oxide-deficient mouse.

BACKGROUND: Children and adult with sickle cell disease (SCD) display priapism associated with low nitric oxide (NO) bioavailability and oxidative stress in penis. AIM: This study aimed to evaluate the effects of hybrid compound RVT-FxMe, derived from resveratrol bearing a NO-donor subunit, on two murine model that display priapism phenotype, SCD transgenic mice and endothelial NO synthase gene-deficient (eNOS-/-) mice. METHODS: Wild-type, SCD, and eNOS-/- mice were treated with RVT-FxMe (25 mg/kg/d, 2 weeks). OUTCOMES: Hematological parameters, concentration-response curves to acetylcholine (ACh) and sodium nitroprusside (SNP), as well as to electrical field stimulation (EFS), were obtained in mice corpus cavernosum strips. RESULTS: Corpus cavernosum relaxations to SNP and EFS were increased in eNOS-/- group, which were normalized by RVT-FxMe treatment. SCD mice exhibited an excessive CC relaxant response induced by ACh, EFS and SNP RVT-FxMe treatment did not change the increased relaxant responses to ACh, EFS and SNP in corpus cavernosum from SCD group. CLINICAL TRANSLATION: Excess of plasma hemoglobin in SCD may interfere in pharmacological activity of NO donors compounds. STRENGTH/LIMITATIONS: While mechanistic data with promising potential is showed, the current study is not without limitations. RVT-FxMe effects in the mid- and long-term warrant complementary studies. CONCLUSION: Treatment with RVT-FxMe reversed the enhanced NO-cGMP-mediated CC relaxations in eNOS-/- mice, but not in SCD mice; it is likely that excess of plasma hemoglobin in SCD mice act to inactivate NO before it reaches soluble guanylyl cyclase, avoiding restoration of NO bioavailability in penis.

Endoscopic Approach at Two Non-Sequential Levels in Lumbar Discitis.

We report a case of spondylodiscitis in two non-sequential segments of the lumbar spine that was unresponsive to antibiotic treatment instituted and guided by results of blood and urine cultures. A 70-year-old female was admitted to our hospital with complaints of adynamia, low fever, and severe lower back pain that caused difficulty in mobilizing the lower limbs. Spinal tomography and magnetic resonance imaging (MRI) of the lumbar spine suggested L2L3 and L5S1 spondylodiscitis. After an initial period of improvement, the patient's condition began to deteriorate again four weeks after initiating the antibiotic therapy. We then opted for surgical treatment through a full-endoscopic transforaminal route, with the aim of collecting intervertebral discs material and performing debridement. After the procedure, the patient experienced immediate relief from the pain and was able to stand and walk without assistance. Cultures from disc fragments showed different bacterial species than that found in the first examination. The endoscopic approach allowed less tissue damage, debridement of the disc, collection of multiple fragments, thereby facilitating the best antibiotic therapy, and shortening the duration of hospital stay.

Aging-associated prostate smooth muscle hypercontractility in rats

Abstract Benign prostatic hyperplasia (BPH) is a multifactorial disease, highly associated with aging and characterized by increased prostate smooth muscle (PSM) contractility. Animal models have been employed to explore the aging-associated PSM hypercontractility; however, studies have focused in old animals, neglecting the initial alterations in early ages. The determination of prostatic dysfunctions onset is crucial to understand the BPH pathophysiology and to propose new BPH treatments. Considering that PSM contractility in 10-month-old rats has already been explored, the aim of the present study was to characterize the PSM contractility in younger rats. Male Wistar control (3.5-month-old), 6- and 8-month-old rats were used. Concentration-response curves to phenylephrine and electrical-field stimulation (EFS) were conducted in prostate from all groups. For the first time, we showed that 6- and 8-month-old rats exhibit PSM hypercontractility. The increased prostate contractility to phenylephrine starts around at 6-month-old, worsening during the aging. The 8-month-old rats exhibited hypercontractility to phenylephrine and EFS compared to the control and 6-month-old groups. Reduced phenylephrine potency was observed in 8-month-old rats, indicating an increased age-dependent prostate sensibility to this agonist. Collectively, our findings support the use of 6- and 8-month-old aged rats as new models to explore prostate hypercontractility in BPH.

Feminismos ciborgues em uma cama de gato, ciência e saberes coletivos universitários de mulheres / Ciborgian feminism in the cat's cradle, science and university collective knowledge of women / Feminismo ciborgs, ciencia y universidad: conocimiento colectivo de mujeres

Este artigo é um ensaio feminista sobre ciência, saberes e universidade. Parte de contribuições relevantes dos trabalhos de Donna Haraway para pensar práticas tecnocientíficas de fabulação. A partir das considerações de Haraway, argumenta-se que é possível pensar a construção de jogos de corda como operador metodológico feminista que converge para a produção de saberes locais nas universidades, em teias potentes de efeitos ciborgues que fraturam a ciência institucionalizada de base masculinista, agonística e pouco aberta à fabulação. Finaliza-se com indagações à Psicologia a partir da possível incorporação de um dos operadores metodológicos de Donna Haraway, a sym fiction.

This article is a feminist essay about science and collective knowledge and the university. It starts from relevant contributions from the works of Donna Haraway to think about technoscientific fabulation practices. Based on Haraway's considerations, we understand that it is to think the construction of rope games as possible as a feminist methodological operator that converges to the production of local knowledge in universities, in powerful webs of cyborg effects that fracture institutionalized science with a masculinist, agonistic and little open to fabulation.

Este artículo es un ensayo feminista a respecto de la ciencia, el conocimiento colectivo y la universidad. Se parte de las contribuciones relevantes de los trabajos de Donna Haraway para pensar en las prácticas de fabricación tecnocientífica. Con base en las consideraciones de Haraway, entendemos que se trata de pensar la construcción de juegos de cuerdas como posible como un operador metodológico feminista que converge a la producción de conocimiento local en las universidades, en poderosas redes de efectos ciborg que fracturan la ciencia institucionalizada con un carácter agonista y masculinista y poco abierto a la fabulación.

Osseous morphology of the medial epicondyle: an anatomoradiological study with potential clinical implications.

PURPOSE: The cubital tunnel is limited anteriorly by the medial epicondyle (ME), laterally by the medial collateral ligament, and superiorly by Osborne's fascia and the cubital tunnel retinaculum. Previous studies were mostly dedicated to the roof of the cubital tunnel, in the way that the study of the groove for ulnar nerve and ME anatomy is relatively scarce in the literature. We sought to describe the radiological anatomy of the groove for ulnar nerve and ME in healthy volunteers with multiplanar computed tomography (CT). METHODS: We analyzed 3D CT images of 30 healthy volunteers (mean age 39 years, range 18-66 years). Nine variables were measured from the right elbow, including sizes, areas and angles in two different planes (coronal and axial). RESULTS: Mean ME width and length were 17.3 ± 3.5 mm and 31.7 ± 4.5 mm, respectively. According to categorical correlation studies, ME width (X) was deemed the most representative morphological characteristic because of the positive correlation to five other different anatomical measurements. A three-tiered anatomical classification was proposed based on data distribution. CONCLUSION: Large individual variation is found in the shape of ME, both in coronal and axial planes. The knowledge of individual osseous morphology is of great value potentially contributing to the surgical decision-making in patients affected by cubital tunnel syndrome.

Perfil sociodemográfico e clínico de pacientes com doenças cardiovasculares em um hospital geral / Perfil sociodemográfico y clínico de pacientes con trastornos cardiovasculares en un hospital general / Sociodemographic and clinical profile of patients with cardiovascular disorders in a general hospital

Objetivo: traçar o perfil sociodemográfico e clínico de pacientes com doenças cardiovasculares. Método: estudo observacional, descritivo, com amostra por conveniência de 50 pacientes com doenças cardiovascular, internados nos serviços de cardiologia e neurologia de hospital de Curitiba, Paraná. Os dados foram coletados por meio de instrumento estruturado de junho de 2018 a janeiro de 2019 e analisado por estatística descritiva. Resultados: verificou-se que 68% dos participantes eram homens, 84% com idade entre 51 e 60 anos, 58% brancos, 78% procedentes de Curitiba e região, 52% com baixa escolaridade. Observou-se que 58% não praticavam atividade física, 52% eram tabagistas; 40% afirmaram ingerir bebida alcoólica, 58% com renda familiar de até um salário mínimo. Dos participantes 58% tinham antecedentes familiares de alterações cardiovasculares, 84% eram hipertensos, 78% faziam uso de polifarmácia. Conclusão: o perfil dos pacientes com doenças cardiovasculares está caracterizado pela falta de hábitos saudáveis dos participantes, hipertensão e fragilidade social.(AU)

Objective: to delineate the sociodemographic and clinical profile of patients with cardiovascular disorders. Method: observational, descriptive study with 50 patients with cardiovascular diseases, admitted to the cardiology and neurology services of hospital, in Curitiba, Paraná, Brazil. Data were collected with structured instrument from June 2018 to January 2019 and analyzed using descriptive statistics. Results: it was found that 68% of the participants were men, 84% aged 51 to 60 years, 58% white, 78% from local region, 52% with low education. It was observed that 58% did not practice physical activity, 52% were smokers; 40% said they drink alcohol, 58% reported having a family income of up to one minimum wage. Of the participants, 58% had a family history of cardiovascular disorders, 84% were hypertensive, 78% used polypharmacy. Conclusion: the profile of patients with cardiovascular disorders is characterized by the participants' lack of healthy habits, hypertension and social fragility.(AU)

Objetivo: delinear el perfil sociodemográfico y clínico de pacientes con trastornos cardiovasculares. Método: estudio observacional, descriptivo con 50 pacientes con trastornos cardiovasculares, ingresados en los servicios de cardiología y neurología de un hospital en Curitiba, Paraná, Brasil. Los datos se recopilaron con instrumento estructurado desde junio de 2018 hasta enero de 2019 y se analizaron mediante estadísticas descriptiva. Resultados: 68% de los participantes eran hombres, 84% de edades entre 51 y 60 años, 58% blancos, 78% de la región local, 52% con baja educación. El 58% no practicaba actividad física, el 52% eran fumadores; el 40% bebían alcohol, el 58% informó tener renta familiar de hasta un salario mínimo. De los participantes, 58% tenían antecedentes familiares de alteraciones cardiovasculares, 84% eran hipertensos, 78% usaban polifarmacia. Conclusión: el perfil de los pacientes con enfermedades cardiovasculares se caracteriza por la falta de hábitos saludables de los participantes, hipertensión y fragilidad social.(AU)

Patient selection protocols for endoscopic transforaminal, interlaminar, and translaminar decompression of lumbar spinal stenosis.

BACKGROUND: The indications of different endoscopic and endoscopically assisted translaminar approaches for lumbar spinal stenosis are not well-defined, and validated protocols for the use of the transforaminal over the interlaminar approach are lacking. METHODS: We performed a retrospective study employing an image-based patient stratification protocol of stenosis location (type I-central canal, type II-lateral recess, type III-foraminal, type IV-extraforaminal) and clinical outcomes on 249 patients consisting of 137 (55%) men and 112 (45%) women with an average age of 56.03±16.8 years who underwent endoscopic surgery for symptomatic spinal stenosis from January 2013 to February 2019. The average follow-up of 38.27±27.9 months. The primary clinical outcome measures were the Oswestry Disability Index (ODI), Visual Analogue Scale (VAS), and modified Macnab criteria. RESULTS: The frequency of stenosis configuration in decreasing order was as follows: type I-121/249; 48.6%, type III-104/249; 41.8%, type II-15/249; 6%, and type IV-9/249; 3.6%. The transforaminal approach (137/249; 55.0%) was used in most type II to IV lesions followed by the interlaminar approach (78/249; 31.3%), and the full endoscopic approach (12/249; 4.8%), and the endoscopically assisted translaminar approach (8/249; 3.2%) which was exclusively used for type I lesions. Macnab outcomes analysis showed Excellent in 47 patients (18.9%), Good in 178 (71.5%), Fair in 18 (7.2%) and Poor in 6 (2.4%), respectively. Paired two-tailed t-test showed statistically significant VAS (5.46±2.1; P<0.0001) and ODI (37.1±16.9; P<0.0001) reductions as a result of the endoscopic decompression surgery. Cross-tabulation of the Macnab outcomes versus the endoscopic approach and surgical technique confirmed beneficial association of the approach selection with Excellent (P=0.001) and Good (P<0.0001) outcomes with statistically significance. CONCLUSIONS: This study suggests that in the hands of skilled endoscopic spines surgeon use of an image-based stenosis location protocol may contribute to obtaining Excellent and Good clinical outcomes in a high percentage (93%) of patients suffering from lumbar stenosis related radiculopathy. Additional comparative studies should examine the prognostic value of choosing the endoscopic approach on the basis of the proposed four-type stenosis protocol by correlating its impact on outcomes with preoperative diagnostic injections and intraoperative direct visualization of symptomatic pain generators under local anesthesia and sedation.

Os impactos do racismo na subjetividade do jogador de futebol negro / The impacts of racism on the subjectivity of black soccer players / Los impactos del racismo en la subjetividad de los futbolistas negros

Resumo Temos visto sucessivos casos de racismo no esporte ao longo dos anos. Essa situação nos possibilita colocar em xeque a ideia de que há uma democracia racial no esporte, justificada pelo fato de que a projeção dos atletas independe de sua cor, pois aconteceria pelo mérito de seu esforço em treinar suas potencialidades. Escolhemos nos concentrar no futebol porque é o esporte que mais converge o sentimento nacionalista em nosso país. O objetivo principal desta pesquisa de conclusão do curso de Psicologia, foi o de investigar se há racismo no futebol brasileiro e se ele afeta a subjetividade dos negros brasileiros que trabalham no futebol. Visamos também investigar como a psicologia tem tratado o sofrimento causado pelo racismo na constituição das subjetividades dos negros. A metodologia escolhida foi a revisão bibliográfica que, percorre o que já foi publicado em livros, sites etc. Constatamos que os negros encontram espaços de trabalho quando são atletas, mas que sua participação é mínima como árbitros, treinadores ou gestores. A pesquisa revelou também que a própria psicologia demorou muito a se pronunciar sobre o sofrimento causado na constituição da subjetividade do negro. Utilizando as orientações técnicas do Centro de Referência em Psicologia e Politicas Publicas (Crepop) do Conselho Federal de Psicologia em 2017, pudemos concluir que, para tratar do sofrimento dos negros no esporte, é necessário ampliar a clínica, escutando o atleta em sua dimensão biopsicossocial.

Abstract We have seen over the years successive cases of racism in sport. This situation makes us question the idea that there is a racial democracy in sport, justified by the fact that the projection of athletes is independent of their color, given that this is due to the merit of their efforts to train their potentialities. We chose to focus on soccer because it is the sport that most converges the feeling of nationalism in our country. We investigated in this research to conclude psychology course, if there is racism in Brazilian soccer and if it affects the subjectivity of Brazilian black people working in soccer. We also aim to investigate how Psychology has treated the suffering caused by racism in the constitution of black subjectivity. The chosen methodology was the bibliographic review that goes through what has already been published in books, websites and etc, The results show that black people find workspaces when they are still athletes, but their participation is minimal as referees, coaches or managers. The research also revealed that Psychology itself took a long time to take a stance on the suffering caused in the constitution of black subjectivity. Using the technical guidelines of the Reference Center in Psychology and Public Policy of the Federal Council of Psychology in 2017, we conclude that to address the suffering of black people in sports it is necessary to expand the clinic, listening to athletes in their bio-psycho-social dimension.

Resumen Han ocurrido muchos casos de racismo en el deporte a lo largo de los años. Esta situación nos permite cuestionar la idea de que existe una democracia racial en el deporte, justificada por el hecho de que la proyección de los deportistas no depende de su color, sino del mérito de su esfuerzo en entrenar sus potenciales. Se eligió el fútbol porque es el deporte que más converge el sentimiento nacionalista en Brasil. El principal objetivo de esta investigatión para concluir el curso de Psicologia, fue investigar se hay racismo en el fútbol brasileño y si afecta la subjetividad de los brasileños negros que trabajan en lo fútbol. Además, se busca investigar cómo la psicología ha tratado el sufrimiento causado por el racismo en la constitución de subjetividades negras. Se optó por hacer una revisión bibliográfica en torno a lo que se ha publicado en libros, internet, etc. Se encontró que los negros encuentran espacios de trabajo cuando son deportistas, pero su participación se reduce a lo mínimo como árbitros, entrenadores o directivos. Además, se reveló que la propia psicología tardó mucho en pronunciarse sobre el sufrimiento causado en la constitución de la subjetividad negra. Con base en los lineamientos técnicos del Centro de Referencia en Psicología y Políticas Públicas del Consejo Federal de Psicología en 2017, se concluye que, para atender el sufrimiento de los negros en el deporte, es necesario ampliar la clínica, escuchando al deportista en su dimensión biopsicosocial.