Individualized positive end-expiratory pressure reduces driving pressure in obese patients during laparoscopic surgery under pneumoperitoneum: a randomized clinical trial.

Introduction: During pneumoperitoneum (PNP), airway driving pressure (ΔPRS) increases due to the stiffness of the chest wall and cephalic shift of the diaphragm, which favors atelectasis. In addition, depending on the mechanical power (MP) formulas, they may lead to different interpretations. Methods: Patients >18 years of age with body mass index >35 kg/m2 were included in a single-center randomized controlled trial during their admission for bariatric surgery by abdominal laparoscopy. Intra-abdominal pressure was set at 15 mmHg at the pneumoperitoneum time point (PNP). After the recruitment maneuver, the lowest respiratory system elastance (ERS) was detected during the positive end-expiratory pressure (PEEP) step-wise decrement. Patients were randomized to the 1) CTRL group: ventilated with PEEP of 5 cmH2O and 2) PEEPIND group: ventilated with PEEP value associated with ERS that is 5% higher than its lowest level. Respiratory system mechanics and mean arterial pressure (MAP) were assessed at the PNP, 5 min after randomization (T1), and at the end of the ventilation protocol (T2); arterial blood gas was assessed at PNP and T2. ΔPRS was the primary outcome. Three MP formulas were used: MPA, which computes static PEEP × volume, elastic, and resistive components; MPB, which computes only the elastic component; and MPC, which computes static PEEP × volume, elastic, and resistive components without inspiratory holds. Results: Twenty-eight patients were assessed for eligibility: eight were not included and 20 patients were randomized and allocated to CTRL and PEEPIND groups (n = 10/group). The PEEPIND ventilator strategy reduced ΔPRS when compared with the CTRL group (PEEPIND, 13 ± 2 cmH2O; CTRL, 22 ± 4 cmH2O; p < 0.001). Oxygenation improved in the PEEPIND group when compared with the CTRL group (p = 0.029), whereas MAP was comparable between the PEEPIND and CTRL groups. At the end of surgery, MPA and MPB were correlated in both the CTRL (rho = 0.71, p = 0.019) and PEEPIND (rho = 0.84, p = 0.020) groups but showed different bias (CTRL, -1.9 J/min; PEEPIND, +10.0 J/min). At the end of the surgery, MPA and MPC were correlated in both the CTRL (rho = 0.71, p = 0.019) and PEEPIND (rho = 0.84, p = 0.020) groups but showed different bias (CTRL, -1.9 J/min; PEEPIND, +10.0 J/min). Conclusion: Individualized PEEP was associated with a reduction in ΔPRS and an improvement in oxygenation with comparable MAP. The MP, which solely computes the elastic component, better reflected the improvement in ΔPRS observed in the individualized PEEP group. Clinical Trial Registration: The protocol was registered at the Brazilian Registry of Clinical Trials (U1111-1220-7296).

Head pre-cooling improves 5-km time-trial performance in male amateur runners in the heat.

This study aimed to evaluate the effect of head pre-cooling on the 5-km time-trial performance of amateur runners in the heat. In a counterbalanced design, 15 male amateur runners (22.6 ± 3.5 y; VO2 max in heat 42.3 ± 4.4 mLO2 /kg/min) completed two 5-km time trials performed in the heat (35°C, 50% relative humidity). In one trial (HCOOL), participants underwent 20 min of head cooling in a temperate environment (23°C, 70% relative humidity) prior to exercise. In another trial (CON), exercise was preceded by 20 min of rest under the same temperature conditions. Exercise time was shorter in HCOOL (25 min and 36 s ± 3 min) compared to CON (27 ± 3 min; p = 0.02). Rectal temperature was reduced during the pre-exercise intervention in HCOOL (p < 0.001), but not in CON (p = 0.55). Relative changes in rectal temperature and mean head temperature were lower throughout HCOOL when compared with CON condition (p = 0.005 and p = 0.022, respectively). Mean skin temperature, heart rate, and rating of perceived exertion did not differ between HCOOL and CON conditions throughout exercise (p = 0.20, p = 0.52 and 0.31, respectively). Thermal comfort was lower in HCOOL condition in pre-exercise (p = 0.014) with no differences observed throughout exercise (p = 0.61). 5-km running performance in a hot environment was improved after a 20-min head cooling intervention, suggesting that this method may be practical as pre-cooling strategy and easily administered to both professional and amateur runners alike.

Non-teratoid ocular medulloepithelioma in an adult horse / Meduloepitelioma ocular não-teratóide em um equino adulto

ABSTRACT: This is a case of medulloepithelioma in a 14-year-old mixed breed gelding horse, presenting a large abnormal mass of tissue involving the entire extension of the right eye. Ophthalmic examination showed deformation and swelling of the eye. The animal showed signs of pain on palpation of the organ, but the specific examination of the systems did not reveal any other changes. Due to the extension of the apparently neoplastic mass and the discomfort experienced by the animal, transpalpebral enucleation procedure was decided. The excised tissue was sent for histopathological analysis, wherein a neoplastic proliferation of neuroectodermal cells was noted. The neoplasm was poorly delimited, unencapsulated, infiltrative, sustained by moderate fibrovascular stroma, and formed cords and rosettes with cells arranged in palisades around the luminal structures (Flexner-Wintersteiner rosettes), suggestive of medulloepithelioma. The immunohistochemical profile was also performed, confirming the diagnosis. The neoplastic cells were immunolabeled to vimentin, S100 protein (S100), and specific neuro enolase (NSE), but not for pan cytokeratin (AE1AE3), glial fibrillary acidic protein (GFAP), and cytokeratin 8/18 (CK8/18). Five months postoperatively, the animal was healthy, without any relapse or evidence of metastasis.

RESUMO: Esse é um caso de meduloepitelioma em um equino sem raça definida, castrado, de 14 anos de idade, que chegou ao atendimento apresentando grande massa de tecido envolvendo toda a extensão do olho direito. No exame oftálmico, foi observada deformação e aumento de volume ocular. O animal manifestou sinais de dor na palpação do órgão, mas o exame específico dos sistemas não revelou demais alterações. Devido à extensão da massa aparentemente neoplásica e o desconforto experimentado pelo equino foi decidida a realização da enucleação transpalpebral. O tecido excisado foi enviado para exame histopatológico, no qual observou-se proliferação neoplásica de células neuroectodérmicas, de forma mal delimitada, não encapsulada, infiltrativa, sustentada por estroma fibrovascular moderado, e formação de cordões e rosetas, com células dispostas em paliçadas ao redor de estruturas luminais (rosetas de Flexner-Wintersteiner), sugestivo de meduloepitelioma. O perfil imunohistoquímico também foi realizado, confirmando o diagnóstico. As células neoplásicas foram imunomarcadas para vimentina, proteína S100 (S100) e neuro enolase específica (NSE), mas não para pan citoqueratina (AE1AE3), proteína glial fibrilar ácida (GFAP) e citoqueratina 8/18 (CK8 / 18). Após cinco meses da realização do procedimento cirúrgico o animal apresentava-se saudável, sem recidiva ou evidência de metástase.

Chemical attributes of soil and growth of castor beans fertilized with drilling gravel from oil wells and castor pie.

The extraction of oil from onshore wells and the production of biodiesel from castor bean crops have grown in recent years, resulting in the production of large volumes of drill cuttings from these wells and castor pie, which can be harmful to the environment. The objective of this work was to evaluate the influence of a combination of different doses of drill cuttings and castor pie on the chemical attributes of a Planosol and on the dry mass production of the aerial part (DMAP) and dry mass of roots (DMR) of castor bean crops (Ricinus communis L.), cultivar BRS-149 Nordestina. The experimental design was a randomized block with a factorial 6 × 6, consisting of five castor pie doses (2, 4, 8, 16, and 32 Mg ha-1); five drill cuttings doses (5, 15, 30, 45, and 60 Mg ha-1) and an experimental control using only soil samples, with three repetitions. The soil used as the main substrate was collected at 0.0-0.2 m depth in a Planosol. The mixture of the topsoil layer with the experimental doses was performed using a mixer for 5 min, and the samples were distributed in 8 dm3 pots; each pot corresponded to an experimental unit. The mixture of cuttings from drill wells and castor pie with a 30: 16 Mg ha-1 ratio, provided favorable chemical conditions for castor bean crop development; however, drill cuttings doses >30 Mg ha-1 can cause soil salinization, and negatively affect the development of castor bean crops.

Pericardite constritiva por tuberculose, uma condição de difícil diagnóstico / Constrictive pericarditis due to tuberculosis a difficult diagnosis condition

A pericardite constritiva (PC) é uma condição clínica caracterizada pela presença de inflamação do tecido pericárdico, culminando em constrição cardíaca. A tuberculose pode acometer o pericárdio e levar à uma condição clínica conhecida como pericardite tuberculosa (PT). Relata-se o caso de um paciente jovem, internado com queixas de insuficiência cardíaca e quadro de PC em que o diagnóstico etiológico de PT foi confirmado por exclusão e resposta à terapêutica.

Pericarditis constrictiva por tuberculosis, una condición de difícil diagnóstico / Constrictive pericarditis due to tuberculosis, a difficult diagnosis condition

La pericarditis constrictiva (PC) es una condición clínica caracterizada por la presencia de inflamación del tejido pericárdico, culminando en constricción cardíaca. La tuberculosis puede afectar al pericardio y llevarlo a una condición clínica conocida como pericarditis tuberculosa (PT). Se relata el caso de un paciente joven, internado con síntomas de insuficiencia cardíaca y cuadro.

Efeitos cognitivos do teste de esforço progressivo em eletricistas com equipamentos de proteção individual / Cognitive effects of the progressive exercise test in electricians wearing personal protective equipment

Resumo Objetivo: verificar o efeito do esforço físico sobre as funções cognitivas de trabalhadores eletricistas utilizando equipamento de proteção individual (EPI). Métodos: participaram 28 eletricistas que trabalhavam na construção, manutenção e operação de redes de distribuição de energia. Todos do sexo masculino, sadios e aptos para a prática de exercícios físicos. As funções cognitivas foram representadas pelo teste de reação simples (TRS) e pelo nível de vigilância mental (NVM). O TRS e o NVM foram mensurados pré e pós-teste máximo progressivo, em esteira rolante, a 27 °C de temperatura seca e umidade relativa do ar de 64%. O teste consistiu em aumentos progressivos na velocidade e na inclinação da esteira até a fadiga, com utilização de EPI. Resultados: a média (desvio padrão) do TRS não foi significativamente diferente antes, 227,8 (35,1) ms, e após o exercício, 220,6 (24,6) ms. O NVM foi significativamente maior após o exercício em todas as situações: frequência crescente - 36,5 (5,1) Hz vs 39,5 (2,7) Hz, frequência decrescente - 36,0 (5,2) vs 39,0 (3,88) Hz, e frequência geral - 36,2 (4,9) vs 39,2 (3,1) Hz. Conclusão: o exercício progressivo máximo realizado com EPI não modificou o tempo de reação simples e aumentou o nível de vigilância mental de eletricistas.

Abstract Objective: to verify the effects of physical effort on the cognitive functions of electricians wearing personal protective equipment (PPE). Methods: 28 electricians participated. They worked on the construction, maintenance and operation of electrical power distribution networks. All were male, healthy and able to practice physical exercises. The cognitive functions were checked by measuring simple reaction time (SRT) and mental alertness level (MAL). SRT and MAL were measured before and after progressive maximal exercise, on a treadmill, at 27 °C dry temperature and 64% relative humidity, wearing PPE. The test consisted of progressive increases in treadmill speed and incline, until fatigue. Results: SRT mean difference was not significantly different before - 227.8 (35.1) ms - and after exercising -220.6 (24.6) ms. MAL was significantly higher after exercise in all situations: increasing frequency - 36.5 (5.1) Hz vs. 39.5 (2.7) Hz; decreasing frequency-36.0 (5.2) Hz vs. 39.0 (3.88) Hz; and general frequency 36.2 (4.9) Hz vs. 39.2 (3.1) Hz. Conclusion: progressive maximal exercise performed while wearing PPE caused no change in simple reaction time, and increased electricians' mental alertness level.

Evaluation of Quality of Life in Patients with and without Heart Failure in Primary Care / Avaliação da Qualidade de Vida em Pacientes com e sem Insuficiência Cardíaca na Atenção Primária

Abstract Background: Heart failure (HF) is a major public health issue with implications on health-related quality of life (HRQL). Objective: To compare HRQL, estimated by the Short-Form Health Survey (SF-36), in patients with and without HF in the community. Methods: Cross-sectional study including 633 consecutive individuals aged 45 years or older, registered in primary care. The subjects were selected from a random sample representative of the population studied. They were divided into two groups: group I, HF patients (n = 59); and group II, patients without HF (n = 574). The HF group was divided into HF with preserved ejection fraction (HFpEF - n = 35) and HF with reduced ejection fraction (HFrEF - n = 24). Results: Patients without HF had a mean SF-36 score significantly greater than those with HF (499.8 ± 139.1 vs 445.4 ± 123.8; p = 0.008). Functional capacity - ability and difficulty to perform common activities of everyday life - was significantly worse (p < 0.0001) in patients with HF independently of sex and age. There was no difference between HFpEF and HFrEF. Conclusion: Patients with HF had low quality of life regardless of the syndrome presentation (HFpEF or HFrEF phenotype). Quality of life evaluation in primary care could help identify patients who would benefit from a proactive care program with more emphasis on multidisciplinary and social support. (Arq Bras Cardiol. 2017; [online].ahead print, PP.0-0)

Resumo Fundamento: A insuficiência cardíaca (IC) é um importante problema de saúde pública, com implicações na qualidade de vida relacionada à saúde (QVRS). Objetivo: Comparar a QVRS, estimada através do Questionário SF-36 (Short-Form Health Survey), em pacientes com e sem IC na comunidade. Métodos: Estudo transversal incluindo 633 indivíduos consecutivos com idade igual ou superior a 45 anos, registrados na atenção primária e selecionados de uma amostra aleatória representativa da população estudada. Foram divididos em dois grupos: grupo I, pacientes com IC (n = 59); e grupo II, pacientes sem IC (n = 574). O grupo I foi dividido em pacientes com IC com fração de ejeção preservada (ICFEP - n = 35) e pacientes com IC com fração de ejeção reduzida (ICFER - n = 24). Resultados: Pacientes sem IC tiveram um escore médio do SF-36 significativamente maior do que aqueles com IC (499,8 ± 139,1 vs 445,4 ± 123,8; p = 0,008). A capacidade funcional - habilidade e dificuldade para realizar atividades comuns da vida diária - foi significativamente pior (p < 0,0001) nos pacientes com IC independentemente de sexo e idade. Não houve diferença entre ICFEP e ICFER. Conclusão: Pacientes com IC mostraram baixa qualidade de vida a despeito da apresentação da síndrome (fenótipo ICFEP ou ICFER). A avaliação da qualidade de vida na atenção primária poderia auxiliar a identificar pacientes que se beneficiariam de um programa de atenção à saúde pró-ativo com maior ênfase em suporte multidisciplinar e social. (Arq Bras Cardiol. 2017; [online].ahead print, PP.0-0)

Evaluation of Quality of Life in Patients with and without Heart Failure in Primary Care.

BACKGROUND: Heart failure (HF) is a major public health issue with implications on health-related quality of life (HRQL). OBJECTIVE: To compare HRQL, estimated by the Short-Form Health Survey (SF-36), in patients with and without HF in the community. METHODS: Cross-sectional study including 633 consecutive individuals aged 45 years or older, registered in primary care. The subjects were selected from a random sample representative of the population studied. They were divided into two groups: group I, HF patients (n = 59); and group II, patients without HF (n = 574). The HF group was divided into HF with preserved ejection fraction (HFpEF - n = 35) and HF with reduced ejection fraction (HFrEF - n = 24). RESULTS: Patients without HF had a mean SF-36 score significantly greater than those with HF (499.8 ± 139.1 vs 445.4 ± 123.8; p = 0.008). Functional capacity - ability and difficulty to perform common activities of everyday life - was significantly worse (p < 0.0001) in patients with HF independently of sex and age. There was no difference between HFpEF and HFrEF. CONCLUSION: Patients with HF had low quality of life regardless of the syndrome presentation (HFpEF or HFrEF phenotype). Quality of life evaluation in primary care could help identify patients who would benefit from a proactive care program with more emphasis on multidisciplinary and social support. (Arq Bras Cardiol. 2017; [online].ahead print, PP.0-0).

Effect of post-activation potentiation in Athletics: a systematic review / Efeito da potencialização pós-ativação no Atletismo: uma revisão sistemática

Abstract Post-activation potentiation is a physiological phenomenon reported to increase muscle performance during high-intensity exercise. To induce post-activation potentiation, maximal strength or power short-duration activities are performed minutes prior the main activity in an attempt to enhance performance. The aim of this study was to evaluate previous publications on the effects of post-activation potentiation on athletic performance. This systematic review used Scielo, Pubmed and SporDiscus database with the following search terms either alone or grouped together: post-activation potentiation, exercise, athletics, track and field, sprint, long jump, triple jump, high jump, shot put, javelin throw, hammer throw e discus throw. The review provided evidence that performing squat, jump and sprint exercises prior to the main activity elicited a state of potentiation that would improve sprint and throw performances and that preparatory activities that can cause post-activation potentiation should be used to improve athletic performance.

Resumo A potencialização pós-ativação é um fenômeno fisiológico capaz de aumentar o desempenho muscular durante exercícios de alta intensidade. Para induzir a potencialização pós-ativação, atividades de curta duração com força máxima ou potência muscular são realizadas minutos antes da atividade principal na tentativa de aumentar o desempenho. O objetivo deste estudo foi avaliar as publicações anteriores sobre os efeitos da potencialização pós-ativação sobre o desempenho no atletismo. Esta revisão sistemática utilizou os bancos de dados Scielo, Pubmed e SportDiscus com os seguintes termos de pesquisa juntos ou separados: post-activation potentiation, exercise, athletics, track and field, sprint, long jump, triple jump, high jump, shot put, javelin throw, hammer throw e discus throw. A revisão evidenciou que a realização de agachamentos, saltos e sprints, antes da atividade principal, desencadeia o estado de potencialização, que então aumenta o desempenho de sprints e lançamentos, e que atividades preparatórias que causam potencialização pós-ativação podem ser utilizadas para aumentar o desempenho no atletismo.

Exercise intensity during official soccer matches / Intensidade de exercício durante partidas oficiais de futebol

Abstract The aims of the study were: 1) to analyze the exercise intensity in several phases (six phases of 15 min) of soccer matches; 2) to compare the match time spent above anaerobic threshold (AT) between different age groups (U-17 and U-20); and 3) to compare the match time spent above AT between players’ positions (backs, midfielders, forwards and wingabcks). Forty-four male soccer players were analyzed. To express players’ effort, the heart rate (HR) was continuously monitored in 29 official matches. Further, HR corresponding to the intensity at the onset of blood lactate accumulation (OBLA) was obtained in a field test. The highest exercise intensity during match was observed in the 15-30 min period of the first half (p< 0.05). Match time spent above AT was not different between players from U-17 and U-20. In the comparison among players’ positions, wingbacks showed lower time above AT (p< 0.05) than players of other positions. The intensity of effort is higher in the 15 to 30 minutes of play (intermediate phase), probably because the players are more rested in the beginning and wearing out is progressive throughout the game. It is also noteworthy that the intensity of exercise (HR and time above AT) of wingbacks was lower, probably because they usually are required to run a larger number of sprints and need more time below the AT to recover.

Resumo Os principais objetivos do presente estudo foram: 1) comparar a intensidade de exercício em diversas fases (seis fases de 15 min) de partidas de futebol; 2) comparar o tempo de partida acima do limiar anaeróbio (LAN) entre diferentes categorias (sub-17 e sub-20); e 3) comparar o tempo de partida acima do LAN entre jogadores de diferentes posições (zagueiros, meio campistas, atacantes e laterais). Quarenta e quatro jogadores foram analisados. A intensidade de esforço como frequência cardíaca (FC) foi monitorada em 29 jogos oficiais. A FC correspondente à intensidade do OBLA (onset of blood lactate accumulation) foi obtida em um teste de campo. A maior intensidade de exercício foi observada no período 15-30 min do primeiro tempo (p< 0,05). O tempo de partida gasto acima do LAN não foi diferente entre jogadores das categorias sub-17 e sub-20. Os laterais apresentaram menor tempo acima do LAN (p< 0,05). Pode concluir-se que a intensidade do esforço foi maior em 15 a 30 min (fase intermediária), provavelmente porque os jogadores estão mais descansados no início e o desgaste é progressivo ao longo do jogo. A intensidade de exercício (FC e tempo acima LAN) dos laterais foi menor, provavelmente porque eles executam um maior número de sprints e necessitam de mais tempo abaixo do LAN para se recuperar.

Comparison of different ways of expressing creatine kinase concentration of soccer players during a competitive season

The aim of this study was to analyze the responses of creatine kinase [CK] expressed in different forms to the training load of professional soccer players during a competitive season. Twelve players (age, 24 ± 4 years) participated in the study. [CK] was analyzed before the pre-season (Pre), after the pre-season (Post), and in the competitive mesocycles (M1, M2, and M3). Results showed [CK] in the Pre, Post, M1, M2, and M3 phases in absolute values (181.3 ± 58.7, 416.4 ± 155.7, 526.4 ± 268.0, 403.8 ± 137.0, and 442.5 ± 212.3 U/L, respectively), relative values (16.3 ± 4.6, 39.5 ± 19.1, 47.8 ± 20.1, 37.5 ± 14.2, 40.1 ± 17.4 %CKmáx, respectively), and values relative to the variation delta (19.9 ± 3.6, 48.1 ± 26.5, 57.0 ± 23.2, 45.1 ± 17.7, and 48.3 ± 22.0 %ΔCKmáx, respectively). [CK] was lower only during the Pre phase compared to the other phases (p < 0.05). [CK] was expressed as %CKmáx or %ΔCKmáx may be more specific to monitor training. In addition, the individualization of this biomarker optimizes the athletes' performance as muscle injuries can be prevented

A unique SaeS allele overrides cell-density dependent expression of saeR and lukSF-PV in the ST30-SCCmecIV lineage of CA-MRSA.

ST30 (CC30)-SCCmec IV (USA1100) is one of the most common community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) lineages. ST30 isolates typically carry lukSF-PV genes encoding the Panton-Valentine leukocidin (PVL) and are responsible for outbreaks of invasive infections worldwide. In this study, twenty CC30 isolates were analyzed. All were very susceptible to non-ß-lactam antimicrobials, 18/20 harbored the lukSF-PV genes, only 1/20 exhibited agr-rnaIII dysfunction, and the majority was not able to form biofilm on inert surfaces. Analysis of lukSF-PV temporal regulation revealed that opposite to other CA-MRSA isolates, these genes were more highly expressed in early log phase than in stationary phase. This inverted lukSF-PV temporal expression was associated with a similar pattern of saeRS expression in the ST30 isolates, namely high level expression in log phase and reduced expression in stationary phase. Reduced saeRS expression in stationary phase was associated with low expression levels of the sae regulators, agr and agr-upregulator sarA, which activate the stationary phase sae-P1 promoter and overexpression of agr-RNAIII restored the levels of saeR and lukSF-PV trancripts in stationary phase. Altered SaeRS activity in the ST30 isolates was attributed to amino acid substitutions (N227S, E268K and S351T) in the HTPase_c domain of SaeS (termed SaeS(SKT)). Complementation of a USA300 saeS mutant with the saeS(SKT) and saeS alleles under the direction of the log phase sae-P3 promoter revealed that saeR and lukSF-PV transcription levels were more significantly activated by saeS(SKT) than saeS. In summary our data identify a unique saeS allele (saeS(SKT)) which appears to override cell-density dependent SaeR and PVL expression in ST30 CA-MRSA isolates. Further studies to determine the contribution of saeS(SKT) allele to the pathogenesis of infections caused by ST30 isolates are merited.

Effects of human head hair on performance and thermoregulatory responses during 10-km outdoor running in healthy men / Efeitos do cabelo da cabeça humana no desempenho e na resposta termorregulatória durante a corrida de 10 km ao ar livre em homens saudáveis

Abstract The aim of the present study was to evaluate the effects of human head hair on performance and thermoregulatory responses during 10-km outdoor running in healthy men. Twelve healthy males (29.5 ± 3.7 years, 174.9 ± 4.3 cm, 72.7 ± 3.2 kg and VO2max 44.6 ± 3.4 ml.kg-1.min-1) participated in two self-paced outdoor 10-km running trials separated by 7 days: 1) HAIR, subjects ran with their natural head hair; 2) NOHAIR, subjects ran after their hair had been totally shaved. Average running velocity was calculated from each 2-km running time. Rectal temperature, heart rate and physiological strain index were measured before and after the 10-km runs and at the end of each 2 km. The rate of heat storage was measured every 2 km. The environmental stress (WBGT) was measured every 10 min. The running velocity (10.9 ± 1 and 10.9 ± 1.1 km.h-1), heart rate (183 ± 10 and 180 ± 12 bpm), rectal temperature (38.82 ± 0.29 and 38.81 ± 0.49oC), physiological strain index (9 ± 1 and 9 ± 1), or heat storage rate (71.9 ± 64.1 and 80.7 ± 56.7 W.m-1) did not differ between the HAIR and NOHAIR conditions, respectively (p>0.05). There was no difference in WBGT between the HAIR and NOHAIR conditions (24.0 ± 1.4 and 23.2 ± 1.5ºC, respectively; p=0.10). The results suggest that shaved head hair does not alter running velocity or thermoregulatory responses during 10-km running under the sun.

Resumo O objetivo do presente estudo foi avaliar os efeitos do cabelo da cabeça humana no desempenho e na resposta termorregulatória durante 10 km de corrida ao ar livre em homens saudáveis. Doze saudável do sexo masculino (29,5 ± 3,7 anos, 174,9 ± 4,3 cm, 72,7 ± 3,2 kg e VO2máx 44,6 ± 3,4 ml.kg-1.min-1) participaram de 2 corridas de 10km separadas por 7 dias de intervalo em ritmo auto regulado: 1) HAIR- voluntários correram com seus cabelos intactos, 2) NOHAIR- voluntários correrram após terem seus cabelos totalmente raspado. A velocidade média da corrida foi calculada a cada série de 2 km. Temperatura retal, freqüência cardíaca e índice de estresse fisiológico foram medidos antes e depois dos 10 km da corrida e no fim de cada 2 km. Taxa de armazenamento de calor foi medida a cada 2 km. Além disso, o estresse ambiental (WBGT) foi medido a cada 10 min. A velocidade de corrida (10,9 ± 1 e 10,9 ± 1,1 km.h-1: freqüência cardíaca (183 ± 10 e 180 ± 12 bpm), temperatura retal (38,82 ± 0,29 e 38,81 ± 0,49º C), índice estresse fisiológico (9 ± 1 e 9 ± 1) e taxa de armazenamento de calor (71,9 ± 64,1 e 80,7 ± 56,7 Wm-1), não foi diferente entre as situações HAIR e NOHAIR, respectivamente (p>0,05). Não houve diferença no WBGT entre HAIR e NOHAIR (24,0 ± 1.4º C e 23,2 ± 1,5º C, respectivamente; p=0,10). Os resultados sugerem que raspar o cabelo da cabeça não altera a velocidade da corrida e as respostas termorregulatórias durante 10 km de corrida sob o sol.

T-Shirt fabric and color affect the physiological strain but not 10 km outdoor running performance.

BACKGROUND: The aim of the present study was to evaluate the effects of T-Shirt fabric and color on the 10 km outdoor running performance. METHODS: Six men and six women (mean±SD: age: 27±5 years; height: 1.70±0.13 m; weight: 64.0±12.7 kg; body surface area: 1.73±0.29 m2; Σskinfolds: 107±24 mm; VO2max: 40.2±8.4 mL.kg-1.min-1) took part in five experimental trials, during each of which they wore: 1) no T-shirt (CON); 2) white polyester T-shirt (WP); 3) black polyester T-shirt (BP); 4) white cotton T-shirt (WC); and 5) black cotton T-shirt (BC). Average running velocity (pace) was calculated from each 2 km running time. Rectal, skin and T-shirt temperatures, heart rates and Physiological Strain Index (PSI) were measured before and after the 10 km runs and at the end of each 2 km. RESULTS: There were no differences in pace, heart rate, rectal and skin temperatures among conditions (P>0.05). PSI was higher in BC and WC conditions when compared to BP and WP conditions. T-shirt temperature was higher for the BC when compared to WP, BP and WC conditions. Rectal temperature and heart rate increased simultaneously with reduced pace throughout self-paced running (P<0.05). CONCLUSIONS: Despite fabric type T-shirt altered PSI, running performance in the 10 km run was not affected by T-shirt type or color.

Analysis of chronic physiological demand of an annual soccer season / Análise da demanda fisiológica crônica de uma temporada anual de futebol

Abstract Exercise intensity monitoring has been essential for the control and planning of sports training. Thus, the aim of the present study was to assess the chronic physiological demand of soccer players during an annual soccer season using blood biomarkers. Ten professional soccer players (21.2 ± 3.7 years) participated in this study. Blood samples were collected on the day before beginning of preseason (C1); at the end of preseason and beginning of competitive calendar (C2); and at the end of the competitive calendar. Interleukin-6 (IL-6), cortisol, testosterone, testosterone/cortisol ratio, creatine kinase and alpha-actin were evaluated. Statistical analysis was performed by using ANOVA with repeated measures and the post-hoc Tukey's test. Significance level was set at P<0.05. The results showed significant differences in the following situations: testosterone - C1 higher than C2 and C3; cortisol - C3 higher than C2; testosterone/cortisol ratio - C2 higher than C1, and C3 lower than C1 and C2; creatine kinase - C2 and C3 higher than C1; alpha-actin - C3 higher than C1. IL-6 concentrations were not different between C1, C2 and C3. It could be concluded that an annual soccer season imposes high physiological demand for professional players, since relevant changes in blood biomarkers analyzed were observed.

Resumo O monitoramento da intensidade de esforço entre atletas tem se mostrado essencial para o controle e planejamento do treinamento desportivo. Assim, o objetivo do presente estudo foi avaliar por meio de biomarcadores sanguíneos a demanda fisiológica crônica de jogadores de futebol ao longo de uma temporada anual. Dez jogadores profissionais (21,2 ± 3,7 anos) participaram desse estudo. As coletas de sangue foram realizadas no dia anterior ao início da pré-temporada (C1), ao final da pré-temporada e início das competições (C2), e ao final do ano competitivo (C3). Investigou-se as variáveis cortisol, testosterona, relação testosterona/cortisol, creatina quinase, alfa-actina e interleucina 6 (IL-6). Para a análise estatística dos dados utilizou-se ANOVA para medidas repetidas e foi adotado nível de significância de 5%. Os resultados encontrados indicaram diferenças significativas nas seguintes situações: testosterona - C1 maior do que C2 e C3; cortisol - C3 maior do que C2; relação testosterona/cortisol - C2 maior do que C1, e C3 menor do que C1 e C2; creatina quinase - C2 e C3 maior do que C1; alfa-actina - C3 maior do que C1. As concentrações de IL-6 em C1, C2 e C3 não demonstraram diferenças significativas. Pode-se concluir que uma temporada anual de futebol impõe elevada demanda fisiológica entre jogadores profissionais, uma vez que foram observadas alterações relevantes sobre os biomarcadores sanguíneos analisados.

Assessment of acute physiological demand for soccer / Avaliação da demanda fisiológica aguda no futebol

Soccer is a sport practiced worldwide, on all continents. It is considered an intermittent activity of high intensity and long duration, in which movements that require great strength and speed, such as jumps and sprints, result in high levels of muscle microtrauma, hampering athletes' training and recovery. The present study aimed to evaluate the magnitude of changes in different markers of physiological demand resulting from a soccer match in healthy individuals. Ten healthy male physical education students participated in the study and were evaluated in two matches: the semi-final and final games of the college tournament at the federal university where they studied. Blood samples were collected from each volunteer pre- and post-match. Cortisol, IL-6 and CK concentrations were increased after the match (p < 0.05). Testosterone and alpha-actin concentrations did not change. Our results indicate that changes in some of the acute response markers evaluated in players before and after competitive soccer matches provide important information for planning training or recovery, as well as nutritional strategies for improving performance.

O futebol é um esporte de abrangência mundial praticado em todos os continentes.É considerada uma atividade intermitente, de alta intensidade e longa duração, na qual as ações de grande força e velocidade como saltos e sprints implicam altos níveis de microtrauma muscular, atrapalhando o treinamento e a recuperação dos atletas. O propósito deste trabalho foi avaliar a magnitude das alterações de diferentes marcadores da demanda fisiológica em indivíduos saudáveis decorrentes de um jogo de futebol. Participaram do estudo, dez homens considerados saudáveis, estudantes de Educação Física. Os indivíduos foram avaliados em dois jogos, sendo a semifinal e a final do torneio universitário da universidade federal onde estudavam. A amostra sanguínea foi retirada de cada voluntário nos momentos pré e pós-jogo. Resultados: As concentrações de Cortisol, IL-6 e CK, apresentaram aumento pós-jogo (p<0,05). As concentrações de Testosterona e alfa-actina não se alteraram. Pode-se concluir que as alterações em parte dos marcadores das respostas agudas avaliados em jogos competitivos de futebol fornecem informações importantes para o planejamento de métodos de treinamento, recuperação ou estratégias nutricionais para o aperfeiçoamento do esporte.

The antimicrobial susceptibility, biofilm formation and genotypic profiles of Staphylococcus haemolyticus from bloodstream infections.

We analysed the antimicrobial susceptibility, biofilm formation and genotypic profiles of 27 isolates of Staphylococcus haemolyticus obtained from the blood of 19 patients admitted to a hospital in Rio de Janeiro, Brazil. Our analysis revealed a clinical significance of 36.8% and a multi-resistance rate of 92.6% among these isolates. All but one isolate carried the mecA gene. The staphylococcal cassette chromosome mec type I was the most prevalent mec element detected (67%). Nevertheless, the isolates showed clonal diversity based on pulsed-field gel electrophoresis analysis. The ability to form biofilms was detected in 66% of the isolates studied. Surprisingly, no icaAD genes were found among the biofilm-producing isolates.

First report in South America of companion animal colonization by the USA1100 clone of community-acquired meticillin-resistant Staphylococcus aureus (ST30) and by the European clone of methicillin-resistant Staphylococcus pseudintermedius (ST71).

BACKGROUND: Methicillin-resistant staphylococci can colonize and cause diseases in companion animals. Unfortunately, few molecular studies have been carried out in Brazil and other countries with the aim of characterizing these isolates. Consequently, little is known about the potential role of companion animals in transmitting these resistant bacteria to humans. In this work we searched for mecA gene among Staphylococcus isolates obtained from nasal microbiota of 130 healthy dogs and cats attended in a veterinary clinic located in the west region of Rio de Janeiro. The isolates recovered were identified to the species level and characterized using molecular tools. RESULTS: A community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) isolate related to USA1100 (Southwest Pacific clone) and susceptible to all non-ß-lactams was detected in a cat (1.7%, 1/60). Another coagulase-positive isolate harboring mecA was recovered from a dog (1.4%, 1/70) and identified as Staphylococcus pseudintermedius (MRSP) related to the European clone (ST71). The two isolates of Staphylococcus conhii subsp. urealyticus (1.4%, 1/70 dogs and 1.7%, 1/60 cats), similarly to the MRSP isolate, also presented high-level multiresistance. The majority of the methicillin-resistant coagulase-negative staphylococci recovered were Staphylococcus saprophyticus (5.7%, 4/70 dogs and 6.7%, 4/60 cats) and all clustered into the same PFGE type. CONCLUSIONS: This work demonstrates that mecA-harboring Staphylococcus isolates are common members of the nasal microbiota of the healthy companion animals studied (9.2%, 12/130 animals), including some high-level multiresistant isolates of S. pseudintermedius and S. conhii subsp. urealyticus. The detection, for the first time in South America, of USA1100-related CA-MRSA and of ST71 MRSP (European clone), colonizing companion animals, is of concern. Both S. pseudintermedius and S. aureus are important agents of infections for animals. The USA1100 CA-MRSA is a causative of severe and disseminated diseases in healthy children and adults. Additionally, MRSP is a nosocomial pathogen in veterinarian settings. It had already been demonstrated that the virulent ST71 MRSP is geographically spread over Europe and USA, with potential for zoonotic infections.

Desfechos hospitalares em pacientes submetidos a intervenção coronária percutânea primária versus de resgate / In-hospital outcomes on patients submitted to primary versus rescue percutaneous coronary intervention

INTRODUÇÃO: Dificuldades de acesso em tempo hábil a centros que oferecem intervenção coronária percutânea (ICP) primária fazem com que a trombólise química seja a modalidade de reperfusão predominante em pacientes com infarto com supradesnivelamento do segmento ST (IAMCSST) no Brasil. Nesse cenário, a ICP de resgate torna-se importante opção para pacientes com insucesso na reperfusão. Comparamos os desfechos hospitalares dessas duas modalidades de ICP no IAMCSST. MÉTODOS: Entre agosto de 2006 e outubro de 2012, pacientes consecutivos do Registro Angiocardio, com IAMCSST, foram submetidos a ICP primária ou de resgate. Foi comparada a incidência de eventos cardíacos e cerebrovasculares adversos maiores (ECCAM) hospitalares. RESULTADOS: Avaliamos 801 pacientes submetidos a ICP primária (n = 599) ou a ICP de resgate (n = 202). No grupo ICP de resgate foi observada menor frequência de trombos, oclusões totais, fluxo TIMI 0/1 pré-procedimento e presença de circulação colateral. O emprego de stents foi similar, assim como a taxa de sucesso do procedimento (91,7% vs. 90,6%; P = 0,75). A incidência de ECCAM (6,3% vs. 6,9%; P = 0,89), óbito (4% vs. 4%; P > 0,99), acidente vascular cerebral (0,3% vs. 0; P = 0,99) e reinfarto (2,7% vs. 3%; P > 0,99) não diferiu entre os grupos. Na análise multivariada, dislipidemia [odds ratio (OR) 2,190, intervalo de confiança de 95% (IC 95%) 1,14-4,16; P = 0,01], classe funcional Killip III ou IV (OR 7,494, IC 95% 3,90-14,31; P < 0,01) e lesões com calcificação moderada/acentuada (OR 2,852, IC 95% 1,39-5,62; P < 0,01) foram as variáveis que melhor explicaram os ECCAM hospitalares. CONCLUSÕES: Neste registro contemporâneo, a ICP de resgate obteve resultados hospitalares similares aos da ICP primária.

BACKGROUND: Difficulties to reach centers that offer primary percutaneous coronary intervention (PCI) in a timely manner turn intravenous thrombolysis into the predominant reperfusion mode in patients with ST segment elevation myocardial infarction (STEMI) in Brazil. In this scenario, rescue PCI becomes an important therapeutic option for patients who fail reperfusion. We have compared hospital outcomes of these two PCI modalities in STEMI. METHODS: Between August 2006 to October 2012, consecutive patients with STEMI enrolled in the Angiocardio Registry were submitted to primary or rescue PCI. The incidence of in-hospital major adverse cardiac and cerebrovascular events (MACCE) was compared. RESULTS: We evaluated 801 patients undergoing primary (n = 599) or rescue PCI (n = 202). In the rescue PCI group a lower frequency of thrombi, total occlusions, pre-procedure TIMI 0/1 flow and angiographically detectable collaterals was observed. The use of stents was similar, as well as the procedure success rates (91.7% vs 90.6%; P = 0.75). The incidence of MACCE (6.3% vs 6.9%; P = 0.89), death (4% vs 4%; P > 0.99), stroke (0.3% vs 0; P = 0.99) and reinfarction (2.7% vs 3%; P > 0.99) was not different between groups. In the multivariate analysis, the presence of dyslipidemia [odds ratio (OR) 2.190, 95% confidence interval (95% CI) 1.14-4.16; P = 0.01], Killip class III or IV (OR 7.494, 95% CI 3.90-14.31; P < 0.01) and lesions with moderate/severe calcification (OR 2.852, 95% CI 1.39-5.62; P < 0.01), were the variables that best explained in-hospital MACCE. CONCLUSIONS: In this contemporary registry, rescue and primary PCI had similar in-hospital results.