Effectiveness of neuromuscular electrical stimulation training combined with exercise on patient-reported outcomes measures in people with knee osteoarthritis: A systematic review and meta-analysis.

OBJECTIVE: This study examined the effectiveness of neuromuscular electrical stimulation (NMES) added to the exercise or superimposed on voluntary contractions on patient-reported outcomes measures (PROMs) in people with knee osteoarthritis (OA). METHODS: This systematic review was described according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Randomized controlled trials (RCTs) were obtained from a systematic literature search in five electronic databases (PubMed, PEDro, LILACS, EMBASE, and SPORTDiscus) in April 2022. We described the effects of intervention according to each PROMs (scores for Pain; Self-reported functional ability; Symptoms (hear clicking, swelling, catching, restricted range of motion, and stiffness); Daily living function; Sports function; and Quality of life) and used a random-effect model to examine the impact of NMES plus exercise on pain compared with exercise in people with knee OA. RESULTS: Six RCTs (n = 367) were included. In the qualitative synthesis, the systematic literature analysis showed improvement in pain after NMES plus exercise compared with exercise alone in three studies. The other three studies revealed no difference between groups in pain, although similar improvement after treatments. In the meta-analysis, NMES at a specific joint angle combined with exercise was not superior to exercise alone in pain management (standardized mean difference = -0.33, 95% CI = -1.05 to 0.39, p = 0.37). There was no additional effect of NMES on exercise on self-reported functional ability, stiffness, and physical function compared with exercise alone. In only one study, symptoms, activities of daily living, sports function, and quality of life improved after whole-body electrostimulation combined with exercise. CONCLUSION: This review found insufficient evidence for the effectiveness of NMES combined with exercise in treating knee OA considering PROMs. While pain relief was observed in some studies, more high-quality clinical trials are needed to support the use of NMES added to the exercise in clinical practice. Electrical stimulation in a whole-body configuration combined with exercise shows promise as an alternative treatment option.

Effects of Urtica urens in the Feed of Broilers on Performances, Digestibility, Carcass Characteristics and Blood Parameters.

With the aim of improving animal health and productivity, plants or plant extracts that have antimicrobial, antifungal and antioxidant properties are often used in studies with broilers. The aim of this work was to investigate the effect of Urtica urens in broilers. Ninety male Ross chicks were used, randomly placed in 30 pens (three broilers per pen). The broilers were assigned to three treatment groups: group CT (control) received a basal diet; group UU1 received a basal diet with 1% dried Urtica urens; and group UU2 received a basal diet with 2% dried Urtica urens. Each treatment consisted of two feeds, distributed from day 1 to 15 (starter) and from day 15 to 36 (grower). As a result of this study, broilers in the UU1 treatment group had higher weight on day 15 (p = 0.029) and day 36 (p = 0.014) than those in treatments CT and UU2 and a higher daily weight gain between days 1 and 15 (p = 0.028) and days 1 and 36 (p = 0.014). Broilers in the UU1 and UU2 groups had lower serum HDL cholesterol (88.8 and 88.9 mg/dL, respectively) than the CT (96.1 mg/dL). In conclusion, the use of dried Urtica urens at 1% as an additive in broiler diets may affect growth performance and blood HDL cholesterol.

Insights from the yield, protein production, and detailed alkaloid composition of white (Lupinus albus), narrow-leafed (Lupinus angustifolius), and yellow (Lupinus luteus) lupin cultivars in the Mediterranean region.

Introduction: Lupins and other legumes have been considered as alternative plant-based protein sources to soybeans for both humans and livestock. Furthermore, they can contribute to more sustainable agricultural systems. The productivity and chemical composition of legumes is highly variable between species, cultivars, and with the edaphoclimatic conditions. Methods: This work evaluated the adaptability of seven Lupinus cultivars in two different sowing locations, during two consecutive years, through the characterization of their seed, as a means of investigating their suitability to be used as a source of food and/or feed. Results and discussion: Lupinus angustifolius cv. Tango and Lupinus luteus cv. Acos were the most stable genotypes across the environments when considering the seed and protein production, while L. luteus cv. Alburquerque and L. luteus cv. Mister showed less variation in the total alkaloid content across the environments. The edaphoclimatic conditions affected seed and protein yields, as higher rainfall resulted in high productivity. The lower temperatures observed in the first year at both locations caused a reduction in the production of alkaloids in L. luteus cv. Acos and Cardiga. Due to the high alkaloid content of some of the studied cultivars their use as food or feed can pose some safety concerns. However, these cultivars can have high levels of resistance to herbivore and insect attacks, which can be of the utmost importance for the use of these crops for recovering poor or exhausted soils.

Effect of Total Replacement of Soya Bean Meal by Whole Lupine Seeds and of Gender on the Meat Quality and Fatty Acids Profile of Growing Rabbits.

In Europe, the most appropriate strategy to replace soybean meal (SBM) in animal feed has been the development of diets containing locally produced protein sources. One of these sources is lupine (Lupinus spp.). The effect of the total substitution of SBM by white lupine (WL) and yellow lupine (YL) seeds in the diets of growing rabbits and of gender on meat quality and the fatty acids (FA) profile were evaluated. Sixty hybrid weaned rabbits (New Zealand × Californian) (20 rabbits per diet), were fed diets that contained 150 g/kg of SBM (SBMD) and WL (WLD) or YL (YLD) for 35 to 69 days. At the end of this period, 30 rabbits (10 rabbits per diet) were slaughtered to evaluate the carcass and meat characteristics and the FA profile of the longissimus dorsi (LD) muscle. In general, the carcass and meat characteristics (pH and colour) were not affected (p > 0.05) by diet or gender. Further, there was no observed effect (p > 0.05) of gender on meat FA and on the calculated indexes related to human health. However, diet had an effect (p < 0.05) on the FA profile, FA categories, and calculated indexes related to human health. The meat from rabbits fed SBMD presented higher (p < 0.05) saturated FA (SFA; 44 vs. 39 g/100 g average on lupine diets) and lower (p < 0.05) polyunsaturated FA (PUFA; 24 vs. 28 g/100 g average on lupine diets). Our results showed that SBM may be completely replaced by WL or YL, improving the quality of LD muscle FA in terms of nutritional quality for humans.

Decontamination of wastewater containing contaminants of emerging concern by electrooxidation and Fenton-based processes - A review on the relevance of materials and methods.

In recent years, there has been an increasingly growing interest regarding the use of electrochemical advanced oxidation processes (EAOPs) which are considered highly promising alternative treatment techniques for addressing environmental issues related to pollutants of emerging concern. In EAOPs, electrogenerated oxidizing agents, such as hydroxyl radical (HO•), can react non-selectively with a wide range of organic compounds, degrading and mineralizing their structures to unharmful molecules like CO2, H2O, and inorganic ions. To this date, a broad spectrum of advanced electrocatalysts have been developed and applied for the treatment of compounds of interest in different matrices, specifically aiming at enhancing the degradation performance. New combined methods have also been employed as alternative treatment techniques targeted at circumventing the major obstacles encountered in Fenton-based processes, such as high costs and energy consumption, which still contribute significantly toward inhibiting the large-scale application of these processes. First, some fundamental aspects of EAOPs will be presented. Further, we will provide an overview of electrode materials which have been recently developed and reported in the literature, highlighting different anode and cathode structures employed in EAOPs, their main advantages and disadvantages, as well as their contribution to the performance of the treatment processes. The influence of operating parameters, such as initial concentrations, pH effect, temperature, supporting electrolyte, and radiation source, on the treatment processes were also studied. Finally, hybrid techniques which have been reported in the literature and critically assess the most recent techniques used for evaluating the degradation efficiency of the treatment processes.

Can the Introduction of Different Olive Cakes Affect the Carcass, Meat and Fat Quality of Bísaro Pork?

The present study aimed to evaluate the effect of the inclusion of different olive cakes in the diet of Bísaro pigs on the carcass, meat and fat. The carcasses of 40 animals fed a diet with five treatments (T1­Basic diet and commercial feed; T2­Basic diet + 10% crude olive cake; T3­Basic diet + 10% olive cake, two phases; T4­Basic diet + 10% exhausted olive cake; T5­Basic diet + 10% exhausted olive cake + 1% olive oil) were used to study the effect on carcass traits, physicochemical meat quality and lipid composition of meat and backfat. There were no significant differences between treatments for the conformation measurements performed, except for the length at the seventh and last rib (p < 0.05). The percentage of prime cuts of the carcass in Bísaro pig is within the values indicated by the Portuguese Standard 2931. No significant differences between treatments for body weight, pH and carcass weight were found. The values of ultimate pH (5.7), L* (51−52), b* (11−12) and SF (3.4−4.2) observed confirm a non-exudative and firm meat without quality deviations, such as DFD or PSE. Thus, as a general conclusion, the inclusion of different olive cakes in the diet of Bísaro pigs did not cause any negative consequences on the carcass characteristics and conformation as well as in the meat and lipidic quality. In addition, the inclusion of this olive industry by-product in the animal diet would be an important contribution to solving the problem of the great environmental impact from olive-mill wastewaters from the extractive industries.

Effects of Dietary Incorporation of Grape Stalks Untreated and Fungi-Treated in Growing Rabbits: A Preliminary Study.

This study aimed to evaluate the effect of the incorporation of untreated grape stalks (UGS) and fungi-treated grape stalks (Lentinula edodes, TGS) in rabbits' diets. The control group was fed with a control diet without grape stalks (C), two experimental groups were fed on diets with 5% and 10% incorporation of UGS (5UGS and 10UGS), and two with 5% and 10% incorporation of TGS (5TGS and 10TGS). Rabbits fed with TGS diets showed higher daily weight gain (p = 0.034), feed conversion rate (p = 0.002), carcass weight (p = 0.038), and reference carcass weight (p = 0.03) when compared to the control diet. Moreover, animals fed with TGS diets showed an increase in the caecum (p = 0.015) and small intestine (p = 0.021) lengths and in the total volatile fatty acid content (p = 0.005) compared to animals fed UGS diets. Blood triglyceride levels were lower in animals fed with TGS diets compared to UGS (p = 0.005) and C (p ≤ 0.001) diets (12% and 19% lower, respectively), and a trend to lower cholesterol levels was observed (p = 0.071). Meat from rabbits fed with TGS diets had higher levels of linoleic acid, γ-linolenic, ∑ω-6, ∑PUFA, and ∑PUFA/∑SFA ratio compared to rabbits fed with the C diet. Results indicated that grape stalks (UGS and TGS) could be effectively used as an alternative raw material in rabbits' diets without compromising animal performance.

Post-Cardiac Arrest: Mechanisms, Management, and Future Perspectives.

Cardiac arrest is an important public health issue, with a survival rate of approximately 15 to 22%. A great proportion of these deaths occur after resuscitation due to post-cardiac arrest syndrome, which is characterized by the ischemia-reperfusion injury that affects the role body. Understanding physiopathology is mandatory to discover new treatment strategies and obtain better results. Besides improvements in cardiopulmonary resuscitation maneuvers, the great increase in survival rates observed in recent decades is due to new approaches to post-cardiac arrest care. In this review, we will discuss physiopathology, etiologies, and post-resuscitation care, emphasizing targeted temperature management, early coronary angiography, and rehabilitation.

Removal of Orange II (OII) dye by simulated solar photoelectro-Fenton and stability of WO2.72/Vulcan XC72 gas diffusion electrode.

The objectives of this study were to determine the viability of removing Orange II (OII) dye by simulated solar photoelectro-Fenton (SSPEF) and to evaluate the stability of a WO2.72/Vulcan XC72 gas diffusion electrode (GDE) and thus determine its best operating parameters. The GDE cathode was combined with a BDD anode for decolorization and mineralization of 350 mL of 0.26 mM OII by anodic oxidation with electrogenerated H2O2 (AO-H2O2), electro-Fenton (EF) and photoelectro-Fenton (PEF) at 100, 150 and 200 mA cm-2 and SSPEF at 150 mA cm-2. The GDE showed successful operation for electrogeneration, good reproducibility and low leaching of W. Decolorization and OII decay were directly proportional to the current density (j). AO-H2O2 had a reduced performance that was only half of the SSPEF, PEF and EF treatments. The mineralization efficiency was in the following order: AO-H2O2 < EF < PEF ≈ SSPEF. This showed that the GDE, BDD anode and light radiation combination was advantageous and indicated that the SSPEF process is promising with both a lower cost than using UV lamps and simulating solar photoelectro-Fenton process. The PEF process with the lowest j (100 mA cm-2) showed the best performance-mineralization current efficiency.

Encapsulated bacteriophages in alginate-nanohydroxyapatite hydrogel as a novel delivery system to prevent orthopedic implant-associated infections.

An innovative delivery system based on bacteriophages-loaded alginate-nanohydroxyapatite hydrogel was developed as a multifunctional approach for local tissue regeneration and infection prevention and control. Bacteriophages were efficiently encapsulated, without jeopardizing phage viability and functionality, nor affecting hydrogel morphology and chemical composition. Bacteriophage delivery occurred by swelling-disintegration-degradation process of the alginate structure and was influenced by environmental pH. Good tissue response was observed following the implantation of bacteriophages-loaded hydrogels, sustaining their biosafety profile. Bacteriophages-loaded hydrogels did not affect osteoblastic cells' proliferation and morphology. A strong osteogenic and mineralization response was promoted through the implantation of hydrogels system with nanohydroxyapatite. Lastly, bacteriophages-loaded hydrogel showed excellent antimicrobial activity inhibiting the attachment and colonization of multidrug-resistant E. faecalis surrounding and within femoral tissues. This new local delivery approach could be a promising approach to prevent and control bacterial contamination during implantation and bone integration.

Sternectomy for Treating Advanced Non-Melanoma Skin Cancer.

INTRODUCTION: Skin cancer is a rare indication of sternectomy. Our goal is to report the clinical course of seven patients who underwent sternectomy for skin cancer. METHODS: The survey data were collected from medical records of patients treated between 2008 and 2018 at Ceará Cancer Institute. RESULTS: All patients had prolonged sunlight exposure and average disease time of two years and age of 60 years. Most patients recovered favorably after treatment with prolonged survival. CONCLUSION: Sternectomy remains an option with curative purposes for locally advanced skin cancer.

Ammonia and greenhouse gas emissions following the application of clinoptilolite on the litter of a breeding hen house.

The husbandry of chicken for meat generates high levels of gases, being a serious problem for the health of birds and workers as well as for the environment. The aim of the present study was to assess the effect of clinoptilolite as litter additive on the concentrations and emissions of ammonia (NH3), nitrous oxide (N2O), carbon dioxide (CO2), and methane (CH4) from a breeding hen house under Mediterranean climate conditions. Two similar breeding hen houses were selected, and one house was assigned as control whereas the other house was treated with clinoptilolite as a litter additive. Data were collected during the winter season, in two occasions, first between 26 November and 18 December 2017 and second from 1 to 20 February 2018. Results showed that the application of clinoptilolite on the litter of a breeding hen house reduces the NH3 and N2O losses in 28 and 34%, respectively, but appears to have no effect on CO2 losses. In addition, the in-house CH4 concentrations were below the detection limits.

Advanced Thyroid Follicular Carcinoma in a Pregnant Woman.

The diagnostic and therapeutic approach for pregnant women with thyroid nodules can present a challenge, especially concerning surgical procedures. In the context of malignant diagnosis, by fine needle aspiration (FNA), during pregnancy, the uncertainty lies in performing surgery. This article reports the case of a 41-year-old pregnant woman in her first gestation, who sought medical care complaining of right shoulder pain. Imaging workup depicted the destruction of the humeral head and involvement of the surrounding soft tissue. She was 20 weeks pregnant. The histological report favored the diagnosis of malignancy and the thyroid as the primary site. At 30 weeks of gestation, the patient underwent a cesarean section, a total thyroidectomy, and total resection of the metastasis. The child was born healthy, but one year after the diagnosis, the patient died. Bone and soft tissue metastasis of thyroid neoplasms are not very common and indicate poor prognosis.

Potential use of cowpea (Vigna unguiculata (L.) Walp.) stover treated with white-rot fungi as rabbit feed.

BACKGROUND: Lignin inhibitory effects within the cell wall structure constitute a serious drawback in maximizing the utilization of fibrous feedstuffs in animal feeding. Therefore treatments that promote efficient delignification of these materials must be applied. This study evaluated the potential of white-rot fungi to upgrade the nutritive value of cowpea stover for rabbit feeding. RESULTS: There was an increase in the crude protein content of all substrates as a result of fungi treatments, reaching a net gain of 13% for Pleurotus citrinopileatus incubation. Overall, net losses of dry and organic matter occurred during fungi treatments. Although the fiber content remained identical, higher consumption of cell wall contents was measured for P. citrinopileatus incubation (between 40 and 45%). The incubation period did not influence lignin degradation for any of the fungi treatments. Differences within the fungal degradation mechanisms indicate that P. citrinopileatus treatment was most effective, enhancing in vitro organic matter digestibility by around 30% compared with the control. CONCLUSION: Treatment of cowpea stover with P. citrinopileatus led to an efficient delignification process which resulted in higher in vitro organic matter digestibility, showing its potential in the nutritional valorization of this feedstuff. © 2017 Society of Chemical Industry.

A novel feedstuff: ensiling of cowpea (Vigna unguiculata L.) stover and apple (Malus domestica Borkh.) mixtures. Evaluation of the nutritive value, fermentation quality and aerobic stability.

BACKGROUND: Agro-industrial by-products are of low economic value as foods for human consumption but may have potential value as animal feedstuffs. This study evaluated a novel feedstuff, ensiled discarded apple (85%) and cowpea stover (15%) mixtures with two different ensiling periods (45 and 60 days), regarding the nutritive value, fermentation quality and aerobic stability. RESULTS: Generally, no differences (P > 0.05) were observed between ensiling periods for nutritive value and fermentation characteristics. Silages were stable after ensiling, presenting high lactic acid (77.3 g kg-1 dry matter (DM)) and acetic acid (54.7 g kg-1 DM) and low ethanol (15.7 g kg-1 DM) and NH3 -N (105.6 g kg-1 total N) concentrations. No butyric acid was detected in silages, and they were aerobically stable for up to 216 h. Lactic acid bacteria numbers were high at silo opening (7.14 log colony-forming units (CFU) g-1 ), while Enterobacteriaceae were not detected and yeasts/moulds were low (2.44 log CFU g-1 ). Yeast/mould and Enterobacteriaceae numbers grew considerably during 12 days of air exposure. CONCLUSION: A mixture of low calibre discarded apples with cowpea stover can be used as animal feed after the ensiling process owing to its nutritive value and long aerobic stability. © 2017 Society of Chemical Industry.

Effects of the dietary incorporation of olive leaves on growth performance, digestibility, blood parameters and meat quality of growing pigs.

BACKGROUND: In a preliminary study the oxidative stability and tocopherol content of pork meat were shown to be improved by olive leaf (OL) feed supplementation at 50 and 100 g kg(-1) . However, growth performance was affected negatively. Therefore the objective of the present study was to assess the influence of OL supplementation at a lower level on feed digestibility, growth performance and meat quality. RESULTS: Pigs were fed a basal diet (control), a basal diet with 25 g OL kg(-1) (OL2.5) or a basal diet with 50 g OL kg(-1) (OL5). The incorporation of OL significantly decreased growth rates (P = 0.010) and backfat thickness (P = 0.035) and increased feed/gain ratio (P = 0.032) in the OL5 group. Feed/gain ratio increased more for females (P = 0.001). The incorporation of OL decreased the crude fat (P = 0.006) and protein (P = 0.037) digestibility of both OL diets. Nevertheless, OL was effective in increasing the tocopherol content of meat (P = 0.009). However, meat from pigs fed the OL diets showed similar conjugated diene content, pH and colour parameters to that from pigs fed the control diet, even after 6 days of storage at 4 °C. CONCLUSION: The data indicate that olive leaves may be included in pig diets at 25 g kg(-1) in order to improve the tocopherol content of meat without excessively compromising growth performance.

Infecção do trato urinário na gravidez: aspectos diagnósticos, terapêuticos e prognósticos / Urinary tract infection in pregnancy: diagnostic, therapeutic and prognostic aspects

Infecção do trato urinário é complicação comum na gravidez devido às mudanças anatômicas e funcionais, sendo responsável por elevado número de complicações mateno-fetais. Em decorrência de sua importância, o presente trabalho faz atualização das recentes evidências quanto ao manejo dessa afecção. Ao final do primeiro trimestre, recomenda-se a triagem para bacteriúria asintomática em todas as gestantes. Mulheres com bacteriúria assintomática ou infecção urinária sintomática durante a gravidez devem ser tratadas e submeterem-se a screenings periódicos durante toda a gestação. Os beta-lactâmicos são os antibióticos de escolha para o tratamento dessas gestantes. Evidências sugerem uso de terapia oral por três a sete dias para cistite e parenteral de 14 dias para pielonefrite. As pacientes devem realizar urocultura de controle com 48 ou 72 horas de tratamento. A profilaxia é indicada em casos especívicos em dose única pós-coital ou diariamente com cefalexina ou nitrofurantoína. O presente artigo ainda discute a conduta em situações especiais, como em pacientes com litíase renal, traço falcêmico e ureterossigmoidostomia.

Urinary tract infection is a common complication of pregnancies due to functional, anatomic and hormonal changes. Given its importance, this current article reviews the current evidence on handling of this illness. At the end of the first trimester, a screening for asymptomatic bacteriuria is recommended for all pregnant women. The ones with asymptomatic bacteriuria or symptomatic UTI during childbearing should be treated and submitted to periodical screenings during all gestation period. The beta-lactams are the antibiotics chosen for the treatment of these pregnant women. Evidence suggests the use of 3 to 7 day oral therapy against cystitis and 14 day parenteral therapy against pielonefhritis. The patients should undergo urine culture within 48 or 72 hours of treatment. The single dose prophylaxis is indicated in specific cases after coitus or on a daily basis with the prescription of cephalexin or nitrofurantoin. This article still discusses the management in special situations, such as renal lithiasis, ureterossigmoidostomy and sickling trace.