Age affects exercise-induced improvements in heart rate response to exercise.

The aim of the present study was to analyze the effects of age on cardiorespiratory fitness (CRF), muscle strength and heart rate (HR) response to exercise adaptation in women in response to a long-term twice-weekly combined aerobic and resistance exercise program. 85 sedentary women, divided into young (YG; n=22, 30.3 ± 6.2 years), early middle-aged (EMG; n=28, 44.1 ± 2.5 years), late middle-aged (LMG; n=20, 56.7 ± 3.5 years) and older (OG; n=15, 71.4 ± 6.9 years) groups, had their CRF, muscle strength (1-repetition maximum test) and HR response to exercise (graded exercise test) measured before and after 12 months of combined exercise training. Exercise training improved CRF and muscle strength in all age groups (P<0.05), and no significant differences were observed between groups. Exercise training also improved resting HR and recovery HR in YG and EMG (P<0.05), but not in LMG and OG. Maximal HR did not change in any group. Combined aerobic and resistance training at a frequency of 2 days/week improves CRF and muscle strength throughout the lifespan. However, exercise-induced improvements in the HR recovery response to exercise may be impaired in late middle-aged and older women.

Low levels of realized seed and pollen gene flow and strong spatial genetic structure in a small, isolated and fragmented population of the tropical tree Copaifera langsdorffii Desf.

Over the past century, the Brazilian Atlantic forest has been reduced to small, isolated fragments of forest. Reproductive isolation theories predict a loss of genetic diversity and increases in inbreeding and spatial genetic structure (SGS) in such populations. We analysed eight microsatellite loci to investigate the pollen and seed dispersal patterns, genetic diversity, inbreeding and SGS of the tropical tree Copaifera langsdorffii in a small (4.8 ha), isolated population. All 112 adult trees and 128 seedlings found in the stand were sampled, mapped and genotyped. Seedlings had significantly lower levels of genetic diversity (A=16.5±0.45, mean±95% s.e.; H(e)=0.838±0.006) than did adult trees (A=23.2±0.81; H(e)=0.893±0.030). Parentage analysis did not indicate any seed immigration (m(seeds)=0) and the pollen immigration rate was very low (m(pollen)=0.047). The average distance of realized pollen dispersal within the stand was 94 m, with 81% of the pollen travelling <150 m. A significant negative correlation was found between the frequency and distance of pollen dispersal (r=-0.79, P<0.01), indicating that short-distance pollinations were more frequent. A significant SGS for both adults (∼50 m) and seedlings (∼20 m) was also found, indicating that most of the seeds were dispersed over short distances. The results suggested that the spatial isolation of populations by habitat fragmentation can restrict seed and pollen gene flow, increase SGS and affect the genetic diversity of future generations.

Preliminary results on the effects of grape (Vitis vinifera) seed condensed tannins on in vitro intestinal digestibility of the lupin (Lupinus angustifolius) seed protein fraction in small ruminants.

Condensed tannins (CT) from grape seeds (Vitis vinifera L.) were added to complex the protein fraction of Lupinus angustifolius seeds. Three CT/protein ratios were used: 96 mg/g (T(1)), 180 mg/g (T(2)) and 0 mg/g (T(0)). The CP losses in the rumen were assessed by the nylon-bag technique and CP intestinal digestibility (CPID) was estimated using an in vitro assay applying a three-step procedure: samples were subject to rumen degradation (in situ, 16 h) and the remaining residues were subject to the digestive enzymes of the abomasum and pancreas in vitro. A positive effect (p < 0.05) of the level of CT on the immediately soluble faction a and the insoluble degradable fraction b was observed between T(0) and T(2) . In the presence of CT the rumen degradation rate was reduced (p < 0.05) from 0.0763/h (T(0)) to 0.0443/h (T(2)). The application of CT showed a reduction (around 10% for T(1)) of effective rumen CP degradability. The CPID did not seem to be affected (p > 0.05) by the presence of CT. These findings suggest that the use of grape seed CT might have the potential to improve the efficiency of utilisation of the protein fraction from lupin seeds.

Improved function and strength in patients with knee osteoarthritis as a result of adding a two-day educational program to usual care. Prospective randomized trial.

Objective: The primary aim was to quantify the improvements on function and pain of patients with knee osteoarthritis (KOA), short education and low income by a two-day self-management program. Secondary aims were verifying if the program improves clinically relevant measures of weight and strength. Design: A prospective randomized clinical trial was conducted in a tertiary hospital in Brazil with 191 patients with Kellgren & Lawrence grades II and III KOA who were allocated to two groups: control (usual care- CG) and intervention (usual care and two days of an OA self-management program with a multiprofessional team - IG). Western Ontario and McMaster Universities Index (WOMAC), weight, body mass index (BMI), Timed up and go (TUG) and five Times Sit to Stand Test (FTSST) were assessed at baseline, six, 12 and 24 months. Results: Groups were similar at baseline (p â€‹> â€‹0.05). Both groups exhibited improved WOMAC total and subsets scores throughout the study (p â€‹< â€‹0.001). However, only IG improved WOMAC total and subsets in all follow-ups above 20% (minimally clinically important difference), with differences in WOMAC pain, function and total scores (p â€‹= â€‹0.001, p â€‹< â€‹0.001, and p â€‹< â€‹0.001, respectively) and best effect sizes at 1 year (0.355, 0.651 and 0.770, respectively). IG group lost weight (p â€‹< â€‹0.001) and BMI (p â€‹< â€‹0.01). Both groups exhibited improvements in TUG and FTSST (p â€‹< â€‹0.001) that remained in all evaluations. FTSST results favored the IG, p â€‹= â€‹0.032. Conclusions: An educational program to patients with KOA, short schooling and low income improves clinically important measures of pain and function.

Severe asthma in obese patients: Improvement of lung function after treatment with omalizumab.

INTRODUCTION: Asthma and obesity have a considerable impact on public health and their prevalence is increasing. Obesity is a known risk factor for asthma and can make it more difficult to control. Omalizumab is recommended in patients with severe allergic persistent asthma. The aim of this study was to assess the impact of omalizumab treatment in obese asthmatic patients with poorly controlled severe persistent asthma. METHODOLOGY: A non-interventional, prospective study was conducted, in an outpatient asthma clinic. All patients with severe asthma who started treatment with omalizumab were included and followed over 12 months. The study population was divided into two groups (obese and non-obese) for statistical analysis (descriptive and comparative analysis). RESULTS: Thirty-two patients (19 obese) were followed. After 12 months of omalizumab treatment, there was a statistically significant improvement in body mass index, number of exacerbations in the previous year, rescue medication, disease control and lung function, in the whole population. At the end of the study obese patients had a significantly better lung function (FEV1) than non-obese. DISCUSSION: As described in the literature, there was a significant reduction in the number of exacerbations in the previous year, rescue medication and better disease control, in the whole population. In relation to lung function, about which published data are inconsistent, treatment with omalizumab significantly improved it in obese patients. CONCLUSION: Our study showed that omalizumab significantly improved asthma control, reduced rescue medication and asthma exacerbations in all the population; and for the first time showed that obese patients achieved significantly improved lung function.

Suckling-induced Fos activation and melanin-concentrating hormone immunoreactivity during late lactation.

AIMS: Melanin-concentrating hormone (MCH) is implicated in the control of food intake, body weight regulation and energy homeostasis. Lactation is an important physiological model to study the hypothalamic integration of peripheral sensory signals, such as suckling stimuli and those related to energy balance. MCH can be detected in the medial preoptic area (MPOA), especially around the 19th day of lactation, when this hormone is described as displaying a peak synthesis followed by a decrease after weaning. The physiological significance of this phenomenon is unclear. Therefore, we aimed to investigate hypothalamic changes associated to sensory stimulation by the litter, in special its influence over MCH synthesis. MAIN METHODS: Female Wistar rats (n=56) were euthanized everyday from lactation days 15-21, with or without suckling stimulus (WS and NS groups, respectively). MCH and Fos immunoreactivity were evaluated in the MPOA and lateral and incerto-hypothalamic areas (LHA and IHy). KEY FINDINGS: Suckling stimulus induced Fos synthesis in all regions studied. An increase on the number of suckling-induced Fos-ir neurons could be detected in the LHA after the 18th day. Conversely, the amount of MCH decreased in the MPOA from days 15-21, independent of suckling stimulation. No colocalization between MCH and Fos could be detected in any region analyzed. SIGNIFICANCE: Suckling stimulus is capable of stimulating hypothalamic regions not linked to maternal behavior, possibly to mediate energy balance aspects of lactation. Although dams are hyperphagic before weaning, this behavioral change does not appear to be mediated by MCH.

Pathophysiological, cardiovascular and neuroendocrine changes in hypertensive patients during the hemodialysis session.

The pathophysiological mechanisms of arterial hypertension during hemodialysis (HD) in patients with end-stage renal disease (ESRD) are still poorly understood. The aim of this study is to investigate physiological, cardiovascular and neuroendocrine changes in patients with ESRD and its correlation with changes in blood pressure (BP) during the HD session. The present study included 21 patients with ESRD undergoing chronic HD treatment. Group A (study) consisted of patients who had BP increase and group B (control) consisted of those who had BP reduction during HD session. Echocardiograms were performed during the HD session to evaluate cardiac output (CO) and systemic vascular resistance (SVR). Before and after the HD session, blood samples were collected to measure brain natriuretic peptide (BNP), catecholamines, endothelin-1 (ET-1), nitric oxide (NO), electrolytes, hematocrit, albumin and nitrogen substances. The mean age of the studied patients was 43 ± 4.9 years, and 54.6% were males. SVR significantly increased in group A (P<0.001). There were no differences in the values of BNP, NO, adrenalin, dopamin and noradrenalin, before and after dialysis, between the two groups. The mean value of ET-1, post HD, was 25.9 pg ml(-1) in group A and 13.3 pg ml(-1) in group B (P = < 0.001). Patients with ESRD showed different hemodynamic patterns during the HD session, with significant BP increase in group A, caused by an increase in SVR possibly due to endothelial dysfunction, evidenced by an increase in serum ET-1 levels.

Postoperative irradiation of primary or recurrent pterygium: results and sequelae.

PURPOSE: To evaluate the efficacy of postoperative beta irradiation and to analyze treatment sequelae in patients with primary and recurrent pterygium. METHODS AND MATERIALS: From June 1986 to June 1998, 94 patients corresponding to 100 eyes received postoperative beta irradiation. Two groups of patients were treated: 37 eyes with primary pterygium (Group I) and 63 eyes with recurrent pterygium (Group II). Terson technique surgery was used in the majority of patients. Time between surgery and beta irradiation ranged from 2 to 48 h. Radiation doses and fractionation consisted of 30 Gy/3 fractions/5 days in 17 cases, 60 Gy/6 fractions/6 weeks in 80 cases, and 20 Gy/1 fraction in 3 patients. RESULTS: Fourteen of the 100 cases (14%) treated with surgery and adjuvant irradiation recurred. The overall crude local recurrence rates were 5.4% for Group I and 19% for Group II patients. The 5-year probability of local tumor control was 83.5% for the whole group of patients, 94% for Group I, and 76.9% for Group II (p = 0.04). The early sequelae related to surgery or irradiation were self limited and disappeared by 6 months after the end of the treatment: ocular irritation (14 cases), scleral atrophy (5 cases), and neovascularization (7 cases). A greater incidence of sequelae was observed in Group II patients, but the difference between the groups was not statistically significant (p = 0.15). No significant correlation between treatment sequelae and treatment dose was noted: 29% sequelae with 30 Gy vs. 18.7% sequelae with 60 Gy (p = 0.32). No late complications have been observed. CONCLUSION: Adjuvant beta irradiation provides effective therapy for primary pterygium, is somewhate less effective in patients with recurrent pterygium, and is associated with a moderate rate of early and transient sequelae.

True agonadism: report of a case analyzed with Y-specific DNA probes.

We report on a 5-year-old girl with a male karyotype (46,XY), severe psychomotor and physical retardation, minor anomalies, and female external genitalia with a blindly ending vagina. She has normal adrenal function, prepubertal serum gonadotropin and testosterone levels, which did not rise after hCG stimulation. On abdominal exploration no gonads were found, and only mesonephric and Müllerian remnants. She was HY positive, and no deletion was detected in the Y chromosome using 5 different probes. Although a genetic defect is not excluded, pregnancy complications suggest an environmental insult to the developing testes.

Hereditary angioedema presenting with adult respiratory distress syndrome.

Adult respiratory distress syndrome (ARDS) could be related to upper airway obstruction. Mechanical obstruction and complement activation could lead to ARDS development. We describe a patient with hereditary angioedema, laryngeal edema, and ARDS.

Squamous cell carcinoma of the breast.

Squamous carcinoma of the breast (SCB) is a rare entity. For its diagnosis, the exclusion of squamous cell carcinoma of local cutaneous structures and metastasis of distant squamous carcinoma are mandatory. The aim was to retrospectively evaluate the prevalence, epidemiological and clinical characteristics of the cases of SCB, studied in our institution, between January 1985 and December 1996. The diagnosis was histopathological. We studied the patients' demographic data and tumour characteristics. In the 11-year study period, 5791 patients with breast carcinoma were admitted to our Institution, seven (0.1%) of which were SCB. All seven patients were female and Caucasian. Their average age was 63 years (range 24-82). The presentation was always a breast lump. Five patients were in Stage II-A and two in Stage II-B. All tumours were hormone-receptor negative. The initial treatment was surgery and four patients received adjuvant radiotherapy. The median follow-up was 64 months. No relapses were diagnosed. SCB is a rare entity. The initial therapeutic approach should be surgical. There is still no consensus regarding adjuvant therapy. The prognosis of this type of breast cancer is still the subject of controversy with some series, including the present study, suggesting an indolent clinical course and a relatively good prognosis.

Effect of pelleted feed on the incidence of ascites in broilers reared at low altitudes.

A study was conducted to investigate whether the use of pelleted feeds might influence the incidence of ascites in broilers reared at low altitudes (730 meters above sea level). In two trials carried out under commercial conditions, broilers were fed practical-type rations from 1 day to 7 weeks of age, in either mash or pellet form. In both trials, low incidences of ascites (less than 5%) were recorded for broilers receiving feed as pellets. No cases of the syndrome were observed in birds fed mash, either in the field or at the processing plant. These data suggest that the positive relationship between pelleted feeds and incidence of ascites observed at high altitudes also exists at lower elevations.

A survey of sensitivity to anticoccidial drugs in 60 isolates of coccidia from broiler chickens in Brazil and Argentina.

Coccidia were isolated from 90 broiler farms in 15 poultry-producing areas in Brazil and Argentina. Sixty isolates were tested for sensitivity to 7 anticoccidial drugs. The common species were: a) Eimeria tenella, 47 isolates; b) E. maxima, 49 isolates; c) E. acervulina, 44 isolates; d) E. mitis, 26 isolates; and e) E. brunetti, 12 isolates. Isolates were considered sensitive to drugs if intestinal lesion scores of medicated broilers were reduced by at least 50% compared with unmedicated infected broilers or if weight gain was at least 75% of that of uninfected birds in a 6-day laboratory test. According to lesion scores, there was evidence of resistance or seriously reduced sensitivity to monensin in 20 isolates, narasin in 29, salinomycin in 11, maduramicin in 1, clopidol in 36, amprolium in 40, and nicarbazin in 1. According to broiler weight gain, there was resistance to monensin in 36 isolates, narasin in 32, salinomycin in 28, maduramicin in 2, clopidol in 28, amprolium in 50, and nicarbazin in 4. These results suggested incomplete cross resistance of coccidia to polyether ionophorous drugs. The degree of resistance might be explained by previous patterns of use of these drugs.

[Distribution of Aedes aegypti and dengue in the State of Maranhão, Brazil]. / Distribuição do Aedes aegypti e do dengue no Estado do Maranhão - Brasil.

Dengue and Aedes aegypti are widespread in the State of Maranhão. During 1995, 87 of the 136 of the State's counties, including 176 towns and 480,687 households, were studied, of which 30 counties (34. 4%), 118 towns (67.0%) and 10,357 households (2.1%) were positive for Aedes aegypti. The positive counties are distributed as follow: 3 on São Luís Island, 7 in the Amazonia of Maranhão, 12 in the southern zone of the cerrados or savannas, and 5 in the mixed forest/savanna/palm grove zone. One positive county for Ae. aegypti was located in each of the following: alluvial fields, forest/palm grove, and sand dune/shoals areas. The Ae. aegypti-positive household rates were higher in the Amazonia of Maranhão (3.5%) and on São Luís Island (2.5%), because they are the most heavily traveled migratory and trade routes between Maranhão and neighboring states and are also the State's main economic centers. Household infestation rates for Ae. aegypti and reported dengue case rates were higher during the rainy season, showing the importance of rain in forming prime breeding sites for Aedes and spreading dengue.

[Liver abscess in childhood: report of 8 cases]. / Abscesso hepático na infância: relato de oito casos.

The authors present eight cases of children with liver abscess diagnosed in the Pediatric Nursery of the "Hospital das Clínicas", State University of Campinas, SP, Brazil, during eight years. Five children were younger than five years. They were four boys and four girls. The symptomatology was inespecific. Staphylococcus aureus was the more frequent etiologic agent and in two cases it was seen Ascaris lumbricoides worm inside the abscess. The findings of ultrasound and computadorized tomography were similar. In most cases, were employed the association of broad spectrum antibiotics and percutaneous draining, and a good clinical outcome was observed in all patients.

[Cholelithiasis in chronic Chageas' disease patients]. / Colelitíase em chagásicos crônicos.

The studies on the occurrence of biliary lithiasis in patients with chronic Chagas' disease have shown conflicting results. Aiming at contributing to a better understanding of the topic was assessed, by ultrasonographic scan, the frequency of Colelithiasis in chagasic patients with different anatomo-clinical forms of the disease. A total of 128 patients were studied, 85 males (mean age: 53 +/- 13 years) and 43 females (mean age: 53 +/_ 10 years) nineteen males and 18 females had the cardiac form ; 32 males and 19 females the digestive form; 20 males and 3 females the cardiac and digestive forms simultaneously; and 14 males and 3 females the indeterminate form. Controls were a series of 1139 individuals without Chagas' disease, 716 males and 423 females (mean age 46 +/_ 14 years for both sexes), who were submitted to postmortem examination. The frequency of cholelithiasis in chagasic males (14.1%) was significantly higher than in the controls (6%); by subgroup, it was significantly higher in the individuals with the cardiac and cardiac-digestive form (26.3% and 20% respectively), but not in those with the digestive form (9.4%). The frequency of colelithiasis was also significantly higher in chagasic females in the total (42%) and in the cardiac (50%) and digestive (31.6%) forms, when compared to the control group (14%). Male and female chronic chagasic patients have an increased frequency of colelithiasis, and therefore the preoccupation about this finding should not be restricted to the digestive form of the disease, as previous studies on this subject have suggested.

Hatchery waste: nutritional evaluation of non-hatched eggs.

Hen's non-hatched eggs were processed by boiling for 30 minutes, milling in a meat grinder, and drying at 60 degrees C with continuous ventilation. The product contained 36% of protein, 27% of ether extract, 17% of ash, 10% of calcium, and 0.6% of phosphorus. The quality of the protein was comparable to that of a reference casein and of fresh egg meal, as determined by protein efficiency ratio and apparent net protein utilization.

Meningoencephalic herniation into the middle ear.

Meningoencephalic herniation into the middle ear (MHME) is a rare condition. It can result from ear surgery, infection, head trauma or can be spontaneous. Diagnosis requires a high degree of clinical suspicion. The presentation may suggest the condition, but sometimes the intraoperative discovery of an occult meningoencephalic herniation may be a frightening situation. Treatment planning must avoid intra-cranial complications. Transmastoid (TM) and middle cranial fossa (MCF) are alternative or complementary approaches, determined by several factors, including the size and the site of the bony defect and the presence or absence of middle ear infection. Three case reports are presented and a review of the literature is performed, to explain some aspects related to MHME, including aetiopathogenesis, clinical presentation, histopathology, diagnosis and treatment.

[Wilm's tumor in children: review of 38 cases]. / Tumor de Wilms' na criança: revisão de 38 casos.

Analysis of the incidence of the Nephroblastoma and of its clinic, echographic and radiologic aspects. Review of 38 cases handled in the Pediatric Surgery Service of Santa Maria Hospital between January 1960 and January 1987. In addition to the distribution by age and stadiation, the results were studied in 3 groupings corresponding to successive therapeutic phases along this period. The survival is more favourable in the etary group under 3 years old and does not differ substantially in stages I and II. In the analysis of the prognostic to the therapeutic sequences, there was an evident improvement of survival from 0% before 1966 (Surgery and Radiotherapy) to 46.15% in the second phase, 1966-76, with the introduction of Chemotherapy (Actinomycina D). In the last phase after 1977, using the therapeutic scheme of National Wilms Tumour Study (NWTS) survival reached 80.95%. Trying to correlate the prognostic with the histologic type, it turns out to be difficult to make a criterious characterization in the cases submitted to pre-operative Radio and/or Chemotherapy. The advantage of this therapeutic attitude in parallel with the faulaification of the histologic type and the Tumour stadiation is hereby discussed.

Genetic relationships of the Portuguese Lidia bovine populations.

To clarify the genetic relationships among the Lidia breed lineages and two main Portuguese Lidia bovine populations, Casta Portuguesa and Brava dos Açores, 24 autosomal microsatellites were analyzed in 120 samples. Brava dos Açores showed the highest observed and expected heterozygosity (0.73 and 0.70, respectively) while Casta Portuguesa showed the lowest observed and expected heterozygosity (0.51 and 0.50, respectively). The results of this study were compared with the previous microsatellites data from the main Lidia bovine lineages. Casta Portuguesa was the most genetically isolated Lidia bovine population as revealed by the average FST genetic distance value with respect to the other lineages (32%). All the populations of Portuguese Lidia had negative FIS values. The Neighbour-joining dendrogram grouped Casta Portuguesa in the same branch with Miura, which was supported by the STRUCTURE software. The results evidenced low levels of genetic diversity and high levels of genetic differentiation in Casta Portuguesa and high levels of genetic diversity in Brava dos Açores populations, probably due to the crossbreeding of different bovine lineages at origin, and genetic flow among herds.