Static stretching increases muscle fatigue during submaximal sustained isometric contractions.

AIM: The purpose of this study was to examine the acute effects of a static stretching protocol on neuromuscular fatigue of the flexor carpi radialis (FC) and flexor digitorum (FD). METHODS: Twenty-six healthy and right-handed men with a mean (SD) age of 27.1 (2.9) years volunteered for this study. The fatigue test was performed before (Pre) and after three sets of 50 s stretching (Post) applied to the right hand, and twice (T1 and T2) without stretching to the left hand as a control condition. Isometric handgrip fatigue exercise was maintained for 30s within the range 50-60% of the maximal voluntary contraction. From the electromyography (EMG), root mean squares (RMS) values and mean frequency (MF) were obtained for each 2s consecutive windows of test and normalized by the MVC obtained in 6s tests. From time series, coefficients of linear regression were determined used to compare Pre with Post and T1 with T2 by paired samples t-tests. RESULTS: Higher rate of increase in EMG on Post compared to Pre was found in both FC (P=0.015) and FD (P=0.006). A higher rate of decrease of MF for FC (P=0.004) and FD (P=0.005) was observed with Post compared to Pre. Conversely, the differences between T1 and T2 were not significant (P>0.05). CONCLUSION: These findings indicate that static stretching performed immediately before submaximal isometric muscle actions may increase neuromuscular fatigue assessed by EMG, suggesting that could reduce muscle's endurance capacity.

Groundwater from infiltration galleries used for small public water supply systems: contamination with pesticides and endocrine disruptors.

Infiltration galleries are among the oldest known means used for small public water fountains. Owing to its ancestral origin they are usually associated with high quality water. Thirty-one compounds, including pesticides and estrogens from different chemical families, were analysed in waters from infiltration galleries collected in Alto Douro Demarcated Wine region (North of Portugal). A total of twelve compounds were detected in the water samples. Nine of these compounds are described as presenting evidence or potential evidence of interfering with the hormone system of humans and wildlife. Although concentrations of the target analytes were relatively low, many of them below their limit of quantification, four compounds were above quantification limit and two of them even above the legal limit of 0.1 µg/L: dimethoate (30.38 ng/L), folpet (64.35 ng/L), terbuthylazine-desethyl (22.28 to 292.36 ng/L) and terbuthylazine (22.49 to 369.33 ng/L).

Postoperative delirium in patients with history of alcohol abuse. / Delirio postoperatorio en pacientes con historial de abuso de alcohol.

INTRODUCTION: Postoperative delirium (POD) is an acute confusional state characterized by changes in consciousness and cognition, which may be fluctuating, developing in a small period of time. The aim of this study was to evaluate the relationship between alcohol abuse and the development of POD. METHODS: We prospectively evaluated consecutively all postoperative patients admitted in the Post-anesthesia Care Unit over a 1-month period for delirium, using the Portuguese versions of the the Nursing Delirium Screening Scale. Before surgery, alcohol consumption was inquired and alcohol abuse was assessed by the CAGE (Cutting Down, Annoyance, Guilt and Eye-opener) questionnaire; a score ≥2 defined alcohol abuse. Fischer exact test or chi-square was applied for comparisons. Risk factors were analyzed in a multivariate analysis using a logistic regression with odds ratios (OR) and 95% confidence intervals (95%CI). RESULTS: Two hundred twenty-one patients were enrolled. Delirium was seen in 11% patients. The incidence of alcohol abuse was 10%. Patients with alcohol abuse were more frequently men (P<.001) and had a higher ASA physical status III/IV (P=.021). POD was more frequent in patients with alcohol abuse (30% vs. 9%; P=.002). Age (OR: 5.9; 95%CI: 2.2-15.9; P<.001 for patients ≥65years), ASA physical statusIII/IV (OR: 4.2; 95%CI: 1.7-10.7; P=.002) and alcohol abuse (OR: 4.2; 95%CI: 1.4-12.9; P=.013) were found to be independent predictors for POD. CONCLUSIONS: Older patients, higher ASA physical status and alcohol abuse were more frequent in patients with POD. Alcohol abuse was considered an independent risk factor for POD.

Overall characterization of cork dust explosion.

Explosibility and ignitability studies of air/cork dust mixtures were conducted in a near-spherical 22.7 L explosibility test chamber using pyrotechnic ignitors and in a furnace of 1.23 L. The suspension dust burned as air-dispersed dust clouds and the uniformity of the dispersion inside the chamber was evaluated through optical dust probes. The range of tested particle sizes went from a mass median diameter of 47.4 to 438.3 microm and the covered dust cloud concentration was up to 700-800 g/m(3). Measured explosion parameters included minimum explosible concentration, maximum explosion pressure, maximum rate of pressure rise and minimum autoignition temperature. The effect of dust particle size on flammability was evaluated and it was found that the minimum explosible concentration is around 40 g/m(3) and it is relatively independent of particle size below 180 microm. Maximum explosion pressure of 7.2 bar and maximum rate of pressure rise of 179 bar/s were detected for the smallest tested sizes. The limitations on the rates of devolatilization of the solid particles became rate controlling at high burning velocities, at high dust loadings and for large particle sizes. The effect of initial pressure on the characteristic parameters of the explosion was studied by varying the initial absolute pressure from 0.9 bar to 2.2 bar, and it was found that as initial pressure increases, there is a proportional increase of minimum explosion limit, maximum explosion pressure, and maximum rate of pressure rise. The influence of the intensity of the ignition energy on the development of the explosion was evaluated using ignition energies of 1000 J, 2500 J and 5000 J, and the experimental data showed that the value of 2500 J is the most convenient to use in the determination of minimum explosion concentration. The behavior of the cork dust explosion in hybrid methane air mixtures was studied for atmospheres with 2% and 3.5% (v/v) of methane. The effect of methane content on the characteristic parameters of the explosions was evaluated. The conclusion is that, the hazard and explosion danger rise with the increase of methane concentration, characterized by the reduction of the minimum dust explosion concentration. The minimum autoignition temperature obtained with the thermal ignition tests was 540 degrees C and the results have shown that this value is independent of particle size, for particles with mass median diameters below 80 microm.

Influence of the drying conditions of Sargassum sp. alga on the bioadsorption of hexavalent chromium.

Industrial wastes containing synthetic organic compounds and heavy metals are among the most dangerous residues, whose growth has followed the increase in industrial activity. Heavy metals are readily assimilated into the food chain and therefore easily accumulated in the ecosystem. To remove heavy metals from aqueous solutions, marine algae may be used as adsorbents either in their natural form or after treatments by a cross-linking process to improve their mechanical resistance. Drying of biosorbents, such as marine algae, is mentioned in many previous works as a step preceding the adsorption/dessorption cycle. Concerning algae, drying of its fresh biomass allows for proper storage and enhances performance in the sorption of heavy metals. In this work, physical and morphological analyses of fresh and dried Sargassum sp. marine algae, harvested offshore São Sebastião, São Paulo state, Brazil, were performed in order to assess the influence of drying conditions on the biosorption process. Chromium concentrations were also determined in different parts of the algal structure before and after the biosorption process. The drying promoted structural changes in the algae, like shrinkage and porosity reduction. It was also observed that the chromium retention was dependent on the structural arrangement of the alga parts, in which the leaf was the major biosorbent.

Acute fluoxetine administration differentially affects brain C-Fos expression in fasted and refed rats.

In the present study we investigated the effect of acute fluoxetine administration on the expression of c-Fos in the rat brain under two different metabolic conditions: fed and fasting states. Wistar male rats, weighing 220+/-30g, received i.p. injections of saline solution or fluoxetine (10mg/kg), and were killed 2 h later. The brains were removed after transcardiac perfusion with phosphate-buffered saline followed by paraformaldehyde, and were then processed for immunohistochemistry. Fos-like immunoreactivity was quantified by a computerized system. Fasted animals faced an 18-h suppression of food intake, while fed groups were submitted to an initial 14-h period of fast followed by a 4-h period in which food was freely available. Both in fasting and fed states, fluoxetine-treated animals presented a significant increase in c-Fos expression in hypothalamic areas, limbic structures, circumventricular areas, and in mesencephalic and rhomboencephalic regions, as compared with saline-treated controls. The quantitative comparison of data obtained from fasted and fed animals showed that fasted rats treated with fluoxetine presented a higher c-Fos expression in the ventromedial hypothalamus and the paraventricular nuclei compared with the fed group, while in fluoxetine-treated fed rats c-Fos expression was higher in the arcuate nuclei, medial amygdala, locus coeruleus and dorsal raphe nuclei, as compared with fasted, fluoxetine-treated animals. These data indicate that the metabolic condition of the animals significantly modifies fluoxetine-induced brain c-Fos expression, suggesting that visceral and behavioral fluoxetine effects may be influenced by the metabolic state of the individual.

Mobilisation of trehalose in mutants of the cyclic AMP signalling pathway, cr-1 (CRISP-1) and mcb (microcycle conidiation), of Neurospora crassa.

The influence of the cAMP-signalling pathway on the metabolism of trehalose in Neurospora crassa was investigated. The changes in intracellular trehalose concentration were measured in two mutants affected in components of the cAMP-signalling pathway: cr-1 (crisp-1), deficient in adenylyl cyclase activity, and mcb (microcyclic conidiation), deficient in the regulatory subunit of PKA. Rapid mobilisation of intracellular trehalose in the wild-type occurred, either at the onset of germination, or after a heat shock, and by carbon starvation. Mutant cr-1 failed to mobilise trehalose at germination, but behaved almost normally after a heat shock, or during carbon starvation. On the other hand, the levels of trehalose in mcb fell to values much lower than in the wild-type at germination, but accumulated trehalose normally during a heat shock. These results are consistent with the involvement of cAMP in the activation of the neutral trehalase at the onset of germination. However, the control of the enzyme under the other physiological conditions which also promote mobilisation of intracellular trehalose was apparently independent of cAMP-signalling.

[Myocardial infarction as a consequence of infective endocarditis in valvar bioprosthesis]. / Infarto do miocárdio conseqüente à endocardite infecciosa em bioprótese valvar.

A sixteen year-old male, followed in the Unicamp Cardiology Clinic with a previous record of rheumatic heart disease and a biological mitral prosthesis, presented with infective endocarditis. In spite of a good initial response to antibiotic therapy, the patient died in two weeks. Autopsy disclosed endocarditis of the prosthetic valve and embolic occlusion of the circumflex branch of left coronary artery.

[Correlation between ventricular arrhythmia and geometric remodeling of the left ventricle in arterial hypertension]. / Correlação entre arritmia ventricular e remodelamento geométrico do ventrículo esquerdo na hipertensão arterial.

PURPOSE: To study the presence and type of ventricular arrhythmias in patients with different geometric patterns of the left ventricle (LV). METHODS: Seventy-two patients with essential hypertension were divided in 4 groups, by the echocardiographic patterns: group I with concentric remodeling of the LV (normal LV mass with increased relative wall thickening); group II with concentric hypertrophy (both LV mass and relative wall thickening increased); group III with normal geometry of the LV (both LV mass and relative wall thickening normal); group IV, with eccentric hypertrophy (increased LV mass with normal relative wall thickening). The groups were compared by the quantity and quality of ventricular arrhythmia, measured by the number of ventricular ectopic beats (VEB) and episodes of ventricular tachycardia (VT) on Holter monitoring, and the presence of late potentials (LP) on signal-averaged electrocardiogram. RESULTS: Group I showed fewer VEB than group II (16.2 +/- 12.85 x 996.4 +/- 518.8, p < 0.05), and a statistic tendency to this result when compared with group IV (16.2 +/- 12.85 x 1634.2 +/- 1001.33, p = 0.063). When compared with group III, no statistical difference was found (16.2 +/- 12.85 x 19.8 +/- 14.81, p = NS). Episodes of VT and the presence of LP were noted only in groups II and IV. CONCLUSION: The group with concentric remodeling of the LV had fewer ventricular arrhythmias than hypertrophic groups, with characteristics closer to the patients with normal LV geometry.

[The heart and diabetes. An anatomo-clinical study]. / Coração e diabetes. Estudo anátomo-clínico.

We performed a retrospective study in 72 autopsies of diabetic patients (DMP) selected out of 2,239 adult autopsies, comprehending the period between 1966 to 1982. In order to analyse the possible Diabetic Cardiomyopathy, the DMP were divided into 8 groups according to the presence or the absence of Myocardial Fibrosis (MF) and Congestive Heart Failure (CHF). The Diabetes Mellitus (DM) incidence according to the race, sex, age and the presence of Kimmestiel-Wilson (KW) were in agreement with the literature data. The majority of the deaths occurred after the sixth-decade and we did not find any DMP with Malignant Hypertension. Hypertension and Coronary Artery Disease (CAD) increased the frequency of anatomical cardiac alterations, as follows: 1. MF was more associated with CAD, 2. Hypertension was more frequent in DMP with KW in the nodular form; 3. Hypertension increased the frequency of left ventricular hypertrophy; 4. Myocardial Infarction occurred in the absence of occlusive vascular phenomena. The Myocardial Fibrosis (MF) observed in DMP without ACD and without hypertension may be final anatomic demonstration of a gradual metabolic-functional process, and not the basic mechanism of the CHF in the possible Diabetic Cardiomyopathy.

[Gastric carcinoid associated with pernicious anemia]. / Carcinóide gástrico associado a anemia perniciosa.

A clinical case of a patient with pernicious anaemia and a carcinoid tumor of the gastric fundus is described. In the context of the case the relationship between pernicious anaemia, achlorhydria, atrophic gastritis and gastric carcinoid is discussed. The gastric neuroendocrine tumours and their structural and functional characteristics were reviewed in an attempt to clarify the nomenclature and the diagnostic and therapeutic approach in these situations.

[Microsurgical reconstruction of the upper extremity. Experience with 24 free flaps]. / Reconstrução microcirúrgica do membro superior. Experiência de 24 retalhos livres.

The authors present the experience of 24 clinical cases of microsurgical reconstruction of the upper limb. These reconstructions were accomplished by different microvascular free flaps which were selected according to the type, size and location of the defects, having applied fasciocutaneous, adipofascial, myo, myocutaneous, tendofasciocutaneous, omentum flaps and 2nd toe transfers. The etiology was traumatic in 23 cases and tumoral in 1 case. A careful analysis was made for surgical times, selection and survival rate of the free flaps and the morphofunctional quality of the reconstructions. Microvascular free flaps are considered the choice technique for upper limb reconstruction, particularly for the hand in certain defects, considering the better anatomic and functional quality of the reconstructions.

[Microsurgical reconstruction of the head and neck: experience of 63 free flaps]. / Reconstrução microcirúrgica da cabeça e pescoço.

The authors present the experience of 63 clinical cases of microsurgical reconstruction of the head and neck. These reconstructions were accomplished by different microvascular free flaps which were selected according to the type, size and location of the defects. Fasciocutaneous, osteofasciocutaneous, adipofascial, myo, myocutaneous, myosseous, jejunum and great omentum flaps were applied. The etiology was traumatic in 10 cases, tumoral in 41 cases, congenital in 7 cases, iatrogenic in 3 cases and infectious in 2 cases. The reconstructed anatomical regions were the scalp in 6 cases, the skull base in 1 case, the orbit in 3 cases, the nose in 1 case, the hemiface in 7 cases, the lips in 1 case, the intraoral cavity in 21 cases, the mandible in 8 cases, the intraoral cavity plus mandible in 11 cases and the cervical esophagus in 1 cases. An analysis was made of surgical times, selection and survival rate of the free flaps and the morphofunctional quality of the reconstructions. Considering the good quality of reconstructions, the amelioration of quality of life and the low morbidity in these patients, microvascular free flaps are considered a first choice technique for head and neck reconstruction when the size and location of the defect prevents the use of local flaps.

Fatty acids derived from a food frequency questionnaire and measured in the erythrocyte membrane in relation to adiponectin and leptin concentrations.

BACKGROUND/OBJECTIVES: Evidence on the association between fatty acids and adiponectin and leptin concentrations is scarce and inconsistent, which may in part be due to limitations of dietary reporting methods. We aimed to estimate the association of fatty acids, derived from a food frequency questionnaire (FFQ) and measured in the erythrocyte membrane, with adiponectin and leptin concentrations. SUBJECTS/METHODS: We studied 330 non-institutionalized inhabitants of Porto (52.4% women; age range: 26-64 years) evaluated in 2010-2011, as part of the EPIPorto cohort study. Fatty acids were derived from a validated semiquantitative FFQ and measured in the erythrocyte membrane by gas chromatography. Serum concentrations of adiponectin and leptin were determined through radioimmunoassay. Regression coefficients (ß) and 95% confidence intervals (95% CI) were obtained from linear regression models, after controlling for gender, age, education, leisure time physical activity and total body fat percentage (obtained from dual energy X-ray absorptiometry). RESULTS: Fatty acids measured by FFQ showed no significant associations with both adipokines. Lauric and linoleic acids, measured in the erythrocyte membrane, were significantly and positively associated with adiponectin (ß=0.292, 95% CI: 0.168-0.416; ß=0.150, 95% CI: 0.020-0.280) and leptin (ß=0.071, 95% CI: 0.003-0.138; ß=0.071, 95% CI: 0.002-0.140), whereas total n-3, eicosapentaenoic and docosahexaenoic acids were significantly but negatively associated with adiponectin (ß=-0.289, 95% CI: -0.420 to -0.159; ß=-0.174, 95% CI -0.307 to -0.040; ß=-0.253, 95% CI -0.383 to -0.124) and leptin (ß=-0.151, 95% CI: -0.220 to -0.083; ß=-0.080, 95% CI: -0.151 to -0.009; ß=-0.146, 95% CI: -0.214 to -0.078). Positive significant associations of palmitic and trans-fatty acids with adiponectin were also observed. CONCLUSIONS: A positive association of lauric and linoleic acids and a negative association of total n-3 fatty acids with both adipokines were observed only with fatty acids measured in the erythrocyte membrane.

Bilateral whole lung lavage in pulmonary alveolar proteinosis--a retrospective study.

Whole lung lavage (WLL) is the gold standard technique for the treatment of Pulmonary Alveolar Proteinosis (PAP). In this paper we evaluated and discuss bilateral WLL, namely the procedure work-up and the therapeutic efficacy. Six bilateral WLL performed through a careful adherence to a modified Royal Brompton Hospital (London) technique were carried out without major complications and were associated with clinical and functional improvement of the PAP patients submitted to this procedure. As there are benefits in terms of time, patient comfort and cost effectiveness compared to unilateral WLL, associated with the efficacy and safety observed, bilateral WLL seems to be a suitable first choice for therapeutic lavage in PAP patients.

Deregulation of adipokines related to target organ damage on resistant hypertension.

Resistant hypertension (RHTN) includes patients with controlled blood pressure (BP) (CRHTN) and uncontrolled BP (UCRHTN). In fact, RHTN patients are more likely to have target organ damage (TOD), and resistin, leptin and adiponectin may affect BP control in these subjects. We assessed the relationship between adipokines levels and arterial stiffness, left ventricular hypertrophy (LVH) and microalbuminuria (MA). This cross-sectional study included CRHTN (n=51) and UCRHTN (n=38) patients for evaluating body mass index, ambulatory blood pressure monitoring, plasma adiponectin, leptin and resistin concentrations, pulse wave velocity (PWV), MA and echocardiography. Leptin and resistin levels were higher in UCRHTN, whereas adiponectin levels were lower in this same subgroup. Similarly, arterial stiffness, LVH and MA were higher in UCRHTN subgroup. Adiponectin levels negatively correlated with PWV (r=-0.42, P<0.01), and MA (r=-0.48, P<0.01) only in UCRHTN. Leptin was positively correlated with PWV (r=0.37, P=0.02) in UCRHTN subgroup, whereas resistin was not correlated with TOD in both subgroups. Adiponectin is associated with arterial stiffness and renal injury in UCRHTN patients, whereas leptin is associated with arterial stiffness in the same subgroup. Taken together, our results showed that those adipokines may contribute to vascular and renal damage in UCRHTN patients.

Quantification of endocrine disruptors and pesticides in water by gas chromatography-tandem mass spectrometry. Method validation using weighted linear regression schemes.

A multi-residue methodology based on a solid phase extraction followed by gas chromatography-tandem mass spectrometry was developed for trace analysis of 32 compounds in water matrices, including estrogens and several pesticides from different chemical families, some of them with endocrine disrupting properties. Matrix standard calibration solutions were prepared by adding known amounts of the analytes to a residue-free sample to compensate matrix-induced chromatographic response enhancement observed for certain pesticides. Validation was done mainly according to the International Conference on Harmonisation recommendations, as well as some European and American validation guidelines with specifications for pesticides analysis and/or GC-MS methodology. As the assumption of homoscedasticity was not met for analytical data, weighted least squares linear regression procedure was applied as a simple and effective way to counteract the greater influence of the greater concentrations on the fitted regression line, improving accuracy at the lower end of the calibration curve. The method was considered validated for 31 compounds after consistent evaluation of the key analytical parameters: specificity, linearity, limit of detection and quantification, range, precision, accuracy, extraction efficiency, stability and robustness.