Low-level laser therapy (LLLT) in human progressive-intensity running: effects on exercise performance, skeletal muscle status, and oxidative stress

The aim of this work was to evaluate the effects of low-level laser therapy (LLLT) on exercise performance, oxidative stress, and muscle status in humans. A randomized double-blind placebo-controlled crossover trial was performed with 22 untrained male volunteers. LLLT (810 nm, 200 mW, 30 J in each site, 30 s of irradiation in each site) using a multi-diode cluster (with five spots - 6 J from each spot) at 12 sites of each lower limb (six in quadriceps, four in hamstrings, and two in gastrocnemius) was performed 5 min before a standardized progressive-intensity running protocol on a motor-drive treadmill until exhaustion. We analyzed exercise performance (VO(2 max), time to exhaustion, aerobic threshold and anaerobic threshold), levels of oxidative damage to lipids and proteins, the activities of the antioxidant enzymes superoxide dismutase (SOD) and catalase (CAT), and the markers of muscle damage creatine kinase (CK) and lactate dehydrogenase (LDH). Compared to placebo, active LLLT significantly increased exercise performance (VO(2 max) p = 0.01; time to exhaustion, p = 0.04) without changing the aerobic and anaerobic thresholds. LLLT also decreased post-exercise lipid (p = 0.0001) and protein (p = 0.0230) damages, as well as the activities of SOD (p = 0.0034), CK (p = 0.0001) and LDH (p = 0.0001) enzymes. LLLT application was not able to modulate CAT activity. The use of LLLT before progressive-intensity running exercise increases exercise performance, decreases exercise-induced oxidative stress and muscle damage, suggesting that the modulation of the redox system by LLLT could be related to the delay in skeletal muscle fatigue observed after the use of LLLT.

A retrospective study of oral manifestations in patients with paracoccidioidomycosis

South American blastomycosis, paracoccidioidomycosis (Pb mycosis) or Lutz disease is an endemically fungal infection in Latin America. It is caused by the dimorphic fungus Paracoccidioides brasiliensis and may cause oral mucosal lesions. The incidence of Pb mycosis oral lesions was evaluated in patients assisted at a Brazilian Dental School's Specialized Oral Diagnosis Service with special focus on the different clinical forms of these lesions, its location, patients' occupation, deleterious habits, and diagnosis methodology. Students' and professionals' initial diagnoses were compared with the definitive diagnosis. Lesions were detected 31 cases (18 patients). The results show that 88.8% of the patients were male with a mean age of 50 years and 39% work(ed) with activities related to agriculture. As much as 88.9% were smokers and 72.2% were alcohol users. Exfoliative cytology was performed in 66.6% of the patients. Oral mucosa (30%), gingiva (16.6%) and lips 16.6% were the most common sites of Pb mycosis oral lesions. Comparing the initial with the definitive diagnosis made by the professionals their accuracy was 33% (6 out of 18 patients). Students' diagnosis was more accurate demonstrating 72.5% of initial correct diagnosis (13 out of 18). Statistical analysis by ANOVA (α=0.05, SPSS WIN) demonstrated a significant difference between the diagnosis of Pb mycosis made by students and professionals when considering initial diagnosis and final diagnosis (after histopathological analysis) (p=0.25). Incisional biopsy and exfoliate cytology are efficient for an early diagnosis of this disease in mouth. Students' training in diagnosis of oral pathologies to recognize lesions is urgent to improve public health.

Atraso no diagnóstico da tuberculose em sistema prisional: a experiência do doente apenado

O estudo analisou as causas de atraso no diagnóstico da tuberculose em sistema prisional, segundo a experiência do doente apenado. Utilizou-se o referencial teórico-metodológico da análise de discurso de matriz francesa, que busca a compreensão dos processos de produção de sentidos, na relação da linguagem com a ideologia e de constituição de sujeitos em suas posições. Foram realizadas entrevistas semidirigidas com sete doentes de tuberculose apenados em um hospital de João Pessoa, Paraíba, Brasil, no período de agosto a outubro de 2009. O atraso no diagnóstico da tuberculose relaciona-se à naturalização da desassistência ao sujeito preso, à interpretação do presídio como um lugar de morte e sofrimentos e à privação do direito à saúde para detentos em decorrência de sua posição nas relações assimétricas de poder e efeitos ideológicos.

Atraso na busca por serviço de saúde para o diagnóstico da tuberculose em Ribeirão Preto (SP)

Foi analisado o atraso na busca por serviço de saúde para o diagnóstico da Tuberculose (TB) em Ribeirão Preto, 2009, em um estudo epidemiológico, transversal, realizado com 94 doentes. Utilizou-se questionário baseado no Primary Care Assessment Tool, adaptado para avaliar a atenção à TB. Estabeleceu-se a mediana (15 dias ou mais) para caracterizar atraso na busca pelo primeiro atendimento. Através da Razão de Prevalência, identificaram-se as variáveis relacionadas ao maior atraso. O primeiro serviço de saúde procurado foi o de pronto atendimento (57,4%). Verificou-se um maior tempo na procura pelos serviços de saúde entre os doentes: do sexo masculino; com idade entre 50 a 59 anos; com renda familiar inferior a cinco salários mínimos; forma pulmonar; casos novos; não coinfecção TB/HIV; não consumiam bebida alcoólica, conhecimento satisfatório sobre TB (apresentou significância estatística na associação com o atraso) e que não procuravam o serviço de saúde próximo do domicílio antes de ter TB. Verificou-se a necessidade de capacitação para os profissionais de saúde quanto aos sinais e sintomas da doença, reduzindo as barreiras de acesso ao diagnóstico oportuno da TB e divulgação ampla para a comunidade em geral.

Postpartum depression and child development in first year of life

The aim of the study was to investigate the characteristics of infant development at four, eight and twelve months of age, as result of postpartum depression. The prevalence of Postpartum Depression - measured by the Edinburgh Postnatal Depression Scale - at four months after delivery was 30.3%; at eight months, 26.4%; and at 12 months, 25.0%. Chi-square tests were used to compare children of mothers with and without Postpartum Depression in relation to developmental milestones. It was found developmental delay in infants of mothers with Postpartum Depression in: two interactional indicators at four months, two motor indicators at eight months and one gross motor indicator at twelve months. However, children of mothers with Postpartum Depression showed better results in one fine motor and in two language items at 12 months. The results point to the necessity of considering external and internal factors of mother and infant in the study of the effects of maternal depression on child development.

UVB-induced cell death signaling is associated with G1-S progression and transcription inhibition in primary human fibroblasts

DNA damage induced by ultraviolet (UV) radiation can be removed by nucleotide excision repair through two sub-pathways, one general (GGR) and the other specific for transcribed DNA (TCR), and the processing of unrepaired lesions trigger signals that may lead to cell death. These signals involve the tumor suppressor p53 protein, a central regulator of cell responses to DNA damage, and the E3 ubiquitin ligase Mdm2, that forms a feedback regulatory loop with p53. The involvement of cell cycle and transcription on the signaling to apoptosis was investigated in UVB-irradiated synchronized, DNA repair proficient, CS-B (TCR-deficient) and XP-C (GGR-deficient) primary human fibroblasts. Cells were irradiated in the G1 phase of the cell cycle, with two doses with equivalent levels of apoptosis (low and high), defined for each cell line. In the three cell lines, the low doses of UVB caused only a transient delay in progression to the S phase, whereas the high doses induced permanent cell cycle arrest. However, while accumulation of Mdm2 correlated well with the recovery from transcription inhibition at the low doses for normal and CS-B fibroblasts, for XP-C cells this protein was shown to be accumulated even at UVB doses that induced high levels of apoptosis. Thus, UVB-induced accumulation of Mdm2 is critical for counteracting p53 activation and apoptosis avoidance, but its effect is limited due to transcription inhibition. However, in the case of XP-C cells, an excess of unrepaired DNA damage would be sufficient to block S phase progression, which would signal to apoptosis, independent of Mdm2 accumulation. The data clearly discriminate DNA damage signals that lead to cell death, depending on the presence of UVB-induced DNA damage in replicating or transcribing regions.

Photodynamic therapy for the treatment of induced mammary tumor in rats

The objective of this work was to evaluate photodynamic therapy (PDT) by using a hematoporphyrin derivative as a photosensitizer and light-emitting diodes (LEDs) as light source in induced mammary tumors of Sprague–Dawley (SD) rats. Twenty SD rats with mammary tumors induced by DMBAwere used. Animals were divided into four groups: control (G1), PDT only (G2), surgical removal of tumor (G3), and submitted to PDT immediately after surgical removal of tumor (G4). Tumors were measured over 6 weeks. Lesions and surgical were LEDs lighted up (200 J/cm2 dose). The light distribution in vivo study used two additional animals without mammary tumors. In the control group, the average growth of tumor diameter was approximately 0.40 cm/week. While for PDT group, a growth of less than 0.15 cm/week was observed, suggesting significant delay in tumor growth. Therefore, only partial irradiation of the tumors occurred with a reduction in development, but without elimination. Animals in G4 had no tumor recurrence during the 12 weeks, after chemical induction, when compared with G3 animals that showed 60 % recurrence rate after 12 weeks of chemical induction. PDT used in the experimental model of mammary tumor as a single therapy was effective in reducing tumor development, so the surgery associated with PDT is a safe and efficient destruction of residual tumor, preventing recurrence of the tumor.

Effects of RegCM3 parameterizations on simulated rainy season over South America

The impacts of change in the Grell convective scheme and biosphere-atmosphere transfer scheme (BATS) in RegCM3 are described. Three numerical experiments (RegZhang, RegClaris and RegArain) are conducted to reduce the RegCM3-Grell rainfall underestimation over tropical South America. The simulation referred to as RegZhang follows modifications made by Zhang et al. (2008) in the BATS. The RegClaris combines the RegZhang BATS parameters with a reduction of water drainage at the bottom of the subsoil layer in the regions covered by the tropical rain forest and a shorter convective time period for the Grell scheme. The RegArain considers this same modification in the Grell scheme, but uses a deeper total soil column and a deeper root system in the BATS. After the first year of simulation, the soil water content in RegZhang is progressively drained out of the soil column resulting in a deficit of rainfall in the Amazon. The RegClaris and RegArain, on the other hand, simulate a similar rainfall annual cycle in the Amazon, showing substantial improvement not only in phase but also in intensity. This improvement is partially related to an increase in evapotranspiration due to a larger availability of water in the soil column. A remote effect is also noted over the La Plata Basin region, where the larger summer rainfall rate may be related to the increase in moisture transport from the Amazon. Wind- and rainfall-based indices are applied to identify South American monsoon (SAM) timing. The RegClaris rainfall rates are adequate to identify the onset and the demise of SAM according to the observed data, whereas the rainfall deficit in RegZhang is associated with a delay in the onset and an early demise of the SAM.

Congenital Adrenal Hyperplasia Due to 21 Hydroxylase Deficiency: From Birth to Adulthood

The most frequent form of congenital adrenal hyperplasia (CAH) is steroid 21-hydroxylase deficiency, accounting for more than 90% of cases. Affected patients cannot synthesize cortisol efficiently. Thus the adrenal cortex is stimulated by corticotropin (ACTH) and overproduces cortisol precursors. Some precursors are diverted to sex hormone biosynthesis, causing signs of androgen excess including ambiguous genitalia in newborn females and rapid postnatal growth in both sexes. In the most severe "salt wasting" form of CAH (similar to 75% of severe or "classic" cases), concomitant aldosterone deficiency may lead to salt wasting with consequent failure to thrive, hypovolemia, and shock. Newborn screening minimizes delays in diagnosis, especially in males, and reduces morbidity and mortality from adrenal crises. CAH is a recessive disorder caused by mutations in the CYP21 (CYP21A2) gene, most of which arise from recombination between CYP21 and a nearby pseudogene, CYP21P (CYP21A1P). Phenotype is generally correlated with genotype. Classic CAH patients require chronic glucocorticoid treatment at the lowest dose that adequately suppresses adrenal androgens and maintains normal growth and weight gain, and most require mineralocorticoid (fludrocortisone). Transition of care of older patients to adult physicians should be planned in advance as a structured, ongoing process.

Mandibular Bisphosphonate-Related Osteonecrosis After Dental Implant Rehabilitation: A Case Report

It has been a matter of debate as to whether dental implant therapies are suitable for patients subjected to long-term use of bisphosphonates (BPs). This report presents a case of a 76-year-old woman who developed BPs-related osteonecrosis of the jaw (BRONJ) in the left hemimandible after dental implant exposure. The implants and the necrotic crestal bone were removed, and postoperatively, a delay in tissue healing with bone exposure was noticed. The histologic analysis of the block biopsies revealed a lamellar bone tissue exhibiting necrotic areas and bacterial colonies associated with the bone outer surface. The bone-implant interface showed viable lamellar bone with enlarged vascular spaces in the areas between the implant threads. The possible mechanisms for the loss of implants in BRONJ patients are discussed, and the potential protocols for dental implant rehabilitation for patients under BP therapies are presented. (Implant Dent 2012;21:449-453)

Cough and dyspnea during bronchoconstriction: comparison of different stimuli

Abstract Background Bronchial challenge tests are used to evaluate bronchial responsiveness in diagnosis and follow-up of asthmatic patients. Challenge induced cough has increasingly been recognized as a valuable diagnostic tool. Various stimuli and protocols have been employed. The aim of this study was to compare cough and dyspnea intensity induced by different stimuli. Methods Twenty asthmatic patients underwent challenge tests with methacholine, bradykinin and exercise. Cough was counted during challenge tests. Dyspnea was assessed by modified Borg scale and visual analogue scale. Statistical comparisons were performed by linear mixed-effects model. Results For cough evaluation, bradykinin was the most potent trigger (p < 0.01). In terms of dyspnea measured by Borg scale, there were no differences among stimuli (p > 0.05). By visual analogue scale, bradykinin induced more dyspnea than other stimuli (p ≤ 0.04). Conclusion Bradykinin seems to be the most suitable stimulus for bronchial challenge tests intended for measuring cough in association with bronchoconstriction.