Value of ultrasonographic contrast in duplex scanning of leg arteries - Comparison with conventional duplex scanning and arteriography

Aim. Duplex scanning has been used in the evaluation of the aorta and proximal arteries of the lower extremities, but has limitations in evaluating the arteries of the leg. The utilization of ultrasonographic contrast (USC) may be helpful in improving the quality of the image in these arteries. The objective of the present study was to verify whether the USC increases the diagnostic accuracy of patency of the leg arteries and if it diminishes the time needed to perform duplex scanning.Methods. Twenty patients with critical ischemia (20 lower extremities) were examined by standard duplex scanning, duplex scanning with contrast and digital subtraction arteriography (DSA). The 3 arteries of the leg were divided into 3 segments, for a total of 9 segments per limb. Each segment was evaluated for patency in order to compare the 3 diagnostic methods. Comparison was made between standard duplex scanning and duplex scanning with contrast in terms of quality of the color-coded Doppler signal and of the spectral curve, and also of the time to perform the exams.Results. Duplex scanning with contrast was similar to arteriography in relation to patency diagnosis (p>0.3) and even superior in some of the segments. Standard duplex scanning was inferior to arteriography and to duplex scanning with contrast (p<0.001). There were improvements of 70% in intensity of the color-coded Doppler signal and 76% in the spectral curve after the utilization of contrast. The time necessary to perform the examinations was 23.7 minutes for standard duplex scanning and 16.9 minutes for duplex scanning with contrast (p<0.001).Conclusion. The use of ultrasonographic contrast increased the accuracy of the diagnosis of patency of leg arteries and diminished the time necessary for the execution of duplex scanning.

Quality of life in women with vulvar cancer submitted to surgical treatment: a comparative study

Objectives: To investigate the occurrence and severity of lymphoedema of the lower extremities (LLE), quality of life (QoL), and urinary and sexual dysfunction in women with vulvar cancer submitted to surgical treatment.Study design: Twenty-eight patients with vulvar cancer submitted to vulvectomy and inguinofemoral lymphadenectomy and 28 healthy, age-matched women (control group) were evaluated. The occurrence and severity of LLE were determined by Miller's Clinical Evaluation. QoL, urinary function and sexual function were assessed by the EORTC QLQ-C30, SF-ICIQ and FSFI questionnaires, respectively. The differences between groups and correlations were assessed using Student's r-test, Chi-squared test, Mann-Whitney U-test and Spearman's rho test.Results: The groups were similar in terms of marital status, educational status, menopausal status, hormone therapy and height. The occurrence and severity of LLE were higher in women with vulvar cancer compared with the control group (p < 0.001 and p = 0.003, respectively). A significant association was found between the severity of LLE and advanced age (p = 0.04), and the severity of LLE and higher body mass index (BMI; p = 0.04) in patients with vulvar cancer. In the patients with vulvar cancer, there was a significant correlation between the severity of LLE and worse QoL in the following domains: physical, cognitive, emotional, social, fatigue, pain, sleep and financial questions (p < 0.05). There was no difference in urinary function between the two groups (p = 0.113). Age and number of deliveries were the only variables associated with the occurrence of urinary incontinence (p = 0.01). Urinary incontinence was present in women with a mean age of 74.9 +/- 4.6 years and a mean of 7.3 +/- 1.3 normal deliveries. There was no difference between the groups in terms of the sexual function. Multivariate analysis showed an association between sexual function and age (p = 0.01), and sexual function and being in a stable relationship (p = 0.02).Conclusion: Patients submitted to vulvectomy or inguinofemoral lymphadenectomy for vulvar cancer are at higher risk of developing LLE compared with healthy, age-matched women. This has a negative effect on QoL, but does not interfere with urinary or sexual function. (C) 2012 Elsevier B.V. All rights reserved.

Acheiropodia is caused by a genomic deletion in C7orf2, the human orthologue of the Lmbr1 gene

Acheiropodia is an autosomal recessive developmental disorder presenting with bilateral congenital amputations of the upper and lower extremities and aplasia of the hands and feet. This severely handicapping condition appears to affect only the extremities, with no other systemic manifestations reported. Recently, a locus for acheiropodia was mapped on chromosome 7q36. Herein we report the narrowing of the critical region for the acheiropodia gene and the subsequent identification of a common mutation in C7orf2-the human orthologue of the mouse Lmbr1 gene-that is responsible for the disease. Analysis of five families with acheiropodia, by means of 15 polymorphic markers, narrowed the critical region to 1.3 cM, on the basis of identity by descent, and to <0.5 Mb, on the basis of physical mapping. Analysis of C7orf2, the human orthologue of the mouse Lmbr1 gene, identified a deletion in all five families, thus identifying a common acheiropodia mutation. The deletion was identified at both the genomic-DNA and mRNA level. It leads to the production of a C7orf2 transcript lacking exon 4 and introduces a premature stop codon downstream of exon 3. Given the nature of the acheiropodia phenotype, it appears likely that the Lmbr1 gene plays an important role in limb development.

Ativação muscular do quadril e do joelho em duas aterrissagens realizadas por atletas do sexo masculino

OBJETIVO: Comparar a atividade muscular antes e após o contato com o solo entre as aterrissagens unilateral (AU) e bilateral (AB) em atletas do sexo masculino. PARTICIPANTES: Quinze atletas masculinos de voleibol sem sinais e sintomas de lesões nas extremidades inferiores (13 ± 1 ano, 1,70 ± 0,12m, 60 ± 12kg). MENSURAÇÕES:Os participantes realizaram dois saltos verticais, aterrissando unilateralmente e bilateralmente. A atividade mioelétrica do reto femoral (RF), bíceps femoral (BF), adutores de quadril (AQ) e a relação BF/RF foram comparados entre as duas aterrissagens e entre as fases caracterizadas por 100ms antes (PRE) e 100ms após (POS) o contato com o solo. RESULTADOS: Em ambas as aterrissagens, a ativação do RF foi maior na fase POS em relação à PRE. Na comparação entre as aterrissagens dentro da mesma fase não encontramos diferenças estatísticas. Apesar de o BF não ter apresentado diferenças entre as fases PRE e POS em cada aterrissagem, sua ativação foi maior na AU. Os AQ apresentaram maior ativação na fase POS durante a AU, no entanto não houve diferenças quando comparadas as duas aterrissagens. A relação BF/RF apresentou valores maiores em ambas as aterrissagens na fase PRE. No entanto, não encontramos diferenças entre as aterrissagens. CONCLUSÃO: Os resultados sugerem que cada músculo apresenta um papel diferente durante a fase de aterrissagem em homens. Enquanto que o RF possui como principal função a frenagem da articulação do joelho e do movimento descendente, caracterizada pelo aumento da ativação na fase pós-contato, o BF parece atenuar a tensão articular do joelho em atividades de maior impacto, mantendo-se mais ativo durante todo o ciclo da AU. Já a maior ativação dos AQ após o contato com solo na AU evidencia a importância da região lombo-pélvica na estabilização pélvica em situações de grande instabilidade. Estudos futuros são necessários para determinar os efeitos da ativação muscular apresentada na imposição de cargas mecânicas potencialmente lesivas no joelho em atletas do sexo masculino.

Significância clínica de tromboembolismo venoso recorrente

Recurrent venous thromboembolism is a significant problem leading to increased morbidity and mortality. It has a high impact on patients' quality of life and imposes a great financial burden on society. Cumulative recurrence has been reported as 40% at 10 years, while the chance of developing postthrombotic signs and symptoms in the lower extremities almost quadruples when ipsilateral. There is also a higher chance of developing pulmonary hypertension. Important factors for recurrence are unprovoked episodes of deep vein thrombosis, malignancy and older age. The evidence for other factors is controversial. Accurate diagnosis and treatment tailored to the patients' history, thrombotic events and risk factors are necessary to optimize management and prevent recurrence.

O andar de pacientes hemiplégicos no solo e na esteira com suporte total e parcial de peso

Pós-graduação em Ciências da Motricidade - IBRC

Estudo comparativo na prevenção da hipotermia no transoperatório: manta versus colchão térmico

Pós-graduação em Enfermagem (mestrado profissional) - FMB

Are cutout handles used when available in real occupational settings? Description of grips and upper extremities movements during industrial box handling

In order to achieve better postures and decrease musculoskeletal risks adequate design of hand/box couplings for manual materials handling (MMH) are still needed. No studies evaluating upper limb movement thorough direct measurements during box handling in workplace were identified in the literature. In this study we describe the types of grip and movements adopted by ten workers when handling redesigned boxes with cutout handles between different heights on industrial pallets. The new handles were used by 90% of the workers through different types of grip. Electrogoniometric measurements showed relatively safe forearm and wrist movements, although elbow inadequate range of movement was recorded. Despite the good acceptance of the cutout by workers, the new design requires extra internal space in the boxes reducing applications for this alternative of box.

Old beagle dogs have lower faecal concentrations of some fermentation products and lower peripheral lymphocyte counts than young adult beagles

The effects of age on microbiota composition, gut fermentation end-product formation and peripheral lymphocyte numbers were compared between old and young adult Beagle dogs fed four kibble diets differing in yeast cell wall contents. The experiment had a double 4 x 4 Latin square design, one with four mature dogs (4 years old) and the other with four old dogs (10 years old), with four replicates (diets) per dog. In each period a 15d adaptation period preceded a 5d total collection of faeces for the digestibility trial. on day 21, fresh faecal samples were collected for the determination of bacterial enumeration, pH, biogenic amine and short-chain fatty acid. Flow cytometry was used for immunophenotypic evaluation. Dogs were fed four kibble diets with similar composition with 0, 0.15, 0.30 and 0.45% of yeast cell wall (as-fed), respectively. Data were evaluated using general linear models of Statistical Analysis Systems statistical software (P<0.05). No evidence of a difference in faecal bacteria counts between ages was found (total aerobes, total anaerobes, Bifidobacterium, Lactobacillus, Clostridium and Escherichia coli: P. 0.15). Faecal concentrations of butyrate, histamine, agmatine and spermine were lower (P <= 0.05) and faecal pH was higher (P=0.03) in older dogs than in mature adult dogs, suggesting an alteration in bacterial metabolic activity, or in the rate of intestinal absorption of these compounds. Concentrations of T-lymphocytes, T-cytotoxic lymphocytes and B-lymphocytes were also lower (P <= 0.01) in older dogs than in mature adult dogs. The study confirmed alterations in peripheral lymphocytes and revealed a reduced concentration of some fermentation end products in the colon of old dogs.

Annual pattern of plasma melatonin and progesterone concentrations in hair and wool ewe lambs kept under natural photoperiod at lower latitudes in the southern hemisphere

To study the annual pattern of plasma melatonin and progesterone concentrations in hair [Santa Ines (SI)] and wool [Romney Marsh (RM) and Suffolk (SU)] ewe lambs kept under natural photoperiods at 21 degrees 59'S, 12 ewe lambs (four/breed) were used. For melatonin, blood samples were collected monthly throughout the year at the onset (17:00, 19:00 and 21:00 hr) and end (04:00, 06:00 and 08:00 hr) of the night, and for progesterone the samples were collected in the morning, two to three times a week throughout the year. Plasma melatonin concentrations at different times of the day changed according to the season. In diurnal periods (17:00 and 8:00 hr) no seasonal differences were observed but they became evident in the nocturnal intervals (21:00 and 4:00 hr) and transitional night-day (6:00 hr) times. The patterns of melatonin secretion were higher in winter and autumn than in spring and summer. The patterns of plasma progesterone secretion were affected by interaction between breed and season. There was no seasonal variation in plasma progesterone concentrations for SI females. The progesterone pattern for RM and SU females varied with season. The plasma levels were higher in autumn and winter than in spring and summer. At 21 degrees 59'S hair and wool ewe lambs showed the same annual pattern of plasma melatonin concentration while the annual progesterone profiles were quite different. For SI females this pattern was constant along all seasons and for RM and SU females this pattern was higher during autumn and winter than spring and summer.

Gastro-intestinal transit time in South American deer

The study of diet and physiological peculiarities of the digestive system of neotropical deer is not well known and the literature shows inconsistencies. To better understand the digestive system of these mammals the difference in the gastro-intestinal transit time of four species of neotropical deer (Mazama americana, Mazama gouazoubira, Mazama nana, Blastocerus dichotomus), kept ill captivity, was evaluated. Four plants (Neonotonia wightii, Morus albans, Medicago sativa, Leucaena leucocephala) were utilized and two variables were measured, mean time of the beginning of the elimination (BE) and mean time of permanence (TP). The results obtained for BE indicated similarity among the deer species, with significant differences between M. gouazoubira (mean = 13.62 hr) and M. Americana (mean = 19.25 hr). For the plants, the BE was faster with N. wightii and L. leucocephala, and slower for M. sativa. The TP results for B. dichotomus showed longer time when compared to the other species, whereas M. gouazoubira had a lower permanence. Overall, N. wightii had the highest retention time in the digestive tract of all the deer species studied. Associated with this observation, N. wightii had the highest quantity of plant fiber of the plants tested. In a similar fashion M. sativa showed the lowest TP in the digestive tract of the deer and had the lowest quantity of acid detergent fiber. The data from this study showed that, within species, the shape of the excretion curve of the plants was similar when the animals consumed N. wightii or M. sativa. Blastocerus dichotomus and M. gouazoubira had the highest and the lowest gastro-intestinal transit time, respectively. This suggests that these species characterize different abilities to digest high fiber food, and consequently, represent the two extremities in the morphophysiological adaptation within the deer species evaluated. This information is vital because it is important to know the digestive physiology to define the diet of captive animals, particularly regarding the quantity and quality of fiber. Zoo Biol 25:47-57, 2006. (C) 2005 Wiley-Liss, Inc.

Mechanisms for consideration for intervention in the development of organophosphorus-induced delayed neuropathy

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Self-Organizing Maps as a New Tool for Classification of Plants at Lower Hierarchical Levels

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Evaluation of the fretting fatigue behaviour of commercially pure titanium

Fretting fatigue occurs when the contact surfaces of two components undergo small oscillatory movement while they are subjected to a clamping force. A cyclic external load gives rise to the early initiation of fatigue cracks, thus reducing their service life. In this paper, the fretting fatigue behaviour of commercially pure titanium flat samples (1.5 mm thick) is evaluated. A fretting device composed of a frame, load cell, and two screw-mounted cylindrical fretting pads with convex extremities was built and set to a servo-hydraulic testing machine. The fatigue tests were conducted under load control at a frequency of 10 Hz and stress ratio R = 0.1, with various contact load values applied to the fretting pads. Additional tests under inert environment allowed assessing the role of oxidation on the wear debris formation. The fracture surfaces and fretting scars were analysed via scanning electron microscopy in order to evaluate the surface damage evolution and its effect on the fatigue crack features. The effect of the fretting condition on the S-N curve of the material in the range of 10(4)-10(6) cycles is described. Fatigue crack growth calculations allowed estimating the crack initiation and propagation lives under fretting conditions. The effect of the fretting condition in fatigue life is stronger for the lower values of cyclic stress and does not seem to depend on the contact loading value.

Lower levels of oxidative DNA damage and apoptosis in lymphocytes from patients undergoing surgery with propofol anesthesia

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)