Effects of radiation therapy on the structure and function of the pelvic floor muscles of patients with cancer in the pelvic area : a systematic review

Purpose Radiation therapy (RT) is often recommended in the treatment of pelvic cancers. Following RT, a high prevalence of pelvic floor dysfunctions (urinary incontinence, dyspareunia, and fecal incontinence) is reported. However, changes in pelvic floor muscles (PFMs) after RT remain unclear. The purpose of this review was to systematically document the effects of RT on the PFM structure and function in patients with cancer in the pelvic area. Methods An electronic literature search using Pubmed Central, CINAHL, Embase, and SCOPUS was performed from date of inception up to June 2014. The following keywords were used: radiotherapy, muscle tissue, and pelvic floor. Two reviewers selected the studies in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA). Out of the 369 articles screened, 13 met all eligibility criteria. The methodological quality was assessed using the QualSyst scoring system, and standardized mean differences were calculated. Results Thirteen studies fulfilled all inclusion criteria, from which four were of good methodological quality. One presented strong evidence that RT affects PFM structure in men treated for prostate cancer. Four presented high-level evidence that RT affects PFM function in patients treated for rectal cancer. Meta-analysis was not possible due to heterogeneity and lack of descriptive statistics. Conclusion There is some evidence that RT has detrimental impacts on both PFMs’ structure and function. Implications for cancer survivors A better understanding of muscle damage and dysfunction following RT treatment will improve pelvic floor rehabilitation and, potentially, prevention of its detrimental impacts.

Design of a myofascial therapy protocol for the treatment of hemophilic arthropathy of the knee and ankle

Hemophilic arthropathy limits daily life activities of patients with hemophilia, presenting with clinical manifestations such as chronic pain, limited mobility, or muscular atrophy. Although physical therapy is considered essential for these patients, few clinical studies have demonstrated the efficacy and safety of the various physiotherapy techniques. Physical therapy may be useful for treating hemophilic arthropathy by applying safe and effective techniques. However, it is necessary to create protocols for possible treatments to avoid the risk of bleeding in these patients. This article describes the musculoskeletal pathology of hemophilic arthropathy and characteristics of fascial therapy. This systematic protocol for treatment by fascial therapy of knee and ankle arthropathy in patients with hemophilia provides an analysis of the techniques that, depending on their purpose and methodology, can be used in these patients. Similarly, the protocol's applicability is analyzed and the steps to be followed in future research studies are described. Fascial therapy is a promising physiotherapy technique for treating fascial tissue and joint contractures in patients with hemophilic arthropathy. More research is needed to assess the efficacy and safety of this intervention in patients with hemophilia, particularly with randomized multicenter clinical trials

Effects of radiation therapy on the structure and function of the pelvic floor muscles of patients with cancer in the pelvic area : a systematic review

Purpose Radiation therapy (RT) is often recommended in the treatment of pelvic cancers. Following RT, a high prevalence of pelvic floor dysfunctions (urinary incontinence, dyspareunia, and fecal incontinence) is reported. However, changes in pelvic floor muscles (PFMs) after RT remain unclear. The purpose of this review was to systematically document the effects of RT on the PFM structure and function in patients with cancer in the pelvic area. Methods An electronic literature search using Pubmed Central, CINAHL, Embase, and SCOPUS was performed from date of inception up to June 2014. The following keywords were used: radiotherapy, muscle tissue, and pelvic floor. Two reviewers selected the studies in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA). Out of the 369 articles screened, 13 met all eligibility criteria. The methodological quality was assessed using the QualSyst scoring system, and standardized mean differences were calculated. Results Thirteen studies fulfilled all inclusion criteria, from which four were of good methodological quality. One presented strong evidence that RT affects PFM structure in men treated for prostate cancer. Four presented high-level evidence that RT affects PFM function in patients treated for rectal cancer. Meta-analysis was not possible due to heterogeneity and lack of descriptive statistics. Conclusion There is some evidence that RT has detrimental impacts on both PFMs’ structure and function. Implications for cancer survivors A better understanding of muscle damage and dysfunction following RT treatment will improve pelvic floor rehabilitation and, potentially, prevention of its detrimental impacts.

Tracing outsideness: young women's institutional journeys and the geographies of closed space

Understanding confinement and its complex workings between individuals and society has been the stated aim of carceral geography and wider studies on detention. This project contributes ethnographic insights from multiple sites of incarceration, working with an under-researched group within confined populations. Focussing on young female detainees in Scotland, this project seeks to understand their experiences of different types of ‘closed’ space. Secure care, prison and closed psychiatric facilities all impact on the complex geographies of these young women’s lives. The fluid but always situated relations of control and care provide the backdrop for their journeys in/out and beyond institutional spaces. Understanding institutional journeys with reference to age and gender allows an insight into the highly mobile, often precarious, and unfamiliar lives of these young women who live on the margins. This thesis employs a mixed-method qualitative approach and explores what Goffman calls the ‘tissue and fabric’ of detention as a complex multi-institutional practice. In order to be able to understand the young women’s gendered, emotional and often repetitive experiences of confinement, analysis of the constitution of ‘closed space’ represents a first step for inquiry. The underlying nature of inner regimes, rules and discipline in closed spaces, provide the background on which confinement is lived, perceived and processed. The second part of the analysis is the exploration of individual experiences ‘on the inside’, ranging from young women’s views on entering a closed institution, the ways in which they adapt or resist the regime, and how they cope with embodied aspects of detention. The third and final step considers the wider context of incarceration by recovering the young women’s journeys through different types of institutional spaces and beyond. The exploration of these journeys challenges and re-develops understandings of mobility and inertia by engaging the relative power of carceral archipelagos and the figure of femina sacra. This project sits comfortably within the field of carceral geography while also pushing at its boundaries. On a conceptual level, a re-engagement with Goffman’s micro-analysis challenges current carceral-geographic theory development. Perhaps more importantly, this project pushes for an engagement with different institutions under the umbrella of carceral geography, thus creating new dialogues on issues like ‘care’ and ‘control’. Finally, an engagement with young women addresses an under-represented population within carceral geography in ways that raise distinctly problematic concerns for academic research and penal policy. Overall, this project aims to show the value of fine grained micro-level research in institutional geographies for extending thinking and understanding about society’s responses to a group of people who live on the margins of social and legal norms.

A single-sided NMR approach to study structural differences of bovine articular tissue

This thesis work has been developed in collaboration between the Department of Physics and Astronomy of the University of Bologna and the IRCCS Rizzoli Orthopedic Institute during an internship period. The study aims to investigate the sensitivity of single-sided NMR in detecting structural differences of the articular cartilage tissue and their correlation with mechanical behavior. Suitable cartilage indicators for osteoarthritis (OA) severity (e.g., water and proteoglycans content, collagen structure) were explored through four NMR parameters: T2, T1, D, and Slp. Structural variations of the cartilage among its three layers (i.e., superficial, middle, and deep) were investigated performing several NMR pulses sequences on bovine knee joint samples using the NMR-MOUSE device. Previously, cartilage degradation studies were carried out, performing tests in three different experimental setups. The monitoring of the parameters and the best experimental setup were determined. An NMR automatized procedure based on the acquisition of these quantitative parameters was implemented, tested, and used for the investigation of the layers of twenty bovine cartilage samples. Statistical and pattern recognition analyses on these parameters have been performed. The results obtained from the analyses are very promising: the discrimination of the three cartilage layers shows very good results in terms of significance, paving the way for extensive use of NMR single-sided devices for biomedical applications. These results will be also integrated with analyses of tissue mechanical properties for a complete evaluation of cartilage changes throughout OA disease. The use of low-priced and mobile devices towards clinical applications could concern the screening of diseases related to cartilage tissue. This could have a positive impact both economically (including for underdeveloped countries) and socially, providing screening possibilities to a large part of the population.

Novel functionalized calcium phosphates: structures, morphologies and potential applications.

The stable increase in average life expectancy and the consecutive increase in the number of cases of bone related diseases has led to a growing interest in the development of materials that can promote bone repair and/or replacement. Among the best candidates are those materials that have a high similarity to bones, in terms of composition, structure, morphology and functionality. Biomineralized tissue, and thus also bones, have three main components: water, an organic matrix and an inorganic deposit. In vertebrates, the inorganic deposit consists of what is called biological apatite, which slightly differ from stoichiometric hydroxyapatite (HA) both in crystallographic terms and in the presence of foreign atoms and species. This justifies the great attention towards calcium phosphates, which show excellent biocompatibility and bioactivity. The performances of the material and the response of the biological tissue can be further improved through their functionalization with ions, biologically active molecules and nanostructures. This thesis focuses on several possible functionalizations of calcium phosphates, and their effects on chemical properties and biological performances. In particular, the functionalizing agents include several biologically relevant ions, such as Cobalt (Co), Manganese (Mn), Strontium (Sr) and Zinc (Zn); two organic molecules, a flavonoid (Quercetin) and a polyphenol (Curcumin); and nanoparticles, namely tungsten oxide (WO3) NPs. Functionalization was carried out on various calcium phosphates: dicalcium phosphate dihydrate (DCPD), dicalcium phosphate anhydrous (DCPA) and hydroxyapatite (HA). Two different strategies of functionalization were applied: direct synthesis and adsorption from solution. Finally, a chapter is devoted to a preliminary study on the development of cements based on some of the functionalized phosphates obtained.

Angiogenic Effects Of Cryosurgery With Liquid Nitrogen On The Normal Skin Of Rats, Through Morphometric Study.

Cryosurgery is an efficient therapeutic technique used to treat benign and malignant cutaneous diseases. The primary active mechanism of cryosurgery is related to vascular effects on treated tissue. After a cryosurgical procedure, exuberant granulation tissue is formed at the injection site, probably as a result of angiogenic stimulation of the cryogen and inflammatory response, particularly in endothelial cells. To evaluate the angiogenic effects of freezing, as part of the phenomenon of healing rat skin subjected to previous injury. Two incisions were made in each of the twenty rats, which were divided randomly into two groups of ten. After 3 days, cryosurgery with liquid nitrogen was performed in one of incisions. The rats' samples were then collected, cut and stained to conduct histopathological examination, to assess the local angiogenesis in differing moments and situations. It was possible to demonstrate that cryosurgery, in spite of promoting cell death and accentuated local inflammation soon after its application, induces quicker cell proliferation in the affected tissue and maintenance of this rate in a second phase, than in tissue healing without this procedure. These findings, together with the knowledge that there is a direct relationship between mononuclear cells and neovascularization (the development of a rich system of new vessels in injury caused by cold), suggest that cryosurgery possesses angiogenic stimulus, even though complete healing takes longer to occur. The significance level for statistical tests was 5% (p<0,05).

The Sperm Of Hexagenia (pseudeatonica) Albivitta Walker (ephemeroptera: Fossoriae: Ephemeridae)

This study describes the sperm morphology of the mayfly Hexagenia (Pseudeatonica) albivitta (Ephemeroptera). Its spermatozoon measures approximately 30 μm of which 9 μm corresponds to the head. The head is composed of an approximately round acrosomal vesicle and a cylindrical nucleus. The nucleus has two concavities, one in the anterior tip, where the acrosomal vesicle is inserted and a deeper one at its base, where the flagellum components are inserted. The flagellum is composed of an axoneme, a mitochondrion and a dense rod adjacent to the mitochondrion. A centriolar adjunct is also observed surrounding the axoneme in the initial portion of the flagellum and extends along the flagellum for at least 2 μm, surrounding the axoneme in a half-moon shape. The axoneme is the longest component of the flagellum, and it follows the 9+9+0 pattern, with no central pair of microtubules. At the posterior region of the flagellum, the mitochondrion has a dumb-bell shape in cross sections that, together with the rectangular mitochondrial-associated rod, is responsible for the flattened shape of the flagellum. An internal membrane is observed surrounding both mitochondrion and its associated structure.

Lipoidoproteinose

OBJETIVO: Apresentar as características clínicas, tratamento cirúrgico e achado histológico de um caso de lipoidoproteinose. DESCRIÇÃO DO CASO: Criança do sexo masculino, cinco anos de idade, branco, que procurou atendimento odontológico na Universidade. A mãe da criança relatou presença de intensa halitose e dificuldade na alimentação e higienização bucal, decorrentes de crescimento gengival generalizado nos arcos dentários superior e inferior. No exame clínico, verificaram-se comprometimento funcional e estético generalizado (rouquidão, artralgia bilateral no joelho e tornozelo, lesões tumorais nas orelhas, entre outros), além de extensa hiperplasia gengival em ambos os arcos dentários. Optou-se pelo tratamento cirúrgico, com remoção do tecido hiperplásico e exodontia de todos os dentes decíduos e de dois permanentes. O exame histopatológico da peça cirúrgica confirmou o diagnóstico de lipoidoproteinose. COMENTÁRIOS: A lipoidoproteinose é uma doença rara caracterizada pela deposição da substância hialina na pele, membranas mucosas e nos órgãos internos. Os sinais que podem surgir após o nascimento, são: rouquidão; lesões pápulo-nodulares na cabeça, pescoço e membros; lesões papulares amareladas nas margens das pálpebras. O curso desta doença é benigno e crônico.

Avaliação da cicatrização de feridas em dorso de ratos tratados com mitomicina C tópica e posterior reforço com injetável

Estudo experimental em animais. A mitomicina C vem sendo usada como inibidor de fibroblastos, acarretando, com isso, diminuição do processo cicatricial em feridas cirúrgicas. OBJETIVO: Este trabalho visa avaliar o uso de Mitomicina C para diminuir o processo cicatricial, através de seu uso tópico com reforços posteriores injetáveis. MATERIAL E MÉTODOS: Foi usado um modelo de feridas em dorso de ratos, com retirada circular da pele e cicatrização por segunda intenção. Foram usados 18 ratos, divididos em três grupos: controle; com uso tópico; e com reforço de mitomicina C injetável, mensalmente e por 2 meses. Após 3 meses os animais foram sacrificados e as cicatrizes retiradas cirurgicamente e submetidas a estudo histológico. RESULTADOS: Notou-se sob vários critérios que a cicatrização com o uso tópico é menos intensa, mas ao se usar o reforço injetável os parâmetros voltam a ser comparados ao do grupo controle. DISCUSSÃO: Acreditamos que a administração injetável de mitomicina C nas cicatrizes, pela sua elevada característica tóxica, acarreta destruição tecidual e neoformação cicatricial. CONCLUSÕES: A mitomicina C diminui o processo cicatricial quando usada topicamente, mas acarreta aumento da cicatrização quando nestas feridas são feitos reforços injetáveis.

Efeito do treinamento físico em alterações induzidas pelo envelhecimento no músculo papilar do rato

FUNDAMENTO: Os efeitos do envelhecimento no músculo papilar têm sido amplamente demonstrados, mas não há dados disponíveis sobre os efeitos do exercício nas alterações relacionadas à idade. OBJETIVO: Analisar os efeitos do envelhecimento nas propriedades morfológicas e quantitativas do músculo papilar e investigar se um programa contínuo de exercícios moderados pode exercer um efeito protetor contra as conseqüências do envelhecimento. MÉTODOS: Microscopia eletrônica foi utilizada para estudar a densidade dos miócitos, capilares e tecido conectivo e área transversal dos miócitos do músculo papilar no ventrículo esquerdo de ratos Wistar de 6 e 13 meses, não-treinados e submetidos a exercícios. RESULTADOS: Como esperado, a densidade de volume dos miócitos diminui significantemente (p<0,05) com a idade. A densidade de comprimento dos capilares também diminui com a idade, mas não de forma significante. A fração de volume intersticial do tecido do músculo capilar aumenta significantemente com a idade (P<0,05). O número de perfis de miócitos mostrou uma redução de 20% que foi acompanhada de hipertrofia dos miócitos no envelhecimento (P<0,05). Animais submetidos a uma sessão diária de 60 minutos, 5 dias/semana a 1,8 km.h-1 de corrida moderada em esteira ergométrica durante 28 semanas mostraram uma reversão de todos os efeitos do envelhecimento observados no músculo papilar. CONCLUSÃO: O presente estudo apóia o conceito de que treinamento físico de longo prazo impede as mudanças deletérias relacionadas à idade no músculo capilar.

Exercise x BCAA supplementation in young trained rats: what are their effects on body growth?

The purpose of this study was to evaluate whether Branched-chain amino acids (BCAAs) supplementation had any beneficial effects on growth and metabolic parameters of young rats submitted to chronic aerobic exercise. Thirty-two young rats (age: 21-d) were randomly assigned to four experimental groups (n = 8): Supplemented Trained (Sup/Ex), Control Trained (Ctrl/Ex), Supplemented Sedentary (Sup/Sed) and Control Sedentary (Ctrl/Sed). The trained groups underwent a five-week swimming protocol and received supplemented (45 mg BCAA/body weight/day) or control ration. Trained animals presented a lower body length and a higher cartilage weight, regardless of supplementation. Physical activity was responsible for a substantial reduction in proteoglycan synthesis in cartilage tissue, and BCAA supplementation was able to attenuate this reduction and also to improve glycogen stores in the liver, although no major differences were found in body growth associated to this supplementation.

Genetic diversity of turmeric germplasm (Curcuma longa; Zingiberaceae) identified by microsatellite markers

Turmeric (Curcuma longa) is a triploid, vegetatively propagated crop introduced early during the colonization of Brazil. Turmeric rhizomes are ground into a powder used as a natural dye in the food industry, although recent research suggests a greater potential for the development of drugs and cosmetics. In Brazil, little is known about the genetic variability available for crop improvement. We examined the genetic diversity among turmeric accessions from a Brazilian germplasm collection comprising 39 accessions collected from the States of Goias, Mato Grosso do Sul, Minas Gerais, Sao Paulo, and Para. For comparison, 18 additional genotypes were analyzed, including samples from India and Puerto Rico. Total DNA was extracted from lyophilized leaf tissue and genetic analysis was performed using 17 microsatellite markers (single-sequence repeats). Shannon-Weiner indexes ranged from 0.017 (Minas Gerais) to 0.316 (Sao Paulo). Analyses of molecular variance (AMOVA) demonstrated major differences between countries (63.4%) and that most of the genetic diversity in Brazil is found within states (75.3%). Genotypes from Sao Paulo State were the most divergent and potentially useful for crop improvement. Structure analysis indicated two main groups of accessions. These results can help target future collecting efforts for introduction of new materials needed to develop more productive and better adapted cultivars.

Evaluation of the spouted bed dried leaf extract of Bauhinia forficata for the treatment of experimental diabetes in rats

Previously, we have demonstrated that treatment of experimental diabetes with a decoction of Bauhinia forficata leaves is beneficial. In this study, we prepared a two-fold concentrate of this extract and tested its effects on physiological, biochemical and toxicity markers in streptozotocin-diabetic rats. Dried and ground leaves were extracted with warm 70% hydroethanol and the filtrate concentrated by evaporation at 50 degrees C. This solution was mixed with colloidal silicon dioxide (Tixosil-333 (R)) and dried in a spouted bed (BfT). Rats were treated with water, insulin and Tixosil particles at low or high doses, alone or coated with dried BfT. Animals were periodically weighed and monitored for water and food intake; urinary volume, glucose, urea and protein; blood glucose, serum lipids, liver toxicity markers transaminase and phosphatase and masses of adipose tissue and skeletal muscle. Insulin treatment gave best rat growth and lowest values for all other markers. No other treatment affected any diabetic marker, but the enzyme activities were changed by diabetes and BfT. Thus, BfT toxicity could arise from secondary products of plant constituents or Tixosil interaction. Therefore, BfT prepared in the spouted bed as described, is unsuitable for treatment of diabetes, which implies that the method of preparation of any medicine is critical for its efficacy and toxicity.

Analysis of breast cancer by small angle X-ray scattering (SAXS)

Small angle X-ray scattering (SAXS) images of normal breast tissue and benign and malignant breast tumour tissues, fixed in formalin, were measured at the momentum transfer range of 0.063 nm(-1) <= q (=4 pi sin(theta/2)/lambda) <= 2.720 nm(-1). Four intrinsic parameters were extracted from the scattering profiles (1D SAXS image reduced) and, from the combination of these parameters, another three parameters were also created. All parameters, intrinsic and derived, were subject to discriminant analysis, and it was verified that parameters such as the area of diffuse scatter at the momentum transfer range 0.50 <= q <= 0.56 nm(-1), the ratio between areas of fifth-order axial and third-order lateral peaks and third-order axial spacing provide the most significant information for diagnosis (p < 0.001). Thus, in this work it was verified that by combining these three parameters it was possible to classify human breast tissues as normal, benign lesion or malignant lesion with a sensitivity of 83% and a specificity of 100%.