Dose-dependent increases in p70S6K phosphorylation and intramuscular branched-chain amino acids in older men following resistance exercise and protein intake.

Resistance exercise and whey protein supplementation are effective strategies to activate muscle cell anabolic signaling and ultimately promote increases in muscle mass and strength. In the current study, 46 healthy older men aged 60–75 (69.0 ± 0.55 years, 85.9 ± 1.8 kg, 176.8 ± 1.0 cm) performed a single bout of unaccustomed lower body resistance exercise immediately followed by ingestion of a noncaloric placebo beverage or supplement containing 10, 20, 30, or 40 g of whey protein concentrate (WPC). Intramuscular amino acid levels in muscle biopsy samples were measured by Gas Chromatography–Mass Spectrometry (GC-MS) at baseline (before exercise and WPC supplementation) plus at 2 h and 4 h post exercise. Additionally, the extent of p70S6K phosphorylation at Thr389 in muscle biopsy homogenates was assessed by western blot. Resistance exercise alone reduced intramuscular branch chain amino acid (BCAA; leucine, isoleucine, and valine) content. Supplementation with increasing doses of whey protein prevented this fall in muscle BCAAs during postexercise recovery and larger doses (30 g and 40 g) significantly augmented postexercise muscle BCAA content above that observed following placebo ingestion. Additionally, the fold change in the phosphorylation of p70S6K (Thr389) at 2 h post exercise was correlated with the dose of whey protein consumed (r = 0.51, P < 001) and was found to be significantly correlated with intramuscular leucine content (r = 0.32, P = 0.026). Intramuscular BCAAs, and leucine in particular, appear to be important regulators of anabolic signaling in aged human muscle during postexercise recovery via reversal of exercise-induced declines in intramuscular BCAAs

Management of bleeding in trauma victims by Portuguese nurses in prehospital setting

Introduction: External bleeding is the leading preventable cause of death from traumatic injuries. Implementation of guidelines for its control have been associated with a significant reduction in mortality. The objectives of this study were to provide a characterisation of trauma patients with external bleeding and to compare the outcomes from specific autonomous interventions applied by nurses in prehospital care.Methods: A non-randomised prospective study was conducted in the Immediate Life Support Ambulances in Portugal, from 1 March 2019 to 30 April 2020. Patients were divided into two groups according to whether external bleeding was controlled or not on their arrival at the emergency room.Results: A total of 189 patients were included in this study (73.0% men; mean age of 53.6 years). Among these patients, 140 (74.1%) had their external bleeding controlled by prehospital nurse’s intervention. The average time of assistance at the incident site was 31.5 min. Patients with uncontrolled bleeding had a higher average rescue time (30.8 ±15.2 vs 33.7 ±13.0). Cryotherapy was administered to 15.9% of all patients and 93.3% of these patients arrived at the emergency room with controlled bleeding (p=0.01).Discussion: Despite the substantial reduction in the number of patients who keep bleeding after prehospital care, it was observed that one fifth of patients have external bleeding on arrival at the emergency room. Cryotherapy has been shown to be effective in controlling external bleeding. Failure to use haemostatic agents may explain the ineffective control of more complex external bleeding.Contribution to Emergency Nursing Practice: The current literature on management of bleeding in trauma patients is scarce and contradictory, especially in terms of interventions provided by AUTHORSMAURO AL MOTA PhD, RN1,2,3,4,5MARGARIDA REIS SANTOS PhD, RN6,7EDUARDO JF SANTOS PhD, RN2,3ANDREA FIGUEIREDO MSN, RN5FILIPE MELO MSN, RN5,8,9SARA ALBUQUERQUE MSc, MD10MADALENA CUNHA PhD, RN2,31. Abel Salazar Institute of Biomedical Sciences, University of Porto, Porto, Portugal2. Health School of the Polytechnic Institute of Viseu, Portugal3. Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Portugal4. Hospital Nossa Senhora da Assunção, Local Health Unit of Guarda, Seia, Portugal5. INEM – National Institute of Medical Emergency. Portugal6. Nursing School of Porto, Porto, Portugal7. CINTESIS – Center for Health Technology and Services Research, University of Porto, Porto, Portugal8. Hospital de Faro. University Hospital Center of Algarve. Faro, Portugal9. ABC – Algarve Biomedical Centre. Faro, Portugal10. Group of Health Centers – Greater Porto VII – Gaia, USF Nova Salus, Gaia, PortugalRESEARCH ARTICLESManagement of bleeding in trauma victims by Portuguese nurses in prehospital setting rehospital teams led by a registered nurse. In addition, interventions vary from country to country.This article increases awareness of autonomous interventions implemented by prehospital nurses to manage external bleeding.Key implications for emergency nursing practice identified in this study suggest greater fluid therapy appears harmful while cryotherapy achieved the best results (control of the bleeding on emergency room arrival). This may contribute to the review of institutional algorithms and training in this area.info:eu-repo/semantics/publishedVersio

Gangrena de Fournier numa Mulher

A fasceíte necrotizante dos tecidos infra-diafragmáticos (gangrena de Fournier) é uma grave infecção sinergística por agentes aeróbicos/anaeróbicos, com uma evolução clínica súbita e rápida de gangrena da fascia e sepsis generalizada, associada a elevada mortalidade. Trata-se de uma emergência médico-cirúrgica necessitando de tratamento intensivo englobando a correcção das anomalias hemodinâmicas, hidroelectrolí- ticas e metabólicas, antibioterapia dupla/tripla de largo espectro por via endovenosa, desbridamento cirúrgico agressivo do tecido necrótico infectado e correcção da determinante etiológica da gangrena. É frequente encontrar como factores de risco a diabetes mellitus, doença crónica hepática, doenças malignas, doenças imunológicas congénitas ou adquiridas, tratamento com fármacos imuno-supressores, alcoolismo crónico e má nutrição. As fontes infecciosas originais conducentes a uma gangrena de Fournier são geralmente abcessos da área peri-anal ou processos infecciosos genitourológicos. Embora a gangrena de Fournier seja muito menos frequente na mulher que no homem, é importante pensar nesse diagnóstico, de forma a proporcionar às doentes a possibilidade de tratamento com sucesso. Descreve-se o caso de uma gangrena de Fournier, determinada porumabscesso da fossa ísquio-rectal, numa mulher diabética e em tratamento de um penfigus vulgaris com fármacos imuno-supressores, com evolução fatal, possivelmente em resultado de diagnóstico e tratamento tardios

Fecal occult blood and fecal calprotectin as point-of-care markers of intestinal morbidity in Ugandan children with Schistosoma mansoni infection.

BACKGROUND: Calprotectin is a calcium-binding cytoplasmic protein found in neutrophils and increasingly used as a marker of bowel inflammation. Fecal occult blood (FOB) is also a dependable indicator of bowel morbidity. The objective of our study was to determine the applicability of these tests as surrogate markers of Schistosoma mansoni intestinal morbidity before and after treatment with praziquantel (PZQ). METHODS: 216 children (ages 3-9 years old) from Buliisa District in Lake Albert, Uganda were examined and treated with PZQ at baseline in October 2012 with 211 of them re-examined 24 days later for S. mansoni and other soil transmitted helminths (STH). POC calprotectin and FOB assays were performed at both time points on a subset of children. Associations between the test results and infection were analysed by logistic regression. RESULTS: Fecal calprotectin concentrations of 150-300 µg/g were associated with S. mansoni egg patent infection both at baseline and follow up (OR: 12.5 P = 0.05; OR: 6.8 P = 0.02). FOB had a very strong association with baseline anemia (OR: 9.2 P = 0.03) and medium and high egg intensity schistosomiasis at follow up (OR: 6.6 P = 0.03; OR: 51.3 P = 0.003). Both tests were strongly associated with heavy intensity S. mansoni infections. There was a significant decrease in FOB and calprotectin test positivity after PZQ treatment in those children who had egg patent schistosomiasis at baseline. CONCLUSIONS: Both FOB and calprotectin rapid assays were found to correlate positively and strongly with egg patent S. mansoni infection with a positive ameloriation response after PZQ treatment indicative of short term reversion of morbidity. Both tests were appropriate for use in the field with excellent operational performance and reliability. Due to its lower-cost which makes its scale-up of use affordable, FOB could be immediately adopted as a monitoring tool for PC campaigns for efficacy evaluation before and after treatment

Multiplicity of Positive Solutions for an Obstacle Problem in R

In this paper we establish the existence of two positive solutions for the obstacle problem \displaystyle \int_{\Re}\left[u'(v-u)'+(1+\lambda V(x))u(v-u)\right] \geq \displaystyle \int_{\Re} f(u)(v-u), \forall v\in \Ka where $f$ is a continuous function verifying some technical conditions and \Ka is the convex set given by \Ka =\left\{v\in H^{1}(\Re); v \geq \varphi \right\}, with $\varphi \in H^{1}(\Re)$ having nontrivial positive part with compact support in $\Re$. \vspace{0.2cm} \noindent \emph{2000 Mathematics Subject Classification} : 34B18, 35A15, 46E39. \noindent \emph{Key words}: Obstacle problem, Variational methods, Positive solutions.Comment: To appear in Progress in Nonlinear Differential Equations and their Application

A Novel Plant-Based Protein Has Similar Effects Compared to Whey Protein on Body Composition, Strength, Power, and Aerobic Performance in Professional and Semi-Professional Futsal Players

IntroductionThe effects of dietary protein on body composition and physical performance seemingly depend on the essential amino acid profile of the given protein source, although controversy exists about whether animal protein sources may possess additional anabolic properties to plant-based protein sources. PurposeTo compare the effects of a novel plant-based protein matrix and whey protein supplementation on body composition, strength, power, and endurance performance of trained futsal players. MethodsFifty male futsal players were followed during 8 weeks of supplementation, with 40 completing the study either with plant-based protein (N = 20) or whey protein (N = 20). The following measures were assessed: bone mineral content, lean body mass, and fat mass; muscle thickness of the rectus femoris; total body water; blood glucose, hematocrit, C-reactive protein, aspartate aminotransferase, alanine aminotransferase, creatine kinase, creatinine, and estimated glomerular filtration rate; salivary cortisol; maximal strength and 1-RM testing of the back squat and bench press exercises; muscle power and countermovement jump; VO2max and maximal aerobic speed. Subjects were asked to maintain regular dietary habits and record dietary intake every 4 weeks through 3-day food records. ResultsNo differences in any variable were observed between groups at baseline or pre- to post-intervention. Moreover, no time*group interaction was observed in any of the studied variables, and a time effect was only observed regarding fat mass reduction. ConclusionsSupplementing with either a novel plant-based protein matrix or whey protein did not affect any of the variables assessed in high-level futsal players over 8 wks. These results suggest that whey protein does not possess any unique anabolic properties over and above those of plant-based proteins when equated to an essential amino acid profile in the population studied. Furthermore, when consuming a daily protein intake >1.6 g/kg BW.day(-1), additional protein supplementation does not affect body composition or performance in trained futsal players, regardless of protein type/source

Analytical and numerical analyses of the micromechanics of soft fibrous connective tissues

State of the art research and treatment of biological tissues require accurate and efficient methods for describing their mechanical properties. Indeed, micromechanics motivated approaches provide a systematic method for elevating relevant data from the microscopic level to the macroscopic one. In this work the mechanical responses of hyperelastic tissues with one and two families of collagen fibers are analyzed by application of a new variational estimate accounting for their histology and the behaviors of their constituents. The resulting, close form expressions, are used to determine the overall response of the wall of a healthy human coronary artery. To demonstrate the accuracy of the proposed method these predictions are compared with corresponding 3-D finite element simulations of a periodic unit cell of the tissue with two families of fibers. Throughout, the analytical predictions for the highly nonlinear and anisotropic tissue are in agreement with the numerical simulations

ATENA–A Novel Rapidly Manufactured Medical Invasive Ventilator Designed as a Response to the COVID-19 Pandemic: Testing Protocol, Safety, and Performance Validation

Background: The urgent need for mechanical ventilators to support respiratory insufficiency due to SARS-CoV-2 led to a worldwide effort to develop low-cost, easily assembled, and locally manufactured ventilators. The ATENA ventilator project was developed in a community-based approach targeting the development, prototyping, testing, and decentralized manufacturing of a new mechanical ventilator. Objective: This article aims to demonstrate ATENA's adequate performance and safety for clinical use. Material: ATENA is a low-cost ventilator that can be rapidly manufactured, easily assembled, and locally produced anywhere in the world. It was developed following the guidelines and requirements provided by European and International Regulatory Authorities (MHRA, ISO 86201) and National Authorities (INFARMED). The device was thoroughly tested using laboratory lung simulators and animal models. Results: The device meets all the regulatory requirements for pandemic ventilators. Additionally, the pre-clinical experiences demonstrated security and adequate ventilation and oxygenation, in vivo. Conclusion: The ATENA ventilator had a good performance in required tests in laboratory scenarios and pre-clinical studies. In a pandemic context, ATENA is perfectly suited for safely treating patients in need of mechanical ventilation.Financial support and sponsorship by CEiiA, INOV4COVID program, donations from scientific patronage, and commercial sales

Two Separate Effects Contribute to Regulatory T Cell Defect in Systemic Lupus Erythematosus Patients and Their Unaffected Relatives

Forkhead box P3 (FoxP3)+ regulatory T cells (Tregs ) are functionally deficient in systemic lupus erythematosus (SLE), characterized by reduced surface CD25 [the interleukin (IL)-2 receptor alpha chain]. Low-dose IL-2 therapy is a promising current approach to correct this defect. To elucidate the origins of the SLE Treg phenotype, we studied its role through developmentally defined regulatory T cell (Treg ) subsets in 45 SLE patients, 103 SLE-unaffected first-degree relatives and 61 unrelated healthy control subjects, and genetic association with the CD25-encoding IL2RA locus. We identified two separate, uncorrelated effects contributing to Treg CD25. (1) SLE patients and unaffected relatives remarkably shared CD25 reduction versus controls, particularly in the developmentally earliest CD4+ FoxP3+ CD45RO- CD31+ recent thymic emigrant Tregs . This first component effect influenced the proportions of circulating CD4+ FoxP3high CD45RO+ activated Tregs . (2) In contrast, patients and unaffected relatives differed sharply in their activated Treg CD25 state: while relatives as control subjects up-regulated CD25 strongly in these cells during differentiation from naive Tregs , SLE patients specifically failed to do so. This CD25 up-regulation depended upon IL2RA genetic variation and was related functionally to the proliferation of activated Tregs , but not to their circulating numbers. Both effects were found related to T cell IL-2 production. Our results point to (1) a heritable, intrathymic mechanism responsible for reduced CD25 on early Tregs and decreased activation capacity in an extended risk population, which can be compensated by (2) functionally independent CD25 up-regulation upon peripheral Treg activation that is selectively deficient in patients. We expect that Treg -directed therapies can be monitored more effectively when taking this distinction into account.info:eu-repo/semantics/publishedVersio

Effect of maternal Schistosoma mansoni infection and praziquantel treatment during pregnancy on Schistosoma mansoni infection and immune responsiveness among offspring at age five years.

INTRODUCTION: Offspring of Schistosoma mansoni-infected women in schistosomiasis-endemic areas may be sensitised in-utero. This may influence their immune responsiveness to schistosome infection and schistosomiasis-associated morbidity. Effects of praziquantel treatment of S. mansoni during pregnancy on risk of S. mansoni infection among offspring, and on their immune responsiveness when they become exposed to S. mansoni, are unknown. Here we examined effects of praziquantel treatment of S. mansoni during pregnancy on prevalence of S. mansoni and immune responsiveness among offspring at age five years. METHODS: In a trial in Uganda (ISRCTN32849447, http://www.controlled-trials.com/ISRCTN32849447/elliott), offspring of women treated with praziquantel or placebo during pregnancy were examined for S. mansoni infection and for cytokine and antibody responses to SWA and SEA, as well as for T cell expression of FoxP3, at age five years. RESULTS: Of the 1343 children examined, 32 (2.4%) had S. mansoni infection at age five years based on a single stool sample. Infection prevalence did not differ between children of treated or untreated mothers. Cytokine (IFNγ, IL-5, IL-10 and IL-13) and antibody (IgG1, Ig4 and IgE) responses to SWA and SEA, and FoxP3 expression, were higher among infected than uninfected children. Praziquantel treatment of S. mansoni during pregnancy had no effect on immune responses, with the exception of IL-10 responses to SWA, which was higher in offspring of women that received praziquantel during pregnancy than those who did not. CONCLUSION: We found no evidence that maternal S. mansoni infection and its treatment during pregnancy influence prevalence and intensity of S. mansoni infection or effector immune response to S. mansoni infection among offspring at age five years, but the observed effects on IL-10 responses to SWA suggest that maternal S. mansoni and its treatment during pregnancy may affect immunoregulatory responsiveness in childhood schistosomiasis. This might have implications for pathogenesis of the disease