Gastric pseudoaneurysm in the setting of Loey’s Dietz Syndrome

Loey’s Dietz syndrome is a disorder of connective tissue caused by a mutation in the genes that encode transforming growth factor (TGF) beta receptor 1 and 2. It is an autosomal dominant disorder similar to Marfan’s syndrome but with a more aggressive clinical course. Patients with Loey’s-Dietz syndrome have progressive dilatation of the aortic root that can lead to aortic dissection and rupture. The location of non-aortic arterial aneurysms may be wide spread but often occur in the head and neck vessels.peer-reviewe

Feasibility Study of Liquid-Based Cytology for Post-Treatment Surveillance of Patients with Vulvar Intraepithelial Neoplasia

Introduction: Colposcopy and tissue biopsy remain the gold standard for diagnosing vulvar intraepithelial neoplasia (VIN). Vulvar colposcopy is fairly nonspecific. As a result, many women undergo unwarranted painful biopsies. Vulvar cytology, which is relatively painless, inexpensive and allows a larger area to be sampled, may likely reduce false negative diagnoses. However, previous cytological studies that used conventional methodologies were largely unsuccessful in diagnosing VIN. In this study, liquid based cytology and HPV typing by PCR have been assessed as possible alternatives to biopsy for follow-up surveillance of women treated for VIN. Methods: Women with a history of VIN and a control group were recruited from a colposcopy clinic. Clinically suspicious lesions and normal vulvar tissue were vigorously brushed and the sample collected in PreservCyt® fluid for cytologic examination and for HPV-typing with a multiplex PCR assay, using primers designated PGMY09/11. Samples (N=82) were obtained from 52 lesions clinically suspicious for VIN, 15 controls from the same women in areas of the vulva with no clinical abnormality, and 15 controls from women with no current clinical evidence or past history of VIN. Concurrent tissue biopsies were obtained, immediately after brushing, from the 52 clinically suspicious VIN lesions. A single pathologist read and interpreted the biopsy samples. To ensure unbiased testing, cytology and HPV analyses were performed at separate independent laboratories by professionals blinded to clinical findings and biopsy results. Cytology was coded as negative, ASCUS, VIN I, VIN 2, or VIN 3. Specificity, sensitivity, and predictive values of cytology and HPV for VIN were calculated. Fisher’s exact was used to determine associations between HPV and cytology. Logistic regression was done to determine if cytology or HPV predicted tissue biopsy results. Results: Vulvar samples (N=82) were collected from 48 women aged 19-65 who participated in this study. Histology results of the 52 lesions clinically suspected as VIN were reported as follows: VIN I (n=33), VIN 2/3 (n=13), benign (n=4), contact dermatitis and condyloma (n=1 each). Ninety percent of the vulvar samples were adequate for cytologic evaluation, but only 72% of samples had adequate cellularity for HPV testing. Sensitivity, specificity and positive predictive value (PPV) of vulvar cytology for recurrent VIN were 95%, 15% and 65% respectively. PCR for HPV, when independently correlated with histology, had, 62% sensitivity, 85% specificity and 89% PPV for VIN. No significant associations were found between cytology and HPV (p=0.3559). Neither cytology nor HPV predicted pathological diagnosis of VIN. Conclusion: By vigorous brushing, it is possible to obtain an adequate cellular sample from the vulva for cytologic and/or molecular evaluation for HPV.The specificity for VIN at cytology was not satisfactory for use as a clinical alternative to biopsy to detect recurrent VIN. This may be due to the small sample size, difficulty in accurately grading vulvar dysplasia at cytology, and possible differences in cytomorphologic criteria for diagnosing dysplasia in the vulva as compared to the cervix. This study will be further refined with the development of more reproducible consensus criteria for cytologic evaluation of VIN. A larger number of participants could shed more light on the significance of cytology with or without HPV testing as an alternative to tissue biopsy for follow up of patients with VIN

Psychosexual aspects of vulvovaginal pain

Vulvovaginal pain problems are major health concerns in women of childbearing age. Controlled studies have shown that vulvovaginal pain can adversely affect women and their partners’ general psychological well-being, relationship adjustment and overall quality of life. These women have significantly lower levels of sexual desire, arousal, and satisfaction, as well as a lower intercourse frequency than normal controls. They also report more anxiety and depression, in addition to more distress about their body image and genital self-image. Empirical studies indicate that specific psychological and relationship factors may increase vulvovaginal pain intensity and its psychosexual sequelae. Randomized clinical trials have shown that psychosexual interventions, namely cognitive-behavioral therapy (CBT), are efficacious in reducing vulvovaginal pain and improving associated psychosexual outcomes. Women reporting significant psychological, sexual and/or relationship distress should be referred for psychosexual treatment. A multimodal approach to care integrating psychosexual and medical management is thought to be optimal

A dança vogue femme : análise cinesiológica do elemento dip na articulação do joelho

O Vogue Femme é uma dança que surgiu sob a forma de batalhas performativas, por volta da década de 60, em bailes da comunidade afro-americana e latina LGBTQ+. O Dip, é o elemento mais icônico do Vogue Femme e, também, um dos mais complicados de ser executado, podendo ocasionar lesões na articulação do joelho devido à posição dessa articulação na finalização do movimento. Apesar do aumento da popularidade da cultura Ballroom, nos últimos 20 anos, ainda há pouco conhecimento no mundo acadêmico sobre a saúde de um Vogue performer. Assim, com esse estudo pretende abrir portas para uma discussão sobre a saúde da comunidade, visto que muitas lesões ocorrem pela falta de informação e pela falta de estudos e publicações nessa área. Esse estudo tem como objetivo geral realizar uma análise cinesiológica qualitativa da articulação do joelho no Dip; e, como objetivos específicos: verificar a musculatura da articulação do joelho envolvida durante a execução do elemento Dip; e, descrever os ângulos da articulação do joelho ao longo da execução do Dip. Essa pesquisa é um estudo de caso do tipo descritivo. O participante estudado é um Vogue Performer selecionado de forma não-probabilística intencional. Para a captura do elemento Dip foi utilizada uma câmera de vídeo GoPro HERO 7 Black, resolução de 1920x1080p, 60 frames por segundo, posicionada a dois metros de distância do bailarino, possibilitando uma visão do elemento em 2D no plano coronal e no sagital. Para a análise do vídeo de captura do elemento Dip foi utilizado o software Kinovea, versão 0.9.4, no qual puderam ser observados os movimentos articulares do joelho e calculados os ângulos articulares em ambos os lados do corpo nas diferentes etapas de execução do elemento. Após a coleta de dados, a análise cinesiológica foi realizada através da observação das imagens capturadas. Para essa análise, o elemento Dip foi dividido em quatro fases, identificando os grupos musculares primários, nas fases excêntrica e concêntrica, atuantes na articulação do joelho e os ângulos articulares do joelho durante a sua execução. Em relação aos músculos primários envolvidos ao longo da execução do Dip, na fase 2 e 3 o grupo muscular quadríceps (músculos reto femoral, vasto lateral, vasto intermédio e vasto medial) realiza uma contração excêntrica; e, na fase 4 os mesmos músculos seguem agindo de forma excêntrica no joelho direito e concêntrica no joelho esquerdo. Em relação aos ângulos atingidos ao longo da execução do elemento Dip, observou-seVogue Femme is a dance that arises from performatic battles that took place in afroamerican community balls around the 1960s. The Dip is the most iconic Vogue Femme element and is also one of the most complicated to execute, with the potential to cause injury to the knee joint due to the position of the knee in the ending pose of the Dip. Although the popularity of Ballroom culture has increased in the last 20 years, there is still little works about it published in the academic field regarding the health of a Vogue Performer. Therefore, this study inteds to create discussions about the Ballroom community health, since many injuries occur due to the lack of information and studies in the Vogue Femme field. The main object of this work is to perform a qualitative kinesiological analysis of the knee joint in the Dip. The specific objectives are to verify the musculature of the knee joint, describing and documentating its angles, during the execution of the Dip element. This paper is a descriptive case study. The studied subject is a Vogue Performer selected in an intentional non-probabilistic manner. To capture the Dip element, a GoPro HERO 7 Black video camera was used (1920x1080p resolution, 60 frames per second), being positioned two meters far from the dancer, allowing a 2D view of the element in the coronal and sagittal planes. Kinovea software (version 0.9.4) was used to analyze the video of the Dip element, in which the knee joint movements could be observed and the joint angles on both sides of the body were calculated in the different stages of the execution. After data collection, kinesiological analysis was performed by observing the captured images. For the analysis, the Dip element was divided into four phases, identifying the primary muscle groups in both eccentric and concentric phases, that act on the knee joint and the knee joint angles during its execution. Regarding the primary muscles involved throughout the execution of the Dip in phase 2 and 3, the quadriceps muscles (rectus femoris, vastus lateralis, vastus intermedius and vastus medialis) perform an eccentric contraction; and, during phase 4, the same muscles continue to act eccentrically in the right knee and concentric in the left knee. Regarding the angles reached during the execution of the Dip element, an average angulation of 45º in the right knee and 97º in the left knee was detected in phase 2; 20º on the right knee and 94º on the left knee in phase 3; and 18º in the right knee and 0º in the left knee in phase 4. After carrying out this research, it is possible to better understand the kinesiological characteristics of the Dip element, and to find a means of preventing injuries, therefore assisting in the teaching of the Vogue Femme dance and contribuiting as reference for future studies

Elemento dip da dança Vogue Femme: análise cinesiológica da articulação do joelho

A dança Vogue Femme surgiu por volta da década de 1980 em Nova Iorque (EUA). Em Porto Alegre (RS), a dança foi introduzida pela pioneira Miss Chi Chi Unique. Dentre os cinco elementos desta dança, o dip é o mais emblemático. O objetivo dessa pesquisa foi analisar a articulação do joelho durante a execução do elemento dip através de uma análise cinesiológica qualitativa para determinar a musculatura primária envolvida em cada fase do movimento. Este é um estudo de caso do tipo descritivo-explanatório que analisou o dip em um bailarino de Vogue Femme. Uma análise 2D foi conduzida utilizando uma câmera GoPro HERO 7 Black (1920x1080p – 60 fps). Marcadores brancos foram posicionados nos pontos anatômicos dos membros inferiores. O elemento foi dividido em quatro fases e analisado no plano coronal. O software Kinovea versão 0.9.4 foi utilizado para determinar os ângulos articulares através da ferramenta goniômetro. O grupo muscular primário responsável pela execução do dip é o quadríceps femoral. Foi observada uma contração excêntrica da musculatura primária durante as fases dois e três. Na fase quatro, foi observada uma contração concêntrica do quadríceps femoral na extensão do joelho esquerdo, enquanto uma contração excêntrica dos músculos no joelho direito foi mantida. Uma média de 26/28/29º foi detectada na articulação do joelho direito nas fases dois, três e quatro respectivamente. Esses ângulos indicam uma possível rotação medial do joelho direito, podendo gerar uma lesão nos meniscos devido à pressão aplicada nestas cartilagens. Para evitar a rotação medial do joelho, sugere-se que o elemento dip seja executado com o pé logo abaixo do quadril. A análise cinesiológica é uma ferramenta fácil e acessível para compreender a execução dos movimentos e este é o primeiro estudo a propor tal abordagem

Elemento dip da dança Vogue Femme: análise cinesiológica da articulação do joelho

The Vogue Femme dance emerged in the 1980s in New York. From the five elements of this dance, the dip is the most emblematic one. The objective of this research was to analyze the knee joint during the execution of the dip element trough a qualitative kinesiological analysis to determine the primary muscles involved. This is a descriptive-explanatory single case study that analyzed a Vogue Femme dancer. A 2D analysis was conducted using a GoPro HERO 7 Black (1920x1080p – 60 fps). White markers were positioned in the anatomic points of the lower limbs. The element was divided into four phases and analyzed in the coronal plane. The Kinovea software version 0.9.4 was used to determine the joint angles trough the goniometer tool. The primary group of muscles responsible for the execution of the dip is the quadriceps femoris. It was observed an eccentric contraction of the primary muscles during phases two and three. In phase four, it was observed a concentric contraction of the quadriceps femoris in the extension of the left knee, while the right knee muscles kept an eccentric contraction. An average of 26/28/29º was detected on the right knee in phases two, three and four respectively. Those angles indicate the possibility of a medial rotation of the right knee, which could lead to an injury in the menisci due to the pressure applied to the cartilages. To avoid the medial rotation of the knee, it is suggested to execute the dip element with the foot right under the hip. The kinesiological analysis is an easy and accessible tool to understand the execution of the movements and this is the first study to propose such an approach.A dança Vogue Femme surgiu por volta da década de 1980 em Nova Iorque (EUA). Em Porto Alegre (RS), a dança foi introduzida pela pioneira Miss Chi Chi Unique. Dentre os cinco elementos desta dança, o dip é o mais emblemático. O objetivo dessa pesquisa foi analisar a articulação do joelho durante a execução do elemento dip através de uma análise cinesiológica qualitativa para determinar a musculatura primária envolvida em cada fase do movimento. Este é um estudo de caso do tipo descritivo-explanatório que analisou o dip em um bailarino de Vogue Femme. Uma análise 2D foi conduzida utilizando uma câmera GoPro HERO 7 Black (1920x1080p – 60 fps). Marcadores brancos foram posicionados nos pontos anatômicos dos membros inferiores. O elemento foi dividido em quatro fases e analisado no plano coronal. O software Kinovea versão 0.9.4 foi utilizado para determinar os ângulos articulares através da ferramenta goniômetro. O grupo muscular primário responsável pela execução do dip é o quadríceps femoral. Foi observada uma contração excêntrica da musculatura primária durante as fases dois e três. Na fase quatro, foi observada uma contração concêntrica do quadríceps femoral na extensão do joelho esquerdo, enquanto uma contração excêntrica dos músculos no joelho direito foi mantida. Uma média de 26/28/29º foi detectada na articulação do joelho direito nas fases dois, três e quatro respectivamente. Esses ângulos indicam uma possível rotação medial do joelho direito, podendo gerar uma lesão nos meniscos devido à pressão aplicada nestas cartilagens. Para evitar a rotação medial do joelho, sugere-se que o elemento dip seja executado com o pé logo abaixo do quadril. A análise cinesiológica é uma ferramenta fácil e acessível para compreender a execução dos movimentos e este é o primeiro estudo a propor tal abordagem

The betaine and choline content of a whole wheat flour compared to other mill streams

Diets that contain high levels of whole grains have been associated with a reduced risk of several chronic diseases (Marquart et al., 2002). A whole grain, as defined by AACC International, should consist of the bran, germ and endosperm in the same proportions as found in nature (AACC, 1999). Whole grains are an important source of dietary fiber, resistant starch, vitamins, minerals and other bioactive nutrients that can play a role in protecting against chronic disease (Slavin, 2003). One of these nutrients is betaine (also known as trimethyl glycine or glycine betaine), an osmolyte and methyl donor shown to protect internal organs and improve vascular risk factors (Craig, 2004). As an osmolyte, it helps protect a variety of cells from osmotic stress. Betaine also plays an important role in cell biochemistry, donating a methyl group to homocysteine to produce methionine and ultimately S-adenosyl-methionine. Betaine accumulates in many plants under stress from drought, high salinity or low temperature. Cereal plants with betaine accumulation include wheat, barley and rye; those with little or no accumulation include rice, millet and sorghum (Kishitani et al., 1994)