Asymmetrical lower extremity loading early after ACL reconstruction is a significant predictor of asymmetrical loading at the time of return to sport

OBJECTIVES: The aim of this study was to examine whether asymmetrical lower limb loading early after anterior cruciate ligament reconstruction (1 mo) can predict asymmetrical lower limb loading at the time of return to sport (6 mos) and whether other early predictors as knee joint range of motion or maximal isometric strength affect this relationship. DESIGN: Ground reaction forces were measured during a sit-to-stand task 1 mo after anterior cruciate ligament reconstruction and a vertical countermovement jump 6 mos after anterior cruciate ligament reconstruction in 58 athletes. Other early postoperative measurements were knee joint range of motion (2 wks, 1 mo, and 2 mos after surgery) and maximal isometric strength of the knee extensor and flexor muscles (2 mos after surgery). Linear regression models were developed using side-to-side limb symmetry index (LSI) of countermovement jump as the dependent variable. RESULTS: LSI of sit-to-stand task 1 mo after surgery was a significant independent predictor of LSI of countermovement jump 6 mos after surgery. After accounting for deficits in knee joint range of motion and LSI of maximal isometric strength (ΔR² = 0.35, P < 0.01), LSI of sit-to-stand task predicted LSI of countermovement jump (ΔR² = 0.14 P < 0.01). CONCLUSIONS: Asymmetrical lower extremity loading 1 mo after anterior cruciate ligament reconstruction is an early predictor of asymmetrical lower extremity loading 6 mos after surgery

Quadriceps muscle compensatory activations are delayed following anterior cruciate ligament reconstruction using hamstring tendon graft

Objective: To investigate compensatory and anticipatory quadriceps muscle activations before and after anterior cruciate ligament reconstruction (ACLR) using hamstrings tendon graft. Design:Twelve participants who underwent ACLR and 12 healthy controls were exposed to 10 either unpredictable or predictable perturbations of the knee joint before ACLR (T1), 2 months (T2) and 6 months (T3) after surgery. Latencies of compensatory and anticipatory postural activations in the vastus lateralis (VL), rectus femoris (RF) and vastus medialis (VM) muscles were recorded by surface electromyography with respect to the arrival of the perturbations. Results:Latency of compensatory activations was significantly delayed in ACLR compared to that in healthy participants at T1 for VL (105 ± 25 vs. 57 ± 9 ms; P<0.001), RF (102 ± 23 vs. 56 ± 9 ms; P<0.001) and VM (107 ± 24 vs. 66 ± 16 ms;P<0.001), at T2 for VL (68 ± 14 vs. 55 ± 10 ms;29 P<0.01) and at T3 for VL (105 ± 22 vs. 58 ± 7 ms;P<0.001), RF (102 ± 22 vs. 58 ± 12 ms; P<0.001) and VM (106 ± 20 vs. 63 ± 8 ms;P<0.001). Anticipatory activations occurred earlier in ACLR than in healthy participants at T1 for VL (-82 ± 64 vs. -14 ± 11 ms; P<0.05) and VM (-105 ± 32 68 vs. -9 ± 12 ms;P<0.05). Conclusion:While anticipatory quadriceps activations show no alterations, compensatory muscle activations are delayed following ACLR with hamstring graft. Post-surgical rehabilitation should address alterations in compensatory lower limb postural control

Micro-Raman mapping of the polymorphs of serpentine

Serpentinites are rocks, often used in buildings, formed in large extent by minerals of the serpentine group: chrysotile, antigorite, lizardite, and polygonal serpentine. The fibrous type (e.g. chrysotile) of serpentine group minerals, along with several amphibole varieties (e.g. actinolite and tremolite), are the major components of asbestos family. The exposure to fine fibrous asbestos powder is linked to diseases such as pleural mesothelioma and asbestosis. The identification of the main varieties of the serpentine group, laminated or fibrous, becomes an issue of great interest for public health. This work introduces an analytical strategy able to distinguish the different serpentine polymorphs directly on the sample, allowing the analysiswithin their textural environment, evidencing at themicrometer scale the mineral reactions of the phases. Samples coming from the Koniambo massif (Grande Terre Island, New Caledonia) were studied by means of optical microscopy, scanning electron microscopy–energy dispersive X-ray spectroscopy, and Raman spectroscopy. Raman peaks observed in the high wavenumber spectral range of 3550–3850 cm-1, associated with OH stretching vibrations, allow the iscrimination of the all four serpentine varieties. The relationship between the different varieties of serpentine, at a micrometric scale, in complex samples, has been investigated by two-dimensional Raman mapping

Polysaccharides on gelatin-based hydrogels differently affect chondrogenic differentiation of human mesenchymal stromal cells

Selection of feasible hybrid-hydrogels for best chondrogenic differentiation of human mesenchymal stromal cells (hMSCs) represents an important challenge in cartilage regeneration. In this study, three-dimensional hybrid hydrogels obtained by chemical crosslinking of poly (ethylene glycol) diglycidyl ether (PEGDGE), gelatin (G) without or with chitosan (Ch) or dextran (Dx) polysaccharides were developed. The hydrogels, namely G-PEG, G-PEG-Ch and G-PEG-Dx, were prepared with an innovative, versatile and cell-friendly technique that involves two preparation steps specifically chosen to increase the degree of crosslinking and the physical-mechanical stability of the product: a first homogeneous phase reaction followed by directional freezing, freeze-drying and post-curing. Chondrogenic differentiation of human bone marrow mesenchymal stromal cells (hBM-MSC) was tested on these hydrogels to ascertain whether the presence of different polysaccharides could favor the formation of the native cartilage structure. We demonstrated that the hydrogels exhibited an open pore porous morphology with high interconnectivity and the incorporation of Ch and Dx into the G-PEG common backbone determined a slightly reduced stiffness compared to that of G-PEG hydrogels. We demonstrated that G-PEG-Dx showed a significant increase of its anisotropic characteristic and G-PEG-Ch exhibited higher and faster stress relaxation behavior than the other hydrogels. These characteristics were associated to absence of chondrogenic differentiation on G-PEG-Dx scaffold and good chondrogenic differentiation on G-PEG and G-PEG-Ch. Furthermore, G-PEG-Ch induced the minor collagen proteins and the formation of collagen fibrils with a diameter like native cartilage. This study demonstrated that both anisotropic and stress relaxation characteristics of the hybrid hydrogels were important features directly influencing the chondrogenic differentiation potentiality of hBM-MSC

Sala de recursos multifuncional: espaço educacional colaborativo para o ensino de língua portuguesa escrita

Este artigo tem como objetivo apresentar uma prática exitosa desenvolvida na Sala de Recursos Multifuncional para a aquisição da língua portuguesa de alunos com impedimento auditivo da rede regular de ensino. Ele visa caracterizar os caminhos traçados deste processo, bem como o desenvolvimento da escrita do aluno com impedimento auditivo, além de apresentar possibilidades para que o ensino seja alcançado de forma significativa. A metodologia utilizada foi uma pesquisa bibliográfica narrativa, descritiva e explicativa, a fim de exemplificar as possibilidades de estratégias de ensino sob a ótica metodológica bilíngue. Como resultado apresentamos práticas diferenciadas desenvolvidas em espaços formais e não formais, como visitas guiadas e o projeto “Sinal Verde para Todos”. Concluímos que as atividades aqui relatadas contribuíram para um ensino de qualidade e realizado de forma eficaz, principalmente porque respeitamos as conquistas linguísticas dos alunos. A inclusão dos discentes no ensino regular é um processo de extrema valia, pois é na diferença e na diversidade de corpos que todos tiveram a oportunidade de atingir o sentido de cidadania

Diets including Animal Food Are Associated with Gastroesophageal Reflux Disease

Gastroesophageal reflux disease (GERD) is a clinical condition with a prevalence of up to 25% in Western countries. Typical GERD symptoms include heartburn and retrosternal regurgitation. Lifestyle modifications, including diet, are considered a first-line therapeutic approach. To evaluate the impact of life habits on GERD in this cross-sectional study, we used data collected through an online survey from 1146 participants. GERD was defined according to the Montreal Consensus. For all participants, clinical and lifestyle characteristics were recorded. Overall, 723 participants (63.1%) consumed a diet including animal food (non-vegans), and 423 participants (36.9%) were vegans. The prevalence of GERD was 11% (CI 95%, 9–14%) in non-vegans and 6% (CI 95%, 4–8%) in vegans. In the multivariate analysis, after adjusting for confounding factors, subjects on a non-vegan diet were associated with a two-fold increase in the prevalence of GERD compared to vegans (OR = 1.96, CI 95%, 1.22–3.17, p = 0.006). BMI and smoking habits were also significantly associated with GERD. This study shows that an animal food-based diet (meat, fish, poultry, dairy, and eggs) is associated with an increased risk of GERD compared to a vegan diet. These findings might inform the lifestyle management of patients with GERD-related symptoms

Telemental health in Brazil: past, present and integration into primary care

Background Telemental Health Care has reported very good results and is included within mental health priorities by the World Health Organization. Objective To provide an overview of the current situation of the integration of Brazilian telemedicine activities into primary health care. Methods Critical review based on MEDLINE database, using the keywords “telemedicine”, “primary health care” “mental health” and “telemental health”, on websites of the Brazilian Ministry of Health and Brazilian Telehealth Network Program, and on personal communication. Results The Brazilian Telehealth Network Program is well positioned and connects primary health care with academic centers. Regulations standards allow a broader scope of activities for psychologists, however, are more restrictive for physicians. In Brazil most of telemental health activities are focused on education and second opinion consulting. A huge challenge must be overcome considering the regional differences and the telehealth implementation experience. Research initiatives have been initiated both in the implementation and evaluation of the mental health assistance into primary health care. Discussion Brazilian Telemental Health initiatives into Primary Care are aligned with other examples around the world, have a great potential for improving mental health care service delivery, and access to proper mental health care, especially if articulated in a national program and coordinated research

Crassicaudiasis in three geographically and chronologically distant Cuvier’s beaked whales (Ziphius cavirostris) stranded off Brazil

The Cuvier’s beaked whale (CBW; Ziphius cavirostris) is a cosmopolitan marine mammal found in deep tropical and temperate waters of all oceans. CBW strandings have been recorded sporadically in Brazil; however, there is lack of information available regarding their causes of stranding and/or death. Herein, we report the epidemiologic, pathologic, morphologic parasitologic features and molecular identification of arterial and renal crassicaudiasis by Crassicauda sp. in three geographically and chronologically distant CBW stranded off Brazil. CBW-1 was an adult male stranded dead in Rio Grande do Sul State. CBW-2 was an adult female that stranded alive in Sergipe State and died shortly after. CBW-3 was and adult male that stranded dead in Santa Catarina State. The most relevant pathologic findings in these three CBW were severe, chronic proliferative mesenteric and caudal aortic endarteritis and chronic granulomatous and fibrosing interstitial nephritis with renicular atrophy and loss, and numerous intralesional Crassicauda sp. nematodes. Furthermore, CBW-1 had concomitant gram-negative bacterial pneumonia and pulmonary and hepatic thromboembolism. Morphologic analysis of renal adult nematodes identified Crassicauda sp. in the three CBW. Molecular analyses targeting the 18S and ITS-2 ribosomal loci of renal nematodes in CBW-2 and CBW-3 identified C. anthonyi. It is believed that severe arterial and renal crassicaudiasis likely resulted or contributed significantly to morbidity and death of these animals. These results expand the known geographical range of occurrence of crassicaudiasis in CBW. Specifically, the present study provides the first accounts of arterial and renal crassicaudiasis in CBW off the southern hemisphere, specifically in CBW off Brazil, and to the authors’ knowledge, it is the first record of C. anthonyi in the southern Atlantic Ocean