Peak expiratory flow mediates the relationship between handgrip strength and timed up and go performance in elderly women, but not men

OBJECTIVE: The aim of the present study was to verify if there is sex difference in the associations among handgrip strength, peak expiratory flow (PEF) and timed up and go (TUG) test results. METHODS: The sample included 288 consecutive elderly men (n=93) and women (n=195). Functional capacity was measured using the TUG test, and muscle strength was measured based on handgrip. Moreover, as a measure of current health status, PEF was evaluated. Linear regression procedures were performed to analyze the relationships between handgrip and both PEF and TUG test results, with adjustment for confounders, and to identify the possible mediating role of PEF in the association between handgrip strength and TUG test results. RESULTS: In men, handgrip strength was associated with both PEF and TUG performance (p<0.01). After adjustment for PEF, the relationship between handgrip strength and TUG performance remained significant. In women, handgrip strength was also associated with both PEF and TUG performance (p<0.01). However, after adjustment for PEF, the relationship between handgrip strength and TUG performance was no longer significant. CONCLUSION: Mobility in the elderly is sex dependent. In particular, PEF mediates the relationship between handgrip strength and TUG performance in women, but not in men

Focal Malignant Liver Lesions: Diagnosis by Dynamic Incremental CT, Early Phase

The purpose of our study was to evaluate the accuracy of dynamic incremental bolus-enhanced conventional CT (DICT) with intravenous contrast administration, early phase, in the diagnosis of malignancy of focal liver lesions. A total of 122 lesions were selected in 74 patients considering the following criteria: lesion diameter 10 mm or more, number of lesions less than six per study, except in multiple angiomatosis and the existence of a valid criteria of definitive diagnosis. Lesions were categorized into seven levels of diagnostic confidence of malignancy compared with the definitive diagnosis for acquisition of a receiver-operator-characteristic (ROC) curve analysis and to determine the sensitivity and specificity of the technique. Forty-six and 70 lesions were correctly diagnosed as malignant and benign, respectively; there were 2 false-positive and 4 false-negative diagnoses of malignancy and the sensitivity and specificity obtained were 92 and 97%. The DICT early phase was confirmed as a highly accurate method in the characterization and diagnosis of malignancy of focal liver lesions, requiring an optimal technical performance and judicious analysis of existing semiological data

The magnitude of syphilis: from prevalence to vertical transmission

ABSTRACT Introduction: In 2013, the World Health Organization (WHO) reported that 1.9 million pregnant women were infected with syphilis worldwide, of which 66.5% had adverse fetal effects in cases of untreated syphilis. Congenital syphilis contributes significantly to infant mortality, accounting for 305,000 perinatal deaths worldwide annually. Aim: To estimate the prevalence of syphilis in parturients, the incidence of congenital syphilis and the vertical transmission rate. Material and methods: a cross-sectional study with data collected from 2041 parturients who had undergone treatment between 2012 and 2014 in the maternity section of the Pedro Ernesto Hospital of the State University of Rio de Janeiro, in the metropolitan area of Rio de Janeiro. The inclusion criterion was positive VDRL and treponemal test in a hospital environment. Results: the prevalence of syphilis in pregnant women was 4.1% in 2012, 3.1% in 2013 and 5% in 2014, with official reporting of 15.6%, 25.0% and 48.1%, respectively. The incidence of congenital syphilis (CS) was 22/1,000 in live births (LB) in 2012; 17/1,000 LB in 2013 and 44.8/1,000 LB in 2014. CS underreporting during the period was 6.7%. Vertical transmission occurred in 65.8% of infants from infected mothers. It was concluded that, in 34.6% of the CS cases, maternal VDRL titers were = 1/4. Conclusion: Results demonstrate the magnitude of the disease, fragility of the reporting system in the assessment of the actual prevalence, impact on perinatal outcomes, and they are a warning about the real situation of syphilis, which is still underestimated in the State

Evolutionary Reduction of the First Thoracic Limb in Butterflies

Members of the diverse butterfly families Nymphalidae (brush-footed butterflies) and Riodinidae (metalmarks) have reduced first thoracic limbs and only use two pairs of legs for walking. In order to address questions about the detailed morphology and evolutionary origins of these reduced limbs, the three thoracic limbs of 13 species of butterflies representing all six butterfly families were examined and measured, and ancestral limb sizes were reconstructed for males and females separately. Differences in limb size across butterflies involve changes in limb segment size rather than number of limb segments. Reduction of the first limb in both nymphalids and riodinids appears particularly extensive in the femur, but the evolution of these reduced limbs is suggested to be a convergent evolutionary event. Possible developmental differences as well as ecological factors driving the evolution of reduced limbs are discussed

High yielding synthesis of N-ethyl dehydroamino acids

Recently we reported the use of a sequence of alkylation and dehydration methodologies to obtain N-ethyl-α, β-dehydroamino acid derivatives. The application of this N-alkylation procedure to several methyl esters of β, β-dibromo and β--bromo, β-substituted dehydroamino acids protected with standard amine protecting groups was subsequently reported. The corresponding N-ethyl, β-bromo dehydroamino acid derivatives were obtained in fair to high yields and some were used as substrates in Suzuki cross coupling reactions to give N-ethyl, β, β-disubstituted dehydroalanine derivatives. Herein, we further explore N-ethylation of β-halo dehydroamino acid derivatives using triethyloxonium tetrafluoroborate as alkylating agent but substituting N,N-diisopropylethylamine for potassium tert-butoxide as auxiliary base. In these conditions, for all β-halo dehydroamino acid derivatives, reactions were complete and the N-ethylated derivative could be isolated in high yield. This method was also applied for N-ethylation of non-halogenated dehydroamino acids. Again, with all compounds the reactions were complete and the N-ethyl dehydroamino acid derivatives could be isolated in high yields. Some of these N-ethyl dehydroamino acid methyl ester derivatives were converted in high yields to their corresponding acids and coupled to an amino acid methyl ester to give N-ethyl dehydrodipeptide derivatives in good yields. Thus, this method constitutes a general procedure for high yielding synthesis of N-ethylated dehydroamino acids, which can be further applied in peptide synthesis.Foundation for Science and Technology (FCT)-Portugal and Fundo Europeu de Desenvolvimento Regional (FEDER) for financial support to Chemistry Centre of University of Minho. The NMR spectrometer Bruker Avance II+ 400 is part of the National NMR Network and was purchased in the framework of the National Program for Scientific Re-equipment; contract REDE/1517/RMN/2005, with funds from POCI 2010, FEDER and FCT

Evaluation of Silver Nanoparticle Toxicity in Skin in Vivo and Keratinocytes in Vitro

IntroductionProducts using the antimicrobial properties of silver nanoparticles (Ag-nps) may be found in health and consumer products that routinely contact skin.ObjectivesThis study was designed to assess the potential cytotoxicity of Ag-nps in human epidermal keratinocytes (HEKs) and their inflammatory and penetrating potential into porcine skin in vivo.Materials and MethodsWe used eight different Ag-nps in this study [unwashed/uncoated (20, 50, and 80 nm particle diameter), washed/uncoated (20, 50, and 80 nm), and carbon-coated (25 and 35 nm)]. Skin was dosed topically for 14 consecutive days. HEK viability was assessed by MTT, alamarBlue (aB), and CellTiter 96 AQueous One (96AQ). Release of the proinflammatory mediators interleukin (IL)-1β, IL-6, IL-8, IL-10, and tumor necrosis factor-α (TNF-α) were measured.ResultsThe effect of the unwashed Ag-nps on HEK viability after a 24-hr exposure indicated a significant dose-dependent decrease (p < 0.05) at 0.34 μg/mL with aB and 96AQ and at 1.7 μg/mL with MTT. However, both the washed Ag-nps and carbon-coated Ag-nps showed no significant decrease in viability at any concentration assessed by any of the three assays. For each of the unwashed Ag-nps, we noted a significant increase (p < 0.05) in IL-1β, IL-6, IL-8, and TNF-α concentrations. We observed localization of all Ag-nps in cytoplasmic vacuoles of HEKs. Macroscopic observations showed no gross irritation in porcine skin, whereas microscopic and ultrastructural observations showed areas of focal inflammation and localization of Ag-nps on the surface and in the upper stratum corneum layers of the skin.ConclusionThis study provides a better understanding Ag-nps safety in vitro as well as in vivo and a basis for occupational and risk assessment. Ag-nps are nontoxic when dosed in washed Ag-nps solutions or carbon coated

Reabilitação Cardíaca Após Síndrome Coronária Aguda. Deveremos Continuar a Reabilitar os Doentes de Baixo Risco? Experiência de um Centro

Introdução: A Reabilitação cardíaca (Rc) é um elemento fundamental na prevenção secundária após síndrome coronária aguda (ScA). A American Association of Cardiovascular and Pulmonary Rehabilitation (AAcPR)definiu critérios de estratificação de risco para os doentes elegíveis para programas de Rc. Contudo, tem sido questionada a integração de doentes de baixo risco em programas estruturados de treino de exercício. Objectivo: comparar o impacto da Rc nos doentes de baixo risco cardiovascular versus risco moderado/alto, segundo os critérios a AAcPR, de forma a avaliar o real benefício da Rc na capacidade de exercício nos doentes de baixo risco, quantificada por prova de esforço cardiorrespiratória (PecR). Métodos: Análise retrospetiva dos doentes submetidos a Rc após ScA e submetidos a PecR antes e após a integração num programa de treino de exercício supervisionado constituído por 36 sessões. Foram incluídos doentes desde janeiro de 2004 a dezembro de 2013, num centro Hospitalar Terciário. Os doentes foram divididos em dois grupos: grupo de risco cardiovascular baixo (GRB) e grupo de doentes com risco moderado a alto (GRMA) de acordo com os critérios da AAcPR. Os parâmetros avaliados na PecR foram: pico de consumo de oxigénio (pVO2), pVO2 em relação ao valor previsto para idade e género (%pVO2), declive da rampa do equivalente ventilatório de dióxido de carbono (Ve/VcO2slope), (Ve/VcO2slope)/pVO2 e potência circulatória de pico (PcP). Resultados: Foram incluídos em programa de Rc, pós ScA, 129 doentes, 86,0% do género masculino, com idade média de 56,3±9,8 anos. Setenta e nove doentes (61,3%) foram incluídos no grupo de baixo risco e 50 doentes (38,7%) no grupo de risco moderado a alto.Comparando os resultados da PecR basal verifica-se uma melhor capacidade funcional nos indivíduos de baixo risco (pVO2 26,7±7,0 versus 23,9±5,7 ml/kg/min; p=0,019). Esta diferença significativa desapareceu após a conclusão do programa de Rc, apresentando o GRB pVO2 final de 28,5±7,3ml/kg/min e o GRMA 27,0±7,0ml/kg/min (p=0,232). Ao confrontar os parâmetros da prova de esforço cardiorrespiratória prévios e após reabilitação cardíaca, verifica-se, em ambos os grupos, um aumento significativo da capacidade funcional expresso pelo aumento do pVO2, (Ve/VcO2slope)/pVO2, PcP e duração da prova. No entanto, apenas no grupo de baixo risco se evidencia uma diminuição signi-ficativa do Ve/VcO2 slope (26,7±6,2 versus 25,7±5,3; p=0,029). A amplitude da melhoria de pVO2 foi menos marcada no GRB (1,8±6,5 ml/kg/min versus 3,1±5,0 ml/kg/min; p=0.133). Um incremento no pVO2 superior a 10% em relação ao valor inicial foi atingido em 41,8% dos doentes no GRB e 58,0% dos doentes no GRMA (p=0,072). Conclusão: independentemente do grau de risco cardiovascular inicial, existe benefício na capacidade funcional de exercício após programa de Rc com 36 sessões de treino de exercício, objetivamente quantificado pelos parâmetros da PecR. No entanto, esta melhoria é mais acentuada nos indivíduos de risco moderado a alto comparativamente aos indivíduos de baixo risco. Atendendo à limitação de recursos, deverá ser privilegiada a inclusão de indivíduos de moderado e alto risco, não subvalorizando, no entanto, o benefício também alcançado pelos indivíduos de baixo risco cardiovascular

Rotating black holes with equal-magnitude angular momenta in d=5 Einstein-Gauss-Bonnet theory

We construct rotating black hole solutions in Einstein-Gauss-Bonnet theory in five spacetime dimensions. These black holes are asymptotically flat, and possess a regular horizon of spherical topology and two equal-magnitude angular momenta associated with two distinct planes of rotation. The action and global charges of the solutions are obtained by using the quasilocal formalism with boundary counterterms generalized for the case of Einstein-Gauss-Bonnet theory. We discuss the general properties of these black holes and study their dependence on the Gauss-Bonnet coupling constant $\alpha$. We argue that most of the properties of the configurations are not affected by the higher derivative terms. For fixed $\alpha$ the set of black hole solutions terminates at an extremal black hole with a regular horizon, where the Hawking temperature vanishes and the angular momenta attain their extremal values. The domain of existence of regular black hole solutions is studied. The near horizon geometry of the extremal solutions is determined by employing the entropy function formalism.Comment: 25 pages, 7 figure