Salmonella Heidelberg and Salmonella Minnesota in Brazilian broilers: Genomic characterization of third-generation cephalosporin and fluoroquinolone-resistant strains

Salmonella serovars Heidelberg and Minnesota encoding antimicrobial resistance to third-generation cephalosporins and fluoroquinolones are often detected in poultry/poultry meat. We analysed the genomes of 10 Salmonella Heidelberg (SH) and 4 Salmonella Minnesota (SM) from faecal isolates of Brazilian poultry. These featured virulent and multidrug-resistant characteristics, with AmpC beta-lactamase (blaCMY-2 ) predominance (9/14), for all SM (4/4) and some SH (3/10) located on IncC plasmid replicons. IncC carrying blaCTX-M-2 was only detected among SH (3/10). Mutation in the gyrA/parC genes was present in all SH, whereas SM harboured parC mutation plus qnrB19 on ColRNAI plasmids (3/4). In silico resistance overall corroborated with phenotypic results. Core genome phylogenies showed close clustering and high similarities between the Brazilian and poultry meat/food isolates from Europe, and to human isolates from European countries with documented import of Brazilian poultry meat. Conjugation assays with SM successfully transferred blaCMY-2 , and qnrB19 to an Escherichia coli recipient. The findings reinforce the ongoing antimicrobial resistance acquisition of SH and Minnesota and the risks for disseminating resistant strains and/or mobile elements which may increasingly affect importing countries and the need for controlling AMR in major poultry-exporting countries like Brazil.

Efectos de ejercicios especializados en la rehabilitación del esguince de tobillo grado 1 en futbolistas / Effects of specialized exercises in the rehabilitation of grade 1 ankle sprain in soccer players

Introducción: Las lesiones en los futbolistas provocan limitaciones en la movilidad osteomuscular, provocando un descanso pasivo, y por ende el no cumplimiento del principio de sistematicidad del entrenamiento; por lo cual, puede provocar abandono deportivo en casos extremos, y normalmente disminución del rendimiento. La recuperación mediante terapia requiere una valoración de su eficiencia, siendo necesario estudiar las acciones más efectivas desde el punto de vista terapéutico. Objetivo: Valorar los efectos de un proceso de intervención con ejercicios terapéuticos para la rehabilitación del esguince de tobillo grado 1 en futbolistas. Métodos: Investigación descriptiva/explicativa de orden cuasiexperimental y enfoque longitudinal (4 años de estudio), investigando a 43 futbolistas con una lesión previa en el tobillo por esguince grado 1 (Grupo 1: Experimental, Grupo 2: Control), interviniendo al grupo experimental con tres fases de tratamiento, que incluye un grupo de ejercicios físicos especializados para fortalecer y mantener las condiciones óptimas del musculo. Resultados: El grupo experimental requiere menos tiempo para recuperarse de una lesión por esguince (p ( 0,001), mientras que la reincidencia de la lesión fue menor que en el grupo control (p ( 0,019) en un periodo de cuatro años. Conclusiones: El proceso de intervención ha sido efectivo al lograse una mejor rehabilitación en la muestra experimental, en términos de prontitud en el proceso de recuperación, y en términos de disminución de las recaídas en un periodo de cuatro años. Una vez recuperado el deportista, se recomienda proseguir sistemáticamente con el proceso de fortalecimiento y prevención en las sesiones de entrenamiento, y en el hogar(AU)

Introduction: Injuries in soccer players cause limitations in musculoskeletal mobility, causing a passive rest, and therefore non-compliance with the principle of systematic training; Therefore, it can cause sports abandonment in extreme cases, and usually a decrease in performance. Recovery through therapy requires an assessment of its efficiency, and it is necessary to study the most effective actions from the therapeutic point of view. Objective: To assess the effects of an intervention process with therapeutic exercises for the rehabilitation of grade 1 ankle sprain in soccer players. Methods: Descriptive/explanatory research of quasi-experimental order and longitudinal approach (4 years of study), researching 43 soccer players with a previous ankle injury due to grade 1 sprain (Group 1: Experimental, Group 2: Control), intervening in the experimental group. with three phases of treatment, which includes a group of specialized physical exercises to strengthen and maintain optimal muscle conditions. Results: The experimental group required less time to recover from a sprain injury (p ( 0.001), while the recurrence of the injury was less than in the control group (p ( 0.019) in a period of four years. Conclusions: The intervention process has been effective in achieving better rehabilitation in the experimental sample, in terms of speed in the recovery process, and in terms of reducing relapses in a four years period. Once the athlete has recovered, it is recommended to systematically continue with the strengthening and prevention process in training sessions and at home(AU)

Encapsulation of benznidazole in nanostructured lipid carriers and increased trypanocidal activity in a resistant Trypanosoma cruzi strain

Abstract Chagas disease is a neglected parasitic disease caused by Trypanosoma cruzi, whose treatment has remained unsatisfactory for over 50 years, given that it is limited to two drugs. Benznidazole (BZN) is an efficient antichagasic drug used as the first choice, although its poor water-solubility, irregular oral absorption, low efficacy in the chronic phase, and various associated adverse effects are limiting factors for treatment. Incorporating drugs with such characteristics into nanostructured lipid carriers (NLC) is a promising alternative to overcome these limiting obstacles, enhancing drug efficacy and bioavailability while reducing toxicity. Therefore, this study proposed NLC-BZN formulations in different compositions prepared by hot-melt homogenization followed by ultrasound, and the optimized formulation was characterized by FTIR, DRX, DSC, and thermogravimetry. Biological activities included in vitro membrane toxicity (red blood cells), fibroblast cell cytotoxicity, and trypanocidal activity against epimastigotes of the Colombian strain of T. cruzi. The optimized NLC-BZN had a small size (110 nm), negative zeta potential (-18.0 mV), and high encapsulation (1.64% of drug loading), as shown by infrared spectroscopy, X-ray diffraction, and thermal analysis. The NLC-BZN also promoted lower in vitro membrane toxicity (<3% hemolysis), and 50% cytotoxic concentration (CC50) for NLC-BZN in L929 fibroblast cells (110.7 µg/mL) was twice the value as the free BZN (51.3 µg/mL). Our findings showed that the NLC-BZN had higher trypanocidal activity than free BZN against the epimastigotes of the resistant Colombian strain, and this novel NLC-BZN formulation proved to be a promising tool in treating Chagas disease and considered suitable for oral and parenteral administration

In vitro antibacterial-antibiofilm effect of Hypericum atomarium Boiss and chemical composition

Abstract Treatment with plant is considered an effective option against increased antibiotic resistance. In this study antibiofilm activity of methanol (CH3OH), chloroform (CHCl3), ethyl acetate (EtOAc) and water (H2O) extracts of Hypericum atomarium Boiss. which is member of Hypericum genus was evaluated in Pseudomonas aeruginosa PAO1 and antibacterial performance against Gram (+) and Gram (-) strains and also bioactive compounds of extract were analysed using by HPLC and GC-MS. According to antibacterial activity test results the extracts were effective all Gram (+) bacteria and Gram (-) Chromobacterium violaceum (MICs ranging from 0.42 µg/ml to 4.3 mg). Inhibition effect of biofilm formation was found to be different rate in extracts (methanol-63%, chloroform-52%). The major flavonoids were detected (−)-epicatechin (2388.93 µg/ml) and (+)-catechin (788.94 µg/ml). The main phenolic acids were appeared as caffeic acid 277.34 µg/ml and chlorogenic acid 261.79 µg/ml. And according to GC results α-pinene was found main compound for three solvent extracts methanol, chloroform and ethyl acetate 67.05, 62.69, 49.28% rate respectively

Phylogenetic variants of Mycoplasma hominis from pregnant women and women presenting with infertility in Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria

Background: Much controversies have been associated with the pathogenicity of Mycoplasma hominis but little has been done to unravel the mystery behind the different views. This study aimed at investigating the genetic variants abounding within M. hominis and the distribution of the virulent genes among the variants. Methodology: Twenty (20) M. hominis isolates from high vaginal swabs of women (11 from pregnant women and 9 from women presenting with infertility) attending the Obstetrics and Gynaecology clinics of Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Nigeria, were sequenced using 16S rRNA universal gene target for the purpose of phylogenetic analysis and epidemiological typing. The isolates were also screened for the presence of M. hominis variable adherence antigen (vaa) and p120 virulent genes using primer constructs from the respective genes in a conventional PCR protocol. Results: Of the 20 M. hominis vaginal isolates, 4 phylogenetic strains were detected; strain MHS43 constituted 10/20 (50.0%) [2/9 (22.2%) from infertile women and 8/11 (72.7%) from pregnant women]; strain MHBS constituted 3/20 (15%) [3/9 (33.3%) from infertile women and 0/11 (0%) from pregnant women]; strain MHSWP2 constituted 4/20 (20.0%) [3/9 (33.3%) from infertile women and 1/11 (9.1%) from pregnant women]; while strain MHKC87 constituted 3/20 (15%) [1/9 (11.1%) from infertile women and 2/11 (18.2%) from pregnant women].Each of vaa and p120 genes was detected in 14 of 20 isolates, while 6 isolates did not carry the genes. A 2-way ANOVA test showed that none of the genes was significantly associated with a particular strain (p=0.8641). Conclusions: The different views regarding the pathogenicity of M. hominis may be linked to the heterogeneity within the species and lack of homogeneity in the virulent genes as witnessed both in the intra species and intra strain levels.

Vaginal distention rodent model for fecal incontinence: a pilot study on the effect on defecation behavior

Objectives: Vaginal balloon inflation simulates the compressive forces on the pelvic floor during the second phase of natural delivery. The foremost use of this animal model of vaginal distention (VD) is to study the mechanisms underlying urinary incontinence. As damage to the pelvic floor during natural birth is a common cause of fecal incontinence, the present paper aimed to investigate the effect of VD on defecation behavior in adult rats. Methods: Vaginal distention was performed in 8 rats for 2 hours, and in 3 rats for 4 hours, and sham inflation was performed in 4 rats. With the use of a latrine box in the rat home-cage and 24/7 video tracking, the defecation behavior was examined. The time spent in and outside the latrine was monitored for two weeks preoperatively and three weeks postoperatively, and a defecation behavior index (DBI; range: 0 [continent] to 1 [incontinent]) was defined. Pelvic floor tissue was collected postmortem and stained with hematoxylin and eosin. Results: Vaginal balloon inflation for 2 hours resulted in fecal incontinence in 29% of the animals (responders) whereas the DBI scores of non-responders (71%) and control animals did not change in the postoperative phase compared with the baseline score. A 4-hour balloon inflation resulted in fecal incontinence in 1 animal and caused a humane endpoint in 2 animals with markedly more tissue damage in the 4-hour responder compared with the 2-hour responders. Conclusions: Vaginal balloon inflation, with an optimum duration between 2 and 4 hours, can be used as a model to study changes in defecation behavior in rats induced by pelvic floor damage. (AU)

Caracterización genotípica y biofilms de E. coli shigatoxigénica aisladas de casos clínicos humanos / Genotypic characterization and biofilms of shigatoxigenic E. coli isolated from human clinical cases

Resumen Escherichia coli shigatoxigénica (STEC) está involucrada en el desarrollo del síndrome urémico hemolítico, entre otras enfermedades que son de gran importancia para la salud pública e inocuidad alimentaria a nivel mundial. La capacidad de STEC de formar biofilms en los alimentos y en diferentes superficies podría conducir a la contaminación cruzada por el desprendimiento de las células bacterianas. El objetivo del presente trabajo fue detectar la presencia de genes que codifican factores de adherencia mediante la técnica de PCR y determinar la capacidad de formación de biofilms por medio de cultivo en microplacas de poliestireno de 96 pocillos y la técnica de cristal violeta, en cepas de STEC aisladas de muestras clínicas humanas en la ciudad de Mar del Plata, Argentina. El perfil de genes de adherencia más frecuente fue efa1, iha, fimCD, ehaA, lpfA1-3, lpfA2-2, cah (43,9%). Todas las cepas de STEC formaron biofilms con valores de densidad óptica entre 0,209 y 3,251 y el 54,4% (31/57) de las mismas fueron clasificadas como fuertes formadoras de biofilms. La capacidad de formación de biofilms de STEC constituye un riesgo evidente en la transmisión de este patógeno al ser humano a tener en cuenta para su vigilancia y control.

Abstract Shigatoxigenic Escherichia coli (STEC) is involved in the development of hemolytic uremic syndrome, among other diseases that are relevant to public health and food safety worldwide. The ability of STEC to form biofilms in food and on different surfaces could lead to cross-contamination by shedding bacterial cells. The aim of this work was to detect the presence of genes encoding adherence factors by the PCR technique and to determine the biofilm formation ability by culture in 96-well polystyrene microplates and the crystal violet technique, in STEC strains isolated from human clinical samples in Mar del Plata city, Argentina. The most frequent adherence gene profile was efa1, iha, fimCD, ehaA, lpfA1-3, lpfA2-2, cah (43.9%). All STEC strains formed biofilms with optical density values between 0.209 and 3.251. Also, the 54.4% (31/57) of STEC strains were classified as strong biofilm formers. The ability of STEC to form biofilms constitutes an evident risk in the transmission of this pathogen to humans, which must be taken into account for its surveillance and control.

Resumo A Escherichia coli shigatoxigênica (STEC) está envolvida no desenvolvimento da síndrome hemolítica urêmica, entre outras doenças relevantes para a saúde pública e segurança alimentar em todo o mundo. A capacidade do STEC de formar biofilmes nos alimentos e em diferentes superfícies poderia levar à contaminação cruzada através do desprendimento de células bacterianas. O objetivo do presente trabalho foi detectar a presença de genes que codificam fatores de aderência através da técnica PCR e determinar a capacidade de formação de biofilme por cultura em microplacas de poliestireno de 96 poços e da técnica de cristal violeta, em cepas STEC isoladas de amostras clínicas humanas na cidade de Mar del Plata, Argentina. O perfil de genes de aderência mais frequente foi efa1, iha, fimCD, ehaA, lpfA1-3, lpfA2-2, cah (43,9%). Todas as cepas de STEC formaram biofilmes com valores de densidade ótica entre 0,209 e 3,251. Também, os 54,4% (31/57) das estirpes STEC foram classificados como fortes formadores de biofilmes. A habilidade de formação de biofilmes de STEC constitui um risco evidente na transmissão deste patógeno ao humano, que deve ser levado em consideração para sua vigilância e controle.

Clinical, sonographic and anatomopathological aspects of ovarian teratoma in a heifer / Aspectos clínicos, ultrassonográficos e anatomopatológicos do teratoma ovariano em uma novilha

Teratomas rarely occur in domestic species, especially in cattle. These tumors originate in fetal life and are characterized by rapid growth, which justifies their frequent detection in young animals. This study reported a case of ovarian teratoma in a heifer. On physical examination, the main signs identified were apathy, abdominal distention and tension, empty rumen, and mushy diarrhea. During rectal palpation, a mass was identified in the pelvic region, which was suggestive of cysts on ultrasound examination. The animal underwent laparotomy, followed by euthanasia due to a poor prognosis. At necropsy, a 54 x 43 x 52 cm (length x width x thickness) tumor was observed in the right ovary with multiple cystic areas, in addition to masses associated with multiple adhesions of the intestinal loops and peritonitis. On histopathology, muscle, cartilage, bone, nervous and epithelial tissue, glands, hair with follicles, were identified in the affected ovary. There was mixed inflammation and foci of necrosis observed with a complete absence of ovarian architecture in both the ovaries. Infiltrations were identified in the lymph nodes and mesenteric vessels. Glandular ducts were seen from the serosa to the intestinal mucosa. A locally infiltrative and expansile ovarian teratoma was diagnosed accordingly. It is considered that this kind of tumor can induce abdominal distension and absence of estrus in previously healthy, non-pregnant heifers.

Os teratomas são tumores raros nas espécies domésticas, sobretudo em bovinos. Esses tumores são caracterizados por crescimento rápido e origem durante a vida fetal, o que justifica seu diagnóstico frequente em animais jovens. O presente trabalho relata um caso de teratoma ovariano em uma novilha. No exame físico, os principais sinais identificados foram apatia, distensão e tensão abdominal, rúmen vazio e diarreia pastosa. Durante a palpação retal, uma massa foi identificada na região pélvica. Ao exame ultrassonográfico, a massa era sugestiva de cistos. O animal foi submetido a laparotomia, seguido de eutanásia devido ao mau prognóstico. Na necropsia foi observado um tumor de 54 x 43 x 52 cm (comprimento x largura x espessura) no ovário direito com múltiplas áreas císticas, além de massas associadas à múltiplas aderências das alças intestinais e peritonite. Na histopatologia foram identificados no ovário acometido a presença de tecidos muscular, cartilaginoso, ósseo, nervoso e epitelial, com glândulas, pelos e folículos. Havia inflamação mista e focos de necrose com ausência completa de arquitetura ovariana em ambos os ovários. Infiltrações foram identificadas em linfonodos e vasos mesentéricos. Ductos glandulares foram vistos desde a serosa até mucosa intestinal. Diagnosticou-se um teratoma ovariano localmente infiltrativo e expansivo. Considera-se que este tumor pode induzir distensão abdominal e ausência de estro em novilhas previamente sadias e não gestantes.

Pharmaceutical co-crystals of posaconazole for improvement of physicochemical properties

Abstract Posaconazole exerts an extended spectrum of antifungal activity against various strains of clinically relevant moulds and yeasts. In recent years, antifungal triazole posaconazole has become increasingly important for the prophylaxis and treatment of systemic mycoses. After oral administration of posaconazole, absolute bioavailability has been estimated to range from 8% to 47%. Pharmaceutical co-crystallization is a promising approach for improving dissolution rate or manipulating other physical properties of API. The objective of this study is to improve the dissolution rate of posaconazole by co-crystallization. A 1:1 stoichiometric co-crystals of adipic acid were prepared by solvent assisted grinding method. The prepared co-crystals were subjected to solid-state characterization by FTIR, PXRD and DSC studies. The physicochemical properties of posaconazole and co-crystals were assessed in terms of melting point, flowability and dissolution rate. The results indicated improvement in flow property and dissolution rate. In vitro dissolution profile of co-crystals showed a significant increased dissolution of posaconazole from initial period in 0.1 N hydrochloric acid solution. The dissolution efficiency for posaconazole-adipic acid co-crystal was 61.65 % against posaconazole, 46.58 %. Thus, co-crystallization can be a promising approach to prepare posaconazole-adipic acid co-crystals with improved physicochemical properties.

Fatores de risco nas entorses de tornozelo em crianças e adolescente atletas: uma revisão integrativa / Risk factors for ankle sprains in children and adolescent athletes: an integrative review

Introdução: As entorses de tornozelo são as lesões em membros inferiores mais frequentes em crianças e adolescentes atletas. Identificar os fatores de risco envolvidos nas práticas esportivas auxilia o planejamento de estratégias preventivas dessas lesões. Objetivos: Revisar os dados disponíveis na literatura sobre os fatores de risco relacionados à ocorrência de entorse de tornozelo em crianças e adolescentes praticantes de esportes. Métodos: Trata-se de uma revisão integrativa da literatura realizada nos portais SciELO, PubMed e BVS. Foram incluídos trabalhos publicados entre 2015 e 2021, obtidos pelas combinações dos descritores "entorse", "tornozelo", "criança", "adolescente", "esportes" e "fatores de risco", que respondiam a questão de pesquisa: "Quais os fatores de risco para entorses de tornozelo em crianças e adolescentes praticantes de esportes?". Resultados: Nove estudos foram selecionados para revisão. Os fatores de risco associados a maior chance de ocorrência de entorse de tornozelo foram a história de entorse de tornozelo prévia, equilíbrio deficiente, déficit na força de extensão do quadril, maior repetição máxima no leg press, maior força isocinética do quadríceps, diferença entre as pernas em relação à força de abdução de quadril, sexo feminino, alto IMC, maior idade, tempo de prática maior que seis anos, jogo de basquete em relação ao jogo de futebol, alterações anatômicas como joelho recurvado e aumento da queda do navicular. Conclusão: A variedade de delineamentos de estudos, amostras e esportes abordados na literatura revisada resultou na identificação de diversos fatores de risco associados a entorses de tornozelo em crianças e adolescentes atletas.

Introduction: Ankle sprains are the most common lower limb injuries in children and teen athletes. Identifying risk factors related to sports helps elaborate strategies to prevent these injuries. Objectives: Review the literature's available data about risk factors related to the incidence of ankle sprains in children and teens who practice sports. Methods: It's an integrative literature review made in the portals SciELO, PubMed, and BVS. Were included articles published between 2015 and 2021, obtained by the combination of the descriptors: sprains, ankle, child, adolescent, sports, and risk factors, that answered the question: "Which are the risk factors for ankle sprains in children and teens who practice sports?". Results: Nine studies were selected to review. The risk factors associated with a greater chance of ankle sprains were: previous ankle sprain history, balance deficit, decrease in hip extension strength, higher one-repetition maximum at the leg press, higher quadriceps isokinetic strength, the difference between the legs related to hip abduction strength, feminine sex, high BMI, higher age, more than six years of playtime, the incidence in basketball is higher than in soccer, anatomical alterations like genu recurvatum, and navicular drop. Conclusion: The variety of outlines in the studies, samples, and sports addressed in the reviewed literature resulted in the identification of several risk factors related to ankle sprains in children and teen athletes.

Effects of wearing an ankle brace on ground reaction forces during jumps in basketball game simulation / Efectos del uso de órtesis de tobillo sobre las fuerzas de reacción del suelo durante los saltos en simulación de juego de baloncesto / Efeitos do uso de órtese de tornozelo sobre as forças de reação do solo durante saltos em simulação do jogo de basquetebol

ABSTRACT Introduction: The use of ankle braces reduces the risk of ankle injuries in basketball players. However, the mechanisms of injury protection provided by the ankle braces in the basketball game are still unknown. Objectives: To analyze the effects of wearing a lace-up ankle brace, and to conduct an exercise protocol that simulated the intensity of the basketball game on ground reaction force (GRF) during basketball-specific vertical jumps. Methods: Eleven male younger basketball players aged under 18 completed 48 vertical jumps, with and without ankle braces, during an exercise protocol composed of four 10-minute periods, simulating the activity profile and intensity of the basketball game as well as the typical intervals between periods. Mediolateral (variables: the greatest medial and lateral peaks) and vertical (variables: vertical peak, impulse peak, impulse at 50 ms of landing, loading rate and jump height) GRF were measured during takeoff and landing for all the jumps performed in the exercise protocol. Results: The use of the ankle brace reduced mediolateral GRF in all periods of the exercise protocol during takeoff and landing ( P < 0.05), without affecting the vertical GRF ( P > 0.05). Mediolateral and vertical GRF (takeoff mediolateral vertical peaks, landing mediolateral peaks, landing impulse peak, takeoff and landing loading rate) increased significantly during four subsequent 10-minute periods ( P < 0.05). However, for mediolateral GRF, the increase overtime was higher without braces. Conclusions: The use of the ankle brace reduced the mediolateral GRF on the lower limb, while there was a progressive increase in the external load applied to the body during the vertical jumps in the subsequent periods of the exercise protocol performed at the same intensity of the basketball game. Level of evidence I; Randomized clinical trial .

RESUMEN Introducción: El uso de órtesis de tobillo reduce el riesgo de lesiones en el tobillo en jugadores de baloncesto. Sin embargo, los mecanismos de protección de lesión proporcionados por las órtesis durante el juego de baloncesto aún son desconocidos. Objetivos: Analizar el efecto del uso de órtesis de tobillo lace-up (con cordón) y de un protocolo de ejercicio que simuló la intensidad del juego de baloncesto sobre la fuerza de reacción del suelo (FRS) durante saltos verticales específicos del baloncesto. Métodos: Once jugadores de baloncesto del sexo masculino con menos de 18 años realizaron 48 saltos verticales, con y sin órtesis de tobillo, durante un protocolo de ejercicios compuesto por cuatro períodos de 10 minutos, que simularon el perfil de actividad e intensidad del juego de baloncesto, así como los intervalos típicos entre los períodos. Las FRS mediolaterales (variables: mayores picos medial y lateral) y verticales (variables: pico vertical, pico de impulso, impulso en 50 ms de aterrizaje, tasa de sobrecarga y altura del salto) fueron medidas durante las fases de despegue y aterrizaje de todos saltos realizados en el protocolo de ejercicio. Resultados: El uso de órtesis redujo la FRS mediolateral en todos los períodos analizados, durante las fases de despegue y aterrizaje (P < 0,05), sin afectar la FRS vertical (P > 0,05). La FRS mediolateral y vertical (picos mediolateral y vertical de despegue, picos mediolaterales de aterrizaje, pico de impulso de aterrizaje, tasa de sobrecarga en el despegue y aterrizaje) aumentaron significativamente durante cuatro períodos subsiguientes de 10 minutos (P < 0,05). Sin embargo, para la FRS mediolateral, el aumento a lo largo del tiempo fue mayor sin el uso de órtesis. Conclusiones: El uso de órtesis de tobillo redujo la FRS mediolateral en el miembro inferior, mientras que hubo un aumento progresivo de la carga externa aplicada al cuerpo durante los saltos en los períodos subsiguientes del protocolo de ejercicios con la misma intensidad del juego de baloncesto. Nivel de evidencia I; Ensayo clínico aleatorizado.

RESUMO Introdução: O uso de órtese de tornozelo reduz o risco de lesões no tornozelo em jogadores de basquetebol. No entanto, os mecanismos de proteção de lesão fornecidos pelas órteses durante o jogo de basquetebol ainda são desconhecidos. Objetivos: Analisar o efeito do uso de órtese de tornozelo lace-up (com cordão) e de um protocolo de exercício que simulou a intensidade do jogo de basquetebol sobre a força de reação do solo (FRS) durante saltos verticais específicos do basquetebol. Métodos: Onze jogadores de basquetebol do sexo masculino com menos de 18 anos realizaram 48 saltos verticais, com e sem órtese de tornozelo, durante um protocolo de exercícios composto por quatro períodos de 10 minutos, que simularam o perfil de atividade e intensidade do jogo de basquetebol, assim como os intervalos típicos entre os períodos. As FRSs mediolaterais (variáveis: maiores picos medial e lateral) e verticais (variáveis: pico vertical, pico de impulso, impulso em 50 ms da aterrissagem, taxa de sobrecarga e altura do salto) foram medidas durante as fases de decolagem e aterrissagem de todos os saltos realizados no protocolo de exercício. Resultados: O uso de órtese reduziu a FRS mediolateral em todos os períodos analisados, durante as fases de decolagem e aterrissagem (P < 0,05), sem afetar a FRS vertical (P > 0,05). A FRS mediolateral e vertical (picos mediolateral e vertical de decolagem, picos mediolaterais de aterrissagem, pico de impulso de aterrissagem, taxa de sobrecarga na decolagem e aterrissagem) aumentaram significativamente durante quatro períodos subsequentes de 10 minutos (P < 0,05). No entanto, para a FRS mediolateral, o aumento ao longo do tempo foi maior sem o uso de órtese. Conclusões: O uso de órtese de tornozelo reduziu a FRS mediolateral no membro inferior, enquanto houve um aumento progressivo da carga externa aplicada ao corpo durante os saltos nos períodos subsequentes do protocolo de exercícios com mesma intensidade do jogo de basquetebol. Nível de evidencia I; Estudo clínico randomizado .

Valor del strain longitudinal global en la detección precoz de cardiotoxicidad inducida por quimioterapia / Global longitudinal strain value in the early detection of chemotherapy-induced cardiotoxicity

RESUMEN Introducción: Los avances en la detección precoz y el tratamiento del cáncer han reducido de manera significativa la mortalidad. El resultado neto es el surgimiento de una cohorte de pacientes cuya supervivencia es suficiente para evidenciar los efectos secundarios de las terapias utilizadas. La cardiotoxicidad es el conjunto de enfermedades cardiovasculares derivadas de los tratamientos onco-hematológicos. Objetivos: Evaluar el papel de la deformación miocárdica (strain) longitudinal global en la detección precoz de cardiotoxicidad en pacientes con tratamiento quimioterápico. Método: Se realizó un estudio cuantitativo, analítico, longitudinal, prospectivo en 44 pacientes con diagnóstico de cáncer de mama o linfoma, que iniciaron tratamiento con quimioterapia en el Instituto de Oncología y Radiobiología de Cuba, en el período comprendido entre febrero de 2017 y abril de 2018. Se utilizaron métodos primarios y secundarios para la recolección del dato primario y se emplearon varias pruebas estadísticas para su análisis. Resultados: Las medias de edad y tiempo de tratamiento fueron de 47,7 años y 5,05 meses, respectivamente. Predominó la hipertensión arterial (18,1%) como factor de riesgo y la mayor cardiotoxicidad (27,8%) en pacientes con disfunción diastólica previa. Entre los que desarrollaron cardiotoxicidad, la variable que demostró mayor afectación fue el strain longitudinal global (p<0,0001), con una reducción de 19,6% respecto al basal. Conclusiones: El strain longitudinal global es un índice ecocardiográfico de deformación miocárdica, que presentó un valor discriminante significativo con respecto a la cardiotoxicidad en pacientes que recibieron tratamiento quimioterápico.

ABSTRACT Introduction: Advances in early detection and treatment of cancer have significantly reduced mortality. The net result is the emergence of a cohort of patients whose survival is sufficient to evidence the side effects of the used therapies. Cardiotoxicity is the set of cardiovascular diseases resulting from onco-hematological treatments. Objectives: To evaluate the role of global longitudinal strain in the early detection of cardiotoxicity in patients undergoing chemotherapy. Method: A quantitative, analytical, prospective, longitudinal study was carried out in 44 patients diagnosed with breast cancer or lymphoma, who started chemotherapy treatment at the Instituto de Oncología y Radiobiología of Cuba, from February 2017 to April 2018. Primary and secondary methods were used for raw data collection and several statistical tests were used for its analysis. Results: The mean age and treatment period were 47.7 years old and 5.05 months, respectively. The most prevalent risk factor was high blood pressure and cardiotoxicity was higher (27.8%) in patients with previous diastolic dysfunction. Among those who developed cardiotoxicity, the variable that showed the greatest affectation was global longitudinal strain (p<0.0001), with a reduction of 19.6% with respect to the basal one. Conclusions: Global longitudinal strain is an echocardiographic index of myocardial performance, which presented a significant discriminating value with respect to cardiotoxicity in patients who received chemotherapeutic treatment.

Utilidad de los medios imagenológicos en la pericarditis tuberculosa / Usefulness of imaging techniques in tuberculous pericarditis

RESUMEN El bacilo de la tuberculosis existe hace 3 millones de años. Esta es una enfermedad infectocontagiosa causada por el complejo Mycobacterium tuberculosis. Básicamente se puede presentar de tres formas: tuberculosis pulmonar, miliar y extrapulmonar, dentro de esta última se encuentra la tuberculosis pericárdica. En el caso específico de la Imagenología se han descrito signos radiológicos con importantes hallazgos en el área cardíaca. El ecocardiograma podría considerarse como el mejor método diagnóstico no invasivo para detectar la presencia de engrosamiento pericárdico y derrame pericárdico con o sin fibrina. La tomografía axial computarizada de tórax proporciona una excelente evaluación de la anatomía del corazón y el pericardio, el grosor del mismo y la presencia de líquido entre sus capas. El estudio mediante tomografía por emisión de positrones (PET) puede ser muy útil para discriminar la pericarditis tuberculosa de la idiopática. La resonancia magnética es muy sensible para valorar la estructura miocárdica, la función, la inflamación y la fibrosis. La infección pericárdica por tuberculosis sigue constituyendo un problema de salud mundial y su diagnóstico un reto para los especialistas que la enfrentan, lo que requiere de varias técnicas de imágenes diagnósticas y de pruebas bacteriológicas, en aras de lograr su confirmación.

ABSTRACT Tuberculosis bacillus has been around for 3 million years. This is an infectious disease caused by the Mycobacterium tuberculosis complex. It basically has three presentation forms: pulmonary, miliary and extrapulmonary tuberculosis, within the latter pericardial tuberculosis is included. Regarding the specific case of Imaging, radiological signs have been described with important findings in the cardiac area. Echocardiogram could be considered the best noninvasive diagnostic method for detecting the presence of pericardial thickening and pericardial effusion with or without fibrin. Chest computed tomography scan provides an excellent assessment of the anatomy of the heart and pericardium, the thickness of the latter, and the presence of fluid between its layers. Positron emission tomography (PET) study is very useful in discriminating tuberculous pericarditis from idiopathic one. Magnetic resonance imaging is very sensitive to assess myocardial structure, function, inflammation, and fibrosis. Pericardial tuberculosis infection remains a global health problem with challenging diagnosis for those specialists facing it, which requires several diagnostic imaging techniques and bacteriological tests, in order to achieve its confirmation.

Relación de los genotipos CagA/VacA del Helicobacter pylori con lesiones precursoras de cáncer gástrico / Relationship of CagA/VacA genotypes of Helicobacter pylori with precursor lesions of gastric cancer

Introducción: El Helicobacter pylori predispone al cáncer gástrico. Los individuos con cepas CagA y VacA s1m1 desarrollan lesiones de la mucosa más graves. El sistema Operative Link on Gastritis Assessment permite determinar el riesgo de cáncer y define la atrofia como la lesión típica de progresión de la gastritis crónica. Objetivo: Relacionar los genotipos CagA y VacA del Helicobacter pylori con lesiones precursoras de cáncer gástrico. Métodos: Se realizó un estudio descriptivo en 62 pacientes. Las variables incluidas fueron los genotipos CagA y VacA del Helicobacter pylori y los estadios de OLGA (0, I, II, III, IV), las cuales se relacionaron. Se emplearon como medidas de resumen para variables cualitativas la frecuencia absoluta y el porcentaje. Para evaluar la asociación entre variables cualitativas se aplicó el test X2 (ji cuadrado). Se aceptó un nivel de significación estadística p ≤ 0,05. Para explorar la relación entre dos variables dicotómicas se utilizó el riesgo relativo. Se trabajó con un nivel de confiabilidad del 95 por ciento. Resultados: El 68 por ciento de los pacientes con atrofia presentaron genotipo CagA y el 55 por ciento genotipo VacA s1m1. El 6 por ciento de los pacientes con CagA se encontraban en estadio 0; 11 por ciento en estadio I; 40 por ciento en estadio II y 16 por ciento en estadio III. El 37 por ciento de los pacientes con VacA s1m1 estaban en estadio II. Conclusiones: Los genotipos CagA y VacA s1m1 fueron los más frecuentes y se relacionaron con la presencia de atrofia gástrica(AU)

Introduction: Helicobacter pylori predisposes to gastric cancer. Individuals with CagA and VacA s1m1 strains develop more severe mucosal lesions. The Operative Link on Gastritis Assessment system allows determining the risk of cancer and defines atrophy as the typical lesion in the progression of chronic gastritis. Objective: Relate the CagA and VacA genotypes of Helicobacter pylori with precursor lesions of gastric cancer. Methods: A descriptive study was carried out in 62 patients. The variables included were the CagA and VacA genotypes of Helicobacter pylori and the OLGA stages (0, I, II, III, IV), which were related. The absolute frequency and the percentage were used as summary measures for qualitative variables. To evaluate the association between qualitative variables, the X2 test (chi-square) was applied. A level of statistical significance p≤0.05 was accepted. To explore the relationship between two dichotomous variables, the relative risk was used. We worked with a confidence level of 95 percent. Development: 68 percent of the patients with atrophy had a CagA genotype and 55 percent had a VacA s1m1 genotype. 6 percent of the patients with CagA were in stage 0; 11 percent in stage I; 40 percent in stage II and 16 percent in stage III. 37 % of the patients with VacA s1m1 were stage II. Conclusions: The CagA and VacA s1m1 genotypes were the most frequent and were related to the presence of gastric atrophy(AU)

Edema óseo secundario a lesiones ligamentarias de tobillo. Hallazgos en las imágenes de resonancia magnética / Bone marrow edema following ankle ligament injuries: an MRI imaging evaluation

Introducción: El esguince agudo de tobillo es una de las lesiones musculoesqueléticas más frecuentes. Su creciente estudio con resonancia magnética ha llevado a una mayor detección de edema óseo. El edema óseo por contusión consiste en una fractura ósea subcondral microtrabecular del hueso esponjoso junto con hemorragia local y edema. El objetivo de este estudio fue analizar una posible relación estadística entre la lesión ligamentaria de tobillo y la localización del edema óseo. materiales y métodos: En-tre 2016 y 2018, se analizaron 50 resonancias de pacientes con diagnóstico clínico de esguince sin lesión ósea en la radiografía. Dos radiólogos independientes analizaron las secuencias T1 y T2 en los planos coronal, axial y sagital. Se comparó la localización del edema óseo y las lesiones ligamentarias con el fin de encontrar posibles asociaciones. Resultados: No hubo diferencias en la presencia de edema óseo en relación con el ligamento lesionado como consecuencia de un esguince de tobillo (p >0,05). En general, el edema óseo fue más frecuente en la cabeza y el cuello del astrágalo (64%). No se halló una relación estadística entre la localización de edema óseo y el ligamento lesionado (p >0,05).Conclusiones: El edema óseo es un hallazgo frecuente en la resonancia magnética después de una lesión ligamentaria a causa de esguinces de tobillo; sin embargo, no hay evidencia de una relación entre la localización del edema y el ligamento lesionado. Nivel de Evidencia: II

Acute ankle sprains are a common type of musculoskeletal injury. With the increased popularity of MRI post-ankle sprain, more cases of bone marrow edema or bone bruise are detected. This is a subchondral osseous fracture of the cancellous microarchitec-ture with accompanied local hemorrhage and edema. This study aims to analyze if the presence of ankle ligament injury presents any significant statistical relation with the specific location. materials and methods: We reviewed 50 MRI performed during 2015-2018 for patients who reported ankle pain and signs of instability. Two different radiologists evaluated the series. Bone marrow edema location and specific ligament lesions were contrasted to find possible associations. Chi-Square was used to analyze the differences. Results: The anterior talofibular ligament was the most commonly injured ligament (84%). CFL injury occurred in 27 cases (54%). There were no differences between the presence of bone marrow edema and the ligament injured after an ankle sprain (p>0.05). Overall, the most common location of bone marrow edema was the head and neck of the talus (64%). There was no statistical relationship between bone marrow edema location and the injured ligament (p>0.05). Conclusion: Bone marrow edema is a frequent finding after a ligament injury following ankle sprains. However, this finding is not directly related to a specific location of the injured ligament. The location of bone marrow edema is not related to specific ligament injuries. MRI findings of bone marrow edema must not change the management of patients with acute ankle sprains. Level of Evidence: II

Isolation and characterization of Lactobacillus brevis C23 with ability to secrete antimicrobial substance for the inhibition of a foodborne pathogen Listeria monocytogenes ATCC 7644

Aims@#This study aims to isolate lactic acid bacteria (LAB) from various food sources to obtain a potent strain against Listeria monocytogenes. @*Methodology and results@#A total of 68 LAB isolates were selected to evaluate their antimicrobial activity against L. monocytogenes, a foodborne pathogen and a causative agent of listeriosis. The selected isolate was identified and characterized. The isolate C23 from cabbage showed the highest antimicrobial activity against L. monocytogenes ATCC 7644 with inhibition ability of 73.94%. The isolate was closely related to Lactobacillus brevis by 16S rRNA sequencing and subsequently deposited in GenBank with an accession number of MN880215, named as L. brevis C23. The cell free supernatant (CFS) of L. brevis C23 had high tolerance in low pH and was able to withstand up to 60 °C. The proteinaceous nature of the antimicrobial agent was also confirmed through the enzymatic test. The CFS was stable on different detergents as well as bile salts. Under transmission electron microscopy (TEM), the inhibitory effect of CFS against L. monocytogenes was proven by causing cell lysis.@*Conclusion, significance and impact of study@#Bacteriocin-like inhibitory substances (BLIS) of L. brevis C23 showed very promising potential in food industrial application.

Cinesioterapia aplicada a entorse de tornozelo: estudo de qualidade metodológica / Kinesiotherapy applied to ankle sprain: methodological quality study

Introdução: A entorse é definida como uma lesão ligamentar cujo trauma é causado por estiramento ou por ruptura das faixas fibrosas que constituem a estrutura ligamentar, acometendo o complexo articular de tornozelo e pé causado por movimentos bruscos de inversão e eversão. Objetivo: Identificar e analisar através da escala PEDro os ensaios clínicos sobre a aplicação da cinesioterapia como tratamento para indivíduos com entorse de tornozelo. Métodos: Trata-se de uma revisão de literatura na qual foram incluídos estudos do tipo ensaio clínico randomizado e não randomizado, referentes aos anos de 2009 a 2019, que usassem exercícios fisioterapêuticos em seu protocolo. A qualidade metodológica dos estudos foi avaliada com base na escala PEDro. Resultados: Os estudos selecionados utilizaram protocolos fisioterapêuticos contendo exercícios terapêuticos isolados e combinados associados ao treinamento de propriocepção para tratamento de curto a longo prazo da entorse de tornozelo. Conclusão: Para pacientes com entorse de tornozelo, o tratamento deve ser baseado na combinação de diferentes métodos fisioterapêuticos para a obtenção do efeito terapêutico positivo na fase aguda e crônica da lesão. (AU)

Introduction: Sprain is defined as a ligament injury whose trauma is caused by stretching or rupture of the fibrous bands that constitute the ligamentous structure, affecting the ankle and foot joint complex, caused by sudden inversion and eversion movements. Objective: To identify and analyze through the PEDro scale clinical trials on the application of kinesiotherapy as a treatment for individuals with ankle sprains. Methods: This is a literature review that included studies of the randomized and nonrandomized clinical trial, referring to the years 2009 to 2019, that used physical therapy exercises in its protocol. The methodological quality of the studies was assessed based on the PEDro scale. Results: The selected studies used physical therapy protocols containing isolated and combined therapeutic exercises associated with proprioception training for short-term long-term treatment of ankle sprains. Conclusion: For patients with ankle sprains, treatment should be based on the combination of different physical therapy methods to obtain a positive therapeutic effect in the acute and chronic phase of the injury. (AU)

Genomic detection of a virus lineage replacement event of dengue virus serotype 2 in Brazil, 2019

BACKGROUND Despite efforts to mitigate the impact of dengue virus (DENV) epidemics, the virus remains a public health problem in tropical and subtropical regions around the world. Most DENV cases in the Americas between January and July 2019 were reported in Brazil. São Paulo State in the southeast of Brazil has reported nearly half of all DENV infections in the country. OBJECTIVES To understand the origin and dynamics of the 2019 DENV outbreak. METHODS Here using portable nanopore sequencing we generated20 new DENV genome sequences from viremic patients with suspected dengue infection residing in two of the most-affected municipalities of São Paulo State, Araraquara and São José do Rio Preto. We conducted a comprehensive phylogenetic analysis with 1,630 global DENV strains to better understand the evolutionary history of the DENV lineages that currently circulate in the region. FINDINGS The new outbreak strains were classified as DENV2 genotype III (American/Asian genotype). Our analysis shows that the 2019 outbreak is the result of a novel DENV lineage that was recently introduced to Brazil from the Caribbean region. Dating phylogeographic analysis suggests that DENV2-III BR-4 was introduced to Brazil in or around early 2014, possibly from the Caribbean region. MAIN CONCLUSIONS Our study describes the early detection of a newly introduced and rapidly-expanding DENV2 virus lineage in Brazil.

Epidemiologic Study of Shoulder Injuries in the PyeongChang 2018 Winter Olympic Games

BACKGROUND: The purpose of this study is to describe and analyze the shoulder injuries in elite athletes during the 2018 Winter Olympics in Pyeongchang. METHODS: To collect the data of all Olympic athletes who visited venue medical centers, polyclinics, and Olympic-designated hospitals for shoulder injuries during the Olympic Games (February 9 through 25, 2018), we reviewed Olympic electronic medical records and patient information obtained from Olympic medical service teams about athletes who complained of shoulder pain. RESULTS: During the Olympics, a total of 14 athletes visited clinics for shoulder-related symptoms. Five athletes were injured in games and nine were injured in training. The injury was due to overuse in four patients. Ten patients had trauma-related symptoms: one after being hit by an opponent and the other nine after a collision with the ground or an object. There were no patients who complained of symptoms related to pre-existing shoulder conditions. The most common cause of shoulder pain was snow-boarding (one big air and three slopestyle). The most common diagnosis was contusion (n = 6), followed by rotator cuff injuries (n = 3), superior labrum from anterior to posterior lesion (n = 1), sprain (n = 1), acromioclavicular-coracoclavicular injury (n = 1), dislocation (n = 1), and fracture (n = 1). CONCLUSIONS: To the best of our knowledge, this study is the first epidemiologic study of shoulder injury conducted during a huge sports event involving a variety of competitions for elite athletes. If the risk factors of shoulder injury can be established by continuing research in the future, it will be helpful to prevent injury and to prepare safety measures for athletes.