PCR múltiplex para el diagnóstico de microorganismos atípicos transmitidos sexualmente / Multiplex PCR testing for the atypical microorganisms diagnosis sexually transmitted

Resumen Antecedentes: Las infecciones de transmisión sexual son un problema de salud pública mundial. El análisis rutinario incluye solo pruebas microbiológicas y serológicas para el diagnóstico de patógenos. Los microorganismos atípicos como Chlamydia trachomatis y micoplasmas no son identificados debido a los requerimientos. Además, no es incluida Gardnerella vaginalis, aunque se asocia a la vaginosis bacteriana. Objetivo: Desarrollar una PCR múltiplex para el diagnóstico de C. trachomatis, micoplasmas y G. vaginalis. Método: Se estandarizó la PCR múltiplex utilizando oligonucleótidos para C. trachomatis (gen ompA, orf6 plasmídico), Mycoplasma/Ureaplasma y G. vaginalis (genes rRNA16s). Resultados: Se estandarizaron pruebas de PCR múltiplex para los microorganismos estudiados, optimizándose las concentraciones y condiciones de las reacciones múltiplex. Se obtuvieron PCR dúplex para C. trachomatis (ompA, orf6), Chlamydia/Gardnerella y Chlamydia/micoplasmas y tríplex para Chlamydia/Mycoplasma/Ureaplasma. También un cuádruplex para Chlamydia/Mycoplasma/Ureaplasma/Gardnerella. Los resultados fueron verificados por PCR e hibridación automática (HybriSpot 12) y análisis in silico. Conclusión: Se desarrollaron pruebas de PCR múltiplex con una alta sensibilidad y especificidad para la identificación de C. trachomatis, micoplasmas y G. vaginalis.

Abstract Background: Sexually transmitted infections are a global public health problem. Routine analysis includes microbiological and serological tests for the diagnosis of pathogens. Atypical microorganisms such as Chlamydia trachomatis and mycoplasmas are not determined due to the requirements for their identification. Furthermore, Gardnerella vaginalis is not included despite being associated with bacterial vaginosis. Objective: To develop a multiplex PCR to diagnose Chlamydia, mycoplasmas, and Gardnerella. Method: Standardization of multiplex PCR tests was carried out using oligonucleotides for the identification of Chlamydia (ompA gene, plasmid orf6), Mycoplasma/Ureaplasma and Gardnerella (rRNA16s genes). Results: Multiplex PCR tests were standardized for the microorganisms studied, optimizing the concentrations and conditions of the multiplex reactions. Duplex PCR was obtained for Chlamydia (ompA, orf6), Chlamydia/Gardnerella, and Chlamydia/mycoplasmas, and triplex PCR for Chlamydia/mycoplasmas. Also, a quadruplex for Chlamydia, Mycoplasma/Ureaplasma and Gardnerella. PCR and automatic hybridization verified the results obtained (HybriSpot 12) and in silico analysis. Conclusion: Multiplex PCR tests with high sensitivity and specificity were developed to identify C. trachomatis, mycoplasmas, and G. vaginalis.

Todo sobre una entidad poco conocida: el síndrome linfoproliferativo postrasplante / All about a little known entity: post transplant lymphoproliferative syndrome

Resumen El síndrome linfoproliferativo postrasplante (SLPT o PTLD por sus siglas en inglés, posttransplantation lymphoproliferative disorder) consiste en un grupo heterogéneo de enfermedades linfoproliferativas que ocurren en el marco de la inmunosupresión postrasplante, que pueden abarcar desde una simple hiperplasia linfoidea hasta un linfoma maligno de alto grado, con eventual evolución fatal. Se estima su desarrollo entre el 1 y el 20% de los pacientes trasplantados. Los principales factores asociados con el desarrollo de SLPT son el grado de inmunosupresión y el virus de Epstein Barr (VEB). La mayoría suceden dentro del primer año postrasplante, pero el riesgo de desarrollarlo continúa hasta los 10 años. Su presentación es variable, puede ser asintomático o con manifestaciones inespecíficas (fiebre, linfadenopatías), lo que dificulta su diagnóstico desde el punto de vista clínico. Por este motivo, los métodos de imagen cumplen un rol fundamental en su diagnóstico, siendo la tomografía computada (TC) el más utilizado. Se deberá sospechar desde las imágenes en todo paciente trasplantado con afección nodal, principalmente en retroperitoneo y mesenterio; y/o extranodal, como el tracto gastrointestinal, órganos y el sistema nervioso central. El objetivo del presente trabajo consiste en realizar una revisión sobre el SLPT mediante las imágenes y conocer la importancia de su sospecha y diagnóstico.

Abstract Post-transplantation lymphoproliferative disease (PTLD) is a heterogeneous group of lymphoproliferative diseases in behave of posttransplant immunosuppression, which ranges from relatively benign lymphoid hyperplasia to poorly differentiated lymphoma, affecting different organs with fatal evolution, eventually. PTLD constitutes a disease with an increasing incidence and detection, estimating its development between 1 and 20% of transplant patients. Although it is based on a multifactorial etiology, the main factors associated with the development of PTLD are the degree of immunosuppression and the Epstein Barr virus (EBV). Most cases of this disorder occur during the first year posttransplant, however, the risk of developing is included in the next 5 to 10 years. The clinical presentation is variable, and the patient may be asymptomatic, or with nonspecific manifestations such as fever, lymphadenopathy, or digestive symptoms, making it difficult to diagnose this entity from clinical suspicion. Imaging plays a fundamental role in diagnosis of PTLD, with the computed tomography (CT) being the most widely used. Findings can mimic those lymphoproliferative processes in patients with no transplant and should be suspect in every transplant patient with nodal affection, such as retroperitoneum and mesenteric¸ or extranodal compromise, like gastrointestinal tract, solid organs, and central nervous system. The aim of this paper is to revise all about the PTLD trough different imaging methods and to know the importance of its suspicion and diagnosis.

Leisure-time physical activity and its relationship with gender and walkingtime to the park or gym / Atividade física de lazer e seu relacionamento com gênero e tempo de caminhada até o parque ou academia

In this cross-sectional study, we describe the leisure-time physical activity (LTPA) of 374 adults who answered an online questionnaire. We also explored the relationship between LTPA, gender, and walking time to the nearest park or gym from the participant's residence. As expected from a recruitment process prone to include physically active individuals, the prevalence of LTPA during the last week was 80.2% (CI95%: 75.8 -84.1). Our median participant reported having performed 280 (CI95%: 240 ­340) minutes of LTPA during the last week. The prevalence of LTPA and the duration of light and total LTPA were similar between men and women. However, in our sample, women practiced more moderate LTPA and men more vigorous LTPA. The relationship between LTPA and walking time distance to the nearest park or gym is not linear, meaning that living closer to parks or gyms does not necessarily imply more LTPA.

Neste estudo transversal, descrevemos a atividade física no lazer (AFL) de 374 adultos que responderam a um questionário online. Também exploramos a relação entre AFL, gênero e tempo de caminhada até o parque ou academia mais próximo da residência do participante. Como esperado de um recrutamento propenso a incluir indivíduos fisicamente ativos, a prevalência de AFL na última semana foi de 80,2% (IC95%: 75,8 - 84,1). Nosso participante mediano relatou ter realizado 280 (IC95%: 240 ­ 340) minutos de AFL na última semana. A prevalência de AFL e a duração da AFL leve e total foram semelhantes entre homens e mulheres. No entanto, em nossa amostra, as mulheres praticaram mais AFL moderadas e os homens AFL vigorosas. A relação entre AFL e distância de caminhada até o parque ou academia mais próxima não é linear, indicando que morar mais perto de parques ou academias não implica necessariamente em mais AFL.

Denosumab como tratamiento neoadyuvante del tumor de células gigantes del hueso. Indicaciones, resultados y efectos adversos / Denosumab as a neoadjuvant treatment for giant cell tumor of bone. Indications, results and side effects

Resumen El tumor de células gigantes óseo es una neoplasia de agresividad local intermedia, que raramente metastatiza. En los últimos años el denosumab, anticuerpo monoclonal humano, surgió como una alternativa de tratamiento para esta enfermedad, al bloquear el comportamiento lítico tumoral. El objetivo de este trabajo fue determinar sus indicaciones y efectos adversos, analizando también los resultados oncológicos, y las tasas de recurrencia local en pacientes con diagnóstico de tumor de células gigantes óseo que recibieron denosumab como tratamiento neoadyuvante. Entre 2010 y 2018 se analizaron 80 pacientes con tumor de células gigantes, de los cuales 14 recibieron denosumab como tratamiento neoadyuvante. El seguimiento mínimo fue 12 meses. En 8 pacientes se trató de un tumor primario, mientras que 6 fueron pacientes con recidiva tumoral. En todos los casos se evidenció una mejoría clínica. Trece presentaron cambios radiográficos, y 11 respuesta histológica completa. En 6 de 14 pacientes se evidenció una recurrencia local y en 7 se identificó al menos un efecto adverso relacionado con el denosumab (incluyendo una malignización tumoral). A pesar de ser una herramienta útil para el tratamiento del tumor de células gigantes, el uso de denosumab está asociado a mayor tasa de recurrencias locales y no está exento de efectos adversos.

Abstract Giant cell tumor of bone is an intermediate, locally aggressive and rarely metastasiz ing, primary bone neoplasia. In recent years denosumab emerged as a treatment alternative for this pathology. The objective of this work was to analyze its indications as well as the clinical outcomes, side effects and local recurrence rates in patients diagnosed with giant cell tumor of bone, who received denosumab as neoadjuvant treatment. Between 2010 and 2018, 80 patients with giant cell tumor were analyzed, of whom 14 received deno sumab as a neoadjuvant treatment. The minimum follow-up was 12 months. In 8 patients it was a primary tumor, while 6 showed tumor recurrence. In all cases, clinical improvement was evident. Thirteen patients presented radiographic changes, and 11 showed complete histological response. A local recurrence was evidenced in 6 of 14 patients, and at least one adverse effect related to denosumab (including tumor malignancy) was identified in 7. Despite being a useful tool for treating giant cell tumor, the use of denosumab is associated with a higher rate of local recurrences and is not free of adverse effects.

The dose-response phenomenon associated with strength training is independent of the volume of sets and repetitions per session / O fenômeno de dose-resposta associado ao treinamento de força é independente do volume de séries e repetições por sessão / El fenómeno de dosis-respuesta asociado al entrenamiento de fuerza es independiente del volumen de series y repeticiones por sesión

ABSTRACT Introduction There are few studies on the effectiveness of training models with high volume sets per session in particular muscle groups. Objective The aim of the study was to investigate the effects of different resistance training (RT) repetitions with equalized volumes on muscle adaptations. Methods This study used an experimental design in which forty-seven volunteers underwent 8 weeks of RT after having been distributed randomly into three groups: ten sets of three maximum repetitions (10x3), three sets of ten maximum repetitions (3x10) and five sets of six maximum repetitions (5x6) for each muscular group per training session. Maximum strength (1RM test) and muscle thickness (MT) were evaluated as outcomes. Results A significant main effect (p=0.001) of time on maximum strength was observed for the three groups, but no significance was observed (p>0.05) in time x group interactions. A significant main effect (p=0.001) of time was observed on MT for biceps, triceps and vastus lateralis, without significant differences for time x group interactions. Significant correlations were found between maximum strength and muscle thickness after general statistical analyses for all protocols. Conclusion Improvements in maximum strength and muscle thickness are similar when repetition volumes are equalized through the number of series and repetitions. Level of evidence I; Therapeutic studies, investigation of treatment results.

RESUMO Introdução Existem poucos estudos sobre a eficácia de modelos de treinamento com conjuntos de alto volume por sessão em grupos musculares específicos. Objetivos O objetivo do estudo foi investigar os efeitos de diferentes repetições do treinamento de resistência (TR) com volumes equalizados nas adaptações musculares. Métodos Este estudo tem desenho experimental com 47 voluntários que realizaram oito semanas de TR depois de serem distribuídos randomicamente em três grupos: dez séries de três repetições máximas (10x3), três séries de dez repetições máximas (3x10) e cinco séries de seis repetições máximas (5x6) para cada grupo muscular por sessão de treinamento. A força máxima (teste de 1RM) e a espessura muscular (EM) foram avaliadas como desfecho. Resultados Verificou-se efeito significativo (p = 0,001) sobre o tempo na força máxima nos três grupos, contudo, nenhuma significância (p > 0,05) foi observada nas interações entre tempo e grupo. Constatou-se efeito significativo (p = 0,001) do tempo sobre a EM para bíceps, tríceps e vasto lateral, sem diferenças significativas nas interações entre tempo e grupo. Correlações significativas foram encontradas entre força máxima e espessura muscular depois das análises estatísticas gerais para todos os protocolos. Conclusões A melhora da força máxima e da espessura muscular é semelhante quando o volume de repetições é equalizado considerando o número de séries e repetições. Nível de evidência I; Estudos terapêuticos, investigação dos resultados do tratamento.

RESUMEN Introducción Existen pocos estudios sobre la eficacia de modelos entrenamiento con conjuntos de alto volumen por sesión en grupos musculares específicos. Objetivos El objetivo del estudio fue investigar los efectos de diferentes repeticiones del entrenamiento de resistencia (ER) con volúmenes ecualizados en las adaptaciones musculares. Métodos Este estudio tiene diseño experimental con 47 voluntarios que realizaron ocho semanas de ER después de ser distribuidos aleatoriamente en tres grupos: diez series de tres repeticiones máximas (10x3), tres series de diez repeticiones máximas (3x10) y cinco series de seis repeticiones máximas (5x6) para cada grupo muscular por sesión de entrenamiento. La fuerza máxima (test de 1RM) y el espesor muscular (EM) fueron evaluados como conclusión. Resultados Se verificó efecto significativo (p = 0,001) sobre el tiempo en la fuerza máxima en los tres grupos, sin embargo, ninguna significancia (p> 0,05) fue observada en las interacciones entre tiempo y grupo. Se constató efecto significativo (p = 0,001) del tiempo sobre el EM para bíceps, tríceps y vasto lateral, sin diferencias significativas en las interacciones entre tiempo y grupo. Fueron encontradas correlaciones significativas entre fuerza máxima y espesor muscular después de los análisis estadísticos generales para todos los protocolos. Conclusiones La mejora de la fuerza máxima y del espesor muscular es semejante cuando el volumen de repeticiones es ecualizado considerando el número de series y repeticiones. Nivel de evidencia I; Estudios terapéuticos, investigación de los resultados del tratamiento.

Stx1 and Stx2 subtyping and antimicrobial resistance in Shiga toxin-producing Escherichia coli (STEC) isolates from cattle and sheep feces in the Southeastern region of the State of Goiás, Brazil / Subtipagem de Stx1 e Stx2 e resistência antimicrobiana em isolados de Escherichia coli produtoras de toxina Shiga (STEC) de fezes de bovinos e ovinos na região sudeste de Goiás, Brasil

The present study was aimed at subtyping of Stx1 and Stx2 genes and characterization of antimicrobial resistance in 106 Shiga toxin-producing Escherichia coli (STEC) strains isolated from cattle and sheep feces. PCR was used to determine the subtypes, and the disk-diffusion method was used to evaluate the antimicrobial resistance. Ten antibiotics from five different classes were tested. Among the isolates of bovine origin, two subtypes of Stx1 (Stx1a and Stx1c), and four subtypes of Stx2 (Stx2a, Stx2b, Stx2c, and Stx2d) were identified. In isolates of sheep origin, two subtypes of Stx1 (Stx1a and Stx1c), and four subtypes of Stx2 (Stx2a, Stx2b, Stx2c, and Stx2 g) were identified. The results obtained suggest the presence of high diversity in Stx1 and Stx2 genes. Further, 96.6% (57/59) of bovine fecal strains and 89.4% (42/47) of sheep fecal strains showed resistance to at least one tested antibiotic. In both animal species, most strains were multidrug-resistant (MDR) (67.8% in cattle and 59.6% in sheep), with no significant difference between host animals. Adult animals were eight times more likely to have STEC with greater pathogenic potential. STEC with the highest pathogenic potential were three times more likely to be multidrug-resistant than STEC with the lowest pathogenic potential. The data reported in this study suggests the occurrence of strains with high potential pathogenicity in the region studied. Therefore, the ruminants of this region are carriers of strains that can cause infections in humans.(AU)

O presente estudo teve como objetivo subtipar os genes Stx1 e Stx2 e caracterizar a resistência antimicrobiana em 106 isolados de Escherichia coli produtoras de toxinas Shiga (STEC) isoladas de fezes de bovinos e ovinos. A PCR foi utilizada para determinar os subtipos e o método de difusão em disco foi utilizado para avaliar a resistência antimicrobiana. Dez antibióticos de cinco classes diferentes foram testados. Entre os isolados de origem bovina, foram identificados dois subtipos de Stx1 (Stx1a e Stx1c) e quatro subtipos de Stx2 (Stx2a, Stx2b, Stx2c e Stx2d). Nos isolados de origem ovina, foram identificados dois subtipos de Stx1 (Stx1a e Stx1c) e quatro subtipos de Stx2 (Stx2a, Stx2b, Stx2c e Stx2g). Os resultados obtidos sugerem a presença de alta variabilidade nos genes Stx1 e Stx2. Além disso, 96,6% (57/59) dos isolados fecais de bovinos e 89,4% (42/47) dos isolados de ovinos mostraram resistência a pelo menos um antibiótico testado. Em ambas as espécies animais, a maioria das cepas foi multirresistente (MDR) (67,8% em bovinos e 59,6% em ovinos), sem diferença significativa entre as espécies animais do reservatório. Os animais adultos tiveram oito vezes mais chances de apresentar STEC com maior potencial patogênico. STEC com o maior potencial patogênico teve três vezes mais chances de ser multirresistente do que o STEC com o menor potencial patogênico. Os dados relatados neste estudo sugerem a ocorrência de cepas com alto potencial de patogenicidade na região estudada. Portanto, os ruminantes dessa região são hospedeiros de isolados que podem causar infecções em humanos.(AU)

Stx1 and Stx2 subtyping and antimicrobial resistance in Shiga toxin-producing Escherichia coli (STEC) isolates from cattle and sheep feces in the Southeastern region of the State of Goiás, Brazil

ABSTRACT: The present study was aimed at subtyping of Stx1 and Stx2 genes and characterization of antimicrobial resistance in 106 Shiga toxin-producing Escherichia coli (STEC) strains isolated from cattle and sheep feces. PCR was used to determine the subtypes, and the disk-diffusion method was used to evaluate the antimicrobial resistance. Ten antibiotics from five different classes were tested. Among the isolates of bovine origin, two subtypes of Stx1 (Stx1a and Stx1c), and four subtypes of Stx2 (Stx2a, Stx2b, Stx2c, and Stx2d) were identified. In isolates of sheep origin, two subtypes of Stx1 (Stx1a and Stx1c), and four subtypes of Stx2 (Stx2a, Stx2b, Stx2c, and Stx2 g) were identified. The results obtained suggest the presence of high diversity in Stx1 and Stx2 genes. Further, 96.6% (57/59) of bovine fecal strains and 89.4% (42/47) of sheep fecal strains showed resistance to at least one tested antibiotic. In both animal species, most strains were multidrug-resistant (MDR) (67.8% in cattle and 59.6% in sheep), with no significant difference between host animals. Adult animals were eight times more likely to have STEC with greater pathogenic potential. STEC with the highest pathogenic potential were three times more likely to be multidrug-resistant than STEC with the lowest pathogenic potential. The data reported in this study suggests the occurrence of strains with high potential pathogenicity in the region studied. Therefore, the ruminants of this region are carriers of strains that can cause infections in humans.

RESUMO: O presente estudo teve como objetivo subtipar os genes Stx1 e Stx2 e caracterizar a resistência antimicrobiana em 106 isolados de Escherichia coli produtoras de toxinas Shiga (STEC) isoladas de fezes de bovinos e ovinos. A PCR foi utilizada para determinar os subtipos e o método de difusão em disco foi utilizado para avaliar a resistência antimicrobiana. Dez antibióticos de cinco classes diferentes foram testados. Entre os isolados de origem bovina, foram identificados dois subtipos de Stx1 (Stx1a e Stx1c) e quatro subtipos de Stx2 (Stx2a, Stx2b, Stx2c e Stx2d). Nos isolados de origem ovina, foram identificados dois subtipos de Stx1 (Stx1a e Stx1c) e quatro subtipos de Stx2 (Stx2a, Stx2b, Stx2c e Stx2g). Os resultados obtidos sugerem a presença de alta variabilidade nos genes Stx1 e Stx2. Além disso, 96,6% (57/59) dos isolados fecais de bovinos e 89,4% (42/47) dos isolados de ovinos mostraram resistência a pelo menos um antibiótico testado. Em ambas as espécies animais, a maioria das cepas foi multirresistente (MDR) (67,8% em bovinos e 59,6% em ovinos), sem diferença significativa entre as espécies animais do reservatório. Os animais adultos tiveram oito vezes mais chances de apresentar STEC com maior potencial patogênico. STEC com o maior potencial patogênico teve três vezes mais chances de ser multirresistente do que o STEC com o menor potencial patogênico. Os dados relatados neste estudo sugerem a ocorrência de cepas com alto potencial de patogenicidade na região estudada. Portanto, os ruminantes dessa região são hospedeiros de isolados que podem causar infecções em humanos.

Detección atípica de Chlamydia pneumoniae no humana en una muestra endocervical. Reporte de caso / Atypical detection of non-human Chlamydia pneumoniae in an endocervical sample. Case Report

Resumen ANTECEDENTES: Chlamydia trachomatis es uno de los principales microorganismos de trasmisión sexual asociado de manera importante con infertilidad femenina. La detección de genotipos y nuevas variantes de Chlamydia trachomatis permite conocer su prevalencia, distribución geográfica, identificar la aparición de resistencia antimicrobiana y las asociaciones clínicas o comportamientos sexuales y desarrollar vacunas. Este caso clínico es el primer informe de infección endocervical por una cepa diferente a C trachomatis. CASO CLÍNICO: Paciente de 25 años, con diagnóstico de infertilidad primaria de 2 años de evolución por factor endocrino-ovárico (sobrepeso e hipotiroidismo subclínico) y por factor masculino de hipospermia y teratozoospermia. El cultivo microbiológico endocervical detectó la infección por Ureaplasma spp y Chlamydia spp. La identificación de la cepa de Chlamydia mediante secuenciación del gen 16S del ARNr informó que era Chlamydia pneumoniae. La existencia de un plásmido en esta cepa de C pneumoniae confirmó que la infección endocervical fue por una cepa de Chlamydia pneumoniae no humana. CONCLUSIÓN: Este caso clínico sugiere la posibilidad de que una cepa de C pneumoniae no humana sea capaz de trasmitirse sexualmente a los humanos, estar circulando en la población mexicana y causar infertilidad, aunque aún se desconocen el origen y la dirección de la trasmisión.

Abstract BACKGROUND: Chlamydia trachomatis is one of the leading sexually transmitted microorganisms that is significantly associated with the development of female infertility. The detection of genotypes and new variants ofChlamydia trachomatisallows us to know their prevalence and geographic distribution, identify the appearance of antimicrobial resistance, clinical associations, or sexual behaviors, and develop vaccines. This clinical case reports for the first time endocervical infection by a strain other thanC. trachomatis. CLINICAL CASE: A 25-year-old woman with primary infertility of 2 years of evolution due to endocrine-ovarian factor (overweight and subclinical hypothyroidism) and male factor characterized by hypospermia and teratozoospermia. Endocervical microbiological culture detected infection byUreaplasma urealyticumandChlamydiaspp. Identification of theChlamydiastrain by sequencing the 16S rRNA gene reported that it wasChlamydia pneumoniae. The presence of plasmid in this strain ofC. pneumoniaeconfirmed that the endocervical infection was by a non-humanChlamydia pneumoniaestrain. CONCLUSION: This clinical case suggests that a non-human strain ofC. pneumoniaecan be sexually transmitted to humans, circulating in the Mexican population, and causing infertility, although the origin and direction of transmission are still unknown.

A compreensão da política por militantes do movimento trans alagoano / The understanding of politics by militants of the alagoan trans movement / La comprensión de la política por militantes del movimiento trans alagoano

Tendo em vista o caráter recente da organização de movimentos sociais trans no Brasil, objetivamos analisar a compreensão da política por travestis e transexuais da cidade de Maceió, que integram a Associação das Travestis e Transexuais de Alagoas (Asttal). Tal estudo se mostra relevante considerando os contextos de transfobia e violência de gênero na cidade em questão. Para tanto, inserimo-nos nas atividades do movimento trans e participamos delas, que foram registradas em diários de campo. Também foram realizadas entrevistas semiestruturadas com sete integrantes dessa associação. Obtivemos conclusões que se subdividiram em três categorias, as quais apontaram para dimensões como a política institucional, partidária; a política específica do movimento LGBT; e a política associada à cidadania e às políticas públicas.

Considering the recent feature of the organization of trans social movements in Brazil, we aimed to analyze the comprehension of politics among travesties and transsexuals in the city of Maceió through the Association of Travestis and Transsexuals of Alagoas (Asttal). This study has relevance, considering the context of transphobia and gender violence in the city mentioned above. To do so, we participated in the activities of the trans movement, recording our experiences in field journals. Semi-structured interviews were also conducted with seven members of this association. We obtained conclusions that were subdivided into three categories that pointed to dimensions such as institutional, partisan politics; the specific politics of the LGBT movement; and the politics associated with citizenship and public policies.

Considerando el carácter reciente de la organización de movimientos sociales trans en Brasil, objetivamos analizar la comprensión de la política por travestís y transexuales en la ciudad de Maceió, por medio de la Asociación de las Travestís y Transexuales de Alagoas (Asttal). El estudio se muestra relevante teniendo en cuenta los contextos de transfobia y violencia de género en la ciudad. Para tal fin, nos insertamos y participamos de las actividades del movimiento trans que fueron registradas en diarios de campo. También fueron realizadas entrevistas estructuradas con siete integrantes de la asociación. Obtuvimos conclusiones que se subdividieron en tres categorías, que señalaron para dimensiones como la política institucional, partidaria; la política específica del movimiento LGBT; y la política asociada a la ciudadanía y a las políticas públicas.

Hydration status, sweating rate, heart rate and perceived exertion after running sessions in different relative humidity conditions: a randomized controlled trial

ABSTRACT The purpose of this study was to analyze the impact of running in normal relative humidity (RH = 53%) and very high RH (94%) on hydration status (HS), sweating rate (SR), heart rate (HR), and rating of perceived exertion (RPE). Fourteen men (25.2 ± 6.6 yrs) performed two sessions of treadmill running. Body mass (normal RH: -1.35%, very high RH: -1.65%) HS (normal RH: -14.8%; very high RH: -20.8%) were reduced while RPE (normal RH: +26%; very high RH: +28%) and HR were increased (very high RH: +5.8%: 20-40 min, +3.1%: 40-60 min, +3%: 20-40 min; +2.3%: 40-60 min for normal RH). As expected, SR was significantly greater during very high RH (-20/8%) compared to normal RH (-14.8%). Running in very high RH at moderate temperature has a greater negative impact on SR, HS, body mass, HR, RPE in men than running in normal RH at the same temperature, which places the runner in greater danger of heat illnesses such as heat exhaustion or heat stroke.

RESUMO Analisar o impacto da corrida em diferentes humidade relativa (HR) (normal (53%), muito alto (94%)), estado de hidratação (EH), taxa de transpiração (TT), freqüência cardíaca (FC), esforço percebido (RPE). Quatorze homens (25,2 anos) realizaram duas sessões de corrida em esteira. Massa corporal (HR normal: -1,35%, HR muito alta: -1,65%) e EH reduziram (HR normal: -14,8%, HR muito alta: -20,8%), RPE (HR normal: + 26%, HR muito alta: + 28%), aumento da FC (HR muito alta: + 5.8%: 20-40 min, + 3.1%: 40-60 min, HR normal: + 3%: 20-40 min; + 2.3%: 40-60 min). TT foi significantemente diferente entre HR (HR normal: -14.8%, HR muito alta: -20.8%). Há um impacto negativo na corrida em EH, massa corporal, FC e RPE em homens com HR normal e muito alta, e TT é mais afetada com HR muito alta.

RESUMEN El objetivo de este estudio fue analizar las repercusiones de correr con diferentes niveles de humedad relativa (HR) (normal [53%], muy alta [94%]) sobre el estado de hidratación (EH), la tasa de sudoración (TS), la frecuencia cardíaca (FC) y el esfuerzo percibido (EP). Catorce hombres (25,2 ± 6,6 años) realizaron dos sesiones en cinta de correr. La masa corporal (HR normal: -1,35%; HR muy alta: -1,65%) y el EH (HR normal: -14,8%; HR muy alta: -20,8%) se redujeron, mientras que el EP (HR normal: +26%; HR muy alta: +28%) y la FC (HR muy alta: +5,8%: 20-40 min; +3,1%: 40-60 min; HR normal: + 3%: 20-40 min; + 2,3%: 40-60) aumentaron. La TS fue considerablemente diferente entre las HR (HR normal: -14,8%; muy alta HR: -20,8%). Hay repercusiones negativas por correr con una HR muy alta y una temperatura moderada en TS, EH, masa corporal, FC y EP en corredores que corren a una HR normal a la misma temperatura, lo que sitúa a estos en gran peligro de sufrir un enfermedad provocada por el calor, como agotamiento por calor o golpe de calor.

Recommendations for head and neck surgical procedures during the COVID-19 pandemic

The coronavirus disease (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread exponentially worldwide. In Brazil, the number of infected people diagnosed has been increasing and, as in other countries, it has been associated with a high risk of contamination in healthcare teams. For healthcare professionals, the full use of personal protective equipment (PPE) is mandatory, such as wearing surgical or filtering facepiece class 2 (FFP2) masks, waterproof aprons, gloves, and goggles, in addition to training in care processes. A reduction in the number of face-to-face visits and non-essential elective procedures is also recommended. However, surgery should not be postponed in the case of the most essential elective indications (mostly associated with head and neck cancers). As malignant tumors of the head and neck are clinically time sensitive, neither consultations for these tumors nor their treatment should be postponed. Postponing surgical treatment can result in a change in the disease stage and alter an individual's chance of survival. In this situation, planning of all treatments must begin with the request for, in addition to routine examinations, a nasal swab polymerase chain reaction for SARS-CoV-2 and chest computed tomography. Only if the results of these tests are positive or if fever or other symptoms suggestive of COVID-19 are present should the surgical procedure be postponed until the patient completely recovers. This is mandatory not only because of the risk of contamination of the surgical team but also because of the increased risk of postoperative complications and high risk of death. During this pandemic, the most effective safety measures are social distancing for the general public and the adequate availability and use of PPE in the healthcare field. The treatment of other chronic diseases, such as cancer, should be continued, as the damming of cases of these diseases will have a deleterious effect on the public healthcare system.

Multivariate linear regression analysis to evaluate multiple-set performance in active and inactive individuals

Abstract Aim: To determine how EMG, anthropometric, and psychological factors, and physical activity levels affect isokinetic peak torque performance (IPT) of multiple set exercise sessions. Methods: 20 participants (27±7 years old), classified as active (A=10) and inactive (I=10), performed 10x10:40secs of maximal unilateral knee flexions and extensions at 120o.s-1. The IPT, EMG, glucose, LDH, and lactate concentrations and perceptions of pain, effort, recovery. Results: Active volunteers showed higher muscularity (52±5 vs 47±4 cm; p<0.05), PTI (262±4 vs 185±4 Nm; p<0.05), relative lower drop in performance (14±2 vs 27±3% ; p<0.05), major MDF (83±1 vs 76±1 Hz; p<0.05), lower log -Fins5 (-12.9±0.3 vs -12.7 ± 0.3 Hz; p<0.05), smaller subjective perception of effort (14.8±0.3 vs 17.0±0.3) and higher subjective perception of recovery (14.2±0.2 vs 12.3±0.3). There was a significant interaction between relative fatigue and the number of sets (F=6.18; p<0.001). Stepwise multiple regressions revealed that subjective perception of recovery best explained the fatigue level generated in the active volunteers [fatigue level= 85.084-5255(SPR)] while for body mass was the best determinant for the inactive group [fatigue level = -21.560 +1.828(BMI)]. Conclusion: Data from the present analysis suggest that physically active individuals show higher torque development and a smaller fatigability index when compared to inactive individuals. Among the fatigue models studied, it is possible that alterations in biochemical components, psychophysiological and EMG are not sensitive to the direct influence of the fatigue dynamics protocol, both in active or inactive individuals.

Foro de opinión: aspectos psicológicos en niños con labio leporino y/o paladar hendido: un breve comentario sobre algunos hallazgos relevantes para los equipos de salud / Fórum de opinião: aspetos psicológicos em crianças com lábio leporino e / ou fenda palatina: um comentário breve sobre algumas conclusões marcantes para as equipes de saúde / Fórum de opinião: aspetos psicológicos em crianças com lábio leporino e / ou fenda palatina: um comentário breve sobre algumas conclusões marcantes para as equipes de saúde

El labio leporino con o sin paladar hendido se encuentra entre los principales defectos congénitos y afecta aproximadamente 1:700 de los recién nacidos vivos (1). Se considera que la etiología de esta patología es multifactorial, incluyendo una interacción entre factores genéticos y ambientales.

Cleft lip with or without cleft palate is among the major birth defects and affects approximately 1:700 of live newborns (1). The aetiology of this pathology is considered to be multifactorial, including an interaction between genetic and environmental factors.

O lábio leporino com ou sem fissura palatina está entre os principais defeitos congênitos e acomete aproximadamente 1:700 de recém-nascidos vivos (1). A etiologia desta patologia é considerada multifactorial, incluindo uma interacção entre factores genéticos e ambientais.

Effects of previous carbohydrate supplementation on muscular fatigue: double-blind, randomized, placebo-controlled crossover study

Aims: The aim of this study was to examine the effects of previous carbohydrate supplementation on high-volume resistance exercise performance Methods: Twenty males physically independent adults aged ≥18 years participated in a double-blind randomized placebo-controlled crossover study. Sixty minutes before the experimental protocol, each participant ingested 0,6 g.kg of body mass-1 of carbohydrate supplementation or placebo. Maximum voluntary isometric contraction tests were performed before and after the dynamic fatigue induction protocol consisting of 10 sets of 8 repetitions of right leg knee extensors at 120º s-1. Results: Lower decrement of the isometric peak torque (p<0,001) and of the rate of torque development (p<0,001) was observed in carbohydrate supplementation after the dynamic protocol. Both concentric and eccentric peak torque differed significantly (p<0,001) between carbohydrate supplementation and placebo treatments from the second set, although the slope of the force-repetitions curve was not different between them. Additionally, the carbohydrate supplementation resulted in a lower session rating of perceived exertion (p<0,05). Conclusions: Previous carbohydrate supplementation attenuates muscle fatigue and internal load exercise in a high-volume isokinetic leg protocol.(AU)

Aspectos psicológicos en niños con labio leporino y/o paladar hendido: un breve comentario sobre algunos hallazgos relevantes para los equipos de salud / Aspectos Psicológicos em crianças com Lábio liporino e / ou fenda Palatina: um breve comentário Sobre alguns resultados Relevantes para equipes de saúde / Psychological Aspects in children With cleft lip and/ Or palate: a brief Commentary onsome Relevant findings for Health teams

El labio leporino con o sin paladar hendido se encuentra entre los principales defectos congénitos y afecta aproximadamente 1:700 de los recién nacidos vivos (1). Se considera que la etiología de esta patología es multifactorial, incluyendo una interacción entre factores genéticos y ambientales (2,3)

Cleft lip and/or palate (CL/P) are among the most prevalent of all birth defects in human, affecting approximately 1:700 live births(1). The etiology of CL/P is thought to be multifactorial, involving an interaction between genetic and environmental factors (2,3).

A fissura labial e / ou palatina (FL / P) está entre as mais prevalentes de todos os defeitos congênitos em humanos, afetando aproximadamente 1: 700 nascidos vivos (1). A etiologia da CL / P é considerada multifatorial, envolvendo uma interação entre fatores genéticos e ambientais (2,3)

Propriedades psicométricas da versão brasileira do Perceived Motivational Climate In Sport Questionnaire-2 (PMCSQ-2) / Psychometric properties of the brazilian version of the Perceived Motivational Climate In Sport Questionnaire-2 (PMCSQ-2)

A motivação tem sido tema central de investigação na Psicologia do Esporte porque se entende que esse fenômeno psicológico pode maximizar o desempenho de diferentes níveis de atletas. O presente estudo teve os seguintes objetivos: i) proceder à tradução e adaptação transcultural (equivalência semântica/conceitual e validade de conteúdo) do Perceived Motivational Climate in Sport Questionnaire-2 (PMCSQ-2); e, ii) verificar as suas propriedades psicométricas (consistência interna, validade fatorial,confiabilidade composta e variância extraída média) A amostra do presente estudo foi composta por 255 atletas (231 do sexo masculino e 24 do sexo feminino) de diferentes modalidades esportivas, com idades compreendidas entre 18 e 52 anos (M = 25,61 e DP = 4,98). O instrumento foi aplicado nos locais de treino dos atletas. A versão brasileira do PMCSQ-2 alcançou bons índices de validade de conteúdo, assim como, de confiabilidade e índices marginais de variância extraída média. Foi suportada a evidência de validade de constructo através dos índices de ajustamentos revelados pela Análise Fatorial Confirmatória (AFC). Conclui-se que esse instrumento pode ser utilizado em futuros estudos, para o entendimento do clima motivacional em equipes esportivas com objetivo de melhorar o desempenho de atleta de competição....(AU)

Motivation has been a central theme of research in Sport Psychology because it has been seen as a psychological phenomenon that maximizes the performance of different levels of athletes. The present study had the following objectives: i) transcultural translation and adaptation (semantic/conceptual equivalence and content validity) of the Perceived Motivational Climate in Sport Questionnaire-2 (PMCSQ-2); and (ii) to verify their psychometric properties (internal consistency, factorial validity, composite reliability and mean extracted variance). The sample consisted of 255 athletes (231 males and 24 females) of different sports ages ranging from 18 to 52 years (M = 25.61 and SD = 4.98). The instrument was applied at athletes' training locations. The Brazilian version of PMCSQ-2 achieved good fit indexes, as well as reliability and marginal indexes of mean extracted variance. Evidence of construct validity was supported through the fit indexes by Confirmatory Factor Analysis (AFC). We conclude that this instrument can be used in future studies to understand the motivational climate in sports teams with the objective of improving the performance of athletes in competition...(AU)

Prevalencia de la infección genital por Chlamydia trachomatis en mujeres que asisten al Instituto Nacional de Perinatología de la Ciudad de México / Prevalence of genital Chlamydia trachomatis infection in women attending in the National Institute of Perinatology from Mexico City

Resumen Introducción: La infección endocervical por Chlamydia trachomatis es considerada una de las principales causas de infertilidad en todo el mundo. Durante el embarazo puede conducir a complicaciones graves como la ruptura prematura de membranas y los partos prematuros. Objetivo: Determinar la prevalencia de infección genital por C. trachomatis en mujeres embarazadas e infértiles de la Ciudad de México. Métodos: La detección de C. trachomatis fue mediante reacción de polimerasa en cadena tiempo real (RPC-TR) con el kit comercial COBAS® TaqMan CT Test v2,0 (Roche Molecular System). Resultados: Se analizaron 2.352 muestras; 102 fueron positivas (4,3%). La prevalencia por edad mostró que las adolescentes embarazadas (15 a 19 años) fueron las de mayor riesgo de infección (10,9%, RR = 3,23 [IC 95%: 1,79-5,84]), seguido de mujeres jóvenes de 20 a 24 años, con prevalencia de 5,6% (RR = 1,65 [IC 95%: 0,82-3,34]). Discusión: Los resultados indican que la prevalencia está dentro del rango reportado en el concierto mundial. Sin embargo, las adolescentes embarazadas tuvieron mayor prevalencia que las mujeres infértiles. Conclusión: Es imperioso realizar un rastreo sistemático de infección por C. trachomatis en mujeres bajo 24 años de edad, y en mujeres embarazadas para disminuir los casos de infertilidad y las complicaciones perinatales.

Background: Endocervical infection by Chlamydia trachomatis is considered one of the leading causes of infertility worldwide. During pregnancy, it can lead to serious complications such as premature rupture of membranes and premature births. Aim: To determine the prevalence of genital infection by C. trachomatis in pregnancy and infertile women from Mexico City. Methods: The detection of C. trachomatis was performed by real-time PCR with the commercial kit COBAS® TaqMan CT Test v2.0 (Roche Molecular System). Results: We analyzed 2,352 endocervical swabs; 102 were positive (4.3%). Age prevalence showed that pregnant adolescents (15 to 19 years of age) had the highest risk of infection (10.9%, RR = 3.23 [95% IC: 1.79-5.84]), followed by young women aged 20 to 24 years, with a prevalence of 5.6% (RR = 1.65 [95% IC: 0.82-3.34]). Discussion: The results indicate that the prevalence is within the range reported worldwide. However, pregnant adolescents were those with a higher prevalence than infertile women were. Conclusion: A systematic screening of C. trachomatis infection in women younger than 24 years of age, and in pregnant women is necessary to reduce the incidence of infertility and perinatal complications.