Muscular and cardiorespiratory parameters of Brazilian professional futsal players: comparison between top national and regional level athletes

Abstract Aim: To compare muscular and cardiorespiratory parameters between Brazilian professional futsal athletes from different competitive levels (national versus regional). A secondary aim was to explore the correlation of physical fitness variables between both competitive levels. Methods: Twenty-two futsal players (24.7 ± 3.7 years), 11 from a regional team and 11 from a national team, were evaluated with countermovement jump test (lower limbs muscle power), square test (the speed with change direction), RSSA (anaerobic power), and YOYOIR1 (aerobic power). Tests were performed in the middle of the season for both teams. Results: The speed with change direction (p = 0.001) and mean anaerobic power (p = 0.04) were higher for national than the regional players. Sprint performance decreased similarly for national and regional level players (p < 0.001), but the latter had poorer performance (p = 0.044). From the fourth sprint on, sprints for the national level players were slower than the first three, while for the regional level players, each sprint speed was slower than the subsequent. A significant correlation was found between anaerobic power with jump height (r = −0.50; p = 0.01), speed with change direction (r=0.65; p = 0.001) and distance covered in the YOYOIR1 (r = −0.54; p = 0.01). Conclusion: National-level athletes were more agile and presented a higher mean anaerobic power than regional ones. Moreover, national-level athletes presented better performance along with repeated sprint tests, maintaining this performance for a longer time during the test.

Aspects of the use of propensity score matching methods in neurosurgery / Aspectos do uso dos métodos de pareamento de escore de propensão em neurocirurgia / Aspectos del uso de los métodos de emparejamiento de puntaje de propensión en neurocirugía

ABSTRACT Objective Observational studies and register data provide researchers with ample opportunities to obtain answers to questions that randomized controlled trials cannot answer for organizational or ethical reasons. One of the most common tools for solving this problem is the use of propensity score matching (PSM) methods. The purposes of our study were to compare various models and algorithms for selecting PSM parameters, using retrospective clinical data, and to compare the results obtained using the PSM method with those of prospective studies. Methods The results of two studies (randomized prospective and retrospective) conducted at the Novosibirsk Research Institute of Traumatology and Orthopedics were used for comparative analysis. The trials aimed to study the effectiveness and safety of surgical treatment of degenerative dystrophic lesions in the lumbar spine. We compared the results using the recommended PSM parameters (caliper=0.2 and 0.6) the propensity score is the probability of assignment to one treatment conditional on a subject's measured baseline covariates. Propensity-score matching is increasingly being used to estimate the effects of exposures using observational data. In the most common implementation of propensity-score matching, pairs of treated and untreated subjects are formed whose propensity scores differ by at most a pre-specified amount (the caliper widthand the caliper values often used in real-life studies (0.05, 0.1, 0.25, 0.5, and 0.8) with the those obtained in a similar prospective study. Results After eliminating systematic selection bias, the results of the retrospective and randomized prospective studies were qualitatively comparable. Conclusion The results of this study provide recommendations for the use of PSM: when evaluating efficacy scores in neurosurgical studies (with a sample size < 150 patients), we recommend matching on the logit of the propensity score using calipers of width equal to 0.6 of the standard deviation of the logit of the propensity score. Level of evidence V; Type of study is expert opinion.

RESUMO Objetivos Estudos observacionais e dados de registro fornecem aos pesquisadores amplas oportunidades de obter respostas às perguntas que os estudos clínicos randomizados não podem responder por razões institucionais ou éticas. Uma das ferramentas mais comuns para resolver esse problema é o uso dos métodos de Propensity Score Matching (PSM, pareamento de escore de propensão). O objetivo do nosso estudo foi comparar vários modelos e algoritmos para a seleção de parâmetros de PSM, usando os dados clínicos retrospectivos e comparar os resultados obtidos com esse método com os de estudos prospectivos. Métodos Os resultados de dois estudos (randomizado prospectivo e retrospectivo), realizados no Instituto de Pesquisa de Traumatologia e Ortopedia de Novosibirsk, foram utilizados para análise comparativa. Os estudos visaram estudar a eficácia e a segurança do tratamento cirúrgico de lesões distróficas degenerativas na coluna lombar. Comparamos os resultados usando os parâmetros recomendados pelo PSM, isto é calibração (caliper) de 0,2 e 0,6 e os valores de calibração usados com frequência em estudos da vida real (0,05, 0,1, 0,25, 0,5 e 0,8) com os obtidos em um estudo prospectivo semelhante. Resultados Depois de eliminar o viés sistemático de seleção, os resultados de estudos randomizados prospectivos e retrospectivos foram qualitativamente comparáveis. Conclusões Os resultados deste estudo fornecem recomendações para o uso do PSM: ao avaliar os escores de eficácia em estudos neurocirúrgicos (com tamanho de amostra < 150 pacientes), recomendamos a correspondência do logit do escore de propensão com calibração de largura de 0,6 do desvio padrão do logit do escore de propensão. Nível de evidência V; Opinião do especialista.

RESUMEN Objetivos Los estudios de observación y los datos de registro brindan a los investigadores amplias oportunidades para obtener respuestas a preguntas que los estudios clínicos aleatorizados no pueden responder por razones institucionales o éticas. Una de las herramientas más comunes para resolver este problema es el uso de los métodos de Propensity Score Matching (PSM, emparejamiento de puntaje de propensión). El objetivo de nuestro estudio fue comparar varios modelos y algoritmos para la selección de parámetros de PSM, utilizando los datos clínicos retrospectivos y comparar los resultados obtenidos con ese método con los de estudios prospectivos. Métodos Los resultados de dos estudios (prospectivo aleatorizado y retrospectivo) realizados en el Instituto de Investigación de Traumatología y Ortopedia de Novosibirsk se utilizaron para el análisis comparativo. Los estudios tuvieron como objetivo estudiar la eficacia y seguridad del tratamiento quirúrgico de las lesiones distróficas degenerativas en la columna lumbar. Comparamos los resultados usando los parámetros recomendados por el PSM, esto es, calibración (caliper) de 0,2 y 0,6 y los valores de calibración usados con frecuencia en estudios de la vida real (0,05, 0,1, 0,25, 0,5 y 0,8) con los obtenidos en un estudio prospectivo semejante. Resultados Después de eliminar el sesgo sistemático de selección, los resultados de estudios prospectivos aleatorizados y retrospectivos fueron cualitativamente comparables. Conclusiones Los resultados de este estudio proporcionan recomendaciones para el uso del PSM: al evaluar los puntajes de eficacia en estudios neuroquirúrgicos (con tamaño de muestra <150 pacientes), recomendamos la correspondencia del logit del puntaje de propensión con calibración de ancho de 0.6 de la desviación estándar del logit de puntaje de propensión. Nivel de evidencia V; Opinión del especialista.

Neuromuscular and physiological responses to different training loads in Randori of elite judo athletes

Abstract Aim: To compare two different randori structure (high volume and short pauses - TRAD training vs low volume with long pauses - COMP training) in the neuromuscular and metabolic responses of elite judo athletes. Methods: The first situation (TRAD) consisted of 12 randoris of 5 minutes with 45 seconds rest, and the other situation (COMP), consisted of 6 randoris of 5 minutes with 10 minutes between them. Physiological (Blood Lactate and Creatine Kinase), neuromuscular (Countermovement Jump and Medicine Ball Throws) and perceptive variables (Rating Perceived Exertion) were measured before and at the end of the sessions. Results: The subjective perception of effort at the end of the training was significantly higher in the TRAD training type (TRADpost: 8.1 ± 0.9 AU; COMPpost: 6.6 ± 1.5 AU, p <0.001). Blood lactate concentration (TRADpost: 6.4 ± 2.2 mmol/L; COMPpost: 8.1 ± 2.9 mmol/L; p <0.001), CMJ height (TRADpost: 36.2 ± 4.6 cm; COMPpost: 35.9 ± 4.3 cm, p = 0.012) and upper limb power performance (TRADpost: 6.4 ± 0.9 m; COMPpost: 6.3 ± 0.9 m p = 0.03) were significantly higher at the end of the two training sessions compared to their start, but there are no group effect. There is group effect in CK (TRADpost: 490.7 ± 273.5 U/L; COMPpost: 357.4 ± 203.8 U/L; p <0.001). Conclusions: This study demonstrated that TRAD and COMP Judo training induced similar physical demands, and both seem to not be enough to reach higher intensities, which made them distant methods of competitive reality.

Symptomatic aortic valve mass - cardiac work-up challenges and role of computed tomography angiography: a case report

Abstract Cardiac papillary fibroelastoma are rare, benign cardiac tumors that may lead to lethal complications from embolization or valvular dysfunction if left untreated. When working up symptomatic tumors with concomitant angina, traditional diagnostic studies such as cardiac catheterization may predispose the patient to embolic complications if the mass is located in the path of the catheter. Newer, non-invasive diagnostic testing, such as cardiac magnetic resonance imaging or dynamic computed tomography angiography, may be considered in lieu of invasive approaches to avoid potentially devastating complications. We herein present a case report of a 77-year-old female with a symptomatic aortic valve tumor and describe our diagnostic strategy and management.

Estudo comparativo entre dois programas de computador (Dolphin Imaging® e Nemotec®) e método manual para análises cefalométricas de pacientes com deformidade dentofacial Padrão II / Comparative study of two computer software programs (Dolphin Imaging® and Nemotec®) and a manual method of cephalometric analysis for patients with dentofacial deformity Class II

Este estudo analisou traçados digitais obtidos por dois programas de computador (Dolphin Imaging® e Nemotec®) em comparação aos obtidos pelo método manual nas análises cefalométricas SNA, SNB, Co-A, Co-Gn, altura facial anterior, A-Nperp, Pg-Nperp e plano mandibular. 30 pacientes leucodermas, portadores de retrognatismo mandibular, foram avaliados e submetidos à cirurgia ortognática para correção da deformidade por meio da osteotomia sagital do ramo mandibular. Os traçados cefalométricos foram realizados em telerradiografias laterais obtidas uma semana antes da cirurgia. O método Manual e o Nemotec® apresentaram excelente confiabilidade em todas as medidas. Por outro lado, o método Dolphin Imaging® apontou baixa confiabilidade nas medidas altura facial anterior, Co-A e Co-Gn. Nas medidas A-Nperp, Pg-Nperp, Plano md, SNA e SNB, não houve diferença entre três métodos estudados. Na medida altura facial anterior, houve diferença entre os métodos Dolphin Imaging® e Nemotec®, mas não foram observadas diferenças em relação ao método manual. Nas medidas Co-A e Co-Gn, foi observado que o método Dolphin Imaging® apresentou média significativamente inferior aos demais métodos estudados. No método manual, somente as medidas Co-Gn, Pg-Nperp e SNB confirmaram o diagnóstico de retrognatismo mandibular, tendo o programa Nemotec® apresentado resultados melhores que o programa Dolphin Imaging®... (AU)

This study analyzed digital tracings obtained by two different computer software programs (Dolphin Imaging® and Nemotec®) and compare them to the manual method using cephalometric measurements SNA, SNB, Co-A, Co-Gn, anterior facial height, A-Nperp, Pg-Nperp and mandibular plane. Thirty Caucasian patients exhibiting mandibular retrognathia were analyzed and were submitted to orthognathic surgery to correct the deformity by bilateral sagittal split osteotomy. The cephalometric tracings were performed with lateral radiographs that were obtained a week prior to the surgery. The manual method and the Nemotec® software exhibited an excellent reliability in all measurements. However, the Dolphin Imaging® method exhibited low reliability in the anterior facial height, Co-A and Co-Gn measurements. For the measurements of A-Nperp, Pg-Nperp, Mandibular plan, SNA and SNB, there were no significant differences between the three methods studied. For the anterior facial height measurement, a statistically significant difference was found between the Dolphin Imaging® and Nemotec® methods, although not in relation to the manual method. For the Co-A and Co-Gn measurements, the Dolphin Imaging® method exhibited a significantly lower mean than the other methods studied. In manual method, only the Co-Gn, Pg-Nperp and SNB measurements confirmed the diagnosis of mandibular retrognathia and Nemotec® software provided better results than Dolphin Imaging®... (AU)

Pharmacokinetic Studies of Factor VIII in Chinese Boys with Severe Hemophilia A: A Single-Center Study / 中华医学杂志(英文版)

<p><b>Background</b>Although much attention has been paid to the pharmacokinetics (PKs) of different factor VIII (FVIII) concentrates in persons with hemophilia A (HA), limited information is available in young boys with severe HA. In this study, we aimed to assess the PK parameters of FVIII products in boys with severe HA in China.</p><p><b>Methods</b>A total of 36 boys (plasma-derived [pd]-FVIII, n = 15; recombinant [r] FVIII, n = 21) were enrolled between January 2015 and May 2016 in Beijing Children's Hospital. PK characteristics of FVIII products were studied according to a reduced 4-sampling time point design (1 h, 9 h, 24 h, and 48 h postinfusion).</p><p><b>Results</b>The mean FVIII half-life (t) was 10.99 ± 3.45 h (range 5.52-20.02 h), the mean in vivo recovery (IVR) was 2.01 ± 0.42 IU/dl per IU/kg (range 1.24-3.02 IU/dl per IU/kg) and mean clearance (CL) of FVIII is 4.34 ± 1.58 ml·kg·h (range 2.29-7.90 ml·kg·h). We also analyzed the influence of several parameters that potentially modulate FVIII PK. The age was closely associated with FVIII half-life (R = 0.32, P < 0.01). The tof FVIII increased by 0.59 h per year. Besides age, von Willebrand factor antigen (VWF:Ag) also was associated with FVIII half-life (R = 0.52, P < 0.01). Patients with blood Group O had a shorter FVIII half-life than patients with non-O blood group (9.40 ± 0.68 h vs. 12.3 ± 0.79 h, t = 2.70, P = 0.01). The FVIII IVR correlated with age (R = 0.21, P < 0.01) and VWF:Ag level (R = 0.28, P < 0.01). CL rates were faster in young patients and in those with low-VWF:Ag levels. CL rates of FVIII are higher in blood Group O versus non-blood Group O persons (5.02 ± 0.38 vs. 4.00 ± 0.32 ml·kg·h, t = 2.53, P = 0.02).</p><p><b>Conclusions</b>Chinese boys with severe HA have similar PK values to other ethnic groups and large differences in FVIII PK between individual patients. Age, blood group, and VWF:Ag levels are important determining factors for FVIII CL.</p>

Draft genome of Nocardia farcinica TRH1, a linear and polycyclic aromatic hydrocarbon-degrading bacterium isolated from the coast of Trindade Island, Brazil

Abstract Here, we report the draft genome sequence and annotation of Nocardia farcinica TRH1, a petroleum hydrocarbons degrading Actinobacteria isolated from the coastal water of Trindade Island, Brazil.

Systemic Candidiasis in Extremely Low Birthweight (ELBW) Neonates Despite the Routine Use of Topical Miconazole Prophylaxis: Trends, Risk Factors and Outcomes over an 11-Year Period

<p><b>INTRODUCTION</b>This study aims to determine the incidence, trends of systemic candidiasis and meningitis in extremely low birthweight (ELBW) neonates (<1000 gms) despite the routine use of topical miconazole prophylaxis and to compare the risk factors, adverse outcomes and comorbidities with controls.</p><p><b>MATERIALS AND METHODS</b>Retrospective cohort study of ELBW neonates with systemic candidiasis and meningitis over an 11-year period (1997 to 2007). Matched case control analyses were performed to determine the risk factors and comorbidities which were severe intraventricular haemorrhage (IVH), severe retinopathy of prematurity (ROP), patent ductus arteriosus (PDA) requiring treatment, necrotising enterocolitis (NEC), chronic lung disease (CLD) and cholestatic jaundice. Mortality and end organ involvement secondary to systemic candidiasis were identified as adverse outcomes.</p><p><b>RESULTS</b>Of the 757 ELBW neonates, 51 (6.7%) had evidence of systemic candidiasis with a significant 3-fold increase in trend noted in 2007 as compared against 1997 (12.1% vs 3.8%) (RR 1.2, 95% CI, 1.06 to 1.36, P <0.001). This corresponds to a significant increasing trend of preceding or co-existent bacterial blood stream infections (BSI) in neonates with systemic candidiasis (0% in 1997 vs 7.1% in 2007, RR 1.40, 95% CI, 1.04 to 1.25, P = 0.005). On logistic regression analysis, decreasing gestational age was an independent risk factor for systemic candidiasis (OR 2.0, 95% CI, 1.52 to 2.63, P <0.001). Candida meningitis was detected in 4/38 (10.5%) and end organ involvement in 17 (33%). The organisms isolated were Candida parapsilosis 31 (61%), Candida albicans 17 (33%) and Candida glabrata 3 (5.8%). Significantly higher mortality was seen in cases when compared to controls 10/51 (19.6%) vs 76/706 (10.7%) (OR 2.02, 95% CI, 1.02 to 4.40, P <0.001).</p><p><b>CONCLUSION</b>Increasing trend in the incidence of systemic candidiasis despite routine use of topical miconazole prophylaxis is of concern and future studies comparing the use of systemic fl uconazole versus oral nystatin may need to be considered.</p>

Borderline viability--neonatal outcomes of infants in Singapore over a period of 18 years (1990 - 2007)

<p><b>INTRODUCTION</b>This study assesses the trends and predictors of mortality and morbidity in infants of gestational age (GA) <27 weeks from 1990 to 2007.</p><p><b>MATERIALS AND METHODS</b>This is a retrospective cross-sectional cohort study of infant deliveries between 1990 and 2007 in the largest perinatal centre in Singapore. This is a study of infants born at <27 weeks in 2 Epochs (Epoch 1 (E1):1990 to 1998, Epoch 2 (E2):1999 to 2007) using logistic regression models to identify factors associated with mortality and composite morbidity. The main outcomes that were measured were the trends and predictors of mortality and morbidity.</p><p><b>RESULTS</b>Four hundred and eight out of 615 (66.3%) live born infants at 22 to 26 weeks survived to discharge. Survival improved with increasing GA from 22% (13/59) at 23 weeks to 87% (192/221) at 26 weeks (P <0.01). Survival rates were not different between E1 and E2, (61.5% vs 68.8%). In logistic regression analysis, higher survival was independently associated with increasing GA and birthweight, while airleaks, severe intraventricular haemorrhage (IVH) and necrotizing enterocolitis (NEC) contributed to increased mortality. Rates of major neonatal morbidities were bronchopulmonary dysplasia (BPD) (45%), sepsis (35%), severe retinopathy of prematurity (ROP) (31%), severe IVH/ periventricular leucomalacie (PVL) (19%) and NEC (10%). Although composite morbidity comprising any of the above was not significantly different between the 2 Epochs (75% vs 73%) a decreasing trend was seen with increasing GA (P <0.001). Composite morbidity/ mortality was significantly lower at 26 weeks (58%) compared to earlier gestations (P <0.001, OR 0.37, 95% CI, 0.28 to 0.48) and independently associated with decreasing GA and birth weight, male sex, hypotension, presence of patent ductus arteriosus (PDA) and airleaks.</p><p><b>CONCLUSION</b>Increasing survival and decreasing composite morbidity was seen with each increasing week in gestation with marked improvement seen at 26 weeks. Current data enables perinatal care decisions and parental counselling.</p>

Neonatal ovarian cysts: role of sonography in diagnosing torsion

<p><b>INTRODUCTION</b>The purpose of this case series was to determine the sonographic features of neonatal ovarian torsion.</p><p><b>MATERIALS AND METHODS</b>Seven surgically proven cases of neonatal ovarian cysts were included in this retrospective study. The patients were divided into 2 groups, torsion and non-torsion. These 7 patients were evaluated for the clinical presentation, sonographic features, surgical and pathological findings. The findings on follow-up sonography after surgery were also noted.</p><p><b>RESULTS</b>The sonographic appearance was variable. Of the 4 cases with torsion, 2 lesions had internal echoes with 'fi sh-net appearance'. The other 2 lesions were predominantly cystic on the sonography with internal echoes and echogenic nodule. A calcific focus was present in 1 of these echogenic nodules. One of the cysts had fluid-fluid level. In the non-torsion group, only 1 lesion had mixed echogenic appearance. The other 2 lesions were cystic with low level internal echoes in 1 of the cysts. The surgical procedure performed in the torsion group was salpingo-oophorectomy in 2 patients and oophorectomy in 1 patient. In 1 patient, cystectomy was attempted without success. In the non-torsion group, only cystectomy was performed with preservation of normal ovaries, which was confirmed on follow-up sonography.</p><p><b>CONCLUSION</b>The sonographic features of cysts with 'fish-net appearance', fluid-debris level and cysts with echogenic nodule favour torsion. The former sign has so far not been described as a sonographic predictor for neonatal ovarian torsion.</p>

Avaliação do efeito mutagênico do extrato hidroalcoólico bruto, por meio de bioensaios in vivo e prospecção fitoquímica de Cecropia glaziovii Sneth (embaúba), Cecropiaceae / Evaluation of mutagenic effect of crude hydroalchoolic extract, using in vivo alive bioassays and phytochemical screening of Cecropia glaziovii Sneth (embaúba), Cecropiaceae

O gênero Cecropia é conhecido popularmente por "embaúba" e apresenta várias espécies medicinais, sendo que estudos com a espécie C. glaziovii Sneth indicam que o extrato aquoso apresenta efeitos broncodilatador, anti-hipertensivo e antidepressivo, provavelmente, atribuídos às catequinas, procianidinas e flavonóides. O presente estudo objetivou avaliar os potenciais efeitos tóxico, citotóxicos, clastogênicos e aneugênicos do extrato bruto hidroalcoólico de folhas de C. glaziovii, por meio da dose letal média (DL50), da análise de micronúcleo em células de medula óssea de roedores e do teste com Allium cepa e realizar a prospecção fitoquímica. Os resultados demonstraram que as concentrações testadas não causaram toxicidade aguda, nem apresentaram atividade clastogênica e aneugênica, sugerindo que o extrato de C. glaziovii não interferem na divisão celular. A prospecção fitoquímica indicou a presença de taninos, flavonóides, fenóis, antraquinonas, cumarinas, catequinas, proteínas, açúcares redutores, depsídeos/depsidonas e triterpenos. Mesmo assim, esses resultados não prescrevem o consumo terapêutico da espécie, sem continuidade da sua avaliação e do cumprimento de todas as etapas pré-clínicas e clínicas.

The genus Cecropia is as known popularly "embaúba" and presents several medical species. Studies with the species C. glaziovii Sneth indicates that the hydroalchoolic extracts presents bronchodilator, anti-hypertensive and antidepressive effects, probably due its contests catechins, procyanidins and flavonoids. The aim of this study was to assess the potential toxic, cytotoxic, clastogenic and aneugenic effects of the crude hydroalchoolic extract of leaves of C. glaziovii, by means of the determination of the median lethal dose (LD50), the analysis of micronucleus in cells from bone marrow of rodents and through the Allium cepa assay, and also to performe the phytochemical screening. The results showed that at the concentrations tested no cause acute toxicity, as well as no clastogenic and aneugenic activity, was observed suggesting that the extract of C. glaziovii do not interfere in cell division. The phytochemical screening indicated the presence of tannins, flavonoids, phenols, anthraquinones, coumarins, catechins, proteins, reducing sugars, depsides, depsidons and triterpenes. Howerver, these results do not prescribe therapeutic consumption of the species, without keeping its evaluation and the achievement of all pre-clinical and clinical stages.

Método espectroscópico para determinação de cumarina em xarope de Mikania glomerata Sprengel / Ultraviolet spectroscopy method for coumarin quantification in Mikania glomerata Sprengel syrup

Este trabalho teve como objetivo desenvolver uma metodologia analítica por espectroscopia UV, para doseamento de cumarina em xaropes de Mikania glomerata. A técnica foi baseada na extração da cumarina utilizando solventes como o clorofórmio e hexano. Após a seleção do solvente, o comprimento de onda foi definido através da sobreposição dos espectros da cumarina, metil parabeno, diluição do xarope e solução extrativa do xarope. Foram preparadas curvas analíticas de cinco soluções de cumarina com concentração variando de 0,002 a 0,03 mg/mL. Para análise da exatidão do método, foram preparados três lotes de xarope de Mikania glomerata Sprengel e o teor de cumarina determinado pela técnica espectrofotométrica foi comparado a técnica por cromatografia líquida de alta eficiência. O solvente selecionado para extração foi o clorofórmio, o comprimento de onda 320 nm. A curva analítica apresentou R² de 0,99978, demonstrando linearidade. A comparação estatística do doseamento da cumarina pela técnica espectrofotométrica estudada com a técnica cromatográfica desenvolvida por Celeghini et al. (2001) demonstrou não existir diferenças significativas, indicativo de exatidão da técnica.

A spectrophotometric procedure for coumarin determination in Mikania glomerata Sprengel (guaco) syrup is described in this work. Due to the high number of constituents in guaco syrups, the coumarin was extracted with apolar extractors (chloroform and hexane), in which chloroform was selected, because of its higher capacity of extraction. After the solvent choice, the wavelength at 320 nm, region where there is the lower interference of syrup constituents, was selected. The calibration curve showed linearity, R² of 0.99978. The spectrophotometric assay of coumarin in three samples of Mikania glomerata Sprengel syrup showed accuracy compared with the HPLC method. The results presented suggest that the spectrophotometric method may be useful for the quantitative analysis of coumarin in Mikania glomerata Sprengel syrup.

Rates of posterior capsule rupture during cataract surgery among different races in Singapore

<p><b>INTRODUCTION</b>The aim of this study was to determine if racial differences exist in the rate of posterior capsule rupture (PCR) during cataract surgery in Singapore.</p><p><b>MATERIALS AND METHODS</b>All intraoperative complications during cataract surgery were prospectively reported as part of a clinical audit programme. A retrospective review of all patients who sustained a PCR during cataract surgery between July 1995 and December 1998 was performed.</p><p><b>RESULTS</b>Of 8230 consecutive eyes which underwent cataract surgery, 6951 (84.5%) were Chinese, 597 (7.3%) were Malay, 524 (6.4%) were Indian, and 158 (1.9%) were of other races. The overall incidence of PCR was 1.9%. The PCR rates were 1.8% [125 of 6951; 95% confidence interval (CI), 1.49 to 2.11] in Chinese, 2.0% (12 of 597; 95% CI, 1.01 to 3.57) in Malay, 2.7% (14 of 524; 95% CI, 1.13 to 3.56) in Indian, and 2.5% (4 of 158; 95% CI, 0.00 to 4.98) in other races. There was no statistical difference between the PCR rates (P = 0.62, chi-square test).</p><p><b>CONCLUSION</b>Racial differences in Singapore do not have an effect on the rates of PCR during cataract surgery.</p>

Ultrastructural study of the in vitro interaction between Biomphalaria glabrata hemocytes and Schistosoma mansoni miracidia

Biomphalaria glabrata and Schistosoma mansoni relationship was studied by light microscopy (LM) and freeze-fracture replica technique (FFR). We observed very thin cytoplasmic extensions of hemocytes in the LM, which then surround immobilize the miracidia. FFR images showed that the contact site between hemocytes cytoplasmic extensions and the external tegumentary coat involved only superficial layers of miracidia. Numerous vacuoles and filopodia were observed in the hemocyte cytoplasm, the latter binding with those from neighboring cells. In spite of the close interfilopodia contact, no cellular junctions were seen at these sites nor between filopodia-miracidia contact areas. The observed migration of hemocytes and their disposition in layers surrounding the miracidia in vitro correspond to previous studies.

Dilemmas in the management of rheumatic heart disease.

Rheumatic heart disease (RHD) is a major health care problem in India and will continue to be so for few more decades. As there is no vaccine against RHD, it is difficult to control the disease. Besides RHD, most children have other preventable ailments as well. Hence the schools, specially for the poor, must act as primary and preventive health care centres. Prevention of RHD starts with school prophylaxis. Primary, secondary and tertiary prophylaxis play their roles afterwords. After the heart valves have been damaged, tertiary prevention might minimise further damage. For mitral stenosis, closed mitral valvotomy (CMV), open mitral valvotomy (OMV) and interventional mitral valvotomy (IMV) are the different options but none is curative. Valve replacement poses many problems and therefore valvotomy is deferred as far as possible. Mild or moderate mitral regurgitation (MR) is best treated medically. For more advanced disease repair or replacement is the option. For aortic stenosis (AS), valvotomy may be preferred to replacement wherever feasible and for aortic regurgitation (AR) repair is not yet well established. In combined mitral and aortic valve disease it is important to assess both the valves carefully and try to repair one or both the valves and to avoid double valve replacement as far as possible. Once the heart valve is damaged any treatment is palliative, hence all efforts should be directed towards prevention of RHD. Indian Medical Association can play a major role in this endeavour and help children in India to grow up free from RHD.

Bronchogenic cyst presenting as dysphagia.

We report an adult patient who masqueraded as a case of gastroesophageal reflux disease for over 6 years. On close questioning he was found to have severe constricting pain in the retrosternal region and non progressive dysphagia for 6 years. Cineradiography of the oesophagus and CT scan chest revealed a large bronchogenic cyst compressing the oesophagus and the trachea. Excision of the cyst relieved the symptoms.

Comparative evaluation of cine-esophagogram with esophageal manometry in assessing esophageal motility in progressive systemic sclerosis.

BACKGROUND: Esophageal manometry is considered the gold standard in the diagnosis of esophageal motility disorders. Cine-esophagogram using barium is also a good investigation to screen patients for motor disorders of the esophagus. Comparison between these two investigations has not often been reported in patients with progressive systemic sclerosis (PSS). AIM: To determine relative merits of cine-esophagogram and esophageal manometry in detecting esophageal motor dysfunction in PSS patients. METHODS: Thirty-five patients with PSS irrespective of esophageal symptoms underwent esophageal manometry and cine-esophagogram, results and their were compared. RESULTS: Sensitivity and specificity of cine-esophagogram as compared to manometry were 96.1% (95% CI 88.7%-100%) and 55.5% (95% CI 23%-87.9%) respectively. Its positive predictive value was 86%. CONCLUSION: While esophageal manometry can identify esophageal motor disorder in PSS, cine-esophagogram can be resorted to in doubtful situations, for confirmation of diagnosis.