Reductions in rearfoot eversion posture due to proximal muscle strengthening are dependent on foot-ankle varus alignment.

BACKGROUND: Strengthening the hip and trunk muscles may decrease foot pronation in upright standing due to expected increases in hip passive torque and lower-limb external rotation. However, considering the increased pronation caused by a more varus foot-ankle alignment, subjects with more varus may experience smaller or no postural changes after strengthening. OBJECTIVE: To investigate the effects of hip and trunk muscle strengthening on lower-limb posture during upright standing and hip passive torque of women with more and less varus alignment. METHODS: This nonrandomized controlled experimental study included 50 young, able-bodied women. The intervention group (n = 25) performed hip and trunk muscle strengthening exercises, and the control group (n = 25) maintained their usual activities. Each group was split into two subgroups: those with more and less varus alignment. Hip, shank, and rearfoot-ankle posture and hip passive external rotation torque were evaluated. Mixed analyses of variance and preplanned contrasts were used to assess prepost changes and between-group differences (α = 0.05). RESULTS: The less-varus subgroup of the intervention group had a reduced rearfoot eversion posture (P = 0.02). No significant changes were observed in the less-varus subgroup of the control group (P = 0.31). There were no significant differences in posture between the control and intervention groups when varus was not considered (P ≥ 0.06). The intervention group had increased hip passive torque (P = 0.001) compared to the control group, independent of varus alignment. CONCLUSION: Despite the increases in hip passive torque, the rearfoot eversion posture was reduced only in women with a less-varus alignment. Having more foot-ankle varus may prevent eversion reductions.

An estimation of the biomechanical properties of the continent and incontinent woman bladder via inverse finite element analysis.

Stress urinary incontinence often results from pelvic support structures' weakening or damage. This dysfunction is related to direct injury of the pelvic organ's muscular, ligamentous or connective tissue structures due to aging, vaginal delivery or increase of the intra-abdominal pressure, for example, defecation or due to obesity. Mechanical changes alter the soft tissues' microstructural composition and therefore may affect their biomechanical properties. This study focuses on adapting an inverse finite element analysis to estimate the in vivo bladder's biomechanical properties of two groups of women (continent group (G1) and incontinent group (G2)). These properties were estimated based on MRI, by comparing measurement of the bladder neck's displacements during dynamic MRI acquired in Valsalva maneuver with the results from inverse analysis. For G2, the intra-abdominal pressure was adjusted after applying a 95% impairment to the supporting structures. The material parameters were estimated for the two groups using the Ogden hyperelastic constitutive model. Finite element analysis results showed that the bladder tissue of women with stress urinary incontinence have the highest stiffness (α1 = 0.202 MPa and µ1 = 7.720 MPa) approximately 47% higher when compared to continent women. According to the bladder neck's supero-inferior displacement measured in the MRI, the intra-abdominal pressure values were adjusted for the G2, presenting a difference of 20% (4.0 kPa for G1 and 5.0 kPa for G2). The knowledge of the pelvic structures' biomechanical properties, through this non-invasive methodology, can be crucial in the choice of the synthetic mesh to treat dysfunction when considering personalized options.

Myofascial stiffness of plantar fascia and Achilles tendon in individuals with plantar fasciopathy: An observational cross-sectional study.

BACKGROUND: Assessment of myofascial tissue stiffness have a role in identifying physical impairments in plantar fasciopathy (PF). It is still unclear which specific functional and tissue differences exist between individuals with PF. AIM: To compare myofascial stiffness of plantar fascia, Achilles tendon, and triceps surae between symptomatic and asymptomatic limbs in individuals with PF and between individuals with and without PF. METHODS: Thirty nine individuals diagnosed with PF and individuals with no history of PF were recruited. Myofascial stiffness of the plantar fascia, Achilles tendon, and triceps surae, range of motion, and clinical tests were performed. Mean difference (MD) and 95% confidence interval (CI) were calculated. RESULTS: Individuals with PF showed lower mean stiffness in Achilles tendon insertion (MD = -1.00 N/mm; 95%CI: -1.80,-0.21) on the symptomatic limb compared to the corresponding symptomatic limb in control group, a lower mean stiffness in plantar fascia (MD = -0.16 N/mm; 95%CI: -0.30, -0.01) on the symptomatic limb compared to asymptomatic limb, and a lower mean stiffness in the region 3 cm above the Achilles tendon insertion (MD = -0.79; 95%CI: -1.59, -0.00) compared to control. Individuals with PF showed fewer repetitions in heel rise test (MD = -3.97 reps; 95%CI: -5.83, -2.12) and in the step-down test (MD = -5.23 reps; 95%CI: -7.02, -3.44) compared to control. CONCLUSIONS: Individuals with PF present reduced stiffness in Achilles tendon insertion and plantar fascia. The reduced stiffness was more evident in Achilles tendon in individuals with PF compared to individuals without PF. Individuals with PF showed lower performance in clinical tests.

Physical demands and psychophysiological stress in young athletes team sports / Exigências físicas e estresse psicofisiológico em jovens atletas de esportes coletivos

ABSTRACT Training monitoring is important in the development process of the athlete. The objective of the study was to characterize the psychophysiological response and physical demands of soccer, basketball, handball, and volleyball with young athletes. The sample consisted of 61 young athletes of both genders and members of team sports, 10 training sessions for each modality were monitored. The psychophysiological responses were monitored by the session rating perception of exertion (Session RPE) and training impulse (TRIMP). The physical demands were, distance covered (DC), DC by speed zone (DC_Z1, DC_Z2, DC_Z3, DC_Z4, DC_Z5), number of sprints, and duration of the session. In addition, the recovery status (TQR) was also collected. Differences were noted between duration (p<0.001), DC_Z1 (p<0.017), DC_Z2 (p<0.05), DC_Z3 (p<0.05), DC_Z4 (p<0.003), DC_Z5 (p < 0.05), sprints (p < 0.001), TRIMP (p<0.02), Session RPE (p<0.05) and TQR (p<0.007). In psychophysiological responses, handball showed more time in zones 4 and 5 than other modalities. According to physical demands, basketball, and handball had a higher number of sprints and also higher values ​​in DP_Z5. Therefore, the simultaneous monitoring of physical demands and psychophysiological responses provides supplementary information in monitoring young athletes.

RESUMO O monitoramento do treinamento é importante no processo de desenvolvimento dos atletas. O objetivo do estudo foi comparar as respostas psicofisiológicas e as demandas físicas de jovens atletas de futebol, basquete, handebol e voleibol. A amostra foi constituída por 61 indivíduos de ambos os gêneros que foram acompanhados ao longo de 10 sessões de treino de cada modalidade em questão. As respostas psicofisiológicas foram monitoradas através da percepção subjetiva de esforço da sessão (PSE da sessão) e o impulso de treinamento (TRIMP). As demandas físicas analisadas foram a distância total percorrida (DP), DP por zona de velocidade (DP_Z1, DP_Z2, DP_Z3, DP_Z4, DP_Z5), número de sprints e a duração das sessões. Além disso, o estado de recuperação (TQR) também foi analisado. Foram observadas diferenças significativas entre a duração das sessões (p<0,001), DP_Z1 (p<0,017), DP_Z2 (p<0,05), DP_Z3 (p<0,05), DP_Z4 (p<0,003), DP_Z5 (p <0,05), número de sprints (p < 0,001), TRIMP (p<0,02), PSE da sessão (p<0,05) e TQR (p<0,007). Nas respostas psicofisiológicas, o handebol apresentou mais tempo nas zonas 4 e 5 em comparação demais modalidades. Nas demandas físicas, o basquete e o handebol apresentaram maior número de sprints e também maiores valores na DP_Z5. Dessa forma, o monitoramento em conjunto das demandas físicas e respostas psicofisiológicas fornecem informações complementares no monitoramento de jovens atletas.

Analysis of different training load monitoring methods in youth women handball players

This study examined the association between different methods for training load (TL) monitoring during youth handball training. Distance covered, heart rate and session rating of perceived exertion [SRPE] were recorded during 12 training sessions in 14 youth women handball athletes (16.9±1.1 years). Internal load models based on SRPE and Edwards’ Trimp were calculated. An oscillatory feature was observed for the three methods of TL assessment (SRPE: 383±159 A.U., Edwards’ Trimp: 252±71 A.U., total distance: 3997±1291 m). A large correlation was found between Edwards’ Trimp and distance covered (r=0.59). A moderate correlation was observed for Edwards’ Trimp vs. SRPE (r=0.36), and between SRPE vs. distance covered (r=0.49). Shared variances of 13–35% were observed between TL methods comparisons. The results suggest that different constructs seem to be measured by each load model. Additionally, SRPE is a simple and low-cost method that might be used for TL monitoring in handball. (AU)

Tridimensional dose evaluation of the respiratory motion influence on breast radiotherapy treatments using conformal radiotherapy, forward IMRT, and inverse IMRT planning techniques.

PURPOSE: To evaluate the respiratory motion influence on the tridimensional (3D) dose delivery to breast-shaped phantoms using conformal radiotherapy (3D-RT), Field-in Field (FiF), and IMRT planning techniques. METHODS: This study used breast-shaped phantoms filled with MAGIC-f gel dosimeter to simulate the breast, and an oscillation platform to simulate the respiratory motion. The platform allowed motion in the anterior-posterior direction with oscillation amplitudes of 0.34 cm, 0.88 cm, and 1.22 cm. CT images of the static phantom were used for the 3D-RT, FiF, and IMRT treatment planning. Five phantoms were prepared and irradiated for each planning technique evaluated. Phantom 1 was irradiated static, phantoms 2-4 were irradiated moving with the three different motion amplitudes, and phantom 5 was used as a reference. The 3D dose distributions were obtained by relaxometry of magnetic resonance imaging, and the respiratory motion influence in the doses distribution was accessed by gamma evaluations (3%/3mm/15% threshold) comparing the measurements of the phantoms irradiated under movement with the static ones. RESULTS: The mean gamma approvals for three oscillatory amplitudes were 96.44%, 93.23%, and 91.65%; 98.42%, 95.66%, and 94.31%; and 94.49%, 93.51%, and 86.62% respectively for 3D-RT, FiF and IMRT treatments. A gamma results profile per slice along the phantom showed that for FiF and IMRT irradiations, most of the failures occurred in the central region of the phantom. CONCLUSIONS: By increasing the respiratory motion movement, the dose distribution variations for the three planning techniques were more pronounced, being the FiF technique variations the smallest one.

Differences between training and game loads in young basketball players / Diferenças entre as cargas de treino e jogo em jovens basquetebolistas

Abstract The same training stimulus can provide different physiological adaptations for athletes of the same team.The aim of this study was to compare training and game loads in young male basketball players. Data were obtained from 4 training sessions and one game session usingPolar Team Pro equipment. Physiological data (HR) were used to monitor internal responses through Edwards'TRIMP,and data on distance traveled by the player on the court (External Training Load).To observe differences between eTRIMP,HR max and distance traveled,the T-Test was used for paired samples. The mean internal training load, according to Edwards'TRIMP, for the four training sessions was 132 ± 69. Mean HR max and distance traveled values were 143 ± 67 and 2.273 ± 1170, respectively. Regarding game load, Edwards'TRIMP,maximum HR and distance traveled were 108 ± 33, 199 ± 4 and 2.240 ± 617, respectively. No statistically significant differences were found between the mean values of training sessions compared to the game session in relation to the Edwards' TRIMP measures and distance traveled, but HR max was significantly higher during the game compared to training. It was concluded that the loads applied during training are similar to those applied in the game.

Resumo O mesmo estímulo de treinamento pode proporcionar diferentes adaptações fisiológicas para os atletas de uma mesma equipe. O objetivo deste estudo foi comparar as cargas de treino e jogo em jovens jogadores de basquetebol do sexo masculino. Os dados foram obtidos de 4 sessões de treinamento e uma sessão de jogo a partir do equipamento Polar Team Pro, sendo mensurados dados fisiológicos(FC), que foram utilizados para monitorar a CIT através do TRIMP de Edwards, e dados sobre a distância percorrida do jogador em quadra (CET). Para observar as diferenças entre o TRIMP, FC máx e distância percorria, foi utilizado o Teste T para amostras pareadas. A média das CIT, de acordo com o TRIMP de Edwards, para as 4 sessões de treinamento foi 132 ± 69. Já a média da FC máxima e da distância percorrida foram 143 ± 67 e 2.273 ± 1170, respectivamente. Em relação a carga de jogo, o TRIMP de Edwards, a FC máxima e a distância percorrida foram de 108 ± 33, 199 ± 4 e 2.240 ± 617, respectivamente. Não foram encontradas diferenças estatisticamente significativas entre a média das sessões de treino em comparação com a sessão do jogo em relação as medidas de TRIMP de Edwards e distância percorrida, porém a FC máxima foi significativamente maior durante a partida em comparação com o treinamento. Conclui-se que, a aplicação das cargas da equipe investigada durante os treinamentos é semelhante àquelas encontradas no jogo.

Modeling the contraction of the pelvic floor muscles.

We performed numerical simulation of voluntary contraction of the pelvic floor muscles to evaluate the resulting displacements of the organs and muscles. Structures were segmented in Magnetic Resonance (MR) images. Different material properties and constitutive models were attributed. The Finite Element Method was applied, and displacements were compared with dynamic MRI findings. Numerical simulation showed muscle magnitude displacement ranging from 0 to 7.9 mm, more evident in the posterior area. Accordingly, the anorectum moved more than the uterus and bladder. Dynamic MRI showed less 0.2 mm and 4.1 mm muscle dislocation in the anterior and cranial directions, respectively. Applications of this model include evaluating muscle impairment, subject-specific mesh implant planning, or effectiveness of rehabilitation.

Associação entre o tamanho tumoral e Achados clínicos e imuno-histoquímicos no adenoma funcionante de hipófise / Association between tumor size and clinical and immunohistochemical findings in functioning hypophyseal adenomas

Introdução: Os adenomas de hipófi se (AH) correspondem a cerca de 10% a 15% dos tumores intracranianos. Em geral, são lesões com padrão de crescimento expansivo, não encapsuladas, as quais determinam alterações clínicas como distúrbios hormonais, cefaleia e desordens do campo visual. Os AH podem ser classificados radiologicamente como microadenomas, quando medem até 10,0 mm, ou macroadenomas quando excedem esta dimensão. Objetivo: Estimar a associação entre tamanho tumoral com queixa clínica principal, perfi l imuno-histoquímico e recidiva em casos de AH. Método: O presente estudo retrospectivo e analítico avaliou 66 casos de AH, sendo determinadas as seguintes variáveis: sexo, idade, tamanho tumoral, queixa clínica principal, expressão imuno-histoquímica dos anticorpos Prolactina, GH, FSH, LH, ACTH e TSH, e recidiva da neoplasia. Resultados: A média de idade foi igual a 51,8 ± 14,6 anos, com predomínio de mulheres (n=41/62,1%) e de macrodenomas (n=41/62,1%). Cefaleia foi o sintoma mais frequente (n=25/37.9%). A análise imuno-histoquímica foi realizada em 37 casos da amostra, sendo os adenomas com expressão de LH os mais comuns (n=14/37,8%). Nove pacientes (13,6%) apresentaram recidiva da lesão, sendo 5 casos de macroadenoma. O tamanho tumoral esteve associado com a presença de alterações visuais (p=0,019), não sendo encontrada associação desta variável com idade (p=0,620), sexo (p=0,987), expressão imuno-histoquímica dos anticorpos (p=0,198) e recidiva (p=0,721). Conclusão: Os AH representam um grupo de neoplasias relativamente heterogêneas quando avaliados diferentes aspectos anatomopatológicos, clínicos e radiológicos. A classifi cação do tamanho tumoral em microadenoma ou macroadenoma não é fator preditivo do perfi l imuno-histoquímico ou taxa de recidiva.

Background: Hypophyseal adenomas (HA) account for about 10% to 15% of intracranial tumors. They are generally non-encapsulated lesions with an expansive growth pattern, which determine clinical changes such as hormonal disorders, headache and disorders of the visual fi eld. HA can be classifi ed radiographically as microadenomas when measuring up to 10.0 mm, or macroadenomas when they exceed this size. Aim: To estimate the association between tumor size and main clinical complaints, immunohistochemical profi le and relapse in cases of HA. Methods: This retrospective and analytical study evaluated 66 cases of HA, taking the following variables: gender, age, tumor size, main clinical complaint, immunohistochemical expression of prolactin antibodies, GH, FSH, LH, ACTH and TSH, and relapsing neoplasm. Results: Mean age was 51.8 ± 14.6 years, with a predominance of women (n = 41/62.1%) and macrodenomas (n = 41/62.1%). Headache was the most common symptom (n = 25/37.9%). Immunohistochemical analysis was performed on 37 cases of the sample, with LH-expressing tumors being the most common (n = 14/37.8%). Nine patients (13.6%) had recurrence of the injury, 5 cases of macroadenoma. Tumor size was associated with presence of visual disturbances (p = 0.019), but there was no association between this variable and age (p = 0.620), sex (p = 0.987), immunohistochemical expression of antibodies (p = 0.198) and recurrence ( p = 0.721). Conclusion: HA represent a relatively heterogeneous group of neoplasms when different pathological, clinical and radiological aspects are evaluated. The classifi cation of tumor size as microadenoma or macroadenoma is not predictive of the immunohistochemical profi le or relapse rate.

Anticoagulants on yield of bone marrow-derived mononuclear cells harvested from dogs / Anticoagulantes no rendimento de células mononucleares da medula óssea de cães

Cell therapy with bone marrow-derived mononuclear cells is an alternative to therapy with mesenchymal stem cell cultures. The aim of the present research was the comparison of the yield of bone marrow-derived mononuclear cells harvested from dogs with two different anticoagulants. Bone marrow was harvested from the iliac crest of five healthy dogs aged between 15 and 30 months, and the effect of two anticoagulant solutions, CPDA-1 (citrate phosphate dextrose adenine-1) and heparin, on the isolation of mononuclear cells was compared. Mononuclear cells were isolated in a density gradient and stained for CD9 and CD44 for characterization by flow cytometry. Means were compared using Student's paired t-test. Samples harvested with CPDA-1 yielded an average of 5.16x106 (±1.76x106) to 20.20x106 (±1.55x106) mononuclear cells/mL, whereas the yield of samples harvested with heparin varied between 4.56x106(±0.69x106) and 24.30x106 (±2.12x106) mononuclear cells mL-1. By flow cytometry, mean percentage of double-stained cells varied from 1.96% (±0.64%) to 5.01% (±0.73%) for CPDA-1 and from 2.23% (±0.70%) to 7.27% (±0.97%) for heparin. No significant statistical differences were observed on yield or CD9 and CD44 expression. Further studies are recommended to assess efficacy of CPDA on mononuclear cell isolation.

A terapia com células mononucleares de medula óssea é uma alternativa ao cultivo de células-tronco mesenquimais. O objetivo deste trabalho foi comparar o rendimento de células mononucleares derivadas da medula óssea de cães, colhidas com dois anticoagulantes diferentes. Foram coletadas medulas ósseas de cinco cães hígidos, com idades variando entre 15 e 30 meses, por punção na crista ilíaca. Foi comparado o efeito da solução anticoagulante no isolamento das células mononucleares, utilizando-se CPDA-1 (citrato, fosfato, dextrose, adenina) ou heparina como soluções anticoagulantes. As células mononucleares foram isoladas em gradiente de densidade e caracterizadas fenotipicamente em citometria de fluxo. Os resultados foram submetidos ao Teste t pareado para comparação de médias. Nas amostras coletadas com CPDA-1, o rendimento médio variou entre 5,16 x 106 (±1,76x106) a 20,20x106 (±1,55x106) células mononucleares mL-1, enquanto que, nas amostras coletadas com heparina, o rendimento variou entre 4,56x106 (±0,69x106) a 24,30x106(±2,12x106) células mononucleares/mL. Na citometria de fluxo, a média de células duplo-marcadas variou de 1,96% (±0,64%) a 5,01% (±0,73%) para CPDA-1 e de 2,23% (±0,70%) a 7,27% (±0,97%) para heparina. Não foram observadas diferenças estatísticas no rendimento ou na expressão de CD9 e CD44. Recomendam-se estudos adicionais para avaliar melhor a eficácia do CPDA no isolamento de células mononucleares.

Relationship between age and progesterone receptor expression with presence of central nervous system metastases in breast invasive ductal carcinoma / Relação entre idade e expressão do receptor de progesterona com presença de metástases no sistema nervoso central no carcinoma ductal invasivo da mama

ABSTRACTIntroduction:Breast invasive carcinoma of no special type (NST) is characterized by great morphological heterogeneity, and accounts for about 70%-80% of malignant breast tumors. The main prognostic factors are tumor size, degree of differentiation, and status of axillary lymph nodes. NST represents 15%-18% of central nervous system metastases (CNSm), and generally the response to systemic treatment/chemotherapy is unsatisfactory.Objective:To estimate the association between clinical and pathological findings of NST with CNSm.Method:Clinical data of 171 specimens of lumpectomy/mastectomy with axillary dissection in NST were evaluated, as well as the following pathological variables: tumor size, histological grade, nodal status, expression of estrogen (ER) and progesterone receptors (PR) and human epidermal growth factor receptor 2 (HER-2/neu) oncogene (c-erb B2), and presence of CNSm. The cases of CNSm in NST underwent resection, and the primary site was identified by immunohistochemistry.Results:The prevalence of CNSm was 9.4% (n = 16), and was related to age (p = 0.01), and the expression of PR (p = 0.004). Although cases of NST with CNSm showed correlation with greater tumor size, higher histological grade and nodal metastases, there was no statistical association (p = 0.221, p = 0.224 and p = 0.99, respectively). Expression of ER and c-erb-B2 was not significant between the two groups (p = 0.072 and p = 0.31, respectively).Conclusion:This study showed that younger patients and the expression of RP correlate with the presence of CNSm. The evaluation of specific pathological findings in NST can help establish risk factors and/or clinical parameters associated with the development of CNSm.

RESUMOIntrodução:O carcinoma ductal invasivo de tipo histológico não especial (CDINE) caracteriza-se por grande heterogeneidade morfológica, sendo responsável por cerca de 70%-80% dos tumores malignos de mama. Os principais fatores prognósticos são o tamanho tumoral, o grau de diferenciação e o status dos linfonodos axilares. O CDINE corresponde a 15%-18% das metástases no sistema nervoso central (MSNC) e, geralmente, sua resposta aos tratamentos sistêmicos/quimioterápicos é pouco satisfatória.Objetivo:Estimar a relação entre achados clínicos e anatomopatológicos do CDINE com a presença de MSNC.Método:Foram avaliadas as informações clínicas de 171 espécimes de setorectomia/mastectomia com esvaziamento axilar por CDINE, sendo determinadas as seguintes variáveis anatomopatológicas: tamanho tumoral, grau histológico, status nodal, expressão dos receptores de estrogênio (RE) e progesterona (RP) e de oncoproteína HER-2/neu/receptor do fator de crescimento epidérmico humano (c-erb-B2) e presença de MSNC. Os casos de MSNC em CDINE foram submetidos a ressecção e comprovação do sítio primário pela técnica de imuno-histoquímica.ResultadosA prevalência de MSNC foi igual a 9,4% (n = 16) e apresentou correlação com faixa etária (p = 0,01) e expressão dos RP (p = 0,004). Embora os casos de CDINE com MSNC estivessem relacionados com maior tamanho tumoral, maior grau histológico e metástases nodais, não foi encontrada associação estatística (p = 0,221, p = 0,224 e p = 0,99, respectivamente). A expressão de RE e c-erb-B2 não foi significativa entre os dois grupos (p = 0,072 e p = 0,31, respectivamente).Conclusão:O presente estudo mostrou que as pacientes mais jovens e a expressão dos RP relacionam-se com a presença de MSNC. A avaliação de achados anatomopatológicos específicos no CDINE pode ajudar a estabelecer fatores de risco e/ou parâmetros clínicos associados ao desenvolvimento de MSNC.

Avaliação ectoscópica simples da anemia: um novo sinal / Simple ectoscopic examination of anemia: A new sign

Foram examinados 130 pacientes e realizadas 241 observações, com a finalidade de investigar a acurácia da palidez no diagnóstico da anemia no adulto. As regiões anatômicas observadas foram as comumente utilizadas pelos médicos, a conjuntiva, lábio, palma da mão, linha palmar e uma região ainda não relatada, a extremidade digital, examinando-se a antiga técnica da gradação da palidez. Os autores concluem pela recomendação dos velhos exames e pela adoção do novo sinal, descrito neste trabalho. Este estudo foi aprovado pela Comissão de Ética da Instituição e todos os pacientes assinaram um consentimento informado.

Tromboembolismo pulmonar como causa de dor torácica na sala de emergência / Pulmonary thromboembolism asa cause of chest pain in the emergency room

Relata-se o caso de uma paciente de 43 anos, tabagista, em uso de análogo sintético do hormônio de liberação do hormônio luteinizante (LHRH), admitida na emergência com precordialgia típica. Eletrocardiograma evidenciou inversão de onda T nas derivações DII, DIII, avF e V1 a V4, sem alteração de enzimas cardíacas. Iniciado tratamento para síndrome coronariana aguda (SCA). Angiografia cardíaca mostrou coronárias pérvias, sendo realizada angiotomografia pulmonar que revelou tromboembolismo maciço e infarto pulmonar. Instituído tratamento específico, tendo a paciente boa evolução clínica. A embolia pulmonar deve ser considerada naqueles pacientes que se apresentam na sala de emergência com dor torácica, como no caso apresentado.

We report a case of a patient 43-year-old woman with a history of cigarette smoking and use of luteinizing hormone releasing hormone (LHRH), that came to emergency with typical precordial pain. Electrocardiography evidenced inversion of T wave in DII, DIII, avF and V1 to V4 derivations, without cardiac enzymes alteration. The patient was treated as an acute coronary syndrome (ACS). Elective coronary angiography showed normal coronaries and pulmonary angiotomography evidenced pulmonary massive thromboembolism and lung infarction. Specific treatment was instituted and the patient had a good clinical evolution. The pulmonary embolism must be remembered in those patients who present in the emergency with thoracic pain as in the presented case.

Mechanisms underlying the vasorelaxant effect induced by proanthocyanidin-rich fraction from Croton celtidifolius in rat small resistance arteries.

Proanthocyanidins are condensed tannins present in fruits, vegetables, and flowers, consumed in the human diet. These compounds are believed to decrease coronary heart disease. The present study was designed to investigate the relaxing effects of a proanthocyanidin-rich fraction (PRF) obtained from Croton celtidifolius BAILL (Euphorbiaceae) barks in rat mesenteric arterial bed (MAB) and isolated mesenteric artery (MA). In the MAB pre-contracted with phenylephrine (Phe), PRF (0.1 - 100 microg) induced a concentration-dependent relaxation of 73% (compared to the control). This effect was significantly reduced by the nitric oxide (NO) synthase inhibitor N(omega)-nitro-L-arginine (L-NOARG) or high K(+) solution and completely abolished in vessels perfused with KCl plus L-NOARG. However, the vasorelaxant effect was not altered by indomethacin, atropine, yohimbine, pyrilamine, or K(+)-channel blockers: BaCl(2), glibenclamide, ouabain, and 4-aminopyridine. In isolated MA pre-contracted with Phe, PRF also induced a concentration-dependent relaxation (0.1 - 30 microg/mL), which was in turn inhibited by endothelial removal, guanylyl cyclase inhibitor 1H[1,2,3]oxadiazolo[4,3-alpha]quinoxalin, charybdotoxin (ChTx), and ChTx plus apamin. Moreover, the relaxant effect was not altered by HOE140 and apamin given alone. The present study demonstrates that the vasorelaxing effect of PRF is dependent upon the NO-cGMP pathway in combination with hyperpolarization due to activation of Ca(2+)-dependent K(+) channels.

Macrominerais para bovinos de corte nas pastagens nativas dos Campos de Cima da Serra - RS / Macro minerals to beef cattle in the native pastures of Campos de Cima da Serra - RS, Brazil

Em face das poucas informações disponíveis sobre a composição mineral das pastagens nativas da região dos Campos de Cima da Serra (RS), o presente trabalho de pesquisa objetivou avaliar os teores dos principais macrominerais, em diferentes épocas do ano, e relacionar o perfil mineral destas pastagens com as necessidades nutricionais recomendadas pelo NRC (1996) para bovinos de corte. O projeto foi conduzido em vinte propriedades particulares, em Cambará do Sul, utilizando áreas de campo nativo que estavam sendo normalmente utilizadas em pastoreio por bovinos de corte e/ou ovinos e que não tinham sofrido nenhum tipo de melhoria, reforma ou recuperação (exceto queimada), no mínimo nos últimos 20 anos. Colheram-se, durante oito meses, e dentro de uma mesma área predeterminada em cada propriedade, amostras para determinar as concentrações de Ca, P, Mg, Na e S. Verificou-se efeito do mês de coleta sobre todos os minerais analisados. Foram constatados teores suficientes de Ca e Mg para as categorias de bovinos de corte menos exigentes. Os teores de Mg são deficientes para vacas em gestação e lactação e os teores de Ca são deficientes para terneiros. Por outro lado, os teores de P, Na e S apresentaram-se abaixo das exigências mínimas para as categorias de bovinos de corte avaliadas.

O manejo das emoções por terapeutas comportamentais / The management of emotions by behavior therapists

Nas últimas décadas, a ênfase nas emoções tem sido considerada fundamental para o processo de análisNe e mudança psicoterápica em diversas abordagens, inclusive pela abordagem Comportamental. Este estudo procurou verificar: a) como terapeutas comportamentais experientes evocam emoções dos clientes nas sessões; e b) como se comportam frente à expressividade emocional do cliente. Participaram três terapeutas comportamentais experientes, que gravaram em áudio três sessões cada. A partir das transcrições das fitas, foram selecionados trechos em que ocorriam episódios de emoção do cliente, e categorizadas as falas dos terapeutas que se davam imediatamente antes e após a expressão emocional do cliente, bem como o restante das falas do terapeuta que pertenciam àquele trecho selecionado. As falas dos clientes que estavam relacionadas com emoções também foram categorizadas. Os resultados mostraram que esses terapeutas comportamentais na maior parte das vezes (95 per cent) evocaram e abordaram as emoções que seus clientes relataram como assunto na terapia, e que em grande parte o fizeram de forma indireta (68 per cent), ou seja, abordaram o tema emocional, mas não nomearam ou descreveram a emoção/sentimento. Foi identificada bastante semelhança entre os comportamentos dos terapeutas frente às emoções dos clientes (AU)