Inter-rater Accuracy and Reliability of a Palpation Protocol of the C7 Spinous Process Comprising a Combination of 3 Traditional Palpation Techniques.

OBJECTIVE: The purpose of this study was to determine the accuracy and intrarater reliability of a palpatory protocol based on a combination of 3 palpatory methods to identify both the C7 spinous process (C7 SP) and the factors that affect the errors and inaccuracy of palpation. METHODS: Twenty-five women between the ages of 18 and 60 years were submitted to a palpation protocol of the C7 SP, and a radiopaque marker was fixed on the skin at the possible location of the vertebrae. A radiograph and a photograph of the cervical spine were obtained in the same posture by a first rater. A second rater performed the same palpation protocol and took a second photograph. The accuracy and measurement error of the palpation protocol of C7 SP were assessed through radiographic images. The inter-rater reliability was estimated by the interclass correlation coefficient and assessed using photographs of each rater. The Pearson's correlation coefficients (r), the Fisher exact test, and the χ2 test were used to identify the factors associated with the error and inaccuracy of palpation. RESULTS: Accuracy of the C7 palpation was 76% with excellent reliability (interclass correlation coefficient = 0.99). There was a moderate correlation between weight and the measurement of palpation error (r = -0.6; P = .003). One hundred percent of inaccuracy palpation was related to the increased soft-tissue thickness (P = .005) in the cervical region. CONCLUSION: The palpation protocol described in this study was accurate and presented excellent reliability in identifying the C7 SP. Increased weight and dorsocervical fat pad were associated to error and palpation inaccuracy, respectively.

Bate palmas mutant mice as a model of Kabuki syndrome: Higher susceptibility to infections and vocalization impairments?

The recessive mutant mouse bate palmas (bapa) arose from N-ethyl-N-nitrosourea mutagenesis. Previous studies of our group revealed some behavioral impairments and a mutation in the lysine (K)-specific methyltransferase 2D (Kmt2d) gene. Because mutations in the KMT2D gene in humans are mainly responsible for Kabuki syndrome, this study was proposed to validate bapa mice as a model of Kabuki syndrome. Besides other symptoms, Kabuki syndrome is characterized by increased susceptibility to infections and speech impairments, usually diagnosed in the early childhood. Thus, juvenile male and female bapa mice were studied in different developmental stages (prepubertal period and puberty). To induce sickness behavior and to study infection susceptibility responses, lipopolysaccharide (LPS) was used. To study oral communication, ultrasonic vocalizations were evaluated. Behavioral (open-field test) and central (astrocytic glial fibrillary acidic protein [GFAP] and tyrosine hydroxylase [TH]) evaluations were also performed. Control and bapa female mice emitted 31-kHz ultrasounds on prepubertal period when exploring a novel environment, a frequency not yet described for mice, being defined as 31-kHz exploratory vocalizations. Males, LPS, and puberty inhibited these vocalizations. Bapa mice presented increased motor/exploratory behaviors on prepubertal period due to increased striatal TH expression, revealing striatal dopaminergic system hyperactivity. Combining open-field behavior and GFAP expression, bapa mice did not develop LPS tolerance, that is, they remained expressing signs of sickness behavior after LPS challenge, being more susceptible to infectious/inflammatory processes. It was concluded that bapa mice is a robust experimental model of Kabuki syndrome.

LPS-induced sickness behavior is not affected by selenium but is switched off by psychogenic stress in rats.

Sickness behavior (SB) is considered part of the adaptive behavioral and neuroimmune changes that occur in response to inflammatory processes. However, SB is a motivational state modulated by the environmental context. The objective of this study was to evaluate if selenium could ameliorate symptoms of SB and if stress would affect these responses. We induced SB in rats using lipopolysaccharide (LPS). We choose selenium based on our findings of LPS-exposure decreasing selenium levels in rats. We exposed these rats to a psychogenic stress and studied motivational modulation paradigms, such as cure of the organism, preservation of the species, and fight or flight. We studied ultrasonic vocalizations, open-field behaviors, body weight, and IL-1 beta and IFN-gamma serum levels. LPS-induced SB was evidenced by decreased motor/exploratory activity and increased proinflammatory mediators' levels. Selenium treatment did not exert beneficial effects on SB, revealing that probably the selenium deficiency was not related to SB. When analyzed with the stress paradigm, the behavior of rats was differentially affected. LPS did not affect behavior in the presence of stress. SB was abrogated during stressor events to prioritize survival behaviors, such as fight-or-flight. Contrarily, the association of LPS, selenium, and stress induced SB even during stressor events, revealing that this combination induced a cumulative toxic effect.

Billings reservoir water used for human consumption presents microbiological contaminants and induces both behavior impairments and astrogliosis in zebrafish.

The Billings reservoir is the largest water-storage facility in the São Paulo Metropolitan Region, with only a small part of the reservoir used for water supply. Recently, the São Paulo Metropolitan Region has experienced the greatest water collapse ever recorded. Thus, the intensification of use of the Billings reservoir should be considered. The objective of this study was to evaluate the quality of the water from different areas of the Billings reservoir related to human consumption (water supply and fishing): Rio Pequeno, Rio Grande, and Bororé rivers. We performed microbiological and physical studies on one water sample collected at each of these sites. Adult zebrafish were exposed to such water samples and their behaviors were evaluated. Finally, we studied central glial fibrillary acidic protein (GFAP) expression, which is related to neuroinflammatory processes. Water samples from Rio Pequeno, Rio Grande, and Bororé presented microbiological contamination for Escherichia coli and heterotrophic bacteria. Water from the Rio Pequeno river induced both motor/exploratory impairments and anxiogenic-like behavior in zebrafish. Water from the Bororé river induced behaviors in zebrafish related to respiratory impairments (hypoxia) as well as higher alarm reaction. Zebrafish exposed to water from the Bororé also presented astrogliosis, which seems to have happened in detrimental of the high heterotrophic bacterial contamination. Rio Grande and Bororé water increased the lethality rates. Considering the present results of microbiological contaminants and behavior impairments, lethality, as well as astrogliosis in zebrafish, the water from Rio Pequeno, Rio Grande, and Bororé rivers should be considered unacceptable for human use in their untreated state. The Basic Sanitation Company of the State of Sao Paulo should consider adopting rigorous processes of microbiological water treatment. Authorization for fishing at Bororé river should be reconsidered.