Effects of prevention programmes on injury risk in military personnel: a systematic review with meta-analysis.

INTRODUCTION: Exercise programmes have been used to prevent injuries in military personnel, as they can reduce modifiable risk factors for injuries. Our aim was to review the literature to evaluate the effects of different exercise protocols on the prevention of injuries in military personnel. METHODS: A systematic literature review examined the effects of different exercise protocols on the prevention of musculoskeletal injuries in the military. Several databases were explored to find experimental studies that investigated the effects of prevention programmes on the risk of injury. We have extracted from the studies: profile of participants, sample size, study design and characteristics of the control group (CG), the type of intervention and the relative risk (RR) in the experimental group and CG, with their significance levels. For data analysis, we used the RevMan V.5.3 software. The measure of RR was investigated. The risk of publication bias was analysed with Begg's test. RESULTS: A total of 13 694 titles and studies were recovered from the databases and by manual search. After the removal of duplicate titles and studies that did not meet the eligibility criteria, 17 studies were selected. The protocols were composed of neuromuscular training, stretching, agility training or combined exercises. The meta-analysis showed that injury prevention exercise programmes reduced the risk of musculoskeletal injuries in military personnel by 14% (RR=0.86; 95% CI=0.76 to 0.98). CONCLUSION: Injury prevention exercise programmes promoted a slight reduction in the risk of musculoskeletal injuries in military personnel. LEVEL OF EVIDENCE: Very low. TRIAL REGISTRATION NUMBER: CRD 42017077946.

Influence of Flat Occlusal Splint on Stresses Induced on Implants for Different Fixed Prosthetic Systems.

OBJECTIVE: The flat occlusal plate has been recommended to reduce stress concentration in implant prosthesis treatments. The purpose was to investigate the influence of the occlusal splint on three-element implant-supported fixed prosthesis. MATERIALS AND METHODS: A three-dimensional virtual model was created consisting of a cortical and spongy bone block simulating the region from first premolar to the maxillary first molar using two HE or MT implants (4 x 11mm) with Ti and/or Y-TZP abutments. The second premolar was the pontic of the prosthesis. The three-element fixed prosthesis with a zirconia infrastructure and Y-TZP coating were cemented, in addition to using a flat occlusal splint made of acrylic resin in the region. Combined axial and oblique loads of 100N and 300N were applied. RESULTS: The tensile stresses on MT implant bone tissue produced values of 4-19% lower than those of HE implants. The lowest differences were observed for oblique loading with an occlusal splint, with a 4% (Ti-Y-TZP) and 9% (Ti-Ti) decrease. When the compressive stresses were evaluated, HE implants produced lower values than MT implants. CONCLUSION: A significant increase was observed in the oblique loading stresses in the absence of occlusal splints, regardless of the applied load.

Candida chorioamnionitis associated with late stillbirth: A case report.

Vulvovaginal candidiasis during pregnancy is common, but serious complications, including chorioamnionitis, are infrequent. A 41-year-old woman presented at 37 weeks of gestation with reduced fetal movements, and fetal death in utero was subsequently confirmed on ultrasound. Histopathology of the cord and placenta revealed Candida infection and microabscesses on the umbilical cord. Overall, these features are suggestive of ascending infection, consistent with Candida as the causative organism. To the best of our knowledge, this is the first reported case of late stillbirth due to Candida chorioamnionitis. More research is needed to determine the mechanism whereby Candida becomes pathogenic in pregnancy. There is also no clear consensus on how to manage such patients in a subsequent pregnancy.

Eosinophilic dermatosis of hematologic malignancy: a case report.

Eosinophilic dermatosis of hematologic malignancy (EDHM) is a dermatosis characterized by tissue eosinophilia that has been previously reported as insect bite-like reaction. It is a rare condition with a wide variety of clinical presentations ranging from papules, nodules, or blisters that simulate arthropod bites, to the formation of plaques of differing sizes. We report a case of eosinophilic dermatosis of hematologic malignancy in a patient with a hematoproliferative disorder.

Spontaneous telangiectatic osteosarcoma in a rhesus macaque (Macaca mulatta).

Osteosarcoma (OS) is the most common type of bone cancer, especially in young. Telangiectatic osteosarcoma (TO) is a rare variant of OS, and hence, its occurrence, presentation, and prognosis are poorly understood. A 4-year-old female rhesus monkey presenting lameness and swelling was examined for a mass on the right humerus. Radiography revealed fracture and disorganized structure of bone tissue. Histopathological examination revealed malignant neoplasm composed of anaplastic osteoblasts, which invaded the bone marrow and surrounded blood-filled cysts in the epiphysis and diaphysis forming septa. Cytogenetic analysis showed aneuploid cells, supernumerary AgNORs, and a marker fragment. The neoplasm was diagnosed as TO. To our knowledge, the occurrence of TO and its cytogenetic analysis were reported for the first time in non-human primates.

Giant placental chorioangioma with favorable outcome: a case report and literature review of literature.

OBJECTIVE: To describe a case of prenatal diagnosis of a giant placental chorioangioma with favorable outcome. DESIGN: A case report. SETTING: Gynecology and Obstetrics Service, Federal University of Triângulo Mineiro (UFTM), Uberaba-MG, Brazil. CASE REPORT: The placental chorioangioma is the most common benign tumor, but the type giant has a small prevalence, ranging from 1:16.000 to 1:50.000 pregnancies. We reported a case of a patient aged 18, pregnant for the first time, who performed a routine obstetric ultrasound was found to have polyhydramnios associated with placental vascular lesions suggestive of chorioangioma also was defined by fetal magnetic resonance imaging and confirmed by pathological examination.

Upper aero-digestive contamination by Pseudomonas aeruginosa and implications in Cystic Fibrosis.

BACKGROUND: Cystic Fibrosis (CF) is a severe genetic disorder that is common among the Caucasian population. Bacterial respiratory infections are the main cause of morbidity and mortality in CF patients. Pseudomonas aeruginosa is the main pathogen of lower airways (LAW) decline. METHOD: To understand chronic broncho-pulmonary colonization, a systematic review is conducted. The aim of our article is to identify the pathways of contamination in the upper aero-digestive tract. RESULTS: A large number of articles report that P. aeruginosa is established first at nasopharyngeal sites. The vast majority of authors agree that the upper aero-digestive tract is the first location of colonization by P. aeruginosa and its presence appears to be predictive of subsequent broncho-pulmonary colonization. CONCLUSION: This review supports the possible involvement of the nasal and paranasal sinuses and oral cavity as means of contamination.

Co-infections of the cestode Echinococcus vogeli and the nematode Calodium hepaticum in the hystricomorphic rodent Agouti paca from a forest reserve in Acre, Brazil.

The helminth fauna of Agouti paca (Linnaeus, 1766) has seldom been studied. In this paper, we report an unusual mixed infection of Echinococcus vogeli Rausch & Bernstein, 1972 and Calodium hepaticum (syn. Capillaria hepatica Bancroft, 1863) in free-ranging paca from a forested region in Acre (Brazil). Gross morphological examination revealed that paca liver contained multiple spherical to subspherical white or translucent lesions, which were isolated or frequently contiguous and partially covered by Glisson's capsule. Microscopic examination revealed unilocular cystic structures that contained abundant brood capsules in which numerous protoscolices budded from the inner surface. The protoscolices possessed rostellar hooks (33-41 µm in length), a morphological characteristic of the blade and calcareous corpuscles that is consistent with the metacestode E. vogeli. The diagnosis of C. hepaticum infection was based on the morphology and morphometry of the egg-shaped ellipsoids with bipolar plugs (44.8 ± 1.9 µm (length) × 24.4 ± 2.0 µm (width)) and liver histopathology. This finding expands the known range of C. hepaticum hosts in South America and, to the best of our knowledge, it is the first case of a mixed infection of E. vogeli and C. hepaticum. Furthermore, our data provide evidence that wild animal meat may be a source of C. hepaticum infection.

Situação epidemiológica da brucelose bovina no Distrito Federal / Epidemiological status of bovine brucellosis in the Federal District, Brazil

Realizou-se um estudo para caracterizar a situação epidemiológica da brucelose bovina no Distrito Federal (DF). No total foram amostrados 2.019 animais, provenientes de 278 propriedades. Em cada propriedade visitada aplicou-se um questionário epidemiológico para verificar o tipo de exploração e as práticas de criação e sanitárias que poderiam estar associadas ao risco de infecção pela doença. O protocolo utilizado foi o da triagem com o teste do antígeno acidificado tamponado e a confirmação dos positivos com o teste do 2-mercaptoetanol. O rebanho foi considerado positivo quando pelo menos um animal foi reagente às duas provas sorológicas. A prevalência no DF foi de 2,5 por cento [1,0-5,1 por cento] para propriedades e de 0,16 por cento [0,04-0,28 por cento] para animais. Em razão dos resultados encontrados, que permitem pensar em estratégias de erradicação, recomenda-se que o DF intensifique o diagnóstico de brucelose, tanto na forma de testes sorológicos sistemáticos como pela introdução de mecanismos de detecção rápida em laticínios, em ambos os casos a fim de aumentar o número de propriedades certificadas como livres da doença e melhorar a sensibilidade do sistema de vigilância ativa.

A study to characterize the epidemiological status of brucellosis was carried out in the Federal District of Brazil. A total of 2,019 serum samples from 278 herds were collected. In each herd, it was applied an epidemiological questionnaire focused on herd traits as well as husbandry and sanitary practices that could be associated with the risk of infection. The serum samples were screened for antibodies against Brucella spp. by the Rose-Bengal Test (RBT), and all positive sera were re-tested by the 2-mercaptoethanol test (2-ME). The herd was considered positive if at least one animal was positive on both RBT and 2-ME tests. Herd prevalence was estimated as 2.5 percent [1.0-5.1 percent] whereas animal prevalence was 0.16 percent [0.04-0.28 percent]. Given these results, that may warrant the implementation of eradication strategies, there is a case for intensifying the serological testing in the Federal District, coupled with the introduction of rapid detection methods by the dairy industries, with a view to increasing the number of accredited free herds and improving the sensitivity of the surveillance system..

Community acquired pneumonia among pediatric outpatients in Salvador, Northeast Brazil, with emphasis on the role of pneumococcus.

Pneumonia is one of the leading causes of hospitalization and death among children in developing countries, and mortality due to pneumonia has been associated with S. pneumoniae infection. This investigation was designed to describe the antimicrobial susceptibility and serotype patterns of pneumococcal strains recovered from the blood of children with community-acquired pneumonia (CAP) and to assess the clinical findings of pneumococcal bacteremic patients with pneumonia. In a 26 month prospective study, blood cultures were obtained as often as possible from children (<16 years of age) diagnosed with CAP in two emergency rooms. Antimicrobial drug susceptibility tests and serotyping were performed when pneumococcus was identified. We studied 3,431 cases and cultured blood samples from 65.5% of those. Pneumococcus was recovered from 0.8% of the blood samples. The differences in age, somnolence, wheezing and hospitalization among children with and without pneumococcal bacteremia were statistically significant. Pneumococcal bacteremia was age-related (mean 1.63 +/- 1.55; median 0.92) and associated with somnolence and hospitalization among children with CAP. One strain was recovered from pleural fluid. Penicillin resistance was detected in 21.0% (4/19) of the strains at an intermediate level, whereas 63.0% of the strains were resistant to trimethoprim-sulfamethoxazole. The most common serotypes were 14 and 6B, and these serotypes included the resistant strains. Eight of our 18 isolates from blood were of types included in the heptavalent conjugate pneumococcal vaccine, recently licensed in the USA.

Estudo anatomopatológico e imuno-histoquímico de carcinoma renal metastático em um bovino / Anatomopathological and immunohistochemical studies of metastatic renal carcinoma in a cow

O presente relato descreve um caso de carcinoma renal metastático em uma vaca mestiça de seis anos de idade com histórico de emagrecimento progressivo, tosse e dificuldade de locomoçäo. Ao exame clínico, foram observados cifose, secreçäo catarral nas narinas e estertores à auscultaçäo pulmonar. A palpaçäo retal foi detectada uma grande massa de consistência firme, caudal ao rim direito. A laparotomia paralombar direita confirmou a presença dessa massa no pólo caudal do rim direito. Devido a impossibilidade da exérese, optou-se pela eutanásia. A necropsia, observou-se uma massa de 50cm de diâmetro, de aproximadamente quatro quilogramas, com superfície lisa, bem vascularizada de consistência firme, coloraçäo esbranquiçada, que rangia ao corte e apresentava-se aderida às alças do intestino grosso. Os linfonodos mediastinais e alguns linfonodos mesentéricos apresentavam-se aumentados de volume, de consistência firme e esbranquiçados e os pulmöes apresentavam nódulos de tamanhos variados e com características similares àquelas da massa renal. Histologicamente, a neoplasia apresentava características de carcinoma de padräo tubular. Pela imuno-histoquímica foi detectada positividade para os seguintes marcadores tumorais: vimentina (V-9), cytokeratin-7, CD68, 35betaH11, CEA poli e RCC ("renal cell carcinoma"), confirmando a origem renal do processo neoplásico

Utilizaçäo do eluato de sangue dessecado em papel de filtro no diagnóstico sorológico da toxoplasmose caprina / Use of dried blood sample for sorological diagnosis of toxoplasmosis in goats

Foi realizada pesquisa de anticorpos anti-Toxoplasma gondii em 183 amostras de sangue dessecado em papel de filtro utilizando as reaçöes de imunofluorescência indireta ELISA e dot-ELISA, tomando como referência os resultados obtidos nos soros. A análise dos resultados demonstrou que papéis com sangue dessecado podem ser conservados por um período mínimo de 45 dias à temperatura ambiente e por seis meses a 4§C, desde que mantidos livres de umidade pela utilizaçäo de agentes dessecantes como a sílica-gel. A reprodutibilidade das reaçöes, avaliada por meio da curva dos títulos de anticorpos no decorrer do tempo após a coleta do sangue em papéis de filtro, demonstrou uma concordância de 97 a 100 por cento entre os resultados obtidos nos soros e eluatos. Os títulos de anticorpos permaneceram estáveis durante o período observado. Os resultados obtidos com eluato de sangue dessecado foram semelhantes na RIFI, ELISA e dot-ELISA, indicando que qualquer uma das três reaçöes pode ser utilizada em eluatos de sangue dessecado para o diagnóstico da toxoplasmose caprina

A avidez de anticorpos específico anti-toxoplasma da classe IgC e sua utilizaçäo na diferenciaçäo entre toxoplasmose recente e crônica em caprinos / Toxoplasma - specific IgC antibodies avidity ELISA and its role in the differentiation between recent and chronic toxoplasmosis in goats

Foi avaliada a avidez de anticorpos IgG como marcador sorológico de infecçäo recente e crônica pelo Toxoplasma gondii, através da dissociaçäo do complexo antígeno-anticorpo com uréia. A avaliaçäo foi realizada medindo-se a percentagem de queda (por cento Q) da absorbância, pelo ELISA, após a lavagem do complexo Ag - Ac formado com soluçäo de uréia. Ficou determinado que a concentraçäo de uréia 9 Molar (M) foi a que melhor diferenciou infecçöes recentes e crônicas de cabras experimentalmente infectadas com Toxoplasma gondii, e que a porcentagem Q da absorbância decresce com o tempo de infecçäo do animal, tornando-se estável em torno do 100§ dia após a inoculaçäo. Em um grupo de 116 amostras de soro, coletadas de caprinos naturalmente infectados, foram demonstrados perfis característicos de toxoplasmose recente, crônica ou em fase de transiçäo. Os perfis foram previamente determinados pela avaliaçäo da evoluçäo dos níveis de anticorpos IgG pela reaçäo de imunofluorescência indireta. Os animais caracterizados como portadores de toxoplasmose crônica apresentaram uma porcentagem Q da absorbância de 26,32 mais ou menos 10,84. Para toxoplasmose recente a porcentagem Q da absorbância observada foi de 77,61 mais ou menos 13,89 e para o perfil de transiçäo, 46,22 mais ou menos 11,94

[A surveillance system for the study of the circulation of influenza in Madrid during the 1986-1991 quinquennium. The Influenza Surveillance Group of Madrid]. / Sistema de vigilancia para el estudio de la circulación gripal en Madrid durante el quinquenio 1986-1991. Grupo de Vigilancia de Gripe de Madrid.

BACKGROUND: The creation of a surveillance system allowing the study of the evolution of the tendency of influenza and act as an alert system for undertaking control measures is necessary due to the great variability characteristic of the circulation of influenza virus. The Madrid Influenza Surveillance Group was therefore designed. The activity carried out during its first five years of existence is evaluated. METHODS: The field work of the Group is based on the clinical study of patients with influenza, among which some are selected for virologic study with the aim to isolate and characterize the circulating virus. The data obtained by the work group itself are used as the dates of the System of Obligatory Disease Declaration and the System of Microbiologic Information as epidemiologic support to define the outbreaks observed. RESULTS: All the virus isolated were similar to those recommended by the World Health Organization for their inclusion in anti-influenza vaccination, with their circulation being largely reproduced throughout Europe. In three of the five seasons studied the type A virus prevailed leading to earlier outbreaks and a greater number of cases than in the two seasons with type B prevalence. CONCLUSIONS: The circulation of the influenza virus in Madrid coincides with that of the rest of Spain at both the maximum peak and relative incidence as well as the type of prevailing virus. The minor circulation detected by the Madrid Group is in concordance with the data provided by the other autonomic communities.

Diagnosis of caprine toxoplasmosis by a dot enzyme-linked immunosorbent assay

Foi avaliada a reaçäo imunoenzimática dot-ELISA, no imunodiagnóstico da toxoplasmose caprina, considerando a reaçäo de Imunofluorescência Indireta (RIFI) como reaçäo de referência. Para a avaliaçäo da dot-ELISA discos de nitrocelulose foram sensibilizados com 0,1 microgramas de proteína/ml de uma soluçäo antigênica obtida através da sonicaçäo de taquizoitas de Toxoplasma gondii. Esta concentraçäo antigênica foi considerada ótima na discriminaçäo de soros reagentes e näo reagentes. Foram testadas 169 amostras de soro, destas 115 (68 por cento) foram reagentes a antígenos de T. gondii, com títulos de anticorpos variando entre 1/16 e 1/16:384, quando testadas através da reaçäo de Imunofluorescência Indireta (RIFI); na dot-ELISA, 119 (70 por cento) foram positivas, com título variando entre 1/16 e 1/65.536. A comparaçäo entre as técnicas mostra os seguintes índices: co-positividade (sensibilidade) 0,89, co-negatividade (especificidade) 0,98, e Youden (concordância) 0,93, quando foi utilizado o título de 1/16 como discriminatório de reaçöes positivas e negativas. Utilizando como discriminatório o título de 1/64, os índices calculados foram co-positividade 0,97, co-negatividade 0,96 e Youden 0,93. Os resultados mostram a possibilidade da utilizaçäo da dot-ELISA no imunodiagnóstico da toxoplasmose caprina. A introduçäo desta reaçäo no imunodiagnóstico da toxoplasmose seria de grande importância, principalmente em estudos soro-epidemiológicos, já que a técnica pode ser realizada sob condiçöes de campo, pois nenhum equipamento especial é requerido para a sua execuçäo

Regulatory studies of L-glutamate dehydrogenase from Trypanosoma cruzi epimastigotes.

1. The specific activity of NADP-dependent L-glutamate dehydrogenase (GDH) from T. cruzi epimastigotes increased from 0.7 at early log-phase to 1.4 mumol/min/mg of protein at the stationary phase. 2. When T. cruzi cells were incubated in the presence of L-glutamate (0.08%), the GDH had a specific activity of 2.2, much higher than that of cells incubated in the presence of D-glucose (0.08%), which was 1.2 mumol/min/mg of protein. 3. The specific activity of NADP-dependent GDH from cells incubated in the presence of L-glutamate did not vary when the cells were treated with cycloheximide (100 ng/ml) or chloramphenicol (0.5 mg/ml). 4. The activity of the NAD-dependent GDH did not change in any of the situations described above. 5. AMP, ADP, ATP, citrate, isocitrate, oxaloacetate, fructose-1,6-diP, pyruvate, L-proline and L-arginine did not have any effect on the NADP-linked GDH activity. Product inhibition studies were done on the latter GDH activity.

Evidence for three respiratory terminals in Trypanosoma cruzi epimastigotes.

The respiration of T. cruzi epimastigotes was studied using KCN (1 mM) and NaN3 (5 mM) as inhibitors and glucose (33 mM) as substrate. NaN3 inhibits 18% and KCN 58% of the oxygen uptake when T. cruzi cultures enter the stationary phase. The azide-inhibition pattern closely follows endogenous respiration pattern throughout the different growth phases. Titration of the oxygen uptake with cyanide and azide, with the results treated as Dixon plots, indicated the presence of: a) one respiratory terminal sensitive to both cyanide and azide; b) another cyanide-sensitive but azide-insensitive; c) a third insensitive to both inhibitors. Ethidium bromide (5 micrograms/ml) treatment caused the disappearance of the azide-sensitive terminal in the stationary phase.

Incorporation of ammonium in amino acids by Trypanosoma cruzi.

Ammonium ions were incorporated into L-glutamate and alpha-ketoglutarate in epimastigote forms of Trypanosoma cruzi through the following enzymatic systems: NADPH and NADH-dependent glutamate dehydrogenase, NADPH-dependent glutamate synthase, L-glutamine synthetase and NADH-dependent glutamate synthase in order of decreasing specific activity (mumoles of product formed/min/mg protein). The pH optima and Km's for the glutamate dehydrogenase system were determined. Disc electrophoresis showed the presence of cathodic bands of GDH activity, which were highly dependent on NADP+.

Purine metabolism in trypanosomatids.

Purine nucleotide biosynthesis was studied in culture forms of Trypanosoma cruzi strain Y, Crithidia deanei (a reduviid trypanosomatid with an endosymbiote) and an aposymbiotic strain of C. deanei (obtained by curing C. deanei with chloramphenicol). Trypanosoma cruzi was found to synthesize purine nucleotides only fring incorporated into both adenine and guanine nucleotides. Similar results were obtained with guanine, indicating that this flagellate has a system for the interconversion of purine nucleotides. Crithidia deanei was able to synthesize purine and pyrimidine nucleotides from glycine ("de novo" pathway) and purine nucleotides from adenine and guanine ("salvage" pathway). Adenine was incorporated into both adenine and guanine nucleotides, while guanine was incorporated into guanine nucleotides only, indicating the presence of a metabolic block at the level of GMP reductase. The aposymbiotic C. deanei strain was unable to utilize glycine for the synthesis of purine nucleotides, although glycine was utilized for synthesizing pyrimidine nucleotides. These results suggest that the endosymbiote is implicated in the de novo purine nucleotide pathway of the C. deanei-endosymbiote complex. The incorporation of adenine and guanine by aposymbiotic C. deanei strain followed a pattern similar to that observed for C. deanei.