Effect of environmental factors on seminal microbiome and impact on sperm quality.

Objective: This review provides a comprehensive overview of the existing research on the seminal microbiome and its association with male infertility, while also highlighting areas that warrant further investigation. Methods: A narrative review was conducted, encompassing all relevant studies published between 1980-2023 on the male reproductive tract microbiome in humans. This review considered studies utilizing culture-based, polymerase chain reaction (PCR)-based, and next-generation sequencing (NGS)-based methodologies to analyze the microbiome. Data extraction encompassed sample types (semen or testicular tissue), study designs, participant characteristics, employed techniques, and critical findings. Results: We included 37 studies comprising 9,310 participants. Among these, 16 studies used culture-based methods, 16 utilized NGS, and five employed a combination of methods for microorganism identification. Notably, none of the studies assessed fungi or viruses. All NGS-based studies identified the presence of bacteria in all semen samples. Two notable characteristics of the seminal microbiome were observed: substantial variability in species composition among individuals and the formation of microbial communities with a dominant species. Studies examining the testicular microbiome revealed that the testicular compartment is not sterile. Interestingly, sexually active couples shared 56% of predominant genera, and among couples with positive cultures in both partners, 61% of them shared at least one genital pathogen. In couples with infertility of known causes, there was an overlap in bacterial composition between the seminal and vaginal microbiomes, featuring an increased prevalence of Staphylococcus and Streptococcus genera. Furthermore, the seminal microbiome had discernible effects on reproductive outcomes. However, bacteria in IVF culture media did not seem to impact pregnancy rates. Conclusion: Existing literature underscores that various genera of bacteria colonize the male reproductive tract. These organisms do not exist independently; instead, they play a pivotal role in regulating functions and maintaining hemostasis. Future research should prioritize longitudinal and prospective studies and investigations into the influence of infertility causes and commonly prescribed medication to enhance our understanding of the seminal microbiota's role in reproductive health.

3-Halochromones Through Oxidative α-Halogenation of Enaminones and its Photophysical Investigation: Another Case of Photo-induced Partially Aromatised Intramolecular Charge Transfer?

A versatile synthesis strategy for fluorescent 3-halo-4H-chromen-4-one derivatives is reported. The method involves the oxidative α-halogenation of enaminones performed by an efficient and sustainable oxidation system. The use of Oxone® in combination with KCl, KBr, or KI enables the preparation of 3-chloro-, 3-bromo-, or 3-iodo-4H-chromen-4-one in good to excellent yields, with great functional group tolerance where the protocol is amenable to gram-scale synthesis. The analysis of the photophysical properties of the presented 4H-chromen-4-one showed absorption in the UV region and fluorescence emission in the violet-to-cyan region with a relatively large Stokes shift. In solution, all compounds present a dual fluorescence emission, regardless of the solvent, assigned to a partially aromatised intramolecular charge transfer mechanism, considering the presence of a pseudo-aromatic ring in the chromone scaffold and the absence of the influence of substituent electronic features in optical behaviour.

Statistical analysis of blast-induced vibration near an open pit mine.

Blast-induced vibration may be harmful to facilities in the vicinity of operating mines, mainly causing structural damage and human discomfort. This study presents an application of multivariate statistics to predict vibration levels regarding their potential to cause structural damage and human discomfort. An extensive seismic monitoring campaign was executed in a large open-pit iron ore mine, near a small village, to gather a dataset for a predictive multivariate analysis. Ten blasting events have produced a dataset of 158 valid measurements. Three classes of vibration peak velocity were adopted from legal standards, which later supported a cluster analysis. Then, it was possible to compare how much these two classification modalities respond to discriminant analysis. The next step was to carry out a principal component analysis (PCA) from the original database, and, comparatively, to plot both the scores concerning the classes derived from the vibration standard and those from the groups obtained from cluster analysis. PCA has considerably explained the data variability, while the three classes from cluster analysis resulted very similar to the corresponding ones from the vibration standards. The results have demonstrated that multivariate statistics may be applied to manage blasting-induced vibration and its deleterious effects with few adjustments and automation.

Effect of varicocele and varicocelectomy on sperm deoxyribonucleic acid fragmentation rates in infertile men with clinical varicocele.

Varicocele is the leading cause of male infertility. It can affect sperm quantity and quality through various non-mutually exclusive pathophysiological mechanisms, mainly oxidative stress. Excessive production of reactive oxygen species may overwhelm the sperm's defenses against oxidative stress and harm the sperm's DNA. Excessive sperm DNA breaks, so-called sperm DNA fragmentation, result from the oxidative stress cascade and are commonly found in the ejaculates of men with varicocele and fertilityrelated issues. Measuring sperm DNA fragmentation can provide valuable information on the extent of harm and might help select candidates for surgical treatment. Varicocelectomy is beneficial for alleviating oxidative stress-associated infertility and improving sperm DNA integrity. However, reproductive outcomes of infertile men with elevated sperm DNA fragmentation rates and surgically treated varicoceles remain poorly studied, and there is a need for well-designed trials to determine the impact of sperm DNA fragmentation reduction on natural and medically assisted reproduction.

MAMMALS IN PORTUGAL: A data set of terrestrial, volant, and marine mammal occurrences in Portugal.

Mammals are threatened worldwide, with ~26% of all species being included in the IUCN threatened categories. This overall pattern is primarily associated with habitat loss or degradation, and human persecution for terrestrial mammals, and pollution, open net fishing, climate change, and prey depletion for marine mammals. Mammals play a key role in maintaining ecosystems functionality and resilience, and therefore information on their distribution is crucial to delineate and support conservation actions. MAMMALS IN PORTUGAL is a publicly available data set compiling unpublished georeferenced occurrence records of 92 terrestrial, volant, and marine mammals in mainland Portugal and archipelagos of the Azores and Madeira that includes 105,026 data entries between 1873 and 2021 (72% of the data occurring in 2000 and 2021). The methods used to collect the data were: live observations/captures (43%), sign surveys (35%), camera trapping (16%), bioacoustics surveys (4%) and radiotracking, and inquiries that represent less than 1% of the records. The data set includes 13 types of records: (1) burrows | soil mounds | tunnel, (2) capture, (3) colony, (4) dead animal | hair | skulls | jaws, (5) genetic confirmation, (6) inquiries, (7) observation of live animal (8), observation in shelters, (9) photo trapping | video, (10) predators diet | pellets | pine cones/nuts, (11) scat | track | ditch, (12) telemetry and (13) vocalization | echolocation. The spatial uncertainty of most records ranges between 0 and 100 m (76%). Rodentia (n =31,573) has the highest number of records followed by Chiroptera (n = 18,857), Carnivora (n = 18,594), Lagomorpha (n = 17,496), Cetartiodactyla (n = 11,568) and Eulipotyphla (n = 7008). The data set includes records of species classified by the IUCN as threatened (e.g., Oryctolagus cuniculus [n = 12,159], Monachus monachus [n = 1,512], and Lynx pardinus [n = 197]). We believe that this data set may stimulate the publication of other European countries data sets that would certainly contribute to ecology and conservation-related research, and therefore assisting on the development of more accurate and tailored conservation management strategies for each species. There are no copyright restrictions; please cite this data paper when the data are used in publications.

Diagnosis and Treatment of Plasmodium Infection in Captive Black and White Tegus.

Malarial protozoa commonly infect both wild and captive lizards but the effects on the general health of these animals are not fully understood. We describe four clinical cases of Plasmodium infection in captive black and white tegus (Salvator merianae). The animals presented with lethargy, anorexia, dehydration and stomatitis. Plasmodium infection was identified in blood smears from all animals. Treatment with a sulphamethoxazole-trimethoprim combination resolved the infection and clinical improvement was observed within 21 days. This is the first report of successful treatment of clinical plasmodiid infection in captive tegus.

Specific surface area of polydispersions as a function of size distribution sharpness.

Knowledge of particulate system properties is very important in various industrial instances and the possibility of fast predicting the behavior of such systems is an important control tool. The specific surface area of simulated particulate systems was studied as a function of the sharpness parameter of the size distribution of the Gates-Gaudin-Schumann, Gaudin-Meloy and Rosin-Rammler equations. The results showed good statistical adherence, especially the Rosin-Rammler equation, in situations where it is the best descriptor of particle size distribution.

Hemoplasma infection in wild captive carnivores / Infecção por hemoplasmas em carnívoros selvagens cativos

Hemoplasmas are bacteria able to adhere themselves loosely to the plasma membrane of erythrocytes and may parasitize several species of mammals. There are three known species of hemoplasmas that parasitize domestic and wild cats: Mycoplasma haemofelis, 'Candidatus Mycoplasma haemominutum' and 'Candidatus Mycoplasma turicensis'. Dogs are infected by at least two species of hemoplasmas: 'Candidatus Mycoplasma haematoparvum' and Mycoplasma haemocanis. The hemoplasmoses are very important in veterinary clinics, either because of its worldwide distribution and severity of clinical signs, depending on parasite species and host immune competence, or due to its zoonotic potential and capability of infecting endangered species. This study set out to investigate which hemoplasmas species parasitize different captive wild carnivores in order to clarify the epidemiology of hemoplasmoses in wild animals. Furthermore, the research intended to characterize the hematological changes caused by different species of hemotropic mycoplasmas infection in order to establish their clinical importance to wild species and the capacity of these species to become a reservoir of studied agents. Samples of 33 wild felids and 18 wild canids were investigated using polymerase chain reaction (PCR) to detect hemoplasmas DNA and it was observed that the occurrence of infection in these species is 45.5% and 83.3%, respectively. Factors such as age, gender or anaemia are not more frequent in animals positive for the infection. Therefore, it is concluded that infection caused by hemoplasmas in wild carnivores has high prevalence, and either agent pathogenicity is low, or chronic stage is more frequent, resulting in a low rate of diagnosis.(AU)

Hemoplasmas são bactérias capazes de aderir frouxamente à membrana plasmática de eritrócitos e que podem parasitar diversas espécies de mamíferos. São conhecidas três espécies de hemoplasmas que parasitam felídeos domésticos e selvagens: Mycoplasma haemofelis, 'Candidatus Mycoplasma haemominutum' and 'Candidatus Mycoplasma turicensis'. Cães são infectados por ao menos duas espécies de hemoplasmas: Candidatus Mycoplasma haematoparvum' and Mycoplasma haemocanis. As hemoplasmoses são de grande importância na clínica veterinária, tanto pela sua distribuição ubíqua e severidade dos sinais clínicos, a depender da espécie do parasita e imunocompetência do hospedeiro, quanto pelo seu potencial zoonótico e capacidade de infectar espécies ameaçadas. Este estudo visa investigar quais espécies de hemoplasmas parasitam diferentes carnívoros selvagens de cativeiro, a fim de esclarecer a epidemiologia das hemoplasmoses em animais selvagens. Além disso, o trabalho objetivou caracterizar as alterações hematológicas causadas pela infecção por diferentes espécies de micoplasmas hemotrópicos visando estabelecer sua importância clínica para espécies selvagens e a capacidade destas espécies de se tornar reservatórios dos agentes estudados. Amostras de 33 felídeos selvagens e de 18 canídeos selvagens foram investigadas por meio da reação em cadeia da polimerase (RCP) para detectar o DNA dos agentes e foi observado que a ocorrência da infecção por hemoplasmas nestas espécies é de 45,5% e 83,3%, respectivamente. Fatores como idade, sexo ou anemia não são mais frequentes em animais positivos para a infecção. Dessa forma, conclui-se que a infecção causada por hemoplasmas em carnívoros selvagens possui alta prevalência, no entanto ou a patogenicidade dos agentes é baixa ou o estágio crônico da infecção é mais frequente, resultando em uma baixa frequência diagnóstica.(AU)

Association between contextual and clinical factors and disability in people with chronic obstructive pulmonary disease.

Background: Chronic obstructive pulmonary disease (COPD) develops as a multifaceted and complex disorder, with clinical and functional repercussions. Objective: To investigate the association among contextual factors (personal and environmental) and clinical features and the disability of COPD patients, with emphasis on activity and social participation. Methods: A cross-sectional study with stable COPD participants (n = 47) was conducted to assess personal and clinical characteristics, activity of daily living using the London Chest Activity of Daily Living scale (LCADL), disability by the World Health Organization Disability Assessment Schedule 2.0 (WHODAS), and environmental factors by the Craig Hospital Inventory of Environmental Factors (CHIEF). Statistical analysis was performed by the multivariate method. Results: In the LCADL predictive analysis, the variables forced expiratory volume in 1 second (FEV1), dyspnea levels 3-4 by the modified Medical Research Council scale (mMRC), and active level of regular physical activity were included in the final model (adjusted R 2 = 0.523). In addition, WHODAS was influenced by CHIEF physical structure score and mMRC 1-2 and mMRC 3-4 grades (adjusted R 2 = 0.500). Conclusions: Disability is a complex in COPD patients and encompasses a prominent role of dyspnea levels in the prediction of activity and participation. Multivariate models presented clinical and contextual factors as functional predictors that included the physical structure of the environment in the determination of social participation.

Investigação molecular de Ehrlichia canis, Anaplasma platys, Anaplasma phagocytophilum e Rickettsia spp. em felídeos selvagens cativos / Molecular investigation of Ehrlichia canis, Anaplasma platys, Anaplasma phagocytophilum and Rickettsia spp. in captive wild felids

Doenças transmitidas por vetores estão emergindo e reemergindo em todo o mundo, representando um desafio na medicina humana e veterinária. Entre essas doenças estão aquelas causadas pelos agentes da ordem das Rickettsiales, que são bactérias Gram-negativas intracelulares obrigatórias, com capacidade de infectar vários animais e seres humanos. As Rickettsiales das espécies Ehrlichia spp. e Anaplasma spp. são observadas em vacúolos citoplasmáticos de leucócitos e plaquetas. As Rickettsiales da espécie Rickettsia spp. infectam livremente citoplasma ou núcleo de células hospedeiras. O objetivo do presente estudo foi investigar a infecção natural por Ehrlichia canis, Anaplasma platys, Anaplasma phagocytophilum e Rickettsia spp. em felídeos selvagens cativos no Distrito Federal e Goiás, Brasil. Além disso, também objetivou-se relacionar possíveis alterações hematológicas decorrentes da presença desses agentes. Amostras de sangue de 34 animais foram analisadas por meio da PCR para detecção de presença de DNA desses agentes. O DNA de Ehrlichia canis foi detectado em 5,8% (2/34) das amostras, A. platys foi detectado 64,7% (22/34), A. phagocytophilum foi detectado em 5,8% (2/34). O DNA de Rickettsia spp. não foi detectado em nenhuma amostra. Dois felídeos apresentaram coinfecção por E. canis e A. platys e dois apresentaram coinfecção por A. platys e A. phagocytophilum. Não houve diferenças significativas nos dados hematológicos das amostras positivas e negativas. Os dados sugerem que os felídeos selvagens cativos podem servir como potenciais reservatórios para Ehrlichia spp. e Anaplasma spp., a despeito de não ocasionarem alterações hematológicas.(AU)

Vector-borne diseases have been emerging and reemerging all over the world, causing a challenge to veterinary and human medicine. Among these diseases are those caused by agents of the order Rickettsiales, obligatory intracellular Gram-negative bacteria, with ability to infect several animals and humans. Rickettsiales of the species Ehrlichia spp. and Anaplasma spp. residing in cytoplasmic vacuoles of leukocytes and platelets. Rickettsiales of the species Rickettsia spp. freely infect cytoplasm or nucleus of host cells. The aim of the present study was to investigate the natural infection with Ehrlichia canis, Anaplasma platys, Anaplasma phagocytophilum and Rickettsia spp. in captive wild felids at the Federal District and Goiás, Brazil. In addition, it was also aimed to relate possible changes in hemogram with the presence of these agents. Blood samples from 34 animals were analyzed by PCR to detect the presence of DNA from these agents. The DNA of Ehrlichia canis was detected in 5.8% (2/34) of samples. A. platys was detected in 64.7% (22/34), A. phagocytophilum was detected in 5.8% (2/34). The DNA of Rickettsia spp. was not detected in any sample. Two felides presented co-infection with E. canis and A. platys, and two presented co-infection with A. platys and A. phagocytophilum. There were no significant differences in hematological data from positive and negative samples. The data suggest that captive wild felids can serve as potential reservoirs for Ehrlichia spp. and Anaplasma spp., despite hematological abnormalities were not observed.(AU)

Touchdown polymerase chain reaction detection of polycystic kidney disease and laboratory findings in different cat populations.

Autosomal-dominant polycystic kidney disease (ADPKD) is the most prevalent inherited genetic disease of cats, predominantly affecting Persian and Persian-related cats. A point mutation (C→A transversion) in exon 29 of the PKD1 gene causes ADPKD, and is the specific molecular target for genetic diagnosis in cats. The current study describes a newly developed touchdown polymerase chain reaction (PCR) to detect this single point mutation, using 2 primers specific for the mutant allele, adapted from an existing multiplex amplification refractory mutation system (ARMS PCR). Furthermore, correlations between the clinical outcomes of tested animals and the results of the genetic test were investigated. A total of 334 cats were tested, 188 from the Veterinary Hospital of Small Animals at the University of Brasilia, and 146 from an anti-rabies vaccine campaign of the Federal District. A total prevalence of 9% was evident among the samples, with 33% of the Persian cats testing positive, and 7% of the Brazilian long- and shorthaired cats testing positive. Prevalence was not correlated with gender or hemogram. Positive animals exhibited hyperglobulinemia ( P = 0.02). This research demonstrated that the mutation does not only occur in Persian and Persian-related cats, and that a touchdown PCR can be used to diagnose ADPKD.

Functional outcomes in patients with chronic obstructive pulmonary disease: a multivariate analysis.

BACKGROUND: Multiple factors can influence the severity of chronic obstructive pulmonary disease (COPD) and the functioning of patients with COPD, such as personal characteristics and systemic manifestations. OBJECTIVE: To evaluate the different factors that can influence the activity and psychosocial impact domains of the Saint George's Respiratory Questionnaire (SGRQ) in COPD patients. METHOD: Participants, recruited in a university-based hospital, responded to the SGRQ, and in addition, personal, anthropometric, and clinical data were collected. The study was approved by the Institutional Ethics Committee. Data were analyzed using multiple linear regression models, with the SGRQ activity and psychosocial impact scores as outcome variables, and 10 explanatory variables (age, gender, forced expiratory volume in the first second - FEV1, smoking load, body mass index, oxygen therapy, associated diseases, regular physical activity, participation in a formal rehabilitation program, and SGRQ symptoms score) were considered. RESULTS: The best regression model for predicting the SGRQ activity score (r2=0.477) included gender, FEV1, and SGRQ symptoms. In contrast, the predictive model with the highest proportion of explained variance in psychosocial impact score (r2=0.426) included the variables gender, oxygen therapy, and SGRQ symptoms. CONCLUSIONS: The results indicate that the outcomes, while based on functioning parameters in COPD patients, could be partly explained by the personal and clinical factors analyzed, especially by the symptoms assessed by the SGRQ. Thus, it appears that the health conditions of these patients cannot be described by isolated variables, including pulmonary function parameters.

Functional outcomes in patients with chronic obstructive pulmonary disease: a multivariate analysis

Background: Multiple factors can influence the severity of chronic obstructive pulmonary disease (COPD) and the functioning of patients with COPD, such as personal characteristics and systemic manifestations. Objective: To evaluate the different factors that can influence the activity and psychosocial impact domains of the Saint George's Respiratory Questionnaire (SGRQ) in COPD patients. Method: Participants, recruited in a university-based hospital, responded to the SGRQ, and in addition, personal, anthropometric, and clinical data were collected. The study was approved by the Institutional Ethics Committee. Data were analyzed using multiple linear regression models, with the SGRQ activity and psychosocial impact scores as outcome variables, and 10 explanatory variables (age, gender, forced expiratory volume in the first second - FEV1, smoking load, body mass index, oxygen therapy, associated diseases, regular physical activity, participation in a formal rehabilitation program, and SGRQ symptoms score) were considered. Results: The best regression model for predicting the SGRQ activity score (r2=0.477) included gender, FEV1, and SGRQ symptoms. In contrast, the predictive model with the highest proportion of explained variance in psychosocial impact score (r2=0.426) included the variables gender, oxygen therapy, and SGRQ symptoms. Conclusions: The results indicate that the outcomes, while based on functioning parameters in COPD patients, could be partly explained by the personal and clinical factors analyzed, especially by the symptoms assessed by the SGRQ. Thus, it appears that the health conditions of these patients cannot be described by isolated variables, including pulmonary function parameters. .

Abdominal and pelvic ultrasound study of the maned wolf (Chrysocyon brachyurus) / Estudo ultrassonográfico abdominal e pélvico de lobo-guará (Chrysocyon brachyurus)

The aim of the present study was the ultrasound characterization of the abdominal and pelvic regions of five maned wolves kept in captivity at the Triage Center of Wild Animals of the Federal University of Viçosa (Centro de Triagem de Animais Silvestres, Universidade Federal de Viçosa). This characterization included descriptions of ultrasonographic aspects and measurements of various structures using B-mode ultrasound. Biometric data were collected to assess the existence of significant linear correlations between these measurements and the measurements obtained by ultrasound. Additionally, hematological and serum biochemistry evaluations of the animals were performed. The ultrasound findings were similar to those available in the literature on domestic dogs, which were used for comparison as a result of the lack of published data regarding maned wolves. The latter species showed characteristics closely resembling those of the former, differing in the spleen and left renal cortex echogenicities, in the appearance of the prostatic and testicular regions and in the hepatic portal vein morphology. In the current study, the biometric values were similar to those previously published; however, no data regarding thoracic perimeter, modified crown-rump length or thoracic depth were found in the literature for this Canidae species. Statistical analysis showed the existence of a strong negative correlation between the modified crown-rump length and left renal length, between the modified crown-rump length and the right renal volume, between the thoracic perimeter and the height at the cranial pole of the left adrenal gland and between the thoracic perimeter and the height at the caudal pole of the left adrenal gland. Laboratory findings, including segmented neutrophil, eosinophil, monocyte and lymphocyte counts and the serum levels of glucose, ALT, alkaline phosphatase, urea, total protein, globulin, creatine phosphokinase, triglyceride, sodium, phosphate, potassium and chloride, were inconsistent with values found by other authors. The ultrasound is a diagnostic imaging method that must be further explored in the medicine of wild animals; therefore, additional research in this area is required.

O presente trabalho objetivou a caracterização ultrassonográfica das regiões abdominal e pélvica de cinco lobos-guarás mantidos em cativeiro no Centro de Triagem de Animais Silvestres da Universidade Federal de Viçosa, com descrição dos aspectos ultrassonográficos e obtenção de medidas de suas diversas estruturas, por meio de ultrassonografia modo-B. Coletaram-se dados de biometria corporal com a finalidade de se verificar a existência de correlação linear significativa entre estas medidas e as mensurações obtidas ultrassonograficamente. Adicionalmente, efetuou-se avaliação hematológica e bioquímica sérica dos animais. Os achados ultrassonográficos foram equiparados aos existentes na literatura de cães domésticos devido à inexistência de dados publicados referentes a lobos-guarás. Esta espécie apresentou características muito semelhantes às do cão, diferindo nas ecogenicidades do baço e córtex renal esquerdo, no aspecto da região prostática, testicular e na morfologia da veia porta hepática. No presente estudo, os valores de biometria corporal foram semelhantes aos anteriormente publicados, porém não se encontraram dados na literatura referentes a perímetro torácico, comprimento vértice-caudal modificado e profundidade torácica para esta espécie de canídeo. A análise estatística revelou a existência de forte correlação negativa entre o comprimento vértice caudal modificado e o comprimento renal esquerdo, entre o comprimento vértice caudal modificado e o volume renal direito, entre o perímetro torácico e a altura do polo cranial da glândula adrenal esquerda e entre o perímetro torácico e a altura do polo caudal da glândula adrenal esquerda. Laboratorialmente, a contagem de neutrófilos segmentados, eosinófilos, monócitos e linfócitos e os níveis séricos de glicose, ALT, fosfatase alcalina, ureia, proteína total, globulina, creatina fosfoquinase, triglicérides, sódio, fosfato, potássio e cloreto foram discordantes de valores obtidos por outros autores. A ultrassonografia é um método de diagnóstico por imagem que necessita ser mais explorado na medicina de animais silvestres, sendo, portanto necessário o incremento de pesquisas nesta área.

Evolution of respiratory muscle strength in post-operative gastroplasty.

BACKGROUND: Obesity is a worldwide health problem that may also induce respiratory dysfunction. Literature linking weight loss and maximum respiratory pressures is inconclusive. OBJECTIVE: To evaluate longitudinally the maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP) of morbidly obese individuals before and after gastric bypass surgery, and to compare them to a control group matched by sex and age. METHODS: A vacuum manometer (GeRar®, SP, Brazil) was used to assess the MIP and MEP of 30 morbidly obese participants (24 women), aged 32±8 years and with body mass index (BMI) of 43±4 kg/m², both before and then one and six months after gastric bypass surgery. After an average of 36 months, 17 patients were reevaluated. A control group of 30 individuals with normal lung function (aged 30±8 with a BMI of 22±2 kg/m²) was also studied. An unpaired t-test and ANOVA for repeated measures were used for statistical analysis, with p<0.05 considered as significant. RESULTS: No significant differences were observed in the baseline evaluation between the two groups. A significant increase was found in MIP after approximately 36 months of surgery in the obese group. A significant decrease in MEP was observed after one month, as well as a significant increase after 36 months compared with one and six months post-surgery. CONCLUSION: The data showed a significant long-term increase in MIP, as well as a significant decrease in MEP after one month followed by a return to pre-operative values, which indicates that gastric bypass surgery has a positive influence on the strength of inspiratory muscles.

Evolution of respiratory muscle strength in post-operative gastroplasty / Evolução da força muscular respiratória no período pós-operatório de gastroplastia redutora

BACKGROUND: Obesity is a worldwide health problem that may also induce respiratory dysfunction. Literature linking weight loss and maximum respiratory pressures is inconclusive. OBJECTIVE: To evaluate longitudinally the maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP) of morbidly obese individuals before and after gastric bypass surgery, and to compare them to a control group matched by sex and age. METHODS: A vacuum manometer (GeRar®, SP, Brazil) was used to assess the MIP and MEP of 30 morbidly obese participants (24 women), aged 32±8 years and with body mass index (BMI) of 43±4 kg/m², both before and then one and six months after gastric bypass surgery. After an average of 36 months, 17 patients were reevaluated. A control group of 30 individuals with normal lung function (aged 30±8 with a BMI of 22±2 kg/m²) was also studied. An unpaired t-test and ANOVA for repeated measures were used for statistical analysis, with p<0.05 considered as significant. RESULTS: No significant differences were observed in the baseline evaluation between the two groups. A significant increase was found in MIP after approximately 36 months of surgery in the obese group. A significant decrease in MEP was observed after one month, as well as a significant increase after 36 months compared with one and six months post-surgery. CONCLUSION: The data showed a significant long-term increase in MIP, as well as a significant decrease in MEP after one month followed by a return to pre-operative values, which indicates that gastric bypass surgery has a positive influence on the strength of inspiratory muscles.

CONTEXTUALIZAÇÃO: A obesidade é um problema de saúde em todo o mundo e pode causar disfunção respiratória. A literatura que associa a perda de peso corporal às pressões respiratórias máximas (PRM) é inconclusiva. OBJETIVO: Avaliar, longitudinalmente, a pressão inspiratória máxima (PImáx) e a pressão expiratória máxima (PEmáx) de pacientes com obesidade mórbida antes e após gastroplastia redutora e compará-los a um grupo controle pareado por sexo e idade. MÉTODO: Um manovacuômetro (GeRar®, SP, Brasil) foi utilizado para avaliar PImáx e PEmáx de 30 participantes obesos (24 mulheres e seis homens, 32±8 anos), com índice de massa corporal (IMC) de 43±4 kg/m², antes da gastroplastia redutora e após um e seis meses. Após 36 meses, em média, foram reavaliados 17 obesos. Como grupo controle, foram avaliados 30 indivíduos com função pulmonar normal, 30±8 anos, e IMC de 22±2 kg/m². Para análise estatística, utilizou-se teste t de Student para grupos independentes e ANOVA para medidas repetidas. Um p<0,05 foi considerado significativo. Resultados: Não foram observadas diferenças significativas na avaliação inicial entre os dois grupos. Houve aumento significativo após 36 meses de cirurgia no grupo com obesidade em relação à PImáx. Em relação à PEmáx, houve diminuição significativa após um mês e aumento significativo após 36 meses, quando comparada com um e seis meses de cirurgia. CONCLUSÕES: Os dados demonstraram aumento significativo da PImáx em longo prazo, bem como redução significativa da PEmáx após um mês, seguido de um retorno aos valores de pré-operatório, indicando influência positiva da gastroplastia redutora sobre a força dos músculos inspiratórios.

Accuracy of preoperative biopsies compared with surgical specimens in the diagnosis of colorectal adenocarcinoma.

OBJECTIVE: Since the first data from a patient with colorectal adenocarcinoma are obtained by biopsy, this study evaluated the accuracy of diagnosis by biopsy as compared with the diagnostic potential of the surgical specimen, considering the histological type, grade of differentiation, and immunohistochemical expression of p53. METHODS: The specimens were obtained from 80 patients assisted at Hospital São Paulo. The biopsy and surgical specimen sections were stained by hematoxylin-eosin and immunohistochemistry and compared by 3 pathologists blinded to the evaluations. RESULTS: The accuracy for the histological types was 88%. The grade of differentiation presented an accuracy of 70% with Kappa = .48. The expression of protein p53 exhibited an accuracy of 68% with Kappa = .22. CONCLUSION: The preoperative biopsy of colorectal adenocarcinoma presented good accuracy compared with histopathological examination of the surgical specimen, but with weak to moderate effective degree of agreement between the results.

Use of Helicobacter pylori-specific antibodies in the evaluation of intestinal metaplasia and gastric dysplasia.

It is believed that Helicobacter pylori acts mainly during the initial phases of gastric carcinogenesis. Therefore, this study aims to assess the usefulness of H. pylori diagnosis in patients with chronic gastritis (CG), intestinal metaplasia (IM) and dysplasia--conditions that are associated with gastric cancer. A cross-sectional study of 94 patients was performed, which involved endoscopic biopsy and determination of specific serum anti-H. pylori antibodies (IgA, IgG and IgM) by enzyme-linked immunosorbent assay (ELISA). Biopsies were taken from the gastric antrum and corpus, and from endoscopic lesions. Two specimens per patient were used for bacterial culture. H. pylori infection status, used as the gold standard, was based on culture results. Validity measures were determined and receiver operating curve (ROC) was used to determine the best cut-off for serum antibody levels. Histopathological evaluation (n = 160) was performed independently by two pathologists. Lesions consistent with CG were found in 86 patients (91%), consistent with IM in 69 patients (73%) and with dysplasia in five patients (5%). In the 86 patients with CG, 38 (44%) were infected by H. pylori, as were 26 (38%) and one (20%) with IM and dysplasia, respectively (P=0.039). Area under the curve (AUC) was 0.40 (95% confidence interval [CI]: 0.28-0.51) for IgM, 0.69 (0.58-0.80) for IgA and 0.83 (0.74-0.92) for IgG for the diagnosis of H. pylori infection. Best cut-off was 41 u/mL for IgG, with a sensitivity (95% CI) of 90% (84-96%) and a negative predictive value (NPV) of 91% (85-97%). For IgA the results were 22 u/mL, 74% (65-83%) and 77% (68-86%), respectively. Prevalence of H. pylori appeared to decrease with increasing severity of the gastric lesion. In conclusion, it is suggested that non-invasive serological evaluation of anti-H. pylori (IgG) status after eradication therapy for peptic ulcer disease could be extended, after proper assessment of cut-off values and their validation, to the follow-up of patients with CG and IM.