Inspiratory Muscle Training in Phase 1 and 2 Postoperative Cardiac Rehabilitation Following Coronary Artery Bypass Graft Surgery: Systematic Review with Meta-Analysis.

OBJECTIVE: This study aimed to determine the effects of inspiratory muscle training (IMT) on exercise capacity, respiratory muscle strength, length of hospital stay (LOS), and quality of life (QOL) following coronary artery bypass graft surgery. METHODS: The search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the Cochrane Handbook and included the databases MEDLINE, EMBASE, CINAHL, Scopus, and CENTRAL. The review included randomized controlled trials utilizing IMT during phase 1 or 2 postoperative cardiac rehabilitation (PoCR) versus alternative treatment (active or passive control) in patients following coronary artery bypass graft surgery. RESULTS: Fifteen studies were included (11 phase 1 studies, 4 phase 2 studies) with no reported adverse events. In phase 1 PoCR, IMT reduced the LOS (-1.02 days; 95% CI = -2.00 to -0.03) and increased exercise capacity (6-minute walk distance [6MWD]).(+75.46 m; 95% CI = 52.34 to 98.57), and maximal inspiratory pressure (MIP) (10.46 cm H2O; 95% CI = 2.83 to 18.10), but had no effect on maximal expiratory pressure. In phase 2 PoCR, IMT increased 6MWD (45.84 m; 95% CI = 10.89 to 80.80), MIP (-23.19 cm H2O; 95% CI = -31.31 to -15), maximal expiratory pressure (20.18 cm H2O; 95% CI = 9.60 to 30.76), and QOL (-11.17; 95% CI = -17.98 to -4.36), with no effect on peak oxygen uptake. There was a high risk of bias for MIP (75% of the phase 1 studies) and 6MWT (1 of 4 phase 2 studies). The quality of the evidence ranged from very low to moderate. CONCLUSIONS: IMT significantly improves exercise capacity, respiratory muscle strength, LOS, and QOL in phase 1 and 2 PoCR. IMPACT: IMT may benefit patients during phase 1 and 2 of PoCR, considering the safety, low cost, and potential benefits.

Follicular Dynamics and Pregnancy Rate in Nellore Heifers Submitted to Fixed-Time Artificial Insemination Protocols (FTAI).

This study aimed to evaluate follicular dynamics and pregnancy rates in Nellore heifers submitted to fixed-time artificial insemination (FTAI) protocols associated with equine chorionic gonadotrophin (eCG) or follicle stimulating hormone (FSH). Nellore heifers (n = 259) were used, divided into two studies. Experiment I evaluated the ovarian follicular dynamics in 64 Nellore heifers submitted to different FTAI protocols (n = 32/group) using either FSH or eCG. In Experiment II, the pregnancy rate was evaluated in 195 heifers submitted to FTAI protocols and divided into two groups: FSH (n = 97) and eCG (n = 98). In Experiment I, the ultrasound examination showed that the maximum diameter of the dominant and preovulatory follicles and the ovulation time were similar between the FSH and eCG groups (p > 0.05). However, the ovulation rate was higher in the eCG group when compared to FSH (p = 0.014). In Experiment II, females that received eCG presented a higher pregnancy rate (58.1%) when compared to FSH (40.2%) (p = 0.012). The use of eCG in the FTAI protocol in Nellore heifers promoted a higher ovulation rate and increased pregnancy rate and may be the most suitable alternative to increase conception rates in animals that are raised in an extensive system under tropical conditions in the Amazon.

Effect of different cryopreservation extenders added with antioxidants on semen quality and in vitro embryo production efficiency in cattle.

To evaluate the addition of antioxidants in extenders on post-thaw bovine semen quality and in vitro embryo production efficiency. Six semen samples were collected from five Holstein bulls. In the experiment I, the samples were diluted with AndroMed® and Bovimix® and added antioxidants glutathione (1.5 and 2.5 mM) and melatonin (0.5 and 1.0 mM). In the experiment II, the best treatments obtained in experiment I were used for in vitro fecundation. Glutathione did not improve sperm viability. Melatonin had a negative effect on semen characteristics. Andromed® showed better results in sperm kinetics parameters. Bovimix® was more efficient in maintaining cell integrity parameters. Significant correlation was found between sperm kinetics parameters and between cell integrity parameters. For in vitro embryo production, after oocyte selection, maturation, fertilization and cultivation were performed using the four treatments previously evaluated. Andromed® was more efficient in the cleavage rate, no effect of the addition of glutathione. However, the addition of 2.5 mM glutathione in the Bovimix® improved the cleavage rate. There was a significant moderate correlation between cleavage rate and sperm kinetic characteristics. Glutathione did not improve sperm viability. Melatonin reduced the maintenance of sperm characteristics. Andromed® was more efficient in in vitro embryo production and no effect of glutathione was found in this extender. Addition of 2.5 mM glutathione in the Bovimix® extender provided a higher cleavage rate.

Decision support system for management of reactive nitrogen flows in wastewater system.

The change in nitrogen balance causes many environmental and socioeconomic impacts. In relation to food production and nitrogen release in wastewater systems, wastewater and sludge discharge and mineral fertilizer use intensify nitrogen imbalance of a region. The replacement of mineral fertilizer by nitrogen from treated wastewater, biosolids, and treated urine is a promising alternative. This work presents a model to support decision taking for the management of reactive nitrogen flows in wastewater systems based on system dynamics. Six scenarios were simulated for nitrogen flows in wastewater systems and related components.

Biomonitoring of gasoline station attendants exposed to benzene: Effect of gender.

Women are employed in increasing numbers as gasoline station attendants, a work category with risk of exposure to benzene. We have assessed the effect of gender on biomarkers of occupational benzene exposure. Gasoline station attendants (20 men and 20 women) and 40 control individuals (20 men and 20 women) with no history of occupational benzene exposure were evaluated. Benzene exposure was monitoring by environmental and biological measurements. Urinary trans,trans-muconic acid levels, well-known genetic and hematological alterations linked to benzene exposure, and non-cancer effects on the immune, hepatic, and renal systems were investigated. Our results suggest a potential effect of gender on some effects of occupational benzene exposure, particularly the hematological parameters and trans,trans-muconic acid levels. Despite limitations of our study, our findings provide important considerations about occupational exposure of women to benzene and may contribute to the development of occupational protection standards.

Relaxin affects cell organization and early and late stages of spermatogenesis in a coculture of rat testicular cells.

Relaxin and its receptor RXFP1 are co-expressed in Sertoli cells, and relaxin can stimulate proliferation of Sertoli cells. In this study, we investigated a role of relaxin in spermatogenesis, using a short-term culture of testicular cells of the rat that allowed differentiation of spermatogonia to spermatids. Sertoli, germ, and peritubular myoid cells were the predominant cell types in the culture. Sertoli and germ cells expressed RXFP1. Cultures were incubated without (control) or with 0.5% fetal bovine serum (FBS) or 100 ng/mL H2 relaxin (RLN) for 2 days. Cell organization, number, and differentiation were analyzed after 2 (D2), 5 (D5) or 8 (D8) days of culturing. Although the proportion of germ cells decayed from D2 to D5, the relative contribution of HC, 1C, 2C, and 4C germ cell populations remained constant in the control group during the whole culture. RLN did not affect the proportion of germ cell populations compared with control, but increased gene and/or protein expression of the undifferentiated and differentiated spermatogonia markers PLZF and c-KIT, and of the post-meiotic marker Odf2 in D5. RLN favored organization of cells in tubule-like structures, the arrangement of myoid cells around the tubules, arrangement of c-KIT-positive spermatogonia at the basal region of the tubules, and expression of the cell junction protein ß-catenin close to the plasma membrane region. Knockdown of relaxin with small interfering RNA (siRNA) reduced expression of ß-catenin at the cell junctions, and shifted its expression to the nucleus. We propose that relaxin may affect spermatogenesis by modulating spermatogonial self renewal and favoring cell contact.

Physiological characteristics of top level off-road motorcyclists.

OBJECTIVES: The study aims to analyse the physiological characteristics of top level off-road motocross, enduro, and desert rally motorcyclists to facilitate the design of a specific training program. METHODS: Twenty seven off-road top level riders participated in this study which measured anthropometric data, maximum aerobic power with incremental tests of both arms and legs, isokinetic dynamometry of the knee and elbow, handgrip strength, heart rate, and blood lactate concentrations during competition. RESULTS: The physical demands of the various races appear to influence the development of distinct musculoskeletal characteristics, as well as aerobic and anaerobic metabolism. Motocross riders have more muscle mass, higher isokinetic handgrip strength, and greater aerobic power than enduro and desert rally riders. However, there are no significant anthropometric and physiological differences between desert rally and enduro riders. Desert rally riders tend to be overweight with maximum aerobic power similar to that of healthy individuals. The mechanical characteristics of the motorcycle and the technical and tactical skills of the riders seem to be more important for race success than the metabolic capabilities of the rider. CONCLUSIONS: Desert rally and enduro riders present similar anthropometric and physiological characteristics. Both have a maximum aerobic power similar to that of healthy normal individuals, although desert rally riders tend to be overweight. Motocross riders on the other hand, have more muscle mass, more strength, and greater aerobic power. The differences observed suggest the need for a specific training program to address the requirements of different riders to reduce the possibility of injury.

Microplacas e parafusos autoperfurantes na osteotomia Le Fort I em cirurgia ortognática bimaxilar / Micro Le Fort I plates in bimaxillary orthognathic surgery

Comparando, quanto á estabilidade dos resultados obtidos, a fixação por meio de fios de aço versus miniplacas e parafusos nas osteotomias tipo Le Fort I da maxila, após revisão da literatura, conclui-se indubitavelmente pela superioridade dos últimos. Por outro lado, em cirurgias ortognáticas bimaxilares, essa estabilidade, condição sine qua non para o êxito das intervenções, pode ser comprometida, quando maior a movimentação óssea maxilomandibular. Os autores testaram um novo sistema modular de 1,5 mm de titânio, com parafusos autoperfantes, denominado Microplacas de Lindorf, específico para osteotomias tipo Lê Fort I, inédito na literatura e que, pela sua morfologia, apresentação e facilidade de aplicação, além de diminuir o tempo cirúrgico, vem trazer resultados clínicos promissores quanto á estabilidade a longo prazo. Gebrüder Martin – Alemanha – Implamend-Implantes Especializados.

As for the stability of teh results obtained in Le Fort I osteotomy of maxilla, concerning fixation versus miniplates and screws, after literature review, the conclusion was clearly by the superiority of the latter. On the hand, in bimaxillary orthognathic sugery, this stability is a necessary condition for the success of surgical interventions and can compromise its results depending on the amplitude of bone’s movements. Because of this, the authors tested a new modular system of 1.5 mm with titanium autodrilled screws, called Lindof Micro Le Fort I Plates, specific for osteotomies type Le Fort I – unheard of until now – and, by its morphology, appearance, easiness of employment and reduced surgical time, the results expected from this new material will be, in long term, highly compensationg.

Outpatient thyroidectomy.

In current clinical practice, the concept of outpatient surgery could apply to thyroidectomy. As the thyroid is anatomically accessible, its removal is not physiologically disabling; it makes surgery safer and precludes hospitalization. To evaluate the feasibility and solidity of outpatient thyroidectomy (OPT), the authors conducted a 12 1/2-year study (1982-1994), including an earlier 4-year randomized trial on 309 and cumulative posttrial experiences in 869 cases. The results showed the safety, practicality, and efficacy of OPT as compared with standard thyroidectomy. The study confirms the validity of OPT and is suggested for selected patients with thyroid disease.