Accidental Use of Milk With an Increased Concentration of Aflatoxins Causes Significant DNA Damage in Hospital Workers Exposed to Ionizing Radiation.

The occupational exposure to ionizing radiation (Irad) or associated with mycotoxin-contaminated food may lead to genome damage and contribute to health risk. DNA damage in 80 blood samples of hospital workers occupationally exposed to low-doses of Irad was compared with 80 healthy controls. Among them, 40 participants accidentally consumed milk with increased concentration of Aflatoxin. All participants underwent the testing for micronuclei from blood, and 40 of them 8-OHdG from urine. The frequency of micronuclei (MN) was analyzed by cytokinesis-block peripheral blood lymphocytes and the level of urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG) by ELISA. The Irad led to increased frequency of MN (p < 0.05) and 8-OHdG level at exposed hospital workers. The consumption of milk with increased concentration of aflatoxin probably raised MN frequency and 8-OHdG value. Higher consumption of aflatoxin-contaminated milk (≥2 L/monthly) caused significantly increased MN frequency and 8-OHdG value in comparison to lower milk intake (≤0.5 L/monthly). Also, confounding factors, such as age, gender, and smoking status of all participants were included in the study. The obtained results revealed an increased incidence of MN and 8-OHdG level among hospital workers exposed to low-doses of IRad and milk with increased aflatoxin concentration.

Enhanced Recovery in Surgical Intensive Care: A Review.

Patients are admitted to the surgical intensive care (SICU) unit after emergency and elective surgery. After elective surgery, for further support, or to manage coexisting comorbidities. The implementation of the ERAS (Enhanced recovery after surgery) protocols in surgery should decrease the need for ICU beds, but there will always be unpredicted complications after surgery. These will require individual management. What we can do for our surgical patients in ICU to further enhance their recovery? To promote early enhanced recovery in surgical intensive care-SICU, three areas need to be addressed, sedation, analgesia, and delirium. Tools for measurement and protocols for management in these three areas should be developed to ensure best practice in each SICU. The fourth important area is Nutrition. Preoperative screening and post-operative measurement of the state of nutrition also need to be developed in the SICU. The fifth important area is early mobilization. ERAS protocols encourage early mobilization of the critically ill patients, even if on mechanical ventilation. Early mobilization is possible and should be implemented by special multidisciplinary ICU team. All team members must be familiar with protocols to be able to implement them in their field of expertise. Personal and professional attitudes are critical for implementation. In the core of all our efforts should be the patient and his well-being.

ULTRASONOGRAPHIC EVALUATION OF THE RUPTURED MEDIAL HEAD OF GASTROCNEMIUS MUSCLE / AVALIAÇÃO ULTRASSONOGRÁFICA DA RUPTURA DA CABEÇA MEDIAL DO MÚSCULO GASTROCNÊMIO / EVALUACIÓN ULTRASONOGRÁFICA DE LA RUPTURA DE LA CABEZA MEDIAL DEL MÚSCULO GASTROCNEMIO

ABSTRACT Introduction: Tennis leg, a common injury of the medial head of gastrocnemius muscle in the muscle-tendon junction, is usually reported in men during recreational sports. Sudden pain is the main symptom accompanied by the feeling of rupture in the calf. Clinical examination followed by ultrasound is the standard diagnostic procedure. Objective: The main objectives of this study are to compare clinical and ultrasonographic findings in cases of tennis leg, evaluate the location and type of lesion in the medial head of gastrocnemius muscle, and evaluate the edema volume and the presence of deep vein thrombosis (DVT). Second, the healing process was monitored with ultrasound to distinguish the level of recovery and to record the presence of chronic sequelae. Methods: Eighty-one subjects with clinical symptoms of rupture of the medial head of gastrocnemius muscle participated in the study. A linear probe (7-12 MHz) was used for ultrasonographic (US) and a Doppler was used to verify the presence of DVT. Results: In 78 of 81 subjects examined, we found obvious US changes (96.3%) and three of them had no positive findings. In 67 of them, we diagnosed rupture of the medial head of the gastrocnemius muscle. Most of them had partial rupture (73.13%) and the remaining had total rupture (26.87%). The edema (30.84%) was found in the space between the aponeurosis of the gastrocnemius and soleus muscles. DVT with the clinical signs of tennis leg was observed in 5 of 81 patients (6.17%). Conclusion: Our findings indicate that ultrasound is very important for early diagnosis of muscle-tendon injuries in the leg. In addition, monitoring the healing process and assessing the chosen treatment showed a high efficiency. Ultrasonography is an effective method to identify and differentiate the sequelae of the injured muscles and vascular complications.

RESUMO Introdução: A "perna do tenista", lesão comum da cabeça medial do músculo gastrocnêmio na junção músculo-tendínea, em geral, é relatada em homens, durante a prática de esportes recreativos. A dor repentina é o principal sintoma, sendo acompanhada pela sensação de ruptura na panturrilha. O exame clínico seguido pelo exame de ultrassom é o procedimento diagnóstico padrão. Objetivo: Este estudo tem como principais objetivos comparar os achados clínicos e ultrassonográficos em casos de perna do tenista, avaliar a localização e o tipo da lesão na cabeça medial do gastrocnêmio e avaliar o volume do edema e a presença de trombose venosa profunda (TVP). Em segundo lugar, o processo de cicatrização foi monitorado com ultrassom para se distinguir o nível de recuperação e registrar a presença de sequelas crônicas. Métodos: Oitenta e um indivíduos com sintomas clínicos de ruptura da cabeça medial do gastrocnêmio participaram do estudo. Empregou-se uma sonda linear (7 a 12 MHz) para a avaliação ultrassonográfica (US) e Doppler para verificar a presença de TVP. Resultados: Em 78 dos 81 indivíduos examinados, foram encontradas alterações US evidentes (96,3%) e três deles não tiveram achados positivos. Em 67 pacientes, diagnosticamos ruptura da cabeça medial do músculo gastrocnêmio. A maioria deles apresentou ruptura parcial (73,13%) e os restantes tiveram ruptura total (26,87%). O edema (30,84%) foi encontrado no espaço entre a aponeurose dos músculos gastrocnêmio e sóleo. A TVP com sinais clínicos de perna do tenista foi verificada em 5 dos 81 pacientes (6,17%). Conclusão: Nossos achados indicam que o exame de ultrassom é muito importante para o diagnóstico precoce de lesões músculo-tendíneas no membro inferior. Além disso, constatou-se grande eficiência na monitoração do processo de cicatrização e na avaliação do tratamento aplicado. A ultrassonografia é um método efetivo para identificar e diferenciar as sequelas nos músculos lesionados e as complicações vasculares.

RESUMEN Introducción: La "pierna de tenista", lesión común de la cabeza medial del músculo gastrocnemio en la unión músculo-tendinosa, en general, es relatada en los hombres durante la práctica de deportes recreativos. El dolor repentino es el síntoma principal, acompañado de la sensación de ruptura en la pantorrilla. El examen clínico seguido de un examen de ultrasonido es el procedimiento de diagnóstico estándar. Objetivo: Los principales objetivos de este estudio son comparar los hallazgos clínicos y ultrasonográficos en los casos de pierna de tenista, evaluar la ubicación y el tipo de lesión en la cabeza medial del músculo gastrocnemio y evaluar el volumen del edema y la presencia de trombosis venosa profunda (TVP). En segundo lugar, el proceso de la curación se monitorizó con ultrasonido para diferenciar el nivel de reparación y registrar la presencia de secuelas crónicas. Métodos: Ochenta y un sujetos con síntomas clínicos de ruptura de la cabeza medial del gastrocnemio participaron en el estudio. Se empleó una sonda lineal (7-12 MHz) para ultrasonografía (US) y Doppler para verificar la presencia de TVP. Resultados: En 78 de los 81 sujetos examinados, fueron encontrados cambios obvios en el US (96,3%) y tres de ellos no presentaran casos positivos. En 67 pacientes hemos diagnosticado ruptura de la cabeza medial del músculo gastrocnemio. La mayoría de ellos presentó ruptura parcial (73,13%) y los restantes tuvieron ruptura total (26,87%). El edema (30,84%) se encontró en el espacio entre la aponeurosis de los músculos gastrocnemio y sóleo. Se observó TVP con los signos clínicos de la pierna de tenista en 5 de 81 pacientes (6,17%). Conclusión: Nuestros hallazgos indican que la ultrasonografía es muy importante para el diagnóstico precoz de las lesiones músculo-tendinosas de la pierna. Además, hubo gran eficiencia en el monitoreo de la curación y la evaluación del tratamiento aplicado. La ultrasonografía es un método efectivo para identificar y diferenciar las secuelas en los músculos lesionados y complicaciones vasculares.

[Parameters of Anaerobic Physiological Profile of Elite Athletes].

INTRODUCTION: Anaerobic capacity is much less evaluated in literature compared to aerobic component. Anaerobic performance of athletes can be measured using different motoric tests, lasting 20 to 30 seconds, one of them being the Wingate anaerobic test (WAnT). OBJECTIVE: The aim of this study was to determine the work performed and power generated by athletes and non-athletes during a 30-second high intensity exercise, as well as to compare explosive characteristics of subjects using a new parameter of WAnT, named explosive power, or slope of power. METHODS: All parameters of anaerobic power were investigated in 152 subjects classed into different groups depending on their physical fitness and sport specialties as follows: non-athletes (n=31), rowers (n=26), volleyball players (n=37), handball players (n=34) and judo players (n=24). The WAnT, as well as basic anthropometric measurements, was administrated to all participants. RESULTS: Values of anaerobic parameters were higher in the group of athletes compared to physically inactive subjects.The highest values of the WAnT parameters were registered in the group of volleyball players (AP=1 006 W; relative AP=11.4 W/ kg, AC=19.8 kJ), compared to athletes of other sport disciplines (volleyball, rowing and judo). The new parameter of the WAnT, explosive power, also showed highest values in volleyball players (EP=1 54 W/s; relative EP=1.74 W/s/kg). These differences were statistically significant (p<0.05). CONCLUSION: The results of laboratory tests can provide useful information on improvements in training processes. The new parameter of the WAnT could be implemented in further analyses of explosive characteristics of muscle contraction.