Physical Capacities and Combat Performance Characteristics of Male and Female Olympic Boxers.

Purpose: The study characterized the anthropometrical and cardiorespiratory profile, and the cardiorespiratory, bio-chemical and immunological responses to 3 × 3 min round (R) free-contact/combat boxing simulation, in elite Olympic Boxers (4 female and 10 male). Methods: The evaluation consisted of resting metabolic rate, anthropometric measurement, maximal graded test exercise (visit 1), free combat simulation (3 × 3 min R, 1 minute rest), and blood samples collected before, during and after the combat (visit 2). Results: Respectively, females and males had (mean±SD; or median: for non-parametric data) body fat percentage (17.2[3.5] and 4.6[0.8]%), predominantly mesomorphic somatotyping, and V˙O2MAX (50.0 ± 2.5 and 56.2 ± 5.2 ml.kg-1.min-1). The free combat simulation resulted in high cardiovascular strain [mean heart rate corresponding to R1: 92 ± 3; R2: 94 ± 2; and R3: 95 ± 2% of maximal HR] and blood chemistry indicative of acidosis (following R3: 7.21 ± 0.08 pH, bicarbonate 13.1 ± 3.6 mmol.L-1, carbon dioxide 13.9 ± 3.8 mmol.L-1, lactate 15.1 ± 3.8 mmol.L-1, and glucose 8.4 ± 1.3 mmol.L-1). Further, notable general catabolism, hematological and immune responses were evident post combat simulation (1-hour post R3: creatinine 95.2 ± 14.5 µmol.L-1, urea 6.4 ± 1.3 mmol.L-1, white blood cell accumulation 7.8 ± 2.6 × 109.L-1, hemoglobin 14.9 ± 0.8 g.dL-1 and hematocrit 43.7 ± 1.9%). Conclusions: Notable cardiovascular strain and acidosis are seen from the 3 × 3 free combat simulation whilst pronounced catabolism and immune responses are evident 1-hour post R3. This characterization is the first in male and female (who recently adopted the 3 × 3 min R format, as used by males) elite Olympic boxers and provides a characterization framework to assist practitioners and athletes in their attempts to deliver evidence-informed practice for specific conditioning session design.

Biological and behavioral features and colonization of the sylvatic mosquito Sabethes identicus (Diptera: Culicidae).

Mosquitoes of the genus Sabethes are exclusively sylvatic species occurring in Central and South Americas, where they play a role in the transmission of arbovirus. Sabethes identicus, a common bamboo-breeder species, has been found naturally infected with yellow fever virus. Our study aimed to describe biological and behavioral features of Sa. identicus in the laboratory, as well as establish and standardize an isolated colony for experimental assays. We tested different larval densities and evaluated larval and pupal development time, oviposition behavior, egg production, and longevity. We also shot and video-documented bionomics and behavioral aspects of the mosquitoes in the field and laboratory. A colony with more than 30 generations was achieved. Embryogenesis of Sa. identicus is completed in about three days with a 79% hatch rate, while larval and pupal development takes approximately 15-17 and nine days, respectively. The mosquito's entire life cycle lasts approximately 30 days. Adult females could survive 71 days, and each individual laid an average of 88 eggs over their lifetime; 50% of females and males survived 37 and 24 days, respectively. Hematophagy peaks as early as the first week of emergence. The net content of a bamboo internode influenced the choice for oviposition, with the average number of eggs laid in those containing rearing water with larval and pupal exuviae being significantly higher than when they had only dechlorinated water or water with yeast. We documented for the first time an ecological association of weevils and Sa. identicus, where the oviposition of the latter depends on the weevil creating a hole in the bamboo wall for egg-laying purposes. Video recordings revealed for the first time the peculiar movements of gravid females during egg-throwing into tiny bamboo holes, as well as the laborious escape of newly emerged adults from the bamboo cavity, and mating behavior.

Back to Where It Was First Described: Vectors of Sylvatic Yellow Fever Transmission in the 2017 Outbreak in Espírito Santo, Brazil.

Evidence of sylvatic yellow fever was first reported in Atlantic Forest areas in Espírito Santo, Brazil, during a yellow fever virus (YFV) outbreak in 1931. An entomological survey was conducted in six forest sites during and after an outbreak reported ~80 years after the last case in the area. Among 10,658 mosquitoes of 78 species, Haemagogus leucocelaenus, and Hg. janthinomys/capricornii were considered the main vectors as they had a relatively high abundance, co-occurred in essentially all areas, and showed high YFV infection rates. Sabethes chloropterus, Sa. soperi, Sa. identicus, Aedes aureolineatus, and Shannoniana fluviatilis may have a secondary role in transmission. This is the first report of Sa. identicus, Ae. aureolineatus, and Sh. fluviatilis infected with YFV. Our study emphasizes the importance of entomological monitoring and maintenance of high vaccination coverage in receptive areas to YFV transmission.

Redescription of Wyeomyia (Decamyia) felicia (Dyar amp; Nez Tovar, 1927) and description of a new species of the subgenus from Trinidad (Diptera: Culicidae).

Mosquito species of the subgenus Decamyia Dyar, 1919 of genus Wyeomyia Theobald, 1901 are known to have immature stages mostly associated with Heliconia plants. Currently, the subgenus includes five species, some of which are poorly characterized. Here, we redescribe and illustrate the larval, pupal and adult life stages of Wy. felicia (Dyar Nez Tovar, 1927). In addition, Wyeomyia monticola, a new species of Decamyia from Trinidad, close to Wy. felicia, is described. The new species can be distinguished by morphological characters of the male genitalia, larva and pupa.

Creatine and creatinine quantification in olympic athletes: dried blood spot analysis pilot study.

Capillary dried blood spot (DBS) samples facilitate field-based collection without venipuncture. This pilot study aims to evaluate the viability of creatine (Cr) and creatinine (Crt) quantification using fresh capillary serum (CrS/CrtS) and DBS samples (CrDBS/CrtDBS), using Flow Injection Analysis Mass Spectrometry (FIA - MS). Nine Olympic Athletes provided a capillary blood sample to assess CrS/CrtS and CrDBS/CrtDBS quantified by FIA - MS. No difference between CrtS (mean ± SD: 813.6 ± 102.4 µmol/L) and CrtDBS (812.4 ± 108.1 µmol/L) was observed with acceptable variance [SEM 88.7; CV 10.7%; ICC 0.57 (CI 95% 0.06 - 0.84)] and agreement [very strong (Spearman: r = 0.77; p < 0.01) or strong (Pearson: r = 0.56; p = 0.04); Bland Altman: lower (-193) and upper (+196) limits of agreement]. CrS (mean ± SD: 691.8 ± 165.2 µmol/L) was significantly different to CrDBS (2911 ± 571.4 µmol/L) with unacceptable variance [SEM 171.6; CV 27%; ICC 0.002 (CI 95% -0.02 - 0.07)] and 'weak' agreement [Spearman: r = 0.21, p = 0.47 and Pearson: r = 0.06, p = 0.84; Bland Altman lower (-3367) and upper (-1072) limits of agreement]. Crt quantification is viable using both CrtS and CrtDBS (but not for Cr and CrS/CrDBS), with the DBS tissue handling technique offering several methodological and practice facing advantages. Future work should expand upon the sample size, explore sport/discipline relevant analytes across a full competitive season, including key training, recovery and performance blocks of their periodized performance plan.

New Predictive Resting Metabolic Rate Equations for High-Level Athletes: A Cross-Validation Study.

PURPOSE: The present study aims a) to assess the agreement between the measured resting metabolic rate (RMR) using indirect calorimetry and different predictive equations (predicted RMR), and b) to propose and cross-validate two new predictive equations for estimating the RMR in high-level athletes. METHODS: The RMR of 102 athletes (44 women) was assessed using indirect calorimetry, whereas the body composition was assessed using skinfolds. Comparisons between measured and predicted RMR values were performed using one-way ANOVA. Mean difference, root mean square error (RMSE), simple linear regression, and Bland-Altman plots were used to evaluate the agreement between measured and predicted RMR. The accuracy of predictive equations was analyzed using narrower and wider accuracy limits (±5% and ±10%, respectively) of measured RMR. Multiple linear regression models were employed to develop the new predictive equations based on traditional predictors (equation 1) and the stepwise method (equation 2). RESULTS: The new equations 1 and 2 presented good agreement based on the mean difference (3 and -15 kcal·d -1 ), RMSE (200 and 192 kcal·d -1 ), and R2 (0.71 and 0.74), respectively, and accuracy (61% of subjects between the limit of ±10% of measured RMR). Cunningham's equation provided the best performance for males and females among the existing equations, whereas Jagim's equation showed the worst performance for males (mean difference = -335 kcal·d -1 ; RMSE = 386 kcal·d -1 ). Compared with measured RMR, most predictive equations showed heteroscedastic distribution (linear regression's intercept and slope significantly different from zero; P ≤ 0.05), mainly in males. CONCLUSIONS: The new proposed equations can estimate the RMR in high-level athletes accurately. Cunningham's equation is a good option from existing equations, and Jagim's equation should not be used in high-level male athletes.

Epilepsia y TDAH / Epilepsy and ADHD

La epilepsia engloba un conjunto de trastornos convulsivos heterogéneos, con diversas características clínicas que excluyen un mecanismo etiológico singular. Individuos con epilepsia presentan una tasa significativamente mayor de condiciones psiquiátricas y neurológicas asociadas. Niños con epilepsia tienen dos a tres veces más riesgo de desarrollar trastornos por déficit de atención e hiperactividad (TDAH) cuando son comparados con individuos sanos, mientras que uno de cada cinco adultos epilépticos presentan síntomas de TDAH. En los niños con epilepsia, la gravedad y frecuencia de las crisis y una edad más temprana de inicio de las crisis son factores de riesgo comunes para padecer TDAH. Se realizó una revisión narrativa de la literatura y se seleccionaron artículos publicados en el periodo entre el año 2003 y 2021 en bases digitales del área de la salud (LILACS, Medline, Web of Science, SciELO y PubMed). La revisión evidenció que la epilepsia puede aumentar el riesgo de desarrollar TDAH en los niños, y que la epilepsia rolándica benigna es el tipo más diagnosticado en estos niños, que incluso tiene alta tasa de trastornos neuroconductuales con síntomas de TDAH asociados. El diagnóstico temprano y un manejo apropiado, llevan a mejor pronóstico en este grupo de pacientes

Epilepsy encompasses a set of heterogeneous seizure disorders, with various clinical characteristics that exclude a unique etiological mechanism. Individuals with this disease have a significantly higher rate for the development of psychiatric and neurological conditions. Children with epilepsy have two to three times increased risk of developing ADHD when compared to healthy individuals, while one in five epileptic adults have ADHD symptoms. In children with epilepsy, the severity and frequency of seizures and an earlier age at the onset of seizures are common risk factors for ADHD. A narrative review of the literature was carried out and articles published in the period between 2003 and 2021 in digital databases of the health area (LILACS, Medline, Web of Science, SciELO and PubMed) were selected. The review showed that epilepsy can increase the risk of developing ADHD in children, and that benign rolandic epilepsy is the most diagnosed type in these children, which even has a high rate of neurobehavioral disorders with associated ADHD symptoms. Early diagnosis and appropriate management lead to a better prognosis in this group of patients.

Maximal and Submaximal Cardiorespiratory Responses to a Novel Graded Karate Test.

The present study aimed to propose and assess the physiological responses of a novel graded karate test. Ten male national-level karate athletes (age 26 ± 5 yrs; body mass 69.5 ± 11.6 kg; height 1.70 ± 0.09 m) performed two exercise tests (separated by 2-7 days): 1) a running-based cardiopulmonary exercise test; 2) a graded karate test. The cardiopulmonary exercise test was comprised of an individualized ramp protocol for treadmill running, and the graded karate test was comprised of a sequence of 'kisami-gyaku-zuki" punching at a fixed frequency of a stationary target that becomes progressively distant. Cardiorespiratory responses, blood lactate concentration, and perceived exertion were measured. A verification phase was also performed in both tests to confirm the maximal physiological outcomes. The graded karate test evoked similar maximal responses to the running protocol: V̇O2 (57.4 ± 5.1 vs 58.3 ± 3.5 mL·kg-1·min-1; p = 0.53), heart rate (192 ± 6 vs 193 ± 10]beats.min-1; p = 0.62) and blood lactate (14.6 ± 3.4 vs 13.1 ± 3.0 mmol·L-1; p = 0.14) with a shorter duration (351 ± 71 vs 640 ± 9 s; p < 0.001). Additionally, the graded karate test evoked higher V̇O2 (72.6 ± 6.5 vs 64.4 ± 4.3 %V̇O2MAX; p = 0.005) and heart rate (89.4 ± 4.6 vs 77.3 ± 7.2 %HRMAX p < 0.001) at the ventilatory threshold and a higher heart rate (97.0 ± 2.4 vs 92.9 ± 2.2 %HRMAX; p = 0.02) at the respiratory compensation point. Incremental and verification phases evoked similar responses in V̇O2 and minute-ventilation during both tests. This novel displacement-based sport-specific test evoked similar maximal and higher submaximal responses, indicating a superior pathway to assess karate athletes.

New Predictive Resting Metabolic Rate Equations for High-Level Athletes: A Cross-validation Study.

PURPOSE: The present study aims a) to assess the agreement between the measured resting metabolic rate (RMR) using indirect calorimetry and different predictive equations (predicted RMR), and b) to propose and cross-validate two new predictive equations for estimating the RMR in high-level athletes. METHODS: The RMR of 102 athletes (44 women) was assessed using indirect calorimetry, while the body composition was assessed using skinfolds. Comparisons between measured and predicted RMR values were performed using one-way ANOVA. Mean difference, Root Mean Square Error, Simple Linear Regression, and Bland-Altman plots were used to evaluate the agreement between measured and predicted RMR. The accuracy of predictive equations was analyzed using narrower and wider accuracy limits (±5% and ± 10%, respectively) of measured RMR. Multiple linear regressions models were employed to develop the new predictive equations based on traditional predictors (Equation 1) and the stepwise method (Equation 2). RESULTS: The new Equations 1 and 2 presented good agreement based on the mean difference (3 and -15 kcal.d-1), RMSE (200 and 192 kcal.d-1), and R2 (0.71 and 0.74), respectively, and accuracy (61% of subjects between the limit of ±10% of measured RMR). Cunningham's equation provided the best performance for males and females among the existing equations, whereas Harris & Benedict's equation showed the worst performance for males (mean difference = 406 kcal.d-1; RMSE = 473 kcal.d-1). Compared to measured RMR, most predictive equations showed heteroscedastic distribution (linear regression's intercept and slope significantly different from zero; p ≤ 0.05), mainly in males. CONCLUSIONS: The new proposed equations can estimate the RMR in high-level athletes accurately. Cunningham's equation is a good option from existing equations, and Harris & Benedict's equation should not be used in high-level male athletes.

Covid-19 and its effect on olympic sport: the importance of studying social isolation and the harm it causes, in order to minimize it / Covid-19 e seu efeito no esporte olímpico: a importância de estudar o isolamento social e seus danos a fim de minimizá-los / Covid-19 y su efecto en el deporte olímpico: la importancia de estudiar el aislamiento social y sus daños a fin de minimizarlos

ABSTRACT In March 2020, the World Health Organization (WHO) declared the disease caused by the SARS-CoV2 virus, known as COVID-19, to be a pandemic. The sporting world, too, is suffering from the global effects of this disease, with the postponement or cancellation of competitions, including the 2020 Tokyo Olympic Games. As a proposal for containing the disease, social isolation was declared. Despite the importance of this measure, it was harmful for Olympic athletes, as they had to stay away from their training site and trainers, as well as their interdisciplinary teams. It is therefore important to study this harm caused, in order to minimize it. In general, it is believed that regular physical activity is associated with improved immune system functioning. The lack of training can therefore have significant consequences for the performance and health of the Olympic athlete. From the athlete's point of view, the impaired immune system, due to the reduced frequency of physical exercise, leaves them more vulnerable to contracting or developing infections or other diseases. The risk of harm due to the decreased performance of preventive works is also evident in this population. The reductions in training load and intensity can cause changes in the athlete's body composition and affect various aspects of cardiorespiratory fitness, as well as reducing strength levels and muscle potency. In relation to the athlete's mental health, two aspects are particularly challenging: isolation and uncertainty. Based on the possible harm caused by social isolation, the need is seen for a specific and joint work, in an attempt to minimize it. This work addresses the following topics: (I) context: transmission, symptoms, diagnosis, treatment, discharge criteria, isolation and post-pandemic consequences; (II) harm and proposals: nutritional, physiological, biomechanical and psychological. Level of evidence II; Review Article.

RESUMO Em março de 2020, a Organização Mundial da Saúde (OMS) declarou como pandemia a doença causada pelo vírus SARS-CoV2, conhecida como COVID-19. O mundo do esporte acompanha e sofre os efeitos globais dessa enfermidade, com o adiamento ou cancelamento de competições, inclusive os Jogos Olímpicos de Tóquio 2020. Como proposta para contenção da doença, foi determinado o isolamento social. Apesar de importante, esta medida traz danos aos atletas olímpicos pelo afastamento do local de treinamento e de treinadores, assim como de sua equipe interdisciplinar. Portanto, entende-se a importância de estudar esses danos a fim de minimizá-los. De forma geral, acredita-se que a atividade física regular esteja associada à melhora do funcionamento do sistema imunológico. Assim, a falta de treinamento pode levar a consequências importantes para o desempenho e a saúde do atleta olímpico. Do ponto de vista da saúde do atleta, o comprometimento do sistema imunológico pela redução da regularidade do exercício físico deixa o atleta mais vulnerável a contrair e desenvolver infecções ou outras patologias. Além disso, o risco de lesões considerando a diminuição da realização dos trabalhos preventivos é evidente nessa população. As reduções da carga e da intensidade de treino podem provocar mudanças na composição corporal do atleta e afetar diversos componentes da aptidão cardiorrespiratória, assim como reduzir níveis de força e potência muscular. Com relação à saúde mental do atleta, dois aspectos são os mais desafiadores: o isolamento e a incerteza. A partir dos possíveis danos causados pelo isolamento social, entende-se a necessidade de um trabalho específico e em conjunto, na tentativa de minimizá-los. Neste trabalho serão abordados os seguintes tópicos: (I) contexto: transmissão, sintomas, diagnóstico, tratamento, critérios de alta, isolamento e consequências pós-pandemia; (II) danos e propostas: nutricionais, fisiológicas, biomecânicas, bioquímicas e psicológicas. Nível de evidência II; Artigo de Revisão.

RESUMEN En marzo de 2020, la Organización Mundial de la Salud (OMS) declaró como pandemia a la enfermedad causada por el virus SARS-CoV2, conocida como COVID-19. El mundo del deporte acompaña y sufre los efectos globales de esa enfermedad, con la postergación o cancelación de competiciones, inclusive los Juegos Olímpicos de Tokio 2020. Como propuesta para contención de la enfermedad, se determinó el aislamiento social. A pesar de importante, esta medida trae daños a los atletas olímpicos por el alejamiento del local de entrenamiento y de entrenadores, así como de su equipo interdisciplinario. Por lo tanto, se entiende la importancia de estudiar esos daños a fin de minimizarlos. De forma general, se cree que la actividad física regular esté asociada a la mejora del funcionamiento del sistema inmunológico. Así, la falta de entrenamiento puede llevar a consecuencias importantes para el desempeño y la salud del atleta olímpico. Desde el punto de vista de la salud del atleta, el compromiso del sistema inmunológico por la reducción de la regularidad del ejercicio físico deja al atleta más vulnerable a contraer y desarrollar infecciones u otras patologías. Además, el riesgo de lesiones considerando la disminución de la realización de los trabajos preventivos es evidente en esa población. Las reducciones de la carga y de la intensidad de entrenamiento pueden provocar cambios en la composición corporal del atleta y afectar diversos componentes de la aptitud cardiorrespiratoria, así como reducir niveles de fuerza y potencia muscular. Con relación a la salud mental del atleta, dos aspectos son los más desafiantes: el aislamiento y la incertidumbre. A partir de los posibles daños causados por el aislamiento social, se entiende la necesidad de un trabajo específico y en conjunto, en la tentativa de minimizarlos. En este trabajo serán abordados los siguientes tópicos: (I) contexto: transmisión, síntomas, diagnóstico, tratamiento, criterios de alta, aislamiento y consecuencias postpandemia; (II) daños y propuestas: nutricionales, fisiológicas, biomecánicas, bioquímicas y psicológicas. Nivel de evidencia II; Artículo de Revisión.

High Speed Video Documentation of the Mosquito Sabethes albiprivus Egg-Catapulting Oviposition Behavior (Diptera: Culicidae).

The oviposition behavior of mosquitoes varies between species. We documented the unusual mechanism of egg laying in the mosquito Sabethes albiprivus Theobald with the aid of high speed video recordings in the laboratory. A sapucaia (Lecythis pisonis Camb.) nut oviposition trap, described herein, was used to simulate a tree hole with a small opening, which is the natural larval habitat of Sa. albiprivus. We showed that females approach the opening and perform a sequence of rapid, short up-and-down flights before egg laying. At this time, the egg is already visible externally, being held at the very tip of the abdomen. Females catapult one egg at a time by rapidly curling their abdomen downward, sending the egg through the opening while their legs are positioned in different configurations throughout the event. The estimated velocity of the catapulted eggs was almost 1 m/s.

Vertebrate Hosts of Aedes aegypti, Aedes albopictus, and Culex quinquefasciatus (Diptera: Culicidae) as Potential Vectors of Zika Virus in Florida.

Zika virus (ZIKV), once considered an obscure pathogen, spread rapidly from 2014 to 2016 to become an internationally notifiable condition of major public health concern. The relative importance of various Culex and Aedes species mosquitoes (Diptera: Culicidae) in ZIKV transmission is a topic of debate. Quantifying host use is important in determining the vectorial capacity of a mosquito species for transmitting ZIKV in nature. In the United States, few data are available on host use of Aedes aegypti L. (Diptera: Culicidae) and Aedes albopictus (Skuse) (Diptera: Culicidae), confirmed and suspected vectors of ZIKV, respectively. Here, we report results of bloodmeal analysis to quantify host use of confirmed (Ae. aegypti) and suspected (Ae. albopictus and Culex quinquefasciatus Say (Diptera: Culicidae)) vectors of ZIKV in two Florida counties. At an auto salvage yard in Indian River County, Ae. aegypti, Ae. albopictus and Cx. quinquefasciatus fed mainly on humans, taking 90.2, 90.8, and 78.6% of bloodmeals from humans, respectively. At a residential area in Martin County, Ae. aegypti, Ae. albopictus took 61.5 and 66.7% of bloodmeals from humans, higher than Cx. quinquefasciatus (11.1%). Patterns of host use suggest that Ae. aegypti and Ae. albopictus are the most likely vectors of ZIKV in Florida and that Cx. quinquefasciatus would likely play a lesser role in ZIKV transmission in Florida. However, the relative importance of the three species in ZIKV transmission is likely location and population specific. Detailed studies quantifying other parameters of vectorial capacity, including vector competence, are needed in order to determine the actual role for each species in ZIKV transmission.

Biomarkers of Renal Injury in Cirrhosis: Association with Acute Kidney Injury and Recovery after Liver Transplantation.

BACKGROUND: To define urine or serum biomarkers in predicting renal function recovery after liver transplantation (LT). METHODS: Adults listed for LT (February 2011-July 2014) and with modified diet for renal disease-6 (MDRD-6) <60 mL/min provided urine/blood samples at baseline and serially until LT for biomarkers in serum (pg/mL) and urine (pg/mg creatinine). RESULTS: Of 271 LT listed patients (mean age 57 years, 63% males, median listing MELD 17.5), 1 year acute kidney injury (AKI) probability was 49%, with odds of 1.3-, 3.0-, 4.6-, and 8.5-fold times for listing MELD 16-20, 21-25, 26-30, and >30, compared to MELD <16. Thirty-seven people died over 1 year from the time of listing, with twofold increased odds with AKI. Among 67 patients with MDRD <60, only urinary epidermal growth factor was different comparing AKI (increase in serum creatinine ≥0.3 mg/dL from baseline within past 3 months) vs. no AKI (2,254 vs. 4,253, p = 0.003). Differences between acute tubular necrosis (ATN) and hepatorenal syndrome could not be ascertained for a small sample of 3 patients with ATN. Analyzing 15 of 43 receiving LT and MDRD-6 <30 prior to LT, biomarkers were not different comparing 5 patients recovering renal function (MDRD-6 >50 mL/min) at 6 months vs. 10 without recovery. CONCLUSIONS: AKI is common among LT listed patients, with a negative impact on transplant-free survival. Serum and urine biomarkers are not associated with the recovery of renal function after LT. Multicenter studies are suggested to (a) develop strategies to reduce the development of AKI and (b) derive novel biomarkers for use in accurately predicting renal recovery after LT.

Knee synergism during gait remain altered one year after acl reconstruction

OBJECTIVE: To compare the activation of the vastus lateralis (VL) and biceps femoris (BF) muscles during gait, as well VL/BF muscular co-contraction (MCC) between healthy (CG) and anterior cruciate ligament reconstructed (ACL-R) subjects. METHODS: Nineteen subjects, ten controls and nine ACL-R patients had a VL and BF electromyogram (EMG) captured to calculate the MCC ratio. A Principal Component (PC) Analysis was applied to reduce the dimensionality effect of each of the MCC, VL and BF curves for both healthy and ACL reconstructed groups. The PC scores were used to calculate the standard distance (SD). SD values were employed in order to compare each dependent variable (MCC, VL and BF) between the two groups using unpaired t-test. RESULTS: ACL-R group presented a lower VL activation at the beginning and at the end of the gait cycle, as compared to the control group. However, no difference was found for BF or VL/BF MCC. CONCLUSION: The gait analysis of ACL reconstructed patients demonstrated a persistent deficit in VL activation when compared to the control group, even one year after surgery. Level of Evidence III. Case Control Study

KNEE SYNERGISM DURING GAIT REMAIN ALTERED ONE YEAR AFTER ACL RECONSTRUCTION.

OBJECTIVE: To compare the activation of the vastus lateralis (VL) and biceps femoris (BF) muscles during gait, as well VL/BF muscular co-contraction (MCC) between healthy (CG) and anterior cruciate ligament reconstructed (ACL-R) subjects. METHODS: Nineteen subjects, ten controls and nine ACL-R patients had a VL and BF electromyogram (EMG) captured to calculate the MCC ratio. A Principal Component (PC) Analysis was applied to reduce the dimensionality effect of each of the MCC, VL and BF curves for both healthy and ACL reconstructed groups. The PC scores were used to calculate the standard distance (SD). SD values were employed in order to compare each dependent variable (MCC, VL and BF) between the two groups using unpaired t-test. RESULTS: ACL-R group presented a lower VL activation at the beginning and at the end of the gait cycle, as compared to the control group. However, no difference was found for BF or VL/BF MCC. CONCLUSION: The gait analysis of ACL reconstructed patients demonstrated a persistent deficit in VL activation when compared to the control group, even one year after surgery. Level of Evidence III. Case Control Study.

Uso de medidas espaço-temporais da marcha para determinar o retorno ao esporte pós-reconstrução do LCA / Use of spatiotemporal gait parameters to determine return to sports after ACL reconstruction

Objetivo: Comparar os parâmetros espaço temporais da marcha de sujeitos hígidos e pacientes submetidos à reconstrução do LCA, classificando o status de normalidade. Método: Quatorze sujeitos hígidos e oito com reconstrução do LCA há aproximadamente um ano caminharam enquanto o movimento era capturado por um sistema de câmeras infravermelhas. Os instantes de contato inicial e retirada do pé do solo foram determinados e as seguintes variáveis dependentes, as quais foram comparadas entre os grupos por meio do teste Mann-Whitney(α=0,05), foram calculadas: percentual de tempo no apoio duplo inicial, percentual de tempo no apoio simples, percentual de tempo no apoio duplo terminal, comprimento da passada e velocidade da marcha. Inicialmente, foi aplicada uma regressão logística a todas as variáveis dependentes para determinar os sujeitos hígidos e aqueles com reconstrução do LCA. Resultados: Os dois grupos não apresentaram diferenças em nenhum parâmetro espaço temporal da marcha(p > 0,05), apesar da cinemática angular do joelho permanecer alterada,como evidenciado por um estudo anterior com a amostra similar.Conclusão: A regressão classificou todos os sujeitos como hígidos,inclusive aqueles do grupo com reconstrução do LCA, sugerindo que as variáveis espaço temporais aplicadas nesse estudo não devem ser usadas como critério isolado de retorno incondicional às atividades esportivas. Nível de Evidência III, Estudo de Caso Controle.

Objective: To compare gait spatiotemporal parameters of healthyand ACL reconstructed subjects in order to classify the status of gaitnormality. Methods: Fourteen healthy subjects and eight patientssubmitted to ACL reconstruction walked along a walkway while thelower limbs movement was captured by an infrared camera system.The frames where the initial contact and toe-off took place were determinedand the following dependent variables, which were comparedbetween groups through the Mann-Whitney test (α=0.05) were calculated:percentage of time in initial double stance, percentage of timein single stance, percentage of time in terminal double stance, stridelength and gait velocity. Initially, all variables were compared betweengroups using a Mann-Whitney test. A logistic regression was applied,including all dependent variables, to create a model that could differentiatehealthy and ACL reconstructed subjects. Results: ACLreconstructed group showed no differences in any spatiotemporalparameter of gait (p > 0.05) in relation to the control group, althoughthe angular kinematic differences of the knee remained altered, asevidenced in a study with a similar sample. Conclusion: The regressionclassified all subjects as healthy, including the ACL reconstructedgroup, suggesting the spatiotemporal variables should not be usedas the sole criterion of return to sports activities at the same level asprior to injury. Level of Evidence III, Case Control Study.

USE OF SPATIOTEMPORAL GAIT PARAMETERS TO DETERMINE RETURN TO SPORTS AFTER ACL RECONSTRUCTION.

OBJECTIVE: : To compare gait spatiotemporal parameters of healthy and ACL reconstructed subjects in order to classify the status of gait normality. METHODS: : Fourteen healthy subjects and eight patients submitted to ACL reconstruction walked along a walkway while the lower limbs movement was captured by an infrared camera system. The frames where the initial contact and toe-off took place were determined and the following dependent variables, which were compared between groups through the Mann-Whitney test (a=0.05) were calculated: percentage of time in initial double stance, percentage of time in single stance, percentage of time in terminal double stance, stride length and gait velocity. Initially, all variables were compared between groups using a Mann-Whitney test. A logistic regression was applied, including all dependent variables, to create a model that could differentiate healthy and ACL reconstructed subjects. RESULTS: : ACL reconstructed group showed no differences in any spatiotemporal parameter of gait (p > 0.05) in relation to the control group, although the angular kinematic differences of the knee remained altered, as evidenced in a study with a similar sample. CONCLUSION: : The regression classified all subjects as healthy, including the ACL reconstructed group, suggesting the spatiotemporal variables should not be used as the sole criterion of return to sports activities at the same level as prior to injury. Level of Evidence III, Case Control Study.

Are fish paratenic natural hosts of the caiman haemoparasite Hepatozoon caimani?

The susceptibility of two fish and four mosquito species to the Caiman yacare haemoparasite Hepatozoon caimani was experimentally investigated. Mosquitoes belonging to four species (Aedes fluviatilis, Aedes albopictus, Aedes aegypti and Culex quinquefasciatus) were blood-fed on two naturally infected C. yacare from the Central-West Region of Brazil that exhibited distinct levels of parasitaemia: caimans A (11.05%) and B (1.25%). None of the engorged A. fluviatilis, A. albopictus or A. aegypti mosquitoes fed on caiman A survived for the duration of the sporogonic cycle; the great majority of the engorged mosquitoes died within 48 h of the blood meal. All A. aegypti fed on caiman B were negative, whereas 91.3% of dissected C. quinquefasciatus fed on the same caiman contained oocysts. Characid fish-Metynnis sp. and Astyanax sp.-were individually fed with C. quinquefasciatus females previously engorged (21-23 days) on caiman B. No parasite was found in the Astyanax fish. By contrast, 100% of the Metynnis fish depicted numerous cysts harbouring cystozoites identical to those of H. caimani, even more than 8 months after the ingestion of the infected mosquitoes. The cysts were located near the veins of the liver and, in some cases, close to the tunica intima of these vessels. No inflammatory reaction was observed. Gametocytes were observed in the blood smears of juvenile caimans that had ingested infected fish 9-12 weeks earlier. The potential role of fish as paratenic vertebrate hosts of H. caimani in nature is discussed.

Teste de força de preensão manual: estudo da fadiga mioelétrica do flexor radial do carpo e flexor superficial dos dedos / Handgrip strength test: a study of myoelectric fatigue of flexor carpi radialis and the flexor digitorum superficialis

Um protocolo de força de preensão manual (FPM) em degraus de intensidade foi empregado para estudo da fadiga dos músculos flexor radial do carpo (FRC) e flexor superficial dos dedos (FSD) por meio do registro da força de preensão sustentada. Foi feita a análise do sinal eletromiográfico de superfície destes músculos no domínio do tempo e da frequência de 2kHz. Foi utilizado um dinamômetro eletrônico e um conversor analógico-digital de 16 bits. Participaram deste estudo 12 indivíduos saudáveis, ativos e destros, com média de idade 21,53 ± 1,26 anos, percentual de gordura 7,76 ± 3,53%, peso corporal 74,9 ± 10,36 kg e estatura 180,69 ± 7,14 cm. Os indivíduos realizaram o teste de contração isométrica voluntária máxima (CIVM) da mão dominante seguido do protocolo de degraus submáximos em 20%, 40% e 60% da CIVM por 10 segundos cada. O processamento dos sinais envolveu a filtragem passa banda e o cálculo dos valores de raiz média quadrática (RMS) e frequência mediana (FM) em cada degrau de contração submáxima. A análise de variância "two-way" foi aplicada para os valores de RMS e FM. O teste proposto não gerou queda do rendimento de força nos degraus submáximos estabelecidos e a instauração do processo de fadiga do FSD. Por outro lado, o FRC apresentou sinais de fadiga mioelétrica sugerindo o processo de falência da FPM. Estes dados sugerem que a fadiga mioelétrica dos flexores dos dedos durante a FPM é um processo tardio à fadiga dos estabilizadores do punho. O protocolo em degrau de 60% parece desencadear o processo de fadiga mioelétrica do músculo FRC, mas não do FSD, baseado na análise da ativação muscular nos domínios do tempo e frequência...

A test protocol of handgrip strength in steps was used in order to study the fatigue of the flexor carpi radialis (FRC) and the flexor digitorum superficialis (FSD) muscles with signal processing in the time and frequency domains. It was used an electronic hand grip dynamometer, and a 16-bits analog-digital converter. The sampling frequency was 2 kHz. The study included 12 healthy subjects, active and right-handed, mean age 21.53 ± 1.26 years, body fat percentage 7.76 ± 3.53%, weight 74.9 ± 10.36 kg and height 180. 69 ± 7.14 cm. The subjects performed the test of maximal voluntary contraction (CIVM) of the dominant hand and then, submaximal protocol of ten seconds steps of 20%, 40% and 60% of CIVM. The proposed test didn't generate a drop on strength performance on the established submaximal steps, as well as the fatigue process establishment of FSD. On the other hand, the FRC showed myoelectric fatigue signs, suggesting stabilizing wrist collapse. These data suggest that myoelectric fatigue of the finger flexors during handgrip is a late process compared to wrist stabilizing fatigue. The protocol in 60% step seems to trigger the myoelectric fatigue muscle process of the FRC but not the FSD, based on analysis of muscle activation in time and frequency domains...

Reducing cross terms effects in the Choi-Williams transform of mioelectric signals.

This study aims at investigating the effect of removing the negative values of Choi-Wiliams distribution (CWD) related to the electromyogram (EMG) for visualization and instantaneous median frequency (IMF) estimation. Beyond the EMG signals from triceps surae and biceps brachialis, the CWD was applied in a simulated sinusoidal signal as like in stationary and non-stationary simulated EMG signals (SES). The CWD negative values of all simulated and EMG signals were removed. The IMF values were obtained for SES and EMG. The CWD IMF values from SES and EMG were thus compared with the IMF values from short time Fourier transform (STFT) by means of correlation. The suppression of negative values from the CWD reduced cross terms influence and improved visualization, as shown by the increased correlation coefficient between the IMF values. Before this suppression, the extracted IMF values showed large oscillation along the time, with various spurious values beyond 500Hz, which disappeared after the suppression. Moreover, this procedure seems to be especially useful for non-stationary signals.