Excessive downhill training leads to early onset of knee osteoarthritis.

OBJECTIVE: Increased levels of pro-inflammatory cytokines are associated with the release of degradative enzymes leading to osteoarthritis (OA) development. Although physical exercise (PE) is generally recognized as beneficial for OA symptoms, excessive training workload and eccentric muscular exercise have increased OA risk. Here, we investigated the effects of excessive exercise workload and exercise type on systemic inflammation and knee joint OA. METHODS: Mice were divided into five groups: sedentary (SED), uphill training (TRU), downhill training (TRD), excessive uphill training (ETU), and excessive downhill training (ETD) for an 8-week training intervention protocol. RESULTS: ETD group had increased pro-inflammatory cytokines in serum, vastus lateralis (VL), and vastus medialis (VM) muscles, while ETU group mice had increased cytokine levels in the VL and VM. Total knee joint OARSI score were more significant in ETD group compared to SED and TRU groups. They were also more meaningful for the medial tibial plateau of ETD group compared to SED group. MMP-3 and cleaved Caspase-3 were higher in the ETD group than the SED and TRU group, while Adamts-5 was higher in the ETD group than the SED group. TRU group had increased PRG-4 levels compared to ETU and ETD group. ETD group had decreased total bone volume, trabecular bone volume, and cortical thickness compared to SED group. CONCLUSION: Excessive downhill training induced a chronic pro-inflammatory state in mice and was associated with early signs of cartilage and bone degeneration that are clinical indicators of knee OA.

Hepatic LC3 II/I ratio is not modulated in exercised mice.

Autophagy plays an essential role in body homeostasis achievement. One of the main proteins involved in this process is the LC3I, which, after lipidation, leads to the formation of LC3II that participates in the formation and maturation of autophagosome. This descriptive study verified the responses of LC3II to LC3I proteins, as well as the time-course of this ratio in mice livers after different types of acute physical exercise protocols. Eight-week-old male C57BL/6 mice were maintained three per cage with controlled temperature (22±2 °C) on a 12:12-h light-dark normal cycle with food (Purina chow) and water ad libitum. Mice were randomly divided into four groups: control (CT, sedentary mice), resistance (RE, submitted to a single bout of resistance exercise), endurance (EE, submitted to a single bout of endurance exercise), and concurrent (CE, submitted to a single bout of endurance combined with resistance exercise). The mice livers were extracted and used for the immunoblotting technique. The hepatic LC3B II/I ratio for the RE and EE groups were not altered during the different time-points. For the CE group, there was a decrease in this ratio 12h after exercise compared to time 0 and 18h. Also, the hepatic LC3B II/I ratios were not different among the acute physical exercise protocols along the time-course. The hepatic LC3B II/I ratio was not influenced by the endurance and resistance protocols but decreased in response to the concurrent protocol at 12h after the stimulus.

Use of a levonorgestrel 52-mg intrauterine system in the control of abnormal uterine bleeding in women with inherited bleeding disorders.

OBJECTIVE: To evaluate the efficacy of a levonorgestrel 52-mg intrauterine system (LNG 52-mg IUS) in controlling abnormal uterine bleeding and improving quality of life in women with inherited bleeding disorders. STUDY DESIGN: We assessed 20 participants laboratory diagnosed with inherited bleeding disorders, who presented with abnormal uterine bleeding and were registered in a Central Blood Center. The primary outcomes were menstrual bleeding volume and quality of life before and after LNG 52-mg IUS placement. We used the Pictorial Blood Loss Assessment Chart (PBAC) score for measuring menstrual bleeding and the Short Form-36 Health Survey to assess quality of life before and after LNG 52-mg IUS placement. We also conducted blood tests to evaluate the hematimetric level. Follow-up visits were conducted at 1, 3, 6, and 12 months after LNG 52-mg IUS placement. Statistical analyses were performed using the Friedman non-parametric test. RESULTS: The use of LNG 52-mg IUS reduced uterine bleeding in women with inherited bleeding disorders. The median PBAC score was higher before LNG 52-mg IUS placement than at 3, 6, and 12 months after placement (p < 0.001). The amenorrhea rate was 70% after 12 months. There was an improvement in all eight parameters of quality of life (p < 0.001). The mean hemoglobin, ferritin, and serum iron levels were also higher at 12 months than before LNG 52-mg IUS placement. CONCLUSION: LNG 52-mg IUS placement can effectively control abnormal uterine bleeding in women with inherited bleeding disorders and consequently improve their quality of life. IMPLICATIONS: The results from our study suggest that women with inherited bleeding disorders who present with heavy menstrual bleeding can benefit from the use of a levonorgestrel-releasing intrauterine system similar to women without bleeding disorders.

Non-alcoholic fatty liver disease in women with polycystic ovary syndrome: systematic review and meta-analysis.

PURPOSE: Non-alcoholic fatty liver disease (NAFLD) is an insidious pathologic condition that can manifest from simple steatosis to steatohepatitis (NASH) with potential progression to cirrhosis. Like the polycystic ovary syndrome (PCOS), NAFLD is associated with obesity, diabetes mellitus, insulin resistance and metabolic syndrome. PCOS women have an increased risk of NAFLD, but it is debatable which features of PCOS, either specific (androgen excess) or unspecific (metabolic derangements) affect the NAFLD risk. METHODS: We performed a systematic review and meta-analysis of studies that addressed the association of PCOS and NAFLD. We selected 17 studies published between 2007 and 2017 that included 2734 PCOS patients and 2561 controls of similar age and body mass index (BMI). RESULTS: PCOS patients have increased prevalence of NAFLD (odds ratio 2.54, 95% confidence interval 2.19-2.95). PCOS women with hyperandrogenism (classic phenotype) have a higher prevalence of NAFLD compared to women with PCOS without hyperandrogenism, even after correction for confounding variables. Among women with PCOS, those with NAFLD have higher serum total testosterone (mean difference 0.40 nmol/L, 95% CI 0.29-0.50 nmol/L) and free androgen index (mean difference 4.46, 95% CI 3.53-5.39) than those without NAFLD. The studies that used multivariate analysis controlling for age, BMI, triglycerides, and insulin resistance index confirmed that serum androgens are independent predictors of NAFLD in women with PCOS. CONCLUSION: The prevalence of NAFLD is increased in women with PCOS and the presence of NAFLD is associated with high serum androgen levels, in addition to obesity and insulin resistance.

Sinos River Hydrographic Basin: urban occupation, industrialization and environmental memory / Bacia Hidrográfica do Rio dos Sinos: ocupação urbana, industrialização e memória ambiental.

This article presents an analysis of the process of industrialization and urbanization of the Sinos Valley in Rio Grande do Sul state, Brazil, starting from the establishment of leather goods and footwear manufacturing in the region during the 19th century when tanneries and factories producing footwear and/or components for footwear began to appear, and with special attention to aspects related to the environmental impact on the Sinos river hydrographic basin. The article is based on both bibliographic and documentary research and also draws on biographical narratives of workers with links to the leather goods and footwear industry obtained using ethnographic method. It was found that contemporary environmental conflicts emerge from within a memory of work and an environmental memory in which the factories, the unplanned urbanization, and the utilization of water and other natural resources form a chain of significance. Significance that precludes any form of fragmented analysis that isolates any of these aspects from the others: the economic, socio-historic, cultural, political, or the environmental.

Resumo O artigo aborda o processo de industrialização e urbanização do Vale do Rio dos Sinos/Rio Grande do Sul/Brasil, desde a implantação da indústria coureiro-calçadista na região, no século XIX, com o surgimento dos curtumes e das fábricas de calçados e/ou componentes para calçados, destacando, em especial, os aspectos ligados ao impacto ambiental na Bacia Hidrográfica dos Sinos. Faz-se uso de pesquisa bibliográfica e documental, além da exposição de narrativas biográficas de trabalhadores ligados à indústria coureiro-calçadista, obtidas por meio do método etnográfico. Verifica-se que os conflitos ambientais contemporâneos emergem do interior de uma memória do trabalho e de uma memória ambiental, nas quais a fábrica, a ocupação urbana desordenada, o uso da água e dos demais recursos naturais formam um encadeamento de sentido que impede qualquer análise fragmentada que isole um destes aspectos: o econômico, o socio-histórico, o cultural, o político, o ambiental.

Sinos River Hydrographic Basin: urban occupation, industrialization and environmental memory

This article presents an analysis of the process of industrialization and urbanization of the Sinos Valley in Rio Grande do Sul state, Brazil, starting from the establishment of leather goods and footwear manufacturing in the region during the 19th century when tanneries and factories producing footwear and/or components for footwear began to appear, and with special attention to aspects related to the environmental impact on the Sinos river hydrographic basin. The article is based on both bibliographic and documentary research and also draws on biographical narratives of workers with links to the leather goods and footwear industry obtained using ethnographic method. It was found that contemporary environmental conflicts emerge from within a memory of work and an environmental memory in which the factories, the unplanned urbanization, and the utilization of water and other natural resources form a chain of significance. Significance that precludes any form of fragmented analysis that isolates any of these aspects from the others: the economic, socio-historic, cultural, political, or the environmental.

Resumo O artigo aborda o processo de industrialização e urbanização do Vale do Rio dos Sinos/Rio Grande do Sul/Brasil, desde a implantação da indústria coureiro-calçadista na região, no século XIX, com o surgimento dos curtumes e das fábricas de calçados e/ou componentes para calçados, destacando, em especial, os aspectos ligados ao impacto ambiental na Bacia Hidrográfica dos Sinos. Faz-se uso de pesquisa bibliográfica e documental, além da exposição de narrativas biográficas de trabalhadores ligados à indústria coureiro-calçadista, obtidas por meio do método etnográfico. Verifica-se que os conflitos ambientais contemporâneos emergem do interior de uma memória do trabalho e de uma memória ambiental, nas quais a fábrica, a ocupação urbana desordenada, o uso da água e dos demais recursos naturais formam um encadeamento de sentido que impede qualquer análise fragmentada que isole um destes aspectos: o econômico, o socio-histórico, o cultural, o político, o ambiental.

Excessive eccentric exercise leads to transitory hypothalamic inflammation, which may contribute to the low body weight gain and food intake in overtrained mice.

Low body weight gain and food intake are related to exhaustive training and overtraining; however, the molecular mechanisms responsible for these alterations remain unknown. The main aim of this study was to evaluate the effects of running overtraining (OT) protocols performed downhill, uphill and without inclination on the inflammatory pathway in the mouse hypothalamus. The rodents were randomized into the control (C), overtrained by downhill running (OTR/down), overtrained by uphill running (OTR/up) and overtrained by running without inclination (OTR) groups. The body weights and food intake were recorded daily. The incremental load, exhaustive, rotarod and grip force tests were used to measure performance. At 36 h after the grip force test was performed at the end of OT protocols (i.e., week eight) and/or after a 2-week total recovery period (i.e., week 10), the hypothalamus and gastrocnemius were extracted for immunoblotting analysis. In addition, the serum was used to determine cytokine and leptin concentrations. From week 0 to week 8, the OTR/down group exhibited decreased body weight and food intake, and the OTR/up group increased their food intake. At week 10, the OTR/down group exhibited increased body weight, while the OTR group decreased their food intake. The OTR/down group exhibited increased IL-1beta, IL-6, TNF-alpha, pSAPK/JNK and SOCS3 levels at week eight. The OTR/down, OTR/up and OTR groups exhibited increased IL-10 levels at week 10. The OTR/up group displayed increased pJAK2 levels at week eight. While the OTR/down group exhibited increased IL-1beta levels, the OTR/down and OTR/up groups exhibited increased IL-6 and TNF-alpha levels, but decreased IL-10 levels in the gastrocnemius at week eight. The three OT protocols increased the IL-1beta and IL-6 levels, but only the OTR/down and OTR/up groups had increased TNF-alpha levels in serum at week eight. The serum leptin levels were lower for the OTR group compared with the CT group at week eight. In conclusion, the OTR/down protocol induced transitory hypothalamic inflammation with concomitant reductions in the body weight and food intake. After the 2-week total recovery period, the OTR/down group had reversed the hypothalamic inflammation, with the concomitant normalization of the body weight and food intake.

Eccentric Exercise Leads to Glial Activation but not Apoptosis in Mice Spinal Cords.

The aim of this investigation was to evaluate the effects of 3 overtraining (OT) protocols on the glial activation and apoptosis in the spinal cords of mice. Rodents were divided into control (C; sedentary mice), overtrained by downhill running (OTR/down), overtrained by uphill running (OTR/up) and overtrained by running without inclination (OTR). The incremental load test, ambulation test, exhaustive test and functional behavioural assessment were used as performance evaluation parameters. 36 h after the exhaustive test, the dorsal and ventral parts of the lumbar spinal cord (L4-L6) were dissected for subsequent protein analysis by immunoblotting. The OT protocols led to similar responses of some performance parameters. The ventral glial fibrillary acidic protein (GFAP) protein levels were diminished in the OTR/up and OTR compared to CT and OTR/down groups. The ventral ionized calcium binding adaptor molecule 1 (Iba-1), and the dorsal GFAP and Iba-1 protein levels were increased in the OTR/down compared to the other groups. The ratio between the cleaved capase-3/caspase-3 and cleaved caspase-9/caspase-9 measured in the spinal cord were not sensitive to the OT protocols. In summary, the OTR/down activated the glial cells in the motor (i. e. Iba-1) and sensory (i. e. GFAP and Iba-1) neurons without leading to apoptosis.

Sinos River Hydrographic Basin: urban occupation, industrialization and environmental memory.

This article presents an analysis of the process of industrialization and urbanization of the Sinos Valley in Rio Grande do Sul state, Brazil, starting from the establishment of leather goods and footwear manufacturing in the region during the 19th century when tanneries and factories producing footwear and/or components for footwear began to appear, and with special attention to aspects related to the environmental impact on the Sinos river hydrographic basin. The article is based on both bibliographic and documentary research and also draws on biographical narratives of workers with links to the leather goods and footwear industry obtained using ethnographic method. It was found that contemporary environmental conflicts emerge from within a memory of work and an environmental memory in which the factories, the unplanned urbanization, and the utilization of water and other natural resources form a chain of significance. Significance that precludes any form of fragmented analysis that isolates any of these aspects from the others: the economic, socio-historic, cultural, political, or the environmental.

Seminal plasma concentrations of Anti-Müllerian hormone and inhibin B predict motile sperm recovery from cryopreserved semen in asthenozoospermic men: a prospective cohort study.

The rate of motile sperm recovery after cryopreservation is very variable and difficult to predict. Anti-Müllerian hormone (AMH) and inhibin B are produced by Sertoli cells and released into the seminal plasma, where they could be functional markers of spermatogenesis and sperm resistance to thermal stress. The aim of this study was to evaluate whether seminal plasma levels of AMH and inhibin B predict sperm recovery after cryopreservation. The study included 153 men enrolled prospectively during a semen analysis. The cohort was stratified by the fresh semen characteristics into: normal (n = 52), high sperm count (n = 55), asthenozoospermia (n = 23), and oligozoospermia (n = 23). The main outcome measure was motile sperm recovery rate, defined as post-thaw total motile sperm count × 100/pre-freezing total motile sperm count. In men with asthenozoospermia there was a significant correlation between motile sperm recovery rate and the pre-freezing concentrations of AMH (r = 0.522, p < 0.05) and inhibin B (0.471, p < 0.05). In this group, the areas under the receiver operating characteristic curves of AMH and inhibin B for prediction of ≥50% motile sperm recovery after cryopreservation were, respectively, 0.808 and 0.638. AMH was particularly useful, with sensitivity of 0.85, specificity of 0.80, positive predictive value of 0.84 and negative predictive value of 0.80. The sensitivity, specificity, positive, and negative predictive values of inhibin B for the same outcome were, respectively, 0.62, 0.60, 0.67, and 0.55. The median motile sperm recovery rate was 83% when seminal plasma AMH concentration was ≥0.84 ng/mL, vs. 27% when AMH concentration was <0.84 ng/mL (p < 0.05). In other patient groups, there was no correlation between the two hormone levels in seminal plasma and the motile sperm recovery rate. In conclusion, seminal plasma AMH and inhibin B concentrations correlate with and can be used to predict motile sperm recovery after semen cryopreservation in asthenozoospermic men.

Clinical and histological evaluation of subepithelial connective tissue after collagen sponge implantation in the human palate.

BACKGROUND AND OBJECTIVE: Successful root-coverage treatment depends on the thickness of the donor tissue. This study aimed to evaluate the thickness of donor tissue after augmentation of the connective tissue in the palatal area by implantation of lyophilized collagen sponge (Hemospon(®) ). MATERIAL AND METHODS: Ten patients with an indication for root coverage, whose palate was deficient in adequate connective tissue, were recruited. The procedure was carried out in two stages. In the first stage, the palatal thickness in the donor site was measured at three standardized points (points 1, 2 and 3), from the distal of the canine to the distal of the first molar, and the lyophilized collagen sponge was inserted. In the second stage, the palatal thickness over the implant was measured (at points 1, 2 and 3), two biopsies of the palatal mucosa were collected - one over the implant (experimental sample) and the other on the contralateral side (control sample) - and then root-coverage treatment was performed. Analyses consisted of clinical assessment of the palatal measurements before and after sponge implantation, and histological assessment of the experimental and control biopsy samples. Data were analyzed using the Wilcoxon test. RESULTS: Both analyses showed a significant increase in mean thickness, of 1.08 mm of neoformed tissue in the clinical analysis (the tissue at point 2 was the thickest of the three points) and of 0.53 mm in the histological analysis. CONCLUSION: The insertion of lyophilized collagen sponge induced a significant increase in the thickness of palatal connective tissue.

[EORTC QLQ-C30 questionnaire role as predictor for malnutrition risk in head and neck cancer Mexican patients]. / Papel del cuestionario EORTC QLQ-C30 en la predicción de riesgo de desnutrición en pacientes mexicanos con cáncer de cabeza y cuello.

INTRODUCTION: Head and neck cancer treatment restricts oral intake and conditioning malnutrition. Adequate nutritional support during treatment can limit the impact of side effects. OBJECTIVE: To describe EORTC QLQ-C30 role for malnutrition risk screening in head and neck cancer patients. METHODS: Analytical and cross-sectional, diagnostic test study in head and neck cancer patients. We correlated malnutrition diagnosis with subjective global assessment (SGA) and score for the EORTC QLQ-C30 scales with Pearson and Spearman correlation. We realized COR (Receiver Operating Characteristic) curves to calculate cut point in the score for the EORTC QLQ-C30 scales; we calculated sensitivity, specificity, positive predictive value, negative predictive value and Odds Ratio through logistic regression. RESULTS: Functional scales (role, physic, global health status/QoL) showed limited utility to malnutrition risk estimation in people with head and neck cancer. Symptoms' scales with strong association were: pain (sensitivity 76.47%, specificity 69.23%), insomnia (sensitivity 88.24%, specificity 53.85%), fatigue (sensitivity 70.59%, specificity 76.92%). CONCLUSIONS: EORTC QLQ-C30 questionnaire is a useful tool to early malnutrition diagnosis in head and neck cancer patients with short term results in nutritional condition, treatment response and a better QoL in this kind of patients.

Oral Health: Validation of a questionnaire of self-perception and self-care habits in Diabetes Mellitus 2, hypertensive and obese patients. The UISESS-B scale.

OBJECTIVES: To develop and to evaluate a questionnaire of self-perception and self-care habits on oral health on a first level population. METHODS: A descriptive, observational study was performed to validate a questionnaire on oral health self-perception (UISESS-B). After non-probabilistic sampling, 94 users, 30-59 years of age, with either diabetes mellitus 2, hypertension or obesity were included. Duration of disease was lesser than 10 years. Pearson's r, Cornbach's , factorial analysis, chi-square and Snedecor's F tests were employed. RESULTS: A Pearson's r of 0.7 and Cronbach's of 0.82 was observed on the pre-post values of the global questionnaire. In the factorial analysis, the variance explained more than 60% for a first factor. A punctuation of very high risk for the three groups with the scale UISESSS-B that coincides with the index CPO-D and the index UISESS-F was observed. CONCLUSIONS: The UISESS-B scale shows significant validity and reliability, suggesting its use as a sensitive instrument for the measurement of oral health in people with chronic illnesses such as diabetes, hypertension and obesity.

Ground roasted peanuts leads to a lower post-prandial glycemic response than raw peanuts.

INTRODUCTION: Few studies have evaluated the effect of nuts processing on the glycemic response and satiety. OBJECTIVE: To evaluate the effect of peanut processing on glycemic response, and energy and nutrients intake. METHOD: Thirteen healthy subjects (4 men and 9 women), with a mean age of 28.5 ± 10 years, BMI 22.7 ± 2.5 kg/m², and body fat 23.7 ± 5.7% participated in this randomized crossover clinical trial. After 10-12 h of fasting, one of the following types of test meals were consumed: raw peanuts with skin (RPS), roasted peanuts without skin, ground-roasted peanuts without skin (GRPWS) or control meal. The test meals had the same nutrient composition, and were consumed with 200 ml of water in 15 minutes. Glycemic response was evaluated 2 hours after each meal. Energy and nutrients intake were assessed through diet records reflecting the habitual food intake and food consumption 24 hours after the ingestion of test meal. RESULT: The area under the glycemic response curve after GRPWS was lower (p = 0.02) the one obtained for RPS. There was no treatment effect on energy intake, macronutrients and fiber consumption after the test meal. CONCLUSION: The consumption of ground-roasted peanuts may favor the control and prevention of diabetes due to its reduction on postprandial glucose response. However, more prospective studies are needed to confirm this hypothesis.

Body fat at pubertal genital stage 2: a comparison between Spanish and Mexican boys.

BACKGROUND/OBJECTIVES: To compare body fat mass at the same stage of pubertal maturation, genital stage 2 (G2), in a Spanish and in a Mexican sample of boys. SUBJECTS/METHODS: Data from Spain (n=177) were from a previous longitudinal clinical follow-up and data from Mexico (n=91) from a cross-sectional study. Subjects were grouped according to the presence of G2 at similar ages. Spanish sample was divided into boys with G2 at age 12 (n=60), 13 (n=74) and 14 (n=43). In Mexican sample, 23 boys were at G2 at 12 years, 38 at age 13 and 30 at 14 years. Height, weight, upper arm circumference and four skinfold thicknesses were recorded. Genital development was assessed (Tanner scale). Sum of four skinfolds (SUM), body mass index (BMI), percentage of body fat (%BF) and extremity/trunk skinfold ratio (ETR=(triceps+biceps)/(subscapular+suprailiac)) was calculated. RESULTS: When comparing subjects with different ages at G2 from the same country, or with the same age at G2 from different countries, no significant differences were found in adiposity variables (%BF, SUM), nor in BMI. Nevertheless, there were differences in body fat distribution: ETR was higher in Spanish boys (P<0.001), because of their greater triceps skinfold thickness (P=0.013), and due to the greater trunk fat stores in Mexican boys (P<0.01, subscapular and suprailiac skinfolds). CONCLUSIONS: There is a subcutaneous fat mass store characteristic of G2 in boys, which is not only independent of age, but is also observable in two different populations.