Relationship between children physical activity,inflammatory mediators and lymphocyte activation: possible impact of social isolation (COVID-19)

Sport Sciences for Health - Lifestyle and body composition may be simultaneously responsible for immune response modulation. This study aimed to compare plasmatic adipokines concentration and...     

Sciatic nerve block with lateral popliteal approach for hallux vagus correction. Comparison between 0.5% bupivacaine and 0.75% ropivacaine

AIM: In this study the authors compared the clinical profile of 2 local anesthetic drugs in the sciatic nerve block used during hallux valgus correction, a surgical procedure known to be post-operatively extremely painful. Since hallux valgus correction is painful post-operatively, many attempts have been tried to ensure a long-lasting analgesia. Block of the sciatic nerve appears to be the right choice balancing ease to performance, satisfaction of the patient and duration of action. METHODS: The authors investigated the use of 20 ml of 0.5% bupivacaine or 0.75% ropivacaine regarding the speed of onset, quality and length of duration of sciatic nerve block performed with a lateral popliteal approach. Sixty ASA I-III patients (aged 19-73 years) were enrolled in this trial. Written informed consent was asked and obtained. A 20 G 50 mm Teflon coated Crawford needle, delivering 0.5 mA at 2 Hz, was used to locate and block the sciatic nerve in the popliteal fossa with a lateral approach. RESULTS: Patients in the ropivacaine group required about 13 minutes to achieve a complete block and about 16 minutes were needed in the bupivacaine group for the anesthesia to be complete. The length of analgesia was 16 h for the ropivacaine group and 13 h for the bupivacaine group. This kind of approach to block the sciatic nerve appeared to the authors to be very easy to perform, with the patient lying in a natural position. Surgical anesthesia required less than 30 min in both groups to be ready, while the ropivacaine group had a longer length of analgesia compared to the bupivacaine group. CONCLUSIONS: Patient satisfaction was high in both groups.     

Severe stenosis of anastomoses by using the symmetry aortic connector system

The St. Jude Medical Symmetry Aortic Connector System was developed to create the proximal vein graft anastomoses in coronary artery bypass grafting. We describe three symptomatic patients with severe stenosis of the proximal anastomosis several months after using the Symmetry aortic connector system. Intravascular ultrasound study showed anastomotic neointimal hyperplasia.     

Intercalary femur and tibia segmental allografts provide an acceptable alternative in reconstructing tumor resections

Intercalary femur and tibia segmental allografts were implanted in 59 consecutive patients after segmental resection-52 for malignant and seven for benign aggressive bone tumors. The patients were followed up for an average of 5 years. Allograft survival was determined with the Kaplan-Meier method. Infection, fracture, and nonunion rates were determined. The overall 5-year survivorship for the 59 intercalary allografts was 79%, and we found no significant differences between allograft survival in patients receiving or not receiving adjuvant chemotherapy. Infection and fracture rates were 5% and 7% respectively. From 118 host-donor junctions, 11 did not initially heal (9%). The nonunion rate (10 of 69 osteotomies) for diaphyseal junctions was higher than the rate (one of 49 osteotomies) for metaphyseal junctions. Although some patients required reoperations because of allograft complications, it seems that the use of intercalary allograft clearly has a place in the reconstruction of a segmental defect created by the resection of a tumor in the diaphyseal and /or metaphyseal portion of the femur or tibia.     

Upper urinary tract tumor: differential diagnosis by radiological images

To perform the adequate treatment of upper urinary tract lesions it is very important to have an exact diagnosis. When the suspicion of an upper tract urothelial tumor is established the initial evaluation is carried out by imaging diagnostic tests (intravenous urography, pyelography, and others). The association of radiological tests and urine cytologies allows us to get to a correct diagnosis in most cases. Upper urinary tract endoscopy solves some equivocal cases, but sometimes it is impossible to clarify the nature of the lesion in spite of a comprehensive diagnostic effort. Therapeutic decision should be individualized in these cases. The objective of this article is to describe the various features of upper tract urothelial tumors in a variety of available imaging tests, and to review all conditions that may have similar images, describing the characteristic radiological findings for each of them. We discuss about differential diagnosis and perform a critical evaluation of the diagnostic difficulties that occasionally present upper urinary tract diseases.     

Validity of cuff-uroflow as a diagnostic technique for bladder outlet obstruction in males

OBJECTIVE: To investigate the validity of the cuff-uroflow method as a diagnostic technique for bladder outlet obstruction (BOO) in males. MATERIAL AND METHODS: A cross-sectional study was carried out on a consecutive series of 93 males (mean age 54.1 years) referred on presenting with lower urinary tract symptoms. The patients were subjected to measurement of the isovolumetric pressure (Pcuff.op) and its corresponding flow (Qcuff.op) by means of the cuff-uroflow method. Subsequently, a study was carried out of the conventional pressure-flow, calculating the degree of BOO according to the provisional International Continence Society (ICS) nomogram. RESULTS: There was a statistical relationship between the Pcuff.op and Qcuff.op values and the degree of BOO according to the provisional ICS nomogram: patients with BOO had a lower value of Qcuff.op and a higher value of Pcuff.op than those without BOO. Using a logistic regression model a nomogram was constructed to link Pcuff.op with Qcuff.op. This nomogram was divided into three areas (obstructed, indeterminate and not obstructed). Most patients (44.1% of the sample) were situated in the indeterminate area. If those patients were excluded, the nomogram gave a sensitivity for the diagnosis of obstruction of 100% and a specificity of 55.6%. The overall rate of correct diagnosis was 84.6%. CONCLUSIONS: The parameters obtained using the cuff-uroflow method were related to the presence of BOO. According to the provisional ICS nomogram, this method showed a better sensitivity than specificity for the diagnosis of BOO.     

Salmonella bacteremia in patients with prosthetic heart valves

During 1982 and 1983, five patients with prosthetic heart valves and documented Salmonella bacteremia were admitted to the Instituto Nacional de Cardiologia in Mexico City. The clinical and microbiologic features in this group of patients are described, as well as the therapeutic implications when Salmonella bacteremia is present in patients with heart prostheses. None of the patients had evidence of infectious endocarditis; however, all received prolonged parenteral antimicrobial therapy for at least four weeks with ampicillin or chloramphenicol, with excellent clinical response.     

In vivo and in vitro evaluation of left ventricular thrombi by two-dimensional echocardiography. Comparison with cineventriculography

The purpose of this study was to assess the capability of two-dimensional echocardiography to identify left ventricular thrombi as compared to standard single plane cineventriculography in 284 patients, who underwent both procedures within 24 hours for diagnostic purposes. In order to obtain informations about the degree of thrombus organization and diagnostic accuracy of the echocardiographic technique, two-dimensional echocardiographic examinations were also performed in 31 thrombi from 16 autopsy specimens. In 249 cases the results were negative and in 14 cases positive by both techniques. Seven cases were positive by cineventriculography but negative by 2D-echocardiography. In seven cases the findings were equivocal by two-dimensional echocardiography; three of them were negative, two positive, and two equivocal by cineventriculography. In two cases the results were negative by two-dimensional echocardiography but equivocal by cineventriculography. Finally five cases were diagnosed to have a thrombus but two-dimensional echocardiography but not by cineventriculography. In two patients, positive by two-dimensional echocardiography, who were on anticoagulant therapy, follow-up studies showed the disappearance of left ventricular thrombi. In all of them the thrombi showed tissue characteristics similar to those of fresh thrombi examined in vitro. Two-dimensional echocardiography seems to be more reliable than cineventriculography for assessing the presence, extension, number, and morphology of left ventricular thrombi. In vitro studies suggest that two-dimensional echocardiography cannot visualize small thrombi, that fibrotic areas may simulate a thrombus and that in some cases under or overestimation is possible.     

Amateur endurance cycling practice and adult’s physical and psychosocial health: a cross-sectional study of the influence of training volume

ABSTRACT

This study aimed to analyse the association between amateur cycling training volume and physical and psychosocial health. A cross-sectional study was developed, via self-reported survey, among 1669 cyclists and 1039 controls, where analysis of variance and hierarchical multiple linear regression test were developed. Independent of gender, high volumes of amateur endurance cycling practice benefited cyclists’ body mass index and male cyclists’ physical conditioning, while psychosocial health did not differ among the training volume groups. Hierarchical multiple linear regression analysis highlighted the contribution of training volume to lower cyclists’ body mass index and better male cyclists’ physical conditioning. All cyclist groups presented better physical and psychosocial health than controls. High volumes of amateur endurance cycling training were associated with better physical health without jeopardizing psychosocial health. The practice of amateur endurance cycling, both in low and high volumes, was associated with better physical and psychosocial health compared with inactivity.     

Serodiagnosis of leprosy: relationships between antibodies to Mycobacterium leprae phenolic glycolipid I and protein antigens.

Sera from leprosy patients and controls were assayed for immunoglobulin M (IgM) and IgG antibodies to the Mycobacterium leprae-specific phenolic glycolipid I antigen (PG) by enzyme-linked immunosorbent assay, for IgG antibodies to M. leprae protein antigens by Western immunoblot, and for antibodies to a 65-kilodalton (kDa) protein antigen of M. leprae by a competition antibody binding assay. Elevated levels of anti-PG IgM were seen in lepromatous and borderline lepromatous patients, and elevated levels of anti-PG IgG were seen in borderline lepromatous patients. There was a significant correlation between the bacillary index (BI) and anti-PG IgM whether all leprosy patients or only multibacillary patients were analyzed. A significant correlation was seen between anti-PG IgG and BI when all leprosy patients were used for analysis, but not when only multibacillary patients were used. IgG antibodies to protein antigens of M. leprae, as detected by Western immunoblot, were more prevalent in lepromatous and borderline lepromatous patients than in borderline tuberculoid patients, while one of eight controls showed one weak band. There were significant correlations between the number of M. leprae protein antigens detected by the sera of patients and both BI and the level of anti-PG IgM. The 65-kDa competition antibody binding assay detected active multibacillary leprosy. Patients positive for antibody to the 65-kDa antigen had a significantly higher BI and levels of anti-PG IgM and anti-PG IgG than did patients that were negative. In addition, the level of antibody to the 65-kDa antigen correlated with both the BI and anti-PG IgM. We conclude that testing for antibodies to protein antigens of M. leprae may provide a useful adjunct to testing for antibodies to PG.