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Context: Understanding the musculoskeletal adaptations in the shoulder complex of varying ages of tennis athletes may suggest preventive protocols and conditioning and rehabilitation programs to this population. This study aimed to generate a bilateral descriptive profile of shoulder flexibility, scapular and clavicular position, and muscle strength in pediatric and adult amateur tennis athletes. The outcome measures were compared between groups and sides. The number and percentage of athletes “at risk” according to cutoff values for shoulder range of motion (ROM) were also analyzed. Design: Cross-sectional study. Methods: 36 pediatric and 28 adult amateur tennis athletes were tested. Outcome measures were ROM of shoulder flexion, abduction, internal and external rotation, posterior capsule tightness, pectoralis minor index (PMI), scapular upward rotation, clavicular elevation, and strength of the external rotators, serratus anterior, and lower trapezius of the dominant/nondominant sides. Results: Pediatric athletes had greater dominant side external rotation (P = .01) and total ROM (P = .04), increased Low Flexion test (P = .01), and decreased PMI (P = .01) compared with the adults. Bilaterally, the pediatric athletes had greater dominant side external rotation ROM (P P = .002) as compared with their nondominant side, whereas the adults displayed lower values on posterior capsule tightness (P = .01) and decreased PMI (P = .02) on their dominant side compared with their nondominant side. For the remaining outcomes, no interaction effects were observed. The cutoff values for shoulder ROM showed that several athletes were “at risk” of shoulder problems. Conclusion: Upper extremity adaptations at the shoulder are present in both pediatric and adult tennis athletes. These data can assist clinicians in better understanding the biomechanical adaptations in the shoulder of amateur tennis athletes in different age groups.

BACKGROUND: Physical therapy is essential to help patients to recover their movements and function following a rotator cuff repair. However, there are uncertainties regarding how long a sling should be used for and when exercises should be started. OBJECTIVE: To investigate the current clinical practice of Brazilian physical therapists treating patients who had a rotator cuff repair. We also explored differences between shoulder specialists and non-specialists. METHODS: An online survey with 38 questions, including a clinical case, regarding the physical therapy clinical practice for patients having a rotator cuff repair. RESULTS: We analyzed 194 responses. Majority of participants were from the Southeast of Brazil (57.5%), had up to 10 years of clinical experience (61.4%) and were not shoulder-specialists (69.8%). Majority of the respondents stated that patients have their first post-operative physical therapy session within the first three weeks (51%). Patients usually use a sling for four to six weeks (60.6%). Passive mobilization is often started in the first-week post-surgery. Fifteen percent of shoulder specialists compared to only six percent of non-shoulder specialists would allow strengthening exercises to start between the first and third weeks post-surgery. CONCLUSION: Physical therapists in Brazil seems to follow similar postoperative programs to other countries. Shoulder specialists allow a faster return to activities and start of strengthening exercises.

Background Scapular focused exercise interventions are frequently used to treat individuals with shoulder pain. However, evidence for changes in scapular motion after intervention is limited. Objective To compare the effects of scapular movement training versus standardized exercises for individuals with shoulder pain. Methods This will be a single-blinded randomized controlled trial. Sixty-four individuals with shoulder pain for at least 3 months, scapular dyskinesis, and a positive scapular assistance test will be randomly allocated to one of two groups: Scapular Movement Training (group 1) and Standardized Exercises (group 2). Group 1 will receive education about scapular position and movement, and be trained to modify the scapular movement pattern. Group 2 will perform stretching and strengthening exercises. Both groups will be treated twice a week for eight weeks. Three-dimensional scapular kinematics and muscle activity of the serratus anterior and upper, middle, and lower trapezius during elevation and lowering of the arm will be assessed at baseline and after 8 weeks of treatment. Pain intensity, function, fear avoidance beliefs, and kinesiophobia will be assessed at baseline and after 4 and 8 weeks of treatment, and 4 weeks after the end of treatment. Conclusions The results of this study may contribute to a better understanding of the efficacy of scapular focused treatments for individuals with shoulder pain. Clinical trial registration: NCT03528499

Vitrification is a superior method for cryopreservation of IVF embryos, but due to complicated warming protocols, it is not commonly used for commercial bovine embryos routine. To overcome the need of laboratory embryo preparation during warming, we developed an in-straw warming protocol compatible with most vitrification devices for embryo transfer without sucrose gradient steps and embryo evaluation. Surprisingly, one of the tested protocols improved embryo survival (95.0%* vs 83.1% expansion rate and 74.2%* vs 51.5% hatching rate) compared to conventional in-plate warming. Embryo quality was also increased, taken by the higher total cell numbers (160.7 ± 8.6* vs 99.0 ± 7.9) and lower apoptosis index (4.9 ± 0.6* vs 11.5 ± 2.4) 48 h after warming. Pregnancy rates were similar between vitrified-warmed embryos and fresh embryos (40% vs 43%). Based on our results, we suggest in-straw warming should always be used for vitrified embryos due to beneficial effects. Direct transfer can be safely performed using this protocol.

Objective To evaluate the association of sleep problems with weight and waist size gain during four years of follow-up. Methods We investigated 13,030 participants (35–74 years) of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), a multicentric cohort conducted with civil servants from six academic institutions recruited between 2008 and 2010. Sleep problems were assessed at baseline by the Clinical Interview Schedule - Revised (CIS-R), designed to detect common mental disorders based on somatic, depressive and anxiety symptoms. Weight and waist size were measured at baseline and at follow-up (2012–2014). Large weight and waist size gain were defined as ≥ 90th percentile (≥1.65 kg/year and ≥2.41 cm/year, respectively). Results Sleep problems were associated with higher risk of a large weight gain (RR = 1.11; 95% CI 1.01–1.24) and large waist size gain (RR = 1.19; 95% CI 1.07–1.32), adjusted for age, sex, ethnicity, income, educational level, investigation center, smoking, alcohol intake, dietary energy intake, leisure-time physical activity and body mass index (BMI) or waist circumference at baseline. After additional adjustment for common mental disorders the associations became non-significant (RR = 0.99; 95% CI 0.88–1.12; RR = 1.08; 95% CI 0.97–1.22, respectively). Conclusion Sleep problems are associated with increased risk of developing large weight and waist size gain, but are not independently associated with common mental disorders.

Made available in DSpace on 2020-12-12T02:02:37Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-03-01 Aim: To assemble, characterize and assess the antifungal effects of a new fluconazole (FLZ)-carrier nanosystem. Materials & methods: The nanosystem was prepared by loading FLZ on chitosan (CS)-coated iron oxide nanoparticles (IONPs). Antifungal effects were evaluated on planktonic cells (by minimum inhibitory concentration determination) and on biofilms (by quantification of cultivable cells, total biomass, metabolism and extracellular matrix) of Candida albicans and Candida glabrata. Results: Characterization results ratified the formation of a nanosystem (

Made available in DSpace on 2019-10-06T15:39:54Z (GMT). No. of bitstreams: 0 Previous issue date: 2019-05-01 Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) Objective: To evaluate the antimicrobial/antibiofilm and mechanical properties, and the effect on enamel demineralization of a resin-modified GIC (RMGIC) containing CHX and nano-sized sodium trimetaphosphate (TMP). Methods: RMGIC was associated with CHX (1.25 or 2.5%) and/or TMP (7 or 14%). Antimicrobial and antibiofilm activity were assessed using agar diffusion test and evaluation of biofilm metabolism, respectively. In addition, fluoride (F) and TMP releases as well as the diametral tensile (DTS) and compressive (CS) strength were determined. The percentage of mineral loss (%SH), integrated loss of subsurface hardness (ΔKHN) and enamel F concentrations were also evaluated. Results: RMGICs containing CHX associated or not with TMP presented higher inhibition zones and effect on S. mutans biofilm. A reduction on CS was observed only for RMGIC + 2.5%CHX and on DTS for RMGIC + 2.5%CHX + 14%TMP. The highest F and TMP releases and lowest %SH and ΔKHN values were detected for RMGIC + 1.25%CHX + 14%TMP and RMGIC + 2.5%CHX + 14%TMP. Higher enamel F concentrations were observed for TMP groups. Conclusion: 1.25%CHX and 14%TMP increased antimicrobial/antibiofilm action and the ability to prevent enamel demineralization, with minimal effect on the mechanical properties of RMGIC. Clinical significance: RMGIC containing CHX and TMP is an alternative material for patients at high risk for dental caries and can be indicated for low-stress regions or provisional restorations. Department of Pediatric Dentistry and Public Health São Paulo State University (UNESP) School of Dentistry Department of Surgery and Integrated Clinic São Paulo State University (UNESP) School of Dentistry Department of Chemistry Federal University of São Carlos Department of Pediatric Dentistry and Public Health São Paulo State University (UNESP) School of Dentistry Department of Surgery and Integrated Clinic São Paulo State University (UNESP) School of Dentistry

Background Posterior capsule tightness (PCT) and shoulder impingement syndrome (SIS) symptoms are both associated with altered shoulder biomechanics and impairments. However, their combined effect on kinematics, pain, range of motion (ROM), strength, and function remain unknown. Objective The purpose of this study was to determine if the combination of PCT and SIS affects scapular and humeral kinematics, glenohumeral joint ROM, glenohumeral joint external rotation strength, pain, and function differently than does either factor (PCT or SIS) alone. Design The design was a cross-sectional group comparison. Methods Participants were placed into 1 of 4 groups based on the presence or absence of SIS and PCT: control group (n = 28), PCT group (n = 27), SIS group (n = 25), and SIS + PCT group (n = 25). Scapular kinematics and humeral translations were quantified with an electromagnetic motion capture system. Shoulder internal rotation and external rotation ROM, external rotation strength, and pain and Shoulder Pain and Disabilities Index scores were compared between groups with ANOVA. Results The SIS group had greater scapular internal rotation (mean difference = 5.13°; 95% confidence interval [CI] = 1.53°–8.9°) and less humeral anterior translation (1.71 mm; 95% CI = 0.53–2.9 mm) than the other groups. Groups without PCT had greater internal rotation ROM (16.05°; 95% CI = 5.09°–28.28°). The SIS + PCT group had lower pain thresholds at the levator scapulae muscle (108.02 kPa; 95% CI = 30.15–185.88 kPa) and the highest Shoulder Pain and Disabilities Index score (∼ 44.52; 95% CI = 33.41–55.63). Limitations These results may be limited to individuals with impingement symptoms and cannot be generalized to other shoulder conditions. Conclusions Decreased ROM and lower pain thresholds were found in individuals with both impingement symptoms and PCT. However, the combination of factors did not influence scapular and humeral kinematics.

Made available in DSpace on 2021-06-25T10:51:59Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Objective: To systematically review the effectiveness of electromyographic biofeedback interventions to improve pain and function of patients with shoulder pain. Design: Systematic review of controlled clinical trials. Literature search: Databases (Medline, EMBASE, CINAHL, PEDro, CENTRAL, Web of Science, and SCOPUS) were searched in December 2020. Study selection criteria: Randomized clinical trials that investigated the effects of electromyographic biofeedback for individuals with shoulder pain. Patient-reported pain and functional outcomes were collected and synthesized. Data synthesis: The level of evidence was synthesized using GRADE and Standardized Mean Differences and 95% confidence interval were calculated using a random-effects inverse variance model for meta-analysis. Results: Five studies were included with a total sample of 272 individuals with shoulder pain. Very-low quality of evidence indicated that electromyographic biofeedback was not superior to control for reducing shoulder pain (standardized mean differences = −0.21, 95% confidence interval: −0.67 to 0.24, P = 0.36). Very-low quality of evidence indicated that electromyographic biofeedback interventions were not superior to control for improving shoulder function (standardized mean differences = −0.11, 95% confidence interval: −0.41 to 0.19, P = 0.48). Conclusion: Electromyographic biofeedback may be not effective for improving shoulder pain and function. However, the limited number of included studies and very low quality of evidence does not support a definitive recommendation about the effectiveness of electromyographic biofeedback to treat individuals with shoulder pain. Laboratory of Analysis and Intervention of the Shoulder Complex Universidade Federal de São Carlos (UFSCar) São Carlos Department of Dental Materials and Prosthodontics Araraquara Dental School Universidade Estadual Paulista (UNESP), Araraquara Department of Dental Materials and Prosthodontics Araraquara Dental School Universidade Estadual Paulista (UNESP), Araraquara

Holstein-Gyr crossbred cattle are strategic for dairy systems in tropical countries, since they combine milk yield genetics with adaptability to tropical climate. However, Holstein (Bos taurus) and Gyr (Bos indicus) breeds present remarkable differences regarding reproductive physiology. Brazil stands out as the world's largest user of embryo in vitro production (IVP) in bovine, and the use of this technique is increasing in dairy systems. As Holstein-Gyr crossbreds are important oocyte donors for IVP, the present work aimed at investigating whether increased Gyr or Holstein breed composition influences donor's performance. Sixteen Holstein-Gyr crossbred females presenting increased (HG, 71.4 to 87.5% Holstein; n = 9) or decreased (GH, 40.2 to 46.6% Holstein; n = 7) Holstein composition were submitted to three ovum pick up (OPU) sessions. We observed similar (P = 0.2946) antral follicle count between HG and GH donors (24.8 ± 3.2 vs 29.4 ± 2.8 respectively; mean ± SEM). Groups also display similar morphological oocyte grading (Grade I: 0.1 ± 0.1 vs 0.1 ± 0.1 - P = 0.9680; Grade II: 0.9 ± 0.5 vs 1.9 ± 0.5 - P = 0.1942; Grade III, 4.0 ± 1.2 vs 7.2 ± 1.4 - P = 0.1047, HG vs GH respectively; mean ± SEM). Additionally, the proportion of viable oocyte was similar between HG and GH groups (27.8% vs 31.9%, respectively, P = 0.3500) and oocyte lipid area fraction (6.8% vs 9.5%, respectively; P = 0.1539). Our results indicate that the individual variation has more influence than breed composition of crossbred oocyte donors.

BACKGROUND: The unilateral and repetitive nature of overhead sports, often result in a biomechanical overload of the upper extremity. Understanding the musculoskeletal shoulder range of motion (ROM) and strength patterns in the youth sports of baseball, softball, and tennis could assist injury prevention screening and further the development of conditioning and rehabilitation programs. PURPOSE: To generate a descriptive profile of shoulder musculoskeletal characteristics and determine whether bilateral differences in shoulder ROM exist in youth baseball, softball, and tennis athletes. A secondary aim was to determine whether shoulder rotational adaptations are correlated with playing position, sport, or years of experience. STUDY DESIGN: Descriptive Laboratory METHODS: A total of 136 competitive youth overhead athletes (baseball: n = 51,12.8 ± 0.9yrs; softball: n = 63,12.3 ± 1.1yrs; and tennis: n = 22,12.5 ± 0.9yrs) participated. Bilateral shoulder internal (IR) and external (ER) passive ROM and external rotation strength were measured using an inclinometer and handheld dynamometer. RESULTS: Significant differences (p

To identify and describe phenotypes related to kinesiophobia, fear-avoidance, and pain catastrophizing, and determine clinical and demographic characteristics related to each phenotype as a function of self-reported function of the upper limbs in individuals with shoulder pain.One hundred and seventy-seven individuals with shoulder pain participated in this study. Tampa Scale of Kinesiophobia, Fear-Avoidance Beliefs Questionnaire, Pain Catastrophizing Scale, Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH), Numerical Pain of Rating Scale, and the angular onset of pain during the elevation of the arm were measured in all participants. A cluster analysis was performed considering kinesiophobia, fear-avoidance, and pain catastrophizing, then clinical and demographic characteristics of clusters were used to model individual's chance to belong to one of the clusters as a function of DASH.Two clusters were identified based on kinesiophobia, fear-avoidance, and pain catastrophizing. The cluster with worse pain-related fear profile presented (p 0.05) higher age, worse function, and higher pain intensity. This same cluster was also associated with involvement of the dominant side (OR = 2.10, 95% CI = 1.03, 4.41) and worse function (OR = 0.96, 95% CI = 0.94, 0.98).This study identified that individuals with worse pain-related fear profile were older, with worse function, and higher pain intensity. Worse function and involvement of the dominant side were associated with the phenotype with a worse pain-related fear condition.

ACE2 is a type I membrane protein with extracellular carboxypeptidase activity displaying a broad tissue distribution with highest expression levels at the brush border membrane (BBM) of small intestine enterocytes and a lower expression in stomach and colon. In small intestinal mucosa, ACE2 mRNA expression appears to increase with age and to display higher levels in patients taking ACE-inhibitors (ACE-I). There, ACE2 protein heterodimerizes with the neutral amino acid transporter Broad neutral Amino acid Transporter 1 (B0AT1) (SLC6A19) or the imino acid transporter Sodium-dependent Imino Transporter 1 (SIT1) (SLC6A20), associations that are required for the surface expression of these transport proteins. These heterodimers can form quaternary structures able to function as binding sites for SARS-CoV-2 spike glycoproteins. The heterodimerization of the carboxypeptidase ACE2 with B0AT1 is suggested to favor the direct supply of substrate amino acids to the transporter, but whether this association impacts the ability of ACE2 to mediate viral infection is not known. B0AT1 mutations cause Hartnup disorder, a condition characterized by neutral aminoaciduria and, in some cases, pellagra-like symptoms, such as photosensitive rash, diarrhea, and cerebellar ataxia. Correspondingly, the lack of ACE2 and the concurrent absence of B0AT1 expression in small intestine causes a decrease in l-tryptophan absorption, niacin deficiency, decreased intestinal antimicrobial peptide production, and increased susceptibility to inflammatory bowel disease (IBD) in mice. Thus, the abundant expression of ACE2 in small intestine and its association with amino acid transporters appears to play a crucial role for the digestion of peptides and the absorption of amino acids and, thereby, for the maintenance of structural and functional gut integrity.

Biopsychosocial aspects seem to influence the clinical condition of rotator cuff related shoulder pain (RCRSP). However, traditional bivariate and linear analyses may not be sufficiently robust to capture the complex relationships among these aspects. This study determined which biopsychosocial aspects would better classify individuals with acute and chronic RCRSP and described how these aspects interact to create biopsychosocial phenotypes in individuals with acute and chronic RCRSP. Individuals with acute (&lt, six months of pain, n = 15) and chronic (&ge, six months of pain, n = 38) RCRSP were included. Sociodemographic data, biological data related to general clinical health status, to shoulder clinical condition and to sensory function, and psychosocial data were collected. Outcomes were compared between groups and a decision tree was used to classify the individuals with acute and chronic RCRSP into different phenotypes hierarchically organized in nodes. Only conditioned pain modulation was different between the groups. However, the tree combined six biopsychosocial aspects to identify seven distinct phenotypes in individuals with RCRSP: three phenotypes of individuals with acute, and four with chronic RCRSP. While the majority of the individuals with chronic RCRSP have no other previous painful complaint besides the shoulder pain and low efficiency of endogenous pain modulation with no signs of biomechanical related pain, individuals with acute RCRSP are more likely to have preserved endogenous pain modulation and unilateral pain with signs of kinesiophobia.

In this document, the photocatalytic activity of TiO2/Fe3O4, prepared by the mixing of the pure oxides, was studied. The photocatalytic degradation of aqueous Methylene Blue (MB) solutions (10 and 30 ppm) was performed, the TiO2/Fe3O4 catalysts in 80/20, 50/50 and 20/80 mass ratios were used during the test, artificial sunlight and natural solar radiation were tested at laboratory and pilot plant scale respectively. Besides, the kinetic reactions were evaluated according to the Langmuir-Hinshelwood model, the apparent velocity constants (kapp) were obtained for the TiO2/Fe3O4 catalysts. In the laboratory test, the TiO2/Fe3O4 catalyst (80/20) had a performance for 93.04% of discoloration, kapp = 0.0238 min−1, while for TiO2/Fe3O4 (50/50, 20/80) had an 83.46%, 65.00% for discoloration of MB and the kapp values were 0.0154 min−1 and 0.0098 min−1, respectively. In the solar test at pilot scale, the percentages of discoloration of 24.32%, and 57.78%, with kapp values of 0.00037 min−1, 0.00121 min−1 respectively were obtained for TiO2/Fe3O4 (80/20), a MB solution of 30 ppm, a load of 0.1 g/L and 0.3 g/L of the catalyst respectively.

Objective The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire is widely used to assess patients with symptoms of subacromial pain syndrome (SPS). No study has analyzed the DASH by using the Rasch model in these patients and related the level of difficulty of the items with the International Classification of Functioning Disability and Health (ICF) domains. The purpose of this study was to evaluate the measurement properties of the DASH in individuals with SPS and to describe which ICF components are influenced by SPS based on the DASH. Methods The full version of the DASH was used to assess upper limb pain and function in individuals with SPS. Responses were assessed using the Rasch model. DASH items were grouped according to the level of difficulty and associated with the ICF domains to identify the most compromised aspect in these individuals. Results Reliability and internal consistency for the DASH were shown to be 0.93 and 0.95, respectively. Item 3 (“Turn a key”) was the easiest and 25 (“Pain during specific activity”) the most difficult. Only item 30 (“Less capable/confident/useful”) was as an erratic item. Item 15 (“Put on a sweater”) showed differential functioning by age and item 11 (“Carry a heavy object”) by sex. Seven items showed differential functioning related to the angular onset of pain during arm elevation. Sixty percent of the most difficult items belonged to the “Body function” domain of the ICF. Conclusion Although some psychometric properties of the DASH are adequate according to the Rasch model, adjustments to some items are necessary for individuals with SPS. Clinicians should be cautious when interpreting the DASH, especially in patients with angular onset of pain above 120 degrees of arm elevation. Impact The information contained in this study should be used by clinicians to interpret the results of the DASH when assessing individuals with SPS. The DASH may not be adequate to assess those with shoulder pain above 120 degrees of arm elevation. These results are not generalizable to other shoulder pathologies.

This study aimed to test the effects of an IVM SPOM adaptation (SPOM-adapted IVM) on the production, total number of cells (TNC), apoptosis, and cryotolerance (post-warming survival and cytoskeleton actin integrity) of bovine IVP embryos. Two experiments were conducted with two experimental groups based on IVM treatment: A control group (TCM 199 without FCS) and an SPOM-adapted group (TCM 199 with forskolin and IBMX in pre-IVM and IVM with cilostamide). The first experiment evaluated embryo in vitro production, TNC, and apoptosis rate on D9 of development. In the second experiment, embryos were vitrified/warmed at D7 (control fresh and vitrified; SPOM-adapted fresh and vitrified) and assessed regarding post-warming survival rates and cytoskeleton actin integrity. Statistical analysis was performed using GraphPad INSTAT software at a significance level of 5%. An increase (p 0.05) in blastocyst production was observed in the SPOM-adapted group comparing to the control group. There was no difference (p 0.05) in the TNC or apoptosis rate between the groups. Regarding cryopreservation, no differences were found (p 0.05) in actin integrity or post-warming survival rates between the vitrified groups. In both vitrified groups, we observed a significantly lower uninjured pattern of actin integrity compared to the fresh groups (p 0.05). We conclude that the SPOM-adapted IVM system is beneficial for blastocyst production and does not affect the quality and cryotolerance of the produced embryos.

Made available in DSpace on 2019-10-06T15:58:46Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-12-01 Objective: To evaluate the effect of a fluoride toothpaste containing nano-sized sodium trimetaphosphate (TMPnano) on enamel demineralization in situ and composition of the biofilm. Design: This crossover double-blind study consisted of four phases (seven days each) and 12 volunteers who wore oral appliances containing four enamel bovine blocks. The cariogenic challenge was performed by 30% sucrose solution (6x/day). The toothpaste treatments (3x/day) were as follows: no F/TMP/TMPnano (Placebo), 1100 ppm F (1100F), 1100F plus 3% micrometric or nano-sized TMP (1100F/TMP; 1100F/TMPnano). Percentage of surface hardness loss (%SH), and integrated loss of subsurface hardness (ΔKHN), as well as enamel calcium (Ca), phosphorus (P), and fluoride (F) were determined. Moreover, biofilm formed on the blocks were analyzed for F, Ca, P, and insoluble extracellular polysaccharide (EPS) concentrations. Data were analyzed using one-way ANOVA, repeated measures followed by Fisher LSD test (p < 0.001). Results: 1100F/TMPnano promoted the lowest %SH and ΔKHN among all groups (p < 0.001). Regarding the F concentrations in the enamel and in the biofilm, there were no significant differences between 1100 F and 1100 F/TMPnano, but significantly increased enamel Ca concentrations (p < 0.001). 1100F/TMPnano showed lower values of EPS concentration when compared with 1100F (∼80%) (p < 0.001). Conclusion: 1100F/TMPnano promoted a greater protective effect against enamel demineralization and significantly affected the composition of biofilm formed in situ when compared to 1100F toothpaste. São Paulo State University (Unesp) School of Dentistry Araçatuba Department of Pediatric Dentistry and Public Health, Rua José Bonifácio 1193 LIEC-Department of Chemistry Federal University of São Carlos (UFSCar) São Paulo State University (Unesp) School of Dentistry Araçatuba Department of Pediatric Dentistry and Public Health, Rua José Bonifácio 1193

This study compared core stability, shoulder isokinetic peak torque and shoulder function in throwers with and without shoulder pain.Cross-sectional study.Throwing athletes.Thirty healthy athletes and 21 with shoulder pain were included.Endurance time of the trunk, the modified star excursion balance test, isokinetic peak torque of internal and external rotation of the shoulder, questionnaires, level of satisfaction with the throwing arm and active range of motion.The symptomatic athletes presented with shorter endurance time for the trunk lateral flexors (P .05), and decreased reach distance for both limbs in the posteromedial direction (P .05) and for takeoff limb in the posterolateral direction (P = .04), and smaller composite score for both limbs (P .05) during star excursion balance test as compared to the healthy ones. No significant differences between groups were found for peak torque of internal and external rotation of the shoulder. Athletes with shoulder pain demonstrated more shoulder disability and a lower level of satisfaction with the throwing arm (P = .000). Range of motion was not different between groups for shoulder internal and external rotation.Throwing athletes with shoulder pain have lower core stability and shoulder function compared to healthy athletes.

Made available in DSpace on 2019-10-06T15:20:22Z (GMT). No. of bitstreams: 0 Previous issue date: 2019-04-01 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) Objective: To evaluate the remineralizing potential of a conventional toothpaste (1,100 ppm F) supplemented with nano-sized sodium hexametaphosphate (HMPnano) in artificial caries lesions in situ. Design: This double-blinded crossed study was performed in 4 phases of 3 days each. Twelve subjects used palatal appliances containing 4 bovine enamel blocks with artificial caries lesions. Volunteers were randomly assigned into the following treatment groups: no F/HMP/HMPnano (Placebo); 1,100 ppm F (1100F); 1100F plus 0.5% micrometric HMP (1100F/HMP) and 1100F plus 0.5% nano-sized HMP (1100F/HMPnano). Volunteers were instructed to brush their natural teeth with the palatal appliances in the mouth for 1 min (3 times/day), so that blocks were treated with natural slurries of toothpastes. After each phase, surface hardness post-remineralization (SH2), integrated recovery of subsurface hardness (ΔIHR), integrated mineral recovery (ΔIMR) and enamel F concentration were determined. Data were submitted to analysis of variance and Student-Newman-Keuls' test (p < 0.001). Results: Enamel surface became 42% harder when treated with 1100F/HMPnano in comparison with 1100F (p < 0.001). Treatment with 1100F/HMP and 1100F/HMPnano promoted an increase of ∼23 and ∼87%, respectively, in ΔIHR when compared to 1100F (p < 0.001). In addition, ΔIMR for the 1100F/HMPnano was ∼75 and ∼33% higher when compared to 1100F and 1100F/HMP respectively (p < 0.001). Enamel F uptake was similar among all groups except for the placebo (p < 0.001). Conclusion: The addition of 0.5% HMPnano to a conventional fluoride toothpaste was able to promote an additional remineralizing effect of artificial caries lesions. Department of Pediatric Dentistry and Public Health São Paulo State University (UNESP) School of Dentistry LIEC-Department of Chemistry Federal University of São Carlos (UFSCar) Department of Pediatric Dentistry and Public Health São Paulo State University (UNESP) School of Dentistry

Background With the availability of high-quality asthma guidelines worldwide, one possible approach of developing a valid guideline, without re-working the evidence, already analysed by major guidelines, is the ADAPTE approach, as was used for the development of National Guidelines on asthma. Methods The guidelines development group (GDG) covered a broad range of experts from medical specialities, primary care physicians and methodologists. The core group of the GDG searched the literature for asthma guidelines 2005 onward, and analysed the 11 best guidelines with AGREE-II to select three mother guidelines. Key clinical questions were formulated covering each step of the asthma management. Results The selected mother guidelines are British Thoracic Society (BTS), GINA and GEMA 2015. Responses to the questions were formulated according to the evidence in the mother guidelines. Recommendations or suggestions were made for asthma treatment in Mexico by the core group, and adjusted during several rounds of a Delphi process, taking into account: 1. Evidence; 2. Safety; 3. Cost; 4. Patient preference – all these set against the background of the local reality. Here the detailed analysis of the evidence present in BTS/GINA/GEMA sections on prevention and diagnosis in paediatric asthma are presented for three age-groups: children with asthma ≤5 years, 6–11 years and ≥12 years. Conclusions For the prevention and diagnosis sections, applying the AGREE-II method is useful to develop a scientifically-sustained document, adjusted to the local reality per country, as is the Mexican Guideline on Asthma.

This study aims to evaluate the influence of the degree of difficulty of the activities in Motor Activity Log (MAL) scores for patients with mild, moderate, and severe hemiparesis, and to estimate the correlation between motor impairment levels of hemiparesis and MAL scores in post-stroke patients. Sixty-six patients with chronic hemiparesis (49 with mild-moderate hemiparesis, and 17 with severe hemiparesis) were evaluated by the Fugl-Meyer upper-limb section and versions of MAL for different degrees of motor impairment. The Rasch model was used to analyze the level of difficulty of the activities of the different versions of MAL. The Spearman's correlation tested the relationship between the Fugl-Meyer Assessment upper-limb section and MAL. The MAL version, developed to evaluate patients with severe hemiparesis, does not contain the easier activities as employed by the Rasch analysis. There was positive correlation between the Fugl-Meyer Assessment upper-limb section scores and Amount of Use of the three versions of the MAL (

Background Reabsorption of amino acids (AAs) across the renal proximal tubule is crucial for intracellular and whole organism AA homeostasis. Although the luminal transport step is well understood, with several diseases caused by dysregulation of this process, the basolateral transport step is not understood. In humans, only cationic aminoaciduria due to malfunction of the basolateral transporter y(+)LAT1/CD98hc (SLC7A7/SLC3A2), which mediates the export of cationic AAs, has been described. Thus, the physiologic roles of basolateral transporters of neutral AAs, such as the antiporter LAT2/CD98hc (SLC7A8/SLC3A2), a heterodimer that exports most neutral AAs, and the uniporter TAT1 (SLC16A10), which exports only aromatic AAs, remain unclear. Functional cooperation between TAT1 and LAT2/CD98hc has been suggested by in vitro studies but has not been evaluated in vivo. Methods To study the functional relationship of TAT1 and LAT2/CD98hc in vivo, we generated a double-knockout mouse model lacking TAT1 and LAT2, the catalytic subunit of LAT2/CD98hc (dKO LAT2-TAT1 mice). Results Compared with mice lacking only TAT1 or LAT2, dKO LAT2-TAT1 mice lost larger amounts of aromatic and other neutral AAs in their urine due to a tubular reabsorption defect. Notably, dKO mice also displayed decreased tubular reabsorption of cationic AAs and increased expression of y(+)LAT1/CD98hc. Conclusions The LAT2/CD98hc and TAT1 transporters functionally cooperate in vivo, and y(+)LAT1/CD98hc may compensate for the loss of LAT2/CD98hc and TAT1, functioning as a neutral AA exporter at the expense of some urinary loss of cationic AAs. Cooperative and compensatory mechanisms of AA transporters may explain the lack of basolateral neutral aminoacidurias in humans.

Glutamine (Gln) is the most concentrated amino acid in blood and considered conditionally essential. Its requirement is increased during physiological stress, such as malnutrition or illness, despite its production by muscle and other organs. In the malnourished state, Gln has been suggested to have a trophic effect on the exocrine pancreas and small intestine. However, the Gln transport capacity, the functional relationship of these two organs, and the potential role of the Gln-glutamate (Glu) cycle are unknown. We observed that pancreatic acinar cells express lower levels of Glu than Gln transporters. Consistent with this expression pattern, the rate of Glu influx into acinar cells was approximately sixfold lower than that of Gln. During protein restriction, acinar cell glutaminase expression was increased and Gln accumulation was maintained. Moreover, Glu secretion by acinar cells into pancreatic juice and thus into the lumen of the small intestine was maintained. In the intestinal lumen, Glu absorption was preserved and Glu dehydrogenase expression was augmented, potentially providing the substrates for increasing energy production via the TCA cycle. Our findings suggest that one mechanism by which Gln exerts a positive effect on exocrine pancreas and small intestine involves the Gln metabolism in acinar cells and the secretion of Glu into the small intestine lumen. The exocrine pancreas acinar cells not only avidly accumulate Gln but metabolize Gln to generate energy and to synthesize Glu for secretion in the pancreatic juice. Secreted Glu is suggested to play an important role during malnourishment in sustaining small intestinal homeostasis.NEW & NOTEWORTHY Glutamine (Gln) has been suggested to have a trophic effect on exocrine pancreas and small intestine in malnourished states, but the mechanism is unknown. In this study, we suggest that this trophic effect derives from an interorgan relationship between exocrine pancreas and small intestine for Gln-glutamate (Glu) utilization involving the uptake and metabolism of Gln in acinar cells and secretion of Glu into the lumen of the small intestine.

Made available in DSpace on 2018-12-11T17:18:06Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-02-20 Objectives: This in vitro study evaluated the effect of microparticles (TMPmicro) or nanoparticles (TMPnano) TMP associated with fluoride (F) in toothpaste formulations on the obliteration of dentinal tubules (DT). Materials and methods: The dentinal tubules of bovine dentin blocks were unobstructed by immersion in 37% phosphoric acid solution. Blocks (n = 20/group) underwent mechanical brushing (2×/day) during 7 days with toothpastes: placebo, 1100 ppm F, and 1100 with 3% TMPmicro or 3% TMPnano. After that, ten blocks of each group were immersed in citric acid (pH 3.2) for 1 min. The number, diameter and area of unobstructed DT, atomic % of chemical elements from precipitates, and the mineral concentration were quantified. Data were submitted to two-way ANOVA, followed by Student-Newman-Keuls test (P < 0.05). Results: Toothpastes containing TMPmicro and TMPnano promoted greater obliteration of DT and greater mineral concentration compared to other groups (P < 0.05). Placebo and 1100 ppm F group presented similar obliteration but 1100 ppm F group promoted higher mineral concentration. Higher Ca/P ratios were observed in groups treated with TMP; the acid challenge reduced Ca/P ratio for all groups. The atomic % of C and N was significantly lower for TMP toothpastes before acid challenge, but increased afterwards. Conclusions: It was concluded that the addition of TMPmicro or TMPnano to F toothpastes produced greater obliteration of dentinal tubules and higher mineral concentration when compared with 1100 ppm F. Clinical relevance: By the addition of TMP, fluoride toothpastes may occlude the dentinal tubules, with potential to reduce dentin hypersensitivity. Department of Pediatric Dentistry and Public Health School of Dentistry Araçatuba São Paulo State University (UNESP) Department of Physics and Chemistry São Paulo State University (UNESP) Department of Chemistry Federal University of São Carlos – UFSCAR Department of Surgery and Integrated Clinic School of Dentistry Araçatuba São Paulo State University (UNESP) Disciplina de Clínica Integrada Faculdade de Odontologia do Campus de Araçatuba, Rua José Bonifácio 1193, CEP Department of Pediatric Dentistry and Public Health School of Dentistry Araçatuba São Paulo State University (UNESP) Department of Physics and Chemistry São Paulo State University (UNESP) Department of Surgery and Integrated Clinic School of Dentistry Araçatuba São Paulo State University (UNESP)

Proper diagnosis is a first step in applying best available treatments, and prognosticating outcomes for clients. Currently, the majority of musculoskeletal diagnoses are classified according to pathoanatomy. However, the majority of physical therapy treatments are applied toward movement system impairments or pain. While advocated within the physical therapy profession for over thirty years, diagnostic classification within a movement system framework has not been uniformly developed or adopted. We propose a basic framework and rationale for application of a movement system diagnostic classification for atraumatic shoulder pain conditions, as a case for the broader development of movement system diagnostic labels. Shifting our diagnostic paradigm has potential to enhance communication, improve educational efficiency, facilitate research, directly link to function, improve clinical care, and accelerate preventive interventions.

Although hydrotherapy is widely used to treat women with fibromyalgia, no studies have investigated the effects of this intervention on scapular kinematics in this population. This study verified the effectiveness of a hydrotherapy program on scapular kinematics, pain and quality of life in women with fibromyalgia.Twenty women completed the study and performed three evaluations before treatment (to establish a baseline), and two other evaluations (after 8 and 16weeks of hydrotherapy) at the end of treatment. Three-dimensional kinematics of the scapula was evaluated during arm elevation in two different planes with the Flock of Birds® system. Patients also answered quality of life and Fibromyalgia Impact Questionnaires and had pain assessed with a digital algometer. Treatment consisted of 2 weekly hydrotherapy sessions, lasting 45min each, for 16weeks. Data were analyzed with a two-way ANOVA (for kinematics results) and one-way ANOVA (for the other variables). Effect size was assessed with Cohen's d coefficient for all quantitative variables.Although an important improvement was achieved in terms of pain and quality of life (P0.05, effect sizes varied from -1.93 to 1.61 depending on the variable), scapular kinematics did not change after treatment (P0.05, effect sizes from -0.40 to 0.46 for all kinematic variables).The proposed program of hydrotherapy was effective to improve quality of life, pain intensity and fibromyalgia impact in women with fibromyalgia. However, scapular kinematics did not change after the period of treatment. Although symptoms improved after the treatment, the lack of changes in scapular kinematics may indicate these women have an adaptive movement pattern due to their chronic painful condition.

To assess concurrent validity, between and within-day reliability of scapular and clavicular digital inclinometer measures.Test-retest and concurrent validity.Laboratory.Twenty-three participants with and without shoulder symptoms.Static positions of scapular upward rotation, anterior/posterior tilting and clavicular elevation were measured between days with an inclinometer and compared to a 3-dimensional electromagnetic tracking system in different positions of sagittal plane humeral elevation (neutral, 30°, 60°, 90°, 120°). The two methods were compared using a two-way Analysis of Variance. Linear regressions at each arm position were also performed to further assess concurrent validity.Between-day reliability demonstrated Intraclass Correlation Coefficients ≥ 0.50 for all comparisons. There were statistically significant differences between methods or interactions of method and arm position for clavicle elevation (p = 0.004, maximum offset between methods 7.7º in the neutral position), and scapular upward rotation (p = 0.001). For scapular upward rotation, the maximum difference between methods was less than 2° across all humeral positions. Clavicle elevation (r = 0.67-0.82) and scapular upward rotation (r = 0.57-0.81) demonstrated higher correlations between measurement methods than scapular anterior/posterior tilt (r = 0.10-0.67).Concurrent validity in assessing scapular upward rotation and clavicle elevation with an inclinometer was shown when compared with electromagnetic tracking. However, the inclinometer method may not have adequate concurrent validity to clinically measure scapular anterior/posterior tilting.

Objective To investigate the short-term effects of thoracic spine manipulation (TSM) on pain, function, scapular kinematics, and scapular muscle activity in individuals with shoulder impingement syndrome. Design Randomized controlled trial with blinded assessor and patient. Setting Laboratory. Participants Patients with shoulder impingement syndrome (N=61). Interventions Participants were randomly allocated to TSM group (n=30) or sham-TSM group (n=31) and attended 2 intervention sessions over a 1-week period. Main Outcome Measures Scapular kinematics and muscle activity were measured at day 1 (baseline, before the first intervention), day 2 preintervention (before second intervention), day 2 postintervention (after the second intervention), and day 3 (follow-up). Shoulder pain and function were assessed by the Disability of the Arm, Shoulder and Hand questionnaire and Western Ontario Rotator Cuff Index at baseline, day 2 preintervention, and follow-up. An assessor blinded to group assignment measured all outcomes. Results Pain decreased by 0.7 points (95% confidence interval, 1.3–0.1 points) at day 2 preintervention and 0.9 points (95% confidence interval, 1.5–0.3 points) at day 2 postintervention in the TSM group. The Disability of the Arm, Shoulder and Hand questionnaire ( P =.01) and Western Ontario Rotator Cuff Index ( P =.02) scores improved in both groups. Scapular upward rotation increased during arm lowering ( P P Conclusions TSM may increase scapular upward rotation during arm lowering. TSM does not seem to influence activity of the scapular muscles. The results concerning shoulder pain, function, scapular tilt, and internal rotation are not conclusive.

Made available in DSpace on 2018-12-11T17:31:18Z (GMT). No. of bitstreams: 0 Previous issue date: 2017-03-01 Oocyte cryopreservation is a strategic tool for assisted reproduction, but has limited use due to the complex cellular structure of oocytes, which leads to sub-optimal survival rates. In this study, we used the SPOM in vitro maturation system, which is based on supplementation of cAMP modulators in order to extend meiotic arrest and improve oocyte maturation. cAMP modulators (Forskolin and IBMX) were administered in a short term culture (STC) before or after vitrification, followed by an extended maturation with cilostamide. We hypothesized that a STC with cAMP modulators would improve immature oocyte health and enhance cryotolerance. We found vitrification caused oocyte damage in a great extent, impairing nuclear maturation rates in all vitrified groups (Percentage of matured oocytes: CONT FRESH 77.8c; CONT VIT 31.4ab; STC/VIT 39.5b; VIT/STC 18.6a). Vitrification also promoted degradation of cytoskeletal actin filaments (Percentage of Injured oocytes: CONT FRESH 0.0a; CONT VIT 50.0b; STC/VIT 39.7b; VIT/STC 74.0c), and increased calcium release (Calcein-AM mean±SD: IMMATURE 1.0±0.49; VIT 1.76±1.13; STC 1.38±0.95; STC/VIT 1.58±0.99). However, STC seemed to attenuate negative effects of vitrification, since oocytes subjected to STC prior to vitrification presented predominance of polymerized actin filaments (Percentage of Intact oocytes). Unfortunately, embryo cleavage rate (SPOM 73.66a; STC/VIT 7.91b; VIT/STC 4.62b) and blastocyst development rate (SPOM 25.14a; STC/VIT 1.34b; VIT/STC 0.00b) was impaired in vitrified groups, regardless STC treatment. In conclusion, STC with cAMP modulators, Forskolin and IBMX, decreases cytoskeleton actin filaments injuries caused by oocyte vitrification, which may consequently increase oocyte viability. Our results suggest STC should be considered and improved for immature oocyte vitrification systems. Federal Fluminense University (UFF) Faculty of Veterinary Medicine, Vital Brazil Filho St., 64 Agricultural Research Company of the Rio de Janeiro State (PESAGRO RIO), São Boa Ventura Av., 770, 24120-19 Fonseca São Paulo State University (UNESP), Prof. Paulo Donato Castellane Rd., S / n, 14884-900 Embrapa Dairy Cattle Laboratory of Animal Reproduction Santa Monica Experimental Field (LRA-CESM), Santa Monica Rd São Paulo State University (UNESP), Prof. Paulo Donato Castellane Rd., S / n, 14884-900

BACKGROUND: Posterior capsule tightness (PCT) is associated with shoulder pain and altered shoulder kinematics, range of motion (ROM), external rotation (ER) strength, and pain sensitization. OBJECTIVE: To assess the effects of two interventions on shoulder kinematics, Shoulder Pain and Disability Index (SPADI) scores, ROM, strength, and pressure pain threshold (PPT) in individuals with PCT and shoulder impingement symptoms. METHODS: In this prospectively registered randomized controlled trial 59 individuals were randomized to either an Experimental Intervention Group (EIG, n=31) or a Control Intervention Group (CIG, n=28). The low flexion (LF) test was used to determine the presence of PCT. Shoulder kinematics, SPADI scores, internal rotation (IR) and ER ROM, ER strength, and PPT were measured pre- and post-treatment. Those in the EIG received an intervention specific to pain and PCT and those in the CIG received a non-specific intervention, both 4 weeks in duration. RESULTS: Individuals in the EIG demonstrated more scapular upward rotation (P=.03; mean difference (MD)=3.3°; 95% Confidence Interval (CI)=1.3°, 4.9°) and improved value on the LF test (P=.02; MD=4.6°; 95%CI=0.7°, 8.6°) than those in the CIG after treatment. Both groups presented less anterior (P

Objective:The objective was to evaluate the effectiveness of early rehabilitation on arm range of motion (ROM), strength and function after breast cancer surgery (BCS). Data sources: PubMed, MEDLINE, Bireme, Embase, LILACS and CINAHL databases were searched.Methods:Two independent reviewers selected randomized controlled trials evaluating women who underwent early rehabilitation to restore arm ROM, strength or function after BCS. Cochrane Collaboration recommendations and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Methodological quality was assessed by the PEDro scale. The International Classification of Functioning, Disability and Health was considered to analyze results. Effect size (ES) was calculated for clinical relevance interpretation of the outcomes of interest, and the evidence was summarized through the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system.Results:Up to June 2019, a total of 1658 references were identified and 15 studies were included. Twelve of them presented adequate methodological quality. A total of 1710 patients were evaluated. Few studies performed the simultaneous assessment of variables related to body structure and function and patient-reported outcomes. A moderate level of evidence was synthesized regarding the effectiveness of ROM exercises for improving arm flexion, abduction and external rotation (ES: 0.45–2.5). A low level of evidence was synthesized regarding the effectiveness of isolated strengthening exercises for patient-reported arm function. ROM exercises associated with muscle strengthening exhibited a moderate level of evidence for improving shoulder flexion (ES: 1.4–2.4).Conclusion:Both ROM and strengthening exercises associated with ROM exercises improved shoulder flexion, abduction and external rotation ROM after BCS. Shoulder abduction and external rotation showed less recovery, irrespective of the intervention applied.

Made available in DSpace on 2019-10-06T16:09:49Z (GMT). No. of bitstreams: 0 Previous issue date: 2019-09-01 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Objective: To evaluate the effect of a fluoride toothpaste containing nano-sized sodium hexametaphosphate (HMPnano) on enamel demineralization on the biochemical composition and insoluble extracellular polysaccharide (EPS) in biofilm formed in situ. Methods: This crossover double-blind study consisted of four phases (7 days each), in which 12 volunteers wore intraoral appliances containing four enamel bovine blocks. The cariogenic challenge was performed using 30% sucrose solution (6×/day). Blocks were treated 3×/day with the following toothpastes: no F/HMP/HMPnano (Placebo), conventional fluoride toothpaste, 1100 ppm F (1100F), 1100F + 0.5% micrometric HMP (1100F/HMP), and 1100F + 0.5% nano-sized HMP (1100F/HMPnano). The percentage of surface hardness loss (%SH), integrated loss of subsurface hardness (ΔKHN), and enamel calcium (Ca), phosphorus (P), and fluoride (F) were determined. Moreover, biofilms formed on the blocks were analyzed for F, Ca, P, and insoluble extracellular polysaccharide (EPS) concentrations. Data were analyzed using one-way ANOVA, followed by Student–Newman–Keuls’ test (p < 0.001). Results: 1100F/HMPnano promoted the lowest %SH and ΔKHN among all groups (p < 0.001). The addition of HMPnano to 1100F significantly increased Ca concentrations (p < 0.001). The 1100F/HMPnano promoted lower values of EPS when compared with 1100F (~ 70%) (p < 0.001) and higher values of fluoride and calcium in the biofilms (p < 0.001). Conclusion: 1100F/HMPnano demonstrated a greater protective effect against enamel demineralization and on the composition of biofilm in situ when compared to 1100F toothpaste. Clinical relevance: This toothpaste could be a viable alternative to patients at high risk of caries. School of Dentistry Araçatuba Department of Pediatric Dentistry and Public Health São Paulo State University (UNESP), Rua José Bonifácio 1193 LIEC-Department of Chemistry Federal University of São Carlos (UFSCar) School of Dentistry Araçatuba Department of Pediatric Dentistry and Public Health São Paulo State University (UNESP), Rua José Bonifácio 1193 FAPESP: 2016/03148-7

Objectives In newborn rodents, intestinal maturation involves delayed fructose transporter GLUT5 expression until weaning. In jejunoileal atresia (JIA), distal intestinal segments lack exposure to amniotic fluid-containing carbohydrates. We assessed in human newborns, the impact of intestinal maturation and obstruction on mucosal monosaccharide transporter expression. Methods Samples were obtained from 10 newborns operated for small intestinal atresia and from 17 adults undergoing gastroduodenoscopy and/or ileocolonoscopy. mRNA expression of the transporters SGLT1, GLUT1, GLUT2, GLUT5, and GLUT7 was measured in neonate samples proximal and distal of the atresia as well as in adult duodenum, ileum, and colon. Protein expression and localization was assessed using immunofluorescence. Results Although mRNA expression of monosaccharide transporters did not significantly differ between newborn and adult samples, luminal fructose transporter GLUT5 protein was absent in 0- to 4-day-old neonates, but expressed in adults. The mRNA expression of the 5 tested monosaccharide transporters was unchanged distal from the JIA relative to proximal. Similarly, luminal sodium-dependent glucose transporter SGLT1 and basolateral GLUT2 were expressed proximal and distal to JIA as visualized by immunofluorescence staining. With the exception of glucose transporter GLUT1 that showed highest expression levels in colon, all investigated hexose transporters showed strongest expression in duodenum, lower levels in ileum and lowest in colon. Conclusions Human newborns lack small intestinal fructose transporter GLUT5 protein expression and small intestinal atresia does not affect the expression of hexose transporters.

Background:Altered glenohumeral joint range of motion can be caused by increased humeral retroversion (HR) and/or posterior capsule tightness (PCT). To make informed clinical decisions, it is vital to understand how HR and PCT alterations, individually and in combination, affect joint range of motion measurements.Purpose:To evaluate the effect of experimental tissue alterations on clinical range of motion measures.Study Design:Controlled laboratory study.Methods:Five clinical measurements were quantified in 8 fresh-frozen cadavers under 4 experimentally created conditions: baseline (no alterations), HR condition (20° increase in HR by transecting the bone), PCT condition (20% decrease in length via thermal energy), and PCT + HR combined. Clinical measurements included bicipital forearm angle, low flexion, glenohumeral internal and external rotation, and horizontal adduction. All measurements were taken by the same blinded tester. Separate 1-factor repeated measures analyses of variance were used to evaluate the effect of the alterations on each clinical measurement.Results:There was a significant main effect of condition for bicipital forearm angle ( P = .02, F = 4.03), low flexion ( P = .02, F = 3.86), internal rotation ( P = .03, F = 3.65), and external rotation ( P < .001, F = 15.15) but not for horizontal adduction ( P = .29, F = 1.33). The HR condition resulted in a decreased bicipital forearm angle of 16.1° and 15.8° as compared with the PCT and PCT + HR conditions, respectively. When compared with baseline, the PCT + HR condition decreased the low flexion test by 13.5°, and the HR condition decreased internal rotation range of motion by 14.2°. All conditions increased external rotation when compared with baseline.Conclusion:Greater measurement changes were noted in both HR conditions, suggesting that bony alterations influence motion to a greater extent than posterior capsule alterations.Clinical Relevance:Clinicians should be aware that humeral retroversion will influence the measurement of posterior shoulder tightness.

Study Design Parallel-group intervention with repeated measures. Introduction Shortening of the pectoralis minor (PM) may contribute to alterations in scapular kinematics. Purpose of the Study To evaluate the effects of a stretching protocol on function, muscle length, and scapular kinematics in subjects with and without shoulder pain. Methods A sample of 25 patients with shoulder pain and 25 healthy subjects with PM tightness performed a daily stretching protocol for 6 weeks. Outcome measures included Disabilities of the Arm, Shoulder, and Hand questionnaire, PM length, and scapular kinematics. Results Disabilities of the Arm, Shoulder, and Hand scores decreased ( P P > .05) were found for PM length in both groups. Scapular anterior tilt increased ( P Discussion This study demonstrated that a daily home stretching protocol significantly decreases pain and improves function in subjects with shoulder pain. The mechanism responsible for these improvements does not appear directly related to PM muscle length or scapula kinematics, suggesting that other neuromuscular mechanisms are involved. Conclusion The PM stretching protocol did not change the PM length or scapular kinematics in subjects with or without shoulder pain. However, pain and function of the upper limbs improved in patients with shoulder pain. Level of Evidence 2b.

This double-blind crossover study assessed the effects of a low-fluoride (low-F) dentifrice containing nanosized sodium trimetaphosphate (TMP) on enamel demineralization in situ. Nineteen subjects wore palatal appliances containing 4 blocks of bovine enamel and were randomly assigned to brush their teeth with placebo (without F/TMP), 250-ppm F (250F), 250F plus 0.05% nanosized TMP (250F-TMPnano), and 1,100-ppm F (1,100F) dentifrices during 7 d, under cariogenic challenge. Enamel surface hardness and cross-sectional hardness (ΔKHN [Knoop hardness number]), as well as F, calcium (Ca), and phosphorus (P) concentrations, were determined. Also, biofilm that formed on the blocks was analyzed for F, Ca, P, and insoluble extracellular polysaccharide concentrations. Data were submitted to analysis-of-variance models and Student-Newman-Keuls test ( P < 0.05). The 250F-TMPnano dentifrice promoted the lowest ΔKHN among all groups ( P < 0.001), while the percentage of surface hardness loss was similar to 1,100F. Also, similar F, Ca, and P concentrations in enamel were observed for 1,100F and 250F-TMPnano. In the biofilm, the highest F content was observed for 1,100F; Ca content was similar between 1,100F and 250F-TMPnano; and P content was similar among all groups. Similar extracellular polysaccharide values were observed for 250F-TMPnano and 1,100F ( P < 0.001), ionic activity of CaHPO40, CaF+, and HF0 ( P < 0.05) and degree of saturation of hydroxyapatite and CaF2 ( P < 0.05). It was concluded that the protective effect of 250F-TMPnano dentifrice was similar to a conventional dentifrice for most of the variables studied, having a more pronounced effect on the subsurface lesion when compared with the conventional toothpaste (1,100F). Knowledge Transfer Statement: Although toothpastes containing ≥1,000-ppm fluoride are more effective than low-fluoride formulations against dental caries, their early use can lead to side effects. This has prompted intensive research on alternatives to increase the anticaries effect of low-fluoride toothpastes. The present in situ study demonstrated that the addition of sodium trimetaphosphate nanoparticles to toothpastes containing 250-ppm fluoride significantly enhances the protective effect of this formulation against enamel demineralization to levels comparable to a 1,100-ppm fluoride toothpaste in terms of most of the variables studied. Most important, this formulation promoted the lowest loss of subsurface hardness among all groups, suggesting that caries lesions would take longer to develop under clinical conditions when compared with a conventional (1,100-fluoride) toothpaste.

Aim To summarise the current evidence regarding the effectiveness of physical therapy on pain, function and range of motion in individuals with subacromial pain syndrome (SAPS). Design Systematic review. Data sources PubMed, Web of Science, CINAHL, Cochrane, Embase, Lilacs, Ibecs and Scielo databases. Eligibility criteria for selecting studies Randomised controlled trials (RCTs) investigating physical therapy modalities for SAPS on pain, function/disability or range of motion were included. Results 64 high-quality RCTs were included. Exercise therapy provided high evidence of being as effective as surgery intervention and better than no treatment or placebo treatment to improve pain, function and range of motion in the short, mid and long terms. The combination of mobilisation and exercises provided high evidence to decrease pain and improve function in the short term. There is limited evidence for improvements on the outcomes with the isolated application of manual therapy. High level of evidence was synthesised regarding the lack of beneficial effects of physical resources such as low-level laser, ultrasound and pulsed electromagnetic field (PEMF) on pain, function or range of motion in the treatment of SAPS. There is limited evidence for microwave diathermy and transcutaneous electrical nerve stimulation. There is moderate evidence to no benefits with taping in the short term. Effects of diacutaneous fibrolysis and acupuncture are not well established yet. Conclusions Exercise therapy should be the first-line treatment to improve pain, function and range of motion. The addition of mobilisations to exercises may accelerate reduction of pain in the short term. Low-level laser therapy, PEMF and taping should not be recommended.

Made available in DSpace on 2018-11-26T16:40:39Z (GMT). No. of bitstreams: 0 Previous issue date: 2016-06-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Introduction: Silver nanoparticles have been used for different purposes in dentistry, including endodontic treatments. The aim of this study was to determine the cytotoxicity of different types of silver nanoparticles on mouse fibroblast cell line L929 and the reaction of subcutaneous connective tissue of Wistar rats to these nanoparticles. Methods: Silver nanoparticles of an average size of 5 nm were synthesized with ammonia (SNA) or polyvinylpyrrolidone (SNP). L929 was exposed to SNA and SNP (0.1-100 mu g/mL), and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide and enzyme-linked immunosorbent assays were performed after 6, 24, and 48 hours. Culture medium was used as the control. Sixteen rats received, individually, 3 polyethylene tubes filled with a fibrin sponge embedded in 100 mu L SNA or SNP (1 mu g/mL). A fibrin sponge with no embedding was the control. Tissue reaction was performed qualitatively and quantitatively after 7, 15, 30, and 90 days of implantation in the dorsal connective tissue of Wistar rats. Results: SNA and SNP were cytotoxic to L929 in higher concentrations, with SNA significantly more toxic than SNP. SNA and SNP did not induce significant interleukin-1 beta and interleukin-6 production. The release of stern cell factor by L929 increased 48 hours after the treatment with SNP at 5 mu g/rnL. Histologic examination showed that the inflammatory responses caused by SNA and SNP at 1 mu g/mL were similar to the control in all experimental periods. Conclusions: It was concluded that SNA and SNP were not cytotoxic at 25 mu g/mL or lower concentrations. However, for safe clinical use, further studies establishing others points of its toxicologic profile are recommended. Univ Estadual Paulista, Aracatuba Dent Sch, Dept Pediat Dent & Publ Hlth Dent, Aracatuba, SP, Brazil Univ Estadual Paulista, Aracatuba Dent Sch, Dept Pathol & Clin Propedeut, Aracatuba, SP, Brazil Univ Estadual Paulista, Aracatuba Dent Sch, Dept Basic Sci, Aracatuba, SP, Brazil Univ Estadual Paulista, Aracatuba Dent Sch, Dept Endodont, Aracatuba, SP, Brazil Univ Estadual Paulista, Aracatuba Dent Sch, Dept Dent Mat & Prosthodont, Aracatuba, SP, Brazil Univ Fed Sao Carlos, Dept Chem, Interdisciplinary Lab Electrochem & Ceram, BR-13560 Sao Carlos, SP, Brazil Univ Estadual Paulista, Aracatuba Dent Sch, Dept Pediat Dent & Publ Hlth Dent, Aracatuba, SP, Brazil Univ Estadual Paulista, Aracatuba Dent Sch, Dept Pathol & Clin Propedeut, Aracatuba, SP, Brazil Univ Estadual Paulista, Aracatuba Dent Sch, Dept Basic Sci, Aracatuba, SP, Brazil Univ Estadual Paulista, Aracatuba Dent Sch, Dept Endodont, Aracatuba, SP, Brazil Univ Estadual Paulista, Aracatuba Dent Sch, Dept Dent Mat & Prosthodont, Aracatuba, SP, Brazil FAPESP: 2013/07296-2 FAPESP: 2010/05788-7

Background: Pectoralis minor adaptive shortening may change scapula resting position and scapular kinematics during arm elevation. A reliable and clinically feasible method for measuring pectoralis minor length will be useful for clinical decision making when evaluating and treating individuals with shoulder pain and dysfunction. Objectives: To evaluate intrarater, interrater, and between-day reliability of a pectoralis minor (PM) muscle length measurement in subjects with and without signs of shoulder impingement. Method: A convenience sample of 100 individuals (50 asymptomatic and 50 symptomatic) participated in this study. Intra- and interrater reliability of the measurement was estimated in 50 individuals (25 asymptomatic and 25 symptomatic), and between-day reliability of the measurement repeated over an interval of 7 days was estimated in an independent sample of 50 additional participants. Pectoralis minor length was measured using a flexible tape measure with subjects standing. Results: Intraclass correlation coefficients (ICC3,k) for intrarater and interrater reliability ranged from 0.86-0.97 and 0.95 for between-day reliability in both groups. Standard error of measurements (SEM) ranged from 0.30-0.42 cm, 0.70-0.84 cm, and 0.40-0.41 cm for intrarater, interrater, and between-day reliability, respectively, across the sample. The minimal detectable change (MDC) for between-day measurements ranged from 1.13-1.14 cm for both groups. Conclusions: In asymptomatic individuals and in those with signs of shoulder impingement, a single rater or pair of raters can measure pectoralis minor muscle length using a tape measure with very good reliability. This measurement can also be reliably used by the same rater over a seven day interval.

Nanocarriers have been used as alternative tools to overcome the resistance of Candida species to conventional treatments. This study prepared a nanocarrier of cetylpyridinium chloride (CPC) using iron oxide nanoparticles (IONPs) conjugated with chitosan (CS), and assessed its antifungal and cytotoxic effects. CPC was immobilized on CS-coated IONPs, and the nanocarrier was physico-chemically characterized. Antifungal effects were determined on planktonic cells of Candida albicans and Candida glabrata (by minimum inhibitory concentration (MIC) assays) and on single- and dual-species biofilms of these strains (by quantification of cultivable cells, total biomass and metabolic activity). Murine fibroblasts were exposed to different concentrations of the nanocarrier, and the cytotoxic effect was evaluated by MTT reduction assay. Characterization methods confirmed the presence of a nanocarrier smaller than 313 nm. IONPs-CS-CPC and free CPC showed the same MIC values (0.78 &micro, g mL&minus, 1). CPC-containing nanocarrier at 78 &micro, 1 significantly reduced the number of cultivable cells for all biofilms, surpassing the effect promoted by free CPC. For total biomass, metabolic activity, and cytotoxic effects, the nanocarrier and free CPC produced statistically similar outcomes. In conclusion, the IONPs-CS-CPC nanocarrier was more effective than CPC in reducing the cultivable cells of Candida biofilms without increasing the cytotoxic effects of CPC, and may be a useful tool for the treatment of oral fungal infections.

Made available in DSpace on 2019-10-06T16:39:01Z (GMT). No. of bitstreams: 0 Previous issue date: 2019-12-01 The ability to manipulate the structure and function of promising systems via external stimuli is emerging with the development of reconfigurable and programmable multifunctional materials. Increasing antifungal and antitumor activity requires novel, effective treatments to be diligently sought. In this work, the synthesis, characterization, and in vitro biological screening of pure α-Ag2WO4, irradiated with electrons and with non-focused and focused femtosecond laser beams are reported. We demonstrate, for the first time, that Ag nanoparticles/α-Ag2WO4 composite displays potent antifungal and antitumor activity. This composite had an extreme low inhibition concentration against Candida albicans, cause the modulation of α-Ag2WO4 perform the fungicidal activity more efficient. For tumor activity, it was found that the composite showed a high selectivity against the cancer cells (MB49), thus depleting the populations of cancer cells by necrosis and apoptosis, without the healthy cells (BALB/3T3) being affected. CDMF LIEC Chemistry Department of the Federal University of São Carlos - (UFSCar), P.O. Box 676 LIA Laboratory of Applied Immunology Department of Genetics and Evolution Federal University of São Carlos - (UFSCar) GROC∙UJI Institut de Noves Tecnologies de la Imatge (INIT University Jaume I (UJI) Department of Inorganic and Organic Chemistry University Jaume I (UJI) Institute for Nanomaterials Advanced Technologies and Innovation Technical University of Liberec, Studentská 1402/2 Department of Analytical and Physical Chemistry University Jaume I (UJI) São Paulo State University (UNESP) Department of Dental Materials and Prosthodontics School of Dentistry at Araraquara Rua Humaitá 1680 São Paulo State University (UNESP) Department of Dental Materials and Prosthodontics School of Dentistry at Araraquara Rua Humaitá 1680

Made available in DSpace on 2019-10-06T17:05:45Z (GMT). No. of bitstreams: 0 Previous issue date: 2019-01-01 Nanocomposites containing antimicrobial agents and calcium phosphates have been developed. Thus, this study assessed the effects of two compounds containing silver nanoparticles (AgNPs) and β-calcium glycerophosphate (CaGP), associated or not with tyrosol (TYR), against planktonic cells and biofilms of Candida albicans and Streptococcus mutans. The nanocompounds were synthesized through chemical and ‘green’ processes and characterized by scanning electron microscopy. The minimum and fractional inhibitory concentrations of each compound were determined for planktonic cells. Next, 24-h single biofilms of C. albicans and S. mutans were treated for 24 h with the nanocompounds alone or in combination with TYR, and the antibiofilm effect was assessed through enumeration of colony forming units. Biofilm data were statistically examined using one-way ANOVA and the Kruskal–Wallis test (α = 0.05). The chemically synthesized nanocompound in combination with TYR demonstrated a synergistic effect against planktonic cells of C. albicans and S. mutans. For the nanocompound obtained through the ‘green’ route associated with TYR, a synergistic effect was observed only against C. albicans. For biofilms, only the combination obtained through the ‘green’ route + TYR demonstrated a synergistic effect against C. albicans. Our results may contribute to the development of oral care products containing AgNPs–CaGP and TYR to combat oral infections. Department of Pediatric Dentistry and Public Health School of Dentistry São Paulo State University (UNESP), Rua José Bonifácio, 1193 Graduate Program in Dentistry (GPD – Master’s Degree) University of Western São Paulo (UNOESTE) Federal University of Grande Dourados Federal University of São Carlos University Center of Adamantina (UNIFAI) Michigan State University Department of Pediatric Dentistry and Public Health School of Dentistry São Paulo State University (UNESP), Rua José Bonifácio, 1193

Background The trapezius is an extensive muscle subdivided into upper, middle, and lower parts. This muscle is a dominant stabilizer of the scapula, normally operating synergistically with other scapular muscles, most notably the serratus anterior. Altered activation, poor control, or reduced strength of the different parts of the trapezius have been linked with abnormal scapular movements, often associated with pain. Several exercises have been designed and studied that specifically target the different parts of the trapezius, with the goal of developing exercises that optimize scapular position and scapulohumeral rhythm that reduce pain and increase function. Methods This paper describes the anatomy, kinesiology, and pathokinesiology of the trapezius as well as exercises that selectively target the activation of the different parts of this complex muscle. Conclusions This review provides the anatomy and kinesiology of the trapezius muscle with the underlying intention of understanding how this muscle contributes to the normal mechanics of the scapula as well as the entire shoulder region. This paper can guide the clinician with planning exercises that specifically target the different parts of the trapezius. It is recommended that this paper be read as a companion to another paper: Kinesiologic considerations for targeting activation of scapulothoracic muscles – part 1: serratus anterior.

Background The serratus anterior (SA) is capable of a wide range of actions across the scapulothoracic joint. Furthermore, the lack of control, strength, or activation of this important muscle is believed to be associated with several painful conditions involving the shoulder complex. Studies and clinical intuition have therefore identified several exercises that selectively target the activation of the SA. Methods This paper reviews the anatomy, innervation, testing, and complex actions of the SA. In addition, this paper describes the classic signs and symptoms of weakness or reduced activation of the SA. Several exercises are described and illustrated that purportedly target the activation of the SA, with the intention of optimizing muscular control and encouraging pain free shoulder motion. Conclusions This review provides the theoretical background and literature-based evidence that can help explain the SA's complex pathokinesiology, as well as guide the clinician to further develop exercises that likely challenge the muscle. This paper is written along with a companion paper entitled: Kinesiologic considerations for targeting activation of scapulothoracic muscles: part 2: trapezius. Both papers prepare the reader to expand their pallet of exercises that target and challenge these two dominant muscles, with a goal of improving function of the shoulder for several painful conditions caused by their reduced or altered activation pattern.

Context Whereas alterations in scapular kinematics, scapulothoracic muscle activity, and pain sensitivity have been described in adult swimmers, no researchers have examined these outcomes in young swimmers. Objectives To compare scapular kinematics, scapulothoracic muscle activation, and the pressure-pain threshold (PPT) of the shoulder muscles among young nonpractitioners (those who were not involved in sports involving the upper limbs), amateur swimmers, and competitive swimmers. Design Cross-sectional study. Setting Laboratory. Patients or Other Participants A total of 90 individuals (age = 11.63 ± 0.61 years) in 3 groups: nonpractitioners, amateur swimmers, and competitive swimmers. Intervention(s) Scapular kinematics and activity of the upper trapezius, lower trapezius, and serratus anterior (SA) were measured during upper extremity elevation in the scapular plane. The PPT was assessed in the upper trapezius, infraspinatus, supraspinatus, middle deltoid, and tibialis anterior. Main Outcome Measure(s) Scapular kinematics, scapulothoracic muscle activation, and PPT. We conducted a 2-way mixed-model analysis of variance and a 1-way analysis of variance for scapular rotation and PPT, respectively. A Kruskal-Wallis test was used to assess muscle activity. The α level was set at .05. Results Competitive swimmers presented more internal rotation at 90° (P = .03) and 120° (P = .047) and more anterior tilt at 90° (P = .03) than nonpractitioners. Amateur swimmers demonstrated more anterior tilt at 90° (P = .004) and 120° (P = .005) than nonpractitioners. Competitive swimmers had greater SA activation in the intervals from 60° to 90° (P = .02) and 90° to 120° (P = .01) than amateur swimmers. They also displayed more SA activation in the interval from 90° to 120° than nonpractitioners (P = .04). No differences were found in any of the muscles for the PPT (P > .05). Conclusions Young competitive swimmers presented alterations in scapular kinematics and scapulothoracic muscle activation during upper extremity elevation that may be due to sport practice. Mechanical pain sensitivity was not altered in young swimmers.

Background Magnetic resonance imaging (MRI) is commonly used to diagnose structural abnormalities in the shoulder. However, subsequent findings may not be the source of symptoms. The aim of this study was to determine comparative MRI findings across both shoulders of individuals with unilateral shoulder symptoms. Materials and methods We prospectively evaluated 123 individuals from the community who had self-reported unilateral shoulder pain with no signs of adhesive capsulitis, no substantial range-of-motion deficit, no history of upper-limb fractures, no repeated shoulder dislocations, and no neck-related pain. Images in the coronal, sagittal, and axial planes with T1, T2, and proton density sequences were generated and independently and randomly interpreted by 2 examiners: a board-certified, fellowship-trained orthopedic shoulder surgeon and a musculoskeletal radiologist. Absolute and relative frequencies for each MRI finding were calculated and compared between symptomatic and asymptomatic shoulders. Agreement between the shoulder surgeon and the radiologist was also determined. Results Abnormal MRI findings were highly prevalent in both shoulders. Only the frequencies of full-thickness tears in the supraspinatus tendon and glenohumeral osteoarthritis were higher (approximately 10%) in the symptomatic shoulder according to the surgeon's findings. Agreement between the musculoskeletal radiologist and shoulder surgeon ranged from slight to moderate (0.00-0.51). Conclusion Most abnormal MRI findings were not different in frequency between symptomatic and asymptomatic shoulders. Clinicians should be aware of the common anatomic findings on MRI when considering diagnostic and treatment planning.

The expression of amino acid transporters in small intestine epithelia of human newborns has not been studied yet. It is further not known whether the maturation of imino acid (proline) transport is delayed as in the kidney proximal tubule. The possibility to obtain small intestinal tissue from patients undergoing surgery for jejunal or ileal atresia during their first days after birth was used to address these questions. As control, adult terminal ileum tissue was sampled during routine endoscopies. Gene expression of luminal imino and amino acid transporter SIT1 (SLC6A20) was approximately threefold lower in newborns versus adults. mRNA levels of all other luminal and basolateral amino acid transporters and accessory proteins tested were similar in newborn mucosa compared with adults. At the protein level, the major luminal neutral amino acid transporter B0AT1 (SLC6A19) and its accessory protein angiotensin-converting enzyme 2 were shown by immunofluorescence to be expressed similarly in newborns and in adults. SIT1 protein was not detectable in the small intestine of human newborns, in contrast to adults. The morphology of newborn intestinal mucosa proximal and distal to the obstruction was generally normal, but a decreased proliferation rate was visualized distally of the atresia by lower levels of the mitosis marker Ki-67. The mRNA level of the 13 tested amino acid transporters and accessory proteins was nonetheless similar, suggesting that the intestinal obstruction and interruption of amniotic fluid passage through the small intestinal lumen did not affect amino acid transporter expression. NEW & NOTEWORTHY System IMINO transporter SIT1 is not expressed in the small intestine of human newborns. This new finding resembles the situation in the proximal kidney tubule leading to iminoglycinuria. Lack of amniotic fluid passage in small intestinal atresia does not affect amino acid transporter expression distal to intestinal occlusion.

Objectives To assess the influence of posterior capsule tightness and humeral retroversion on shoulder motion measurements. Design Cross-Sectional study. Setting Controlled university laboratory. Participants 75 asymptomatic individuals were assigned to one of 4 groups: control (n = 28); posterior capsule tightness only (n = 17); humeral retroversion only (n = 15); and combined posterior capsule tightness and retroversion (n = 15). Main outcome measures Six clinical measurements were compared across groups: bicipital forearm angle, low flexion, glenohumeral internal and external rotation, horizontal adduction and extension with internal rotation. Results The group with both adaptations had decreased internal rotation compared to the control and retroversion only groups, as well as increased external rotation compared to the control and posterior capsule only groups. There were no between group differences for the horizontal adduction or extension with internal rotation measurements. The retroversion only and combined groups showed decreased bicipital forearm angle compared with the control and posterior tightness groups. The posterior capsule tightness and combined groups demonstrated decreased low flexion compared to the other groups. Conclusion The combination of osseous and soft tissue adaptions alter shoulder motion measures more than a single adaption, making a comprehensive clinical assessment vital when managing individuals with shoulder pain.

Nanobiomaterials combining remineralization and antimicrobial abilities would bring important benefits to control dental caries. This study aimed to produce nanocompounds containing calcium glycerophosphate (CaGP) and silver nanoparticles (AgNP) by varying the reducing agent of silver nitrate (sodium borohydride (B) or sodium citrate (C)), the concentration of silver (1% or 10%), and the CaGP forms (nano or commercial), and analyze its characterization and antimicrobial activity against ATCC Candida albicans (10231) and Streptococcus mutans (25175) by the microdilution method. Controls of AgNP were produced and silver ions (Ag+) were quantified in all of the samples. X-ray diffraction, UV-Vis, and scanning electron microscopy (SEM) analysis demonstrated AgNP associated with CaGP. Ag+ ions were considerably higher in AgCaGP/C. C. albicans was susceptible to nanocompounds produced with both reducing agents, regardless of Ag concentration and CaGP form, being Ag10%CaGP-N/C the most effective compound (19.5&ndash, 39.0 &micro, g Ag mL&minus, 1). While for S. mutans, the effectiveness was observed only for AgCaGP reduced by citrate, also presenting Ag10%CaGP-N the highest effectiveness (156.2&ndash, 312.5 &micro, 1). Notably, CaGP enhanced the silver antimicrobial potential in about two- and eight-fold against C. albicans and S. mutans when compared with the AgNP controls (from 7.8 to 3.9 and from 250 to 31.2 &micro, 1, respectively). The synthesis that was used in this study promoted the formation of AgNP associated with CaGP, and although the use of sodium borohydride (B) resulted in a pronounced reduction of Ag+, the composite AgCaGP/B was less effective against the microorganisms that were tested.